bluuebunny/crossref_metadata_2025_split huggingface dataset:
Presyncope and Ophthalmoparesis Due to Intracranial Erdheim-Chester Disease
Authors: Schipani Bailey Elke , Oakley Carlee I. , Smith Kelsey M. 
Published: May 2023

Introduction: An 82-year-old female presented to the emergency department with presyncope and was found to be bradycardic with proptosis and ophthalmoparesis. MRI revealed an extra-axial enhancing mass compressing the medulla and bilateral enhancing retro-orbital masses. Case Description: Imaging, including nuclear medicine bone scan, PET CT, and cardiac MRI raised the suspicion for a histiocytic neoplasm. These findings, along with a fibrohistiocytic infiltrate on bone biopsy and a BRAF V600E oncogenic mutation on plasma cell-free DNA confirmed a diagnosis of Erdheim-Chester disease. Discussion: These enhancing masses invoke a broad differential, including a histiocytic or granulomatous process, fungal infection, amyloidosis, IgG4 disease, and lymphoma. Systematic laboratory, radiologic, pathology, and genetic testing yielded a diagnosis of this rare histiocytic disorder with frequent neurologic involvement.
Rhinologist Use of Antibiotics With Nasal Packing for Epistaxis
Authors: Mallen Jonathan Ross , Aasen Davis M. , Vuncannon Jackson Ross , Kuo Chia-Ling , Mu Jinjian , Tessema Belachew , Brown Seth M. 
Published: May 2023

Background There is limited evidence supporting the usage of prophylactic antibiotics in the setting of nasal packing for epistaxis. It is unclear what current antiobiotic usage patterns are by otolaryngologists. Objectives Characterize the antibiotic prescribing practices employed by otolaryngologists in the management of epistaxis patients treated with packing as well as the underlying rationale. Explore the impact of experience, geography, and academic affiliation on treatment decisions. Methods An anonymous survey of antibiotic prescribing patterns for patients with epistaxis requiring nasal packing was distributed to all physician members of the American Rhinologic Society. Responses to each question were descriptively summarized including 95% confidence intervals and were linked to demographics using Fisher's exact tests. Results One thousand one hundred and thirteen surveys were distributed with 307 responses (27.6%). Antibiotic prescription rates varied based on packing type, with 20.0% prescribing antibiotics for dissolvable packing compared to 84.2% to 84.6% for nondissolvable packing. The absorbance of nondissolvable packing does not impact the decision to prescribe antibiotics ( P > .999). Precisely 69.7% (95% CI: 64.0%-74.8%) stop antibiotics immediately following packing removal. Precisely 85.6% (95% CI: 81.6%-89.9%) cite the risk of toxic shock syndrome (TSS) when prescribing antibiotics. Notable regional differences include greater utilization of amoxicillin-clavulanate in the Midwest (67.6%) and Northeast (61.4%) as compared with the South (42.1%) and West (45.1%) ( P = .013). Further, years in practice were positively associated with several patterns including prescribing antibiotics for patients with dissolvable packing ( P = .008), citing prevention of sinusitis as a rationale for antibiotic use ( P < .001), and a higher likelihood of having treated a patient with TSS ( P = .002). Conclusions Antibiotic use in patients with epistaxis controlled with nondissolvable packing is common. Treatment patterns are influenced by geography, years in practice, and practice type. Level of Evidence 4.
Uncontrolled blood pressure and associated factors in adult hypertensive patients undergoing follow-up at public health facility ambulatory clinics in Bishoftu town, Ethiopia: a multi-center study
Authors: Solomon Menawork , Negussie Yohannes Mekuria , Bekele Nardos Tilahun , Getahun Mihiret Shawel , Gurara Abenet Menene 
Published: May 2023

Abstract
Background
Uncontrolled blood pressure is an important medical and public health problem in developing countries like Ethiopia. Improving the management of hypertension requires a better comprehension of the factors influencing blood pressure control and the application of interventions. But in clinical practice, blood pressure is still not adequately controlled. Thus, this study aimed to assess uncontrolled blood pressure and associated among adult hypertensive patients on follow-up at public health facility ambulatory clinics in Bishoftu, Ethiopia.

Methods
A hospital-based cross-sectional study was conducted among 398 adult hypertensive patients who were on treatment and follow-up from April to May 31, 2022. Systematic random sampling was used to select study participants. Data were collected using an interviewer-administered, semi-structured questionnaire and chart review. The Eighth Joint National Committee (JNC 8) criteria was applied to define blood pressure control status. Binary logistic regression analysis was used to model the association between dependent and independent variables. An adjusted odds ratio and 95% confidence interval were used to measure the strength of the association. Finally, at a p-value < 0.05, statistical significance was proclaimed.

Result
Of the total study participants, 249(62.6%) were male. The mean age was 62.26 ± 11.55 years. The overall proportion of uncontrolled blood pressure was 58.8% (95% CI: 54–64). Salt intake (AOR = 2.51; 95% CI: 1.49–4.24), lack of physical activity (AOR = 1.40; 95% CI: 1.10–2.62), habitual coffee consumption (AOR = 4.52; 95% CI: 2.67–7.64), higher BMI (AOR = 2.08; 95% CI: 1.24–3.49), and non-adherence to antihypertensive medications (AOR = 2.31; 95% CI: 1.3–3.89) were independent predictors of uncontrolled blood pressure.

Conclusion
More than half of the hypertensive patients in this study had uncontrolled blood pressure. Healthcare providers and other accountable stakeholders should urge patients to follow salt restriction, physical activity, and antihypertensive medication regimes. Reduced coffee consumption and weight maintenance are other crucial blood pressure control measures.
The effect of perturbation-based balance training on balance control and fear of falling in older adults: a single-blind randomised controlled trial
Authors: Gerards Marissa , Marcellis Rik , Senden Rachel , Poeze Martijn , de Bie Rob , Meijer Kenneth , Lenssen Antoine 
Published: May 2023

Abstract
Background
Perturbation-based balance training (PBT) is an emerging intervention shown to improve balance recovery responses and reduce falls in everyday life in older adults. However, perturbation interventions were heterogeneous in nature and need improvement. This study aims to investigate the effects of a PBT protocol that was designed to address previously identified challenges of PBT, in addition to usual care, on balance control and fear of falling in older adults at increased risk of falling.

Methods
Community-dwelling older adults (age ≥ 65 years) who visited the hospital outpatient clinic due to a fall incident were included. Participants received PBT in addition to usual care (referral to a physiotherapist) versus usual care alone. PBT consisted of three 30-minute sessions in three weeks. Unilateral treadmill belt accelerations and decelerations and platform perturbations (shifts and tilts) were applied during standing and walking on the Computer Assisted Rehabilitation Environment (CAREN, Motek Medical BV). This dual-belt treadmill embedded in a motion platform with 6 degrees of freedom is surrounded by a 180° screen on which virtual reality environments are projected. Duration and contents of the training were standardised, while training progression was individualised. Fear of falling (FES-I) and balance control (Mini-BESTest) were assessed at baseline and one week post-intervention. Primary analysis compared changes in outcome measures between groups using Mann-Whitney U tests.

Results
Eighty-two participants were included (PBT group n = 39), with a median age of 73 years (IQR 8 years). Median Mini-BESTest scores did not clinically relevantly improve and were not significantly different between groups post-intervention (p = 0.87). FES-I scores did not change in either group.

Conclusions
Participation in a PBT program including multiple perturbation types and directions did not lead to different effects than usual care on clinical measures of balance control or fear of falling in community-dwelling older adults with a recent history of falls. More research is needed to explore how to modulate PBT training dose, and which clinical outcomes are most suitable to measure training effects on balance control.

Trial registration
Nederlands Trial Register NL7680. Registered 17-04-2019 – retrospectively registered. https://www.trialregister.nl/trial/7680.
Bartholin’s gland cyst caused by Sneathia amnii: a case report
Authors: Zhang Ranran , Zhang Zhezhong , Xu Minjing , Li Wenjie , Sun Yanwen , Dai Yuliang , Yang Xuejing , Lin Shaohua 
Published: May 2023

Abstract
Background
Sneathia amnii is a conditional pathogen of the female genital tract that is involved in bacterial vaginosis and poor reproductive and perinatal outcomes. Few studies have reported subcutaneous cysts following invasive infection caused by S amnii.

Case presentation
Here we report the case of a 27-year-old woman who presented with Bartholin’s gland cyst due to S amnii infection, and was successfully treated with surgical neostomy and antibiotic agents. The isolate was gram-negative, bacillary, anaerobic, and was identified by polymerase chain reaction (PCR) amplification of the 16 S rRNA.

Conclusions
S amni is an important but underappreciated pathogen that needs further investigation. This report describes the microbial and pathogenic characteristics of S amnii and is expected to provide a valuable reference in obstetric and gynecologic clinical practice.
Is there a relation between stillbirth and low levels of vitamin D in the population? A bi-national follow-up study of vitamin D fortification
Authors: Lindqvist Pelle G. , Gissler Mika , Essén Birgitta 
Published: May 2023

Abstract
Background
Stillbirth has been associated with low plasma vitamin D. Both Sweden and Finland have a high proportion of low plasma vitamin D levels (< 50 nmol/L). We aimed to assess the odds of stillbirth in relation to changes in national vitamin D fortification.

Methods
We surveyed all pregnancies in Finland between 1994 and 2021 (n = 1,569,739) and Sweden (n = 2,800,730) with live or stillbirth registered in the Medical Birth Registries. The mean incidences before and after changes in the vitamin D food fortification programs in Finland (2003 and 2009) and Sweden (2018) were compared with cross-tabulation with 95% confidence intervals (CI).

Results
In Finland, the stillbirth rate declined from ~ 4.1/1000 prior to 2003, to 3.4/1000 between 2004 and 2009 (odds ratio [OR] 0.87, 95% CI 0.81–0.93), and to 2.8/1000 after 2010 (OR 0.84, 95% CI 0.78–0.91). In Sweden, the stillbirth rate decreased from 3.9/1000 between 2008 and 2017 to 3.2/1000 after 2018 (OR 0.83, 95% CI 0.78–0.89). When the level of the dose-dependent difference in Finland in a large sample with correct temporal associations decreased, it remained steady in Sweden, and vice versa, indicating that the effect may be due to vitamin D. These are observational findings that may not be causal.

Conclusion
Each increment of vitamin D fortification was associated with a 15% drop in stillbirths on a national level. If true, and if fortification reaches the entire population, it may represent a milestone in preventing stillbirths and reducing health inequalities.
Post-progression treatment in cancer randomized trials: a cross-sectional study of trials leading to FDA approval and published trials between 2018 and 2020
Authors: Olivier Timothée , Haslam Alyson , Prasad Vinay 
Published: May 2023

Abstract
Background

Suboptimal treatment upon progression may affect overall survival (OS) results in oncology randomized controlled trials (RCTs). We aim to assess the proportion of trials reporting post-progression treatment.

Methods
This cross-sectional analysis included two concurrent analyses. The first one examined all published RCTs of anti-cancer drugs in six high impact medical/oncology journals between January 2018 and December 2020. The second studied all US Food and Drug Administration (FDA) approved anti-cancer drugs during the same period. Included trials needed to study an anti-cancer drug in the advanced or metastatic setting. Data abstracted included the tumor type, characteristics of trials, and reporting and assessment of post-progression treatment.

Results
There were 275 published trials and 77 US FDA registration trials meeting inclusion criteria. Assessable post-progression data were reported in 100/275 publications (36.4%) and 37/77 approvals (48.1%). Treatment was considered substandard in 55 publications (n = 55/100, 55.0%) and 28 approvals (n = 28/37, 75.7%). Among trials with assessable post-progression data and positive OS results, a subgroup analysis identified substandard post-progression treatment in 29 publications (n = 29/42, 69.0%) and 20 approvals (n = 20/26, 76.9%). Overall, 16.4% of publications (45/275) and 11.7% of registration trials (9/77) had available post-progression data assessed as appropriate.

Conclusion
We found that most anti-cancer RCTs do not report assessable post-progression treatment. When reported, post-progression treatment was substandard in most trials. In trials reporting positive OS results and with assessable post-progression data, the proportion of trials with subpar post-progression treatment was even higher. Discrepancies between post-progression therapy in trials and the standard of care can limit RCT results’ applicability. Regulatory rules should enforce higher requirements regarding post-progression treatment access and reporting.
Stereoptic serious games as a visual rehabilitation tool for individuals with a residual amblyopia (AMBER trial): a protocol for a crossover randomized controlled trial
Authors: Simon-Martinez Cristina , Antoniou Maria-Paraskevi , Bouthour Walid , Bavelier Daphne , Levi Dennis , Backus Benjamin T. , Dornbos Brian , Blaha James J. , Kropp Martina , Müller Henning , Murray Micah , Thumann Gabriele , Steffen Heimo , Matusz Pawel J. 
Published: May 2023

Abstract
Background
Amblyopia is the most common developmental vision disorder in children. The initial treatment consists of refractive correction. When insufficient, occlusion therapy may further improve visual acuity. However, the challenges and compliance issues associated with occlusion therapy may result in treatment failure and residual amblyopia. Virtual reality (VR) games developed to improve visual function have shown positive preliminary results. The aim of this study is to determine the efficacy of these games to improve vision, attention, and motor skills in patients with residual amblyopia and identify brain-related changes. We hypothesize that a VR-based training with the suggested ingredients (3D cues and rich feedback), combined with increasing the difficulty level and the use of various games in a home-based environment is crucial for treatment efficacy of vision recovery, and may be particularly effective in children.

Methods
The AMBER study is a randomized, cross-over, controlled trial designed to assess the effect of binocular stimulation (VR-based stereoptic serious games) in individuals with residual amblyopia (n = 30, 6–35 years of age), compared to refractive correction on vision, selective attention and motor control skills. Additionally, they will be compared to a control group of age-matched healthy individuals (n = 30) to account for the unique benefit of VR-based serious games. All participants will play serious games 30 min per day, 5 days per week, for 8 weeks. The games are delivered with the Vivid Vision Home software. The amblyopic cohort will receive both treatments in a randomized order according to the type of amblyopia, while the control group will only receive the VR-based stereoscopic serious games. The primary outcome is visual acuity in the amblyopic eye. Secondary outcomes include stereoacuity, functional vision, cortical visual responses, selective attention, and motor control. The outcomes will be measured before and after each treatment with 8-week follow-up.

Discussion
The VR-based games used in this study have been conceived to deliver binocular visual stimulation tailored to the individual visual needs of the patient, which will potentially result in improved basic and functional vision skills as well as visual attention and motor control skills.

Trial registration
This protocol is registered on ClinicalTrials.gov (identifier: NCT05114252) and in the Swiss National Clinical Trials Portal (identifier: SNCTP000005024).
Enhanced in vitro antibacterial effect against Enterococcus faecalis by using both low-dose cetylpyridinium chloride and silver ions
Authors: Lv Silei , Fan Wei , Fan Bing 
Published: May 2023

Abstract
Background
Enterococcus faecalis (E. faecalis) is frequently isolated from root canals with failed root canal treatments. Due to the strong ability of E. faecalis to resist many often-used antimicrobials, coping with E. faecalis infections remains a challenge. The aim of this study was to investigate the synergistic antibacterial effect of low-dose cetylpyridinium chloride (CPC) and silver ions (Ag+) against E. faecalis in vitro.

Methods
The minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and the fractional inhibitory concentration index (FICI) were used to confirm the existence of the synergic antibacterial activity between low-dose CPC and Ag+. Colony-forming unit (CFU) counting, time-killing curve and dynamic growth curve were used to evaluate the antimicrobial effects of CPC and Ag+ combinations against planktonic E. faecalis. Four weeks biofilms were treated with drug-contained gels to determine the antimicrobial effect on biofilm-resident E.faecalis, and the integrity of E.faecalis and its biofilms were observed by FE-SEM. CCK-8 assays was used to test the cytotoxicity of CPC and Ag+ combinations on MC3T3-E1 cells.

Results
The results confirmed the synergistic antibacterial effect of low-dose CPC and Ag+ against both planktonic and 4-week biofilm E. faecalis. After the addition of CPC, the sensitivity of both planktonic and biofilm-resident E. faecalis to Ag+ improved, and the combination showed good biocompatibility on MC3T3-E1 cells.

Conclusions
Low-dose CPC enhanced the antibacterial ability of Ag+ against both planktonic and biofilm E.faecalis with good biocompatibility. It may be developed into a novel and potent antibacterial agent against E.faecalis, with low toxicity for root canal disinfection or other related medical applications.
Practice education facilitators perceptions and experiences of their role in the clinical learning environment for nursing students: a qualitative study
Authors: Mathisen Cathrine , Bjørk Ida T. , Heyn Lena G. , Jacobsen Turid-Iren , Hansen Elisabeth H. 
Published: May 2023

Abstract
Background
Clinical placement is recognised as essential for nursing students’ development of clinical competence. However, difficulties in providing supportive clinical learning environments are a well-known challenge in nursing education. In Norway, the use of nurse educators in joint university and clinical roles has been recommended as an initiative to strengthen the clinical learning environment and enhance the educational quality. In this study we use the term practice education facilitator in a generic sense for these roles. The aim of this study was to explore how practice education facilitators can contribute to strengthen the clinical learning environments for nursing students.

Methods
This study has a qualitative explorative design with a purposive sample of practice education facilitators affiliated to three different universities located in southeast, mid-, and northern Norway. Individual in-depth interviews with 12 participants were conducted during spring 2021.

Results
A thematic analysis resulted in four themes: “coherence between theory and practice”; “student support and guidance during placement”; “supporting the supervisors to support the students” and “factors influencing the practice education facilitators’ performance in their role”. The participants experienced that the practice education facilitator role contributed to strengthened clinical learning environments. However, their performance in the role was found to be contingent upon factors such as time allocated for the role, personal and professional attributes of the post holder, and a common understanding within the organisations regarding practice learning and role remits for the practice education facilitator.

Conclusions
Findings indicate that the practice education facilitator role can be a valuable resource for clinical supervisors and nursing students in clinical placement. Moreover, nurse educators who are familiar with the clinical area, and who are insiders in both settings, are ideally placed to contribute to bridge the theory-practice gap. The benefits of using these roles, however, were influenced by personal attributes of the post holder, time allocated for the role and the number of practice education facilitators positions, and management anchorage. Thus, to achieve the full potential of these roles, efforts to reduce these barriers should be considered.
Evaluating person-centered care in residential care facilities from the perspective of caregivers in South Korea: a survey
Authors: Chin Young-Ran , Lee Hyo Young 
Published: May 2023

Abstract
Background
As many older people spend their time in residential care facilities, the demand for person-centered care (PCC), which affects their quality of life, is increasing. Many residential care facility residents have cognitive problems, such as dementia and strokes. Providing quality care upholds their rights as human beings. Currently, the PCC tools used in South Korea are only translations of foreign tools into Korean, so it is necessary to develop tools for older adult care facilities that reflect the reality of Korean care facilities for older adults. This study aims to develop a tool for measuring PCC in residential care facilities for older people from the perspectives of care givers.

Methods
The draft of 34 questions was developed through literature reviews, interviews with LTC practitioners and researchers. This developed questionnaire was then administered to 402 direct caregivers working in the residential care facilities because many of the residents had cognitive problems. By measuring the interrater reliability, the items with high levels of agreement were selected and the validity of the construct was checked through factor analysis. To determine whether the domains adequately measured each concept, we calculated correlation coefficients and Cronbach’s α.

Results
Four domains and 32 items concerning service conditions, resident’s right to self-determination, a comfortable living environment for all residents, and resident and staff satisfaction are derived, thus explaining 24.7%, 23.6%, 14.6%, and 8.00% of the total variance, respectively. Cronbach’s alphas for each domain are 0.965, 0.948, 0.652, and 0.525, respectively, thus demonstrating internal consistency. The inter-rater agreement is high (66.7%~100.0%). The correlation between service conditions and resident’s right to self-determination (r = 0.643, p < 0.001), a comfortable living environment for all residents, resident and staff satisfaction (r = 0.674, p < 0.001), and resident’s right to self-determination and comfortable living environment (r = 0.695, p < 0.001) is strong.

Conclusions
It is important that caregivers recognize PCC and provide services. When evaluating the residential care services, measuring the degree of PCC should be made compulsory. If the facility becomes more person-centered, it will be possible to promote quality of life for older people.

Trial registration
Not applicable.