bluuebunny/crossref_metadata_2025_split huggingface dataset:
Getting Ready for Residency: A Qualitative Analysis of Fourth-Year Medical Student Learning Plans Mapped to Accreditation Council for Graduate Medical Education Residency Competencies
Authors: Mallaro Hannah L. , O’Brien Celia Laird , Sanguino Sandra M. , Dolan Brigid M. 
Published: February 2025

Abstract

Purpose
Undergraduate medical education (UME) to graduate medical education (GME) transition gaps may limit opportunities for learner improvement along each individual’s learning trajectory. Additional information regarding learner perspectives on skill-based learning goals in preparation for the residency transition is needed. The authors hypothesized that fourth-year medical student (MS4) learning plans may provide information to fill the gap in understanding learner perspectives on the knowledge, skills, and opportunities they consider important in supporting their residency readiness.

Method
Directed thematic analysis informed by a constructivist analytical approach was used to review readiness for residency reflections as part of a portfolio assessment system at a large, urban, research-intensive medical school during academic years 2021 and 2022. The authors identified student-selected Accreditation Council for Graduate Medical Education (ACGME) competencies and subcompetencies, iteratively identified non–subcompetency-based themes, refined the codes, and achieved consensus. They then analyzed the frequency of competencies and subcompetencies within learner reflections and explored additional themes.

Results
In the final set of 291 reflections, the ACGME competencies selected for MS4 learning plans were patient care (227 learning plans), medical knowledge (144 learning plans), interpersonal and communication skills (94 learning plans), practice-based learning and improvement (79 learning plans), system-based practice (67 learning plans), and professionalism (63 learning plans). The top 3 ACGME subcompetencies identified as growth areas by MS4s were practice-based learning and improvement: evidence-based and informed practice, patient care: clinical reasoning, and interpersonal and communication skills: interprofessional and team communication. Teaching was the most common learning goal outside the ACGME subcompetencies.

Conclusions
The MS4 readiness for residency reflections offered important insight into student perspectives on UME to GME transition preparation. Learners’ reflections yielded a diverse set of learning goals for the fourth year of medical school, highlighting the importance of individualized approaches in addition to standardized curricula at the time of transition.
Evaluation of Caregivers’ Experiences in the Management of Pressure Injuries in Palliative Care Patients: A Phenomenologic Study
Authors: Pamuk Cebeci Sevil , Duru Pınar , Kaya Zeynep Irmak , Topçu Mihraç 
Published: February 2025

ABSTRACT

OBJECTIVE
To evaluate the experiences of caregivers (patients’ companions and nurses) in managing pressure injuries (PIs) in patients in palliative care.

METHODS
Included in this qualitative phenomenologic study were 10 caregivers (five patient companions and five nurses) involved in the care of five patients hospitalized in the palliative care unit of a single facility between January and March 2023. The research data were collected through face-to-face, in-depth interviews using semistructured interviews.

RESULTS
Two main themes emerged from the interviews: “approach to care” and “factors affecting the care of PIs.” Regarding “approach to care,” subsidiary analytic themes included “management of PIs” and “feelings.” For "factors affecting the care of PIs,” analytic themes were “level of knowledge,” “facilitators,” “difficulty in caregiving,” and “experience of care.”

CONCLUSIONS
The interviewed nurses and patients’ companions identified factors facilitating and complicating the effective management of PIs, knowledge of which may steer the development of strategies by healthcare providers and administrators that meet the needs of healthcare personnel. These findings may contribute to creating interventions and policies for managing PIs, potentially increasing the patients’ quality of life.
Evaluation of the Effect of Massage on Pressure Injury Prevention among Intensive Care Patients: A Randomized Controlled Study
Authors: Özkan Esra , Çilingir Dilek 
Published: February 2025

ABSTRACT

BACKGROUND
Few studies have investigated the application of massage to bony prominences, and international guidelines do not currently recommend additional massage in these areas.

OBJECTIVE
To investigate the impact of the effleurage technique, a component of classical massage known for its clinical applicability and practicality, in preventing pressure injuries (PIs).

METHODS
The study focused on bedridden patients in the ICU of a state hospital. The sample included patients admitted between July 1, 2021, and November 30, 2021, without preexisting PIs. Using a randomized controlled trial design with simple randomization, routine nursing care was provided to the control group of 30 patients, and the experimental group of 30 patients received classical massage (effleurage technique) in addition to routine care. Both groups were followed up for an average of 12 days using various assessment tools, including a patient information form, the Braden Risk Assessment Scale, the Pressure Wound Staging Form, and an experimental/control group follow-up form.

RESULTS
The research results revealed a statistically significant impact of massage application on preventing PIs (P < .05). The average day of PI development was 10.93 ± 2.31 in the experimental group and 6.79 ± 4.42 in the control group.

CONCLUSIONS
The study findings suggest that the effleurage technique, as part of classical massage, can be integrated into nursing practices to effectively prevent PIs.
Exploring the Extent and Depth of Clinical Education on Sepsis SEP-1 Core Measure and the Reported Impact on Outcomes and Compliance rate: A Scoping Review
Authors: Wells Alexis J. , Sapp Alysha , Walker Danielle K. , Baker Kathy A. 
Published: February 2025

OBJECTIVES:
This scoping review aimed to understand the extent and depth of education provided on the severe sepsis and septic shock management bundle quality measure (SEP-1) to frontline clinicians to elicit insight regarding the impact on patient outcomes, the compliance rate, and any efforts to alleviate concerns about clinical judgment challenges with SEP-1.

DATA SOURCES:
Seven databases were used: ProQuest, EBSCO Host, Embase, Web of Science, PubMed, MEDLINE, and CINAHL for studies published in 2015 and later using key terms related to sepsis and SEP-1 quality measure.

STUDY SELECTION:
Two independent reviewers selected studies that mentioned the Centers for Medicare and Medicaid Services SEP-1 and included education to frontline clinicians on the quality measure as one of the interventions.

DATA EXTRACTION:
Data extraction included study design, publication type, what was educated to frontline clinicians, Bennet and Bennet’s “depth of knowledge” through education provided, and any mention of patient outcomes and change in SEP-1 compliance rate from the study.

DATA SYNTHESIS:
The initial search yielded 493 articles. After screening for eligibility criteria, 20 studies were ultimately included. When evaluating what details of SEP-1 are being educated, 95% (19/20) of the studies focused on how to identify sepsis as well as the bundle elements required to pass the measure (19/20); however, the deeper details of the measure that allow clinical judgment and still pass the measure are severely lacking.

CONCLUSIONS:
Multiple education opportunities not currently addressed in the literature may lead to improvement of the national SEP-1 compliance rate and alleviate clinician concern that the quality measure does not allow for clinical judgment. Without deeper education, this knowledge gap could be a key factor in why the quality measure national compliance rate has halted, raising calls to retire the measure prematurely.
Mpox and the impact on people with HIV
Authors: Lima Mauricio Teixeira , Kroon Erna Geessien , Campos Marco Antônio 
Published: February 2025

Purpose of review
This review explores the intersection of Mpox and HIV, highlighting clinical manifestations, immune evasion mechanisms, epidemiological challenges, and prevention strategies. People with HIV (PWH), particularly those with low CD4+ cell count, face severe Mpox outcomes. Prevention relies on education, vaccination, and early detection. Integrating Mpox management into HIV care systems is vital.

Recent findings
Since May 2022, Mpox caused by Orthopoxvirus monkeypox (MPV) Clade IIb, has affected 126 countries. In 2024, Clade Ib emerged in the Democratic Republic of Congo, leading to its declaration as a Public Health Emergency of International Concern (PHEIC). Research on MPV-HIV co-infections has provided genomic insights and protective strategies for PWH. Antivirals like tecovirimat show promise despite emerging resistance concerns.

Summary
The global Mpox outbreak caused by Clade IIb and the emergence of Clade Ib underscores its growing threat. Mpox disproportionately impacts PWH, leading to severe outcomes and higher fatality rates. This review emphasizes clinical challenges, genomic advances, and prevention strategies. Enhanced surveillance, vaccination, and tailored therapies are essential to addressing this evolving health crisis.
Central/mixed venous oxygen saturation and lactate levels might be of limited use as physiologic transfusion triggers in cardiac surgery
Authors: Noitz Matthias , Brooks Roxane , Schlömmer Christine , Tschoellitsch Thomas , Mahečić Tina Tomić , Baronica Robert , Maletzky Alexander , Zierer Andreas , Dünser Martin W. , Meier Jens 
Published: February 2025

BACKGROUND
Current guidelines differ in their recommendations regarding the use of physiologic transfusion triggers to guide transfusion practice. Data on the interaction between haemoglobin (Hb) and physiologic transfusion triggers, or their response to packed red blood cell (pRBC) transfusions are limited.

OBJECTIVES
This study aimed to evaluate the interactions between Hb, mixed/central venous oxygen saturation (SvO2) and lactate levels as well as their changes (ΔSvO2, Δlactate) in response to pRBC transfusion in cardiac surgery patients.

DESIGN
Retrospective exploratory data analysis.

SETTING
A 22-bed intensive care unit (ICU) at a single tertiary academic centre and university hospital in Austria.

PATIENTS
Adult (age ≥ 18 years) patients who underwent cardiac surgery.

MAIN OUTCOME MEASURES
Pearson correlation coefficients (r) and coefficients of determination (r
2) between Hb, mixed/central venous oxygen saturation (SvO2), and lactate levels. Pearson correlation coefficients (r) and coefficients of determination (r
2) between ΔSvO2, Δlactate and pretransfusion Hb.

RESULTS
A total of 5025 cardiac surgery patients, in whom 20 542 blood gas analyses were performed, were included in the final analysis. Correlations between Hb levels and SvO2 (r
2 = 0.026, P < 0.001) and between Hb and lactate levels (r

2
= 0.001, P < 0.001) were statistically significant but weak overall. No correlations were found between ΔSvO2 (r

2
= 0.002, P = 0.13) or Δlactate (r

2
= 0.003, P = 0.087) and pretransfusion Hb levels.

CONCLUSIONS
Hb, SvO2 and lactate levels were only weakly correlated with each other, and changes in SvO2 and lactate levels in response to pRBC transfusion did not correlate with pretransfusion Hb. Our findings question the usefulness of SvO2 and lactate levels as physiologic transfusion triggers to guide transfusion practice in cardiac surgery patients.

TRIAL REGISTRATION
Johannes Kepler University Ethics Committee Study Reference Number 1063/2023.
Effect of neuraxial anaesthesia or analgesia on postpartum relapse rates in multiple sclerosis
Authors: Ioannopoulos Dimitrios , Manika Kleanthi , Lykoudis Panagis M. , Papadopoulou Marianna , Lelekaki Eleftheria , Tsani Zoi , Kouki Pinelopi 
Published: February 2025

BACKGROUND
Multiple sclerosis (MS) is a chronic autoimmune disease affecting primarily women of childbearing age. Recent advancements in treatment have led to more women with MS pursuing motherhood. Despite much new evidence on the safety of neuraxial anaesthesia/analgesia, many anaesthetists are still reluctant to provide neuraxial anaesthesia/analgesia to these patients.

OBJECTIVE
The present systematic review aimed to evaluate the safety of administrating neuraxial anaesthesia/analgesia to parturients with MS.

OUTCOME
The incidence of MS relapses occurring up to 1 year after childbirth was the main outcome of interest.

DESIGN
A systematic review of randomised and non-randomised controlled trials.

DATA SOURCES
MEDLINE (PubMed), Library of Congress and LiSTA (EBSCO) were searched to identify eligible trials.

ELIGIBILITY CRITERIA
Randomised or nonrandomised prospective studies and retrospective comparative studies, comparing MS relapses following caesarean section or vaginal delivery were included.

RESULTS
Eight studies involving 1315 parturients were included. There was no statistically significant difference in the incidence of postpartum relapses between women who received neuraxial anaesthesia/analgesia and those who did not (P > 0.05). A statistically significant increase in the probability of a relapse was consistently observed across the majority of studies in women who had experienced relapses during pregnancy or during the year preceding the pregnancy (P < 0.05).

CONCLUSION
Neuraxial analgesia/anaesthesia does not increase the risk of postpartum relapse in MS parturients in the year following delivery. The risk of postpartum relapse is related to symptom exacerbation during the year before pregnancy or during pregnancy. Adequately powered, prospective, studies are strongly recommended to confirm the above results.
Prospective Validation of a Nomogram for Determining the Optimal Dose of Lamotrigine for Augmentation Therapy in Patients With Treatment-Resistant Depression
Authors: Suzuki Takeshi , Nagai Goyo , Mihara Kazuo , Tomori Yoko , Kagawa Shoko , Nakamura Akifumi , Nemoto Kenji , Kondo Tsuyoshi 
Published: February 2025

Background:
Previous research has shown that a plasma lamotrigine concentration of 12.7 µmol/L may be a threshold for a good therapeutic response to lamotrigine augmentation therapy in Japanese patients with treatment-resistant depression. The optimal dose of lamotrigine can be predicted using a previously established nomogram based on the plasma lamotrigine concentration at week 2. The aim of the present study was to prospectively evaluate the validity of this nomogram.

Methods:
Participants included 59 patients with depression who showed insufficient therapeutic responses to psychotropics, including antidepressants, antipsychotics, and mood stabilizers. The patients were diagnosed with major depressive disorder (n = 26), bipolar II disorder (n = 25), or bipolar I disorder (n = 8). Lamotrigine was administered to all the patients. The initial dose of lamotrigine was 25 mg/d for 32 patients not taking valproate and 25 mg/d every other day for 27 patients taking valproate. Blood samples were collected at week 2 and at least 2 weeks after the final daily dose, which was estimated by a nomogram based on the plasma lamotrigine concentration at week 2. The plasma concentrations of lamotrigine were measured by liquid chromatography–mass spectrometry.

Results:
In 30 of the 32 patients (93.8%) who were not taking valproate and 23 of the 27 patients (85.2%) who were taking valproate, a plasma lamotrigine concentration of 12.7 mcg/mL or higher was achieved at the final daily administration of lamotrigine.

Conclusions:
The results of the present study suggest that the previously established nomogram is valid for determining the optimal dose of lamotrigine for Japanese patients with treatment-resistant depression in clinical settings.
Development of the Observer Scales of the Patient and Observer Scar Assessment Scale: An International Delphi Study
Authors: Carrière Michelle E. , Mokkink Lidwine B. , Pleat Jonathon , Tyack Zephanie , Pijpe Anouk , de Vet Henrica C.W. , van Zuijlen Paul P.M. ,   The POSAS Group
Published: February 2025

Background:
This Delphi study aimed to develop the Observer Scale of the Patient and Observer Scar Assessment Scale (POSAS) 3.0 for measurements of scar quality in patients with all types of scars. The POSAS 3.0 Patient Scale has been developed using an extensive qualitative study, which has been published separately.

Methods:
An online, 3-round Delphi study was performed with 124 international scar experts from 23 countries spanning 7 continents. Panelists rated their (dis)agreement with proposals regarding the wording and relevance of scar characteristics on a 5-point scale (“strongly disagree” to “strongly agree”), and provided arguments for their decisions. Consensus was reached if ≥67% of the panelists agreed or strongly agreed to a proposal.

Results:
Consensus was reached on the inclusion of 9 items. Two versions of the Observer Scale of the POSAS 3.0 have been developed, 1 generic version including 7 items, and 1 linear scar version, containing the same 7 items and 2 additional scar-specific items.

Conclusions:
This is the first study using the Delphi process to develop an instrument for the assessment of scars. Panelists from all over the world reached a consensus on the content of 2 versions of the Observer Scale, the generic version and the linear scar version. By involving the potential end-user community of the new POSAS version in its development, we expect the developed instrument to have high content validity. For a comprehensive scar assessment, the Observer Scale should be used in combination with the Patient Scales of the POSAS 3.0.
Bilateral giant retinal tear detachments in an infant with Donnai-Barrow syndrome: A case report and review of literature
Authors: Huang Alan Y. , Caplash Sonny , Scoles Drew 
Published: February 2025

Purpose:
To report a rare case of bilateral giant retinal tear (GRT)-related retinal detachments in a 24-month-old male with Donnai-Barrow syndrome (DBS) and to review the current literature on this disorder.

Methods:
Clinical information was obtained from the medical records of a patient with Donnai-Barrow syndrome seen at the Children’s Hospital of Philadelphia. A literature review was conducted to identify all published cases of genetically or clinically diagnosed Donnai-Barrow syndrome.

Results:
We report a case of a 24-month-old male with a history of DBS presenting with sudden loss of vision in both eyes. Ophthalmic examination revealed bilateral retinal detachments with GRT, complicated by grade C proliferative vitreoretinopathy (PVR) in the right eye. The patient underwent sequential scleral buckling, pars plana vitrectomy, membrane peeling, perfluoron, endolaser, fluid air exchange, and silicone oil placement in both eyes. Both eyes developed re-detachment, requiring repeat pars plana vitrectomy. Literature review revealed 10 reported cases of retinal detachments out of 38 DBS patients who survived past 1 year (26.3%).

Conclusion:
This case highlights the early presentation and complexity of GRT-related retinal detachment in DBS patients. Early, aggressive management using prophylactic laser retinopexy or scleral buckling may be essential in improving visual outcomes in DBS patients.
Accuracy of Predicted Refraction Using Two Swept-Source Optical Coherence Biometers and an Intraoperative Aberrometer
Authors: Watanabe Keizo 
Published: February 2025

Purpose:
To compare the refractive accuracy of Optiwave Refractive Analysis (ORA) using biometric measurements of ARGOS and OA-2000 in the same patient planned for a monofocal intraocular lens (IOL) insertion.

Setting:
Single center

Design:
Prospective, observational study

Methods:
Patients scheduled for cataract surgery between January 2021 and March 2022 (expected corrected distance visual acuity of ≥0.8 postoperatively at 1-3 months) underwent preoperative ocular measurements using ARGOS and OA-2000 biometers on the same day, which were entered into the intraoperative aberrometer ORA system to assess the refractive accuracy of the IOL implant and postoperative spherical equivalent at 1–3 months. The refractive accuracy was compared between ORA using ARGOS (ORA-AR) and ORA using OA-2000 (ORA-OA). The primary endpoint was the comparison of the mean absolute refractive prediction error (MAE) between the ORA-AR and ORA-OA methods.

Results:
A total of 117 eyes of 81 patients were evaluated (mean ± standard deviation [SD] age, 72.8 ± 7.4 years; male, 65.4%). The criteria for noninferiority were met between the ORA-AR and ORA-OA methods, as the upper boundary of the confidence interval (CI) was lower than the noninferiority margin of 0.10 D for the difference in MAE (−0.03 D; 95% CI: −0.061 to 0.001). MAE was numerically smaller with ORA-AR (0.243 ± 0.215 D) but not significantly different from that with ORA-OA (0.269 ± 0.246 D).

Conclusions:
Postoperative MAE obtained using ORA-AR was noninferior to that of ORA-OA. However, the MAE and SD of refractive prediction errors with ORA-AR were numerically lower compared with ORA-OA.
The Arabic Version of the Prosthesis Embodiment Scale (AR-PEmbs): Translation, Cross-Cultural Adaptation, Reliability, and Validity in Lebanese Individuals with Lower-Limb Amputation
Authors: Saleh Nour El Hoda , Yassine Zainab , Saleh Fatima , Summaka Marwa , Hamieh Fatima , Naim Ibrahim 
Published: February 2025

ABSTRACT

Introduction
This study aimed to translate and cross-culturally adapt the Arabic version of the Prosthesis Embodiment Scale for Individuals with lower-limb amputation (AR-PEmbS-LLA) and evaluate its validity and reliability.

Methods
The AR-PEmbS-LLA was developed using a forward-backward translation process, expert reviews, and pilot testing with 10 individuals with lower-limb amputation (LLA). A cross-sectional, correlational study was conducted with 60 Lebanese adults with major LLAs who used prosthetic devices. Participants completed the AR-PEmbSLLA and the Houghton scale for prosthetic use, the revised Trinity Amputation and Prosthesis Experience Scale (TAPES-R) for adjustment and satisfaction, and the Locomotor Capabilities Index (LCI) for locomotor abilities. Internal consistency, test-retest reliability, and exploratory factor analysis were performed to assess the psychometric properties of the AR-PEmbS-LLA. Convergent validity was evaluated using Spearman correlations with the other scales.

Results
The AR-PEmbS-LLA demonstrated high internal consistency (Cronbach α = 0.97) and test-retest reliability (intraclass correlation coefficient = 0.95, P < 0.01). Exploratory factor analysis confirmed a single-factor structure explaining 78.23% of the variance. Significant correlations were found with TAPES-R general adjustment (r = 0.37, P < 0.001), social adjustment subscales (r = 0.33, P = 0.001), and the LCI basic activities score (r = 0.39, P < 0.001), and the LCI advanced activities score (r = 0.35, P < 0.01).

Conclusions
The AR-PEmbS-LLA is a reliable and valid instrument for assessing prosthesis embodiment in Arabic-speaking individuals with LLA. It can be effectively used in clinical and research settings to understand and enhance the prosthesis integration experience.

Clinical Relevance
The AR-PEmbS-LLA represents a valuable addition to the limited toolkit for evaluating and optimizing prosthetic outcomes in Arabic-speaking individuals with LLA, enhancing clinical practice and research endeavors in this field.