bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding the experiences of receiving and providing maternity care for autistic adults: A Multi-perspectival Interpretative Phenomenological Analysis study
Authors: Moore Laura , Foley Sarah , Larkin Fionnuala 
Published: September 2024

Available research suggests autistic mothers experience greater dissatisfaction with maternity care compared to non-autistic mothers. Limited research exists exploring autistic mothers’ experiences of maternity care, and no research to date has considered maternity care professionals’ experiences of delivering care to autistic mothers. This qualitative study aims to explore the experiences of receiving and providing maternity care for autistic mothers. Data were collected using semi-structured interviews with four autistic mothers and four midwives. Data were analysed using Multi-perspectival Interpretative Phenomenological Analysis. Three overarching themes emerged: ‘challenges faced within maternity care, ‘the importance of the caring relationship’, and ‘the challenge of navigating competing demands and priorities’. Findings highlight the unique challenges experienced by autistic mothers during labour and birth, the need for increased autism awareness in midwifery, and further suggest universal changes to the delivery of maternity care which would benefit autistic women. Lay abstract Autistic mothers may experience unique challenges when accessing maternity care. A better understanding of the experience of autistic mothers and maternity care professionals would help to create opportunities to support better maternity care. In this study, we interviewed autistic mothers and professional midwives, living and working across the United Kingdom and Ireland. In the interviews, the autistic mothers recalled challenges they faced in the hospital settings, difficulties in communicating their needs, and distress when being physically examined. The midwives we interviewed brought their personal experiences of autism (some were autistic themselves, while others had autistic family members) and made efforts to accommodate autistic mothers where possible. This included paying attention to potential sensory issues, trying to establish a relationship with the mothers and communicating what was going on without medical jargon. However, the midwives were limited in their ability to fully attend to the needs of autistic mothers due to time and resource restraints. Both the midwives and autistic mothers felt that midwife-led births were more attentive to the needs of mothers. Based on our findings, we recommend further training and awareness on autism in midwifery and suggest that changes relating to sensory and communication challenges would benefit both autistic and non-autistic. Our study provides important insight into this experience of maternity care from two perspectives and emphasises the need for greater inclusivity in maternity care services.
Occupational prestige and future sickness absence and disability pension in women and men: a Swedish nationwide prospective cohort study
Authors: Hensing Gunnel , Müller Mira , Ulfsdotter Eriksson Ylva , Alexanderson Kristina , Farrants Kristin 
Published: September 2024

Background: Little is known about associations between occupational prestige, that is, the symbolic evaluation and social positioning of occupations, and sickness absence (SA) or disability pension (DP). We explored whether occupational prestige was associated with future SA or DP among women and men. Methods: A Swedish 4-year prospective cohort study of all those in paid work and aged 25–59 in 2010 ( N = 2,605,227; 47% women), using linked microdata from three nationwide registers and Standard International Occupational Prestige Scale values, categorised as ‘very low’, ‘low’, ‘medium’, ‘high’, or ‘very high’. Odds ratios (ORs), 95% confidence intervals (CIs), crude and adjusted for several sociodemographic factors, were calculated for three outcomes: at least one SA spell (>14 days), >90 SA days, or DP occurrence, during follow-up (2011–2013). Results: The mean number of SA days in 2010 varied by occupational prestige group, for example, ‘very high’: 3.0, ‘very low’: 6.5. Compared to those in occupations with ‘very high’ prestige, all other groups had higher adjusted ORs for all three outcomes. Among men, those with ‘very low’ occupational prestige had the highest OR for at least one SA spell: OR 1.51 (95% CI 1.47–1.56); among women, the ‘medium’ group had the highest OR: 1.30 (1.27–1.32). The results were similar for SA >90 days. OR for DP among women with ‘very low’ occupational prestige was 2.01 (1.84–2.19), and 3.55 (3.15–4.01) for men. Conclusions: Working in lower occupational prestige occupations was generally associated with higher odds of future SA/DP than working in higher prestige occupations; these associations were stronger for men than for women.
A shared decision-making intervention for individuals living with chronic obstructive pulmonary disease who are considering the menu of pulmonary rehabilitation treatment options; a feasibility study
Authors: Barradell AC , Doe G , Bekker HL , Houchen-Wolloff L , Robertson N , Singh SJ 
Published: September 2024

Objectives Shared Decision Making (SDM) has potential to support Pulmonary Rehabilitation (PR) decision-making when patients are offered a menu of centre- and home-based options. This study sought to evaluate the feasibility and acceptability of a three-component PR SDM intervention for individuals with Chronic Obstructive Pulmonary Disease (COPD) and PR healthcare professionals. Methods Participants were recruited from Dec 2021–Sep 2022. Healthcare professionals attended decision coaching training and used the consultation prompt during consultations. Individuals received the Patient Decision Aid (PtDA) at PR referral. Outcomes included recruitment capability, data completeness, intervention fidelity, and acceptability. Questionnaires assessed patient activation and decisional conflict pre and post-PR. Consultations were assessed using Observer OPTION-5. Optional interviews/focus groups were conducted. Results 13% of individuals [ n = 31, 32% female, mean (SD) age 71.19 (7.50), median (IQR) MRC dyspnoea 3.50 (1.75)] and 100 % of healthcare professionals ( n = 9, 78% female) were recruited. 28 (90.32%) of individuals completed all questionnaires. SDM was present in all consultations [standardised scores were mean (SD) = 36.97 (21.40)]. Six healthcare professionals and five individuals were interviewed. All felt consultations using the PtDA minimised healthcare professionals’ bias of centre-based PR, increased individuals’ self-awareness of their health, prompted consideration of how to improve it, and increased involvement in decision-making. Discussion Results indicate the study processes and SDM intervention is feasible and acceptable and can be delivered with fidelity when integrated into the PR pathway.
Transformation of zinc acetate into ZnO nanofibers for enhanced NOx gas sensing: Cost-effective strategies and additive-free optimization
Authors: Khomarloo Niloufar , Bagherzadeh Roohollah , Gidik Hayriye , Mohsenzadeh Elham , Latifi Masoud , Debliquy Marc , Ly Ahmadou , Lahem Driss 
Published: September 2024

Gas sensors based on ZnO nanocomposites have been widely investigated for the detection of various gases. However, few studies have reported electrospun ZnO for NOx gases, especially NO (nitrogen monoxide), due to its high tendency for oxidation upon contact with air. The development of gas sensors that operate at temperatures below 300°C is challenging for metal oxide gas sensors, as decreasing the temperature can lead to lack of sensitivity and very long recovery times. In this study, the operating temperature was improved to 200°C while achieving a high response to a low concentration of 0.5 ppm gas, with recovery times of 572s and 105s for NO and NO2 (nitrogen dioxide), respectively. Detecting NO and NO2 at low ppm and ppb levels is a major demand and challenge for the development of metal oxide-based gas sensors, especially for health monitoring portable sensors. This study focuses on the design and performance of a NOx gas sensor based on ZnO nanofibrous material with precise structural optimization. The study optimizes the precursor for electrospinning without using any additives. The sensing materials proportion were optimized by changing the ratio of ZnAc:PVA in the precursor of electrospinning solution. Choosing ZnAc:PVA = 1.5 as the optimum precursor for synthesizing ZnO nanofibers resulted in the highest response of 27 and 16 (Ohm/Ohm) for 0.5 ppm NO and NO2, respectively, at 200°C and relative humidity of 50%. Additionally, reproducible sensors were developed, which is crucial for mass production. This remarkable sensitivity in low concentration indicates that the design of material structure and the control of zinc acetate amount in the electrospun solution has great practical applications to detect both gases.
Emblica officinalis Gaertn as a Potential Alternative Therapy for the Treatment of Epilepsy: An Animal Study
Authors: Rivadeneyra-Domínguez Eduardo , Zamora-Bello Isaac , Rodríguez-Landa Juan Francisco , Ortega-García Armando Alejandro , Rosales-Sánchez Óscar 
Published: September 2024

Introduction: Epilepsy is a neurological disorder characterized by recurrent seizures. Although antiepileptic drugs (AEDs) reduce the frequency of epileptic seizures, they can cause renal and hepatic damage. Several preclinical studies have indicated that Emblica officinalis Gaertn (AMLA) exerts an anticonvulsant effect related to its tannin and polyphenol content. Objective: We aim to evaluate the anticonvulsant effects of chronic oral AMLA administration and its impact on biochemical and hematological parameters in rats. Methods: Twenty-eight male Wistar rats (250 to 300 g) were divided into four experimental groups (n = 7): vehicle (purified water), AMLA (500 and 700 mg/kg), and carbamazepine (CBZ) (300 mg/kg) as the pharmacological control of anticonvulsant activity. Treatments were administered orally every 24 hours for 28 days, while carbamazepine was administered every 48 hours for 5 days before the behavioral, biochemical, and hematological test. On day 29, Status epilepticus (SE) was induced using the lithium-pilocarpine model (3 mEq/kg, i. p. and 30 mg/kg, s. c.), after which the behavioral and biochemical effects were evaluated. Results: The AMLA 500 mg/kg and CBZ 300 mg/kg groups presented fewer phase V seizures than the vehicle group did. None of the treatments modified biochemical or hematological parameters. Conclusion: AMLA could be considered as a potential alternative therapy for the treatment of epilepsy.
Social support within couples coping with Parkinson's disease
Authors: Martin Summer C 
Published: September 2024

Objectives To contribute to a better understanding of the complexities of social support exchanged within couples coping with Parkinson's disease (PD), the present study aimed to identify costs and complications of support between persons with PD (PWPs) and their partners, as well as how to effectively manage such challenges. Methods In-depth interviews were conducted with 63 participants, including 31 PWPs and 32 partners. Interviews were transcribed and analyzed using constant comparative techniques. Results Participants reported the following complications and costs of social support: partners’ differing approaches to coping can make support difficult, support can be perceived as identity-threatening and controlling, support can lead to dependency, and support can be draining. In addition, participants discussed effectively managing challenges of support by seeking/providing support subtly, taking the other's perspective, and relinquishing control. Discussion In health care and interventions, it is important for PWPs and partners to be educated about social support so that couples can anticipate these costs and complications of support and consider which management strategies are likely to be effective for them in various circumstances.
The importance of social oocyte cryopreservation in supporting local municipalities: A prospective study
Authors: Ohno Motoharu , Kikuchi Iwaho , Kagawa Noriko , Shinozaki Ikumi , Shirosaki Yuka , Ichiyama Takuhiko , Makino Shintaro , Yoshida Koyo 
Published: September 2024

Background: With the trend toward late marriages and late childbearing, cryopreservation of oocytes for fertility preservation is attracting attention as a method to counteract the declining birthrate. Objectives: To examine the impact of social oocyte cryopreservation on local communities by assessing the significance of government assistance for cryofreezing and capturing the participants’ subsequent feelings regarding this assistance. Design: Descriptive study Methods: A prospective study was conducted on city-dwelling women <35 years old attending monthly seminars on oocyte retrieval/cryopreservation to whom the study concept was explained. Egg collection and storage management costs were free for 3 years after the project completed, and subsequent actual storage costs were borne by the individuals. After oocyte retrieval, we conducted a questionnaire on oocyte cryopreservation and administrative assistance. Results: Of the 62 seminar participants, 2 became pregnant naturally without oocyte retrieval. Oocytes were retrieved in 34 women (average age: 32.8 years, number of oocytes obtained: 8.3), among whom 4 subsequently became pregnant and gave birth through natural pregnancy or artificial insemination, and 1 became pregnant and gave birth using frozen oocytes. In a follow-up questionnaire given to these 34 subjects, all responded that they were glad to have oocyte cryopreservation, but 23 subjects (67.6%) answered that they could not perform cryopreservation without financial assistance. Twenty-five participants (73.5%) wanted to try to conceive without using frozen oocytes as a post-cryopreservation plan. Conclusions: As a countermeasure against the declining birthrate, oocyte cryopreservation and associated workshops that can provide the information and education needed to conduct this task in a “planned” manner may be useful in providing women with additional reproductive options. Financial assistance will also be required to offer this service to the women who need it.
A lifetime economic model of mortality and secondary care use for patients discharged from hospital following acute stroke
Authors: McMeekin Peter , McCarthy Stephen , McCarthy Andrew , Porteous Jennifer , Allen Michael , Laws Anna , White Phil , James Martin , Ford Gary A , Shaw Lisa , Price Christopher I 
Published: September 2024

Background: The long-term health-economic consequences of acute stroke are typically extrapolated from short-term outcomes observed in different studies, using models based on assumptions about longer-term morbidity and mortality. Inconsistency in these assumptions and the methods of extrapolation can create difficulties when comparing estimates of lifetime cost-effectiveness of stroke care interventions. Aims: To develop a long-term model consisting of a set of equations to estimate the lifetime effects of stroke care interventions to promote consistency in extrapolation of short-term outcomes. Methods: Data about further admissions and mortality were provided for acute stroke patients discharged between 2013 and 2014 from a large English service. This was combined with data from UK life tables to create a set of parametric equations in a model that use age, sex, and modified Rankin Scores to predict the lifetime risk of mortality and secondary care resource utilization including ED attendances, non-elective admissions, and elective admissions. A cohort of 1509 (male 51%; mean age 74) stroke patients had median follow-up of 7 years and represented 7111 post-discharge patient years. A logistic model estimated mortality within 12 months of discharge, and a Gompertz model was used over the remainder of the lifetime. Hospital attendances were modeled using a Weibull distribution. Non-elective and elective bed days were both modeled using a log-logistic distribution. Results: Mortality risk increased with age, dependency, and male sex. Although the overall pattern was similar for resource utilization, there were different variations according to dependency and gender for ED attendances and non-elective/elective admissions. For example, 65-year-old women with a mRS at discharge of 1 would gain an extra 6.75 life years compared to 65-year-old women with a mRS at discharge of 3. Over their lifetime, 65-year-old women with an mRS at discharge of 1 would experience 0.09 less ED attendances, 2.12 less non-elective bed days, and 1.28 additional elective bed days than 65-year-old women with an mRS at discharge of 3. Conclusions: Using long-term follow-up publicly available data from a large clinical cohort, this new model promotes standardized extrapolation of key outcomes over the life course and potentially can improve the real-world accuracy and comparison of long-term cost-effectiveness estimates for stroke care interventions. Data assess statement: Data are available upon reasonable request from third parties.
Procedural times with robotic-assisted bronchoscopy: a high volume single-center study
Authors: Styrvoky Kim , Schwalk Audra , Pham David , Madsen Kristine , Chiu Hsienchang , Abu-Hijleh Muhanned 
Published: September 2024

Background: Incidental and screen-detected pulmonary nodules are common. The increasing capabilities of advanced diagnostic bronchoscopy will increase bronchoscopists’ procedural volume necessitating optimization of procedural scheduling and workflow. Objectives: The objectives of this study were to determine total time in the procedure room, total bronchoscopy procedure time, and robotic-assisted bronchoscopy procedure time longitudinally and per specific procedure performed. Design: A single-center observational study of all consecutive patients undergoing shape-sensing robotic-assisted bronchoscopy (RAB) biopsy procedures for the evaluation of pulmonary lesions with variable probability for malignancy. Methods: Chart review to collect patient demographics, lesion characteristics, and procedural specifics. Descriptive and comparative statistics are reported. Results: Actual bronchoscopy procedure time may decrease with increased institutional experience over time, however, there is limited ability to reduce non-bronchoscopy related time within the procedure room. The use of cone beam computed tomography (CBCT), rapid on-site evaluation (ROSE), and performance of staging endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) in a single procedure are each associated with additional time requirements. Conclusion: Institutional procedural block times should adapt to the nature of advanced diagnostic bronchoscopy procedures to allow for the accommodation of new modalities such as RAB combined with other technologies including radial endobronchial ultrasound, CBCT, ROSE, and staging linear EBUS. Identifying institutional median procedural times may assist in scheduling and ideal block time utilization.
Genetic landscape of homologous recombination repair and practical outcomes of PARPi therapy in ovarian cancer management
Authors: Chen Mengyu , Lei Ningjing , Guo Ruixia , Han Liping , Zhao Qinghe , Zhao Yang , Qiu Luojie , Wu Fengling , Jiang Shan , Tong Ningyao , Wang Kunmei , Li Siyu , Chang Lei 
Published: September 2024

Background: Genetic studies of ovarian cancer (OC) have historically focused on BRCA1/2 mutations, lacking other studies of homologous recombination repair (HRR). Poly (ADP-ribose) polymerase inhibitors (PARPi) exploit synthetic lethality to significantly improve OC treatment outcomes, especially in BRCA1/2 deficiency patients. Objectives: Our study aims to construct a mutation map of HRR genes in OC and identify factors influencing the efficacy of PARPi. Design: A retrospective observational analysis of HRR gene variation data from 695 OC patients from March 2019 to February 2022 was performed. Methods: The HRR gene variation data of 695 OC patients who underwent next-generation sequencing (NGS) in the First Affiliated Hospital of Zhengzhou University were retrospectively collected. Clinical data on the use of PARPi in these patients were also gathered to identify factors that may interfere with the efficacy of PARPi. Results: Out of 127 pathogenic variants in the BRCA1/2 genes, 104 (81.9%) were BRCA1 mutations, and 23 (18.1%) were BRCA2 mutations. Among the 59 variants of uncertain significance (VUS), 20 (33.9%) were BRCA1, while 39 (66.1%) were BRCA2 mutations. In addition to BRCA1/2, HRR gene results showed that 9 (69%) of 13 were HRR pathway pathogenic variants; and 16 (1.7%) of 116 VUS were Food and Drug Administration (FDA)-approved mutated HRR genes. Notably, the treatment regimen significantly influenced the effectiveness of PARPi, especially when using first-line maintenance therapy, leading to enhanced progression-free survival (PFS) compared to alternative protocols. Conclusion: Focusing on HRR gene mutations and supporting clinical research about PARPi in OC patients is crucial for developing precision treatment strategies and enhancing prognosis.
Electronic Health Record Alert With Heart Failure Risk and Sodium Glucose Cotransporter 2 Inhibitor Prescriptions in Diabetes: A Randomized Clinical Trial
Authors: Segar Matthew W. , Patel Kershaw V. , Keshvani Neil , Kannan Vaishnavi , Willett Duwayne , Klonoff David C. , Pandey Ambarish 
Published: September 2024

Background: Sodium glucose cotransporter 2 inhibitors (SGLT2i) prevent heart failure (HF) in patients with type 2 diabetes mellitus (T2DM) but prescription rates are low. The effect of an electronic health record (EHR) alert notifying providers of patients’ estimated risk of developing HF on SGTL2i prescriptions is unknown. Methods: This was a pragmatic, randomized clinical trial that compared an EHR alert and usual care among patients with T2DM and no history of HF or SGLT2i use at a single center. The EHR alert notified providers of their patient’s HF risk and recommended HF prevention strategies. Randomization was performed at the provider level across general and subspecialty internal medicine as well as family medicine outpatient clinics. The primary outcome was proportion of SGLT2i prescriptions within 30 days. Proportion of natriuretic peptide (NP) tests within 90 days was also assessed. Results: A total of 1524 patients (median age 75 years, 45% women, 23% Black) were enrolled between September 28, 2021, and April 29, 2022 from 189 outpatient clinics. SGLT2i were prescribed to 1.2% (9/780) of patients in the EHR alert group and 0% (0/744) of those in the usual care group ( P value = 0.009). Natriuretic peptide testing was performed within 90 days among 10.8% (84/780) of patients in the EHR alert group and 7.3% (54/744) of patients in the usual care group ( P value = 0.02). Conclusions: In a single-center trial with low overall SGLT2i use, an EHR alert incorporating HF risk information significantly increased SGLT2i prescriptions and NP testing although the absolute rates were low.