bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changing the Playing Field: A Prehospital Blood Product Pilot Project in Rural North Georgia
Authors: Creel Nathan , Gibson Jesse , Gibson Kyle , Shirley Lissa , Richart Charles 
Published: February 2023

Background In Georgia, the paramedic’s scope of practice prohibited the initiation of blood products. Due to the rural landscape in Georgia, one region’s Regional Trauma Advisory Committee (RTAC) advocated expanding the scope of practice for Georgia’s paramedics to allow them to initiate blood products in the prehospital environment. This study evaluated the safety and feasibility of allowing paramedics to initiate blood products for hemorrhaging patients utilizing a regionally established prehospital blood pilot program. Materials and Methods Approval was obtained from the state medical directors and the Office of EMS and Trauma. The project team addressed product selection, equipment, prehospital service selection, education, policies and procedures, monitoring, and performance improvement. Four EMS services were identified to participate. Liquid plasma was selected due to cost and availability. Equipment was secured for blood storage and temperature monitoring to ensure the hospital’s blood bank could maintain standards for exchange. A transfusion guideline was created, an administrative policy was developed, and an education plan was developed. A process with the trauma center’s blood bank was also instituted to minimize waste and reduce costs. Results and Discussion The pilot project began in spring of 2020, and as of January 2023, there have been 100 field initiations and no adverse effects, demonstrating the safety of paramedics to initiate blood products in the field. A post-licensure skill for paramedics is now available in Georgia for the initiation of blood products. The repeatability of a similar project depends on the resources available, the stakeholder commitment, and the partnerships across disciplines.
Federal Charities Law and the Taxation Power: Three Constitutional Problems
Authors: Aroney Nicholas 
Published: February 2023

AbstractThe Australian Charities and Not-for-Profits Commission Act 2012 and Australian Charities and Not-for-Profits Commission Regulation 2013 have established a comprehensive regulatory framework for the charities and not-for-profit sector at a federal level. When making the Act and Regulation the Commonwealth relied upon several heads of legislative power in section 51 of the Constitution, the most important of which is the taxation power. This article develops and assesses three arguments why the relevant provisions of the legislative scheme are not supported by the taxation power. These arguments are, firstly, that the Act and Regulations do not have a sufficient connection to the subject matter of taxation, secondly, that they are not reasonably capable of being considered appropriate and adapted to achieving a legitimate purpose or object that falls within the taxation power and, thirdly, that in combination with the Income Tax Act 1986 and Income Tax Assessment Act 1997, they impose an obligation to pay money in a manner that is so arbitrary that they cannot be characterised as laws with respect to the subject matter of taxation. It is concluded that these three lines of argument provide strong reasons why the Act and Regulations are not supported by the taxation power.
Against Project Arcadia
Authors: Jenkins David 
Published: February 2023

This essay is part of a special issue celebrating 50 years of Political Theory. The ambition of the editors was to mark this half century not with a retrospective but with a confabulation of futures. Contributors were asked: What will political theory look and sound like in the next century and beyond? What claims might political theorists or their descendants be making in ten, twenty-five, fifty, a hundred years’ time? How might they vindicate those claims in their future contexts? How will the consistent concerns of political theorists evolve into the questions critical for people decades or centuries from now? What new problems will engage the political theorists (or their rough equivalents) of the future? What forms might those take? What follows is one of the many confabulations published in response to these queries. Our earth is approaching its end. Through Project Arcadia our species has a chance at escape. In this paper, I want to argue that Arcadia is all things considered unjustifiable and unadvisable. It is unjustifiable because human beings have proven themselves incapable of stewarding sentient life on planet earth; for example, our collective response to climate change has been dire, handled almost exclusively through adaptation, committing vast areas of the world to desolation, desertification, or disappearance. Basic respect for life, and what we likely will make of some other instances of it, should counsel humility as we contemplate relocating ourselves to other life-supporting domains. It is inadvisable because our species, like the world, is impermanent. We will, at some point, have to contemplate the ceasing of our existence, and it is my argument that we contemplate this ceasing on the terra firm of our own planet. In conclusion, and drawing on the work of Samuel Scheffler and the Japanese concept of mono no aware, I will argue that there is considerable value, admittedly tainted with considerable melancholy, to be had in grasping the opportunity provided by planetary devastation to achieve some semblance of narrative completion.
Sports-Related Concussion Affects Cognitive Function in Adolescents: A Systematic Review and Meta-analysis
Authors: Hou Xianyun , Zhang Yu , Fei Xueyin , Zhou Qian , Li Jie 
Published: February 2023

Background: Rates of sports-related concussion (SRC) are high in adolescents. Ambiguity exists regarding the effect of SRC on cognitive function in adolescents. Purpose: To rigorously examine adolescents’ cognitive function after SRC. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: Web of Science, Scopus, and PubMed were searched from database inception until September 2021. Studies were included if participants were adolescents aged 13 to 18 years, if the definition of SRC was fully consistent with the Berlin Consensus Statement on Concussion in Sport, if the study included a control group or in-group baseline test, and if the study reported cognitive outcomes (eg, visual memory, processing speed) that could be separately extracted. Results: A total of 47 studies were included in the systematic review, of which 31 were included in the meta-analysis, representing 8877 adolescents with SRC. Compared with individuals in the non-SRC group, individuals with SRC had worse performance in cognitive function and reported more symptoms not only in the acute phase but also in the prolonged phase (1-6 months after injury) (visual memory: d = −0.21, 95% CI, −0.37 to −0.05, P = .012; executive function: d = −0.56, 95% CI, −1.07 to −0.06, P = .028; and symptoms: d = 1.17, 95% CI, 0.13 to 2.22, P = .028). Lower scores in most of the outcomes of cognitive function were observed at <3 days and at 3 to 7 days, but higher scores for verbal memory ( d = 0.10; 95% CI, 0.03 to 0.17; P = .008) and processing speed ( d = 0.17; 95% CI, 0.10 to 0.24; P < .001) were observed at 7 to 14 days after SRC relative to baseline. The effects of SRC on cognitive function decreased over time (100% of the variance in reaction time, P < .001; 99.94% of the variance in verbal memory, P < .001; 99.88% of the variance in visual memory, P < .001; 39.84% of the variance in symptoms, P = .042) in control group studies. Study design, participant sex, measurement tools, and concussion history were found to be modulators of the relationship between cognitive function and SRC. Conclusion: This study revealed that adolescent cognitive function is impaired by SRC even 1 to 6 months after injury. Results of this study point to the need for tools to measure cognitive function with multiple parallel versions that have demographically diversiform norms in adolescents. Effective prevention of SRC, appropriate treatment, and adequate evaluation of cognitive function before return to play are needed in adolescent SRC management. Moreover, caution is warranted when using the baseline-to-postconcussion paradigm in return-to-play decisions.
Physical and Extracurricular Activity in Adolescents With and Without ADHD: Examining Group Differences and the Role of Cognitive Disengagement Syndrome Symptoms
Authors: Wiggs Kelsey K. , Thornton Keely , Fredrick Joseph W. , Cusick Caroline N. , Langberg Joshua M. , Becker Stephen P. 
Published: February 2023

Objective: This study examined extracurricular and physical activity related to ADHD (diagnosis and symptoms) and cognitive disengagement syndrome (CDS) symptoms. Methods: Participants were 302 adolescents (ages 12–14) with and without ADHD and primary caregivers. ADHD diagnosis was determined with parent interview. Questionnaires provided information on parent-reported demographic characteristics, ADHD symptoms, and extracurricular activity involvement; and adolescent-reported ADHD and CDS symptoms and indices of physical activity. Results: Although ADHD diagnosis and symptom dimensions were correlated with less extracurricular and physical activity involvement, CDS symptoms were most often independently associated with these outcomes. Females and adolescents from lower income homes also often had less involvement in extracurricular and physical activity. Conclusions: Findings point to the need for more research in this area, careful assessment of risk factors (i.e., CDS symptoms, economic burden), and interventions that address inactivity in adolescents with ADHD, including those that address inequity related to income and sex.
Associations Between ADHD, Sleep Problems, and Mental Health Symptoms in Adolescents
Authors: Loram George , Ling Mathew , Silk Tim , Sciberras Emma 
Published: February 2023

Objective: This study examined associations between objective and subjective sleep parameters, and mental health symptoms (internalizing symptoms, externalizing symptoms, and irritability) and whether these relationships differed for adolescents with and without ADHD. Method: Participants were 373 adolescents aged 10 to 19 years ( M = 13.21, SD = 2.37). Sleep was measured both via actigraphy and self- and parent-report scales. Mental health symptoms were measured via a range of validated measures. Results: Few relationships were detected when examining actigraphy variables. Subjective sleep parameters were associated with almost all mental health variables. Some relationships were moderated by ADHD status, generally consistent with stronger relationships between subjective sleep quality and mental health in the non-ADHD group. Conclusion: Sleep problems, particularly subjective difficulties, are associated with a range of mental health outcomes, regardless of the presence of ADHD. Sleep problems may be a beneficial intervention target for adolescents experiencing mental health issues.
Perception and satisfaction of nephrology education and training in Iraq
Authors: Ali Ala , Al-Omar Dhurgham , Lami Faris , Bhandari Sunil 
Published: February 2023

Background: Interest in training in nephrology is declining around the world. This is a particularly worrisome issue for future nephrology practice with the aging population and the increasing number of patients with kidney disease. We wished to understand the perception and measure the satisfaction of Iraqi medical interns regarding nephrology and explore factors affecting career decisions towards becoming a specialist nephrologist. Methods: A web-based authors-constructed survey consisting of a Likert-type scale questionnaire to assess perception and satisfaction was used. It comprised multiple-choice yes/no/maybe questions and addressed the willingness to pursue a career in nephrology. Iraqi medical interns in their final 2 years of training, 2021–2022, were assessed. Results: One hundred and twenty internal medicine Iraqi fellows participated in the survey (response rate 84.2%). Sixty-eight fellows (74%) described nephrology as a complex science. Acid–base and electrolytes disorders and transplantation were the most challenging topics, followed by glomerular diseases. Twenty-one fellows (23%) were satisfied with the quality of training and nephrology education during their medical school, residency and internship. In addition, 14% stated that they would pursue a future career in nephrology. The most selected barrier (34%) against choosing nephrology was a fellow’s perception of the patient’s complexity and the potentially futile outcome. Conclusion: The majority (76%) of Iraqi medical interns are currently not satisfied with nephrology training and education. One in seven would pursue a future career in nephrology. New targeted innovative approaches are urgently needed for the various grades of trainees to highlight the benefits of nephrology as a career.
Mechanism of Kruppel-Like Factor 4 in Pyroptosis of Nasal Mucosal Epithelial Cells in Mice With Allergic Rhinitis
Authors: Yao Jiaoli , Kong Qingfeng , Wang Yin , Zhang Yanting , Wang Qinxue 
Published: February 2023

Background Allergic rhinitis (AR) is a chronic nasal inflammation, characterized by nasal epithelial dysfunction. Gene therapy targeting transcription factors is a promising strategy for quenching allergic inflammation, including AR. Objective This study sought to probe the mechanism of Kruppel-like factor 4 (KLF4) in pyroptosis of nasal mucosal epithelial cells (NEpCs) in AR mice and provide targets for AR treatment. Methods AR mouse models were established using sensitization with ovalbumin, followed by injection with short hairpin RNA KLF4 (sh-KLF4). AR symptoms were assessed by the times of sneezing and nose rubbing, hematoxylin-eosin, and periodic acid-Schiff staining. Levels of KLF4, nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3), cleaved caspase-1, and N-terminal domain (GSDMD-N) in nasal mucosal tissues were determined by Western blot assay, and levels of interleukin (IL)-1β and IL-18 in nasal lavage fluid were determined by enzyme-linked immunosorbent assay. The binding of KLF4 to the NLRP3 promoter was verified using chromatin immunoprecipitation and dual-luciferase assays. The functional rescue experiment was performed with oe-NLRP3 and sh-KLF4 in AR mice. Results KLF4 was upregulated in nasal mucosal tissues of AR mice. KLF4 inhibition reduced the times of sneezing and nose rubbing, inflammatory cell infiltration, and goblet cell hyperplasia in nasal mucosal tissues, and levels of NLRP3, cleaved caspase-1, GSDMD-N, IL-1β, and IL-18. KLF4 was enriched on the NLRP3 promoter and improved NLRP3 expression. NLRP3 overexpression reversed the inhibition of sh-KLF4 on pyroptosis of NEpCs in AR mice. Conclusion KLF4 bound to the NLRP3 promoter and promoted pyroptosis of NEpCs in AR mice via activating NLRP3.
Magnesium and Fracture Risk in the General Population and Patients Receiving Dialysis: A Narrative Review
Authors: Cowan Andrea C. , Clemens Kristin K. , Sontrop Jessica M. , Dixon Stephanie N. , Killin Lauren , Anderson Sierra , Acedillo Rey R. , Bagga Amit , Bohm Clara , Brown Pierre Antoine , Cote Brenden , Dev Varun , Harris Claire , Hiremath Swapnil , Kiaii Mercedeh , Lacson Eduardo , Molnar Amber O. , Oliver Matthew J. , Parmar Malvinder S. , McRae Jennifer M. , Nathoo Bharat , Quinn Kathleen , Shah Nikhil , Silver Samuel A. , Tascona Daniel J. , Thompson Stephanie , Ting Robert H. , Tonelli Marcello , Vorster Hans , Wadehra Davinder B. , Wald Ron , Wolf Myles , Garg Amit X. 
Published: February 2023

Purpose of Review: Magnesium is an essential mineral for bone metabolism, but little is known about how magnesium intake alters fracture risk. We conducted a narrative review to better understand how magnesium intake, through supplementation, diet, or altering the concentration of dialysate magnesium, affects mineral bone disease and the risk of fracture in individuals across the spectrum of kidney disease. Sources of Information: Peer-reviewed clinical trials and observational studies. Methods: We searched for relevant articles in MEDLINE and EMBASE databases. The methodologic quality of clinical trials was assessed using a modified version of the Downs and Black criteria checklist. Key Findings: The role of magnesium intake in fracture prevention is unclear in both the general population and in patients receiving maintenance dialysis. In those with normal kidney function, 2 meta-analyses showed higher bone mineral density in those with higher dietary magnesium, whereas 1 systematic review showed no effect on fracture risk. In patients receiving maintenance hemodialysis or peritoneal dialysis, a higher concentration of dialysate magnesium is associated with a lower concentration of parathyroid hormone, but little is known about other bone-related outcomes. In 2 observational studies of patients receiving hemodialysis, a higher concentration of serum magnesium was associated with a lower risk of hip fracture. Limitations: This narrative review included only articles written in English. Observed effects of magnesium intake in the general population may not be applicable to those with chronic kidney disease particularly in those receiving dialysis.
Quality of Cancer Care in Tanzania as Experienced by Patients: A Qualitative Study
Authors: Kidayi Paulo L. , Manhica Hélio , Mtuya Christina C. , Johnson Mahande Michael , Furaha Serventi , Aune Ragnhild E. , Björling Gunilla 
Published: February 2023

Introduction Cancer is a disease of public importance in Tanzania. Considering a limited health care system with few cancer centers and low health literacy in general, people are diagnosed at late stage and face difficulties in accessing care for their cancer. All these challenges affect the caring situation for the nurses who meet the patients at the cancer care centers. Objective This study aimed to explore the journey of cancer care experienced by patients with cancer. Research questions: How do patients experience the quality of care at the cancer care centers? How do patients experience the family’s and the community's role? Methods Semi-structured qualitative interviews were carried out with 15 patients treated for colorectal-, breast-, or prostate cancer in three cancer care centers in Tanzania. A purposive sampling was used. Qualitative content analysis according to Graneheim and Lundman was employed. Results Three main themes and six sub-themes emerged. The main themes were e xperiences of cancer care services, the role of the family, community challenges and cancer care. The sub-themes were communication, resource allocation at the cancer care centers, fmily's denial, family challenges, limitations of primary care and misconceptions, and accessibility of cancer service and the health care system. The findings show that patients experienced incapacitated health care facilities for cancer care, misconceptions in the community and challenges for the families. Conclusions The quality of cancer care in Tanzania needs to be improved, patients face challenges in all levels of health care facilities, including families, and the community at large. The distance to oncology care, economic hardship, and lack of knowledge in the community including families, lead to late diagnosis and suffering for the patients. There is a great need for education regarding cancer within healthcare, as well as in the community, to change the situation for patients with cancer.
A study of differential microRNA expression profile in migraine: the microMIG exploratory study
Authors: Gallardo V. J. , Gómez-Galván J. B. , Asskour L. , Torres-Ferrús M. , Alpuente A. , Caronna E. , Pozo-Rosich P. 
Published: February 2023

AbstractBackgroundSeveral studies have described potential microRNA (miRNA) biomarkers associated with migraine, but studies are scarcely reproducible primarily due to the heterogeneous variability of participants. Increasing evidence shows that disease-related intrinsic factors together with lifestyle (environmental factors), influence epigenetic mechanisms and in turn, diseases. Hence, the main objective of this exploratory study was to find differentially expressed miRNAs (DE miRNA) in peripheral blood mononuclear cells (PBMC) of patients with migraine compared to healthy controls in a well-controlled homogeneous cohort of non-menopausal women.MethodsPatients diagnosed with migraine according to the International Classification of Headache Disorders (ICHD-3) and healthy controls without familial history of headache disorders were recruited. All participants completed a very thorough questionnaire and structured-interview in order to control for environmental factors. RNA was extracted from PBMC and a microarray system (GeneChip miRNA 4.1 Array chip, Affymetrix) was used to determine the miRNA profiles between study groups. Principal components analysis and hierarchical clustering analysis were performed to study samples distribution and random forest (RF) algorithms were computed for the classification task. To evaluate the stability of the results and the prediction error rate, a bootstrap (.632 + rule) was run through all the procedure. Finally, a functional enrichment analysis of selected targets was computed through protein–protein interaction networks.ResultsAfter RF classification, three DE miRNA distinguished study groups in a very homogeneous female cohort, controlled by factors such as demographics (age and BMI), life-habits (physical activity, caffeine and alcohol consumptions), comorbidities and clinical features associated to the disease: miR-342-3p, miR-532-3p and miR-758-5p. Sixty-eight target genes were predicted which were linked mainly to enriched ion channels and signaling pathways, neurotransmitter and hormone homeostasis, infectious diseases and circadian entrainment.ConclusionsA 3-miRNA (miR-342-3p, miR-532-3p and miR-758-5p) novel signature has been found differentially expressed between controls and patients with migraine. Enrichment analysis showed that these pathways are closely associated with known migraine pathophysiology, which could lead to the first reliable epigenetic biomarker set. Further studies should be performed to validate these findings in a larger and more heterogeneous sample.