bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of polypharmacy and associated adverse health outcomes in adult patients with chronic kidney disease: protocol for a systematic review and meta-analysis
Authors: Okpechi Ikechi G. , Tinwala Mohammed M. , Muneer Shezel , Zaidi Deenaz , Ye Feng , Hamonic Laura N. , Khan Maryam , Sultana Naima , Brimble Scott , Grill Allan , Klarenbach Scott , Lindeman Cliff , Molnar Amber , Nitsch Dorothea , Ronksley Paul , Shojai Soroush , Soos Boglarka , Tangri Navdeep , Thompson Stephanie , Tuot Delphine , Drummond Neil , Mangin Dee , Bello Aminu K. 
Published: July 2021

Abstract
Background
Polypharmacy, often defined as the concomitant use of ≥ 5 medications, has been identified as a significant global public health threat. Aging and multimorbidity are key drivers of polypharmacy and have been linked to a broad range of adverse health outcomes and mortality. Patients with chronic kidney disease (CKD) are particularly at high risk of polypharmacy and use of potentially inappropriate medications given the numerous risk factors and complications associated with CKD. The aim of this systematic review will be to assess the prevalence of polypharmacy among adult patients with CKD, and the potential association between polypharmacy and adverse health outcomes within this population.

Methods/design
We will search empirical databases such as MEDLINE, Embase, Cochrane Library, CINAHL, Web of Science, and PsycINFO and grey literature from inception onwards (with no language restrictions) for observational studies (e.g., cross-sectional or cohort studies) reporting the prevalence of polypharmacy in adult patients with CKD (all stages including dialysis). Two reviewers will independently screen all citations, full-text articles, and extract data. Potential conflicts will be resolved through discussion. The study methodological quality will be appraised using an appropriate tool. The primary outcome will be the prevalence of polypharmacy. Secondary outcomes will include any adverse health outcomes (e.g., worsening kidney function) in association with polypharmacy. If appropriate, we will conduct random effects meta-analysis of observational data to summarize the pooled prevalence of polypharmacy and the associations between polypharmacy and adverse outcomes. Statistical heterogeneity will be estimated using Cochran’s Q and I2 index. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., sex, kidney replacement therapy, multimorbidity).

Discussion
Given that polypharmacy is a major and a growing public health issue, our findings will highlight the prevalence of polypharmacy, hazards associated with it, and medication thresholds associated with adverse outcomes in patients with CKD. Our study will also draw attention to the prognostic importance of improving medication practices as a key priority area to help minimize the use of inappropriate medications in patients with CKD.

Systematic review registration
PROSPERO registration number: [CRD42020206514].
Limits and benefits of participatory agenda setting for research and innovation
Authors: Gudowsky Niklas 
Published: July 2021

AbstractCurrent governance of science, technology and innovation (STI) faces tough challenges to meet demands arising from complex issues such as societal challenges or targets, e.g. the United Nations’ Sustainable Development Goals. For decades, scholars and civil society institutions have called for increased public participation in STI, and political institutions have been taking up the request to integrate engagement activities into their decision-making processes, at least in the form of consultations. Moving engagement in research and development further upstream makes early interventions and social shaping of technologies and innovation possible. Since research has also faced repeated requests towards taking on more responsibility for solving societal problems, engagement processes thus help in shaping research. Here, the earliest point for possible engagement can be found within the constituting phase of research agendas as topics, general lines of enquiry and targets are shaped in this phase. These are the boundaries in between which researchers later navigate. This article serves as introduction to this journal’s topical collection on participatory agenda setting for research and innovation (PASE). It provides a review of the literature on theory and practice of PASE activities, summarises the topical collection’s contributions regarding current international cases and analyses respective PASE limits and benefits, thereby promoting its conceptual and practical understanding.
The use of digital twins in healthcare: socio-ethical benefits and socio-ethical risks
Authors: Popa Eugen Octav , van Hilten Mireille , Oosterkamp Elsje , Bogaardt Marc-Jeroen 
Published: July 2021

AbstractAnticipating the ethical impact of emerging technologies is an essential part of responsible innovation. One such emergent technology is the digital twin which we define here as a living replica of a physical system (human or non-human). A digital twin combines various emerging technologies such as AI, Internet of Things, big data and robotics, each component bringing its own socio-ethical issues to the resulting artefacts. The question thus arises which of these socio-ethical themes surface in the process and how they are perceived by stakeholders in the field. In this report we present the results of a qualitative study into the socio-ethical benefits and socio-ethical risks of using digital twins in healthcare. Employing insights from ethics of technology and the Quadruple Helix theory of innovation, we conducted desk research of white literature and 23 interviews with representatives from the four helixes: industry, research, policy and civil society. The ethical scan revealed several important areas where the digital twin can produce socio-ethical value (e.g., prevention and treatment of disease, cost reduction, patient autonomy and freedom, equal treatment) but also several important areas of socio-ethical risks (e.g., privacy and property of data, disruption of existing societal structures, inequality and injustice). We conclude with a reflection on the employed analytical tool and suggestions for further research.
Applications of artificial intelligence and machine learning in orthodontics: a scoping review
Authors: Bichu Yashodhan M. , Hansa Ismaeel , Bichu Aditi Y. , Premjani Pratik , Flores-Mir Carlos , Vaid Nikhilesh R. 
Published: July 2021

Abstract
Introduction
This scoping review aims to provide an overview of the existing evidence on the use of artificial intelligence (AI) and machine learning (ML) in orthodontics, its translation into clinical practice, and what limitations do exist that have precluded their envisioned application.

Methods
A scoping review of the literature was carried out following the PRISMA-ScR guidelines. PubMed was searched until July 2020.

Results
Sixty-two articles fulfilled the inclusion criteria. A total of 43 out of the 62 studies (69.35%) were published this last decade. The majority of these studies were from the USA (11), followed by South Korea (9) and China (7). The number of studies published in non-orthodontic journals (36) was more extensive than in orthodontic journals (26). Artificial Neural Networks (ANNs) were found to be the most commonly utilized AI/ML algorithm (13 studies), followed by Convolutional Neural Networks (CNNs), Support Vector Machine (SVM) (9 studies each), and regression (8 studies). The most commonly studied domains were diagnosis and treatment planning—either broad-based or specific (33), automated anatomic landmark detection and/or analyses (19), assessment of growth and development (4), and evaluation of treatment outcomes (2). The different characteristics and distribution of these studies have been displayed and elucidated upon therein.

Conclusion
This scoping review suggests that there has been an exponential increase in the number of studies involving various orthodontic applications of AI and ML. The most commonly studied domains were diagnosis and treatment planning, automated anatomic landmark detection and/or analyses, and growth and development assessment.
Assessment of beef carcass contamination with Salmonella and E. coli O 157 in slaughterhouses in Bishoftu, Ethiopia
Authors: Gutema Fanta D. , Abdi Reta D. , Agga Getahun E. , Firew Seyoum , Rasschaert Geertrui , Mattheus Wesley , Crombe Florence , Duchateau Luc , Gabriël Sarah , De Zutter Lieven 
Published: July 2021

Abstract
Background
Salmonella and E. coli O157 are common causes of foodborne diseases. Evisceration and de-hiding steps can lead to carcass contamination during slaughter operation. In Ethiopia, information on the association between the presence of these pathogens in the rectal content and/or on the hide of cattle and their presence on the carcass is lacking.

Methods
The aim of this study was to assess the sources of beef carcass contamination with Salmonella and E. coli O157 during slaughter. Rectal contents and hide- and carcass-swabs (from three sites: foreleg, brisket and hind leg) were collected from 70 beef cattle at two small scale slaughterhouses. Isolates were genotyped by the Pulsed Field Gel Electrophoresis method and tested for resistance against 14 microbial drugs.

Results
Salmonella was detected at equal proportions (7.1%) in rectal content samples and hide swabs. E. coli O157 was detected in 8.6% of the rectal contents and 4.3% of the hide swabs. The proportion of contaminated carcasses was 8.6% for Salmonella and 7.1% for E. coli O157. Genetic linkage between the Salmonella and E. coli O157 isolates from the rectal contents and/or hides and carcasses were observed only in a few cases (2 and 1 carcasses, respectively) indicating the limited direct transfer of the pathogens from the feces and/or hide to the carcass during slaughter. Most carcasses became positive by cross contamination. All the S. Typhimurium isolates (n = 8) were multidrug resistant being resistant to ampicillin, chloramphenicol, sulfamethoxazole and tetracycline. The two S. Dublin isolates were resistant to colistin. All E. coli O157 isolates were susceptible to the antimicrobials tested.

Conclusion
The results indicated that cross contamination may be an important source for carcass contamination.
Application of data linkage techniques to Pacific Northwest commercial fishing injury and fatality data
Authors: Nahorniak Jasmine , Bovbjerg Viktor , Case Samantha , Kincl Laurel 
Published: July 2021

Abstract
Background
Commercial fishing consistently has among the highest workforce injury and fatality rates in the United States. Data related to commercial fishing incidents are routinely collected by multiple organizations which do not currently coordinate or automatically link data. Each data set has the potential to generate a more complete picture to inform prevention efforts. Our objective was to examine the utility of using statistical data linkage methods to link commercial fishing incident data when personally identifiable information is not available.

Methods
In this feasibility study, we identified true matches and discrepancies between de-identified data sets using the Python Record Linkage Toolkit. Four commercial fishing data sets from Oregon and Washington were linked: the Commercial Fishing Incident Database, the Vessel Casualty Database, the Nonfatal Injuries Database, and the Oregon Trauma Registry. The data sets each covered different date ranges within 2000–2017, containing 458, 524, 184, and 11 cases respectively. Several data linkage classifiers were evaluated.

Results
The Naïve-Bayes classifier returned the highest number of true matches between these small data sets. A total of 41 true matches and 8 close matches were identified, of which 29 were determined to be duplicates. In addition, linkage highlighted 4 records that were not commercial fishing cases from Oregon and Washington. The optimum match parameters were the date, state, vessel official number, and number of people on board.

Conclusions
Statistical data linkage enables accurate, routine matching for small de-identified injury and fatality data sets such as those in commercial fishing. It provides information needed to improve the accuracy of existing data records. It also enables expanding and sharpening details of individual incidents in support of occupational safety research.
Induced hypernatremia in patients with moderate-to-severe ARDS: a randomized controlled study
Authors: Bihari Shailesh , Prakash Shivesh , Dixon Dani L. , Cavallaro Elena , Bersten Andrew D. 
Published: July 2021

Abstract
Background
Induced hypernatremia and hyperosmolarity is protective in animal models of lung injury. We hypothesized that increasing and maintaining plasma sodium between 145 and 150 mmol/l in patients with moderate-to-severe ARDS would be safe and will reduce lung injury. This was a prospective randomized feasibility study in moderate-to-severe ARDS, comparing standard care with intravenous hypertonic saline to achieve and maintain plasma sodium between 145 and 150 mmol/l for 7 days (HTS group). Both groups of patients were managed with lung protective ventilation and conservative fluid management. The primary outcome was 1-point reduction in lung injury score (LIS) or successful extubation by day 7.

Results
Forty patients were randomized with 20 in each group. Baseline characteristics of severity of illness were well balanced. Patients in the HTS group had higher plasma sodium levels during the first 7 days after randomization when compared with the control group (p = 0.04). Seventy five percent (15/20) of patients in the HTS group were extubated or had ≥ 1-point reduction in LIS compared with 35% (7/20) in the control group (p = 0.02). There was also a decrease in length of mechanical ventilation and hospital length of stay in the HTS group.

Conclusion
We have shown clinical improvement in patients with moderate-to-severe ARDS following induced hypernatremia, suggesting that administration of hypertonic saline is a safe and feasible intervention in patients with moderate-to-severe ARDS. This suggests progress to a phase II study.
Clinical Trial Registration Australian and New Zealand Clinical Trials Registry (ACTRN12615001282572)
How virtual avatar experience interplays with self-concepts: the use of anthropometric 3D body models in the visual stimulation process
Authors: Park Juyeon , Ogle Jennifer Paff 
Published: July 2021

AbstractWe explored how viewing one’s anthropometric virtual avatar would affect the viewer’s self-body perception through the comparative evaluation of self-concepts—self-esteem and self-compassion, within the framework of allocentric lock theory. We recruited 18 female adults, aged 18–21, who identified themselves to have some level of body image concerns, and who had had no clinical treatment for their body image. Participants were randomly assigned either to the experimental or control group. The experimental group participated in both body positivity program and virtual avatar program, whereas the control group attended the body positivity program, only. The results affirmed that the body positivity program served as a psychological buffer prior to the virtual avatar stimulus. After the virtual avatar experience, the participants demonstrated self-acceptance by lowering their expectation on how they should look like. The findings from exit interviews enriched the quantitative results. This study verified the mechanism of the altered processing of the stored bodily memory by the egocentric sensory input of virtual avatars, and offered practical potential of the study outcomes to be applied in various emerging fields where novel applications of virtual 3D technology are sought, such as fashion e-commerce.
Malaria prevalence, knowledge, attitude, and practice among febrile patients attending Chagni health center, Northwest Ethiopia: a cross-sectional study
Authors: Belay Bogale , Gelana Tegenu , Gebresilassie Araya 
Published: July 2021

Abstract
Background
Ethiopia has achieved considerable progresses in the prevention and control of malaria in the past decades; hitherto it is a formidable health concern and socio-economic impediment. This study aimed at assessing the magnitude, knowledge, attitudes and practices towards malaria among febrile patients attending Chagni health center, northwest Ethiopia.

Methods
Health facility-based cross-sectional study was conducted to estimate the prevalence of malaria and KAP towards malaria among febrile patients at Chagni health center in Chagni Town during September 2017 to February 2018. In order to determine the magnitude of malaria, finger prick blood samples were collected and thick and thin smears were prepared and microscopically examined for the presence of malaria parasites. A pre-tested structured questionnaire was also applied to assess KAP of suspected malaria patients, attending the health center. Data were analyzed using SPSS version 20.0.

Results
Prevalence of malaria among febrile patients, who visited the sampled health facility, was 7.3%. Of these, Plasmodium falciparum, P. vivax, and mixed infections accounted for 55, 44.3 and 0.7% of the cases, respectively. This study also revealed that 97% of the respondents had ever heard about malaria and recognized it as a serious health problem. Mosquito bite was identified as the main malaria transmission. Taking drug (86.3%), use of mosquito nets (73.3%), drain stagnated water (68%), and house spay with insecticides (66%) were mentioned as the main malaria prevention methods. Mosquito net coverage and utilizations in the prior night were 98 and 75%, respectively. Indoor residual spraying (IRS) coverage was 99%, of which 77.5% of study participants’ houses have been sprayed in the last 6 months.

Conclusions
The current study revealed that prevalence of malaria among febrile illnesses in the study area was relatively low (7.3%) with a high proportion of P. falciparum. Besides, participants had adequate knowledge, encouraging attitudes, and good practices about prevention and control of malaria. However, some misconceptions on malaria disease, its transmission, and prevention have been noted that actually require due attention by the concerned stakeholders. The findings of this study could be used as important inputs for the implementation of effective malaria prevention and control methods, including community health education programs, and scaling up coverage of evidence-based interventions.
Candida species in community-acquired pneumonia in patients with chronic aspiration
Authors: Moss Benjamin J. , Musher Daniel M. 
Published: July 2021

Abstract
Background
When Candida species is found in a sputum culture, clinicians generally dismiss it as a contaminant. We sought to identify cases of community-acquired pneumonia (CAP) in which Candida might play a contributory etiologic role.

Methods
In a convenience sample of patients hospitalized for CAP, we screened for “high-quality sputum” by Gram stain (> 20 WBC/epithelial cell) and performed quantitative sputum cultures. Criteria for a potential etiologic role for Candida included the observation of large numbers of yeast forms on Gram stain, intracellular organisms and > 106 CFU/ml Candida in sputum. We gathered clinical information on cases that met these criteria for possible Candida infection.

Results
Sputum from 6 of 154 consecutive CAP patients had large numbers of extra- and intracellular yeast forms on Gram stain, with > 106 CFU/ml Candida albicans, glabrata, or tropicalis on quantitative culture. In all 6 patients, the clinical diagnoses at admission included chronic aspiration. Greater than 105 CFU/ml of a recognized bacterial pathogen (Streptococcus pneumoniae, Staphylococcus aureus, or Pseudomonas) or > 106 CFU/ml of other ‘normal respiratory flora’ (Lactobacillus species) were present together with Candida spp. in every case. Blood cultures yielded Candida in 2 cases, and 1,3-beta-D glucan was > 500 ng/mL in 3 of 3 cases in which it was assayed. Since all patients were treated with anti-bacterial and anti-fungal drugs, no inference about etiology can be derived from therapeutic response.

Conclusions
Candida spp. together with a recognized bacterial pathogen or normal respiratory flora may contribute to the cause of CAP in patients who chronically aspirate.
Atmospheric variables and subarachnoid hemorrhage: narrative review
Authors: Vasquez Harold E. , Prasad Lakshmi , Moscote-Salazar Luis Rafael , Agrawal Amit 
Published: July 2021

Abstract
Background
Stroke is a neurological emergency that tends to be the first cause of death in many countries. Atmospheric variables are strongly associated with stroke, in which subarachnoid hemorrhage (SAH) has been associated in many studies to meteorological risk factors such as air pollution, air pressure, weather changes, and ambient temperature. These characteristics may influence the brain circulation and cause SAH, being diagnosed as idiopathic SAH or SAH with unknown cause.

Objective
The main objective of this review is to present the most relevant meteorological risk factors that may develop subarachnoid hemorrhage according to the current evidence that supports the strong association.

Conclusion
Brain vessel circulation may be influenced by atmospheric variables such as air pollution and weather changes, generating intrinsic changes in the intima of the vessels which leads to vasospasm and with comorbidities associated may develop SAH.
Myths and misperceptions in pacemaker patients: a quasi experimental study to assess effect of an educational intervention
Authors: Kubra Ghulam , Hasan Fariha , Qadir Faisal , Rasheed Shazia , Shafquat Azam 
Published: July 2021

Abstract
Background
Misconceptions regarding activities after pacemaker implantation can result in restrictions in daily life. This study aims at measuring the correction of misconceptions following an educational intervention utilizing a picture based brochure and personal counseling.

Methods
One hundred and twenty-eight patients were enrolled in a quasi experimental study on the day after pacemaker implantation. Patients’ perceptions about safety of various daily activities, medical procedures, and usage of appliances, in the presence of pacemaker was assessed using a questionnaire before and ten days after an educational intervention using a pictorial brochure. The number of correct responses before and after the intervention was compared to assess the change in patients’ perception.

Results
A total of 128 patients were interviewed at baseline, of which 115 followed-up at 10 days. Mean age of patients was 60.31 ± 12.81 years. In total, 76 (59.4%) were male and 61(47.7%) were illiterate. Mean correct responses increased from 64.47 ± 29.48% to 92.29 ± 14.42% (p < 0.001). Percent of questions answered correctly improved in all three categories after the intervention. Correct answers increased from 74.57 ± 24.94% to 95.65 ± 11.48% (p < 0.001) for routine daily activities, 51.09 ± 33.9% to 84.78 ± 20.86% (p < 0.001) for medical procedures and 64.03 ± 37.36% to 92.57 ± 18.79% (p < 0.001) for domestic appliance usage.

Conclusion
Misconception that can adversely affect pacemaker patient’s quality of life can be corrected by counseling with pictorial based brochures regardless of the patient’s baseline knowledge or education.