bluuebunny/crossref_metadata_2025 huggingface dataset:
Resistance and Transitional Justice
Authors: Jones Briony , Bernath Julie
Published: December 2023

Transitional justice is never a neutral or simply technical process. It is political and based on a series of choices and compromises which prioritize certain practices, discourses, and actors over others. Taking this as a starting point, this chapter explores resistance as an inherent part of the empirical unfolding of transitional justice. This is an underexplored yet rich area, which places an emphasis on the contexts in which transitional justice processes are implemented, and the agency of those living in transitional societies. Drawing on the cases of Burundi, Cambodia, and Côte d’Ivoire the chapter demonstrates that resistance to transitional justice must be seen in the context of longer-term struggle and the working out of a contested politics, rather than as a simple act of deviancy or spoilerism.
The Hopes of Transitional Justice
Authors: Sitze Adam
Published: December 2023

This chapter outlines a critique of transitional justice. Its claim is that transitional justice simultaneously expresses and represses a set of hopes it inherits from prior traditions of justice. It argues that transitional justice’s relation to hope has gone through three distinct phases. The first was characterized by overflowing hope bordering on revolutionary enthusiasm. The second was characterized by a data-driven reaction against the normative excesses of this initial phase. The third and current phase is characterized by an ambivalent relation both to human rights and to revolutionary discourse, whose hopes it at once promotes and also negates. In each case, transitional justice fails to achieve self-consciousness about the obscure hopes it both affirms and denies.
Transformative Justice
Authors: Gready Paul
Published: December 2023

Transitional justice is in crisis. Assumptions have turned into questions and core elements of the paradigm have been subjected to sustained critique. However, there is much less commentary that goes beyond critique and the suggestion of micro-alternatives to set out in a comprehensive fashion what an alternative approach might look like. This chapter discusses one such alternative: transformative justice. It unpacks the concept of transformative justice by addressing four questions: given that alternatives can perform various functions, does transformative justice seek to replace or reform transitional justice? How should transformative justice engage with the state and state institutions? Is its main focus on the past, and redress for the past, or does it adopt a different temporal register? And, lastly, how can a complex, holistic agenda be delivered in practice? The chapter concludes that transformative justice can best be seen in terms of a practice stretching eclectically across time and the local-to-global, questioning conventional categories and ways of working, shining a light on silences and exclusions, and privileging process and pluralism. These insights inform a definition of transformative justice as (i) emphasizing local agency and resources; (ii) prioritizing process and pluralism rather than singular paradigms and preconceived outcomes; (iii) addressing a violent past but in a way that acknowledges continuities between past and present and that creating a better future is an open-ended, ongoing project; and (iv) challenging unequal and intersecting power relationships and structures of exclusion through strategic action spanning local, national (the state), and global levels.
Acquisition of Irish English by Recent Migrants
Authors: Diskin-Holdaway Chloé
Published: December 2023

This chapter presents the different ways Irish English has been perceived and portrayed from the twelfth century into the present day. I present these three distinct groups as actors in a triangular relationship where linguists are central in describing observed language variation, analysing language perceptions, and understanding the importance of media representations of language varieties. These three approaches reinforce the notion of Irishness—and more to the point, specific types of Irishness—through sound and vision. The current chapter seeks to examine the through lines between the observations of linguists, the perceptions of non-linguists and the ways that writers access and manipulate these data in crafting believable and authentic texts. The chapter ends with the experimental model of language use, perception, and representation as proposed by the author.
Medicines and other factors causing deaths in English and welsh care homes: five-years of preventing future death reports by coroners
Authors: Irons Malcolm , Auta Asa , Portlock Jane Caroline , Manfrin Andrea
Published: December 2023

Background

Whilst information has been published on the impact, severity and causes of incidents involving medicines in care homes, it has not been systematically described. This review explored whether coroners’ Preventing Future Death (PFD) reports involving medicines for people living in care homes could add to this evidence base.

Methods

PFD reports made publicly available between 2017 and 2021 classified as ‘care home-related deaths’ were reviewed. Reports describing medicines and/or medicines processes were identified. Contributory factors within these reports were then identified.

Results

Within the timeframe, 156 reports were published, and 25 described medicines (n = 27) or medicines processes (n = 5) concerning people living in care homes. The impact of medicines and/or medicines processes was quantified as no impact (n = 7), contributory (n = 6) and direct (n = 14) per report. Two key themes emerged. Four deaths had an association between their falls risk, prescribed anticoagulants, and the failure of the service to seek timely emergency care following a fall and two deaths concerned endocrine medicines, where people refused insulin or blood sugar monitoring and staff did not seek timely advice.

Conclusion

This study demonstrated PFD reports provide an insight into the potential association between medicines, and other aspects of the person’s care in causing harm.
The Global Transcription Regulator XooClp Governs Type IV Pili System-Mediated Bacterial Virulence by Directly Binding to TFP-Chp Promoters to Coordinate Virulence Associated Functions
Authors: Verma Raj Kumar , Gondu Parimala , Saha Tirthankar , Chatterjee Subhadeep
Published: December 2023

Type IV pili (TFP) play a crucial role in the sensing of the external environment for several bacteria. This surface sensing is essential for the lifestyle transitions of several bacteria and involvement in pathogenesis. However, the precise mechanisms underlying TFP's integration of environmental cues, particularly in regulating the TFP-Chp system and its effects on Xanthomonas physiology, social behavior, and virulence, remain poorly understood. In this study, we focused on investigating Clp, a global transcriptional regulator similar to CRP-like proteins, in Xanthomonas oryzae pv. oryzae, a plant pathogen. Our findings reveal that Clp integrates environmental cues detected through diffusible signaling factor (DSF) quorum sensing into the TFP-Chp regulatory system. It accomplishes this by directly binding to TFP-Chp promoters in conjunction with intracellular levels of cyclic-di-GMP, a ubiquitous bacterial second messenger, thereby controlling TFP expression. Moreover, Clp-mediated regulation is involved in regulating several cellular processes, including the production of virulence-associated functions. Collectively, these processes contribute to host colonization and disease initiation. Our study elucidates the intricate regulatory network encompassing Clp, environmental cues, and the TFP-Chp system, providing insights into the molecular mechanisms that drive bacterial virulence in Xanthomonas spp. These findings offer valuable knowledge regarding Xanthomonas pathogenicity and present new avenues for innovative strategies aimed at combating plant diseases caused by these bacteria.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
The IMPACT (Infection Management Plus Addiction Care Together) Pilot: A Case Series of Combined Contingency Management for Substance Use Disorders and Antibiotic Adherence in the Hospital Setting
Authors: Appa Ayesha , Baral Stefan , Stein Brianna , Knight Kelly , Gandhi Monica , Coffin Phillip , Martin Marlene
Published: December 2023

Objectives

Psychostimulant-related mortality is rising alongside increasing substance use-related hospitalizations, which are commonly complicated by patient-directed (or “against medical advice”) discharges. Contingency management (CM) is an underused evidence-based treatment for substance use disorders with proven efficacy to support medication adherence. Our objective was to describe feasibility and preliminary effectiveness of a novel CM intervention incentivizing both drug use reduction and antibiotic adherence in the hospital setting.

Methods

We conducted a pilot intervention of twice weekly CM for stimulant and/or opioid use disorder and antibiotic adherence conducted on inpatient wards and/or an embedded skilled nursing facility in an urban public hospital. Based on point-of-care urine drug test results and objective antibiotic adherence review, participants earned increasing opportunities to receive incentives. We measured feasibility via number of visits attempted and cost of gift cards dispensed. We evaluated effectiveness via antibiotic completion, discharge type, and participant perception of intervention effectiveness collected via structured survey.

Results

Of 13 participants enrolled, most had opioid use disorder (fentanyl in 10/13) and stimulant use disorder (methamphetamine in 7/13). Almost all were receiving treatment for osteomyelitis and/or endocarditis (12/13). Feasibility challenges included competing demands of acute care with variable range of completed visits per participant (1–12 visits). Despite this, antibiotic completion was high (92%, 12/13 participants) with only two patient-directed discharges. Participants described CM as very effective in aiding infection treatment but had greater variability in beliefs regarding CM facilitation of reduced drug use.

Conclusions

Providing CM in the hospital setting may represent an effective approach to improving health outcomes by increasing antibiotic adherence and addressing substance use.
CHOROIDAL NEOVASCULARIZATION IN A CHILD WITH DOWN SYNDROME
Authors: Morikawa Hazuki , Yoshida Tomoyo , Kashizuka Emi , Hayashi Shion , Yokoi Tadashi , Tomita Kaoru , Azuma Noriyuki , Nishina Sachiko
Published: December 2023

Purpose:

The aim of this study was to report a case of Down syndrome with myopic choroidal neovascularization (CNV) and the treatment outcome.

Methods:

Case report: Main outcome measures include refractive error, fundus examination, optical coherence tomography, OCT angiography, fluorescein angiography, and anti-vascular endothelial growth factor injections.

Results:

A 12-year-old boy with Down syndrome presented at a regular checkup with decreased visual acuity with macular degeneration in the left eye. The best-corrected visual acuity was 0.6 in the right eye and 0.1 in the left eye, which decreased from 0.3 one year ago. The refractive error (spherical equivalent) was −5.25 diopters (D) in the right eye and −8.00 D in the left eye. Detailed examinations were performed under general anesthesia. The fundus examination showed macular degeneration with retinal pigment epithelium atrophy, pigmentary changes, and fibrous tissue in the left eye. Optical coherence tomography showed CNV at the macula with edema, and OCT angiography showed spreading CNV above the retinal pigment epithelium at the macula in the left eye. Fluorescein angiography showed hyperfluorescence in the early phase and late dye leakage from the CNV. Intravitreal ranibizumab injections were administered twice within 2 months, and he maintained a visual acuity of 0.1 in the left eye.

Conclusion:

CNV and associated macular degeneration may occur in Down syndrome with high myopia possibly because of the abnormal choroidal structure. In children with Down syndrome, regular fundus examinations with optical coherence tomography are important for early detection and treatment of CNV.
Blood Pressure Regulation in Persons with a Transfemoral Amputation: Effects of Wearing a Prosthesis
Authors: Nishioka Yasuko , Hoekstra Sven , Sawada Koshiro , Nakamura Takeshi , Tajima Fumihiro , Mikami Yasuo
Published: December 2023

INTRODUCTION

The purpose of this study was to investigate the effect of wearing a transfemoral prosthesis (FP) on blood pressure regulation in response to postural change.

METHODS

We enrolled seven persons with a transfemoral amputation who underwent a head-up tilt test while wearing an FP (PROS test) and without wearing an FP (control [CON] test). Systolic blood pressure (SBP), heart rate variability, and muscle blood flow using near-infrared spectroscopy were measured continuously.

RESULTS

In the CON (no FP) test, SBP decreased from supine to standing positions in all participants (P = 0.001). In contrast, in the PROS (wearing an FP) test, SBP increased (P = 0.001) during the postural change.

CONCLUSIONS

The findings suggest that a transfemoral prosthesis increases peripheral vascular resistance in the lower limbs and stimulates the baroreflex, helping to stabilize the circulatory dynamics upon postural change.

CLINICAL RELEVANCE

Because circulatory dynamics may be hampered in persons with a transfemoral amputation, wearing a prosthesis not only assists in ambulation but can also play a significant role in blood pressure regulation during activities of daily living.
Clinical Characteristics and Detection Sensitivity of Cervical Cancer Screening in Vaginal Intraepithelial Neoplasia
Authors: Chen Yusha , Chen Qiaoyun , Xue Huifeng , Zheng Jinwen , Chen Jiancui , Zheng Xiangqin
Published: December 2023

Objective

This study aimed to investigate the characteristics and screening history of vaginal intraepithelial neoplasia (VaIN) or vaginal cancer and compare the sensitivity of cytology and human papillomavirus (HPV) tests on the cervix against vaginal and cervical high-grade squamous intraepithelial lesion or cancer.

Methods

This study included patients who underwent colposcopy-directed biopsy and were diagnosed with VaIN or vaginal cancer from February 2013 to November 2022. Clinical information was obtained from the medical records of the department. Statistical analysis was performed on SPSS 26.0 (IBM Corp, Armonk, NY) using t test, chi-square, and Fisher exact tests.

Results

A total of 1,166 patients were included in this study. The median age of VaIN2+ patients was 50.5 years, whereas VaIN1 reported a median age of 42.1 years old, p < .001. This study reported that VaIN was significantly and positively correlated with cervical lesions (r = 0.244). The high-risk HPV (hr-HPV) detection rate was 88.2% (858/973) in VaIN and 95.2% in VaIN2+. Human papillomavirus 16 was the most prevalent HPV type in VaIN2+, which accounted for 54.9%, followed by HPV58 (19.5%), HPV52 (15.2%), HPV51 (12.2%), and HPV18 (11.0%). The sensitivity of hr-HPV and cytology tests on the cervix for detecting VaIN2+ was 94.7% and 83.4%, respectively. Both tests were not significantly different from detecting cervical intraepithelial neoplasia 2+.

Conclusions

Human papillomavirus 16 is the dominant HPV type in vaginal precancer lesions. Cervical cancer screening has similar sensitivity for VaIN2+ as for cervical intraepithelial neoplasia 2+, with hr-HPV testing showing higher sensitivity than cytology.
Inflammatory Markers and Fatigue in Individuals With Moderate to Severe Chronic Obstructive Pulmonary Disease
Authors: Lee Jung Eun , Nguyen Huong Q. , Fan Vincent S.
Published: December 2023

Background

Fatigue, a prevalent complex symptom among patients with chronic obstructive pulmonary disease (COPD), is considered an important clinical indicator of disease severity. However, the underlying mechanisms of COPD-related fatigue are not fully understood.

Objectives

This analysis explored the relationships between peripheral inflammatory markers and COPD-related fatigue in people with moderate to severe COPD.

Methods

This is a secondary analysis of a longitudinal observational study of individuals with COPD examining the biological causes and functional consequences of depression. The data used in this study were collected at baseline. Systemic inflammation markers included C-reactive protein (CRP) and three pro-inflammatory cytokines consisting of interleukin-6 (IL-6), IL-8, and tumor necrosis factor-α. COPD-related fatigue was self-reported using the Chronic Respiratory Questionnaire. Covariates included age; gender; smoking status; disease severity; symptoms of depression, anxiety, and pain; and social support. Multivariable linear regression analyses were conducted.

Results

The sample included 300 adults living with COPD; 80% were male, and the average age was 67.6 years. Modest correlations were found between two systemic inflammatory markers (CRP and IL-8) and COPD-related fatigue. CRP was the only inflammatory marker significantly associated with fatigue symptoms after adjusting for covariates in multivariable analyses. Depression, pain, and education level were also significant predictors of COPD-related fatigue.

Discussion

The findings suggest that altered immune response based on CRP may contribute to COPD-related fatigue. Management of depression and pain may work as an effective treatment strategy for COPD-related fatigue. Further longitudinal studies with a broader range of inflammatory markers and multidimensional measures of fatigue symptoms are warranted.
Introduction to a special issue on big data and pain
Authors: Baskozos Georgios
Published: December 2023

This special issue comprised 7 articles from leaders in the field that focus on “big pain data”, the large datasets and the associated methods for data analysis that are currently emerging in pain research. This collection of articles highlights the power and potential as well as points of caution that multi-disciplinary research utilising big data and their associated methods and interpretations present for pain research.
A Rare Case of Thyroid Sarcoidosis
Authors: Nazerani-Zemann Tina , Pernthaler Birgit , Abete Luca , Wienerroither Valerie Fanny , Gstettner Christian
Published: December 2023

Thyroid sarcoidosis is a rare manifestation of sarcoidosis, an inflammatory disease characterized by the formation of noncaseating granulomas in various organs. The diagnosis of thyroid sarcoidosis is challenging because of its nonspecific symptoms and the absence of specific biomarkers. Here, we report the case of a 43-year-old woman who presented with a 2-year history of neck swelling, dysphonia, and dysphagia, and suspected nodule in her left thyroid.
Life-Threatening Involvement of Bilateral Pulmonary Arteries in Behçet Disease on FDG PET
Authors: Hou Naifeng , Fan Chengzhong , Shen Guohua
Published: December 2023

A 29-year-old man with Behçet disease exhibiting lower-limb swelling and dyspnea underwent 18F-FDG PET/CT. The imaging revealed bilateral pulmonary artery involvement, and pulmonary artery aneurysms and mural thrombus were confirmed by CT pulmonary angiography. This case underscores the utility of 18F-FDG PET in identifying life-threatening vasculitis complications in Behçet disease.
Serial Migration of Iatrogenic Microembolus on 18F-FDG PET/CT Images
Authors: Han Yeon-Hee , Jeong Hwan-Jeong , Lim Seok Tae
Published: December 2023

A 51-year-old woman who had a history of partial nephrectomy underwent an 18F-FDG PET/CT image for a routine health checkup. Focal intense FDG avidity without any anatomical correlation on CT was detected in the lung. On the delayed image after 20 minutes, the focal activity migrated to a more peripheral portion. An iatrogenic microembolus is a rare but crucial false-positive finding that nuclear physicians should be aware of. Our case emphasizes the importance of meticulous FDG injection and cautious interpretation. In addition, delayed PET/CT imaging through wet reading can aid in diagnosing and help prevent unnecessary investigations.
Antibiotic prophylaxis in trauma: Global Alliance for Infection in Surgery, Surgical Infection Society Europe, World Surgical Infection Society, American Association for the Surgery of Trauma, and World Society of Emergency Surgery guidelines
Authors: Coccolini Federico , Sartelli Massimo , Sawyer Robert , Rasa Kemal , Ceresoli Marco , Viaggi Bruno , Catena Fausto , Damaskos Dimitrios , Cicuttin Enrico , Cremonini Camilla , Moore Ernest E. , Biffl Walter L. , Coimbra Raul
Published: December 2023

Trauma is a complex disease, and the use of antibiotic prophylaxis (AP) in trauma patients is common practice. However, considering the increasing rates of antibiotic resistance, AP use should be questioned and limited only to specific cases. Antibiotic stewardship is of paramount importance in fighting resistance spread. Definitive rules or precise indications about AP in trauma remain unclear. The present article describes the indications of AP in traumatic lesions to the head, brain, torso, maxillofacial, extremities, skin, and soft tissues endorsed by the Global Alliance for Infection in Surgery, Surgical Infection Society Europe, World Surgical Infection Society, American Association for the Surgery of Trauma, and World Society of Emergency Surgery.
Electroconvulsive Therapy Across Nations
Authors: Rohde Paul , Noorani Rachel , Feuer Elyssa , Lisanby Sarah H. , Regenold William T.
Published: December 2023

Objectives

We aimed to characterize worldwide electroconvulsive therapy (ECT) practice and compare practice across nations and global regions.

Method

Our anonymous survey was open on SurveyMonkey.com from January to June 2022. We sent invitations to providers identified using a Medicare provider database, an advanced PubMed search function, and professional group listservs. Participants were instructed to submit one survey per ECT site. Response frequencies were pooled by global region and compared using nonparametric methods.

Results

Responses came from 126 sites, mostly in the United States (59%, n = 74), Europe (18%, n = 23), Canada (10%, n = 12), and South/East Asia (6%, n = 8). With some exceptions, sites were broadly consistent in practice as indicated by: a likely shift internationally from bitemporal to right unilateral electrode placement; predominant use of pulse widths <1 ms; preference for seizure threshold titration over age-based dosing methods; widespread availability of continuation/maintenance ECT (97%); and frequent use of quantitative outcome measures for depressive symptoms (88%) and cognitive adverse effects (80%).

Conclusions

This is the first, published survey that aimed to characterize worldwide ECT practice. With some exceptions, responses suggest a concordance in practice. However, responses were primarily from the Global North. To obtain a truly worldwide characterization of practice, future surveys should include more responses from the Global South.
Predicting instabilities: an embodied perspective on unstable experiences with art and design
Authors: Muth Claudia , Carbon Claus-Christian
Published: December 2023

Predictive Processing (PP) provides a theoretical framework that describes perception as a process attempting to increase the predictability of stimulations by updating predictions or exploring new sensations. Moreover, perception and action are assumed to be closely linked within this process. While organisms seem to strive for predictability, we sometimes expose ourselves to objects and situations that challenge sense-making—such conditions often break perceptual habits or offer multiple possible meanings. This paper updates a previous qualification of these experiences of ‘Semantic Instability’ (
SeIns
) by following an embodied and situated understanding of perception and cognition. We suggest that art perception essentially differs from problem-solving as in engaging with art, we typically integrate contradictory elements dynamically and without the ultimate goal of resolving the contradictions—on the contrary,
SeIns
itself can generate aesthetic hedonics and interest. We discuss how current embodied accounts of PP might help understand what motivates such unstable yet insightful and pleasurable nonlinear sense-making processes.

This article is part of the theme issue ‘Art, aesthetics and predictive processing: theoretical and empirical perspectives’.
Parallelisms and deviations: two fundamentals of an aesthetics of poetic diction
Authors: Menninghaus Winfried , Wagner Valentin , Schindler Ines , Knoop Christine A. , Blohm Stefan , Frieler Klaus , Scharinger Mathias
Published: December 2023

Poetic diction routinely involves two complementary classes of features: (i) parallelisms, i.e. repetitive patterns (rhyme, metre, alliteration, etc.) that enhance the predictability of upcoming words, and (ii) poetic deviations that challenge standard expectations/predictions regarding regular word form and order. The present study investigated how these two prediction-modulating fundamentals of poetic diction affect the cognitive processing and aesthetic evaluation of poems, humoristic couplets and proverbs. We developed quantitative measures of these two groups of text features. Across the three text genres, higher deviation scores reduced both comprehensibility and aesthetic liking whereas higher parallelism scores enhanced these. The positive effects of parallelism are significantly stronger than the concurrent negative effects of the features of deviation. These results are in accord with the hypothesis that art reception involves an interplay of prediction errors and prediction error minimization, with the latter paving the way for processing fluency and aesthetic liking.

This article is part of the theme issue ‘Art, aesthetics and predictive processing: theoretical and empirical perspectives’.
Women’s autonomy, neonatal, infant and under-five mortality in the Upper East Region of Ghana
Authors: Achana Fabian Sebastian , Tanle Augustine , Doku David Teye
Published: December 2023

Background

Eight years to the set deadline for the 2030 SDGs, child mortality remains a major health challenge in Sub-Saharan Africa. Child survival is greatly influenced by household circumstances and mother’s healthcare choices. Notwithstanding tremendous investment in women empowerment in Ghana, there is limited empirical evidence on whether women’s autonomy translates into better child mortality outcomes.

Objective

To examine the association between women’s autonomy and neonatal, infant and under-five mortality in the Upper East Region of Ghana.

Methods

Data were obtained from a randomized cluster household survey among 15-49 years old women in seven districts in the Upper East Region. Data analysis was restricted to 3,243 women who reported ever having given birth. Based on Principal Component Analysis (PCA), we constructed an autonomy index categorized into least, moderate, and high autonomy based on responses to six questions regarding household decision-making. Bivariate and multivariate logistic regressions were used to assess the association of women’s autonomy status and mortality outcomes.

Results

Attaining secondary education or higher was significantly associated with infant mortality (adjusted odds ratio (aOR)= 0.39, CI= 0.16, 0.94) and under-five mortality (aOR= 0.39, CI= 0.18-0.87). Also, maternal age was significantly associated with neonatal, infant, and under-five mortality, while living in rural setting was significantly associated with lower risk of neonatal (aOR= 0.38, CI=0.19-0.75) and under-five (aOR= 0.63, CI= 0.48-0.83) mortality. However, we found that compared to women with least autonomy, infants of those with moderate autonomy (aOR= 1.76, CI 1.07-2.89) and high autonomy (aOR= 1.75; CI= 1.04- 2.93) were significantly more likely to die.

Conclusion

In this study setting, women’s autonomy was not predictive of child mortality. Interventions that aim to improve child mortality should pay attention to community and family level factors that promote increase utilization of essential early childhood interventions.
Contextual modulation of primary visual cortex by temporal predictability during motion extrapolation
Authors: Agostino Camila Silveira , Hinrichs Herman , Noesselt Toemme
Published: December 2023

Predicting future events is a fundamental cognitive ability which often depends on the volatility of the environment. Previous studies on apparent motion reported that when the brain is confronted with low levels of predictability, activity in low-level sensory areas is increased, including primary visual cortex. However, other studies on temporal predictability reported opposite effects potentially due to the influence of attention. It remains unclear, however, how temporal predictability modulates brain responses in a more ecologically valid real motion paradigm. Our study investigated whether motion extrapolation in high and low predictable contexts would differently modulate fMRI-responses in subject-specific primary visual cortex during visible and partially occluded stimulation. To this end, participants performed a modified version of the interception paradigm in visible and occluded phases, in which they observed a stimulus moving horizontally, then vertically at two different velocities. They were instructed to press when and where the stimulus would reach a given point-of-contact. In high predictable context, the velocity was identical during horizontal and vertical (occluded) movement; whereas, in low predictable context, the velocity could change during the vertical trajectory. MVPA results revealed accuracies above chance for all classification analyses carried out with low and highly predictable context data. Moreover, trial-history analysis showed that a change in trial type (constant velocity after change in velocity and vice versa) increased BOLD-responses in V1. This pattern of results suggests motion extrapolation can enhance activity in primary visual cortex, regardless of trial-specific predictability, but it is affected by recent trial history.

Highlights

* Ignoring trial history high and low temporal predictability similarly enhance response in V1

* In recent trial-history analysis, low temporal predictability enhanced responses in V1 compared to high temporal predictability

* Shared regions inside primary visual cortex encode visible and partially occluded information
Sensitivity, specificity and avoidable workload of using a large language models for title and abstract screening in systematic reviews and meta-analyses
Authors: Tran Viet-Thi , Gartlehner Gerald , Yaacoub Sally , Boutron Isabelle , Schwingshackl Lukas , Stadelmaier Julia , Sommer Isolde , Aboulayeh Farzaneh , Afach Sivem , Meerpohl Joerg , Ravaud Philippe
Published: December 2023

Importance

Systematic reviews are time-consuming and are still performed predominately manually by researchers despite the exponential growth of scientific literature.

Objective

To investigate the sensitivity, specificity and estimate the avoidable workload when using an AI-based large language model (LLM) (Generative Pre-trained Transformer [GPT] version 3.5-Turbo from OpenAI) to perform title and abstract screening in systematic reviews.

Data Sources

Unannotated bibliographic databases from five systematic reviews conducted by researchers from Cochrane Austria, Germany and France, all published after January 2022 and hence not in the training data set from GPT 3.5-Turbo.

Design

We developed a set of prompts for GPT models aimed at mimicking the process of title and abstract screening by human researchers. We compared recommendations from LLM to rule out citations based on title and abstract with decisions from authors, with a systematic reappraisal of all discrepancies between LLM and their original decisions. We used bivariate models for meta-analyses of diagnostic accuracy to estimate pooled estimates of sensitivity and specificity. We performed a simulation to assess the avoidable workload from limiting human screening on title and abstract to citations which were not “ruled out” by the LLM in a random sample of 100 systematic reviews published between 01/07/2022 and 31/12/2022. We extrapolated estimates of avoidable workload for health-related systematic reviews assessing therapeutic interventions in humans published per year.

Results

Performance of GPT models was tested across 22,666 citations. Pooled estimates of sensitivity and specificity were 97.1% (95%CI 89.6% to 99.2%) and 37.7%, (95%CI 18.4% to 61.9%), respectively. In 2022, we estimated the workload of title and abstract screening for systematic reviews to range from 211,013 to 422,025 person-hours. Limiting human screening to citations which were not “ruled out” by GPT models could reduce workload by 65% and save up from 106,268 to 276,053-person work hours (i.e.,66 to 172-person years of work), every year.

Conclusions and Relevance

AI systems based on large language models provide highly sensitive and moderately specific recommendations to rule out citations during title and abstract screening in systematic reviews. Their use to “triage” citations before human assessment could reduce the workload of evidence synthesis.
Single voxel autocorrelation reflects hippocampal function in temporal lobe epilepsy
Authors: Bouffard Nichole R. , Audrain Sam , Golestani Ali M. , Barense Morgan D. , Moscovitch Morris , McAndrews Mary Pat
Published: December 2023

We have previously shown that analyses of autocorrelation of BOLD signal applied to single voxels in healthy controls can identify gradients of temporal dynamics throughout the hippocampal long-axis that are related to behavior. A question that remains is how changes in functional and structural integrity in the brain affect single voxel autocorrelation. In this study we investigate how hippocampal autocorrelation is affected by structural and functional hippocampal dysfunction by investigating a population of patients with unilateral temporal lobe epilepsy (TLE). Many patients with TLE have mesial temporal sclerosis (MTS), characterized by scarring and neuronal loss particularly in the anterior hippocampus. Here we compared patients with left and right TLE, some with and without MTS, to healthy controls. We applied our single voxel autocorrelation method and data-driven clustering approach to segment the hippocampus based on the autocorrelation. We found that patients with left TLE had slower signal dynamics (i.e., higher autocorrelation) compared to controls, particularly in the anterior-medial portion of the hippocampus. This was true for both the epileptogenic and non-epileptogenic hemispheres. We also evaluated the extent of cluster preservation (i.e., spatial overlap with controls) of patient autocorrelation clusters and the relationship to verbal and visuospatial memory. We found that patients with greater cluster preservation in the anterior-medial hippocampus had better memory performance. Surprisingly, we did not find any effect of MTS on single voxel autocorrelation, despite the structural changes associated with the condition. These results suggest that single voxel autocorrelation may be related to functional, rather than structural, integrity.
Assessing the usability of the new automated medication dispensation device for patients and the adherence dashboard for real-time medication monitoring for healthcare providers: a study protocol
Authors: Patel Tejal , Laeer Christoph , Darabi Hamed , Lachance Maxime , Anawati Michelle , Chomienne Marie-Hélène
Published: December 2023

Background

Non-adherence to prescribed medication regimens can lead to suboptimal control of chronic health conditions and increased hospitalizations. Older adults may find it particularly challenging to self-manage medications due to physical and cognitive limitations resulting in medication non-adherence. While automated medication dispensing technologies may offer a solution for medication self-management among older adults, these technologies must demonstrate usability before effectiveness can be investigated and products made available for widespread use.

Objectives

This study will aim to measure usability, workload, and unassisted task completion rates of an automated medication dispenser and medication adherence dashboard on the Medipense portal with older adults and their clinicians, respectively.

Methods

This study is designed as convergent parallel mixed methods observational study with older adults and their clinicians. Usability will be examined with the use the System Usability Scale while NASA-TLX will be utilized to assess the workload of both the device and the adherence monitoring platform. Cognitive walkthrough will be utilized prior to usability testing to identify series of steps required to use the automated dispenser and adherence dashboard. The study will assess the unassisted task completion rates to successfully operate the device. Semi-structured interviews with both types of participants will provide qualitative data with which to comprehensively gauge user experience with the automated dispenser.

Results

The results of this study will allow us to examine usability of both the automated medication dispensing system and the adherence monitoring dashboard from older adult and heath care provider perspectives. The results of this study will highlight and address the challenges with usability that older adults and healthcare providers may face with this device and dashboard.

Conclusions:

The results of this study will be used to optimize the usability of both the automated medication dispenser and the adherence dashboard.
Multidimensional evaluation of the early emergence of executive function and development in Bangladeshi children using nutritional and psychosocial intervention: A randomized controlled trial protocol
Authors: Shama T. , O’Sullivan J.M. , Rahman N. , Kakon S.H. , Tofail F. , Hossain M.I. , Zeilani M. , Haque R. , Gluckman P. , Forrester T. , Nelson C.A.
Published: December 2023

Introduction

Reversing malnutrition-induced impairment of cognition and emotional regulation is a critical global gap. We hypothesize that brain-targeted micronutrient supplemented nutritional rehabilitation in children with moderate acute malnutrition, followed by 2 years micronutrient supplementation will impact on the cognition and emotion regulation of these children.

Methods

The primary outcome of this prospective, randomized controlled trial is to study the development of executive functions (EFs) and emotion regulation (ER) in this cohort.

Moderate acute malnourished (MAM; WLZ/WHZ <-2 and ≥-3 z-score, and/or 11.5 cm ≤ MUAC < 12.5cm; n=140)children aged around one year (11m-13m) in Mirpur, Dhaka, Bangladesh will be randomized (1:1) to receive either locally produced Ready to Use Supplementary Food (RUSF) or Enhanced Ready to Use Supplementary Food (E-RUSF) until anthropometric recovery (WLZ/WHZ > -1SD), or for 3 months after enrollment (whichever is earlier). The randomized MAMs groups will be given either Small Quantity Lipid Based Nutrient Supplement (SQLNS) or Enhanced Small Quantity Lipid Based Nutrient Supplement (E-SQLNS), respectively until the end of the 2-year follow up period. Standard psychosocial stimulation will be provided to the MAMs intervention groups. Biological samples will be collected, anthropometric and neurocognitive assessments will be performed at 2 (22m-26m) and 3 (34m-38m) years of age.

Two control groups will be recruited: 1), non-malnourished one-year (11m-13m) old children (WLZ/WHZ score>-1SD; n=70); and 2) three –year (34m-38m) old children (n=70) with untreated MAM (WHZ <-2 and ≥-3 z-score, and/or 11.5≤MUAC<12.5 cm). The 3-year-old MAM reference group will be assessed once and provided with 2 months of nutritional rehabilitation support (RUSF Nutriset’s Plumpy’SupTM).

Ethics and dissemination

The study protocol has been reviewed and approved by all the relevant ethical review boards at each research site (icddr,b Bangladesh; University of the West Indies, Kingston Jamaica; and University of Auckland, New Zealand). The results will be disseminated through peer-reviewed publications and national and international scientific conferences.

Protocol version 1 (1/11/2022)

Trial registration number

NCT05629624. Registered on November 29, 2022.
Predictors of advanced-stage presentation among breast and cervical cancer patients in Ethiopia
Authors: Shewarega Birtukan , Getachew Sefonias , Assefa Nigussie , Yesufe Abdu Adem , Trabizsch Josephin , Dandena Yonas , Gashawubeza Biruck , Addissie Adamu , Kantelhardt Eva Johanna , Gizaw Muluken
Published: December 2023

Breast and cervical cancers are the most common causes of cancer incidence and mortality in women in Africa. Women with breast and cervical cancers in Sub-Saharan Africa (SSA) are frequently diagnosed at advanced stages. Delays in health seeking, diagnosis and treatment are contributing factors to high mortality in Ethiopia. This study aimed to assess predictors of advanced stage presentation among breast and cervical cancer patients attending public hospitals in Addis Ababa, Ethiopia. A cross-sectional study was conducted with a total of 418 patients at Tikur Anbessa specialized hospital and Saint Pauls’ Hospital Millennium Medical College from October to November 2021. Stages III and IV were considered advanced stages. Data were collected by reviewing medical records and in face-to-face interviews with a structured questionnaire. Bivariate and multivariate analyses were performed to examine the association between independent and outcome variables. A total of 269 patients with breast cancer and 149 patients with cervical cancer were included in the study, and the mean age was 44 years (SD = 10.9 years) and 50 years (SD = 11.2) years, respectively. About 66.9% of breast cancers and 71.1% of cervical cancers were diagnosed at an advanced disease stage. Rural residence (AOR = 2.041, 95% CI: 1.108–3.758), indirect referral (AOR = 3.8, 95% CI: 1.485–9.946), financial difficulty (AOR = 10, 95% CI: 1.859–56.495) and no prior advise/awareness about screening (AOR = 4.029 95%CI: 1.658–10.102) were independent predictors of advanced-stage presentation. This study revealed a high prevalence of advanced-stage breast and cervical cancer diagnosis in Ethiopia, similar to data collected 10 years ago, despite the introduction of a cancer control plan in 2015. For better implementation, interventions should aim to improve referral pathways, adapt screening and early detection services and increase cancer awareness at the community level in a culturally accepted way.
Retrospective analysis of Covid-19 hospitalization modelling scenarios which guided policy response in France
Authors: Starck Thomas , Langevin Maxime
Published: December 2023

Abstract

During the COVID-19 pandemic, epidemiological modelling has played a key role in public debate and policy making for anticipating the epidemic trajectory, as well as proposing and evaluating non-pharmaceuticals interventions. Despite its importance, evaluations of models’ ability to accurately represent the evolution of the disease remain scarce. Robust and systematic evaluation is needed to assess models. We investigate the following research question : were the COVID-19 scenarios proposed by modellers during the pandemic to policy-makers relevant for decision making ? To answer this, we conduct a retrospective assessment of modelling reports which guided policy response in France in 2020-2022. After systematically verifying the scenarios hypotheses (e.g., exclusion of no-lockdown scenarios when a lockdown was effectively in place), we find that out of 10 reports, reality was below the best-case scenario in 6 reports; within the best-case / worst case scenarios range in 3 reports; above the worst-case scenario in 1 report. Best-case scenarios were the closest to reality, but often came from report with a large span between best-case and worst-case scenarios beyond 2 weeks, precluding certainty about future outcomes at the time of publishing. Our results hint a systematic overestimation bias for these particular models used to anticipate epidemic evolution, which can be of importance if such models are used to contractually estimate the effectiveness of non pharmaceutical interventions. To our knowledge, this is the only national systematic retrospective assessment of COVID-19 pandemic scenarios assessing hospital burden; such an approach should be reproduced in other countries whenever possible.

Graphical Abstract

Reality (black line) compared to prospective scenarios (colored lines) which informed policy during the COVID-19 pandemic in France for Intensive Care Units (top) and New Hospital Admissions (bottom). Colors indicate the error between reality and scenarios, expressed as a percentage of the 1st wave peak (horizontal dashed line).
Determinants of overweight and obesity among children between 5 to 11 years in Ecuador: a secondary analysis from the National Health Survey 2018
Authors: Tello Betzabé , Ocaña José , García-Zambrano Paúl , Enríque-Moreira Betsabé , Dueñas-Espín Iván
Published: December 2023

Background

During the 1990s, global eating habits changed, affecting poorer and middle-income nations, as well as richer countries. This shift, known as the “obesity transition,” led to more people becoming overweight or obese worldwide. In Ecuador, this change is happening, and now, one in three children is affected by overweight or obesity (OW/OB). This study explores the links between social, economic, and demographic factors and childhood obesity in Ecuador, seeking to provide insights for shaping future health policies in response to this intricate shift.

Methods

A cross-sectional study using 2018 National Health and Nutrition Survey data from Ecuador. Weighted percentages were computed, and odds ratios for OW/OB unadjusted and adjusted for each category of explanatory variables were estimated using multilevel multivariate logistic regression models.

Results

Among 10,807 Ecuadorian school children aged 5 to 11, the prevalence of OW/OB was 36.0%. Males exhibited 1.26 times higher odds than females (95% CI: 1.20 to 1.33), and each additional year of age increased the odds by 1.10 times (95% CI: 1.09 to 1.10). Economic quintiles indicated increased odds (1.17 to 1.39) from the 2nd to 5th quintile (the richest) compared with the first quintile (the poorest). Larger household size slightly reduced odds of OW/OB (adjusted odds ratio [aOR]=0.93, 95% CI: 0.91 to 0.95), while regular physical activity decreased odds ([aOR]=0.79, 95% CI: 0.75 to 0.82). The consumption of school-provided meals showed a non-significant reduction (aOR: 0.93, 95% CI: 0.82 to 1.06). Children from families recognizing and using processed food labels had a higher likelihood of being overweight or obese (aOR=1.14, 95% CI: 1.02 to 1.26).

Conclusion

Age, male gender, and higher economic quintile increase OW/OB in Ecuadorian school children. Larger households and physical activity slightly decrease risks. Ecuador needs policies for healthy schools and homes, focusing on health, protection, and good eating habits.