bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the impact of telemedicine interventions on systolic and diastolic blood pressure reduction: A systematic review and meta-analysis
Authors: Moulaei Khadijeh , Parhizkar Roudsari Peyvand , Shahrokhi Sardoo Adel , Hosseini Mobina , Anabestani Mehrdad , Moulaei Reza , Sabet Babak , Afrash Mohammad Reza 
Published: November 2024

Background Hypertension, characterized by high blood pressure, poses a significant risk for cardiovascular diseases, stroke, and heart attack. Managing it is particularly challenging in areas with limited healthcare access and for patients who cannot attend regular in-person visits. Telemedicine interventions offer a promising solution by improving patient adherence and facilitating timely treatment adjustments. This study aims to systematically evaluate the impact of these telemedicine interventions on reducing systolic and diastolic blood pressure. Methods A comprehensive search of PubMed, Scopus, and Web of Science was conducted to identify relevant studies. Two independent reviewers screened and selected eligible articles, extracting key data using a standardized form. The quality of the included studies was assessed with the Mixed Methods Appraisal Tool (MMAT). A random effects model was used to combine the results, with treatment effects measured using standardized mean differences (Hedges's g). Consistency of findings was evaluated through statistical tests, including the Q test and I² statistic, to assess heterogeneity. Data analysis was conducted using Stata statistical software version 17.0. Results Of the 2700 articles retrieved, 35 studies were selected for inclusion in the analysis. Using a random-effects model, the overall effect size was Hedges's g = −0.22 (95% CI: −0.30 to −0.15; p-value < 0.001), indicating a small but meaningful reduction in blood pressure (systolic and diastolic). Telemedicine interventions had a greater impact on systolic blood pressure (Hedges's g = −0.27, 95% CI: −0.39 to −0.15; p-value < 0.001) compared to diastolic blood pressure (Hedges's g = −0.17, 95% CI: −0.26 to −0.07; p-value < 0.001), though both reductions were clinically relevant. Conclusion This study demonstrates that telemedicine interventions significantly reduce both systolic and diastolic blood pressure, with a more pronounced effect on systolic pressure. The overall effect size indicates a small but meaningful improvement in hypertension management. These findings highlight the potential of telemedicine as an effective strategy for enhancing patient outcomes in hypertension care.
Lack of diversity in patients undergoing carotid artery stenting: Implications for the Distressed Community Index
Authors: Pajarillo Carmen , Romain Gaëlle , Cleman Jacob , Scierka Lindsey , Grubman Scott , Schenck Christopher , Kluger Jonathan , Smolderen Kim G , Mena-Hurtado Carlos 
Published: November 2024

Introduction: As the role of social determinants in carotid artery stenting (CAS) outcomes remains unclear, we investigated the association between the Distressed Community Index (DCI) (zip-code based) and post-CAS mortality/stroke outcomes. Methods: We analyzed patients undergoing CAS from 2015 to 2019 using the Medicare claims-linked Vascular Quality Initiative database. Patients were grouped based on high (DCI ⩾ 60) and low (DCI < 60) community distress. We analyzed 36-month mortality using Kaplan–Meier survival curves and hierarchical Cox regression, and 36-month stroke using cumulative incidence function curves and Fine–Gray models. Results: The final cohort included 8717 patients (3032 DCI ⩾ 60), with a mean DCI score of 46.2 (± 28.5) and mean age of 74.7 (± 7.8) years. Most participants were men (64.3%), White (92.7%), and non-Hispanic/Latino (97.7%). There was no significant difference in the 36-month mortality incidence between high and low community distress groups (25.6% vs 23.5%, p = 0.22), and no significant association between high community distress and mortality (unadjusted HR: 1.04; 95% CI 0.90–1.21; adjusted HR: 1.02; 95% CI 0.89–1.17). The high community distress group experienced an elevated 36-month stroke incidence (26.8% vs 22.4%, p = 0.048), but no significant association with stroke was observed (unadjusted sub-HR: 1.12; 95% CI 1.00–1.24; adjusted sub-HR: 1.03; 95% CI 0.92–1.16). Conclusion: Our cohort showed underrepresentation in terms of sex, race, and ethnicity, with a skewed DCI distribution towards lower community distress. Contrary to what we know about community distress, no independent association between higher community distress and post-CAS stroke/mortality risk was found. Future work must examine whether accessibility barriers and selective CAS allocation explain our results.
Anti-hypertensives associated with survival in cancer patients receiving immunotherapy: new evidence from a real-world cohort study and meta-analysis
Authors: Ma Ping , Zhang Zhihuan , Qian Mengying , Jiang Hao , Zhao Yu , Shan Qing , Liu Xia , Yao Tianming , Guo Jinmin 
Published: November 2024

Background: The efficacy of immune checkpoint inhibitors (ICIs) in cancer patients taking anti-hypertensive drugs is still not well established. Objective: To elucidate the effect of anti-hypertensive drugs on the clinical outcome of cancer patients receiving immunotherapy. Design: A retrospective cohort study and meta-analysis. Method: We conducted a real-world retrospective study of cancer patients treated with immunotherapy at two tertiary centers between January 2019 and June 2023, with primary outcomes being overall survival (OS) and progression-free survival (PFS). In addition, we performed a meta-analysis to synthesize currently relevant clinical studies. Results: A retrospective clinical study of 336 patients from 2 centers suggested that the use of anti-hypertensive drugs was related to a preferable OS (hazard ratio (HR) = 0.55, 95% confidence interval (CI): 0.33–0.90) compared to non-users. For PFS, no significant correlation was detected (HR = 0.71, 95% CI: 0.49–1.03). Further analysis revealed that renin–angiotensin system inhibitor (RASi) and calcium channel blocker (CCB) have a synergistic effect with ICIs. In addition, subgroup analysis found that the benefits of RASi or CCB in combination with ICIs are greater in women or patients ⩾65 years of age. There was better disease control in lung cancer patients using RASi, and a significantly longer OS was observed in patients with gastrointestinal tumors taking CCB. Meta-analysis suggested that anti-hypertensive drugs were associated with improved OS, but only the combination of RASi and immunotherapy showed a synergistic effect. No significant correlation with OS was found for other anti-hypertensive drugs, and there was no overall positive effect on PFS. Conclusion: Our study found that use of anti-hypertensive drugs, particularly RASi or CCB, was associated with improved OS in patients undergoing immunotherapy. The synergistic effects of RASi or CCB with ICIs were more pronounced in females or elderly. RASi or CCB exhibited different benefits in various types of tumors. These findings provide valuable insights for treating cancer patients with hypertension.
To live or to stay alive? A thematic and sentiment analysis of public posts on social media during the 2022 Shanghai COVID-19 outbreak
Authors: Chen Lixiong , Xu Nairui 
Published: November 2024

ObjectiveThe use of social media during the COVID-19 pandemic has been researched extensively since the outbreak. Sina Weibo, as one of most commonly used social media platforms in China, played an important role in public expression for the duration of COVID-19. We investigated the themes that emerged from the posts and examined the sentiments associated with each theme.MethodsFor this study, we collected 72,084 Weibo posts related to the 2022 Shanghai public health event to present a thematic and sentiment analysis of posts by the public.ResultsThe findings showed that the public was more inclined to express concerns about the impact of the outbreak and of outbreak containment measures on their personal lives on social media and exhibited negative attitudes and opinions rather than discussing the impact of COVID-19 on human life and health, suggesting that the impact of the outbreak on people's daily lives was greater than was the impact on their livelihoods and health risks.ConclusionsThis research highlights the importance of understanding the role of social media in times of crisis and the potential insights that can be gained from analyzing online public discourse. Our empirical findings provide insights for future public health communication strategies and crisis management plans in China in the information age.
Effect of a Low Salt Diet on the Progression of Chronic Kidney Disease: A Prospective, Open-Label, Randomized Controlled Trial
Authors: Trakarnvanich Thananda , Chailimpamontree Worawon , Kantachuvesiri Surasak , Anutrakulchai Sirirat , Manomaipiboon Basmon , Ngamvitchukorn Tanun , Suraamornkul Swangjit , Trakarnvanich Thanphisit , Kurathong Sathit 
Published: November 2024

Introduction: A causal relationship exists between salt intake and hypertension, stroke, and kidney disease. However, whether or not reduced salt intake slows progression of renal diseases has been intensely debated. Methods: In this prospective, open-label, randomized controlled trial, we examined the impact of a low salt diet on renal function, blood pressure, and other metabolic parameters. Herein, 194 patients with chronic kidney disease (CKD) stages 1 to 3 were randomized in low salt (intervention) and control groups. The intervention group was provided a low salt diet (1.5 g/day) for 3 months. The control group consumed their usual diet, and daily food intake was recorded in the control group. Renal function tests, 24-h urinary sodium excretion, urinary protein, serum calcium, phosphorus, and electrolyte levels were recorded monthly. Results: After 3 months, the mean reduction in estimated glomerular filtration rate was significantly higher in the control group (mean reduction in eGFR, −3.011 mL/min/1.73 m2; 95% confidence interval (CI) = −5.367, −0.656, P = .013). Blood pressure (BP) decreased significantly in both groups; systolic and diastolic BP reduction at 3 months was significantly greater in the intervention group (systolic BP mean reduction −6.57/−4.29 mmHg; 95% CI = −10.24, −2.89) and diastolic BP mean reduction −6.95, −1.64 mmHg) compared with the control group (systolic BP mean reduction −0.58/−2.63 mmHg; 95%, CI = −4.33, 3.17 and diastolic BP mean reduction −5.34, −0.08 mmHg). The mean reduction in 24-h urine sodium excretion was greater in the intervention group, reaching a significant level at month 2 (−14.45 mmol/day; 95% CI = −27.63, −1.22). Conclusion: Overall, salt restriction can help slow the progression of renal insufficiency and results in statistically significant and clinically important reductions in BP among patients with CKD. ClinicalTrials.Gov Identifier: NCT05716386 on 28/01/2023.
Collaboration in Occupational Health Nursing: A Concept Analysis Review
Authors: Kobayashi Kisaki , Honda Hikaru 
Published: November 2024

Objectives: Establishing collaboration with occupational health staff is essential to support workers and organizations in the field of occupational health. Accordingly, occupational health nurses (OHNs) have recognized the need to collaborate with other professionals, including non-health care professionals. This review aimed to examine the components of collaboration in OHNs. Methods: This review was conducted using Walker and Avant’s eight-step analysis method on 267 papers (174 in Japanese and 93 in English) identified through an extensive literature review. Results: Key attributes, antecedents, consequences, and empirical referents helped shape an operational definition of the concept of collaboration. Collaboration among OHNs is a process that integrates individuals, organizations, and systems. Further, OHNs are responsible for ensuring that employers and workers collaborate to actively promote and facilitate occupational health activities. In addition, OHNs assess the health status of individuals and organizations to determine whether collaboration is needed through the occupational nursing process. The quality and outcomes of collaboration are influenced by social trends and the health culture of each organization. Through collaboration with various stakeholders, OHNs contribute to making the workplace a better environment, improving labor efficiency, increasing worker productivity, and ensuring health and safety. Conclusions: This review provides a comprehensive understanding of collaboration in occupational health nursing. Collaboration among OHNs is notably characterized by its “integration.” OHNs can facilitate collaboration between employers and employees in occupational health activities, potentially benefiting both businesses and health care. The clarification of collaboration in this review has the potential to enhance OHN practices and guide future research.
Predictors of Early Mortality After Traumatic Spinal Cord Injury in South Africa
Authors: Jacob Alina , Wirtz Christian R. , Loibl Markus , Kruger Stefan , Blankson Benjamin H. , Dunn Robert N. , Kruger Nicholas A. 
Published: November 2024

Study Design Retrospective cohort study. Objectives To identify predictors for early mortality following traumatic spinal cord injury (TSCI), as recognition of factors associated with early mortality is essential for public resource allocation and optimized acute care. Methods Retrospective Analysis of SCI patients admitted to the acute SCI ward from 2003 to 2022 was performed. Days elapsing from the date of injury to date of death established the survival time. Early mortality was defined as survival time ≤ 365 days. Multivariable logistic regression was used in modeling of early death following TSCI with age, gender, neurologic deficit, type of neurologic injury, ventilation status, and count of complications as covariates. Results Simple logistic regression indicated a significant association of early mortality with the number of complications ( P < .0001), neurological deficit ( P < .0001), complete neurological injury ( P < .0001), ventilation status ( P < .0001), and age group ( P < .0003). After adjusting for other covariates, complete neurological injury (OR: 1.75, P < .0001), ventilation (OR: 2.80, P < .0001), and Age group (over 60 OR: 17.71, P < .0001) were significantly associated with early mortality. The multivariable model showed a good overall fit (Hosmer-Lemeshow P = .315; AUC 0.85). Conclusions Predictors of early mortality after TSCI are high complete spinal cord injury, age, number of complications, and the need for ventilation. Identification of high-risk patients is crucial to rationalize and improve acute care to potentially reduce mortality rates.
Impact of a Unilateral High Tibial Osteotomy With a Large Correction on Functional Lateral Acetabular Coverage of the Hip Joint
Authors: Song Sang Jun , Yoon Kyoung Ho , Lee Seung Jae , Park Cheol Hee 
Published: November 2024

Background: Changes in limb length and coronal pelvic tilt, which occur along with changes in limb alignment, may affect the functional lateral acetabular coverage of the hip joint under weightbearing conditions. Purpose: To analyze the functional lateral acetabular coverage after unilateral closed-wedge and open-wedge high tibial osteotomies with a large wedge correction of ≥10 mm. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective analysis was conducted for 107 unilateral closed-wedge high tibial osteotomies (CWHTOs) and 100 unilateral open-wedge high tibial osteotomies (OWHTOs) with a wedge correction of ≥10 mm and without correction loss during a 2-year follow-up. Limb length and coronal pelvic tilt were measured. Functional lateral acetabular coverage was evaluated using the lateral center-edge angle (LCEA), acetabular index, sharp angle, and femoral head extrusion index (FHEI) with reference to the ground horizontal line. Appropriate ranges of the LCEA (22° to 40°), acetabular index (−8° to 14°), sharp angle (34° to 43°), and FHEI (11% to 27%) were investigated. Results: Limb length significantly decreased after CWHTO (−7.2 mm) and increased after OWHTO (11.5 mm). The pelvis of the operative limb tilted downward after CWHTO (−1.0°) and upward after OWHTO (2.1°). The mean parameters for functional lateral acetabular coverage significantly changed toward more coverage after CWHTO and less coverage after OWHTO (change in LCEA, acetabular index, sharp angle, and FHEI = 1.2°, −1.1°, −1.0°, and −0.7%, respectively, in CWHTO and −1.3°, 1.8°, 1.6°, and 2.7%, respectively, in OWHTO). When evaluating the appropriateness of each parameter for coverage, cases of conversions from undercoverage to appropriate coverage (1.9% to 4.7%) and appropriate to overcoverage (0.9% to 5.6%) after CWHTO and from overcoverage to appropriate coverage (0% to 8%) and appropriate to undercoverage (2% to 7%) after OWHTO were observed. Conclusion: The functional lateral acetabular coverage increased after CWHTO and decreased after OWHTO. Surgeons may want to consider the acetabular coverage of the ipsilateral hip joint when performing a unilateral high tibial osteotomy with a large correction.
The efficacy and safety of continuous blanket suture for severe recurrent pterygium with symblepharon
Authors: Ma Huixiang , Shen Jiahui , Chen Xuhao , Ye Xianfeng , Xu Shuxia , Zhang Zongduan 
Published: November 2024

Background: Managing recurrent pterygium combined with symblepharon presents significant challenges in ophthalmology. Clinicians aim to reconstruct the ocular surface, alleviate eye movement restrictions, and minimize recurrence risks. Objective: Evaluation of efficacy and safety of continuous blanket sutures (CBS) for fixation of large autologous conjunctival grafts in patients with severe recurrent pterygium with symblepharon. Methods: Retrospective, observational case series. Thirty-nine patients (40 eyes) were included, all with severe recurrent pterygium with symblepharon. During surgery, CBS was employed to affix large autologous conjunctival grafts to the exposed sclera, aiming to restore the ocular surface to smoothness as much as possible. All patients were followed up for more than one year. Main outcome measures include the rate of recurrence, improvement of eye movement, and intraoperative and postoperative complications. Results: Nearly all patients exhibited a smooth ocular surface and largely restored physiological structures during the follow-up period. There were no graft loss or contraction cases until the last follow-up, with only three eyes experiencing a pterygium recurrence (recurrence rate 7.5%, 3/40). Preoperative eye movement limitations improved significantly from 2.10 ± 0.71 (range 1–3) to 0.33 ± 0.53 (range 0–2; p < 0.001) post-surgery. Other postoperative complications included varying degrees of corneal scarring and a single instance of conjunctival granulomatous hyperplasia (1 eye, 2.5%). Conclusion: When addressing severe recurrent pterygium with Symblepharon, using CBS to secure large autologous conjunctival grafts during surgery can achieve favorable postoperative outcomes. This surgical method is safe and feasible and effectively rebuilds a smooth ocular surface, improves the appearance of the ocular surface, and reduces the recurrence rate of pterygium after excision.
Utility of patient-derived xenografts to evaluate drug sensitivity and select optimal treatments for individual non-small-cell lung cancer patients
Authors: Wang Xiaoqing , Zhu Ju , Li Lingling , Zhao Qilin , Huang Yutang , Wen Chunjie , Chen Dan , Wu Lanxiang 
Published: November 2024

Abstract
Background
Patient-derived xenograft (PDX) is currently considered a preferred preclinical model to evaluate drug sensitivity, explore drug resistance mechanisms, and select individualized treatment regimens.

Methods
Histopathological examination, immunohistochemistry and whole-exome sequencing confirmed similarity between our PDX tumors and primary tumors in terms of morphology and genetic characteristics. The drug reactivity of the PDX tumor was validated in vivo. The mechanisms of acquired resistance to Osimertinib PDX tumors were investigated by WES and WB.

Results
We successfully established 13 NSCLC-PDXs derived from 62 patients, including eight adenocarcinomas, four squamous-cell carcinoma, and one large-cell neuroendocrine carcinoma. Histological subtype and clinical stage were significant factors affecting the successful PDXs establishment. The treatment responses to conventional chemotherapy in PDXs were entirely consistent with that of their corresponding patients. According to the genetic status of tumors, more appropriate targeted agents were selected in PDXs for their corresponding patients as alternative treatment options. In addition, a PDX model with acquired resistance to osimertinib was induced, and the overactivation of RAS mitogen-activated protein kinase (MAPK)-extracellular signal-regulated kinase (ERK) signaling pathway caused by the dual-specificity phosphatase 6 (DUSP6) M62I mutation was found to play a key role in the development of osimertinib resistance. Trametinib, a specific inhibitor of the MAPK-ERK pathway significantly slowed down the tumor growth in osimertinib-resistant PDX models, providing an alternative treatment in patients after osimertinib failure.
Thinking on your feet: potentially enhancing phylogenetic tree learning accessibility through a kinaesthetic approach
Authors: Laurentino Telma G. , Scheller Meike , Glover Gillian , Proulx Michael J. , de Sousa Alexandra A. 
Published: November 2024

Abstract
Background
Phylogenetics is one of the main methodologies to understand cross-cutting principles of evolution, such as common ancestry and speciation. Phylogenetic trees, however, are reportedly challenging to teach and learn. Furthermore, phylogenetics teaching methods traditionally rely solely on visual information, creating inaccessibility for people with visual impairment. Sensory learning style models advocate for tailoring teaching to individual preferred sensory learning style. However, recent research suggests that optimal learning, independently of preferred learning style, depends on the types of transmitted information and learning tasks. The lack of empirically-supported education into the effectiveness of teaching phylogenetics through alternative sensory modalities potentially hinders learning. The aim of this study was to determine whether phylogenetic trees could be better understood if presented in kinaesthetic or multisensory teaching modalities.

Results
Participants (N = 52) self-assessed personal learning style and were randomly assigned to: visual, kinaesthetic or multisensory learning conditions. Phylogeny reading performance was better for both kinaesthetic and multisensory teaching conditions, compared to the visual teaching condition. There was no main effect and no interaction effect of personal learning style.

Conclusions
This study establishes a baseline for further research by suggesting that easy-to-implement kinaesthetic teaching modalities might support phylogenetic tree learning and reading. This has practical implications for evolution education and accessibility for students with visual impairment, underscoring the need to shift from vision-centric teaching paradigms towards evidence-based instructional strategies that accommodate sensory diversity.