bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perspectives of healthcare professionals on cross-sectoral collaboration between mental health centers and municipalities: A qualitative study
Authors: Jørgensen Kim , Juhl Rikke , Hansen Morten , Lerbæk Birgitte , Frederiksen Jesper , Watson Emma , Bjerrum Merete , Karlsson Bengt 
Published: December 2024

Aims: This paper aims to explore the intricacies of cross-sectoral collaboration in mental health care, focusing on the perspectives of health professionals across various disciplines. It seeks to understand how collaboration can enhance service delivery and patient outcomes while identifying existing challenges. Background: The evolving healthcare landscape emphasizes the importance of integrating services across sectors, particularly in mental health care, to improve continuity and efficiency of care. Design: The study utilizes qualitative methods to investigate health professionals’ experiences with cross-sectoral collaboration in mental health services. Methods: Purposive sampling was used to select 21 health professionals for focus group discussions held at a mental health center in Region Zealand, Denmark. Data was collected through these discussions, and content analysis was performed to extract key themes. The data collection took place in 2022. Results/findings: Health professionals recognized the potential benefits of cross-sectoral collaboration, such as enhanced service delivery and improved patient outcomes. However, significant barriers were identified, including bureaucratic obstacles, communication gaps, and insufficient organizational support. Conclusion: Cross-sectoral collaboration in mental health care offers significant advantages, but challenges must be addressed to fully realize its potential. Efforts should focus on policy reforms, organizational support, and fostering interdisciplinary communication to improve care delivery.
Investigating Eating Symptoms in the LGBTQIA+ Population: Do Discrimination and Adverse Conditions Matter?
Authors: Tempia Valenta Silvia , Porru Fabio , Bornioli Anna , Di Vincenzo Matteo , Fiorillo Andrea , De Ronchi Diana , Rita Atti Anna 
Published: December 2024

Background: Eating disorders (EDs) have traditionally been studied among heterosexual cisgender women, but recent research highlights a higher prevalence in LGBTQIA+ individuals. Aims: This study aims (1) to investigate the association between different groups based on gender identity and sexual orientation (GISO) and experiencing eating symptoms, and (2) to explore the extent to which self-perceived discrimination and adverse conditions explain this association. Methods: We administered an online survey to assess eating symptoms using the Eating Disorder Examination Questionnaire (EDE-Q 6.0) and measures of self-perceived discrimination and adverse conditions. Multistep logistic regressions were employed to analyze the associations between GISO and eating symptoms, initially unadjusted, then adjusted for sociodemographic variables, and finally adjusted for self-perceived discrimination and/or adverse conditions. Results: A total of 560 adults aged 30 ± 10.9 years old were included. After adjusting for socio-demographics all groups were more likely to experience eating symptoms compared to heterosexual men, with odds ratios (ORs) of 5.7 [95% CI: 1.3, 24.3] for cisgender heterosexual women, 6.7 [95% CI: 1.5, 29.8] for cisgender non-heterosexual women, and 9.3 [95% CI: 1.8, 47.5] for non-cisgender individuals. After adjusting for self-perceived discrimination and adverse conditions, the associations for women were attenuated, while the associations for non-cisgender individuals were no longer significant. Conclusion: This study (1) confirms that sexual and gender minorities may be at higher risk for EDs, and (2) suggests that discrimination and adverse conditions may contribute to the higher prevalence of eating symptoms in this population. Additional research is needed to investigate these minority stressors as they may represent targets for effective interventions to prevent eating symptoms in the LGBTQIA+ community.
Context-dependent effects of morphosyntax processing in Turkish–Persian bilinguals: Electrophysiological and neuroanatomic correlates
Authors: Meykadeh Simin , Motie Nasrabadi Ali , Batouli Seyed Amir Hossein , Sommer Werner 
Published: December 2024

Aims and objectives: Morphosyntax processing is related to the P600 event-related potentials (ERPs) component and blood-oxygen-level dependent (BOLD) activation of the Pars opercularis (PO). First, this paper aims to investigate the relation of these variables across individuals. Second, we consider the role of context in morphosyntactic processing. Design/methodology: Highly proficient Turkish–Persian bilinguals ( N = 33) made morphosyntactic judgments on sentences. In a monolingual context, only L2 sentences (Persian) were presented, and the electroencephalography (EEG) was recorded. In a bilingual context, Persian and Turkish sentences alternated, and functional magnetic resonance imaging (fMRI) was measured. Data and analysis: The EEG and fMRI data were taken from separately published experiments on the same participants. Here, we correlated amplitudes of EEG-derived ERP components and the number of activated voxels in fMRI in designated brain regions because both parameters are proportionally attuned to the number of activated neurons. Findings/conclusions: Morphosyntactic violations in a Persian monolingual context yielded a P600 component in the ERP. In L1, morphosyntactic violations increased BOLD activation in the left PO and in L2 they activated the posterior superior temporal gyrus (pSTG). The P600 amplitude correlated only with BOLD activity in the left PO for L1. These results first support a critical role of the PO in generating the P600; second, the findings are context-specific and are most pronounced for the presumed base languages in different contexts (i.e., L2 in monolingual and L1 in bilingual contexts). These results are consistent with predictions of the adaptive control theory. Originality: This study contributes to the rarely investigated interface between ERPs and fMRI in bilingual speakers during morphosyntactic processing. The results offer novel insights into language context effects. Significance/implications: Our findings highlight the importance of cross-modality neuroimaging in bilinguals and language processing in both monolingual and bilingual contexts.
The Consideration of Appropriate Surrogate Endpoint in Premarket Clinical Trials of Drug-Coated Balloon Catheter for the Treatment of Femoropopliteal Artery Stenosis
Authors: Hao Jun , Wang Duoer , Zhao Yanyan , Zhu Yingxuan , Tinley Tenzin , Liu Weida , Li Wei , Wang Chuangshi , Wang Yang 
Published: December 2024

Purpose: Most clinical trials of drug-coated balloon (DCB) for the treatment of femoropopliteal artery stenosis chose 12-month primary patency rate (PPR) or 6-month late lumen loss (LLL) as the primary endpoint. It is still debatable whether 6-month LLL can be served as an appropriate surrogate endpoint for 12-month PPR. This study aimed to identify whether LLL can serve as an appropriate surrogate endpoint in peripheral DCB clinical trials, and shed light on the selection of primary outcome for subsequent confirmatory clinical trials of DCB in the treatment of femoropopliteal artery stenosis. Materials and Methods: The linear regression model was used to evaluate the correlation between 12-month PPR and 6-month LLL. Pooled standardized mean differences (SMDs) and relative gain between the DCB and plain old balloon angioplasty (POBA) group were computed to assess the consistency and surrogacy, using fixed or random effect model as appropriate. The coefficient of variation (CV) was calculated for both endpoints to compare their degree of variation overall and at study level. Results: A total of 34 studies are eligible for this study. A significant negative linear correlation was found between 12-month PPR and 6-month LLL (R2=0.67, slope=–0.309, p=0.007). The SMD (DCB-POBA) of LLL and PPR was –0.76 (95% confidence interval [CI]: –0.98, –0.54), and 0.59 (95% CI: 0.46, 0.72) (p=0.18). The pooled relative gain of PPR (43%, 95% CI: 35%, 50%) was significantly lower than that of LLL (72%, 95% CI: 61%, 84%) (p<0.001). Coefficient of variation of LLL was larger than that of PPR overall in DCB and POBA groups. Conclusion: Although a significant moderate correlation was observed between 12-month PPR and 6-month LLL, PPR shows more conservative and robust than LLL, which may exaggerate clinical benefits. Late lumen loss should be used discreetly depending on different situations and clinical benefits for patients. Clinical Impact This study addresses the critical issue of primary endpoint selection in clinical trials of drug-coated balloon for femoropopliteal artery stenosis. By elucidating the moderate correlation between 6-month late lumen loss (LLL) and 12-month primary patency rate (PPR), the findings underscore the limitations of LLL as a surrogate endpoint due to its variability and potential to overstate clinical benefits. The study advocates for the use of 12-month PPR as a more robust and conservative endpoint in pivotal trials, particularly for novel devices. These findings provide clinicians with a nuanced understanding of outcome measures, promoting evidence-based decision-making and regulatory alignment to ensure patient benefits in vascular interventions.
Total Aortic Arch Repair With Double-Fenestrated Physician-Modified Endograft Under Local Anesthesia And Sedation: A Prospective Study
Authors: Bacri Christoph , Hireche Kheira , Alric Pierre , Canaud Ludovic 
Published: December 2024

Objective: Endovascular aortic arch repair is an emerging procedure for all aortic pathologies, not only in high-risk patients. Little is known about the association between the type of anesthesia and outcomes. The aim of this study is to demonstrate the feasibility on short-term clinical outcomes of patients undergoing total aortic arch repair with double-fenestrated physician-modified endografts (PMEGs) under local anesthesia with sedation (also known as monitored anesthesia care [MAC]). Methods: From January to May 2024, data were prospectively collected on all procedures for total aortic arch repair with double-fenestrated PMEGs. Exclusion criteria were general anesthesia (GA). Study endpoints were technical success, time spent in the operating room, hospital stay, 30-day mortality, short-term complications, and re-interventions, according to the type of anesthesia. Results: Between January and May 2024, prospective data were collected on 20 procedures at a single referral center. A total of 14 procedures were performed under MAC. Technical success was 100%. In total, 71% of the patients were treated electively, and all major aortic pathologies were encountered (aneurysm, acute and chronic dissection, trauma, etc). In total, 93% of the procedures were done totally percutaneously, and MAC was no limitation for femoral surgical cutdown. No conversions from MAC to GA were necessary. The mean procedure time was 54 minutes (range=29-108 minutes). At 30 days follow-up, there were no major endoleaks, stent occlusions, or graft migrations. No patient died or experienced stroke. One patient had an asymptomatic retrograde dissection discovered on the follow-up computed tomography (CT) scan at 1 month requiring open surgical replacement. There were no cases of acute lung, myocardial, bowel, or kidney injury. The mean hospital stay was 4.9 days (range=2-23 days) and the mean intensive care unit (ICU) stay was 1.1 days (range=0-23 days). Conclusion: Endovascular total aortic arch repair with double-fenestrated PMEGs is feasible under local anesthesia with sedation. The short-term outcomes in a small patient cohort are promising for the development of MAC in aortic arch repair. Clinical Impact The outcomes of local anesthesia and sedation (also referred to as monitored anesthesia care) in endovascular aortic arch repair are not well-studied or widely reported. This study aims to demonstrate the feasibility and safety of this approach using physician-modified endografts for total aortic arch repair and showing it is a promising alternative to general anesthesia. Only a few exclusion criteria necessitate performing the procedure under general anesthesia and no conversions to general anesthesia were required.
Characterizing esophageal mixed neuroendocrine–non-neuroendocrine neoplasms: insights from a retrospective multicenter study of clinical outcomes and prognostic indicators
Authors: Hong Qian , Wu Kaiming , Chen Chen , Dang Yan , Zhang Qiuju , Zhang Xue , Wang Liting , Han Rui , Zhao Chenguang , Yi Hang , Li Fang , Zhang Renquan , Mu Juwei , Li Jiagen 
Published: December 2024

Background: The esophageal mixed neuroendocrine–non-neuroendocrine neoplasm (MiNEN) is an extremely rare but poor prognosis tumor. Objectives: This retrospective study aimed to analyze the clinical characteristics of MiNEN and to investigate postoperative survival and prognostic factors. Design: This retrospective study analyzed 69 patients diagnosed with esophageal MiNEN at two major esophageal cancer centers in China from January 2000 to December 2021. Methods: We assessed demographic data, tumor characteristics, treatment modalities, and survival outcomes. Statistical analyses included Kaplan–Meier survival curves and Cox regression models to evaluate prognostic factors. Results: The most common histological types were combinations of small-cell carcinoma and squamous carcinoma (91.3%). The correct diagnostic rate of preoperative pathologic biopsy was only 4.3%. The median overall survival (OS) was 24.0 months, and disease-free survival (DFS) was 16.6 months. The 1-, 3-, and 5-year survival rates were 84.1%, 34.8%, and 25.3%, respectively. A peak period of recurrence or metastasis occurs in the first year after surgery, and regional lymph node recurrence is the main route of postoperative recurrence or metastasis. Tumor size, T-stage, N-stage, and tumor, lymph node, metastasis (TNM) stage were significant prognostic factors. Subgroup analyses showed that in patients with limited-stage MiNEN in stages I–III, the postoperative adjuvant treatment modality failed to improve OS and DFS compared with surgery alone. Postoperative adjuvant therapy also failed to prolong OS and DFS in patients with lymph node-positive MiNEN. No significant survival benefits were observed with different surgical techniques or adjuvant chemotherapy regimens. Conclusion: Esophageal MiNEN has aggressive behavior and a poor prognosis. In China, the pathologic type of esophageal MiNEN may be dominated by a combination of small-cell carcinoma and squamous carcinoma. Early-stage disease significantly correlated with improved survival outcomes. Current treatment protocols, similar to those for other esophageal cancers, show limited efficacy in improving patient survival.
A comatose vertebrobasilar occlusion patient recovering with bilateral hearing loss following full recanalization with mechanical thrombectomy
Authors: Bajrami Arsida , Senadim Songul , Geyik Serdar 
Published: December 2024

Acute occlusion of vertebrobasilar artery mostly presents with severe neurologic impairment. Bilateral sensorineural hearing loss (SNHL) as the first clinical symptom on onset is a rare phenomenon. Clinical benefit of mechanical thrombectomy (MT) in terms of hearing loss in these cases is poorly understood. We describe a case of a patient with vertebrobasilar occlusion who presented with only sudden bilateral SNHL and recovered poorly in terms of hearing loss after full recanalization with MT. We describe a 52-year-old right-handed male patient with an unremarkable medical history. On admission, he was hypertensive to 200/102 mm Hg; neurological examination was significant for mild right facial palsy and bilateral SNHL, later confirmed by an audiogram. diffusion-weighted imaging (DWI) showed infarction of bilateral anterior cerebellum, cerebellar peduncles, and pons with negative flair. Computed tomography angiography showed occlusion in the level of the vertebrobasilar junction. Patients’ neurological status deteriorated within hours into a comatose status with anarthria and quadriplegia. He was treated with MT and stenting and full recanalization was achieved. All neurological examination findings have completely resolved, except for the bilateral SNHL. Acute onset of sudden bilateral deafness in isolation or accompanied by vestibular, cerebellar, and/or brainstem signs may indicate large vessel occlusion. Although rapid recanalization with MT helps improve the symptoms, the specific impact over SNHL varies between patients.
Pre-exposure prophylaxis access, uptake and usage by young people: a systematic review of barriers and facilitators
Authors: Warzywoda Sarah , Fowler James A. , Dyda Amalie , Fitzgerald Lisa , Mullens Amy B. , Dean Judith A. 
Published: December 2024

Background: Young people’s sexual health decision-making, including decisions to access and adhere to HIV prevention strategies such as Pre-Exposure Prophylaxis (PrEP), are influenced by a range of internal and external factors. Synthesizing these factors is essential to guide the development of youth-focused PrEP health promotion strategies to contribute to international goals of ending HIV transmission. Objective: To understand the individual, interpersonal, sociocultural and systemic barriers and facilitators to PrEP access, uptake and use experienced by young people 24 years and younger. Design: A systematic review that adhered to the Preferred Reporting Items of Systematic Review and Meta-Analysis Protocols. Data Sources and Methods: Eight databases (PubMed, Scopus, Cochrane, Medline, CINAHL, JBI, EMBASE, Web of Science) were systematically searched using terms related to young people, HIV and PrEP use. A narrative synthesis approach was used to delineate key barriers and facilitators to PrEP access, uptake and use. Results: Of 11,273 returned articles, 32 met the eligibility criteria for inclusion: 18 from the United States, 10 from African nations and two from Brazil. Barriers and facilitators to PrEP access, uptake and use experienced by young people were identified across intrapersonal, interpersonal, community and systems levels. These factors are described under four overarching themes that relate to knowledge, side effects and perceptions of risk; attitudes and perceptions of family and partners; community attitudes and stigma; and negative healthcare provider experiences and difficulties navigating complex costly healthcare systems. Conclusion: Findings suggest individual-level factors need consideration alongside the impacts of healthcare systems and broader systemic sociocultural structures within young people’s relationships when developing PrEP health promotion strategies and services. Without considering these wider external implications to access, uptake and use of PrEP, global targets towards the elimination of HIV transmission will likely remain out of reach. Registration: This review was registered with Prospero (CRD42022296550).
External validation of ID-BactER and Shapiro scores for predicting bacteraemia in the emergency department
Authors: Quintero Montealegre Sebastián , Flórez Monroy Andrés Felipe , Garzón Herazo Javier Ricardo , Perez Mendez Wilfran , Piraquive Natalia María , Cortes Fraile Gloria , Muñoz Velandia Oscar Mauricio 
Published: December 2024

Introduction: The blood culture positivity rate in the emergency department (ED) is <20%; however, the mortality associated with Community-acquired bacteraemia (CAB) is as high as 37.8%. For this reason, several models have been developed to predict blood culture positivity for the diagnosis of CAB. Objective: To validate two bacteraemia prediction models in a high-complexity hospital in Colombia. Design: External validation study of the ID-BactER and Shapiro scores based on a consecutive cohort of patients who underwent blood culture within 48 h of ED admission. Methods: Scale calibration was assessed by comparing expected and observed events (calibration belt). Discriminatory ability was assessed by area under the ROC curve (AUC-ROC). Results: We included 1347 patients, of whom 18.85% were diagnosed with CAB. The most common focus of infection was the respiratory tract (36.23%), and the most common microorganism was Escherichia coli (52.15%). The Shapiro score underestimated the risk in all categories and its discriminatory ability was poor (AUC 0.68 CI 95% 0.64–0.73). In contrast, the ID-BactER score showed an adequate observed/expected event ratio of 1.07 (CI 0.85–1.36; p = 0.018) and adequate calibration when expected events were greater than 20%, in addition to good discriminatory ability (AUC 0.74 95% CI 0.70–0.78). Conclusion: The Shapiro score is not calibrated, and its discriminatory ability is poor. ID-BactER has an adequate calibration when the expected events are higher than 20%. Limiting blood culture collection to patients with an ID-BactER score ⩾4 could reduce unnecessary blood culture collection and thus health care costs.
Adenocarcinoma originating from presumed liver ectopic thyroid in a cat
Authors: Caprioli Lucia , Parisi Francesca , Caprioli Lisa , Massaro Maria , Buracco Paolo , Dilli Noemi , Borgonovo Simone , Abramo Francesca 
Published: December 2024

Case summary Ectopic thyroid tissue is rarely reported in dogs and cats in its prediaphragmatic location and has never been described in the liver. A 15-year-old spayed female domestic shorthair cat was diagnosed by ultrasound with a heterogeneous hypoechoic nodular area in the liver at the periphery of the quadrate lobe. A generic diagnosis of carcinoma was made after ultrasound-guided fine-needle aspiration and cytological examination. The patient underwent staging by CT scan and subsequently underwent hepatic lobectomy. Histologically, a diagnosis of thyroid adenocarcinoma was made, confirmed immunohistochemically using positive thyroglobulin staining; the tumour was suspected to be of metastatic origin. CT scans excluded primary thyroid involvement; in addition, lesions at other sites were not detected. Therefore, a final diagnosis of thyroid adenocarcinoma arising from ectopic thyroid tissue in the liver was made. The cat recovered uneventfully from surgery. Relevance and novel information This report describes an unusual case of an adenocarcinoma originating from presumed thyroid ectopic tissue within the liver of a cat. Ectopic thyroid tissue has been rarely reported in both dogs and cats and, to the authors’ knowledge, it has never been described in the liver of a cat.
Evolution of Medical and Community Resource Services Within a Student-Run Clinic Following COVID-19 Pandemic
Authors: Zaremba Samantha , Hand Allison , Wright Alexis , Thampy Daphne , Ramirez Hillary , Aldrich Jennifer , Maher Zoe 
Published: December 2024

Introduction/Objectives: With redistribution of resources and time during the COVID-19 pandemic, the Thrive Bridge Clinic altered its focus, alongside the changes in the healthcare system and needs of the population. This paper describes how the Thrive clinic services have been altered between 2019 and 2022 as a result of COVID-19. Methods: Data was collected via retrospective chart review of patient encounters. Results: Following the onset of the COVID-19 pandemic, utilization of acute medical triage decreased while community resources requests increased. Of the community resources requested, all services increased with the largest increase being transportation. Primary care, specialty medical care, legal assistance, and substance use were additional topics commonly discussed. Conclusion: Social support and community resource requests now act as the primary focus of the Thrive Bridge Clinic following the COVID-19 pandemic. Future studies can focus on better understanding whether these resources truly reflect patient needs and how often resources that we refer are being utilized.