bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dual-task assessments for predicting future falls in neurologic conditions: A systematic review
Authors: Peters Joseph , Lauinger Alexa , Mayr Maximillian , Ginell Keara , Abou Libak 
Published: March 2024

AbstractThis review investigated the ability of dual-task tests to predict falls in people with neurological disorders (ND). Databases were searched to identify prospective cohort studies that analyzed dual-task testing and falls in people with NDs. Reviewers screened studies for eligibility and extracted key information like participant characteristics, intervention details, outcome measures, and significant outcomes. Reviewers assessed methodological quality of eligible studies using the Standard Quality Assessment Criteria. 18 studies of strong methodological qualified with 1750 participants were included in the review. Dual-task performances was predictive of future falls in people with Huntington’s disease, spinal cord injury, and moderate cognitive impairment, although only one independent study was included for each disability type. In people with stroke, thirty-seven percent of eligible studies showed dual-task assessments to be predictive of future falls. No dual-task tests predicted prospective falling in people with Alzheimer’s or Parkinson’s disease. Complex dual-tasks appeared to be more predictive of fall risk than simpler dual-tasks. Results suggest that disability type, severity of disability, and task complexity play a role in the predictive ability of dual-task assessments and future falling in NDs. Future studies may benefit from using this review to guide the design of effective dual-task assessments and fall interventions.
Student-Led Workshop on Disability Advocacy
Authors: Piasecki-Masters Colette , Newcomb Nora , Smeltz Lydia , Bresier Valerie , Rubenstein Dana , Ankam Nethra , Turk Margaret A. 
Published: March 2024

Abstract
Medical students can be powerful advocates for and in partnership with the disability community, yet opportunities for targeted advocacy training are sparse. In February 2023, a medical student-led workshop on disability advocacy for trainees took place at the Association of Academic Physiatrists’ Annual Conference. The aims of this session were for trainees to (1) identify existing gaps in disability education at their institution and in policy around disability-related issues; (2) improve perceived ability to engage in disability-related education and policy-based advocacy; and (3) apply an intersectional lens to identify opportunities for intersectionality in disability advocacy. Presession and postsession responses were anonymously submitted via Qualtrics. Of 31 presurvey respondents, 18 responded to the postsurvey, and 12 were identified as having matching unique identifiers. After the workshop, participants overall were more likely to report being very/somewhat confident about their ability to identify gaps in disability education at their institution (75.0% vs. 100.0%, P = 0.011), policy around disability-related issues (41.7% vs. 100.0%, P < 0.006), and opportunities for intersectionality in disability advocacy (33.3% vs. 91.7%, P < 0.015). Participants were more likely to report being very/somewhat confident in engaging in education-based advocacy (58.3% vs. 100.0%, P = 0.006), policy-based advocacy (16.7% vs. 91.7%, P < 0.002), and intersectional disability advocacy (41.7% vs. 91.7%, P < 0.006). All attendees strongly/somewhat agreed with the statements “I hope that this session will continue in future years” and “I think that other trainees would benefit from a similar course.” This session was shown to effectively meet the intended goals of the program.
How does orthotic walker boot design influence lower limb and trunk function during gait?
Authors: Haworth Lauren , Booth Nicole , Chohan Ambreen , Chapman Graham , Richards Jim 
Published: March 2024

Background:
Undesirable lower limb gait deviations have previously been reported when wearing orthotic walker boots; therefore, there is a need to optimize orthotic walker boot designs to facilitate normal gait.

Objective:
This study explored the biomechanical effects of 2 designs of orthotic walker boot on the lower limb and trunk compared with usual footwear.

Study design:
A repeated measures analysis of variance was used to evaluate selected kinematic and kinetic variables under different walking conditions.

Methods:
Sixteen healthy participants walked in 3 conditions using: Walker A (Airselect Elite, Enovis), Walker B (Townsend XLR8 Series Walker, Thuasne, France), and a usual shoe. A 10-camera motion analysis system and 4 force plates were used to collect kinematic and kinetic data.

Results:
Gait speed was significantly slower in both orthotic walker boots, and there was significantly decreased ankle range of motion, which is their primary function. Significant deviations in normal knee and hip kinematics and kinetics, shank-to-vertical angle, and pelvic and trunk movements were noted with both walker boots, with the greatest deviations from the shoe condition observed in Walker B. Recline and incline shank angular velocities showed the greatest differences in Walker B, which could be associated with adverse knee joint moments and a significantly greater perceived ease of walking in Walker A.

Conclusions:
Orthotic walker boot design significantly affects walking mechanics. Orthotic walkers with greater forefoot rocker profiles and inclined vertical shank angles may at least partly mitigate known gait deviations when wearing orthotic walkers.
The lived experience of military beneficiaries with amputations at the hip and pelvic level
Authors: Spinuzza Nicholas , McHugh Terrence R. , Garland Jared S. , Roddy William T. , Hewitt Melissa A. , Harrington Colin J. , Thaper Akshay , Reini Josh , Smith Douglas G. , Pasquina Paul F. 
Published: March 2024

Background:
Hip- and pelvic-level amputations are devastating injuries that drastically alter patient function and quality of life. This study examined the experience of military beneficiaries with a hip- or pelvic-level amputation to better characterize their challenges and specific needs and to optimize treatment in the future.

Methods:
We conducted a retrospective review of the Military Health System and identified 118 patients with a history of one or more amputation(s) at the hip or pelvic level between October 2001 and September 2017. Surviving participants (n = 97) were mailed a letter which explained the details of the study and requested participation in a telephonic interview. A total of six individuals (one female, five males) participated in structured interviews.

Results:
The study group included four participants with hip disarticulations and two participants with hemipelvectomies (one internal, one external). All six participants reported significant challenges with activities related to prosthetic use, mobility, residual limb health, pain, gastrointestinal and genitourinary function, psychiatric health, and sexual function.

Conclusions:
These interviews highlight the unique needs of individuals with hip- and pelvic-level amputations and may improve access to higher echelons of care that would enhance the function and quality of life for these participants.
Low Pneumoperitoneum Pressure Reduces Gas Embolism During Laparoscopic Liver Resection
Authors: Luo Wenchen , Jin Danfeng , Huang Jian , Zhang Jinlin , Xu Yongfeng , Gu Jiahui , Sun Caihong , Yu Jian , Xu Peiyao , Liu Luping , Zhang Zhenyu , Guo Chenyue , Liu Hongjin , Miao Changhong , Zhong Jing 
Published: March 2024

Objective:
To compare the effect of low and standard pneumoperitoneal pressure (PP) on the occurrence of gas embolism during laparoscopic liver resection (LLR).

Background:
LLR has an increased risk of gas embolism. Although animal studies have shown that low PP reduces the occurrence of gas embolism, clinical evidence is lacking.

Methods:
This parallel, dual-arm, double-blind, randomized controlled trial included 141 patients undergoing elective LLR. Patients were randomized into standard (“S,” 15 mm Hg; n = 70) or low (“L,” 10 mm Hg; n = 71) PP groups. Severe gas embolism (≥ grade 3, based on the Schmandra microbubble method) was detected using transesophageal echocardiography and recorded as the primary outcome. Intraoperative vital signs and postoperative recovery profiles were also evaluated.

Results:
Fewer severe gas embolism cases (n = 29, 40.8% vs n = 47, 67.1%, P = 0.003), fewer abrupt decreases in end-tidal carbon dioxide partial pressure, shorter severe gas embolism duration, less peripheral oxygen saturation reduction, and fewer increases in heart rate and lactate during gas embolization episodes was found in group L than in group S. Moreover, a higher arterial partial pressure of oxygen and peripheral oxygen saturation were observed, and fewer fluids and vasoactive drugs were administered in group L than in group S. In both groups, the distensibility index of the inferior vena cava negatively correlated with central venous pressure throughout LLR, and a comparable quality of recovery was observed.

Conclusions:
Low PP reduced the incidence and duration of severe gas embolism and achieved steadier hemodynamics and vital signs during LLR. Therefore, a low PP strategy can be considered a valuable choice for the future LLR.
Off-target depletion of plasma tryptophan by allosteric inhibitors of BCKDK
Authors: Bowman Caitlyn E. , Neinast Michael D. , Jang Cholsoon , Patel Jiten , Blair Megan C. , Mirek Emily T. , Jonsson William O. , Chu Qingwei , Merlo Lauren , Mandik-Nayak Laura , Anthony Tracy G. , Rabinowitz Joshua D. , Arany Zolt 
Published: March 2024

AbstractThe activation of branched chain amino acid (BCAA) catabolism has garnered interest as a potential therapeutic approach to improve insulin sensitivity, enhance recovery from heart failure, and blunt tumor growth. Evidence for this interest relies in part on BT2, a small molecule that promotes BCAA oxidation and is protective in mouse models of these pathologies. BT2 and other analogs allosterically inhibit branched chain ketoacid dehydrogenase kinase (BCKDK) to promote BCAA oxidation, which is presumed to underlie the salutary effects of BT2. Potential “off-target” effects of BT2 have not been considered, however. We therefore tested for metabolic off-target effects of BT2 inBckdk-/-animals. As expected, BT2 failed to activate BCAA oxidation in these animals. Surprisingly, however, BT2 strongly reduced plasma tryptophan levels and promoted catabolism of tryptophan to kynurenine in both control andBckdk-/-mice. Mechanistic studies revealed that none of the principal tryptophan catabolic or kynurenine-producing/consuming enzymes (TDO, IDO1, IDO2, or KATs) were required for BT2-mediated lowering of plasma tryptophan. Instead, using equilibrium dialysis assays and mice lacking albumin, we show that BT2 avidly binds plasma albumin and displaces tryptophan, releasing it for catabolism. These data confirm that BT2 activates BCAA oxidation via inhibition of BCKDK but also reveal a robust off-target effect on tryptophan metabolism via displacement from serum albumin. The data highlight a potential confounding effect for pharmaceutical compounds that compete for binding with albumin-bound tryptophan.
Plasma Cell-free RNA Signatures of Inflammatory Syndromes in Children
Authors: Loy Conor J. , Servellita Venice , Sotomayor-Gonzalez Alicia , Bliss Andrew , Lenz Joan , Belcher Emma , Suslovic Will , Nguyen Jenny , Williams Meagan E. , Oseguera Miriam , Gardiner Michael A. ,   Pediatric Emergency Medicine Kawasaki Disease Research Group (PEMKDRG),   The CHARMS Study Group, Choi Jong-Ha , Hsiao Hui-Mien , Wang Hao , Kim Jihoon , Shimizu Chisato , Tremoulet Adriana , Delaney Meghan , DeBiasi Roberta L. , Rostad Christina A. , Burns Jane C. , Chiu Charles Y. , Vlaminck Iwijn De 
Published: March 2024

ABSTRACTInflammatory syndromes, including those caused by infection, are a major cause of hospital admissions among children and are often misdiagnosed because of a lack of advanced molecular diagnostic tools. In this study, we explored the utility of circulating cell-free RNA (cfRNA) in plasma as an analyte for the differential diagnosis and characterization of pediatric inflammatory syndromes. We profiled cfRNA in 370 plasma samples from pediatric patients with a range of inflammatory conditions, including Kawasaki disease (KD), Multisystem Inflammatory Syndrome in Children (MIS-C), viral infections and bacterial infections. We developed machine learning models based on these cfRNA profiles, which effectively differentiated KD from MIS-C — two conditions presenting with overlapping symptoms — with high performance (Test Area Under the Curve (AUC) = 0.97). We further extended this methodology into a multiclass machine learning framework that achieved 81% accuracy in distinguishing among KD, MIS-C, viral, and bacterial infections. We further demonstrated that cfRNA profiles can be used to quantify injury to specific tissues and organs, including the liver, heart, endothelium, nervous system, and the upper respiratory tract. Overall, this study identified cfRNA as a versatile analyte for the differential diagnosis and characterization of a wide range of pediatric inflammatory syndromes.
Detection of Suicidality Through Privacy-Preserving Large Language Models
Authors: Wiest Isabella Catharina , Verhees Falk Gerrik , Ferber Dyke , Zhu Jiefu , Bauer Michael , Lewitzka Ute , Pfennig Andrea , Mikolas Pavol , Kather Jakob Nikolas 
Published: March 2024

AbstractImportanceAttempts to use Artificial Intelligence (AI) in psychiatric disorders show moderate success, high-lighting the potential of incorporating information from clinical assessments to improve the models. The study focuses on using Large Language Models (LLMs) to manage unstructured medical text, particularly for suicide risk detection in psychiatric care.ObjectiveThe study aims to extract information about suicidality status from the admission notes of electronic health records (EHR) using privacy-sensitive, locally hosted LLMs, specifically evaluating the efficacy of Llama-2 models.Main Outcomes and MeasuresThe study compares the performance of several variants of the open source LLM Llama-2 in extracting suicidality status from psychiatric reports against a ground truth defined by human experts, assessing accuracy, sensitivity, specificity, and F1 score across different prompting strategies.ResultsA German fine-tuned Llama-2 model showed the highest accuracy (87.5%), sensitivity (83%) and specificity (91.8%) in identifying suicidality, with significant improvements in sensitivity and specificity across various prompt designs.Conclusions and RelevanceThe study demonstrates the capability of LLMs, particularly Llama-2, in accurately extracting the information on suicidality from psychiatric records while preserving data-privacy. This suggests their application in surveillance systems for psychiatric emergencies and improving the clinical management of suicidality by improving systematic quality control and research.Key PointsQuestionCan large language models (LLMs) accurately extract information on suicidality from electronic health records (EHR)?FindingsIn this analysis of 100 psychiatric admission notes using Llama-2 models, the German fine-tuned model (Emgerman) demonstrated the highest accuracy (87.5%), sensitivity (83%) and specificity (91.8%) in identifying suicidality, indicating the models’ effectiveness in on-site processing of clinical documentation for suicide risk detection.MeaningThe study highlights the effectiveness of LLMs, particularly Llama-2, in accurately extracting the information on suicidality from psychiatric records, while preserving data privacy. It recommends further evaluating these models to integrate them into clinical management systems to improve detection of psychiatric emergencies and enhance systematic quality control and research in mental health care.
Informing an investment case for Japanese encephalitis vaccine introduction in Bangladesh
Authors: Duque Mariana Perez , Naser Abu Mohd , Paul Kishor K. , Rahman Mahmudur , Alam Mohammad Shafiul , Al-Amin Hasan Mohammad , Ziaur Rahman Mohammed , Hossain Mohammad Enayet , Paul Repon C , Luby Stephen P. , Cauchemez Simon , Vanhomwegen Jessica , Gurley Emily S. , Salje Henrik 
Published: March 2024

AbstractBackgroundJapanese encephalitis virus (JEV) is a major threat to human health. Bangladesh is considering introducing a JEV vaccine, however, the investment case is hampered by a poor understanding of key aspects of JEV ecology, including underlying patterns of infection, the infection fatality ratio, and which host and vectors maintain transmission.MethodsWe conducted a seroprevalence study in individuals of all ages in Chapai Nawabganj, Bangladesh. We tested blood samples for anti-JEV antibodies using a novel assay that limits cross-reactivity with dengue virus, trapped mosquitoes, and collected information about potential host species. We combined our results with data from a pig census, human case data and healthcare seeking patterns, all from the same region, and used mathematical models to recover risk factors for infection, and underlying probabilities of severe disease and death.FindingsWe found 14.3% (203/1455) of participants had antibodies against JEV. We estimated 0.5% of the susceptible population gets infected each year, however, infection risk was spatially heterogeneous, with the presence of pigs in the vicinity being the most important predictor of seropositivity. We identified 10 different known mosquito vectors for JEV. We estimated that 1 in 1,000 infections result in severe disease, 1 in 10,000 result in death, and 76% of severe cases are missed by surveillance systems.InterpretationJEV infection risk is highly spatially heterogeneous, with the underlying potential of vaccines linked to the distribution of pig-raising communities.FundingCenters for Disease Control and Prevention (CDC)
Suicidal behavior during the Covid-19 pandemic: Results from cross-sectional surveys of Brazilian adults from 2020 to 2022
Authors: Faro André , Palhano Dandara , Silva Luanna dos Santos , Falk Derek 
Published: March 2024

AbstractThis study aimed to analyze the predictive capacity of fear of Covid-19, anxiety and depressive symptoms, and the variable pandemic year on suicidal behaviors in the years 2020, 2021, and 2022. The total sample consisted of 7,735 adults from all regions of the country and over 1.300 Brazilian cities, with an average age of 34 years. The research instruments used were the Fear of Covid-19 Scale (FCV-19S), the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire Scale (PHQ-9), and a question assessing the absence, presence of suicidal ideation, and suicide planning or attempts. Data analysis was conducted using multinomial logistic regression. The main findings showed that fear of Covid-19 (severe [OR = 0.696]), anxiety (mild [OR = 2.183], moderate [OR = 2.436], and severe [OR = 2.757]), and depression (mild [OR = 2.831], moderate [OR = 4.769], and severe [OR = 10.660]) were statistically significant in relation to suicidal ideation. As for suicide planning and attempts, predictors included year (2022 [OR = 1.297]), fear of Covid-19 (moderate [OR = 0.614] and severe [OR = 0.445]), anxiety (mild [OR = 2.253], moderate [OR = 2.988], and severe [OR = 3.577]), and depression (mild [OR = 3.021], moderate [OR = 8.189], and severe [OR = 40.363]). In conclusion, the effects of the pandemic need to continue to be monitored, as mental health surveillance data are crucial in guiding effective policies aimed at suicidal behavior.
A Western Dietary Pattern during Pregnancy is Associated with Neurodevelopmental Disorders in Childhood and Adolescence
Authors: Horner David , Jepsen Jens Richardt M. , Chawes Bo , Aagaard Kristina , Rosenberg Julie B. , Mohammadzadeh Parisa , Sevelsted Astrid , Følsgaard Nilo , Vinding Rebecca , Fagerlund Birgitte , Pantelis Christos , Bilenberg Niels , Pedersen Casper-Emil T. , Eliasen Anders , Chen Yulu , Prince Nicole , Chu Su H. , Kelly Rachel S. , Lasky-Su Jessica , Halldorsson Thorhallur I. , Strøm Marin , Strandberg-Larsen Katrine , Olsen Sjurdur F. , Glenthøj Birte Y. , Bønnelykke Klaus , Ebdrup Bjørn H. , Stokholm Jakob , Rasmussen Morten Arendt 
Published: March 2024

ABSTRACTDespite the high prevalence of neurodevelopmental disorders, there is a notable gap in clinical studies exploring the impact of maternal diet during pregnancy on child neurodevelopment. This observational clinical study examined the association between pregnancy dietary patterns and neurodevelopmental disorders, as well as their symptoms, in a prospective cohort of 10-year-old children (n=508). Data-driven dietary patterns were derived from self-reported food frequency questionnaires. A Western dietary pattern in pregnancy (per SD change) was significantly associated with attention-deficit / hyperactivity disorder (ADHD) (OR 1.66 [1.21 - 2.27], p=0.002) and autism diagnosis (OR 2.22 [1.33 - 3.74], p=0.002) and associated symptoms (p<0.001). Findings for ADHD were validated in three large (n=59725, n=656, n=348), independent mother-child cohorts. Objective blood metabolome modelling at 24 weeks gestation identified 15 causally mediating metabolites which significantly improved ADHD prediction in external validation. Temporal analyses across five blood metabolome timepoints in two independent mother-child cohorts revealed that the association of Western dietary pattern metabolite scores with neurodevelopmental outcomes was consistently significant in early to mid-pregnancy, independent of later child timepoints. These findings underscore the importance of early intervention and provide robust evidence for targeted prenatal dietary interventions to prevent neurodevelopmental disorders in children.
Association between prescription drugs and all-cause mortality risk in the UK population
Authors: Morin Jonas , Rolland Yves , Bischoff-Ferrari Heike A. , Ocampo Alejandro , Perez Kevin 
Published: March 2024

AbstractAlthough most drugs currently approved are meant to treat specific diseases or symptoms, it has been hypothesized that some might bear a beneficial effect on lifespan in healthy older individuals, outside of their specific disease indication. Such drugs include, among others, metformin, SGLT2 inhibitors and rapamycin. The UK biobank has recorded prescription medication and mortality data for over 500’000 patients during more than 40 years. In this work we examined the impact of the top 406 prescribed medications on overall mortality rates within the general population of the UK. As expected, most drugs harbor a negative effect on lifespan, probably due to the underlying negative effect of the disease the drug is intended for. Importantly, a few drugs seem to have a beneficial effect on lifespan, including notably Sildenafil, Atorvastatin, Naproxen and Estradiol. These retrospective results warrant further investigation in randomized controlled trials.