bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine learning and artificial intelligence: applications in healthcare epidemiology
Authors: Hamilton Alisa J. , Strauss Alexandra T. , Martinez Diego A. , Hinson Jeremiah S. , Levin Scott , Lin Gary , Klein Eili Y. 
Published: October 2021

AbstractArtificial intelligence (AI) refers to the performance of tasks by machines ordinarily associated with human intelligence. Machine learning (ML) is a subtype of AI; it refers to the ability of computers to draw conclusions (ie, learn) from data without being directly programmed. ML builds from traditional statistical methods and has drawn significant interest in healthcare epidemiology due to its potential for improving disease prediction and patient care. This review provides an overview of ML in healthcare epidemiology and practical examples of ML tools used to support healthcare decision making at 4 stages of hospital-based care: triage, diagnosis, treatment, and discharge. Examples include model-building efforts to assist emergency department triage, predicting time before septic shock onset, detecting community-acquired pneumonia, and classifying COVID-19 disposition risk level. Increasing availability and quality of electronic health record (EHR) data as well as computing power provides opportunities for ML to increase patient safety, improve the efficiency of clinical management, and reduce healthcare costs.
Sharing data among clinical trials of therapeutics in COVID-19: Barriers and facilitators to collaborating in a crisis
Authors: Palm Marisha E. , Lindsell Christopher J. , Selker Harry P. 
Published: October 2021

Abstract

Background:
The Clinical and Translational Science Award Program (CTSA) Trial Innovation Network (TIN) was launched in 2016 to increase the efficiency and effectiveness of multisite trials by supporting the development of national infrastructure. With the advent of the COVID-19 pandemic, it was therefore well-positioned to support clinical trial collaboration. The TIN was leveraged to support two initiatives: (1) to create and evaluate a mechanism for coordinating Data and Safety Monitoring Board (DSMB) activities among multiple ongoing trials of the same therapeutic agents, and (2) to share data across clinical trials so that smaller, likely underpowered studies, could be combined to produce meaningful and actionable data through pooled analyses. The success of these initiatives was understood to be dependent upon the willingness of investigators, study teams, and US National Institutes of Health research networks to collaborate and share information.

Methods:
To inform these two initiatives, we conducted semistructured interviews with members of CTSA hubs and clinical research stakeholders that probed barriers and facilitators to collaboration. Thematic analysis identified topics relevant across institutions, individuals, and DSMBs.

Results:
The DSMB coordination initiative was viewed as less controversial, while the data pooling initiative was seen as complex because of its potential impact on publication, authorship, and the rewards of discovery. Barriers related to resources, centralization, and technical work were significant, but interviewees suggested these could be handled by the provision of central funding and supportive frameworks. The more intractable findings were related to issues around credit and ownership of data.

Conclusion:
Based on our interviews, we conclude with nine recommended actions that can be implemented to support collaboration.
Invest in Innovation or Not? How Managerial Cognition and Attention Allocation Shape Corporate Responses to Performance Shortfalls
Authors: He Lerong , Huang Liying , Yang Guangqing 
Published: October 2021

ABSTRACTThis study investigates the influence of managerial cognition and attention allocation on firms’ responses to negative performance feedback. We explore how managerial cognition, as shaped by managers’ experiences, connections, positions, and industry environments, affects underperforming firms’ attention allocation and, consequently, their decisions to invest in innovation. Utilizing a longitudinal sample of Chinese high-tech firms from 2009 to 2017, we find that firms increase investment in research and development (R&D) when performance falls below aspiration levels. We also document that underperforming firms are associated with an even larger R&D investment increase when their CEOs have an R&D or engineering background, serve simultaneously as the board chair, or are not politically connected. In addition, we highlight the moderating effects of industry competition and industry norms on the relationship between firm underperformance and R&D intensity. We conclude that managerial cognition affects firms’ allocation of attention to innovation as a solution for closing performance gaps and shapes corporate responses to negative performance feedback.
Superior semicircular canal dehiscence: a narrative review
Authors: Kontorinis G , Lenarz T 
Published: October 2021

AbstractBackgroundDescribed just over 20 years ago, superior semicircular canal dehiscence remains a relatively unknown and easily missed cause of dizziness and auditory symptoms.ObjectiveThis review focused on the origin, presenting symptoms and underlying pathophysiology of superior semicircular canal dehiscence, and the available treatment options.Main findings and conclusionThe bony dehiscence acts as a ‘third window’, affecting inner-ear homeostasis, and resulting in hypersensitivity and a vestibular response to lower sound level stimuli. The third window effect explains the pressure- and sound-induced vertigo, oscillopsia, and nystagmus, as well as autophony, conductive hyperacusis and tinnitus. The origin of superior semicircular canal dehiscence is linked to the combination of a congenital or developmental factor, and a ‘second event’ like head trauma, rapid pressure changes or age-related factors. Computed tomography of the temporal bone and reduced vestibular-evoked myogenic potential thresholds can confirm the diagnosis. Despite only retrospective cohorts, surgery is considered a safe treatment option, targeting mainly vestibular but also auditory symptoms, with transmastoid approaches gaining popularity.
Effect of high-endurance exercise intervention on sleep-dependent procedural memory consolidation in individuals with schizophrenia: a randomized controlled trial
Authors: Lo Lincoln Lik Hang , Lee Edwin Ho Ming , Hui Christy Lai Ming , Chong Catherine Shiu Yin , Chang Wing Chung , Chan Sherry Kit Wa , Lin Jessie Jingxia , Lo William Tak Lam , Chen Eric Yu Hai 
Published: October 2021

AbstractBackgroundLittle is known about the effects of physical exercise on sleep-dependent consolidation of procedural memory in individuals with schizophrenia. We conducted a randomized controlled trial (RCT) to assess the effectiveness of physical exercise in improving this cognitive function in schizophrenia.MethodsA three-arm parallel open-labeled RCT took place in a university hospital. Participants were randomized and allocated into either the high-intensity-interval-training group (HIIT), aerobic-endurance exercise group (AE), or psychoeducation group for 12 weeks, with three sessions per week. Seventy-nine individuals with schizophrenia spectrum disorder were contacted and screened for their eligibility. A total of 51 were successfully recruited in the study. The primary outcome was sleep-dependent procedural memory consolidation performance as measured by the finger-tapping motor sequence task (MST). Assessments were conducted during baseline and follow-up on week 12.ResultsThe MST performance scored significantly higher in the HIIT (n = 17) compared to the psychoeducation group (n = 18) after the week 12 intervention (p < 0.001). The performance differences between the AE (n = 16) and the psychoeducation (p = 0.057), and between the AE and the HIIT (p = 0.999) were not significant. Yet, both HIIT (p < 0.0001) and AE (p < 0.05) showed significant within-group post-intervention improvement.ConclusionsOur results show that HIIT and AE were effective at reverting the defective sleep-dependent procedural memory consolidation in individuals with schizophrenia. Moreover, HIIT had a more distinctive effect compared to the control group. These findings suggest that HIIT may be a more effective treatment to improve sleep-dependent memory functions in individuals with schizophrenia than AE alone.
Associations between dental problems and underweight status among rural women in Burkina Faso: results from the first WHO Stepwise Approach to Surveillance (STEPS) survey
Authors: Diendéré Jeoffray , Zeba Augustin Nawidimbasba , Kiemtoré Sibraogo , Sombié Olivier Ouahamin , Fayemendy Philippe , Jésus Pierre , Millogo Athanase , Savadogo Aly , Tinto Halidou , Desport Jean-Claude 
Published: October 2021

AbstractObjective:To explore the relationships between dental problems and underweight status among rural women in Burkina Faso by using nationally representative data.Design:This was a cross-sectional secondary study of primary data obtained by the 2013 WHO Stepwise Approach to Surveillance survey conducted in Burkina Faso. Descriptive and analytical analyses were performed using Student’s t test, ANOVA, the χ2 test, Fisher’s exact test and logistic regression.Setting:All thirteen Burkinabè regions were categorised using quartiles of urbanisation rates.Participants:The participants were 1730 rural women aged 25–64 years.Results:The prevalence of underweight was 16·0 %, and 24·1 % of participants experienced dental problems during the 12-month period. The women with dental problems were more frequently underweight (19·9 % and 14·7 %; P < 0·05) and had a lower mean BMI (21·1 ± 3·2 and 21·6 ± 3·7 kg/m2, P < 0·01) than those without dental problems. More risk factors for underweight were observed in less urbanised regions among elderly individuals (> 49 years old) and smokeless tobacco users. Age > 49 years, professions with inconsistent income, a lack of education, smokeless tobacco use and low BMI were factors that were significantly associated with dental problems, while residency in a low-urbanisation area was a protective factor.Conclusion:The prevalence of underweight in rural Burkinabè women is among the highest in sub-Saharan Africa, and women with dental problems are more frequently affected than those without dental problems. Public health measures for the prevention of these disorders should specifically target women aged over 49 years and smokeless tobacco users.
Barriers and facilitators to implementing a cancer risk assessment tool (QCancer) in primary care: a qualitative study
Authors: Akanuwe Joseph N. A. , Black Sharon , Owen Sara , Siriwardena Aloysius Niroshan 
Published: October 2021

AbstractAim:We aimed to explore service users’ and primary care practitioners’ perspectives on the barriers and facilitators to implementing a cancer risk assessment tool (RAT), QCancer, in general practice consultations.Background:Cancer RATs, including QCancer, are designed to estimate the chances of previously undiagnosed cancer in symptomatic individuals. Little is known about the barriers and facilitators to implementing cancer RATs in primary care consultations.Methods:We used a qualitative design, conducting semi-structured individual interviews and focus groups with a convenience sample of service users and primary care practitioners.Findings:In all, 36 participants (19 service users, 17 practitioners) living in Lincolnshire, were included in the interviews and focus groups. Before asking for their views, participants were introduced to QCancer and shown an example of how it estimated cancer risk. Participants identified barriers to implementing the tool namely: additional consultation time; unnecessary worry; potential for over-referral; practitioner scepticism; need for training on use of the tool; need for evidence of effectiveness; and need to integrate the tool in general practice systems. Participants also identified facilitators to implementing the tool as: supporting decision-making; modifying health behaviours; improving speed of referral; and personalising care.Conclusions:The barriers and facilitators identified should be considered when seeking to implement QCancer in primary care. In addition, further evidence is needed that the use of this tool improves diagnosis rates without an unacceptable increase in harm from unnecessary investigation.
Building Indigenous health workforce capacity and capability through leadership – the Miwatj health leadership model
Authors: Harfield Stephen , Davy Carol , Dawson Anna , Mulholland Eddie , Braunack-Mayer Annette , Brown Alex 
Published: October 2021

Abstract

Aim:
In the crowded field of leadership research, Indigenous leadership remains under-researched. This article explores the Leadership Model of an Aboriginal Community Controlled Primary Health Care Organisation providing services to the Yolngu people of remote northern Australia: the Miwatj Health Aboriginal Corporation (Miwatj).

Background:
The limited research which does exist on Indigenous leadership points to unique challenges for Indigenous leaders. These challenges relate to fostering self-determination in their communities, managing significant community expectations, and navigating a path between culturally divergent approaches to management and leadership.

Methods:
Guided by Indigenous methodology and using a mixed methods approach, semi-structured interviews, self-reported health service data, organisational and publicly available documents, and literature were analysed using a framework method of thematic analysis to identify key themes of the Miwatj Leadership Model.

Findings:
The Miwatj Leadership Model is underpinned by three distinctive elements: it offers Yolngu people employment opportunities; it supports staff who want to move into leadership positions and provides capacity building through certificates and diplomas; and it provides for the physical, emotional, and cultural wellbeing of all Yolngu staff. Furthermore, the model respects traditional Yolngu forms of authority and empowers the community to develop, manage and sustain their own health. The Miwatj Leadership Model has been successful in providing formal pathways to support Indigenous staff to take on leadership roles, and has improved the accessibility and acceptability of health care services as a result of Yolngu employment and improved cultural safety.

Conclusions:
Translating the Miwatj Leadership Model into other health services will require considerable thought and commitment. The Miwatj Leadership Model can be adapted to meet the needs of other health care services in consideration of the unique context within which they operate. This study has demonstrated the importance of having a formal leadership model that promotes recruitment, retention, and career progression for Indigenous staff.
Protecting working welfare recipients through human rights experimentalism
Authors: Dermine Elise , Eleveld Anja 
Published: October 2021

AbstractIn this paper, we adopt an experimentalist approach to determining the content of international human rights for assessing national mandatory work programmes for recipients of social assistance (MWPs). This approach implies going back and forth between law and experience in order to determine the better way to secure human rights in an ever-changing environment. After having identified six criteria for evaluating MWPs in the soft case-law of international bodies, we confront this emerging international human rights framework with an empirical study on MWP practices in the Netherlands. This confrontation reveals that specific aspects of the capability for voice of working welfare recipients are absent in the human rights framework and that the framework is not gender-neutral. Including these aspects, we construct an experimentalist human-rights-based instrument that is suitable for evaluating national MWPs.
Screening of final beneficiaries – a red line in humanitarian operations. An emerging concern in development work
Authors: Gillard Emanuela-Chiara , Goswami Sangeeta , van Deventer Fulco 
Published: October 2021

AbstractFunding agreements for humanitarian action frequently include restrictions and requirements in their grants that aim to ensure that recipients of the funding comply with counterterrorism measures and sanctions adopted by the donor. These measures can be problematic if they prevent humanitarian actors from operating in accordance with humanitarian principles or are incompatible with international humanitarian law. While attention has focused primarily on requirements in grants for humanitarian action, increasingly donors to development work have also started including sanctions- and counterterrorism-related restrictions in their grants. The present article focuses on one such measure that is currently a live concern: requirements to screen and, thus, potentially exclude final beneficiaries. It explains why these requirements go over and above what sanctions and counterterrorism measures require, and why they are inconsistent with humanitarian principles and international humanitarian law. The article also explores the position in relation to development interventions.
Erstellung und Validierung einer Kurzversion des Fragebogens zur Erfassung aversiver und protektiver Kindheitserfahrung (APK-18)
Authors: Volz Matthias , Zimmermann Johannes , Schauenburg Henning , Dinger Ulrike , Nikendei Christoph , Friederich Hans-Christoph , Ehrenthal Johannes C. 
Published: October 2021

Zusammenfassung. Die Erfassung von Kindheitserfahrungen stellt einen wichtigen Baustein für Verständnis und Behandlung psychischer Belastungen im Erwachsenenalter dar. Dabei kommt der Erfassung protektiver Kindheitserfahrungen neben etablierten aversiven Erlebnissen eine wachsende Bedeutung zu. Ziel der vorliegenden Studie ist die Erstellung einer validen, reliablen und zeitökonomischen Kurzform des Fragebogens zur Erfassung aversiver und protektiver Kindheitserfahrungen (APK). Mithilfe des Ant-Colony Optimization (ACO) Algorithmus wurden an einer klinisch-psychotherapeutischen Stichprobe ( n = 701) aus den 59 Items der Langversion ein Set von 18 Items identifiziert und an einer nicht-klinischen Stichprobe ( n = 643) validiert. Die Kurzversion (APK-18) zeigte gute Reliabilität und Validität und unterschied anhand latenter Mittelwertunterschiede zuverlässig zwischen klinischen und nicht-klinischen Teilnehmenden. Einschränkungen bezüglich der Reliabilität ergaben sich bei 2 der insgesamt 8 Sub-Skalen, „Sonstige traumatische Ereignisse“ und „Trennungserfahrungen“. Mit der Kurzversion APK–18 liegt ein ökonomisches und valides Messinstrument vor, welches in klinische Routineerhebungen integriert werden kann.
The bacterial gut microbiome of probiotic-treated very-preterm infants: changes from admission to discharge
Authors: Westaway Jacob A. F. , Huerlimann Roger , Kandasamy Yoga , Miller Catherine M. , Norton Robert , Staunton Kyran M. , Watson David , Rudd Donna 
Published: October 2021

AbstractBackgroundPreterm birth is associated with the development of acute and chronic disease, potentially, through the disruption of normal gut microbiome development. Probiotics may correct for microbial imbalances and mitigate disease risk. Here, we used amplicon sequencing to characterise the gut microbiome of probiotic-treated premature infants. We aimed to identify and understand variation in bacterial gut flora from admission to discharge and in association with clinical variables.MethodsInfants born <32 weeks gestation and <1500 g, and who received probiotic treatment, were recruited in North Queensland Australia. Meconium and faecal samples were collected at admission and discharge. All samples underwent 16S rRNA short amplicon sequencing, and subsequently, a combination of univariate and multivariate analyses.Results71 admission and 63 discharge samples were collected. Univariate analyses showed significant changes in the gut flora from admission to discharge. Mixed-effects modelling showed significantly lower alpha diversity in infants diagnosed with either sepsis or retinopathy of prematurity (ROP) and those fed formula. In addition, chorioamnionitis, preeclampsia, sepsis, necrotising enterocolitis and ROP were also all associated with the differential abundance of several taxa.ConclusionsThe lower microbial diversity seen in infants with diagnosed disorders or formula-fed, as well as differing abundances of several taxa across multiple variables, highlights the role of the microbiome in the development of health and disease. This study supports the need for promoting healthy microbiome development in preterm neonates.ImpactLow diversity and differing taxonomic abundances in preterm gut microbiota demonstrated in formula-fed infants and those identified with postnatal conditions, as well as differences in taxonomy associated with preeclampsia and chorioamnionitis, reinforcing the association of the microbiome composition changes due to maternal and infant disease.The largest study exploring an association between the preterm infant microbiome and ROP.A novel association between the preterm infant gut microbiome and preeclampsia in a unique cohort of very-premature probiotic-supplemented infants.
Fecal diversion does not support healing of anus-near pressure ulcers in patients with spinal cord injury—results of a retrospective cohort study
Authors: Pussin Andreas M. , Lichtenthäler Luisa C. , Aach Mirko , Schildhauer Thomas A. , Brechmann Thorsten 
Published: October 2021

AbstractStudy DesignRetrospective cohort study including spinal cord injured patients with anus-near pressure ulcers.ObjectiveThe primary objective was to evaluate the impact of stool diversion via stoma on the decubital wound healing. Secondary objectives included the risk of complications and ulcer recurrence. Associations between the wound healing and potentially interfering parameters were determined.SettingUniversity hospital with a spinal cord injury unit.MethodsA total of 463 consecutive patients who presented with a decubitus were retrospectively included. Patients with and without a stoma were compared using descriptive and explorative statistics including multiple regression analysis.ResultsThe severity of the pressure ulcers was determined as stage 3 in two-thirds and stage 4 in one-third of all cases. The wound healing lasted longer in the 71 stoma-presenting patients than in the 392 patients with undeviated defecation (77 vs. 59 days,p = 0.02). The age (regression coefficientb = 0.41,p = 0.02), the ASA classification (b = 16.04,p = 0.001) and the stage of the ulcers (b = 19.65,p = 0.001) were associated with prolonged ulcer treatment in the univariate analysis. The multiple regression analysis revealed that the fecal diversion (b = −18.19,p = 0.03) and the stage of the ulcers (b = 21.62,p = 0.001) were the only predictors of delayed wound healing.ConclusionThe presence of a stoma is not related to improved wound healing of ulcers near the anus. On the contrary, stoma patients needed more time until complete wound healing, conceivably related to selection bias. Nonetheless, we currently do not recommend fecal diversion to be the standard concept for decubitus treatment.