bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunisation health workforce capacity building in Southeast Asia: reflections from training programme implementation in Cambodia and Lao PDR
Authors: Saravanos Gemma , Teo Alvin Kuo Jing , Yam Esabelle Lo Yan , Chou Sok Chamreun , Chanlivong Niramonh , Chanthorn Phorng , Thy Chhit , Sayavong Souphon , Leask Julie , Yi Siyan , Danchin Margie , Morgan Chris , Jenkins Kylie , Kirk Martyn , Macartney Kristine , Coghlan Ben , Apostol Michelle , Arora Dinesh , Gray Darren , Smart Tracy , Sheel Meru 
Published: February 2025

The Immunization Agenda 2030 emphasises the need for a motivated, skilled and knowledgeable workforce equipped to plan, manage, implement and monitor immunisation programmes at all levels. The rapid introduction of COVID-19 vaccines during the pandemic highlighted the adaptability of the health workforce but also exposed gaps in professional development and learning.This practice paper describes the implementation of an immunisation training programme in the Kingdom of Cambodia and the Lao People’s Democratic Republic. The programme was developed and delivered by the project team in partnership with local stakeholders and technical experts. A country-centric approach ensured that training programmes met each country’s needs, while input from technical experts ensured an evidence-based programme that aligned with international standards. There were 445 training participants from professional groups across various levels and sectors of the health system. Training curricula included a range of differentiated training modules which aimed to build knowledge and skills to drive increased vaccine demand, improve service delivery and optimise monitoring and evaluation of programmes.The Gavi Learning and Performance Management framework supported a structured reflection of programme strengths, limitations and opportunities. Strengths were the country-centric and learner-centric approach and the high technical quality of the programme. The pandemic context necessitated agility and adaptation to meet changing country needs and priorities, however, this introduced some limitations. Future training programmes should undertake an enhanced assessment of training needs, workforce and digital capabilities and learning and performance management systems, alongside the development of country-driven immunisation workforce training roadmaps to ensure optimal impact and sustainability.
Chronotherapeutic intervention targeting emotion regulation brain circuitry, symptoms, and suicide risk in adolescents and young adults with bipolar disorder: a pilot randomised trial
Authors: Kim Jihoon A , Sankar Anjali , Marks Rebecca , Carrubba Erin , Lecza Bernadette , Quatrano Susan , Spencer Linda , Constable R. Todd , Pittman Brian , Lebowitz Eli R , Silverman Wendy K , Swartz Holly A , Blumberg Hilary P 
Published: February 2025

BackgroundMood episodes and high suicide risk of bipolar disorder (BD) are thought to derive from amygdala–ventral prefrontal cortex emotion regulation brain circuitry dysfunction and resulting emotion dysregulation, making these potential intervention targets.ObjectiveTo assess feasibility, acceptability, and preliminary efficacy in engaging the emotion regulation targets of two Brain Emotion Circuitry-targeted Self-Monitoring and Regulation Therapy (BE-SMART) variations in adolescents and young adults with BD (BDAYA): BE-SMART-ER, which directly targets emotion regulation, and BE-SMART-DR, a social rhythm therapy (SRT)-based chronotherapeutic intervention designed to reduce daily rhythm (DR) irregularities.MethodsIn a single-blind, parallel, pilot-randomised trial, 60 BDAYA(aged 16–29 years) were randomised to 12 weekly sessions (9 telehealth) of BE-SMART-DR or BE-SMART-ER. Nineteen BE-SMART-DR and 16 BE-SMART-ER participants completed the intervention, with 11 and 13, respectively, having pre-intervention and post-intervention functional MRI data.FindingsIn addition to demonstrating feasibility, only BE-SMART-DR showed pre-treatment to post-treatment improvements in DR regularity (Cohen’sd=0.55; 95% CI [0.06, 1.03]), associated with reductions in left amygdala responses to emotional face stimuli (pFWE (family-wise error)-SVC (small volume correction)<0.05), difficulties in emotion regulation (d=0.75; 95% CI [0.23, 1.25]) and suicide risk (d=0.65; 95% CI [0.15, 1.14]). Significant correlations were observed among these changes (p<0.05). Both interventions showed high acceptability and improvements in depression and mania symptoms. No intervention-related adverse events were observed.ConclusionsRegularising DRs may enhance emotion regulation brain circuitry functioning, emotion regulation, and reduce suicide risk in BDAYA.Clinical implicationsChronotherapeutic interventions regularising DRs, such as SRT, should be studied further as potential treatment strategies for BDAYA.Trial registration numberNCT03183388.
Can behavioural science be used to understand factors that influence the prescription choice for Parkinson’s disease? A pan-European focus group study of clinicians’ prescribing practice
Authors: Begley Emma , Thomas Jason Michael , Hind William , Senior Carl 
Published: February 2025

ObjectivesThis study aimed to establish a consensus on key factors that influence medication choices for Parkinson’s disease and to identify the behavioural determinants of these factors using behavioural change theory as a theoretical lens.DesignThis qualitative study used the nominal group technique to conduct structured online focus group meetings. A facilitator guided participants to (1) individually generate a list of factors that influence their decision to prescribe, (2) collectively share these factors, (3) refine and clarify factors and (4) rank the most important factors. Subsequently, the most important factors identified were mapped to the Theoretical Domains Framework (TDF) and the Capability, Opportunity, Motivation–Behaviour (COM-B) model to identify the behavioural determinants that influence medication choice.ParticipantsEighteen healthcare professionals, including neurologists, consultants and specialist nurses/practitioners who prescribe medication, were recruited across Europe and participated in one of seven focus groups.ResultsThere was good consensus among the participants about which factors influence their prescribing decisions. Overall, participants identified 60 unique factors that were broadly categorised into the following themes: medical or symptom concern, patient characteristics, side effects, access to treatment, clinical guidelines, social support and patient preference. Factors discussed and prioritised by the participants aligned with seven of the 14 TDF domains: knowledge; memory, attention and decision processes; beliefs about consequences; goals; social/professional role and identity; environment context and resources; and social influences. Together, these were subsequently mapped onto four of the six subdomains of the COM-B model: psychological capability, reflective motivation, physical opportunity and social opportunity.ConclusionsThese findings suggest that prescribing decisions for Parkinson’s disease are determined by a complex range of factors linked to the COM-B components capability, motivation and opportunity. These can be further understood by specific behavioural domains, as identified by the TDF, which should be targeted to help optimise subsequent prescribing decisions.
Effect of statins on neurological functional outcomes in critically ill adult patients with traumatic brain injury: a systematic review and meta-analysis
Authors: Veillette Charles , Umana Mauricio , Gagnon Marc-Aurèle , Costerousse Olivier , Zarychanski Ryan , McAuley Daniel F , Lawler Patrick , Lauzier Francois , English Shane W , Moore Lynne , Isaac Chartelin Jean , Turgeon Alexis F 
Published: February 2025

BackgroundStatins are considered a promising therapy in traumatic brain injury (TBI) because of their role in mediating inflammatory injury and other endothelial properties. Whether they can improve patient outcomes is unknown.ObjectivesTo evaluate the effect of statins in critically ill patients with TBI.DesignSystematic review and meta-analysis of randomised controlled trials.Eligibility criteriaTrials of adult patients with acute moderate or severe TBI.MethodsWe searched Medline, Embase, Cochrane Central and Web of Science databases for trials comparing the use of any statin with placebo or other interventions. Our primary outcome was the Glasgow Outcome Scale (GOS or GOS extended); secondary outcomes were mortality, intensive care unit (ICU) and hospital length of stay. We used inverse variance random-effects models to calculate risk ratios (RR) and weighted mean differences. We assessed the risk of bias of trials using the Cochrane risk of bias assessment tool and the presence of statistical heterogeneity using the I2index. Levels of evidence for summary effect measures were evaluated using Grading of Recommendations Assessment, Development and Evaluation methodology.1ResultsOf the 2418 retrieved records, 7 trials met our eligibility criteria. Three studied simvastatin, and four studied atorvastatin. The duration of the intervention ranged from 2 to 10 days, and outcomes were assessed between ICU discharge and 6 months. Five trials were considered at high risk of bias. We observed no statistically significant association between statins and the GOS (RR 0.42; 95% CI, 0.14 to 1.22; two trials; n=84, I2=0%; very low certainty) or mortality (RR 0.59; 95% CI, 0.25 to 1.44; three trials; n=160, I2=0%; very low certainty). No significant effect was observed for ICU length of stay, while hospital length of stay was evaluated in one trial showing shorter duration.ConclusionWe found no conclusive evidence supporting the use of statins in critically ill adult patients with TBI at this time. Nevertheless, the trials were limited, and wide confidence intervals resulted in significant uncertainty of the findings. A potential benefit cannot be ruled out, underscoring the need for a larger, well-designed trial.PROSPERO registration numberCRD42023421227.
Idiopathic pulmonary fibrosis in the UK: findings from the British Thoracic Society UK Idiopathic Pulmonary Fibrosis Registry
Authors: Fahim Ahmed , Loughenbury Maria , Stewart Iain , Agnew Sarah , Almond Howard , Casimo Leo , Chaudhuri Nazia , Fletcher Sophie V , Haney Sarah , Ho Ling-Pei , Hodkinson Clare , Minnis Paul , Palmer Evelyn , Wilson Andrew M 
Published: February 2025

ObjectivesIdiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease (ILD) and the most common idiopathic interstitial pneumonia. The UK IPF Registry was established in 2013 to collect data pertaining to clinical features, therapeutic approaches and outcomes. From February 2023, the Registry expanded to include any ILD with evidence of fibrosis.DesignThe UK IPF Registry is a national, multicentre observational registry, including both prospective and retrospective data of patients with IPF in secondary or tertiary care. Cases eligible for inclusion were those with a diagnosis of IPF, presenting at participating centres from January 2013.ResultsBetween January 2013 and February 2023, 5052 IPF cases were registered from 64 participating centres. There was a male preponderance (77.8%) with mean±SD age of 74±8.1 years, 66% were ex-smokers and 76% had at least one comorbidity. Over a third (36.7%) experienced symptoms for more than 24 months prior to their first clinic visit. The majority of cases were discussed at a multidisciplinary team (MDT) meeting and the most common radiological patterns at presentation were probable (54.6%) and definite (42.7%) usual interstitial pneumonia. There was a reduction in surgical lung biopsies from 14% in 2013 to 5.5% in 2022. Antifibrotic therapy prescription rose from 36.0% in 2013 to 55.9% in 2023. The use of nintedanib (approved by National Institute of Clinical Excellence in January 2016) rose from 6.7% in 2013 to 31.5% in 2022 and pirfenidone (approved in April 2013) was initially used in around a third of cases before dropping to between 16.8% and 24.9% after nintedanib was approved.ConclusionThese data reflect clinical practice across the UK and it is intended the data will have a role in informing the future of IPF care and providing a model for benchmarking, ultimately increasing knowledge and improving clinical care for this devastating disease.
Cadaveric study of the obturator nerve: frequency of skin innervation and the optimal site for blocking the cutaneous branch
Authors: Jessen Christian , Moriggl Bernhard , Hörmann Romed , Bendtsen Thomas Fichtner 
Published: February 2025

BackgroundClinical understanding of the obturator nerve’s cutaneous and motor branches is crucial for performing effective obturator nerve blocks, particularly for procedures involving the thigh and hip. Literature and anatomical references report highly variable patterns of the frequency and cutaneous distribution of obturator nerve innervation.This study examines the frequency and distribution of the cutaneous branch of the anterior ramus of the obturator nerve (cb-ar-ON) and assesses the most effective anatomical sites for nerve blockade.MethodsDissections were conducted on 14 sides from eight cadavers to identify the presence, branching pattern and innervation areas of the cb-ar-ON. Ultrasound-guided injections of low-volume dye were performed proximally between the adductor longus and gracilis muscles and distally near the great saphenous vein to assess optimal targeting.Resultscb-ar-ON were found in 43% of cadaveric sides, branching off the anterior ramus of the obturator nerve 6–10 cm distal to the inguinal ligament. When present, the cb-ar-ON innervated a 4–9 cm2area in the posteromedial popliteal fossa. Proximal ultrasound-guided blocks targeting the area between the adductor longus and gracilis muscles effectively stained the cb-ar-ON in 100% of cases where the branch was present.ConclusionThe cb-ar-ON provides variable and limited cutaneous innervation, appearing in 43% of cases, primarily in the posteromedial popliteal fossa. Effective blockade can be achieved with a proximal approach between the adductor longus and gracilis muscles.These findings suggest that clinical evaluation of obturator nerve block based on cutaneous anesthesia is unreliable.
Dynamical reconstruction of the $$\Lambda $$CDM model in the scalar–tensor representation of $$f\left( Q,T\right) $$ gravity
Authors: Kaczmarek Adam Z. , Rosa João Luís , Szczȩśniak Dominik 
Published: February 2025

Abstract
Motivated by the growing interest in the nonmetricity-matter couplings, we develop the scalar–tensor formulation of recently introduced f(Q, T) gravity, where Q is the nonmetricity and T is the trace of the energy–momentum tensor. The main properties of the scalar–tensor formalism for the Friedmann–Lemaître–Robertson–Walker (FLRW) Universe are discussed, and we introduce an appropriate set of dynamical variables to analyze the cosmic evolution of the scalar–tensor f(Q, T) cosmology as a dynamical system. By considering two distinct cosmic fluids, namely matter and radiation, we have demonstrated that the cosmological phase space exhibits the typical curvature-dominated, radiation-dominated, matter-dominated, and exponentially accelerated fixed points. Furthermore, under an appropriate set of initial conditions compatible with the current observations from the Planck satellite, our analysis shows that the scalar–tensor f(Q, T) successfully yields models indistinguishable from the

$$\Lambda $$

Λ

CDM cosmology and compatible with the weak-field solar system dynamics, without the inclusion of a cosmological constant

$$\Lambda $$

Λ

. Thus, the theory introduced herein may be regarded as a suitable candidate to describe the cosmological dynamics of the Universe.
Horizon quantum mechanics for coherent quantum black holes
Authors: Feng Wenbin , Giusti Andrea , Casadio Roberto 
Published: February 2025

Abstract
The formalism of the horizon quantum mechanics is applied to electrically neutral and spherically symmetric black hole geometries emerging from coherent quantum states of gravity to compute the probability that the matter source is inside the horizon. We find that quantum corrections to the classical horizon radius become significant if the matter core has a size comparable to the Compton length of the constituents, and the system is indeed a black hole with probability very close to one unless the core radius is close to the (classical) gravitational radius.
A Holistic View of Climate Sensitivity
Authors: Jeevanjee Nadir , Paynter David J. , Dunne John P. , Sentman Lori T. , Krasting John P. 
Published: February 2025

The notion of climate sensitivity has become synonymous with equilibrium climate sensitivity (ECS), or the equilibrium response of the Earth system to a doubling of CO2. But there is a hierarchy of measures of climate sensitivity, which can be arranged in order of increasing complexity and societal relevance and which mirror the historical development of climate modeling. Elements of this hierarchy include the well-known ECS and transient climate response and the lesser-known transient climate response to cumulative emissions and zero emissions commitment. This article describes this hierarchy of climate sensitivities and associated modeling approaches. Key concepts reviewed along the way include climate forcing and feedback, ocean heat uptake, and the airborne fraction of cumulative emissions. We employ simplified theoretical models throughout to encapsulate well-understood aspects of these quantities and to highlight gaps in our understanding and areas for future progress.

▪
There is a hierarchy of measures of climate sensitivity, which exhibit a range of complexity and societal relevance.

▪
Equilibrium climate sensitivity is only one these measures, and our understanding of it may have reached a plateau.

▪
The more complex measures introduce new quantities, such as ocean heat uptake efficiency and airborne fraction, which deserve increased attention.
Determinants of Stunting Severity Among Under‐Fives: Comparison of Agricultural and Nonagricultural Households in South Lampung Regency, Indonesia
Authors: Bakri Samsul , Puspaningrum Dewi Ayu , Berawi Khairun Nisa , Zuraida Reni 
Published: February 2025

Introduction: One of the efforts to achieve Indonesia Emas, a vision of a prosperous and developed nation by 2045, is to prevent or eliminate stunting in under‐five children due to its long‐term adverse effects. Given the persistent prevalence of stunting in South Lampung Regency, Indonesia, there is a significant need to identify the influence of mother–child variables. Moreover, comparative studies between agricultural and nonagricultural households on stunting remain underresearched.Methods: An ordinal logistic regression model was applied at a 95% confidence level. The response variables are four levels of stunting under‐fives. The determinant variables tested were from the children’s side (age, gender, and nutritional status), the mother’s side (duration of breastfeeding, age during pregnancy, birth spacing, and livelihood), and household livelihoods (agricultural vs. nonagricultural). Data collection was designed cross‐sectionally and carried out from July to August 2022.Results: The research results showed that the nutritional status and age of the child and maternal factors such as exclusive breastfeeding, age during pregnancy, and birth spacing were determining risk factors (stunting). In particular, children from nonagricultural households show a lower risk of stunting than children from agricultural households.Discussion: The determinants of stunting in under‐five children in South Lampung Regency are significantly influenced by child‐specific factors, maternal conditions, and households with agricultural household livelihoods. To address stunting, it is essential to enhance maternal and child health programs and implement targeted nutritional interventions, particularly for agricultural households with farming fathers. Future research should investigate the impact of agricultural practices on child nutrition and assess the efficacy of interventions across various socioeconomic settings. Longitudinal studies are crucial for evaluating and refining stunting prevention strategies, ultimately contributing to the achievement of Indonesia Emas 2045.
Multimodal Treatment of a Spontaneously Ruptured Echinococcus Cyst of the Spleen and Its Complications
Authors: Bruijn Sévérine De , Weerdt Annick De , Broeckx Glenn , Spinhoven Maarten , Paep Rudi De , Robert Dominique , Komen Niels , Jorens Philippe G. 
Published: February 2025

Introduction: Cystic echinococcosis, also known as hydatid cyst, is a parasitic infection of mammals that can affect any organ. Although the diagnosis of primary splenic echinococcosis is challenging, especially in nonendemic areas, it can be life‐saving because an anaphylactic shock may occur when the cyst ruptures. Recommendations regarding optimal treatment options after rupture are scarce, and the overall prognosis remains poor.Case Presentation: A patient with a spontaneous rupture of an isolated splenic hydatid cyst was treated with splenectomy and peritoneal lavage with a hypertonic salt solution. The patient survived despite rapidly progressive hypernatremia, which was treated with conventional therapy along with continuous venovenous hemofiltration with gradient sodium replacement.Discussion: When the decision is made to treat a patient with a spontaneously ruptured splenic echinococcus cyst, splenectomy is the only surgical option. Hypernatremia is a complication to be expected when hypertonic saline is used to rinse the splenic and abdominal cavities.Conclusion: This case highlights the importance of prompt surgical intervention and the management of hypernatremia in patients with ruptured splenic hydatid cysts.
Associations of Education Attainment With Postpartum Depression and the Mediating Exploration: A Mendelian Randomization Study
Authors: Wang Xuanping , Zhou Fang-Yue , Hao Yanhui , Wu Jiaying , Su Kaizhen , Chen Si-Yue , Yu Wen , Zhang Chen , Wu Yan-Ting , Huang He-Feng 
Published: February 2025

Background: Many studies have explored the relationship between education and postpartum depression (PPD), with inconsistent results. Our study is to identify which education‐related factors (education attainment, qualifications, cognitive performance) played the predominant role in PPD using Mendelian randomization (MR) analysis. Then, we explored the factors that may mediate the effect of education on PPD.Method: We performed two‐sample multivariable Mendelian randomization (MVMR) to assess the independent impact of education‐related factors on PPD. Based on the literature review, three mediating factors that may play a role in the path of education attainment and PPD were involved in mediation analysis, including childbearing age, neuroticism score, and average total household income before tax. Then, we used two‐step MR and MVMR to estimate the indirect effect of these mediators.Results: We identified genetically predicted 1‐SD (3.71 years) higher education attainment (OR: 0.632; [95% confidential interval (CI): 0.464–0.860]); qualifications (OR: 0.418; [95% CI: 0.245–0.714]); or cognitive performance (OR: 0.770; [95% CI: 0.652–0.909]) was associated with lower risk of PPD, and the causal effects of education attainment (OR: 0.407; [95% CI: 0.214–0.773]) on PPD were independent of qualifications and cognition. Childbearing age (β: −0.497; [95% CI: −0.788−0.238]; p  < 0.001) and neuroticism score (β: −0.07; [95% CI: −0.120−0.030]; p  < 0.001) were identified as mediators of the association between education attainment and PPD.Conclusions: These results suggested the predominant impact of education attainment on PPD independent of qualifications and cognition. Education level mainly affects PPD by changing the childbearing age.Trial Registration: Chinese Clinical Trial Registry identifier: ChiCTR2000033433