bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thoracoabdominal duplication accompanied by intestinal malrotation: a case report and literature review of a rare congenital anomaly in an infant
Authors: Mashlah Qusai , Al Laham Omar , Odah Bashi Hajar , Sharaf Aldeen Rahaf , Alashi Sami , Abdulkader Mohammd 
Published: January 2024

Introduction and importance:
Thoracoabdominal duplication and intestinal malrotation are extremely rare congenital alimentary tract anomalies that can manifest in any segment of the gastrointestinal tract. Still, tubular duplications are an even rarer subset of alimentary tract duplications. Misdiagnosis could occur and this will yield devastating ramifications. Therefore, consideration in the clinical settings is warranted to aid in conducting timely therapeutic interventions.

Case presentation:
In this article, we illustrate the overwhelmingly rare occurrence of thoracoabdominal duplication coexistent with intestinal malrotation in a 7-month-old male whose primary complaint was chronic dyspnoea since birth that progressed to involve cough and fever. Imaging analysis revealed a significant intrathoracic fluid-filled cyst.

Clinical discussion:
The intestinal malrotation was treated through Ladd’s procedure, and surgical excision of the duplicated segments was accomplished. The subsequent analysis of the resected specimens via means of histopathology utilizing Hematoxylin and Eosin dyes established the definitive diagnosis of a foregut duplication cyst.

Conclusion:
Thoracoabdominal duplication is one of the most crucial topics in the field of Paediatric Surgery. It is exceptionally rare in occurrence, and the scarcity of available resources that document and describe this topic is evident in the published literature. The authors must opt to document, study, and broaden awareness regarding this life-threatening pathology so that they can circumvent the resultant complications by means of early detection and the performance of apt surgical interventions. Upon careful review of the available literature, we can state that ours is the first-ever case documented from their country regarding this topic and this co-incidence.
Perceptions of telemedicine among healthcare professionals in rural tertiary care hospitals of rural Sindh, Pakistan: a qualitative study
Authors: Shardha Harsha K. , Kumar Grouve , Sagar  , Kumar Rajesh , Qazi Mansoor A. , Munir Saqib , Tariq Waleed , Maheshwari Payal , Kumar Bhavesh , Tahir Muhammad J. , Shrateh Oadi N. , Ahmed Ali 
Published: January 2024

Background:
Telemedicine has proven to be a boon in the field of medical sciences, as it provides a platform for all health-care personnel to assist patients remotely through digital technology advancements. It brings hope to the lower middle-income regions of the world. Thus, the study was conducted to explore the perceptions regarding telemedicine among healthcare professionals (HCP) in rural Sindh, Pakistan.

Methodology:
Overall, 19 in-depth interviews were conducted and this comprised of HCP working in the Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences (PAQSJIMS) and Peoples University of Medical and Health Sciences for Women (PUMHSW) being involved in providing online consultations and practicing telemedicine. The interviews were conducted and audio recorded in Sindhi and Urdu and were later transcribed in to English, coded for themes and sub-themes, and were analyzed using content analysis.

Results:
The opportunities perceived with the use of telemedicine services were reducing nosocomial infections, facilitating the healthcare in remote areas, handling telemedicine tools, application of telemedicine services on the ground and reducing stress. However, inadequate awareness regarding telemedicine, difficulty in physical examination, the need for training, lack of compliance, and concerns regarding accuracy in diagnosis and treatment were identified as the perceived barriers to the use of telemedicine services.

Conclusion:
HCP had perception toward telemedicine as have numerous opportunities favoring implementation as well as various barriers are needed to overcome to promote the usage of telemedicine. Increased awareness, training programs, and technological advancements are key to overcome these challenges.
Vesicular herpes zoster eruption following chronic obstructive pulmonary disease treatment in the emergency department: lessons learnt from immunosuppression
Authors: Shrestha Abhigan Babu , Gupta Pukar , Gurung Nisha , kandel Sudarshan , Upadhyay Mahima , Gurung Amrita , Karki Shailendra , Mokbul Mobin Ibne 
Published: January 2024

Background:
Herpes zoster (HZ) is a reactivation of the varicella-zoster virus (VZV) that can occur in people with weakened immune systems. Chronic obstructive pulmonary disease (COPD) is a chronic lung disease that can also impair the immune system.6–8

Case presentation:
The authors present the case of a 65-year-old male with COPD who developed HZ. The patient was initially admitted to the hospital for an acute exacerbation of COPD. After his condition stabilized, he developed vesicular rashes on the medial aspect of his left leg. A skin biopsy confirmed the diagnosis of HZ.

Clinical discussion:
This case report provides further evidence that HZ can be induced in patients who are undergoing treatment for COPD. The authors recommend that COPD patients be vaccinated against HZ to prevent this complication.

Conclusion:
HZ can develop in COPD patients, mainly using inhaled steroids. Compliance to medication should be monitored, on the other hand zoster vaccination should be provided to prevent it and its foremost complication which includes secondary bacterial infection, post-herpetic neuralgia, scarring, nerve palsy and encephalitis in case with disseminated zoster.
Reconceptualizing Patient Safety Beyond Harm
Authors: Jeffs Lianne , Kuluski Kerry , Flintoft Virginia , MacLaurin Anne , Asselbergs Maaike , Zeng Rui Lin , Bruno Frances , Schonewille Noah , Baker G. Ross 
Published: January 2024

Background:
Although patients' and care partners' perspectives on patient safety can guide health care learning and improvements, this information remains underutilized. Efforts to leverage this valuable data require challenging the narrow focus of safety as the absence of harm.

Purpose:
The purpose of this study was to gain a broader insight into how patients and care partners perceive and experience safety.

Methods:
We used a mixed-methods approach that included a literature review and interviews and focus groups with patients, care partners, and health care providers. An emergent coding schema was developed from triangulation of the 2 data sets.

Results:
Two core themes—feeling unsafe and feeling safe—emerged that collectively represent a broader view of safety.

Conclusion:
Knowledge from patients and care partners about feeling unsafe and safe needs to inform efforts to mitigate harm and promote safety, well-being, and positive outcomes and experiences.
Exploring Hospital Transfers for Long-Stay Nursing Home Residents With End-Stage Renal Disease
Authors: Canada Kelli E. , Vogelsmeier Amy A. , Popejoy Lori L. , Powell Kimberly , Brandt Lea , Rantz Marilyn 
Published: January 2024

Background:
Nursing home residents with end-stage renal disease (ESRD) are an understudied, yet growing population within nursing homes.

Purpose:
To describe hospital transfers for nursing home residents diagnosed with ESRD and receiving hemodialysis.

Methods:
Data were analyzed for residents with ESRD transferred to the hospital between October 2016 and September 2020 (n = 219). Descriptive statistics, bivariate analyses, logistic regression, and content analysis were used for analysis.

Results:
Clinical factors associated with transfers included abnormal vitals, altered mental state, and pain. Other factors included lack of care planning and advance directives, provider communication, resident/family preferences, missing/refusing dialysis, and facility resources. The odds of an observation/emergency department only visit was 2.02 times larger when transferred from the dialysis clinic.

Conclusions:
Advance care planning and coordinated care between nursing home and dialysis clinics are needed along with proactive planning when residents miss dialysis or experience a condition change at the dialysis clinic.
Comparable Efficacy of Repeated Transcranial Direct Current Stimulation, Cognitive Behavioral Therapy, and Their Combination in Improvement of Cold and Hot Cognitive Functions and Amelioration of Depressive Symptoms
Authors: Nejati Vahid , Nozari Masoumeh , Mirzaian Bahram , Pourshahriar Hosein , Salehinejad Mohammad Ali 
Published: January 2024

Abstract
This study aimed to evaluate the effectiveness of repeated transcranial direct current stimulation (rtDCS), cognitive behavioral therapy (CBT), and their combination (rtDCS-CBT) in the treatment of cognitive dysfunction, social cognition, and depressive symptoms in women diagnosed with major depressive disorder (MDD). A total of 40 female participants with MDD were randomly assigned to one of four groups: rtDCS, CBT, rtDCS-CBT, and a control group. The participants' depressive symptoms, executive functions, and social cognition were assessed at baseline, preintervention, postintervention, and during a 1-month follow-up. The rtDCS group received 10 sessions of anodal dorsolateral and cathodal ventromedial prefrontal cortex (2 mA for 20 minutes). The CBT group received 10 sessions of traditional CBT, whereas the combined group received CBT after the tDCS sessions. The results of the analysis of variance indicated that all intervention groups demonstrated significant improvements in depressive symptoms, cognitive dysfunction, and social cognition compared with the control group (all p < 0.001). Furthermore, the rtDCS-CBT group exhibited significantly greater reductions in depressive symptoms when compared with each intervention alone (all p < 0.001). Notably, working memory improvements were observed only in the rtDCS group (p < 0.001). In conclusion, this study suggests that both CBT and tDCS, either individually or in combination, have a positive therapeutic impact on enhancing executive functions, theory of mind, and depressive symptoms in women with MDD.
Interpersonal Sensitivity as a Mediator of the Effect of Childhood Parenting Quality on Depressive Symptoms
Authors: Morishita Chihiro , Masuya Jiro , Ishii Yoshitaka , Seki Tomoteru , Deguchi Ayaka , Higashiyama Motoki , Ono Miki , Honyashiki Mina , Higashi Shinji , Kusumi Ichiro , Inoue Takeshi 
Published: January 2024

Abstract
The aim of this study was to analyze whether interpersonal sensitivity mediates the effect of qualitative parenting characteristics experienced during childhood on the appraisal of life experiences and depression severity during adulthood in adult community volunteers. A total of 404 Japanese adult volunteers answered the following four self-report questionnaires: Parental Bonding Instrument, Interpersonal Sensitivity Measure, Life Experiences Survey, and Patient Health Questionnaire-9. Structural equation modeling was performed to analyze whether childhood parenting quality increases depressive symptom severity through interpersonal sensitivity, which then affects the appraisal of recent life events. In the two structural equation models, inadequate care and excessive overprotection received during childhood were associated with the negative evaluation of life experiences and depression severity in adulthood through high interpersonal sensitivity. Our findings indicate interpersonal sensitivity as a mediator of the effect of inadequate care and excessive overprotection experienced in childhood on the negative evaluation of life experiences and depression severity in adulthood.
Trend Analysis of Inpatient Medical Adverse Events in Taiwan (2014–2020): Findings From Taiwan Patient Safety Reporting System
Authors: Munkhtogoo Dulmaa , Liu Yueh-Ping , Hung Sheng-Hui , Chan Pi-Tuan , Ku Chih-Hung , Shih Chung-Liang , Wang Pa-Chun 
Published: January 2024

Objectives
Medical adverse event (MAE) reporting and management are essential for patient safety campaigns. An epidemiological assessment of MAE trends is crucial for understanding the effectiveness of patient safety improvement efforts. This study analyzed the trends of inpatient MAEs, focusing on MAE incidence and harm severity.

Methods
Longitudinal secondary data (over 2014–2020) on MAEs reported by 18 hospitals were retrieved from the Taiwan Patient-safety Reporting system. The numbers and incidence rates (per 1000 inpatient days) of reported MAEs were calculated. The harm severity levels of six major MAE categories were analyzed. Trend and generalized estimating equation analyses were conducted to investigate changes in MAE patterns.

Results
Trend analyses revealed significant decreasing trends in the number (4763–3107 per year; Jonckheere-Terpstra test = −1.952, P = 0.05) and incidence rates (0.92–0.62 per 1000 inpatient days; β = −0.5017, P = 0.00) of harmful MAEs over 7-year study period. Among the most frequently reported MAEs, tube-related events exhibited the most significant decreasing trend (28%–23.8%; Jonckheere-Terpstra test = −2.854, P = 0.00). The reported numbers, incidence rates, and severity of falls and tube-related events dropped significantly.

Conclusions
By analyzing representative longitudinal MAE data, this study demonstrated the effectiveness of nationwide patient safety improvement campaigns in Taiwan. Our data reveal significant reductions in the reported numbers, incidence rates, and severity of several major MAEs. Specifically, our data indicate significant reductions in the incidence and severity of tube-related events, which can be beneficial for patient safety improvement efforts.
Impact of Repeated Reimbursement Penalties on Hospital Total Quality Scores
Authors: Brewer Alice , Hughes M. Courtney , Patel Kunal N. 
Published: January 2024

Objectives
The incidence of hospital-acquired conditions (HACs) is a serious public health issue with implications ranging from patient morbidity and mortality to negative financial impacts on patients and health care systems. Despite substantial efforts to address and reduce HACs, research into the effect of quality improvement programs is inconclusive. This study seeks to better understand the relationship between repeated reimbursement penalties and improvement in HAC quality scores.

Methods
A quantitative comparative analysis of U.S. health care data was conducted. Data on quality outcomes and hospital characteristics were sourced from the Hospital-Acquired Condition Reduction Program from fiscal years 2018 and 2019 and the Centers for Medicare & Medicaid Services Inpatient Prospective Payment System impact files, respectively.

Results
In total, 3123 U.S. hospitals were analyzed to compare differences between total HAC scores of hospitals with and without penalties in consecutive years. Hospitals with repeated penalties had significantly greater improvement in scores (t
497.262 = −13.00, P < 0.001), and the impact was greatest in small hospitals (<100 beds). Repeated penalties had a smaller impact on disproportionate share hospitals (Cohen d = 0.73). Among all hospitals, the effect of repeated penalties was large (Cohen d = 0.75)

Conclusions
This study suggests that repeated penalties can improve quality scores in U.S. hospitals. However, the effect may be exaggerated for smaller hospitals and those that serve patient populations with a relatively higher socioeconomic status. The reason disproportionate share hospitals did not show as much improvement as nondisproportionate hospitals may be because hospitals serving vulnerable populations often have fewer resources.
Structural Competency in Simulation-Based Health Professions Education
Authors: Sagalowsky Selin T. , Woodward Hilary , Agnant Joanne , Bailey Bart , Duncan Ellen , Grad Jennifer , Kessler David O. 
Published: January 2024

Summary Statement
Simulation-based health professions educators can advance diversity, equity, and inclusion by cultivating structural competency, which is the trained ability to discern inequity not only at an individual level, but also at organizational, community, and societal levels. This commentary introduces Metzl and Hansen's Five-Step Model for structural competency and discusses its unique applicability to the metacognitive underpinnings of simulation-based health professions education. We offer a pragmatic guide for simulation-based health professions educators to collaboratively design learning objectives, simulation cases, character sketches, and debriefs in which structural competency is a simulation performance domain, alongside patient management, resource usage, leadership, situational awareness, teamwork, and/or communication. Our overall goal is to promote a paradigm shift in which educators are empowered to partner with patients, colleagues, and communities to recognize, learn about, and challenge the factors driving health inequities; a skill that may be applied to a broad range of health professions education within and outside of simulation.
Building Global Partnerships
Authors: Gower Shelley , Mossenson Adam , Ndekezi Jackson Kwizera , Livingston Patricia 
Published: January 2024

Introduction
Effective educational initiatives can elevate the quality of patient care globally. Simulation-based education is widely used in high-resource settings, but barriers exist to its widespread use in low-resource settings. Vital Anesthesia Simulation Training (VAST) overcomes these barriers by offering immersive, low-cost portable simulation along with simulation facilitator training. During the COVID-19 pandemic, in-person courses were stopped for more than 2 years. Postpandemic, a 3-day VAST SIMposium was hosted in Rwanda to unite 42 VAST facilitators from 12 widespread countries to introduce new and revised course materials and to rejuvenate dormant skills. The purpose of this study was to explore how the VAST SIMposium influenced perceived development of skills, confidence, and engagement in a community of practice for simulation educators working in low-resource settings.

Methods
This qualitative study involved in-depth interviews with a purposive sample of 16 VAST SIMposium attendees. Transcripts of audio recordings were analyzed using inductive thematic analysis.

Results
Six themes were identified during data analysis: 1) Diversity with shared passion for medical education; 2) Supportive in-person learning environment; 3) Simulation-based education relevant to low-resource settings; 4) Camaraderie; 5) Building knowledge, skills, and confidence; and 6) Being part of a community of practice.

Conclusion
The SIMposium rejuvenated passion, knowledge, skills, and, most importantly, strengthened global connections and partnerships. These collaborations will benefit areas that are underrepresented in simulation and will ultimately improve patient outcomes. A SIMposium of this format is an efficient and effective way to foster sustainable global dissemination of simulation-based global health education.
Does the injury pattern drive the surgical treatment strategy in multiply injured patients with major fractures?
Authors: Halvachizadeh Sascha , Pfeifer Roman , Duncan James , Klingebiel Felix Karl Ludwig , Kalbas Yannik , Berk Till , Neuhaus Valentin , Pape Hans-Christoph 
Published: January 2024

BACKGROUND
The timing of definitive surgery in multiple injured patients remains a topic of debate, and multiple concepts have been described. Although these included injury severity as a criterion to decide on the indications for surgery, none of them considered the influence of injury distributions. We analyzed whether injury distribution is associated with certain surgical strategies and related outcomes in a cohort of patients treated according to principles of early and safe fixation strategies.

METHODS
In this retrospective cohort study, multiple injured patients were included if they were primarily admitted to a Level I trauma center, had an Injury Severity Score of ≥16 points, and required surgical intervention for major injuries and fractures. The primary outcome measure was treatment strategy. The treatment strategy was classified according to the timing of definitive surgery after injury: early total care (ETC, <24 hours), safe definitive surgery (SDS, <48 hours), and damage control (DC, >48 hours). Statistics included univariate and multivariate analyses of mortality and the association of injury distributions and surgical tactics.

RESULTS
Between January 1, 2016, and December 31, 2022, 1,471 patients were included (mean ± SD age, 55.6 ± 20.4 years; mean Injury Severity Score, 23.1 ± 11.4). The group distribution was as follows: ETC, n = 85 (5.8%); SDS, n = 665 (45.2%); and DC, n = 721 (49.0%); mortality was 22.4% in ETC, 16.1% in SDS, and 39.7% in DC. Severe nonlethal abdominal injuries (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.4–3.5) and spinal injuries (OR, 1.6; 95% CI, 1.2–2.2) were associated with ETC, while multiple extremity injuries were associated with SDS (OR, 1.7; 95% CI, 1.4–2.2). Severe traumatic brain injury was associated with DC (OR, 1.3; 95% CI, 1.1–1.4). When a correction for the severity of head, abdominal, spinal, and extremity injuries, as well as differences in the values of admission pathophysiologic parameters were undertaken, the mortality was 30% lower in the SDS group when compared with the DC group (OR, 0.3; 95% CI, 0.2–0.4).

CONCLUSION
Major spinal injuries and certain abdominal injuries, if identified as nonlethal, trigger definitive surgeries in the initial setting. In contrast, severe TBI was associated with delayed fracture care. Patients with major fractures and other injuries were treated by SDS (definitive care, <48 hours) when the pathophysiological response was adequate. The choice of a favorable surgical treatment appears to depend on injury patterns and physiological patient responses.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level IV.
Applied machine learning techniques for chronic disease treatment default prediction and its potential benefits for patient outcome: A case series study approach
Authors: Owusu-Adjei Michael , Abdul-Salaam Gaddafi , Frimpong Twum , Hayfron-Acquah James Ben 
Published: January 2024

AbstractIn medical diagnosis context, consideration for missing diagnosis and false diagnosis of disease types are important clinical considerations for disease treatment decisions. Effect and impact of disease types especially on others forms the basis for critical clinical decisions. Impact and consequences varies across disease types especially for communicable and non-communicable diseases. Increasing use of predictive techniques owing to high use of connected internet of things devices in healthcare provides sufficient opportunity for potential benefit assessment of predictive modeling impact on disease treatment management. Effective and efficient management of non-communicable diseases such as hypertension is hampered in part by instances of multiple forms of its occurrence in patients leading to treatment management complications. Probing predictive modeling effect and implications for clinical decisions to enhance patient treatment outcome provides important evidence-based justifications for its use in healthcare systems. Effective predictive technique use is significantly dependent on areas of its application and the consequences of error for its use in context.Author summaryThe use of macro average score in class imbalance context is to treat all classes equally regardless of variations in class distributions. Clinical significance as identified in this research work includes the determination of effective and accurate predictive modeling techniques for real-world application context where class distribution variation is a characteristic feature. Identifying various sections of healthcare delivery process ensures effective application of predictive modeling techniques for the required impact on clinical decisions and its effect on patient outcome.