bluuebunny/crossref_metadata_2025_split huggingface dataset:
First-time use of electronic patient-reported outcome measures in a cluster randomized trial: a qualitative study
Authors: Skåre Terese Solvoll , Lundeby Tonje , Lund Jo Åsmund , Hjermstad Marianne Jensen , Midtbust May Helen 
Published: January 2025

Abstract

Background
Although there is clear evidence supporting the beneficial effects of regularly assessing patient-reported outcomes (PROs), the comprehensive integration of patient-reported outcome measures (PROMs) into routine cancer care remains limited. This study aimed to explore the facilitators and barriers encountered by principal investigators (PIs) (oncologists) and study nurses during the implementation of the Eir ePROM within a cluster randomized trial (c-RCT) in cancer outpatient clinics. Additionally, we sought to examine the influence of Eir on the working routines of the participants.

Methods
Individual semi-structured interviews and a focus group were conducted with nine oncologists and study nurses involved in the implementation of the ePROM tool Eir. Interviews elucidated their experiences of barriers and facilitators when implementing Eir through a cluster randomized trial. Data were analysed according to Framework Analysis, using both an inductive and deductive approach. The Consolidated Framework for Implementation Research (CFIR) was used in the deductive stages of analysis.

Results
Three overarching themes were identified from the data: (1) Willingness to invest; accepting that new eras come with a cost, (2) Management anchoring; changes start at the top, and (3) Creation of a cohesive framework; fostering collective comprehension. We found a notable disparity between oncologists and nurses in their willingness to invest time and effort in implementing the tool. While participants recognized the need to transform patient consultation methods to benefit from digital symptom management, opinions varied on whether the potential benefits justified the associated cost. Furthermore, the degree of management anchoring at various levels significantly impacted the implementation process. At the local level, it was seen as either a facilitator or a barrier, influencing the outcome of the implementation. Additionally, establishing a cohesive framework was crucial, as this fostered a collective understanding among those involved in the implementation.

Conclusions
Our study underscores the importance of considering the diverse perspectives of health care professionals and fostering interprofessional collaboration for the successful implementation of ePROMs in healthcare settings. Future research should explore strategies to bridge professional disparities and promote a shared understanding of the value provided by ePROMs.
Next generation bioelectronic medicine: making the case for non-invasive closed-loop autonomic neuromodulation
Authors: Lerman Imanuel , Bu Yifeng , Singh Rahul , Silverman Harold A. , Bhardwaj Anuj , Mann Alex J. , Widge Alik , Palin Joseph , Puleo Christopher , Lim Hubert 
Published: January 2025

Abstract
The field of bioelectronic medicine has advanced rapidly from rudimentary electrical therapies to cutting-edge closed-loop systems that integrate real-time physiological monitoring with adaptive neuromodulation. Early innovations, such as cardiac pacemakers and deep brain stimulation, paved the way for these sophisticated technologies. This review traces the historical and technological progression of bioelectronic medicine, culminating in the emerging potential of closed-loop devices for multiple disorders of the brain and body. We emphasize both invasive techniques, such as implantable devices for brain, spinal cord and autonomic regulation, while we introduce new prospects for non-invasive neuromodulation, including focused ultrasound and newly developed autonomic neurography enabling precise detection and titration of inflammatory immune responses. The case for closed-loop non-invasive autonomic neuromodulation (incorporating autonomic neurography and splenic focused ultrasound stimulation) is presented through its applications in conditions such as sepsis and chronic inflammation, illustrating its capacity to revolutionize personalized healthcare. Today, invasive or non-invasive closed-loop systems have yet to be developed that dynamically modulate autonomic nervous system function by responding to real-time physiological and molecular signals; it represents a transformative approach to therapeutic interventions and major opportunity by which the bioelectronic field may advance. Knowledge gaps remain and likely contribute to the lack of available closed loop autonomic neuromodulation systems, namely, (1) significant exogenous and endogenous noise that must be filtered out, (2) potential drift in the signal due to temporal change in disease severity and/or therapy induced neuroplasticity, and (3) confounding effects of exogenous therapies (e.g., concurrent medications that dysregulate autonomic nervous system functions). Leveraging continuous feedback and real-time adjustments may overcome many of these barriers, and these next generation systems have the potential to stand at the forefront of precision medicine, offering new avenues for individualized and adaptive treatment.
Injectable Estradiol Dosing Regimens in Transgender and Nonbinary Adults Listed as Male at Birth
Authors: Kanin Maralee , Slack Margaret , Patel Reema , Chen Kuan-Ting , Jackson Nicholas , Williams Kristen C , Grock Shira 
Published: January 2025

Abstract

Context
Many transgender and nonbinary (TGNB) individuals assigned male at birth (AMAB) seek hormone therapy to achieve physical and emotional changes. Standard therapy includes estradiol, with or without an anti-androgen. Our clinical observations suggest that currently recommended injectable estradiol dosing may lead to supratherapeutic estradiol levels.

Objective
We sought to evaluate whether lower-than-recommended doses of injectable estradiol were effective in achieving serum estradiol and testosterone goals.

Methods
We conducted a retrospective cohort study to evaluate injectable estradiol dosing in treatment-naïve AMAB individuals initiating hormone therapy. Data from a single provider at an academic center from January 2017 to March 2023 were analyzed. A total of 29 patients were eligible for inclusion. The primary variables of estradiol dosage, serum estradiol and testosterone levels were analyzed over 15 months.

Results
The average estradiol dose decreased from 4.3 to 3.7 mg weekly (p &lt; 0.001) during the study period with a final on-treatment estradiol level of 248 pg/mL. All individuals achieved a testosterone &lt;50 ng/dL during the study period. The average initial on-treatment testosterone level was not significantly different from average final on-treatment measurement of 24.0 mg/dL (p=0.95). Spironolactone use at study initiation was not associated with a lower initial on-treatment testosterone level, though it was associated with a lower estradiol level of 285 pg/dL compared to 427 pg/dL for those on estradiol monotherapy (p=0.017).

Conclusion
Lower doses of injectable estradiol can achieve therapeutic estradiol levels with excellent testosterone suppression. Spironolactone was not associated with additional testosterone suppression and may result in lower estradiol levels.
Comparing General Anesthesia–Based Regimens for Endovascular Treatment of Acute Ischemic Stroke: A Systematic Review and Network Meta-Analysis
Authors: Plitman Eric , Mohammed Ayman , Rajaleelan Wesley , Nakatani Rodrigo , Englesakis Marina , Shankar Jai , Venkatraghavan Lashmi , Chowdhury Tumul 
Published: January 2025

BACKGROUND:
Total intravenous anesthesia (TIVA)-based and volatile-based general anesthesia have different effects on cerebral hemodynamics. The current work compares these 2 regimens in acute ischemic stroke patients undergoing endovascular therapy.

METHODS:
We conducted a systematic literature search across MEDLINE, Embase, Cochrane, CINAHL, Web of Science, and Scopus. We identified English language studies including adult acute ischemic stroke patients managed with endovascular therapy under general anesthesia delineable into TIVA only and/or volatile only, and obtained categorical data for favorable functional outcomes using the modified Rankin scale (mRS ≤2), at 90 days after endovascular therapy. Odds ratios (OR) and standardized mean differences were calculated to inform a network meta-analysis approach, which permitted the inclusion of studies comparing a form of general anesthesia (ie, TIVA only or volatile only) to conscious sedation.

RESULTS:
The search rendered 6235 articles, of which 15 met inclusion criteria. Three studies directly investigated TIVA versus volatile, whereas 12 studies compared general anesthesia to conscious sedation. The total number of subjects was 3015 (conscious sedation: n = 1067; general anesthesia: n = 1948 [TIVA: n = 1212, volatile: n = 736]). No significant differences were identified between TIVA and volatile groups in 90-day neurological outcome (OR = 1.25, 95% confidence interval [CI], 0.81–1.91; P = .31), 90-day mortality (OR = 0.72, 95% CI, 0.42–1.24; P = .24), successful recanalization (OR = 1.33, 95% CI, 0.70–2.52; P = .39), or recanalization time (standardized mean difference = 0.03, 95% CI, –0.35 to 0.41; P = .88). Additionally, no significant differences were identified between the conscious sedation group and the TIVA group in 90-day neurological outcome (OR = 1.14, 95% CI, 0.84–1.53; P = .40), 90-day mortality (OR = 0.87, 95% CI, 0.62–1.23; P = .43), successful recanalization (OR = 0.76, 95% CI, 0.52–1.10; P = .15), or recanalization time (standardized mean difference = –0.18, 95% CI, –0.47 to 0.11; P = .23), and between the conscious sedation group and the volatile group in 90-day neurological outcome (OR = 1.42, 95% CI, 0.92–2.17; P = .11), 90-day mortality (OR = 0.63, 95% CI, 0.36–1.12; P = .11), successful recanalization (OR = 1.01, 95% CI, 0.52–1.94; P = .98), or recanalization time (standardized mean difference = –0.15, 95% CI, –0.52 to 0.23; P = .44).

CONCLUSIONS:
This network meta-analysis showed that the perioperative use of either general anesthesia-based regimen, or sedation, did not significantly impact various endovascular therapy-related outcomes. However, the current work was underpowered to detect differences in anesthetic agents, clinico-demographic characteristics, or procedural factors.
Recognition, differentiation, and the knowledge about mimic expressions of emotions among patients diagnosed with schizophrenia
Authors: Subocz Dawid 
Published: January 2025

Cel pracyCelem badania jest ocena zdolności rozpoznawania, różnicowania oraz wiedzy o ekspresjach mimicznych emocji wśród osób cierpiących na schizofrenię.MetodaW badaniu udział wzięło 100 osób chorujących na schizofrenię oraz 100 osób zdrowych. Uczestnicy wykonywali trzy zadania w komputerowym eksperymencie rozpoznawania ekspresji mimicznych. Wykorzystane w nim zostały twarze 30 osób (14 mężczyzn i 16 kobiet) z zestawu Warsaw Set of Emotional Facial Expression Pictures. Zdjęcia te przedstawiają 6 podstawowych emocji (radość, strach, wstręt, złość, smutek, zaskoczenie).WynikiOsoby chorujące na schizofrenię gorzej od osób zdrowych rozpoznawały i różnicowały wybrane ekspresje emocjonalne. Chorzy wykazali się też mniejszą wiedzą o ekspresjach mimicznych emocji.WnioskiW badaniu wykazano, że problemy przy rozpoznawaniu emocji wynikają nie tylko z dysfunkcji na wczesnych etapach percepcji ekspresji mimicznych emocji ale również z dysfunkcji w zakresie odgórnego przetwarzania bodźców afektywnych. Wyniki badania stanowią podstawę do tworzenia treningów rozpoznawania ekspresji mimicznych. Treningi te powinny uczyć chorych prawidłowej kategoryzacji emocji oraz rozwijać ich wiedzę na temat ekspresji emocjonalnych.
Designing Information to Engage Customers
Authors: Guo Liang 
Published: January 2025

Collaborative customization is common in many markets. Sellers and customers can collectively discover the value of the product’s basic design. Customers’ willingness to pay can also be increased by being engaged to improve the product design. We study how a seller can design the information structure of collective learning about the product’s basic value to induce costly customer engagement. We consider a setting in which the parties’ expected payoffs are determined endogenously through the strategic interaction between seller pricing and customer engagement and purchase. The customer tends to be engaged in equilibrium, as the uncertainty on the product’s basic value becomes higher to dilute the responsiveness of the optimal price to customer engagement. Therefore, the seller seeks to maximize the probability of generating an intermediate posterior belief. Thus, the optimal information design involves either exaggerating or downplaying the product’s basic value when the prior is low or high, respectively. We show that considering restrictive information structures can generate qualitatively different implications. We also examine how the unobservability of engagement may influence the parties’ strategic interaction, their expected payoffs, and the seller-optimal information design. Interestingly, unobservability may lead to lower equilibrium engagement, hurt the seller, render the customer’s equilibrium expected payoff to increase as customer engagement becomes less important or more costly, and yield more or less information provision. This paper was accepted by Dmitri Kuksov, marketing.
Current concepts in restoring endodontically treated teeth
Authors: Mishra Lora , Francis Tony , Nooji Deviprasad , Aggarwal Himanshi , McColl Ewen , Eachempati Prashanti 
Published: January 2025

Restoration of endodontically treated teeth (ETT) is crucial for long-term success. This article reviews current concepts in restoring ETT, which focuses on structural integrity and functional performance. Key factors, including residual tooth structure, ferrule effect and peri-cervical dentine preservation, are discussed alongside advances in conservative access designs, biomimetic protocols and innovative materials, such as ultra-high molecular weight polyethylene fibres. Decision-making frameworks, including the Restorative Difficulty Evaluation System (RDES), are highlighted to support clinicians in achieving predictable outcomes, ensuring tooth survival and patient satisfaction. CPD/Clinical Relevance: The long-term success of endodontically treated teeth depends on selecting appropriate restorative strategies that ensure structural integrity, functional performance and aesthetic outcomes, informed by current evidence and tailored clinical decision-making.
The orthodontic–paediatric interface. Part 1
Authors: Patel Trishna A , Donnell Christopher C , Kirby Jennifer E , Frawley Tom 
Published: January 2025

The orthodontic–paediatric interface ensures that children are assessed and managed by the right people, in the right place, at the right time. This two-part series offers general dental practitioners (GDPs) and specialists an update on common joint orthodontic–paediatric problems in the mixed dentition alongside practical considerations to resolve them. The first paper will focus on: management of compromised first permanent molars, extraction of primary teeth and subsequent space maintenance, management of habits and possible sequelae, and orthodontic management of dental trauma. CPD/Clinical Relevance: This series will enable GDPs to recognize and manage common problems in primary care, while also increasing knowledge regarding the optimal time for referral to specialist care.
Emergency multidisciplinary management of a sodium hypochlorite injury in an adolescent: Case Report
Authors: Shah Mira , Lawrence M , Fan Kathleen 
Published: January 2025

This case report describes the multidisciplinary team (MDT) management of a severe sodium hypochlorite (NaOCl) injury in a 16-year-old male caused by NaOCl extrusion during emergency extirpation of the UL2 without the use of a dental dam. Ophthalmology, oral and maxillofacial surgery (OMFS) and acute dental input were required to manage this patient during their 72-hour inpatient hospital admission. Plain film and CT imaging were used to assess the degree of NaOCl infiltration and guide treatment. Serial dilution using sterile saline irrigation intra-orally and extra-orally of the left eye was required to reduce the cytotoxicity of NaOCl. CPD/Clinical Relevance: Clinicians should be aware of the potentially hazardous complications of NaOCl incidents, their clinical presentation and the importance of early recognition and management by an appropriate MDT.
Application of the Omaha System-Based Continuous Care Model in Diabetes Health Management for Outpatients within the Framework of “Internet +”
Authors: Chen Ying , Yan Xia , Liu Jianjun , Bian Zhengxia , Yan Li 
Published: January 2025

Aims/Background Diabetes is a chronic lifelong condition that requires consistent self-care and daily lifestyle adjustments. Effective disease management involves regular blood glucose monitoring and ongoing nursing support. Inadequate education and poor self-management are key factors contributing to increased mortality among diabetic individuals. Providing personalized guidance and behavioral interventions through continuous nursing care is crucial for achieving optimal glycemic control and fostering positive societal outcomes. This study aimed to evaluate the impact of an Omaha System-based continuous nursing model, implemented through the “Internet+” framework, on enhancing self-health management skills, glycemic control, and treatment adherence among patients with type 2 diabetes mellitus (T2DM). Methods This retrospective study analyzed clinical data of T2DM patients who visited the diabetes health management clinic of Zhang Ye People's Hospital affiliated to Hexi University between December 2023 and May 2024. Participants were categorized into intervention and control groups based on whether they received the “Internet+”-enabled Omaha System continuous nursing care model. Variables, including demographic characteristics, self-management behaviors, cognitive abilities, environmental factors, glycemic control indicators, and treatment adherence (medication compliance, dietary compliance, lifestyle adherence, and follow-up punctuality), were assessed and compared at baseline, 1 month, and 3 months post-intervention. Results The study included 52 patients in the intervention group and 68 in the control group. Baseline characteristics revealed no significant differences between the two groups (p > 0.05). At 1 and 3 months post-intervention, the intervention group exhibited significant improvements in self-management behaviors, cognitive abilities, environmental factors, and overall scores compared to baseline and the control group (p < 0.05). Fasting plasma glucose (FPG) levels were also significantly reduced in the intervention group compared to baseline and the control group (p < 0.05). 3 months post-intervention, the intervention group demonstrated significantly higher adherence rates to dietary recommendations, healthy lifestyle practices, and treatment compliance compared to the control group (p < 0.05). Conclusion The “Internet+”-based Omaha System continuous nursing model significantly enhances self-health management capabilities, stabilizes glycemic control, and promotes adherence to healthy behaviors among patients with T2DM. These findings highlight the potential of the model for broader clinical application in diabetes management.
Anticalculi and antibacterial activity of methanol extract of Holothuria atra
Authors: Irwan Irwan , Saputra Mulia Jefri , Karina Softyatuddin , Nurliza Eli 
Published: January 2025

Sea cucumbers are a type of marine organism with significant economic worth and potential applications as nutraceuticals. This marine organism possesses possibly useful chemicals, making it a viable alternative for the fisheries product processing businesses. The objective of this study was to assess the efficacy of the methanol extract of Holothuria atra in preventing the formation of calculi and its ability to inhibit the growth of bacteria. Extraction was performed using the maceration method with methanol as the solvent over a period of 72 hours The analysis revealed the presence of four bioactive components in the methanol fraction: alkaloid, triterpenoids, flavonoids, and saponins. In vitro anticalculi activity was assessed by measuring the decomposition of kidney stones (Ca) using an atomic absorption spectrophotometer (AAS). The maximum decline of calcium stones was regarded at a concentration of 500 ppm of sea cucumber extract. The disc diffusion method was employed to assess the antibacterial activity against Escherichia coli and Staphylococcus aureus. The inhibition zone diameter was measured at all concentrations (25%, 50%, 75%, and 100%), indicating their potential as antibacterial agents. The greatest level of antibacterial effectiveness against Escherichia coli was observed at a concentration of 50%, resulting in a zone of inhibition of 1.90 mm. In contrast, the most significant antibacterial activity against Staphylococcus aureus was observed at a concentration of 25%, resulting in a zone of inhibition measuring 4.50 mm. Keywords:Holothuria atraExtractMethanolAnticalculiAntibacteria
"Monilla Amena". Principios amazónicos para entender la producción cultural del mundo amerindio – Abiayalense
Authors: Rojas-Sotelo Miguel 
Published: January 2025

Usando una de las historias de origen Amazónico, Monilla Amena (el árbol de la vida y abundancia), se puede insertar críticamente la producción cultural y artística de este territorio transnacional y dar cuenta de artistas-territorio amazónicos que con agencia actúan sobre espacios hegemónicos de producción cultural. Este texto ofrece unos principios para entender la producción cultural del mundo amazónico, usa este mito como línea de tiempo y espacio, y pone a la estética situada y la práctica encarnada como ejes metodológicos. Esta aproximación, en tres dimensiones, contextualiza y sitúa cada práctica a su lugar de enunciación y enfatiza cómo el sujeto productor cultural encarna, literalmente, su territorio como interrupción colectiva y no solo individual. Adicionalmente introduce las nociones de fábula, diálogo, escucha en una suerte poliglotismo humananimal y vegehumano del mundo amazónico. Esta es una lectura crítica a las disciplinas académicas que miran a los productos culturales, categorizándolos y separándolos en ejercicios taxonómicos de captura y control. Para este ejercicio, los productores culturales son denominados artistas-territorio, pues trabajan situada y contextualmente y en continuo diálogo intercultural. Sus prácticas encarnadas son actos y eventos de tipo documental simbólico (político-estético) que interrumpen espacios dentro y fuera del mundo del arte y la cultura como estrategias para ejercer soberanía cultural desde el mundo amazónico. El corpus a tratar son pinturas rupestres ubicadas en los tepuyes precámbricos del Amazonas colombiano. Que se contrasta con el análisis de una pieza audiovisual contemporánea que representa al pueblo shipibo-konibo del noreste de Perú (Favarón, Bensho). Finalmente, el texto introduce a la generación emergente de artistas-territorio Pan Amazónicos. Entiéndase esta contribución también como un homenaje al maestro Fernando Urbina Rangel, guía al mundo amazónico y como una práctica cultural encarnada, ritualizada, situada y contextual que, de otra forma, sería un simple ejercicio académico.