bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with radiographic progression in rheumatoid arthritis starting biological diseases modifying anti-rheumatic drugs (bDMARDs)
Authors: Adami Giovanni , Fassio Angelo , Pistillo Francesca , Benini Camilla , Viapiana Ombretta , Rossini Maurizio , Gatti Davide 
Published: September 2023

Background: Biological DMARDs (bDMARDs) have been proven to prevent joint damage and bone erosions. Nevertheless, approximately 15% of rheumatoid arthritis (RA) patients on bDMARDs will progress despite good control of joint inflammation. Objectives: The objective of our study is to investigate the factors associated with radiological progression of patients treated with bDMARDs. Design: We conducted a retrospective analysis of longitudinally collected data on RA patients starting bDMARDs. Methods: Presence or development of new erosions was assessed by a skilled rheumatologist at the time of the visit (baseline and 12 months thereafter). To determine the predictors of erosions, we employed multivariable logistic regression models. Discriminatory capacity for the prediction of new erosion development was assessed with receiver operating characteristic (ROC) curve, which was based on the logistic regression model. Results: A total of 578 RA patients starting bDMARDs were included in the study. Overall, 46 patients (approximately 10%) had radiographic progression (at least one new erosion) at 12 months of follow-up. The factors independently associated with higher risk of developing new erosions while on bDMARD were younger age, high disease activity at baseline, not being treated with cDMARDs, and presenting with erosions at baseline. In addition, we built a predictive model that can accurately foresee new erosions (AUC 0.846) in patients receiving bDMARDs Conclusion: We found that baseline erosive disease, higher disease activity during treatment, younger age, and monotherapy were the factors independently associated with the development of bone erosions. Our study may inform future targeted intervention in RA patients at risk of radiographic progression.
The Quality of Discharge Summaries After Acute Kidney Injury
Authors: Giles Cameron , Novakovic Milica , Hopman Wilma , Barreto Erin F. , Beaubien-Souligny William , Birks Peter , Neyra Javier A. , Wald Ron , Silver Samuel A. 
Published: September 2023

Background: Acute kidney injury (AKI) increases the risk of hospital readmission, chronic kidney disease, and death. Therefore, effective communication in discharge summaries is essential for safe transitions of care. Objective: The objectives of this study were to determine the quality of discharge summaries in AKI survivors and identify predictors of higher quality discharge summaries. Design: Retrospective chart review. Setting: Tertiary care academic center in Ontario, Canada. Patients: We examined the discharge summary quality of 300 randomly selected adult patients who survived a hospitalization with AKI at our tertiary care hospital, stratified by AKI severity. We included 150 patients each from 2015 to 2016 and 2018 to 2019, before and after introduction of a post-AKI clinic in 2017. Measurements: We reviewed charts for 9 elements of AKI care to create a composite score summarizing discharge summary quality. Methods: We used multivariable logistic regression to identify predictors of discharge summary quality. Results: The median discharge summary composite score was 4/9 (interquartile range, 2-6). The least frequently mentioned elements were baseline creatinine (n = 55, 18%), AKI-specific follow-up labs (n = 66, 22%), and medication recommendations (n = 80, 27%). The odds of having a higher quality discharge summary (composite score ≥4/9) was greater for every increase in baseline creatinine of 25 μmol/L (adjusted odds ratio [aOR]: 1.27; 95% confidence interval [CI]: 1.03, 1.56), intrarenal etiology (aOR: 2.32; 95% CI: 1.26, 4.27), and increased AKI severity (stage 2 aOR: 2.57; 95% CI: 1.35, 4.91 and stage 3 aOR: 3.36; 95% CI: 1.56, 7.22). There was no association between discharge summary quality and the years before and after introduction of a post-AKI clinic (aOR: 0.77; 95% CI: 0.46, 1.29). Limitations: The single-center study design limits generalizability. Conclusions: Most discharge summaries are missing key AKI elements, even in patients with severe AKI. These gaps suggest several opportunities exist to improve discharge summary communication following AKI.
Adherence to e-health interventions for substance use and the factors influencing it: Systematic Review, meta-analysis, and meta-regression
Authors: Shams Farhud , Tai Andy M.Y. , Kim Jane , Boyd Marisha , Meyer Maximilian , Kazemi Alireza , Krausz Reinhard Michael 
Published: September 2023

Background Substance use disorders affect 36 million people globally, but only a small proportion of them receive the necessary treatment. E-health interventions have been developed to address this issue by improving access to substance use treatment. However, concerns about participant engagement and adherence to these interventions remain. This review aimed to evaluate adherence to e-health interventions targeting substance use and identify hypothesized predictors of adherence. Methods A systematic review of literature published between 2009 and 2020 was conducted, and data on adherence measures and hypothesized predictors were extracted. Meta-analysis and meta-regression were used to analyze the data. The two adherence measures were (a) the mean proportion of modules completed across the intervention groups and (b) the proportion of participants that completed all modules. Four meta-regression models assessed each covariate including guidance, blended treatment, intervention duration and recruitment strategy. Results The overall pooled adherence rate was 0.60 (95%-CI: 0.52–0.67) for the mean proportion of modules completed across 30 intervention arms and 0.47 (95%-CI: 0.35–0.59) for the proportion of participants that completed all modules across 9 intervention arms. Guidance, blended treatment, and recruitment were significant predictors of adherence, while treatment duration was not. Conclusion The study suggests that more research is needed to identify predictors of adherence, in order to determine specific aspects that contribute to better exposure to intervention content. Reporting adherence and predictors in future studies can lead to improved meta-analyses and the development of more engaging interventions. Identifying predictors can aid in designing effective interventions for substance use disorders, with important implications for e-health interventions targeting substance use.
Exploring the impact of patient, physician and technology factors on patient video consultation satisfaction
Authors: Tenfelde Kim , Bol Nadine , Schoonman Guus G , Bunt Jan Erik H , Antheunis Marjolijn L 
Published: September 2023

Objective Video consultations (VCs) were made available to the general population during the COVID-19 pandemic to compensate for the cutback of face-to-face doctor–patient interactions. However, little is known about what patient-related (e.g. age), physician-related (e.g. patient–physician relationship) and technology-related (e.g. online privacy concerns) factors contribute to video consultation satisfaction among patients. This study aims to gain a better understanding of what makes patients satisfied with video consultations. Methods A total of 180 patients who recently engaged in a video consultation were invited to answer questions about patient-, physician- and technology-related variables and their satisfaction with the video consultation. To examine which factors predict patient video consultation satisfaction, a multiple hierarchical regression analysis was performed. Results Overall, patients were satisfied with their video consultation. The final hierarchical model, including all patient-related, physician-related and technology-related factors, significantly contributed to patient video consultation satisfaction. Predictors of higher patient video consultation satisfaction were experiencing less technical issues, having higher general positive attitudes towards online communication, reporting higher importance of less travel time and being more satisfied with physicians’ affective and instrumental communication. Conclusions Video consultations can be appropriate in a variety of situations, provided that technical issues can be minimized, patients have a positive attitude towards online communication and attach value to reduced travel time and online patient–physician interactions can be experienced as affective and instrumental. Findings from this study contribute to understanding how video consultations can be best utilized for effective patient–physician communication.
Feasibility study of using mobile application to support triage and diagnosis clinical decisions for pediatricians: User-centered design approach
Authors: Choosri Noppon , Kungsuwan Supakanya 
Published: September 2023

Background While there is some evidence in the literature demonstrating success in using a triage software application in ED, none of the solution was developed specifically to support a holistic decision of pediatricians in triage and diagnosis purposes to initiate the first treatment properly. To explore the usefulness and possibility of employing a digital-based solution to enhance clinician performance, the mobile application was developed and then assessed in different perspectives. Objective The primary objective of this study is to contribute implementation practice of an application to support pediatric triage and diagnoses. The secondary objective is to present the results of the preliminary evaluation of the application. Methods The application called Pedicmeter was developed. Formative tests with revisions were applied throughout the development phase. A number of summative extensive evaluations were also conducted to investigate the efficacy of the proposed method. The evaluation focused on measuring the ability of an application to support a pediatric staff’s decision to determine an overall severity level and disease diagnosis. Finally, the user’s (clinician's) satisfaction of using the application was measured. Results The application Pedicmeter enables clinicians to make more accurate decisions in determining emergency level of pediatric patients by 6.66%. The application accurately diagnosed a disease with 73.08% accuracy and 66.67% accuracy for respiratory and infectious diseases, respectively. The diagnostic information that the application suggested shows that it does have an influence on a clinician’s diagnosis. Using the app showed improvements in diagnostic accuracy for asthma, croup, sepsis, but it showed a decrease in the accuracy of a clinician's decision for pneumonia. The benefit of the application that satisfies the pediatricians the most is the helpfulness of the features of the application (86%), while the least satisfying factor was the required number of inputs (63%). Conclusion The developed application conceptually shows a promising opportunity to enhance clinicians’ decisions from the pilot study. However, the study also reveals further tweaks are required and unveils challenging issues and the concerns of clinician users when use the application. Further research will be conducted to investigate and determine the limiting factors and specific issues revealed by this study. Longitudinal data collection and analysis also need to be conducted to investigate the clinical implications.
Allogenous Bone Grafting Technique for Staged Revision Anterior Cruciate Ligament Surgery
Authors: Vindfeld Søren , Lindanger Line , Inderhaug Eivind 
Published: September 2023

Background: Tunnel widening, slightly malplaced former tunnels or bone loss due to hardware removal might prevent a 1-stage anterior cruciate ligament (ACL) revision procedure due to tunnel convergence or challenging graft fixation. A range of graft sources and bone grafting techniques are described—all with their strengths and limitations. Common autograft techniques come with substantial donor site morbidity that might hinder postoperative rehabilitation. Indications: Graft tunnel issues might prompt the need for structural grafts and a 2-stage ACL revision approach. The use of the current dowel allograft technique gives a flexible approach where 1 or several cylindrical grafts can be placed in prepared sockets for reliable bony ingrowth. Technique Description: Using femoral head allografts and cannulated coring reamers, multiple bone dowels (up to 6) can give a flexible and adaptable bone grafting situation. The intra-articular tunnels are dilated, and dowels are produced to allow a press-fit fixation that facilitates good bone healing. Removal of sclerotic bone and microfracture is key to allow optimal bone-to-bone healing. Use of cannulas inserted through the arthroscopic portals and tamps plug advancement will give a reliable graft deployment without dowel breakage. Results: The current authors have used this uniform technique for 119 patients since 2014. All cases displayed good bony healing at 5 months after surgery on computed tomography and radiographs, and 115 out of 119 went on to have a stage 2 revision ACL surgery at 6 months spacing from the bone grafting. The most common reason for not going through the second-stage revision was improvement of symptoms due to graft removal and bone grafting during the first surgery. Discussion/Conclusion: The current allograft dowel bone grafting allows for a flexible bone grafting in cases where a 1-step ACL revision procedure is not feasible. Reliable bony ingrowth is seen in the current cohort allowing the final step of ACL revision at 6 months spacing from bone grafting. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Venous thromboembolism associated with severe dyspnoea and asthma in 102 792 adults
Authors: Nilausen Kristin Felicia , Landt Eskild Morten , Al-Shuweli Suzan , Nordestgaard Børge G. , Bødtger Uffe , Dahl Morten 
Published: September 2023

BackgroundThe most recent guideline on acute pulmonary embolism (PE) indicates possible long-term sequelae such as dyspnoea and chronic thromboembolic pulmonary hypertension after a PE event. However, effects on lung function or asthma risk have not been evaluated in the general population.MethodsWe tested whether individuals with a venous thromboembolism (VTE) encompassing PE and deep vein thrombosis (DVT) have reduced lung function, or greater risks of dyspnoea and asthma using data from 102 792 adults from the Copenhagen General Population Study. Diagnoses of PE, DVT and asthma were collected from the national Danish Patient Registry. Factor V Leiden and prothrombin G20210A gene variants were determined using TaqMan assays.ResultsPrevalences of PE, DVT and VTE were 2.2%, 3.6% and 5.2%, respectively. Individuals with VTE had forced expiratory volume in 1 s of 92% predicted compared with 96% pred in individuals without VTE (p<0.001). Individuals with VTEversusthose without had adjusted OR (95% CI) for light, moderate and severe dyspnoea of 1.4 (1.2–1.6), 1.6 (1.4–1.8) and 1.7 (1.5–1.9), respectively. Individuals with VTEversusthose without had an adjusted OR for asthma of 1.6 (95% CI 1.4–1.8). Factor V Leiden and prothrombin G20210A genotype also associated with increased risk of asthma (p for trend=0.002). Population-attributable fractions of severe dyspnoea and asthma due to VTE were 3.5% and 3.0%, respectively, in the population.ConclusionIndividuals with VTE have worse lung function and higher risks of severe dyspnoea and asthma, and may account for 3.5% and 3.0% of people with severe dyspnoea and asthma, respectively, in the general population.
Multidomain interventions for non-pharmacological enhancement (MINE) program in Chinese older adults with mild cognitive impairment: a multicenter randomized controlled trial protocol
Authors: Wu Xiaochu , Zhang Tianyao , Tu Yanhao , Deng Xueling , Sigen A , Li Yuxiao , Jing Xiaofan , Wei Lixuan , Huang Ning , Cheng Ying , Deng Linghui , Jia Shuli , Li Jun , Jiang Ning , Dong Birong 
Published: September 2023

Abstract
Background
Dementia is characterized by progressive neurodegeneration and therefore early intervention could have the best chance of preserving brain health. There are significant differences in health awareness, living customs, and daily behaviors among Chinese older adults compared to Europeans and Americans. Because the synergistic benefits of multidomain non-pharmacological interventions are consistent with the multifactorial pathogenicity of MCI, such interventions are more appealing, easier to adhere to, and more relevant to daily life than single-mode interventions. One of the aims of this study is to verify the effect of multidomain intervention strategies for MCI patients based on Chinese population characteristics, and the other is to establish a biobank and image database to investigate the pathogenesis and pathways of cognitive impairment.

Methods
Our study was designed as a national multicenter, community-based randomized controlled trial (RCT). Twelve medical institutions in ten Chinese cities will participate in our study from 2020 to 2024, and 1080 community residents aged 50 and above will be enrolled as participants. Each sub-center will be responsible for 90 participants (30 people per community) across three communities (non-contact control group, health education group, and multidomain intervention group). The community will be the basic unit of the present study, and all participants in each community will receive the same intervention/control measure. Three working groups are set up in each sub-center to manage the three communities independently to minimize interference at the implementation level between the groups. The multidomain intervention group will receive integrated interventions including exercise, nutrition, sleep, health education and mindfulness meditation. All data generated by the research will be analyzed and processed by statistical software (such as SPSS 21.0, Python 3.0, etc.), and part of the research data will be displayed in the form of graphs and tables.

Discussion
In order to achieve a high-quality community intervention study, it is crucial to have a well-designed experimental protocol that follows rigorous scientific methodology. In addition, effective management of quality control measures and monitoring compliance throughout the study process are essential components. This study provides a detailed discussion of stakeholder compliance, research quality control, potential harm and mitigation, auditing, and future plans in order to better address research issues.

Trial registration
: ChiCTR2000035012 (July 27, 2020).
Early prediction of response to palliative chemotherapy in patients with stage-IV gastric and esophageal cancer
Authors: Ma Xiaoyuan , Pierce Eric , Anand Harsh , Aviles Natalie , Kunk Paul , Alemazkoor Negin 
Published: September 2023

Abstract
Background
The goal of therapy for many patients with advanced stage malignancies, including those with metastatic gastric and esophageal cancers, is to extend overall survival while also maintaining quality of life. After weighing the risks and benefits of treatment with palliative chemotherapy (PC) with non-curative intent, many patients decide to pursue treatment. It is known that a subset of patients who are treated with PC experience significant side effects without clinically significant survival benefits from PC.

Methods
We use data from 150 patients with stage-IV gastric and esophageal cancers to train machine learning models that predict whether a patient with stage-IV gastric or esophageal cancers would benefit from PC, in terms of increased survival duration, at very early stages of the treatment.

Results
Our findings show that machine learning can predict with high accuracy whether a patient will benefit from PC at the time of diagnosis. More accurate predictions can be obtained after only two cycles of PC (i.e., about 4 weeks after diagnosis). The results from this study are promising with regard to potential improvements in quality of life for patients near the end of life and a potential overall survival benefit by optimizing systemic therapy earlier in the treatment course of patients.
Effect of changes in sleeping behavior on skeletal muscle and fat mass: a retrospective cohort study
Authors: Song Jihun , Park Sun Jae , Choi Seulggie , Han Minjung , Cho Yoosun , Oh Yun Hwan , Park Sang Min 
Published: September 2023

Abstract
Background
An association between sleep behaviors and muscle-fat mass is continuously interesting topic.

Methods
Based on the survey on sleep behaviors (quality and duration), the poor quality of sleep was evaluated when the subject did not feel satisfied after sleep, while the good quality was evaluated as they feel refreshed. A total of 19,770 participants were divided into the four groups according to changes in sleep quality: Good-to-Good (those who continuously maintained good quality), Good-to-Poor (those who reported initial good quality but subsequently reported a poor quality), Poor-to-Poor (those who continuously maintained poor quality), and Poor-to-Good (those who reported improved quality of sleep). As changes in skeletal muscle and fat mass index [kg/m2] were estimated by a validated prediction equation, multiple linear regression was used to calculate adjusted mean (adMean) of muscle and fat mass according to changes in sleep behavior.

Results
When sleep duration decreased and quality of sleep deteriorated (from good to poor), fat mass index significantly increased (adMean: 0.087 for the Good-to-Good group and 0.210 for the Good-to-Poor group; p-value = 0.006). On the other hand, as the quality of sleep deteriorated, skeletal muscle mass more decreased despite the maintained sleep duration (adMean: -0.024 for the Good-to-Good group and − 0.049 for the Good-to-Poor group; p-value = 0.009).

Conclusion
Our results showed that changes in sleep quality and duration affect changes in muscle and fat mass. Thus, we suggest maintaining a good quality of sleep, even if sleep duration is reduced, to preserve muscle mass and inhibit the accumulation of fat.