bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of acute stroke presentations to an emergency ambulance service
Authors: Loudon W. , Bosley E. , Wong A. , Tippett V. 
Published: February 2024

Objective Stroke is a devastating condition with significant societal and personal costs. Attempts to improve outcomes have increasingly focussed on improvements in prehospital care of these patients. This study aims to provide an epidemiologic profile of stroke presentations to an ambulance service. Methods A descriptive quantitative analysis of linked administrative and clinical patient data across prehospital, hospital, and death records from a two-year period (2016–2017), was used to profile the acute stroke cohort transported by ambulance in Queensland, Australia. The epidemiologic profile of patients and sub-type of stroke is presented. Results There were 17,603 presentations of suspected acute stroke in Queensland during the study period amongst 2,078,140 ambulance responses. A total of 11,578 patients had a confirmed diagnosis of stroke at the time of their final discharge. Of this population 49.8% suffered an Acute Ischaemic Stroke, 12.9% had intracerebral haemorrhage, 4.5% had subarachnoid haemorrhage and 32.8% were transient ischaemic attack. Of those with acute ischaemic stroke (AIS) 9.2% were due to a large vessel occlusion. The three-month stroke related fatality rate was 10%. Conclusion This study demonstrated a lower annual presentation rate of stroke, to an emergency ambulance service, than would be expected based on population studies while the overall mortality rate amongst this population was higher. The reasons for these differences warrant further investigation.
Inhibition of valve mesenchymal stromal cell calcium deposition by bFGF through alternative polyadenylation regulation of the CAT gene
Authors: Zhang Jiajun , Wu Jun , Gao Yuan , Fan Xingli , Liu Xiaohong , Zhang Guanxin , Tang Yangfeng , Han Lin 
Published: February 2024

Abstract
Objective
Calcific aortic valve disease (CAVD) is the leading cause of angina, heart failure, and death from aortic stenosis. However, the molecular mechanisms of its progression, especially the complex disease-related transcriptional regulatory mechanisms, remain to be further elucidated.

Methods
This study used porcine valvular interstitial cells (PVIC) as a model. We used osteogenic induced medium (OIM) to induce calcium deposition in PVICs to calcify them, followed by basic fibroblast growth factor (bFGF) treatment to inhibit calcium deposition. Transcriptome sequencing was used to study the mRNA expression profile of PVICs and its related transcriptional regulation. We used DaPars to further examine alternative polyadenylation (APA) between different treatment groups.

Results
We successfully induced calcium deposition of PVICs through OIM. Subsequently, mRNA-seq was used to identify differentially expressed mRNAs for three different treatments: control, OIM-induced and OIM-induced bFGF treatment. Global APA events were identified in the OIM and bFGF treatment groups by bioinformatics analysis. Finally, it was discovered and proven that catalase (CAT) is one of the potential targets of bFGF-induced APA regulation.

Conclusion
We described a global APA change in a calcium deposition model related to CAVD. We revealed that transcriptional regulation of the CAT gene may contribute to bFGF-induced calcium deposition inhibition.
Selecting a randomization method for a multi-center clinical trial with stochastic recruitment considerations
Authors: Sverdlov Oleksandr , Ryeznik Yevgen , Anisimov Volodymyr , Kuznetsova Olga M. , Knight Ruth , Carter Kerstine , Drescher Sonja , Zhao Wenle 
Published: February 2024

Abstract
Background
The design of a multi-center randomized controlled trial (RCT) involves multiple considerations, such as the choice of the sample size, the number of centers and their geographic location, the strategy for recruitment of study participants, amongst others. There are plenty of methods to sequentially randomize patients in a multi-center RCT, with or without considering stratification factors. The goal of this paper is to perform a systematic assessment of such randomization methods for a multi-center 1:1 RCT assuming a competitive policy for the patient recruitment process.

Methods
We considered a Poisson-gamma model for the patient recruitment process with a uniform distribution of center activation times. We investigated 16 randomization methods (4 unstratified, 4 region-stratified, 4 center-stratified, 3 dynamic balancing randomization (DBR), and a complete randomization design) to sequentially randomize $$n=500$$

n
=
500

patients. Statistical properties of the recruitment process and the randomization procedures were assessed using Monte Carlo simulations. The operating characteristics included time to complete recruitment, number of centers that recruited a given number of patients, several measures of treatment imbalance and estimation efficiency under a linear model for the response, the expected proportions of correct guesses under two different guessing strategies, and the expected proportion of deterministic assignments in the allocation sequence.

Results
Maximum tolerated imbalance (MTI) randomization methods such as big stick design, Ehrenfest urn design, and block urn design result in a better balance–randomness tradeoff than the conventional permuted block design (PBD) with or without stratification. Unstratified randomization, region-stratified randomization, and center-stratified randomization provide control of imbalance at a chosen level (trial, region, or center) but may fail to achieve balance at the other two levels. By contrast, DBR does a very good job controlling imbalance at all 3 levels while maintaining the randomized nature of treatment allocation. Adding more centers into the study helps accelerate the recruitment process but at the expense of increasing the number of centers that recruit very few (or no) patients—which may increase center-level imbalances for center-stratified and DBR procedures. Increasing the block size or the MTI threshold(s) may help obtain designs with improved randomness–balance tradeoff.

Conclusions
The choice of a randomization method is an important component of planning a multi-center RCT. Dynamic balancing randomization with carefully chosen MTI thresholds could be a very good strategy for trials with the competitive policy for patient recruitment.
Radiographers’ perspectives on interactional processes during older persons diagnostic medical imaging encounters: a qualitative study
Authors: Ding Kevin , Makanjee Chandra 
Published: February 2024

Abstract
Background
Within a diagnostic medical imaging context, an interaction encompasses communication, physical contact and emotional support. These intricacies are an integral part in achieving a successful medical imaging outcome. An increasing ageing population presents unique challenges and leads to a higher demand for medical imaging services. There is a paucity of literature exploring the specialised knowledge and skills required by radiographers to service optimal person-centred care for elderly patients. The purpose of the study was to explore radiographers’ perspectives on interactional processes during older persons diagnostic medical imaging encounters.

Methods
The study used a qualitative exploratory research design with a descriptive approach to gain insights from 12 purposively sampled Australian radiographers, through open-ended interviews conducted online or by telephone. Verbatim transcripts were produced, and a thematic analysis employed until data saturation had been reached.

Results
The three themes that emerged from the data analysis were: (1) optimising care and communication, (2) expectations and preconceptions and (3) physical and emotional comfort and safety. Generally, the approach to undertaking older persons examinations entailed more adaptive and flexible competencies and skills in comparison to the familiarised routine diagnostic medical imaging encounters with the younger cohort. Radiographers shared aspects on striking a balance between efficiency and proficiency with the elderly patient needs, preferences, values, safety and well-being considerations. This required swift, complex decision-making and judgement calls due to the unpredictable nature of the context in which the elderly person was situated. The result was the adaptation of examination protocols through equipment manipulation, with minimal disruptions to emotional and physical comfort, achieved through interventions and support strategies.

Conclusion
The results highlight the many considerations for radiographers during a short clinical interaction. There is optimism in adding value to the elderly persons experience through a complex interactional process. It is anticipated that the identified skills will inform on best practice principles to achieve an elderly person-centred care medical imaging outcome.
Latent class of multidimensional dependency in community-dwelling older adults: evidence from the longitudinal ageing study in India
Authors: Marbaniang Strong P. , Chungkham Holendro Singh 
Published: February 2024

Abstract
Background
Existing studies have used ADL and IADL separately as measures of dependency. However, dependency is a heterogeneous and complex issue, and the dependency of each older adult is a synergistic combination of several functional activities. In this study, we assess the pattern of multidimensional dependency of older adults based on ADL, IADL, visual impairment, difficulty in climbing a flight of stairs, pushing or pulling objects, depressive symptoms, cognitive impairment, marital status, and economic distress. It is important to classify the dependency status of older adults because this will be key to evaluating the needs for care, and plan services that effectively cater for the needs of the older adults. The classification into different latent classes means that older adults within each class have the same needs of dependency but different needs between the latent classes. Our objective is to identify patterns of multidimensional dependency in older adults.

Methods
Data from the Longitudinal Ageing Study in India (LASI) Wave-1, was used, the analytical sample consisted of 32,827 individuals of age 45 years and above. LCA was used to identify the multidimensional dependency class. LCA was conducted in R statistical package, using the poLCA package. The optimal number of classes was selected based on the comparison of model fit statistics. Independent variables were incorporated to explore the association between these variables and the latent class.

Results
Based on nine indicator variables, three latent classes were identified: “Active Older adults”, “Moderately independent” and “Psychological and physically impaired”. The “Active older adults” profile is comprised of older adults who have a very low probability of needing help for any ADL, IADL and other activities. The “Moderately independent” class were characterized as those older adults who were visually impaired but less likely to need help for IADL activities. The “Psychological and physically impaired”, the smallest of all classes, comprised of older adults with poor dependency status.

Conclusions
In this study, we found that the dependency status of older adults which is based on several domains of functional activity has been classified into three distinct classes. These three classes have distinct physical, psychological, economic, and socio-demographic characteristics in terms of activities in which help is required.
PulmoNet: a novel deep learning based pulmonary diseases detection model
Authors: Abdulahi AbdulRahman Tosho , Ogundokun Roseline Oluwaseun , Adenike Ajiboye Raimot , Shah Mohd Asif , Ahmed Yusuf Kola 
Published: February 2024

AbstractPulmonary diseases are various pathological conditions that affect respiratory tissues and organs, making the exchange of gas challenging for animals inhaling and exhaling. It varies from gentle and self-limiting such as the common cold and catarrh, to life-threatening ones, such as viral pneumonia (VP), bacterial pneumonia (BP), and tuberculosis, as well as a severe acute respiratory syndrome, such as the coronavirus 2019 (COVID-19). The cost of diagnosis and treatment of pulmonary infections is on the high side, most especially in developing countries, and since radiography images (X-ray and computed tomography (CT) scan images) have proven beneficial in detecting various pulmonary infections, many machine learning (ML) models and image processing procedures have been utilized to identify these infections. The need for timely and accurate detection can be lifesaving, especially during a pandemic. This paper, therefore, suggested a deep convolutional neural network (DCNN) founded image detection model, optimized with image augmentation technique, to detect three (3) different pulmonary diseases (COVID-19, bacterial pneumonia, and viral pneumonia). The dataset containing four (4) different classes (healthy (10,325), COVID-19 (3,749), BP (883), and VP (1,478)) was utilized as training/testing data for the suggested model. The model’s performance indicates high potential in detecting the three (3) classes of pulmonary diseases. The model recorded average detection accuracy of 94%, 95.4%, 99.4%, and 98.30%, and training/detection time of about 60/50 s. This result indicates the proficiency of the suggested approach when likened to the traditional texture descriptors technique of pulmonary disease recognition utilizing X-ray and CT scan images. This study introduces an innovative deep convolutional neural network model to enhance the detection of pulmonary diseases like COVID-19 and pneumonia using radiography. This model, notable for its accuracy and efficiency, promises significant advancements in medical diagnostics, particularly beneficial in developing countries due to its potential to surpass traditional diagnostic methods.
Understanding rapid implementation from discovery to scale: Rwanda’s implementation of rotavirus vaccines and PMTCT in the quest to reduce under-5 mortality
Authors: Sayinzoga Felix , Hirschhorn Lisa R. , Ntawukuriryayo Jovial Thomas , Beyer Caroline , Donahoe Kateri B. , Binagwaho Agnes 
Published: February 2024

Abstract
Background
Over the last eight decades, many evidence-based interventions (EBIs) have been developed to reduce amenable under-5 mortality (U5M). Implementation research can help reduce the lag between discovery and delivery, including as new EBIs emerge, or as existing ones are adapted based on new research. Rwanda was the first low-income African country to implement the rotavirus vaccine (RTV) and also adopted Option B+ for effective prevention of mother-to-child transmission (PMTCT) before the World Health Organization’s (WHO) recommendation. We use implementation research to identify contextual factors and strategies associated with Rwanda’s rapid uptake of these two EBIs developed or adapted during the study period.

Methods
We conducted a mixed methods case study informed by a hybrid implementation research framework to understand how Rwanda outperformed regional and economic peers in reducing U5M, focusing on the implementation of health system-delivered EBIs. The research included review of existing literature and data, and key informant interviews to identify implementation strategies and contextual factors that influenced implementation outcomes. We extracted relevant results from the broader case study and used convergent methods to understand successes and challenges of implementation of RTV, a newly introduced EBI, and PMTCT, an adapted EBI reflecting new research.

Results
We found several cross-cutting strategies that supported the rapid uptake and implementation of PMTCT, RTV, and leveraging facilitating contextual factors and identifying and addressing challenging ones. Key implementation strategies included community and stakeholder involvement and education, leveraging of in-country research capacity to drive adoption and adaptation, coordination of donors and implementing partners, data audit and feedback of coverage, a focus on equity, and integration into pre-existing systems, including community health workers and primary care. The availability of donor funding, culture of evidence-based decision-making, preexisting accountability systems, and rapid adoption of innovation were facilitating contextual factors.

Conclusion
Implementation strategies which are generalizable to other settings were key to success in rapidly achieving high acceptability and coverage of both a new and an evolving EBI. Choosing strategies which leverage their facilitating factors and address barriers are important for other countries working to accelerate uptake of new EBIs and implement needed adaptations based on emerging evidence.
Embedded implementation research in programming at scale – the new normal to be!
Authors: Peterson Stefan Swartling 
Published: February 2024

AbstractIf you want to run faster, don’t just buy a new pair of shoes; also consider your training methods and where you run.This supplement examines six countries that have run faster than others in reducing under-five mortality, taking an implementation research approach, with country case studies done with local researchers and local institutions. Key generalizable learnings are to choose and adapt implementation strategies to context, design strategies to target the most vulnerable, systematically learn from implementation experience, and to leverage non-health-sector contributions.Embedding implementation research in programming has the potential to greatly improve and accelerate the contextualization and implementation of evidence-based child survival interventions to improve equity in coverage and overall effectiveness in reducing under-five mortality. It is now time to build such capacity in local institutions at scale, and incentives for concerned stakeholders to make this the new normal. Regional institutions should now take the lead in making this happen, not just in individual institutions and countries, but across entire regions, supported by global partners.Trial registration N/A.
Using implementation research to understand lessons in reducing child mortality
Authors: Binagwaho Agnes , Hirschhorn Lisa R. 
Published: February 2024

AbstractUnder-5 mortality decreased significantly worldwide between 2000 and 2015, but there is still progress to be made, particularly in lower- and middle-income countries. This supplement shares the work over the last four years on a project to understand how six countries (Bangladesh, Ethiopia, Nepal, Peru, Rwanda, and Senegal) were more successful in decreasing child mortality than many of their regional and economic peers. The use of implementation research across these countries identifies common implementation strategies and contextual factors that can facilitate or impede successful implementation of an evidence-based intervention and explores a common pathway to implementation. The work highlights how the use of implementation research to understand the “how” and the “why” behind countries’ success provides important actionable knowledge and lessons to country-level decision-makers, donors, and implementers as we arrive at the midpoint of the Sustainable Development Goal era.
Recognition of others’ interoceptive states in those with and without eating disorders
Authors: Gajperia Chandni , McBride Jennifer , Treasure Janet , Cardi Valentina , Brewer Rebecca 
Published: February 2024

Abstract
Background
The ability to recognize one’s own emotions is associated with one’s ability to recognize others’ emotions. Beyond the domain of emotion, however, the relationship between recognition of one’s own internal states (interoception) and others’ interoceptive states has not been investigated, either in the typical population or clinical groups with interoceptive difficulties (e.g. eating disorders; EDs).

Method
This study investigated recognition of one’s own and others’ internal states in adults with and without eating disorders, using a high frequency visual noise paradigm. Participants completed self-report measures of interoception, alexithymia (difficulties recognising one’s own emotional internal states) and ED symptomatology, and the Heartbeat Counting Task measure of cardiac interoceptive accuracy.

Results
Alexithymia was significantly negatively correlated with recognition of others’ interoceptive states. EDs were not associated with difficulties recognising others’ interoceptive states.

Conclusions
The ability to recognise one’s own emotional internal states is associated with the recognition of others’ interoceptive states, which may contribute to social skills and the ability to care for others.
Modelling climate change impacts on the spatial distribution of anthrax in Zimbabwe
Authors: John Learnmore , Shekede Munyaradzi Davis , Gwitira Isaiah , Mazhindu Aldridge Nyasha , Pfukenyi Davies Mubika , Chikerema Silvester 
Published: February 2024

Abstract
Background
In Zimbabwe, anthrax is endemic with outbreaks being reported almost annually in livestock, wildlife, and humans over the past 40 years. Accurate modelling of its spatial distribution is key in formulating effective control strategies. In this study, an Ensemble Species Distribution Model was used to model the current and future distribution of anthrax occurrence in Zimbabwe.

Methods
Bioclimatic variables derived from the Beijing Climate Centre Climate System Model were used to model the disease. Collinearity testing was conducted on the 19 bioclimatic variables and elevation to remove redundancy. Variables that had no collinearity were used for anthrax habitat suitability modelling. Two future climate change scenarios for different Representative Concentration Pathways (RCP), RCP4.5 and RCP8.5 were used. Model evaluation was done using true skill, Kappa statistics and receiver operating characteristics.

Results
The results showed that under current bioclimatic conditions, eastern and western districts of Zimbabwe were modelled as highly suitable, central districts moderately suitable and southern parts marginally suitable for anthrax occurrence. Future predictions demonstrated that the suitable (8%) and highly suitable (7%) areas for anthrax occurrence would increase under RCP4.5 scenario. In contrast, a respective decrease (11%) and marginal increase (0.6%) of suitable and highly suitable areas for anthrax occurrence were predicted under the RCP8.5 scenario. The percentage contribution of the predictors varied for the different scenarios; Bio6 and Bio18 for the current scenario, Bio2, Bio4 and Bio9 for the RCP4.5 and Bio3 and Bio15 for the RCP8.5 scenarios.

Conclusions
The study revealed that areas currently suitable for anthrax should be targeted for surveillance and prevention. The predicted future anthrax distribution can be used to guide and prioritise surveillance and control activities and optimise allocation of limited resources. In the marginally to moderately suitable areas, effective disease surveillance systems and awareness need to be put in place for early detection of outbreaks. Targeted vaccinations and other control measures including collaborative ‘One Health’ strategies need to be implemented in the predicted highly suitable areas. In the southern part where a high decrease in suitability was predicted, continued monitoring would be necessary to detect incursions early.