bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of armed conflict on health professionals’ education and training in Syria: a systematic review
Authors: Bdaiwi Yamama , Sabouni Ammar , Patel Preeti , Ekzayez Abdulkarim , Alchalati Safwan , Abdrabbuh Omer , Abbara Aula , Glogowska Margaret 
Published: July 2023

ObjectivesTo provide an overview of the holistic impact of the armed conflict on medical education and health professionals’ training (MEHPT) in Syria.SettingSyria is a country which underwent an armed conflict for 10 years and suffered from the weaponisation of health.MethodsA mixed-methods systematic review including quantitative, qualitative, mixed-methods and textual literature between 2011 and 2021 including papers on the Syrian MEHPT undergraduate and postgraduate education and training personnel (including medicine, dentistry, pharmacy, nursing, midwifery and allied health professionals). The electronic search was conducted in October 2018 in Embase, Global Health, Medline, PsycINFO, Web of Science, PubMed, Scopus, CINAHL and grey literature. And an update to the search was conducted in August 2021 in PubMed, Google Scholar and Trip database.OutcomesThe impact of conflict on the MEHPT system, personnel, experiences, challenges and channels of support.ResultsOf the 5710 citations screened, 70 met the inclusion criteria (34 quantitative, 3 qualitative, 1 mixed-method, and 32 reports and opinion papers). The two major cross-cutting themes were attacks on MEHPT and innovations (present in 41% and 44% of the papers, respectively), followed by challenges facing the MEHPT sector and attitudes and knowledge of trainees and students, and lastly health system and policy issues, and narrating experiences.ConclusionConflict in Syria has politicised all aspects of MEHPT. Influenced by political control, the MEHPT system has been divided into two distinguished geopolitical contexts; government-controlled areas (GCAs) and non-GCAs (NGCAs), each having its characteristics and level of war impact. International and regional academic institutes collaboration and coordination efforts are needed to formulate educational platforms using innovative approaches (such as online/blended/store-and-forward/peer-training/online tutoring) to strengthen and build the capacity of the health workforce in conflict-affected areas.
Are trajectories of depressive symptoms during the first half of drug-sensitive pulmonary tuberculosis treatment associated with loss to follow-up? A secondary analysis of longitudinal data
Authors: Ruiz-Grosso Paulo , Loret de Mola Christian , Otero Larissa , Ugarte-Gil Cesar 
Published: July 2023

ObjectiveThe objective of this study was to identify trajectories of depressive symptoms (DSs) during the first half of drug-sensitive pulmonary tuberculosis (PTB) treatment and examine their association with loss to follow-up (LTFU) in the second half.DesignThis study involved a secondary analysis of longitudinal data to identify potential trajectories of DS and their relationship with LTFU.SettingThe study was conducted in first and second-level health centres located in San Juan de Lurigancho, Lima, Peru.ParticipantsAnonymised data from 265 individuals, including monthly measures of DSs from diagnosis to the completion of treatment, initiation of treatment for multidrug resistant TB, LTFU or death, were collected.ResultsThree trajectories were identified: ‘declining’, ‘growth’ and ‘high’. These trajectories were observed in 182 (68.7%), 53 (20%) and 30 (11.3%) of the 265 individuals, respectively, during the first half of PTB treatment. Compared with those with a ‘declining’ trajectory, individuals with a ‘growth’ trajectory had a higher likelihood of experiencing LTFU during the second half of PTB treatment, after controlling for sociodemographic factors and at least weekly alcohol use (OR 3.9; 95% CI 1.09 to 13.97, p=0.036).ConclusionsThe findings suggest that a trajectory of increasing DSs during the first half of PTB treatment is associated with a higher risk of LTFU during the second half.
Efficacy of high-intensity versus low-intensity psychoanalytically oriented long-term treatments and determinants of outcome: individual participant data Meta-analysis of Long-term Analytic treatment Studies (MeLAS)
Authors: Krakau Lina , Leuzinger-Bohleber Marianne , Brähler Elmar , Schmidt Peter , Rost Felicitas , Huber Dorothea , Klug Guenther , Löffler-Stastka Henriette , Rössler-Schülein Hemma , Leichsenring Falk , Salzer Simone , Brockmann Josef , Jakobsen Thorsten , Ernst Mareike , Beutel Manfred E 
Published: July 2023

IntroductionLong-term psychodynamic/psychoanalytic psychotherapy (LTPP) is a prevalent treatment option for complex mental disorders. Yet, little is known about the role of treatment intensity in LTPP. We present a study protocol for a systematic review and individual participant data (IPD) meta-analysis aggregating and analysing individual data from randomised and quasi-experimental trials by meta-analysis. The purpose is to (1) determine the treatment effectiveness of LTPP with low versus high intensity (up to 2 weekly sessions vs three or more), (2) compare their joint effectiveness to shorter therapies and treatments as usual, (3) identify predictors and moderators of treatment outcomes and (4) determine reciprocal relationships between different outcome domains (symptomatic and structural/personality change) over the courses of LTPP.Methods and analysisWe include studies from (randomised controlled trial, RCT) and quasi-experimental trials, where at least one condition was LTPP of high or low frequency. Long-term treatment is defined as ≥1 year or ≥50 sessions. To be eligible studies must include a standardised outcome measure of symptoms (global or disorder specific) with at least one proof of reliability. The primary outcome is symptom reduction (global or specific), secondary outcome criteria are reliable change, remission, functional capacities, personality, personality functioning and interpersonal pathology. Relevant studies will mainly be identified by searching relevant databases: PubMed, PsycINFO (via EBSCO), Web of Science (via Elsevier), Chochrane’s Central Register of Controlled Trials (via Wiley). Risk of bias will be evaluated in line with the Cochrane assessments tools for quasi-experimental trials and RCTs, respectively.Ethics and disseminationAggregation of data from primary trials collected based on ethics votes. Dissemination into clinical practice via open access publications of findings.PROSPERO registration numberCRD42022304982; Pre-results.
Manchester Intermittent and Daily diet Type 1 Diabetes App Study (MIDDAS-Type 1): protocol for a randomised feasibility trial of an intermittent and continuous low-energy diet in patients with type 1 diabetes and overweight and obesity
Authors: McDiarmid Sarah , Harvie Michelle , Aglan Azza , Winterbottom Hannah , Mubita Womba , Hulme Amanda , Davies Jane , Yates James , Krizak Suzanne , Perry Diane , Issa Basil G 
Published: July 2023

IntroductionRising levels of overweight and obesity among people with type 1 diabetes (T1D) contribute to insulin resistance, dyslipidaemia, retinopathy, cardiometabolic complications and psychological morbidity. Continuous low-energy diets (CLED) providing approximately 800 kcal (3347 kJ)/day can produce significant weight loss in type 2 diabetes, and intermittent low-energy diets (ILED) may be an alternative. The Manchester Intermittent and Daily diet Type 1 Diabetes App Study (MIDDAS-Type 1) aims to assess the safety, acceptability and feasibility of remotely delivered ILED and CLED programmes for people with T1D and overweight and obesity.Methods and analysisTwelve participants with T1D and body mass index ≥27.5 kg/m2(≥25 kg/m2in high-risk ethnic minorities) recruited from an National Health Service (NHS) trust and research register in England will be randomised to a remotely delivered CLED (n=6) or ILED (n=6) for 12 weeks. The CLED includes a daily Optifast 850 kcal (3556 kJ) 75 g carbohydrate formula diet. The ILED includes 2 days/week of Optifast and 5 days of a portion-controlled Mediterranean diet (170–250 g carbohydrate/day). Both groups will receive matched high-frequency remote support from a dietitian, nurse and psychologist via telephone and/or the Oviva app. The primary outcome will assess safety (occurrence of severe hypoglycaemia, ketonaemia, ketoacidosis and time above and below target blood glucose). Secondary outcomes include study uptake, retention, dietary adherence, acceptability, intervention delivery fidelity and potential efficacy in relation to change in weight, insulin requirements, glycated haemoglobin, lipids, insulin resistance (estimated glucose disposal rate) and quality of life. Participants will be invited for optional repeat measurements at 52 weeks.Ethics and disseminationThe trial protocol (V4.0/08.06.2022) was granted ethical approval by Cambridge East Research Ethics Committee (Ref: 21/EE/0014). The study will inform progression to a full-scale randomised controlled trial to test the efficacy of these programmes for patients with T1D and overweight and obesity.Trial registration numberNCT04674384; Pre-results.
Unequal access? Use of sickness absence benefits by precariously employed workers with common mental disorders: a register-based cohort study in Sweden
Authors: Hernando-Rodriguez Julio C , Matilla-Santander Nuria , Murley Chantelle , Blindow Katrina , Kvart Signild , Almroth Melody , Kreshpaj Bertina , Thern Emelie , Badarin Kathryn , Muntaner Carles , Gunn Virginia , Padrosa Eva , Julià Mireia , Bodin Theo 
Published: July 2023

ObjectiveThis study compares the use of sickness absence benefits (SABs) due to a common mental disorder (CMD) between precariously employed and non-precariously employed workers with CMDs.DesignRegister-based cohort study.ParticipantsThe study included 78 215 Swedish workers aged 27–61 who experienced CMDs in 2017, indicated by a new treatment with selective serotonin reuptake inhibitors (SSRIs). Excluded were those who emigrated or immigrated, were self-employed, had an annual employment-based income <100 Swedish Krona, had >90 days of unemployment per year, had student status, had SABs due to CMDs during the exposure measurement (2016) and the two previous years, had an SSRI prescription 1 year or less before the start of the SSRI prescription in 2017, had packs of >100 pills of SSRI medication, had a disability pension before 2017, were not entitled to SABs due to CMDs in 2016, and had no information about the exposure.OutcomeThe first incidence of SABs due to CMDs in 2017.ResultsThe use of SABs due to a CMD was slightly lower among precariously employed workers compared with those in standard employment (adjusted OR [aOR] 0.92, 95% CI 0.81 to 1.05). Particularly, women with three consecutive years in precarious employment had reduced SABs use (aOR 0.48, 95% CI 0.26 to 0.89), while men in precarious employment showed weaker evidence of association. Those in standard employment with high income also showed a lower use of SABs (aOR 0.74, 95% CI 0.67 to 0.81). Low unionisation and both low and high-income levels were associated with lower use of SABs, particularly among women.ConclusionsThe study indicates that workers with CMDs in precarious employment may use SABs to a lower extent. Accordingly, there is a need for (1) guaranteeing access to SABs for people in precarious employment and/or (2) reducing involuntary forms of presenteeism.
Adolescent childbirth and mobility disability among women ages 15–49: an analysis of population health surveys from 14 low-income and middle-income countries
Authors: Peck Katherine E , Bassani Diego G , Camara Saionara MA , Domingues Marlos R , Sentell Tetine , Velez Maria P , Pirkle Catherine M 
Published: July 2023

ObjectivesAdolescent childbirth is associated with older adult adverse health outcomes that negatively affect mobility function, but these associations have not been studied globally in large samples of reproductive-age women. This study examines the association between age at first childbirth and mobility disability in national surveys from low-income and middle-income countries, and hypotheses that adolescent childbirth is associated with mobility disability.DesignCross-sectional analysis.SettingPopulation health surveys from 2013 to 2018 containing mobility disability measures among ever-pregnant women ages 15–49. These included 13 Demographic Health Surveys from Haiti, Pakistan, Uganda, Cambodia, Colombia, South Africa, Timor-Leste, Albania, Gambia, Maldives, Peru, Senegal and Yemen and 1 Maternal Health Survey from Ghana.ParticipantsThe sample included 157 988 women ages 15–49 years.Primary outcome measureAdolescent childbirth was defined as 10–19 years of age. Poisson regression models were used to estimate prevalence ratios (PRs) of mobility disability among women who first gave birth during adolescence and in adult life (ages 20–45 years) in each country and across the whole sample. Countries were also analysed according to the use of standard and non-standard mobility disability measures. Covariates included current age, urban/rural residence, education and household wealth.ResultsPrevalence of adolescent childbirth (17.5%–66.2%) and mobility disability (0.32%–21.45%) varied widely across countries. Adolescent childbirth was significantly (p<0.05) associated with greater mobility disability in six of eight countries using standard disability measures. Among the six countries that did not use standard disability measures, none showed a statistically significant association between adolescent childbirth and mobility disability. Considering the whole sample and adjusting for all covariates, women who gave birth during adolescence had greater prevalence of mobility disability (pooled PR 1.19, 95% CI 1.06–1.31).ConclusionsThis analysis suggests a moderate and consistent association of adolescent childbearing with subsequent mobility disability.
Oral health surveys of Traditional Peoples and Communities in Brazil: a scoping review protocol
Authors: Raymundo Maria Letícia Barbosa , Araújo Elza Cristina Farias de , Silva Rênnis Oliveira da , Santiago Bianca Marques , Vieira Thiago Isidro , Sousa Simone Alves , Lucena Edson Hilan Gomes de , Cavalcanti Yuri Wanderley 
Published: July 2023

ObjectiveThe objective of this review protocol is to map the available evidence regarding all the oral health surveys of Traditional Peoples and Communities (TPCs) in Brazil.Methods and analysisThe review question of the protocol is: ‘What evidence is available on the oral health surveys of Traditional Peoples and Communities in Brazil?’. Observational studies that report oral health surveys of TPC in Brazil will be included. The protocol considered the Problem, Concept and Context strategy to guide data collection, as established by the Joanna Briggs Institute. The search strategy will consider Medical Subject Headings terms, synonyms and relevant free terms about epidemiological surveys in oral health and TPC in Brazil, with no limits to data, language, subject or search type, in the databases Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS), Scopus, Web of Science and Embase. Bibliographic searches will be updated until June 2023. The selection will be carried out by two independent, blinded reviewers, following the eligibility criteria, based on the title and abstract identified in the initial search. Potentially eligible studies will be fully read to confirm eligibility and collect relevant information. The categorisation of the studies will consider the author and year of publication, the traditional group studied, the study design, geographic location, age group, sample size, data collection method and the main oral health problem evaluated and its outcome. The data obtained and extracted will be presented in table format and text and presented using the visualisation of similarities method.Ethics and disseminationThe present study does not need ethical approval. The protocol title was registered in the Open Science Framework (DOI 10.17605/OSF.IO/BQ5J3). A final article will be prepared presenting the results of the scoping review, and will be submitted for publication in a peer-reviewed journal. The findings of this review will be presented at national conferences and scientific meetings.
TeleRehabilitation with Aims to Improve Lower extremity recovery in community-dwelling individuals who have had a stroke: protocol for a multisite, parallel group, assessor-blinded, randomised attention-controlled trial
Authors: Sakakibara Brodie M , Wiley Elise , Barclay Ruth , Bayley Mark , Davis Jennifer C , Eng Janice J , Harris Anne , Inness Elizabeth L , MacKay-Lyons Marilyn , Monaghan Jennifer , Pollock Courtney , Pooyania Sepideh , Schneeberg Amy , Teasell Robert , Yao Jennifer , Tang Ada 
Published: July 2023

IntroductionTelerehabilitation is an accessible service delivery model that may support innovative lower extremity rehabilitation programmes that extend the stroke recovery continuum into the community. Unfortunately, there is limited evidence on the provision of exercises for lower extremity recovery after stroke delivered using telerehabilitation. In response, we developed the TeleRehabilitation with Aims to Improve Lower extremity recovery poststroke (TRAIL) programme, a 4-week progressive exercise and self-management intervention delivered synchronously using video-conferencing technology. Our primary hypothesis is that individual within 1-year poststroke who participate in TRAIL will experience significantly greater improvements in functional mobility than individuals in an attention-controlled education programme (EDUCATION).Methods and analysisIn this multisite, parallel group, assessor-blinded randomised attention-controlled trial, 96 community-living stroke survivors within 1-year poststroke will be recruited from five sites (Vancouver, Winnipeg, Toronto, London and Halifax, Canada) from the CanStroke Recovery Trials Platform which is a network of Canadian hospital sites that are affiliated with academic institutions to facilitate participant recruitment and quality trial practices. Participants will be randomised on a 1:1 basis to TRAIL or EDUCATION. Participants randomised to TRAIL will receive eight telerehabilitation sessions where they will perform exercises and receive self-management support to improve lower extremity recovery from a TRAIL physical therapist. The primary outcome will be measured using the Timed Up and Go. Secondary outcomes include lower extremity muscle strength, functional balance, motor impairment, balance self-efficacy, health-related quality of life and health service use for our economic evaluation. Measurements will be taken at baseline, immediately after the intervention, 3-month and 6-month postintervention.Ethics and disseminationEthics approval for this research has been obtained by all participating sites. All study participants will provide their informed consent prior to enrolling them in the study. Findings from this trial will be disseminated in peer-reviewed journals and presentations at international scientific meetings.Trial registration numberClinicalTrials.gov,NCT04908241.
HPV42, a “Low-Risk” Type, and Digital Papillary Adenocarcinoma
Authors: Starrett Gabriel J. , Schiller John T. , Lowy Douglas R. 
Published: July 2023

Summary:
Chronic infection by several “high-risk” human papillomavirus (HPV) types has been causally implicated in several forms of anogenital and oropharyngeal cancers. Now, HPV42, which is usually classified as a “low-risk” type, can be listed as the main cause of digital papillary adenocarcinoma, an uncommon malignant tumor of the fingers and toes.
See related article by Leiendecker et al., p. 70 (3).
Identification of the susceptible genes and mechanism underlying the comorbid presence of coronary artery disease and rheumatoid arthritis: a network modularization analysis
Authors: Zhang Siqi , Niu Qikai , Tong Lin , Liu Sihong , Wang Pengqian , Xu Haiyu , Li Bing , Zhang Huamin 
Published: July 2023

Abstract
Objective
The comorbidities of coronary artery disease (CAD) and rheumatoid arthritis (RA) are mutual risk factors, which lead to higher mortality, but the biological mechanisms connecting the two remain unclear. Here, we aimed to identify the risk genes for the comorbid presence of these two complex diseases using a network modularization approach, to offer insights into clinical therapy and drug development for these diseases.

Method
The expression profile data of patients CAD with and without RA were obtained from the GEO database (GSE110008). Based on the differentially expressed genes (DEGs), weighted gene co-expression network analysis (WGCNA) was used to construct a gene network, detect co-expression modules, and explore their relation to clinical traits. The Zsummary index, gene significance (GS), and module membership (MM) were utilized to screen the important differentiated modules and hub genes. The GO and KEGG pathway enrichment analysis were applied to analyze potential mechanisms.

Result
Based on the 278 DEGs obtained, 41 modules were identified, of which 17 and 24 modules were positively and negatively correlated with the comorbid occurrence of CAD and RA (CAD&RA), respectively. Thirteen modules with Zsummary < 2 were found to be the underlying modules, which may be related to CAD&RA. With GS ≥ 0.5 and MM ≥ 0.8, 49 hub genes were identified, such as ADO, ABCA11P, POT1, ZNF141, GPATCH8, ATF6 and MIA3, etc. The area under the curve values of the representative seven hub genes under the three models (LR, KNN, SVM) were greater than 0.88. Enrichment analysis revealed that the biological functions of the targeted modules were mainly involved in cAMP-dependent protein kinase activity, demethylase activity, regulation of calcium ion import, positive regulation of tyrosine, phosphorylation of STAT protein, and tissue migration, etc.

Conclusion
Thirteen characteristic modules and 49 susceptibility hub genes were identified, and their corresponding molecular functions may reflect the underlying mechanism of CAD&RA, hence providing insights into the development of clinical therapies against these diseases.
‘Drive the doctor’ for endovascular thrombectomy in a rural area: a simulation study
Authors: Maas Willemijn J. , van der Zee Durk-Jouke , Lahr Maarten M.H. , Bouma Marc , Buskens Erik , Uyttenboogaart Maarten 
Published: July 2023

Abstract
Background
Patients who present in a primary stroke center (PSC) with ischemic stroke are usually transferred to a comprehensive stroke center (CSC) in case of a large vessel occlusion (LVO) for endovascular thrombectomy (EVT) treatment, the so-called ‘drip-and-ship’ (DS) model. The ‘drive-the-doctor’ (DD) model modifies the DS model by allowing mobile interventionalists (MIs) to transfer to an upgraded PSC acting as a thrombectomy capable stroke center (TSC), instead of transferring patients to a CSC. Using simulation we estimated time savings and impact on clinical outcome of DD in a rural region.

Methods
Data from EVT patients in northern Netherlands was prospectively collected in the MR CLEAN Registry between July 2014 - November 2017. A Monte Carlo simulation model of DS patients served as baseline model. Scenarios included regional spread of TSCs, pre-hospital patient routing to ‘the nearest PSC’ or ‘nearest TSC’, MI’s notification after LVO confirmation or earlier prehospital, and MI’s transport modalities. Primary outcomes are onset to groin puncture (OTG) and predicted probability of favorable outcome (PPFO) (mRS 0–2).

Results
Combining all scenarios OTG would be reduced by 28–58 min and PPFO would be increased by 3.4-7.1%. Best performing and acceptable scenario was a combination of 3 TSCs, prehospital patient routing based on the RACE scale, MI notification after LVO confirmation and MI’s transfer by ambulance. OTG would reduce by 48 min and PPFO would increase by 5.9%.

Conclusions
A DD model is a feasible scenario to optimize acute stroke services for EVT eligible patients in rural regions. Key design decisions in implementing the DD model for a specific region are regional spread of TSCs, patient routing strategy, and MI’s notification moment and transport modality.