bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Efficacy and Safety of Bisphosphonate Therapy for Osteopenia/Osteoporosis in Patients With Chronic Kidney Disease: A Systematic Review and Individual Patient-Level Meta-Analysis of Placebo-Controlled Randomized Trials
Authors: Whitlock Reid , MacDonald Kerry , Tangri Navdeep , Walsh Michael , Collister David 
Published: October 2024

Background: The efficacy and safety of bisphosphonate therapy for the treatment of osteoporosis and osteopenia in the setting of chronic kidney disease (CKD) is unclear. Objective: To determine the effect of bisphosphonate therapy on fractures, bone mineral density (BMD), and adverse events in adults across the spectrum of CKD and dialysis. Design: Systematic review and individual patient-level meta-analysis. Setting: Searches of Ageline, CINAHL, the Cochrane Library, EMBASE, and Medline from inception to August 25, 2016, supplemented with manual screening and clinicalstudydatarequest.com . Authors were contacted for individual patient-level data. Patients: Randomized, placebo-controlled trials with 100 or more participants that evaluated the treatment of primary osteoporosis/osteopenia in adult men and women with bisphosphonate therapy. Measurements: Study characteristics, quality, and data were assessed independently by 2 reviewers. Outcome measures were fractures, BMD, and adverse events including decline in estimated glomerular filtration rate (eGFR) and hypocalcemia (calcium <2.00 mmol/L). Methods: Single-stage individual patient-level meta-analysis. Results: Of 39 eligible studies, individual patient-level data was available for 7 studies, all of which were studies of ibandronate. Of 7428 participants (5010 ibandronate, 2418 placebo), 100% were female, 98.6% were white, the mean body mass index was 25.7 kg/m2 (SD 3.9), 18.9% were smokers and there were 740 fracture events. The mean eGFR was 69.1 mL/min/1.73 m2 (SD 15.9) including 14.5%, 54.9%, 27.5%, 3.0%, and 0.2% stages G1, G2, G3A, G3B, and G4 CKD. Ibandronate increased hip and lumbar spine BMD and decreased the risk of fracture in the overall population (hazard ratio (HR) 0.871, 95% confidence interval (CI) 0.746, 1.018) but in patients with stage G3B CKD, it increased the risk of fracture (HR 3.862, 95% CI 1.156, 12.903). Ibandronate did not impact eGFR over 12 months but increased the risk of hypocalcemia (HR 1.324, 95% CI 1.056, 1.660) with no evidence of any effect modification by CKD stage (all tests of interaction p > 0.05). Limitations: Clinically significant heterogeneity among studies, lack of long-term follow-up and bone biopsy results, limited representation of stage G4 and G5 CKD patients. Conclusions: Chronic kidney disease potentially modifies the efficacy but not the safety of bisphosphonate therapy in osteopenia and osteoporosis. Registration: PROSPERO CRD42020145613
Effects of smartphone-based music intervention on improving emotional and psychosomatic symptoms of patients with hematological malignancy: A study protocol for a non-inferiority randomized controlled trial
Authors: Zhang Weifen , Chen Lo-Ting , Xu Nengwen , Ke Feifei , Lan Liming , Li Linjie , Liu Wei’e , Chen Xijing 
Published: October 2024

Objectives Smartphone-based music intervention (S-MI) may increase the accessibility and feasibility for benefiting patients. This study aims to assess the effectiveness of S-MI in alleviating emotional and psychosomatic symptoms in patients with hematological malignancies, compared to the smartphone delivered Mindfulness-Based Stress Reduction Training (S-MBSR). Methods This study will be a non-inferiority randomized controlled trial design. A total of 120 eligible participants with hematological malignancies will be randomly assigned to either the experimental group (S-MI) ( n = 60) or the comparison group (S-MBSR) ( n = 60). Participants will use the Mind Habit app to participate in daily sessions of S-MI or S-MBSR, lasting 5–10 min each, for 2 weeks. The primary outcome, anxiety, and the secondary outcomes, depression, sleep quality, psychological perceived harmony, emotional regulation self-efficacy, as well as the exploratory outcome performance status, will be assessed four times (i.e., pre-test, mid-test, post-test, and follow-up) using validated instruments: the General Anxiety Disorder-7, Patient Health Questionnaire-9, Pittsburgh Sleep Quality Index Inventory, Balanced Index of Psychological Mindedness, Regulatory Emotional Self-Efficacy Scale and Zubrod/ECOG/WHO. In addition, participants will provide daily self-reports on their mood and psychosomatic symptoms both before and after each day's intervention. Physiological parameters will be collected at pre- and post-test. Compliance will be measured at pre-test and follow-up. Intent-to-Treat and Per Protocol Set analysis will be used for data analysis. Results The primary outcome will focus on evaluating the change of anxiety. Secondary outcomes will examine the changes in depression, sleep quality, psychological perceived harmony, and emotional regulation self-efficacy. The exploratory outcomes will encompass assessments of performance status, self-reported evaluations, physiological parameters, and compliance. Conclusion This study aims to provide empirical evidence supporting the efficacy of S-MI in mitigating emotional and psychosomatic symptoms in patients with hematological malignancies. Trial Registration The trial was registered and identified as ChiCTR2200065896.
Specialized nurses’ role in ensuring patient safety within the context of telehealth in home care: A scoping review
Authors: Vaismoradi Mojtaba , Rae John , Turunen Hannele , Logan Patricia A. 
Published: October 2024

Objectives Specialized nurses are uniquely positioned to implement innovative telehealth solutions to improve the quality and safety of home care, and this has become a focal point of contemporary healthcare research. This review aimed to identify the nature and scope of specialized nurses’ roles in ensuring patient safety within the context of telehealth in home care. Methods A scoping review of the international literature was carried out from January 1, 2013, to August 29, 2024. The review employed Levac et al.'s framework to delineate the research phenomenon and consolidate existing empirical research findings. Through a comparative analysis, the review integrated findings from selected studies, highlighting both similarities and differences related to this phenomenon, which led to the development of distinct categories. Results The search yielded 1127 articles, from which 23 studies met the inclusion criteria for research synthesis and subsequent reporting of results. These studies spanned specialized nurses’ roles in telehealth and various fields in which specialized nurses utilized telehealth to deliver high-quality and safe home care. The findings highlighted key outcomes linked to the improvement of patient safety in home care encompassing continuity of care, confidence in care, monitoring and early intervention, medication safety, engagement and adherence, and healthcare costs. Conclusions The review revealed the crucial role played by specialized nurses in harnessing telehealth in healthcare to meet the highest care standards, creating an environment that prioritizes the well-being and patient safety in home care.
Internet-delivered cognitive behaviour therapy for affective disorders, anxiety disorders and somatic conditions: An updated systematic umbrella review
Authors: Käll Anton , Biliunaite Ieva , Andersson Gerhard 
Published: October 2024

Background Internet-delivered cognitive behaviour therapy (ICBT), which can involve guidance from a clinician, continues to be a way to deliver psychological treatments. A previous umbrella review identified moderate-to-large effect sizes favouring ICBT compared to control conditions when treating major depression and anxiety disorders. Given the rapid developments in the field, an updated umbrella review of available meta-analyses can show other conditions and subpopulations for which ICBT is effective. The aim of the study was to provide an expanded overview of the efficacy of ICBT for a broader range of adult psychiatric and somatic conditions. Methods We conducted an updated search of the literature since the publication of the previous umbrella review back in 2019 and up until March 2024. Five different search engines were used (Medline (OVID), Scopus, Web of Science, Cochrane library and CINAHL). The search was expanded to include additional psychiatric conditions (e.g., suicidal ideation) and somatic conditions (e.g., tinnitus and chronic pain). Results Of the 6509 identified articles, 39 meta-analyses met the inclusion criteria. In these meta-analyses 19 unique outcomes were represented. The most common outcome was symptoms of major depressive disorder, followed by symptoms of anxiety. Effect sizes for the comparisons against control conditions ranged between small (e.g., SMD = 0.10 for stress in employees) to large (e.g., SMD = 1.20 for depressive symptoms among older adults). Conclusions ICBT can generally reduce symptoms of a wide range of conditions including both psychiatric and somatic conditions, as well as other mental health problems. This updated review of available meta-analyses also indicated that ICBT has been successful in treating symptoms in different subpopulations such as older adults and students. However, some knowledge gaps remain, including the use of ICBT for psychotic disorders, and the quality of the available meta-analyses’ points to a need for more stringent methodological procedures.
Multitask learning to predict successful weaning in critically ill ventilated patients: A retrospective analysis of the MIMIC-IV database
Authors: Lin Ming-Yen , Chi Hsin-You , Chao Wen-Cheng 
Published: October 2024

Objective Weaning is an essential issue in critical care. This study explores the efficacy of multitask learning models in predicting successful weaning in critically ill ventilated patients using the Medical Information Mart for Intensive Care (MIMIC) IV database. Methods We employed a multitask learning framework with a shared bottom network to facilitate common knowledge extraction across all tasks. We used the Shapley additive explanations (SHAP) plot and partial dependence plot (PDP) for model explainability. Furthermore, we conducted an error analysis to assess the strength and limitation of the model. Area under receiver operating characteristic curve (AUROC), calibration plot and decision curve analysis were used to determine the performance of the model. Results A total of 7758 critically ill patients were included in the analyses, and 78.5% of them were successfully weaned. Multitask learning combined with spontaneous breath trial achieved a higher performance to predict successful weaning compared with multitask learning combined with shock and mortality (area under receiver operating characteristic curve, AUROC, 0.820 ± 0.002 vs 0.817 ± 0.001, p < 0.001). We assessed the performance of the model using calibration and decision curve analyses and further interpreted the model through SHAP and PDP plots. The error analysis identified a relatively high error rate among those with low disease severities, including low mean airway pressure and high enteral feeding. Conclusion We demonstrated that multitask machine learning increased predictive accuracy for successful weaning through combining tasks with a high inter-task relationship. The model explainability and error analysis should enhance trust in the model.
Initial feasibility evaluation of the RISES system: An innovative and activity-based closed-loop framework for spinal cord injury rehabilitation and recovery
Authors: Madarshahian Shirin , Guerrero Tatiana , Aung Phyo Thuta , Gustafson Kristin , Harrop James S. , Johnson Dana R. , Khantan Mehdi , Lee Yunsoo , Matias Caio , McCurdy Michael , Grampurohit Namrata , Mulcahey MaryJane , Napoli Alessandro , Vaccaro Alexander , Serruya Mijail 
Published: October 2024

Background Electrical stimulation of the spinal cord may improve rewiring of the affected pathways. Immediate modulation of stimulation parameters, and its effects of it on kinematics and electromyographic variables is unclear. Methods This study piloted the safety and feasibility of the Reynolds Innovative Spinal Electrical Stimulation (RISES) technology with a focus on its novel closed-loop setting. This personalized, task-specific non-invasive stimulation system enables real-time stimulation parameter modulation and supports multi-data acquisition and storage. Four SCI participants underwent a clinical trial coupled with activity-based training. Primary safety outcome measures included adverse events (AEs) and skin integrity; secondary measures were vital signs, pain, and fatigue assessed at the pre, mid, and post-stimulation sessions. The trial included open-loop and closed-loop blocks of transcutaneous spinal cord stimulation (tSCS). Results Results showed no serious adverse events, with skin integrity unaffected. Vital signs and pain showed no significant differences across session timepoints. Fatigue levels differed significantly with post-session > mid-session > pre-session. Comparisons between open-loop and closed-loop blocks showed no significant differences in setup time, vital signs, pain, or fatigue. Average stimulation duration per task was significantly longer for open-loop (467.6 sec) than Closed-loop (410.8 sec). Conclusions RISES, demonstrated safety and feasibility. Further work will focus on clinical efficacy.
Ratio of Tibial Tubercle–Trochlear Groove Distance to Patellar Width as a Predictor of Patellar Dislocation: Analysis of Individualized Tibial Tubercle Lateralization Parameters
Authors: Chen Yurou , Tian Wei , Yuan Mao , Yang Haitao , Lv Fajin , Lv Furong , Li Jia 
Published: October 2024

Background: Available conventional tibial tubercle lateralization (TTL) parameters fail to account for individual patient size or anatomy. Purposes: To evaluate the predictive ability of individualized TTL parameters and clarify the best predictor of patellar dislocation (PD) and to determine the relationship of the best predictor with other risk factors of PD with quadriceps isotonic contraction. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A total of 15 patients with PD (28 knees) and 14 controls (28 knees) underwent 4-dimensional computed tomography, and the image with the knee fully extended and quadriceps isotonically contracted was selected for evaluation. The following TTL parameters were measured on the images: tibial tubercle–trochlear groove (TT-TG) distance, tibial tubercle–Roman arch distance, and tibial tubercle–posterior cruciate ligament distance, as well as their ratios to femoral condylar width and patellar width (PW). In addition, the following parameters were measured: Insall-Salvati ratio, Blackburne-Peel ratio, Caton-Deschamps ratio, modified Insall-Salvati ratio, bisect offset index, congruence angle, lateral patellar tilt, lateral trochlear inclination, sulcus depth, sulcus angle, trochlear groove medialization, patella–patellar tendon angle, patellofemoral axis angle (P-FAA), patellar articular facet–patellar tendon angle, patellar articular facet–femoral axis angle (PA-FAA), and patellar shape according to Wiberg type. The area under the receiver operating characteristic curve (AUC) was calculated to access the diagnostic accuracy of the TTL parameters for PD, and the TTL parameters with high diagnostic ability were evaluated for correlation with the remaining parameters. Results: The TT-TG/PW ratio had the best diagnostic ability for PD (AUC = 0.890). The TT-TG/PW ratio was positively correlated with bisect offset index, congruence angle, lateral patellar tilt, P-FAA and PA-FAA ( r = 0.610, 0.465, 0.635, 0.553 and 0.418, respectively; P≤ .027 for all), and TT-TG/PW ratio was greater in knees with type II versus type III patella ( P = .017). Conclusion: With the knee fully extended and quadriceps isotonically contracted, the TT-TG/PW ratio was found to be the best predictor of PD and reflected individualized TTL, which helps with clinical preoperative planning.
The joys of fragile X: Understanding the strengths of fragile X and delivering a diagnosis in a helpful, holistic way
Authors: Herring Jonathan , Johnson Kirsten , Scerif Gaia , Weight Emilie , Richstein Jörg , Crawford Hayley , Robinson Heloise , Gawarammana Radhini , Ellis Katherine 
Published: October 2024

The purpose of this article is to provide a positive framework for a doctor, geneticist, genetic counsellor or other professional to deliver a fragile X syndrome diagnosis and to offer support thereafter. Our aim is not to glamourise the condition nor downplay its impacts but rather to suggest that a more accurate and holistic definition of fragile X syndrome would cover all the aspects of the condition, including its variability and positive aspects. Fragile X syndrome is commonly described in terms of the ‘problems’ associated with it and stigmatic language is used. Instead, we believe that giving diagnosis and support in a holistic and family-centred way is imperative. In delivering a fragile X syndrome diagnosis, the strengths of those living with fragile X syndrome should be the starting point, encouraging development that builds on those strengths while supporting the areas of need. This article will set out these more positive aspects of fragile X syndrome to assist those providing a diagnosis of fragile X syndrome. Lay abstract The purpose of this article is to provide a positive framework for a doctor, geneticist, genetic counsellor or other professional to deliver a fragile X syndrome (FXS) diagnosis and offer support. Our aim is to give a more accurate and holistic definition of FXS. This would cover all the aspects of the condition, including its variability and positive aspects. FXS is commonly described in terms of the ‘problems’ associated with it and stigmatic language is used. Instead, we believe that giving diagnosis and support in a holistic and family-centred way is important. In delivering a FXS diagnosis, the strengths of those living with FXS should be the starting point. These strengths should be built on at the same time as supporting areas of need.
Association Between Patient-Level Factors and Positive Treatment Response Among Individuals With a Psychostimulant Use Disorder: A Cross-Sectional Study
Authors: Abulez Dana , Brown Clare C , Cucciare Michael A , Hayes Corey J 
Published: October 2024

Objectives: The purpose of this study was to provide insights into which patient-level characteristics are associated with a positive treatment response among patients whose primary drug of choice was a psychostimulant with a particular emphasis on understanding the impact of age at first use and co-occurring psychiatric comorbidities. Methods: We used a cross-sectional study design and the 2019 US Treatment Episode Data Set: Discharges (n = 167 802) to identify outpatient treatment episodes for which the primary drug of choice was a psychostimulant. We defined a positive treatment response as (1) a reduction in drug use between treatment admission and discharge or (2) no use at both admission and discharge. Multivariable logistic regression was conducted, overall and stratified by presence of psychiatric comorbidity, to identify demographic, clinical, and treatment-level factors associated with positive treatment response. Results: Treatment episodes among patients 11 years and under at the time of first use had a 22% higher odds of having a positive response to treatment as compared to those treatment episodes in which the person was 30 years or older at the time of first use. The presence of psychiatric comorbidity resulted in substantial differences in direction and magnitude of the relationships between treatment response and covariates. Positive response to treatment was less likely for episodes among Non-Hispanic Black/African American persons, in detoxification settings, for unemployed individuals, or for individuals living in the South, but a positive response was more likely for episodes occurring in rehabilitation/residential settings. Conclusions: Race/ethnicity, geographic region, treatment setting, and employment status were the strongest predictors of response to treatment. Treatment programs should maximize treatment of psychiatric conditions, intensify support for persons of color seeking treatment in detoxification settings, and increase efforts to find adequate employment for patients.
Is home environment associated with child fluid reasoning abilities in middle childhood in high-risk settings? findings from a cross-sectional study in Pakistan
Authors: Rasheed Muneera A. , Nilsen Sondre Aasen , Strand Tor A. , Shaheen Fariha , Kvestad Ingrid 
Published: October 2024

Abstract
Background
Evidence from low- and middle-income countries (LMIC) suggests that home environment is associated with early childhood development outcomes. However, studies from LMIC that have examined how the home environment during middle childhood is associated with intellectual abilities are scarce. The objective of the study was to explore the association between different aspects of the home environment at 7–8 years and fluid reasoning abilities in a rural, high-risk cohort in Pakistan.

Methods
We employed a cross-sectional research design to examine 1172 children between 7 and 8 years and their families, utilizing the Home Observation for Measurement of Environment for Middle Childhood (HOME-MC) to evaluate various aspects of the home environment and the Fluid Reasoning Index (FRI) of the Wechsler Intelligence for Children (WISC)-5th edition to assess the fluid reasoning abilities of the children. Multivariable regression analyses were used to examine the association between different components of HOME-MC (scored as indices) and FRI scores.

Findings
Learning materials and opportunities (β = 1.74, 95% CI = 1.15, 2.33) and Responsivity (β = 1.73, 95% CI = 1.07, 2.38) indices had the strongest association with FRI score followed by Family companionship index (β = 1.27, 95% CI = 0.63, 1.90). The eight different indices of the HOME-DC explained 22% of the total variation in FRI scores.

Conclusion
We conclude that concurrent learning opportunities, parental responsivity and family companionship at home are associated with fluid reasoning abilities during middle childhood which is comparable to what has been found in early childhood years.