bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification and evaluation of human errors in the care of pregnant mothers using the extensive CREAM technique
Authors: Babaei-Pouya Amin , Pajouhandeh Zahra , Shrinzadeh-Feizabadi Atefeh , Teimori-Boghsani Gholamheidar , Feiz-Arefi Maryam , Laal Fereydoon 
Published: December 2024

Background Care of pregnant mothers is one of the most important services provided in the healthcare system. Objective This study aims to identify and evaluate human errors in the care process of pregnant mothers using the extensive Cognitive Reliability and Error Analysis Method (CREAM). Methods In this study, tasks and activities related to the care of pregnant mothers in the health center and hospital were first analyzed using the HTA (hierarchical task analysis). Then, using extensive CREAM, human errors in tasks related to the care of pregnant mothers in the health center and hospital were identified and evaluated. Results In general, 34 main tasks and 106 subtasks were identified in the process of caring for pregnant Mothers. Thirty seven activities are related to midwifery associates or experts, and 19 activities are related to gynecologists. The highest Cognitive Failure Probability total (CFPt) was related to the duties of measures related to the infant, preparing the pregnant mother for transfer to the operating room, routine obstetric measures, taking delivery, measures related to resuscitation, and measures related to the control of the condition after delivery. Conclusions The process of caring for pregnant mothers is very vital and prone to errors due to different levels of service. The presence of experienced and capable personnel can largely prevent the occurrence of human errors. Increasing the number of personnel can be effective in reducing workload and preventing errors.
Insights About Dyadic Cancer Survivorship Interventions for Black Women and Their Caregivers: A Rapid Qualitative Analysis of Collaborator Perspectives
Authors: Thompson Tess , Lero Christi M. , Levitan Julia , Bradley Cory D. , James Aimee S. , Heiden-Rootes Katie , Sargent Emani , Johnson LaShaune P. 
Published: December 2024

Background Breast cancer patients and their informal caregivers often report unmet psychosocial, relational, and physical health needs. Dyadic interventions may improve patient and caregiver outcomes, but few have been integrated into clinical care or designed for Black breast cancer patients and their female caregivers. We used the Health Equity Implementation Framework to design for dissemination by identifying facilitators and barriers to implementing a dyadic survivorship intervention delivered via video teleconferencing (e.g., Zoom). Methods We conducted semi-structured interviews with a purposive sample of 18 collaborators with roles at a comprehensive cancer center and community organizations to understand facilitators and barriers to implementing a dyadic intervention for Black breast cancer patients and their caregivers. We used rapid qualitative analysis (templated summaries synthesized in matrices) to conduct a directed content analysis. We identified patterns in responses to interview guide questions and developed cross-cutting themes. Results Collaborators’ roles fell into four domains: patient-facing mental health (33%), patient-facing physical health (28%), research/administration (28%), and cancer-focused community groups (11%). Participants were supportive of a dyadic intervention for Black women with breast cancer and female caregivers. Collaborators noted that psychosocial care at the cancer center was already being delivered via Zoom and saw benefits to including caregivers. Overarching themes include the need to address gaps in care (for caregivers, Black women, and long-term breast cancer survivors); the importance of representation in building trust and mitigating stigma; and the challenges within the healthcare system around providing care services to dyads. Conclusion Application of these findings can help address the challenges of implementing a dyadic survivorship intervention for Black women with breast cancer and their caregivers in clinical settings. Expanding models such as the Health Equity Implementation Framework to include caregivers may help focus dissemination and implementation efforts on both members of a dyad and improve outcomes for both.
Impact of Educational Background on the Quality of Standardized Residency Training Program: The Case of China, a Cohort Study
Authors: Tu Xiaoyu , Ding Xiaoquan , Huang Wanru , Xu Xiangrong , Moreira Paulo , Zhang Runju 
Published: December 2024

Objectives: Residency training is important worldwide and recent studies have put more emphasis on its quality evaluation. This study aims to first explore the impact of educational backgrounds on the quality of gynecology and obstetrics (OB-GYN) standardized resident training (SRT) program in China, which may provide crucial evidence for policy considerations to improve SRT quality. Methods: A total of 397 OB-GYN resident graduates were enrolled in this retrospective cohort study. They were divided into three groups according to their educational background, that is Bachelor of Medicine (BM), Master of Medicine (MM), and Doctor of Medicine (DM) groups. The characteristics and the results of SRT graduation examination and annual assessment of these residents were collected and compared using one-way analysis of variance or Pearson’s chi-square test. A multivariable logistic regression analysis was performed to identify the association between sociodemographic variables and pass rates of SRT graduation examination. Besides, a subgroup analysis on training time for the DM group was performed. Strobe protocol was followed. Results: The residents were older in DM group than that in BM and MM groups ( P < 0.001). There was significant difference of the training length and the proportion taking part in SRT graduation examination among three groups ( P < 0.001). Although the written test scores of SRT graduation examination were the lowest in BM group ( P = 0.015), there was no significant difference in other results among three groups. No significant variable was found associated with the pass rates of SRT examination. No significant difference was found in the subgroup analysis of DM group. Conclusion: Overall, the SRT quality of OB-GYN residents with different educational backgrounds was good and comparable. However, residents with BM degrees had lowest written scores and need to be strengthened during training. The training time of residents with DM degrees can be shortened according to their own conditions.
Real-World Effectiveness of Tildrakizumab for Moderate-to-Severe Plaque Psoriasis in Canada
Authors: Abu-Hilal Mohannad , Cowger Jeff , Bawazir Mohammed , Sajic Dusan , Savinova Iryna , Yap Belinda , El-Sayegh Rami , Bolatova Talshyn , Chan Pak , Cy Ajith 
Published: December 2024

Background: Tildrakizumab is an interleukin-23 inhibitor approved in Canada in 2021 for the treatment of adults with moderate-to-severe plaque psoriasis. Objectives: To evaluate real-world effectiveness of tildrakizumab for the treatment of moderate-to-severe plaque psoriasis in Canada. Methods: A multicenter, retrospective study was conducted in Canada in adults with moderate-to-severe plaque psoriasis for ≥1 year treated with tildrakizumab for ≥12 weeks. Effectiveness was evaluated from proportions of patients achieving ≥75%/≥90%/100% improvement from baseline in Psoriasis Area and Severity Index (PASI 75/90/100 response) and Physician Global Assessment (PGA) 0 or 1 at weeks 16 (±4), 24 (±8), and 48 (±12). Subgroup analyses were performed based on prior biologic use and special site involvement. Results: The study included 75 patients (mean age, 50.5 years; 52.0% female; 82.7% bio-naïve; 73.3% with special site involvement). Absolute mean (standard deviation) PASI score improved from 16.1 (6.7) at baseline to 1.3 (1.7) at the week 48 (91.7% improvement), 95.7%/69.6%/34.8% of patients achieved PASI 75/90/100 response, and 93.0% achieved PGA 0/1 at the week 48. In subgroup analyses, 94.7%/71.1%/34.2% of bio-naïve patients, 100.0%/62.5%/37.5% of bio-experienced patients, 100.0%/71.4%/28.6% of patients with special site involvement, and 81.8%/63.6%/54.6% of patients without special site involvement achieved PASI 75/90/100 response, and 87.5%, 94.3%, 97.0%, and 80.0% of patients, respectively, achieved PGA 0/1 at the week 48. None of the differences among subgroups were statistically significant; however, patient numbers were too small to support robust conclusions. Conclusions: Tildrakizumab is effective for the treatment of moderate-to-severe plaque psoriasis in adults in a real-world setting in Canada.
Short report on a distinct electroencephalogram endophenotype for MTHFR gene variation co-occurring in autism spectrum disorder
Authors: Ezedinma Uchenna , Jones Evan , Ring Alexander , Miller Spencer , Ladhams Andrew , Fjaagesund Shauna , Downer Terri , Campbell Gary , Oprescu Florin 
Published: December 2024

Anecdotal reports link a distinct, bilateral, parieto-temporally generated 4.5-Hz rhythm on an electroencephalogram to a methylenetetrahydrofolate reductase gene variant co-occurring in autism spectrum disorder, but the validation of its precision is needed. The electroencephalograms of children with autism spectrum disorder showing the distinct bilateral parieto-temporally generated 4.5-Hz rhythm and their clinical chart report on polymerase chain reaction screening for methylenetetrahydrofolate reductase gene variants, 677C>T and 1298A>C, were retrieved from an outpatient clinic between February 2019 and April 2024. Twenty-five cases were identified. Patients were between 2 and 12 (7 ± 3) years old from Asian ( n = 16, 64%), European ( n = 5, 20%), African ( n = 1, 4%) and mixed ( n = 3, 12%) ethnicities. Twenty patients (80%) were positive for 677  C>Theterozygous ( n = 3, 15%), 1298A>Cheterozygous ( n = 8, 40%) or both ( n = 9, 45%). The polymerase chain reaction testing detected neither variant in 5 (20%) patients. Therefore, the electroencephalogram-endophenotype showed 80% precision in identifying methylenetetrahydrofolate reductase gene variant within the sample. This preliminary data support the precision of the proposed distinct, bilateral, parieto-temporally generated 4.5-Hz rhythm in identifying methylenetetrahydrofolate reductase gene variants and its potential clinical applications as a valuable, non-invasive and objective measure within the population. Lay abstract Methylenetetrahydrofolate reductase mutations refer to genetic variations in the methylenetetrahydrofolate reductase enzyme, which plays an important role in folate metabolism. Folate is essential for neural development and signalling. Children with autism spectrum disorder have atypical neural signals compared with control. This study used a non-invasive method to identify a distinct neural signal that may be useful in future screening for methylenetetrahydrofolate reductase mutation in children with autism spectrum disorder. Given that the underlying causes of autism spectrum disorder have multiple genetic factors and often require subjective assessment, this study introduces a potential non-invasive screening method for methylenetetrahydrofolate reductase gene mutation. This method could provide valuable biomarkers for screening and personalised treatments, offering hope for improved risk stratification and bespoke nutritional support and supplements to mitigate the impact on affected individuals and their descendants.
Adolescents’ screen-based media use and the relationship with moderate-to-vigorous physical activity, sports club participation and active commuting
Authors: Haug Ellen 
Published: December 2024

Aim: A worry regarding young people’s physical activity engagement relates to a potentially competing development: the role of screen-based media (SBM) in their everyday lives. The present study aimed to assess time spent on different types of SBM, self-reported moderate-to-vigorous physical activity (MVPA) and physical activity in different domains and their interrelations. Methods: The study is based on data from 3737 participants aged 11, 13 and 15 years from Norway collected in 2021/2022 as part of the Health Behaviour in School-aged Children collaborative cross-national survey. Results: The findings revealed high amounts of total SBM time. There were age and gender differences in physical activity, especially with lower levels of active transport during leisure time among girls than among boys. A series of binary logistic regression analyses with adjustment for age, gender and socioeconomic status showed that high levels of total SBM time were negatively associated with involvement in club sports, active school transport, active travel to friends and leisure activities, and 60 min MVPA 5 days/week. Gaming and social media use were also negatively associated with most of the physical activity indicators. All SBM variables were negatively associated with involvement in club sports and 60 min MVPA 5 days/week. Conclusions: The study demonstrates negative associations between SBM time among adolescents and physical activity in various domains. Actions to facilitate youth physical activity in the digital age seem crucial. Additional studies with nuanced data on these behaviours and longitudinal research design allowing for examining their interrelations over time are needed.
Characterization of PBAT/TPS blends for plastic wrapping materials of pathological waste buried in soil environments
Authors: Mohd Nizam Nuraina Hanim , Tuan Sharif Sharifah Emilia , Wen Da Oh , Ku Ishak Ku Marsilla 
Published: December 2024

This study investigates the incorporation of thermoplastic starch (TPS) into polybutylene adipate terephthalate (PBAT) to create biodegradable plastic wraps for pathological waste burial in soil. TPS is added to PBAT to enhance biodegradability, as PBAT alone degrades slowly. The research examines the mechanical properties, biodegradation, morphology, and swelling behaviour of the blends. Key tests include xenon arc light exposure for accelerated aging, a formalin swelling test for permeability, and soil degradation analysis for weight loss. Results show that adding TPS significantly reduces tensile strength (65.53%) and elongation at break (93.35%), but the material still effectively serves its purpose as a wrapping for pathological waste. Morphological analysis reveals phase separation, and UV exposure further decreases tensile strength by 27.6%. The highest TPS composition (30TPS/70PBAT) shows the fastest mechanical degradation, indicating accelerated biodegradation. Despite minimal formalin absorption (16% within 1 day), the blends prevent formalin leaching, making them suitable for pathological waste containment.
Graphic Paper: The perspectives of homeless people using the services of a mobile health clinic in relation to their health needs: a qualitative study on community-based outreach nursing
Authors: Brenchley Alex 
Published: December 2024

JRN is delighted to present a graphic depiction of the 2023 JRN Veronica Bishop Paper of the Year award winners’ paper. This paper won the award for its potential to impact policy, practice and/or research. We hope you enjoy this graphic paper and rereading the original work. We have inserted the original paper’s abstract below with links to that paper and its associated commentary. Background: Significant social and health issues are associated with homelessness. Negative experiences with the healthcare system are also frequent and cause people experiencing homelessness to avoid health services. Aims: The purpose of this study was to (1) explore participants’ health needs concerning outreach nursing services and (2) describe the perceptions and preferences of people who access this form of community-based intervention. Methods: We conducted a critical ethnography with semi-structured interviews of 12 people experiencing homelessness who receive the services of a nurse-led mobile clinic, and 60 hours of observation during the provision of these services. Results: Our results describe the perspectives of people experiencing homelessness in three main categories: (1) worrisome health and social needs, (2) non-use of healthcare and (3) what connects us to health services. Conclusions: Timely access to healthcare is an important issue for people experiencing homelessness. Nurse-led clinics meet needs that go far beyond health issues.
Awareness of heart failure, blood pressure management and self-efficacy: The Research Goes Red for Women Registry
Authors: Conners Katherine M , Hashemian Maryam , Kinzy Claire , Hall Jennifer L , Herr Christine , Sharma Reeti , Mallya Pratheek , Zhao Juan , Ibrahim Nasrien E , Shearer Joseph J , Hong Haoyun , Roger Véronique L 
Published: December 2024

Background: Heart failure (HF) is increasing in the United States, and awareness is needed for prevention. Hypertension is the leading cause of HF, and adherence to antihypertensive medication is critical for reducing HF risk. Self-efficacy positively influences health-promoting behaviors. Objectives: Assess HF awareness, test associations with antihypertensive medication adherence, and self-efficacy for managing chronic conditions. Design: We conducted a cross-sectional, observational survey research study. Methods: We leveraged data from participants enrolled in the American Heart Association’s Research Goes Red™ registry, an online platform powered by Verily. Three surveys ascertained HF awareness, blood pressure management, and self-efficacy. Chi-squared and Wilcoxon rank sum determined associations between survey domains and participant characteristics. Results: Two thousand three hundred twenty women took the HF awareness survey, 678 the blood pressure management survey, and 755 the self-efficacy survey (response rates: 12%, 78%, and 76%, respectively). Participants were predominantly non-Hispanic White (78%), with a median age of 51 (interquartile range (IQR): 39, 62). Median HF awareness score was 4/5 (IQR: 4, 5). Participants with high HF awareness versus low were more likely to be older ( p < 0.001), non-Hispanic White ( p < 0.001), and less likely to smoke ( p < 0.001) or have depression ( p = 0.004). Nearly 90% of hypertensive participants reported medication adherence, which was not associated with HF awareness or self-efficacy. Participants with greater self-efficacy versus less were more likely to have higher HF awareness ( p = 0.01), be older ( p = 0.01), and less likely to have depression ( p < 0.001). Conclusion: Women’s awareness of HF and adherence to antihypertensive medication in this cohort was high. Depression and younger age may be important factors affecting women’s HF awareness and confidence in managing chronic disease medication plans.
Neighborhood deprivation and association with 18-month neurodevelopmental impairment of preterm infants born in a dense urban setting
Authors: Sahni Prateek V , Kim Faith , Isler Joseph R , Sahni Rakesh 
Published: December 2024

Background Neighborhood adversity’s impact on 18-month neurodevelopmental impairment (NDI) is not well-described. The aim of our study was to determine whether area deprivation index (ADI), a measure of neighborhood socioeconomic disadvantage, at birth is associated with 18-month NDI of preterm infants born in dense urban setting. Methods A retrospective case-cohort study was performed in infants born at 23–32 weeks gestational age (GA) with birth weight (BW) ≤1250 g between 2013 and 2017 and evaluated for NDI at 18-month corrected age (CA). Socioeconomic deprivation was computed geospatially using subject addresses that were mapped to national ADI rankings. Subjects were categorized as low (<26th percentile) or high (26–100th percentile) ADI neighborhoods and with/without NDI if any of Bayley-III cognition, language, or motor composite scores were <70. The relationship between ADI and NDI was analyzed using logistic regression adjusted for GA and BW and group comparisons were made. Results Data were available in 119 patients (GA = 27.2 ± 2.2 weeks, BW = 870 ± 246 g). Children with NDI at 18-month CA were born at an earlier GA ( p < .001) with lower BW ( p < .03) and to mothers living in high ADI neighborhoods ( p < .02). Patients from lower ADI neighborhoods at birth had higher Bayley-III cognition ( p < .0001), language ( p < .005), and motor ( p = .03) composite scores at 18-month CA. Cognition ( p < .01), language ( p < .003) and motor ( p < .03) composite scores decreased with increasing ADI percentiles. Conclusions Among infants born 23–32 weeks GA in a dense urban setting, ADI at birth is associated with NDI at 18 months with lower cognitive, language, and motor scores in preterm infants from higher ADI neighborhoods.
Survey of Utilization of Weightbearing Computed Tomography Within AOFAS Membership
Authors: Reddy Sudheer C. , Netto Cesar de Cesar 
Published: December 2024

Background Weightbearing computed tomography (WBCT) has been increasingly employed to evaluate and treat patients with varied pathologies such as progressive collapsing foot deformity (PCFD), posttraumatic deformity, hallux valgus, ankle arthritis, Charcot arthropathy, lisfranc, and syndesmosis injuries. However, little is known regarding its overall availability to foot and ankle providers and how it is being used in clinical practice. The goal of this study is to assess the utilization of WBCT among AOFAS members, identify the indications for use in clinical practice and potential barriers for implementation. Methods A survey was emailed to AOFAS members inquiring about the use WBCT in clinical practice. Practice and demographic information were also collected. A total of 220 responses were collected over a 2-month period. Respondents were queried with respect to the availability of WBCT in practice, indications for use, frequency of use, ownership of the scanner, and barriers to implementation. Results 58% of respondents did not have access to WBCT. Most respondents were in practice 10 years or more (69%). Single-specialty private practice was the most common practice type (39%). Of those with access to WBCT, 5 or fewer scans were ordered per week (57% of respondents). Evaluation of hindfoot/ankle deformity was the most common indication (69% of respondents) with it being used as a preoperative evaluation tool approximately 25% of the time (57% of respondents). Radiology department owned WBCT in most institutions (34%). 75% of respondents with WBCT use it postoperatively less than 25% of the time. Of those without WBCT, 94% stated they would like to have it with cost being the most significant barrier to implementation. Conclusion Most respondents surveyed did not have access to WBCT, with cost being the greatest barrier. However, 94% of those without it would like to have access to it. For those with access, it is used 5 or fewer times per week with evaluation of hindfoot/ankle deformity being the most common indication. Level of Evidence: Level IV (Observational Study)