bluuebunny/crossref_metadata_2025 huggingface dataset:
Speech Mismatch Negativity (MMN) in Schizophrenia with Auditory Verbal Hallucinations
Authors: Schryver Bronwen , Javier Aster , Choueiry Joëlle , Labelle Alain , Knott Verner , Jaworska Natalia
Published: November 2024

Auditory verbal hallucinations (AVH) are experienced by many individuals with schizophrenia (SZ), a neurodevelopmental disease that encumbers the quality of life and psychosocial outcome of those afflicted by it. While many hypotheses attempt to better define the etiology of AVHs in SZ, their neural profile and its moderation by current neuroleptics remains limited. The Mismatch Negativity (MMN) is an event related potential (ERP) measured from electroencephalographic (EEG) activity during the presentation of a deviance detection auditory paradigm. The neural regions and activity underlying the generation of the MMN include the primary auditory cortex and the prefrontal cortex which are regions also found to be activated during the experience of AVHs. Decreased MMN amplitudes have been robustly noted in SZ patients during the presentation of MMN tasks using auditory tones. However, the MMN generation to speech stimuli has not been extensively examined in SZ nor in relation to AVHs. The primary objective of this study was to examine the MMN to five speech-based deviants in SZ patients and healthy controls. Second, we assessed MMN features with AVH characteristics in 19 SZ patients and 21 HC. While AVH features did not correlate with measures of MMN, we found decreased MMN amplitudes to speech-based frequency and vowel change deviants in SZ patients compared to HC potentially reflecting deficiencies in basic speech processing mechanisms.
Online Lifestyle Medicine Continuing Medical Education (CME) Course Completion Predicts Increases in Clinician Knowledge, Confidence, and Practice of Lifestyle Medicine
Authors: Ames Meghan L. , Staffier Kara Livingston , Kees Alexandra , Freeman Kelly , Shetty Paulina , Gittelsohn Joel , Karlsen Micaela C.
Published: November 2024

Introduction: Despite growing evidence linking lifestyle changes to disease reversal, lifestyle medicine (LM) is not widely practiced. Lack of clinician training and knowledge is cited as a barrier to LM adoption. This study measures changes in LM knowledge, attitudes, confidence, and practice behaviors following completion of a 5.5-h, asynchronous, online continuing medical education (CME) course. Methods: Participants completed a pre- and post-course survey. A repeated-measures linear model tested changes in knowledge, confidence, interest, experience, and practice of LM, after adjusting for age, gender, race, ethnicity, clinical degree/licensure, and presence of a health system value-based care model. Results: Surveys from n = 2954 course participants were analyzed. Overall, statistically significant improvements were observed in self-reported knowledge (+.47 of points) and confidence (+.53 of points) of LM. Participants across the sample reported greater frequency (+.08 of 5 points) and reach (+.10 of 5 points) of LM with their patients (p<.0001 for both). Discussion: This study demonstrated that a brief, scalable, online CME course can improve LM knowledge, confidence, attitudes, and practice. Future research should examine long-term practice changes as well as differences in outcomes across types of healthcare professionals.
Pedagogical principles for encouraging (socially just) youth climate action: A schema for citizenship education curriculum analysis
Authors: Evans Rebecca S , McGregor Heather E , Reed Brenda
Published: November 2024

This article synthesizes pedagogical principles for supporting youth climate action from across local (Ontario) and global literature. It also seeks out stories of Indigenous youth engaging in climate action in distinct ways—highlighting examples from Sioux (of Standing Rock) and Inuit youth. The authors propose the Pedagogical Principles for Supporting Climate Action curriculum analysis schema before using it to examine the Ontario citizenship framework. The findings reveal how the curriculum segment in its current form is incongruent with the pedagogical principles of supporting youth climate action. The authors articulate both immediate and urgent curriculum revisions that are necessary for supporting youth in socially just climate action—with a call for immediate revisions that include a shift toward centering Indigenous knowledges, integrating climate justice and upholding relationality to the land and all that it sustains.
The role of general motor skills in talent identification: A systematic review
Authors: Sliedrecht Froukje , Schoof Suzan , Hartman Esther
Published: November 2024

Successful talent identification increases the chances of sporting and financial success since it provides talented children and adolescents with the most optimal learning environment to realize their potential. Hence, coaches and clubs of many sport disciplines are eager to identify talented athletes. General motor skills are often incorporated in talented identification research, as it is considered fundamental to learning sport-specific motor skills. This systematic review aimed to examine to what extent general motor skills can contribute to the identification of talented athletes aged six to eighteen. Five electronic databases were searched, which resulted in 22 eligible studies (13 cross-sectional and 9 longitudinal studies). Quality assessment was done using the Quality Assessment with Diverse Studies tool. The vast majority of both cross-sectional and longitudinal studies found either differences in general motor skills in favour of the talented athletes (59% of the studies) or no differences between talented athletes and their peers (36% of the studies). These results show that assessing general motor skills could contribute to talent identification programs, but caution should be paid prior to the implementation of these general motor skill test batteries due to the inconclusive nature of the findings. Hence, there is a need for future high-quality longitudinal studies which are recommended to conduct sex- and age-specific analyses, address the existing gap in the literature by including athletes from diverse sports beyond football, and investigate whether assessing manipulative skills and capturing movement quality could be a valuable addition to assessing locomotor skills for identifying athletic talent.
Translating player monitoring into training prescriptions: Real world soccer scenario and practical proposals
Authors: Pillitteri Guglielmo , Clemente Filipe Manuel , Sarmento Hugo , Figuereido Antonio , Rossi Alessio , Bongiovanni Tindaro , Puleo Giuseppe , Petrucci Marco , Foster Carl , Battaglia Giuseppe , Bianco Antonino
Published: November 2024

Data-driven training prescription based on previous training or match data is thought to be associated with better training outcome, compared to prescription without considering any monitoring data. Understanding the complex relationship between training load, physical performance, fitness status, fatigue and injury risk represents a challenge for health and performance practitioners and researchers. Although studies have revealed a positive correlation between training load and injury risk, this cause-effect relation cannot be determined given the multifactorial nature of injuries. Additionally, conflicting findings have been published explaining the relationship between training load and injuries, underlining the importance of training load management, prescription, and communication within the multidisciplinary team to improve physical performance and reduce injury risk. In this sense, practitioners may benefit from practical examples based on training load data to make informed decisions for prescribing training. This narrative review provides real-world examples of training decisions based on training load data in soccer, including training prescription, drill design and multidisciplinary team communication. Finally, a framework was provided to make informed training prescription from a physiological standpoint and elucidate the relationship between training load and injury risk.
Beyond “Lügenpresse”: How Politicians Criticize and Delegitimize the Media in Germany
Authors: Buttgereit Lina , Hameleers Michael , Gattermann Katjana , Schuck Andreas
Published: November 2024

Media criticism is a crucial part of meta-journalistic discourse, ensuring that journalists adhere to their democratic functions, such as informing citizens in an honest and complete manner. However, the profession increasingly faces hostile, nonevidence-based attacks from politicians that attempt to strategically fuel distrust among citizens and delegitimize opposed viewpoints. Despite this reality, we lack a systematic overview of the boundaries between constructive feedback and weaponized attacks in media criticism. To address this gap, we inductively analyzed how media criticism is represented within the social media discourse of ten German politicians from all major parties. Using a grounded theory approach, we conducted a qualitative content analysis of a subset of their tweets from 2015, 2017, and 2022 that contain media criticism ( N = 545), mapping the types and severity of the criticism, the construction of opposing narratives, and the explicitness of references to facticity over opinions. We identified four themes within media criticism discourse, ranging from misinformation attributions to severe accusations of the intentional distortion of reality through the media. Politicians (strategically) employ a wide range of media criticism and inaccuracy claims beyond judgments of facticity with differing degrees of severity for the profession. Based on our findings, we propose a typology of media criticism from political elites that adds nuance to our understanding regarding the boundaries between supportive and disruptive criticism for journalism.
Advancing skin model development: A focus on a self-assembled, induced pluripotent stem cell-derived, xeno-free approach
Authors: Dubau Marla , Tripetchr Tarada , Mahmoud Lava , Kral Vivian , Kleuser Burkhard
Published: November 2024

The demand for skin models as alternatives to animal testing has grown due to ethical concerns and the need for accurate substance evaluation. These alternatives, known as New Approach Methodologies (NAMs), are increasingly used for regulatory decisions. Current skin models from primary human cells often rely on bovine collagen, raising ethical issues. This study explores self-assembled skin models (SASM) as a new method, utilizing hair follicle-derived keratinocytes reprogrammed into induced pluripotent stem cells (iPSC) and differentiated into fibroblasts and keratinocytes. The model relies on the ability of fibroblasts to secrete collagen to produce a xeno-free dermal layer and on the differentiation of keratinocytes to create a functional epidermal layer. These layers exhibited confirmed metabolic activity and the capability to withstand test substances. The successful development of SASM underscores the significance of accurate alternatives in dermatological research, providing an ethical and reliable option for substance evaluation and regulatory testing.
Diagnosing epileptic seizures using combined features from independent components and prediction probability from EEG data
Authors: Khalid Madiha , Raza Ali , Akhtar Adnan , Rustam Furqan , Ballester Julien Brito , Rodriguez Carmen Lili , Díez Isabel de la Torre , Ashraf Imran
Published: November 2024

Objective

Epileptic seizures are neurological events that pose significant risks of physical injuries characterized by sudden, abnormal bursts of electrical activity in the brain, often leading to loss of consciousness and uncontrolled movements. Early seizure detection is essential for timely treatments and better patient outcomes. To address this critical issue, there is a need for an advanced artificial intelligence approach for the early detection of epileptic seizure disorder.

Methods

This study primarily focuses on designing a novel ensemble approach to perform early detection of epileptic seizure disease with high performance. A novel ensemble approach consisting of a fast, independent component analysis random forest (FIR) and prediction probability is proposed, which uses electroencephalography (EEG) data to investigate the efficacy of the proposed approach for early detection of epileptic seizures. The FIR model extracts independent components and class prediction probability features, creating a new feature set. The proposed model combined integrated component analysis (ICA) with predicting probability to enhance seizure recognition accuracy scores. Extensive experimental evaluations demonstrate that FIR assists machine learning models to obtain superior results compared to original features.

Results

The research gap is addressed using combined features to improve the performance of epileptic seizure detection compared to a single feature set. In particular, the ensemble model FIR with support vector machine (FIR + SVM) outperforms other methods, achieving an accuracy of 98.4% for epileptic seizure detection.

Conclusions

The proposed FIR has the potential for early diagnosis of epileptic seizures and can significantly help the medical industry with enhanced detection and timely interventions.
Cannabinoids for spasticity in patients with multiple sclerosis: A systematic review and meta-analysis
Authors: Azadvari Mohaddeseh , Pourshams Maryam , Guitynavard Fatemeh , Emami-Razavi Seyede Zahra , Taftian-Banadkouki Ensieh , Ghajarzade Mahsa , Rastkar Mohsen
Published: November 2024

Background

One of the most disabling symptoms of patients with multiple sclerosis (MS) is spasticity which affects their quality of life. Nowadays, cannabinoids are used for spasticity control in patients with MS, while the efficacy and safety are not clearly understood. So, we designed this systematic review and meta-analysis to assess the efficacy of cannabinoids for controlling MS-related spasticity.

Methods

PubMed, Scopus, EMBASE, Web of Science, and Google Scholar were systematically searched by two independent researchers on 1 May 2023. They also searched gray literature (references of included studies, as well as conference abstracts).

Results

A literature search revealed 6552 records, 95 full-texts were evaluated, and finally, 31 studies remained for systematic review. Among included studies, six randomized trials were included. Nabiximols was the most commonly used medication for controlling MS-related spasticity. Mean Expanded Disability Status Scale ranged between 4.6 and 7. Most studies (17 studies) were done in Italy, followed by Germany (4 studies). The pooled standardized mean difference (SMD) of NRS (Numeric Rating Scale) (after–before) is estimated as −1.41 (95% confidence interval (CI): −1.65, −1.17) (I2 = 97%, p < 0.001). The pooled standardized mean difference (SMD) of Ashworth (after-before) is estimated as −0.39 (95% CI: −0.72, −0.06) (I2 = 69.9%, p = 0.005).

Conclusion

The results of this systematic review and meta-analysis showed that nabiximols was the most common cannabinoid which was used to control MS-related spasticity, and it was effective in controlling MS-related spasticity (significantly decreased SMD of NRS, and Ashworth after treatment).
Nationwide Geospatial Analysis to Identify Variations in Primary Cardiovascular Risk in Ethiopia
Authors: Alemu Yihun Mulugeta , Bagheri Nasser , Wangdi Kinley , Chateau Dan
Published: November 2024

Background:

Cardiovascular disease (CVD) varies across regions due to socioeconomic, cultural, lifestyle, healthcare access, and environmental factors.

Objective:

To find geographical variations in 10-year primary CVD risk and assess the impact of contextual factors on CVD risk.

Method:

Data from 2658 Ethiopians aged 40 to 69 years with no previous CVD who participated in a nationally representative World Health Organization (WHO) STEPS survey in 2015 were included in the analysis. The mean 10-year CVD risk for 450 enumeration areas (EA) was used to identify spatial autocorrelation (using Global Moran’s I) and CVD hot spots (using getas-Ord Gi*). Geographically Weighted Regression (GWR) analysis quantified the relationship between mean 10-year CVD risk and climate-related factors across areas.

Result:

The spatial autocorrelation analysis identified significant spatial variation in the 10-year CVD risk at the EA level, with a global Moran’s I value of 0.016. Statistically significant hot spot areas with 10-year CVD risk were identified in Addis Ababa (the capital), Benishangul Gumuz, SNNPR (Southern Nations, Nationalities, and Peoples’ Region), Amhara, Afar, Oromia, and Hareri regions. In a multivariable GWR analysis, average water vapor pressure was a statistically significant explanatory variable for the geographical variations in 10-year CVD risk.

Conclusion:

Hot spot areas for 10-year CVD risk were identified across numerous country regions rather than concentrated in a specific region. Alongside these hot spot areas, regions with a higher annual water vapor pressure (humidity) were identified as geographical targets for CVD prevention.
Efficacy of Diagnostic In-Office Shoulder Ultrasound in the Surgical Treatment of Full-Thickness Rotator Cuff Tears
Authors: Greif Dylan N. , Minto Jonathan , Zhang Linda , Ramirez Gabriel A. , Maloney Michael D. , Voloshin Ilya N.
Published: November 2024

Background:

Early surgical management of full-thickness traumatic rotator cuff tears (RCTs) may optimize functional outcomes, prioritizing timely diagnoses. Ultrasound and magnetic resonance imaging (MRI) are highly sensitive and specific modalities for RCT diagnosis, yet MRI remains the gold standard diagnostic tool despite increased costs and potential delays in care. Ultrasound can provide same-day diagnosis, thus possibly expediting care.

Hypothesis:

The use of diagnostic shoulder ultrasound alone in the orthopaedic surgeon's office could increase the efficiency of diagnosis and care of traumatic full-thickness RCTs compared with MRI.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective chart review of patients with full-thickness traumatic RCT diagnosed via ultrasound or MRI who subsequently underwent rotator cuff repair with 1 of 2 ultrasound-trained surgeons between January 1, 2014, and December 31, 2019, was performed. Inclusion criteria included patients ≥18 years old, documentation of a first-time traumatic event, and the patient's desire to have immediate surgical management. Revision surgeries, long-term shoulder instability, and nontraumatic injuries were excluded. Basic demographic data were collected, and the number of preoperative office visits and the timing from initial evaluation to diagnosis and surgery were calculated for the ultrasound and the MRI cohorts. A power analysis of 0.8 with an alpha of .05 required 38 patients per group.

Results:

Overall, 133 patients were diagnosed via MRI compared with 76 via ultrasound. Besides body mass index, there were no significant differences in demographic variables or insurance status. Compared with the MRI cohort, patients in the ultrasound cohort received their diagnosis almost 2 weeks faster ( P < .0001), were scheduled for surgery almost 3 weeks faster ( P < .0001), and underwent surgery 2 weeks faster after initial evaluation ( P < .0001) while requiring nearly half as many clinical visits ( P < .0001). Regression analysis confirmed that ultrasound significantly reduced time to imaging, scheduling, and surgery after initial evaluation while requiring fewer clinical visits ( P < .05).

Conclusion:

The study findings indicated that ultrasound was a time-saving alternative diagnostic modality for traumatic RCT compared with MRI without compromising standard of care. These results were achieved independent of patient insurance status, disability index, or other demographic variables.
Establishing Clinically Significant Improvement for Patients After Arthroscopic Surgery for Shoulder Instability With Large Labral Tears
Authors: Scanaliato John P. , Magnuson Justin A. , Klahs Kyle J. , Childs Benjamin R. , Tyler John , Hettrich Carolyn M. , Parnes Nata
Published: November 2024

Background:

Patients with large labral tears represent a subset of traumatic shoulder instability cases. Outcomes after arthroscopic stabilization in these patients have been studied less compared with other tears.

Purpose:

To establish minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB) thresholds for patients after arthroscopic repair of labral tears ≥270°. Patient-reported outcome measures (PROMs) included the Rowe instability score, American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE), and visual analog scale (VAS) for pain.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A total of 52 arthroscopic large labral repairs (52 patients, mean age 28.7 years) performed in male active-duty military patients with a mean follow-up of 79.2 months (range, 24-117 months) met inclusion criteria and were included in the final analysis. All included patients completed the Rowe, ASES, SANE, and VAS pain preoperatively and at final follow-up, and the MCID, PASS, and SCB were calculated for each PROM score. Factors associated with achieving clinically relevant improvement were also calculated.

Results:

The MCID, PASS, and SCB, respectively, for each PROM were as follows: 10.4 points, 90, and 35 points for the Rowe; 9.7 points, 80, and 43 points for the ASES; 9.9 points, 87, and 65 points for the SANE; and 1.1 points, 3, and 6 points for VAS pain. More than 90% of patients improved according to the MCID for each PROM, while >75% achieved the PASS threshold for each score. The percentage of patients who improved according to the SCB ranged from 9.6% for the ASES to 75% for the SANE. Maintenance of active-duty status was associated with achieving the MCID for the ASES and SANE, while recurrent instability was associated with lower rates of Rowe MCID achievement and SANE PASS achievement. Higher preoperative scores were also associated with lower rates of achieving clinical improvement.

Conclusion:

Thresholds found for the MCID, PASS, and SCB in active-duty patients undergoing surgery for shoulder instability with labral tears ≥270° were similar to those for all-comers with anterior instability. Factors associated with achieving success or lack thereof on PROMs included maintenance of active-duty status and lower preoperative PROM scores.
An Online Cross-Sectional Study of Nursing Students’ Perceptions of Workplace Incivility in Nursing Schools During the COVID-19 Pandemic
Authors: Mrayyan Majd T. , Algunmeeyn Abdullah , Abunab Hamza Yousef
Published: November 2024

Introduction

Despite a growing body of evidence on academic incivility, limited information exists on workplace incivility perceived by nursing students in nursing schools. This study, conducted amid the COVID-19 pandemic, explores nursing students’ perceptions of workplace incivility in Jordanian nursing schools and investigates demographic-based differences.

Methods

This study employed a descriptive cross-sectional design, using an online survey for data collection. A convenience sample of 104 nursing students from diverse backgrounds and various Jordanian universities participated, allowing for a comprehensive examination of workplace incivility perceptions at a specific point in time. The online survey ensured efficient data collection, enhancing accessibility and ease of participation. This approach aimed to capture a snapshot of nursing students’ perspectives on workplace incivility within a given time frame and across multiple educational institutions, efficiently gathering data from a geographically dispersed and demographically varied sample.

Results

Students perceived workplace incivility in nursing schools as “mild,” with moderate confidence in schools’ ability to address it. Workplace civility was rated between 60.00% and 70.00% on a 0–100 scale. The overall mean for uncivil behaviors was “sometimes,” with criticism of expertise as the most common. Incivility in the past year was seen as “rare,” with misusing authority being the most frequent. Male and low-GPA students reported higher perceptions of incivility. Stress was the most perceived contributing factor, and a lack of administrative support was the main barrier. Establishing codes of conduct was considered the key strategy for fostering workplace civility.

Conclusion

Workplace civility is prevalent in Jordanian nursing schools, even amid the COVID-19 pandemic. However, the occasional occurrence of incivility behaviors should be approached with caution. To enhance perceptions of workplace civility, nursing schools should prioritize effective teaching, a friendly environment, and respectful relationships. Encouraging faculty members to reassess their performance, starting with identifying academic workplace incivility, is crucial.
Predictors of Clinical Performance Among Emergency Nurses: A Cross-Sectional Study
Authors: Subih Maha , Al-Amer Rasmieh , Bani Saleh Enas Ghaleb , Thultheen Imad Numan
Published: November 2024

Introduction

Poor nursing performance is considered a threat to patient safety, affecting the quality of care provided and ultimately impacting patient outcomes.

Objectives

The main aim of this study was to identify the predictors of nursing performance.

Methods

A cross-sectional predictive design was used. A convenient sampling technique was used to recruit 251 emergency nurses in three health sectors. They were assessed using the secondary traumatic stress scale and the nursing performance scale. Data were collected between June and August 2022.

Results

Nurses experienced severe levels of secondary traumatic stress ( M = 57.9, SD = 14.94). The nursing performance level was below average ( M = 27.48, SD = 9.36), and the mental performance subscale received the lowest rating ( M = 5.82, SD = 2.69). There was a strong negative association between the secondary traumatic stress total score and the total score of nursing performance ( r = −.77). Additionally, factors such as high body mass index, smoking, the presence of chronic diseases, working overtime, and high levels of secondary traumatic stress were identified as significant predictors of nursing performance.

Conclusion

It is recommended that emergency nurses be provided with treatment programs and interventions to reduce their secondary traumatic stress to improve their performance, thereby ensuring high-quality patient care.
Towards a Context-Contingent Stage Theory of Entrepreneurial Opportunity: Introducing the PETII Model
Authors: Quan Xiaohong Iris
Published: November 2024

Understanding opportunity is a crucial aspect of entrepreneurship research. Existing studies have extensively examined individual factors in facilitating entrepreneurial activities such as new venture creation. Although there are some discussions on contextual factors, few connect context with the origin of entrepreneurship—opportunity. Recognising the objectivity of entrepreneurial opportunity, this theoretical article first proposes two types of opportunities—innovative opportunity and imitative opportunity—to understand the nature of opportunity. It then proposes a systematic framework—the PETII (Population, Economic status, Technological advancement, Industry life cycle, Institutions) model—to analyse the role of context in the distribution of opportunity. Furthermore, it examines how both objective contextual factors and subjective individual factors influence each of the three stages in the entrepreneurship opportunity theory, from opportunity discovery, to opportunity evaluation and to opportunity exploitation. The research helps understand the origin of entrepreneurship opportunities and can stimulate thoughts on how to encourage entrepreneurship in different places. Further discussions and implications are given at the end.
Deciphering the role of host-gut microbiota crosstalk via diverse sources of extracellular vesicles in colorectal cancer
Authors: Song Yun , Shi Min , Wang Yugang
Published: November 2024

Colorectal cancer is the most common type of cancer in the digestive system and poses a major threat to human health. The gut microbiota has been found to be a key factor influencing the development of colorectal cancer. Extracellular vesicles are important mediators of intercellular communication. Not only do they regulate life activities within the same individual, but they have also been found in recent years to be important mediators of communication between different species, such as the gut microbiota and the host. Their preventive, diagnostic, and therapeutic value in colorectal cancer is being explored. The aim of this review is to provide insights into the complex interactions between host and gut microbiota, particularly those mediated through extracellular vesicles, and how these interactions affect colorectal cancer development. In addition, the potential of extracellular vesicles from various body fluids as biomarkers was evaluated. Finally, we discuss the potential, challenges, and future research directions of extracellular vesicles in their application to colorectal cancer. Overall, extracellular vesicles have great potential for application in medical processes related to colorectal cancer, but their isolation and characterization techniques, intercellular communication mechanisms, and the effectiveness of their clinical application require further research and exploration.
Early onset and increasing disparities in neurodevelopmental delays from birth to age 6 in children from low socioeconomic backgrounds
Authors: Han Tae Hwan , Chae Kyu Young , Han Boeun , Kim Ju Hee , Ha Eun Kyo , Rhie Seonkyeong , Han Man Yong
Published: November 2024

Objective

To analyze the complex relationship between socioeconomic status (SES) and neurodevelopmental achievements by investigating the temporal dynamics of these associations from birth to age 6.

Methods

This retrospective cohort study was conducted over 6 years using population-based data from the National Health Insurance Service and integrated data from the National Health Screening Program for Infants and Children. Participants were children born between 2009 and 2011 in Korea without neurodevelopmental delays with potential developmental implications. We analyzed results from the Korean Developmental Screening Test, administered at age 6, which covered overall assessment and six domains of gross and fine motor function, cognition, language, sociality, and self-care. The secondary outcome was to determine when neurodevelopmental outcomes began after birth and how these differences changed over time.

Results

Of 276,167 individuals (49.2% males), 66,325, 138,980, and 60,862 had low, intermediate, and high SES, respectively. Neurodevelopmental delays observed across all developmental domains were more prevalent in the low-SES group than in the high-SES group. Disparities in neurodevelopment according to these statuses were apparent as early as age 2 and tended to increase over time (interaction, P < 0.001). The cognition and language domains exhibited the most substantial disparities between SES levels. These disparities persisted in subgroup analyses of sex, birthweight, head circumference, birth data, and breastfeeding variables.

Conclusions

Low SES was significantly associated with an increased risk of adverse neurodevelopmental outcomes in preschool children, particularly those affecting cognitive and language domains. These differences manifested in early childhood and widened over time.
A chromosome-level genome assembly of a model conifer plant, the Japanese cedar, Cryptomeria japonica D. Don
Authors: Fujino Takeshi , Yamaguchi Katsushi , Yokoyama Toshiyuki T. , Hamanaka Toshiya , Harazono Yoritaka , Kamada Hiroaki , Kobayashi Wataru , Ujino-Ihara Tokuko , Uchiyama Kentaro , Matsumoto Asako , Izuno Ayako , Tsumura Yoshihiko , Toyoda Atsushi , Shigenobu Shuji , Moriguchi Yoshinari , Ueno Saneyoshi , Kasahara Masahiro
Published: November 2024

Background

The Japanese cedar (Cryptomeria japonica D. Don) is one of the most important Japanese forest trees, occupying approximately 44% of artificial forests and planted in East Asia, the Azores Archipelago, and certain islands in the Indian Ocean. Although the huge genome of the species (ca. 9 Gbp) with abundant repeat elements may have represented an obstacle for genetic analysis, this species is easily propagated by cutting, flowered by gibberellic acid, transformed by Agrobacterium, and edited by CRISPR/Cas9. These characteristics of C. japonica recommend it as a model conifer species for which reference genome sequences are necessary.

Results

Herein, we report the first chromosome-level assembly of C. japonica (2n = 22) using third-generation selfed progeny (estimated homozygosity rate = 0.96). Young leaf tissue was used to extract high molecular weight DNA (> 50 kb) for HiFi PacBio long-read sequencing and to construct an Hi-C/Omni-C library for Illumina short-read sequencing. The 29× and 26× genome coverage of HiFi and Illumina reads, respectively, for de novo assembly yielded 2,651 contigs (9.1 Gbp, N50 contig size 12.0 Mbp). Hi-C analysis mapped 97% of the nucleotides on 11 chromosomes. The assembly was verified through comparison with a consensus linkage map comprising 7,781 markers. BUSCO analysis identified ∼ 91% conserved genes.

Conclusions

Annotations of genes and comparisons of repeat elements with other Cupressaceae and Pinaceae species provide a fundamental resource for conifer research.
The mobile seniors’ clinic - an innovative transition of care for frail older adults
Authors: Boucher Valérie , Jouhair Eva-Marie , Sirois Marie-Josée , Tailleur Luc , Voyer Philippe , Mercier Éric , Giguère Anik , Dionne Clermont E. , Légaré France , Dallaire Clémence , Bergeron Stéphane , Carmichael Pierre-Hugues , Emond Marcel
Published: November 2024

Background

This study aims to evaluate the impact of Quebec’s first hospital-at-home-inspired mobile Seniors’ Clinic, the “Clinique des Ainés (CDA)”, on frail older adults’ returns to the Emergency Department (ED), mortality, and hospital Length Of Stay (LOS) and rehospitalizations.

Methods

Design: Quasi-experimental pre-post implementation cohort study. Population: Patients aged ≥ 75 years admitted to the short-term geriatric unit after an ED consultation (control) or included by the CDA (intervention). Outcomes: return to ED (RtoED), mortality, ED & hospital LOS, and rehospitalizations. Statistical analyses: Multivariable regression modelling.

Results

Overall, 891 patients were included. At the intervention site (CDA) (n = 437), RtoED were similar at 30 (17.5% & 19.5%, p = 0.58), 90 (34.4% & 37.3%, p = 0.46) and 180 days (47.2% & 54.0%, p = 0.07) in the pre and post-implementation phases. No mortality differences were found. The hospitalization LOS was significantly shorter (28.26 and 14.22 days, p < 0.01). At 90 days, rehospitalization LOS was decreased by 8.51 days (p = 0.02) and by 6.48 days at 180 days (p = 0.03). Compared to the control site (n = 454) in the post-implementation phase, RtoED was 54% at the intervention site compared to 44.1% (p = 0.02) at 180 days. The CDA had a lower adjusted probability of mortality at 90 days compared to the control site (4.8% VS 11.7%, p = 0.03). No rehospitalization LOS differences were noted.

Conclusions

The Clinique des Ainés showed effectiveness in caring for frail older patients in their homes by decreasing their hospital LOS by half and 90 days mortality risk. It was a safe care trajectory without a clinically significant increase in ED returns or mortality.
Assessment of potential myopia risk factors, including chronotype, in Estonian adolescents: a cross-sectional study
Authors: Palumaa Teele , Linntam Delis , Rebane Reili , Harak Kristel , Tamsalu Mari , Sõnajalg Katrin , Ülper Karina , Belova Svetlana , Keller Triin , Tammaru Marika , Palumaa Kadi
Published: November 2024

Background

Myopia is a growing healthcare concern worldwide. Increasing evidence suggests that sleep and circadian rhythms may be associated with myopia. Furthermore, the risk factors of myopia have not been studied in the Estonian population to date. This study aimed to evaluate chronotype, lifestyle factors, and parental myopia in relation to myopia in Estonian secondary school students.

Methods

Grade 10 students from three secondary schools in Tallinn, each with distinct focuses: one science-oriented, one arts-oriented, and one sports-oriented, were invited to participate. They underwent a comprehensive ocular examination, including cycloplegic autorefraction and ocular biometry. Chronotype was evaluated with the Morningness − Eveningness Questionnaire. Participants reported parental myopia and replied to a set of questions, separately for schooldays and free days, to indicate the amount of time they spent outdoors, doing near work and intermediate distance activities. Myopia was defined as cycloplegic SER ≤ − 0.50 D. Logistic regression analysis was performed to assess the association of the studied factors with myopia.

Results

A total of 123 students (57% female) participated in the study, with a mean age of 16.71 years (standard deviation 0.41). In a multivariable regression model, having two myopic parents was associated with higher odds of myopia (OR 3.78, 95% CI 1.15 − 12.42). We found no association between myopia and chronotype. Notably, time spent outdoors and doing near work or intermediate distance work did not affect the likelihood of having myopia. We observed that students attending the sports-oriented school had lower odds of myopia than those attending the science-oriented school (OR 0.12, 95% CI 0.03–0.51).

Conclusion

Chronotype was not associated with myopia in our study sample. Consistent with previous reports, we identified parental myopia as a myopia risk factor. Interestingly, there was no association between myopia and time spent outdoors or near work. However, the odds of myopia varied depending on the school attended by the participants, which may reflect the educational load or lifestyle of participants in earlier childhood.
Nationwide trends in the use of ADHD medications in the period 2006–2022: a study from the Norwegian prescription database
Authors: Hartz Ingeborg , Madsstuen Nils Henry Haugen , Andersen Per Normann , Handal Marte , Odsbu Ingvild
Published: November 2024

Background

The use of medication for Attention-Deficit/Hyperactivity Disorder (ADHD) increased globally throughout the early 2000s. This study examine trends in prevalences and incidences of medication use in Norway from 2006 to 2022.

Methods

Data from the Norwegian Prescription Database were used to present one-year-prevalence and incidence rates of ADHD medication (ATC-group N06BA and C02AC02) for the overall population (ages 6–64) and within sex and age subgroups of children (ages 6–17) and adults (ages 18–64). Incident use was defined as the dispensing of medication, with no recorded use in the previous two calendar years.

Results

The overall prevalence of ADHD medication use in 6- to 64-year-olds increased from 5.2 to 19.4 per 1000 in the period, most pronounced from 2020 and onwards. While males experienced a nearly threefold increase in use (from 7.3 to 20.6 per 1000), the use among females increased almost sixfold during the study period (from 3.0 to 18.1 per 1000). Consequently, the male-to-female prevalence-ratio decreased from 2.4 to 1. Children exhibited a higher prevalence of use compared to adults throughout the period, although the largest relative increase was observed in adults, particularly in female adults. In children the male-to-female ratio decreased from 3.2 to 2.0, primarily due to an increasing use in 13–17-year-old females. Among adults, prevalences were similar across most age groups, with the highest rates observed among those aged 18–24, where female use exceeded male use by the end of the period. The male-to-female prevalence-ratio in adults decreased from 1.6 to 0.9 during the period. Parallel to prevalent use, overall incident use increased from 1.4 to 5.0 per 1000 during the period, with the most pronounced increase occurring from 2020 and onwards. From this point, incident use among females aged 13–17, 18–24, and 25–34, exceeded that of males. The male-to-female incidence-ratio decreased from 1.8 to 0.9. The overall incidence to prevalence ratio remained similar throughout the period, being 0.27 in 2006 and 0.25 in 2022.

Conclusion

A sustained increase in the prevalence of ADHD medication use was observed, with the most pronounced rise occurring among females and adults from 2020 and onwards. By 2022, the overall gender disparity in ADHD medication use had diminished, which should be considered in the context of a steep increase in incident use among adolescent and young adult females starting from 2020.
The alcohol harm paradox: is it valid for self-reported alcohol harms and does hazardous drinking pattern matter?
Authors: Rossow Ingeborg , Bye Elin K.
Published: November 2024

Background

The alcohol harm paradox (APH) posits that alcohol harms are more prevalent in low socioeconomic position (SEP) groups compared to high SEP groups, when adjusted for alcohol consumption volume.

Aim

We explored whether APH is valid for self-reported alcohol harms and whether SEP differences in hazardous drinking patterns may explain SEP differences in alcohol harms, accounting for consumption volume.

Data and methods

We applied cross-sectional data from national population surveys in Norway, restricted to a subsample of past month drinkers aged 25–79 years (n = 8 171). Two binary outcome measures of self-reported alcohol-related harms were constructed from the AUDIT-10 items 4 through 10; alcohol dependence symptoms and alcohol related consequences. We separated two SEP groups based on education level: low versus high. Employing logistic regression models, we examined the extent to which SEP differences in alcohol-related harms were attributable to a more hazardous drinking pattern in terms of: (i) heavy episodic drinking and (ii) proportion of consumption volume by spirits, adjusting for consumption volume and demographic characteristics.

Results

In the low SEP group, alcohol-related harms were significantly more prevalent as compared to the high SEP group when adjusted for gender and age, and more so after adjustment for consumption volume. Measures of hazardous drinking pattern and having a spouse could only to a minor extent account for the elevated risk of alcohol-related harm in the low SEP group. The findings were robust across various sensitivity analyses.

Conclusion

Low SEP was associated with alcohol-related harm and a more hazardous drinking pattern but also with lower consumption volume. The findings support the validity of the alcohol harm paradox for self-reported alcohol harms.
Analysis and knowledge extraction of newborn resuscitation activities from annotation files
Authors: Abukmeil Mohanad , Meinich-Bache Øyvind , Eftestøl Trygve , Rettedal Siren , Myklebust Helge , Tysland Thomas Bailey , Ersdal Hege , Mduma Estomih , Engan Kjersti
Published: November 2024

Deprivation of oxygen in an infant during and after birth leads to birth asphyxia, which is considered one of the leading causes of death in the neonatal period. Adequate resuscitation activities are performed immediately after birth to save the majority of newborns. The primary resuscitation activities include ventilation, stimulation, drying, suction, and chest compression. While resuscitation guidelines exist, little research has been conducted on measured resuscitation episodes. Objective data collected for measuring and registration of the executed resuscitation activities can be used to generate temporal timelines. This paper is primarily aimed to introduce methods for analyzing newborn resuscitation activity timelines, through visualization, aggregation, redundancy and dimensionality reduction. We are using two datasets: 1) from Stavanger University Hospital with 108 resuscitation episodes, and 2) from Haydom Lutheran Hospital with 76 episodes. The resuscitation activity timelines were manually annotated, but in future work we will use the proposed method on automatically generated timelines from video and sensor data. We propose an encoding generator with unique codes for combination of activities. A visualization of aggregated episodes is proposed using sparse nearest neighbor graph, shown to be useful to compare datasets and give insights. Finally, we propose a method consisting of an autoencoder trained for reducing redundancy in encoded resuscitation timeline descriptions, followed by a neighborhood component analysis for dimensionality reduction. Visualization of the resulting features shows very good class separability and potential for clustering the resuscitation files according to the outcome of the newborns as dead, admitted to NICU or normal. This shows great potential for extracting important resuscitation patterns when tested on larger datasets.
Adaptive questionnaires for facilitating patient data entry in clinical decision support systems: methods and application to STOPP/START v2
Authors: Jean-Baptiste Lamy , Abdelmalek Mouazer , Romain Léguillon , Romain Lelong , Stéfan Darmoni , Karima Sedki , Sophie Dubois , Hector Falcoff
Published: November 2024

Clinical decision support systems are software tools that help clinicians to make medical decisions. However, their acceptance by clinicians is usually rather low. A known problem is that they often require clinicians to manually enter a lot of patient data, which is long and tedious. Existing solutions, such as the automatic data extraction from electronic health record, are not fully satisfying, because of low data quality and availability. In practice, many systems still include long questionnaire for data entry. In this paper, we propose an original solution to simplify patient data entry, using an adaptive questionnaire, i.e. a questionnaire that evolves during user interaction, showing or hiding questions dynamically. Considering a rule-based decision support systems, we designed methods for determining the relationships between rules and translating the system’s clinical rules into display rules that determine the items to show in the questionnaire, and methods for determining the optimal order of priority among the items in the questionnaire. We applied this approach to a decision support system implementing STOPP/START v2, a guideline for managing polypharmacy. We show that it permits reducing by about two thirds the number of clinical conditions displayed in the questionnaire, both on clinical cases and real patient data. Presented to clinicians during focus group sessions, the adaptive questionnaire was found “pretty easy to use”. In the future, this approach could be applied to other guidelines, and adapted for data entry by patients.