bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telehealth use and receipt of recommended services within one-year postpartum
Authors: Kishkovich Thomas P , James Kaitlyn E , Orona Katie C , Bernstein Sarah N , Cohen Jessica L , Clapp Mark A 
Published: December 2024

Introduction In obstetrics, telehealth is widely used in the provision of prenatal and postpartum care. The objective was to compare the utilization of commonly recommended services after delivery among individuals receiving telehealth versus in-person postpartum care. Study Design We performed a retrospective cohort study of individuals receiving postpartum care at a single institution between 1 July 2020 and 30 June 2023. The primary exposure was the exclusive use of telehealth versus an in-person visit for postpartum care. Two primary outcomes were assessed between 0 and 365 days after the delivery: 1) long-acting reversible contraceptive (LARC) method use and 2) pap smear screening. Secondary outcomes occurring between 0 and 365 days after delivery included: clinic-based weight assessment, clinic-based blood pressure assessment, any prescription contraception use, primary care visit, and pregnancy within 1 year. Results Among the 9953 individuals, 9058 (91.0%) had a postpartum visit. 1811 (19.9%) utilized telehealth exclusively, which peaked during the COVID-19 pandemic. Exclusive telehealth users were less likely to have a pap smear (21.6 vs. 40.1%, p < 0.001) or use LARCs (8.6 vs. 19.4%, p < 0.001) than those receiving in-person care. In the adjusted analysis, the odds ratio for receiving a pap smear was 0.38 (95% confidence interval [CI] 0.32–0.47) and for using a LARC was 0.38 (95% CI 0.31–0.47) when comparing telehealth to in-person care. Reduced odds of all secondary outcomes were seen in the exclusive telehealth use compared to the in-person cohort, with the exception of subsequent pregnancy within 1 year, which was not significantly different. Discussion Acknowledging that telehealth now has become an important means for patients to access medical care, these findings should prompt clinicians to consider when an in-person postpartum visit should be offered or recommended over telehealth, especially when a patient may not have a preference or reported barriers to accessing an in-person visit.
Legal obstacles jeopardise research in personalised medicine – experiences from a Nordic collaboration within rheumatology
Authors: Glintborg Bente , Hansson Mats , Hammer Hilde Berner , Klareskog Lars , Saevarsdottir Saedis , Westerlind Helga , Rönnelid Johan , Gehring Isabel , Benson Mikael , Esbensen Bente Appel , Hetland Merete Lund , Padyukov Leonid , Kragstrup Tue Wenzel , Hauge Ellen-Margrethe , AxnÄs Barbara Bislawska , Krogh Niels Steen , Johannesson Martina , Askling Johan 
Published: December 2024

Aims: Personalised medicine in chronic complex diseases such as rheumatoid arthritis (RA) is within reach but requires international multi-stakeholder collaboration. We exemplify how national implementations of the General Data Protection Regulation (GDPR) have introduced administrative delays and created disincentives for data sharing and collaborative research. Methods: Our Danish/Swedish/Norwegian research collaboration (the 3-year NordForsk-funded “NORA” project) aims to develop a personalised medicine approach for the management of RA, built on the exploitation of unique existing data sources: longitudinal data from clinical rheumatology registries, research cohorts, nationwide health care registries, and biobank material from >20 sample collections. Data and results are shared and accessed remotely by collaborators at secure servers. New biomarker assays and patient-centric implementations of the results are to be explored, validated, and disseminated to patients and health care via the development of digital tools. Results: Following the advice of legal experts at the involved academic or public institutions and private companies, GDPR compliance resulted in >20 legal documents to govern the collaboration (consortium-, joint controller-, research collaboration-, data sharing-, and a series of unique two-way data processing-, and material transfer agreements). Lack of agreed-upon templates, policies, procedures, and a shortage of legal resources have caused considerable delays. Thus, our research consortium has spent more time ensuring GDPR compliance than on actual research activities. Conclusions: The current interpretation and implementation of the legal premises (rather than the GDPR per se) for research collaborations caused unnecessary barriers and delays. Our experiences call for Nordic trust-based code-of-conduct-like framework agreements, and for harmonisation of procedures and templates, lest the Nordic advantage in research be lost.
Estimation of the health economic benefit of widening pulmonary rehabilitation uptake and completion
Authors: Steiner Michael , Mahon James , Fuld Jonathan , Hex Nick 
Published: December 2024

Objectives: Increasing uptake and completion of Pulmonary Rehabilitation in people with COPD has the potential to deliver health benefit and reduce health inequalities. We have quantified the cost-effectiveness of enhancing PR access and completion by reviewing the cost-effectiveness literature for PR in COPD. Methods: A literature review identified studies that provided cost-effectiveness evidence for PR compared to no PR. The key metrics of interest were healthcare resource use and cost savings, and quality adjusted life year (QALY) gains. Healthcare resource use data were valued using the UK NHS National Tariff 2022/23. From the literature search we identified the QALY gain resulting from completion of PR. The value of the QALY gain resulting from PR completion was calculated using the standard willingness-to-pay threshold of £20,000 considered by the UK National Institute for Health and care Excellence (NICE). Results: We estimated a QALY gain resulting from completion of PR of 0.065 and value of the QALY gain was therefore calculated to be £1300 per person completing PR. We estimated the 12 month reduction in hospitalisation following completion of PR to be 8.2% giving a total cost reduction per patient of £245. We therefore calculated that up to £1545 could be spent per person with COPD to deliver PR cost-effectively. Conclusion: Our analysis provides commissioners with the information they need to make informed decisions about planning and provision of PR. The data allows estimation of additional resources that could be deployed in addressing inequitable access to PR among disadvantaged and underserved populations whilst retaining cost effectiveness of the intervention.
“It’s easy to be burned out in this line of work”: Experiences of burnout among Black women pelvic floor therapists in the United States
Authors: Thorpe Shemeka , Iyiewuare Praise , Duroseau Brenice , Malone Natalie , Palomino Kaylee A 
Published: December 2024

Background: Burnout disproportionately affects professionals who spend much of their time in direct patient care. The physical and emotional demands of pelvic floor therapists, coupled with identity-based stressors, may place Black women pelvic floor therapists at an increased risk for experiencing burnout. Objective: The purpose of this study was to explore the experiences of burnout among Black women pelvic floor therapists in the United States. Design: This is a short-form qualitative study with data collected from an online survey. Methods: We recruited Black women pelvic floor therapists from November 2023 to February 2024 to complete an online survey comprised of open-ended questions about their experiences of burnout. The coding team analyzed the short-form qualitative data using inductive structural tabular thematic analysis. Results: Of the 59 participants in the total sample, 37 reported experiencing professional burnout. Main themes were: (1) contributors to burnout, (2) signs of burnout, and (3) consequences of burnout. Notably, contributors to burnout were predominantly structural and included workplace factors, such as unrealistic productivity standards and experiences of discrimination and microaggressions. Signs of burnout were primarily emotional. Consequences of burnout included leaving the current work setting, a strong desire to transition to a different setting, or taking a break from the profession overall. Conclusion: This study revealed that it is not only the intensity of Black women pelvic floor therapists’ workload but also the nature of their tasks and the contexts within which they operate that contribute to burnout.
Exploring global trends in scientific research on Rubus glaucus Benth.: A comprehensive analysis integrating bibliometrics, LDA, and HJ-Biplot
Authors: Abril-Espin Edy , Montes-Escobar Karime , de la Hoz-M Javier , Garcés-Fiallos Felipe R. , Salas-Macias Carlos A. 
Published: December 2024

Background Rubus glaucus Benth, called Andean blackberry, is a species of significant economic and ecological importance. Despite its relevance, scientific research on this plant remains fragmented and scattered across disciplines. Objective This study aims to systematically assess the state of scientific knowledge on R. glaucus, identifying research trends, collaborations, and thematic evolutions within the global research community. Methods We employed a comprehensive bibliometric analysis integrated with Latent Dirichlet Allocation (LDA) and HJ-Biplot methodologies to analyze publications from Scopus and Web of Science databases. Results Our findings reveal a substantial increase in research interest from the 1990s, reaching a peak in the early 2010s before a recent decline. The study highlights significant contributions from the United States, the United Kingdom, Canada, Italy, and Colombia, with notable international collaborations. Thematic analysis underscored the ecological role, nutritional benefits, and genetic improvement of R. glaucus as focal areas of research, pointing out gaps in pest management and sustainable cultivation practices. Conclusions This comprehensive bibliometric analysis offers valuable insights into the research landscape of R. glaucus, underscoring the need for focused research efforts on underexplored areas. The study lays the groundwork for future research directions, encouraging interdisciplinary collaboration to leverage the plant's full potential for agricultural innovation.
Hydrogen-rich water treatment maintains the quality and prolongs the shelf-life of postharvest table grapes by regulating respiratory and energy metabolisms
Authors: Yu Peng , Zheng Fangying , Shi Qiaofang , Zhao Anqi , Peng Xingyuan , Zhang Lixiang , Yang Yingjun , Yu Yihe 
Published: December 2024

Background Table grapes suffer from a dramatic deterioration in quality, a reduction in shelf life and commercial value resulting from allivated postharvest respiratory metabolism and excessive energy consumption after harvest. Objective In this study, effects of hydrogen-rich water (HRW) on berry quality, respiratory metabolism, and energy level were investigated by multi concentration gradient tests (0% (control), 20%, 40%, 60%, 80%, and 100%). Methods To achieve this goal, by measuring fruit quality, respiratory metabolism, related enzyme activities, energy status, and other related indicators, to study its impact on postharvest fruit quality and further explore the mechanism of maintaining fruit quality after harvest. Results Compared to the control group, samples treated with HRW exhibited higher fruit firmness, total soluble solids (TSS), and titratable acids (TA), with the most prominent effect observed after treatment with 60% HRW. Compared with the control group, grapes treated with 60% HRW exhibited more effective regulation in the expression of GPI, AOX, SDH1, COX6a, G6DH, 6PGD, NADK, and AGPase gene, which helped maintain normal respiratory metabolism and energy levels in the fruit samples. Conclusions Our results showed that HRW treatment could potentially maintain the quality and prolong the shelf life of postharvest grapes by regulating gene expression and the activity of key enzymes involved in respiratory and energy metabolisms.
Relationship Between the Subchondral Trabecular Bone Microstructure in the Hip Joint and Pain in Patients with Hip Osteoarthritis
Authors: Kaneta Hiroki , Shoji Takeshi , Kato Yuichi , Shozen Hideki , Ueki Shinichi , Morita Hiroyuki , Kozuma Yosuke , Adachi Nobuo 
Published: December 2024

Objective This study aimed to investigate the relationship between clinical findings and the trabecular microstructure of the subchondral bone in patients with hip osteoarthritis (OA) due to developmental dysplasia of the hip (DDH) using multidetector row computed tomography (MDCT). Design A total of 63 patients (69 hips) with OA due to DDH were retrospectively reviewed, with 12 healthy controls being included for comparison. Clinical evaluation was performed using the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ). The trabecular bone microstructure was analyzed using MDCT. Regions of interest in the subchondral trabecular bones of the acetabulum and femoral head were defined in the coronal view, and various trabecular microstructural parameters were evaluated. Results Bone volume fraction (BV/TV) and trabecular thickness (Tb.Th) exhibited a significant positive correlation with the OA stage, whereas trabecular separation (Tb.Sp) showed a negative correlation. In addition, BV/TV and Tb.Th were negatively correlated with the JHEQ total and pain scores, whereas Tb.Sp was positively correlated with the pain score in all regions. Conclusions This is the first study to evaluate the bone microstructure and its relationship with clinical findings in patients with hip OA due to DDH. Our findings suggest that as OA progresses, osteosclerotic changes increase in the acetabulum and femoral head; these changes are associated with worsening clinical symptoms, particularly pain. Targeting the subchondral bone may emerge as a novel treatment strategy for patients with OA due to DDH; nevertheless, further comprehensive studies are required.
Exploring the Efficacy of Joint Lavage in Knee Osteoarthritis: A Focus on Cytokines, Degrading Enzymes, and Oxidative Stress
Authors: Dinç Mustafa , Cevdet Soydemir Ömer 
Published: December 2024

Purpose/Aim This study aimed to assess the effectiveness of joint lavage in managing knee osteoarthritis (OA) by evaluating its effect on pain relief, inflammatory markers, cartilage-degrading enzymes, and oxidative stress. Methods Seventy patients with Kellgren–Lawrence grade 2 or 3 knee OA were selected for this single-center study. Joint lavage was performed, and pain and function were measured using the visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores at baseline and 24 weeks postintervention. Synovial fluid samples were collected at baseline, before lavage, and 24 weeks postintervention. Samples were stored at −80°C and analyzed in batches to minimize variability. At the time of analysis, the samples were thawed and evaluated for levels of proinflammatory cytokines, interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α), matrix metalloproteinase-3 (MMP-3), and total oxidant status (TOS), and oxidative stress index (OSI). Results Postintervention, VAS, and WOMAC scores significantly decreased ( P < 0.001), with 100% achieving the minimal clinically important difference (MCID). Patient acceptable symptom state (PASS) rates varied: VAS (80%), WOMAC pain (50%), function (81.4%), and total (84.3%). Cytokine levels (IL-1β, IL-6, TNF-α) and MMP-3 significantly decreased ( P < 0.001), along with TOS and OSI. Baseline TNF-α, IL-6, and IL-1β levels were significantly correlated with improvements in VAS and WOMAC scores. Moderate correlations were observed between reductions in IL-6/TNF-α and improvements in VAS/WOMAC. No significant associations were found between confounders and outcomes. Conclusions Joint lavage resulted in marked pain relief and functional improvement while significantly reducing inflammatory markers, cartilage-degrading enzymes, and oxidative stress.
The Psychiatry Clerkship at Nassau University Medical Center: A Mentorship Model in the Post-COVID-19 Era
Authors: St. Victor Guitelle , Ajeti Albulena , Ahmed Saeed , Jain Lakshit , Sarfraz Zouina , Person Ulziibat 
Published: December 2024

Background: This study evaluated the impact of the mentorship model used in the psychiatry clerkship at Nassau University Medical Center (NUMC), with a focus on its effectiveness in improving medical knowledge and professional development in psychiatry. Methods: This survey-based study at NUMC involved 16 attending psychiatrists and 13 past medical student mentees. Data were collected via electronic surveys from March to May 2022, examining effectiveness of mentorship and mentees’ experiences. Descriptive analyses were performed using R (v. 4.1.2). Results: The attendings were mostly in the 46 to 55 years age group (37.5%), and a gender distribution showing a slight majority of females (56.25%). Regarding the mentorship, 75% of attendings reported that mentoring was not time-consuming, and all of them found it beneficial. All mentees (100%) confirmed that the clerkship improved their understanding of psychiatric disorders and interviewing skills. A significant 69.2% of mentees believed the mentorship model should be an essential component of the Psychiatry Clerkship, and 92.3% did not find the management of psychiatric disorders overly challenging. Conclusion: NUMC’s Psychiatry Clerkship employs a strong mentorship model that markedly enhances medical education and prepares mentees effectively for psychiatric practice. Emphasizing empathy and interdisciplinary understanding, this model shows positive outcomes. Future research should include larger and more diverse cohorts to further substantiate and refine these mentorship practices in medical education.
Functional Outcomes After Nonoperative Management in Older Adult Low-Energy Stable and Unstable Ankle Fractures: A Retrospective Review of 158 Patients
Authors: Kleinsmith Rebekah M. , Huyke-Hernandez Fernando A. , Abernathy Bailey R. , Sibley Andrew , Ammons Jordan , Qian Lily , Switzer Julie A. , Onizuka Naoko 
Published: December 2024

Background There is ongoing debate regarding the optimal management of older adult ankle fractures. The purpose of this study was to describe baseline characteristics and functional outcomes including complications in older adult patients receiving nonoperative treatment for low-energy ankle fracture and compare the outcomes of those with unstable vs stable fracture patterns. Methods Patients aged ≥65 from January 2012 to March 2019 that sustained an ankle fracture were identified. Those who had surgical treatment, age <65, high-energy trauma, bilateral ankle fractures, and patients without adequate follow-up (minimum 12 weeks) were excluded. Baseline demographics, injury characteristics, Charlson Comorbidity Index (CCI) score, and functioning regarding ambulatory status, living environment, and assistance personnel in the household were collected for all patients. The primary outcome of interest was retention of baseline ambulation, living environment, and assistance requirements at follow-up (>12 weeks). Pain improvement, radiographic changes, and adverse clinical events were also assessed. Results A total of 158 patients were included with an average follow-up timeframe of 41.6 weeks. Eighty-six percent of patients (n = 136) retained their ambulatory status at long-term follow up. Most patients retained the same living environment (n = 145, 91.8%). Thirty-five patients (22.2%) required additional assistance long-term. Approximately 67.1% of the entire cohort retained all three functional metrics. Patients who experienced functional decline were older (77.8 vs 71.6, P < 0.001), had higher CCI (3.2 vs 1.6, P < 0.001), had a diagnosis of dementia or cognitive impairment (36.5% vs 3.8%, P < 0.001), had lower baseline functional status (ambulation, living environment, and assistance required; all P < 0.001), and had an unstable fracture pattern ( P = 0.003). Conclusions Understanding the functional outcomes of non-operative treatment in geriatric ankle fracture cases can contribute to a shared decision-making among healthcare providers, patients, and families.
Factors Influencing the Amount of ACL Remnant Available for Preservation at the Time of ACL Surgery
Authors: Carrozzo Alessandro , Lahsika Mohammed , Lattermann Christian , Saithna Adnan , An Jae-Sung , Giurazza Giancarlo , Cardarelli Silvia , Dutra Vieira Thais , Sonnery-Cottet Bertrand 
Published: December 2024

Background: The preservation of the anterior cruciate ligament (ACL) remnant during reconstruction or repair could offer advantages such as enhanced vascularity, proprioception, and biomechanical properties. However, research on the clinical factors influencing ACL remnant preservation at the time of surgery is limited. Purpose/Hypothesis: The purpose was to identify clinical factors influencing the amount of ACL remnant during surgery. It was hypothesized that not solely the delay from injury to surgery influences the amount of ACL remnant present at the time of surgery, but also other patient characteristics such as sex and age, as well as intraoperative findings. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A retrospective analysis of prospectively collected data was performed on patients who underwent arthroscopic ACL reconstruction between January 2013 and December 2022. ACL remnants were categorized based on their location into tibial attachment, midsubstance, and femoral attachment, accounting for 20%, 60%, and 20% of the total ACL length, respectively. A multivariate logistic regression was performed to identify factors predictive of the amount of ACL remnant. Results: In a cohort of 5725 patients, different variables were associated with an ACL remnant <20% at the time of surgery. Patients aged ≤20 years had an odds ratio of 1.748 (95% CI, 1.473-2.075; P < .0001), and those aged between 20 and 30 years had an odds ratio of 1.440 compared with those aged >30 years. Female patients had an odds ratio of 1.253 (95% CI, 1.087-1.446; P = .0019). A surgical delay >12 months was associated with an odds ratio of 3.134 (95% CI, 2.640-3.720; P < 0001). The presence of meniscal and chondral lesions had odds ratios of 1.784 (95% CI, 1.570-2.028; P < .0001) and 1.761 (95% CI, 1.426-2.171; P < .0001), respectively. Conclusion: Increased age at surgery was positively associated with a remnant size ≥20% of the ACL. Female sex, longer delay between accident and surgery, and associated injuries of intra-articular structures were risk factors for a remnant size <20%.