bluuebunny/crossref_metadata_2025_split huggingface dataset:
Providing compassionate care via eHealth
Authors: Su Jing Jing , Bayuo Jonathan , Lin Rose SY , Batalik Ladislav , Chen Xi , Abu-Odah Hammoda , Chan Engle Angela 
Published: January 2024

Background eHealth was widely used during the COVID-19 pandemic. Much attention was given to the technical aspects of eHealth, such as infrastructure and cost, while the soft skill of compassion remained underexplored. The wide belief in compassionate care is more compatible with in-person interactions but difficult to deliver via e-platforms where personal and environmental clues were lacking urges studying this topic. Purpose to explore the experience of delivering compassionate care via an eHealth platform among healthcare professionals working to contain the COVID-19 pandemic. Methods A qualitative study design with an interpretative phenomenological analysis approach was used. Twenty healthcare professionals (fifteen nurses and five physicians) who provided care using technology platforms, such as telephone hotlines, mobile apps, and social media, were interviewed individually. Ethical considerations Permission to conduct the study was obtained from the Institutional Review Board. Results Participants stated that “eHealth enabled compassionate care during the pandemic” by ensuring patient care availability and accessibility. They shared experiences of “communicating compassionate care via eHealth” with suggestions of addressing patients’ needs with empathy, adopting a structured protocol to guide eHealth communication, and using more advanced visual-media methods to promote human-to-human interaction. They recommended “setting realistic mutual expectations” considering the limitations of eHealth in handling complex health situations and staffing shortages. Participants considered “low eHealth literacy hinders compassion.” Additionally, they recommended the need for “institutional/system-level support to foster compassionate care.” Conclusion Participants recognized the importance of integrating compassion into eHealth services. Promotion of compassionate care requires standardization of eHealth services with institutional and system-level support. This also includes preparing adequate staffing who can communicate compassionate care via eHealth, set realistic expectation, and adjust communication to eHealth literacy level while meeting the needs of their patients.
Drivers and Barriers to Tolerable and Effective Treatment for ADHD: The Importance of Treatment Perseverance and Duration of Effect
Authors: Way Nate , Mikl Jaromir , Cataldo Marc , Erensen Jennifer G. , Martin Ashley , Li Vicky , Pliszka Steven R. 
Published: January 2024

Objective: To examine treatment outcomes for classes of ADHD drugs in conjunction with physicians’ prescribing rationales and the utility of treatment perseverance in treatment effectiveness. Methods: A retrospective non-interventional study using physician-provided chart data for treated adolescent and adult ADHD patients in the United States (April–June 2019). Multivariable analyses compared the effectiveness and tolerability of drug classes. Results: Among the 1,232 ADHD patients included in this study, 37.7% experienced one, 11.8% two, and 6.7% three treatment changes post their first prescribed regimen. These changes were mostly attributed to lack of rapid onset and duration of effect. Achieving best response correlated with the number of previous treatments for adolescents, but not adults. Maintaining full response correlated with the length of current treatment for adolescents and adults. Conclusion: Physicians’ prescribing rationales targeted duration of effect and tolerability. ER monotherapy demonstrated potential advantages over other regimens. Treatment perseverance is integral to effective ADHD management.
Recent trends in disease-modifying therapy use and associated sickness absence and disability pension among people with multiple sclerosis in Sweden
Authors: Teni Fitsum Sebsibe , Machado Alejandra , Fink Katharina , Gyllensten Hanna , Hillert Jan , Friberg Emilie 
Published: January 2024

Background: Disease-modifying therapies (DMTs) have led to improved health and work productivity among people with multiple sclerosis (PwMS). Objectives: To describe trajectories of recent DMT use and their association with sickness absence and/or disability pension (SADP) among PwMS in Sweden. Methods: A longitudinal register–based study was conducted among 1395 PwMS with treatment start in 2014/2015. While DMT use over 5 years was assessed using sequence analysis resulting in four clusters, a 7-year (Y−2 toY4) trend of SADP was analyzed using zero-inflated negative binomial regression. Results: Four clusters of DMT use trajectories were identified: long-term non-high-efficacy (483, 34.6%), long-term high-efficacy (572, 41%), escalation (221, 15.8%), and discontinuation (119, 8.5%). Progressive MS and higher expanded disability status scale scores were associated with the escalation, long-term high-efficacy, or discontinuation clusters. PwMS in the long-term high-efficacy and escalation clusters had higher likelihood of being on SADP. However, PwMS initiating high-efficacy DMTs demonstrated steeper decline in SADP than others. Conclusion: Using sequence analysis, this study showed recent DMT use trajectories among PwMS where initiation of high-efficacy DMTs has become more common. The trend of SADP was stable and lower in those using non-high-efficacy DMTs and larger improvements were shown in those initiating high-efficacy DMTs.
Employment profiles of autistic people: An 8-year longitudinal study
Authors: Bury Simon M , Hedley Darren , Uljarević Mirko , Li Xia , Stokes Mark A , Begeer Sander 
Published: January 2024

Autistic adults experience high rates of unemployment, yet research investigating what predicts employment success produces inconsistent results. By utilising longitudinal person-oriented analyses, this study aimed to identify employment trajectories of autistic adults to better understand what may predict stable autistic employment. Participants were 2449 autistic adults (1077 men, 1352 women, 20 non-binary, M  = 42.25 years, SD = 14.24), recruited via the Netherlands Autism Register. Latent class analysis utilising employment status across eight annual waves was used to identify longitudinal employment profiles. Fit indices and the interpretability of results indicated a four-class model best fit the data, with profiles reflecting stable unemployment ( n = 1189), stable employment ( n = 801), early unemployment increasing in probability of employment ( n = 183) and high probability of employment reducing across time to low employment ( n = 134). Multinominal analyses suggested that compared to the ‘stable unemployment’ group, membership in the ‘stable employment’ profile was predicted by fewer autistic traits, lower age, male gender, higher education and diagnosis age, and fewer co-occurring conditions. Higher education predicted both other profiles, with lower age and fewer co-occurring conditions predicting membership in the increasing employment class. Taken together, findings highlight the utility of person-oriented approaches in understanding the longitudinal challenges autistic adults experience maintaining employment and identifies key areas of support. Lay abstract Autistic adults experience difficulties finding and keeping employment. However, research investigating reasons that might explain this difficulty produce mixed results. We gave a survey to 2449 autistic adults and used a statistic method to group them based on their employment status over 8 years. We identified four employment groups that best captured the experiences of autistic adults; this included a group that experienced stable unemployment, a group that experienced stable employment, a group that had high employment that reduced over time, and a group whose employment increased over the 8 years. Further analysis showed that those with fewer autistic traits, younger age, male gender, higher education, later diagnosis age and no co-occurring conditions were more likely to have stable employment. People whose employment changed over time were more likely to have a higher level of education than the stable unemployment group, and those in the increasing employment group were younger age and had no co-occurring conditions. These findings help us better understand that not all autistic adults’ experiences of employment are the same, which helps focus where employment programmes and support may be most needed, for example, people who identify as women or have a co-occurring condition.
Implementation of Virtual Integrative Oncology Shared Medical Appointment Series (VIOSMAS) Within Mixed Diagnosis Population
Authors: Loy Michelle H. , Prisco Lauren , Parikh Chiti 
Published: January 2024

Background: Integrative oncology [IO] is sought-after by patients, endorsed by clinical guidelines, and valued within National Cancer Institute Centers. Shared Medical Appointments [SMA] leverage health education and social connection to deliver enhanced patient experience, population health, cost-reduction, and clinician well-being. Integrative Oncology Shared Medical Appointments increase access to integrative medicine but delivering these services via telehealth have not been evaluated. Objective: We created, and pilot tested a Virtual Integrative Oncology Shared Medical Appointment Series (VIOSMAS) to assess its feasibility, acceptability, and efficacy at an urban academic teaching hospital. Methods: The 7-session hour-long Living Well with and after Cancer series included didactics, multi-disciplinary experiential sessions, and group discussion. Topics included (1) Introduction, (2) Herbs/Botanicals/Fungi, (3) Mindful Movement, (4) Acupuncture, (5) Narratives and Nature, (6) Diet and Culinary Medicine, and (7) Vitamins/Supplements. Virtual visits via telehealth were offered to enhance patient participation during the pandemic. Outcome measures included recruitment, retention, pre/post-series patient survey and qualitative clinician feedback. Results: Between 9/2021 and 4/2023, 72 unique patients were recruited to 5 cohorts and had a total of 332 VIOSMAS visits. A total of 50 patients (69%) attended 4 or more of the 7-session series; 60 (83% were women); patients ranged in age from 28 to 93 years (median 66); 36 (50%) lived outside the city center; the most common cancer diagnoses were breast, lymphoma, and lung cancer. Patients were from diverse demographics. Pre-program, patients reported desiring assistance in addressing diverse symptoms including fatigue, insomnia, pain, gastrointestinal (GI) symptoms, anxiety, and depression. Post-series, patients reported that the VIOSMAS addressed their goals and symptoms; they also reported incorporating recommended lifestyle changes in diet, exercise, sleep, and stress management; they were satisfied with the number of sessions and telehealth format. The participating clinicians reported high levels of satisfaction with VIOSMAS. Revenue to the institution from VIOSMAS exceeded the revenue potential of equivalent time spent for individual visits while supporting extended physician-patient contact. Conclusion: VIOSMAS is feasible for patients and clinicians, addresses patients’ symptoms and questions about lifestyle and complementary therapies, and generates more revenue than individual visits. Larger implementation trials with appropriate comparison groups are recommended.
Partially Lacerated Digital Flexor Tendons: A Cadaveric Study Determining the Intact Cross-sectional Area and Biomechanical Analysis
Authors: Hui-Ying Kang Gavrielle , Wong Yoke-Rung , LiYu Toh Alyssa , Yong Fok-Chuan 
Published: January 2024

Background: The extent of injury in partially lacerated tendons has conventionally been expressed as a percentage of the total tendon, to justify surgical repair. We propose a more objective method to estimate the cross-sectional area of the remnant intact tendon and to determine if the remaining tendon fibers can withstand the tensile forces of early active mobilization against resistance. Methods: The study was done on 20 cadaveric specimens, which were randomly assigned to receive a laceration of 25%, 50%, or 75% of the measured transverse tendon diameter. The circumference of the remaining intact portion of the partially lacerated tendon was measured and converted using a formula to determine the derived cross-sectional area (D-CSA). These D-CSA values were then validated by comparing them to digitally measured cross-sectional areas using a computer software program (computer-measured cross-sectional area, C-CSA). In addition, the ultimate tensile strength (UTS) of these partially lacerated tendons was analyzed to determine if a threshold exists beyond which surgical repair of a partially lacerated tendon is indicated. Results: We found that the D-CSAs matched moderately with C-CSAs, with 0.622 of Pearson correlation coefficient. The UTSs of tendons with CSAs above 8 mm in circumference were consistently above 150 N. Conclusion: Measurement of the circumference of the partially lacerated tendon to obtain the D-CSA could be an accurate and practical method to benchmark residual tendon strength in the management of partially lacerated tendons.
The symbolic two-step method applied to cancer care delivery research: Safeguarding against designing an underpowered cluster randomized trial with a continuous outcome by accounting for the imprecision in the within- and between-center variation
Authors: Zahrieh David , Kandler Blaize W , Le-Rademacher Jennifer 
Published: January 2024

Background: Knowing the predictive factors of the variation in a center-level continuous outcome of interest is valuable in the design and analysis of parallel-arm cluster randomized trials. The symbolic two-step method for sample size planning that we present incorporates this knowledge while simultaneously accounting for patient-level characteristics. Our approach is illustrated through application to cluster randomized trials in cancer care delivery research. The required number of centers (clusters) depends on the between- and within-center variance; the within-center variance is a function of estimates obtained by regressing the log within-center variance on predictive factors. Obtaining accurate estimates of the components needed to characterize the within-center variation is challenging. Methods: Using our previously derived sample size formula, our objective in the current research is to directly account for the imprecision in these estimates, using a Bayesian approach, to safeguard against designing an underpowered study when using the symbolic two-step method. Using estimates of the required components, including the number of centers that contribute to those estimates, we make formal allowance for the imprecision in these estimates on which a sample size will be based. Results: The mean of the distribution for power is consistently smaller than the single point estimate that the sample size formula yields. The reduction in power is more pronounced in the presence of increased uncertainty about the estimates with the reduction becoming more attenuated with increased numbers of centers that contribute to the estimates. Conclusions: Accounting for imprecision in the estimates of the components required for sample size estimation using the symbolic two-step method in the design of a cluster randomized trial yields conservative estimates of power.
Effect of altered gene expression in lipid metabolism on cognitive improvement in patients with Alzheimer’s dementia following fecal microbiota transplantation: a preliminary study
Authors: Kim Jun-Seob , Park Hyelim , Lee Jung-Hwan , Shin Jongbeom , Cha Boram , Kwon Kye Sook , Shin Yong Woon , Kim Yerim , Kim YeoJin , Bae Jong Seok , Lee Ju-Hun , Choi Seok-Jin , Kim Tae Jung , Ko Sang-Bae , Park Soo-Hyun 
Published: January 2024

Background: The brain–gut axis has emerged as a potential target in neurodegenerative diseases, including dementia, as individuals with dementia exhibit distinct gut microbiota compositions. Fecal microbiota transplantation (FMT), the transfer of fecal solution from a healthy donor to a patient, has shown promise in restoring homeostasis and cognitive enhancement. Objective: This study aimed to explore the effects of FMT on specific cognitive performance measures in Alzheimer’s dementia (AD) patients and investigate the relationship between cognition and the gut microbiota by evaluating changes in gene expression following FMT. Methods: Five AD patients underwent FMT, and their cognitive function [Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB)] was assessed before and after FMT. The patients’ fecal samples were analyzed with 16S rRNA to compare the composition of their gut microbiota. We also assessed modifications in the serum mRNA expression of patients’ genes related to lipid metabolism using serum RNA sequencing and quantitative real-time polymerase chain reaction. Results: Significant improvements in cognitive function, as measured by the MMSE (pre- and post-FMT was 13.00 and 18.00) and MoCA were seen. The MoCA scores at 3 months post-FMT (21.0) were the highest (12.0). The CDR-SOB scores at pre- and post-FMT were 10.00 and 5.50, respectively. Analysis of the gut microbiome composition revealed changes via 16S rRNA sequencing with an increase in Bacteroidaceae and a decrease in Enterococcaceae. Gene expression analysis identified alterations in lipid metabolism-related genes after FMT. Conclusion: These findings suggest a link between alterations in the gut microbiome, gene expression related to lipid metabolism, and cognitive function. The study highlights the importance of gut microbiota in cognitive function and provides insights into potential biomarkers for cognitive decline progression. FMT could complement existing therapies and show potential as a therapeutic intervention to mitigate cognitive decline in AD.
Differential prognostic value of tumor and plasma T790M mutations in EGFR TKI-treated advanced NSCLC
Authors: Tung Pi-Hung , Chiu Tzu-Hsuan , Huang Allen Chung-Cheng , Ju Jia-Shiuan , Huang Chi-Hsien , Wang Chin-Chou , Ko How-Wen , Chung Fu-Tsai , Hsu Ping-Chih , Fang Yueh-Fu , Guo Yi-Ke , Kuo Chih-Hsi Scott , Yang Cheng-Ta 
Published: January 2024

Background: Substitution of methionine for threonine at codon 790 (T790M) of epidermal growth factor receptor (EGFR) represents the major mechanism of resistance to EGFR tyrosine kinase inhibitors (TKIs) in EGFR-mutant non-small-cell lung cancer. We determined the prognostic impact and association of secondary T790M mutations with the outcomes of osimertinib and chemotherapy. Methods: Patients (n = 460) progressing from first-line EGFR-TKI treatment were assessed. Tissue and/or liquid biopsies were used to determine T790M status; post-progression overall survival (OS) was analyzed. Results: Overall, 143 (31.1%) patients were T790M positive, 95 (20.7%) were T790M negative, and 222 (48.2%) had unknown T790M status. T790M status [T790M positive versus T790M negative: hazard ratio (HR) 0.48 (95% confidence interval (CI), 0.32–0.70); p < 0.001, T790M unknown versus T790M negative: HR 1.97 (95% CI, 1.47–2.64); p < 0.001] was significantly associated with post-progression OS. T790M positivity rates were similar for tissue (90/168, 53.6%) and liquid (53/90, 58.9%) biopsies (Fisher’s exact test, p = 0.433). Tumor T790M-positive patients had significantly longer post-progression OS than tumor T790M-negative patients (34.1 versus 17.1 months; log-rank test, p = 8 × 10−5). Post-progression OS was similar between plasma T790M-positive and -negative patients (17.4 versus not reached; log-rank test, p = 0.600). In tumor T790M-positive patients, post-progression OS was similar after osimertinib and chemotherapy [34.1 versus 29.1 months; log-rank test, p = 0.900; HR 1.06 (95% CI, 0.44–2.57); p = 0.897]. Conclusion: T790M positivity predicts better post-progression OS than T790M negativity; tumor T790M positivity has a stronger prognostic impact than plasma T790M positivity. Osimertinib and chemotherapy provide similar OS benefits in patients with T790M-positive tumors.
Analysis of circulating tumor DNA identifies distinct therapeutic response to intraperitoneal and intravenous paclitaxel plus S-1 in gastric cancer patients with peritoneal metastasis
Authors: Yuan Hong , Xu Fei , Wang Shengzhou , Liu Di , Zhang Huan , Zhang Jun , Shi Min , Yan Chao , Zhu Zhenggang 
Published: January 2024

Background: Circulating tumor DNA (ctDNA) is a promising technique for predicting curative effects and monitoring tumor recurrence. The utility of ctDNA for gastric cancer with peritoneal dissemination remains elusive. Objectives: To assess the feasibility of ctDNA in predicting tumor response to chemotherapy in gastric cancer with peritoneal dissemination. Design: This was a prospective study. Methods: We enrolled 30 patients with gastric cancer peritoneal metastasis, treated with intraperitoneal and intravenous paclitaxel plus S-1. Peripheral blood samples of patients were prospectively collected at baseline, after treatment initiation accompanied by computed tomography scan and disease progression. Mutational profiles from ctDNA were analyzed to evaluate its association with chemotherapeutic response. Results: Tumor protein 53 ( TP53) was the most frequently altered gene at baseline blood samples. Although baseline TP53 mutation was not related to therapeutic response, patients with TP53 mutation had worse progression-free survival (PFS) and overall survival (OS). Additionally, baseline ctDNA content fraction (CCF) was found to be significantly lower in responders than non-responders. Meanwhile, patients with high CCF had a trend of worse PFS and OS. Combining TP53 alteration and CCF, the prognosis of TP53-wt patients could be further stratified. Patients with CCF-low_ TP53-wt had markedly longer survival than those with CCF-high_ TP53-wt. Conclusion: Our study highlighted the significance of ctDNA in predicting potential clinical outcomes in gastric cancer patients during chemotherapy. Trial registration: ChiCTR-IIR-16009802 (Chinese Clinical Trial Registry).
Cost-effective office 3D printing process in orthopaedics and its benefits: A case presentation and literature review
Authors: Cheo Feng Yi , Soeharno Henry , Woo Yew Lok 
Published: January 2024

Background and objectives The advent of 3-Dimensional (3D) printing technology is one of the most revolutionising breakthroughs of the generation. Its benefits in surgical practice are undeniable, however a steep learning curve and concerns regarding costs may pose a barrier to large scale implementation. Methods We set up an in-house 3D printing facility in our institution and described our workflow. Using the described workflow, we 3D printed models which were used in the surgical management of three patients with differing conditions. Results We present three case examples to display the uses that 3D printing technology is able to provide in our experience, and show how 3D printing technology can be beneficial in the field of orthopaedic oncology and surgically complex cases. 3D printing has proven to be useful and improved quality of care in these case examples. The processes for each case were described individually. The benefits of our in-house 3D printing facility were discussed in detail. Conclusion An in-house office 3D printing facility is advantageous and cost-efficient. Its benefits can be maximised if implemented on a larger scale and has the potential to be standard of care in many institutions.