bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers and Facilitators to a Task-Shifted Stroke Prevention Program for Children with Sickle Cell Anemia in a Community Hospital: A Qualitative Study
Authors: Bello-Manga Halima , Haliru Lawal , Ahmed Kudirat , Ige Samuel , Musa Hayatu , Muhammad-Idris Zainab Kwaru , Monday Binshak , Sani Abdulrashid M. , Bonnet Kemberlee , Schlundt David G. , Varughese Taniya , Tabari Abdulkadir M. , DeBaun Michael R. , Baumann Ana A. , King Allison A. 
Published: July 2023

Abstract
Background
Children with sickle cell anemia (SCA) are at high risk for stroke. Protocols for stroke prevention including blood transfusions, screening for abnormal non-imaging transcranial Doppler (TCD) measurements, and hydroxyurea therapy are difficult to implement in low-resource environments like Nigeria. This study aimed to examine the contextual factors around TCD screening in a community hospital in Nigeria using qualitative interviews and focus groups.
Methods
We conducted focus groups with health care providers and interviews with administrative leadership of the community hospital. Interview guides and analysis were informed by the Consolidated Framework for Implementation Research (CFIR) framework. Transcripts were coded and analyzed using an iterative deductive (CFIR)/Inductive (transcribed quotes) qualitative methodology.
Results
We conducted two focus groups and five interviews with health care workers (nurses and doctors) and hospital administrators, respectively. Themes identified key elements of the inner setting (clinic characteristics, resource availability, implementation climate, and tension for change), characteristics of individuals (normative, control, and behavioral beliefs), and the implementation process (engage, implement, and adopt), as well as factors that were influenced by external context, caregiver needs, team function, and intervention characteristics. Task shifting, which is already being used, was viewed by providers and administrators as a necessary strategy to implement TCD screening in a clinic environment that is overstressed and under-resourced, a community stressed by poverty, and a nation with an underperforming health system.
Conclusion
Task shifting provides a viable option to improve health care by making more efficient use of already available human resources while rapidly expanding the human resource pool and building capacity that is more sustainable.
Trial registration:
NCT05434000
Game-Based Educational Experience in Clinical Simulation and Academic Achievement in Medical Students
Authors: Salafia-Recupero Maria Amalia , Perez-Ochoa María Elena 
Published: July 2023

Abstract
BACKGROUND: In recent years, medical education has increasingly embraced gamification as a method for teaching clinical skills. In Peru, social isolation resulting from the COVID-19 pandemic forced universities and academic institutions to restructure their teaching methods. Therefore, this work aims to determine whether a game-based strategy is associated with the achievement of clinical skills of students from a Peruvian medical school.
METHOD: We conducted a retrospective and cross-sectional study on medical students’ users of the Full Code Medical Simulation platform. We retrieved qualification data from selected cases of clinical courses with an appropriate number of users [Clinical Medicine (CM) I (7 cases), CM II (17 cases), Surgery I (6 cases) and Surgery II (6 cases). cases)]. We also evaluate correlation between academic performance levels and quantitative variables obtained in the Full Code platform were determined using the Kruskal-Wallis test.
RESULTS: A total of 590 students were enrolled. We found a direct correlation between the student's course grade and Full Code score in all courses (CM I: p<0.001, CM II: p<0.05, Surgery I: p<0.05 and Surgery II: p < 0.05). CM II course students who dedicated more time to case development received better grades (p < 0.05). There was no relationship between the percentage of correctly diagnosed cases and having better grades.
CONCLUSION:The use of gamification in clinical simulation positively influenced the learning outcomes of students in clinical courses. However, the guidance and commitment of the teachers were crucial to motivate and improve the skills of the students.
How to measure digital public health system maturity on a national level: An international multidisciplinary Delphi study
Authors: Maaß Laura , Zeeb Hajo , Rothgang Heinz 
Published: July 2023

AbstractUnlocking the full potential of digital public health (DiPH) systems requires a comprehensive tool to assess their maturity. While the World Health Organization and the International Telecommunication Union released a toolkit in 2012 covering various aspects of digitalizing national healthcare systems, a holistic maturity assessment tool has been lacking ever since. To bridge this gap, we conducted a pioneering Delphi study, including 82 experts from diverse continents and academic fields. Our research aimed to gather indicators from multiple domains to evaluate the maturity of DiPH systems. Over three survey panels, participants collaborated to develop and establish consensus on these indicators, with a threshold of 70% agreement on indicator importance. Eventually, 96 indicators were identified and agreed upon by experts. Notably, 48% of these indicators were found to align with existing validated tools, highlighting their relevance and reliability. However, further investigation is required to assess the suitability and applicability of all the suggestions put forward by our participants. Nevertheless, this Delphi study is an essential initial stride toward a comprehensive measurement tool for DiPH system maturity. By working towards a standardized assessment of DiPH system maturity, we aim to empower decision-makers to make informed choices, optimize resource allocation, and drive innovation in healthcare delivery. The results of this study mark a significant milestone on the path to advancing DiPH on a global scale. Introduction
Regeneration of collecting lymphatic vessels following injury
Authors: Razavi Mohammad S. , Lei Pin-Ji , Amoozgar Zohreh , Leartprapun Nichaluk , Nadkarni Seemantini , Baish James , Padera Timothy , Munn Lance 
Published: July 2023

Abstract

Secondary lymphedema is a debilitating condition driven by impaired regeneration of lymphatic vasculature following lymphatic injury, surgical removal of lymph nodes in cancer patients or infection. However, the extent to which collecting lymphatic vessels regenerate following injury remains unclear. Here, we employed a novel mouse model of lymphatic injury in combination with state-of-the-art lymphatic imaging to demonstrate that the implantation of an optimized fibrin gel following lymphatic vessel injury leads to the growth and reconnection of the injured lymphatic vessel network, resulting in the restoration of lymph flow to the draining node. Intriguingly, we found that fibrin implantation elevates the tissue levels of CCL5, a potent macrophage-recruiting chemokine. Notably, CCL5-KO mice displayed a reduced ability to reconnect injured vessels following fibrin gel implantation. These novel findings shed light on the mechanisms underlying lymphatic regeneration and suggest that enhancing CCL5 signaling may be a promising therapeutic strategy for enhancing lymphatic regeneration.
Alpha-Fetoprotein and APRI as a Predictive Marker for Patients with Type C Hepatitis B-Related Acute-on-Chronic Liver Failure: A retrospective study
Authors: Li Chunyan , Hu Hao , Bai Chengzhi , Xu Huaqian , Liu Lin , Tang Shanhong 
Published: July 2023

Abstract
Background: Type C hepatitis B-related acute-on-chronic liver failure (HBV-ACLF), which based on decompensated cirrhosis, have different laboratory tests, precipitating events, organ failure and clinical outcome. The predictors of prognosis for the type C HBV-ACLF patients are different from other subgroups. This study aimed to construct a novel, short-term prognostic score that applied serological indicators of hepatic regeneration and noninvasive assessment of liver fibrosis to predict outcomes in patients with type C HBV-ACLF.
Method: Patients with type C HBV-ACLF were observed for 90 days. Demographic information, clinical examination, and laboratory test results of the enrolled patients were collected. Univariate and multivariate Logistic regression was performed to identify independent prognostic factors and develop a novel prognostic scoring system. And a receiver operating characteristic (ROC) curve was used to analyze the performance of the model.
Results: A total of 224 patients with type C HBV-ACLF were finally incorporated. The overall survival rate within 90 days was 47.77 %. Age, total bilirubin (TBil), international normalized ratio (INR), alpha-fetoprotein (AFP), white blood cell (WBC), serum natrium (Na), and Aspartate aminotransferase/platelet ratio index (APRI) were found to be independent prognostic factors. According to the results of the Logistic regression analysis, a new prognostic model (we named it the A3Twin score) was established. The area under the curve (AUC) of the receiver operating characteristic curve (ROC) was 0.851[95% CI（0.801-0.901）], the sensitivity of 78.8%, and specificity of 71.8%,which was significantly higher than that of the MELD, IMELD,MELD-Na, TACIA and COSSH‐ACLF II scores (all P < 0.001).Patients with lower A3Twin scores (<-9.07) would survive longer.
Conclusions: A new prognostic scoring system for patients with type C HBV-ACLF based on seven routine indexes was established in our study, and can accurately predict short-term mortality and might be used to guide clinical management.
Formulations containing Artemisia afra Jacq. Ex Willd for topical delivery
Authors: Olivier Duné , Kooy Frank Van der , Gerber Minja 
Published: July 2023

Abstract
Artemisia afra (A. afra) is an herbal medicine, traditionally prepared as a tea infusion, used for centuries in African countries to treat a vast number of ailments. This herb contains an ample amount of known and unknown compounds and has antibacterial, anti-viral and anti-fungal properties; hence, topical treatment was considered. A liquid chromatography mass spectrometry (LC-MS/MS) method was developed and validated to detect the six selected marker compounds used during this study: two organic acids (4,5-dicaffeoylquinic acid (DCQA) and chlorogenic acid (CGA), two flavonoids (luteolin and quercetin) and two coumarins (scopoletin and scopolin). The formulations selected had to accommodate the hydrophilic nature of the A. afra infusion; therefore, there was an infusion, hydrogel and emulgel selected. The hydrogel and emulgel contained a gelling agent, xanthan gum, whereas the emulgel additionally contained a chemical penetration enhancer, evening primrose oil (EPO), to improve penetration through the lipophilic stratum corneum. The characterisation of the semi-solid formulations was to ensure skin application suitability. Membrane release studies confirmed sufficient release of the different markers from the formulations. During the in vitro skin diffusion studies, the discovery was that the infusion had the highest median flux and amount per area diffused compared to the other formulations. Thereafter, there was tape stripping performed, and established that there were markers present in the stratum corneum-epidermis (SCE) and epidermis-dermis (ED). The testing of cytotoxicity was to determine the safety of topical delivery, and the finding was that A. afra showed no cytotoxicity at the levels tested.
Spatially resolved immune exhaustion within the alloreactive microenvironment predicts liver transplant rejection.
Authors: Barbetta Arianna , Rocque Brittany , Bangerth Sarah , Street Kelly , Weaver Carly , Chopra Shefali , Kim Janet , Sher Linda , Gaudilliere Brice , Akbari Omid , Kohli Rohit , Emamaullee Juliet 
Published: July 2023

Abstract
Allograft rejection is a frequent complication following solid organ transplantation, but defining specific immune subsets mediating alloimmunity has been elusive due to the scarcity of tissue in clinical biopsy specimens. Single cell techniques have emerged as valuable tools for studying mechanisms of disease in complex tissue microenvironments. Here, we developed a highly multiplexed imaging mass cytometry panel, single cell analysis pipeline, and semi-supervised immune cell clustering algorithm to study archival biopsy specimens from 79 liver transplant (LT) recipients with histopathological diagnoses of either no rejection (NR), acute T-cell mediated rejection (TCMR), or chronic rejection (CR). This approach generated a spatially resolved proteomic atlas of 461,816 cells derived from 98 pathologist-selected regions of interest relevant to clinical diagnosis of rejection. We identified 41 distinct cell populations (32 immune and 9 parenchymal cell phenotypes) that defined key elements of the alloimmune microenvironment (AME), identified significant cell-cell interactions, and established higher order cellular neighborhoods. Our analysis revealed that both regulatory (HLA-DR+ Treg) and exhausted T-cell phenotypes (PD1+CD4+ and PD1+CD8+ T-cells), combined with variations in M2 macrophage polarization, were a unique signature of TCMR. TCMR was further characterized by alterations in cell-to-cell interactions among both exhausted immune subsets and inflammatory populations, with expansion of a CD8 enriched cellular neighborhood comprised of Treg, exhausted T-cell subsets, proliferating CD8+ T-cells, and cytotoxic T-cells. These data enabled creation of a predictive model of clinical outcomes using a subset of cell types to differentiate TCMR from NR (AUC = 0.96 ± 0.04) and TCMR from CR (AUC = 0.96 ± 0.06) with high sensitivity and specificity. Collectively, these data provide mechanistic insights into the AME in clinical LT, including a substantial role for immune exhaustion in TCMR with identification of novel targets for more focused immunotherapy in allograft rejection. Our study also offers a conceptual framework for applying spatial proteomics to study immunological diseases in archival clinical specimens.
Prediction of Surface Residual Stress in Grinding Process
Authors: Lyu Yu-Ting , Ay Herchang , Huang Yu-Chun , Hung Tsung-Pin , Jang Kevin , Lee Rong-Tsong , Hong Zheng-Han , Tseng Po-Han 
Published: July 2023

Abstract
This study mainly constructs a finite element analysis model. The temperature, energy partition and changes of FC300 gray cast iron workpiece during dry grinding are investigated. Thermal load and mechanical deformation of workpiece during grinding can leave residual stress on the surface, which has a considerable impact on the fatigue properties of the workpiece. In the experimental part, different grinding wheel speeds (1200, 900, 600, 400 rpm), workpiece speeds (1000, 3000, 5000, 10000 mm/min), and grinding depths (10, 20 mm/min) were measured μm) Changes in residual stress under conditions. A moving heat source model and a multi abrasive model are established to simplify the condition of the grinding wheel contacting the workpiece. The comparison of material residual forces measured by X-ray diffraction measurements shows that the finite element analysis model proposed in this paper has good reliability. Finally, this model is used to analyze the effects of grinding wheel speed, workpiece speed, and grinding depth on the residual stress on the workpiece surface, and to understand the possible causes of residual stress during grinding.
Translation and Validation of Iranian Version of Nursing Professional Values Scale-3 (NPVS-3) among Nursing Students: A Psychometric Analysis
Authors: Talebian Fateme , Yaghoubi Tahere , Nia Hamid Sharif , Haghighat Sahar 
Published: July 2023

Abstract

Background
The development pillars of a profession’s identity are the values of that profession. It’s highly critical to recognize and honor those professional values in nursing since nurses are in the frontline of the health system. In order to validate the 28-item scale of nursing professional value (NPVS-3), it was executed among nursing students. To conduct a Persian translation and validation of the nursing professional values scale-3 (NPVS-3).
Method
A methodological design was performed using convenient sampling method with a 400-subject sample size. As prescribed by the World Health Organization protocol, the NPVS-3 was translated.
Results
Removing 3 items, the exploratory factor analysis revealed a 3-factor structure (profession, activity, care), respectively, with 25 remaining items for the NPVS-3. These 3 factors overall accounted for 24.48% of the total variance of the NPVS-3 in this sample. Regarding the findings of the confirmatory factor analysis, all the fitness indices were appropriate and the fitness of the model was confirmed. As surveying the convergent and divergent validity displayed, all 3 factors are of befitting convergent and divergent validity. McDonald's Omega(ꙍ), CR and Cronbach's alpha, 3 factors extracted from the 25-item NPVS-3 were greater than 0.7.
Conclusions
The current research findings reported that the validity and reliability of the 25-item version of the NPVS-3 has been verified. This scale can be utilized to measure the awareness about the values of the nursing profession and the adherence and compliance level among the nursing students.
Expression of inflammatory mediators in biofilm samples and clinical association in multiple sclerosis patients in remission – a pilot study of case series
Authors: Fehlhofer Jakob , Ries Jutta , Nickel Florian Tobias , Rothhammer Veit , Schwab Stefan , Kesting Marco , Buchbender Mayte 
Published: July 2023

Abstract
Background: Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of unknown etiology that affects the central nervous system and can lead to neurological impairment. Our aim was to determine whether MS patients also show inflammatory changes in the oral cavity more frequently than healthy individuals.
Material and Methods: We examined plaque samples for various mediators and their correlation with clinical findings. A study group (MS) and a control group were examined and compared. The plaque samples were analyzed for the expression of interleukins (IL-2, -6, -10), matrix metalloproteinases (MMP-7, MMP-9) and a surface antigen CD90 by quantitative real-time PCR. Clinical parameters examined were the Mombelli plaque index (MPI), bleeding on probing (BOP) index, gingival pocket depth (PD) and Decayed, missing and filled tooth (DMFT) index.
Results: The expression of MMP9 was significantly (p=0.035) higher in the control group. The expression of IL-2 was increased 4-fold in the MS group, but this difference was not statistically significant. The mean PD (p<0.001) and BOP index (p=0.029) were increased in the study group.
Conclusion: The clinical parameters of the BOP index and PD were significantly amplified in the MS patients. However, no causal relationship between the investigated inflammatory mediators and the clinical findings could be established in this case series.
The study was registered in the German clinical trial registry (DRKS00022956,registered 28/08/2020).
New perspectives on Australian hydroclimate and population dynamics during Last Glacial Maximum and terminal Pleistocene
Authors: Cadd Haidee , Williams Alan , Saktura Wanchese , Cohen Timothy , Mooney Scott , He Chengfei , Turney Chrisitan , Otto-Bliesner Bette 
Published: July 2023

Abstract
Long-standing interpretations of the Last Glacial Maximum (LGM; 21,000 ± 2,000 years ago) in Australia suggest that the period was one of extreme cold and aridity, during which the Indo-Australian summer monsoon (IASM) system collapsed, and human populations declined and retreated to ecological refuges to survive. Here, we use transient iTRACE simulations, combined with palaeoclimate proxy records and archaeological data to re-interpret the late LGM and terminal Pleistocene (21,000–11,000 yrs) in Australia. The models suggest climates during the peak LGM were cooler than present (-4 to -6°C), but there is no evidence of IASM collapse or substantial precipitation decreases in northern Australia. Kernel Density Estimates (KDE) of archaeological ages show relatively stable and persistent human activity across most regions throughout the late LGM and terminal Pleistocene, consistent with genetic evidence. Spatial coverage of archaeological sites steadily increased across the terminal Pleistocene; however population collapse is not evident.
Evaluating the safety and quality of portable x-ray imaging in a new infectious disease biocontainment unit: an in situ simulation and video-reflexive study
Authors: Wyer Mary , Hor Su-Yin , Barratt Ruth , Garraghy Phillip , Moore Cameron , Veazey Leah , Degeling Chris , Gilbert Gwendolyn L 
Published: July 2023

Abstract
Background
During a pre-commissioning inspection of a new biocontainment centre, radiographers noted several structural features of quarantine rooms that could compromise staff and patient safety and the quality of X-rays, even with significant modifications to a previously developed and tested radiography protocol.
Methods
To evaluate the safety and effectiveness of the existing protocol in the new space, two simulated mobile x-rays were undertaken in the unit prior to commissioning. The simulations were videoed, and participants and other stakeholders collaboratively analysed video footage to identify potential problems and devise solutions. These sessions were audio-recorded, transcribed and analysed thematically. Identified problems and solutions were collated and communicated to the hospital executive, to be endorsed and actioned where possible.
Results
Seven healthcare workers volunteered to participate. Participants identified serious latent safety threats including: increased risks of exposure to infection, occupational injury and radiation, interference with communication, and X-ray quality. Several unforeseen but important issues, across all four areas of risk, were identified only during facilitated group reviews of video footage.
Conclusions
In situ simulation is increasingly used to evaluate and improve healthcare practices. This study confirmed the added value of video-reflexive methods, which provide experienced participants with a richer view of a familiar protocol, in a new setting. Video footage can be examined immediately or later, if required, and by a broader group of stakeholders with diverse experience or expertise. Using video-reflexivity, clinicians were able to identify, collate and present latent safety threats to those who could endorse and implement the modifications.
Trial registration:
Not applicable.