bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the addition of convex uniplanar screws in hybrid constructs improve 3D surgical correction in thoracic adolescent idiopathic scoliosis posterior fusion?
Authors: Simon Laurie , Finoco Mikael , Julien-Marsollier Florence , Happiette Adèle , Simon Anne-Laure , Ilharreborde Brice 
Published: February 2024

Purpose: Hybrid techniques using thoracic sublaminar bands have proved their efficacy in adolescent idiopathic scoliosis posterior fusion, but clinical axial correction sometimes remained disappointing. One solution found was “the frame technique” and the second alternative was the replacement of the convex sublaminar bands by periapical uniplanar screws. The goal of this study was to compare clinical and radiological outcomes of both techniques in a consecutive cohort of adolescent idiopathic scoliosis patients. Methods: All patients undergoing primary posterior fusion for thoracic adolescent idiopathic scoliosis between January 2017 and March 2020 were included. Two groups were compared: Group 1 with thoracic sublaminar bands only and Group 2 with periapical uniplanar screws. All patients underwent standing stereoradiographs. The main frontal, sagittal, and axial (apical vertebra rotation) radiological parameters of interest were analyzed. Functional outcomes were assessed using the Scoliosis Research Society 30 score. Results: A total of 147 adolescents were included (Group 1, n = 73 and Group 2, n = 74 patients). In the frontal plane, a greater reduction index was observed in Group 2 (68% versus 62%, p < 0.001) as well as a better apical axial correction (67.8% versus 46.6%, p = 0.03). The number of thoracoplasty performed was reduced (6.7% versus 20.5%, p = 0.02) in Group 2, with a significant decrease in the rate of mechanical complication. No significant loss of correction was observed during follow-up in any of the group. Conclusion: The adjunction of convex uniplanar screws at the periapical levels improved the three-dimensional surgical correction of thoracic adolescent idiopathic scoliosis treated with hybrid constructs. Level of evidence: level III, retrospective comparative study
Dermatofibrosarcoma protuberans: Case series in a tropical setting and review of literature
Authors: Ashindoitiang John Adi , Canice Nwagbara Victor Ikechukwu , Ipeh Ugbem Theophilus , Owusu George Peter , Asuquo Maurice Efana 
Published: February 2024

Dermatofibrosarcoma protuberans (DFSP) is an infrequent cutaneous tumour that may involve subcutaneous fat and in some cases fascia, muscles and bone. The infrequent occurrence lessens its clinical awareness in addition to its clinical semblance to many common cutaneous lesions. It is characterized by proclivity for local recurrence. We evaluated the clinical presentation and treatment outcomes of six consecutive cases of DFSP with histologic diagnosis in the University of Calabar Teaching Hospital, Calabar seen between January 2013 and December 2022. This was compared with total cutaneous malignances in the same period. The six consecutive patients comprised of two males and four females (M = F: 1:2) whose ages ranged from 21 to 57 years (mean of 36.5 years) and accounted for 7% of cutaneous malignancies. The site distribution was trunk (back) involved in 3 (50%) of the patients, limbs 3 (50%); upper 1 (17%) and lower limb 2 (33%). Clinical presentation was in the form of firm cutaneous mass with some ulcerated lesions that bled and some fungated. 50 percent of the patients presented with recurrent lesions and in all there was no regional lymphadenopathy or evidence of metastasis. There was a patient with Neurofibromatosis- 1 who had a huge fungated limb lesion offered amputation, four had wide local excision and one incision biopsy. Follow up was poor and the period ranged from 2 to 14 months (mean 7 months). Dermatofibrosarcoma protuberans is an uncommon tumour with clinical semblance to other cutaneous lesions. Early presentation, preoperative histologic diagnosis will enhance the goal of ensuring adequate excision. Adjuvant therapy with Imatinib with or without adjuvant radiotherapy are recommended in the treatment plan in view of the frequency of late presentation with advanced recurrent lesions and poor follow up.
Patients’ awareness of recovery mediates the link between clinical and level of functional remission in schizophrenia to a larger extent in those treated with long-acting antipsychotics
Authors: Mallet Jasmina , Dondé Clément , Dubertret Caroline , Gorwood Philip 
Published: February 2024

Background: Clinical remission is a step towards functional remission for subjects with schizophrenia. While recovery is both a subjective personal journey and a clinical outcome to be targeted, data on patient self-rated outcomes are scarce. Objectives: (i) To determine the extent to which the association between clinical and functional remission is mediated by the subjective experience of recovery as reported by patients versus their relatives or their psychiatrist and (ii) to assess differences according to treatment, specifically with oral antipsychotics only versus long-acting injectable antipsychotics (LAIs). Design: Clinical observational study. Methods: Community-dwelling participants with schizophrenia enrolled in the EGOFORS cohort ( N = 198) were included. Clinical symptoms and remission were assessed using the Positive and Negative Syndrome Scale. Functional remission was assessed with the Functional Remission of General Schizophrenia Scale. Awareness of recovery was assessed with one question ‘What percentage of recovery do you think you have now (from 0% – no recovery – to 100% – full recovery)?’, asked of the patient, also of the patient’s close relative, and the psychiatrist. We used mediation analyses, taking into account the type of pharmacological treatment. Results: Remission criteria and perceived remission measures were significantly correlated, both within and between groups ( r > 0.330). The patient’s awareness of recovery mediated the relationship between clinical remission and level of functional remission, while the level of recovery according to psychiatrists or close relatives did not. The direct effect of clinical remission on the level of functional remission became non-significant when taking into account the mediator (patients’ awareness of recovery) in the group of patients with LAI ( t = 1.5, p = 0.150) but not in the group of patients with other treatments ( t = 3.1, p = 0.003). Conclusion: Patients with LAIs may be more efficient in reporting their level of functional remission. Higher patient awareness could be an interesting candidate to explain this. However, as the study was cross-sectional, such a proposal should be tested with a more specifically designed protocol, such as a long-term cohort.
Redistar Versus Velocity
Authors: Fatma Sabeeha 
Published: February 2024

The case discusses the pitfalls of hasty decisions taken to achieve instant success. The case also highlights how unethical practices erode the image of the organization and sets in malicious culture. The Radiance Group, founded by Sarabhai Karmarkar (1930–2005), one of the largest private sector companies in India, with petroleum and energy as it core business, has always been an ambitious company. Sarabhai, the founder of the company, was a man of high aspirations. Since the very inception of the company, Radiance Industries Limited’s only vision was Profit Maximization. Sarabhai Karmarkar believed in utilitarian philosophy which preaches that end justifies the means. After the demise of Sarabhai, Vithalbhai Karmarkar, eldest son of Sarabhai, became the director of the company. He was an intelligent and sharp minded young man, full of new ideas and energy. He wanted to explore new ideas and diversify into new products and markets. In his haste to make Radiance grow exponentially, Vithalbhai committed many mistakes which proved to be fatal for the brand. The case discusses the setbacks that strategic myopia can lead to. The case further discusses the long-term damage that unethical means can cause. The case emphasizes upon the importance of ethical conduct for gaining customer’s loyalty and trust.
Similarities and differences among selected gemmological varieties of chalcedony: chemistry, mineralogy and microstructure
Authors: Monico Sara , Cantaluppi Marco , Diella Valeria , Gatta G. Diego , Adamo Ilaria , Fumagalli Patrizia , Marinoni Nicoletta 
Published: February 2024

AbstractThis study describes a new variety of chalcedony with a unique inhomogeneous bluish green hue, named aquaprase. It was discovered in Africa and is considered to be a valuable addition to the gem trade. A multi-methodological approach was used to examine its chemistry, mineralogy and microstructure, which were then compared to those of chrysoprase and agate, two of the most popular varieties of chalcedony. Optical microscopy revealed a complex microstructural heterogeneity in the different colour intensity areas/bands of aquaprase and agate, whereas chrysoprase exhibited a more homogeneous coexistence of micro- and cryptocrystalline quartz. High-resolution synchrotron XRD was essential for highlighting the complex assemblage of various types of α-quartz in aquaprase and agate (which differ in terms of crystal size and/or cell parameters). Micro-Raman spectroscopy revealed α-quartz and moganite in all three varieties of chalcedony and the presence of the nickel-bearing layered silicate mineral, willemseite, in chrysoprase, which is responsible for its green colouration. The chemical analysis displayed a homogeneous composition of agate, as well as high levels of nickel content in the chrysoprase variety. Aquaprase showed significant amounts (ppm by weight) of trace elements (Al, Mg, Na, K, Ca, Ti, U and Fe) characteristic of its formation environment, as well as high values of Cr, which are thought to be the cause of its bluish green colouration.
Extraction frequent patterns in trauma dataset based on automatic generation of minimum support and feature weighting
Authors: Kohzadi Zahra , Nickfarjam Ali Mohammad , Arani Leila Shokrizadeh , Kohzadi Zeinab , Mahdian Mehrdad 
Published: February 2024

Abstract
Purpose
Data mining has been used to help discover Frequent patterns in health data. it is widely used to diagnose and prevent various diseases and to obtain the causes and factors affecting diseases. Therefore, the aim of the present study is to discover frequent patterns in the data of the Kashan Trauma Registry based on a new method.

Methods
We utilized real data from the Kashan Trauma Registry. After pre-processing, frequent patterns and rules were extracted based on the classical Apriori algorithm and the new method. The new method based on the weight of variables and the harmonic mean was presented for the automatic calculation of minimum support with the Python.

Results
The results showed that the minimum support generation based on the weighting features is done dynamically and level by level, while in the classic Apriori algorithm considering that only one value is considered for the minimum support manually by the user. Also, the performance of the new method was better compared to the classical Apriori method based on the amount of memory consumption, execution time, the number of frequent patterns found and the generated rules.

Conclusions
This study found that manually determining the minimal support increases execution time and memory usage, which is not cost-effective, especially when the user does not know the dataset's content. In trauma registries and massive healthcare datasets, its ability to uncover common item groups and association rules provides valuable insights. Also, based on the patterns produced in the trauma data, the care of the elderly by their families, education to the general public about encountering patients who have an accident and how to transport them to the hospital, education to motorcyclists to observe safety points in Recommended when using a motorcycle.
Exploring the usability of the virtual reality module LEAF CAFÉ: a qualitative think-aloud study
Authors: Siette Joyce , Campbell Christopher , Adam Patrick J. , Harris Celia B. 
Published: February 2024

Abstract
Background
The global healthcare system faces increasing strain from our ageing population, primarily due to the growing prevalence of age-related health conditions such as dementia. While modern healthcare technology offers potential solutions, it frequently lacks user-friendliness for older adults. Virtual Reality (VR) has emerged as a promising tool for diagnosing cognitive impairment, offering innovative solutions where traditional methods may fall short. This study explores older adults’ perspectives on the usability of a newly designed VR module for cognitive assessment.

Methods
During a 100-min session, participants were asked to engage and complete recall and recognition tasks within the VR module (think-aloud approach) and provide feedback upon completion (semi-structured interviews). Audio materials were transcribed for analysis and recordings of the users’ interactions with the module were annotated to provide additional context. These combined textual data were analysed using content coding and thematic analysis to identify themes that reflect how participants used the module’s features and what features are desirable to support that process better.

Results
Participants (N = 10; Mean age = 73.3, SD = 7.53, range = 65–83 years) perceived the VR module as user-friendly and endorsed its potential as a cognitive screener due to its engaging and immersive nature. Older adults highlighted three key aspects of the module: the usefulness of the platform’s ability to offer a comprehensive and reliable evaluation of an individual’s cognitive abilities; the need to present concise and relevant content to optimise engagement and use; and the importance of overcoming barriers to support implementation. Suggested game improvements centred on food recognition and adjusting difficulty levels. Barriers to implementation included technology challenges for older adults and concerns about the game’s suitability for everyday scenarios. Participants stressed the need for reliable implementation strategies, proposing locations such as libraries and advocating for home-based screening.

Conclusion
Continued improvements in accessibility suggest that VR tools could help with diagnosing cognitive impairment in older adults. Using a simulated environment to assess cognitive status might fill the gap between current diagnostic methods, aiding treatment planning and early intervention. However, these findings should be approached cautiously, as more research is needed to fully grasp the potential impact of VR tools in this context.
Extended use of point-of-care technology versus usual care for in-home assessment by acute community nurses in older adults with signs of potential acute respiratory disease: an open-label randomised controlled trial protocol
Authors: Smedemark Siri Aas , Laursen Christian B. , Jarbøl Dorte Ejg , Rosenvinge Flemming S. , Andersen-Ranberg Karen 
Published: February 2024

Abstract
Background
Due to ageing-related physiological changes, diagnosing older adults is challenging. Delayed disease recognition may lead to adverse health outcomes and increased hospitalisation, necessitating the development of new initiatives for timely diagnosis and treatment of older adults. Point-of-care technology, such as focused lung ultrasound scan and bedside analysis of blood samples (leucocytes with differential count, electrolytes, and creatinine) conducted in the patients’ home, may support clinical decision-making, and potentially reduce acute hospital admissions.
We present the protocol for a randomized controlled trial, which aims at assessing the effect of focused lung ultrasound scan and bedside blood analysis during in-home assessments among older adults with signs of potential acute respiratory disease on hospital admissions.

Method
We will use a parallel open-label, individually randomised controlled trial design in an acute community healthcare setting. The trial will initiate on October 2022 and is expected to end one year later. The study population will include older adults (65 + year), with at least one of the following inclusion criteria: Cough, dyspnoea, fever, fall, or rapid functional decline. Expected study sample will comprise 632 participants. Participants in the control group will receive usual care, while the intervention group will undergo extended point-of-care technology (focused lung ultrasound scan and bedside venous blood analysis), in addition to usual care.
The primary outcome is acute hospital admission within 30 days follow-up. Secondary outcomes include readmissions, mortality, length of hospital stay, hospital-free days, complications during hospital admission, treatment initiations or changes, functional level, re-referrals to the acute community healthcare service, and contacts to the primary care physician. A tertiary outcome is the diagnostic accuracy of Acute Community Nurses for conducting focused lung ultrasound compared with a specialist. Outcomes will be analysed as intention-to-treat.

Discussion
To our knowledge, this is the first randomised controlled trial examining the effect of extended use of point-of-care technology conducted in an in-home setting. We expect that the results may contribute to the development of new interventions aiming to improve timely diagnostics, treatment decisions, and reduce acute hospital admissions.

Trial Registration
www.clinicaltrials.org NCT05546073 (Date of registration: September 19th, 2022).
Optimising diagnosis and management of kidney disease: an implementation trial of a clinical decision support system future health today
Authors: Wallace Hannah , Wang Qiumian , Botha Tanita , Hunter Barbara , Lumsden Natalie , Nelson Craig 
Published: February 2024

Abstract
Background
Chronic kidney disease affects more than 10% of the world’s population and is a non-communicable disease of global concern and priority. There is a significant implementation gap between best practice guideline recommendations and current kidney disease management. Previous research has shown the need to partner with primary care to improve education, collaboration, and kidney disease awareness. This implementation trial will explore use of an innovative clinical decision support software, Future Health Today, to improve screening, diagnosis, and management of kidney disease in primary care. The program will be supported by tertiary care outreach services. The primary aim is to test the hypothesis that the Future Health Today implementation program will improve screening, diagnosis, and management of kidney disease. Secondary aims are to evaluate primary care satisfaction and broader health service impacts.

Methods
This pre-post implementation trial using an interrupted time series design will evaluate the clinical and service outcomes of Future Health Today, using a mixed methods study in twenty general practices with an estimated population size of 150,000. Deidentified patient data will be extracted from participating practices to examine the primary aims of the study. Surveys and semi-structured interviews with general practice will inform secondary hypotheses. Data linkage between primary care and tertiary care data will examine the broader health service impacts.

Discussion
This investigator driven trial will assess the impact of Future Health Today software coupled with education and clinical outreach support. Investigators hypothesise that there will be improvement in appropriate screening, diagnosis, and management of kidney disease. This program has the potential to be scaled more broadly.

Trial Registration
Australian New Zealand Clinical Trial Registry: ACTRN12623001096640.
Action recommendations review in community-based therapy and depression and anxiety outcomes: a machine learning approach
Authors: Spinrad Amit , Taylor C. Barr , Ruzek Josef I. , Jefroykin Samuel , Friedlander Tamar , Feleke Israela , Lev-Ari Hila , Szapiro Natalia , Sadeh-Sharvit Shiri 
Published: February 2024

Abstract
Background
While the positive impact of homework completion on symptom alleviation is well-established, the pivotal role of therapists in reviewing these assignments has been under-investigated. This study examined therapists' practice of assigning and reviewing action recommendations in therapy sessions, and how it correlates with patients’ depression and anxiety outcomes.

Methods
We analyzed 2,444 therapy sessions from community-based behavioral health programs. Machine learning models and natural language processing techniques were deployed to discern action recommendations and their subsequent reviews. The extent of the review was quantified by measuring the proportion of session dialogues reviewing action recommendations, a metric we refer to as “review percentage”. Using Generalized Estimating Equations modeling, we evaluated the correlation between this metric and changes in clients' depression and anxiety scores.

Results
Our models achieved 76% precision in capturing action recommendations and 71.1% in reviewing them. Using these models, we found that therapists typically provided clients with one to eight action recommendations per session to engage in outside therapy. However, only half of the sessions included a review of previously assigned action recommendations. We identified a significant interaction between the initial depression score and the review percentage (p = 0.045). When adjusting for this relationship, the review percentage was positively and significantly associated with a reduction in depression score (p = 0.032). This suggests that more frequent review of action recommendations in therapy relates to greater improvement in depression symptoms. Further analyses highlighted this association for mild depression (p = 0.024), but not for anxiety or moderate to severe depression.

Conclusions
An observed positive association exists between therapists’ review of previous sessions’ action recommendations and improved treatment outcomes among clients with mild depression, highlighting the possible advantages of consistently revisiting therapeutic homework in real-world therapy settings. Results underscore the importance of developing effective strategies to help therapists maintain continuity between therapy sessions, potentially enhancing the impact of therapy.