bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paucity of viral infection symptoms in patients with immune-mediated inflammatory diseases
Authors: Yalcin Mutlu Melek , Kleyer Arnd , Kroenke Gerhard , Fagni Filippo , Temiz Selahattin Alp , Meder Christine , Dietrich Peter , Orlemann Till , Mößner Johanna , Schoenau Verena , Bohr Daniela , Schuster Louis , Hartmann Fabian , Minopoulou Ioanna , Leppkes Moritz , Ramming Andreas , Pachowsky Milena L , Schuch Florian , Ronneberger Monika , Kleinert Stefan , Hueber Axel J , Manger Karin , Manger Bernhard , Atreya Raja , Berking Carola , Sticherling Michael , Neurath Markus F , Schett Georg , Simon David , Tascilar Koray 
Published: January 2025

ObjectivesAlthough patients with immune-mediated inflammatory diseases (IMID) are thought to be more susceptible to viral infections, it is unclear whether their presentation differs between patients with IMID and healthy controls. This study aimed to investigate the symptom pattern of common viral infections in patients with IMID and compare it with controls without IMIDs.DesignA cross-sectional study conducted between 1 February and 30 April 2020, using a questionnaire.SettingSeven tertiary regional care centers in Germany, which specialised in the care of patients with IMID (namely, in gastroenterology, dermatology, rheumatology and immunology clinical care).ParticipantsOne thousand nine hundred nine participants completed the survey (757 patients with IMID; 1152 non-IMID controls).Primary outcome measureThe occurrence of 11 common viral illness symptoms within the preceding 3 months in patients with IMID and non-IMID controls.ResultsSymptom data were clustered, based on number and co-occurrance, into 3 major clusters and 2 subclusters ranked by the average number of symptoms. Patients with inflammatory bowel disease and psoriasis were significantly overrepresented in the lower-frequency subcluster of the polysymptomatic cluster. Patients with rheumatoid arthritis were overrepresented in the lower-frequency subclusters of the intermediate and oligo-/asymptomatic clusters. Controls were over-represented only in the higher-frequency subclusters of each major cluster where none of the IMIDs were over-represented. Spondyloarthritis and other IMIDs were also overrepresented in the low-frequency subcluster, but the results were not significant. Overall, patients with rheumatoid arthritis patients reported fewer symptoms (rate ratio=0.68, 95% CI, 0.59 to 0.80) than non-IMID controls.ConclusionPatients with IMID are over-represented in low-frequency subclusters, even among individuals who have reported a broad range of viral infection symptoms. This pattern suggests that the manifestations of viral infections are different between patients with IMID and controls, thus challenging the accurate and early diagnosis of infections.
Effect of different intraoperative blood pressure regulation levels on postoperative myocardial injury in patients undergoing radical mastectomy for breast cancer after receiving neoadjuvant chemotherapy: a study protocol for a randomised controlled trial
Authors: Zhou Zhou , Liu Hongya , Wang Xinxin , Sang Xiaoqiao , Zhang Ying , Liu Yingge , Zhang Xiaobao 
Published: January 2025

IntroductionFor patients with breast cancer receiving preoperative neoadjuvant chemotherapy with anthracyclines, there is an increased risk of postoperative myocardial injury due to the cardiotoxicity of the chemotherapeutic agents. The optimal intraoperative blood pressure regulation regimen for these patients is unclear. This study is being conducted to determine whether targeting mean arterial pressure (MAP) to 100%–120% of the patient’s baseline blood pressure reduces the incidence of myocardial injury after non-cardiac surgery (MINS) compared with targeting MAP to 80%–100%. MINS is defined as elevated cardiac troponin levels within 30 days after non-cardiac surgery with or without clinical and electrocardiographic signs of cardiac ischaemia.Methods and analysisThe study is a single-centre, single-blind, prospective randomised controlled trial. It is expected to enrol 166 subjects receiving neoadjuvant chemotherapy with anthracyclines, between the ages of 40 and 75 years, scheduled for radical mastectomy. Participants will be randomised 1:1 to a lower-level group:intraoperative MAP control at 80%–100% of baseline values or a higher-level group:intraoperative MAP control at 100%–120% of baseline values. The primary outcome is defined by the incidence of MINS at 6–8 hours, 24 hours and 48 hours postoperatively. The secondary outcomes are heart-type free fatty acid-binding protein values at 1–2 hours, 6–8 hours and 24 hours postoperatively; the incidence of acute kidney injury within 48 hours postoperatively; the Quality of Recovery-15 score at 24 hours, 48 hours postoperatively; post-anaesthesia care unit length of stay; other postoperative cardiovascular complications; the number of times rescue analgesia and antiemetics are required; the time to first ambulation and length of postoperative hospitalisation.Ethics and disseminationThis study involves the participation of human subjects and has received approval from the Clinical Trial Ethics Committee at The Affiliated Lianyungang Hospital of Xuzhou Medical University (approval number: KY-20230915001). Study results will be presented at scientific meetings and in scientific publications.Trial registration numberChiCTR2300077675.
Effectiveness ofFewer Falls, an online group-based self-management fall prevention programme for people with multiple sclerosis: protocol of a randomised controlled trial
Authors: Tuvemo Johnson Susanna , Flink Maria , Gottberg Kristina , Walker Peterson Elizabeth , Meijer Ulrika , Bylinder Johanna , Kierkegaard Marie , Ytterberg Charlotte 
Published: January 2025

IntroductionFewer Fallsis a manualised self-management fall prevention programme co-developed for and with ambulatory and non-ambulatory people with multiple sclerosis (PwMS). Findings from a feasibility study indicate the necessity of a full-scale randomised controlled trial (RCT).Methods and analysisA parallel-group RCT with a mixed methods process evaluation as well as a cost-effectiveness evaluation will be conducted. We aim to recruit 240 PwMS, who will be stratified by ambulation level and randomised 1:1 in blocks of eight to intervention or control. The group-based self-management fall prevention intervention involves eight 2-hour online synchronous sessions (approximately eight participants/group) facilitated by a licensed healthcare professional and home assignments to be completed by participants between sessions. The setting is online, and participants can be located anywhere in Sweden. The control and intervention groups will also receive a brochure on fall risk factors and fall prevention in addition to their standard MS care and rehabilitation. Data collection will be performed at baseline and 3, 6 and 12 months after the start of the intervention. Falls will be monitored via a short message service every week during 1 year from the start of the intervention. The primary outcome is fall frequency (falls/person/year). Secondary outcomes include injurious falls, falls control, fear of falling, falls self-efficacy, activity curtailment, perceived effect of MS, self-rated health and cost-effectiveness.Ethics and disseminationEthical approval has been obtained from the Swedish Ethical Review Authority (registration numbers 2022-06667-01 and 2023-07723-02). The RCT will adhere to the Declaration of Helsinki. Written consent to participate will be obtained from all participants. Study-related information about participants will be stored securely at Karolinska Institutet. The results will be presented in peer-reviewed journals, through the patient organisation Neuro Sweden, at conferences, and in social media.Trial registration numberClinicalTrials.gov,NCT05789225.
Relationship between social support and depressive symptoms among internal migrant workers and the mediating role of healthy lifestyle: a cross-sectional study in China
Authors: Ye Beizhu , Chen Yiyang , Ma Mingze , Liu Jingru , Tarimo Clifford Silver , Han Shuo , Xue Kunyu , Zuo Binghe , Wang Yunyun , Song Yalin 
Published: January 2025

ObjectivesTo investigate the association between social support and depressive symptoms among internal migrant workers with a focus on the mediating role of a healthy lifestyle.DesignCross-sectional study.SettingThe research was conducted among internal migrant workers in Henan Province, China, in August 2023.ParticipantsInternal migrant workers are defined as individuals residing outside their registered household location (excluding mobility within the municipal district) and participating in various social and economic activities, including employment, entrepreneurship and social services.Primary outcome measures and analysesSocial support was measured using the Chinese version of the social support rating scale. The severity of depression among the study participants was evaluated using the Patient Health Questionnaire-9. A healthy lifestyle was assessed based on the questionnaire we developed based on the American Medical Association Healthy Lifestyle Scale. Statistical analyses, including logistic regression, Spearman’s correlation and mediation analysis, were deployed to explore the associations between social support, healthy lifestyle and depressive symptoms.ResultsAmong 19 326 participants, 21.45% exhibited depressive symptoms, with a higher prevalence observed among males. Social support levels among internal migrant workers were found to be lower than those in the general population, and higher social support was significantly associated with a decreased risk of depressive symptoms (OR=0.102, 95% CI: 0.086 to 0.121). Mediation analysis revealed that a healthy lifestyle partially mediated the relationship between social support and depressive symptoms among internal migrant workers, with a mediation effect of −0.063, accounting for 18.75% of the total effect.ConclusionThis study provides insights into the complex interplay between social support, healthy lifestyle and depressive symptoms among internal migrant workers in China. Implementing interventions aimed at enhancing social support and promoting healthy lifestyle behaviours can significantly improve the mental health and overall well-being of internal migrant workers.
Adherence to guidelines for natriuretic peptide testing in heart failure: a nationwide survey of healthcare professionals in Vietnam
Authors: Do Doan-Loi , Truong Thanh Huong , Kim Ngoc-Thanh 
Published: January 2025

ObjectivesThis study aimed to determine doctors’ level of adherence to the natriuretic peptide testing guideline and to identify the factors influencing their adherence.DesignCross-sectional study.SettingWeb-based survey.ParticipantsFull-time doctors involved in heart failure (HF) treatment in Vietnam.Primary and secondary outcome measuresDoctors using natriuretic peptide testing for diagnosis, differential diagnosis, treatment assessment and prognosis of patients with HF were classified as adhering to the guidelines. We assessed the practice of natriuretic peptide testing and stratified the doctors based on their professional qualifications. Univariate and multivariate logistic regression analyses were used to estimate the Odds Ratio (ORs) and 95% CIs for associations between guideline adherence and selected covariates.ResultsOver half of the participants adhered to the natriuretic peptide testing guidelines (57.4%). Cardiologists adhered more closely to the guidelines than other professionals; they had approximately four times higher odds of adherence than other doctors (univariate model, OR: 3.88, 95% CI: 2.56 to 5.89, p<0.001; multivariate model, OR: 4.24, 95% CI: 2.64 to 6.82, p<0.001). Cardiologists also had significantly higher rates of using natriuretic peptide testing for diagnosis (93.8% vs 84.1%, p<0.002), differential diagnosis (71.4% vs 53.5%, p<0.001), treatment assessment (87% vs 64.2%, p<0.001) and prognosis (68.2% vs 50.4%, p<0.001) than other professionals. More years of professional experience correlated with higher guideline adherence (<2 years was used as a reference point; >5 to <10 years, OR: 2.59, 95% CI: 1.45 to 4.60, p<0.001; ≥10 years, OR: 2.30, 95% CI: 1.30 to 4.09, p<0.004).ConclusionThe level of adherence to natriuretic peptide testing guidelines among doctors treating patients with HF varies across Vietnam. Targeted interventions are needed to enhance understanding and proficiency, especially among non-cardiologists and those with limited experience. A dedicated fact sheet focusing on natriuretic peptide testing in HF management, separate from the existing guidelines, could bridge this gap.
Effect of tropical climates on the quality of commonly used antibiotics: the protocol for a systematic review and meta-analysis
Authors: Suleman Sultan , Hasen Gemmechu , Melaku Tsegaye , Belew Sileshi , Thitiri Johnstone , Shangala Jimmy , Obiero Christina W , Ngari Moses , Berkley James A 
Published: January 2025

IntroductionMedicine quality can be influenced by environmental factors. In low- and middle-income countries (LMICs) with tropical climates, storage facilities of medicines in healthcare settings and homes may be suboptimal. However, knowledge of the effects of temperature and other climatic and environmental factors on the quality of medicines is limited. A better understanding of the effects of climates may assist in the development of control strategies to help reduce factors contributing to poor-quality medicines. Therefore, this systematic review aims to synthesise data from published studies describing the effects of storage conditions on the quality of antibiotic medicines commonly used in LMICs.Methods and analysisWe will search literature from databases, including the PubMed, Web of Science, Scopus and Google Scholar, and grey literature between 1987 and 2022. Experimental studies that evaluate the influence of temperature, humidity and sunlight on the quality of antibiotics applicable to Africa and South Asia will be included. Experimental studies that assess naturally occurring and simulated storage conditions and medicines prepared from powder with water and stored in hospitals or at home to be used across several doses will be also included. The key search terms related to the tropical climate, quality and commonly used antibiotics, such as temperature, storage condition, humidity, sunlight and moisture; quality, assay, purity, dissolution, disintegration, hardness, friability, weight variation, weight uniformity, degradation, impurities and stability; and amoxicillin, ceftriaxone, azithromycin, ciprofloxacin, doxycycline, metronidazole, trimethoprim-sulfamethoxazole, erythromycin, ampicillin and gentamicin, respectively, will be connected using the appropriate Boolean operators (OR, AND). The search terms will be used in correspondence with Medical Subject Heading terms by keyword arrangement. The available evidence for the poor quality of commonly used antibiotics is summarised by the type of diagnosis, type of drug and region. Meta-analysis using random effects will be performed using RevMan software to determine the pooled effects of environmental exposures. The degree of heterogeneity will be evaluated by the inverse of variance (I2). Forest plots will be used to present the meta-analysis data.Ethics and disseminationEthical approval is not required as the study is a systematic review. This review will be disseminated through open-access peer-reviewed publication.PROSPERO registration numberCRD42023432848.
Cardiac arrhythmia assessment with patch electrocardiogram versus insertable cardiac monitor: a cohort study in endurance athletes with atrial fibrillation
Authors: Apelland Turid , Sellevold Andreas Berg , Letnes Jon Magne , Onarheim Sophia , Enger Steve , Tveit Arnljot , Delpire Boris , Claessen Guido , La Gerche Andre , Loennechen Jan Pal , Berge Trygve , Myrstad Marius 
Published: January 2025

ObjectivesThe objective of this study was to assess the quality of ECG recordings and the concordance between the automatic detection of cardiac arrhythmia episodes by a patch ECG and an insertable cardiac monitor.DesignProspective cohort study.Setting and participantsEndurance athletes diagnosed with paroxysmal atrial fibrillation (AF) and no other relevant comorbidities participating in a randomised controlled trial on the effects of training adaption.MethodsA patch ECG (ECG247 Smart Heart Sensor) was sent to 29 non-elite endurance athletes with clinical paroxysmal AF. ECG247 continuously monitors, detects and categorises cardiac arrhythmias. The participants were simultaneously monitored with an insertable cardiac monitor (Confirm Rx, Abbott). ECG recording quality was assessed by an experienced physician. Training sessions were monitored using sports watches.ResultsOut of 29 invited athletes, 14 athletes (mean age 60.4 years, 2 women) made use of the patch ECG and were monitored for a total of 2987 hours and a median of 14 (range 1–17) days. During this period, the athletes performed a total of 112 training sessions. ECG quality varied between athletes and by type of exercise, with poor quality in 16% and 40% of recordings during cross-country skiing and running, respectively. In two athletes, the patch ECG detected AF episodes that were confirmed with insertable cardiac monitor recordings. One technical artefact was falsely classified as ventricular tachycardia by the ECG247 Smart Heart Sensor system.ConclusionMonitoring with patch ECG was feasible in endurance athletes, but ECG recording quality varied between athletes and by type of exercise.Trial registrationNCT04991337(for the related randomised controlled trial).
Quality improvement on reducing neonatal mortality through intensive Clinical Mentorship Intervention: a case study in Biak Regional Hospital, Papua-Indonesia
Authors: Kresnawati Windhi , Froulina Liza , Syahrizal Bobby Marwal , Sinaga Nurlely Bethesda , Manuama Edit Oktavia , Rohsiswatmo Rinawati , Wandita Setya 
Published: January 2025

BackgroundThe neonatal mortality rate in Papua Province of Indonesia is unacceptably high. To address the issue, the Ministry of Health and UNICEF Indonesia initiated a hospital mentoring programme from 2014 to 2016 to improve the quality of care and health workers’ capacity to provide neonatal care. This study aimed to assess the impact of hospital mentoring on neonatal mortality.MethodsThe study was conducted at Biak District Hospital, Indonesia. The neonatal mortality was compared for three periods: preintervention (2011–2013), mentorship intervention phase (2014–2016) and postintervention (2017–2020). The mentoring programme is a combination of a direct-intensive-regular mentoring process and a scholarship programme for paediatricians. In the mentoring process, paediatricians, neonatal nurses and electromedical staff from national hospitals were sent to train the nurses on nursing management for sick neonates, clinical neonatal resuscitation, stabilisation and transportation. The neonatal mortality data were collected from birth registers, medical records, death case review reports and mentoring programme reports.ResultsA significant decrease in the percentage of death cases before 24 hours of hospitalisation and death cases due to asphyxia was observed in the three periods. In the death cases from referrals, a significant decrease from 70% in the intervention period to 39.7% in the postintervention period was observed (p<0.05). The survival rate of neonates with body weights under 1500 g and 1500–2500 g was compared in the intervention and postintervention period, a significant increase from 21% to 58% and 55% to 94% was observed, respectively (p<0.05).ConclusionThe direct-intensive-regular mentoring intervention programme was found to be effective in reducing neonatal mortality through quality improvement in low-resource district hospitals.
Improving the evaluation of non-accidental trauma across multiple specialties at a single institution
Authors: Kroese Lani , Port Courtney , Hauda William 
Published: January 2025

BackgroundBased on the presenting injury, patients undergoing abuse evaluation may be managed by different specialties. Our local child abuse specialist expressed concern over the variability in evaluation of patients presenting with injuries concerning for non-accidental trauma (NAT). The aim of this quality improvement project was to increase the percentage of patients for whom there is a concern for NAT who receive a guideline-adherent evaluation from 7.7% to 50% in 6 months’ time.MethodsA committee of physician stakeholders developed criteria for a complete NAT evaluation which were integrated into an order panel with built-in clinical guidance for test selection within our electronic medical record. Data on the completeness of NAT evaluation in paediatric patients 0–18 years of age were collected before and after the order panel release and analysed by admitting service, injury category and equity factors.ResultsThis initiative increased the percentage of patients with a guideline-adherent evaluation from a mean of 7.7% to 25% within 6 months’ time. The number of days between patients with complete evaluations decreased from 63 days to 35 days. Order panel utilisation increased to 55%, and the percentage of evaluation opportunities was more complete when the order panel was used (79% vs 92%).ConclusionsStandardisation of NAT evaluations through creation of an order panel with a clinical decision tool resulted in more guideline-adherent evaluations. The potential reduction of bias in such evaluations remains an area of interest.
Enhancing end-of-life care practices on the medicine units: perspectives from nurses and families
Authors: Reid Julie C , Hoad Neala , Landau Lucinda , Boyle Anne , Hanmiah Rajendar , Cook Deborah J 
Published: January 2025

BackgroundDeath is a part of life. While most often a sombre event, opportunities exist to optimise the experience both for the dying patient and their loved ones. This is especially true in institutionalised settings, such as acute care hospitals where cure and recovery tend to be paramount.PurposeTo understand ways to improve end-of-life (EOL) care from the perspective of frontline nursing staff and patient and family advisors (PFAs).MethodsWe conducted focus groups with frontline nursing staff (n=14) and PFAs (n=5) to understand ways to optimise EOL care. Using a videoconference platform, one researcher used a flexible interview guide while a second researcher took field notes. These focus groups were in follow-up to a comprehensive need assessment survey as part of a programme to enhance EOL care practices on the general internal medicine units at our hospital. We used source data from deidentified audio recordings and researcher field notes.ResultsFive important categories regarding current EOL care practices emerged: communication among key stakeholders, assessment and management of symptoms, engagement of the palliative care team, engagement of the spiritual care team and ongoing tests and interventions at the EOL. We identified challenges specific to each respondent group as well as common challenges from both the professional and public perspectives.ConclusionsViews elicited from patients, families and nurses in this qualitative study have informed the development of strategies to enhance EOL practices in our hospital that may be useful in othercentres.