bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring care of persons with dementia and significant violence risk in Victoria: A Delphi study
Authors: Cousins Zoe , Pang Sam , Rego Thomas 
Published: February 2025

Background Significant violence associated with dementia is uncommon, though care for these people is an important issue. This group is heterogeneous and encompasses people with no forensic history to those living in forensic and custodial settings. It is expected that over the next 40 years, the Australian population aged over 65 years will double, and persons over 85 years will increase threefold. This ageing population will likely mean increased persons living with dementia who may enact significant violence and place increased pressure on services to provide care. To date, there is no research on their specific care needs in Victoria. Objectives This study aimed to explore the current service landscape for persons with dementia and significant violence risk in Victoria through a small group of medical practitioners with expertise in dementia, psychiatry of old age, and forensic psychiatry. Methods A modified Policy Delphi study was used to interview 12 medical practitioners with backgrounds including Forensic Psychiatry, Psychiatry of Old Age, General Practice, and Geriatric Medicine. Findings The research identified five key recommendations to enhance service provision for this population in Victoria, including recommendations for specific care pathways, service agreements, physical environment considerations, educational needs, and consideration of a specialised service.
Impact of Patient and Caregiver Beliefs on Utilization of Hospice and Palliative Care in Diverse Patients With Advanced Lung Cancer
Authors: Besculides Melanie , Mazor Melissa B. , Moreno Alvarado Carolina , Jain Mayuri , Li Lihua , Morillo Jose , Wisnivesky Juan P. , Smith Cardinale B. 
Published: February 2025

Objectives To evaluate the impact of patient and caregiver hospice care (HC) and palliative care (PC) beliefs and patient/caregiver belief-agreement on subsequent utilization of HC/PC among racially and ethnically diverse patients. Methods A prospective cohort study of newly diagnosed patients ≥18 years old with advanced lung cancer and their caregivers was conducted. Participants completed validated surveys at multiple points and electronic health records were reviewed to evaluate utilization. Logistic regression models were used: (i) to estimate the association between caregiver health belief composite scores and utilization of HC or PC; and (ii) to estimate the association between level of agreement between patient and caregivers, and utilization of HC or PC. Results Among the 43 patient/caregiver dyads enrolled in the study, 27 (63%) identified as Black and/or Latino (minoritized) and 16 (37%) as Non-Hispanic White (non-minoritized). Mean age was 65.2 ± 10.2 and 52.1 ± 15.2 years among patients and caregivers, respectively. Minoritized patients held more negative health beliefs (2.7 ± 6.7 vs. 7.1 ± 4.9; p = 0.02) than their non-minoritized counterparts however, they were more likely to use HC and/or PC (67% vs. 25%; p = 0.02). Level of health belief agreement between patients and caregivers was lower in minoritized vs non-minoritized dyads (mean (SD) Kappa: 0.31 (0.18) vs. 0.18 (0.18); p < 0.01). Caregiver beliefs and patient/caregiver agreement in beliefs did not predict utilization of HC/PC. Conclusion Minoritized lung cancer patients held more negative beliefs about HC/PC yet were more likely to receive HC/PC. Further work is needed to understand factors that impact utilization among diverse patients with advanced cancer.
Efficacy of Chinese Medicine on Postoperative Rehabilitation of Non-small Cell Lung Cancer (NSCLC), a Randomized Controlled Study
Authors: Gu Yifeng , Wang Yichao , Zhou Huiling , Qi Ao , Wu Guanjin , Li Jiaqi , Zhang Congmeng , Yang Yong , Yao Jialin , Yang Wenxiao , Su Lingzi , Liu Yi , Tian Xueqi , Song Jiajun , Gong Yabin , Qin Xiong , Jiao Lijing , Xu Ling 
Published: February 2025

Background: With an increasing number of non-small cell lung cancer (NSCLC) patients being offered surgical treatment, postoperative rehabilitation is also being increasingly emphasized. Traditional Chinese medicine (TCM) holds promise for enhancing postoperative recovery, with treatment methods still in refinement. This study aims to evaluate the efficacy of Chinese herbal decoction and Liuzijue exercises in NSCLC patients during the rapid postoperative recovery period. Methods: A randomized, parallel-group clinical trial assigned 50 patients to receive Chinese herbal medicine and Liuzijue exercise plus symptomatic treatment, and 49 to symptomatic treatment alone. Treatment continued until postoperative complications resolved, chest tubes were removed, and no abnormal examination findings were reported. The primary outcome was Quality of Life Questionnare-Core 30 (QLQ-C30) score. Secondary outcomes included MOS item short form 36-Item Short Form Health Survey (SF-36) score, rate of complications, six-minute walk test (6MWT) distance, Leicester Cough Questionnaire (LCQ) score, numerical rating scale (NRS) score, and functional activity score (FAS). Results: Significant improvements in role (MD: 12.15, 95%CI: 2.99-21.32, P < .05) and social functioning (MD: 10.25, 95%CI: 1.72-18.78, P < .05) were observed in the intervention group vs. controls, as measured by QLQ-C30. The intervention group showed better post-treatment SF-36 scores in Role-Physical (RP), Social Function (SF), Role-Emotional (RE), and Mental Health Summary (MCS) ( P < .05). The complication rate was lower in the intervention (20.00%) than the control group (44.44%) ( P < .05). The intervention group also had a significant increase in FAS scores ( P < .05) and covered a better 6MWT distance ( P < .05). Conclusion: Chinese herbal decoction and Liuzijue exercises during the rapid recovery period after lung cancer surgery enhanced patients’ QoL and physical endurance, and mitigated complications. Trial registration: This tial was registered with chictr.org.cn (Registration number:ChiCTR2100044776).
Facial Nerve Palsy Amid the SARS-CoV-2 Pandemic: A Pooled Analysis
Authors: Mirza Ahmad A. , Almalki Abdulaziz H. , Noori Faisal A. , Neazy Sultan A. , Dahm Valerie , Bajin Münir Demir , Lin Vincent Y. 
Published: February 2025

Importance Idiopathic facial nerve palsy (FNP) has devastating sequelae and is potentially linked to coronavirus disease-19 (COVID-19). Objective The rate of FNP was compared in the pandemic versus pre-pandemic periods. Furthermore, the risk of FNP was estimated among the COVID-19 vaccinated group. Design Systematic review and meta-analysis. Setting An electronic search was conducted in 7 databases: Scopus, Web of Science core collection, PubMed, Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and CINAHL. Participants English observational studies investigating an association between idiopathic FNP and COVID-19 or its vaccination were included, irrespective of patients’ demographics. Exposures COVID-19 or COVID-19 vaccine. Main Outcome Measures Change in FNP incidence between the pre-pandemic and pandemic periods; risk of developing FNP in individuals vaccinated against COVID-19 compared to those who were unvaccinated against COVID-19. Results After excluding duplicates, the search yielded 906 related articles, of which 118 articles were included. The risk of FNP was statistically significantly higher during the COVID-19 pandemic than the pre-pandemic period (RR: 1.68, [95% CI: 1.16-2.43], P = .01). A nonsignificant increase in FNP risk was identified among COVID-19 vaccinated individuals compared to unvaccinated individuals (overall OR: 1.07, [95% CI: 0.85-1.35], P = .55). Conclusions and Relevance A remarkable increase in FNP rates was identified during the pandemic compared to pre-pandemic, which seemed unlikely to be attributed to COVID-19 vaccination.
Beyond Septic Encephalopathy: A Case Report of Severe RCVS and PRES in a Patient With HLH due to Appendicitis
Authors: Swider Kathryn , Tadevosyan Aleksey , Kunst Mara M. , Burns Joseph D. 
Published: February 2025

Background and Objectives: We report a rare case of severe posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS) in an adult patient with hemophagocytic lymphohistiocytosis (HLH), and speculate that these three diagnoses are related by similar mechanisms of vascular endothelial dysfunction. Methods: Informed consent for this case report was obtained from the patient’s legally authorized surrogate decision maker. Discussion and Practical Implications: Our patient initially presented with HLH secondary to intra-abdominal sepsis, and was later found to have severe PRES and RCVS resulting in extensive border-zone cortex infarction. Improvement of the severe systemic inflammatory syndrome characteristic of HLH and arrest of PRES and RCVS progression occurred only after HLH-specific treatment was initiated. In addition to illustrating the potential of HLH to manifest as PRES and RCVS, this case emphasizes the importance of prompt recognition and treatment of HLH and the role the neurologist can play in this process. This case also sheds light on the pathophysiological links between PRES, RCVS, and HLH. These three diagnoses may be related by similar mechanisms of vascular endothelial dysfunction caused by uncontrolled and severe systemic inflammation.
Inter- and Intrarater Agreement of the AO Spine-DGOU Osteoporotic Fracture Classification System Using Radiography and Computed Tomography Imaging
Authors: Ba-Ali Shakib , Bech Rune Dueholm , Hallager Dennis Winge 
Published: February 2025

Study Design Cross-sectional rater agreement. Objectives This study assessed whether inter- and intra-rater agreement for the AO spine-DGOU Osteoporotic Fracture (OF) Classification system differs between classifications based on computed tomography (CT) or radiography. Methods Radiography and CT were retrieved for 64 consecutive patients with a single osteoporotic vertebral fracture (OVF) treated at our institution having both imaging modalities performed on the same date. Four spine surgeons independently classified the fractures twice 1 week apart after training on 10 cases. Classifications were based on radiography and CT separately. Crude (%) and Fleiss’ Kappa (k) agreements were calculated for radiography and CT, respectively, and for intrarater agreement between radiography and CT within each rater. The proportion of cases with complete agreement among raters (concordant cases) was compared between radiography and CT using McNemar’s test. Fracture-type distribution differences were analyzed using McNemar’s test as well. Results Intra-rater agreement ranged 75%–81% (k = 0.49-0.64) for radiography and 64%–77% (k = 0.42-0.63) for CT. Inter-rater agreement was 56% (k = 0.49) with radiography and 50% (k = 0.51) with CT. No significant difference in the proportion of concordant cases was found between imaging modalities ( P = 0.37). Fractures were classified as higher-order OF types with CT ( P < 0.001). Conclusions We found moderate to substantial reliability of the OF system for radiography and CT. Using CT over radiography for classification did not increase the rater agreement. However, fractures are likely to be categorized as a higher-order OF type when the classification is based on CT compared to radiography.
Outcomes After Posterior Cruciate Ligament Reconstruction With Suture Tape Augmentation and an Accelerated Rehabilitation Protocol: A Retrospective Cohort Study
Authors: Paroneto Arthur Cardoso , Gomes Pedro Soneghet , Carrijo Paulo Vitor , Cohen Moises , Ramos Leonardo Addeo 
Published: February 2025

Background: Although posterior cruciate ligament (PCL) reconstruction is often performed for grade 3 PCL injuries, the effectiveness of different surgical techniques and rehabilitation protocols is a topic of debate. Purpose/Hypothesis: The purpose of this study was to evaluate and compare functional outcomes and residual instability in patients who underwent PCL reconstruction with versus without suture tape augmentation. It was hypothesized was that adding high-resistance suture tape to PCL reconstruction would improve functional scores and reduce postoperative laxity. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 48 patients were included in the study; all patients underwent PCL reconstruction with an autologous quadriceps tendon graft and had a minimum follow-up of 2 years. Overall, 23 patients were treated with a graft only, while 25 were treated with a graft and suture tape. Patients in the suture tape augmentation group also underwent an accelerated rehabilitation program with earlier range of motion and weightbearing. Patient characteristics, Lysholm scores, posterior tibial laxity on stress radiographs at 90° of knee flexion, and postoperative complications were compared between treatment groups. Results: No statistically significant differences were found between groups in terms of patient characteristics. Similar results were seen in both groups in terms of postoperative complications. Furthermore, on average, the Lysholm score increased from 1- to 2-year follow-up by 6.99 points (standard error = 0.97 points; P < .001), indicating progressive functional improvement, and posterior tibial laxity decreased from preoperatively to postoperatively by 7.55 mm (standard error = 0.24 mm; P < .001), indicating an improvement in knee stability. Patients in both treatment groups saw significant improvements during the follow-up period in the Lysholm score and posterior tibial laxity ( P < .001 for both). Conclusion: PCL reconstruction with suture tape augmentation and an accelerated rehabilitation protocol did not result in significantly improved functional scores or postoperative laxity compared with isolated PCL reconstruction. The results showed no disadvantage of a more aggressive rehabilitation protocol.
Cam Morphology and Sex-Based Differences in the Proximal Femur Anatomy of Collegiate Athletes Without Hip Pain: A 3-Dimensional Statistical Shape Modeling Analysis
Authors: Braun Bergen , Mozingo Joseph D. , Atkins Penny R. , Foreman K. Bo , Metz Allan K. , Aoki Stephen K. , Maak Travis G. , Anderson Andrew E. 
Published: February 2025

Background: Radiographic studies have reported a high prevalence of cam morphology in athletes, especially in male athletes, suggesting these individuals are at an elevated risk of developing femoroacetabular impingement syndrome (FAIS). However, recent research has shown that 2-dimensional measurements do not accurately characterize cam deformities, motivating the need for 3-dimensional (3D) analyses. Purpose: To develop a 3D statistical shape model of the proximal femur to evaluate cam morphology in collegiate athletes through (1) quantifying shape variation, (2) establishing sex-based shape differences, and (3) comparing shapes between male athletes and male cam FAIS patients. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Double-echo steady-state magnetic resonance images were prospectively acquired of the hips of Division I collegiate athletes (28 male, 23 female). An existing data set of computed tomography scans of cam FAIS patients (26 male) and morphologically screened controls (30 male, 17 female) was also evaluated. The proximal femur was segmented, reconstructed into a 3D surface, and analyzed to generate a correspondence model using ShapeWorks. Principal component analysis, parallel analysis, and linear discriminant analysis quantified variation in proximal femoral shape. Results: Variation in the full cohort primarily occurred in the head-neck junction, femoral offset, and location of the greater trochanter relative to the head/neck (mode VIII, adjusted P = .01; modes I and IV, adjusted P = .002 and adjusted P = .003, respectively; modes IV and VIII, adjusted P = .0003 and adjusted P = .0007, resepctively. P < .001). Modes represented anatomic variation significantly different between pairs within a group. Variation between male and female athletes occurred in the concavity of the head at the head-neck junction, length of the femur, and length of the femoral offset (modes I and II, adjusted P = .006 and adjusted P = .009, respectively). Variation between male athletes and male patients and between male patients and male controls occurred in the concavity of the head at the head-neck junction and femoral torsion (mode IV, adjusted P = .02 and adjusted P = .003, respectively). Shape scores, which represented a generalized value of the entire shape, were significantly different between athletes and patients (adjusted P = .003) and patients and controls (adjusted P < .0001). Conclusion: Athletes in our study had a proximal femur shape more similar to morphologically screened controls than FAIS patients. Sex-based differences occurred in athletes in regions where cam morphology typically occurs.
Awareness and Attitudes of Medical Students, Interns, and Residents Toward Telemedicine in Medical Education During the COVID-19 Pandemic: Survey-Based Cross-Sectional Study From Northern Iran
Authors: Sharififar Rahmat Allah , Mazandarani Mahdi , Lashkarbolouk Narges , Ghorbani Somayeh 
Published: February 2025

BACKGROUND Telemedicine is widely used in medical treatment and education systems. Therefore, it is essential to investigate the attitudes and awareness of medical students about it. We aimed to examine the awareness and attitudes of medical students, interns and residents toward telemedicine in medical education during the COVID-19 pandemic. METHOD This cross-sectional study was conducted after new educational approaches were implemented due to the COVID-19 pandemic. Two questionnaires were used to assess the new educational methodologies. Participants included residents (R), interns (I), and students (S) from the internal medicine department. A census sampling method was employed, inviting all medical education members who met the entry criteria to participate. The data were analyzed descriptively, and group differences were tested using chi-square, independent samples T-test, Mann–Whitney, and Kruskal–Wallis tests. RESULT Out of 278 medical education members eligible to participate, 249 (89.5%) completed the study. The mean score for participants’ attitudes was above 3 ( M = 3.78, SD = 0.24) indicating a generally favorable view of telemedicine. A significant gap was noted between participants’ awareness and attitudes, with residents showing the lowest scores in both areas ( P-value = .02). Our assessment revealed that “Satisfaction with the platform and facilities for e-classes” received the highest consensus from residents and interns, rated moderately agreeable by students (R: 64.5%, I: 59.7%, S: 48.8%). Responses to “Using e-learning courses alongside postcrisis face-to-face courses” and “Using e-learning courses alone postcrisis” varied among the groups (R: 58.1% and 54.9%, I: 59% and 58.2%, S: 47.6% and 45.3%). CONCLUSION The results of this survey reveal that medical students and interns may demonstrate a favorable awareness and attitude toward telemedicine. Consequently, developing educational programs and enhancing exposure to telemedicine should be considered since these elements could be vital for the future training of medical professionals.
“Don’t leave us behind”: a qualitative study exploring the feasibility of a palliative care training program for non-health caregivers in Honduras
Authors: Ruiz Sheryl , Stafström Martin , Parham Leda , Orellana Luis 
Published: February 2025

Background: Palliative care (PC) can alleviate suffering and improve quality of life. Yet, disparities persist, particularly in Honduras. Training efforts in PC for non-health caregivers have proven to reduce burnout and stress while enhancing the quality of life for both caregivers and patients. Purpose: This study aimed to explore the feasibility of a PC training program for non-health caregivers in Honduras. Methods: This exploratory study utilized latent content analysis within an interpretivist paradigm. Data was collected through individual semi-structured interviews with 25 participants belonging to different key groups: patients diagnosed with cancer, non-health caregivers, PC experts, and health-related decision makers. Interviews were conducted in Honduras’ three main cities: Tegucigalpa, San Pedro Sula, and La Ceiba. The sampling technique employed was maximum variation. Results: PC patients and caregivers face significant emotional challenges, often worsened by poverty and resource limitations, which leads to a strain in family dynamics. A lack of education, driven by inadequate healthcare education and policies, contributes to widespread misconceptions about PC. However, progress through various sectors aligned with the same goals proves Honduras is a country with potential. A program with a bottom-up approach, with intersectoral collaboration and training tailored to the needs of caregivers and patients, is urgently needed. Conclusion: It highlights the feasibility, necessity, and potential replicability of implementing a PC training program for non-health caregivers in Honduras, which could offer significant benefits at both individual and national levels. A program that truly accounts for health determinants may help mitigate PC shortages in similar regions. Further research and policy advocacy are essential to empower underserved populations and foster health equity across low- and middle-income settings, to ensure no one is left behind.
Blue carbon cycling in the coastal areas of Qatar
Authors: Strakhov Ivan , Elsayed Hadil , DiLoreto Zach A. , Avetisyan Khoren , Al Disi Zulfa Ali , Naja Khaled , Al-Kuwari Hamad A. S. , Sadooni Fadhil N. , Alkhayat Jassim , Dittrich Maria 
Published: February 2025

Abstract
Coastal wetland sediments are vital to the global carbon cycle as they represent large sinks of blue carbon – carbon from atmospheric and oceanic sources – which are threatened by ecosystem loss. The forms of sequestered carbon and the sequestration capability are affected by many bio- and geochemical factors that change unpredictably along coastal locales. In the present study, we investigated three unique coastal sites – a coastal mangrove and two sabkhas with contrasting geology and tidal influence in the Qatar peninsula – for their carbon capture ability to determine how biogeochemical indices affect their blue carbon sequestration potential. We applied a suite of biological and geochemical tools, collecting the sediment cores of approximately 40 cm depth; analysed sediment porewater; performed depth-profiling of the organic matter, sedimentary minerals, microbial community and analysis of sediment surface for pH, oxygen (O2); redox potential and hydrogen sulfide (H2S) by microsensors. High-resolution transmission electron microscopy with energy-dispersive X-ray spectroscopy (TEM-EDXS) and scanning transmission X-ray microscopy (STXM) revealed templating effects that promoted Mg-carbonate nucleation in coastal hypersaline environments. Microsensing reveals the intricacy of the oxic/anoxic transition at the sediment surface. Microbial DNA sequencing at various sediment depths shows the occurrence of microbial genera, whose functions explain the geochemical trends and carbon sequestration pathways observed at each site. Notably, we found that carbon sequestration in the mangrove and carbonate-sand sabkha was correlated with organic matter degradation and inorganic carbon content, while in the siliciclastic sabkha it was solely influenced by sediment density and depth.