bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral and long-acting injectable antipsychotic discontinuation and relationship to side effects in people with first episode psychosis: a longitudinal analysis of electronic health record data
Authors: Patel Rashmi , Brinn Aimee , Irving Jessica , Chaturvedi Jaya , Gudiseva Shanmukha , Correll Christoph U. , Fusar-Poli Paolo , McGuire Philip 
Published: December 2023

Background: Discontinuation of treatment in people with first episode psychosis (FEP) is common, but the extent to which this is related to specific adverse effects of antipsychotic medications is unclear. Objectives: To investigate whether antipsychotic discontinuation is associated with the prescription of particular antipsychotics and particular adverse effects. Design: Retrospective cohort study. Methods: We assembled de-identified electronic health record (EHR) data from 2309 adults with FEP who received care from the South London and Maudsley NHS Foundation Trust between 1st April 2008 and 31st March 2019. Associations between antipsychotic medications, clinician-recorded side effects and treatment discontinuation were investigated across a mean follow-up period of 34.2 months using Cox regression. Results: The mean age of patients was 26.7 years and 1492 (64.6%) were male. Among first prescribed antipsychotic medications, discontinuation occurred earlier with haloperidol [hazard ratio (HR) = 2.78, 95% CI = 1.69–4.60] and quetiapine (HR = 1.43, 95% CI = 1.16–1.80) than with olanzapine. Discontinuation occurred sooner when there was evidence of extrapyramidal symptoms (HR = 1.33, 95% CI = 1.08–1.64) or sexual dysfunction (HR = 1.59, 95% CI = 1.03–2.46). Among antipsychotics prescribed at any point during treatment, lurasidone (HR = 1.40, 95% CI = 1.10–1.78) and aripiprazole (HR = 1.09, 95% CI = 1.01–1.19) were associated with earlier discontinuation than olanzapine. Conversely, clozapine (HR = 0.55, 95% CI = 0.41–0.73) and paliperidone 1-monthly (PP1M) long-acting injectable (HR = 0.80, 95% CI = 0.68–0.94) were associated with later discontinuation. Unexpectedly, for antipsychotics prescribed at any stage of treatment, sedation (HR = 0.89, 95% CI = 0.81–0.97), weight gain (HR = 0.73, 95% CI = 0.64–0.83), and multiple side effects (HR = 0.83, 95% CI = 0.76–0.90) were associated with later discontinuation. Conclusion: Earlier treatment discontinuation associated with sexual or extrapyramidal side effects could be related to their rapid onset and poor tolerability. Later treatment discontinuation associated with clozapine and PP1M could be related to the relative efficacy of these treatments. These findings merit consideration when selecting antipsychotic therapy for people with FEP.
Barriers to and facilitators of online health information-seeking behaviours among cancer patients: A systematic review
Authors: Ferraris Giulia , Monzani Dario , Coppini Veronica , Conti Lorenzo , Maria Pizzoli Silvia Francesca , Grasso Roberto , Pravettoni Gabriella 
Published: December 2023

Objective: Disparities in cancer care contribute to higher rates of cancer mortality. Online health information would be a resource for cancer patients to obtain knowledge and make health decisions. However, factors that hinder or facilitate online searching behaviours among patients remain unexplored. The current systematic review aims to identify and synthesise evidence of cancer patients’ barriers to and facilitators of online health information-seeking behaviours. Methods: Electronic databases (PubMed, EMBASE, Scopus) were systematically searched, and a total of 123 full-text studies were reviewed of which 24 met the inclusion criteria. Results: Thematic analysis was performed to identify barriers and facilitators of online health information-seeking behaviours. Seven key themes were identified: (1) socio-demographic characteristics (age, gender, education, income, ethnicity and language), (2) psychosocial aspects (psychological wellbeing, need for a face to face contact, motivation, support), (3) accessibility (Internet access, residence), (4) quality and quantity of information (amount, reliability), (5) cancer stage and symptoms (time since diagnosis, experiencing symptoms), (6) aspects related to healthcare professionals (relationship with the patients and opinions on online health information) and (7) digital literacy (computer skills and literacy). Conclusions: Findings underscore the significance of recognising the multifaceted nature of barriers and facilitators affecting cancer patients’ online health information-seeking behaviours. A strong link between these factors and cancer patients’ ability to make informed decisions and cope effectively with their diagnosis emerged. Consequently, addressing these barriers and leveraging the identified facilitators could lead to improvements in patient-centred care, ultimately contributing to better healthcare services and informed decision-making for cancer patients. Future research should prioritise exploring strategies for enhancing cancer care accessibility across all stakeholders involved. Registration CRD42023408091
Deep Learning Artificial Intelligence Tool for Automated Radiographic Determination of Posterior Tibial Slope in Patients With ACL Injury
Authors: Lu Yining , Pareek Ayoosh , Yang Linjun , Rouzrokh Pouria , Khosravi Bardia , Okoroha Kelechi R. , Krych Aaron J. , Camp Christopher L. 
Published: December 2023

Background: An increased posterior tibial slope (PTS) corresponds with an increased risk of graft failure after anterior cruciate ligament (ACL) reconstruction (ACLR). Validated methods of manual PTS measurements are subject to potential interobserver variability and can be inefficient on large datasets. Purpose/Hypothesis: To develop a deep learning artificial intelligence technique for automated PTS measurement from standard lateral knee radiographs. It was hypothesized that this deep learning tool would be able to measure the PTS on a high volume of radiographs expeditiously and that these measurements would be similar to previously validated manual measurements. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A deep learning U-Net model was developed on a cohort of 300 postoperative short-leg lateral radiographs from patients who underwent ACLR to segment the tibial shaft, tibial joint surface, and tibial tuberosity. The model was trained via a random split after an 80 to 20 train-validation scheme. Masks for training images were manually segmented, and the model was trained for 400 epochs. An image processing pipeline was then deployed to annotate and measure the PTS using the predicted segmentation masks. Finally, the performance of this combined pipeline was compared with human measurements performed by 2 study personnel using a previously validated manual technique for measuring the PTS on short-leg lateral radiographs on an independent test set consisting of both pre- and postoperative images. Results: The U-Net semantic segmentation model achieved a mean Dice similarity coefficient of 0.885 on the validation cohort. The mean difference between the human-made and computer-vision measurements was 1.92° (σ = 2.81° [ P = .24]). Extreme disagreements between the human and machine measurements, as defined by ≥5° differences, occurred <5% of the time. The model was incorporated into a web-based digital application front-end for demonstration purposes, which can measure a single uploaded image in Portable Network Graphics format in a mean time of 5 seconds. Conclusion: We developed an efficient and reliable deep learning computer vision algorithm to automate the PTS measurement on short-leg lateral knee radiographs. This tool, which demonstrated good agreement with human annotations, represents an effective clinical adjunct for measuring the PTS as part of the preoperative assessment of patients with ACL injuries.
Culturally Safe Practices in the Co-creation of Medical Education Curriculum with Indigenous Animators: Outcomes From an Indigenous Learning Circle
Authors: Bessette Nicole , Reade Maurianne , McGregor Lorrilee , Berti Joahnna , Naokwegijig Bruce , Maar Marion 
Published: December 2023

OBJECTIVES To explore the experiences of Indigenous patient actors who co-created and enacted Indigenous patient scenarios in collaboration with medical school faculty. We critically examine the structures and systems in a medical school that mediate cultural safety for Indigenous patient actors. The Truth and Reconciliation Commission of Canada has called on medical schools and healthcare institutions to help address the intergenerational harms inflicted on Indigenous people by the Indian residential school (IRS) system. Institutions are striving to incorporate cultural competency, conflict resolution, human rights, and anti-racism education into their curricula. However, the structural inequities within undergraduate, postgraduate, and continuing medical education practices must be identified and challenged to ensure that medical education is authentic and culturally safe for those involved in the development and delivery of the Indigenous health curriculum. To explore potential structural inequities in the co-creation process of simulated cultural communication scenarios (SCCS), the Indigenous animators at Debajehmujig Storytellers and collaborating faculty and professional staff at the Northern Ontario School of Medicine University (NOSM U) examined cultural safety in their curriculum design and delivery process. METHODS We utilized the qualitative Indigenous research methodology of the Learning Circle to deconstruct the co-creation process and to explore the experience of cultural safety from the Indigenous animators’ perspective throughout the curriculum design and delivery process. RESULTS A framework for culturally safe co-creation practices with Indigenous people, rooted within Indigenous teachings of the Medicine Wheel, emerged from the qualitative data. CONCLUSIONS This framework has the potential to guide the practice of culturally safe co-creation of Indigenous patient simulations in medical education and healthcare workplace learning. While the Medicine Wheel teachings are held by specific Indigenous nations, we anticipate that the results and recommendations of this study will apply to Indigenous co-creators and academic medical educators internationally.
Comparative Outcomes of Magnetic Sphincter Augmentation and Fundoplication in Revisional Surgery
Authors: Bell Reginald , Buckley F. Paul , Lipham John , Parajuli Subigya , Heidrick Rachel 
Published: December 2023

Background: Outcomes of laparoscopic revisional surgery involving Magnetic Sphincter Augmentation (MSA) have not been clearly delineated, whether MSA was the presenting or the revisional surgery. We compared safety and clinical outcomes of 4 main categories: fundoplication revised to fundoplication (F-F); fundoplication to MSA (F-M), MSA to fundoplication (M-F) and MSA to MSA (M-M). Methods: Analysis of prospective data from 10 U.S. sites participating in the Registry of Outcomes of Anti-Reflux Surgery (ROARS). Patients had undergone at least one prior procedure on the esophagogastric junction with subsequent need for revisional surgery. Results: Between 2/1/2005 and 1/19/23, 742 patients underwent 819 revisional surgeries, of which 645 patients had 722 surgeries in the 4 main categories. Seventy-six percent had their prior operation elsewhere. Indications for reoperation (GERD, hiatal hernia, dysphagia, gas-bloat) were similar across categories. Preoperative and intraoperative findings disclosed disruption of prior hernia repair in 80% and 97% of patients respectively. Hernia size was larger with an antecedent fundoplication (13% >5 cm, 37% 3-5 cm) compared to patients with prior MSA (1.5% >5 cm, 18% 3-5 cm ( P < .0001). Revision of fundoplication resulted in 11% intraoperative complication rate, versus 2% for MSA. Six hundred patients (73.2%) were followed a mean of 2.7 years. Subsequent operation was performed on 77 (12.7%) a mean of 2.5 years; no difference between categories. Kaplan-Meier analysis showed equivalent subsequent reoperation rates at 5 years (20% ± 5%). Similar improvements in GERD-HRQL, bloating, dysphagia scores, ability to belch or vomit were seen. Conclusions: Over 95% of patients had disruption of the hiatus requiring repair, though prior MSA was associated with far fewer >3 cm hernias than prior fundoplication. Patients with an antecedent MSA can be revised with similar safety and outcomes as those having an antecedent fundoplication. MSA has equivalent results to fundoplication when used as a revisional procedure post antecedent fundoplication.
Incidence and Cause of Occupational Burnout Syndrome Among Sonographers
Authors: Tran My 
Published: December 2023

Objective: To investigate the level of occupational burnout syndrome in a cohort of sonographers and to determine any associations between sex, number of hours worked per week, and burnout. Materials and Methods: This study used a cross-sectional approach that replicated the Oldenburg Burnout Inventory and surveyed a convenience sample of sonographers who are members of the Society for Diagnostic Medical Sonography. Results: The study survey offered the total scores of occupational burnout, disengagement, and exhaustion, with a potential minimum score of 16 and a maximum score of 64. The results yielded a minimum score of 17 and a maximum score of 64. The mean score was 43.11 (SD = 7.02), indicating a moderate level of burnout. Conclusion: This cohort of sonographers demonstrated moderate levels of burnout, so it is important to acknowledge that preventing occupational burnout is necessary to ensure that workplace stress is managed to avoid significant issues. Further research is needed to assess how occupational burnout syndrome affects retention in the profession.
Cord blood transplantation for adult mature lymphoid neoplasms in Europe and Japan
Authors: Watanabe Mizuki , Kanda Junya , Volt Fernanda , Ruggeri Annalisa , Suzuki Ritsuro , Rafii Hanadi , Kimura Fumihiko , Cappelli Barbara , Kondo Eisei , Scigliuolo Graziana Maria , Takahashi Satoshi , Kenzey Chantal , Rivera-Franco Monica M. , Okamoto Shinichiro , Rocha Vanderson , Chevallier Patrice , Sanz Jaime , Fürst Sabine , Cornelissen Jan , Milpied Noel , Uchida Naoyuki , Sugio Yasuhiro , Kimura Takafumi , Ichinohe Tatsuo , Fukuda Takahiro , Mohty Mohamad , Peffault de Latour Régis , Atsuta Yoshiko , Gluckman Eliane 
Published: December 2023

Abstract
To clarify the different characteristics and prognostic factors of cord blood transplantation (CBT) in adult patients with lymphoid neoplasms in Europe and Japan, we conducted a collaborative study. Patients aged 18-75 years receiving their first CBT (Europe: single CBT, n = 192; double CBT, n = 304; Japan: single CBT, n = 1150) in 2000-2017 were analyzed. Fewer patients with Hodgkin lymphoma (Europe vs Japan, 26% vs 5%), and older patients (≥50 years) (39% vs 59%) with a higher refined disease risk index (rDRI) (high-very high: 49% vs 14%) were included in the Japanese registry. High-very high rDRI was associated with inferior overall survival (OS) (vs low rDRI, Europe: hazard ratio [HR], 1.87; P = .001; Japan: HR, 2.34; P &lt; .001) with higher progression/relapse risks. Total body irradiation (TBI)–containing conditioning contributed to superior OS both in Europe (vs TBI–reduced-intensity conditioning [RIC], non-TBI-RIC: HR, 1.93; P &lt; .001; non-TBI–Myeloablative conditioning [MAC]: HR, 1.90; P = .003) and Japan (non–TBI-RIC: HR, 1.71; P &lt; .001; non–TBI-MAC: HR 1.50, P = .007). The impact of HLA mismatches (≥2) on OS differed (Europe: HR, 1.52; P = .007; Japan: HR, 1.18; P = .107). CBT for lymphoid neoplasms, especially in those with high rDRI showed poor outcomes despite all the different characteristics in both registries. TBI should be considered in conditioning regimens to improve these outcomes. The different impacts of HLA mismatches call attention to the fundamental differences among these populations.
The modified Medical Research Council scale misclassifies exertional breathlessness among people referred for exercise testing
Authors: Gustafsson David , Elmberg Viktor , Schiöler Linus , Jensen Dennis , Ekström Magnus 
Published: December 2023

BackgroundExertional breathlessness is a major symptom in cardiorespiratory disease and is often assessed using the modified Medical Research Council (mMRC) questionnaire. The mMRC might underestimate exertional breathlessness in people with impaired exercise capacity who have reduced their physical activity to avoid the symptom. We aimed to evaluate the ability of mMRC to detect abnormally high exertional breathlessness or abnormally low exercise capacity during incremental cycle exercise testing (IET).MethodsA secondary analysis of data from a randomised controlled trial of outpatients aged 18 years or older referred for IET was carried out. Participants completed the mMRC before IET. Abnormally high exertional breathlessness was defined as a breathlessness (Borg 0–10) intensity response more than the upper limit of normal. Abnormally low exercise capacity was defined using published reference equations. The sensitivity, specificity, accuracy and discriminative ability of each mMRC rating to detect each outcomewas calculated.Results92 participants were included; the mean age was 59 years, 61% were male, and 64% and 15% had mMRC 1 and ≥2, respectively. An mMRC ≥2 had the highest accuracy (71%) to detect abnormally high exertional breathlessness, with a specificity of 93% but a sensitivity of only 28%, failing to identify 72% of people with abnormally high exertional breathlessness. The accuracy, specificity and sensitivity for abnormally low exercise capacity was 64%, 88% and 19%, respectively.ConclusionAmong people referred for clinical exercise testing, the mMRC dyspnoea scale misclassified exertional breathlessness and exercise capacity assessed using cycle IET, with substantial underdetection. A mMRC dyspnoea rating of 0–1 does not preclude the presence of abnormally high exertional breathlessness or abnormally low exercise capacity.
Realized Genetic Gain in Rice: Achievements from Breeding Programs
Authors: Seck Fallou , Covarrubias-Pazaran Giovanny , Gueye Tala , Bartholomé Jérôme 
Published: December 2023

AbstractGenetic improvement is crucial for ensuring food security globally. Indeed, plant breeding has contributed significantly to increasing the productivity of major crops, including rice, over the last century. Evaluating the efficiency of breeding strategies necessitates a quantification of this progress. One approach involves assessing the genetic gain achieved through breeding programs based on quantitative traits. This study aims to provide a theoretical understanding of genetic gain, summarize the major results of genetic gain studies in rice breeding, and suggest ways of improving breeding program strategies and future studies on genetic gain. To achieve this, we present the concept of genetic gain and the essential aspects of its estimation. We also provide an extensive literature review of genetic gain studies in rice (Oryza sativa L.) breeding programs to understand the advances made to date. We reviewed 29 studies conducted between 1999 and 2023, covering different regions, traits, periods, and estimation methods. The genetic gain for grain yield, in particular, showed significant variation, ranging from 1.5 to 167.6 kg/ha/year, with a mean value of 36.3 kg/ha/year. This translated into a rate of genetic gain for grain yield ranging from 0.1% to over 3.0%. The impact of multi-trait selection on grain yield was clarified by studies that reported genetic gains for other traits, such as plant height, days to flowering, and grain quality. These findings reveal that while breeding programs have achieved significant gains, further improvements are necessary to meet the growing demand for rice. We also highlight the limitations of these studies, which hinder accurate estimations of genetic gain. In conclusion, we offer suggestions for improving the estimation of genetic gain based on quantitative genetic principles and computer simulations to optimize rice breeding strategies.
Hydrological response of tropical rivers basins to climate change using the GR2M model: the case of the Casamance and Kayanga-Géva rivers basins
Authors: Sadio Cheikh Abdoul Aziz Sy , Faye Cheikh , Pande Chaitanya B. , Tolche Abebe Debele , Ali Mohd Sajid , Cabral-Pinto Marina M. S. , Elsahabi Mohamed 
Published: December 2023

AbstractThe main objective of this research is to evaluate the effects of climate change first on precipitation and temperature, and then on the runoff characteristics of two tropical watersheds located in Senegal and Guinea-Bissau. To achieve this, eighteen General Circulation Models (GCMs) were selected to measure various climate change scenarios under the Shared Socioeconomic Pathways (SSP) SSP1-2.6 and SSP5-8.5, using the reference period of 1985–2014. The GR2M hydrological model was employed to replicate past monthly surface runoff patterns for the Casamance and Kayanga-Géva watersheds. After calibrating and validating the GR2M model, the researchers simulated the predictable effect of climate change on the flow for the near future (2021–2040), medium future (2041–2060), and distant future (2081–2100) for each watershed, using the GCM multi-model ensemble mean. The quantile method was used to correct bias in temperature and precipitation data. The results of bias correction give a correlation coefficient greater than 0.9% for temperatures and 0,6% precipitation between the outputs of the multi-model ensemble and observations used. The results indicate also that all watersheds are expected to experience drier conditions in the near-future, mid-future, and far-future periods under both the SSP1-2.6 and SSP5-8.5 scenarios. Furthermore, the predictable temperature trends consistently show a warmer situation with growing radiative making in the future times. However, the primary factor influencing changes in flow for all watersheds is the projected precipitation changes. The anticipated drier conditions in the near-future, mid-future, and far-future horizons under both scenarios would lead to significantly reduced runoff volumes at the beginning and middle of the rainy season. Consequently, the projected seasonal changes in river flow for all catchments (e.g., under SSP5-8.5 scenario, a decline of -34.47%, -56.01%, and -68.01% was noted, respectively, for the horizons 2050, 2070, and 2090 for the Casamance basin) could lead to new frequent occurrences of drought and water scarcity associated with past hydrological regimes. These scenarios enhance the necessity of improving water management, water prizing, and water recycling policies, to ensure water supply and to reduce tensions among regions and countries.