bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stereotactic body radiation therapy as an effective local treatment for advanced hepatocellular carcinoma patients with inferior vena cava and right atrial tumor thrombus
Authors: Zhang Dan , Li Qian , Li Dong , Jia Jun , Ding JunQiang , Sun Jing , Duan Xuezhang 
Published: November 2022

Abstract
Background
The aim of our study was to evaluate the curative effect and safety of stereotactic body radiation therapy (SBRT) in treating hepatocellular carcinoma (HCC) patients with inferior vena cava (IVCTT) and right atrial tumor thrombus (RATT).

Methods
This retrospective study included fifteen advanced HCC patients with IVCTT and RATT who were treated with SBRT between 2013 and 2020. The prescribed dose delivered to the tumor was 45–50 Gy/7–10 fx. We report their treatment responses according to survival time and toxicities.

Results
For these patients, the median follow-up time was 15 months (2–52 months). Local tumor control rates of the treated area were 80% at the time of death or at the last follow-up. The 6-month, 12-month, 18-month and 24-month OS rates were 80.0%, 60.0%, 33.3% and 26.7%, respectively. None of these patients died from the toxicity outcomes and complications of SBRT.

Conclusion
SBRT is an effective option for advanced HCC patients with IVCTT and RATT.
Lateral flow assay (LFA) in the diagnosis of COVID-19-associated pulmonary aspergillosis (CAPA): a single-center experience
Authors: Serin Istemi , Baltali Sevim , Cinli Tahir Alper , Goze Hasan , Demir Burçak , Yokus Osman 
Published: November 2022

Abstract
Background
Invasive pulmonary aspergillosis (IPA) is seen during coronavirus-2019 (COVID-19), has been reported in different incidences, and is defined as COVID-19-associated pulmonary aspergillosis (CAPA). Detection of galactomannan antigen is an important diagnostic step in diagnosing IPA. Enzyme-linked immunoassay (ELISA) is the most frequently used method, and lateral flow assay (LFA) is increasingly used with high sensitivity and specificity for rapid diagnosis. The present study aimed to compare the sensitivity of LFA and ELISA in the diagnosis of CAPA in COVID-19 patients followed in our hospital's ICU for pandemic (ICU-P).

Methods
This study included patients with a diagnosis of COVID-19 cases confirmed by polymerase chain reaction and were followed up in ICU-P between August 2021 and February 2022 with acute respiratory failure. The diagnosis of CAPA was based on the European Confederation of Medical Mycology (ECMM) and the International Society for Human and Animal Mycology 2020 (ECMM/ ISHAM) guideline. Galactomannan levels were determined using LFA and ELISA in serum samples taken simultaneously from the patients.

Results
Out of the 174 patients followed in the ICU-P, 56 did not meet any criteria for CAPA and were excluded from the analysis. The rate of patients diagnosed with proven CAPA was 5.7% (10 patients). A statistically significant result was obtained with LFA for the cut-off value of 0.5 ODI in the diagnosis of CAPA (p < 0.001). The same significant statistical relationship was found for the cut-off value of 1.0 ODI for the ELISA (p < 0.01). The sensitivity of LFA was 80% (95% CI: 0.55–1.05, p < 0.05), specificity 94% (95% CI: 0.89–0.98, p < 0.05); PPV 53% (95% CI: 0.28–0.79, p > 0.05) and NPV was 98% (95% CI: 0.95–1.01, p < 0.05). The risk of death was 1.66 (HR: 1.66, 95% CI: 1.02–2.86, p < 0.05) times higher in patients with an LFA result of ≥ 0.5 ODI than those with < 0.5 (p < 0.05).

Conclusions
It is reckoned that LFA can be used in future clinical practice, particularly given its effectiveness in patients with hematological malignancies and accuracy in diagnosing CAPA.
Technology-free predictors of preterm birth in singleton women with threatened preterm labor: a prospective cohort study
Authors: Najjarzadeha Maryam , Mohammad-Alizadeh-Charandabi Sakineh , Abbasalizadeh Shamsi , Asghari-Jafarabadi Mohammad , Mirghafourvand Mojgan 
Published: November 2022

Abstract
Background
Prediction of preterm birth is still a challenge due to its multiple etiologies. This prospective cohort study aimed to determine the technology-free predictors of preterm birth in singleton women with threatened preterm labor.

Methods
This prospective cohort study was performed on 371 singleton women with gestational age of 23+ 6 to 36+ 4 weeks hospitalized for threatened preterm labor. The data were collected using a questionnaire including demographic characteristics, medical and maternal history, as well as the Perceived Stress Scale (PSS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the WHO’s questionnaire of Violence against Women (VAW). The participants were followed-up until childbirth. The predictors were determined using multivariate logistic regression.

Results
Preterm birth occurred in 51% of women. Seven variables were determined as predictors; rupture of membranes [adjusted odds ratio 11.7, 95% confidence interval 5.4 to 25.6], cervical dilation [AOR 4.1, 95% CI 2.0 to 7.0], gravidity ≥6 [AOR 27.4, 95%CI 2.8 to 264.3], psychological violence during pregnancy [AOR 2.0, 95% CI 1.1 to 3.2], medical problems in pregnancy onset [AOR 1.7, 95% CI 1.1 to 2.8], vaginal bleeding/spotting [AOR 2.1, 95% CI 1.2 to 4.0] and woman age ≤ 19 [AOR 2.2, 95% CI 1.1 to 4.5]. The proportion of variance explained by all these factors was 33.6%.

Conclusions
The technology-free factors seems to have moderate power in preterm birth prediction in singleton pregnant women hospitalized for threatened preterm labor. However, these results are discoveries without verification or validation and need to be confirmed by generalizable studies.
Comparison of surgical outcomes with and without Ologen collagen matrix augmentation during XEN gel stent implantation
Authors: Park Jimin , Shin Joong Won , Sung Kyung Rim 
Published: November 2022

Abstract
Background
To compare the surgical outcomes and postoperative complications with and without Ologen collagen matrix augmentation during XEN gel stent implantation.

Methods
We retrospectively analyzed patients who underwent XEN gel stent implantation with an ab externo technique. The amount of intraocular pressure (IOP) reduction, percentage of postoperative complications and additional management, and surgical success defined as IOP reduction greater than 20% compared with the preoperative IOP measurement were compared between Ologen-augmented and non-augmented groups. Groups of patients who underwent XEN gel stent implantation alone and combined with phacoemulsification were analyzed separately.

Results
A total 103 eyes of 103 participants were included. Of those, 72 eyes underwent standalone XEN gel stent implantation: 42 eyes with Ologen augmentation (Oloxen group) and 30 eyes without Ologen augmentation (Xen group). Thirty-one eyes underwent XEN gel stent implantation with phacoemulsification: 19 eyes with Ologen augmentation (Phaco-Oloxen group) and 12 eyes without Ologen augmentation (PhacoXen group). The surgical success rate at six months postoperatively was not different between the Oloxen and Xen groups (56.4% vs 43.3%, P > 0.05) or between the Phaco-Oloxen group and PhacoXen group (57.9% vs 41.7%, P > 0.05). The prevalence of postoperative hypotony, 5-fluorouracil injections, use of anti-glaucoma medications, bleb needling, and additional glaucoma surgeries was not different between the Oloxen and Xen groups or between the Phaco-Oloxen and PhacoXen groups when assessed six months postoperatively.

Conclusions
All groups showed significant IOP reduction after XEN gel stent implantation, but there was no significant difference between the Ologen collagen matrix augmented and non-augmented groups in surgical outcomes.
Vitamin D levels among children, adolescents, adults, and elders in Pakistani population: a cross-sectional study
Authors: Arshad Saba , Zaidi Syed Jaffar Abbas 
Published: November 2022

Abstract
Background
Vitamin D is not only an essential part of a healthy diet but it is also known as the sunshine hormone. It helps to absorb calcium and phosphate within the body and is essential for the development of teeth and bones in growing children. Deficiency in vitamin D causes weak bones, osteoporosis in older individuals, and osteomalacia in children. It also causes loss of alveolar bone around the teeth, increased dental cavities, and other problems associated with gum disease. It can cause depression, fatigue, and appetite loss. This study aims to observe vitamin D deficiency, insufficiency, and sufficiency among children, adults, adolescents, and elders in the Pakistani population.

Methods
A cross-sectional survey was conducted with 27,880 individuals referred from the general out-patient-department (OPD) to Dow Diagnostic Research and Reference Laboratory (DDRRL) units at Dow University of Health Sciences (DUHS) Karachi, Pakistan, for a period of three months from January to March 2017. They were examined for laboratory findings of serum 25 hydroxyvitamin D levels to determine vitamin D deficiency, insufficiency, and sufficiency among all age groups of both male and female genders.

Results
A total of 26,750 individuals with a mean age of 38 ± 18 years were statistically examined for laboratory findings of serum vitamin D levels. Vitamin D deficiency was observed in 56% of individuals with a mean log of 1.01 ± 0.18 ng/ml serum vitamin D levels, vitamin D insufficiency in 20% of individuals with a mean log of 1.38 ± 0.05 ng/ml serum vitamin D levels and vitamin D sufficiency in 24% individuals with a mean log of 1.63 ± 0.12 ng/ml serum vitamin D levels. The highest percentage of individuals deficient in vitamin D were children and adolescents of age ranging between 6 to 18 years.

Conclusion
The findings of vitamin D deficiency in children and adolescents direct higher authorities in the public health sector to take immediate steps to screen, intervene and educate high-risk populations incorporating vitamin D supplements to establish preventive and therapeutic measures.
Comparison of supervised exercise therapy with or without biopsychosocial approach for chronic nonspecific low back pain: a randomized controlled trial
Authors: Hrkać Antonija , Bilić Darko , Černy-Obrdalj Edita , Baketarić Ivan , Puljak Livia 
Published: November 2022

Abstract
Background
A biopsychosocial rehabilitation is recommended for chronic nonspecific low back pain (CNLBP); however, its effectiveness compared to the traditional supervised exercise therapy of CNLBP treatment is still unclear.

Methods
This was a parallel-group randomized controlled clinical trial. The sample consisted of 180 participants of both sexes, aged ≥18 years, with CNLBP for ≥3 months. Using web randomization and concealed allocation, they were assigned to three groups; graded activity receiving cognitive-behavioral therapy, group-based combined exercise therapy and education (GA; n = 59), supervised group-based combined exercise therapy and education (SET; n = 63), and a control group receiving usual care (n = 58). Interventions were administered for 4 weeks (8 sessions). The primary outcome was pain intensity. Outcome measures were collected baseline, after interventions (4 weeks), and during two follow-up periods (3 and 6 months).

Results
After the intervention, GA had a significant large effect on pain reduction compared to the control group (MD of 22.64 points; 95% CI = 16.10 to 29.19; p < 0.0001; Cohen’s d = 1.70), as well as SET compared with the control group (MD of 21.08 points; 95% CI = 14.64 to 27.52; p < 0.0001; Cohen’s d = 1.39), without significant difference between two intervention groups. At 3 and 6 months of follow-up, GA had a statistically significantly better effect in reducing pain, disability and fear-avoidance beliefs, and improving spinal extensor endurance, range of extension and quality of life compared to SET and the control group. A statistically significantly better effect of SET compared with the control group was found in reducing pain, disability, fear-avoidance beliefs, and improving the physical component of quality of life. Harms were not reported.

Conclusion
This study suggests that graded activity and group-based supervised exercise therapy have beneficial effects over the control group in the treatment of CNLBP. The graded activity was more beneficial than supervised group-based exercise therapy only during the follow-up.

Trial registration
Clinicaltrials.gov (NCT04023162; registration date: 17/07/2019).
Chondromalacia patella increases the risk of herpes zoster: a population-based study
Authors: Chen Chia-Hung , Cheng Yung-Chi , Yang Hsin-Yi , Tsai Ching-Fang , Hsu Chao-Yu , Ke Der-Shin , Hsieh Wen-Che 
Published: November 2022

AbstractBackgroundThe reactivation of herpes zoster (HZ) is associated with disease stress. However, the relationship between chondromalacia patella (CMP) and HZ remains poorly understood. This study investigated the relationship between CMP and the risk of developing HZ.MethodsData were collected from the Taiwan’s National Health Insurance Research Database. Patients with CMP diagnosed between 2000 and 2017 were assigned to the case group; patients without CMP were randomly selected from the same database and paired with controls matched by age and sex. The primary outcome was a diagnosis of HZ. All patients were followed until their diagnosis of HZ, their withdrawal from the NHI program, their death, or the end of 2017, whichever was earliest. The risk of developing HZ was compared between the case and control groups.ResultsIn total, 22,710 patients with CMP and 90,840 matched controls were enrolled. The overall incidence rates of HZ in the CMP and control cohorts were 7.94 and 7.35 per 1,000 person-years, respectively. After potential confounders were controlled for, the case group exhibited a higher risk of HZ than did the control group [adjusted hazard ratio (aHR) = 1.06, p < 0.05]. In a stratification analysis by age, patients over 65 years old in the CMP group exhibited a higher risk of HZ than did those in the control group (aHR = 1.22, p < 0.01). In a stratification analysis by sex, women with CMP were at greater risk of developing HZ than women without CMP (aHR = 1.18, p < 0.01).ConclusionPatients with CMP, especially elder adults and women, exhibited a higher risk of HZ. The HZ risk of patients with CMP should thus be assessed, and the necessity of HZ vaccination should be informed.
False certainty in the acquisition of anatomical and physiotherapeutic knowledge
Authors: von Hoyer Johannes , Bientzle Martina , Cress Ulrike , Grosser Johannes , Kimmerle Joachim , Peter Holtz  
Published: November 2022

Abstract
Background
Efficient metacognitive monitoring, that is the monitoring of one’s own thought processes and specifically one’s state of knowledge, is essential for effective clinical reasoning. Knowing what one does and does not know is a competency that students of health professions need to develop. Students often tend to develop false certainty in their own knowledge in the longer course of their education, but the time frame that is required for this effect to occur has remained unclear. We investigated whether students developed false certainty already after one course unit.

Methods
This study analysed data from one sample of medical students and four samples of physiotherapy students in two formal educational settings (total N = 255) who took knowledge tests before and after a course unit. We examined changes in students’ confidence separately for correctly and incorrectly answered questions and analysed their ability to assign higher levels of confidence to correct answers than to incorrect answers (discrimination ability).

Results
Students’ knowledge as well as confidence in their correct answers in knowledge tests increased after learning. However, consistently for all samples, confidence in incorrect answers increased as well. Students’ discrimination ability improved only in two out of the five samples.

Conclusions
Our results are in line with recent research on confidence increase of health professions students during education. Extending those findings, our study demonstrated that learning in two different formal educational settings increased confidence not only in correct but also in incorrect answers to knowledge questions already after just one learning session. Our findings highlight the importance of improving metacognition in the education of health professionals—especially their ability to know what they do not know.
Effect of different teaching/learning approaches using virtual patients on student’s situational interest and cognitive load: a comparative study
Authors: Fuoad Sura Ali , El-Sayed Walid , Marei Hesham 
Published: November 2022

Abstract
Background
Virtual Patients (VPs) have been receiving considerable attention in medical education as an authentic learning and teaching approach. The study aimed to evaluate the effect of using different approaches of conduction of virtual patients (VPs) on students’ cognitive load and situational interest.

Methods
The study is an experimental study. Two different cohorts have participated during the academic year 2019/2020 and 2020/2021. The first cohort (Group 1) was exposed to a lecture followed by an independent VPs session, and the second cohort (Group 2) was exposed to a collaborative VPs session. The situational interest and Cognitive load were compared between the two groups. All sessions are about one topic related to maxillofacial trauma.

Results
Findings showed that there was no significant difference between the median score of the situational interest at repeated time points during the Collaborative VPs (Group 2). However, in group 1, there was a significant difference between the median score of situational interest at repeated time points during independent VPs where the lowest score was found to be at the end of the session. Also, results showed that the collaborative VPs (Group 2) showed a high median score of situational interest than both lecture and independent VPs (Group 1). Furthermore, the study showed that there is no significant difference in the intrinsic cognitive load among the three sessions. However, the extraneous cognitive load was low in collaborative VPs (Group 2) than in both lecture and independent VPs sessions (Group 1).

Conclusion
The use of VPs in a collaborative interactive learning activity is more effective than its use as an independent learning activity in enhancing students’ situational interest and reducing cognitive load. However, giving independent VPs after the lecture with the same topic is considered a limitation of the study as this can affect the situational interest of the students by filling their gab of knowledge.
‘A life in a day’ simulation experience: perceptions of oncology nurses and pharmacy staff
Authors: Ehibhatiomhan Rachel , Foreman Emma , Barrott Lisa , Shek Jessica , Nabhani-Gebara Shereen 
Published: November 2022

Abstract
Background
Due to an increase in patient numbers, more cancer patients are being reviewed by non-medical healthcare professionals (HCPs), and it is essential that they can empathise with patients and care for them holistically. ‘A Life in a Day’ is a role reversal simulation (RRS) which demonstrates the challenges, choices and impacts that cancer patients face every day, facilitated by a Smartphone application (app). This study focused on renal cell carcinoma (RCC) and was designed to evaluate the impact of RRS on participants from the British Oncology Pharmacy Association (BOPA) and the UK Oncology Nursing Society (UKONS), and identify any changes made to clinical practice as a result.

Method
A survey was conducted via the app before and after the experience. Individual semi-structured interviews were conducted with participants over Microsoft Teams.

Results
Data from the survey showed that after the experience 97% of all participants strongly agreed that they ‘feel empathy for RCC patients’ and 90% strongly agreed that they ‘feel inspired to place patients at the centre of their work’. There were 5 themes extrapolated from the qualitative data: Holistic understanding of Patients, Reflections on Practice, Changes in Practice, Outreach to Colleagues, Education & Training.

Conclusion
Participants reported an increase in empathy for their patients which inspired them to make changes to their practice. This involved being more holistic in their care and taking on more responsibility. They recommended use of RRS for HCP training and continued professional development. They also suggested incorporation of RRS into the pharmacy undergraduate curriculum.
Comparison between immunotherapy efficacy in early non-small cell lung cancer and advanced non-small cell lung cancer: a systematic review
Authors: Wang Yimin , Li Chuling , Wang Zimu , Wang Zhaofeng , Wu Ranpu , Wu Ying , Song Yong , Liu Hongbing 
Published: November 2022

Abstract
Background
Currently, immunotherapy is widely used in the treatment of various stages of non-small cell lung cancer. According to clinical experience and results of previous studies, immunotherapy as neoadjuvant therapy seems to exhibit better efficacy against early resectable non-small cell lung cancer as compared to advanced lung cancer, which is often defined as unresectable non-small cell lung cancer. However, this observation has not been established in clinical studies. This systematic review aimed to evaluate the efficacy of immunotherapy in early and late lung cancer, wherein objective response rate (ORR) and disease control rate (DCR) were used as evaluation indexes. The present study also evaluated the safety of immunotherapy in early and late lung cancer, wherein the rate of treatment-related adverse reactions (TRAEs) was used as an indicator.

Methods
Electronica databases, including PubMed, Cochrane Library, Embase, and other databases, were searched to identify relevant studies. Besides this, all the available reviews, abstracts, and meeting reports from the main international lung cancer meetings were searched manually. ORR, DCR, and TRAEs were extracted as the primary outcomes.

Results
A total of 52 randomized controlled trials involving 13,660 patients were shortlisted. It was observed that immunotherapy alone significantly improved DCR in early lung cancer in comparison to advanced lung cancer. Importantly, the improvement in ORR was not to the same extent as reported in the case of advanced lung cancer. The combination of immunotherapy with other therapies, especially immunochemotherapy, significantly improved ORR and DCR in early lung cancer. In terms of safety, immunotherapy either alone or in combination with other therapies exhibited a better safety profile in early lung cancer than in advanced lung cancer.

Conclusions
Altogether, the benefits of immunotherapy in early lung cancer appeared to be better than those observed in advanced lung cancer, especially with the regard to the regimen of immunotherapy in combination with chemotherapy. In terms of safety, both immunotherapy alone and its combination with chemotherapy were found to be safer in early lung cancer as compared to advanced lung cancer.