bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal Metabolic Profiling of Maternal Obesity, Gestational Diabetes, and Hypertensive Pregnancy Disorders
Authors: Kivelä Jemina , Sormunen-Harju Heidi , Girchenko Polina V , Huvinen Emilia , Stach-Lempinen Beata , Kajantie Eero , Villa Pia M , Reynolds Rebecca M , Hämäläinen Esa K , Lahti-Pulkkinen Marius , Murtoniemi Katja K , Laivuori Hannele , Eriksson Johan G , Räikkönen Katri , Koivusalo Saila B 
Published: June 2021

AbstractContextComprehensive assessment of metabolism in maternal obesity and pregnancy disorders can provide information about the shared maternal-fetal milieu and give insight into both maternal long-term health and intergenerational transmission of disease burden.ObjectiveTo assess levels, profiles, and change in the levels of metabolic measures during pregnancies complicated by obesity, gestational diabetes (GDM), or hypertensive disorders.Design, Setting and ParticipantsA secondary analysis of 2 study cohorts, PREDO and RADIEL, including 741 pregnant women.Main Outcome MeasuresWe assessed 225 metabolic measures by nuclear magnetic resonance in blood samples collected at median 13 [interquartile range (IQR) 12.4-13.7], 20 (IQR 19.3-23.0), and 28 (27.0-35.0) weeks of gestation.ResultsAcross all 3 time points women with obesity [body mass index (BMI) ≥ 30kg/m2] in comparison to normal weight (BMI 18.5-24.99 kg/m2) had significantly higher levels of most very-low-density lipoprotein-related measures, many fatty and most amino acids, and more adverse metabolic profiles. The change in the levels of most metabolic measures during pregnancy was smaller in obese than in normal weight women. GDM, preeclampsia, and chronic hypertension were associated with metabolic alterations similar to obesity. The associations of obesity held after adjustment for GDM and hypertensive disorders, but many of the associations with GDM and hypertensive disorders were rendered nonsignificant after adjustment for BMI and the other pregnancy disorders.ConclusionsThis study shows that the pregnancy-related metabolic change is smaller in women with obesity, who display metabolic perturbations already in early pregnancy. Metabolic alterations of obesity and pregnancy disorders resembled each other suggesting a shared metabolic origin.
maxRatio improves the detection of samples with abnormal amplification profiles on QIAgen’s artus HIV-1 qPCR assay
Authors: Marongiu Luigi , Shain Eric B. , Martinelli Marianna , Pagliari Matteo , Allgayer Heike 
Published: June 2021

Background: Accurate viral load (VL) determination is paramount to determine the efficacy of anti-HIV-1 therapy. The conventional method used, fit-point (FP), assumes an equal efficiency in the polymerase chain reaction (PCR) among samples that might not hold for low-input templates. An alternative approach, maxRatio, was introduced to compensate for inhibition in PCR. Methods: Herein, we assessed whether maxRatio could improve VL quantification using 2,544 QIAgen artus HI virus-1 RT-PCR reactions. The assay’s standard dilutions were used to build external standard curves with either FP or maxRatio that re-calculated the VLs. Results: FP and maxRatio were highly comparable (Pearson’s ρ=0.994, Cohen’s κ=0.885), and the combination of the two methods identified samples (n=41) with aberrant amplification profiles. Conclusions: The combination of maxRatio and FP could improve the predictive value of the assay.
iCAT: diagnostic assessment tool of immunological history using high-throughput T-cell receptor sequencing
Authors: Rajeh Ahmad , Wolf Kyle , Schiebout Courtney , Sait Nabeel , Kosfeld Tim , DiPaolo Richard J. , Ahn Tae-Hyuk 
Published: June 2021

The pathogen exposure history of an individual is recorded in their T-cell repertoire and can be accessed through the study of T-cell receptors (TCRs) if the tools to identify them were available. For each T-cell, the TCR loci undergoes genetic rearrangement that creates a unique DNA sequence. In theory these unique sequences can be used as biomarkers for tracking T-cell responses and cataloging immunological history. We developed the immune Cell Analysis Tool (iCAT), an R software package that analyzes TCR sequencing data from exposed (positive) and unexposed (negative) samples to identify TCR sequences statistically associated with positive samples. The presence and absence of associated sequences in samples trains a classifier to diagnose pathogen-specific exposure. We demonstrate the high accuracy of iCAT by testing on three TCR sequencing datasets. First, iCAT successfully diagnosed smallpox vaccinated versus naïve samples in an independent cohort of mice with 95% accuracy. Second, iCAT displayed 100% accuracy classifying naïve and monkeypox vaccinated mice. Finally, we demonstrate the use of iCAT on human samples before and after exposure to SARS-CoV-2, the virus behind the COVID-19 global pandemic. We were able to correctly classify the exposed samples with perfect accuracy. These experimental results show that iCAT capitalizes on the power of TCR sequencing to simplify infection diagnostics. iCAT provides the option of a graphical, user-friendly interface on top of usual R interface allowing it to reach a wider audience.
The effectiveness of EMR implementation regarding reducing documentation errors and waiting time for patients in outpatient clinics: a systematic review
Authors: Albagmi Salem 
Published: June 2021

Background: Electronic medical records (EMRs) refer to the digital copies of paper notes prepared in the physician’s office, outpatient clinics and other departments in health care institutes. EMRs are considered to be significant and preferable to paper records because they allow providers to keep accurate track of patient data and monitoring over time, thus reducing errors, and enhance overall health care quality. The aim of this systematic review was to highlight the significance of EMRs and the effectiveness of implementation regarding reducing documentation errors and waiting time for patients in outpatient clinics. Methods: PubMed, Central, Ovid, Scopus, Science Direct, Elsevier, Cochrane , WHO website and the McMaster University Health Evidence website from 2005-2020 were searched to identify studies that investigated the association between the EMR implementation and documentation error and waiting time for patients. A reviewer screened identified citations and extracted data according to the PRISMA guidelines and data was synthesized in a narrative manner. Results: After full text examination of the articles selected for this literature review, the major themes of relevance that were identified in the context of reducing documentation errors and waiting time for patients in outpatient clinic include: reduction of medical errors because of fewer documentation errors resulting from EMR implementation and reduction of waiting time for patients due to overall improvement of system workflow after use of EMRs. Conclusion: In summary of the reviewed evidence from published material, the implementation of an EMR system in any outpatient setting appears to reduce documentation errors (medication dose errors, issues of prescription errors). It was also seen that in many settings, waiting time for patients in outpatient clinics was reduced with EMR use, while in other settings it was not possible to determine if any significant improvement was seen in this aspect after EMR implementation.
Refining the content and design of an alcohol reduction app, Drink Less, to improve its usability and effectiveness: a mixed methods approach
Authors: Garnett Claire , Perski Olga , Michie Susan , West Robert , Field Matt , Kaner Eileen , Munafò Marcus R. , Greaves Felix , Hickman Matthew , Burton Robyn , Brown Jamie 
Published: June 2021

Background: Digital interventions have the potential to reduce alcohol consumption, although evidence on the effectiveness of apps is lacking. Drink Less is a popular, evidence-informed app with good usability, putting it in a strong position to be improved upon prior to conducting a confirmatory evaluation. This paper describes the process of refining Drink Less to improve its usability and likely effectiveness. Methods: The refinement consisted of three phases and involved qualitative and quantitative (mixed) methods: i) identifying changes to app content, based on findings from an initial evaluation of Drink Less, an updated review of digital alcohol interventions and a content analysis of user feedback; ii) designing new app modules with public input and a consultation with app developers and researchers; and iii) improving the app’s usability through user testing. Results: As a result of the updated review of digital alcohol interventions and user feedback analysis in Phase 1, three new modules: ‘Behaviour Substitution’, ‘Information about Antecedents’ and ‘Insights’, were added to the app. One existing module – ‘Identity Change’ – was removed based on the initial evaluation of Drink Less. Phases 2 and 3 resulted in changes to existing features, such as improving the navigational structure and onboarding process, and clarifying how to edit drinks and goals. Conclusions: A mixed methods approach was used to refine the content and design of Drink Less, providing insights into how to improve its usability and likely effectiveness. Drink Less is now ready for a confirmatory evaluation.
Perceptions of fatigue and fatigue management interventions among people with multiple sclerosis: a systematic literature review and narrative synthesis
Authors: Power Míde , Arafa Nora , Wenz Anke , Foley Geraldine 
Published: June 2021

Background/Aims Fatigue is the most common symptom of multiple sclerosis. Evidence supports the effectiveness of fatigue management interventions for people with multiple sclerosis. This review aimed to identify how people with multiple sclerosis experience fatigue and to examine their perceptions of fatigue management interventions. Methods The review was conducted systematically, searching the following electronic databases: AMED, CINAHL Complete, eBook Nursing Collection, ERIC, Health Source: Nursing/Academic Edition, MEDLINE, APA PsycArticles, and APA PsycInfo for original peer-reviewed empirical research published in English between January 2000 and June 2020. Qualitative and mixed-methods studies that captured the perspectives of people with multiple sclerosis on their fatigue and/or their perceptions of fatigue management interventions were included. A narrative synthesis was used to synthesise the findings. Results A total of 23 qualitative and eight mixed-methods studies were extracted comprising a total of 662 people with multiple sclerosis (relapsing remitting n=293; secondary progressive n=129; primary progressive n=73; relapsing progressive n=3; benign n=2; fulminant n=1; type of multiple sclerosis not reported n=161). Fatigue was perceived by people with multiple sclerosis as a debilitating symptom of the condition and which they felt impacted adversely on their lives. A lack of understanding from others about multiple sclerosis fatigue was challenging for people with multiple sclerosis. People with multiple sclerosis valued the physical and psychosocial-based content of fatigue management interventions and felt fatigue management interventions enabled them to legitimise their fatigue and feel more in control of their fatigue. Conclusions From the perspective of people with multiple sclerosis, fatigue is a central and debilitating feature of the everyday experience of living with multiple sclerosis. Research on the potential of fatigue management interventions to foster control for people with multiple sclerosis to help them manage their fatigue is warranted. Healthcare professionals should consider how they can empower people with multiple sclerosis to educate others about their fatigue. Some evidence being generated for practice might not be sufficiently contextualised to different forms of multiple sclerosis.
Machine-learning-based soft-failure localization with partial software-defined networking telemetry
Authors: Mayer Kayol S. , Soares Jonathan A. , Pinto Rossano P. , Rothenberg Christian E. , Arantes Dalton S. , Mello Darli A. A. 
Published: June 2021

Soft-failure localization frameworks typically use if-else rules to localize failures based on the received telemetry data. However, in certain cases, particularly in disaggregated networks, some devices may not implement telemetry, or their telemetry may not be readily available. Alternatively, machine-learning-based (ML-based) frameworks can automatically learn complex relationships between telemetry and the fault location, incorporating information from the telemetry data collected network-wide. This paper evaluates an ML-based soft-failure localization framework in scenarios of partial telemetry. The framework is based on an artificial neural network (ANN) trained by optical signal and noise power models that simulate the network telemetry upon all possible failure scenarios. The ANN can be trained in less than 2 min, allowing it to be retrained according to the available partial telemetry data. The ML-based framework exhibits excellent performance in scenarios of partial telemetry, practically interpolating the missing data. We show that in the rare cases of incorrect failure localization, the actual failure is in the localized device’s vicinity. We also show that ANN training is accelerated by principal component analysis and can be carried out using cloud-based services. Finally, the evaluated ML-based framework is emulated in a software-defined-networking-based setup using the gNMI protocol for streaming telemetry.
Frequency-resolved spatial beam mapping in multimode fibers: application to mid-infrared supercontinuum generation
Authors: Leventoux Y. , Granger G. , Krupa K. , Mansuryan T. , Fabert M. , Tonello A. , Wabnitz S. , Couderc V. , Février S. 
Published: June 2021

We present a new, to the best of our knowledge, spatial-spectral mapping technique permitting measurement of the beam intensity at the output of a graded-index multimode fiber (GIMF) with sub-nanometric spectral resolution. We apply this method to visualize the fine structure of the beam shape of a sideband generated at 1870 nm by geometric parametric instability (GPI) in a GIMF. After spatial-spectral characterization, we amplify the GPI sideband with a thulium-doped fiber amplifier to obtain a microjoule-scale picosecond pump whose spectrum is finally broadened in a segment of

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optical fiber to achieve a supercontinuum ranging from 1.7 up to 3.4 µm.
Linearity improvement of analog photonic link based on a phase-coherent orthogonal light wave generator
Authors: Han Mengyao , Wang Muguang , Wu Beilei , Zhang Naihan , Mu Hongqian , Zhang Jianyong , Yan Fengping 
Published: June 2021

This Letter presents a novel, to the best of our knowledge, linearized analog photonic link (APL) based on a phase-coherent orthogonal light wave generator that consists of a polarization-dependent Mach–Zehnder modulator (MZM) and a polarization controller (PC). By adjusting the PC and bias voltage of MZM, the third-order intermodulation (IMD3) terms can be suppressed while retaining a high gain for the fundamental terms, which indicates that the spurious free dynamic range (SFDR) of the proposed APL can be much improved. To further verify the feasibility of the proposed APL, a proof-of-concept experiment is performed, and the performances are compared with conventional APL. The experimental results demonstrate that a 14 dB improvement in the fundamental to IMD3 power ratio and an SFDR of

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are achieved. In addition, an orthogonal frequency division multiplexing signal with 30 MHz bandwidth centered at 2.5 GHz is delivered by our proposed APL, whose signal-to-noise ratio is increased by 10 dB, compared to conventional APL.
Rheumatic heart disease in pregnancy and neonatal outcomes: A systematic review and meta-analysis
Authors: Liaw Joshua , Walker Betrice , Hall Leanne , Gorton Susan , White Andrew V. , Heal Clare 
Published: June 2021

PurposeAssociations between rheumatic heart disease (RHD) in pregnancy and fetal outcomes are relatively unknown. This study aimed to review rates and predictors of major adverse fetal outcomes of RHD in pregnancy.MethodsMedline (Ovid), Pubmed, EMcare, Scopus, CINAHL, Informit, and WHOICTRP databases were searched for studies that reported rates of adverse perinatal events in women with RHD during pregnancy. Outcomes included preterm birth, intra-uterine growth restriction (IUGR), low-birth weight (LBW), perinatal death and percutaneous balloon mitral valvuloplasty intervention. Meta-analysis of fetal events by the New-York Heart Association (NYHA) heart failure classification, and the Mitral-valve Area (MVA) severity score was performed with unadjusted random effects models and heterogeneity of risk ratios (RR) was assessed with the I2statistic. Quality of evidence was evaluated using the GRADE approach. The study was registered in PROSPERO (CRD42020161529).FindingsThe search identified 5949 non-duplicate records of which 136 full-text articles were assessed for eligibility and 22 studies included, 11 studies were eligible for meta-analyses. In 3928 pregnancies, high rates of preterm birth (9.35%-42.97%), LBW (12.98%-39.70%), IUGR (6.76%-22.40%) and perinatal death (0.00%-9.41%) were reported. NYHA III/IV pre-pregnancy was associated with higher rates of preterm birth (5 studies, RR 2.86, 95%CI 1.54–5.33), and perinatal death (6 studies, RR 3.23, 1.92–5.44). Moderate /severe mitral stenosis (MS) was associated with higher rates of preterm birth (3 studies, RR 2.05, 95%CI 1.02–4.11) and IUGR (3 studies, RR 2.46, 95%CI 1.02–5.95).InterpretationRHD during pregnancy is associated with adverse fetal outcomes. Maternal NYHA III/IV and moderate/severe MS in particular may predict poor prognosis.
Pregnant women, their male partners and health care providers’ perceptions of HIV self-testing in Kampala, Uganda: Implications for integration in prevention of mother-to-child transmission programs and scale-up
Authors: Rujumba Joseph , Homsy Jaco , Mbazzi Femke Bannink , Namukwaya Zikulah , Amone Alexander , Rukundo Gordon , Katabira Elly , Byamugisha Josaphat , Fowler Mary Glenn , King Rachel L. 
Published: June 2021

Background
HIV status awareness is critical for HIV prevention and care but HIV testing rates remain low in Uganda, especially among men. One suggested approach to increase access and utilisation of HIV testing services is HIV self-testing. We explored perceptions of pregnant and lactating women and their male partners who attended antenatal care, and health care providers in a government hospital in Kampala, Uganda, about HIV self-testing for initial or repeat testing for women and their partners during pregnancy and postpartum We draw implications for scaling-up this new testing approach in Uganda.

Methods
This was a qualitative study conducted at Mulago National Referral Hospital, Kampala, Uganda, between April and December 2017. We conducted in-depth interviews with five pregnant or lactating women and their five male partners; five focus group discussions (two with women, two with health workers and one with male partners of women attending antenatal care) and five key informant interviews with health workers providing prevention of mother-to-child HIV transmission (PMTCT) services. Data were analysed using content thematic approach.

Results
There was limited awareness about HIV self-testing especially among pregnant or lactating women and their male partners. Study participants mentioned that HIV self-testing would enable people to know their HIV status faster, they thought the approach would be cost- and time-saving compared to health facility-based HIV testing, improve confidentiality and reduce stigma for those who test HIV positive. They expressed however, a general fear that HIV self-testing would lead to harm to self and others in case one tested HIV positive, including suicide, violence among couples, intentional transmission of HIV, and limited linkage to care due to lack of counselling. The likely misinterpretation of HIV test results especially among those with no or limited education, and possible coercion exerted by male partners on their wives were other potential concerns raised about the use of HIV self-testing.

Conclusions
There was limited knowledge about HIV self-testing among pregnant and lactating women, their partners and health workers. While the self-testing modality was perceived to be critical for helping people, especially those in casual and distant relationships, to know their HIV status and that of their partners, most study participants believed that HIV self-testing could potentially result in a multitude of negative outcomes in the absence of pre- and post-test counselling. Successful scale-up and integration of self-testing in HIV programs requires community education, provision of information materials and making self-test kits accessible and affordable, especially in rural areas.
Stress and anxiety among physicians during the COVID-19 outbreak in the Iraqi Kurdistan Region: An online survey
Authors: Saeed Banaz A. , Shabila Nazar P. , Aziz Aram Jalal 
Published: June 2021

BackgroundDuring infectious disease outbreaks, healthcare workers are at high risk of infection, infecting others, and psychological distress. This study aimed to determine the prevalence of stress and anxiety in physicians during the COVID-19 outbreak in the Iraqi Kurdistan Region and assess their associated factors.MethodsThis cross-sectional study was carried out in Erbil, Iraqi Kurdistan Region, from March 28 to April 15, 2020. An online self-administered survey questionnaire was used to collect data from physicians working in specialized COVID-19 centers and other healthcare facilities. The level of stress was measured based on the 10-items Perceived Stress Scale. The level of anxiety was measured based on the 7-item Generalized Anxiety Disorder scale.ResultsA total of 370 participants responded to the perceived stress component of the survey, of whom 57 (15.4%) had low perceived stress, 249 (67.3%) had moderate stress, and 64 (17.3%) had high stress. Being female was significantly associated with having moderate/high stress (adjusted odds ratio (AOR) = 2.40 (95% CI 1.31–4.39)). A total of 201 participants responded to the generalized anxiety disorder component of the survey, of whom 19 (9.5%) had no anxiety, 57 (28.4%) had mild anxiety, 79 (39.3%) had moderate anxiety, and 46 (22.9%) had severe anxiety. Working in COVID-19 centers (AOR = 2.23 (95% CI 1.02–4.86)) and being general practitioners (AOR = 4.16 (95% CI 1.14–15.14)) were significantly associated with having moderate/severe anxiety.ConclusionA considerable proportion of physicians experience stress and anxiety during the COVID-19 outbreak in Iraqi Kurdistan region. Generalists and those in special COVID-19 units report the greatest anxiety. There a need to establish mechanisms to reduce the risks of stress and anxiety among physicians. Mental health coping interventions through counseling should be based on COVID-19 protocol guidelines. Interventions should also emphasize physicians’ ability to work safely and efficiently in providing care to the patients.