bluuebunny/crossref_metadata_2025_split huggingface dataset:
Benefits, challenges and sustainability of digital healthcare for NHS Wales: a qualitative study
Authors: Johns Gemma , Whistance Bethan , Burhouse Anna , Khalil Sara , Whistance Megan , Ahuja Saiba , Ogonovsky Mike , Ahuja Alka 
Published: May 2023

IntroductionDigital healthcare in the UK was adopted out of necessity rather than choice during the COVID-19 pandemic. However, as we move forward, UK governments and healthcare services have acknowledged its evident benefits for patients, staff and the National Health Service (NHS), and are keen to sustain its improvements in the long term.ObjectiveTo understand the benefits, challenges and sustainability of a future-proof digital healthcare.DesignA semi-structured interview study was conducted.SettingIn NHS services in Wales, UK.ParticipantsWith clinical and non-clinical staff across a mix of clinical specialties.Outcome measuresSemi-structured interviews were conducted to address benefits, challenges and sustainability of a national video consulting (VC) service, and thematically coded using a quantification method of qualitative work.ResultsA total of 203 interviews were conducted and 3 dominant domains emerged, with 7 themes and 26 categories.LimitationsIt is important to acknowledge that these findings were captured during a pandemic.ConclusionsNHS Wales has demonstrated that currently there are an equal measure of benefits and challenges to a national digital healthcare. However, with ongoing government and service support, improvement and evaluation, it has potential for a sustainable digital future, in which the benefits can outweigh the challenges.
Impact of COVID-19 pandemic on health service utilisation and household economy of pregnant and postpartum women: a cross-sectional study from rural Sri Lanka
Authors: Gunarathna Sajan Praveena , Wickramasinghe Nuwan Darshana , Agampodi Thilini Chanchala , Prasanna Indika Ruwan , Agampodi Suneth Buddhika 
Published: May 2023

ObjectivesThis study aims to describe how household economies and health service utilisation of pregnant and postpartum women were affected during the pandemic.DesignA cross-sectional study.SettingThis study was conducted in the Anuradhapura district, Sri Lanka.ParticipantsThe study participants were 1460 pregnant and postpartum women recruited for the Rajarata Pregnancy Cohort during the initial stage of the COVID-19 pandemic.Primary and secondary outcome measuresHousehold economic (income, poverty, nutritional and health expenditures) and health service utilisation details during the COVID-19 pandemic were gathered through telephone interviews. Sociodemographic and economic data were obtained from the cohort baseline and analysed with descriptive and non-parametric analysis.ResultsOut of the 1460 women in the sample, 55.3% (n=807) were pregnant and 44.7% (n=653) were postpartum women. Of the total sample, 1172 (80.3%) women participated in the economic component. The monthly household income (median (IQR)=212.39 (159.29–265.49)) reduced (median (IQR)=159.29 (106.20–212.39)) in 50.5% (n=592) families during the pandemic (Z=−8.555, p<0.001). Only 10.3% (n=61) of affected families had received financial assistance from the government, which was only 46.4% of the affected income. The nutritional expenditure of pregnant women was reduced (Z=−2.023, p=0.043) by 6.7%. During the pandemic, 103 (8.8%) families with pregnant or postpartum women were pushed into poverty, and families who were pushed into poverty did not receive any financial assistance. The majority of women (n=1096, 83.3%) were satisfied with the free public health services provided by the public health midwife during the pandemic.ConclusionDuring the early stages of the pandemic, healthcare utilisation of pregnant women was minimally affected. Even before the country’s current economic crisis, the household economies of pregnant women in rural Sri Lanka were severely affected, pushing families into poverty due to the pandemic. The impact of COVID-19 and the aftermath on pregnant women will have many consequences if the policies and strategies are not revised to address this issue.
Tackling childbirth-related intrusive memories with a single-session behavioural intervention involving a visuospatial task: protocol for a single-blind, waitlist-controlled randomised trial
Authors: Fort Déborah , Deforges Camille , Messerli-Bürgy Nadine , Michael Tanja , Baud David , Lalor Joan , Rimmele Ulrike , Horsch Antje 
Published: May 2023

IntroductionApproximately 12.3% of mothers experience childbirth-related post-traumatic stress symptoms (CB-PTSS). However, evidence-based interventions to treat CB-PTSS are lacking. Intrusive memories (IM), a key CB-PTSS, are distressing and can trigger other PTSS by reliving the traumatic event. Emerging evidence shows that a behavioural intervention involving a visuospatial task (BI-VT) can reduce the number of IM and PTSS, supposedly by interfering with the reconsolidation of the trauma memory. This study aims to test the efficacy of a single-session BI-VT targeting IM to reduce the number of childbirth-related (CB-)IM and PTSS, in comparison to a waitlist control group (WCG).Methods and analysisIn this multicentre, single-blind, randomised controlled trial being undertaken at one regional and one university hospital in Switzerland, 60 participants will be allocated to the Immediate Intervention Group (IIG), receiving the immediate intervention on day 15, and 60 participants to the WCG receiving the delayed intervention on day 30. All participants will report their CB-IM during the 2 weeks preimmediate and postimmediate intervention in diaries. The IIG will additionally report their CB-IM over weeks 5 and 6 postimmediate intervention. Self-report questionnaires will assess CB-PTSS at 2 weeks preimmediate and postimmediate intervention in both groups, and at 6 weeks postimmediate intervention in the IIG. A feedback questionnaire will evaluate the intervention acceptability. The primary outcome will be group differences in the number of CB-IM between the 2 weeks preimmediate and postimmediate intervention. Secondary outcomes will be CB-PTSS at 2 and 6 weeks postimmediate intervention, the number of CB-IM at weeks 5 and 6 postimmediate intervention, and intervention acceptability.Ethics and disseminationEthical approval was granted by the Human Research Ethics Committee of the Canton of Vaud (study number 202200652). Participants will provide an informed consent before study participation. Results will be presented in peer-reviewed journals and at conferences.Trial registration numberNCT05381155.
Clearing the path to vision restoration: an analysis of attitudes and associated factors towards cornea donation in Syria
Authors: Soqia Jameel , Alhomsi Rawan , Ataya Jamal , Al-Mashhour Obaida , Hamzeh Farah , Hamwy Romeo , Sulayman Siba , Alhomsi Nadimah , Hamzeh Ammar 
Published: May 2023

ObjectiveThis study aims to assess attitudes and associated factors towards cornea donation among visitors of a main public hospital in Damascus. Findings of this study can contribute to the development of effective donation campaigns and applying cornea donation in Syria.MethodsThis cross-sectional study included individuals who were above 18 years old and were visitors of Al-Mouwasat University Hospital in Damascus, Syria. Data were gathered using a questionnaire administered through face-to-face interviews with the participants. A validated questionnaire was used and consisted of three sections: demographic information, awareness assessment and evaluation of participants’ attitudes towards corneal donation. Associations between participants’ demographics and variables were tested using χ2test, and a p value of <0.05 was considered significant.Results637 participants were randomly interviewed. 70.8% of the sample were female and 45.7% have heard about cornea donation. 68.3% of the participants accepted donation of their cornea after death, but this decreased to 56.2% when it comes to donation from relatives after their death. The main reasons for refusing and accepting cornea donation were religious beliefs (10.8%) and intention to help others (65.8%), respectively. Women were more likely to accept donation after death than men (71.4% vs 60.8%, p=0.009). Finally, acceptance of cornea donation would increase if participants lived in a more developed country (71.7% vs 68.3%).ConclusionDespite the high willingness, corneal donation in Syria is still not enough. Corneal donation requires an ensured donation system that supports and organises the processes, a simplified education about the importance of donation, and clarifying the right instructions of religion.
Can running-related injuries be prevented through an online behavioural intervention in adult novice runners? Results of a randomised controlled trial
Authors: van der Does Henrike , Kemler Ellen , Gouttebarge Vincent 
Published: May 2023

ObjectiveTo evaluate the effectiveness of the Runfitcheck on time until the onset of a new running-related injury (RRI) among adult novice runners.MethodsA three-arm randomised controlled trial was conducted over 7 months. Adult novice runners completed a baseline online questionnaire on their characteristics, running activity, RRIs and injury preventive behaviour. Runners were randomly allocated to one of two intervention groups or the control group (n=238). One intervention group obtained access to the Runfitcheck (n=252), an online intervention to encourage injury preventive behaviour, and was fortnightly promoted to use Runfitcheck; the other intervention group (n=251) was directed towards the Runfitcheck once. Runners were followed for 4 months, not all starting at the same time over 7 months. The main outcome measure was time to a new RRI using the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire, and was analysed with survival analysis Cox regression. Generalised estimating equations (GEE) were used to gain insight into the effectiveness of the Runfitcheck.ResultsThe time to the occurrence of the first RRI did not differ between the study groups (Wald χ2=0.893). GEE analysis showed no difference in the risk of a new RRI in the group that was referred to the Runfitcheck once (OR 1.22, 95% CI 0.86 to 1.74) nor in the active approach group (OR 1.01, 95% CI 0.71 to 1.45) compared with the control group. Furthermore, the onset of the new RRIs did not change over time (OR 0.96, 95% CI 0.91 to 1.01).ConclusionsThe online intervention Runfitcheck was ineffective in reducing the instantaneous risk of new RRIs in adult novice runners. More research is needed to determine how injuries in novice runners can be prevented.Trial registration numberDutch Trial Registry (ID: NL7823).
What evidence is needed to inform postoperative opioid consumption guidelines? A cohort study of the Michigan Surgical Quality Collaborative
Authors: Song Jiyeon , Li Yi , Waljee Jennifer F , Gunaseelan Vidhya , Brummett Chad M , Englesbe Michael J , Bicket Mark C 
Published: May 2023

IntroductionTo balance adequate pain management while minimizing opioid-related harms after surgery, opioid prescribing guidelines rely on patient-reported use after surgery. However, it is unclear how many patients are required to develop precise guidelines. We aimed to compare patterns of use, required sample size, and the precision for patient-reported opioid consumption after common surgical procedures.MethodsWe analyzed procedure-specific 30-day opioid consumption data reported after discharge from 15 common surgical procedures between January 2018 and May 2019 across 65 hospitals in the Michigan Surgical Quality Collaborative. We calculated proportions of patients using no pills and the estimated number of pills meeting most patients’ needs, defined as the 75th percentile of consumption. We compared several methods to model consumption patterns. Using the best method (Tweedie), we calculated sample sizes required to identify opioid consumption within a 5-pill interval and estimates of pills to meet most patients’ needs by calculating the width of 95% CIs.ResultsIn a cohort of 10,688 patients, many patients did not consume any opioids after all types of procedures (range 20%–40%). Most patients’ needs were met with 4 pills (thyroidectomy) to 13 pills (abdominal hysterectomy). Sample sizes required to estimate opioid consumption within a 5-pill wide 95% CI ranged from 48 for laparoscopic appendectomy to 188 for open colectomy. The 95% CI width for estimates ranged from 0.7 pills for laparoscopic cholecystectomy to 7.0 pills for ileostomy/colostomy.ConclusionsThis study demonstrates that profiles of opioid consumption share more similarities than differences for certain surgical procedures. Future investigations on patient-reported consumption are required for procedures not currently included in prescribing guidelines to ensure surgeons and perioperative providers can appropriately tailor recommendations to the postoperative needs of patients.
No microplastics detected in the first assessment of Atlantic walrus stomachs from Nunavut, Canada
Authors: Jardine Alexander M. , Matthews Cory J.D. , Provencher Jennifer F. , Hornby Claire , Gamberg Mary , Bourdages Madelaine P.T. , Alexander David , Naullaq Manasie , Vermaire Jesse C. 
Published: May 2023

As plastic pollution continues to persist at a global level, the Arctic has drawn increased research interest as a possible sink for marine pollutants. Plastic and microplastics are highly durable and can be transported across vast distances. To date, only a handful of studies have directly assessed microplastics in Arctic mammals. In Canada, it is still unclear whether they show a concrete propensity for microplastic retention and ingestion. Atlantic walruses ( Odobenus rosmarus rosmarus (Linnaeus, 1758)) are economically and culturally important for Inuit and are key predators in Arctic marine ecosystems. Here, we present the first assessment of microplastic pollution in Canadian walruses and the first gastrointestinal assessment of microplastic in walruses globally. Since microplastics accumulate in benthic sediment and animals, we expected that walruses may ingest and retain microplastic contaminants when sifting in search of prey or when eating contaminated bivalves and invertebrates. We detected no microplastics ≥80 µm in our evaluation of 36 walruses from five communities in NU, Canada. Our results suggest that walruses in this region do not retain microplastic particles ≥80 µm in their stomachs, which is consistent with findings in other pinnipeds that have been evaluated in Arctic Canada.
Protective role of VEGF/VEGFR2 against mitochondrial dysfunction that underpins high fatality associated with hepatic encephalopathy
Authors: Tsai Ching-Yi 
Published: May 2023

Hepatic encephalopathy (HE) is a neurological complication arising from acute liver failure and is associated with high mortality. Clinical reports showed that the degree of baroreflex dysregulation is related to the severity of HE. Furthermore, mitochondrial dysfunction in the rostral ventrolateral medulla (RVLM), a key neural substrate that maintains blood pressure and sympathetic vasomotor tone, is known to underpin impairment of baroreflex. In addition to angiogenic and vasculogenic effects, vascular endothelial growth factor (VEGF) and its receptor (VEGFR2) elicits neuroprotection by maintaining mitochondrial function, and the guiding hypothesis of this study is that the VEGF/VEGFR2 signaling plays a protective role against mitochondrial dysfunction in the RVLM to ameliorate baroreflex dysregulation that underpins the high fatality associated with HE. In this study, we were carried out in proof-of-concept experiments using an in vitro model of HE that involved incubation of cultured mouse neurons with ammonium chloride. Corroboratory experiments were subsequently performed using an azoxymethane-induced acute liver failure model of HE in adult male C57BL/6 mice and VEGFR2 wild-type and heterozygous mice. We demonstrated that VEGFR2 is present in cultured neurons, and observed that whereas recombinant VEGF maintained cell viability, gene-knockdown of vegfr2 enhanced the reduction of cell viability. In mouse model of HE, we found that VEGFR2 heterozygous mice exhibited shorter survival rate and time when compared to wild-type mice. In C57BL/6 mice, results from 31P magnetic resonance spectroscopy chemical shift imaging obtained from mouse brainstem showed reduced ratio between phosphocreatine and γATP, indicating mitochondrial dysfunction during HE. Furthermore, there was a progressive reduction in VEGFR2 mRNA and protein expression, mitochondrial membrane potential and ATP levels, alongside augmentation of apoptotic cell death in the RVLM, accompanied by a decrease in baroreflex-mediated sympathetic vasomotor tone and hypotension. Loss-of-function of VEGF by immunoneutralization exacerbated mitochondrial membrane potential reduction or apoptotic cell death during HE. We therefore suggest that, acting via VEGFR2, the endogenous VEGF plays a protective role against high fatality associated with HE by amelioration of baroreflex dysregulation through sustaining mitochondrial bioenergetics functions and eliciting anti-apoptotic action in the RVLM. This study was supported by research grants from the National Science and Technology Council, Taiwan (NSTC-106-2320-B-182A-014-MY3 and NSTC-109-2320-B-182A-007-MY3) and the Chang Gung Medical Foundation, Taiwan (CLRPG8J0031-3). This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.
The protective effect of Allium Cepa against kidney stones diseases in rat model
Authors: Wahid Reham , Hassan Nancy , Samy Walaa , FaragAllah Eman , El-Malkey Nanees , Talaat Aliaa , Malek Mahmoud 
Published: May 2023

Background and aim: Kidney stone disease (KSD) is considered one of the serious medical problems, despite recent management methods for kidney stones, there are many undesired consequences, thus recent literatures highlight the great need for natural compounds for safe, effective and affordable management of KSD. So, we aimed in this study to investigate the protective effect of Allium cepa administration against both stone formation process and its kidney injury effect. Hypothesis: Allium cepa administration has a beneficial role against renal stones formation and subsequent renal injury. Methods: 24 adult male albino rats were assigned into 3 groups; group I: control group; group II: received 0.75% ethylene glycol in the drinking water for 4 weeks; and group III received 0.75% EG in the drinking water plus freshly prepared Allium Cepa extract (ACE) 5ml/kg administration using intragastric tube for 4 weeks. The concentrations of creatinine and BUN in serum were measured, and urine analysis was done to assess creatinine clearance, proteinuria and kidney injury molecule-1 (KIM-1) levels. Tissue oxidative stress markers (SOD and MDA) were assessed, and kidney expression of SIRT-1, Beclin, LC3, osteopontin, and Regucalcin were measured by RT-qPCR. Histopathological assessment using Semi-thin Toluidine Blue Staining was done and immunohistochemistry for Bax, Beclin-1 and TNF-α markers was performed. Results: There was a significant increase of creatinine clearance value (P<0.05) with low serum creatinine and BUN levels in the ACE received group compared to EG group (P<0.001), in addition to decreased proteinuria and urine KIM levels in the ACE received group compared to EG group (P<0.001). The present study showed less stone formation, damage and apoptosis in the ACE received group compared to EG group (P<0.001). Moreover, the ACE received group showed significant lower expression of osteopontin and autophagy genes, but higher expression of regucalcin and SIRT-1 genes compared to the EG group (P<0.001). Regarding oxidative stress and inflammatory markers, MDA, TNF-α and mast cells filtration were significantly lower and SOD was significantly higher in the ACE received group than their levels in EG group (P<0.001). Conclusion: Alium Cepa extract administration has a significant protective effect against formation of renal stones and a great beneficial effect against renal injury in KSD. There were no external funding sources for this study, it is self-funding This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.
Impact of aging on the response to mechanical ventilation in mice
Authors: Veldhuizen Ruud , Manji Aminmohamed , Troitskaya Alexandra , McCaig Lynda , Pape Cynthia , Gill Sean 
Published: May 2023

Mechanical ventilation is a critical, life-saving therapy that can also negatively impact the lung by affecting edema formation, surfactant metabolism and function, and the release of inflammatory mediators. Outcomes in elderly patients requiring ventilation are generally worse than in younger patients; however, the impact that age has on the response to mechanical ventilation has not been explored in detail. We hypothesized that aged mice would have an altered response to mechanical ventilation compared to young mice.To test our hypothesis male mice of 2-3 (young) and 22-23 (aged) months of age were mechanically ventilated at a tidal volume of 20ml/kg for 3 hours. Subsequently, lungs were lavaged and the lavage fluid was analyzed for total protein and IgM to assess edema, surfactant amounts and function, and the concentration of inflammatory mediators. Frozen lung tissue was used for qPCR analysis of inflammatory mediators. Separate cohorts of young and aged mice were used as non-ventilated controls.Our results showed that protein and IgM concentrations in the lavage fluid were significantly higher in aged-ventilated as compared to the young-ventilated group. Although surfactant levels were similar between young and aged mice, the function of the surfactant was significantly impaired in aged-ventilated as compared to the young-ventilated group. The lavage concentrations of pro-inflammatory mediators (IL6, IL1β, CXCL1, CXCL2, and CCL2) were significant lower in aged-ventilated as compared to the young-ventilated mice, with mRNA levels following a similar pattern. Further, the MRNA levels of inflammatory mediators in non-ventilated animals were markedly lower than in ventilated animals.In conclusion, the response to mechanical ventilation is affected by age. Since surfactant impairment and edema formation contribute to the severity of lung injury, the data for these outcomes suggest a more harmful response in the aged animals. Overwhelming inflammation has also been associated with augmented lung injury. The reduced level of inflammation in the aged mice implies altered inflammatory responses; the impact of this on overall outcomes during mechanical ventilation requires further investigation. Canadian Institute of Health Research; Western University This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.