bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical study of modified INFIX combined with sacroiliac joint screws for pelvic instable injuries
Authors: Zhao Peishuai , Li Renjie , Liu Leyu , Wang Xiaopan , Chen Xiaotian , Guan Jianzhong , Wu Min 
Published: November 2023

Abstract
Objective
The INFIX technique is becoming one of the most commonly performed surgical procedures for anterior pelvic ring instability injuries. The purpose of this article is to compare the clinical outcomes of modified anterior subcutaneous internal fixation (M-INFIX) with conventional anterior subcutaneous internal fixation (C-INFIX) for anterior pelvic ring instability injuries.

Patients and methods
A retrospective analysis of 36 cases of unstable pelvic injuries treated operatively at our institution, 20 of which were treated with C-INFIX and 16 with M-INFIX. Data collected included age, gender, ISS score, fracture typing, operative time, operative bleeding, postoperative complications, fracture healing time, Matta score, Majeed score, and follow-up time. Statistical sub-folding of each variable between the two groups was performed.

Results
There was no statistical difference between the C-INFIX and M-INFIX groups in terms of age, gender, ISS (Injury Severity Score), follow-up time, fracture typing, fracture healing time, and Majeed score (P > 0.05). the M-INFIX had a significantly lower incidence of postoperative complications than the C-INFIX group, especially in the incidence of Lateral femoral cutaneous nerve (LFCN) injury (P < 0.05). In contrast, the M-INFIX group had statistically higher operative time, intraoperative bleeding, and Matta score than the C-INFIX group (P < 0.05).

Conclusion
This study was based on a modified application of the surgical experience with C-INFIX and showed better clinical outcomes in terms of complication rates and quality of repositioning than the conventional surgical approach. These findings indicate that further analytical studies of this study would be valuable.
Benign prostatic hyperplasia and metabolic syndrome; prevalence and association: a cross-sectional study in Syria
Authors: Daher Mohanad , Saqer Tareq , Jabr Mahmoud , Al-Mousa Samaher 
Published: November 2023

Abstract
Background
Benign Prostatic Hyperplasia (BPH) is considered the most common cause of lower urinary tract symptoms in men aged 40 years and older. BPH is related to sex steroids, but there are increasing studies investigating the relationship between the urinary symptoms and the metabolic syndrome. They still have inconsistent results; some reported a significant positive association, while others found no significant association. In this study, we aim to assess the prevalence rate of metabolic syndrome in BPH patients and whether there is an association between symptoms linked to BPH and metabolic syndrome in the Syrian community.

Methods
The participants of this observational cross-sectional study were benign prostatic hyperplasia patients aged 40-year-old and older from Homs, Syria. An interview questionnaire was performed to collect data from all patients who visited the urology clinic of Homs Military Hospital in the period of January 10 to March 10, 2023. We used the International Prostate Symptom Score (IPSS) to assess the urinary symptoms, and we used the US National Cholesterol Education Program Adult Treatment Panel (NCEP ATPIII) criteria to define the metabolic syndrome.

Results
The final sample size was 426 patients. The overall prevalence of metabolic syndrome was 46.2%. Patients with metabolic syndrome had higher International Prostate Symptom Score compared to patients without metabolic syndrome (21 vs. 18, P < 0.001), and 59.3% of patients with metabolic syndrome suffered from severe symptoms compared to 36.2% of patients without metabolic syndrome who suffered from severe lower urinary tract symptoms (P < 0.001). There was a positive association between (waist circumference, diabetes, triglycerides) (P < 0.001), HDL (P = 0.014) and higher International Prostate Symptom Score. However, there was no statistically significant association between blood pressure and International Prostate Symptom Score (P = 0.879).

Conclusion
Our results showed that patients with metabolic syndrome had a higher International Prostate Symptom Score. This idea should be used to design a new benign prostatic hyperplasia/lower urinary tract symptoms treatment.
Comparison of exenatide alone or combined with metformin versus metformin in the treatment of polycystic ovaries: a systematic review and meta-analysis
Authors: Hu Yan , Song Xiangxin , Hamiti Shaila , Ma Yanyong , Yusufu Mainu , Wang Xing , Zhang Kaidi , Guo Yanying 
Published: November 2023

Abstract
Background
Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility in women of childbearing age. Randomized controlled trials (RCTs) have reported that exenatide and metformin are effective in the treatment of PCOS. In this meta-analysis, we aimed to compare the effectiveness and safety of exenatide alone or in combination with metformin versus metformin in patients suffering from PCOS.

Methods
RCTs of exenatide therapy were identified through a search of electronic databases in November 2022 and updated in October 2023. Eligible studies were identified independently by the reviewers. Outcomes were analysed with Revman 5.4.

Results
Nine RCTs among 214 studies on 1059 women with PCOS were included in the analysis, and among the nine RCTs, eight studies compared exenatide with metformin. Our meta-analysis demonstrated that exenatide was more effective than metformin in terms of pregnancy rate (RR 1.85 [95% CI 1.19,2.86] P = 0.006), sex hormone-binding globulin (SHBG) (MD 5 [95% CI 3.82,6.18] P < 0.001), and follicle-stimulating hormone (FSH) (MD 0.82 [95% 0.41,1.24] P < 0.001). The reductions in total testosterone (TT) (SMD -0.43 [95% CI -0.84, -0.03] P = 0.04) was more significant after treatment with exenatide than after treatment with metformin. In terms of safety, exenatide had a lower diarrhea rate (RR 0.11 [95% CI 0.01, 0.84]) than metformin. In the other three studies, exenatide plus metformin was compared with metformin. Exenatide combined with metformin was more effective in improving SHBG (MD 10.38[95%CI 6.7,14.06] P < 0.001), Matsuda index (MD 0.21[95%CI 0.05,0.37]) and reducing free androgen index (FAI) (MD -3.34 [-4.84, -1.83] P < 0.001), Weight (MD -2.32 [95%CI -3.89, -0.66]) and WC (MD-5.61[95%CI -8.4, -2.82] P < 0.001). The incidence of side effects between exenatide plus metformin and metformin was not statistically significant.

Conclusions
Exenatide alone or in combination with metformin is more effective than metformin for women with PCOS. Considering the evidence on effectiveness and safety, exenatide alone or in combination with metformin may be a better treatment approach than metformin for women with PCOS.

Trial registration
INPLASY https://inplasy.com/inplasy-protocols/ ID: 10.37766/inplasy2022.11.0055.
Breast conserving surgery versus mastectomy: the effect of surgery on quality of life in breast cancer survivors in Malaysia
Authors: Dahlui Maznah , Azzani Meram , Taib Nur Aishah , Hoong See Mee , Jamaris Suniza , Islam Tania 
Published: November 2023

Abstract
Background
In the competitive health care environment, patient satisfaction and quality of life (QoL) have become the subject of interest to evaluate the efficacy of therapeutic interventions as we experience improved breast cancer survival in modern times. The knowledge of the long-term effects of surgery on the QoL in breast cancer patients is currently limited in the Asian setting. The purpose of this longitudinal study is to evaluate the QoL of early-stage breast cancer patients undergoing mastectomy and breast-conserving surgery (BCS).

Methods
In this prospective cohort study, the QoL of 208 patients who underwent mastectomy and the BCS treatment were assessed, using the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire. The questionnaire was administered at the baseline, 6 and 12 months following diagnosis. One-way ANCOVA was used for statistical analysis.

Results
A total of 208 female survivors of Stage 0–II breast cancer were included, among them 47.1% underwent BCS and 52.9% underwent mastectomy. Older (63.3%), Chinese women (63.6%), and patients with primary education (71.7%) were more likely to undergo mastectomy. At baseline, no significant differences were observed for QoL in both treatment groups. At 6 months, patients who underwent BCS had better social functioning scales( P = 0.006) and worse symptom scales for dyspnoea (P = 0.031), compared to mastectomy patients. One year after diagnosis, the role functioning score of the mastectomy group was significantly higher than the BCS group, specifically among patients who had undergone chemotherapy (P = 0.034).

Conclusion
Patients who underwent BCS had better social functioning and worse dyspnoea symptoms compared to patients undergoing mastectomy at six months. During one year, there were only significant improvements in the role functioning among the mastectomy groups compared to the BCS groups. After further stratification, only mastectomy patients who received chemotherapy exhibited improved role functioning compared to patients those who did not undergo chemotherapy. Providing social and physical support postoperatively and monitoring patients for cancer worry, or other symptoms in the long-term survivorship period would be important to ensure optimal QoL.
Self-perceived competence in managing obstetric emergencies among recently graduated physicians from Lima, Peru
Authors: Nieto-Gutierrez Wendy , Taype-Rondan Alvaro 
Published: November 2023

Abstract
Objective
This study aimed to examine the self-perception of competencies in obstetric emergencies among recently graduated physicians from universities in Lima, Peru; and to identify its associated factors.

Methods
An analytical study was conducted, with the study population comprising newly graduated doctors who attended the “VI SERUMS National Convention” in 2017. We used Poisson regressions to assess the factors associated with the self-perception of competencies in obstetric emergencies, calculating prevalence ratios (PR) and their 95% confidence intervals (95% CI).

Results
We analyzed a population of 463 newly graduated physicians (mean age: 25.9 years), of which 33.3% reported feeling competent in obstetric emergencies. In the adjusted analyses, we found that having a previous health career (PR: 1.77, 95% CI: 1.12—2.81), having completed the internship in EsSalud hospitals (PR: 1.48, 95% CI: 1.31—1.68), and completing a university externship (PR: 1.62, 95% CI: 1.34—1.96) were associated with a higher prevalence of self-perceived competence in obstetric emergencies.

Conclusion
Our findings suggest that certain academic factors, such as completing an externship and internship in specific hospital settings, may enhance the competencies or competence self-perception of recently graduated physicians in obstetric emergencies. Further studies are needed to confirm these results and identify other factors that may impact physicians’ competencies in this field.
Evaluation of an online modular eating disorders training (PreparED) to prepare healthcare trainees: a survey study
Authors: Glasofer Deborah R. , Lemly Diana C. , Lloyd Caitlin , Jablonski Monica , Schaefer Lauren M. , Wonderlich Stephen A. , Attia Evelyn 
Published: November 2023

Abstract
Background
Eating disorders (EDs) are serious, complex disorders for which broad-based clinical training is lacking. This study aimed to evaluate the efficacy of a free, brief, web-based curriculum, PreparED, in increasing comfort and confidence with, and knowledge about EDs in healthcare trainees, and to obtain program feedback from key stakeholders (i.e., learners).

Methods
This programmatic evaluation study was designed as a quantitative, repeated measures (i.e., pre- and post-test intervention) investigation. A convenience sample of two groups of healthcare trainees across geographically diverse training sites completed an anonymous survey pre- and post- engagement with PreparED. The survey included items to assess prior exposure to EDs, as well as program feasibility. The main educational outcomes included (1) Confidence and Comfort with EDs and (2) Knowledge of EDs. User experience variables of interest were likeability, usability, and engagement with the training modules. Mixed effects linear regression was used to assess the association between PreparED and educational outcome variables.

Results
Participants (N = 67) included 41 nutrition graduate students and 26 nurse practitioner students recruited from Teacher’s College/Columbia University in New York, NY, USA, Columbia University School of Nursing in New York, NY, USA and North Dakota State University School of Nursing in Fargo, ND, USA. Confidence/Comfort scores and Knowledge scores significantly improved following engagement with PreparED (β = for effect of intervention = 1.23, p < 0.001, and 1.69, p < 0.001, respectively). Neither training group nor prior exposure to EDs moderated the effect on outcomes. All learners agreed the program was easy to follow; the overwhelming majority (89.4%) felt the length of the modules was “just right.” All participants perceived that PreparED had increased their knowledge of EDs, and the majority (94.0%) reported greater confidence in and comfort with caring for people with these disorders, including assessment of symptoms, awareness of associated medical complications, and likelihood of future screening.

Conclusions
Findings suggest that brief, user-friendly, online courses can improve knowledge and attitudes about EDs, filling a critical gap in healthcare training.
Identifying the data elements and functionalities of clinical decision support systems to administer medication for neonates and pediatrics: a systematic literature review
Authors: Norouzi Somaye , Galavi Zahra , Ahmadian Leila 
Published: November 2023

Abstract
Background
Patient safety is a central healthcare policy worldwide. Adverse drug events (ADE) are among the main threats to patient safety. Children are at a higher risk of ADE in each stage of medication management process. ADE rate is high in the administration stage, as the final stage of preventing medication errors in pediatrics and neonates. The most effective way to reduce ADE rate is using medication administration clinical decision support systems (MACDSSs). The present study reviewed the literature on MACDSS for neonates and pediatrics. It identified and classified the data elements that mapped onto the Fast Healthcare Interoperability Resources (FHIR) standard and the functionalities of these systems to guide future research.

Methods
PubMed/ MEDLINE, Embase, CINAHL, and ProQuest databases were searched from 1995 to June 31, 2021. Studies that addressed developing or applying medication administration software for neonates and pediatrics were included. Two authors reviewed the titles, abstracts, and full texts. The quality of eligible studies was assessed based on the level of evidence. The extracted data elements were mapped onto the FHIR standard.

Results
In the initial search, 4,856 papers were identified. After removing duplicates, 3,761 titles, and abstracts were screened. Finally, 56 full-text papers remained for evaluation. The full-text review of papers led to the retention of 10 papers which met the eligibility criteria. In addition, two papers from the reference lists were included. A total number of 12 papers were included for analysis. Six papers were categorized as high-level evidence. Only three papers evaluated their systems in a real environment. A variety of data elements and functionalities could be observed. Overall, 84 unique data elements were extracted from the included papers. The analysis of reported functionalities showed that 18 functionalities were implemented in these systems.

Conclusion
Identifying the data elements and functionalities as a roadmap by developers can significantly improve MACDSS performance. Though many CDSSs have been developed for different medication processes in neonates and pediatrics, few have actually evaluated MACDSSs in reality. Therefore, further research is needed on the application and evaluation of MACDSSs in the real environment.

Protocol Registration
(dx.doi.org/10.17504/protocols.io.bwbwpape).
Interpreting and coding causal relationships for quality and safety using ICD-11
Authors: Januel Jean-Marie , Southern Danielle A. , Ghali William A. 
Published: November 2023

AbstractMany circumstances necessitate judgments regarding causation in health information systems, but these can be tricky in medicine and epidemiology. In this article, we reflect on what the ICD-11 Reference Guide provides on coding for causation and judging when relationships between clinical concepts are causal. Based on the use of different types of codes and the development of a new mechanism for coding potential causal relationships, the ICD-11 provides an in-depth transformation of coding expectations as compared to ICD-10. An essential part of the causal relationship interpretation relies on the presence of “connecting terms,” key elements in assessing the level of certainty regarding a potential relationship and how to proceed in coding a causal relationship using the new ICD-11 coding convention of postcoordination (i.e., clustering of codes). In addition, determining causation involves using documentation from healthcare providers, which is the foundation for coding health information. The coding guidelines and examples (taken from the quality and patient safety domain) presented in this article underline how new ICD-11 features and coding rules will enhance future health information systems and healthcare.
A Chinese telemedicine-dialogue dataset annotated for named entities
Authors: Wang Shanshan , Yan Yajing , Yan Rong , Li Ting , Ma Kaijie , Yan Yani 
Published: November 2023

Abstract
Background
A large collection of dialogues between patients and doctors must be annotated for medical named entities to build intelligence for telemedicine. However, since most patients involved in telemedicine deliver related named entities in informal and long multiword expressions, it is challenging to tag their telemedicine dialogue data. This study aims to address this issue.

Methods
With the telemedicine dialogue dataset for obstetrics and gynecology taken from haodf.com, we developed guidelines and followed a two-round procedure to tag six types of named entities, including disease, symptom, time, pharmaceutical, operation, and examination. Additionally, we developed four deep-learning models based on this dataset to establish a benchmark for named-entity recognition (NER).

Results
The distilled obstetrics and gynecology dataset contains 2,383 consultations between doctors and patients, of which 13,411 sentences were from doctors, and 17,929 were from patients. With 63,560 named entities in total, the average number of characters per named entity is 4.33. The experimental results suggest that LatticeLSTM performs best on our dataset in terms of accuracy, precision, recall, and F score.

Conclusion
Compared with other datasets, this dataset offers three novel facets. This study offers intricately tagged long multiword expressions for medical named entities. Second, this study is one of the first attempts to mark temporal entities in a medical dataset. Third, this annotated dataset is balanced across the six types of labels, which we believe will play a considerable role in expanding telemedicine artificial intelligence.
Mapping a comprehensive assessment tool to a holistic definition of health for person-centred care planning in home care: a modified eDelphi study
Authors: Fowokan A. , Giosa J.L. , Saari M. , Holyoke P. 
Published: November 2023

AbstractBackgroundResearchers in the Netherlands proposed the Pillars for Positive Health (PPH) as a broadly encompassing health definition to support more realistic and meaningful care planning for people living with chronic disease and other life-long health conditions. The PPH was subsequently converted to the My Positive Health (MPH) spider web visualization tool. This study sought to identify opportunities for more person-centred care planning at the point of care in home care, using the MPH tool as a framework to link comprehensive assessment and dialogue-based goal-setting.MethodsA modified eDelphi method was used to conduct domain mapping with a purposively sampled expert panel (n = 25). The panel consisted of researchers, health care providers, older adults and caregivers. A two-stage eDelphi process was conducted, with each stage consisting of three survey rounds. In the first stage, participants were asked to map 201 elements of the interRAI Home Care (interRAI HC) comprehensive assessment tool to the six MPH domains or “No pillar of best fit”. The second stage focused on identifying opportunities to adapt or expand comprehensive assessment as it relates to the MPH domains.ResultsIn Stage 1, 189 of 201 elements reached consensus in domain mapping. These included: 80 elements for Bodily Functions, 32 for Daily Functioning, 32 for Mental Wellbeing, 24 for Quality of Life, 10 for Participation, and 1 for Meaningfulness. Ten elements were identified to have no pillar of best fit. The 12 elements that did not reach consensus in Stage 1 formed the basis for Stage 2, where expert panel participants proposed four new assessment elements in Meaningfulness and Participation and 11 additional descriptors across the six MPH domains. Of these, two elements and nine of the 11 descriptors reached consensus.ConclusionFindings show that elements of the interRAI HC are oriented toward the physical, functional, and mental health domains. Consequently, complementary assessment elements and/or tools may be needed to support comprehensive assessment of ‘Meaningfulness’ and ‘Participation’ in person-centred home and community care. Additional descriptors may also be needed to aid communication regarding the understanding and application of MPH domains.