bluuebunny/crossref_metadata_2025_split huggingface dataset:
An initiative to promote value‐based stress test selection in primary care and cardiology clinics: A mixed methods evaluation
Authors: Kling Samantha M. R. , Kalwani Neil M. , Winget Marcy , Gupta Kush , Saliba‐Gustafsson Erika A. , Baratta Juliana , Garvert Donn W. , Veruttipong Darlene , Brown‐Johnson Cati G. , Vilendrer Stacie , Gaspar Cindie , Levin Eleanor , Tsai Sandra 
Published: July 2023

AbstractObjectivesExercise stress echocardiograms (stress echos) are overused, whereas exercise stress electrocardiograms (stress ECGs) can be an appropriate, lower‐cost substitute. In this post hoc, mixed methods evaluation, we assessed an initiative promoting value‐based, guideline‐concordant ordering practices in primary care (PC) and cardiology clinics.MethodsChange in percent of stress ECGs ordered of all exercise stress tests (stress ECGs and echos) was calculated between three periods: baseline (January 2019–February 2020); Period 1 with reduced stress ECG report turnaround time + PC‐targeted education (began June 2020); and Period 2 with the addition of electronic health record‐based alternative alert (AA) providing point‐of‐care clinical decision support. The AA was deployed in two of five PC clinics in July 2020, two additional PC clinics in January 2021, and one of four cardiology clinics in February 2021. Nineteen primary care providers (PCPs) and five cardiologists were interviewed in Period 2.ResultsClinicians reported reducing ECG report turnaround time was crucial for adoption. PCPs specifically reported that value‐based education helped change their practice. In PC, the percent of stress ECGs ordered increased by 38% ± 6% (SE) (p < 0.0001) from baseline to Period 1. Most PCPs identified the AA as the most impactful initiative, yet stress ECG ordering did not change (6% ± 6%; p = 0.34) between Periods 1 and 2. In contrast, cardiologists reportedly relied on their expertise rather than AAs, yet their stress ECGs orders increased from Period 1 to 2 to a larger degree in the cardiology clinic with the AA (12% ± 5%; p = 0.01) than clinics without the AA (6% ± 2%; p = 0.01). The percent of stress ECGs ordered was higher in Period 2 than baseline for both specialties (both p < 0.0001).ConclusionsThis initiative influenced ordering behaviour in PC and cardiology clinics. However, clinicians' perceptions of the initiative varied between specialties and did not always align with the observed behaviour change.
Rules, practices and principles: Putting bioethical principles in their place
Authors: Hardman Doug , Hutchinson Phil 
Published: July 2023

AbstractBioethics seems preoccupied with establishing, debating, promoting and sometimes debunking principles. While these tasks trade on the status of the word ‘principle’ in our ordinary language, scant attention is paid to the way principles operate in language. In this paper, we explore how principles relate to rules and practices so as to better understand their logic. We argue that principles gain their sense and power from the practices which give them sense. While general principles can be, and are, establishable in abstraction from specific practices, as they are in principlist bioethics, such principles are impotent as moral guides to action. We show that the purchase any principle has as a moral guide to action emerges from its indexical properties as a principle which has sense in a specific practice. The meaning of any principle is internal to the practice and context in which it is invoked and, therefore, principles are not kinds of master rule which dictate moral judgement in new contexts but rather chameleon‐like rules which change with the contexture in which they are invoked.
Child traumatic physical abuse rates and comparisons during the COVID‐19 pandemic: Retrospective paediatric single institution review in Texas
Authors: Ezeokoli Ekene U , Pang Lon Kai , Loyd Nathaniel G , Borici Neritan , Bachim Angela , Vogel Adam M , Rosenfeld Scott B 
Published: July 2023

AimThe COVID‐19 pandemic drastically altered human behaviour and socialisation and may have created an environment that could lead to increased incidence of domestic abuse and non‐accidental trauma, or child physical abuse (CPA). Initial reports about the effect of the COVID‐19 pandemic on the rates of CPA have been mixed. The purpose of this study is to describe the effects of COVID‐19 on rates of CPA in a large metropolitan paediatric hospital and level I paediatric trauma centre.MethodsWe identified and compared all CPA admissions under 18 years from May 2019 to February 2020 and considered that to be the pre‐COVID time frame. The ensuing 12‐month period of March 2020 to February 2021 was considered to be the intra‐COVID time frame.ResultsThere were 49 (0.32%) unique CPA patients pre‐COVID and 83 (0.85%) unique CPA patients intra‐COVID (P < 0.001) with lower total admissions for any reason during the intra‐COVID time frame. Monthly CPA cases were increased (P < 0.03) during the intra‐COVID time period (mean 6.9, 95% confidence interval: 5.8–12.7) compared to the pre‐COVID time period (mean 4.9, 95% confidence interval: 3.3–8.2).ConclusionDuring the COVID‐19 pandemic, there were decreased overall hospital admissions in the period of mandated shutdowns and isolation. However, we saw an increased rate of CPA admissions compared to the time period prior to the pandemic. Knowledge of such data, trends and circumstances will help keep health‐care providers alert and vigilant in identifying children at risk for maltreatment, and may impact child abuse protocols and guidelines.
Epistemic Silences and Experiential Knowledge in Decisions After a First Cesarean: The case of a vaginal birth after cesarean calculator
Authors: Rubashkin Nicholas 
Published: July 2023

AbstractEvidence‐based obstetrics can employ statistical models to justify greater use of cesareans, sometimes excluding experiential elements from informed decision making. Over the past decade, prenatal providers adopted a vaginal birth after cesarean (VBAC) calculator designed to support patients in making informed decisions about their births by estimating their probability for a VBAC. Among other factors, the calculator used race and ethnicity to make its estimate, assigning lower probabilities for a successful VBAC to Black and Hispanic patients. I analyze how a diverse group of women and their providers engaged with the VBAC calculator. Some providers used low calculator scores to remove a shared decision‐making model by prescriptively counseling Black and Hispanic women who desired a VBAC into undergoing repeat cesareans. Consequently, women racialized by the calculator as Black or Hispanic used experiential knowledge to challenge the calculator's assessment of their supposed lesser ability to give birth vaginally.
Relationships between phenotypic plasticity and epigenetic variation in two Caribbean Acropora corals
Authors: Hackerott Serena , Virdis Francesca , Flood Peter J. , Souto Daniel Garcia , Paez Wendy , Eirin‐Lopez Jose M. 
Published: July 2023

AbstractThe plastic ability for a range of phenotypes to be exhibited by the same genotype allows organisms to respond to environmental variation and may modulate fitness in novel environments. Differing capacities for phenotypic plasticity within a population, apparent as genotype by environment interactions (GxE), can therefore have both ecological and evolutionary implications. Epigenetic gene regulation alters gene function in response to environmental cues without changes to the underlying genetic sequence and likely mediates phenotypic variation. DNA methylation is currently the most well described epigenetic mechanism and is related to transcriptional homeostasis in invertebrates. However, evidence quantitatively linking variation in DNA methylation with that of phenotype is lacking in some taxa, including reef‐building corals. In this study, spatial and seasonal environmental variation in Bonaire, Caribbean Netherlands was utilized to assess relationships between physiology and DNA methylation profiles within genetic clones across different genotypes of Acropora cervicornis and A. palmata corals. The physiology of both species was highly influenced by environmental variation compared to the effect of genotype. GxE effects on phenotype were only apparent in A. cervicornis. DNA methylation in both species differed between genotypes and seasons and epigenetic variation was significantly related to coral physiological metrics. Furthermore, plastic shifts in physiology across seasons were significantly positively correlated with shifts in DNA methylation profiles in both species. These results highlight the dynamic influence of environmental conditions and genetic constraints on the physiology of two important Caribbean coral species. Additionally, this study provides quantitative support for the role of epigenetic DNA methylation in mediating phenotypic plasticity in invertebrates.
First report of Culicoides caucoliberensis in Spain: Exploring molecular phylogeny, host‐feeding behaviour and avian haemosporidian parasites
Authors: González Mikel A. , Bravo‐Barriga Daniel , López‐Mercadal Júlia , Miranda Miguel Ángel , Gutiérrez‐López Rafael , Barceló Carlos 
Published: July 2023

AbstractCulicoides biting midges (Diptera: Ceratopogonidae) are vectors of pathogens that affect wildlife and livestock. Understanding the composition and distribution of vector species is crucial for implementing control strategies and preventing the spread of infectious diseases. This study provides a morphological and molecular characterisation of Culicoides caucoliberensis, which represents the first record for Spain, increasing the number of Culicoides species in the country to 85. A total of 213 specimens were collected using Onderstepoort‐ultraviolet down‐draught light traps on a rocky coastline in the Balearic Islands during two sampling periods in 2022. Phylogenetic analysis showed that C. caucoliberensis forms a monophyletic cluster within the Maritimus group. Host preferences were determined for the first time and showed propensity to feed on the European shag (Phalacrocorax aristotelis). The vector role of C. caucoliberensis for haemosporidian transmission remains unclear since molecular detection of Haemosporidians (Haemoproteus and Plasmodium) was negative for all the pools of parous and engorged females analysed. This study emphasises the importance of conducting entomofauna studies in lesser‐known Mediterranean islet landscapes and highlights the need for research on vectors within the One Health framework.
When to err is inhuman: An examination of the influence of artificial intelligence‐driven nursing care on patient safety
Authors: Johnson Elizabeth A. , Dudding Katherine M. , Carrington Jane M. 
Published: July 2023

AbstractArtificial intelligence, as a nonhuman entity, is increasingly used to inform, direct, or supplant nursing care and clinical decision‐making. The boundaries between human‐ and nonhuman‐driven nursing care are blurred with the advent of sensors, wearables, camera devices, and humanoid robots at such an accelerated pace that the critical evaluation of its influence on patient safety has not been fully assessed. Since the pivotal release of To Err is Human, patient safety is being challenged by the dynamic healthcare environment like never before, with nursing at a critical juncture to steer the course of artificial intelligence integration in clinical decision‐making. This paper presents an overview of artificial intelligence and its application in healthcare and highlights the implications which affect nursing as a profession, including perspectives on nursing education and training recommendations. The legal and policy challenges which emerge when artificial intelligence influences the risk of clinical errors and safety issues are discussed.
The significance of elective neck dissection for patients with T2N0M0 OSCC at different ages
Authors: Xu Qiaoshi , Zhang Lirui , Li Bo , Cheng Aoming , Wang Chong , Li Delong , Han Zhengxue , Feng Zhien 
Published: July 2023

AbstractBackgroundThe aim of this study was to determine the significance of elective neck dissection (END) for patients of different ages with T2N0M0 oral squamous cell carcinoma (OSCC) and sought to analyze the reasons behind it and its value for clinical guidance.MethodsThis study enrolled 391 patients with T2N0M0 OSCC who were surgically treated in our hospital and were divided into young‐, moderate‐, and advanced‐age groups according to our previous study. The Chi‐square test and Kaplan–Meier analysis were performed for statistical analysis.ResultsCompared with moderate‐ and advanced‐age patients, young patients with T2N0M0 OSCC had higher lymph node metastasis rates and lymph node ratios. Therefore, END significantly improved the recurrence (p = 0.001) and survival (p = 0.001) for young patients, but not for moderate‐age patients. Advanced‐age patients even benefit from watchful waiting. END significantly improved recurrence and survival in young patients with smoking or alcohol consumption habits.ConclusionsEND improved the prognosis of young patients, and it was related to their higher metastasis rate. However, advanced‐age patients benefited from the wait‐and‐see policy. END is essential for the young patients with smoking or drinking habit, it is also highly recommended for nonsmokers and nondrinkers.
Aloe vera‐derived graphene‐coupled phenosafranin photocatalyst for generation and regeneration of ammonia and NADH by mimicking natural photosynthetic route
Authors: Shukla Ravindra K. , Yadav Rajesh K. , Gole V. L. , Na Chae Yeong , Jeong Gyoung Hwa , Singh Satyam , Baeg Jin‐Ook , Choi Myong Yong , Gupta Navneet Kumar , Kim Tae Wu 
Published: July 2023

AbstractAloe vera‐derived graphene (ADG) coupled system photocatalyst, mimicking natural photosynthesis, is one of the most promising ways for converting solar energy into ammonia (NH3) and nicotinamide adenine dinucleotide (NADH) that have been widely used to make the numerous chemicals such as fertilizer and fuel. In this study, we report the synthesis of the aloe vera‐derived graphene‐coupled phenosafranin (ADGCP) acting as a highly efficient photocatalyst for the generation of NH3 and regeneration of NADH from nitrogen (N2) and oxidized form of nicotinamide adenine dinucleotide (NAD+). The results show a benchmark instance for mimicking natural photosynthesis activity as well as the practical applications for the solar‐driven selective formation of NH3 and the regeneration of NADH by using the newly designed photocatalyst.
Disentangling the US military's climate change paradox: An institutional approach
Authors: Payne Corey R. , Swed Ori 
Published: July 2023

AbstractStudies estimate that the US military it is a bigger polluter than 140 individual countries, having emitted hundreds of millions of tons of greenhouse gases in the twenty‐first century. Despite this, the military is also one of the organizations most affected by climate change, given its global infrastructural reach, and one that is positioning itself to grapple with the social and political upheavals resulting from the climate crisis. Thus, paradoxically, despite its role as a major driver of ecological degradation, the military is one of the few influential institutions in the US that has demonstrated a willingness to grapple with the effects of climate change. In this paper we explore these two sides of the relationship between the military and climate change. Combining perspectives from the military and environmental sociology literature, we review the military's role as a polluter as well as a stakeholder. We examine the military's attempts to reconcile those two approaches through the adoption of a philosophy of “winners and losers” of climate change, highlighting the limits and possibilities of this approach. To make sense of the military's response, we review the conflicting institutional logics guiding the Pentagon's efforts. We conclude by suggesting that policymakers resolve these tensions through a strategic retreat from its globe‐spanning presence.
The use of clinical simulation to support development of interprofessional skills and understanding: Perspectives from allied health students
Authors: Robson Kristy , Parnell Tracey , Smith-Tamaray Michelle , Lustig Kim , Hoffman Laura , Davidson Wendy Rose , Wells Cherie , Hayes Karen 
Published: July 2023

Introduction: Allied health professionals require skills in interprofessional collaboration to work effectively to achieve person-centred health outcomes. Simulated interprofessional experiences provide students with unique opportunities in a supported environment to develop the necessary skills required for future practice.
Methods: An exploratory cross-sectional study using a qualitative survey design was employed to understand the attitudes and perceptions of allied health students after completing a university based, cross-campus, interprofessional simulation experience.
Results: Over 200 students from four disciplines across three campuses of a regional Australian university were involved in a simulated experience that included a range of different interprofessional activities. Post-experience survey data from approximately 40% of students suggested that students perceived the experience had several positive learnings, including a better understanding of their own and other professions and the value of interprofessional collaboration and teamwork in client care; increased confidence, particularly in communicating with other healthcare professionals; and a broader understanding of healthcare, including eHealth. The results also highlighted the challenges of implementing a project across multiple disciplines and campuses and provided useful suggestions to further improve the experience.
Conclusion: The findings of this research suggest that carefully developed and authentic interprofessional experiences through simulation can provide allied health students with the opportunity to develop valuable skills in communication and teamwork as well as an emerging appreciation of the benefits of a coordinated team approach to person-centred healthcare.
Real world data in mechanical thrombectomy: who are we losing to follow-up?
Authors: Hahn Marianne , Gröschel Sonja , Othman Ahmed , Brockstedt Lavinia , Civelek Arda , Brockmann Marc A , Gröschel Klaus , Uphaus Timo 
Published: July 2023

BackgroundMissing outcome data (MOD) is a common problem in clinical trials and registries, and a potential bias when drawing conclusions from these data. Identifying factors associated with MOD may help to increase follow-up rates and assess the need for imputation strategies. We investigated MOD in a multicenter, prospective registry study of mechanical thrombectomy (MT) in large vessel occlusion ischemic stroke.Methods13 082 patients enrolled in the German Stroke Registry-Endovascular Treatment from May 2015 to December 2021 were analyzed with regard to MOD (90 day modified Rankin Scale, mRS). Univariate logistic regression analyses identified factors unbalanced between patients with and without MOD. Subgroup analyses were performed to identify patients for whom increased efforts to perform clinical follow-up after hospital discharge are needed.ResultsWe identified 19.7% (2580/13 082) of patients with MOD at the 90 day follow-up. MOD was more common with higher pre-stroke disability (mRS 3–5, 32.2% vs mRS 0–2, 13.7%; P<0.001), absence of bridging intravenous thrombolysis, longer time to treatment, and in patients with high post-stroke disability at discharge (mRS 3–5 vs 0–2: OR 1.234 (95% CI 1.107 to 1.375); P<0.001). In contrast, MOD was less common with futile recanalization (thrombolysis in cerebral infarction (TICI) score of 0–2a, 12.4% vs TICI 2b–3, 15.0%; P=0.001). In patients discharged alive with well documented baseline characteristics, shorter hospital stay (OR 0.992 (95% CI 0.985 to 0.998); P=0.010) and discharge to institutional care or hospital (OR 1.754 (95% CI 1.558 to 1.976); P<0.001) were associated with MOD.ConclusionMOD in routine care MT registry data was not random. Increased efforts to perform clinical follow-up are needed, especially in the case of higher pre-stroke and post-stroke disability and discharge to hospital or institutional care.Trial registrationNCT03356392.
Acute ischemic stroke outcomes in patients with COVID-19: a systematic review and meta-analysis
Authors: Ferrone Sophia R , Sanmartin Maria X , Ohara Joseph , Jimenez Jean C , Feizullayeva Chinara , Lodato Zachary , Shahsavarani Shaya , Lacher Gregory , Demissie Seleshi , Vialet Jaclyn Morales , White Tim G , Wang Jason J , Katz Jeffrey M , Sanelli Pina C 
Published: July 2023

BackgroundAlthough patients with COVID-19 have a higher risk of acute ischemic stroke (AIS), the impact on stroke outcomes remains uncertain.AimsTo determine the clinical outcomes of patients with AIS and COVID-19 (AIS-COVID+).MethodsWe performed a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Our protocol was registered with the International Prospective Register of Systematic Reviews (CRD42020211977). Systematic searches were last performed on June 3, 2021 in EMBASE, PubMed, Web-of-Science, Scopus, and CINAHL Databases. Inclusion criteria: (1) studies reporting outcomes on AIS-COVID+; (2) original articles published in 2020 or later; (3) study participants aged ≥18 years. Exclusion criteria: (1) case reports with <5 patients, abstracts, review articles; (2) studies analyzing novel interventions. Risk of bias was assessed using the Mixed Methods Appraisal Tool. Random-effects models estimated the pooled OR and 95% confidence intervals (95% CI) for mortality, modified Rankin Scale (mRS) score, length of stay (LOS), and discharge disposition.ResultsOf the 43 selected studies, 46.5% (20/43) reported patients with AIS without COVID-19 (AIS-COVID−) for comparison. Random-effects model included 7294 AIS-COVID+ and 158 401 AIS-COVID−. Compared with AIS-COVID−, AIS-COVID+ patients had higher in-hospital mortality (OR=3.87 (95% CI 2.75 to 5.45), P<0.001), less mRS scores 0–2 (OR=0.53 (95% CI 0.46 to 0.62), P<0.001), longer LOS (mean difference=4.21 days (95% CI 1.96 to 6.47), P<0.001), and less home discharge (OR=0.31 (95% CI 0.21 to 0.47), P<0.001).ConclusionsPatients with AIS-COVID had worse outcomes, with almost fourfold increased mortality, half the odds of mRS scores 0–2, and one-third the odds of home discharge. These findings confirm the significant impact of COVID-19 on early stroke outcomes.
Topologically nontrivial black holes of Lovelock gravity sourced by logarithmic electrodynamics
Authors: Ali Askar 
Published: July 2023

AbstractI investigate the topologically nontrivial black holes of Lovelock gravity sourced by logarithmic electrodynamics. To calculate the solution describing these black holes, additional constraints are also imposed on the base manifold of the higher dimensional spacetime. Relying on the selection of geometric mass, electric charge, and the nonlinearity parameter, this solution can be portrayed as a black hole with a single horizon, two horizons, or naked singularity. I also look into how the thermodynamical and conserved quantities of this solution are affected by the logarithmic electromagnetic field. Additionally, it is demonstrated that these quantities correspond to the first law of thermodynamics. At last, the local and global thermodynamic stabilities of the accomplished black hole are studied as well.