bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Early Snapshot of Attitudes Toward Generative Artificial Intelligence in Physical Therapy Education
Authors: Severin Richard , Gagnon Kendra 
Published: October 2024

Introduction.
Generative artificial intelligence (AI) is rapidly gaining popularity across health care, education, and society. The purpose of this study was to assess perceptions and use of generative AI in academic physical therapy (PT).

Review of Literature.
Generative AI became one of the fastest-growing technologies ever after the public release of ChatGPT in November 2022. Early data indicate that attitudes toward generative AI in higher education are mixed and rapidly evolving, with significant ethical concerns around use and potential misuse. There are no published studies investigating perceptions and use of generative AI in PT education.

Subjects.
A total of 175 surveys were completed and analyzed. Respondents included PT educators, administrators, and students.

Methods.
An anonymous, online survey on use and perception of AI was distributed through email and social media. Descriptive statistics and cross-tabulations were performed to analyze respondent characteristics and responses to survey questions.

Results.
Most respondents (61.1%) reported they did not use generative AI during the 2022-2023 academic year, whereas 35.4% were generative AI users. More than 40% of respondents were optimistic or very optimistic toward generative AI. Users of AI were more likely to report an optimistic or very optimistic disposition toward AI compared with nonusers. AI users were more likely to agree or completely agree that generative AI has more benefits than drawbacks compared with nonusers.

Discussion and Conclusion.
Results of this survey suggest that, despite the rapid uptake of generative AI in society, many PT educators and students harbor reservations and uncertainties toward its use. Artificial intelligence users were less likely to hold negative perceptions toward it and were more likely to find it useful. Understanding use and perceptions of generative AI in PT education may inform strategies to promote innovation, policy-making, and ethical integration of this new and rapidly evolving technology.
Biofeedback Measures of Pelvic Floor Muscle Contraction, Relaxation, and Resting Tone for Males With and Without Chronic Pelvic Pain: A Scoping Review
Authors: Wong Calvin , Ow Nikki , Fagan Matthew James 
Published: October 2024

Background:
We sought to identify and explore the utility of biofeedback assessments used to characterize pelvic floor muscles (PFMs) in terms of contraction, relaxation, and resting tone and determine if these methods have identified differences between males diagnosed with chronic pelvic pain (CPP) as opposed to healthy controls.

Methods:
A search strategy was developed with the assistance of a health sciences librarian. Search terms were generated related to key concepts including sex, CPP, and biofeedback. Five electronic databases (PubMed, EMBASE, CINAHL, Medline, and PEDro) were searched for English language articles. This scoping review was completed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, and the protocol was registered with the Open Science Framework.

Results:
Five eligible studies comparing males with CPP to nonpainful controls were identified. Ultrasound imaging, surface electromyography, and anorectal manometry were used in the studies. Identification of increased pelvic floor muscle resting tone and reduced endurance were noted as the most salient pelvic floor muscle findings.

Discussion:
Biofeedback use included males with urologic chronic pelvic pain and chronic anorectal pain. PFMs may behave differently in males with CPP compared to nonpainful controls as measured using biofeedback methods including ultrasound imaging, surface electromyography, and anorectal manometry; however, further research is needed to verify the conclusions of the studies done to date. Biofeedback assessment measures can be useful when PFMs are involved in CPP to identify specific muscle dysfunction and clarify treatment targets for physiotherapists.
A Survey of Pain and Musculoskeletal Dysfunction Prevalence After Gender-Confirming Surgery of the Urogenital System
Authors: Alappattu Meryl J. , Stetten Nichole E. , Rivas Adriana C. , Chim Harvey W.M. , Bishop Mark D. 
Published: October 2024

Purpose:
We sought to (1) explore the prevalence of pain, and movement and urogenital dysfunction reported following gender confirming vaginoplasty (V) and phalloplasty (P), (2) identify which providers were consulted for pain, and movement and urogenital dysfunction after surgery, and (3) compare these factors between people receiving V and P surgeries.

Methods:
A custom internet survey, built in REDCap, was distributed through LGBTQIA+ organizations across the US. The survey collected demographic information, types of surgery, postsurgical impairments (pain and urogenital dysfunction), and activity limitations, along with the types of providers seen and interventions provided. Summary statics were calculated and proportions or means and standard deviations based on the data structure. Nonparametric measures were used to test associations between postsurgical care, gender identity, and geographic location.

Results:
584 responses remained after data cleaning of which 89 people reported having vaginoplasty (V) and 118 had phalloplasty (P). The average age of respondents was 28.6 ± 5.2 years. 70% of respondents reported pain, 25% difficulty moving, 23% bowel or bladder dysfunction, and 9% dyspareunia. Significantly more respondents who had V reported dyspareunia, while more respondents who had P reported incontinence. 20%, 29%, 15%, and 13% of included respondents received care from a physical therapist for pain, difficulty moving, incontinence, and dyspareunia, respectively.

Discussion:
These results indicate that both individuals who undergo V or P procedures report musculoskeletal pain, movement problems, and pelvic floor dysfunction following GCS. Notably, these issues are commonly addressed in cisgender patients by physical rehabilitation providers. However, less than half of our sample were referred to a physical therapist.
Unintended Pregnancy After Kidney Transplantation
Authors: Yin Ophelia , Gliwa Catherine , Walia Anjali , Coscia Lisa , Constantinescu Serban , Moritz Michael , Sarkar Monika , Irani Roxanna , Afshar Yalda 
Published: October 2024

OBJECTIVE:
To define risk factors, obstetric morbidity, and allograft outcomes associated with an unintended pregnancy after kidney transplant.

METHODS:
This is a retrospective cohort study of pregnancies in women after kidney transplantation enrolled in the Transplant Pregnancy Registry International with births between 1967 and 2019, with cohorts categorized as intended pregnancies and unintended pregnancies. The primary outcome was acute kidney rejection during pregnancy or by 6 weeks postpartum. Secondary outcomes included allograft loss, severe maternal morbidity, and neonatal composite morbidity. Multivariable logistic regression, Kaplan–Meier curves, and Cox proportional hazards regression models were performed, with adjustment for covariates pertinent to allograft function.

RESULTS:
Among 1,723 pregnancies of kidney transplant recipients, 1,081 (62.7%) were intended and 642 (37.3%) were unintended pregnancies. Risk factors for unintended pregnancy included younger age, Black race, nulliparity, chronic hypertension, and transplant from a deceased donor. Exposure to mycophenolate products (16.0% vs 5.7%) and termination (4.7% vs 0.4%) were more common in unintended pregnancies (P<.001). Unintended pregnancy was not associated with acute kidney rejection (2.3% vs 0.9%, adjusted odds ratio [AOR] 2.38, 95% CI, 0.91–6.30, P=.08). Unintended pregnancy was independently associated with allograft loss at 2 years from the end of pregnancy (8.1% vs 3.5%, AOR 2.27, 95% CI, 1.32–3.94, P=.003) but not allograft survival (adjusted hazard ratio 1.22, 95% CI, 1.00–1.49, P=.05). There were no differences in severe maternal morbidity (3.3% vs 3.6%) or neonatal composite morbidity (12.9% vs 14.3%) by pregnancy intention.

CONCLUSION:
Unintended pregnancy was not associated with acute kidney allograft rejection in the peripartum period, but it was associated with mycophenolate exposure and allograft loss at 2 years from pregnancy. The same social vulnerabilities that underlie difficulty in accessing reproductive care may be similarly important for transplant health. We recommend prepregnancy counseling and longitudinal follow-up of transplant recipients to reduce rates of unintended pregnancy and to optimize transplantation success over time.
Implementing Screening for Neonatal Delirium in the Neonatal Intensive Care Unit: A Quality Improvement Initiative
Authors: Karmarkar Meghana , Speziale Mark , Jenkins Willough , Heath Danielle , Kang Jane , Suvak Julia , Grimm Peggy , Moyer Laurel 
Published: October 2024

Introduction:
Delirium is not commonly diagnosed in neonatal intensive care units and can adversely impact patient outcomes in the ICU setting. Recognition of delirium in the NICU is a necessary first step to address the potential impact on neonatal outcomes.

Methods:
We conducted a quality improvement initiative implementing screening for neonatal delirium. We aimed to increase screening in NICU patients from 0% to 85% by March 2022. Interdisciplinary meetings were held with key stakeholders to develop a clinical algorithm. We used standardized tools for delirium screening. Our process measures included weekly nursing compliance with Richmond Agitation Sedation Scale/Cornell Assessment of Pediatric Delirium/ scoring documentation (Fig. 1) and patients referred to psychiatry. Outcome measures included the percentage of patients screened for delirium before discharge. We conducted Plan-Do-Study Act cycles to optimize the screening process in the electronic medical record (EMR). This included creating an order set, documentation flowsheets, and prompts in the EMR for patients.

Results:
After initial implementation, we achieved an average weekly screening compliance of 76% (Fig. 1). Inclusion criteria expansion resulted in a downward compliance shift to 59%. Subsequently, the addition of the EMR checklist resulted in a center-line shift to a sustained average weekly screening compliance of 77%. An average of 82% of all eligible NICU patients received delirium screening before discharge (Fig. 2).

Conclusions:
Using quality improvement methodology, there was increased screening and recognition of delirium in our NICU. Future research efforts could focus on assessing preventive measures and the impact of neonatal delirium on patient outcomes.
Intelligent Verification Tool for Surgical Information of Ophthalmic Patients: A Study Based on Artificial Intelligence Technology
Authors: Lin Hui , Huang Xiaofang , Sheng Yaying , Tang Ning , Lian Hengli , Zhang Wenjie , Zhao Lvjun , Zhu Hanqing , Chang Pingjun , Guo Yingxuan 
Published: October 2024

Objective:
With the development of day surgery, the characteristics of “short, frequent and fast” ophthalmic surgery are becoming more prominent. However, nurses are not efficient in verifying patients’ surgical information, and problems such as patient privacy leakage are becoming more prominent. To improve the situation, we developed a new augmented reality (AR)-based tool for visual recognition and artificial intelligent (AI) interpretation of the pattern and location of patient surgical skin markings for the verification of the correct surgical site and procedure. The tool can also display a variety of other verbally requested patient information. The purpose of this proposal is to evaluate its feasibility of use by surgical nurses in a real clinical setting.

Methods:
We developed a tool with image recognition technologies to interpretation patient surgical skin markings and match the information obtained with the patients surgical records, thus, verify the patient’s surgical information. Verification includes the proper surgical site and type of procedure to be performed. Nurses can interact with the device through its speech recognition capabilities and the device provides them with a variety of other requested patient information via a heads-up display. Three hundred patients in an outpatient ophthalmology clinic were divided into an AR intelligent verification experimental group and a manual verification control group. The accuracy of information verification, work time consumption, and economic cost data were compared between the 2 groups to evaluate the effectiveness of the AR Surgical Information Intelligent Verification Tool in clinical patient surgical information verification.

Results:
There was no statistically difference in the correct rates of patient surgical information review between the experimental group (95.33%) and the control group (98.67%) (χ2 = 2.934, P = 0.087). The median time for information verification was 10.00 (10.00, 11.00) seconds in the experimental group and 21.00 (20.00, 24.00) seconds in the control group, a statistically difference (Z = 0.000, P < 0.001). The experimental group saved 11 seconds per patient per review compared with the control group. Considering 10,531 surgeries in 2023, printing 1 page of surgical information per 9 patients and requiring 4 copies, 4680 pages of printing paper could be saved.

Conclusions:
The AR Surgical Information Intelligent Verification Tool has advantages in assisting medical staff in patient surgical information verification, improving nursing efficiency, preventing surgical mark errors or nonstandardization, protecting patient privacy, and saving costs. It has certain research and application value in the scenario of patient surgical information verification in ophthalmic day ward.
A Randomized Controlled Trial on Teaching the Safe Handling of Firearms Using a Simulation-Based Assessment
Authors: Hoyne Jake , Yee Jennifer , Lei Charles , Grossestreuer Anne V. , Li-Sauerwine Simiao , Burns William , Olson Nate , Pirotte Matthew , Dubosh Nicole , Ketterer Andrew R. 
Published: October 2024

Introduction
Emergency providers risk encountering firearms in the emergency department, but a minority report familiarity with handling firearms. It may be unsafe if unfamiliar, untrained providers attempt to remove a firearm from the clinical care space. This study assessed the efficacy of an educational intervention training resident physicians in this task.

Methods
Five emergency medicine residency programs conducted a prospective, single-blinded randomized controlled trial assessing performance of safely removing a firearm from the clinical care space during a simulated patient encounter. The primary outcome was completion of critical actions previously assessed in a pilot study. Residents viewed a 5-minute educational video developed for this study detailing the principles of safely removing a firearm from the clinical care space. The training video was emailed to prospective participants in the intervention group ahead of the simulation session. Afterward, a debriefing session was held with all participants to review the safe handling of firearms.

Results
Sixty-six of 170 prospective participants (38.8%) consented to participate. There were no significant differences in gender, clinical training level, environment of upbringing, confidence in handling firearms, firearm usage frequency, or prior firearm training. Twenty-nine participants handled the firearm during simulation. The intervention group performed significantly better than the control group, completing a median of 7 critical actions (interquartile range, 7–8) versus 6 critical actions (interquartile range, 5–7), P = 0.035. This effect held among participants who handle firearms outside of work and/or have prior firearms training.

Conclusions
This study demonstrates how a brief educational intervention was associated with improvement in participants' ability to safely remove a firearm from a simulated clinical care space. This approach can be integrated into existing curricula, and its success suggests broad applicability.
Aerobic Conditioning in Geriatric Rehabilitation
Authors: Moffat Marilyn , Park Ha Yeon 
Published: October 2024

This article reviews the historical development of aerobic conditioning. The many physiological effects of aerobic conditioning are presented including the effects on cardiovascular, muscular, and neuromuscular health leading to increased physical endurance and increased lifespan. Aerobic exercise prescription follows the frequency, intensity, time, and type, as well as the volume and progression principles. Frequency recommendations are at least 3 d/wk and 3 to 5 d/wk appears to be conducive to meeting overall physical activity recommendations. Intensity determination is based on several methods that include heart rate methods, ratings of perceived exertion (Borg and OMNI), the talk test, and the counting talk test. Time recommendations include at least 150 to 300 minutes a week of moderate-intensity aerobic activity, 75 to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activities. Type recommendations include any aerobic activities involving major muscle groups used in a continuous or intermittent manner. Volume recommendations include ≥500 to 1000 metabolic equivalent minutes per week and approximately 150 min/wk of moderate-intensity activity. Progression recommendations include the gradual advancing of the exercise duration, frequency, and intensity, making sure that the progressions allows for the best adherence to aerobic exercise on an ongoing basis. The benefits of aerobic exercise have been shown to be important for every aspect of living a healthy lifestyle across the age span, particularly for aging adults, adults with chronic conditions, and adults with disabilities.
Surgical Recovery Through the Lens of Patients with Colorectal Disease: A Qualitative Study in an Enhanced Recovery after Surgery Setting
Authors: Li Yaxin , Hajjar Rana , Gramlich Leah , Nelson Gregg , Ljungqvist Olle , Gillis Chelsia 
Published: October 2024

BACKGROUND:
As perioperative care shifts to a more patient-centered model, understanding needs and experiences of patients is vital. Gaining such insight can enhance the alignment of care with patient priorities, encouraging adherence to recovery-oriented interventions. We aimed to explore patient-defined recovery and the elements that modify the recovery process for patients with colorectal disease under enhanced recovery after surgery (ERAS) care.

STUDY DESIGN:
A qualitative study was conducted at an ERAS-participating hospital in Alberta, Canada, between April 2018 and June 2019. A co-design focus group set the research direction, and semistructured interviews were conducted postoperatively in-hospital or within 3 months postdischarge. Diverse patient ages and colorectal conditions were targeted through purposive sampling. Interviews were transcribed verbatim and analyzed through manifest and latent content analysis.

RESULTS:
Twenty patients with mean age 62 (SD 13) years and 45% with cancer (17 interview, 2 focus group + interview, and 1 focus group only) were enrolled. Recovery was defined by patients as the return to normal routines and four themes were identified. First, phases of recovery: recovery was described as multidimensional phases distinctively as early, late or long-term, and the endpoint. Second, recovery facilitators: recovery was supported through positive mindsets, conscious recovery, and taking an active role. Third, recovery barriers: recovery was hindered by negative mindsets and treatment side effects. Finally, recovery catalysts: communication, autonomy, and expectations facilitated active or passive recovery.

CONCLUSIONS:
Our patient-oriented recovery model may contribute a new dimension to the ERAS framework by capturing patients’ recovery experiences. Further research is encouraged to explore its value in enhancing patient-centered care within ERAS.
Testing Neuroprotective Strategies in Prolonged Field Care Model of Traumatic Brain Injury and Hemorrhagic Shock
Authors: Bhatti Umar F , Dawood Zaiba Shafik , Shang Zhenhua , Jin Guang , Liggett Marjorie R , Chtraklin Kiril , Liu Baoling , Redondo Ramon-Lorenzo , Wang Bowen , Alam Hasan B 
Published: October 2024

BACKGROUND:
Prolonged field care is a military adaptation of tactical combat casualty care providing extended prehospital management during delayed extrication. Effects of addition of valproic acid (VPA) to fresh–frozen plasma (FFP) in a prolonged field care model of hemorrhagic shock and traumatic brain injury are not known. We hypothesized that VPA is associated with decreased neurological impairment, and its protective changes are detected at the transcriptomic level.

STUDY DESIGN:
Swine underwent traumatic brain injury and 40% blood volume hemorrhage. After 2 hours of shock, they were randomized to (1) normal saline (NS), (2) NS + 250 mL FFP (NS + FFP), or (3) NS + FFP + 150 mg/kg VPA (NS + FFP + VPA). At 72 hours, they were transfused packed RBCs before being euthanized. Intraoperative variables and neurological outcomes were compared. Brain lesion size was measured, and gene expression profiles were analyzed using RNA sequencing. Pathway and network analyses were performed on differentially expressed genes. Real-time polymerase chain reaction was performed to validate key genes.

RESULTS:
NS + FFP and NS + FFP + VPA required significantly less crystalloid resuscitation (974 mL: NS + FFP; 1,461 mL: NS + FFP + VPA vs 4,540 mL: NS, p < 0.001), had smaller brain lesion size (2,477 mm3: NS + FFP; 3,018.0 mm3: NS + FFP + VPA vs 4,517.0 mm3: NS, p < 0.01), and required less functional neurologic impairment compared with NS. Per pathway analysis of differentially expressed genes, VPA was associated with enrichment of numerous metabolic changes in injured brains, which were not observed with FFP. Network analysis showed enrichment of various gene networks. Mitochondrially encoded ATP synthase membrane subunit 8 gene was downregulated in VPA-treated animals.

CONCLUSIONS:
The addition of FFP to the resuscitation protocol resulted in a significant reduction in crystalloid requirements. Both the NS + FFP and NS + FFP + VPA groups showed improved neurological recovery compared with NS alone and had distinctive transcriptomic profiles in injured brains at 72 hours. The mitochondrially encoded ATP synthase membrane subunit 8 gene, involved in worsening ischemia following brain injury, was downregulated in VPA-treated animals.
Closed-loop fMRI at the mesoscopic scale of columns and layers: Can we do it and why would we want to?
Authors: Chaimow Denis , Lorenz Romy , Weiskopf Nikolaus 
Published: October 2024

Technological advances in fMRI including ultra-high magnetic fields (≥ 7 T) and acquisition methods that increase spatial specificity have paved the way for studies of the human cortex at the scale of layers and columns. This mesoscopic scale promises an improved mechanistic understanding of human cortical function so far only accessible to invasive animal neurophysiology. In recent years, an increasing number of studies have applied such methods to better understand the cortical function in perception and cognition. This future perspective article asks whether closed-loop fMRI studies could equally benefit from these methods to achieve layer and columnar specificity. We outline potential applications and discuss the conceptual and concrete challenges, including data acquisition and volitional control of mesoscopic brain activity. We anticipate an important role of fMRI with mesoscopic resolution for closed-loop fMRI and neurofeedback, yielding new insights into brain function and potentially clinical applications.
This article is part of the theme issue ‘Neurofeedback: new territories and neurocognitive mechanisms of endogenous neuromodulation’.