bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding factors influencing safety and team functionality at operative vaginal birth through multidisciplinary perspectives: a mixed methods study
Authors: Skinner Sasha M. , Kippen Eleanor , Rolnik Daniel L. , Neil Peter , Hodges Ryan J. , Murry Nadine , Mol Ben W. , Kumar Arunaz 
Published: January 2025

Abstract

Background
Operative vaginal birth (OVB) relies on effective teamwork to optimise outcomes. This study aims to explore providers’ perspectives of factors influencing safety and team functionality at OVB.

Methods
This mixed methods study involved four maternity sites at Monash Health, Australia. Surveys sent to healthcare providers invited quantitative and qualitative appraisal of safety and team functionality at OVB. Semi-structured interviews further explored themes emerging from survey responses. Categorical survey data were compared between staff roles using Pearson’s chi-squared tests. Thematic analysis of free-text survey responses and interviews identified themes influencing safety and team functionality at OVB.

Findings
We received 100 survey responses from obstetric (n = 41), midwifery (n = 52) and paediatric (n = 7) staff, including senior (n = 49) and junior (n = 51) roles. Overall, 99% thought team communication should improve and 82% had witnessed practices outside protocol. Obstetric versus midwifery or paediatric staff were less likely to rate communication as low or very low quality (5% vs. 29%, p = 0.010). Reporting being extremely or very confident to escalate concerns was more likely in obstetric versus midwifery or paediatric staff (49% vs.12%, p = 0.003) and senior versus junior staff (44% vs. 10%, p = 0.008). Five overarching themes impacted on team functionality at OVB; (1) Quality of communication, (2) Preparation and risk assessment, (3) Leadership and interpersonal dynamics, (4) Transfer from Birth Unit to Operating Theatre, (5) Variation in clinical practice.

Discussion
Some care providers perspectives of team functionality at OVB differed, with midwifery and paediatric staff more likely to report challenges with communication and were less empowered to escalate concerns. Training in factors impacting team functionality at OVB should be considered.
Theoretical impact of a bedside decision-making tool on antibiotic use for suspected neonatal healthcare-associated infection: an observational study
Authors: Lloyd Lizel Georgi , van Weissenbruch Mirjam Maria , Bekker Adrie , Ferreyra Cecilia , Gleeson Birgitta , Dramowski Angela 
Published: January 2025

Abstract

Background and objectives
Healthcare-associated infections (HAI) are a leading contributor to morbidity and mortality in hospitalised neonates. Diagnosing neonatal HAI is challenging owing to non-specific symptoms and lack of definitive diagnostic markers, contributing to high rates of inappropriate antibiotic use. This study evaluated the theoretical impact of implementing a bedside tool for decision-making on antibiotic length of therapy (LOT).

Methods
This prospective observational physician-blinded study consecutively enrolled patients with suspected HAI events at a large South African neonatal unit from September 2022 to September 2023. The antibiotic decision-making tool included an infection prediction score (NeoHoP), and a point-of-care C-reactive protein test (CRP) performed at HAI diagnosis and 24 h later. The theoretical impact of the tool on antibiotic LOT was calculated.

Results
We recruited 180 neonates with 214 episodes of suspected HAI, of which 22 (10.3%) were proven HAI, 56 (26.2%) were presumed HAI and 136 (63.6%) had HAI ruled out. The median observed antibiotic LOT was three days (9 days for proven HAI, 7 days for presumed HAI, and 3 days for no HAI). The antibiotic decision-making tool would theoretically reduce overall antibiotic LOT by 2 days (p < 0.001), particularly in neonates where HAI was subsequently excluded.

Conclusion
We developed an antibiotic decision-making tool to support the clinical evaluation of suspected neonatal HAI and demonstrated a significant potential impact on reducing antibiotic LOT. Given increasing antibiotic resistance rates globally, this tool should be further evaluated to minimise unnecessary antibiotic use in hospitalised neonates.
Health professionals’ willingness to share responsibility and strengthen interprofessional collaboration: a cross-sectional survey
Authors: Brandt Sophie Karoline , Essig Stefan , Balthasar Andreas 
Published: January 2025

Abstract

Background
Doctors’ unwillingness to share responsibility acts as a major barrier to interprofessional collaboration (IPC). Educating both doctors and allied health professionals in taking on or relinquishing responsibility could enhance IPC. Yet there is no evidence that these educational efforts increase IPC willingness. This study aims to (1) compare the willingness to take on or relinquish responsibility for decision-making in patient care and their willingness to strengthen IPC between members of five main health professions, and (2) investigate associations between the willingness to take on or relinquish responsibility and the willingness to strengthen IPC.

Methods
We conducted a cross-sectional survey targeting pharmacists, doctors, medical practice assistants, nurses, and physiotherapists in Switzerland. Group differences were assessed, and associations were examined using multivariable logistic regression analyses.

Results
Overall, 3670 health professionals participated. Members of all allied health professions were highly willing to take on more responsibility for decision-making for patient care (ranging from 74.3% to 86.5%). Medical practice assistants (52.3%) and nurses (46.8%) were highly willing to relinquish responsibility, less so pharmacists (34.2%) and physiotherapists (37.8%); doctors were torn between high (49.2%) and neither high nor low willingness (38%). Members of all professions were highly willing to strengthen IPC (ranging from 76.4 to 91.2%). We found a strong, statistically significant relationship between willingness to take on more responsibility and willingness to strengthen IPC (OR = 5.30, p < .001). The relationship between willingness to relinquish responsibility and willingness to strengthen IPC was smaller (OR = 3.30, p < .001).

Conclusion
Increasing the health professionals’ willingness to take on responsibility is crucial to strengthen IPC. Increasing the willingness to relinquish responsibility would likely be less effective. Actions required include educational and political efforts to transfer responsibility to allied health professionals and to enable health professionals to decide when it is appropriate to take on or relinquish responsibility. Given the willingness of many health professionals to strengthen IPC, substantial potential in practice is evident.
What are the training and support needs for homelessness hostel staff supporting older residents with memory and cognitive problems? A qualitative study
Authors: Zalc Luna , Gaber Sophie N. , Rapaport Penny 
Published: January 2025

Abstract

Background
An increasing number of older people are experiencing homelessness and memory problems, many of whom are supported in temporary hostel accommodation. This can be a challenge for hostel staff who may not have adequate training and support but who often support those with significant memory impairment in their day-to-day work. The study aimed to investigate the training and support that hostel staff require to meet the needs of older hostel residents experiencing memory and cognitive problems, and thus enhance hostel resident quality of life and well-being, considering what additional knowledge, skills, and support hostel staff need to achieve this.

Methods
In this qualitative study, we conducted inductive reflexive thematic analysis of semi-structured interviews with health and social care practitioners (n = 17) and hostel staff and managers (n = 15). Participants were recruited from six homelessness hostels, one specialist care home, and National Health and Local Authority Services in England.

Results
We identified three main themes: (a) Emotional and psychoeducational support needs within
hostel staff
teams, including training on memory and cognitive problems, responsive behaviours, communication strategies, and reflective spaces for hostel staff to manage their emotional responses (b) Training and support needs to deliver a person-centred approach, including tools and support packages to enhance hostel residents’ independence, multidisciplinary meetings to evaluate hostel residents’ needs, and communication strategies tailored to hostel residents’ understanding and (c) Support to facilitate collaboration with external agencies, including training on professional language, capacity assessment, dementia case studies, improved communication skills to bring external services into hostels, and reflective practices to advocate for hostel residents with dual diagnoses.

Conclusions
The present study highlights how hostel staff could benefit from targeted training in emotional support, person-centred approaches for older hostel residents with memory and cognitive problems, and collaboration with external services. Overall, the current study contributes to understanding of the need for tailored training and support methods within hostels to provide higher quality support to a population that is frequently overlooked.
Prenatal maternal stress: triangulating evidence for intrauterine exposure effects on birth and early childhood outcomes across multiple approaches
Authors: Lund Ingunn Olea , Hannigan Laurie J. , Ask Helga , Askelund Adrian D. , Hegemann Laura , Corfield Elizabeth C. , Wootton Robyn E. , Ahmadzadeh Yasmin I. , Davey Smith George , McAdams Tom A. , Ystrom Eivind , Havdahl Alexandra 
Published: January 2025

Abstract

Background
Maternal stress during pregnancy may impact offspring development via changes in the intrauterine environment. However, genetic and environmental factors shared between mothers and children might skew our understanding of this pathway. This study assesses whether prenatal maternal stress has causal links to offspring outcomes: birthweight, gestational age, or emotional and behavioral difficulties, triangulating across methods that account for various measured and unmeasured confounders.

Methods
We used data from the Norwegian Mother, Father, and Child Cohort Study (MoBa), including maternal reports on prenatal stress at work, at home, and via stressful life events as exposures. Outcomes were children’s birthweight and gestational age, from the Medical Birth Registry of Norway, and maternal reports on early offspring emotional and behavioral difficulties. We assessed associations using four approaches: sibling control analyses, gene-environment interaction analyses, intergenerational Mendelian randomization (MR), and negative control (i.e., postnatal stress) analyses.

Results
Maternal prenatal stress was observationally associated with offspring lower birthweight (e.g., βwork = − 0.01 [95%CI: − 0.02, − 0.01]), earlier birth (e.g., βwork = − 0.04 [95%CI: − 0.04, − 0.03])), and more emotional (e.g., βevents = 0.08 [95%CI: 0.07, 0.09]) and behavioral difficulties (e.g., βrelationship = 0.08 [95%CI: 0.07, 0.09]) in the full sample (N = 112,784). However, sibling control analyses (N = 36,511) revealed substantial attenuation of all associations after accounting for familial factors. Gene-environment interaction models (N = 76,288) showed no clear evidence of moderation of associations by mothers’ polygenic scores for traits linked to stress sensitivity. Intergenerational MR analyses (N = 29,288) showed no clear evidence of causal effects of maternal plasma cortisol on any offspring outcomes. Negative control exposure analyses revealed similar effect sizes whether exposures were measured prenatally or postnatally.

Conclusions
Our results indicate that links between prenatal maternal stress and variation in early offspring outcomes are more likely to be confounded than causal. While no observational study can rule out causality, the consistency of our findings across different approaches is striking. Other sources of prenatal stress or more extreme levels may represent intrauterine causal risk factors for offspring development. Nonetheless, our research contributes to identifying boundary conditions of the fetal programming and developmental origins of health and disease hypotheses, which may not be as universal as sometimes assumed.
Harnessing national data systems to understand circumstances surrounding veteran suicide: linking Department of Veterans Affairs and National Violent Death Reporting System Data
Authors: Hoffmire Claire A. , Schneider Alexandra L. , Gaeddert Laurel A. , Logan Joseph , Kittel Julie A. , Holliday Ryan , Monteith Lindsey L. 
Published: January 2025

Abstract

Background
Veterans are at elevated risk for suicide compared to non-Veteran U.S. adults. Data sources and analyses to inform prevention efforts, especially for those who do not use Department of Veterans Affairs (VA) healthcare services, are needed. This study aimed to link VA and CDC’s National Violent Death Reporting System (NVDRS) data to create a novel data source to characterize the circumstances precipitating and preceding suicide among Veterans, including among those who did not use VA healthcare.

Methods
Multi-variable, multi-stage, deterministic linkage of VA-Department of Defense (DoD) Mortality Data Repository (MDR) and NVDRS-Restricted Access Database suicide and undetermined intent mortality records within 189 state-year strata (42 states, 2012–2018). Three linkage stages: (1) exact (matched on: age, sex, death date, underlying cause of death, day of month of birth, first initial of last name); (2) probable (all but one variable matched); (3) possible (all but 2 variables matched). Linkage success and accuracy of NVDRS-documented military history were assessed.

Results
Across all state-years, 22,019 matches (89.20% of 24,685 MDR Veteran records) were identified (65.47% exact). When high missingness (2 + matching variables in > 10% of records; n = 23) or incomplete reporting (n = 12) state-years were excluded, match rate increased to 94.29% (77.15% exact). NVDRS-documented military history (ever served) was accurate for 87.79% of matched records, with an overall sensitivity of 84.62%. Sensitivity was lower for female (61.01%) and younger (17–39 years; 77.51%) Veterans.

Conclusions
Accurate linkage of VA-DoD and NVDRS data is feasible and offers potential to improve understanding of circumstances surrounding suicide among Veterans.
Adoption of digital transformation from a firm’s creation to decline: the role of China’s mass entrepreneur and innovation campaign
Authors: Maqsood Umer Sahil , Li Qian , Zahid R. M. Ammar 
Published: January 2025

Abstract
Following the global economy’s shift toward a digital-based system, the significance of digital transformation (DT) at the firm level has become increasingly important. Accordingly, this study aims to enhance understanding of a firm’s DT by examining the varying impacts ofirm life cycle (FLC) stages on DT adoption. We consider the impact of the mass entrepreneur and innovation campaign (MEIC) on this relationship. Based on the data of China A-share non-financial companies listed on the Shanghai and Shenzhen stock exchanges from 2010 to 2020. The baseline findings reveal that firms in the growth stage are likelier to adopt DT than firms in the introduction and decline stages; however, DT adoption in the maturity stage is uncertain. MEIC encourages DT adoption during the introduction, maturity, and decline stages. Furthermore, the univariate test demonstrates a relative enhancement in DT after implementing MEIC, underscoring its role in effectively allocating resources within the firms to embrace DT. This study’s results are robust across various estimation techniques and instrumental variables. The empirical results offer insights into policy implications, highlighting the factors shaping firms’ DT adoption decisions at different FLC stages and endorsing resource-based and agency theories.
Cardiovascular health in breast cancer patients: insight on BRCA1/2 mutations impact
Authors: Mallios Panagiotis , Manshadi Mehdi Dehghan , Hubbert Laila , Aydin Tajeri , Maes Claudia , Rantala Johanna , Liljegren Annelie , Kiani Narsis A. , Hedayati Elham 
Published: January 2025

Abstract

Background
Breast cancer (BC) and cardiovascular disease (CVD) are prevalent comorbidities in aging populations. Advances in BC treatment have improved survival rates but increased the risk of CVD, particularly among younger patients with BRCA1/2 mutations. BRCA1/2 gene mutations, prevalent in younger BC patients, impair cardioprotective effects, elevating CVD risk alongside cancer treatments. This study examined the prevalence and incidence of CVD and cardiovascular risk factors (CVRFs) before and after BC diagnosis in BRCA1/2 mutation carriers (BRCA-BC) and those with sporadic BC (Sporadic-BC).

Methods
This descriptive retrospective cohort study analyzed BC patients from 1995 to 2020 in Stockholm-Gotland, Sweden. Data from regional and national registries provided insights into CVRFs, pre-existing CVDs, demographics, and cancer treatments. Analyses focused on single and multiple CVD events, comparing inpatient and outpatient settings across subgroups.

Results
The cohort included 438 BRCA-BC and 32,626 Sporadic-BC patients. BRCA-BC patients were younger at BC diagnosis (median: 45 years, IQR 37–53) and first CVD event (median: 62 years, IQR 53–68) compared to Sporadic-BC patients (median: 61 years, IQR 51–71; and 74 years, IQR 65–81, respectively). Before BC diagnosis, CVD prevalence was lower in BRCA-BC patients (4.2%) than in Sporadic-BC patients (11.1%). Post-diagnosis, CVD prevalence increased in both groups, reaching 19.7% in BRCA-BC and 24.6% in Sporadic-BC patients. Heart failure (HF) was the most common major adverse cardiovascular event (MACE), affecting 4.6% of BRCA-BC and 9.5% of Sporadic-BC patients. Sporadic-BC patients exhibited a higher overall cardiovascular burden, including arrhythmias, coronary artery disease, and stroke.

Conclusions
Distinct cardiovascular profiles between BRCA-BC and Sporadic-BC patients underscore the need for tailored survivorship care. Early cardiovascular screening benefits BRCA-BC patients, while Sporadic-BC patients require comprehensive management of pre-existing CVRFs. These findings align with international cardio-oncology guidelines advocating integrated cardiovascular care for BC survivors.
High fatigue levels among psychiatric outpatients – the validity of the Danish Patient Reported Outcomes Measurement Information System Fatigue Short-Form (PROMISF-SF)
Authors: Olsen Ragnar Klein , Arnfred Sidse M. , Madsen Christina , Hovmand Oliver Rumle 
Published: January 2025

Abstract

Background
Patient Reported Outcomes Measurement Information System Fatigue Short-Form (PROMIS-F-SF) is a self-administered, patient reported outcome (PRO) designed to assess fatigue in healthy and clinical populations and for tracking progress during treatment for disorders complicated with fatigue.

Methods
Patients in the Mental Health Service Outpatient Clinics and healthy volunteers were invited to complete a survey, which included the Danish translation of the PROMIS-F-SF, the Chalder Fatigue Scale (CFS-11), and measures of depression and anxiety. We conducted a confirmatory factor analysis of the previously suggested single-factor structure of the instrument. We furthermore evaluated the construct validity of the PROMIS-F-SF by means of its relationship with the CFS-11. Finally, we evaluated the utility of the PROMIS-F-SF to identify patient-status by conducting receiver operating characteristic curves.

Results
70 healthy volunteers and 62 patients completed the instruments. The PROMIS-F-SF had a average fit to the previously reported single-factor structure. Cronbach’s alpha and McDonald’s omega showed good internal reliability (α = 0.96, ωtotal = 0.97). PROMIS-F-SF score was positively correlated with the CFS-11 (r =.76) and it correlated highly with depression (r =.78) and anxiety (r =.74) score. The optimal cut-off point in the ROC-analyses was 15, which yielded a sensitivity of 89% and a specificity of 67% in the prediction of patient status.

Conclusions
Level of fatigue among psychiatric outpatients is high in patients with psychiatric illness, compared to levels measured in healthy volunteers. The Danish PROMIS-F-SF shows good psychometric properties in this combined sample of healthy adults and psychiatric patients with non-psychotic disorders and it is recommended as PRO measure for psychiatric populations. Examination of psychometric properties in patient populations with somatic disorder could be a natural next step.
Efficacy of biocontrol agents against damping-off and Sclerotinia stem rot diseases and their role in eliciting defense in chickpea plants
Authors: El-Gammal Yaser H. , El-Blasy Salama A. S. , Khalifa Neamat A. M. , Abu El-Maaty Shereen , Awaly Sara B. H. 
Published: January 2025

Abstract

Background
Chickpea (Cicer arietinum L.) is the third most important pulse crop grown worldwide. Sclerotinia sclerotiorum causes damping-off and stem rot diseases, leading to significant economic losses in chickpea crop yield. Biological control has proved to be an effective alternative for managing plant diseases.

Results
These pathogenic fungi were isolated from different governorates in Egypt and differed in terms of their pathogenicity on Giza 3 cv.-chickpea plants in vivo. S. sclerotiorum Sakha-S1 with accession No. (PQ558663) was the most aggressive isolate. Trichoderma atroviride was the most effective fungal bioagent in vitro since recorded the highest S. sclerotiorum growth decrease, followed by T. hamatum and T. harzianum; meanwhile, Serratia sp. was the least effective isolate. In greenhouse conditions, Topsin M-70® emerged as the most successful treatment for reducing disease prevalence. Combinations of microbial bioagents specifically all four (T. atroviride, Pseudomonas fluorescens, Bacillus polymyxa, and Serratia sp.) and a combination of three (P. fluorescens, B. polymyxa, and Serratia sp.) followed in effectiveness. Serratia sp. applied alone proved to be the least effective treatment. The same results were obtained in a two-year field study (2020–2021 and 2021–2022) and assessed the impact of various treatments on chickpea disease, growth, and yield components. Interestingly, all the microbial bioagents substantially enhanced chickpea growth parameters, including plant height, number of branches per plant, number of capsules per plant, number of seeds per plant, seed weight per plant, average weight of 100 seeds, and overall chickpea yield. The role of these microbial bioagents in the defense of oxidation enzymes (Peroxidase, polyphenol oxidase, and catalase) associated with defense-related genes (ABR18, PRP, and PR-4) which shown notable variations in gene expression levels of defense-related genes due to treated with various microbial bioagents after 14 days from application. All three genes were up-regulated in combinations including (P. fluorescens + Serratia sp.), (T. atroviride + P. fluorescens), and (T. atroviride + Serratia sp.), demonstrating a collaborative impact on defense gene expression.

Conclusion
The study investigated the effectiveness of microbial bioagents against chickpea stem rot disease, their role in the defense of oxidation enzymes and defense-related genes, and their impact on growth and yield components. It will focus on producing commercial biofungicides to minimize the use of fungicides.