bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying research priorities in newborn medicine: a Delphi study of parents’ views
Authors: Eeles Abbey L , Burnett Alice C , Cheong Jeanie LY , Aldis Alex , Pallot Louise , Polonidis Tien , Rust Krista , Hunt Rod W , Delany Clare , Spittle Alicia J 
Published: November 2021

ObjectiveNeonatal conditions can have lifelong implications for the health and well-being of children and families. Traditionally, parents and patients have not been included in shaping the agenda for research and yet they are profoundly affected by the neonatal experience and its consequences. This study aimed to identify consensus research priorities among parents/patients of newborn medicine in Australia and New Zealand.DesignParents/patients with experience of neonatal care in Australia and New Zealand completed an online Delphi study to identify research priorities across four epochs (neonatal admission, early childhood, childhood/adolescence and adulthood). Parents/patients first generated key challenges in each of these epochs. Through inductive thematic analysis, recurring topics were identified and research questions generated. Parents/patients rated these questions in terms of priorities and a list of questions consistently rated as high priority was identified.Participants393 individuals participated, 388 parents whose children had received neonatal care and 5 adults who had received neonatal care themselves.ResultsMany research questions were identified as high-priority across the lifespan. These included how to best support parental mental health, relationships between parents and neonatal clinical staff (including involvement in care and communication), bonding and the parent–child relationship, improving neonatal medical care and addressing long-term impacts on child health and neurodevelopment.ConclusionsParents with experience of newborn medicine have strong, clear and recurring research priorities spanning neonatal care practices, psychological and other impacts on families, and impacts on child development. These findings should guide neonatal research efforts. In addition to generating new knowledge, improved translation of existing evidence to parents is also needed.
Predictive model and risk analysis for diabetic retinopathy using machine learning: a retrospective cohort study in China
Authors: Li Wanyue , Song Yanan , Chen Kang , Ying Jun , Zheng Zhong , Qiao Shen , Yang Ming , Zhang Maonian , Zhang Ying 
Published: November 2021

ObjectiveAiming to investigate diabetic retinopathy (DR) risk factors and predictive models by machine learning using a large sample dataset.DesignRetrospective study based on a large sample and a high dimensional database.SettingA Chinese central tertiary hospital in Beijing.ParticipantsInformation on 32 452 inpatients with type-2 diabetes mellitus (T2DM) were retrieved from the electronic medical record system from 1 January 2013 to 31 December 2017.MethodsSixty variables (including demography information, physical and laboratory measurements, system diseases and insulin treatments) were retained for baseline analysis. The optimal 17 variables were selected by recursive feature elimination. The prediction model was built based on XGBoost algorithm, and it was compared with three other popular machine learning techniques: logistic regression, random forest and support vector machine. In order to explain the results of XGBoost model more visually, the Shapley Additive exPlanation (SHAP) method was used.ResultsDR occurred in 2038 (6.28%) T2DM patients. The XGBoost model was identified as the best prediction model with the highest AUC (area under the curve value, 0.90) and showed that an HbA1c value greater than 8%, nephropathy, a serum creatinine value greater than 100 µmol/L, insulin treatment and diabetic lower extremity arterial disease were associated with an increased risk of DR. A patient’s age over 65 was associated with a decreased risk of DR.ConclusionsWith better comprehensive performance, XGBoost model had high reliability to assess risk indicators of DR. The most critical risk factors of DR and the cut-off of risk factors can be found by SHAP method to render the output of the XGBoost model clinically interpretable.
Diabetes, obesity, hypertension and risk of severe COVID-19: a protocol for systematic review and meta-analysis
Authors: Li Chaoyang , Islam Nazrul , Gutierrez Juan Pablo , Lacey Ben , Moolenaar Ronald L , Richter Patricia 
Published: November 2021

IntroductionPrevious evidence from several countries, including China, Italy, Mexico, UK and the USA, indicates that among patients with confirmed COVID-19 who were hospitalised, diabetes, obesity and hypertension might be important risk factors for severe clinical outcomes. Several preliminary systematic reviews and meta-analyses have been conducted on one or more of these non-communicable diseases, but the findings have not been definitive, and recent evidence has become available from many more populations. Thus, we aim to conduct a systematic review and meta-analysis of observational studies to assess the relationship of diabetes, obesity and hypertension with severe clinical outcomes in patients with COVID-19.Method and analysisWe will search 16 major databases (MEDLINE, Embase, Global Health, CAB Abstracts, PsycINFO, CINAHL, Academic Research Complete, Africa Wide Information, Scopus, PubMed Central, ProQuest Central, WHO Virtual Health Library, Homeland Security COVID-19 collection, SciFinder, Clinical Trials and Cochrane Library) for articles published between December 2019 and December 2020. We will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2016 guidelines for the design and reporting the results. We will include observational studies that assess the associations of pre-existing diabetes, obesity and hypertension in patients with COVID-19 with risk of severe clinical outcomes such as intensive care unit admission, receiving mechanical ventilation or death. Stata V.16.1 and R-Studio V.1.4.1103 statistical software will be used for statistical analysis. Meta-analysis will be used to estimate the pooled risks and to assess potential heterogeneities in risks.Ethics and disseminationThe study was reviewed for human subjects concerns by the US CDC Center for Global Health and determined to not represent human subjects research because it uses data from published studies. We plan to publish results in a peer-reviewed journal and present at national and international conferences.PROSPERO registration numberCRD42021204371.
Identification of the most vulnerable populations in the psychosocial sphere: a cross-sectional study conducted in Catalonia during the strict lockdown imposed against the COVID-19 pandemic
Authors: Farrés Judith , Ruiz Jose Luis , Mas Jose Manuel , Arias Lilibeth , Sarrias Maria-Rosa , Armengol Carolina , Cardona Pere-Joan , Munoz-Moreno Jose A , Vilaplana Miriam , Arranz Belen , Usall Judith , Serrano-Blanco Antoni , Vilaplana Cristina 
Published: November 2021

Design and objectivesA cross-sectional study to evaluate the impact of COVID-19 on the psychosocial sphere in both the general population and healthcare workers (HCWs).MethodsThe study was conducted in Catalonia (Spain) during the first wave of the COVID-19 pandemic when strict lockdown was in force. The study population included all people aged over 16 years who consented to participate in the study and completed the survey, in this case a 74-question questionnaire shared via social media using snowball sampling. A total of 56 656 completed survey questionnaires were obtained between 3 and 19 April 2020.The primary and secondary outcome measures included descriptive statistics for the non-psychological questions and the psychological impact of the pandemic, such as depression, anxiety, stress and post-traumatic stress disorder question scores.ResultsA n early and markedly negative impact on family finances, fear of working with COVID-19 patients and ethical issues related to COVID-19 care among HCWs was observed. A total of seven target groups at higher risk of impaired mental health and which may therefore benefit from an intervention were identified, namely women, subjects aged less than 42 years, people with a care burden, socioeconomically deprived groups, people with unskilled or unqualified jobs, patients with COVID-19 and HCWs working with patients with COVID-19.ConclusionsActive implementation of specific strategies to increase resilience and to prepare an adequate organisational response should be encouraged for the seven groups identified as high risk and susceptible to benefit from an intervention.Trial registration numberNCT04378452.
Sequential multiple assignment randomised trial of a brief contact intervention for suicide risk management among discharged psychiatric patients: an implementation study protocol
Authors: Liu Huiming , Chen Guanjie , Li Jinghua , Hao Chun , Zhang Bin , Bai Yuanhan , Song Liangchen , Chen Chang , Xie Haiyan , Liu Tiebang , Caine Eric D , Hou Fengsu 
Published: November 2021

IntroductionThe postdischarge suicide risk among psychiatric patients is significantly higher than it is among patients with other diseases and general population. The brief contact interventions (BCIs) are recommended to decrease suicide risk in areas with limited mental health service resources like China. This study aims to develop a postdischarge suicide intervention strategy based on BCIs and evaluate its implementability under the implementation outcome framework.Methods and analysisThis study will invite psychiatric patients and family members, clinical and community mental health service providers as the community team to develop a postdischarge suicide intervention strategy. The study will recruit 312 patients with psychotic symptoms and 312 patients with major depressive disorder discharged from Shenzhen Kangning Hospital (SKH) in a Sequential Multiple Assignment Randomised Trial. Participants will be initially randomised into two intervention groups to receive BCIs monthly and weekly, and they will be rerandomised into three intervention groups to receive BCIs monthly, biweekly and weekly at 3 months after discharge according to the change of their suicide risk. Follow-ups are scheduled at 1, 3, 6 and 12 months after discharge. With the intention-to-treat approach, generalised estimating equation and survival analysis will be applied. This study will also collect qualitative and quantitative information on implementation and service outcomes from the community team.Ethics/disseminationThis study has received ethical approval from the Ethics Committee Review Board of SKH. All participants will provide written informed consent prior to enrolment. The findings of the study will be disseminated through peer-reviewed scientific journals, conference presentations. A project report will be submitted to the National Natural Science Foundation of China as the concluding report of this funded project, and to the mental health authorities in the Shenzhen to refine and apply evidence-based and pragmatic interventions into health systems for postdischarge suicide prevention.Trial registration numberNCT04907669.
Feasibility of completing Multidimensional Dyspnea Profile and Dyspnea-12 over the telephone in patients with oxygen-dependent disease
Authors: Bech Thea Wilhelmine , Eklund Moa , Spaak Elisabeth , Palm Andreas , Ekström Magnus 
Published: November 2021

BackgroundBreathlessness is prevalent in severe disease and consists of different dimensions that can be measured using the Multidimensional Dyspnea Profile (MDP) and Dyspnea-12 (D-12). We aimed to evaluate the feasibility of MDP and D-12 over telephone interviews in oxygen-dependent patients, compared with other patient-reported outcomes (modified Medical Research Council (mMRC) and Chronic Obstructive Pulmonary Disease Assessment Test (CAT)) and with completion by hand.MethodsCross-sectional, telephone study of 50 patients with home oxygen therapy. Feasibility was assessed as completion time (self-reported by patients and measured), difficulty (self-reported) and help required to complete the instruments (staff). Completion time was compared with mMRC and CAT, and feasibility was compared with completion by hand in cardiopulmonary outpatients (n=182). Feasibility by age and gender was analysed using logistic regression.ResultsOf 136 patients approached, 50 (37%) participated (mean age: 72±10 years, 66% women). Completion times (in minutes) were relatively short for MDP (self-reported 6 (IQR 5–10), measured 8 (IQR 6–10)) and D-12 (self-reported 5 (IQR 3–8), measured 3 (IQR 3–4)), and slightly longer than mMRC (median 1 (IQR 1–1)) and CAT (median 3 (IQR 2–5)). Even though the majority of patients required no help, more assistance was required by older patients. Compared with patients reporting by hand, completion over the telephone required somewhat longer time and more assistance.ConclusionMany patients with severe oxygen-dependent disease were unable or unwilling to assess symptoms over the telephone. However, among those able to participate, MDP and D-12 are feasible to measure multiple dimensions of breathlessness over the telephone.
Footprints of a microbial toxin from the gut microbiome to mesencephalic mitochondria
Authors: Esteves A Raquel , Munoz-Pinto Mário F , Nunes-Costa Daniela , Candeias Emanuel , Silva Diana F , Magalhães João D , Pereira-Santos A Raquel , Ferreira I Luisa , Alarico Susana , Tiago Igor , Empadinhas Nuno , Cardoso Sandra Morais 
Published: November 2021

ObjectiveIdiopathic Parkinson’s disease (PD) is characterised by alpha-synuclein (aSyn) aggregation and death of dopaminergic neurons in the midbrain. Recent evidence posits that PD may initiate in the gut by microbes or their toxins that promote chronic gut inflammation that will ultimately impact the brain. In this work, we sought to demonstrate that the effects of the microbial toxin β-N-methylamino-L-alanine (BMAA) in the gut may trigger some PD cases, which is especially worrying as this toxin is present in certain foods but not routinely monitored by public health authorities.DesignTo test the hypothesis, we treated wild-type mice, primary neuronal cultures, cell lines and isolated mitochondria with BMAA, and analysed its impact on gut microbiota composition, barrier permeability, inflammation and aSyn aggregation as well as in brain inflammation, dopaminergic neuronal loss and motor behaviour. To further examine the key role of mitochondria, we also determined the specific effects of BMAA on mitochondrial function and on inflammasome activation.ResultsBMAA induced extensive depletion of segmented filamentous bacteria (SFB) that regulate gut immunity, thus triggering gut dysbiosis, immune cell migration, increased intestinal inflammation, loss of barrier integrity and caudo-rostral progression of aSyn. Additionally, BMAA inducedin vitroandin vivomitochondrial dysfunction with cardiolipin exposure and consequent activation of neuronal innate immunity. These events primed neuroinflammation, dopaminergic neuronal loss and motor deficits.ConclusionTaken together, our results demonstrate that chronic exposure to dietary BMAA can trigger a chain of events that recapitulate the evolution of the PD pathology from the gut to the brain, which is consistent with ‘gut-first’ PD.
Building leadership capabilities in maternity
Authors: Ashmore Ayisha Adeeba , Kanga Kate , Kaur-Desai Tejinder , Thorman Kate , Archer Natasha 
Published: November 2021

BackgroundOver recent years, there has been increasing recognition that effective leadership is critical to establishing positive organisational culture and improving patient outcomes. In maternity, there is a unique interplay between different specialties and disciplines in providing high-quality services.MethodsReview of literature pertaining to leadership and maternity.ResultsGood leadership is the key determinant in ensuring that our multi-professional teams function effectively. The relational aspects of teamworking, linked to safer delivery of services, have been explored in great detail in maternity services. However, there has been less focus on the application of leadership theory in this environment and the impact of interventions used in developing leadership skills within maternity teams.ConclusionsIn this paper, we discuss how leadership theory can be used to understand high profile maternity service failures and how effective team culture, clinical team building and individual leadership skill-development are strong contributors to this thinking. Specific examples are used to describe ongoing work in our drive for improvement and to highlight the current lack of evidence in this area.
Prevention and partial reversion of the lupus phenotype in ABIN1[D485N] mice by an IRAK4 inhibitor
Authors: Petrova Tsvetana , Nanda Sambit K , Scudamore Cheryl , Wright Stephen W , Rao Vikram R , Cohen Philip 
Published: November 2021

ObjectiveWe have reported previously that the IRAK4 inhibitor PF06426779 given to ubiquitin-binding-defective ABIN1[D485N] mice at 6 weeks of age prevents the major facets of lupus that develop 10 weeks later. The present study was undertaken to investigate whether PF06426779 could reverse the lupus phenotype when administered to 13-week-old ABIN1[D485N] mice that had already developed symptoms of lupus.MethodsSplenomegaly, the number of splenic neutrophils, TFHand Germinal Centre B (GCB) cells, serum levels of immunoglobulins, the extent of kidney, liver and lung pathology, and glomerular IgA and IgM were measured after feeding 13-week-old ABIN1[D485N] and wild-type mice for another 10 weeks with R&M3 diet with and without PF06426779 (4 g/kg).ResultsFollowing drug treatment, spleen size and weight, splenic neutrophil numbers, and serum IgA and glomerular IgA levels of ABIN1[D485N] mice returned to those seen in wild-type mice. The rise in splenic TFHand GCB numbers, the increase in kidney and liver pathology, and the concentrations of serum IgG1, IgG2A and IgE between 13 and 23 weeks were suppressed. There was no reduction in the level of anti-self double-stranded DNA, anti-self nuclear antigens or IgM during the drug treatment.ConclusionsThe results demonstrate the therapeutic potential of IRAK4 inhibitors for the treatment of lupus and raise the possibility of monitoring efficacy by measuring decreases in the serum levels of IgA. Our results support the view that there may be a closer connection between lupus and IgA nephropathy than realised previously.
Benefit–harm analysis of azithromycin for the prevention of acute exacerbations of chronic obstructive pulmonary disease
Authors: Ahmadian Safa , Sin Don D , Lynd Larry , Harrison Mark , Sadatsafavi Mohsen 
Published: November 2021

BackgroundLow-dose oral azithromycin therapy is recommended as a preventive treatment for acute exacerbations of COPD. However, the overall benefit–harm balance of this treatment has not been well studied.MethodsA probabilistic Markov model of COPD was created to simulate the course of COPD over 20 years. The model was populated with evidence from the literature and dedicated data analysis. The benefit of azithromycin was modelled as a reduction in exacerbation rates. Adverse events, including cardiovascular events, hearing loss, gastrointestinal symptoms and antimicrobial resistance (leading to a gradual decline in the effectiveness of azithromycin), were considered. All outcomes were assigned a health-related utility weight to estimate the overall net change in the quality-adjusted life year (QALY) associated with the use of azithromycin.ResultsIn patients with a positive exacerbation history, azithromycin resulted in a net QALY gain of 17.9 per 100 patients (99.8% probability of expected QALY gain) over 20 years. The net benefit increased to 21.8 QALYs per 100 patients (99.9% probability of expected QALY gain) among the ‘frequent exacerbator’ subgroup. Azithromycin was not net beneficial among those without any moderate/severe exacerbations in the previous year. Findings were robust against series of sensitivity, scenario and threshold analyses.ConclusionsLong-term therapy with azithromycin confers a net benefit to ex-smoker patients with COPD with a recent history of exacerbations and an even larger benefit to those who are frequent exacerbators.
A Data-Driven Optimization Model of Important Multidimensional Factors Affecting College Students’ Cognitive Engagement in Ideological and Political Theory Course
Authors: Wang Liangliang 
Published: November 2021

The optimization of important multidimensional factors is conducive to cognitive engagement, which is a crucial dimension of student engagement and plays a significant role in college students’ learning of the Ideological and Political Theory Course. However, because there are many influencing factors associated with cognitive engagement, the influence mechanism and analysis strategy of this kind of model are relatively complex. In order to solve this research gap, this paper establishes an optimization model affecting Chinese college students’ cognitive engagement in IPTC on the basis of sample collection and investigation. In this process, 4,700 questionnaires were distributed to 47 colleges and universities across the country, and copies were effectively recovered (N = 3992); the effective recovery rate was 84.94%. Cronbach’s alpha of 0.759 indicates that the scale has high reliability and Pearson’s correlation coefficient

P

≤ 0.001 shows that the scale has good validity. The KMO value of 0.703 in the Bartlett sphere test also shows that the scale is suitable for factor analysis. Firstly, according to the method of factor analysis, there are six important factor dimensions affecting college students’ cognitive engagement in the IPTC, namely, attention and motivation factor dimension, behavior and value attainment factor dimension, interest and practicality factor dimension, personality and will factor dimension, evaluation and time factor dimension, and knowledge and strategy factor dimension. Then, through descriptive analysis, it is found that personality and will factor dimension (M = 6.5837) plays a relatively major role while knowledge motivation dimension (M = 6.3505) has a weak impact on cognitive engagement. Finally, from linear regression analysis, there is a significant positive correlation between cognitive engagement and other variables. In addition, undergraduates are slightly lacking motivation in the learning of the course, and vigorously strengthening college students’ cognitive engagement is still necessary, so as to effectively enhance the effectiveness of the IPTC in the future.
Niche overlap of benthic macrofauna in a tropical estuary: diurnal variation
Authors: Oliveira Mário Herculano de , Lima Lidiane Gomes de , Lima Caroline Stefani da Silva , Gomes Jéssica de Oliveira Lima , Paiva Franciely Ferreira , Barros Graciele de , Medeiros Carlinda Railly , Molozzi Joseline 
Published: November 2021

The complexity of estuaries allows for the establishment of diverse communities composed of species with different survival strategies. The vertical migration of animals in the sediment is linked to competition, escape from predators and adaptations to diurnal physio-chemical changes related to variations in water levels. The present study aimed to evaluate niche overlap and amplitude, as well as the composition and structure, of communities of polychaetes and molluscs between sediment aliquots during the day and at night. Data sampling was performed in the Tubarão River estuary. The highest individual occurrence was registered during the diurnal period. Communities of polychaetes varied significantly between sediment aliquots during the day and at night, while molluscs did not show diurnal variation. Niche overlap results for polychaetes showed higher values between aliquots during the night, while molluscs showed greater overlap during the day. This indicates that polychaetes and molluscs have different mechanisms of coexistence. This may be related to different attributes of species allowing for the division of resources among individuals. Examination of niche overlap provides insights into coexistence of mechanisms within benthic macroinvertebrate communities.