bluuebunny/crossref_metadata_2025_split huggingface dataset:
The efficacy of preoperative tranexamic acid administration among patients undergoing arthroscopic rotator cuff repair: A systematic review and meta-analysis of randomized controlled trials
Authors: Alyousef Mahdi Yousef , Alaqaili Sadiq Issa , Alzayer Mohammed Ali , Alsultan Ali Sultan , Abusultan Ammar J , Alzahrani Mohammad M , Alqahtani Saad M 
Published: October 2023

Aim To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) that investigated the effectiveness of tranexamic acid (TXA) among patients undergoing arthroscopic rotator cuff repair (ARCR). Methods Five databases were screened until December 18, 2022. The included RCTs were assessed for risk of bias, and the endpoints were summarized as mean difference/standardized mean difference (MD/SMD) or risk ratio (RR) with the 95% confidence interval (CI) in a random-effects model. Results Seven RCTs with 510 patients (TXA = 261 and control/placebo = 249) were analyzed. The overall risk of bias was “low” and “unclear” in four and three RCTs, respectively. The mean operative time (n = 5 RCTs, MD = −9.64 min, 95% CI [−15.74, −3.54], p = 0.002) and mean postoperative pain score on postoperative day 1 (n = 5 RCTs, MD = −0.56, 95% CI [−1.06, −0.05], p = 0.03) were significantly reduced in the TXA group compared with the control group. However, there were no significant differences between both groups regarding visual clarity, amount of irrigation solution, and estimated intraoperative blood loss. Conclusion Among patients undergoing ARCR, preoperative TXA did not reduce intraoperative blood loss or improve visual clarity. However, TXA administration correlated with significant reductions (statistically) in operative time and postoperative day 1 pain score compared with the control group. Level of evidence: Level I; Systematic Review and Meta-analysis of Randomized Controlled Trials
PD-L1 expression-related PI3K pathway correlates with immunotherapy efficacy in gastric cancer
Authors: Liu Langbiao , Niu Lei , Zheng Xue , Xiao Fei , Sun Huaibo , Deng Wei , Cai Jun 
Published: October 2023

Background: The programed death ligand-1 combined positive score (PD-L1 CPS), the only FDA-approved biomarker for immune checkpoint inhibitor therapy in gastric cancer (GC) patients, is an important but imperfect predictive biomarker. The molecular characteristics of tumors that influence the PD-L1 CPS are largely unknown and would be helpful for screening patients who would benefit from immunotherapy. Methods: PD-L1 immunohistochemistry (IHC) and targeted next-generation sequencing techniques were used to compare genomic alterations in 492 GC patients in two groups (PD-L1 CPS ⩾ 1, positive; CPS < 1, negative). Screened PD-L1 expression-related factors were analyzed for immunotherapy efficacy in three distinct GC cohorts from public databases. Results: Positive PD-L1 expression occurred in 40% of GC patients and was associated with a higher proportion of phosphatidylinositol 3-kinase (PI3K), SWItch/Sucrose NonFermentable (SWI/SNF), lysine demethylase (KDM), and DNA (cytosine-5)-methyltransferase (DNMT) (all p < 0.01), pathway alterations. Compared to wild-type GC patients, those with PI3K pathway alterations had a higher response rate ( p = 0.002) and durable clinical benefit rate with immunotherapy ( p = 0.023, p = 0.038) as well as longer progression-free survival ( p = 0.084, p = 0.0076) and overall survival ( p = 0.2, p = 0.037) with immunotherapy. Conclusion: This study revealed PD-L1 expression-related factors in the tumor genome in a GC cohort. Alterations in the PI3K pathway associated with PD-L1 positivity were shown to be associated with better immunotherapy efficacy in three distinct GC cohorts from public databases. Our results provide a potential avenue for patient selection and rational immune combination development for GC patients.
Designing a comprehensive minimum dataset for patients with COVID-19 in Iranian hospital information systems
Authors: Salmani Hosna , Sharafi Sadegh , Almanie Ahlam , Niknam Fatemeh , Naseri Zeynab , Mobarak Sara , Jelvay Saeed 
Published: October 2023

Background: The Minimum Data Set (MDS) plays a vital role in data exchange, collection and quality improvement. In the context of the COVID-19 pandemic, there is a need for a tailored MDS that aligns with the specific information needs of the Iranian community and integrates seamlessly into the country’s Hospital Information Systems (HIS). Objective: The study aimed to develop a comprehensive MDS for COVID-19 patients in Iran, with objectives to identify essential data elements and integrate the MDS into HIS, enhancing data exchange and supporting decision-making. Method: This study employed a comparative-descriptive approach to design COVID-19 patient data elements based on World Health Organisation and Centers for Disease Control and Prevention guidelines. The Delphi technique involved 35 experts in two rounds for checklist refinement. The finalised MDS consisted of 9 main terms and 80 sub-terms, analysed using descriptive statistics and IBM SPSS software. Results: Of 35 experts involved with the study, 69% were male and 31% female, and Health Information Management experts were the majority (34%). The refined MDS for COVID-19 in Iran comprises 50 data elements, while 30 elements were excluded. The MDS includes 8 main terms and 80 sub-terms, with unanimous approval for identity, underlying disease, and treatment sections. Conclusion: The customised MDS for COVID-19 patients in Iran addresses data collection challenges and supports effective disease prevention and management. By providing comprehensive and reliable information, the MDS enhances healthcare quality, facilitates timely access to medical records, and fosters integrated health services.
First International Survey on Diabetes Providers’ Assessment of Skin Reactions in Youth With Type 1 Diabetes Using Technological Devices
Authors: Passanisi Stefano , Berg Anna Korsgaard , Chobot Agata , Dos Santos Tiago Jeronimo , Piona Claudia Anita , Messer Laurel , Lombardo Fortunato ,   ISPAD Jenious Group
Published: October 2023

Background: Advances in diabetes technological devices led to optimization of diabetes care; however, long-lasting skin exposure to devices may be accompanied by an increasing occurrence of cutaneous reactions. Methods: We used an open-link web-based survey to evaluate diabetes-care providers’ viewpoint on prevalence, management practices, and knowledge related to skin reactions with the use of diabetes technological devices. A post hoc analysis was applied to investigate differences in the level of awareness on this topic in relation to the experience in diabetes technology. Results: One hundred twenty-five responses from 39 different countries were collected. Most respondents (69%) routinely examine patients’ skin at each visit. All the preventive measures are not clear and, mainly, homogenously put into clinical practice. Contact dermatitis was the most frequently reported cutaneous complication due to diabetes devices, and its most common provocative causes are not yet fully known by diabetes-care providers. Almost half of the respondents (42%) had discussed the presence of harmful allergens contained in adhesives with device manufacturers. There is general agreement on the need to strengthen knowledge on dermatological complications. Conclusions: Although diabetes-care providers are quite aware of the chance to develop skin reactions in people with diabetes using technological devices, there are still some unmet needs. Large follow-up studies and further dissemination tools are awaited to address the gaps revealed by our survey.
The Influence of Knee Position on Ultrasound Imaging of Femoral Cartilage in Individuals with Anterior Cruciate Ligament Reconstruction
Authors: Battersby Harry S. , Holmes Skylar C. , Shumski Eric J. , Heredia Caitlyn E. , Garcia Steven A. , Pamukoff Derek N. 
Published: October 2023

Background Articular cartilage is important for knee function and can be imaged using ultrasound. The purpose was to compare femoral cartilage thickness and echo intensity (EI) measured at 90° and 140° of knee flexion and between limbs in a cohort with unilateral anterior cruciate ligament reconstruction (ACLR). We also examined associations between gait biomechanics and cartilage outcomes. Methods Twenty-seven individuals with primary unilateral ACLR participated (12 men, 15 women; age = 22.3 ± 3.8 years; time since ACLR = 71.2 ± 47.2 months). Ultrasound was used to obtain femoral cartilage measurements. Gait outcomes included peak KFA (knee flexion angle) and peak external knee flexion moment (KFM). Cartilage outcomes were compared using a 2 ( position) × 2 ( limb) repeated measures ANOVA (analysis of variance). Gait and cartilage associations were assessed using linear regression. Findings There were no position × limb interactions for any cartilage outcome (all P > 0.05). Medial ( P = 0.038) and central cartilage ( P < 0.001) were thicker, whereas central ( P = 0.029) and lateral cartilage EI ( P = 0.003) were lower when measured at 90° than those at 140° of knee flexion. Medial cartilage was thicker in the ACLR than that in the contralateral limb ( P = 0.016). A larger KFM was associated with thicker medial cartilage (ΔR2 = 0.146, P = 0.021) and central cartilage (ΔR2 = 0.159, P = 0.039) measured at 140° of knee flexion in the ACLR limb but not at 90°. Interpretation Findings suggest that imaging position influences cartilage thickness and EI measurements in individuals with ACLR and should be considered in study designs and clinical evaluation. A greater KFM was associated with thicker cartilage within specific portions of the distal femur.
Infrastructural considerations of implementing gene therapy for hemophilia in the Nordic context
Authors: Astermark Jan , Baghaei Fariba , Strandberg Karin , Toplican Petra Gabric , Birkedal Maj Friberg , Grahn Emma Engman , Hansson Charlotta , Kampmann Peter , Lehtinen Anna-Elina , Täckström Kinga , Holme Pål Andre , Magnusson Maria 
Published: October 2023

Background: Despite improvements in hemophilia care, challenges remain, including treatment burden and impaired quality of life. Gene therapy may overcome these. However, its introduction presents a challenge. Objectives: To outline a function-based gene therapy working model describing critical milestones associated with gene therapy handling, administration, and follow-up to facilitate and implement an effective infrastructure for gene therapy introduction. Design: Literature review and consensus discussion among Hemophilia Comprehensive Care centers (HCCCs) in the Nordic region. Methods: Representatives from six HCCCs sought to pinpoint milestones and key stakeholders for site readiness at the pre-, peri-, and post-infusion stages, including authority and genetically modified organism (GMO) product requirements, awareness, medical eligibility, logistics and product handling for infusion, laboratory monitoring, and follow-up. Results: A gene therapy transit map was developed with key stakeholders identified. The approach to prepare the vector will differ between the Nordic centers, but the contracted pharmacy unit will be a key stakeholder. Therefore, a pharmacy checklist for the implementation of gene therapy was developed. For the future, Advanced Therapy Medicinal Product centers will also be implemented. Patients’ expectations, commitments, and concerns need to be addressed repeatedly and education of patients and the expanded health-care professionals team will be the key to successful and optimal clinical management. Eligibility testing according to the product’s summary of product characteristics and frequent follow-up and monitoring post-infusion according to the World Federation of Hemophilia chart will be crucial. Conclusion: The approach to deliver gene therapy in the Nordic region will differ partly between the hemophilia centers, but the defined road map with checklists for the implementation of this advanced therapy will be applicable to all. The map may also serve as a platform for the use of future GMO product options both within and outside the area of hemophilia.
Role of exosomes in the development, diagnosis, prognosis and treatment of hepatocellular carcinoma
Authors: Liu Meijin , Lai Zhonghong , Yuan Xiaoying , Jin Qing , Shen Haibin , Rao Dingyu , Huang Defa 
Published: October 2023

AbstractHepatocellular carcinoma (HCC) is the most common primary liver cancer. It is characterized by occult onset resulting in most patients being diagnosed at advanced stages and with poor prognosis. Exosomes are nanoscale vesicles with a lipid bilayer envelope released by various cells under physiological and pathological conditions, which play an important role in the biological information transfer between cells. There is growing evidence that HCC cell-derived exosomes may contribute to the establishment of a favorable microenvironment that supports cancer cell proliferation, invasion, and metastasis. These exosomes not only provide a versatile platform for diagnosis but also serve as a vehicle for drug delivery. In this paper, we review the role of exosomes involved in the proliferation, migration, and metastasis of HCC and describe their application in HCC diagnosis and treatment. We also discuss the prospects of exosome application in HCC and the research challenges.
Association between tooth loss and frailty among Chinese older adults: the mediating role of dietary diversity
Authors: Xu Xin , Zhao Yuan , Wu Bei , Pei Yaolin , Gu Danan 
Published: October 2023

Abstract
Background
This study aimed to examine the association between tooth loss and frailty among Chinese older adults and the mediating role of dietary diversity in this association.

Methods
Data from five waves of the Chinese Longitudinal Healthy Longevity Survey conducted between 2005 and 2018 were used. Path analyses were employed to assess both concurrent and cross-lagged relationships between tooth loss and frailty index while accounting for intrapersonal correlation. Furthermore, the mediation effect of dietary diversity was also examined.

Results
In concurrent models, severe tooth loss was associated with frailty after adjusting for demographic characteristics (odds ratio [OR] = 1.82, p < 0.001). The OR of frailty for severe tooth loss was only slightly decreased to 1.74 (p < 0.001) when dietary diversity was added to the model and to 1.64 (p < 0.001) when socioeconomic status, family support, and healthy lifestyles were further adjusted. In the cross-lag or longitudinal models, the ORs were mildly or moderately reduced to 1.29, 1.27, and 1.23, respectively, yet remained statistically significant (p < 0.001 or p < 0.01). The mediation analyses showed that dietary diversity had some small yet significant effects on the relationship between tooth loss and frailty in both concurrent and longitudinal settings.

Conclusions
This study improves current knowledge regarding the impact of tooth loss on frailty among Chinese older adults. Future intervention strategies designed to improve healthy diets may have preventive effects against the risk of frailty among Chinese older adults with severe tooth loss.
Risk factor analysis of the development of severe radiation pneumonitis in patients with non-small cell lung cancer treated with curative radiotherapy, with focus on underlying pulmonary disease
Authors: Kim Hakyoung , Hwang Jeongeun , Kim Sun Myung , Choi Juwhan , Yang Dae Sik 
Published: October 2023

Abstract
Background
We aim to identify the multifaceted risk factors that can affect the development of severe radiation pneumonitis (RP) in patients with non-small cell lung cancer (NSCLC) treated with curative high-dose radiotherapy with or without concurrent chemotherapy.

Methods
We retrospectively reviewed the medical records of 175 patients with stage-I-III NSCLC treated with curative thoracic X-ray radiotherapy at the Korea University Guro Hospital between June 2019 and June 2022. Treatment-related complications were evaluated using the Common Terminology Criteria for Adverse Events (version 4.03).

Results
The median follow-up duration was 15 months (range: 3–47 months). Idiopathic pulmonary fibrosis (IPF) as an underlying lung disease (P < 0.001) and clinical stage, regarded as the concurrent use of chemotherapy (P = 0.009), were associated with a high rate of severe RP. In multivariate analyses adjusting confounding variables, the presence of IPF as an underlying disease was significantly associated with severe RP (odds ratio [95% confidence interval] = 48.4 [9.09–347]; P < 0.001). In a subgroup analysis of stage-I-II NSCLC, the incidence of severe RP in the control, chronic obstructive pulmonary disease (COPD), and IPF groups was 3.2%, 4.3%, and 42.9%, respectively (P < 0.001). The incidence of severe RP was 15.2%, 10.7%, and 75.0% in the control, COPD, and IPF groups, respectively (P < 0.001) in the stage-III NSCLC group.

Conclusions
This study revealed that IPF as an underlying lung disease and the concurrent use of chemotherapy are associated with a high rate of severe RP. In contrast, COPD did not increase the risk of pulmonary toxicity after receiving curative high-dose radiotherapy.
Association between bullying victimization and post-traumatic stress disorders among Chinese adolescents: a multiple mediation model
Authors: Li Tianchang , Chen Bo , Li Qian , Wu Xinyue , Li Yifan , Zhen Rui 
Published: October 2023

Abstract
Background
Research that focused on the mechanisms underlying the relation between school bullying victimization and PTSD ignored the simultaneous effect of emotional and cognitive factors, which may limit our comprehensive understanding of their roles. Besides, most researchers included non-bullying victims in data analysis, and this may mask the true effect among bullying victims. The present study aimed to explore the relation between bullying victimization and PTSD, and the mediating roles of social anxiety, loneliness, and rumination, after filtering out non-bullying victims.

Materials and methods
In April 2019, we used convenience sampling to recruit 5013 students from Grade 10 and 11 in two high schools in Anhui Province, China. The mean age of these students was 16.77 (SD = 0.92) years. They completed five self-report questionnaires including the Delaware Bullying Victimization Scale-Student Chinese Revision (DBVS-S), the modified PTSD Checklist, the Social Anxiety Scale, the Adolescent Loneliness Scale, and the Rumination Scale. Further, a total of 443 bullying victims were screened out for this study according to the critical score of the DBVS-S.

Results
The results showed that bullying victimization had a direct and positive association with PTSD among adolescents (β = 0.16, 95%CI: 0.046–0.252). Bullying victimization was positively associated with PTSD through increasing adolescents’ social anxiety (β = 0.06, 95%CI: 0.017–0.105), as well as through increasing their loneliness (β = 0.16, 95%CI: 0.109–0.215). In addition, bullying victimization was positively associated with PTSD through social anxiety via loneliness (β = 0.04, 95%CI: 0.013–0.067), as well as through loneliness via rumination (β = 0.02, 95%CI: 0.003–0.033). Bullying victimization was also positively associated with PTSD through a three-step path from social anxiety to rumination via loneliness (β = 0.004, 95%CI: 0.001–0.009).

Conclusions
Social anxiety, loneliness, and rumination have important mediating effects in the relation between bullying victimization and adolescents’ PTSD, in which emotional factors (e.g., social anxiety, loneliness) are more crucial than cognitive factors (e.g., rumination). Intervention should pay more attention to timely alleviate victims’ emotional problems to reduce the risk of developing PTSD.
Barriers to implementing health programs based on community participation: the Q method derived perspectives of healthcare professional
Authors: Mahmoodi Hassan , Bolbanabad Amjad Mohamadi , Shaghaghi Abdolreza , Zokaie Mehdi , Gheshlagh Reza Ghanei , Afkhamzadeh Abdorrahim 
Published: October 2023

Abstract
Background
Community participation in implementing health programs leads to positive organizational, social and individual consequences. This study aimed to investigate the prospects of a sample of Iranian healthcare professionals about their perceived barriers to implementing health programs based on community participation.

Methods
This was a cross-sectional study that employed a Q-methodology approach. Twenty health professional sorted the 47 statements into a 9-column Q-sort diagram ranging from − 4 as not important to + 4 as very important. The data were analyzed with PQMethod 2.35 software. The centroid factor analysis and varimax rotation were used for data analysis. Factors identified were interpreted and described in terms of the participants perspectives on the phenomenon.

Results
Analysis of the study participants’ viewpoints (the Q-sorts) resulted in a five factor solution (accounted for 57% of the total variance) to endorse the main barriers to the implementation of health programs based on community participation in Iran. Barriers related to government, health programs, lack of necessary skills amongst health professionals and weak coordination between departments, barriers related to community, lack of understanding of goals, benefits and transparency of roles and responsibilities were among the important emanated factors to implementing health programs based community participation.

Conclusion
Health policymakers and managers should consider the five mentioned identified barriers based on the community when planning and implementing the health program participation and try to empower the community to implement the programs in Iran.
Application of laparoscopic backtracking full-thickness continuous everting suture for non-AOSC choledocholithiasis
Authors: Yuan Bo , Zhang Xuanfeng , Kong Chenchen , Zhang Cancan , Li Huansong 
Published: October 2023

Abstract
Background
Based on the current trend of increasing incidence of choledocholithiasis, it is of great significance to explore the closure method of the common bile duct during laparoscopic choledocholithotomy.

Methods
Backtracking full-thickness continuous everting suture was selected for primary closure of the common bile duct suture, while traditional T-tube drainage was selected for the control group. Propensity score matching (PSM) was used to reduce baseline differences between the two groups.

Result
The intraoperative blood loss, operation time, postoperative recovery speed, postoperative bleeding, postoperative pancreatitis, recurrence rate of bile duct stones, and hospitalization time in the primary closure group were all less than those in the T-tube drainage group.

Conclusion
Under certain conditions, backtracking full-thickness continuous everting suture could benefit patients with choledocholithiasis compared with traditional T-tube drainage.