bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inflammatory Neuropathy Consortium base (INCbase): a protocol of a global prospective observational cohort study for the development of a prediction model for treatment response in chronic inflammatory demyelinating polyneuropathy
Authors: Michael Milou R. , Wieske Luuk , Allen Jeffrey A. , Lunn Michael P. , Doppler Kathrin , Tan Cheng-Yin , Koike Haruki , Markvardsen Lars K. , Kapoor Mahima , Hsieh Sung-Tsang , Nobile-Orazio Eduardo , Jacobs Bart C. , Rajabally Yusuf A. , Basta Ivana , Ripellino Paolo , Querol Luis , Eftimov Filip ,   on behalf of the INCbase Consortium, Querol Luis , Gutiérrez-Gutiérrez Gerardo , Pascual Ivonne Jericó , Sevilla Teresa , Moris German , Martinez-Hernandez Eugenia , Llaurado-Gayete Arnau , Theaudin Marie , Humm Andrea , Hundsberger Thomas , Nagy Sara , Lascano Agustina , Sung Jia-Ying , Ro Long-Sun , Lai Kuan-Lin , Hoke Ahmet , Pasnoor Mamatha , Stino Amro M. , Gable Karissa , Vytopil Michal , Castro Diana 
Published: October 2024

Abstract
Background
INCbase is an international, multicenter prospective observational study using a customizable web-based modular registry to study the clinical, biological and electrophysiological variation and boundaries of chronic inflammatory demyelinating polyneuropathy (CIDP). The primary objective of INCbase is to develop and validate a clinical prediction model for treatment response.

Methods
All patients meeting clinical criteria for CIDP can be included in INCbase. Collected data include demographics, clinical history, diagnostics and various domains of clinical outcomes. Data is collected at a minimum of every 6 months for two years, and more frequently at the discretion of the investigational site to allow for assessment of unexpected changes in treatment response or clinical status. Participants can be enrolled in various sub-studies designed to capture data relevant to specific groups of interest. Data is entered directly into the web-based data entry system by local investigators and/or participants. Collection and local storage of biomaterial is optional. To develop a clinical prediction model for treatment response, newly diagnosed patients with active disease warranting start of first-line treatment will be included. The study population will be split into a development and validation cohort. Univariate and multivariate logistic regression analysis will be used to identify and combine predictors at start of treatment for treatment response at six months. Model performance will be assessed through discrimination and calibration in an external validation cohort. The externally validated prediction model will be made available to researchers and clinicians on the INCbase website.

Discussion
With this study, we aim to create a clinically relevant and implementable prediction model for treatment response to first line treatments in CIDP. INCbase enrollment started in April 2021, with 29 centers across 8 countries and 303 patients participating to date. This collaborative effort between academia, patient advocacy organizations and pharmaceutical industry will deepen our understanding of how to diagnose and treat CIDP.
Identifying distinct phenotypes of patients with juvenile systemic lupus erythematosus: results from a cluster analysis by the Egyptian college of rheumatology (ECR) study group
Authors: Hammam Nevin , Gheita Tamer A , Bakhiet Ali , Mahmoud Mohamed Bakry , Owaidy Rasha El , Nabi Hend Abdel , Elsaman Ahmed M , Khalifa Iman , ElBaky Abeer M Nour ElDin Abd , Ismail Faten , Hassan Eman , El Shereef Rawhya R , El-Gazzar Iman I , Moshrif Abdelhfeez , Khalil Noha M , Amer Marwa A , Fathy Hanan M , Salam Nancy Abdel , Elazeem Mervat I Abd , Hammam Osman , Fathi Hanan M , Tharwat Samar 
Published: October 2024

Abstract
Purpose
Juvenile systemic lupus erythematosus (J-SLE) is a complex, heterogeneous disease affecting multiple organs. However, the classification of its subgroups is still debated. Therefore, we investigated the aggregated clinical features in patients with J-SLE using cluster analysis. Methods: Patients (≤ 16 years) diagnosed using the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria were identified from the clinical database of the Egyptian College of Rheumatology (ECR) SLE study group. Demographic data, clinical characteristics, laboratory features, and current therapies were selected. A cluster analysis was performed to identify different clinical phenotypes. Results: Overall, 404 patients, of whom 355 (87.9%) were female, had a mean age at diagnosis of 11.2 years and a mean disease duration of 2.3 years. We identified four distinct subsets of patients. Patients in cluster 1 (n = 103, 25.5%) were characterized predominantly by mucocutaneous and neurologic manifestations. Patients in cluster 2 (n = 101, 25%) were more likely to have arthritis and pulmonary manifestations. Cluster 3 (n = 71, 17.6%) had the lowest prevalence of arthritis and lupus nephritis (LN), indicative of mild disease intensity. Patients in cluster 4 (n = 129, 31.9%) have the highest frequency of arthritis, vasculitis, and LN. Cluster 1 and 4 patients had the highest disease activity index score and were less likely to use low-dose aspirin (LDA). The SLE damage index was comparable across clusters. Conclusions: Four identified J-SLE clusters express distinct clinical phenotypes. Attention should be paid to including LDA in the therapeutic regimen for J-SLE. Further work is needed to replicate and clarify the phenotype patterns in J-SLE.
The effect of nurse health literacy interventions on patient health literacy scores in specialty consultations: a quasi-experimental study
Authors: McCaskill Angela , Gasch-Gallen Angel , Montero-Marco Jesica 
Published: October 2024

Abstract
Background
Patient health literacy (HL) affects health and wellbeing on both individual and population levels. The ability to receive, understand, manage and act upon health information can be positively influenced by nurses’ use of HL strategies. This study examined the relationship between nurses’ use of a HL checklist (intervention) and before and after patient HL scores, and the effects of frequency and types of strategies used in specialty consultations in Spain.

Methods
This quasi-experimental, non-randomized study used the HLS19-Q12 to calculate HL scores for 149 patients. Calculations were performed both before and after a nursing intervention that consisted of using a HL checklist. Paired samples t-test assessed the difference between patient HL scores pre- and post-nurse intervention. Frequency analysis and Pearson correlation where used to examine frequencies of nursing HL strategies used and associations with HL scores.

Results
The mean difference between the HLS19-Q12 scores before and after intervention was − 9.94, with a standard deviation of 11.50. There was a statistically significant effect of the intervention on HL score (t = -10.00, p < 0.001). No participant had HL classified as ‘inadequate’ after the nursing intervention. Verbal teach back method was the most frequent strategy used by nurses, and the use of a computer image was the most frequent visual aid.

Conclusions
The use of a standardized HL intervention by nurses was shown to have a positive effect on patient general HL scores in specialty consultations in Spain. These results not only suggest that the use of a HL checklist can be an effective HL tool, but also reinforce the potential of nurses to make a positive impact on both individual and population health. Overall, these findings provide data that can be used by health systems, hospitals management, and nurse education programs to adopt strategies to improve patient HL and health outcomes, while potentially lowering costs and ineffective resource utilization related to inadequate HL.
Bilateral adrenal hemorrhage in a postpartum woman with multiple thromboemboli: A case report
Authors: Jiang Anna Yi Nan , Abasszade Joshua Haron , Abrahams Timothy , Nan Kirollos , Low Michael Sze Yuan , Barnes Sara Laura , Lim Ann Nee , Shen Jimmy Zhen Long 
Published: October 2024

Abstract
Background
Bilateral adrenal hemorrhage is a rare but often a fatal cause of primary adrenal insufficiency that can result in adrenal crisis if not identified and managed appropriately.

Case presentation
We present a case of a 27-year-old Caucasian female who was admitted to the hospital 17 days postpartum with pleuritic chest and flank pain, shortness of breath and nausea. Computed tomography imaging confirmed multiple thromboemboli including pulmonary emboli and noted bilateral bulky adrenal glands. She was managed for infection and pulmonary emboli; however, she complained of persistent headaches, nausea, and vomiting despite appropriate management. Radiology re-review found the computed tomography imaging was consistent with bilateral adrenal hemorrhage in hindsight. Subsequent endocrine evaluation with hypothalamic–pituitary–adrenal axis interrogation and adrenocorticotropic hormone (Synacthen) stimulation testing confirmed resultant primary adrenal insufficiency. She required urgent intravenous hydrocortisone and was subsequently discharged on oral adrenal replacement therapy and anticoagulation.

Conclusions
Delay in identification and treatment of adrenal insufficiency can lead to catastrophic outcomes. This case highlights the challenge of diagnosing bilateral adrenal hemorrhage and resultant adrenal insufficiency as patients may not present with the classic risk factors, signs, symptoms, and electrolyte derangements.
Divergent interpretations of child abuse in legal judgments: perspectives from clinicians and forensic experts
Authors: Tang Ching-Min , Lou Chen-Fang , Hsia Shao-Hsuan , Liang Kuang-Tsung , Chang Wen , Lin Jainn-Jim , Chan Oi-Wa , Lin Kuang-Lin , Lee En-Pei 
Published: October 2024

Abstract
Background
Child abuse in Taiwan is a major societal concern that severely affects the well-being of children. Despite the complexity in detecting abuse, reports of child abuse are increasing, evidenced by a rise in cases and heightened awareness. This study utilizes judicial judgments as a lens to understand the varied interpretations of child abuse by clinical and forensic experts and explores the broader epidemiological trends of such abuse within the declining youth population of Taiwan.

Methods
We conducted a retrospective study by analyzing official court judgments on child abuse allegations judged from 2008 to 2022 from the online database of Judicial Yuan. Furthermore, the study analyzed demographic factors, injury patterns, and opinions from various experts.

Results
The results reveal that severe criminal cases of child abuse predominantly involve biological fathers as the primary offenders and physical abuse as the most common form of maltreatment. Victims are typically aged less than 5 years, which frequently leads to an unfavorable prognosis. Analysis also highlights the TEN-4-FACESp acronym as a highly predictive indicator of child abuse and underscores the prevalence of abusive head trauma (AHT). Moreover, the findings emphasize ongoing disparities in opinions between forensic medical examiners and clinical physicians, especially in AHT cases, which potentially influences judicial decisions.

Conclusions
In summary, the study reveals ongoing disagreements between forensic medical examiners and clinical physicians, especially in cases of AHT, which may impact judicial decisions. Promoting consensus through interdisciplinary collaboration and improved communication can aid in revealing the truth in child abuse cases.
A Comparison of Remimazolam versus Propofol on Blood Pressure Changes During Therapeutic Endoscopic Retrograde Cholangiopancreatography: A Randomized Controlled Trial
Authors: Xiao Yan-Ying , Zou Hai-Ding , Qin Xiu-Nan , Zhu Rong , Dai Ru-Ping 
Published: October 2024

BACKGROUND:
Intraoperative hypotension is the most common adverse event in endoscopic retrograde cholangiopancreatography (ERCP) and is usually attributed to the vasodilatory effect of the anesthetic. The aim of this randomized controlled trial was to evaluate the impact of remimazolam versus propofol on blood pressure changes during the therapeutic ERCP procedure.

METHODS:
Adult patients scheduled for elective therapeutic ERCP were randomized to receive either remimazolam or propofol anesthesia (40 patients in each group). The primary outcomes included the change in mean arterial pressure (MAP) during induction and the area under the baseline (AUB), calculated as the blood pressure below baseline multiplied by the duration, throughout the procedure. These measures, respectively, indicated the severity of blood pressure decrease during anesthesia induction and the overall impact of blood pressure changes throughout the procedure. Any incidences of hypotension, defined as MAP <65 mm Hg for at least 1 minute, were recorded. The recovery time and any adverse events were also reported.

RESULTS:
The change in MAP after induction was smaller in the remimazolam group compared to the propofol group (−7.5 [−14.0 to 0] mm Hg vs −25.0 [−33.8 to −14.3] mm Hg), with a median difference of 17.0 mm Hg (95% confidence interval [CI], 12.0–22.0; P <.001). The AUB in the remimazolam group was less than in the propofol group (−373 [−82 to −854] mm Hg·min vs −705 [−272 to −1100] mm Hg·min), with a median difference of 255 mm Hg·min (95% CI, 29–477; P =.021). The incidence of hypotension was significantly lower for remimazolam than propofol (5% vs 30%; P =.006). There were no serious adverse events in either group.

CONCLUSIONS:
Remimazolam may be considered as an alternative to propofol for general anesthesia during therapeutic ERCP procedures, with the potential advantage of stable hemodynamics.
New Insights on Cord Attachment and Social Hierarchy in Six Khipus from the Santa Valley, Peru
Authors: FitzPatrick Mackinley 
Published: October 2024

Abstract
This article analyzes the potential khipu-document “match” involving six Inka-style khipus from Peru’s Santa Valley that record data similar to a 1670 colonial census of San Pedro de Corongo. Despite its potential as a breakthrough in khipu decipherment, crucial details surrounding these potential “Rosetta khipus” and their associated colonial document have been left out, overlooked, or confused in the literature. This article’s objective is to synthesize and evaluate what is known about this khipu-document “match” while also using combinatorics to identify an optimal moiety alignment for the six lineage groups listed in the 1670 census. This novel moiety alignment differs from the one proposed in 2018 by Manuel Medrano and Gary Urton and is supported by additional structures found in the six khipus. This discovery could lead to a broader understanding of the social hierarchy of San Pedro de Corongo in 1670, as well as an expanded reading of the six Santa Valley khipus. Furthermore, this study presents the first-ever identification of recto and verso cord attachment knot orientations being used as a marked and unmarked sign, respectively. This article’s findings provide a significant contribution toward the ongoing decipherment of nonnumerical khipu signs.
Advanced practitioners working with older people in primary care and community settings: a survey of roles and use of technology
Authors: Febrey Samantha , Frost Julia , Hall Abi J , Morley Naomi , Whitney Julie , Johnston Vicky , Wilson Payal , Kilgore Cliff , Goodwin Victoria A 
Published: October 2024

Background: Advanced practitioner (AP) roles are becoming increasingly common in primary care and community settings for supporting older people and those living with frailty. Aims: The aim of this study was to explore health and social work AP roles in primary care and community settings in the UK, and understand how they support older people and factors that may impact on APs use of technology in practice. Methods: A cross-sectional, web-based survey was adopted to explore the views and perspectives of APs. Results: The survey received 111 responses. There were different views as to whether technology was suitable for older people. Although digital exclusion was a concern, it was perceived that this would change in the future as generations become more digitally literate. Respondents suggested that using technology brought about efficiencies and the ability to respond sooner to symptom changes, with some concerns mentioned regarding the accuracy of technology that may miss signs and symptoms. Conclusion: This is the first national survey to explore advanced practice roles with older people in non-hospital settings. While APs have wide-ranging skills, few use technology in their practice. Findings will inform a future study on digitally enhanced comprehensive geriatric assessments.
Physiotherapy advanced clinical practitioners in an inpatient medical team: opportunities and challenges
Authors: Connolly Alexandra 
Published: October 2024

Background: Physiotherapy advanced clinical practitioners (ACPs) working within inpatient medical teams are being used to deliver healthcare in community hospitals. Little is known about how physiotherapists working in this type of role impact, and are viewed by, ward staff. Aim: To explore ward staffs' experience of physiotherapy ACPs working in an inpatient medical team in a community hospital setting. Method: An interview-based questionnaire was completed by 16 participants from the multi-disciplinary team between November 2022 and January 2023 across three community hospitals. All 16 participants worked directly with physiotherapy ACPs. Data were collected and analysed using the Braun and Clarke (2006) thematic analysis six-step model for pattern recognition. Findings: A total of four themes (‘inpatient ACPs are all the same’; ‘missing opportunities?’; ‘a great asset’; and ‘challenges’) and eight subthemes (medical role, generic role, underutilisation, innovation potential, improved patient care, team enhancement, prescribing, and role confusion) were identified. Conclusion: Physiotherapy ACPs provide general medical care to patients in the community hospital setting. They are an asset to the inpatient medical team, particularly in driving the importance of rehabilitation in this setting. The physiotherapy ACPs encountered profession-specific barriers around prescribing, which negatively impacted their ability to fulfil this role.
Prognostic value of isolated tumor cells and micrometastasis of lymph nodes in invasive urinary bladder cancer
Authors: Cheong Harin , Yoo Youngeun , Sung Sun Hee , Park Sanghui , Lee Dong Hyeon , Kong Kyoung Ae , Park Heae Surng , Cho Min-Sun 
Published: October 2024

Introduction
The prognostic significance of nodal micrometastasis and isolated tumor cells (ITC) in urinary bladder cancer (UBC) is unknown. We aimed to evaluate the prevalence, clinical impact, and clinicopathological characteristics of nodal micrometastasis and ITC in UBC.

Materials and methods
A total of 124 patients with UBC undergoing surgery were investigated. Detection of micrometastasis and ITC was performed using pancytokeratin immunohistochemistry (IHC). Histopathologic and clinical findings were correlated with patients’ outcome.

Result
IHC detected nodal micrometastasis and ITC (pNmi group) in 12.9% (13/101) of originally node-negative patients and in 26.1% (6/23) of originally node-positive patients (pN+ group). The remaining 88 were truly node-negative patients (pN0 group). After IHC, all 13 patients in the pNmi group were upstaged from pN0 to pN1-2 and one patient in the pN+ group was changed from pN1 to pN2. Nodal micrometastasis and ITC were significantly associated with mixed urothelial carcinoma (UC) (p = 0.002), UC with discohesive pattern (p = 0.006), glandular differentiation (p = 0.043), lymphovascular invasion (p = 0.009), and budding-like tumor cell clusters (p = 0.002). The pNmi group had significantly worse cancer-specific survival than the pN0 group in univariate (p = 0.004) and multivariate (p = 0.040) analysis.

Conclusion
IHC frequently identified nodal micrometastasis and ITC in originally node-negative UBC patients on routine pathological examination. Nodal micrometastasis and ITC were independently associated with cancer-related mortality in UBC. IHC might be selectively used to detect micrometastasis and ITC in UBC having specific pathological features.
How is the quality of randomized controlled trials (RCTs) for acupuncture treatment of post-stroke aphasia? A report quality assessment
Authors: Qin Chenyang , Deng Shizhe , Li Boxuan , Zhu Weiming , Liu Chaoda , Jiang Hailun , Zhuo Bifang , Zhang Menglong , Lyu Yuanhao , Chen Junjie , Chi Shihao , Cao Beidi , Yang Xinming , Meng Zhihong 
Published: October 2024

Objective
This study aimed to assess the quality of randomized controlled trials (RCTs) that have reported the use of acupuncture for the treatment of post-stroke aphasia (PSA).

Methods
We systematically searched PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Wanfang data Information Site, and China Science and Technology Journal Database from January 2013 to June 2023. RCTs utilizing acupuncture as an intervention for the treatment of post-stroke aphasia were included in this study. The overall quality score (OQS) of RCTs was independently evaluated by two researchers using the Consolidated Standards for Reporting Trials (CONSORT) and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) guidelines, with the agreement between researchers calculated using Cohen’s kappa statistics.

Results
In conclusion, we included 38 RCTs in this study. The median OQS of the 38 RCTs was 13 (minimum 8, maximum 20) based on the CONSORT statement. Out of all CONSORT items, 10 (27%) had a positive rate of greater than 80%, while 17 (46%) had a positive rate of less than 10%. The median OQS of the 38 RCTs was 12 (minimum 6, maximum 14) based on the STRICTA guideline. Within the STRICTA guideline, 6 items (35%) had a positive rate of greater than 80%, and 3 items (18%) had a positive rate of less than 10%. Most items based on the CONSORT and STRICTA guidelines were observed to have a perfect or good degree of agreement.

Conclusions
The overall reporting quality of RCTs for acupuncture treatment of PSA was found to be suboptimal. Notably, the reporting quality of the STRICTA guideline is higher compared to the CONSORT statement. Therefore, strict adherence to both the CONSORT and STRICTA statements is recommended to enhance the quality of RCT reports on acupuncture treatment for post-stroke aphasia.