bluuebunny/crossref_metadata_2025_split huggingface dataset:
Iron deficiency anemia in patients with heavy menstrual bleeding: The patients’ perspective from diagnosis to treatment
Authors: Akpan Imo J , Narang Mohit , Zampaglione Edio , Marshall Steve , Stefanik Dawn 
Published: February 2025

Background: Heavy menstrual bleeding (HMB) associated with iron deficiency anemia (IDA) negatively affects quality of life (QoL). Management of IDA usually begins with oral iron supplementation or, if ineffective/poorly tolerated, then intravenous iron (IVI) is given; however, no guidance exists on transitioning from oral to IVI in patients with HMB. While various IVI products exist, safety profiles and distinct properties affecting treatment logistics make product choice important. Objectives: Assess the IVI treatment journey for patients with HMB and IDA. Design: A survey was designed to assess multiple aspects of IVI treatment to evaluate patient perspectives. Methods: Patients (⩾18 years) from the United States with IDA currently prescribed IVI completed a survey conducted by The Harris Poll in 2023. Questions covered symptoms, time to diagnosis/treatment, IVI appointment logistics, IVI infusion experience, impact on daily activities, and patient preferences. Results: Of 323 respondents, 71 (22.0%) were prescribed IVI for HMB and received ⩾2 IVI infusions monthly. The mean age for these patients was 33.5 years; they experienced a mean of 2.9 years from symptom onset until IDA diagnosis, and 1.4 years between diagnosis and IVI treatment. Most patients agreed that navigating IVI treatment logistics interfered with productivity and social commitments, and felt they must schedule their life around treatment. Patients who were also diagnosed with hypophosphatemia following IVI (12/71; 16.9%) reported a mean of 8.2 additional hospital visits. Furthermore, 36.6% of patients missed an IVI dose; of these, 80.8% preferred single-dose IVI. Conclusion: Patients with IDA and HMB experienced substantial delays from symptom onset to subsequent IVI treatment, demonstrating a gap in management. Therefore, oral iron may not be an appropriate first-line treatment for some of these patients. Multiple-dose IVI and associated appointment logistics can negatively impact patients’ perspectives on treatment. Single-dose IVI preferences should be considered to improve patients’ adherence and QoL.
Pleural and pericardial effusion associated with Bartonella henselae infection in a feline patient
Authors: Torrano Guillamón Ana , Juarez Sarrión Casandra , Álvarez Fernández Alejandra , Solano-Gallego Laia , González Villajos Carlos , Arenas Bermejo Carolina , Castro López Jorge 
Published: February 2025

Case summary A 7-year-old female spayed domestic shorthair cat was presented to our hospital with a 2-day history of anorexia, dyspnoea and lethargy. Blood tests revealed mild anaemia (packed cell volume [PCV] 22.4%) and the biochemistry panel was unremarkable. Thoracic radiographs and echocardiography showed the presence of pericardial effusion with cardiac tamponade as well as pleural effusion. During the initial attempt at pericardiocentesis, a small sample was obtained, sufficient only for fluid analysis and cytology. Subsequently, the pericardial effusion immediately resolved, presumably owing to the drainage of pericardial fluid into the pleural space. Thoracocentesis was then performed, yielding 50 ml of fluid. The analysis of the fluid was consistent with a protein-rich transudate associated with macrophagic-neutrophilic inflammation in both sampled areas. PCR was positive for Bartonella henselae in the pleural/pericardial fluid pool and peripheral blood. Bacterial culture was negative and feline coronavirus real-time PCR was negative. The patient was treated with marbofloxacin 5 mg/kg PO q24h for 5 weeks. No clinical signs were reported at this time; however, blood B henselae PCR remained positive. Treatment was changed to doxycycline at 5 mg/kg PO q12h for 6 weeks. The cat remained subclinical throughout the treatment, and a blood PCR after 6 weeks yielded negative results. Relevance and novel information  To the best of the authors’ knowledge, the present clinical findings related to B henselae infection in a cat without concurrent heart failure have not been previously documented. This clinical case highlights the need to include Bartonella species as a differential diagnosis in cats with protein-rich transudate effusions associated with neutrophilic-macrophagic inflammation and fever.
Influence of Workers’ Compensation Status on Functional Recovery and Return to Work After Proximal Hamstring Avulsion Surgery: A Matched Cohort Study
Authors: Lefèvre Nicolas , Moussa Mohamad K. , Bohu Yoann , Valentin Eugénie , Gerometta Antoinne , Khiami Frédéric , Grimaud Olivier , Khalaf Zeinab , Meyer Alain , Hardy Alexandre 
Published: February 2025

Background: While patients receiving workers’ compensation (WC) often exhibit lower postoperative functional outcomes after orthopaedic surgery, this has not been completely explored with proximal hamstring avulsion injury (PHAI). Purpose: To (1) investigate the impact of patients with WC status on the functional outcome of PHAI repair and (2) identify risk factors for worse outcomes after PHAI repair. Study Design: Cohort study; Level of evidence, 3. Methods: This study focused on adults >18 years who underwent primary PHAI repair between 2008 and 2021 and had minimum 2-year follow-up data. Patients were divided into a WC group and a control group matched based on age, Tegner score, injury type (chronicity and tendon involved), and follow-up duration. The primary outcome measure was the Parisian Hamstring Avulsion Score (PHAS), with secondary outcomes including return-to-work metrics, activity levels measured by the Tegner and University of California at Los Angeles scores, and complications. The association between WC status and having worse postoperative outcomes (work changes, PHAS scores in the bottom 25% of cases, delayed return to work, or complications) was assessed, and the model that showed a statistically significant association with WC status was included in a multivariate analysis to adjust for confounders. Results: Overall, 104 patients (51 WC and 53 controls), with a mean age of 49.56 ± 9 years and a mean follow-up of 58.99 ± 44.61 months, were included. PHAS scores improved significantly after repair in both groups, yet WC patients exhibited lower postoperative PHAS scores (158.78 ± 34.43) than did control patients (171.77 ± 32.17; P = .049). Regression analysis revealed that patients with WC had a significantly higher risk of scoring in the bottom 25% (<150.75) on the PHAS (odds ratio [OR], 2.81 [95% CI, 1.09-7.28]; P = .033). On multivariate analysis, injury chronicity emerged as a significant risk factor for PHAS scores of <150.75 (OR, 8.09 [95% CI, 2.07-31.59]; P = .003), while the direct impact of the WC status was reduced (OR, 2.13 [95% CI, 0.75-6.07]; P = .155). Conclusion: The lower functional outcomes seen in patients with WC were not significant after adjusting for confounders, with injury chronicity being the key factor affecting postoperative results. No association was detected between WC status and return-to-work metrics.
Demographic and Social Characteristics of Internationally Educated Nurses in Sweden: Descriptive Statistical Study Comparisons Between Two Different Pathways for Recertification
Authors: Hadziabdic Emina , Årestedt Kristofer , Juuso Päivi , Marekovic Anna-Maria Sarstrand , Heikkilä Kristiina 
Published: February 2025

Background Nurse migration impacts global healthcare, which has a shortage of nurses, as many nurses move from lower-income to higher-income countries for better opportunities, working conditions, and salaries. Internationally educated nurses (IENs) have often been seen as a crucial solution to this issue. However, policies and regulations have been set in place to protect the public, including the recertification process and training to ensure educational comparability and competence. IENs’ contributions to the nursing workforce are significant, underscoring the importance of these policies and regulations. Aim The aim was to describe the demographic and social characteristics of IENs who had completed recertification for nurses’ licenses in Sweden and to compare these characteristics among those who completed recertification through the National Board of Health and Welfare (NBHW) or bridging programs. Methods A cross-sectional design using a survey and 818 questionnaires was sent to IENs with an identified postal address who had undergone the recertification process in Sweden. Of them, 296 (38%) were completed. Data were analyzed with descriptive statistics, chi-square tests, Fischer's exact tests, and independent sample t-tests. Results Most IENs who had participated in a bridging program were women, commonly aged between 31 and 40 years of age who had immigrated mainly from Asian or Middle Eastern countries for family-related reasons. The average time to obtain a nursing license was 5.9 years, starting from the year they immigrated until recertification. IENs who received recertification by the NBHW were significantly younger ( p < .001), had been in Sweden for a shorter time ( p < .001), and the time to license was shorter ( p < .001). Significant differences were also shown for origin ( p < .001) and reason for immigration ( p < .001). Conclusions The findings can be used by decision-makers and authorities when developing higher education strategies for legalization and immigration policy to contribute to IENs’ career advancement opportunities.
The impact of predialytic oral protein-based supplements on nutritional status and quality of life in hemodialysis patients: a randomized clinical trial
Authors: Elsayed Mohamed Mamdouh , Abdelkader Mohamed Magdy , ElKazaz Amr Mohamed , Elgohary Iman Ezzat 
Published: February 2025

Abstract

Background
Administration of oral nutritional supplements (ONS) inside hemodialysis (HD) units before sessions is an increasingly adopted option. Our aim was to assess the effects of predialytic ONS on nutritional status and quality of life (QOL) in HD patients.

Methods
One hundred HD patients were enrolled in this prospective, multicentric randomized clinical trial. Patients were assigned to receive ONS (25 gm protein powder) 1 h prior to the start of the HD session (predialytic) or maintained on their routine nutrition regimen for 3 months.

Results
At study end, supplemented patients showed a significant increase in serum albumin (p < 0.001), and a non-significant decrease in the median subjective global assessment (SGA) score. While in the control group, serum albumin remained stable, and the median SGA score increased significantly (p < 0.001). Body mass index and anthropometric measures did not differ between both groups. The supplemented patients showed significant improvement in three subscales of the Kidney Disease Quality of Life-36, without a significant change in QOL in control patients. Supplemented patients had significantly higher blood pressure (BP) (p = 0.037), lower urea reduction ratio (p = 0.020) and Kt/V (p = 0.021), higher serum calcium, lower total cholesterol and lower CRP (p = 0.047) levels compared to controls. There was no significant difference between groups regarding serum sodium, potassium, or phosphorus or adverse events.

Conclusions
Predialytic ONS administration may contribute to improvements in serum albumin, and QOL. The effects on BP, CRP, and the reduction in dialysis adequacy, should be carefully considered while adopting such strategy.

Clinical trials registration
ClinicalTrials.gov NCT05952570.

First registration date
2/07/2023.
Development and preliminary validation of the Danish headache questionnaire
Authors: Dissing K. B. , Jensen R. K. , Christensen H. W. , Jensen M. E. , Lauridsen H. H. 
Published: February 2025

Abstract

Background
The prevalence of headache disorders is imposing a growing burden on public health. Although most patients are seen in primary care, there is an absence of validated questionnaires designed to describe how clinicians manage patients with headache in primary care. The aim of this study was to develop a standardised headache questionnaire for use by primary care clinicians, covering diagnostic procedures, management strategies, and treatment modalities, and to assess the prevalence of consultations for headache in primary care.

Methods
The Danish Headache Questionnaire was developed through a three-phase process: a development phase, a content validation phase via iterative feedback, and a phase to create a generic English version. The Danish Headache Questionnaire includes a survey that covers diagnostic procedures, management strategies, and treatment modalities, and a logbook for tracking the prevalence of consultations for headaches. The questionnaire was tested by Danish chiropractors in primary care from 2020 to 2022.

Results
The Danish Headache Questionnaire underwent several modifications. The survey was expanded to include questions about the Danish profession-specific guideline for managing headaches, different headache types, medical history, radiographic imaging, and potential side effects. The logbook was revised to allow for the documentation of multiple headaches and included a separate form for recording the total number of consultations. The generic version was adapted by removing or adjusting profession-specific terms and questions to suit other clinical environments. The final Danish Headache Questionnaire is available in a generic and a chiropractic-specific format, and was translated to English through a cross-cultural adaptation process.

Conclusions
The Danish Headache Questionnaire has good content validity and is a feasible tool for assessing clinicians’ knowledge in managing patients with headaches and gathering data on headache prevalence in primary care. The generic version promotes a uniform approach and enables comparative analysis across different settings. The Danish Headache Questionnaire may be a valuable instrument guiding teaching a standardised assessment and for clinical assessment in primary care. Furthermore, it may have the potential to fill in gaps of knowledge which could improve the management of headache disorders in primary care.
Healthy ageing for older adult people with intellectual disability: a scoping review
Authors: El Mrayyan Nadia , Holmgren Marianne , Ahlström Gerd 
Published: February 2025

Abstract

Background
The increasing longevity of people with intellectual disability creates a need for a healthy-ageing perspective, translated into evidence-based interventions in this multi-morbidity group. Accordingly, the aim of this scoping review was to identify, summarise and analyse the empirical research on healthy ageing in older adults with intellectual disability.

Methods
This review was based on the PRISMA 2020 guidelines for Scoping Reviews (PRISMA-ScR) and a PICO protocol (Patient/population, Intervention, Comparison/control, and Outcome). Empirical studies in English were included if they concerned older adults with intellectual disability with an average age of at least 45 and were based on a clearly expressed healthy-ageing perspective. An information specialist conducted a search in 11 databases with no geographical or temporal restrictions. Two independent researchers performed study selection, quality assessment and data extraction. Disagreements were resolved in consultation with a third researcher. A textual narrative synthesis was based on PICO domains and the seven research questions.

Results
The 11 studies were all from developed countries and had different designs: qualitative, mixed-method and one systematic review. Only three studies highlighted the term “healthy ageing”, most used synonymous terms. Eight studies focused on healthy ageing on the individual level, three on the organisational and societal level. The intervention studies in the systematic review were mainly nonrandomised, concerned interventions varying in intensity and duration, considered different research questions and employed different outcome measures.

Conclusions
The findings highlight a major knowledge gap concerning evidence-based interventions with a healthy-ageing perspective in the case of older adults with intellectual disability. There is an urgent need to initiate healthy-ageing studies in developing countries, where such people are even more vulnerable to stigma and discrimination than those in developed countries. Our findings confirm the need to scale up healthy-ageing interventions in line with the WHO’s ambition to develop evidence-based approaches to optimise the functional capacity of all older people, including older adults with intellectual disability, by 2030.

Registration
The study is registered in the International Prospective Register of Systematic Reviews (PROSPERO), CRD42022337211 (13 June 2022).
Population-specific genetic-risk scores enable improved prediction of mortality within 28 days of sepsis onset: a retrospective Taiwanese cohort study
Authors: Hsieh Ming-Shun , Wu Pei-Hsuan , Chiu Kuan-Chih , Liao Shu-Hui , Chen Che-Shao , Hsiao Tzu-Hung , Chen Yi-Ming , Hu Sung-Yuan , How Chorng-Kuang , Chattopadhyay Amrita , Lu Tzu-Pin 
Published: February 2025

Abstract

Background
Sepsis is characterized by organ dysfunction as a response to infection and is one of the leading causes of mortality and loss of health. The heterogeneous nature of sepsis, along with ethnic differences in susceptibility, challenges a thorough understanding of its etiology. This study aimed to propose prediction models by leveraging genetic-risk scores and clinical variables that can assist in risk stratification of patients.

Methods
A total of 1,403 patients from Taiwan, diagnosed with sepsis, were utilized. Genome-wide survival analysis was conducted, with death within 28 days from sepsis onset, as the primary event to report significantly associated SNPs. A polygenic risk score (PRS-sepsis) was constructed via clumping and thresholding method which was added to clinical-only models to generate better performing prognostic models for identifying high-risk patients. Kaplan–Meier analysis was conducted using PRS-sepsis.

Results
A total of five single-nucleotide-polymorphisms (SNPs) reached genome-wide significance (p < 5e-8), and 86 SNPs reached suggestive significance (p < 1e-5). The prognostic model using PRS-sepsis showed significantly improved performance with c-index [confidence interval (CI)] of 0.79 [0.62–0.96] and area under receiver operating characteristic curve (AUROC) [CI] of 0.78 [0.75–0.80], in comparison to clinical-only prognostic models (c-index [CI] = 0.63 [0.45– 0.81], AUROC [CI] = 0.61 [0.58–0.64]). The ethnic specificity was established for our proposed models by comparing it with models generated using significant SNPs from prior European studies (c-index [CI] = 0.63 [0.42–0.85], AUROC [CI] = 0.60 [0.58–0.63]). Kaplan–Meier plots showed that patient groups with higher PRSs have inferior survival probability compared to those with lower PRSs.

Conclusions
This study proposed genetic-risk models specific for Taiwanese populations that outperformed clinical-only models. Also it established a strong racial-effect on the underlying genetics of sepsis-related mortality. The model can potentially be used in real clinical setting for deciding precise treatment courses for patients at high-risk thereby reducing the possibility of worse outcomes.
Investigating the expression level of 9-methylated septin 9 in different grades of colorectal cancer—a meta-analysis study
Authors: Mohandesi khosrosroshahi Elaheh , Bashi Zadeh Fakhar Haniyeh , Akbari Mohammad-Esmaiel , Izadi Neda 
Published: February 2025

Abstract

Introduction
Colorectal cancer (CRC) is a leading cause of cancer mortality in the USA, highlighting the urgent need for early detection. Methylated septin 9 (mSEPT9) is a promising tumor marker for CRC, offering high sensitivity for early stage detection, but its use in Asia is limited.

Method
We conducted a systematic review of empirical quantitative studies on mSEPT9 gene in cell-free DNA collected from plasma in CRC, following PRISMA and Cochrane guidelines, with searches yielding 1,340 records, of which 13 met our inclusion criteria. Quality was assessed using the STROBE checklist, ensuring robust data extraction and analysis.

Result
A total of 13 quantitative studies analyzed showed an overall positive detection rate of 66.98% for mSEPT9 as a diagnostic test for colorectal cancer, with the highest detection rate of 99.99% in Stage IV and the lowest at 51.21% in Stage I.

Conclusion
Our study demonstrates that mSEPT9 gene expression was a key biomarker for diagnosing and staging CRC, with higher detection rates in advanced stages, particularly Stage IV. Its role in critical signaling pathways highlights its potential for improving early detection and treatment planning in CRC patients.
Mode Connectivity in Auction Design
Authors: Hertrich Christoph , Tao Yixin , Végh László A. 
Published: February 2025

Optimal auction design is a fundamental problem in algorithmic game theory. This problem is notoriously difficult already in very simple settings. Recent work in differentiable economics showed that neural networks can efficiently learn known optimal auction mechanisms and discover interesting new ones. In an attempt to theoretically justify their empirical success, we focus on one of the first such networks, RochetNet, and a generalized version for affine maximizer auctions. We prove that they satisfy mode connectivity; that is, locally optimal solutions are connected by a simple, piecewise linear path such that every solution on the path is almost as good as one of the two local optima. Mode connectivity has been recently investigated as an intriguing empirical and theoretically justifiable property of neural networks used for prediction problems. Our results give the first such analysis in the context of differentiable economics, where neural networks are used directly for solving nonconvex optimization problems. Funding: All three authors gratefully acknowledge support by the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program [Grant ScaleOpt–757481 (all three authors); Grant ForEFront–615640 (C. Hertrich)]. Y. Tao is partially supported by the National Key R&D Program of China [Grant 2023YFA1009500].
Notes on the coexistence of sympatric northern raccoons and white-nosed coatis in a dry forest of northwest Costa Rica
Authors: Montalvo Victor H. , Fuller Todd K. , Sáenz-Bolaños Carolina , Carrillo Eduardo 
Published: February 2025

El uso de recursos por especies simpátricas que coexisten es poco conocido. Considerando las especies de prociónidos simpátricos en el bosque seco de Costa Rica (Parque Nacional Santa Rosa), planteamos la hipótesis que la presencia del mapache (Procyon lotor) es relativamente alta en tipos de cobertura donde el pizote (Nasua narica) está ausente. Colocamos 56 cámaras trampa entre junio de 2016 y junio de 2017 para comparar la ocurrencia y actividad del pizote y el mapache en diferentes tipos de cobertura, incluyendo éstas y otras 45 cámaras monitoreadas de manera irregular entre 2011 y 2016. En un año, ninguna cámara registró ambas especies, con la excepción del bosque ribereño. Las tasas fotográficas de mapache fueron mayores en el manglar y bosque de playa, no obteniendo registros en bosque primario y secundario. Los registros de pizote fueron mayores en bosque secundario y ausentes en el manglar y bosque de playa o pastizales arbolados. El mapache mostró mayor actividad nocturna mientras el pizote diurna, observando tasas fotográficas de pizotes (1.37/100 noches de trampa [tn]; n = 20.416 tn) que fueron más del doble que los mapaches (0.48). Las diferencias en los registros fotográficos para cada especie por tipo de cobertura y horario sugieren un patrón de alopatría local. Esta segregación interespecífica entre pizote y mapache puede atribuirse a diferencias en alimentación, además de competencia. Finalmente, este estudio mostró que las cámaras pueden proporcionar información valiosa sobre la ecología de las especies crípticas como este estudio.