bluuebunny/crossref_metadata_2025 huggingface dataset:
What predicts citation counts and translational impact in headache research? A machine learning analysis
Authors: Danelakis Antonios , Langseth Helge , Nachev Parashkev , Nelson Amy , Bjørk Marte-Helene , Matharu Manjit S. , Tronvik Erling , May Arne , Stubberud Anker
Published: May 2024

Background

We aimed to develop the first machine learning models to predict citation counts and the translational impact, defined as inclusion in guidelines or policy documents, of headache research, and assess which factors are most predictive.

Methods

Bibliometric data and the titles, abstracts, and keywords from 8600 publications in three headache-oriented journals from their inception to 31 December 2017 were used. A series of machine learning models were implemented to predict three classes of 5-year citation count intervals (0–5, 6–14 and, >14 citations); and the translational impact of a publication. Models were evaluated out-of-sample with area under the receiver operating characteristics curve (AUC).

Results

The top performing gradient boosting model predicted correct citation count class with an out-of-sample AUC of 0.81. Bibliometric data such as page count, number of references, first and last author citation counts and h-index were among the most important predictors. Prediction of translational impact worked optimally when including both bibliometric data and information from the title, abstract and keywords, reaching an out-of-sample AUC of 0.71 for the top performing random forest model.

Conclusion

Citation counts are best predicted by bibliometric data, while models incorporating both bibliometric data and publication content identifies the translational impact of headache research.
Visual artists’ professional and social status: Insights from post-socialist Serbia
Authors: Đorđević Milan , Mihaljinac Nina
Published: May 2024

This article suggests a new model for artist engagement by analysing challenges independent visual artists face in Serbia due to the shift to neoliberal capitalism. The aim is to address the alienation of independent visual artists from broader socio-political issues and to improve their social status through a socio-emancipatory mission of artistic practice. The methodology involves analysing international working conditions for artists, different cultural policy models, and alternative modes of artistic engagement, as well as case study of a community art project in Stara Pazova (Serbia). The significance of studying Serbia rests in its historical experience of self-management when culture was considered an integral part of the socialist society, fostering emancipation and creative freedom. The proposed model emphasizes the horizontality of decision-making and the need for progressive cultural policies that foster experimentation, autonomy, and freedom from bureaucratic requirements.
Understanding carceral mobilities in and through lived experiences of incarceration
Authors: Turnbull Sarah , Moore Dawn
Published: May 2024

Recent scholarship on carceral mobilities critiques conceptualizations of carceral spaces as fixed and stable, and movements within or around sites of confinement as linear and horizontal. According to this critique, criminological studies of imprisonment have typically embraced what Turner and Peters (2017) [‘Rethinking mobility in criminology’, Punishment & Society 19(1), 96–114] term a ‘sedentarist ontology’ by failing to consider the complexities of prisoner mobilities in the lived experiences of the carceral. We draw on qualitative interview data from the Prison Transparency Project, a multiyear study initially across four research sites in Canada focused on former prisoners’ narratives of their carceral experiences, to identify and analyze the multifaceted mobilities that characterize prison life. We focus on three aspects of carceral mobilities: the use of psychotropic medications to produce docility, the coercive (im)mobilities of physical restraints and the ‘prison on wheels’ (i.e., prisoner transport vehicles). Using the concept of ‘kinetic immobility’, in which prisoners’ bodies are immobilized so they can be coercively moved (or not) through space and time, we consider the degree to which the theoretical work on carceral mobilities aligns with lived experiences of incarceration, as narrated by research participants.
Don't Flip the Table Yet: A Framework for the Analysis of Visual and Cognitive Ergonomics in Board Games
Authors: Passarelli Marcello , Masini Michele , Piccinno Tommaso Francesco , Rizzi Alessandro
Published: May 2024

Board games provide immersive and enjoyable experiences for players, but they can also pose usability challenges. This article presents a comprehensive framework for analyzing board game design, focusing on identifying the elements that make play inadvertently difficult or fatiguing. The proposed framework analyses board games as a user interface between the players and the board game mechanics, thereby focusing on the presentation aspects without altering the underlying rules. The intent is to preserve the deliberate design challenges that enhance gameplay while pinpointing the elements that affect the game experience negatively. We employ a methodology that begins with the observation of players’ behavioral cues to infer internal states such as cognitive or visual fatigue. These inferred states serve as a basis to identify problematic features in the game components or presentation. We illustrate the framework through a series of case studies, providing practical examples of the analysis process through an idiographic approach.
Human milk products in the National Health Service: a cross-sectional survey of use and industry contact across England's trusts
Authors: Steele Sarah L. , Cooke Noah C.A.
Published: May 2024

Summary

Objectives

Commentators and professional organisations note that an expanding market in human milk-based products (HMBPs) could reduce breastfeeding, compromising maternal and infant health, and undermine public milk bank donations. We investigate whether English NHS trusts purchased these products and whether HMBP companies have marketed to them.

Design

Freedom of Information (FOI) requests asking: (1) whether trusts obtained human milk; (2) if so, how; and (3) whether HMBP companies had approached them. We analysed trusts’ responses qualitatively. In 2023, an FOI request to the Food Standards Authority (FSA) following a product recall.

Setting

England.

Participants

One hundred and ninety-four NHS trusts, the FSA.

Main Outcome Measures

Obtaining human milk, approaches by companies, and trust responses to approaches.

Results

One hundred and seventy-six trusts responded, 102 reporting human milk from milk banks. No trusts reported purchasing from companies in 2022. In 2023, the FSA confirmed six English hospitals used HMBPs from one company; an FOI for trusts’ names was refused on law enforcement grounds. Two trusts reported participating in clinical trials funded by companies. Twenty-one reported approaches, using several strategies, including uninvited ward visits. Trusts rejected marketing based on guidance from: (1) trust dieticians or physicians; (2) regional regulatory bodies; (3) professional bodies; and (4) perceived application of an International Code on breastfeeding.

Conclusions

Companies market to trusts, adopting methods previously used by the formula industry. Trusts express confusion over whether this infringes agreements designed to promote breastfeeding. We encourage clarification and guidance for professionals and trusts to ensure safety, infant and maternal health, and protect public provision.
A mobile app to predict and manage behavioral and psychological symptoms of dementia: Development, usability, and users’ acceptability
Authors: Cho Eunhee , Yang Minhee , Jang Jiyoon , Cho Jungwon , Kang Bada , Jang Yoonhyung , Kim Min Jung
Published: May 2024

Objective: Non-pharmacological interventions are considered the first-line treatment for behavioral and psychological symptoms of dementia (BPSD); however, traditional approaches have shown only small effect sizes. Mobile technology offers an opportunity to improve BPSD assessment and management in people living with dementia (PLWD). We aimed (1) to develop a mobile application (app) featuring a real-time BPSD diary, machine-learning-based BPSD prediction, and individualized non-pharmacological care programs, including therapeutic use of music and reminiscent content, and (2) to test its usability, acceptability, and preliminary efficacy among PLWD and caregivers. Methods: An Android-based app was developed through the following three phases: (1) needs assessment, (2) software development and initial testing with experts, and (3) beta-testing with end users who were dyads of PLWD and caregivers. The preliminary efficacy, usability, and acceptability of the app were assessed using validated BPSD questionnaires and face-to-face interviews with the dyads. Logs of the dyads’ program participation (i.e., types, time, and duration), BPSD diaries, and engagement levels of PLWD were also collected through the app. Results: Five dyads created BPSD diaries (range: 22–48) over 3 weeks. Overall, the BPSD symptoms decreased after the beta-testing period. Each dyad participated in the care programs for 106–204 min, during which music alone was most frequently used. Engagement levels ranged from 3.38 to 4.94 (out of 5). Conclusions: The app was deemed usable, acceptable, and feasible for PLWD and caregivers. The upgraded app will be further tested and can be easily implemented at home or in the community.
Lessons from autopsy: Topographical variability of atherosclerosis plaques
Authors: Faa Gavino , Cau Riccardo , Ravarino Alberto , Canino Andrea , Van Eyken Peter , Fraschini Matteo , Suri Jasjit S , Saba Luca
Published: May 2024

Atherosclerosis is a complex disease characterized by the accumulation of plaques in arterial walls. Understanding its pathogenesis remains incomplete, with factors like inflammation, oxidative stress, and hypertension playing critical roles. The disease exhibits preferential localization of plaques, with variability observed even within the same individual. Genetic, environmental, and lifestyle factors contribute to its heterogeneity. Histological plaque phenotypes vary widely, prompting classification schemes focusing on systemic and local factors deteriorating fibrous caps. Recent research highlights differences in plaque histology among arterial systems, suggesting unique pathophysiological mechanisms. This study reports on multiple atherosclerotic plaques detected at autopsy in various vascular sites of a single subject, emphasizing their histological diversity and underscoring the systemic nature of atherosclerosis.
Impact of hematopoietic cell transplantation on myocardial fibrosis in young patients with sickle cell disease
Authors: Sharma Akshay , Selukar Subodh , Bi Yu , Merlocco Anthony , Morin Cara E. , Goode Chris , Rai Parul , Towbin Jeffrey A. , Hankins Jane S. , Gottschalk Stephen , Triplett Brandon , Johnson Jason N.
Published: May 2024

Serial cardiovascular magnetic resonance evaluation of children and young adults with SCD who underwent hematopoietic cell transplantation showed mean ECV, representing diffuse myocardial fibrosis, decreased 3.4% from baseline to 12 months posttransplantation. This trial was registered at www.clinicaltrials.gov as #NCT04362293.
Dynamic evolution of the mTHF gene family associated with primary metabolism across life
Authors: Rork Adam M. , Bala Arthi S. , Renner Tanya
Published: May 2024

Background

The folate cycle of one-carbon (C1) metabolism, which plays a central role in the biosynthesis of nucleotides and amino acids, demonstrates the significance of metabolic adaptation. We investigated the evolutionary history of the methylenetetrahydrofolate dehydrogenase (mTHF) gene family, one of the main drivers of the folate cycle, across life.

Results

Through comparative genomic and phylogenetic analyses, we found that several lineages of Archaea lacked domains vital for folate cycle function such as the mTHF catalytic and NAD(P)-binding domains of FolD. Within eukaryotes, the mTHF gene family diversified rapidly. For example, several duplications have been observed in lineages including the Amoebozoa, Opisthokonta, and Viridiplantae. In a common ancestor of Opisthokonta, FolD and FTHFS underwent fusion giving rise to the gene MTHFD1, possessing the domains of both genes.

Conclusions

Our evolutionary reconstruction of the mTHF gene family associated with a primary metabolic pathway reveals dynamic evolution, including gene birth-and-death, gene fusion, and potential horizontal gene transfer events and/or amino acid convergence.
Aspergillus flavus pangenome (AflaPan) uncovers novel aflatoxin and secondary metabolite associated gene clusters
Authors: Gangurde Sunil S. , Korani Walid , Bajaj Prasad , Wang Hui , Fountain Jake C. , Agarwal Gaurav , Pandey Manish K. , Abbas Hamed K. , Chang Perng-Kuang , Holbrook C. Corley , Kemerait Robert C. , Varshney Rajeev K. , Dutta Bhabesh , Clevenger Josh P. , Guo Baozhu
Published: May 2024

Background

Aspergillus flavus is an important agricultural and food safety threat due to its production of carcinogenic aflatoxins. It has high level of genetic diversity that is adapted to various environments. Recently, we reported two reference genomes of A. flavus isolates, AF13 (MAT1-2 and highly aflatoxigenic isolate) and NRRL3357 (MAT1-1 and moderate aflatoxin producer). Where, an insertion of 310 kb in AF13 included an aflatoxin producing gene bZIP transcription factor, named atfC. Observations of significant genomic variants between these isolates of contrasting phenotypes prompted an investigation into variation among other agricultural isolates of A. flavus with the goal of discovering novel genes potentially associated with aflatoxin production regulation. Present study was designed with three main objectives: (1) collection of large number of A. flavus isolates from diverse sources including maize plants and field soils; (2) whole genome sequencing of collected isolates and development of a pangenome; and (3) pangenome-wide association study (Pan-GWAS) to identify novel secondary metabolite cluster genes.

Results

Pangenome analysis of 346 A. flavus isolates identified a total of 17,855 unique orthologous gene clusters, with mere 41% (7,315) core genes and 59% (10,540) accessory genes indicating accumulation of high genomic diversity during domestication. 5,994 orthologous gene clusters in accessory genome not annotated in either the A. flavus AF13 or NRRL3357 reference genomes. Pan-genome wide association analysis of the genomic variations identified 391 significant associated pan-genes associated with aflatoxin production. Interestingly, most of the significantly associated pan-genes (94%; 369 associations) belonged to accessory genome indicating that genome expansion has resulted in the incorporation of new genes associated with aflatoxin and other secondary metabolites.

Conclusion

In summary, this study provides complete pangenome framework for the species of Aspergillus flavus along with associated genes for pathogen survival and aflatoxin production. The large accessory genome indicated large genome diversity in the species A. flavus, however AflaPan is a closed pangenome represents optimum diversity of species A. flavus. Most importantly, the newly identified aflatoxin producing gene clusters will be a new source for seeking aflatoxin mitigation strategies and needs new attention in research.
Evaluation of the “Burgenland PREvention trial of colorectal cancer Disease with ImmunologiCal Testing” (B-PREDICT)—a population-based colorectal cancer screening program
Authors: BREZINA Stefanie , LEEB Gernot , BAIERL Andreas , GRÄF Evelyn , HACKL Monika , HOFER Philipp , LANG Harald , KLEIN Michaela , MACH Karl , SCHWARZER Remy , WLASSITS Wilhelm , PÜSPÖK Andreas , GSUR Andrea
Published: May 2024

Background

The colorectal cancer (CRC) screening program B-PREDICT is a population based invited two stage screening project using a faecal immunochemical test (FIT) for initial screening followed by a colonoscopy for those with a positive FIT. B-PREDICT was compared with the opportunistic screening colonoscopy (OPP-COL), performed in course of the nationwide screening program.

Methods

Within B-PREDICT all residents of the Austrian federal state Burgenland, aged between 40 and 80 are annually invited to FIT testing. All individuals who underwent initial colonoscopy in Burgenland between 01/2003 and 12/2014, were included in this study. Individuals from the FIT-triggered invited screening program B-PREDICT were compared with those from the non-FIT triggered OPP-COL.

Results

15 133 individuals from B-PREDICT were compared to 10 045 individuals with OPP-COL. CRC detection rates were 1.34% (CI-95%, [1.15; 1.52]) in B-PREDICT compared to 0.54% in OPP-COL (95%-CI, [0.39; 0.68] p < 0.001). The decrease in the age standardized incidence rates of CRC was more pronounced in the population screened with FIT than in the general population screened with colonoscopy. Changes in incidence rates per year were -4.4% (95%-CI, [-5.1; -3.7]) vs. -1.8% (95%-CI, [-1.9; -1.6] p < 0.001).

Conclusions

B-PREDICT shows a two-fold higher detection rate of CRC as well as HRA compared to OPP-COL.
Rapid, sensitive, and user-friendly detection of Pseudomonas aeruginosa using the RPA/CRISPR/Cas12a system
Authors: Zhang Wenjing , Qu Hai , Wu Xin , Shi Jingjing , Wang Xinling
Published: May 2024

Background

Pseudomonas aeruginosa (P. aeruginosa) is a life-threatening bacterium known for its rapid development of antibiotic resistance, posing significant challenges in clinical treatment, biosecurity, food safety, and environmental monitoring. Early and accurate identification of P. aeruginosa is crucial for effective intervention.

Methods

The lasB gene of P. aeruginosa was selected as the target for the detection. RPA primers for recombinase polymerase amplification (RPA) and crRNA for CRISPR/Cas12a detection were meticulously designed to target specific regions within the lasB gene. The specificity of the RPA/CRISPR/Cas12a detection platform was assessed using 15 strains. The detection limit of RPA/CRISPR/Cas12a detection platform was determined by utilizing a pseudo-dilution series of the P. aeruginosa DNA. The practical applicability of the RPA/CRISPR/Cas12a detection platform was validated by comparing it with qPCR on 150 samples (35 processed meat product samples, 55 cold seasoned vegetable dishes, 60 bottled water samples).

Results

The RPA/CRISPR/Cas12a detection platform demonstrates high specificity, with no cross-reactivity with non-P. aeruginosa strains. This assay exhibits remarkable sensitivity, with a limit of detection (LOD) of 100 copies/µL for fluorescence assay and 101 copies/µL for the LFTS method. Furthermore, the performance of the RPA/CRISPR/Cas12a detection platform is comparable to that of the well-established qPCR method, while offering advantages such as shorter reaction time, simplified operation, and reduced equipment requirements.

Conclusions

The RPA/CRISPR/Cas12a detection platform presents a straightforward, accurate, and sensitive approach for early P. aeruginosa detection and holds great promise for diverse applications requiring rapid and reliable identification.
Automated region growing-based segmentation for trabecular bone structure in fresh-frozen human wrist specimens
Authors: Klintström Eva , Klintström Benjamin , Smedby Örjan , Moreno Rodrigo
Published: May 2024

Bone strength depends on both mineral content and bone structure. Measurements of bone microstructure on specimens can be performed by micro-CT. In vivo measurements are reliably performed by high-resolution peripheral computed tomography (HR-pQCT) using dedicated software. In previous studies from our research group, trabecular bone properties on CT data of defatted specimens from many different CT devices have been analyzed using an Automated Region Growing (ARG) algorithm-based code, showing strong correlations to micro-CT.

The aim of the study was to validate the possibility of segmenting and measuring trabecular bone structure from clinical CT data of fresh-frozen human wrist specimens. Data from micro-CT was used as reference. The hypothesis was that the ARG-based in-house built software could be used for such measurements.

HR-pQCT image data at two resolutions (61 and 82 µm isotropic voxels) from 23 fresh-frozen human forearms were analyzed. Correlations to micro-CT were strong, varying from 0.72 to 0.99 for all parameters except trabecular termini and nodes. The bone volume fraction had correlations varying from 0.95 to 0.98 but was overestimated compared to micro-CT, especially at the lower resolution. Trabecular separation and spacing were the most stable parameters with correlations at 0.80-0.97 and mean values in the same range as micro-CT.

Results from this in vitro study show that an ARG-based software could be used for segmenting and measuring 3D trabecular bone structure from clinical CT data of fresh-frozen human wrist specimens using micro-CT data as reference. Over-and underestimation of several of the bone structure parameters must however be taken into account.
Social inequalities in pregnancy metabolic profile: findings from the multi-ethnic Born in Bradford cohort study
Authors: Elhakeem Ahmed , Clayton Gemma L. , Soares Ana Goncalves , Taylor Kurt , Maitre Léa , Santorelli Gillian , Wright John , Lawlor Deborah A. , Vrijheid Martine
Published: May 2024

Background

Lower socioeconomic position (SEP) associates with adverse pregnancy and perinatal outcomes and with less favourable metabolic profile in nonpregnant adults. Socioeconomic differences in pregnancy metabolic profile are unknown. We investigated association between a composite measure of SEP and pregnancy metabolic profile in White European (WE) and South Asian (SA) women.

Methods

We included 3,905 WE and 4,404 SA pregnant women from a population-based UK cohort. Latent class analysis was applied to nineteen individual, household, and area-based SEP indicators (collected by questionnaires or linkage to residential address) to derive a composite SEP latent variable. Targeted nuclear magnetic resonance spectroscopy was used to determine 148 metabolic traits from mid-pregnancy serum samples. Associations between SEP and metabolic traits were examined using linear regressions adjusted for gestational age and weighted by latent class probabilities.

Results

Five SEP sub-groups were identified and labelled ‘Highest SEP’ (48% WE and 52% SA), ‘High-Medium SEP’ (77% and 23%), ‘Medium SEP’ (56% and 44%) ‘Low-Medium SEP’ (21% and 79%), and ‘Lowest SEP’ (52% and 48%). Lower SEP was associated with more adverse levels of 113 metabolic traits, including lower high-density lipoprotein (HDL) and higher triglycerides and very low-density lipoprotein (VLDL) traits. For example, mean standardized difference (95%CI) in concentration of small VLDL particles (vs. Highest SEP) was 0.12 standard deviation (SD) units (0.05 to 0.20) for ‘Medium SEP’ and 0.25SD (0.18 to 0.32) for ‘Lowest SEP’. There was statistical evidence of ethnic differences in associations of SEP with 31 traits, primarily characterised by stronger associations in WE women e.g., mean difference in HDL cholesterol in WE and SA women respectively (vs. Highest-SEP) was -0.30SD (-0.41 to -0.20) and -0.16SD (-0.27 to -0.05) for ‘Medium SEP’, and -0.62SD (-0.72 to -0.52) and -0.29SD (-0.40 to -0.20) for ‘Lowest SEP’.

Conclusions

We found widespread socioeconomic differences in metabolic traits in pregnant WE and SA women residing in the UK. Further research is needed to understand whether the socioeconomic differences we observe here reflect pre-conception differences or differences in the metabolic pregnancy response. If replicated, it would be important to explore if these differences contribute to socioeconomic differences in pregnancy outcomes.
Recent clinical practice guidelines for the management of low back pain: a global comparison
Authors: Zhou Tianyu , Salman David , McGregor Alison. H.
Published: May 2024

Background

Low back pain (LBP) is a significant health problem worldwide, with a lifetime prevalence of 84% in the general adult population. To rationalise the management of LBP, clinical practice guidelines (CPGs) have been issued in various countries around the world. This study aims to identify and compare the recommendations of recent CPGs for the management of LBP across the world.

Methods

MEDLINE, EMBASE, CINAHL, PEDro, and major guideline databases were searched from 2017 to 2022 to identify CPGs. CPGs focusing on information regarding the management and/or treatment of non-specific LBP were considered eligible. The quality of included guidelines was evaluated using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument.

Results

Our analysis identified a total of 22 CPGs that met the inclusion criteria, and were of middle and high methodological quality as assessed by the AGREE II tool. The guidelines exhibited heterogeneity in their recommendations, particularly in the approach to different stages of LBP. For acute LBP, the guidelines recommended the use of non-steroidal anti-inflammatory drugs (NSAIDs), therapeutic exercise, staying active, and spinal manipulation. For subacute LBP, the guidelines recommended the use of NSAIDs, therapeutic exercise, staying active, and spinal manipulation. For chronic LBP, the guidelines recommended therapeutic exercise, the use of NSAIDs, spinal manipulation, and acupuncture.

Conclusions

Current CPGs provide recommendations for almost all major aspects of the management of LBP, but there is marked heterogeneity between them. Some recommendations lack clarity and overlap with other treatments within the guidelines.
Obesity and metabolic syndrome in patients with heart failure with preserved ejection fraction: a cross-sectional analysis of the Veradigm Cardiology Registry
Authors: Bae Jay P , Kallenbach Lee , Nelson David R , Lavelle Kevin , Winer-Jones Jessamine P , Bonafede Machaon , Murakami Masahiro
Published: May 2024

Background

The proportion of heart failure patients with preserved ejection fraction has been rising over the past decades and has coincided with increases in the prevalence of obesity and metabolic syndrome. The relationship between these interconnected comorbidities and heart failure with preserved ejection fraction (HFpEF) is still poorly understood. This study characterized obesity and metabolic syndrome among real-world patients with HFpEF.

Methods

We identified adults with heart failure in the Veradigm Cardiology Registry, previously the PINNACLE Registry, with a left ventricular ejection fraction measurement ≥ 50% between 01/01/2016 and 12/31/2019. Patients were stratified by obesity diagnosis and presence of metabolic syndrome (≥ 3 of the following: diabetes, hypertension, hyperlipidemia, and obesity). We captured baseline demographic and clinical characteristics and used multivariable logistic regression to examine the odds of having cardiac (atrial fibrillation, coronary artery disease, coronary artery bypass surgery, myocardial infarction, and stroke/transient ischemic attack) and non-cardiac (chronic kidney disease, chronic liver disease, and peripheral artery disease) comorbidities of interest. The models adjusted for age and sex, and the main covariates of interest were obesity and metabolic burden score (0–3 based on the presence of diabetes, hypertension, and hyperlipidemia). The models were run with and without an obesity*metabolic burden score interaction term.

Results

This study included 264,571 patients with HFpEF, of whom 55.7% had obesity, 52.5% had metabolic syndrome, 42.5% had both, and 34.3% had neither. After adjusting for age, sex, and burden of other metabolic syndrome-associated diagnoses, patients with HFpEF with obesity had lower odds of a diagnosis of other evaluated comorbidities relative to patients without obesity. The presence of metabolic syndrome in HFpEF appears to increase comorbidity burden as each additional metabolic syndrome-associated diagnosis was associated with higher odds of assessed comorbidities except atrial fibrillation.

Conclusion

Obesity was common among patients with HFpEF and not always co-occurring with metabolic syndrome. Multivariable analysis suggested that patients with obesity may develop HFpEF in the absence of other driving factors such as cardiovascular disease or metabolic syndrome.
A substance use disorder training curriculum for internal medicine residents using resident-empaneled patients
Authors: Ari Mim , Oyler Julie L.
Published: May 2024

Background

Internal Medicine (IM) residents frequently encounter, but feel unprepared to diagnose and treat, patients with substance use disorders (SUD). This is compounded by negative regard for patients with SUD. Optimal education strategies are needed to empower IM residents to care for patients with SUD. The objective of this study was to evaluate a brief SUD curriculum for IM residents, using resident-empaneled patients as an engaging educational strategy.

Methods

Following a needs assessment, a 2-part SUD curriculum was developed for IM residents at the University of Chicago during the 2018–2019 academic year as part of the ambulatory curriculum. During sessions on Opioid Use Disorder (OUD) and Alcohol Use Disorder (AUD), a facilitator covered concepts about screening, diagnosis, and treatment. In session, residents completed structured worksheets applying concepts to one of their primary care patients. A post-session assessment included questions on knowledge, preparedness & attitudes.

Results

Resident needs assessment (n = 44/105, 42% response rate) showed 86% characterized instruction received during residency in SUD as none or too little, and residents did not feel prepared to treat SUD. Following the AUD session, all residents (n = 22) felt prepared to diagnose and treat AUD. After the OUD session, all residents (n = 19) felt prepared to diagnose, and 79% (n = 15) felt prepared to treat OUD. Residents planned to screen for SUD more or differently, initiate harm reduction strategies and increase consideration of pharmacotherapy.

Conclusions

A brief curricular intervention for AUD and OUD using resident-empaneled patients can empower residents to integrate SUD diagnosis and management into practice.
Using word evolution to predict drug repurposing
Authors: Preiss Judita
Published: May 2024

Background

Traditional literature based discovery is based on connecting knowledge pairs extracted from separate publications via a common mid point to derive previously unseen knowledge pairs. To avoid the over generation often associated with this approach, we explore an alternative method based on word evolution. Word evolution examines the changing contexts of a word to identify changes in its meaning or associations. We investigate the possibility of using changing word contexts to detect drugs suitable for repurposing.

Results

Word embeddings, which represent a word’s context, are constructed from chronologically ordered publications in MEDLINE at bi-monthly intervals, yielding a time series of word embeddings for each word. Focusing on clinical drugs only, any drugs repurposed in the final time segment of the time series are annotated as positive examples. The decision regarding the drug’s repurposing is based either on the Unified Medical Language System (UMLS), or semantic triples extracted using SemRep from MEDLINE.

Conclusions

The annotated data allows deep learning classification, with a 5-fold cross validation, to be performed and multiple architectures to be explored. Performance of 65% using UMLS labels, and 81% using SemRep labels is attained, indicating the technique’s suitability for the detection of candidate drugs for repurposing. The investigation also shows that different architectures are linked to the quantities of training data available and therefore that different models should be trained for every annotation approach.
Hospital performance evaluation indicators: a scoping review
Authors: Hadian Shirin Alsadat , Rezayatmand Reza , Shaarbafchizadeh Nasrin , Ketabi Saeedeh , Pourghaderi Ahmad Reza
Published: May 2024

Background

Hospitals are the biggest consumers of health system budgets and hence measuring hospital performance by quantitative or qualitative accessible and reliable indicators is crucial. This review aimed to categorize and present a set of indicators for evaluating overall hospital performance.

Methods

We conducted a literature search across three databases, i.e., PubMed, Scopus, and Web of Science, using possible keyword combinations. We included studies that explored hospital performance evaluation indicators from different dimensions.

Results

We included 91 English language studies published in the past 10 years. In total, 1161 indicators were extracted from the included studies. We classified the extracted indicators into 3 categories, 14 subcategories, 21 performance dimensions, and 110 main indicators. Finally, we presented a comprehensive set of indicators with regard to different performance dimensions and classified them based on what they indicate in the production process, i.e., input, process, output, outcome and impact.

Conclusion

The findings provide a comprehensive set of indicators at different levels that can be used for hospital performance evaluation. Future studies can be conducted to validate and apply these indicators in different contexts. It seems that, depending on the specific conditions of each country, an appropriate set of indicators can be selected from this comprehensive list of indicators for use in the performance evaluation of hospitals in different settings.
Identifying barriers to outpatient appointment attendance in patient groups at risk of inequity: a mixed methods study in a London NHS trust
Authors: Sung Beatrice , O’Driscoll Fiona , Gregory Alice , Grailey Kate , Franklin Hannah , Poon Sharon , Lawrence-Jones Anna , Shepherd Leila , McCrudden Clare , Klaber Bob , Pavlakis Chris , Darzi Ara , Huf Sarah
Published: May 2024

Background

There is significant health inequity in the United Kingdom (U.K.), with different populations facing challenges accessing health services, which can impact health outcomes. At one London National Health Service (NHS) Trust, data showed that patients from deprived areas and minority ethnic groups had a higher likelihood of missing their first outpatient appointment. This study’s objectives were to understand barriers to specific patient populations attending first outpatient appointments, explore systemic factors and assess appointment awareness.

Methods

Five high-volume specialties identified as having inequitable access based on ethnicity and deprivation were selected as the study setting. Mixed methods were employed to understand barriers to outpatient attendance, including qualitative semi-structured interviews with patients and staff, observations of staff workflows and interrogation of quantitative data on appointment communication. To identify barriers, semi-structured interviews were conducted with patients who missed their appointment and were from a minority ethnic group or deprived area. Staff interviews and observations were carried out to further understand attendance barriers. Patient interview data were analysed using inductive thematic analysis to create a thematic framework and triangulated with staff data. Subthemes were mapped onto a behavioural science framework highlighting behaviours that could be targeted. Quantitative data from patient interviews were analysed to assess appointment awareness and communication.

Results

Twenty-six patients and 11 staff were interviewed, with four staff observed. Seven themes were identified as barriers – communication factors, communication methods, healthcare system, system errors, transport, appointment, and personal factors. Knowledge about appointments was an important identified behaviour, supported by eight out of 26 patients answering that they were unaware of their missed appointment. Environmental context and resources were other strongly represented behavioural factors, highlighting systemic barriers that prevent attendance.

Conclusion

This study showed the barriers preventing patients from minority ethnic groups or living in deprived areas from attending their outpatient appointment. These barriers included communication factors, communication methods, healthcare the system, system errors, transport, appointment, and personal factors. Healthcare services should acknowledge this and work with public members from these communities to co-design solutions supporting attendance. Our work provides a basis for future intervention design, informed by behavioural science and community involvement.
Health system lessons from the global fund-supported procurement and supply chain investments in Zimbabwe: a mixed methods study
Authors: Lesego Abaleng , Were Lawrence P. O. , Tsegaye Tsion , Idris Rafiu , Morrison Linden , Peterson Tatjana , Elhussein Sheza , Antonio Esther , Magwindiri Godfrey , Dumba Ivan , Mtambirwa Cleyland , Madzikwa Newman , Simbi Raiva , Ndlovu Misheck , Achoki Tom
Published: May 2024

Background

The Global Fund partnered with the Zimbabwean government to provide end-to-end support to strengthen the procurement and supply chain within the health system. This was accomplished through a series of strategic investments that included infrastructure and fleet improvement, training of personnel, modern equipment acquisition and warehouse optimisation. This assessment sought to determine the effects of the project on the health system.

Methods

This study employed a mixed methods design combining quantitative and qualitative research methods. The quantitative part entailed a descriptive analysis of procurement and supply chain data from the Zimbabwe healthcare system covering 2018 – 2021. The qualitative part comprised key informant interviews using a structured interview guide. Informants included health system stakeholders privy to the Global Fund-supported initiatives in Zimbabwe. The data collected through the interviews were transcribed in full and subjected to thematic content analysis.

Results

Approximately 90% of public health facilities were covered by the procurement and distribution system. Timeliness of order fulfillment (within 90 days) at the facility level improved from an average of 42% to over 90% within the 4-year implementation period. Stockout rates for HIV drugs and test kits declined by 14% and 49% respectively. Population coverage for HIV treatment for both adults and children remained consistently high despite the increasing prevalence of people living with HIV. The value of expired commodities was reduced by 93% over the 4-year period.

Majority of the system stakeholders interviewed agreed that support from Global Fund was instrumental in improving the country's procurement and supply chain capacity. Key areas include improved infrastructure and equipment, data and information systems, health workforce and financing. Many of the participants also cited the Global Fund-supported warehouse optimization as critical to improving inventory management practices.

Conclusion

It is imperative for governments and donors keen to strengthen health systems to pay close attention to the procurement and distribution of medicines and health commodities. There is need to collaborate through joint planning and implementation to optimize the available resources. Organizational autonomy and sharing of best practices in management while strengthening accountability systems are fundamentally important in the efforts to build institutional capacity.
Gene gain and loss from the Asian corn borer W chromosome
Authors: Dai Wenting , Mank Judith E. , Ban Liping
Published: May 2024

Background

Sex-limited chromosomes Y and W share some characteristics, including the degeneration of protein-coding genes, enrichment of repetitive elements, and heterochromatin. However, although many studies have suggested that Y chromosomes retain genes related to male function, far less is known about W chromosomes and whether they retain genes related to female-specific function.

Results

Here, we built a chromosome-level genome assembly of the Asian corn borer, Ostrinia furnacalis Guenée (Lepidoptera: Crambidae, Pyraloidea), an economically important pest in corn, from a female, including both the Z and W chromosome. Despite deep conservation of the Z chromosome across Lepidoptera, our chromosome-level W assembly reveals little conservation with available W chromosome sequence in related species or with the Z chromosome, consistent with a non-canonical origin of the W chromosome. The W chromosome has accumulated significant repetitive elements and experienced rapid gene gain from the remainder of the genome, with most genes exhibiting pseudogenization after duplication to the W. The genes that retain significant expression are largely enriched for functions in DNA recombination, the nucleosome, chromatin, and DNA binding, likely related to meiotic and mitotic processes within the female gonad.

Conclusions

Overall, our chromosome-level genome assembly supports the non-canonical origin of the W chromosome in O. furnacalis, which experienced rapid gene gain and loss, with the retention of genes related to female-specific function.
Quantifying reciprocal relationships between poverty and health: combining a causal loop diagram with longitudinal structural equation modelling
Authors: Reumers Laurens , Hameleers Niels , Hilderink Henk , Bekker Marleen , Jansen Maria , Ruwaard Dirk
Published: May 2024

Background

This study takes on the challenge of quantifying a complex causal loop diagram describing how poverty and health affect each other, and does so using longitudinal data from The Netherlands. Furthermore, this paper elaborates on its methodological approach in order to facilitate replication and methodological advancement.

Methods

After adapting a causal loop diagram that was built by stakeholders, a longitudinal structural equation modelling approach was used. A cross-lagged panel model with nine endogenous variables, of which two latent variables, and three time-invariant exogenous variables was constructed. With this model, directional effects are estimated in a Granger-causal manner, using data from 2015 to 2019. Both the direct effects (with a one-year lag) and total effects over multiple (up to eight) years were calculated. Five sensitivity analyses were conducted. Two of these focus on lower-income and lower-wealth individuals. The other three each added one exogenous variable: work status, level of education, and home ownership.

Results

The effects of income and financial wealth on health are present, but are relatively weak for the overall population. Sensitivity analyses show that these effects are stronger for those with lower incomes or wealth. Physical capability does seem to have strong positive effects on both income and financial wealth. There are a number of other results as well, as the estimated models are extensive. Many of the estimated effects only become substantial after several years.

Conclusions

Income and financial wealth appear to have limited effects on the health of the overall population of The Netherlands. However, there are indications that these effects may be stronger for individuals who are closer to the poverty threshold. Since the estimated effects of physical capability on income and financial wealth are more substantial, a broad recommendation would be that including physical capability in efforts that are aimed at improving income and financial wealth could be useful and effective. The methodological approach described in this paper could also be applied to other research settings or topics.
Relationship between ocular manifestations, laboratory findings, echocardiographic findings, and intravenous immunoglobulin resistance in Kawasaki disease
Authors: Jari Mohsen , Esmaeili Hajar
Published: May 2024

Background

This study investigates the incidence of ocular involvement in Kawasaki disease (KD) and evaluates the relationship between ocular manifestations, laboratory findings, echocardiographic findings, and intravenous immunoglobulin (IVIG) resistance.

Methods

We conducted a cross-sectional study with 58 KD patients from June 2021 to March 2023. For all patients, a complete ophthalmologic examination and echocardiography were performed in the acute phase before starting the treatment. We analyzed the age, sex, mean of white blood cell (WBC) count, platelet count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), echocardiographic findings and IVIG responses for all patients and compared the group with ocular involvement with the group without involvement.

Results

The incidence of bilateral acute conjunctivitis was 70.7%, while that of acute uveitis was 30%. Patients with uveitis had significantly higher rates of Coronary artery dilatation and IVIG resistance, as well as higher mean levels of WBC, platelet, and CRP compared to those without uveitis. (P < 0.05). Additionally, the age of patients with uveitis involvement was lower than those without involvement. No significant relationships existed between ESR, AST, or ALT values and uveitis (P > 0.05). Furthermore, no significant correlations existed between any examined items and acute bilateral conjunctivitis.

Conclusion

Uveitis in KD is significantly associated with coronary artery dilatation, IVIG resistance, higher WBC count, platelet count, and CRP level.
Prevalence of metabolic syndrome among patients with hepatocellular carcinoma of different etiologies: a retrospective study
Authors: Yang Da-Long , Liu Shao-Ping , Wang Hong-Liang , Li Jian-Rong , Su Jia-Yong , Li Min-Jun , Teng Yu-Xian , Deng Zhu-Jian , Li Zhong-Hai , Huang Jian-Li , Guo Ping-Ping , Ma Liang , Li Zhen-Zhen , Zhong Jian-Hong
Published: May 2024

Aims

This study compared the prevalences of metabolic syndrome and of cardiac or kidney comorbidities among patients with hepatocellular carcinoma (HCC) associated with metabolic dysfunction-related fatty liver disease (MAFLD), chronic infection with hepatitis B or C virus (HBV or HCV), or the combination of MAFLD and chronic HBV infection.

Methods

Medical records were retrospectively analyzed for patients with HCC who underwent hepatectomy between March 2013 and March 2023. Patients with HCC of different etiologies were compared in terms of their clinicodemographic characteristics and laboratory data before surgery.

Results

Of the 2422 patients, 1,822 (75.2%) were chronically infected with HBV without MAFLD and HCV, 415 (17.2%) had concurrent MAFLD and chronic HBV infection but no HCV infection, 121 (5.0%) had MAFLD without hepatitis virus infection, and 64 (2.6%) were chronically infected with HCV in the presence or absence of MAFLD and HBV infection. Compared to patients chronically infected with HBV without MAFLD and HCV, those with MAFLD but no hepatitis virus infection showed significantly lower prevalence of cirrhosis, ascites, portal hypertension, alpha-fetoprotein concentration ≥ 400 ng/mL, tumor size > 5 cm, multinodular tumors and microvascular invasion. Conversely, they showed significantly higher prevalence of metabolic syndrome, hypertension, type 2 diabetes, abdominal obesity, history of cardiovascular disease, T-wave alterations, hypertriglyceridemia and hyperuricemia, as well as higher risk of arteriosclerotic cardiovascular disease. Compared to patients with MAFLD but no hepatitis virus infection, those with concurrent MAFLD and chronic infection with HBV showed significantly higher prevalence of cirrhosis, ascites and portal hypertension, but significantly lower prevalence of hypertension and history of cardiovascular disease. Compared to patients with other etiologies, those chronically infected with HCV in the presence or absence of MAFLD and HBV infection, showed significantly higher prevalence of cirrhosis, portal hypertension, ascites, and esophagogastric varices.

Conclusion

Patients with HCC associated with MAFLD tend to have a background of less severe liver disease than those with HCC of other etiologies, but they may be more likely to suffer metabolic syndrome or comorbidities affecting the heart or kidneys.