bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ensuring continuity of care in times of crisis: A longitudinal analysis of dementia care delivery during armed conflict
Authors: Radomyslsky Zorian , Kivity Sara , Alon Yaniv , Saban Mor 
Published: November 2024

Background Individuals with dementia are particularly vulnerable during emergency situations due to challenges with cognition, mobility, and daily functioning. However, little is known about how disruptive events may specifically impact the health of those with dementia. Objective To evaluate changes in health outcomes for individuals with and without dementia surrounding the Israel-Gaza war in October 2023. Specifically, we analyzed and compared changes in mental health status, medication adherence, healthcare service utilization, and associated costs between individuals with dementia (Study Group) and those without dementia (Control Group) during the period surrounding the Israel-Gaza war in October 2023. Method A prospective cohort study compared outcomes between individuals with dementia (Study Group, n = 24,178) and without (Control Group, n = 250,652) before and after the crisis onset. The conflict precipitously threw national systems into disarray, recruited healthcare personnel to the war effort, and disrupted supply chains. Results Compared to baseline, analysis revealed alterations in patterns of dementia diagnoses, healthcare service utilization, medication adherence, and associated costs during the crisis period for both groups. However, the Study Group experienced comparatively larger declines. Conclusions Findings provide insights into how humanitarian emergencies, through disruption of health systems and care networks, differentially impact continuity of dementia care. This underscores the need for tailored crisis response strategies to address the heightened vulnerabilities of patients with dementia.
Spontaneous umbilical cord entwinement in 1-day-old kittens
Authors: Glavinić Aida , Spahija Nermina , Kučlar Muftić Soraja , Šunje-Rizvan Amila , Čengić Benjamin , Mutevelić Tarik , Maksimović Alan 
Published: November 2024

Case summary A 1-year-old domestic shorthair queen with five neonates was referred for umbilical cord entwinement in three kittens 24 h after parturition. The owner noticed the kittens were stuck to each other 3 h before admission. Despite a conservative treatment approach, prolonged ischaemia led to dry gangrenous changes in one of the kitten’s metatarsi. Relevance and novel information This and other neonatal complications in cats are rarely reported. Primiparity is a known factor contributing to postpartum complications. Furthermore, inexperienced owners require more assistance in mitigating these challenges. Therefore, further research and collaboration among breeders, owners and veterinary professionals are imperative in order to accurately determine the prevalence of this condition in kittens and develop effective strategies to address it.
A national data sharing solution for the prevention and treatment of obesity—a qualitative study of stakeholders’ needs
Authors: Christenson Anne , Hemmingsson Joanna Uddén , Lagerros Ylva Trolle 
Published: November 2024

Study objectives Obesity-related health data is needed for studies and precision medicine, but existing registers, medical chart systems, and digital platforms are seldom compatible. Before creating improved ways of sharing health data, this study aimed to gather opinions, experiences, and wishes from stakeholders that may use obesity-related health data: healthcare, researchers, people with overweight or obesity, the pharmaceutical industry, and IT-specialists. Methods We performed semistructured interviews with 28 stakeholders and analyzed qualitative text data with inductive content analysis. We grouped the suggested parameters in categories. Results Time efficient data entering was perceived crucial. Access to health data was important to all participants. Some parameters, such as age, BMI, and sex were requested by all stakeholders. Other data were stakeholder specific, such as population-specific laboratory references, suggested by healthcare professionals only. For people with overweight or obesity, ability to share data with healthcare staff about fitness level or previous weight loss attempts, was important. Conclusion The results from this study can be used in the design and implementation of a national health data sharing solution that may be used for precision healthcare use and to evaluate and guide obesity treatment and preventive measures. Data parameters requested by all populations, such as BMI, sex, and age, should be prioritized when designing a data solution. Ability for individuals with overweight or obesity to share health data, may improve healthcare appointments and reduce weight stigma.
Health information-seeking behavior among people living with the two common chronic diseases in low and middle-income countries (LMICs). A systematic review and meta-analysis
Authors: Tesfa Getanew Aschalew , Demeke Abel Desalegn , Zewold Mesafint , Ngusie Habtamu Setegn 
Published: November 2024

Objective The main aim of this review was to systematically collect and summarize the available evidence on health information-seeking behavior among people living with the two common types of chronic diseases in LMICs. Methods For this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, Google Scholar, and forward and backward citations from included studies. The preferred reporting items for Systematic Reviews and Meta-Analyses (PRISMA) procedure were followed to develop and report the review. The pooled effect size and the effect's 95% confidence interval were calculated using a random-effect model meta-analysis for each research. A sub-group analysis was done to investigate potential sources of heterogeneity. To identify publication bias, Egger-weighted regression tests were employed. Results A total of 4281 articles were retrieved, with ten studies meeting the eligibility criteria for qualitative synthesis and only seven studies were eligible for the meta-analysis. The pooled extent of health information-seeking behavior among chronic disease patients was 50.5% (95% CI: 35.36–65.70, p = 0.00), with high heterogeneity (I2 = 98.25). Based on the sub-group analysis, it was found that 55% (95% CI: 29.9–79.4) of cancer patients and 40% (95% CI: 36.9%–43.9%) of DM patients sought out health-related information. In studies conducted before 2015, the level of health information seeking was 49%, increasing to 52% (95% CI: 41.0%–62.2%) after 2015. Conclusion The overall health information seeking behavior among diabetes and cancer patients has increased over time, but remains relatively low, with only nearly half actively seeking information. The findings also emphasize that patients require health-related information on various topics.. Health educators and health professionals should consider this diversity when developing interventions and educational materials to provide patients with the most comprehensive information and education regarding their healthcare issues. Protocol registration number CRD42023433169.
Identifying persistent high-cost patients in the hospital for care management: development and validation of prediction models
Authors: de Ruijter Ursula W. , Kaplan Z. L. Rana , Eijkenaar Frank , Maas Carolien C. H. M. , van der Heide Agnes , Bax Willem A. , Lingsma Hester F. 
Published: November 2024

Abstract
Background
Healthcare use by High-Need High-Cost (HNHC) patients is believed to be modifiable through better coordination of care. To identify patients for care management, a hybrid approach is recommended that combines clinical assessment of need with model-based prediction of cost. Models that predict high healthcare costs persisting over time are relevant but scarce. We aimed to develop and validate two models predicting Persistent High-Cost (PHC) status upon hospital outpatient visit and hospital admission, respectively.

Methods
We performed a retrospective cohort study using claims data from a national health insurer in the Netherlands—a regulated competitive health care system with universal coverage. We created two populations of adults based on their index event in 2016: a first hospital outpatient visit (i.e., outpatient population) or hospital admission (i.e., hospital admission population). Both were divided in a development (January-June) and validation (July-December) cohort. Our outcome of interest, PHC status, was defined as belonging to the top 10% of total annual healthcare costs for three consecutive years after the index event. Predictors were predefined based on an earlier systematic review and collected in the year prior to the index event. Predictor effects were quantified through logistic multivariable regression analysis. To increase usability, we also developed smaller models containing the lowest number of predictors while maintaining comparable performance. This was based on relative predictor importance (Wald χ2). Model performance was evaluated by means of discrimination (C-statistic) and calibration (plots).

Results
In the outpatient development cohort (n = 135,558), 2.2% of patients (n = 3,016) was PHC. In the hospital admission development cohort (n = 24,805), this was 5.8% (n = 1,451). Both full models included 27 predictors, while their smaller counterparts had 10 (outpatient model) and 11 predictors (hospital admission model). In the outpatient validation cohort (n = 84,009) and hospital admission validation cohort (n = 20,768), discrimination was good for full models (C-statistics 0.75; 0.74) and smaller models (C-statistics 0.70; 0.73), while calibration plots indicated that models were well-calibrated.

Conclusions
We developed and validated two models predicting PHC status that demonstrate good discrimination and calibration. Both models are suitable for integration into electronic health records to aid a hybrid case-finding strategy for HNHC care management.
An economic evaluation of first-line cryoballoon ablation versus antiarrhythmic drug therapy for the treatment of paroxysmal atrial fibrillation from a German healthcare payer perspective
Authors: Kuniss Malte , Hillcoat Lucy , Moss Joe , Straube Florian , Andrade Jason , Wazni Oussama , Chierchia Gian Battista , Schwegmann Lukas , Ismyrloglou Eleni , Sale Alicia , Mealing Stuart , Bromilow Tom , Lane Emily , Lewis Damian , Goette Andreas 
Published: November 2024

Abstract
Background
Three recent randomized controlled trials demonstrated that, in patients with symptomatic paroxysmal atrial fibrillation (PAF), first-line pulmonary vein isolation with cryoballoon catheter ablation reduces atrial arrhythmia recurrence compared to initial antiarrhythmic drug (AAD) therapy. This study aimed to evaluate the cost-effectiveness of first-line cryoablation compared to first-line AADs from a German healthcare payer perspective.

Methods
Individual patient-level data from 703 participants with untreated PAF enrolled into three randomized clinical trials (Cryo-FIRST, STOP AF First and EARLY-AF) were used to derive parameters for the cost-effectiveness model (CEM).
The CEM structure consisted of a hybrid decision tree and Markov model. The decision tree (one-year time horizon) informed initial health state allocation in the first cycle of the Markov model (40-year time horizon; three-month cycle length). Health benefits were expressed in quality-adjusted life years (QALYs). Cost inputs were sourced from German diagnosis-related groups and the Institute for the Hospital Remuneration System (InEK). Costs and benefits were discounted at 3% per annum.

Results
Cryoablation was cost-effective, incurring ~ €200 per patient while offering an increase in QALYs (~ 0.18) over a lifetime. This produced an average incremental cost-effectiveness ratio of ~ €1,000 per QALY gained. Individuals were expected to receive ~ 1.2 ablations over a lifetime, regardless of initial treatment. However, those initially treated with cryoablation as opposed to AADs experience 0.9 fewer re-ablations and a 45% reduction in time spent in AF health states.

Conclusion
Initial rhythm control with cryoballoon ablation in symptomatic PAF is a cost-effective treatment option in a German healthcare setting.
Heparan sulfate in cerebrospinal fluid as a biomarker to assess disease severity and for treatment monitoring in patients with Mucopolysaccharidosis Type II: a position statement
Authors: Giugliani Roberto , de Siqueira Ana Cecília Menezes , Santos Emerson Santana , Leão Emília Katiane E. A. , Carvalho Gerson da Silva , Santos Mara Lúcia Schmitz Ferreira , Raskin Salmo , Martins Ana Maria 
Published: November 2024

AbstractPatients with mucopolysaccharidosis type II (MPS II) can present with a severe neuronopathic phenotype or an attenuated non-neuronopathic phenotype. In the light of the recent development of drugs that cross the blood-brain barrier for treatment of neurologic MPS II symptoms, it is critical to define biomarkers that objectively differentiate phenotypes and monitor therapeutic outcomes of advanced treatments. In December 2023, a panel of Brazilian experts discussed the potential of quantifying heparan sulfate (HS) in the cerebrospinal fluid (CSF) as a biomarker for assessing neurological impairment in patients with MPS II, as well as the potential of the molecule as an objective parameter for therapeutic monitoring. Based on scientific evidence, the experts concluded that HS in CSF is predominantly derived from the brain and reflects neurological impairment in patients with MPS II. CSF HS levels may help differentiate between neuronopathic and non-neuronopathic forms of MPS II, with preliminary observations suggesting a potential threshold around 4,000 ng/mL when HS quantification is performed using the same method described in clinical studies of pabinafusp alfa. According to the authors, monitoring HS levels in CSF can serve as an objective parameter for assessing the effectiveness of treatment with drugs that cross the blood-brain barrier. The recommended timing of HS evaluations in CSF of patients with the severe phenotype is: (i) before treatment; (ii) six months after starting treatment; and (iii) two years after starting treatment. The same monitoring scheme is recommended for patients with the attenuated MPS II phenotype, however, after two years of treatment, the physician may elect to perform regular neurocognitive evaluations instead of measuring HS in CSF. Lastly, the authors reinforced the importance of evaluating adherence to treatment, including interruptions, to provide a more meaningful assessment of the treatment’s real-world impact and to determine the ideal timing of CSF collection for therapeutic monitoring.
YTHDF2 promotes anaplastic thyroid cancer progression by activating the DDIT4/AKT/mTOR signaling pathway
Authors: Dai Bao , Xu Lei , Rong Shikuo , Song Muye , Lan Ziteng , Chen Weijian , Zhang Lingyun , Liu Yongchen , Wang Linhe , Li Jinghua , Chen Jian , Wu Zeyu 
Published: November 2024

Abstract
Background
RNA methylation, an important reversible post-transcriptional modification in eukaryotes, has emerged as a prevalent epigenetic alteration. However, the role of the m6A reader YTH domain family 2 (YTHDF2) has not been reported in anaplastic thyroid cancer (ATC) and its biological mechanism is unclear.

Methods
The relationship between YTHDF2 expression and ATC was determined using data sets and tissue samples. A range of analytical techniques were employed to investigate the regulatory mechanism of YTHDF2 in ATC, including bioinformatics analysis, m6A dot-blot analysis, methylated RNA immunoprecipitation sequencing (MeRIP-seq), RNA immunoprecipitation (RIP) assays, RNA sequencing, RNA stability assays and dual luciferase reporter gene assays. In vitro and in vivo assays were also conducted to determine the contribution of YTHDF2 to ATC development.

Results
YTHDF2 expression was significantly increased in ATC. The comprehensive in vitro and in vivo experiments demonstrated that YTHDF2 knockdown significantly attenuated ATC proliferation, invasion, migration, and apoptosis promotion, whereas YTHDF2 overexpression yielded the opposite trend. Mechanistically, RNA-seq, MeRIP-seq and RIP-seq analysis, and molecular biology experiments demonstrated that YTHDF2 accelerated the degradation of DNA damage-inducible transcript 4 or regulated in DNA damage and development 1 (DDIT4, or REDD1) mRNA in an m6A-dependent manner, which in turn activated the AKT/mTOR signaling pathway and induced activation of epithelial-mesenchymal transition (EMT), thereby promoting ATC tumor progression.

Conclusions
This study is the first to demonstrate that elevated YTHDF2 expression levels suppress DDIT4 expression in an m6A-dependent manner and activate the AKT/mTOR signaling pathway, thereby promoting ATC progression. YTHDF2 plays a pivotal role in ATC progression, and it may serve as a promising therapeutic target in the future.
Impact of chemical snail control on intermediate host snail populations for urogenital schistosomiasis elimination in Pemba, Tanzania: findings of a 3-year intervention study
Authors: Trippler Lydia , Ali Said Mohammed , Masoud Msanif Othman , Mohammed Zahor Hamad , Amour Amour Khamis , Suleiman Khamis Rashid , Ame Shaali Makame , Kabole Fatma , Hattendorf Jan , Knopp Stefanie 
Published: November 2024

Abstract
Background
The World Health Organization (WHO) has set the goal of eliminating schistosomiasis as a public health problem globally by 2030 and to interrupt transmission in selected areas. Chemical snail control is one important measure to reduce transmission and achieve local elimination. We aimed to assess the impact of several rounds of chemical snail control on the presence and number of the Schistosoma haematobium intermediate snail host (Bulinus spp.) in water bodies (WBs) on Pemba Island, Tanzania, a setting targeted for elimination of urogenital schistosomiasis.

Methods
During the three annual intervention periods of the SchistoBreak study implemented in the north of Pemba from 2020 to 2024, malacological surveys were conducted up to four times per period in WBs of hotspot implementation units (IUs). Present freshwater snail species, vegetation, and WB characteristics were recorded. If Bulinus were found, the snails were inspected for Schistosoma infection and snail control with niclosamide was conducted.

Results
Across the three intervention periods, a total of 112 WBs were identified in 8 hotspots IUs. The spatial distribution of WBs with Bulinus per IU was heterogeneous, ranging from 0.0% (0/15) of WBs infested in one IU in 2022 to 80.0% (8/10) of WBs infested in one IU in 2021. Bulinus presence was significantly associated with lower pH values in WBs (odds ratio: 0.2, 95% confidence interval 0.1–0.4). A total of 0.2% (6/2360) of collected Bulinus were shedding Schistosoma cercariae. Following snail control, the number of Bulinus decreased or remained absent in 56.7% (38/67) of visits at WBs when compared with the previous visit in 2021, 54.9% (28/51) in 2022, and 33.3% (32/96) in 2023. In a total of 43.1% (22/55) of initially infested WBs, no Bulinus were found in the survey round conducted a few weeks after the first application of niclosamide. However, 25.4% (14/55) of WBs showed a pattern of recurring Bulinus presence.

Conclusions
The distribution of WBs containing Bulinus was very heterogeneous. The percentage of Bulinus with patent Schistosoma infection in our study area was extremely low. Repeated niclosamide application reduced the number of Bulinus in WBs, but snails often recurred after one or multiple treatments. While chemical mollusciciding can reduce snail numbers, to fully break the S. haematobium transmission cycle, timely diagnosis and treatment of infected humans, access to clean water, sanitation, and health communication remain of prime importance.
Trial registration: ISRCTN, ISRCTN91431493. Registered 11 February. 2020, https://www.isrctn.com/ISRCTN91431493

Graphical Abstract
Analysis of spatial filtering in neural spatiospectral filters and its dependence on training target characteristics
Authors: Briegleb Annika , Kellermann Walter 
Published: November 2024

AbstractMask-based multichannel speech enhancement methods based on artificial neural networks estimate a mask that is applied to the multichannel input signal or a reference channel to obtain the estimated desired signal. For the estimation, both spectral and spatial cues from the multichannel input can be used. However, the interplay of the two inside the neural network is typically unknown. In this contribution, we propose a framework to analyze neural spatiospectral filters (NSSFs) with respect to their capabilities to extract and represent spatial information. We explicitly take the characteristics of the training target signal into account and analyze its effect on the functionality of the NSSF. Using two conceptually different NSSFs as example, we show that not all NSSFs use spatial information under all circumstances and that the training target signal has a significant influence on the spatial filtering behavior of an NSSF. These insights help to assess the signal processing capabilities of neural networks and allow to make informed decisions when configuring, training, and deploying NSSFs.
Numerical Response of Concrete-Filled Steel Tubular (CFST) Columns Externally Strengthened with FRP Composites Subjected to Cyclic Loading
Authors: Mansour Walid , Osama Bothaina , Li Weiwen , Wang Peng , Sobuz Md. Habibur Rahman 
Published: November 2024

AbstractThe ultimate load-carrying capacity of concrete-filled steel tubular (CFST) columns exposed to monotonic loadings can be greatly increased by strengthening those columns, and the occurrence of the steel tube's outward buckling can be postponed. The current research aims to study the possibility of improving the structural characteristics of CFST columns exposed to cyclic loadings in terms of lateral load capacity and absorbed energy by strengthening them with different patterns of fiber-reinforced polymer (FRP) sheets. The ABAQUS software was used to create a three-dimensional (3D) non-linear finite element model (FEM) to simulate the behavior of FRP-strengthened CFST columns exposed to monotonic and cyclic loadings. After ascertaining the accuracy of the proposed model's results in successfully predicting failure patterns and lateral loads compared to the experimental results of tested specimens available in the literature, the model was used to create a parametric study. The parametric study focused on the impacts of the thickness, location, and length of the strengthening sheets on the failure pattern, lateral load-carrying capacity, stiffness, cumulative energy, absorbed energy, and viscous damping factor of the CFST columns exposed to cyclic loadings. The results revealed that the un-strengthened specimen displayed a maximum lateral load of 185 kN and a viscous damping factor of 45.2% at a lateral drift of 5.7%. On the other hand, strengthening the CFST column using five layers of FRP sheets exhibited the highest lateral load of all investigated columns (50% more than the un-strengthened specimen). Additionally, at a lateral drift of 5.7%, the decrease in viscous damping factor of CFST specimens due to strengthening using 1, 2, 3, 4, and 5 layers of FRP sheets with respect to the control specimen was 7.9%, 14.9%, 20.8%, 27.7%, and 30.3%, respectively.