bluuebunny/crossref_metadata_2025_split huggingface dataset:
Doing, being, becoming and belonging in forging professional identity: Lived experiences of occupational therapists’ professional identity currently working in physical health community roles in the UK
Authors: French Emily Rosalyn , Clarke Channine 
Published: June 2024

Introduction: Professional identity is a multifaceted conceptual term combining behaviours, knowledge, skills, values, beliefs, contextual and socio-cultural factors with personal and group identity. The historical underpinning of occupational therapy is partly attributed to the difficulties occupational therapists face articulating their unique identity and the profession being misunderstood by others. Little is known about how occupational therapists working in community physical health settings experience their professional identity. Method: Interpretative phenomenological analysis was used to understand how five occupational therapists interpreted and made sense of their experiences of professional identity working in community UK physical health settings. Interviews were carried out following social media recruitment and analysed using interpretative phenomenological analysis guidance. Findings: Participants identified that their professional identity was forged through experiences over time developing skills, confidence and their inner understanding of who they were as an occupational therapists. Maintaining a secure professional identity was attributed to building their community of practice and creating a sense of belonging. Conclusion: Professional identity was forged through time and experience of ‘doing’, ‘being’ and ‘becoming’ occupational therapists. Building a community of practice and creating a sense of ‘belonging’ were key components of how these occupational therapists working in community physical health roles sustained their professional identity.
Analysis on characteristics of ground vibration induced by underground high-speed trains based on in-situ test
Authors: Dai Feng , Yang Jizhong , Bi Lanxiao , Liu Yutao 
Published: June 2024

With the increasingly emerging traffic intersection form of high-speed railways passing underneath integrated transport terminals, the ground vibration induced by trains running on underground high-speed railways has attracted extensive attention. In combination with the engineering example of a high-speed railway in construction passing underneath an airport, the wheel-drop impact test in the high-speed railway tunnel was designed to obtain the vibration characteristics of surrounding soil. The vehicle-track-tunnel-ground semi-analytical three-dimensional model was established to determine the initial dynamic load condition of the vehicle loads. The amplitude-frequency characteristic and transmission law of the ground vibration induced by trains running on underground high-speed railways were predicted and analyzed. The influences of different operation conditions, track parameters, and tunnel burial depths were compared. The research results show that the ground vibration obtained through the wheel-drop test is greatly attenuated within 10 m from the track centerline, with an attenuation rate up to 70%. The vertical vibration amplitude is obviously larger than that of the other two directions. The lateral ground vibration amplitude is the smallest with the slowest vibration attenuation speed. When the high-speed train passes through at the speed of 350 km/h, the vertical and lateral vibration levels of the ground surface within 80 m range are 20∼80 dB and 43∼72 dB, respectively. The maximum attenuation coefficient of Z-vibration level reaches 0.276 dB/m. For each increase of 50 km/h of the train speed, the Z-vibration level of the ground increases by about 2 dB. The smaller fastener stiffness leads to the greater ground vibration within 20∼50 Hz. The ground vibration level is positively correlated with the fastener stiffness above 79 Hz. When the burial depth of the tunnel is greater than 14 m, the burial depth of the tunnel has little effect on the change of the Z-vibration level of the ground.
Association Between Co-occurring Anxiety and Depressive Symptoms at Baseline and Risk for Sports-Related Concussion in Collegiate Athletes
Authors: Thomas Garrett A. , Bradson Megan L. , Riegler Kaitlin E. , Sakamoto McKenna S. , Arnett Peter A. 
Published: June 2024

Background: There is limited research examining whether mental health problems increase the risk for future concussions, even though these problems are highly prevalent in college-aged populations—including student-athletes. Purpose/Hypothesis: To examine whether affective disturbance (ie, depressive and anxiety symptoms) at baseline increases the risk for prospective concussion. It was hypothesized that athletes with co-occurring depressive/anxiety symptoms would incur the greatest risk for injury. Methods: A total of 878 collegiate athletes completed baseline neuropsychological testing. Athletes were separated into the following 4 groups based on self-reported anxiety and depressive symptoms at baseline: healthy controls; depressive symptoms alone; anxiety symptoms alone; and co-occurring depressive and anxiety symptoms. Of the 878 athletes, 88 sustained future concussions. Logistic regression was conducted with prospective concussion (yes/no) as the outcome and the affective group as the predictor. Sport was included as a covariate. Results: After controlling for sport, athletes in the co-occurring depressive/anxiety symptoms group were more than twice as likely to be diagnosed with a future concussion compared with healthy controls (odds ratio, 2.72 [95% CI, 1.33-5.57]; P = .01). The co-occurring depressive/anxiety symptoms group also showed an increased risk for prospective concussion compared with the depressive symptoms alone and anxiety symptoms alone groups, respectively. However, the results were not statistically significant. Athletes in the depressive symptoms alone and anxiety symptoms alone groups did not show a significantly increased risk for prospective concussion compared with healthy controls. Conclusion: Athletes with co-occurring depressive/anxiety symptoms at baseline showed a notably increased risk of being diagnosed with a future concussion, even after controlling for sport. This suggests that co-occurring depressive/anxiety symptoms infer a unique risk that is associated with a greater susceptibility to concussion diagnosis.
Clinical and laboratory parameters as predictors of mortality in patients with chronic liver disease presenting to emergency department- a cross sectional study
Authors: Ameena M S Salva , Nagasubramanyam Vempalli , Sharma Anand , Kaeley Nidhi , Bhardwaj Bharat Bhushan , Arora Poonam , Assis Althaf , Shankar Takshak , Prasad Hari , Rajta Mukund , Pundir Ashwani 
Published: June 2024

Abstract
Background
The World Health Organization (WHO) reports that Asia and Africa have the highest Chronic Liver Disease (CLD) mortality rate. Cirrhosis, responsible for 22.2 fatalities per 100,000 people, is India’s 10th most common cause of mortality. The increasing prevalence of chronic liver disease necessitates a study to identify predictive factors for patients who visit the emergency department. Identifying elements that enhance the predictive value of mortality in unstable patients with CLD complications is important in emergency departments. This study aims to determine Clinical and Laboratory Parameters as mortality predictors in adult chronic liver disease patients.

Methodology
The study was conducted at the emergency department of a tertiary healthcare center in Northern India. Patients with chronic liver disease above 18 years of age who satisfied the inclusion criteria were clinically evaluated. Clinical and demographic details were collected, and data was analyzed.

Results
Two hundred thirty-six patients were enrolled. The mean age was 50.77 ± 14.26 years. 78.4% of the participants were men. Abdominal distension, affecting 59.7% of patients, was the most common presenting ailment, followed by melena and hematemesis, affecting 41.9% and 32.6%, respectively. The mean stay in the emergency department was 10.29 ± 8.10 h. Refractory septic shock, the leading cause of mortality, accounts for 69.2% of all deaths, alongside grade 4 hepatic encephalopathy and massive Upper Gastrointestinal (UGI) bleeding, as identified in our study. Factors such as altered mental sensorium, high respiratory rate, low SpO2, increased heart rate, low systolic blood pressure, low diastolic blood pressure, and low Glasgow Coma Scale (GCS) on Emergency Department (ED) arrival are significantly associated with mortality.

Conclusions
Chronic liver disease, a prevalent condition in India, most commonly seen in middle aged men and lower socioeconomic groups. The parameters independently associated with mortality in our study were presence of altered mental sensorium, Glasgow coma scale, Child Pugh class and need for ICU admission. Understanding the presentation pattern, and mortality predictors can help ED physicians in managing acute events and follow-ups.
The RHCE gene encodes the chicken blood system I
Authors: Fulton Janet E. , McCarron Amy M. , Lund Ashlee R. , Drobik-Czwarno Wioleta , Mullen Abigail , Wolc Anna , Szadkowska Joanna , Schmidt Carl J. , Taylor Robert L. 
Published: June 2024

Abstract
Background
There are 13 known chicken blood systems, which were originally detected by agglutination of red blood cells by specific alloantisera. The genomic region or specific gene responsible has been identified for four of these systems (A, B, D and E). We determined the identity of the gene responsible for the chicken blood system I, using DNA from multiple birds with known chicken I blood system serology, 600K and 54K single nucleotide polymorphism (SNP) data, and lowpass sequence information.

Results
The gene responsible for the chicken I blood system was identified as RHCE, which is also one of the genes responsible for the highly polymorphic human Rh blood group locus, for which maternal/fetal antigenic differences can result in fetal hemolytic anemia with fetal mortality. We identified 17 unique RHCE haplotypes in the chicken, with six haplotypes corresponding to known I system serological alleles. We also detected deletions in the RHCE gene that encompass more than 6000 bp and that are predicted to remove its last seven exons.

Conclusions
RHCE is the gene responsible for the chicken I blood system. This is the fifth chicken blood system for which the responsible gene and gene variants are known. With rapid DNA-based testing now available, the impact of I blood system variation on response against disease, general immune function, and animal production can be investigated in greater detail.
Leveraging permutation testing to assess confidence in positive-unlabeled learning applied to high-dimensional biological datasets
Authors: Xu Shiwei , Ackerman Margaret E. 
Published: June 2024

Abstract
Background
Compared to traditional supervised machine learning approaches employing fully labeled samples, positive-unlabeled (PU) learning techniques aim to classify “unlabeled” samples based on a smaller proportion of known positive examples. This more challenging modeling goal reflects many real-world scenarios in which negative examples are not available—posing direct challenges to defining prediction accuracy and robustness. While several studies have evaluated predictions learned from only definitive positive examples, few have investigated whether correct classification of a high proportion of known positives (KP) samples from among unlabeled samples can act as a surrogate to indicate model quality.

Results
In this study, we report a novel methodology combining multiple established PU learning-based strategies with permutation testing to evaluate the potential of KP samples to accurately classify unlabeled samples without using “ground truth” positive and negative labels for validation. Multivariate synthetic and real-world high-dimensional benchmark datasets were employed to demonstrate the suitability of the proposed pipeline to provide evidence of model robustness across varied underlying ground truth class label compositions among the unlabeled set and with different proportions of KP examples. Comparisons between model performance with actual and permuted labels could be used to distinguish reliable from unreliable models.

Conclusions
As in fully supervised machine learning, permutation testing offers a means to set a baseline “no-information rate” benchmark in the context of semi-supervised PU learning inference tasks—providing a standard against which model performance can be compared.
Reweighting and validation of the hospital frailty risk score using electronic health records in Germany: a retrospective observational study
Authors: Kaier Klaus , Heidenreich Adrian , Jäckel Markus , Oettinger Vera , Maier Alexander , Hilgendorf Ingo , Breitbart Philipp , Hartikainen Tau , Keller Till , Westermann Dirk , von zur Mühlen Constantin 
Published: June 2024

Abstract
Background
In the hospital setting, frailty is a significant risk factor, but difficult to measure in clinical practice. We propose a reweighting of an existing diagnoses-based frailty score using routine data from a tertiary care teaching hospital in southern Germany.

Methods
The dataset includes patient characteristics such as sex, age, primary and secondary diagnoses and in-hospital mortality. Based on this information, we recalculate the existing Hospital Frailty Risk Score. The cohort includes patients aged ≥ 75 and was divided into a development cohort (admission year 2011 to 2013, N = 30,525) and a validation cohort (2014, N = 11,202). A limited external validation is also conducted in a second validation cohort containing inpatient cases aged ≥ 75 in 2022 throughout Germany (N = 491,251). In the development cohort, LASSO regression analysis was used to select the most relevant variables and to generate a reweighted Frailty Score for the German setting. Discrimination is assessed using the area under the receiver operating characteristic curve (AUC). Visualization of calibration curves and decision curve analysis were carried out. Applicability of the reweighted Frailty Score in a non-elderly population was assessed using logistic regression models.

Results
Reweighting of the Frailty Score included only 53 out of the 109 frailty-related diagnoses and resulted in substantially better discrimination than the initial weighting of the score (AUC = 0.89 vs. AUC = 0.80, p < 0.001 in the validation cohort). Calibration curves show a good agreement between score-based predictions and actual observed mortality. Additional external validation using inpatient cases aged ≥ 75 in 2022 throughout Germany (N = 491,251) confirms the results regarding discrimination and calibration and underlines the geographic and temporal validity of the reweighted Frailty Score. Decision curve analysis indicates that the clinical usefulness of the reweighted score as a general decision support tool is superior to the initial version of the score. Assessment of the applicability of the reweighted Frailty Score in a non-elderly population (N = 198,819) shows that discrimination is superior to the initial version of the score (AUC = 0.92 vs. AUC = 0.87, p < 0.001). In addition, we observe a fairly age-stable influence of the reweighted Frailty Score on in-hospital mortality, which does not differ substantially for women and men.

Conclusions
Our data indicate that the reweighted Frailty Score is superior to the original Frailty Score for identification of older, frail patients at risk for in-hospital mortality. Hence, we recommend using the reweighted Frailty Score in the German in-hospital setting.
Clinic-based evaluation of point-of-care dual HIV/syphilis rapid diagnostic tests at primary healthcare antenatal facilities in South Africa and Zambia
Authors: Kularatne Ranmini , Blondeel Karel , Kasaro Margaret , Maseko Venessa , Bosomprah Samuel , Silva Ronaldo , Laverty Maura , Kurbonov Firdavs , Mirandola Massimo , Peeling Rosanna W 
Published: June 2024

Abstract
Background
Southern African countries have the largest global burden of HIV and syphilis, with a high prevalence among women of reproductive age. Although antenatal screening is standard of care, syphilis screening has generally lagged behind HIV screening. We aimed to evaluate the performance and operational characteristics of two commercial dual HIV/syphilis point-of-care tests (POCTs) for simultaneous maternal HIV/syphilis screening.

Methods
A clinic-based evaluation of dual HIV/syphilis POCTs (SD Bioline and Chembio) was conducted at five primary healthcare centres (PHCs) in South Africa and Zambia. POCT results using capillary fingerprick blood were compared to reference laboratory syphilis and HIV serological assays.

Results
Three thousand four hundred twelve consenting pregnant women aged ≥ 18 years were enrolled. The prevalence of treponemal antibody seropositivity and HIV infection ranged from 3.7 to 9.9% (n = 253) and 17.8 to 21.3% (n = 643), respectively. Pooled sensitivity for syphilis compared to the reference assay was 66.0% (95%CI 57.7–73.4) with SD Bioline and 67.9% (95%CI 58.2–76.3) with Chembio. Pooled specificity for syphilis was above 98% with both POCTs. The sensitivities of SD Bioline and Chembio assays were 78.0% (95%CI 68.6–85.7) and 81.0% (95%CI 71.9–88.2), respectively compared to an active syphilis case definition of treponemal test positive with a rapid plasma reagin titre of ≥ 8. The negative predictive values (NPVs) based on various prevalence estimates for syphilis with both assays ranged from 97 to 99%. The pooled sensitivity for HIV was 92.1% (95%CI 89.4–94.2) with SD Bioline; and 91.5% (95%CI 88.2–93.9) with Chembio. The pooled specificities for HIV were 97.2% (95%CI 94.8–98.5) with SD Bioline and 96.7% (95%CI 95.1–97.8) with Chembio. The NPV based on various prevalence estimates for HIV with both assays was approximately 98%. Most participating women (91%) preferred dual POCTs over two single POCTs for HIV and syphilis, and healthcare providers gave favourable feedback on the utility of both assays at PHC level.

Conclusions
Based on the need to improve antenatal screening coverage for syphilis, dual HIV/syphilis POCTs could be effectively incorporated into antenatal testing algorithms to enhance efforts towards elimination of mother-to-child transmission of these infections.
Clinical efficacy and safety of switching from eculizumab to ravulizumab in adult patients with aHUS– real-world data
Authors: Schönfelder Kristina , Kühne Lucas , Schulte-Kemna Lena , Kaufeld Jessica , Rohn Hana , Kribben Andreas , Schröppel Bernd , Brinkkötter Paul T. , Gäckler Anja 
Published: June 2024

Abstract
Background
The complement factor 5 (C5)-inhibitor eculizumab has been established as standard-of-care for the treatment of atypical hemolytic uremic syndrome (aHUS). In 2021, the long-acting C5-inhibitor ravulizumab was approved, extending intervals of intravenous treatment from two to eight weeks resulting in improvement of quality of life for patients and lowering direct and indirect therapy associated costs.

Methods
This multicenter, retrospective data analysis of 32 adult patients with aHUS (including 10 kidney transplant recipients) treated with eculizumab for at least three months and switched to ravulizumab aims to evaluate the safety and efficacy of switching medication in the real-world setting. Hematologic parameters, kidney function, concurrent therapy and aHUS associated events were evaluated three months before and until up to 12 months after switching to ravulizumab.

Results
Mean age (range) at ravulizumab initiation was 41 years (19–78 years) and 59% of the patients were female. Genetic analysis was available for all patients with 72% showing a pathogenic variant. Median time (range) on eculizumab before switching was 20 months (3–120 months). No new events of TMA or worsening of renal function were reported during up to 12 months of follow-up during ravulizumab treatment.

Conclusions
This is the largest, non-industry derived, multi-center retrospective analysis of adult patients with aHUS switching C5-inhibitor treatment from eculizumab to ravulizumab in the real-world setting. Switching to ravulizumab was safe and efficient resulting in sustained hematological stability and preservation of renal function.
Basement membrane-related MMP14 predicts poor prognosis and response to immunotherapy in bladder cancer
Authors: Zhang Xuezhou , Hong Baoan , Li Hongwei , Zhao Jiahui , Li Mingchuan , Wei Dechao , Wang Yongxing , Zhang Ning 
Published: June 2024

Abstract
Background
Basement membrane (BM) is an important component of the extracellular matrix, which plays an important role in the growth and metastasis of tumor cells. However, few biomarkers based on BM have been developed for prognostic assessment and prediction of immunotherapy in bladder cancer (BLCA).

Methods
In this study, we used the BLCA public database to explore the relationship between BM-related genes (BMRGs) and prognosis. A novel molecular typing of BLCA was performed using consensus clustering. LASSO regression was used to construct a signature based on BMRGs, and its relationship with prognosis was explored using survival analysis. The pivotal BMRGs were further analyzed to assess its clinical characteristics and immune landscape. Finally, immunohistochemistry was used to detect the expression of the hub gene in BLCA patients who underwent surgery or received immune checkpoint inhibitor (ICI) immunotherapy in our hospital.

Results
We comprehensively analyzed the relationship between BMRGs and BLCA, and established a prognostic-related signature which was an independent influence on the prognostic prediction of BLCA. We further screened and validated the pivotal gene-MMP14 in public database. In addition, we found that MMP14 expression in muscle invasive bladder cancer (MIBC) was significantly higher and high MMP14 expression had a poorer response to ICI treatment in our cohort.

Conclusions
Our findings highlighted the satisfactory value of BMRGs and suggested that MMP14 may be a potential biomarker in predicting prognosis and response to immunotherapy in BLCA.