bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paroxysmal sympathetic hyperactivity caused by neurosyphilis
Authors: Fujiki Shuko , Fujino Masaki , Machida Akira 
Published: October 2024

BackgroundParoxysmal sympathetic hyperactivity (PSH) is a condition characterised by dysregulation of the autonomic nervous system commonly associated with severe traumatic brain injury. Recently, non-traumatic causes, such as infections and autoimmune conditions, have also been reported as potential triggers.Case presentationA 30-year-old man presented with convulsions following 5 days of soliloquy, insomnia and agitation. Neurosyphilis was diagnosed based on elevated non-treponemal and treponemal test findings in the serum and cerebrospinal fluid. Intravenous penicillin administration improved his alertness; however, by day 9, he experienced recurrent episodes of tachycardia, tachypnoea, hyperthermia, hypertension, limb stiffness and diaphoresis. The exclusion of sepsis, pulmonary embolism and malignant syndrome, combined with unremarkable interictal electroencephalogram findings and a high PSH Assessment Measure Score, led to a PSH diagnosis on day 40. Treatment with propranolol, gabapentin and clonidine resolved the episodes, and the patient regained independent ambulation.ConclusionsThis is the first reported case of neurosyphilis accompanied by PSH. Although PSH is rare in central nervous system infections compared with traumatic brain injury, early recognition is crucial, as untreated cases can persist and result in severe complications.
Association of regular plasmapheresis donation with serum protein and electrolyte levels: a multicentre cross-sectional study in China
Authors: Xiao Guanglin , Li Changqing , Chen Yongjun , Song Wenfu , Yang Hui , Yang Yating , Zhang Yu , Pu Zhongping , Wang Xiufang , Xie Shina , Yang Shouqiang , Zeng Jun , Li Wan , Wang Ya 
Published: October 2024

BackgroundChina’s plasmapheresis donation policy differs from that of Western countries. The association between regular plasmapheresis donation and donor health in China is still unknown.ObjectivesTo investigate the association of regular plasmapheresis donation with serum protein and electrolyte levels and provide scientific evidence for policy improvement.DesignMulticentre cross-sectional study.Setting and participantsA total of 767 regular and 726 new donors from the provinces of Sichuan, Hunan, Henan and Yunnan were recruited from September 2021 to October 2022.Primary and secondary outcome measuresOur primary outcome focused on measuring the levels of serum protein and electrolyte levels, including total serum protein (TSP), IgG, albumin (Alb), haemoglobin (Hb), calcium, potassium (K+) and magnesium (Mg2+). The secondary outcome assessed their abnormal rates.ResultsMale and female donors in the high donation frequency group (>16 donations per year) exhibited lower IgG levels compared with new donors (p=0.008 for male donors and p=0.007 for female donors). Additionally, female donors with high donation frequency and a high total number of lifetime donations (>100 donations) had significantly lower Hb concentrations than new donors. However, no significant changes were observed in TSP, Alb, calcium, K+and Mg2+levels. There were also no statistically significant differences in the rates of abnormal protein and electrolyte values below the respective threshold levels between new and regular donors.ConclusionsPlasmapheresis donation is not associated with an increased risk of abnormalities in the analysed parameters. However, the results provide preliminary evidence supporting the routine inclusion of IgG screening for donors, as plasmapheresis donation is associated with a decrease in IgG levels. Particular attention should be paid to the Hb levels of female donors, especially those who donate frequently. Testing of TSP at each donation may not be necessary.
Piloting a PREMs and PROMs longitudinal survey on the integration of healthcare services for patients living with hepatitis C in Tuscany region: study protocol
Authors: Corazza Ilaria , Moretti Giaele , Ceccarelli Luca , Tavoschi Lara , Vainieri Milena 
Published: October 2024

IntroductionPatient-reported measures are an invaluable resource for health systems to improve the quality of healthcare services. Patients with hepatitis C virus (HCV) are an under-represented group within the stream of literature on collecting and using the experiences and outcomes reported by patients to improve healthcare performance. This protocol outlines the methodology to implement a longitudinal survey in Tuscany, Italy, to systematically gather patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) for patients with HCV, with a focus on the integration of primary and hospital care.Methods and analysisWe designed and developed a longitudinal survey to collect HCV PREMs and PROMs. The survey, which lasts 1 year, consists of three questionnaires, starting with the first visit with a specialist/treatment initiation, with follow-ups at 6 and 12 months. It was implemented in six hospitals in Tuscany, Italy, of which three are University Hospitals. The survey was offered to all patients treated for HCV at these healthcare centres, deliberately not applying a specific criterion for patient selection, through both paper based and electronic modes of completion. The data from the three structured questionnaires will be analysed quantitatively.Ethics and disseminationThe Ethics Committee for Clinical Experimentation of Area Vasta Nord Ovest approved the protocol (CEAVNO—CODE 18829). Participation in this study is voluntary. Study results will be disseminated through peer-reviewed publications and academic conferences.
Modified tai chi movement training based on sEMG and movement analysis on improving upper extremities motor function: a protocol for a clinical randomised controlled trial
Authors: Li Zhi , Li Xiaoyi , Fu Xueming , Zhou Ting , Wang Pei , Fang Leiwen , Sun Zihan , Wang Hongxing 
Published: October 2024

IntroductionStroke survivors often face motor dysfunction, increasing fall risk. Lower extremity muscle weakness is a key factor affecting walking ability. Tai chi (TC) has been shown to improve muscle strength and mobility in patients with stroke more effectively than traditional walking training. However, existing TC programmes for stroke rehabilitation are often too simplified and fail to fully use TC’s benefits. Additionally, subjective assessment scales are time-consuming and prone to bias. This study proposes integrating TC’s early movement features with neurodevelopmental therapy, using surface electromyography and inertial measurement unit (IMU) sensors to thoroughly analyse diverse TC movements. Tailored exercises, based on stroke-induced impairments, will be objectively assessed through biomechanical analysis.Methods and analysisThe study unfolds in two phases. The initial phase employs the IMU sensor and electromyography to objectively analyse TC’s biomechanics, informing personalised rehabilitation plans aligned with distinct movement impairments. The second phase adopts a randomised, single-blind, parallel controlled trial design involving 60 patients with stroke randomly assigned to either the intervention or control group. The intervention group undergoes biomechanics-based TC training alongside routine rehabilitation for 12 weeks, practicing the 24-form TC three times weekly. The control group engages in routine rehabilitation thrice weekly for the same duration. Primary and secondary outcomes, including kinematic/dynamic data, surface electromyography, motion analysis, comprehensive the international classification of functioning, disability and health Core Set for Stroke, Modified Barthel Index and Fugl-Meyer Assessment, will be evaluated at baseline and post-intervention.Ethics and disseminationThe study has received approval from the Ethics Committee of Zhongda Hospital Southeast University (2023ZDSYLL378-P01). All prospective participants will receive comprehensive information regarding the study protocol, and their informed consent will be obtained before their participation. Additionally, the trial will be registered with the Chinese Clinical Trial Registry to ensure transparency and compliance with research regulations. Results from this study will be disseminated through peer-reviewed journals, conference presentations and public databases to ensure wide accessibility and to contribute to the advancement of medical knowledge.Protocol version2.0 (14 June 2024).Trial registration numberwww.chictr.org.cn, identifier ChiCTR2400080158.
ABO blood types and head and neck cancer: a systematic review with meta-analysis of observational studies
Authors: Shi Hanbo , Yao Jingjing , Jiang Chenchen , Xu Wenying , Jiang Zhongliang , Chen Yan , Qian Yun 
Published: October 2024

ObjectivesThis research aims to explore the correlation between ABO blood groups and neoplasms in the head and neck region, specifically investigating the susceptibility of different blood groups to tumours.DesignSystematic review and meta-analysis.Data sourcesCNKI, WANFANG DATA, PubMed, Web of Science and Embase databases were systematically searched from inception to January 2024.Eligibility criteriaAll studies of ABO blood type and head and neck tumours will be included in this study.Data extraction and synthesisA systematic literature review was performed using digital platforms on CNKI, WANFANG DATA, PubMed, Web of Science and Embase databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for meta-analysis. Two authors independently extracted the data and assessed the quality of included studies. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. Comparisons were made between blood types A, B, AB and their combined group versus O, along with subgroup analyses. Systematic analysis was performed by using Review Manager V.5.4 and Stata V.18 statistical software.Results30 articles were included, involving 737 506 subjects, among which 21 382 were patients with head and neck tumours. The overall analysis indicated a significant association between type AB blood (OR 0.762, 95% CI 0.637 to 0.910) and a reduced risk of head and neck tumours. In the Caucasoid race, type A blood is significantly linked to an elevated likelihood of head and neck tumours (OR 1.353, 95% CI 1.076 to 1.702), while in the Mongoloid race, type AB blood is significantly linked to a reduced likelihood of developing tumours in the head and neck area (OR= 0.732, 95% CI 0.588 to 0.910). No significant associations were found in the subgroup analysis by gender. Regarding different types of cancer, type A blood is significantly associated with an increased risk of salivary gland tumours (OR 1.338, 95% CI 1.075 to 1.665), and type AB blood is significantly linked to a lower likelihood of nasopharyngeal carcinoma (OR 0.590, 95% CI 0.429 to 0.812).ConclusionA correlation exists between ABO blood groups and tumours in the head and neck region. However, the link between blood type and head and neck tumours requires further confirmation through more prospective studies.PROSPERO registration numberCRD42024510176.
Metabolic and bariatric surgery for obstructive sleep apnoea syndrome: bibliometric analysis and visualisation from 1999 to 2023
Authors: Jiang Tao , Zhang Xuan , Wang Hui , Yi Xianhao 
Published: October 2024

ObjectivesMetabolic and bariatric surgery (MBS) for obstructive sleep apnoea syndrome (OSAS) has garnered significant research interest. The main aim of this study was to analyse the unique characteristics of publications centred around MBS for OSAS. We aimed to provide valuable insights into the present status of the field and offer predictions regarding future trends.DesignBibliometric analysis through science mapping and performance analysis methods.Data sourcesScientific articles.Data extraction and synthesisA comprehensive search was conducted in the Web of Science database to retrieve publications on MBS for OSAS within the time frame of 1999–2023. The search was performed using keywords such as “Obstructive Sleep Apnea syndrome”, “OSAS”, “metabolic surgery” and “bariatric surgery” to identify relevant papers. To analyse the bibliometric characteristics of these publications, VOSviewer and R software were used. This analysis encompassed various aspects, including the number of publications, contributions by different countries and institutions, the most cited author, journal publications, citation frequency and the identification of keywords related to popular scientific fields.Results1264 papers on MBS for OSAS were identified and are currently in a stage of rapid growth. The relevant study involved 1230 institutions from 53 different countries, with the USA topping the field with 465 publications contributed. Assistance Publique Hopitaux Paris proved to be the most productive institution, with De Vries N posting the highest number of papers (n=24). The most prolific journal wasObesity Surgery, with 241 publications. Keywords “Bariatric surgery”, “Obstructive sleep apnea”, “Obesity”, “Weight loss” and “Morbid obesity” have the highest frequency of occurrence.ConclusionsThe relationship between obesity and OSAS, various metabolic surgical techniques, and the mechanism of MBS for OSAS will continue to be related areas of frontiers. Furthermore, while there has been a gradual increase in basic research, the mechanisms involved and the long-term efficacy of bariatric MBS for OSAS still require further investigation. It is anticipated that these research areas may emerge as potential hot topics in the future.
Analysis and validation of clinical subgroups of Kawasaki disease in children in China: a retrospective study
Authors: Gong Chuxiong , Liu Kai , Li Bin , Li Yamin , Gao Huiqing , Wang Ziyu , Fu Yanan , Gao Lin , Hu Linzhen , Wang Yanchun , Wang Meifen , Zhao Bo , Liu Xiaomei 
Published: October 2024

ObjectiveAlthough Kawasaki disease (KD) is commonly regarded as a single disease entity, clinical subgroups have recently been described. We aimed to validate previous research on clinical subgroups and establish a KD subgroup differentiation model specific to China.MethodsWe analysed clinical data of 1682 patients diagnosed with KD at the Kunming Children’s Hospital from December 2014 to December 2022. We performed principal component analysis and hierarchical clustering on 13 continuous variables. Then, we grouped the patients based on the optimal number of clusters and analysed the clinical characteristics of each subgroup.ResultsWe ultimately identified three subgroups. In cluster 1, younger patients predominantly exhibited the highest risk of coronary artery aneurysm and the lowest rate of intravenous immunoglobulin resistance. Cluster 2 was characterised by high inflammatory markers and a lowered risk of coronary artery aneurysm. Cluster 3 was characterised by liver involvement, with significant elevations in liver enzymes, gamma-glutamyl transferase and total bilirubin. We found a positive correlation between the ratio of the rising trend and intravenous immunoglobulin resistance. Cluster 1 and cluster 3 shared similarities with the previously identified younger age subgroup and liver subgroup, respectively, whereas cluster 2 was unique to our study.ConclusionsOur study preliminarily validated a previous KD subgroup study and established a KD subgroup model in China.
Through the patients’ eyes: psychometric evaluation of the 64-item version of the Experienced Patient-Centeredness Questionnaire (EPAT-64)
Authors: Christalle Eva , Zeh Stefan , Führes Hannah , Schellhorn Alica , Hahlweg Pola , Zill Jördis Maria , Härter Martin , Bokemeyer Carsten , Gallinat Jürgen , Gebhardt Christoffer , Magnussen Christina , Müller Volkmar , Schmalstieg-Bahr Katharina , Strahl André , Kriston Levente , Scholl Isabelle 
Published: October 2024

BackgroundPatient-reported experience measures (PREMs) are valuable tools to evaluate patient-centredness (PC) from the patients’ perspective. Despite their utility, a comprehensive PREM addressing PC has been lacking. To bridge this gap, we developed the preliminary version of the Experienced Patient-Centeredness Questionnaire (EPAT), a disease-generic tool based on the integrative model of PC comprising 16 dimensions. It demonstrated content validity. This study aimed to test its psychometric properties and to develop a final 64-item version (EPAT-64).MethodsIn this cross-sectional study, we included adult patients treated for cardiovascular diseases, cancer, musculoskeletal diseases and mental disorders in inpatient or outpatient settings in Germany. For each dimension of PC, we selected four items based on item characteristics such as item difficulty and corrected item–total correlation. We tested structural validity using confirmatory factor analysis, examined reliability by McDonald’s Omega and tested construct validity by examining correlations with general health status and satisfaction with care.ResultsAnalysis of data from 2.024 patients showed excellent acceptance and acceptable item–total correlations for all EPAT-64 items, with few items demonstrating ceiling effects. The confirmatory factor analysis indicated the best fit for a bifactor model, where each item loaded on both a general factor and a dimension-specific factor. Omega showed high reliability for the general factor, while varying for specific dimensions. Construct validity was confirmed by absence of strong correlations with general health status and a strong correlation of the general factor with satisfaction with care.ConclusionsEPAT-64 demonstrated commendable psychometric properties. This tool allows comprehensive assessment of PC, offering flexibility to users who can measure each dimension with a four-item module or choose modules based on their needs. EPAT-64 serves multiple purposes, including quality improvement and evaluation of interventions aiming to enhance PC. Its versatility empowers users in diverse healthcare settings.
Finding a way in and making it stick: an exploration of chiropractor experiences working in team-oriented elite sport practice settings
Authors: Myburgh Corrie , Lee Alexander D , Kazemi Mohsen , Howarth Samuel , Hill Jacob , Mior Silvano 
Published: October 2024

Interprofessional healthcare teams have become the benchmark for optimising athlete health and performance in high-stakes sports. Despite a history of utility as provider partners, chiropractors are currently a relatively underutilised human resource in this rapidly developing and challenging field. Consequently, our study explored the global experiences and distinct perspectives of elite-level career sports chiropractors.Through a qualitative explorative single case study, we purposively sampled and interviewed 15 chiropractors active in elite-level athletic contexts.‘Professional characteristics and competencies’, ‘Running the gamut of professional career development’ and ‘Navigating team development in a small organisational structure’ emerged as the three key themes from the data.Our data indicate that chiropractors gain provider as members of the elite athletic health and performance management team as multirole manual medicine practitioners. However, thriving in a team-oriented practice, this context appears to be reliant on their capacity for development as part of a small organisational group.
Nurse practitioner medication abortion providers in Canada: results from a national survey
Authors: Stirling-Cameron Emma , Carson Andrea , Abdulai Abdul-Fatawu , Martin-Misener Ruth , Renner Regina , Ennis Madeleine , Norman Wendy V 
Published: October 2024

BackgroundIn 2017, nurse practitioners (NPs) became the first non-physician healthcare providers authorised to independently provide medication abortion (MA) in Canada. We aimed to report on demographic and clinical characteristics of NPs providing mifepristone/misoprostol MA in Canada and to identify context-specific barriers and enablers to NP provision of mifepristone/misoprostol MA in Canada among MA providers and non-providers.MethodsFrom August 2020 to February 2021, we invited Canadian NPs to complete a national, web-based, bilingual (English/French) survey. The survey was distributed through national and provincial nursing associations and national abortion health professional organisations. We collected demographic and clinical care characteristics and present descriptive statistics and bivariate analyses to compare the experiences of NP providers and non-providers of MA.ResultsThe 181 respondents represented all Canadian provinces and territories. Sixty-five NPs (36%) had provided MA at the time of the survey and 116 (64%) had not. Nearly half (47%) of respondents worked in rural or remote communities and 81% in primary care clinics. Significant barriers impacting non-providers’ abilities to provide MA included limited proximity to a pharmacy that dispensed mifepristone/misoprostol, few experienced abortion providers in their community of practice, poor access to procedural abortion services, policy restrictions in NPs’ places of employment, and no access to clinical mentorship. Some 98% of NPs providing MA services had never encountered anti-choice protest activity.ConclusionsNPs appear prepared and able to provide MA, yet barriers remain, particularly for NPs in smaller, lower-resourced communities. Our findings inform the development of supports for NPs in this new practice to improve abortion access in Canada.
Physiological monitoring of movement and manoeuvrability during a military skiing exercise
Authors: Chatterjee Tirthankar , Bhattacharyya D 
Published: October 2024

IntroductionMilitary forces receive training in various high-altitude warfare techniques to safeguard border regions and lives. Skiing is one of such practices where research evidences are limited. Therefore, a study was conducted to continuously monitor the physiological status of soldiers during military skiing practice to quantify the actual demands.Methods11 Indian soldiers skied a distance of 8 km while carrying 18 kg of military equipment. Physiological status and heart rate variability (HRV) were continuously recorded throughout the exercise. The participants completed the event in about 3 hours. The icy track consisted of about 50% upward slopes, 40% downward slopes and only 10% of flat surface. The full data set was divided into four phases (45 min each), to understand the degree of changes in physiological, and autonomic responses with progress in time and intensity. Repeated measures analysis of variance was used to examine the degree of significance between the phases.ResultsPhysiological factors including HR rose consistently from the first to the fourth phase, increasing from 116 to 150 beats/min. The peak acceleration was maintained within 0.4–0.6 g and ground speed varied from 0 to 14.8 km/hour, respectively. The time domain parameters decreased steadily from pre-exercise to the first half of the event, then slightly increased at the beginning of the second half before decreasing again during the final part. The low frequency increased during the first half and remained low until the end of the second half, while the high frequency exhibited an exactly opposite pattern.ConclusionThe HRV data indicated parasympathetic withdrawal and sympathetic activation in first half, primarily due to the uphill climb. The third phase featured with the flatter surface, which increased the speed and led to partial parasympathetic activation. The final incline caused a rise in physiological responses and sympathetic dominance. Persistent cold, exposure to hypoxia and job requirements ensured that the physiological variables remained at a ‘moderately’ high level.