bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of prucalopride in patients with chronic idiopathic constipation stratified by age, body mass index, and renal function: a post hoc analysis of phase III and IV, randomized, placebo-controlled clinical studies
Authors: Lembo Anthony , Staller Kyle , Boules Mena , Feuerstadt Paul , Spalding William , Gabriel André , Youssef Ashraf , Xie Yunlong , Terreri Brian , Cash Brooks D. 
Published: December 2024

Background: Prucalopride (1 or 2 mg once daily) is approved for treating adults with chronic idiopathic constipation (CIC). Objectives: We determined the effect of age, body mass index (BMI), and renal function on the efficacy and safety of prucalopride in adults with CIC. Design: Data were pooled from six 12-week, phase III–IV clinical studies in adults who received prucalopride (1 or 2 mg once daily) or placebo for CIC. Methods: Adults were stratified by age (<50; 50–64; ⩾65 years), BMI (underweight/healthy weight, <25 kg/m2; overweight, 25 to <30 kg/m2; obese, ⩾30 kg/m2), and renal function (normal renal function, estimated glomerular filtration rate (eGFR) ⩾90 mL/min/1.73 m2; mild renal impairment, eGFR 60 to <90 mL/min/1.73 m2; moderate renal impairment, eGFR 30 to <60 mL/min/1.73 m2). The primary efficacy endpoint was the proportion of patients with a mean of ⩾3 complete spontaneous bowel movements/week over 12 weeks. Safety data were evaluated descriptively. Results: Of 2484 patients stratified by age (prucalopride, n = 1237; placebo, n = 1247), 1402, 708, and 374 were aged <50, 50–64, and ⩾65 years, respectively. Of 2482 patients stratified by BMI (prucalopride, n = 1237; placebo, n = 1245), 1425, 713, and 344 were underweight/healthy weight, overweight, and obese, respectively. Of 2474 patients stratified by renal function (prucalopride, n = 1233; placebo, n = 1241), 1444, 869, and 161 had normal renal function, mild renal impairment, and moderate renal impairment, respectively. More prucalopride-treated than placebo-treated patients achieved the primary efficacy endpoint. The difference was significant for all subgroups, except for the obese and moderate renal impairment subgroups. More prucalopride-treated than placebo-treated patients reported treatment-related adverse events in most subgroups. Conclusion: Prucalopride demonstrated efficacy in adults with CIC, irrespective of age, BMI, and renal function. No unexpected safety concerns were identified. Trial registration: ClinicalTrials.gov identifiers ( https://clinicaltrials.gov/ ): NCT01147926, NCT01424228, NCT01116206, NCT00483886, NCT00485940, NCT00488137.
Research on the Extraction Conditions of Naringin, Antioxidant, Antibacterial Properties From Duong La Cam Pomelo Peel, Vietnam
Authors: Nguyen Thi Truc Phuong , Hoang Bich Ngoc , Huynh Xuan Phong , Bach Long Giang 
Published: December 2024

Objective Naringin was known to be a flavonoid compound with many biological activities and was present in pomelo peel. Duong La Cam pomelo was a speciality grapefruit in Tan Trieu commune, Vinh Cuu district, Dong Nai province. This study evaluated Duong La Cam pomelo extract's naringin content and antioxidant and antibacterial activities. Method Duong La Cam pomelo extract was extracted by ultrasonic method. Naringin content was determined based on the naringin standard curve. Biological activities were evaluated by DPPH, ABTS, Agar disk-diffusion method and The minimum inhibitory concentration (MIC). Results The research results of enriching the Naringin component in the Duong La Cam Pomelo extract were recorded with a content of 114 mg/gDW. Duong La Cam Pomelo extract was extracted by ultrasonic method with solvent and raw material ratio 1 g/10 mL, time 60 min, temperature 70 °C and using 80% Ethanol solvent. The results showed antioxidant capacity with IC50 values of 0.127 mg/mL (ABTS); 14 511 mg/mL (DPPH). Besides, the antibacterial ability of the sample was also recorded at the minimum inhibitory concentration of Escherichia coli of 2.5 mg/mL and Staphylococcus aureus of 5 mg/mL. Conclusions The study showed that the ultrasonic extraction method saves time but still ensures high naringin content and good activity in extraction. It can be seen that naringin extract from Duong La Cam grapefruit has great potential for application in the medical field.
Perceived barriers and facilitators of implementing a sustained smartphone-based telemonitoring program for pregnant women at high-risk for pre-eclampsia in the public and private sectors in Pakistan
Authors: Shahil-Feroz Anam , Riaz Andaz , Yasmin Haleema , Saleem Sarah , Bhutta Zulfiqar , Seto Emily 
Published: December 2024

Background In Pakistan, a smartphone-based telemonitoring (TM) program (Raabta) has been designed to support pregnant women with high risk for preeclampsia (HRPE) in Pakistan. However, implementing TM interventions is often challenging, particularly in low-resource settings, given the complexity of healthcare environments and variations in public and private health sectors. This study explores the potential barriers and facilitators for a sustained implementation of the Raabta program in public and private sector hospitals in Pakistan. Methods Using a qualitative description design, 57 semi-structured interviews with a diverse group of participants including patients from the public ( n = 15) and private sector hospitals ( n = 17), obstetricians from the public ( n = 5) and private sector hospitals ( n = 7), decision-makers ( n = 7) and telehealth experts ( n = 6). Participants were recruited using purposive and snowball sampling techniques. Interview transcripts were deductively analyzed using the Consolidated Framework for Implementation Research (CFIR) domains. Results Based on the CFIR domains, the findings included: (1) Raabta being perceived as user-friendly even for patients with low digital and language literacy; (2) Outer settings: Limited health and digital literacy, poor language proficiency, and cultural norms can influence the willingness and ability of public sector patients to use the Raabta; (3) Inner settings: The private health sector is well-equipped for the Raabta implementation, while the public health sector faces challenges related to physical space, limited human and financial resources, and physician resistance; (4) Individual characteristics: Majority participants demonstrated positive attitudes toward the Raabta program and expressed confidence in using it (5) Process: Recommendations included adopting a nurse-led model for the private sector, leveraging paramedics for monitoring the Raabta dashboard, integrating Raabta with existing digital platforms, and establishing an advisory committee for program sustainability. Conclusion Raabta implementation may be more feasible in the private sector due to patient demographics, health and digital literacy, cultural norms, financial resources, physician readiness, and hospital infrastructure.
RemoteHealthConnect: Innovating patient monitoring with wearable technology and custom visualization
Authors: Arun Sasipriya , Sykes Edward R. , Tanbeer Syed 
Published: December 2024

Objective This paper introduces RemoteHealthConnect, a novel web-based healthcare system designed to enable healthcare professionals to monitor patients remotely with enhanced efficacy. Central to our system is its integration with the Vitaliti™ wearable, equipped with biosensors for real-time vital signs monitoring. RemoteHealthConnect distinguishes itself by offering advanced, custom visualizations for interactive engagement with medical data, facilitating rapid clinical decision-making through intuitive access to vital signs and trends. The primary research question we sought to answer was: ‘Which design of vital sign visualizations is most effective in improving intuitive and rapid understanding for healthcare practitioners?’ Methods An iterative agile/SCRUM methodology was employed in the design and development of RemoteHealthConnect. We describe the architectural design of our web-based application, data visualization techniques, and user interface design. A user interface/user experience (UI/UX) study was conducted to assess the efficacy of our system. Results The usability study revealed the system's capacity to translate complex bedside data into accessible, real-world visualizations, promoting efficient pattern recognition and anomaly detection. This is crucial for enhancing clinician performance, regardless of the patient's location. The paper further details a usability study involving healthcare practitioners to ascertain RemoteHealthConnect's efficacy. The System Usability Scale (SUS) assessment yielded a score of 71.5, indicating high usability. This score is significant, positioning our system above the average usability threshold for healthcare technologies, and suggesting it as a valuable tool for remote patient monitoring. Conclusion Our web-based healthcare system and findings from the usability study contribute to the domains of Mobile Health (mHealth) and e-Health by advancing remote monitoring capabilities and offering a promising avenue for healthcare IT to improve patient care and clinician workflow.
Complex audio signal data compression and reconstruction: A benchmark data pre-processing approach for machine classification of chronic respiratory diseases
Authors: Albiges Timothy , Sabeur Zoheir , Arbab-Zavar Banafshe 
Published: December 2024

Objective To develop and evaluate innovative methods for compressing and reconstructing complex audio signals from medical auscultation, while maintaining diagnostic integrity and reducing dimensionality for machine classification. Methods Using the ICBHI Respiratory Challenge 2017 Database, we assessed various compression frameworks, including discrete Fourier transform with peak detection, time-frequency transforms, dictionary learning and singular value decomposition. Reconstruction quality was evaluated using mean squared error (MSE). The study has been conducted at Bournemouth University from January 2023 to 2024. Results The multi-resolution wavelet transform (MRWT) framework demonstrated superior performance with the lowest average MSE score of 0.037. The proposed time-frequency framework with MRWT achieved 80% accuracy in distinguishing chronic obstructive pulmonary disease from healthy samples. Conclusion Our study advances signal processing in medical auscultation, while it offers insights into effective compression and reconstruction methods for preserving diagnostic information. The MRWT approach shows promising outcomes for balancing compression efficiency and reconstruction accuracy in complex audio signals.
Member Adherence to a Health Insurer-Sponsored Gap Closure Program Using Multi-Target Stool DNA Test for Colorectal Cancer Screening
Authors: Greene Mallik , Pew Timo , Le Quang , Philp Alisdair , Johnson William K. , Ozbay A. Burak , Kisiel John , Dore Michael , Ebner Derek , Fendrick A. Mark , Limburg Paul 
Published: December 2024

Objectives: To describe member adherence to a mail-based, health insurer-sponsored gap closure program for colorectal cancer (CRC) screening using multi-target stool DNA (mt-sDNA; Cologuard®) tests. Methods: Combined patient data from Exact Sciences Laboratories LLC and data from mass-mailed mt-sDNA orders placed by a large Medicare Advantage Insurance Plan were analyzed (03/01/2023-06/30/2023). Adherence and time to test return were the primary and secondary outcomes, respectively. Their association with patient characteristics was evaluated using multivariable regression. Results: Among the 3201 member-patients included (86.6% aged 65-75 years; 58.7% female), adherence rate was 49.4%, and mean time to test return was 25.5 days. After multivariable adjustment, the odds of test return were significantly higher among 65- to 75-year-olds (odds ratio [OR] = 1.59 relative to 45- to 64-year-olds), those living in small towns (OR = 1.43 relative to metropolitan-located individuals), and with digital outreach via both SMS and email (OR = 4.31 relative to no digital outreach). Time to test return was shorter in 65- to 75-year-olds than in 45- to 64-year-olds and was not associated with other patient characteristics. Conclusions: Mass-mailed mt-sDNA tests for CRC screening were associated with an overall adherence rate of about 50% in this Medicare Advantage population, with higher likelihood of test return among patients receiving digital outreach.
Sexual and Gender Minority Health Care Issues Related Competence and Preparedness Among the Health Care Professionals and Trainees in India: A Comparative Study
Authors: Sharma Mini , Mohlia Apoorva , Kukreti Prerna , Saurabh  , Kataria Dinesh 
Published: December 2024

Background: The Lesbian, Gay, Bisexual, Transgender and additional Queer, Intersex, asexual and agender (LGBTQIAA+) community is roughly 3.8% of the population of India. However, the services in terms of availability and competence are currently limited in the Indian healthcare system. Aim: To assess self-reported competence and preparedness of primary healthcare individuals and trainees in India (primarily Delhi) and compare the findings with Western studies. Setting and design: A cross-sectional study was designed to study sexual and gender minority (SGM) healthcare issues related to the competence and preparedness among the primary healthcare individuals and trainees at a tertiary healthcare centre. The study population included: Faculty members, Residents, Postgraduate trainees, Undergraduate trainees and Nursing staff. The study was conducted using an online Google survey after ethical clearance. Method and material: A cross-sectional Web-based survey was conducted for the medical and nursing healthcare professionals and trainees at a tertiary healthcare centre to assess competence and preparedness to deal with SGM healthcare issues using a questionnaire for the assessment of self-reported competence, comfort and preparedness for sexual orientation, gender identity and sex development health issues based on competencies outlined by the AAMC (Association of American Medical Colleges). A minimum of 25 participants in each of the four equally stratified groups were recruited using purposive sampling over 3 months. Statistical analysis used: The data was analysed using Epicollect software. Results: Satisfactory comfort and competence among the study groups are in line with the available Western literature though contrary to findings of Indian studies where inadequacy of knowledge regarding homosexuality was a major finding. A majority of positive responses in comfort, competency and knowledge are reflective of the change in attitude and culture among the modern society and effectiveness of awareness and support groups in government colleges of Delhi which was comparable with the available Indian and Western literature. Conclusion: Our study is a pioneer work to assess the healthcare workers’ skills in the assessment approach for the SGM population. The findings of our study may be useful further to develop objective measures to evaluate the competency and knowledge of healthcare providers.
Outcomes of an integrated knowledge translation approach in five African countries: a mixed-methods comparative case study
Authors: Sell Kerstin , Rehfuess Eva , Osuret Jimmy , Bayiga-Zziwa Esther , Geremew Bezinash , Pfadenhauer Lisa 
Published: December 2024

Abstract
Background
Integrated knowledge translation (IKT) aims to enhance evidence-informed decision-making in public health and healthcare by establishing continuous relationships between researchers and knowledge users, in particular decision-makers. The Collaboration for Evidence-Based Healthcare and Public Health in Africa (CEBHA+) undertook research on noncommunicable diseases in Ethiopia, Malawi, Rwanda, South Africa and Uganda. Alongside the research activities, we implemented an IKT approach, which entailed training and the development and implementation of site-specific IKT strategies. We evaluated these strategies according to a predefined programme theory.

Methods
Drawing on our published protocol (https://rdcu.be/dyfBP), we interviewed and surveyed CEBHA+ researchers and their decision-making counterparts during two project stages (3/2020–2/2021; 9/2022–5/2023) and collected IKT-related documents. Transcripts and documents were analysed using qualitative content analysis and surveys were analysed descriptively, with subsequent integration, cross-case analysis and revision of the programme theory.

Results
A total of 36 researchers and 19 decision-makers participated in surveys, focus groups and/or interviews, and we collected 92 documents. Relationship building, capacity building and collaborative research were the most proximal intervention outcomes: CEBHA+ researchers and their counterparts built mutual appreciation and partnerships, accessed contacts and networks, and expanded skills in conducting and using research and in IKT. The level of trust between partners varied. Intermediate outcomes were changes in attitudes and knowledge; beyond the conceptualization in our initial programme theory, researchers substantially increased their understanding of the decision-making context and developed a vision for “research impact”. While it was challenging to evaluate distal outcomes, the IKT approach was linked to the production of research perceived as addressing local priorities and being highly applicable and contextualized, and some consideration of evidence among decision-makers. Unintended effects included high opportunity costs associated with undertaking IKT. An unanticipated outcome was the heightened interest of the research funder in policy engagement. Our updated programme theory constitutes a low-level theory for IKT.

Conclusions
Whilst this study faced many challenges common to the evaluation of knowledge translation interventions, it presents rich, theory-informed insights into IKT outcomes. These are based on documented IKT activities and participants’ views, particularly in-depth insights of researchers’ experiences with implementing the CEBHA+ IKT approach.
Longitudinal study on the influence of sow and piglet vaccination on seroprevalence of Salmonella Typhimurium in rearing pigs and at slaughter in a farrow-to-finish production system
Authors: Nicolaisen Thies , Vornholz Hubertus , Köchling Monika , Lillie-Jaschniski Kathrin , Brinkmann Detert , Vonnahme Jörg , Hennig-Pauka Isabel 
Published: December 2024

Abstract
Background
Salmonella is widespread in pig husbandry and pork is an important source for human salmonellosis. Surveillance programmes are conducted in many European countries and various management measures are implemented on farm level to control Salmonella. Piglet or maternal vaccination can reduce Salmonella shedding and lower the likelihood of piglet infection. Proper management of risk factors can help to maintain low infection pressure. The aim of the study was to evaluate the effect of sow vaccination and piglet vaccination on Salmonella seroprevalence at slaughter.

Results
Different vaccination strategies were evaluated for their effect on seroprevalences in nursery (serum) and slaughter pigs (meat juice) in a farrow-to-finish production chain tested positive for Salmonella Typhimurium (ST). Antibody levels of four piglet groups from one rearing farm and of pigs from four downstream fattening farms were measured by Salmonella LPS-ELISA in a longitudinal study (UNVAC: no vaccination against Salmonella; PIGVAC: piglets vaccinated twice with an attenuated Salmonella Cholerasuis (SC) live vaccine; SOWVAC-1: piglets born from sows vaccinated twice before farrowing with attenuated ST live vaccine; SOWVAC-2: Piglets from vaccinated sows (ST) which had been vaccinated twice already as a piglet (ST). Results revealed significantly lower ELISA optical density (OD) values (p < 0.05) and fewer serological positive piglets (OD > 40) from groups PIGVAC, SOWVAC-1 and SOWVAC-2 compared to group UNVAC at the end of rearing period. Summarizing results from pigs of all fattening farms revealed that pigs from group PIGVAC had significantly lower ELISA OD values in meat juice samples than all other groups (p < 0.05).

Conclusion
Piglet (SC) and sow vaccination (ST) led to significant reduction in detectable antibodies in a ST positive production chain and thus to reduced likelihood of infection during rearing. The results reflect that vaccination with a live attenuated SC vaccine resulted in cross-protection against ST without producing antibodies detectable by standard Salmonella LPS-ELISA. Summarizing all fattening farms, piglet vaccination reduced seroprevalence at the time of slaughter. In conclusion, sow and piglet vaccination with attenuated live vaccines against Salmonella are good instruments to reduce the infection pressure in the rearing period but need additional management measures to show effect on seroprevalence at slaughter.
Enhancing Thyroid Pathology With Artificial Intelligence: Automated Data Extraction From Electronic Health Reports Using RUBY
Authors: Culié Dorian , Schiappa Renaud , Contu Sara , Seutin Eva , Pace-Loscos Tanguy , Poissonnet Gilles , Villarme Agathe , Bozec Alexandre , Chamorey Emmanuel 
Published: December 2024

PURPOSE
Thyroid nodules are common in the general population, and assessing their malignancy risk is the initial step in care. Surgical exploration remains the sole definitive option for indeterminate nodules. Extensive database access is crucial for improving this initial assessment. Our objective was to develop an automated process using convolutional neural networks (CNNs) to extract and structure biomedical insights from electronic health reports (EHRs) in a large thyroid pathology cohort.

MATERIALS AND METHODS
We randomly selected 1,500 patients with thyroid pathology from our cohort for model development and an additional 100 for testing. We then divided the cohort of 1,500 patients into training (70%) and validation (30%) sets. We used EHRs from initial surgeon visits, preanesthesia visits, ultrasound, surgery, and anatomopathology reports. We selected 42 variables of interest and had them manually annotated by a clinical expert. We developed RUBY-THYRO using six distinct CNN models from SpaCy, supplemented with keyword extraction rules and postprocessing. Evaluation against a gold standard database included calculating precision, recall, and F1 score.

RESULTS
Performance remained consistent across the test and validation sets, with the majority of variables (30/42) achieving performance metrics exceeding 90% for all metrics in both sets. Results differed according to the variables; pathologic tumor stage score achieved 100% in precision, recall, and F1 score, versus 45%, 28%, and 32% for the number of nodules in the test set, respectively. Surgical and preanesthesia reports demonstrated particularly high performance.

CONCLUSION
Our study successfully implemented a CNN-based natural language processing (NLP) approach for extracting and structuring data from various EHRs in thyroid pathology. This highlights the potential of artificial intelligence-driven NLP techniques for extensive and cost-effective data extraction, paving the way for creating comprehensive, hospital-wide data warehouses.