bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving uptake of colorectal cancer screening by complex patients at an academic primary care practice: a feasibility study
Authors: Desponds Charlotte , Ducros Cyril , Rochat Carine , Galassini Laure , Bodenmann Patrick , Grazioli Veronique S , Plys Ekaterina , von Plessen Christian , Gouveia Alexandre , Selby Kevin 
Published: August 2024

BackgroundRegular screening reduces mortality from colorectal cancer (CRC). The Canton of Vaud, Switzerland, has a regional screening programme offering faecal immunochemical tests (FITs) or colonoscopy. Participation in the screening programme has been low, particularly among complex patients. Patient navigation has strong evidence for increasing the CRC screening rate.Design and objectiveThis feasibility study tested patient navigation performed by medical assistants for complex patients at an academic primary care practice.Baseline measurementsA review of 328 patients’ medical charts revealed that 51% were up-to-date with screening (16% within the programme), 24% were ineligible, 5% had a documented refusal and 20% were not up-to-date, of whom 58 (18%) were complex patients.Intervention (February 2023 to May 2023)We tried to help complex patients participate in the screening programme using either in-person or telephone patient navigation. Each intervention was piloted by a physician-researcher and then performed by a medical assistant. Based on the reach, effectiveness, adoption, implementation, maintenance framework, we collected: Intervention participation and refusal, screening acceptance and completion and both patients and medical assistant acceptability (ie, qualitative interviews).ResultsOnly 4/58 (7%) patients participated in the in-person patient navigation test phase due to scheduling problems. All four patients accepted a prescription and 2/4 (50%) completed their test. We piloted a telephone intervention to bypass scheduling issues but all patients refused a telephone discussion with the medical assistant. At two months after the last intervention, the proportion of patients up-to-date increased from 51% to 56%.ConclusionOur overall approach was resource-intensive and had little impact on the overall participation rate. It was likely not sustainable. New approaches and reimbursement for a specific patient navigator role are needed to increase CRC screening of complex patients.
Reference values for reticulocyte haemoglobin equivalent in healthy Chinese children under 5 years and its associations with various blood parameters
Authors: Tung Keith Tsz Suen , Chen Chen , Chiu Yung Tuen , So Hung Kwan , So Chi Chiu , Ip Patrick 
Published: August 2024

BackgroundReticulocyte haemoglobin equivalent (RET-He) is a useful tool for evaluating recent iron usage irrespective of inflammatory status. This study aims to establish a reference for RET-He among Hong Kong healthy children under the age of 5 years and to investigate the association between RET-He and various blood parameters.MethodsA total of 946 children aged 2–48 months from July 2019 to December 2022 were recruited in this cross-sectional study. The RET-He and other haematological parameters were measured by the haematology analyser from Sysmex XN-9100/XN-1500. The ferritin test was performed with the electrochemiluminescence immunoassay. Interval 2.5th percentile to 97.5th percentile represented the normal RET-He ranges. Linear multiple regression analysis was performed to examine the relation between RET-He and various blood parameters. Receiver-operating characteristic curve analysis revealed the sensitivity and specificity of RET-He in identifying iron deficiency.ResultsThe RET-He in the study population was approximately normally distributed. The age-specific lower limit of RET-He ranges from 25.81 pg (25–36 months) to 27.15 pg (13–24 months). RET-He was found to be lower in the age group 2–6 months (mean=29.47 pg) and 7–12 months (mean=29.41 pg). Changes in RET-He and haemoglobin in relation to age were observed in both sexes (both p<0.001). RET-He was influenced by age, some red blood cell parameters and reticulocyte concentrations (all p<0.05). A cut-off value of RET-He ≤27.8 pg was determined for identifying iron deficiency.ConclusionsRET-He levels varied with age, with a relatively lower level in infants than in other age groups. The value below the age-specific lower limit of the reference range of RET-He can be used as a limit for preliminary iron-deficiency screening.
Assessing the health impacts of parenthood on people with cystic fibrosis: the HOPeCF prospective cohort protocol
Authors: Kazmerski Traci M , Stransky Olivia M , Lee MinJae , Prangley Kelly A , Jain Raksha , Georgiopoulos Anna M , Shaw Daniel S , Taylor-Cousar Jennifer 
Published: August 2024

IntroductionPeople with cystic fibrosis (CF) are living longer and healthier lives with a growing number considering and pursuing parenthood. The decision of whether to become a parent is complex for people with CF, and CF is a major factor in reproductive decision-making. Unfortunately, in people with CF who become parents, there are no prospective studies of disease trajectory, no data on the impact of parenthood on mental health, disease self-management, or quality of life, and no research regarding non-genetic parenthood.Methods and analysisHealth Outcomes of Parents with CF (HOPeCF) is a prospective, multicentre observational cohort study which will enrol 146 new parents with CF of children less than 5 years of age. The primary aim of this 60-month study is to assess the rate of lung function decline as impacted by mental health, parental stress and responsibility, and the use of CF transmembrane conductance regulator modulators. In addition, we will conduct dyadic interviews with a subset of study participants and their key supports (partner/family/friend) to inform future interventions.Ethics and disseminationThis longitudinal, observational multicentre study is a necessary and timely step in understanding parental health outcomes in CF and will provide data essential for care guidance to people with CF, their partners, and healthcare providers. The University of Pittsburgh Institutional Review Board approved this study (STUDY23080161). As people with a variety of paediatric-onset chronic diseases are living longer and considering parenthood, these results may have widespread applicability and will be distributed at international meetings and submitted to peer-reviewed journals.
Physiological and perceptual responses of wearing a dryrobe for rewarming after passive cold-water immersion in men
Authors: Read Dale B , Flood Tess R , Harwood Amy E , Dos’Santos Thomas , Weakley Jonathon J S , Evans Gethin H 
Published: August 2024

ObjectivesTo investigate the physiological and perceptual responses to wearing a dryrobe for rewarming after passive cold-water immersion (CWI).Methods15 unhabituated healthy Caucasian men (age: 28.9 (5.4) years) attended the laboratory on three occasions and performed passive CWI (14°C) for 30 min followed by 15 min of rewarming wearing either a dryrobe, towel or foil blanket while positioned in front of fans replicating a 10 mph wind. Physiological (deep body temperature, skin temperature and heart rate) and perceptual (thermal sensation and thermal comfort) variables were measured.ResultsAt 15 min post-immersion, deep body temperature was higher in the dryrobe condition (mean: 37.09 (SD: 0.49)°C) compared with the foil blanket (36.98 (0.64)°C) and towel (36.99 (0.49)°C) (p<0.001). On average across the 15 min post-immersion period, the dryrobe increased skin temperature to the greatest degree (18.9 (1.0)°C, +2.4°C), compared with the foil blanket (18.1 (1.2)°C, +1.8°C, p=0.034) and the towel (16.6 (1.2)°C, +1.3°C, p<0.001). Average heart rate across the 15 min post-immersion period was lower when wearing the dryrobe (dryrobe: 74 (10) b.min−1, foil blanket: 78 (6) b.min–1and towel: 82 (14) b.min−1(p=0.015). Thermal sensation and thermal comfort were higher at all post-immersion time points in the dryrobe compared with the foil blanket and towel.ConclusionsDuring the rewarming period following CWI, physiological and perceptual responses are improved when wearing clothing that combines an insulative layer with a vapour barrier, such as the dryrobe compared with a towel or foil blanket. This might have future implications for safety recommendations during rewarming.
Exploring the relationship between low energy availability, depression and eating disorders in female athletes: a cross-sectional study
Authors: Halioua Robin , Wasserfurth Paulina , Toepffer Désirée , Claussen Malte Christian , Koehler Karsten 
Published: August 2024

ObjectiveThis cross-sectional study aimed to investigate the role of low energy availability (LEA) in the interplay between depression and disordered eating/eating disorders (DE/EDs) among female athletes. The International Olympic Committee consensus statement on Relative Energy Deficiency in Sport (REDs) identified depression as both an outcome of LEA and a secondary risk factor for REDs. However, the direct link between LEA and depression has yet to be fully established.MethodsWe assessed 57 female athletes participating in weight-sensitive sports at different levels of competition training at least four times a week. Assessment was conducted using laboratory analyses, clinical interviews and the Patient Health Questionnaire-9 questionnaire. Participants were recruited through various channels, including German sports clubs, Olympic training centres, social media platforms and the distribution of flyers at competitions. Indicators of LEA were defined if at least two of the following three physiological indicators were present: menstrual disturbances, suppressed resting metabolic rate and suppressed thyroid hormones. Logistic and linear regression analysis were used to examine the relationship between LEA, depression and DE/ED.ResultsThe lifetime prevalence of depressive disorders was 29.6%. 19% of the participants were diagnosed with an ED, and an additional 22.6% exhibited DE.LEA was not significantly associated with either lifetime prevalence of depressive disorders or current depressive symptoms. However, a significant association was found between depression and DE/ED in terms of both lifetime prevalence and current depressive symptoms. DE/ED increased the probability of lifetime prevalence of depressive disorders by 34% (19%–49%) compared with normal eating behaviour.ConclusionWe found no evidence that LEA is an independent factor for depression in female athletes. Its association with LEA and REDs appears to occur primarily in the presence of DE/ED.
Differences in the technical performance of heading between men and women football players during FIFA World Cup 2022 and FIFA Women’s World Cup 2023 matches
Authors: Peek Kerry , Georgieva Julia , Serner Andreas , Orest Filip 
Published: August 2024

ObjectivesTo compare the incidence of headers, attempted headers, and other head impacts, and the difference in heading descriptors, including technical performance, between men and women in a purposive sample of FIFA World Cup 2022 (FWC22) and FIFA Women’s World Cup (FWWC23) matches.MethodsVideo analysis of all observed headers, attempted headers and other head impacts during eight FWC matches (FWC22 (n=4); FWWC23 (n=4)) where the same national teams competed. Heading descriptors (including ball delivery method, purpose of the header and involvement of other players) and technical performance of each header (including controlled or uncontrolled header, use of upper body, point of head contact) were analysed using negative binomial regression analyses with men as the reference group (reported as incidence rate ratios (IRR)). Timing of eye closure was analysed using a t-test; α-error, p=<0.05.ResultsFrom 973 head impacts, 845 (87%) were headers (FWC22 mean 5.0 headers/player/match, FWWC23 mean 4.6 headers/player/match), 93 (10%) were attempted headers and 35 (4%) were unintentional head impacts. When compared with men, women were less likely to perform controlled headers (73% vs 83%, IRR 1.20, p=0.01), use their foreheads (IRR 2.36, p=<0.001) and their upper body during the header (80% vs 88%, IRR 1.29, p=0.005). Women also closed their eyes earlier before the header (1.91 vs 1.56 frames, d=0.41, p=0.002).ConclusionThere were significant differences in heading technique between women and men, which could be important to address in training to improve heading performance and potentially reduce short-term and long-term burden of heading.
Randomised study for the Optimal Treatment of symptomatic patients with low-gradient severe Aortic valve Stenosis and preserved left ventricular ejection fraction (ROTAS trial)
Authors: Galli Elena , Le Ven Florent , Coisne Augustin , Sportouch Catherine , Le Tourneau Thierry , Lavie-Badie Yoan , Bernard Anne , Eicher Jean-Christophe , Dreyfus Julien , Ternacle Julien , Baleynaud Serge , Auffret Vincent , Le Pabic Estelle , Pibarot Philippe , Oger Emmanuel , Donal Erwan 
Published: August 2024

BackgroundThe best management of symptomatic patients with low-gradient (LG) severe aortic stenosis (AS) and preserved left ventricular ejection fraction (LVEF) has not been established. The Randomised study for the Optimal Treatment of symptomatic patients with low-gradient severe Aortic valve Stenosis (ROTAS) trial aimed to assess the superiority of aortic valve replacement (AVR) versus medical treatment (MT) in this specific group of AS patients.MethodsPatients with symptomatic LG severe AS and preserved LVEF (>50%) underwent dobutamine stress echocardiography and/or CT-aortic calcium score to confirm AS severity and were then randomised 1:1 to AVR or MT. The primary endpoint was a composite of overall death and/or cardiovascular hospitalisation.ResultsThe ROTAS study was stopped early because of insufficient recruitment. In the end, only 52 patients (age 79±7 years; women 54%; NYHA III-IV 27%; median STS score 3.3%) were included in the study. During follow-up (mean: 14±7 months), the primary endpoint occurred in 12 (23%) patients. Compared with MT, AVR was not associated with a significant prognostic benefit (events: 5/26 (19%) vs 7/26 (27%) (HR 0.76, 95% CI 0.24 to 2.39, p=0.63). During follow-up, 11 (42%) patients in the MT group developed class I criteria for AVR or severe symptoms justifying a cross-over to the AVR group.ConclusionsBecause of the small number of included patients and short follow-up the ROTAS trial was underpowered and unable to demonstrate a difference in the study endpoint between treatment arms. In patients in the MT arm, a regular echocardiographic and clinical assessment might be useful to disclose those developing class I indications of AVR or severe AS-related symptoms.Trial registration numberNCT01835028.
Adenovirus vaccine targeting kinases induces potent antitumor immunity in solid tumors
Authors: Zhu Fei , Lu Zheng , Tang Wenjing , Zhao Guangya , Shao Yingxiang , Lu Bowen , Ding Jiage , Zheng Yanyan , Fang Lin , Li Huizhong , Wang Gang , Chen Renjin , Zheng Junnian , Chai Dafei 
Published: August 2024

BackgroundTargeting kinases presents a potential strategy for treating solid tumors; however, the therapeutic potential of vaccines targeting kinases remains uncertain.MethodsAdenovirus (Ad) vaccines encoding Aurora kinase A (AURKA) or cyclin-dependent kinase 7 (CDK7) were developed, and their therapeutic potentials were investigated by various methods including western blot, flow cytometry, cytotoxic T lymphocyte assay, and enzyme-linked immunospot (ELISpot), in mouse and humanized solid tumor models.ResultsCo-immunization with Ad-AURKA/CDK7 effectively prevented subcutaneous tumor growth in the Renca, RM-1, MC38, and Hepa1-6 tumor models. In therapeutic tumor models, Ad-AURKA/CDK7 treatment impeded tumor growth and increased immune cell infiltration. Administration of Ad-AURKA/CDK7 promoted the induction and maturation of dendritic cell subsets and augmented multifunctional CD8+T-cell antitumor immunity. Furthermore, the vaccine induced a long-lasting antitumor effect by promoting the generation of memory CD8+T cells. Tumor recovery on CD8+T-cell depletion underscored the indispensable role of these cells in the observed therapeutic effects. The potent efficacy of the Ad-AURKA/CDK7 vaccine was consistently demonstrated in lung metastasis, orthotopic, and humanized tumor models by inducing multifunctional CD8+T-cell antitumor immune responses.ConclusionsOur findings illustrate that the Ad-AURKA/CDK7 vaccine targeting dual kinases AURKA and CDK7 emerges as a promising and effective therapeutic approach for the treatment of solid tumors.
Providing medically assisted dying in Canada: a qualitative study of emotional and moral impact
Authors: Winters Janine Penfield , Jaye Chrystal , Pickering Neil John , Walker Simon 
Published: August 2024

PurposeMedical assistance in dying (MAiD) in Canada places the medical provider at the centre of the process. The MAiD provider holds primary responsibility for determining eligibility and becomes acquainted with patients’ inner desires and expressions of suffering. This is followed by the MAiD procedure of administering the lethal agent and being present at the death of eligible patients. We report participants’ perceptions of the emotional and moral impacts of this role.MethodologyTwo years after MAiD was legalised in Canada, 22 early-adopting physician providers were interviewed. Data were examined using both phenomenological analysis and a novel ChatGPT-enhanced analysis of an anonymised subset of interview excerpts.FindingsParticipants described MAiD as emotionally provocative with both challenges and rewards. Providers expressed a positive moral impact when helping to optimise a patient’s autonomy and moral comfort with their role in relieving suffering. Providers experienced tensions around professional duty and balancing self with service to others. Personal choice and patient gratitude enhanced the provider experience, while uncertainty and conflict added difficulty.ConclusionsParticipants described MAiD provision as strongly aligned with a patient-centred ethos of practice. This study suggests that, despite challenges, providing MAiD can be a meaningful and satisfying practice for physicians. Understanding the emotional and moral impact and factors that enhance or detract from the providers’ experience allows future stakeholders to design and regulate assisted dying in ways congruent with the interests of patients, providers, families and society.
Venous sinus stenting versus ventriculoperitoneal shunting: comparing clinical outcomes for idiopathic intracranial hypertension
Authors: Hilvert Austin Michael , Gauhar Fatima , Longo Michael , Grimaudo Heather , Dugan John , Mummareddy Nishit , Chitale Rohan , Froehler Michael T , Fusco Matthew R 
Published: August 2024

BackgroundVenous sinus stenting (VSS) has been shown to reduce intracranial venous pressures and improve symptoms in patients with idiopathic intracranial hypertension (IIH). However, long-term follow-up data are limited, raising concerns about sustained symptom improvement. We aimed to assess long-term outcomes of VSS compared with ventriculoperitoneal shunting (VPS).MethodsA retrospective case-control study assessed 87 patients with IIH who met inclusion criteria and underwent either VSS (n=27) or VPS (n=60) between 2017 and 2022. Descriptive statistics for baseline characteristics and outcomes were calculated, followed by multivariate logistic regression to identify factors associated with headache recurrence.ResultsBaseline characteristics were similar between VSS and VPS groups, including age (p=0.58), sex (p=0.74), body mass index (p=0.47), and preoperative lumbar puncture opening pressure (p=0.62). Preoperative symptoms of headaches (p=0.42), papilledema (p=0.35), and pulsatile tinnitus (p=0.56) were also similar. Initial headache improvement was comparable (96% vs 91%, p=0.42). However, headache recurrence was less common in the VSS group (31% vs 60%, p=0.015) at the last follow-up, averaging over 1 year. Multivariate analysis showed VSS was independently associated with reduced odds of headache recurrence (OR 0.24, p=0.015). Longer follow-up was associated with increased odds of headache recurrence in both groups (OR 1.01, p=0.032).ConclusionVSS was independently associated with reduced odds of headache recurrence compared with VPS in multivariate analysis. Longer follow-up was significantly associated with headache recurrence in both groups. This suggests that VSS may lead to better outcomes for continued headache relief, but headache recurrence may increase with longer follow-up regardless of treatment modality.
Rupture risk assessment in cerebral arteriovenous malformations: an ensemble model using hemodynamic and morphological features
Authors: Zhu Haoyu , Liu Lian , Liang Shikai , Ma Chao , Chang Yuzhou , Zhang Longhui , Fu Xiguang , Song Yuqi , Zhang Jiarui , Zhang Yupeng , Jiang Chuhan 
Published: August 2024

BackgroundCerebral arteriovenous malformation (AVM) is a cerebrovascular disorder posing a risk for intracranial hemorrhage. However, there are few reliable quantitative indices to predict hemorrhage risk accurately. This study aimed to identify potential biomarkers for hemorrhage risk by quantitatively analyzing the hemodynamic and morphological features within the AVM nidus.MethodsThis study included three datasets comprising consecutive patients with untreated AVMs between January 2008 to December 2023. Training and test datasets were used to train and evaluate the model. An independent validation dataset of patients receiving conservative treatment was used to evaluate the model performance in predicting subsequent hemorrhage during follow-up. Hemodynamic and morphological features were quantitatively extracted based on digital subtraction angiography (DSA). Individual models using various machine learning algorithms and an ensemble model were constructed on the training dataset. Model performance was assessed using the confusion matrix-related metrics.ResultsThis study included 844 patients with AVMs, distributed across the training (n=597), test (n=149), and validation (n=98) datasets. Five hemodynamic and 14 morphological features were quantitatively extracted for each patient. The ensemble model, constructed based on five individual machine-learning models, achieved an area under the curve of 0.880 (0.824–0.937) on the test dataset and 0.864 (0.769–0.959) on the independent validation dataset.ConclusionQuantitative hemodynamic and morphological features extracted from DSA data serve as potential indicators for assessing the rupture risk of AVM. The ensemble model effectively integrated multidimensional features, demonstrating favorable performance in predicting subsequent rupture of AVM.