bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rational Choice as an Empirical and Normative Model of Political Behavior
Authors: Chong Dennis 
Published: September 2023

Abstract
Rational choice theory is both a normative and empirical model of behavior. The model predicts (or prescribes) how individuals will (or should) choose from alternative courses of action given their objectives and beliefs about the instrumental relationship between those alternatives and their goals. The economic version of the theory assumes perfect, unbounded, or substantive rationality, while bounded rationality assumes that peoples’ decision-making procedures and the quality of their decisions will vary by the demands of the problem and the abilities, goals, and motivations of the decision-maker. This chapter explores the economic and the psychological rationality of political choice by evaluating the attitudes and behavior of citizens against this normative and empirical model in various decision-making contexts. It assesses the degree to which people pursue their self-interest, whether and when individuals can make good decisions with limited information, the circumstances in which beliefs are updated and information is processed rationally, and the consistency and coherence of preferences across alternative framings of issues.
Targeted Treatment of Schizophrenia Symptoms as They Manifest, or Continuous Treatment to Reduce the Risk of Psychosis Recurrence
Authors: Davidson Michael , Carpenter William T 
Published: September 2023

Abstract
Current pharmacological treatment of schizophrenia employs drugs that interfere with dopamine neurotransmission, aiming to suppress acute exacerbation of psychosis and maintenance treatment to reduce the risk of psychosis recurrence. According to this treatment scheme, available psychotropic drugs intended to treat negative symptoms, cognitive impairment, or anxiety are administered as add-ons to treatment with antipsychotics. However, an alternative treatment scheme proposes a targeted or intermittent treatment approach, by which antipsychotic drugs are administered upon psychosis exacerbation and discontinued upon remission or stabilization, while negative symptoms, cognitive impairment, or anxiety are treated with specific psychotropics as monotherapy. Along these lines, antipsychotics are renewed only in the event of recurrence of psychotic symptoms. This 50-year-old debate between targeted and continuous treatment schemes arises from disagreements about interpreting scientific evidence and discordant views regarding benefit/risk assessment. Among the debate’s questions are: (1) what is the percentage of individuals who can maintain stability without antipsychotic maintenance treatment, and what is the percentage of those who exacerbate despite antipsychotic treatment? (2) how to interpret results of placebo-controlled 9- to 18-month-long maintenance trials in a life-long chronic disorder, and how to interpret results of the targeted trials, some of which are open label or not randomized; (3) how to weigh the decreased risk for psychotic recurrence vs the almost certainty of adverse effects on patient’s quality of life. Patients’ profiles, preferences, and circumstances of the care provision should be considered as the targeted vs continuous treatment options are considered.
Region-specific changes in brain activity and memory after continuous positive airway pressure therapy in obstructive sleep apnea: a pilot high-density electroencephalography study
Authors: D’Rozario Angela L , Kao Chien-Hui , Phillips Craig L , Mullins Anna E , Memarian Negar , Yee Brendon J , Duffy Shantel L , Cho Garry , Wong Keith K H , Kremerskothen Kyle , Chapman Julia , Haroutonian Carla , Bartlett Delwyn J , Naismith Sharon L , Grunstein Ron R 
Published: September 2023

Abstract

Study Objectives
Limited channel electroencephalography (EEG) investigations in obstructive sleep apnea (OSA) have revealed deficits in slow wave activity (SWA) and spindles during sleep and increased EEG slowing during resting wakefulness. High-density EEG (Hd-EEG) has also detected local parietal deficits in SWA (delta power) during NREM. It is unclear whether effective continuous positive airway pressure (CPAP) treatment reverses regional SWA deficits, and other regional sleep and wake EEG abnormalities, and whether any recovery relates to improved overnight memory consolidation.

Methods
A clinical sample of men with moderate-severe OSA underwent sleep and resting wake recordings with 256-channel Hd-EEG before and after 3 months of CPAP. Declarative and procedural memory tasks were administered pre- and post-sleep. Topographical spectral power maps and differences between baseline and treatment were compared using t-tests and statistical nonparametric mapping (SnPM).

Results
In 11 compliant CPAP users (5.2 ± 1.1 hours/night), total sleep time did not differ after CPAP but N1 and N2 sleep were lower and N3 was higher. Centro-parietal gamma power during N3 increased and fronto-central slow spindle activity during N2 decreased (SnPM &lt; 0.05). No other significant differences in EEG power were observed. When averaged specifically within the parietal region, N3 delta power increased after CPAP (p = 0.0029) and was correlated with the change in overnight procedural memory consolidation (rho = 0.79, p = 0.03). During resting wakefulness, there were trends for reduced delta and theta power.

Conclusions
Effective CPAP treatment of OSA may correct regional EEG abnormalities, and regional recovery of SWA may relate to procedural memory improvements in the short term.
Dizziness Directly Influences Postconcussion Symptoms and Is Predictive of Poorer Mental Health in UK Military Personnel: A Retrospective Analysis
Authors: Denby Emma , Dempster Tammy , White Toni , Brockman Katherine , Ellis Henrietta , Dharm-Datta Shreshth , Wilkinson David , Brunger Helen 
Published: September 2023

Objective:
To investigate the contribution of dizziness to postconcussion symptoms, depression, and anxiety symptoms.

Setting:
Mild traumatic brain injury (mTBI) service, Defence Medical Rehabilitation Centre, Stanford Hall.

Participants:
Two hundred eighty-three UK military personnel from the Royal Navy, Royal Airforce, Royal Marines, and British Army.

Design:
A retrospective analysis of data from the Ministry of Defence medical records database.

Main measures:
Sixteen-item Rivermead Post Concussion Symptoms Questionnaire, Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire-9, The Dizziness Handicap Inventory.

Results:
Injuries from sports or falls were the most common mechanism of mTBI, accounting for 23%, respectively. Chi-square analysis indicated that individuals with dizziness and postconcussion symptoms (PCS) had greater severity of PCS, depression, and anxiety than those with PCS alone. Mediation analysis showed dizziness directly and independently influenced the severity of PCS, despite the indirect effects of mediating depression and anxiety symptoms.

Conclusion:
Comorbid dizziness and PCS were predictive of poorer mental health compared with PCS alone. In addition, dizziness directly influenced the severity of PCS irrespective of the indirect effects of mental health symptoms. These observations suggest that treating dizziness with vestibular rehabilitation may improve PCS and mental health.
Clinical Features and Follow-up of Referred Children and Young People With Long COVID
Authors: Weakley Kathryn E. , Schikler Allegra , Green Julianne V. , Blatt Daniel B. , Barton Shanna M. , Statler Victoria A. , Feygin Yana , Marshall Gary S. 
Published: September 2023

Background:
Patient-level data on the clinical features and outcomes of children and young people referred for possible long coronavirus disease (COVID) can guide clinicians on what to expect in managing patients and advising families.

Methods:
A Post-Acute COVID Clinic for persons <21 years of age was established in October 2020. Intake was standardized and management was tailored to presenting symptoms. Data were abstracted from the charts of all patients evaluated through December 2021, and the study cohort consisted of patients who had a history of confirmed severe acute respiratory syndrome coronavirus 2 infection, had ≥1 symptom persisting for ≥12 weeks and had no pre-existing diagnosis that explained the symptoms. A structured follow-up interview was conducted in early 2022.

Results:
A total of 104 patients were referred, 81 of whom met inclusion criteria. The median age was 14 years (interquartile range, 13–16), and most were female, White/Caucasian and had commercial health insurance. Patients reported previously good health but over half reported moderate-to-severe disability at their first visit. Two clusters of presenting symptoms—fatigue with multiple symptoms, and fatigue and headache with cardiopulmonary symptoms—were identified. Extensive routine testing did not affirm alternative diagnoses. Incident conditions—most commonly anxiety, depression and/or panic disorder; migraines; and autonomic dysfunction—were diagnosed on clinical grounds. Telephone interviews (N = 55) revealed that 78% of patients were improved by about 6 months.

Conclusions:
Within the limits of a single-center, referral-based, observational cohort, this study provides reassurance to patients and parents in that most cases of long COVID were self-limited. Extensive evaluations may be more useful in ruling out alternative diagnoses than in affirming specific physiologic disturbances.
Nighttime Sleep and Respiratory Disturbances in Individuals Receiving Methadone to Treat Opioid Use Disorder
Authors: Finlay Myles , Erwin Julie A. , Skeiky Lillian , Hansen Devon A. , Layton Matthew E. , Quock Raymond , Van Dongen Hans P. A. , Wilson Marian 
Published: September 2023

Abstract
Opioids are a leading cause of drug overdose deaths in the United States. Methadone used as medication for opioid use disorder (MOUD) reduces drug cravings and promotes abstinence. However, individuals in methadone-based MOUD treatment commonly report subjective sleep complaints and are at risk for respiratory depression from opioids. We investigated nighttime sleep and respiratory function in eight individuals (six women, two men; ages 31–68 years) in their first 90 days of methadone-based MOUD treatment. Participants underwent overnight cardiorespiratory polysomnography. Sleep and respiratory variables were characterized with descriptive statistics for comparison to reference data from similarly aged healthy adults. Although participants spent 8.1 ± 0.3 hours (mean ± SD) in bed, their total sleep time was only 6.8 ± 1.3 hours. They exhibited longer sleep latency and intermittent wakefulness. Sleep structure was irregular, with disrupted sleep cycles. Participants also displayed a decreased amount of N1 sleep and an increased amount of N3 sleep, compared with reference data. Participants showed respiratory depression, with an average apnea–hypopnea index of 16.5 ± 8.9 events per hour. Central sleep apneas comprised 69.1% ± 20.9% of the respiratory events. A Cheyne–Stokes-like breathing pattern, consisting of 30-second cycles of three central sleep apneas, was observed in 75% of participants. Our results suggest that individuals early in methadone-based MOUD treatment experience disordered sleep and respiratory disturbances. Such nighttime physiological changes may have serious long-term health consequences and contribute to unintended overdose rates. Identifying and treating MOUD individuals with sleep apnea could reduce risk of death.
“We Don't Want to Screen for the Sake of Screening”
Authors: Cordova-Ramos Erika G. , Burke Judith , Sileo Nicole , McGean Maggie , Torrice Vanessa , Mantri Saaz , Parker Margaret G. , Drainoni Mari-Lynn 
Published: September 2023

Background:
Low uptake of social determinants of health (SDH) screening and referral interventions within neonatal intensive care units (NICUs) is partly due to limited understanding of the best procedures to integrate this practice into routine clinical workflows.

Purpose:
To examine the feasibility and acceptability of an SDH screening and referral intervention in the NICU from the perspective of neonatal nurses; and to identify factors affecting implementation outcomes.

Methods:
We conducted 25 semistructured interviews with NICU nurses. We used the Promoting Action on Research Implementation in Health Services (PARiHS) framework to guide interview questions and codebook development for directed content analysis. Themes were mapped onto the 3 PARiHS domains of context, evidence, and facilitation.

Findings:
Analysis yielded 8 themes. Context: Nurses felt that stressors experienced by NICU families are magnified in a safety net environment. Nurses shared varying viewpoints of the roles and responsibilities for social care in the NICU, and feared that scarcity of community resources would make it difficult to address families' needs. Evidence: The intervention was perceived to increase identification of adverse SDH and provision of resources; and to potentially jump-start better caregiver and infant health trajectories. Facilitation: Procedures that improved acceptability included dynamic training and champion support, regular feedback on intervention outcomes, and strategies to reduce stigma and bias.

Conclusion:
We identified contextual factors, concrete messaging, and training procedures that may inform implementation of SDH screening and referral in NICU settings.
Nurse practitioner education: Uniting the 2021 essentials with The Core Competencies on Disability Health Care Education
Authors: Kronk Rebecca , Lucas Denise , Williams Susan 
Published: September 2023

ABSTRACT
People with disabilities (PWD) are the largest minority group in the world, making up 16% of the world's population, an estimated 1.3 billion people. People with disabilities die earlier, have poorer health outcomes, and are more affected by emergencies and natural disasters. Factors contributing to health inequities can be characterized as socioeconomic, political, involve social determinants of health, include higher risk factors, and display a wide spectrum of health system barriers. Too often, health care training programs exclude specific standards for disability training. By mapping the new American Association of Colleges of Nursing (AACN) The Essentials: Core Competencies for Professional Education with The Core Competencies for Disability Health Care Education, we can provide a synergistic relationship that will prepare future advanced practice nurses to provide effective care to people with disabilities across the lifespan and in every delivery care system.
Predicting Persistent Opioid Use after Hand Surgery: A Machine Learning Approach
Authors: Baxter Natalie B. , Ho Allister Z. , Byrd Jacqueline N. , Fernandez Anne C. , Singh Karandeep , Chung Kevin C. 
Published: September 2023

Background:
The aim of this study was to evaluate the use of machine learning to predict persistent opioid use after hand surgery.

Methods:
The authors trained 2 algorithms to predict persistent opioid use, first using a general surgery data set and then using a hand surgery data set, resulting in 4 trained models. Next, the authors tested each model’s performance using hand surgery data. Participants included adult surgery patients enrolled in a cohort study at an academic center from 2015 to 2018. The first algorithm (Michigan Genomics Initiative model) was designed to accommodate patient-reported data and patients with or without prior opioid use. The second algorithm (claims model) was designed for insurance claims data from patients who were opioid-naive only. The main outcome was model discrimination, measured by area under the receiver operating curve (AUC).

Results:
Of 889 hand surgery patients, 49% were opioid-naive and 21% developed persistent opioid use. Most patients underwent soft-tissue procedures (55%) or fracture repair (20%). The Michigan Genomics Initiative model had AUCs of 0.84 when trained only on hand surgery data, and 0.85 when trained on the full cohort of surgery patients. The claims model had AUCs of 0.69 when trained only on hand surgery data, and 0.52 when trained on the opioid-naive cohort of surgery patients.

Conclusions:
Opioid use is common after hand surgery. Machine learning has the potential to facilitate identification of patients who are at risk for prolonged opioid use, which can promote early interventions to prevent addiction.
Biomarker-confirmed suboptimal adherence to isoniazid preventive therapy among children with HIV in western Kenya
Authors: Onyango Dickens Otieno , van der Sande Marianne A.B. , Yuen Courtney M. , Were Joyce , Mecha Jerphason , Njagi Lilian N. , Panpradist Nuttada , Matemo Daniel , Leon Daniel , Lutz Barry , Kinuthia John , John-Stewart Grace , Lacourse Sylvia M. 
Published: September 2023

Objectives:
The aim of this study was to assess the level and correlates of biomarker-confirmed adherence to isoniazid (INH) preventive therapy (IPT) among children with HIV (CLHIV).

Design:
This prospective cohort study assessed adherence among CLHIV on IPT in public sector HIV clinics from 2019 through 2020.

Methods:
Adherence was assessed by pill counts or caregiver or self-reports, and urine biomarkers (in-house dipstick and Isoscreen). Both urine biomarker tests detect INH metabolites within 48 h of ingestion. Consistent adherence was defined as having positive results on either biomarker at all visits. Correlates of biomarker-confirmed nonadherence at each visit were evaluated using generalized estimating equations. The in-house dipstick was validated using Isoscreen as the reference.

Results:
Among 97 CLHIV on IPT with adherence assessments, median age was 10 years (IQR 7–13). All were on ART at IPT initiation (median duration 46 months [IQR 4–89]); 81% were virally suppressed (<1000 copies/ml). At all visits, 59% (n = 57) of CLHIV reported taking at least 80% of their doses, while 39% (n = 38) had biomarker-confirmed adherence. Viral nonsuppression (adjusted risk ratio [aRR] = 1.65; 95% confidence interval [95% CI] 1.09–2.49) and the sixth month of IPT use (aRR = 2.49; 95% CI 1.34–4.65) were independent correlates of biomarker-confirmed nonadherence at each visit. Sensitivity and specificity of the in-house dipstick were 98.1% (94.7–99.6%) and 94.7% (88.1–98.3%), respectively, versus Isoscreen.

Conclusion:
Biomarker-confirmed adherence to IPT was sub-optimal and was associated with viral nonsuppression and duration of IPT. Urine dipstick testing may be useful in assessing adherence to IPT in clinical care.
Common antiretroviral combinations are associated with somatic depressive symptoms in women with HIV
Authors: Parra-Rodriguez Luis , O’Halloran Jane , Wang Yuezhe , Jin Wei , Dastgheyb Raha M. , Spence Amanda B. , Sharma Anjali , Gustafson Deborah R. , Milam Joel , Weber Kathleen M. , Adimora Adaora A. , Ofotokun Igho , Fischl Margaret A. , Konkle-Parker Deborah , Maki Pauline M. , Xu Yanxun , Rubin Leah H. 
Published: September 2023

Objective:
While modern antiretroviral therapy (ART) is highly effective and safe, depressive symptoms have been associated with certain ART drugs. We examined the association between common ART regimens and depressive symptoms in women with HIV (WWH) with a focus on somatic vs. nonsomatic symptoms.

Design:
Analysis of longitudinal data from the Women's Interagency HIV Study.

Methods:
Participants were classified into three groups based on the frequency of positive depression screening (CES-D ≥16): chronic depression (≥50% of visits since study enrollment), infrequent depression (<50% of visits), and never depressed (no visits). Novel Bayesian machine learning methods building upon a subset-tree kernel approach were developed to estimate the combined effects of ART regimens on depressive symptoms in each group after covariate adjustment.

Results:
The analysis included 1538 WWH who participated in 12 924 (mean = 8.4) visits. The mean age was 49.9 years, 72% were Black, and 14% Hispanic. In the chronic depression group, combinations including tenofovir alafenamide and cobicistat-boosted elvitegravir and/or darunavir were associated with greater somatic symptoms of depression, whereas those combinations containing tenofovir disoproxil fumarate and efavirenz or rilpivirine were associated with less somatic depressive symptoms. ART was not associated with somatic symptoms in the infrequent depression or never depressed groups. ART regimens were not associated with nonsomatic symptoms in any group.

Conclusions:
Specific ART combinations are associated with somatic depressive symptoms in WWH with chronic depression. Future studies should consider specific depressive symptoms domains as well as complete drug combinations when assessing the relationship between ART and depression.
Viral blips and virologic failures following mpox vaccination with MVA-BN among people with HIV
Authors: Raccagni Angelo Roberto , Diotallevi Sara , Lolatto Riccardo , Lucente Maria Francesca , Candela Caterina , Gianotti Nicola , Trentacapilli Benedetta , Canetti Diana , Castagna Antonella , Nozza Silvia 
Published: September 2023

Objectives:
The study aim was to evaluate whether mpox vaccination with modified vaccinia Ankara-Bavarian Nordic (MVA-BN) may be associated with viral blips or confirmed virologic failures (CVF) in people with HIV (PWH) receiving antiretroviral therapy and the associated factors.

Design:
PWH who received MVA-BN, with HIV-RNA less than 50 copies/ml, and CD4+ lymphocytes at least 200 cells/μl in the 6 months prior to vaccination and at least 1 HIV-RNA determination within 3 months from vaccination.

Methods:
The primary outcome was occurrence of viral blips (1 HIV-RNA ≥50 copies/ml) and CVF (1 HIV-RNA ≥1000 copies/ml or ≥2 consecutive HIV-RNA ≥50 copies/ml) following MVA-BN. Changes in CD4+ and CD4+/CD8+ were secondary outcomes. Residual viremia was defined as detectable HIV-RNA less than 50 copies/ml. PWH already vaccinated against smallpox received single-dose MVA-BN. Mann--Whitney rank-sum test or chi-square/Fisher's test applied.

Results:
Overall, 187 PWH were included: 147 received two doses of MVA-BN, 40 single-dose. Six viral blips [incidence rate = 1.59/100-person months of follow-up (PMFU), 95% confidence interval (95% CI) = 0.58–3.47], and three CVFs [incidence rate = 0.80/100-PMFU (95% CI = 0.16–2.33)] were observed. Two CVFs occurred at second dose with presence of detectable HIV-RNA following first one, with high compliance to antiretroviral therapy (ART). PWH with viral blips or CVFs had, prior to first vaccination, more frequently residual viremia [77% (n = 7) versus 35% (n = 62), P = 0.01]. No differences in ART (P = 0.42) and number of MBA-BN doses (P = 0.40) was found. In two cases of CVFs, ART was changed; all VBs resolved within 1 month.

Conclusion:
Although rare, viral blips and CVFs following MVA-BN vaccination among PWH receiving ART were identified. Close monitoring of HIV-RNA during mpox vaccination should be encouraged.