bluuebunny/crossref_metadata_2025_split huggingface dataset:
Negotiating the ambiguity of an (in)authentic working life: a grounded theory study into severe perineal trauma
Authors: Tjernström Katharina , Lindberg Inger , Wiklund Maria , Persson Margareta 
Published: February 2023

Abstract
Background
In Sweden, persistent physical and psychological health problems occur in about three in ten women who sustain severe perineal trauma (SPT) during childbirth. As most Swedish women work outside the home, the question of if and how SPT-related morbidity influences working life needs exploration. This study aims to qualitatively explore how women with persistent SPT-related morbidities experience and conceptualise their problems concerning working life. Further, we theorise the findings by applying Simone de Beauvoir’s feminist framework of immanence and transcendence as well as authentic and inauthentic life.

Methods
Ten interviews with women recruited via a Swedish social media community for perineal trauma were analysed according to Charmaz’s constructivist approach to grounded theory.

Results
The theoretical model and related core category ‘Negotiating the ambiguity of an (in)authentic working life’ reflected the women’s negotiations of immanence as ‘the silent covert object’ versus transcendence as the ‘the resourceful overt subject’. The model also mirrored the conflict of (in)authenticity in working life. An inauthentic working life was experienced when women were denied their subjectivity at work or constructed themselves as subjects in denial of their SPT. On the other hand, women who acknowledged their SPT and were constructed as subjects by ‘others’ achieved an authentic working life despite SPT.

Conclusions
The conflicting gendered process of ‘the silent covert object’ versus ‘the resourceful overt subject’ problematised women’s vulnerability at work. Aspects that enable subjectification and transcendence are essential for policymakers, employers, healthcare services, and society to eradicate the taboo of SPT and create a working environment characterised by understanding, support, and flexibility. Further, access to adequate care, sick leave, and occupational rehabilitation are essential. Such measures support transcendence towards an authentic working life and, consequently, a more gender-equal working environment that does not deprive women of career opportunities due to a physical ailment.
Do personal and behavioural characteristics of physiotherapy students predict performance during training and course completion?
Authors: Paynter Sophie , Iles Ross , Hodgson Wayne C. , Hay Margaret 
Published: February 2023

Abstract
Background
Specific personal and behavioural characteristics are required for competent health care practice. Research investigating relationships between these characteristics and course performance of health professions students is expanding, yet little research is conducted within the undergraduate physiotherapy student population. This study aimed to explore the relationships between personality, approaches to learning, and coping strategies of undergraduate physiotherapy students and their performance in academic, clinical and in-course assessment tasks and course progression.

Methods
Participants from six cohorts of undergraduate physiotherapy students (commencing years 2012–2017, 66% response rate) completed questionnaires measuring personality (NEO-FFI-3), approaches to learning (RASI) and coping strategies (Brief COPE). Correlation and multiple regression analysis were conducted to investigate relationships between scores on written examinations, in-course assessment tasks and assessments of clinical performance. Mann–Whitney U test was used to compare subgroups on these measures in those who completed or did not complete the course.

Results
Conscientiousness and a strategic approach to learning predicted higher scores in written examinations, and for most clinical and in-course assessments with conscientiousness being a stronger predictor. A lack of purpose (surface) learning approach was predictive of lower clinical placement scores. Non-course completers had higher scores for lack of purpose (surface) approach to learning and lower scores for the coping strategies of support seeking and humour.

Conclusions
This study confirms the importance of conscientiousness and a strategic learning approach on the academic and clinical performance of undergraduate physiotherapy students. Identifying learners with a surface learning approach and low support seeking coping strategies could assist in providing support to students at risk of poor performance and minimising attrition.
Informed or misinformed consent and use of modified texture diets in dysphagia
Authors: O’Keeffe Shaun T. , Leslie Paula , Lazenby-Paterson Tracy , McCurtin Arlene , Collins Lindsey , Murray Aoife , Smith Alison , Mulkerrin Siofra ,   SPARC (Swallow Perspectives, Advocacy and Research Collective)
Published: February 2023

Abstract
Background
Use of modified texture diets—thickening of liquids and modifying the texture of foods—in the hope of preventing aspiration, pneumonia and choking, has become central to the current management of dysphagia. The effectiveness of this intervention has been questioned. We examine requirements for a valid informed consent process for this approach and whether the need for informed consent for this treatment is always understood or applied by practitioners.

Main text
Valid informed consent requires provision of accurate and balanced information, and that agreement is given freely by someone who knows they have a choice. Current evidence, including surveys of practitioners and patients in different settings, suggests that practice in this area is often inadequate. This may be due to patients’ communication difficulties but also poor communication—and no real attempt to obtain consent—by practitioners before people are ‘put on’ modified texture diets. Even where discussion occurs, recommendations may be influenced by professional misconceptions about the efficacy of this treatment, which in turn may poison the well for the informed consent process. Patients cannot make appropriate decisions for themselves if the information provided is flawed and unbalanced. The voluntariness of patients’ decisions is also questionable if they are told ‘you must’, when ‘you might consider’ is more appropriate. Where the decision-making capacity of patients is in question, inappropriate judgements and recommendations may be made by substitute decision makers and courts unless based on accurate information.

Conclusion
Research is required to examine the informed consent processes in different settings, but there is ample reason to suggest that current practice in this area is suboptimal. Staff need to reflect on their current practice regarding use of modified texture diets with an awareness of the current evidence and through the ‘lens’ of informed consent. Education is required for staff to clarify the importance of, and requirements for, valid informed consent and for decision making that reflects people’s preferences and values.
The effectiveness of pay-for-performance contracts with non-governmental organizations in Afghanistan – results of a controlled interrupted time series analysis
Authors: Samad Diwa , Hamid Bashir , Sayed Ghulam Dastagir , Liu Yueming , Zeng Wu , Rowe Alexander K. , Loevinsohn Benjamin 
Published: February 2023

Abstract
Background
In many contexts, including fragile settings like Afghanistan, the coverage of basic health services is low. To address these challenges there has been considerable interest in working with NGOs and examining the effect of financial incentives on service providers. The Government of Afghanistan has used contracting with NGOs for more than 15 years and in 2019 introduced pay-for-performance (P4P) into the contracts. This study examines the impact of P4P on health service delivery in Afghanistan.

Methods
We conducted an interrupted time series (ITS) analysis with a non-randomized comparison group that employed segmented regression models and used independently verified health management information system (HMIS) data from 2015 to 2021. We compared 31 provinces with P4P contracts to 3 provinces where the Ministry of Public Health (MOPH) continued to deliver services without P4P. We used data from annual health facility surveys to assess the quality of care.

Findings
Independent verification of the HMIS data found that consistency and accuracy was greater than 90% in the contracted provinces. The introduction of P4P increased the 10 P4P-compensated service delivery outcomes by a median of 22.1 percentage points (range 10.2 to 43.8) for the two-arm analysis and 19.9 percentage points (range: - 8.3 to 56.1) for the one-arm analysis. There was a small decrease in quality of care initially, but it was short-lived. We found few other unintended consequences.

Interpretation
P4P contracts with NGOs led to a substantial improvement in service delivery at lower cost despite a very difficult security situation. The promising results from this large-scale experience warrant more extensive application of P4P contracts in other fragile settings or wherever coverage remains low.
Characteristics of systematic lymph node dissection and influencing factors of sentinel lymph node biopsy using carbon nanoparticles in endometrial carcinoma: a single-center study
Authors: Tao Siqi , Zhang Zhibang , Li Liling , Yuan Xiaorui , Chen Hongliang , Zhang Yongjing , Fu Chun 
Published: February 2023

Abstract
Background
Carbon nanoparticles (CNPs) are a new tracer for lymph node mapping, which can quickly reach and develop lymph nodes through a lymphatic network. This research investigated the characteristics of systematic lymph node dissection and sentinel lymph node biopsy mapped with CNPs in endometrial carcinoma.

Methods
We first applied CNPs to systematic lymph node dissection in 18 endometrial carcinoma patients as the study group and another 18 endometrial carcinoma patients who were not injected with anything served as the control group. Then, we applied CNPs to sentinel lymph nodes biopsy in 54 endometrial carcinoma patients. All 54 patients received systematic lymph node dissection after sentinel lymph node biopsy. The detection rate, sensitivity, specificity, and accuracy of systematic lymph node dissection and sentinel lymph node biopsy by CNPs were respectively analyzed. A nomogram model for predicting the success of sentinel lymph node mapping was established.

Results
The average number of lymph nodes removed in the CNP-labeled study group was higher than that in the control group (p<0.001). CNPs improved the number of lymph nodes with a diameter ≤ 0.5cm. The detection rate, sensitivity, specificity, and accuracy of sentinel lymph nodes biopsy by CNPs for endometrial carcinoma were 70.4%, 100%, 100%, and 100%, respectively. The nomogram model included factors of long menopause time, cervical cyst, and hard cervical texture, and the area of ROC curve was 0.816.

Conclusions
CNPs improve the detection rate of small lymph nodes. CNPs can trace sentinel lymph nodes in evaluating lymph node metastasis in endometrial carcinoma.
A novel approach to frontline health worker support: a case study in increasing social power among private, fee-for-service birthing attendants in rural Bangladesh
Authors: Curry Dora , Islam Md. Ahsanul , Sarker Bidhan Krishna , Laterra Anne , Khandaker Ikhtiar 
Published: February 2023

Abstract
Background
Expanding the health workforce to increase the availability of skilled birth attendants (SBAs) presents an opportunity to expand the power and well-being of frontline health workers. The role of the SBA holds enormous potential to transform the relationship between women, birthing caregivers, and the broader health care delivery system. This paper will present a novel approach to the community-based skilled birth attendant (SBA) role, the Skilled Health Entrepreneur (SHE) program implemented in rural Sylhet District, Bangladesh.

Case presentation
The SHE model developed a public–private approach to developing and supporting a cadre of SBAs. The program focused on economic empowerment, skills building, and formal linkage to the health system for self-employed SBAs among women residents. The SHEs comprise a cadre of frontline health workers in remote, underserved areas with a stable strategy to earn adequate income and are likely to remain in practice in the area. The program design included capacity-building for the SHEs covering traditional techno-managerial training and supervision in programmatic skills and for developing their entrepreneurial skills, professional confidence, and individual decision-making. The program supported women from the community who were social peers of their clients and long-term residents of the community in becoming recognized, respected health workers linked to the public system and securing their livelihood while improving quality and access to maternal health services. This paper will describe the SHE program's design elements to enhance SHE empowerment in the context of discourse on social power and FLHWs.

Conclusion
The SHE model successfully established a private SBA cadre that improved birth outcomes and enhanced their social power and technical skills in challenging settings through the mainstream health system. Strengthening the agency, voice, and well-being of the SHEs has transformative potential. Designing SBA interventions that increase their power in their social context could expand their economic independence and reinforce positive gender and power norms in the community, addressing long-standing issues of poor remuneration, overburdened workloads, and poor retention. Witnessing the introduction of peer or near-peer women with well-respected, well-compensated roles among their neighbors can significantly expand the effectiveness of frontline health workers and offer a model for other women in their own lives.
Brain metastases in Japanese NSCLC patients: prognostic assessment and the use of osimertinib and immune checkpoint inhibitors—retrospective study
Authors: Higaki Hajime , Nishioka Kentaro , Otsuka Manami , Nishikawa Noboru , Shido Motoyasu , Minatogawa Hideki , Nishikawa Yukiko , Takashina Rikiya , Hashimoto Takayuki , Katoh Norio , Taguchi Hiroshi , Kinoshita Rumiko , Yasuda Koichi , Mori Takashi , Uchinami Yusuke , Koizumi Fuki , Fujita Yoshihiro , Takahashi Shuhei , Hattori Takahiro , Nishiyama Noriaki , Aoyama Hidefumi 
Published: February 2023

Abstract
Background
The Graded Prognostic Assessment for lung cancer using molecular markers (Lung-molGPA) has not been validated for use with Japanese non-small cell lung cancer (NSCLC) patients with brain metastasis (BM) and the factors impacting survival need to be assessed.

Methods
We retrospectively analyzed 294 NSCLC patients who were newly diagnosed with BM between 2013 and 2020 and had received radiotherapy for BM initially at the Hokkaido Cancer Center. We evaluated the effect on the prognosis of Lung-molGPA items, the expression of PD-L1 (classified as high, low, and no expression), and the treatment history. The main outcome was the survival measured from the day of the diagnosis of BM, and log-rank tests were performed to evaluate the results.

Results
The median overall survival (OS) times for adenocarcinoma by groups of GPA scores (0‒1.0, 1.5‒2.0, 2.5‒3.0, and 3.5‒4.0) were 5.5, 14.8, 28.3, and 39.0 months (p < 0.0001), respectively. The median survival times for non-adenocarcinoma by groups of GPA scores (0‒1.0, 1.5‒2.0, and 2.5‒3.0) were 3.2, 11.0, and 16.0 months (p = 0.0011), respectively. In adenocarcinoma patients with gene mutations, osimertinib significantly improved the outcome (median OS: 34.2 and 17.6 months with and without osimertinib, respectively (p = 0.0164)). There was no significant difference in the OS between patients who were initially treated with tyrosine-kinase inhibitor for BM and those who initially received radiotherapy (p = 0.5337). In patients tested for PD-L1 expression, the median survival times after the diagnosis of BM were 5.6, 22.5, and 9.3 months for the high-, low- and no-expression groups (p = 0.2198), respectively. Also, in patients with high PD-L1 expressions, those with ICI had survival (median OS, 8.6 months) than those without (median OS, 3.6 months).

Conclusions
We confirmed that Lung-molGPA successfully classified Japanese NSCLC patients with BM by the prognosis. Osimertinib prolonged survival of EGFR-positive NSCLC patients with BM, and ICI was effective in patients with high PD-L1 expressions.
Describing the factors related to rural podiatry work and retention in the podiatry workforce: a national survey
Authors: Couch Anna , Menz Hylton B. , O'Sullivan Belinda , Haines Terry , Williams Cylie M. 
Published: February 2023

AbstractBackgroundMaldistribution of podiatrists limits capacity to address the footcare needs of the population. Understanding factors that impact recruitment and retention of Australian podiatrists is a key solution. The primary aim of this study was to describe factors related to rural podiatry work, and overall professional retention amongst Australian podiatrists.MethodsWe used data collected from the most recent relevant response of a cohort of Australian podiatrists between 2017 and 2020 of four online surveys. Person and job role variables known to impact current work and retention were collected. Logistic regression models were used to determine factors associated with rural work and intent to leave direct patient care or the profession entirely.ResultsThere were 1129 podiatrists (21% of 5429) who participated in at least one of the survey waves. Podiatrists who had a rural background (30%) were less likely to work in a metropolitan location (OR = 0.20, 95%CI = 0.11,0.37). Podiatrists who undertook a regional/rural placement during their undergraduate education (43%) were more likely to work in a metropolitan location (OR = 1.86, 95%CI = 1.38,2.51). Podiatrists who indicated they were planning to leave direct patient care within 5 years (n = 282, 26%), were less satisfied with working conditions (OR = 0.77, 95% CI = 0.66, 0.92), less satisfied with opportunities to use their abilities (OR = 0.83, 95% CI = 0.69, 0.99), perceived less personal accomplishment (OR = 0.94, 95% CI 0.86, 0.94) and less job satisfaction (OR = 0.92, 95% CI = 0.91, 0.98). Podiatrists who indicated that they were planning to leave podiatry work entirely within 5 years (n = 223, 21%), were less satisfied with opportunities to use their abilities (OR = 0.74, 95% CI = 0.62, 0.88), agreed they had a poor support network from other podiatrists (OR = 1.35, 95% CI = 1.13, 1.61), had less job satisfaction (OR = 0.89, 95% CI = 0.86, 0.94), and did not have access to paid annual leave (OR = 0.62, 95% CI = 0.38, 0.99).ConclusionFindings suggest ways to promote rural work, including selecting university students with rural backgrounds, and optimising the experience of rural placements which currently predict metropolitan practice. To retain podiatrists, it is important to ensure access to leave, professional support, and appropriate physical working conditions. Further research is required to understand why intention to leave is so high.
Continuous estimates of heat emission at Mt. Ruapehu using the Unscented Kalman Smoother
Authors: Behr Yannik , Sherburn Steve , Hurst Tony 
Published: February 2023

AbstractVolcanic lakes often capture a significant amount of volcanic heat emission and thus provide a unique opportunity to monitor changes inside the volcano. We present a Bayesian inversion method to automatically infer changes in volcanic heat emission over time at the base of a volcanic lake from lake monitoring data using a non-linear Kalman Smoother. Our method accounts for the, sometimes large, uncertainties in observations and the underlying physics-based model to generate probabilistic estimates of heat emission. We verify our results using a synthetic test case and then estimate the daily heat input rate into Mt. Ruapehu’s Crater Lake, New Zealand, between 2016 and 2022. Time-frequency analysis of the heat input rate shows dominant periods of heating cycles ranged between 100 - 250 days. The period between 2017 and 2020 was dominated by shorter cycles and greater-than-average heat input rate which points to changes in the magmatic heat supply and the hydrothermal system during this time.
Reversal of pacing-induced cardiomyopathy after left bundle branch area pacing: a case report
Authors: Kwon Soonil , Lee So-Ryoung , Choi Eue-Keun , Oh Seil 
Published: February 2023

Abstract
Background
Conventional right ventricular apex (RVa) pacing increases the risk of pacing-induced cardiomyopathy (PICM), especially in elderly patients with a higher ventricular pacing burden. Left bundle branch area pacing (LBBAP) has been suggested as an alternative to conventional RVa pacing. However, there is a lack of evidence that LBBAP may reverse PICM. We report a case of a reversal of PICM after LBBAP.

Case presentation
An 81-year-old woman with a history of complete atrioventricular block and baseline QRS duration of 142 ms received permanent pacemaker implantation with dual pacing. The ventricular lead was placed at the apical direction and paced QRS duration was 146 ms. After 8 months, the patient visited with acute heart failure. The patient’s ventricular pacing burden was > 99%, and echocardiography found severe depression of left ventricular ejection fraction (LVEF, 30%), left ventricular dyssynchrony, and global hypokinesia. Despite 3 months of optimal medical management of heart failure, there was minimal improvement in LVEF (35%) and ventricular dyssynchrony persisted. The patient's presentation was consistent with PICM. LBBAP was performed with a stylet-driven lead and a delivery sheath (Biotronik Selectra 3D, Biotronik, Berlin, Germany). The lead was placed at the area of the left bundle branch trunk and non-selective LBBAP was achieved with a left ventricular activation time of 71 ms, paced QRS duration of 110 ms, and bipolar stimulation to QRS end of 136 ms. After a month, echocardiography found improved LVEF (53%) and N-terminal Pro-B-Type natriuretic peptide was decreased from 1011 to 645 pg/mL. The patient was relieved from dyspnea.

Conclusions
We report a case that PICM was resolved after LBBAP. LBBAP could be a rescue therapy for PICM induced by conventional RVa pacing.
All-fiber device for single-photon detection
Authors: Dai Yue , Jia Kunpeng , Zhu Guanghao , Li Hui , Fei Yue , Guo Yuqing , Yuan Hang , Wang Hao , Jia Xiaoqing , Zhao Qingyuan , Kang Lin , Chen Jian , Zhu Shi-ning , Wu Peiheng , Xie Zhenda , Zhang Labao 
Published: February 2023

AbstractFiber components form the standard not only in modern telecommunication but also for future quantum information technology. For high-performance single-photon detection, superconducting nanowire single-photon detectors (SPDs) are typically fabricated on a silicon chip and fiber-coupled for easy handling and usage. The fiber-to-chip interface hinders the SPD from being an all-fiber device for full utilization of its excellent performance. Here, we report a scheme of SPD that is directly fabricated on the fiber tip. A bury-and-planar fabrication technique is developed to improve the roughness of the substrate for all-fiber detectors’ performance for single-photon detection with amorphous molybdenum silicide (MoSi) nanowires. The low material selectivity and universal planar process enable fabrication and packaging on a large scale. Such a detector responds to a broad wavelength range from 405 nm to 1550 nm at a dark count rate of 100 cps. The relaxation time of the response pulse is ~ 15 ns, which is comparable to that of on-chip SPDs. Therefore, this device is free from fiber-to-chip coupling and easy packaging for all-fiber quantum information systems.