bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tafamidis improves myocardial longitudinal strain in A97S transthyretin cardiac amyloidosis
Authors: Wu Yuan-Kun (Aden) , Yu An-Li , Cheng Mei-Fang , Lin Lung-Chun , Lee Ming-Jen , Chou Chia-Hung , Shun Chia-Tung , Hsueh Hsueh-Wen , Juang Jimmy Jyh-Ming , Tseng Ping-Huei , Lin Siao-Ping , Su Mao-Yuan , Chao Chi-Chao , Hsieh Sung-Tsang , Tsai Cheng-Hsuan , Lin Yen-Hung 
Published: January 2024

Background: Transthyretin cardiomyopathy (ATTR-CM) is a debilitating disease that has received much attention since the emergence of novel treatments. The Transthyretin Cardiomyopathy Clinical Trial showed that tafamidis, a transthyretin tetramer stabilizer, effectively reduced the declines in functional capacity and quality of life. However, Ala97Ser (A97S) hereditary ATTR-CM is underrepresented in major ATTR-CM tafamidis trials. Objectives: We aim to investigate the change in global longitudinal strain (GLS) of A97S ATTR-CM patients after 12 months of tafamidis treatment. Methods: We retrospectively analysed a prospective cohort of patients with A97S ATTR-CM who received tafamidis meglumine (61 mg/day) at the National Taiwan University Hospital. Echocardiography with speckle tracking strain analysis was performed at baseline and 12 months after treatment. Results: In all, 20 patients were included in the cohort. The baseline left ventricular ejection fraction (LVEF) and interventricular septum (IVS) thickness were 59.20 ± 13.23% and 15.10 ± 3.43 mm, respectively. After 12 months of tafamidis treatment, the LVEF and IVS were 61.83 ± 15.60% ( p = 0.244) and 14.59 ± 3.03 mm ( p = 0.623), respectively. GLS significantly improved from −12.70 ± 3.31% to −13.72 ± 3.17% ( p = 0.048), and longitudinal strain (LS) in apical and middle segments significantly improved from −16.05 ± 4.82% to −17.95 ± 3.48% ( p = 0.039) and −11.89 ± 4.38% to −13.58 ± 3.12% ( p = 0.039), respectively. Subgroup analysis showed that patients with LVEF < 50% had a better treatment response and improvement in GLS. The patients with an IVS ⩾ 13 mm had an improvement in two-chamber LS from −10.92 ± 4.25% to −13.15 ± 3.87% ( p = 0.042) and an improvement in apical left ventricular LS from −15.30 ± 5.35% to −17.82 ± 3.99% ( p = 0.031). Conclusion: Tafamidis significantly improved GLS, and particularly apical and middle LS in A97S ATTR-CM patients.
Digital therapeutics-based lumbar core exercise for patients with low back pain: A prospective exploratory pilot study
Authors: Son Seong , Yoo Byung Rhae , Jeong Yu Mi 
Published: January 2024

Objective This study aimed to implement a digital therapeutics-based approach based on motion detection technology and analyze the clinical results for patients with chronic low back pain (LBP). Methods A prospective, single-arm clinical trial was conducted with 22 patients who performed mobile app-based sitting core twist exercise for 12 weeks. Clinical outcomes were assessed using the visual analog scale (VAS) for LBP, Oswestry Disability Index-Korean version (K-ODI), and EuroQol-5 dimension 5-level version (EQ-5D-5L) every 4 weeks after the initiation of treatment. Laboratory tests for factors associated with muscle metabolism, plain X-ray for evaluating sagittal balance, and magnetic resonance imaging for calculating cross-sectional area (CSA) of back muscles were performed at pretreatment and 12 weeks post-treatment. Results The study population included 20 female patients with an average age of 45.77 ± 15.45 years. The clinical outcomes gradually improved throughout the study period in the VAS for LBP (from 6.05 ± 2.27 to 2.86 ± 1.86), K-ODI (from 16.18 ± 6.19 to 8.64 ± 5.58), and EQ-5D-5L (from 11.09 ± 3.24 to 7.23 ± 3.89) ( p < 0.001, respectively). The laboratory test results did not show significant changes. Pelvic incidence (from 53.99 ± 9.70° to 50.80 ± 9.20°, p = 0.002) and the mismatch between pelvic incidence and lumbar lordosis (from 8.97± .67° to 5.28 ± 8.57°, p = 0.027) decreased significantly. Additionally, CSA of erector spinae and total back muscles increased by 5.20% ( p < 0.001) and 3.08% ( p = 0.013), respectively. Conclusions The results of this study suggest that the efficacy of digital therapy-based lumbar core exercise for LBP is favorable. However, further large-scale randomized controlled studies are necessary.
Providing compassionate care in a virtual context: Qualitative exploration of Canadian primary care nurses’ experiences
Authors: Rouleau Geneviève , Wu Kelly , Parry Monica , Richard Lauralie , Desveaux Laura 
Published: January 2024

ObjectiveVirtual care presents a promising opportunity to create new communication channels and increase access to healthcare. However, concerns have been raised around the potential for unintended emotional distances created through virtual care environments that could strain patient–provider relationships. While compassionate care is an enabler of emotional connectivity and a core tenant of nursing, little is known about whether or how nurses have adapted their compassion skills into virtual interactions. These concerns are particularly relevant in primary care, where there is a focus on relational continuity (i.e. relationship-based, longitudinal care) and a broad uptake of virtual care. The aim of this study was to explore the meaning of compassionate virtual care and to uncover how nurses operationalized compassionate care through virtual interactions in primary care.MethodsWe used a qualitative interpretive descriptive lens to conduct semistructured interviews with primary care nurses (Ontario, Canada) who had provided virtual care (i.e. video visits, remote patient monitoring, or asynchronous messaging). We used a thematic approach to analyze the data.ResultsWe interviewed 18 nurse practitioners and two registered nurses. Participants described how: (1) compassionate care was central to nursing practice, (2) compassionate care was evolving through virtual nurse–patient interaction, and (3) nurses balanced practice with patients’ expectations while providing virtual compassionate care.ConclusionsThere is an opportunity to better align nurses’ understanding and operationalization of compassionate care in virtual primary care contexts. Exploring how compassionate care is operationalized in primary care settings is a necessary first step to building compassionate competencies across the nursing profession to support the continued virtual evolution of health service delivery.
Sequential Depth Stimulation Within the Psoas Offers No Benefit for Localization of the Lumbar Plexus During Lateral Lumbar Fusion Surgery
Authors: Barkay Gal , Oshtori Rayshad , Reto Javier , Gan Wenqi , Moss Isaac 
Published: January 2024

Study Design Prospective cohort study. Objectives In this study we aim to assess the difference in triggered EMG readings throughout different depths in the psoas muscle during the lateral approach to the lumbar spine and their effect on surgeon decision making. Methods Three surgeons, practicing at different institutions, assessed triggered EMG readings during the trans psoas approach at the level of the disc and 5,10 and 15 millimeters into the psoas muscle with sequential dilators. Measurement of distance into the psoas muscle was done with a specially designed instrument. Results of anterior and posterior directed stimulation as well as the delta value between these were recorded and underwent statistical analysis. Patients who had partial readings were excluded from the study. Results A total of 40 levels in 35 patients were included in the study. There was no significant difference found between means of anterior or posterior threshold readings along the different distance groups. A significant difference was found ( P = .024) in the mean difference between the distance groups with a decrease in the difference between anterior and posterior threshold values found as the distance from the disc space increased. None of the surgeons reported a decision to abort the fusion of a spinal level. Conclusions In the trans-psoas approach to the lumbar spine, the assessment of the location of the femoral nerve using directional neuromonitoring when advancing in the psoas muscle shows no clear benefit as opposed to stimulating solely when adjacent to the disc space.
Association of the Coronal Lateral Collateral Ligament Sign in ACL-Deficient Knees With Greater Anterior Tibial Translation and Femorotibial Rotation in Adults and Adolescents
Authors: Lin Yu-Ju , Cheng Ting-An , Hsu Kai-Lan , Kuan Fa-Chuan , Su Wei-Ren , Hong Chih-Kai 
Published: January 2024

Background: The coronal lateral collateral ligament (LCL) sign (the entire LCL being seen in 1 coronal slice on a magnetic resonance imaging [MRI] scan), is a new secondary sign of anterior cruciate ligament (ACL) tear. Purpose: To (1) evaluate the coronal LCL sign in adults with ACL tears and (2) compare the magnitude of the MRI scan parameters between adolescent and adult ACL-deficient knees with positive coronal LCL signs. Study Design: Cross-sectional study; Level of evidence: 3. Methods: We retrospectively reviewed patients who underwent ACL reconstruction between February 1, 2013, and May 31, 2021, and divided them into adolescent (10-18 years) and adult (>18 years) groups. Tibial translation, femorotibial rotation, and presence of the coronal LCL sign were evaluated using MRI. The static femorotibial position parameters were also compared between positive and negative coronal LCL sign groups. Independent Student t tests were used to identify statistically significant differences for continuous variables, whereas the categorical variables were compared using the chi-square test. Results: A total of 65 adolescents and 300 adults with ACL tears were identified. The coronal LCL sign was present in a similar percentage of adolescents and adults with ACL tears (57% vs 58%; P = .873). The anterior tibial translation (ATT) in patients with positive coronal LCL signs (adolescents, 7.9 ± 3.4 mm; adults, 6.6 ± 3.5 mm) was significantly greater compared with those with negative signs (adolescents, 1.5 ± 2.6 mm, P < .001; adults, 2.3 ± 4.2 mm, P < .001). Femorotibial rotation was also statistically greater in positive coronal LCL sign groups (adolescents, 6.4°± 5.6°; adults, 7.0°± 5.0°) compared with negative sign groups (adolescents, 0.7°± 4.7°, P < .001; adults, 3.5°± 4.2°, P < .001). Conclusion: The occurrence of the coronal LCL sign on MRI scans was comparable between adolescents and adults with ACL-deficient knees. The presence of the LCL sign was associated with a greater ATT and femorotibial rotation in both adolescents and adults with ACL tears.
Preoperative Patient Education: Perceptions and Actual Practice among Nurses Working in Surgical Units
Authors: Almutary Hayfa , Almashi Ashwaq 
Published: January 2024

Introduction Preoperative education is an essential nursing task that can be affected by the nurses’ perception. Patients may be receiving insufficient vital information before surgery. However, the essential information that should be provided to patients undergoing surgery is not fully addressed. Objective To assess the essential elements of preoperative information as perceived by the surgical nurses. Methods This was a cross-sectional study. A convenience sample of 224 registered nurses who were working at surgical units was recruited from two hospitals. A preoperative teaching questionnaire was used. Results Details about the operation (4.39 ± 0.61) and preoperative preparation (4.36 ± 0.61) were the most important domains of preoperative education as perceived by nurses. The results show significant differences between the perceived and actual preoperative educational practice across all domains except the preoperative preparation. Conclusions The delivery of preoperative education could be affected by nurses’ perceptions. Efforts to facilitate the implementation of effective education as perceived by nurses should be conducted by minimizing potential barriers.
Opioid Overdose Recognition: A Survey of Perceived Preparedness and Desire for Curricular Integration Among Current US Medical Students
Authors: Walsh Lindsay , Chapman Brittany , Carey Jennifer , Loycano Kayla , Carreiro Stephanie 
Published: January 2024

OBJECTIVES Opioid overdose deaths remain a major health issue in the United States (US). As future physicians, medical students must receive comprehensive training to recognize and manage opioid overdoses. This study aimed to highlight training gaps at the medical student level and understand students’ attitudes toward patients with opioid use disorder (OUD). METHODS We assessed baseline knowledge of and attitudes toward the management of opioid overdoses and naloxone administration among medical students in the US. Two validated survey tools (Opioid Overdose Knowledge Scale and Opioid Overdose Attitude Scale) were administered to medical students training at accredited institutions along with supplemental questions measuring knowledge and attitudes towards opioid overdose management, naloxone administration, and prior training. RESULTS The final sample had N = 73 participants from US medical schools with a mean age of 25.3 (range of 22–37): 72.6% of respondents were female. Although most respondents reported personal/professional experience with OUD before medical school, they expressed interest in additional training. Knowledge surrounding opioid overdoses increased insignificantly over the 4 years of medical school. However, there was a significant increase in both perceived competence in overdose recognition/management and in concerns about intervening from the first to fourth year of medical school. Female respondents had significantly lower perceived competence and readiness to intervene sub-scores than male counterparts; however, there was no significant difference in overall attitude and knowledge scores when stratified by sex. Incorporating opioid overdose prevention training (OOPT) into early medical education was favorable among respondents, who expressed an overwhelming interest in learning and supporting patients with OUD. CONCLUSIONS Given the ongoing opioid crisis, medical students are ideally placed to identify and manage opioid overdoses. Medical students are ready to receive this training, thus strengthening the argument for OOPT integration into early medical student curricula.
Early tirofiban administration after intravenous thrombolysis in acute ischemic stroke (ADVENT): Study protocol of a multicenter, randomized, double-blind, placebo-controlled clinical trial
Authors: Guo Zhen-Ni , Zhang Ke-Jia , Zhang Peng , Qu Yang , Abuduxukuer Reziya , Nguyen Thanh N , Chen Hui-Sheng , Yang Yi 
Published: January 2024

Background: Nearly half of patients with acute ischemic stroke who undergo intravenous thrombolysis (IVT) fail to achieve excellent functional outcomes. Early administration of tirofiban after IVT may improve patient outcomes. Objective: To evaluate the efficacy and safety of early tirofiban administration after intravenous tenecteplase in patients with acute ischemic stroke. Methods and design: The ADVENT trial is a multicenter, randomized, parallel-controlled, double-blind clinical trial. A total of 1084 patients undergoing IVT without subsequent endovascular treatment will be recruited from multiple hospitals in China. Subjects will be randomized in a 1:1 ratio to receive tirofiban or placebo, which will be infused within 6 h after IVT until 24 h after IVT, at 0.4 μg/kg/min for 30 min and then at 0.1 μg/kg/min. The primary efficacy outcome is the proportion of patients with excellent functional outcomes (modified Rankin Scale (mRS) ⩽ 1) at 90 days. Secondary outcomes include the proportion of patients with favorable functional outcomes (mRS ⩽ 2) at 90 days and neurological functional assessments evaluated during hospitalization. Symptomatic intracranial hemorrhage will be the primary safety outcome. Mortality and other adverse events will be recorded. Discussion: This pivotal trial will provide important data on the early administration of antiplatelet therapy after IVT and may promote progress in treatment standards. Trial registry: ClinicalTrials.gov (NCT06045156)
Global Uncertainty, Climate Change and the Unemployment-Economic Growth Relationship in Nigeria
Authors: Edeme Richardson Kojo , Emeka Ekene ThankGod , Ogbuabor Jonathan Emenike 
Published: January 2024

This study investigates global uncertainty, climate change and the unemployment-economic growth relationship in Nigeria. The study utilised the autoregressive distributed lag (ARDL) estimation technique using quarterly data, 1990–2020. Findings indicate that global uncertainty and unemployment impact negatively economic growth both in the short run and long run. Also, climatic change variables employed in this study such as temperature and level of rainfall have a negative impact on economic growth both in the long-run and short-run. The moderating effects of global uncertainty and climatic variables on the unemployment-economic growth relationship were positive, though insignificant. The policy implication underlying the finding is that tackling economic uncertainty and climate change is necessary for solving unemployment problem and the attainment of sustainable growth in Nigeria. JEL Codes: C22, D80, Q25, E24, O40
Scoping Review of Healthcare Disparities in Treatment of Craniosynostosis: Assessing Impacts of Race, Insurance, and Socioeconomic Status
Authors: Amin Sharmi C. , Tursak Hailey R. , Ulma Raquel M. , Vercler Christian J. 
Published: January 2024

Background: Racial and socioeconomic factors persist as barriers to timely diagnosis and treatment for children with craniosynostosis, contributing to inequitable care. This scoping review aims to better understand how disparities influence differences in services, approach, and outcomes for patients undergoing surgical corrections for craniosynostosis. Methods: We conducted a PRISMA systematic review of all articles published between 2003 and 2023 within PubMed/Medline, Embase, and a Scopus cited review. Variables of interest included sociodemographic factors such as race, socioeconomic status (SES), and insurance status, and measurements of treatment access or outcomes within craniosynostosis surgical repair. Results: The final analysis included 28 studies, of which 21 studies examined race, 13 examined insurance status, and 5 examined household income or other socioeconomic factors. Overall, non-White, minority patients, patients with Medicaid or government-funded insurance, and patients from lower SES were more likely to experience delays in diagnosis and presentation for surgery compared to White and privately-insured patients. Black and Hispanic patients and patients with public insurance were more likely to undergo open cranial vault reconstruction (CVR) at an older age and experience longer total surgery time, increasing perioperative complication risk, compared to patients who underwent endoscopic procedures. Sociodemographic factors including non-White race, lower SES, and being underinsured or uninsured predisposed patients to the more expensive CVR procedure, increased hospital length of stay (LOS), and a higher rate of readmission, accumulating to greater total cost of care. Conclusion: Significant disparities continue to exist in craniosynostosis management. It is still unknown whether these discrepancies in the type of operation lead to significant clinical differences in neurocognitive outcomes, revision operations, or patient/parent satisfaction with appearance. This study highlights gaps in the current body of knowledge to better inform future aeas of investigation to ensure the best outcomes for all children born with craniosynostosis regardless of patient demographic.
Sfrp1 inhibits lung fibroblast invasion during transition to injury-induced myofibroblasts
Authors: Mayr Christoph H. , Sengupta Arunima , Asgharpour Sara , Ansari Meshal , Pestoni Jeanine C. , Ogar Paulina , Angelidis Ilias , Liontos Andreas , Rodriguez-Castillo José Alberto , Lang Niklas J. , Strunz Maximilian , Porras-Gonzalez Diana , Gerckens Michael , De Sadeleer Laurens J. , Oehrle Bettina , Viteri-Alvarez Valeria , Fernandez Isis E. , Tallquist Michelle , Irmler Martin , Beckers Johannes , Eickelberg Oliver , Stoleriu Gabriel Mircea , Behr Jürgen , Kneidinger Nikolaus , Wuyts Wim A. , Wasnick Roxana Maria , Yildirim Ali Önder , Ahlbrecht Katrin , Morty Rory E. , Samakovlis Christos , Theis Fabian J. , Burgstaller Gerald , Schiller Herbert B. 
Published: January 2024

BackgroundFibroblast-to-myofibroblast conversion is a major driver of tissue remodelling in organ fibrosis. Distinct lineages of fibroblasts support homeostatic tissue niche functions, yet their specific activation states and phenotypic trajectories during injury and repair have remained unclear.MethodsWe combined spatial transcriptomics, multiplexed immunostainings, longitudinal single-cell RNA-sequencing and genetic lineage tracing to study fibroblast fates during mouse lung regeneration. Our findings were validated in idiopathic pulmonary fibrosis patient tissuesin situas well as in cell differentiation and invasion assays using patient lung fibroblasts. Cell differentiation and invasion assays established a function of SFRP1 in regulating human lung fibroblast invasion in response to transforming growth factor (TGF)β1.Measurements and main resultsWe discovered a transitional fibroblast state characterised by highSfrp1expression, derived from bothTcf21-Cre lineage positive and negative cells.Sfrp1+cells appeared early after injury in peribronchiolar, adventitial and alveolar locations and preceded the emergence of myofibroblasts. We identified lineage-specific paracrine signals and inferred converging transcriptional trajectories towardsSfrp1+transitional fibroblasts andCthrc1+myofibroblasts. TGFβ1 downregulated SFRP1 in noninvasive transitional cells and induced their switch to an invasive CTHRC1+myofibroblast identity. Finally, using loss-of-function studies we showed that SFRP1 modulates TGFβ1-induced fibroblast invasion and RHOA pathway activity.ConclusionsOur study reveals the convergence of spatially and transcriptionally distinct fibroblast lineages into transcriptionally uniform myofibroblasts and identifies SFRP1 as a modulator of TGFβ1-driven fibroblast phenotypes in fibrogenesis. These findings are relevant in the context of therapeutic interventions that aim at limiting or reversing fibroblast foci formation.