bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breathing techniques to reduce symptoms in people with serious respiratory illness: a systematic review
Authors: Burge Angela T. , Gadowski Adelle M. , Jones Alice , Romero Lorena , Smallwood Natasha E. , Ekström Magnus , Reinke Lynn F. , Saggu Ravijyot , Wijsenbeek Marlies , Holland Anne E. 
Published: October 2024

BackgroundIn adults with serious respiratory illness, breathlessness is prevalent and associated with reduced health-related quality of life. The aim of this review was to assess the impact of breathing techniques on breathlessness in adults with serious respiratory illness.MethodsElectronic databases were searched to identify randomised controlled trials testing breathing techniques (techniques that aim to alter the respiratory pattern, excluding respiratory muscle training) in people with serious respiratory illness. The primary outcome was breathlessness and secondary outcomes were health-related quality of life and adverse events. Two authors independently screened for inclusion, evaluated risk of bias and extracted data.Results73 randomised controlled trials were included with 5479 participants, most with COPD or asthma. Breathing exercises (pursed lip and/or diaphragmatic breathing) reduced breathlessness measured by the modified Medical Research Council scale compared to usual care (mean difference (MD) −0.40 points, 95% CI −0.70– −0.11, eight studies, n=323), although the effect did not exceed the minimal important difference. Yoga breathing also improved modified Medical Research Council score compared to usual care (MD −1.05 points, 95% CI −2.45–0.35, three studies, n=175). Breathing techniques consistently improved health-related quality of life in people with COPD and asthma on multiple health-related quality of life measures in comparison to usual care, with effects that generally exceeded the minimal important difference. No adverse events related to breathing techniques were reported.ConclusionBreathing techniques may improve breathlessness, and consistently improve health-related quality of life, in people with serious respiratory illness. These findings support the use of breathing exercises in the care of people with serious respiratory illness.
Regional distribution of unbound eletriptan and sumatriptan in the CNS and PNS in rats: implications for a potential central action
Authors: Svane Nana , Bällgren Frida , Ginosyan Aghavni , Kristensen Mie , Brodin Birger , Loryan Irena 
Published: October 2024

Abstract
Background
Triptans are potent 5-HT1B/1D/1F receptor agonists used in migraine therapy, thought to act through peripheral mechanisms. It remains unclear whether triptans cross the blood-brain barrier (BBB) sufficiently to stimulate central 5-HT1B/1D/1F receptors. This study investigates the disposition of eletriptan and sumatriptan in central nervous system (CNS) and peripheral nervous system (PNS) regions and predicts regional 5-HT1B/1D/1F receptor occupancies at clinically relevant concentrations.

Methods
Using the Combinatory Mapping Approach (CMA) for regions of interest (ROI), we assessed the unbound tissue-to-plasma concentration ratio (Kp, uu, ROI) in rats at steady state across CNS (hypothalamus, brain stem, cerebellum, frontal cortex, parietal cortex, striatum, hippocampus, whole brain, and spinal cord) and PNS (trigeminal ganglion and sciatic nerve) regions. We used Kp, uu, ROI values to estimate unbound target-site concentrations and 5-HT1B/1D/1F receptor occupancies in humans.

Results
We observed heterogenous triptan transport across CNS and PNS regions with the highest extent of unbound drug transport across the blood-nerve barrier in the trigeminal ganglion (Kp, uu, TG: eletriptan: 0.519, and sumatriptan: 0.923). Both drugs displayed restricted entry across the BBB (Kp, uu, whole brain: eletriptan: 0.058, and sumatriptan: 0.045) combined with high inter-regional variability. We estimated near-complete receptor occupancy in the trigeminal ganglion, while lower occupancies were observed in the whole brain, irrespective of the drug or receptor subtype. For instance, eletriptan was predicted to achieve 84% 5-HT1B receptor occupancy in the trigeminal ganglion and 37% in the whole brain at clinically relevant concentrations.

Conclusions
This study suggests that despite low BBB transport, both eletriptan and sumatriptan achieve unbound concentrations sufficient to stimulate 5-HT1B, 5-HT1D, and 5-HT1F receptors not only in the trigeminal ganglion, but also in the CNS. Further research is needed to determine whether central mechanisms contribute to triptan’s antimigraine effect and/or side effects.

Graphical Abstract
Towards realist-informed ripple effects mapping (RREM): positioning the approach
Authors: Harris Kevin , Nobles James , Ryan Louis , Szedlak Christoph , Taylor Hannah , Hawkins Rowena , Cline Alice , Smith Elizabeth , Hall Amelia 
Published: October 2024

Abstract
Background
Evaluation approaches such as ripple effects mapping (REM) and realist evaluation have emerged as popular methodologies to evidence impact, and the processes of change within public health as part of whole systems approaches. Despite the various examples of their implementation across different evaluation settings, there has been little or no evidence of how they might be effective when combined.

Methods
With REM’s potential to pragmatically illustrate impact, and realist evaluation’s strength to identify how and why impacts emerge, this paper develops a rationale and process for their amalgamation. Following this, we outline a realist-informed ripple effects mapping (RREM) protocol drawing upon a physical activity based case study in Essex that may be suitable for application within evaluation settings in a range of public health, whole system and physical activity settings.

Discussion
Combining these two approaches has the potential to more effectively illuminate the impacts that we see within public health and whole system approaches and initiatives. What is more, given the complexity often imbued within these approaches and initiatives, they hold capability for also capturing the causal mechanisms that explain these impacts.

Conclusions
It is our conclusion that when combined, this novel approach may help to inspire future research as well as more effective evaluation of public health and whole system approaches. This is crucial if we are to foster a culture for learning, refinement and reflection.
Low transthyretin concentration linked to adverse prognosis in elderly inpatients
Authors: Wang Ting , Yang Zhi-kai , Wan Yu-hao , Chai Ke , Li Ying-ying , Luo Yao , Zeng Min , Sun Ning , Zou Song , Wang Hua 
Published: October 2024

Abstract
Background
To investigate the association between low transthyretin (prealbumin) concentration and mortality or readmission for all causes in elderly inpatients.

Methods
This analysis is based on a prospective cohort study conducted from September 2018 to April 2019 in ten wards of three tertiary referral hospitals in Beijing. Patients aged 65 years or older were enrolled, and their clinical data, laboratory test results, and auxiliary test results for patients were collected. A three-year follow-up was conducted with patients. Based on the 5th and 95th percentiles of transthyretin concentration, patients were split into three groups. The correlation between transthyretin concentration and the outcome of elderly hospitalized patients was investigated. The primary outcome of the research was death or readmission from all causes within three years.

Results
Among the 636 individuals in the study, 335 (52.7%) were males, with a median age of 74.7 years (interquartile range [IQR]: 69.3–80.1). During a median follow-up period of 1,099.0 days (IQR: 1,016.3-1,135.0), 363 individuals (57.0%) experienced all-cause mortality or readmission events. Patients with transthyretin concentrations at or below the 5th percentile had a significantly increased risk of all-cause mortality or readmission compared to those with concentrations between the 5th and 95th percentiles (hazard ratio [HR]: 2.25; 95% confidence interval [CI]: 1.55–3.26). Even after adjusting for potential confounders, low transthyretin concentration remained an independent risk factor for poor prognosis in elderly inpatients (HR: 1.84; 95% CI: 1.03–3.28). Since women have consistently lower baseline transthyretin levels than men, we performed gender-specific analysis. We found that low transthyretin concentration is an independent risk factor for adverse prognosis in elderly male inpatients (HR: 2.99; 95% CI: 1.35–6.62) but not in females.

Conclusions
Low transthyretin concentrations are associated with increased all-cause mortality or readmission in elderly inpatients, particularly among male patients.

Graphical Abstract
Assessing the change in prevalence and characteristics of canadians utilizing chiropractic services across two time periods 2001–2010 and 2015–2018: a population-based repeated cross-sectional study
Authors: Mior Silvano , Wang Dan , Wong Jessica J. , Hogg-Johnson Sheilah , Côté Pierre 
Published: October 2024

Abstract
Background
Despite increases in musculoskeletal disorders (MSD) in Canada, evidence suggests utilization of chiropractic services has remained relatively stable over time. Understanding the extent to which chiropractors are consulted and factors associated with their utilization may suggest factors related to accessing care. We assessed the change in prevalence and characteristics of Canadians seeking chiropractic care across two time periods 2001–2010 and 2015–2018.

Methods
We used national cross-sectional data from seven cycles of the Canadian Community Health Survey between 2001 and 2018. The survey included Canadians aged 12 years and older living in private dwellings in all provinces and territories. National annual weighted prevalence and age-standardized weighted prevalence (and 95% confidence intervals) of chiropractic utilization were calculated. We calculated prevalence of chiropractic utilization stratified by demographic, socioeconomic, lifestyle and health-related variables. Crude linear trends and change in prevalence from 2001 to 2010 were assessed using linear regression models.

Results
The national annual prevalence of Canadians consulting a chiropractor in the previous 12 months slightly increased from 11.0% (95% CI 10.8, 11.3) in 2001 to 11.4% (95%CI 11.1, 11.7) in 2010, and in those reporting receiving regular health care from a chiropractor from 7.5% (95%CI 7.2, 7.7) in 2015 to 7.9% (95%CI 7.7, 8.2) in 2018. Prevalence of utilization varied by province, highest in the Western provinces but lowest in Atlantic provinces. The age-specific prevalence of chiropractic utilization was highest in those aged 35–49 years and remained stable over time, except for slight increase in those aged 65–79 years. A higher percentage of Canadians identifying as white, Canadian-born, in the highest quintile of household income, overweight, physically active and in excellent health reported seeking chiropractic services. The most common reported chronic conditions measured in the survey among Canadians consulting chiropractors were chronic back problems, arthritis, fibromyalgia and headaches.

Conclusion
The national prevalence of utilization of chiropractic services among Canadians slightly increased over time but varied by province and respondents’ socioeconomic and health characteristics. Chronic back problems were the most common reported chronic condition. This comprehensive population-based study on chiropractic utilization in Canada can be used to inform decisions concerning health human resources and access to rehabilitation care for MSD.
Exploring action-oriented models via active inference for autonomous vehicles
Authors: Nozari Sheida , Krayani Ali , Marin Pablo , Marcenaro Lucio , Gomez David Martin , Regazzoni Carlo 
Published: October 2024

AbstractBeing able to robustly interact with and navigate a dynamic environment has been a long-standing challenge in intelligent transportation systems. Autonomous agents can use models that mimic the human brain to learn how to respond to other participants’ actions in the environment and proactively coordinate with the dynamics. Modeling brain learning procedures is challenging for multiple reasons, such as stochasticity, multimodality, and unobservant intents. Active inference may be defined as the Bayesian modeling of a brain with a biologically plausible model of the agent. Its primary idea relies on the free energy principle and the prior preference of the agent. It enables the agent to choose an action that leads to its preferred future observations. An exploring action-oriented model is introduced to address the inference complexity and solve the exploration–exploitation dilemma in unobserved environments. It is conducted by adapting active inference to an imitation learning approach and finding a theoretical connection between them. We present a multimodal self-awareness architecture for autonomous driving systems where the proposed techniques are evaluated on their ability to model proper driving behavior. Experimental results provide the basis for the intelligent driving system to make more human-like decisions and improve agent performance to avoid a collision.
A bayesian shared component spatial modeling approach for identifying the geographic pattern of local associations: a case study of young offenders and violent crimes in Greater Toronto Area
Authors: Law Jane , Abdullah Abu Yousuf Md 
Published: October 2024

Abstract
Background setting
Traditional spatial or non-spatial regression techniques require individual variables to be defined as dependent and independent variables, often assuming a unidirectional and (global) linear relationship between the variables under study. This research studies the Bayesian shared component spatial (BSCS) modeling as an alternative approach to identifying local associations between two or more variables and their spatial patterns.

Methods
The variables to be studied, young offenders (YO) and violent crimes (VC), are treated as (multiple) outcomes in the BSCS model. Separate non-BSCS models that treat YO as the outcome variable and VC as the independent variable have also been developed. Results are compared in terms of model fit, risk estimates, and identification of hotspot areas.

Results
Compared to the traditional non-BSCS models, the BSCS models fitted the data better and identified a strong spatial association between YO and VC. Using the BSCS technique allowed both the YO and VC to be modeled as outcome variables, assuming common data-generating processes that are influenced by a set of socioeconomic covariates. The BSCS technique offered smooth and easy mapping of the identified association, with the maps displaying the common (shared) and separate (individual) hotspots of YO and VC.

Conclusions
The proposed method can transform existing association analyses from methods requiring inputs as dependent and independent variables to outcome variables only and shift the reliance on regression coefficients to probability risk maps for characterizing (local) associations between the outcomes.
A cluster analysis of attachment styles in patients with borderline personality disorder, bipolar disorder and ADHD
Authors: Kouros I. , Isaksson M. , Ekselius L. , Ramklint M. 
Published: October 2024

Abstract
Background
Insecure adult attachment has been associated with psychiatric disorders characterized by emotional dysregulation, such as borderline personality disorder (BPD), bipolar disorder (BD) and attention deficit/hyperactivity disorder (ADHD). However, little is known about the differences in attachment patterns between these diagnostic groups. The aim of this study was to identify clusters of adult attachment style in a cross-diagnostic group of patients with BDP and/or BD and/or ADHD and explore the characteristics of these clusters based on temperament profile, childhood trauma and psychiatric diagnoses.

Methods
K-means cluster analysis was used to identify subgroups, based on the Attachment Style Questionnaire Short Form dimensions, in a clinical cohort of 150 young adults (113 women and 37 men, mean age ± SD = 23.3 ± 2.1) diagnosed with BPD, and/or BD, and/or ADHD.

Results
Three distinct clusters were identified: a secure, an insecure/avoidant-anxious and an insecure/avoidant cluster. These three clusters differed in temperament profile and related psychiatric diagnoses.

Conclusions
The three clusters of attachment in individuals with BPD, BD and/or ADHD could support differentiation between the disorders as well provide information usable for planning of treatment.
Development and evaluation of a standardised sampling protocol to determine the effect of cleaning in the pig sty
Authors: Dahlin Lisa , Hansson Ingrid , Fall Nils , Sannö Axel , Jacobson Magdalena 
Published: October 2024

Abstract
Background
All-in, all-out with strict hygienic routines is necessary in modern pig production. Furthermore, a standardised, validated method is needed to quantitatively control the effect of these hygiene protocols. This study aimed to establish a reproducible and reliable sampling method to assess cleaning of the pig pen.

Methods
Sterilised pig faeces were mixed with indicator bacteria (i.e. Enterococcus hirae, Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus) and spread out in a controlled environment. The retrieval rate of three different sampling methods were evaluated; swabbing by (i) a cloth and (ii) a sponge, analysed by standardised bacterial culture and counting of colony-forming units, and (iii) a cotton swab analysed by adenosine triphosphate (ATP) bioluminescence. Two time-points were evaluated during the study; after drying overnight and after manual scraping of the surfaces. To determine sample-to-sample variability, sampling by the cloth and the cotton swab was carried out after manual scraping and further, after high-pressure washing with cold water.

Results
Sampling by the cloth and the sponge showed few differences in in the number of CFU obtained before and after the manual scraping (retrieval rate), whereas the swabs, measuring ATP bioluminescence, showed a very high retrieval rate. Sample-to-sample variability was low for all three methods.

Conclusions
In conclusion, to sample pens for the presence of bacteria, the cloth was assessed as the preferable material, being cheap, easy, specific, and approachable, and with a low sample-to-sample variability. The ATP measurement could have potential for use when evaluating the cleaning of stables, however, threshold values for evaluating the cleaning of a pig sty needs to be developed.
Probing clarity: AI-generated simplified breast imaging reports for enhanced patient comprehension powered by ChatGPT-4o
Authors: Maroncelli Roberto , Rizzo Veronica , Pasculli Marcella , Cicciarelli Federica , Macera Massimo , Galati Francesca , Catalano Carlo , Pediconi Federica 
Published: October 2024

Abstract
Background
To assess the reliability and comprehensibility of breast radiology reports simplified by artificial intelligence using the large language model (LLM) ChatGPT-4o.

Methods
A radiologist with 20 years’ experience selected 21 anonymized breast radiology reports, 7 mammography, 7 breast ultrasound, and 7 breast magnetic resonance imaging (MRI), categorized according to breast imaging reporting and data system (BI-RADS). These reports underwent simplification by prompting ChatGPT-4o with “Explain this medical report to a patient using simple language”. Five breast radiologists assessed the quality of these simplified reports for factual accuracy, completeness, and potential harm with a 5-point Likert scale from 1 (strongly agree) to 5 (strongly disagree). Another breast radiologist evaluated the text comprehension of five non-healthcare personnel readers using a 5-point Likert scale from 1 (excellent) to 5 (poor). Descriptive statistics, Cronbach’s α, and the Kruskal–Wallis test were used.

Results
Mammography, ultrasound, and MRI showed high factual accuracy (median 2) and completeness (median 2) across radiologists, with low potential harm scores (median 5); no significant group differences (p ≥ 0.780), and high internal consistency (α > 0.80) were observed. Non-healthcare readers showed high comprehension (median 2 for mammography and MRI and 1 for ultrasound); no significant group differences across modalities (p = 0.368), and high internal consistency (α > 0.85) were observed. BI-RADS 0, 1, and 2 reports were accurately explained, while BI-RADS 3–6 reports were challenging.

Conclusion
The model demonstrated reliability and clarity, offering promise for patients with diverse backgrounds. LLMs like ChatGPT-4o could simplify breast radiology reports, aid in communication, and enhance patient care.

Relevance statement
Simplified breast radiology reports generated by ChatGPT-4o show potential in enhancing communication with patients, improving comprehension across varying educational backgrounds, and contributing to patient-centered care in radiology practice.

Key Points

AI simplifies complex breast imaging reports, enhancing patient understanding.

Simplified reports from AI maintain accuracy, improving patient comprehension significantly.

Implementing AI reports enhances patient engagement and communication in breast imaging.

Graphical Abstract
Adaptation of the International Outcome Inventory for Hearing Aids (IOI-HA) in Hindi
Authors: Rachana Dhananjay , Rajalakshmi K. 
Published: October 2024

Abstract
Purpose
The specific objectives of this study were as follows: (1) to translate and adapt the English version of the International Outcome Inventory for Hearing Aids (IOI-HA) into Hindi, (2) to present data obtained from the hearing aid users, (3) and to investigate the effect of different factors on effective hearing aid use using the Hindi version of the IOI-HA.

Method
The English version of IOI-HA was translated to Hindi by three native Hindi speakers who were proficient in both Hindi and English and had Hindi as their first language. The Hindi version of IOI-HA along with a demographic questionnaire was given to 100 experienced hearing aid users who were literate and more than 18 years of age.

Results
The findings indicated 53% of individuals utilize their hearing aids for over 8 h daily, while 46% use them for 4 to 8 h a day. A greater number of participants experienced benefits from wearing their hearing aids, suggesting their overall effectiveness for users. Also, 64% of people said their HA was fulfilling their expectations. Sixty-seven percent of participants said life has become quite a lot better with HA usage. The results revealed that age, gender, and type of hearing loss showed no significant association with any test item.

Conclusion
The Hindi version of the IOI-HA has proven to be a valuable self-assessment tool for hearing aid users. It aids clinicians and audiological practitioners in comprehending the challenges faced by users and can offer guidance for counseling and assessing the benefits derived from hearing aids.