bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamic Interplay of Online Risk and Resilience in Adolescence (DIORA): a protocol for a 12-month prospective observational study testing the associations among digital activity, affective and cognitive reactions and depression symptoms in a community sample of UK adolescents
Authors: Kostyrka-Allchorne Katarzyna , Stoilova Mariya , Bourgaize Jake , Murray Aja , Azeri Eliz , Hollis Chris , Townsend Ellen , Livingstone Sonia , Sonuga-Barke Edmund 
Published: October 2024

IntroductionThe impact of digital activity on adolescent mental health has been difficult to assess because of methodological limitations and a lack of strong theory.Dynamic Interplay of Online Risk and Resilience in Adolescence(DIORA) is a longitudinal study designed to address these core limitations and tease apart the reciprocal influences linking digital activity and depression symptoms (hereafter ‘depression’) over 12 months in middle adolescence. This study will examine whether negative affective and cognitive reactions evoked by risky digital activities increase depression. It will additionally examine whether protective characteristics (eg, self-efficacy) moderate the associations between digital activity and depression. DIORA will also explore the reverse pathways between digital activity and depression, namely whether depression exacerbates negative affective and cognitive reactions and, in turn, increase risky digital activities or, further, whether risks can be mitigated through active management of digital activity and/or reactions that it evokes. Finally, the study will examine whether the effects of digital activity observed for depression contrast with those observed for well-being.Methods and analysisThis is a prospective observational study with three assessment points: baseline (T1), 6 months (T2) and 12 months (T3). We aim to recruit a minimum of 276 adolescents aged between 13 and 14 years from secondary schools in the UK and 1 parent/caregiver/guardian (hereafter, ‘parent’) for each adolescent. Study questionnaires will be completed online.We will fit a range of models to examine the direct and indirect associations among digital activity, the reactions it evokes, depression and wellbeing, and individual and contextual mediators and moderators drawing on the structural equation modelling framework.Ethics and disseminationThe study was approved by the London School of Economics and Political Science Research Ethics Committee, reference number 249287. The results will be published in peer-reviewed scientific journals and disseminated through presentations, posters and blogs.
Association of early statin initiation during COVID-19 admission with inpatient mortality at an academic health system in Illinois, March 2020 to September 2022: a target trial emulation using observational data
Authors: Rivera Adovich , Al-Heeti Omar , Feinstein Matthew J , Williams Janna , Taiwo Babafemi , Achenbach Chad , Petito Lucia 
Published: October 2024

Objective
We assessed the association of early statin initiation with inpatient mortality among hospitalised COVID-19 patients.

Design, setting and participants
This observational study emulated a hypothetical target trial using electronic health records data from Northwestern Medicine Health System, Illinois, 2020–2022. We included patients who were ≥40 years, admitted ≥48 hours for COVID-19 from March 2020 to August 2022 and had no evidence of statin use before admission.

Interventions
Individuals who initiated any statins within 48 hours of admission were compared with individuals who did not initiate statins during this period.

Primary outcome measures
Inpatient mortality at hospital days 7, 14, 21 and 28 were determined using hospital records. Risk differences between exposure groups were calculated using augmented inverse propensity weighting (AIPW) with SuperLearner.

Results
A total of 8893 individuals (24.5% early statin initiators) were included. Early initiators tended to be older, male and have higher comorbidity burdens. Unadjusted day 28 mortality was higher in early initiators (6.0% vs 3.6%). Adjusted analysis showed slightly higher inpatient mortality risk at days 7 (RD: 0.5%, 95% CI: 0.2 to 0.8) and 21 (RD: 0.6%, 95% CI: 0.04 to 1.1), but not days 14 (RD: 0.4%, 95% CI: −0.03 to 0.9) and 28 (RD: 0.4%, 95% CI: −0.2 to 1.1). Sensitivity analyses using alternative modelling approaches showed no difference between groups.

Conclusions
Early statin initiation was not associated with lower mortality contrasting with findings of previous observational studies. Trial emulation helped in identifying and addressing sources of bias incompletely addressed by previous work. Statin use may be indicated for other conditions but not COVID-19.
Global mapping survey research on physiotherapeutic interventions for osteoarthritis: a scoping review protocol
Authors: Monteiro Nívea Renata Oliveira , dos Anjos Gabriely Cristina Sousa , Nunes Pinto Ana Carolina Pereira , Matos Areolino Pena 
Published: October 2024

IntroductionPhysiotherapists provide non-pharmacological conservative treatment for osteoarthritis (OA) using a wide spectrum of interventions. Previous surveys have identified global physiotherapy OA management practices. However, no review to date summarises the scope and findings of these studies. This article describes a scoping review protocol to map the surveys investigating physiotherapeutic interventions offered to patients with OA to identify the treatment interventions currently used for OA, the physiotherapists’ attributes and organisational practice factors potentially associated with the choice of these interventions and to detect knowledge-practice gaps in the provision of physiotherapeutic interventions in OA treatment, contributing to guiding future research on this topic.Methods and analysisThis is a protocol for a scoping review that will be based on Arksey and O’Malley scoping review methodology and the methodological guidance for conducting scoping reviews published by the Joanna Briggs Institute (JBI). Relevant articles will be searched using the following databases: Medline (PubMed), Embase, Web of Science and Google Scholar. Surveys studies addressing physiotherapeutic interventions offered to patients with OA will be included. Study will be selected through title/abstract and full-text screening stages and data will be extracted using an instrument based on the model available in the JBI Manual. The findings will be summarised using descriptive statistics according to our research questions. This review will be reported in accordance with the Preferred Items for Systematic Reviews and Meta-Analyses for Scoping Reviews.Ethics and disseminationEthical approval is not required for this scoping review. Review findings will be disseminated through peer-reviewed publications, scientific conference presentations and scientific meetings.Study registrationThis protocol has been registered with the Open Science Framework (DOI10.17605/OSF.IO/J3RBT).
Multicohort study testing the generalisability of the SASKit-ML stroke and PDAC prognostic model pipeline to other chronic diseases
Authors: Palmer Daniel , Henze Larissa , Murua Escobar Hugo , Walter Uwe , Kowald Axel , Fuellen Georg 
Published: October 2024

ObjectivesTo validate and test the generalisability of the SASKit-ML pipeline, a prepublished feature selection and machine learning pipeline for the prediction of health deterioration after a stroke or pancreatic adenocarcinoma event, by using it to identify biomarkers of health deterioration in chronic disease.DesignThis is a validation study using a predefined protocol applied to multiple publicly available datasets, including longitudinal data from cohorts with type 2 diabetes (T2D), inflammatory bowel disease (IBD), rheumatoid arthritis (RA) and various cancers. The datasets were chosen to mimic as closely as possible the SASKit cohort, a prospective, longitudinal cohort study.Data sourcesPublic data were used from the T2D (77 patients with potential pre-diabetes and 18 controls) and IBD (49 patients with IBD and 12 controls) branches of the Human Microbiome Project (HMP), RA Map (RA-MAP, 92 patients with RA, 22 controls) and The Cancer Genome Atlas (TCGA, 16 cancers).MethodsData integration steps were performed in accordance with the prepublished study protocol, generating features to predict disease outcomes using 10-fold cross-validated random survival forests.Outcome measuresHealth deterioration was assessed using disease-specific clinical markers and endpoints across different cohorts. In the HMP-T2D cohort, the worsening of glycated haemoglobin (HbA1c) levels (5.7% or more HbA1c in the blood), fasting plasma glucose (at least 100 mg/dL) and oral glucose tolerance test (at least 140) results were considered. For the HMP-IBD cohort, a worsening by at least 3 points of a disease-specific severity measure, the "Simple Clinical Colitis Activity Index" or "Harvey-Bradshaw Index" indicated an event. For the RA-MAP cohort, the outcome was defined as the worsening of the "Disease Activity Score 28" or "Simple Disease Activity Index" by at least five points, or the worsening of the "Health Assessment Questionnaire" score or an increase in the number of swollen/tender joints were evaluated. Finally, the outcome for all TCGA datasets was the progression-free interval.ResultsModels for the prediction of health deterioration in T2D, IBD, RA and 16 cancers were produced. The T2D (C-index of 0.633 and Integrated Brier Score (IBS) of 0.107) and the RA (C-index of 0.654 and IBS of 0.150) models were modestly predictive. The IBD model was uninformative. TCGA models tended towards modest predictive power.ConclusionsThe SASKit-ML pipeline produces informative and useful features with the power to predict health deterioration in a variety of diseases and cancers; however, this performance is disease-dependent.
Artificial intelligence-powered chatbots in search engines: a cross-sectional study on the quality and risks of drug information for patients
Authors: Andrikyan Wahram , Sametinger Sophie Marie , Kosfeld Frithjof , Jung-Poppe Lea , Fromm Martin F , Maas Renke , Nicolaus Hagen F 
Published: October 2024

BackgroundSearch engines often serve as a primary resource for patients to obtain drug information. However, the search engine market is rapidly changing due to the introduction of artificial intelligence (AI)-powered chatbots. The consequences for medication safety when patients interact with chatbots remain largely unexplored.ObjectiveTo explore the quality and potential safety concerns of answers provided by an AI-powered chatbot integrated within a search engine.MethodologyBing copilot was queried on 10 frequently asked patient questions regarding the 50 most prescribed drugs in the US outpatient market. Patient questions covered drug indications, mechanisms of action, instructions for use, adverse drug reactions and contraindications. Readability of chatbot answers was assessed using the Flesch Reading Ease Score. Completeness and accuracy were evaluated based on corresponding patient drug information in the pharmaceutical encyclopaedia drugs.com. On a preselected subset of inaccurate chatbot answers, healthcare professionals evaluated likelihood and extent of possible harm if patients follow the chatbot’s given recommendations.ResultsOf 500 generated chatbot answers, overall readability implied that responses were difficult to read according to the Flesch Reading Ease Score. Overall median completeness and accuracy of chatbot answers were 100.0% (IQR 50.0–100.0%) and 100.0% (IQR 88.1–100.0%), respectively. Of the subset of 20 chatbot answers, experts found 66% (95% CI 50% to 85%) to be potentially harmful. 42% (95% CI 25% to 60%) of these 20 chatbot answers were found to potentially cause moderate to mild harm, and 22% (95% CI 10% to 40%) to cause severe harm or even death if patients follow the chatbot’s advice.ConclusionsAI-powered chatbots are capable of providing overall complete and accurate patient drug information. Yet, experts deemed a considerable number of answers incorrect or potentially harmful. Furthermore, complexity of chatbot answers may limit patient understanding. Hence, healthcare professionals should be cautious in recommending AI-powered search engines until more precise and reliable alternatives are available.
Evidence-based incorporation of key parameters into MELD score for acute-on-chronic liver failure
Authors: Yu Xia , Zhou Ruoqi , Tan Wenting , Wang Xiaobo , Zheng Xin , Huang Yan , Chen Jinjun , Li Beiling , Liu Xinxin , Li Zhiwei , Meng Zhongji , Gao Yanhang , Qian Zhiping , Liu Feng , Lu Xiaobo , Shang Jia , Yan Huadong , Zheng Yubao , Zhang Weituo , Yin Shan , Gu Wenyi , Deng Guohong , Xiang Xiaomei , Zhou Yi , Hou Yixin , Zhang Qun , Xiong Shue , Liu Jing , Chen Ruochan , Long Liyuan , Jiang Xiuhua , Luo Sen , Chen Yuanyuan , Jiang Chang , Zhao Jinming , Ji Liujuan , Mei Xue , Li Jing , Li Tao , Zheng Rongjiong , Zhou Xinyi , Cai Qun , Li Hai , Sheng Jifang , Shi Yu 
Published: October 2024

BackgroundThe model for end-stage liver disease (MELD) score is widely used for the prognostication in end-stage liver disease but has limited performance in acute-on-chronic liver failure (ACLF). In this study, we identified additional predictive parameters and reformed the MELD score to predict ACLF more accurately.MethodsA meta-analysis was performed on relevant studies to identify the predictive factors of 28-day/90-day outcomes of ACLF, which were validated in two large prospective cohorts. A prognostic score was developed by incorporating predictive parameters into the MELD score. The model was evaluated with a focus on discrimination and calibration.ResultsThe meta-analysis incorporated 32 cohort studies with a total of 13 939 patients, of which 13 risk factors were identified, and 3 risk factors (age, neutrophil count and hepatic encephalopathy (HE) grade) besides MELD score were validated in 751 patients with ACLF derived from two prospective cohorts. A new model (Chinese Acute-on-Chronic Liver Failure Consortium (CATCH-LIFE)-MELD score) was developed as follows: 0.028×age+0.3×HE grade+0.039×neutrophil count+0.079×MELD score. CATCH-LIFE-MELD score achieved a concordance index of 0.791/0.788 for 28-day/90-day outcomes, which is superior to other traditional scores. Other discrimination indices, including net reclassification improvement, integrated discrimination improvement and probability density function, and calibration including Nagelkerke’s R2and Brier scores confirmed its superiority. Moreover, the accuracy of CATCH-LIFE-MELD score remained stable. It was highest in patients with or without hepatitis B virus infection, cirrhosis, liver failure or under the Chinese Group on the Study of Severe Hepatitis B (COSSH) criteria or European Association for the Study of the Liver (EASL) criteria. All results were substantiated by an evaluation using an external cohort.ConclusionsCATCH-LIFE-MELD score, a modified MELD score exhibited improved accuracy in predicting the short-term prognosis of ACLF than other traditional scores.
Dancing with disorder: chorea – an unusual and neglected manifestation of antiphospholipid syndrome
Authors: Hu Shikai , Zhou Yangzhong , Li Mengtao , Zeng Xiaofeng , Zhao Jiuliang 
Published: October 2024

ObjectivesChorea, characterised by involuntary, irregular movements, is a rare neurological manifestation of antiphospholipid syndrome (APS). The specific clinical features remain unclear. This study aimed to summarise the available evidence on antiphospholipid antibody (aPL)-associated chorea.MethodsWe used a mixed-methods approach, combining data from patients with chorea with aPL positivity admitted to Peking Union Medical College Hospital (PUMCH) from 2014 to 2024, with cases identified in public databases since 1983. We collected and analysed clinical, laboratory, and imaging results, along with their treatments and outcomes.ResultsA total of 180 patients with incident aPL-associated chorea were included (13 from PUMCH and 167 from the literature). The majority (81.7%) were female, with a mean age of chorea onset 22.8 years (SD=16.0). Chorea was the initial symptom in 87.9% of cases and often occurred as a single episode (67%), involving bilateral limbs (58.8%) and both upper and lower limbs (87.2%). 43.3% met the 2023 American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) APS classification criteria. Thrombocytopenia (30.0%) and arterial thrombosis (29.1%) were the most common manifestations. Lupus anticoagulant was positive in 84.2% of patients, anticardiolipin IgG in 70.8%, and anti-β2 glycoprotein I IgG in 52.9%. Among those who had results available for the three tests, 57.6% were triple-positive. ANAs were positive in 63.6%. MRI revealed basal ganglia lesions in only 14.8% of patients, whereas all positron emission tomography (PET) scans showed contralateral striatal hypermetabolism. Treatment varied, with most receiving combination therapies of neuroleptics, anticoagulants, antiplatelets, steroids and immunosuppressants. Chorea completely or partially improved in 95.5% of patients.ConclusionChorea is a significant but under-recognised manifestation of APS, predominantly affecting young women and often presenting as the initial symptom. Characteristic PET findings of contralateral striatal hypermetabolism can assist in diagnosis. Treatments with glucocorticoids and immunosuppressive therapies appear beneficial. Further research is needed to understand the pathophysiology and optimise management strategies for aPL-associated chorea.
Reconstructive surgery for gunshot injuriesof the knee:experience from the Russo-Ukranian War 2022–2024
Authors: Klapchuk Yurii , Los D , Buryanov O , Yarmoliuk Y , Bazarov M , Bets I , Lyanskorunsky V , Vashkevych B , Ramasamy A 
Published: October 2024

The invasion of Ukraine by the Russian Federation in February 2022 has witnessed the first peer-on-peer full-scale European conflict since World War 2. We have noted that the vast majority of injuries affect the extremities. Within that group, injuries to the joints pose a huge clinical challenge. Specifically, 17.1% of all gunshot injuries (GSWs) involved the joints, which represents 22.3% of all limb injuries. 55.6% of all GSW to the joints involved the knee; 10% had a concomitant vascular injury and 15%–20% had a nerve injury.The surgical management of ballistic knee injuries includes initial damage control surgery with debridement of non-vitalised tissue, vascular reconstruction and fasciotomies where necessary, with stabilisation of bone injury with a spanning external fixator. Following repatriation to Role 4 facilities, staged reconstruction is performed with cement spacers followed by autograft, endoprosthesis or arthrodesis. Where reconstruction is not possible, above-knee amputation remains an option.In this paper, based on the analysis of 33 cases, we describe the Ukrainian early experience of the management of gunshot wounds to the knee joint with three clinical case studies as representative examples.
Patient experiences in high-grade gliomas: from symptoms to radiotherapy
Authors: Chainey Jonathan , Kim Michael J , Chan Vivien Ka-Ying , Au Karolyn 
Published: October 2024

ObjectivesLittle is known in the literature about felt experience and supportive care needs of patients with new diagnosis of adult-type diffuse gliomas Central Nervous System WHO grades 3 and 4. The purpose of this study is to influence clinicians’ attitudes and facilitate the referral process and the development of support services by better understanding the patient’s journey.MethodsAdult patients with a new histopathological diagnosis of high-grade glioma, who underwent radiotherapy, participated in a semistructured, face-to-face interview. Different segments of the patient’s journey were explored focusing on patient’s emotions, interactions with healthcare providers, satisfaction during the process and access to supports. Descriptive thematic analysis in the tradition of grounded theory was performed.ResultsFifteen patients were interviewed, and four themes were emerged from the analysis. First, information conveyed by the medical team was frequently disconnected from patients’ understanding regarding diagnosis and treatment. Second, specific events created a lasting impression that the medical system, and at times medical care providers, lacked empathy. Third, patients’ perceptions of shortcomings within the medical system led to decreased trust, particularly regarding the follow-up process. Finally, although respondents identified multiple inadequacies during their journey, they nonetheless acknowledged the great support and quality of services they received.ConclusionsThis study provides insight into patients’ experiences and perceived shortcomings of the medical system, from the time of presentation until the end of radiotherapy treatment in patients with new diagnosis of high-grade glioma. These findings should influence clinicians’ attitudes and guide systematic changes including delivery of information and the referral process.
Residue management and overwinter survival in winter canola (Brassica napus L.)
Authors: Page Eric R. , Meloche Sydney , Thibodeau Alyssa , Moran Meghan , Caldbeck Brian 
Published: October 2024

Winter canola production in eastern Canada is a growing segment of the Canadian canola industry. Crop establishment and survival overwinter have been identified as two of the major challenges associated with the production of winter canola. Environmental conditions can interact with agronomic practices, including seeding date, plant population density, fertility, and residue management, to influence stand establishment in autumn and overwinter survival. The objective of the current research was to evaluate the impact and interaction of preceding crop residue and tillage practices on the establishment, overwinter survival, and yield of winter canola in southern Ontario. Winter canola was seeded following either winter wheat or soybean and using conventional, no-till, or strip-till practices. Over the course of the 3 years of study, the annual decline in winter canola plant population density was influenced by the type of tillage practice used but not by the preceding crop. The overwinter decrease in plant population density was largest in no-till, followed by strip-till, and finally conventional tillage. At physiological maturity, winter canola yields in reduced tillage practices (i.e., no-till and strip-till) were equivalent to those achieved utilizing conventional tillage practices. When grain yields were standardized as a function of the spring plant population density, the highest and lowest yield per plant coincided with the lowest and highest plant population densities and were observed in strip-till (14.2 g plant−1) and no-till (9.1 g plant−1), respectively. Results of this research have established that winter canola can be successfully produced in Ontario utilizing a range of tillage practices.