bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detection of primary Sjögren’s syndrome in primary care: developing a classification model with the use of routine healthcare data and machine learning
Authors: Dros Jesper T. , Bos Isabelle , Bennis Frank C. , Wiegersma Sytske , Paget John , Seghieri Chiara , Barrio Cortés Jaime , Verheij Robert A. 
Published: August 2022

Abstract
Background
Primary Sjögren’s Syndrome (pSS) is a rare autoimmune disease that is difficult to diagnose due to a variety of clinical presentations, resulting in misdiagnosis and late referral to specialists. To improve early-stage disease recognition, this study aimed to develop an algorithm to identify possible pSS patients in primary care. We built a machine learning algorithm which was based on combined healthcare data as a first step towards a clinical decision support system.

Method
Routine healthcare data, consisting of primary care electronic health records (EHRs) data and hospital claims data (HCD), were linked on patient level and consisted of 1411 pSS and 929,179 non-pSS patients. Logistic regression (LR) and random forest (RF) models were used to classify patients using age, gender, diseases and symptoms, prescriptions and GP visits.

Results
The LR and RF models had an AUC of 0.82 and 0.84, respectively. Many actual pSS patients were found (sensitivity LR = 72.3%, RF = 70.1%), specificity was 74.0% (LR) and 77.9% (RF) and the negative predictive value was 99.9% for both models. However, most patients classified as pSS patients did not have a diagnosis of pSS in secondary care (positive predictive value LR = 0.4%, RF = 0.5%).

Conclusion
This is the first study to use machine learning to classify patients with pSS in primary care using GP EHR data. Our algorithm has the potential to support the early recognition of pSS in primary care and should be validated and optimized in clinical practice. To further enhance the algorithm in detecting pSS in primary care, we suggest it is improved by working with experienced clinicians.
The Otago Exercise Program compared to falls prevention education in Zuni elders: a randomized controlled trial
Authors: Waters Debra L. , Popp Janet , Herman Carla , Ghahate Donica , Bobelu Jeanette , Pankratz Vernon S. , Shah Vallabh O. 
Published: August 2022

Abstract
Background
When a Zuni elder sustains a fall-related injury, the closest tribal skilled nursing facility is 100 miles from the Pueblo and no physical therapy services are available. Thus, fall prevention strategies as a primary intervention to avert injurious falls and preserve aging in place are needed. The objective of the study is to compare the effectiveness of a community health representative (CHR)-delivered, culturally-adapted Otago Exercise Program (OEP) fall prevention program compared to the standard of care education-based fall risk management.

Methods
“Standing Strong in Tribal Communities: Assessing Elder Falls Disparity” is mixed-methods research with a randomized controlled trial. The CHRs will be trained to deliver the culturally-adapted OEP trial and offer advantages of speaking “Shiwi” (Zuni tribal language) and understanding Zuni traditions, family structures, and elders’ preferences for receiving health information. Focus groups will be conducted to assure all materials are culturally appropriate, and adapted. A physical therapist will train CHRs to screen elders for falls risk and to deliver the OEP to the intervention group and education to the control group. Up to 400 Zuni elders will be screened by the CHRs for falls risk and 200 elders will be enrolled into the study (1:1 random allocation by household). The intervention is 6 months with measurements at baseline, 3, 6 and 12 months. The primary outcome is improved strength and balance (timed up and go, sit to stand and 4 stage balance test), secondary outcomes include falls incidence, self-efficacy using Attitudes to Falls-Related Interventions Scale, Medical Outcomes Study Short Form 12 (SF-12v2) and Self-Efficacy for Managing Daily Activities.

Discussion
Fall prevention for Zuni elders was identified as a tribal priority and this trial is built upon longstanding collaborations between the investigative team, Zuni tribal leaders, and multiple tribal health programs. Delivery by the CHRs make this model more acceptable, and thus, more sustainable long term. This study has the potential to change best practice for elder care in tribal and rural areas with limited access to physical therapist-delivered fall prevention interventions and aligns with tribal goals to avert fall-related injury, reduce healthcare disparity, and preserve elder’s independence.

Trial registration
NCT04876729
Responsiveness level and its effect on services quality from the viewpoints of the older adults hospitalized during COVID-19 pandemic
Authors: Yusefi Ali Reza , Davarani Esmat Rezabeigi , Daneshi Salman , Bastani Misagh , Mehralian Gholamhossein , Bastani Peivand 
Published: August 2022

Abstract
Background
Aging is a sensitive period of life. Attention to the needs of this stage is considered a social necessity. This study is conducted to investigate the responsiveness level and its effect on service quality from the hospitalized older adults’ viewpoints during the COVID-19 pandemic in the south of Iran.

Methods
It was a cross-sectional descriptive-analytic study that was conducted on 386 old patients. The study instrument was a standard questionnaire that includes three sections of demographic information, World Health Organization Responsiveness, and SERVQUAL. Data were analyzed applying descriptive and inferential statistics the same as Independent T-test, ANOVA, Pearson correlation, and multiple linear regression.

Results
The mean levels of responsiveness and service quality were 90.72 ± 9.38 (from 160) and 68.01 ± 8.51 (from 110) respectively. This indicates the average level of these variables from the old patients’ viewpoints. There was a significant positive correlation between responsiveness and service quality (r = 0.585). According to the results of multiple linear regression, the dimensions of communication, dignity, prompt attention, primary facilities, social support, information confidentiality, right to choose, and autonomy were identified as the predictors of service quality.

Conclusion
The average level of responsiveness and service quality perceived from the old patients’ viewpoints during the COVID-19 pandemic can be considered a necessity for supportive planning among the older adults. Meanwhile, according to the impacts of responsiveness on service quality, educational programs are recommended to promote the level of healthcare providers’ responsiveness.
Early diagnosis of spinal tuberculosis by magnetic resonance: perfusion weighted imaging in a rabbit model
Authors: Liu Xiaochen , Wang Yunlin , Jia Wenxiao 
Published: August 2022

Abstract
Background
This study aimed to analyze the application value of magnetic resonance (MR)-perfusion weighted imaging (PWI) in the early imaging diagnosis of rabbit spinal tuberculosis.

Methods
Spinal tuberculosis model was established using ATCC25177 Mycobacterium tuberculosis strain in the lumbar spine of rabbits. Forty rabbits were divided into 2 groups: rabbits in the experiment group were injected with 0.2 ml of 5.0 mg/ml tuberculosis suspension (n = 30) and those in the control group were injected with 0.2 ml of normal saline (n = 10) after vertebrae drilling surgery. Routine MRI and MR-PWI were performed at 4, 6, and 8 weeks after surgery. The statistical difference in terms of perfusion parameter values in the early MR-PWI scan of spinal tuberculosis between two groups was analyzed. The receiver operating characteristic (ROC) curve analysis was conducted for the accuracy of MR-PWI parameters in the early diagnosis of spinal tuberculosis.

Results
Except time to peak, the other perfusion parameters in the experiment group were all increased with time. In addition, the difference between the two groups, as well as the differences at each time point was statistically significant (all P < 0.05). First-pass enhancement rate (Efirst), early enhancement rate (Ee), peak height (PH), maximum slope of increase (MSI), maximum signal enhancement rate (Emax) and signal enhancement rate (SER) showed high values in early diagnosing spinal tuberculosis.

Conclusion
The parameters including Efirst, Ee, PH, MSI, Emax and SER may provide valuable imaging evidence for the early diagnosis of spinal tuberculosis in clinical application.
Lambda light chain-induced monoclonal gammopathy of renal significance, manifesting with Fanconi Syndrome and osteomalacia
Authors: Gutiérrez-Peredo Gabriel Brayan , Filho José César Batista Oliveira , Montaño-Castellón Iris , Gutiérrez-Peredo Andrea Jimena , Crusoé Edvan de Queiroz , Gusmao-Flores Dimitri 
Published: August 2022

Abstract
Background
Monoclonal gammopathy of renal significance (MGRS) encompasses a heterogeneous group of kidney diseases in which a monoclonal immunoglobulin secreted by a clone of B cells or plasma cells causes kidney damage without meeting the hematological criteria for malignancy. Among the various forms of involvement, MGRS can manifest as a proximal tubule disorder, such as Fanconi syndrome (FS), characterized by urinary loss of phosphate, glucose, amino acids, uric acid and bicarbonate. Few cases of MGRS have been described in the literature, manifesting as FS and monoclonal production of lambda light chains, almost all of which are secondary to the production of kappa light chains.

Case presentation
Here we report a clinical case of a 45-year-old Brazilian male, African descent, with proximal weakness of the lower limbs, whose initial assessment showed a urine summary with the presence of proteinuria and glycosuria without hyperglycemia, associated with mild worsening of renal function, hypouricemia, hypocalcemia and phosphaturia. Evolution was characterized by a MGRS manifesting as FS and osteomalacia.

Conclusion
The diagnosis of MGRS is not always easy, it requires knowledge of the clinical characteristics, diagnostic criteria and prognosis of each case. Therefore, all possible efforts should be made for multidisciplinary diagnosis.
Efficacy of a transdiagnostic guided internet-delivered intervention for emotional, trauma and stress-related disorders in Mexican population: study protocol for a randomized controlled trial
Authors: de la Rosa-Gómez Anabel , Flores-Plata Lorena A. , Esquivel-Santoveña Esteban E. , Santillán Torres Torija Carolina , García-Flores Raquel , Dominguez-Rodriguez Alejandro , Arenas-Landgrave Paulina , Castellanos-Vargas Rosa O. , Berra-Ruiz Enrique , Silvestre-Ramírez Rocío , Miranda-Díaz Germán Alejandro , Díaz-Sosa Dulce M. , Hernández-Posadas Alejandrina , Flores-Elvira Alicia I. , Valencia Pablo D. , Vázquez-Sánchez Mario F. 
Published: August 2022

Abstract
Background
Emotional and stress-related disorders show high incidence, prevalence, morbidity, and comorbidity rates in Mexico. In recent decades, research findings indicate that cognitive behavioral interventions, from a disorder-specific perspective, are the effective front-line treatment for anxiety and depression care. However, these treatments are not often used. Reasons include limited access and low availability to effective interventions and comorbidity between mental disorders. Emotional deregulation of negative affectivity has been found to be a mediating factor in addressing emotional disorders from a transdiagnostic perspective, aimed at two or more specific disorders. In addition, technological advancement has created alternatives for psychological assistance, highlighting the possibilities offered by technologies since Internet-supported intervention programs have been empirically tested for effectiveness, efficiency and efficacy and can be key to ensuring access to those who are inaccessible. The aim of the study is to evaluate the efficacy, moderators of clinical change and acceptability of a transdiagnostic guided Internet-delivered intervention versus a transdiagnostic self-guided Internet-delivered intervention for emotional, trauma and stress-related disorders, and waiting list in community sample.

Methods
A three-armed, parallel group, superiority randomized controlled clinical trial with repeated measurements at four times: pretest, posttest, follow-up at 3, 6 and 12 months. Outcomes assessor, participant, care provider and investigator will be blinded. Participants aged 18 to 70 years will be randomly allocated 1:1:1 to one of three study arms: a) Transdiagnostic guided internet-delivered intervention with synchronous assistance, b) Transdiagnostic self-guided internet-delivered intervention, c) Waiting list group. Based on sample size estimation, a minimum of 207 participants (69 in each intervention group) will be included.

Discussion
The study could contribute to improving the efficacy of transdiagnostic internet-delivered interventions to promote the dissemination of evidence-based treatments and eventually, to decrease the high prevalence of emotional and trauma-related disorders in the Mexican population.

Trial registration
ClinicalTrial.gov: NCT05225701. Registered February 4, 2022.
Development and validation of a prognostic nomogram among patients with acute exacerbation of chronic obstructive pulmonary disease in intensive care unit
Authors: Peng Jiang-Chen , Gong Wen-Wen , Wu Yan , Yan Tian-Yi , Jiang Xiao-Yan 
Published: August 2022

Abstract
Background
Acute exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) contributes significantly to mortality among patients with COPD in Intensive care unit (ICU). This study aimed to develop a nomogram to predict 30-day mortality among AECOPD patients in ICU.

Methods
In this retrospective cohort study, we extracted AECOPD patients from Medical Information Mart for Intensive Care III (MIMIC-III) database. Multivariate logistic regression based on Akaike information criterion (AIC) was used to establish the nomogram. Internal validation was performed by a bootstrap resampling approach with 1000 replications. The discrimination and calibration of the nomogram were evaluated by Harrell’s concordance index (C-index) and Hosmer–Lemeshow (HL) goodness-of-fit test. Decision curve analysis (DCA) was performed to evaluate its clinical application.

Results
A total of 494 patients were finally included in the study with a mean age of 70.8 years old. 417 (84.4%) patients were in the survivor group and 77 (15.6%) patients were in the non-survivor group. Multivariate logistic regression analysis based on AIC included age, pO2, neutrophil-to-lymphocyte ratio (NLR), prognostic nutritional index (PNI), invasive mechanical ventilation and vasopressor use to construct the nomogram. The adjusted C-index was 0.745 (0.712, 0.778) with good calibration (HL test, P = 0.147). The Kaplan–Meier survival curves revealed a significantly lower survival probability in the high-risk group than that in the low-risk group (P < 0.001). DCA showed that nomogram was clinically useful.

Conclusion
The nomogram developed in this study could help clinicians to stratify AECOPD patients and provide appropriate care in clinical setting.
Polyethylene glycol recombinant human growth hormone in Chinese prepubertal slow-growing short children: doses reported in a multicenter real-world study
Authors: Chen Jiajia , Zhong Yan , Wei Haiyan , Chen Shaoke , Su Zhe , Liu Lijun , Liang Liyang , Lu Ping , Chen Linqi , Chen Ruimin , Ni Shining , Wang Xinli , Li Li , Wang Yunfeng , Xu Xu , Xiao Yanfeng , Yao Hui , Liu Geli , Jin Runming , Cao Bingyan , Wu Di , Su Chang , Li Wenjing , Qin Miao , Li Xiaoqiao , Luo Xiaoping , Gong Chunxiu 
Published: August 2022

Abstract
Background
To evaluate the effectiveness of individualized-dose polyethylene glycol recombinant human growth hormone (PEG-rhGH) for short stature.

Methods
This real-world study enrolled children with short stature in 19 hospitals throughout China. They were treated with PEG-rhGH for 6 months. The starting dosage ranged from 0.10 to 0.20 mg/kg/week. The primary outcome was the change in height standard deviation score (ΔHt SDS).

Results
Five hundred and ten patients were included and grouped based on dosage as A (0.10–0.14 mg/kg/week), B (0.15–0.16 mg/kg/week), C (0.17–0.19 mg/kg/week), and D (0.20 mg/kg/week). The mean 6-month ΔHt SDS for the total cohort was 0.49 ± 0.27, and the means differed among the four dose groups (P = 0.002). The ΔHt SDS was lower in group A than in groups B (LSM difference [95%CI], -0.09 [-0.17, -0.01]), C (LSM difference [95%CI], -0.10 [-0.18, -0.02]), and D (LSM difference [95%CI], -0.13 [-0.21, -0.05]) after adjusting baseline covariates. There were no significant differences among groups B, C, and D. When the baseline IGF-1 was < -2 SDS or > 0 SDS, the △Ht SDS was not different among the four groups (P = 0.931 and P = 0.400). In children with baseline IGF-1 SDS of -2 ~ 0 SDS, a higher dosage was associated with a better treatment effect (P = 0.003), and the △Ht SDS was lower in older children than in younger ones (P < 0.001).

Conclusions
PEG-rhGH could effectively increase height in prepubertal short children. When the baseline IGF-1 was < -2 SDS, 0.10 mg/kg/week could be a starting dose. In other IGF-1 statuses, 0.15–0.20 mg/kg/week might be preferred.

Trial registration
ClinicalTrials.gov: NCT03249480, retrospectively registered.
Case report: coexistence of primary hyperparathyroidism with giant toxic nodular goiter
Authors: Zhang Wei , Liu Fangyi , Chen Kang , Wang Yajing , Dou Jingtao , Mu Yiming , Lyu Zhaohui , Zang Li 
Published: August 2022

Abstract
Background
The coexistence of primary hyperparathyroidism (PHPT) and giant toxic nodular goiter is very rare. Moreover, PHPT could be easily overlooked because hyperthyroidism may also lead to hypercalcemia. A 99mTc-MIBI scan of the parathyroid glands is often negative when they are concomitant.

Case presentation
Here, we report a rare case of the coexistence of giant toxic nodular goiter and PHPT that had been ignored for many years but was successfully treated with an ultrasound-guided parathyroid adenoma microwave ablation (MWA).

Conclusion
Reoperation for PHPT carries an increased risk of cure failure and complications. Thermal ablation has been proven effective in inactivating hyperfunctioning parathyroid lesions and in normalizing both serum parathyroid hormone (PTH) and calcium.
Digitally prefabricated versus conventionally fabricated implant-supported full-arch provisional prosthesis: a retrospective cohort study
Authors: Chen Chaoqun , Lai Haiyan , Zhu Huiyong , Gu Xinhua 
Published: August 2022

AbstractBackgroundTo evaluate and compare the clinical outcomes of digitally prefabricated and conventionally fabricated implant-supported full-arch provisional prostheses.MethodsIn this retrospective study, a total of 39 patients (22 males and 17 females) who underwent implant-supported full-arch rehabilitation using the All-on-4 concept with an immediate loading protocol were included: 20 patients treated with digitally prefabricated provisional prostheses were assigned into Group A, and 19 patients treated with conventionally fabricated provisional prostheses were assigned into Group B. Implant/provisional prosthesis survival rates and complications were reviewed. Marginal bone loss (MBL) was investigated by CBCT. Surgical time, restorative time, and total operative time were analyzed. Postoperative pain and swelling were evaluated with the visual analog scale (VAS). The oral health impact profile (OHIP) questionnaire was administered before and after surgery.ResultsThe implant/provisional prosthesis survival rate was 100%, and complications appeared with low frequency in both groups, while the mean MBL was 0.30 ± 0.29 mm in Group A and 0.31 ± 0.41 mm in Group B after 3~ 6 months (P > 0.05). The average restorative time in Group A (116.16 ± 16.61 min) was significantly shorter than that in Group B (242.11 ± 30.14 min) (P < 0.05). Patients in Group A showed lower pain/swelling VAS scores after surgery than Group B (P < 0.05). Low OHIP scores with high satisfaction with the overall effects were shown in both groups.ConclusionPrefabricated prostheses reduced the prosthetic time and postoperative discomfort in patients whose immediate rehabilitation was based on the All-on-4 concept. This prefabrication technology may be a predictable alternative to improve the short-term clinical outcome of implant-supported full-arch provisional rehabilitation.
Reliability and validity of the Chinese version of the Brief Emotion and Regulation Beliefs Scale in Chinese nursing students
Authors: Zhang Dongmei , Yang Liu , Wang Congzhi , Yuan Ting , Wei Huanhuan , Li Jing , Lei Yunxiao , Sun Lu , Li Xiaoping , Hua Ying , Liu Mingming , Liu Haiyang , Zhang Lin 
Published: August 2022

Abstract
Background
Nursing students are experiencing complex learning environments and will experience complex work environments in future clinical work, which lead to emotional problems easily. However, one’s beliefs about controlling their emotions portend a series of vital psychological outcomes. So, it is especially important to search for suitable tools to assess the emotion and regulation beliefs of nursing students and give timely intervention to improve their physical and mental health. This study aimed to translate the American version of the Emotion and Regulation Beliefs Scale (ERBS) into Chinese, revise the original scale and form a simplified version, and assess the reliability and validity of the brief Chinese version in nursing students.

Methods
The study adopted a cross-sectional design and the multistage sampling design. The ERBS was translated into Chinese, and the reliability and validity of the Chinese version were tested in 980 nursing students.

Results
The content validity index was 0.920. Exploratory factor analysis supported a three-factor model for the Chinese version of Brief-ERBS, and confirmatory factor analysis indicated that the model fit the Brief-ERBS well. Furthermore, the three-factors model was obtained by using exploratory factor analysis, explaining 51.023% variance, and the communalities of the items ranged from 0.359 to 0.680. With modified confirmatory factor analysis, the fit indices were chi-square/degree of freedom (CMIN/DF) = 4.092, goodness of fit index (GFI) = 0.949, adjusted goodness of fit index (AGFI) = 0.927, comparative fit index (CFI) = 0.913, incremental fit index (IFI) = 0.914, Tucker Lewis index (TLI) = 0.908, root-mean-square error of approximation (RMSEA) = 0.061. The two-tailed independent samples t-test showed the scores of the top (50%) and low (50%) groups reached the level of significance (P < 0.001). A highly positive correlation between the Brief-ERBS total score and the ERBS total score was found (r = 0.972, P < 0.01). The Cronbach’s α coefficient of the scale was 0.798, the split-half reliability coefficient was 0.784, and the retest coefficient was 0.879.

Conclusion
The Chinese version of Brief-ERBS has good reliability and validity, and may be used for the beliefs about emotional management in Chinese nursing students.