bluuebunny/crossref_metadata_2025_split huggingface dataset:
Digital skills of health care professionals in cancer care: A systematic review
Authors: Leena Tuominen , Jenna Poraharju , Carme Carrion , Leeni Lehtiö , Helena Leino-Kilpi , Sònia Moretó , Minna Stolt , Virpi Sulosaari , Heli Virtanen 
Published: March 2024

Background The digital transformation of healthcare enables new ways of working in cancer care directing attention on the digital skills of healthcare professionals. This systematic review aims to identify existing evidence about digital skills among health care professionals in cancer care to identify the needs for future education and research. Methods Database searches were conducted in PubMed, CINAHL, Web of Science, Scopus, Cochrane and ERIC to identify studies until March 2023. The inclusion criteria were digital skills of health care professionals in cancer care as described by themselves, other health care professionals, patients or significant others. The CASP tool was used for quality assessment of the studies. Data was analysed following inductive content analysis. Results The search produced 4563 records, of which 24 studies were included (12 qualitative, 10 quantitative, 1 mixed methods design and 1 strategy paper). Four main categories were identified describing HCPs’ required skills, existing skills and development areas of digital skills in cancer care: Skills for information technology, Skills for ethical practice, Skills for creating a human-oriented relationship and Skills for digital education and support. In development areas, one more main category, Skills for implementing digital health, was identified. Conclusion The digital skills of health care professionals in cancer care are multifaceted and fundamental for quality cancer care. The skills need to be assessed to provide education based on actual learning needs. The review findings can be used for education and research in this field.
Sensing the impact of extreme heat on physical activity and sleep
Authors: Cheong So-Min , Gaynanova Irina 
Published: March 2024

Introduction This study assesses the person-specific impact of extreme heat on low-income households using wearable sensors. The focus is on the intensive and longitudinal assessment of physical activity and sleep with the rising person-specific ambient temperature. Methods This study recruited 30 participants in a low-income and predominantly Black community in Houston, Texas in August and September of 2022. Each participant wore on his/her wrist an accelerometer that recorded person-specific ambient temperature, sedentary behavior, physical activity intensity (low and moderate to vigorous), and sleep efficiency 24 h over 14 days. Mixed effects models were used to analyze associations among physical activity, sleep, and person-specific ambient temperature. Results The main findings include increased sedentary time, sleep impairment with the rise of person-level ambient temperature, and the mitigating role of AC. Conclusions Extreme heat negatively affects physical activity and sleep. The negative consequences are especially critical for those with limited use of AC in lower-income neighborhoods of color. Staying home with a high indoor temperature during hot days can lead to various adverse health outcomes including accelerated cognitive decline, higher cancer risk, and social isolation.
The 2023 AO Spine-Praxis Guidelines in Acute Spinal Cord Injury: What Have We Learned? What Are the Critical Knowledge Gaps and Barriers to Implementation?
Authors: Fehlings Michael G. , Moghaddamjou Ali , Evaniew Nathan , Tetreault Lindsay A. , Alvi Mohammed Ali , Skelly Andrea C. , Kwon Brian K. 
Published: March 2024

Study Design Narrative summary of the 2023 AO Spine-Praxis clinical practice guidelines for management in acute spinal cord injury (SCI). Objectives The objective of this article is to summarize the key findings of the clinical practice guidelines for the optimal management of traumatic and intraoperative SCI (ISCI). This article will also highlight potential knowledge translation opportunities for each recommendation and discuss important knowledge gaps and areas of future research. Methods Systematic reviews were conducted according to accepted methodological standards to evaluate the current body of evidence and inform the guideline development process. The summarized evidence was reviewed by a multidisciplinary guidelines development group that consisted of international multidisciplinary stakeholders. The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach was used to rate the certainty of the evidence for each critical outcome and the “evidence to recommendation” framework was used to formulate the final recommendations. Results The key recommendations regarding the timing of surgical decompression, hemodynamic management, and the prevention, diagnosis, and management of ISCI are summarized. While a strong recommendation was made for early surgery, further prospective research is required to define what constitutes sufficient surgical decompression, examine the role of ultra-early surgery, and assess the impact of early surgery in different SCI phenotypes, including central cord syndrome. Furthermore, additional investigation is required to evaluate the impact of mean arterial blood pressure targets on neurological recovery and to determine the utility of spinal cord perfusion pressure measurements. Finally, there is a need to examine the role of neuroprotective agents for the treatment of ISCI and to prospectively validate the new AO Spine-Praxis care pathway for the prevention, diagnosis, and management of ISCI. To optimize the translation of these guidelines into practice, important barriers to their implementation, particularly in underserved areas, need to be explored. Ultimately, these recommendations will help to establish more personalized approaches to care for SCI patients. Conclusions The recommendations from the 2023 AO Spine-Praxis guidelines not only highlight the current best practice in the management of SCI, but reveal critical knowledge gaps and barriers to implementation that will help to guide further research efforts in SCI.
Prospective Randomized Comparison of Minimally Invasive Tlif versus Open Tlif: Clinical Effectiveness and Restoration of Working Capacity in Railway Workers
Authors: Byvaltsev Vadim A. , Kalinin Andrei A. , Pestryakov Yurii Ya. , Hozeev Dmitriy V. , Kundubayev Rustem A. , Biryuchkov Mikhail Y. , Riew K. Daniel 
Published: March 2024

Study Design Randomized Clinical Trial. Objective To compare the clinical efficacy and restoration of working capacity after MI (minimally invasive)-TLIF and O (open)-TLIF in railway workers with lumbar degenerative disease. Methods 83 patients, who were indicated for two-level lumbar decompression and fusion were randomly assigned to one of two groups: group 1 (n = 44) had MI-TLIF procedure and group 2 (n = 39) had O-TLIF procedure. The functional status was assessed using SF-36, ODI and VAS for back and leg pain, preoperatively, at discharge, and at 3, 6, and 12 months postoperatively. MRI and CT were obtained 1-year follow-up. The percentage of patients who returned to work at 1-year, work intensity and the time to return to work post-operatively were analyzed. Results At 1-year follow-up, the MI-TLIF group had significantly better ODI, VAS and SF-36 scores compared to the O-TLIF group. The postoperative MRIs revealed a statistically significantly less multifidus muscle atrophy in the MI group compared to the Open group. At 1-year follow-up, a comparable fusion ratio between MI group and Open group was recorded. After MI-TLIF procedure, depending on the workload, patients had a statistically significantly earlier return to work ( P < .05) and statistically significantly higher return to work rate compared with the O-TLIF group ( P < .05). Conclusions The use of two-level MI-TLIF in railway workers has made it possible to significantly improve long-term clinical results, reduce the risk of surgical complications, muscle atrophy and time to return to work compared to O-TLIF.
Chloroplast genome of Calamus tetradactylus revealed rattan phylogeny
Authors: Zhang Haibo , Liu Peng , Zhang Yi , Sun Huayu , Wang Yue , Gao Zhimin , Liu Xin 
Published: March 2024

Abstract
Background
Calamus tetradactylus, a species primarily distributed in Vietnam, Laos, and southern China, is highly valued for its utilization as a small-diameter rattan material. While its physical and mechanical properties have been extensively studied, the genomic characteristics of C. tetradactylus remain largely unexplored.

Results
To gain a better understanding of its chloroplast genomic features and evolutionary relationships, we conducted sequencing and assembly of the chloroplast genome of C. tetradactylus. The complete chloroplast genome exhibited the typical highly conserved quartile structure, with specific variable regions identified in the single-copy region (like psbF-psbE, π = 0.10327, ndhF-rpl32, π = 0.10195), as well as genes such as trnT-GGU (π = 0.05764) and ycf1 (π = 0.03345) and others. We propose that these regions and genes hold potential as markers for species identification. Furthermore, phylogenetic analysis revealed that C. tetradactylus formed a distinct clade within the phylogenetic tree, alongside other Calamus species, and C. tetradactylus was most closely related to C. walkeri, providing support for the monophyly of the genus.

Conclusion
The analysis of the chloroplast genome conducted in this study provides valuable insights that can contribute to the improvement of rattan breeding programs and facilitate sustainable development in the future.
Estimating individualized treatment effects using an individual participant data meta-analysis
Authors: Bouvier Florie , Chaimani Anna , Peyrot Etienne , Gueyffier François , Grenet Guillaume , Porcher Raphaël 
Published: March 2024

Abstract
Background
One key aspect of personalized medicine is to identify individuals who benefit from an intervention. Some approaches have been developed to estimate individualized treatment effects (ITE) with a single randomized control trial (RCT) or observational data, but they are often underpowered for the ITE estimation. Using individual participant data meta-analyses (IPD-MA) might solve this problem. Few studies have investigated how to develop risk prediction models with IPD-MA, and it remains unclear how to combine those methods with approaches used for ITE estimation. In this article, we compared different approaches using both simulated and real data with binary and time-to-event outcomes to estimate the individualized treatment effects from an IPD-MA in a one-stage approach.

Methods
We compared five one-stage models: naive model (NA), random intercept (RI), stratified intercept (SI), rank-1 (R1), and fully stratified (FS), built with two different strategies, the S-learner and the T-learner constructed with a Monte Carlo simulation study in which we explored different scenarios with a binary or a time-to-event outcome. To evaluate the performance of the models, we used the c-statistic for benefit, the calibration of predictions, and the mean squared error. The different models were also used on the INDANA IPD-MA, comparing an anti-hypertensive treatment to no treatment or placebo ($$N = 40\,237$$

N
=
40

237

, 836 events).

Results
Simulation results showed that using the S-learner led to better ITE estimation performances for both binary and time-to-event outcomes. None of the risk models stand out and had significantly better results. For the INDANA dataset with a binary outcome, the naive and the random intercept models had the best performances.

Conclusions
For the choice of the strategy, using interactions with treatment (the S-learner) is preferable. For the choice of the method, no approach is better than the other.
Improvement of scoring system used before discharge to predict 30-day all-cause unplanned readmission in geriatric population: a prospective cohort study
Authors: Setiati Siti , Ardian Laurentius Johan , Fitriana Ika , Azwar Muhammad Khifzhon 
Published: March 2024

Abstract
Background
Data taken from tertiary referral hospitals in Indonesia suggested readmission rate in older population ranging between 18.1 and 36.3%. Thus, it is crucial to identify high risk patients who were readmitted. Our previous study found several important predictors, despite unsatisfactory discrimination value.

Methods
We aimed to investigate whether comprehensive geriatric assessment (CGA) -based modification to the published seven-point scoring system may increase the discrimination value. We conducted a prospective cohort study in July–September 2022 and recruited patients aged 60 years and older admitted to the non-surgical ward and intensive coronary care unit. The ROC curve was made based on the four variables included in the prior study. We conducted bivariate and multivariate analyses, and derived a new scoring system with its discrimination value.

Results
Of 235 subjects, the incidence of readmission was 32.3% (95% CI 26–38%). We established a new scoring system consisting of 4 components. The scoring system had maximum score of 21 and incorporated malignancy (6 points), delirium (4 points), length of stay ≥ 10 days (4 points), and being at risk of malnutrition or malnourished (7 points), with a good calibration test. The C-statistic value was 0.835 (95% CI 0.781–0.880). The optimal cut-off point was ≥ 8 with a sensitivity of 90.8% and a specificity of 54.7%.

Conclusions
Malignancy, delirium, length of stay ≥ 10 days, and being at risk of malnutrition or malnourished are predictors for 30-day all-cause unplanned readmission. The sensitive scoring system is a strong model to identify whether an individual is at higher risk for readmission. The new CGA-based scoring system had higher discrimination value than that of the previous seven-point scoring system.
Comment on “A novel
super-enhancer-related gene signature predicts prognosis and immune microenvironment for
breast cancer”
Authors: Chehelgerdi Matin , Khorramian-Ghahfarokhi Milad , Dehkordi Fereshteh Behdarvand , Chehelgerdi Mohammad 
Published: March 2024

AbstractThe primary aim of this study is to critically evaluate and comment on
the research presented in the article titled “A Novel Super-Enhancer-Related
Gene Signature Predicts Prognosis and Immune Microenvironment for Breast
Cancer” by Wu et al. Our specific objectives include assessing the
methodology employed by the authors, particularly in regard to the utilization of a
super-enhancer-related gene signature for breast cancer prognosis prediction. We
propose the necessity of subgroup analysis to effectively address the heterogeneity
in breast cancer subtypes, which is crucial for the applicability of the SERGs
across diverse breast cancer cases. Additionally, we suggest conducting a more
comprehensive immune panel study to deepen the understanding of how the immune
microenvironment impacts breast cancer prognosis. Our commentary seeks to provide
valuable insights into the strengths and weaknesses of the study, contributing to a
more comprehensive understanding of its findings and potential clinical
implications.
Management of corneal melting after collagen cross-linking for keratoconus: a case report and a review of the literature
Authors: Moramarco Antonio , di Geronimo Natalie , Gardini Lorenzo , Grendele Arianna , Fontana Luigi 
Published: March 2024

Abstract
Purpose
We describe the management of a case of severe corneal melting after corneal cross-linking (CXL) treated with a staged approach using a conjunctival flap followed by deep anterior lamellar keratoplasty (DALK).

Methods
A 12-year-old male developed severe corneal melting with pending perforation after an accelerated epithelium-off CXL protocol. We initially treated the patient with a conjunctival flap to prevent perforation. Three months later, we performed DALK to restore vision.

Results
Conjunctival flap surgery allowed us to avoid corneal perforation and penetrating keratoplasty (PK) à chaud. Once the inflammation had resolved, we recessed the conjunctiva and performed DALK for optical purposes. Twelve months later, the graft was clear and the corrected visual acuity was 20/25 (Snellen). No complications occurred after surgery.

Conclusions
Although CXL is considered a safe procedure, in rare cases it can lead to serious complications, such as corneal haze, infectious and non-infectious keratitis, stromal melting and perforation. Corneal melting and perforation are usually managed by emergency PK. Herein we suggest a staged approach involving an emergency conjunctival flap followed by DALK at a later time that allowed us to avoid PK à chaud.
Factors associated with antenatal depression among women attending antenatal care at Mubende Regional Referral Hospital: a cross-sectional study
Authors: Kasujja Musa , Omara Samuel , Senkungu Nasifu , Ndibuuza Shamim , Kirabira Joseph , Ibe Usman , Barankunda Lyse 
Published: March 2024

Abstract
Introduction
This study aimed to investigate the prevalence, severity, and factors associated with antenatal depression among women receiving antenatal care at Mubende Regional Referral Hospital (MRRH) in Uganda. Antenatal depression is a critical concern for maternal and child well-being, as it is associated with adverse outcomes such as preterm birth, abortion, low birth weight, and impaired maternal-infant bonding. Despite several international guidelines recommending routine screening for antenatal depression, local Ugandan guidelines often overlook this essential aspect of maternal care.

Methods
A cross-sectional study involving 353 pregnant women utilized the Patient Health Questionnaire 9 (PHQ-9) to assess antenatal depression. Participants were categorized as having antenatal depression if their total PHQ-9 score was ≥ 5 and met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for either major or minor depression. Psychosocial demographic and obstetric characteristics were recorded. Logistic regression analysis identified factors linked to antenatal depression.

Results
The burden of antenatal depression was notably high, affecting 37.68% of the participants. Among those with antenatal depression, the majority exhibited mild symptoms 94 (70.68%). The significant factors associated with antenatal depression, revealed by multivariate analysis, included younger age (≤ 20 years), older age (≥ 35 years), history of domestic violence, alcohol use, gestational age, history of abortion, history of preeclampsia, and unplanned pregnancies.

Conclusion
This study revealed a significantly high prevalence of antenatal depression, emphasizing its public health importance. Most cases were classified as mild, emphasizing the importance of timely interventions to prevent escalation. The identified risk factors included age, history of domestic violence, alcohol use, first-trimester pregnancy, abortion history, previous preeclampsia, and unplanned pregnancy.
Medical education during the COVID-19 pandemic: a reflection on the JHUSOM experience
Authors: Wade Sydney A. , Ali Iman , Milstone Aaron M. , Clever Sarah L. , Xiao Shaoming , Koontz Danielle Winner , Hansoti Bhakti 
Published: March 2024

Abstract
Background
We sought to understand the relative risk of COVID-19 infection and identify risk factors for infection to identify targets for mitigation among medical students.

Methods
An observational cohort study of Johns Hopkins School of Medicine students was conducted from June 2020 to July 2021. Blood samples were collected and tested at three visits to assess for antibodies against SARS-CoV-2. Additionally, a questionnaire was administered at each visit to collect demographic information and assess potential social and behavioral risk factors.

Results
264 students enrolled in the study, and 38 participants completed all study requirements by study end. Roughly 6% of the first- and second-year classes had a reported positive COVID-19 test compared to 5% of third- and fourth-year students. By visit 3, 92% of medical students had detectable antibodies against COVID-19 compared to 4% during the study enrollment period. From study enrollment to visit 3, there was a 10-fold increase in the percentage of students reporting attending large social gatherings and dining in restaurants.

Conclusions
Overall, few COVID-19 cases were found among medical students, even those on clinical rotations. As the study progressed, students reported engaging in higher-risk social behaviors in conjunction with increasing vaccination rates among students.
A novel large intragenic DPYD deletion causing dihydropyrimidine dehydrogenase deficiency: a case report
Authors: Malekkou Anna , Tomazou Marios , Mavrikiou Gavriella , Dionysiou Maria , Georgiou Theodoros , Papaevripidou Ioannis , Alexandrou Angelos , Sismani Carolina , Drousiotou Anthi , Grafakou Olga , Petrou Petros P. 
Published: March 2024

Abstract
Background
Dihydropyrimidine dehydrogenase (DPD), is the initial and rate-limiting enzyme in the catabolic pathway of pyrimidines. Deleterious variants in the DPYD gene cause DPD deficiency, a rare autosomal recessive disorder. The clinical spectrum of affected individuals is wide ranging from asymptomatic to severely affected patients presenting with intellectual disability, motor retardation, developmental delay and seizures. DPD is also important as the main enzyme in the catabolism of 5-fluorouracil (5-FU) which is extensively used as a chemotherapeutic agent. Even in the absence of clinical symptoms, individuals with either complete or partial DPD deficiency face a high risk of severe and even fatal fluoropyrimidine-associated toxicity. The identification of causative genetic variants in DPYD is therefore gaining increasing attention due to their potential use as predictive markers of fluoropyrimidine toxicity.

Methods
A male infant patient displaying biochemical features of DPD deficiency was investigated by clinical exome sequencing. Bioinformatics tools were used for data analysis and results were confirmed by MLPA and Sanger sequencing.

Results
A novel intragenic deletion of 71.2 kb in the DPYD gene was identified in homozygosity. The deletion, DPYD(NM_000110.4):c.850 + 23455_1128 + 8811del, eliminates exons 9 and 10 and may have resulted from a non-homologous end-joining event, as suggested by in silico analysis.

Conclusions
The study expands the spectrum of DPYD variants associated with DPD deficiency. Furthermore, it raises the concern that patients at risk for fluoropyrimidine toxicity due to DPYD deletions could be missed during pre-treatment genetic testing for the currently recommended single nucleotide polymorphisms.