bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes and management of invasive procedures in participants with hemophilia A post gene therapy: a post hoc analysis of the GENEr8-1 phase III trial
Authors: Quon Doris V. , Wang Jiaan-Der , Wang Michael , Pepperell Dominic , Park Young-Shil , Kenet Gili , Mahlangu Johnny , Khoo Teh-Liane , Robinson Tara M. , Chavele Konstantia-Maria , Pipe Steven W. 
Published: December 2024

Background: Hemophilia A is caused by coagulation factor VIII (FVIII) deficiency and increases bleeding risk during invasive procedures. Objectives: To investigate FVIII concentrate use and bleeding outcomes for invasive procedures after valoctocogene roxaparvovec gene transfer. Design: This manuscript presents post hoc analysis of the phase III GENEr8-1 trial. Methods: A post hoc analysis was performed for GENEr8-1, a global, single-arm, open-label, phase III trial that enrolled 134 adults with severe hemophilia A. FVIII activity and bleeding were evaluated after 2 years of follow-up. Invasive procedures were reviewed and categorized as major or minor. FVIII activity was measured with a chromogenic assay. Bleeding was self-reported by participants. Principal investigators completed questionnaires about perioperative management. Results: In total, 111 invasive procedures were performed in 65 participants during GENEr8-1 as of the data cut. Procedures performed with FVIII treatment included 33 minor and 11 major procedures. The remaining 67 invasive procedures were minor and performed without FVIII treatment. When considering these 67 minor procedures, 43/46 investigators completing the questionnaires reported that the gene-therapy-derived FVIII activity was sufficient for the type of procedure. Minor procedures performed without FVIII treatment were associated with participants’ higher mean endogenous FVIII activity (50.5 IU/dL) compared with major procedures (14.2 IU/dL) or minor procedures (16.4 IU/dL) performed with concomitant FVIII. Fourteen participants experienced 18 procedure-related bleeds (13 co-occurring with FVIII use). Participants who received FVIII treatment for procedure-related bleeds had numerically lower mean endogenous FVIII activity than those who did not receive FVIII treatment. Conclusion: Invasive procedures were safely performed in participants following treatment with valoctocogene roxaparvovec. The questionnaire responses from investigators generally suggest they used endogenous FVIII activity derived from valoctocogene roxaparvovec to inform clinical decisions in a manner comparable to exogenously administered FVIII, and more commonly prescribed supplementary FVIII concentrate in the peri-procedural period for participants with lower FVIII activity levels.
The association of artificial intelligence ethical awareness, attitudes, anxiety, and intention-to-use artificial intelligence technology among nursing students
Authors: Migdadi Moh''d Khair , Oweidat Islam Ali , Alosta Mohammad R. , Al-Mugheed Khalid , Saeed Alabdullah Amany Anwar , Farghaly Abdelaliem Sally Mohammed 
Published: December 2024

Background As artificial intelligence (AI) continues to permeate various sectors including healthcare, understanding its impact on nursing students’ attitudes and intentions to use is crucial. To examine the association of AI ethical awareness, attitudes, anxiety, and intention-to-use AI technology among Jordanian nursing students. Method A descriptive, cross-sectional design was used. The study was conducted in three private universities in Jordan, utilizing a convenience sampling technique; data were collected from a sample of 140 nursing students between January and March 2024. Results Results showed moderate levels of AI ethical awareness, attitudes toward AI technology, anxiety to use AI, and intention-to-use AI technology among Jordanian nursing students. There are no significant differences found in the levels of AI ethical awareness, attitudes toward AI technology, anxiety to use AI, and intention-to-use AI based on gender and study year ( p < 0.01). Intention-to-use AI had a significant positive relationship with AI ethical awareness ( r = 0.521, p < 0.001), students’ attitudes toward AI (0.558, p < 0.001), and anxiety to use AI ( r = 0.407, p < 0.001). Conclusion The need to keep pace with technological developments is urgent and crucial, especially in nursing educational institutions. The findings shed important light on the levels of behavioral intention toward AI, as well as on variables such as ethical awareness, attitudes, and anxiety about AI, and the effect of demographics on participants’ attitudes, anxiety, and intentions to use AI technology.
Technology use in long-term care during the COVID-19 pandemic: A qualitative study of paid employees’ experiences in Western Canada
Authors: Chew Hui-Jun , Freeman Shannon , Jackson Piper , Hemingway Dawn , Klassen-Ross Tammy , Martin-Khan Melinda , Banner Davina 
Published: December 2024

Background During the COVID-19 pandemic, governments across the world implemented processes and policies to limit the spread of COVID-19, especially in long-term care (LTC) homes. This led to changes in technology use for persons living in LTC homes, their families and friends, as well as the paid workforce dedicated to caring for them. Objective The study describes the role of technology and its impact on the experiences of LTC staff working in northern and rural areas in Western Canada during COVID-19. Methods A secondary analysis of semi-structured interviews with 52 LTC staff was conducted. Qualitative data was analysed thematically using Braun and Clarke's thematic analysis approach. Results Analysis of the study data revealed that new and innovative uses of technology emerged in the LTC setting during COVID-19, including technologies to support communication and collaboration with medical and health care professionals external to the LTC homes. Video-conferencing technology were rapidly implemented to facilitate virtual visits for LTC residents to connect to their families, further new streaming services were introduced to support recreational activities, including live music and spiritual services. LTC residents required significant support from staff to participate in virtual activities. Inadequate Internet infrastructure and scheduling difficulties in the context of severe staff shortages created challenges in technology adoption. Conclusions This research provides insight into how technology can support LTC teams in northern and rural communities, as well as supports needed for LTC residents and staff to integrate technology effectively. The study informs actionable insights for those working in rural LTC settings.
Prevalence of Congenital Heart Disease in Children and Adolescents Under 18 in Africa: A Systematic Review and Meta-Analysis
Authors: Danso Kwadwo A. , Appah Grace , Akuaku Rosemary S. , Karikari Yaa S. , Ansong Annette K. , Edwin Frank , Yao Nana-Akyaa 
Published: December 2024

Background There are limited population-based studies on congenital heart disease (CHD) in the pediatric population in Africa. Technological advancements in diagnostic tools have resulted in multiple echocardiographic studies in hospital settings. We aimed to determine the prevalence of CHD in both settings (population-based and hospital based) followed by comparing the two estimates for a difference. Methods We systematically searched PubMed, Google Scholar, African Journals Online, and African Index Medicus for eligible studies from 1992 through 2022. We performed a meta-analysis using the random-effects model. Results We selected 42 studies; 10 population studies with 1,011,163 participants, and 32 hospital-based studies with 605,268 patients for the analyses. The population and hospital-based prevalence were 5.12 versus 12.63 per 1,000 population of children ( P = .007). Ventricular septal defect was the most common type of CHD in both settings (0.61 vs 1.88 per 1,000), followed by atrial septal defect (0.26 vs 0.68 per 1,000). Tetralogy of Fallot was the most common cyanotic heart lesion in both settings (0.08 vs 0.52 per 1,000). Conclusions The population-based prevalence of CHD was significantly lower than the hospital-based prevalence (5.12 vs 12.63 per 1,000 population of children). Juxtaposing these two prevalence estimates against each other can be a reasonable alternative to quantifying the contemporary burden of CHD in the pediatric population of Africa. Moving forward, efforts should bolster awareness of CHD in Africa, and further advocacy for children with CHD should be a priority on the continent.
Systematic literature review of the impact of spinal muscular atrophy therapies on bulbar function
Authors: McGrattan Katlyn , Walsh Katie , Mehl Lesa , Kaur Simarjeet , Dilly Keith W 
Published: December 2024

Background: Improvement and maintenance of bulbar function are important goals of disease-modifying treatments (DMTs) for spinal muscular atrophy (SMA), but standardized and validated measures for assessing bulbar function do not exist, nor does a widely accepted definition of bulbar function in SMA. As such, the impact of DMTs on bulbar function has not yet been comprehensively evaluated. Objective: We conducted a systematic literature review (SLR) to identify evidence about the impact of DMTs for SMA on bulbar function. Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines to conduct this review. Embase® and MEDLINE® databases were searched through August 10, 2023. Eligible studies included patients with SMA who were treated with any DMT and reported bulbar function outcomes. Non-English studies were excluded. Results: We identified 51 studies (across 83 publications) that evaluated SMA DMTs and bulbar function for more than 1600 patients. The ability to feed orally, the ability to tolerate liquids, and the need for nutrition support were commonly reported. Most infants treated with any DMT before SMA symptom onset preserved bulbar function. Infants, children, and adults treated after SMA symptom onset experienced variable results in terms of bulbar function outcomes. Conclusions: The definition and assessment of bulbar function are not standardized. Therefore, the tools, scales, methods, and timing used for bulbar function assessments varied among studies. Larger prospective studies using standardized and age-based assessments with longer follow-up periods are needed to assess the clinical stability of bulbar function for patients with SMA who receive DMTs.
The Association Between Intensive Care Unit Nurses’ Perception of Nursing Professional Autonomy and Nursing Professionalism: A Descriptive Correlational Design
Authors: Al-sbehat Alaa Mefleh , Eshah Nidal Fareed , Rayan Ahmad Hussien , Abu Raddaha Ahmad H. , Al Omari Omar , Alhalaiqa Fadwa 
Published: December 2024

Introduction The evolving landscape of healthcare in Jordan presents unique challenges and opportunities for nursing professionals. With a focus on critical care nurses, understanding the dynamics of professional autonomy and professionalism within this context is crucial for advancing nursing practice and improving patient care. Objectives This study aimed to investigate the relationships between perceived nursing professional autonomy and professionalism among critical care nurses in Jordan. Methods A descriptive correlation design was used among critical care nurses from five major Jordanian governmental hospitals. A total of 227 questionnaires were distributed, with a final sample size of 200 participants. Data were collected between August and September 2023. Professional autonomy and professionalism were measured using the Dempster Practice Behaviors Scale and the Nurses' Professionalism Inventory, respectively. We used the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines in the current study. Results The study revealed moderate levels of perceived professional autonomy (mean DPBS total score: 103.94) and professionalism (mean NPI total score: 119.12) among participants. A significant positive correlation ( r = .49, p < .001) was observed between these two constructs. However, demographic and work-related factors showed minimal influence on these perceptions. Conclusion The study highlights the importance of professional autonomy and professionalism in improving nursing care in Jordan. It recommends targeted approaches like ongoing education and supportive workplace policies to bolster these aspects. These findings have significant implications for nursing policy and education across various healthcare settings.
Intrauterine Device Use and Perceptions Among Women in Tanzania—A Mixed Methods Study
Authors: Massay Catherine Safari , Rivenes Lafontan Sara , Rogathi Jane Januarius , Safari Upendo S. , Sigalla Geofrey Nimrod 
Published: December 2024

Introduction The intrauterine device (IUD) represents the most cost-effective, long-acting reversible form of contraception, but accounts for only 1% of all contraception methods used in Tanzania. Objective This study aims to determine the uptake of IUD use and investigate the perceptions, challenges, and recommendations surrounding the use of intrauterine devices among women of reproductive age in Tanzania. Method A cross-sectional study was conducted including 347 women, as well as qualitative semi-structured interviews with 11 women. Quantitative data were entered into SPSS, and descriptive statistics were employed to summarize the data. Content analysis was used to analyse the qualitative data. Results The prevalence of IUD use was 5%. The majority of the women interviewed were aware of myths and misconceptions concerning IUDs but wanted to use it after receiving information from healthcare providers. Conclusion The study found that the use of intrauterine devices was low in the study area and that there is a need to strengthen community engagement to reduce misconceptions about the use of IUDs.
Finite Element Analysis of the Influence that Bone Density and Implant Fixation Features have on Total Ankle Tibial Component Stability
Authors: Johnson Joshua E. , Clarke Gabriel , de Cesar Netto Cesar , Chrea Bopha , Anderson Donald D. 
Published: December 2024

Background: Primary implant stability is important for successful outcomes after uncemented total ankle replacement (TAR). However, the influence of patient-specific bone density on TAR performance is poorly understood, especially for implants that rely on press-fit for stable primary fixation. Our goal was to evaluate how bone density influences implant-bone interfacial micromotions in 3 press-fit tibial component designs by sampling from a TAR preoperative planning database using finite element analysis (FEA). Methods: FEA was conducted in 4 TAR patients with relatively low-density (n = 2, lowest 10% of a sample including 58 patients) and average-density (n = 2, midrange of sample) bone as assessed from deidentified patient CT scans. Three tibial implant designs were evaluated: a bone-sparing resurfacing implant, a cortex-sparing anterior approach monoblock stemmed implant, and a distal-reaming modular stemmed implant. Implants were inserted into tibia geometries obtained from the CT scans. Press-fit implantation was modeled first, followed by loadings from the stance phase of gait, and the associated micromotions were computed from the FEA output. Results: In general, patients with average-density bone had FEA predicted lower micromotions than patients with low-density bone. FEA suggests that implant fixation features had less influence on micromotions in patients with average-density bone, with peak micromotions ranging from 2 to 23 µm (3.1 ± 1.3 µm average micromotion). For patients with low-density bone, interfacial regions are predicted to experience micromotions exceeding the bony ingrowth threshold of 50 µm only for the resurfacing implant. Conclusion: We investigated the influence of bone density on implant-bone micromotions with varying primary fixation features using FEA. The model predicts that micromotions are less in average-density bone, regardless of implant fixation features. However, both stemmed devices showed lower micromotions in less-dense bone, albeit with the corresponding clinical trade-off of requiring more tibial bone removal. Clinical Relevance: The results presented here implicate the complementary role that local bone density plays in the primary fixation stability of uncemented TAR.
10-Year Survival Rate of 82% Following 262 Cases of Arthroscopic Bone Marrow Stimulation for Osteochondral Lesions of the Talus
Authors: Rikken Quinten , Aalders Margot , Dahmen Jari , Sierevelt Inger , Stufkens Sjoerd , M.M.J. Kerkhoffs Gino M 
Published: December 2024

Category: Arthroscopy; Ankle Introduction/Purpose: The long-term sustainability of arthroscopic bone marrow stimulation (BMS) for osteochondral lesions of the talus (OLT) remains a matter of debate. The primary aim of the present study is to assess the 10-year survival following arthroscopic BMS for OLT. The secondary aim is to evaluate the influence of baseline patient- and lesion characteristics on survival. Methods: Patients who underwent arthroscopic BMS for a symptomatic OLT with a minimum follow-up of 10-years were included to assess procedure survival. The primary outcome, the 10-year cumulative survival rate, was analysed with a Kaplan-Meier survival analysis. Secondary outcomes concerned the median time to survival and the effect of baseline factors (i.e., lesion size, primary or non-primary lesion type, preoperative cysts, and obesity (body mass index ≥30 kg/m²) on survival and was analysed with a cox-regression model and reported with hazard ratios (HR). Results: From the 262 patients included at a mean 15.3 ± 4.8 years follow-up, the 10-year cumulative survival rate of arthroscopic BMS was 82% [95%-CI: 77% - 87%]. At 15-years follow-up the cumulative survival rate was 82% [95%-CI: 76% - 86%]. The median time to revision was 2.4 (interquartile range: 1.3 – 5.1) years. Of the baseline factors, obesity (HR: 3.0 [95%-CI: 1.44 – 6.43], p= < 0.01) was associated with decreased survival. Lesion size (HR: 0.9 [95%-CI: 0.5– 1.8] p= 0.8), non-primary lesion type (HR: 1.8 [95%-CI: 0.9 – 3.4] p= 0.1), and the presence of preoperative cysts (HR: 1.0 [95%-CI: 0.6 – 1.9] p= 0.9) were not significantly associated with survival. Conclusion: At a minimum follow-up of 10-years, the survival rate of arthroscopic BMS for OLT was 82%. At 15- and 20-years follow-up survival seems to remain stable. Obesity (BMI ≥30 kg/m2) was associated with a higher likelihood of revision surgery. This risk factor should be incorporated into the treatment algorithm for OLT when counselling patients for surgery.
A Cadaveric Study: Does Ankle Positioning Impact the Quality of Anatomic Syndesmosis Reduction?
Authors: Foster Jeffrey A. , Aneja Arun , Nazal Mark R. , Griffin Jarod T. , Muhammad Maaz , Sierra-Arce Carlos R. , Southall Wyatt G.S. , Wagner Robert K. , Borgida Jacob S.W. , Ly Thuan V. , Srinath Arjun 
Published: December 2024

Category: Trauma; Ankle Introduction/Purpose: To compare the quality of syndesmotic reduction with the ankle in maximal dorsiflexion versus neutral plantarflexion (normal resting position). Methods: Two fellowship-trained orthopaedic surgeons disrupted syndesmoses of 10 cadaveric ankle specimens from 5 donors. All ankles were initially placed in neutral plantarflexion and were subsequently reduced and stabilized with one 0.062-inch K-wire in a quadricortical fashion. Post-reduction computed tomography (CT) scans were then obtained. This process was repeated with the ankles placed in maximal dorsiflexion. Post-reduction CT scans were compared to baseline CT imaging obtained prior to syndesmotic disruption. Mixed-effects linear regression was used to assess differences between baseline scans and reduction in neutral plantarflexion and maximal dorsiflexion with significance set at P< 0.05. Results: Syndesmotic reduction and stabilization in maximal dorsiflexion led to increased external rotation of the fibula compared to baseline scans [13.0 degrees ± 5.4 degrees (mean ± SD) vs. 7.5 degrees ± 2.4 degrees, P=0.002]. There was a tendency towards lateral translation of the fibula with the ankle placed in maximal dorsiflexion (3.3 mm ± 1.0 mm vs. 2.7 mm ± 0.7 mm, P=0.096). No other statistically significant differences between measurements of reduction with the ankle placed in neutral plantarflexion or maximal dorsiflexion and baseline were present (P>0.05). Conclusion: Reducing the syndesmosis with the ankle in maximal dorsiflexion leads to malreduction with external rotation of the fibula. There was no statistically significant difference in reduction quality with the ankle placed in neutral plantarflexion. Future studies should assess the clinical implications of ankle positioning during syndesmotic fixation.
Agreement Analysis on Postoperative Care Between ChatGPT and a High-Volume Foot and Ankle Surgeon.
Authors: Efrima Ben , Barbero Agustin , Indino Cristian , Maccario Camilla , Giuseppe Usuelli Federico 
Published: December 2024

Category: Other; Ankle Arthritis Introduction/Purpose: ChatGPT is an Artificial intelligence (AI) algorithm based on a user-friendly interface that does not requires advanced programming skills. Since its release to the public, it has made AI more accessible. As a result, the Patient refers to chat GTP for medical inquiries. This study compares the postoperative (PO) information provided by chatGPT to those of a high-volume foot and ankle orthopedics surgeon Methods: The study includes 251 patients treated for end-stage osteoarthritis with total ankle arthroplasty. Postoperative emails containing inquiries about their PO status were uploaded to chatGTP. We then evaluated the agreement in simple (SA) and complex (CA) answers. The SA abbreviated the answer provided into "yes" or "no" Its agreement analysis was made using Cohens Kappa. In contrast, CA contained detailed information, and answers were classified into complete agreement, partial agreement, or complete disagreement. Additionally, in partial agreement answers, we calculated the percentage of agreement. Finally, we measured the cases where the surgeon added additional information unrelated to the inquiry. Results: There was only a slight agreement in the SA category (K=0.08). In the CA category, we found 27 percent of complete agreement; in 52 percent, we found complete disagreement; in 20 percent, we found only partial agreement. In 50 % of the cases, the surgeon added information unrelated to the question Conclusion: We found limited agreement between chat GPT and the primary surgeon regarding postoperative information. Indicating that chat, GPT is currently an unreliable source for postoperative management. TABLE 1. Agreement Between a High-volume foot and ankle surgeon and ChatGPT response to postoperative inquiries from patients with total ankle arthroplasty in Simple Response Category