bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systemic sclerosis associated interstitial lung disease: a survey of current practices in France
Authors: Nicolas Amélie , Leroy Sylvie , Mouthon Luc , Uzunhan Yurdagul , Cottin Vincent , Mekinian Arsene , Queyrel Viviane , Hachulla Eric , Gachet Benoit , Launay David , Martis Nihal ,   Groupe Orphalung, Groupe Francophone de Recherche sur la Sclérodermie
Published: May 2023

Background: Interstitial lung disease (ILD) is the leading cause of mortality in systemic sclerosis (SSc). Objective: We performed an overview of the diagnostic approaches, follow-up and treatment strategies used in France for the management of SSc-associated ILD (SSc-ILD). Design: Structured nationwide online survey.Methods: A structured nationwide online survey was submitted to participants via the French Medical Societies for Internal Medicine and Pneumology, and research groups on SSc-ILD from May 2018 to June 2020. The 79 multiple-choice and 9 open-ended questions covered the screening of ILD at baseline, monitoring of patients with established SSc-ILD and its management. Fourteen optional vignettes exploring different clinical phenotypes of SSc-ILD were submitted to evaluate therapeutic decisions. Results: All of the 93 participants screened SSc patients for ILD at baseline with 83 (89%) participants relying on a systematic chest computed tomography (CT) scan. Pulmonary function tests (PFT) were prescribed by 87 (94%) participants at baseline and during follow-up. Treatment was started based on abnormal PFT (95%), chest CT scan characteristics (89%), worsening dyspnoea (72%) and drop in SpO2 during 6-min walk tests (66%). First-line therapy was cyclophosphamide (CYC) (89%), mycophenolate mofetil (MMF) (83%) and prednisone (73%). Rituximab as second-line immunosuppressive therapy (41%) was preferred to antifibrotic agents (18%), and a median daily prednisone dose of 10 mg (interquartile range, 10–15) was prescribed by 73% participants. Extensive SSc-ILD with worsening PFT (95%), regardless of diffusing capacity for carbon monoxide values and skin extension, were more likely to be treated, and CYC was favoured over MMF ( p < 0.01). Extensive SSc-ILD with disease duration of less than 5 years was also a criterium for treatment initiation. Conclusion: This overview of practices in diagnosis, follow-up and treatment of SSc-ILD in France describes real-life management of patients. It highlights heterogeneity in this management and gaps in current strategies that should be addressed to improve and harmonize clinical practices in SSc-ILD.
Diabetes prevention program outcomes by in-person versus distance delivery mode among ethnically diverse, primarily lower-income adults
Authors: Welshons Kate F , Johnson Nikki A , Gold Abby L , Reicks Marla 
Published: May 2023

Objective Physical activity and weight loss outcomes of a diabetes prevention program were compared for ethnically diverse adults, with the majority participating in public assistance programs. Outcomes were compared for those who completed the program in person versus by distance delivery. Methods A two-group, pre–post study design compared National Diabetes Prevention Program outcomes based on in-person delivery (2018–2020 pre-COVID-19 pandemic, n = 47) and distance delivery (after March 2020, n = 31). Outcomes were measured or self-reported depending on the delivery method. Linear mixed models with a random intercept for coach and covariates were used to assess delivery mode group differences in percent weight loss and weekly physical activity minutes. Results Completion rates were similar by in-person versus distance delivery mode (57% vs. 65%). Among those who completed the program, the mean age was 58 years, the mean baseline body mass index was 33, and 39% were Hispanic. The majority were female (87%), participating in a public assistance program (63%), and living in a micropolitan area (61%). Percent weight loss was greater in the distance delivery group (7.7%) compared to the in-person group (4.7%) in the unadjusted analysis ( p = 0.009) but not when adjusted for covariates. No differences were observed in adjusted weekly physical activity minutes between the in-person (219 min) versus the distance group (148 min). Conclusions No differences were observed by delivery mode in percent weight loss or weekly physical activity minutes, indicating that distance delivery does not compromise program effectiveness.
Assessing the healthcare quality issues for digital incident reporting in Sweden: Incident reports analysis
Authors: Rahman Jabin Md Shafiqur , Steen Mary , Wepa Dianne , Bergman Patrick 
Published: May 2023

Objective This study explored healthcare quality issues affecting the reporting and investigation levels of digital incident reporting systems. Methods A total of 38 health information technology-related incident reports (free-text narratives) were collected from one of Sweden's national incident reporting repositories. The incidents were analysed using an existing framework, i.e., the Health Information Technology Classification System, to identify the types of issues and consequences. The framework was applied in two fields, ‘event description’ by the reporters and ‘manufacturer's measures’, to assess the quality of reporting incidents by the reporters. Additionally, the contributing factors, i.e., either human or technical factors for both fields, were identified to evaluate the quality of the reported incidents. Results Five types of issues were identified and changes made between before-and-after investigations: Machine to software-related issues ( n  =  8), machine to use-related issues ( n  =  5), software to software-related issues ( n  =  5), use to software-related issues ( n  =  4) and use to use-related issues ( n  =  1). Over two-thirds ( n  =  15) of the incidents demonstrated a change in the contributing factors after the investigation. Only four incidents were identified as altering the consequences after the investigation. Conclusion This study shed some light on the issues of incident reporting and the gap between the reporting and investigation levels. Facilitating sufficient staff training sessions, agreeing on common terms for health information technology systems, refining the existing classifications systems, enforcing mini-root cause analysis, and ensuring unit-based local reporting and standard national reporting may help bridge the gap between reporting and investigation levels in digital incident reporting.
Assessing the physiological effect of non-driving-related task performance in conditionally automated driving systems: A systematic review and meta-analysis protocol
Authors: Coyne Rory , Ryan Leona , Moustafa Mohamed , Smeaton Alan F , Corcoran Peter , Walsh Jane C 
Published: May 2023

Background Level 3 automated driving systems involve the continuous performance of the driving task by artificial intelligence within set environmental conditions, such as a straight highway. The driver's role in Level 3 is to resume responsibility of the driving task in response to any departure from these conditions. As automation increases, a driver's attention may divert towards non-driving-related tasks (NDRTs), making transitions of control between the system and user more challenging. Safety features such as physiological monitoring thus become important with increasing vehicle automation. However, to date there has been no attempt to synthesise the evidence for the effect of NDRT engagement on drivers’ physiological responses in Level 3 automation. Methods A comprehensive search of the electronic databases MEDLINE, EMBASE, Web of Science, PsycINFO, and IEEE Explore will be conducted. Empirical studies assessing the effect of NDRT engagement on at least one physiological parameter during Level 3 automation, in comparison with a control group or baseline condition will be included. Screening will take place in two stages, and the process will be outlined within a PRISMA flow diagram. Relevant physiological data will be extracted from studies and analysed using a series of meta-analyses by outcome. A risk of bias assessment will also be completed on the sample. Conclusion This review will be the first to appraise the evidence for the physiological effect of NDRT engagement during Level 3 automation, and will have implications for future empirical research and the development of driver state monitoring systems.
Academic and Wellness Outcomes Associated with use of Anki Spaced Repetition Software in Medical School
Authors: Wothe Jillian K , Wanberg Lindsey J , Hohle Rae D , Sakher Aliya A , Bosacker Laura E , Khan Faizel , Olson Andrew PJ , Satin David J 
Published: May 2023

OBJECTIVES Medical students are increasingly using a spaced repetition software called Anki to study. There are limited studies evaluating the relationship between Anki and learner outcomes. In this study, we describe the history of Anki use in medical school and assess the potential relationships between use of Anki and medical student academic, extracurricular, and wellness outcomes. METHODS We used cross-sectional data from a 50-item online survey and retrospective academic performance data from our institution's outcomes database. Participants were medical students. The survey assessed the frequency and timing of Anki use, student perceived stress, sleep quality, burnout risk, and involvement in extracurricular activities. Academic success was measured by USMLE Step 1 and Step 2 scores. RESULTS 165 students responded survey. 92 (56%) identified as daily Anki users. Daily Anki use was correlated with increased Step 1 score ( P = .039), but not Step 2 scores. There was an association between Anki use and increased sleep quality ( P = .01), but no difference for other measurements of wellness or extracurricular involvement. CONCLUSION The study demonstrates potential benefits of daily use of Anki but also confirms that a variety of study methods can be used to achieve similar medical school outcomes.
Delayed Esophagectomy is Associated With Inferior Survival: A National Cancer Database Study
Authors: Dolan Daniel Powell , Kanagasegar Nithya , Dingillo Gianna , Alvarado Christine E. , Badrinathan Avanti , Bassiri Aria , Rice Jonathan D. , Sinopoli Jillian , Tapias Leonidas , Linden Philip A. , Towe Christopher W. 
Published: May 2023

Background: Locoregionally advanced esophageal cancer is typically treated with neoadjuvant chemoradiation followed by surgery 4 to 8 weeks later. Occasionally surgery is delayed >12 weeks; outcomes of this approach are not well studied. We hypothesized that delayed esophagectomy after chemoradiation would have inferior long-term overall survival relative to planned trimodality esophagectomy. Methods: Adult patients with locally advanced esophageal cancer (T2−4aN0M0, T0−4aN+M0) who received multi-agent chemotherapy, radiation, and esophagectomy were identified in the 2018 National Cancer Database. Esophagectomy performed within 90 days from end of chemoradiation were categorized as “trimodality” and those ≥90 days were categorized as “delayed.” Primary outcome was overall survival measured using Kaplan-Meier estimates and Cox proportional hazard models. Secondary outcomes included surgical margin status, hospital length of stay, and readmission. Results: Included were 19 698 patients, 3905 (19.8%) “delayed.” Median time to surgery for trimodality patients was 51 days (IQR 41-63) versus 110 days (IQR 98-131) for delayed patients. Delayed patients tended to be older, non-white, have non-private insurance, and have more comorbidities. Overall survival was shorter for delayed patients (34.8 months) versus trimodality patients (43.1 months, P ≤ .001). In multivariable analysis, delay was associated with inferior overall survival (HR 1.15, 95% CI 1.08-1.23). Length of stay and readmission rate were similar between cohorts, but delay was associated with a higher rate of positive surgical margins (6.7% vs 4.6%, P ≤ .001). Conclusions: In the National Cancer Database, delayed esophagectomy is associated with inferior long-term survival. Nonetheless, delayed esophagectomy may be appropriate for select patients; further research is needed to identify the optimal approach.
External validation and longitudinal application of the DO-GAP index to individualise survival prediction in idiopathic pulmonary fibrosis
Authors: Chandel Abhimanyu , King Christopher S. , Ignacio Rosalinda V. , Pastre Jean , Shlobin Oksana A. , Khangoora Vikramjit , Aryal Shambhu , Nyquist Alan , Singhal Anju , Flaherty Kevin R. , Nathan Steven D. 
Published: May 2023

BackgroundThe Distance-Oxygen-Gender-Age-Physiology (DO-GAP) index has been shown to improve prognostication in idiopathic pulmonary fibrosis (IPF) compared to the Gender-Age-Physiology (GAP) score. We sought to externally validate the DO-GAP index compared to the GAP index for baseline risk assessment in patients with IPF. Additionally, we evaluated the utility of serial change in the DO-GAP index in predicting survival.MethodsWe performed an analysis of patients with IPF from the Pulmonary Fibrosis Foundation-Patient Registry (PFF-PR). Discrimination and calibration of the two models were assessed to predict transplant-free survival and IPF-related mortality. Joint longitudinal time-to-event modelling was utilised to individualise survival prediction based on DO-GAP index trajectory.ResultsThere were 516 patients with IPF from the PFF-PR with available demographics, pulmonary function tests, 6-min walk test data and outcomes included in this analysis. The DO-GAP index (C-statistic: 0.73) demonstrated improved discrimination in discerning transplant-free survival compared to the GAP index (C-statistic: 0.67). DO-GAP index calibration was adequate, and the model retained predictive accuracy to identify IPF-related mortality (C-statistic: 0.74). The DO-GAP index was similarly accurate in the subset of patients taking antifibrotic medications. Serial change in the DO-GAP index improved model discrimination (cross-validated area under the curve: 0.83) enabling the personalised prediction of disease trajectory in individual patients.ConclusionThe DO-GAP index is a simple, validated, multidimensional score that accurately predicts transplant-free survival in patients with IPF and can be adapted longitudinally in individual patients. The DO-GAP may also find use in studies of IPF to risk stratify patients and possibly as a clinical trial end-point.
Reprogramming tumor microenvironment via dual targeting co-delivery of regorafenib and alpha-difluoromethylornithine in osteosarcoma
Authors: Wang Hongsheng , Jin Xinmeng , Gao Yinghua , He Xin , Xu Yiming , Mu Haoran , Jiang Yafei , Wang Zhuoying , Yu Chen , Zhang Tao , Hua Yingqi , Cai Zhengdong , Xu Jing , Ma Xiaojun , Sun Wei 
Published: May 2023

Abstract
Background
Tumor angiogenesis, immunosuppression, and progression are all closely correlated with the tumor microenvironment (TME). Immune evasion is supported by both M2 phenotype tumor-associated macrophages (TAMs) and vascular aberrations in the TME. TME reprogramming is a promising therapeutic approach for treating tumors. Anti-angiogenesis has the power to control the polarization of macrophages, prevent progression, and increase drug penetration. Additionally, polyamine blocking therapy can increase CD8+ T cell infiltration and decrease immunosuppressive cells. These results led to developing a potential therapeutic regimen that targets TAMs and angiogenesis to reprogram the osteosarcoma TME.

Results
For the targeted biomimetic co-delivery of regorafenib and alpha-difluoromethylornithine via the mannose receptor, which is overexpressed in both TAMs and osteosarcoma cells, mannosylated poly(lactide-co-glycolide)-polyethylene glycol nanoparticles (Man-NPs) were synthesized. The superior physiological properties and intratumoral accumulation of the Man-NPs efficiently promoted TAMs polarization and inhibited angiogenesis. Macrophage repolarization further activated immune cells, which contributed to remodeling the TME.

Conclusion
Overall, these findings suggested that using Man-NPs as an immunotherapeutic approach to treat osteosarcoma may be promising.

Graphical Abstract
Characterization of oral bacterial and fungal microbiome in recovered COVID-19 patients
Authors: Wei Nana , Zhu Guangqi , Zhao Tingxiao , Wang Yan , Lou Haifei , Li Haoxuan , Yang Zhejuan , Zhang Zheen , Wang Qiujing , Han Mingfang , Lin Zhibing , Li Shibo 
Published: May 2023

AbstractCOVID-19 has emerged as a global pandemic, challenging the world’s economic and health systems. Human oral microbiota comprises the second largest microbial community after the gut microbiota and is closely related to respiratory tract infections; however, oral microbiomes of patients who have recovered from COVID-19 have not yet been thoroughly studied. Herein, we compared the oral bacterial and fungal microbiota after clearance of SARS-CoV-2 in 23 COVID-19 recovered patients to those of 29 healthy individuals. Our results showed that both bacterial and fungal diversity were nearly normalized in recovered patients. The relative abundance of some specific bacteria and fungi, primarily opportunistic pathogens, decreased in recovered patients (RPs), while the abundance of butyrate-producing organisms increased in these patients. Moreover, these differences were still present for some organisms at 12 months after recovery, indicating the need for long-term monitoring of COVID-19 patients after virus clearance.
German translation, cultural adaptation and validation of the Person-Centred Practice Inventory—Staff (PCPI-S)
Authors: von Dach Christoph , Schlup Nanja , Gschwenter Stefan , McCormack Brendan 
Published: May 2023

Abstract
Background
The person-centred practice framework represents the cornerstone of a middle-range theory. Internationally, person-centredness has become an increasingly common topic. The measurement of the existence of a person-centred culture is complex and subtle. The Person-Centred Practice Inventory—Staff (PCPI-S) measures clinicians’ experience of a person-centred culture in their practice. The PCPI-S was developed in English. Therefore, the aims of this study were (1) to translate the PCPI-S into German and to cross-culturally adapt and test in the acute care setting (PCPI-S aG Swiss) and (2) to investigate the psychometric properties of the PCPI-S aG Swiss.

Methods
The two-phase investigation of this cross-sectional observational study followed the guidelines and principles of good practice for the process of translation and cross-cultural adaptation of self-reporting measures. Phase 1 involved an eight-step translation and cultural adaptation of the PCPI-S testing in an acute care setting. In Phase 2, psychometric retesting and statistical analysis based on a quantitative cross-sectional survey were undertaken. To evaluate the construct validity, a confirmatory factor analysis was implemented. Cronbach’s alpha was used to determine the internal consistency.

Results
A sample of 711 nurses working in a Swiss acute care setting participated in testing the PCPI-S aG Swiss. Confirmatory factor analysis indicated a good overall model fit, validating the strong theoretical framework, which underpins the PCPI-S aG Swiss. Cronbach’s alpha scores demonstrated excellent internal consistency.

Conclusion
The chosen procedure ensured cultural adaptation to the German-speaking part of Switzerland. The psychometric results were good to excellent and comparable with other translations of the instrument.
Efficacy of dapagliflozin in the treatment of HFrEF with obstructive sleep apnea syndrome (DAHOS study): study protocol for a multicentric, prospective, randomized controlled clinical trial
Authors: Xie Liang , Song Songsong , Li Shengnan , Wei Qin , Liu Hong , Zhao Chao , Yu Fuchao , Tong Jiayi 
Published: May 2023

Abstract
Background
Heart failure with reduced ejection fraction (HFrEF) is associated with sleep dyspnea (SDB), which plays an adverse role in the pathophysiology of the condition. SDB management in HFrEF, however, remains controversial. HFrEF’s medical management has recently made significant progress with the discovery of new therapeutic avenues, namely sodia-glucose cotransporter-2 (SGLT-2) inhibitors, and better treatment of co-morbidities. Dapagliflozin, one of the SGLT-2 inhibitors, is a good candidate for correcting SDB of HFrEF patients because their known mechanisms of action are likely to counteract the pathophysiology of SDB in HFrEF.

Methods/design
The trial is a 3-month, multicentric, prospective, randomized controlled clinical study. Patients (i.e., adults with left ventricular ejection fraction ≤ 40%, Apnoea–Hypopnoea Index ≥ 15) will be randomized to receive optimized heart failure therapy plus a standard dose of dapagliflozin, while the control group will receive only optimized heart failure therapy. Patients will be evaluated before and after 3 months (nocturnal ventilatory polygraphy, echocardiography, laboratory testing, and quality-of-life and SDB questionnaires). The primary outcome is the change in the Apnoea–Hypopnoea Index, before and after 3 months of treatment.

Trial registration
www.chictr.org.cn, ChiCTR2100049834. Registered 10 August 2021.
The effect of implementing a critical thinking intervention program on English language learners’ critical thinking, reading comprehension, and classroom climate
Authors: Moghadam Zahra Bakhtiari , Narafshan Mehry Haddad , Tajadini Massoud 
Published: May 2023

AbstractEntering the age of globalization and multi-cultures, the education system has become more accountable to provide a positive and productive learning atmosphere in which both life skills and academic skills are taught and trained. Following this welcoming trend, the present study sought to integrate a proposed critical thinking-based intervention program (3Es) on the ground of Bloom’s original and revised Taxonomy (1956, 2001) into a BA English reading course. This study examined the treatment’s effect on learners’ critical thinking, attitudes toward L2 classroom climate, and reading comprehension in an English as a foreign language context of Iran. According to the placement test results, excluding the upper-intermediate ones left a sample of 40 (29 females and 11 males) intermediate participants being assigned to two groups: control and experimental. While the former received conventional instruction, the latter was exposed to the critical thinking program presented in three stages: exposure, exploration, and evaluation. The data were derived from Honey's critical thinking questionnaire (2004), the L2-contextualized adapted version of WIHIC (What Is Happening In The Class) designed by Fraser et al. (1986), and the British Council reading comprehension tests. After analyzing the data, the results demonstrated positive changes in the experimental group participants’ critical thinking, reading comprehension, and learners’ attitudes toward classroom climate after implementing the critical thinking intervention program. Our findings contribute to firstly EFL practitioners and curriculum designers, as the main authorities in revising and developing curricula and educational facilities to include the skill of critical thinking as one of the major contributors to the positive atmosphere of the class, and next to the teachers to become cognizant of the influential role of critical thinking in students’ attitudes toward the classroom and their academic development.