bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the effectiveness of large language models in patient education for conjunctivitis
Authors: Wang Jingyuan , Shi Runhan , Le Qihua , Shan Kun , Chen Zhi , Zhou Xujiao , He Yao , Hong Jiaxu 
Published: August 2024

Aims
To evaluate the quality of responses from large language models (LLMs) to patient-generated conjunctivitis questions.

Methods
A two-phase, cross-sectional study was conducted at the Eye and ENT Hospital of Fudan University. In phase 1, four LLMs (GPT-4, Qwen, Baichuan 2 and PaLM 2) responded to 22 frequently asked conjunctivitis questions. Six expert ophthalmologists assessed these responses using a 5-point Likert scale for correctness, completeness, readability, helpfulness and safety, supplemented by objective readability analysis. Phase 2 involved 30 conjunctivitis patients who interacted with GPT-4 or Qwen, evaluating the LLM-generated responses based on satisfaction, humanisation, professionalism and the same dimensions except for correctness from phase 1. Three ophthalmologists assessed responses using phase 1 criteria, allowing for a comparative analysis between medical and patient evaluations, probing the study’s practical significance.

Results
In phase 1, GPT-4 excelled across all metrics, particularly in correctness (4.39±0.76), completeness (4.31±0.96) and readability (4.65±0.59) while Qwen showed similarly strong performance in helpfulness (4.37±0.93) and safety (4.25±1.03). Baichuan 2 and PaLM 2 were effective but trailed behind GPT-4 and Qwen. The objective readability analysis revealed GPT-4’s responses as the most detailed, with PaLM 2’s being the most succinct. Phase 2 demonstrated GPT-4 and Qwen’s robust performance, with high satisfaction levels and consistent evaluations from both patients and professionals.

Conclusions
Our study showed LLMs effectively improve patient education in conjunctivitis. These models showed considerable promise in real-world patient interactions. Despite encouraging results, further refinement, particularly in personalisation and handling complex inquiries, is essential prior to the clinical integration of these LLMs.
Systematic mapping review of player safety, sport science and clinical care in lacrosse
Authors: Wallace Kyle , Scarneo-Miller Samantha E. , Monnin Jennifer , Lincoln Andrew E , Hraky Omar , Gosnell Griffith , Jeong Suin , Skinner Wilson , Schaefer Eliana , Desai Dharmi K , Caswell Shane V 
Published: August 2024

ObjectiveThe objective is to comprehensively classify the types, topics and populations represented in the published lacrosse literature.DesignMapping review. Protocol registration at Open Science Framework (https://osf.io/kz4e6).Data sources10 electronic databases were searched from inception to 31 March 2023.Eligibility criteriaPeer-reviewed studies in English that included lacrosse were eligible. Publications without participant demographic or lacrosse-specific data were excluded.ResultsWe identified 498 articles pertaining to lacrosse, with 270 (54.2%) focused on player safety, 128 (25.7%) on sport science and 74 (14.9%) on clinical care. Musculoskeletal injury was the focus of 179 studies (35.9%), and the most common study design was cross-sectional (n=162, 32.5%). Most (n=423, 84.9%) originated in the USA. Over half (n=254, 51.0%) were published since 2017. 216 articles (43.4%) included female and male athletes, while 112 (22.5%) and 142 (28.5%) focused solely on female and male athletes, respectively. Collegiate athletes were the most frequent study population (n=277, 55.6%), and traditional field lacrosse was the focus of 298 (59.8%) articles. We observed that 77.1% (27/35) of quasiexperimental, 91.3% (21/23) of randomised controlled trials and 62.1% (18/29) of systematic reviews had a high or moderate risk of bias.ConclusionThe vast majority of lacrosse research originates from the USA, is in collegiate athletes, with a focus on player safety, and has a high risk of bias. With the sport’s inclusion in the 2028 Olympics and growing global participation, higher quality research studies that are more inclusive and adaptable to diverse athletic groups and changing gameplay parameters are needed.
Adipose tissue–derived adipsin marks human aging in non-type 2 diabetes population
Authors: Maity Sujay Krishna , Das Sharma Avinil , Sarkar Jit , Chaudhuri Tamonash , Tantia Om , Chakrabarti Partha 
Published: August 2024

IntroductionAdipsin or complement factor D is an adipokine that augments insulin secretion, is altered in various degrees of obesity, and is involved in alternative complement pathway. However, whether adipsin has any independent association with risk factors and biomarkers in patients with type 2 diabetes (T2D) remains elusive.Research design and methodsWe performed an oral glucose tolerance test on a subset of 43 patients with T2D from the community health cohort to access the role of adipsin in insulin secretion. We further cross-sectionally examined the role of adipsin in plasma, adipose tissue (AT), and secretion in a community cohort of 353 subjects and a hospital cohort of 52 subjects.ResultsWe found that plasma adipsin has no significant correlation with insulin secretion in people with diabetes. Among the risk factors of T2D, adipsin levels were independently associated only with age, and a positive correlation between plasma adipsin and age among subjects without T2D was lost in patients with T2D. Plasma adipsin levels, AT adipsin expression, and secretion were upregulated both in T2D and aging, with a corresponding drop in Homeostatic Model Assessment for assessing β-cell function. Adipsin expression was positively associated with other aging biomarkers, such as β-galactosidase, p21, and p16. These results also corroborated with existing plasma proteomic signatures of aging, including growth, and differentiation factor-15, which strongly correlated with adipsin.ConclusionsOur results demonstrate an increase in circulating adipsin in T2D and aging, and it scores as a candidate plasma marker for aging specifically in non-T2D population.
Associations of gut microbiota features and circulating metabolites with systemic inflammation in children
Authors: Bohn Bruno , Tilves Curtis , Chen Yingan , Doyon Myriam , Bouchard Luigi , Perron Patrice , Guérin Renée , Massé Éric , Hivert Marie-France , Mueller Noel T 
Published: August 2024

ObjectiveGut microbes and microbe-dependent metabolites (eg, tryptophan-kynurenine-serotonin pathway metabolites) have been linked to systemic inflammation, but the microbiota-metabolite-inflammation axis remains uncharacterised in children. Here we investigated whether gut microbiota features and circulating metabolites (both microbe-dependent and non-microbe-dependent metabolites) associated with circulating inflammation markers in children.MethodsWe studied children from the prospective Gen3G birth cohort who had data on untargeted plasma metabolome (n=321 children; Metabolon platform), gut microbiota (n=147; 16S rRNA sequencing), and inflammation markers (plasminogen activator inhibitor-1 (PAI-1), monocyte chemoattractant protein-1, and tumour necrosis factor-α) measured at 5–7 years. We examined associations of microbial taxa and metabolites—examining microbe-dependent and non-microbe-dependent metabolites separately—with each inflammatory marker and with an overall inflammation score (InfSc), adjusting for key confounders and correcting for multiple comparisons. We also compared the proportion of significantly associated microbe-dependent versus non-microbe-dependent metabolites, identified a priori (Human Microbial Metabolome Database), with each inflammation marker.ResultsOf 335 taxa tested, 149 were associated (qFDR<0.05) with at least one inflammatory marker; 10 of these were robust to pseudocount choice. Several bacterial taxa involved in tryptophan metabolism were associated with inflammation, including kynurenine-degradingRuminococcus, which was inversely associated with all inflammation markers. Of 1037 metabolites tested, 315 were previously identified as microbe dependent and were more frequently associated with PAI-1 and the InfSc than non-microbe dependent metabolites. In total, 87 metabolites were associated (qFDR<0.05) with at least one inflammation marker, including kynurenine (positively), serotonin (positively), and tryptophan (inversely).ConclusionA distinct set of gut microbes and microbe-dependent metabolites, including those involved in the tryptophan-kynurenine-serotonin pathway, may be implicated in inflammatory pathways in childhood.
Self-care in patients affected by inflammatory bowel disease and caregiver contribution to self-care (IBD-SELF): a protocol for a longitudinal observational study
Authors: Napolitano Daniele , Vellone Ercole , Iovino Paolo , Scaldaferri Franco , Cocchieri Antonello 
Published: August 2024

IntroductionSupporting patient self-care and the contribution of their caregivers is crucial in chronic illness care. Inflammatory bowel disease (IBD) is a chronic condition whose prevalence is expected to double, especially in Western countries. IBD symptoms can negatively impact patients’ well-being, causing high anxiety, depression, stress and reduced quality of life. These symptoms also affect the health of family members and friends, who often take on caregiving roles during exacerbations. Knowledge about self-care in IBD (IBD-SELF) is limited, and few studies have explored this context. This paper outlines a research protocol for a multicentre longitudinal study to investigate patient self-care and caregiver contributions to IBD-SELF.Methods and analysisA sample of 250 consecutive patients diagnosed with IBD and their caregivers will be recruited from 9 dedicated IBD units in northern, central and southern Italy during outpatient visits. Data collection will occur at baseline, 6 and 12 months after enrolment. Multivariable regressions, path analyses and structural equation models will identify predictors (eg, health literacy, caregiver burden and depression) and outcomes (use of healthcare services, disease severity and quality of life) of self-care and caregiver contributions. Dyadic analyses will control for the interdependence of dyad members.Ethics and disseminationEthical approval was obtained from the Territorial Ethics Committee (Lazio 3) N. 0023486/23 and registered on ClinicalTrials.gov (Identifier number:NCT06015789). This study will enhance our understanding of the self-care process in the patient–caregiver dyad in IBD, aiding the design of future educational interventions and promoting greater patient and caregiver involvement in the care pathway.Trial registration numberClinicalTrials.gov:NCT06015789.
Defining and identifying the critical elements of operational readiness for public health emergency events: a rapid scoping review
Authors: English René , Carlson Heather , Geduld Heike , Nyasulu Juliet Charity Yauka , Louw Quinette , Berner Karina , Charumbira Maria Yvonne , Pappin Michele , McCaul Michael , Joseph Conran , Gobat Nina , Boulanger Linda Lucy , Emiroglu Nedret 
Published: August 2024

IntroductionCOVID-19 showed that countries must strengthen their operational readiness (OPR) capabilities to respond to an imminent pandemic threat rapidly and proactively. We conducted a rapid scoping evidence review to understand the definition and critical elements of OPR against five core sub-systems of a new framework to strengthen the global architecture for Health Emergency Preparedness Response and Resilience (HEPR).MethodsWe searched MEDLINE, Embase, and Web of Science, targeted repositories, websites, and grey literature databases for publications between 1 January 2010 and 29 September 2021 in English, German, French or Afrikaans. Included sources were of any study design, reporting OPR, defined as immediate actions taken in the presence of an imminent threat, from groups who led or responded to a specified health emergency. We used prespecified and tested methods to screen and select sources, extract data, assess credibility and analyse results against the HEPR framework.ResultsOf 7005 sources reviewed, 79 met the eligibility criteria, including 54 peer-reviewed publications. The majority were descriptive reports (28%) and qualitative analyses (30%) from early stages of the COVID-19 pandemic. Definitions of OPR varied while nine articles explicitly used the term ‘readiness’, others classified OPR as part of preparedness or response. Applying our working OPR definition across all sources, we identified OPR actions within all five HEPR subsystems. These included resource prepositioning for early detection, data sharing, tailored communication and interventions, augmented staffing, timely supply procurement, availability and strategic dissemination of medical countermeasures, leadership, comprehensive risk assessment and resource allocation supported by relevant legislation. We identified gaps related to OPR for research and technology-enabled manufacturing platforms.ConclusionsOPR is in an early stage of adoption. Establishing a consistent and explicit framework for OPRs within the context of existing global legal and policy frameworks can foster coherence and guide evidence-based policy and practice improvements in health emergency management.
Social provisions in patients with mitochondrial diseases
Authors: Haque Sameen , Crawley Karen , Schofield Deborah , Shrestha Rupendra , Davis Ryan , Sue Carolyn M 
Published: August 2024

BackgroundMitochondrial diseases often follow a chronic, multimorbid disease course in adults. Like other chronic conditions, mitochondrial diseases present a challenge to public and community health models and patients are potentially at higher risk of social isolation and loneliness. However, there is lack of data on social provisions in mitochondrial diseases.MethodsWe performed a cross-sectional observational study on patients with a confirmed genetic or clinical diagnosis of mitochondrial disease, recruited between September 2018 and December 2021. Participants completed the Social Provisions Scale (SPS) as a measure of social support. Designated carers similarly completed the SPS in carer-specific questionnaires.Results95 mitochondrial disease patients and 24 designated carers completed the SPS. Social provisions were met for all six subscales of SPS in the mitochondrial disease cohort: (1) guidance 90.5% (n=86), (2) reassurance of self-worth 82.8% (n=77), (3) social integration 88.4% (n=84), (4) attachment 83.2% (n=79), (5) opportunity of nurturance, 61.1% (n=58) and (6) reliable alliance 95.8% (n=91). All social provisions were also met in the carer cohort.ConclusionPatients with mitochondrial diseases and their carers demonstrate a high perceived level of social support in the setting of a tertiary referral centre specialised in mitochondrial disease despite the burden of chronic disease.
Effect of acceptance and commitment therapy on fear of falling and physical activity in Parkinson’s disease: a randomised controlled trial
Authors: Gwak Jiyoung , Park Jinse 
Published: August 2024

IntroductionThis study aimed to evaluate the efficacy of acceptance and commitment therapy (ACT) in reducing the fear of falling (FOF) and promoting physical activity in individuals diagnosed with Parkinson’s disease (PD).Methods and analysisThis is a prospective, multicentre, rater-blinded and randomised controlled trial. Patients with PD and a history of falls will be randomly assigned to either an 8-week ACT intervention group or a control group receiving standard care. The primary outcomes measured will include FOF assessment using the Falls Efficacy Scale-International and physical activity levels measured via wearable sensor devices. Secondary outcomes will encompass the assessment of motor function, balance and fall frequency using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale, Berg Balance Scale and Timed Up and Go test. Objective measures of balance and physical activity will be obtained through static posturography and wearable sensors over a 3-day period, both before and after the intervention. Data will be analysed using mixed-effects models to evaluate the impact of ACT on FOF and physical activity.Ethics and disseminationWe hypothesised that ACT would lead to a significant reduction in FOF and an increase in physical activity levels compared with standard care. Additionally, this study will also examine the relationship between reduced FOF and improvements in balance and motor function. Our results will provide valuable evidence to support the effectiveness of ACT in reducing FOF and promoting physical activity among patients with PD, and if validated, ACT could be recommended as a beneficial intervention to enhance the quality of life and reduce fall-related morbidity in patients with PD.
Implementation of the WHO standards to assess the quality of care for children with acute diarrhoea: findings of a multicentre study (CHOICE) in Italy
Authors: Lazzerini Marzia , Sforzi Idanna , Liguoro Ilaria , Felici Enrico , Martelossi Stefano , Bressan Silvia , Trobia Gian Luca , Lubrano Riccardo , Fasoli Silvia , Troisi Angela , Pandullo Michela , Gagliardi Marta , Moras Paola , Galiazzo Silvia , Arrabito Marta , Sanseviero Mariateresa , Labruzzo Mariangela , Dal Bo Sara , Baltag Valentina , Dalena Paolo 
Published: August 2024

BackgroundThere is no documented experience in the use of the WHO standards for improving the quality of care (QOC) for children at the facility level. We describe the use of 10 prioritised WHO-Standard-based Quality Measures to assess QOC for children with acute diarrhoea (AD) in Italy.MethodsIn a multicentre observational study in 11 paediatric emergency departments with different characteristics and geographical location, we collected data on 3061 children aged 6 months to 15 years with AD and no complications. Univariate and multivariate analyses were conducted.ResultsStudy findings highlighted both good practices and gaps in QoC, with major differences in QOC across facilities. Documentation of body weight and temperature varied from 7.7% to 98.5% and from 50% to 97.7%, respectively (p<0.001); antibiotic and probiotic prescription rates ranged from 0% to 10.1% and from 0% to 80.8%, respectively (p<0.001); hospitalisations rates ranged between 8.5% and 62.8% (p<0.001); written indications for reassessment were provided in 10.4%–90.2% of cases (p<0.001). When corrected for children’s individual characteristics, the variable more consistently associated with each analysed outcome was the individual facility. Higher rates of antibiotics prescription (+7.6%, p=0.04) and hospitalisation (+52.9%, p<0.001) were observed for facilities in Southern Italy, compared with university centres (−36%, p<0.001), independently from children characteristics. Children’s clinical characteristics in each centre were not associated with either hospitalisation or antibiotic prescription rates.ConclusionsThe 10 prioritised WHO-Standard-based Quality Measures allow a rapid assessment of QOC in children with AD. Action is needed to identify and implement sustainable and effective interventions to ensure high QOC for all children.
Injury prevention in the US Maternal, Infant and Early Childhood Home Visiting programme
Authors: Shields Wendy , Shiang Evelyn , Omaki Elise , Kenney Anne , Gielen Andrea C 
Published: August 2024

BackgroundMany home-based interventions have been demonstrated to reduce unintentional and intentional injuries in young children aged 0–4 years, but an understanding of their inclusion in federally-funded home visiting programmes in the USA is needed.MethodsThe study team administered a survey to key informants at each of the 21 home visiting models approved for United States Maternal, Infant, and Early Childhood Home Visiting program funding being implemented in 2023. Respondents were based across the United States and in other developed countries. The survey collected information about the content used by models to address unintentional injury, parental health/wellbeing, and child abuse/neglect in children aged 0-4 years.ResultsCompleted surveys were returned by all respondents (n=21). Most models reported the inclusion of some unintentional injury, parental health/well-being and child abuse/neglect content. While models on average covered four of the five child abuse/neglect topics listed, only five of the nine topics listed for unintentional injury and parental health/well-being were covered. Among the services used by models to address topics, covering content via standardised curriculum and referrals were the most frequent while less than one-quarter of models (n=5) provided families with safety equipment to address unintentional injury. Less than half of the models evaluated outcomes from their injury prevention services, and no models conducted cost-effectiveness evaluations.ConclusionsHome visiting programmes are a promising way to reduce injuries in children at high risk, but further development and evaluation of their injury prevention content could increase their impact in the USA.
Biallelic variants in α-tubulin isotypes cause female infertility characterised as recurrent preimplantation embryo arrest
Authors: Hu Huiling , Wan Xian , Zhang Honghui , Sun Jiaqi , Meng Fei , Zhang Shuoping , Gu Yifan , Gong Fei , Zhao Han , Lin Ge , Zheng Wei 
Published: August 2024

Background

Recurrent preimplantation embryo developmental arrest (RPEA) is the most common phenotype in assisted reproductive technology treatment failure associated with identified genetic abnormalities. Currently known maternal genetic variants explain only a limited number of cases. Variants of the β-tubulin subunit gene,
TUBB8
, cause oocyte meiotic arrest and RPEA through a broad spectrum of spindle defects. In contrast, α-tubulin subunit genes are poorly studied in the context of preimplantation embryonic development.

Methods
Whole exome sequencing was performed on the PREA cohort. Functional characterisations of the identified candidate disease-causing variants were validated using Sanger sequencing, bioinformatics, in vitro functional analyses and single-cell RNA-sequencing of arrested embryos.

Results

Four homozygous variants were identified in the PREA cohort: two of
TUBA1C
(p.Gln358Ter and p.Asp444Metfs*42) and two of
TUBA4A
(p.Arg339Cys and p.Tyr440Ter). These variants cause varying degrees of spindle assembly defects. Additionally, we characterised changes in the human arrested embryo transcriptome carrying
TUBA4A
variants, with a particular focus on spindle organisation, chromosome segregation and mRNA decay.

Conclusion

Our findings identified
TUBA1C
as a novel genetic marker and expanded the genetic and phenotypic spectrum of
TUBA4A
in female infertility and RPEA, which altogether highlighted the importance of α-tubulin isotypes in preimplantation embryonic development.