bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community readiness to address disparities in access to cancer, palliative and end-of-life care for ethnic minorities
Authors: Wainwright Jodi Emma , Cook Erica Jane , Ali Nasreen , Wilkinson Emma , Randhawa Gurch 
Published: December 2024

Abstract
Background
Inequalities in cancer, palliative, and end-of-life care services remain a significant challenge, particularly for ethnic minorities who face systemic barriers such as limited awareness, cultural stigmas, and language differences. These disparities hinder equitable access to essential services and contribute to poorer health outcomes for affected communities. Addressing these challenges requires targeted, culturally sensitive initiatives that promote both awareness and uptake of care. Community readiness is a critical factor in the success of such interventions, as it reflects the willingness and capacity of a community to engage with and support change.

Methods
A mixed-methods approach was used, combining individual interviews and two focus groups with key informants (N = 14). This study, conducted in the ethnically and geographically diverse region of Bedfordshire, Luton, and Milton Keynes in southeast England, aimed to assess community readiness to embrace initiatives designed to reduce health inequalities in cancer, palliative, and end-of-life care. The key informants, including faith leaders and professional stakeholders, rated community readiness on five anchored scales: Knowledge of efforts, Leadership, Knowledge of the issue, Community Climate, and Resources. The focus groups facilitated a discussion of the ratings, providing deeper insights into community dynamics and barriers.

Results
Overall, the community was identified as being at the pre-planning stage of readiness to address disparities in cancer, palliative, and end-of-life care for ethnic minorities. Quantitatively, faith and religious leaders assessed readiness at the vague awareness stage (mean: 3.88), while professional stakeholders rated it at the pre-planning stage (mean: 4.87). Qualitative findings highlighted limited community knowledge, passive leadership with potential for ‘community champions’ to foster openness, a positive climate influenced by younger generations, widespread misconceptions, language barriers, and resource constraints affecting service accessibility.

Conclusions
The Community Readiness Model provides an insight into the community’s position regarding disparities in access to cancer, palliative and end-of-life services. In order to ensure that continuing efforts are successful in addressing existing inequalities rather than exacerbating them, this study emphasises how critical it is to evaluate the readiness of the community in order to avoid widening inequalities in access and use of services.
Management of Methicillin-Resistant Staphylococcus aureus-infected femoral nonunion during lengthening in achondroplasia using circular external fixator: a case report
Authors: Nozaka Koji , Shirahata Tsuyoshi , Yuasa Yusuke , Miyakoshi Naohisa 
Published: December 2024

Abstract
Background
Achondroplasia, the most common form of rhizomelic dwarfism, occurs in approximately 1 in 25,000 individuals. Clinical features include attenuated growth, rhizomelic limb shortening, and craniofacial abnormalities. Limb-lengthening surgery is widely employed to improve quality of life. However, reports on Methicillin-Resistant Staphylococcus aureus (MRSA) infections in femoral nonunions at lengthening sites are scarce.

Case presentation
A 15-year-old boy with achondroplasia presented with MRSA-infected femoral nonunion. Bilateral femoral lengthening had been performed at age 13 using unilateral external fixators. Following a 7 cm lengthening of the right femur, surgical site infection occurred, with MRSA detected on postoperative day 127. Despite debridement and autologous iliac bone graft with non-locking screws, nonunion persisted. Referred to our hospital at age 15, the patient underwent radical debridement until punctate bleeding appeared, and vancomycin-loaded cement beads were implanted. A circular external fixator, effective even with bone weakened by prolonged non-weight bearing, was applied. Six weeks later, further debridement and vancomycin bead replacement were performed. Final fixation included refreshing the nonunion site and placing a cancellous bone graft from the contralateral iliac bone. Bone fusion progressed, and the ring was removed 9 months post-surgery. After seven years, no recurrence of infection was noted. Although slight knee flexion limitation persisted, the patient experiences no pain while walking and has become a healthy working adult.

Conclusion
This case highlights the effectiveness of radical debridement, antibiotic-loaded cement beads, autologous bone grafting, and circular external fixation in treating MRSA-induced nonunion at femoral lengthening sites in achondroplasia. Circular external fixators provide stable fixation even in cases of prolonged bone weakness.
A meta-analysis comparing open and minimally invasive cervical tumor surgery wound infection and postoperative complications
Authors: Song Ran , Ma Mingming , Yang Nana , Chen Chunfang , Wang Huan , Li Juan 
Published: December 2024

AbstractTo evaluate the impact of open surgical care (OSC) compared to minimally invasive surgery (MIS) on the occurrence of wound infection (WI) and overall postoperative aggregate complications (POACs) in female cervical cancer (CC) patients, we conducted this meta-analysis study. A thorough examination of the literature up to March 2024 was conducted, and 1849 related studies were examined. The 44 studies that were selected included 11,631 females who had CC. The odds ratio (ORs) and the estimation using 95% confidence intervals (CIs) were used to calculate the impact of open surgical management and MIS on WI and POACs in females with CC, using dichotomous methodologies and a random or fixed model. When comparing MIS to open surgical care, there was a substantial decrease in WI (OR, 0.19; 95% CI, 0.13–0.29, p < 0.001) and POACs (OR, 0.49; 95% CI, 0.38–0.62, p < 0.001) in females with CC. On the other hand, among female patients with CC, MIS did not differ significantly from open surgical care in pelvic infection and abscess (PI&A) incidence (OR, 0.59; 95% CI, 0.31–1.16, p = 0.13). When compared to OSC, women with CC who underwent MIS experienced considerably fewer WI and POACs; however, there was no discernible difference in PI&A rates. However, given several of the designated examinations for the meta-analysis had relatively small sample sizes, caution must be used while handling its values.
Associations between mental health conditions in pregnancy and maternal socioeconomic status: a population-based retrospective cohort study in Ontario, Canada
Authors: Miao Qun , Zai Gwyneth , Joiner Ian , Burnside Jessica , Walker Mark 
Published: December 2024

Abstract
Background
The World Health Organization has recognized maternal mental illness as an emerging issue. Previous studies have indicated that maternal mental illness is associated with socioeconomic status (SES). However, there is a lack of research concerning the mental health of pregnant people with low SES in Ontario, Canada. In this study, we examined associations between mental health conditions during pregnancy and two SES indicators: the pregnant person’s residential neighbourhood income and education level.

Methods
A population-based retrospective cohort study was conducted, consisting of all singleton pregnancies resulting in stillbirths or live births in Ontario hospitals from April 1, 2012, to March 31, 2021. Data were linked from the BORN Information System database, Canadian Institute for Health Information Discharge Abstract Database, and Canadian Census. Poisson regression with robust error variance models was performed to estimate the relative risks of anxiety, depression, anxiety and/or depression, or any mental health condition during pregnancy, by SES indicator. We adjusted for maternal age, obesity status in pre-pregnancy, certain pre-existing maternal health conditions, substance use during pregnancy, race, and rural or urban residence.

Results
Within the cohort (n = 1,202,292), 10.5% (126,076) and 8.1% (97,135) of pregnant individuals experienced anxiety and depression, respectively, and 15.8% (189,616) had at least one mental health condition during pregnancy. The trend test (p < 0.0001) showed a significant downward trend in the total rates of mental health conditions by increasing SES quintiles. Pregnant individuals in the lowest neighbourhood income quintile tended to have a higher risk of anxiety (aRR: 1.24, 95%CI: 1.22–1.27), depression (aRR: 1.56, 95%CI: 1.52–1.59), anxiety and/or depression (aRR: 1.13, 95%CI: 1.11–1.15), or any mental health condition (aRR: 1.18, 95%CI: 1.16–1.19). Similarly, pregnant people living in the lowest education level neighbourhoods had higher likelihoods of anxiety (aRR: 1.66, 95%CI: 1.62–1.69), depression (aRR: 2.09, 95%CI: 2.04–2.14), anxiety and/or depression (aRR: 1.42, 95%CI: 1.39–1.44), and any mental health condition (aRR: 1.41, 95%CI: 1.38–1.43).

Conclusions
Despite a universal healthcare system, the variations in mental health prevalence and risk during pregnancy based on SES suggest health inequity in Ontario, Canada. Future studies are needed to examine the mechanisms of this health inequity to guide policy makers in reducing disparities in Ontario.
From decision to destination: factors influencing healthcare students’ career paths in Qatar
Authors: Yasin Yasin M. , Alomari Albara , MacNevin Shannan , Kmainasi Baysan , Abdulla Mohammad , Hassanin Sondos 
Published: December 2024

Abstract
Background
Healthcare education is crucial for building a workforce in Qatar that is in line with Vision 2030. Although various factors influence career choices, little research exists on their impact on healthcare students in Qatar. This study explores the factors influencing healthcare students in Qatar to pursue healthcare careers, as well as the facilitators and challenges they face during their education.

Methods
A cross-sectional survey was conducted among 364 healthcare students in Qatar. Quantitative data was analyzed to identify key factors influencing career choice, while qualitative data provided deeper insights into challenges and support systems.

Results
Quantitative findings identified “contribution to society” and “quality” as key factors shaping career choices. Demographic variables such as gender, income, and birthplace influenced these decisions. Qualitative analysis revealed that students face numerous challenges, such as academic demands, financial pressures, and logistical difficulties, but these were mitigated by support from family, peers, and institutional resources.

Conclusion
This study underscores the importance of tailored support systems to foster student retention and success in healthcare education, particularly for students from diverse cultural backgrounds. Policymakers and educators should develop strategies that support a sustainable, culturally competent healthcare workforce in Qatar that meets the nation’s evolving healthcare needs.

Clinical trial number
Not applicable.
‘Death on an industrial scale’- general practice trainees’ perceptions and experiences of dying and death during covid-19: an interpretative phenomenological analysis
Authors: Holdsworth Rebecca , Alberti Hugh , Burford Bryan , Farrington Emma , Vance Gillian 
Published: December 2024

Abstract
Context
The COVID-19 pandemic led to an increase in numbers of patients dying at home in the UK, meaning that general practitioners (GPs) were exposed to more patient death than would be pre-COVID. This project aimed to gain insight into GP trainees’ experiences of patient death between March and July 2020. This insight can inform support for GPs, leading to improved wellbeing, workforce retention and ultimately, better patient-centred care.

Methods
Interpretative Phenomenological Analysis (IPA) of semi-structured interviews was used to explore GP trainees’ experiences of patient death in one region of England.

Results
Seven trainees, two male and five female, participated. They were working in both rural and urban community settings and were at different stages of GP training. Group experiential themes related to heightened emotional responses to patient death, managing uncertainty and the increased salience of relationships. Most appreciated positive teamworking and solidarity, though some had felt isolated within their surgery and wider community. There were some unforeseen positive experiences of individual and organisational healthcare changes, including a perceived new appreciation for the NHS workforce equality, diversity and inclusion (EDI) by actions to identify and reduce occupational hazards to at-risk healthcare staff. There were potential effects on career choice with participants feeling that changes during COVID-19 offered new flexibility in working arrangements and opportunity to sub-specialise within GP.

Conclusion
More support to help navigate the amplified emotional responses to managing dying and death in the community is needed. Some experiences, particularly around managing uncertainty, can cause moral injury if not managed in a safe and supportive environment.
Social interaction of people living with dementia in residential long-term care: an ecological momentary assessment study
Authors: Gebhard Doris , Lang Leonie , Maier Marco J. , Dichter Martin N. 
Published: December 2024

Abstract
Background
The importance of social health is increasingly recognized in dementia research. For most people living with dementia, their social environment changes as the disease progresses, especially when they move into a long-term care facility. However, maintaining social interactions in the new living environment contributes significantly to health and quality of life. Staff and other residents are the most readily available interaction partners to provide this. The aim of this study is to investigate the frequency, contexts, partners and influencing factors (personal and contextual) of social interactions of people living with dementia in residential long-term care.

Methods
Participants were observed for two days in 20-min slots (from 7 am to 7 pm) in 12 long-term care facilities in Germany. The Maastricht Electronic Daily Live Observation Tool (MEDLO-tool) was used for ecological momentary assessment. Age, gender, functional status, cognitive status and length of stay at the facility were recorded. Generalized linear mixed-effect models were used for the data analysis.

Results
In all, 106 people living with dementia (average age: 85.16 ± 7.42 years, 82.9% female) were observed at 6134 time points. No social interaction take place in 71.9% of the observations. The place where the participants spend their time influences the occurrence of social interaction (p < 0.001), with a significantly higher probability of social interaction in communal spaces. Most frequently, interaction takes place with staff (43.4%), closely followed by other residents (40.9%), with the context (location, p < 0.001; time of day, p < 0.001) and functional status (care level, p < 0.001) influencing which of the two groups people living with dementia interact with.

Conclusion
A better understanding of the context of social interactions and its influencing factors provide a basis for more targeted interventions. As the increasing staff shortage will further limit the opportunities for social interaction with staff, future concepts should focus on other residents. Meaningful activities that enable people living with dementia to co-operate and share responsibility can provide a stimulating framework for this. In addition, social assistance robots and the application of peer-mentoring/leading represent promising approaches for creating a socially interactive environment.
Infection survey, molecular, pathogenicity, and morphological characteristics of Sarcocystis species naturally infected water buffaloes (Bubalus bubalis) in Egypt
Authors: Elsharkawy Lamiaa K. , Barghash Safaa M. , El-Nour Basma M. Abou , Labib Wafaa , Sadek Al-Shaimaa M. 
Published: December 2024

Abstract
Background
Sarcocystosis is a parasitic disease found worldwide, resulting from various Sarcocystis species. The current research was carried out in three significant economic areas in Egypt: Greater Cairo, the Nile Delta, and Upper Egypt. It aimed to investigate the occurrence of Sarcocystis spp. in locally bred water buffaloes Bubalus bubalis.

Methods
To achieve this objective, 317 buffalos were slaughtered in different slaughterhouses in various regions of Egypt. Samples of heart, skeletal muscle, esophagus, and tongue were assessed using macroscopic and microscopic tests. Examination methods included direct optical observation of tissues as well as digestion and examination of the sediment obtained from the tissues. Additionally, ultrastructural features were analyzed using scanning and transmission electron microscopy. Molecular characterization was conducted through PCR, followed by nucleotide sequencing and phylogenetic analysis.

Results
A total of 317 slaughtered buffaloes were examined for Sarcocystis during the period from September 2021 to October 2023. The prevalence of infection was recorded with 229 out of 317 (72.2%) infected with Sarcocystis spp. The results also showed that the prevalence of Sarcocystis species in females was higher than males. Based on the age of carcasses, adults (> 2 years) had a higher infection rate compared to young ones (< 2 years). Regarding seasonal variation, the highest prevalence of infection was recorded during the summer followed by spring, and then autumn, while winter had the lowest prevalence of infection. Additionally, the skeletal muscle was the most susceptible organ to sarcocystosis (87.3%) followed by the esophageal muscle (8.3%), the tongue (4.4%), and no infection in the heart muscle. The use of scanning and transmission electron microscopy allowed the identification of S. fusiformis and S. cruzi in buffaloes in Egypt. Furthermore, the Sarcocystis 18 S rRNA genes from skeletal tissue samples were cloned and sequenced under accession numbers OQ507387, OQ507388, and OQ507389 for S. fusiforms, and one OQ507391 for S. cruzi.

Conclusion
The findings revealed a notably high prevalence of Sarcocystis infection (72.2%) in buffaloes from Egypt, with skeletal muscle identified as the organ most susceptible to the parasite. Two Sarcocystis species were detected: S. fusiformis and S. cruzi.
Spatial distribution of Q fever in sheep and goats of selective villages of Punjab Province, Pakistan
Authors: Amin Freeha , Ali Shahzad , Hassan Ahmad , Rashid Imran , Neubauer Heinrich , Mertens-Scholz Katja 
Published: December 2024

AbstractThis study aimed to assess the geographical distribution of Q fever in sheep and goats in different areas of Punjab, Pakistan. Three hundred blood samples of small ruminants including sheep and goats were collected from 60 villages of three districts (Okara, Kasur, and Pakpattan) of Punjab Province Pakistan and tested for the detection of anti-Coxiella burnetii antibodies using a commercial Indirect ELISA kit. Data related to sampling location, host species, gender, age, and GPS coordinates were collected for spatial analysis. A surface plot was created using inverse distance weight (IDW) by interpolation of the Aeronautical Reconnaissance Coverage Geographic Information system (Arc GIS). The district Kasur (14%) and the tehsil Chunian (24%) had the most prominent Q fever prevalence in both species. No ovine males were seropositive but 19.2% of male goats were seropositive. No samples of sheep younger than 1 year were found seropositive. Gender in sheep and age in goats have to be considered as significant risk factors based on multiple logistic regression analysis. Based on spatial analysis, seropositivity for C. burnetii antibodies was more likely observed in villages of tehsil Kasur, Pattoki, Okara, Depalpur, and Renala Khurd in the case of goats while in case of sheep villages of tehsil Chunian, Renala Khurd and Pakpattan. The main outcome of this study is that Q fever-specific antibodies of C. burnetii are prevalent in the goat and sheep populations of the study area and we have identified potential risk zones. The findings of this study can be used for the control of Q fever in small ruminants of the study area to minimize the risk of this zoonosis in other animals and the associated human population.
Regulating the regulators: long non-coding RNAs as autophagic controllers in chronic disease management
Authors: Kumar Aviral , Yap Kenneth Chun-Hong , BharathwajChetty Bandari , Lyu Juncheng , Hegde Mangala , Abbas Mohamed , Alqahtani Mohammed S. , Khadlikar Soham , Zarrabi Ali , Khosravi Arezoo , Kumar Alan Prem , Kunnumakkara Ajaikumar B. 
Published: December 2024

AbstractThe increasing prevalence of chronic diseases and their associated morbidities demands a deeper understanding of underlying mechanism and causative factors, with the hope of developing novel therapeutic strategies. Autophagy, a conserved biological process, involves the degradation of damaged organelles or protein aggregates to maintain cellular homeostasis. Disruption of this crucial process leads to increased genomic instability, accumulation of reactive oxygen species (ROS), decreased mitochondrial functions, and suppression of ubiquitination, leading to overall decline in quality of intracellular components. Such deregulation has been implicated in a wide range of pathological conditions such as cancer, cardiovascular, inflammatory, and neurological disorders. This review explores the role of long non-coding RNAs (lncRNAs) as modulators of transcriptional and post-transcriptional gene expression, regulating diverse physiological process like proliferation, development, immunity, and metabolism. Moreover, lncRNAs are known to sequester autophagy related microRNAs by functioning as competing endogenous RNAs (ceRNAs), thereby regulating this vital process. In the present review, we delineate the multitiered regulation of lncRNAs in the autophagic dysfunction of various pathological diseases. Moreover, by highlighting recent findings on the modulation of lncRNAs in different stages of autophagy, and the emerging clinical landscape that recognizes lncRNAs in disease diagnosis and therapy, this review highlights the potential of lncRNAs as biomarkers and therapeutic targets in clinical settings of different stages of autophagic process by regulating ATG and its target genes. This focus on lncRNAs could lead to breakthroughs in personalized medicine, offering new avenues for diagnosis and treatment of complex diseases.
Graphical Abstract