bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences with an integrated screening programme targeted at women who had a hypertensive disorder or diabetes in pregnancy in the Netherlands: a qualitative study
Authors: van Smoorenburg Sam , Kist Janet M , Vos Rimke C , Vos Hedwig M M 
Published: August 2023

ObjectivesPregnancy is a predictor of women’s health later in life. The risk of eventually developing cardiovascular disease (CVD) and/or type 2 diabetes (T2D) increases three to seven times, after pre-eclampsia, hypertension gravidarum or gestational diabetes. The Heart for Women in The Hague project was designed to offer targeted screening to this high-risk population. This research aimed to gather insight regarding the initial experiences of healthcare providers and women with pre-eclampsia, hypertension gravidarum or gestational diabetes.Design and settingThis study applied a qualitative semistructured interview design using an interview guide based on ‘The Consolidated Framework for Implementation Research (CFIR).’ Interviews were recorded, transcribed and coded in accordance with the five main CFIR themes. The setting of the study was primary and secondary care in The Hague, the Netherlands. Interviews were carried out from December 2021 until February 2022. The language was Dutch or English.ParticipantsParticipants (n=13) were women of the target population (n=7) and relevant healthcare professionals (n=6).ResultsHealthcare providers and women were generally positive concerning screening. Healthcare providers agreed that this forgotten group deserves attention and felt that the regional transmural agreement (RTA) provided a clear policy. Women stated that they would like screening to continue and were open-minded regarding lifestyle guidance. Reported barriers included current lack of an easy way of contacting the population after a year, lack of knowledge among the women concerning increased risk, unfamiliarity of new colleagues with the RTA and lack of evidence that screening actually prevents disease.ConclusionImplementation of screening programmes to prevent or delay the development of CVD and/or T2D after complicated pregnancies will likely improve awareness in both patients and healthcare providers. Healthcare providers considered the RTA important because it concerns a forgotten high-risk population. Future research should focus on the improved effectiveness of tailored interventions to delay or prevent CVD.
Effectiveness of acceptance and commitment therapy in patients who had a stroke: a systematic review protocol
Authors: Xu Ke , Zhang Xiao Yan , Ma Jun Yan , Guo Xin , Zhu Shan-Shan , Zhang Huimin , Sun Yu Yan 
Published: August 2023

IntroductionStroke is a common chronic disease with high rates of morbidity and disability and a great burden on patients. As a result, it affects daily activities of patients and causes negative emotions, which seriously affect their quality of life. As a new type of cognitive–behavioural therapy, acceptance and commitment therapy (ACT) may be useful to improve the mental health of patients who had a stroke. This study aimed to systematically evaluate the intervention effect of ACT in patients who had a stroke, which may provide further clinical evidence.Methods and analysisA systematic search of databases, including CNKI, WanFang Data, VIP, CBM, PubMed, Embase, Cochrane Library, CINAHL and APA PsycArticles, will be conducted from their inception to 31 October 2022. All randomised controlled trials, quasi-experiments and case studies relevant to ACT will be included in English and Chinese. Two independent reviewers will conduct the review, with data extraction and quality evaluation. Review Manager V.5.4 will be used to assess the risk of bias and meta-analysis.Ethics and disseminationThis systematic review does not require formal ethical approval, because all data will be analysed anonymously. The results will provide an overall review and evidence of the efficacy of ACT in patients who had a stroke. These findings will be disseminated through peer-reviewed publications.PROSPERO registration numberCRD42022355629.
Defining the capabilities and competencies of high-performing family physicians: a mixed methods study
Authors: Aggarwal Monica , Scott Geoffrey , Kokorelias Kristina Marie , Kulasegaram Kulamakan , Katz Alan , Upshur Ross E G 
Published: August 2023

IntroductionHigh-performing primary care is recognised as the foundation of an effective and efficient healthcare system. Many medical graduates report they are not prepared for independent practice. To date, no research has been conducted to identify the key capabilities and competencies of high-performing family medicine graduates in Canada. This pilot project aims to identify the capabilities and competencies of high-performing early-career family physicians in Ontario, Canada, and explore opportunities for enhancing learning, teaching and assessment within family medicine residency programmes.Methods and analysisEmploying a mixed-methods explanatory sequential study design, this research will use a theory-driven Professional Capability Framework, previously validated in studies across nine professions, to guide the investigation. The first (quantitative) phase involves surveying ~50 high-performing early-career family physicians identified as high performing by educators, colleagues and leaders. The objective of the survey is to identify the key competencies and personal, interpersonal and cognitive capabilities of high-performing family physicians. The second (qualitative) phase involves conducting workshops with stakeholders, including educators, professional associations, regulators and colleges, to test the veracity of the results. Quantitative data will be analysed using descriptive statistics, and qualitative data will be analysed using Braun and Clarke’s thematic analysis. The first and second phases will identify the key capabilities and competencies required to confidently adapt to the independent practice of comprehensive family medicine and inform fit-for-purpose educational strategies for teaching, learning and assessment.Ethics and disseminationThe study is approved by the University of Toronto’s Health Sciences Research Ethics Board (#41799). Research findings will be discussed with professional bodies, educators responsible for family medicine curricula and universities. Study findings will also be disseminated through academic conferences and academic publications in peer-reviewed journals. Project summaries and infographics will be developed and disseminated to key stakeholders.
How is primary care access changing? A retrospective, repeated cross-sectional study of patient-initiated demand at general practices in England using a modern access model, 2019–2022
Authors: Chappell Paul , Dias Alison , Bakhai Minal , Ledger Jean , Clarke Geraldine M 
Published: August 2023

ObjectivesTo explore trends in patient-initiated requests for general practice services and the association between patient characteristics including demographics, preferences for care and clinical needs and modes of patient contact (online vs telephone), and care delivery (face-to-face vs remote) at practices using a modern access model.DesignRetrospective repeated cross-sectional study spanning March 2019 to February 2022.SettingGeneral practices in England using the askmyGP online consultation system to implement a modern general practice access model using digital and non-digital (multimodal) access pathways and digitally supported triage to manage patient-initiated requests.Participants10 435 465 patient-initiated requests from 1 488 865 patients at 154 practices.ResultsMost requests were initiated online (72.1% in 2021/2022) rather than by telephone. Online users were likely to be female, younger than 45 years, asking about existing medical problems, had used the system before and frequent attenders (familiar patients). During the pandemic, request rates for face-to-face consultations fell while those for telephone consultations and online messages increased, with telephone consultations being most popular (53.8% in 2021/2022). Video was seldom requested. More than 60% of requests were consistently delivered in the mode requested. Face-to-face consultations were more likely to be used for the youngest and oldest patients, new medical problems, non-frequent attenders (unfamiliar patients) and those who requested a face-to-face consultation. Over the course of the study, request rates for patients aged over 44 years increased, for example, by 15.4% (p<0.01) for patients aged over 74 years. Rates for younger patients decreased by 32.6% (p<0.001) in 2020/2021, compared with 2019/2020, before recovering to prepandemic levels in 2021/2022.ConclusionsDemand patterns shed light on the characteristics of patients making requests for general practice services and the composition of the care backlog with implications for policy and practice. A modern general practice access model can be used effectively to manage patient-initiated demand.
Sodium bicarbonate for the treatment of severe metabolic acidosis with moderate or severe acute kidney injury in the critically ill: protocol for a randomised clinical trial (BICARICU-2)
Authors: Jung Boris , Huguet Helena , Molinari Nicolas , Jaber Samir 
Published: August 2023

IntroductionWhen both severe metabolic acidemia (pH equal or less than 7.20; PaCO2 equal or less than 45 mm Hg and bicarbonate concentration equal or less than of 20 mmol/L) and moderate-to-severe acute kidney injury are observed, day 28 mortality is approximately 55%–60%. A multiple centre randomised clinical trial (BICARICU-1) has suggested that sodium bicarbonate infusion titrated to maintain the pH equal or more than 7.30 is associated with a higher survival rate (secondary endpoint) in a prespecified stratum of patients with both severe metabolic acidemia and acute kidney injury patients. Whether sodium bicarbonate infusion may improve survival at day 90 (primary outcome) in these severe acute kidney injury patients is currently unknown.Methods and analysisThe sodium bicarbonate for the treatment of severe metabolic acidosis with moderate or severe acute kidney injury in the critically ill: a randomised clinical trial (BICARICU-2) trial is an investigator-initiated, multiple centre, stratified, parallel-group, unblinded trial with a computer-generated allocation sequence and an electronic system-based randomisation. After randomisation, the intervention group will receive 4.2% sodium bicarbonate infusion to target a plasma pH equal or more than 7.30 while the control group will not receive sodium bicarbonate. The primary outcome is the day 90 mortality. Main secondary outcomes are organ support dependences.Ethics and disseminationThe trial has been approved by the appropriate ethics committee (CPP Nord Ouest, Rouen, France, 25 April 2019, number: 19.03.15.72446). Informed consent is required. If sodium bicarbonate improves day 90 mortality, it will become part of the routine care.Trial registration numberNCT04010630.
Lumiares
Authors: Nakamura Alline Alves 
Published: August 2023

O ensaio[1] faz parte de uma pesquisa visual que tem como foco o deslocar por lugares familiares e íntimos, como um processo de redescoberta e de ressignificação do cotidiano através da fotografia. Com Lumiares pretendo revisitar o arquivo desta pesquisa, selecionando imagens que são atentas às fugazes aparições luminosas e ao sentimento de esperança aflorado por essas luminâncias.Palavras-Chave: ensaio, paisagem, fotografia, deslocamento, cotidiano.

[1] A maioria das fotos foi disponibilizada nas redes sociais da autora (Instagram e Facebook), sem estarem na forma de ensaio e com diferentes nuances nos tratamentos de luz, contraste, proporção, cortes e cor. A sexta imagem fez parte do ensaio visual Anteparos, publicado na Revista ARS, v. 18, n. 38, no ano de 2020. Disponível em: https://www.revistas.usp.br/ars/issue/view/11481. Acesso em 10 mar. 2023.
Genetically Predicted Blood Pressure and Cognition in Midlife: A UK Biobank Study
Authors: Lennon Matthew J. , Thalamuthu Anbupalam , Lam Ben Chun Pan , Crawford John D. , Sachdev Perminder S. 
Published: August 2023

BACKGROUND:
This UK Biobank study uses a mendelian randomization approach to mitigate the variability and confounding that has affected previous analyses of the relationship between measured blood pressure (BP) and cognition and thus delineate the true association between the two.

METHODS:
Systolic BP (SBP) and diastolic BP polygenic risk scores (PRSs) were calculated using summary statistics from the International Consortium of Blood Pressure-Genome Wide Association Study (n=299 024). Adjusted nonlinear mixed-effects regression models were used, including a natural splines term for BP-PRS with outcomes of fluid intelligence, reaction time (RT), and composite attention score. Moderating effects of age, sex, and antihypertensive use were assessed in separate models.

RESULTS:

There were 448 575 participants (mean age, 56.3 years; age range, 37–72 years) included in the analysis after genetic and neurological disease exclusions. Genetic propensity for high SBP had an approximately linear association with worsened fluid intelligence (
P
=0.0018). This relationship was significantly moderated by age (
P
<0.0001). By contrast, genetic propensity for high and low SBP and diastolic BP predicted worse attention function (
P
=0.0099 and
P
=0.0019), with high PRSs predicting worse function than low PRSs. Genetic propensity for low SBP and diastolic BP was associated with considerably worse RTs, while for high SBP-PRSs, the RT plateaued (
P
<0.0001). The relationships between RT and the PRSs were significantly moderated by sex (
P
<0.0001) and antihypertensive use (
P
<0.0001).

CONCLUSIONS:
Genetic propensity for high and low BP impacts on midlife cognition in subtle ways and differentially affects cognitive domains. While a genetic propensity to low BP may preserve nontimed tests in midlife, it may come at a trade-off with worsened attention scores and RT.
Evaluating Carlquist’s Law from a physiological perspective
Authors: Johnson Kate M. , Everbach Sophie R. , Holbrook N. Michele , Olson Mark E. 
Published: August 2023

Summary
“Carlquist’s Law” is a striking pattern of association between anatomical features in the wood of vessel-bearing plants. It derives from Sherwin Carlquist’s observation that xylem vessels tend to be solitary when embedded in a matrix of imperforate tracheary elements that appear to be conductive, whereas xylem vessels tend to be grouped when surrounded by seemingly non-conductive cells. Vessel-vessel contacts (vessel grouping) allow water to travel between conduits, but also provide pathways for air to propagate from embolized (air-filled) vessels into functional vessels. If the background matrix is conductive, it is conceivable that water could bypass embolized vessels, providing an alternative transport route in species with conductive backgrounds and solitary vessels. Much remains to be tested in this hypothesis, including the topology of the vessel networks in species with solitary versus grouped vessels and how conductive the different imperforate tracheary element types are. Exploring Carlquist’s Law promises to provide key insight into the causes of embolism in plant conduits, the modes of embolism passage between conduits, and how vessels and the cells in which they are imbedded may interact to govern the pathways of water flow through plants.
Gender and Austronesian Indigenous Identities: Narratives of Women in Seediq Bale and Utu
Authors: Fu Yu-wen 
Published: August 2023

Abstract
As early as 1989, Kimberlé Crenshaw had proposed investigating the interconnection between gender and ethnic identities, especially in her work about black identities. Subsequently, many scholars have extended investigation of the interconnection to the field of Indigenous studies. However, most studies focus on women’s suffering, rather than their active engagement in the process of anti-colonial resistance and Indigenous identity formation. Despite painful colonial histories—including displacement and assimilation—Indigenous peoples have resisted and survived and have been revived. Indigenous women played a crucial part in these processes, but their contributions were often neglected or forgotten. Through analyses of two renowned post-colonial films—Seediq Bale (dir. Wei Te-sheng, 2011) from Taiwan and Utu (dir. Geoff Murphy, 1983) from New Zealand—this essay explores how Seediq and Maori women showed great strength in Austronesian indigenous people’s resistance to colonialism and in their campaign to rewrite history.
Multivariate analysis of medical adhesive-related skin injury at the site of peripherally inserted central catheter insertion in cancer patients: A prospective cohort study
Authors: Yang Yanying , Liu Hongmei , He Mei , Yang Yuwei , Hu Meiling , He Run , Yang Jing 
Published: August 2023

Objective: At the site of peripherally inserted central catheter (PICC) catheterization in tumor patients, medical adhesive-related skin injury (MARSI) was reported related to patient age, infusion of certain chemotherapeutic agents, and tumor type, but did not review its relation to the use of clear patches and the puncture site of PICC. This study aims to analyze the risk factors for MARSI in more detail to provide supported data for reducing MARSI. Method: Total 382 cancer patients receiving catheterization via PICC were involved in this study from March 1, 2021, to September 28, 2021. According to MARSI occurrence or not, they were assigned into MARSI or non-MARSI group. Univariate and multivariate logistic regressions were used to analyze the risks of MARSI occurrence at PICC insertion site. Results: 15% (60 of 382 cases) resulted in MARSI, out of which 8.1% (31/382) was categorized as contact dermatitis, and 7.1% (27/382) as mechanical injuries. The univariate analysis showed that there were significant differences in six aspects of the study, including BMI, MARSI history, dressing types, treatment by paclitaxel or 5-FU versus oxaliplatin, dressing frequency, and catheterization at biceps brachii medial ( p < 0.05). Via multivariate logistic regression analysis, it was discovered that except for previously reported risk factors, dressing change frequency (OR (95% CI) = 7.49 (2.36–23.80), p = 0.001), catheterization at biceps brachii medial (OR (95% CI) = 4.07 (1.82–9.10), p = 0.001), and breast cancer (OR (95% CI) = 3.27 (1.05–10.15), p = 0.041), there were significant risk factors for MARSI occurrence in tumor patients with PICC catheterization. Conclusion: Our study revealed a high incidence of MARSI at the PICC insertion site of cancer patients, presenting with contact dermatitis and mechanical injury. Independent risk factors were previous history of MARSI, a diagnosis of breast cancer, frequent dressing replacement, use of paclitaxel or 5-FU, and PICC catheterization at biceps brachii medial.
Assessment of adequacy and appropriateness of pain management practice among trauma patients at the Ethiopian Aabet Hospital: A prospective observational study
Authors: Ayano Wondwossen Alemu , Fentie Atalay Mulu , Tileku Melaku , Jiru Tilahun , Hussen Shemsu Umer 
Published: August 2023

Abstract
Introduction
Pain is unpleasant sensory and emotional experiences associated with actual and/or potential tissue damage. It is the most common and prevalent reason for emergency departments (ED) visits with prevalence over 70% in the world.

Aim of the Study
The study aimed to assess the adequacy and appropriateness of pain management at Aabet Hospital, Addis Ababa, Ethiopia.

Methods
A hospital-based prospective cross-sectional study was conducted at Aabet hospital from December 1, 2020 to March 30, 2021. Adult trauma patients having pain (at least score 1 on Numeric Rating Scale) with Glasgow Coma Scale score > 13 were eligible to participate in the study. The pain intensity was evaluated at the time of admission (o minute) and then at 60, 120, 180, and 240 minutes. The time of the first analgesics was registered. The adequacy and the appropriateness of the pain management were calculated through pain management index (PMI).

Results
Two hundred thirty-two (232) participants were included in this study of which 126 (54.3%) were admitted due to road traffic accident followed by fall 44(19%). Only 21 (9.1%) study participants received the first analgesic treatment within 30 minutes while 27(11.6%) participants had no treatment at all within 240 minutes. The mean pain intensity score at admission was 5.55 ± 2.32 and reduced to 4.09 ± 2.69. Nearly half 110 (47.4%) of the study participants were treated inadequately (PMI (-) score). There was a weak and negative correlation between PMI and time to analgesia (r = − .159, p = 0.0001). The type of analgesia used, the time to analgesia, and the degree of pain may predict 65% of the variance in PMI score (R2 = 0.65, P = .001).

Conclusion
From the results of this study, it can be concluded that acute pain in trauma patients was under and inappropriately treated.
Anaplastic lymphoma kinase overexpression enhances aggressive phenotypic characteristics of endometrial carcinoma
Authors: Yokoi Ako , Nakamura Yusaku , Hashimura Miki , Oguri Yasuko , Matsumoto Toshihide , Nakagawa Mayu , Ishibashi Yu , Ito Takashi , Ohhigata Kensuke , Harada Youhei , Fukagawa Naomi , Saegusa Makoto 
Published: August 2023

Abstract
Background
Although anaplastic lymphoma kinase (ALK) is overexpressed in several primary solid tumor types, its role in endometrial carcinoma (Em Ca) remains unclear.

Methods
We evaluated expression of ALK and its related molecules in clinical samples consisting of 168 Em Ca tissues. We also used Em Ca cell lines to evaluate the functional role of ALK.

Results
Cytoplasmic ALK immunoreactivity in the absence of chromosomal rearrangement was positively correlated with ALK mRNA expression, and was significantly higher in Grade (G) 3 Em Ca than in G1 or G2 tumors. ALK immunoreactivity was also significantly associated with expression of cancer stem cell (CSC)-related molecules (cytoplasmic CD133, ALDH1, Sox2) and neuroendocrine markers (CD56 and synaptophysin). Although the proliferative index was significantly higher in ALK-positive Em Ca when compared to ALK- negative malignancies, there was no association between ALK expression and other clinicopathological factors in this disease. In Em Ca cell lines, full-length ALK overexpression increased proliferation, decreased susceptibility to apoptosis, enhanced cancer stem cell features, and accelerated cell mobility, whereas these phenotypes were abrogated in ALK-knockdown cells. Finally, patients with tumors harboring either wild-type ALK or high ALK mRNA expression had a poorer prognosis than those with either mutant ALK or low ALK mRNA expression.

Conclusion
Full-length ALK overexpression occurs in a subset of Em Ca, particularly in G3 tumors, and contributes to the establishment and maintenance of aggressive phenotypic characteristics through modulation of several biological processes.