bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiological shifts in chronic kidney disease: a 30-year global and regional assessment
Authors: Qin Kaili , Qing Jianbo , Wang Qian , Li Yafeng 
Published: December 2024

Abstract
Background
Chronic kidney disease (CKD) presents a growing global health challenge, with significant variability in disease burden across different regions and countries. This study aimed to analyze the trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for CKD from 1990 to 2019, utilizing data from the Global Burden of Disease Study.

Methods
We conducted an in-depth study on the global and age-standardized incidence, prevalence, mortality, and DALYs of CKD, and assessed trends over a 30-year period. Additionally, we explored the associations between healthcare access and quality (HAQ), the Socio-Demographic Index (SDI), and CKD. Furthermore, we conducted a detailed analysis of six risk factors closely related to CKD, and based on these findings, provided strong evidence for enhancing the management of CKD.

Results
In 2019, there were 18,986,903 cases of CKD, with an average annual percent change (AAPC) of 1.82 (95% CI = 1.8 to 1.82) in incidence since 1990. The age-standardized incidence rate increased from 192.45 per 100,000 in 1990 to 233.65 per 100,000 in 2019. Prevalence also rose, with a total of 69,729,430 cases in 2019 and an AAPC of 1.19 (95% CI = 1.19 to 1.2). Mortality and DALYs have increased correspondingly, with the mortality rate reaching 18.29 per 100,000 and total DALYs at 41,538,592 in 2019. The analysis showed that higher HAQ levels are associated with better outcomes in terms of lower mortality and DALY rates, whereas lower HAQ levels correlate with poorer outcomes. In addition, high fasting plasma glucose and high systolic blood pressure are the main contributors to CKD-related deaths, with their population attributable fraction (PAF) significantly decreasing as the SDI decreases.

Conclusion
The burden of CKD has significantly increased over the past three decades, influenced by demographic changes and variations in healthcare quality and access. Effective public health strategies and improvements in healthcare delivery are needed to address the disparities in CKD outcomes globally.
Mathematical modeling of biohydrogen production via dark fermentation of fruit peel wastes by Clostridium butyricum NE95
Authors: Elerakey Norhan , Rasmey Abdel-Hamied M. , Aboseidah Akram A. , Hawary Heba 
Published: December 2024

Abstract
Background
Biohydrogen production from agro-industrial wastes through dark fermentation offers several advantages including eco-friendliness, sustainability, and the simplicity of the process. This study aimed to produce biohydrogen from fruit and vegetable peel wastes (FVPWs) by anaerobic fermentative bacteria isolated from domestic wastewater. Kinetic analysis of the produced biohydrogen by five isolates on a glucose medium was analyzed using a modified Gompertz model (MGM). Besides, the feasibility of hydrogen production by Clostridium butyricum NE95 using FVPWs as substrates was investigated.

Results
The bacterial isolate NE95 was selected as the highest biohydrogen producer with maximum biohydrogen production (Hmax) of 1617.67 ± 3.84 mL/L, Rmax (MGM) of 870.77 mL/L/h and lag phase (λ) of 28.37 h. NE95 was phenotypically and genetically identified as C. butyricum and its 16 S rRNA gene sequence was deposited in the GenBank under the accession number PP581833. The genetic screening of hydrogenase gene clusters indicated the presence of Fe-Fe hydrogenase gene in C. butyricum NE95. C. butyricum NE95 showed the ability to produce biohydrogen from different FVPWs, with watermelon and melon peels being the most promising feedstocks for fermentation. It was revealed that using a mixture (1:1, w/w) of watermelon and melon peels as a substrate for C. butyricum NE95 significantly increased biohydrogen yield with Hmax of 991.00 ± 10.54 mL/L, Rmax of 236.31 mL/L/h, λ of 33.92 h and a high accuracy of R2 (0.997).

Conclusions
The study highlights the effectiveness of C. butyricum NE95 on the valorization of FVPWs and generates a sustainable source of biohydrogen production.
Interventions to improve pharmacists’ competency in chronic disease management: a systematic review of randomized controlled trials
Authors: Rendrayani Farida , Utami Auliasari M. , Insani Widya N. , Puspita Falerina , Alfian Sofa D. , Nguyen Thang , Puspitasari Irma M. 
Published: December 2024

Abstract
Introduction
Effective chronic disease management (CDM) is vital for addressing chronic disease challenges. Given the importance of ensuring pharmacists’ competence in CDM, interventions targeting knowledge, skills, and attitudes are essential. Therefore, a comprehensive and up-to-date study is needed to analyze these interventions’ effect and potential development. Categorizing the interventions based on the Effective Practice and Organization of Care (EPOC) taxonomy is essential for better informing policymakers. The objectives of this systematic review were to identify interventions to improve pharmacists’ competency in chronic disease management based on the EPOC taxonomy and summarize their effectiveness.

Methods
Following methods in the Cochrane Handbook, a systematic search was conducted up to April 2024 on MEDLINE and Scopus. The inclusion criteria were an intervention study with a randomized controlled trial (RCT) design published in English, targeting pharmacists, and measuring knowledge, skills, and attitudes in aspects of CDM. The risk of bias was assessed using Cochrane’s RoB 2 tool for either randomized or cluster-randomized trials. Findings are reported narratively and align with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Results
We included 11 RCT studies that focused on various aspects of CDM among community and hospital pharmacists. Implementation strategies and combined implementation strategies–delivery arrangements interventions were identified. Six implementation strategies interventions consistently yielded effective results, with scores ranging from 0.99 to 9.17 (p < 0.05). However, the other two implementation strategies interventions reported mixed results, with no significant improvements in knowledge or skills. Two implementation strategies-delivery arrangements interventions showed improvements, with score differences ranging from 4.5% (95% CI: 1.6%-7.4%) to 30% (95% CI: 29%-40%). Conversely, one implementation strategies-delivery arrangements intervention showed no significant improvement. The risk of bias assessment revealed varying levels of bias across the studies.

Conclusions
Implementation strategies and combined implementation strategies–delivery arrangements interventions improved pharmacists' competency in CDM. Most interventions consistently resulted in significant improvements in pharmacists' knowledge, skills, and attitudes. These findings underscore the potential of tailored, competency-based interventions to improve pharmacist competencies in CDM. Policymakers can use these insights to create guidelines and policies that promote ongoing professional development for pharmacists.
Exploring perspectives of type 2 diabetes prevention program coaches and training delivery staff on e-learning training: a qualitative study
Authors: Cranston Kaela D. , Grieve Natalie J. , Jung Mary E. 
Published: December 2024

Abstract
Background
E-learning can be an effective and efficient mode of training healthcare practitioners. E-learning training for diabetes prevention program coaches was designed and developed with input from end users. Insight from those who deliver the training and coaches who have taken the training can provide critical feedback for further refinement of the e-learning training. The purpose of this study was to understand diabetes prevention coaches’ (i.e., those taking the training) and training delivery staffs’ (i.e., those overseeing the training) perspectives of the coach e-learning training. Individuals wishing to become diabetes prevention program coaches were required to complete and pass the e-learning training to become a certified coach.

Methods
A pragmatic paradigm guided the methodology for this study. Semi-structured interviews were conducted with a purposive sample of diabetes prevention program coaches (n = 8) and diabetes prevention program training staff (n = 3). Interviews were recorded, transcribed verbatim, and analyzed using template analysis. Themes were separately constructed from coach and staff data.

Results
There were seven high order themes constructed from the coach data: (a) training design, (b) “I didn’t know what to expect from the training”, (c) technology usability, (d) learning, (e) coaches’ backgrounds shaped their training experience, (f) support, and (g) coaches valued the training. Two high order themes were constructed from the staff interviews: (a) streamlining the training delivery, and (b) ensuring coaches meet the diabetes prevention program standard.

Conclusions
This study highlights the importance of exploring perspectives of both those receiving and delivering e-learning training to refine content and processes. Qualitatively evaluating the delivery of e-learning training and modifying the training based on the evaluation results can lead to a more acceptable, efficient, and effective e-learning training. Coaches and staff emphasized the benefits of having high-quality online components, and that the brief training promoted gains in knowledge and improvements in skills. Resultswere used to inform modifications to the coach e-learning training for this diabetes prevention program and can be used to inform other healthcare practitioner e-learning trainings.
Investigating the accuracy of adjusting for examiner differences in multi-centre Objective Structured Clinical Exams (OSCEs). A simulation study of video-based Examiner Score Comparison and Adjustment (VESCA)
Authors: Yeates Peter , McCray Gareth 
Published: December 2024

Abstract
Introduction
Ensuring examiner equivalence across distributed assessment locations is a priority within distributed Objective Structured Clinical Exams (OSCEs) but is challenging as examiners are typically fully nested within locations (i.e. no overlap in performances seen by different groups of examiners). Video-based Examiner Score Comparison and Adjustment (VESCA) is a recently developed method which uses video-based linking to compare and (potentially) adjust for the effect of different groups of examiners within OSCEs. Whilst initial research on VESCA has been promising, the accuracy of the resulting adjusted scores is unknown. Given this, we aimed to investigate the accuracy of adjusted scores produced by VESCA under a range of plausible operational parameters.

Methods
Using statistical simulation, we investigated how: 1/proportion of participating examiners, 2/ number of linking videos, 3/baseline differences in examiner stringency between schools (i.e. whether examiners in School A are, on average, more stringent than the examiners in School B), 4/number of OSCE stations and 5/different degrees of random error within examiners’ judgements influenced accuracy of adjusted scores.
We generated distributions of students’ “true” performances across several stations, added examiner error, and simulated linking through crossed video-scoring (as occurs in VESCA). We then used Many Facet Rasch Modelling to produce an adjusted score for each student which we compared with their corresponding original “true” performance score. We replicated this 1000 times for each permutation to determine average error reduction and the proportion of students whose scores became more accurate. Simulation parameters were derived from a real, summative, whole curriculum undergraduate Year 3 OSCE at Keele University School of Medicine.

Results
We found that in all conditions where no baseline difference existed between groups of examiners, score adjustment only minimally improved or even worsened score accuracy. Conversely, as the size of baseline differences between schools increased, adjustment accuracy increased, reducing error by up to 71% and making scores more accurate for up to 93% of students in the 20% baseline-difference condition.

Conclusions
Score adjustment through VESCA has the potential to substantially enhance equivalence for candidates in distributed OSCEs in some circumstances, whilst making scores less accurate in others. These findings will support judgements about when score adjustment may beneficially aid OSCE equivalence.
‘The upside-down’ healthcare professional students’ experiences of delirium: an all-Ireland focus group study
Authors: Mitchell Gary , Graham Margaret , Murphy Jill , Barry Heather E. , Coffey Alice , Boland Pauline , Anderson Tara , Tuohy Dympna , Birch Matt , Tierney Audrey , Stark Patrick , McCurtin Arlene , McMahon James , Creighton Laura , Henderson Elizabeth , Craig Stephanie , McConnell Hannah , Guttridge Heather , Cook Lana , Cunningham Emma , Curran Geoffrey M. , Brown Wilson Christine 
Published: December 2024

Abstract
Background
Delirium is a complex neuropsychiatric syndrome characterised by an acute state of confusion, with a substantial impact on medical inpatients. Despite its growing recognition as a global healthcare concern, delirium remains underdiagnosed, partly due to a lack of awareness among healthcare professionals. The aim of this study was to explore how healthcare professional students experience caring for individuals experiencing delirium, the influence of their current pre-registration healthcare education, and importance of interprofessional teamwork in their role.

Methods
This qualitative study used a focus group approach to collect data from 40 healthcare professional students, including nursing, pharmacy, and medical students, across two universities in Ireland. The focus groups explored participants’ experiences of caring for people with delirium, their delirium education, and their collaboration with interdisciplinary teams. The data were analysed using a reflexive thematic analysis approach.

Results
Following thematic analysis, three themes are reported. The first is “The Upside Down,” revealing student perceptions of caring for people with delirium who are facing distressing situations. The second team reported is, “Teamwork Makes the Dream Work,” emphasising the critical role of interprofessional collaboration in delirium management and patient outcomes. Finally, the theme of “A Little Is Not Enough,” highlighted students’ critiques of current delirium education in their pre-registration training. Collectively, these themes illuminate challenges in delirium care, advocate for teamwork in healthcare settings, and call for improvements in educational preparation for future healthcare professionals.

Conclusions
This study contributes to the existing literature by providing insights into the perspectives of healthcare professional students on delirium care. The findings also highlight the challenging nature of caring for individuals with delirium and the need for improved delirium education and interdisciplinary collaboration.
Uncertainty-aware automatic TNM staging classification for [18F] Fluorodeoxyglucose PET-CT reports for lung cancer utilising transformer-based language models and multi-task learning
Authors: Barlow Stephen H. , Chicklore Sugama , He Yulan , Ourselin Sebastien , Wagner Thomas , Barnes Anna , Cook Gary J.R. 
Published: December 2024

Abstract
Background
[18F] Fluorodeoxyglucose (FDG) PET-CT is a clinical imaging modality widely used in diagnosing and staging lung cancer. The clinical findings of PET-CT studies are contained within free text reports, which can currently only be categorised by experts manually reading them. Pre-trained transformer-based language models (PLMs) have shown success in extracting complex linguistic features from text. Accordingly, we developed a multi-task ‘TNMu’ classifier to classify the presence/absence of tumour, node, metastasis (‘TNM’) findings (as defined by The Eight Edition of TNM Staging for Lung Cancer). This is combined with an uncertainty classification task (‘u’) to account for studies with ambiguous TNM status.

Methods
2498 reports were annotated by a nuclear medicine physician and split into train, validation, and test datasets. For additional evaluation an external dataset (n = 461 reports) was created, and annotated by two nuclear medicine physicians with agreement reached on all examples. We trained and evaluated eleven publicly available PLMs to determine which is most effective for PET-CT reports, and compared multi-task, single task and traditional machine learning approaches.

Results
We find that a multi-task approach with GatorTron as PLM achieves the best performance, with an overall accuracy (all four tasks correct) of 84% and a Hamming loss of 0.05 on the internal test dataset, and 79% and 0.07 on the external test dataset. Performance on the individual TNM tasks approached expert performance with macro average F1 scores of 0.91, 0.95 and 0.90 respectively on external data. For uncertainty an F1 of 0.77 is achieved.

Conclusions
Our ‘TNMu’ classifier successfully extracts TNM staging information from internal and external PET-CT reports. We concluded that multi-task approaches result in the best performance, and better computational efficiency over single task PLM approaches. We believe these models can improve PET-CT services by assisting in auditing, creating research cohorts, and developing decision support systems. Our approach to handling uncertainty represents a novel first step but has room for further refinement.
Assessing caregiver stress and resource needs in pediatric cancer care
Authors: Amin Shaimaa Mohamed , Khedr Mahmoud Abdelwahab , Mansy Azza Medhat Aziz , El-Monshed Ahmed Hashem , Malek Mohamed Gamal Noaman , El-Ashry Ayman Mohamed 
Published: December 2024

Abstract

Background
Caregivers of pediatric cancer patients often face significant stress and emotional strain, which can negatively impact their well-being and the quality of care provided to their children. Understanding the socio-demographic factors influencing caregiver stress and identifying the specific needs and resources required by caregivers are crucial for improving support systems in pediatric cancer care.

Aim of the study
This study aimed to analyze the levels of caregiver stress and their resource needs within pediatric cancer care.

Methods
A cross-sectional descriptive design was used, and the study was conducted at El-Minia Oncology Center outpatient clinics, Egypt. The sample included 258 pediatric cancer caregivers selected based on predefined eligibility criteria. Data were collected using the Caregiver Needs and Resources Assessment (CNRA) and the King Stone Caregiver Stress Scale (KCSS), both of which demonstrated strong reliability and validity. Descriptive statistics, t-tests, ANOVA, and Pearson correlation coefficients were employed for data analysis using SPSS version 29, with a significance level set at p < 0.05.

Results
Caregivers reported moderate to high stress levels, with an average stress score of 34.59 (SD = 7.649). Age, education level, marital status, and income were significant predictors of caregiver stress (p < 0.001), with lower income and higher educational levels contributing to increased stress. The number of children, child’s age, and duration since cancer diagnosis also significantly impacted stress levels (p < 0.001). Correlation analysis revealed that psychological needs were positively related to stress (r = 0.488, p < 0.001), while spirituality was negatively associated with stress (r = -0.241, p < 0.001). Regression analysis indicated that physiological needs (ß = 0.331) and role conflict (ß = 0.294) were the strongest predictors of stress (R² = 0.636).

Conclusion and implications
This study emphasizes the impact of socio-demographic factors on caregiver stress in pediatric cancer care. Targeted interventions that address caregivers’ psychological, social, and financial needs are essential to alleviate stress. Implementing caregiver-centered support programs in pediatric oncology can enhance the well-being of both caregivers and patients. Future research should explore sustainable strategies to further reduce caregiver burden.

Clinical trial number
Not applicable.
Impact of COVID-19 on nurse outcomes in the private sector of South Africa: a cross-sectional study
Authors: Gohentsemang Granny Solofelang , Coetzee Siedine Knobloch , Botha Stephani , Fourie Erika 
Published: December 2024

Abstract
Background
This study explored and described the impact of the COVID-19 pandemic on nurse outcomes in the private sector of South Africa. National research shows that nurses had poor nurse outcomes prior to the pandemic, amidst these issues the COVID-19 pandemic occurred, with nurses having to play a key role in the public health response. International studies have shown that although nurses were willing to serve in this manner, they experienced moderate to high burnout, anxiety, depression, fear and exhaustion. However, this topic has received comparatively little attention in African countries.

Methods
A cross-sectional survey design was conducted. Multistage sampling was applied in selection of provinces, hospital groups, hospitals, units, and nursing personnel. Valid and reliable tools were used to measure nurse outcomes. Data was collected from April 2021 until January 2022.

Results
Nurses described having high levels of compassion satisfaction, moderate levels of compassion fatigue, and high levels of burnout. Nurses appeared satisfied with their job and career. Almost a quarter of nurses reported the intention to leave their job, and of those about a fifth indicated that they intended to leave the profession. The nurses who routinely cared for COVID-19 patients had a small statistically significant increase in compassion fatigue, compassion satisfaction, emotional exhaustion and, job turnover intention, and a small statistically significant decrease in job satisfaction. Increased exposure to death and dying showed small correlations with emotional exhaustion and career turnover intentions.

Conclusion
The results of this study show that nurses were impacted by COVID-19 and death and dying during the pandemic, and that follow-up studies are needed post-pandemic.

Implications of study
It is important that burnout and compassion fatigue be addressed on an organizational level, as nurse outcomes were already negative prior to the pandemic, and all global evidence points to the worsening of these outcomes post-pandemic. There were many psychological support interventions with proven effectiveness that should be explored and applied for the South African context.