bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-Effective Quality of Life Improvement While Reducing Health Care Professional Burnout With an AI-Driven Intervention for Personalized Medicine
Authors: Kelly Ryan Charles , Holt Richard I. G. , Price Hermione , Phiri Peter , Cummings Michael , Ali Amar , Patel Mayank , Barnard Ethan , Allard Sharon , Hunter Victoria , Rojkova Jana , Bolger Clare , Georgieva Daniela , Schinz Maren , Rothenbühler Martina , Lizoain Aritz , Barnard-Kelly Katharine 
Published: January 2025

Background and Aims: Burnout affects >50% of physicians and nurses. Spotlight-AQ is a personalized digital health platform designed to improve routine diabetes visits. We assessed cost-effectiveness, visit length, and association with health care professional (HCP) burnout. Materials and Methods: Complete case within-trial cost-effectiveness analysis embedded within a multicenter, parallel-group randomized controlled trial. Adults with diabetes were recruited from primary and secondary care. Intervention group participants completed the Spotlight-AQ pre-clinic assessment before each routine visit. Health status was assessed with EQ-5D-5L to calculate quality-adjusted life years (QALYs). Client Service Receipt Inventory measured downstream resource use. Total costs and QALYs were calculated using baseline-controlled seemingly unrelated regression with bootstrapping. Haemoglobin (HbA1c) data were collected. Health care professionals completed the Maslach Burnout Inventory at baseline and study end. Results: A total of 98 adults (49 intervention) and 18 HCPs participated. Total costs: £243 (US$310) intervention arm versus £230 (US$293) control arm; incremental cost: £13 (US$16). Total QALYs: 0.362 intervention arm and 0.358 control arm, with an incremental QALY: 0.004. Spotlight-AQ intervention dominated usual care with a 68% probability of cost-effectiveness at a threshold of £30 000 (US$38 294) per QALY gained. Health care professionals reported reduced burnout, emotional exhaustion, depersonalization, and a greater sense of personal achievement. Doctors are more so than nurses. Conclusion: Spotlight-AQ has demonstrated cost-effective while delivering improved care and reduced HCP burnout. Trial Registration: ISRCTN15511689, registration date: November 1, 2021.
“Nobody Seemed to Notice My Work”: The Lived Experiences of Home Care Workers Assisting People With Chronic Diseases: A Phenomenological Study
Authors: Cacciapuoti Valentina , Simeone Silvio , Virgolesi Michele , Sterling Medeline R. , Dallago Elisa , Vellone Ercole , Alvaro Rosaria , Pucciarelli Gianluca 
Published: January 2025

Introduction: Home care workers (HCWs) are paid caregivers who provide support to patients with chronic conditions and functional limitations. Additionally, they provide emotional support to patients and familial support. Although several qualitative studies have been conducted on HCWs, they focused more on studying prevalently the lived experiences about the workplace violence, the end of life, stressor and resilience, during the COVID-19 pandemic or focused more in dementia and heart failure, but not on feelings and working conditions. Methods: The study was carried out using Cohen’s phenomenological methodology. The subjects were enrolled in several cities of Central Italy and interviewed with open questions to allow them full freedom of expression and asked to describe their lived experience of HCWs who helped people with chronic diseases. Each interview was recorded audio and lasted between 20 and 60 min. Researchers involved in the analysis were independently immersed in the data by reading and rereading the transcripts to gain a sense of the entire data set. The extrapolation of the themes followed. The individual researchers compared the various extrapolated themes. Results: Seventeen HCWs, all women, with a mean age of 54 years were enrolled in this study. All had more than a year (from 4 to 26 years) of experience in Italy, and almost the whole sample lived with the person they were assisting. Three themes were identified in the interviews: (1) feeling inadequate as a nurse, (2) feeling valued in this role, and (3) uncertain future. Feeling inadequate due to lack of training, difficulties related to the Italian language, or uncertainty about their future were topics identified by the HCWs. Conclusions: Since HCWs represent an important resource which, if properly trained, could positively influence the quality of life of the elderly population and a valid support for their families, understanding the lived experience can suggest interventions that could be implemented by a health care professional and provide evidence to inform political decision makers to increase the support for HCWs.
Overcoming Hesitancy and Barriers to Care with Integration of Telemedicine in a Free Student-run Health Clinic
Authors: Krysov Vikki A. , Balshin Michelle E. , Azar Elijah N. , Cernioglo Karina , Perekopskiy David , Nurpeissova Altynay T. , Shi Lucy Zhonglu 
Published: January 2025

Introduction: Nadezhda Clinic is a free student-run health clinic that provides culturally sensitive primary care services to the underserved Russian-speaking population of the greater Sacramento area. At the onset of the COVID-19 pandemic, the clinic suspended in-person services and solely offered telemedicine visits. Most patients were hesitant to utilize telemedicine due to poor technological literacy, privacy concerns, and a preference for in-person care. Objective: This quality improvement project aimed to evaluate whether the implementation of culturally sensitive telemedicine services and outreach strategies would help address patient hesitancy and barriers to care. Methods: Successful implementation of telemedicine was dependent on building trust with the community, providing multilingual technological assistance, and offering personalized support. Some measures that were reviewed in order to assess this included comparison of patient demographics, clinic attendance, and distance reached between in-person and telemedicine services. Results: Telemedicine implementation was associated with increased clinic attendance rates with a no-show rate as low as 13% when compared to in-person services with a no-show rate of 20%. Telehealth services also enabled the clinic to reach patients in rural areas up to 120 miles away. Conclusions: With the implementation of a culturally sensitive telemedicine protocol, Nadezhda Clinic achieved greater patient retention rates and reached patients at further distances, suggesting an overall reduction in hesitancy and barriers to care. Free clinics offering telemedicine are critical to further address healthcare disparities in marginalized communities.
Prediction nomogram for antepartum hemorrhage in placenta previa women
Authors: Fan Dazhi , Hu Pengzhen , Rao Jiaming , Lin Dongxin , Yang Jie , Liu Zhengping , Guo Xiaoling 
Published: January 2025

Background: Placenta previa with antepartum hemorrhage (APH) is common and closely related to maternal and fetal morbidity and mortality. It is of the utmost importance to prepare for the possibility of APH using perinatal factors prior to delivery. Objective: To develop and validate a nomogram predicting APH in women with placenta previa based on the perinatal factors. Design: This was a retrospective and prospective cohort study of pregnant women with placenta previa. Methods: The model was developed in the retrospective and validated in the prospective cohort study. Multivariate logistic regression was applied to discover independent variables and develop a nomogram to predict the possibility of APH. An Excel form computer interface was constructed to use the model. Results: There are 1601 and 693 participants in the retrospective and prospective cohort study. Maternal age (odds ratio 0.950, 95% confidence interval 0.918–0.984), married (0.533, 0.309–0.920), parity (1.240, 1.024–1.502), threatened abortion (5.059, 3.648–7.014), and complete placenta previa (1.833, 95% CI 1.469–2.289) were independent variables for APH in placenta previa women. The area under the curve and concordance index were 0.828 and 0.676, respectively. The model was a good fit by the Hosmer–Lemeshow test ( p = 0.352). The prospective validation proved the reliability of the prediction nomogram. The Excel form computer interface was practical. Conclusion: A nomogram based on perinatal factors was developed and validated to predict APH in women with placenta previa. The reliable tool may thereafter offer important assistance for decision-making processes.
Initial therapy in patients with pulmonary arterial hypertension and cardiovascular comorbidities
Authors: Boucly Athénaïs , Montani David , Bauer Fabrice , Artaud-Macari Elise , Bergot Emmanuel , Boissin Clément , Chaouat Ari , Cottin Vincent , Dauphin Claire , Degano Bruno , De Groote Pascal , du Roure Camille , Favrolt Nicolas , Horeau-Langlard Delphine , Jaïs Xavier , Jevnikar Mitja , Lacoste-Palasset Thomas , Picard François , Prévôt Grégoire , Reynaud-Gaubert Martine , Roche Anne , Turquier Ségolène , Humbert Marc , Sitbon Olivier , Savale Laurent 
Published: January 2025

BackgroundEuropean guidelines recommend initial monotherapy in PAH patients with cardiovascular (CV) comorbidities based on the limited of evidence for combination therapy in this growing population.MethodsA retrospective analysis was conducted on incident PAH patients enrolled in the French Pulmonary Hypertension Registry between 2009 and 2020. Propensity score matching was used to investigate initial dual oral combination therapyversusoral monotherapy in patients with at least one CV comorbidity (i.e., hypertension, obesity, diabetes and coronary artery disease).ResultsOf the 1784 patients identified, 1088 had ≥1 CV comorbidity, including 20% with ≥3 comorbidities. In the propensity score matched population (N=708), the majority of patients were female, with idiopathic/heritable/drug-induced PAH, at intermediate 1-year mortality risk. At first follow-up, initial dual therapy led to larger improvements in symptoms, exercise capacity, hemodynamics, and risk status than initial monotherapy, with no differences in long-term survival. Treatment discontinuations were observed in 23% of patients initiated on dual therapy and 24% of those initiated on monotherapy.ConclusionsInitial dual oral combination therapy may be beneficial and well tolerated in most PAH patients with CV comorbidities.
Protein biomarkers of interstitial lung abnormalities in relatives of patients with pulmonary fibrosis
Authors: Rose Jonathan A. , Steele Mark P. , Kosak Lopez Esteban J. , Axelsson Gisli Thor , Galecio Chao Andrea G. , Waich Alan , Regan Katie , Gulati Swati , Maeda Anthony H. , Sultana Sharmin , Cutting Claire , Tukpah Ann-Marcia C. , Synn Andrew J. , Rice Mary B. , Goldberg Hilary J. , Lee Joyce S. , Lynch David A. , Putman Rachel K. , Hatabu Hiroto , Raby Benjamin A. , Schwartz David A. , Rosas Ivan O. , Hunninghake Gary M. 
Published: January 2025

RationaleFirst-degree relatives of patients with pulmonary fibrosis (relatives) are at high risk for interstitial lung abnormalities (ILA), highlighting the need for biomarkers for risk prediction. We aimed to identify blood proteins associated with and predictive of ILA among relatives of patients with pulmonary fibrosis.MethodsRelatives enrolled in two independent cohorts had protein levels measured using an aptamer-based proteomic platform. ILA was assessed with CT scans per Fleischner Society recommendations. Protein associations with ILA were assessed using regression, and significant proteins were used with clinical variables to detect ILA.ResultsOf 237 relatives from two independent cohorts, 26% had ILA. Seven proteins were associated with ILA in the discovery cohort after FDR-adjustment, and all remained significant after adjusting for age, gender, and smoking status. Six of seven were significant in the validation cohort including GDF15, SFTPD, and SFTPB. In a multivariable model, six proteins combined with basic demographics in the discovery cohort had AUC=0.92 (0.88 in validation cohort). LASSO modelling identified three proteins and age as predictors with an AUC=0.89. When applied to the combined cohorts, this simple model would reduce the need for CT imaging in one of every three relatives screened.ConclusionPeripheral blood proteins are associated with ILA in relatives of patients with pulmonary fibrosis and can be used to detect ILA. Our findings demonstrate the potential utility of blood biomarkers in this high-risk group and suggests molecular targets for future investigation.
Leadless pacemaker implantation in a patient with congenital azygos continuation of the inferior vena cava
Authors: Guo Lanyan , Zhang Minxia , Zhao Ying , Yan Qun , Feng Xuyang , Tao Ling 
Published: January 2025

Abstract

Abstract
In case of venous route abnormality during a leadless pacemaker (LP) implantation, it can be challenging if we still performed via the predesigned femoral vein. We report a patient with normal preoperative laboratory and image results, but azygos continuation of the inferior vena cava (IVC) was suspected during the procedure. Then, we decided to change the implantation strategy, the LP implantation was successfully performed via right jugular vein instead of the classical IVC route. Finally, venous computed tomography (CT) angiography was conducted to testify such venous developmental abnormality.

Clinical trial number
Not applicable
The incidence of outpatient care within 24 months from SARS-CoV-2 infection in the general population: a multicenter population-based cohort study
Authors: Banchelli Federico , Gagliotti Carlo , De Paoli Angela , Buttazzi Rossella , Narne Elena , Ricchizzi Enrico , Pierobon Silvia , Fedeli Ugo , Pitter Gisella , Fabbri Elisa , Tonon Michele , Gentilotti Elisa , Rolli Maurizia , Tacconelli Evelina , Moro Maria Luisa , Russo Francesca , Berti Elena 
Published: January 2025

Abstract

Background
The long-term effects of COVID-19, which can vary significantly in type and timing, are considered relevant and impacting on the well-being of individuals. The present study aims to assess the incidence of outpatient care in the post-acute phase of SARS-CoV-2 infection in two Italian regions.

Methods
The study has a multicentre, population-based, pre-post, repeated measures design to compare the incidence rate of access to outpatient visits and diagnostics before and after SARS-CoV-2 infection, considering a follow-up of 24 months. The study made use of previously recorded large-scale healthcare data available in the administrative databases of the Emilia-Romagna (E-R) and Veneto regions. Analyses were carried out separately in the two regions and results were pooled using random effects meta-analysis.

Results
There were 27,140 subjects in E-R and 22,876 in Veneto who were included in the analysis. The pooled outputs showed an increase in rates of outpatient visits and diagnostics starting from month 2 after SARS-CoV-2 infection (IRR = 1.68, 95% CI = 1.56–1.81) with a peak at month 4 (IRR = 2.05, 95% CI = 1.95–2.15); the increase continued with reduced intensity up to month 15. Stratified analysis revealed that subjects with severe acute COVID-19 had a higher increase in rates (up to IRR = 3.96, 95% CI = 2.89–5.44), as well as patients with no comorbidities (up to IRR = 2.71, 95% CI = 2.60–2.83).

Conclusion
Long-term effects of COVID-19 include an increase in the healthcare burden especially in the first months after the acute infection. The increased demand for resources can last up to two years after infection in particular subgroups of patients such as subjects admitted to hospital during the acute phase due to the severe presentation of the disease.
Distinct Circle of Willis anatomical configurations in healthy preterm born adults: a 3D time-of-flight magnetic resonance angiography study
Authors: Greggio Julien , Malamateniou Christina , Baruteau Kelly Pegoretti , Reyes-Aldasoro Constantino Carlos , Huckstep Odaro J. , Francis Jane M. , Williamson Wilby , Leeson Paul , Lewandowski Adam J. , Lapidaire Winok 
Published: January 2025

Abstract

Background
Preterm birth (< 37 weeks’ gestation) alters cerebrovascular development due to the premature transition from a foetal to postnatal circulatory system, with potential implications for future cerebrovascular health. This study aims to explore potential differences in the Circle of Willis (CoW), a key arterial ring that perfuses the brain, of healthy adults born preterm.

Methods
A total of 255 participants (108 preterm, 147 full-term) were included in the analysis. High-resolution three-dimensional Time-of-Flight Magnetic Resonance Angiography (3D TOF MRA) datasets were analysed, measuring vessel diameters and classifying segments into different groups of CoW anatomical variations. Statistical comparisons assessed the prevalence of each variant group between preterm and full-term populations, as well as the relationship between CoW variability, sex, and degree of prematurity.

Results
We identified 164 participants with variant CoW configurations. Unilateral segment hypoplasia (30%) and unilateral segment absence (29%) were the most common variations, with over 50% related to the posterior communicating artery (PComA). However, the incidence of absent segments was lower in preterm adults, who were more likely to exhibit variants associated with complete CoW configurations compared to full-term adults (p = 0.025). Preterm males had a higher probability of a group 1 variant (circles with one or more hypoplastic segments only) than the full-term group (p = 0.024). In contrast, preterm females showed higher odds of a group 4a variant (circles with one or more accessory segments, without any absent segments) in comparison to their full-term counterparts (p = 0.020).

Conclusions
Preterm birth is linked to a distinct vascular phenotype of CoW in adults born preterm, with a higher likelihood of a CoW configuration with hypoplastic segments but a lower likelihood of absent segments. Future work should focus on larger prospective studies and explore the implications of these findings for normal development and cerebrovascular disease. Furthermore, TOF MRA might be a useful adjunct in the neurovascular assessment of preterm-born individuals.
Staging of esophageal cancer using PET/MRI: a systematic review with head-to-head comparison
Authors: Mohebbi Alisa , Mohammadzadeh Saeed , Moradi Zahra , Mohammadi Afshin , Poustchi Hossein , Tavangar Seyed Mohammad 
Published: January 2025

Abstract

Purpose
To evaluate the staging performance of positron emission tomography/magnetic resonance imaging (PET/MRI) for confirmed esophageal cancer based on the TNM classification system as well as compare it to other alternative modalities (e.g., endoscopic ultrasonography (EUS), computed tomography (CT), MRI, and PET/CT) in a full head-to-head manner.

Methods
Protocol was pre-registered a priori at (http://osf.io/6qj5m/). We searched PubMed, Web of Science, Embase, and Cochrane Library for studies until September 10, 2024. The risk of bias was assessed using Modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) and Quality Assessment of Diagnostic Accuracy Studies–Comparative (QUADAS-C). The classification performance of PET/MRI in T, N, and M staging of esophageal cancer and resectability status were evaluated and compared to other relative modalities. Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used for certainty evaluation.

Results
Nine studies were included with 245 esophageal cancer patients. For T, N, and M staging, PET/MRI showed 9.1%, 2.0%, and 10.7% upstaging than the histopathological evaluation while these numbers were 19.4%, 12.4%, and 5.3% for downstaging. For direct comparison with PET/CT, PET/MRI showed 0.7% and 5.6% less downstaging and upstaging for N staging and 2.5% and 4.0% for M staging. As for predicting resectability status, pre-ADCmean and post-ADCmean were promising, unlike other parameters (i.e., ΔADCmean, pre-SUVmax, post-SUVmax, and ΔSUVmax).

Conclusion
With protocol adjustments, PET/MRI might be utilized in the future for preoperative staging of esophageal cancer.

Clinical trial number
N/A.
Reduced fetal movements and COVID-19 infection: a retrospective cohort study
Authors: Gentili Amira , Sterpu Irene , Tingström Joanna , Wiberg-Itzel Eva 
Published: January 2025

Abstract

Background
Fetal movements are an important indicator of fetal well-being; therefore, reduced fetal movements (RFMs) can indicate fetal compromise. RFM is associated with fetal growth restriction (FGR) and intrauterine fetal death (IUFD). Studies have implied that COVID-19 infection increases the risk of adverse fetal outcomes, such as preterm birth and IUFD. It is unclear how COVID-19 infection may aggravate these fetal outcomes among women presenting with RFM.
The aims of the study were to (1) determine whether adverse fetal outcomes in women with RFM increased in 2020 compared to 2019, the year before the pandemic, and (2) evaluate whether maternal COVID-19 infection during pregnancy was a risk factor for adverse fetal outcomes in comparison to previously established risk factors among women seeking care for RFM.

Methods
All women who sought care due to RFM and were delivered at Soder Hospital from 2019 to 2020 were included. Fetal composite outcomes were constructed and compared between women with RFM and COVID-19 and women with RFM but without COVID-19.

Results
COVID-19 infection did not increase the risk of adverse fetal outcomes in women who sought care for RFM. A twofold risk for adverse fetal outcomes was found among all primiparous women vs. multiparous women with RFM (98/788 [12.4%] vs 37/644 [9.8%], AOR = 2.5, 95% CI (1.6–3.7).

Conclusion
The proportion of adverse composite outcomes among women with RFM during the first year of the pandemic did not increase compared to the year before. Composite outcomes were marginally higher in the COVID-19-positive group compared to the COVID-19-negative group, but it was not statistically significant.