bluuebunny/crossref_metadata_2025_split huggingface dataset:
Professional development from the perspective of new-graduate physiotherapists within Australian hospital settings: A qualitative study
Authors: Tan Shaun , Phan Andrew , Martin Romany , Mandrusiak Allison , Forbes Roma 
Published: January 2023

Introduction: The transition from physiotherapy student to clinician within hospital settings has been identified as overwhelming, leaving new graduates experiencing significant anxiety and stress. Professional development plays a major role in facilitating the transition from student to clinician. However, the perceived professional development needs of new graduates in hospital settings and the factors that influence graduates’ decision-making regarding professional development remain relatively unknown. The aim of this study was to explore the professional development needs of new-graduate physiotherapists working in hospital settings and to explore graduates’ decision-making relating to engagement in professional development.
Methods: A qualitative study utilising a general inductive approach was undertaken to investigate new-graduate physiotherapists’ experiences. Telephone interviews were conducted with 15 new-graduate participants, and data were subject to thematic analysis.
Results: Five key themes regarding hospital-based new-graduate physiotherapists’ professional development needs and decision-making were generated following analysis: 1) practical and clinical relevance, 2) influence from external supports, 3) translation to practice, 4) accessing professional development and 5) professional development for the future. This provided insight regarding the challenges faced in accessing professional development during the transition from student to clinician.
Conclusions: This study has highlighted the complexity of new-graduate physiotherapists’ decision-making and perceived needs surrounding professional development within the hospital setting. New-graduate physiotherapists perceived that the hospital workplace provided sufficient resources for professional development. However, guidance from supervisors and colleagues within the hospital workplace was highly valued by new graduates when choosing professional development, including informal professional development opportunities. Research is needed to further understand the role of professional development of physiotherapists in hospital settings.
Place of death and associated factors among reviewed maternal deaths in Ethiopia: a generalised structural equation modelling
Authors: Tesfay Neamin , Tariku Rozina , Zenebe Alemu , Habtetsion Medhanye , Woldeyohannes Fitsum 
Published: January 2023

ObjectiveThe study aims to determine the magnitude and factors that affect maternal death in different settings.Design, setting and analysisA review of national maternal death surveillance data was conducted. The data were obtained through medical record review and verbal autopsies of each death. Generalised structural equation modelling was employed to simultaneously examine the relationships among exogenous, mediating (urban/rural residence) and endogenous variables.OutcomeMagnitude and factors related to the location of maternal death.ParticipantsA total of 4316 maternal deaths were reviewed from 2013 to 2020.ResultsFacility death constitutes 69.0% of maternal deaths in the reporting period followed by home death and death while in transit, each contributing to 17.0% and 13.6% of maternal deaths, respectively. Educational status has a positive direct effect on death occurring at home (β=0.42, 95% CI 0.22 to 0.66), obstetric haemorrhage has a direct positive effect on deaths occurring at home (β=0.41, 95% CI 0.04 to 0.80) and death in transit (β=0.68, 95% CI 0.48 to 0.87), while it has a direct negative effect on death occurring at a health facility (β=−0.60, 95% CI −0.77 to −0.44). Moreover, unanticipated management of complication has a positive direct (β=0.99, 95% CI 0.34 to 1.63), indirect (β=0.05, 95% CI 0.04 to 0.07) and total (β=1.04, 95% CI 0.38 to 1.70) effect on facility death. Residence is a mediator variable and is associated with all places of death. It has a connection with facility death (β=−0.70, 95% CI −0.95 to −0.46), death during transit (β=0.51, 95% CI 0.20 to 0.83) and death at home (β=0.85, 95% CI 0.54 to 1.17).ConclusionAlmost 7 in 10 maternal deaths occurred at the health facility. Sociodemographic factors, medical causes of death and non-medical causes of death mediated by residence were factors associated with the place of death. Thus, factors related to the place of death should be considered as an area of intervention to mitigate preventable maternal death that occurred in different settings.
Fixed dose combination drugs for cardiovascular disease in a prolonged humanitarian crisis in Lebanon: an implementation study
Authors: Ansbro Éimhín , Masri Sahar , Prieto-Merino David , Willis Ruth , Aoun Bahous Sola , Molfino Lucas , Boulle Philippa , Perel Pablo 
Published: January 2023

ObjectivesThis pre–post implementation study evaluated the introduction of fixed dose combination (FDC) medications for atherosclerotic cardiovascular disease (ASCVD) secondary prevention into routine care in a humanitarian setting.SettingTwo Médecins sans Frontières (MSF) primary care clinics serving Syrian refugee and host populations in north Lebanon.ParticipantsConsenting patients ≥18 years with existing ASCVD requiring secondary prevention medication were eligible for study enrolment. Those with FDC contraindication(s) or planning to move were excluded. Of 521 enrolled patients, 460 (88.3%) were retained at 6 months, and 418 (80.2%) switched to FDC. Of these, 84% remained on FDC (n=351), 8.1% (n=34) discontinued and 7.9% (n=33) were lost to follow-up by month 12.InterventionsEligible patients, enrolled February–May 2019, were switched to Trinomia FDC (atorvastatin 20 mg, aspirin 100 mg, ramipril 2.5/5/10 mg) after 6 months’ usual care. During the study, the COVID-19 pandemic, an economic crisis and clinic closures occurred.Outcome measuresDescriptive and regression analyses compared key outcomes at 6 and 12 months: medication adherence, non-high density lipoprotein cholesterol (non-HDL-C) and systolic blood pressure (SBP) control. We performed per-protocol, intention-to-treat and secondary analyses of non-switchers.ResultsAmong 385 switchers remaining at 12 months, total adherence improved 23%, from 63% (95% CI 58 to 68) at month 6, to 86% (95% CI 82 to 90) at month 12; mean non-HDL-C levels dropped 0.28 mmol/L (95% CI −0.38 to −0.18; p<0.0001), from 2.39 (95% CI 2.26 to 2.51) to 2.11 mmol/L (95% CI 2.00 to 2.22); mean SBP dropped 2.89 mm Hg (95% CI −4.49 to −1.28; p=0.0005) from 132.7 (95% CI 130.8 to 134.6) to 129.7 mm Hg (95% CI 127.9 to 131.5). Non-switchers had smaller improvements in adherence and clinical outcomes.ConclusionImplementing an ASCVD secondary prevention FDC improved adherence and CVD risk factors in MSF clinics in Lebanon, with potential for wider implementation by humanitarian actors and host health systems.
Behavioural Economics to Improve Antihypertensive Therapy Adherence (BETA): protocol for a pilot randomised controlled trial in Los Angeles
Authors: Ebinger Joseph E , Ghai Ishita , Barajas Denisse , Vallejo Rocío , Blyler Ciantel A , Morales Michelle , Garcia Nairy , Joung Sandy , Palimaru Alina , Linnemayr Sebastian 
Published: January 2023

IntroductionNon-adherence to antihypertensive therapy is one of the major barriers to reducing the risk of cardiovascular disease. Several interventions have targeted higher medication adherence, yet most do not result in sustained adherence. Routinisation has emerged as a potential method for mitigating this problem, but requires high motivation during the relatively long habit formation phase. This pilot randomised controlled trial aims to test the feasibility, acceptability, and preliminary efficacy of behavioural economics-based incentives and text messages to support the routinisation of the medication-taking behaviour for promoting long-term medication adherence.Methods and analysisThis study will recruit and randomly assign 60 adult patients seeking care for hypertension at the Cedars-Sinai Medical Center in Los Angeles to one of the three groups,Control(n=20),Messages(n=20) andIncentives(n=20) in a 1:1:1 ratio. All participants will receive information about the importance of routinisation and will select an existing behavioural routine (‘anchor’) to which they will tie their pill-taking to, and the corresponding time. Additionally, participants in theMessagesgroup will receive daily text messages reminding them of the importance of routines, while those in theIncentivesgroup will receive daily text messages and conditional prize drawings. The interventions will be delivered over three months. Participants will be followed for six months post-intervention to measure behavioural persistence. Surveys will be administered at baseline, month-3 and month-9 visits. Primary outcomes include: (1) electronically measured mean medication adherence during the intervention period and (2) post-intervention period; and (3) mean timely medication adherence based around the time of the participants’ anchor during the intervention period, and (4) post-intervention period.Ethics and disseminationThe study was approved by the Cedars-Sinai Institutional Review Board (Study ID: Pro00057764). Findings will be published in scientific peer-reviewed journals.Trial registration numberNCT04029883.
Preferences, barriers and facilitators regarding virtual pelvic healthcare in individuals with gynaecological cancers: protocol for a patient-oriented, mixed-methods study
Authors: Bernard Stéphanie , Tandon Puneeta , Waters Alexandra , Selmani Sabrina , Wiebe Ericka , Turner Jill , Dufour Sinead , McNeely Margaret L 
Published: January 2023

IntroductionVaginal pain during intercourse and urinary incontinence are common complaints after gynaecological cancer treatments. Pelvic health physiotherapy treatments aim at optimising function through education on the use of vaginal moisturisers, dilation therapy programme and pelvic floor muscle training. Given that barriers such as time, travel, and costs are known to limit access to physiotherapy services, a virtual pelvic health physiotherapy programme may help to facilitate access. The primary objective of this study is to identify preferences, barriers and facilitators from individuals with gynaecological cancer regarding virtual pelvic healthcare survivorship care.Methods and analysisThis patient-oriented, mixed-methods study will involve an online cross-sectional survey data (phase I) and qualitative data from a series of virtual focus groups (phase II). Phase I: an anonymous survey will be used to assess the demographics, health status, prevalence of urogenital symptoms, as well as knowledge, barriers and facilitators to pelvic health services of people with gynaecological cancer. A total of N=50 participants from Canada will be recruited through convenience and self-selection sampling. Phase II: a series of virtual semi-structured focus groups will be conducted with 10–15 participants on key topics related to virtual pelvic healthcare. Interviews will be audio-recorded and transcribed, from which key themes and quotes will be identified. An interpretive description qualitative method will guide analysis and implementation of results.Ethics and disseminationApproval from the Health Research Ethics Board of Alberta—Cancer Committee (HREBA.CC-21-0498) and of the CISSS Bas-Saint-Laurent (CISSSBSL-2021-10) have been obtained. Informed, electronically signed consent will be required from all participants. Results from this work will be published in a peer-reviewed journal and will be used to inform the development and implementation of a new Pelvic eHealth Module for individuals treated for gynaecological cancers. This module will be incorporated into a comprehensive educational and exercise programme offered by a web-based application.
Thyroid function screening and follow-up of children with abdominal distension in Nanjing, China: a cross-sectional study
Authors: Xie Hang , Chen Dongmei , Gu Wei , Li Wei , Wang Xu , Tang Weibing 
Published: January 2023

ObjectiveTo describe the thyroid function test among children with abdominal distention and to follow up the treatment received by children with abnormal thyroid function.DesignCross-sectional study.Setting and participantsA total of 1089 children (median age:30 days (IQR=21–60 days) with abdominal distension were included in this single centre study in Nanjing, China.ResultThyroid dysfunction was found in 43 of 148 Hirschsprung’s disease (HSCR) cases, with 3 (2.03%) having hypothyroidism, 3 (2.03%) having subclinical hypothyroidism and 3 (2.03%) having subclinical hyperthyroidism. Thyroid dysfunction was found in 206 of 941 functional abdominal distension cases, with 4 (0.43%) having hypothyroidism, 23 (2.4%) having subclinical hypothyroidism, 28 (2.9%) having subclinical hyperthyroidism and 1 (0.11%) having hyperthyroidism. Among total 65 cases (9 from HSCR, 56 from functional abdominal distension) diagnosed with thyroid diseases, 12 were treated with levothyroxine (LT-4), of which 9 were discontinued treatment at about 2 years old, and 3 were still receiving LT-4. Thirty-two cases received no treatment and thyroid function returned to normal in about 1 month. Twenty-one cases were lost during the follow-up.ConclusionThe paediatrician should be vigilant for hypothyroidism when dealing with children with abdominal distension. Thyroid function should be followed up rather than simply administering a short-term levothyroxine treatment.
Improvement and implementation of a national individual care plan in paediatric palliative care: a study protocol
Authors: Joren Chantal Y , Kars Marijke C , Kremer Leontien C M , Rippen Hester , Verhagen A A Eduard , Aris-Meijer Judith L 
Published: January 2023

IntroductionPaediatric palliative care (PPC) is care for children with life-threatening or life-limiting conditions, and can involve complex high-tech care, which can last for months or years. In 2015, the National Individual Care Plan (ICP) for PPC was developed and has shown to be successful. The ICP can be seen as an instrument to facilitate coordination, quality and continuity of PPC. However, in practice, an ICP is often completed too late and for too few children. We aim to improve the coordination, quality and continuity of care for every child with a life-threatening or life-limiting condition and his/her family by further developing and implementing the ICP in the Netherlands.Methods and analysisTo evaluate the original ICP, ICP 1.0, interviews and questionnaires will be held among parents of children who have or have had an ICP 1.0 and healthcare professionals (HCPs) who used ICP 1.0. Based on the results, ICP 1.0 will be further developed. An implementation strategy will be written and the renewed ICP, ICP 2.0, will be nationally tested in an implementation period of approximately 7 months. During the implementation period, ICP 2.0 will be used for all children who are registered with Children’s Palliative Care teams. After the implementation period, ICP 2.0 will be evaluated using interviews and questionnaires among parents of children who received ICP 2.0 and HPCs who worked with ICP 2.0. Based on these results, ICP 2.0 will be further optimised into the final version: ICP 3.0.Ethics and disseminationThis study received ethical approval. The ICP 3.0 will be disseminated through the Dutch Centre of Expertise in Children’s Palliative Care, to ensure wide availability for the general public and HCPs within PPC. Additionally, we aim to publish study results in open-access, peer-reviewed journals and to present results at national and international scientific meetings.
Attributes, skills and actions of clinical leadership in nursing as reported by hospital nurses: a cross-sectional study
Authors: Mrayyan Majd T , Algunmeeyn Abdullah , Abunab Hamzeh Y , Kutah Ola A , Alfayoumi Imad , Khait Abdallah Abu 
Published: January 2023

BackgroundResearch shows a significant growth in clinical leadership from a nursing perspective; however, clinical leadership is still misunderstood in all clinical environments. Until now, clinical leaders were rarely seen in hospitals’ top management and leadership roles.PurposeThis study surveyed the attributes and skills of clinical nursing leadership and the actions that effective clinical nursing leaders can do.MethodsIn 2020, a cross-sectional design was used in the current study using an online survey, with a non-random purposive sample of 296 registered nurses from teaching, public and private hospitals and areas of work in Jordan, yielding a 66% response rate. Data were analysed using descriptive analysis of frequency and central tendency measures, and comparisons were performed using independent t-tests.ResultsThe sample consists mostly of junior nurses. The ‘most common’ attributes associated with clinical nursing leadership were effective communication, clinical competence, approachability, role model and support. The ‘least common’ attribute associated with clinical nursing leadership was ‘controlling’. The top-rated skills of clinical leaders were having a strong moral character, knowing right and wrong and acting appropriately. Leading change and service improvement were clinical leaders’ top-rated actions. An independent t-test on key variables revealed substantial differences between male and female nurses regarding the actions and skills of effective clinical nursing leadership.ConclusionsThe current study looked at clinical leadership in Jordan’s healthcare system, focusing on the role of gender in clinical nursing leadership. The findings advocate for clinical leadership by nurses as an essential element of value-based practice, and they influence innovation and change. As clinical leaders in various hospitals and healthcare settings, more empirical work is needed to build on clinical nursing in general and the attributes, skills and actions of clinical nursing leadership of nursing leaders and nurses.
Efficient solar hydrogen production of zinc trimesityl porphyrin-based photocatalysts
Authors: Agapaki Eleni , Ladomenou Kalliopi , Nikolaou Vasilis , Coutsolelos Athanassios G. 
Published: January 2023

Dye-sensitized photocatalytic systems (DSPs) have emerged as a promising strategy to achieve efficient and stable solar-driven H2 evolution systems. In this work, we prepared and tested a series of zinc-trimesityl porphyrin carboxylic acid derivatives as photosensitizes in DSPs for H2 evolution. In order to unveil the influence of the anchoring group, different positions of the carboxylic acid were studied. All porphyrins were adsorbed onto platinum-doped titanium dioxide nanoparticles (Pt-TiO2 NPs) and were irradiated by a white LED source. The DSPs coated with Zn-TM(pCOOH)P(i.e. the carboxylic acid at the para-phenyl position) illustrated increased stability (2514 TONs for 1.0 × 10[Formula: see text] M) and the highest H2 evolution activity (1959 mmol g[Formula: see text] h[Formula: see text] for 1.5 × 10[Formula: see text] M). These results reveal that efficient and stable DSPs for H2 evolution can be developed by utilizing porphyrin derivatives as photosensitizers.
Redundant Signaling as the Predominant Mechanism for Resistance to Antibodies Targeting the Type-I Insulin-Like Growth Factor Receptor in Cells Derived from Childhood Sarcoma
Authors: Shackleford Terry J. , Hariharan Seethalakshmi , Vaseva Angelina V. , Alagoa Karina , Espinoza Maricruz , Bid Hemant K. , Li Fuyang , Zhong Haihong , Phelps Doris A. , Roberts Ryan D. , Cam Hakan , London Cheryl A. , Guttridge Denis C. , Chen Yidong , Rao Manjeet , Shiio Yuzuru , Houghton Peter J. 
Published: January 2023

AbstractAntibodies targeting insulin-like growth factor 1 receptor (IGF-1R) induce objective responses in only 5% to 15% of children with sarcoma. Understanding the mechanisms of resistance may identify combination therapies that optimize efficacy of IGF-1R–targeted antibodies. Sensitivity to the IGF-1R–targeting antibody TZ-1 was determined in rhabdomyosarcoma and Ewing sarcoma cell lines. Acquired resistance to TZ-1 was developed and characterized in sensitive Rh41 cells. The BRD4 inhibitor, JQ1, was evaluated as an agent to prevent acquired TZ-1 resistance in Rh41 cells. The phosphorylation status of receptor tyrosine kinases (RTK) was assessed. Sensitivity to TZ-1 in vivo was determined in Rh41 parental and TZ-1–resistant xenografts. Of 20 sarcoma cell lines, only Rh41 was sensitive to TZ-1. Cells intrinsically resistant to TZ-1 expressed multiple (&gt;10) activated RTKs or a relatively less complex set of activated RTKs (∼5). TZ-1 decreased the phosphorylation of IGF-1R but had little effect on other phosphorylated RTKs in all resistant lines. TZ-1 rapidly induced activation of RTKs in Rh41 that was partially abrogated by knockdown of SOX18 and JQ1. Rh41/TZ-1 cells selected for acquired resistance to TZ-1 constitutively expressed multiple activated RTKs. TZ-1 treatment caused complete regressions in Rh41 xenografts and was significantly less effective against the Rh41/TZ-1 xenograft. Intrinsic resistance is a consequence of redundant signaling in pediatric sarcoma cell lines. Acquired resistance in Rh41 cells is associated with rapid induction of multiple RTKs, indicating a dynamic response to IGF-1R blockade and rapid development of resistance. The TZ-1 antibody had greater antitumor activity against Rh41 xenografts compared with other IGF-1R–targeted antibodies tested against this model.
Liposome-Encapsulated Eribulin Shows Enhanced Antitumor Activity over Eribulin for Combination Therapy with Anti–PD-1 Antibody
Authors: Niwa Yuki , Adachi Keito , Tabata Kimiyo , Ishida Ryoga , Hotta Koichiro , Ishida Tomomi , Mano Yuji , Ozawa Yoichi , Minoshima Yukinori , Funahashi Yasuhiro , Semba Taro 
Published: January 2023

AbstractEribulin is a microtubule dynamics inhibitor with tumor microenvironment modulation activity such as vascular remodeling activity. Here, we investigated antitumor and immunomodulatory activities of eribulin and its liposomal formulation (eribulin-LF) as monotherapies or in combination with anti–programmed death 1 (PD-1) Ab. The antitumor activity of eribulin or eribulin-LF as monotherapy or in combination with anti–PD-1 Ab was examined in a P-glycoprotein–knockout 4T1 model. Eribulin and eribulin-LF showed stronger antitumor activity in immunocompetent mice compared with immunodeficient mice, indicating that they have immunomodulatory activity that underlies its antitumor activity. Combination therapy of eribulin and eribulin-LF with anti–PD-1 Ab showed antitumor activity, and the combination activity of eribulin-LF with anti–PD-1 Ab was observed at a lower dose and longer interval of administration compared with that using eribulin. To examine the immunomodulatory activity of eribulin and eribulin-LF and its underlying mechanisms, we performed flow cytometry, IHC, and gene expression profiling. IHC and flow cytometry revealed that eribulin-LF increased microvessel density and intratumoral populations of cytotoxic T cells and natural killer cells rather than eribulin. Gene expression profiling demonstrated that eribulin-LF induces IFNγ signaling. Furthermore, IHC also showed that eribulin-LF increased infiltration of CD8-positive cells together with increased CD31-positive cells. Eribulin-LF also increased ICAM-1 expression, which is essential for lymphocyte adhesion to vascular endothelial cells. In conclusion, eribulin showed combination antitumor activity with anti–PD-1 Ab via immunomodulation due to its vascular remodeling activity, and the liposomal formulation showed improved antitumor activity over the standard formulation.