bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital falls clinical practice guidelines: a global analysis and systematic review
Authors: McKercher Jonathan P , Peiris Casey L , Hill Anne-Marie , Peterson Stephen , Thwaites Claire , Fowler-Davis Sally , Morris Meg E 
Published: July 2024

Abstract

Background
Hospital falls continue to be a persistent global issue with serious harmful consequences for patients and health services. Many clinical practice guidelines now exist for hospital falls, and there is a need to appraise recommendations.

Method
A systematic review and critical appraisal of the global literature was conducted, compliant with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Web of Science, Embase, CINAHL, MEDLINE, Epistemonikos, Infobase of Clinical Practice Guidelines, Cochrane CENTRAL and PEDro databases were searched from 1 January 1993 to 1 February 2024. The quality of guidelines was assessed by two independent reviewers using Appraisal of Guidelines for Research and Evaluation Global Rating Scale and Appraisal of Guidelines of Research and Evaluation Recommendation Excellence (AGREE-REX). Certainty of findings was rated using Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence from Reviews of Qualitative Research. Data were analysed using thematic synthesis.

Results
2404 records were screened, 77 assessed for eligibility, and 20 hospital falls guidelines were included. Ten had high AGREE-REX quality scores. Key analytic themes were as follows: (i) there was mixed support for falls risk screening at hospital admission, but scored screening tools were no longer recommended; (ii) comprehensive falls assessment was recommended for older or frail patients; (iii) single and multifactorial falls interventions were consistently recommended; (iv) a large gap existed in patient engagement in guideline development and implementation; (v) barriers to implementation included ambiguities in how staff and patient falls education should be conducted, how delirium and dementia are managed to prevent falls, and documentation of hospital falls.

Conclusion
Evidence-based hospital falls guidelines are now available, yet systematic implementation across the hospital sector is more limited. There is a need to ensure an integrated and consistent approach to evidence-based falls prevention for a diverse range of hospital patients.
Prevalence and Risk Factors for the Development of Bulimia Nervosa and Binge Eating Disorder in a Large U.S. Military Cohort
Authors: Jacobson Isabel G , Geronimo-Hara Toni Rose , Sharifian Neika , McMaster Hope S , Mehlman Haley , Rull Rudolph P , Maguen Shira ,   for the Millennium Cohort Study Team, Esquivel Alejandro P , Ray Travis N , Klimek-Johnson Patrycja , Baccetti Anna , Belding Jennifer , Boparai Satbir , Carey Felicia , Castañeda Sheila , Harbertson Judith , Kolaja Claire , Lewis Crystal , Magallon Sandra , Richard Erin , Rivera Anna , Sheppard Beverly , Trone Daniel , Villalobos Javier , Walstrom Jennifer , Wooten Nikki , Zhu Katie 
Published: July 2024

Abstract
While bulimia nervosa (BN) and binge eating disorder (BED) are prevalent in military populations, an understanding of risk and protective factors is limited by a lack of longitudinal population-based epidemiological research. This study examined the prevalence of BN and BED among active duty service members and identified military and psychosocial factors associated with their development. Millennium Cohort Study participants were followed for up to 15 years and prevalence was ascertained using survey and electronic medical record data. Longitudinal multivariable logistic regression models evaluated risk factors associated with the development of bulimia nervosa (n=96,245) or binge eating disorder (n=113,733). Weighted prevalence estimates from survey data (range, 0.80%-4.80%) were higher than those from medical records (0.04%-0.14%). Military factors significantly associated with increased risk for BN and BED included active duty component (vs Reserve/Guard); serving in the Army, Marines, or Navy/Coast Guard (vs Air Force); and combat deployment (vs deployment without combat). Associated psychosocial factors included lack of social support, experiencing at least one life stressor, and screening positive for posttraumatic stress disorder or problem drinking. Findings highlight the critical need for disordered eating screening and prevention efforts that bolster coping skills, which can ultimately improve service member functioning and readiness.
Role of contrast-enhanced mammogram as an adjunct to tomosynthesis in evaluation of circumscribed breast lesions
Authors: Porkodi Dharmalingam , Devimeenal Jagannathan 
Published: July 2024

Abstract

Objectives
We evaluated the role of contrast-enhanced mammogram (CEM) in the characterization of circumscribed lesions detected in digital breast tomosynthesis (DBT) and correlated with histopathology.

Methods
A retrospective study was done on 205 circumscribed breast masses detected with DBT and for whom CEM was done before core biopsy/excision biopsy. Morphology of lesion enhancement was noted at a 2-min CEM image and depending on the enhancement pattern, they were classified as benign, malignant, and indeterminate. Indeterminate lesions were further characterized by contrast kinetics at 8 min and divided into benign and malignant lesions. The results were correlated with histopathology reports.

Results
Among the 205 lesions, 158 were benign and 47 were malignant by histopathology. All 47 malignant cases were diagnosed as malignant (sensitivity-100%) and 150 out of 158 benign lesions were diagnosed as benign by CEM (specificity-95%). Eight benign lesions were reported as malignant (false positive) by CEM. Positive predictive value was 85.4% (47/55); negative predictive value (NPV) was 100% (150/150); accuracy was 96% (197/205).

Conclusions
The high sensitivity of CEM in our study suggests that CEM helps in the early diagnosis of benign-looking circumscribed breast malignancies. The high NPV of CEM helps to avoid unnecessary biopsies and interventions in benign lesions.

Advances in knowledge
This study describes the contrast enhancement pattern of benign and malignant circumscribed breast lesions and thereby helps in the diagnosis of malignancy at an early stage. CEM is a promising adjunct tool since it offers functional imaging as a supplement to anatomical imaging by DBT.
Broader anti-EBV TCR repertoire in multiple sclerosis: disease specificity and treatment modulation
Authors: Schneider-Hohendorf Tilman , Wünsch Christian , Falk Simon , Raposo Catarina , Rubelt Florian , Mirebrahim Hamid , Asgharian Hosseinali , Schlecht Ulrich , Mattox Daniel , Zhou Wenyu , Dawin Eva , Pawlitzki Marc , Lauks Sarah , Jarius Sven , Wildemann Brigitte , Havla Joachim , Kümpfel Tania , Schrot Miriam-Carolina , Ringelstein Marius , Kraemer Markus , Schwake Carolin , Schmitter Thomas , Ayzenberg Ilya , Fischer Katinka , Meuth Sven G , Aktas Orhan , Hümmert Martin W , Kretschmer Julian R , Trebst Corinna , Kleffner Ilka , Massey Jennifer , Muraro Paolo A , Chen-Harris Haiyin , Gross Catharina C , Klotz Luisa , Wiendl Heinz , Schwab Nicholas 
Published: July 2024

Abstract
Epstein-Barr virus (EBV) infection has long been associated with the development of multiple sclerosis (MS). Patients with MS have elevated titres of EBV-specific antibodies in serum and show signs of CNS damage only after EBV infection. Regarding CD8+ T cells, an elevated but ineffective response to EBV was suggested in MS patients, who present with a broader MHC-I-restricted EBV-specific T-cell receptor beta chain (TRB) repertoire compared to controls. It is not known whether this altered EBV response could be subject to dynamic changes, e.g. by approved MS therapies, and whether it is specific for MS.
Peripheral blood TRB repertoire samples (n = 1317) of healthy donors (n = 409), patients with MS (n = 710) before and after treatment, patients with neuromyelitis optica spectrum disorder (n = 87), MOG antibody-associated disease (MOGAD) (n = 64) and Susac’s syndrome (n = 47) were analysed.
Apart from MS, none of the evaluated diseases presented with a broader anti-EBV TRB repertoire. In MS patients undergoing autologous haematopoietic stem-cell transplantation, EBV reactivation coincided with elevated MHC-I-restricted EBV-specific TRB sequence matches. Therapy with ocrelizumab, teriflunomide or dimethyl fumarate reduced EBV-specific, but not CMV-specific MHC-I-restricted TRB sequence matches.
Together, these data suggest that the aberrant MHC-I-restricted T-cell response directed against EBV is specific to MS with regard to neuromyelitis optica, MOGAD and Susac’s syndrome and that it is specifically modified by MS treatments interfering with EBV host cells or activated lymphocytes.
Exploring the psychological impact of childhood-onset psoriasis: a systematic review
Authors: Shah Veranca , Larson Allison , Jafferany Mohammad 
Published: July 2024

Abstract
Childhood-onset psoriasis is often associated with various psychological challenges. Numerous studies have delved into the connection between adult-onset psoriasis and its potential to heighten a patient’s susceptibility to various psychological challenges. However, less has been written about the influence of childhood psoriasis on psychological disorders, particularly anxiety and depression, eating disorders and substance abuse. In this study, we delve into studies that shed light on these associated risks. A systematic literature review was conducted using PubMed, focusing on the psychological impacts of childhood-onset psoriasis. From an initial pool of 313 articles, we utilized Covidence, a specialized software designed for screening and selection, adhering to strict exclusion criteria such as psoriasis in adulthood and incorrect study designs. This process refined our focus to 12 relevant articles, which were critically analysed to understand the psychological comorbidities associated with childhood-onset psoriasis. Our review reveals a significant link between childhood-onset psoriasis and increased instances of depression and anxiety. Notably, children with psoriasis demonstrate higher frequencies of suicidal thoughts and behaviours, as well as a marked propensity for substance abuse and addiction. The study also uncovers a strong connection between psoriasis in children and the development of eating disorders such as anorexia nervosa and bulimia nervosa. Childhood-onset psoriasis significantly affects the psychological wellbeing of children, with heightened risks for depression, anxiety, suicidality, substance abuse and eating disorders. These findings underscore the need for comprehensive management strategies that encompass not only the physical symptoms but also mental health and psychological support for children with psoriasis. Early intervention and regular screenings are crucial in mitigating these risks and improving the quality of life of paediatric patients with psoriasis.
Lateral expansion of the mammalian cerebral cortex is related to anchorage of centrosomes in apical neural progenitors
Authors: Morozov Yury M , Rakic Pasko 
Published: July 2024

Abstract
The centrosome is the main microtubule organizing center in stem cells, and its mother centriole, anchored to the cell membrane, serves as the basal body of the primary cilium. Prolonged anchorage of centrosomes and primary cilia to the apical segment of the membrane of apical neural progenitor cells is considered vital for interkinetic nuclear translocation and repetitive cycling in the ventricular zone. In contrast, the basolateral anchorage of primary cilia has been regarded as the first step in delamination and conversion of apical to basal neural progenitor cells or neurons. Using electron microscopy analysis of serial sections, we show that centrosomes, in a fraction of cells, anchor to the basolateral cell membrane immediately after cell division and before development of cilia. In other cells, centrosomes situate freely in the cytoplasm, increasing their probability of subsequent apical anchorage. In mice, anchored centrosomes in the cells shortly after mitosis predominate during the entire cerebral neurogenesis, whereas in macaque monkeys, cytoplasmic centrosomes are more numerous. Species-specific differences in the ratio of anchored and free cytoplasmic centrosomes appear to be related to prolonged neurogenesis in the ventricular zone that is essential for lateral expansion of the cerebral cortex in primates.
Enhanced multistage deep learning for diagnosing anterior disc displacement in the temporomandibular joint using MRI
Authors: Min Chang-Ki , Jung Won , Joo Subin 
Published: July 2024

Abstract

Objectives
This study aimed to propose a new method for the automatic diagnosis of anterior disc displacement of the temporomandibular joint (TMJ) using MRI and deep learning. By using a multistage approach, the factors affecting the final result can be easily identified and improved.

Methods
This study introduces a multistage automatic diagnostic technique using deep learning. This process involves segmenting the target from MR images, extracting distance parameters, and classifying the diagnosis into 3 classes. MRI exams of 368 TMJs from 204 patients were evaluated for anterior disc displacement. In the first stage, 5 algorithms were used for the semantic segmentation of the disc and condyle. In the second stage, 54 distance parameters were extracted from the segments. In the third stage, a rule-based decision model was developed to link the parameters with the expert diagnosis results.

Results
In the first stage, DeepLabV3+ showed the best result (95% Hausdorff distance, Dice coefficient, and sensitivity of 6.47 ± 7.22, 0.84 ± 0.07, and 0.84 ± 0.09, respectively). This study used the original MRI exams as input without preprocessing and showed high segmentation performance compared with that of previous studies. In the third stage, the combination of SegNet and a random forest model yielded an accuracy of 0.89 ± 0.06.

Conclusions
An algorithm was developed to automatically diagnose TMJ-anterior disc displacement using MRI. Through a multistage approach, this algorithm facilitated the improvement of results and demonstrated high accuracy from more complex inputs. Furthermore, existing radiological knowledge was applied and validated.
Wait-times benchmarks for risk-based prioritization in transcatheter aortic valve implantation: a simulation study
Authors: Miranda Rafael N , Austin Peter C , Fremes Stephen E , Mamas Mamas A , Sud Maneesh K , Naimark David M J , Wijeysundera Harindra C 
Published: July 2024

Abstract

Background
Demand for transcatheter aortic valve implantation (TAVI) has increased in the last decade, resulting in prolonged wait-times and undesirable health outcomes in many health systems. Risk-based prioritization and wait-times benchmarks can improve equitable access to patients.

Methods and results
We used simulation models to follow-up a synthetic population of 50 000 individuals from referral to completion of TAVI. Based on their risk of adverse events, patients could be classified as ‘low-’, ‘medium-’, and ‘high-risk’, and shorter wait-times were assigned for the higher risk groups. We assessed the impacts of the size and wait-times for each risk group on waitlist mortality, hospitalization, and urgent TAVIs. All scenarios had the same resource constraints, allowing us to explore the trade-offs between faster access for prioritized patients and deferred access for non-prioritized groups. Increasing the proportion of patients categorized as high-risk, and providing more rapid access to the higher-risk groups achieved the greatest reductions in mortality, hospitalizations and urgent TAVIs (relative reductions of up to 29%, 23%, and 38%, respectively). However, this occurs at the expense of excessive wait-times in the non-prioritized low-risk group (up to 25 weeks). We propose wait-times of up to 3 weeks for high-risk patients and 7 weeks for medium-risk patients.

Conclusion
Prioritizing higher-risk patients with faster access leads to better health outcomes, however this also results in unacceptably long wait-times for the non-prioritized groups in settings with limited capacity. Decision-makers must be aware of these implications when developing and implementing waitlist prioritization strategies.
Is the output growth rate in NIPA a welfare measure?
Authors: Durán Jorge , Licandro Omar 
Published: July 2024

Abstract
This paper shows that, in a dynamic general equilibrium framework, the rate of output growth as measured by national income and product accounts reflects changes in welfare in the precise sense of equivalent variation. The main argument is straightforward. In a two-sector dynamic general equilibrium model of heterogeneous households, recursive preferences and quasi-concave technology, the Bellman equation provides a representation of household preferences over current consumption and investment. When applied to this representation of preferences, a Fisher–Shell true quantity index turns out to be equal to the Divisia index, closely approximated by the Fisher ideal chain index used in national income and product accounts.
Transportation model for acute aortic dissection: implications for reduced treatment centres
Authors: Goehlich Amelie , Prasse Paul , Zaschke Lisa , Habazettl Helmut , Falk Volkmar , Kurz Stephan D 
Published: July 2024

Abstract

OBJECTIVES
The objective of the present study was to model the effects of a reduced number of treatment centres for acute type A aortic dissection on preclinical transportation distance and time. We examined whether treatment in selected centres in Germany would be implementable with respect to time to treatment.

METHODS
For our transportation model, the number of aortic dissections and respective mean annual volume were collected from the annual quality reports (2015–2017) of all German cardiac surgery centres (n = 76). For each German postal code, the fastest and shortest routes to the nearest centre were calculated using Google Maps. Furthermore, we analysed data from the German Federal Statistical Office from January 2005 to December 2015 to identify all surgically treated patients with acute type A aortic dissection (n = 14 102) and examined the relationship between in-hospital mortality and mean annual volume of medical centres.

RESULTS
Our simulation showed a median transportation distance of 27.13 km and transportation time of 35.78 min for 76 centres. Doubling the transportation time (70 min) would allow providing appropriate care with only 12 medical centres. Therefore, a mean annual volume of &gt;25 should be obtained. High mean annual volume was associated with significantly lower in-hospital mortality rates (P &lt; 0.001). A significantly lower mortality rate of 14% was observed (P &lt; 0.001) if a mean annual volume of 30 was achieved.

CONCLUSIONS
Operationalizing the volume–outcome relationship with fewer but larger medical centres results in lower mortality, which outweighs the disadvantage of longer transportation time.
Atrial fibrillation and risk of sudden cardiac arrest in young adults
Authors: Kim Yun Gi , Jeong Joo Hee , Han Kyung-Do , Roh Seung-Young , Lee Hyoung Seok , Choi Yun Young , Shim Jaemin , Kim Young-Hoon , Choi Jong-Il 
Published: July 2024

Abstract

Aims
Evidence of an association between atrial fibrillation (AF) and sudden cardiac arrest (SCA) in young adults is limited. In this study, we aim to evaluate this association in a general population aged between 20 and 39 years.

Methods and results
Young adults who underwent health check-ups between 2009 and 2012 were screened from a nationwide healthcare database in South Korea. A history of AF diagnosis before the health check-ups was identified based on the relevant International Classification of Diseases, 10th edition codes reported in the database. Associations between an established diagnosis of AF and the risk of SCA during follow-up were examined. A total of 6 345 162 young people were analysed with a mean follow-up duration of 9.4 years. The mean age was 30.9 ± 5.0 years, and 5875 (0.09%) individuals were diagnosed with AF. During follow-up, SCA occurred in 5352 (0.08%) individuals, and the crude incidence was 0.56 and 0.09 events per 1000 person-years for participants with and without AF, respectively. Individuals with AF had a 3.0-fold higher risk in a multivariate model adjusted for age, sex, lifestyle, anthropometric data, and medical comorbidities (adjusted hazard ratio 2.96, 95% confidence interval 1.99–4.41, P &lt; 0.001). Both incident and prevalent AFs were associated with an increased risk of SCA, with no significant differences between the two groups.

Conclusion
Atrial fibrillation was associated with a significantly higher risk of SCA developing in healthy young adults. Whether the rate or rhythm control influences the risk of SCA in young patients with AF remains to be examined.
Geographic variation in shortfalls of dementia specialists in the United States
Authors: Liu Jodi L , Baker Lawrence , Chen Annie Yu-An , Wang Jue (Jessie) 
Published: July 2024

Abstract
Dementia specialists—neurologists, geriatricians, and geriatric psychiatrists—serve a critical clinical function in diagnosing early-stage Alzheimer's disease and determining eligibility for treatment with disease-modifying therapies. However, the availability of dementia specialists is limited and varies across the United States. Using data from the Area Health Resources Files, we found that the median density of dementia specialists across hospital referral regions in United States is 28.8 per 100 000 population aged 65 years and older (interquartile range 19.3-43.6). We derived thresholds of 33-45 dementia specialists per 100 000 population aged 65 years and older as the provider density necessary to care for older adults with mild cognitive impairment and dementia. Based on these thresholds, we estimated that 34%-59% of the population aged 65 years and older resided in areas with potential dementia specialist shortfalls. The extent of potential shortfalls varied by state and rurality. A better understanding of potential gaps in the availability of dementia specialists will inform policies and practices to ensure access to services for people with cognitive impairment and dementia.