bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing autologous blood, corticosteroid, and a combined injection of both for treating lateral epicondylitis: a randomized clinical trial
Authors: Cakar Albert , Gozlu Ozgur Dogus 
Published: July 2024

Abstract
Background
Because lateral epicondylitis is a common musculoskeletal disorder that affects the forearm's extensor tendons, an effective therapeutic approach should reverse the degeneration and promote regeneration. This study aimed to compare the efficacies of autologous blood (AB) injection, corticosteroid (CS) injection, and a combined injection of both in treating lateral epicondylitis (LE), hypothesizing that the combined approach might offer immediate symptom resolution and a lower recurrence.

Materials and methods
A total of 120 patients diagnosed with lateral epicondylitis were systematically distributed among three distinct therapeutic injection groups. Those in the AB group were administered 1 ml of autologous venous blood mixed with 2 ml of 2% prilocaine HCl. Participants in the CS category were given 1 ml of 40 mg methylprednisolone acetate mixed with 2 ml of 2% prilocaine HCl. Meanwhile, patients in the combined group received a mixture containing 1 ml each of autologous venous blood and 40 mg methylprednisolone acetate along with 1 ml of 2% prilocaine HCl. Prior to receiving their respective injections, a comprehensive assessment of all participants was carried out. Follow-up assessments were subsequently conducted on days 15, 30, and 90 utilizing metrics of the patient-rated tennis elbow evaluation (PRTEE) and measurements of hand grip strength (HGS).

Results
One patient dropped out from the combined group, and 119 patients completed the trial. No complications were recorded during the course of follow-up. By day 15, all groups had demonstrated significant PRTEE improvement, with CS showing the most pronounced reduction (p = 0.001). However, the benefits of CS had deteriorated by day 30 and had deteriorated further by day 90. The AB and AB + CS groups demonstrated sustained improvement, with AB + CS revealing the most effective treatment, achieving a clinically significant improvement in 97.4% of the patients. The improved HGS parallelled the functional enhancements, as it was more substantial in the AB and AB + CS groups (p = 0.001), corroborating the sustained benefits of these treatments.

Conclusions
The study concluded that while AB and CS individually offer distinct benefits, a combined AB + CS approach optimizes therapeutic outcomes, providing swift and sustained functional improvement with a lower recurrence rate. These findings have substantial clinical implications, suggesting a balanced, multimodal treatment strategy for enhanced patient recovery in LE.
Level of evidence: Randomized clinical trial, level 1 evidence.
Trial registration: NCT06236178.
The association between systemic inflammation markers and paroxysmal atrial fibrillation
Authors: Zhao Xuechen , Huang Lei , Hu Jianan , Jin Nake , Hong Jun , Chen Xudong 
Published: July 2024

Abstract
Background
Systemic inflammation markers have recently been identified as being associated with cardiac disorders. However, limited research has been conducted to estimate the pre-diagnostic associations between these markers and paroxysmal atrial fibrillation (PAF). Our aim is to identify potential biomarkers for early detection of PAF.

Methods
91 participants in the PAF group and 97 participants in the non-PAF group were included in this study. We investigated the correlations between three systemic inflammation markers, namely the systemic immune inflammation index (SII), system inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI), and PAF.

Results
The proportion of patients with PAF gradually increased with increasing logSII, logSIRI, and logAISI tertiles. Compared to those in the lowest tertiles, the PAF risks in the highest logSII and logSIRI tertiles were 3.2-fold and 2.9-fold, respectively. Conversely, there was no significant correlation observed between logAISI and PAF risk within the highest tertile of logAISI. The restricted cubic splines (RCS) analysis revealed a non-linear relationship between the elevation of systemic inflammation markers and PAF risk. Specifically, the incidence of PAF is respectively increased by 56%, 95%, and 150% for each standard deviation increase in these variables. The ROC curve analysis of logSII, logSIRI and logAISI showed that they had AUC of 0.6, 0.7 and 0.6, respectively. It also demonstrated favorable sensitivity and specificity of these systemic inflammation markers in detecting the presence of PAF.

Conclusions
In conclusion, our study reveals significant positive correlations between SII, SIRI, and AISI with the incidence of PAF.
Mid-upper arm circumference predicts the risk of gestational diabetes in early pregnancy
Authors: Ma Ning , Bai Liwei , Niu Ziru , Lu Qiang 
Published: July 2024

Abstract
Background
The present work aimed to assess the value of mid-upper arm circumference (MUAC) at 8 to 12 weeks in predicting the occurrence of gestational diabetes mellitus (GDM).

Methods
According to eligibility criteria, 328 women with singleton pregnancies who underwent routine antenatal check-ups at Qinhuangdao Maternal and Child Health Hospital from September 2017 to September 2020 were included. The patients were divided into the gestational diabetes mellitus (GDM) and non-GDM groups according to oral glucose tolerance test (OGTT) data from gestation weeks 24 to 28. Clinical data were compared between the two groups. Logistic regression analysis was performed to determine factors independently predicting GDM. Receiver operating characteristic (ROC) curve analysis was employed to analyze the value of MUAC in predicting the occurrence of GDM. The optimal cut-off points were calculated.

Results
In logistic regression analysis, pre-pregnancy weight, waist circumference, MUAC, UA, TG, and HDL-C independently predicted the occurrence of GDM (P < 0.05). MUAC retained statistical significance upon adjustment for various confounders (OR = 8.851, 95%CI: 3.907–20.048; P < 0.001). ROC curve analysis revealed good diagnostic potential for MUAC in GDM (AUC = 0.742, 95%CI: 0.684–0.800, P < 0.001), with a cut-off of 28.5 cm, sensitivity and specificity were 61% and 77%, respectively.

Conclusion
Pregnant women with MUAC >28.5 cm are prone to develop GDM during pregnancy, indicating that MUAC as an important predictive factor of GDM in early pregnancy.
Applying the multiphase optimization strategy to evaluate the feasibility and effectiveness of an online road safety education intervention for children and parents: a pilot study
Authors: Pham Julia , Buttazzoni Adrian , Gilliland Jason 
Published: July 2024

Abstract
Background
Reports of children’s engagement in active transportation outline low participation rates in many countries despite many associated mental, physical, and social health benefits. One of the main contributors to this phenomenon is a cited lack of education and knowledge among children regarding active travel (AT), specifically road safety. To address this issue, the aim of this study was to evaluate the feasibility and effectiveness of an online road safety education intervention to promote AT among children and their parents.

Methods
Applying the Multiphase Optimization Strategy (MOST) for intervention development, implementation, and evaluation, we designed and assessed a four-module online road safety education intervention with a sample of 57 parent-child dyads using a 23 factorial design featuring both qualitative and quantitative analyses.

Results
Main intervention feasibility findings include positive and critical feedback on the program’s content and design, and moderate participant engagement as reflected by program retention and completion rates. With respect to the preliminary intervention effectiveness on children, a significant improvement in road safety knowledge scores was observed for groups that feature the “wheeling safety and skills” module. Slight improvements in AT knowledge scores across all the intervention groups were observed, but were not of significance. Preliminary intervention effectiveness on select parental AT practices and perceptions saw significant improvements in some groups. Groups that featured the ‘wheeling safety and skills’ module exhibited significantly higher guided choice scores upon completion of the program than those who did not receive this component.

Conclusion
The MOST framework allowed us to design and evaluate the feasibility and preliminary effectiveness of an online road safety education intervention. The developed intervention has demonstrated that it has the potential to improve children’s road safety knowledge and some areas of parental AT practices and perceptions, to which improvements may be attributed to the inclusion of the “wheeling safety and skills” module, suggesting that the targeted focus on cycling skills is a prioritized area. AT programming and practice implications are discussed. Future research is encouraged to refine modules to better reflect the priorities of children and parents and to test these refined components among larger samples.

Word count
9,391 (excludes abstract, tables, figures, abbreviations, and references).
Diagnostic and therapeutic delays in lung cancer during the COVID-19 pandemic: a single center experience at a German Cancer center
Authors: Tarawneh Thomas S. , Mack Elisabeth K. M. , Faoro Charis , Neubauer Andreas , Middeke Martin , Kirschbaum Andreas , Holland Angélique 
Published: July 2024

Abstract
Background
The COVID-19 pandemic has had negative drawbacks on the healthcare system worldwide and on individuals other than those directly affected by the virus. Delays in cancer therapy and diagnosis have been reported in the literature. We hypothesized similar effects on patients with lung cancer at our center.

Methods
We retrospectively analyzed data of patients referred to our center with newly diagnosed lung cancer from 2018 to 2022. We considered distribution of UICC Stages and time from case presentation in our multidisciplinary tumor board or from therapeutic indication from treating physician to therapy initiation (surgery, systemic therapies and radiation) to define delays in diagnosis and treatment.

Results
1020 patients with newly diagnosed lung cancer were referred to our center from 2018 to 2022, with a median of 206 cases yearly (range: 200–208). Cases with Stage IV in 2020–2022 were significantly higher than in 2018–2019 (57% vs. 46%, p = 0,001). 228 operative resections took place between 2018 and 2022, 100 from January 2018 to February 2020 and 128 from March 2020 to December 2022. Median time from presentation in our tumor board to resection was also significantly longer after the beginning of the pandemic than before (22 days vs. 15,5 days, p = 0,013). No significant delays were observed for administration of systemic treatment and initiation of radiation.

Conclusions
During the pandemic higher disease stages were reported for patients with lung cancer, yet there were no clinically relevant delays in treatment. In the context of the post-covid era new diagnostic strategies are necessary to facilitate early diagnosis of lung cancer. Despite the pandemic, for patients with suspicious symptoms prompt access to healthcare facilities is essential for early diagnosis.
Clinical students’ perception of educational environment in a Nigerian university: a mixed method study
Authors: Akinpelu Aderonke O. , Oyewole Olufemi O. , Odunaiya Nse , Odole Adesola C. , Olley Jesupelumi P. 
Published: July 2024

Abstract
Background
Learning environment (LE) research has been given priority in higher education institutions globally because of its influence on learning processes and outcomes. Although studies reporting the perceptions of health science students about LE in Nigeria are available, none have compared the perceptions of students from different health professions. Therefore, this study aimed to assess final-year clinical students’ perceptions of their LE from four programs (dentistry, medicine, nursing, and physiotherapy) and compared their LE perceptions.

Methods
This study adopted a cross-sectional study design using a mixed method approach. The quantitative survey involved all the final-year clinical students at the University of Ibadan, and they completed the Dundee Ready Education Environment Measure (DREEM) questionnaire. The qualitative aspect involved 24 consenting students in four focus group discussions.

Results
A total of 214 out of 223 copies of the DREEM questionnaire were duly completed and returned, yielding 96.0% response rate. The participants’ mean age was 24 ± 2.3 years (ranged between 22 and 25 years, p = 0.001). The mean DREEM scores of the students from the four programs ranged between 119.68 ± 18.02 and 147.65 ± 15.89 out of a maximum of 200, interpreted as more positive than negative perceptions of LE. Physiotherapy students’ DREEM score was significantly higher than those of medical, dental, and nursing students (p < 0.001). The DREEM scores of other students did not differ significantly (p > 0.05). Dental and medical students had similar positive perceptions. The qualitative aspect revealed that the students had positive perceptions of their teachers’ knowledge base and self-acquisition of knowledge but negative perceptions of their teachers’ communication skills, infrastructural facilities, lecturer-student relationships, and hostel accommodations.

Conclusion
Although the survey indicated that these clinical students had more positive than negative perceptions of their learning environment, the qualitative aspect of the study revealed many challenges that the students were confronted with. The clinical students’ perception of their learning environment could be improved if the university authorities would address these challenges.
First real-time imaging of bronchoscopic lung volume reduction by electrical impedance tomography
Authors: Torsani Vinicius , Cardoso Paulo Francisco Guerreiro , Borges João Batista , Gomes Susimeire , Moriya Henrique Takachi , Cruz Andrea Fonseca da , Santiago Roberta Ribeiro de Santis , Nagao Cristopher Kengo , Fitipaldi Mariana Fernandes , Beraldo Marcelo do Amaral , Junior Marcus Henrique Victor , Mlček Mikuláš , Pego-Fernandes Paulo Manuel , Amato Marcelo Britto Passos 
Published: July 2024

Abstract
Background
Bronchoscopic lung volume reduction (BLVR) with one-way endobronchial valves (EBV) has better outcomes when the target lobe has poor collateral ventilation, resulting in complete lobe atelectasis. High-inspired oxygen fraction (FIO2) promotes atelectasis through faster gas absorption after airway occlusion, but its application during BLVR with EBV has been poorly understood. We aimed to investigate the real-time effects of FIO2 on regional lung volumes and regional ventilation/perfusion by electrical impedance tomography (EIT) during BLVR with EBV.

Methods
Six piglets were submitted to left lower lobe occlusion by a balloon-catheter and EBV valves with FIO2 0.5 and 1.0. Regional end-expiratory lung impedances (EELI) and regional ventilation/perfusion were monitored. Local pocket pressure measurements were obtained (balloon occlusion method). One animal underwent simultaneous acquisitions of computed tomography (CT) and EIT. Regions-of-interest (ROIs) were right and left hemithoraces.

Results
Following balloon occlusion, a steep decrease in left ROI-EELI with FIO2 1.0 occurred, 3-fold greater than with 0.5 (p < 0.001). Higher FIO2 also enhanced the final volume reduction (ROI-EELI) achieved by each valve (p < 0.01). CT analysis confirmed the denser atelectasis and greater volume reduction achieved by higher FIO2 (1.0) during balloon occlusion or during valve placement. CT and pocket pressure data agreed well with EIT findings, indicating greater strain redistribution with higher FIO2.

Conclusions
EIT demonstrated in real-time a faster and more complete volume reduction in the occluded lung regions under high FIO2 (1.0), as compared to 0.5. Immediate changes in the ventilation and perfusion of ipsilateral non-target lung regions were also detected, providing better estimates of the full impact of each valve in place.

Trial registration
Not applicable.
Protein glycation products associate with progression of kidney disease and incident cardiovascular events in individuals with type 1 diabetes
Authors: Adeshara Krishna , Gordin Daniel , Antikainen Anni A. , Harjutsalo Valma , Sandholm Niina , Lehto Markku J. , Groop Per-Henrik ,   on behalf of the FinnDiane Study Group
Published: July 2024

Abstract
Background
Despite improved glycemic treatment, the impact of glycation on pathological consequences may persist and contribute to adverse clinical outcomes in diabetes. In the present study we investigated the association between serum protein glycation products and progression of kidney disease as well as incident major adverse cardiovascular events (MACE) in type 1 diabetes.

Methods
Fructosamine, advanced glycation end products (AGEs), and methylglyoxal-modified hydro-imidazolone (MG-H1) were measured from baseline serum samples in the FinnDiane study (n = 575). Kidney disease progression was defined as steep eGFR decline (> 3 mL/min/1.73 m2/year) or progression of albuminuria (from lower to higher stage of albuminuria). MACE was defined as acute myocardial infarction, coronary revascularization, cerebrovascular event (stroke), and cardiovascular death.

Results
Fructosamine was independently associated with steep eGFR decline (OR 2.15 [95% CI 1.16–4.01], p = 0.016) in the fully adjusted model (age, sex, baseline eGFR). AGEs were associated with steep eGFR decline (OR 1.58 per 1 unit of SD [95% CI 1.07–2.32], p = 0.02), progression to end-stage kidney disease (ESKD) (HR 2.09 per 1 unit of SD [95% CI 1.43–3.05], p < 0.001), and pooled progression (to any stage of albuminuria) (HR 2.72 per 1 unit of SD [95% CI 2.04–3.62], p < 0.001). AGEs (HR 1.57 per 1 unit of SD [95% CI 1.23–2.00], p < 0.001) and MG-H1 (HR 4.99 [95% CI 0.98–25.55], p = 0.054) were associated with incident MACE. MG-H1 was also associated with pooled progression (HR 4.19 [95% CI 1.11–15.89], p = 0.035). Most AGEs and MG-H1 associations were no more significant after adjusting for baseline eGFR.

Conclusions
Overall, these findings suggest that protein glycation products are an important risk factor for target organ damage in type 1 diabetes. The data provide further support to investigate a potential causal role of serum protein glycation in the progression of diabetes complications.
Potent synergy and sustained bactericidal activity of polymyxins combined with Gram-positive only class of antibiotics versus four Gram-negative bacteria
Authors: Wang Yan , Feng Jianwen , Yu Jiameng , Wen Lirong , Chen Lidan , An Huijie , Xiao Weibin , Zhang Bing , Feng Huanhuan , Zhou Mou , Jiang Zhihui 
Published: July 2024

Abstract
Background
Gram-negative bacteria (GNB) are becoming increasingly resistant to a wide variety of antibiotics. There are currently limited treatments for GNB, and the combination of antibiotics with complementary mechanisms has been reported to be a feasible strategy for treating GNB infection. The inability to cross the GNB outer membrane (OM) is an important reason that a broad spectrum of Gram-positive only class of antibiotics (GPOAs) is lacking. Polymyxins may help GPOAs to permeate by disrupting OM of GNB.

Objective
To identify what kind of GPOAs can be aided to broaden their anti-GNB spectrum by polymyxins, we systematically investigated the synergy of eight GPOAs in combination with colistin (COL) and polymyxin B (PMB) against GNB in vitro.

Methods
The synergistic effect of COL or PMB and GPOAs combinations against GNB reference strains and clinical isolates were determined by checkerboard tests. The killing kinetics of the combinations were assessed using time-kill assays.

Results
In the checkerboard tests, polymyxins-GPOAs combinations exert synergistic effects characterized by species and strain specificity. The synergistic interactions on P. aeruginosa strains are significantly lower than those on strains of A. baumannii, K. pneumoniae and E. coli. Among all the combinations, COL has shown the best synergistic effect in combination with dalbavancin (DAL) or oritavancin (ORI) versus almost all of the strains tested, with FICIs from 0.16 to 0.50 and 0.13 to < 0.28, respectively. In addition, the time-kill assays demonstrated that COL/DAL and COL/ORI had sustained bactericidal activity.

Conclusions
Our results indicated that polymyxins could help GPOAs to permeate the OM of specific GNB, thus showed synergistic effects and bactericidal effects in the in vitro assays. In vivo combination studies should be further conducted to validate the results of this study.
The role of nurses in implementation of public policy on adolescent health in Colombia, Ecuador, and Peru
Authors: De Bortoli Cassiani Silvia Helena , Moreno Dias Bruna , Rivera Jairo , Deubel Andre Noel Roth , Pérez Taycia Ramírez , Malpica Dinora Rebolledo , Caffe Sonja 
Published: July 2024

Abstract
Background
In Latin America, interventions aimed at adolescents’ health suffer from a shortfall of investment and lack of sustainability. Nurses, as an integral part of health services and systems, can lead the implementation and development of public health policies to improve adolescent health.

Objective
To identify and analyze the role of nurses in the development and implementation of public policies and in the provision of health care to adolescents in Colombia, Ecuador, and Peru.

Methods
The research was carried out in three phases: a documentary analysis, an online survey, and semi-structured focus groups. A total of 48 documents were analyzed, 288 nurses participated in the survey, and 29 nurses participated in the focus groups.

Results
State policies aim to guarantee rights, with special protection for children and adolescents. It is an incremental process, with greater involvement of civil society and governments. Participants reported a lack of synergy between law and practice, as well as differences in regulatory compliance in rural areas and in populations of different ethnicities and cultures. Their perception was that the protection of adolescents is not specifically enshrined in the legal bases and regulatory structures of the countries, meaning that there are both protective factors and tensions in the regulatory framework. While nurses are highly committed to different actions aimed at adolescents, their participation in policy development and implementation is low, with barriers related to a lack of specialized training and working conditions.

Conclusions
Given nurses’ involvement in different actions aimed at adolescents, they could play a fundamental role in the development of policies for adolescents and ensure their effective implementation. Policymakers should consider revising the budget to make compliance viable, incorporating and using monitoring indicators, and increasing the involvement of educational institutions and the community.