bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical effectiveness of cardiac rehabilitation and barriers to completion in patients of low socioeconomic status in rural areas: A mixed-methods study
Authors: Beleigoli Alline , Dafny Hila Ariela , Pinero de Plaza Maria Alejandra , Hutchinson Claire , Marin Tania , Ramos Joyce S. , Suebkinorn Orathai , Gebremichael Lemlem G. , Bulamu Norma B. , Keech Wendy , Ludlow Marie , Hendriks Jeroen , Versace Vincent , Clark Robyn A. 
Published: April 2024

Objective To investigate cardiac rehabilitation utilisation and effectiveness, factors, needs and barriers associated with non-completion. Design We used the mixed-methods design with concurrent triangulation of a retrospective cohort and a qualitative study. Setting Economically disadvantaged areas in rural Australia. Participants Patients (≥18 years) referred to cardiac rehabilitation through a central referral system and living in rural areas of low socioeconomic status. Main measures A Cox survival model balanced by inverse probability weighting was used to assess the association between cardiac rehabilitation utilization and 12-month mortality/cardiovascular readmissions. Associations with non-completion were tested by logistic regression. Barriers and needs to cardiac rehabilitation completion were investigated through a thematic analysis of semi-structured interviews and focus groups (n = 28). Results Among 16,159 eligible separations, 44.3% were referred, and 11.2% completed cardiac rehabilitation. Completing programme (HR 0.65; 95%CI 0.57–0.74; p < 0.001) led to a lower risk of cardiovascular readmission/death. Living alone (OR 1.38; 95%CI 1.00–1.89; p = 0.048), having diabetes (OR 1.48; 95%CI 1.02–2.13; p = 0.037), or having depression (OR 1.54; 95%CI 1.14–2.08; p = 0.005), were associated with a higher risk of non-completion whereas enrolment in a telehealth programme was associated with a lower risk of non-completion (OR 0.26; 95%CI 0.18–0.38; p < 0.001). Themes related to logistic issues, social support, transition of care challenges, lack of care integration, and of person-centeredness emerged as barriers to completion. Conclusions Cardiac rehabilitation completion was low but effective in reducing mortality/cardiovascular readmissions. Understanding and addressing barriers and needs through mixed methods can help tailor cardiac rehabilitation programmes to vulnerable populations and improve completion and outcomes.
Effectiveness of Rehabilitation Interventions in Individuals With Emerging Virtual Respiratory Tract Infectious Disease: A Systematic Review and Meta-Analysis
Authors: Huang Jinming , Qiao Xu , Song Kangping , Liu Rong , Huang Shuangshuang , He Jing , Zhu Siyi , Reinhardt Jan D. , He Chengqi 
Published: April 2024

ObjectiveAssessing rehabilitation effectiveness for persistent symptoms post-infection with emerging viral respiratory diseases.Data sourcesSystematic review of seven databases (MEDLINE, EMBASE, Cochrane Library, PEDro, MedRxiv, CNKI, Wanfang) until 30 December 2023.Review methodsEvaluated 101 studies (9593 participants) on respiratory function, exercise capacity, and quality of life. Methodological quality was assessed using the Cochrane Collaboration's Risk of Bias tool for randomized controlled trials (RCTs), the Newcastle-Ottawa Scale (NOS) for observational studies and non-RCTs, and the NIH Quality Assessment Tools for before-after studies.ResultsThe most common rehabilitation program combined breathing exercises with aerobic exercise or strength training. Rehabilitation interventions significantly enhanced respiratory function, as evidenced by improvements on the Borg Scale (MD, −1.85; 95% CI, −3.00 to −0.70, low certainty), the mMRC Dyspnea Scale (MD, −0.45; 95% CI, −0.72 to −0.18, low certainty), and the Multidimensional Dyspnoea-12 Scale (MD, −4.64; 95% CI, −6.54 to −2.74, moderate certainty). Exercise capacity also improved, demonstrated by results from the Six-Minute Walk Test (MD, 38.18; 95% CI, 25.33–51.03, moderate certainty) and the Sit-to-Stand Test (MD, 3.04; 95% CI, 1.07–5.01, low certainty).ConclusionRehabilitation interventions are promising for survivors of viral respiratory diseases, yet gaps in research remain. Future investigations should focus on personalizing rehabilitation efforts, utilizing remote technology-assisted programs, improving research quality, and identifying specific subgroups for customized rehabilitation strategies to achieve the best outcomes for survivors.
Co-transplantation of autologous treg cells: A groundbreaking cell therapy for brain diseases
Authors: Cheng Yue , Zhang Yueman , Li Peiying 
Published: April 2024

Cell therapy and regenerative medicine have made remarkable progress in treating neurodegenerative disorders. Induced pluripotent stem cells (iPSCs) offer a promising source for cell replacement therapies, but their practical application faces challenges due to poor survival and integration after transplantation. Park et al. propose a novel therapeutic strategy involving the co-transplantation of regulatory T cells (Tregs) and iPSC-derived dopamine neurons. This combined approach enhances the survival of transplanted cells and protects against neuroinflammation-induced damage. In PD animal models, the co-transplantation approach significantly suppressed the host immune response, resulting in improved behavioral recovery. Additionally, Tregs demonstrate acute neuroprotection and contribute to delayed neuro-restoration in ischemic stroke. This combined approach of cell therapy with immunomodulation offers a promising avenue for advancing our understanding of neurological diseases and promoting the development of novel treatments.
Radiation dose reduction of 50% in dynamic myocardial CT perfusion with skipped beat acquisition: a retrospective study
Authors: Sliwicka Olga , Oostveen Luuk J , Swiderska Chadaj Zaneta , van Everdingen Wouter M , Michielsen Koen , Gommers Jessie , Brink Monique , Snoeren Miranda , Salah Khibar , Peters-Bax Liesbeth , Stille Tip , Habets Jesse , Sechopoulos Ioannis 
Published: April 2024

Background Dynamic myocardial computed tomography perfusion (CTP) is a novel imaging technique that increases the applicability of CT for cardiac imaging; however, the scanning requires a substantial radiation dose. Purpose To investigate the feasibility of dose reduction in dynamic CTP by comparing all-heartbeat acquisitions to periodic skipping of heartbeats. Material and Methods We retrieved imaging data of 38 dynamic CTP patients and created new datasets with every fourth, third or second beat (Skip1:4, Skip1:3, Skip1:2, respectively) removed. Seven observers evaluated the resulting images and perfusion maps for perfusion deficits. The mean blood flow (MBF) in each of the 16 myocardial segments was compared per skipped-beat level, normalized by the respective MBF for the full dose, and averaged across patients. The number of segments/cases whose MBF was <1.0 mL/g/min were counted. Results Out of 608 segments in 38 cases, the total additional number of false-negative (FN) segments over those present in the full-dose acquisitions and the number of additional false-positive cases were shown as acquisition (segment [%], case): Skip1:4: 7 (1.2%, 1); Skip1:3: 12 (2%, 3), and Skip1:2: 5 (0.8%, 2). The variability in quantitative MBF analysis in the repeated analysis for the reference condition resulted in 8 (1.3%) additional FN segments. The normalized results show a comparable MBF across all segments and patients, with relative mean MBFs as 1.02 ± 0.16, 1.03 ± 0.25, and 1.06 ± 0.30 for the Skip1:4, Skip1:3, and Skip1:2 protocols, respectively. Conclusion Skipping every second beat acquisition during dynamic myocardial CTP appears feasible and may result in a radiation dose reduction of 50%. Diagnostic performance does not decrease after removing 50% of time points in dynamic sequence.
Changes in clinical parameters and inflammatory markers after blood culture collection facilitate early identification of positive culture in adult patients with COVID-19 and clinically suspected bloodstream infection
Authors: Li Nana , Zhang Long , Gao Yang , Lai Qiqi , Tang Yujia , Du Xue , Chen Pengfei , Yue Chuangshi , Zhao Mingyan , Yu Kaijiang , Kang Kai 
Published: April 2024

Objective We explored whether changes in clinical parameters and inflammatory markers can facilitate early identification of positive blood culture in adult patients with COVID-19 and clinically suspected bloodstream infection (BSI). Methods This single-center retrospective study enrolled 20 adult patients with COVID-19 admitted to the intensive care unit who underwent blood culture for clinically suspected BSI (February 2020–November 2021). We divided patients into positive (Pos) and negative blood culture groups. Clinical parameters and inflammatory markers were obtained from medical records between blood culture collection and the first positive or negative result and compared between groups on different days. Results Patients in the positive culture group had significantly older age and higher D-dimer, immunoglobulin 6 (IL-6), and Sequential Organ Failure Assessment score as well as lower albumin (ALB). The area under the receiver operating characteristic curve (AUC) was 0.865 for IL-6, D-dimer and ALB on the first day after blood culture collection; the AUC was 0.979 for IL-6, IL-10, D-dimer, and C-reactive protein on the second day after blood culture collection. Conclusion Changes in clinical parameters and inflammatory markers after blood culture collection may facilitate early identification of positive culture in adult patients with COVID-19 and clinically suspected BSI.
EMDR Flash Technique in adolescents with depression: A twelve-week follow-up study
Authors: Inci Izmir Sevim Berrin , Çitil Akyol Canan 
Published: April 2024

This study aims to investigate the specific effects of the EMDR Flash Technique on adolescents with depression. This follow-up study consists of 32 adolescents, 12–17 years of age ( M = 14.34, SD = 1.56), including 7 males and 25 females. They were evaluated with Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present, the Beck Depression Inventory (BDI), and Children Revised Impact of Event Scale-8 (Crıes-8). These were administered at baseline, at the end of the 4th and 12th weeks of treatment. The EMDR Flash Technique which can be utilized in the preparation phase of Eye Movement Desensitization and Reprocessing (EMDR) to reduce the intensity of highly distressing memories rapidly and relatively painlessly was applied for 12 weeks, one session per week as a free-standing intervention. Also, the EMDR Flash Technique can be effective in decreasing the rate of noncompliance and drop-outs of adolescents. The baseline means of total BDI scores decreased from 48.19 to 2.16 at the end of the 12th week of treatment. Also, the CRIES scores decreased from 31.78 to 0.44 at the end of the 12th week of treatment. In addition, the baseline means of SUD scores decreased from 9.53 to zero at the end of the 12th week of treatment. Overall, our results underscore the effectiveness of the EMDR-Flash Technique in adolescents with depression.
One generation apart: Individual income and life expectancy in two Swedish cohorts born before and after the expansion of the welfare state
Authors: Gurzo Klara , Rehnberg Johan , Martikainen Pekka , Östergren Olof 
Published: April 2024

Aims: Social inequalities in mortality persist or even increase in high-income countries. Most evidence is based on a period approach to measuring mortality – that is, data from individuals born decades apart. A cohort approach, however, provides complementary insights using data from individuals who grow up and age under similar social and institutional arrangements. This study compares income inequalities in cohort life expectancy in two Swedish cohorts, one born before and one born after the expansion of the welfare state. Methods: Data on individuals born in Sweden in 1922–1926 and 1951–1955 were obtained from total population registries. These data were linked to individual disposable income from 1970 and 1999 and mortality between 50 and 61 years of age in 1972–1987 and 2001–2016, respectively. We calculated cohort temporary life expectancies in the two cohorts by income and gender. Results: Life expectancy, income, and income inequalities in life expectancy increased between the two cohorts, for both men and women. Women born in 1922–1926 had modest income differences in life expectancy, but pronounced differences emerged in the cohort born in 1951–1955. Men with low incomes born in 1951–1955 had roughly similar life expectancy as those with low incomes born in 1922–1926. Conclusions: Compared with a period approach to life expectancy trends, the cohort approach highlights the stagnation of mortality at the lowest income groups for men and the rapid emergence of a mortality gradient for women. Future research on health inequalities in welfare states should consider underlying factors both from a cohort and period perspective.
Efficacy of Hyaluronic Acid/Collagenase Ointment in the Treatment of Chronic Wounds: A Retrospective Observational Study
Authors: Calavul Abdulkadir 
Published: April 2024

Background Chronic wounds, including diabetic ulcers, posttraumatic ulcers, and pressure sores, present a significant challenge in healthcare due to their complex nature and resistance to conventional treatments. This retrospective observational study aimed to evaluate the efficacy of an ointment containing hyaluronic acid and collagenase in treating such wounds. Methods The study included 70 patients with various chronic wounds treated in our clinic from January 1, 2020, to October 1, 2023. The patients were selected according to specific inclusion and exclusion criteria, and comprehensive baseline data was collected. The treatment involved the application of a hyaluronic acid and collagenase ointment, followed by regular follow-up and data analysis. Results Significant improvements in wound bed scores (WBS) were observed, with a reduction in healing times for all types of wounds. High patient satisfaction rates were reported, along with efficient debridement and notable pain reduction. Diabetic ulcers showed the most significant improvement in terms of healing time and WBS. Conclusions Hyaluronic acid and collagenase ointment demonstrated promising results in the treatment of chronic wounds. This treatment may offer a valuable addition to current wound care practices, particularly in challenging cases such as diabetic ulcers. More research is recommended, including randomized controlled trials, to validate these findings.
One-stage or two-stage elective coronary artery bypass graft surgery and abdominal aortic aneurysm open repair in low and moderate cardiac surgical risk patients.
Authors: Gómez-Galán Sebastián , Velandia-Sánchez Alejandro , Corso-Ramírez Julián M , Polanía-Sandoval Camilo A , Florez-Amaya Paula C , Ortigoza-Espitia Sergio A , Suarez-Vásquez Sofía N , Sanabria-Arévalo Lina M , Barrera-Carvajal Juan G , Camacho-Mackenzie Jaime 
Published: April 2024

Objectives Coronary artery disease (CAD) and abdominal aortic aneurysm (AAA) are common arterial pathologies that might occur simultaneously; however, there is not enough evidence about the optimal strategy for patients with concomitant indications of coronary artery bypass grafting (CABG) and open repair of the AAA (AAOR). This study aims to present the outcomes in low and moderate cardiac surgical risk patients who underwent one-stage or two-stage elective CABG and AAOR in a middle-income country. Methods An observational, retrospective case series study was conducted. Patients who had low and moderate cardiac surgical risk (less than 8% mortality risk on the STS score) and had the concomitant indication for CABG and AAOR between December 2005 and August 2021 were included. Patients were assigned to one of three strategies: Group 1 underwent one-stage surgery for CABG and AAOR, Group 2 underwent two-stage surgery within the same in-patient stay, and Group 3 underwent two-stage surgery in a new in-patient stay within 6 months. Results Twenty seven, patients with simultaneous requirements of CABG and AAOR were identified, with a mean age of 69.5 ± 6.1 years and 92.6% were male. The most common comorbidities were hypertension at 77.8% and dyslipidemia at 55.6%. The average mortality risk calculated by the STS score was 2.09% ± 1.53%. In Group 1 ( n = 9), 1/9 had in-hospital mortality and no reinterventions were needed. In Group 2 ( n = 10), 1/10 had in-hospital mortality, and the most common postoperative complication was acute kidney injury 2/10. Furthermore, 2/10 required a reintervention. In Group 3 ( n = 8), no in-hospital mortality was present, however, complications such as sepsis, atrial fibrillation, and acute kidney injury occurred in 2/8 patients each, and 2/8 required a reintervention. Conclusion Patients with CAD and AAA that need a concomitant surgical correction with CABG and an AAOR are uncommon in contemporary practice, given the advances in endovascular therapy. When indicated, one-stage surgery can be performed in patients with low cardiac surgical risk, proper patient selection plays a fundamental role and might be performed in experienced centers. However, two-staged surgeries at the same or different inpatient stay may be considered for asymptomatic AAA with close monitoring during the postoperative period. These findings can hold significance for addressing sociodemographic barriers in low and middle-income countries. More robust and extensive studies are needed to make clear comparisons between the different strategies.
Incidence, risk factors, and clinical outcomes of acute brain swelling associated with traumatic acute subdural hematoma: a retrospective study utilizing novel diagnostic criteria
Authors: Fu Shilong , Liu Haibing , Wang Guofeng , Hu Xiaofang , Wang Shousen 
Published: April 2024

Background: Post-traumatic acute brain swelling (ABS) is a major cause of elevated intracranial pressure and thus mortality. The current definition of post-traumatic ABS has certain limitations, and there is limited information available regarding ABS associated with traumatic acute subdural hematoma (ASDH). Objectives: To investigate the incidence, risk factors, and clinical outcomes of ABS associated with traumatic ASDH. Design: Retrospective study. Methods: Data for 161 patients diagnosed with traumatic ASDH were retrospectively collected. Novel computed tomography-based criteria were proposed for diagnosing ABS in patients with ASDH and determining its incidence. Univariate and multivariate logistic regression analyses were performed to explore the risk factors of post-traumatic ABS. The Glasgow Outcome Scale (GOS) score, mortality, and functional prognosis of all patients at discharge and the proportion of intraoperative malignant brain bulge in surgical patients were taken as clinical outcome measures. Results: A total of 45 (28%) patients experienced post-traumatic ABS, exhibiting significantly lower Glasgow Coma Scale scores on admission ( p < 0.001). The incidence of hemispheric and whole-brain swelling was 8.1% and 19.9%, respectively. Risk factors independently associated with post-traumatic ABS were: (1) age [odds ratio (OR) = 0.917, p < 0.001]; (2) platelet to white blood cell ratio (PWR) (OR = 0.887, p = 0.012); and (3) traumatic subarachnoid hemorrhage (SAH) (OR = 4.346, p = 0.005). The ABS cohort had a lower GOS score [2 (1–3) versus 4 (3–5); p < 0.001], higher mortality (46.7% versus 6.9%; p < 0.001), and higher proportion of unfavorable functional prognosis (75.6% versus 34.5%; p < 0.001) upon discharge compared to the no ABS cohort, along with higher proportion of intraoperative malignant brain bulge (43.8% versus 0%; p < 0.001). Conclusion: The incidence of ABS associated with ASDH is significantly high overall. Patients with ASDH who have young age, low PWR, and traumatic SAH are at an increased risk of developing post-traumatic ABS, and therefore of poor clinical outcomes.
ChatGPT is capable of providing satisfactory responses to frequently asked questions regarding total shoulder arthroplasty
Authors: Yeramosu Teja , Johns William L. , Onor Gabriel , Menendez Mariano E , Namdari Surena , Hammoud Sommer 
Published: April 2024

Background The rising prominence of artificial intelligence in healthcare has revolutionized patient access to medical information. This cross-sectional study sought to assess if ChatGPT could satisfactorily address common patient questions about total shoulder arthroplasty (TSA). Methods Ten commonly encountered questions in TSA practice were selected and posed to ChatGPT. Each response was assessed for accuracy and clarity using the Mika et al. scoring system, which ranges from “excellent response not requiring clarification” to “unsatisfactory response requiring substantial clarification,” and a modified DISCERN score. The readability was further evaluated using the Flesch Reading Ease Score and the Flesch-Kincaid Grade Level. Results The mean Mika et al. score was 2.93, corresponding to an overall subjective rating of “satisfactory but requiring moderate clarification.” The mean DISCERN score was 46.60, which is considered “fair.” The readability analysis suggested that the responses were at a college-graduate level, higher than the recommended level for patient educational materials. Discussion Our results suggest that ChatGPT has the potential to supplement the collaborative decision-making process between patients and experienced orthopedic surgeons for TSA-related inquiries. Ultimately, while tools like ChatGPT can enhance traditional patient education methods, they should not replace direct consultations with medical professionals.
Continuous Glucose Monitoring for Prediabetes: What Are the Best Metrics?
Authors: Zahalka Salwa J. , Galindo Rodolfo J. , Shah Viral N. , Low Wang Cecilia C. 
Published: April 2024

Background: Continuous glucose monitoring (CGM) has transformed the care of type 1 and type 2 diabetes, and there is potential for CGM to also become influential in prediabetes identification and management. However, to date, we do not have any consensus guidelines or high-quality evidence to guide CGM goals and metrics for use in prediabetes. Methods: We searched PubMed for all English-language articles on CGM use in nonpregnant adults with prediabetes published by November 1, 2023. We excluded any articles that included subjects with type 1 diabetes or who were known to be at risk for type 1 diabetes due to positive islet autoantibodies. Results: Based on the limited data available, we suggest possible CGM metrics to be used for individuals with prediabetes. We also explore the role that glycemic variability (GV) plays in the transition from normoglycemia to prediabetes. Conclusions: Glycemic variability indices beyond the standard deviation and coefficient of variation are emerging as prominent identifiers of early dysglycemia. One GV index in particular, the mean amplitude of glycemic excursion (MAGE), may play a key future role in CGM metrics for prediabetes and is highlighted in this review.