bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of different cover letter information and incentives on Veterans’ emotional responses to an unsolicited mailed survey about military traumas: a randomized, 3x2x2 factorial trial
Authors: Murdoch Maureen , Clothier Barbara A , Kehle-Forbes Shannon , Vang Derek , Noorbaloochi Siamak 
Published: December 2022

Abstract
Background
Altering cover letter information to reduce non-response bias in trauma research could inadvertently leave survey participants unprepared for potentially upsetting questions. In an unsolicited, mailed survey, we assessed participants’ change in affect post-survey after altering key cover letter information and promising different incentives. We tested direct and indirect effects of participants carefully reading the cover letter on changes in their affect post-survey.

Methods
In a 3X2X2 randomized, factorial trial, 480 male and 480 female, nationally representative Veterans who were applying for posttraumatic stress disorder disability benefits were randomized to receive one of 12 different cover letters. The cover letters provided general versus more explicit information about the survey’s trauma content and how their names were selected for study; we also promised different incentives for returning the survey. The main outcome was change in affect post-survey. We examined five potential moderators: combat or military sexual trauma exposure, posttraumatic stress disorder or serious mental illness diagnosis, and recency of military service. Mediators between reading the cover letter carefully and post-survey affect included how participants rated the cover letters’ information and whether they thought the cover letters prepared them for the survey’s content. A Bonferroni corrected alpha of 0.003 was the threshold for statistical significance.

Results
One hundred ninety men and 193 women reported their pre-and post-survey affect. Across all study conditions, out of 16 possible points, the net change in affect post-survey was less than a quarter-point for men and women. Mean changes in post-survey affect did not differ statistically significantly across any of the study factors (ps > 0.06); nor were there statistically significant interactions between any of the study factors and the 5 moderators after accounting for multiple comparisons (ps > 0.02). After controlling for pre-survey affect, reading the cover letter carefully had small effects on changes in post-survey affect, with larger associations seen in the women compared to men. Mediators’ effects were often in opposite directions for men and women.

Conclusion
General descriptions of a survey’s trauma content appear ethically defensible. Research on cover letters’ impacts on survey participants’ emotional reactions and how those impacts differ by gender is needed.
Efficacy of ustekinumab, vedolizumab, or a second anti-TNF agent after the failure of a first anti-TNF agent in patients with Crohn’s disease: a multicentre retrospective study
Authors: Rayer Cassandra , Nachury Maria , Bourreille Arnaud , Roblin Xavier , Peyrin-Biroulet Laurent , Viennot Stephanie , Flamant Mathurin , Laharie David , Caron Bénédicte , Dewitte Marie , Siproudhis Laurent , Fumery Mathurin , Bouguen Guillaume 
Published: December 2022

AbstractBackgroundNo study has performed a face-to-face comparison of biologics after the failure of the first anti-TNF agent in patients with Crohn’s disease (CD). The aim of the study was to compare the efficacy of biologics in this setting.MethodsPatients with CD who were refractory to a first anti-TNF agent, and treated with ustekinumab (UST), vedolizumab (VDZ), or a second anti-TNF drug as a second-line biological agent at 10 French tertiary centres from 2013 to 2019 were retrospectively included in this study.ResultsAmong the 203 patients included, 90 (44%) received UST, 42 (21%) received VDZ and 71 (35%) received a second anti-TNF agent. The first anti-TNF agent was discontinued due to a primary nonresponse in 42 (21%) patients. At weeks 14–24, the rates of steroid-free remission were similar between the UST, VDZ and second anti-TNF groups (29%, 38% and 44%, respectively,p = 0.15). With a mean follow-up of 118 weeks, drug survival was shorter for patients who received ustekinumab treatment (p = 0.001). In the case of trough level less than 5 µg/ml, patients treated with a second anti-TNF agent had a higher postinduction remission rate (p = 0.002), and drug survival (p = 0.0005). No other relevant factors were associated with treatment efficacy, including trough levels greater than 5 µg/ml.ConclusionsVDZ, UST and a second anti-TNF agent exhibit similar efficacy in the short term, as second-biological line treatment in patients with CD who are refractory to a first anti-TNF agent, but shorter drug maintenance is observed for patients treated with UST.
Cultural adaptation and validation of the Malay Chronic Kidney Disease Self-management instrument (MCKD-SM)
Authors: Al Sawad Ayat Ali , Lim Soo Kun , Tang Li Yoong , Rashid Aneesa Abdul , Chew Boon-How 
Published: December 2022

Abstract
Background
There is growing evidence that self‐management behaviour can improve outcomes for patients with chronic kidney disease (CKD). However, no measures are available in Malay to effectively assess the self-management of CKD. The aim of this study was to translate, culturally adapt and validate the Malay Chronic Kidney Disease Self-Management (MCKD-SM) instrument for Malay-speaking health professionals and patients.

Methods
This study was carried out in two phases: the translation and cultural adaptation phase and the validation phase. The instrument was translated from English to Malay and then adapted and validated in a sample of 337 patients with CKD stages 3–4 attending a nephrology clinic in a tertiary hospital in Malaysia. Structural validity was evaluated by exploratory factor analysis. The instrument’s reliability was assessed by internal consistency and test–retest reliability. The correlations between the MCKD-SM and kidney disease knowledge and the MCKD-SM and self-efficacy were hypothesised a priori and investigated.

Results
The MCKD-SM instrument has 29 items grouped into three factors: ‘Understanding and Managing My CKD’, ‘Seeking Support’ and ‘Adherence to Recommended Regimen’. The three factors accounted for 56.3% of the total variance. Each factor showed acceptable internal reliability, with Cronbach’s α from 0.885 to 0.960. The two-week intra-rater test–retest reliability intraclass correlation coefficient values for all items ranged between 0.938 and 1.000. The MCKD-SM scores significantly correlated with kidney disease knowledge (r = 0.366, p < 0.01) and self-efficacy (r = 0.212, p < 0.01).

Conclusion
The MCKD-SM was found to be a valid and reliable patient‐reported outcome measure of pre-dialysis CKD self-management behaviour in the Malay-speaking population.
Primary intraventricular synovial sarcoma of the brain with recurrence - case presentation
Authors: McCool Anna , Turner Clinton , Turner Sarah , Heppner Peter , Saran Frank 
Published: December 2022

Abstract
Background
We report a case of recurrent primary intraventricular synovial sarcoma of the brain with no extracranial primary, initially reported as a haemangiopericytoma. We believe this is the first reported case of primary intraventricular synovial sarcoma at this site.

Case presentation
A 27-year-old male presented to hospital with a new onset of seizures. Imaging revealed a left ventricular trigone mass with surrounding oedema. He underwent a left occipito-temporal craniotomy and resection with the histology reported as haemangiopericytoma. Resection was followed by adjuvant radiation treatment. Seven years later follow-up imaging revealed a 4 mm contrast enhancing lesion in the previous surgical bed. The patient underwent resection. Histological analysis of the recurrence revealed a spindle cell tumour with a SS18 gene rearrangement consistent with synovial sarcoma. Retrospective fluorescent in-situ hybridisation analysis of original histology also revealed a SS18 gene rearrangement consistent with a diagnosis of synovial sarcoma.

Conclusion
Synovial sarcoma should be included as part of the differential diagnosis for patients presenting with intraventricular spindle cell tumours in the brain.
Risk prediction models of gestational diabetes mellitus before 16 gestational weeks
Authors: Wei Yiling , He Andong , Tang Chaoping , Liu Haixia , Li Ling , Yang Xiaofeng , Wang Xiufang , Shen Fei , Liu Jia , Li Jing , Li Ruiman 
Published: December 2022

Abstract
Background
Gestational diabetes mellitus (GDM) can lead to adverse maternal and fetal outcomes, and early prevention is particularly important for their health, but there is no widely accepted approach to predict it in the early pregnancy. The aim of the present study is to build and evaluate predictive models for GDM using routine indexes, including maternal clinical characteristics and laboratory biomarkers, before 16 gestational weeks.

Methods
A total of 2895 pregnant women were recruited and maternal clinical characteristics and laboratory biomarkers before 16 weeks of gestation were collected from two hospitals. All participants were randomly stratified into the training cohort and the internal validation cohort by the ratio of 7:3. Using multivariable logistic regression analysis, two nomogram models, including a basic model and an extended model, were built. The discrimination, calibration, and clinical validity were used to evaluate the models in the internal validation cohort.

Results
The area under the receiver operating characteristic curve of the basic and the extended model was 0.736 and 0.756 in the training cohort, and was 0.736 and 0.763 in the validation cohort, respectively. The calibration curve analysis showed that the predicted values of the two models were not significantly different from the actual observations (p = 0.289 and 0.636 in the training cohort, p = 0.684 and 0.635 in the internal validation cohort, respectively). The decision-curve analysis showed a good clinical application value of the models.

Conclusions
The present study built simple and effective models, indicating that routine clinical and laboratory parameters can be used to predict the risk of GDM in the early pregnancy, and providing a novel reference for studying the prediction of GDM.
Cerclage performance analysis – a biomechanical comparison of different techniques and materials
Authors: Hägerich L. M. , Dyrna F. G. E. , Katthagen J. C. , Michel P. A. , Heilmann L. F. , Frank A. , Raschke M. J. , Schliemann B. , Riesenbeck O. 
Published: December 2022

AbstractBackgroundWire cerclages play a fundamental role in fracture fixation. With an increasing variety of designs being commercially available the question arises which cerclage should be used.This study investigates the biomechanical properties of metallic and non-metallic cerclages and their different application-types. Furthermore, potential influence of muscular interposition between bone and cerclage constructs was tested.MethodsSamples of the following four different cerclage types were tested on 3D printed models of human humeri as well as on human cadaveric humeri with and without muscular interposition:Titanium Cable Cerclage (CC), Steel Wire Cerclage (SWC), Suture Tape (ST), Suture Tape Cerclage (STC) with both single- (sSTC) and double-loop application (dSTC). A preinstalled self-locking mechanism secured by the provided tensioner in the STCs being the main difference to the STs.Cyclic loading was performed to 1 kN and then linearly to a maximum load of 3 kN.Statistical analysis was performed using either one-way ANOVA and post-hoc Tukey or Kruskal–Wallis and post-hoc Dunn test depending on normalization of data (p < 0.05).ResultsWhilst all cerclage options could withstand high loads during failure testing,onlywithin the CC and dSTC group, all samples reached the maximal testing load of 3000 N without any failure. The SWC reached 2977.5 ± 63.6 N, the ST 1970.8 ± 145.9 N, and the sSTC 1617.0 ± 341.6 N on average.Neither muscular interposition nor bone quality showed to have a negative influence on the biomechanical properties of the cerclage constructs, presenting no significant differences.ConclusionAll tested cerclage constructs produce reliable stability but differ in their resulting compression forces, in a simplified fracture model. Therefore, non-metallic cerclage alternatives can provide similar stability with less compression and stiffness to metallic cable constructs, but they may offer several advantages and could possibly provide future benefits. Especially, by offering more elasticity without losing overall stability, may offer a biologic benefit. Installing any cerclage constructs should be performed carefully, especially if poor bone quality is present, as the tightening process leads to high forces on the construct.
Management of radicular cyst associated with primary teeth using decompression: a retrospective study
Authors: Pei Jun , Zhao Shimin , Chen Hui , Wang Jun 
Published: December 2022

Abstract
Background
Radicular cysts arising from primary teeth are rare. Enucleation and marsupialization or decompression are treatment approach to odontogenic cysts. Decompression known to achieve good results in various cysts is widely used in clinic. This study aims to evaluate the efficiency of decompression in reducing radicular cysts associated with primary teeth in children.

Methods
Cases of radicular cysts associated with primary teeth treated by decompression were reviewed in the present study. Clinical information and radiologic data of pre and post decompression were measured and analyzed.

Results
Twenty-three patients treated for 25 cysts were included. All lesions with mean initial area 3.66 ± 2.00 cm2 were reduced after decompression time ranging 2 to 10 months. Mean rate of reduction was 0.77 ± 0.44 cm2/mo and large lesions (> 3.5 cm2) had a significantly higher reduction rate compared to smaller ones (< 3.5 cm2) (P < 0.00). All effected succedaneous teeth erupted after treatment at follow-up while 12 (46%) of them had root development problems.

Conclusions
Decompression represents superiority as an effective and less invasive treatment in radicular cysts associated with primary teeth.
Trial registration: This study was retrospectively registered in the Ethics Committee of Ninth People’s Hospital Affiliated with Shanghai JiaoTong University School of Medicine (No.SH9H-2022-T158-1).
Structured implementation of the Supportive and Palliative Care Indicators Tool in general practice – A prospective interventional study with follow-up
Authors: Afshar Kambiz , van Baal Katharina , Wiese Birgitt , Schleef Tanja , Stiel Stephanie , Müller-Mundt Gabriele , Schneider Nils 
Published: December 2022

Abstract
Background
General practitioners (GPs) play a key role in the provision of primary palliative care (PC). The identification of patients who might benefit from PC and the timely initiation of patient-centred PC measures at the end of life are essential, yet challenging. Although different tools exist to support these key tasks, a structured approach is often missing.

Objective
The study aimed at implementing the German version of the Supportive and Palliative Care Indicators Tool (SPICT-DE™) in general practices, following a structured and regional approach, in order to evaluate the effects of this tool on the identification of patients with potential PC needs and the initiation of patient-centred PC measures.

Methods
The intervention of this mixed-methods study comprised a standardised training of 52 GPs from 34 general practices in two counties in Lower Saxony, Germany, on the use of the SPICT-DE™. The SPICT-DE™ is a clinical tool which supports the identification of patients with potential PC needs. Subsequently, over a period of 12 months, GPs applied the SPICT-DE™ in daily practice with adult patients with chronic, progressive diseases, and completed a follow-up survey 6 months after the initial patient assessment. The outcome parameters were alterations in the patient’s clinical situation, and the type and number of initiated patient-centred PC measures during the follow-up interval. Additionally, 12 months after the standardised training, GPs provided feedback on their application of the SPICT-DE™.

Results
A total of 43 GPs (n = 15 female, median age 53 years) out of an initial sample of 52 trained GPs assessed 580 patients (n = 345 female, median age 84 years) with mainly cardiovascular (47%) and cancer (33%) diseases. Follow-up of 412 patients revealed that 231 (56%) experienced at least one critical incident in their disease progression (e.g. acute crisis), 151 (37%) had at least one hospital admission, and 141 (34%) died. A review of current treatment/medication (76%) and a clarification of treatment goals (53%) were the most frequently initiated patient-centred PC measures. The majority of GPs deemed the SPICT-DE™ practical (85%) and stated an intention to continue applying the tool in daily practice (66%).

Conclusions
The SPICT-DE™ is a practical tool that supports the identification of patients at risk of deterioration or dying and promotes the initiation of patient-centred PC measures.

Trial registration
The study was registered in the German Clinical Trials Register (N° DRKS00015108; 22/01/2019).
Integrated clinical case discussions – a fully student-organized peer-teaching program on internal medicine
Authors: Reifenrath Johannes , Seiferth Nick , Wilhelm Theresa , Holzmann-Littig Christopher , Phillip Veit , Wijnen-Meijer Marjo 
Published: December 2022

Abstract
Background
In response to students´ poor ratings of emergency remote lectures in internal medicine, a team of undergraduate medical students initiated a series of voluntary peer-moderated clinical case discussions. This study aims to describe the student-led effort to develop peer-moderated clinical case discussions focused on training cognitive clinical skill for first and second-year clinical students.

Methods
Following the Kern Cycle a didactic concept is conceived by matching cognitive learning theory to the competence levels of the German Medical Training Framework. A 50-item survey is developed based on previous evaluation tools and administered after each tutorial. Educational environment, cognitive congruence, and learning outcomes are assessed using pre-post-self-reports in a single-institution study.

Results
Over the course of two semesters 19 tutors conducted 48 tutorials. There were 794 attendances in total (273 in the first semester and 521 in the second). The response rate was 32%. The didactic concept proved successful in attaining all learning objectives. Students rated the educational environment, cognitive congruence, and tutorials overall as “very good” and significantly better than the corresponding lecture. Students reported a 70%-increase in positive feelings about being tutored by peers after the session.

Conclusion
Peer-assisted learning can improve students´ subjective satisfaction levels and successfully foster clinical reasoning skills. This highlights successful student contributions to the development of curricula.
Analysis of the effect of an artificial intelligence chatbot educational program on non-face-to-face classes: a quasi-experimental study
Authors: Han Jeong-Won , Park Junhee , Lee Hanna 
Published: December 2022

Abstract
Background
Education and training are needed for nursing students using artificial intelligence-based educational programs. However, few studies have assessed the effect of using chatbots in nursing education.

Objectives
This study aimed to develop and examine the effect of an artificial intelligence chatbot educational program for promoting nursing skills related to electronic fetal monitoring in nursing college students during non-face-to-face classes during the COVID-19 pandemic.

Design
This quasi-experimental study used a nonequivalent control group non-synchronized pretest–posttest design.

Methods
The participants were 61 junior students from a nursing college located in G province of South Korea. Data were collected between November 3 and 16, 2021, and analyzed using independent t-tests.

Results
The experimental group—in which the artificial intelligence chatbot program was applied—did not show statistically significant differences in knowledge (t = -0.58, p = .567), clinical reasoning competency (t = 0.75, p = .455), confidence (t = 1.13, p = .264), and feedback satisfaction (t = 1.72, p = .090), compared with the control group; however, its participants’ interest in education (t = 2.38, p = .020) and self-directed learning (t = 2.72, p = .006) were significantly higher than those in the control group.

Conclusion
The findings of our study highlighted the potential of artificial intelligence chatbot programs as an educational assistance tool to promote nursing college students’ interest in education and self-directed learning. Moreover, such programs can be effective in enhancing nursing students’ skills in non-face-to face-situations caused by the ongoing COVID-19 pandemic.
Perfusion imaging heterogeneity during NO inhalation distinguishes pulmonary arterial hypertension (PAH) from healthy subjects and has potential as an imaging biomarker
Authors: Winkler Tilo , Kohli Puja , Kelly Vanessa J. , Kehl Ekaterina G. , Witkin Alison S. , Rodriguez-Lopez Josanna M. , Hibbert Kathryn A. , Kone Mamary T. , Systrom David M. , Waxman Aaron B. , Venegas Jose G. , Channick Richard N. , Harris R. Scott 
Published: December 2022

Abstract
Background
Without aggressive treatment, pulmonary arterial hypertension (PAH) has a 5-year mortality of approximately 40%. A patient’s response to vasodilators at diagnosis impacts the therapeutic options and prognosis. We hypothesized that analyzing perfusion images acquired before and during vasodilation could identify characteristic differences between PAH and control subjects.

Methods
We studied 5 controls and 4 subjects with PAH using HRCT and 13NN PET imaging of pulmonary perfusion and ventilation. The total spatial heterogeneity of perfusion (CV2Qtotal) and its components in the vertical (CV2Qvgrad) and cranio-caudal (CV2Qzgrad) directions, and the residual heterogeneity (CV2Qr), were assessed at baseline and while breathing oxygen and nitric oxide (O2 + iNO). The length scale spectrum of CV2Qr was determined from 10 to 110 mm, and the response of regional perfusion to O2 + iNO was calculated as the mean of absolute differences. Vertical gradients in perfusion (Qvgrad) were derived from perfusion images, and ventilation-perfusion distributions from images of 13NN washout kinetics.

Results
O2 + iNO significantly enhanced perfusion distribution differences between PAH and controls, allowing differentiation of PAH subjects from controls. During O2 + iNO, CV2Qvgrad was significantly higher in controls than in PAH (0.08 (0.055–0.10) vs. 6.7 × 10–3 (2 × 10–4–0.02), p < 0.001) with a considerable gap between groups. Qvgrad and CV2Qtotal showed smaller differences: − 7.3 vs. − 2.5, p = 0.002, and 0.12 vs. 0.06, p = 0.01. CV2Qvgrad had the largest effect size among the primary parameters during O2 + iNO. CV2Qr, and its length scale spectrum were similar in PAH and controls. Ventilation-perfusion distributions showed a trend towards a difference between PAH and controls at baseline, but it was not statistically significant.

Conclusions
Perfusion imaging during O2 + iNO showed a significant difference in the heterogeneity associated with the vertical gradient in perfusion, distinguishing in this small cohort study PAH subjects from controls.