bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fluid balance and clinical outcomes in patients with aortic dissection: a retrospective case-control study based on ICU databases
Authors: Lei Jiahao , Zhang Zhuojing , Li Yixuan , Wu Zhaoyu , Pu Hongji , Xu Zhijue , Yang Xinrui , Wang Ruihua , Qiu Peng , Chen Tao , Lu Xinwu 
Published: February 2025

ObjectivesAortic dissection (AD) is a life-threatening condition that requires intensive care and management. This paper explores the role of fluid management in the clinical care of AD patients, which has been unclear despite the substantial existing research that has been conducted on the treatment of AD.DesignA retrospective case-control study using data for AD patients from public databases.SettingTwo public intensive care unit (ICU) databases with hospital courses from the USA, Medical Information Mart for Intensive Care (MIMIC)-IV critical care dataset and the eICU Collaborative Research Database, with data from 2008 to 2019.ParticipantsA total of 751 adult AD patients with detailed fluid management records from two databases were included.InterventionsThe mean 24-hour intake and output were calculated by dividing the total amount of intake and output by the number of days in the ICU, respectively. The mean 24-hour fluid balance was generated by subtracting the output from the intake.Outcome measuresThe relationship between the mean 24-hour fluid management and all-cause in-hospital death was assessed through univariate and multivariable regression analyses.ResultsA positive correlation was found between mean 24-hour fluid intake and in-hospital mortality among AD patients (OR 1.029, 95% CI (1.018, 1.041), p<0.001), whereas a negative correlation was revealed between mean 24-hour fluid output and in-hospital mortality (OR 0.941, 95% CI (0.914, 0.968), p<0.001). A similar result was found for mean 24-hour fluid balance (OR 1.030, 95% CI (1.019, 1.042), p<0.001), and the cut-off was selected to be 5.12 dL (AUC=0.778, OR 3.066, 95% CI (1.634, 5.753), p<0.001).ConclusionsThis study stresses the importance of fluid balance in the clinical care of AD patients and provides new insights for optimising fluid management and monitoring strategies beyond the conventional focus on blood pressure and heart rate management.
Validation of insurance claims data on aetiology, surgical type and prosthesis for isolated valve surgery: a retrospective observational surgery
Authors: Hou Bo-Cheng , Huang Jo-Ting , Chen Chun-Yu , Chang Feng-Cheng , Cheng Yu-Ting , Wu Victor Chien-Chia , Chan Yi‐Hsin , Lin Chia-Pin , Chu Pao-Hsien , Chou An-Hsun , Chen Shao-Wei 
Published: February 2025

ObjectivesAdministrative database research is pivotal for developing guidelines in cardiovascular surgery and valvular heart disease. However, validation studies specific to Asia are lacking. This study validated the coding of valvular heart repair and replacement surgeries in Taiwan’s National Health Insurance (NHI) Research Database using International Classification of Diseases, Clinical Modification (ICD-CM) codes.MethodsThis retrospective observational study used data from the Chang Gung Research Database between 2015 and 2018, identifying 1171 patients using Taiwanese NHI reimbursement codes. The gold standard was defined as a blinded retrospective review of operation notes. Claims data, including ICD diagnostic codes, ICD procedural codes and NHI supply codes for surgical materials, were validated. Positive predictive values (PPVs) were calculated as the number of true positives divided by the total claims data.ResultsThe PPVs (95% CI) for aortic valve (AV) surgery aetiologies were as follows: infectious endocarditis (IE), 94.1% (87.6%–97.7%); rheumatic heart disease (RHD), 88.2% (67.3%–97.5%); bicuspid AV, 93.3% (83.3%–98.1%); and degeneration, 91.7% (85.3%–95.8%). For mitral valve surgery, the surgery aetiologies and PPVs were IE, 93.2% (87.9%–96.6%); RHD, 94.9% (88.3%–98.2%); ischaemic mitral regurgitation, 87.5% (73.0%–95.6%); and degeneration, 88.4% (83.9%–92.0%). Surgical types generally exhibited higher PPVs, except for mechanical prostheses (<90%). The accuracy of mechanical prosthesis identification improved with the inclusion of supply codes along with ICD procedural codes.ConclusionsThe PPVs for both aetiologies and surgical types of valvular heart disease were generally satisfactory. The inclusion of supply codes for mechanical valve replacements enhanced accuracy but led to fewer eligible patients being included in the sample. This study provides a potentially optimal framework for future research on valve diseases and surgeries using claims databases.
Types of electronic nicotine delivery systems (ENDS) used by people of different age and smoking status groups: results from a US nationally representative survey
Authors: Massey Zachary B , Fairman Robert T , Cham Bai , Alqahtani Mohammed , Luo Ruiyan , Weaver Scott , Popova Lucy , Ashley David L 
Published: February 2025

ObjectivesThe type of electronic nicotine delivery system (ENDS) used by different age groups may be associated with ENDS and cigarette use behaviours. This study sought to identify differences in the use of ENDS device type based on age and cigarette use status to inform policy about regulating ENDS.DesignThis was a cross-sectional study.SettingData was derived from a national survey conducted in 2021 in the USA.ParticipantsParticipants include 2369 US youth and adults (13 years or older) who reported past 30-day ENDS use.Outcome measuresPast 30-day fairly regular use (i.e., several times a week or more) of ENDS device types, namely cigalikes, disposables, refillable tank/box mods, closed pods, refillable pods and drippers. Cigarette smoking status was also measured.ResultsWe used weighted regression models to determine the association between ENDS device type current regular use and age group and the association between each ENDS type current regular use and smoking status separately for each age group. Youth ENDS users 13–17 years old were more likely to regularly use cigalikes (OR=2.71), disposables (OR=3.44), closed pods (OR=2.57) and drippers (OR=2.86) and 18–29 years old were more likely to regularly use disposables (OR=3.67), closed pods (OR=1.58) and drippers (OR=1.94), compared with 30+ years old ENDS users (all p<0.05). Among 13–17 years old, current (vs never) smokers had greater odds of current regular use for cigalikes (OR=2.79), disposables (OR=2.33), refillable tanks (OR=2.27), closed pods (OR=2.62) and drippers (OR=6.32; all p<0.05). Similarly, 18–29 years old current (vs never) smokers had higher odds of reporting current regular use of refillable tanks (OR=1.80), refillable pods (OR=2.63), closed pods (OR=2.20) and drippers (OR=4.89; p<0.05).ConclusionsBoth age and smoking status were associated with current regular use of ENDS, especially for youth and young adults. These findings inform regulatory agencies as they monitor and enforce policy on ENDS allowed on the US market.
Phase I trial on the safety of olprinone for low central venous pressure management aimed at haemorrhage control during open and laparoscopic hepatectomy: a study protocol
Authors: Miura Yuya , Sugiura Teiichi , Ashida Ryo , Ohgi Katsuhisa , Yamada Mihoko , Otsuka Shimpei , Kato Yoshiyasu , Oyakawa Takuya , Ando Eiji , Tamai Sunao , Uesaka Katsuhiko 
Published: February 2025

IntroductionHepatectomy is the primary treatment for malignant liver tumours. It is crucial to control bleeding during liver parenchymal transection. Methods to reduce central venous pressure (CVP), such as fluid restriction and the use of vasodilators, are essential for minimising bleeding but can lead to haemodynamic instability. Phosphodiesterase-3 (PDEIII) inhibitors such as milrinone have shown efficacy in managing low CVP and maintaining haemodynamic stability. This study investigates olprinone, another PDEIII inhibitor with a potentially strong vasodilatory effect, for its safety and efficacy in CVP management during hepatectomy.Methods and analysisThis single-centre phase I trial at Shizuoka Cancer Center evaluates the intraoperative administration of olprinone for open and laparoscopic hepatectomy. The trial employs a 3+3 cohort study design to determine the maximum tolerated dose (MTD) and identify dose-limiting toxicities. The study also assesses the trends in CVP and circulatory dynamics using the FloTrac System, alongside safety evaluations. The trial aims to establish the safety and MTD of olprinone during hepatectomy, potentially offering a method to control CVP without causing haemodynamic instability. This could lead to reduced blood loss, shorter operative time and fewer postoperative complications.Ethics and disseminationThe study protocol was approved by the Certified Review Board of Shizuoka Cancer Center (approval number CRB4180010).Trial registration numberjRCTs041230110 and jRCTs041230111.
Hospitalisation rates for epilepsy, asthma and insulin-dependent diabetes in 796 190 school-aged children and young people with and without intellectual disabilities: a record-linkage cohort study
Authors: Smith Gillian S , Fleming Michael , Cooper Sally-Ann , Henderson Angela , Pell Jill , Melville Craig , Cairns Deborah 
Published: February 2025

ObjectivesTo investigate hospitalisation rates for the ambulatory care-sensitive conditions of epilepsy, asthma and insulin-dependent diabetes in school-aged children and young people with intellectual disabilities in comparison with their peers.DesignRecord-linkage cohort study. Scotland’s Pupil Census, 2008–2013, was used to identify pupils with and without intellectual disabilities and was linked with the Prescribing Information Service to identify pupils with epilepsy, asthma and insulin-dependent diabetes, and the Scottish Morbidity Records-01 to identify hospital admissions.SettingThe general child population of Scotland.ParticipantsSchool pupils aged 4–19 years; 18 278 with intellectual disabilities and 777 912 without intellectual disabilities.OutcomesOverall, emergency and non-emergency hospitalisations for epilepsy, asthma and/or diabetes; and length of stay.ResultsEpilepsy and asthma were more prevalent in pupils with intellectual disabilities (8.8% and 8.9%, respectively, compared with 0.8% and 6.9% among pupils without intellectual disabilities, p<0.001), whereas insulin-dependent diabetes was not (0.5% prevalence). After adjusting for prevalence, pupils with intellectual disabilities and epilepsy had more epilepsy-related admissions than their peers (adjusted Hazard Ratio (aHR) 2.24, 95% CI 1.97, 2.55). For emergency admissions, these stays were longer compared with controls (adjusted incidence rate ratio (aIRR) 2.77, 95% CI 2.13, 3.59). Pupils with intellectual disabilities and asthma had similar admission rates due to asthma as control pupils with asthma (aHR 0.81, 95% CI 0.62, 1.06), but emergency admissions were longer (aIRR 2.72, 95% CI 1.49, 4.96). Pupils with intellectual disabilities and insulin-dependent diabetes had similar admission rates to controls (aHR 0.94, 95% CI 0.63, 1.41) but with shorter admissions (aIRR 0.71, 95% CI 0.51, 0.99).ConclusionsOur findings suggest pupils with intellectual disabilities may receive poorer community healthcare than their peers for the common conditions of epilepsy and asthma. Hospital admissions are disruptive for both the child and their family. Epilepsy and asthma are associated with avoidable deaths; hence, a better understanding of these hospitalisations is important.
Beneficiaries’ satisfaction with health insurance and associated factors in Sub-Saharan Africa: a systematic review and meta-analysis
Authors: Kase Bizunesh Fantahun , Shibeshi Abdu Hailu , Seid Abubeker Alebachew , Mehari Molla Getie , Moloro Abdulkerim Hassen 
Published: February 2025

ObjectiveBeneficiaries’ satisfaction with health insurance schemes is crucial for the success of these programmes, influencing their effective implementation and reducing dropout rates. This systematic review and meta-analysis aimed to assess the proportion of beneficiaries satisfied with health insurance and identify factors associated with their satisfaction in Sub-Saharan Africa (SSA).DesignA systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines.Data sourcesPubMed/MEDLINE, African Journals Online, Cumulative Index to Nursing & Allied Health Literature and Google Scholar were searched up to 23 May 2024.Eligibility criteriaObservational and quantitative studies conducted in SSA that reported the proportion of health insurance beneficiaries satisfied with the scheme and/or determined factors associated with satisfaction were included.Data extraction and synthesisData were extracted using Microsoft Excel and analysed with STATA V.17 software. The quality of studies was assessed using Joanna Briggs Institute checklists. A random-effects model was employed to estimate pooled outcomes. Publication bias was evaluated with a funnel plot and Egger’s regression test, while heterogeneity was assessed using the I² statistic.ResultThe study included 29 primary studies with a total of 11,488 participants. Among the included studies, 17 (58.62%) were found to have a low risk of bias, while the remaining studies exhibited a moderate risk of bias. The findings suggested publication bias among the included studies. To address this, a trim-and-fill analysis imputed 10 hypothetical missing studies, resulting in a more symmetrical funnel plot. The pooled finding showed that 61.84% of beneficiaries were satisfied with their health insurance (95% CI: 55.14 to 68.55, (I2=98.6%, p<0.001)). Having a good knowledge of health insurance (OR=2.75, 95% CI: 1.42 to 5.34, (I2=95.3%, p<0.001)), availability of prescribed drugs (OR=5.69, 95% CI: 3.04 to 10.62, (I2=88.6%, p<0.001)) and availability of lab services (OR=4.20, 95% CI: 2.18 to 8.11, (I2=88.4%, p<0.001)) were significantly associated to higher satisfaction with health insurance.ConclusionThe results of this review show that a significant number of beneficiaries are satisfied with their health insurance. The findings highlight that beneficiaries’ satisfaction is significantly influenced by their knowledge of health insurance, as well as the availability of prescribed drugs and essential laboratory services. It is recommended that health insurance programmes in SSA focus on these factors to improve overall satisfaction among beneficiaries.PROSPERO registration numberCRD42024496847.
Development and validation of the respite care model for adults with cancer in Iran: study protocol for a multimethod research project
Authors: Kheibar Nasrin , Pakpour Vahid , Rahmani Azad , Rassouli Maryam , Sadeghi-Ghyassi Fatemeh 
Published: February 2025

IntroductionThe primary caregivers of patients with cancer, especially in advanced stages, experience significant physical and emotional strain and require comprehensive support. Respite care has been acknowledged as an effective strategy to aid primary caregivers, and different models have been established in Western nations. However, implementing these models poses challenges due to notable cultural, social and healthcare system variances between Western and non-Western regions like Iran and other Middle Eastern countries. It is crucial to develop a model tailored to the country’s specific needs, culture and resources to systematically support caregivers and ensure care continuity. Hence, this study aims to develop and validate a respite care model for adult patients with cancer in Iran.Methods and analysisThis study will use a multimethod approach across three stages. In the first phase, a scoping review will be conducted to identify, describe, conceptualise and implement the respite care system based on available documents and evidence. Then, a directed content analysis will be carried out to clarify care requirements and system establishment needs from stakeholders’ perspectives. Data from the scoping review and directed content analysis will be integrated to identify the crucial components of the model using the Delphi method in the second phase. In the third phase, another Delphi study will be conducted to assess the importance, scientific credibility and feasibility of the model, with the aim of finalising it.Ethics and disseminationThis research project has received the code of ethics (IR.TBZMED.REC.1402.720) from Ethics Committee of Tabriz University of Medical Sciences. The findings of this study will be published in reputable journals and disseminated in accessible formats through various media channels.
Physiotherapists’ perspectives on the implementation of direct access to physiotherapy services in Saudi Arabia: a cross-sectional study
Authors: Mohammed Osama , Alzahrani Hosam , Marouf Elaf , Shaheen Razaz 
Published: February 2025

ObjectiveThis study investigates Saudi Arabian physiotherapists’ perspectives on direct access to physiotherapy (DAPT) services, focusing on perceived benefits, barriers and implementation in clinical practice.MethodsA cross-sectional observational study design was used. Data collection occurred between December 2022 and June 2023 via an online structured questionnaire distributed through email and text messages. The DAPT section comprised items on awareness, endorsement, obstacles/barriers to implementation in Saudi Arabia, perceived benefits and expected benefits of various resources to guide evidence-based practice for physiotherapists. This section featured closed-ended questions using a 5-point Likert scale. The study included licensed physiotherapists currently working in Saudi Arabia.ResultsThe study included 401 participants, with a nearly equal distribution of 203 males (50.6%) and 198 females (49.4%). The most common age group was 25–34 years, comprising 70.6% of the participants. A significant proportion (61.6%) were aware of DAPT, and 88% acknowledged its potential to reduce delays in care. However, 49.9% had not engaged with relevant literature. The primary barriers to DAPT identified were laws and regulations (mean=3.69, SD=1.21), physician support (mean=3.59, SD=0.99), entry-level education (mean=3.45, SD=1.17), patient beliefs (mean=3.38, SD=1.24), self-confidence (mean=3.35, SD=1.15) and professional autonomy (mean=3.34, SD=1.22).ConclusionPhysiotherapists in Saudi Arabia demonstrate substantial awareness of direct access. Organisational initiatives and increased awareness are essential to promote direct access. This study highlights that direct patient access to physiotherapists offers significant benefits to patients, healthcare workers and the broader community.
Human Papillomavirus, Human Immunodeficiency Virus, and Oral Microbiota Interplay in Nigerian Youth (HOMINY): A Prospective Cohort Study Protocol
Authors: Osagie Esosa , Akhigbe Paul , Idemudia Nosakhare , Obuekwe Ozoemene , Adebiyi Ruxton , Schlecht Nicolas , Liu Jia , Bromberg Yana , Eki-Udoko Fidelis E , Osazuwa-Peters Nosayaba , Coker Modupe Oluseun 
Published: February 2025

IntroductionPersistent oral infections with high-risk human papillomavirus (HR-HPV) are a potential cause of most oropharyngeal cancers (OPCs). Oral HR-HPV infection and persistence are significantly higher in people living with HIV (PLWH). Most data on oral HR-HPV in PLWH come from developed countries or adult cohorts. This study aims to investigate oral HR-HPV susceptibility and persistence among children and adolescents living with HIV (CALHIV) and to understand the roles of perinatal HIV exposure, infection, antiretroviral treatment, and the oral microbiome.Methods and analysisThis prospective cohort study is ongoing at the University of Benin Teaching Hospital (UBTH), Nigeria, involving mother-child pairs followed at 6-month intervals for 2 years. Participants include children aged 9–18 and their mothers aged 18 and above. The study targets 690 adolescents in three groups: 230 CALHIV, 230 HIV-exposed but uninfected and 230 HIV-unexposed and uninfected. Oral rinse, saliva, buccal swabs and supragingival plaque samples are collected at each visit. Blood samples are tested for HIV, Hepatitis B virus (HBV) and Hepatitis C virus (HCV), with CD4, CD8 and full blood counts performed. Oral HPV is assessed for incidence, persistence, and clearance. Statistical analyses to look for associations between cohort baseline characteristics and findings will be conducted using univariable and multivariable models for repeated data and high-dimensional microbiome data. All statistical tests will be two-sided; a p value <0.05 will indicate significance. Multiple comparisons will be adjusted using the False Discovery Rate (FDR) correction to control for Type I error.Ethics and disseminationThe study was approved by Rutgers State University (Pro2022000949) and the UBTH (ADM/E22/A/VOL. VII/14813674). Informed consent was obtained from all parents/guardians.
SHoes for Adolescent PatEllofemoral pain: study protocol for the SHAPE Australian community-based, randomised clinical trial
Authors: Paterson Kade L , Shearer Sam , Bennell Kim L , Bryant Adam , Li Peixuan , De Silva Anurika P , Lamb Karen Elaine , Manski-Nankervis Jo-Anne , Hinman Rana S 
Published: February 2025

IntroductionPatellofemoral pain affects one-third of adolescents, with most experiencing symptoms into adulthood. Guidelines recommend exercise and foot orthoses based on clinical trials in adults; however, these approaches have been found to be ineffective and have poor adherence in adolescents. ‘Minimalist’ shoes can reduce patellofemoral joint forces in adults; and may therefore be a promising low burden management approach for patellofemoral pain. This article outlines the protocol for a randomised clinical trial (RCT) that aims to determine if minimalist footwear improves pain, function and other symptoms compared with motion control shoes, in adolescents with patellofemoral pain.Methods and analysisThis is a 3-month, pragmatic, two-arm parallel group, comparative effectiveness, superiority RCT conducted in Melbourne, Australia. We are recruiting 158 participants aged between 12 and 19 years with patellofemoral pain from the community. Following baseline assessment, participants are randomised to receive either minimalist shoes (intervention group) or motion control shoes (control group, given that clinicians typically advocate motion control shoes for patellofemoral pain). Participants choose one pair of shoes in their allocated group from two colour options. They are advised to wear their study shoes for all planned sports and exercise-based activities over the subsequent 3 months and are also advised that they may wear them as much as desired at other times. The primary outcomes are the 3-month change in (1) severity of the worst knee pain experienced over the past week, measured using a Numerical Rating Scale, and (2) the function in sport and play subscale of the Knee Injury and Osteoarthritis Outcome Score for Children. The secondary outcomes include changes in other parameters of knee pain, symptoms, function in daily activities, health-related and knee-related quality of life, global improvement and fear of movement. Other measures include cointervention use, adherence, adverse events, shoe comfort, descriptive characteristics, physical activity levels, footwear characteristics and objective foot measures.Ethics and disseminationThis study has been approved by the University of Melbourne Greater than Low Risk Human Research Ethics Committee (reference: 2022-25470-35344-4). Written informed consent is obtained from each participant prior to enrolment. The SHoes for Adolescent PatEllofemoral pain trial will provide the first RCT evidence on the efficacy of minimalist shoes compared with motion control shoes in adolescents with patellofemoral pain. Outcomes will be presented at national and international scientific conferences and published in peer-review journals.Trial registration numberAustralian New Zealand Clinical Trials Registry reference: ACTRN12623000042640.