bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of specialist care referrals (SCR) following emergency department review or hospital admission in adults with previous acute COVID-19: a prospective UK cohort study
Authors: Saigal Anita , Xiao Songyuan , Siddique Owais , Naran Prasheena , Bintalib Heba M , Niklewicz Camila Nagoda , Seligmann George , Naidu Sindhu Bhaarrati , Shah Amar J , Ogbonnaya Chibueze , Hurst John R , Lipman Marc Ci , Mandal Swapna 
Published: January 2025

Abstract

Background
Long-COVID research to date focuses on outcomes in non-hospitalised vs. hospitalised survivors. However Emergency Department attendees (post-ED) presenting with acute COVID-19 may experience less supported recovery compared to people admitted and discharged from hospital (post-hospitalised group, PH).

Objective
We evaluated outcomes and predictors of specialty care referrals (SCR) in those with ongoing symptomatic Long-COVID, comparing post-ED and PH adults.

Methods
This prospective observational cohort study evaluates 800 PH and 484 post-ED adults from a single hospital in London, United Kingdom. Participants had either confirmed laboratory-positive SARS-CoV-2 infection or clinically suspected acute COVID-19 and were offered post-COVID clinical follow-up at approximately six weeks after their ED attendance or inpatient discharge, to assess ongoing symptoms and support recovery. Multiple logistic regression determined associations with specialist care referrals (SCR) to respiratory, cardiology, physiotherapy (including chest physiotherapy), and mental health services.

Results
Presence of at least one Long-COVID symptom was lower in adults attending ED services with acute COVID-19 compared to those hospitalised (70.1% post-ED vs. 79.5% PH adults, p < 0.001). Total number of Long-COVID symptoms was associated with increased SCR in all patients (adjusted odds ratio (aOR) = 1.26, 95%CI:1.16, 1.36, p < 0.001), with post-ED adults more likely to need a SCR overall (aOR = 1.82, 95%CI:1.19, 2.79, p = 0.006). Post-ED adults had higher SCR to both physiotherapy (aOR = 2.59, 95%CI:1.35, 4.96, p = 0.004) and mental health services (aOR = 3.84, 95%CI:2.00, 7.37, p < 0.001), with pre-existing mental illness linked to the latter (aOR = 4.08, 95%CI:1.07, 15.6, p = 0.04).

Conclusions
We demonstrate greater specialist care referrals to mental health and physiotherapy services in patients attending the ED and discharged with acute COVID-19, compared to those admitted, despite lower ongoing COVID-19 symptom burden. Total number of symptoms, pre-existing co-morbidity such as smoking status, cardiac co-morbidities, and mental health illnesses may predict those requiring healthcare input. This information may enable better post-COVID support for ED attendees, a distinct group who should not be neglected when preparing for future pandemics.

Trial registration
This study had HRA approval (20/HRA/4928).
Intraocular inflammation after intravitreal injection of aflibercept 8 mg for treatment-refractory neovascular age-related macular degeneration: a case report
Authors: Hashiya Nozomu , Maruko Ichiro , Miyaguchi Yuri , Maruko Ruka , Hasegawa Taiji , Iida Tomohiro 
Published: January 2025

Abstract

Background
To report a case of intraocular inflammation (IOI) after intravitreal injection of aflibercept 8 mg for treatment-refractory neovascular age-related macular degeneration.

Case presentation
An 80-year-old man with diabetes mellitus had neovascular age-related macular degeneration refractory to treatment with aflibercept 2 mg. Despite ten injections of faricimab, the exudation remained, and we switched to brolucizumab, which resulted in a mild IOI. The IOI improved with only topical steroids, and we switched back to aflibercept 2 mg for the exudation. However, the exudation remained, and we decided to switch to aflibercept 8 mg after careful discussion with the patient. Two weeks later, he experienced minor ocular pain and photophobia. One month later, although a dry macula was achieved, severe visual impairment occurred due to anterior chamber inflammation, retinal vasculitis, and retinal vascular occlusion. We diagnosed the severe IOI following aflibercept 8 mg and immediately started steroid eye drops and a sub-Tenon injection of triamcinolone acetonide. Although the inflammation resolved, his visual acuity did not improve.

Conclusions
This case demonstrated a potential dose-dependent inflammatory response following aflibercept 8 mg, which did not occur with aflibercept 2 mg in patients with a history of intraocular inflammation.
A web-based pilot randomized controlled trial to test the efficacy of education and contact-based interventions in reducing public suicide stigma
Authors: Oexle Nathalie , Lühr Matthias , Valacchi Daniele , Rüsch Nicolas 
Published: January 2025

Abstract

Background
Interventions to reduce public suicide stigma (i.e. negative attitudes towards persons affected by suicide/suicidality) could contribute to suicide prevention. However, such interventions could unintentionally increase suicide normalization (i.e. liberal attitudes towards suicide) and therefore increase suicide risk. We aimed to test the efficacy of education- and contact-based interventions delivered online via video or text on both public suicide stigma and suicide normalization.

Methods
We conducted a web-based randomized controlled trial among N = 2,043 participants recruited from an established online research panel. Participants were randomized into six groups, receiving either one of four contact- or education-based interventions that were transferred via text or video (contact text, contact video, education text, education video) or control group content (contact control, education control). Information about suicide stigma and suicide normalization were collected directly before (t0) and after intervention participation (t1) as well as about two weeks later (t2). To explore the attractiveness of the provided intervention material, we used Brown-Mood’s median test to compare the times participants spent with the provided intervention material in each group. We then used linear mixed models to compare effects on suicide stigma and suicide normalization between intervention groups and control groups.

Results
Median times spent with provided material were generally longer among participants exposed to video material than among participants exposed to text material, and among participants in contact-based interventions than among participants in education-based interventions. We did not observe stronger effects in intervention groups compared to control groups on suicide stigma or suicide normalization. Surprisingly, suicide stigma and suicide normalization appeared to decrease from t0 to t1 in both intervention and control groups.

Conclusion
Our findings suggest a higher attractiveness of video- and contact-based material compared to text- and education-based material. However, none of the interventions had a significant effect on public suicide stigma or suicide normalization. Future research should explore innovative and safe approaches to reduce public suicide stigma. Experimental studies may focus on interventions with higher attractiveness (i.e. video and contact-based interventions), use interventions with higher intensity (i.e. longer interventions, more repetitions), and assess suicide stigma with implicit measures to avoid response bias.

Trial registration
The RCT was registered at clinicaltrials.gov on February 11th, 2021 (NCT04756219).
“We’re all in the same storm, but not all of us are in the same boat”: qualitative exploration of UK response-focused civil servants experiences of working from home during COVID-19
Authors: Hall Charlotte E. , Brooks Samantha K. , Greenberg Neil , Weston Dale 
Published: January 2025

Abstract

Introduction
The experiences of UK Government response-focused employees, who were considered frontline workers during the coronavirus response, are missing from current literature. Meeting the demands of being on the frontline, whilst also adjusting from a normal and practiced way of working to having to work from within one’s home, may bring a plethora of new barriers and facilitators associated with providing an effective pandemic response.

Method
This interview study collected and analysed data from 30 UK Civil servants who worked on the COVID-19 pandemic response from their own homes. Interviews aimed to: (1) explore UK Government employee’s experiences of working from home whilst contributing to the pandemic response; and, (2) establish what support and guidance employees were offered, and what they would recommend for future public health emergencies requiring homeworking.

Results
Seven themes were extracted from the data: overall experience of working from home; preparedness for working from home; experience of contributing to the response effort; work life balance; relationships with colleagues; space and equipment; and, inclusivity. Findings suggested that during the pandemic, participants reported feeling a strong sense of purpose and achievement for contributing to the response. But, the work was demanding, particularly for those who had to rapidly, and unexpectedly, transition from office or lab work to home working. More generally, the nature of their homeworking experience depended on a range of practical (e.g., space in the home), organisational (e.g., relationships with managers) and personal factors (e.g., caring responsibilities). Many participants were underprepared to work from home, but participants provided a plethora of information relating to what support offers they would find useful during future work on the frontline from their own homes.

Conclusion
The results of this study demonstrate that frontline UK Civil servants may need more tailored and flexible multilevel support (i.e., from peers, managers, organisations) during future public health emergencies when they are required to work from home. A series of data-informed recommendations are created and discussed.
Temporal and spatial pattern of DNA damage in neurons following spinal cord Injury in mice
Authors: Scheijen Elle EM , Veeningen Naomi , Duwé Sam , Ivanova Anna , Van Broeckhoven Jana , Hendrix Sven , Wilson David M 
Published: January 2025

Abstract

Background
Deficient DNA repair and excessive DNA damage contribute to neurodegenerative disease. However, the role of DNA damage and repair in spinal cord injury (SCI) is unclear. SCI, a debilitating disruption of the structural and biological network of the spinal cord, is characterized by oxidative stress. Nevertheless, the pathophysiological mechanisms leading to neuronal loss following SCI remain incompletely defined. Methods: Using a contusion model, a severe SCI was induced at the L1 spinal level in C57Bl/6J mice. The temporal and spatial presence of DNA damage was then determined via immunolabeling for the DNA damage marker, γH2AX, from 1 h post-injury (hpi) to 28 days post-injury (dpi). Results: Our analysis revealed that increased DNA damage foci were present from 1 hpi to 3 dpi in SCI mice relative to controls (sham surgery and naive), with the damage signal spreading over time longitudinally from the affected area to more rostral and caudal regions. Co-labeling of γH2AX with NeuN revealed neuronal specificity of DNA damage, with increased early cell death (pan-nuclear γH2AX) peaking at 1 dpi and apoptosis (cleaved Caspase-3) arising later at 3 dpi. Conclusion: Our study indicates a possible role of DNA damage in neuronal loss following SCI and highlights the need for early interventions targeting DNA repair to preserve neuronal tissue.
Demographic disparities in access to COVID-19 clinical trial sites across the United States: a geospatial analysis
Authors: Cuomo Raphael , McMann Tiana , Xu Qing , Li Zhuoran , Yang Joshua , Hsieh Julie , Lee Christine , Lolic Milena , Araojo Richardae , Mackey Tim 
Published: January 2025

Abstract
Throughout the COVID-19 pandemic, underserved populations, such as racial and ethnic minority communities, were disproportionately impacted by illness and death. Ensuring people from diverse backgrounds have the ability to participate in clinical trials is key to advancing health equity. We sought to analyze the spatial variability in locations of COVID-19 trials sites and to test associations with demographic correlates. All available and searchable COVID-19 studies listed on ClinicalTrials.gov until 04/04/2022 and conducted in the United States were extracted at the trial-level, and locations were geocoded using the Microsoft Bing API. Publicly available demographic data were available at the county level for national analysis and the census tract level for local analysis. Independent variables included eight racial and ethnic covariates, both sexes, and twelve age categories, all of which were population-normalized. The county-level, population-normalized count of study site locations, by type, was used as the outcome for national analysis, thereby enabling the determination of demographic associations with geospatial availability to enroll as a participant in a COVID-19 study. Z-scores of the Getis-Ord Gi statistic were used as the outcome for local analysis in order to account for areas close to those with clinical study sites. For both national (p < 0.001) and local analysis (p = 0.006 for Los Angeles, p = 0.030 for New York), areas with greater proportions of men had significantly fewer studies. Sites were more likely to be found in counties with higher proportions of Asian (p < 0.001) and American Indian or Alaska Native residents (p < 0.001). Areas with greater concentrations of Black or African American residents had significantly lower concentrations of observational (p < 0.001) and government-sponsored COVID-19 studies (p = 0.003) in national analysis and significantly fewer concentrations of study sites in both Los Angeles (p < 0.001) and New York (p = 0.007). Though there appear to be a large number of COVID-19 studies that commenced in the US, they are distributed unevenly, both nationally and locally.
Developing a comprehensive inventory to define harm reduction housing
Authors: Zaragoza Sofia , Silcox Joseph , Rapisarda Sabrina , Summers Charlie , Case Patricia , To Clara , Chatterjee Avik , Walley Alexander Y. , Komaromy Miriam , Green Traci C 
Published: January 2025

Abstract

Background
The City of Boston has faced unprecedented challenges with substance use amidst changes to the illicit drug supply and increased visibility of homelessness. Among its responses, Boston developed six low threshold harm reduction housing (HRH) sites geared towards supporting the housing needs of people who use drugs (PWUD) and addressing health and safety concerns around geographically concentrated tent encampments. HRH sites are transitional supportive housing that adhere to a “housing first” approach where abstinence is not required and harm reduction services and supports are co-located. Despite the importance of HRH, the specific characteristics and operations of these sites are not well understood. This study sought to address this gap by cataloging the common features of Boston’s HRH sites to generate a comprehensive inventory tool for evaluating implementation of harm reduction strategies at transitional housing locations.

Methods
We collected data between June and September 2023 and included semi-structured qualitative interviews with HRH staff (n = 19), ethnographic observations and photos at six HRH sites. Candidate inventory components were derived through triangulation of the data. Two expert medical staff unaffiliated with data collection reviewed a draft inventory measuring awareness and utility of HRH inventory components. We then pilot tested the inventory with three HRH residents across two sites for readability and reliability. Awareness, frequency of use, and perceived helpfulness of key inventory items were further tested in a survey to 106 residents.

Results
HRH staff identified best practices, resources, and policies in HRH sites that were further contextualized with ethnographic field notes. Common to all were overdose prevention protocols, behavioral policies, security measures, and distribution of harm reduction supplies. The initial 44-item inventory of services, policies and site best practices was further refined with expert and participant feedback and application, then finalized to generate a 32-item inventory. Residents identified and valued harm reduction services; medical supports were highly valued but less utilized.

Conclusion
The HRH inventory comprehensively assesses harm reduction provision and residents’ awareness and perceived helpfulness of HRH operational components in staying safe from drug-related harms. Characterizing the critical components of HRH through this tool will aid in standardizing the concept and practice of HRH for PWUD and may assist other cities in planning and implementing HRH.
Emerging targets of α-synuclein spreading in α-synucleinopathies: a review of mechanistic pathways and interventions
Authors: Kuo Grace , Kumbhar Ramhari , Blair William , Dawson Valina L. , Dawson Ted M. , Mao Xiaobo 
Published: January 2025

Abstract
α-Synucleinopathies constitute a spectrum of neurodegenerative disorders, including Parkinson’s disease (PD), Lewy body dementia (LBD), Multiple System Atrophy (MSA), and Alzheimer’s disease concurrent with LBD (AD-LBD). These disorders are unified by a pathological hallmark: aberrant misfolding and accumulation of α-synuclein (α-syn). This review delves into the pivotal role of α-syn, the key agent in α-synucleinopathy pathophysiology, and provides a survey of potential therapeutics that target cell-to-cell spread of pathologic α-syn. Recognizing the intricate complexity and multifactorial etiology of α-synucleinopathy, the review illuminates the potential of various membrane receptors, proteins, intercellular spreading pathways, and pathological agents for therapeutic interventions. While significant progress has been made in understanding α-synucleinopathy, the pursuit of efficacious treatments remains challenging. Several strategies involving decreasing α-syn production and aggregation, increasing α-syn degradation, lowering extracellular α-syn, and inhibiting cellular uptake of α-syn are presented. The paper underscores the necessity of meticulous and comprehensive investigations to advance our knowledge of α-synucleinopathy pathology and ultimately develop innovative therapeutic strategies for α-synucleinopathies.

Graphical Abstract
Neutrophil-to-lymphocyte ratio as a predictor of short- and long-term complications in pediatric burns
Authors: Delgado-Miguel Carlos , Fuentes Gómez Lara , García Morán Ada , Miguel-Ferrero Miriam , Díaz Mercedes , López-Gutiérrez Juan Carlos 
Published: January 2025

Abstract

Background
Neutrophil-to-Lymphocyte Ratio (NLR) has been postulated as a useful inflammatory biomarker in the prediction of complications in different pediatric diseases. Our aim is to analyze the predictive value of NLR in the development of complications in burned children, both in the short-term (need for grafting) and in the long-term (need for surgery of the sequelae).

Methods
A retrospective study was performed on burned patients under 18-years admitted to our Burn Unit between 2015 and 2021. Demographic, clinical and laboratory data at admission were evaluated. Predictive factors for the development of complications after burns (time of evolution, burned total body surface area, and acute phase reactants) were analyzed using sensitivity and specificity analysis (ROC curves).

Results
A total of 342 patients (198 males, 144 females) were included, with a median age of 27 months (interquartile range 15–83 months). In 97.4% of the cases, burns were primarily caused by thermal injuries (78.4% scald burns). Acute escharectomy and grafting were performed in 85 patients (24.9%), while long-term sequelae were observed in 112 cases (32.7%). NLR was the most sensitive and specific predictor for the need for escharectomy and grafting (Sensitivity 90%, Specificity 88.4%; AUC 0.920), for the development of long-term sequelae (Sensitivity 80.4%, Specificity 83.5%; AUC 0.849) and for the need for surgery of the sequelae (Sensitivity 83.5%, Specificity 80.9%; AUC 0.833).

Conclusion
NLR may be considered a useful predictor for the development of short- and long-term complications in childhood burns. It may help in the identification of high-risk patients to prevent sequelae.
Clinical manifestations in Egyptian Pompe disease patients: Molecular variability and enzyme replacement therapy (ERT) outcomes
Authors: Hussein Mohamed Abdelghafar , ElTaher Heba , Mahmoud Ranim , Sobh Donia , Al-Haggar Mohammad 
Published: January 2025

Abstract

Background
Pompe disease is a rare genetic disorder caused by a deficiency of the enzyme acid alpha-glucosidase. This condition leads to muscle weakness, respiratory problems, and heart abnormalities in affected individuals.

Methods
The aim of the study is to share our experience through cross sectional study of patients with infantile-onset Pompe disease (IOPD) with different genetic variations, resulting in diverse clinical presentations. We evaluated their phenotype, genotype, radiological and laboratory findings including their cross-reactive immunologic material (CRIM) status. Infantile Pompe disease was diagnosed by measurement of the activity of the enzyme alpha-glucosidase. The diagnosis was confirmed by molecular genetic testing using PCR amplification and sequencing of the acid alpha-glucosidase (GAA) gene. Routine two-D echocardiography, and multi-parametric ECG-gated cardiac magnetic resonance imaging (CMR) were done to patients six months after starting enzyme replacement therapy (ERT).

Results
The results of our study revealed different genetic mutations among our patients, different CRIM status and also CMR abnormalities. CMR imaging revealed abnormalities in all cases that underwent the procedure, including myocardial and vascular changes, with feature tracking indicating issues across all parameters and LGE suggesting fibrosis. The patient with a positive immune response had the most severe cardiac abnormalities, despite improvements in muscle weakness and motor skills from ERT. This underscores that delayed diagnosis and ERT can lead to irreversible heart damage from autophagy buildup.

Conclusion
Pompe disease has various clinical presentations and results in significant CMR findings, which can be attributed to different genetic mutations. Early initiation of enzyme replacement therapy in infantile-onset Pompe disease is important to maximize its benefits.