bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electronic patient-reported outcome measures (ePROs) as tools for assessing health-related quality of life (HRQoL) in women with gynecologic and breast cancers: a systematic review
Authors: Boutib Amal , Azizi Asmaa , Youlyouz-Marfak Ibtissam , Kouiti Malak , Taiebine Mohamed , Benfatah Mohamed , Nejjari Chakib , Bounou Salim , Marfak Abdelghafour 
Published: November 2024

ObjectivesTo provide a comprehensive review of the use of electronic patient-reported outcomes measures (ePROs) as digital health tools to assess health-related quality of life (HRQoL) in women with breast, ovarian, cervical, and endometrial cancers.MethodsA systematic review was conducted to identify studies that used ePROs to evaluate HRQoL in women diagnosed with breast and gynecological cancers. The review followed the 2020 update of the PRISMA guidelines and a pre-registered protocol in PROSPERO (CRD42024516737). Inclusion criteria encompassed studies focusing on ePROs for HRQoL assessment in the specified cancers, without language restrictions, and published between January 2000 and December 2023. Studies were retrieved from PubMed, Web of Science, and Scopus. Two reviewers independently screened titles, abstracts, and full texts to identify eligible studies.ResultsThe search yielded 4978 articles. After removing duplicates, 900 articles were assessed for eligibility by screening the titles and abstracts. After screening the full text of 168 articles, a total of 16 studies were included in this systematic review. These studies were mainly conducted in Europe and the Americas and included different study designs such as randomized controlled trials (four articles), prospective studies (seven articles), and feasibility and validation studies (five articles). The majority of the studies focused on breast cancer (87.5%), with fewer studies addressing ovarian and cervical cancers. A variety of ePRO tools were used, including the FACT and EORTC QLQ. Findings show that ePROs enhance therapeutic management, treatment adherence, and HRQoL through improved symptom monitoring and communication between patients and providers.ConclusionThe integration of ePROs in oncology care facilitates a patient-centered approach, enhances communication between patients and healthcare providers, and supports personalized treatment strategies. These findings underscore the importance of incorporating ePROs into routine cancer care to improve overall patient outcomes and HRQoL.
A Qualitative Exploration of COVID+ Learning Network Webinars: Healthcare Learnings at Pace in a State of Rapid Change
Authors: Morris Brett , Rayner Jo-Anne , Bartlett Chantelle , Fetherstonhaugh Deirdre , McArdle Emmalee , O’Brien Amber 
Published: November 2024

Background: Learning Networks are increasingly used to educate clinicians and disseminate information to health professionals. During the height of the second COVID-19 lockdown in Victoria, Australia, COVID+ Learning Network webinars were introduced as a mechanism for disseminating emerging evidence and up-to-date information to health service managers, and primary care and community healthcare clinicians, and for obtaining feedback from the healthcare sector. Methods: A qualitative descriptive study design was used to explore the COVID+ Learning Network webinars from users’ perspectives. Fifteen webinar participants from different professional backgrounds, roles during the COVID-19 pandemic, and geographic locations were individually interviewed. Results: The webinars attracted state-wide engagement and participants described them as an effective way to inform and support health services, and primary care and community healthcare clinicians. However, data analysis revealed important considerations for using Learning Networks to disseminate information in the future. In particular, the importance of tailoring the webinars to address the specific needs of the different participant groups was highlighted. Conclusion: Health service managers, and primary care and community healthcare clinicians, require information pertinent to their specific roles, with consideration of geographic and socio-economic factors important to planning webinar content. Future learning network webinars would benefit from a more targeted approach to address the specific informational needs of the groups participating.
Bridging Gaps in Breast Cancer Screening: A Comparative Study of Mexican Women in U.S. Rural and Urban Areas
Authors: Bekteshi Venera , Schootman Mario 
Published: November 2024

Background: This study investigates breast cancer screening disparities among Mexican immigrant women in rural and urban U.S. communities, focusing on cultural beliefs, healthcare access, and geographical differences. Methods: A cross-sectional study of 350 Mexican immigrant women aged 40+ without prior cancer diagnosis was conducted in rural (<2000 population) and urban parts of the U.S. in 2015. Culturally tailored surveys during household visits, clinic appointments, and community meetings assessed cultural beliefs, mammography engagement, and family support. Comparative analyses t-tests and chi-square tests were conducted, with significance set at P < .05. Results: Rural women demonstrated higher adherence to spiritualismo ( M = 4.31, SD = 1.13) compared to their urban counterparts ( M = 3.91, SD = 1.36), marianismo ( M = 3.33, SD = 0.45 vs M = 3.21, SD = 0.48), and machismo ( M = 3.02, SD = 0.52 vs M = 2.80, SD = 0.61). The rural women also reported higher mammography rates (54.4% vs 45.6%), with 60.4% undergoing four or more mammograms. Despite barriers such as doctor non-recommendation (55.0% rural vs 45.0% urban) and embarrassment (67.9% rural vs 32.1% urban), rural women engaged more in family discussions about cancer screenings (61.7% vs 38.3%) and received more family assistance in finding health information (59.8% vs 40.2%). Conclusions: This study elucidates significant rural-urban disparities in cultural adherence and family support among Mexican immigrant women, underscoring the necessity for culturally tailored interventions to enhance breast cancer screening rates and health outcomes.
Liposomal Bupivacaine Versus Plain Bupivacaine for Pain Control Following Congenital Cardiac Surgery
Authors: Tanner Brandon M. , Herrmann Jeremy , Lutfi Riad , Yabrodi Mouhammad , Abbasi Rania K. 
Published: November 2024

Background Pain control following cardiac surgery can be challenging, and inadequate pain control is associated with postoperative complications. Liposomal bupivacaine can improve postoperative pain control due to its prolonged duration compared with plain bupivacaine. However, there is a paucity of data regarding its efficacy in congenital cardiac surgery. The primary outcome was to compare opioid requirements between liposomal bupivacaine and plain bupivacaine for local infiltration in pediatric patients undergoing cardiac surgical procedures via a median sternotomy approach. Secondary outcomes included antiemetic use, adjunct pain medication use, length of stay, and pain scores. Methods This single center retrospective study analyzed data from 2017 to 2022 involving patients who underwent congenital cardiac surgery via median sternotomy. Sixty-three patients who received liposomal bupivacaine were matched with 33 patients who received plain bupivacaine. Patient data were extracted from the electronic medical record and underwent statistical analysis using Wilcoxon, χ2, and Fisher exact tests. Results There were no demographic differences between the two groups. Postoperative opioid use did not differ significantly between the liposomal bupivacaine and plain bupivacaine groups. The liposomal bupivacaine group had increased acetaminophen and antiemetic use, while the plain bupivacaine group had increased ketorolac use. Otherwise, there were no significant differences in secondary outcomes, including length of stay. Conclusion Liposomal bupivacaine may not offer any advantage over plain bupivacaine in congenital cardiac postoperative pain control.
Outcomes for Degenerative Cervical Myelopathy Following Implementation of the AO Spine International Guidelines: A Single-Centre Service Evaluation
Authors: Brannigan Jamie , Vellaiyappan Sundar K. , Mowforth Oliver D. , Magee Joseph , Francis Jibin J. , Davies Benjamin M. , Kotter Mark R. 
Published: November 2024

Introduction Degenerative cervical myelopathy (DCM) is a syndrome of symptomatic cervical spinal cord compression due to degenerative spinal changes. Until recently there was no formal consensus on exactly which patients are suitable for surgical or conservative management. The AO Spine international guidelines were introduced to address this issue, based on the best available current evidence. However, their implementation into routine clinical practice has not yet been reported. The objective was to evaluate surgical outcomes following the implementation of the AO Spine guidelines at our spinal neurosurgical centre. Methods A service evaluation was conducted using data collected from electronic healthcare records for 259 patients, with outcomes of interest including change in mJOA score and complications. Data from 193 patients were included in the final analysis. Results There was a mean improvement of the mJOA score by 1.53 points, 1.44 point and 1.92 points at post-operative intervals of 3 months ( P < .001), 6 months ( P < .001) and 12 months ( P < .001). The percentage (number) of patients whose increase in mJOA score was greater than or equal to the minimal clinically importance difference (MCID) was 41% (44/107), 34% (33/96) and 43% (49/114) at these respective time intervals. Intraoperative complications occurred in 28 patients (11.7%). No association was found between BMI and postoperative change in mJOA score. Conclusion Our results are comparable to those from best practice data and suggest adherence to international guidelines provides a service that promotes meaningful recovery for patients with DCM. Therefore, our results offer support for implementation of the AO Spine international guidelines in clinical practice.
Magnetic Macro Drivers of Trade Openness: A Study of BRICS Economies
Authors: Suleman Shahida , Thaker Hassanudin Mohd Thas , Hoh Calvin Cheong Wing 
Published: November 2024

The major goal of this study endeavour is to thoroughly evaluate the impact of macro factors on trade openness (TOP). The study was conducted through the examination of numerous trade conceptions, with a specifically emphasis on examining these patterns within the economies of the BRICS nations (Russia, India, China and South Africa) from 1995 to 2020. Stepwise regression for selecting models, Pedroni, Johnson, Granger causality and advance panel regression are some of the techniques used including FMOLS, Panel OLS and FEM. The study’s outcomes reveal the presence of both long-term and short-term associations between TOP and (a) total investment, (b) human capital, (c) trade reserves, (d) trade balance and (e) exchange rate. The study authors found both one-way and two-way causal association between TOP and these five factors. Additionally, trade balance emerges as the most significant factor impacting TOP. Notably, the exchange rate does not exhibit significant economic importance. JEL Classification: F14, F15, F17
Establishing Clinical Significance for Patients Undergoing Arthroscopic Repair of Type II SLAP Lesions
Authors: Parnes Nata , Magnuson Justin A. , Hettrich Carolyn M. , Oh Luke S. , Klahs Kyle J. , Mozes Adam D. , Scanaliato John P. 
Published: November 2024

Background: Type II superior labrum anterior to posterior (SLAP) lesions may be treated with either arthroscopic repair or biceps tenodesis. There are no previous reports of measures of clinically significant improvement after arthroscopic repair of SLAP lesions. Purpose: To establish the minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB) for patients undergoing arthroscopic repair for type II SLAP lesions. Study Design: Case series; Level of evidence, 4. Methods: A total of 69 arthroscopic repair procedures for isolated type II SLAP lesions were performed in a military population. The mean age was 28.1 ± 4.7 years, 97.1% were male, and the mean follow-up was 99.5 ± 19.7 months. The MCID, PASS, and SCB were calculated for each patient-reported outcome measure, consisting of the American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE), and visual analog scale (VAS) for pain, using anchor- and distribution-based models. Factors associated with achieving a clinically relevant improvement were also determined. Results: The MCID, PASS, and SCB for each measure were as follows: 7.7, 70, and 34 for the ASES score, respectively; 10.4, 80, and 45 for the SANE, respectively; and 1.0, 4, and 6 for the VAS pain, respectively. At least 85% of patients achieved the MCID for each measure; however, PASS rates were lower, with 50.7% for the SANE and 69.6% for both the ASES score and VAS pain. The ASES score had the highest percentage of patients achieving the SCB at 44.9%, followed by the SANE (26.1%) and VAS pain (10.1%). Greater forward flexion at final follow-up was associated with achieving the MCID and PASS for both the ASES score and SANE. Internal rotation stiffness at final follow-up was negatively associated with achieving the PASS for the VAS pain. Combat arms military occupational specialty was associated with a lesser likelihood of achieving the SCB for the ASES score. Conclusion: Clinical metrics of improvement were defined for the ASES score, SANE, and VAS pain using the MCID, PASS, and SCB for patients undergoing arthroscopic repair of type II SLAP lesions. Better final range of motion was positively associated with achieving improvement, while high-intensity military duty was negatively associated.
Evaluation of an Active Rehabilitation Program With Early Weightbearing and No Immobilization After Tibial Tubercle Distalization
Authors: Rahnel Timo , Weitz Frederick K. , Launonen Antti P. , Sillanpää Petri J. , Hyvärinen Anna V. 
Published: November 2024

Background: Abnormal patellar height (patella alta) has been reported to be one of the main predisposing factors for recurrent patellar dislocation, and it can be surgically corrected by distalizing tibial tubercle osteotomy (DTTO). Rehabilitation after DTTO often includes limitations on weightbearing and restrictions on knee range of motion by means of bracing, increasing the risk of slow progression of the rehabilitation. Hypothesis: An active rehabilitation program with no restrictions on weightbearing and range of movement would yield a low risk of postoperative complications and a fast recovery period. Study Design: Case series; Level of evidence, 4. Methods: Included were 102 consecutive knees in 80 patients who underwent DTTO between January 2010 and December 2017. In the majority of knees (89.2%), the patient underwent simultaneous medial patellofemoral ligament reconstruction. The mean age of the patients at the time of surgery was 19.39 ± 8.02 years, and 80.4% of the knees (82/102) were of female patients. The patients underwent an active rehabilitation program with immediate weightbearing as tolerated and active quadriceps and hip muscle exercises with no immobilization or bracing. The protocol was active (patient unsupervised), including daily exercises, as instructed by a physical therapist. Crutches were recommended for the first 3 to 4 weeks. Results: There were 3 acute failures of fixation (2.9% of knees) requiring revision surgery. In these cases, the patients had a fall, slip, or knee-twisting accident during the first 6 weeks after surgery. Two late failures characterized by tibial stress fracture at the distal part of the osteotomy level occurred at 2 and 3 months postoperatively and were considered unrelated to the early rehabilitation process. The stress fracture rate was 2%, and the overall DTTO failure rate was 6.9%. With the active rehabilitation program, adverse effects such as knee stiffness, arthrofibrosis, or delayed ability to perform daily activities were rare. Conclusion: An active rehabilitation program after DTTO was found to be safe and effective. Furthermore, the risk of failure related to surgical fixation strength and of later stress fracture was low.
Comparison of Medial Hamstring Length Between Harvesting Methods Using Anterior and Posterior Approaches
Authors: Yau W.P. 
Published: November 2024

Background: Medial hamstring tendons harvesting can be performed through either an anterior or a posterior approach. It has been suggested that using a posterior approach may result in a longer length of harvestable tendon compared with an anterior approach. Hypothesis: There would be no difference in the length of the harvestable tendon between the anterior and posterior approaches. Study Design: Case-control study; Level of evidence, 3. Methods: A retrospective study was conducted at the primary institution using prospectively collected data from skeletally mature Chinese patients who underwent medial hamstring tendons harvesting between January 2008 and December 2021. Patients were excluded if they had experienced graft harvesting complication or if only 1 medial hamstring tendon was harvested. One-to-one exact matching was performed between the 2 approaches based on body height and sex. The outcome assessed was the length of the harvested tendon. Results: A total of 536 patients underwent medial hamstring tendons harvesting using an anterior approach, while 58 underwent it using a posterior approach, all of whom met the inclusion criteria. A group of 54 matched pairs were identified. The length of the harvested semitendinosus tendon was 263 ± 29 mm in the anterior approach and 256 ± 28 mm in the posterior approach ( P = .09; Student t test). The mean difference in the length of the harvested semitendinosus tendon between the 2 approaches was 7 mm. The length of the gracilis tendon was 226 ± 29 mm and 223 ± 29 mm in the anterior approach and the posterior approach, respectively ( P = .30; Student t test). Conclusion: In a retrospective 1:1 case-control study with exact matching of body height and sex, it was found that there was no difference in the length of the semitendinosus tendon and the gracilis tendon harvested using a posterior approach compared with an anterior approach. The mean difference between the 2 approaches was 7 mm for the semitendinosus tendon and 3 mm for the gracilis tendon, respectively.
The utility of wearable electroencephalography combined with behavioral measures to establish a practical multi-domain model for facilitating the diagnosis of young children with attention-deficit/hyperactivity disorder
Authors: Chen I-Chun , Chang Che-Lun , Chang Meng-Han , Ko Li-Wei 
Published: November 2024

Abstract
Background
A multi-method, multi-informant approach is crucial for evaluating attention-deficit/hyperactivity disorders (ADHD) in preschool children due to the diagnostic complexities and challenges at this developmental stage. However, most artificial intelligence (AI) studies on the automated detection of ADHD have relied on using a single datatype. This study aims to develop a reliable multimodal AI-detection system to facilitate the diagnosis of ADHD in young children.

Methods
78 young children were recruited, including 43 diagnosed with ADHD (mean age: 68.07 ± 6.19 months) and 35 with typical development (mean age: 67.40 ± 5.44 months). Machine learning and deep learning methods were adopted to develop three individual predictive models using electroencephalography (EEG) data recorded with a wearable wireless device, scores from the computerized attention assessment via Conners’ Kiddie Continuous Performance Test Second Edition (K-CPT-2), and ratings from ADHD-related symptom scales. Finally, these models were combined to form a single ensemble model.

Results
The ensemble model achieved an accuracy of 0.974. While individual modality provided the optimal classification with an accuracy rate of 0.909, 0.922, and 0.950 using the ADHD-related symptom rating scale, the K-CPT-2 score, and the EEG measure, respectively. Moreover, the findings suggest that teacher ratings, K-CPT-2 reaction time, and occipital high-frequency EEG band power values are significant features in identifying young children with ADHD.

Conclusions
This study addresses three common issues in ADHD-related AI research: the utility of wearable technologies, integrating databases from diverse ADHD diagnostic instruments, and appropriately interpreting the models. This established multimodal system is potentially reliable and practical for distinguishing ADHD from TD, thus further facilitating the clinical diagnosis of ADHD in preschool young children.
Specific binding between Arabidopsis thaliana phytochrome-interacting factor 3 (AtPIF3) bHLH and G-box originated prior to embryophyte emergence
Authors: Hsin Kuan-Ting , Lee Yu-Hsuan , Lin Kai-Chun , Chen Wei , Cheng Yi-Sheng 
Published: November 2024

AbstractThe basic helix-loop-helix (bHLH) domain via critical amino acid residues on basic region binding to E-box (5′-CANNTG-3′) is known in embryophyte. However, the dictated E-box types selection by bHLH dimers and the significant impact of these critical amino acid residues along embryophyte evolution remain unclear. The Arabidopsis thaliana PIF3-bHLH (AtPIF3-bHLH) recombinant protein and a series of AtPIF3-bHLH mutants were synthesized and analyzed. The reduced DNA binding ability and affinity of AtPIF3-bHLH point-mutation proteins, observed via fluorescence-based electrophoretic mobility shift assay (fEMSA) and isothermal titration calorimetry (ITC), suggest the critical role of these DNA-recognition sites in maintaining the AtPIF3-bHLH–DNA interaction. The purifying selection signals and the DNA-recognition-site conservation at the species level suggest the invariant roles of these sites throughout embryophyte evolution. The G-box outcompeted other types of E-box for binding in our competitive fEMSAs. The dynamic hydrogen bond formed between AtPIF3-bHLH and the G-box core indicates flexible identification of the core region. These features highlight a fast fixation of the bHLH-G-box recognition mechanism through embryophyte evolution and serve as a blueprint for studying DNA recognition determinants of other TF families.
Prevalence of blaOXA-48 and other carbapenemase encoding genes among carbapenem-resistant Pseudomonas aeruginosa clinical isolates in Egypt
Authors: Abdelraheem Wedad M. , Ismail Doaa Elzaeem , Hammad Safaa S. 
Published: November 2024

Abstract
Background
Resistance to carbapenem, the last line of treatment for gram-negative bacterial infections has been increasing globally and becoming a public health threat. Since integrons may aid in the transmission of resistance genes, the purpose of this study was to detect the frequency of class 1, 2, and 3 integrons as well as carbapenem-resistant genes in clinical isolates of P. aeruginosa that are resistant to carbapenem.

Methods
This study was carried out on 97 clinical isolates of P. aeruginosa isolated from wound and urine samples. The antimicrobial susceptibility for all isolates was tested by the disc diffusion method. The presence of integrons and carbapenem-resistant genes among carbapenem-resistant P. aeruginosa isolates was evaluated by conventional PCR.

Results
The antimicrobial resistance rate among P. aeruginosa clinical isolates was high, with imipenem resistance in 58.8% of the studied isolates. In this study, 86% of the carbapenem-resistant P. aeruginosa isolates carry carbapenemase genes, with blaVIM being the most common gene followed by the blaOXA−48 gene. Class 1 and class 2 integrons were reported in 37 (64.9%) and 10 (17.5%) of the tested carbapenem-resistant P. aeruginosa isolates, respectively.

Conclusion
Our data reported a high prevalence of class 1 integrons in carbapenem-resistant P. aeruginosa clinical isolates, suggesting the important role of integrons in carbapenem-resistant gene transfer among such isolates.