bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stroke nurse navigator utilization reduces unplanned 30-day readmission in stroke patients treated with thrombolysis
Authors: Jun-O'Connell Adalia H. , Grigoriciuc Eliza , Gulati Akanksha , Silver Brian , Kobayashi Kimiyoshi J. , Moonis Majaz , Henninger Nils 
Published: June 2023

BackgroundUnplanned 30-day hospital readmissions following a stroke is a serious quality and safety issue in the United States. The transition period between the hospital discharge and ambulatory follow-up is viewed as a vulnerable period in which medication errors and loss of follow-up plans can potentially occur. We sought to determine whether unplanned 30-day readmission in stroke patients treated with thrombolysis can be reduced with the utilization of a stroke nurse navigator team during the transition period.MethodsWe included 447 consecutive stroke patients treated with thrombolysis from an institutional stroke registry between January 2018 and December 2021. The control group consisted of 287 patients before the stroke nurse navigator team implementation between January 2018 and August 2020. The intervention group consisted of 160 patients after the implementation between September 2020 and December 2021. The stroke nurse navigator interventions included medication reviews, hospitalization course review, stroke education, and review of outpatient follow-ups within 3 days following the hospital discharge.ResultsOverall, baseline patient characteristics (age, gender, index admission NIHSS, and pre-admission mRS), stroke risk factors, medication usage, and length of hospital stay were similar in control vs. intervention groups (P &gt; 0.05). Differences included higher mechanical thrombectomy utilization (35.6 vs. 24.7%, P = 0.016), lower pre-admission oral anticoagulant use (1.3 vs. 5.6%, P = 0.025), and less frequent history of stroke/TIA (14.4 vs. 27.5%, P = 0.001) in the implementation group. Based on an unadjusted Kaplan–Meier analysis, 30-day unplanned readmission rates were lower during the implementation period (log-rank P = 0.029). After adjustment for pertinent confounders including age, gender, pre-admission mRS, oral anticoagulant use, and COVID-19 diagnosis, the nurse navigator implementation remained independently associated with lower hazards of unplanned 30-day readmission (adjusted HR 0.48, 95% CI 0.23–0.99, P = 0.046).ConclusionThe utilization of a stroke nurse navigator team reduced unplanned 30-day readmissions in stroke patients treated with thrombolysis. Further studies are warranted to determine the extent of the results of stroke patients not treated with thrombolysis and to better understand the relationship between resource utilization during the transition period from discharge and quality outcomes in stroke.
In vivo evaluation of an innovative synbiotics on stage IIIb-IV chronic kidney disease patients
Authors: Vacca Mirco , Celano Giuseppe , Calabrese Francesco Maria , Rocchetti Maria Teresa , Iacobellis Ilaria , Serale Nadia , Calasso Maria , Gesualdo Loreto , De Angelis Maria 
Published: June 2023

BackgroundMicrobiota unbalance has been proven to affect chronic kidney disease (CKD) patients and, noteworthy, microbiota composition and activity are implicated in CKD worsening. The progression of kidney failure implies an exceeding accumulation of waste compounds deriving from the nitrogenous metabolism in the intestinal milieu. Therefore, in the presence of an altered intestinal permeability, gut-derived uremic toxins, i.e., indoxyl sulfate (IS) and p-cresyl sulfate (PCS), can accumulate in the blood.MethodsIn a scenario facing the nutritional management as adjuvant therapy, the present study assessed the effectiveness of an innovative synbiotics for its ability to modulate the patient gut microbiota and metabolome by setting a randomized, single-blind, placebo-controlled, pilot trial accounting for IIIb-IV stage CKD patients and healthy controls. Metataxonomic fecal microbiota and fecal volatilome were analyzed at the run-in, after 2 months of treatment, and after 1 month of wash out.ResultsSignificant changes in microbiota profile, as well as an increase of the saccharolytic metabolism, in feces were found for those CKD patients that were allocated in the synbiotics arm.ConclusionsNoteworthy, the here analyzed data emphasized a selective efficacy of the present synbiotics on a stage IIIb-IV CKD patients. Nonetheless, a further validation of this trial accounting for an increased patient number should be considered.Clinical trial registrationhttps://clinicaltrials.gov/, identifier NCT03815786.
A nomogram model for predicting distant metastasis of newly diagnosed colorectal cancer based on clinical features
Authors: He Jiang-Hua , Cao Cong , Ding Yang , Yi Yun , Lv Yu-Qing , Wang Chun , Chang Ying 
Published: June 2023

ObjectiveColorectal cancer is one of the most common primary malignancies and the third most common cause of cancer death in both men and women in the United States. Among people diagnosed with initial colorectal cancer, 22% had metastatic colorectal cancer, while the 5-year survival rate was less than 20%. The purpose of this study is to develop a nomogram for predicting distant metastasis in newly diagnosed colorectal cancer patients and to identify high-risk groups.MethodsWe retrospectively reviewed the data of patients who were diagnosed with colorectal cancer at Zhong nan Hospital of Wuhan University and People’s Hospital of Gansu Province between January 2016 and December 2021. Risk predictors for distant metastasis from colorectal patients were determined by the univariate and multivariate logistic regression analyses. Nomograms were developed to predict the probabilities of distant metastatic sites of colorectal cancer patients and evaluated by calibration curves, receiver operating characteristic curves, and decision curve analysis (DCA).ResultsA total of 327 cases were included in this study: 224 colorectal cancer patients from Zhong nan Hospital of Wuhan University were incorporated into the training set, and 103 colorectal cancer patients from Gansu Provincial People’s Hospital were incorporated into the testing set. By univariate logistic regression analysis, platelet (PLT) level (p = 0.009), carcinoembryonic antigen (CEA) level (p = 0.032), histological grade (p &lt; 0.001), colorectal cancer tumor markers (p &lt; 0.001), N stage (p &lt; 0.001), and tumor site (p = 0.005) were associated with distant metastasis in colorectal cancer patients. Multivariate logistic regression analysis showed that N stage (p &lt; 0.001), histological grade (p = 0.026), and colorectal cancer markers (p &lt; 0.001) were independent predictors of distant metastasis in patients initially diagnosed with colorectal cancer. The above six risk factors were used to predict distant metastasis of newly diagnosed colorectal cancer. The C-indexes for the prediction of the nomogram were 0.902 (95% confidence interval (CI), 0.857–0.948).ConclusionThe nomogram showed excellent accuracy in predicting distant metastatic sites, and clinical utility may facilitate clinical decision-making.
Evaluation of artificial intelligent breast ultrasound on lesion detection and characterization compared with hand-held ultrasound in asymptomatic women
Authors: Xu Bin , Luo Weidong , Chen Xin , Jia Yiping , Wang Mengyuan , Tian Lulu , Liu Yi , Lei Bowen , Li Jiayuan 
Published: June 2023

IntroductionTo compare the accuracy of Artificial Intelligent Breast Ultrasound (AIBUS) with hand-held breast ultrasound (HHUS) in asymptomatic women and to offer recommendations for screening in regions with limited medical resources.Methods852 participants who underwent both HHUS and AIBUS were enrolled between December 2020 and June 2021. Two radiologists, who were unaware of the HHUS results, reviewed the AIBUS data and scored the image quality on a separate workstation. Breast imaging reporting and data system (BI-RADS) final recall assessment, breast density category, quantified lesion features, and examination time were evaluated for both devices. The statistical analysis included McNemar’s test, paired t-test, and Wilcoxon test. The kappa coefficient and consistency rate were calculated in different subgroups.ResultsSubjective satisfaction with AIBUS image quality reached 70%. Moderate agreements were found between AIBUS with good quality images and HHUS for the BI-RADS final recall assessment (κ = 0.47, consistency rate = 73.9%) and breast density category (κ = 0.50, consistency rate = 74.8%). The lesions measured by AIBUS were statistically smaller and deeper than those measured by HHUS (P &lt; 0.001), though they were not significant in clinical diagnosis (all &lt; 3 mm). The total time required for the AIBUS examination and image interpretation was 1.03 (95% CI (0.57, 1.50)) minutes shorter than that of HHUS per case.ConclusionModerate agreement was obtained for the description of the BI-RADS final recall assessment and breast density category. With image quality comparable to that of HHUS, AIBUS was superior for the efficiency of primary screening.
Efficacy and safety of subcutaneous immunotherapy in asthmatic children allergic to house dust mite: a meta-analysis and systematic review
Authors: Zheng Chen , Xu Hao , Huang Shumin , Chen Zhimin 
Published: June 2023

BackgroundSubcutaneous immunotherapy (SCIT) has been proved to be effective and safe in adult asthma. But it is still controversial in children.ObjectTo evaluate the efficacy and safety of SCIT in asthmatic children with allergy to house dust mite.MethodWe searched the databases of Cochrane Library, EMBASE and MEDLINE (from 1 January 1990 to 1 December 2022). Two reviewers independently screened studies, extracted data and critically appraised the risk of bias. We used the Revman 5 to synthesize the effect sizes.ResultsWe finally selected 38 eligible studies including 21 randomized controlled trials to evaluate the efficacy and safety of SCIT and 17 observational studies to assess the safety. The results revealed that short-term asthma symptom scores were declined with a standardized mean difference (SMD) of −1.19 (95% CI: −1.87, −0.50) in 12 researches with high heterogeneity. Short-term asthma medication scores were decreased with SMD −1.04 (95% CI: −1.54, −0.54) in 12 heterogeneous researches. One study showed no significant reduction in combined symptom and medication scores without providing details. No studies we reviewed reported long-term efficacy. SCIT resulted in an obviously increased risk of adverse reactions compared with placebo. For secondary outcomes, SCIT improved life quality and reduced the numbers of annual asthma attacks and allergen-specific airway hyperreactivity, but without significant improvement in pulmonary function, asthma control or hospitalization.ConclusionsSCIT can reduce the short-term symptom scores and medication scores regardless of different treatment duration or mono/polysensitization, but with an increased incidence of local and systemic adverse effects. Further studies on pediatric asthma are needed to evaluate the long-term efficacy, and clarify the effectiveness of SCIT in specific population using mix allergen extracts or with severe asthma. Overall, it is recommended for children with mild-moderate HDM-driven allergic asthma.
Pharmacological approaches to pulmonary fibrosis following COVID-19
Authors: Lassan Stefan , Tesar Tomas , Tisonova Jana , Lassanova Monika 
Published: June 2023

Background: In the past few years, COVID-19 became the leading cause of morbidity and mortality worldwide. Although the World Health Organization has declared an end to COVID-19 as a public health emergency, it can be expected, that the emerging new cases at the top of previous ones will result in an increasing number of patients with post-COVID-19 sequelae. Despite the fact that the majority of patients recover, severe acute lung tissue injury can in susceptible individuals progress to interstitial pulmonary involvement. Our goal is to provide an overview of various aspects associated with the Post-COVID-19 pulmonary fibrosis with a focus on its potential pharmacological treatment options.Areas covered: We discuss epidemiology, underlying pathobiological mechanisms, and possible risk and predictive factors that were found to be associated with the development of fibrotic lung tissue remodelling. Several pharmacotherapeutic approaches are currently being applied and include anti-fibrotic drugs, prolonged use or pulses of systemic corticosteroids and non-steroidal anti-inflammatory and immunosuppressive drugs. In addition, several repurposed or novel compounds are being investigated. Fortunately, clinical trials focused on pharmacological treatment regimens for post-COVID-19 pulmonary fibrosis have been either designed, completed or are already in progress. However, the results are contrasting so far. High quality randomised clinical trials are urgently needed with respect to the heterogeneity of disease behaviour, patient characteristics and treatable traits.Conclusion: The Post-COVID-19 pulmonary fibrosis contributes to the burden of chronic respiratory consequences among survivors. Currently available pharmacotherapeutic approaches mostly comprise repurposed drugs with a proven efficacy and safety profile, namely, corticosteroids, immunosuppressants and antifibrotics. The role of nintedanib and pirfenidone is promising in this area. However, we still need to verify conditions under which the potential to prevent, slow or stop progression of lung damage will be fulfilled.
Identification of potential quality markers of Zishen Yutai pill based on spectrum–effect relationship analysis
Authors: Wu Sijia , Huang Qiuling , Sheng Feiya , Zhang Lele , Zou Liang , Yang Lele , Cao Jiliang , Pang Xiufei , Ning Na , Li Peng 
Published: June 2023

Introduction: The current quality evaluation of traditional Chinese medicine (TCM) is difficult to attribute to clinical efficacy due to the complexity of TCM. Zishen Yutai pill (ZYP), a well-known traditional Chinese patent medicine, has been widely used to prevent recurrent miscarriage and treat threatened abortion. However, the chemical components of ZYP are unknown, and there is no convincing quality control method applied on ZYP. Although ZYP has been found to promote endometrial receptivity and treat impending abortion, the substantial basis of the therapeutic effects is unclear. The aim of this study was to clarify the quality markers correlated with the potential medicinal activities and provide a theoretical foundation for scientific quality control and product quality improvement of ZYP.Methods: The chemical constituents of ZYP were comprehensively analyzed by offline two-dimensional liquid chromatography-mass spectrometry (2DLC-LTQ-Orbitrap-MS). The efficacy of the 27 ZYP orthogonal groups was investigated using the HTR-8/SVneo oxidative damage model and migration model in vitro, as well as the endometrial receptivity disorder mouse model and premature ovarian failure mouse model in vivo. Based on the efficacy and mass spectral results, spectrum–effect relationship analysis was used to identify the chemical components with corresponding pharmacological activities.Results: A total of 589 chemical components were found in ZYP, of which 139 were not identified in the literature. The potential quality markers for ZYP were successfully identified through orthogonal design and spectrum–effect relationship analysis. By combining mass spectrum data and pharmacological results of 27 orthogonal groups, 39 substances were identified as potential quality markers.Conclusion: The approaches used in this study will provide a feasible strategy for the discovery of quality markers with bioactivity and further investigation into the quality evaluation of TCM.
Life situation of a caregiver of a child with congenital heart defect and/or other cardiac problems: structure and preliminary validation of a new questionnaire
Authors: Kolarczyk Ewelina , Morka Aleksandra , Barański Kamil , Szydłowski Lesław 
Published: June 2023

BackgroundIllness in a child with cardiac disease causes stress, brings additional responsibilities, reorganizes family life, and changes the functioning of the family.AimThis study aimed to validate a new questionnaire evaluating the life situations of caregivers/parents of children with congenital heart disease (CHD) and/or other cardiac diseases (OCD).Materials and methodsThe questionnaire comprised 10 questions aimed at assessing the life situation of an ill child’s caregiver in two main areas: personal and spiritual. The total score of the questionnaire assessing the life situation of the caregiver of a child with a CHD and/or OCD can range from 0 to 32 points, with scores &lt;26 indicating a poor, 25 to 32 indicating an average, and &gt;32 indicating a good level of life situation in the personal sphere of the caregiver. The questionnaire was assessed using Cronbach’s alpha tests, and repeatability was assessed using Cohen’s Kappa test (retest) within a time interval of two to 4  weeks from the first measurement.ResultsThe research covered 50 respondents. Cohesion in the personal sphere obtained a satisfactory value of Cronbach’s α = 0.72, in the spiritual sphere: Cronbach’s α = 0.83, and the result common for both sections was: Cronbach’s α = 0.66.ConclusionThe Life Situation Assessment Questionnaire for caregivers of children with CHD and OCD is a reliable and homogeneous tool for measuring the functioning of parents in the event of a child’s illness.
Models, frameworks and theories in the implementation of programs targeted to reduce formal coercion in mental health settings: a systematic review
Authors: Lantta Tella , Duxbury Joy , Haines-Delmont Alina , Björkdahl Anna , Husum Tonje Lossius , Lickiewicz Jakub , Douzenis Athanassios , Craig Elaine , Goodall Katie , Bora Christina , Whyte Rachel , Whittington Richard 
Published: June 2023

IntroductionImplementation models, frameworks and theories (hereafter tools) provide researchers and clinicians with an approach to understand the processes and mechanisms for the successful implementation of healthcare innovations. Previous research in mental health settings has revealed, that the implementation of coercion reduction programs presents a number of challenges. However, there is a lack of systematized knowledge of whether the advantages of implementation science have been utilized in this field of research. This systematic review aims to gain a better understanding of which tools have been used by studies when implementing programs aiming to reduce formal coercion in mental health settings, and what implementation outcomes they have reported.MethodsA systematic search was conducted using PubMed, CINAHL, PsycINFO, Cochrane, Scopus, and Web of Science. A manual search was used to supplement database searches. Quality appraisal of included studies was undertaken using MMAT—Mixed Methods Appraisal Tool. A descriptive and narrative synthesis was formed based on extracted data. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed in this review.ResultsWe identified 5,295 references after duplicates were removed. Four additional references were found with a manual search. In total eight studies reported in nine papers were included in the review. Coercion reduction programs that were implemented included those that were holistic, and/or used professional judgement, staff training and sensory modulation interventions. Eight different implementation tools were identified from the included studies. None of them reported all eight implementation outcomes sought from the papers. The most frequently reported outcomes were acceptability (4/8 studies) and adaptation (3/8). With regards to implementation costs, no data were provided by any of the studies. The quality of the studies was assessed to be overall quite low.DiscussionSystematic implementation tools are seldom used when efforts are being made to embed interventions to reduce coercive measures in routine mental health care. More high-quality studies are needed in the research area that also involves perspectives of service users and carers. In addition, based on our review, it is unclear what the costs and resources are needed to implement complex interventions with the guidance of an implementation tool.Systematic review registration[Prospero], identifier [CRD42021284959].
Nutritional factors and cross-national postpartum depression prevalence: an updated meta-analysis and meta-regression of 412 studies from 46 countries
Authors: Fish-Williamson Adi , Hahn-Holbrook Jennifer 
Published: June 2023

BackgroundPostpartum depression (PPD) is the most common complication associated with childbirth and can lead to adverse outcomes for both mothers and their children. A previous meta-analysis found that PPD prevalence varies widely across countries. One potential underexplored contributor to this cross-national variation in PPD is diet, which contributes to mental health and varies significantly around the world. Here, we sought to update the global and national estimates of PPD prevalence using systematic review and meta-analysis. Further, we examined whether cross-national variation in PPD prevalence is associated with cross-national variation in diet using meta-regression.MethodsTo estimate national rates of PPD prevalence, we conducted an updated systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale between 2016–2021 and combined our findings with a previous meta-analysis of articles published between 1985–2015. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To examine dietary predictors, we extracted data on sugar-sweetened beverage, fruit, vegetable, total fiber, yogurt, and seafood consumption from the Global Dietary Database. Random effects meta-regression was used to test whether between-country and within-country variation in dietary factors predicted variation in PPD prevalence, controlling for economic and methodological variables.Results412 studies of 792,055 women from 46 countries were identified. The global pooled prevalence of PPD was 19.18% (95% confidence interval: 18.02 to 20.34%), ranging from 3% in Singapore to 44% in South Africa. Countries that consumed more sugar-sweetened beverages (SSBs) had higher rates of PPD (Coef. = 0.325, p = 0.044, CI:0.010–0.680); Moreover, in years when higher rates of sugar-sweetened beverages were consumed in a country, there were correspondingly higher rates of PPD in that country (Coef. = 0.129, p = 0.026, CI: 0.016–0.242).ConclusionThe global prevalence of PPD is greater than previous calculations, and drastically varies by country. Sugar-sweetened beverage consumption explained some of the national variation in PPD prevalence.