bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healing Havens: How Evidence-Based Design is Transforming Medical Spaces Into Therapeutic Environments
Authors: Sabet Cameron , Hammond Alessandro , Marzouk Sammer 
Published: October 2024

Objectives To explore how evidence-based design is transforming healthcare environments into transforming spaces that improve patient outcomes and staff experiences. Background Traditional hospital designs often prioritize functionality over patient and staff well-being. This editorial examines the shift toward evidence-based design in healthcare facilities. Methods We review recent studies and case examples demonstrating the impact of thoughtful healthcare design on infection rates, patient recovery, and staff performance. Results Evidence shows that elements such as private rooms, access to nature, and improved lighting can significantly reduce infections, accelerate healing, and enhance staff satisfaction. Conclusions Implementing evidence-based design principles in healthcare environments can lead to measurable improvements in patient outcomes, staff performance, and overall healthcare quality.
Patterns of Arterial Wall Lesions in Eagle Syndrome: Case Series and Literature Review
Authors: Constant dit Beaufils Pacôme , Gaalon Solène de , Ferron Christophe , Marc Guillaume , Auffray-Calvier Elisabeth , Daumas-Duport Benjamin , Guillon Benoît 
Published: October 2024

Background: Impingement of an elongated styloid process (ESP) or calcified stylohyoid ligament on surrounding neck structures defines Eagle syndrome. The vascular variant, also called stylocarotid syndrome, results from impingement of vascular structures and remains poorly known among physicians. Research Design: We report our own experience and review the literature in order to clarify the diagnostic and therapeutic management. Patients with vascular events in relation to an ESP and hospitalized at our institution were extracted from our databank and retrospectively reviewed. We also performed a comprehensive review of the literature on Eagle syndrome using PubMed® and Google Scholar, analysing the presentation, management, and follow-up. Results: We report five cases of the vascular variant of Eagle syndrome: one carotid perforation, one focal arteriopathy, one with both acute and chronic dissection and two acute internal carotid dissection. Vascular compression, whether permanent or transient, is also reported in the literature. Management varies, although styloidectomy is deemed appropriate for symptomatic compression, while stenting is preferred in cases of perforation. Conclusions: A common definition of Eagle syndrome is required for better diagnosis and management. The choice of styloidectomy is understandable for compression but remains to be investigated in other cases.
Relationship of Forearm-Hand Inertia With Throwing Motion Patterns and Elbow Valgus Load in Adolescent Baseball Players
Authors: Tsutsui Toshiharu , Sakamaki Wataru , Maemichi Toshihiro , Torii Suguru 
Published: October 2024

Background: Growth-specific physical characteristics in adolescence may mediate throwing-related loads and movement patterns associated with elbow injuries. In a previous study, the authors calculated the forearm-hand inertia, which is the moment of inertia centered at the elbow joint. Purpose: To determine the relationship of forearm-hand inertia values with throwing motion patterns and elbow valgus load in adolescent baseball players. Study Design: Descriptive laboratory study. Methods: A total of 35 adolescent baseball players underwent measurements by dual-energy x-ray absorptiometry (DXA) scans and a throwing trial. Forearm-hand inertia was determined as the joint moment around the elbow using the subregion analysis mode of DXA. Elbow valgus torque and ball speed during throwing were measured using a dedicated sensor and speed gun, and throwing efficiency was calculated by dividing the elbow valgus load by the ball speed. Players were divided according to the throwing motion pattern in which maximum acceleration occurred: pelvis–upper arm–forearm (proximal-to-distal sequencing [PDS] group; n = 19) or pelvis-forearm–upper arm (proximal upper extremity [PUE] group; n = 16). The groups were compared in terms of ball speed, elbow valgus torque, throwing efficiency, and forearm-hand inertia using t tests and analysis of covariance, with forearm-hand inertia as covariates. The chi-square test was used to examine the relationship between throwing motion patterns and forearm-hand inertia. Results: The PUE group had a higher elbow valgus load (effect size [ES] = 0.65; P = .03), throwing efficiency (ES = 0.63; P = .02), and forearm-hand inertia values (ES = 0.64; P = .04) than the PDS group. In addition, a significant relationship was observed with throwing patterns when forearm-hand inertia values were 350 kg·m2 (OR, 2.36; 95% CI, 1.09-5.12; P = .012) and 400 kg·m2 (OR, 1.68; 95% CI, 0.99-2.85; P = .037). Conclusion: Study results indicated that growth-specific physical characteristics in adolescent baseball players exhibited in forearm-hand inertia mediated the relationship between high elbow valgus and poor throwing efficiency caused by poor throwing motion patterns. Clinical Relevance: A better understanding of the details in muscle function with throwing mechanics may prevent future injuries.
Long-term Outcomes of Complete Tears of the Distal Biceps Tendon: An Analysis of Surgical Management at a Median Follow-up of 14.7 Years
Authors: Tagliero Adam J. , Till Sara E. , Pan Xuankang , Reinholz Anna K. , Johnson Adam C. , Sanchez-Sotelo Joaquin , Barlow Jonathan D. , Camp Christopher L. 
Published: October 2024

Background: Surgical repair of full thickness biceps tears has demonstrated adequate outcomes in short and mid-term studies. However, data on the long-term outcomes of full thickness distal biceps injuries and their treatment are currently lacking. Purpose/Hypothesis: The purpose of this study was to report on patient demographics, injury characteristics, and long-term outcomes for patients with full-thickness distal biceps tears. It was hypothesized that complete distal biceps tears managed operatively would demonstrate robust clinical success at long-term follow-up. Study Design: Case series; Level of evidence, 4. Methods: Patients with magnetic resonance imaging–confirmed, complete distal biceps tendon rupture sustained between 1996 and 2016 were identified. Patients were cross-referenced with a regional geographic database. Results: A total of 66 patients (3 female, 63 male) with a median age of 50.8 years (IQR, 41.5-60.4) and a median clinical follow-up of 14.7 years (IQR, 9.6-17.9 years) were included. Patients who sustained a full-thickness distal biceps tendon tear were likely to be in their early 50s, male, right-hand dominant, current/former smokers, and laborers with a history of traumatic injury during an intentional movement. Most of these patients had pain and supination weakness but no loss of range of motion. All included tears were treated operatively. At final follow-up, patients maintained a majority of near-normal range of motion (median total arc of flexion/extension 140° and supination/pronation 80°), excellent elbow flexion strength (91% of patients had full strength), and adequate elbow supination strength (76% of patients had full strength). The overall complication rate was 24%, with 16 out of 66 patients experiencing some type of complication between infection, rerupture, heterotopic ossification, reoperation, and nerve complications. Overall return to work was 98%, and 85% of those who returned to work did so without restrictions. Conclusion: Complete tears of the distal biceps were most common in patients 50 years of age, male sex, right-hand dominant, and current/former smokers. The most common profession was laborer, and injuries were primarily traumatic in nature during intentional activity. Patients managed operatively demonstrated high rates of success at long-term follow-up with respect to elbow function and clinical outcomes.
Nurses’ Perceptions of Nurse–Physician Collaboration and Quality of Care in Public Hospitals
Authors: Al-Bustanji Muhammad Fuad , Rayan Ahmad , Eshah Nidal F. , Masa'deh Rami , Baqeas Manal Hassan , Rayyan Nadin , Rayyan Deema , ALBashtawy Mohammed 
Published: October 2024

Introduction Nurse–physician collaboration is a fundamental part of the healthcare information flow, while poor or improper collaboration could result in poor healthcare outcomes and increased medical errors. Objective This study investigated the relationship between nurse–physician collaboration and the perceived quality of healthcare services offered in Jordanian public hospitals, and associated factors. Methods A descriptive correlational research design was used. A sample of 385 nurses employed in five Jordanian public hospitals was recruited. Nurse–Physician Collaboration Scale was used to assess collaboration, while the HEALTHQUAL scale was used to evaluate healthcare service quality. The IBM SPSS software (version 26) was used to analyze the data. Results There was a positive correlation between nurse–physician collaboration and the perceived quality of healthcare services provided to patients ( r = 0.778, p < .01). There was variability in the perception of nurse–physician collaboration based on gender, RN-to-patient staffing ratios, age, and income level ( p < .05). No association was found between nurses’ demographics and their perceptions of the quality of healthcare services provided to patients. Conclusions Healthcare organizations should implement effective practices to promote nurse–physician collaboration, which could subsequently improve the quality of tangible services provided to patients.
The presence of a ghost infarct core is associated with fast core growth in acute ischemic stroke
Authors: Saito Mikito , Kawano Hiroyuki , Adachi Takuya , Gomyo Miho , Yokoyama Kenichi , Shiokawa Yoshiaki , Hirano Teruyuki 
Published: October 2024

Introduction: The overestimation of ischemic core volume by CT perfusion (CTP) is a critical concern in the selection of candidates for reperfusion therapy. This phenomenon is termed a ghost infarct core (GIC). Core growth rate (CGR) is an indicator of ischemic severity. We aimed to elucidate the association between GIC and CGR. Patients and methods: Consecutive patients with acute ischemic stroke who underwent mechanical thrombectomy in our institute from March 2017 to July 2022 were enrolled. The initial ischemic core volume (IICV) was measured by pretreatment CTP, and the final infarct volume (FIV) was measured by diffusion-weighted imaging. A GIC was defined by IICV minus FIV > 10 ml. The CGR was calculated by dividing the IICV by the time from onset to CTP. Univariable analysis and a multivariable logistic regression model were used to evaluate the association between GIC-positive and CGR. Results: Of all 91 patients, 21 (23.1%) were GIC-positive. The GIC-positive group had higher CGR (14.2 [2.6–46.7] vs 4.8 [1.6–17.1] ml/h, p = 0.02) and complete recanalization ( n = 15 (71.4%) vs 29 (41.4%), p = 0.02) compared to the GIC-negative group. On receiver-operating characteristic curve analysis, the optimal cutoff point of CGR to predict GIC-positive was 22 ml/h (sensitivity, 0.48; specificity, 0.85; AUC, 0.67). Multivariable logistic regression analysis showed that CGR ⩾ 22 ml/h (OR 6.44, 95% CI [1.59–26.10], p = 0.01) and complete recanalization (OR 3.72, 95% CI [1.14–12.08], p = 0.02) were independent predictors of GIC-positive. Conclusions: A GIC was associated with fast CGR in acute ischemic stroke. Overestimation of the initial ischemic core may be determined by core growth speed.
Utilization of Diabetes Self-Management Education and Support Among Medicare Beneficiaries Newly Diagnosed With Diabetes in Arkansas, 12 Months Postdiagnosis (2015-2018)
Authors: Rezaeiahari Mandana , Acharya Mahip , Henske Joseph , Owsley Kelsey , Bodenhamer Jodi 
Published: October 2024

Purpose The purpose of the study was to determine the rate of diabetes self-management education and support (DSMES) utilization among Medicare fee-for-service (FFS) and Medicare Advantage (MA) populations with type 2 diabetes in Arkansas. Methods The Arkansas All-Payer Claims Database was used to identify Medicare FFS and MA beneficiaries diagnosed with type 2 diabetes from 2015 to 2018. Claims from 2013 to 2020 were analyzed to determine newly diagnosed individuals from 2015 to 2018. The criteria included 1 outpatient diabetes claim in the index year and at least 1 inpatient or outpatient claim in the 2 years following the initial claim. A total of 15 648 Medicare FFS individuals and 7520 MA individuals with newly diagnosed type 2 diabetes were identified. The use of DSMES 1 year following the diagnosis dates for both Medicare FFS and MA populations was assessed. Descriptive statistics and multiple logistic regression analyses were conducted to understand the factors associated with DSMES utilization. Results DSMES utilization consistently remained lower in the MA population compared to Medicare FFS (2.3% vs 4.9%). The adjusted analysis indicated that factors such as older age, living in a rural area, belonging to a racial group other than White, and MA enrollment were associated with a lower likelihood of receiving DSMES. Conclusions DSMES utilization in Arkansas, where the prevalence of diabetes is higher than the national average, is notably low. There is a need for coordinated efforts at various levels to enhance access to DSMES.
Mosaic loss of chromosome Y, tobacco smoking and risk of age-related lung diseases: insights from two prospective cohorts
Authors: Weng Chenghao , Zhao Yuxuan , Song Mingyu , Shao Zilun , Pang Yuanjie , Yu Canqing , Pei Pei , Yang Ling , Millwood Iona Y. , Walters Robin G. , Chen Yiping , Du Huaidong , Chen Junshi , Chen Zhengming , Genovese Giulio , Terao Chikashi , Lv Jun , Li Liming , Sun Dianjianyi 
Published: October 2024

BackgroundLittle is known about the underlying relationship between mosaic loss of chromosome Y (mLOY), the most common chromosomal alterations in older men, and the risk of age-related lung diseases.MethodsWe included 217 780 participants from the UK Biobank (UKB) and 42 859 participants from the China Kadoorie Biobank. The mLOY events were detected using the Mosaic Chromosomal Alterations (MoChA) pipeline. Outcomes included all lung diseases, COPD, lung cancer and idiopathic pulmonary fibrosis (IPF). Cox proportional hazard models were fitted to estimate the hazard ratios and 95% confidence intervals of mLOY with lung diseases in both cohorts. The combined hazard ratios were derived from meta-analysis.ResultsResults from the two cohorts showed that expanded mLOY was associated with increased risks of all lung diseases (HR 1.19 (95% CI 1.04–1.36)), COPD (HR 1.20 (95% CI 1.13–1.28)), lung cancer (HR 1.34 (95% CI 1.21–1.48)) and IPF (HR 1.34 (95% CI 1.16–1.56) in the UKB). There was evidence of positive interactions between mLOY and smoking behaviour (relative excess risk due to interaction (97.5% CI) >0). Additionally, we observed that current smokers with expanded mLOY had the highest risk of incident lung diseases in both cohorts.ConclusionsmLOY may be a novel predictor for age-related lung diseases. For current smokers carrying mLOY, adopting quitting smoking behaviour may contribute to substantially reducing their risk of incident lung diseases.
Machine learning classification of archaea and bacteria identifies novel predictive genomic features
Authors: Bobbo Tania , Biscarini Filippo , Yaddehige Sachithra K. , Alberghini Leonardo , Rigoni Davide , Bianchi Nicoletta , Taccioli Cristian 
Published: October 2024

Abstract
Background
Archaea and Bacteria are distinct domains of life that are adapted to a variety of ecological niches. Several genome-based methods have been developed for their accurate classification, yet many aspects of the specific genomic features that determine these differences are not fully understood. In this study, we used publicly available whole-genome sequences from bacteria ($$N=2546$$

N
=
2546

) and archaea ($$N=109$$

N
=
109

). From these, a set of genomic features (nucleotide frequencies and proportions, coding sequences (CDS), non-coding, ribosomal and transfer RNA genes (ncRNA, rRNA, tRNA), Chargaff’s, topological entropy and Shannon’s entropy scores) was extracted and used as input data to develop machine learning models for the classification of archaea and bacteria.

Results
The classification accuracy ranged from 0.993 (Random Forest) to 0.998 (Neural Networks). Over the four models, only 11 examples were misclassified, especially those belonging to the minority class (Archaea). From variable importance, tRNA topological and Shannon’s entropy, nucleotide frequencies in tRNA, rRNA and ncRNA, CDS, tRNA and rRNA Chargaff’s scores have emerged as the top discriminating factors. In particular, tRNA entropy (both topological and Shannon’s) was the most important genomic feature for classification, pointing at the complex interactions between the genetic code, tRNAs and the translational machinery.

Conclusions
tRNA, rRNA and ncRNA genes emerged as the key genomic elements that underpin the classification of archaea and bacteria. In particular, higher nucleotide diversity was found in tRNA from bacteria compared to archaea. The analysis of the few classification errors reflects the complex phylogenetic relationships between bacteria, archaea and eukaryotes.
Comparative analysis of MitraClip/TriClip and PASCAL in transcatheter tricuspid valve repair for tricuspid regurgitation: a systematic review and meta-analysis
Authors: Balata Mahmoud , Gbreel Mohamed Ibrahim , Hassan Marwa , Becher Marc Ulrich 
Published: October 2024

Abstract
Background
The edge-to-edge transcatheter tricuspid valve repair (TTVR) has emerged as a promising technique for the treatment of tricuspid regurgitation (TR). Despite its potential, comparative data on the performance of the novel edge-to-edge devices—MitraClip, PASCAL, and TriClip—remain controversial. In this study, we aim to evaluate the safety and efficacy of these devices in treating TR.

Methods
Five databases were systematically searched up to May 2023, with an updated search conducted in May 2024. Only original studies were included in the analysis and were critically evaluated using an adapted version of the Newcastle-Ottawa Scale (NOS) for observational cohort studies and the Cochrane Risk of Bias (ROB) tool for randomized controlled trials.

Results
The database search yielded 2239 studies, out of which 21 studies were included in the final analysis. These studies encompassed a total of 2178 patients who underwent TTVR using either the MitraClip, TriClip, or PASCAL devices. The risk of bias across these studies ranged from moderate to high. No significant differences were found among the three devices in terms of effective regurgitant orifice area (EROA) and tricuspid regurgitant volume. However, TriClip demonstrated statistically superior efficacy in reducing vena contracta compared to both MitraClip and PASCAL (P < 0.01) [TriClip: (MD = -7.4; 95% CI: -9.24, -5.56), MitraClip: (MD = -4.04; 95% CI: -5.03, -3.05), and PASCAL: (MD = -6.56; 95% CI: -7.76, -5.35)]. The procedural success rates and incidence of single leaflet device attachment (SLDA) were similar across all devices. Furthermore, there were no significant differences in mortality, stroke rates, or major bleeding events among the three devices.

Conclusion
The TriClip outperforms the MitraClip and PASCAL in reducing vena contracta width, indicating greater effectiveness for severe tricuspid regurgitation. All devices show similar safety profiles and procedural success rates. Further research is needed to confirm these results.
The feasibility and acceptability of engaging older adults living with multiple long-term conditions, frailty, and a recent deterioration in health in research: Findings from the Lifestyle in Later Life – Older People’s Medicine (LiLL-OPM) study
Authors: Hurst Christopher , Dismore Lorelle , Granic Antoneta , Noble Jane M. , Hillman Susan J. , Witham Miles D. , Sayer Avan A. , Dodds Richard M. , Robinson Sian M. 
Published: October 2024

Abstract
Background
Older adults living with multiple long-term conditions (MLTC, also known as multimorbidity) and frailty are more likely to experience a deterioration in their health requiring specialist referral or hospital admission than individuals without these syndromes. However, this group of older people are underserved by research meaning that there is a limited evidence base for their care. This study therefore aimed (1) to determine if it is feasible to recruit and collect quantitative data to describe the health and lifestyle of older adults living with MLTC, frailty and a recent deterioration in health and (2) to assess if taking part in research is acceptable to this group of older adults.

Methods
Participants were approached and recruited for this study via an Older People’s Medicine Day Unit in Newcastle upon Tyne, UK. The study took a mixed methods approach, involving quantitative and qualitative data collection. To determine the feasibility of carrying out research in this group, we quantified recruitment rate and collected data on the health and lifestyle, including diet and physical activity, of the participants. Qualitative semi-structured interviews were undertaken to assess acceptability. Two separate interviews were carried out focusing on involving older adults in research and the participants’ experiences of taking part in the research. Interviews were analysed using thematic analysis.

Results
Fifty patients were approached to participate in the study with twenty-nine (58%) successfully recruited. It was feasible to collect information to describe the health and lifestyle of these older adults who demonstrated very low levels of physical activity. Participants reported that taking part in the research was acceptable to them with interview analysis generating three themes (1) developing a meaningful partnership, (2) enabling factors to participation: research at home with flexible delivery and (3) social and psychological benefits of research participation.

Conclusions
It is feasible and acceptable to recruit and carry out research with this underserved group of older adults. Participants found taking part in this research to be acceptable and reported overall positive experiences of their involvement in the study and indicated that they would be willing to contribute to further research in the future.