bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Innovative Clinic-Based Intervention to Improve Adolescent Access to Sexual and Mental Health Services: The Total Teen Program
Authors: Garney Whitney , Han Gan , Esquivel Christi , Garcia Kristen , Ajayi Kobi V. , Wilson Kelly 
Published: January 2025

Objective: Adolescents encounter numerous healthcare access barriers, leading to poor health outcomes. Researchers developed the Total Teen (TT) program to improve access to sexual and reproductive health (SRH) and mental health (MH) services in settings providing adolescents and young adults (12-25) health services. This pilot study assessed the TT’s impact on care across three settings: school-based health clinics, a federally qualified health center, and an adolescent health clinic for 12 weeks. Methods: Sociodemographic data, including age, race/ethnicity, gender, and insurance status, were collected. MH was assessed using patient health questionnaire (PHQ)-9 and generalized anxiety disorder (GAD)-2 scales, and sexual health was evaluated based on CDC guidelines and additional evidence-based questions. One-on-one time, confidential consultations, SRH and MH micro visits, and referrals measured access. Descriptive statistics, Pearson Chi-square tests, and Kruskal–Wallis tests compared site outcomes, while logistic regression models adjusted for age, gender, race, and site. Results: Four hundred and fifty-one participated in the TT program across the three sites. Concerning micro visits and referrals, being male was associated with lower depression rates ( P = .0003) and generalized anxiety disorder ( P = .0099). Being males also predicted micro visit receipt ( P = .0199). Concerning SRH micro visits, higher sexual behavior scores ( P < .0001) were significantly associated with a greater likelihood of utilizing SRH micro visits. Conclusions: Results indicate that TT improves access to SRH and MH services and referrals for at-risk adolescents. Findings underscore the importance of integrating SRH and MH services into routine adolescent care and involving health organizations and providers as key stakeholders in enhancing preventive healthcare access.
Outcomes in Late Presenting Obstructed Infracardiac Total Anomalous Pulmonary Venous Connection—Single Centre Experience
Authors: Patel Kartik , Kakkar Deepti , Pandya Himani , Kothari Shyam S , Sheth Megha , Patel Herin , Gajjar Trushar , Mishra Amit 
Published: January 2025

Background Survival beyond one month of age is rare in children born with obstructed infracardiac total anomalous pulmonary venous connection (TAPVC). There are limited data available on surgical outcomes of the same subset. We conducted this retrospective study to identify risk factors associated with surgical outcomes in this patient population. Method We present a retrospective study of patients presenting at our institute with obstructed infracardiac TAPVC surviving beyond one month of age during the period from January 2015 to August 2019 (n = 14). Data reviewed included demographic parameters, preoperative laboratory results, echocardiogram images, and computed tomography if performed. Intraoperative as well as postoperative data including type of surgery, use of deep hypothermic arrest, mortality, and morbidity were noted. Follow-up clinical data were also collected from institutional record or telephonically. We have also collected echocardiographic data on follow up. Results The mean age of our study cohort was 2.14 ± 0.68 months. Out of 14 total patients 3 patients eventually died. Risk factors that were significantly associated with mortality were low weight (odds ratio [OR] = 7.8, P = .005), preoperative bilirubin level (OR = 7.4, P = .007), use of deep hypothermic circulatory arrest (OR = 4.6, P = .031), tricuspid regurgitation grade (OR = 3.8, P = .050), and pulmonary artery hypertension (OR = 10.5, P = .001). Mean follow up for the study cohort was 2189 ± 538 days. One patient has mild flow acceleration across the anastomosis with a gradient of 5/3 mm Hg without any symptoms. The remainder of the patients are alive with excellent clinical as well as echocardiographic outcome. Conclusion The presentation of infants with obstructed infracardiac TAPVC beyond one month of age is very rare. However, timely intervention can provide acceptable early and excellent late outcomes in this rare patient cohort.
Frontline Voice: AO Spine Member Survey Regarding Spine Oncology Knowledge Generation and Translation Needs
Authors: Goodwin Matthew L. , Loomans Janneke I. , Barzilai Ori , Dea Nicolas , Gasbarrini Alessandro , Lazáry Aron , Netzer Cordula , Reynolds Jeremy , Rhines Laurence , Sahgal Arjun , Verlaan Jorrit-Jan , Fisher Charles G. , Laufer Ilya , on behalf of AO Spine Knowledge Forum Tumor  
Published: January 2025

Study Design cross-sectional survey. Objectives To evaluate AO Spine members’ practices and comfort in managing metastatic and primary spine tumors, explore the use of decision-support and patient assessment tools, and identify knowledge gaps and future needs in spine oncology. Methods An online survey was distributed to AO Spine members to query comfort levels with key decisions in spinal oncology management, utilization of decision frameworks and spine oncology-specific instruments, and educational material preferences. Results Responses were obtained from 381 members across 82 countries. Most respondents were orthopedic spine surgeons (62%) or neurosurgeons (36%), with 42% performing 100-200 spine surgeries per year. Extradural primary and metastatic tumors were managed by 84% and 95% of respondents, respectively, with survival and frailty assessment tools used for both. While most surgeons felt comfortable determining when emergency surgery was needed (81% for primary and 82% for metastatic tumors), nuanced decisions about surgical timing were more challenging. Surgeons also noted challenges in tailoring the oncologic surgical plan to what the patient could safely tolerate. There was a strong desire for guidelines on tumor-related spinal pain (85%), treatment timing (85%), stabilization (85%), and glucocorticoid use for symptomatic extradural metastatic tumors (77%). Interest was high for classification systems for spine tumor pain (65%) and stabilization decisions (80%). Conclusions Additional support is needed in decision-making regarding surgical timing, patient selection, and tailoring treatment invasiveness to life expectancy and frailty. Surgeons seek further guidance to prevent neurologic deterioration and optimize recovery. Guidelines and classification systems were highly coveted for daily practice.
Genetic landscape of Charcot–Marie–Tooth disease in Vietnam: A prospective multicenter study
Authors: Nghia Hoang Tien Trong , Umapathi Thirugnanam , Duc Nguyen Minh , Hieu Nguyen Le Trung , Thao Mai Phuong 
Published: January 2025

Background: In many developing regions, genetic data on Charcot–Marie–Tooth disease (CMT) remains scarce. Objective: This study aimed to investigate the genetic landscape of CMT in Vietnam to guide the development of cost-effective diagnostic algorithms for patients with suspected genetic neuropathies. Methods: We recruited 44 patients with a diagnosis of CMT from three tertiary centers between March 2021 and December 2023 and recorded their clinical and electrophysiological characteristics. All patients were analyzed for duplications or deletions of PMP22, GJB1, MPZ, and MFN2 via multiplex ligation-dependent probe amplification (MLPA) and for 94 genes via targeted next-generation sequencing (NGS). The identified variants were classified per the American College of Medical Genetics and Genomics 2015 guidelines using VarSome, a bioinformatics engine. Results: Among 44 patients, 24 carried a total of 26 variants. Of these 26 variants, 15 were (57.7%) pathogenic, 6 (23.1%) were likely pathogenic, and 5 (19.2%) were variants of uncertain significance (VUS). Excluding the VUS, the diagnostic yield of the targeted sequencing was 43.2% (19/44). Through MLPA, PMP22 duplications were identified in 10 patients with the demyelinating type of CMT and 1 patient with the unclassified CMT type. The combined yield of MLPA and gene panels was 68.2% (30/44). We detected three novel pathogenic/likely pathogenic variants in GJB1, INF2, and IGHMBP2, as well as three novel VUS in MPZ, PMP22, and INF2. IGHMBP2 may represent the most prevalent autosomal recessive gene associated with CMT in Vietnam. Conclusions: We propose a sequential genetic testing approach for CMT in resource-limited settings, with the initial testing via MLPA for demyelinating CMT, followed by NGS for those who test negative. Our findings broaden the CMT genotype–phenotype profile of the Vietnamese population by identifying six novel candidate variants.
Utility of a Wearable Tracker to Assess Sleep Quality in Nurses and Their Spouses: A Prospective Cohort Study
Authors: Ishinuki Tomohiro , Goda Erika , Tatsumi Hiroomi , Kutomi Goro , Ohyanagi Toshio , Ohnishi Hirofumi , Masuda Yoshiki , Hui Thomas T. , Mizuguchi Toru 
Published: January 2025

Introduction Sleep disturbances among nurses engaged in night duty and their spouses need to be improved to ensure their ability to provide care and perform daily tasks. Therefore, an objective investigation is needed to establish a sleep improvement strategy. Objective To investigate the utility of a sleep tracker to assess sleep quality in nurses and spouses. Method Nurses ( n = 30) and spouses ( n = 30) wore a sleep tracker for 14 days to investigate sleep scores. Sleep quality and number of steps were evaluated by Fitbit. They responded to the Richards-Campbell Sleep Questionnaire and Pittsburgh Sleep Quality Index. A multiple regression analysis was performed to identify the factors affecting sleep quality. Results Factors affecting sleep scores in nurses were hypnotic medication, night duty, and steps, while those in spouses were mental instability, hypnotic medication, alcohol, night duty, and steps. Factors affecting the Richards-Campbell Sleep Questionnaire in nurses were household chores, night duty, and steps, while those in spouses were hypnotic medication and steps. Conclusion The sleep quality of nurses was affected by household chores, hypnotic medication, night duty, and steps. Besides the factors of nurses, spouses were affected by mental instability and alcohol. Night duty affected negativity in both nurses and spouses. Steps exerted positive effects in both the sleep tracker and the Richards-Campbell Sleep Questionnaire. The sleep tracker may be useful for identifying factors that improve sleep quality.
Self-reported health status of patients with acute retinal ischemia and stroke related hemianopia
Authors: Rimmele David Leander , Petersen Elina L , Schrage Theresa , Härter Martin , Kriston Levente , Thomalla Götz 
Published: January 2025

Background: We aimed to assess impairments on health-related quality of life, and mental health resulting from Retinal artery occlusion (RAO) with monocular visual field loss and posterior circulation ischemic stroke (PCIS) with full or partial hemianopia using patient-reported outcome measures (PROMs). Methods: In a prospective study, consecutive patients with acute RAO on fundoscopy and PCIS on imaging were recruited during their surveillance on a stroke unit over a period of 15 months. Baseline characteristics were determined from medical records and interviews. Health-related quality of life (PROM Information System 10-Question-Short-Form, PROMIS-10), and mental health symptoms (Patient-Health-Questionnaire-4, PHQ-4) were assessed 3 and 12 months after admission postally and via phone. Results: Ffity-seven patients with RAO and 19 with isolated full or partial hemianopia determined by the NIHSS (median = 2; IQR:0/2) according to PCIS were included. Characteristics of cardiovascular risk factors, and functional status pre-stroke were comparable between the groups. At 3 months, mean ± standard deviation T-scores of PROMIS physical and mental health were 47.1 ± 8.8 and 46.7 ± 8.8 for patients with RAO, and 43.4 ± 9.8 and 43.2 ± 6.2 for PCIS. Compared to 50 ± 10 in the general population, scores after RAO ( p = 0.04; p = 0.02) and PCIS ( p = 0.01; p < 0.001) were lower in both domains after 3 months. Concerning PCIS, scores in the mental health domain remained decreased at 12 months ( p = 0.04). On the PHQ-4, 25% of patients with RAO, and 62% with PCIS scored indicative for anxious and/or depressive syndromes at 3 months. Conclusions: RAO led only to partial and to less persistent mental impairments than PCIS. This suggests that a different approach involving complex visual and neuropsychological treatment over a longer period of time needs to be considered for post-stroke care of PCIS. Trial Registration Information: The trial was submitted at http://www.clinicaltrials.gov , under NCT03795948.
Not getting better but not getting worse: A cluster randomized controlled pilot trial of a leadership implementation strategy
Authors: Locke Jill , Corbin Catherine M. , Goosey Roger , Collins Vaughan K. , Ehrhart Mark G. , Hatch Kurt , Espeland Christine , Lyon Aaron R. 
Published: January 2025

Background Implementation of evidence-based practices (EBPs) in schools is fraught with challenges. Even when EBPs are initiated, deterioration of implementation efforts often hinders their long-term success. School leadership behaviors can influence teachers’ EBP implementation. Our study tested an implementation strategy called Helping Educational Leaders Mobilize Evidence (HELM), adapted from the Leadership and Organizational Change for Implementation strategy, to enhance EBP implementation through improvements in school leadership teams’ implementation leadership and climate to buffer against the deterioration of implementation efforts. This study explores the impact of HELM on theorized mechanisms of change (i.e., implementation leadership, climate), educator-level factors (i.e., implementation citizenship), and implementation outcomes (i.e., fidelity, initiative stability). Method One school district and 10 schools in Washington participated. Five of the schools were randomized to receive the HELM strategy and the remaining five schools received an alternative leadership training as an implementation attention control. Teachers at every school ( n = 341) received training for an EBP called Positive Greetings at the Door that has been previously demonstrated to reduce student behavior problems. Principals and Assistant Principals ( n = 18) received the HELM strategy or alternative leadership training. Three district Administrators also participated in HELM as part of the Organizational Strategy Development meetings. Results HELM significantly slowed the average decline of implementation leadership (perseverant leadership and communication), three dimensions of implementation climate (recognition, rewards, and existing supports) and total implementation climate, and one dimension of implementation citizenship (keeping informed). No significant effects were found with regard to implementation outcomes (i.e., fidelity, initiative stability). Conclusions HELM shows promise in buffering the deterioration of EBP implementation efforts in schools. HELM positively influenced implementation leadership and climate, which are the hypothesized mechanisms for promoting successful long-term implementation efforts. An appropriately powered trial is needed to determine the efficacy of HELM in the future. Name of the registry: clinicaltrials.gov Trial registration number: NCT06340074 Date of registration: March 29, 2024. Retrospectively registered URL of trial registry record: https://clinicaltrials.gov/study/NCT06340074?intr=helm&rank=
Developing a Novel Integrative Health Equity and Anti-racism Tool (IHEART) for Pilot Application in a Multicenter Integrative Health Elective for Medical Students and Resident Physicians: A Study Protocol
Authors: Minichiello Vincent , Ring Melinda , Walsh Elizabeth G , Mehta Darshan 
Published: January 2025

Background This study protocol introduces the Integrative Health Equity and Anti-Racism Tool (IHEART), an innovative instrument designed to infuse equity, diversity, and inclusion (EDI) into Integrative Health (IH) education. Recognizing the gaps in current IH training that fail to address social and systemic inequities adequately, the IHEART is intended to respond to the growing need for inclusivity in IH practices and educational materials. The tool is mainly focused on addressing issues such as accessibility of complementary and integrative health (CIH) therapies, cultural misappropriation, anti-racism, gender diversity, disability justice, trauma-informed care, weight inclusivity, and planetary health, which are currently inconsistently covered in IH training. Methods/Design Developed by a team seeking to embed EDI more consistently in IH education, the IHEART provides reflection questions tailored to the unique philosophy and topics of IH. These questions are intended for use by IH educators in creating and delivering educational content, including handouts, slides, textbooks, and curricula. This tool differentiates itself from existing health equity tools used in general medical education by catering to the nuanced needs of IH training. The article outlines the iterative development process of the IHEART and plans for future pilot implementation and revision. Discussion By introducing this tool, the study protocol aims to enhance the inclusivity and relevance of IH education, aligning it more closely with contemporary social justice imperatives. The IHEART is positioned as a crucial step towards transforming IH education and practice, making it more accessible and equitable for diverse communities and ensuring that IH continues to evolve as a holistic and inclusive field.
Investigating BLS instructors’ ability to evaluate CPR performance: focus on compression depth, rate, and recoil
Authors: Lin Shih-Jhan , Chang Chih-Jan , Chu Shao-Chung , Chang Ying-Hsin , Hong Ming-Yuan , Huang Po-Chang , Kao Chia-Lung , Chi Chih-Hsien 
Published: January 2025

Abstract

Background
Out-of-hospital cardiac arrest (OHCA) presents significant challenges with low survival rates, emphasizing the need for effective bystander CPR training. In Basic Life Support (BLS) training, the role of instructors is pivotal as they assess and correct learners’ cardiopulmonary resuscitation (CPR) techniques to ensure proficiency in life-saving skills. This study evaluates the concordance between CPR quality assessments by Basic Life Support (BLS) instructors and those determined through Quantitative CPR (QCPR) devices, utilizing data from BLS courses conducted at National Cheng Kung University Hospital from October 2017 to April 2018.

Methods
The study analyzed existing data from BLS courses, comparing CPR quality assessments made by instructors with those recorded by QCPR devices. Key metrics such as chest compression speed, depth, and recoil were examined to identify the degree of consistency between human and automated evaluations.

Results
In this study, CPR performance was analyzed using QCPR devices and BLS instructors across metrics like speed, depth, and recoil. Employing the Cohen kappa statistic revealed moderate to low interrater reliability, the kappa value is 0.65 (95% C.I. 0.65–0.65) for depth, 0.56 (95% C.I. 0.33–0.79) for speed, and 0.50 (95% C.I.0.28–0.71) for recoil. Correlation analysis visualized in a heatmap indicated a higher consistency in depth evaluations (correlation coefficient = 0.7) compared to speed and recoil, suggesting a need for improved alignment in CPR training assessments.

Conclusions
The study underscores the importance of refining CPR training methods and adopting advanced technological aids to enhance the reliability of CPR skill assessments. By improving the accuracy of these evaluations, the training can be better tailored to increase the effectiveness of life-saving interventions, potentially boosting survival rates in out-of-hospital cardiac arrest scenarios.
Circulating Levels of Glial Cell Line-Derived Neurotrophic Factor (GDNF) in Schizophrenia: a systematic review and meta-analysis
Authors: Davarinejad Omran , Komasi Saeid , Moradi Mohammad-Taher , Golmohammadi Farzaneh , Bahrami Maryam , Lashgarian Hamed Esmaeil , Jalalvand Masumeh , Hookari Sara , Kazemisafa Fatemeh 
Published: January 2025

Abstract

Background
Glial cell line-derived neurotrophic factor (GDNF) has emerged as a potential biomarker for schizophrenia (SCZ). However, GDNF levels remain unclear in affected individuals compared to healthy controls. Therefore, we aimed to calculate a pooled estimate of GDNF levels in patients with SCZ in comparison with healthy controls.

Methods
A systematic search was performed in PubMed, Scopus, Web of Science, and Science Direct for published studies from the first date available up to 17 June 2024. Twelve studies (n = 817 patients and 691 healthy controls) were included in the meta-analysis. Subgroup analyses and meta-regression were performed, addressing heterogeneity and publication bias.

Results
Random-effects estimates (d = –0.80, p < 0.001) of the present meta-analysis revealed a significant mean difference in GDNF levels between SCZ patients and healthy controls. Subgroup analyses indicated that the standardized mean difference of GDNF was larger in European samples (d = –1.01, p ≤ 0.001) than in the Asian population (d = –0.61, p = 0.011). Non-medicated SCZ patients (d = –1.08, p ≤ 0.001) exhibited lower GDNF levels than those on medication (d = – 0.70, p = 0.004). Additionally, patients with a disease duration of ≥ 10 years showed lower levels of GDNF (d = –0.93, p = 0.058 versus d = –0.82, p = 0.002).

Conclusions
The findings suggested that GDNF may be a promising biomarker and therapeutic target for schizophrenia. Future research should focus on elucidating the mechanisms underlying altered GDNF levels and exploring its implications for treatment strategies.
Prominosomes - a particular class of extracellular vesicles containing prominin-1/CD133?
Authors: Karbanová Jana , Thamm Kristina , Fargeas Christine A. , Deniz Ilker A. , Lorico Aurelio , Corbeil Denis 
Published: January 2025

Abstract
Extracellular membrane vesicles (EVs) offer promising values in various medical fields, e.g., as biomarkers in liquid biopsies or as native (or bioengineered) biological nanocarriers in tissue engineering, regenerative medicine and cancer therapy. Based on their cellular origin EVs can vary considerably in composition and diameter. Cell biological studies on mammalian prominin-1, a cholesterol-binding membrane glycoprotein, have helped to reveal new donor membranes as sources of EVs. For instance, small EVs can originate from microvilli and primary cilia, while large EVs might be produced by transient structures such as retracting cellular extremities of cancer cells during the mitotic rounding process, and the midbody at the end of cytokinesis. Here, we will highlight the various subcellular origins of prominin-1+ EVs, also called prominosomes, and the potential mechanism(s) regulating their formation. We will further discuss the molecular and cellular characteristics of prominin-1, notably those that have a direct effect on the release of prominin-1+ EVs, a process that might be directly implicated in donor cell reprogramming of stem and cancer stem cells. Prominin-1+ EVs also mediate intercellular communication during embryonic development and adult homeostasis in healthy individuals, while disseminating biological information during diseases.

Graphical abstract