bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coming to my own wisdom: A qualitative study exploring the role of the Take Charge intervention in stroke recovery
Authors: Fu Vivian , Fernando Kathryn Mary , Bright Felicity , Riley Judith , McPherson Kathryn , McNaughton Harry ,   on behalf of the Taking Charge After Stroke trial investigators
Published: February 2025

Objective The Take Charge intervention, delivered early after hospital discharge following acute stroke, is effective at improving 12-month health status, independence and advanced activities of daily living. This study aims to provide a deeper understanding of the experiences of receiving Take Charge. Design This was a qualitative study nested within a large randomised control trial, the Taking Charge After Stroke (TaCAS) study. Data were analysed using thematic analysis, and we describe our findings using interpretive description. Participants People with stroke aged over 18 years, who were participants in the TaCAS study conducted in Aotearoa New Zealand. Intervention Take Charge, a person-centred conversation delivered face-to-face, designed to explore a person's identity and priorities, conducted by a trained facilitator and guided by a workbook. Results We interviewed nine participants, three from each of the three arms of the TaCAS trial – each would have received one, two, or zero Take Charge sessions (the control group). The overall theme of ‘Doing things my way/coming to know my own wisdom and expertise’ was enabled by ‘being listened to and feeling heard’ and ‘focusing on the goals which were important to me’, both strongly expressed by people who received the Take Charge intervention, and hindered by ‘medical paternalism’ and ‘loss of sense of self/“not me”’ most commonly expressed by people in the control arm. Conclusions The Take Charge intervention empowers people with stroke by enhancing intrinsic motivation. A trusting, therapeutic relationship and non-judgemental facilitation are essential to ensure that the person feels heard.
Rapamycin ameliorates inflammatory pain via recovery of autophagy flux mediated by mammalian target of rapamycin (mTOR) signaling pathway in the rat spinal cord
Authors: Zhang Jiawei , Chen Shi , Zhang Rongyi , Zheng Xiaoting , Liu Chang , Zhang Jiqian , Zhang Lei , Yang Zhilai , Wang Likui 
Published: February 2025

Objective: This study aimed to investigate the effect of rapamycin on inflammatory pain in rats. Introduction: Inflammatory pain is a kind of pathological pain caused by inflammatory mediators or factors such as TNF-α (Tumor Necrosis Factor-α), IL-1β (Interleukin-1β), and IL-6 (Interleukin-6). NSAIDs and opioid analgesics are commonly used for relieving inflammatory pain, but the side effects limit their clinical application. New drugs based on new mechanisms for inflammatory pain are urgently needed. Autophagy is an evolutionarily conserved homeostatic process for lysosomal degradation of intracellular components. Recent reports indicate the involvement of autophagy in the development and maintenance of neuropathic pain, but the role of autophagy in inflammatory pain still needs to be explored. Methods: The pain-related behaviors of rats were studied by paw withdrawal threshold and paw withdrawal latency. The autophagy level of the rat spinal cord was detected by western blots. The concentrations of TNF-α, IL-1β, and IL-6 were detected by ELISA. Results: We found that the paw withdrawal threshold and paw withdrawal latency were both significantly decreased after CFA (Complete Freund’s Adjuvant) injection, accompanied by the activation of mTOR signaling pathway and the inhibited autophagy flux in the spinal cord. And inflammatory cytokines were increased in the spinal cord after CFA injection. Then, we studied the effect of rapamycin on CFA-induced inflammatory pain in rats, and found that rapamycin restored the autophagy flux and significantly reduced mechanical allodynia and thermal hyperalgesia. In addition, rapamycin significantly decreased the levels of TNF-α, IL-1β, and IL-6 after CFA injection in the spinal cord. Conclusion: Our results suggested that rapamycin might be a promising candidate for the treatment of inflammatory pain by restoring the autophagy flux in the spinal cord.
Design and performance test analysis of sine-wave curved carbon fiber composite membrane disk
Authors: Wang Xiaohong , Xu Jiang , Zhu Guanyu , Liu Changxi , Bi Fengyang 
Published: February 2025

The diaphragm plate is one of the key components of elastic coupling. The use of carbon fiber composite materials (CFRP) to manufacture elastic coupling diaphragms can better improve the operation of the shaft system in the transmission system. Diaphragm surface design is a key content of diaphragm design. In this paper, a sine-wave curved membrane disk structure is designed based on ABAQUS. The effects of different surface forms, ply angles and ply angle ratios on the structural properties of CFRP diaphragms were compared and analyzed. The CFRP sine-wave curved diaphragm plate is fabricated by the compression molding process, and experimental testing and validation research on the torque transmitting ability and the axial displacement compensation ability of the CFRP sine-wave curved elastic membrane disk structure are carried out. The test results show that the CFRP sine-wave curved elastic membrane disk structure of this pavement structure can transmit a torque of 7.5 kN·m, and the axial displacement compensation capacity can reach 4 mm, which is better than that of the ordinary elastic membrane disk structure with better axial displacement compensation capacity.
Factors Associated With Physical Activity in Alzheimer’s Disease: A Cross-Sectional Study of Individuals and Their Caregivers
Authors: Clina Julianne G. , Bodde Amy E. , Chang Joy , Helsel Brian C. , Sherman Joseph R. , Vidoni Eric D. , Williams Kristine N. , Washburn Richard A. , Donnelly Joseph E. , Ptomey Lauren T. 
Published: February 2025

Introduction Physical activity (PA) is associated with better outcomes in individuals living with Alzheimer’s and related dementia (ADRD). We examined environmental, intra-, and interpersonal correlates of PA for persons living with ADRD. Methods PA (accelerometry), cognitive function, physical function, and sociodemographic factors were collected in adults with ADRD and their caregivers. Spearman’s correlations and generalized linear models were used to evaluate factors associated with PA of persons living with ADRD. Results Valid data were obtained from 65 pairs of adults living with ADRD (73.6 ± 8.4 years, 39.4% female) and caregivers (69.4 ± 9.4 years, 69.2% female, 93.8% spouse). Moderate-to-vigorous PA (MVPA) and light PA of persons living with ADRD were correlated with upper and lower body strength, aerobic fitness, and agility. MVPA and sedentary time of persons living with ADRD were associated with that of their caregiver. Conclusion Physical function and caregiver PA may be targets for interventions in those living with ADRD.
Deep learning-based AI model for sinusitis diagnosis
Authors: Zhang Jingfei , Wang Dianyi , Li Wentao , Wang Jingyi 
Published: February 2025

Problem statement While CT (Computed Tomography) is commonly used, its diagnostic accuracy for chronic sinusitis remains uncertain. Moreover, the high cost of CT examinations limits its use as a routine diagnostic method. There is an urgent need to develop an AI-assisted diagnostic model for sinusitis. Objective The primary aim of this study is to develop an AI-assisted diagnostic model for sinusitis that can improve diagnostic accuracy and accessibility compared to traditional CT methods. Methodology This study utilized a retrospective approach, focusing on patients diagnosed with chronic sinusitis via CT and normal patients admitted to the People's Hospital between January 2018 and January 2019. A total of 5000 sinus CT images were collected. All cases underwent T (targeted) coronal plain scans in the hospital's CT room, ensuring complete CT images. In constructing the chronic sinusitis classification model based on deep learning, 5000 CT images of soft tissue windows and sinuses were gathered. This included 1000 CT images for each of the four groups diagnosed with sphenoid sinusitis, frontal sinusitis, ethmoid sinusitis, and maxillary sinusitis, along with 1000 images from normal cases (250 images per group). The sigmoid function replaced the softmax function, and the binary cross-entropy function was used to assess the model's predictive accuracy. Results The model achieved an accuracy of 85.8%, outperforming doctors with low (71.7%), medium (78.4%), and senior (73.4%) qualifications. The model demonstrated high accuracy, superior feature extraction, and resolution capabilities.
Terminally Ill Patients: Self-Care Abilities and Compassion in Nurses and Informal Caregivers
Authors: Baykal Dilek , Akar Ezgi Nur , Sahin Eraslan Aysenur , Yilmaz Mihriban 
Published: February 2025

Background Palliative care units are centers where comprehensive care is provided, primarily by nurses, but also by informal caregivers who are usually the patients’ relatives. The difference is that nurses fulfill this duty professionally, and their levels of self-care and compassion are not expected to be affected by their work. In this regard, comparing the levels of compassion and self-care in patients’ relatives and nurses will provide evidence to help raise awareness and support both groups. Aims This study aimed to determine the relationship between the self-care abilities and compassion of nurses and informal caregivers. Design This was a descriptive, cross-sectional study. Settings/Participants The study was conducted between August 2023 and July 2024 in palliative care units in Istanbul. A total of 98 nurses and 96 informal caregivers participated in the study. They were administered the Exercise of Self-Care Agency Scale and the Compassion Scale. Results The mean compassion scores of the informal caregivers and nurses were high, with no significant difference ( P > .05). However, a significant difference was observed in their self-care ability scores, with nurses scoring lower in self-care compared to informal caregivers ( P < .05). Conclusions Nurses working in palliative care had a similar level of compassion as the primary relatives of the patients. However, it is concerning that the nurses had less ability to engage in self-care than the informal caregivers. This result indicates that nurses need support to enhance their self-care.
Evaluation of the Reliability of Facial Models Digitalized with Different Imaging Methods in Cleft Lip and Palate
Authors: Budak Hüseyin , Yilmaz Hanife Nuray 
Published: February 2025

Objective To compare the reliability of different digitizing methods not only among themselves but also with direct measurements from facial plaster models of unoperated cleft babies. Design Single-center retrospective study. Setting The study consisted facial models of babies with unilateral (UCLP, n = 65) and bilateral (BCLP, n = 65) cleft lip and palate from the archives of the Department of Orthodontics, Marmara University, Istanbul, Turkey. Those models were digitized using Medit i600, iTero Element 2 (Align Technology), and E3 3Shape scanning devices. A digital caliper with a 0.03 precision (INSIZE Digital Caliper) was used for manual measurements on plaster models. 3Shape Ortho Analyzer software was used for digital measurements. Results All scanning methods were reliable and compatible with a rate of 90% or more compared to manual measurements. The E3 3Shape device showed the lowest deviations (UCLP, between 0.04 and 0.11 mm; BCLP, between 0.04 and 0.25 mm) from manual measurements. In the UCLP group, Medit i600 presented the highest deviation (0.15-0.58 mm) whereas Itero Element 2 showed the highest deviation in the BCLP group (0.16-0.46 mm). Although there were statistically significant differences in the deviations of digital measurements, the values were still within clinically acceptable limits. Conclusion Intraoral scanners were less reliable in topographic measurements, especially in cases with increased depth. Although the highest compatible results were found with E3 3Shape model scanner, iTero Element 2 and Medit i600 were promising and advisable for digitizing and archiving the plaster models of babies with cleft lip and palate.
Cost-Consequence Analysis of Apixaban Versus Rivaroxaban for Managing Patients with Venous Thromboembolism in Saudi Arabia
Authors: Almutairi Abdulaali R. , Alruthia Yazed , Alyami Majed S. , Alshaya Omar A. , Alanazi Taif Z. , Al Daghreer Sarah I. , Korayem Ghazwa B. , Alrasheed Sarah A. , Alorf Reema A. , Almohammed Omar A. 
Published: February 2025

Background and Objective Direct oral anticoagulants (DOACs) have been proven to be cost-effective for treating various conditions, including venous thromboembolism (VTE). Nevertheless, there are no studies assessing the cost-effectiveness of DOACs for VTE treatment in Saudi Arabia using real-world data. Hence, this study seeks to examine the costs and medical consequences of apixaban compared to rivaroxaban in treating VTE patients in Saudi Arabia. Methods A retrospective cohort study was carried out in three tertiary care hospitals spanning from January 2016 to December 2020. The measure of effectiveness is defined as the likelihood of preventing the composite of VTE recurrence (rVTE), major bleeding (MB), or clinically relevant non-major bleeding (CRNMB) within 90 days of the indexed VTE event, and rehospitalization due to rVTE, MB, or CRNMB. The effectiveness was determined by calculating 1 minus the probability of experiencing the composite outcome. The incremental cost-effectiveness ratio (ICER) was computed from the perspective of the Saudi National Health System, therefore only direct costs were considered. The 95% confidence interval surrounding mean costs and effectiveness rates was calculated using the bootstrapping method. Sensitivity analyses were also carried out. Results In the analysis, 367 patients were included, with 176 on apixaban and 191 on rivaroxaban. The average annual medication costs for apixaban and rivaroxaban were $547.05 and $577.77, respectively. The mean annual direct medical costs for apixaban and rivaroxaban were $6496.83 (95%CI 5748.86-7457.97) and $5528.58 (95%CI 4836.21-6024.52), respectively. Apixaban's and rivaroxaban's mean effectiveness rates were 0.91 (95%CI 0.87-0.96) and 0.77 (95%CI 0.71-0.83), respectively. This resulted in an ICER of $6916.07 for the prevention of an additional composite outcome when using apixaban instead of rivaroxaban. The use of apixaban for preventing composite outcomes has been found to be more effective but costlier in 94.81% of the bootstrap cost-effectiveness distributions compared to rivaroxaban. It was also found to be more effective and less costly in 5.19% of the bootstrap cost-effectiveness distributions. Conclusion Apixaban demonstrated superiority over rivaroxaban in preventing composite outcomes, encompassing rVTE, MB, CRNMB, and rehospitalization. Nevertheless, this was correlated with increased direct medical expenses. These findings emphasize the necessity of a well-rounded approach when choosing anticoagulants, considering both clinical effectiveness and economic considerations. This study's results are impactful for improving patient care and resource allocation, underscoring the pivotal role of cost-effectiveness in healthcare decision-making.
Beyond Crisis: Enhancing Behavioral Response Through a Conceptual Framework
Authors: Olmedo Alirio , Muir Jane 
Published: February 2025

Objective The objective of the study is to present a conceptual model informed by existing literature surrounding behavioral health crises and response teams. Method The Behavioral Crisis Response Model (BCRM) was developed through a comprehensive literature review, synthesizing existing knowledge to clarify the structure, relationships, and processes between patients and Behavioral Response Teams (BRTs), focusing on published literature from 2018 to 2023. Themes to inform the BCRM were developed through iterative review and discussion with an expert panel. Results The BCRM framework comprises five key domains: Patient-Centered Care, Preparation, Planning, Execution, and Evaluation. Each domain encompasses specific actions and strategies to ensure comprehensive and effective crisis intervention. The Patient-Centered Care domain ensures the patient remains the focus during a crisis. The Preparation domain focuses on readiness through training and resource verification. The Planning domain involves initial and risk assessments, followed by devising a tailored response plan. The Execution domain emphasizes the implementation of the response plan with adaptable leadership styles. The Evaluation domain involves debriefing, root cause analysis, and performance reviews to promote continuous improvement. Conclusion The BCRM offers a patient-centered, structured approach to managing behavioral health crises and enhancing team cohesion and effectiveness. Further evaluation of adopting the BCRM is needed within health care institutions to improve patient outcomes, reduce harm, and advance better care quality.
Postural drainage and high flow nasal oxygen therapy in four cats with decompensated cardiogenic pulmonary oedema
Authors: Adamik Katja-Nicole , Guillet Claire , Hennink Imke 
Published: February 2025

Case series summary This case series describes four cats with decompensated congestive heart failure and fulminant cardiogenic pulmonary oedema (CPE) that did not respond to conventional treatment and oxygen therapy, and subsequently developed hypoxaemic respiratory failure. The cats were anaesthetised to enable endotracheal intubation, manually ventilated with 100% oxygen and postural drainage was performed immediately to evacuate pulmonary oedema. Afterwards, the cats were extubated and transitioned to high-flow nasal oxygen (HFNO). HFNO allowed significant improvement in the respiration parameters without causing clinical complications. In three of the cats, the procedure was successful; duration of HFNO ranged between 4 and 44 h, and they were successfully weaned off the HFNO therapy. One cat required re-intubation due to HFNO-response failure and was ultimately euthanased. Another cat was euthanased 5 days later due to the severity of its underlying disease. Relevance and novel information This is the first report describing the combined technique of postural drainage and HFNO in cats with decompensated CPE. This combined technique could be a life-saving option for cats that fail to respond to conventional therapies and for which positive pressure ventilation is not an option.
Shear wave elastography of the deltoid muscle in healthy volunteers – quantifying age-dependent normal values
Authors: Ivanov David V , Voelkel Jacob E , Giambini Hugo , Sanchez-Sotelo Joaquin , Dave Jaydev K , Kummer Tobias 
Published: February 2025

Introduction Reverse shoulder arthroplasty (RSA) is performed for various shoulder pathologies. Inadequate tensioning of the deltoid muscle can lead to complications, highlighting the need for optimization. Preoperative quantification of deltoid health may improve operative execution and outcomes. Shear wave elastography (SWE) quantifies stiffness as a marker for muscle health and tensioning. This study establishes normal reference values for the deltoid in healthy individuals. Methods 40 participants were enrolled, 10 in each 18–30, 31–40, 41–55, and 55 + age groups. Two operators performed SWE in 3 deltoid regions, and the intra- and inter-operator agreement was assessed. Results Mean values were 23.2 ± 4.6, 26.4 ± 5.6, and 17.9 ± 5.2 kPa for the anterior, lateral, and posterior regions. The posterior region did not show any age dependency. However, there were significant differences between the age groups of 18–30 and 55 + years in the anterior (19.7 ± 3.7 vs. 26.7 ± 5.3 kPa) and lateral (22.0 ± 5.4 vs. 30.2 ± 8.8 kPa). Intra-operator reliability ranged from 0.45 to 0.60, and inter-reader agreement from 0.57 to 0.85. Conclusion This study provides reference values of deltoid stiffness which could serve as a comparison with clinical measurements for RSA operative planning and execution and prediction of surgical outcomes.
Keeping Healthcare Workers Safe During a Pandemic: Evaluating Doffing Area Design for Safer Removal of Personal Protective Equipment
Authors: Matić Zorana , Oh Yeinn , Grindle Amanda , DuBose Jennifer R. , Lim Lisa 
Published: February 2025

Objective This study proposes a user-centered methodology to quantify the design affordances of doffing spaces, focusing on the safety and efficiency of healthcare workers (HCWs). Background Doffing personal protective equipment (PPE) poses a significant challenge for healthcare workers (HCWs) due to the high risk of self-contamination. The physical design of the doffing area plays an important role in ensuring safety during this process. However, there currently are no established spatial metrics for assessing the design of doffing spaces. Methods Four doffing areas in two Biocontainment Units (BCUs) were evaluated using Functional Scenario (FS) analysis method. FSs, representing the spatial needs of key users (HCW and Trained Observer—TO) were developed based on observations, literature, and discussions with staff. For each FS, we defined quantifiable metrics for visualizing the user's needs and evaluating doffing area design performance. Results We defined 11 FSs (seven for HCWs and four for TOs) and 19 associated spatial metrics. FSs for the HCW focused on the prevention of self- and cross-contamination, as well as facilitating visibility, efficiency, and situational and process awareness. The FSs for the TO center on preventing self-contamination, promoting visibility and process awareness, and safe waste management. Conclusions The FS approach allowed for the quantification of doffing area affordances and evaluation of how they impact HCW performance, emphasizing design aspects that enhance safety and efficiency. The presented metrics and study findings are expected to inform the future design of spaces where doffing occurs and provide new guidance for improved doffing safety.
A multi-disciplinary, protocolised care for hip fracture surgeries shortens hospital stay, time to admission and surgery
Authors: Wong Khai Cheong , Cheok Gideon Jia Wei , Tay Kenny Xian Khing , Koh Joyce Suang Bee , Howe Tet Sen , Ng Yeong Huei 
Published: February 2025

Background Our institution implemented a multi-disciplinary protocolised care for surgically managed hip fractures in 2017, initiating measures pre-operatively to provide early access to surgery, and post-operatively to ensure early mobilisation and smooth transition to step down care. Objectives Key performance indicators (time to admission and time to surgery) and acute outcomes (length of stay, discharge disposition and inpatient mortality) were evaluated to determine the impact of multi-disciplinary protocolised care on surgically managed hip fracture patients. Methods 935 patients in the POST-PROTOCOL group (between February 2017 to January 2020) were compared with 701 patients in the PRE-PROTOCOL group (between January 2015 to January 2017) in terms of key performance indicators and acute outcomes. Results In the POST-PROTOCOL group, a higher proportion were of ASA class III and IV ( p = .026). More patients in the POST-PROTOCOL group were admitted to the ward within 4 hours (97.2% vs 86.0%; p < .001) and operated on within 48 hours (56.4% vs 36.8%; p < .001). Mean length of stay was shorter in the POST-PROTOCOL group (11.2 ± 9.0 vs 14.8 ± 13.0 days; 95% CI, 2.5 to 4.7; p < .001), with more patients discharged within 9 days (55.6% vs 43.2%; p < .001). Inpatient mortality rate was similar ( p = .213). Conclusion Despite having a higher proportion of patients with poorer physiological status, time to admission, time to surgery and length of stay improved in the POST-PROTOCOL group.