bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of number of medications and use of potentially inappropriate medications on frailty among early-stage older outpatients
Authors: Uragami Yuya , Takikawa Kazuhiro , Kareki Hajime , Kimura Koji , Yamamoto Kazuyuki , Iihara Naomi 
Published: May 2021

Abstract
Background
Frailty is an urgent concern among an aging population worldwide. However, the relationship between frailty and number and types of medications has not been studied in detail among early-stage older patients, and it is unclear what prescriptions may have a role in preventing frailty. This study aimed to clarify the effects of number of medications and use of potentially inappropriate medications (PIMs) on frailty among early-stage older outpatients in Japan.

Methods
A cross-sectional study was undertaken. Frailty scores and medications of outpatients aged 65–74 years who regularly visited community pharmacies were investigated. Frailty scores were classified as 0 (non-frailty), 1–2 (pre-frailty), and ≥ 3 (frailty). The association between frailty and number of medications was analyzed by age and compared between PIM use and non-use groups. The proportion of patients who used PIMs was also analyzed by frailty score.

Results
Of 923 older outpatients, 49 (5.3%) and 318 (34.5%) patients had frailty and pre-frailty scores, respectively. The numbers of medications among patients with pre-frailty and frailty were significantly higher than among those with non-frailty (p <  0.001 for both). A similar increase was shown for PIM use groups aged 69–71 and 72–74 years, but not for the PIM use group aged 65–68 years and all groups without PIM use. An increasing linear trend was observed for the relationship between the proportion of patients who used any PIM, as well as some subcategories of PIMs (such as NSAIDs, benzodiazepines, loop diuretics and antithrombotic drugs) and frailty score.

Conclusions
Unnecessary medication use among early-stage older outpatients, especially patients aged ≥69 years who use PIMs and many medications, seems to be associated with frailty, but further research is needed to confirm these findings.
Surgical resection of extremely rare primary giant splenic angiomyolipoma: a case report
Authors: Sato Kaoru , Saijo Fumito , Katayose Yu , Mutoh Mitsuhisa , Iwama Noriyuki , Nakayama Fumie , Tokumura Hiromi 
Published: May 2021

AbstractBackgroundAngiomyolipoma is a benign mesenchymal tumor that develops commonly in the kidney and rarely in other organs. The involvement of the spleen in angiomyolipoma is extremely rare, and only one such case has been reported in the English literature.Case presentationA 27-year-old man presented with adenoid hyperplasia and bilateral palatal tonsillar hyperplasia. During the treatment for adenoid hyperplasia, a 15-cm tumor was detected in the spleen using abdominal ultrasonography and enhanced computed tomography. Partial resection of the spleen was successfully performed. A giant tumor of approximately 13 cm with a smooth surface was observed in the upper left quadrant of the abdomen. The tumor was confirmed to be continuous with the upper spleen, and there was no invasion of the other organs. The postoperative course was good, and the patient was discharged on the 7th postoperative day. The excised specimen was a smooth, extremely soft tumor measuring 123 × 120 × 82 mm. The cleaved surface of the tumor was reddish brown, and a distressing yellow color was observed. Pathological examination revealed a proliferation of mature adipocytes and an increase in the number of blood vessels of various sizes. Furthermore, spindle-shaped cell proliferation foci were visible between the adipocytes and the surrounding blood vessels. Profuse leakage of erythrocytes from the blood vessels, hemosiderin deposition, and small round cell infiltration were also noted. Immunostaining disclosed that the spindle-shaped cells were weakly positive for smooth muscle antibody and were identified as smooth muscle cells. The adipocytes and spindle cells were negative for HMB 45, Melan A, MDM, and CDK4. However, some parts of the cells were positive for estrogen and progesterone receptors. Besides, vascular endothelial cells were positive for CD31 and CD34 and negative for CD8. Based on these findings, the patient was diagnosed to have primary angiomyolipoma of the spleen.ConclusionsWe have reported the surgical treatment for an extremely rare case of giant splenic angiomyolipoma in a young man. Globally, this is the second report on this condition. We believe that partial splenic resection is a feasible option for the management of giant tumors.
A high-dimensionality-trait-driven learning paradigm for high dimensional credit classification
Authors: Yu Lean , Yu Lihang , Yu Kaitao 
Published: April 2021

AbstractTo solve the high-dimensionality issue and improve its accuracy in credit risk assessment, a high-dimensionality-trait-driven learning paradigm is proposed for feature extraction and classifier selection. The proposed paradigm consists of three main stages: categorization of high dimensional data, high-dimensionality-trait-driven feature extraction, and high-dimensionality-trait-driven classifier selection. In the first stage, according to the definition of high-dimensionality and the relationship between sample size and feature dimensions, the high-dimensionality traits of credit dataset are further categorized into two types: 100 < feature dimensions < sample size, and feature dimensions ≥ sample size. In the second stage, some typical feature extraction methods are tested regarding the two categories of high dimensionality. In the final stage, four types of classifiers are performed to evaluate credit risk considering different high-dimensionality traits. For the purpose of illustration and verification, credit classification experiments are performed on two publicly available credit risk datasets, and the results show that the proposed high-dimensionality-trait-driven learning paradigm for feature extraction and classifier selection is effective in handling high-dimensional credit classification issues and improving credit classification accuracy relative to the benchmark models listed in this study.
Involving elderly research participants in the co-design of a future multi-generational cohort study
Authors: Nunn Jack S. , Sulovski Merrin , Tiller Jane , Holloway Bruce , Ayton Darshini , Lacaze Paul 
Published: May 2021

Abstract
Background
It has been proposed that the existing ASPirin in Reducing Events in the Elderly Extension observational cohort study (ASPREE-XT) would provide a platform for a future multigenerational research study (MGRS). An advert was sent to 14,268 participants (aged 74 years and older, from Australia, and located in both metropolitan and rural locations) to invite them to share views and preferences about being involved in the co-design of a future MGRS, as their preferences were not known. The objective of this article is to report as a case study the process of involving study participants and how this impacted the co-design of a proposed multi-generational research study, using a novel standardised reporting tool.

Methods
We used participatory action research to involve elderly research participants in the co-design of a proposed multi-generational cohort study between 2017 and 2019 using newsletters, telephone interviews and an in-person workshop. We used the novel ‘Standardised Data on Initiatives Alpha Version 0.1’ (STARDIT 0.1) to plan and report how participant involvement activities positively impacted the study design.

Results
Fifty-nine ASPREE-XT participants were interviewed by telephone and 18 participants attended a face-to-face event. Involving participants positively impacted the proposed study design by improving the research objectives, developing protocols, influencing funding decisions and improving ethics applications. Learning points included the importance of maintaining the ideals of ASPREE-XT (respect, quality and transparency); research participants’ preference for the option of receiving results (including genetic results); participants’ need for involvement in decisions about recruitment, data access, governance and other ethical issues; and the preference for different communication methods, including both face-to-face and online methods. Data from the process indicated it was highly valued by all stakeholders, including research participants, study staff and lead investigators. Involvement of participants was described by a lead study investigator of ASPREE-XT as “enormously helpful”.

Conclusions
This case study demonstrates that including participants in the design of a research study positively impacted the study design, participants and researchers. Using a standardised reporting tool to describe the methods and impacts provides a way for learning from this case study to inform future research studies planning to involve people.
Effect of beneficiary participation in program design and implementation on satisfaction and acceptability among internally displaced persons in Borno, Nigeria
Authors: Ieren Igbaver Isaac , Kabuk-Agbadu Salome , Umeokonkwo Chukwuma 
Published: May 2021

AbstractInsurgency and other security challenges have intensified across Nigeria with a resultant displacement of over a million people from over 100,000 households who depend on interventions from government and non-governmental organizations for survival since 2009. We conducted the study to determine the level of involvement of the displaced persons in planning, implementation and review of these interventions, and the effect of the participation on satisfaction with the interventions among camp dwellers in selected camps in Borno, Nigeria. A total of 278 internally displaced persons (IDPs) across 9 IDP camps were surveyed using an interviewer-administered questionnaire. Data was collected using Android-based Open Data Kit (ODK), exported into Microsoft Excel, and analyzed with SPSS version 21. Out of the 278 respondents, 143 (51.4%) were male, 82 (29.5%) respondents were within the age bracket of 26-35 years and above (mean age 38.9±12.3), over 78% were married, and 29.9% were involved in trading before their displacement. Among the respondents, 256 (92.1%) had benefitted from at least one intervention during their stay in the IDP camps. Over 96% of the beneficiaries were female, compared to 87.4% of males, which was statistically significant (p<0.05). All the respondents within the age group 26-35 years and above 45 years old who had received information about the interventions were satisfied, and this finding was statistically significant (p<0.05). Overall, 91.5% of respondents who had benefitted from previous interventions would like to be involved in all the intervention stages (planning, implementation, and review). In comparison, 100% of IDPs who benefitted from previous interventions would like to be involved in the implementation, and 96.8% of them would like to be involved in planning the proposed interventions. To ensure maximum coverage, and that optimum benefit is derived from development projects, beneficiaries should be involved in all stages of the project cycle.
Association of apolipoprotein B XbaI (rs693) polymorphism and gallstone disease risk based on a comprehensive analysis
Authors: Zhu Haifeng , Yu Linhai , Feng Linsong 
Published: May 2021

Abstract
Background
Our aim was to investigate the association between XbaI gene polymorphisms in the apolipoprotein B (APOB) gene and gallstone disease (GD) risk through a comparison of the allele and genotype distribution frequencies at this site using meta-analysis.

Methods
A literature search was performed using PubMed and Wanfang through Jun 1, 2020. Odds ratios (ORs) and 95 % confidence intervals (CIs) were used to assess the strength of associations.

Results
After a comprehensive search, 14 different articles that met the inclusion criteria were selected, with 1583 cases and 1794 controls. Individuals carrying the A-allele or AA genotype of the rs693 polymorphism were determined to possibly have an increased risk of GD. For example, there was a significant relationship between the rs693 polymorphism and increased GD risk in the whole group (OR: 1.40, 95 % CI: 1.05–1.87 in the allelic contrast model), the Asian population (OR: 1.58, 95 % CI: 1.48–2.84 in the heterozygote model), and the hospital-based source of the control (OR: 1.79, 95 % CI: 1.13–2.84 in the dominant model).

Conclusions
This study suggests that the APOB rs693 polymorphism is potentially associated with GD susceptibility, which might offer a detection marker for use in future large scale clinic research.
Learning analytics in higher education: a preponderance of analytics but very little learning?
Authors: Guzmán-Valenzuela Carolina , Gómez-González Carolina , Rojas-Murphy Tagle Andrés , Lorca-Vyhmeister Alejandro 
Published: May 2021

AbstractIn a context where learning mediated by technology has gained prominence in higher education, learning analytics has become a powerful tool to collect and analyse data with the aim of improving students’ learning. However, learning analytics is part of a young community and its developments deserve further exploration. Some critical stances claim that learning analytics tends to underplay the complexity of teaching-learning processes. By means of both a bibliometric and a content analysis, this paper examines the publication patterns on learning analytics in higher education and their main challenges. 385 papers that were published in WoScc and SciELO indexes between 2013 and 2019 were identified and analysed. Learning analytics is a vibrant and fast-developing community. However, it continues to face multiple and complex challenges, especially regarding students’ learning and their implications. The paper concludes by distinguishing between a practice-based and management-oriented community of learning analytics and an academic-oriented community. Within both communities, though, it seems that the focus is more on analytics than on learning.
Implementation support for contingency management: preferences of opioid treatment program leaders and staff
Authors: Scott Kelli , Jarman Shelly , Moul Samantha , Murphy Cara M. , Yap Kimberly , Garner Bryan R. , Becker Sara J. 
Published: April 2021

Abstract
Background
Contingency management (CM), a behavioral intervention that provides incentives for achieving treatment goals, is an evidence-based adjunct to medication to treat opioid use disorder. Unfortunately, many front-line treatment providers do not utilize CM, likely due to contextual barriers that limit effective training and ongoing support for evidence-based practices. This study applied user-informed approaches to adapt a multi-level implementation strategy called the Science to Service Laboratory (SSL) to support CM implementation.

Methods
Leaders and treatment providers working in community-based opioid treatment programs (OTPs; N = 43) completed qualitative interviews inquiring about their preferences for training and support implementation strategies (didactic training, performance feedback, and external facilitation). Our team coded interviews using a reflexive team approach to identify common a priori and emergent themes.

Results
Leaders and providers expressed a preference for brief training that included case examples and research data, along with experiential learning strategies. They reported a desire for performance feedback from internal supervisors, patients, and clinical experts. Providers and leaders had mixed feelings about audio-recording sessions but were open to the use of rating sheets to evaluate CM performance. Finally, participants desired both on-call and regularly scheduled external facilitation to support their continued use of CM.

Conclusions
This study provides an exemplar of a user-informed approach to adapt the SSL implementation support strategies for CM scale-up in community OTPs. Study findings highlight the need for user-informed approaches to training, performance feedback, and facilitation to support sustained CM use in this setting.
Diagnostic performance of lung volumes in assessment of reversibility in chronic obstructive pulmonary disease
Authors: Agmy Gamal , A. Mahmoud Manal , Ali Azza Bahaa El-Din , Adam Mohamed 
Published: May 2021

AbstractBackgroundReversibility measured by spirometry in chronic obstructive pulmonary disease (COPD) is defined as an increase in forced expiratory volume in first second (FEV1) that is both more than 12% and 200 mL above the pre-bronchodilator value in response to inhaled bronchodilators. FEV1 only may not fully reverberate the changes caused by reduction in air trapping or hyperinflation. To date, the studies that examined the effect of inhaled bronchodilators (BD) on residual volume (RV) and total lung capacity (TLC) are limited. This study was carried out to assess the differences between flow and volume responses after bronchodilator reversibility testing in patients with different COPD GOLD stages (GOLD stage I to stage IV). Spirometry and whole body plethysmography were done before and 15 min after inhalation of 400 μg salbutamol.ResultsMajority (53.3%) of cases were volume responders, 18.7% were flow responders, 20% were flow and volume responders, and 8% were non responders. Significant increase in Δ FEV1% was found in 15% of cases while 55% showed a significant increase in Δ FVC (P= < 0.001). Mean difference of Δ FVC (L) post BD was significantly increased with advancing GOLD stage (P= 0.03). A cutoff point > 20% forΔRV% had 70% sensitivity and 60% specificity and > 12% forΔTLC% showed 90% sensitivity and 45% specificity for prediction of clinically significant response to BD based on FEV1. A cutoff point > 18% forΔRV% had 78% sensitivity and 29% specificity and > 14% for Δ TLC% had 50% sensitivity and 70% specificity for prediction of clinically significant response to BD based on FVC.ConclusionΔFEV1 underestimates the true effect of bronchodilators with advancing GOLD stage. Measurement of lung volumes in addition to the standard spirometric indices is recommended when determining bronchodilator response in COPD patients.
Referral patterns for specialist child and adolescent mental health services in the Republic of Ireland during the COVID-19 pandemic compared with 2019 and 2018
Authors: McNicholas Fiona , Kelleher Ian , Hedderman Elma , Lynch Fionnuala , Healy Elaine , Thornton Therese , Barry Edwina , Kelly Lisa , McDonald James , Holmes Keith , Kavanagh Glenda , Migone Maria 
Published: May 2021

Background
Countries worldwide are experiencing a third wave of the coronavirus disease 2019 (COVID-19) pandemic. Government-imposed restrictive measures continue with undetermined effects on physical and mental health.

Aims
To compare child and adolescent mental health services (CAMHS) referrals over 11 months (January–November) in 2020, 2019 and 2018 and examine any impact the different phases of the COVID-19 restrictions might have on referral rates.

Method
Monthly CAMHS Health Service Executive data were examined, covering a catchment population of 260 560 or 12.7% of all youth (age group 0–18 years) in Ireland. The total number of urgent and routine referrals, appointments offered, rates of non-attendances and discharge outcome are presented.

Results
There was a significant drop in referrals in 2020, compared with prior years (χ2 = 10.3, d.f. = 2, P = 0.006). Referrals in 2020 dropped from March to May by 11% and from June to August by 10.3%. From September, both routine and urgent referrals increased by 50% compared with previous years (2018/2019), with the highest increase in November 2020 (180%). Clinic activity also increased from September, with double the number of out-patient appointments offered, compared with previous years (χ2 = 5171.72, d.f. = 3, P < 0.001) and lower (6.6%) rates of non-attendance (χ2 = 868.35, d.f. = 3, P < 0.001).

Conclusions
In 2020, following an initial decline, referrals to CAMHS increased consistently from September. Such unprecedented increase in referrals places further strain on services that are already underresourced and underfunded, with the likelihood of increased waiting lists post COVID-19. It is envisaged that once the pandemic is over, resources will be even more constrained, and CAMHS will be urgently in need of additional ring-fenced funding.
Association between epilepsy and psychiatric disorders in adults with intellectual disabilities: systematic review and meta-analysis
Authors: Akrout Brizard Basma , Limbu Bharati , Baeza-Velasco Carolina , Deb Shoumitro 
Published: May 2021

BackgroundPsychiatric disorders, such as depression and anxiety, are commonly associated with epilepsy in the general population, but the relationship between psychiatric disorders and epilepsy among adults with intellectual disabilities is unclear.AimsTo conduct a systematic review and meta-analysis to assess whether epilepsy is associated with an increased rate of psychiatric disorders in adults with intellectual disabilities.MethodWe included literature published between 1985 and 2020 from four databases, and hand-searched six relevant journals. We assessed risk of bias by using SIGN 50 and the Cochrane risk of bias tool. Several meta-analyses were carried out.ResultsWe included 29 papers involving data on 9594 adults with intellectual disabilities, 3180 of whom had epilepsy and 6414 did not. Of the 11 controlled studies that compared the overall rate of psychiatric disorders between the epilepsy and non-epilepsy groups, seven did not show any significant inter-group difference. Meta-analysis was possible on pooled data from seven controlled studies, which did not show any significant inter-group difference in the overall rate of psychiatric disorders. The rates of psychotic disorders, depressive disorders and anxiety disorders were significantly higher in the non-epilepsy control groups compared with the epilepsy group, with effect sizes of 0.29, 0.47 and 0.58, respectively. Epilepsy-related factors did not show any definite association with psychiatric disorders.ConclusionsIt is difficult to pool data from such heterogeneous studies and draw any definitive conclusion because most studies lacked an appropriately matched control group, which will be required for future studies.