bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perspectives of patients with osteoarthritis for using digital technology in rehabilitation at a public community centre in the Cape Metropole area: A qualitative study
Authors: Prins Gabriela B. , Nizeyimana Eugene , Ernstzen Dawn V. , Louw Quinette A. 
Published: October 2024

Objectives To explore the perspectives of people with osteoarthritis (OA) on the use of digital technology into their rehabilitation program, including their awareness, views on accessibility, affordability and willingness to accept digital modalities for rehabilitation delivery. Methods A qualitative, descriptive design was conducted. Patients with OA who receive care at a public community rehabilitation centre in the Western Cape, South Africa were eligible to participants. Semi-structured interviewed were conducted and Atlas.ti 23 software was used for thematic analysis. Results The findings showed that the participants had limited awareness and exposure to telerehabilitation (TR), along with minimal digital literacy and skills. They were sceptical about the effectiveness of TR and concerned about the inherent lack of physical interactions with health professionals. However, some acknowledged TR's potential benefits for accessibility, convenience, family involvement and long-term community health improvement. Participants were willing to learn more about TR. Conclusion Considering the benefits of TR in lower resource settings such as South Africa, investment to increase awareness and patient education and training in TR may assist in enhancing access and quality of care. Resources dedicated to TR and management buy-in in low-and-middle income countries (LMICs) is necessary to facilitate the fit-for-context roll-out of TR.
Surgical Specialty Outcome Differences for Major Spinal Procedures in Low-Acuity Patients
Authors: Price Anthony , File Christopher , LeBlanc Alvin , Fredricks Nathan , Ju Rylie , Pratt Nathan , Lall Rishi , Jupiter Daniel 
Published: October 2024

Study Design Retrospective Cohort Study. Objectives There is an ongoing debate as to the influence of specialty training on spine surgery. Alomari et al. indicated the influence of specialty on ACDF procedures. However, deeper analysis into other spine procedures and lower-acuity procedures has yet to occur. In this study, we aim to determine if the outcomes of the low American Society of Anesthesiologists (ASA) classification (ASA 1&2) patients undergoing spine surgery vary based on whether the operating surgeon was an orthopedic surgeon or a neurosurgeon. Methods The NSQIP databases from 2015 to 2021 were queried based on the CPT code for nine common spine procedures. Indicators of surgical course and successful outcomes were documented and compared between specialties. Results Neurosurgeons had minimally shorter operative times in the ASA 1&2 combined classification (ASA-C) group for cervical, lumbar, and combined spinal procedural groups. Neurosurgeons had a slightly lower percentage of perioperative transfusions in select ASA-C classes. Orthopedic surgeons had shorter lengths of stay for the cervical groups in ASA-C and ASA-1 classes (ASA-1). However, many specialty differences found in spine patients become less pronounced when considering only ASA-1 patients. Finally, postoperative complication outcomes and re-admission were similar between orthopedic and neurological surgeons in all cases. Conclusions These results, while statistically significant, are very likely clinically insignificant. They demonstrate that both orthopedic surgeons and neurosurgeons perform spinal surgery exceedingly safely with similarly low complication rates. This lays the groundwork for future exploration and benchmarking of performance in spine surgeries across neurosurgery and orthopedics.
H-Loop Knotless Double-Row Repair Versus Krackow Repair for Achilles Tendon Rupture: A Biomechanical Study in a Cadaveric Model
Authors: Hou Jingyi , Li Yuxiang , Zheng Zhenze , Long Yi , Zhou Min , Yang Yitao , Yang Rui 
Published: October 2024

Background: Surgery is widely recognized as an effective treatment for Achilles tendon rupture; however, there remains debate regarding the optimal surgical approach. Purpose: To compare the biomechanical properties of 2 techniques, the H-loop knotless double-row (HLDR) suture repair and the Krackow suture repair, for Achilles tendon rupture in a cadaveric model. Study Design: Controlled laboratory study. Methods: Ten matched Achilles tendon specimens from 5 male and 5 female donors were obtained. Each specimen from a matched pair was randomly distributed to 1 of 2 repair groups, the HLDR group or the Krackow group. Tendon elongation was recorded after exposure to 10, 100, 200, 400, 600, 800, and 1000 load cycles. The gap distance after application of a 100-N force, the force needed to produce a 2-mm gap, and the load to failure were measured. All biomechanical properties were compared between the HLDR and Krackow groups using the paired t test. Results: The HLDR group consistently exhibited significantly less elongation than the Krackow group after exposure to the 7 load cycles ( P < .01 for all). In addition, the HLDR group exhibited a significantly smaller gap distance after applying a 100-N force (0.30 ± 0.02 vs 8.10 ± 0.46 mm for Krackow group), required significantly more force to generate a 2-mm gap (419.68 ± 39.48 vs 22.29 ± 3.40 N for the Krackow group), and had a significantly higher ultimate failure load (519.91 ± 57.29 vs 220.30 ± 19.27 N for the Krackow group) ( P < .01 for all). Conclusion: The study findings demonstrated that the HLDR technique had more advantages compared with the Krackow technique with regard to elongation after different cyclic loadings, gap distance after a 100-N load, force needed to produce a 2-mm gap, and load to failure in a cadaveric model. Clinical Relevance: The HLDR technique could be a viable option for Achilles tendon rupture repair.
Psychometric Validation of the Digital Competence Questionnaire for Nurses
Authors: Golz Christoph , Hahn Sabine , Zwakhalen Sandra M.G. 
Published: October 2024

Introduction No brief questionnaire comprising knowledge, skills, and attitudes is available to measure digital competence among clinical practice nurses. Objective The aim was to evaluate the structural validity and internal consistency of the Digital Competence Questionnaire (DCQ) for Clinical Practice Nurses. Methods A cross-sectional study was conducted with English-speaking clinical practice nurses. Twenty-six items from an initial item pool, developed in a prior conducted Delphi Study, were included. Exploratory factor analysis for structural validity with “oblimin” rotation and a two-factor solution as well as internal consistency test using Cronbach's alpha were conducted. Results Data from 185 nurses was obtained. The final questionnaire comprised of 12 items allocated to two factors: knowledge & skills and attitude. Factor “attitude” explained 33% of the variance and factor “knowledge & skills” 24%, resulting in a cumulative explanation of the variance of 57% by both factors. Internal consistency per factor was satisfactory, with 0.81 and 0.91, respectively. Conclusion The DCQ for clinical practice nurses is valid and has satisfactory internal consistency. Researchers and nurse managers can use it to assess the level of digital competence among clinical practice nurses. Future psychometric validation of the DCQ for clinical practice nurses is required to allow a conclusion on the goodness of fit and reliability.
Perceptions of Adult Obesity Education: A Pilot Study
Authors: Williams Seleda Ann , Sandholdt Cara Marie , Fine Jeffrey Robert , Mbe Kougang Anne 
Published: October 2024

Objectives This pilot research study, conducted at a large academic healthcare facility, used mixed methodology to (1) administer a survey to a group of primary care trainees and faculty and (2) conduct key informant interviews with the program directors, or their delegates of these primary care training programs, so as to gain insight into respondents’ perceptions about their training on adult obesity. To maintain confidentiality of the key informants, they were defined as “Administrators.” Faculty and trainees were from family medicine and internal medicine residency programs, as well as family nurse practitioner and physician assistant training programs. Methods This study used a quantitative survey and four qualitative key informant (Administrator) interviews. Descriptive statistics, χ2, or Fisher exact tests were used to analyze select survey responses. Administrator interviews were analyzed with thematic analysis. Results Survey respondents (n = 75) included primary care trainees (n=34), faculty (n=30), other (n=2), did not answer (n=9). Surveys indicated that additional training is needed for bariatric surgery, weight loss medications, and clinical nutrition. The three highest ranked topics in the surveys on adult obesity were basic nutrition, behavioral weight management, and a rotation on adult obesity. Most agreed on the need for interprofessional collaboration, a centralized obesity treatment center, and an introductory obesity course. Key themes from the four Administrator interviews revealed the need: for more training; to build upon current curriculum; use innovative technology; fiscal challenges; and time management. Conclusions Both faculty and trainees perceive that academic and clinical training on adult obesity is inadequate, and that trainees need more education on such topics as nutrition, physical activity, behavioral health, antiobesity medications, and bariatric surgery. Competency to treat varied by topic. It also showed that more interprofessional collaboration and a centralized obesity treatment center are needed. Recommendations included integrating modular units about obesity into already established primary care training programs and providing additional resources.
Association of Lesbian, Gay, Bisexual, and Transgender (LGBT) Cultural Competency Training With Provider Practice Characteristics and Perceptions of Patient Care
Authors: Hsiang Elaine , Ney John P. , Weathers Allison L. , Rosendale Nicole 
Published: October 2024

BACKGROUND While issues related to lesbian, gay, bisexual, and transgender (LGBT) health are increasingly incorporated into medical training, there remains limited guidance and opportunities for continuing medical education in LGBT health. It is unclear how participation in LGBT-specific training is distributed across physician specialties and practice regions. Additionally, national data assessing cultural competency training for physicians are scarce and do not delineate LGBT-specific training or training completed prior to, during, or after graduate medical education. METHODS Using data from the 2016 National Culturally and Linguistically Appropriate Services Physician Survey, this study evaluated patterns of post-residency cultural competency training, as well as associations between LGBT-specific training and provider perceptions of patient care outcomes. RESULTS Provider specialty, practice region, and receiving cultural competency training as a trainee were associated with post-residency LGBT-specific training. Surgical providers (odds ratio [OR]: 0.42; confidence interval [CI] 0.25–0.73; p = .002) and those practicing in the South (OR: 0.49; CI: 0.26–0.92; p = .025) had lower odds of completing LGBT-specific cultural competency training while in independent practice. Post-residency LGBT-specific training was associated with provider agreement that cultural competency training improves the quality of care (OR: 2.76; CI: 1.44–5.28; p = .002), patient satisfaction (OR: 2.55; CI: 1.32–4.93; p = .005), and patient comprehension (OR: 2.03; CI: 1.05–3.90; p = .034). CONCLUSIONS Our findings provide disaggregated analyses that nuance the assessment of cultural competency interventions and support a broader effort to increase attention to LGBT health in continuing medical education.
Efficacy assessment of intravenous immunoglobulin for gastrointestinal involvement in systemic sclerosis using UCLA SCTC GIT: Case-based review
Authors: Neto Marcelo , Albuquerque Fernando , Oliveira João , Cadório Maria João , Salvador Maria João , Santiago Tânia 
Published: October 2024

Objectives: To summarize the published evidence in the literature on the use of intravenous immunoglobulin in gastrointestinal tract involvement in systemic sclerosis patients and report the experience of our department. Methods: A systematic literature review was performed; and a literature search was conducted in MEDLINE and Embase until 1/5/2024, using the participants, intervention, comparator and outcomes framework. Only full-text articles involving systemic sclerosis adults, submitted to intravenous immunoglobulin (at least one administration) to treat primary gastrointestinal tract manifestations. The outcome was the University of California at Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract 2.0 score to evaluate response to treatment. Two reviewers performed the assessment of data extraction and synthesis, independently. Results: Four papers (two case reports and two retrospective studies) out of 35 references were included. In addition, we added two systemic sclerosis patients from our department in this review. In 25 systemic sclerosis patients, with various gastrointestinal tract manifestations, the intravenous immunoglobulin therapy was found to improve digestive tract symptoms in SSc patients, as shown by the decrease in the scores of University of California at Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract 2.0. No adverse events were reported, except for one case of low-grade fever post-administration. Conclusion: The results from this systematic literature review based on case series suggest that intravenous immunoglobulin may improve gastrointestinal tract symptoms assessed by the University of California at Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract 2.0 scale, with only minor reported adverse events, suggestive of an acceptable safety profile. We believe that this systematic literature review will contribute to shed light on the efficacy and safety aspects of intravenous immunoglobulin treatment in the management of gastrointestinal tract symptoms; and multicenter randomized placebo-controlled trials are urgently needed to foster progress in this field.
A process mining model to detect adverse patient safety events: Blood products watch
Authors: Sumer Ahmet Murat , Ceylan Cemil 
Published: October 2024

Introduction Patient safety incidents and adverse events are reported voluntarily by healthcare staff. The Global Trigger Tool, developed by the Institute for Healthcare Improvement, is used to capture unreported events. The objective of the new model is to use process mining in the context of adverse event detection to increase reporting efficiency. Methods In the first phase, the process mining model is used to discover the actual process map by querying inpatient processes using the provided log data. Transfusions of blood or blood products within 24 h after surgery, a subset of The Transfusion of Blood or Use of Blood Products trigger of Institute for Healthcare Improvement (GTT-C1) was deployed as a process pattern within the actual process map. Only detected patients were reviewed in the last phase. Results The model ran on a single hospital data set, which included 2870 patients, 1048 of which included surgeries. The model reduced the analyzed data to 57 patients. The expert group analyzed these 57 patients and defined 12 adverse events. The calculated adverse event ratio was 1.1%, comparable with other manual Global Trigger Tool studies. In addition, the reviewers’ time required decreased by 94.6%, from 138.28 to 7.52 h. Two reviewers validated the model by reviewing a sample of patients. Conclusions Process mining can be used in healthcare institutions to conduct routine surveillance and detect unreported safety events. This allows healthcare providers to allocate financial and human resources to more urgent needs and increase efficiency. Further research is needed to evaluate the model with other triggers.
Emergency Knowledge Translation, COVID-19 and indoor air: evaluating a virtual ventilation and filtration consultation program for community spaces in Ontario
Authors: Katz Amy , Li Tianyuan , James LLana , Buhariwala Pearl , Osei-Twum Jo-Ann , Siegel Jeffrey , O’Campo Patricia 
Published: October 2024

Abstract
Background
An October, 2021 review of Public Health Ontario's COVID-19 guidance for congregate settings such as shelters and long-term care homes demonstrated that this guidance did not include references to ventilation or filtration. In April 2022, an interdisciplinary team with expertise in indoor air quality (IAQ), engineering, epidemiology, community programming and knowledge translation launched a virtual ventilation and filtration consultation program for community spaces in Toronto, Ontario. The program gives people working in community spaces direct access to IAQ experts through 25-min online appointments. The program aims to help reduce the risk of COVID-19 transmission in community spaces, and was designed to help compensate for gaps in public health guidance and action.

Methods
Representatives from participating organizations (n. 27) received a link to an online survey via email in April 2023. Survey questions explored the impacts of the program on topics such as: purchase and use of portable air filters; maintenance and use of bathroom fans; and, maintenance and modification of HVAC systems. Survey participation was anonymous, and no demographic information was collected from participants.

Results
Representatives from 11 organizations completed the survey (40%). Of those who responded, nine (82%) made changes as a result of the program, with eight (73%) making two or more changes such as purchasing portable air filters and increasing routine maintenance of HVAC systems.

Conclusions
When presented with brief access to expert support and tailored plain language guidance, people working in community spaces increased their use of ventilation and filtration strategies for COVID-19 infection prevention and control.
Of the article: evaluation of the masticatory efficiency of children with stainless steel crowns: a pilot cross-sectional split-mouth study
Authors: Sen Madhura , Yarmunja Mahabala Karuna , Natarajan Srikant , Gupta Deveshi , Shekhar Shrehya , Rao Ashwin , Nayak P Anupama 
Published: October 2024

Abstract
Background
Stainless steel crowns (SSCs) are commonly employed to restore the posterior teeth of children and over the years, they are available with improved anatomical shapes. This study was conducted to evaluate and assess the effect of the placement of SSCs on the masticatory efficiency of children.

Methods
This pilot cross-sectional split-mouth study assessed masticatory efficiency in children aged 6–11 years. Fifteen participants, each with stainless-steel crowns placed unilaterally at least one month prior, were included. This study utilized two flavours of trident chewing gum (red and green) to measure masticatory efficiency. The child was asked to chew half a strip of red and green chewing gum placed one on top of the other using either the noncrown or crown side 15 times. Another set of chewing gum was given to the child to chew 20 times on the same side. The chewing exercise was repeated using teeth on the other side. Chewed gum samples were collected, photographed, and analysed via ImageJ software to determine the red and green areas. Masticatory efficiency was subsequently calculated with the help of a formula in which the red areas and green areas were calculated via ImageJ software. The data were analysed with paired t tests via SPSS (version 20.0).

Results
When the mean values of the crown side were compared with those of the noncrown side following 15 chewing cycles, the chewing efficiency on the noncrown side was greater, with a difference of 0.303, whereas the chewing efficiency following 20 chewing cycles was greater on the crown side, with a difference of 0.814. However, both differences were statistically nonsignificant, with t values of -0.07 and 0.26, respectively, and p values of 0.94 and 0.8, respectively.

Conclusion
The presence of SSCs on the molars of children did not affect masticatory efficiency.
Recommended recumbency to avoid insertional complications during small-bore wire-guided thoracostomy tube placement in cats—a cadaver study
Authors: Siegelmayer Desiree , Schnabl-Feichter Eva , Tichy Alexander , Gradner Gabriele , Degasperi Brigitte , Liehmann Lea 
Published: October 2024

Abstract
Background
Small-bore wire-guided thoracostomy tubes (SBWGTT) are commonly used in cats to manage pleural disease and generally have a low complication rate. Our study aimed to explore the correlation between recumbency of cats, placement method, and the occurrence of insertional complications to identify risk factors during SBWGTT placement.
In this experimental cadaveric study, SBWGTT placement using a modified Seldinger technique was conducted in 24 feline cadavers. Cats, euthanized for reasons unrelated to the study, were randomly assigned to pleural effusion (EFF; n = 12) and pneumothorax (PNEU; n = 12) groups. Each cadaver was intubated and ventilated with a peak inspiratory pressure (PIP) of 10 mmHg, and sterile saline or air was instilled into the thorax over a 5 mm thoracoscopic trocar in the fourth intercostal space (ICS). Instillation was stopped when the lateral thoracic wall to lung distance (TWLD) reached 10 to 12 mm, measured with ultrasound in the favorable position. Sternal recumbency was the favorable position for the EFF group, and lateral recumbency for the PNEU group. Following the placement of the first SBWGTT in each group, the cadavers were positioned unfavorably (lateral recumbency for EFF group, sternal recumbency for PNEU group), and a second drain was introduced contralaterally. A bilateral 8th ICS thoracotomy was then performed to visually assess intrathoracic structures and drain integrity.
A binary logistic regression mixed model was conducted to determine interaction between the induced condition and body position.

Results
A total of 48 SBWGTTs were placed, with complications observed in 33.3% (8/24) of cases. Five of these were major complications consisting of lung lacerations. Complications were more common in the unfavorable position, accounting for 75% of cases, although this result was not statistically significant. The odds of complication rates were > 70% in the unfavorable position and decreased with an increase in TWLD (< 30%).

Conclusion
Complications associated with SBWGTT placement are influenced by recumbency, although the data did not reach statistical significance. Placing cats in lateral recumbency for pneumothorax treatment and sternal recumbency for pleural effusion treatment may reduce insertional complications.