bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology and antimicrobial resistance patterns of urinary tract infection: insights and strategies from a 5-year serial cross-sectional study in Vietnam
Authors: Que Anh Tram , Tran Anh Dao , Trang Thi Hong Nhung , Tran Thi Nhu Le , Bui Ngoc-Niem , Lai Chih-Ho 
Published: February 2025

Background: Urinary tract infection (UTI) is one of the most common bacterial infections in clinical practice. Given the rapid increase in antimicrobial resistance and the scarcity of new antibiotics, along with the absence of individual antibiogram testing in some countries, there is an urgent need for robust surveillance systems. Objective: This study aimed to provide evidence for the surveillance of resistance, a crucial component in developing national UTI treatment guidelines and guiding empirical therapy decisions. Design: This study utilized a retrospective, serial cross-sectional design. Methods: Antimicrobial surveillance was conducted using data collected from January 1, 2017 to December 31, 2021. A total of 2595 patients with UTIs were recruited for this study. From these patients, 2004 bacterial isolates were identified and subjected to epidemiological and antibiotic resistance analyses. Results: Escherichia coli ( E. coli, 42.7%), Pseudomonas aeruginosa ( P. aeruginosa, 11.9%), and Klebsiella pneumoniae ( K. pneumoniae, 10.9%) were identified as the predominant causes of UTIs. E. coli isolates demonstrated a high level of sensitivity (80%–90%) to carbapenems (imipenem, ertapenem, and meropenem), aminoglycosides (amikacin), piperacillin/tazobactam, cefoperazone/sulbactam, and fosfomycin. The antibiotic resistance rates of K. pneumoniae strains consistently exceeded 50%, except for amikacin, ertapenem, imipenem, meropenem, and fosfomycin. Notably, all K. pneumoniae strains isolated from patients with UTIs were resistant to ampicillin. During the coronavirus disease pandemic, the E. coli and K. pneumoniae isolates exhibited reduced antibiotic resistance compared to the pre-pandemic period. The resistance rate of P. aeruginosa isolates remained consistently high (60%–70%). Conclusion: Amikacin, ertapenem, imipenem, meropenem, and fosfomycin are promising treatment options for enterobacterial UTIs. However, their efficacy against P. aeruginosa is limited. This study revealed alarmingly high rates of primary etiological pathogen resistance to commonly prescribed empirical therapies for UTIs. These findings provide crucial data for optimizing national guidelines and implementing personalized treatment strategies to enhance the effectiveness of UTI treatments.
Intra-operative blood transfusions raise the risk of postoperative delirium and impede functional recovery in elderly hip fracture patients: a propensity score-matched study
Authors: Li Yanan , Wang Tao , Zhang Jiajie , Wang Zhiqian , Guo Junfei , Zhang Qi 
Published: February 2025

Abstract

Background
This retrospective analysis was performed to investigate the potential influence of intra-operative blood transfusion (IBT) in patients aged 65 years or older with intertrochanteric fractures (IF) who underwent intramedullary fixation.

Methods
The outcomes of interest included the incidence of postoperative delirium (POD), pain score at discharge, length of hospital stay (LOS), functional outcomes, and mortality. The study included all surgically treated patients with IF between Jan. 2018 and Dec. 2021. Data on patient demographics, injury-related factors, surgical procedures, intraoperative details, in-hospital information, and postoperative outcomes were collected. In order to mitigate potential confounding and selection bias, the researchers employed the propensity score matching (PSM) technique using a 1:1 ratio via the caliper matching method. Following PSM, the association between IBT and outcome analyses was assessed using McNemar's Chi-square tests. Additionally, the Spearman correlations between IBT, POD and postoperative functional outcomes were computed.

Results
Out of the initial 2159 consecutive patients screened, a final sample of 1681 individuals was included, consisting of 1278 in the non-IBT group and 403 in the IBT group. After PSM, each group comprised 298 participants. The disparities in POD rate and functional outcomes became significant after employing propensity score-based matching (P < 0.001 and 0.029, respectively), despite their lack of significance prior to matching. There were no notable distinctions observed in other operation-related data, LOS, and crude mortality rates at 30-day, 90-day, and 12-month intervals before and after PSM. Furthermore, incidence of POD (P = 0.006) and functional outcomes (P = 0.013) were significantly associated with IBT.

Conclusion
In conclusion, IBT significantly increases the incidence of POD and hinders postoperative functional recovery in elderly patients with hip fracture.
Group integrated exercise versus recovery class for veterans with posttraumatic stress disorder: a randomized clinical trial
Authors: Neylan Thomas C. , Muratore Laura A. , Williams Chanda L. , Schmitz Martha , Valdez Courtney V. , Maguen Shira , O’Donovan Aoife , Kelley D. Parker , Metzler Thomas J. , Cohen Beth E. , West Anna C. , Phan Jordan D. V. , Antonetti Victor , Mayzel Olga , Hlavin Jennifer A. , Chesney Margaret A. , Mehling Wolf E. 
Published: February 2025

Abstract
There are no reported randomized trials testing exercise versus an active comparator for Posttraumatic Stress Disorder (PTSD). This randomized clinical trial assessed the effectiveness of group exercise versus psychoeducation to improve quality of life and reduces symptomatic severity in Veterans with PTSD. Veterans who met criteria for current PTSD (DSM-5) and/or endorsed moderate levels of PTSD symptoms (CAPS 5 score ≥ 23) were randomly assigned to treatment. Integrative Exercise (IE) combines fitness exercises (aerobics, resistance training, stretching) with mindful body/breath awareness versus Recovery Class (REC) psychoeducation control condition. A total of 84 participants were enrolled of which 41 participants were randomized to IE and 43 participants to REC. There were no significant pre-post differences in change in the WHOQOL Psychological Domain in either group. There was a modest reduction in the total CAPS-5 score in both groups (IE: -8.2 (9.9), p < .001: REC: -7.8 (2.0), p < .001) but no differences across the two conditions. In the IE subsample that was remote, there was a greater improvement in PTSD symptom severity (F[1, 50] = 4.62, p = .036) and in in the WHOQOL Psychological Domain (F(1, 47) = 6.46, p = .014) in those who attended more sessions.

Trial registration ClinicalTrials.gov Identifier: NCT02856412 (registration date: February 27, 2017).
Associations between dietary diversity and self-rated health in a transverse study of four local food systems (French Guiana, Guadeloupe, Portugal and Senegal)
Authors: Rapinski Michael , Raymond Richard , Davy Damien , Bedell Jean-Philippe , Ka Abdou , Lubszynski Jean , Lopez Pascal Jean , Da Silva Eduardo Ferreira , Deghel Nathalie El , Macia Enguerran , Duboz Priscilla 
Published: February 2025

Abstract

Background
The nutrition transition is linked to the double-burden of malnutrition worldwide, and its impact on the quality of life is considerable. The dietary diversity score and self-rated health are two proxies that have been used to assess, for the former, nutrient adequacy and overall diet quality, and for the latter, health from a sociological, epidemiological and economical lens. The general aim of this study was to evaluate the relation between food and subjective health, and to test the hypothesis that greater dietary diversity is positively associated with a better perception of health.

Methods
A transverse comparison of foods consumed in four highly contrasted local socio-ecosystems (i.e., two French oversea territories: French Guiana, Guadeloupe, Portugal and Senegal) was conducted using 24-hour dietary recalls. Dietary diversity was calculated using 18 food groups based on classifications provided by WHO and FAO. Binary logistic regressions were used to assess the relationship between dietary diversity scores and answers to the question assessing self-rated health.

Results
Overall, 465 individuals, 18 years and older, from Senegal, Guiana, Guadeloupe and Portugal were interviewed using a 24-hour dietary recall. Participants were selected via a combination of non-probability sampling methods. The mean dietary diversity score for all regions combined was 9.22. Over one-third of participants reported their health as ‘good’ (39.8%), whereas ‘bad’ and ‘excellent’ health were the least reported, at 6.45% and 9.03%, respectively. Multiple binary logistic regression notably found that dietary diversity score (OR = 0.88, 95% CI [0.79, 0.99], p = 0.010) and at-home meal preparation, specifically with the reference category ‘all the time’ compared to ‘never’ (OR = 3.31, 95% CI [1.55, 7.07], p = 0.002) were statistically significant predictors of self-rated health (i.e., declaring overall bad health).

Conclusions
This study demonstrates a positive association between dietary diversity and self-rated health across distinct cultural contexts. The findings reinforce the importance of diverse diets for subjective well-being, regardless of differences in food systems. Public health messaging should continue to promote dietary diversity and home-cooked meals as effective strategies for improving health. Self-rated health could serve as a useful tool for quickly assessing the outcomes of nutrition therapy.
Societal views on using risk-based innovations to inform cancer screening and referral policies: findings from three community juries
Authors: Dennison Rebecca A. , Clune Reanna J. , Tung Joanna , John Stephen D. , Moorthie Sowmiya A. , Waller Jo , Usher-Smith Juliet A. 
Published: February 2025

Abstract

Background
Recent advances mean that innovations are emerging that enable better stratification of individuals based on their risk of cancer so that screening or diagnostic investigations can be targeted to those at greatest need. We explored the views of the public, from a societal perspective, of using such risk-based innovations to identify people’s cancer risk and allocating healthcare accordingly.

Methods
We conducted three community juries, each with 7–9 participants. Participants were informed about the topic and potential novel risk-based innovations through a series of presentations from experts and discussions. Polygenic risk scores, geodemographic segmentation, continuous monitoring of biomarkers, minimally invasive tests, artificial intelligence analysis of medical records, and wearable devices were used as examples. The participants then deliberated over the research questions before reporting their verdicts on the acceptability of these novel data-based approaches in principle. Transcripts were analysed using codebook thematic analysis.

Results
All juries found that the proposed risk-based approaches to cancer healthcare were, in general, acceptable. Primarily this was because the approaches would enable use of information in a positive and constructive way. However, there were a number of qualifiers or caveats. In particular, participants highlighted the necessity of using accurate and robust data with a well-evidenced association with cancer risk. They also expressed concerns about unintended consequences such as for insurance, scams or erosion of personal liberty, and the burden to participate in data collection across society. All agreed that opting-out must be straightforward.

Conclusions
Informed members of the public supported the concept of using innovations to estimate cancer risk and inform healthcare. Their priorities for accuracy, data security, participation burden, and personal liberty and choice tended to overlap with those of developers and policymakers. Work to ready these innovations for implementation should continue, with the public’s priorities accounted for in their development and dissemination in order to address any unintended consequences upfront.
Midshaft clavicle fractures with associated ipsilateral acromioclavicular joint injuries: a systematic review
Authors: Wang Chaoqun , Li Xugui , Dong Shengnan , Xie Wei , Ling Zexi , Meng Chengfei , Stöckle Ulrich 
Published: February 2025

Abstract

Background and aim
Isolated midshaft clavicle fractures (MCF) and acromioclavicular joint (ACJ) injuries are common, but simultaneous cases are rare and often receive insufficient clinical attention, resulting in missed diagnoses. Moreover, there is no consensus on the injury mechanism, classification, and treatment, and the prognosis remains poorly summarized. This review aims to provide an overview of MCFs with ipsilateral ACJ injuries, focusing on injury mechanism, classification, treatment, and prognosis.

Methods
We searched the literature published between 1962 and 2024 on PubMed, Web of Science, and EMBASE using the search terms “clavicle fracture [Title/Abstract]) AND (acromioclavicular [Title/Abstract])”. Studies reporting clinical outcomes in patients with MCF and ipsilateral ACJ injuries were included. 37 studies were included after screening. The study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Data on study design, patient demographics, treatment approaches, and outcomes were extracted for qualitative analysis. We then summarized key findings and presented our insights.

Results
MCFs with ipsilateral ACJ injuries are often associated with comorbidities such as rib fractures, hemopneumothorax, scapula fractures, neurovascular injuries, and atypical MCF displacement patterns. These cases should raise suspicion for combined injuries. Due to the "floating" nature of the lateral clavicle, the "Piano Key Sign" is typically negative and not reliable for diagnosis. Initial ACJ evaluation may be inconclusive, so reevaluation after MCF fixation is recommended. Type IV ACJ injuries can be underestimated on anteroposterior radiographs, and additional axillary radiographs and CT scans may better visualize posterior clavicle displacement. Most researchers believe ACJ capsule and ligament damage occurs first, but is insufficient to cause significant dislocation, suggesting that isolated MCF may involve combined ACJ injury with intact coracoclavicular ligaments. Notably, most patients reported favorable outcomes without major complications within two years, regardless of treatment approach.

Conclusions
MCFs with ipsilateral ACJ injuries are rare and often missed when ACJ injuries are mild. The injury mechanism is unclear, and no classification system exists to indicate severity. These injuries are typically treated separately without a unified protocol. Despite promising outcomes, further studies are needed to address these issues and improve understanding of long-term results.
Efficacy comparison of PD-1/PD-L1 inhibitor monotherapy and combination with PARPis or antiangiogenic agents in advanced or recurrent endometrial cancer: a systematic review and network meta-analysis
Authors: Ji Shiya , Chen Xupeng , Yu Yebo , Jia Qiuping , Zhang Xingxing , Gao Zixin 
Published: February 2025

Abstract

Purpose
The network meta-analysis (NMA) was aimed to compare and assess the effectiveness of programmed cell death 1 (PD-1)/ programmed cell death ligand 1 (PD-L1) inhibitor monotherapy or combination therapy with other agents for individuals with advanced or recurrent endometrial cancer (EC).

Methods
The NMA was registered on the PROSPERO website (ID: CRD42024545968) and multiple databases were queried to retrieve the articles. It assessed the progression-free survival (PFS) and overall survival (OS) of persons with advanced or recurrent EC, as well as those with deficient mismatch repair (dMMR) and proficient mismatch repair (pMMR) in terms of PFS.

Results
The NMA included 12 studies involving a total of 4,515 patients. Compared to chemotherapy, the PD-1/PD-L1 inhibitor monotherapy (hazard ratio [HR], 0.59; 95% confidence interval [CI]: 0.44–0.78) in PFS, combination therapy with poly (ADP-ribose) polymerase inhibitors (PARPis) (HR, 0.53; 95% CI: 0.32–0.89) or with antiangiogenic agents (HR, 0.48; 95% CI: 0.25–0.83) all showed significant improvements in PFS. PD-1/PD-L1 inhibitor monotherapy resulted in a significantly higher OS (HR, 0.61; 95% CI: 0.37–0.97) compared to chemotherapy. Combination therapy with antiangiogenic agents demonstrated the highest efficacy in extending PFS, while the combination with PARPis had the best performance in extending OS. Patients with dMMR and pMMR subtypes derive greater benefits from PD-1/ PD-L1 inhibitor monotherapy and PD-1/PD-L1 inhibitors combined with PARPis respectively.

Conclusion
Monotherapy with PD-1/PD-L1 inhibitors and combination therapies with PARPis or antiangiogenic agents demonstrate significant potential for individuals with advanced or recurrent EC.
Transforming narratives of physician identity formation and healing: a longitudinal qualitative study of physicians’ stories about spirituality and medicine, from residency to practice
Authors: Anandarajah Gowri , Sleeth Georgia , Mennillo Meera , Srinivasan Achutha 
Published: February 2025

Abstract

Background
Concern about burnout has prompted increased attention on fostering physician resilience throughout the educational continuum. Studies indicate that lack of meaning-making and connection (domains of spiritual wellbeing) place physicians at risk for burnout. While evidence support including spiritual care in comprehensive patient care to help patients/families heal from impactful experiences, few studies explore physicians’ spiritual wellbeing as they routinely confront suffering and death in their daily work. Storytelling taps into spiritual aspects of human experience. This study, unique in the literature, examined the stories physicians chose to tell about spirituality and medicine over 20-years, from trainee to practicing physician, to explore how these experiences impact professional development and wellbeing.

Methods

Design: Qualitative individual interview study – secondary analysis of a rich dataset of physician interviews, gathered over 20-years beginning in first-year residency, regarding attitudes and approach to spiritual care. For this new study, researchers extracted and analyzed the previously unexplored stories participants spontaneously told during interviews.

Setting: Participants completed the same USA residency program and now practice throughout USA and Canada.

Participants: In study-year 1, all residents (PGY1,2,3) participated; response rate (RR) 97%, reflected a diversity of personal beliefs (atheist to religious). Researchers followed the PGY1 class for 20-years (2001–2020), interviewing them in study-years 1, 3, 11 and 20 (RR 100%, 100%, 97%, 54%).

Data Collection: Researchers extracted stories from interview transcripts.

Analysis: 4 researchers analyzed 204 stories from 66 interviews with 34 physicians, using grounded theory.

Results
Irrespective of personal spiritual beliefs, trainees and practicing physicians told numerous spirituality-related stories. Longitudinal story themes—(1) Dissonance to Integration, (2) Formation and Transformation, and (3) Accidental to Purposeful Healing – reflected physicians’ ongoing spiritual journeys as they grappled with meaning, values, purpose, and connection in their daily work. Spiritually impactful moments, whether distressing or uplifting, occurred throughout physicians’ careers influencing professional/personal development, resilience and clinical approach. Spiritual practices (religious/secular) and reflection fostered healing for patients/families and physicians.

Conclusion
Physicians’ longitudinal spiritual-care stories provide new insights into their professional/personal development. Reflection on spiritually impactful moments, both distressing and uplifting, may trigger transformative learning towards meaning-making, resilience, burnout prevention and positive physician identity formation.
FAPI-PET/CT guided radiotherapy for patients with esophageal cancer
Authors: Kröger Kai , Pepper Niklas Benedikt , Ventura David , Troschel Fabian M. , Backhaus Philipp , Rahbar Kambiz , Glasbrenner Bernhard , Brüwer Matthias , Pascher Andreas , Schäfers Michael , Eich Hans Theodor , Roll Wolfgang 
Published: February 2025

Abstract

Background
Cancer associated fibroblasts have become a target of interest in different malignancies for positron emission tomography (PET) imaging, using positron emitter labelled fibroblast activation protein inhibitors (FAPI). New data underline the advanced imaging properties of FAPI-PET/CT for the staging of esophageal cancer compared to standard imaging. Potential benefits of FAPI-PET/CT in radiation therapy planning are the subject of this investigation.

Methods
Ten patients with newly diagnosed esophageal cancer treated with radiochemotherapy (RCT) were retrospectively analyzed. All patients underwent [68Ga]OncoFAP-PET/CT in treatment position to facilitate radiation treatment planning. Six patients received neoadjuvant RCT as part of a trimodal therapy and four patients underwent definitive RCT. In five cases, restaging after initial treatment was performed with FAPI-PET/CT.

Results
[68Ga]OncoFAP-PET/CT based imaging showed a high correlation with the endoscopic staging for initial imaging. In three cases, new sites of disease were unmasked, not visible in CT- and endosonographic staging. [68Ga]OncoFAP-PET/CT based RT delineation offered good definition of clinical target volumes, especially in retro-/paracardial areas and the gastroesophageal junction.

Conclusion
[68Ga]OncoFAP-PET/CT may aid and improve radiation treatment planning for patients with esophageal cancer.
Pattern of recurrence after fractionated stereotactic reirradiation in adult glioblastoma
Authors: Margulies Agathe , Sahki Nassim , Rech Fabien , Vogin Guillaume , Blonski Marie , Peiffert Didier , Taillandier Luc , Lesanne Grégory , Demogeot Nicolas 
Published: February 2025

Abstract

Background
Glioblastomas all eventually relapse after initial treatment, and an option to treat these recurrences is fractionated stereotactic reirradiation (fSRT). The location of recurrences following reirradiation has not been studied for fSRT delivered by a dedicated stereotactic device. We aimed to analyze these locations to better elucidate safety margins, dose and fractionation regimens.

Methods
We retrospectively analyzed the data of patients with glioblastoma recurrence that had been reirradiated by fSRT in October 2010-December 2020, in 25 Gy in 5 fractions delivered by a CyberKnife® at Institut de Cancérologie de Lorraine. We matched the images of the post-fSRT relapse with the stereotactic radiation treatment planning scan to determine the relapse location.

Results
The location of recurrences after fSRT was “out-field” in 43.5%, “marginal” in 40.3%, and “in-field” in 16.1% of patients (N = 62). A GTV-PTV margin of 1 mm (versus 2–3 mm, HR = 0.38 [0.15–0.95], p = 0.037) and a PTV volume of ≥ 36 cc (HR = 5.18 [1.06–25.3], p = 0.042) were significantly associated with the “marginal” recurrences. Being ≥ 60 years old at initial treatment (HR = 3.06 [1.17–8.01], p = 0.023) and having one or more previous recurrences (HR = 5.29 [1.70–16.5], p = 0.004) were significantly associated with “out-field” recurrences. The median PFS from fSRT was 3.4 months, and OS from diagnosis and from fSRT were 25.7 and 10.8 months respectively.

Conclusion
Reirradiation of glioblastoma recurrence by fSRT with 25 Gy in 5 fractions provides good local control.