bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parental expectations and perceptions of augmentative and alternative communication: A Sri Lankan perspective
Authors: Hettiarachchi Shyamani , Nizar Shamra , Kitnasamy Gopi , Gopi Dilani 
Published: November 2024

From a critical disability rights lens, everyone has a right to communicate using any means available, which includes augmentative and alternative communication. The uptake of augmentative and alternative communication beyond the therapy room may be influenced by awareness, perceptions and acceptance of augmentative and alternative communication by caregivers, family members and the wider society. This study aimed to uncover parental perceptions of augmentative and alternative communication in a Global South context. Ten mothers and six fathers (16 participants) of children with complex communication needs were invited to be part of the study. A focus-group discussion and semi-structured interviews were undertaken using an interview guide. The participant data were analysed using Framework Analysis and through the lens of gender and critical disability theory. The key theme expressed was fear of augmentative and alternative communication deterring speech development. In addition, there was also concern that siblings might adopt the alternative communication method and stop talking. The participants questioned whether the visibility of a communication device could highlight their child’s disability, thereby fearing societal stigma and negativity. Overall, parents’ attitudes towards perspectives of and openness to use augmentative and alternative communication impact its uptake. The results suggest the need to consider the preparedness of parents prior to introducing augmentative and alternative communication and the need to offer on-going parental training. Lay abstract Everybody has a right to communicate in any way they can, which includes augmentative and alternative communication. The uptake of augmentative and alternative communication in everyday life may be influenced by awareness, perceptions and acceptance of augmentative and alternative communication by caregivers, family members and the wider society. This study aimed to uncover what parents thought about augmentative and alternative communication in a Global South context. Eleven mothers and five fathers (16 participants) of children with complex communication needs were included. Data were collected using an interview guide from a focus-group discussion and semi-structured interviews. The data were analysed using Framework Analysis and from a gender and critical disability theory viewpoint. The key theme found was fear of augmentative and alternative communication stopping the child from learning to speak. The parents wondered if siblings might also use the alternative communication method and stop talking. They worried whether the communication device will negatively highlight their child in society. As parents’ views on augmentative and alternative communication influence whether they use it with their child, informing and preparing parents before introducing augmentative and alternative communication to a child and on-going parent training should be considered.
Effectiveness of computer-based telerehabilitation software (RehaCom) compared to other treatments for patients with cognitive impairments: A systematic review
Authors: Sarpourian Fatemeh , Bahaadinbeigy Kambiz , Fatemi Aghda Seyed Ali , Fatehi Farhad , Ebrahimi Saeid , Fallahnezhad Meysam 
Published: November 2024

Background The rehabilitation process for cognitive disorders is long and complex, which can lead to reduced rehabilitation outcomes and reduced quality improvement. Thus, there is a need to use new methods to boost conventional rehabilitation (e.g., drug therapy, herbal therapy, paper, and pencil tasks). Innovations such as RehaCom can be helpful to remove the obstacles to treatment, but evidence for their effectiveness is limited. Objectives To compare the effectiveness of RehaCom with other cognitive therapies (computer-based, non- computer) in patients with cognitive impairment (CI). Methods Eight bibliographic databases (PubMed, Cochran Library, Scopus, Science Direct, Web of Science, Embase, ProQuest, and google scholar) were used in this research. The initial search resulted in the extraction of 2466 articles; after the review of the title, abstract, and full text, 19 articles were selected. Quality assessment was performed using the CONSORT checklist. Then, data extraction was done using the form set by the researcher in Word 2016 software. Results Overall, RehaCom achieved more positive clinical effects compared to other cognitive therapies (e.g., improvement in memory, attention, and motor function) on multiple sclerosis ( n = 7), schizophrenia ( n = 6), stroke ( n = 3), Parkinson ( n = 1), mild CI ( n = 1), and acquired brain damage ( n = 1). In six studies, a follow-up period of some weeks to 6 months has been used. Additionally, six studies used conventional therapy plus RehaCom for intervention. Except one study, all studies used RehaCom individual training. Conclusions This review provides evidence for the potential effectiveness of RehaCom for the improvement of clinical outcomes in patients with CI. However, more robust Randomised Controlled Trials (RCTs) are needed to confirm the observed positive effects.
Comparative insights into clinic onboarding and interaction practices for patient engagement in long COVID digital health care
Authors: Ismaila Hadiza , Blandford Ann , Sunkersing David , Stevenson Fiona , Goodfellow Henry 
Published: November 2024

Objectives This study explores the influence of clinic-led onboarding and interaction processes on patient engagement within a digital health program for long COVID care, the Living with COVID Recovery (LWCR) program. We compared clinical practices and patient engagement levels across seven clinics utilising LWCR, gaining insights that could optimise digital health interventions (DHIs) for long COVID care. Methods Using a mixed-methods approach, we conducted qualitative interviews with clinicians from seven clinics (out of thirty five) to understand their onboarding and interaction strategies for the LWCR program. We also performed a descriptive quantitative analysis of patient and clinic usage data to rank and classify patient engagement. These rankings were then compared against qualitative insights to explore the influence of clinic-led strategies on patient engagement. Additionally, we conducted interviews with 12 patients under the care of seven clinics to complement our mixed-method analysis. Results Four key practices were identified in clinics with higher patient engagement: pre-assessment onboarding, proactive communication, patient education and the involvement of clinically experienced staff. Clinics that integrated these interdependent practices into a cohesive strategy demonstrated notably higher patient engagement levels. Conclusion This study highlights the critical role of integrating multiple, interdependent clinic-led strategies to optimise patient engagement in DHIs, particularly for long COVID care. These findings provide actionable insights for healthcare providers and policymakers, suggesting that a comprehensive approach is essential for maximising patient engagement and improving care outcomes. The study lays the groundwork for future research to explore the broader applicability of these strategies across different healthcare contexts.
Multiple sclerosis in Colombia: A review of the literature
Authors: Miranda-Acuña Jahir , Casallas-Vanegas Adriana , McCauley Jacob , Castro-Castro Pedro , Amezcua Lilyana 
Published: November 2024

BackgroundThe prevalence of multiple sclerosis (MS) in Latin America is generally considered low to moderate. However, accurate data regarding MS epidemiology in Colombia is lacking.ObjectiveThis study aims to discuss the situation of MS in Colombia.ResultsAnalysis reveals a lack of accurate data regarding MS epidemiology in Colombia, however, there have been notable improvements in diagnosis and ultimately leading to better access to treatment for MS patients. While ethnic diversity may potentially influence MS prevalence, there is currently no strong data supporting this claim. MS treatment in Colombia, focuses on early disease-modifying therapy, nevertheless, MS is considered an orphan disease in Colombia, contributing to MS patients not receiving comprehensive evaluation in MS centers. Regional efforts are ongoing to improve diagnostic access and access to treatment for MS patients.ConclusionDespite the challenges in accurately defining MS epidemiology in Colombia, an increase in neurological training, diagnostic capabilities, and access to treatment has been observed. However, the status of MS as an orphan disease in Colombia poses challenges to comprehensive care for affected individuals. Further studies are needed to elucidate risk factors and improve care conditions for MS patients in the region.
Risk Factors for Failure of Non-operative Management in Isolated Unilateral Non-displaced Facet Fractures of the Subaxial Cervical Spine: Systematic Review and Meta-Analysis
Authors: Cirillo Ignacio , Ricciardi Guillermo Alejandro , Cabrera Juan Pablo , Lopez Muñoz Felipe , Romero Valverde Lyanne , Joaquim Andrei , Carazzo Charles , Yurac Ratko 
Published: November 2024

Study Design systematic review. Objective To evaluate risk factors associated with failure of non-operative management of isolated unilateral facet fractures of the subaxial cervical spine in neurologically intact patients. Methods A systematic review of the PubMed, Embase, LILACS, and Cochrane Library databases was conducted in order to determine risk factors associated with failure of non-operative management in isolated unilateral facet fractures of the subaxial cervical spine without facet and/or vertebral displacement, in neurologically intact patients. Our research was in line with the PRISMA Statement and registered on PROSPERO (CRD42023405699). Results A total of 1639 studies were identified through a database search on May 5, 2023. In total, 7 studies from the databases were included, along with 1 study found through a manual citation search. The evidence showed high clinical heterogeneity, a serious risk of bias according to the ROBINS-I tool, and a predominance of retrospective cohort studies. In comparison to less complex facet fractures, lateral floating mass fractures were found to have 5.41 times higher odds of failure of non-operative management (OR = 5.41; 95% CI = 1.32, 22.19). We calculated the potential association between lower absolute fracture height and non-operative treatment success [Fracture height (percentage) Mean Difference = −17.51 (−28.22, −6.79 95% CI); Absolute height Mean Difference: −0.46 (−0.60, −0.31 95% CI)]. Other risk factors were not included in the meta-analysis due to lack of data. The level of certainty was rated as “very low”. Conclusions Lateral floating mass cervical facet fractures and larger fracture fragment size (measured either in absolute terms or as a percentage) are significant risk factors for failure of non-operative treatment.
Effect of Patient Resilience on Functional Outcomes After Meniscectomy
Authors: Hanna Adeeb Jacob , Perez Andres R. , He Alice , Sonnier John Hayden , Destine Henson , Muchintala Rahul , Cook Ralph W. , Bryan Sean , Tjoumakaris Fotios P. , Freedman Kevin B. 
Published: November 2024

Background: Recent literature has identified that patient resilience may affect outcomes after meniscectomy. Research into psychological risk factors for poor surgical outcomes has been a focus in orthopaedic surgery. Purpose/Hypothesis: The purpose of this study was to examine the relationship between preoperative patient resilience and 2-year postoperative outcomes after arthroscopic meniscectomy. It was hypothesized that there would be no relationship between resilience and patient-reported outcomes after meniscectomy. Study Design: Cohort study; Level of evidence, 2. Methods: Patients who underwent meniscectomy between January and June 2020 at a single multicenter institution were identified, and those aged ≥18 years without evidence of significant osteoarthritis who completed the brief resilience scale (BRS) preoperatively were considered for inclusion. Included patients completed the International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR), Single Assessment Numeric Evaluation (SANE), and visual analog scale (VAS) for pain at a minimum of 2 years postoperatively. Based on BRS scores, patients were stratified into low resilience (LR), normal resilience (NR), and high resilience (HR) groups, and differences and changes in outcomes were compared among the groups using the analysis of variance or the Kruskal-Wallis test for continuous data and the chi-square test for categorical data. Results: Overall, 100 patients were included (LR group, n = 17; NR group, n = 65; HR group, n = 18). Patients with higher preoperative resilience had higher preoperative IKDC ( P = .004) and KOOS-JR ( P = .003) scores. However, resilience was not a fixed construct: The median BRS increased in the LR group and decreased in the HR group from pre- to postoperatively (+0.17 and –0.58, respectively; P = .001). At the 2-year follow-up, there was no difference in patient-reported outcome scores across resilience groups, nor was there a difference in the change in IKDC or KOOS-JR scores. Although a positive correlation was observed between preoperative resilience and preoperative IKDC ( rS = 0.331) and KOOS-JR ( rS = 0.334) scores, preoperative resilience did not correlate with postoperative or 2-year improvements in IKDC or KOOS-JR scores. A weak positive correlation was observed between postoperative resilience and postoperative IKDC ( rS = 0.229) and SANE ( rS = 0.202) scores, and a weak negative correlation was observed between postoperative resilience and VAS pain scores ( rS = ∓0.256). Conclusion: Our study indicated that preoperative patient resilience was not predictive of functional outcome scores at a 2-year follow-up after arthroscopic meniscectomy.
Engagement in Extracurricular Activities During Medical School: A Cross-Sectional Study on Student Motivations and Challenges
Authors: Oliveira Natália Machado , Viana Dayanne de Aguiar , Santos Jade Rodrigues , Quintanilha Luiz Fernando , de Jesus Rodrigo Francisco , Avena Katia de Miranda , Andrade Bruno Bezerril 
Published: November 2024

Objectives Extracurricular activities (EA) are crucial for medical education, fostering professional and personal growth. They complement formal curriculum structures, addressing students’ social, psychological, and academic needs. Understanding students’ motivations for choosing EA is essential for creating effective educational strategies. Our study examined medical students’ engagement in EA, focusing on the most common activities, perceived importance, and the motivations and challenges faced. Methods This was a cross-sectional study, employing both quantitative and qualitative designs, involving a convenience sample of medical students from Brazil. Data collection was carried out using an anonymous, structured electronic form to gather information on the sociodemographic profile of students and aspects related to EA participation. The analysis included both descriptive statistics and qualitative content analysis, providing detailed insights into student motivations and their experiences with EA. Results Out of 221 study participants, 82.4% were actively involved in EA. Sports (44.8%), scientific events (39.4%), artistic activities (33.5%), and participation in scientific programs (28.1%) were prominent choices, with students dedicating 8.5 h per week. Students under the age of 28 ( P = .017) and those without a previous academic degree ( P = .036) showed a higher frequency of involvement in EA, as confirmed by logistic regression analysis revealing significant associations for these variables (OR = 1.16, 95% CI: 1.02-1.32, P = .017; and OR = 0.88, 95% CI: 0.78-1.00, P = .036, respectively). Motivations for EA participation were primarily driven by a desire to enhance curriculum vitae and develop essential professional skills. Challenges such as time management and academic adjustment were common among medical students. Conclusions Our findings highlight the widespread involvement of medical students in EA, illustrating a diverse range of interests. Younger students and those without previous academic training are more likely to participate. Motivations include enriching the curriculum and refining skills, yet challenges such as time management and adjusting to academic demands are significant, especially for new students.
Time-varying differences in stroke recurrence risk between types of atrial fibrillation based on screening methods and timing of detection
Authors: Alvarado-Bolanos Alonso , Ayan Diana , Lodol Facundo , Khaw Alexander V. , Mai Lauren M. , Mandzia Jennifer L. , Mrkobrada Marko , Bres-Bullrich Maria , Fleming Lorraine , Lippert Corbin , Cecile Meredith , Bagur Rodrigo , Fridman Sebastian , Sposato Luciano A. 
Published: November 2024

Introduction: Atrial fibrillation (AF) burden progresses with time. Among ischemic stroke (IS) patients, AF can be detected at different burden progression stages based on the timing and screening method. We hypothesized that AF detected after IS on 12-lead ECGs (ECG-AF) and via 14-day-Holter prolonged cardiac monitoring (AFDAS) are linked to lower IS recurrence risk than AF known before stroke occurrence (KAF) because of being at an earlier progression stage than KAF. Additionally, we posited that IS recurrence risk differences between AF types vary over time due to their differential progression stages. Patients and methods: Retrospective observational cohort study including IS/TIA patients with KAF, ECG-AF, and AFDAS [2018–2021]. Adjusted hazard ratios (aHR) were estimated using multivariable cause-specific Cox proportional-hazard models to compare IS recurrence between ECG-AF versus KAF and AFDAS versus KAF. Proportional hazards assumptions were tested to assess whether IS recurrence risk differences were time-varying. Results: Of 758 AF patients (385 KAF, 236 ECG-AF, 137 AFDAS), 603 received anticoagulation and 59 experienced a recurrent IS after 1441 patient-years of follow-up. No IS recurrence risk differences were observed at the end of follow-up between ECG-AF and KAF (aHR 0.67, 95% CI 0.36–1.26), although ECG-AF showed lower risk only within the first year (aHR 0.15; 95% CI 0.04–0.56). AFDAS exhibited a lower IS recurrence risk than KAF (aHR 0.22, 95% CI 0.08–0.63), without time-varying differences. Discussion: Differences in IS recurrence risk between ECG-AF and KAF varied over time. However, AFDAS showed a consistently lower IS risk than KAF throughout the entire study period.
Stroke triage using the FAST-ED score shortens process times in large vessel occlusion strokes in a physician staffed pre-hospital emergency medical (PHEM) system
Authors: Illian Hanna , Grimm Clemens , Haller Anna , Liman Jan , Nikos Psychogios Marios , Riedel Christian Heiner , Blaschke Sabine , Göricke Meike Bettina , Roessler Markus , Kunze-Szikszay Nils 
Published: November 2024

Introduction: The impact of streamlining algorithms for stroke patients on process times in pre-hospital emergency medicine (PHEM) is not well investigated. We analyzed the changes in pre- and in-hospital process times after implementation of a streamlining algorithm in a physician staffed PHEM system. Patients: We conducted a prospective observational study and analyzed process times of adult stroke patients attended by emergency physicians (EP) of the city of Göttingen PHEM service after implementation of a streamlining algorithm including stroke triage using the FAST-ED score. Stroke patients with standard emergency treatment attended before the implementation served as a control group. All patients were transported directly to the University Medical Center Göttingen (UMG) and received endovascular therapy (EVT) and/or systemic thrombolytic therapy. Results: Of 75 suitable patients eligible in the study group, 37 (49.3%) received EVT and were compared to 44 patients in the control group. Pre-hospital process times did not differ significantly. Median door-to-CT time (12 vs 18 min, p = 0.017) and door-to-lysis time (20 vs 24 min, p = 0.005) were significantly shorter in the study group. Door-to-groin time was also shortened in the study group (42 vs 49 min) but not significantly ( p = 0.088). Discussion and conclusions: Our findings indicate that a PHEM streamlining algorithm (namely the FAST-ED score) can significantly shorten in-hospital process times without delaying pre-hospital care. This improved coordination between PHEM and in-hospital emergency medicine (IHEM) may enhance neurological outcomes for stroke patients. Further research is needed to confirm these results and assess their applicability in other healthcare settings.
Beauty Contest in Equity-Based Crowdfunding Campaigns
Authors: Trzebiński Artur A. , Kołodziejczyk Łukasz 
Published: November 2024

Purpose This study investigates how investor sentiment influences equity-based crowdfunding campaigns outcomes, with a particular focus on sentiment related to specific industries. The motivation stems from the need to understand the behavioural drivers behind crowdfunding outcomes, especially in a context where both private and public funding coexist. Study Design We employed a machine learning approach, utilizing the PolBERT model to analyse investor sentiment from online forum discussions in Poland. The data consisted of sentiment expressed across various industry-specific discussions, which were analysed to assess their impact on crowdfunding campaign outcomes. Findings The study reveals that while positive investor industry sentiment enhances the capital raised for IPO-targeted companies, it negatively affects overall campaign success and the number of investors, particularly in non-IPO-targeted firms. These findings suggest a complex relationship between sentiment and campaign outcomes, where higher sentiment can sometimes deter participation in certain cases. Contributions This research introduces a novel category of behavioural success drivers in the context of equity crowdfunding, proposing a new classification of meta-drivers of crowdfunding success. Methodologically, the study demonstrates the efficacy of fine-tuned BERT-class models in processing language, offering new insights into the investor sentiment analysis. Implications The results have significant implications for both researchers and practitioners. For researchers, the study expands the understanding of behavioural finance in crowdfunding, while for practitioners, it provides strategic insights into how investor sentiment can influence campaign timing, structure, and expectations. The findings also offer value for policymakers by shedding light on investor behaviour in equity-based crowdfunding markets.