bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can artificial intelligence replace biochemists? A study comparing interpretation of thyroid function test results by ChatGPT and Google Bard to practising biochemists
Authors: Stevenson Emma , Walsh Chelsey , Hibberd Luke 
Published: September 2023

Background Public awareness of artificial intelligence (AI) is increasing and this novel technology is being used for a range of everyday tasks and more specialist clinical applications. On a background of increasing waits for GP appointments alongside patient access to laboratory test results through the NHS app, this study aimed to assess the accuracy and safety of two AI tools, ChatGPT and Google Bard, in providing interpretation of thyroid function test results as if posed by laboratory scientists or patients. Methods Fifteen fictional cases were presented to a team of clinicians and clinical scientists to produce a consensus opinion. The cases were then presented to ChatGPT and Google Bard as though from healthcare providers and from patients. The responses were categorized as correct, partially correct or incorrect compared to consensus opinion and the advice assessed for safety to patients. Results Of the 15 cases presented, ChatGPT and Google Bard correctly interpreted only 33.3% and 20.0% of cases, respectively. When queries were posed as a patient, 66.7% of ChatGPT responses were safe compared to 60.0% of Google Bard responses. Both AI tools were able to identify primary hypothyroidism and hyperthyroidism but failed to identify subclinical presentations, non-thyroidal illness or secondary hypothyroidism. Conclusions This study has demonstrated that AI tools do not currently have the capacity to generate consistently correct interpretation and safe advice to patients and should not be used as an alternative to a consultation with a qualified medical professional. Available AI in its current form cannot replace human clinical knowledge in this scenario.
Electrical dry needling versus a non-invasive multicomponent intervention in the treatment of myofascial trigger points in patients with chronic low back pain: A randomised clinical trial
Authors: Lara-Palomo Inmaculada Carmen , Antequera-Soler Eduardo , Fernández-Sánchez Manuel , Castro-Sánchez Adelaida María , García-López Héctor 
Published: September 2023

Objective To compare the effects of electrical dry needling with a non-invasive multi-component intervention in patients with chronic low back pain. Design A randomised single-blind clinical trial. Setting Outpatient Physiotherapy Clinic; home. Participants Sixty-four patients with chronic low back pain aged 30–65 years. Interventions Six-week electrical dry needling on myofascial trigger points, and a non-invasive multicomponent intervention (home exercise programme, stretching and ischemic compression). Main measures Pain (Visual Analogue Scale), disability (Roland-Morris Disability Questionnaire and Oswestry Disability Index), kinesiophobia (Tampa Scale of Kinesiophobia), quality of life and sleep (Short Form 36-item Health Survey and Pittsburgh Sleep Quality Index), isometric endurance of trunk flexor muscles (McQuade test), lumbar mobility in flexion (finger-to-floor distance), and pressure pain threshold (algometer) were assessed at baseline, after 6 weeks, and after 2 months. Results ANOVA showed statistically significant differences in group-by-time interaction for most pain pressure thresholds of myofascial trigger points ( P < 0.05), for disability (Roland-Morris Disability Questionnaire: F = 6.14, P = 0.016; and Oswestry Disability Index: F = 7.36, P = 0.009), for trunk anteflexion (F = 10.03, P = 0.002) and for habitual sleep efficacy (F = 6.65, P = 0.012), use of hypnotics (F = 4.77, P = 0.033) and total score of quality of sleep (F = 8.23, P = 0.006). Conclusions In comparison to a non-invasive multicomponent intervention, electrical dry needling has more positive effects on disability, pain intensity, kinesiophobia, and reducing patients’ sensitivity to myofascial trigger points pressure, at post-treatment and at 2 months. Clinical Trial Registration number NCT04804228. Registered on May 28th, 2021. Available at https://clinicaltrials.gov/ct2/show/NCT04804228
Self-management Experience of Nurses Living with Migraine: A Qualitative Study
Authors: Dione Marionette Ngole , Donelle Lorie , Smye Victoria , Befus Deanna 
Published: September 2023

Background Migraine is a neurobiological condition characterized by a constellation of unpredictable symptoms and is the second cause of disability worldwide. Migraine is prevalent among nurses. However, literature exploring nurses’ experience of living with migraine is scarce which has important individual and systems implications for health and wellness and patient safety. Self-management is essential in chronic disease management as the patient engages in various strategies to be able to live with their condition. Purpose This study explored the experiences of living and working with migraine among female nurses in Ontario, with particular attention to their priorities and strategies for self-management. Methods Interpretive description methodology was employed to guide this study and informed a thematic analysis approach to examine the self-management experiences of nurses living with migraine. Results Nurses engaged in various self-management strategies including pharmacological and non-pharmacological strategies and highlighted the role of technology in migraine self-management. Participants described experiences of living with migraine as an invisible condition including feelings of not being understood, stigmatization, and the absence of formal support at the workplace. Conclusion The implications of these findings support the incorporation of a critical approach to relational engagement that is person-centred including nonjudgemental, strength-based care as a practice approach when caring for persons living with migraines and the need to include experiential learning in educational curriculums as a strategy to reduce stigma against migraines.
Factors Associated with Nurses’ Motivation to Provide Care for Patients with Alcohol Use and Alcohol Use-Related Problems
Authors: Mahmoud Khadejah F. , Finnell Deborah. S. , Sereika Susan M. , Lindsay Dawn , Cipkala-Gaffin Janet , Mitchell Ann M. 
Published: September 2023

Background: There is a high human and economic cost associated with alcohol use and alcohol use-related problems. Nurses have a pivotal role in addressing the needs of this patient population. Purpose: The study aimed to examine the correlation between nurses’ demographics/background characteristics, personal attitudes, professional attitudes, and their motivation to provide care to patients with alcohol use and alcohol use-related problems. Methods: A descriptive, cross-sectional correlational design was utilized. Nurses were recruited from four Southwestern Pennsylvania hospitals. The study variables were examined using questionnaires that explored nurses’ demographic/background characteristics, their personal and professional attitudes, and motivation to care for patients with alcohol use and alcohol use-related problems. Results: The sample included 234 nurses. Demographic/background characteristics were identified as associated with nurse’s alcohol use-related motivation, including gender, primary work setting and specialization. Previous personal experience with alcohol use-related problems (nurses themselves or co-workers), familiarity, perceived dangerousness, fear, social distance, personal responsibility beliefs and disease model were also associated with nurses’ alcohol use-related motivation to care for these patients. In addition, all professional attitudes were associated with nurses’ motivation toward caring for patients with alcohol use and alcohol use-related problems. Conclusions: The study revealed that certain demographic/background characteristics and personal and professional attitudes were associated with nurses’ motivation to provide care to this patient population. This study provides the foundation for future studies aimed at exploring predictors of nurse’s motivation to care for patients with alcohol use and alcohol use-related problems.
Assessing dynamic characteristics for friction draft gears with worn wedge shoes
Authors: Liangliang Yang , Xiaocui Huang , Maohai Fu , Shihui Luo , Wenchang Zeng 
Published: September 2023

A friction draft gear model was developed to assess the degraded dynamic characteristics of worn draft gears in the vehicle impact condition. It presents an approach to simulate multiple typical wear profiles of wedge shoes and reflect their effects on the draft gear performance. Based on the rated design indexes and existing overhaul regulations of MT-2 type friction draft gears in China, the safety wear limits for wedge shoes with different wear profiles were classified and assessed. The results indicate that wedge shoes with uniform or concave wear can significantly worsen draft gear performance, and the existing maintenance limit of 1 mm only applies to wedge shoes with uniform wear but not to the most common wedge shoes with concave wear. Also, for wedge shoes with concave wear, when the wear area covers 50%, 75%, and 100% of the total main friction surface, the corresponding safety wear limits are 0.5 mm, 0.8 mm, and 1.3 mm, respectively. Therefore, it is proposed to design multiple graded and dynamic maintenance limits to ensure the service safety of MT-2 type friction draft gears.
Effect of Upright Positioning on the Process and Outcome of Labour Among Parturient in Primary Health Care Setting
Authors: Muhammed Auwalu , Habibu Hannatu Sarki , Ibrahim Abdullahi Haruna , Abdulrashid Idris 
Published: September 2023

Introduction The position of the woman during labour is an essential part of maternal care, but some care providers often neglect it. There are also some recommended birthing positions, but there is a lack of data on how midwives translate the findings into practice. Objective This study aimed to compare upright and supine births concerning the birth process and outcomes among women who have given birth in primary health care settings. Material and Methods This is a quantitative comparative study among parturient in primary health care setting. An observational checklist was used as a data collection tool. A total of 40 parturient (20 each for upright and recumbent position groups) were selected as the study participants. Data were analysed using an independent t-test and chi-square test. Results Findings indicated that although the uterus contracts more frequent in an upright position, there was no substantial difference between the groups concerning the progress of labour ( p > .05). However, findings suggested that the upright position is associated with a shorter duration in the third stage of labour compared to the recumbent position ( p < .05). Blood lost was <500 mils for 75% of the upright position and 55% of the recumbent position group ( p = .054). Conclusion Upright position may shorten the duration of the third stage of labour (compared to recumbent position) among parturients. Hence, midwives can utilise the upright/vertical protocol during their practice to ensure better outcome of the labour and minimise blood loss for the parturient.
Including an Adventure Education Training Program in Physical Education Teacher Education Programs
Authors: González-Rivas Ramon Alfonso , Núñez Enriquez Oscar , Marttinen Risto , Baena-Extremera Antonio , Zueck-Enríquez María del Carmen , Gastélum-Cuadras Gabriel 
Published: September 2023

Introduction Different international guidelines indicate the need for improving educational procedures. This study aims to contribute to the professional development training program of higher education professors from a Physical Education Teacher Education degree in México. Methodology This qualitative study used a participatory action research design through four cycles: (a) diagnosis; (b) elaboration of the action plan; (c) implementation and evaluation; and (d) feedback. The participants were the professor, six experts, and 17 students. Data were collected from semi-structured interviews with students and the professor, the analysis of the class syllabus, and nonparticipatory observations. Findings The importance of carrying out a diagnostic cycle allowed us to identify the specific needs of the class. Similarly, the model of development and evaluation of academic competencies (M-DECA) allowed the professor to develop specific pedagogical and disciplinary competencies from the training program. Conclusion A continuous professional development training program for university professors in pedagogical and disciplinary strategies generates better learning results. The inclusion of innovative content in the class syllabus was also crucial.
Evaluation of Basal Plus Versus Sliding Scale Insulin Therapy on Glucose Variability in Critically Ill Patients Without Preexisting Diabetes
Authors: Webster Rachel E. , Belfer Julie J. , Schmidt Kyle J. 
Published: September 2023

Background: There is limited evidence evaluating the impact of insulin treatment strategies on glucose variability in critically ill patients without preexisting diabetes. Objective: Compare basal plus insulin (BPI) and sliding scale insulin (SSI) impact on glycemic control outcomes in critically ill patients without preexisting diabetes experiencing hyperglycemia. Methods: This multicenter, retrospective review analyzed critically ill patients with hyperglycemia who received either BPI or SSI. Patients with a hemoglobin A1C >6.5% during the admission of interest or in the previous 3 months, or a diagnosis of diabetes at the time of discharge were excluded. The primary outcome was glucose variability during the intensive care unit (ICU) admission. Secondary outcomes included hypoglycemia frequency, frequency of goal glucose levels, mortality, and length of stay. Results: The analysis included 228 patients (39 in BPI, 189 in SSI). Average glucose variability was higher in the BPI group compared with the SSI group (85.8 mg/dL ± 33.1 vs 70.2 mg/dL ± 30.7; P = 0.009), which remained when controlling for baseline confounding (−12.1 [5.6], 95% CI −23.2 to −0.99; P = 0.033). Hypoglycemia incidence was similar between groups. BPI patients had a lower incidence of glucose values within goal range than SSI patients ( P = 0.046). There was no difference in length of stay or hospital mortality. Conclusions and Relevance: The use of SSI compared with a BPI regimen may result in reduced glycemic variability in critically ill patients without preexisting diabetes. Future prospective studies, with a larger sample size, are warranted to confirm our exploratory findings and characterize clinically significant benefits.
Targeted Therapies for Previously “Undruggable” KRAS-Mutated Non–Small Cell Lung Cancer: A Review of Sotorasib and Adagrasib
Authors: Mausey Natalie , Halford Zachery 
Published: September 2023

Objective: To evaluate the safety and efficacy of the novel KRAS-targeting agents, sotorasib and adagrasib, in treating KRAS G12C-mutated non–small cell lung cancer (NSCLC). Data Sources: A comprehensive English-based literature search of PubMed and Clinicaltrials.gov between January 2000 and July 2023 was conducted using the terms sotorasib, Lumakras, AMG 510, adagrasib, Krazati, and MRTX849. Study Selection and Data Extraction: Relevant prescribing information, clinical trials, and treatment guidelines were evaluated. Data Synthesis: Sotorasib and adagrasib received accelerated US Food and Drug Administration (FDA) approval following pivotal phase I/II clinical trials. Sotorasib, a first-in-class KRAS inhibitor, demonstrated an overall response rate (ORR) of 41% and a progression-free survival (PFS) of 6.3 months. In a phase III confirmatory trial, sotorasib showed significantly longer PFS compared with docetaxel (5.6 vs. 4.5 months; P = 0.0017). Adagrasib produced an ORR of 42.9% and a PFS of 6.5 months. Both drugs present unique safety profiles, with common toxicities, including diarrhea, musculoskeletal pain, fatigue, and hepatotoxicity. Relevance to Patient Care and Clinical Practice: With KRAS mutations being among the most common oncogenic alterations in NSCLC, sotorasib and adagrasib offer new therapeutic avenues for this previously “undruggable” target. Current treatment guidelines list sotorasib and adagrasib as second-line options in patients with confirmed KRAS G12C-mutated NSCLC. Additional studies are required to further differentiate the safety and efficacy profiles of these 2 agents and identify their optimal place in therapy. Conclusion: Sotorasib and adagrasib demonstrated promising outcomes in targeting the constitutively active KRAS G12C oncogenic driver, underscoring the need for further research to optimize their therapeutic application in this high-risk population.
Results of intrastromal corneal ring implantation in advanced keratoconus With the aim of postpoing or avoiding corneal transplantation
Authors: Soares Jordana Sandes Barbosa , Chaves Luís Fernando Oliveira Borges , Torquetti Leonardo , Cunha Paulo Ferrara de Almeida da , Toledo Marcia , Rocha Guilherme , Magacho Leopoldo 
Published: September 2023

Purpose To evaluate the safety and efficacy of the surgery of intracorneal ring segment implantation with 320° of arc (320-ICRS) in patients with advanced keratoconus stage IV and maximum keratometry (Kmax) above 60 D. Methods A prospective, interventional case series study evaluating 25 eyes of 19 patients with keratoconus stage IV and Kmax > 60D in which 320-ICRS were implanted using VisuMax® femtosecond. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometric values (mean - mean-K, flat - K1, and steep - K2), maximum keratometry (Kmax), tomographic astigmatism, refractive astigmatism and asphericity (Q) were assessed preoperatively and at 3, 6 and 12 months after the procedure. Results The UDVA improved from 1.03 ± 0.28 LogMAR (20/200) to 0.54 ± 0.21 LogMAR (20/60), (p < 0.001), the CDVA (with glasses) improved from 0.63 ± 0.29 LogMAR (20/80) to 0.31 ± 0.16 LogMAR (20/40),(p = 0.004), K1 reduced from 54.41 ± 4.46 D to 49.36 ± 4.11 D (p < 0.001), K2 reduced from 61.15 ± 4.37 D to 53.715 ± 4.05 D, (p < 0.001), mean-K reduced from 57.55 ± 4,17 D to 51.44 ± 3,94 D (p < 0.001), Kmax reduced from 69.80 ± 8.20 D to 63.43 ± 6.31 D (p < 0.001) and asphericity (Q) changed from −1.57 ± 0.35 to −0.77 ± 0.56 (p < 0.001). A total of 89.9% patients reached BCVA wearing scleral contact lens  0.2 LogMAR(20/25). Conclusion 320-ICRS to treat advanced keratoconus appears to be an efficacious and safe procedure, being a surgical alternative to delay or even prevent corneal transplantation.
“He went from being a monster to a person:” Using narrative analysis to explore how victim-offender dialogue (VOD) participants transform through the VOD process
Authors: Littman Danielle Maude , Valdovinos Miriam , Sliva Shannon 
Published: September 2023

Restorative justice practices such as victim-offender dialogue (VOD) have gained traction in the past few decades as routes towards healing amidst high incarceration and recidivism rates and growing public dissatisfaction with punitive carceral structures. However, little work has sought to understand the nuanced experiences of those who engage in VOD processes, in their own words. In this manuscript, we use narrative analytic methods to explore how a dyad involved in VOD process—the individual who engaged in a crime, and a mother and daughter impacted by this crime—transformed over the course of the process (before, 2 weeks after, and 6 months after the dialogue). We found that, for the participating dyad, engaging in the VOD process cracked open the humanity of the other through the vehicles of religion and forgiveness. Our findings echo—and expand—prior work on “forgiveness” in RJ processes, and suggest the need for future research which explores the nuanced role of religion in VOD. Finally, we advocate for the expansion of facilitated dialogue processes as a process with the potential to catalyze individual and community healing.
Iatrogenic cerebral amyloid angiopathy: A multinational case series and individual patient data analysis of the literature
Authors: Pikija Slaven , Pretnar-Oblak Janja , Frol Senta , Malojcic Branko , Gattringer Thomas , Rak-Frattner Kinga , Staykov Dimitre , Salmaggi Andrea , Milani Riccardo , Magdic Jozef , Iglseder Sarah , Trinka Eugen , Kraus Theo , Toma Andreea , DiFrancesco Jacopo C. , Tabaee Damavandi Payam , Fabin Natalia , Bersano Anna , de la Riva Juez Patricia , Albajar Gomez Ines , Storti Benedetta , Fandler-Höfler Simon 
Published: September 2023

Background: The transmission of amyloid β (Aβ) in humans leading to iatrogenic cerebral amyloid angiopathy (iCAA) is a novel concept with analogies to prion diseases. However, the number of published cases is low, and larger international studies are missing. Aims: We aimed to build a large multinational collaboration on iCAA to better understand the clinical spectrum of affected patients. Methods: We collected clinical data on patients with iCAA from Austria, Croatia, Italy, Slovenia, and Spain. Patients were included if they met the proposed Queen Square diagnostic criteria (QSC) for iCAA. In addition, we pooled data on disease onset, latency, and cerebrospinal fluid (CSF) biomarkers from previously published iCAA cases based on a systematic literature review. Results: Twenty-seven patients (22% women) were included in this study. Of these, 19 (70%) met the criteria for probable and 8 (30%) for possible iCAA. Prior neurosurgical procedures were performed in all patients (93% brain surgery, 7% spinal surgery) at median age of 8 (interquartile range (IQR) = 4–18, range = 0–26 years) years. The median symptom latency was 39 years (IQR = 34–41, range = 28–49). The median age at symptom onset was 49 years (IQR = 43–55, range = 32–70). Twenty-one patients (78%) presented with intracranial hemorrhage and 3 (11%) with seizures. Conclusions: Our large international case series of patients with iCAA confirms a wide age boundary for the diagnosis of iCAA. Dissemination of awareness of this rare condition will help to identify more affected patients.
Exploring maturity of electronic medical record use among allied health professionals
Authors: Schwarz Maria , Ward Elizabeth C , Coccetti Anne , Simmons Joshua , Burrett Sara , Juffs Philip , Perkins Kristy 
Published: September 2023

Background: Electronic medical records (EMRs) have the potential to improve and streamline the quality and safety of patient care. Harnessing the full benefits of EMR implementation depends on the utilisation of advanced features, defined as “mature usage.” At present, little is known about the maturity of EMR usage by allied health professionals (AHPs). Objective: To examine current maturity of EMR use by AHPs and explore perceived barriers to mature EMR utilisation and optimisation. Method: AHPs were recruited from three health services. Participants completed a 27-question electronic questionnaire based on the EMR Adoption Framework, which measures clinician EMR utilisation (0 =  paper chart, 5 =  theoretical maximum) across 10 EMR feature categories. Interviews were conducted with both clinicians and managers to explore the nature of current EMR utilisation and perceived facilitators and barriers to mature usage. Results: Questionnaire responses were obtained from 193 participants AHPs. The majority of questions (74%) showed a mean score of <3, indicating a lack of mature EMR use. Pockets of mature usage were identified in the categories of health information, referrals and administration processes. Interviews with 21 clinicians and managers revealed barriers to optimisation across three themes: (1) limited understanding of EMR opportunities; (2) complexity of the EMR change process and (3) end-user and environmental factors. Conclusion: Mature usage across EMR feature categories of the EMR Adoption Framework was low. However, questionnaire and qualitative interview data suggested pockets of mature utilisation. Implications: Achieving mature allied health EMR use will require strategies implemented at the clinician, EMR support, and service levels.