bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telemedicine for follow-up of systemic lupus erythematosus during the 2019 coronavirus pandemic: A pragmatic randomized controlled trial
Authors: So Ho , Chow Evelyn , Cheng Isaac T , Lau Sze-Lok , Li Tena K , Szeto Cheuk-Chun , Tam Lai-Shan 
Published: June 2023

Introduction Patients with systemic lupus erythematous were vulnerable to severe coronavirus disease 2019 infection and the negative impact of disrupted healthcare delivery. Telemedicine has been a popular alternative to standard in-person care during the pandemic despite the lack of evidence. Methods This was a 1-year pragmatic randomized-controlled trial. Patients followed at the lupus nephritis clinic were randomized to either telemedicine or standard follow-up in a 1:1 ratio. Patients in the telemedicine group were followed up via videoconferencing. Standard follow-up group patients continued conventional in-person outpatient care. The primary outcome of the study was the proportion of patients in low disease activity after 1 year. Secondary outcomes included cost-of-illness, safety, and various patient-reported outcomes. Results From 6/2020 to 12/2021, 144 patients were randomized and 141 patients (telemedicine: 70, standard follow-up: 71) completed the study. At 1 year, 80.0% and 80.2% of the patients in the telemedicine group and standard follow-up group were in lupus low disease activity state or complete remission, respectively ( p = 0.967). Systemic lupus erythematous disease activity indices, number of flares and frequency of follow-ups were also similar. There were no differences in the cost-of-illness, quality of life or mental health scores. However, significantly more patients in the telemedicine group (41.4% vs 5.6%; p < 0.001) required switch of mode of follow-up and higher proportion of them had hospitalization during the study period (32.9% vs 15.5%; p = 0.016). Being in the telemedicine group or not in low disease activity at baseline were the independent predictors of hospitalization (odds ratio: 2.6; 95% confidence interval: 1.1–6.1, odds ratio: 2.7, 95% confidence interval: 1.1–6.7, respectively) in the post hoc analysis. Conclusions In patients with systemic lupus erythematous, telemedicine predominant follow-up resulted in similar 1-year disease control compared to standard care. However, it needed to be complemented by in-person visits, especially in patients with unstable disease.
Comparative efficacy and safety of various mechanical thrombectomy strategies for patients with acute ischemic stroke: a Bayesian network meta-analysis
Authors: Meng Jiahao , Yan Zeya , Zhang Jie , Wang Wei , Tao Xinyu , Gu Feng , Yang Xingyu , Xue Tao , You Wanchun , Chen Zhouqing , Wang Zhong , Chen Gang 
Published: June 2023

Background: Stent retriever, contact aspiration, and combined treatment are crucial mechanical thrombectomy strategies for patients with acute ischemic stroke (AIS). Objectives: The aim of this study was to compare and rank three different mechanical thrombectomy strategies for AIS due to large vessel occlusion by means of a Bayesian network meta-analysis. Design: A systematic review and Bayesian network meta-analysis based on PRISMA guidelines. Data sources and methods: Relevant randomized controlled trials (RCTs) were identified in Embase, MEDLINE, the Cochrane Library database, and Clinicaltrials.gov from inception to 15 March 2022. We used random effect models to estimate corresponding odds ratios (ORs) and rank probabilities using pairwise and Bayesian network meta-analysis. We applied the grading of recommendations assessment, development, and evaluation (GRADE) methodology to rate the certainty of evidence. Results: We identified 10 RCTs enrolling 2098 participants. As for modified Rankin Scale (mRS) 0–2, moderate certainty evidence established all mechanical thrombectomy strategies that were more effective than standard medical treatment [combined: log OR 0.9288, 95% credibility intervals (CrI) 0.1268–1.7246; contact aspiration: log OR 0.9507, 95% CrI 0.3361–1.5688; stent retriever: log OR 1.0919, 95% CrI 0.6127–1.5702]. The same applied to mRS 0–3 (combined: log OR 0.9603, 95% CrI 0.2122–1.7157; contact aspiration: log OR 0.7554, 95% CrI 0.1769–1.3279; stent retriever: log OR 1.0046, 95% CrI 0.6001–1.4789). Combined treatment was superior to stent retriever in substantial reperfusion (log OR 0.8921, 95% CrI 0.2105–1.5907, high certainty). Stent retriever had the highest probability of being optimal for mRS 0–2 and mRS 0–3. Standard medical treatment had the lowest risk of subarachnoid hemorrhage. For all other outcomes, combined treatment was most likely the best treatment. Conclusion: Our results indicated that, with the exception of functional outcome, combined treatment might be the outstanding strategy. Apart from subarachnoid hemorrhage, all three mechanical thrombectomy strategies proved better strategies than standard medical treatment. Registration: PROSPERO (CRD42022351878).
Potential of social engagement for overcoming barriers to physical activity in individuals with spinal cord injury
Authors: Canori Alexandra , Lakshminarayanan Rithika , Nunn Melissa , Schmidt-Read Mary , Intille Stephen S , Hiremath Shivayogi V 
Published: June 2023

Introduction Many barriers to physical activity (PA) exist for individuals with spinal cord injury (SCI). Social engagement may improve motivation to perform PA, which in turn may increase PA levels. This pilot study investigates how social engagement facilitated by mobile technology may reduce lack of motivation as a barrier to PA in individuals with SCI and demonstrates design implications for future technologies. Methods A user-needs survey was conducted with participants in the community. We recruited 26 participants (16 individuals with SCI and 10 family members or peers). A participatory design process using semi-structured interviews was used to identify themes relating to PA barriers. Results One theme related to PA barriers was lack of PA-focused forums to connect with peers. Participants with SCI considered connecting with other individuals with SCI more motivating than connecting with their family members. Another key finding was that participants with SCI did not perceive that personal fitness trackers were targeted towards wheelchair-based activities. Conclusions Engagement and communication with peers who have similar functional mobility levels and life experiences can potentially improve motivation for PA; however, PA-motivational platforms are not tailored towards wheelchair-users. Our preliminary findings show that some individuals with SCI are not satisfied with current mobile-technologies for wheelchair-based PA.
Quantifying the changes in body mass index and performance status during androgen deprivation therapy for advanced prostate cancer in southeast Nigeria
Authors: Okolie Louis Tochukwu , Nnabugwu Ikenna Ifeanyi , Echetabu Kevin Ndubuisi , Anikwe Obinna Nnabuife , Anyimba Solomon Kenechukwu , Ozoemena Francis Oyiogu 
Published: June 2023

Abstract
Background
Androgen deprivation therapy (ADT) for advanced prostate cancer (aPCa) causes changes in body mass index (BMI) and in the performance status depending on the extent of cancer remission. The aim of this study is to quantify these changes.

Methods
A prospective cohort study in a public tertiary urology centre in Enugu, southeast Nigeria. With appropriate sample size determined, men with aPCa for ADT, by surgical or medical modality, were recruited into a test group (TG), taking note of the Gleason score. A cohort of similar men without malignant or debilitating diseases formed the control group (CG). The age, weight and the Eastern Cooperative Oncology Group (ECOG) score were determined before ADT and at 2 monthly intervals for the TG. Same parameters were assessed for the CG at 2 monthly intervals. Additionally, total prostate-specific antigen (tPSA) was done for the TG at 3 monthly intervals.

Results
In all, 119 men in the TG and 68 men in the CG were recruited with no differences in age (F 2.777; p 0.10) and height (F 0.409; p 0.52) at recruitment. In the TG, BMI increased from 25.20 ± 3.92 to 26.26 ± 3.90 kg/m2 (p 0.001), median tPSA dropped from 36.9 ng/ml (IQR 20.4–65.7) to 3.7 ng/ml (IQR 1.1–8.7) and ECOG score improved (χ2 34.1; df9; p < 0.001) with reduction in the proportion of men with ECOG > 1 from 84.0 to 20.4%. A secondary finding is that gains in BMI and in ECOG score are earlier in the surgical modality than in the medical modality of ADT.

Conclusions
In the first 6 months of ADT, there are gains in BMI and ECOG scores. These gains are earlier with surgical modality of ADT.
Identification and characterization of transcribed enhancers during cerebellar development through enhancer RNA analysis
Authors: Ramirez Miguel , Robert Remi , Yeung Joanna , Wu Joshua , Abdalla-Wyse Ayasha ,   FANTOM 5 Consortium, Goldowitz Daniel 
Published: June 2023

Abstract
Background
The development of the brain requires precise coordination of molecular processes across many cell-types. Underpinning these events are gene expression programs which require intricate regulation by non-coding regulatory sequences known as enhancers. In the context of the developing brain, transcribed enhancers (TEs) regulate temporally-specific expression of genes critical for cell identity and differentiation. Transcription of non-coding RNAs at active enhancer sequences, known as enhancer RNAs (eRNAs), is tightly associated with enhancer activity and has been correlated with target gene expression. TEs have been characterized in a multitude of developing tissues, however their regulatory role has yet to be described in the context of embryonic and early postnatal brain development. In this study, eRNA transcription was analyzed to identify TEs active during cerebellar development, as a proxy for the developing brain. Cap Analysis of Gene Expression followed by sequencing (CAGE-seq) was conducted at 12 stages throughout embryonic and early postnatal cerebellar development.

Results
Temporal analysis of eRNA transcription identified clusters of TEs that peak in activity during either embryonic or postnatal times, highlighting their importance for temporally specific developmental events. Functional analysis of putative target genes identified molecular mechanisms under TE regulation revealing that TEs regulate genes involved in biological processes specific to neurons. We validate enhancer activity using in situ hybridization of eRNA expression from TEs predicted to regulate Nfib, a gene critical for cerebellar granule cell differentiation.

Conclusions
The results of this analysis provide a valuable dataset for the identification of cerebellar enhancers and provide insight into the molecular mechanisms critical for brain development under TE regulation. This dataset is shared with the community through an online resource (https://goldowitzlab.shinyapps.io/trans-enh-app/).
Laboratory risk factors for coexistent primary biliary cholangitis in patients with Sjögren’s syndrome: a retrospective study
Authors: Gao Xuan , Xiao Guangzhi , Yang Fengfan , Dou Rongrong , Xue Miao , Zhang Yingying , Zheng Zhaohui , Ding Jin 
Published: June 2023

Abstract
Background
Limited research exists on the laboratory characteristics of coexistent primary biliary cholangitis (PBC) and Sjögren’s syndrome (SS). This study aimed to investigate the laboratory risk factors for the coexistence of PBC in patients with SS.

Methods
Eighty-two patients with coexistent SS and PBC (median age 52.50 years) and 82 age- and sex-matched SS controls were retrospectively enrolled between July 2015 and July 2021. The clinical and laboratory characteristics of the two groups were compared. Laboratory risk factors for the coexistence of PBC in patients with SS were analyzed using logistic regression analysis.

Results
Both groups had a similar prevalence of hypertension, diabetes, thyroid disease, and interstitial lung disease. Compared with the SS group, patients in the SS + PBC group had higher levels of liver enzymes, immunoglobulins M (IgM), G2, and G3 (P < 0.05). The percentage of patients with an antinuclear antibody (ANA) titre > 1:10000 in the SS + PBC group was 56.1%, higher than that in the SS group (19.5%, P < 0.05). Additionally, cytoplasmic, centromeric, and nuclear membranous patterns of ANA and positive anti-centromere antibody (ACA) were observed more frequently in the SS + PBC group (P < 0.05). Logistic regression analysis showed that elevated IgM levels, high ANA titre, cytoplasmic pattern, and ACA were independent risk factors for PBC coexistence in SS.

Conclusions
In addition to established risk factors, elevated IgM levels, positive ACA, and high ANA titre with cytoplasmic pattern provide clues to clinicians for the early screening and diagnosis of PBC in patients with SS.
Conventional manual technique of post placental IUD insertion versus intra-cesarean post placental introducer withdrawal IUD insertion technique: a new standardized technique for IUD insertion during cesarean section: a randomized controlled trial
Authors: Seleem Mostafa , Sedik Mona M. , Megahed Azza M. M. , Nabil Hala 
Published: June 2023

Abstract
Background
Inserting IUDs during cesarean section reduces the need for more manipulation and discomfort. The current conventional manual technique for IUD insertion during cesarean section is not standardized with many modifications and high rates of expulsion, displacement, missed threads, and discontinuation. This study aims to find a standard technique for IUD insertion during cesarean section with the least possible problems, especially displacement and missed threads.

Methods
A randomized controlled study was conducted at Kasr Al-Ainy Maternity Hospital, Cairo University, Egypt. The study was performed over 12 months, from September 2020 to September 2021. Two groups of patients were selected; each group included 420 patients with a desire for IUD insertion during cesarean section. Group (A) (Control group) was subjected to a post-placental intrauterine device (Copper T380) during cesarean section using a conventional manual method; Group (B) (Study group): the IUD (Copper T380) was placed at the top of the uterine fundus using a new technique (intra-cesarean post placental introducer withdrawal IUD insertion technique).

Results
There was a significant statistical difference between the two groups regarding displacement of the IUDs at the end of puerperium, at 6 months, non-visibility of IUD threads, and continuation of use with p-value < 0.05. There was no significant statistical difference in the term of duration of surgery.

Conclusion
The new technique of post-placental IUD insertion can be the standard technique of intra-cesarean section IUD insertion as it is associated with more favorable outcomes among the included women in the form of lower incidence of IUD displacement, non-visibility of IUD threads, and higher rates of continuation without increasing the duration of surgery as compared with the conventional manual technique.

Trial registration
ClinicalTrial.gov ID: NCT05788354, registration date: 28/03/2023 (retrospectively registered).
Unmet supportive care needs of breast cancer survivors: a systematic scoping review
Authors: Fan Rongrong , Wang Lili , Bu Xiaofan , Wang Wenxiu , Zhu Jing 
Published: June 2023

AbstractBackgroundBreast cancer is the most common type of cancer in women worldwide. Though improved treatments and prolonged overall survival, breast cancer survivors (BCSs) persistently suffer from various unmet supportive care needs (USCNs) throughout the disease. This scoping review aims to synthesize current literature regarding USCNs among BCSs.MethodsThis study followed a scoping review framework. Articles were retrieved from Cochrane Library, PubMed, Embase, Web of Science, and Medline from inception through June 2023, as well as reference lists of relevant literature. Peer-reviewed journal articles were included if USCNs among BCSs were reported. Inclusion/exclusion criteria were adopted to screen articles’ titles and abstracts as well as to entirely assess any potentially pertinent records by two independent researchers. Methodological quality was independently appraised following Joanna Briggs Institute (JBI) critical appraisal tools. Content analytic approach and meta-analysis were performed for qualitative and quantitative studies respectively. Results were reported according to the PRISMA extension for scoping reviews.ResultsA total of 10,574 records were retrieved and 77 studies were included finally. The overall risk of bias was low to moderate. The self-made questionnaire was the most used instrument, followed by The Short-form Supportive Care Needs Survey questionnaire (SCNS-SF34). A total of 16 domains of USCNs were finally identified. Social support (74%), daily activity (54%), sexual/intimacy (52%), fear of cancer recurrence/ spreading (50%), and information support (45%) were the top unmet supportive care needs. Information needs and psychological/emotional needs appeared most frequently. The USCNs was found to be significantly associated with demographic factors, disease factors, and psychological factors.ConclusionBCSs are experiencing a large number of USCNs in fearing of cancer recurrence, daily activity, sexual/intimacy, psychology and information, with proportions ranging from 45% to 74%. Substantial heterogeneity in study populations and assessment tools was observed. There is a need for further research to identify a standard evaluation tool targeted to USCNs on BCSs. Effective interventions based on guidelines should be formulated and conducted to decrease USCNs among BCSs in the future.
Investigating the intensity of social contacts associated with tuberculosis: a weighted networks model
Authors: Amoori Neda , Amini Payam , Cheraghian Bahman , Alavi Seyed Mohammad 
Published: June 2023

Abstract
Background
Tuberculosis is known as one of the principal health problems, especially in developing countries. This study aimed to visualize, statistically model, and describe the weighted networks to investigate the intensity of social contacts associated with tuberculosis.

Methods
In this case–control study, we applied weighted network analysis to assess the network of person-time spent in stores, workplaces, restaurants, mosques, Police bases, homes, hospitals, colleges, hairdressers, schools, contact homes, health centers, cinemas, parks, and markets. Modules will be determined based on the similarities between the variables in a topology overlap matrix. The most important variables will be found considering the association between each variable and module eigenvalues.

Results
The result shows the extracted modules of locations based on the connectivity followed by the person-time at each place. The correlation (p-value) between TB and the turquoise, blue, and brown modules was 0.058 (0.351), 0.004 (0.943), and 0.117 (0.039), respectively. The brown module is the most important one, demonstrating a significant connection between homes, contact homes, health centers, and hospitals. Therefore, an association was found between person-time in four places and the occurrence of TB.

Conclusion
The finding of this study showed that most transmission of tuberculosis infection occurs in homes, contact homes, health centers, and hospitals. These place evaluations allow the identification of people with more contact and in need of screening, so critically leading to the identification of more patients with active TB.
Do malpractice claim clinical case vignettes enhance diagnostic accuracy and acceptance in clinical reasoning education during GP training?
Authors: van Sassen Charlotte , Mamede Silvia , Bos Michiel , van den Broek Walter , Bindels Patrick , Zwaan Laura 
Published: June 2023

AbstractBackgroundUsing malpractice claims cases as vignettes is a promising approach for improving clinical reasoning education (CRE), as malpractice claims can provide a variety of content- and context-rich examples. However, the effect on learning of adding information about a malpractice claim, which may evoke a deeper emotional response, is not yet clear. This study examined whether knowing that a diagnostic error resulted in a malpractice claim affects diagnostic accuracy and self-reported confidence in the diagnosis of future cases. Moreover, suitability of using erroneous cases with and without a malpractice claim for CRE, as judged by participants, was evaluated.MethodsIn the first session of this two-phased, within-subjects experiment, 81 first-year residents of general practice (GP) were exposed to both erroneous cases with (M) and erroneous cases without (NM) malpractice claim information, derived from a malpractice claims database. Participants rated suitability of the cases for CRE on a five-point Likert scale. In the second session, one week later, participants solved four different cases with the same diagnoses. Diagnostic accuracy was measured with three questions, scored on a 0–1 scale: (1) What is your next step? (2) What is your differential diagnosis? (3) What is your most probable diagnosis and what is your level of certainty on this? Both subjective suitability and diagnostic accuracy scores were compared between the versions (M and NM) using repeated measures ANOVA.ResultsThere were no differences in diagnostic accuracy parameters (M vs. NM next step: 0.79 vs. 0.77,p = 0.505; differential diagnosis 0.68 vs. 0.75,p = 0.072; most probable diagnosis 0.52 vs. 0.57,p = 0.216) and self-reported confidence (53.7% vs. 55.8%p = 0.390) of diagnoses previously seen with or without malpractice claim information. Subjective suitability- and complexity scores for the two versions were similar (suitability: 3.68 vs. 3.84,p = 0.568; complexity 3.71 vs. 3.88,p = 0.218) and significantly increased for higher education levels for both versions.ConclusionThe similar diagnostic accuracy rates between cases studied with or without malpractice claim information suggests both versions are equally effective for CRE in GP training. Residents judged both case versions to be similarly suitable for CRE; both were considered more suitable for advanced than for novice learners.