bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhancing Healthcare Workers' Preparedness In Covid-19 Pandemic Response: Role of Pre-Pandemic Training Programmes on Personal Protective Equipment (PPE)
Authors: Haq Zia Ul , Sher Zarghona Fazal , Khattak Farhad Ali Khattak Ali , Khan Zala , Hakim Muhammad , Ullah Naeem , Rahim Abid , Hussain Umar , Afaq Saima 
Published: August 2023

Abstract

Background: The COVID-19 pandemic has revealed vulnerabilities in healthcare systems worldwide, emphasizing the importance of healthcare worker safety through adequate utilization of personal protective equipment (PPE). This study aims to assess the impact of pre-pandemic PPE training on the practices of frontline healthcare workers during the COVID-19 pandemic in Pakistan and provide insights into the effectiveness of such training programs for future initiatives.
Methods: A cross-sectional study was conducted among the frontline healthcare workers against COVID-19 in Pakistan, utilizing an online structured questionnaire shared via WhatsApp and Facebook. Statistical analyses, including chi-square tests for proportion and logistic regression for the association while multi-logistic regression for potential confounders, were performed using SPSS version 22.
Results: A total of 453 healthcare staff participated, with 68.9% (n=312) reporting no prior PPE training and 31.1% (n=141) having received training. Significant associations were found between prior training and healthcare group distribution (p=0.006), with doctors exhibiting the highest proportion of training 82 (37.61%), followed by nurses 50 (27.32%) and paramedics 9 (17.31%). The location also demonstrated a significant association (p=0.05), with Sind (48.00%) followed by Baluchistan (40.0%) reporting the highest proportions of prior training. Multi-logistic regression analysis identified paramedics as 0.26 times less likely to have received prior PPE training (Adjusted OR 0.26, 95% CI 0.10-0.65, p=0.01) compared to medical doctors. Healthcare workers in tertiary care hospitals were 0.46 times less likely to undergo PPE training (Adjusted OR 0.46, 95% CI 0.25-0.87,p=0.01) compared to those working at COVID-19 facilities/hospitals/quarantine centers.
Conclusion: Our findings highlight that healthcare levels, type of healthcare, and doffing skills are important predictors of whether healthcare workers have taken prior training in PPE. These findings imply developing effective training programs for healthcare workers to ensure safety while providing care during pandemics like COVID-19.
Use of double plate fixation with Masquelet technique fixation for large segmental bone defects of distal tibia: A Retrospective Study and Literature Review
Authors: Wang Zhaohui , Zhan Xiaohuan , Li Xiaohuan , Chen Guocai , Gao Junqing 
Published: August 2023

Abstract
Background
There is no effective consensus on the choice of internal fixation method for the Masquelet technique in the treatment of large segmental bone defects of the distal tibia. The aim of the study was to investigate the outcomes of the Masquelet technique combined with double plate fixation in the treatment of large segmental bone defects of the distal tibia.
Methods
This was a retrospective study. 21 patients with large segmental bone defects of the distal tibia were treated between June 2017 and June 2020. The length of bone defect ranged from 6.0 cm to 10.5 cm (mean, 7.8 cm). In the first stage of treatment, following complete debridement, a cement spacer was placed to induce membrane formation. In the second stage, double plate fixation and autologous cancellous bone graft were used for bone reconstruction. Each patient’s full weight-bearing time, bone healing time, and Iowa ankle score were recorded, and the occurrence of any complications was noted.
Results
All patients were followed up for 16 to 26 months (mean, 20.2 months). The group mean full weight-bearing time and bone healing time after bone grafting were 3.8 (± 0.7) months and 7.5 (± 0.8) months, respectively. During the treatment, one patient had a wound infection on the medial side of the leg, and the medial plate was removed. The wound healed after debridement, and the infection did not recur. After extraction of iliac bone for grafting, one patient had a large number of iliac bone defects, which were filled using cement spacer. Patients reported mild pain in the left bone extraction area after surgery. The Iowa ankle score was 84–94, versus preoperative and postoperative scores, P < 0.05, with 15 cases rated as “excellent” on this system, and 6 cases rated as “good.”
Conclusions
The Masquelet technique combined with double plate fixation is a safe and effective method for the repair of large segmental bone defects of the distal tibia.
Prognostic potential of preoperative circulating tumor cells to predict the early progression recurrence in hepatocellular carcinoma patients after hepatectomy
Authors: Lu Zhan , Ni Hanghang , Yang Xihua , Tan Lihao , Zhuang Haixiao , Mo Yunning , Wei Xingyu , Qi Lunnan , Xiang Bangde 
Published: August 2023

Abstract
Background The role of circulating tumor cells (CTCs) in prognosis prediction has been actively studied in hepatocellular carcinoma (HCC) patients. However, their efficiency in accurately predicting early progression recurrence (EPR) is unclear. This study aimed to investigate the clinical potential of preoperative CTCs to predict EPR in HCC patients after hepatectomy.
Methods 145 HCC patients, whose preoperative CTCs were detected, were enrolled. Based on the recurrence times and types, the patients were divided into four groups, including early oligo-recurrence (EOR), EPR, late oligo-recurrence (LOR), and late progression recurrence (LPR).
Results Among the 145 patients, 133 (91.7%) patients had a postoperative recurrence, including 51 EOR, 42 EPR, 39 LOR, and 1 LPR patient. Kaplan–Meier survival curve analysis indicated that the HCC patients with EPR had the worst OS. There were significant differences in the total-CTCs (T-CTCs) and CTCs subtypes count between the EPR group with EOR and LOR groups. Cox regression analysis indicated that the T-CTC count of >5/5 mL,the presence of microvascular invasion (MVI)and satellite nodules were the independent risk factors for EPR. The efficiency of T-CTCs was superior as compared to those of the other indicators in predicting EPR. Moreover, the combined model demonstrated a markedly superior area under the curve (AUC).
Conclusions the HCC patients with EPR had the worst OS. The preoperative CTCs might serve as a prognostic indicator of EPR for HCC patients. The combined models, including T-CTCs, MVI, and satellite nodules, had the best performance to predict EPR after hepatectomy.
Building climate resilience: Awareness of climate change adaptation in German Primary Care
Authors: Litke Nicola Alexandra , Poß-Doering Regina , Fehrer Valeska , Köppen Martina , Kümmel Stephanie , Szecsenyi Joachim , Wensing Michel 
Published: August 2023

Abstract
Background:Climate change is seen as the biggest health threat of the 21st century. Making primary care institutions resilient is therefore crucial to protect vulnerable groups and maintain quality of care. Awareness is a precondition for action. This study aims to explore awareness (knowledge, experience and attention) of climate change adaptation among primary care stakeholders.
Methods:Semi-structured interviews and focus groups with primary care stakeholders were conducted. The qualitative data were analysed in a two-step Thematic Analysis process.
Results: In total, n=40 stakeholders participated in two focus groups and 26 interviews. The findings show a mixed degree of awareness in primary care institutions. The spectrum ranged from a passive role with curative acting only, handing over responsibility to others and a low perceived self-efficacy to a proactive and responsible implementation of adaptation strategies. Participants who saw the need and responsibility of climate change adaptation in primary care perceived low additional workload. In general, implementation of climate change adaptation measures and general awareness of climate change adaptation appeared to be depending on a certain tension for change and a higher self-efficacy.
Conclusion: Primary care plays a crucial role in climate change adaptation, and awareness needs to be increased further in order to cope with consequences of climate change. To facilitate this, there should be a strong emphasis on climate change adaptation strategies being part of healthcare provider roles rather than being perceived as an “add-on” to already high workloads.
The Relational Approach to Treating Self-Harm (RELATE): Study protocol for a Feasibility Randomised Controlled Trial Study of Cognitive Analytic Therapy for Adults who Self-Harm versus Treatment at Usual
Authors: Taylor Peter , Adeyemi Isabel , Marlow Katie , Cottam Sarah , Airnes Zerena , Hartley Samantha , Howells Victoria , Dunn Barney , Elliott Rachel , Hann Mark , Latham Cameron , Robinson Catherine , Turpin Clive , Kellett Stephen 
Published: August 2023

Abstract

Background
Self-harm is a prevalent behaviour that has a major detrimental impact on a person’s life. Psychological therapies have the potential to help, but evidence of effective interventions remains limited. Access and acceptability of interventions can also be a significant challenge, with individuals either being unable to access help, or having to endure long waiting-lists. Cognitive analytic therapy (CAT) is a time-limited and relationally-focused psychotherapy that may provide a valuable treatment option for people who self-harm. This protocol outlines the methodology for the first feasibility randomised controlled trial (RCT) of CAT for adults that self-harm. The trial will aim to determine the feasibility, acceptability and safety of undertaking larger-scale evaluations of CAT for self-harm within an RCT context.
Method
An RCT design with 1:1 allocation to CAT plus treatment as usual (TAU) or TAU alone. Participants will be adult outpatients with three or more instances of self-harm in the past year (target sample of n = 60). CAT will be 8 one-to-one weekly 60-minute sessions plus a follow-up session up to 8 weeks after the last session. Assessments will occur at baseline, 12 weeks and 18 weeks after randomisation. Qualitive interviews with participants will gain insights into feasibility and acceptability of CAT. Feasibility outcomes will be judged against progression criteria.
Discussion
CAT may be an effective and accessible treatment option for people who self-harm, providing a more relationally orientated alternative to more behavioural therapies. The proposed feasibility RCT is an important first step in evaluating CAT as a treatment for self-harm.
Trial Registration:
The trial was pre-registered (21/10/22) on ISR CTN (ISRCTN code: ISRCTN75661422)
Prediction of postoperative complications after hepatectomy with dynamic monitoring of central venous oxygen saturation
Authors: Ida Shinya , Morita Yoshifumi , Matsumoto Akio , Muraki Ryuta , Kitajima Ryo , Furuhashi Satoru , Takeda Makoto , Kikuchi Hirotoshi , Hiramatsu Yoshihiro , Takeuchi Hiroya 
Published: August 2023

Abstract
Background
The usefulness of static monitoring using central venous pressure has been reported for anesthesia management in hepatectomy. It is unclear whether intra-hepatectomy dynamic monitoring can predict the postoperative course. We aimed to investigate the association between intraoperative dynamic monitoring and post-hepatectomy complications. Furthermore, we propose a novel anesthetic management strategy to reduce postoperative complication.
Methods
From 2018 to 2021, 93 patients underwent hepatectomy at our hospital. Fifty-three patients who underwent dynamic monitoring during hepatectomy were enrolled. Flo Trac system was used for dynamic monitoring. The baseline central venous oxygen saturation was defined as the average central venous oxygen saturation for 30 min after anesthesia induction. Central venous oxygen saturation fluctuation was defined as the difference between the baseline and minimum central venous oxygen saturation. Postoperative complications were evaluated using the comprehensive complication index (CCI).
Results
Patients with central venous oxygen saturation fluctuation ≥ 10% had significantly higher CCI scores (0 vs. 20.9: p = 0.043). Patients with higher CCI scores demonstrated significantly higher preoperative C-reactive protein-to-lymphocyte ratio (7.51 vs. 24.49: p = 0.039), intraoperative bleeding (105 vs. 581 ml: p = 0.008), number of patients with major hepatectomy (4/45 vs. 3/8: p = 0.028), and number of patients with central venous oxygen saturation fluctuation ≥ 10% (11/45 vs. 6/8; p = 0.010). Central venous oxygen saturation fluctuation ≥ 10% (odds ratio: 9.53, p = 0.016) was the only independent predictor of elevated CCI.
Conclusions
Central venous oxygen saturation fluctuation during hepatectomy is a predictor of postoperative complications. Anesthetic management based on intraoperative dynamic monitoring and suppression of central venous oxygen saturation fluctuation may be effective measures to prevent postoperative complications.
A randomized double-blind clinical trial on safety and efficacy of tauroursodeoxycholic acid (TUDCA) as add-on treatment in patients affected by amyotrophic lateral sclerosis (ALS): the statistical analysis plan of TUDCA-ALS trial
Authors: Lombardo Flavia L. , Alegiani Stefania Spila , Mayer Flavia , Cipriani Marta , Giudice Maria Lo , Ludolph Albert Christian , McDermott Christopher J. , Corcia Philippe , Damme Philip Van , Berg Leonard H. Van den , Hardiman Orla , Nicolini Gabriele , Vanacore Nicola , Dickie Brian , Albanese Alberto , Puopolo Maria 
Published: August 2023

Abstract
Background: Amyotrophic Lateral Sclerosis (ALS) is a highly debilitating neurodegenerative condition. Despite recent advancements in understanding the molecular mechanisms underlying ALS, there have been no significant improvements in therapeutic options for ALS patients in recent years. Currently, there is no cure for ALS, and the only approved treatment in Europe is riluzole, which has been shown to slow the disease progression and prolong survival by approximately three months. Recently, tauroursodeoxycholic acid (TUDCA) has emerged as a promising and effective treatment for neurodegenerative diseases due to its neuroprotective activities.
Methods: The ongoing TUDCA-ALS study is a double-blinded, parallel arms, placebo-controlled, randomized multicenter phase III trial with the aim to assess the efficacy and safety of TUDCA as add-on therapy to riluzole in patients with ALS. The primary outcome measure is defined as a minimum 20% improvement in the ALS Functional Rating Scale-Revised (ALSFRS-R) slope during the randomisation period (18 months) compared to the lead-in period (3 months), Randomization will be stratified by country. Primary analysis will be conducted based on the intention-to-treat principle. Data recruitment commenced on February 22, 2019, and was closed on 23rd December 2021. The database will be locked in September 2023.
Discussion: This paper provides a comprehensive description of the statistical analysis plan in order to ensure reproducibility of the analysis and avoid selective reporting of outcomes and data-driven analysis. Sensitivity analyses have been included in the protocol to assess the impact of intercurrent events related to the Coronavirus disease 2019. By focusing on clinically meaningful and robust outcomes, this trial aims to determine whether TUDCA can be effective in slowing the disease progression in patients with ALS.
Trial registration: ClinicalTrials.gov NCT03800524. Registered on January 11, 2019, https://clinicaltrials.gov/study/NCT03800524
Earthquake knowledge level and sustainable earthquake awareness of university students
Authors: bayraktar demet turan , ÇOL Bahar KEFELİ , BAŞARAN Ayşe GÜMÜŞLER , KÖSE Burcu GENÇ 
Published: August 2023

Abstract
Purpose
The aim of this study is to determine the relationship between the earthquake knowledge level of university students and their sustainable earthquake awareness levels.
Materials and Methods
A descriptive-cross-sectional study was conducted in April 2023 with 546 students enrolled in the School of Health Services. Data were collected using the Student Information Form, Earthquake Knowledge Level Scale, and Sustainable Earthquake Awareness Scale. Percentages, means, standard deviations, Mann-Whitney U test, Kruskal-Wallis analysis, Bonferroni correction, Tamhane's T2 test, and Spearman correlation analysis were used for data evaluation. Prior to answering the study questions, informed consent was obtained from the students after obtaining ethical committee approval.
Findings
Among the participants, 82.1% were female, with a mean age of 20.78±2.17. 55.7% of the students had experienced an earthquake, 19.2% had lost a loved one in an earthquake, and 5.5% had participated in earthquake response efforts. The mean score on the Earthquake Knowledge Level scale was found to be 69.13±13.79, and the mean score on the Sustainable Earthquake Awareness scale was 64.65±14.89. The total score on the earthquake knowledge level scale was significantly higher among those who had participated in earthquake response efforts (p= .030). The knowledge score regarding the distribution of earthquake-prone regions was significantly higher among males and those who had participated in earthquake response efforts (p= .034, p= .002). The sub-dimension of knowledge about the effects of earthquakes was significantly higher among those who had experienced an earthquake, lost a loved one in an earthquake, and participated in earthquake response efforts (p= .000, p= .000, p= .001). There was no significant difference in the total and sub-dimension scores of the sustainable earthquake awareness scale among the independent variables. A positively moderate and significant correlation was found between earthquake knowledge level and sustainable earthquake awareness (r=.499, p<.001).
Conclusion:It was observed that the earthquake knowledge level of students was at a moderate level, while the sustainable earthquake awareness was below the moderate level. It can be stated that the earthquake knowledge level has an influence on earthquake awareness.
Lateral Heterometal Junction Rectifier Fabricated by Sequential Transmetallation of Coordination Nanosheet
Authors: Nishihara Hiroshi , Tan Choon Meng , Fukui Naoya , Takada Kenji , Maeda Hiroaki , Selezneva Ekaterina , Bourgès Cédric , Tsukagoshi Kazuhito , Mori Takao , Masunaga Hiroyasu , SASAKI Sono , Sirringhaus Henning 
Published: August 2023

Abstract
Heterostructures of two-dimensional materials realise novel and enhanced physical phenomena, making them attractive research targets. Compared to inorganic materials, coordination nanosheets have virtually infinite combinations, leading to tunability of physical properties and are promising candidates for heterostructure fabrication. Although stacking of coordination materials into vertical heterostructures is widely reported, reports of lateral coordination material heterostructures are few. Here we show the successful fabrication of a sharp and seamless lateral heterojunction showing diode behaviour, by sequential and spatially limited immersion of a new metalladithiolene coordination nanosheet, Zn3BHT, into aqueous Cu(II) and Fe(II) solutions. Upon immersion, the Zn centres in insulating Zn3BHT are replaced by Cu or Fe ions, resulting in remarkable increase of conductivity. The transmetallation is spatially confined, occurring only within the immersed area. We anticipate that our results will be a starting point towards exploring transmetallation of various two-dimensional materials to produce lateral heterojunctions, by providing a new and facile synthetic route.
The Escape Path PlanningAlgorithm in Large Building Fires Based on Multiple Fusion Strategies
Authors: Zhijun Gao , Hongyan Zhang , Wang Xin , Laghari Asif Ali , Anwar Muhammad Shahid 
Published: August 2023

Abstract
Background: Large building fires are currently the most direct and serious type of fire that causes property damage and casualties, and delayed evacuation is one of the important reasons for casualties. Therefore, how to safely and quickly evacuate trapped individuals has become the focus of research by many scholars. Our goal is to propose a robust, universal, and high-precision fire escape path that utilizes minimal human intervention, making the algorithm practical and highly fitting to the scene.
Results: This article constructs a framework for evacuating and evacuating fire personnel. Through the drone relay communication platform, multi-source information data collected at the fire scene is synchronously transmitted to the information exchange center, and uploaded to the cloud for real-time processing. In the cloud processing stage, the dynamic path planning method for large-scale building fires that integrates multiple strategies proposed in this article is used to generate escape paths, and the information exchange center is used to guide personnel to evacuate and escape. In addition, the information exchange center synchronizes the comprehensive scheduling of rescue agencies such as fire alarms and emergency centers.
Conclusions: This article proposes a dynamic pathfinder path planning method that integrates multiple strategies based on the original FPA. By utilizing the mapping relationship between personnel location and fitness, the path planning problem is transformed into a set sorting problem, shortening escape time and improving path safety; A multi-objective path planning mechanism based on the A * algorithm has been constructed. By defining a dynamic matching degree to adapt to environmental changes, the population density at the exit is reduced, and the algorithm's global search ability and escape efficiency are improved. A cloud server IoT fire evacuation and escape model based on relay communication drones is designed, which utilizes the drone's adaptive height characteristics to ensure communication quality while expanding communication coverage, By using cloud processing to shorten runtime, the superiority of the method was verified through comparative experiments on single objective and multi-objective global path planning under multiple sets of grid maps with different specifications.
Coupling effect of solidification and consolidation on characteristics of the dredged silt
Authors: Shu Shi , Li Lei , Cao Mingwei , Pan Zhengguo , Li Ruoyu , Xu Gaofeng , Tang Yan 
Published: August 2023

Abstract
Dehydration with a plate and frame filter press is a common method for treating dredged silt from rivers and lakes. The silt is often conditioned by the addition of solidifying materials before plate and frame press filtration and, therefore, is subjected to the coupling effect of solidification and consolidation. In this study, consolidation tests of the silt with cement were carried out and compared with the silt after only solidification or only consolidation in terms of moisture content, unconfined compressive strength, and leaching concentration. The test results showed that the moisture content of the silt can be reduced to less than 60% under the coupling action of solidification and consolidation, which was 22% and 4% lower than with solidification only or consolidation only, respectively. The effect of consolidation accelerated the hydration reactions of cement; the unconfined compressive strength increased rapidly during the initial consolidation stage and was 30–150% higher than that of solidified silt. The coupling effects of solidification and consolidation on the leaching concentrations of Ni and Cr in silt were the most significant, and the lowest leaching concentrations were 60% and 90% lower than those of solidified only and consolidated only silt, respectively.