bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the Motivations, Challenges, and Integration of Internationally Educated Healthcare Workers in the UK: A Scoping Review
Authors: Omiyi David , Wilkinson Elaine , Snaith Beverly 
Published: November 2024

Background Healthcare worker migration, influenced by push and pull factors, is accentuated by active recruitment strategies of developed nations. This scoping review explores experiences of internationally educated nurses, midwives, and healthcare professionals in the UK since 2010, acknowledging the historical context of UK recruitment policy and the implementation of codes of practice by the World Health Organisation and the UK government. Methods Using the Population, Concept, and Context framework, systematic literature searches were conducted in various databases, including CINAHL, Science Direct, Scopus, PubMed/Medline, and Google Scholar. Covidence software facilitated screening, with data systematically extracted and analyzed. Results The scoping review included 24 papers focusing on nurses ( n = 19), midwives ( n = 1), and various allied health professions ( n = 4), spanning from 2010 to 2023. Findings revealed diverse challenges and facilitators, from professional recognition and career opportunities to discrimination, language barriers, and socioeconomic factors influencing integration and retention. Conclusion The review highlights the multifaceted experiences of internationally educated healthcare professionals (IEHPs) in the UK workforce. Despite their significant contributions, IEHPs face challenges such as unrecognized skills, third-party recruitment issues, and cultural adjustment difficulties. Addressing registration processes, recruitment practices, and cultural competence training is crucial to creating an inclusive environment that maximizes IEHPs’ contributions and ensures their professional growth and well-being, ultimately benefiting the healthcare sector.
Functional Outcomes and Complications of Carotid Tandem Lesions After Mechanical Thrombectomy for Treatment of Large-Vessel Occlusion Stroke
Authors: Scott Colin , Abdulrahman Lena , Snyder Mackenzie , Castillo Lidia , Lu Jeffrey , Dunlap Eleanor , Nagarsheth Khanjan 
Published: November 2024

Background Large Vessel Occlusion (LVO) stroke patients with tandem lesions (TLs) have been observed to have worse outcomes when compared to patients with simple isolated intracranial occlusions. Objective To examine the difference in post-operative functional status at discharge for patients treated with mechanical thrombectomy for an acute LVO stroke based on the presence of a tandem carotid lesion. Methods This is a retrospective cohort study of 589 patients presenting within the first 24 hours of stroke onset who underwent mechanical thrombectomy. The primary outcome was functional status quantified by modified Rankin Score (mRS) at time of discharge. The secondary outcomes were presence of hemorrhagic conversion, midline shift >5 cm, malignant cerebral edema, reocclusion, Thrombolysis in Cerebral Infarction Scale (TICI), and discharge location. Results Patients with tandem occlusions and those with isolated intracranial lesions had similar baseline demographics. However, in patients with TLs, there was a significantly higher NIH stroke scale at admission and a longer time to recanalization. Modified Rankin Score prior to admission was similar for both groups, but was significantly higher in patients with TLs at discharge. The secondary outcomes were similar for hemorrhagic conversion, discharge to hospice, and a TICI scale of 0, but were significantly worse for patients with TLs for in-hospital mortality, midline shift >5 mm, and malignant cerebral edema. The presence of a tandem lesion predicted a higher modified Rankin Score at discharge in univariate regression modeling (β = .45; P-value = .006). Conclusion The two groups were similar in baseline characteristics and cardiovascular risk factors, yet patients with tandem carotid lesions experienced more complications during their hospitalization and had greater functional disability at discharge. Patients with a TL had a longer mean time to recanalization, representing a potential explanation for these differences in outcomes.
Empowering mothers: Advancing maternal health literacy and numeracy through the introduction of Maternal and Child Health Calendar
Authors: Meherali Salima , Matthews Brett , Myhre David , Nisa Saba , Idrees Sobia , Faraz Ashiq , Ullah Kaleem , Shah Roheena , Lassi Zohra 
Published: November 2024

Background: The health literacy and numeracy skills of women in Pakistan are very low compared to other low- and middle-income countries. Objective: The aim of this study was to improve the health literacy and numeracy skills of unschooled women in Northern Pakistan by developing a Maternal and Child Health Calendar (MCHC). The MCHC utilizes locally contextualized icons to promote and enhance service utilization and maternal and child health (MCH) outcomes. Methods: We conducted a qualitative exploratory study design to understand the experiences and usefulness of the MCHC among women. We recruited the participants using purposive sampling. Using a semi-structured interview guide, we conducted individual interviews with nine Key informants, that is, Agha Khan Rural Support Staff and Community-based savings group staff and five focus group discussions with unschooled women. We followed Braun and Clarke’s steps to conduct an inductive thematic data analysis. Results: The findings of our study are categorized into the following themes: (1) the benefits of using MCHC, (2) the usefulness of the MCHC in women’s healthcare decision-making, (3) empowerment of poorly schooled women, (4) enabling numeracy and record-keeping skills, (5) MCHC implementation challenges, and (6) participants suggestions to improve the MCHC. Our findings revealed that the MCHC improved the health literacy and numeracy of illiterate or less educated women by using localized images to help them comprehend their own and their children’s health. Additionally, it effectively empowered these women in their healthcare decision-making, such as discussing family planning with their husbands. Women also suggested modifying some images in the MCHC to enhance their clarity and usefulness. Conclusion: The MCHC has the potential to safely and sustainably build basic MCH literacy and numeracy skills among both literate and illiterate women in Northern Pakistan. Further research is needed to assess its potential as a stand-alone intervention to improve MCH outcomes.
PrEP initiation and adherence among Black cisgender women in Mississippi: The role of HIV and PrEP stigma and social support
Authors: Knight Deja , Monger Mauda , Phillips Karlye , Antar Amina , Baral Stefan , Stockman Jamila K. , Nunn Amy , Chan Philip , Mayer Kenneth , Mena Leandro , Kershaw Trace , Willie Tiara C 
Published: November 2024

Background: Stigma and lack of social support are barriers to HIV prevention, especially among cisgender Black women in the United States. While HIV pre-exposure prophylaxis (PrEP) can decrease HIV transmission, PrEP initiation and adherence remains low among Black women, especially in the U.S. South. Objectives: The purpose of this study was to characterize experiences with stigma and social support among PrEP-naïve and PrEP-experienced Black cisgender women in Mississippi. Design: Qualitative study in which semi-structured interviews and focus groups were conducted. Methods: We purposively recruited PrEP-naïve cisgender Black women who met PrEP indications to participate in focus groups and all PrEP-experienced cisgender Black women at a sexual health clinic in Jackson, Mississippi to participate in one-on-one semi-structured interviews. Inductive thematic analysis was used to analyze focus group and interview transcripts. Results: A total of 37 PrEP-naïve Black cisgender women participated across 6 focus groups and 8 PrEP-experienced cisgender Black women completed semi-structured interviews. Four themes were identified: (1) the intersection of gendered racism, discrimination, and HIV stigma, (2) enacted and anticipated PrEP stigma, (3) stigma mitigation strategies and PrEP adherence, and (4) social support’s role in PrEP initiation and adherence. PrEP-naïve and -experienced Black women discussed the negative consequence that sexual stigmatization and gendered racism has on HIV testing. PrEP-naïve Black women discussed how HIV stigma decreases PrEP initiation. Conversely, PrEP-experienced Black women were able to identify strategies they utilized to mitigate stigma. PrEP-experienced Black women discussed how differing levels of social support impact their PrEP use. Conclusion: Improving social support and stigma mitigation strategies could help improve PrEP initiation and adherence among cisgender Black women at-risk of acquiring HIV in the U.S. South. Educating communities on PrEP, and training providers on stigma-mitigating strategies when serving Black women in the U.S. South who are seeking HIV prevention is paramount.
Continuous Glucose Monitoring–Derived Glycemic Phenotyping of Childhood Hypoglycemia due to Hyperinsulinism: A Year-long Prospective Nationwide Observational Study
Authors: Worth Chris , Auckburally Sameera , Worthington Sarah , Ahmad Sumera , O’Shea Elaine , Senniappan Senthil , Shaikh Guftar , Dastamani Antonia , Ferrara-Cook Christine , Betz Stephen , Salomon-Estebanez Maria , Banerjee Indraneel 
Published: November 2024

Background: The glycemic characterization of congenital hyperinsulinism (HI), a rare disease causing severe hypoglycemia in childhood, is incomplete. Continuous glucose monitoring (CGM) offers deep glycemic phenotyping to understand disease burden and individualize patient care. Typically, CGM has been restricted to severe HI only, with performance being described in short-term, retrospective studies. We have described CGM-derived phenotyping in a prospective, unselected national cohort providing comprehensive baseline information for future therapeutic trials. Methods: Glycemic frequency and trends, point accuracy, and patient experiences were drawn from a prospective, nationwide, observational study of unselected patients with persistent HI using the Dexcom G6 CGM device for 12 months as an additional monitoring tool alongside standard of care self- monitoring blood glucose (SMBG). Findings: Among 45 patients with HI, mean age was six years and 53% carried a genetic diagnosis. Data confirmed higher risk of early morning (03:00-07:00 h) hypoglycemia throughout the study period and demonstrated no longitudinal reduction in hypoglycemia with CGM use. Device accuracy was suboptimal; 17 500 glucose levels paired with SMBG demonstrated mean absolute relative difference (MARD) 25% and hypoglycemia detection of 40%. Patient/parent dissatisfaction with CGM was high; 50% of patients discontinued use, citing inaccuracy and pain. However, qualitative feedback was also positive and families reported improved understanding of glycemic patterns to inform changes in behavior to reduce hypoglycemia. Interpretation: This comprehensive study provides unbiased insights into glycemic frequency and long-term trends among patients with HI; such data are likely to influence and inform clinical priorities and future therapeutic trials.
Anterior Cruciate Ligament Reconstruction and Concomitant Focal Cartilage Lesions: A Systematic Review and Meta-Analysis of Prognosis after Surgical Treatment
Authors: Jevremovic Diko , Årøen Asbjørn , Thomas Owen Matthew Truscott , Berge Hilde Moseby , Khan Ahsan Ayub , Ulstein Svend 
Published: November 2024

Objective To synthesize available evidence on the impact of concomitant focal cartilage lesions and their surgical treatment on clinical outcomes in the setting of anterior cruciate ligament (ACL)-reconstruction at short (6-36 months) and midterm (3-8 years) follow-up. Design Original level 1 or 2 studies comparing any patient-reported or objective outcomes in ACL-reconstructed patients (1) with and without concomitant focal cartilage lesion(s) or (2) after any type of cartilage surgical treatment were considered for inclusion. Systematic searches were conducted in MEDLINE via Ovid, Cochrane Library, EMBASE via OvidSP, and Web of Science. Results In meta-analysis performed across 6 studies (n=8,789 patients), we discovered with very low certainty, the correlation of concomitant any-thickness cartilage lesions and worse Patient-Reported Outcome Measure scores (PROMS) at cumulative short to mid, (pooled standardized mean difference (psmd) = −0.36; 95% confidence interval (CI) –0.62 to −0.10), short (psmd = −0.43; 95% CI = −0.94 to 0.08), and midterm (psmd = −0.22; 95% CI –0.43 to 0.00). Full-thickness lesions predicted worse PROMS with moderate certainty at cumulative short-midterm (psmd = −0.32; 95% CI = −0.41 to −0.23) and low certainty at both short (psmd = −0.45; 95% CI –0.83 to −0.07) and midterm (psmd = −0.30; 95% CI –0.38 to −0.22). In 4 studies for each outcome, mixed results were reported on osteoarthritis (OA) and reoperation rates. Conclusions As the main finding, concomitant full-thickness cartilage lesions in ACL-reconstructed patients are a predictor of worse PROMS in the cumulative short to midterm. Correlations of any-thickness lesions or different cartilage treatments with short- or midterm PROMS, OA, or reoperation rates were either with very low certainty, unmeasured, or with mixed results.
Exploring the opportunities of large language models for summarizing palliative care consultations: A pilot comparative study
Authors: Chen Xiao , Zhou Wei , Hoda Rashina , Li Andy , Bain Chris , Poon Peter 
Published: November 2024

Introduction Recent developments in the field of large language models have showcased impressive achievements in their ability to perform natural language processing tasks, opening up possibilities for use in critical domains like telehealth. We conducted a pilot study on the opportunities of utilizing large language models, specifically GPT-3.5, GPT-4, and LLaMA 2, in the context of zero-shot summarization of doctor–patient conversation during a palliative care teleconsultation. Methods We created a bespoke doctor–patient conversation to evaluate the quality of medical conversation summarization, employing established automatic metrics such as BLEU, ROUGE-L, METEOR, and BERTScore for quality assessment, and using the Flesch-Kincaid grade Level for readability to understand the efficacy and suitability of these models in the medical domain. Results For automatic metrics, LLaMA2-7B scored the highest in BLEU, indicating strong n-gram precision, while GPT-4 excelled in both ROUGE-L and METEOR, demonstrating its capability to capture longer sequences and semantic accuracy. GPT-4 also led in BERTScore, suggesting better semantic similarity at the token level compared to others. For readability, LLaMA 7B and LLaMA 13B produced summaries with Flesch-Kincaid grade levels of 11.9 and 12.6, respectively, which are somewhat more complex than the reference value of 10.6. LLaMA 70B generated summaries closest to the reference in simplicity, with a score of 10.7. GPT-3.5’s summaries were the most complex at a grade level of 15.2, while GPT-4’s summaries had a grade level of 13.1, making them moderately accessible. Conclusion Our findings indicate that all the models have similar performance for the palliative care consultation, with GPT-4 being slightly better at balancing understanding content and maintaining structural similarity to the source, which makes it a potentially better choice for creating patient-friendly medical summaries. Threats and limitations of such approaches are also embedded in our analysis.
Stroke thrombectomy in the elderly: A propensity score matched study on a nationwide real-world registry
Authors: Romoli Michele , Migliaccio Ludovica , Saia Valentina , Pracucci Giovanni , Cirillo Luigi , Forlivesi Stefano , Romano Daniele , Casetta Ilaria , Fainardi Enrico , Sallustio Fabrizio , Limbucci Nicola , Nencini Patrizia , Da Ros Valerio , Diomedi Marina , Vallone Stefano , Bigliardi Guido , Vinci Sergio Lucio , La Spina Paolino , Bergui Mauro , Cerrato Paolo , Bracco Sandra , Tassi Rossana , Saletti Andrea , Azzini Cristiano , Ruggiero Maria , Castellan Lucio , Benzi Markushi Tiziana , Menozzi Roberto , Pezzini Alessandro , Lazzarotti Guido Andrea , Giannini Nicola , Castellano Davide , Naldi Andrea , Comai Alessio , Dall’Ora Elisa , Plebani Mauro , Cappellari Manuel , Frauenfelder Giulia , Puglielli Edoardo , Casalena Alfonsina , Burdi Nicola , Boero Giovanni , Nappini Sergio , Loizzo Nicola Davide , Cavasin Nicola , Critelli Adriana , Ivaldi Diego , Tassinari Tiziana , Biraschi Francesco , Nicolini Ettore , Zimatore Sergio , Petruzzellis Marco , Filauri Pietro , Orlandi Berardino , Gallesio Ivan , Ferrandi Delfina , Pavia Marco , Invernizzi Paolo , Amistá Pietro , Russo Monia , Paladini Adriana , Rizzo Annalisa , Besana Michele , Giossi Alessia , Filizzolo Marco , Mannino Marina , Mangiafico Salvatore , Toni Danilo , Zini Andrea 
Published: November 2024

Introduction: Data on safety and efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke in older patients are limited and controversial, and people aged 80 or older were under-represented in randomized trials. Our aim was to assess EVT effect for ischemic stroke patients aged ⩾80 at a nationwide level. Patients and methods: The cohort included stroke patients undergoing EVT from the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS). Patients were a priori divided into younger and older groups (<80 vs ⩾80). Primary outcome was good functional outcome (modified Rankin scale, mRS, 0–2 at 90 days). Secondary outcomes were symptomatic intracranial hemorrhage (sICH), successful reperfusion, EVT abortion. Propensity score matching (PSM) was performed between age groups for baseline features, functional status, stroke severity and neuroradiological features. Logistic regression was implemented to test the weight of age group on the predefined outcomes. Results: Overall, 5872 individuals (1:1 matching, n = 2936 aged ⩾80 vs n = 2936 < 80) were matched from 13,922 records. In ⩾80 group 34.1% had good functional outcome, vs 51.2% in <80 group (absolute difference = −17.1%, p < 0.001), with a 4.4% excess in EVT abortion. Age ⩾80 was a negative independent predictor of good functional outcome (aOR = 0.4, 95% CI = 0.3–0.5), but had no impact on sICH. Discussion and conclusion: Age ⩾80 years represents a consistent predictor of worse functional outcome, independently from successful reperfusion and sICH. Cost-effectiveness studies are needed for tailored and implement sustainable care, and research should focus on strategies to improve functional outcome in older age patient groups.
American Foregut Society White Paper on the Endoscopic Assessment of the Gastroesophageal Valve after Anti-Reflux Surgery
Authors: Nguyen Ninh T. , Bell Reginald , Abu Dayyeh Barham , Chang Kenneth , Lipham John , Buckley Francis Paul , Hinojosa Marcelo W. , Brunaldi Vitor , Dunst Christy M. , Mittal Ravinder K. , Oelschlager Brant K. , Houghton Caitlin , Schnoll-Sussman Felice , Kahrilas Peter J. 
Published: November 2024

Background: Pathologic reflux is a common debilitating digestive condition and anti-reflux surgery is an effective treatment option. Depending on the specifics of the procedure, anti-reflux surgery leads to distinct changes in the endoscopic appearance of the esophagogastric junction (EGJ). This American Foregut Society (AFS) white paper develops nomenclature for describing the endoscopic characteristics of the EGJ after commonly performed laparoscopic antireflux operations. Methods: The AFS Anti-Reflux Barrier Collaborative analyzed the anatomic manipulation and corresponding endoscopic appearance of the EGJ after commonly performed anti-reflux surgery including: (1) 360° anterior/posterior (AP) fundoplication (Nissen); (2) posterior partial fundoplication (Toupet); (3) anterior partial fundoplication (Watson, Dor); (4) magnetic sphincter augmentation; and (5) concomitant hiatal hernia repair with transoral fundoplication (cTIF). Results: Characteristics common to the anti-reflux surgery procedures include restoration of intra-abdominal esophageal length and crural diaphragm repair such that the hiatal aperture is no longer visible in the retroflexed endoscopic view. With regard to the geometry of anti-reflux procedures, the Collaborative established that when evaluated endoscopically in retroflection, the surgically constructed valve should be described in reference to the angle of His and the extent of anatomic change described in terms of (1) the depth of the anterior and posterior grooves, (2) the apposition of the valve collar to the endoscope, (3) the length of the valve, and (4) the position of the squamocolumnar junction relative to the lip of the valve. Conclusions: Current anti-reflux operations share much in common but employ varying degrees of valvular reconstruction leading to distinct endoscopic characteristics. Developing a consistent nomenclature for describing the appearance of the post-surgical valve is essential to develop a better understanding of how variables such as the tightness of the hiatal repair, tightness of the valve collar, and length of the valve can impact the outcome of anti-reflux surgery and predict reflux recurrence.
HIV phylogenetic clusters point to unmet hiv prevention, testing and treatment needs among men who have sex with men in kenya
Authors: Cholette François , Lazarus Lisa , Macharia Pascal , Walimbwa Jeffrey , Kuria Samuel , Bhattacharjee Parinita , Musyoki Helgar , Mugambi Mary , Ongaro Martin K. , Olango Kennedy , Musimbi Janet , Emmanuel Faran , Isac Shajy , Pickles Michael , Becker Marissa L. , Mishra Sharmistha , McKinnon Lyle R. , Blanchard James , Ho John , Henry Omari , Fabia Rissa , Sandstrom Paul , Lorway Robert , Shaw Souradet Y. 
Published: November 2024

Abstract
Background
The HIV epidemic in Kenya remains a significant public health concern, particularly among gay, bisexual, and other men who have sex with men (GBMSM), who continue to bear a disproportionate burden of the epidemic. This study’s objective is to describe HIV phylogenetic clusters among different subgroups of Kenyan GBMSM, including those who use physical hotspots, virtual spaces, or a combination of both to find male sexual partners.

Methods
Dried blood spots (DBS) were collected from GBMSM in Kisumu, Mombasa, and Kiambu counties, Kenya, in 2019 (baseline) and 2020 (endline). HIV pol sequencing was attempted on all seropositive DBS. HIV phylogenetic clusters were inferred using a patristic distance cutoff of ≤ 0.02 nucleotide substitutions per site. We used descriptive statistics to analyze sociodemographic characteristics and risk behaviors stratified by clustering status.

Results
Of the 2,450 participants (baseline and endline), 453 (18.5%) were living with HIV. Only a small proportion of seropositive DBS specimens were successfully sequenced (n = 36/453; 7.9%), likely due to most study participants being virally suppressed (87.4%). Among these sequences, 13 (36.1%) formed eight distinct clusters comprised of seven dyads and one triad. The clusters mainly consisted of GBMSM seeking partners online (n = 10/13; 76.9%) and who tested less frequently than recommended by Kenyan guidelines (n = 11/13; 84.6%).

Conclusions
Our study identified HIV phylogenetic clusters among Kenyan GBMSM who predominantly seek sexual partners online and test infrequently. These findings highlight potential unmet HIV prevention, testing, and treatment needs within this population. Furthermore, these results underscore the importance of tailoring HIV programs to address the diverse needs of GBMSM in Kenya across different venues, including both physical hotspots and online platforms, to ensure comprehensive prevention and care strategies.