bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microcredentials training in pharmacy practice and education: an exploratory study of its viability and pharmacists’ professional needs
Authors: Lok Peggy , Beyene Kebede , Awaisu Ahmed , Woods David , Kheir Nadir 
Published: April 2022

Abstract
Background
Microcredentials (MCs) are short courses that certify/recognise an individual’s achievement of specific skills or knowledge. Schools of pharmacy could be well-placed to contribute to the continuing professional development (CPD) of pharmacists through the inclusion of MCs training in their programs. This study aimed to explore pharmacy professionals’ views on the need and viability of MC courses globally.

Methods
Eleven semi-structured telephone interviews were conducted with pharmacy practitioners, policymakers, and academics across seven countries. The participants were selected using purposive sampling to explore information from varying pharmacy disciplines. Interviews were audio-recorded, transcribed verbatim, and analysed using a general inductive approach.

Results
Participants regarded MCs in pharmacy as an innovative idea, well-suited to the increasingly technology-driven world. They believe MCs provide easily accessible means of skills and knowledge acquisition that fulfils the needs of the pharmacy profession. MCs were also perceived as an alternative pathway of meeting the requirements of traditional CPD programmes. Many participants believe universities are well-suited to provide MCs; however, numerous challenges such as recognition, time and resources have been identified as potential barriers to enrolment and implementation.

Conclusions
This study provides an insight into the views of pharmacy practitioners and academics on MCs, and their potential utility in pharmacy education and practice. The findings should help in the development of MCs that could be utilised by pharmacy practitioners around the world for CPD purposes. This study comes at a time when alternative models of teaching and learning are being explored as a direct result of the COVID-19 pandemic.
Improving medical term embeddings using UMLS Metathesaurus
Authors: Chanda Ashis Kumar , Bai Tian , Yang Ziyu , Vucetic Slobodan 
Published: April 2022

AbstractBackgroundHealth providers create Electronic Health Records (EHRs) to describe the conditions and procedures used to treat their patients. Medical notes entered by medical staff in the form of free text are a particularly insightful component of EHRs. There is a great interest in applying machine learning tools on medical notes in numerous medical informatics applications. Learning vector representations, or embeddings, of terms in the notes, is an important pre-processing step in such applications. However, learning good embeddings is challenging because medical notes are rich in specialized terminology, and the number of available EHRs in practical applications is often very small.MethodsIn this paper, we propose a novel algorithm to learn embeddings of medical terms from a limited set of medical notes. The algorithm, calleddefinition2vec, exploits external information in the form of medical term definitions. It is an extension of a skip-gram algorithm that incorporates textual definitions of medical terms provided by the Unified Medical Language System (UMLS) Metathesaurus.ResultsTo evaluate the proposed approach, we used a publicly available Medical Information Mart for Intensive Care (MIMIC-III) EHR data set. We performed quantitative and qualitative experiments to measure the usefulness of the learned embeddings. The experimental results show thatdefinition2veckeeps the semantically similar medical terms together in the embedding vector space even when they are rare or unobserved in the corpus. We also demonstrate that learned vector embeddings are helpful in downstream medical informatics applications.ConclusionThis paper shows that medical term definitions can be helpful when learning embeddings of rare or previously unseen medical terms from a small corpus of specialized documents such as medical notes.
A case of superficial spreading type of poorly differentiated adenocarcinoma of the stomach with invasion to the esophagus
Authors: Mase Junichi , Adachi Takahito , Kiriyama Shunya , Horaguchi Takeshi , Yawata Kazunori , Ikawa Aiko , Sano Bun , Imai Susumu , Okamoto Kiyohisa , Shiroko Takashi 
Published: April 2022

Abstract
Background
Invasion is more likely to occur in gastric cancer affecting larger areas. Poorly differentiated adenocarcinoma tends to invade deep. The cardiac region prefers submucosal invasion because the submucosa is coarser than the other regions.

Case presentation
A 75-year-old man presented with a chief complaint of abdominal discomfort and weight loss. Esophagogastroduodenoscopy revealed an irregular ulcerative lesion with partial redness of the upper body and lesser curve of the stomach. A continuous shallow depressed lesion invaded the abdominal esophagus by approximately 40 mm. Poorly differentiated adenocarcinomas (por, sig) were observed on biopsy. Grossly, the cancer appeared to extend into the muscle layer; however, we could not confirm invasion into the muscle layer in our biopsy tissue. We diagnosed the lesion as a superficial spreading type of advanced gastric cancer and performed a total gastrectomy, D2-lymph node dissection (spleen preservation), Roux-en-Y reconstruction, and cholecystectomy. Postoperative histopathological examination revealed extensive infiltration of poorly differentiated adenocarcinoma (90 mm × 55 mm), and all were intramucosal lesions. The final pathological diagnosis was T1a, N0, M0, and Stage IA. The postoperative course was uneventful and the patient was discharged on postoperative day (POD) 11. Five years have passed since the operation, and the patient is alive without recurrence.

Conclusion
We encountered a case of gastric carcinoma in which poorly differentiated adenocarcinomas expanded extensively. All lesions were intramucosal.
Evaluation of Apixaban safety and effectiveness in morbidly obese patients with atrial fibrillation: a retrospective cohort study
Authors: Al Sulaiman Khalid , Badreldin Hisham A. , Korayem Ghazwa B. , Alenazi Abeer A. , Alsuwayyid Faisal , Alrashidi Abdulrahman , Alhijris Mohammed , Almutairi Faisal , Alharthi Fahad , Vishwakarma Ramesh , Al Shaya Omar , Al Amri Abdulrahman , Tayyab Saqiba , Al Bekairy Abdulkareem M. , Aljuhani Ohoud 
Published: May 2022

Abstract
Background
The benefit of apixaban to reduce stroke risk in morbidly obese patients with nonvalvular atrial fibrillation (AF) is still undetermined. The International Society of Thrombosis and Hemostasis recommends avoiding the use of direct oral anticoagulants (DOAC)s in morbidly obese patients (body mass index > 40 or weight > 120 kg) because of limited clinical data. This exploratory study aims to evaluate the effectiveness and safety of using apixaban in morbidly obese (body mass index (BMI) ≥ 40) patients with AF.

Methods
An exploratory retrospective cohort study was conducted at a single-center, including adult patients with non-valvular AF using apixaban between 01/01/2016 and 31/12/2019. Patients were excluded if they were known to have liver cirrhosis Child-Pugh C, mechanical valve, serum creatinine > 1.5 mg/dL, follow up < 3 months, or using apixaban with a dose of ≤5 or > 10 mg/day. Included patients were categorized into two groups based on their BMI (BMI<40 Vs. BMI ≥ 40). The primary outcome was all thrombotic events, while the secondary outcomes were major and minor bleeding after apixaban initiation. Propensity score (PS) matching was used (1:1 ratio) based on the patient’s age, gender, and HAS-BLED score.

Results
A total of 722 patients were eligible; 254 patients were included after propensity score matching based on the selected criteria. The prevalence of all thrombotic events was similar between the two groups in the first year of apixaban initiation (OR (95%CI): 0.58 (0.13, 2.5), p-value = 0.46). In addition, the odds of developing major and minor bleeding were not statistically significant between the two groups (OR (95%CI): 0.39 (0.07, 2.03), p-value = 0.26 and OR (95%CI): 1.27 (0.56, 2.84), p-value = 0.40), respectively).

Conclusion
This exploratory study showed similar effectiveness and safety of apixaban use in both morbid and non-morbid obese patients with non-valvular AF. However, a larger randomized controlled trial with a longer follow-up period needs to confirm our findings.
I expected to be pain free: a qualitative study exploring athletes’ expectations and experiences of care received by sports chiropractors
Authors: Eindhoven Evan , Lee Alex , Stilwell Peter , Mior Silvano 
Published: May 2022

Abstract
Background
Knowledge about patient satisfaction and experience with care they receive can guide practitioners in establishing doctor-patient relationships and improve health outcomes. Although evidence suggests high patient satisfaction with chiropractic care in general, there is limited understanding of the expectations and experiences of athletes receiving sports chiropractic care.

Objective
To explore the athletes’ expectations and experiences with care received from sports chiropractors, and their perceptions of relevant areas of future research.

Methods
A qualitative study was conducted through an interpretivist lens exploring the perspectives of elite and competitive athletes receiving care from sports chiropractors in Canada. Participants were purposively recruited and interviewed until saturation was reached. Two research team members independently analyzed the interview transcripts using a conventional approach to content analysis. Content was inductively coded and discussed by the research team to generate categories.

Results
We interviewed 18 participants between December 2018 and March 2020, 14 were national level athletes participating in sports ranging from paddling to combat sports. Reported reasons for seeking care included acute care, injury prevention, enhancing performance and maintenance care. Generated categories were organized under topics of experience with care, expectations of care, and research agenda. Participants experienced a variety of interventions, reassurance, varying treatment times, and reported positive impact on their athletic performance. They expected musculoskeletal assessment and treatment including at and beyond the injury site, symptom improvement, good communication and expertise from the chiropractor. Some participants suggested interpersonal and interprofessional communication can be improved, in particular the level of collaboration with other members of their health care team. Overall, participants reported a high level of trust and satisfaction with care received from sports chiropractors. From our participants’ perspective, suggested areas of research should focus on injury mechanics and prevention, impact of care on performance, and interprofessional collaboration.

Conclusions
In general, participants were very satisfied with care. Overall, participants’ expectations and experiences aligned but changed over time. Addressing the findings of this study can be used to enhance the quality of care provided to athletes from sports chiropractors, as well as inform future research agendas. Further work assessing if athletes in other competitive levels have similar experiences and expectations is needed.
Genome-wide DNA Methylation Differences in Nonfunctioning Pituitary Adenomas With and Without Postsurgical Progression
Authors: Hallén Tobias , Johannsson Gudmundur , Dahlén Rahil , Glad Camilla A M , Örndal Charlotte , Engvall Angelica , Carén Helena , Skoglund Thomas , Olsson Daniel S 
Published: April 2022

Abstract

Context
Tumor progression in surgically treated patients with nonfunctioning pituitary adenomas (NFPAs) is associated with excess mortality. Reliable biomarkers allowing early identification of tumor progression are missing.

Objective
To explore DNA methylation patterns associated with tumor progression in NFPA patients.

Methods
This case-controlled exploratory trial at a university hospital studied patients who underwent surgery for NFPA that had immunohistochemical characteristics of a gonadotropinoma. Cases included patients requiring reintervention due to tumor progression (reintervention group, n = 26) and controls who had a postoperative residual tumor without tumor progression for at least 5 years (radiologically stable group, n = 17). Genome-wide methylation data from each tumor sample were analyzed using the Infinium MethylationEPIC BeadChip platform.

Results
The analysis showed that 605 CpG positions were significantly differently methylated (differently methylated positions, DMPs) between the patient groups (false discovery rate adjusted P value &lt; 0.05, beta value &gt; 0.2), mapping to 389 genes. The largest number of DMPs were detected in the genes NUP93 and LGALS1. The 3 hypomethylated DMPs and the 3 hypermethylated DMPs with the lowest P values were all significantly (P &lt; 0.05) and individually associated with reintervention-free survival. One of the hypermethylated DMPs with the lowest P value was located in the gene GABRA1.

Conclusion
In this exploratory study, DNA methylation patterns in NFPA patients were associated with postoperative tumor progression requiring reintervention. The DMPs included genes that have been previously associated with tumor development. Our study is a step toward finding epigenetic signatures to predict tumor progression in patients with NFPA.
Using behavioural science to enhance use of core outcome sets in trials: protocol
Authors: Matvienko-Sikar Karen , Byrne Molly , Clarke Mike , Kirkham Jamie , Kottner Jan , Mellor Katie , Quirke Fiona , J. Saldanha Ian , Smith Valerie , Toomey Elaine , Williamson Paula 
Published: April 2022

Background: Core outcome sets (COS) represent agreed-upon sets of outcomes, which are the minimum that should be measured and reported in all trials in specific health areas. Use of COS can reduce outcome heterogeneity, selective outcome reporting, and research waste, and can facilitate evidence syntheses. Despite benefits of using COS, current use of COS in trials is low. COS use can be understood as a behaviour, in that it is something trialists do, or not do, adequately. The aim of this study is to identify stakeholder-prioritised strategies, informed by behaviour change theory, to increase COS use in trials. Methods: The project will be conducted in three stages, informed by the behaviour change wheel (BCW). The BCW is a theoretically based framework that can be used to classify, identify, and develop behaviour change strategies. In Stage 1, barriers and enablers to COS use will be extracted from published studies that examined trialist’s use of COS. Barriers and facilitators will be mapped to the components of COM-B model (capability, opportunity, and motivation), which forms part of the BCW framework. Stage 2 will build on Stage 1 findings to identify and select intervention functions and behaviour change techniques to enhance COS use in trials. Stage 3 will involve an online stakeholder consensus meeting including trialists, healthcare professionals, and patient/public representatives. The purpose of the meeting is to prioritise identified intervention approaches that will inform future research to increase COS use. Discussion: The findings of this study will provide an understanding of the behavioural factors that influence COS use in trials, what strategies might be used to target these factors to increase COS use, and what strategies key stakeholders perceive as especially important in future research to enhance COS use in trials.
Bridging the gaps in the global governance of antimicrobial resistance: the UN sustainable development goals and global health security agenda
Authors: Esiovwa Regina , Connolly John , Hursthouse Andrew , Mukherji Soumyo , Mukherji Suparna , Parasnis Anjali , Sachwani Kavita , Henriquez Fiona 
Published: April 2022

Background: This paper examines the suitability of extant governance frameworks at an international level for addressing antimicrobial resistance (AMR), which is a creeping crisis for global health security. Methods: Our study begins by evaluating the place of antimicrobial resistance (AMR) within United Nations (UN) Sustainable Development Goals (SDG) targets and indicators. This is followed by a discussion of the global health security agenda (GHSA). We examine how AMR needs to be taken more seriously within global policy frameworks based on adopting a One Health approach. The research is supported by a systematic analysis of the national action plans for addressing AMR published by the World Health Organisation (WHO). Results: We determine that political leaders need to do more to promote the problem of AMR and that global health institutions need to invest more energy in thinking about how AMR is governed as part of an already busy global health security agenda. This includes building capacities within health systems, embedding evaluation processes, and enhancing public service leadership within this area. Conclusions: Our review of global policy frameworks and the national plans for AMR highlight the patchy coverage of AMR strategies globally and nationally. This article represents a springboard for future research including whether and to what extent a One Health approach to AMR in the environment has been implemented in practice within national health and environmental systems.
Comparative study of electrolyte exchange in patients with varying severity of urinary syndrome of chronic pyelonephritis
Authors: Gozhenko Anatoliy , Kushneruk Anatoliy , Zukow Walery , Popovych Igor 
Published: April 2022

Background. The severity of urinary syndrome in chronic pyelonephritis varies widely. Concomitant changes in electrolyte exchange are also differently expressed. The aim of this study is to compare the rates of electrolyte metabolism in patients with minimal and moderate manifestations of urinary syndrome. Materials and Methods. The object of clinical-physiological observation were 68 men and 20 women aged 24-76 years, who underwent rehabilitation treatment in the Truskavets’ spa of chronic pyelonephritis in remission with of neuroendocrine-immune complex dysfunction. Urinary syndrome was assessed by quantitative and quantitative-qualitative levels of bacteriuria, leukocyturia and erythrocyturia. We determined in daily urine and blood plasma the concentration of sodium, potassium, chloride, calcium, magnesium and phosphates. Results. By transforming the actual values into normalized (Z-score) in patients with minimal expressed urinary syndrome (n=25) compared with moderately expressed (n=63) more pronounced decrease in phosphatemia (-1,26±0,17 vs -0,77±0,13), while a more significant increase in excretion of magnesium (+1,16±0,34 vs +0,27±0,24), sodium (+2,92±0,64 vs +1,41±0,31) and chloride (+2,44±0,76 vs +1,04±0,37). Conclusion. Probably, common causal factors for both sets of parameters are changes in neuro-endocrine regulation of electrolyte exchange and immunity, especially bactericidal mechanisms, which, in turn, cause a reduction in bacteriuria and leukocyturia, ie resolving chronic pyelonephritis. Evidence of this hypothesis we have obtained and will be presented in the next article.
Initial Research of Renewable Energy Resources for Hybrid Microgrid Implementation, Using Solar and Wind; Transforming the Diesel Dependence. Case Study of Mamburit Island - Indonesia
Authors: Hughes Arrocha Eric Marcos 
Published: April 2022

Electrical demands are growing rapidly in the world, especially in larger cities, and Indonesia is not an exception. Indonesia's average peak demand is projected to increase by 73% (reaching 43.7 GW) in 2020, by 142% (reaching 61.2 GW) in 2025, and by 205% (reaching 77.3 GW) in 2030, compared with 25.3 GW in 2010 [1]. However, the challenge of completing the growing demand in big cities reveals another huge problem, which are those small villages, communities and islands who doesn’t have access to electricity until now.Many countries apply and use the concept of Micro Grid [MG] as an effective solution, which can be defined as: the grid where each generator or load has to take part in the network management, joining in reactive power supply/voltage control, active power supply/frequency control, fault ride-through capability, and power quality control independently [5].Using an Indonesian remote Island as a real case, different renewable energy sources available will be evaluated to propose the best Micro Grid design integration system to supply electricity facility.This research will describe the principles, measurement process and general mathematical description for the application of the MG model integration.Planning to minimize the traditional electric sources of fossil dependence, the design for Mamburit Island in Sumenep-Indonesia will integrate different generation sources such as, Solar Panel System [PV/SHS] showing Daily Average Irradiation [DNI] of 5.78 kwh/ , vertical Axis Wind Turbine [VAWT] shows wind speed annual average of 8.82 m/s and energy Storage system [ESS] as a real, feasible and friendly options to complete the demand, integrated with Engine Diesel Generator [EDG] present as the actual main sources; minimizing the fossil dependence, through MG principle. Keywords— Smart Micro Grid, Micro Grid Integration, Renewable Energy.
Effects of walking in individuals with prehypertension and stage 1 hypertension in India: a randomised controlled trial
Authors: Punia Sonu , Singh Varun , Joshi Shabnam , Malik Manoj , Saini Minaxi 
Published: May 2022

Background/Aims Physical activity, such as walking, is a cheap approach with a low risk of injury that can be used in daily life. The aim of this study was to determine the effects of low impact aerobic exercise training on resting blood pressure in patients with prehypertension and stage 1 hypertension specifically for people in India. Methods A total of 63 sedentary adults with prehypertension and stage 1 hypertension participated in the study. All sedentary adults were randomly allocated to either the study group (aerobic training) (n=30) or the control group (n=33). Those in the study group walked for 30 minutes, three times a week for 8 weeks at an intensity of 60–75% of their target heart rate. The control group received no training but followed their usual prescribed medication and diet. The primary outcomes of systolic blood pressure and diastolic blood pressure were measured at the end of every 2 weeks for 8 weeks. Secondary outcomes of pulse pressure, mean arterial pressure and pulse rate were calculated. Results Significant changes in various outcome measures in the study group were noted (systolic blood pressure=7.30 mmHg (95% confidence interval [CI] 2.14 to 3.00; P=0.001); diastolic blood pressure=6.50 mmHg (95% CI 1.23 to 4.04; pulse pressure=0.000; mean arterial pressure=6.77 mmHg (95% CI 1.46 to 3.84; P=0.000) and pulse rate=6.90 bpm (95% CI 1.73 to 3.43; P=0.000) when compared with those in the control group, who had non-significant changes. Conclusions The findings of the present study concluded that aerobic exercise training improves blood pressure.