bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interaction of Systemic Morbidity and Oral Health in Ambulatory Patients in Need of Home Care (InSEMaP): an observational study at the sector boundary between dental and general practice care in Germany
Authors: Zimmermann Thomas , Koenig Alena , Porzelt Sarah , Schmage Petra , Konnopka Claudia , Schellhammer Stefanie , Behrens-Potratz Anja , Ijeoma Okoro Edelqueen , Henken Espen , Stratmeyer Peter , Beikler Thomas , König Hans-Helmut , Scherer Martin , Konnopka Alexander 
Published: March 2023

IntroductionOlder people in need of home care are at risk of declining oral health as their visits to dentists are becoming less frequent due to restricted mobility. There is increasing evidence that poor oral health and systemic diseases are closely associated, for example, in cardiological, metabolic or neurodegenerative conditions. Thus, Interaction of Systemic Morbidity and Oral Health in Ambulatory Patients in Need of Home Care (InSEMaP) is investigating the need, provision and utilisation of oral healthcare, systemic morbidity and clinical status of the oral cavity in older people.Methods and analysisInSEMaP consists of four subprojects (SP), all involving the target population of older people in need of home care. In SP1 part a, a sample is surveyed using a self-report questionnaire. In SP1 part b, stakeholders (general practitioners, dentists, medical assistants, family and professional caregivers) are interviewed regarding barriers and facilitators using focus groups and personal interviews. In SP2, a retrospective cohort study, health insurance claims data are examined to investigate the utilisation of oral healthcare, its association with systemic morbidity and healthcare costs. In SP3, a clinical observational study will assess the oral health of participants by a dentist’s visit at home. SP4 synthesises the results of SP1, SP2 and SP3 to develop integrated clinical pathways, identifying strategies to uphold oral healthcare in older people. In assessing and evaluating the process of oral healthcare, and its associated systemic morbidity, InSEMaP aims to improve general healthcare across the sector boundary of dental and general practitioner care.Ethics and disseminationEthics approval was obtained from the Institutional Review Board of the Hamburg Medical Chamber (approval number: 2021-100715-BO-ff). The results of this study will be disseminated through conference presentations and publications in peer-reviewed journals. An expert advisory board to support the InSEMaP study group will be established.Trial registration numberGerman Clinical Trials Register: DRKS00027020.
Performance of digital early warning score (NEWS2) in a cardiac specialist setting: retrospective cohort study
Authors: Alhmoud Baneen , Bonnici Tim , Melley Daniel , Patel Riyaz , Banerjee Amitava 
Published: March 2023

IntroductionPatients with cardiovascular diseases (CVD) are at significant risk of developing critical events. Early warning scores (EWS) are recommended for early recognition of deteriorating patients, yet their performance has been poorly studied in cardiac care settings. Standardisation and integrated National Early Warning Score 2 (NEWS2) in electronic health records (EHRs) are recommended yet have not been evaluated in specialist settings.ObjectiveTo investigate the performance of digital NEWS2 in predicting critical events: death, intensive care unit (ICU) admission, cardiac arrest and medical emergencies.MethodsRetrospective cohort analysis.Study cohortIndividuals admitted with CVD diagnoses in 2020; including patients with COVID-19 due to conducting the study during the COVID-19 pandemic.MeasuresWe tested the ability of NEWS2 in predicting the three critical outcomes from admission and within 24 hours before the event. NEWS2 was supplemented with age and cardiac rhythm and investigated. We used logistic regression analysis with the area under the receiver operating characteristic curve (AUC) to measure discrimination.ResultsIn 6143 patients admitted under cardiac specialties, NEWS2 showed moderate to low predictive accuracy of traditionally examined outcomes: death, ICU admission, cardiac arrest and medical emergency (AUC: 0.63, 0.56, 0.70 and 0.63, respectively). Supplemented NEWS2 with age showed no improvement while age and cardiac rhythm improved discrimination (AUC: 0.75, 0.84, 0.95 and 0.94, respectively). Improved performance was found of NEWS2 with age for COVID-19 cases (AUC: 0.96, 0.70, 0.87 and 0.88, respectively).ConclusionThe performance of NEWS2 in patients with CVD is suboptimal, and fair for patients with CVD with COVID-19 to predict deterioration. Adjustment with variables that strongly correlate with critical cardiovascular outcomes, that is, cardiac rhythm, can improve the model. There is a need to define critical endpoints, engagement with clinical experts in development and further validation and implementation studies of EHR-integrated EWS in cardiac specialist settings.
Feasibility and effectiveness of disinfection of gloves during routine care: a scoping review protocol
Authors: Li Ke , Han Shuyu , Yang Zhennan , Zhang Mengjie , Zhang Jianxia 
Published: March 2023

IntroductionDisinfecting gloves during patient care has potential benefits and risks. In recent years, disinfection of disposable medical gloves for prolonged use has occurred in clinical practice. However, there is limited high-level evidence to know if this practice can prevent nosocomial infections, reduce microbial levels on the glove surface. This concept was researched using a scoping review to explore the feasibility and effectiveness of disinfecting disposable gloves for prolonged use.Methods and analysisThe review will be conducted in accordance with the Arksey and O'Malley scoping review methodology framework. From the date of database construction to 10 February 2023, the following 16 electronic databases in English and Chinese will be searched: PubMed, Embase, CINAHL, Web of Science, Cochrane Library, ProQuest, China National Knowledge Infrastructure, Wanfang, SinoMed Database, Google Scholar, Centers for Disease Control and Prevention (CDC), European Centre for Disease Prevention and Control, WHO, China CDC, International Nosocomial Infection Control Consortium and European Medicines Agency Science Medicines Health. The screening and data extraction of the study will be carried out by two reviewers (KL and SH). Differences between the two reviewers will be handled through negotiation. If there are still differences, they will be discussed with a third reviewer. Any study, for example, intervention study or observational study, that provide insights about the disinfection of disposable medical gloves for prolonged use will be included. Data charts will be used to extract relevant data from the included studies. Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, to define the scope of evaluation. A narrative summary will be completed to synthesise key research findings and background information on the disinfection of gloved hands.Ethics and disseminationEthical approval will not be required because only publicly available data will be analysed. The findings from the scoping review will be published in a peer-reviewed journal and presented at scientific meetings. By highlighting the feasibility and effectiveness of the disinfection of gloved hands in the literature, this review will provide direction for future research and clinical guidelines.Trial registration numberThis scoping review protocol has been registered in the Open Science Framework (registration number: 10.17605/OSF.IO/M4U8N).
Global HIV prevention, care and treatment services for children: a cross-sectional survey from the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium
Authors: Vreeman Rachel C , Yiannoutsos Constantin T , Yusoff Nik Khairulddin Nik , Wester C William , Edmonds Andrew , Ofner Susan , Davies Mary-Ann , Leroy Valériane , Lumbiganon Pagakrong , de Menezes Succi Regina Célia , Twizere Christella , Brown Steven , Bolton-Moore Carolyn , Takassi Ounoo Elom , Scanlon Michael , Martin Roxanne , Wools-Kaloustian Kara 
Published: March 2023

ObjectivesTo assess access children with HIV have to comprehensive HIV care services, to longitudinally evaluate the implementation and scale-up of services, and to use site services and clinical cohort data to explore whether access to these services influences retention in care.MethodsA cross-sectional standardised survey was completed in 2014–2015 by sites providing paediatric HIV care across regions of the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We developed a comprehensiveness score based on the WHO’s nine categories of essential services to categorise sites as ‘low’ (0–5), ‘medium’, (6–7) or ‘high’ (8–9). When available, comprehensiveness scores were compared with scores from a 2009 survey. We used patient-level data with site services to investigate the relationship between the comprehensiveness of services and retention.ResultsSurvey data from 174 IeDEA sites in 32 countries were analysed. Of the WHO essential services, sites were most likely to offer antiretroviral therapy (ART) provision and counselling (n=173; 99%), co-trimoxazole prophylaxis (168; 97%), prevention of perinatal transmission services (167; 96%), outreach for patient engagement and follow-up (166; 95%), CD4 cell count testing (126; 88%), tuberculosis screening (151; 87%) and select immunisation services (126; 72%). Sites were less likely to offer nutrition/food support (97; 56%), viral load testing (99; 69%) and HIV counselling and testing (69; 40%). 10% of sites rated ‘low’, 59% ‘medium’ and 31% ‘high’ in the comprehensiveness score. The mean comprehensiveness of services score increased significantly from 5.6 in 2009 to 7.3 in 2014 (p<0.001; n=30). Patient-level analysis of lost to follow-up after ART initiation estimated the hazard was highest in sites rated ‘low’ and lowest in sites rated ‘high’.ConclusionThis global assessment suggests the potential care impact of scaling-up and sustaining comprehensive paediatric HIV services. Meeting recommendations for comprehensive HIV services should remain a global priority.
Neoadjuvant Arterial Embolization Chemotherapy Combined PD-1 Inhibitor for Locally Advanced Rectal Cancer (NECI Study): a protocol for a phase II study
Authors: Fan Yiqun , Zhu Xiaoling , Xu Chengcai , Ding Caiyou , Hu Jibo , Hong Qiang , Wang Jianwei 
Published: March 2023

IntroductionThe NICHE trial showed remarkable results of neoadjuvant immunotherapy in colorectal cancer patients with mismatch repair (MMR) deficiency (dMMR). However, rectal cancer patients with dMMR accounted for only 10% of case. The therapeutic effect is unsatisfactory in MMR-proficient patients. Oxaliplatin has been demonstrated to induce immunogenic cell death (ICD), which may improve the therapeutic effect of programmed cell death 1 blockade; however, a maximum tolerated dose is required to induce ICD. Arterial embolisation chemotherapy provides drugs locally and can easily reach the maximum tolerated dose, which could be a significant method for delivering chemotherapeutic agents. Therefore, we designed a multicenter, prospective, single-arm, phase II study.Methods and analysisFirst, recruited patients will receive neoadjuvant arterial embolisation chemotherapy (NAEC) with oxaliplatin 85 mg/m2and 3 mg/m2. After 2 days, three cycles of immunotherapy with intravenous tislelizumab (200 mg/body, day 1) will be initiated at an interval of 3 weeks. From the second cycle of immunotherapy, the XELOX regimen will be added. 3 weeks after neoadjuvant therapy finished, the operation will be initiated. Neoadjuvant Arterial Embolization Chemotherapy Combined PD-1 Inhibitor for Locally Advanced Rectal Cancer (NECI) Study combined arterial embolisation chemotherapy, immunotherapy and systemic chemotherapy. Based on this combination therapy, the maximum tolerated dose could easily be reached, and ICD could be induced by oxaliplatin easily. To our knowledge, the NECI Study is the first multicenter, prospective, single-arm, phase II clinical trial to assess the efficacy and safety of NAEC combined with tislelizumab and systemic chemotherapy in locally advanced rectal cancer. This study is expected to provide a new neoadjuvant therapeutic regimen for locally advanced rectal cancer.Ethics and disseminationThe Human Research Ethics Committee of the Fourth Affiliated Hospital of Zhejiang University School of Medicine approved this study protocol. The results will be published in peer-reviewed journals and presented at appropriate conferences.Trial registration numberNCT05420584.
Basal ganglia lesions may be a risk factor for characteristic features of a glaucomatous optic disc: population-based cohort study in Japan
Authors: Fukuoka Hideki , Nishita Yukiko , Tange Chikako , Otsuka Rei , Ando Fujiko , Shimokata Hiroshi 
Published: March 2023

BackgroundWe conducted a study to investigate the relationship between optic nerve vertical cup-to-disc ratio (VCDR), body and ocular parameters, and brain lesions in middle-aged and above Japanese subjects, because although various risk factors for glaucoma have been previously characterised, it is theorised that there are unidentified neurological components.MethodsIn this population-based, age/gender-stratified, cross-sectional study that involved 2239 Japanese subjects (1127 men and 1112 women) aged 40 years and older (mean age: 59.3±11.7 years) living in the central geographical region of Japan who participated in the National Institute of Longevity Sciences–Longitudinal Study of Aging between 2002 and 2004, 4327 eyes and 2239 obtained MRIs of the head were evaluated. Multivariate mixed model and trend analyses were also performed.ResultsNo significant relationship between VCDR and brain lesions, other than basal ganglia lesions, was found. VCDR significantly increased with the high grade of basal ganglia infarct lesions (p=0.0193) and high intraocular pressure (p<0.0001) after adjustment for influential factors using a multivariate mixed model. A significant positive linear trend was observed between the predicted VCDR and the degrees of the basal ganglia lesions (p value trend=0.0096).ConclusionOur findings suggest that in subjects with higher grades of basal ganglia lesions, strict attention should be paid to elevated VCDR; however, further studies are needed to support/confirm our results.
Sex-specific trajectories of molecular cardiometabolic traits from childhood to young adulthood
Authors: O'Keeffe Linda M , Tilling Kate , Bell Joshua A , Walsh Patrick T , Lee Matthew A , Lawlor Deborah A , Davey Smith George , Kearney Patricia M 
Published: March 2023

BackgroundThe changes which typically occur in molecular causal risk factors and predictive biomarkers for cardiometabolic diseases across early life are not well characterised.MethodsWe quantified sex-specific trajectories of 148 metabolic trait concentrations including various lipoprotein subclasses from age 7 years to 25 years. Data were from 7065 to 7626 offspring (11 702 to14 797 repeated measures) of the Avon Longitudinal Study of Parents and Children birth cohort study. Outcomes were quantified using nuclear magnetic resonance spectroscopy at 7, 15, 18 and 25 years. Sex-specific trajectories of each trait were modelled using linear spline multilevel models.ResultsFemales had higher very-low-density lipoprotein (VLDL) particle concentrations at 7 years. VLDL particle concentrations decreased from 7 years to 25 years with larger decreases in females, leading to lower VLDL particle concentrations at 25 years in females. For example, females had a 0.25 SD (95% CI 0.20 to 0.31) higher small VLDL particle concentration at 7 years; mean levels decreased by 0.06 SDs (95% CI −0.01 to 0.13) in males and 0.85 SDs (95% CI 0.79 to 0.90) in females from 7 years to 25 years, leading to 0.42 SDs (95% CI 0.35 to 0.48) lower small VLDL particle concentrations in females at 25 years. Females had lower high-density lipoprotein (HDL) particle concentrations at 7 years. HDL particle concentrations increased from 7 years to 25 years with larger increases among females leading to higher HDL particle concentrations in females at 25 years.ConclusionChildhood and adolescence are important periods for the emergence of sex differences in atherogenic lipids and predictive biomarkers for cardiometabolic disease, mostly to the detriment of males.
Prevention of in-stent restenosis with drug-eluting balloons in patients with postirradiated carotid stenosis accepting percutaneous angioplasty and stenting
Authors: Wu Chia-Hung , Lin Te-Ming , Chung Chih-Ping , Yu Kai-Wei , Tai Wei-An , Luo Chao-Bao , Lirng Jiing-Feng , Chang Feng-Chi 
Published: March 2023

ObjectiveTo investigate the technical safety and outcome of in-stent restenosis (ISR) prevention with drug-eluting balloon (DEB) in patients with postirradiated carotid stenosis (PIRCS) undergoing percutaneous angioplasty and stenting (PTAS).MethodsBetween 2017 and 2021, we prospectively recruited patients with severe PIRCS for PTAS. They were randomly separated into two groups based on endovascular techniques performed with and without DEB. Preprocedural and early postprocedural (within 24 hours) MRI, short-term ultrasonography (6 months after PTAS), and long-term CT angiography (CTA)/MR angiography (MRA), 12 months after PTAS, were performed. Technical safety was evaluated based on periprocedural neurological complications and the number of recent embolic ischemic lesions (REIL) in the treated brain territory on diffusion-weighted imaging of early postprocedural MRI.ResultsSixty-six (30 with and 36 without DEB) subjects were enrolled, with one failure in techniques. For 65 patients in the DEB versus conventional groups, technical neurological symptoms within 1 month (1/29 (3.4%) vs 0/36; P=0.197) and REIL numbers within 24 hours (1.0±2.1 vs 1.3±1.5; P=0.592) after PTAS showed no differences. Peak systolic velocity (PSVs) on short-term ultrasonography was significantly higher in the conventional group (104.13±42.76 vs .81.95±31.35; P=0.023). The degree of in-stent stenosis (45.93±20.86 vs 26.58±8.75; P<0.001) was higher, and there were more subjects (n=8, 38.9% vs 1, 3.4%; P=0.029) with significant ISR (≥ 50%) in the conventional group than in the DEB group on long-term CTA/MRA.ConclusionsWe observed similar technical safety of carotid PTAS with and without DEBs. The number of cases of significant ISR were fewer and the degree of stenosis of ISR was less in primary DEB-PTAS of PIRCS than for conventional PTAS in the 12-month follow-up.
Good construct validity of the CT Syndesmophyte Score (CTSS) in patients with radiographic axial spondyloarthritis
Authors: Stal Rosalinde , Ramiro Sofia , Baraliakos Xenofon , Braun Juergen , Reijnierse Monique , van den Berg Rosaline , van der Heijde Désirée , van Gaalen Floris A 
Published: March 2023

ObjectivesTo assess construct validity of the CT Syndesmophyte Score (CTSS) for the measurement of structural spinal damage in patients with radiographic axial spondyloarthritis.MethodsLow-dose CT and conventional radiography (CR) were performed at baseline and 2 years. CT was assessed with CTSS by two readers and CR with modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) by three readers. Two hypotheses were tested: (1) syndesmophytes scored with CTSS are also detected with mSASSS at baseline or 2 years later; (2) CTSS is non-inferior to mSASSS in correlations with spinal mobility measures. Presence of a syndesmophyte was determined per reader per corner for all anterior cervical and lumbar corners on CT at baseline and CR at baseline and 2 years. Correlations of CTSS and mSASSS with six spinal/hip mobility measurements plus Bath Ankylosing Spondylitis Metrology Index (BASMI) were tested.ResultsData from 48 patients (85% male, 85% HLA-B27+, mean age 48 years) were available for hypothesis 1 and 41/48 were available for hypothesis 2. At baseline, syndesmophytes were scored with CTSS in 348 (reader 1, 38%) and 327 (reader 2, 36%) corners out of 917. Of these, depending on reader pairs, 62%–79% were also seen on CR at baseline or after 2 years. CTSS correlated well (rs0.46–0.73), and with higher correlation coefficients than mSASSS (rs0.34–0.64), with all spinal mobility measures and BASMI.ConclusionsThe good agreement between syndesmophytes detected by CTSS and mSASSS and the strong correlation of CTSS with spinal mobility support the construct validity of the CTSS.
The evolution of sanguivory in vampire bats: origins and convergences
Authors: Riskin Daniel K. , Carter Gerald G. 
Published: March 2023

Blood-feeding (sanguivory) has evolved more than two dozen times among birds, fishes, insects, arachnids, molluscs, crustaceans, and annelids; however, among mammals, it is restricted to the vampire bats. Here, the authors revisit the question of how it evolved in that group. Evidence to date suggests that the ancestors of phyllostomids were insectivorous, and that carnivory, omnivory, and nectarivory evolved among phyllostomids after vampire bats diverged. Frugivory likely also evolved after vampire bats diverged, but the phylogeny is ambiguous on that point. However, vampire bats lack any genetic evidence of a frugivorous past, and the behavioural progression from frugivory to sanguivory is difficult to envision. Thus, the most parsimonious scenario is that sanguivory evolved in an insectivorous ancestor to vampire bats via ectoparasite-eating, wound-feeding, or some combination of the two—all feeding habits found among blood-feeding birds today. Comparing vampire bats with other sanguivores, the authors find several remarkable examples of convergence. Further, it was found that blood-feeding has been ca. 50 times more likely to evolve in a vertebrate lineage than in an invertebrate one. The authors hypothesize that this difference exists because vertebrates are more likely than invertebrates to have the biochemical necessities required to assimilate the components of vertebrate blood.
A Design Practice for Social Systems
Authors: Cook Daniel 
Published: March 2023

On grim winter days it is easy to feel that we live in a predatory digital ecology intentionally designed to foster negative emotions. We prime players with mechanisms that actively generate social comparison, fear of missing out, loneliness, anxiety, and polarization. Why? So our games can more easily extract their time and cash. What a sad state.
As a designer of social architectures lived in by millions, I doggedly ask myself the following questions. What is a brighter path forward? What adds to our player's lives? What can we do as smart, thoughtful, caring builders to create new digital worlds that help players thrive?
Because, no matter how gloomy or entrenched certain business practices might be, the future is yet to be written. We have an obligation to create design theory and practice that increases player happiness (both hedonic and eudaimonic) and health (both physical and mental). At the scale of individual players and across massive communities.
I see four opportunities to turn this challenge into a reality.