bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of efficacy between levonorgestrel intrauterine system and dienogest in adenomyosis: a randomized clinical trial
Authors: Choudhury Satish , Jena Saubhagya Kumar , Mitra Subarna , Padhy Biswa Mohan , Mohakud Sudipta 
Published: January 2024

Background: Medical management of adenomyosis is an emerging perspective in modern gynecology. Though levonorgestrel intrauterine system (LNG-IUS) and dienogest (DNG) effectively relieve symptoms in adenomyosis, neither has been approved for the same indication. Our study aims to compare the efficacy and safety of these progestins in treating adenomyosis. Objective: To study the efficacy and safety of LNG-IUS versus DNG in patients with symptomatic adenomyosis. Design: Open-labeled, parallel, single-centered, randomized clinical trial. Methods: Patients with adenomyosis-associated pain with or without abnormal uterine bleeding were randomly allocated to either LNG-IUS group or DNG group. The primary outcome was a reduction in painful symptoms after 12 weeks of treatment measured by visual analog scale (VAS) score. Changes in menstrual blood loss (MBL), improvement in quality of life (QoL), and adverse drug reactions were also analyzed. Results: The VAS score significantly decreased from baseline in both groups. The baseline and post-treatment VAS scores in the LNG-IUS group were 6.41 ± 1.07 and 3.41 ± 1.04 ( p = <0.001) and in the DNG group, were 6.41 ± 0.95 and 3.12 ± 1.40 ( p = <0.001), respectively. A significantly greater proportion of patients in the LNG-IUS group experienced lighter MBL as compared to the DNG group [27/30 (90%) in the LNG-IUS group versus 17/22 (77.2%) in the DNG group ( p = 0.006)]. Both the groups had improvement in QOL scores calculated by the World Heath Organisation QOL scale (WHOQOL BREF) questionnaire; however, it was more pronounced in the DNG group [(28.76 ± 30.47 in the LNG-IUS group versus 48.26 ± 44.91 in the DNG group ( p = 0.04)]. Both the agents were safe as there were no reported major adverse drug reactions. Conclusion: DNG can be an effective and safe alternative to LNG-IUS for the medical management of adenomyosis. Trial registration: The trial was prospectively registered at the clinical trial registry – India (CTRI) vide CTRI number CTRI/2020/05/025186.
Is Botox or Dermabond Superior in the Appearance of the Lip Scar After Primary Cleft Lip Repair and Revision? A Systematic Review and Meta-Analysis
Authors: Martinez Paul F. , Webster Theresa K. , Imahiyerobo Thomas A. 
Published: January 2024

Background: Cleft lip scar formation is an inevitable consequence of cleft lip repair (CLR) and is exacerbated by the dynamic movement of the middle face. Various methods to correct or prevent these deformities have been described including silicone sheeting, surgical revisions, laser therapy, and more recently, Botulinum toxin-A (Botox) and Dermabond. This study aims to analyze and compare the impact of Botox versus Dermabond on scar appearance after CLR. Methods: Following PRISMA guidelines, a systematic review was performed on Medline, Embase, Cochrane, and CINAHL using the following keywords: “Dermabond,” “botulinum toxin,” and “cleft lip.” Outcomes of interest were the rates of scar hypertrophy, scar width, Vancouver scar scale (VSS), visual analog scale (VAS), Hollander wound evaluation scale (HWES), and complications. Results: Nine studies were included of which 4 articles analyzed Botox and 5 analyzed Dermabond. Forest plots for scar width at the first and second time point supported the use of Botox to achieve a smaller scar width with P < .0001 (95% CI: −1.09 [−1.56 to −0.63] and 95% CI: −0.94 [−1.37 to −0.50], respectively). A significant increase in VAS was observed with Botox (95% CI: 1.66 [1.27-2.05], P value < .0001) and VSS was insignificant. Of the articles that analyzed Dermabond, scar appearance was comparable to the traditional suture closure group. There were no feeding complications for either intervention. Pooled forest plots for VAS comparing Botox and Dermabond supported the use of Botox with improved VAS (95% CI: 1.66 [1.27-2.05], P < .0001) compared to Dermabond (95% CI: 0.07 [ −0.48 to 0.61], P = .80). Conclusions: The current literature supports the use of Botox for scar improvement following CLR or revision. However, there is limited data to support Dermabond’s utility in improving scars in CLR, which highlights the need for further studies.
The Anatomy and Physiology of the Glymphatic System and Its Role in Craniectomies and Syndrome of the Trephined
Authors: Talbot-Stetsko Haley K. , Holste Katherine G. , Dietze-Fiedler Megan , Hespe Geoffrey E. , Vercler Christian J. , Muraszko Karin M. 
Published: January 2024

Background: The glymphatic system, a relatively recently discovered system for transport of cerebrospinal fluid (CSF) and waste products in the central nervous system, has been implicated in several neurologic disorders. Altered CSF dynamics are seen after decompressive craniectomy, suggesting this procedure may impact glymphatic function. We aimed to systematically review the current literature to understand the effect of the glymphatic system on patients with decompressive craniectomies and Syndrome of the Trephined (SoT). Methods: PubMed and Embase were searched for preclinical and clinical studies investigating the glymphatic system and craniectomy, cranioplasty, or SoT in years 2012 to 2023. Results: Sixty-three studies were identified for review. Intracranial oscillations, cerebral perfusion, and arterial pulsations have been identified as major drivers of glymphatic influx. Each of these processes are diminished following craniectomy, suggesting craniectomy may impair glymphatic function. Reductions in brain pulsatility and alterations in glymphatic drainage after craniectomy were accompanied by impaired functional outcomes, as seen in SoT. Radiologically, CSF flow alterations are seen after craniectomies, which improve with cranioplasty. Conclusions: Glymphatic system dysfunction after craniectomy and in SoT may be a potential therapeutic target for patients with iatrogenically altered cranial vault anatomy.
Virus-reactive T cells expanded in aplastic anemia eliminate hematopoietic progenitor cells by molecular mimicry
Authors: Ben Hamza Amin , Welters Carlotta , Stadler Serena , Brüggemann Monika , Dietze Kerstin , Brauns Olaf , Brümmendorf Tim H. , Winkler Thomas , Bullinger Lars , Blankenstein Thomas , Rosenberger Leonie , Leisegang Matthias , Kammertöns Thomas , Herr Wolfgang , Moosmann Andreas , Strobel Julian , Hackstein Holger , Dornmair Klaus , Beier Fabian , Hansmann Leo 
Published: January 2024

Abstract
Acquired aplastic anemia is a bone marrow failure syndrome characterized by hypocellular bone marrow and peripheral blood pancytopenia. Frequent clinical responses to calcineurin inhibition and antithymocyte globulin strongly suggest critical roles for hematopoietic stem/progenitor cell–reactive T-cell clones in disease pathophysiology; however, their exact contribution and antigen specificities remain unclear. We determined differentiation states and targets of dominant T-cell clones along with their potential to eliminate hematopoietic progenitor cells in the bone marrow of 15 patients with acquired aplastic anemia. Single-cell sequencing and immunophenotyping revealed oligoclonal expansion and effector differentiation of CD8+ T-cell compartments. We reexpressed 28 dominant T-cell receptors (TCRs) of 9 patients in reporter cell lines to determine reactivity with (1) in vitro–expanded CD34+ bone marrow, (2) CD34− bone marrow, or (3) peptide pools covering immunodominant epitopes of highly prevalent viruses. Besides 5 cytomegalovirus-reactive TCRs, we identified 3 TCRs that recognized antigen presented on hematopoietic progenitor cells. T cells transduced with these TCRs eliminated hematopoietic progenitor cells of the respective patients in vitro. One progenitor cell–reactive TCR (11A5) also recognized an epitope of the Epstein-Barr virus–derived latent membrane protein 1 (LMP1) presented on HLA-A∗02:01. We identified 2 LMP1-related mimotopes within the human proteome as activating targets of TCR 11A5, providing proof of concept that molecular mimicry of viral and self-epitopes can drive T cell–mediated elimination of hematopoietic progenitor cells in aplastic anemia.
Positive airway pressure telehealth models and long-term therapy termination: a healthcare database analysis
Authors: Woehrle Holger , Schoebel Christoph , Ficker Joachim H. , Graml Andrea , Schnepf Jürgen , Fietze Ingo , Young Peter , Arzt Michael 
Published: January 2024

BackgroundTelemonitoring-guided interventions can improve short-term positive airway pressure (PAP) therapy adherence, but long-term effects are unknown. This study investigated long-term PAP therapy termination in patients with sleep apnoea managed with standard care, telemonitoring-guided proactive care or telemonitoring-guided proactive care + patient engagement tool.MethodsGerman healthcare provider data were analysed retrospectively. Individuals aged 18–100 years who started PAP from 2014 to 2019 and had device type/interface data were included. Time-to-termination periods were analysed using Kaplan–Meier plots and Cox proportional hazards regression, adjusted for age, sex, insurance type, and device and mask type.ResultsThe per-protocol population (valid telemonitoring data) included 104 612 individuals (71% male; 95% aged >40 years). Mean follow-up was 3.3±2.0 years. The overall therapy termination rate was significantly lower in the telemonitoring-guided proactive care groupversusstandard care (20%versus27%; p<0.001), and even lower in the telemonitoring-guided care + patient engagement tool group (11%; p<0.001versusother treatment groups). Adjusted risk of therapy termination was lowerversusstandard care (hazard ratio 0.76, 95% confidence interval 0.74–0.78; and 0.41 (0.38–0.44) for telemonitoring-guided proactive care alone + patient engagement). Age <50 or >59 years and use of a nasal pillows or full-face mask were significant predictors of therapy termination; male sex, use of telemonitoring-guided proactive care (± patient engagement) and private insurance were significantly associated with lower therapy termination rates.ConclusionsUse of telemonitoring-guided proactive care and a patient engagement tool was associated with lower rates of PAP therapy termination.
Clinical, tomographic and functional comparison of sporadic and tuberous sclerosis complex-associated forms of lymphangioleiomyomatosis: a retrospective cohort study
Authors: Oliveira Martina Rodrigues , Wanderley Mark , Freitas Carolina Salim Gonçalves , Kairalla Ronaldo Adib , Chate Rodrigo Caruso , Amaral Alexandre Franco , Arimura Fabio Eiji , Samorano Luciana Paula , Watanabe Elieser Hitoshi , Carvalho Carlos Roberto Ribeiro , Baldi Bruno Guedes 
Published: January 2024

BackgroundLymphangioleiomyomatosis (LAM) is a rare disease that can occur sporadically (S-LAM) or associated with the tuberous sclerosis complex (TSC-LAM). The natural history of LAM is not completely understood, including whether there is a difference between the clinical courses of the two forms. This study aimed to compare the clinical, functional and tomographic features between S-LAM and TSC-LAM, and evaluate the annual rates of change in lung function.MethodsThis retrospective cohort study included patients with LAM followed up between 1994 and 2019. Clinical, functional and imaging variables were evaluated, and the lung cysts were automatically quantified. Quality of life and predictors of lung function impairment were accessed, and the annual rate of lung function decline was compared between S-LAM and TSC-LAM.ResultsOf the 107 patients included, 77 had S-LAM and 30 had TSC-LAM. Although patients with TSC-LAM had a higher prevalence of renal angiomyolipomas and neurological and dermatological manifestations, pulmonary function tests were similar. Patients with S-LAM had a greater rate of forced expiratory volume in 1 s decline and a higher extent of cysts. Pneumothorax, desaturation in the 6-minute walking test and a higher extent of lung cysts were predictors of functional impairment. A greater impact on vitality and emotional health was observed in the TSC-LAM.ConclusionGreater functional decline and a higher cystic extension were found in patients with S-LAM. Our study provides a broad clinical, functional and tomographic characterisation of patients with LAM, adding valuable information to the existing evidence to better understand the two forms of the disease.
Bandwidth tunability of graphene absorption enhancement by hybridization of delocalized surface plasmon polaritons and localized magnetic plasmons
Authors: Wu Yifan , Nie Qingmiao , Tang Chaojun , Yan Bo , Liu Fanxin , Zhu Mingwei 
Published: January 2024

AbstractThe bandwidth-tunable absorption enhancement of monolayer graphene is theoretically studied in the near-infrared wavelengths. The monolayer graphene is placed on the silver substrate surface with a periodic array of one-dimensional slits. Two absorption peaks are found to result from the hybridization of delocalized surface plasmon polaritons and localized magnetic plasmons. The positions of absorption peaks are accurately predicted by a coupling model of double oscillators. The full width at half maximum of absorption peaks is largely tuned from about 1–200 nm by changing the array period of slits. The effect of the slit size on absorption peaks is also investigated in detail. Our work is promising in applications for photoelectric devices.
Live longer, work longer? An investigation of the health capacity to work at older ages in Denmark using combined register and survey data
Authors: Aaskoven Maiken Skovrider , Lauridsen Jørgen T. , Kjær Trine 
Published: January 2024

AbstractPublicly funded pension systems are facing the challenge of remaining financially sustainable without lowering pensions. Raising the statutory retirement age gradually in line with the increase in life expectancy has been a key measure to solve the problem. The implicit assumption is that the additional years of life are lived in good health, or as a minimum that health status is compatible with work. However, some individuals may not have the ability to work. Furthermore, a uniform retirement age ignores the different exposures to morbidity and mortality risks across social groups. Consequently, it is important to examine whether the health of older individuals will allow them to continue working and whether there is significant heterogeneity in the ability to work. Combining the Survey of Health, Ageing and Retirement in Europe (SHARE) with data from the Danish registers enables us to create a composite health index that includes an extensive range of health indicators. Utilising the health capacity to work approach, we estimate the health capacity to work among Danes aged 55 and above. We divide health capacity into physical and mental health. We investigate heterogeneity in health capacity across educational and occupational attainment. Substantial additional work capacity is found for older Danes. Depending on the type of health index applied, the health capacrk varies. There is evidence of a socio-economic gradient in work capacity. Results thereby show that policies that intend to utilise the additional work capacity should consider heterogeneity in health.Highlights

We provide new evidence of the health capacity work in Denmark.

The combination of survey and register data allow for comprehensive health indices.

There is substantial additional health capacity to work.

There is variation across health indices.

There is variation across educational and occupational attainment.
Acute care pathway assessed through performance indicators during the COVID-19 pandemic in OECD countries (2020–2021): a scoping review
Authors: V. Carvalho Ana Sofia , Broekema Bente , Brito Fernandes Óscar , Klazinga Niek , Kringos Dionne 
Published: January 2024

Abstract
Background
The COVID-19 pandemic severely impacted care for non-COVID patients. Performance indicators to monitor acute care, timely reported and internationally accepted, lacked during the pandemic in OECD countries. This study aims to summarize the performance indicators available in the literature to monitor changes in the quality of acute care in OECD countries during the first year and a half of the pandemic (2020-July 2021) and to assess their trends.

Methods
Scoping review. Search in Embase and MEDLINE (07-07-2022). Acute care performance indicators and indicators related to acute general surgery were collected and collated following a care pathway approach. Indicators assessing identical clinical measures were grouped under a common indicator title. The trends from each group of indicators were collated (increase/decrease/stable).

Results
A total of 152 studies were included. 2354 indicators regarding general acute care and 301 indicators related to acute general surgery were included. Indicators focusing on pre-hospital services reported a decreasing trend in the volume of patients: from 225 indicators, 110 (49%) reported a decrease. An increasing trend in pre-hospital treatment times was reported by most of the indicators (n = 41;70%) and a decreasing trend in survival rates of out-of-hospital cardiac arrest (n = 61;75%). Concerning care provided in the emergency department, most of the indicators (n = 752;71%) showed a decreasing trend in admissions across all levels of urgency. Concerning the mortality rate after admission, most of the indicators (n = 23;53%) reported an increasing trend. The subset of indicators assessing acute general surgery showed a decreasing trend in the volume of patients (n = 50;49%), stability in clinical severity at admission (n = 36;53%), and in the volume of surgeries (n = 14;47%). Most of the indicators (n = 28;65%) reported no change in treatment approach and stable mortality rate (n = 11,69%).

Conclusion
This review signals relevant disruptions across the acute care pathway. A subset of general surgery performance indicators showed stability in most of the phases of the care pathway. These results highlight the relevance of assessing this care pathway more regularly and systematically across different clinical entities to monitor disruptions and to improve the resilience of emergency services during a crisis.
A time series driven model for early sepsis prediction based on transformer module
Authors: Tang Yan , Zhang Yu , Li Jiaxi 
Published: January 2024

AbstractSepsis remains a critical concern in intensive care units due to its high mortality rate. Early identification and intervention are paramount to improving patient outcomes. In this study, we have proposed predictive models for early sepsis prediction based on time-series data, utilizing both CNN-Transformer and LSTM-Transformer architectures. By collecting time-series data from patients at 4, 8, and 12 h prior to sepsis diagnosis and subjecting it to various network models for analysis and comparison. In contrast to traditional recurrent neural networks, our model exhibited a substantial improvement of approximately 20%. On average, our model demonstrated an accuracy of 0.964 (± 0.018), a precision of 0.956 (± 0.012), a recall of 0.967 (± 0.012), and an F1 score of 0.959 (± 0.014). Furthermore, by adjusting the time window, it was observed that the Transformer-based model demonstrated exceptional predictive capabilities, particularly within the earlier time window (i.e., 12 h before onset), thus holding significant promise for early clinical diagnosis and intervention. Besides, we employed the SHAP algorithm to visualize the weight distribution of different features, enhancing the interpretability of our model and facilitating early clinical diagnosis and intervention.
Feasibility of a reconfigured domestic violence and abuse training and support intervention responding to affected women, men, children and young people through primary care
Authors: Szilassy Eszter , Coope Caroline , Emsley Elizabeth , Williamson Emma , Barbosa Estela Capelas , Johnson Medina , Dowrick Anna , Feder Gene 
Published: January 2024

Abstract
Background
Identification in UK general practice of women affected by domestic violence and abuse (DVA) is increasing, but men and children/young people (CYP) are rarely identified and referred for specialist support. To address this gap, we collaborated with IRISi (UK social enterprise) to strengthen elements of the IRIS + intervention which included the identification of men, direct engagement with CYP, and improved guidance on responding to information received from other agencies. IRIS + was an adaptation of the national IRIS (Identification and Referral to Improve Safety) model focused on the needs of women victim-survivors of DVA. Without diminishing the responses to women, IRIS + also responded to the needs of men experiencing or perpetrating DVA, and CYP living with DVA and/or experiencing it in their own relationships. Our study tested the feasibility of the adapted IRIS + intervention in England and Wales between 2019–21.

Methods
We used mixed method analysis to triangulate data from various sources (pre/post intervention questionnaires with primary care clinicians; data extracted from medical records and DVA agencies; semi-structured interviews with clinicians, service providers and referred adults and children) to assess the feasibility and acceptability of the IRIS + intervention.

Results
The rate of referral for women doubled (21.6/year/practice) from the rate (9.29/year/practice) in the original IRIS trial. The intervention also enabled identification and direct referral of CYP (15% of total referrals) and men (mostly survivors, 10% of total referrals). Despite an increase in self-reported clinician preparedness to respond to all patient groups, the intervention generated a low number of men perpetrator referrals (2% of all referrals). GPs were the principal patient referrers. Over two-thirds of referred women and CYP and almost half of all referred men were directly supported by the service. Many CYP also received IRIS + support indirectly, via the referred parents. Men and CYP supported by IRIS + reported improved physical and mental health, wellbeing, and confidence.

Conclusions
Although the study showed acceptability and feasibility, there remains uncertainty about the effectiveness, cost-effectiveness, and scalability of IRIS + . Building on the success of this feasibility study, the next step should be trialling the effectiveness of IRIS + implementation to inform service implementation decisions.