bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Polypharmacy on Symptoms and Health Outcomes in Older Adults With and Without Alzheimer’s Disease and Related Dementias
Authors: Coates Martha C. , McClure Leslie A. , Vader Daniel , Finley Margaret , Sefcik Justine S. , Gitlin Laura N. , DiMaria-Ghalili Rose Ann 
Published: October 2024

Background There is a critical gap in understanding the symptom experience and health outcomes of older adults with and without Alzheimer’s Disease and related dementias (ADRD) and polypharmacy (PPY). The primary aim of the study was to compare the number of symptoms experienced over time in older adults with and without ADRD by polypharmacy status. The secondary aim was to examine the trajectory of physical function and health outcomes over time in each group. Methods This study utilized longitudinal data from the National Health and Aging Trends Study, a nationally representative sample of Medicare beneficiaries from 2016–2019. The sample was separated into four groups ( N = 2,052): neither ADRD or PPY ( n = 1,048), PPY only ( n = 761), ADRD only ( n = 116), and both ADRD and PPY( n = 127). Results The overall sample was predominately female (57.9%), White (70.9%), aged 84 or younger (75%), married (46%), and had some college or a college degree (50%). Participants with both ADRD and PPY experienced more symptoms on average, had higher odds of falls, hospitalizations, and mortality than all other groups. Older adults with both ADRD and PPY had lower physical function, needed more assistance with activities of daily living and higher assistive device utilization compared to the other three groups. Conclusions Findings indicate that older adults with both ADRD and PPY experience more symptoms, negative health outcomes and physical function decline that can negatively impact their quality of life. Further research is needed to identify strategies for reducing PPY in people with ADRD.
Telehealth versus face-to-face delivery of speech language pathology services: A systematic review and meta-analysis
Authors: Scott Anna M , Clark Justin , Cardona Magnolia , Atkins Tiffany , Peiris Ruwani , Greenwood Hannah , Wenke Rachel , Cardell Elizabeth , Glasziou Paul 
Published: October 2024

Background There is an increasing demand for the provision of speech language pathology (SLP) services via telehealth. Therefore, we systematically reviewed randomized controlled trials comparing telehealth to face-to-face provision of SLP services. Methods We searched Medline, Embase and Cochrane, clinical trial registries, and conducted a citation analysis to identify trials. We included randomized trials comparing similar care delivered live via telehealth (phone or video), to face-to-face. Primary outcomes included: % syllables stuttered (%SS) (for individuals who stutter); change in sound pressure levels monologue (for individuals with Parkinson's disease); and key function scores (for other areas). Where data were sufficient, mean differences were calculated. Results Nine randomized controlled trials were included; eight evaluated video and one evaluated phone telehealth. Risk of bias was generally low or unclear, excepting blinding. There were no significant differences at any time-point up to 18 months for %SS (mean difference, MD 0.1, 95% CI −0.4 to 0.6, p = 0.70). For people with Parkinson's disease, there was no difference between groups in change in sound pressure levels (monologue) (MD 0.6, 95% CI −1.2 to 2.5, p = 0.49). Four trials investigated interventions for speech sound disorder, voice disorder and post-stroke dysphagia and aphasia; they found no differences between telehealth service delivery and face-to-face delivery. Conclusions Evidence suggests that the telehealth provision of SLP services may be a viable alternative to their provision face-to-face, particularly to people who stutter and people with Parkinson's disease. The key limitation is the small number of randomized controlled trials, as well as evidence on the quality of life, well-being and satisfaction and economic outcomes.
Meta-Analysis of Randomised Controlled Trials Comparing Bypass and Endovascular Revascularisation for Peripheral Artery Disease
Authors: Pegler Angus H. , Thanigaimani Shivshankar , Pai Siddharth S. , Morris Dylan , Golledge Jonathan 
Published: October 2024

Objective Peripheral artery disease affects approximately 250 million people globally. Multiple randomised controlled trials have compared bypass and endovascular interventions but the optimum revascularisation approach remains unclear. The recently published BEST-CLI and BASIL-2 trials provide current and robust data addressing this question, however their findings are not concordant. This systematic review and meta-analysis provides an overview of the worldwide randomised evidence comparing bypass surgery and endovascular revascularisation in lower limb peripheral artery disease. Methods A comprehensive literature search of MEDLINE, Embase and CENTRAL databases was performed of all time periods up to 7 May 2023 to identify randomised controlled trials comparing bypass and endovascular revascularisation for treating lower limb peripheral artery disease. The primary outcome was major amputation. Secondary outcomes were mortality, re-intervention, 30-day adverse events and 30-day mortality. Odds ratios were calculated and pooled using the random-effects model. Risk of bias was assessed using the Cochrane risk of bias 2 tool. Results Fourteen cohorts were identified across thirteen studies, enrolling 3840 patients. There was no significant difference in major amputation (OR 1.12; 95% CI 0.80-1.57) or mortality (OR 0.96; 95% CI 0.79-1.17) between the bypass and endovascular groups. Bypass was associated with a significant reduction in re-intervention compared with endovascular treatment (OR 0.57, 95% CI 0.40-0.82). Conclusions These findings suggest that rates of major amputation and mortality are similar following bypass and endovascular interventions. Patients who undergo bypass surgery have a significantly lower re-intervention rate post-operatively.
The applications of CT with artificial intelligence in the prognostic model of idiopathic pulmonary fibrosis
Authors: Chen Zeyu , Lin Zheng , Lin Zihan , Zhang Qi , Zhang Haoyun , Li Haiwen , Chang Qing , Sun Jianqi , Li Feng 
Published: October 2024

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and heterogeneous interstitial lung disease with a median survival of 2–5 years. Though the diagnosis has been improved due to newly published guidelines, the recognition of the prognosis of IPF remains a challenge. Recently, several studies attempted to build prognostic models by extracting predictive variates from pulmonary function data, basic information, or chest computed tomography (CT) and CT-derived parameters with clinical characteristics. Artificial intelligence (AI) algorithms, including principal component analysis, support vector machine, random survival forest, and convolutional neural network, could be applied to the procedure of IPF prognostic model, that is, region of interest extraction, image feature selection, clinical feature selection, and model construction. Compared to human visualization, AI algorithms show a higher efficiency in calculating and extracting deep features and a lower inter-observer variation. Thus, this review provides a comprehensive CT evaluation of IPF prognostic models and discusses the role of AI in constructing IPF prognostic models. The potential improvements of AI in CT assessments, including time-series CT analysis, optimization of AI algorithms, utilization of multi-modal data, and discovery of new biomarkers through unsupervised algorithms, could be introduced to make a more accurate and convenient assessment for the prognosis of IPF patients. This review describes the status quo and future direction of AI applications in CT analysis for prognostic models of IPF. Take home message The review summarizes the applications of CT and AI algorithms for prognostic models in IPF and procedures of model construction. It reveals the current limitations and prospects of AI-aid models, and helps clinicians to recognize the AI algorithms and apply them to more clinical work.
Exploring Work-Related Experiences of Newly Hired Hospital Nurses in Ghana: A Qualitative Study
Authors: Darkwah Ernest , Annor Francis , Oppong Seth , Hagan Sylvia 
Published: October 2024

Introduction Early work-related experiences of newly hired employees can have important implications for their work performance over time and their future health and well-being trajectories. In health care work, such outcomes may hold implications for the services delivered and the patients whose lives depend on them. Objective(s) This study was conducted to explore the work-related experiences of newly hired hospital nurses in Ghana. Methods Using qualitative methods, thirty-six (36) newly hired nurses in three (3) hospitals in the Eastern Region of Ghana were purposively sampled and interviewed. Thematic network analyses were applied to the data collected. Results Five main themes emerged which summarized the experiences of the nurses. The themes indicated that newly hired nurses experienced the nursing profession as stressful and yet fulfilling, different from their preentry expectations with multiple sources of stressors and resources. Religion and faith, family support, and a perceived lack of suitable alternative sources of income emerged as the main motivators of the intention to stay. Conclusion The findings suggest a highly stressful and quite unpredictable work environment for newly hired nurses. Despite this, they are determined to stay on the job. Employee assistance programs that have specialized components targeted at providing emotional and psychosocial assistance to newly hired nurses are recommended.
The prognostic role of circulating tumour DNA detected prior to clinical diagnosis of colorectal cancer in the HUNT study
Authors: Brenne Siv Stakset , Madsen Poul Henning , Pedersen Inge Søkilde , Hveem Kristian , Skorpen Frank , Krarup Henrik Bygum , Xanthoulis Athanasios , Laugsand Eivor Alette 
Published: October 2024

Abstract
Background
Today, the prognostic tools available at the time of diagnosis in colorectal cancer (CRC) are limited. Better prognostic tools are a prerequisite for personalised treatment.
This study aimed to investigate whether circulating tumour DNA (ctDNA) markers found in plasma before clinical diagnosis of CRC could contribute to the prediction of poor prognosis.

Methods
This observational cohort study included patients diagnosed with CRC stage I-III within 24 months following participation in the Trøndelag Health Study (n = 85). Known methylated ctDNA biomarkers of CRC were analysed by PCR in plasma. Outcomes were overall survival (OS), recurrence-free survival (RFS) and poor prognosis (PP). Candidate clinical and methylated ctDNA predictors of the outcomes were identified by Cox regression analyses.

Results
Methylated GRIA4 (HR 1.96 (1.06–3.63)), RARB (HR 9.48 (3.00–30.00)), SLC8A1 (HR 1.97 (1.03–3.77)), VIM (HR 2.95 (1.22–7.14)) and WNT5A (HR 5.83 (2.33–14.56)) were independent predictors of OS, methylated RARB (HR 9.67 (2.54–36.81)), SDC2 (HR 3.38 (1.07–10.66)), SLC8A1 (HR 2.93 (1.01–8.51)) and WNT5A (HR 6.95 (1.81–26.68)) were independent predictors of RFS and methylated RARB (HR 6.11 (1.69–22.18)), SDC2 (HR 2.79 (1.20–6.49)) and WNT5A (HR 5.57 (3.04–15.26)) were independent predictors of PP (p < 0.05).

Conclusions
Prediagnostic ctDNA markers are promising contributors to predicting poor prognosis in CRC, potentially becoming one of the tools guiding more personalised treatment.
Effect of pulmonary rehabilitation on all-cause mortality in patients with chronic respiratory disease: a retrospective cohort study in an Australian teaching hospital
Authors: Sharifi Vahid , Brazzale Danny J. , McDonald Christine F. , Hill Catherine J. , Michael Chris , Ruehland Warren R. , Berlowitz David J. 
Published: October 2024

Abstract
Background
Pulmonary rehabilitation (PR) is widely recommended for short-term benefits in chronic respiratory diseases, yet long-term outcomes remain uncertain. This retrospective cohort study addresses this gap, comparing 20-year mortality rates between PR participants and matched controls, and hypothesizing that the short-term benefits of PR contribute to improved long-term survival.

Methods
The 20-year mortality of stable chronic respiratory patients who participated in an outpatient PR program was compared with a matched control group based on the type of lung disease. Demographic and clinical variables, and the dates of deaths, were extracted and compared between two groups with two sample t-test and chi-square tests. Kaplan-Meier plots and Cox regression analyses were employed to evaluate survival differences.

Results
Between 2000 and 2002, 238 individuals enrolled in a pulmonary rehabilitation (PR) program (58% male, mean age ± SD: 69 ± 8 years, mean FEV1% predicted ± SD: 46 ± 21%). An equal number of people with comparable lung disease were selected as controls (88% COPD, 5% ILD). Controls had lower FEV1% predicted values (mean ± SD: 39 ± 17%, P < 0.001), smoked more (mean ± SD: 48 ± 35 pack-years, P = 0.032), and no differences in age, BMI, sex, and Index of Relative Socio-economic Advantage and Disadvantage (IRSAD). Median (IQR) follow-up time was 68 months (34–123), with 371 (78%) deaths. Univariable (HR = 1.71, p < 0.001) and multivariable (HR = 1.64, p < 0.001) Cox regression found higher mortality risk in controls. Subgroup analysis for COPD replicated these findings (HR = 1.70, P < 0.001).

Discussion
Despite some methodological limitations, our study suggests that clinically stable patients with chronic respiratory disease who undertake PR may have lower mortality than matched controls.

Trial registration
Retrospectively registered.
Association of serum and salivary dipeptidyl peptidase-4 (DPP-4) with oral cancerous and precancerous lesions; an observational diagnostic accuracy study
Authors: Abdel Fattah Tarrad Nayroz , Gamil Shaker Olfat , Abdelkawy Maha , Hassan Sandy 
Published: October 2024

Abstract
Background
Enhancing the prognosis and treatment outcomes of oral cancer relies heavily on its early detection. This study aims to establish a connection between serum and salivary dipeptidyl peptidase-4 (DPP-4) levels and oral squamous cell carcinoma (OSCC), comparing them with oral potentially malignant lesions (OPMLs) and control subjects and validating salivary DPP-4 as a diagnostic marker for the early detection of oral cancer.

Methodology
Forty-five systemically healthy individuals were categorized into three groups: Group I consisted of 15 patients diagnosed with OSCC, Group II comprised 15 patients with OPMLs (including leukoplakia and oral lichen planus), and Group III included 15 participants without any oral mucosal lesions. Serum and whole unstimulated salivary samples were collected from all participants to assess DPP-4 levels using an enzyme-linked immunosorbent assay (ELISA) kit. Receiver operating characteristic (ROC) analysis was conducted to determine the area under the curve (AUC), sensitivity, specificity, and diagnostic accuracy of DPP-4.

Results
Both serum and salivary DPP-4 levels were highest in the healthy group, followed by OPMLs, and lowest in the OSCC group, with statistically significant differences observed. ROC analysis demonstrated excellent diagnostic accuracy of salivary DPP-4 in distinguishing OSCC from healthy individuals, OPMLs from healthy individuals, and OSCC from OPMLs, with accuracies of 100%, 100%, and 96.67%, respectively. Salivary DPP-4 levels also exhibited a statistically significant correlation with OSCC grades.

Conclusions
DPP-4 appears to play a protective, anti-oncogenic role in maintaining oral tissue health. The remarkable diagnostic accuracy of both serum and salivary DPP-4 in discriminating between OSCC, OPMLs, and healthy controls suggests its potential utility as a well-established marker for early oral cancer diagnosis. Salivary DPP-4, being non-invasive, could serve as a convenient chair-side diagnostic tool for the early detection of OSCC.

Clinical trial registration
The study was retrospectively registered on clinicaltrial.gov with NCT06087042, date of registration (first posted date): 17/10/2023
A systematic scoping review on group non-written reflections in medical education
Authors: Burla Neha , Ong Rui Song Ryan , Chee Ryan Choon Hoe , Wong Ruth Si Man , Neo Shao Yun , Abdul Hamid Nur Amira Binte , Lim Crystal , Ong Eng Koon , Somasundaram Nagavalli , Krishna Lalit Kumar Radha 
Published: October 2024

Abstract
Background
Medical education is tasked with shaping how medical students and physicians think, feel and act as professionals, or their Professional Identity Formation (PIF). This process has traditionally rested upon imparting knowledge; integrating sociocultural, professional and organizational expectations and codes of conduct; inculcating program and practice beliefs, values and principles (belief systems); and imbuing shared identities – quintessential elements that, together, comprise the socialization process. Key to supporting this socialization process is reflective practice. However, regnant approaches to mobilizing reflective cycles are faced with resource, personnel and time constraints, hindering efforts to nurture PIF. Group non-written reflections (GNWR) – broadly defined as facilitator-led discussions of shared reflective experiences within groups of learners – may prove to be an effective compromise. To address diverse approaches and a lack of effective understanding, we propose a systematic scoping review (SSR) to map the current use of GNWR in medical training and its role in shaping PIF.

Methods
Guided by the Systematic Evidence-Based Approach (SEBA)’s constructivist ontological and relativist epistemological position, this SSR in SEBA searched for articles on GNWR published in PubMed, Embase, Psychinfo, CINAHL, ERIC, ASSIA, SCOPUS, Google Scholar, Open Grey, GreyLit and ProQuest databases. The data found was concurrently analyzed using thematic and direct content analysis. Complementary themes and categories identified were combined, creating the domains that framed the discussion.

Results
Of the 8560 abstracts and 336 full-text articles reviewed, 98 articles were included. The four domains identified were: (1) Indications of use and their value; (2) Structure and how they can be used; (3) Models of reflective practice in GNWR; and (4) Features of communities of practice and the socialisation process.

Conclusion
This SSR in SEBA concludes that GNWR does impact PIF when effectively structured and supported. The Krishna-Pisupati Model for PIF platforms a model that explains GNWR’s effects of PIF and advances fourteen recommendations to maximize GNWR use.
MiR-5195-3p predicts clinical prognosis and represses colorectal cancer progression by targeting TLR4/MyD88 signaling
Authors: Lv Yandong , Guo Shuwei , Jin Lingtong , Wang Kai , Li Yongsheng , Li Haonan , Lu Yikang , Liu Hongzhou 
Published: October 2024

Abstract
Background
Recent studies have highlighted the role of miR-5195-3p in suppressing cell growth in various cancers. However, the specific functional impact of miR-5195-3p in colorectal cancer (CRC) remain to be fully clarified. The importance of miR-5195-3p in CRC was evaluated, aiming to uncover its underlying molecular mechanism and identify it as a potential therapeutic target for CRC.

Results
Our research has shown that miR-5195-3p is markedly under-expressed in CRC tissues and cell cultures, with its reduced presence associated with a higher TNM stage, lymphatic invasion, and unfavorable survival outcome. Ectopic miR-5195-3p expression curtailed proliferation, migration, and invasion of SW1116 and HT29 cells. Additionally, we discovered that miR-5195-3p directly targets and negatively influences Toll-like receptor 4 (TLR4) in CRC cells. Moreover, an inverse relationship was noted between miR-5195-3p and TLR4 expression in CRC tissue samples. Notably, restoring TLR4 expression counteracted miR-5195-3p’s suppressive impact on cell growth, motility, invasiveness, epithelial-mesenchymal transition (EMT), and the TLR4/MyD88 signaling pathway in SW1116 and HT29 cells.

Conclusions
MiR-5195-3p suppresses the CRC cellular functions through the downregulation of TLR4/MyD88 signaling, indicating that targeting miR-5195-3p might offer a viable therapeutic strategy for CRC.
Predictors of Methicillin-resistant Staphylococcus aureus infection in children with acute osteomyelitis
Authors: Wang Kang , Wang Chen , Zhu Hua , Zou Yan , Feng Yanhua , Zhang Fang , Qu Yi , Tian Yiren 
Published: October 2024

Abstract
Background
This study aims to identify risk factors associated with Methicillin-resistant Staphylococcus aureus (MRSA) infection in children diagnosed with acute osteomyelitis (AO) and to elucidate the laboratory characteristics of these MRSA-infected children to enhance early targeted therapeutic interventions.

Methods
We conducted a retrospective analysis involving 123 children with acute osteomyelitis treated at our hospital. Upon admission, we measured white blood cell (WBC) counts, C-reactive protein (CRP) levels, erythrocyte sedimentation rates (ESR), and platelet counts. Patients were categorized into two groups: the non-MRSA group (n = 73) and the MRSA group (n = 50), with values assigned as follows (non-MRSA group = 0, MRSA group = 1).

Results
The MRSA group had a significantly higher average age compared to the non-MRSA group (P < 0.05). Notably, the incidence of suppurative arthritis was significantly lower in the MRSA group (P < 0.05). At the time of admission, CRP levels in the MRSA group were markedly elevated compared to those in the non-MRSA group (P < 0.01). After three days of empirical therapy, both WBC and CRP levels remained significantly higher in the MRSA group compared to the non-MRSA group (P < 0.05).

Conclusions
In children newly admitted with acute osteomyelitis, a CRP level exceeding 73.23 µg/mL may indicate a high likelihood of MRSA infection. For children with AO who have been hospitalized for three days on empirical therapy, the presence of WBC > 10.95 × 10^9/L, CRP > 49.56 µg/mL, age > 3.5 years, and the absence of suppurative arthritis suggests a heightened risk of MRSA infection.