bluuebunny/crossref_metadata_2025_split huggingface dataset:
Consensus on the Structure and Content of Birth Plans: A Modified Delphi Study
Authors: Vendittelli Françoise , Adalid Lucie , Peyronnet Violaine , Guillaume Sophie , Piquée Nathalie , Viard‐Cretat Aurore , Crenn‐Hébert Catherine , Rivière Olivier , Guiguet‐Auclair Candy ,   Study Group
Published: December 2024

ABSTRACTBackgroundFew pregnant women in France wrote birth plans as in many other countries. The literature stresses the heterogeneity of birth plan content, which limits the utility of assessing the effects of birth plans on women's experience of childbirth. This study aimed to obtain a French national consensus on the structure and content of birth plans.MethodsA multidisciplinary steering committee was established. An electronic modified Delphi study was conducted to develop a structure and content for birth plans between November 2022 and June 2023. During three Delphi consensus rounds, panellists, including perinatal health care professionals and user representatives, were asked to rate individually and independently each proposed section and subsection formulation of the birth plan for its appropriateness. An external board assessed the understandability of the final birth plan's preamble and content.ResultsThe steering committee proposed 103 formulations corresponding to items to be covered in a birth plan, categorized into 8 sections and 30 subsections, for evaluation in the Delphi rounds. The first round was completed by 42 panellists (mainly midwives), the second by 39, and the third by 36. Finally, the steering committee approved the final components of the structured birth plan in 8 sections and 19 subsections, after its reviewing by the 21 members of the external board.ConclusionA French national Delphi process, after three rounds and validation by an external board, made it possible to reach a consensus on the structure and content of a birth plan in 8 sections and 19 subsections.Patient or Public ContributionUser representatives were included as experts in the Delphi rounds, and in the external board to approve the final version of the structured birth plan.
The drivers of deskilling: Comparing highly skilled Ukrainian refugee women in Austria and Poland
Authors: Aigner Petra , Bešić Almina , Kubiciel‐Lodzińska Sabina , Bacher Johann , Maj Jolanta , Prischl Clara 
Published: December 2024

AbstractThe arrival of Ukrainian refugees in the European Union (EU) has reignited debates about the accessibility of labour markets, deskilling and underemployment. The Ukrainian case is especially significant because most refugees are highly skilled women and the implementation of the EU's temporary protection directive has provided them with immediate access to the EU's labour market. This paper examines the labour market access and deskilling of highly skilled Ukrainian women in the European Union. We compare two regions, Opole Voivodeship (Poland) and Upper Austria. Utilising a quantitative survey, we offer a comparative exploration of the drivers behind deskilling. This paper contributes to the growing literature on labour market access for female refugees, corroborating existing literature on ‘double’ and ‘triple disadvantage’ scenarios by highlighting deskilling processes and underemployment mechanisms in the context of instant labour market access. Moreover, it compares the diverse drivers of deskilling, ‘gender blindness’ in policy responses and the influence policymaking has on the allocation of migrant and refugee labour into sectors with shortages.
Comparative Effectiveness of Cell‐Based Versus Egg‐Based Influenza Vaccines in Prevention of Influenza Hospitalization During the 2022–2023 Season Among Adults 18–64 Years
Authors: Rayens Emily , Ku Jennifer H. , Sy Lina S. , Qian Lei , Ackerson Bradley K. , Luo Yi , Tubert Julia E. , Lee Gina S. , Modha Punam P. , Park Yoonyoung , Sun Tianyu , Anderson Evan J. , Tseng Hung Fu 
Published: December 2024

ABSTRACTThis retrospective cohort study evaluated the comparative vaccine effectiveness (cVE) of licensed standard‐dose cell‐based versus egg‐based influenza vaccines in preventing influenza hospitalization among adults 18–64 years during the 2022–2023 season. The cohort included eligible Kaiser Permanente Southern California members who received ≥ 1 dose of influenza vaccine (n = 848,334). The adjusted cVE against influenza hospitalization was −10.1% (95% CI: −49.8%, 37.8%) in the 18‐ to 49‐year‐old cohort. In the 50‐ to 64‐year‐old cohort, the adjusted cVE was 14.9% (−33.8%, 52.1%). Cell‐based and egg‐based influenza vaccines conferred comparable protection against influenza hospitalization in adults 18–64 years of age in the 2022–2023 season.
Revisiting negative pressure wound therapy from a mechanobiological perspective supported by clinical and pathological data
Authors: Gefen Amit , Russo Serena , Ciliberti Marino 
Published: December 2024

AbstractNegative pressure wound therapy is used often in the management of surgical incisions, chronic wounds and subacute lesions, and there are numerous publications discussing its clinical application and outcomes. However, whilst clinical use and associated literature have expanded since these systems became commercially available in the 90s, important research and discussion around the mode of action have waned, leading to a deficit in the understanding of how this important therapy influences healing. Further, much research and many publications are predominantly reflective, discussing early theorem, some of which have been proven incorrect, or at least not fully resolved leading to misunderstandings as to how the therapy works, thus potentially denying the clinician the opportunity to optimise use towards improved clinical and economic outcomes. In this narrative review, we discuss established beliefs and challenges to same where appropriate and introduce important new research that addresses the manner in which mechanical strain energy (i.e., deformations) is transferred to tissue and how this influences biological response and healing. In addition, we assess and discuss the effect of different negative pressure dressing formats, how they influence the mode of action and how this understanding can lead to more efficient and effective use and clinical economic outcomes.
Uncomplicated Extravascular Implantable Cardioverter‐Defibrillator Extraction After 4 Years Dwell Time: A Case Report
Authors: de Veld Jolien A. , Kooiman Kirsten M. , Knops Reinoud E. 
Published: December 2024

ABSTRACTThe extravascular implantable cardioverter‐defibrillator (EV‐ICD) was developed to overcome complications associated with transvenous leads while being able to deliver anti‐tachycardia pacing (ATP). The lead is implanted in the substernal space, which makes extraction a cautious procedure. We present a case of a 51‐year‐old women with a successful EV‐ICD extraction after a lead dwell time of 4 years, which is the longest reported. The EV‐ICD lead was extracted using simple traction after the removal of all adhesions at the xiphoidal site around the lead. We advise to only use extraction tools if the initial attempt is not successful and if no adhesions at the caudal part of the lead are visible anymore, as these tools could also damage the surrounding tissue and the lead.
The Effect of Lean Hospital Practices on Nurses' Direct Care Activities: Time and Motion Study
Authors: Koc Zibel , Alpar Sule Ecevit 
Published: December 2024

ABSTRACTBackgroundThis study investigates the effects of lean management practices on nurses' direct patient care activities and the interruptions they encounter in healthcare settings. The literature indicates that lean management enhances efficiency and improves patient care. Increased nursing time per patient correlates with better outcomes; however, rising patient loads and frequent interruptions hinder nurses' ability to deliver effective care, jeopardising patient safety. Addressing these inefficiencies is essential, given nurses' critical role in ensuring quality care.MethodUsing a single‐centre, observational, pre‐post time and motion design alongside participatory action research from August 2019 to July 2022, the study included three phases: a survey assessing nurses' views on problem‐solving and lean management; observations identifying nurses' activities and interruptions; and focus group discussions. The results presented here are from the observation phase, with 34 nurses from surgical, internal medicine, and mixed services participating. Quantitative variables were expressed as means, standard deviations, and significance was assessed at a 95% confidence interval (p < 0.05).ResultsObservations in 2019 (324 h) and 2022 (314 h) revealed that nurses dedicated a significant portion of their time to direct patient care, which increased post‐lean implementation (surgical: 50.67%, internal: 50.09%, mixed: 44.38%). Waste rates decreased by 35.81%, and documentation time decreased by 23.55%. Overall interruptions also decreased significantly (p < 0.05).ConclusionLean management effectively reduces waste and improves direct patient care time, enhancing patient safety and care quality. Continuous improvement initiatives in nursing practices are essential for success.
Lipopolysaccharide differentially alters systemic and brain glucocorticoid levels in neonatal and adult mice
Authors: Hamden Jordan E. , Salehzadeh Melody , Bajaj Hitasha , Li Michael X. , Soma Kiran K. 
Published: December 2024

AbstractGlucocorticoids (GCs) are secreted by the adrenal glands and increase in response to stressors (e.g., infection). The brain regulates local GC levels via GC synthesis, regeneration and/or metabolism. Little is known about local GC regulation within discrete brain regions at baseline or in response to stress. We treated male and female C57BL/6J mice at postnatal day 5 (PND5) or PND90 with lipopolysaccharide (LPS; 50 μg/kg bw i.p.) or vehicle and collected blood and brain after 4 h. We microdissected the prefrontal cortex, hippocampus, hypothalamus and amygdala. We measured seven steroids, including corticosterone, via liquid chromatography–tandem mass spectrometry and measured transcripts for key steroidogenic enzymes (Cyp11b1, Hsd11b1, Hsd11b2) via qPCR. At both ages, LPS increased GC levels in blood and all brain regions; however, the increases were much greater at PND90 than at PND5. Interestingly, PND5 corticosterone levels were lower in prefrontal cortex than in blood, but higher in amygdala than in blood. These changes in corticosterone levels align with local changes in steroidogenic enzyme expression, demonstrating robust regional heterogeneity and a possible mechanism for the region‐specific effects of early‐life stress. In contrast, PND90 corticosterone levels were lower in all brain regions than in blood and similar among regions, and steroidogenic enzyme mRNA levels were generally not affected by LPS. Together, these data indicate that local GC levels within discrete brain regions are more heterogeneous at baseline and in response to LPS at PND5 than at PND90, as a result of increased local GC production and metabolism in the neonatal brain.
Using digital PCR to investigate the prevalence of KRAS variants in pituitary tumours
Authors: Aran Veronica , Lamback Elisa , Lyra Miranda Renan , Guterres Alexandro , Souza Barbosa Isabel , Chimelli Leila , Gadelha Mônica Roberto , Moura Neto Vivaldo 
Published: December 2024

AbstractPituitary tumours (PT) are formed in the pituitary gland, a small gland situated at the base of the brain. These tumours can be categorized according to their histological origin and hormone production. In surgical series, non‐functioning PT are the commonest subtype, followed by functioning somatotroph and corticotroph tumours. Different somatic alterations have been implicated in the pathogenesis of these tumours and the objective of our study was to expand our previous new finding of KRAS pathogenic genetic variants in pituitary tumours. We conducted a digital polymerase chain reaction (PCR) analysis on formalin‐fixed paraffin‐embedded tissue blocks belonging to 189 patients. The results showed that, from the 184 pituitary tumours with good quality samples, 13 tumours (7.1%) presented mutant KRAS. The median age of the mutated group was 47 years old (range 19–77) and most patients with mutant KRAS tumours were from the female gender (61.5%, 8/13) and non‐functioning subtype. For the first‐time, mutant KRAS in corticotroph and somatotroph tumours were detected, and the variants showed low allele frequencies. In conclusion, we demonstrated that pituitary tumours might have mutant KRAS, and these data were not previously described probably due to lack of sensitivity of previous technologies. By identifying these variants, even at minimal levels, we open doors to a deeper understanding of the tumour microenvironment, clonal evolution and potential therapeutic targets.
Can machine learning assist us in the classification of older patients suffering from dementia based on classic neuropsychological tests and a new financial capacity test performance?
Authors: Giannouli Vaitsa , Kampakis Stylianos 
Published: December 2024

AbstractAimsPredicting the diagnosis of an older adult solely based on their financial capacity performance or other neuropsychological test performance is still an open question. The aim of this study is to highlight which tests are of importance in diagnostic protocols by using recent advancements in machine learning.MethodsFor this reason, a neuropsychological battery was administered in 543 older Greek patients already diagnosed with different types of neurocognitive disorders along with a test specifically measuring financial capacity, that is, Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). The battery was analysed using a random forest algorithm. The objective was to predict whether an older person suffers from dementia. The algorithm's performance was tested through cross‐validation.ResultsMachine learning was applied for the first time in data analysis regarding financial capacity and three factors‐tests were revealed as the best predictors: two subscales from the LCPLTAS measuring ‘financial decision making’ and ‘cash transactions’, and the widely used MMSE which measures general cognition. The algorithm demonstrated good performance as measured by the F1‐score, which is a measure of the harmonic mean of precision and recall. This evaluation metric in binary and multi‐class classification integrates precision and recall into a single metric to gain a better understanding of model performance.ConclusionsThese findings reveal the importance of focusing on these scales and tests in neuropsychological assessment protocols. Future research may clarify in other cultural settings if the same variables are of importance.
The Clinical Relevance of Prior Metabolic and Bariatric Surgery in Alcohol‐Related Liver Disease in a Nationwide Belgian Liver Transplant Population
Authors: Lefere Sander , Troisi Roberto Ivan , Karam Vincent , Fondevila Constantino , Nevens Frederik , Verbeek Jef , Detry Olivier , Lanthier Nicolas , Serenari Matteo , Wiering Leke , Vanwolleghem Thomas , Moreno Christophe , Berrevoet Frederik , Geerts Anja 
Published: December 2024

ABSTRACTBackground and AimsPatients with a history of metabolic and bariatric surgery (MBS) are susceptible to developing alcohol use disorder. Outcome after transplantation for alcohol‐related liver disease (ALD) has not been studied in‐depth.MethodsWe included adult patients who underwent a liver transplantation (LT) in Belgium between 1 January 2013 and 31 December 2022 for ALD. We captured all patients with a history of MBS prior to developing ALD, and included non‐MBS patients for comparison.ResultsWe identified 39 patients who underwent MBS before developing ALD, and included 443 non‐MBS patients with an LT for ALD as controls. The median time between MBS and diagnosis of severe liver disease was 7.2 years. MBS patients were 9 years younger at the time of transplantation (p < 0.001). Pre‐LT hepatocellular carcinoma was more prevalent in the non‐MBS group (p < 0.001), while severe bacterial infections occurred more frequently in those with prior MBS. Importantly, patients with MBS had a lower survival after LT in age‐ and sex‐adjusted Cox regression analysis (HR 2.205, p = 0.023). Liver disease was listed in 70.0% versus 13.3% of patients as the main cause of death. Liver‐related mortality was linked to alcohol use relapse post‐LT, with significantly more MBS patients experiencing relapse (30.8% vs. 13.3%, p = 0.003).ConclusionFollowing MBS, excessive alcohol use can progress to end‐stage ALD and need for LT. These patients present at a younger age, with more signs of hepatic decompensation, and can be at a higher risk for post‐LT mortality, especially liver‐related death.
“And that main artery's name is life”: Ecosocial injury and resurgent care in Deanuleahki, Sápmi
Authors: Herranen‐Tabibi Annikki 
Published: December 2024

AbstractBased on 28 months of ethnographic research in Deanuleahki—a river valley in Sápmi, the transborder Indigenous Sámi homeland—this article traces my interlocutors’ striving to reclaim and repair ecological and kin relations through the everyday praxis of care. I trace this striving through the unmaking and remaking of local relations of care amidst encroachment by post‐Second World War Nordic welfare states and regimes of environmental stewardship. I propose a dual conceptualization of ecosocial injury and resurgent care to account for, on the one hand, care's alienation from its social and ecological contexts; and, on the other, the intimate everyday labor of revivifying relations of kinship and belonging, and conditions of material livability, within local ecologies. This defiant and desirous politics of care carves out an opening to attend ethnographically and theoretically to both dislocation and repair in spaces of Indigenous resurgence. In conceptualizing such a politics of care, the article brings into conversation key literatures in medical anthropology and in the interdisciplinary scholarship on care and Indigenous resurgence.
The genetic architecture of floral trait divergence between hummingbird‐ and self‐pollinated monkeyflower (Mimulus) species
Authors: Chen Hongfei , Berg Colette S. , Samuli Matthew , Sotola V. Alex , Sweigart Andrea L. , Yuan Yao‐Wu , Fishman Lila 
Published: December 2024

Summary
Pollination syndromes are a key component of flowering plant diversification, prompting questions about the architecture of single traits and genetic coordination among traits. Here, we investigate the genetics of extreme floral divergence between naturally hybridizing monkeyflowers, Mimulus parishii (self‐pollinated) and M. cardinalis (hummingbird‐pollinated).
We mapped quantitative trait loci (QTLs) for 18 pigment, pollinator reward/handling, and dimensional traits in parallel sets of F2 hybrids plus recombinant inbred lines and generated nearly isogenic lines (NILs) for two dimensional traits, pistil length and corolla size.
Our multi‐population approach revealed a highly polygenic basis (n = 190 QTLs total) for pollination syndrome divergence, capturing minor QTLs even for pigment traits with leading major loci. There was significant QTL overlap within pigment and dimensional categories. Nectar volume QTLs clustered with those for floral dimensions, suggesting a partially shared module. The NILs refined two pistil length QTLs, only one of which has tightly correlated effects on other dimensional traits.
An overall polygenic architecture of floral divergence is partially coordinated by genetic modules formed by linkage (pigments) and likely pleiotropy (dimensions plus nectar). This work illuminates pollinator syndrome diversification in a model radiation and generates a robust framework for molecular and ecological genomics.
Life‐Threatening Pneumomediastinum Following Dental Scaling and Prophylaxis—Case Report
Authors: Fung Victor C. K. , Lee George C. C. , Chow Velda L. Y. 
Published: December 2024

ABSTRACTBackgroundSubcutaneous emphysema (SE) following invasive dental surgeries have been documented in previous literatures in which majority of cases are secondary to use of air‐driven devices. However, there has been limited reports on development of SE and pneumomediastinum following minimally invasive dental scaling procedures.AimThe aim of this case repot is to discuss the presentation, potential complications and management of SE and pneumomediastinum in dental patients.MethodsThe authors report two cases of extensive cervicofacial emphysema and pneumomediastinum following dental scaling at two different dentist's clinics.Results and ConclusionThis case report highlights the potential dangers of this commonly performed dental procedure in office‐based setting that is seemingly low risk. A high index of suspicion, immediate termination of procedure and appropriate management in hospital setting is warranted for the prevention of life‐threatening complications.
“It's like I used to share a room with self‐injury, but now it lives next door”: Exploring experiences of naturalistic improvement in non‐suicidal self‐injury
Authors: Hudson E. , Hartley S. , Taylor P. J. 
Published: December 2024

AbstractBackgroundMany people who engage in non‐suicidal self‐injury (NSSI) do not access support from health services, and evidence regarding the effectiveness of interventions is mixed. Despite this, NSSI prevalence rates decrease from adolescence into adulthood. Little is known about what helps alleviate difficulties with NSSI beyond psychological or medical intervention. This study sought to understand factors influencing naturalistic improvements in NSSI.MethodsSemi‐structured interviews were conducted over video call with 16 participants who believed their difficulties with NSSI had improved due to factors not attributed to psychological or medical intervention. Interviews were audio recorded and transcribed verbatim for analysis.ResultsA reflexive thematic analysis revealed four main themes. Increased insight into NSSI experiences promoted self‐compassion and self‐acceptance and enabled participants to reflect on the conflicting role of NSSI. Safe and supportive relationships helped alleviate loneliness, and developing alternative coping strategies enhanced feelings of control over self‐injury. Creating a life guided by personal values promoted independence, choice, and self‐esteem.ConclusionsThe findings of the study highlight several internal and external naturalistic processes deemed meaningful in improving difficulties with NSSI. Clinical implications include the importance of developing and embedding these approaches within services and interventions to improve outcomes for individuals who self‐injure while promoting a person‐centred approach.