bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol for a construct and clinical validation study of MyCog Mobile: a remote smartphone-based cognitive screener for older adults
Authors: Young Stephanie Ruth , McManus Dworak Elizabeth , Byrne Greg J , Jones Callie Madison , Yoshino Benavente Julia , Yao Lihua , Curtis Laura M , Varela Diaz Maria , Gershon Richard , Wolf Michael , Nowinski Cindy 
Published: April 2024

IntroductionAnnual cognitive screening in older adults is essential for early detection of cognitive impairment, yet primary care settings face time constraints that present barriers to routine screening. A remote cognitive screener completed on a patient’s personal smartphone before a visit has the potential to save primary care clinics time, encourage broader screening practices and increase early detection of cognitive decline. MyCog Mobile is a promising new remote smartphone-based cognitive screening app for primary care settings. We propose a combined construct and clinical validation study of MyCog Mobile.Methods and analysisWe will recruit a total sample of 300 adult participants aged 65 years and older. A subsample of 200 healthy adult participants and a subsample of 100 adults with a cognitive impairment diagnosis (ie, dementia, mild cognitive impairment, cognitive deficits or other memory loss) will be recruited from the general population and specialty memory care centres, respectively. To evaluate the construct validity of MyCog Mobile, the healthy control sample will self-administer MyCog Mobile on study-provided smartphones and be administered a battery of gold-standard neuropsychological assessments. We will compare correlations between performance on MyCog Mobile and measures of similar and dissimilar constructs to evaluate convergent and discriminant validity. To assess clinical validity, participants in the clinical sample will self-administer MyCog Mobile on a smartphone and be administered a Mini-Cog screener and these data will be combined with the healthy control sample. We will then apply several supervised model types to determine the best predictors of cognitive impairment within the sample. Area under the receiver operating characteristic curve, accuracy, sensitivity and specificity will be the primary performance metrics for clinical validity.Ethics and disseminationThe Institutional Review Board at Northwestern University (STU00214921) approved this study protocol. Results will be published in peer-reviewed journals and summaries provided to the study’s funders.
Using Blood Wisely: lessons learnt in establishing a national implementation programme to reduce inappropriate red blood cell transfusion
Authors: Lin Yulia , Levinson Wendy , Day Doreen , Lett Ryan , Petraszko Tanya , Huynh Tai , Patey Andrea M 
Published: April 2024

BackgroundUp to 50% of blood is transfused inappropriately despite best evidence. In 2020, Choosing Wisely Canada launched a major national programme, ‘Using Blood Wisely’, the aim was to engage hospitals to audit their red blood cell transfusion use against national benchmarks and participate in a programme to decrease inappropriate use.Study designUsing Blood Wisely is a quality improvement programme including national benchmarks, an audit tool, recommended evidence-based effective interventions and a designation to reward success. Hospital engagement was measured using the number of hospitals signing up, performing a baseline audit, submitting the planning survey, entering two or more audits and achieving hospital designation. Barriers to implementation were collected.ResultsFrom 1 September 2020 to 31 December 2022, 229 individual hospitals signed up over time to participate. Their results are reported as 159 hospitals and hospital groups. Collectively, this accounts for 72% of the blood used in Canada. Overall, 147 (92%) performed a baseline audit, 10 (6%) submitted a planning survey and 130 (82%) entered two or more audits. At baseline (time of enrolment), 75 (51%) met both benchmarks. The designation was awarded to 62 (39%) hospital groups (a total of 105 individual hospitals) that met and sustained benchmarks. Barriers to implementation included human resource shortages, lack of local expertise to advise the team, need for more education of transfusion prescribers and competing priorities.ConclusionIn its initial phase, Using Blood Wisely engaged a substantial number of hospitals in transfusion quality improvement work and maintained that engagement. This large-scale engagement across a big country was more successful than anticipated. Additional efforts are needed to rigorously evaluate the programme’s impact on utilisation.
Paediatricians’ perspectives in treating lower urinary tract symptoms: a qualitative exploratory needs assessment study
Authors: Spinzi Stav , Agrawal Gunjan , Sharma Aditi , Venkatapuram Pranaya , Sharma Kritika , Brown-Johnson Cati , Kan Kathleen M 
Published: April 2024

BackgroundPaediatric lower urinary tract symptoms (LUTS) are common experiences among school-aged children, with prevalence rates reaching as high as 20%. Paediatricians are often first-line stakeholders in providing treatment for these bothersome symptoms, yet there is no formal resource to support them with the treatment of LUTS. Evaluating paediatricians’ experiences is an important step in informing health promotion efforts to improve health outcomes in children. This study aims to explore paediatricians’ knowledge, beliefs, practice patterns, and perceived barriers and facilitators in providing LUTS care.MethodsIn this qualitative study, we conducted semistructured focus groups of paediatricians within California. Focus groups were conducted via Zoom, and participants were enrolled until thematic saturation was reached. Participants were asked about their current practices, knowledge and beliefs, barriers and facilitators to care, training and education, and responsibility for behaviour and action. Thematic analysis was performed using deductive and inductive approaches; themes were mapped through an iterative, team-based process.Results15 paediatricians, aged 30–69 years, with 13 (86.7%) women, were interviewed. Most (11, 73.3%) practised in general outpatient settings. Interviewed paediatricians recognised paediatric LUTS as a common problem that can significantly impact children’s well-being. In practice, paediatricians did not actively screen for LUTS beyond the potty-training milestone due to short visit duration and competing healthcare demands. Lack of guidelines, parental mistrust and inadequate clinical education were barriers identified by paediatricians.ConclusionsPaediatricians expressed a willingness to help patients but indicated several limitations to providing adequate LUTS care. Future professional development work can emphasise guideline development, early screening strategies to support timely intervention and better education for clinicians.
Twenty-four-hour blood pressure trajectories and clinical outcomes in patients who had an acute ischaemic stroke
Authors: Wang Ruirui , Liu Yang , Zhang Qilu , Zhang Jing , Peng Hao , Shi Mengyao , Peng Yanbo , Xu Tian , Wang Aili , Xu Tan , Chen Jing , Zhang Yonghong , He Jiang 
Published: April 2024

ObjectiveThe management of blood pressure (BP) in acute ischaemic stroke remains a subject of controversy. This investigation aimed to explore the relationship between 24-hour BP patterns following ischaemic stroke and clinical outcomes.MethodsA cohort of 4069 patients who had an acute ischaemic stroke from 26 hospitals was examined. Five systolic BP trajectories were identified by using latent mixture modelling: trajectory category 5 (190–170 mm Hg), trajectory category 4 (180–140 mm Hg), trajectory category 3 (170–160 mm Hg), trajectory category 2 (155–145 mm Hg) and trajectory category 1 (150–130 mm Hg). The primary outcome was a composite outcome of death and major disability at 3 months poststroke.ResultsPatients with trajectory category 5 exhibited the highest risk, while those with trajectory category 1 had the lowest risk of adverse outcomes at 3-month follow-up. Compared with the patients in the trajectory category 5, adjusted ORs (95% CIs) for the primary outcome were 0.79 (0.58 to 1.10), 0.70 (0.53 to 0.93), 0.64 (0.47 to 0.86) and 0.47 (0.33 to 0.66) among patients in trajectory category 4, trajectory category 3, trajectory category 2 and trajectory category 1, respectively. Similar trends were observed for death, vascular events and the composite outcome of death and vascular events.ConclusionPatients with persistently high BP at 180 mm Hg within 24 hours of ischaemic stroke onset had the highest risk, while those maintaining stable BP at a moderate-low level (150 mm Hg) or even a low level (137 mm Hg) had more favourable outcomes.
Arrhythmias and cardiac MRI associations in patients with established cardiac dystrophinopathy
Authors: Bourke John , Tynan Margaret , Stevenson Hannah , Bremner Leslie , Gonzalez-Fernandez Oscar , McDiarmid Adam K 
Published: April 2024

AimsSome patients with cardiac dystrophinopathy die suddenly. Whether such deaths are preventable by specific antiarrhythmic management or simply indicate heart failure overwhelming medical therapies is uncertain. The aim of this prospective, cohort study was to describe the occurrence and nature of cardiac arrhythmias recorded during prolonged continuous ECG rhythm surveillance in patients with established cardiac dystrophinopathy and relate them to abnormalities on cardiac MRI.Methods and resultsA cohort of 10 patients (36.3 years; 3 female) with LVEF<40% due to Duchenne (3) or Becker muscular (4) dystrophy or Duchenne muscular dystrophy-gene carrying effects in females (3) were recruited, had cardiac MRI, ECG signal-averaging and ECG loop-recorder implants. All were on standard of care heart medications and none had prior history of arrhythmias.No deaths or brady arrhythmias occurred during median follow-up 30 months (range 13–35). Self-limiting episodes of asymptomatic tachyarrhythmia (range 1–29) were confirmed in 8 (80%) patients (ventricular only 2; ventricular and atrial 6). Higher ventricular arrhythmia burden correlated with extent of myocardial fibrosis (extracellular volume%, p=0.029; native T1, p=0.49; late gadolinium enhancement, p=0.49), but not with LVEF% (p=1.0) on MRI and atrial arrhythmias with left atrial dilatation. Features of VT episodes suggested various underlying arrhythmia mechanisms.ConclusionsThe overall prevalence of arrhythmias was low. Even in such a small sample size, higher arrhythmia counts occurred in those with larger scar burden and greater ventricular volume, suggesting key roles for myocardial stretch as well as disease progression in arrhythmogenesis. These features overlap with the stage of left ventricular dysfunction when heart failure also becomes overt. The findings of this pilot study should help inform the design of a definitive study of specific antiarrhythmic management in dystrophinopathy.Trial registration numberISRCTN15622536.
The role of dietary intake of live microbes in the association between leisure-time physical activity and depressive symptoms: a population-based study
Authors: You Yanwei , Wang Rui , Li Jinwei , Cao Fei , Zhang Yang , Ma Xindong 
Published: April 2024

Current research has shown promising associations between factors such as diet, total physical activity, and mental health outcomes, acknowledging the intricate interplay between these variables. However, the role of dietary intake of live microbes, coupled with leisure-time physical activity (LTPA), in their relationship to depressive symptoms necessitates further exploration. The present study examined a cohort of 25 747 individuals who participated in the National Health and Nutrition Examination Survey between the years 2007 and 2018. Patient’s Health Questionnaire (PHQ-9) was employed, whereby individuals scoring ≥ 10 were classified as exhibiting symptoms of depression. LTPA status was reported by the Global Physical Activity Questionnaire and calculated by metabolic equivalent-minutes/week. Foods consumed by participants were evaluated by live microbes per gram, which were categorized into three groups: low, medium, and high. After controlling for all covariates, findings indicated that LTPA was negatively associated with depressive symptoms (OR (95% confidence interval (CI): 0.983 (0.976, 0.990), p < 0.001). Participating in more LTPA was positively correlated with consuming all three levels of dietary live microbes (low, β (95% CI): 0.086 (0.063, 0.109); medium, β (95% CI): 0.009 (0.007, 0.012); high, β (95% CI): 0.002 (0.001, 0.002)). Moreover, taking more foods with medium live microbes was associated with lower depressive likelihood (OR (95% CI): 0.931(0.882, 0.982), p = 0.010). Intake of medium and high levels of live microbes mediated the association between LTPA and depressive symptoms by 4.15% and 0.83%, respectively. Dietary intake of foods containing medium and high levels of live microbes may be a mediator of LTPA’s negative association with depressive symptoms.
Dirac–Bergmann analysis and degrees of freedom of coincident f(Q)-gravity
Authors: Tomonari Kyosuke , Bahamonde Sebastian 
Published: April 2024

AbstractWe investigate the propagating degrees of freedom off(Q)-gravity in a 4-dimensional space-time under the imposition of the coincident gauge by performing the Dirac–Bergmann analysis. In this work, we start with a top-down reconstruction of the metric-affine gauge theory of gravity based only on the concept of a vector bundle. Then, the so-called geometrical trinity of gravity is introduced and the role of the coincident GR is clarified. After that, we reveal relationships between the boundary terms in the variational principle and the symplectic structure of the theory in order to confirm the validity of the analysis for our studied theories. Then, as examples, we revisit the analysis of GR and its$$f({\mathop {R}\limits ^{\circ }})$$f(R∘)-extensions. Finally, after reviewing the Dirac–Bergmann analysis of the coincident GR and that off(T)-gravity, we perform the analysis of coincidentf(Q)-gravity. Under the imposition of appropriate spatial boundary conditions, we find that, as a generic case, the theory has five primary, three secondary, and two tertiary constraint densities and all these constraint densities are classified into second-class constraint density; the number six is the propagating degrees of freedom of the theory and there are no longer any remaining gauge degrees of freedom. We also discuss the condition of providing seven pDoF as a generic case. The violation of diffeomorphism invariance of coincidentf(Q)-gravity make it possible to emerge such several sectors.
A quantum moving target segmentation algorithm for grayscale video based on background difference method
Authors: Wang Lu , Liu Yuxiang , Meng Fanxu , Liu Wenjie , Zhang Zaichen , Yu Xutao 
Published: April 2024

AbstractThe classical moving target segmentation (MTS) algorithm in a video can segment the moving targets out by calculating frame by frame, but the algorithm encounters a real-time problem as the data increases. Recently, the benefits of quantum computing in video processing have been demonstrated, but it is still scarce for MTS. In this paper, a quantum moving target segmentation algorithm for grayscale video based on background difference method is proposed, which can simultaneously model the background of all frames and perform background difference to segment the moving targets. In addition, a feasible quantum subtractor is designed to perform the background difference operation. Then, several quantum units, including quantum cyclic shift transformation, quantum background modeling, quantum background difference, and quantum binarization, are designed in detail to establish the complete quantum circuit. For a video containing $2^{m}$

2
m

frames (every frame is a $2^{n} \times 2^{n}$

2
n

×

2
n

image with q grayscale levels), the complexity of our algorithm is O$(n+q)$
(
n
+
q
)
. This is an exponential speedup over the classical algorithm and also outperforms the existing quantum algorithms. Finally, the experiment on IBM Q demonstrates the feasibility of our algorithm in this noisy intermediate-scale quantum (NISQ) era.
White Blood Cell Count, Neutrophil-to-Lymphocyte Ratio, and Incident Cancer in the UK Biobank
Authors: Song Minkyo , Graubard Barry I. , Loftfield Erikka , Rabkin Charles S. , Engels Eric A. 
Published: April 2024

Abstract

Background:
The peripheral white blood cell (WBC) and neutrophil-to-lymphocyte ratio (NLR) reflect levels of inflammation and adaptive immunity. They are associated with cancer prognosis, but their associations with cancer incidence are not established.

Methods:
We evaluated 443,540 cancer-free adults in the UK Biobank with data on total WBC and its subsets, follow-up starting one year after baseline. Cox regression was used to estimate hazard ratios (HR) per quartile of WBC or NLR for incidence of 73 cancer types.

Results:
22,747 incident cancers were diagnosed during a median of 6.9 years of follow-up. WBC was associated with risk of cancer overall [HR, 1.05; 95% confidence interval (CI), 1.03–1.06], chronic lymphocytic leukemia/small lymphocytic leukemia (CLL/SLL, 2.79; 95% CI, 2.45–3.18), lung cancer (1.14, 95% CI, 1.08–1.20), and breast cancer (95% CI, 1.05–1.02–1.08). NLR was positively associated with cancer overall (HR, 1.03; 95% CI, 1.02–1.04, per quartile) and kidney cancer (1.16; 95% CI, 1.07–1.25), and inversely with CLL/SLL (0.38; 95% CI, 0.33–0.42).

Conclusions:
High WBC or NLR may reflect excessive inflammatory status, promoting development of some cancers. Conversely, low NLR indicates a relative rise in lymphocytes, which could reflect an increase in circulating premalignant cells before CLL/SLL diagnosis. Peripheral WBC and NLR, in combination with other clinical information or biomarkers, may be useful tools for cancer risk stratification.

Impact:
Elevated levels of WBCs or an increased NLR may indicate an overly active inflammatory response, potentially contributing to the eventual onset of certain types of cancer.
Geospatial Science for the Environmental Epidemiology of Cancer in the Exposome Era
Authors: VoPham Trang , White Alexandra J. , Jones Rena R. 
Published: April 2024

Abstract
Geospatial science is the science of location or place that harnesses geospatial tools, such as geographic information systems (GIS), to understand the features of the environment according to their locations. Geospatial science has been transformative for cancer epidemiologic studies through enabling large-scale environmental exposure assessments. As the research paradigm for the exposome, or the totality of environmental exposures across the life course, continues to evolve, geospatial science will serve a critical role in determining optimal practices for how to measure the environment as part of the external exposome. The objectives of this article are to provide a summary of key concepts, present a conceptual framework that illustrates how geospatial science is applied to environmental epidemiology in practice and through the lens of the exposome, and discuss the following opportunities for advancing geospatial science in cancer epidemiologic research: enhancing spatial and temporal resolutions and extents for geospatial data; geospatial methodologies to measure climate change factors; approaches facilitating the use of patient addresses in epidemiologic studies; combining internal exposome data and geospatial exposure models of the external exposome to provide insights into biological pathways for environment–disease relationships; and incorporation of geospatial data into personalized cancer screening policies and clinical decision making.
Assessing the Causal Relationship between Waterpipe Smoking and Bladder Cancer
Authors: Rosser Charles J. 
Published: April 2024

AbstractRates of waterpipe use increase with very little data reporting any potential health consequences. The current study, a large case–control study, of 4,194 patients from Iran denotes an elevated risk of bladder cancer in exclusive waterpipe smokers compared with non-users. Additional studies are needed to further understand the risk waterpipe smoking has on bladder cancer.See related article by Hadji et al., p. 509
KLRG1, Another Opportunity for a Breakthrough in MTCL
Authors: Varma Gaurav , Diefenbach Catherine S. 
Published: April 2024

Summary
Outcomes in mature T-cell lymphomas remain poor, with previous attempts at developing mAbs compromised by limited efficacy and significant immunocompromise. Anti–killer cell lectin-like receptor G1 mAbs may have greater selectivity and specificity for malignant T cells and avoid the toxicity concerns with previous agents.
See related article by Assatova et al., p. 2514
Interactions between MDSCs and the Autonomic Nervous System: Opportunities and Challenges in Cancer Neuroscience
Authors: Shu Lin-Zhen , Ding Yi-Dan , Zhang Jin-Yao , He Rui-Shan , Xiao Li , Pan Bing-Xing , Deng Huan 
Published: April 2024

AbstractMyeloid-derived suppressor cells (MDSC) are a population of heterogeneous immune cells that are involved in precancerous conditions and neoplasms. The autonomic nervous system (ANS), which is composed of the sympathetic nervous system and the parasympathetic nervous system, is an important component of the tumor microenvironment that responds to changes in the internal and external environment mainly through adrenergic and cholinergic signaling. An abnormal increase of autonomic nerve density has been associated with cancer progression. As we discuss in this review, growing evidence indicates that sympathetic and parasympathetic signals directly affect the expansion, mobilization, and redistribution of MDSCs. Dysregulated autonomic signaling recruits MDSCs to form an immunosuppressive microenvironment in chronically inflamed tissues, resulting in abnormal proliferation and differentiation of adult stem cells. The two components of the ANS may also be responsible for the seemingly contradictory behaviors of MDSCs. Elucidating the underlying mechanisms has the potential to provide more insights into the complex roles of MDSCs in tumor development and lay the foundation for the development of novel MDSC-targeted anticancer strategies.
Stressing the Role of CCL3 in Reversing the Immunosuppressive Microenvironment in Gliomas
Authors: Cui Xiaoteng , Kang Chunsheng 
Published: April 2024

AbstractPatients with gliomas often experience mental health problems, such as depression and anxiety, that lead to worsening tumor progression and shortened survival. In this issue, Wang and colleagues report a novel mechanism underlying this, finding that chronic stress reduces secretion of the chemokine CCL3, which leads to an immunosuppressive glioma microenvironment. CCL3 administration enhances the infiltration of antitumor immune cells, providing rationale for a potential new therapeutic approach.See related article by Wang et al., p. 516 (4).