bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe osmotic demyelination syndrome with cortical involvement in the context of severe hyponatremia and central diabetes insipidus: an uncommon presentation of an unusual combination
Authors: Giglio Andres , Reccius Andres , Ferre Andres , Dreyse Jorge 
Published: January 2024

Background: Osmotic demyelination syndrome (ODS) with cerebral cortical involvement is a rare complication of severe hyponatremia correction. Careful management of hyponatremia is crucial, particularly in patients with risk factors, such as alcohol use disorder and diabetes insipidus.Case: A patient in his 40s with a history of alcohol use disorder and central diabetes insipidus developed ODS after a 24 mEq/L osmolar increase during the treatment of hyponatremia. The patient’s condition progressed into locked-in syndrome and then improved to spastic tetraparesis after cortical basal ganglia ODS improved.Discussion: The differential diagnosis of cortical demyelination includes laminar cortical necrosis, being the interpretation of Apparent Diffusion Coefficient (ADC) MRI sequence is a useful tool.This case underscores the need to investigate and improve diagnosis and treatment strategies in patients with ODS. It also emphasises the significance of careful hyponatremia correction and frequent monitoring, particularly in patients with known risk factors for ODS.
Open lateral condyle Hoffa’s fracture with intra-articular patella dislocation, quadriceps tendon rupture and PCL avulsion
Authors: Bandebuche Ajinkya , Munde Kishor , Sharan Sudhir 
Published: January 2024

We present a rare case of open lateral condyle Hoffa’s fracture with concurrent patellar intra-articular dislocation, quadriceps rupture and posterior cruciate ligament (PCL) avulsion. The early adolescent male sustained these injuries in a road traffic accident. Diagnostic evaluation and a multidisciplinary approach guided treatment decisions. The patient underwent single-stage open reduction and internal fixation for the lateral condyle Hoffa’s fracture and quadriceps tendon repair, while conservative management was chosen for the PCL avulsion. At the 1-year follow-up, the patient exhibited improved knee function.This case underscores the management of complex knee injuries and contributes to understanding unique injury patterns, enhancing patient care.
Mpox gastrointestinal manifestations: a systematic review
Authors: Ramakrishnan Rahul , Shenoy Atira , Madhavan Ranganathan , Meyer Damon 
Published: January 2024

IntroductionMpox is a viral infection caused by the monkeypox virus, a member of the Poxviridae family and Orthopoxvirus genus. Other well-known viruses of the Orthopoxvirus genus include the variola virus (smallpox), cowpox virus and vaccinia virus. Although there is a plethora of research regarding the dermatological and influenza-like symptoms of mpox, particularly following the 2022 mpox outbreak, more research is needed on the gastrointestinal (GI) effects.ObjectivesThis systematic review is to outline the GI manifestations of the monkeypox virus.MethodsThe authors conducted this systematic review using guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A search was conducted through the PubMed, EMBASE and MEDLINE databases from January 1958 to June 2023. The authors selected English language papers that discussed the GI symptoms in mpox patients. A manual search was also conducted in the reference sections of these publications for other relevant papers.Results33 papers involving 830 patients were selected for this review. The GI manifestations in mpox patients are proctitis, vomiting, diarrhoea, rectal pain, nausea, tenesmus, rectal bleeding and abdominal pain. Although various papers explored transmission routes, one paper established a direct connection between anal-receptive sex transmission route and the development of a GI complication (proctitis). Another study reported that the mode of transmission could potentially impact the occurrence of GI symptoms and severity of the disease. The reviewed papers did not discover a relation between the severity of dermatological and influenza-like symptoms and the GI manifestations mentioned.ConclusionThis systematic review confirms that GI manifestations are observed in mpox patients. GI symptoms of mpox are crucial for gastroenterologists and other healthcare professionals to recognise in order to address patient discomfort and further understand the pathophysiology of the virus.
Validity assessment of the POLARS score tool in the prediction of post rectal cancer surgery LARS score in a population-based Swedish cohort
Authors: Rethy Boglarka , Nordenvall Caroline , Pieniowski Emil , Jansson-Palmer Gabriella , Johar Asif , Lagergren Pernilla , Abraham-Nordling Mirna 
Published: January 2024

ObjectiveLow anterior resection syndrome (LARS) is one of the most common functional impairments after rectal cancer surgery with a high impact on quality of life. The Pre-Operative LARS score (POLARS) nomogram and its online tool has been developed to predict the degree of postoperative LARS. The aim of this study was to analyse how accurately the POLARS score could predict LARS scores when compared with actual patient-reported LARS (PR-LARS) scores in a population-based Swedish cohort.DesignThis retrospective cohort study included patients who underwent curative rectal cancer surgery between 2007 and 2013 in Stockholm County and were identified using the Swedish Colorectal Cancer Registry (SCRCR). Information regarding preoperative risk factors, patient and treatment characteristics, and presence of LARS postoperatively were collected from patient charts, SCRCR and patient questionnaires. The POLARS model formula was used to predict LARS scores, which then were compared with the actual PR-LARS scores. Individual LARS score differences between the two estimates were shown with a modified Bland-Altman plot of difference.ResultsThe cohort included 477 patients, of whom 359 (75%) of patients were categorised as having no/minor LARS based on the POLARS score. The correctly identified patients by the POLARS score were 80/255 (31%) in the major LARS group and 184/222 (83%) no/minor LARS group. The sensitivity was 31% for major LARS and the positive predictive value was 68%.ConclusionThe POLARS score has a low sensitivity for major LARS in this Swedish cohort. Other methods to predict the risk of LARS need to be developed.
Convergence of HIV and non-communicable disease epidemics: geospatial mapping of the unmet health needs in an HIV hyperendemic community in South Africa
Authors: Cuadros Diego F , Devi Chayanika , Singh Urisha , Olivier Stephen , Castle Alison C , Moosa Yumna , Edwards Johnathan A , Kim Hae-Young , Siedner Mark J , Wong Emily B , Tanser Frank 
Published: January 2024

IntroductionAs people living with HIV (PLHIV) are experiencing longer survival, the co-occurrence of HIV and non-communicable diseases has become a public health priority. In response to this emerging challenge, we aimed to characterise the spatial structure of convergence of chronic health conditions in an HIV hyperendemic community in KwaZulu-Natal, South Africa.MethodsIn this cross-sectional study, we used data from a comprehensive population-based disease survey conducted in KwaZulu-Natal, South Africa, which collected data on HIV, diabetes and hypertension. We implemented a novel health needs scale to categorise participants as: diagnosed and well-controlled (Needs Score 1), diagnosed and suboptimally controlled (Score 2), diagnosed but not engaged in care (Score 3) or undiagnosed and uncontrolled (Score 4). Scores 2–4 were indicative of unmet health needs. We explored the geospatial structure of unmet health needs using different spatial clustering methods.ResultsThe analytical sample comprised 18 041 individuals. We observed a similar spatial structure for HIV among those with combined needs Score 2–3 (diagnosed but uncontrolled) and Score 4 (undiagnosed and uncontrolled), with most PLHIV with unmet needs clustered in the southern urban and peri-urban areas. Conversely, a high prevalence of need Scores 2 and 3 for diabetes and hypertension was mostly distributed in the more rural central and northern part of the surveillance area. A high prevalence of need Score 4 for diabetes and hypertension was mostly distributed in the rural southern part of the surveillance area. Multivariate clustering analysis revealed a significant overlap of all three diseases in individuals with undiagnosed and uncontrolled diseases (unmet needs Score 4) in the southern part of the catchment area.ConclusionsIn an HIV hyperendemic community in South Africa, areas with the highest needs for PLHIV with undiagnosed and uncontrolled disease are also areas with the highest burden of unmet needs for other chronic health conditions, such as diabetes and hypertension. Our study has revealed remarkable differences in the distribution of health needs across the rural to urban continuum even within this relatively small study site. The identification and prioritisation of geographically clustered vulnerable communities with unmet health needs for both HIV and non-communicable diseases provide a basis for policy and implementation strategies to target communities with the highest health needs.
Establishing cost-effectiveness threshold in China: a community survey of willingness to pay for a healthy life year
Authors: Xu Lizheng , Chen Mingsheng , Angell Blake , Jiang Yawen , Howard Kirsten , Jan Stephen , Si Lei 
Published: January 2024

IntroductionThe willingness to pay per quality-adjusted life year gained (WTP/Q) is commonly used to determine whether an intervention is cost-effective in health technology assessment. This study aimed to evaluate the WTP/Q for different disease scenarios in a Chinese population.MethodsThe study employed a quadruple-bounded dichotomous choice contingent valuation method to estimate the WTP/Q in the general public. The estimation was conducted across chronic, terminal and rare disease scenarios. Face-to-face interviews were conducted in a Chinese general population recruited from Jiangsu province using a convenience sampling method. Interval regression analysis was performed to determine the relationship between respondents’ demographic and socioeconomic conditions and WTP/Q. Sensitivity analyses of removing protest responses and open question analyses were conducted.ResultsA total of 896 individuals participated in the study. The WTP/Q thresholds were 128 000 Chinese renminbi (RMB) ($36 364) for chronic diseases, 149 500 RMB ($42 472) for rare diseases and 140 800 RMB ($40 000) for terminal diseases, equivalent to 1.76, 2.06 and 1.94 times the gross domestic product per capita in China, respectively. The starting bid value had a positive influence on participants’ WTP/Q. Additionally, residing in an urban area (p<0.01), and higher household expenditure (p<0.01), educational attainment (p<0.02) and quality of life (p<0.02) were significantly associated with higher WTP/Q. Sensitivity analyses demonstrated the robustness of the results.ConclusionThis study implies that tailored or varied rather than a single cost-effectiveness threshold could better reflect community preferences for the value of a healthy year. Our estimates hold significance in informing reimbursement decision-making in health technology assessment in China.
A hybrid effectiveness-implementation trial of application-based tiered care (Mom’s Good Mood) in treating perinatal anxiety within a primary health care system in China
Authors: Zhu Beibei , Hou Yanyan , Yu Xiayan , Jiang Minmin , Lu Mengjuan , Shang Mengqing , Zhen Hualong , Gu Yue , Li Haiyan , Tao Fangbiao 
Published: January 2024

IntroductionPerinatal anxiety (PNA) is a major public health concern.MethodsA hybrid effectiveness-implementation trial was conducted in two antenatal clinics in Hefei, China, to assess the effectiveness and cost-effectiveness of application-based tiered care (Mom’s Good Mood, MGM) in treating PNA and to understand how well it fits into routine practices. Pregnant women who scored at least 5 points on the 7-Item Generalised Anxiety Disorder Scale (GAD-7) scale were successively assigned to the control group or the intervention group, which were given the usual care and MGM on usual care, respectively. At 6 months post partum, anxiety, depression and life satisfaction were assessed. Intention-to-treat analysis and the Reach, Effectiveness, Adoption, Implementation and Maintenance framework were adopted.ResultsA total of 214 women were assigned to the control group and 341 to the intervention group. The mean changes in GAD-7 scores (Least-squares means, LSM, −1.42, 95% CI −2.18 to −0.66) and the risk of anxiety (adjusted odds ratio, aOR 0.30, 95% CI 0.18 to 0.51) were decreased, and the anxiety remission rate (aOR 2.72, 95% CI 1.69 to 4.40) were improved in the intervention group. Similar findings were observed regarding the change in Edinburgh Postnatal Depression Scale scores (LS −1.92, 95% CI −2.85 to −0.99), depression remission rate (aOR 2.24, 95% CI 1.39 to 3.63) and the risk of depression (aOR 0.57, 95% CI 0.33 to 0.98). MGM only costs ¥1.88 (US$0.27) per pregnant woman to boost the postpartum anxiety remission rate by 1% and was revealed to have a high reach rate of 78.3%, an adoption rate of 51.3%–80.8%.ConclusionMGM is a cost-effective and accessible tool in coping with PNA.Trial registration numberChiCTR2100053419.
Institutional leadership afterDobbs: a mixed methods analysis of US medical schools' public statements regarding abortion
Authors: McNeilly Sarah M , Kim Vivian E , Conroy Carmen , Danvers Antoinette 
Published: January 2024

IntroductionMedical schools, as significant and influential organisations within their communities, have the potential and the capacity to impact abortion policy. Organisations often engage in advocacy by issuing public statements that clarify their stance on specific policies. This study analyses the quantity and quality of publicly discoverable statements that US medical schools issued regardingDobbs v Jackson Women’s Health Organization.MethodsWe conducted a mixed methods study using an explanatory sequential design. Using qualitative analysis, an inductive thematic approach was used to identify themes from public statements made within 6 months of 2 May 2022,Dobbsleak. Descriptive statistics and logistic regression analysis were used to assess the association between themes and institutional characteristics.ResultsMost institutions (n=124/188, 65.96%) did not issue public statements regardingDobbs. Among all 188 US medical schools, allopathic institutions (OR=12.19, 95% CI (2.83 to 52.57), p=0.001), schools in protective states (OR=3.35, 95% CI (1.78 to 6.29), p<0.0001) and those with family planning divisions (OR=4.60, 95% CI (2.33 to 9.08), p<0.0001) were at increased odds of issuing statements. Of the 64 medical schools with statements, 64.06% (n=41/64) espoused pro-choice views, 34.37% (n=22) were neutral/non-committal and 1.56% (n=1) expressed antiabortion views. Those in protective states were at 3.35 times increased odds of issuing pro-choice statements (95% CI (1.16 to 9.72), p=0.03) compared with restrictive counterparts.ConclusionMedical schools largely did not take a public stance onDobbs. By refraining from actively engaging in this critical discourse, medical schools are foregoing a leadership opportunity to affect meaningful sociopolitical change, particularly in states with restrictive abortion laws.
What is the impact of healthcare innovation on measurable outcomes of healthcare organisation performance? A systematic review
Authors: Madden Caoimhe , O'Malley Róisín , O'Dowd Emily , O'Connor Paul , Lydon Sinéad , Gormly Jared , Byrne Dara 
Published: January 2024

ObjectiveThe lack of quantitative evidence of effectiveness has been cited as a notable shortcoming of initiation and diffusion of innovations in healthcare. Therefore, this review aimed to synthesise research assessing the impact of healthcare innovations on measurable outcomes of healthcare organisation performance.DesignA systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesSystematic searches were conducted across three electronic databases, namely MEDLINE, CINAHL and PsycINFO.Eligibility criteria for selecting studiesArticles were required to: (a) be published in an English-language, peer-reviewed journal since 2000; (b) describe the application of a specific innovation within a secondary healthcare setting; (c) report data on the summative evaluation of the impact of the innovation on healthcare outcomes, using an outcome measure in line with Level Four of Kirkpatrick’s Evaluation Hierarchy (ie, a measure of organisation performance) and (d) consist of a research design that allowed for evaluation of innovation impact on outcome measures by means of a comparator.ResultsInnovations targeting organisational change were most commonly implemented. Innovations generally had a positive impact, evident in almost two-thirds of the outcome measures assessed across the included articles. Innovation impact was predominantly measured via health utilisation metrics and medical-clinical indicators, with safety outcomes and patient/family perceptions less frequently assessed.ConclusionThere is evidence to show that innovations result in discernible change in organisational importance, including on important metrics such as finance and healthcare utilisation. Bundling outcome measures are recommended to provide a more complete picture of the true impact of innovation on healthcare organisation performance.
Exploratory study to assess the functional capacity, safety and ability to isolate novel COVID-19 of a novel self-administrative nasopharyngeal wash specimen collecting device
Authors: Mohanasundari S K , Thanigainathan Sivam , Gadapalli R , Rawat Pankaj , Vandana S , Deepak K , Gupta N 
Published: January 2024

IntroductionAlthough nasopharyngeal/oropharyngeal swabs are considered the gold standard for SARS-CoV-2 diagnosis, these procedures are distressing, require trained personnel and may pose a risk of transmission.AimThis study aims to assess the functional capacity, safety, ability to isolate the novel COVID-19 and end-users’ acceptance of a novel self-collection device for obtaining nasopharyngeal wash samples.MethodsInitially, the novel device’s functional capacity (amount of nasopharyngeal wash specimen collected by participants themselves using the novel device) and safety (procedure-related complications such as bleeding, aspiration or syncope) were assessed in 15 healthy volunteers. Then, its ability to isolate the novel COVID-19 in symptomatic patients, procedure-related discomfort and end-users’ acceptance were compared with the conventional nasopharyngeal/oropharyngeal swab technique.ResultsAll 15 volunteers obtained more than 1 mL of nasopharyngeal wash sample using the novel device, with no reported medical complications. Out of 14 COVID-19-suspected patients, 9 tested positive using the novel method compared with 8 with the conventional method (p=0.09). The novel method demonstrated significantly less discomfort (median score 1 vs 5, p<0.001) and significantly higher acceptability (median score 9 vs 2, p<0.001) compared with the conventional method.ConclusionThe novel self-administrative nasopharyngeal wash specimen-collecting device allowed patients to collect samples safely. The procedure could isolate the novel COVID-19 from the nasopharynx, similar to the conventional nasopharyngeal swab technique. The novel method was less discomforting and more acceptable for end-users compared with the conventional method and is suitable for mass screening.
A chatbot to improve adherence to internet-based cognitive–behavioural therapy among workers with subthreshold depression: a randomised controlled trial
Authors: Yasukawa Sakiko , Tanaka Taku , Yamane Kenji , Kano Ritsuko , Sakata Masatsugu , Noma Hisashi , Furukawa Toshi A , Kishimoto Takuya 
Published: January 2024

BackgroundInternet-based cognitive–behavioural therapy (iCBT) is effective for subthreshold depression. However, iCBT has problems with adherence, especially when unaccompanied by human guidance. Knowledge on how to enhance adherence to iCBT without human involvement can contribute to improving the effectiveness of iCBT.ObjectiveThis is an implementation study to examine the effect of an automated chatbot to improve the adherence rate of iCBT.MethodsWe developed a chatbot to increase adherence to an existing iCBT programme, and a randomised controlled trial was conducted with two groups: one group using iCBT plus chatbot (iCBT+chatbot group) and one group not using the chatbot (iCBT group). Participants were full-time employees with subthreshold depression working in Japan (n=149, age mean=41.4 (SD=11.1)). The primary endpoint was the completion rate of the iCBT programme at 8 weeks.FindingsWe analysed data from 142 participants for the primary outcome. The completion rate of the iCBT+chatbot group was 34.8% (24/69, 95% CI 23.5 to 46.0), that of the iCBT group was 19.2% (14/73, 95% CI 10.2 to 28.2), and the risk ratio was 1.81 (95% CI 1.02 to 3.21).ConclusionsCombining iCBT with a chatbot increased participants’ iCBT completion rate.Clinical implicationsEncouraging messages from the chatbot could improve participation in an iCBT programme. Further studies are needed to investigate whether chatbots can improve adherence to the programme in the long term and to assess their impact on depression, anxiety and well-being.Trial registration numberUMIN000047621.
Relationship between emotion recognition and cognition in multiple sclerosis: a meta-analysis protocol
Authors: Degraeve Béatrice , Henry Audrey , Lenne Bruno 
Published: January 2024

IntroductionMultiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system characterised by a broad and unpredictable range of symptoms, including cognitive and socio-cognitive dysfunction. Alongside the well-known deficits in information processing speed (IPS), executive functioning and episodic memory, recent evidence also highlighted socio-cognitive impairments in MS, such as emotion-recognition deficits. Recently, several studies investigated the association between emotion-recognition and cognitive impairment to assess whether social cognition is parallel to (or even dependent on) general cognitive dysfunction. Yet, there have been inconsistent findings, raising the need for a meta-analysis of the literature.ObjectivesThe aim of the present paper is to outline the protocol for an upcoming meta-analysis we designed to clarify these conclusions.Methods and analysisWe plan to estimate combined effect sizes for the association between emotion-recognition and cognitive impairment in MS across three cognitive domains (IPS, executive functions and episodic memory) and 7 emotion scores of interests (total and by 6-basic emotions subscores). Further, we plan to investigate whether identified variables are the cause for heterogeneity in any combined association. To that end, we will conduct additional meta-regression analyses to explore whether overall correlations differ according to clinical characteristics of MS patients (ie, disease duration, MS-phenotype, severity of depression and disability). Ultimately, this study will provide support either for an association of these disorders (in which emotion-recognition deficits might result from more fundamental cognitive dysfunction), or for two distinct sets of symptoms which may occur independently, for targeted patient profiles.