bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysing expression of loneliness and insomnia through social intelligence analysis
Authors: Shah Hurmat Ali , Househ Mowafa 
Published: January 2025

BackgroundLoneliness and insomnia are mutually occurring conditions. This paper investigates whether keywords depicting loneliness and insomnia are expressed together on social media. Understanding loneliness through data fills the gaps or validates the literature on loneliness from sociological and psychological perspectives. Loneliness is associated with various physical and mental health conditions but there are opportunities to understand it from the perspectives and lens of health informatics through social media data. Because loneliness is a subjective phenomenon, therefore, the self-reporting nature of social media data can provide an intimate glimpse into the feelings associated with loneliness.MethodsThis study uses sentiment analysis of collected tweets on loneliness and insomnia to filter out the tweets that have negative connotations. Those tweets are then further analysed to find out categories and themes associated with loneliness and insomnia.ResultsThrough the frequency of word occurrence analysis, it was seen that the association between loneliness and insomnia can be found. The association, in the tweets analysed, is mediated by words denoting depressive symptoms. Moreover, the themes and categories which are associated with the expression of both loneliness and insomnia are those of personal feelings and time.
Large language models for data extraction from unstructured and semi-structured electronic health records: a multiple model performance evaluation
Authors: Ntinopoulos Vasileios , Rodriguez Cetina Biefer Hector , Tudorache Igor , Papadopoulos Nestoras , Odavic Dragan , Risteski Petar , Haeussler Achim , Dzemali Omer 
Published: January 2025

ObjectivesWe aimed to evaluate the performance of multiple large language models (LLMs) in data extraction from unstructured and semi-structured electronic health records.Methods50 synthetic medical notes in English, containing a structured and an unstructured part, were drafted and evaluated by domain experts, and subsequently used for LLM-prompting. 18 LLMs were evaluated against a baseline transformer-based model. Performance assessment comprised four entity extraction and five binary classification tasks with a total of 450 predictions for each LLM. LLM-response consistency assessment was performed over three same-prompt iterations.ResultsClaude 3.0 Opus, Claude 3.0 Sonnet, Claude 2.0, GPT 4, Claude 2.1, Gemini Advanced, PaLM 2 chat-bison and Llama 3-70b exhibited an excellent overall accuracy >0.98 (0.995, 0.988, 0.988, 0.988, 0.986, 0.982, 0.982, and 0.982, respectively), significantly higher than the baseline RoBERTa model (0.742). Claude 2.0, Claude 2.1, Claude 3.0 Opus, PaLM 2 chat-bison, GPT 4, Claude 3.0 Sonnet and Llama 3-70b showed a marginally higher and Gemini Advanced a marginally lower multiple-run consistency than the baseline model RoBERTa (Krippendorff’s alpha value 1, 0.998, 0.996, 0.996, 0.992, 0.991, 0.989, 0.988, and 0.985, respectively).DiscussionClaude 3.0 Opus, Claude 3.0 Sonnet, Claude 2.0, GPT 4, Claude 2.1, Gemini Advanced, PaLM 2 chat bison and Llama 3-70b performed the best, exhibiting outstanding performance in both entity extraction and binary classification, with highly consistent responses over multiple same-prompt iterations. Their use could leverage data for research and unburden healthcare professionals. Real-data analyses are warranted to confirm their performance in a real-world setting.ConclusionClaude 3.0 Opus, Claude 3.0 Sonnet, Claude 2.0, GPT 4, Claude 2.1, Gemini Advanced, PaLM 2 chat-bison and Llama 3-70b seem to be able to reliably extract data from unstructured and semi-structured electronic health records. Further analyses using real data are warranted to confirm their performance in a real-world setting.
Barcode medication administration system use and safety implications: a data-driven longitudinal study supported by clinical observation
Authors: Williams Rachel , Kantilal Kumud , Man Kenneth K C , Blandford Ann , Jani Yogini 
Published: January 2025

ObjectivesBarcode medication administration (BCMA) systems may improve patient safety with successful integration and use. This study aimed to explore the barriers and enablers for the successful use of a BCMA system by examining the patterns of medication and patient scanning over time and potential safety implications.MethodsRetrospective longitudinal study informed by prospective clinical observations using data extracted from five hospital wards over the first 16 months after implementation to determine trends in medication and patient scanning rates, reasons for non-compliance and scanning mismatch alerts. Regression models were applied to explore factors influencing medication scanning rates across wards of different specialties.ResultsElectronic data on 613 868 medication administrations showed overall medication scanning rates per ward ranged from 5.6% to 67% and patient scanning rates from 4.6% to 89%. Reported reasons for not scanning medications were ‘barcode not readable’ and ‘unavailability of scanners’. Scanning rates declined over time and the pattern of reason codes for not scanning also changed. Factors associated with higher scanning rates included a locally led quality improvement (QI) initiative, the medication administration time and the medication formulation, for example, tablets and liquids. Overall, 37% of scanning alerts resulted in a change in user action. Staff tried to comply with the BCMA system workflow, but workarounds were observed.DiscussionCompliance with BCMA systems varied across wards and changed over time. QI initiatives hold promise to ensure sustained use of BCMA systems.ConclusionsBCMA systems may help to improve medication safety, but further research is needed to confirm sustained safety benefits.
Cost-utility of behavioural activation for mitigating psychological impacts of COVID-19 on socially isolated older adults with depression and multiple long-term conditions compared with usual care: results from a pragmatic randomised controlled trial
Authors: Wang Han-I , Gilbody Simon , Littlewood Elizabeth , Baird Kalpita , Ekers David , McMillan Dean , Bailey Della , Chew-Graham Carolyn , Coventry Peter , Fairhurst Caroline , Hewitt Catherine , Parrott Steve 
Published: January 2025

BackgroundDepression alongside multiple long-term conditions (MLTCs) in older adults poses a critical public health challenge, worsening physical and mental health and increasing healthcare costs. COVID-19 restrictions further exacerbated these impacts. Behavioural activation (BA) shows promise as a remote intervention for depression during isolation, but its cost-effectiveness for depressed, socially isolated older adults remains uncertain.ObjectiveThis study aimed to assess the cost-utility of BA versus usual care for older adults with depression and MLTCs during COVID-19 restrictions.MethodsA randomised controlled trial recruited and randomised individuals aged 65 and over with depressive symptoms and MLTC (n=435) to either the BA intervention or usual care. Costs were measured from the perspective of the National Health Service and personal social services. Quality-adjusted life years (QALYs) were measured using the EQ-5D-3L at baseline, and 1, 3 and 12 months postrandomisation. Incremental cost-effectiveness ratios were calculated, with uncertainty addressed through non-parametric bootstrapping. Sensitivity analyses were conducted to assess the robustness of the primary analysis.FindingsPrimary analysis indicated that BA generated a small cost-saving (£62.34 per older adult; 95% CI: −£120.44 to £239.70) while QALY improvements remained unchanged (0.007; 95% CI −0.036 to 0.022) compared with usual care. The probability of BA being the preferred option is 0.71. Sensitivity analyses supported the primary analysis findings, confirming their robustness.Conclusions and clinical implicationsCompared with usual care, BA demonstrated a slight cost reduction while maintaining QALY improvement. The findings provide promise for BA interventions for older people with depression and MLTCs facing isolation.
Exploring pre-exposure prophylaxis (PrEP) modality preferences among black cisgender women attending family planning clinics in Chicago via a cross-sectional mixed-methods study
Authors: Johnson Amy K , Ott Emily , Friedman Eleanor E , Pandiani Agustina , Moore Amy , Alvarez Isa , Desmarais Catherine , Haider Sadia 
Published: January 2025

BackgroundDespite pre-exposure prophylaxis (PrEP) demonstrated effectiveness, black cisgender women continue to be at an elevated risk for HIV acquisition and uptake of daily oral PrEP is low in this population in the USA. As advancements in PrEP delivery options continue, it is important to understand women’s acceptability of these additional options, specifically black cisgender women, in order to inform uptake and adherence among this population at increased need of HIV prevention options.SettingA cross-sectional survey among black cisgender women ages 13–45 (inclusive) attending women’s health clinics in Chicago, Illinois, USA, prior to the approval of cabotegravir long-acting injectable.MethodsDescriptive statistics were used to describe the sample and bivariate analysis was used to detect differences between categorical and outcome variables using χ2test. Responses to open-ended questions were thematically coded to explore black cisgender women’s attitudes and preferences between the three methods of PrEP delivery including vaginal ring, long-acting injectable and a combined method that would prevent both pregnancy and HIV.ResultsIn total, 211 cisgender women and adolescents responded to the survey. Both injections and combination pills were popular among participants, with 64.5% and 67.3% expressing interest in these forms of PrEP, respectively. The least popular method was the vaginal ring option, with 75.4% of respondents indicating that they would not consider using this modality. Overall, responses were not statistically different between the two surveys administered (χ2p values for injection PrEP method 0.66, combination PrEP method 0.93 and ring PrEP method 0.66) suggesting that the popularity of each method was not dependent on clinic location or the age of participants.ConclusionThis research provides important insights into the preferences and attitudes of different PrEP modalities among black cisgender women. As different modalities continue to be approved for use among cisgender women, more research is needed to investigate the acceptability and preferences of these different modalities in order to improve uptake and adherence among this population.
Cluster randomised controlled trial on the effects of long-term home-based exercise for patients with chronic obstructive pulmonary disease with recent exacerbation: research protocol of theCOPDtoParisProject
Authors: Stoustrup Anna Lei , Thomsen Lars Pilegaard , Andreasen Jane , Palsson Thorvaldur S , Weinreich Ulla Møller 
Published: January 2025

BackgroundChronic obstructive pulmonary disease (COPD) is a highly prevalent respiratory disease associated with significant health decline and economic burdens. Pulmonary rehabilitation is an effective intervention, but securing adherence to exercise is difficult, particularly for frail and disabled patients, challenged by leaving their home. Home-based exercise is an emerging alternative for persons with COPD, but long-term adherence is unclear. This study aims to investigate the effects, experiences and acceptability of long-term home-based cycling for patients with COPD post exacerbation.Methods and analysesThis cluster randomised controlled trial will recruit hospitalised patients with COPD following hospitalisation following exacerbation of COPD. Participants will be referred to acute rehabilitation for 8 weeks at discharge. After rehabilitation, participants are randomised in clusters of five into 1 year of home-based cycling with the goal of cycling from Aalborg to Paris, or into the control group, who will receive standard care. Data will be collected at baseline, postrehabilitation/intervention initiation, at 6 and 12 months. Primary outcome is physical performance, while secondary outcomes include daily activity levels, lung function, mobility, frailty, symptom severity, health-related quality of life, survival rates and readmissions. A qualitative substudy will uncover experiences from participants. Daily activity levels will be measured using leg-mounted triaxial accelerometers. Other parameters will be tested with physical tests, questionnaires and interviews. The study aims to include 50 patients, with 25 participants in each group. A cost-effectiveness analysis will assess the impact on disease prevention and hospitalisation.Ethics and disseminationThis study, approved by The North Denmark Region Committee on Health Research Ethics (N-20230008) and compliant with the Helsinki Declaration, includes annual safety and progress reporting of potential adverse events. Results will be disseminated through peer-reviewed publications, conference presentations and community outreach to ensure accessibility to participants, healthcare professionals and the public.Trial registration numberNCT06235502and Northern Jutland trial register (F2023-066).
Pan-tumor analysis to investigate the obesity paradox in immune checkpoint blockade
Authors: Alden Stephanie L , Charmsaz Soren , Li Howard L , Tsai Hua-Ling , Danilova Ludmila , Munjal Kabeer , Brancati Madelena , Warner Aanika , Howe Kathryn , Griffin Ervin , Nakazawa Mari , Thoburn Chris , Gizzi Jennifer , Hernandez Alexei , Gross Nicole E , Coyne Erin M , Hallab Elsa , Shin Sarah S , Durham Jennifer , Lipson Evan J , Ged Yasser , Baretti Marina , Hoffman-Censits Jean , Seiwert Tanguy Y , Guha Aditi , Bansal Sanjay , Tang Laura , Chandler G Scott , Mohindra Rajat , Garonce-Hediger Rachel , Jaffee Elizabeth M , Ho Won Jin , Kao Chester , Yarchoan Mark 
Published: January 2025

BackgroundObesity is a risk factor for developing cancer but is also associated with improved outcomes after treatment with immune checkpoint inhibitors (ICIs), a phenomenon called the obesity paradox. To interrogate mechanisms of divergent immune responses in obese and non-obese patients, we examined the relationship among obesity status, clinical responses, and immune profiles from a diverse, pan-tumor cohort of patients treated with ICI-based therapy.MethodsFrom June 2021 to March 2023, we prospectively collected serial peripheral blood samples from patients with advanced or metastatic solid tumors who received ICI as standard of care at Johns Hopkins. Patients were stratified by obesity status at treatment initiation, with obesity defined as body mass index (BMI)≥30 at treatment initiation and BMI≥18.5 and <30 considered non-obese; underweight patients (BMI<18.5) were excluded. We evaluated the concentration of 37 cytokines and used cytometry by time of flight to characterize immune cell clusters and cell-surface expression markers at baseline and on-treatment.ResultsWe enrolled 94 patients, of whom 30 (32%) were obese and 64 (68%) were non-obese. Compared with non-obese patients, obese patients had superior progression-free survival (HR: 0.44 (95% CI: 0.24 to 0.81), p=0.01) and overall survival (OS) (HR: 0.24 (95% CI: 0.07 to 0.80), p=0.02). Obese patients had lower serum IL-15 levels at treatment baseline and lower on-treatment levels of IL-6, IL-8, and IL-15. Low on-treatment IL-6 was associated with improved OS (HR: 0.27 (95% CI: 0.08 to 0.88), p=0.03), as was low on-treatment IL-8 (HR: 0.19 (95% CI: 0.05 to 0.70), p=0.01). Obese patients demonstrated lower levels of T effector cells with reduced expression of cytotoxicity markers and higher expression of exhaustion markers at baseline and on-treatment.ConclusionsObese and non-obese patients with cancer have divergent immunological responses to ICIs. Obesity is associated with reduced levels of certain inhibitory cytokines and higher expression of T-cell exhaustion markers. ICI-based therapy may more effectively reverse T-cell dysfunction in obese patients, potentially contributing to the paradoxically improved responses in this population.
Under-recognised neurocognitive deficits in adults and adolescents with tuberous sclerosis complex
Authors: Boisclair Mélissa , Blondeau Laury-Anne , Bouchard Florence , Drouin-Engler Rose-Marie , Li Jimmy , Bertrand Samuel , Zine-Eddine Fayçal , Létourneau-Guillon Laurent , Larochelle Catherine , Major Philippe , Boucher Olivier , Keezer Mark R 
Published: January 2025

BackgroundTuberous sclerosis complex (TSC) is a genetic disease characterised by the growth of benign tumours. The Tuberous sclerosis Associated Neuropsychiatric Disorders (TAND) Checklist is used to identify patient-reported neurocognitive deficits. Patients may, however, under-recognise mild cognitive impairment. We aimed to determine the frequency of abnormal scores on three objective tests of cognitive function in people with and without diagnosed intellectual disability and examine associations between scores on these tests with self-reported TAND Checklist symptoms.MethodsWe conducted a cross-sectional study where people with TSC (PwTSC; n=46) completed the TAND Checklist and three cognitive tests: Symbol Digit Modalities Test (SDMT), Montreal Cognitive Assessment test and Trail Making Test—Parts A and B. We examined associations between cognitive test scores and the TAND Checklist using Pearson’s correlations (95% CI). Receiver operating characteristics (ROC) curves were plotted to determine the screening accuracy of each measure in identifying physician-diagnosed neurocognitive disorders.ResultsThere were minimal correlations between the cognitive test scores and the TAND Checklist. More than 20% of PwTSC reported no cognitive issues on the TAND Checklist but had abnormal performance on at least one cognitive test. The ROC curves demonstrated similar results, with areas under the curve of 0.93 (95% CI 0.79 to 1.00) for the SDMT but only 0.70 (95% CI 0.45 to 0.95) for the TAND Checklist.ConclusionObjective tests of cognitive function are useful in identifying unrecognised neurocognitive deficits in PwTSC. Deficits likely have multifactorial origins, including undiagnosed intellectual disability and the impact of chronic epilepsy.
Elevated serum neurofilament light chain levels in patients with neuropsychiatric systemic lupus erythematosus: a cross-sectional study
Authors: Balajková Veronika , Prokopcová Aneta , Elisak Martin , Mojžišová Hana , Pavelka Karel , Olejárová Marta 
Published: January 2025

BackgroundThe neurofilament light chain (NfL) in cerebrospinal fluid (CSF) and serum as a marker of neuronal damage may be a potential biomarker of neuropsychiatric involvement in SLE (NPSLE).Methods80 patients with SLE were included.We obtained paired serum and CSF samples from 48 patients (NPSLE n=32, non-NPSLE n=16) and 31 controls. The serum and CSF levels of NfL were determined using ELISA.ResultsPatients with NPSLE demonstrated significantly higher levels of serum NfL compared with the non-NPSLE group (mean 31.68±36.63 pg/mL vs mean 16.75±12.48 pg/mL, respectively, p<0.05) and with controls (mean 10.74±4.36 pg/mL, p<0.01). Notably, CSF NfL concentrations in patients with NPSLE showed an upward trend (mean 1600±2852 pg/mL) in contrast to non-NPSLE patients (mean 393.4±191.9 pg/mL) and controls (mean 509.7±358.5 pg/mL). Furthermore, a positive correlation was observed between serum and CSF NfL levels in patients with NPSLE (R=0.8686, p<0.01). Elevated serum triacylglycerol concentrations, C reactive protein and organ damage were linked to increased serum (p=0.002; p<0.001; p=0.036) and CSF (p=0.008; p=0.007; p<0.001) NfL concentrations. In addition, we established a significant correlation between intrathecal NfL concentrations and interleukin-6 levels in the CSF of patients with NPSLE (R=0.5118, p<0.05).ConclusionThe serum NfL levels may be a readily available marker of neuropsychiatric involvement in SLE.
Longitudinal associations of flare and damage accrual in patients with systemic lupus erythematosus
Authors: Kandane-Rathnayake Rangi , Milea Dominique , Louthrenoo Worawit , Hoi Alberta , Golder Vera , Cho Jiacai , Lateef Aisha , Luo Shue-Fen , Wu Yeong-Jian Jan , Hamijoyo Laniyati , Sockalingam Sargunan , Li Zhanguo , Navarra Sandra , Zamora Leonid , Harigai Masayoshi , Katsumata Yasuhiro , Chan Madelynn , Hao Yanjie , Zhang Zhuoli , O’Neill Sean , Goldblatt Fiona , Oon Shereen , Xu Xiaomeng , Navarro Rojas Aldo A , Bae Sang-Cheol , Lau Chak Sing , Nikpour Mandana , Morand Eric 
Published: January 2025

ObjectiveTo estimate the prevalence of organ damage (damage) and flare and to examine longitudinal associations between flares and subsequent damage accrual, in patients with systemic lupus erythematosus (SLE).MethodsPatients enrolled in the Asia Pacific Lupus Collaboration cohort with ≥3 years of prospectively captured data were studied. Flares were assessed at routine visits, while damage ((Systemic Lupus International Collaborating Clinics/American College of Rheumatology) Damage Index) was assessed annually. Multivariable, multifailure survival analyses were carried out to quantify the association between flares and damage accrual.Results1556 patients with SLE with a median (IQR) of 5.7 (3.9, 7.0) years of follow-up were studied. 39.5% (n=614) of patients had damage at enrolment, and 31.9% (n=496) accrued damage during the study observation period. The incidence of damage accrual during observation was ~58/1000 person-years. Overall, 74.1% (n=1153) of patients experienced a flare of any severity (mild/moderate or severe) at least once; 56.9% (n=885) experienced recurrent (≥2) flares. The risk of subsequent damage accrual in patients who experienced mild-to-moderate flare, after controlling for confounders, was 32% greater than in patients without flares (adjusted HR) (95% CI 1.32 (1.17 to 1.72)). The risk of damage accrual was greater if patients had severe flares (HR (95% CI) 1.58 (1.18 to 2.11)). For each additional flare, the risk of damage accrual increased by 7% (HR (95% CI) 1.07 (1.02 to 1.13)).ConclusionsFlares independently increased the risk of damage accrual. Prevention of flares should be considered a necessary goal of SLE disease management to minimise permanent damage.