bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic review of clinical prediction models for psychosis in individuals meeting At Risk Mental State criteria
Authors: Hunt Alexandra , Law Heather , Carney Rebekah , Mulholland Rachel , Flores Allan , Tudur Smith Catrin , Varese Filippo , Parker Sophie , Yung Alison R. , Bonnett Laura J. 
Published: October 2024

ObjectivesThis study aims to review studies developing or validating a prediction model for transition to psychosis in individuals meeting At Risk Mental State (ARMS) criteria focussing on predictors that can be obtained as part of standard clinical practice. Prediction of transition is crucial to facilitating identification of patients who would benefit from cognitive behavioural therapy and, conversely, those that would benefit from less costly and less-intensive regular mental state monitoring. The review aims to determine whether prediction models rated as low risk of bias exist and, if not, what further research is needed within the field.DesignBibliographic databases (PsycINFO, Medline, EMBASE, CINAHL) were searched using index terms relating to the clinical field and prognosis from 1994, the initial year of the first prospective study using ARMS criteria, to July 2024. Screening of titles, abstracts, and subsequently full texts was conducted by two reviewers independently using predefined criteria. Study quality was assessed using the Prediction model Risk Of Bias ASessment Tool (PROBAST).SettingStudies in any setting were included.Primary and secondary outcome measuresThe primary outcome for the review was the identification of prediction models considering transition risk and a summary of their risk of bias.ResultsForty-eight unique prediction models considering risk of transition to psychosis were identified. Variables found to be consistently important when predicting transition were age, gender, global functioning score, trait vulnerability, and unusual thought content. PROBAST criteria categorised four unique prediction models as having an overall low-risk bias. Other studies were insufficiently powered for the number of candidate predictors or lacking enough information to draw a conclusion regarding risk of bias.ConclusionsTwo of the 48 identified prediction models were developed using current best practice statistical methodology, validated their model in independent data, and presented low risk of bias overall in line with the PROBAST guidelines. Any new prediction model built to evaluate the risk of transition to psychosis in people meeting ARMS criteria should be informed by the latest statistical methodology and adhere to the TRIPOD reporting guidelines to ensure that clinical practice is informed by the best possible evidence. External validation of such models should be carefully planned particularly considering generalisation across different countries.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPEROFILES/108488_PROTOCOL_20191127.pdf, identifier CRD42018108488.
The influence of perceived formative assessment on the learning autonomy of medical students: the chain mediating role of psychological empowerment and positive academic emotions
Authors: Wang Jiali , Zhou Guorun , Guo Juntang , Sun Xiaodong , Sun Lin 
Published: October 2024

IntroductionMedical students’ autonomous learning is a cornerstone of their educational journey. Formative assessment is defined as a process to enhance learning and improve academic performance, and the key to the effectiveness of formative assessment is the students’ perceptions of it. The present study investigates the impacts of perceived formative assessment on the learning autonomy of medical students, explores the chain mediating role of psychological empowerment and positive academic emotions, and offers strategies for facilitating medical students’ autonomous learning.MethodsA cross-sectional investigation was conducted using a convenience sampling method involving 713 medical students (mean age 19.72 ± 1.18 years; 207 male and 506 female students; the proportion of participants is 93.69%) in Shandong Second Medical University. Perceived formative assessment was performed using a self-designed questionnaire of Perceived Formative Evaluation for Medical Students, learning autonomy using the Autonomy in Learning Rating Scale for College Students, positive academic emotions using the General Academic Emotion Questionnaire for College Students, and psychological empowerment of medical students using the Chinese version of Psychological Empowerment Scale (PES). The data were analyzed using descriptive statistics, Pearson’s correlation, multiple regression, and mediation analysis using the SPSS26.0 program and PROCESS3.1.ResultsPerceived formative assessment significantly predicted learning autonomy (β = 0.06, p &lt; 0.05). It also positively predicted psychological empowerment (β = 0.20, p &lt; 0.001), and psychological empowerment positively predicted the learning autonomy of medical students (β = 0.36, p &lt; 0.001). Psychological empowerment also positively predicted positive academic emotions (β = 0.64, p &lt; 0.001), and positive academic emotions positively predicted learning autonomy (β = 0.44, p &lt; 0.001). The direct effect value of perceived formative assessment on learning autonomy was 0.18, while the total indirect effect was 0.43. The mediation effect of psychological empowerment on the relationship between perceived formative assessment and learning autonomy was 0.22, and the chain mediation effect of psychological empowerment and positive academic emotions was 0.18, accounting for 30%, 70%, 36%, and 30% of the total effect, respectively.ConclusionPerceived formative assessment directly enhances medical students’ learning autonomy. This relationship is partially mediated by psychological empowerment and positive academic emotions. The results suggest that formative evaluation boosts psychological empowerment, which fosters positive academic emotions and further promotes learning autonomy.
How do health content creators perform well? An integration research of short video and livestream behaviors
Authors: Liu Jing , Ye Qing , Wu Hong , Ma Rongyang , Guo Shanshan , Long Han 
Published: October 2024

IntroductionShort-video platforms have demonstrated vast potential for health education. To meet diverse user requirements, many short-video platforms have integrated livestreaming functionalities. This integration presents challenges for health content creators in formulating effective performance strategies, including decisions about which format to use (short video or livestream) and what type of content to produce. This study utilizes panel data from a prominent short-video platform in China to empirically investigate the impact of different forms and content characteristics on the performance of health content creators.MethodsWe conducted an empirical analysis using panel data obtained from a leading short-video platform in China. Our analysis focused on understanding how the behaviors associated with short videos and livestreaming impact the performance of health content creators. We examined form-level differences, analyzing the distinct roles of short video and livestreaming behaviors. Additionally, we explored content-level characteristics, investigating the effects of content coverage, health knowledge content, and advertising content on both short-term and long-term performance. The moderation effects of the creator’s occupation and certification type were also analyzed.ResultsOur form-level analysis revealed that health creators’ behaviors in short videos and livestreaming play distinct roles in their performance. Livestreaming behaviors resulted in short-term economic returns, while short video behaviors had a more significant effect on follow-ups, which are often viewed as long-term, more sustainable performance indicators. Content-level analysis showed that content coverage and health knowledge content enhance long-term performance but do not increase short-term performance. Conversely, advertising content was found to be essential for securing short-term financial income. The study also identified that the creator’s occupation and certification type moderate the impact of content on performance.ConclusionThis study integrates two media forms (short video and livestream), providing direct insights into the performance of health content creators in the realm of health education. Health content creators need to strategically balance their use of short videos and livestreaming to optimize both short-term and long-term performance outcomes. Specifically, increasing content coverage and health knowledge can enhance long-term engagement, while incorporating advertising content is crucial for immediate financial gains.
Generative AI with WGAN-GP for boosting seizure detection accuracy
Authors: Abou-Abbas Lina , Henni Khadidja , Jemal Imene , Mezghani Neila 
Published: October 2024

BackgroundImbalanced datasets pose challenges for developing accurate seizure detection systems based on electroencephalogram (EEG) data. Generative AI techniques may help augment minority class data to facilitate automatic epileptic seizure detection.New methodThis study investigates the impact of various data augmentation (DA) approaches, including Wasserstein Generative Adversarial Network with Gradient Penalty (WGAN-GP), Vanilla GAN, Conditional GAN (CGAN), and Cramer GAN, on classification performance with Random Forest models. The best-performing GAN variant, WGAN-GP, was then integrated with a bidirectional Long Short-Term Memory (LSTM) architecture and compared against traditional and synthetic oversampling methods.ResultsThe evaluation of different GAN variants for data augmentation with Random Forest classifiers identified WGAN-GP as the most effective approach. The integration of WGAN-GP with bidirectional LSTM yielded substantial performance improvements, outperforming traditional oversampling methods and achieving an accuracy of 91.73% on the augmented data, compared to 86% accuracy on real data without augmentation.Comparison with existing methodsThe proposed generative AI approach combining WGAN-GP and recurrent neural network models outperforms comparative synthetic oversampling methods on metrics relevant for reliable seizure detection from imbalanced EEG datasets.ConclusionsIncorporating the WGAN-GP generative AI technique for data augmentation and integrating it with bidirectional LSTM elevates seizure detection accuracy for imbalanced EEG datasets, surpassing the performance of traditional oversampling and class weight adjustment methods. This approach shows promise for improving epilepsy monitoring and management through enhanced automated detection system effectiveness.
Linezolid Adsorption on Filters during Continuous Renal Replacement Therapy: An In Vitro Study
Authors: Nosek Krzysztof , Samiec Milena , Ziółkowski Hubert , Markowska-Buńka Paulina , Czuczwar Mirosław , Borys Michał , Onichimowski Dariusz 
Published: October 2024

Background: Renal replacement therapy (RRT), widely used in the treatment of renal injury during sepsis, aims to eliminate the toxins and proinflammatory cytokines involved in the pathomechanism underlying septic shock. Dialysis filters are characterized by a high adsorption potential for cytokines in RRT in the case of septic renal injury. For the treatment of sepsis with antibiotics, it is of key importance to achieve the desired values of PK/PD indices. Continuous renal replacement therapy (CRRT) may affect antimicrobial clearance, increasing their elimination in some cases. Methods: The aim of this study was to determine the degree of adsorption for linezolid on three different types of filters used in CRRT. In our in vitro study, a continuous veno-venous hemofiltration (CVVH) was conducted using three types of filters: polysulfone (PS), polyethyleneimine-treated polyacrylonitrile (PAN PEI), and non-PEI-treated polyacrylonitrile (PAN). Each type of filter was used in three CVVH cycles, involving the use of 600 mg of linezolid dissolved in 700 mL of bovine blood or in 700 mL of 0.9% NaCl. In each case, the total volume of the obtained solution was 1000 mL. Blood samples were collected at particular time points to measure their drug concentration. The differences in mean drug/NaCl adsorption and drug/blood adsorption were determined using a one-way ANOVA with multiple comparisons via Tukey’s post hoc test; a p-value of <0.05 was considered significant. Results: A significant adsorption of linezolid was found for PAN PEI filters, both in samples obtained from bovine blood and 0.9% NaCl solutions, at the endpoint. In PAN PEI samples, the concentration of linezolid in 0.9% NaCl solutions decreased from 594.74 μg/mL to 310.66 μg/mL after 120 min (the difference was established at 52%). In blood samples, the initial concentration was 495.18 μg/mL, which then decreased to 359.84 μg/mL (73% of the beginning value). No significant adsorption was demonstrated on PAN or PS filters. Conclusion: There is a need for in vivo research to confirm the effect of filter type on linezolid concentration in patients undergoing CRRT.
Antibiotic prescribing intensity and community UTI resistance: a cross-sectional ecological study
Authors: McDonnell Lucy , Ashworth Mark , Schofield Peter , Durbaba Stevo , Redmond Patrick 
Published: October 2024

BackgroundAntibiotic overuse is associated with antimicrobial resistance (AMR). It is unclear whether community AMR is driven by overall antibiotic use or by high levels of repeated (intense) use by individual patients.AimTo determine the association between high antibiotic prescribing intensity (all antibiotic prescriptions; any indication), and rates of UTI resistance among patients within small communities.Design & settingRepeated cross-sectional ecological analysis of geographical areas (population averaging 1500) from 2012-2015 using anonymised primary care data and urine cultures.MethodFor each area, we compared the percentage of antibiotic-prescribed patients who received≥5 prescriptions/3 years or≥4 prescriptions/year, with subsequent or same year UTI resistance rates. We also compared ‘Average Daily Quantities’ of all antibiotics prescribed, with UTI resistance rates, per year, per area. Results were adjusted for co-variates and analysed at area level using mixed effects logistic regression.ResultsOf 196,513 patients prescribed antibiotics in 69 areas, 16% were prescribed intensively (≥5 prescriptions in 3 years), receiving almost 30% of prescriptions. Of 12 308 confirmed UTI specimens (80%Escherichia Coli), 65% were resistant to at least one antibiotic (amoxicillin; cefalexin; ciprofloxacin; trimethoprim; nitrofurantoin). We found no significant association between high intensity ‘any’ antibiotic prescribing (same year/two preceding years) or overall ‘any’ antibiotic prescribing (same year) and UTI resistance.ConclusionWe found no relationship between concurrent high intensity ‘any’ antibiotic prescribing, and UTI resistance rates in small urban communities, pre-covid. Individual patient use of multiple antibiotics, even at high intensity, may not be an independent risk factor for community UTI resistance.
Exploring the equity of distribution of general medical services funding allocations in Wales: a time-series analysis
Authors: Currie Jonny , Thomas Kathrin , Cunningham Anne Marie , Bailey Kerry , Ahmed Haroon , Farewell Daniel , Lewis Sally 
Published: October 2024

BackgroundGood access to quality primary care in high-income countries can improve population health. Access to primary care is however often not equal among socioeconomic groups; our analysis sought to explore whether funding, a determinant of service supply, is equitably distributed among GP practices in Wales.AimWe sought to explore the relationship between funding and deprivation among GP practices in Wales, to understand the equity of current funding policies.Design & settingWe obtained funding data for general practices in Wales between 2014 and 2022 and explored the equity of distribution using the percentage of practice patients living in the 20% most deprived small areas in Wales. We generated a linear regression model exploring the relationship between practice funding and deprivation, with an interaction term with time in years.ResultsPractice funding rose for all practices between 2014 and 2022. Practice deprivation and time in years were both associated with practice funding, with increases in practice deprivation associated with reduced funding allocations, and time being associated with a small increase in funding over the study period. Over the period of analysis of 2004-2022, for every 10% increase in patients living in the most deprived LSOAs, funding per patient decreases on average by 1%.ConclusionPrimary cares in Wales in more deprived areas receive discernibly less funding per patient than those in less deprived areas. Given the potential and likelihood primary care can affect population health outcomes, this underinvestment may be contributing to existing health inequalities and requires urgent further analysis and action.
Vulnerable older people’s views on proactive care planning - a qualitative interview study in primary care
Authors: Kastbom Lisa , Olaison Anna , Sverker Annette , Segernäs Anna 
Published: October 2024

BackgroundPatients in old age often have complex care needs due to multimorbidity and polypharmacy. This qualitative study is part of a larger ongoing Swedish intervention trialSecure And Focused primary care for older pEople(SAFE), including shorter care agreements based on person-centred patient goals.AimTo explore, in a primary care setting, the views of older and vulnerable patients on a more systematic, proactive approach to care planning, including establishing and documenting care agreements based on person-centred goals.Design & settingIndividual semi-structured interviews with patients (n 25) aged>75 years from 12 intervention primary health care centres.MethodQualitative content analysis.ResultsThree categories, with 10 sub-categories, were found:I would like to live in the present, so why plan ahead? Let me decide vs. they know best,andCare agreements usually went unnoticed. The latent theme,The ambivalence of care planning in the fourth age,was created to give a deeper meaning to the content of the categories.ConclusionThis study emphasises that older, vulnerable persons have varying attitudes towards participation in proactive care planning. This ambivalence may originate from the individuals’ desire to have their autonomy respected on the one hand and to avoid or postpone end-of-life conversations and care planning on the other hand. Patients also expressed a desire to be more actively involved in care planning. Although care agreements have the potential to increase patient involvement in proactive care planning, they often went unnoticed. The conversation itself was essential.
Content and timing of the 6-8 week maternal postnatal check: a mixed methods study
Authors: Macdonald Clare , Cross-Sudworth Fiona , Quinn Laura , MacArthur Christine , Bick Debra , Jones Ellie , Taylor Beck 
Published: October 2024

BackgroundSince 2020, the General Medical Services contract requires GP practices in England to offer women a GP appointment 6-8 weeks after birth: the ‘6-8 week postnatal check’ or ‘consultation’. Historically, provision of checks was variable, and women still frequently report poor experiences.AimTo explore GPs’ and women’s perspectives of the 6-8 week postnatal check, including key components and timing.Design & settingMixed methods study: focus groups of GPs and women, and an online survey of GPs in England.MethodFocus groups explored GPs’ and women’s experiences of postnatal consultations. An online survey explored GPs’ clinical approach, organisation, and improvement potential. Quantitative analysis examined associations between demographics and clinical approach. Thematic framework analysis was used for qualitative data.Results18 women and 14 GPs participated in focus groups. 671 GPs completed the survey. Mental wellbeing and contraception were reported as important topics, although some women were not asked about mental health. GP survey responses indicated most recommendations from national guidance were ‘always’ or ‘very often’ covered by most, but not all GPs. Clinical coverage was higher for GPs who used clinical templates, had awareness of guidance, were female or a parent. Many GPs (n=326, 49%) needed more time than was allocated for the consultation: (n=524, 78% allocated<15 minutes;n=351, 52% completed in<15 minutes).ConclusionThis study suggests GPs are allocated insufficient time for postnatal consultations, with substantial variation in practice. Specifying consultation duration and consideration of template usage in policy may improve care and outcomes for women.
Patient and Caregiver Perspectives on Gender Disparity in CKD
Authors: Lewandowski Michał J. , Kurnikowski Amelie , Vanek Lenka , Bretschneider Philipp , Schwaiger Elisabeth , Krenn Simon , Hödlmoser Sebastian , Gauckler Philipp , Pirklbauer Markus , Horn Sabine , Brunner Maria , Zitt Emanuel , Kirsch Bernhard , Windpessl Martin , Aringer Ida , Wiesholzer Martin , Ritschl Valentin , Stamm Tanja , Jauré Allison , Hecking Manfred 
Published: October 2024

Key Points

Women felt vulnerable and felt that their housework obligations may interfere with CKD treatment, especially dialysis.Women felt they were good at protecting their health, whereas men might expect help from others and live in denial when confronted with advanced CKD.

Background
CKD affects more women than men worldwide; however, men comprise most patients who receive KRT. We aimed to describe the perspectives of patients and their caregivers regarding gender disparities in CKD.

Methods
Semi-structured interviews were conducted with 45 patients with CKD (20 women) and 14 caregivers (12 women) from seven clinics in Austria. The interviews were analyzed thematically.

Results
Five themes were identified in this study. Participants perceived that women were disadvantaged and vulnerable (silent and intimidated, single mother predicament, impeded access to care and support because of socioeconomic disadvantage, had to fend for themselves); fulfilling gender roles and norms (primarily responsible for childcare, pressure to perform well as homemakers, put others' needs before their own, encouraging husband's treatment adherence); and protecting their own health (self-disciplined, vigilant, confronted health challenges, advocated for their needs). Men were seen to place the onus of care on others (expected help from family, relied on others for decisions). Both men and women experienced a disease-related identity crisis and distress (women: impaired body image, mental distress; men: denial and self-destruction, emasculated by sickness).

Conclusions
Women with CKD felt vulnerable and were inclined to fulfill gender norms and responsibilities as caregivers, but were also vigilant about protecting their own health. Men tended to be reluctant to accept CKD and appeared to depend on others for disease management. Better awareness and addressing these concerns can inform strategies to minimize gender disparities in access to care and outcomes in CKD.