bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of mindfulness meditation on pro-inflammatory biomarkers in patients with end-stage renal disease: A randomized trial
Authors: Alhawatmeh Hossam , Najadat Ishraq , Hweidi Issa , Abuhammad Sawsan 
Published: December 2024

Background and aim: Mindfulness meditation has been inadequately used in patients with end-stage renal disease although it has been effective in reducing pro-inflammatory biomarkers in patients with chronic illnesses. Thus, this study examined mindfulness meditation effect on pro-inflammatory biomarkers and C-reactive protein in patients with end-stage renal disease. Materials and methods: Repeated measures, randomized, control experimental design was used. A convenience sampling technique was used to select the sample from a hospital located in northern Jordan. The participants were randomly distributed into experimental ( n = 31) and control ( n = 31) groups. During hemodialysis sessions, the group of experiment participants practiced 30 min of the Attentional behavioral cognitive theory version of mindfulness meditation; 3 times a week for 8 weeks). The inflammatory biomarkers including C-reactive protein, tumor necrosis factor-alpha, and interleukine-6 were measured by collecting peripheral blood through venipuncture. These biomarkers were analyzed using the enzyme-linked immunosorbent assay (ELISA) protocol after 5 weeks of the intervention, and at its end (8 weeks). An Excel sheet was used to collect data for participants. Results: Compared to the control condition, mindfulness meditation led to statistically significant reductions in C-reactive protein and tumor necrosis factor over time but a nonsignificant effect on interleukine-6. Conclusion: Study’s results support the evidence-based practice recommendation of adding mindfulness meditation as a complementary treatment to the nurse’s care plans for patients with end-stage renal disease. Trial registration: Clinical trial.gov; ID: NCT06064708; Date: 09/26/2023.
Validation of artificial intelligence-based quantitative coronary angiography
Authors: Kim Do-Hyun , Kim Sun-Hwa , Chu Hyun-Wook , Kang Si-Hyuck , Yoon Chang-Hwan , Youn Tae-Jin , Chae In-Ho 
Published: December 2024

Background Coronary angiography is fundamental for the diagnosis and treatment of coronary artery disease. Manual quantitative coronary angiography (QCA) is accurate and reproducible; however, it is time-consuming and labor-intensive. However, recent advancements in artificial intelligence (AI) have enabled automated and rapid analysis of medical images, addressing the need for real-time quantitative coronary analysis. Aims This study aimed to evaluate the accuracy of AI-based QCA (AI-QCA) compared with that via manual QCA and clinician acceptance. Methods This retrospective, single-center study was conducted in two phases. Phase 1 was a pilot study comparing AI-QCA with manual QCA and visual estimation. It involved 15 patients who underwent coronary angiography at Seoul National University Bundang Hospital between September 2011 and July 2021. Phase 2 included a larger cohort of 762 patients, with 1002 coronary angiograms analyzed between May 2020 and April 2021. Results In phase 1, AI-QCA and manual QCA consistency varied among the observers, with AI-QCA showing superior consistency compared with visual estimation. However, a strong correlation between AI-QCA and manual-QCA was found in phase 2. AI-QCA accurately identified and quantitatively analyzed multiple lesions in the major vessels, providing results comparable with those of manual QCA. Conclusions AI-QCA demonstrated high concordance with manual QCA, offering real-time analysis and reduced workload. Therefore, AI-QCA has the potential to be a valuable tool for diagnosing and treating coronary artery disease, necessitating further studies for clinical validation.
Lateral Fusion is a Unique Feature in Oblique Lumbar Interbody Fusion Surgery: A Retrospective Cohort Study
Authors: Yongjun Tong , Chudi Fu , Qibin Zhang , Bao Huang , Changjiang Ou , Xuyang Zhang , Junhui Liu , Shunwu Fan , Fengdong Zhao 
Published: December 2024

Study Design Retrospective cohort study. Objective Limited clinical literature addresses potential differences in fusion features between Oblique lumbar interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF). We observed that in OLIF, there are many cases with the appearance of extra-vertebral bone bridges (EVB), a phenomenon distinct from traditional TLIF fusion. This study aims to compare fusion rates, cage subsidence, and fusion features among OLIF stand-alone (OLIF-SA), OLIF with posterior pedicle screw fixation (OLIF-PS), and TLIF. Methods We retrospectively analyzed 198 patients (311 levels) undergoing OLIF-SA, OLIF-PS, or TLIF from July 2017 to June 2021. We assessed patient-reported outcomes, cage subsidence, fusion rate, and fusion features on CT scans. Results The study included 64 OLIF-SA patients (102 levels), 60 OLIF-PS patients (99 levels), and 74 TLIF patients (110 levels). Cage settling rates were 33.3% (OLIF-SA), 17.2% (OLIF-PS), and 32.8% (TLIF), with significant differences between OLIF-PS and TLIF ( P < 0.05). Cage subsidence rates showed no significant difference: 11.8% (OLIF-SA), 9.1% (OLIF-PS), and 12.7% (TLIF) ( P > 0.05). Fusion rates were 100% (OLIF-SA), 97.0% (OLIF-PS), and 96.4% (TLIF) ( P = 0.167). Lateral fusion rates significantly differed: 49.0% (OLIF-SA), 30.3% (OLIF-PS), and 10.9% (TLIF) ( P < 0.001). Preoperative osteophytes strongly promote lateral fusion ( P < 0.001). VAS and ODI scores improved significantly post-surgery ( P < 0.01). Conclusions OLIF-SA, OLIF-PS, and TLIF surgeries show satisfactory results with comparable fusion rates. Notably, distinctive differences exist in fusion features between OLIF and TLIF surgeries, with lateral fusion more prevalent in OLIF, particularly in OLIF-SA surgeries.
Return to Soccer After Anterior Cruciate Ligament Reconstruction: An Outcome or a Decision?
Authors: Hållén Isabelle , Kvist Joanna , Forssblad Magnus , Sandon Alexander 
Published: December 2024

Background: The return-to-sports rate is often used as an outcome measure after anterior cruciate ligament (ACL) reconstruction (ACLR). Although most soccer players want to return to sports after their ACL injury, up to 40% do not believe they will return to soccer after their ACL injury. Purpose: To investigate whether self-reported presurgical beliefs regarding return to soccer correspond to registered official match participation after ACLR. Study Design: Cohort study; Level of evidence, 2. Methods: Included were soccer players with a primary unilateral ACL injury who were ≥15 years at the time of ACLR and who had completed a presurgical question about their future sports participation beliefs. ACLR surgical data were extracted from the Swedish National Knee Ligament Registry, and game participation data were extracted from the Swedish Football Association's administrative data system. Results: A total of 959 soccer players (617 [64%] male and 342 [36%] female) were included. The follow-up time after ACLR ranged from 18 months to 5.5 years. Of 720 soccer players (75%) who believed that they would return to play (RTP), 462 (64%) players actually did. Of the players who believed that they would not RTP, 181 (76%) did not. Presurgical beliefs predicted RTP (odds ratio [OR], 5.59; P < .001). Younger age at the time of ACLR favored RTP, where 61% of the players aged 15-20 years had RTP (OR, 3.85; P < .001). At the top competitive level, 84% of the players RTP compared to 14% at the recreational level. Players active at higher levels were more likely to believe that they would RTP, and they also actually did so (OR, 33.06; P < .001). Overall, 67% of players followed their presurgical intention to return to soccer. Conclusion: The findings indicated that presurgical beliefs, age, and level of play helped to predict the actual RTP of soccer players after ACLR.
Nurse's Clinical Competence and Its Associated Factors Among Working in Ethiopia: A Cross-Sectional Study
Authors: Tura Meseret Robi , Mulu Dinaol , Kadir Ajib , Getahun Ababo , Megersa Yohanis 
Published: December 2024

Background Clinical competence is a critical element in providing high-quality nursing care. A higher level of clinical competence positively influences patient health outcomes as well as nurses’ job performance and satisfaction. Nonetheless, there is limited data on nurses’ clinical competence in Ethiopia. Objective This study aimed to assess the level of clinical competency among nurses working in selected public hospitals. Method Institution-based cross-sectional study design was conducted from March 1 to 30, 2022. Two hundred five randomly selected nurses from three selected hospitals in the West Shoa Zone namely Ambo University Riferral Hospital, Ambo General Hospital, and Guder Primary Hospital participated in the study via a structured self-administered questionnaire. The collected data were checked for completeness and then entered Epi-data v.4.2.2 and analyzed by Stata software v.14.2. Independent t-test and analysis of variance were used to identify factors associated with nurses’ clinical competence. The level of statistical significance was declared at a p-value < .05. Results The overall clinical competence of participants was 2.501 ( SD = 0.36), indicating a moderate level of clinical competence. Participants had higher competence scores on the professional development dimension and lower competence scores on the leadership dimension. The null hypothesis was rejected. Age, work experience, professional satisfaction, level of satisfaction, level of hospital, current position, shifting status, retrieval of newly published information, previous training, and frequency of training were the identified factors associated with nurses’ clinical competence. Conclusion Nearly five in 10 participants in the study setting had inadequate clinical competence. Professional satisfaction, level of satisfaction, previous training, and frequency of training were factors related to nurses’ clinical competence. It is recommended that responsible stakeholders like the Minister of Health and the Ethiopian Nursing Association should work to improve nurses’ clinical competence by focusing on the identified factors. Also, health policymakers should set strategies to assess nurses’ clinical competence frequently to ensure quality nursing care.
Impact of Virtual Clinics on Streamlining NHS Outpatient Waiting Lists and Carbon Emissions
Authors: Bhavanasi Bhaskar Amarnath , Kulkarni Shrikant 
Published: December 2024

Background: The National Health Service (NHS) outpatient waiting list is growing, affecting specialties like foot and ankle. Delays are due to increasing demand, limited resources, and administrative inefficiencies. Virtual clinics are being explored to reduce physical clinic burdens and provide timely care. This study investigates the effectiveness of virtual clinics in reducing prolonged waiting times in the foot and ankle specialty. Emissions from personal vehicles are a primary driver of climate change, which is a little recognized benefit of virtual clinics. Methods: We analyzed outcomes from a virtual elective foot and ankle clinic, overseen by a specialist consultant, for new elective referrals over 4 months. Data for 175 patients were collected from Lorenzo, our electronic health records system. We also assessed the success rate of virtual consultations in terms of accurate diagnoses and effective treatment plans. Measured distance to the hospital based was on patients’ residential address. Results: The virtual clinic effectively managed patients. Of the 175 patients, 48.6% completed treatment, and were discharged, and 53.7% were managed without face-to-face consultations. In addition, 66.3% did not need in-person visits; this includes patients treated and discharged and who were referred for investigations. In this clinic, avoiding 1 visit to the hospital by 116 patients saved travel of 1040 miles. Conclusion: The widespread adoption of virtual clinics can provide a convenient and cost-effective health care solution for patients and also potentially help reduce carbon emissions contributing to control global warming. Level of Evidence: Level IV, retrospective case series.
Digital knowledge translation tools for sexual and reproductive health information to adolescents: an evidence gap-map
Authors: Meherali Salima , Hussain Amber , Rahim Komal Abdul , Idrees Sobia , Bhaumik Soumyadeep , Kennedy Megan , Lassi Zohra S. 
Published: December 2024

Background: Digital knowledge translation (KT) interventions play a crucial role in advancing adolescent sexual and reproductive health (ASRH). Despite the extensive literature on their effectiveness, there’s a lack of synthesized evidence on the efficacy of digital KT tools for adolescent ASRH globally. Objectives: This review aimed to systematically identify and map existing empirical evidence on digital KT tools targeting ASRH outcomes and identify research gaps. Design: The review employed an evidence gap-map (EGM) approach following 2020 PRISMA reporting guidelines. Data sources and methods: A comprehensive literature search was conducted across databases including Medline, EMBASE, Global Health, CINAHL, Scopus, and Cochrane. Covidence software was used for data management. EPPI-Mapper software was used to synthesize findings and develop a graphical EGM. Results: The EGM comprises 68 studies: 59 experimental and 9 systematic reviews, predominantly from African (19 studies) and American regions (22 studies), with limited research from the Eastern Mediterranean and South East Asian regions. It examines digital KT tools’ influence on sexual and reproductive health (SRH) outcomes, identifying research gaps. Websites are extensively studied for their impact on adolescent behavior, knowledge, attitude, and self-efficacy, yet research on their effects on ASRH and health services access is limited. Similarly, mobile apps and short message service (SMS)/text messages impact various aspects of SRH outcomes, but research on their effects on health services utilization is insufficient. Interventions like digital pamphlets and gaming lack exploration in health service access. OTT media and social media need further investigation. Mass media, including radio, television, and podcasts, are largely unexplored in adolescent SRH outcomes. Topics such as menstrual hygiene, abortion, and sexual and intimate partner violence also lack research. Conclusion: The review underscores the dominance of certain KT tool interventions like SMS and websites. Despite advancements, research gaps persist in exploring diverse digital platforms on underrepresented outcomes globally. Future research should expand exploration across digital platforms and broaden the scope of outcome measures. Trial registration: The protocol is registered with PROSPERO (CRD42022373970).
Deficiency of neutrophil gelatinase-associated lipocalin elicits a hemophilia-like bleeding and clotting disorder in mice
Authors: Xue Min , Wang Shaoying , Li Changjiang , Wang Yuewei , Liu Ming , Huang Xiaoshan , Wang Gan , Yin Qikai , Xiao Dandan , Yang Shuo , Yan Musan , Niu Liyuan , Awais Muhammad , Shen Chuanbin , Wang Jianxun , Lai Ren , Ni Heyu , Tang Xiaopeng 
Published: December 2024

Abstract
Coagulation is related to inflammation, but the key pathway, especially innate immune system and coagulation regulation, is not well understood and need to be further explored. Here, we demonstrated that neutrophil gelatinase-associated lipocalin (NGAL), an innate immune inflammatory mediator, is upregulated in patients with thrombosis. Furthermore, it contributes to the initiation and amplification of coagulation, hemostasis, and thrombosis. This occurs by enhancing tissue factor expression on the cell surface, potentiating various clotting factors such as thrombin, kallikrein, factor XIa (FXIa), and FVIIa, promoting thrombin-induced platelet aggregation, and inhibiting antithrombin. NGAL knockout led to strikingly prolonged clot reaction time and kinetic time in thromboelastography analysis, along with reduced thrombus generation angle and lower thrombus maximum amplitude, which were in line with remarkably prolonged activated partial thromboplastin time and prothrombin time. In several mouse hemostasis and thrombosis models, NGAL overexpression or IV administration promoted coagulation and hemostasis and aggravated thrombosis, whereas NGAL knockout or treatment with anti-NGAL monoclonal antibody significantly prolonged bleeding time and alleviated thrombus formation. Notably, NGAL knockout prolonged mouse tail bleeding time or artery occlusion time to over 40 or 60 minutes, respectively, resembling uncontrollable bleeding and clotting disorder seen in hemophilic mice. Furthermore, anti-NGAL monoclonal antibody treatment markedly reduced the formation of blood clots in inflammation-induced thrombosis models. Collectively, these findings unveil a previously unidentified role of NGAL in the processes of coagulation, hemostasis, and thrombosis, as well as the cross talk between innate immunity, inflammation, and coagulation. Thus, modulating NGAL levels could potentially help balance thrombotic and hemorrhagic risks.
Acute Promyelocytic Leukemia Asian Consortium study of arsenic trioxide in newly diagnosed patients: impact and outcome
Authors: Gill Harinder , Raghupathy Radha , Hou Hsin-An , Cheng-Hong Tsai Xavier , Tantiworawit Adisak , Ooi Melissa G. , Gan Gin-Gin , Wong Chieh-Lee , Yim Rita , Chin Lynn , Lee Paul , Li Vivian W.K. , Au Lester , Zhang Qi , Leung Garret M.K. , Wu Tony K.Y. , Lee Carmen Y.Y. , Chng Wee-Joo , Tien Hwei-Fang , Kumana Cyrus R. , Kwong Yok-Lam 
Published: December 2024

Abstract
The Acute Promyelocytic Leukemia (APL) Asian Consortium analyzed a contemporaneous cohort of newly diagnosed patients with APL treated with and without frontline arsenic trioxide (ATO) in 6 centers. The objectives were to define the impact of ATO on early deaths and relapses and its optimal positioning in the overall treatment strategy. In a 21.5-year period, 324 males and 323 females at a median age of 45.5 years (range, 18.1-91.8; low/intermediate risk, n = 448; high risk, n = 199) were treated. Regimens included frontline all-trans retinoic acid (ATRA)/chemotherapy and maintenance with/without ATO (n = 436), ATRA/IV-ATO/chemotherapy (ATRA/IV-ATO; n = 61), and ATRA/oral-ATO/ascorbic acid with ATO maintenance (oral-AAA; n = 150). The ATRA/chemotherapy group had significantly more frequent early deaths within 60 days (8.3% vs 3.3%; P = .05), inferior 60-day survival (91.7% vs 98.4%/96%; P &lt; .001), inferior 5-year relapse-free survival (RFS; 76.9% vs 92.8%/97.8%; P &lt; .001), and inferior 5-year overall survival (OS; 84.6% vs 91.4%/92.3%; P = .03) than ATO-containing groups (ATRA/IV-ATO and oral-AAA). The addition of oral-ATO maintenance partly mitigated the inferior 5-year RFS resulting from the omission of ATO during induction (ATRA/chemotherapy/non-ATO maintenance vs ATRA/chemotherapy/ATO maintenance vs ATRA/IV-ATO vs oral-AAA, 71.1% vs 87.9% vs 92.8% vs 97.8%; P &lt; .001). The favorable survival impacts of ATO were observed in all risk groups. In conclusion, ATO decreased early deaths, improved 60-day survival, and resulted in significantly superior RFS and OS. This trial was registered at www.clinicaltrials.gov as #NCT04251754.
Exploring barriers and enablers of last-mile crowdshipping: understanding the motivation of potential groups of crowdshippers in the slovenian context
Authors: Bajec Patricija , Tuljak-Suban Danijela 
Published: December 2024

AbstractThe impact of motivational and demotivational factors on the willingness to work (WTW) as crowdshippers, specifically focusing on different groups of crowdshippers, has been largely neglected or overlooked in the literature. This study therefore aims to address this gap by determining and examining a comprehensive set of potential factors that either hinder or encourage the WTW of crowdshippers and tests their impact on four key groups of potential crowdshippers in Slovenia: employed individuals, retirees, students, and unemployed. Significant interactions between the groups and statistical differences between them were detected using the significance level and correlation approaches. The findings of this study confirm that not only are potential crowdshipper groups heterogeneous, but there is also heterogeneity within crowdshipper groups such as retirees and students. Furthermore, the study highlights that the influence of these factors slightly varies depending on the specific business models (business to customer and business to business).
Fungal infection-related conditions and outcomes in severe COVID-19: a nationwide case-control study
Authors: Maeshima Katsuya , Yamamoto Ryo , Matsumura Kazuki , Kaito Daiki , Homma Koichiro , Yamakawa Kazuma , Tagami Takashi , Hayakawa Mineji , Ogura Takayuki , Hirayama Atsushi , Yasunaga Hideo , Sasaki Junichi ,   the J-RECOVER study group
Published: December 2024

Abstract
Background
Fungal infections are significant complications of severe coronavirus disease 2019 (COVID-19). Although various risk factors for poor outcomes in patients with COVID-19 have been identified, clinical and treatment factors associated with fungal infections in patients with severe COVID-19 remain unclear. This study aimed to elucidate clinical factors associated with fungal infections during severe COVID-19 treatment.

Methods
This was a post hoc analysis of the J-RECOVER study, a multicenter retrospective observational study involving patients with COVID-19 who required admission at 66 hospitals between January and September 2020. Inclusion criteria were ages ≥ 18 years, COVID-19 diagnosis with reverse-transcription polymerase chain reaction, and treatment with mechanical ventilation (MV). Patients who received antifungal drugs before MV were excluded. Potential predictors were identified through univariate analysis of patient and treatment characteristics between patients with- and those without fungal infection, which was defined as antifungal agent use for ≥ 5 days. To account for facility-specific data clustering, generalized estimating equations (GEE) were employed as adjusted analyses to calculate the relative risks of potentially associated factors. Two sensitivity analyses were performed with modified definitions for the two groups: patients who received antifungal drugs for ≤ 4 days were excluded, and fungal infection was re-defined as antifungal drug use for ≥ 14 days.

Results
Among 4,915 patients in the J-RECOVER study, 559 adults with COVID-19 who required MV were included. Fungal infections occurred in 57 (10.2%) patients. Univariate analyses identified age, age ≥ 65 years, D-dimer level, remdesivir use, steroid use, and duration of steroid therapy as potential predictors of fungal infections. Multivariate analysis using GEE on these six factors revealed that only the duration of steroid use was significantly associated with an increased risk of fungal infection (odds ratio [OR] for a day increase: 1.01; 95% confidence interval [CI]: 1.00–1.01; p < 0.001). The two sensitivity analyses similarly showed that the duration of steroid use was associated with fungal infection (odds ratio for a day increase: 1.01; 95% CI: 1.00–1.01; p < 0.001 for both).

Conclusions
In patients with severe COVID-19 requiring MV, each additional day of steroid use was associated with prolonged use of antifungal medications for ≥ 5 days.