bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measurement of visual function in infantile nystagmus: a systematic review
Authors: Almagren Bader ,   Nystagmus UK Eye Research Group (NUKE), Dunn Matt J 
Published: December 2023

Background/aims
Recent work has called into question the ability of visual acuity (VA) to accurately represent changes in visual function in infantile nystagmus (IN). This systematic review investigated factors affecting visual performance in IN, to guide development of suitable alternatives to VA.

Methods
Included studies used an experimental manipulation to assess changes in visual function in people with IN. Interventional studies, case series and case studies were excluded. Six databases were searched in August 2023. Selection, detection, attrition and measurement bias were assessed. Due to heterogeneous methodologies, narrative synthesis was undertaken.

Results
Eighteen relevant papers were identified, 11 of which complied with the review criteria. Articles were grouped according to the factor manipulated to evoke within-participant changes in performance (motion blur, psychological state, gaze angle or visual crowding). Optotype, image, grating and moving stimuli have been employed under varying lighting conditions and exposure duration.

Conclusion
Several factors affecting visual performance should be considered when assessing visual function in IN. While maximum VA is a useful metric, its measurement deliberately minimises nystagmus-specific factors such as changes in visual performance with gaze angle and the ‘slow to see’ phenomenon. Maximum VA can be measured using the null zone, providing unlimited viewing time, reducing stress/mental load and minimising visual crowding. Gaze-dependent functional vision space is a promising measure which quantifies the impact of the null zone but does not consider temporal vision. Although no complete measurement technique has yet been proven, this review provides insights to guide future work towards development of appropriate methods.
COVID-19 vaccination implementation in 52 African countries: trajectory and implications for future pandemic preparedness
Authors: Wariri Oghenebrume , Afolabi Muhammed Olanrewaju , Mukandavire Christinah , Saidu Yauba , Balogun Obe Destiny , Ndiaye Sidy , Okpo Emmanuel A , Nomhwange Terna , Uthman Olalekan A , Kampmann Beate 
Published: December 2023

IntroductionTo end the COVID-19 pandemic, the WHO set a goal in 2021 to fully vaccinate 70% of the global population by mid-2022. We projected the COVID-19 vaccination trajectory in 52 African countries and compared the projected to the ‘actual’ or ‘observed’ coverage as of December 2022. We also estimated the required vaccination speed needed to have attained the WHO 70% coverage target by December 2022.MethodsWe obtained publicly available, country-reported daily COVID-19 vaccination data, covering the initial 9 months following the deployment of vaccines. We used a deterministic compartmental Susceptible-Exposed-Infectious-Recovered-type model and fit the model to the number of COVID-19 cases and vaccination coverage in each African country using a Markov chain Monte Carlo approach within a Bayesian framework.FindingsOnly nine of the 52 African countries (Tunisia, Cabo Verde, Lesotho, Mozambique, Rwanda, Seychelles, Morocco, Botswana and Mauritius) were on track to achieve full COVID-19 vaccination coverage rates ranging from 72% to 97% by the end of December 2022, based on their progress after 9 months of vaccine deployment. Of the 52 countries, 26 (50%) achieved ‘actual’ or ‘observed’ vaccination coverage rates within ±10 percentage points of their projected vaccination coverage. Among the countries projected to achieve <30% by December 2022, nine of them (Chad, Niger, Nigeria, South Sudan, Tanzania, Somalia, Zambia, Sierra Leone and Côte d’Ivoire) achieved a higher observed coverage than the projected coverage, ranging from 12.3 percentage points in South Sudan to 35.7 percentage points above the projected coverage in Tanzania. Among the 52 countries, 83% (43 out of 52) needed to at least double their vaccination trajectory after 9 months of deployment to reach the 70% target by December 2022.ConclusionOur findings can guide countries in planning strategies for future global health emergencies and learning from each other, especially those that exceeded expectations and made significant progress towards the WHO’s 2022 COVID-19 vaccination target despite projected poor coverage rates.
‘It was a joint plan we worked out together’. How the I-WOTCH programme enabled people with chronic non-malignant pain to taper their opioids: a process evaluation
Authors: Nichols Vivien P , Abraham Charles , Eldabe Sam , Sandhu Harbinder Kaur , Underwood Martin , Seers Kate 
Published: December 2023

BackgroundThe Improving the Wellbeing of people with Opioid Treated CHronic pain (I-WOTCH) randomised controlled trial found that a group-based educational intervention to support people using strong opioids for chronic non-malignant pain helped a significant proportion of people to stop or decrease opioid use with no increase in pain-related disability. We report a linked process evaluation of the group-based intervention evaluated in comparison to a usual-care control group that received a self-help booklet and relaxation CD.MethodsWe interviewed 18 intervention facilitators, and 20 intervention and 20 control participants who had chronic non-malignant pain and were recruited from general (family) practices in the UK. Quantitative data included change mechanism questions on the trial questionnaires which explored motivation, expectations and self-efficacy. Fidelity was assessed by listening to a sample of audio-recorded group sessions and nurse consultations. Quantitative and qualitative data were integrated using ‘follow a thread’ and a mixed-methods matrix.FindingsFour overarching themes emerged: (1) the right time to taper, (2) the backdrop of a life with chronic pain, (3) needing support and (4) the benefits of being in a group. Delivery fidelity was good, adherence (83%) and competence (79%) across a range of intervention groups. Staff delivering the intervention found three typical responses to the intervention: resistance, open to trying and feeling it was not the right time. The group experience was important to those in the intervention arm. It provided people with a forum in which to learn about the current thinking about opioid usage and its effects. It also gave them examples of how feasible or personally relevant coming off opioids might be.ConclusionThe process evaluation data showed that the I-WOTCH intervention was well delivered, well received and useful for most interviewees. Being ‘the right time’ to taper and having support throughout tapering, emerged as important factors within the context of living with chronic pain.Trial registration numberISRCTN49470934.
Abortion restrictions and medical residency applications
Authors: Mermin-Bunnell Kellen , Traub Ariana M , Wang Kelly , Aaron Bryan , King Louise Perkins , Kawwass Jennifer 
Published: December 2023

Residency selection is a challenging process for medical students, one further complicated in the USA by the recentDobbs v Jackson Women’s Health Organization(Dobbs) decision over-ruling the federal right to abortion. We surveyed medical students to examine howDobbsis influencing the ideological, personal and professional factors they must reconcile when choosing where and how to complete residency.Between 6 August and 22 October 2022, third-year and fourth-year US medical students applying to US residency programmes were surveyed through social media and direct outreach to medical schools. Analysis of quantitative and qualitative data from 494 responses was performed to assess downstream effects ofDobbson residency applicants’ family, health and career choices.Most respondents said changes in abortion access would likely or very likely influence their decision regarding location of considered residency programme (76.9%), where to start a family (72.2%) and contraceptive planning for them or their partner (57.9%). Cis-gender females were more influenced byDobbsregarding where (5 (4, 5) p<0.001) and when (3 (3, 5) p<0.001) to start a family. In qualitative responses, medical trainees highlighted the importance of abortion access for their patients, themselves and their loved ones.Medical trainees are incorporating state abortion access into their residency programme choices. Future physicians care about both the quality of care they will be able to provide and their own health. For personal and professional reasons, reproductive healthcare access is now a key factor in residency match decisions.
Improved naming in patients with Broca’s aphasia with tDCS
Authors: Bonilha Leonardo , Rorden Chris , Roth Rebecca , Sen Souvik , George Mark S , Fridriksson Julius 
Published: December 2023

BackgroundLanguage impairment (aphasia) is a common neurological deficit after strokes. For individuals with chronic aphasia (beyond 6 months after the stroke), language improvements with speech therapy (ST) are often limited. Transcranial direct current stimulation (tDCS) is a promising approach to complement language recovery but interindividual variability in treatment response is common after tDCS, suggesting a possible relationship between tDCS and type of linguistic impairment (aphasia type).MethodsThis current study is a subgroup analysis of a randomised controlled phase II futility design clinical trial on tDCS in chronic post-stroke aphasia. All participants received ST coupled with tDCS (n=31) vs sham tDCS (n=39). Confrontation naming was tested at baseline, and 1, 4, and 24 weeks post-treatment.ResultsBroca’s aphasia was associated with maximal adjunctive benefit of tDCS, with an average improvement of 10 additional named items with tDCS+ST compared with ST alone at 4 weeks post-treatment. In comparison, tDCS was not associated with significant benefits for other aphasia typesF(1)=4.23,p=0.04. Among participants with Broca’s aphasia, preservation of the perilesional posterior inferior temporal cortex was associated with higher treatment benefit (R=0.35,p=0.03).ConclusionsThese results indicate that adjuvant tDCS can enhance ST to treat naming in Broca’s aphasia, and this may guide intervention approaches in future studies.
Complexity growth of BTZ black hole in massive gravity with a null string
Authors: Zhou Yu-Ting 
Published: December 2023

AbstractIn this paper, we investigate the complexity growth of the tensionless limit of string in the neutral BTZ black hole horizon in massive gravity. When the string approaches the horizon, we observe a novel phenomenon for the Nambu–Goto action growth that produces significant difference from tensile string geometry. The string’s tension is then suggested to partially contribute to the growth of the action. We also argue a potential proposal that reconstructs the complexity from the renormalization group (RG) flow.
Overcoming Resistance in Chronic Lymphocytic Leukemia—Maybe Less Is More?
Authors: Al-Sawaf Othman , Davids Matthew S. 
Published: December 2023

AbstractAcquired mutations in BTK, PLCG2, and BCL2 are associated with resistance to continuous targeted agent therapy in chronic lymphocytic leukemia (CLL). Here, we discuss new evidence that limiting the duration of CLL therapy may prevent the evolution of such resistance mutations, potentially facilitating effective retreatment strategies.See related article by Jain et al., p. 498
Ecobordering
Authors: Okolie Mary J.N. , Ukwueze Ogochukwu 
Published: December 2023

Abstract
Considering the literary response to the environmental crisis in the Niger Delta, it is observable that most critics of the literary arts on the Niger Delta homogenise the effects of the environmental problem, rather than focusing on particular groups of ecological subjects. These critics universalise environmental discourse, thereby overlooking more silenced and marginalised ecological subjects and subverting environmental justice. Using Helon Habila’s Oil on Water and Kaine Agary’s Yellow Yellow, this study responds to the need to individualise the effect of environmental degradation by focusing on Niger Delta women who are both culturally and environmentally constrained. It combines border theories and ecofeminism to pay detailed attention to the literary representation of women’s precarious positionality, a situation of both spatial and symbolic vulnerability. It also explores women’s reception of and interaction with the polluted environment, given that the locations of degradation (the farms and freshwater), according to African culture, are gender-sensitive spaces and that African rural women mostly depend on farming and water for household work. Lastly, this paper examines women’s response to the violence of environmental pollution, thereby underscoring agency and visibility for women in connection with environment.
Positivity, daily time use, mood, and functioning in patients with schizophrenia spectrum disorders: Results from the diapason multicentric study
Authors: Martinelli Alessandra , Moncalieri Giulia , Zamparini Manuel , Alessandri Guido , Vittorio Caprara Gian , Castelnuovo Gianluca , Rocchetti Matteo , Starace Fabrizio , Zarbo Cristina , de Girolamo Giovanni 
Published: December 2023

Background: Positivity (POS) indicates the proclivity to see life and experiences in a positive light. There is limited research on its effects on individuals with Schizophrenia Spectrum Disorders (SSD). Very little is known about the relationship between POS and daily activities in people with SSD. Aim: The study aims to compare the POS rated by patients with SSD with those obtained in an Italian normative sample matched by age and sex and to use the Ecological Momentary Assessment (EMA) to investigate the association between POS and daily time use (i.e. productive activities, leisure activities), functioning and mood in individuals with SSD. Method: 620 SSD patients were recruited from mental health services in Italy as part of the DiAPAson project. POS, symptom severity, functioning, and quality of life (QoL) were assessed. POS scores were compared to a normative sample of 5,002 Italian citizens. Additionally, a subset of 102 patients underwent 7-day assessments using mobile EMA. Results: People with SSD did not significantly differ from the Italian normative sample in POS levels (0.035, p = .190). POS showed a significant inverse association with support network (−0.586, p = .036) and symptomatology (BPRS −0.101; 95% p < .001; BNSS B = −0.113, p < .001). A significant direct association was found between POS and QoL ( B = 0.310, p < .001) and functioning ( B = 0.058, p < .001). In the subsample using EMA, POS ratings showed significant associations with Positive Emotions ( B = 0.167, p < .001) and Negative Emotions ( B = −0.201, p < .001). Conclusion: People with SSD exhibited comparable levels of POS to the normative sample. Higher POS was linked to better functioning, QoL, fewer severe symptoms, and increased positive emotions. However, it did not relate to increased productivity or engagement in leisure activities. Further research is needed to understand the relationship between POS and time use in individuals with SSD.
Extracorporeal membrane oxygenation in diabetic ketoacidosis-related cardiac and respiratory failure
Authors: Sharif Ammar , Brewer J Michael , El Banayosy Aly , Mihu Mircea R , Reaves Zachary , Swant Laura V , Schoaps Robert S , Benson Clayne , Khalid Malik Ibithaj , Maybauer Marc O 
Published: December 2023

Introduction: Diabetic ketoacidosis (DKA) is a common clinical problem. When patients develop severe shock and/or respiratory failure, extracorporeal membrane oxygenation (ECMO) may be considered. This case series describes the clinical presentation and outcomes of patients with DKA supported with ECMO. Methods: We conducted a retrospective and anonymized review of 15 patients with DKA who required ECMO at our institution. Demographic and ECMO-specific data were collected. Additional variables include ICU length of stay (LOS), acute kidney injury and use of continuous renal replacement therapy, disposition, and mortality. Results: All ECMO cannulations were performed by an intensivist using peripheral vascular access. The majority of patients were female (73%) with a median age of 27 (IQR = 21.5–45) years. A diagnosis of diabetes mellitus (DM) prior to ECMO was present in 11 (73%) patients. Venoarterial ECMO was the initial mode used in 11 (73%) patients. The median duration of ECMO support was 7 (IQR = 6–14) days. The median ICU LOS was 12 (IQR = 8.5–20.5) days, and the median hospital LOS was 21 (IQR = 11–36.5) days. Eight patients had cardiac arrest and underwent extracorporeal cardiopulmonary resuscitation (ECPR) of which 4 (50%) patients survived to discharge. Overall, 10 (66.7%) patients were successfully weaned from ECMO and survived to discharge. Conclusion: This is the largest case series regarding the use of ECMO for patients with refractory shock, cardiac arrest, or respiratory failure related to DKA. The findings suggest that ECMO is a viable support option for managing these patients and has excellent outcomes, including patients with cardiac arrest.
Emtricitabine/tenofovir alafenamide usage in a Scottish sexual health service providing HIV pre-exposure prophylaxis: A service evaluation
Authors: Burley Nathan , MacDonald Rona , Khan Aafreen 
Published: December 2023

Background: In this service evaluation we evaluate the usage of emtricitabine and tenofovir alafenamide (FTC-TAF) in a large Scottish sexual health service providing Human Immunodeficiency Virus (HIV) Pre-Exposure Prophylaxis (PrEP) over a one-year period (May 2022-May 2023). Purpose: We evaluated the use of FTC-TAF as it is 30 times more expensive per 30 tablet supply than emtricitabine/tenofovir disoproxil (FTC-TDF). We sought to establish: - Number of patients initiated on FTC-TAF - Reasons for FTC-TAF initiation - Adherence to FTC-TAF. Results: Out of a total cohort of 1744 patients on HIV PrEP as of May 2023, seven patients (0.4%) had been initiated on FTC-TAF. The remainder (99.6%) were taking FTC-TDF. The majority of patients ( n = 6) were initiated on FTC-TAF due to renal reasons, one patient was initiated FTC-TAF for bone mineral density concerns. Conclusions: All of the patients met eligibility criteria. In terms of adherence, three patients were regular attenders, two patients used FTC-TAF sporadically, and two had initiated and subsequently discontinued FTC-TAF altogether at the time of data analysis. FTC-TAF utilisation was lower than anticipated, initiated apropriately, and followed similar adherence patterns to FTC-TDF users. This will be helpful for financial forecasting and in the development of services where FTC-TAF is newly commissioned.
Utility of Routine Blood Cultures for Upper Extremity Abscesses
Authors: Kurucan Etka , Echeverria Nicolas J. , Jacquez Evan , Ramsey Frederick V. , Solarz Mark 
Published: December 2023

Background: Patients with skin and soft tissue infections (SSTIs) are often admitted by the emergency department for intravenous antibiotic therapy and surgical drainage of abscesses if necessary. As part of the initial diagnostic workup, blood cultures are routinely drawn at our institution in patients with SSTIs. This study seeks to identify the utility of performing blood cultures in patients with upper extremity abscesses as it relates to the number of incision and drainage (I&D) procedures performed, patient readmission rates, and length of hospital stay. Methods: A retrospective chart review of 314 patients aged 18 to 89 years who underwent 1 or more I&D procedures of upper extremity abscesses were included in the study. Patient demographic data, comorbidities, laboratory values, wound and blood culture results, number of I&D procedures performed, length of stay, and readmission rates were evaluated. Results: Increasing age and white blood count were associated with an increased number of I&Ds performed. Obtaining blood cultures, whether positive or negative, was associated with increased length of stay. There was no association between obtaining blood cultures and number of procedures performed on multivariable analysis. Positive blood cultures were associated with increased readmission rates. Conclusions: Routinely obtaining blood cultures in patients with upper extremity abscesses may not be beneficial. Obtaining blood cultures is not associated with an increased number of I&D procedures or readmission rates. Furthermore, obtaining blood cultures, regardless of positivity, is associated with increased lengths of hospital stay.
The Center-Center Image Closely Approximates Other Methods for Syndesmosis Reduction Clamp Placement
Authors: Jackson Nicholas J. , Flores Koen , Blake Andrew , Harley Joel B. , Reb Christopher W. , Nichols Jennifer A. 
Published: December 2023

Background The optimal placement for a syndesmosis reduction clamp remains an open question. This study compared the center-center axis, which localizes clamp placement using only an internally rotated lateral ankle X-ray, with other common approaches, whose accuracy can only be confirmed using computed tomography (CT). Methods Bone models of anatomically aligned (n = 6) and malreduced (n = 48) limbs were generated from CT scans of cadaveric specimens. Four axes for guiding clamp placement (center-center, centroid, B2, and trans-syndesmotic) were then analyzed, using digitally reconstructed radiographs derived from the bone models. Each axis’ location was defined using angle-height pairs that describe axis orientation along the full anatomical region where syndesmosis fixation occurs. Results In anatomically aligned limbs, the center-center axis was located on average (±95% CI [confidence interval]), 0.64° (±0.50°) internal rotation, 1.03° (±0.73°) internal rotation, and 2.09° (±7.29°) external rotation from the centroid, B2, and trans-syndesmotic axes, respectively. Fibular displacement altered the magnitude of limb rotation needed to identify the center-center axis. Conclusion The center-center technique is a valid method that closely approximates previously described methods for syndesmosis clamp placement without using CT, and the magnitude of C-arm rotation needed to transition from a talar dome lateral to a center-center view may be a potential method for assessing syndesmosis reduction. Levels of Evidence: Level III: Retrospective comparative study