bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laser Ablation of an Isolated External Auditory Canal Skin Wedge
Authors: Lakpa Koffi L. , Eyassu Daniel G. , Wiedermann Joshua P. 
Published: December 2024

Introduction: External ear malformations represent a spectrum of congenital anomalies that may involve the external auditory canal (EAC), tympanic membrane (TM), or associated structures. A rare anomaly, the EAC skin wedge, results from incomplete canalization during embryologic development. This report presents the clinical presentation, diagnostic evaluation, and surgical management of this condition. Objective: To detail the successful surgical management of an isolated EAC skin wedge and demonstrate the applicability of argon laser in treating these congenital anomalies. Methods: A 13-month-old female presented with recurrent otitis media and mild bilateral conductive hearing loss. Physical examination revealed a fan-like skin wedge spanning the EAC to the TM. Imaging with temporal bone computed tomography confirmed the extent of the anomaly. Under general anesthesia, the skin wedge was ablated using an argon laser, followed by antibiotic-soaked packing to prevent scarring and recurrence. Follow-up audiometry and endoscopic evaluations assessed outcomes. Results: The procedure was well-tolerated, with no intraoperative complications. At 3 weeks and 3 months postoperatively, no recurrence of the skin wedge was observed, and audiometry normalized. The patient demonstrated improved middle ear ventilation and resolution of conductive hearing loss. Conclusions: This case demonstrates the successful use of argon laser in the management of a rare congenital EAC anomaly. Argon lasers offer precise ablation and excellent hemostasis, making them a valuable option for similar cases. This report emphasizes the importance of tailored surgical approaches for rare pediatric ear malformations.
Parental perspectives on barriers and facilitators of early adolescent outdoor play: A qualitative study
Authors: Cox Lindsay J , Cox Ashley , Morley Helen 
Published: December 2024

Background: Outdoor play supports physical and psychological health among children and early adolescents (EA; ages 10–14). However, most research to date has focused on younger children (under 10), leaving a gap in understanding the specific barriers and facilitators of outdoor play for EA. Objective: This study investigated parental perspectives on the barriers and facilitators of outdoor neighbourhood play for EA in the UK. Methods: Eleven parents (ages 30–50, 82% women) from diverse socioeconomic backgrounds participated in semi-structured online interviews. A content thematic analysis, guided by the socioecological model, was used to identify key themes. Results: Six key themes were developed: autonomy and independence, social connectedness, the built environment, social development, technology and parental behaviours. While parents recognised the importance of outdoor play for EA, concerns about neighbourhood safety, traffic and inadequate play and recreational facilities were significant barriers. Technology played a dual role: facilitating safety through regular communication but also contributing to sedentary behaviour. Parents also drew attention to lack of community cohesion, which limited their comfort about unsupervised outdoor play. Conclusion: Parents valued outdoor play but imposed restrictions due to safety concerns at a time at which EA should be developing independence and autonomy. Addressing these concerns by improved play and recreational facilities, fostering community trust and utilising safe technological solutions such as GPS trackers and apps providing location sharing could enhance outdoor play opportunities for EA. Future programmes and interventions should be tailored to meet the unique developmental needs of members of this age group.
The potential of experience sampling methods in palliative care
Authors: Geeraerts Joran , Pivodic Lara , Nooijer Kim de , Rosquin Lise , Naert Eline , Crombez Geert , De Ridder Mark , Van den Block Lieve 
Published: December 2024

Background: Experience sampling methods typically involve multiple self-report assessments per day over consecutive days. Unlike traditional patient-reported outcome measures or interviews, such methods offer the possibility to capture the temporal fluctuations of experiences in daily environments, making them valuable for studying the daily lives of people with advanced illness. Yet, their use in palliative care research is limited. Aims: To introduce experience sampling methods to the field of palliative care as a valuable tool for studying the everyday experiences of people with advanced illness, and to present the findings of an experience sampling methods pilot study with people with advanced breast or advanced lung cancer. Evidence used to support the information presented: We draw on published health research using experience sampling methods. We present a newly developed experience sampling methods questionnaire (ESM-AC) and report pilot study findings on the feasibility and acceptability of experience sampling methods among people with advanced breast or lung cancer. Key learning points: Experience sampling methods hold potential to uncover the dynamics of everyday experiences of people with advanced illness. The methods offer considerable flexibility and options to answer a variety of research questions, but consideration is required regarding sampling protocols and participant burden. We showed appropriate feasibility and acceptable participant burden of the methods among people with advanced breast or advanced lung cancer.
Exploring the epidemiological burden of RSV pre- and post-COVID-19 pandemic: A Jordanian tertiary hospital experience
Authors: Al-Zayadneh Enas , Marie Dana , Khraisat Farah A. , Musa Suzan S. , AlSamhori Jehad Feras , Altamimi Dina Alkhateeb , Khashman Alia O. , Daher Amirah , AL-Iede Montaha 
Published: December 2024

Objectives To describe changes in respiratory syncytial virus (RSV) epidemiology, its associated clinical outcomes and predictors of severe acute lower respiratory tract infection (ALRTI) pre- and post-COVID-19. Methods In this retrospective cohort, we analysed data from electronic medical record of children <5 years who were hospitalized at Jordan University Hospital with RSV-associated ALRTI from 2018 to 2022. Results 325 inpatients with respiratory infections were included. Rate of RSV infections decreased from 74% pre-pandemic to 30% post-pandemic. Patients diagnosed with ALRTI post-COVID had significantly higher SpO2, less chronic disease, lower temperature and respiratory rate at admission and fewer days in hospital compared with those diagnosed pre-COVID. Furthermore, patients diagnosed pre-pandemic were significantly more likely to have abnormal X-rays, used more antibiotics and antivirals, and had higher rates of severe disease than those with infection post-COVID. Conclusion COVID-19 and its associated social restriction measures led to changes in RSV epidemiology, characterized by a decline in rates and clinical severity in the post-pandemic period. However, further studies are needed to characterize the impact of COVID-19 on subsequent RSV seasons.
Based on fNIRS Technology: The Effects of Scalp Acupuncture Combined with iTBS on Cognitive Function After Stroke
Authors: Zhong Lida , Luo Jinning , Ma Xiancong , Yan Jiayan , Tang Qiong , Bao Xiao , Lan Shouhuang 
Published: December 2024

Objective To explore the impact of integrating scalp acupuncture with iTBS therapy on cognitive impairments post-stroke. Methods This study was a randomized, controlled, single-blind trial. Fifty-four patients completed the study and were allocated into the SA group, iTBS group, and combined group using a random number table method. The SA group received scalp acupuncture treatment for 4 weeks, the iTBS group underwent intermittent theta burst stimulation for 4 weeks, and the combined group received both scalp acupuncture and iTBS treatments for 4 weeks. All enrolled patients also received standard pharmacological and conventional rehabilitation treatments, six days a week, for four weeks in total. Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) before treatment (baseline) and after treatment (4 weeks). Additionally, changes in cerebral hemodynamics during the experiment were measured using functional near-infrared spectroscopy (fNIRS). Results Scalp acupuncture therapy, iTBS therapy, and the combination of scalp acupuncture with iTBS therapy all significantly activated the cortical regions of the frontal and temporal lobes in patients with Post-Stroke Cognitive Impairment No Dementia (PSCIND) ( P < 0.05). Compared to scalp acupuncture or iTBS therapy alone, the combined therapy activated more channels, with more significant activation in the right Superior Temporal Cortex (r-STC), right Ventrolateral Prefrontal Cortex (r-VLPFC), Medial Prefrontal Cortex (mPFC), left Ventrolateral Prefrontal Cortex (l-VLPFC), right Superior Frontal Cortex (r-SFC), and left Dorsolateral Prefrontal Cortex (l-DLPFC) ( P < 0.05). The combined therapy enhances cognitive functions in PSCIND patients, exhibiting superior clinical effectiveness compared to either scalp acupuncture or iTBS therapy when used individually ( P < 0.05). Conclusion The combination of scalp acupuncture with iTBS therapy represents a novel and promising neurorehabilitation treatment technique for post-stroke cognitive impairment. Future clinical research is needed to explore its therapeutic mechanisms and further refine this technique.
Optimal Antithrombotic Regimen After Cryptogenic Stroke: A Systematic Review and Network Meta-Analysis
Authors: Abuelazm Mohamed , Mazen Amin Ahmed , Tharwat Ali Hossam , Ayyad Mohammed , Nazir Abubakar , Tanashat Mohammad , Ramadan Shrouk , Abdelazeem Basel , Brašić James Robert 
Published: December 2024

Although several antithrombotic strategies have been investigated for the management of cryptogenic strokes, ie, ischemic strokes without known etiologies, an optimal antithrombotic strategy for cryptogenic strokes is unknown. We aim to assess oral antithrombotic agents’ comparative efficacy and safety after cryptogenic stroke to identify an optimal treatment. A systematic review and meta-analysis synthesizing evidence from randomized controlled trials (RCTs) obtained from PubMed, Embase Cochrane, Scopus, and Web of Science until February 2024. We used the random-effects model to report dichotomous outcomes using a risk ratio (RR) with a 95% confidence interval (CI). Frequentist network meta-analysis was conducted using R, version 4.3.1. Seven RCTs with 15,240 patients were included. None of the OACs showed a significant efficacy in preventing all-cause mortality, stroke recurrence, cardiovascular mortality, and major adverse cardiac events compared to aspirin. Also, safety measures were similar between different OACs and aspirin regarding safety measures, including major bleeding, intracranial hemorrhage, and gastrointestinal bleeding. However, only rivaroxaban significantly increased the incidence of major bleeding (RR: 2.69, CI [1.67, 4.33]). There was no difference between various OACs and aspirin regarding efficacy and safety outcomes. There is a greater risk of major bleeding with rivaroxaban. Further research is still warranted to define a personalized strategy for selecting antithrombotic strategies after cryptogenic stroke on a case-by-case basis.
Potential Use of Voice-Activated Personal Assistants in Diabetes Prevention and Management: An Exploratory Qualitative Study Using the Consolidated Framework for Implementation Research
Authors: Jacobs Sara , Rotunda Wendi , Sarris Esquivel Nikie , Horvitz Casey , Ng Valerie , Vincent Adam , Arena Laura , Feher John , Hulbert LaShonda , Mensa-Wilmot Yvonne 
Published: December 2024

Background Diabetes affects millions of people in the United States and poses significant health and economic challenges, but it can be prevented or managed through health behavior changes. Such changes might be aided by voice-activated personal assistants (VAPAs), which offer interactive and real-time assistance through features such as reminders, or obtaining health information. However, there are little data on interest and acceptability of integrating VAPAs into programs such as the National Diabetes Prevention Program (National DPP) or diabetes, self-management, education, and support (DSMES) services. Methods We conducted individual and small-group semi-structured interviews of National DPP and DSMES staff and program participants. We used rapid-turnaround qualitative thematic analysis to identify emerging themes using an adapted version of the Consolidated Framework for Implementation Research (CFIR). Results Nearly all program participants and staff had prior experience with VAPAs, but not in the context of these programs. Most program participants felt confident in their ability to use VAPAs but were concerned about their privacy and security. Program staff were optimistic about the feasibility of integrating VAPAs into existing programs given their ability to support healthy habit formation, but staff were less optimistic about using VAPAs to share health information. Program staff also felt that additional resources to support VAPA use would help ensure that VAPAs would not create an extra burden on staff and program participants. Implications Integrating VAPAs as a resource to enhance mobile applications already in use shows potential to support health behavior change. Future research should include how this technology could be further optimized to enhance utility.
Association between muscular atrophy and mortality risk in patients with COPD: a systematic review
Authors: Li Wenyan , Wu Ying , Yang Xun , Zhu Jing , Feng Mei , Deng Rong , Yang Cui , Sun Chengcheng 
Published: December 2024

Background: Muscular atrophy often can be seen at the end of stage in many chronic diseases. It will also negatively influence patients’ outcomes. Different studies showed that the association between muscular atrophy and mortality in patients with chronic obstructive pulmonary disease (COPD) was unclear. This study will continue to assess the influence of muscular atrophy on mortality in patients with COPD. Objectives: To systematically evaluate the association between muscular atrophy and death in patients with COPD. Design: Systematic review. Methods and data sources: A systematic review and meta-analysis was conducted. Databases including PubMed, Web of Science, Embase, the Cochrane Library, the China Biomedical Literature Service System, China Biomedical Literature Service System (CINAHL), China National Knowledge Infrastructure, the Wanfang database, and the WeiPu (VIP) were systematically searched for cohort studies on muscular atrophy and COPD from inception to July 1st, 2023. Two reviewers independently review, assess, and extract data from the included studies. Meta-analysis was performed using RevMan 5.4 software. Results: Thirteen cohort studies were ultimately included, involving 10,528 patients with COPD. There were seven cohort studies included in the meta-analysis, including 3,458 COPD patients. The meta-analysis showed that patients with COPD combined with muscular atrophy had a higher mortality risk (HR = 2.20, 95%CI (1.74, 2.79), p < 0.00001). At the same time, patients with COPD who had muscular atrophy may had longer hospital stays. Conclusion: Muscular atrophy is associated with the mortality and disease prognosis of patients with COPD. The conclusion needs to be supported and validated by more high-quality studies given the limitation of the number of articles included in this study. Trial registration: This systematic review protocol was prospectively registered with PROSPERO (No. CRD42024589435).
Look above the IRP: predicting abnormal confirmatory testing in patients with esophagogastric junction outflow obstruction
Authors: Strauss Starling Alexandra , Thanawala Shivani U. , Beveridge Claire A. , Falk Gary W. , Lynch Kristle L. 
Published: December 2024

Background: Esophagogastric junction outflow obstruction (EGJOO) is a manometric diagnosis based on Chicago Classification version 4.0 (CC4.0) that requires confirmatory testing for clinical relevancy. However, it is still unclear which patients will respond to therapy. Objectives: To evaluate manometric and clinical predictors of abnormal confirmatory testing for patients with EGJOO. Design: This was a prospective observational study of patients with manometric EGJOO and chest pain or dysphagia who underwent confirmatory testing. Methods: Patients with EGJOO on manometry were enrolled and underwent timed barium esophagram or endoFLIP. A subset of patients was given validated surveys, including Eckardt scores (ES) and PROMIS-10. Results: For patients with a CC4.0 EGJOO diagnosis, abnormal peristalsis (OR = 7.0, 95% CI = 1.01–44.6, p = 0.04) and increases in ES (OR = 2.34 95% CI = 1.13–4.86, p = 0.02) were associated with positive confirmatory testing. Conclusion: Patients with potentially actionable EGJOO were more likely to have an abnormal peristaltic subtype of EGJOO or higher ES.
A comparative analysis of a central metaphyseal humeral fixation stemless shoulder arthroplasty to an anatomic shoulder arthroplasty in a national registry cohort
Authors: Peckston Dane C , D’Costa Elliott , Gill David RJ , Harries Dylan , Page Richard , Baba Mohammed 
Published: December 2024

Background This study aimed to determine the revision outcome between a centrally fixed stemless anatomic design and other total anatomic shoulder replacements using data from a large national arthroplasty registry. Methods The study period was from December 2011 to December 2022 and included three cohorts; primary Affinis stemless anatomic (AFS), all other primary total stemless anatomic (sTSA) and primary total stemmed anatomic shoulder arthroplasty (aTSA). The endpoint was all-cause revision using cumulative percent revision (CPR). Hazard ratio (HR) models were adjusted for age and gender. Results There were 2489 primary AFS, 1593 primary sTSA and 11,023 primary aTSA. There was no difference in revision rates between the AFS and the sTSA group. The aTSA group had a significantly higher rate of revision compared to both AFS (HR = 1.63, 95% confidence interval (CI) 1.30–2.05, p < 0.001) and sTSA (HR = 1.61, 95% CI 1.21–2.15, p = 0.001). However, sub-analyses stratifying for highly crosslinked polyethylene (XLPE) showed no differences between the groups. Discussion The rates of revision between the AFS design and other stemless prostheses were similar. Stemless had lower revision rates to aTSA. When only considering XLPE cemented glenoids, there was no significant difference in revision rates.
Effectiveness, pharmacokinetics, and safety of triptorelin acetate microspheres in patients with locally advanced and metastatic prostate cancer
Authors: Wu Guolan , Zhou Feng , Wang Haiping , Liu Kan , Yu Dexin , Fan Lianlian , Han Yangyun , Ai Xiaohong , Cao Youhan , Wang Xiaolin , Wang Sheng , He Chaohong , Wu Jitao , Wu Ji , Wang Youlei , Wang Yanqing , Jin Baiye , Shentu Jianzhong 
Published: December 2024

Background: A newly generic microspheres, sustained-release formulation of triptorelin acetate 3.75 mg has been developed. Objectives: To evaluate the efficacy, pharmacokinetics, and safety of triptorelin 1-month formulation in Chinese patients with prostate cancer. Design: An open-label, multicenter clinical trial with one arm testing a 1-month sustained-release triptorelin formulation in prostate cancer patients. Methods: Patients with prostate cancer received three consecutive 28-day injections of triptorelin acetate. The primary endpoint was the proportion of successful patients over the total number of evaluable patients. Treatment success was defined as testosterone suppression below the clinical castration level (i.e., <0.5 ng/mL) at day 28 and maintenance of clinical castration until study completion (day 84). The frequency of patients with testosterone concentrations <0.2 ng/mL was also studied. Results: The study included 125 patients. All 125 patients received at least one dose of the study drug and 122 completed the study. The successful patient proportion among the evaluable patients was 97.6% (122/125; 95% CI, 92.7–99.2). 95.1% (116/122) achieved testosterone concentrations <0.2 ng/mL. The pharmacokinetic profile of triptorelin during the first 3 months of treatment, evaluated in a subset of the study population ( n = 11), showed sustained release of triptorelin from the formulation. Values for AUC0−τ calculated from day 0 to 28, and day 56 to 84 were 134.42 (28.76), and 154.72 (21.86) h*ng/mL, respectively. The most common treatment-related adverse events were increased alanine aminotransferase (18.4%), increased aspartate aminotransferase (16.0%), and hot flashes (9.6%). Prolonged QT interval on electrocardiogram, erectile dysfunction, and decreased libido each occurred in ⩽4% of the patients. The frequently reported local adverse reaction was pain at the injection site, experienced by 2.4% (3/125) of the patients. Conclusion: 3.75-mg Triptorelin acetate microspheres for injection were effective in achieving and maintaining testosterone suppression and were well tolerated in patients with prostate cancer. Trial registration: chictr.org.cn (ChiCTR2000033188).
Mapping two decades of research in rheumatology-specific journals: a topic modeling analysis with BERTopic
Authors: Madrid-García Alfredo , Freites-Núñez Dalifer , Merino-Barbancho Beatriz , Pérez Sancristobal Inés , Rodríguez-Rodríguez Luis 
Published: December 2024

Background: Rheumatology has experienced notable changes in the last decades. New drugs, including biologic agents and Janus kinase (JAK) inhibitors, have blossomed. Concepts such as window of opportunity, arthralgia suspicious for progression, or difficult-to-treat rheumatoid arthritis (RA) have appeared; and new management approaches and strategies such as treat-to-target have become popular. Statistical learning methods, gene therapy, telemedicine, or precision medicine are other advancements that have gained relevance in the field. To better characterize the research landscape and advances in rheumatology, automatic and efficient approaches based on natural language processing (NLP) should be used. Objectives: The objective of this study is to use topic modeling (TM) techniques to uncover key topics and trends in rheumatology research conducted in the last 23 years. Design: Retrospective study. Methods: This study analyzed 96,004 abstracts published between 2000 and December 31, 2023, drawn from 34 specialized rheumatology journals obtained from PubMed. BERTopic, a novel TM approach that considers semantic relationships among words and their context, was used to uncover topics. Up to 30 different models were trained. Based on the number of topics, outliers, and topic coherence score, two of them were finally selected, and the topics were manually labeled by two rheumatologists. Word clouds and hierarchical clustering visualizations were computed. Finally, hot and cold trends were identified using linear regression models. Results: Abstracts were classified into 45 and 47 topics. The most frequent topics were RA, systemic lupus erythematosus, and osteoarthritis. Expected topics such as COVID-19 or JAK inhibitors were identified after conducting dynamic TM. Topics such as spinal surgery or bone fractures have gained relevance in recent years; however, antiphospholipid syndrome or septic arthritis have lost momentum. Conclusion: Our study utilized advanced NLP techniques to analyze the rheumatology research landscape and identify key themes and emerging trends. The results highlight the dynamic and varied nature of rheumatology research, illustrating how interest in certain topics has shifted over time.