bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mixed Mode Substantially Increases Hospital Consumer Assessment of Healthcare Providers and Systems Response Rates Relative to Single-Mode Protocols
Authors: Beckett Megan K. , Elliott Marc N. , Hambarsoomian Katrin , Lehrman William G. , Goldstein Elizabeth , Giordano Laura A. , Brown Julie 
Published: August 2024

Background:
Low response rates (RRs) can affect hospitals’ data collection costs for patient experience surveys and value-based purchasing eligibility. Most hospitals use single-mode approaches, even though sequential mixed mode (MM) yields higher RRs and perhaps better patient representativeness. Some hospitals may be reluctant to incur MM’s potential additional cost and complexity without knowing how much RRs would increase.

Objective:
The aim of this study was to estimate the differences in RR and patient representation between MM and single-mode approaches and to identify hospital characteristics associated with the largest RR differences from MM of single-mode protocols (mail-only, phone-only).

Research Design:
Patients were randomized within hospitals to one of 3 modes (mail-only, phone-only, MM).

Subjects:
A total of 17,415 patients from the 51 nationally representative US hospitals participating in a randomized HCAHPS mode experiment.

Results:
Mail-only RRs were lowest for ages 18–24 (7%) and highest for ages 65+ (31%–35%). Phone-only RRs were 24% for ages 18–24, increasing to 37%–40% by ages 55+. MM RRs were 28% for ages 18–24, increasing to 50%–60% by ages 65–84. Lower hospital-level mail-only RRs strongly predicted greater gains from MM. For example, a hospital with a 15% mail-only RR has a predicted MM RR >40% (with >25% occurring in telephone follow-up).

Conclusion:
MM increased representation of hard-to-reach (especially young adult) patients and hospital RRs in all mode experiment hospitals, especially in hospitals with low mail-only RRs.
The Mediating Role of Insomnia Severity in the Relationship Between Anxiety Symptoms and Suicidal Ideation
Authors: Berardelli Isabella , Sarubbi Salvatore , Trocchia Maria Anna , Longhini Ludovica , Moschillo Antonella , Rogante Elena , Cifrodelli Mariarosaria , Erbuto Denise , Innamorati Marco , Pompili Maurizio 
Published: August 2024

Abstract
Insomnia and anxiety symptoms are independent clinical variables involved in suicidal ideation in psychiatric inpatients. In this article, we investigated the relationship among insomnia severity, severity of anxiety symptoms, and suicidal ideation in a sample of psychiatric inpatients with severe mental disorders. We used a mediation model considering insomnia severity as the possible mediator of the relationship between anxiety severity and suicidal ideation. We administered the Columbia Suicide Severity Rating Scale, the Insomnia Severity Index, and the Hamilton Anxiety Rating Scale to 116 consecutive inpatients to the psychiatric unit of Sant'Andrea Hospital in Rome. The effect of anxiety symptoms was mediated by insomnia severity; patients who perceive higher anxiety symptoms were more likely to experience higher levels of insomnia and, thus, higher suicidal ideation intensity. Results showed the importance of assessing and treating both insomnia and anxiety in clinical practice.
Manifestations of Paranoid Personality in Workaholic Middle Managers
Authors: Spytska Liana 
Published: August 2024

Abstract
The problem of paranoid disorders is widespread and difficult to diagnose due to the many mental symptoms that a person often perceives as character traits. Passion for work, the so-called pathological workaholism, harms not only the suffering person but also all the people around them, affecting their quality of life and disrupting social and family ties. The purpose of study was to determine the level of pathological workaholism and its main symptoms. The objectives of the study included interviewing respondents and identifying the correlation between the level of workaholism and mental manifestations, and finding differences in the manifestations of workaholism in men and women. For this purpose, 78 people were examined, including 38 women and 40 men. All participants worked as middle managers in multinational companies. The aim was to identify people with pathological workaholism among the participants using the “Work Addiction Risk Test” questionnaire. Among managers, a high degree of predisposition to workaholism was diagnosed. We found that women have a strong tendency to be fixated on work, and as a result, they have increased rumination anxiety. Regardless of gender, managers who took part in the study showed a pronounced manifestation of paranoid and obsessive-phobic disorders, depression, and asthenic manifestations. Regarding the relationship between neurotic symptoms and a tendency to workaholism, a high correlation was observed (p < 0.05). The results of this study may be useful for specialists to develop means of preventing and effectively treating paranoid workaholism, as a disease that is increasingly having a negative impact on society.
Exploring Effects of Food Shaming on Consumers’ Food-Related Attitudes and Behaviors
Authors: Broome Jessica , Kaplan Hannah , McCullars Jessica , Harris Janet , Rosenbloom Christine 
Published: August 2024

Objective
To compare attitudes and behaviors of American adults who have experienced food shaming versus those who have not.

Design
This was an online survey of 2003 US adults, followed by an additional 5 one-on-one in-depth interviews, for a total of 2008. Data were collected between September and November 2022.

Participants
US adults (n = 2008) recruited via commercial research panels.

Main Outcome Measures
Prevalence of food shaming, and attitudes and behaviors among adults who have experienced food shaming versus those who have not.

Analysis

χ
2 and analysis of covariance investigating associations between experience with food shaming and food-related attitudes and behaviors, controlling for body mass index where possible.

Results
Nearly 3 in 10 American adults report that they have experienced food shame. Experiencing food shame correlates with higher guilt and shame, greater likelihood to engage in regimented eating, and more prevalent, as well as negative, emotions around food and imagined interactions with food and nutrition professionals.

Conclusions and Implications
Food shaming is a phenomenon with wide-reaching impacts on attitudes and behaviors. We expect that this innovative study will inform registered dietitian nutritionists and other health professionals to help people develop healthy, sustainable relationships with food.
Medical Coders’ Use of the ICD-10-CM “Unspecified” Codes for Head and Brain Injury in Emergency Department Settings
Authors: Wharton Tracy , Bailey Morgan , Peterson Alexis , Sarmiento Kelly , Bleser Julia A. , Costello Emily Hunt 
Published: August 2024

Context
In the emergency department (ED) setting, prioritizing triage and patient care may lead to challenges in capturing detailed documentation necessary for specific International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding in medical records. Consequently, the prevalent use of the “unspecified head injury” code poses concerns about the precision of ED-based administrative billing claims data when analyzed for public health surveillance of nonfatal traumatic brain injuries (TBIs). Understanding the perspective of medical coders can illuminate coding processes and opportunities to enhance coding accuracy for TBI and other head injuries in the ED.

Objective
This evaluation explores medical coders’ perspectives and challenges when assigning ICD-10-CM codes to head injuries in the ED.

Design
This qualitative evaluation utilized a phenomenological approach, which employed semi-structured interviews to understand medical coders’ perspectives, processes, and coding determinations for head injuries in the ED.

Setting
Interviews were conducted using a HIPAA-compliant video-based platform between July 2022 and January 2023.

Participants
Seventeen medical coders with ED coding experience were interviewed. Their backgrounds were diverse, though most had more than 15 years of experience.

Main Outcomes
Four qualitative themes emerged, which highlighted challenges with lack of detailed documentation, defaulting to unspecified codes, time, and productivity pressure, and additional insights into coders’ assumptions and code determination processes.

Results
Medical coders expressed challenges assigning ICD-10-CM codes to the highest level of specificity, citing issues including insufficient documentation by ED providers and terminology variations. Workplace time constraints and pressure for expedited claims also led to defaulting to unspecified codes.

Conclusions
This evaluation highlights the need for improved documentation consistency and detail in ED records to facilitate accurate ICD-10-CM coding. Alleviating time pressures, improving algorithms, and offering specialized training opportunities to medical coders could be helpful steps to improve coding specificity and data accuracy for head injuries in the ED.
Choosing Wisely in Physical Medicine and Rehabilitation
Authors: Neferu Ramona , Fortin Christian , Guo Meiqi , Robinson Lawrence , Bateman Emma A. 
Published: August 2024

Abstract
Choosing Wisely Canada aims to reduce potentially harmful or unnecessary diagnostic investigations and practices in healthcare delivery. A committee of the Canadian Association of Physical Medicine & Rehabilitation surveyed the general membership seeking suggestions on new or revised Physical Medicine & Rehabilitation Choosing Wisely Canada recommendations. Draft recommendations were revised and refined with an emphasis on resource stewardship and alignment with the Choosing Wisely Canada mission. The updated 2023 Choosing Wisely Canada recommendations for physical medicine and rehabilitation are to avoid: (1) investigating and treating asymptomatic bacteriuria in patients with neurogenic bladder; (2) recommending more than a brief period of physical and cognitive rest after mild traumatic brain injury; (3) starting opioid treatment for chronic noncancer pain without exhausting other approaches; (4) ordering diagnostic imaging for low back pain in the absence of red flags; (5) repeating injections without evaluating patients’ responses to them; and (6) recommending carpal tunnel release without first confirming nerve entrapment with electrodiagnostic studies or ultrasonography. We present unique implementation tools to equip practitioners with quality improvement strategies to adopt these recommendations into their practices. Future work will include developing recommendations that consider planetary health co-benefits, creating knowledge translation tools, and assessing the impact of recommendation adoption into clinical practice.
Attitudes and Knowledge of Electroconvulsive Therapy
Authors: Botham Nicola , Sharp Laura , Paterson Helena , Wilson Mia , Martin Daniel , Kelly Stephen , Varveris Daphne , Langan Martin Julie 
Published: August 2024

Aims
To explore knowledge and attitudes of medical students before and after exposure to a technology-enhanced learning and teaching (TELT) session about electroconvulsive therapy (ECT).

Background
Adequate knowledge of and attitudes toward ECT is essential for medical students. However, the impact of teaching on knowledge and attitudes is infrequently studied.

Methods
Fourth- and fifth year medical students at the University of Glasgow were provided with an online questionnaire before and after engaging in a remote TELT session, led by a consultant psychiatrist with expertise in ECT. The online teaching session used resources developed by a multidisciplinary team who specialize in ECT. The teaching session lasted around 1 hour. The questionnaire contained 3 sections: baseline demographics, knowledge of ECT, and attitudes toward ECT. Changes in scores were analyzed.

Results
Sixty-seven students completed the teaching session. Response rate to the precourse questionnaire was 68.7% (n = 46), and the postcourse questionnaire was 44.8% (n = 30). Prior to engaging with the learning materials, 9 students reported no knowledge of ECT and a third believed that ECT did not cause a seizure. In general, students who had personal experience of mental illness (friend, relative, or self) had more positive attitudes toward ECT and higher knowledge scores. In general, an increase in knowledge and attitude scores was found in the postcourse questionnaire.

Conclusions
Exposing medical students to a TELT session focused on ECT during their psychiatric placement appeared to improve knowledge and attitudes surrounding ECT.
Modified Electroconvulsive Therapy Normalizes Plasma GNA13 Following Schizophrenic Relapse
Authors: Zhang Hongli , Li Hui , Yu Mei , Yu Minglan , Feng Shuangshuang , Tingting Wang , Yu Yang , Zhang Jin , Liu Kezhi , Tan Youguo , Xiang Bo 
Published: August 2024

Objective
GNA13 is an important member of the G protein family, and its coding gene GNA13 has been identified as one of the risk genes for schizophrenia (SCZ). This study aimed to investigate the relationship between GNA13 levels and the clinical symptoms of SCZ following treatment with modified electroconvulsive therapy (MECT).

Methods
This study recruited 82 SCZ patients and 86 healthy controls (HCs). Each SCZ patient received 6 sessions of MECT. The Positive and Negative Syndrome Scale (PANSS) was used to assess SCZ symptom severity. Plasma levels of GNA13 were measured by enzyme-linked immunosorbent assay.

Results
Pretreatment, SCZ patients had a higher GNA13 level than HC (t = 8.199, P < 0.001). MECT reduced the GNA13 level significantly (t = 11.13, P < 0.001) and normalized the difference between SCZ and HC (t = 0.219, P = 0.827). After treatment, the downregulation of GNA13 (ΔGNA13) was negatively correlated with the positive symptoms score reduction rate (ΔP) (r = −0.379, P = 0.027) and positively correlated with the negative score reduction rate (ΔN) (r = 0.480, P = 0.004) in females. In both males and females, the receiver operating characteristic curve revealed that the pretreatment GNA13 level could help differentiate SCZ from HC (male: area under the curve = 0.792, P < 0.001; female: area under the curve = 0.814, P < 0.001).

Conclusion
The reduced expression of GNA13 after MECT may be related to the exhibition of both negative and positive symptoms of SCZ in female patients.
Electroconvulsive Therapy for Psychogenic Polydipsia and Hyponatremia in Chronic Schizophrenia
Authors: Mancini Kathryn , Plimpton Teagan , Lewis Alan S. 
Published: August 2024

Abstract
Compulsive drinking of excessive quantities of water, called psychogenic polydipsia (PP), is a challenging complication of chronic psychotic disorders, which can lead to hyponatremia and downstream morbidity or mortality. Treatments include behavioral modifications such as free water restriction, medications to modify free water excretion, and psychotropic medications to target psychotic symptoms. However, in many cases, these options remain ineffective and/or intolerable, necessitating chronic institutionalization with poor patient quality of life. Here we report the use of an acute course of 8 sessions of bilateral electroconvulsive therapy (ECT) in a 57-year-old man with chronic schizophrenia, PP, and moderate hyponatremia refractory to standard treatments in an inpatient psychiatric setting. Serum sodium normalized and remained stable during and immediately following his ECT course, despite chronic hyponatremia with high variability for months prior to ECT initiation. A literature review found remarkably few reported cases of ECT for PP in chronic schizophrenia, a surprising result given the use of this modality for patients with psychotic illness in many countries. Our findings support future investigation into the clinical utility and mechanism of ECT for PP in this patient population.
The danger zone: the joint trap of incomplete lineage sorting and long-branch attraction in placing Rafflesiaceae
Authors: Cai Liming , Liu Liang , Davis Charles C. 
Published: August 2024

AbstractTwo key factors have been implicated as major impediments to phylogenomic inference: incomplete lineage sorting (ILS)—especially in cases where clades are in the anomaly zone—and erroneous gene tree estimation—commonly manifested by long-branch attraction in the Felsenstein zone. Seldom have these factors been analyzed when they occur simultaneously as in cases involving ancient adaptive radiations. Rafflesiaceae (Malpighiales) is an iconic holoparasitic plant clade growing west of Wallace’s line in tropical Southeast Asia. This clade has been notoriously difficult to place phylogenetically and is nested within an explosive ancient radiation in Malpighiales. To complicate matters, parasitic plants like Rafflesiaceae are well-known to exhibit accelerated rates of nucleotide substitution. Here, using 2,141 genes we identify for the first time that accelerated substitution rates is a genome-wide phenomenon in holoparasites. We demonstrate two orders of magnitude increase in substitution rates in Rafflesiaceae compared to its free-living relatives, rendering nearly every gene prone to long-branch attraction. Our analyses rejected the monophyletic (Rafflesiaceae, Euphorbiaceae) clade proposed in previous studies but favored an earlier divergence of Rafflesiaceae in close affinity with Euphorbiaceae, Peraceae, Putranjivaceae, and Pandaceae. Rafflesiaceae is therefore prey to a joint trap of the anomaly and Felsenstein zones. Moreover, owing to massive gene loss within Rafflesiaceae, our simulation suggests that this represents an intractable phylogenetic problem that will never achieve a single phylogenetic resolution. Our case study highlights a seemingly insurmountable confluence of factors—a danger zone—that hinders phylogenomic resolution and demonstrates the need to be flexible in cases where multiple phylogenomic placements are equally likely.
A principled approach to community detection in interareal cortical networks
Authors: Armas Jorge Martinez , Knoblauch Kenneth , Kennedy Henry , Toroczkai Zoltan 
Published: August 2024

AbstractStructural connectivity between cortical areas, as revealed by tract-tracing is in the form of highly dense, weighted, directed, and spatially embedded complex networks. Extracting the community structure of these networks and aligning them with brain function is challenging, as most methods use local density measures, best suited for sparse graphs. Here we introduce a principled approach, based on distinguishability of connectivity profiles using the Hellinger distance, which is relatable to function. Applying it to tract-tracing data in the macaque, we show that the cortex at the interareal level is organized into a nested hierarchy of link-communities alongside with a node-community hierarchy. We find that the ½-Rényi divergence of connection profiles, a non-linear transform of the Hellinger metric, follows a Weibull-like distribution and scales linearly with the interareal distances, a quantitative expression between functional organization and cortical geometry. We discuss the relationship with the extensively studied SLN-based hierarchy.
PTEN Deletion in the Adult Dentate Gyrus Induces Epilepsy
Authors: Yonan Jennifer M. , Chen Kevin D. , Baram Tallie Z. , Steward Oswald 
Published: August 2024

ABSTRACTEmbryonic and early postnatal promotor-driven deletion of the phosphatase and tensin homolog (PTEN) gene results in neuronal hypertrophy, hyperexcitable circuitry and development of spontaneous seizures in adulthood. We previously documented that focal, vector-mediated PTEN deletion in mature granule cells of adult dentate gyrus triggers dramatic growth of cell bodies, dendrites, and axons, similar to that seen with early postnatal PTEN deletion. Here, we assess the functional consequences of focal, adult PTEN deletion, focusing on its pro-epileptogenic potential. PTEN deletion was accomplished by injecting AAV-Cre either bilaterally or unilaterally into the dentate gyrus of double transgenic PTEN-floxed, ROSA-reporter mice. Hippocampal recording electrodes were implanted for continuous digital EEG with concurrent video recordings in the home cage. Electrographic seizures and epileptiform spikes were assessed manually by two investigators, and corelated with concurrent videos. Spontaneous electrographic and behavioral seizures appeared after focal PTEN deletion in adult dentate granule cells, commencing around 2 months post-AAV-Cre injection. Seizures occurred in the majority of mice with unilateral or bilateral PTEN deletion and led to death in several cases. PTEN-deletion provoked epilepsy was not associated with apparent hippocampal neuron death; supra-granular mossy fiber sprouting was observed in a few mice. In summary, focal, unilateral deletion of PTEN in the adult dentate gyrus suffices to provoke time-dependent emergence of a hyperexcitable circuit generating hippocampus-origin, generalizing spontaneous seizures, providing a novel model for studies of adult-onset epileptogenesis.
Research on the Mechanism of Lphn1 Knockout in Inhibiting Colorectal Cancer
Authors: Wang Yi 
Published: August 2024

AbstractDecades ago, colorectal cancer was rarely diagnosed. Today, it is the fourth leading cause of cancer-related deaths worldwide, with nearly 90,000 fatalities each year.By analyzing single-cell data from tumor-bearing colorectal cancer model mice with Lphn1 knockout and wild-type Lphn1, we identified five key target genes for anticancer therapy: Ulbp1, Klrk1, Ccl6, Tlr4, Cd48, Prdm5, VSTM2A, RET, OAS2, Hdac11 and Ptchd4, along with their corresponding cell types. Additionally, we discovered tumor-inhibiting cell subpopulations, including Cd244a_T_cells_subcluster_1, Cd48_Cd244a_NK_cells_subcluster_2, and C3_Macrophages_subcluster_1, which are potential candidates for therapeutic intervention. We propose that cancer-associated fibroblasts (CAFs) serve as the primary antigen presenters for MHC class I, providing antigens to macrophages, NK cells, and T cells to combat colorectal cancer. From a cellular perspective, the knockout of Lphn1 activates the anti-colorectal cancer functions of subpopulations of macrophages, NK cells, and T cells. Macrophages enhance antitumor immune activity by engaging the Ulbp1-Klrk1 receptor pair to activate NK cells. Additionally, macrophages activate downstream functions of T cells against colorectal cancer through CD48 signaling. After the knockout of Lphn1, macrophages are recruited by autocrine Ccl6 and Ccl6 secreted by CAFs. They exhibit high expression of Tlr4 and have the potential to transition into M1-type macrophages due to changes in their cellular state. After the knockout of Lphn1, the CAFs were reduced by half. CAFs, which are part of the cell network communication associated with tumor cells, typically play an immunosuppressive role. A reduction by half indicates that the immunosuppression in the Lphn1 knockout group has significantly decreased. This suggests that the efficacy of various cancer immunotherapy drugs can be significantly enhanced. These findings could open new avenues for the treatment of colorectal cancer and contribute to the development of personalized medicine.