bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic features, management and prognosis of type 2 myocardial infarction compared to type 1 myocardial infarction: a systematic review and meta-analysis
Authors: White Kyle , Kinarivala Mansey , Scott Ian 
Published: February 2022

ImportanceDistinguishing type 2 (T2MI) from type 1 myocardial infarction (T1MI) in clinical practice can be difficult, and the management and prognosis for T2MI remain uncertain.ObjectiveTo compare precipitating factors, risk factors, investigations, management and outcomes for T2MI and T1MI.Data sourcesMedline and Embase databases as well as reference list of recent articles were searched January 2009 to December 2020 for term ‘type 2 myocardial infarction’.Study selectionStudies were included if they used a universal definition of MI and reported quantitative data on at least one variable of interest.Data extraction and synthesisData were pooled using random-effect meta-analysis. Risk of bias was assessed using Newcastle-Ottawa quality assessment tool. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. All review stages were conducted by two reviewers.Main outcomes and measuresRisk factors, presenting symptoms, cardiac investigations such as troponin and angiogram, management and outcomes such as mortality.Results40 cohort studies comprising 98 930 patients with T1MI and 13 803 patients with T2MI were included. Compared with T1MI, patients with T2MI were: more likely to have pre-existing chronic kidney disease (OR 1.87; 95% CI 1.53 to 2.28) and chronic heart failure (OR 2.35; 95% CI 1.82 to 3.03), less likely to present with typical cardiac symptoms of chest pain (OR 0.19; 95% CI 0.13 to 0.26) and more likely to present with dyspnoea (OR 2.64; 95% CI 1.86 to 3.74); more likely to demonstrate non-specific ST-T wave changes on ECG (OR 2.62; 95% CI 1.81 to 3.79) and less likely to show ST elevation (OR 0.22; 95% CI 0.17 to 0.28); less likely to undergo coronary angiography (OR 0.09; 95% CI 0.06 to 0.12) and percutaneous coronary intervention (OR 0.06; 95% CI 0.04 to 0.10) or receive cardioprotective medications, such as statins (OR 0.25; 95% CI 0.16 to 0.38) and beta-blockers (OR 0.45; 95% CI 0.33 to 0.63). T2MI had greater risk of all cause 1-year mortality (OR 3.11; 95% CI 1.91 to 5.08), with no differences in short-term mortality (OR 1.34; 95% CI 0.63 to 2.85).Conclusion and relevanceThis review has identified clinical, management and survival differences between T2MI and T1MI with greater precision and scope than previously reported. Differential use of coronary revascularisation and cardioprotective medications highlight ongoing uncertainty of their utility in T2MI compared with T1MI.
Vaccine hesitancy from parents and healthcare providers perspectives in Hadhramout Governorate, Yemen: a mixed-method study protocol
Authors: Sutan Rosnah , Batarfi Suha Ali , Ismail Halim , Bin-Ghouth Abdulla Salem 
Published: February 2022

IntroductionAlthough immunisation prevents the death of millions of infants and children each year, the vaccination coverage of routine childhood vaccination does not reach its target. The reasons for low vaccination uptake can be related to both demand and supply side determinants. The prevalence of vaccine hesitancy is increasing globally. However, data on vaccine hesitancy in low-income Arabic countries are scarce. To investigate this issue in Yemen, an Arabic low-income country, we aim to examine the link between vaccine hesitancy and the immunisation status of children living in Costal Hadhramout, Yemen, from the perspective of their parents and healthcare providers.Methods and analysisWe will use a mixed-method research design. The study will be conducted in Costal Hadhramout in three phases. Phase 1 will involve a situational analysis using secondary data from records of the national expanded immunisation programme in Costal Hadhramout to examine the trend for previous years. Phase 2 will be a quantitative study aimed at assessing the prevalence of vaccination status of children aged <2 years and the determinants of parental vaccine hesitancy perception through a validated questionnaire. Lastly, phase 3 will be a qualitative study that explores vaccine hesitancy in Yemen using in-depth interviews and focus group discussions with parents and healthcare providers, respectively.Ethics and disseminationThe study has been approved by the Research Committee of the Faculty of Medicine, University Kebangsaan Malaysia. The findings will be disseminated via publication in peer-reviewed academic journals, academic conferences and public presentations.
Qualitative inquiry into barriers and facilitators to transforming primary care for lesbian, gay, bisexual and transgender people in US federally qualified health centres
Authors: Gagnon Kelly W , Bifulco Lauren , Robinson Sarafina , Furness Bruce , Lentine Daniel , Anderson Daren 
Published: February 2022

ObjectivesHealth systems must rapidly move knowledge into practice to address disparities impacting sexual and gender minority (SGM) patients. This qualitative study explores barriers and facilitators that arose during an initiative to improve care for SGM patients in federally qualified health centres (FQHCs) from the perspectives of FQHC staff.DesignCross-sectional qualitative content analysis, using a general inductive approach, of secondary data from transcripts of intervention events offered to FQHC staff and semistructured interviews with staff and FQHC leadership during the intervention.Setting10 FQHCs from nine states in the USA.ParticipantsFQHC quality improvement (QI) and clinical care staff, and leaders at each FQHC.InterventionsThe transforming care for lesbian, gay, bisexual and transgender people QI initiative combined two evidence-based programmes, Learning Collaborative (LC) and Project Extension for Community Healthcare Outcomes (ECHO), to assist primary care health centres in developing capacity to identify SGM patients, monitor their health and care, and improve disparities.Primary and secondary outcome measuresThe primary outcome was identification of barriers and facilitators to implementing initiatives to improve care for SGM patients. The secondary outcome was clarification of how intervention participants used Project ECHO sessions versus LC meetings to obtain information that influenced implementation of the initiative at their FQHC.ResultsBarriers and facilitators mapped to two major themes: ‘Clinical’ (patients’ health, wellness, and available treatment) and Health Systems and Institutional Culture (FQHC operations, and customs and social institutions within the FQHCs and in the external environment). Common ‘Clinical’ inquiries were for assistance with behavioural health, pre-exposure prophylaxis and transgender hormone therapy. Prevalent facilitators included workflow change and staff training, while adapting electronic health records for data collection, decision support and data extraction was the most prevalent barrier.ConclusionsProject ECHO and LC provided complimentary forums to explore clinical and operational changes needed to improve care for SGM at FQHCs.
Assessment of the Cow’s Milk-related Symptom Score (CoMiSS) as a diagnostic tool for cow’s milk protein allergy: a prospective, multicentre study in China (MOSAIC study)
Authors: Vandenplas Yvan , Zhao Zheng-Yan , Mukherjee Rajat , Dupont Christophe , Eigenmann Philippe , Kuitunen Mikael , Ribes Koninckx Carmen , Szajewska Hania , von Berg Andrea , Bajerová Kateřina , Meyer Rosan , Salvatore Silvia , Shamir Raanan , Järvi Anette , Heine Ralf G 
Published: February 2022

ObjectivesThe MOSAIC study aimed to evaluate if the Cow’s Milk-related Symptom Score (CoMiSS) can be used as a stand-alone diagnostic tool for cow’s milk protein allergy (CMPA).DesignSingle-blinded, prospective, multicentre diagnostic accuracy study.Setting10 paediatric centres in China.Participants300 non-breastfed infants (median age 16.1 weeks) with suspected CMPA.InterventionsAfter performing the baseline CoMiSS, infants commenced a cow’s milk protein elimination diet with amino acid-based formula for 14 days. CoMiSS was repeated at the end of the elimination trial. Infants then underwent an open oral food challenge (OFC) with cow’s milk-based formula (CMF) in hospital. Infants who did not react during the OFC also completed a 14-day home challenge with CMF. A diagnosis of CMPA was made if acute or delayed reactions were reported.Primary outcome measuresA logistic regression model for CoMiSS to predict CMPA was fitted and a receiver–operator characteristic (ROC) curve generated. An area under the curve (AUC) of ≥0.75 was deemed adequate to validate CoMiSS as a diagnostic tool (target sensitivity 80%–90% and specificity 60%–70%).ResultsOf 254 infants who commenced the OFC, 250 completed both challenges, and a diagnosis of CMPA made in 217 (85.4%). The median baseline CoMiSS in this group fell from 8 (IQR 5–10) to 5 (IQR 3–7) at visit 2 (p<0.000000001), with a median change of −3 (IQR −6 to −1). A baseline CoMiSS of ≥12 had a low sensitivity (20.3%), but high specificity (87.9%) and high positive predictive value (91.7%) for CMPA. The ROC analysis with an AUC of 0.67 fell short of the predefined primary endpoint.ConclusionsThe present study did not support the use of CoMiSS as a stand-alone diagnostic tool for CMPA. Nevertheless, CoMiSS remains a clinically useful awareness tool to help identify infants with cow’s milk-related symptoms.Trial registration numberNCT03004729; Pre-results.
Suicide prevention for international students: a scoping review protocol
Authors: McKay Sam , Li Angela Yuen Chun , Bailey Eleanor , Lamblin Michelle , Robinson Jo 
Published: February 2022

IntroductionThe existing literature demonstrates that international students face a variety of stressors and barriers that can heighten the risk of suicide. However, up to now, no research has sought to summarise the available literature on the prevention strategies for suicide for international students in tertiary education. This document provides a scoping review protocol that aims to systematically chart and synthesise the published, unpublished and grey literature on the prevention strategies for suicide in the international student community.Methods and analysisThe enhanced six-stage methodological framework for scoping reviews of Arksey and O’Malley will be used. Two main research questions guide the review: (1) What is the extent, range and nature of the evidence regarding suicide prevention for international students? and (2) What suicide prevention strategies are promising for targeting international students? Peer-reviewed and non-peer-reviewed articles, reports and policy documents will be eligible to be included in the review with no limits on publication date. Electronic searches of the CINAHL, ERIC, Medline, PsycInfo and ProQuest will be conducted to identify relevant academic publications. Grey literature searches will be undertaken on relevant databases as well as government and organisational websites. The reporting of the review will follow the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Criteria for evidence inclusion and exclusion will be used during literature screening and mapping. Screening and data charting of the published and grey literature will be conducted by three reviewers. Relevant stakeholders and experts will be consulted regarding the findings and their input will be integrated into the final report.Ethics and disseminationThe study will be disseminated through a peer-reviewed journal, conference presentations and consultations with relevant stakeholders in policy and professional settings. Ethical approval is not required for this review.
Biology of selective caries removal: a systematic scoping review protocol
Authors: Widbiller Matthias , Weiler Rita , Knüttel Helge , Galler Kerstin M , Buchalla Wolfgang , Scholz Konstantin J 
Published: February 2022

IntroductionPrimary goal of restorative caries therapy is to preserve pulp vitality and the dentition. Whereas the conventional approach of complete caries removal aims at the elimination of all affected substances without regard to losses of hard tissue or pulp vitality, the innovative concept of selective caries removal (SCR) is characterised by a targeted and non-invasive excavation. It presents a lower risk of accidental pulp exposure, which reportedly has a positive effect on tooth survival. Although clinical data show the benefits of SCR, knowledge about the biological processes during this procedure in the pulp-dentine complex of permanent teeth is scarce. Hence, the aim of this work is to systematically scope the existing literature and map the existing evidence according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guideline. This protocol details the scoping review’s methodological and analytical approaches.Methods and analysisFirst, a structure was established (phase I) as basis for a systematic scoping of literature (phase II). In the course of phase I, a total of 100 systematic reviews related to selective caries removal were searched in MEDLINE and information or theories on the biological processes were extracted. During the entire procedure, two reviewers independently screened the articles, and controversies were mediated by vote of a third reviewer. Eventually, it became apparent that different biological explanations can be organised into four categories: pulp response, cavity seal, remaining bacteria and cavity liner. Based on this structure, a search for original publications (phase II) will be performed and retrieved evidence will be assembled using a predefined conceptual framework.Ethics and disseminationAs primary data will not be included in this study, ethical approval is not required. Findings will be disseminated through peer-reviewed publications, conference presentations and summaries for key stakeholders.
First among equals? Adaptive preferences and the limits of autonomy in medical ethics
Authors: Pennings Susan , Symons Xavier 
Published: February 2022

Respect for patient autonomy is a central principle of medical ethics. However, there are important unresolved questions about the characteristics of an autonomous decision, and whether some autonomous preferences should be subject to more scrutiny than others.In this paper, we consider whetherinappropriately adaptive preferences—preferences that are based on and that may perpetuate social injustice—should be categorised as autonomous in a way that gives them normative authority. Some philosophers have argued that inappropriately adaptive preferences do not have normative authority, because they are only a reflection of a person’s social context and not of their true self. Under this view, medical professionals who refuse to carry out actions which are based on inappropriately adaptive preferences are not in fact violating their patient’s autonomy. However, we argue that it is very difficult to articulate a systematic and principled distinction between normal autonomous preferences and inappropriately adaptive preferences, especially if this distinction needs to be useful for clinicians in real-life situations. This makes it difficult to argue that inappropriately adaptive preferences are straightforwardly non-autonomous.Given this problem, we argue that there are significant theoretical issues with contemporary understandings of autonomy in bioethics. We discuss what this might mean for the practice of medicine and for medical ethics education.
Downed wood dynamics in the riparian and littoral zone of small lakes in tolerant hardwood forests
Authors: Pearce Jennie L. , Mallory Elaine C. , Smokorowski Karen E. 
Published: February 2022

Large wood (LW) is an important structural feature in forested lake ecosystems, but little is known about the production of LW in riparian forests and its movement across the forest–lake ecotone, both of which we describe here for eight small (<30 ha) lakes in Ontario, Canada. The creation of snags through live-tree death varied by species, ranging from 0.24% year−1 for eastern white cedar to 5.60% year−1 for balsam fir. Snag breakage was best described as a function of snag height and snag fall described as a function of tree species, decay stage, and diameter. Long LW pieces and pieces generated close to the lake were more likely to be deposited at the shoreline. The density of LW at the shoreline was 125–550 pieces·km−1, and density and volume of LW were positively related to riparian slope. LW was a stable resource at the shoreline, with a recruitment rate about equal to the loss rate and average movement along the shoreline of 2.89 cm·year−1. LW volumes at the shoreline and in the littoral zone of the lake were positively related to lakebed slope. LW could reside in the littoral zone for centuries, providing physical structure for multiple generations of aquatic organisms in these small lakes. Our results indicate that critical habitat for fish that need aquatic LW extends at least 5 m into riparian forest and that removal of trees within 5 m of the forest edge would reduce LW input to the littoral zone.
Thermodynamical and dynamical stability of a self-gravitating charged thin shell
Authors: Reyes Luz Marina , Chiapparini Marcelo , Bergliaffa Santiago Esteban Perez 
Published: February 2022

AbstractA study of the thermodynamical and dynamical stability of self-gravitating charged shells is presented. The matter on the shell is described by a barotropic equation of state, and the charge is assumed to be proportional to the mass. For a given form of the entropy of the matter on the shell, it is shown that strong restrictions on the states of the shell follow from the imposition of both types of stability plus the condition that the speed of sound is less than one, in some cases leading to the absence of stable states.
Observation on the Rehabilitation Effect of Athletes with Anterior Cruciate Ligament Injury of the Knee Based on Multidisciplinary Combined Nondrug Therapy
Authors: He Xiao 
Published: February 2022

This study analyzes the rehabilitation effects of athletes with anterior cruciate ligament injury of the knee based on multidisciplinary combined nondrug therapy. For this purpose, 70 athletes with anterior cruciate ligament injury of the knee admitted from September 2019 to December 2020, who were randomly selected, were the subjects of the study. According to the random number table method, they were divided into the control group and observation group, with 35 cases in each group. The control group was given conventional conservative treatment such as braces braking, local physiotherapy, and routine rehabilitation exercise after injury. For the observation group, multidisciplinary combined nondrug therapy was implemented on the basis of the control group. After receiving the intervention, the balance function score of the observation group was significantly higher than that of the control group, and the difference between the two groups was statistically significant (

P

< 0.05). After receiving the intervention, the functional recovery scores of the knee joint of the observation group were significantly higher than that of the control group, and the difference between the two groups was statistically significant (

P

< 0.05). Before treatment, there was no significant difference in knee flexion extension, internal rotation, and external rotation between the two groups (

P

> 0.05). After treatment, flexion extension, internal rotation, and external rotation of the knee joint in the observation group were significantly higher than those in the control group (

P

< 0.05). There was no significant difference in VAS scores between the two groups before treatment (

P

> 0.05). After treatment, the VAS score of the observation group was significantly lower than that of the control group (

P

< 0.05). Multidisciplinary combined nondrug therapy has a good therapeutic effect in the treatment of anterior cruciate ligament injury of the knee for athletes. It can be used as a conservative treatment method to improve the score of balance function and recovery of lacquer joint function, enhance the range of motion of the knee joint, and reduce the VAS.
Intestinal Deletion of 3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Promotes Expansion of the Resident Stem Cell Compartment
Authors: Doerfler Alexandria M. , Han Jun , Jarrett Kelsey E. , Tang Li , Jain Antrix , Saltzman Alexander , De Giorgi Marco , Chuecos Marcel , Hurley Ayrea E. , Li Ang , Morand Pauline , Ayala Claudia , Goodlett David R. , Malovannaya Anna , Martin James F. , de Aguiar Vallim Thomas Q. , Shroyer Noah , Lagor William R. 
Published: February 2022

Background:
The intestine occupies the critical interface between cholesterol absorption and excretion. Surprisingly little is known about the role of de novo cholesterol synthesis in this organ, and its relationship to whole body cholesterol homeostasis. Here, we investigate the physiological importance of this pathway through genetic deletion of the rate-limiting enzyme.

Methods:

Mice lacking 3-hydroxy-3-methylglutaryl-coenzyme A reductase (
Hmgcr
) in intestinal villus and crypt epithelial cells were generated using a
Villin
-Cre transgene. Plasma lipids, intestinal morphology, mevalonate pathway metabolites, and gene expression were analyzed.

Results:

Mice with intestine-specific loss of
Hmgcr
were markedly smaller at birth, but gain weight at a rate similar to wild-type littermates, and are viable and fertile into adulthood. Intestine lengths and weights were greater relative to body weight in both male and female
Hmgcr
intestinal knockout mice. Male intestinal knockout had decreased plasma cholesterol levels, whereas fasting triglycerides were lower in both sexes. Lipidomics revealed substantial reductions in numerous nonsterol isoprenoids and sterol intermediates within the epithelial layer, but cholesterol levels were preserved.
Hmgcr
intestinal knockout mice also showed robust activation of SREBP-2 (sterol-regulatory element binding protein-2) target genes in the epithelium, including the LDLR (low-density lipoprotein receptor). At the cellular level, loss of
Hmgcr
is compensated for quickly after birth through a dramatic expansion of the stem cell compartment, which persists into adulthood.

Conclusions:

Loss of
Hmgcr
in the intestine is compatible with life through compensatory increases in intestinal absorptive surface area, LDLR expression, and expansion of the resident stem cell compartment.