bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Just a knife wound this week, nothing too painful”:an ethnographic exploration of how homeless clients attending an urban primary care and addiction service view their own health and healthcare
Authors: Ingram Carolyn , Buggy Conor , MacNamara Isobel , Perrotta Carla 
Published: December 2024

AbstractThis study used an ethnographic approach grounded in a social constructivist research paradigm to explore the perspectives of people in homelessness attending a primary care and addiction service on their priority health and healthcare needs. Participant observations and informal interviews were conducted with homeless clients attending the service for three hours every Monday morning between October 2022 and April 2023. Field note data from active participant observation and informal conversations were collected, anonymised, and analysed using inductive thematic analysis in accordance with the Declaration of Helsinki and the researchers’ institutional Research Ethics Committee. Three main themes emerged from the analysis: self-identified priorities, satisfaction with services, and migrant health. Clients’ priority concerns relate to their mental health, maintaining ties with children and families, navigating complex romantic relationships, finding meaningful activities, and feeling better physically. These challenges differ from those of the general population in terms of their severity observed both prior to and during experiences of homelessness, coupled with disproportionately high levels of loss, fear, injury, pain, disability, fatigue, and isolation. In terms of services, clients are satisfied with their ability to access primary care and harm reduction in a social environment where positive exchanges with friends and providers take place. Conversely, barriers to accessing mental health and addiction services persist including the internalised belief that one is beyond help, lack of access to information on available services and their entry requirements, and lingering stigma within a health system that treats addiction as separate to health. Moving forward, health practitioners may consider holding more regular and open conversations with homeless clients about the care they are receiving, its rationale, and whether or not changes are desired that can be safely made. The health needs of migrants and asylum seekers entering homelessness in Ireland are urgent and should be prioritised in future research.
Development of a differential treatment selection model for depression on consolidated and transformed clinical trial datasets
Authors: Perlman Kelly , Mehltretter Joseph , Benrimoh David , Armstrong Caitrin , Fratila Robert , Popescu Christina , Tunteng Jingla-Fri , Williams Jerome , Rollins Colleen , Golden Grace , Turecki Gustavo 
Published: December 2024

ABSTRACTObjectiveMajor depressive disorder (MDD) is the leading cause of disability worldwide, yet treatment selection still proceeds via “trial and error”. Given the varied presentation of MDD and heterogeneity of treatment response, the use of machine learning to understand complex, non-linear relationships in data may be key for treatment personalization. Well-organized, structured data from clinical trials with standardized outcome measures is useful for training machine learning models; however, combining dataacrosstrials poses numerous challenges. There is also persistent concern that machine learning models can propagate harmful biases.MethodsWe have created a methodology for organizing and preprocessing depression clinical trial data such that transformed variables harmonized across disparate datasets can be used as input for feature selection. Using bayesian optimization, we identified an optimal multi-layer dense neural network which used data from 21 clinical and sociodemographic features as input in order to perform differential treatment benefit prediction.ResultsWith this combined dataset of 5032 individuals and 6 drugs, we created a differential treatment benefit prediction model. Our model generalized well to the held-out test set and produced similar accuracy metrics in the test and validation set with an AUC of 0.7 when predicting binary remission. To address the potential for bias propagation, we used a bias testing performance metric to evaluate the model for harmful biases related to ethnicity, age, or sex.ConclusionWe present a full pipeline from data preprocessing to model validation that was employed to create the first differential treatment benefit prediction model for MDD containing 6 treatment options.
The cost of myopic pandemic response
Authors: Nowak Sarah , de Lima Pedro Nascimento , Vardavas Raffaele 
Published: December 2024

ABSTRACTPrior to the availability of COVID-19 vaccines, non-pharmaceutical interventions (NPIs) served as a primary strategy to mitigate the spread of the disease. However, the efficiency of these interventions relies on understanding and incorporating human behavior into infectious disease models. This study addresses the need for models that better account for the influence of temporal discounting on behavioral dynamics to enhance forecasting accuracy and develop robust mitigation strategies. Our previous research introduced Known Time Horizon (KTH) policies, optimizing social distancing measures based on a central planner’s rational assessment of the pandemic’s time frame and associated costs. In this paper, we contrast the KTH policy with a model reflecting myopic decision-making, an extreme form of temporal discounting that emphasizes short-term outcomes over long-term consequences. By comparing the expected social distancing behavior under myopic decision-making with the optimal policy derived from KTH approaches, we elucidate the impact of temporal bias on social distancing practices and assess its implications for infection dynamics and associated costs. We find that myopic policy always results in greater total costs throughout an epidemic compared to a KTH policy. However, each cost component – the costs of infection and social distancing – derived from a myopic strategy may be either larger or smaller than the component costs for a strategy developed using a full optimization model, depending on the specific parameters involved as myopic decision-makers seek to delay both costs of social distancing and infection.
Post Tuberculosis (TB) Bronchiectasis versus Non-TB Bronchiectasis in Northern Pakistan: A single centre retrospective cohort study on frequency, demographics, microbiology, and complications
Authors: Hoole Anbesan Samuel , Ilyas Ahsan , Munawar Sunaina , Cant Matthew , Hameed Rizwan , Gill Shahzad , Riaz Joel , Siddiq Issac 
Published: December 2024

AbstractIntroductionWhile Post Tuberculous (TB) Bronchiectasis is the most common cause of Bronchiectasis in South Asia, there has been little research into its microbiology and clinical characteristics in Pakistan. This single centre retrospective cohort study at Bach Christian Hospital (BCH) in rural Northern Pakistan seeks to address this issue.MethodsDemographic, Imaging, Aetiological and Microbiological data were obtained from 32 patients with Bronchiectasis at BCH from between January 2023 and December 2023(1–3).Results76% (25/32) of all cases of Bronchiectasis were Post TB. TB infection was seen in 5 cases of Post TB Bronchiectasis, TB with bacterial or fungal co infections in 4, and single bacterial infections in 4. In post TB Bronchiectasis 4 patients had growth of a single bacterium. Drug sensitivities were obtained for bacterial isolates.One patient each with Post TB and Non-TB Bronchiectasis died from Type 2 Respiratory failure despite appropriate treatment. 2 patients with Post TB Bronchiectasis and destroyed lung syndrome improved but with ongoing significant respiratory impairment(4). All other patients improved with treatment.DiscussionThe frequency of Post TB Bronchiectasis is very high even for South Asia(5–8).A significant number (8/24) of Post TB Bronchiectasis had re-infection or failure to improve despite appropriate drug treatment. TB PCR (Polymerase Chain Reaction) on Bronchoalveolar lavage (BAL) was key in the management of these patients(9).Among patients with Post TB Bronchiectasis, those with co-infection present a difficult treatment challenge.Some patients with Post TB Bronchiectasis have significant complications such as destroyed lung syndrome which is difficult to manage.Drug susceptible bacteria and NTM were less commonly isolated than in other studies(10–12).ConclusionFurther research is needed particularly to manage Post TB Bronchiectasis patients with co-infections or complications such as significant structural lung disease.Key MessagesWhat is known about this topicTuberculosis (TB) is the most common cause of bronchiectasis in South Asia, but little is known about microbiology or clinical characteristics of post-TB Bronchiectasis.What this study addsPost TB Bronchiectasis has a very high prevalence in our region, with TB PCR key for diagnosis of TB re-infection in some cases. Mycobacterial, Bacterial and Fungal co-infections form a treatment challenge, as does significant structural lung disease such as destroyed lung.How this study might affect research, practice, or policyTB PCR testing is a valuable tool in Post TB Bronchiectasis and further research and larger-scale studies are needed to determine optimal treatment for co-infections and significant structural lung disease.
Navigating Visual Challenges: How Parkinson’s Disease Alters Cognitive Priorities in Visual Search
Authors: Beylergil Sinem Balta , Skelly Peggy , Quagraine Ibrahim , Kilbane Camilla , Ghasia Fatema F. , Shaikh Aasef G. 
Published: December 2024

AbstractObjectiveParkinson’s disease (PD) hampers visual control in tasks such as reading, driving, and navigation. This study explores the impact of contextual visual priors on visual search behavior in PD, examining expectations from past experiences and guiding cognitive processes.MethodsWe compared eye movements during a visual search task with complex scenes to evaluate gaze strategies in PD, compared to healthy controls.ResultsPD participants prolonged fixation on high-probability areas for the target object, consistent across expected and unexpected locations. The emphasis on visual priors was proven beneficial in expected locations but presented challenges when the target was situated in an unlikely place.ConclusionThese findings indicate that PD alters attention allocation and visual processing by affecting the utilization of contextual visual priors. This study contributes to understanding how PD impacts visual search behavior and cognitive processing, providing insights for potential interventions targeting visual deficits in PD patients.
Sex hormones, obesity, and risk of cholecystectomy in men and women: a population-based prospective study and mediation analysis
Authors: Lyu Jie-Qiong , Jiang Wei , Jia Yi-Ping , Miao Meng-Yuan , Wang Jia-Min , Tao Hao-Wei , Zhao Miao , Hua Yong-Fei , Chen Guo-Chong 
Published: December 2024

AbstractBackgroundObesity affects hormone metabolisms and contributes to gallstone disease more strongly in women than in men. This study assessed the sex-specific associations between serum levels of sex hormone-binding globulin (SHBG) and testosterone and risk of cholecystectomy, and their mediation role in the obesity-cholecystectomy association.MethodsIncluded were 176,909 men and 160,147 women from the UK Biobank. Serum SHBG and total testosterone were measured by immunoassay. Incident cases of cholecystectomy for gallstone disease were identified using hospital inpatient records. Multivariable Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% confidence interval (CI) of cholecystectomy associated with the serum hormones. A mediation analysis was performed to estimate the proportion of the obesity-cholecystectomy association potentially mediated by the two sex hormones.ResultsA total of 2877 men and 4607 women underwent cholecystectomies during the follow-up. Regardless of sex, higher levels of SHBG were associated with a lower risk of cholecystectomy. The HRs of cholecystectomy comparing the highest with the lowest quartiles of SHBG were 0.68 (95% CI: 0.59-0.77) in men (P-trend <0.001) and 0.39 (95% CI: 0.36-0.53) in women (P-trend <0.001). Higher levels of testosterone were associated with a higher risk of cholecystectomy in women (HRQ4 vs. Q1= 1.28; 95% CI: 1.18-1.39; P-trend <0.001) but not in men (P-trend = 0.12). In women, it was estimated that 14.71% and 2.74% of the association between obesity and cholecystectomy was significantly medicated by SHBG and testosterone, respectively.ConclusionsSHBG levels are inversely associated with risk of cholecystectomy in both sexes, whereas higher testosterone levels are associated with a higher risk of cholecystectomy only in women. Both hormones mediate the obesity-cholecystectomy association in women.
Anticipating the risk and spatial spread of measles in populations with high MMR uptake: using school-household networks to understand the 2013 - 2014 outbreak in the Netherlands
Authors: Munday James D , Atkins Katherine E , Klinkenberg Don , Meurs Marc , Fleur Erik , Hahne Susan , Wallinga Jacco , van Hoek Albert Jan 
Published: December 2024

AbstractMeasles outbreaks are still routine, even in countries where vaccination coverage exceeds the guideline of 95%. Therefore, achieving ambitions for measles eradication will require understanding how unvaccinated children interact with others who are unvaccinated. Here we propose a novel framework for modelling measles transmission to better understand outbreaks in high uptake situations.The high importance of school- and home-based transmission to overall outbreak dynamics is well established. Making use of this, we created a network of all primary and secondary schools in the Netherlands based on the total number of household pairs between each school. A household pair are siblings from the same household who attend a different school. We parameterised the network with individual level administrative household data provided by the Dutch Ministry for Education and estimates of school level uptake of the Mumps, Measles and Rubella (MMR) vaccine. We analyse the network to establish the relative strength of contact between schools. We simulated measles outbreaks on the network and evaluated the model against empirical measles data per postcode-area from a large outbreak in 2013 (2766 cases), comparing the model to alternative models that do not account for specific network structure or school-level vaccine uptake.Our network analysis shows that schools associated with low vaccine uptake are highly connected, particularly Orthodox-Protestant schools (Coleman Homophily Index = 0.63). Simulations on the Network were able to reproduce the observed size and spatial distribution of the historic outbreak much more clearly than the alternative models, with a case weighted Receiver Operating Condition sensitivity of 0.94 for the data-driven network model and 0.38 and 0.23 for the alternative models. Further, we establish that variation in local network properties result in clear differences in final size of outbreaks seeded in orthodox-protestant-affiliated and other schools with low MMR coverage.Our framework indicates that clustering of unvaccinated children in primary schools connected by unvaccinated children in related secondary schools lead to large, connected clusters of unvaccinated children. Using our approach, we could explain historical outbreaks on a spatial level. Our framework could be further developed to aid future outbreak response.
Rates of Positive M-CHAT-R Screenings by Pandemic Birth and Prenatal SARS-CoV-2 Exposure
Authors: Firestein Morgan R. , Manessis Angela Gigliotti , Warmingham Jen , Hu Yunzhe , Finkel Morgan A. , Kyle Margaret , Hussain Maha , Ahmed Imaal , Lavallée Andréane , Solis Ana , Chaves Vitoria , Rodriguez Cynthia , Goldman Sylvie , Muhle Rebecca A. , Lee Seonjoo , Austin Judy , Silver Wendy G. , O’Reilly Kally C. , Bain Jennifer M. , Penn Anna A. , Veenstra-VanderWeele Jeremy , Stockwell Melissa S. , Fifer William P. , Marsh Rachel , Monk Catherine , Shuffrey Lauren C. , Dumitriu Dani 
Published: December 2024

AbstractMaternal stress and viral illness during pregnancy are associated with neurodevelopmental conditions in offspring. Children born during the COVID-19 pandemic, including those exposed prenatally to maternal SARS-CoV-2 infections, are reaching the developmental age for the assessment of risk for neurodevelopmental conditions. We examined associations between birth during the COVID-19 pandemic, prenatal exposure to maternal SARS-CoV-2 infection, and rates of positive screenings on the Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R). Data were drawn from the COVID-19 Mother Baby Outcomes (COMBO) Initiative. Participants completed the M-CHAT-R as part of routine clinical care (COMBO-EHR cohort) or for research purposes (COMBO-RSCH cohort). Maternal SARS-CoV-2 status during pregnancy was determined through electronic health records. The COMBO-EHR cohort includes n=1664 children (n=442 historical cohort, n=1222 pandemic cohort; n=997 SARS-CoV-2 unexposed prenatally, n=130 SARS-CoV-2 exposed prenatally) who were born at affiliated hospitals between 2018-2023 and who had a valid M-CHAT-R score in their health record. The COMBO-RSCH cohort consists of n=359 children (n=268 SARS-CoV-2 unexposed prenatally, n=91 SARS-CoV-2 exposed prenatally) born at the same hospitals who enrolled into a prospective cohort study that included administration of the M-CHAT-R at 18-months. Birth during the pandemic was not associated with greater likelihood of a positive M-CHAT-R screen in the COMBO-EHR cohort. Maternal SARS-CoV-2 was associated with lower likelihood of a positive M-CHAT-R screening in adjusted models in the COMBO-EHR cohort (OR=0.40, 95% CI=0.22 - 0.68,p=0.001), while analyses in the COMBO-RSCH cohort yielded similar but non-significant results (OR=0.67, 95% CI=0.31-1.37,p=0.29).These results suggest that children born during the first 18 months of the COVID-19 pandemic and those exposed prenatally to a maternal SARS-CoV-2 infection are not at greater risk for screening positive on the M-CHAT-R.
Examining the association between theFTOgene and neuroticism reveals indirect effects on subjective well-being and problematic alcohol use
Authors: Cai Wenjie , Forsell Yvonne , Lavebratt Catharina , Melas Philippe A. 
Published: December 2024

AbstractAssociations between the fat mass and obesity-associated (FTO) gene and obesity are well-established. However, recent studies have linkedFTOto addiction phenotypes and dopaminergic signaling, thus suggesting broader psychiatric implications. We explored this assumption by conducting a phenome-wide association study (PheWAS) across 4,756 genome-wide association studies (GWASs), identifying 26 psychiatric traits associated withFTOat the multiple-corrected significance level. These traits clustered into four categories: substance use, chronotype/sleep, well-being, and neuroticism. To validate these findings, we analyzed a functionally suggestiveFTOvariant (rs1421085) in a separate cohort, examining its impact on (i) alcohol use based on the Alcohol Use Disorders Identification Test (AUDIT), (ii) subjective well-being based on the WHO (Ten) Well-Being Index, and (iii) neuroticism based on Schafer’s Five Factor Model (FFM) or the Karolinska Scales of Personality (KSP). Our results confirmed a direct association between rs1421085 and neuroticism that was independent of age, sex, alcohol use, body mass index (BMI), and childhood adversities. Interestingly, while no direct association with alcohol intake was observed, both cross-sectional and lagged longitudinal mediation analyses uncovered indirect relationships between rs1421085 and problematic alcohol use (AUDIT-P), with increased neuroticism acting as the intermediary. Mediation analyses also supported an indirect effect of rs1421085 on lower well-being through the pathways of increased neuroticism and BMI. Our study is the first to validate a direct association betweenFTOand neuroticism. However, additional studies are warranted to affirm the causal pathways linkingFTOto well-being and alcohol use through neuroticism.
Long-term conditions in minoritised urban populations: Latin American community of London
Authors: Scuffell James , Bailey James , Dodhia Hiten , Durbaba Stevo , Ashworth Mark 
Published: December 2024

AbstractBackgroundMinoritised populations in the United Kingdom frequently identify in multiple ethnic groupings and therefore little is known of their health needs. There were 136,062 Latin American people recorded in the 2021 UK Census across six different ethnic groups.AimCharacterise the incidence of long-term conditions (LTCs) and multiple LTCs (mLTCs) amongst the Latin American community of London.Design and settingRetrospective cohort study using pseudonymised primary care data from 890,922 individuals in an urban, superdiverse area of London from 2005-2022.MethodLatin American individuals were identified using country of birth, language and ethnicity codes, and validated against Census findings. Multivariable competing risks regression models estimated the effect of being Latin American, compared to the White British ethnic group, on incidence of 32 LTCs and risk factors relevant to urban populations.Results28,617 Latin American people were identified in this cohort, 3.2% of total. In multivariable analysis, compared to the White British ethnic group, being Latin American was associated with twice the rate of HIV/AIDS (hazard ratio (HR) 2.00; 95% confidence interval (CI) 1.65–2.43), 60% increased rate of diabetes (HR 1.61; 95%CI 1.47–1.77) and almost twice the rate of systemic lupus erythematosus and rheumatoid arthritis (HRs 2.28; 95% CI 1.18–4.38 and 1.69; 95% CI 1.32–2.17 respectively).ConclusionUsing commonly-recorded primary care codes accurately and reliably identifies markedly higher risks of HIV/AIDS, diabetes and joint disease among London’s Latin American population. These data can be used to target inclusive and equitable health interventions.How it fits inLittle is known of the health of the United Kingdom’s (UK) Latin American population, who usually identify in multiple ethnic groups and are therefore hidden from ethnicity statistics. This study identified 28,617 Latin Americans using country of birth, ethnicity and language codes in a large primary care record dataset in London (n=890,438). Compared to the White ethnic group, the Latin American population are at higher risk of HIV/AIDS, diabetes, systemic lupus erythematosus and rheumatoid arthritis. These data reveal health inequalities in a frequently hidden and locally important population of the UK.