bluuebunny/crossref_metadata_2025_split huggingface dataset:
Facilitating well-being with female social workers in northern Canada: A participatory narrative inquiry
Authors: Yurach Wanda Seidlikoski , Ramsden Vivian R 
Published: February 2025

Summary Limited information exists on the lived experiences and well-being of female social workers providing mental health services in northern Canada. Participatory narrative inquiry was utilized as a collaborative approach to gather stories from/with outsider female social worker mental health providers herein referred to as providers. Ten providers participated in this project through individual and group semistructured interviews in three phases. Transcribed interviews from each phase were analyzed through participatory narrative analysis to collaboratively generate themes, while ensuring the context of participant stories was maintained. Findings Collaborative participatory narrative analysis of participant stories revealed the following major themes: the work is complex and impactful including direct and/or indirect secondary trauma; safety and well-being supports are required; relationships are central to the work; and personal growth and understanding the trauma history of Indigenous peoples is crucial to carrying out northern trauma services. Applications/conclusion Providers believe that they need to feel safe and supported to protect their personal well-being and, in turn, to effectively carry out trauma services. However, current northern work environments lack networking, clinical supervision, and the safety supports required to meet the providers’ needs. Well-being support recommendations for providers included: adopt a strength-based attitude/outlook as well as an effective long-term relational team-based practice approach, improve networking through a “community of practice,” develop trauma-informed northern work-specific competencies and training, and advocate for safety improvements as well as governance agency provider supports.
Optimizing Patients With Chronic Obstructive Pulmonary Disease Preoperatively May Reduce Complications and Improve Outcomes in Infrainguinal Endovascular Revascularization
Authors: Li Renxi , Silverman Rachel , Sidawy Anton , Nguyen Bao-Ngoc 
Published: February 2025

Background: Peripheral artery disease (PAD) and chronic obstructive pulmonary disease (COPD) are both systemic inflammatory diseases that may share similar pathophysiological pathways. Given their potential overlap, the impact of COPD on perioperative outcomes following infrainguinal endovascular revascularization warrants further examination. Therefore, this study aimed to analyze the 30-day postoperative outcomes for COPD patients after infrainguinal endovascular revascularization. Methods: Chronic obstructive pulmonary disease and non-COPD patients who underwent infrainguinal endovascular revascularization were identified in the ACS-NSQIP database from 2012 to 2022. Exclusion criteria included aged less than 18 years and emergency cases. A 1:1 propensity-score matching was used to match demographics, baseline characteristics, symptomatology, and anesthesia. Thirty-day postoperative outcomes were compared. Results: Of 24 223 patients who underwent infrainguinal endovascular revascularization, 2472 (10.21%) had COPD. All COPD patients were 1:1 propensity-score-matched to the non-COPD patients. Chronic obstructive pulmonary disease patients had higher risks of mortality (3.24% vs 2.18%, p=0.03), major adverse cardiovascular events (MACE) (3.48% vs 2.47%, p=0.04), pulmonary complications (3.24% vs 2.02%, p=0.01), and 30-day readmission (15.41% vs 13.23%, p=0.03). All other 30-day outcomes were comparable between the groups. Conclusion: Chronic obstructive pulmonary disease independently increases the risk of 30-day mortality and cardiopulmonary complications after infrainguinal endovascular revascularization. Identification and optimization of COPD patients before considering invasive treatment can be important for preventing complications. Patients may undergo mini-spirometry to screen for COPD. If identified, COPD patients may begin intensive inhalation therapy and medical treatment prior to the surgery. Clinical Impact Both PAD and COPD are systemic inflammatory diseases that may share similar pathophysiological pathways. This study analyzed the 30-day postoperative outcomes for COPD patients after infrainguinal endovascular revascularization. It was found that COPD independently increases the risk of mortality, cardiopulmonary complications, and 30-day readmissions. Identification and optimization of COPD patients before considering invasive treatment can be important for preventing complications in infrainguinal endovascular revascularization. Patients may undergo mini-spirometry to screen for COPD. If identified, COPD patients may begin intensive inhalation therapy and medical treatment prior to the surgery.
Fenestrated/Branched Physician-Modified Endovascular Grafts for Aortic Pathologies Involving the Aberrant Subclavian Artery
Authors: Yu Lu , Jiang Xiaolang , Qiao Guanyu , Zhou Min , Fu Weiguo , Dong Zhihui 
Published: February 2025

Purpose: The case series aim to explore the feasibility and effectiveness of using fenestrated/branched physician-modified endovascular grafts (PMEGs) to treat aortic pathologies involving the aberrant subclavian artery (ASA). Technique: We presented 3 cases with multiple anomalies and complications related to the ASA. Two patients had aberrant right subclavian arteries (ARSA) and developed aortic dissection spontaneously or iatrogenically after endovascular intervention for myocardial infarction. The third patient had an aberrant left subclavian artery (ALSA) together with a Kommerell’s diverticulum (KD) arising from a right-sided aortic arch and developed an aortic dissection. In all 3 cases, an Ankura thoracic endograft (Lifetech, Shenzhen, China) was back-table modified by adding an inner branch and a fenestration for bilateral subclavian arteries, respectively. All procedures were successfully conducted, and all patients underwent 6-month follow-up courses, which were uneventful. Conclusion: Our case series demonstrate a feasible and less invasive therapeutic approach, which produces promising results in treating the aortic pathologies involving the ASA. Further studies and long-term follow-up are required to refine this technical approach and to validate its durability. Clinical Impact The case series illustrate a total endovascular approach to treat aortic arch pathologies involving the ASA, which is one of the most frequent aortic arch anomalies. The use of PMEGs allows meticulous subclavian artery reconstruction without significant trauma brought by traditional open or hybrid approach. Our cases suggest that using PMEGs for total endovascular management of patients with ASA is feasible and effective, and it may help streamline the treatment of complex aortic pathologies.
Local Versus General Anesthesia in Emergency Endovascular Repair of Infrarenal Abdominal Aortic Aneurysm
Authors: Li Renxi , Sidawy Anton , Nguyen Bao-Ngoc 
Published: February 2025

Background: While general anesthesia (GA) has been the common choice of anesthesia for patients undergoing endovascular aneurysm repair (EVAR), local anesthesia (LA) has been proposed as an effective alternative for eligible patients. However, the choice of anesthesia in emergency EVAR situations remains less explored. Therefore, this study aimed to perform a retrospective analysis to compare the 30-day outcomes of patients who underwent emergency infrarenal EVAR receiving either LA or GA. Methods: Patients who underwent emergency infrarenal EVAR were identified in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) targeted database from 2012 to 2022. Exclusion criteria included age less than 18 years, acute intraoperative conversion to open surgery, and intraoperative anesthesia conversion. The 1:1 propensity-score matching and multivariable logistic regression were separately used to balance preoperative factors between patients who received LA and GA. Thirty-day postoperative outcomes were examined. Results: There were 258 (14.58%) and 1512 (85.42%) patients who underwent emergency EVAR under LA and GA, respectively. After multivariable analysis, patients who were under LA had lower mortality (11.24% vs 13.96%, aOR=0.61, 95% confidence interval [CI]=0.395-0.944, p=0.03), pulmonary complications (10.85% vs 17.59%, aOR=0.495, 95% CI=0.322-0.76, p<0.01), renal complications (5.04% vs 7.47%, aOR=0.545, 95% CI=0.303-0.983, p=0.04), wound complications (0.39% vs 3.64%, aOR=0.089, 95% CI=0.012-0.649, p=0.02), and 30-day readmission (6.59% vs 11.24%, aOR=0.564, 95% CI=0.334-0.953, p=0.03). Moreover, patients under LA had shorter operative time (p<0.01) and shorter length of stay (p=0.02). Conclusion: The LA is associated with better 30-day outcomes in emergency infrarenal EVAR. Therefore, in emergency EVAR, it may be advisable to consider LA over GA for eligible patients. Prospective studies in the future can be warranted to further support this anesthesia practice. Clinical Impact The choice of anesthesia in emergency endovascular aneurysm repair (EVAR) remains unexplored. This study performed a retrospective analysis to compare the 30-day outcomes of patients who underwent emergency infrarenal EVAR receiving local anesthesia (LA) or general anesthesia (GA). After propensity-score matching/multivariable analysis to balance preoperative differences, patients under LA were found to have lower 30-day mortality, pulmonary, renal, and wound complications, 30-day readmission, shorter operative time, and shorter hospital stay. In emergency EVAR, it may be advisable to consider LA over GA for eligible patients. Prospective studies in the future can be warranted to further support this anesthesia practice.
Comparative assessment of 5-factor modified frailty index and American Society of Anesthesiologists classification for morbidity and mortality prediction in arthroplasty: A prospective observational study
Authors: Sarkar Soumya , Gautam Deepak , Anand Rahul Kumar , Goyal Devansh , Batra Sahil , Malhotra Rajesh , Khanna Puneet , Baidya Dalim Kumar 
Published: February 2025

Background: Identifying early predictors of postoperative complications is paramount in frail patients. While the American Society of Anaesthesiologists classification is subjective, the 5-factor modified frailty index is simpler and associated with promising results in predicting morbidity and mortality in various surgical specialities. Methods: This prospective observational study assessed the comparative utility of 5-factor modified frailty index and American Society of Anaesthesiologists classification in predicting intensive care unit admission and revision surgery in 220 patients following arthroplasty with standardised anaesthesia techniques under the same group of surgeons. The 5-factor modified frailty index and American Society of Anaesthesiologists class were assessed 1 day before surgery, and postoperatively, all the patients were followed up for 30 days. Results: American Society of Anaesthesiologists and 5-factor modified frailty index had a significant association with postoperative intensive care unit requirements (odds ratio = 7.5, 95% confidence interval 1.3 to 42.4 and odds ratio = 8.3, 95% confidence interval 1.6 to 17.6, respectively). Only the 5-factor modified frailty index was significantly associated (odds ratio = 5.3, 95% confidence interval 1.3 to 9.7) with revision surgery. Patients with the 5-factor modified frailty index value of 3 had the best predictive odds for postoperative intensive care unit admission (odds ratio = 73.6, 95% confidence interval 7.5 to 718.8) and revision of surgery, particularly during total hip replacement (odds ratio = 54, 95% confidence interval 3.3). Conclusion: The 5-factor modified frailty index exhibited a more robust predictive capacity for postoperative intensive care unit requirements and the likelihood of revision surgery, particularly a 5-factor modified frailty index score of 3 in total hip replacement procedures.
Itopride in functional dyspepsia: open-label, 1-year treatment follow-up of two multicenter, randomized, double-blind, placebo-controlled trials
Authors: Broeders Bert , Tack Jan , Talley Nicholas J. 
Published: February 2025

Background: Functional dyspepsia (FD) is common but few efficacious therapies exist. Itopride, a prokinetic, acts via dopamine D2 receptor antagonism and acetylcholinesterase inhibition, and is now approved in Japan, Mexico, and Europe for FD. However, long-term efficacy and safety data have not been published. Objective: To evaluate the long-term safety and potential effectiveness of itopride. Design: A long-term open-label drug effectiveness study. Methods: Males and females, 18–65 years, with FD (Rome II) and the absence (by upper endoscopy) of any relevant structural disease were recruited. After the double-blind treatment phase, patients were treated in an open-label extension phase. Results: A total of 798 patients were included in these two open-label trials and received at least one dose of study medication; 551 patients (69.0%) completed 6 months of treatment, and 294 patients (36.8%) completed a 12-month period. Response rates based on the global physician assessment were 61.7%, 64.8%, 69.0 %, 69.1%, 70.1%, 73.1%, and 77.9% at weeks 8, 16, 24, 32, 40, 48, and 52, respectively. Compliance was above 95%. The safety and tolerability profiles were as expected, with the majority of adverse events being gastrointestinal. Prolactin elevations occurred in 3% of the cases but were not clinically significant. No ECG changes were identified. Conclusion: In this population, itopride, given for up to 12 months, was safe, and up to two-thirds appeared to maintain symptom benefit. Trial registration: NCT00110968 and NCT00112203.
Crosstalk between the gut microbiota and brain network topology in poststroke aphasia patients: perspectives from neuroimaging findings
Authors: Cao Yun , Huang Jiaqin , Zhang Danli , Ji Jianguang , Lei Xiaojing , Tan Zhongjian , Chang Jingling 
Published: February 2025

Background: Emerging evidence indicates that gut inflammatory and immune response play a key role in the pathophysiology of stroke and may become a promising therapeutic target. However, the specific role of the microbiota-gut-brain axis in poststroke aphasia (PSA) patients remains unclear. Objectives: The aim of this study was to investigate the relationships among the gut microbiota, neuroendocrine-immune network, brain network properties, and language function in patients with PSA. Design: This is a cross-sectional, observational, monocentric study. Methods: This study enrolled 15 PSA patients, 10 non-PSA patients, and 15 healthy controls (HCs). All subjects underwent stool microbiota analysis, blood inflammatory cytokines assessment, and brain-gut peptide examination. PSA patients and HCs underwent additional resting-state functional MRI (rs-fMRI) brain scans. The rs-fMRI data were utilized to create whole-brain connectivity maps, and graph theory was employed to characterize the network topological properties. Analysis of variance and the Kruskal–Wallis test were used for comparisons among the three groups. Correlation analyses were subsequently conducted to explore relationships among factors showing significant group differences. Results: Compared with non-PSA patients and HCs, PSA patients displayed alterations in the gut microbiota composition, increased systemic inflammation, changes in brain-gut peptides, and had worse language performance. Graph theoretical analysis revealed that PSA patients exhibited small-world topology. Furthermore, nodal measures in brain network analysis showed activation of homologous speech areas in the right hemisphere, while the nodal properties of brain regions near the lesion in the left hemisphere decreased in patients with PSA compared with HCs. Conclusion: The present study revealed, for the first time, that an imbalance in gut microbiota was accompanied by the neuroendocrine-immune network disorder and abnormal changes in the brain network in PSA patients.
Financial Inclusion, Mobile Money, and Tax Revenue in Africa
Authors: Ren Pengyu , Moumbark Toure , Appiah Ebenezer , Koudalo Yawovi M. A. 
Published: February 2025

Financial inclusion (FI) could create vast sums of revenue in the African economy, generating numerous chances and difficulties for countries. As the population becomes more financially included, their income rises over time, increasing government tax contributions. This paper investigates whether tax revenue changes are related to the evolution of financial inclusion (FI) in Africa. The paper employed panel microdata from 36 African countries from 2011 to 2017. The data was sourced from the Global Findex database. The paper uses Fixed Effects (FE) and Generalized Method of Moment (GMM) strategies. The empirical results indicate that the relationship between financial inclusion (FI) and tax revenue is significant and positive, proving that more access to financial services defined by credit card ownership (% age 15+) increases government tax revenue. The result using different tax proxies and other FI proxies is robust. The paper also unearths that mobile money, an alternative for FI, decreases tax revenue. Governments should prioritize policies that promote access to basic banking services, such as savings and checking accounts and consider providing tax incentives for mobile money operators who facilitate transactions that contribute to formal economic activity. JEL Classification: E62, H24, O16, G20
The Relationship Between the Emotional Intelligence and Clinical Decision-Making Among Nurses in Neonatal Intensive Care Units
Authors: Ayed Ahmad 
Published: February 2025

Introduction Emotional intelligence (EI) is crucial for managing stress, enhancing well-being, and improving clinical decision-making (CDM). In neonatal intensive care units (NICUs), where rapid decisions, emotional demands, and complex interactions are common, understanding how EI supports CDM is key to ensuring high-quality care and effective outcomes. Objective This study aimed to explore the relationship between EI and CDM among NICU nurses. Methods The study was cross-sectional in design and used a convenience sample of 178 NICU nurses. Data collection gathered by paper-based between 10 January and 10 April 2024, employing the “Schutte Self-Report Emotional Intelligence Test” and the “CDM Scale.” Results The analysis revealed that the average EI score among participants was 151.9 ± 1.7 (range: 33–165, CI = 151.613–152.096), reflecting a high level of EI. High EI in the NICU context is characterized by nurses’ ability to manage their own stress effectively, empathize with families facing emotional distress, and maintain composure in high-pressure situations. Similarly, participants demonstrated a high level of CDM, with an average score of 179.6 ± 8.6 (range: 40–200, CI = 178.349–180.770). High CDM involves making accurate and timely clinical decisions, such as assessing neonatal conditions, prioritizing interventions, and collaborating with interdisciplinary teams to ensure optimal outcomes. A significant positive relationship was found between EI and CDM ( r = 0.53, p < .001, effect size = 0.8). Furthermore, EI was a significant predictor of enhanced accuracy, timeliness, and prioritization in CDM ( p < .001, CI = 1.991–3.337). Conclusion Nurses in NICUs demonstrated both high EI and strong CDM skills. A positive association between these two variables was evident.
The Relationship Between the Nurse Practice Environment and Perceived Patient-Centered Care in Intensive Care Units: Nursing Perspective
Authors: Bardhia Musab , Batran Ahmad , Ayed Ahmad , Ejheisheh Moath Abu , Alassoud Bahaa , Abu-Siam Ibraheem 
Published: February 2025

Introduction The intensive care unit is a distinct environment that emphasizes the importance of professional and skilled nursing practice. Purpose This study aims to assess the relationship between the nurse practice environment and perceived patient-centered care (PCC) among nurses in intensive care units (ICUs) in Palestinian southern West Bank hospitals. Methods A cross-sectional, descriptive correlational design was employed for this study. The sample composed of 150 ICUs nurses. Data were collected using scales that assessed the practice environment and PCC. Results The practice environment scores ranged from 2.1 to 3.2, with a mean of 2.7 (±0.3), reflecting a moderately favorable environment. The PCC competency scores ranged from a mean 1.9 to 4.1, with of 3.4 (±0.5), indicating a generally high level of competency. A positive correlation was found between the practice environment and PCC competency ( r = .397, p = .001). Predictors of PCC included the practice environment ( B = .836, p = .001), age ( B = .027, p = .006), and educational level ( B = .154, p = .015). Conclusion The study found a moderately favorable practice environment and a generally high level of competency in PCC among nurses. Additionally, there were significant positive correlations between the practice environment and PCC competency. Age, educational level, and the practice environment were identified as predictors of PCC.
Evidence on improvements in medical liability outcomes after the introduction of a communication-and-resolution program at a hospital in Tennessee
Authors: LeCraw Florence R , Montanera Daniel , Hetzler Dale , Jackson Joy P , Keys Janice C , Mroz Thomas A 
Published: February 2025

Background In 2009, the Erlanger Hospital System (EHS) in Tennessee introduced a Communications-and-Resolution Program (CRP) for addressing adverse medical outcomes. The program requires transparency from their medical staff whenever a patient suffers an unexpected outcome. Healthcare professionals often fear that such transparency could lead to worse liability outcomes, especially increased litigation and reporting to the National Practitioner Data Bank (NPDB). Methods Using a difference-in-difference model, we compared the liability outcomes of EHS to all healthcare entities in the state of Tennessee from 2005 to 2015. We reviewed charts after CRP was implemented to determine whether there was a written request for compensation or only a verbal request for compensation. Results After introducing the CRP, EHS defense costs fell by 58% ( p < 0.001) and the number of claims filed fell by 42% ( p = 0.01), compared to that in Tennessee. We found a statistically insignificant impact on compensation at EHS after CRP was implemented compared to compensation in Tennessee. We find weak evidence of relative reductions in Total Liability Costs ( p = 0.34; 95% CI = −81% to +31%). Under the CRP, 40% of paid compensations resulted from only a verbal request for money, not a written request. Conclusion Our results provide the first evidence using a comparison group to demonstrate that CRP can lower defense costs and claims filed in court while not significantly increasing other compensation or total liability costs. The large fraction of cases with only a verbal request for compensation suggests that there could be less reporting to the NPDB when a hospital implements CRP.