bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient and health professional attitudes towards the use of telemedicine for abortion care in Britain: Findings from the SACHA study
Authors: Meiksin Rebecca , Lewandowska Maria , Scott Rachel H , Palmer Melissa , McCarthy Ona , Salaria Natasha , Lohr Patricia A , Shawe Jill , French Rebecca Sophia , Wellings Kaye ,   the SACHA Study Team
Published: November 2024

Introduction Use of telemedicine in abortion care is safe and effective. Patient satisfaction with telemedically supported abortion is high, but as use expands in Britain, little is known about patients’ or health professionals’ views on how it is best used. We sought the views of both groups on telemedicine's role in abortion provision and how its use might be optimised. Methods We administered a structured survey with an additional free-text response option to a range of health professionals from services identified via clustered random sampling. We conducted semi-structured interviews with patients with recent experience of abortion, purposively sampled from abortion services. Participants were recruited from England, Scotland and Wales. We analysed qualitative data using thematic analysis alongside framework analysis. Results Support for telemedicine was high among participants, which included 771 health professionals from a range of services and 48 patients. Among health professionals, 23% opposed the use of telemedicine in abortion provision. Opposition was highest among those uninvolved, or who did not feel skilled, in remote provision. Reported benefits included patient convenience and comfort. Patient concerns centred on adequate provision of emotional support. Participants made suggestions for augmenting and extending the use of telemedicine to meet some patients’ needs, including combining telemedical consultation with in-person care and providing information and follow-up via digital methods. Conclusions Acceptability of telemedically supported abortion, which offers logistical and emotional benefits to patients, is high in Britain. Novel ways of providing telemedical support should be explored to enhance remote abortion provision. In-person care should remain an option for patients.
Accuracy of wrist-worn activity trackers for measuring steps in patients after major abdominal surgery: A validation study
Authors: Li Zhi , Feng Weiyan , Zhou Lili , Gong Shu 
Published: November 2024

Background Wearable activity trackers provide a simple and objective measurement of postoperative mobilization. However, few have validated the accuracy of trackers in patients after major abdominal surgery. Objective To examine the accuracy of wrist-worn activity trackers to measure steps of patients in early mobilization after major abdominal surgery, and to explore the influence of clinical variables and gait parameters on the accuracy of trackers. Methods Forty-five patients after major abdominal surgery were recruited to participate in modified six-minute walk tests wearing three trackers simultaneously, the Fitbit Inspire HR, Xiaomi MI 4, and HONOR 5. The differences in displayed steps before and after the walking test were considered as the step counts measured by the trackers; the actual steps taken were determined as the average of the values manually counted by two researchers. The intraclass correlation coefficient, Bland–Altman method, mean percentage error, and mean absolute percentage error were used to assess the accuracy of trackers with reference to manual step counts. Results The three trackers undercounted postoperative steps by −65.5% to −23.5%. Analysis showed low-to-good agreement between step counts recorded by trackers and actual steps (ICC = 0.35–0.75); the mean absolute percentage errors ranged from 24.5% to 65.7%. For all trackers, mean absolute percentage errors correlated negatively with postoperative days ( r = −0.626 to −0.744), walking speed ( r = −0.714 to −0.854), step length ( r = −0.466 to −0.615), and cadence ( r = −0.681 to −0.790), while there were positive correlations between mean absolute percentage errors and the number of abdominal drains ( r = 0.450–0.514). Conclusions The specific activity trackers used in this study might not be reliable tools for measuring steps counts during the walking test in the early postoperative period for patients undergoing major abdominal surgery.
Is Endoscopic Surgery a Safe and Effective Treatment for Lumbar Disc Herniation? A Meta-Analysis of Randomized Controlled Trials
Authors: Cai Bo-Tao , Yang Fan , Wang Deng-Chao 
Published: November 2024

Study Design Systematic Review. Objective This meta-analysis systematically evaluates the safety and effectiveness of endoscopic techniques in the treatment of lumbar disc herniation (LDH). Methods A comprehensive computerized search was conducted on PubMed, Embase, Cochrane Library, China National Biomedical Literature Database (CBM), VIP Database, China National Knowledge Infrastructure (CNKI) and Wanfang Database. Randomized controlled trials (RCTs) comparing endoscopic techniques with non-endoscopic techniques for the treatment of LDH were identified. Meta-analysis was performed using RevMan 5.4 software. Results Seventeen RCTs involving 1748 LDH patients were analyzed. The meta-analysis revealed that, compared to the non-endoscopic discectomy (NED) group, the endoscopic discectomy (ED) group exhibited significantly lower intraoperative blood loss [MD = −74.45 mL, 95% CI (−124.88, −24.02), P = .004], shorter hospitalization duration [MD = −4.07 days, 95% CI (−6.67, −1.48), P = .002], lower Visual Analogue Scale (VAS) pain scores at the last follow-up [MD = −.35, 95% CI (−.63, −.07), P = .01], and a lower incidence of complications [RR = .35, 95% CI (.25, .48), P < .00001]. Moreover, the ED group exhibited a higher ratio of excellent and good therapeutic effects postoperatively [RR = 1.05, 95% CI (1.01, 1.10), P = .01]. However, there were no statistically significant differences between the 2 groups in terms of the Oswestry Disability Index (ODI) scores at the last follow-up [SMD = −.49, 95% CI (−1.14, .17), P = .14] and operation time [MD = −10.17 min, 95% CI (−27.05, 6.71), P = .24]. Conclusion Endoscopic techniques in the treatment of LDH exhibit significant superiority in intraoperative blood loss, hospitalization duration, postoperative pain, complication rates, and postoperative therapeutic effects. This provides patients with a safer and more effective treatment option.
Understanding the Multifactorial Influences on Postsurgical Pain After Rotator Cuff Repair: A Retrospective Cohort Study
Authors: Lazaridou Asimina , Brune Daniela , Schneller Tim , George Steven Z. , Edwards Robert R. , Scheibel Markus 
Published: November 2024

Background: The experience of chronic postsurgical pain (CPSP) can vary widely among patients after rotator cuff repair (RCR). Purpose: To determine the prevalence and predictive factors of CPSP at 6 months after RCR. Study Design: Cohort study; Level of evidence, 3. Methods: The following assessments were conducted preoperatively and 6 months postoperatively in adult patients with RCR who had undergone primary arthroscopic RCR (N = 1987): Constant score, pain assessed on the numeric rating scale (0-10), the Subjective Shoulder Value, the Oxford Shoulder Score, and quality of life as measured by the EuroQol–5 Dimensions–5 Level (EQ-5D-5L). Patient characteristics—including age, sex, body mass index, and smoking status—and surgical factors—including the duration of surgery and the American Society of Anesthesiologists (ASA) classification—were also reported. Multivariate logistic regression analysis was performed to determine which variables were predictors for CPSP. Results: The prevalence of moderate to severe preoperative pain in the patients was 30.4% for CPSP. After adjusting for age, surgery duration, ASA classification, sex, and body mass index, results revealed that unique predictors for CPSP were as follows: (1) the presence of preoperative negative affect—assessed using the anxiety/depression dimension of the EQ-5D-5L (odds ratio [OR], 1.46 ( P < .001); (2) preoperative pain (OR, 1.17; P < .001); and (3) shoulder function (OR, 0.96; P < .001). None of the surgical factors appeared to predict CPSP. Conclusion: Patients predisposed to CPSP can be identified during the preoperative phase. Collectively, there is a call for a more in-depth assessment of biopsychosocial risk factors that could substantially influence the postoperative pain experience.
Nurses’ Self-Leadership in the Face of Challenging Situations, Such as Patient Deterioration
Authors: Prinsloo Carine 
Published: November 2024

Background Nurses play an essential role as frontline caregivers, particularly in recognizing and responding to patient deterioration. This study addresses nurses’ self-leadership in the face of challenging situations such as patient deterioration, emphasizing the importance of self-leadership skills in navigating complex patient care scenarios. Delayed recognition of subtle changes in patient’s conditions has been linked to adverse outcomes, necessitating a closer examination of the role of self-leadership in nursing practice. Objective The objective of this research was to explore and understand the implications of self-leadership among nurses when confronted with challenging situations, specifically focusing on patient deterioration. Methods A qualitative, exploratory, and descriptive research design was employed, utilizing focus group discussions (FGDs) with nurses from a private hospital in Pretoria, South Africa. Semistructured interview guide facilitated the FGDs, and data saturation was achieved after the eight sessions. The sample included nurses with various qualifications and shifts, offering diverse perspectives on self-leadership in patient care. Rigorous data collection and trustworthiness measures, including member checking and verbatim transcriptions, were employed to enhance the conformability of the study. Results The findings revealed six overarching themes and 15 subthemes, demonstrating the interconnectedness of self-leadership and nursing practice. Themes included responsibility and autonomy, compassion and care, support and collaboration, learning from experience, teamwork, and appreciation and recognition. These themes explained how nurses actively engaged in self-observation, constructive thought patterns, and natural reward strategies to proactively address patient deterioration. Conclusion The study underlines the significance of integrating self-leadership principles into nursing practice. Embracing self-leadership in nursing holds promise for improving patient outcomes and nurturing a resilient and competent nursing workforce.
“Well I Failed, but I Have No Idea Why”…: Experiences of Feedback After High-Stakes Summative Specialist Medical Examination in Ophthalmology
Authors: Jessup Belinda , Allen Penny , Kirschbaum Melissa , Khanal Santosh , Baker-Smith Victoria , Graham Barnabas , Barnett Tony 
Published: November 2024

OBJECTIVE Medical specialist trainees report dissatisfaction with both the usefulness and timing of feedback provided following summative examinations. This study aimed to explore ophthalmology trainee and supervisor experiences of feedback following final summative examination (the Royal Australian and New Zealand College of Ophthalmologists Advanced Clinical Examination (RACE)). METHODS Semi-structured interviews were undertaken with ophthalmology trainees who had recently sat RACE (2017-2021) ( n = 19) and supervising ophthalmologists who support trainees to prepare for RACE ( n = 10). Interview data were thematically analyzed. RESULTS Two themes were identified. Inadequate feedback related to trainee experiences receiving feedback relating to examination performance that was insufficient and unhelpful in identifying gaps in learning, explaining the reasons for failure and supporting preparation for resitting. Inability to contextualize feedback encompassed trainee and supervisor concerns regarding the inability to review examination manuscripts after sitting the examination, the absence of marking criteria, rubrics and model answers to understand the passing standard and the lack of opportunity to discuss performance with examiners. CONCLUSIONS Detailed, individualized task-level and process-level feedback on examination performance is needed for all trainees. Opportunities to view examination manuscripts, marking criteria and model answers, as well as speak with examiners, would improve transparency of the assessment process, enhance feedback and improve trainee success.
Extracellular vesicles from microglial cells activated by abnormal heparan sulfate oligosaccharides from Sanfilippo patients impair neuronal dendritic arborization
Authors: Dias Chloé , Ballout Nissrine , Morla Guillaume , Alileche Katia , Santiago Christophe , Guerrera Ida Chiara , Chaubet Adeline , Ausseil Jerome , Trudel Stephanie 
Published: November 2024

Abstract
Background
In mucopolysaccharidosis type III (MPS III, also known as Sanfilippo syndrome), a pediatric neurodegenerative disorder, accumulation of abnormal glycosaminoglycans (GAGs) induces severe neuroinflammation by triggering the microglial pro-inflammatory cytokines production via a TLR4-dependent pathway. But the extent of the microglia contribution to the MPS III neuropathology remains unclear. Extracellular vesicles (EVs) mediate intercellular communication and are known to participate in the pathogenesis of adult neurodegenerative diseases. However, characterization of the molecular profiles of EVs released by MPS III microglia and their effects on neuronal functions have not been described.

Methods
Here, we isolated EVs secreted by the microglial cells after treatment with GAGs purified from urines of Sanfilippo patients (sfGAGs-EVs) or from age-matched healthy subjects (nGAGs-EVs) to explore the EVs’ proteins and small RNA profiles using LC–MS/MS and RNA sequencing. We next performed a functional assay by immunofluorescence following nGAGs- or sfGAGs-EVs uptake by WT primary cortical neurons and analyzed their extensions metrics after staining of βIII-tubulin and MAP2 by confocal microscopy.

Results
Functional enrichment analysis for both proteomics and RNA sequencing data from sfGAGs-EVs revealed a specific content involved in neuroinflammation and neurodevelopment pathways. Treatment of cortical neurons with sfGAGs-EVs induced a disease-associated phenotype demonstrated by a lower total neurite surface area, an impaired somatodendritic compartment, and a higher number of immature dendritic spines.

Conclusions
This study shows, for the first time, that GAGs from patients with Sanfilippo syndrome can induce microglial secretion of EVs that deliver a specific molecular message to recipient naive neurons, while promoting the neuroinflammation, and depriving neurons of neurodevelopmental factors. This work provides a framework for further studies of biomarkers to evaluate efficiency of emerging therapies.

Graphical Abstract
Reduction of neck pain severity in patients with medication-overuse headache
Authors: Hong Yooha , Park Hong-Kyun , Kang Mi-Kyoung , Oh Sun-Young , Kang Jin-Ju , Moon Heui-Soo , Song Tae-Jin , Lee Mi Ji , Chu Min Kyung , Cho Soo-Jin 
Published: November 2024

Abstract
Background
Neck pain and primary headache disorders are highly prevalent in populations and clinical cohorts. Medication-overuse headache (MOH) is a treatable secondary headache, mainly developing in migraine sufferers, that accounts for the majority of patients presenting to headache clinics. Nevertheless, the association between neck pain and MOH has not been reported. This study evaluated the prevalence and clinical course of neck pain in patients with MOH before and after MOH treatment.

Methods
We analyzed 635 MOH patients enrolled in a nationwide, prospective, multicenter MOH registry. Demographics and clinical data were collected at baseline and 3 months to evaluate changes in the status and severity of neck pain and headache. Severity of neck pain was graded into 4 groups, and severe neck pain was defined as grade 3 or 4.

Results
Among 635 patients with MOH, 366 (57.6%) reported neck pain at baseline. MOH patients with neck pain had an earlier onset of their primary headache disorder (23.4 ± 12.7 vs. 26.2 ± 13.3 years, p = 0.007). Although monthly headache days were comparable between the patients with neck pain and those without neck pain, the neck pain group had higher levels of anxiety (7.4 ± 5.8 vs. 6.4 ± 5.4, p = 0.017), more severe cutaneous allodynia (2.4 ± 3.3 vs. 1.8 ± 3.0, p = 0.038), and poorer quality of life (171.7 ± 70.4 vs. 184.0 ± 68.9, p = 0.029). At 3 months, 456 (71.8%) were followed-up, and 257 (56.4%) were recovered from MOH. Compared to the baseline, the proportion of severe neck pain (40.4% vs. 19.4%, p < 0.001) was decreased. The proportion of severe neck pain was much lower in patients with recovery from MOH compared to those without (4.7% vs. 15.1%, p < 0.001).

Conclusions
Neck pain in MOH patients was associated with earlier onset of headache, higher levels of anxiety and allodynia, and poorer quality of life. Improvement in neck pain improvement was linked to recovery from MOH. These findings suggest the potential importance of integrating and management of neck pain into clinical practice for MOH.
PangeBlocks: customized construction of pangenome graphs via maximal blocks
Authors: Avila Cartes Jorge , Bonizzoni Paola , Ciccolella Simone , Della Vedova Gianluca , Denti Luca 
Published: November 2024

Abstract
Background
The construction of a pangenome graph is a fundamental task in pangenomics. A natural theoretical question is how to formalize the computational problem of building an optimal pangenome graph, making explicit the underlying optimization criterion and the set of feasible solutions. Current approaches build a pangenome graph with some heuristics, without assuming some explicit optimization criteria. Thus it is unclear how a specific optimization criterion affects the graph topology and downstream analysis, like read mapping and variant calling.

Results
In this paper, by leveraging the notion of maximal block in a Multiple Sequence Alignment (MSA), we reframe the pangenome graph construction problem as an exact cover problem on blocks called Minimum Weighted Block Cover (MWBC). Then we propose an Integer Linear Programming (ILP) formulation for the MWBC problem that allows us to study the most natural objective functions for building a graph. We provide an implementation of the ILP approach for solving the MWBC and we evaluate it on SARS-CoV-2 complete genomes, showing how different objective functions lead to pangenome graphs that have different properties, hinting that the specific downstream task can drive the graph construction phase.

Conclusion
We show that a customized construction of a pangenome graph based on selecting objective functions has a direct impact on the resulting graphs. In particular, our formalization of the MWBC problem, based on finding an optimal subset of blocks covering an MSA, paves the way to novel practical approaches to graph representations of an MSA where the user can guide the construction.
Postnatal care after gestational diabetes – a systematic review of clinical practice guidelines
Authors: Ohene-Agyei Phyllis , Iqbal Ariba , Harding Jane E. , Crowther Caroline A. , Lin Luling 
Published: November 2024

Abstract
Background
Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnancy and later is associated with an increased risk of type 2 diabetes and other metabolic disorders. Consistent and evidence based postnatal care is key to improving maternal long-term health. We therefore aimed to review and compare recommendations of national and international clinical practice guidelines (CPG) for postnatal care after GDM and identify any evidence gaps in recommendations needing further research.

Methods
We searched five databases and forty professional organization websites for CPGs providing recommendations for postnatal care after GDM. CPGs which had full versions in English, endorsed, prepared, or authorized by a professional body, and published between 2013 and 2023 were eligible for inclusion. Two reviewers independently screened the articles, extracted the recommendations, and appraised the included CPGs using the Appraisal of Guidelines, Research, and Evaluation (AGREE) II tool.

Results
Twenty-six CPGs from 22 countries were included. Twelve CPGs (46%) were appraised as low quality with the lowest scoring domains being rigor of development and editorial independence. We found little high certainty evidence for most recommendations and few recommendations were made for maternal mental health and postpartum metabolic screening. Evidence gaps pertained to postpartum glucose screening, including frequency, tests, and ways to improve uptake, evaluation of effective uptake of lifestyle interventions, and ongoing long-term follow up care.

Conclusions
Most of the postnatal care recommendations in GDM guidelines are not based on high certainty evidence. Further efforts are needed to improve the global evidence base for postnatal care after GDM to improve long-term maternal health.

Protocol Registration
This review was registered in PROSEPRO (CRD42023454900).
Osteosarcoma cells depend on MCL-1 for survival, and osteosarcoma metastases respond to MCL-1 antagonism plus regorafenib in vivo
Authors: Ji Yanhao , Harris Michael A. , Newton Lucas M. , Harris Tiffany J. , Fairlie W. Douglas , Lee Erinna F. , Hawkins Christine J. 
Published: November 2024

AbstractOsteosarcoma is the most common form of primary bone cancer, which primarily afflicts children and adolescents. Chemotherapy, consisting of doxorubicin, cisplatin and methotrexate (MAP) increased the 5-year osteosarcoma survival rate from 20% to approximately 60% by the 1980s. However, osteosarcoma survival rates have remained stagnant for several decades. Patients whose disease fails to respond to MAP receive second-line treatments such as etoposide and, in more recent years, the kinase inhibitor regorafenib. BCL-2 and its close relatives enforce cellular survival and have been implicated in the development and progression of various cancer types. BH3-mimetics antagonize pro-survival members of the BCL-2 family to directly stimulate apoptosis. These drugs have been proven to be efficacious in other cancer types, but their use in osteosarcoma has been relatively unexplored to date. We investigated the potential efficacy of BH3-mimetics against osteosarcoma cells in vitro and examined their cooperation with regorafenib in vivo. We demonstrated that osteosarcoma cell lines could be killed through inhibition of MCL-1 combined with BCL-2 or BCL-xL antagonism. Inhibition of MCL-1 also sensitized osteosarcoma cells to killing by second-line osteosarcoma treatments, particularly regorafenib. Importantly, we found that inhibition of MCL-1 with the BH3-mimetic S63845 combined with regorafenib significantly prolonged the survival of mice bearing pulmonary osteosarcoma metastases. Together, our results highlight the importance of MCL-1 in osteosarcoma cell survival and present a potential therapeutic avenue that may improve metastatic osteosarcoma patient outcomes.