bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cause-specific excess mortality after first diagnosis of bipolar disorder: population-based cohort study
Authors: Paljärvi Tapio , Herttua Kimmo , Taipale Heidi , Lähteenvuo Markku , Tanskanen Antti , Fazel Seena , Tiihonen Jari 
Published: July 2023

BackgroundBipolar disorder (BD) is associated with increased mortality, but evidence on cause-specific mortality is limited.ObjectiveTo investigate cause-specific premature excess mortality in BD.MethodsFinnish nationwide cohort study of individuals with and without a diagnosis of BD who were aged 15–64 years during 2004–2018. Standardised mortality ratios (SMRs) with 95% CIs were calculated for BD using the mortality rates in the Finnish general population without BD as weights. Causes of death were defined by the International Classification of Diseases, 10th revision codes.FindingsOf the included 47 018 individuals with BD, 3300 (7%) died during follow-up. Individuals with BD had sixfold higher mortality due to external causes (SMR: 6.01, 95% CI: 5.68, 6.34) and twofold higher mortality due to somatic causes (SMR: 2.06, 95% CI: 1.97, 2.15). Of the deaths due to external causes, 83% (1061/1273) were excess deaths, whereas 51% (1043/2027) of the deaths due to somatic causes were excess. About twice the number of potential years of life were lost in excess due to external causes than due to somatic causes. Alcohol-related causes contributed more to excess mortality than deaths due to cardiovascular disease.ConclusionExternal causes of death contributed more to the mortality gap than somatic causes after controlling for age-specific background general population mortality.Clinical implicationA balanced consideration between therapeutic response, different treatment options and risk of cause-specific mortality is needed to prevent premature mortality in BD and to reduce the mortality gap.
Sustainability and impact of the implementation of a frailty checklist for the acute medical unit: experience from a tertiary public hospital in Singapore
Authors: Kasunuran-Cruz Maria Teresa , Tan Drusilla Kai Yan , Yeo Charmaine Yan , Hooi Benjamin Ming-Yew , Soong John Tshon Yit 
Published: July 2023

BackgroundAccelerated population ageing is associated with an increasing prevalence of frailty. International guidelines call for systematic assessment and timely interventions for older persons requiring acute care. Checklists have been applied successfully in healthcare settings.ObjectiveThis study describes the implementation of a safety checklist for frailty in the acute medical unit (AMU) of a tertiary public hospital in Singapore. We explored the sustainability of processes up to 6 months after initial implementation. Additionally, we investigated process and system outcome benefits following the implementation of the checklist.MethodsThis retrospective observational study used case notes review of patients admitted to the AMU of a tertiary public hospital in Singapore from February to August 2019. Process outcomes measured to include compliance with AMU frailty checklist assessments and interventions at 24 hours of hospital admission. System and patient outcomes studied to include the length of hospital stay; 30-day emergency department reattendance rate; 30-day hospital readmission rate and inpatient mortality. Propensity scores were used to create balanced cohorts for comparison between those with complete and incomplete compliance with the checklist. Logistic regression was used to adjust for known confounders.ResultsAverage weekly (all-or-nothing) compliance with the frailty checklist (14.7%) was sustained for 6 months. Where assessments detected high risk, appropriate interventions were appropriately triggered (44%–97.4%). While trends to benefit systems and patient outcomes were present, these were not statistically significant. Contextual patterns are discussed.ConclusionA safety checklist for frailty was feasibly implemented in the AMU. The checklist was a complex intervention. Full compliance with the checklist was challenging to achieve. Further research assessing optimal patient selection criteria and how checklists may shift team behaviour is a priority.
Preventing lost-to-follow up diagnostic imaging in ambulatory care: evaluation of an electronic notification tool
Authors: Dadlez Nina M , Le Clair Amy M , Wasima Syeda , Mayer Nicole , Harvey William F , Roberts Kari , Mazzullo John , Lominac Eric , Koethe Benjamin C , Weingart Saul N 
Published: July 2023

ObjectiveMissed or cancelled imaging tests may be invisible to the ordering clinician and result in diagnostic delay. We developed an outpatient results notification tool (ORNT) to alert physicians of patients’ missed radiology studies.DesignRandomised controlled evaluation of a quality improvement intervention.Setting23 primary care and subspecialty ambulatory clinics at an urban academic medical centre.Participants276 physicians randomised to intervention or usual care.Main outcome measure90-day test completion of missed imaging tests.ResultsWe included 3675 radiology tests in our analysis: 1769 ordered in the intervention group and 1906 in the usual care group. A higher per cent of studies were completed for intervention compared with usual care groups in CT (20.7% vs 15.3%, p=0.06), general radiology (19.6% vs 12.0%, p=0.02) and, in aggregate, across all modalities (18.1% vs 16.1%, p=0.03). In the multivariable regression model adjusting for sex, age and insurance type and accounting for clustering with random effects at the level of the physician, the intervention group had a 36% greater odds of test completion than the usual care group (OR: 1.36 (1.097–1.682), p=0.005). In the Cox regression model, patients in the intervention group were 1.32 times more likely to complete their test in a timely fashion (HR: 1.32 (1.10–1.58), p=0.003).ConclusionsAn electronic alert that notified the responsible clinician of a missed imaging test ordered in an ambulatory clinic reduced the number of incomplete tests at 90 days. Further study of the obstacles to completing recommended diagnostic testing may allow for the development of better tools to support busy clinicians and their patients and reduce the risk of diagnostic delays.
Persistent poverty and child dental caries: time-varying exposure analysis
Authors: Matsuyama Yusuke , Isumi Aya , Doi Satomi , Fujiwara Takeo 
Published: July 2023

BackgroundThis study investigated the cumulative impact of persistent poverty on dental caries among elementary schoolchildren in Japan.MethodsData were derived from four-wave longitudinal data of children in all public elementary schools in Adachi City, Tokyo, Japan, from 2015 to 2020 (n=4291, response rate: 80.1%–83.8%). Poverty status, defined as annual household income <JPY3 million, material deprivation or payment difficulties for lifeline utilities, was assessed by caregiver questionnaires when the children were in the first, second, fourth and sixth grades. School dentists assessed dental caries. We estimated the difference in the number of primary and permanent teeth with incidences of dental caries from second to sixth grade by persistent poverty and never having experienced poverty. Targeted maximum likelihood estimation was used to consider baseline and time-varying confounders.ResultsChildren with persistent poverty experienced more dental caries (mean: 3.81, SD: 3.73) than children who had never experienced poverty (mean: 2.39, SD: 3.27). After controlling for confounders, being in persistent poverty was significantly associated with having more dental caries than never being in poverty (mean difference: 1.54, 95% CI 0.60, 2.48). The magnitude of the association was greater than that of poverty assessed at first grade only (mean difference: 0.75, 95% CI 0.35, 1.16) or experience of poverty at any of the four waves (mean difference: 0.69, 95% CI 0.39, 0.99).ConclusionThe cumulative impact of persistent poverty could be larger than the poverty assessed at a single time point.
Does employment status mediate the association between disability status and mental health among young adults? Evidence from the Household, Income and Labour Dynamics in Australia (HILDA) survey
Authors: Shields Marissa , Spittal Matthew J , Aitken Zoe , Dimov Stefanie , Kavanagh Anne , King Tania Louise 
Published: July 2023

ObjectiveYoung adults with disabilities are less likely to be employed and more likely to have poor mental health than peers without disabilities. Growing evidence shows that social determinants of health may be causally related to mental health outcomes of people with disabilities. We aimed to assess if the disability to mental health association was mediated by employment status among young adults aged 20–35 years.MethodsFour consecutive years (2016–2019) of data from the Household, Income and Labour Dynamics in Australia survey were used to conduct a causal mediation analysis. We decomposed the total causal effect of disability status on mental health (Short Form-36 Mental Health Inventory-5) into the natural direct effect from disability to mental health and the natural indirect effect representing the pathway through the employment mediator (being employed; being unemployed or wanting to work).Results3435 participants (3058 with no disabilities, 377 with disabilities) were included in the analysis. The total causal effect of disability status on mental health was an estimated mean decrease in mental health of 4.84 points (95% CI −7.44 to –2.23). The indirect effect, through employment status, was estimated to be a 0.91-point decline in mental health (95% CI −1.50 to –0.31).ConclusionsResults suggest disability has an effect on the mental health of young adults; a proportion of this effect appears to operate through employment. The mental health of young adults with disabilities could potentially be improved with interventions to improve employment outcomes among this group, and by supporting individuals with disabilities into suitable employment.
Learning from parental experience in a neonatal surgical unit: a qualitative service evaluation
Authors: Littlejohns Anna , Crouzen Emile , Mernenko Rebecca , Metcalfe Fiona , Moni-Nwinia Waaka , Chauhan Hemma , Johnson Bethan , McConachie Douglas , Lawson Elizabeth , Tricklebank Victoria , McElwaine John G , Sagoo Gurdeep S , McKechnie Liz , Latchford Gary , Sutcliffe Jonathan 
Published: July 2023

ObjectivesPatient experience is directly related to health outcomes, and parental experience can be used as a proxy for this in neonatal care. This project was designed to assess parental experience of neonatal surgical care to inform future service developments and improve the care we provide.MethodsThis was a qualitative study using rapid qualitative analysis. The study was carried out in a large neonatal surgical intensive care unit in the UK. Parents of infants treated by the neonatal surgical team between March 2020 and February 2021, during the COVID-19 pandemic were included. Purposive sampling was used to ensure that a representative range of parents were interviewed. A semistructured interview was created and tested in a previous phase of work. This questionnaire was used to ask parents open questions about different aspects of their infants’ healthcare journey from the antenatal phase through to discharge from the neonatal unit (NUU).ResultsRapid qualitative analysis was employed, and parental experiences were grouped into five main categories: before admission to the NNU, initial admission to NNU, information and support, COVID-19 and discharge. Within these five groups, we highlighted positive experiences to be fed back to the healthcare teams to reinforce good practice, areas that warranted improvement and suggestions for service development.ConclusionsThe wealth of data generated from the interviews has been summarized and shared with healthcare teams who are putting the service improvement suggestions into practice. The tool is available for services that wish to measure parental experience.
TargetingKRAS-Mutated NSCLC: Novel TKIs and Beyond
Authors: Cantor David J. , Aggarwal Charu 
Published: July 2023

SummaryKRAS-mutated non–small cell lung cancer (NSCLC) is the most common genetically altered subtype of NSCLC, yet targeted therapies remain limited. Multiple studies have investigated combinations of MEK inhibitors with chemotherapy without success. Here we discuss these studies and novel approaches to targeting KRAS-mutated NSCLC.See related article by Gadgeel et al., p. 3641
Application of artificial intelligence in medical technologies: A systematic review of main trends
Authors: Bitkina Olga Vl , Park Jaehyun , Kim Hyun K. 
Published: July 2023

Objective Artificial intelligence (AI) has been increasingly applied in various fields of science and technology. In line with the current research, medicine involves an increasing number of artificial intelligence technologies. The introduction of rapid AI can lead to positive and negative effects. This is a multilateral analytical literature review aimed at identifying the main branches and trends in the use of using artificial intelligence in medical technologies. Methods The total number of literature sources reviewed is n = 89, and they are analyzed based on the literature reporting evidence-based guideline PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) for a systematic review. Results As a result, from the initially selected 198 references, 155 references were obtained from the databases and the remaining 43 sources were found on open internet as direct links to publications. Finally, 89 literature sources were evaluated after exclusion of unsuitable references based on the duplicated and generalized information without focusing on the users. Conclusions This article is identifying the current state of artificial intelligence in medicine and prospects for future use. The findings of this review will be useful for healthcare and AI professionals for improving the circulation and use of medical AI from design to implementation stage.
Small interfering RNA–mediated allele-selective silencing of von Willebrand factor in vitro and in vivo
Authors: Jongejan Yvonne K. , Schrader Echeverri Elisa , Dirven Richard J. , Paunovska Kalina , Linthorst Noa A. , de Jong Annika , Wellershoff Johannes C. , van der Gouw Kim D. , van Vlijmen Bart J. M. , Dahlman James E. , Eikenboom Jeroen C. J. 
Published: July 2023

Abstract
An imbalance in von Willebrand factor (VWF) may either lead to bleeding (von Willebrand disease, VWD) or thrombosis. Both disorders have shortcomings in the currently available treatments. VWF itself could be a potential therapeutic target because of its role in both bleeding and thrombosis. Inhibiting VWF gene expression through allele-selective silencing of VWF with small interfering RNAs (siRNAs) could be a personalized approach to specifically inhibit mutant VWF in VWD or to normalize increased VWF levels in thrombotic disorders without complete VWF knockdown. Therefore, we investigated a method to allele-selectively silence the VWF gene in mice as a therapeutic strategy. Fourteen candidate siRNAs targeting murine Vwf of either the C57BL/6J (B6) or the 129S1/SvImJ (129S) strain were tested in vitro in cells expressing B6- and 129S-Vwf for inhibitory effect and allele-selective potential. Together with a nonselective siVwf, 2 lead candidate siRNAs, siVwf.B6 and siVwf.129S, were further tested in vivo in B6 and 129S mice. Efficient endothelial siRNA delivery was achieved by siRNA encapsulation into 7C1 oligomeric lipid nanoparticles. Treatment with the nonselective siVwf resulted in dose-dependent inhibition of up to 80% of both lung messenger RNA and plasma VWF protein in both mouse strains. In contrast, the allele-selective siVwf.B6 and siVwf.129S were shown to be effective in and selective solely for their corresponding mouse strain. To conclude, we showed efficient endothelial delivery of siRNAs that are highly effective in allele-selective inhibition of Vwf in mice, which constitutes an in vivo proof of principle of allele-selective VWF silencing as a therapeutic approach.
Young people’s proposals for a web-based intervention for sexual health promotion: a French qualitative study
Authors: Martin Philippe , Alberti Corinne , Gottot Serge , Bourmaud Aurélie , de La Rochebrochard Elise 
Published: July 2023

Abstract
Background
Promoting sexual health is key to improving the supportive behaviors and well-being of young people. With the advent of the Internet, web-based features for sexual health promotion may be attractive to a diverse range of young people. This study aims to assess young people’s proposals regarding a web-based intervention for sexual health promotion.

Methods
Nineteen French young people aged 15–24 years participated to the study. In a semi-structured interview, they presented their views on a web-based intervention for sexual promotion. Data were coded with N’Vivo and subjected to qualitative thematic analysis to explore their proposals.

Results
The majority of participants (n = 18) thought that a web-based intervention for sexual health promotion would be attractive. Young people interviewed made 31 concrete proposals for sexual health promotion on the Internet. Participatory and interactive dimensions on the internet appeared essential, with the need for stimulating activities and interaction with peers, but also with competent professionals and moderation. Face to the risks of the internet, they expressed the need of a secure and confidential space, to generate trust and participation in intervention. For participants, sexual health should be addressed in all its dimensions, taking into account the relational, sexual, and gender dimensions, and by incrementing on the internet valid, credible and personalized content.

Conclusions
In sexual health promotion, young people are indispensable stakeholders who can make concrete proposals and can also participate in content creation and research. More broadly, in health promotion, involving target audiences in decisions represents a promising perspective.
Suprascapular nerve entrapment caused by a large hematoma of the scapula: a case report
Authors: Joo Yong Bum , Lee Woo Yong , Chung Hyung Jin 
Published: July 2023

Abstract
Background
Suprascapular nerve entrapment is a rare disorder that is frequently misdiagnosed as another disease. The suprascapular nerve is commonly entrapped at the following two sites: the suprascapular and spinoglenoid notches. Nerve entrapment at the spinoglenoid notch causes infraspinatus muscle weakness and atrophy. Patients present with posterior shoulder pain and weakness. Magnetic resonance imaging is used to confirm the diagnosis of a spinoglenoid cyst and nerve compression. Open or arthroscopic aspiration or decompression is indicated for patients with cysts in whom conservative treatment has failed and those with cysts associated with suprascapular nerve compression.

Case presentation
Herein, we describe the case of a 49-year-old man with suprascapular nerve entrapment caused by a large cyst, namely, a hematoma, in the superior scapular and spinoglenoid notches. Open surgical decompression of the suprascapular nerve was performed owing to an intact rotator cuff and glenoid labrum.

Conclusion
Posterior shoulder pain promptly resolved without complications.
Implementation strategies, facilitators, and barriers to scaling up and sustaining post pregnancy family planning, a mixed-methods systematic review
Authors: Nabhan Ashraf , Kabra Rita , Allam Nahed , Ibrahim Eman , Abd-Elmonem Norhan , Wagih Nouran , Mostafa Nourhan , Kiarie James ,   Family Planning Research Collaborators, Zenhom Ahmed , Ashraf Alyaa , Alshabrawy Amal , Atwa Emry , Elghamry Fatma , Abouelnaga Mai , Kodsy Mariam , Elgendi Marwa , Snosi Marwa , Kamel Menna , Salama Mohamed , Makram Nada , Sakna Noha , Eltayeb Salma , bahnasy Samhaa , Galal Sara , Taha Shorouk 
Published: July 2023

Abstract
Background
Post pregnancy family planning includes both postpartum and post-abortion periods. Post pregnancy women remain one of the most vulnerable groups with high unmet need for family planning. This review aimed to describe and assess the quality of the evidence on implementation strategies, facilitators, and barriers to scaling up and sustaining post pregnancy family planning.

Methods
Electronic bibliographic databases (MEDLINE, PubMed, Scopus, the Cochrane Library, and Global Index Medicus) were searched from inception to October 2022 for primary quantitative, qualitative, and mixed method reports on scaling up post pregnancy family planning. Abstracts, titles, and full-text papers were assessed according to the inclusion criteria to select studies regardless of country, language, publication status, or methodological limitations. Data were extracted and methodological quality assessed using the Mixed Methods Appraisal Tool. The convergent integrated approach and a deductive thematic synthesis were used to identify themes and sub-themes of strategies to scale up post pregnancy family planning. The health system building blocks were used to summarize barriers and facilitators. GRADE-CERQual was used to assess our confidence in the findings.

Results
Twenty-nine reports (published 2005–2022) were included: 19 quantitative, 7 qualitative, and 3 mixed methods. Seven were from high-income countries, and twenty-two from LMIC settings. Sixty percent of studies had an unclear risk of bias. The included reports used either separate or bundled strategies for scaling-up post pregnancy family planning. These included strategies for healthcare infrastructure, policy and regulation, financing, human resource, and people at the point of care. Strategies that target the point of care (women and / or their partners) contributed to 89.66% (26/29) of the reports either independently or as part of a bundle. Point of care strategies increase adoption and coverage of post pregnancy contraceptive methods.

Conclusion
Post pregnancy family planning scaling up strategies, representing a range of styles and settings, were associated with improved post pregnancy contraceptive use. Factors that influence the success of implementing these strategies include issues related to counselling, integration in postnatal or post-abortion care, and religious and social norms.

Trial registration
Center for Open Science, OSF.IO/EDAKM