bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of statistical methods for the analysis of patient-reported outcomes in randomised controlled trials: A simulation study
Authors: Qian Yirui , Walters Stephen J , Jacques Richard M , Flight Laura 
Published: October 2024

Patient-reported outcomes (PROs) that aim to measure patients’ subjective attitudes towards their health or health-related conditions in various fields have been increasingly used in randomised controlled trials (RCTs). PRO data is likely to be bounded, discrete, and skewed. Although various statistical methods are available for the analysis of PROs in RCT settings, there is no consensus on what statistical methods are the most appropriate for use. This study aims to use simulation methods to compare the performance (in terms of bias, empirical standard error, coverage of the confidence interval, Type I error, and power) of three different statistical methods, multiple linear regression (MLR), Tobit regression (Tobit), and median regression (Median), to estimate a range of predefined treatment effects for a PRO in a two-arm balanced RCT. We assumed there was an underlying latent continuous outcome that the PRO was measuring, but the actual scores observed were equally spaced and discrete. This study found that MLR was associated with little bias of the estimated treatment effect, small standard errors, and appropriate coverage of the confidence interval under most scenarios. Tobit performed worse than MLR for analysing PROs with a small number of levels, but it had better performance when analysing PROs with more discrete values. Median showed extremely large bias and errors, associated with low power and coverage for most scenarios especially when the number of possible discrete values was small. We recommend MLR as a simple and universal statistical method for the analysis of PROs in RCT settings.
Nurses’ adherence to ethical principles – A qualitative study
Authors: Wong Valery , Hassan Norasyikin , Wong Yoke Ping , Chua Sophia Yen Nee , Abdul Rahman Shaliza , Mohamad Mas Linda , Lim Siriwan 
Published: October 2024

Background Nursing is regulated by a set of professional standards. Whilst many forms of ethics apply to nursing, the biomedical ethical framework is common, involving autonomy, beneficence, non-maleficence and justice. In healthcare, nurses often encounter ethical dilemmas that require them to navigate conflicting ethical principles. However, how nurses adhere to these principles in such situations is unclear. Research Aim To explore how registered nurses adhere to ethical principles when dealing with ethical dilemmas at work. Research Design A qualitative descriptive study design. Participants and Research Context Between August and December 2023, 21 registered nurses were recruited from a teaching hospital through purposive sampling. Data were collected through semi-structured in-person interviews or online video conferencing. Braun and Clarke’s thematic analysis approach was employed to analyse the data. Ethical Considerations Interview participation was voluntary. Written consent was obtained before participation. Participants’ real identities were replaced with pseudonyms. This study was approved by the SingHealth Centralised Institutional Review Board. Findings The data analysis developed four major themes and 15 subthemes. The four major themes are “Addressing the dilemma,” “Contemplating the principles and consequences,” “Coordinating for well-informed, ethical decision,” and “Self-reflecting and finding consolation.” Conclusion This study explains how nurses navigate and uphold ethical principles when caring for patients to the best of their ability. Fully adhering to ethical principles can be challenging for caring for actively dying patients. Further research can expound on nurses’ experiences and adherence to ethical principles in complex clinical cases.
Uncovering the Therapeutic Target and Molecular Mechanism of Upadacitinib on Sjogren’s Syndrome
Authors: Yang Youguo , Liu Yuan , Li Xiaofen , Zeng Yongping , He Weiqian , Zhou Juan 
Published: October 2024

Objective: Upadacitinib, a selective Janus associated kinase 1 (JAK-1) inhibitor, can be prescribed particularly for the clinical treatment with Crohn’s disease or rheumatoid arthritis. It is clinically observed that upadacitinib has been found with potential therapeutic effectiveness on Sjogren’s syndrome (SS). However, the anti-SS targets and mechanisms involved in upadacitinib treatment remain uninvestigated. Materials and methods: Thus, this study was designed to identify therapeutic targets and mechanisms of upadacitinib for treating SS through conducting network pharmacology and molecular docking analyses. Results: In total, we identified 298 upadacitinib-related target genes, 1339 SS-related targets before collecting 56 overlapped target genes and 12 hub target genes. Upadacitinib largely exerted the critical biological processes including regulation of microenvironment homeostasis, inflammatory response, and cell apoptosis, and largely acted on pivotal molecular mechanisms including hypoxia-inducible factor 1 (HIF-1) signaling pathway, apoptosis pathway, phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway, or Th17 cell differentiation pathway. Molecular docking data suggested that upadacitinib exhibited the high affinities with signal transducer and activator of transcription 3 (STAT3), HIF1A, poly(ADP-ribose) polymerase 1 (PARP1) target proteins, in which the structural interactions between upadacitinib and STAT3, HIF1A, PARP1 showed potential therapeutic activities against SS. Conclusion: In conclusion, upadacitinib possesses the bright anti-inflammatory and anti-apoptotic activities on SS, and this study can provide a theoretical basis for clinical therapy of SS using upadacitinib.
Post-earthquake inspection of high-speed railway viaducts with multi-scale task interaction deep learning strategy
Authors: Shu Jiangpeng , Yang Han , Liu Gaoyang , Yu Hongchuan , Ning Yingjie , Bairán Jesús-Miguel 
Published: October 2024

Automated computer vision-based inspections of railway infrastructures, such as component type, damaged status, and location, have been investigated actively by resorting to task-specific deep learning models. However, task-specific models that fulfill these separate inspection tasks encountered bottlenecks in improving inference accuracy, and bring huge computational costs. Multi-task deep learning, which can fulfill these inspection tasks concurrently, has yet to be fully investigated in the context of structural inspection. In this study, a multi-scale task interaction deep learning strategy is presented towards component recognition, damage segmentation, and depth estimation for a comprehensive post-earthquake inspection of high-speed railway viaducts. Three modules for multi-scale task interaction were proposed to modify the multi-task deep neural network, taking full advantage of task commonalities at multiple scales. The proposed method was validated with a large-scale image dataset of high-speed railway viaducts. Component recognition and depth estimation were incorporated to implement multi-task learning since they have higher pattern affinities at multiple scales. Results reported that mean Intersection over Unions of testing samples of component and damage tasks were 91.2% and 72.1%, RMSE of depth estimation was 1.54 m. Compared with single-task cases, training time, inference duration, and FLOPs of the multi-task model were reduced by 23%, 30%, 27% respectively. Results showed improvement in both inference accuracy and training efficiency, substantiating the superiority of the proposed strategy.
Functional status following pulmonary rehabilitation in people with interstitial lung disease: A systematic review and meta-analysis
Authors: Rodrigues Guilherme , Santos Rute , Pinto Rita , Oliveira Ana , Marques Alda 
Published: October 2024

Background Individuals with interstitial lung disease (ILD) often experience worsening symptoms and activity avoidance. Limited data exists on outcome measures for assessing functional status (capacity and performance), as well as on the effectiveness of pulmonary rehabilitation (PR) in improving these outcomes in ILD. Aim This review aimed to systematically assess the effects of PR on both functional capacity and performance in individuals with ILD. Methods Randomised controlled trials involving pulmonary rehabilitation (PR) in adults with ILD, which included at least an exercise training component and education and/or psychosocial support, were included. Risk of bias and quality of evidence were assessed. Mean changes from baseline and standard deviations were retrieved for each group, and a random-effects model was applied. Results Eight studies were included, mostly involving individuals with idiopathic pulmonary fibrosis ( n = 5). PR duration ranged from 3 to 26 weeks. Seven studies used the 6MWT to evaluate functional capacity and one also used the 30-s STS. Two studies assessed functional performance, measuring time spent in moderate physical activity with the SenseWear Armband, number of steps per day with the same device, and energy expenditure in MET-min using the international physical activity questionnaire. PR improved functional capacity (6MWT-MD 45.82 m, 95%CI [26.14; 65.50], I2 = 71.54%, p < .001; 30-s STS- PR: 3.7 ± 2.6 reps; control group: −0.4 ± 2.5 reps, p < .001) compared to usual care. Only self-reported physical activity levels increased after PR (PR: 51.4 ± 57.7MET-min; control group: 20.9 ± 37.2MET-min, p = .03). Conclusion PR is effective at improving functional capacity; however, functional performance is often overlooked, resulting in limited and inconclusive findings.
Temperature Distribution on Classical Two Needles IRE Setup Versus a Single Needle Prototype
Authors: Jouni Ali , Baragona Marco , Pedersoli Federico , Ritter Andreas 
Published: October 2024

Objectives Irreversible Electroporation (IRE) is a non-thermal minimally invasive cancer therapy used in the treatment of liver tumors. However, the therapy entails an electrical current flux which can be high enough to cause a noticeable temperature increase. Therefore, the analysis of the heat distribution is important: during any IRE treatment, the target area is intended to be treated with non-thermal effects, where existing thermal effects should not damage nearby sensitive structures. This article aims to compare the established two parallel needles electrode setup, used by FDA-approved electroporation delivering devices, to a single needle, multiple electrode prototype design. Methods Levels and distributions of the temperature at different distances from the applicators during an IRE liver treatment were investigated. The prototype results were collated with already published in-vivo data. All electrode configurations were analyzed numerically in COMSOL Multiphysics for different pulse protocols. Results The extension of coagulation necrosis predicted by the model matched available in-vivo data. While the maximum average temperature during pulsation was higher for the prototype (74 °C) than for the two-needle IRE setup (57 °C), the thickness of the coagulation necrosis around the conductive electrodes was in the same range for both configurations. However, the location differed completely: the necrosis engendered by the prototype was located inside the tumor, while the two-needle IRE setup created necrosis outside the tumor, potentially closer to sensitive structures. Conclusion The results highlighted the importance of heat distribution analysis for the design of new IRE needles as well as for IRE treatment planning. Proper analysis ensures that the non-thermal effects are maximized while minimizing any potential thermal damage to surrounding sensitive structures.
The Efficacy of Internet-Based Cognitive Behavioral Therapy for Patients With Breast Cancer: A Systematic Review and Meta-Analysis
Authors: Yang Lihong , Hao Shujie , Tu Dongying , Gu Xiaolian , Chai Chunyan , Ding Huan , Gu Bin , Yang Xuefang 
Published: October 2024

Objective: To systematically review and analyze the effects of Internet-based cognitive behavioral therapy (ICBT) on physical, psychological, and daily life outcomes in patients with breast cancer. Methods: Relevant studies were retrieved from Wanfang, CBM, CNKI, CINAHL, PsycINFO, Web of Science, The Cochrane Central Register of Controlled Trials, Embase and PubMed from inception to December 2023. Two independent authors conducted the literature search and data extraction. The Cochrane bias risk assessment tool was used to evaluate the included studies for methodological quality, and the data analysis was performed using Stata (Version 15.0). Results: Among 700 records, 11 randomized controlled trials were identified in this study. The meta-analysis showed statistically significant effects of ICBT on depression (standardized mean difference (SMD) = −0.38, 95% confidence interval (CI): −0.70 to −0.06, P = .019) and insomnia severity (SMD = −0.71, 95% CI: −1.24 to −0.19, P = .008). However, there were no statistically significant effects on anxiety, fatigue, sleep quality and quality of life. Conclusions: ICBT appears to be effective for improving depression and reducing insomnia severity in patients with breast cancer, but the effects on anxiety, fatigue, sleep quality and quality of life are non-significant. This low-cost treatment needs to be further investigated. More randomized controlled trials with a larger sample size, strict study design and multiple follow-ups are required to determine the effects of ICBT on patients with breast cancer.
Exploring Facilitators and Barriers to STD/STI/HIV Self-Testing Among College Students in the United States: A Scoping Review
Authors: Reeves Jaquetta M. , Zigah Edem Yaw , Shamrock Osman W. , Khan Dhanyal , Batten Janene , Abu-Ba’are Gamji Rabiu , Nelson LaRon E. , Djiadeu Pascal 
Published: October 2024

Background: HIV affects 1.2 million Americans, with 20% of new diagnoses being 13 to 24-year-olds. Young adult college students are more likely than the general population of 18 to 24-year-olds in the U.S. to engage in sexual practices that increase their risk of STIs. Objectives: This scoping review explores factors that promote or hinder STD/STI/HIV self-testing among U.S. college students. Search Methods: A scoping review of original, experimental (randomized or nonrandomized), observational (longitudinal and cross-sectional), and qualitative or mixed-methods U.S. research was conducted using OVID Medline, OVID Embase, PubMed, CINAHL, Web of Science Core Collection, and Cochrane CENTRAL. English-language studies measured STD/STI/HIV self-test kits and college student testing. Selection Criteria: Inclusion and exclusion criteria were used to narrow down articles that addressed barriers and facilitators to STD/STI/HIV testing, and self-testing among college students in the U.S. Results: Database searches yielded 8,373 articles. After removing duplicates, 6173 items remained. After independent dual-title/abstract screening, 100 papers were full-text reviewed. Seven retrieved articles were unavailable, and 93 were selected for full-text screening. After reviewing the whole text, 89 papers did not fulfill the inclusion requirements and were deleted, leaving 4 articles in the final analysis. Conclusion: Additional research on self-testing among college students in the U.S. is urgently required. The results should guide university health policies on the need to cater to the unique requirements of college students by increasing the availability of healthcare and embracing STD/STI/HIV self-testing. This can enhance testing rates, diminish stigmas, and ultimately contribute to wider endeavors to reduce the transmission of infections in the U.S.
Dependent Adult Abuse Trends in Iowa, 1984 to 2023
Authors: Daly Jeanette M. , Ely John W. , Jogerst Gerald J. 
Published: October 2024

Introduction: Little is known about trends in the incidence of dependent adult abuse (DAA). Objectives: To determine the annual incidence of DAA in Iowa from 1984 to 2023. Trends in abuse rates were evaluated for their associations with calendar year, number of caseworkers and abuse laws, political party, and unemployment. Methods: Iowa Department of Health and Human Services DAA reports, investigations, and substantiations were analyzed. Report data were available for 10 years. Investigation and substantiation data were available for 40 years. Long-term trends over time were described and associations between abuse rates and number of caseworkers and abuse laws, political party, and unemployment were explored. Results: Both investigations and substantiations increased from 50 to 182 per 100 000 adults and 17 to 38 per 100 000 adults between 1984 and 2023, respectively. Increasing calendar year and Democratic party majority in the Iowa legislature were positively and independently associated with investigated and substantiated abuse rates. An inverse correlation between the proportion of reports that were investigated and the proportion of investigations that were substantiated (Spearman’s rho = −.81; P < .01) was found. Conclusions: During the 40-year study period, investigated and substantiated cases of DAA in Iowa have been steadily increasing.
Unsupervised Clustering of Adult Spinal Deformity Patterns Predicts Surgical and Patient-Reported Outcomes
Authors: Lafage Renaud , Song Junho , Elysee Jonathan , Fourman Mitchell S. , Smith Justin S. , Ames Christopher , Bess Shay , Daniels Alan H. , Gupta Munish , Hostin Richard , Kim Han Jo , Klineberg Eric , Mundis Gregory , Diebo Bassel G. , Shaffrey Christopher , Schwab Frank , Lafage Virginie , Burton Douglas ,   on behalf of International Spine Study Group
Published: October 2024

Study Design Retrospective cohort study. Objectives To evaluate whether different radiographic clusters of adult spinal deformity identified using artificial intelligence-based clustering are associated with distinct surgical outcomes. Methods Patients were classified based on the results of a previously conducted analysis that examined clusters of deformity, including Moderate Sagittal (Mod Sag), Severe Sagittal (Sev Sag), Coronal, and Hyper-Thoracic Kyphosis (Hyper-TK). The surgical data, HRQOL, and complication outcomes of these clusters were then compared. Results The final analysis included 1062 patients. Similar to published results on a different patient sample, Mod Sag and Sev Sag patients were older, more likely to have a history of previous spine surgery, and more disabled. By 2-year, all clusters improved in HRQOL and reached a similar rate of minimal clinically important difference (MCID). The Sev Sag cluster had the highest rate major complications (53% vs 34-40%), and complications leading to reoperation (29% vs 17-23%), implant failures (20% vs 8-11%), and operative complications (27% vs 10-17%). Coronal patients had the highest rate of pulmonary complications (9% vs 3-6%) but the lowest rate of X-ray imbalance (10% vs 19-21%). No significant differences were found in neurological complications, infection rate, gastrointestinal, or cardiac events (all P > .1). Kaplan-Meier survival curves demonstrated a lower time to first complications for the Sev Sag cluster. Conclusions All clusters of adult spinal deformity benefit similarly from surgery as they all achieved similar rates of MCID. Although the rates of complications varied among the clusters, the types of complications were not significantly different.
Changes in the prevalence of intellectual disability among 10-year-old children in Sweden during 2011 through 2021: a total population study
Authors: Morinaga Maki , Ahlqvist Viktor H. , Lundberg Michael , Hollander Anna-Clara , Rai Dheeraj , Magnusson Cecilia 
Published: October 2024

Abstract
Background
Recent studies have suggested an increasing prevalence of intellectual disability diagnoses in some countries. Our aim was to describe the trend in the prevalence of intellectual disability diagnoses in Sweden and explore whether associated sociodemographic and perinatal factors can explain changes in the prevalence.

Methods
We used a register-based nationwide cohort of residents in Sweden born between 2001 and 2011. We calculated the prevalence of intellectual disability diagnoses by age 10 for each birth cohort and the prevalence ratios in relation to the baseline year 2011, overall and by severity of intellectual disability, and comorbidity of autism and attention-deficit/hyperactivity disorder. The prevalence ratios were stratified and adjusted for associated sociodemographic and perinatal factors.

Results
Among 1,096,800 individuals, 8,577 were diagnosed with intellectual disability by age 10. Among these, 3,949 (46%) and 2,768 (32%) were also diagnosed with autism and attention-deficit/hyperactivity disorder, respectively, and 4% were diagnosed with profound, 8% severe, 20% moderate, 52% mild, and 16% other/unspecific intellectual disability. The recorded age-10 prevalence of intellectual disability diagnoses increased from 0.64% (95% confidence interval 0.59–0.69%) in 2011 to 1.00% (0.94–1.06%) in 2021, corresponding to an annual prevalence ratio of 1.04 (1.04–1.05). The increase was, however, restricted to mild, moderate, and other/unspecific intellectual disability diagnoses, while the trends for profound and severe intellectual disability diagnoses were stable. The increasing trend was perhaps less pronounced among females and children with diagnosed attention-deficit/hyperactivity disorder, but independent of the co-occurrence of autism. The prevalence ratios did not change with stratification or adjustment for other associated demographic and perinatal factors.

Conclusion
The recorded prevalence of diagnosed mild and moderate intellectual disability among 10-year-olds in Sweden has increased over the recent decade. This increase could not be explained by changes in associated sociodemographic or perinatal factors, including birth weight, gestational age, and parental age, migration status, and education at the child’s birth. The increase instead may be due to changes in diagnostic practices in Sweden over time.