bluuebunny/crossref_metadata_2025_split huggingface dataset:
Placenta accreta spectrum: imaging and diagnosis
Authors: Self Alice , Cavallaro Angelo , Collins Sally L. 
Published: January 2025

Key content
Antenatal imaging is a screening tool integral to ensuring women are cared for in the most appropriate setting.
The pretest probability of PAS should be considered before any imaging is performed.
PAS is an iatrogenic disease. Any process which disrupts the endometrium increases the risk. Caesarean birth is the most common cause.
Specialist placental assessment in asymptomatic women should be offered between 24 and 28 weeks.
Ultrasound and MRI have similar diagnostic value, and MRI should only be used as an adjunct following ultrasound assessment by a specialist in placental imaging.
Learning objectives
To understand the pathophysiology of PAS.
To understand the distinction between screening for and diagnosis of PAS.
To increase confidence in the interpretation of sonographic features of PAS.
To provide a rationale for PAS care being provided in centres of excellence.
Ethical issues
If women increasingly prefer caesarean section over vaginal birth, it is likely that this trend will result in increasing numbers of complex caesarean deliveries and PAS cases.
Many studies have shown decreased morbidity and mortality if PAS cases are managed by an experienced multi‐disciplinary team (MDT) in a PAS centre of excellence; therefore, accurate screening and timely referral are vital to improve patient care for women with risk factors.
Clinical aspects of middle ear tympanokeratoma in dogs diagnosed through advanced imaging, otoendoscopy and histopathological evaluation
Authors: Botelho Cristiane Bazaga , Tortoriello Rafaella , Koch Sandra Nogueira , Fernandes Julio Israel 
Published: January 2025

AbstractBackgroundCanine aural cholesteatoma (more appropriately named tympanokeratoma) is an epidermoid cyst whose aetiopathogenesis remains poorly recognised in veterinary medicine. There are a few reports published, possibly because it may be underdiagnosed.ObjectivesTo characterise the clinical aspects of dogs with tympanokeratoma, to describe the otoendoscopic, advanced imaging and histopathological findings of tympanokeratoma and to report the best approach to diagnose canine auricular tympanokeratoma in a retrospective study.Material and MethodsOf 890 dogs with suspected tympanokeratoma and otitis media, 100 animals underwent advanced imaging and otoendoscopy at radiology and dermatology reference centres in Brazil.ResultsMost affected dogs were male (71%) neutered (95%) with an average age of 6.8 years. Ninety‐one of the 100 affected dogs were brachycephalic. Otitis externa (OE; 81%) was the main non‐neurological manifestation observed. The main neurological clinical manifestations observed were: “head tilt” (66%), ataxia (31%) and nystagmus (25%). Advanced imaging findings could not propose a presumptive diagnosis of tympanokeratoma in 60 of 100 (60%) of the dogs. The absence of tympanic membrane and the presence of a dense pearly yellowish material resembling keratin in the tympanic bulla, after myringotomy, was the main otoendoscopic finding. The advanced imaging findings did not correlate with otoendoscopy and histopathological findings in more than half of the dogs.Conclusions and Clinical RelevanceTympanokeratoma should be suspected in brachycephalic dogs with OE and peripheral vestibular syndrome, and samples of keratinous material from the middle ear associated with histopathological results may be the best approach for the diagnosis.
A Faster Walking Speed Is Important for Improving Biomechanical Function and Walking Performance in Stroke Survivors
Authors: Jarvis Hannah L. , Nagy Philip , Reeves Neil D. 
Published: January 2025

This study compares joint kinematics and kinetics of young stroke survivors who walk <0.79 m/s (slow) or >0.80 m/s (fast) with reference to a healthy able-bodied group and provides clinical recommendations for guiding the gait rehabilitation of stroke survivors. Twenty-two young stroke survivors (18–55 y) were recruited from 6 hospital sites in the United Kingdom. Stroke participants were classified by walking speed as slow (<0.79) or fast (>0.80 m/s), and joint kinematics and kinetics at the pelvis, hip, knee, and ankle were measured during walking on level ground at self-selected speed. Ten walking biomechanical parameters correlated to walking speed (ρ ≥ .550). Stroke survivors in the slow group walked with significantly greater range of sagittal plane pelvic motion (P < .009), reduced range of hip adduction and abduction (P < .011), and smaller peak hip extension angle (P < .011) and hip flexion moment (P < .029) for the paretic limb. For the nonparetic limb, a significantly reduced hip flexion moment (P < .040) was observed compared with the fast group and control. We are the first to report how biomechanical function during walking is compromised in young stroke survivors classified by walking speed as slow (<0.79 m/s) or fast (>0.80 m/s) and propose that these biomechanical parameters be used to inform rehabilitation programs to improve walking for stroke survivors.
The Effect of Shoe Insole Stiffness Modifications on Walking Performance in Older Adults: A Feasibility Study
Authors: White Logan T. , Malcolm Philippe , Franz Jason R. , Takahashi Kota Z. 
Published: January 2025

Shoes or insoles embedded with carbon fiber materials to increase longitudinal stiffness have been shown to enhance running and walking performance in elite runners, and younger adults, respectively. It is unclear, however, if such stiffness modifications can translate to enhanced mobility in older adults who typically walk with greater metabolic cost of transport compared to younger adults. Here, we sought to test whether adding footwear stiffness via carbon fiber insoles could improve walking outcomes (eg, distance traveled and metabolic cost of transport) in older adults during the 6-minute walk test. 20 older adults (10 M/10 F; 75.95 [6.01] y) performed 6-minute walk tests in 3 different shoe/insole stiffnesses (low, medium, and high) and their own footwear (4 total conditions). We also evaluated participants’ toe flexor strength and passive foot compliance to identify subject-specific factors that influence performance from added shoe/insole stiffnesses. We found no significant group differences in distance traveled or net metabolic cost of transport (P ≥ .171). However, weaker toe flexors were associated with greater improvement in distance traveled between the medium and low stiffness conditions (P = .033, r = −.478), indicating that individual foot characteristics may help identify potential candidates for interventions involving footwear stiffness modifications.
A 3-Month Dual-Task Exercise Randomized Pilot Trial Improves Dynamic Stability and Coordination in Community-Dwelling Older Adults
Authors: Alessio Helaine M. , Malay Nancy , Jones Annemarie , Stein Lindsay , Thornburg Taylor , O’Connell Michael , Smith Dean L. 
Published: January 2025

Introduction: Dual-task (DT) exercises combine both physical and cognitive activities and have the potential to efficiently enhance both physical and cognitive function. Background/Objectives: This study aimed to determine if, compared with exercise-only (EO) and control (C) groups, adults in a DT training program improved measures of cognitive and/or physical functioning. Methods: Thirty-five participants (Mage = 65.7 ± 8.5 years; 74.3% female, 25.7% male) were randomly sorted into EO (n = 15), DT (n = 10), and C (n = 10). EO and DT participated in 3 months of twice weekly, 50-min exercise. DT played cognitive games on a SMARTfit Cognitive-Motor Exercise System during exercise sessions. C did not participate in any supervised sessions. Cognition was assessed with a Cognivue Thrive program. Dynamic stability, coordination, and lower body strength were assessed. Linear mixed-effects models investigated effects for different groups. For outcomes showing significant (p < .05) differences, pairwise t tests were conducted between all treatment and time comparisons. Results: Dynamic stability and coordination improved in DT and EO (p = .002 and .04, respectively), but not in C in the first 6 weeks (p = .58). Cognition and memory did not change over time among the three groups. Conclusion: Healthy, independent-living older adults in either DT or EO improved dynamic stability and coordination over time and DT improved balance and functional mobility more than either EO or C. No improvements in several standard cognition or memory measurements were observed. Significance/Implications: A DT exercise program improved balance and coordination, but not cognition or memory, in healthy, independent-living older adults.
Association of 30-s Sit-to-Stand Power Test Outcome With Body Balance in Physically Active Older Adults
Authors: Monteiro Pedro Henrique Martins , Valenciano Paola Janeiro , Mendes Pedro Henrique Silva , Teixeira Luis Augusto 
Published: January 2025

Amount of serial sitting and standing movements has been employed in clinical and research settings to assess legs’ muscular strength. In this cross-sectional study, we aimed to test the correlation between the 30-s sit-to-stand power test (30STSp) outcome and body balance in older adults. We evaluated physically active male and female (n = 51) individuals with an age range of 60–80 years (M = 69.29). Participants were assessed on the maximum number of repetitions for 30STSp and on the performance of balance tasks, as follows: quiet standing in unipedal support, unipedal support while alternately touching two targets on the ground with the toe of the nonsupporting foot in either the anteroposterior (AP) or mediolateral (ML) direction, and paced sit-to-stand supported on a narrow bipedal support base. Performance on the balance tasks was measured through smartphone-based triaxial trunk accelerometry (meters per second squared), with analysis made through root mean square for the AP and ML axes. Analysis indicated significant negative correlation coefficients of 30STSp outcome with trunk acceleration on unipedal quiet stance tasks both in the ML (rs = −.46) and AP (rs = −.40) directions and with the AP alternate target touching task for ML trunk acceleration (rs = −.34) and the ML alternate target touching task for AP trunk acceleration (rs = −.31). These results suggest that in active older adults, the 30STSp outcome is associated with balance in unipedal quiet standing and dynamic tasks. Our findings indicate the contribution of balance control in the performance of 30STSp.
Model for sinistral offset of the Cretaceous magmatic arc of southwestern North America along the Nacimiento fault system
Authors: Ingersoll Raymond V. 
Published: January 2025

Abstract
Finite-element paleogeologic restoration of southwestern North America at 60 Ma shows the western edge of Cretaceous granodiorite plutons, formed as a continuous magmatic arc above the Franciscan subduction zone, to be offset ~400 km in southern California, USA. This offset is successfully restored by reversing sinistral slip along a proposed Nacimiento–Caborca–Durango–Zacatecas (NCDZ) fault trace active approximately from 75 Ma to 60 Ma. The Franciscan trench west of the finite-element model can be restored by extending the NCDZ fault northward through coastal Franciscan terrane, where it formed a trench–trench–fault triple junction. As the trench–trench–fault triple junction migrated southeastward along the continental margin, a new forearc margin was exposed sequentially from NW to SE, beneath which the Pelona–Orocopia–Rand Schist was underplated. NCDZ fault displacement occurred concurrently with Laramide flat-slab subduction and intersection of the continental margin with an aseismic oceanic ridge. The trench–trench–fault triple junction would have tracked the intersection point of the NE–SW ridge with the NW–SE continental margin. Tests of this model (following palinspastic restoration) include: (1) The oldest ages of Pelona–Orocopia–Rand Schist should young NW–SE, (2) the initiation of forearc deep-marine sedimentation directly on Mesozoic magmatic-arc basement of Salinia should young NW–SE, (3) the detrital-zircon age spectra and other provenance indicators should correlate with potential source areas, (4) the metamorphic and plutonic belts of the batholithic belt should realign, (5) the Great Valley forearc belts should realign, and (6) the Franciscan belts should realign. Finite-element modeling provides rigorous constraints on paleogeologic and paleogeographic reconstructions and suggests additional avenues of investigation.
Sharing data matters: exploring the attitudes of older consumers on an emerging healthy ageing data platform using electronic health records for research
Authors: Naude Kim , Snowdon David A , Parker Emily , McNaney Roisin , Srikanth Velandai , Andrew Nadine E 
Published: January 2025

BackgroundIn Australia, with the recent introduction of electronic health records (EHRs) into hospitals, the use of hospital-based EHRs for research is a relatively new concept. The aim of this study was to explore the attitudes of older healthcare consumers on sharing their health data with an emerging EHR-based Research Data Platform within the National Centre for Healthy Ageing.MethodsThis was a qualitative study. Two workshops were conducted in March 2022 with consumer representatives across Peninsula Health, Victoria, Australia. The workshops comprised three parts: (1) an ice-breaker (2) an introduction to EHR-based research through the presentation of ‘use case’ scenarios and (3) focus group discussions. Qualitative data were analysed using reflexive thematic analysis.ResultsConsumer participants (n=16) were aged between 62 and 83 years and were of mixed gender. The overarching theme was related to trust in the use of EHR data for research; themes included: (1) benefits of sharing data, (2) uncertainty around data collection processes and (3) data sharing fears. The three themes within the overarching theme all reflect participants’ levels of trust.ConclusionOur study identified fundamental issues related to trust in the use of EHR data for research, with both healthcare and broader societal factors contributing to consumer attitudes. Processes to support transparent and clear communication with consumers are essential to support the responsible use of EHR data for research.
Impact of the SARS-CoV-2/COVID-19 pandemic on the patient journeys of those with a newly diagnosed paediatric brain tumour in the UK: a qualitative study
Authors: Akhter Kalsoom , Casson Roland , Brewster Liz , Burke G A Amos , Kilday John-Paul , Macarthur Donald , Isba Rachel , Jalloh Ibrahim 
Published: January 2025

ObjectivesTo explore the impact of the SARS-CoV-2/COVID-19 pandemic on the diagnosis, management and patient journey for children and young people with a newly diagnosed brain tumour in the UK.DesignExploratory qualitative study focused on patient journeys from multiple perspectives, conducted as part of a wider mixed-methods study.SettingThree paediatric oncology tertiary centres in the UK.Participants10 children and young people with brain tumours (n=6 females, n=4 males), 20 caregivers (n=16 females, n=4 males) and 16 stakeholders (specialist nurses, consultant neurosurgeons and oncologists, and representatives from brain tumour charities) were interviewed between January 2022 and June 2023.ResultsThe paper incorporates multiple perspectives, including those of children and young people, parents/caregivers, clinical staff and charity representatives, to explore the patient journey. Five themes describe the journey for new patients with paediatric brain tumour during the pandemic, focusing on (1) challenges getting into the healthcare system, (2) managing as a family during restrictions imposed by the pandemic, (3) complexities of building a cohesive and supportive healthcare team, (4) difficulties caregivers experienced in accessing practical and emotional support in hospital and (5) ongoing difficulties experienced by families in the community.ConclusionsFindings from this study offer practical insights from children, parents/caregivers and relevant stakeholders to improve the healthcare system during future disruptions. Overall, this study not only sheds light on the challenges faced by families during the pandemic but also provides suggestions for improving healthcare services to ensure a more comprehensive and effective response in times of crisis.
IMPACT-ICU feasibility study: pragmatic mixed-methods randomised controlled trial of a follow-up care intervention for survivors of critical illness and caregivers
Authors: Jawa Natasha Arianne , Maslove David M , Sibley Stephanie , Muscedere John , Hunt Miranda , Hanley Michaela , Boyd Tracy , Westphal Robin , Mathur Sunita , Fakolade Afolasade , Tryon Michelle , Boyd John Gordon 
Published: January 2025

IntroductionSurvivors of critical illness and their caregivers are at risk for long-term cognitive, physical and psychiatric impairments known as post-intensive care syndrome (PICS) and PICS-family, respectively. This study will assess the feasibility of a randomised controlled trial (RCT) evaluating an intensive care unit (ICU) follow-up care bundle versus standard-of-care for ICU patients and their caregivers.Methods and analysisThis is a single-centre feasibility study. Survivors of critical illness will be eligible if: age ≥18 years, life expectancy ≥6 months and high risk for PICS. We define high risk as ICU stay ≥4 days or involving 1+ of mechanical ventilation, tracheostomy, delirium or lack of access to a primary care physician (PCP). 20 ICU survivor-primary caregiver dyads will be enrolled (n=10 dyads per group) and randomised 1:1 to the intervention versus control group. The intervention will be: (1) diaries to journal patient experiences, (2) information packages on expectations post-discharge and (3) specialised follow-up care at 1 and 3 months post-discharge. The control group will receive standard of care in the ICU and follow-up with their PCP. The primary outcome is feasibility, defined as: (1) consent rate >80%, (2) enrolment rate of 4 participants/month, (3) follow-up rate>70% and (4) data capture rate >80%. Our secondary objective is to explore the perspectives of survivors of critical illness and their families about the intervention and their participation in the study. Tertiary outcomes will be a battery of cognitive, physical functioning and psychiatric outcomes.ImplicationsSurvivorship from critical illness extends beyond surviving an ICU stay. This project will lay the foundation for performing a large, multicentre pragmatic RCT with survivors of critical illness and their caregivers, paving the way for improved long-term healthcare.Ethics and disseminationThis study has received approval (6039808) from the Queen’s University Health Sciences/Affiliated Teaching Hospitals Research Ethics Board. Results will be presented at critical care conferences. A lay summary co-designed with ICU survivor participants will be provided to patients.Trial registration numberNCT06681649.
Predictive value of cough peak flow for successful extubation in mechanically ventilated patients after craniotomy: a single-centre prospective diagnostic study
Authors: Zhou Jianfang , Li Hong-Liang , Luo Xu-Ying , Chen Guang-Qiang , Yang Yan-Lin , Zhang Linlin , Xu Ming , Shi Guang Zhi , Zhou Jian-Xin 
Published: January 2025

ObjectivesThe purpose of this study was to evaluate the predictive value of the cough peak flow (CPF) for successful extubation in postcraniotomy critically ill patients.DesignThis was a single-centre prospective diagnostic study.SettingThe study was conducted in three intensive care units (ICUs) of a teaching hospital.ParticipantsPostcraniotomy patients who were 18 years or older, stayed in ICU for more than 24 hours and underwent mechanical ventilation for more than 24 hours were eligible for the study. Patients were excluded if one of the following was present: no extubation attempt during the ICU stay; underwent tracheostomy without extubation attempt; pregnant or lactating women; enrolled in other clinical trials; declined to participate in the study. A total of 4879 patients were screened and 1037 were eligible for the study, among whom 785 were included in the study.Outcome measuresCPF, including involuntary (CPF-invol) and voluntary CPF (CPF-vol), were measured before extubation. The area under the receiver operating characteristic curve (AUC) was calculated to explore the diagnostic accuracy of CPF in predicting successful extubation.ResultsThere were 641 successful extubation cases (81.7%). The AUC of CPF-invol for predicting successful extubation was 0.810 (95% CI 0.766 to 0.854), with a cut-off value of 63.2 L/min, a sensitivity of 87.4% and a specificity of 66.7%. For conscious patients, the AUC of CPF-invol for the prediction of successful extubation was 0.849 (95% CI 0.794 to 0.904), with a cut-off value of 63.2 L/min and the AUC of CPF-vol was 0.756 (95% CI 0.696 to 0.817), with a cut-off value of 68.2 L/min.ConclusionsThe CPF was much higher in patients with successful extubation than that in patients with failed extubation. CPF might be valuable for the prediction of extubation outcomes in postcraniotomy critically ill patients. Multicentre studies could be carried out to further validate the results of this study.Trial registration numberNCT04000997.
Individualised acute normovolaemic haemodilution for non-cardiac surgery with anticipated high-dose red cell transfusion: study protocol for a randomised controlled trial in West China Hospital of Sichuan University
Authors: Liao Chenxi , Tan Jinzhe , An Jingjing , Zhong Jie , Lai Xingning , Tian Leilei , Liao Ren 
Published: January 2025

IntroductionAcute normovolaemic haemodilution (ANH) is a perioperative blood management technique involving the removal of whole blood and simultaneous infusion of colloids or crystalloids to achieve haemodilution while maintaining normovolaemia. However, its efficacy in reducing the requirement for perioperative allogeneic blood transfusion remains controversial due to inconsistent findings in the literature. An individualised red cell transfusion strategy, guided by the West China Liu’s Score, has demonstrated effectiveness in reducing the need for allogeneic red cell transfusion. Building on this evidence, we propose an individualised ANH approach and hypothesise that individualised ANH, guided by the West China Liu’s Score, can reduce the requirement for allogeneic red cells during the perioperative period.Methods and analysisThis is a single centre, prospective, randomised controlled trial designed to evaluate the superiority of the individualised ANH, based on the West China Liu’s Score, in reducing perioperative red cell requirements compared with current clinical practice. Adult patients undergoing elective non-cardiac surgery with an anticipated red cell transfusion volume exceeding eight units (or 1600 mL) will be enrolled and randomly allocated to either the ‘ANH group’ or the ‘Control group’ in a 1:1 ratio. The primary outcome is the perioperative consumption of the allogeneic red blood cells. Data analysis will adhere to the intent-to-treat principle.Ethics and disseminationThe study protocol (V.1.0) has been approved by the Biological Medical Ethical Committee of the West China Hospital of Sichuan University, with approval No. 2024(595) on 17 April 2024. The results of this trial will be disseminated by publication in peer-reviewed journals and academic conference presentations.Trial registration numberNational Institutes of Health Clinical Trials Registry,NCT06399536. 2 May 2024.