bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of PTSD and Obstructive Sleep Apnea on Cognition in Older Adult Veterans
Authors: Noland Madeline D.W. , Paolillo Emily W. , Noda Art , Lazzeroni Laura C. , Holty Jon-Erik C. , Kuschner Ware G. , Yesavage Jerome , Kinoshita Lisa M. 
Published: January 2023

Background: Posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA) are highly prevalent and comorbid among older adult male veterans. Both PTSD and OSA are independently associated with cognitive deficits in older adults, but little research regarding the impact of comorbid PTSD and OSA among older adults exists. Purpose: The current study aimed to examine the independent and interactive effects of PTSD and OSA on cognitive functioning in older adult veterans. Study Sample: Older adult male veterans with ( n = 106) and without PTSD ( n = 69), ranging in age from 55 to 89 ( M = 63.35). Data Collection: Participants underwent polysomnography evaluation to assess severity of OSA symptoms and comprehensive neuropsychological evaluation to assess cognitive functioning in 3 domains: attention and processing speed, learning and memory, and executive functioning. Results: Multiple regression analyses showed that the interaction between PTSD and OSA did not predict cognitive performance. However, PTSD significantly predicted poorer attention and processing speed, and increased OSA severity predicted poorer learning and memory. Conclusions: While PTSD and OSA did not have a synergistic detrimental impact on cognition, each independently predicted poorer cognitive functioning within certain domains, suggesting that older adults with these comorbid conditions may experience a wider array of cognitive difficulties.
New strategy for the development of lightweight ballistic armors with limited backface signature
Authors: Berrouane Abdelwahed , Derradji Mehdi , Khiari Karim , Amri Bouchra , Mehelli Oussama , Abdous Slimane , Zegaoui Abdeljalil , Ramdani Noureddine , Belgacemi Raouf , Liu Wenbin 
Published: January 2023

In this study, a new strategy is adopted for the development of advanced, and lightweight ballistic armor. This new generation of ballistic protections is referred to as “hybrid”, in which certain layers of Kevlar have been impregnated with a high-performance green and bisphenol-A free thermosetting resin, namely the vanillin-based benzoxazine (Va-BZ). The role of thermosetting polymer is to slow down and stop the projectile. In addition, the backface signature (BFS) with a minimum number of Kevlar layers is reduced. Indeed, this kind of matrix not only possesses one of the highest crosslinking densities in the field, but also offers excellent mechanical and thermal properties. The adopted experimental approach consists in gradually changing, in increments of 5, the number of impregnated Kevlar layers. The ultimate goal is to reduce the number of Kevlar layers from 26 (currently in use) to 20 while ensuring a BFS of less than 44 mm (as per the requirement of the National Institute of Justice standard NIJ-0101.06). Indeed, the adopted strategy allowed significant reduction in the BFS. For instance, armors made of 20 layers of Kevlar layers in which 10 layers were impregnated by the Va-BZ displayed the minimal BFS value of 36.54 mm. Hence, by introducing the Va-BZ resin, the non-perforated Kevlar fabrics gained enough rigidity to sustain the impact with minimal deformation. Overall, these newly developed armors offer the best BFS possible to protect vital human body parts.
Palliative Care in Patients With Hematological Malignancies. We Have a Long Way to Go…
Authors: Allende-Pérez Silvia , García-Salamanca María F. , Peña-Nieves Adriana , Ramírez-Ibarguen Ana , Verástegui-Avilés Emma , Hernández-Lugo Isabel , LeBlanc Thomas W. 
Published: January 2023

Background: Patients with hematological malignancies have significant and diverse palliative care needs but are not usually referred to specialist palliative care services in a timely manner, if at all. Objective: To identify the characteristics of patients with hematological malignancies referred to the palliative care service in a tertiary hospital in Mexico City. Patients: Retrospective study including consecutive patients with hematological malignancies referred to palliative care services at Mexico’s National Cancer Institute. Results: Between 2011 and 2019, 5,017 patients with hematological malignancies were evaluated for first time at Mexico’s National Cancer Institute. Of these, 9.1% (n = 457) were referred to palliative care. Most were male (53.4%), with a median age of 58 years. The most frequent diagnosis was non-Hodgkin lymphoma (54.9%). The primary indication for referral to palliative care was for cases wherein chemotherapy was no longer an option (disease refractory to treatment, 42.8%). The median time of referral to the palliative care service occurred 11.2 months after the first evaluation at the National Cancer Institute and death occurred on median 1.1 months after the first palliative care evaluation. Conclusion: Patients with hematological neoplasms are infrequently referred to Palliative Care at the Institute (9.1%). We found no clear referral criteria for Palliative Care referral and note that hematologists’ optimism regarding a cure can delay referrals. Clearly, we have a long way to go in improving the number of patients referred, and we still saw frequent referrals near the end of life, but the high rate of outpatient referrals is encouraging.
Medical Students’ Reflections on Their Experiences in a Trauma Chaplain Shadowing Program
Authors: Suda Seiji , Burkbauer Laura , White Betty , Browning James , DeLisser Horace M. 
Published: January 2023

The importance of spirituality in patient care is well recognized and efforts to develop educational opportunities to improve medical students’ competency in spirituality and health are ongoing. In this regard, shadowing of healthcare chaplains has emerged as an experiential approach for providing exposure to and instruction in issues of spirituality in the patient experience and in patient care. Recently published data suggest that a 6-8 hour experience of shadowing a trauma chaplain is effective at introducing first-year medical students to healthcare chaplaincy, difficult spiritual conversations with patients and families, and interprofessional collaboration. As a follow-up to these data, this study provides a qualitative analysis of student reflections written immediately after their shadowing experience with the goal of further characterizing the educational impact of trauma chaplain shadowing. Qualitative analysis of 90 anonymous, student reflections indicated that trauma chaplain shadowing was an experience that provided insights about nature of chaplaincy, enabled opportunities to closely observe the relational skills of chaplains, allowed students to bear witness to suffering, fostered growth toward a professional identity, and facilitated recognition of shortcomings in medical education and clinical medicine. These data therefore provide further evidence of the value of chaplain shadowing in not only enhancing students’ understanding of various dimensions of spirituality and medicine but also in promoting their development of a strong physician identity.
Pre-Occupation: A Meta-Analysis and Meta-Regression of Gender Differences in Adolescent Vocational Interests
Authors: Baerg MacDonald Kristi , Benson Alex , Sakaluk John Kitchener , Schermer Julie Aitken 
Published: January 2023

Vocational interests have important implications for a range of life outcomes, such as satisfaction with career choice. Extending research on gender differences in vocational interests with adult samples, we sought to evaluate whether a similar pattern emerged during adolescence in a meta-analysis and explored moderators via meta-regression. Examining 41 studies using 3-level meta-analysis, gender differences in vocational interests are substantially accounted for using Holland’s RIASEC framework. Male adolescents have higher interests in Realistic and Investigative careers and female adolescents have higher interests in Social and Artistic careers. The differences were not moderated by year, national gender inequality ratings, or scale type. The study highlights that there are patterns in gender differences in the vocational interests of adolescents, that these differences reflect those found with adult samples, and that the differences have been stable over the past 80 years.
Parent-to-parent support among parents of children with autism: A review of the literature
Authors: Lee James D , Terol Adriana Kaori , Yoon Christy D , Meadan Hedda 
Published: January 2023

Parents of autistic children have historically reported hardships related to raising their children. However, the access to resources related to the childrearing of an autistic child is not equitable, therefore resulting in exacerbated difficulties for parents in low-resource settings. In these situations, peer support may be a protective factor for parental resilience in which they receive various supports from other parents of an autistic child with similar experiences. Despite its potential utility, little is known about such parent-to-parent support as evidenced by no synthesis of relevant literature. To address this gap, we present a scoping review of 25 studies that included parent-to-parent support among parents of autistic children. Across these studies, a total of 141 and 747 parents participated as parent mentors and mentees with some heterogeneity in their demographic characteristics. We also identified how parent mentors were trained to provide support to their peers and social validity data related to parent-to-parent support and provided implications for future intervention research. Lay Abstract Parents of autistic children have long reported feelings of isolation and increased stress during and after receiving their child’s diagnosis. Increasing global prevalence of autism also calls for increased services and supports to meet the needs of these families, but most parents who live in low-resource settings still report exacerbated barriers. This may indicate the need for diversifying intervention delivery models to increase contextual fit and enhance implementation effects for different populations. For example, many parents have reported parent-to-parent (P2P) model to be a source of emotional support, advocacy, and knowledge related to their child’s diagnosis, and practical advice. However, little is known about this topic due to the lack of synthesis of relevant autism literature. To address this gap, we conducted a literature review to gain a deeper understanding of how P2P support is used. We identified 25 studies based on our inclusion and exclusion criteria, which we coded to extract variables such as demographic information of participants, types of P2P, dosage, target outcomes, and social validity. About half of studies focused on providing support groups for parents, and the other half focused on individual matching and mentoring for skill acquisition of parents. Across the included 25 studies, a total of 141 parents participated as parent mentors and 747 parents as parent mentees. We also present implications for future research.
Allegations of Failure to Obtain Informed Consent in Otolaryngology: Evidenced-Based Recommendations for Sinus Surgeons
Authors: Fritz Christian G. , Romeo Dominic J. , Lowery Anne S. , Rajasekaran Karthik 
Published: January 2023

Background Informed consent requires preoperative discussion of surgical risks, complications, and alternative treatment options. Allegations of incomplete informed consent are common in the field of otolaryngology. Objectives Analyze outcomes and case variables in cases of alleged informed consent failure involving otolaryngologists. Methods A legal research database containing state and federal case records from across the United States was retrospectively reviewed for malpractice claims involving informed consent and otolaryngology. Results Among the 128 informed consent cases identified, 72.6% resulted in favorable verdicts for otolaryngologists. Functional endoscopic sinus surgery (FESS) was the most common source of informed consent litigation in the field of otolaryngology, with an incidence four-fold higher than the next most litigated procedure of uvulopalatopharyngoplasty (21.9% vs 5.4%). The top four factors cited in FESS-related cases were CSF leak (10), inadequate discussion of alternative therapies (4), diplopia (3), and meningitis (3). Cases resulting in a transient injury were significantly less likely to result in a payment from a plaintiff verdict or settlement (9.1%) as compared to payment-rates among cases involving permanent complications (34.6%) ( p = 0.005). Conclusions Failure to obtain informed consent is an important factor in medical malpractice litigation. This report identifies specific, actionable recommendations aimed at protecting sinus surgeons from liability and ensuring that patients are better informed.
A systematic review of screening diagnostic tools for trigeminal neuralgia
Authors: Teshima THN , Zakrzewska JM , Potter R 
Published: January 2023

Background and objective Trigeminal neuralgia (TN) is a rare chronic neuropathic pain condition of sudden and severe pain, often described as an electric shock. Diagnosis is challenging for non-expert clinicians, particularly in primary care settings. We wanted to identify and assess the diagnostic accuracy of existing screening tools for TN and orofacial pain that could be used to support the diagnosis of TN in primary care. Databases and data treatment We searched key databases (MEDLINE, ASSIA, Embase, and Web of Knowledge and PsycINFO) supplemented by citation tracking from January 1988 to 2021. We used an adapted version of the Quality of Diagnostic Accuracy Studies (QUADAS-2) to assess the methodological quality of each study. Results Searches identified five studies, from the UK, USA and Canada; three validated self-report questionnaires; and two artificial neural networks. All screened for multiple orofacial pain diagnoses, including dentoalveolar pain, musculoskeletal pain (temporomandibular disorders) and neurological pain (trigeminal neuralgia, headache, atypical facial pain and postherpetic neuralgia). The overall quality assessment was low for one study. Conclusions Diagnosis of TN can be challenging for non-expert clinicians. Our review found few existing screening tools to diagnose TN, and none is currently suitable to be used in primary care settings. This evidence supports the need to adapt an existing tools or to create a new tool for this purpose. The development of an appropriate screening questionnaire could assist non-expert dental and medical clinicians to identify TN more effectively and empower them to manage or refer patients for treatment more effectively.
Is High-Dose Tranexamic Safe in Spine Surgery? A Systematic Review and Meta-Analysis
Authors: Akosman Izzet , Lovecchio Francis , Fourman Mitchell , Sarmiento Manuel , Lyons Keith , Memtsoudis Stavros , Kim Han Jo 
Published: January 2023

Study Design Literature review and meta-analysis. Objectives Single-center series may be underpowered to detect whether high-dose (HD) tranexamic acid (TXA) confers a higher risk of complications. We sought to determine the safety and efficacy of HD TXA as compared to low-dose (LD) or placebo. Methods A systematic literature review was performed to find studies where spine surgery patients were given HD TXA (loading dose ≥30 mg/kg). Complication rates were pooled, and meta-analyses performed on outcomes of interest. Articles were evaluated for risk of bias and a strength of evidence assessment was given for each conclusion. Results Twenty three studies (n = 2331) were included. The pooled medical complication rate was 3.2% in pediatric patients, 8.2% in adults. Using lower dose TXA or placebo as the reference, meta-analysis showed no difference in medical complications (n = 1,723, OR 1.22 [95% CI, .78 to 1.22]; P = .388; I2 = 0%) or thrombotic events (n = 1158 patients, OR 1.27 [95% CI, .71 to 2.63]; P = .528; I2 = 0%). Compared to LD, HD TXA was associated with less intraoperative blood loss (823 patients, WMD = −285 [95% CI, −564 to −5.90]; P = .0454; I2 = 86%), fewer perioperative transfusions (n = 505, OR .28 [95% CI, .082 to .96]; P = .043; I2 = 76%) and lower perioperative transfusion volumes (n = 434, WMD −227.7 mL [95% CI, −377.3 to −78.02]; P = .0029; I2 = 0%). Conclusion Compared to LD TXA or placebo, there is moderate evidence that HD is not associated with an increased risk of medical complications. Compared to LD, there is moderate evidence that HD reduces transfusion requirements. High-Dose TXA can be safely utilized in healthy patients undergoing major spine surgery.
Still a private universe? Community college students’ understanding of evolution
Authors: Dorner Meredith A. , Sadler Philip , Alters Brian 
Published: January 2023

Abstract
Background
Measuring what students know and retain about evolution is essential to improving our understanding of how students learn evolution. The literature shows that college students appear to have a poor understanding of evolution, answering questions on various instruments correctly only about half of the time. There is little research regarding evolution understanding among community college students and so this study examines if those students who are enrolled in life science classes, who are assessed using questions based on grade eight standards, show a better understanding of evolutionary principles than younger students and if there are differences in knowledge based on course enrollment. The authors utilized a survey of 41 items of the Life Sciences Concept Inventory that were specifically designed to measure knowledge about various aspects of evolution that relate to the 5–8 grade science standards on evolution. They administered it to 191 adult students who were enrolled in nine sections across five life sciences courses at one community college in Southern California.

Results
Results indicated that the students in this study possessed a fair understanding of evolution, averaging scores of nearly 70%, higher than what other researchers have found (using different instruments). Students enrolled in biology major classes scored significantly higher than those enrolled in non/mixed-major courses. There was a strong relationship between item difficulty and discrimination as well as difficulty and misconception strength. When compared with the 5–8 grade student data, the community college students showed a lower level of difficulty and higher levels of item discrimination, but the proportion choosing the most popular wrong answer (the dominant misconception), was comparable. College students showed similar patterns to the grade 5–8 students in terms of which questions and which material were the most challenging, despite performing better overall.

Conclusions
In this study, students possessed fair understanding of evolution. However, they were assessed with an instrument designed for 5th through 8th grade students. The results of this study support the need for more research into how community college students understand evolution and which factors impact that understanding.
Real world challenges in integrating electronic medical record and administrative health data for regional quality improvement in diabetes: a retrospective cross-sectional analysis
Authors: Swaleh Rukia , McGuckin Taylor , Campbell-Scherer Denise , Setchell Brock , Senior Peter , Yeung Roseanne O. 
Published: January 2023

Abstract
Background
Linked electronic medical records and administrative data have the potential to support a learning health system and data-driven quality improvement. However, data completeness and accuracy must first be assessed before their application. We evaluated the processes, feasibility, and limitations of linking electronic medical records and administrative data for the purpose of quality improvement within five specialist diabetes clinics in Edmonton, Alberta, a province known for its robust health data infrastructure.

Methods
We conducted a retrospective cross-sectional analysis using electronic medical record and administrative data for individuals ≥ 18 years attending the clinics between March 2017 and December 2018. Descriptive statistics were produced for demographics, service use, diabetes type, and standard diabetes benchmarks. The systematic and iterative process of obtaining results is described.

Results
The process of integrating electronic medical record with administrative data for quality improvement was found to be non-linear and iterative and involved four phases: project planning, information generating, limitations analysis, and action. After limitations analysis, questions were grouped into those that were answerable with confidence, answerable with limitations, and not answerable with available data. Factors contributing to data limitations included inaccurate data entry, coding, collation, migration and synthesis, changes in laboratory reporting, and information not captured in existing databases.

Conclusion
Electronic medical records and administrative databases can be powerful tools to establish clinical practice patterns, inform data-driven quality improvement at a regional level, and support a learning health system. However, there are substantial data limitations that must be addressed before these sources can be reliably leveraged.
Confirmation of the presence of Anopheles stephensi among internally displaced people’s camps and host communities in Aden city, Yemen
Authors: Allan Richard , Weetman David , Sauskojus Hendrik , Budge Sophie , Hawail Tarek Bin , Baheshm Yasser 
Published: January 2023

Abstract
Background
Declines in global malaria cases and deaths since the millennium are currently challenged by multiple factors including funding limitations, limits of, and resistance to vector control tools, and also recent spread of the invasive vector species, Anopheles stephensi—especially into novel urban settings where malaria rates are typically low. Coupled with general increases in urbanization and escalations in the number of conflicts creating rapid and unplanned population displacement into temporary shelter camps within host urban areas, particularly in the Middle East and sub-Saharan Africa, increased urban malaria is a major threat to control and elimination.

Methods
Entomological monitoring surveys (targeting Aedes aegypti) of water containers across urban areas hosting internally displaced people (IDP) communities in Aden city, Yemen, were performed by The MENTOR Initiative, a non-governmental organisation. As part of these surveys in 2021 23 larvae collected and raised to adults were morphologically identified as An. stephensi. Twelve of the samples were sent to Liverpool School of Tropical Medicine for independent morphological assessment and genetic analysis by sequencing the ribosomal ITS2 region and the mitochondrial COI gene.

Results
All twelve samples were confirmed morphologically and by sequence comparison of the single ITS2 and COI haplotype detected to the NCBI BLAST database as An. stephensi. Phylogenetic analysis with comparable COI sequences indicated close relationship to haplotypes found in Djibouti and Ethiopia.

Conclusion
The study results confirm the presence of An. stephensi in Yemen. Confirmation of the species in multiple urban communities hosting thousands of IDPs living in temporary shelters with widescale dependency on open water containers is of particular concern due to the vulnerability of the population and abundance of favourable breeding sites for the vector. Proactive monitoring and targeted integrated vector management are required to limit impacts in this area of typically low malaria transmission, and to prevent further the spread of An. stephensi within the region.