bluuebunny/crossref_metadata_2025_split huggingface dataset:
Australian community and inpatient general public sector mental health services between 2017–18 and 2021–22: Relative stasis in bed capacity, increasing outpatient demand, and stunted expenditure
Authors: Cornell Hayden , Allison Stephen , Bastiampillai Tarun , Kisely Stephen R , Looi Jeffrey CL , Brazel Matthew 
Published: November 2024

Objective To descriptively analyse Australian public sector General Mental Health Services (GMHS) expenditure, ambulatory, and inpatient services, including key performance indicators (KPIs) in comparison with other subspeciality mental health services (MHS). Method We descriptively analysed data published by the Australian Institute of Health and Welfare (AIHW), including inpatient, ambulatory services, expenditure, and KPIs. Results From 2017–18 to 2021–22, per capita expenditure for Australian GMHS (18–64) rose by an average annual inflation-adjusted change of 2%. Overall bed numbers remained static, with non-acute beds declining, and commensurate expansion of acute beds. Community GMHS had high outpatient utilisation, with high rates of schizophrenia, schizoaffective disorder, and bipolar affective disorders as primary diagnoses in mid-life. From 2017–18 to 2021–22, GMHS inpatient and ambulatory episodes had decreasing rates of significant improvement and increasing rates of significant deterioration. Conclusions Although GMHS has the highest overall population and service utilisation, there has been static bed availability and relatively small increases in expenditure which are occurring concurrently with worsening clinical outcomes. Evidence-based modelling of GMHS and outcomes is required to inform future service improvement.
How can specialist investigation agencies inform system-wide learning for patient safety? A qualitative study of perspectives on the early years of the English Healthcare Safety Investigation Branch
Authors: Crompton Amanda , Waring Justin , Macrae Carl , Overton Charlotte , Benneyworth Rosie 
Published: November 2024

Objectives System-wide learning for patient safety is a core challenge for the health care sector, despite the prevalence of localised reporting and learning approaches. There is growing interest in how health care services could emulate other safety-critical sectors with the introduction of specialist safety investigation agencies to inform sector-wide safety. This paper reports on a study of the introduction and early operation of one such agency in the English health and care system. Methods This was a qualitative interview study carried out between 2019 and 2021 and co-designed through a partnership between University researchers and the Executive Team from the Healthcare Safety Investigation Branch (HSIB) to explore the organisational development of this ‘first of type’ organisation. The study involved interviews with 33 internal and external stakeholders and documentary analysis of HSIB reports. Results The study findings highlight the organisational competencies and developmental challenges experienced in the early years of HSIB operations focusing on (i) independence and fit within the wider system; (ii) the selection and scope of investigations; (iii) the methodology and investigation approach; and (iv) the skill and competencies of investigators. Conclusions This study offers practical learning to health care decision-makers about the importance of securing independence and integration, about the production of system-wide learning, the standardisation of robust methodologies and the support for a multidisciplinary specialist workforce.
The use of Language ENvironment Analysis in autism research: A systematic review
Authors: Putnam Orla C , Markfeld Jennifer E , Wright Sarah Towner , Feldman Jacob I , Goldblum Jessica , Karpinsky Maia , Neal Amanda J , Swanson Meghan R , Harrop Clare 
Published: November 2024

The Language ENvironment Analysis (LENA) system has been used increasingly in research to record and evaluate the everyday speech of autistic children and their families. However, it is unclear how researchers are using LENA and whether the system is well-suited for work with autistic individuals. The purpose of this systematic review is to summarize the use of LENA in autism research, to highlight the strengths and limitations of the system as identified by researchers, and to provide recommendations for future research and clinical use. Forty-two studies that used LENA with samples of autistic children were identified through a systematic database search. Researchers using LENA in autism did so across a variety of ages, settings, and analytical approaches. Most studies used LENA within recommended guidelines. The most common purpose of using LENA was for exploratory research. Noted strengths of the LENA system included ecological validity, cost-effectiveness, and timely clinical feedback. Limitations included lower rates of speaker identification compared to human coders and limited information regarding speech context and language development. This systematic review provides key insights into the methods surrounding LENA use in autism research and serves to inform researchers and clinicians on best practices for future use with this technology. Lay abstract In research, language ability has historically been measured using structured tasks in laboratory settings. In recent years, there has been a growing emphasis on the need to instead capture language ability in an individual’s natural setting (i.e. through social interaction or in their home). Considering natural language may be particularly important for the autistic population, as an autistic child’s language ability can be very different depending on the setting. One common tool for capturing natural language is the LENA recording system, which takes audio recordings over long periods of time and provides estimates of children’s and caregivers’ speech. The purpose of this systematic review is to summarize the use of LENA in autism research, to highlight the strengths and limitations of the system as identified by researchers, and to provide recommendations for future research and clinical use. We identified 42 autism studies that used LENA in a variety of ways and settings. Most studies used LENA within the guidelines put forth by its creators, and it was most commonly used to understand speech or speech development for autistic children. LENA is a useful tool for clinicians and caregivers to gain some insights into child speech, but those considering using it should be aware of concerns about its accuracy and limitations about the information it provides. In this review, we supplement the official LENA guidelines with specific suggestions for use with the autistic population.
Diagnosing epileptic seizures using combined features from independent components and prediction probability from EEG data
Authors: Khalid Madiha , Raza Ali , Akhtar Adnan , Rustam Furqan , Ballester Julien Brito , Rodriguez Carmen Lili , Díez Isabel de la Torre , Ashraf Imran 
Published: November 2024

Objective Epileptic seizures are neurological events that pose significant risks of physical injuries characterized by sudden, abnormal bursts of electrical activity in the brain, often leading to loss of consciousness and uncontrolled movements. Early seizure detection is essential for timely treatments and better patient outcomes. To address this critical issue, there is a need for an advanced artificial intelligence approach for the early detection of epileptic seizure disorder. Methods This study primarily focuses on designing a novel ensemble approach to perform early detection of epileptic seizure disease with high performance. A novel ensemble approach consisting of a fast, independent component analysis random forest (FIR) and prediction probability is proposed, which uses electroencephalography (EEG) data to investigate the efficacy of the proposed approach for early detection of epileptic seizures. The FIR model extracts independent components and class prediction probability features, creating a new feature set. The proposed model combined integrated component analysis (ICA) with predicting probability to enhance seizure recognition accuracy scores. Extensive experimental evaluations demonstrate that FIR assists machine learning models to obtain superior results compared to original features. Results The research gap is addressed using combined features to improve the performance of epileptic seizure detection compared to a single feature set. In particular, the ensemble model FIR with support vector machine (FIR + SVM) outperforms other methods, achieving an accuracy of 98.4% for epileptic seizure detection. Conclusions The proposed FIR has the potential for early diagnosis of epileptic seizures and can significantly help the medical industry with enhanced detection and timely interventions.
Cannabinoids for spasticity in patients with multiple sclerosis: A systematic review and meta-analysis
Authors: Azadvari Mohaddeseh , Pourshams Maryam , Guitynavard Fatemeh , Emami-Razavi Seyede Zahra , Taftian-Banadkouki Ensieh , Ghajarzade Mahsa , Rastkar Mohsen 
Published: November 2024

Background One of the most disabling symptoms of patients with multiple sclerosis (MS) is spasticity which affects their quality of life. Nowadays, cannabinoids are used for spasticity control in patients with MS, while the efficacy and safety are not clearly understood. So, we designed this systematic review and meta-analysis to assess the efficacy of cannabinoids for controlling MS-related spasticity. Methods PubMed, Scopus, EMBASE, Web of Science, and Google Scholar were systematically searched by two independent researchers on 1 May 2023. They also searched gray literature (references of included studies, as well as conference abstracts). Results A literature search revealed 6552 records, 95 full-texts were evaluated, and finally, 31 studies remained for systematic review. Among included studies, six randomized trials were included. Nabiximols was the most commonly used medication for controlling MS-related spasticity. Mean Expanded Disability Status Scale ranged between 4.6 and 7. Most studies (17 studies) were done in Italy, followed by Germany (4 studies). The pooled standardized mean difference (SMD) of NRS (Numeric Rating Scale) (after–before) is estimated as −1.41 (95% confidence interval (CI): −1.65, −1.17) (I2 = 97%, p < 0.001). The pooled standardized mean difference (SMD) of Ashworth (after-before) is estimated as −0.39 (95% CI: −0.72, −0.06) (I2 = 69.9%, p = 0.005). Conclusion The results of this systematic review and meta-analysis showed that nabiximols was the most common cannabinoid which was used to control MS-related spasticity, and it was effective in controlling MS-related spasticity (significantly decreased SMD of NRS, and Ashworth after treatment).
Nationwide Geospatial Analysis to Identify Variations in Primary Cardiovascular Risk in Ethiopia
Authors: Alemu Yihun Mulugeta , Bagheri Nasser , Wangdi Kinley , Chateau Dan 
Published: November 2024

Background: Cardiovascular disease (CVD) varies across regions due to socioeconomic, cultural, lifestyle, healthcare access, and environmental factors. Objective: To find geographical variations in 10-year primary CVD risk and assess the impact of contextual factors on CVD risk. Method: Data from 2658 Ethiopians aged 40 to 69 years with no previous CVD who participated in a nationally representative World Health Organization (WHO) STEPS survey in 2015 were included in the analysis. The mean 10-year CVD risk for 450 enumeration areas (EA) was used to identify spatial autocorrelation (using Global Moran’s I) and CVD hot spots (using getas-Ord Gi*). Geographically Weighted Regression (GWR) analysis quantified the relationship between mean 10-year CVD risk and climate-related factors across areas. Result: The spatial autocorrelation analysis identified significant spatial variation in the 10-year CVD risk at the EA level, with a global Moran’s I value of 0.016. Statistically significant hot spot areas with 10-year CVD risk were identified in Addis Ababa (the capital), Benishangul Gumuz, SNNPR (Southern Nations, Nationalities, and Peoples’ Region), Amhara, Afar, Oromia, and Hareri regions. In a multivariable GWR analysis, average water vapor pressure was a statistically significant explanatory variable for the geographical variations in 10-year CVD risk. Conclusion: Hot spot areas for 10-year CVD risk were identified across numerous country regions rather than concentrated in a specific region. Alongside these hot spot areas, regions with a higher annual water vapor pressure (humidity) were identified as geographical targets for CVD prevention.
Efficacy of Diagnostic In-Office Shoulder Ultrasound in the Surgical Treatment of Full-Thickness Rotator Cuff Tears
Authors: Greif Dylan N. , Minto Jonathan , Zhang Linda , Ramirez Gabriel A. , Maloney Michael D. , Voloshin Ilya N. 
Published: November 2024

Background: Early surgical management of full-thickness traumatic rotator cuff tears (RCTs) may optimize functional outcomes, prioritizing timely diagnoses. Ultrasound and magnetic resonance imaging (MRI) are highly sensitive and specific modalities for RCT diagnosis, yet MRI remains the gold standard diagnostic tool despite increased costs and potential delays in care. Ultrasound can provide same-day diagnosis, thus possibly expediting care. Hypothesis: The use of diagnostic shoulder ultrasound alone in the orthopaedic surgeon's office could increase the efficiency of diagnosis and care of traumatic full-thickness RCTs compared with MRI. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective chart review of patients with full-thickness traumatic RCT diagnosed via ultrasound or MRI who subsequently underwent rotator cuff repair with 1 of 2 ultrasound-trained surgeons between January 1, 2014, and December 31, 2019, was performed. Inclusion criteria included patients ≥18 years old, documentation of a first-time traumatic event, and the patient's desire to have immediate surgical management. Revision surgeries, long-term shoulder instability, and nontraumatic injuries were excluded. Basic demographic data were collected, and the number of preoperative office visits and the timing from initial evaluation to diagnosis and surgery were calculated for the ultrasound and the MRI cohorts. A power analysis of 0.8 with an alpha of .05 required 38 patients per group. Results: Overall, 133 patients were diagnosed via MRI compared with 76 via ultrasound. Besides body mass index, there were no significant differences in demographic variables or insurance status. Compared with the MRI cohort, patients in the ultrasound cohort received their diagnosis almost 2 weeks faster ( P < .0001), were scheduled for surgery almost 3 weeks faster ( P < .0001), and underwent surgery 2 weeks faster after initial evaluation ( P < .0001) while requiring nearly half as many clinical visits ( P < .0001). Regression analysis confirmed that ultrasound significantly reduced time to imaging, scheduling, and surgery after initial evaluation while requiring fewer clinical visits ( P < .05). Conclusion: The study findings indicated that ultrasound was a time-saving alternative diagnostic modality for traumatic RCT compared with MRI without compromising standard of care. These results were achieved independent of patient insurance status, disability index, or other demographic variables.
Establishing Clinically Significant Improvement for Patients After Arthroscopic Surgery for Shoulder Instability With Large Labral Tears
Authors: Scanaliato John P. , Magnuson Justin A. , Klahs Kyle J. , Childs Benjamin R. , Tyler John , Hettrich Carolyn M. , Parnes Nata 
Published: November 2024

Background: Patients with large labral tears represent a subset of traumatic shoulder instability cases. Outcomes after arthroscopic stabilization in these patients have been studied less compared with other tears. Purpose: To establish minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB) thresholds for patients after arthroscopic repair of labral tears ≥270°. Patient-reported outcome measures (PROMs) included the Rowe instability score, American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE), and visual analog scale (VAS) for pain. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 52 arthroscopic large labral repairs (52 patients, mean age 28.7 years) performed in male active-duty military patients with a mean follow-up of 79.2 months (range, 24-117 months) met inclusion criteria and were included in the final analysis. All included patients completed the Rowe, ASES, SANE, and VAS pain preoperatively and at final follow-up, and the MCID, PASS, and SCB were calculated for each PROM score. Factors associated with achieving clinically relevant improvement were also calculated. Results: The MCID, PASS, and SCB, respectively, for each PROM were as follows: 10.4 points, 90, and 35 points for the Rowe; 9.7 points, 80, and 43 points for the ASES; 9.9 points, 87, and 65 points for the SANE; and 1.1 points, 3, and 6 points for VAS pain. More than 90% of patients improved according to the MCID for each PROM, while >75% achieved the PASS threshold for each score. The percentage of patients who improved according to the SCB ranged from 9.6% for the ASES to 75% for the SANE. Maintenance of active-duty status was associated with achieving the MCID for the ASES and SANE, while recurrent instability was associated with lower rates of Rowe MCID achievement and SANE PASS achievement. Higher preoperative scores were also associated with lower rates of achieving clinical improvement. Conclusion: Thresholds found for the MCID, PASS, and SCB in active-duty patients undergoing surgery for shoulder instability with labral tears ≥270° were similar to those for all-comers with anterior instability. Factors associated with achieving success or lack thereof on PROMs included maintenance of active-duty status and lower preoperative PROM scores.
An Online Cross-Sectional Study of Nursing Students’ Perceptions of Workplace Incivility in Nursing Schools During the COVID-19 Pandemic
Authors: Mrayyan Majd T. , Algunmeeyn Abdullah , Abunab Hamza Yousef 
Published: November 2024

Introduction Despite a growing body of evidence on academic incivility, limited information exists on workplace incivility perceived by nursing students in nursing schools. This study, conducted amid the COVID-19 pandemic, explores nursing students’ perceptions of workplace incivility in Jordanian nursing schools and investigates demographic-based differences. Methods This study employed a descriptive cross-sectional design, using an online survey for data collection. A convenience sample of 104 nursing students from diverse backgrounds and various Jordanian universities participated, allowing for a comprehensive examination of workplace incivility perceptions at a specific point in time. The online survey ensured efficient data collection, enhancing accessibility and ease of participation. This approach aimed to capture a snapshot of nursing students’ perspectives on workplace incivility within a given time frame and across multiple educational institutions, efficiently gathering data from a geographically dispersed and demographically varied sample. Results Students perceived workplace incivility in nursing schools as “mild,” with moderate confidence in schools’ ability to address it. Workplace civility was rated between 60.00% and 70.00% on a 0–100 scale. The overall mean for uncivil behaviors was “sometimes,” with criticism of expertise as the most common. Incivility in the past year was seen as “rare,” with misusing authority being the most frequent. Male and low-GPA students reported higher perceptions of incivility. Stress was the most perceived contributing factor, and a lack of administrative support was the main barrier. Establishing codes of conduct was considered the key strategy for fostering workplace civility. Conclusion Workplace civility is prevalent in Jordanian nursing schools, even amid the COVID-19 pandemic. However, the occasional occurrence of incivility behaviors should be approached with caution. To enhance perceptions of workplace civility, nursing schools should prioritize effective teaching, a friendly environment, and respectful relationships. Encouraging faculty members to reassess their performance, starting with identifying academic workplace incivility, is crucial.
Predictors of Clinical Performance Among Emergency Nurses: A Cross-Sectional Study
Authors: Subih Maha , Al-Amer Rasmieh , Bani Saleh Enas Ghaleb , Thultheen Imad Numan 
Published: November 2024

Introduction Poor nursing performance is considered a threat to patient safety, affecting the quality of care provided and ultimately impacting patient outcomes. Objectives The main aim of this study was to identify the predictors of nursing performance. Methods A cross-sectional predictive design was used. A convenient sampling technique was used to recruit 251 emergency nurses in three health sectors. They were assessed using the secondary traumatic stress scale and the nursing performance scale. Data were collected between June and August 2022. Results Nurses experienced severe levels of secondary traumatic stress ( M = 57.9, SD = 14.94). The nursing performance level was below average ( M = 27.48, SD = 9.36), and the mental performance subscale received the lowest rating ( M = 5.82, SD = 2.69). There was a strong negative association between the secondary traumatic stress total score and the total score of nursing performance ( r = −.77). Additionally, factors such as high body mass index, smoking, the presence of chronic diseases, working overtime, and high levels of secondary traumatic stress were identified as significant predictors of nursing performance. Conclusion It is recommended that emergency nurses be provided with treatment programs and interventions to reduce their secondary traumatic stress to improve their performance, thereby ensuring high-quality patient care.
Deciphering the role of host-gut microbiota crosstalk via diverse sources of extracellular vesicles in colorectal cancer
Authors: Song Yun , Shi Min , Wang Yugang 
Published: November 2024

AbstractColorectal cancer is the most common type of cancer in the digestive system and poses a major threat to human health. The gut microbiota has been found to be a key factor influencing the development of colorectal cancer. Extracellular vesicles are important mediators of intercellular communication. Not only do they regulate life activities within the same individual, but they have also been found in recent years to be important mediators of communication between different species, such as the gut microbiota and the host. Their preventive, diagnostic, and therapeutic value in colorectal cancer is being explored. The aim of this review is to provide insights into the complex interactions between host and gut microbiota, particularly those mediated through extracellular vesicles, and how these interactions affect colorectal cancer development. In addition, the potential of extracellular vesicles from various body fluids as biomarkers was evaluated. Finally, we discuss the potential, challenges, and future research directions of extracellular vesicles in their application to colorectal cancer. Overall, extracellular vesicles have great potential for application in medical processes related to colorectal cancer, but their isolation and characterization techniques, intercellular communication mechanisms, and the effectiveness of their clinical application require further research and exploration.