bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the COVID-19 era on preventative primary care for children 0–5 years old: a scoping review protocol
Authors: Qi Xin , Jordan Mackenzie , Mignacca Isabella , Bayoumi Imaan , Li Patricia 
Published: April 2024

Abstract
Background
The COVID-19 pandemic has resulted in widespread disruptions to primary healthcare delivery and shifts to virtual care. Reduced in-person paediatric primary care visit rates have been reported. However, the extent to which access to primary preventative care has been impacted remains unclear. The objective of this scoping review is to characterise the utilisation of preventative primary care and its association with child development for children ages 0–5 years old during the COVID-19 era. In addition, we will determine if specific groups of children are at greater risk for reduced access to care.

Methods
A systematic search will be conducted for studies published between March 11, 2020, and October 2023 in the following databases: MEDLINE (Ovid), Embase (Ovid), Cochrane Library (CENTRAL and CDSR), Web of Science, and CINAHL (EBSCOhost). This scoping review will follow the methodological framework developed by Arksey and O’Malley and updated by the Joanna Briggs Institute (JBI). Studies related to primary preventative care of children aged 0–5 years old conducted in English and in high-income countries will be screened. Studies published before March 11, 2020, in acute care and low–middle-income settings will be excluded. Results will be summarised for appointments attended, delayed, and missed. In addition, we will summarise findings on the impact of COVID-19 on child development. Findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines.

Discussion
Further investigation is required to better understand the relationship between attendance of preventative primary care for children and its effects on child development. The findings obtained from this review will offer essential context to guide policy-making and healthcare service planning for the period following the pandemic.
Agomirs upregulating carboxypeptidase E expression rescue hippocampal neurogenesis and memory deficits in Alzheimer’s disease
Authors: Jiang Dongfang , Liu Hongmei , Li Tingting , Zhao Song , Yang Keyan , Yao Fuwen , Zhou Bo , Feng Haiping , Wang Sijia , Shen Jiaqi , Tang Jinglan , Zhang Yu-Xin , Wang Yun , Guo Caixia , Tang Tie-Shan 
Published: April 2024

Abstract
Background
Adult neurogenesis occurs in the subventricular zone (SVZ) and the subgranular zone of the dentate gyrus in the hippocampus. The neuronal stem cells in these two neurogenic niches respond differently to various physiological and pathological stimuli. Recently, we have found that the decrement of carboxypeptidase E (CPE) with aging impairs the maturation of brain-derived neurotrophic factor (BDNF) and neurogenesis in the SVZ. However, it remains unknown whether these events occur in the hippocampus, and what the role of CPE is in the adult hippocampal neurogenesis in the context of Alzheimer’s disease (AD).

Methods
In vivo screening was performed to search for miRNA mimics capable of upregulating CPE expression and promoting neurogenesis in both neurogenic niches. Among these, two agomirs were further assessed for their effects on hippocampal neurogenesis in the context of AD. We also explored whether these two agomirs could ameliorate behavioral symptoms and AD pathology in mice, using direct intracerebroventricular injection or by non-invasive intranasal instillation.

Results
Restoration of CPE expression in the hippocampus improved BDNF maturation and boosted adult hippocampal neurogenesis. By screening the miRNA mimics targeting the 5’UTR region of Cpe gene, we developed two agomirs that were capable of upregulating CPE expression. The two agomirs significantly rescued adult neurogenesis and cognition, showing multiple beneficial effects against the AD-associated pathologies in APP/PS1 mice. Of note, noninvasive approach via intranasal delivery of these agomirs improved the behavioral and neurocognitive functions of APP/PS1 mice.

Conclusions
CPE may regulate adult hippocampal neurogenesis via the CPE–BDNF–TrkB signaling pathway. This study supports the prospect of developing miRNA agomirs targeting CPE as biopharmaceuticals to counteract aging- and disease-related neurological decline in human brains.
Estimating additional health and social costs in eating disorder care for young people during the COVID-19 pandemic: implications for surveillance and system transformation
Authors: Obeid Nicole , Coelho Jennifer S. , Booij Linda , Dimitropoulos Gina , Silva-Roy Patricia , Bartram Mary , Clement Fiona , de Oliveira Claire , Katzman Debra K. 
Published: April 2024

Abstract
Background
The impact of the COVID-19 pandemic on young people with eating disorders (EDs) and their families was profound, with surging rates of hospitalizations and referrals reported internationally. This paper provides an account of the additional health and social costs of ED care for young people living in Canada incurred during the COVID-19 pandemic, drawing attention to the available data to inform these estimates while noting gaps in data capacities to account for a full view of the ED system of care.

Methods
Three methodologies were used to capture costs: (1) provincial administrative data holdings available at the Canadian Institute of Health Information (CIHI) were used by Deloitte Access Economics to conduct analyses on costs related to hospitalizations, emergency room visits, outpatient visits with physicians and loss of well-being from being on a waitlist. These were examined across three fiscal years (April 1 to March 31, 2019–2022) to compare costs from one year before to two years after the onset of the pandemic, (2) data collected on support-based community ED organizations and, (3) costs identified by young people, caregivers and health care professionals.

Results
Estimates of additional health care costs and social costs arising from ED care waitlists were estimated to have increased by 21% across the two years after the onset of the pandemic and is likely to represent an underestimate of costs. Costs related to some standard ED care services (e.g. day treatment programs) and support-based community ED organizations that saw a 118% increase in services during this time, are some examples of costs not captured in the current cost estimate.

Conclusions
This paper provides a first account of the additional health and social ED care costs associated with the pandemic, which indicate at minimum, a 21% increase. The results invite discussion for more investments in ED services for young people in Canada, as it is unclear if needs are expected to remain elevated. We suggest a call for a national surveillance strategy to improve data holdings to aid in managing services and informing policy. A robust strategy could open the door for much-needed, data-informed, system transformation efforts that can improve ED care for youth, families and clinicians.
Predictive factors and risk and protection groups for loneliness in older adults: a population-based study
Authors: Carrasco Pedro Montejo , Crespo David Prada , García Ana Isabel Reinoso , Ibáñez Monserrat Lozano , Rubio Borja Montejo , Montenegro-Peña Mercedes 
Published: April 2024

Abstract
Background
Loneliness is considered a public health problem, particularly among older adults. Although risk factors for loneliness have been studied extensively, fewer studies have focused on the protected and risk groups that these factors configure. Our objective is to analyze the variables and latent factors that predict loneliness in older adults and that enable risk and protected groups to be configured.

Methods
We employed an epidemiological, cross-sectional survey that was carried out on a random sample of 2060 people over 65 years extracted from the census. A structured telephone interview was used to assess mental and physical health, habits, quality of life, and loneliness, applying the COOP-Wonca, Goldberg General Health (GHQ-12), and Barber Questionnaires.

Results
Predictors of loneliness were: mental health, living alone, quality of life, depressive symptoms, low educational level, and some deficiency situations such as having no one to turn to for help. The factors extracted (Factorial Analysis) were: a subjective experience of poor health, objective isolation, and psychological isolation. We established at risk and protected groups (“Decision Tree” procedure), and loneliness was referred to by 73.2% of the people living alone and with poor mental health and quality of life (risk group). By contrast, only 0.8% of people living with others, with good mental health and good quality of life felt loneliness (protected group).

Conclusion
In a well-developed city, subjective and objective factors are associated with loneliness. These factors, especially those associated with at risk or protected groups, must be considered to develop strategies that address loneliness.
DFA-Net: Dual multi-scale feature aggregation network for vessel segmentation in X-ray digital subtraction angiography
Authors: Deng He , Liu Xu , Fang Tong , Li Yuqing , Min Xiangde 
Published: April 2024

AbstractEven though deep learning is fascinated in fields of coronary vessel segmentation in X-ray angiography and achieves prominent progresses, most of those models probably bring high false and missed detections due to indistinct contrast between coronary vessels and background, especially for tiny sub-branches. Image improvement technique is able to better such contrast, while boosting extraneous information, e.g., other tissues with similar intensities and noise. If incorporating features derived from original and enhanced images, the segmentation performance is improved because those images comprise complementary information from different contrasts. Accordingly, inspired from advantages of contrast improvement and encoding-decoding architecture, a dual multi-scale feature aggregation network (named DFA-Net) is introduced for coronary vessel segmentation in digital subtraction angiography (DSA). DFA-Net integrates the contrast improvement using exponent transformation into a semantic segmentation network that individually accepts original and enhanced images as inputs. Through parameter sharing, multi-scale complementary features are aggregated from different contrasts, which strengthens leaning capabilities of networks, and thus achieves an efficient segmentation. Meanwhile, a risk cross-entropy loss is enforced on the segmentation, for availably decreasing false negatives, which is incorporated with Dice loss for joint optimization of the proposed strategy during training. Experimental results demonstrate that DFA-Net can not only work more robustly and effectively for DSA images under diverse conditions, but also achieve better performance, in comparison with state-of-the-art methods. Consequently, DFA-Net has high fidelity and structure similarity to the reference, providing a way for early diagnosis of cardiovascular diseases.
Prognostic nutritional index as a predictive marker for acute kidney injury in adult critical illness population: a systematic review and diagnostic test accuracy meta-analysis
Authors: Chen Jia-Jin , Lee Tao-Han , Lai Pei-Chun , Chang Chih-Hsiang , Wu Che-Hsiung , Huang Yen-Ta 
Published: April 2024

Abstract
Background
The prognostic nutritional index (PNI), integrating nutrition and inflammation markers, has been increasingly recognized as a prognostic predictor in diverse patient cohorts. Recently, its effectiveness as a predictive marker for acute kidney injury (AKI) in various clinical settings has gained attention. This study aims to assess the predictive accuracy of the PNI for AKI in critically ill populations through systematic review and meta-analysis.

Methods
A systematic review was conducted using the databases MEDLINE, EMBASE, PubMed, and China National Knowledge Infrastructure up to August 2023. The included trials reported the PNI assessment in adult population with critical illness and its predictive capacity for AKI. Data on study characteristics, subgroup covariates, and diagnostic performance of PNI, including sensitivity, specificity, and event rates, were extracted. A diagnostic test accuracy meta-analysis was performed. Subgroup analyses and meta-regression were utilized to investigate the sources of heterogeneity. The GRADE framework evaluated the confidence in the meta-analysis’s evidence.

Results
The analysis encompassed 16 studies with 17 separate cohorts, totaling 21,239 patients. The pooled sensitivity and specificity of PNI for AKI prediction were 0.67 (95% CI 0.58–0.74) and 0.74 (95% CI 0.67–0.80), respectively. The pooled positive likelihood ratio was 2.49 (95% CI 1.99–3.11; low certainty), and the negative likelihood ratio was 0.46 (95% CI 0.37–0.56; low certainty). The pooled diagnostic odds ratio was 5.54 (95% CI 3.80–8.07), with an area under curve of summary receiver operating characteristics of 0.76. Subgroup analysis showed that PNI’s sensitivity was higher in medical populations than in surgical populations (0.72 vs. 0.55; p < 0.05) and in studies excluding patients with chronic kidney disease (CKD) than in those including them (0.75 vs. 0.56; p < 0.01). Overall, diagnostic performance was superior in the non-chronic kidney disease group.

Conclusion
Our study demonstrated that PNI has practical accuracy for predicting the development of AKI in critically ill populations, with superior diagnostic performance observed in medical and non-CKD populations. However, the diagnostic efficacy of the PNI has significant heterogeneity with different cutoff value, indicating the need for further research.
Exploring dietary changes and supplement use among cancer patients in Norway: prevalence, motivations, disclosure, information, and perceived risks and benefits: a cross sectional study
Authors: Kristoffersen Agnete E. , Stub Trine , Nilsen Jorunn V. , Nordberg Johanna Hök , Broderstad Ann Ragnhild , Wider Barbara , Bjelland Mona 
Published: April 2024

Abstract
Background
Cancer is the leading cause of death in Norway, with prostate, breast, lung, and colon cancers being the most prevalent types. Adopting a healthy and varied diet can help reduce cancer risk and recurrence. However, access to dietary counselling remains limited for cancer patients in Norway. This study aimed to investigate the prevalence of dietary supplement use and dietary changes made by cancer patients and survivors. Additionally, it sought to explore the reason(s) for such practices, communication with healthcare providers, sources of information, and reported benefits and potential harms resulting from these changes and supplement use.

Methods
Conducted in collaboration with the Norwegian Cancer Society (NCS), this online cross-sectional study targeted members of their user panel who had either current or previous cancer (n = 706). The study took place in September/October 2021, utilizing a modified cancer-specific version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). Out of 468 participants (315 women and 153 men), 67.2% consented to participate. Between-group analyses were conducted using Pearson chi-square tests and Fisher exact tests for categorical variables, while independent sample t-tests were applied for continuous variables.

Results
The majority of the participants (97%) reported making changes to their diet (78%) and/or incorporating dietary supplements (73%) in response to their cancer diagnosis. The primary goal of these changes was to strengthen their body and immune system. Almost half of the participants (49%) reported that they found these changes beneficial and discussed them openly with their healthcare providers, with family physicians being the most common point of discussion (25%). Adverse effects were reported by only a few participants, mostly mild. Information about dietary changes and supplements was primarily sourced from the internet or healthcare providers.

Conclusions
This study highlights that most individuals affected by cancer attribute to dietary adjustment. It also emphasizes the importance of addressing adherence to dietary recommendations and using reliable sources of information. Additionally, the study highlights the potential, yet currently underutilized, role of healthcare professionals in initiating dialogues about dietary interventions to address any unmet needs of patients. Such proactive engagement may contribute to the promotion of reliable sources of information and the prevention of non-evidence-based and potentially harmful diets or supplement adoption.
Comparing code-free deep learning models to expert-designed models for detecting retinal diseases from optical coherence tomography
Authors: Touma Samir , Hammou Badr Ait , Antaki Fares , Boucher Marie Carole , Duval Renaud 
Published: April 2024

Abstract
Background
Code-free deep learning (CFDL) is a novel tool in artificial intelligence (AI). This study directly compared the discriminative performance of CFDL models designed by ophthalmologists without coding experience against bespoke models designed by AI experts in detecting retinal pathologies from optical coherence tomography (OCT) videos and fovea-centered images.

Methods
Using the same internal dataset of 1,173 OCT macular videos and fovea-centered images, model development was performed simultaneously but independently by an ophthalmology resident (CFDL models) and a postdoctoral researcher with expertise in AI (bespoke models). We designed a multi-class model to categorize video and fovea-centered images into five labels: normal retina, macular hole, epiretinal membrane, wet age-related macular degeneration and diabetic macular edema. We qualitatively compared point estimates of the performance metrics of the CFDL and bespoke models.

Results
For videos, the CFDL model demonstrated excellent discriminative performance, even outperforming the bespoke models for some metrics: area under the precision-recall curve was 0.984 (vs. 0.901), precision and sensitivity were both 94.1% (vs. 94.2%) and accuracy was 94.1% (vs. 96.7%). The fovea-centered CFDL model overall performed better than video-based model and was as accurate as the best bespoke model.

Conclusion
This comparative study demonstrated that code-free models created by clinicians without coding expertise perform as accurately as expert-designed bespoke models at classifying various retinal pathologies from OCT videos and images. CFDL represents a step forward towards the democratization of AI in medicine, although its numerous limitations must be carefully addressed to ensure its effective application in healthcare.
Assessment of serum complement level in a sample of patients of idiopathic childhood epilepsy
Authors: Adel Fatema Amr , Ahmed Nahed Salah El Deen , Nassef Ayman Mohammed , El Din Mona Mokhtar Wahid 
Published: April 2024

Abstract
Background
The etiology of epilepsy is still unknown in over a third of cases and a third of patients have seizures resistant to current antiseizure drugs. Most antiseizure drugs work on suppressing seizures, not targeting the underlying pathophysiological mechanisms because these mechanisms are incompletely understood. Understanding the process of epileptogenesis may lead to pathophysiology-driven drug development of more effective treatment. The aim of this study is to assess the role of the immune system in children with epilepsy, using complement as an immune marker.

Results
The serum complement level in the cases group ranged from 1.8 to 4.5 mg/ml, with mean value 2.850 ± 0.646 mg/ml. While in the control group ranged from 2.7 to 26 mg/ml, with mean value 9.208 ± 4.805 mg/ml. The study showed a statistically significant decrease in C3 serum level in cases compared to control group with P-value < 0.001. Also, there was no statistically significant relation between seizure control and serum C3 level.

Conclusion
To conclude, it was found that complement component C3 levels are significantly lower in idiopathic childhood epilepsy patients in relation to control group.
Unnecessary organizational burden: a conceptual framework
Authors: Ginzburg Oren , Weil Stefanie , van Witteloostuijn Arjen 
Published: April 2024

AbstractThis paper investigates the mechanisms that lead organizations to impose unnecessary burdens on their actors. The prevailing narrative in the literature is that unnecessary organizational burden (UOB) is created either on purpose—as a way for an organizational actor to assert control—or inadvertently through the passage of time as layers of policies, rules, and processes accumulate. Based on a wide review of relevant literature, we propose a different explanation: in our conceptual framework, the onset and mitigation of unnecessary burdens are explained, respectively, by organizational decision-makers’ weaknesses and strengths. Our framework combines (1) a typology of unnecessary burdens with (2) a typology of factors influencing the likelihood of UOB mitigation, and (3) a typology of managerial mitigation responses to such burdens. The conceptual framework, and a series of 12 propositions, aim to offer researchers and practitioners a shared language to empirically investigate unnecessary organizational burden, and implement effective solutions.
Universality of kappa distributions
Authors: Livadiotis George , McComas David J. 
Published: April 2024

Abstract
This paper reveals the universality of the particle energy distribution function, despite the arbitrariness that characterizes the generalized thermodynamic entropic function. We show that the canonical distribution, that is, the distribution function that maximizes this entropy under the constraints of canonical ensemble, is always the same and given by the kappa distribution function. We use the recently developed entropy defect to express the generalized entropic formulation. The entropy defect is a thermodynamic concept that describes the loss of entropy due to the order induced by the presence of correlations. Then we carry out functional analysis to maximize the implicit expression of the generalized entropy. Critically, we show that the Lagrange multipliers have the same exact arbitrariness as the generalized entropic function, allowing us to cancel it out and proving the universality of canonical distribution as the kappa distribution function.