bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of the International IFOMPT Cervical Framework to inform clinical reasoning in postgraduate level physiotherapy students: a qualitative study using think aloud methodology
Authors: Kowalski Katie L. , Gillis Heather , Henning Katherine , Parikh Paul , Sadi Jackie , Rushton Alison 
Published: May 2024

Abstract
Background
Vascular pathologies of the head and neck are rare but can present as musculoskeletal problems. The International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) Cervical Framework (Framework) aims to assist evidence-based clinical reasoning for safe assessment and management of the cervical spine considering potential for vascular pathology. Clinical reasoning is critical to physiotherapy, and developing high-level clinical reasoning is a priority for postgraduate (post-licensure) educational programs.

Objective
To explore the influence of the Framework on clinical reasoning processes in postgraduate physiotherapy students.

Methods
Qualitative case study design using think aloud methodology and interpretive description, informed by COnsolidated criteria for REporting Qualitative research. Participants were postgraduate musculoskeletal physiotherapy students who learned about the Framework through standardized delivery. Two cervical spine cases explored clinical reasoning processes. Coding and analysis of transcripts were guided by Elstein’s diagnostic reasoning components and the Postgraduate Musculoskeletal Physiotherapy Practice model. Data were analyzed using thematic analysis (inductive and deductive) for individuals and then across participants, enabling analysis of key steps in clinical reasoning processes and use of the Framework. Trustworthiness was enhanced with multiple strategies (e.g., second researcher challenged codes).

Results
For all participants (n = 8), the Framework supported clinical reasoning using primarily hypothetico-deductive processes. It informed vascular hypothesis generation in the patient history and testing the vascular hypothesis through patient history questions and selection of physical examination tests, to inform clarity and support for diagnosis and management. Most participant’s clinical reasoning processes were characterized by high-level features (e.g., prioritization), however there was a continuum of proficiency. Clinical reasoning processes were informed by deep knowledge of the Framework integrated with a breadth of wider knowledge and supported by a range of personal characteristics (e.g., reflection).

Conclusions
Findings support use of the Framework as an educational resource in postgraduate physiotherapy programs to inform clinical reasoning processes for safe and effective assessment and management of cervical spine presentations considering potential for vascular pathology. Individualized approaches may be required to support students, owing to a continuum of clinical reasoning proficiency. Future research is required to explore use of the Framework to inform clinical reasoning processes in learners at different levels.
Resident worklife and wellness through the late phase of the pandemic: a mixed methods national survey study
Authors: Linzer Mark , Mallick Sanjoyita , Shah Purva , Becker Anne , Nankivil Nancy , Poplau Sara , Patel Shivani K. , Nosal Caitlin , Sinsky Christine A. , Goelz Elizabeth , Stillman Martin , Alexandrou Michaella , Sullivan Erin E. , Brown Roger 
Published: May 2024

Abstract
Background
System contributors to resident burnout and well-being have been under-studied. We sought to determine factors associated with resident burnout and identify at risk groups.

Methods
We performed a US national survey between July 15 2022 and April 21, 2023 of residents in 36 specialties in 14 institutions, using the validated Mini ReZ survey with three 5 item subscales: 1) supportive workplace, 2) work pace/electronic medical record (EMR) stress, and 3) residency-specific factors (sleep, peer support, recognition by program, interruptions and staff relationships). Multilevel regressions and thematic analysis of 497 comments determined factors related to burnout.

Results
Of 1118 respondents (approximate median response rate 32%), 48% were female, 57% White, 21% Asian, 6% LatinX and 4% Black, with 25% PGY 1 s, 25% PGY 2 s, and 22% PGY 3 s. Programs included internal medicine (15.1%) and family medicine (11.3%) among 36 specialties. Burnout (found in 42%) was higher in females (51% vs 30% in males, p = 0.001) and PGY 2’s (48% vs 35% in PGY-1 s, p = 0.029). Challenges included chaotic environments (41%) and sleep impairment (32%); favorable aspects included teamwork (94%), peer support (93%), staff support (87%) and program recognition (68%). Worklife subscales were consistently lower in females while PGY-2’s reported the least supportive work environments. Worklife challenges relating to burnout included sleep impairment (adjusted Odds Ratio (aOR) 2.82 (95% CIs 1.94, 4.19), absolute risk difference (ARD) in burnout 15.9%), poor work control (aOR 2.25 (1.42, 3.58), ARD 12.2%) and chaos (aOR 1.73 (1.22, 2.47), ARD 7.9%); program recognition was related to lower burnout (aOR 0.520 (0.356, 0.760), ARD 9.3%). These variables explained 55% of burnout variance. Qualitative data confirmed sleep impairment, lack of schedule control, excess EMR and patient volume as stressors.

Conclusions
These data provide a nomenclature and systematic method for addressing well-being during residency. Work conditions for females and PGY 2’s may merit attention first.
Exploring environmental sustainability in dentistry among students and educators in the United Arab Emirates: a cross-sectional survey
Authors: Nassar Mohannad , Shalan Wed , Al-Janaby Uesser , Elnagar Hagar , Alawadhi Maryam , Jaser Sara , Joury Easter 
Published: May 2024

Abstract
Objectives
Creating environmentally sustainable healthcare culture within the dental field requires embedding the content in the dental curriculum at the undergraduate level. This study aimed to explore the current awareness and drivers among dental students and educators regarding environmentally sustainable dentistry (ESD) in the United Arab Emirates (UAE) and identify barriers and enablers to embrace it.

Methods
A cross-sectional survey using online questionnaires was carried out in six undergraduate dental education institutes within the UAE. Data analysis included descriptive statistics.

Results
In total 153 students and 53 educators participated in the survey. Most students and educators were not aware of any ESD content in their curricula. However, the majority of educators were familiar with the concept of ESD, while students were mostly unfamiliar or slightly familiar. Nonetheless, students largely agreed on its importance and their interest in learning it, as they viewed it relevant to their future practice. Educators agreed that the dental profession has a responsibility to be environmentally friendly and expressed their desire in introducing ESD content into the curricula. Several barriers were reported such as lack of knowledge, curricula space, educational resources, and time. Meanwhile, enablers included providing ESD capacity building, training and resources.

Conclusions
There was no explicit presence of ESD content in the dental curricula in the UAE. Despite the lack of adequate awareness on this topic among educators and more so among students, they both had positive views towards incorporating ESD into dental curricula. Overall, this study highlighted the importance of promoting ESD in dental programs. Clinical significance: ESD is gradually becoming a critical aspect of modern oral healthcare system. It has been mandated in the dental curricula in several regions globally. Embedding ESD in the UAE dental curricula would have several benefits for the environment as well as the future of the dental profession in the region. The clinical significance includes, but not limited to, improved treatment outcomes; patients, students and staff health and well-being; reduced health risks, and cost savings.
“Being the main character but not always involved in one’s own care transition” - a qualitative descriptive study of older adults’ experiences of being discharged from in-patient care to home
Authors: Ingvarsson Emelie , Schildmeijer Kristina , Hagerman Heidi , Lindberg Catharina 
Published: May 2024

Abstract
Background
The growing number of older adults with chronic diseases challenges already strained healthcare systems. Fragmented systems make transitions between healthcare settings demanding, posing risks during transitions from in-patient care to home. Despite efforts to make healthcare person-centered during care transitions, previous research indicates that these ambitions are not yet achieved. Therefore, there is a need to examine whether recent initiatives have positively influenced older adults’ experiences of transitions from in-patient care to home. This study aimed to describe older adults’ experiences of being discharged from in-patient care to home.

Methods
This study had a qualitative descriptive design. Individual interviews were conducted in January–June 2022 with 17 older Swedish adults with chronic diseases and needing coordinated care transitions from in-patient care to home. Data were analyzed using inductive qualitative content analysis.

Results
The findings indicate that despite being the supposed main character, the older adult is not always involved in the planning and decision-making of their own care transition, often having poor insight and involvement in, and impact on, these aspects. This leads to an experience of mismatch between actual needs and the expectations of planned support after discharge.

Conclusions
The study reveals a notable disparity between the assumed central role of older adults in care transitions and their insight and involvement in planning and decision-making.
Racism against healthcare users in inpatient care: a scoping review
Authors: Merz Sibille , Aksakal Tuğba , Hibtay Ariam , Yücesoy Hilâl , Fieselmann Jana , Annaç Kübra , Yılmaz-Aslan Yüce , Brzoska Patrick , Tezcan-Güntekin Hürrem 
Published: May 2024

Abstract
Background
Racism in the healthcare system has become a burgeoning focus in health policy-making and research. Existing research has shown both interpersonal and structural forms of racism limiting access to quality healthcare for racialised healthcare users. Nevertheless, little is known about the specifics of racism in the inpatient sector, specifically hospitals and rehabilitation facilities. The aim of this scoping review is therefore to map the evidence on racial discrimination experienced by people receiving treatment in inpatient settings (hospitals and rehabilitation facilities) or their caregivers in high-income countries, focusing specifically on whether intersectional axes of discrimination have been taken into account when describing these experiences.

Methods
Based on the conceptual framework developed by Arksey and O’Malley, this scoping review surveyed existing research on racism and racial discrimination in inpatient care in high-income countries published between 2013 and 2023. The software Rayyan was used to support the screening process while MAXQDA was used for thematic coding.

Results
Forty-seven articles were included in this review. Specifics of the inpatient sector included different hospitalisation, admission and referral rates within and across hospitals; the threat of racial discrimination from other healthcare users; and the spatial segregation of healthcare users according to ethnic, religious or racialised criteria. While most articles described some interactions between race and other social categories in the sample composition, the framework of intersectionality was rarely considered explicitly during analysis.

Discussion
While the USA continue to predominate in discussions, other high-income countries including Canada, Australia and the UK also examine racism in their own healthcare systems. Absent from the literature are studies from a wider range of European countries as well as of racialised and disadvantaged groups other than refugees or recent immigrants. Research in this area would also benefit from an engagement with approaches to intersectionality in public health to produce a more nuanced understanding of the interactions of racism with other axes of discrimination. As inpatient care exhibits a range of specific structures, future research and policy-making ought to consider these specifics to develop targeted interventions, including training for non-clinical staff and robust, transparent and accessible complaint procedures.
A methodological exploration of distinguishing hair quality based on hair proteomics
Authors: Wu Xiaolin , Zhang Tao , Mao Mingsong , Zhang Yali , Zhang Zhenpeng , Xu Ping 
Published: May 2024

AbstractHair is an advantageous biological sample due to its recordable, collectable, and storable nature. Hair's primary components are keratin and keratin-associated proteins. Owing to its abundance of cystine, keratin possesses impressive mechanical strength and chemical stability, formed by creating disulfide bonds as crosslinks within the protein peptide chain. Furthermore, keratin is cross-linked with keratin-associated proteins to create a complex network structure that provides the hair with strength and rigidity. Protein extraction serves as the foundation for hair analysis research. Bleaching hair causes damage to the structure between keratin and keratin-associated proteins, resulting in texture issues and hair breakage. This article outlines various physical treatment methods and lysate analysis that enhance the efficiency of hair protein extraction. The PLEE method achieves a three-fold increase in hair protein extraction efficiency when using a lysis solution containing SDS and combining high temperatures with intense shaking, compared to previous methods found in literature. We utilized the PLEE method to extract hair from both normal and damaged groups. Normal samples identified 156–157 proteins, including 51 keratin and keratin-associated proteins. The damaged group consisted of 155–158 identified proteins, of which 48–50 were keratin and keratin-associated proteins. Bleaching did not cause any notable difference in the protein identification of hair. However, it did reduce coverage of keratin and keratin-associated proteins significantly. Our hair protein extraction method provides extensive coverage of the hair proteome. Our findings indicate that bleaching damage results in subpar hair quality due to reduced coverage of protein primary sequences in keratin and keratin-associated proteins.
Sexual dimorphism in atherosclerotic plaques of aged Ldlr−/− mice
Authors: Smit Virginia , de Mol Jill , Kleijn Mireia N. A. Bernabé , Depuydt Marie A. C. , de Winther Menno P. J. , Bot Ilze , Kuiper Johan , Foks Amanda C. 
Published: May 2024

Abstract
Background
Atherosclerosis, the main underlying pathology of cardiovascular disease, is a chronic inflammatory disease characterized by lipid accumulation and immune cell responses in the vascular wall, resulting in plaque formation. It is well-known that atherosclerosis prevalence and manifestation vary by sex. However, sexual dimorphism in the immune landscape of atherosclerotic plaques has up to date not been studied at high-resolution. In this study, we investigated sex-specific differences in atherosclerosis development and the immunological landscape of aortas at single-cell level in aged Ldlr−/− mice.

Methods
We compared plaque morphology between aged male and female chow diet-fed Ldlr−/− mice (22 months old) with histological analysis. Using single-cell RNA-sequencing and flow cytometry on CD45+ immune cells from aortas of aged Ldlr−/− mice, we explored the immune landscape in the atherosclerotic environment in males and females.

Results
We show that plaque volume is comparable in aged male and female mice, and that plaques in aged female mice contain more collagen and cholesterol crystals, but less necrotic core and macrophage content compared to males. We reveal increased immune cell infiltration in female aortas and found that expression of pro-atherogenic markers and inflammatory signaling pathways was enriched in plaque immune cells of female mice. Particularly, female aortas show enhanced activation of B cells (Egr1, Cd83, Cd180), including age-associated B cells, in addition to an increased M1/M2 macrophage ratio, where Il1b+ M1-like macrophages display a more pro-inflammatory phenotype (Nlrp3, Cxcl2, Mmp9) compared to males. In contrast, increased numbers of age-associated Gzmk+CD8+ T cells, dendritic cells, and Trem2+ macrophages were observed in male aortas.

Conclusions
Altogether, our findings highlight that sex is a variable that contributes to immunological differences in the atherosclerotic plaque environment in mice and provide valuable insights for further preclinical studies into the impact of sex on the pathophysiology of atherosclerosis.
First parechovirus reported case in Saudi Arabia in hospitalized immunocompromised adult patient
Authors: Alshammari Abdullah , Alotaibi Jawaher , Almaghrabi Reem , Bawazeer Reema , Althawadi Sahar , Tayeb Hamsa 
Published: May 2024

AbstractHuman parechovirus, a member of the Picornaviridae family (PeVs), can lead to severe infections, including severe meningitis, meningoencephalitis, and sepsis-like syndrome. We report a case of human parechovirus-related encephalitis in a 52-year-old woman diagnosed with glioblastoma multiforme. She underwent surgical resection in June 2022. Unfortunately, her disease recurred, and she underwent a second resection in August 2022, followed by radiation therapy and Temozolomide therapy. She presented to the hospital with acute confusion followed by seizures, necessitating intubation for airway support. A cerebrospinal fluid (CSF) sample was obtained and processed using the Biofire FilmArray, which reported the detection of HSV-1. Despite being on Acyclovir, the patient did not show signs of improvement. Consequently, a second CSF sample was obtained and sent for next-generation sequencing (NGS), which returned a positive result for Parechovirus. In this presented case, the patient exhibited symptoms of an unknown infectious cause. The utilization of NGS and metagenomic analysis helped identify Parechovirus as the primary pathogen present, in addition to previously identified HSV. This comprehensive approach facilitated a thorough assessment of the underlying infection and guided targeted treatment. In conclusion, the application of NGS techniques and metagenomic analysis proved instrumental in identifying the root cause of the infection.
Irregular word reading as a marker of semantic decline in Alzheimer’s disease: implications for premorbid intellectual ability measurement
Authors: Marier Anna , Dadar Mahsa , Bouhali Florence , Montembeault Maxime ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: May 2024

Abstract
Background
Irregular word reading has been used to estimate premorbid intelligence in Alzheimer’s disease (AD) dementia. However, reading models highlight the core influence of semantic abilities on irregular word reading, which shows early decline in AD. The primary objective of this study is to ascertain whether irregular word reading serves as an indicator of cognitive and semantic decline in AD, potentially discouraging its use as a marker for premorbid intellectual abilities.

Method
Six hundred eighty-one healthy controls (HC), 104 subjective cognitive decline, 290 early and 589 late mild cognitive impairment (EMCI, LMCI) and 348 AD participants from the Alzheimer’s Disease Neuroimaging Initiative were included. Irregular word reading was assessed with the American National Adult Reading Test (AmNART). Multiple linear regressions were conducted predicting AmNART score using diagnostic category, general cognitive impairment and semantic tests. A generalized logistic mixed-effects model predicted correct reading using extracted psycholinguistic characteristics of each AmNART words. Deformation-based morphometry was used to assess the relationship between AmNART scores and voxel-wise brain volumes, as well as with the volume of a region of interest placed in the left anterior temporal lobe (ATL), a region implicated in semantic memory.

Results
EMCI, LMCI and AD patients made significantly more errors in reading irregular words compared to HC, and AD patients made more errors than all other groups. Across the AD continuum, as well as within each diagnostic group, irregular word reading was significantly correlated to measures of general cognitive impairment / dementia severity. Neuropsychological tests of lexicosemantics were moderately correlated to irregular word reading whilst executive functioning and episodic memory were respectively weakly and not correlated. Age of acquisition, a primarily semantic variable, had a strong effect on irregular word reading accuracy whilst none of the phonological variables significantly contributed. Neuroimaging analyses pointed to bilateral hippocampal and left ATL volume loss as the main contributors to decreased irregular word reading performances.

Conclusions
While the AmNART may be appropriate to measure premorbid intellectual abilities in cognitively unimpaired individuals, our results suggest that it captures current semantic decline in MCI and AD patients and may therefore underestimate premorbid intelligence. On the other hand, irregular word reading tests might be clinically useful to detect semantic impairments in individuals on the AD continuum.
Evaluating consumer preferences for reduced cooking time, taste and colour of beans in rural and urban communities in Uganda
Authors: Asiimwe Robert , Katungi Enid , Marimo Pricilla , Mukankusi Clare , Rubyogo Jean Claude , Anthony Vivienne 
Published: May 2024

Abstract
Background
Common bean breeders strive to deliver farmer- and consumer-preferred varieties that are well-adapted to distinct production environments, changing markets and end uses. However, there is information gap on the key traits that customers prefer and are willing to pay for. This paper examined the preferences and willingness to pay for reduced cooking time and other selected traits in the Ugandan bean markets using a choice experiment data elicited from 1152 urban and rural bean consuming households. A latent class model was used to assess preferences and the willingness to pay for reduced cooking time.

Results
Results indicated that taste, cooking time, bean swelling on cooking, and grain color were the preferred attributes in decreasing order among non-bean-producers. About 72% of the urban consumers were willing to pay 41 shillings, 53 shillings and 42 shillings above prices for reduction in cooking time from 120 (status quo) to 90, 75, and 60 min, respectively. For consumers who also grow their beans for food and surplus for sale, reduced cooking time is important but not as much as yield and climate resilience. The study identified four distinct customer segments—two among bean-producing households and two among non-bean-producing households. Gender, education, level of altruism/openness to change, household economic status, and price sensitivity were the major factors influencing segment membership.

Conclusions
The study findings demonstrated that breeding to reduce cooking time will generate a significant social savings in terms of less cooking fuel, water and time, but cooking time ought to be considered alongside other attributes preferred by consumers and farmers to succeed. Results also suggest that women urban consumers attach more importance to higher levels of intrinsic traits (non-visible but experienced by consumers) compared to men—thus promotional campaigns popularizing new varieties should target women to stimulate demand.