bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early and Intensive Motor Training for people with spinal cord injuries (the SCI-MT Trial): protocol of the process evaluation
Authors: Chu Jackie , Glinsky Joanne V , Liu Hueiming , Ben Marsha , Spooren Annemie I , Roberts Sharon , Chen Lydia W , Di Natal Fernanda , Tamburella Federica , Jørgensen Vivien , Gollan Emilie J , Agostinello Jacqui , van Laake-Geelen Charlotte , Lincoln Claire , van der Lede Jessica , Stolwijk Janneke M , Bell Chris , Paddison Sue , Rainey Donna , Scivoletto Giorgio , Oostra Kristine M , Jan Stephen , Sherrington Catherine , Harvey Lisa A 
Published: August 2023

IntroductionPeople with spinal cord injury receive physical rehabilitation to promote neurological recovery. Physical rehabilitation commences as soon as possible when a person is medically stable. One key component of physical rehabilitation is motor training. There is initial evidence to suggest that motor training can enhance neurological recovery if it is provided soon after injury and in a high dosage. The Early and Intensive Motor Training Trial is a pragmatic randomised controlled trial to determine whether 10 weeks of intensive motor training enhances neurological recovery for people with spinal cord injury. This pragmatic randomised controlled trial will recruit 220 participants from 15 spinal injury units in Australia, Scotland, Italy, Norway, England, Belgium and the Netherlands. This protocol paper describes the process evaluation that will run alongside the Early and Intensive Motor Training Trial. This process evaluation will help to explain the trial results and explore the potential facilitators and barriers to the possible future rollout of the trial intervention.Methods and analysisThe UK Medical Research Council process evaluation framework and the Implementation Research Logic Model will be used to explain the trial outcomes and inform future implementation. Key components of the context, implementation and mechanism of impact, as well as the essential elements of the intervention and outcomes, will be identified and analysed. Qualitative and quantitative data will be collected and triangulated with the results of the Early and Intensive Motor Training Trial to strengthen the findings of this process evaluation.Ethics and disseminationEthical approval for the Early and Intensive Motor Training Trial and process evaluation has been obtained from the Human Research Ethics Committee at the Northern Sydney Local Health District (New South Wales) in Australia (project identifier: 2020/ETH02540). All participants are required to provide written consent after being informed about the trial and the process evaluation. The results of this process evaluation will be published in peer-reviewed journals.Trial registration numberAustralian New Zealand Clinical Trial Registry (ACTRN12621000091808); Universal Trial Number (U1111-1264-1689).
Feasibility of biomarkers to measure stress, burnout and fatigue in emergency nurses: a cross-sectional study
Authors: Mithen Lucinda M , Weaver Natasha , Walker Frederick R , Inder Kerry J 
Published: August 2023

IntroductionRetaining nurses in the workforce is an urgent concern in healthcare. Emergency nurses report high levels of stress and burnout, however, there is no gold standard of how to measure these responses. This study aims to measure stress, burnout, and fatigue in emergency nurses using biomarkers and psychometric instruments. Biomarkers will be used to better understand nurses’ levels of stress and burnout and to assess the feasibility of using biomarkers as a viable stress measurement tool in a real-world setting.Methods and analysisA two stage cross-sectional design to measure stress, burnout and fatigue in emergency nurses while they work is proposed. All registered and enrolled nurses working in the emergency department from four hospitals in Australia will be invited to participate. Validated psychometric tools will be used in stage 1 to measure depression, anxiety, acute stress, chronic stress, burnout and fatigue. Biomarkers comprising hair cortisol, saliva alpha amylase and heart rate variability will be collected as an objective measure of stress and burnout in stage 2 over one working shift per participant. Written consent will be sought for stage 2 where nurses will provide one hair sample, wear a heart rate sensor and be asked to collect their saliva at three different time points of one shift. Data analysis will measure the domains of acute stress, chronic stress and burnout and explore relationships and correlation between psychometric measures and biomarkers.Ethics and disseminationEthics approval obtained from the Human Research Ethics Committee of the Hunter New England Local Health District (approval number: HREC/2020/ETH01684) and University of Newcastle HREC (H-2022-0169). Results will be reported in peer-reviewed publications using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Public dissemination will occur by presenting at conferences and to the participating local health district.
Industry payments to family medicine residents in Portugal: a descriptive analysis of the national transparency database
Authors: Ruivo Marta , Cossutta Fabrizio , Moreira Fonseca Nuno 
Published: August 2023

ObjectiveTo analyse payments made to family medicine residents by the pharmaceutical industry during their residency in Portugal, using mandatory disclosure data.Design and participantsCohort study of residents starting their family medicine training in 2015, using data collected from the public national transparency database (Plataforma de Comunicações Transparência e Publicidade). Payments were categorised into six groups, including scientific meetings, educational activities, travel allowances, fees, gifts and undetermined.Main outcome measuresNumber of payments and the total value received by family medicine residents during their training period; number of payments according to their nature (six categories); number of payments and total value by paying entity.ResultsWe analysed data of 457 family medicine residents. A total of 2790 payments were made to 424 (92.8%) residents, amounting to €826 271.14. Thirty-three residents did not receive any payment. The median number of payments per resident was 5 and the median amount received per resident was €1309.51. Residents who ranked in the top 25%, according to value received, were subsidised more than €2500.90 over the course of their residency. This subset of residents received 59.1% of the total amount disbursed in payments. Payments were primarily for attending scientific meetings (80.9%) and educational activities (17.1%). The top 10 paying entities accounted for 69.2% of the total amount paid.ConclusionPharmaceutical industry funding for family medicine residents was highly prevalent, raising concerns over industry influence on medical education, while payment distribution was heterogeneous.
Initial dosage optimisation of cyclosporine in Chinese paediatric patients undergoing allogeneic haematopoietic stem cell transplantation based on population pharmacokinetics: a retrospective study
Authors: Feng Huanwen , Wang Xianggui , Zheng Wei , Liu Sha , Jiang Hua , Lin Yuxian , Qiu Haojie , Chan Teng Fong , Huang Min , Li Yan , Mo Xiaolan , Li Jiali 
Published: August 2023

ObjectiveImproved understanding of cyclosporine A (CsA) pharmacokinetics in children undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT) is crucial for effective prevention of acute graft-versus-host disease and medication safety. The aim of this study was to establish a population pharmacokinetic (Pop-PK) model that could be used for individualised therapy to paediatric patients undergoing allo-HSCT in China.Design, setting and participantsA retrospective analysis of 251 paediatric HSCT patients who received CsA intravenously in the early post transplantation period at Women and Children’s Medical Center in Guangzhou was conducted.Analysis measuresThe model building dataset from 176 children was used to develop and analyse the CsA Pop-Pk model by using the nonlinear mixed effect model method. The basic information was collected by the electronic medical record system. Genotype was analysed by matrix-assisted time-of-flight mass spectrometry. The stability and predictability of the final model were verified internally, and a validation dataset of 75 children was used for external validation. Monte Carlo simulation is used to adjust and optimise the initial dose of CsA in paediatric allo-HSCT patients.ResultsThe typical values for clearance (CL) and volume of distribution (Vd) were 14.47 L/hour and 2033.53 L, respectively. The body weight and haematocrit were identified as significant variables forV, while only body weight had an impact onCL. The simulation based on the final model suggests that paediatrics with HSCT required an appropriate intravenous dose of 5 mg/kg/day to reach the therapeutic trough concentration.ConclusionsThe CsA Pop-PK model established in this study can quantitatively describe the factors influencing pharmacokinetic parameters and precisely predict the intrinsic exposure to CsA in children. In addition, our dosage simulation results can provide evidence for the personalised medicationsTrial registration numberChiCTR2000040561
Tracking of Gaussian pulse release length inside mode-locked semiconductor laser amplifier
Authors: Hamad Oglah Mubarak , Ibrahim Mahmood Watban , Basheer Adday Nawras 
Published: August 2023

The behavior of the optical pulse release was investigated during chirped pulses amplification, which consisted of two chirped fiber Bragg grating and one semiconductor optical amplifier (SOA). This occurred when the pulse width, &lt;&lt; carrier lifetime , as well as the effect of the length parameter on the shape and spectrum of the electric field, intensity, and phase of amplified pulses, were taken into consideration. The purpose of this research is to investigate the effect of release length on the temporal electric field laser amplifier while simultaneously generating optical pulses with the help of a mode-locked laser system semiconductor. In the scenario where τp and τc are taken into account, we discovered that the length of the release has a significant impact on the modes of the phase and the electric field.
Cascaded H-bridge multilevel inverter-based DSTATCOM with an artificial neural fuzzy inference systembased controller
Authors: Chenchireddy Kalagotla , Jegathesan Varghese 
Published: August 2023

<span>In this paper, <span>a voltage source inverter is utilized as a distributed static compensator (DSTATCOM). The DSTATCOM is used for the elimination of harmonics caused by the nonlinear load. The reference currents of DSTATCOM were estimated with a synchronous reference frame (SRF). Conventionally, the SRF uses voltage, load current and filter current to compute the reference current to track desired source current for DSTATCOM. The sliding mode controller and feedback linearization are used to design the current controller. The feedback linearization technique and sliding mode control are used to cancel nonlinearities and offer invariant stability due to modeling uncertainties due to the DSTATCOM parameter and external load disturbance. The sliding mode controller requires a rigorous mathematical model of the system. To overcome this, an artificial neuro-fuzzy inference system (ANFIS) is devised for the control of DSTATCOM. The training data of the ANFIS controller is generated from the sliding mode controller algorithm. The overall system of DSTATCOM including the ANFIS algorithm is implemented in MATLAB/Simulink SimPower block sets. The simulated response of DSTATCOM was found to be improved and better than the sliding mode controller scheme.</span></span>
S14-Phosphorylated RPN6 Mediates Proteasome Activation by PKA and Alleviates Proteinopathy
Authors: Yang Liuqing , Parajuli Nirmal , Wu Penglong , Liu Jinbao , Wang Xuejun 
Published: August 2023

BACKGROUND:
A better understanding of the regulation of proteasome activities can facilitate the search for new therapeutic strategies. A cell culture study shows that PKA (cAMP-dependent protein kinase or protein kinase A) activates the 26S proteasome by pS14-Rpn6 (serine14-phosphorylated Rpn6), but this discovery and its physiological significance remain to be established in vivo.

METHODS:

Male and female mice with Ser14 of Rpn6 (regulatory particle non-ATPase 6) mutated to Ala (S14A [Rpn6/Psmd11
S14A
]) or Asp (S14D) to respectively block or mimic pS14-Rpn6 were created and used along with cells derived from them. cAMP/PKA were manipulated pharmacologically. Ubiquitin-proteasome system functioning was evaluated with the GFPdgn (green fluorescence protein with carboxyl fusion of the CL1 degron) reporter mouse and proteasomal activity assays. Impact of S14A and S14D on proteotoxicity was tested in mice and cardiomyocytes overexpressing the misfolded protein R120G-CryAB (R120G [arginine120 to glycine missense mutant alpha B-crystallin]).

RESULTS:
PKA activation increased pS14-Rpn6 and 26S proteasome activities in wild-type but not S14A embryonic fibroblasts (mouse embryonic fibroblasts), adult cardiomyocytes, and mouse hearts. Basal 26S proteasome activities were significantly greater in S14D myocardium and adult mouse cardiomyocytes than in wild-type counterparts. S14D::GFPdgn mice displayed significantly lower myocardial GFPdgn protein but not mRNA levels than GFPdgn mice. In R120G mice, a classic model of cardiac proteotoxicity, basal myocardial pS14-Rpn6 was significantly lower compared with nontransgenic littermates, which was not always associated with reduction of other phosphorylated PKA substrates. Cultured S14D neonatal cardiomyocytes displayed significantly faster proteasomal degradation of R120G than wild-type neonatal cardiomyocytes. Compared with R120G mice, S14D/S14D::R120G mice showed significantly greater myocardial proteasome activities, lower levels of total and K48-linked ubiquitin conjugates, and of aberrant CryAB (alpha B-crystallin) protein aggregates, less fetal gene reactivation, and cardiac hypertrophy, and delays in cardiac malfunction.

CONCLUSIONS:
This study establishes in animals that pS14-Rpn6 mediates the activation of 26S proteasomes by PKA and that the reduced pS14-Rpn6 is a key pathogenic factor in cardiac proteinopathy, thereby identifying a new therapeutic target to reduce cardiac proteotoxicity.
Differentiating the Prognostic Determinants of Myocardial Steatosis for Heart Failure With Preserved Ejection Fraction by Cardiac Magnetic Resonance Imaging
Authors: Lin Ting‐Tse , Lee Chih‐Kuo , Huang Kuan‐Chih , Wu Cho‐Kai , Lee Jen‐Kuang , Lan Chen‐Wei , Su Mao‐Yuan M. , Hwang Juey‐Jen , Wang Yi‐Chih , Lin Lian‐Yu 
Published: August 2023

Background
Myocardial steatosis and fibrosis may play a role in the pathophysiology of heart failure with preserved ejection fraction. We therefore investigated the prognostic significance of epicardial fat (epicardial adipose tissue [EAT]) and myocardial diffuse fibrosis.

Methods and Results

Myocardial fibrosis, estimated as extracellular volume (ECV), and EAT were measured using cardiac magnetic resonance imaging in 163 subjects with heart failure with preserved ejection fraction. We also evaluated cardiac structure and diastolic and systolic function by echocardiography and cardiac magnetic resonance imaging. After 24 months' follow‐up, 39 (24%) subjects had experienced cardiovascular events, including hospitalization for heart failure, acute coronary syndrome, and cardiovascular death. Median EAT and mean ECV were significantly higher in subjects with cardiovascular events than survivors (EAT, 35 [25–45] versus 31 [21–38],
P
=0.006 and ECV, 28.9±3.16% versus 27.2±3.56%,
P
=0.04). Subjects with high EAT (≥42 g) had increased risk of cardiovascular events (hazard ratio [HR], 2.528 [95% CI, 1.704–4.981];
P
=0.032). High ECV (>29%) was also significantly associated with poorer outcomes (HR, 1.647 [95% CI, 1.263–2.548];
P
=0.013). With respect to secondary end points, high EAT and high ECV were associated with increased risk of the incident acute coronary syndrome (HR, 1.982 [95% CI, 1.008–4.123];
P
=0.049) and hospitalization for heart failure (HR, 1.789 [95% CI, 1.102–6.987];
P
=0.033), respectively.

Conclusions
Our study suggested that increased epicardial fat and ECV detected by cardiac magnetic resonance imaging have an impact on cardiovascular prognosis, in particular acute coronary syndrome and hospitalization for heart failure, respectively.
Evolutionary Action–Machine Learning Model Identifies Candidate Genes Associated With Early‐Onset Coronary Artery Disease
Authors: Shapiro Dillon , Lee Kwanghyuk , Asmussen Jennifer , Bourquard Thomas , Lichtarge Olivier 
Published: August 2023

Background
Coronary artery disease is a primary cause of death around the world, with both genetic and environmental risk factors. Although genome‐wide association studies have linked >100 unique loci to its genetic basis, these only explain a fraction of disease heritability.

Methods and Results

To find additional gene drivers of coronary artery disease, we applied machine learning to quantitative evolutionary information on the impact of coding variants in whole exomes from the Myocardial Infarction Genetics Consortium. Using ensemble‐based supervised learning, the Evolutionary Action–Machine Learning framework ranked each gene's ability to classify case and control samples and identified 79 significant associations. These were connected to known risk loci; enriched in cardiovascular processes like lipid metabolism, blood clotting, and inflammation; and enriched for cardiovascular phenotypes in knockout mouse models. Among them,
INPP5F
and
MST1R
are examples of potentially novel coronary artery disease risk genes that modulate immune signaling in response to cardiac stress.

Conclusions
We concluded that machine learning on the functional impact of coding variants, based on a massive amount of evolutionary information, has the power to suggest novel coronary artery disease risk genes for mechanistic and therapeutic discoveries in cardiovascular biology, and should also apply in other complex polygenic diseases.
Prevention of Cardiovascular Disease in Women With Pregnancy‐Related Risk Factors: A Prospective Women's Heart Clinic Study
Authors: Marschner Simone , Mukherjee Swati , Watts Monique , Min Haeri , Beale Anna L. , O'Brien Jessica , Juneja Aashima , Tremmel Jennifer A. , Zaman Sarah 
Published: August 2023

Background
Hypertensive disorders of pregnancy, gestational diabetes, and having a small‐for‐gestational‐age baby are known to substantially increase a woman's risk of cardiovascular disease. Despite this, evidence for models of care that mitigate cardiovascular disease risk in women with these pregnancy‐related conditions is lacking.

Methods and Results

A 6‐month prospective cohort study assessed the effectiveness of a multidisciplinary Women's Heart Clinic on blood pressure and lipid control in women aged 30 to 55 years with a past pregnancy diagnosis of hypertensive disorders of pregnancy, gestational diabetes, or a small‐for‐gestational age baby in Melbourne, Australia. The co‐primary end points were (1) blood pressure <140/90 mm Hg or <130/80 mm Hg if diabetes and (2) total cholesterol to high‐density lipoprotein cholesterol ratio <4.5. The study recruited 156 women with a mean age of 41.0±4.2 years, 3.9±2.9 years from last delivery, 68.6% White, 20.5% South/East Asian, and 80.5% university‐educated. The proportion meeting blood pressure target increased (69.2% to 80.5%,
P
=0.004), with no significant change in lipid targets (80.6% to 83.7%,
P
=0.182). Systolic blood pressure (−6.9 mm Hg [95% CI, −9.1 to −4.7],
P
<0.001), body mass index (−0.6 kg/m
2
[95% CI, −0.8 to −0.3],
P
<0.001), low‐density lipoprotein cholesterol (−4.2 mg/dL [95% CI, −8.2 to −0.2],
P
=0.042), and total cholesterol (−4.6 mg/dL [95% CI, −9.1 to −0.2]
P
=0.042) reduced. Heart‐healthy lifestyle significantly improved with increased fish/olive oil (36.5% to 51.0%,
P
=0.012), decreased fast food consumption (33.8% to 11.0%,
P
<0.001), and increased physical activity (84.0% to 92.9%,
P
=0.025).

Conclusions
Women at high risk for cardiovascular disease due to past pregnancy‐related conditions experienced significant improvements in multiple cardiovascular risk factors after attending a Women's Heart Clinic, potentially improving long‐term cardiovascular disease outcomes.

Registration

URL:
https://www.anzctr.org.au
; Unique identifier: ACTRN12622000646741.
Human Milk Feeding and Direct Breastfeeding Improve Outcomes for Infants With Single Ventricle Congenital Heart Disease: Propensity Score‐Matched Analysis of the NPC‐QIC Registry
Authors: Elgersma Kristin M. , Wolfson Julian , Fulkerson Jayne A. , Georgieff Michael K. , Looman Wendy S. , Spatz Diane L. , Shah Kavisha M. , Uzark Karen , McKechnie Anne Chevalier 
Published: August 2023

Background
Infants with single ventricle congenital heart disease undergo 3 staged surgeries/interventions, with risk for morbidity and mortality. We estimated the effect of human milk (HM) and direct breastfeeding on outcomes including necrotizing enterocolitis, infection‐related complications, length of stay, and mortality.

Methods and Results

We analyzed the National Pediatric Cardiology Quality Improvement Collaborative (NPC‐QIC) registry (2016–2021), examining HM/breastfeeding groups during stage 1 and stage 2 palliations. We calculated propensity scores for feeding exposures, then fitted Poisson and logistic regression models to compare outcomes between propensity‐matched cohorts. Participants included 2491 infants (68 sites). Estimates for all outcomes were better in HM/breastfeeding groups. Infants fed exclusive HM before stage 1 palliation (S1P) had lower odds of preoperative necrotizing enterocolitis (odds ratio [OR], 0.37 [95% CI, 0.17–0.84];
P
=0.017) and shorter S1P length of stay (rate ratio [RR], 0.87 [95% CI, 0.78–0.98];
P
=0.027). During the S1P hospitalization, infants with high HM had lower odds of postoperative necrotizing enterocolitis (OR, 0.28 [95% CI, 0.15–0.50];
P
<0.001) and sepsis (OR, 0.29 [95% CI, 0.13–0.65];
P
=0.003), and shorter S1P length of stay (RR, 0.75 [95% CI, 0.66–0.86];
P
<0.001). At stage 2 palliation, infants with any HM (RR, 0.82 [95% CI, 0.69–0.97];
P
=0.018) and any breastfeeding (RR, 0.71 [95% CI, 0.57–0.89];
P
=0.003) experienced shorter length of stay.

Conclusions
Infants with single ventricle congenital heart disease in high‐HM and breastfeeding groups experienced multiple significantly better outcomes. Given our findings of improved health, strategies to increase the rates of HM/breastfeeding in these patients should be implemented. Future research should replicate these findings with granular feeding data and in broader congenital heart disease populations, and should examine mechanisms (eg, HM components, microbiome) by which HM/breastfeeding benefits these infants.