bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical and mental components after cardiac rehabilitation intervention: a systematic review and meta-analysis
Authors: Delgado B R U N O , Boto P A U L O , Moreira J O S E 
Published: July 2024

Abstract

Background
Cardiovascular disease is a major public health problem associated with high mortality and morbidity, reduced exercise capacity, and Health-related quality of life (HRQol). Interventions in Cardiac Rehabilitation (CR) programmes have gained ground in optimising these indicators, using patient-reported outcome measures (PROMs) to assess the HRQol of patients participating in these programmes, allowing them to show their state of health and make more informed clinical decisions.

Purpose
To analyse, using PROMs, the effect of CR programmes on the HRQoL of patients after a cardiac event, depending on the time of assessment.

Methods
The search was carried out in the MEDLINE, CINAHL, CENTRAL and Web of Science databases after registering the protocol in PROSPERO. We included all randomized controlled trials (RCTs) that compared interventions in CR programmes with usual care after a cardiac event and that used PROMs to assess HRQoL over time. The risk of bias was assessed using the Cochrane tool (RoB2) and the quality of evidence using the GRADE system. A meta-analysis was carried out with studies that assessed HRQoL in patients with coronary pathology using the SF-12 PROM at 6 months after a CR programme.

Results
17 studies with 4,993 patients participating in CR programmes were included. The PROMs used in these studies to assess HRQoL were SF-12 (n=7), SF-36 (n=2), EQ5D (n=5), KCCQ (n=3), MacNewHRQL (n=3) and HeartQol (n=1). In the 3 RCTs of the meta-analysis, and after applying the SF-12 PROM at 6 months after a CR programme in patients with coronary pathology, the effect of participation was positive on HRQoL only in the physical component (MD 7.02; 95%CI [0.41,13.62]; p=0.04). The results of our meta-analysis indicate a moderate overall quality of evidence, using the GRADE approach, when assessing HRQoL at 6 and 12 month after intervention in a CR program.

Conclusions
This study develops knowledge on CR by showing the different PROMs applied after a programme, demonstrating a positive effect of CR on HRQoL after evaluation by the same PROM. The importance of time for assessing HRQoL was demonstrated by applying the SF-12 after the CR programme in patients with coronary pathology, with statistically significant results in the physical domain at 6 months. Given the importance of these results in improving HRQoL, it will be important for healthcare organisations to implement PROMs, investing more time and resources in a utilisation strategy.
Nurses' perceptions of virtual consultations and home-monitoring in patients with cardiac disease: a qualitative meta-synthesis
Authors: Rosenstroem S 
Published: July 2024

Abstract

Objective
This study aims to investigate the facilitators and barriers perceived by nurses in utilizing video-consultations supported by home-monitoring for patients with cardiac disease.

Methodology
A systematic search was conducted in PubMed, CINAHL, Scopus, and Web of Science for qualitative data published in English, Norwegian, Swedish, or Danish between 2013-2023. Ten studies were included in the qualitative synthesis using Braun and Clarke's methodology.

Findings
From the qualitative meta-synthesis, a main theme emerged: Nurses’ uncertainty toward telemedicine is a risk toward the use of video-consultations and home-monitoring The findings spans from nurses' positive encounters to their frustrations with the implementation process and the inadequate technical support for both clinicians and patients. Nurses frequently experienced frustration and uncertainty regarding the quality of care delivered through virtual consultations.

Conclusion
The successful implementation of video-consultations and home-monitoring necessitates a focus on the specific context in which they are applied, considering the perspectives of both patients and nurses. Additionally, active involvement of nurses, leveraging their clinical expertise, is crucial for the effective integration of these technologies.
Cultural Differences in Daily Coupling of Subjective Views of Aging and Negative Affect
Authors: Shenkman Geva , Shrira Amit , Kornadt Anna E , Neupert Shevaun D , Tse Dwight C K , Can Reyyan , Palgi Yuval 
Published: July 2024

Abstract

Objectives
The established link between subjective views of aging (VoA) and well-being shows variations across different cultures. Although VoA show daily fluctuations, little is known about cultural differences in such fluctuations and the daily coupling of VoA and well-being. We compared Israeli Arabs to Israeli Jews in the daily coupling of VoA and negative affect (NA).

Methods
Community-dwelling older adults (N = 76, Mage = 66.71) completed measures of subjective age, subjective accelerated aging, ageist attitudes, and NA over 14 consecutive days.

Results
Respondents reported higher daily NA when they felt older, reported to be aging faster, or had more ageist attitudes. The daily coupling between subjective age/subjective accelerated aging and NA was stronger among Israeli Arabs compared to Israeli Jews. There was no such interaction with ageist attitudes.

Discussion
It is important to adopt a cultural perspective when investigating daily fluctuations in VoA and their correlates. In applied contexts, this might help to identify cultural groups that are particularly sensitive to the effects of VoA.
Sequence-to-expression approach to identify etiological non-coding DNA variations in P53 and cMYC-driven diseases
Authors: Kin Katherine , Bhogale Shounak , Zhu Lisha , Thomas Derrick , Bertol Jessica , Zheng W Jim , Sinha Saurabh , Fakhouri Walid D 
Published: July 2024

Abstract
Disease risk prediction based on genomic sequence and transcriptional profile can improve disease screening and prevention. Despite identifying many disease-associated DNA variants, distinguishing deleterious non-coding DNA variations remains poor for most common diseases. In this study, we designed in vitro experiments to uncover the significance of occupancy and competitive binding between P53 and cMYC on common target genes. Analyzing publicly available ChIP-seq data for P53 and cMYC in embryonic stem cells showed that ~344–366 regions are co-occupied, and on average, two cis-overlapping motifs (CisOMs) per region were identified, suggesting that co-occupancy is evolutionarily conserved. Using U2OS and Raji cells untreated and treated with doxorubicin to increase P53 protein level while potentially reducing cMYC level, ChIP-seq analysis illustrated that around 16 to 922 genomic regions were co-occupied by P53 and cMYC, and substitutions of cMYC signals by P53 were detected post doxorubicin treatment. Around 187 expressed genes near co-occupied regions were altered at mRNA level according to RNA-seq data analysis. We utilized a computational motif-matching approach to illustrate that changes in predicted P53 binding affinity in CisOMs of co-occupied elements significantly correlate with alterations in reporter gene expression. We performed a similar analysis using SNPs mapped in CisOMs for P53 and cMYC from ChIP-seq data, and expression of target genes from GTEx portal. We found significant correlation between change in cMYC-motif binding affinity in CisOMs and altered expression. Our study brings us closer to developing a generally applicable approach to filter etiological non-coding variations associated with common diseases.
The potential and pitfalls of using a large language model such as ChatGPT, GPT-4, or LLaMA as a clinical assistant
Authors: Zhang Jingqing , Sun Kai , Jagadeesh Akshay , Falakaflaki Parastoo , Kayayan Elena , Tao Guanyu , Haghighat Ghahfarokhi Mahta , Gupta Deepa , Gupta Ashok , Gupta Vibhor , Guo Yike 
Published: July 2024

Abstract

Objectives
This study aims to evaluate the utility of large language models (LLMs) in healthcare, focusing on their applications in enhancing patient care through improved diagnostic, decision-making processes, and as ancillary tools for healthcare professionals.

Materials and Methods
We evaluated ChatGPT, GPT-4, and LLaMA in identifying patients with specific diseases using gold-labeled Electronic Health Records (EHRs) from the MIMIC-III database, covering three prevalent diseases—Chronic Obstructive Pulmonary Disease (COPD), Chronic Kidney Disease (CKD)—along with the rare condition, Primary Biliary Cirrhosis (PBC), and the hard-to-diagnose condition Cancer Cachexia.

Results
In patient identification, GPT-4 had near similar or better performance compared to the corresponding disease-specific Machine Learning models (F1-score ≥ 85%) on COPD, CKD, and PBC. GPT-4 excelled in the PBC use case, achieving a 4.23% higher F1-score compared to disease-specific “Traditional Machine Learning” models. ChatGPT and LLaMA3 demonstrated lower performance than GPT-4 across all diseases and almost all metrics. Few-shot prompts also help ChatGPT, GPT-4, and LLaMA3 achieve higher precision and specificity but lower sensitivity and Negative Predictive Value.

Discussion
The study highlights the potential and limitations of LLMs in healthcare. Issues with errors, explanatory limitations and ethical concerns like data privacy and model transparency suggest that these models would be supplementary tools in clinical settings. Future studies should improve training datasets and model designs for LLMs to gain better utility in healthcare.

Conclusion
The study shows that LLMs have the potential to assist clinicians for tasks such as patient identification but false positives and false negatives must be mitigated before LLMs are adequate for real-world clinical assistance.
Accounting for taste: preferences mediate the relationship between documentation time and ambulatory physician burnout
Authors: Apathy Nate C , Hartman-Hall Heather , Tran Alberta , Kim Dae Hyun , Ratwani Raj M , Marchalik Daniel 
Published: July 2024

Abstract

Objectives
Physician burnout in the US has reached crisis levels, with one source identified as extensive after-hours documentation work in the electronic health record (EHR). Evidence has illustrated that physician preferences for after-hours work vary, such that after-hours work may not be universally burdensome. Our objectives were to analyze variation in preferences for after-hours documentation and assess if preferences mediate the relationship between after-hours documentation time and burnout.

Materials and Methods
We combined EHR active use data capturing physicians’ hourly documentation work with survey data capturing documentation preferences and burnout. Our sample included 318 ambulatory physicians at MedStar Health. We conducted a mediation analysis to estimate if and how preferences mediated the relationship between after-hours documentation time and burnout. Our primary outcome was physician-reported burnout. We measured preferences for after-hours documentation work via a novel survey instrument (Burden Scenarios Assessment). We measured after-hours documentation time in the EHR as the total active time respondents spent documenting between 7 pm and 3 am.

Results
Physician preferences varied, with completing clinical documentation after clinic hours while at home the scenario rated most burdensome (52.8% of physicians), followed by dealing with prior authorization (49.5% of physicians). In mediation analyses, preferences partially mediated the relationship between after-hours documentation time and burnout.

Discussion
Physician preferences regarding EHR-based work play an important role in the relationship between after-hours documentation time and burnout.

Conclusion
Studies of EHR work and burnout should incorporate preferences, and operational leaders should assess preferences to better target interventions aimed at EHR-based contributors to burnout.
The incremental design of a machine learning framework for medical records processing
Authors: Streiffer Christopher , Saini Divya , Whitehead Gideon , Daniel Jency , Garzon-Mrad Carolina , Kavanaugh Laura , Anyanwu Emeka 
Published: July 2024

Abstract

Objectives
This work presents the development and evaluation of coordn8, a web-based application that streamlines fax processing in outpatient clinics using a “human-in-the-loop” machine learning framework. We demonstrate the effectiveness of the platform at reducing fax processing time and producing accurate machine learning inferences across the tasks of patient identification, document classification, spam classification, and duplicate document detection.

Methods
We deployed coordn8 in 11 outpatient clinics and conducted a time savings analysis by observing users and measuring fax processing event logs. We used statistical methods to evaluate the machine learning components across different datasets to show generalizability. We conducted a time series analysis to show variations in model performance as new clinics were onboarded and to demonstrate our approach to mitigating model drift.

Results
Our observation analysis showed a mean reduction in individual fax processing time by 147.5 s, while our event log analysis of over 7000 faxes reinforced this finding. Document classification produced an accuracy of 81.6%, patient identification produced an accuracy of 83.7%, spam classification produced an accuracy of 98.4%, and duplicate document detection produced a precision of 81.0%. Retraining document classification increased accuracy by 10.2%.

Discussion
coordn8 significantly decreased fax-processing time and produced accurate machine learning inferences. Our human-in-the-loop framework facilitated the collection of high-quality data necessary for model training. Expanding to new clinics correlated with performance decline, which was mitigated through model retraining.

Conclusion
Our framework for automating clinical tasks with machine learning offers a template for health systems looking to implement similar technologies.
Development and Validation of a GC–MS Method Based on Solid-Phase Extraction and Derivatization for Analysis of Free and Glucuronide-Conjugated Bisphenol F in Biological Samples
Authors: Cao Xu-Liang , Popovic Svetlana , Gill Santokh 
Published: July 2024

Abstract

Background
As one of the speculated bisphenols to replace bisphenol A (BPA), bisphenol F (BPF), naturally present in mustard, is structurally similar to BPA and may have similar estrogenic activity, but information on its toxicity is very limited compared to BPA.

Objective
In order to support the toxicology study of BPF at Heath Canada, a GC–MS method based on solid-phase extraction (SPE) and derivatization was developed for analysis of BPF in liver samples.

Methods
Samples were treated with β-glucuronidase to convert BPF glucuronide to free BPF for analysis of total BPF.

Results
The method was validated for free BPF at different spiking levels, and recoveries ranged from 90–97.5% with RSDs from 0.11–5.54%. The method was also validated for glucuronide-conjugated BPF at different spiking levels of BPF mono-β-D-glucuronide: recoveries ranged from 72.3–93.3% with RSDs from 1.7–8.94%. The method was used to analyze 60 liver tissue samples from rats dosed with BPF at different levels in a toxicology study. Free and glucuronide-conjugated BPF were not detected in any of the control samples, which were not dosed with BPF (average method detection limit: 0.31 ng/g) but detected in all the other liver tissue samples with levels increasing at higher doses. The percentage of glucuronide-conjugated BPF in total BPF varied among the liver samples, from as low as 9.8% to as high as 77.9%, indicating the importance of analyzing biological samples for BPF in both free and conjugated forms for total exposure.

Conclusion
A GC–MS method based on solid-phase extraction (SPE) and derivatization was developed for analysis of both free and glucuronide-conjugated BPF in liver samples. This method was validated not only for free BPF, but also for mono-β-D-glucuronide-conjugated BPF for the first time to confirm the efficiency of the deconjugation procedure with enzyme.

Highlights
This method can be adapted and applied for analysis of free and glucuronide-conjugated BPF in other biological samples with appropriate validation in target sample matrixes.
Penalization and Color Code Technical Approaches for Method Greenness and Whiteness Appraisal in Veterinary Medication: Assay of Toltrazuril Suspension
Authors: Kamal Miranda F , Youssef Rasha M , El-Sayed Nehal W , Morshedy Samir , Elbordiny Haydi S 
Published: July 2024

Abstract

Background
Intestinal coccidiosis is a debilitating disease in poultry and livestock, leading to economic impact worldwide. Coccidiosis is prevented and treated in broilers by the inclusion of anticoccidials in feed. Toltrazuril is administered in potable water to treat coccidiosis.

Objective
Three robust analytical methods for the quantitation of toltrazuril in pure and pharmaceutical formulations are developed. Furthermore, ecological metrics, either penalization- or color-code-based techniques, are applied for the appraisal of assays.

Methods
First, second-derivative (Δλ; 5 nm) spectrophotometric method is used. Toltrazuril is measured from peak to peak at 244–260 nm within a linearity range of 5–25 μg/mL. The second method is an HPTLC analysis performed on an aluminum sheet of silica gel using ethyl acetate–methanol–ammonium chloride buffer–water (8:1:0.5:0.5, by volume respectively) as the elution phase. Toltrazuril, at a retardation factor of 0.66 ± 0.01, is linearly determined in the range of 1–9 μg/spot at 243 nm. The third method is reversed-phase HPLC with diode array detection, using an Agilent C18 column (5 μm, 4.6 × 150 mm) in isocratic elution mode at 1 mL/min flow rate with a mobile phase of acetonitrile and water in a ratio of 80:20 (v/v). Toltrazuril elutes at a retention time of 2.58 ± 0.1 min and is linearly determined at 243 nm in the range of 0.25–25 μg/mL.

Results
Calculated 2D-values and peak areas are highly correlated to their corresponding drug concentrations at coefficients: r &gt; 0.999. All methods were International Council of Harmonization (ICH) validated and applied to the dosage form with satisfactory % recoveries (97–103%). Statistical comparisons versus reported one using t-test and F-test disclose insignificant variation. In examining greenness and whiteness norms, the proposed methods were evaluated and ranked alongside four different reported methods.

Conclusions
The proposed methods are green, accurate, and can be applied in routine QC for the determination of toltrazuril in pharmaceutical formulations.

Highlights
Intestinal coccidiosis substantially affects the chicken intestinal tract leading to reduced growth. Toltrazuril is used for the treatment and prevention of intestinal coccidiosis. Three robust, accurate, and precise analytical methods are developed for toltrazuril determination in pure and pharmaceutical formulations. All proposed methods were ecologically assessed and compared with published ones.
One-carbon metabolite supplementation increases vitamin B12, folate, and methionine cycle metabolites in beef heifers and fetuses in an energy dependent manner at day 63 of gestation
Authors: Syring Jessica G , Crouse Matthew S , Entzie Yssi L , King Layla E , Hirchert Mara R , Ward Alison K , Reynolds Lawrence P , Borowicz Pawel P , Dahlen Carl R , Caton Joel S 
Published: July 2024

Abstract
One-carbon metabolites (OCM) are metabolites and cofactors which include folate, vitamin B12, methionine, and choline that support methylation reactions. The objectives of this study were to investigate the effects of moderate changes in maternal body weight gain in combination with OCM supplementation during the first 63 d of gestation in beef cattle on (1) B12 and folate concentrations in maternal serum (2) folate cycle intermediates in maternal and fetal liver, allantoic fluid (ALF), and amniotic fluid (AMF) and (3) metabolites involved in one-carbon metabolism and related metabolic pathways in maternal and fetal liver. Heifers were either intake restricted (RES) and fed to lose 0.23 kg/d, or fed to gain 0.60 kg/d (CON). Supplemented (+ OCM) heifers were given B12 and folate injections weekly and fed rumen-protected methionine and choline daily, while non-supplemented (-OCM) heifers were given weekly saline injections. These two treatments were combined in a 2 × 2 factorial arrangement resulting in 4 treatments: CON-OCM, CON + OCM, RES-OCM, and RES + OCM. Samples of maternal serum, maternal and fetal liver, ALF, and AMF were collected at slaughter on day 63 of gestation. Restricted maternal nutrition most notably increased (./ ≤ 0.05) the concentration of vitamin B12 in maternal serum, 5,10-methylenetetrahydrofolate and 5,10-methenyltetrahydrofolate in maternal liver, and cystathionine in the fetal liver; conversely, maternal restriction decreased (P = 0.05) 5,10-methylenetetrahydrofolate concentration in fetal liver. Supplementing OCM increased (P ≤ 0.05) the concentrations of maternal serum B12, folate, and folate intermediates, ALF and AMF 5-methyltetrahydrofolate concentration, and altered (P ≤ 0.02) other maternal liver intermediates including S-adenosylmethionine, dimethylglycine, cystathionine Glutathione reduced, glutathione oxidized, taurine, serine, sarcosine, and pyridoxine. These data demonstrate that OCM supplementation was effective at increasing maternal OCM status. Furthermore, these data are similar to previously published literature where restricted maternal nutrition also affected maternal OCM status. Altering OCM status in both the dam and fetus could impact fetal developmental outcomes and production efficiencies. Lastly, these data demonstrate that fetal metabolite abundance is highly regulated, although the changes required to maintain homeostasis may program altered metabolism postnatally.
Piscivory by the crabs Cancer productus Randall, 1840 and Pugettia producta (Randall, 1840) (Decapoda: Brachyura: Cancridae, Epialtidae)
Authors: Jensen Gregory C 
Published: July 2024

ABSTRACT
Cancer productus Randall, 1840 and Pugettia producta (Randall, 1840) have been observed in the field feeding on live teleost fishes, an unexpected behavior for the molluscivorous C. productus and the largely herbivorous P. producta. Crabs were seen employing a speculative hunting technique of pouncing on tufts of algae or open areas of sediment followed by probing with the pereopods. Such behaviors suggest that food web relationships involving crabs may be much more complex than usually assumed.
A Bipartisan Approach to Political Prosecutions
Authors: Ayres Ian , Prakash Saikrishna Bangalore 
Published: July 2024

Abstract
The multiple prosecutions of a former President, and the threat of reprisals should he return to the Oval Office, places the Republic on an awful precipice. There is a pervasive perception that prosecutions have been, or soon will be, weaponized against opponents. To restore confidence, an innovative check is essential. We propose the creation of a Prosecutor Jury—a mechanism that balances the requirement that politicians be held accountable for their crimes, against the need to avert weaponized prosecutions that target enemies. Before prosecuting high-level politicians, the Department of Justice should randomly select ten former prosecutors nominated by Democratic Presidents and ten former prosecutors nominated by Republican Presidents. The Department should prosecute only if at least two-thirds of these former prosecutors agree that a prosecution is warranted. Further, the Department should apply this framework to decide whether to prosecute presidential candidates, members of Congress, candidates for Congress, and federal judges. To test our procedure and provide a simulacrum, we applied our framework, and conducted surveys of former US Attorneys to assess whether former President Donald Trump should have been indicted, yielding fascinating results. The results differed substantially across the indictments, with strong bipartisan support for the Florida prosecution. We believe that Prosecutor Juries have the potential to ensure that no high officer is above the law, nor laid low because of partisan machinations.