bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of a closed-loop medication order executive system on safe medication administration at a tertiary hospital: a quasi-experimental study
Authors: Yin Xuwen , Song Haiyan , Lu Jieyu , Yang Jing , Wang Rong , Lin Zheng , Jiang Shudi , Yuan Hui , Wang Xumei , Xu Dongmei , Gao Chunhong , Zhou Yuan , Xu Jiayi , Chen Chen , Gu Chenyu , Diao Qingqing , Li Fang , Gu Zejuan 
Published: October 2024

Background: Closed-loop electronic medication management systems are effective measures for preventing medication errors (MEs). However, there is limited evidence supporting this, and few studies have evaluated the long-term effects of these systems on safe medication. Objective: To evaluate the long-term effects of implementing a closed-loop medication order executive system on the safe clinical use of medications. Design: A quasi-experimental design. Method: Data from 2017 to 2023 were extracted and retrospectively analyzed. The primary outcome indicator was the ME rate. Secondary outcome indicators were the accuracy of order verification and patient identification and the implementation rate of fresh medicine dispensing. The autoregressive integrated moving average (ARIMA) model in time-series analysis was used to evaluate the level and trend changes in ME rates using SPSS 25.0 before and after system implementation. Root cause analysis and descriptive statistics were used to assess changes in types, stages, and causes of ME rates. The independent samples t-test was used to analyze secondary outcomes. Results: Overall, 295 MEs were reported with a mean of 0.26 ± 0.26 ME rates per month during 2017–2023. The ARIMA model showed a decrease in the average level of ME rates after system implementation, with no statistically significant decrease in the long term, and a significant drop in the ME rate in the short and medium term ( p < 0.01). Nurses’ administration accounted for more than 60% of errors post-implementation, and lack of communication was a prominent factor. The accuracy of order verification and patient identification and the implementation rate of fresh medicine dispensing all increased after implementation. Conclusion: Adopting a closed-loop executive system is beneficial for ensuring patient medication safety, but a single integrated system does not completely eliminate MEs. Optimizing system functionalities and applying structured handoff tools are recommended to meet clinical needs and enhance system usability.
Modified circumferential preputioplasty using a Keyes biopsy punch for treatment of type I phimosis in two kittens
Authors: Hertel Beatrice , Roberts Victoria , Deroy-Bordenave Claire , Adamany Jessica , Vallefuoco Rosario 
Published: October 2024

Case series summary Medical records of two kittens diagnosed with type I phimosis were reviewed. Clinical signs on presentation, investigations, description of the surgical technique, and short- and long-term follow-up were reported. Type I phimosis was diagnosed in both kittens based on the clinical, radiographic and surgical exploration findings. Modified circumferential preputioplasty using 4 and 6 mm Keyes biopsy punches was performed by the same surgeon in each case. The biopsy punch was centred over the existing narrowed preputial orifice and rotated clockwise and anticlockwise to obtain a sharp circumferential cut through the skin and submucosa of predictable diameter. The underlying mucosa was resected with micro curved scissors and mucocutaneous apposition was achieved with simple interrupted sutures placed circumferentially. Minor protrusion of the tip of the penis was recorded in the short-term follow-up (2 weeks) but resolved on the long-term follow-up (10 and 72 months). No evidence of urinary tract infection, strictures or clinical signs associated with phimosis were recorded at long-term follow-up. Relevance and novel information This short case series describes the surgical correction of type I phimosis by circumferential preputioplasty implemented using a Keyes biopsy punch in two kittens. The technique described in this case series can be considered alongside other reported surgical techniques, and appears to provide a reliable, rapid and accurate removal of preputial skin in the two reported cases.
The effects of shared decision-making informed dietary intervention based on digital health technology in older adults with type 2 diabetes mellitus: A randomized controlled trial
Authors: Zhang Wei , Zhu Xiaoling , Que Xianfeng , Zhang Xiaoyi 
Published: October 2024

Objectives To evaluate the effectiveness of shared decision-making informed dietary intervention based on digital health technology, for older adults with type 2 diabetes mellitus and determine its impact on patients’ glycemic control (hemoglobin A1c (HbA1c) and fasting plasma glucose), physical indicators (blood pressure and body mass index), self-management behavior, and self-efficacy. Design A double-arm-randomized controlled trial using a parallel group design was conducted. Participants 124 older adults with type 2 diabetes mellitus recruited from the endocrinology department or diabetes clinics were randomly assigned to the intervention ( n = 64) or control group ( n = 60). Interventions Patients in the intervention group received shared decision-making informed dietary intervention through the digital health system and those in the controlled group received routine dietary management. Primary and secondary outcome measures The primary outcome was HbA1c, and the secondary outcomes were fasting plasma glucose, blood pressure, body mass index, self-management ability, and self-efficacy. Results After 3 months of intervention, compared to the control group, the intervention group showed a statistically significant decrease in HbA1c, diastolic blood pressure, and fasting plasma glucose ( P < 0.05). After the intervention, there were time, group main effects, and interaction effects on diabetes self-management ability and diabetes self-efficacy scores of older adults with type 2 diabetes mellitus ( P < 0.05). Conclusions The intervention program based on a digital health system significantly improved glycemic control and enhanced self-care ability in older adults with type 2 diabetes mellitus. Practice implications Clinicians can integrate digital health technology in behavior change intervention, especially in older adults with chronic disease. Trial registration It was registered and approved by the China Clinical Trials Center (ChiCTR2300071455).
Predicting suicidal behavior in individuals with depression over 50 years of age: Evidence from the UK biobank
Authors: Zhang Jian , Liu Yujun , Zhang Chao , Chen Yilong , Hu Yao , Yang Xiujia , Liu Wentao , Zhang Wei , Liu Di , Song Huan 
Published: October 2024

Objective To construct applicable models suitable for predicting the risk of suicidal behavior among individuals with depression, particularly on the progression from no history of suicidal behavior to suicide attempts, as well as from suicidal ideation to suicide attempts. Methods Based on a prospective cohort from the UK Biobank, a total of 55,139 individuals aged 50 and above with depression were enrolled in the study, among whom 29,528 exhibited suicidal behavior. Specifically, they were divided into control (25,611), suicidal ideation (24,361), and suicide attempt (5167) groups. Least absolute shrinkage and selection operator (LASSO) regression was used to identify a subset of important features for distinguishing suicidal ideation and suicide attempts. We used the Gradient Boosting Decision Tree (GBDT) algorithm with stratified 10-fold cross-validation and grid-search to construct the prediction models for suicidal ideation or suicide attempts. To address the dataset imbalance in classifying suicide attempts, we used random under-sampling. The SHapley Additive exPlanations (SHAP) were used to estimate the important variables in the GBDT model. Results Significant differences in sociodemographic, economic, lifestyle, and psychological factors were observed across the three groups. Each classifier optimally utilized 8–11 features. Overall, the algorithms predicting suicide attempts demonstrated slightly higher performance than those predicting suicidal ideation. The GBDT classifier achieved the highest accuracy, with AUROC scores of 0.914 for suicide attempts and 0.803 for suicidal ideation. Distinctive predictive factors were identified for each group: while depression's inherent characteristics crucially distinguished the suicidal ideation group from controls, some key predictors, including the age of depression onset and childhood trauma events, were identified for suicide attempts. Conclusions We established applicable machine learning-based models for predicting suicidal behavior, particularly suicide attempts, in individuals with depression, and clarified the differences in predictors between suicidal ideation and suicide attempts.
Effectiveness of digital health interventions in improving mental health of older adults with mild cognitive impairment: A systematic review and meta-analysis protocol
Authors: Huang An , Liu Xueqi , Gu An , Zhao Dan , Huang Cheng , Wang Lina 
Published: October 2024

Background Mental health issues are highly prevalent in older adults with mild cognitive impairment (MCI). Digital Health Interventions (DHIs) for individuals with MCI have proven effective in improving cognitive function, but their impact on mental health has received less attention. Objective Reporting a protocol for a systematic review and meta-analysis to evaluate the effectiveness of DHIs for older adults with MCI, focusing on mental health outcomes both overall and within homogeneous subgroups. Methods A systematic review and meta-analysis of randomized controlled trials will be conducted, with searches performed in the Cochrane Library, PubMed, Embase, Web of Science, CINAHL, CNKI, and WanFang date from inception to March 2024. Mental health outcomes are the primary outcome. Risk of bias will be assessed with the Cochrane Collaboration tool, and evidence quality will be evaluated with Grading of Recommendations Assessment, Development, and Evaluation. If sufficient studies are available, subgroup analysis will assess variations based on population and intervention characteristics, including types and modalities of DHIs, intervention settings, session frequency, and duration, focusing on specific mental health outcomes and both short- and long-term effects. Additionally, sensitivity analysis and meta-regression analysis will identify sources of other potential heterogeneity. Conclusion The protocol will guide a systematic review and meta-analysis to determine the effectiveness of DHIs in improving mental health of older adults with MCI. This effort will enhance understanding and optimization of DHIs, vital for reducing mental health disparities and improving psychotherapy access for older adults with MCI. PROSPERO registration number CRD42024522342
Effectiveness of endoscopic ultrasound-guided simple puncture-aspiration (non-stenting) in the management of abdominal collections
Authors: Velasquez-Rodriguez Julio G. , Loras Carme , Maisterra Sandra , Colán-Hernández Juan , Busquets Juli , Gornals Joan B. 
Published: October 2024

Background: Endoscopic management of abdominal collections includes endoscopic ultrasound (EUS)-guided transmural drainage, transpapillar via endoscopic retrograde cholangiopancreatography (ERCP), and EUS-guided simple puncture-aspiration (SPA). The latter is little reported, and there are some doubts about its real usefulness. Objectives: The aim of this study was to assess the effectiveness of EUS-guided SPA as a first-line approach for treatment in selected abdominal collections. Design: Retrospective observational study performed in two tertiary centers (Barcelona area). Methods: Inclusion of all consecutive patients with abdominal collections that underwent EUS-guided SPA from July 2007 to July 2021. The decision was based on endoscopist criteria and collection characteristics. Clinical success was defined as avoidance of an additional interventional approach (endoscopic stenting, percutaneous drainage, surgery). Results: Of 241 patients with abdominal collections treated endoscopically, 55 were included for analysis (mean age, 56 ± 12 years). Collection features: mean size 63.3 ± 24.8 mm; positive culture in 22 (40%) and pancreatic nature in 45 (81.8%). EUS–SPA was performed successfully in all cases, and clinical success was achieved in 76.3% (95% confidence interval (CI), 65.5–87.3) of cases ( n-42/55). The most frequently used needle size was 19 Ga (85%). A nonsignificant trend for success was detected for noninfected collections (84.8 vs 63.6; p = 0.07) and lower size (mean ± SD; 60.2 ± 22.9 vs 73.8 ± 29 mm; p = 0.09). Two related adverse events were detected: one bleeding and one abdominal pain. Recurrence was detected in five pseudocysts after clinical success. Median follow-up was 629 days (IQR 389–877). Conclusion: EUS–SPA of selected abdominal collections seems to be a safe and effective technique, avoiding a more aggressive strategy such as transmural stenting. EUS–SPA may be a viable alternative in collections with limited size and preferably noninfected. Graphical abstract [Formula: see text]
Factors Associated with Sexual Intercourse Frequency Among South African Women: Evidence from a National Cross-sectional Survey
Authors: Motsima Tshaudi 
Published: October 2024

Background: Engaging in regular healthy sexual intercourse activities is good for human health and well-being. Greater sexual intercourse frequency (SIF) for people in relationships is often associated with well-being, greater relationship satisfaction, reduced mortality, increased life expectancy, positive emotions and happiness, while lack of sexual activity is usually associated with depression and marital disharmony. Aim: The primary purpose of this study is to identify the factors associated with SIF among women in South Africa. Data and Methods: The South African Demographic and Health Survey 2016 data were used, and the negative binomial regression model (NBRM) was employed for analysis. Results: Age was significantly associated with high SIF (IRR = 1.02; p < .001). African women had significantly higher SIF than Indian/Asian women (IRR = 1.28; p = .049). Married women had a significantly higher SIF than women who were never married (IRR = 1.42; p < .001). Women who resided in urban areas were significantly associated with higher SIF than women who resided in rural areas (IRR = 1.14; p < .001). Conclusion: Being young, being Indian/Asian, being unmarried, and residing in rural areas is associated with low SIF, whereas being older, being African, being married, and staying in urban areas is associated with high SIF. Generally, without violating cultural, religious and societal beliefs, married women should be taught about the benefits of sexual intercourse activity (SIA) and be encouraged not to be ashamed of entering into sexual intercourse activities.
Co-regulation and synteny of GFM2 and NSA2 links ribosomal function in mitochondria and the cytosol with chronic kidney disease
Authors: Zhang Minjie , Hogstrand Christer , Pontrelli Paola , Malik Afshan N 
Published: October 2024

Abstract
Background
We previously reported aberrant expression of the cytosolic ribosomal biogenesis factor Nop-7-associated 2 (NSA2) in diabetic nephropathy, the latter also known to involve mitochondrial dysfunction, however the connections between NSA2, mitochondria and renal disease were unclear. In the current paper, we show that NSA2 expression is co-regulated with the GTP-dependent ribosome recycling factor mitochondrial 2 (GFM2) and provide a molecular link between cytosolic and mitochondrial ribosomal biogenesis with mitochondrial dysfunction in chronic kidney disease (CKD).

Methods
Human renal tubular cells (HK-2) were cultured (+/- zinc, or 5mM/20mM glucose). mRNA levels were quantified using real-time qPCR. Transcriptomics data were retrieved and analysed from Nakagawa chronic kidney disease (CKD) Dataset (GSE66494) and Kidney Precision Medicine Project (KPMP) (https://atlas.kpmp.org/). Protein levels were determined by immunofluorescence and Western blotting. Cellular respiration was measured using Agilent Seahorse XF Analyzer. Data were analysed using one-way ANOVA, Students’ t-test and Pearson correlation.

Results
The NSA2 gene, on human chromosome 5q13 was next to GFM2. The two genes were syntenic on opposite strands and orientation in multiple species. Their common 381 bp 5’ region contained multiple transcription factor binding sites (TFBS) including the zinc-responsive transcription factor MTF1. NSA2 and GFM2 mRNAs showed a dose-dependent increase to zinc in-vitro and were highly expressed in proximal tubular cells in renal biopsies. CKD patients showed higher renal NSA2/GFM2 expression. In HK-2 cells, hyperglycaemia led to increased expression of both genes. The total cellular protein content remained unchanged, but GFM2 upregulation resulted in increased levels of several mitochondrial oxidative phosphorylation (OXPHOS) subunits. Furthermore, increased GFM2 expression, via transient transfection or hyperglycemia, correlated with decrease cellular respiration.

Conclusion
The highly conserved synteny of NSA2 and GFM2, their shared 5’ region, and co-expression in-vitro and in CKD, shows they are co-regulated. Increased GFM2 affects mitochondrial function with a disconnect between an increase in certain mitochondrial respiratory proteins but a decrease in cellular respiration. These data link the regulation of 2 highly conserved genes, NSA2 and GFM2, connected to ribosomes in two different cellular compartments, cytosol and mitochondria, to kidney disease and shows that their dysregulation may be involved in mitochondrial dysfunction.
Outcome of Pneumocystis Jirovecii pneumonia (PcP) in post-CAR-T patients with hematological malignancies
Authors: Zu Cheng , Li Wenxiao , Zhang Mingming , Dong Yetian , Fu Shan , Feng Jingjing , Hong Ruimin , Huang He , Hu Yongxian , Su Junwei 
Published: October 2024

Abstract
Background
Pneumocystis jirovecii pneumonia (PcP) is an opportunistic infection associated with immunocompromised patients. The development of novel immunotherapies has promoted the incidence of PcP. This study describes the clinical course and outcome of PcP in chimeric antigen receptor (CAR) T cell recipients with hematological malignancies.

Methods
This is a retrospective case series of CAR-T recipients diagnosed with PcP in our center. The cases were all confirmed by metagenomic next-generation sequencing of clinical samples. The demographic, clinical, and outcome data were retrieved from the patients’ medical charts and electronic medical record system.

Results
In total, 8 cases of PcP were identified. The underlying malignancies included T-acute lymphoblastic leukemia (ALL) (n = 1), diffuse large B cell lymphoma (DLBCL) (n = 4), and B-ALL (n = 3). One patient received short-term sulfamethoxazole-trimethoprim (SMZ-TMP) while the others had no prophylaxis. Four patients had neutropenia/lymphopenia at the diagnosis of PcP, and two patients had immunosuppressants within one month before PcP manifestation. The median time from CAR-T infusion to PcP diagnosis was 98.5 days (range 52–251). Seven patients recovered from PcP after proper management while one died of septic shock.

Conclusion
PcP can occur after different CAR-T product, and the long-term depletion of immune cells seems to be related to PcP. SMZ-TMP is effective in this setting. More real-world experience of CAR-T therapy is required to assess the incidence and outcome of PcP in this population.
What makes patients tick? Vaccine preferences against tick-borne encephalitis in four European countries
Authors: Zacharias Charlotta , Torgler Ralph , Cummins Jennifer 
Published: October 2024

Abstract
Background
We explored vaccine motivation and preferences for tick-borne encephalitis (TBE) vaccine attributes among participants in TBE-endemic countries in Europe.

Methods
An online survey was conducted among the general public in Austria, Germany, Switzerland, and Sweden. Participants were ≥ 18 years old, open to receiving vaccines, and living in, or regularly traveling to, TBE-endemic regions in the aforementioned countries. Participants were asked about their general vaccine knowledge and motivations for vaccination, before rating the importance of TBE vaccine attributes, such as efficacy, safety, dosing schedule, and booster interval. Thereafter, participants were shown three hypothetical TBE vaccine profiles with different combinations of attributes. Assuming equal efficacy and safety, participants were asked to select their preferred profile from 12 screens as part of a discrete-choice conjoint analysis. Utility scores were calculated to show the importance of each attribute. Data are presented for the overall survey group and by age and gender, using t-tests to compare means.

Results
For 73% of participants (n = 1003/1379), self-protection was among the top three reasons to get vaccinated. Disease severity, protection of children or family, and advice or recommendation from a doctor/healthcare professional (HCP) were top three reasons for over half of participants. The majority (58–69%) agreed or strongly agreed that they trust their doctor/HCP on the subject of vaccines, they rely on their doctor/HCP’s vaccine knowledge, and they prefer their doctor/HCP to make recommendations on which vaccines they or their families should take. Efficacy and safety were the most important standalone TBE vaccine attributes; however, among TBE vaccine profiles including 3-, 5- and 10-year booster intervals, the 10-year booster interval was the most influential attribute level when choosing a preferred vaccine profile (utility score: 0.58 [standard error: 0.01]). Differences in motivators and preferences were observed between age and gender subgroups.

Conclusion
The high level of doctor/HCP reliance highlights the key role doctors/HCPs play in influencing vaccine decision-making. Booster interval was the biggest driver of choice when selecting a hypothetical TBE vaccine profile, with the strongest preference for a 10-year booster interval. These findings could be used to inform TBE vaccination recommendations and in the further development of TBE vaccines.