bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systemic lupus international collaborating clinics-2012 and European league against rheumatism/American college of rheumatology-2019 classification criteria for systemic lupus erythematosus associated with childhood-onset auto-immune cytopenia
Authors: Granel Jérôme , Fernandes Helder , Richer Olivier , Clet Johanna , Dubrasquet Mathilde , Pillet Pascal , Aladjidi Nathalie 
Published: October 2024

Introduction Systemic Lupus Erythematosus (SLE) can be diagnosed using the 2012 criteria of the Systemic Lupus International Collaborating Clinics (SLICC) and, more recently, the 2019 criteria of the European League Against Rheumatism/American College of Rheumatology (EULAR/ACR). Hematological involvement is scored differently by these classifications. Our objective was to compare both criteria in a cohort of children with autoimmune cytopenia (AIC)-associated SLE. Method We included 79 patients with childhood-onset AIC as the first manifestations of SLE. Results The median age at SLE diagnosis was 14.5 years (1.1–21.4 years). The SLICC criteria were fulfilled by 76/79 (96%) patients and the EULAR/ACR criteria by 72/79 (91%) patients during follow-up. The SLICC and EULAR/ACR criteria were discordant (not concomitantly fulfilled) in 25/79 (32%) patients. Non-hematological clinical manifestations were more frequently observed in SLE diagnosis when the criteria were concordant (30/54, 56%) than when they were not (5/25, 20%) ( p = 0.004). In 16/25 (64%) discordant patients, the SLICC criteria allowed earlier diagnosis of SLE. Finally, the attribution of a maximum weight of 6 to the hematological involvement of the EULAR/ACR criteria increased the sensitivity thereof from 63/79 (80%) to 76/79 (96%) in our population. Conclusion The SLICC 2012 and EULAR/ACR 2019 criteria do not effectively diagnose SLE in children when AIC is the predominant feature. The SLICC criteria appear to be more effective in this population of SLE patients. An increase in the maximum weight of hematological involvement to 6 increases the sensitivity of the EULAR/ACR criteria for SLE diagnosis in children.
Ethical aspects of staff responses when older people with dementia express false beliefs
Authors: Villar Feliciano , Martínez Daniela 
Published: October 2024

Background Challenging false beliefs are common situations among people living with dementia. They frequently imply time-shifts, that is, situations in which the person re-lives past experiences. Since they have emotional implications and important ethical implications, they are difficult to manage by caregivers, who are faced with the decision of telling or not telling the truth. Aims The study aimed to explore professional staff’s perceptions of common and best practices to manage a situation in which a person living with dementia is having a false belief, specifically a time-shift. The study compares technical staff’s and assistant carers’ responses. Participants and research context Forty-two staff members working in four Spanish long-term care facilities were interviewed. 21 were assistant carers and 21 were technical staff. Research design This study involved a qualitative design, content-analyzing participant’s responses to semi-structured interviews. Participants read a vignette about a person living with dementia having a time-shift and were asked (1) how a situation like that is commonly managed and (2) how it should be managed. Ethical considerations The principles of informed consent, confidentiality, and assessment of consequences for participants were observed throughout the entire study, which was approved by the University of Barcelona Ethics Committee (IRB 00003099). Written participant’s consent was obtained prior to interviews. Findings All the participants mentioned having experienced a situation similar to that described in the vignette. In the case of common practices, lying was the most frequently mentioned strategy. As for best practices, lying and telling the truth were mentioned as well as responses that lie in-between, such as distracting or relaxing. However, most assistant carers reported that they do not know how a challenging false belief should be managed. Conclusion Our findings stress the importance of organizational guidelines and staff development in the management of challenging false beliefs (and specifically time-shifts) in PLWD.
Uric acid-to-high-density lipoprotein cholesterol ratio and osteoporosis: Evidence from the national health and nutrition examination survey
Authors: Liu Zeyu , Tang Yuchen , Sun Ying , Lei Miao , Cheng Minghuang , Pan Xiaohan , Hu Zhenming , Hao Jie 
Published: October 2024

Background: The uric acid-to-high-density lipoprotein cholesterol ratio (UHR) has emerged as a novel indicator of inflammatory and metabolic status. This study aims to examine the association between UHR and bone mineral density (BMD), as well as the risk of osteoporosis, in individuals aged ≥50 years. Methods: This cross-sectional study used data from the National Health and Nutrition Examination Survey, focusing on participants aged ≥50 years. Femoral neck BMD (FN-BMD) was measured using dual-energy X-ray absorptiometry. Linear regression models were employed to examine the association between UHR and FN-BMD. Additionally, generalised additive models were used to assess the nonlinear relationship between UHR and FN-BMD. Logistic regression models were employed to evaluate the association between UHR and the risk of osteoporosis. Results: Finally, the study included 2963 adults with a mean age of 64.16 ± 8.92 years. Linear regression analyses revealed a positive association between UHR and FN-BMD, regardless of covariate adjustments. Logistic regression analyses indicated that elevated UHR was associated with a reduced risk of osteoporosis with or without covariate adjustments. Subgroup analyses revealed that the positive association between UHR and BMD was significant in individuals aged ≥65 years but not in those aged 50 to 64 years. Interaction analyses by age showed significant differences after adjusting for all covariates. Conclusions: Clinicians should be vigilant regarding the potential risk of osteoporosis in individuals with a low UHR. UHR might serve as a risk indicator for osteoporosis.
The Role of the Public Health Nurse in Collaborative Efforts to Manage COVID-19 in a Rural Hispanic Population: A Qualitative Inquiry
Authors: Young Susan E. , Duea Stephanie R. 
Published: October 2024

Introduction: While local health departments (LHDs) recognize the need to provide culturally congruent care to rural Hispanic populations, the COVID-19 pandemic tested their capacity to leverage available knowledge, skills, and resources to integrate effective transcultural collaborations to improve health outcomes. Methodology: Twelve semi-structured interviews of community leaders were conducted and interpreted using qualitative thematic analysis. The role of the LHD’s Public Health Nurse (PHN) in the pandemic response was examined using the Public Health Intervention Wheel (2019), specifically collaboration, coalition-building, and community organizing components. Results: The PHN directed the community response to the pandemic. Four pivotal themes emerged from the data: identifying gaps, forming alliances, putting boots on the ground, and moving forward. Discussion: The need to provide culturally congruent care to the Hispanic population required the development of transcultural knowledge through multi-faceted strategies. Sustaining relationships borne out of the pandemic is important to enhance community response to future disasters.
Cilioretinal artery occlusion after cataract and macular hole surgery: A case report
Authors: Bilgin Sinan , Doğruya Suzan 
Published: October 2024

Purpose To report cilioretinal artery occlusion in a patient undergoing cataract and macular hole surgery. Material and Method A 78-year-old male patient was operated on for a left eye cataract and tractional macular hole. The patient had no intraoperative problems and developed sudden visual loss on the 15th postoperative day. Optic coherence tomography (OCT), fundus fluorescein angiography (FFA), and optic coherence tomography angiography (OCTA) images revealed occlusion of the cilioretinal artery. After medical treatment and 20 sessions of hyperbaric oxygen therapy, the best visual acuity was 50 cmFC, the optic nerve was pale, the macula was ischemic, and the central macular thickness was 139 microns at the last eye examination. Discussion Mitigating the risk of cilioretinal artery occlusion after vitreoretinal surgery requires a comprehensive approach that addresses patient-specific factors, surgical techniques, and perioperative management. Conclusion Occlusion of the cilioretinal artery may rarely occur after cataract and macular hole surgery. Careful follow-up, early diagnosis, and prompt intervention can minimize visual loss.
The efficacy of a netilmicin/dexamethasone gel combination in the treatment of posterior blepharitis in moderate-severe dry eye patients
Authors: Oliverio Giovanni William , Inferrera Leandro , Postorino Elisa I , Palino Paola , Aragona Pasquale 
Published: October 2024

Purpose To evaluate the safety and efficacy of netilmicin/dexamethasone combination in the treatment of meibomian gland dysfunction (MGD)-associated posterior blepharitis. Methods In this prospective and controlled study were enrolled 40 patients with MGD and symptoms of dry eye disease. Two groups were established: 20 patients (group 1) received netilmicin 3 mg/ml and dexamethasone 1 mg/ml eye gel, whereas in group 2 (20 patients) received vehicle for 15 days. Patients were evaluated at baseline, 15 and 45 days, including SANDE and VARS questionnaire, non-invasive tear film breakup time (NIBUT), tear meniscus height (TMH), ocular redness and meibography score. Moreover, fluorescein tear-film breakup time (TBUT), fluorescein ocular surface staining, lid margin evaluation including hyperemia, edema and meibum expressibility and quality examinations were carried out. Furthermore, intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were considered as safety parameters. Results In group 1, at 15 and 45 days there were statistically significant changes in VARS and SANDE score (p < 0.0001) as well as lid margin parameters, TBUT and fluorescein ocular surface staining (p < 0.0001). Comparing the two groups, a significant improvement of SANDE score was observed at 15 days in group 1 as well as lid margin parameters, TBUT and fluorescein ocular surface staining at 15 and 45 days (all p < 0.0001). Conclusion Netilmicin/dexamethasone combination is effective and safe to treat MGD-associated posterior blepharitis improving both symptoms and ocular surface signs.
Quality-of-life measurement in randomised controlled trials of mental health interventions for autistic adults: A systematic review
Authors: Timmerman Amanda , Totsika Vasiliki , Lye Valerie , Crane Laura , Linden Audrey , Pellicano Elizabeth 
Published: October 2024

Autistic people are more likely to have co-occurring mental health conditions compared to the general population, and mental health interventions have been identified as a top research priority by autistic people and the wider autism community. Autistic adults have also communicated that quality of life is the outcome that matters most to them in relation to mental health research and that they want to be involved more actively in the research process. Our systematic review aimed to determine the extent and nature of (1) quality of life measurement in randomised controlled trials of mental health interventions for autistic adults and (2) community involvement taking place within identified randomised controlled trials. We searched Medline, Embase, APA PsycInfo, Web of Science and grey literature sources. After screening over 10,000 records, 19 studies were eligible and five of those studies measured quality of life as an outcome. Of those five, three included community involvement and two did not report on community involvement. We conclude there is a need for increased use of quality of life measurement when trialling mental health interventions, including the use of measures validated for autistic adults – which would be facilitated by greater autistic involvement in the research process. Lay Abstract Autistic people are more likely to have health problems than the general population. They, and people who care about them, have said mental health research is very important, and some autistic adults have said quality of life is the most helpful area to research when focusing on mental health. Autistic people should also be more deeply involved in making decisions in research. Our review aimed to find out if and how quality of life is being measured when mental health treatments are being tested, and how autistic people and the wider autism community are involved in these studies. We searched four databases and other sources and found over 10,000 records. But just 19 research studies were testing mental health treatments for autistic adults, and only five of those measured quality of life. When they did measure quality of life, it was measured in different ways and there was not much information given on how communities were involved. We suggest mental health research should measure quality of life more often and in ways that are more helpful for autistic people. Our analysis found that mental health research needs to include a wider variety of autistic people, and autistic people should be more involved in the various parts of research.
Long-Term Outcomes of PETTICOAT Technique-Assisted Thoracic Endovascular Aortic Repair for the Treatment of Acute and Subacute Complicated Type B Aortic Dissection
Authors: Wang Shuaishuai , Chen Yonghui , Liu Zongwei , Ren Jianli , Guo Jiayin , Wang Jiaxin , Cui Dongsheng , Bi Jiaxue , Dai Xiangchen 
Published: October 2024

Objective: To evaluate the long-term outcomes of the provisional extension to induce complete attachment technique (PETTICOAT) for the treatment of acute and subacute complicated type B aortic dissection (TBAD). Methods: We retrospectively collected and analyzed the clinical data of patients with acute and subacute TBAD who were treated using the PETTICOAT technique at our center between March 2014 and March 2023. The primary endpoint was all-cause mortality; secondary endpoints were a composite of complications, such as entry flow, stent-graft-induced new entry (SINE), and re-intervention. Results: The technical success was 92% (46/50). The perioperative mortality was 2% (1/50), and the procedure-related re-intervention was also 2% (1/50). The mean follow-up time was (74.9±33.9) months. The mortality was 4.1% (2/49). The incidence of aortic-related complications was 8.2% (4/49), including new entry flow, 2 retrograde type A aortic dissections, and 1 distal stent graft-induced new entry SINE. The procedure-related re-intervention rate was 4.1% (2/49). After 5 years of follow-up, the total aortic diameter at the renal artery level was reduced from that at the third year of follow-up but was still significantly larger than preoperatively (26.9±6.6 mm vs. 24.1±4.2 mm, p=0.013). While at the covered stent, bare stent, stentless, and celiac artery (CA) levels, the total aortic diameters did not change significantly compared with preoperative values, whereas true lumen (TL) diameters and TL ratios were maintained at obviously higher levels than preoperative. The rate of complete thrombosis of false lumen in the thoracic aortic segment was significantly higher than that in the abdominal aortic segment (79.6% vs 30.6%, p=0.0001). Conclusions: The results indicated that the PETTICOAT technique is safe and effective and could promote positive remodeling of the aorta from the level of the covered stent to the CA. Remodeling of the distal abdominal aorta may fluctuate and requires close follow-up review. Clinical Impact The long-term results from our center suggest that the PETTICOAT technique promotes positive remodeling of the aorta from the level of the covered stent to the CA; whereas this advantage does not seem to be significant in the more distal segment of the abdominal aorta, mainly at the level of RA and distal. Therefore, further procedures may be required for aortic dissection of the abdominal segment. In addition, aortic remodeling may fluctuate to some extent during the follow-up period, especially in the abdominal visceral region, so close follow-up review is quite important, and prompt re-intervention is required if necessary.
Assessment of Carbon Dioxide Angiography in Iliac Branched Repair
Authors: Vaccarino Roberta , Karelis Angelos , Singh Bharti , Marinko Elisabet , Tasopoulou Kalliopi-Maria , Resch Timothy , Sonesson Björn , Dias Nuno V. 
Published: October 2024

Objective: The objective of this study was to investigate whether the use of carbon dioxide (CO2) angiography decreases the intraoperative use of iodine contrast medium (ICM), thereby decreasing the risk of developing postoperative renal damage in patients undergoing iliac branch device (IBD) implantation. Methods: Patients undergoing IBD implantation at a single tertiary center between May 2013 and August 2019 were screened for inclusion in the study. A cohort of patients in whom an intraoperative imaging protocol using predominantly CO2 was compared with a control group in whom ICM was used (CO2 and ICM groups). Fusion imaging was used in both groups. Retrospective review of the medical charts and all imaging was performed. Variables were expressed as median with interquartile range (IQR) or absolute number and percentage. Wilcoxon-Mann-Whitney and χ2 tests were used to compare continuous and categorical variables, respectively. P values of <0 .05 were considered statistically significant. Results: Twenty-three patients were included in the CO2 group and 21 in the ICM group without significant differences in patient characteristics between the groups. Intraoperative iodine exposure was lower in the CO2 group than in the ICM group (8.2 g [IQR, 7.1-10.9 g) vs 15.8 g (IQR 7.6-21 g); P = 0.015, respectively). There were no differences in technical success, clinical success, fluoroscopy time, and dose-area product in the 2 groups. There were no adverse events that could be related to the intraoperative use of CO2. There was no difference in postoperative survival nor renal function assessment between the groups despite the higher number of accessory renal arteries embolized in the CO2 group ( P = 0.221). Conclusions: Reduction of intraoperative ICM exposure during IBD implantation is feasible through the predominant use of CO2 automated angiography. This can be done safely without affecting the technical success or radiation exposure. The immediate postoperative renal damage was low when a modern intraoperative imaging protocol with ICM was used and was not significantly reduced by the use of CO2. Further and larger studies are needed to investigate the long-term effects. Clinical Impact This study aimed to investigate how to minimize intraoperative risk during iliac branched repair exploring the intraoperative use of automated carbon dioxide angiography in order to decrease the use of contrast media protecting renal function and thereby potentially impacting long-term survival
Scoping review: Machine learning interventions in the management of healthcare systems
Authors: Arueyingho Oritsetimeyin V , Al-Taie Anmar , McCallum Claire 
Published: October 2024

Background Healthcare institutions focus on improving the quality of life for end-users, with key performance indicators like access to essential medicines reflecting the effectiveness of management. Effective healthcare management involves planning, organizing, and controlling institutions built on human resources, data systems, service delivery, access to medicines, finance, and leadership. According to the World Health Organization, these elements must be balanced for an optimal healthcare system. Big data generated from healthcare institutions, including health records and genomic data, is crucial for smart staffing, decision-making, risk management, and patient engagement. Properly organizing and analysing this data is essential, and machine learning, a sub-field of artificial intelligence, can optimize these processes, leading to better overall healthcare management. Objectives This review examines the major applications of machine learning in healthcare management, the algorithms frequently used in data analysis, their limitations, and the evidence-based benefits of machine learning in healthcare. Methods Following PRISMA guidelines, databases such as IEEE Xplore, ScienceDirect, ACM Digital Library, and SCOPUS were searched for eligible articles published between 2011 and 2021. Articles had to be in English, peer-reviewed, and include relevant keywords like healthcare, management, and machine learning. Results Out of 51 relevant articles, 6 met the inclusion criteria. Identified algorithms include topic modelling, dynamic clustering, neural networks, decision trees, and ensemble classifiers, applied in areas such as electronic health records, chatbots, and multi-disease prediction. Conclusion Machine learning supports healthcare management by aiding decision-making, processing big data, and providing insights for system improvements.
Capturing patient experiences of care with digital technology to improve service delivery and quality of care: A scoping review
Authors: Dodson Patrick , Haase Anne M. , Jeffreys Mona , Hales Caz 
Published: October 2024

Objective Patient experience significantly impacts healthcare quality, outcomes, resource utilisation and treatment adherence. Digital technologies offer promising approaches for capturing real-time, multi-faceted patient experiences. This scoping review investigated how digital technologies are used to capture patient experience during healthcare encounters and their potential to improve health service delivery and care. Methods A scoping review was conducted to determine associations between patients’ use of digital technology and subsequent outcomes. Four electronic databases were searched using six combination search terms in titles and/or abstracts published between 2016 and 2022. Inclusion criteria focused on studies where patients were primary users of digital technology, reporting on their experience during care. Studies had to report on at least one outcome: health service delivery, quality of care or patient experience. Screening, data extraction and analysis were performed systematically. Results Of the 377 studies retrieved, 20 were included. Most studies incorporated aspects allowing patients to share experiences with digital technologies. Eighty percent ( n = 16) of studies reported improvements in patient experiences, 75% ( n = 15) enhancements in service delivery aspects and 50% ( n = 10) indicated improved quality of care associated with the use of digital technologies. Real-time journaling and narrative methods alongside treatment were linked to improved communication, healthcare efficiencies and patient agency. Technologies facilitating bidirectional communication were particularly associated with positive effects on patients’ sense of agency. Conclusion Digital technologies facilitating documentation of patient experiences demonstrate potential in enhancing care quality through increased patient voice, collaboration and agency. Technologies designed to map and evaluate patients’ healthcare experiences represent a promising approach to improving healthcare outcomes, service delivery and overall patient experience. Further research is needed to establish standardised methodologies and evaluate long-term impacts across diverse populations. Integrating digital narrative medicine principles may offer valuable insights for future interventions aimed at capturing and enhancing patient experiences in healthcare.