bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of Internet-based healthcare derived from the COVID-19 pandemic on outpatients in a cardiology department
Authors: Liu Jie , Fei Yunhan , Gao Ying , Meng Yu , Huang Dongxue , Zhao Wenjuan , Xie Keliang 
Published: February 2025

ObjectiveThis study examines the impact of a COVID-19 pandemic-derived online medical service on cardiovascular patient visits and assesses whether these services can ease the strain on medical resources.MethodThis study investigated the impact of the COVID-19 pandemic on cardiology services and hospital operations. We analyzed key primary medical indicators in cardiology, including outpatient visits, inpatient improvement rates, cure rates, and mortality rates, over three years from 2019 to 2021. Furthermore, the study assessed the influence of the development of Internet-based medical services on the treatment of cardiovascular disease. Specifically, we compared the changes in the number of outpatient visits in four categories of offline outpatient clinics in the Department of Cardiology during two phases: Phase I (1 February 2019 to 28 February 2020) and Phase II (1 March 2020 to 28 February 2021).ResultsCompared to the period before online services (T1), the second stage (T2) saw a significant decrease in total offline and general clinic visits. After the establishment of the online clinic, the third period (P3) showed a significant reduction in total offline, general, and senior clinic visits compared to the first period (P1), while vice-senior and VIP/international clinic visits increased. The number of online clinic visits and VIP/international clinic visits continued to rise. Online consultations had the highest proportion (55.9%), while prescriptions and examinations had the lowest (3.3%), although they showed a gradually increasing trend. After the implementation of the online clinic, the improvement rate of patients' conditions increased and the mortality rate decreased.ConclusionSince the advent of online medical services, cardiovascular patients have increasingly opted for online diagnosis and treatment. Since March 2021, the online outpatient service has driven the overall growth in hospital outpatient numbers while maintaining medical quality. The primary use of the online medical service is for consultations, which shortens medical time and reduces implicit costs for patients.
Adaptation of a digital health intervention for rural adults: application of the Framework for Reporting Adaptations and Modifications-Enhanced
Authors: Kepper Maura M. , Walsh-Bailey Callie , Parrish Loni , Mackenzie Ainsley , Klesges Lisa M. , Allen Peg , Davis Kia L. , Foraker Randi , Brownson Ross C. 
Published: February 2025

IntroductionAdaptation is a key aspect of implementation science; interventions frequently need adaptation to better fit their delivery contexts and intended users and recipients. As digital health interventions are rapidly developed and expanded, it is important to understand how such interventions are modified. This paper details the process of engaging end-users in adapting the PREVENT digital health intervention for rural adults and systematically reporting adaptations using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME). The secondary objective was to tailor FRAME for digital health interventions and to document potential implications for equity.MethodsPREVENT's adaptations were informed by two pilot feasibility trials and a planning grant which included advisory boards, direct clinic observations, and qualitative interviews with patients, caregivers, and healthcare team members. Adaptations were catalogued in an Excel tracker, including a brief description of the change. Pilot coding was conducted on a subset of adaptations to revise the FRAME codebook and generate consensus. We used a directed content analysis approach and conducted a secondary data analysis to apply the revised FRAME to all adaptations made to PREVENT (n = 20).ResultsAll but one adaptation was planned, most were reactive (versus proactive), and all adaptations preserved fidelity to PREVENT. Adaptations were made to content and features of the PREVENT tool and may have positive implications for equity that will be tested in future trials.ConclusionEngaging rural partners to adapt our digital health tool prior to implementation with rural adults was critical to meet the unique needs of rural, low-income adult patients, fit the rural clinical care settings, and increase the likelihood of generating the intended impact among this patient population. The digital health expansion of FRAME can be applied prospectively or retrospectively by researchers and practitioners to plan, understand, and characterize digital health adaptations. This can aid intervention design, scale up, and evaluation in the rapidly expanding area of digital health.
Future prevalence of type 2 diabetes in Germany: a projection until 2040 including incidence trends observed during the SARS-CoV-2 pandemic
Authors: Tönnies T. , Voeltz D. , Voß S. , Hoyer A. , Brinks R. 
Published: February 2025

IntroductionPrevious studies indicate that the prevalence of type 2 diabetes (T2D) will increase substantially over the coming decades. One projection from 2019 estimated an increase in prevalence in Germany by 54% to 77% (depending on future trends in incidence and mortality) between 2015 and 2040. We aim to update this projection by incorporating recently published trends in T2D incidence in Germany that include the changes during the SARS-CoV-2 pandemic.Materials and methodsWe used a partial differential equation that describes the illness-death model to project the age- and sex-specific T2D prevalence among adults between 2015 and 2040. This required input data for the age- and sex-specific incidence, mortality of the general population, mortality rate ratio of people with vs. without T2D and prevalence in the initial year of the projection. We considered five scenarios with different future trends in incidence and their impact on prevalence. Using the most recently available data on T2D incidence, we assumed that the incidence remains constant as observed in 2021 for the whole projection horizon (first scenario). In further scenarios, we assumed that the observed age- and sex-specific trends in incidence between 2015 and 2021 would continue until 2025 (second scenario), 2030 (third scenario), 2035 (fourth scenario) and 2040 (fifth scenario). One additional scenario assumed that the age-specific prevalence remains constant.ResultsObserved trends in incidence suggest a decrease between 2015 and 2017, and a slight upward trend thereafter until 2021 in most age groups. Depending on how long these observed increases in incidence continue, the number of people with T2D in Germany will increase from 6.8 million in 2015 to between 10.9 million and 14.2 million in 2040. These numbers correspond to increases in prevalence from 10.5% in 2015 to between 15.5% and 20.1% in 2040. In the constant prevalence scenario, the overall prevalence and number of people with T2D in 2040 was 11.4% and 8.1 million, respectively.ConclusionsThe future prevalence of T2D in Germany strongly depends on how long the recently observed increasing trend in T2D incidence will continue, which warrants close monitoring of these trends in post-pandemic years.
Similarities and differences of a proliferation-inducing ligand expression in lacrimal gland lesions of patients with IgG4-associated ophthalmic diseases and mucosa-associated lymphoid tissue lymphoma
Authors: He Lvfu , Zhan Lisha , Yang Yu , He Weimin 
Published: February 2025

ObjectiveThis study aimed to investigate the expression condition of a proliferation-inducing ligand (APRIL) in lacrimal gland lesions of patients with IgG4-associated ophthalmic diseases (IgG4-ROD) and mucosa-associated lymphoid tissue (MALT) lymphoma.Patients and methodsFifteen patients with IgG4-ROD, 3 with MALT lymphoma, and 1 with elevated IgG4 with lacrimal gland lesions, treated in West China Hospital of Sichuan University from April 2022 to November 2023, were included. Immunofluorescence staining was used to detect the expression of APRIL in the specimen of lacrimal gland.ResultsThe average expression level of APRIL in patients with lacrimal gland lesions of IgG4-ROD and MALT lymphoma were 8471.12 pixels/HPF and 2950.78 pixels/HPF respectively. The positive rates of APRIL were 10.49% and 7.23% respectively. CD138 and APRIL were colocalized, and the positive rate of their colocalization was 8.83%, and the positive areas of colocalization coincidence was 946.84 pixels/HPF in patients with IgG4-ROD. CD20 and APRIL were colocalized, and the positive rate of their colocalization was 7.04%, and the positive areas of colocalization coincidence was 949.78 pixels/HPF in patients with MALT lymphoma. We also found that the expression level and the positive rate of APRIL were positively correlated with the level of serum IgG4 in IgG4-ROD patients (r=0.5820, P=0.029; r= 0.6261, P=0.017; respectively). In addition, the positive rate and the positive areas of CD138 and APRIL colocalization were also positively correlated with serum IgG4 level (r=0.6420, P=0.013; r= 0.5673, P=0.034; respectively).ConclusionAPRIL is highly expressed in lacrimal gland lesions of patients with IgG4-ROD and MALT lymphoma. This overexpression may facilitate the enrichment of CD138+ plasma cells and is associated with elevated serum IgG4 levels in patients with IgG4-ROD. Additionally, it may promote the proliferation of CD20+ B lymphocytes in patients with MALT lymphoma.APRIL may play a certain role in the possible transformation of IgG4-ROD into MALT lymphoma.
High-dose radiation induces dendritic cells maturation by promoting immunogenic cell death in nasopharyngeal carcinoma
Authors: Zeng Xianlin , Jin Xianhuai , Leng Ji , Zhang Shuai , Wang Yun , Chen Jin , Zhang Shichao , Teng Lijing , Hu Zuquan , Zhou Shi , Zeng Zhu , Long Jinhua 
Published: February 2025

Aim and backgroundDue to the radiosensitivity and deep anatomical location of nasopharyngeal carcinoma (NPC), radiotherapy serves as the cornerstone of standardized treatment for this malignancy. Beyond its cytotoxic effects, radiotherapy can serve as an immunological adjuvant by inducing immunogenic cell death (ICD). Dendritic cells (DCs), as potent antigen-presenting cells, play a critical role in tumor immunotherapy, but their exact role in the ICD process of NPC remains unclear. The effects of high-dose radiation (≥2 Gy) on DCs and the type of immune response it elicits in NPC have not been fully elucidated.MethodsAn in vitro study was conducted to assess whether ICD of NPC 5-8F cells induced by high-dose radiation could regulate the immune response of DCs. Specifically, the maturation and antigen-presenting capacity of DCs were evaluated following co-culture with NPC cells exposed to high-dose radiation.ResultsHigh-dose radiation was found to induce ICD in NPC 5-8F cells, as evidenced by increased pro-inflammatory factor levels and reduced anti-inflammatory factor levels in the cell culture supernatant. Co-culture with NPC cells exposed to high-dose radiation for 15 minutes significantly enhanced the expression of surface molecules on DCs, promoting their immune sensitization.ConclusionHigh-dose radiation-induced apoptosis of NPC 5-8F cells is a form of ICD, which plays an
important role in regulating DC immune function. These findings provide insight into the immunomodulatory effects of radiotherapy in NPC and its potential to enhance tumor immunotherapy through DC activation.
The hemoglobin, albumin, lymphocyte, and platelet score as a useful predictor for mortality in older patients with hip fracture
Authors: Wang Zhicong , Liu Hailong , Liu Mozhen 
Published: February 2025

ObjectiveWith a rapidly aging population, identifying effective prognostic predictors has always been a research hotspot in older patients with hip fracture. Recently, the score combining hemoglobin, albumin, lymphocyte and platelet (HALP) has been proposed as a novel biomarker for reflecting systemic inflammation and nutritional status. However, it is unclear whether the HALP score could be a potential prognostic indicator for mortality following hip fracture. Thus, the objective of this study was to explore the relationship between the HALP score and mortality risk in older patients with hip fracture, and further evaluate its predictive value.MethodsConsecutive patients were identified from our institutional hip fracture database over the period from January 1, 2013 to December 31, 2022. Outcomes were 90-day all-cause mortality and overall mortality at the longest follow-up. Multivariate Cox proportional hazard models and restricted cubic spline (RCS) models were employed to assess this relationship. The incremental predictive performance of the HALP score was assessed using the c statistic, net reclassification improvement (NRI) and integrated discrimination improvement (IDI).ResultsIn total, 1707 patients were included with a median follow-up duration of 44.4 months, of whom 174 cases (10.2%) died within 90 days and 667 cases (39.1%) died at the longest follow-up. After multivariate adjustment, compared to tertile 1 group, tertile 2 and tertile 3 groups exhibited 0.676-fold (95% confidence interval [CI]: 0.471–0.972, p = 0.035) and 0.598-fold (95% CI: 0.390–0.918, p = 0.019) lower risks of 90-day mortality, as well as 0.681-fold (95% CI: 0.566–0.820, p &lt; 0.001) and 0.618-fold (95% CI: 0.504–0.759, p &lt; 0.001) decreased risks of overall mortality, respectively. For each unit increase in the HALP score, there was a significant decrease in 90-day mortality by 1.1% and in overall mortality by 1.0% (all p &lt; 0.05). RCS analyses indicated nonlinear relationships between the HALP score and 90-day and overall mortality (all P for nonlinear &lt;0.01). Moreover, adding the HALP score significantly improved the predictive ability for 90-day and overall mortality (all p &lt; 0.05).ConclusionThe HALP score was independently associated with mortality risk, highlighting its potential as a useful prognostic indicator for predicting mortality in older patients with hip fracture.
Working memory capacity moderates the effect of hearing aid experience on phonological processing performance
Authors: Ning Ruijing , Holmer Emil , Danielsson Henrik , Signoret Carine , Micula Andreea , Rönnberg Jerker 
Published: February 2025

PurposeIndividuals with acquired hearing impairment often experience declines in phonological processing abilities, a phenomenon thought to be mediated by working memory capacity (WMC). However, the role of hearing aid use in this context remains underexplored. Therefore, in the current study, we aimed (1) to tease apart the effect of hearing impairment and hearing aid use on phonological processing performance, and (2) to investigate the effect of hearing aid use on phonological processing in more detail, while considering the involvement of WMC.MethodUsing mixed effect models, we investigated rhyme judgment performance and its reliance on WMC among three groups of participants: a group of hearing aid users (n = 202), a group of hearing-impaired individuals without hearing aid (n = 54), and a group of normal hearing controls (n = 201). We also examined how years of hearing aid use was associated with rhyme judgment performance and its reliance on WMC in hearing aid users.ResultsWe found that hearing impairment was associated with increased dependence of rhyme judgment performance on WMC regardless of the use of hearing aids. Furthermore, hearing aid use was overall positively associated with rhyme judgment performance, with this relationship influenced by variations in WMC.ConclusionWMC influences the effectiveness of hearing aids for phonological processing. This role may result from working memory’s involvement in the processing of output signals from hearing aids, as well as in the strategies hearing aid users implement to deal with phonological processing tasks.
Prognostic value of serum lipids in newly diagnosed acute promyelocytic leukemia
Authors: Wang Shijie , Wang Qian , Lv Shuxin , Qin Ling 
Published: February 2025

Background and purposeDyslipidemia has been linked to acute promyelocytic leukemia (APL), with abnormal lipid metabolism observed during treatment. However, its role in APL pathogenesis remains unclear. This study investigates the relationship between serum lipid levels and clinical features, risk stratification, bleeding tendency, and prognosis of newly diagnosed APL patients, focusing on the role of the PTK2 gene in regulating lipid metabolism and its potential as a therapeutic target.Materials and methodsWe analyzed 90 newly diagnosed APL patients and 99 controls. Statistical analyses, including logistic regression, survival analysis, and protein-protein interaction (PPI) network, were used to assess lipid correlations with APL. Subgroup analyses explored specific clinical impacts, and functional experiments validated PTK2’s role in lipid metabolism.ResultsElevated triglycerides (TG) were positively associated with high-risk APL, while reduced high-density lipoprotein cholesterol (HDL-C) levels correlated with lower risk. Low-density lipoprotein cholesterol (LDL-C) was an independent prognostic marker, with lower levels linked to poorer outcomes. PTK2 expression significantly promoted APL cell proliferation, migration, and lipid metabolism, highlighting its role in APL pathogenesis. PTK2 regulates lipid metabolism-related factors, such as LDL and fibrinogen, through molecular pathways.ConclusionDyslipidemia is closely related to APL, with TG and LDL-C levels being key prognostic indicators. PTK2 plays a crucial role in lipid metabolism regulation and APL progression, providing a new molecular basis for risk assessment and targeted therapy. These findings offer potential biomarkers for early diagnosis and personalized treatment strategies.
The median effective dose of ciprofol combined with a low-dose sufentanil for gastroscopy in obese or nonobese patients: a dose-finding study using Dixon’s up-and-down method
Authors: Zhao Jie , Zhang Yixiao , Su Guowei , Wang Shaoyi , Zhang Xiaolin , Wang Guoxiang , Chen Gang 
Published: February 2025

ObjectivesUnderstanding the different pharmacodynamic responses to narcotics in patients with or without obesity is particularly important for the safety of gastroscopy sedation. This study aimed to determine the median effective dose (ED50) of ciprofol combined with low-dose sufentanil to inhibit the response to gastroscope insertion in obese or nonobese patients.MethodsA total of 27 obese patients (BMI 30–40 kg/m2) and 25 nonobese patients (BMI 18–25 kg/m2), aged between 18 and 65 years, with ASA physical status of 1–2, were included in this study. All patients underwent painless gastroscopy and received intravenous sufentanil at a dose of 0.1 μg/kg, followed by ciprofol administration. The initial dose of ciprofol for the first patient in both groups was 0.4 mg/kg, the subsequent dose was determined by the response of the previous patient to gastroscope insertion (cough, choking, body movement, etc.) using Dixon’s up-and-down method. The dose was increased or decreased by 0.05 mg/kg depending on the observed responses. Data collection continued until 7 crossover points were obtained. Probit regression and bootstrapping methods were employed to calculate the median effective dose (ED50) and 95% confidence intervals (CIs). The ED50 values were then compared between the obese and nonobese patient groups.ResultsThe ED50 of ciprofol combined with sufentanil inhibiting response to gastroscope insertion in patients with obesity was 0.186 mg/kg with 95% CI of 0.153∼0.209 mg/kg, was significantly lower than patients with nonobese was 0.237 mg/kg with 95% CI of 0.206∼0.253 mg/kg (p &lt; 0.05).ConclusionThe ED50 values of ciprofol combined with sufentanil inhibiting response to gastroscope insertion in patients with obesity was lower than in patients with normal weight.Trial registrationhttps://www.chictr.org.cn/bin/project/edit?pid=202873, identifier ChiCTR2300074216.
Psychometric properties of the Persian version of the electroconvulsive related anxiety questionnaire for psychiatric patients
Authors: EghbalManesh Azadeh , Ebadi Abbas , Zoladl Mohammad , Rasoul Zadeh Haghighi Zahra 
Published: February 2025

IntroductionECT is one of the most effective treatments for psychiatric patients. The results of several studies have reported ECT-related anxiety, which makes the patients ignore the advantages of the treatment and subsequently avoid it. Adopting an appropriate instrument to evaluate and manage this anxiety is so significant. Since there is no valid questionnaire to assess the patients' anxiety for ECT in Persian, we aimed to translate the EARQ into Persian and evaluate its validity and reliability in the present study.MethodsIn this methodological study, 170 patients with MDD, BMD, and schizophrenia aged 20–73 were recruited through convenience sampling and completed the 17-item EARQ in 2023. We used all aspects of face, content, and construct validity for the questionnaire. McDonald's Omega was calculated for the domains and 17 items to assess the reliability of the questionnaire.ResultsExploratory and confirmatory factor analysis revealed three factors, death anxiety, physical concern, and mental concern. Confirmatory factor analysis indicated moderate fit indices to support the three domains: CMIN/DF = 4.8 (p &lt; 0/05), RMSEA = 0.152, CFI = 0.92, and NFI = 0.91; GFI = 0.72. In our study, McDonald's Omega was 0.965 for death anxiety, 0.91 for physical concerns, 0.964 for brain concerns, and a total of 0.98.ConclusionsThe EARQ has acceptable validity and reliability, so specialists can use it to assess patients' anxiety before ECT and, according to the score, use suitable interventions to eliminate it.
Strengthening social skills: developing a social competence intervention for physical education using intervention mapping—protocol paper
Authors: Schüller Iris , Wergin V. Vanessa , Mess Filip 
Published: February 2025

IntroductionThe promotion of social competences using multi-method approaches is an understudied area in education and psychology. This study addresses the gap by developing and presenting a program to enhance social competences using theory-derived program and assessment designs.Materials and equipmentBartholomew’s Intervention Mapping (IM) approach, initially used for health promotion, was innovatively applied to a psychological and educational context. The development process and implementation challenges are presented in this article.MethodsThe six-step IM process was adapted to create a comprehensive program design that models social behavior, specifically for Physical Education in schools. The program targets perceptive-cognitive, emotional-motivational, and behavioral components of social competence, along the social competence model by Kanning. Results on effect sizes have yet to be calculated.DiscussionThe IM process was time-consuming and extensive but provided a systematic structure, methodological quality, and traceability of effects. Future adaptations of this program could include extensions to different situational contexts and specific need groups, such as classes with a history of bullying or psychological conditions. This study contributes valuable insights into using the IM approach for promoting behavioral change in a systematic and evidence-based manner.