bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of vision with monofocal intraocular lens after cataract surgery: Comprehensive evaluation and graphical illustration
Authors: Henriques Jorge FS , Duarte Marisa A , Queirós Tatiana SM , Coimbra Rita , Caramelo Francisco , Rosa Andreia FM , Fonseca Conceição L Lobo , Murta Joaquim CN 
Published: December 2024

Purpose To comprehensively characterize the quality of vision (QV) in an otherwise healthy population undergoing bilateral consecutive cataract surgery with the implantation of a monofocal intraocular lens (IOL) and to propose a graphical illustration. Setting Centro Hospitalar e Universitário de Coimbra, Portugal. Design Cross-sectional study. Methods This study included patients that underwent sequential bilateral cataract surgery with implantation of a monofocal acrylic foldable single-piece IOL. Patients were evaluated at the 3rd postoperative month in terms of bilateral uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA) and corrected near visual acuity (CNVA); sphero-cylindrical refraction; bilateral reading speed and contrast sensitivity function (CSF); corneal topography/tomography; aberrometry; pupillometry; negative dysphotopsia (ND); Catquest-9SF and Quality of Vision (QoV) questionnaires. Results Both eyes from 26 (n = 26) consecutive patients with mean age of 68 years ± 6.68 were included. UDVA mean was logMAR = 0.01 ± 0.04, and CDVA was logMAR = 0.00 ± 0.04. The average reading speed was 110.42 words/minute. The CSF showed a descendent curve for higher spatial frequencies and was lower with glare. ND was present in 1.92% of the patients. Catquest-9SF mean was 95.46% and QoV mean score was 4.48 points. A radar graph showing median scores across the multiple variables assessed was produced demonstrating a wide panorama of QV. Conclusion Patients’ satisfaction was correlated with CSF, reading speed, CNVA and residual spherical equivalent. To the author's best knowledge, this study establishes, for the first time, a comprehensive panorama of visual performance through a radar graph that can be utilized to describe the QV.
A qualitative exploration of the experience of autistic females in Hong Kong
Authors: Lam Gary Yu Hin , Chow Constance Kit Ching , Chan Sibyl Wai 
Published: December 2024

There are fewer females than males diagnosed with autism, but autistic females are said to be under-identified and underrepresented in the existing diagnostic and service systems. The gender discrepancy may potentially be attributed to the lack of accurate understanding of autistic females and their needs. Emerging research has begun to document the experiences of autistic women in Western countries, but their experience in Eastern cultures is almost unknown. This study aimed to investigate the lived experience of autistic women in Hong Kong. Thirteen formally diagnosed or self-diagnosed autistic women completed semi-structured interviews, discussing how they identified with autism, their diagnostic experience, and their understanding of autism. Results based on thematic analysis revealed Hong Kong autistic women commonly experienced emotional problems and encountered autistic models on the way they came to identify with autism, despite often being dismissed by families and professionals. They found an autism diagnosis or identity meaningful to their self-understanding. Societal misunderstanding toward autism had a great impact on their self-identity as an autistic female. Findings can inform improved services for autistic women in Hong Kong and provide insights to enhance understanding of autism in Chinese culture. Lay abstract There are more males than females with autism. One of the reasons can be that we do not understand autistic females well. Some research in Western cultures has begun to document the lived experience of autistic females, but no such studies are conducted with Chinese autistic females. This study explored the first-person experience of living with autism in Hong Kong autistic women. We conducted qualitative interviews with 13 women with a formal diagnosis of autism or self-diagnosed as autistic. We used semi-structured interviews to discuss how they came to recognize or identify with autism, their diagnostic experience, and their understanding of autistic females. We summarized several broad themes that depicted their experience. Participants recognized autism in themselves when seeing other autistic people. They indicated mental health challenges that led them to seek help from professionals, who might sometimes reject their concerns about autism. Participants found it meaningful to have an autism diagnosis or identity, but other people’s judgment would affect their self-understanding. Participants also described themselves different from the stereotypes of autism, not the same as autistic males, and were perceived by others as not autistic enough. Our findings suggested autistic women in Hong Kong faced challenges in identity development and support services. There is a need to increase awareness and knowledge about autism in professionals and the public. Understanding how unique cultural factors that influence the identity of autistic women or individuals in Chinese cultures is important to promote their well-being.
The Implications for Clinical Practice of Circulating miR144-3p and miR190a-5p as Promising Diagnostic Biomarkers for Thyroid Nodule Differentiation
Authors: Hassan Basima , Omran Mohamed M. , Youssef Magdy M. , Refaat Manar , Abouzid Amr , Abdel Wahab Abdel Hady A. , Bakr Yasser M. 
Published: December 2024

Background and Aims Thyroid cancer, a prevalent endocrine malignancy, often presents as thyroid nodules, whose benign or malignant nature is challenging to determine. This study aims to identify circulating miRNA panels that may distinguish between benign nodules, papillary thyroid cancer, and normal thyroid conditions, building on extensive research into miRNAs as potential thyroid cancer biomarkers. Materials and Methods As a cross-sectional case-control study the study revealed the quantification of the 17-miRNA panel was evaluated using qRT-PCR method on 60 blood samples, comprising 25 patients diagnosed with PTC, 24 patients with benign lesions, and 11 healthy controls. Results We found that seven miRNAs, including miR144-3p and miR190a-5p, exhibited statistically significant variations in their expression levels, and miR144-3p exhibited the most superior diagnostic capability in distinguishing between malignant and healthy groups, as well as between benign and healthy groups. The concurrent utilization of miR144-3p, miR148a-3p, and miR190a-5p resulted in an enhancement of sensitivity from 76% to 88%. Conclusion Our study suggests that miR144-3p and miR190a-5p exhibit potential as biomarkers for distinguishing between benign and malignant thyroid nodules and healthy individuals, and further investigation is necessary to evaluate their clinical significance.
Psychometric properties of the Assessment of Positive Occupation 15 for individuals with physical illness
Authors: Noguchi Takuya , Kyougoku Makoto 
Published: December 2024

Objectives The Assessment of Positive Occupation 15 (APO-15) is a scale initially developed to evaluate participation in well-being-promoting occupations among individuals with mental illness. This study examines the psychometric properties of the Japanese version of the APO-15 for individuals with physical illness, focusing on its validity, reliability, and interpretability. Methods We evaluated the psychometric properties of the APO-15 using a sample of 1,259 individuals with physical illness living at home, in hospitals, and in nursing homes. Validity was evaluated using confirmatory factor analysis (CFA) to confirm the factor structure, and concurrent validity was examined by correlating APO-15 scores with measures of happiness and psychological distress. Reliability was assessed by internal consistency analysis using Cronbach's alpha, and item difficulty was analyzed using the Rasch Rating Scale Model (RSM). Interpretability was established through a T-scale-based five-level criterion for client status. Results The APO-15 showed strong psychometric properties. CFA indicated a good fit for the factor structure (RMSEA= 0.100, CFI= 0.944, TLI= 0.930). Internal consistency was high, with a Cronbach’s alpha of 0.914. Item difficulty analysis revealed a bias towards easier items, consistent with previous findings in mental illness populations. The T-scale-based five-level criterion effectively classified client status, though significance was noted between most levels except levels 1 and 2. Conclusion The Japanese version of the APO-15 is a reliable and valid tool for assessing occupational participation and promoting well-being among individuals with physical illness. It provides a robust framework for occupational therapists to support clients' well-being through targeted occupational engagement.
Assessing severity of pediatric pneumonia using multimodal transformers with multi-task learning
Authors: Li Jing , Nan Ziang , Qi Guoqiang , Cai Junlan , Zhao Xinkui , Li Xiang , Liu Shaofeng , Wang Yuqi , Wu Yangyang , Miao Xiaoye , Yu Gang 
Published: December 2024

Objective While current multimodal approaches in the diagnosis and severity assessment of pneumonia demonstrate remarkable performance, they frequently overlook the issue of modality absence—a common challenge in clinical practice. Thus, we present the robust multimodal transformer (RMT) model, crafted to bridge this gap. The RMT model aims to enhance diagnosis and severity assessment accuracy in situations with incomplete data, thereby ensuring it meets the complex needs of real-world clinical settings. Method The RMT model leverages multimodal data, integrating X-ray images and clinical text data through a sophisticated AI-driven framework. It employs a Transformer-based architecture, enhanced by multi-task learning and mask attention mechanism. This approach aims to optimize the model’s performance across different modalities, particularly under conditions of modality absence. Results The RMT model demonstrates superior performance over traditional diagnostic methods and baseline models in accuracy, precision, sensitivity, and specificity. In tests involving various scenarios, including single-modal and multimodal tasks, the model shows remarkable robustness in handling incomplete data. Its effectiveness is further validated through extensive comparative analysis and ablation studies. Conclusion The RMT model represents a substantial advancement in pediatric pneumonia severity assessment. It successfully harnesses multimodal data and advanced AI techniques to improve assessment precision. While the RMT model sets a new precedent in AI applications in medical diagnostics, the development of a comprehensive pediatric pneumonia dataset marks a pivotal contribution, providing a robust foundation for future research.
Understanding frictions in patient-reported outcome-based community healthcare – An institutional logics perspective
Authors: Mejdahl Caroline Trillingsgaard , Nielsen Berit Kjærside , Nielsen Camilla Palmhøj , Nielsen Lise Arnth , Terkildsen Morten Deleuran 
Published: December 2024

Objective Patient-reported outcome (PRO) measures in community-based healthcare play a significant role in the emerging field of digital health. This qualitative study explored healthcare professionals’ (HCPs’) experiences of integrating ‘MyPROfile’ as a dialogue tool in consultations in community healthcare. Methods Adopting a qualitative approach with a social constructivist perspective, the study utilised qualitative interviews, participant observations, and focus group interviews. Data were analysed using reflective thematic analysis, guided by theories on institutional logics. Results In the analysis, we identified two distinct institutional logics related to HCPs’ experiences integrating PRO measures into their existing practice. Frictions emerged as HCPs integrated the PRO-based dialogue tool, highlighting frictions between an existing Care logic rooted in a holistic health promotion paradigm and the introduced PRO logic. According to the HCPs, the PRO-based practice was perceived as divergent from holistic, narrative-based care, emphasising a shift towards a more reductionist and evaluative model of care. Conclusions The study underscores the importance of understanding institutional logics in integrating technologies like PRO measures in healthcare settings. The identified frictions necessitate reflexive venues and collaborative relationships to align differing logics for successful integration. Additionally, incorporating citizens’ perspectives is vital for developing effective rehabilitation and prevention programmes. Moving forward, stakeholder engagement in reflective discussions and workshops is crucial to bridge the gap between the introduced technology and the existing health promotion paradigm, ensuring a seamless and meaningful integration of PRO measures in community healthcare settings.
Analysis of spinal muscular atrophy patients from the spinal muscular atrophy and muscular dystrophy registry of Pakistan
Authors: Aziz Bisma , Arif Ahmed A , Kazi Kulsum , Kirmani Salman , Ansar Zeeshan , Nasir Asghar , Ibrahim Shahnaz Hamid , Ahmed Khairunnisa Mukhtiar , Hasan Zahra , Khan Sara 
Published: December 2024

Background Spinal Muscular Atrophy (SMA) leads to motor neuron loss, with progressive muscle weakness and wasting. Nationwide registries for neuromuscular diseases are pivotal for assessing epidemiology, preparing for clinical trials, and for adopting standardized management guidelines. Objectives This paper aims to present data gathered during the establishment of Pakistan's inaugural registry for genetically confirmed SMA cases. Methods In this retrospective study, 215 participants with genetically confirmed SMA were recruited. Telephonic interviews were conducted to collect data for the Muscular Disease Registry of Pakistan that was analyzed using STATA version 17.0. Results SMA type 1 was the most common type (71.2%, n = 153). Amongst patients who were tested for survival motor neuron ( SMN2) copies, the majority (84.4%, n = 168) had two SMN2 copies. SMA types were significantly associated with the ability to sit (p < 0.001) and walk (p < 0.001), and usage of a wheelchair (p = 0.0054). SMN2 copy numbers were significantly associated with the ability to sit (p = 0.020) and walk (p = 0.031). Conclusions This study highlights the high prevalence of SMA genotypes and phenotypes associated with severe disease in our population. Our findings reiterate the challenging prognosis for Pakistani children with SMA and underscore the necessity of the development of nationwide newborn screening programs and making treatments available.
Plasma-derived protein and imaging biomarkers distinguish disease severity in oculopharyngeal muscular dystrophy
Authors: Smith Ian C , Sampaio Marcos L , Melkus Gerd , Meier-Ross Kaitlynn , Chakraborty Shaoni , Stotts Cameron , Bourque Pierre R , Lochmuller Hanns , Brais Bernard , Ayoub Othmane , Perkins Theodore J , Khacho Mireille , Warman-Chardon Jodi 
Published: December 2024

Background: Oculopharyngeal muscular dystrophy (OPMD) is a rare, late-onset, slowly progressive neuromuscular disorder characterized by ptosis, dysphagia, and proximal limb weakness. Emerging clinical trials require rapidly accessible and sensitive biomarkers to evaluate OPMD disease progression and potential response to future treatments. Objective: This cross-sectional study was designed to identify candidate circulating protein and imaging biomarkers of OPMD severity for future use in clinical trials. Methods: Twenty-five individuals with OPMD (age 63.3 ± 10.5 years; GCN copy number of 13 in PABPN1) were assessed using the 7k SOMAScan assay to profile the plasma proteome, and MRI to quantify replacement of muscle by fat. OPMD severity was first categorized using the clinical presence/absence of limb weakness, and protein signals were considered distinguishing if they differed by more than 30% between subgroups and had statistically significant P-values after correcting for multiple comparisons. Distinguishing proteins were contrasted with age-matched controls ( n = 10). OPMD severity was also treated as a continuous variable using fat fraction of the soleus muscle, and proteins were considered distinguishing if the slope of relationship between protein signal and soleus fat fraction differed significantly from zero after correcting for multiple comparisons. Pathway analyses were conducted using Metascape and the Database for Annotation, Visualization, and Integrated Discovery webtools. Results: Eighteen plasma proteins distinguished OPMD on both indicators of severity. Pathway analyses identified skeletal muscle tissue, phagocytosis/engulfment, and extracellular matrix organization as enriched ontology clusters in OPMD with limb weakness. The most distinguishing plasma protein signals (ACTN2, MYOM2, CA3, APOBEC2, MYL3, and PDLIM3) were over 200% higher in OPMD with limb weakness than OPMD without limb weakness as well as controls, and correlated strongly with percent of fatty replacement of soleus ( r = 0.89 ± 0.04). Conclusions: The candidate biomarkers identified contribute to the ongoing search for sensitive and accessible biomarkers of OPMD progression, prognosis, and monitoring.
The Impact of Humble Leadership on Knowledge-Sharing and Creativity in Nursing Setting: A Cross-Sectional Study
Authors: Al-Rjoub Saleem , Mrayyan Majd T. 
Published: December 2024

Introduction Leadership styles are pivotal in encouraging employee engagement, influencing team dynamics, and enhancing patient outcomes. Humble leadership is characterized by self-awareness, openness, and appreciation for others. This leadership style is underexplored in healthcare. Objective This study investigated whether humble leadership impacts knowledge-sharing and employees’ creativity. Methods A descriptive cross-sectional design was used. Data were collected from nursing educators, nurses, and nursing leaders from various universities and hospitals in Jordan. Descriptive analysis was applied to display the general characteristics of the study participants. The general linear model was conducted to analyze the impact of humble leadership on knowledge-sharing and employees’ creativity. Results This study revealed that humble leadership significantly impacted knowledge-sharing and employees’ creativity. These findings highlight the critical role of humble leadership in promoting and fostering knowledge-sharing and creativity within educational institutions and healthcare settings. Conclusion Leaders’ humble leadership impacted knowledge-sharing among employees and the creativity of nursing educators, nurses, and nursing leaders. Training programs are needed to develop humble nurses’ and leaders’ leadership because they contribute to nursing educators’, nurses’, and nursing leaders’ creativity while maintaining employee knowledge-sharing.
2024 IFFAS Award for Excellence Winner: Minimally Invasive Chevron Akin for Hallux Valgus Surgery: A Prospective Observational Study with Mean 6.7 year Follow Up
Authors: Townsend Oliver , Hill Niall , Reaney Adam , Koç Togay , Lewis Thomas L. , Gordon David 
Published: December 2024

Category: Bunion Introduction/Purpose: Minimally invasive chevron and Akin (MICA) osteotomy surgery has become an established technique for correction of hallux valgus deformities. As a relatively new technique, however, long-term follow-up data is limited in the literature to 2-3 years. The purpose of this study is to assess a large cohort of patients undergoing MICA with minimum 5 year follow up, to evaluate the longer-term results of this procedure, using validated patient reported outcome measures (PROMs). Methods: 5-year PROM data was prospectively collected from 101 patients who underwent 147 primary MICA osteotomies between July 2014 and April 2018, performed by a single surgeon. Primary clinical outcome measures collected included visual analogue scale for pain (VAS-pain), Manchester-Oxford Foot Questionnaire (MOXFQ) and EuroQol-5 Dimensions (EQ-5D). Data were collected pre-operatively, at 2 years and after minimum 5 years. Statistical significance was set at p< 0.05. Results: 147 MICA osteotomies were performed on the feet of 101 patients (96 females, 5 males). Mean follow-up was 6.5 years (standard deviation [SD] 0.9 years), with all patients completing at least 5 years follow-up. The MOXFQ scores (mean ± SD) for all 147 feet improved for all domains: from 45.8 ± 21.9 preoperatively to 10.3 ± 16.8 postoperatively for Pain (p < 0.001), from 40.0 ± 23.8 to 9.1 ± 18.2 for Walking and Standing (p < 0.001), and from 48.5 ± 23.1 to 8.9 ± 18.5 for Social Interaction (p < 0.001). VAS-pain improved from 31.3 ± 22.6 preoperatively to 12.0 ± 20.6 postoperatively (p < 0.001). EQ-5D-5L Index improved from 0.739 ± 0.144 preoperatively to 0.900 ± 0.120 postoperatively (p < 0.001). Conclusion: This is the largest study reporting the patient reported outcomes following MICA with minimum five year follow up. This study demonstrates significant improvement in patient reported clinical outcome measures at mean 6.5 year follow up. MICA can be considered as an effective and long-lasting option for the correction of hallux valgus deformity.
Atelocollagen Injection Enhances the Healing of Nonoperatively Treated Achilles Tendon Tears
Authors: Song Jaehwang , Kang Chan , Jo Seongkyeong 
Published: December 2024

Category: Basic Sciences/Biologics; Sports Introduction/Purpose: There is growing interest in nonoperative treatment for the management of Achilles tendon ruptures (ATRs). However, nonoperative treatment is limited by the risk of tendon reruptures and low satisfaction rates. Recently, atelocollagen injections have been reported to have beneficial effects on tendon healing. The purpose of this study is to evaluate the beneficial effects of injected atelocollagen on Achilles tendon healing and investigate the mechanism of atelocollagen on tendon healing. Methods: Percutaneous tenotomy of the right Achilles tendon in 66 rats was performed. The animals were equally divided into the noninjection group (NG) and the collagen injection group (CG). At 1, 3, and 6 weeks, the Achilles functional index (AFI), cross-sectional area, load to failure, stiffness, stress, and the modified Bonar score were assessed. Transmission electron microscopy (TEM), western blotting, and immunohistochemistry were also performed. Results: The AFI (–6.8 vs 243.0, respectively; P = .040), load to failure (42.1 vs 27.0 N, respectively; P = .049), and stiffness (18.8 vs 10.3 N/mm, respectively; P = .049) were higher in the CG than those in NG at 3 weeks. There were no significant differences in histological scores. TEM analysis showed that the mean diameter of collagen fibrils in the CG was greater than that in the NG at 3 weeks (117.2 vs 72.6 nm, respectively; P < .001) and 6 weeks (202.1 vs 144.0 nm, respectively; P < .001). Western blot analysis showed that the expression of collagen type I in the CG was higher than that in the NG at 1 week (P = .005) and 6 weeks (P = .001). Conclusion: An atelocollagen injection had beneficial effects on the healing of nonoperatively treated Achilles tendon injuries. The Achilles tendon of CG rats exhibited better functional, biomechanical, and morphological outcomes compared with NG rats. The molecular data indicated that the mechanism of atelocollagen injections may be associated with an increased amount of collagen type I. The scheme and the outcomes of the present study 1. The flowchart of the experiment groups and surgical procedures involved in this study. 2. Functional analysis. 3. Biomechanical testing. 4. Histological analysis. 5. Transmission electron microscopy (TEM) analysis. 6. Western blot analysis.