bluuebunny/crossref_metadata_2025_split huggingface dataset:
Practitioners’ views on community implementation of point-of-care ultrasound (POCUS) in the UK: a qualitative interview study
Authors: Akanuwe Joseph N.A , Siriwardena Aloysius Niroshan , Bidaut Luc , Mitchell Pauline , Bird Paul , Lasserson Daniel , Apenteng Patricia , Lilford Richard 
Published: January 2023

Abstract
Background
Implementing Point-of-care ultrasound (POCUS) in community practice could help to decide upon and prioritise initial treatment, procedures and appropriate specialist referral or conveyance to hospital. A recent literature review suggests that image quality, portability and cost of ultrasound devices are all improving with widening indications for community POCUS, but evidence about community POCUS use is needed in the UK. We aimed to explore views of clinical practitioners, actively using ultrasound, on their experiences of using POCUS and potential facilitators and barriers to its wider implementation in community settings in the UK.

Methods
We conducted a qualitative interview study with practitioners from community and secondary care settings actively using POCUS in practice. A convenience sample of eligible participants from different clinical specialties and settings was recruited using social media adverts, through websites of relevant research groups and snowball sampling. Individual semi-structured interviews were conducted online using Microsoft Teams. These were recorded, transcribed verbatim, and analysed using a Framework approach supported by NVivo 12.

Results
We interviewed 16 practitioners aged between 40 and 62 years from different professional backgrounds, including paramedics, emergency physicians, general practitioners, and allied health professionals.
Participants identified key considerations and facilitators for wider implementation of POCUS in community settings in the UK: resource requirements for deployment and support of working devices; sufficient time and a skilled workforce; attention to training, education and support needs; ensuring proper governance, guidelines and quality assurance; workforce considerations; enabling ease of use in assisting decision making with consideration of unintended consequences; and more robust evidence to support perceptions of improved patient outcomes and experience.

Conclusions
POCUS could be useful for improving patient journey and health outcomes in community care, but this requires further research to evaluate outcomes. The facilitators identified could help make community POCUS a reality.
Preoperative and intraoperative assessment of myometrial invasion in patients with FIGO stage I non-endometrioid endometrial carcinoma—a large-scale, multi-center, and retrospective study
Authors: Yang Xiaohang , Yin Jingjing , Fu Yu , Shen Yuanming , Zhang Chuyao , Yao Shuzhong , Xu Congjian , Xia Min , Lou Ge , Liu Jihong , Lin Bei , Wang Jianliu , Zhao Weidong , Zhang Jieqing , Cheng Wenjun , Guo Hongyan , Guo Ruixia , Xue Fengxia , Wang Xipeng , Han Lili , Li Xiaomao , Zhang Ping , Zhao Jianguo , Li Wenting , Dou Yingyu , Wang Zizhuo , Liu Jingbo , Li Kezhen , Chen Gang , Sun Chaoyang , Sun Pengming , Lu Weiguo , Yao Qin 
Published: January 2023

Abstract
Introduction
Myometrial invasion is a prognostic factor for lymph node metastases and decreased survival in non-endometrioid endometrial carcinoma patients. Herein, we explored the mode of myometrial invasion diagnosis in FIGO stage I non-endometrioid carcinoma and evaluated the differences in diagnostic efficiency among intraoperative frozen section (IFS), intraoperative gross examination (IGE), magnetic resonance imaging (MRI), and computed tomography (CT) in clinical practice. Finally, we suggested which test should be routinely performed.

Method
This was a historical cohort study nationwide with 30 centers in China between January 2000 and December 2019. Clinical data, including age, histology, method of myometrial invasion evaluation (MRI, CT, IGE, and IFS), and final diagnosis of postoperative paraffin sections, were collected from 490 non-endometrioid endometrial carcinoma (serous, clear cell, undifferentiated, mixed carcinoma, and carcinosarcoma) women in FIGO stage I.

Results
Among the 490 patients, 89.59% presented myometrial invasion. The methods reported for myometrial invasion assessment were IFS in 23.47%, IGE in 69.59%, MRI in 37.96%, and CT in 10.20% of cases. The highest concordance was detected between IFS and postoperative paraffin sections (Kappa = 0.631, accuracy = 93.04%), followed by IGE (Kappa = 0.303, accuracy = 82.40%), MRI (Kappa = 0.131, accuracy = 69.35%), and CT (Kappa = 0.118, accuracy = 50.00%). A stable diagnostic agreement between IFS and the final results was also found through the years (2000–2012: Kappa = 0.776; 2013–2014: Kappa = 0.625; 2015–2016: Kappa = 0.545; 2017–2019: Kappa = 0.652).

Conclusion
In China, the assessment of myometrial invasion in non-endometrioid endometrial carcinoma is often performed via IGE, but the reliability is relatively low in contrast to IFS. In clinical practice, IFS is a reliable method that can help accurately assess myometrial invasion and intraoperative decision-making (lymph node dissection or not). Hence, it should be routinely performed in non-endometrioid endometrial carcinoma patients.
Effect of blended and unguided online delivery of mindfulness-based cognitive therapy versus care as usual on distress among cancer patients and survivors: protocol for the three-arm parallel randomized controlled buddy trial
Authors: Badaghi Nasim , van Kruijsbergen Mette , Prins Judith , Kelders Saskia , Cillessen Linda , Compen Félix , Donders Rogier , Kwakkenbos Linda , Speckens Anne 
Published: January 2023

Abstract
Background
One third of cancer patients and survivors experience psychological distress. Previous studies have shown that online mindfulness-based cognitive therapy (eMBCT) supports cancer patients and survivors in managing distress. Lack of peer support and asynchronicity during online interventions have been reported as barriers for treatment adherence and can result in higher drop-out rates. Considering this, two new formats of eMBCT were created. The primary objective of the Buddy trial is to evaluate the (cost) effectiveness of blended and unguided eMBCT versus care as usual (CAU) on psychological distress among cancer patients and survivors. Secondary objectives include evaluating effects on other psychological outcomes and investigating working mechanisms and treatment effect moderators.

Methods
The Buddy trial is a parallel three-armed randomized controlled trial. Participants will be randomly assigned to blended therapist-assisted eMBCT, unguided individual eMBCT or CAU. Eligible participants will be Dutch-speaking adult cancer patients or survivors with access to internet. The primary outcome will be psychological distress scores as assessed by the Hospital Anxiety and Depression scale immediately post-treatment. Secondary outcome measures include fear of cancer recurrence (FCRI), fatigue (CIS-F), rumination (RRQ), mindfulness skills (FFMQ), decentering (EQ), self-compassion (SCS-SF), positive mental health (MHCSF), health related quality of life (EQ-5D), and costs associated with psychiatric illness (TiC-P). Outcome measures will be evaluated at baseline, mid-treatment, immediately post-treatment, and three-, six-, and nine-months follow-up. Possible mediators, such as engagement with interventions (TWEETS), and moderators will be also analyzed.

Discussion
There is room to improve eMBCT for cancer patients prior to implementation to ensure adherence and scalability. Blended and unguided eMBCT may reduce psychological distress and improve quality of life and be easily accessible to cancer patients and survivors.
Trial registration clinicaltrials.gov, NCT05336916, registered on April 20th, 2022. https://clinicaltrials.gov/ct2/show/NCT05336916.
Determining the impact of cannabis use and severity on tobacco cessation outcomes: study protocol for a prospective tobacco treatment trial
Authors: Walters Kyle J. , Baker Nathaniel L. , Tomko Rachel L. , Gray Kevin M. , Carpenter Matthew J. , McClure Erin A. 
Published: January 2023

Abstract
Background
Several evidence-based tobacco cessation treatment strategies exist, though significant barriers to cessation remain which must be addressed to improve abstinence rates for sub-populations of those smoking cigarettes. Cannabis co-use among those who use tobacco is common and appears to be increasing among adults in the United States (US). The literature evaluating the impact of cannabis use on tobacco cessation has been mixed and has several important limitations, which precludes development of treatment recommendations specific to individuals who use tobacco and co-use cannabis. To date, no prospective studies have evaluated the impact of cannabis use and severity on tobacco cessation or quantified cannabis use changes during tobacco treatment to assess for concurrent reductions, abstinence, or compensatory (i.e., increased) cannabis use. This study’s aims are to: (1) evaluate tobacco cessation outcomes among participants who co-use cannabis compared to participants only using tobacco, (2) using daily diaries and biochemical verification, assess changes in cannabis use during tobacco treatment, and (3) assess for a dose-dependent impact of cannabis use on tobacco cessation.

Method
A multi-site, prospective, quasi-experimental 12-week tobacco treatment trial enrolling treatment-seeking adults (ages 18–40; N = 208) from three sites across South Carolina (US) who use tobacco daily and oversampling (2:1) those who co-use cannabis. Participants receive tobacco cessation pharmacotherapy (varenicline) paired with behavioral support, while cannabis use is not addressed as part of treatment. The primary outcome is 7-day point prevalence tobacco abstinence at the week 12 end of treatment visit, measured via biochemical verification and self-report. Secondary outcome measures include changes in cannabis use (via biochemical verification and self-report) during tobacco cessation treatment.

Discussion
Results from this trial have the potential to inform tobacco treatment among those co-using cannabis, which may require a tailored approach to address the role of cannabis in quitting tobacco.

Trial registration

The trial is registered with ClinicalTrials.gov: NCT04228965. January 14th, 2020.
Is There Evidence for the Development of Sex-Specific Guidelines for Ultramarathon Coaches and Athletes? A Systematic Review
Authors: Kelly Claudia P. M. G. 
Published: January 2023

AbstractBackgroundThere is evidence of sex differences in the physiology of endurance exercise, yet most of the advice and guidelines on training, racing, nutrition, and recovery for ultramarathons are based on research that has largely excluded female athletes. The objective was therefore to review the current knowledge of sex differences in ultramarathon runners and determine if sufficient evidence exists for providing separate guidelines for males and females.MethodsThis systematic review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three databases were searched for studies investigating differences in elite and recreational male and female ultramarathon runners. Studies were included if they compared males and females and looked at outcomes relating to the performance or health of ultramarathon runners. The quality of the included studies was determined using the Grading of Recommendations Assessment Development and Evaluation (GRADE) approach.ResultsThe search strategy identified 45 studies that met the inclusion criteria. Most studies were observational in design, with only three papers based on randomised controlled trials. The overall quality of the evidence was low. Sex differences in the predictors of ultramarathon performance; physiological responses to training, racing, and recovery; chronic and acute health issues; and pacing strategies were found. There were areas with contradictory findings, and very few studies examined specific interventions.ConclusionThe results from this review suggest that the development of sex-specific guidelines for ultramarathon coaches and athletes could have a significant effect on the performance and health of female runners. At present, there is insufficient high-quality evidence on which to formulate these guidelines, and further research is required.
Predictive digital twin for offshore wind farms
Authors: Haghshenas Amirashkan , Hasan Agus , Osen Ottar , Mikalsen Egil Tennfjord 
Published: January 2023

AbstractAs wind turbines continue to grow in size, they are increasingly being deployed offshore. This causes operation and maintenance of wind turbines becoming more challenging. Digitalization is a key enabling technology to manage wind farms in hostile environments and potentially increasing safety and reducing operational and maintenance costs. Digital infrastructure based on Industry 4.0 concept, such as digital twin, enables data collection, visualization, and analysis of wind power analytic at either individual turbine or wind farm level. In this paper, the concept of predictive digital twin for wind farm applications is introduced and demonstrated. To this end, a digital twin platform based on Unity3D for visualization and OPC Unified Architecture (OPC-UA) for data communication is developed. The platform is completed with the Prophet prediction algorithm to detect potential failure of wind turbine components in the near future and presented in augmented reality to enhance user experience. The presentation is intuitive and easy to use. The limitations of the platform include a lack of support for specific features like electronic signature, enhanced failover, and historical data sources. Simulation results based on the Hywind Tampen floating wind farm configuration show our proposed platform has promising potentials for offshore wind farm applications.
Effect of visual distraction on discomfort score during flexible fiberoptic direct laryngoscopy: a randomized control trial
Authors: Pyarali Maheen , Aslam Afshan , Nawaz Ahmed , Akhtar Saeed , Andleeb Hira , Syed Dania 
Published: January 2023

Abstract
Background
Flexible fiberoptic direct laryngoscopy is the standard technique for evaluating the larynx and hypopharynx and is a routine outpatient procedure performed in ENT. This study aims to find the effect of patients’ own procedure video as a distractor over the discomfort score, during flexible fiberoptic direct laryngoscopy. It can be a cost-effective alternative to local anesthetics and should be included in our routine practice.

Results
The study included 60 patients undergoing flexible laryngoscopy at a tertiary care hospital. Patients were divided into two groups: group A (those patients who had visualized their procedure video while performing FFODL) and group B (those patients who had not visualized their procedure video while performing FFODL). Visual distraction was involving patients to see their own video while FFODL was being performed. After, the procedure discomfort score was assessed using a visual analog scale. In our study, both groups were comparable in terms of age and gender. The mean discomfort score was significantly reduced in group A as compared to group B (p value 0.003).

Conclusion
This study has shown that visual distraction significantly reduced the procedure-specific mean discomfort scores and that it should be practiced routinely to alleviate patient’s anxiousness and fear to go through this procedure and to gain the confidence of patients.
The United Auto Workers’ Jimmy Hoffa: The Backstory to the Current Corruption Scandal
Authors: Witwer David 
Published: January 2023

Abstract
Richard Gosser was a national leader in the United Auto Workers (UAW) union and a contemporary of James R. Hoffa. Both men had similar backgrounds, had similar ties to organized crime, and faced similar allegations of corruption, but the results of those allegations differed dramatically. Hoffa was singled out by a congressional investigative committee, and his name became a byword for the menace of labor racketeering. After an initial period of controversy, Gosser enjoyed a reputation as a labor statesman. A comparison of their careers highlights the political nature of union corruption probes. Gosser's career also provides a historical perspective on the sources of the recent corruption scandals that have shaken the UAW.
Liver and Renal Injury with Remdesivir treatment in SARS-CoV-2 Patients
Authors: Rabiah Sadaf  , Ali Faiza Sadaqat , Rasheed Tazeen , Bader Faiyaz Zuberi  
Published: January 2023

Objective: To determine the effect of Remdesivir on liver enzymes and renal functions in SARS-CoV-2 patients.
Methods: This prospective cohort study was conducted at Dr. Ruth KM Pfau, Civil Hospital Karachi between 1st December 2021 to 31st January, 2022. All patients of severe SARS-CoV-2 infection who received Inj. Remdesivir for five days as per protocol of SARS-CoV-2 management were included. Biodata of selected patients including age, gender, diabetic, hypertensive status was recorded. Patients Liver Function Tests and Serum Creatinine were performed on days 0, 3, 5, 7 and 14.
Results: This study included 85 patients, out of which 55 (64.7%) were males and 30 (35.3%) were females. Out of 85 patients, Remdesivir was stopped in 3 (3.5%) patients. Among these three patients Remdesivir was stopped in one patient on day three because of decrease in CrCl to <30 ml/min. His CrCl improved after stopping Remdesivir. In the remaining two patients, Remdesivir was stopped due to increase in ALT to greater than 10 times from normal values on day three. Similarly, in these two patients the ALT improved after stopping Remdesivir.
Conclusion: Only three patients developed adverse effects resulting in stopping of Remdesivir, however these were reversible on stopping the drug. Therefore, Remdesivir is a relatively safe drug and well tolerated in SARS-CoV-2 patients.
doi: https://doi.org/10.12669/pjms.39.2.6236
How to cite this: Sadaf R, Ali FS, Rasheed T, Zuberi BF. Liver and Renal Injury with Remdesivir Treatment in SARS-CoV-2 Patients. Pak J Med Sci. 2023;39(2):---------. doi: https://doi.org/10.12669/pjms.39.2.6236
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Efficacy of Adjunctive Chlorhexidine in non-surgical treatment of Peri-Implantitis/Peri-Implant Mucositis: An updated systematic review and meta-analysis
Authors: Ye Mingfu , Liu Wenjun , Cheng Shaolong , Yan Lihui 
Published: January 2023

Objective: The current review aimed to assess the efficacy of adjunctive chlorhexidine (CHX) in the non-surgical treatment of peri-implantitis/peri-implant mucositis.
Methods: PubMed, Embase, Science Direct, CENTRAL, and Google Scholar databases were searched up to 10th March 2022 for relevant randomized controlled trials or controlled clinical trials.
Results: Fourteen studies were included. Meta-analysis revealed significantly lower probing depths in peri-implant mucositis patients using CHX adjuncts as compared to controls (SMD: -1.49 95% CI: -2.56, -0.42 I2=95% p=0.006). However, the same effect was not noted in peri-implantitis (SMD: -1.18 95% CI: -0.04, 2.40 I2=96% p=0.06). CHX was not found to improve bleeding of probing in peri-implant mucositis while sufficient data was unavailable for peri-implantitis. Results on other outcome variables were conflicting.
Conclusion: Evidence on the efficacy of adjunctive CHX for peri-implant mucositis is conflicting. Similarly, strong conclusions on the effect of CHX for peri-implantitis cannot be drawn due to limited number of studies. Overall, there seems to be a trend of non-significant impact of CHX on outcomes of peri-implant mucositis as well as peri-implantitis.
doi: https://doi.org/10.12669/pjms.39.2.7253
How to cite this: Ye M, Liu W, Cheng S, Yan L. Efficacy of Adjunctive Chlorhexidine in non-surgical treatment of Peri-Implantitis/Peri-Implant Mucositis: An updated systematic review and meta-analysis. Pak J Med Sci. 2023;39(2):---------. doi: https://doi.org/10.12669/pjms.39.2.7253
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Compact on-chip crystalline resonator integration with etching of tapered fiber waveguide
Authors: Yue Jun , Rong Jiamin , Xing Enbo , Xu Weikang , Bai Jiamin , Liu Wenyao , Tang Jun , Liu Jun 
Published: January 2023

Whispering-gallery-mode crystalline resonators currently maintain the best quality factor (

Q

) record; however, compact on-chip packaging is still a challenge, although various coupling architectures have been developed. Here, a chemical etching method is proposed to fabricate a miniaturized tapered fiber waveguide on silicon substrate. The Marangoni effect is implemented to reduce the surface roughness of the cone region. The optical loss of 0.1 dB/mm is obtained, and the

Q

of the on-chip crystalline resonator exceeds

1

0

8

. Additionally, thermoelectric cooler (TEC) is implanted in the package to actively customize the temperature, and the temperature response of 18 pm/°C is consistent with the theoretical calculation.
Dysprosium gain-switched fiber laser at 3.24 µm pumped at 1064 nm
Authors: Jobin Frédéric , Aydin Yiğit Ozan , Bernier Martin , Vallée Réal 
Published: January 2023

We report a dysprosium-doped gain switched fluoride fiber laser pumped at 1064 nm and emitting at 3244 nm. Pulses with energies up to 1 µJ were generated on a wide range of repetition rates between 100 kHz and 200 kHz, the highest reported for a pulsed dysprosium-doped fiber laser, producing an average output power reaching 207 mW. Stable 8.9 µJ pulses were also generated near 10 kHz, which is the highest pulse energy reported to date from a 1.1 µm band pumped dysprosium-doped fiber laser. This shows the 1.1 µm band as a valuable alternative for the pumping of dysprosium-doped fiber lasers emitting far from the emission peak and is thus of potential interest for future field applications.