bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilizing patient-nurse verbal communication in building risk identification models: the missing critical data stream in home healthcare
Authors: Zolnoori Maryam , Sridharan Sridevi , Zolnour Ali , Vergez Sasha , McDonald Margaret V , Kostic Zoran , Bowles Kathryn H , Topaz Maxim 
Published: October 2023

AbstractBackgroundIn the United States, over 12 000 home healthcare agencies annually serve 6+ million patients, mostly aged 65+ years with chronic conditions. One in three of these patients end up visiting emergency department (ED) or being hospitalized. Existing risk identification models based on electronic health record (EHR) data have suboptimal performance in detecting these high-risk patients.ObjectivesTo measure the added value of integrating audio-recorded home healthcare patient-nurse verbal communication into a risk identification model built on home healthcare EHR data and clinical notes.MethodsThis pilot study was conducted at one of the largest not-for-profit home healthcare agencies in the United States. We audio-recorded 126 patient-nurse encounters for 47 patients, out of which 8 patients experienced ED visits and hospitalization. The risk model was developed and tested iteratively using: (1) structured data from the Outcome and Assessment Information Set, (2) clinical notes, and (3) verbal communication features. We used various natural language processing methods to model the communication between patients and nurses.ResultsUsing a Support Vector Machine classifier, trained on the most informative features from OASIS, clinical notes, and verbal communication, we achieved an AUC-ROC = 99.68 and an F1-score = 94.12. By integrating verbal communication into the risk models, the F-1 score improved by 26%. The analysis revealed patients at high risk tended to interact more with risk-associated cues, exhibit more “sadness” and “anxiety,” and have extended periods of silence during conversation.ConclusionThis innovative study underscores the immense value of incorporating patient-nurse verbal communication in enhancing risk prediction models for hospitalizations and ED visits, suggesting the need for an evolved clinical workflow that integrates routine patient-nurse verbal communication recording into the medical record.
Using natural language processing to characterize and predict homeopathic product-associated adverse events in consumer reviews: comparison to reports to FDA Adverse Event Reporting System (FAERS)
Authors: Konkel Karen , Oner Nurettin , Ahmed Abdulaziz , Jones S Christopher , Berner Eta S , Zengul Ferhat D 
Published: October 2023

Abstract

Objective
Apply natural language processing (NLP) to Amazon consumer reviews to identify adverse events (AEs) associated with unapproved over the counter (OTC) homeopathic drugs and compare findings with reports to the US Food and Drug Administration Adverse Event Reporting System (FAERS).

Materials and methods
Data were extracted from publicly available Amazon reviews and analyzed using JMP 16 Pro Text Explorer. Topic modeling identified themes. Sentiment analysis (SA) explored consumer perceptions. A machine learning model optimized prediction of AEs in reviews. Reports for the same time interval and product class were obtained from the FAERS public dashboard and analyzed.

Results
Homeopathic cough/cold products were the largest category common to both data sources (Amazon = 616, FAERS = 445) and were analyzed further. Oral symptoms and unpleasant taste were described in both datasets. Amazon reviews describing an AE had lower Amazon ratings (X2 = 224.28, P &lt; .0001). The optimal model for predicting AEs was Neural Boosted 5-fold combining topic modeling and Amazon ratings as predictors (mean AUC = 0.927).

Discussion
Topic modeling and SA of Amazon reviews provided information about consumers’ perceptions and opinions of homeopathic OTC cough and cold products. Amazon ratings appear to be a good indicator of the presence or absence of AEs, and identified events were similar to FAERS.

Conclusion
Amazon reviews may complement traditional data sources to identify AEs associated with unapproved OTC homeopathic products. This study is the first to use NLP in this context and lays the groundwork for future larger scale efforts.
Visualizing machine learning-based predictions of postpartum depression risk for lay audiences
Authors: Desai Pooja M , Harkins Sarah , Rahman Saanjaana , Kumar Shiveen , Hermann Alison , Joly Rochelle , Zhang Yiye , Pathak Jyotishman , Kim Jessica , D’Angelo Deborah , Benda Natalie C , Reading Turchioe Meghan 
Published: October 2023

Abstract

Objectives
To determine if different formats for conveying machine learning (ML)-derived postpartum depression risks impact patient classification of recommended actions (primary outcome) and intention to seek care, perceived risk, trust, and preferences (secondary outcomes).

Materials and methods
We recruited English-speaking females of childbearing age (18-45 years) using an online survey platform. We created 2 exposure variables (presentation format and risk severity), each with 4 levels, manipulated within-subject. Presentation formats consisted of text only, numeric only, gradient number line, and segmented number line. For each format viewed, participants answered questions regarding each outcome.

Results
Five hundred four participants (mean age 31 years) completed the survey. For the risk classification question, performance was high (93%) with no significant differences between presentation formats. There were main effects of risk level (all P &lt; .001) such that participants perceived higher risk, were more likely to agree to treatment, and more trusting in their obstetrics team as the risk level increased, but we found inconsistencies in which presentation format corresponded to the highest perceived risk, trust, or behavioral intention. The gradient number line was the most preferred format (43%).

Discussion and conclusion
All formats resulted high accuracy related to the classification outcome (primary), but there were nuanced differences in risk perceptions, behavioral intentions, and trust. Investigators should choose health data visualizations based on the primary goal they want lay audiences to accomplish with the ML risk score.
Virtual reality and augmented reality smartphone applications for upskilling care home workers in hand hygiene: a realist multi-site feasibility, usability, acceptability, and efficacy study
Authors: Gasteiger Norina , van der Veer Sabine N , Wilson Paul , Dowding Dawn 
Published: October 2023

Abstract

Objectives
To assess the feasibility and implementation, usability, acceptability and efficacy of virtual reality (VR), and augmented reality (AR) smartphone applications for upskilling care home workers in hand hygiene and to explore underlying learning mechanisms.

Materials and Methods
Care homes in Northwest England were recruited. We took a mixed-methods and pre-test and post-test approach by analyzing uptake and completion rates of AR, immersive VR or non-immersive VR training, validated and bespoke questionnaires, observations, videos, and interviews. Quantitative data were analyzed descriptively. Qualitative data were analyzed using a combined inductive and deductive approach.

Results
Forty-eight care staff completed AR training (n = 19), immersive VR training (n = 21), or non-immersive VR training (n = 8). The immersive VR and AR training had good usability with System Usability Scale scores of 84.40 and 77.89 (of 100), respectively. They had high acceptability, with 95% of staff supporting further use. The non-immersive VR training had borderline poor usability, scoring 67.19 and only 63% would support further use. There was minimal improved knowledge, with an average of 6% increase to the knowledge questionnaire. Average hand hygiene technique scores increased from 4.77 (of 11) to 7.23 after the training. Repeated practice, task realism, feedback and reminding, and interactivity were important learning mechanisms triggered by AR/VR. Feasibility and implementation considerations included managerial support, physical space, providing support, screen size, lagging Internet, and fitting the headset.

Conclusions
AR and immersive VR apps are feasible, usable, and acceptable for delivering training. Future work should explore whether they are more effective than previous training and ensure equity in training opportunities.
Making the most of it: thinking about educational time with Hägglund and Levinas
Authors: Parker Lana 
Published: October 2023

Abstract
This paper explores the concept of time in education. It argues that the neoliberal capitalist construct of time as a resource to be deployed in service of labour—ever-accelerating—has permeated education, with implications for curriculum, teaching, and learning. To slow the effects of neoliberal capitalism in schools requires a reconsideration of time that permits both different understandings of how time is encountered and different values orienting how one spends one’s time. Using Hägglund’s argument for finitude and Levinas’ idea of time as a gift, the paper articulates the philosophical rationale and pedagogical implications for making the most of one’s educational time.
Early-Life Temperamental Differences as Longitudinal Predictors of Unintentional Injuries
Authors: Ksinan Albert J , Dalecká Andrea , Kukla Lubomír , Pikhart Hynek , Bobák Martin 
Published: October 2023

Abstract

Objective
Unintentional injuries are the leading cause of hospitalization and death among children. Compared to environmental factors, less attention in injury preventive efforts has been paid to how individual characteristics relate to the risk of injury. Using a large prospective cohort, the current study assessed the longitudinal impact of early-life temperament on the cumulative number of injuries until mid-adolescence.

Methods
The data came from the European Longitudinal Study of Pregnancy and Childhood (ELSPAC-CZ). Temperament was evaluated by mothers when children were 3 years old (N = 3,545). The main outcome was the pediatrician-reported sum of child’s injuries from age 3 to 15 (seven timepoints). Latent profile analysis (LPA) was used to determine classes based on temperamental dimensions and then extended to a mixture model with a distal count outcome. The covariates included maternal conflict and attachment, sex, family structure, and maternal education.

Results
The LPA determined the existence of three classes: shy children (8.1% of the sample; lowest activity/highest shyness), outgoing children (50.8%; highest activity/lowest shyness), and average: children (41.1%; middle values). Results from a mixture model showed that the outgoing temperament was associated with the highest longitudinal risk for injuries, as both average children (IRR = 0.89 [0.80, 0.99]), and the shy children (IRR = 0.80 [0.68, 0.95]) had lower risk.

Conclusions
Early childhood temperamental differences can have long-term effects on injury risk. Highly active children showed the highest risk for future injuries, suggesting that these characteristics make them more likely to be involved in novel and potentially dangerous situations.
Complementary and Integrative Medicine Prevalence and Utilization in International Military and Veteran Settings and Communities: A Systematic Review
Authors: Bayes Jessica , Palencia John , Wardle Jon 
Published: October 2023

ABSTRACT

Introduction
Active duty military personnel and veterans have unique and complex health needs, with the high demands of military life often leading to chronic physical and mental health conditions. Complementary and integrative medicine (CIM) could be a possible solution to this problem. Some military health systems have started integrating CIM into health care delivery. However, there has been no systematic evaluation of the prevalence and utilization of CIM in military and veteran populations globally.

Materials and Methods
A Preferred Reporting Items For Systematic Reviews and Meta-Analysis Protocols protocol was used to systematically search for original research assessing the prevalence and utilization of CIM among active serving military or veterans. CINAHL, MEDLINE, Scopus, and AMED databases were searched up to February 3, 2023.

Results
A total of 27 studies met the inclusion criteria and were included in this review. The overall quality of evidence was high with a low risk of bias. Utilization of CIM varied. The lowest utilization demonstrated that only 1.9% of services delivered by military health system were CIM. The majority of studies found utilization rates between 30% and 80%, with some studies reporting use as high as 90%. The most commonly used CIM therapies included chiropractic care, massage, mindfulness/meditation, and acupuncture. Utilization of CIM products was high and ranged from 32% to 87%. The most frequently used products were dietary supplements, particularly multivitamins and minerals and protein supplements/amino acids. The use of herbal products was high among veterans ranging from 10% to 79%.

Conclusions
The high demand for CIM by military personnel and veterans has important implications for policy, funding allocation, and integration of these services into clinical practice, particularly by countries not currently doing so. Further research is needed to assess the implementation of CIM into real-world settings to explore barriers and facilitators for their use in clinical practice and, by extension, their integration into the wider health care system.
Training, Deployment Preparation, and Behavioral Health of New York National Guard Personnel Deployed to Assist with COVID-19 Decedent Work
Authors: Riviere Lyndon A , Kim Paul Y , Baker Matthew D , Beymer Matthew R 
Published: October 2023

ABSTRACT

Introduction
A small body of research conducted mostly among civilians has shown that adequate training and preparation can prevent or reduce the development of behavioral health problems in first responders. Several civilian studies have shown that social support is protective against behavioral health problems. However, very few studies have examined the impact of these factors on the behavioral health of military first responders. Military first responders, who serve in the aftermath of natural disasters and disease outbreaks such as the coronavirus disease 2019 (COVID-19) pandemic, are often members of the National Guard (NG). The purpose of this study was to examine the impact of mortuary affairs training/handling human remains, role preparation, equipment preparation, and unit social support provided to families on the behavioral health of New York (NY) NG personnel deployed to assist the NY Office of Chief Medical Examiner with handling the remains of COVID-19 decedents.

Materials and Methods
We invited 410 NYNG personnel who deployed for the Office of Chief Medical Examiner mission to complete an anonymous online questionnaire 3 to 6 months post-mission. Of the 158 participants, we used the data of the 141 participants who provided consent. Standard behavioral health measures (depression, anxiety, post-traumatic stress disorder, alcohol misuse, and insomnia) as well as study-specific items designed to understand the unique dynamics of this deployment were included. Hierarchical logistic regression analysis was used to examine the relationships between mortuary training, role preparation, equipment preparation, and unit support with behavioral health.

Results
Close to two-thirds of the sample reported that they had not been trained in mortuary affairs/handling human remains before the mission. We also found that that lower levels of role preparation and unit support provided to the service members’ families increased the odds of meeting criteria for one or more behavioral health problems, but that training in mortuary affairs and equipment preparation was unrelated to behavioral health.

Conclusions
Our research points to the importance of emotionally and cognitively preparing service members for the specific dynamics of a deployment and the roles that that they are expected to play. Furthermore, it suggests that supporting the families of NG personnel during domestic missions can benefit the behavioral health of the NG personnel. Additional research is needed to corroborate these findings, particularly the impact of unit support provided to family members on service members’ behavioral health.
More Than a Bruise: Two Cases of Morel-Lavallée Lesions in Active Duty Soldiers
Authors: Rodgers David K , Castañeda Philip , Simmons Cecil J , Carius Brandon M 
Published: October 2023

ABSTRACT
Soft tissue injuries are common in the military, generally producing simple hematomas without the need for intensive evaluation and management. In certain situations, a shearing effect between fascial planes whereby a disruption of the vasculature and lymphatic systems creates a “closed degloving injury” is more generally referred to as a Morel-Lavallée Lesion (MLL). With a consistent pool of blood, lymph, and pieces of soft tissue, an M7LL can cause significant poor cosmesis, chronic pain, and risk secondary infection if left undetected and untreated. Proper diagnosis can be made through the effective use of ultrasound and, if detected early enough, through conservative measures to include needle aspiration and compression sleeves. Prior cases describe chronic MLLs existing for extended periods of time, in some cases years, requiring operative intervention, and in some cases poor outcomes. We present two cases of active duty soldiers presenting with seemingly innocuous injuries found on closer evaluation to have MLL, treated in one case with needle aspiration and compression, in the other with operative management.
A Safe Road to Infallibilism?
Authors: Davis Wayne A 
Published: October 2023

Abstract
In “How to Be an Infallibilist,” Julien Dutant (2016, 149) presents a simple and seemingly plausible argument that knowledge requires infallible belief—roughly, belief that could not be mistaken. As Dutant recognizes, infallibilism is almost universally dismissed, in large part because it seems to rule out any knowledge of the physical world. He seeks to show how we can be an Infallibilist without being a skeptic, based on the assumption that knowledge has a safety condition. I critically examine each line of Dutant’s argument, showing that the argument is unsound on any plausible interpretation. I also question the idea that knowledge cannot be the conjunction of true belief and a nonfactive condition, that any belief about the physical world could not be false, and that any nonskeptical alternative to infallibilism would have to allow knowledge of chancy outcomes. I briefly suggest that a fallibilist account can be strict enough to satisfy the Infallibilist’s quest for certainty.
How Infallibilists Can Have It All
Authors: Climenhaga Nevin 
Published: October 2023

Abstract
I advance a novel argument for an infallibilist theory of knowledge, according to which we know all and only those propositions that are certain for us. I argue that this theory lets us reconcile major extant theories of knowledge, in the following sense: for any of these theories, if we require that its central condition (evidential support, reliability, safety, etc.) obtains to a maximal degree, we get a theory of knowledge extensionally equivalent to infallibilism. As such, the infallibilist can affirm that, when their conditions are suitably interpreted, most post-Gettier theories of knowledge offer necessary and sufficient conditions for knowledge. The infallibilist can thus reconcile major theories of knowledge, and is in a better position to explain the intuitive appeal of these theories than the fallibilist who only accepts one of them, and rejects the rest.
Gliomatosis cerebri (GC) growth pattern: A single-center analysis of clinical, histological, and molecular characteristics of GC and non-GC glioblastoma
Authors: Divé Iris , Weber Katharina J , Hartung Tabea I , Steidl Eike , Wagner Marlies , Hattingen Elke , Franz Kea , Fokas Emmanouil , Ronellenfitsch Michael W , Herrlinger Ulrich , Harter Patrick N , Steinbach Joachim P 
Published: October 2023

Abstract

Background
The biological understanding of glioblastoma (GB) with gliomatosis cerebri (GC) pattern is poor due to the absence of GC-specific studies. Here, we aimed to identify molecular or clinical parameters that drive GC growth.

Methods
From our methylome database of IDH (isocitrate dehydrogenase)-wildtype GB, we identified 158 non-GC and 65 GC cases. GC cases were subdivided into diffuse-infiltrative (subtype 1), multifocal (subtype 2), or tumors with 1 solid mass (subtype 3). We compared clinical, histological, and molecular parameters and conducted a reference-free tumor deconvolution of DNA methylation data based on latent methylation components (LMC).

Results
GC subtype 1 less frequently showed contrast-enhancing tumors, and more frequently lacked morphological GB criteria despite displaying GB DNA methylation profile. However, the tumor deconvolution did not deliver a specific LMC cluster for either of the GC subtypes. Employing the reference-based analysis MethylCIBERSORT, we did not identify significant differences in tumor cell composition. The majority of both GC and non-GC patients received radiochemotherapy as first-line treatment, but there was a major imbalance for resection. The entire GC cohort had significantly shorter overall survival (OS) and time to treatment failure (TTF) than the non-GC cohort. However, when filtering for cases in which only stereotactic biopsy was performed, the comparison of OS and TTF lost statistical significance.

Conclusions
Our study offers clinically relevant information by demonstrating a similar outcome for GB with GC growth pattern in the surgically matched analysis. The limited number of cases in the GC subgroups encourages the validation of our DNA methylation analysis in larger cohorts.