bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Validation of a Comprehensive Nursing Competence Assessment Questionnaire (CNCAQ) to Determine the Perceived Clinical Competence of Nursing Graduates
Authors: Srivastava Sunita , Pandurangan Hariprasath , Kumar Anil 
Published: May 2024

Background: An assessment of the clinical competency of nurses at the time of their graduation is essential to get a fair estimate of their level of competence. It helps to lessen the burden on the healthcare system. A “Comprehensive Nursing Competence Assessment Questionnaire (CNCAQ)” has been constructed to fulfil this purpose. Aim: This study aims to develop and validate a CNCAQ to determine the perceived clinical competence of final-year nursing graduates who are about to graduate within three months from selected private and government nursing colleges in India. Methods: A mixed methodology was used and completed in two phases. In phase 1, along with an extensive literature review, focus group discussions, expert evaluation, and pretesting were done, in which 10 nursing experts participated. In phase 2, data were collected from 649 nursing graduates to establish the validity of the construct. The study period was from August to October 2022. Results: The developed CNCAQ has 36 items, comprising four sections: (a) conceptual knowledge and skill in routine nursing care; (b) skill in basic nursing procedures; (c) skill in advanced nursing procedures; and (d) assessment of infusion/transfusion-related nursing procedures. The overall reliability of the tool was 0.963, indicating its high reliability. Overall, there was no difference in clinical competency skills between female and male upcoming nursing graduates. However, statistically significant differences in basic nursing skills and advanced and analytical nursing skills were observed. Conclusions: Assessing nursing students’ competencies is crucial to ensure that they possess the necessary knowledge, skills, and attitudes to provide safe and effective patient care. The development and validation of a valid and reliable instrument for assessing nursing competencies are essential to evaluate nursing students’ clinical performance accurately. In the present research, a tool with a total of 36 items was used. It demonstrates high reliability; however, it needs to be applied to a larger population of nursing graduates with diverse backgrounds. Nurse educators and administrators can use it to assess the level of competence and, accordingly, a tailor-made induction program based on identified weak areas in theoretical and practical knowledge or skill can be developed. No patient’s were involved in the study. It involved developing a CNCAQ and validating it on a selected group of upcoming nursing graduates.
‘We have so much to offer’: Community members’ perspectives on autism research
Authors: Haar Tori , Brownlow Charlotte , Hall Gabrielle , Heyworth Melanie , Lawson Wenn , Poulsen Rebecca , Reinisch Tamara , Pellicano Elizabeth 
Published: May 2024

Autism research is on the cusp of significant change. There are mounting calls from Autistic self-advocates, researchers, and other scientists for a paradigm shift in autism research. Yet little is known about what non-academic members of the Autistic and autism communities think about autism research. We – a team of Autistic and non-autistic researchers – addressed this gap by conducting a secondary analysis of data collected as part of an in-depth research priority-setting exercise in Australia. Specifically, we asked: what are community members’ views and experiences of autism research? In immersive online text-based focus-group discussions held over 10 days, 55 community members, including Autistic people, family members, and professionals, shared their perspectives and experiences of autism research. We analysed the data using reflexive thematic analysis, adopting an inductive approach. Respondents resoundingly agreed that autism research could play a powerful role in helping to shape good Autistic lives, yet they felt that to do that effectively, major changes were needed. These included a shift away from overly narrow, deficits-based views of Autistic people to a greater focus on contextual factors, and more community-led decisions in what is researched and how. These findings highlight new possibilities for research processes, findings, and translation. Lay Abstract Autism research is changing. Autistic activists and researchers want Autistic people in the community to have more of a say about what is researched and how. But we haven’t asked people in the community what they think. This study used the information obtained from 55 community members, including Autistic people, their families, and professionals working with Autistic people, from an existing study on their priorities for autism research. We re-looked at what was said to see if we could understand community members’ views and experiences of autism research. People agreed strongly that research can play a powerful role in shaping good Autistic lives. They also felt that big changes were needed for research to do this. Some of these changes were that researchers should stop thinking about autism narrowly and in a negative way, where Autistic people are seen as the problem. Researchers need to think more about how to improve systems, experiences and how other people respond to Autistic people. They also want the autism community to be more involved in what is researched and how it is researched. The findings from our study here highlight the potential for research to be positive when Autistic people and their families are listened to, approached with understanding, and are respected and valued as individuals in the research process.
A Structured Literature Review on the Research and Design of Rehabilitation Environments
Authors: Pasha Samira , Shepley Mardelle McCuskey 
Published: May 2024

Aim: This literature review is conducted to identify knowledge gaps and shape a framework for the development of guidelines and future research on programming and design of rehabilitation environments. Background: Patients suffering from trauma, stroke, neurological or cardiopulmonary conditions, or recovering from surgery or cancer treatment require rehabilitation services. A comprehensive rehabilitation program can support continuum of care for inpatient and outpatient groups. However, within most facilities, rehabilitation environments are found to be outdated and undersized compared to other programs or lack the correct adjacencies within the facility. Unfortunately, this deficiency is echoed by limited guidelines on programming, planning, and design of these environments. General guidelines derived from healthcare environments research is not adaptable to rehabilitation environments, because the paradigm used in most healthcare environment research does not address specific needs of rehabilitation patients in regaining confidence or relearning daily life skills. Method: We conducted a structured literature review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses as a basis for reporting the available body of work on evidence-based research in rehabilitation environments. Result and Conclusion: Through analysis of the limited literature, specific mediators such as patient confidence and motivation were identified. An environment that creates a balance between privacy and social interaction can promote these mediators. Creating enriched environments through elements that engage the senses and encourage more social and physical interaction is essential for recovery. Finally, accessibility and wayfinding are of great importance in these environments due to potential limited mobility or cognitive impairments of patients.
Limb Salvage by Means of Hindfoot Arthrodesis Utilizing Bulk Allograft and External Fixation
Authors: Lindberg Carl Brandon , Lagisetti Rishika , Saxena Amol 
Published: May 2024

Format Retrospective Review. Length of follow-up 18 months. Classification Rearfoot and Ankle Reconstruction. Methodology Level 4 Retrospective Review. Procedures A retrospective review was performed of 6 patients who had undergone limb salvage procedures between January 2016 and April 2019. Patients underwent surgery due to severe limb-threatening diagnosis including Charcot and/or osteomyelitis. Salvage arthrodesis was performed with bulk femoral head allograft incorporation using a hexapod external fixation system. The external fixation was retained for an average of 16 weeks. All patients were followed for a postoperative period of 16 months. Results Successful rearfoot arthrodesis and limb salvage was achieved in ⅚ (83%) of patients. Discussion This review demonstrates that limb salvage and arthrodesis are possible using femoral head allograft incorporation by external fixation alone. The involved patients had resolution of the osteomyelitis and Charcot deformity, salvage arthrodesis of the rearfoot and avoidance of a major limb amputation. Levels of Evidence: IV.
Airblast observations and near-field modeling of the large surface explosion coupling experiment
Authors: Vorobiev Oleg , Ford Sean 
Published: May 2024

Seismoacoustic wave generation for two consecutive surface chemical explosions of the same yield (approximately 1 ton TNT-equivalent) was studied during the Large Surface Explosion Coupling Experiment (LSECE) conducted at Yucca Flat on the Nevada National Security Site (NNSS) site in alluvium geology. We have performed numerical simulations for both chemical explosions to investigate how the non-central source initiation, site topography and soil mechanical properties affect the evolution of the explosion (fireball and cloud), its crater, and variations in the generated blast waves. The results can be used to improve the understanding of surface explosions and their effects and how those effects can be used to infer source information such as explosive yield and emplacement. We find that the non-central detonation of the explosive cube results in non-axisymmetric blast overpressures which persist through the strong and weak shock regimes, in this case out to 200 m and more. The pattern of the secondary shock (i.e., shock created due to slowing explosive products within the expanding fireball) is also affected and its arrival relative to the main shock and may be indicative of explosive type due to its dependence on the explosive products ratio of heats. Small reflections are visible within the overpressure signal that are most probably due to small artifacts in blast path. Importantly, the fireball growth, cavity generation, and cloud formation also depart from spherical and ideal approximations due to ground interactions and material dependence, which shows the importance of realistic geomaterial models for accurate prediction. The asymmetry in peak overpressure is diminished for the second chemical explosion, which was placed in the crater of the first. Numerical modeling shows that the explosive jetting created by the non-central detonation is reduced upon interaction with the crater walls and this has the effect of making the blast generation more axisymmetric.
Evaluation of the National Tuberculosis Program and Tuberculosis Surveillance System, Jordan 2021
Authors: Khader Yousef , Al-Rahamneh Moad J , Abu Khudair Sara , Abaza Hiba , Al Shatnawi Ayah , Abuhmed Ibrahim , Saleh Abu Rumman Ahmad , Okkah Khaled , Mohammed Alghoul Suha , Falah Maia Ibrahim , Satyanarayana Srinath 
Published: May 2024

Objectives: Evaluate and determine the gaps in the National Tuberculosis Program and Tuberculosis Surveillance System in Jordan. Methods: A concurrent embedded mixed quantitative/qualitative methods study was conducted to assess the National Tuberculosis Program and Tuberculosis Surveillance System in Jordan. A semi-structured questionnaire was developed based on the Updated CDC Guideline for Evaluating Public Health Surveillance System to collect necessary information from service providers and other stakeholders. Results: The National Tuberculosis Program and Tuberculosis Surveillance System encounter various gaps and challenges across several critical domains, including infrastructure, human resources, National Tuberculosis Program functions, surveillance system performance, coordination, case findings, and data collection and notification. Regrettably, not all of the Tuberculosis Surveillance System’s objectives were successfully achieved in the past. Coordination of tuberculosis services has been repeatedly reported as inadequate. This deficiency manifests in the delay in diagnosing tuberculosis patients and, in some instances, misdiagnoses. The root cause is often traced back to insufficient knowledge of tuberculosis case definitions among healthcare providers at peripheral tuberculosis clinics. Additionally, a structured approach to active case finding is conspicuously absent. Furthermore, the tuberculosis management guidelines remain unfamiliar to many healthcare providers in tuberculosis centers, leaving them inadequately equipped to handle tuberculosis cases effectively. The utilization and analysis of the system’s data are also far from optimal. A glaring concern is the delay in tuberculosis case notifications received from the stakeholders involved in the Tuberculosis Surveillance System. Conclusions: Our study showed different gaps in the National Tuberculosis Program and Tuberculosis Surveillance Systems across several areas. The structure of National Tuberculosis Program and the clinical expertise of human resources do not support tuberculosis elimination. An electronic data collection and notification system is essential to facilitate tuberculosis case detection, reporting, and follow-up. Decision-makers should push the tuberculosis epidemic on the national health agenda. Jordan should focus on allocating national and international resources for tuberculosis control programs.
Assessing the efficacy of clinical triage in the prostate cancer best practice pathway
Authors: Roberts Charlotte , Vaggers Sophie , Martin Linda , Elson Denise , Noble Alexandra , Carrinton Karen , Dyer James 
Published: May 2024

Objective: The Prostate Cancer UK timed prostate cancer diagnostic pathway is a new UK pathway to deliver a diagnosis within 28 days for patients with suspected prostate cancer. We aim to review our experience of implementing this pathway, in particular the success of clinical triage. Subjects/patients (or materials) and methods: We reviewed consecutive referrals to the prostate cancer best timed pathway from September 2019 to September 2020. Patients were triaged either straight to test multiparametric magnetic resonance imaging (mpMRI) or straight to outpatient clinic. Inappropriate triage was defined as either: patients referred straight to test mpMRI who were diagnosed with prostate cancer and managed with watchful waiting or androgen deprivation therapy (ADT) or patients who were referred straight to clinic who subsequently had an mpMRI and underwent radical treatment. Results: A total of 154/155 (99.6%) of patients were appropriately triaged in the straight to mpMRI group. A total of 124/132 (94.0%) of patients were appropriately triaged in the straight to clinic group (patients who required review to ascertain if mpMRI was appropriate and then received radical treatment). Conclusion: The implementation of a consultant supervised triage process has been successful in avoiding unnecessary mpMRIs or unnecessary clinic appointments before a patient received a diagnosis or reassuring test. We advise that outcomes are audited regularly to ensure the effective use of resources. Level of evidence: 2C
Successful treatment of non-pruritus, excessive hair shedding and scales in a cat due to Demodex gatoi with fluralaner topical spot-on
Authors: Chuenngam Thapanee , Chermprapai Suttiwee 
Published: May 2024

Case summary A 1-year-old female intact Scottish Fold cat was presented with a 1-month history of excessive hair shedding with white scales on the coat without pruritus. The cat lived mostly indoors and had no history of any systemic disease. Dermatological examinations were performed step by step. Several Demodex gatoi were identified from cellophane tape impressions from the scales and examined under a low-power objective (10×) microscope. Skin cytology showed keratinocytes without any microorganisms. Based on the findings, fluralaner (Bravecto for cats; MSD) spot-on was used once every 12 weeks for ectoparasiticidal control. An essential fatty acid supplement was recommended to repair and restore the coat and skin barrier. After 4 weeks of treatment, the cat showed substantial improvement, with a normal coat and no scales. Re-examination using a cellophane tape impression for mites was negative. Ectoparasitic control is highly recommended regularly for the treatment and prevention of ectoparasites. Relevance and novel information Feline demodicosis is an uncommon parasitic dermatosis with primary clinical signs that may cause generalised or localised dermatitis with frequent pruritus, erythema and alopecia. The aims of this study were to report on dermatological lesions with excessive hair shedding and scales in a cat that were caused by demodicosis, without presenting the main clinical sign of pruritus or overgrooming. In addition, to the authors’ knowledge, this is the first report of the successful treatment of demodicosis due to D gatoi infestation with fluralaner single spot-on in an off-label use that was safe and easy to apply clinically.
Ultrasound-Guided Subfascial Platelet-Rich Plasma Injections Versus Enthesis Needling for Greater Trochanteric Pain Syndrome: A Randomized Controlled Trial
Authors: Atilano Leire , Martin Nerea , Ignacio Martin Jose , Iglesias Gotzon , Mendiola Josu , Bully Paola , Aiyegbusi Ayoola , Manuel Rodriguez-Palomo Jose , Andia Isabel 
Published: May 2024

Background: Greater trochanteric pain syndrome (GTPS) is characterized by gluteal enthesopathy involving the peritrochanteric space and associated with chronic pain and functional impairment. A corticosteroid injection in the trochanteric bursa is the usual palliative treatment for pain. However, it is important to investigate treatment options that will relieve pain in the peritrochanteric space. Purpose: To compare the clinical efficacy of subfascial platelet-rich plasma (PRP) injection and enthesis needling for GTPS. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 92 patients (90% women; mean age, 55 years old; mean body mass index, 25.3 kg/m2) were randomly divided into a subfascial PRP injection group and an enthesis needling group. Descriptive data and radiographic measurements of the pelvis—including leg-length difference, pelvic width difference, and pelvic trochanteric index—were recorded. The primary outcome measures were the Hip Outcome Score (HOS) activities of daily living (HOS-ADL) and sports-specific (HOS-SS) subscales and the visual analog scale for pain at 3, 6, and 12 months posttreatment. In addition, we evaluated the presence or absence of ultrasound characteristics (fascia nodules, trochanteric bursa distension, and calcium deposits) over time in response to treatment. Results: Baseline demographic and radiological characteristics were similar between the groups. The PRP group saw significantly greater improvement from baseline to 12 months posttreatment on the HOS-SS subscore compared with the needling group (32.09 [95% CI, 28.99-40.20] vs 20.52 [95% CI, 11.99-29.05]; P = .048). At 3 months, 60% of patients in the PRP group versus 33.3% in the needling group had a reduction in pain compared with a baseline of >20% ( P = .040). After subfascial PRP injection, fewer patients had a fascia nodule over the trochanter and/or bursa distension ( P = .006 and P = .004, respectively). The pelvic trochanteric index was predictive of HOS-ADL and HOS-SS outcomes ( P = .011 and P = .022, respectively). The interaction between treatment modality and fascia nodule influenced HOS-ADL and HOS-SS outcomes ( P = .021 and P = .023) as well as the interactions of treatment modality, fascia nodules, and calcifications ( P = .027). Conclusion: Both subfascial PRP injection and enthesis needling resulted in clinical improvements, but the improvement in the HOS-SS was greater in the PRP group. Registration: NCT04231357 (ClinicalTrials.gov identifier).
Polyphyllin I alleviates neuroinflammation after cerebral ischemia–reperfusion injury via facilitating autophagy-mediated M2 microglial polarization
Authors: Kang Chunyang , Sang Qiuling , Liu Dingxi , Wang Libo , Li Jia , Liu Xiaoyang 
Published: May 2024

AbstractMicroglial activation and polarization play a central role in poststroke inflammation and neuronal damage. Modulating microglial polarization from pro-inflammatory to anti-inflammatory phenotype is a promising therapeutic strategy for the treatment of cerebral ischemia. Polyphyllin I (PPI), a steroidal saponin, shows multiple bioactivities in various diseases, but the potential function of PPI in cerebral ischemia is not elucidated yet. In our study, the influence of PPI on cerebral ischemia–reperfusion injury was evaluated. Mouse middle cerebral artery occlusion (MCAO) model and oxygen–glucose deprivation and reoxygenation (OGD/R) model were constructed to mimic cerebral ischemia–reperfusion injury in vivo and in vitro. TTC staining, TUNEL staining, RT-qPCR, ELISA, flow cytometry, western blot, immunofluorescence, hanging wire test, rotarod test and foot-fault test, open-field test and Morris water maze test were performed in our study. We found that PPI alleviated cerebral ischemia–reperfusion injury and neuroinflammation, and improved functional recovery of mice after MCAO. PPI modulated microglial polarization towards anti-inflammatory M2 phenotype in MCAO mice in vivo and post OGD/R in vitro. Besides, PPI promoted autophagy via suppressing Akt/mTOR signaling in microglia, while inhibition of autophagy abrogated the effect of PPI on M2 microglial polarization after OGD/R. Furthermore, PPI facilitated autophagy-mediated ROS clearance to inhibit NLRP3 inflammasome activation in microglia, and NLRP3 inflammasome reactivation by nigericin abolished the effect of PPI on M2 microglia polarization. In conclusion, PPI alleviated post-stroke neuroinflammation and tissue damage via increasing autophagy-mediated M2 microglial polarization. Our data suggested that PPI had potential for ischemic stroke treatment.