bluuebunny/crossref_metadata_2025_split huggingface dataset:
Construct validity, responsiveness and minimal important difference of the cumulated ambulation score in older adults with hip fracture in sub-acute rehabilitation facility
Authors: Arcolin Ilaria , Giardini Marica , Corna Stefano , Sartorio Francesco , Caligari Marco , Godi Marco 
Published: April 2024

Objective To assess the construct validity, responsiveness and minimal important difference of the cumulated ambulation score in patients with hip fracture in sub-acute rehabilitation facility. Design Observational, prospective, monocenter, cohort study. Setting Rehabilitation Institute. Participants 456 older adults with hip fracture (≥65 years) admitted for inpatient rehabilitation. Main outcome measures Cumulated ambulation score, functional independence measure and functional ambulation category were collected at admission and discharge. Construct validity and responsiveness were assessed through hypothesis testing and minimal important difference was determined using the anchor-based method; floor and ceiling effects were also assessed. Results The cumulated ambulation score showed strong correlations with the functional independence measure and functional ambulation category scores at both admission and discharge, satisfying all the hypotheses for construct validity. The effect size of cumulated ambulation score was 1.63. Changes in cumulated ambulation score had a moderate-to-strong correlation with changes of other instruments and were able to discriminate patients improved from those not-improved, and patients classified as independent ambulators from those dependent. A ceiling effect was found only at discharge. The estimated minimal important difference was 2 points. Conclusions The cumulated ambulation score showed high levels of construct validity and responsiveness according to the hypothesis testing. A two points improvement at the end of rehabilitation was found to be clinically important in people with hip fracture in the sub-acute phase. The ceiling effect found at discharge suggested the limitation of the scale in assessing people with a partially recovered autonomy in performing postural changes and gait.
Deep learning in the radiologic diagnosis of osteoporosis: a literature review
Authors: He Yu , Lin Jiaxi , Zhu Shiqi , Zhu Jinzhou , Xu Zhonghua 
Published: April 2024

Objective Osteoporosis is a systemic bone disease characterized by low bone mass, damaged bone microstructure, increased bone fragility, and susceptibility to fractures. With the rapid development of artificial intelligence, a series of studies have reported deep learning applications in the screening and diagnosis of osteoporosis. The aim of this review was to summary the application of deep learning methods in the radiologic diagnosis of osteoporosis. Methods We conducted a two-step literature search using the PubMed and Web of Science databases. In this review, we focused on routine radiologic methods, such as X-ray, computed tomography, and magnetic resonance imaging, used to opportunistically screen for osteoporosis. Results A total of 40 studies were included in this review. These studies were divided into three categories: osteoporosis screening (n = 20), bone mineral density prediction (n = 13), and osteoporotic fracture risk prediction and detection (n = 7). Conclusions Deep learning has demonstrated a remarkable capacity for osteoporosis screening. However, clinical commercialization of a diagnostic model for osteoporosis remains a challenge.
The inertia of anger and sadness among adolescents and adults: The role of self-efficacy in regulating negative emotions
Authors: Manfredi Lucia , López-Pérez Belén , Gregori Fulvio , Lundie David , Shannon Lee , Zuffianò Antonio 
Published: April 2024

Emotional inertia (i.e., the resistance to change of emotional states) is an index of regulatory deficit linked to psychological maladjustment. Using ecological momentary assessment, we explored the role of Self-efficacy in Regulating Negative Affect (SRN), as a baseline measure, to buffer sadness and anger inertia, measured three times a day over 28 days in two samples from the UK: (1) adults ( n = 166 adults; Mage = 35.71, SD = 12.96; 73% women) and (2) adolescents ( n = 82 adolescents; Mage 14.88, SD = 1.34; 72% girls). Dynamic Structural Equation Modeling showed that both sadness and anger had significant levels of inertia. Importantly, the inertia of sadness was weakened by high levels of SRN among both adults and adolescents ( β = −.211, 95% CI [−.303, −.112]; and β = −.485, 95% CI [−.707, −.162], respectively). No buffering effect of SRN was found for the inertia of anger. These findings suggest the importance of strengthening adults’ and adolescents’ SRN to manage their sadness in everyday life.
Recognising inaccuracies in Australian suicide and ‘hidden suicide’ data
Authors: Snowdon John 
Published: April 2024

Objective To examine the effects of revision of Australian mortality statistics every year since 2007 on numbers and rates of suicide and ‘hidden suicide’. Method Nine months after the end of each year, the Australian Bureau of Statistics releases preliminary statistics concerning deaths registered in that year, together with revised and finalised data regarding previous years. Numbers and rates of suicide and of deaths coded to selected categories of accidental, undetermined and unknown cause deaths were tabled. Results Upward revision of suicide and accidental drug poisoning death numbers, three years after first release, show that true rates are substantially higher than initially released data suggested. Concomitant downward revision of rates of undetermined and unknown cause deaths supports evidence that at first release some suicides are coded to these categories. Conclusions Australia’s finalised suicide data are likely to be more accurate than equivalent data from nations that do not revise mortality data. More comprehensive investigation (including verbal or psychological autopsy) in doubtful cases in Australia and elsewhere would probably lead to reported suicide rates being higher.
Cat owners do not provide more reliable weight estimates for cats compared with veterinary professionals in an emergency setting
Authors: Gonçalves Ronald , Odunayo Adesola , Blystone Nicole , Ng Zenithson , Zhu Xiaojuan 
Published: April 2024

Objectives The aim of the present study was to assess the accuracy of weight estimation in cats provided by pet owners, veterinary technicians, house officers (interns and residents) and attending clinicians in an emergency room (ER). An additional objective was to determine whether carrying the cat contributed to a more accurate weight estimate. Methods A total of 72 cats presented to an ER and were enrolled in the study. Pet owners, veterinary technicians, house officers and attending clinicians were asked to record the cats’ estimated weights on individual data collection cards. The actual weights of the cats were then obtained and compared with participants’ estimations. Results There were no significant differences between weight estimates provided by pet owners, veterinary technicians, house officers and attending clinicians. Similarly, neither the length of experience of the veterinary staff nor carrying the cat had an effect on the provision of a more accurate weight estimate. Conclusions and relevance Pet owners are no better at weight estimation of cats in the ER setting compared with veterinary professionals. Carrying the cat did not improve the accuracy of weight estimation among veterinary professionals. The mean cat weight of 4.9 kg could be used as an average cat weight in an emergency situation for an adult cat.
Axillary necklace graft salvage of a locally infected Haemodialysis with Reliable Outflow (HeRO®) graft
Authors: Lloyd Adam , Bennett Philip C , Stather Philip W 
Published: April 2024

Background: A 48-year-old patient presented 4 months after insertion of a right sided Haemodialysis with Reliable Outflow (HeRO®, Merit Medical) graft with a discharging abscess at the site of the brachial artery anastomosis. There was localised involvement of the arterial Gore® Acuseal inflow graft that necessitated its removal. The venous outflow component was thought salvageable as infection was well localised to the region of the antecubital fossa. Objectives: Alternative access options were limited so we sought to preserve the venous outflow portion of the patient’s original graft – minimising tissue damage and avoiding the need for a dialysis line. Methods: The infected arterial graft was excised, leaving behind the original SuperHero® connector and venous graft. A left sided tunnelled axillary necklace technique was utilised to restore arterial inflow. Results: After a four-day recovery, the patient went on to successfully resume their usual haemodialysis regimen without any complications. Convalescent imaging, repeat blood cultures, and monitoring of inflammatory markers showed no signs of residual infection at 6 weeks. Conclusions: The originality of this case was the way in which an axillary necklace inflow graft was connected to the pre-existing venous outflow portion of the HeRO® haemodialysis graft system, allowing the excision of the infected inflow graft at the brachial anastomosis. This technique could be viewed as an effective salvage procedure as it allowed the venous outflow portion of the original graft to remain in situ, minimised tissue damage and enabled the patient to swiftly resume haemodialysis without the need for a line.
Minimally Invasive Treatment of Pelvic Fractures with Titanium Elastic Nailing: An Innovative Technology
Authors: Jia Zhaofeng , Qin Hanjun , Lin Jiandong , Wang Xin , Bai Ruochen , Zou Suying , Huang Wenjun , Hu Xinjia 
Published: April 2024

Background Minimally invasive treatment has become the most popular and effective treatment for pelvic fractures. This study aimed to evaluate the safety and efficacy of a new technique, titanium elastic nailing (TEN), for the minimally invasive treatment of pelvic fractures. Method Twenty-four patients with pelvic fractures were referred to us between January 2020 to January 2022, including sixteen males and 8 females. Pelvic fractures were temporarily fixed by pelvic fixation belt accompanied by traction from the lower limb bone. Anterior pelvic ring injuries (superior ramus of pubis) and ilium fractures were treated with closed reduction and intramedullary fixation with minimally invasive TEN. Intraoperative C-arm, including pelvic anteroposterior, pelvic outlet, inlet and ilium oblique views, and O-arm fluoroscopy (intraoperative CT) were employed to assess fractures reduction and determine the location of the elastic titanium nail within the bone channel. Results By adopting closed reduction and minimally invasive incision techniques, pelvic fractures could be safely fixed by placing an elastic titanium nail in the osseous medullary cavity channels of the pelvis. Postoperative investigation indicated that the wounds of all patients were healed in the first stage without any occurrence of complications, such as injuries to the nerves, blood vessels, and important tissue structures. Patients are essential quickly after the operation and could perform the functional exercise in the early stages of the recovery. Conclusion TEN can be used for minimally invasive treatment of pelvic fractures. This novel technique has no obvious complications and is worthwhile in clinical practice.
How institutional logics shape the adoption of virtual reality in mental health care: A qualitative study
Authors: Terkildsen Morten D , Bollerup Stina , Palmhøj Camilla , Jensen Lotte G , Lou Stina 
Published: April 2024

Objective To analyse institutional logics’ role in adopting virtual reality in mental health care. Methods Data were collected via qualitative, semi-structured interviews with four frontline staff and seven administrative and service staff, two focus group interviews with three frontline staff and four administrative and service staff, and via participant observation in meetings between stakeholders working on virtual reality. Data were collected from May 2021 to February 2022, analysed using thematic analysis, and theoretically driven by the framework of Institutional logics. Results We identified two different forms of institutional logics being drawn upon by frontline staff and administrative and service staff, respectively, when working with the adoption of virtual reality in mental health care. Frontline staff drew mainly on a Professional logic; administrative and service staff drew on a Diffusion logic. Each logic defined a unique focal point, causal pathway, and perceptions of a meaningful adoption process for virtual reality. Conclusions By taking institutional logics as our theoretical and analytical point of departure, this study demonstrates how the meaning of virtual reality and its adoption in mental health care is grounded in multiple and sometimes conflicting institutional logics. Acknowledging the existence and influence of often multiple institutional logics in the adoption process is crucial to guide the future adoption of virtual reality in mental health care. Organising collaborative venues for stakeholders where their multiple institutional logics are made the subject of joint reflection is essential to counter frictions.
Risk Factors for Birth Asphyxia in Hospital-Delivered Newborns in Dodoma, Tanzania: A Case-Control Study
Authors: Msisiri Laidi S. , Kibusi Stephen M. , Kimaro Franisca D. 
Published: April 2024

Introduction Asphyxia at birth remains the leading cause of neonatal morbidity and mortality worldwide, accounting for ∼23% of all neonatal deaths. Although the causes vary from country to country, early identification and treatment of risk factors can improve the situation. Objectives To determine the risk factors of birth asphyxia in hospital-delivered neonates in Dodoma, Tanzania. Methods A matched case-control study was conducted from May to July 2017 at Dodoma Region Referral Hospital. Data were collected using a semistructured questionnaire and a standard antenatal care index card. Cases were neonates diagnosed with asphyxia at birth ( N  =  100), while controls were neonates not diagnosed with asphyxia at birth ( N  =  300). A binary logistic regression model was used to assess the independent variables associated with birth asphyxia and reported as crude and adjusted odds ratios along with their 95% confidence intervals. Results A total of 400 newborns and their birth mothers were involved in the study. The average age of the case mothers was 26.9 years ( SD  =  7.85) and that of the control mothers was 27.24 years ( SD  =  6.08). Place of residence, anemia, maternal age, prenatal visits attended, use of herbs during labor, previously complicated pregnancy, duration of labor, meconium-stained amniotic fluid, and mode of delivery were predictors of birth asphyxia. Conclusion The study showed that most predictors of birth asphyxia can be prevented. The results suggest appropriate health education before conception, effective follow-up through prenatal care, early identification and treatment of high-risk pregnant women, and proper monitoring of labor and delivery.
Electrothermal Model Based Remaining Charging Time Prediction of Lithium-Ion Batteries against Wide Temperature Range
Authors: Xiong Rui , Zhao Zian , Chen Cheng , Li Xinggang , Shen Weixiang 
Published: April 2024

AbstractBattery remaining charging time (RCT) prediction can facilitate charging management and alleviate mileage anxiety for electric vehicles (EVs). Also, it is of great significance to improve EV users' experience. However, the RCT for a lithium-ion battery pack in EVs changes with temperature and other battery parameters. This study proposes an electrothermal model-based method to accurately predict battery RCT. Firstly, a characteristic battery cell is adopted to represent the battery pack, thus an equivalent circuit model (ECM) of the characteristic battery cell is established to describe the electrical behaviors of a battery pack. Secondly, an equivalent thermal model (ETM) of the battery pack is developed by considering the influence of ambient temperature, thermal management, and battery connectors in the battery pack to calculate the temperature which is then fed back to the ECM to realize electrothermal coupling. Finally, the RCT prediction method is proposed based on the electrothermal model and validated in the wide temperature range from − 20 ℃ to 45 ℃. The experimental results show that the prediction error of the RCT in the whole temperature range is less than 1.5%.
Health-related quality of life, work ability and disability among individuals with persistent post-dural puncture headache
Authors: Kapan Ali , Waldhör Thomas , Schiffler Tobias , Beck Jürgen , Wöber Christian 
Published: April 2024

Abstract
Background and objectives
Postdural puncture headache (PDPH) is an acknowledged consequence of procedures like lumbar punctures, epidural analgesia, and neurosurgical interventions. Persistence over more than three months, however has been poorly studied. In particular, little is known about the impact of persistent PDPH (pPDPH) on health related quality of life (HRQoL), disability and ability to work. The study aimed to provide a holistic understanding of pPDPH, encompassing medical, physical and psychological aspects.

Methods
We conducted a cross-sectional anonymous online survey in individuals aged 18 or older, diagnosed with, or suspected to have pPDPH via self-help groups on Facebook. Participants completed a structured questionnaire covering diagnosis, symptoms, and the ability to work. For assessing headache related disability, and mental health, they filled in the Henry Ford Hospital Headache Disability Inventory (HDI) and the Depression Anxiety Stress Scale-21 (DASS-21).

Results
A total of 179 participants (83.2% female, mean age 39.7 years) completed the survey. PPDPH had been present for one year or more in 74.3%, and 44.1% were unable to be in an upright position for more than one hour per day without having to lie down or sit down. Headaches were extremely severe or severe in 18% and 34%, respectively. According to the HDI, 31.8% of participants had mild, 25.7% moderate, and 42.5% severe disability. DASS-21 revealed substantial mental health challenges with depression, anxiety and stress experienced by 83%, 98%, and 88% of the respondents. The ability to work was limited considerably: 27.9% were unable to work, 59.8% worked part-time, 1.1% changed their job because of pPDPH, and only 11.2% were able to work full-time in their previous job. Despite treatment, the patients’ condition had deteriorated in 32.4% and remained unchanged in 27.9%.

Conclusion
This study stresses the burden of pPDPH in terms of substantial disability, limited quality of life, mental health concerns, and significant impact on the ability to work. The study highlights the long-term impact of pPDPH on individuals, emphasizing the need for timely diagnosis and effective treatment. It underscores the complexity of managing pPDPH and calls for further research into its long-term effects on patient health and HRQoL.
Impact of COVID-19 on essential healthcare services at the primary healthcare level in Armenia: a qualitative study
Authors: Hayrumyan Varduhi , Abrahamyan Arpine , Harutyunyan Arusyak , Libaridian Lorky , Sahakyan Serine 
Published: April 2024

Abstract
Background
The COVID-19 pandemic has presented significant global healthcare challenges, particularly impacting the continuity of essential health services in low- and middle-income countries. This study investigates the impact of the COVID-19 pandemic on the utilization and provision of essential health services in Armenia.

Methods
We employed a conventional qualitative study design, conducting semi-structured in-depth interviews (n = 17) within public and private primary healthcare (PHC) facilities in Armenia in 2021. Our study participants encompassed physicians providing specialty services in PHC facilities (e.g. endocrinologists, gynecologists/obstetricians, and pediatricians), regular visitors to PHC facilities (e.g. adults with chronic diseases, parents of children), and policymakers. Thematic analysis was conducted, yielding five emergent categories: mobilization and organization of PHC services during COVID-19; PHC visits during COVID-19; worsening of chronic conditions due to the decline in PHC visits; problems with routine childhood vaccinations; and patient-provider communication challenges.

Results
The number of in-person visits to PHC facilities declined due to adaptations in service delivery, imposed lockdown measures, and the public’s fear of visiting healthcare facilities. Maternal and child health services continued with no major disruptions. PHC providers deliberately limited the number of maternal and child visits to essential antenatal care, newborn screenings, and routine childhood immunizations. Still, children experienced some delays in vaccination administration. The pandemic resulted in a notable reduction in follow-up visits and monitoring of patients with chronic conditions, thereby exacerbating their chronic conditions. Phone calls were the primary method of patient-provider communication during the pandemic.

Conclusions
The COVID-19 pandemic has had a profound impact on the delivery and utilization of essential healthcare services at PHC facilities, especially for those with chronic conditions who needed continuous care. Unified national-level guidance and technical capacity are needed to direct the provision of essential services at the PHC level, promote effective health communication, and implement digital platforms for the uninterrupted provision of essential care during public health emergencies.
“Just pee in the diaper” - a constructivist grounded theory study of moral distress enabling neglect in nursing homes
Authors: Lund Stine Borgen , Malmedal Wenche K. , Mosqueda Laura , Skolbekken John-Arne 
Published: April 2024

AbstractBackgroundA growing body of evidence shows that many nursing home residents’ basic care needs are neglected, and residents do not receive qualitatively good care. This neglect challenges nursing staff´s professional and personal ideals and standards for care and may contribute to moral distress. The aim of this study was to investigate how nursing staff manage being a part of a neglectful work culture, based on the research question: “How do nursing home staff manage their moral distress related to neglectful care practices?”MethodsA qualitative design was chosen, guided by Charmaz´s constructivist grounded theory. The study was based on 10 individual interviews and five focus group discussions (30 participants in total) with nursing home staff working in 17 different nursing homes in Norway.ResultsNursing staff strive to manage their moral distress related to neglectful care practices in different ways: by favouring efficiency and tolerating neglect they adapt to and accept these care practices. By disengaging emotionally and retreating physically from care they avoid confronting morally distressing situations. These approaches may temporarily mitigate the moral distress of nursing staff, whilst also creating a staff-centred and self-protecting work culture enabling neglect in nursing homes.ConclusionsOur findings represent a shift from a resident-centred to a staff-centred work culture, whereby the nursing staff use self-protecting strategies to make their workday manageable and liveable. This strongly indicates a compromise in the quality of care that enables the continuation of neglectful care practices in Norwegian nursing homes. Finding ways of breaking a downward spiralling quality of care are thus a major concern following our findings.