bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating D-Dimer Thresholds into the Revised Caprini Risk Stratification to Predict Deep Vein Thrombosis Risk in Preoperative Knee Osteoarthritis Patients
Authors: Guo Yi-Feng , Zhang Dingding , Chen Yaping , Liu Weinan , Gao Na , Weng Xisheng , Lin Jin , Jin Jin , Qian Wenwei , Yang Xu , Zhang Yin-Ping , Huo Xiaopeng 
Published: January 2025

Introduction Preoperative patients with knee osteoarthritis have a significantly increased risk of venous thromboembolism (VTE). While the Caprini risk assessment model offers some clinical guidance in predicting deep vein thrombosis (DVT), it has a relatively low predictive accuracy. Enhancing the model by integrating biomarkers, such as D-dimers, can potentially improve its accuracy. In this study, we explored the effectiveness of combining the Caprini risk model with D-dimer levels for individualized DVT risk assessment in patients with knee osteoarthritis. Materials and Methods This retrospective cohort study included 1605 knee osteoarthritis patients scheduled for total knee arthroplasty from Peking Union Medical College Hospital, screened between January 2015 and December 2018. A revised Caprini risk stratification model was developed, and a predictive DVT model was developed based on this revised system. The sensitivity, specificity, and the area under the curve (AUC) were used to determine predictive effectiveness of the model. Results In the revised Caprini risk stratification, the incidence of DVT increased with higher risk levels: 2.52% in the low-risk group (scores 0-2), 2.88% in the moderate-risk group (score 3), 6.47% in the high-risk group (score 4), and 9.09% in the highest-risk group (score ≥ 5). The incidence of DVT was 3.869-fold higher in the highest-risk group and 2.676-fold higher in the high-risk group compared to the low-risk group (p = 0.013 and p = 0.014, respectively). Combining the revised Caprini risk stratification with D-dimer level demonstrated an improved AUC of 0.792, compared to D-dimer level alone (AUC 0.774) and the revised Caprini model alone (AUC 0.598). Furthermore, applying specific D-dimer thresholds across the four Caprini risk stratifications outperformed the combination of the revised Caprini model and D-dimer level in terms of AUC, specificity, and reduction in unnecessary ultrasonography. Using the Youden index, the AUC for the threshold-based method was slightly higher (0.775 vs 0.754, p = 0.310), with significantly better specificity (76.8% vs 63.6%, p < 0.001) and a greater reduction in ultrasound use (74.1% vs 61.4%). At a sensitivity of 85.5%, the differences were modest but still favored the threshold-based approach. At a sensitivity of 100%, the specificity (36.0% vs 24.7%, p < 0.001) and ultrasound reduction (34.8% vs 23.9%) were significantly better. Conclusion The revised Caprini risk stratification improves preoperative DVT prediction in patients with knee osteoarthritis. Incorporating specific D-dimer thresholds into the four-level Caprini risk model enhances specificity and reduces unnecessary ultrasonography, outperforming both the use of individual indicators and the combination of the revised Caprini model with D-dimer level.
The effectiveness of inhaled methoxyflurane compared to procedural sedation for the reduction of acute traumatic limb injuries – a systematic review and meta-analysis
Authors: Dowsing Joe , Price James , Hibberd Owen , Thomas Stephen H. , Barnard Edward B.G. 
Published: January 2025

Background Manipulation and reduction (M&R) of an injured limb is often required to reduce pain, bleeding and restore anatomical alignment, typically using procedural sedation and analgesia (PSA). Inhaled methoxyflurane (IMF) may be a suitable alternative that is simple to administer, does not require intravenous access, and has a favourable side effect profile. The objective of this systematic review and meta-analysis was to determine the effectiveness of IMF compared to PSA for M&R in acute traumatic limb injury. The primary outcome measure was procedural success rate. The secondary outcomes were to compare the length of stay, adverse events, patient satisfaction and cost-effectiveness. Methods This systematic review was planned, conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and is registered on PROSPERO CRD42024561087. A literature search was conducted and included studies from database inception to the search date (22 February 2024), using MEDLINE, EMBASE, Cochrane, CINAHL and PubMed platforms. All studies involving the use of IMF for M&R of acute traumatic limb injuries were included. Animal studies, case-reports, non-English language publications and opinion articles were excluded. The risk of bias was assessed using the Risk of Bias in Non-Randomised Studies of Interventions (ROBINS-I) tool. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Meta-analysis was undertaken for the primary outcome of procedural success. Narrative synthesis was undertaken for the themes of length of stay, adverse events, patient satisfaction and cost-effectiveness. Results Fifty one abstracts were screened through a database search, reference review, and search of the grey literature. Following full-text review and exclusions, a total of six studies were included, with two suitable for meta-analysis. No significant differences in performance were observed between IMF and PSA (RR 0.90, 95% confidence interval 0.77–1.04, p = 0.16). Patients receiving IMF had a shorter emergency department length of stay, a low incidence of adverse events, and overall positive patient satisfaction. There may be cost-savings associated with the use of IMF. Conclusion Inhaled methoxyflurane was observed to perform no differently to procedural sedation for the successful manipulation and reduction of acute traumatic limb injuries in the emergency department. The overall quality of the evidence is poor, and further higher-level evidence is required.
Subacute distal radio-ulnar joint subluxation after a distal radius fracture
Authors: Giddins Grey , Fraser Tristan , Lambert Robert 
Published: January 2025

We report a series of 12 patients who developed early distal radioulnar joint subluxation after a distal radial fracture, not present on the initial radiographs. Early identification and management of this condition can give good clinical results. Level of evidence: IV
The impact of rhythm perception on chest compression rate during CPR: Insights from a pilot simulation study
Authors: Peran David , Bohm Pavel , Petru Matej , Kubalova Jana 
Published: January 2025

Objective: This pilot study aims to assess how individuals with rhythm perception, particularly musicians, are able to maintain the predefined chest compression rate during cardiopulmonary resuscitation compared to people without rhythm perception. Methods: The study was conducted at the Pilsen Emergency Medicine Conference (Czechia) using a simulation-based cohort design. Participants performed chest compressions on a manikin for 120 s, with the first 10 s guided by a metronome. Participants were grouped based on self-reported rhythmic perception, such as playing a musical instrument. The primary outcome was the average chest compression rate per minute. Results: A total of 67 participants were included. Both groups provided chest compression rate within the recommended limits. Musicians maintained a better chest compression rate (mean 110.56 compressions per minute) compared to nonmusicians (mean 107.31; T-test, p = 0.00074). Those with any rhythmic perception experience also performed better ( T-test, p = 0.036931). Secondary factors, including gender, clinical experience, and prior resuscitation training, did not significantly affect the results. Conclusion: This study demonstrates that individuals with rhythm perception, especially musicians, follow the predefined frequency of chest compressions more effectively.
Consistency between headache diagnoses and ICHD-3 criteria across different levels of care
Authors: Overeem Lucas Hendrik , Ulrich Marlene , Fitzek Mira Pauline , Lange Kristin Sophie , Hong Ja Bin , Reuter Uwe , Raffaelli Bianca 
Published: January 2025

Abstract
Background
Diagnosing headache disorders poses significant challenges, particularly in primary and secondary levels of care (PSLC), potentially leading to misdiagnosis and underdiagnosis. This study evaluates diagnostic agreement for migraine, tension-type headache (TTH), and cluster headache (CH) between PSLC and tertiary care (TLC) and assesses adherence to the International Classification of Headache Disorders 3rd edition (ICHD-3) guidelines.

Methods
A retrospective, cross-sectional analysis was conducted at Charité - Universitätsmedizin Berlin’s tertiary headache center. The patients’ self-reported diagnoses from the PSLC were compared with those in TLC and with ICHD-3 criteria. Cohen’s kappa (κ) and R² were used to assess diagnostic agreement.

Results
Among 1,468 patients (43.4 ± 14.4 years; 74.5% women), 69.5% reported a diagnosis in PSLC, and 99.5% were diagnosed at their first TLC visit. Overall agreement between PSLC and TLC was 80% (κ = 0.55; R²=30%). Agreement between the PSLC and ICHD-3 was 77% for migraine, 82% for TTH, and 96% for CH (κ = 0.65; R²=41%). TLC diagnoses aligned with ICHD-3 in over 90%.

Conclusion
Our findings indicate a significant degree of diagnostic agreement across different levels of care according to the ICHD-3 guidelines. However, there remains insufficient reliability in clinical diagnostics, highlighting the need for continued efforts to improve the early recognition and diagnostic accuracy and consistency of primary headaches to optimize patient care and treatment outcomes in Germany.
Diagnostic role of circulating long non-coding RNA LINC00312 in patients with non-small cell lung cancer: a retrospective study
Authors: Zhang Ruoqian , Jiang Yan , Gu Jing , Zhang Xilin , Xie Yanping 
Published: January 2025

Abstract
Background
LINC00312 has shown to play a suppressive role in the development and progression of non-small cell lung cancer (NSCLC). However, the expression pattern and diagnostic role of circulating LINC00312 in NSCLC remain to be confused.

Methods
A total of 319 patients diagnosed with NSCLC and 180 healthy volunteers were enrolled from the First Affiliated Hospital of Huzhou University between January, 2022 and December, 2023. The participates were randomly assigned into the training and validation groups with a ratio of 6:4, while the remaining was named as the exosomal group. Reverse transcription-quantitative PCR (RT-qPCR) was employed to investigate the expression pattern of LINC00312 in NSCLC tissues, serum samples and cell lines. Receiver operating characteristic (ROC) curve analysis was carried out for distinguishing NSCLC from healthy volunteers.

Results
Here, we revealed that LINC00312 was lowly expressed in NSCLC and low LINC00312 expression manifested a poor prognosis. Additionally, compared with the healthy volunteer group, a reduction of circulating LINC00312 in patients with NSCLC was observed in both the training and validation groups. Further correlation analysis indicated that circulating LINC00312 expression was tightly associated with lymph node metastasis, cancer thrombus, spread through air space (STAS) status and pathological type. Moreover, circulating LINC00312 showed a good performance to distinguish NSCLC from healthy volunteers with a higher sensitivity and specificity values. Lastly, exosomal LINC00312 level was also decreased in NSCLC compared with in healthy volunteers.

Conclusions
Taken together, these data unveil that circulating LINC00312 was notably downregulated in NSCLC, offering a novel non-invasive marker for diagnosis of NSCLC.
Effectiveness of a comic book intervention on mental health literacy among adolescents and youth in Burkina Faso: a randomized controlled trial protocol
Authors: Brandt Irene , Some Sylvain , Millogo Ourohiré , Sourabié Oumar , Burns Jacob , Shinde Sachin , Haucke Matthias , Sivewright Nathan , Neumann Christine , Bajaria Shraddha , Napon Katian , Dah Clarisse , Taonda Marina , Siegel Jason T. , Sando Mary Mwanyika , Bärnighausen Till , Sié Ali , Liu Shuyan 
Published: January 2025

Abstract
Background
In Burkina Faso, nearly half of the population is under 15 years old, and one in four adolescents experience depression. This underscores the critical need to enhance mental health literacy among adolescents and youth, empowering them to manage their mental well-being effectively. Comic books offer an engaging approach to health education, yet their effectiveness in addressing mental health remains largely untested. Our study aims to fill this gap by evaluating the effectiveness of comic books in enhancing mental health literacy among adolescents and young adults aged 10–24 years.

Methods
We will recruit 2,007 participants aged 10–24, stratify them by age, and randomly assign them to three groups (1:1:1): a comic book intervention group (Intervention 1), a text-only flyer group (Intervention 2), and a control group with no intervention. The primary outcome will be mental health literacy and secondary outcomes will include anxiety, depression, and intentions to cope.

Discussion
We hypothesize that the comic book intervention and flyer intervention will prove more effective in improving mental health literacy than the control group. We further hypothesize that for younger adolescents (10–14), the comic book will be more effective at increasing mental health literacy than the flyer. Conversely, we hypothesize that the flyer will be more effective in increasing mental health literacy for older adolescents (15–24). Our study will provide evidence on novel interventions designed to enhance mental health literacy among adolescents and young adults in low-resource settings.

Trial registration
This trial has been registered on the German Clinical Trials Register (DRKS), with the registration number DRKS00034242.
Effects of self-monitoring physical activity with wearable activity trackers on perceived joint function and health-related quality of life in people with hip and knee osteoarthritis: a secondary analysis of a cluster-randomised clinical trial
Authors: Östlind Elin , Eek Frida , Stigmar Kjerstin , Ekvall Hansson Eva 
Published: January 2025

Abstract
Background
Osteoarthritis (OA) often leads to pain and functional limitations, impacting work and daily life. Physical activity (PA) is an important part of the treatment. Wearable activity trackers (WATs) offer a novel approach to promote PA but could also aid in finding a sustainable PA level over time. The aim of this secondary analysis was to examine the effects of self-monitoring PA with a WAT on perceived joint function and health-related quality of life in people with hip and knee OA.

Method
A two-armed cluster-randomized controlled trial (C-RCT) was conducted in southern Sweden including 160 individuals with hip or knee OA. The participants were cluster-randomized to a Supported Osteoarthritis Self-management Program (SOASP) with the addition of self-monitoring PA using a commercial WAT for 12 weeks (n = 86), or only the SOASP (n = 74). The outcomes include perceived joint function measured with HOOS/KOOS and health-related quality of Life (HRQoL) measured with EQ-5D-3L index and EQ VAS. Participants responded to the questionnaires at baseline and at follow-up after 3, 6 and 12 months. Statistical analyses involved linear mixed models, ANCOVA and paired t-test.

Results
Participants with data from baseline and at least one follow-up were included in the analyses (n = 124). The analyses showed no statistically significant differences in changes between the groups in perceived joint function or HRQoL throughout the study period. Both groups improved in pain and symptoms, but the changes were small.

Conclusion
The addition of WAT-use did not have any effect on perceived joint function or HRQoL. The participants’ relatively high baseline scores might have influenced the outcomes of this study. We suggest that future WAT-interventions target inactive people with OA and use devices that also captures other activities such as cycling or aquatic exercise.

Trial registration
ClinicalTrials.gov, NCT03354091. Registered 15/11/2017.
Barriers and facilitators for the implementation of delayed-prescription of antibiotics in family medicine: a qualitative study
Authors: Rinaldi Aline , Petrocchi Serena , Gabutti Luca , Bullo Anna , Schulz Peter Johannes 
Published: January 2025

Abstract
Background
Delayed prescription is a strategy used in various countries to reduce antibiotic overuse and contend the effects of antibiotic resistance; however this practice is not yet used in Switzerland. The present qualitative study was thus conducted to investigate Swiss patients’ attitudes towards the possible implementation of delayed prescription.

Method
Five focus groups with the general population based on a fixed script of questions to elicit opinions on delayed prescription.

Results
A total of 29 participants were involved (M = 39,76 years of age, SD = 15,91; 19 females). Participants naturally polarized into two distinct groups: one expressing attitudes against delayed prescription and the other in favor of such practice. One driver for their opposing stance was their pre-existing negative attitudes about the use of antibiotics. Other relevant themes contributing to the formation of one’s opinion on delayed prescription included the participants’ perceived convenience of this prescribing practice and their desired level of autonomy during and after a medical encounter. Another theme that emerged was the potential impact of these stances on the interpersonal relationship between doctors and their patients.

Conclusion
The present study highlights the existence of several barriers and facilitators perceived by patients. Should delayed prescription be implemented in Switzerland, these results will inform policymakers about patients’ attitudes towards the practice. Doctors may also benefit from this study as it identifies the limitations to consider when discussing treatment options with patients.
Exploring the effects of gut microbiota on cholangiocarcinoma progression by patient-derived organoids
Authors: Lederer Ann-Kathrin , Görrissen Nele , Nguyen Tinh Thi , Kreutz Clemens , Rasel Hannah , Bartsch Fabian , Lang Hauke , Endres Kristina 
Published: January 2025

Abstract
Background
Recent research indicates a role of gut microbiota in development and progression of life-threatening diseases such as cancer. Carcinomas of the biliary ducts, the so-called cholangiocarcinomas, are known for their aggressive tumor biology, implying poor prognosis of affected patients. An impact of the gut microbiota on cholangiocarcinoma development and progression is plausible due to the enterohepatic circulation and is therefore the subject of scientific debate, however evidence is still lacking. This review aimed to discuss the suitability of complex cell culture models to investigate the role of gut microbiota in cholangiocarcinoma progression.

Main body
Clinical research in this area is challenging due to poor comparability of patients and feasibility reasons, which is why translational models are needed to understand the basis of tumor progression in cholangiocarcinoma. A promising approach to investigate the influence of gut microbiota could be an organoid model. Organoids are 3D cell models cultivated in a modifiable and controlled condition, which can be grown from tumor tissue. 3D cell models are able to imitate physiological and pathological processes in the human body and thus contribute to a better understanding of health and disease.

Conclusion
The use of complex cell cultures such as organoids and organoid co-cultures might be powerful and valuable tools to study not only the growth behavior and growth of cholangiocarcinoma cells, but also the interaction with the tumor microenvironment and with components of the gut microbiota.
Biophysical mapping of TREM2-ligand interactions reveals shared surfaces for engagement of multiple Alzheimer’s disease ligands
Authors: Greven Jessica A. , Wydra Joshua R. , Greer Rory A. , Zhi Cynthia , Price David A. , Svoboda Jordyn D. , Camitta Christopher L. M. , Washington Mya , Leung Daisy W. , Song Yuhua , Alexander-Brett Jen , Brett Tom J. 
Published: January 2025

AbstractTREM2 is a signaling receptor expressed on microglia that has emerged as an important drug target for Alzheimer’s disease and other neurodegenerative diseases. While a number of TREM2 ligands have been identified, little is known regarding the structural details of how they engage. To better understand this, we created a protein library of 28 different TREM2 variants that could be used to map interactions with various ligands using biolayer interferometry. The variants are located in previously identified putative binding surfaces on TREM2 called the hydrophobic site, basic site, and site 2. We found that mutations to the hydrophobic site ablated binding to apoE4 and TDP-43. Competition binding experiments indicated that apoE4 and oAβ42 share overlapping binding sites on TREM2. In contrast, binding to C1q was disrupted most strongly by mutations to the basic site, including R46, with some mutations to the hydrophobic site also attenuating binding, thus suggesting a broader mediation of binding across the two sites. Supporting this, competition experiments indicated that C1q binding could be blocked by both apoE and oAβ42. TREM2 binding to IL-34 was mediated by the basic site at a surface centering on R76. Competition binding experiments validated the unique site for IL-34, showing little to no competition with either oAβ42 or apoE4. However, competition experiments between C1q and IL34 suggest that the ligands compete for binding at the basic site. Altogether, our results suggest that TREM2 utilizes the hydrophobic site (consisting of CDR1, CDR2, and CDR3) as a common site to engage multiple ligands, and uses distinct basic sites to engage others. Our findings imply that pharmaceutical strategies targeting these surfaces might be effective to modulate TREM2 functions.
Graph pangenome reveals the regulation of malate content in blood-fleshed peach by NAC transcription factors
Authors: Chen Wenbo , Xie Qi , Fu Jia , Li Shaojia , Shi Yanna , Lu Jiao , Zhang Yuanyuan , Zhao Yingjie , Ma Ruijuan , Li Baijun , Zhang Bo , Grierson Donald , Yu Mingliang , Fei Zhangjun , Chen Kunsong 
Published: January 2025

Abstract
Background
Fruit acidity and color are important quality attributes in peaches. Although there are some exceptions, blood-fleshed peaches typically have a sour taste. However, little is known about the genetic variations linking organic acid and color regulation in peaches.

Results
Here, we report a peach graph-based pangenome constructed from sixteen individual genome assemblies, capturing abundant structural variations and 82.3 Mb of sequences absent in the reference genome. Pangenome analysis reveals a long terminal repeat retrotransposon insertion in the promoter of the NAC transcription factor (TF) PpBL in blood-fleshed peaches, which enhances PpBL expression. Genome-wide association study identifies a significant association between PpBL and malate content. Silencing PpBL in peach fruit and ectopic overexpression of PpBL in tomatoes confirm that PpBL is a positive regulator of malate accumulation. Furthermore, we demonstrate that PpBL works synergistically with another NAC TF, PpNAC1, to activate the transcription of the aluminum-activated malate transporter PpALMT4, leading to increased malate content.

Conclusions
These findings, along with previous research showing that PpBL and PpNAC1 also regulate anthocyanin accumulation, explain the red coloration and sour taste in blood-fleshed peach fruits.