bluuebunny/crossref_metadata_2025_split huggingface dataset:
30 Years of Youth System of Care Lessons Learned - A Qualitative Study of Hawaiʻi’s Partnership with the Substance Abuse and Mental Health Services Administration
Authors: Okamura Kelsie , Jackson David , Ching Danielle Carreira , Suh Da Eun , Hartsock Tia , Hee Puanani , Shimabukuro Scott 
Published: February 2024

Abstract
Background: The Hawai‘i State Department of Health, Child and Adolescent Mental Health Division (CAMHD) has maintained a longstanding partnership with Substance Abuse and Mental Health Services Administration (SAMHSA) to enhance capacity and quality of community-based mental health services. The current study explored CAMHD’s history of SAMHSA system of care (SOC) awards and identified common themes, lessons learned, and recommendations for future funding.
Methods: Employing a two-phase qualitative approach, the study first conducted content analysis on seven final project reports, identifying themes and lessons learned based on SOC values and principles. Subsequently, interviews were conducted with 11 system leaders in grant projects and SOC award projects within the state. All data from project reports and interview transcripts were independently coded and analyzed using rapid qualitative analysis techniques.
Results: Content validation and interview coding unveiled two content themes, interagency collaboration and youth and family voice, as areas that required long-term and consistent efforts across multiple projects. In addition, two general process themes, connection and continuity, emerged as essential approaches to system improvement work. The first emphasizes the importance of fostering connections in family, community, and culture, as well as within workforce members and child-serving agencies. The second highlights the importance of nurturing continuity throughout the system, from interagency collaboration to individual treatment.
Conclusions: The study provides deeper understanding of system of care evaluations, offering guidance to enhance and innovate youth mental health systems. The findings suggest that aligning state policies with federal guidelines and implementing longer funding mechanisms may alleviate administrative burdens.
Efficacy of soothing cream gel on the range of motion and chronic pain at shoulder and elbow: Protocol of a Double-blinded, Randomized, Placebo-controlled Trial
Authors: LO Cho Wing , SUM Kim Wai Raymond , LEUNG Fung Lin Elean , YANG Yijian , CHAN Kam Leung , LAM Koon Kit , LAU Kam Wai , SUM Chi Him , LIN Wai Ling , HO Shing Hin , LIN Zhixiu 
Published: February 2024

Abstract
Background: Upper limb problems are very common, which affects about 4-35% of people worldwide. Among the joints of the upper limbs, the point prevalence of shoulder pain was 7-26% and elbow pain was 11%. Due to the pain symptom, it will affect the range of motion of the joints and even the quality of life of those populations. Nowadays, the treatment for pain symptoms usually includes nonsteroidal anti-inflammatory drugs or corticosteroids. However, the relapse rate and the treatment cost are very high. Therefore, many patients seek non-pharmaceutical therapies or complementary and alternative medicine to relieve the symptoms. To offset this shortcoming, topical treatment is another option for upper limb problems with fewer side effects.
Objective: To evaluate the efficacy of soothing cream gel (SCG) on the range of motion and chronic pain at the shoulder and elbow.
Methods: Soothing cream gel and placebo gel will be used in this double-blinded, randomized, placebo-controlled trial. The soothing cream gel consists of Vitis Vinifera essence, Melaleuca Viridiflora essential oil, and Eucalyptus Globulus essential oil, and is produced and packed by a manufacturer with a Good Manufacturing Practice certificate. Placebo cream gel is provided by the same manufacturer, it does not contain any active ingredients but will match the appearance, texture and smell as closely as the soothing cream gel. A total of 70 participants who suffer from upper limb problems and fulfil the eligibility criteria will be randomized into the treatment group (soothing cream gel) or the placebo group (placebo gel) for 2 weeks. The range of motion of the upper limb will be measured as the primary outcome; active flexion and abduction will be measured by a goniometer for the shoulder and active flexion and extension will be measured for the elbow. The primary efficacy analyses will be based on the full analysis set (FAS) following the intention-to-treat principle.
Discussion:The study medication used in this trial is an extraction of some botanicals, which have inflammatory and analgesic effects. We expected that the soothing cream gel could refresh the sore and fatigued muscles and improve the participants’ motor ability of the affected upper limb. Besides, we hope to provide evidence of an effective and safe treatment for this prevalent health problem. Trial registration: This trial was registered at ClinicalTrials.gov on 7 June 2023, with the registration ID: NCT05799391.
From Office to Digital Primary Care Services: Analysing Income-Related Inequalities in Utilization
Authors: Wilkens Jens , Thulesius Hans , Ekman Björn 
Published: February 2024

Abstract

The use of digital technologies to deliver primary health care has increased over the past decade. While some technologies have been shown to be effective and efficient, the effects of digital primary care on the policy goal of equality in the use of such types of care have not been studied using large register data. The aim of this study was to analyse how digital contacts differ from officebased visits by income as an indicator of socioeconomic status. Specifically, we estimated differences in primary care utilization across income, factors of contribution to these inequalities, and applied a needs-based standardisation of utilization to estimate differences in equity. We used a purposively built consultation level dataset with 726 000 Swedish adult patients diagnosed with an infection, including clinical and sociodemographic variables. Applying concentration indexes (CI) and graphical illustrations we measured how the two types of services are distributed relative to income. We estimated how much of the inequalities were attributed to different sociodemographic factors by decomposing the concentration indexes. Standardised utilization for sex, age and comorbidity allowed for the estimation of horizontal inequity indexes for both types of services. Utilization by the two types of care showed large income inequalities. Office-based visits were propoor (CI -0.116), meaning lowincome patients utilized relatively more of these services, while digital contacts were prorich (CI 0.205). However, within the patient group who had at least one digital contact, the utilization was also propoor (CI -0,101), although these patients had higher incomes on average. The standardised utilization showed a smaller prorich digital utilization (CI 0.143), although large differences remained. Decomposing the concentration indexes showed that education level and being born in Sweden were strong attributes of prorich digital service utilization. The prorich utilization effects of digital primary care may risk undermining the policy goals of access and utilization to services regardless of socioeconomic status. As digital health technologies continue to expand, policy makers need to be aware of the risk.
Lung Adenocarcinoma Presenting as Abdominal Skin Metastasis – A Case Report with Extensive Literature Review
Authors: Verma Jyoti , Kanakapudi Josephain , Bharti Jyotsna Naresh , Singh Hemant Kumar , Mithilesh Aramulla 
Published: February 2024

Abstract

Skin metastasis is the spread of malignant cells to the skin from a primary malignancy. It is quite uncommon for skin or cutaneous metastasis of internal malignancies to manifest as an initial presentation. It occurs in about 5.3% of patients with internal malignancies, representing 2% of all skin tumors. Lung Cancer (LC) has the highest incidence and is the most common cause of cancer death worldwide. Metastasis to the skin should be carefully investigated to rule out a metastatic manifestation of an occult primary site tumor. It mostly occurs late in the course of the disease & indicates a poor prognosis. We report a case of a 65-year-old male presenting with multiple abdominal skin nodules as an initial uncommon presentation of unknown primary along with the review of literature for which we performed a Medline search for articles on cutaneous metastases from internal malignancies including LC, using PubMed, and manual search of pertinent references and textbooks.
Bladder Height to Width Ratio as a surrogate marker for non-physiological storage pressures in children with spinal dysraphism
Authors: Aithal Shrilakshmi , Sinha Arvind , Pathak Manish , Rathod Kirtikumar , Jadhav Avinash , Saxena Rahul , Nayak Shubhalakshmi , Bhaskar S 
Published: February 2024

Abstract

Introduction
: Spinal dysraphism is the most frequent cause of neurogenic bladder. Urodynamic study (UDS) is an important component of the follow up of a child with neurogenic bladder. However, it suffers from a lack of widespread availability and is further hampered by technical difficulties along with difficulty in its interpretation in children. A neurogenic bladder often appears vertically elongated, sparce literature is available regarding objectively defining the bladder shape and the urodynamic parameters in the cohort.
Objectives
The aim of this study was to investigate the usefulness of the height to width ratio (HWR) of the bladder on cystogram as a screening tool for identifying “non-physiological” bladder in children with spinal dysraphism. A prospective study was undertaken to evaluate children operated for spinal dysraphism. Cystogram, ultrasonography and UDS evaluation was performed. HWR was calculated by the ratio of the maximum height to the maximum width of the bladder at maximum cystometric capacity. The children were categorised into groups based on maximum detrusor pressure (MDP) into two groups (MDP ≥ 30 cmH2O and MDP < 30 cmH2O). A receiver-operative characteristic curve was constructed to analyse the sensitivity and specificity of HWR in predicting the MDP.
Results
A total of 53 children, operated for spinal dysraphism, met the study criteria. The median age of children was 4 years (IQR – 3-5.5 years). The HWR ratio was compared between the two groups and was significantly higher for the non-physiological pressure bladders than for physiological pressure bladders (median 1.55 vs 1.3, p = 0.001). On evaluating the sensitivity and specificity of HWR for discerning children with non-physiological bladder pressures were 87.5% and 48.28%, respectively. The area under curve (AUC) was 0.781 with a cut off value of 1.3.
Discussion
We attempted to objectively evaluate the HWR based on bladder shape. We demonstrated that there was a moderate correlation between the bladder shape and the bladder pressures. A HWR of 1.3 or higher could be considered significant for identifying a non-physiological bladder storage pressure.
Conclusion
The height to width ratio of the bladder on cystogram is a useful tool as a surrogate marker for non-physiological storage pressures in bladders of children with spinal dysraphism.
Preparation of flexible highly conductive polyurethane elastomers with low PEDOT:PSS content based on novel feasible pore collapse strategy for flexible conductor
Authors: Sun Mengxue , Wan Tong , Zhu Xiaohan , Ge Fan , Liang Shubo , Xu Bowen , Ni Kai , Zhang Yingying 
Published: February 2024

Abstract
Meeting the requirements of flexible electronic devices remains a challenge in achieving stable and highly conductive polyurethane composites (CPCs) with minimal loading PEDOT:PSS. In this study, PEDOT:PSS based CPCs were prepared using a novel method involving pore collapse of aerogels. Initially, polyurethane aerogels (PUAs) were synthesized with varying pore sizes ranging from 3.2µm to 9.1µm based on specific formula ratios. Subsequently, solvent evaporation at 120°C caused shrinkage and collapse of the PUAs' pore structure, resulting in the formation of a continuous conductive circuit composed of PEDOT:PSS in polyurethane elastomers (CAPPs). CAPPs containing 1.53 wt% PEDOT:PSS exhibited remarkably high conductivity characteristics (1590 S/m). These CAPPs demonstrated excellent mechanical flexibility as they could withstand stretching, bending, and twisting without significant changes in resistance or affecting LED brightness. Moreover, they proved suitable for use as soft electrodes for electrocardiography (ECG) during exercise to monitor heart rate. This work presents an innovative approach for constructing highly conductive networks through pore collapse of aerogels and obtaining low-loading conductive polymers.
Identification of a novel T cell-related signature to predict prognosis in colorectal cancer via integrating single-cell and bulk RNA sequencing
Authors: Zhang Wei , Zhu Xiaoming , Wen Rongbo , Wu Jiaqi , Zhou Leqi , Fan Hao , zhang Tianshuai , Li Yiyang , Liu Zixuan , Yu Guanyu , Cao Fuao 
Published: February 2024

Abstract
Background: T cells, the key mediators of tumor destruction, have a considerable impact on tumor prognosis. However, the clinical significance of T cell-associated biomarkers in colorectal cancer (CRC) haven’t been well understood. The aim of this study was to investigate the expression profile of T cell marker genes in CRC and develop a prognostic signature based on these genes.
Methods: Single-cell RNA-sequencing (scRNA-seq) data were retrieved from the Gene Expression Omnibus (GEO) database. Bulk RNA-sequencing data and clinical information were downloaded from The Cancer Genome Atlas (TCGA) and GEO databases. We firstly conducted a comprehensive analysis of scRNA-seq data to investigate the heterogeneity of various cells in the CRC tumor microenvironment (TME). Then, we performed cell-cell communication analysis and cell trajectory analysis to explore the intercellular interactions and functional changes of T cells. By combing the bulk RNA-seq data, a T-cell related gene signature was eventually constructed and its predictive ability was determined by the Kaplan–Meier (K-M), and receiver operating characteristic (ROC) curves in three independent cohorts.
Results: ScRNA-seq data obtained from the GEO database were re-integrated and analyzed, resulting in 23 cell clusters. Distinct cell clusters were annotated using extensively reported cell markers. The CellChat algorithm revealed that tumor cells suppress the cellular function of tumor-infiltrating T cells through the MIF/CD74 pathway. The evolutionary trajectory of tumor-infiltrating T cells was elucidated by the CytoTRACE and monocle2 algorithms. Eventually, a prognostic prediction model based on 5 T cell-related genes was constructed using single-cell and bulk RNA sequencing data. The validation results from several independent CRC cohorts indicated that the 5 T cell-related genes prognostic model could accurately predict the survival outcomes of CRC patients, providing new evidence for precision treatment in CRC.
Conclusions: Our study not only offers prospects for a better understanding of the cellular heterogeneity of TME, but also provides a useful tool for stratifying patients with different prognoses and facilitating personalized treatment.
Proteomic Profile of Extracellular Vesicles from Plasma and CFS of Multiple Sclerosis Patients Reveals Disease Activity- Associated EAAT2
Authors: D’Ambrosio Antonella , Zamboni Silvia , Camerini Serena , Casella Marialuisa , Sanchez Massimo , Pietraforte Donatella , Vanacore Nicola , Diociauti Marco , Altieri Marta , Piero Vittorio Di , Francia Ada , Pontecorvo Simona , Puthenparampil Marco , Gallo Paolo , Margutti Paola 
Published: February 2024

Abstract

Background and Objectives
There is an urgent need to discover blood-based biomarkers of multiple sclerosis (MS) to better define the underlying biology of relapses and monitor disease progression. The main goal of this study is to search for candidate biomarkers of MS relapses associated with circulating extracellular vesicles (EVs), an emerging tool for biomarker discovery.
Methods
EVs, purified from unpaired plasma and CSF samples of RRMS patients by size-exclusion chromatography (SEC), underwent qualitative proteomic analysis to discover novel biomarkers associated with MS relapses. The candidate biomarkers of disease activity were detected by comparison approach between plasma- and CSF-EV proteomes associated with relapses. Among them, a selected potential biomarker was evaluated in a cohort of MS patients, using a novel and highly reproducible flow cytometry-based approach in order to detect low abundant EV subsets in a complex body fluid such as plasma.
Results
The proteomic profiles of both SEC-purified plasma EVs (from 6 patients in relapse and 5 patients in remission) and SEC-puirified CSF EVs (from 4 patients in relapse and 3 patients in remission) revealed a set of proteins associated with MS relapses significant enriched in the synaptic transmission pathway. Among common proteins, excitatory amino-acid transporter 2, EAAT2, responsible for the majority of the glutamate uptake in CNS, was worthy of further investigation. By screening plasma samples from 110 MS patients, we found a significant association of plasma EV-carried EAAT2 protein (EV-EAAT2) with MS relapses, regardless of disease-modifying therapies. This finding was confirmed by investigating the presence of EV-EAAT2 in plasma samples collected longitudinally from 10 RRMS patients, during relapse and remission. Moreover, plasma EV-EAAT2 levels correlated positively with Expanded Disability Status Scale (EDSS) score in remitting MS patients but showed a negative correlation in patients with secondary progressive (SPMS) and EDSS > 3.
Conclusion
Our results emphaticize the usefulness of plasma EVs as a source of accessible biomarkers to remotely analyse the CNS status. Plasma EV-EAAT2 showed to be a promising biomarker for MS relapses. Further studies are required to assess the clinical relevance of this biomarker also for disability progression independent of relapse activity and transition from RRMS towards SPMS.
Comorbid problems in children with autism spectrum disorder as measured with the Child Behavior Checklist (CBCL) and the effect of the Essential 5® systemic behavioral intervention treatment.
Authors: Brunt Tibor Markus , Naber Fabiënne Bertina Anolda , Fernando Srimali Irosha , Heikoop Hanneke Johanna 
Published: February 2024

Abstract
Comorbid problems often coincide in individuals with autism spectrum disorder (ASD). Many parent-mediated systemic interventions have been developed for children to address these comorbid problems, with varying success. This study presents a systemic parent-mediated intervention, The Essential 5®. The effects of this intervention on comorbid social, cognitive and emotional problems in children with ASD were measured with the Child Behavioral Checklist (CBCL). In this study 952 children (6–16 years) and their parents/caregivers participated. There was a significant reduction on the CBCL total scale after the intervention (F = 504,149; p < .001, η²=.347), both for boys and girls separately. The reduction was found on all scales. When the CBCL was analysed as a clinical DSM-scale, all scales significantly decreased after the intervention for the whole group and for boys and girls separately. Based on the CBCL normative data 60% of the children had t-scores below the clinical range at the end of the intervention, compared to 36.6% before the intervention (χ2 = 11.34, p < 0.01). Therefore, it can be concluded that The Essential 5® intervention is effective in reducing comorbid problem behavior in children with ASD. These results clearly invites for more research into the validity of this intervention.
DistilBERT: A Novel Approach to Detect Text Generated by Large Language Models (LLM)
Authors: Kumar BV Pranay , Ahmed MD Shaheer , Sadanandam Manchala 
Published: February 2024

Abstract
Large language models (LLMs) have emerged as powerful tools for generating human-quality text, raising concerns about their potential for misuse in academic settings. This paper investigates the use of DistilBERT, a distilled version of BERT, for detecting LLM-generated text. We evaluate its performance on two publicly available datasets, LLM-Detect AI Generated Text and DAIGT-V3 Train Dataset, achieving an average accuracy of around 94%. Our findings suggest that DistilBERT is a promising tool for safeguarding academic integrity in the era of LLMs.
Effects of red blood cell transfusion on patients undergoing cardiac surgery in Queensland – a retrospective cohort study
Authors: Obonyo Nchafatso. G. , Dhanapathy Vikash , White Nicole , Sela Declan P. , Rachakonda Reema H. , Tunbridge Matthew , Sim Beatrice , Teo Derek , Nadeem Zohaib , Hoe Louise E. See , Bassi Gianluigi Li , Fanning Jonathon P. , Tung John-Paul , Suen Jacky Y. , Fraser John F. 
Published: February 2024

Abstract

Background
Packed red blood cell (pRBC) transfusion is a relatively safe and mainstay treatment commonly used in cardiac surgical patients. However, there is limited evidence on clinical effects of transfusing blood nearing end-of shelf life that has undergone biochemical changes during storage.
Objective
To investigate evidence of associations between morbidity/mortality and transfusion of blood near end of shelf-life (>35 days) in cardiac surgical patients.
Methods
Data from the Queensland Health Admitted Patient Data Collection database 2007-2013 was retrospectively analysed. Coronary artery bypass graft and valvular repair patients were included. Multivariable logistic regression was used to examine the effect of pRBC age (<35 days vs ≥35 days) on in-hospital mortality and morbidity. As secondary analysis, outcomes associated with the number of pRBC units transfused (≤4 units vs ≥5 units) were also assessed.
Results
A total of 4514 cardiac surgery patients received pRBC transfusion. Of these, 292 (6.5%) received pRBCs ≥35 days. No difference in in-hospital mortality or frequency of complications was observed.
Transfusion of ≥5 units of pRBCs compared to the ≤4 units was associated with higher rates of in-hospital mortality (5.6% vs 1.3%), acute renal failure (17.6% vs 8%), infection (10% vs 3.4%), and acute myocardial infarction (9.2% vs 4.3%). Infection carried an odds ratio of 1.37 between groups (CI=0.9-2.09; p=0.14) and stroke/neurological complications, 1.59 (CI=0.96-2.63; p=0.07).
Conclusion
In cardiac surgery patients, transfusion of pRBCs closer to end of shelf-life was not shown to be associated with significantly increased mortality or morbidity. Dose-dependent differences in adverse outcomes (particularly where units transfused were >4) were supported.