bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ferric carboxymaltose and exercise capacity in heart failure with preserved ejection fraction and iron deficiency: the FAIR-HFpEF trial
Authors: von Haehling Stephan , Doehner Wolfram , Evertz Ruben , Garfias-Veitl Tania , Derad Carlotta , Diek Monika , Karakas Mahir , Birkemeyer Ralf , Fillippatos Gerasimos , Lainscak Mitja , Butler Javed , Ponikowski Piotr , Böhm Michael , Friede Tim , Anker Stefan D 
Published: August 2024

Abstract

Background and Aims
Evidence is lacking that correcting iron deficiency (ID) has clinically important benefits for patients with heart failure with preserved ejection fraction (HFpEF).

Methods
FAIR-HFpEF was a multicentre, randomized, double-blind trial designed to compare intravenous ferric carboxymaltose (FCM) with placebo (saline) in 200 patients with symptomatic HFpEF and ID (serum ferritin &lt; 100 ng/mL or ferritin 100–299 ng/mL with transferrin saturation &lt; 20%). The primary endpoint was change in 6-min walking test distance (6MWTD) from baseline to week 24. Secondary endpoints included changes in New York Heart Association class, patient global assessment, and health-related quality of life (QoL).

Results
The trial was stopped because of slow recruitment after 39 patients had been included (median age 80 years, 62% women). The change in 6MWTD from baseline to week 24 was greater for those assigned to FCM compared to placebo [least square mean difference 49 m, 95% confidence interval (CI) 5–93; P = .029]. Changes in secondary endpoints were not significantly different between groups. The total number of adverse events (76 vs. 114) and serious adverse events (5 vs. 19; rate ratio 0.27, 95% CI 0.07–0.96; P = .043) was lower with FCM than placebo.

Conclusions
In patients with HFpEF and markers of ID, intravenous FCM improved 6MWTD and was associated with fewer serious adverse events. However, the trial lacked sufficient power to identify or refute effects on symptoms or QoL. The potential benefits of intravenous iron in HFpEF with ID should be investigated further in a larger cohort.
The impact of digital interventions on health insurance coverage for reproductive, maternal, newborn and child health services utilization in Kakamega, Kenya: a cluster randomized controlled trial
Authors: Abajobir Amanuel , de Groot Richard , Wainaina Caroline , Pradhan Menno , Janssens Wendy , Sidze Estelle M 
Published: August 2024

Abstract
The National Hospital Insurance Fund (NHIF) of Kenya was upgraded to improve access to healthcare for impoverished households, expand universal health coverage, and boost the uptake of essential reproductive, maternal, newborn and child health (RMNCH) services. However, premiums may be unaffordable for the poorest households. The Innovative Partnership for Universal Sustainable Healthcare (i-PUSH) programme targets low-income women and their households to improve their access to and utilization of quality healthcare, including RMNCH services, by providing subsidized, mobile phone-based NHIF coverage in combination with enhanced, digital training of community health volunteers and upgrading of health facilities. This study evaluated whether expanded NHIF coverage increased the accessibility and utilization of quality basic RMNCH services in areas where i-PUSH was implemented using a longitudinal cluster randomized controlled trial in Kakamega, Kenya. A total of 24 pair-matched villages were randomly assigned either to the treatment or the control group. Within each village, 10 eligible households (i.e. with a woman aged 15–49 years who was either pregnant or with a child &lt;4 years old) were randomly selected. The study applied a difference-in-difference methodology based on a pooled cross-sectional analysis of baseline, midline and endline data, with robustness checks based on balanced panels and Analysis of Covariance methods. The analysis sample included 346 women, of whom 248 had had a live birth in the 3 years prior to any of the surveys, and 424 children aged 0–59 months. Improved NHIF coverage did not have a statistically significant impact on any of the RMNCH outcome indicators at midline nor endline. Uptake of RMNCH services, however, improved substantially in both control and treatment areas at endline compared to baseline. For instance, significant increases were observed in the number of antenatal care visits from baseline to midline (mean = 2.62–2.92, P &lt; 0.01) and delivery with a skilled birth attendant from baseline to midline (mean = 0.91–0.97, P &lt; 0.01). Expanded NHIF coverage, providing enhanced access to RMNCH services of unlimited duration at both public and private facilities, did not result in an increased uptake of care, in a context where access to basic public RMNCH services was already widespread. However, the positive overall trend in RMNCH utilization indicators, in a period of constrained access due to the COVID-19 pandemic, suggests that the other components of the i-PUSH programme may have been beneficial. Further research is needed to better understand how the provision of insurance, enhanced community health volunteer training and improved healthcare quality interact to ensure pregnant women and young children can make full use of the continuum of care.
A realist evaluation of the implementation of a national tobacco control programme and policy in India
Authors: Hebbar Pragati B , Dsouza Vivek , Nagelhout Gera E , van Belle Sara , Srinivas Prashanth Nuggehalli , Schayck Onno C P van , Babu Giridhara R , Bhojani Upendra 
Published: August 2024

Abstract
There is a growing interest in studying and unpacking the implementation of policies and programmes as it provides an opportunity to reduce the policy translation time lag taken for research findings to translate into policies and be implemented and to understand why policies may fail. Realist evaluation is a theory-driven approach that embraces complexity and helps to identify the mechanisms generating the observed policy outcomes in a given context. We aimed to study facilitators and barriers while implementing the Cigarettes and Other Tobacco Products Act 2003 (COTPA), a comprehensive national tobacco control policy, and the National Tobacco Control Programme 2008 (NTCP), using realist evaluation. We developed an initial programme theory (IPT) based on a realist literature review of tobacco control policies in low- and middle-income countries. Three diverse states—Kerala, West Bengal and Arunachal Pradesh—with varying degrees of implementation of tobacco control laws and programmes were chosen as case studies. Within the three selected states, we conducted in-depth interviews with 48 state and district-level stakeholders and undertook non-participant observations to refine the IPT. Following this, we organized two regional consultations covering stakeholders from 20 Indian states for a second iteration to further refine the programme theory. A total of 300 intervention–context–actor–mechanism–outcome configurations were developed from the interview data, which were later synthesized into state-specific narrative programme theories for Kerala, West Bengal and Arunachal Pradesh. We identified five mechanisms: collective action, felt accountability, individual motivation, fear and prioritization that were (or were not) triggered leading to diverse implementation outcomes. We identified facilitators and barriers to implementing the COTPA and the NTCP, which have important research and practical implications for furthering the implementation of these policies as well as implementation research in India. In the future, researchers could build on the refined programme theory proposed in this study to develop a middle-range theory to explain tobacco control policy implementation in India and other low- and middle-income countries.
Changes from initial Posting to subsequent Posting and Transfer: a frontline perspective from India
Authors: Purohit Bhaskar , Hill Peter S 
Published: August 2024

Abstract
The deployment of the health workforce, carried out through initial and subsequent posting and transfer (PT), is a key element of health workforce management. However, the focus of the currently available PT literature is mostly on subsequent PT, and the distinction between initial and subsequent PT has received little research attention. Drawing on this gap, in this paper, we examine how doctors experience their subsequent PT compared with their initial postings in two states in India. The distinctions have been drawn using the prism of six norms that we developed as evidence for implied policy in the absence of documented policy. This mixed-methods study used in-depth interviews of doctors and key informants, with job histories providing quantitative data from their accounts of their PT experience. Based on the interviews of these frontline doctors and other key policy actors, this paper brings to light key differences between initial and subsequent postings as perceived by the doctors: compared with initial postings, where the State demands to meet service needs dominated, in subsequent postings, doctors exercised greater agency in determining outcomes, with native place a central preoccupation in their choices. Our analysis provides a nuanced understanding of PT environment through this shift in doctors’ perceptions of their own position and power within the system, with a significant change in the behaviour of doctors in subsequent PT compared with their initial postings. The paper brings to light the changing behaviour of doctors with subsequent PT, providing a deeper understanding of PT environment, expanding the notion of PT beyond the simple dichotomy between service needs and doctors’ requests.
Software application profile: tpc and micd—R packages for causal discovery with incomplete cohort data
Authors: Andrews Ryan M , Bang Christine W , Didelez Vanessa , Witte Janine , Foraita Ronja 
Published: August 2024

Abstract

Motivation
The Peter Clark (PC) algorithm is a popular causal discovery method to learn causal graphs in a data-driven way. Until recently, existing PC algorithm implementations in R had important limitations regarding missing values, temporal structure or mixed measurement scales (categorical/continuous), which are all common features of cohort data. The new R packages presented here, micd and tpc, fill these gaps.

Implementation
micd and tpc packages are R packages.

General features
The micd package provides add-on functionality for dealing with missing values to the existing pcalg R package, including methods for multiple imputations relying on the Missing At Random assumption. Also, micd allows for mixed measurement scales assuming conditional Gaussianity. The tpc package efficiently exploits temporal information in a way that results in a more informative output that is less prone to statistical errors.

Availability
The tpc and micd packages are freely available on the Comprehensive R Archive Network (CRAN). Their source code is also available on GitHub (https://github.com/bips-hb/micd; https://github.com/bips-hb/tpc).
Computing Klein-Gordon Spectra
Authors: Rösler Frank , Tretter Christiane 
Published: August 2024

AbstractWe study the computational complexity of the eigenvalue problem for the Klein–Gordon equation in the framework of the Solvability Complexity Index Hierarchy. We prove that the eigenvalue of the Klein–Gordon equation with linearly decaying potential can be computed in a single limit with guaranteed error bounds from above. The proof is constructive, i.e. we obtain a numerical algorithm that can be implemented on a computer. Moreover, we prove abstract enclosures for the point spectrum of the Klein–Gordon equation and we compare our numerical results to these enclosures. Finally, we apply both the implemented algorithm and our abstract enclosures to several physically relevant potentials such as Sauter and cusp potentials and we provide a convergence and error analysis.
Ulk1 regulates T cell development and response to Listeria monocytogenes stimulation
Authors: Xu Yudai , Wang Zijian , Deng Jieping , Li Shumin , Gao Lijuan , Liu Guolong , Chen Guobing 
Published: August 2024

Abstract
T cells are crucial for the normal functioning of the immune system. The development and response of these cells to foreign antigens involve many complex stages and interactions between various types of cells. However, many details of these processes are still unclear. Our research revealed a key role for a protein called ULK1, a serine/threonine protein kinase, in regulating T-cell development and function. During T-cell maturation, the absence of Ulk1 (as in Ulk1−/− mice) leads to an increase in a cell type called DN3 in the thymus. We also found a reduction in the number of T cells in peripheral immune organs, such as the spleen, in Ulk1−/− mice. In response to Listeria infection, Ulk1−/− mice have a weaker ability to clear this bacterium, and their T cells also have defects in producing cytokines. However, the absence of Ulk1 did not affect the activation or apoptosis of naive CD4+ T cells in vitro. In a bone marrow chimeric mouse model, T cells from Ulk1−/− mice did not differ developmentally from those from control mice. Furthermore, RNA-seq revealed that Ulk1 deficiency affects the metabolic function of splenocytes and T-cell function in mice, potentially through the canonical Wnt signaling cascade and the ERK1/ERK2 signaling cascades. Overall, these results suggest that Ulk1 is essential for T-cell maturation in the thymus, the balance of peripheral T cells, and the functional response of T cells to antigens.
Causal estimators for incorporating external controls in randomized trials with longitudinal outcomes
Authors: Zhou Xiner , Zhu Jiawen , Drake Christiana , Pang Herbert 
Published: August 2024

Abstract
Incorporating external data, such as external controls, holds the promise of improving the efficiency of traditional randomized controlled trials especially when treating rare diseases or diseases with unmet needs. To this end, we propose novel weighting estimators grounded in the causal inference framework. As an alternative framework, Bayesian methods are also discussed. From trial design perspective, operating characteristics including Type I error and power are particularly important and are assessed in our realistic simulation studies representing a variety of practical scenarios. Our proposed weighting estimators achieve significant power gain, while maintaining Type I error close to the nominal value of 0.05. An empirical application of the methods is demonstrated through a Phase III clinical trial in rare disease.
Pornography use, problematic pornography use, impulsivity, and sensation seeking: a meta-analysis
Authors: Bocci Benucci Sara , Di Gesto Cristian , Ghinassi Simon , Casale Silvia , Fioravanti Giulia 
Published: August 2024

Abstract

Background
While some individuals engage in recreational pornography use (PU), others may develop an uncontrolled pattern of use termed problematic pornography use (PPU). PPU is characterized by persistent, excessive, or compulsive engagement with pornographic content, despite distress and adverse consequences. Impulsivity has been identified as a factor associated with PU and PPU.

Aim
The present meta-analysis aims to sum up the existing research on the relationship between impulsivity and PU/PPU and investigate whether age and gender could moderate this relationship.

Methods
A keyword-based systematic literature search was performed to identify articles that assessed PU/PPU and impulsivity. Extracted correlations were converted into Fisher’s Z. Meta-regression analyses were also performed. Publication bias was assessed by Egger’s regression intercept.

Outcomes
Outcomes included general impulsivity and its dimensions (ie, negative and positive urgency, lack of premeditation and perseverance), sensation seeking, PU, and PPU.

Results
Meta-analytic results of the random effects model showed a significant positive correlation between impulsivity as total score and PU (n = 1504, k = 4, Fisher’s Z = 0.21, P &lt; .001) and PPU (n = 20174, k = 13, Fisher’s Z = 0.17, P &lt; .001). Significant and positive associations were also found between sensation seeking and PU (n = 11707, k = 11, Fisher’s Z = 0.14, P &lt; .001) and PPU (n = 20152, k = 9, Fisher’s Z = 0.06, P &lt; .001). Concerning the relationship between PPU and different dimensions of impulsivity, almost all the associations were significant and positive. The dimension of positive urgency and attentional and nonplanning impulsivity showed the strongest association. Age (β = –0.50, Q = 101.26, df = 11, P &lt; .001) and gender (female = 1; β = –0.46, Q = 102.54, df = 12, P &lt; .001) moderated the association between general impulsivity and PPU. No risk of publication bias emerged.

Clinical Implications
Prevention programs of PPU should focus on impulsivity and certain key dimensions (eg, positive urgency, attentional and nonplanning impulsivity) and be tailored to individual impulsivity profiles, considering age and gender differences.

Strengths and Limitations
The primary strength of this meta-analysis is that it considers various conceptualizations of impulsivity. However, the results are to be interpreted with caution since &gt;30% of relevant studies had to be excluded because information could not be gathered from the study authors.

Conclusion
These results suggest that general impulsivity is linked to PU and PPU and that specific dimensions of impulsivity (ie, attentional impulsivity, nonplanning impulsivity, and positive urgency) can serve as risk factors for PPU.
Epstein–Barr virus-encoded RNA-positive lymphocytes in bone marrow and lymph nodes in an autopsy case of TAFRO syndrome
Authors: Tsugita Nao , Miyagawa Ippei , Nakayamada Shingo , Nawata Aya , Kosaka Shumpei , Ueno Masanobu , Tanaka Yoshiya 
Published: August 2024

ABSTRACT
A 55-year-old man was admitted to the hospital with vomiting, diarrhoea, and chest pain. Upon examination, he exhibited signs of increased inflammatory response, acute kidney injury, and thrombocytopenia, leading to a diagnosis of TAFRO syndrome, which was supported by the clinical evidence of generalised lymphadenopathy, pleural effusion, and hepatosplenomegaly. Despite receiving intensive multimodal immunosuppressive therapy, including glucocorticoid pulse therapy (methylprednisolone 1000 mg/day), tocilizumab, and cyclosporine in the intensive care unit, the patient showed minimal response and succumbed to the disease on the seventh day of hospitalisation. Histopathological analysis of the lymph nodes revealed idiopathic multicentric Castleman disease-like features, and Epstein–Barr virus-encoded RNA (EBER) in situ hybridisation identified multiple EBER-positive cells. These findings highlight the elusive pathogenic mechanism of TAFRO syndrome and the potential resistance of some patients to standard treatments such as tocilizumab. The presence of EBER-positive cells in lymph nodes or bone marrow may serve as an indicator of disease severity and treatment resistance. Therefore, histopathological detection of EBER-positive cells may help predict responsiveness to conventional treatments, disease severity, and prognosis in patients with TAFRO syndrome.
Successful treatment of aggressive AA amyloidosis with tocilizumab in a patient with polymyalgia rheumatica
Authors: Atas Nuh , Çalışkan Ali Rıza , Akatlı Ayşenur 
Published: August 2024

ABSTRACT
Polymyalgia rheumatic (PMR) associated amyloidosis is an extremely rare condition that can be rapidly progressive with high morbidity and mortality and management is challenging. Tocilizumab is a monoclonal anti–IL-6 receptor antibody, which is in the therapeutic arsenal of PMR. The efficiency of tocilizumab in improvement of PMR activity score and decreasing steroid dose is well-established, while efficiency in PMR–associated amyloidosis has not been published. Herein, we reported a PMR patient with amyloid A amyloidosis who was treated effectively with tocilizumab.
Belief in living a meaningful life and adjustment to chronic pain
Authors: Reed David E , Day Melissa A , Ferreira-Valente Alexandra , Jensen Mark P 
Published: August 2024

Abstract

Objective
Chronic pain is a global health concern and often interferes with multiple aspects of individuals’ lives (eg, physical activities), diminishing a person’s ability to engage in activities that promote meaning in life. However, it is not well understood how believing that one can live a meaningful life despite pain could contribute to improved function among individuals with chronic pain. The aim of the present study was to better understand the role that belief in living a meaningful life despite pain might have on adjustment to chronic pain.

Methods
Participants (n = 164) were individuals with chronic pain who completed baseline data from 2 closely related randomized clinical trials. Hierarchical regression analyses were used to examine the hypotheses that one’s belief in living a meaningful life despite pain will be associated with function (pain interference and symptoms of posttraumatic stress disorder, depression, and anxiety) and that the belief in living a meaningful life despite pain would moderate the associations between pain intensity and function.

Results
Belief in living a meaningful life despite pain was significantly associated with less pain interference and less severe symptoms of posttraumatic stress disorder, anxiety, and depression, supporting the potential role of this variable in adaptive adjustment to chronic pain. However, one’s belief in living a meaningful life despite pain did not moderate the associations between pain intensity and function.

Conclusions
Results provide important theoretical and clinical information about how believing that one can live a meaningful life despite pain might serve as an important process for adjustment to chronic pain.
Sexual dysfunction in women living with HIV: an updated narrative review
Authors: Tiecco Giorgio , Salvi Martina , Delbarba Andrea , Di Gregorio Marco , Colangelo Cosimo , Castelli Francesco , Quiros-Roldan Eugenia 
Published: August 2024

AbstractIntroductionFemale sexual dysfunction is a significant concern for many women worldwide, with chronic health conditions such as HIV infection contributing to its prevalence. However, there is a paucity of studies focusing this subject in the available literature.ObjectivesThis narrative review aimed to provide a comprehensive and updated overview of the current state of knowledge regarding sexual dysfunction in women living with HIV (WLWH).MethodsReferences for this review were identified from MEDLINE, Embase, and Cochrane databases using the search terms “sexual dysfunction” AND “HIV” AND “female” OR “woman.” The final reference list was generated based on the timeline, originality, and relevance to the scope of this narrative review.ResultsIn the general population, female sexual function is influenced by various factors, including biological, psychological, physiological, sociocultural, and relational ones. In WLWH, the role of antiretroviral therapy in female sexual dysfunction is controversial. Although current international guidelines recommend collecting a thorough sexual life anamnesis during routine outpatient visits, sexual difficulties are often inadequately addressed.ConclusionA tailored clinical approach that focuses on the multidimensional domains of sexual dysfunction may improve the sexual health and quality of life in WLWH.