bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the precision of an online visual acuity test tool
Authors: Gobira Mauro , Freire Vinícius , de Aquino Glauco Sérgio Avelino , Dib Vanessa , Gobira Matheus , Carricondo Pedro Carlos , Dias Ariadne , Negreiros Marco Antonio 
Published: May 2024

Objective The aim of this study was to assess the precision of a web-based tool in measuring visual acuity (VA) in ophthalmic patients, comparing it to the traditional in-clinic evaluation using a Snellen chart, considered the gold standard. Methods We conducted a prospective and in-clinic validation comparing the Eyecare Visual Acuity Test® to the standard Snellen chart, with patients undergoing both tests sequentially. Patients wore their standard spectacles as needed for both tests. Inclusion criteria involved individuals above 18 years with VA equal to or better than +1 logMar (20/200) in each eye. VA measurements were converted from Snellen to logMAR, and statistical analyses included Bland–Altman and descriptive statistics. Results The study, encompassing 322 patients and 644 eyes, compared Eyecare Visual Acuity Test® to conventional methods, revealing a statistically insignificant mean difference (0.01 logMAR, P = 0.1517). Bland–Altman analysis showed a narrow 95% limit of agreement (0.22 to −0.23 logMAR), indicating concordance, supported by a significant Pearson correlation (r = 0.61, P < 0.001) between the two assessments. Conclusion The Eyecare Visual Acuity Test® demonstrates accuracy and reliability, with the potential to facilitate home monitoring, triage, and remote consultation. In future research, it is important to validate the Eyecare Visual Acuity Test® accuracy across varied age cohorts, including pediatric and geriatric populations, as well as among individuals presenting with specific comorbidities like cataract, uveitis, keratoconus, age-related macular disease, and amblyopia.
Relationship Between Diameter and Pelvic Vein Reflux
Authors: Barros Fanilda Souto , Storino Joana 
Published: May 2024

Introduction: Diameter has been a complementary measurement in the evaluation of venous valvular insufficiency of superficial veins of the lower extremity. Small veins with reflux or large veins without reflux may indicate alternative treatments. Awareness of pelvic vein reflux is increasing. The pelvic vein diameter-reflux relationship was investigated. Methods: Findings of lower extremity ultrasound (US) and/or clinical conditions—pelvic pain, dyspareunia and dysmenorrhoea—were indications for pelvic/abdominal venous US. Complete US examination included renal, internal iliac and gonadal/ovarian veins. Diameters of the largest right or left pelvic veins were compared with presence of reflux. Intravaginal US was completed in 104 women, age 46 ± 11 (standard deviation) (range 25-76) years old. Pelvic symptoms were reported by 30 (29%) patients. The other patients had pelvic-related recurrent varicose veins or suspected pelvic source of lower extremity venous reflux. Positive and negative predictive values (PPV, NPV) and other statistics at the 90-95% level were calculated relating diameter to pelvic vein reflux. Results: Pelvic vein reflux was detected in 54 (52%) women. Pelvic vein diameters were larger in refluxing, 8.4 ± 1.9 (5.1-14.0) mm, than in nonrefluxing veins, 5.2 ± 1.0 (3.4-8.3) mm ( P < .001 by t test). Diameters ≥6.3 mm had 91% (49/54) sensitivity and 92% (49/53) PPV. Diameters ≤6.3 mm had 94% specificity (47/50) and 89% (47/53) NPV. All veins with diameter ≥8.4 mm ( n = 21) had reflux. All veins with diameter ≤5.0 mm ( n = 27) did not have reflux. Conclusions: Probabilities of pelvic vein reflux were estimated based on diameters. Diameter-reflux agreement solidifies diagnosis. An explanation for contradiction between small diameter and reflux or large diameter and no reflux is recommended.
Calcium channel blockers and Parkinson’s disease: a systematic review and meta-analysis
Authors: Lin Junyu , Pang Dejiang , Li Chunyu , Ou Ruwei , Yu Yujiao , Cui Yiyuan , Huang Jingxuan , Shang Huifang 
Published: May 2024

Background: The calcium channel has been considered to have great potential as a drug target for neuroprotective therapy in Parkinson’s disease (PD), but previous studies yielded inconsistent results. Objectives: This study aimed to conduct a systematic review and meta-analysis to assess the relationship between using calcium channel blockers (CCBs) and the risk and progression of PD. Data sources and methods: The terms such as ‘Parkinson’s disease’, ‘PD’, ‘calcium channel blockers’, and ‘CCB’ were used to search the literature published before 1 May 2023 in English databases, including PubMed, Embase, and Cochrane Library, for studies on CCB and PD. Data analysis was performed using Review Manager 5.3 software. Results: A total of 190 works of literature were preliminarily retrieved, and 177 works of literature were excluded by eliminating duplicates, reading abstracts, and reading full texts. A total of nine studies were finally included in the meta-analysis of the CCB and the risk of PD, and five studies were included in the systematic review of the CCB and the progression of PD. A total of 2,961,695 participants were included in the meta-analysis. The random-effects model was used for analysis due to significant heterogeneity. The main results of the meta-analysis showed that the use of CCB could reduce the risk of PD (relative risk 0.78, 95% confidence interval 0.62–0.99). Conclusion: CCB use was associated with a significantly reduced risk of PD. Whether CCB use has a disease-modifying effect on PD needs further study. Registration: PROSPERO: CRD42024508242.
Head-to-neck screw fixation and radial head arthroplasty result in similar postoperative outcomes for low-comminuted radial head fractures with neck involvement
Authors: Gonzalez-Morgado Diego , Mendoza-Aguilo Carlos , Gallardo-Calero Irene , Martinez-Collado Pablo , Bustos-Mardones Andres , Bargallo-Granero Julia , Lluch-Bergada Alex , Esteban-Feliu Ignacio 
Published: May 2024

Background Fixation of radial head fractures with neck involvement presents challenges. It remains unclear whether the outcomes of head-to-neck screw fixation are similar to those of arthroplasty in this scenario. We conducted a retrospective cohort study to evaluate the clinical outcomes of these two methods for treating such fractures. Methods Demographic data, fracture type, number of fragments, and concomitant injuries were recorded. Range of motion, Visual Analogue Scale for pain, Mayo Elbow Performance Score, and Quick-Disabilities of the Arm, Shoulder, and Hand at three-year follow-up, complications, and reintervention were compared. Results A total of 14 patients underwent fixation with head-to-neck screws, and 15 an arthroplasty. Baseline characteristics between groups were similar ( P > .05). Satisfactory range of motion (arc > 100°) was achieved in nine patients (64%) in the fixation group, and eight patients (53%) in the arthroplasty group ( P = .55). The mean Visual Analogue Scale, Mayo Elbow Performance Score, and Quick-Disabilities of the Arm, Shoulder, and Hand were 1.2 ± 1.2, 91.7 ± 10.7, and 9.1 ± 1, respectively, ( P = .651, P = .651, and P = .155). Three patients (21%) in the fixation group underwent a reintervention and three (20%) in the arthroplasty group ( P = .639). Discussion Head-to-neck screw fixation and radial head arthroplasty result in similar postoperative outcomes for low-comminuted radial head fractures with neck involvement.
Management of osteonecrosis of the humeral head in the pediatric population: A systematic review
Authors: Desai Vineet M , Syed Akbar N , Batley Morgan , Wells Lawrence , Williams Brendan A 
Published: May 2024

Purpose: Humeral head osteonecrosis in the pediatric patients most often occurs in patients with underlying hemoglobinopathies, exposure to chronic corticosteroids, or after trauma. The purpose of this study was to perform a systematic review evaluating the prevalence, clinical characteristics, and management of humeral head osteonecrosis in the pediatric population. Methods: PubMed, Ovid MEDLINE, and Scopus were screened with the terms “osteonecrosis,” “avascular necrosis,” “pediatric,” and “proximal humerus” on January 10, 2024. A total of 218 studies were screened, and 74 studies were evaluated for eligibility. Studies that reported on the prevalence and/or management of pediatric humeral head osteonecrosis were included. The systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Results: Twelve studies met inclusion criteria: four retrospective case series, three prospective case series, one retrospective cohort study, one retrospective case-control study, and three case reports. A majority of the studies (67%) discussed chemotherapy-induced osteonecrosis of the humeral head. A total of 77 patients (106 shoulders) with humeral head osteonecrosis were identified. The overall prevalence of osteonecrosis of the humeral head across eight studies examining at-risk populations (underlying hemoglobinopathies or undergoing chemotherapy) was 2%. Intra-articular steroid injections, physical therapy, and activity modification are effective conservative management strategies. Additionally, core decompression and hemiarthroplasty are surgical treatment options. Conclusions: The prevalence of osteonecrosis of the humeral head is low even among at-risk populations with associated medical conditions. A variety of conservative and surgical treatment options have been described, but no comparative evaluations of these modalities has been conducted. Level of evidence: IV.
Prevalence of advanced HIV disease and associated factors among antiretroviral therapy naïve adults enrolling in care at public health facilities in Kampala, Uganda
Authors: Ainembabazi Bridget , Katana Elizabeth , Bongomin Felix , Wanduru Phillip , Mayega Roy William , Mukose Aggrey David 
Published: May 2024

Background: Despite adoption of the ‘test-and-treat’ strategy, a high proportion of antiretroviral therapy (ART) naïve people living with HIV (PLHIV) enrol in care with, and die of advanced HIV disease (AHD) in Uganda. In this study, we aimed to determine the prevalence of AHD among ART naïve adults enrolling in care and associated factors at selected public health facilities in Kampala, Uganda. Methods: From April to July 2022, we conducted a mixed-methods study at Kiswa Health Centre III, Kitebi Health Centre III, and Kawaala Health Centre IV. The study involved cross-sectional enrolment and evaluation of 581 participants, utilizing an interviewer-administered questionnaire and chart reviews. Modified Poisson regression was employed to identify factors associated with AHD, complemented by a qualitative component comprising fifteen in-depth interviews, with data analysed through thematic analysis. Results: Overall, 35.1% (204/581) of the study participants had AHD. Being male [adjusted prevalence ratio (aPR): 1.4, 95% CI: 1.04–1.88] and aged 35–50 years (aPR: 1.81, 95% CI: 1.14–2.88) were associated with AHD. Participants with no personal health perception barriers had 37% lower odds of presenting to care with AHD (aPR: 0.63, 95% CI: 0.46–0.85). Qualitative findings indicated that individual factors, such as waiting until physical health deteriorated and initially opting for alternative therapies, took precedence in contributing to enrolment in care with AHD. Conclusion: Over one in every three ART naïve adults presents to public health facilities in Uganda with AHD. Male gender, age 35–50 years, and personal health perception barriers emerged as significant factors associated with AHD; emphasizing the need for targeted interventions to address these disparities and enhance early detection and engagement in care. Routine HIV testing should be emphasized and incentivized especially for men and persons aged 35–50 years.
Association of vitamin B12, folate, and homocysteine with COVID-19 severity and mortality: A systematic review and meta-analysis
Authors: Ulloque-Badaracco Juan R , Al-Kassab-Córdova Ali , Alarcon-Braga Esteban A , Hernandez-Bustamante Enrique A , Huayta-Cortez Miguel A , Cabrera-Guzmán Juan C , Robles-Valcarcel Pamela , Benites-Zapata Vicente A 
Published: May 2024

Objective: We aimed to review the available evidence on the association between vitamin B12, folate, and homocysteine levels with worse outcomes among COVID-19 patients. Methods: The search was carried out in ten databases simultaneously run on 10 May 2023, without language restrictions. We included cross-sectional, case-control, and cohort studies. The random-effects meta-analysis was performed using the Sidik-Jonkman method and corrected 95% confidence intervals using the truncated Knapp-Hartung standard errors. Standardized mean difference and 95% CI was used as the measure effect size. Results: Thirteen articles were included in this review ( n = 2134). Patients with COVID-19 who did not survive had the highest serum vitamin B12 values (SMD: 1.05; 95% CI: 0.31–1.78; p = 0.01, I2 = 91.22%). In contrast, low serum folate values were associated with patients with severe COVID-19 (SMD: −0.77; 95% CI: −1.35 to −0.19; p = 0.02, I2 = 59.09%). The remaining tested differences did not yield significant results. Conclusion: Elevated serum levels of vitamin B12 were associated with higher mortality in patients with COVID-19. Severe cases of COVID-19 were associated with low serum folate levels. Future studies should incorporate a larger sample size.
Student Nurses’ Perceptions of the Role of High-Fidelity Simulation in Developing Decision-Making Skills for Clinical Practice: A Qualitative Research Study
Authors: Abdulmohdi Naim , McVicar Andrew 
Published: May 2024

Introduction The integration of high-fidelity simulation (HFS) in nursing education has increased, but its effect on students’ clinical decision-making skills and their ability to transfer these skills to clinical practice remains unclear. Aim This qualitative study aimed to explore nursing students’ perceptions of simulation's role in developing decision-making skills for clinical practice. Methods Twenty-three self-selected final-year nursing students participated in an HFS exercise in 2016. They engaged in “think-aloud” activities during the simulation, reviewed videos of their performance, and attended a structured debriefing session. Four to six weeks later, face-to-face semistructured interviews were conducted to gather their views on the application of learning from simulation into practice. Thematic analysis was used to analyze the interview data. Results Four themes emerged from the analysis: “enhancing clinical decision-making skills,” “recognition of the types of clinical decision-making,” “recognition of cognitive biases,” and “transferability and integrating theory into practice.” Simulation improved student self-awareness, decision-making skills, and recognition of cognitive biases applied in practice. Overall, students found that the simulation improved their ability to apply theoretical knowledge gained through simulation to practice. The students’ perception of the authenticity of activities in relation to real-world scenarios played a crucial role in enhancing the transferability and application of acquired knowledge from simulation to clinical practice. Conclusion The findings provide valuable insights into how simulation optimizes learning and decision-making skills, ultimately promoting effective care in clinical settings.
Exploring undergraduate paramedic students’ understanding and experiences of person-centred care while on practice placement
Authors: McAteer Lorraine , Brown Donna 
Published: May 2024

Objective To explore paramedic students’ understanding and experience of the perceived facilitators and barriers to implementing person-centred care in urgent and emergency practice-based placement situations. Aim To explore paramedic students’ understanding of this concept and how it may be applied to clinical practice. Methods A non-probability convenience sample of participants was drawn from a second-year undergraduate Bachelor of Science (Hons) programme in Paramedic Science, at a United Kingdom university. The programme was underpinned by the Person-centred Practice Framework. Undergraduate paramedic students participated in face-to-face, audio-recorded, semi-structured interviews. A qualitative reflexive thematic analysis was then conducted to identify themes arising from the data. Results Ten participants were interviewed. Four key themes emerged from the data: (1) realising person-centred prerequisites which have two sub-themes – curriculum and reality of practice, (2) challenge of high-acuity calls, (3) developing a rapport with vulnerable people and, (4) factors in the macro environment. Conclusion Paramedic students witnessed moments of person-centred practice and were enabled to reflect on their learning experiences in positive ways, by working with paramedics/practice educators. However, their person-centred ideals were constantly challenged as students negotiated to work in complex, dynamic situations and in a health system under pressure.
Sperlingite, (H2O)K(Mn2+Fe3+)(Al2Ti)(PO4)4[O(OH)][(H2O)9(OH)]⋅4H2O, a new paulkerrite-group mineral, from the Hagendorf-Süd pegmatite, Oberpfalz, Bavaria, Germany
Authors: Rewitzer Christian , Hochleitner Rupert , Grey Ian E. , Kampf Anthony R. , Boer Stephanie , MacRae Colin M. , Mumme William G. , Wilson Nicholas C. , Davidson Cameron J. 
Published: May 2024

AbstractSperlingite, (H2O)K(Mn2+Fe3+)(Al2Ti)(PO4)4[O(OH)][(H2O)9(OH)]⋅4H2O, is a new monoclinic member of the paulkerrite group, from the Hagendorf-Süd pegmatite, Oberpfalz, Bavaria, Germany. It was found in corrosion pits of altered zwieselite, in association with columbite, hopeite, leucophosphite, mitridatite, scholzite, orange–brown zincoberaunite sprays and tiny green crystals of zincolibethenite. Sperlingite forms colourless prisms with pyramidal terminations, which are predominantly only 5 to 20 μm in size, rarely to 60 μm and frequently are multiply intergrown and are overgrown with smaller crystals. The crystals are flattened on {010} and slightly elongated along [100] with forms {010}, {001} and {111}. Twinning occurs by rotation about c. The calculated density is 2.40 g⋅cm–3. Optically, sperlingite crystals are biaxial (+), α = 1.600(est), β = 1.615(5), γ = 1.635(5) (white light) and 2V (calc.) = 82.7°. The optical orientation is X = b, Y = c and Z = a. Neither dispersion nor pleochroism were observed. The empirical formula from electron microprobe analyses and structure refinement is A1[(H2O)0.96K0.04]Σ1.00A2(K0.52□0.48)Σ1.00M1(Mn2+0.60Mg0.33Zn0.29Fe3+0.77)Σ1.99M2+M3(Al1.05Ti4+1.33Fe3+0.62)Σ3.00(PO4)4X[F0.19(OH)0.94O0.87]Σ2.00[(H2O)9.23(OH)0.77]Σ10.00⋅3.96H2O. Sperlingite has monoclinic symmetry with space group P21/c and unit-cell parameters a = 10.428(2) Å, b = 20.281(4) Å, c = 12.223(2) Å, β = 90.10(3)°, V = 2585.0(8) Å3 and Z = 4. The crystal structure was refined using synchrotron single-crystal data to wRobs = 0.058 for 5608 reflections with I > 3σ(I). Sperlingite is the first paulkerrite-group mineral to have co-dominant divalent and trivalent cations at the M1 sites; All other reported members have Mn2+ or Mg dominant at M1. Local charge balance for Fe3+ at M1 is achieved by H2O → OH– at H2O coordinated to M1.
Increased risk of venous thromboembolism in young and middle-aged individuals with hereditary angioedema: a family study
Authors: Sundler Björkman Linda , Pirouzifard MirNabi , Grover Steven P. , Egesten Arne , Sundquist Jan , Sundquist Kristina , Zöller Bengt 
Published: May 2024

Abstract
Hereditary angioedema (HAE), caused by C1 inhibitor protein deficiency, was recently shown to be associated with an increased risk for venous thromboembolism (VTE). To our knowledge, this is the first national family study of HAE, which aimed to determine the familial risk of VTE. The Swedish Multi-Generation Register was linked to the Swedish National Patient Register for the period of 1964 to 2018. Only patients with HAE with a validated diagnosis were included in the study and were linked to their family members. Hazard ratios (HRs) and 95% confidence intervals (CIs) for VTE were calculated for patients with HAE in comparison with relatives without HAE. Among 2006 individuals (from 276 pedigrees of 365 patients with HAE), 103 individuals were affected by VTE. In total, 35 (9.6%) patients with HAE were affected by VTE, whereas 68 (4.1%) non-HAE relatives were affected (P &lt; .001). The adjusted HR for VTE among patients with HAE was 2.51 (95% CI, 1.67-3.77). Patients with HAE were younger at the first VTE than their non-HAE relatives (mean age, 51 years vs 63 years; P &lt; .001). Before the age of 70 years, the HR for VTE among patients with HAE was 3.62 (95% CI, 2.26-5.80). The HR for VTE for patients with HAE born after 1964 was 8.29 (95% CI, 2.90-23.71). The HR for VTE for patients with HAE who were born in 1964 or earlier was 1.82 (95% CI, 1.14-2.91). HAE is associated with VTE among young and middle-aged individuals in Swedish families with HAE. The effect size of the association is in the order of other thrombophilias. We suggest that HAE may be considered a new rare thrombophilia.
EVIDENCE meta-analysis: evaluating minimal residual disease as an intermediate clinical end point for multiple myeloma
Authors: Landgren Ola , Prior Thomas J. , Masterson Tara , Heuck Christoph , Bueno Orlando F. , Dash Ajeeta B. , Einsele Hermann , Goldschmidt Hartmut , Knop Stefan , Li Cong , Mellqvist Ulf-Henrik , McFadden Ian , Oprea Corina , Ross Jeremy A. , Talpes Mihaela , Hydren Jay R. , Ahlstrom Jennifer M. , Kazandjian Dickran , Weinhold Niels , Zhang Rick , Stetler-Stevenson Maryalice , Marti Gerald , Devlin Sean M. 
Published: May 2024

Abstract
Estimating progression-free survival (PFS) and overall survival superiority during clinical trials of multiple myeloma (MM) has become increasingly challenging as novel therapeutics have improved patient outcomes. Thus, it is imperative to identify earlier end point surrogates that are predictive of long-term clinical benefit. Minimal residual disease (MRD)-negativity is a common intermediate end point that has shown prognostic value for clinical benefit in MM. This meta-analysis was based on the US Food and Drug Administration guidance for considerations for a meta-analysis of MRD as a clinical end point and evaluates MRD-negativity as an early end point reasonably likely to predict long-term clinical benefit. Eligible studies were phase 2 or 3 randomized controlled clinical trials measuring MRD-negativity as an end point in patients with MM, with follow-up of ≥6 months following an a priori–defined time point of 12 ± 3 months after randomization. Eight newly diagnosed MM studies evaluating 4907 patients were included. Trial-level associations between MRD-negativity and PFS were R2WLSiv, 0.67 (95% confidence interval [CI], 0.43-0.91) and R2copula 0.84 (0.64 to &gt;0.99) at the 12-month time point. The individual-level association between 12-month MRD-negativity and PFS resulted in a global odds ratio (OR) of 4.02 (95% CI, 2.57-5.46). For relapse/refractory MM, there were 4 studies included, and the individual-level association between 12-month MRD-negativity and PFS resulted in a global OR of 7.67 (4.24-11.10). A clinical trial demonstrating a treatment effect on MRD is reasonably likely to eventually demonstrate a treatment effect on PFS, suggesting that MRD may be an early clinical end point reasonably likely to predict clinical benefit in MM, that may be used to support accelerated approval and thereby, expedite the availability of new drugs to patients with MM.