bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Immersive Virtual Reality to Enhance Social Interaction Among Older Adults: A Cross-Site Investigation
Authors: Kalantari Saleh , Xu Tong Bill , Mostafavi Armin , Kim Benjamin , Dilanchian Andrew , Lee Angella , Boot Walter R , Czaja Sara J 
Published: April 2023

Abstract

Background and Objectives
Virtual reality (VR) applications are increasingly being targeted toward older adults as a means to maintain physical and cognitive skills and to connect with others, especially during the coronavirus disease 2019 era. Our knowledge about how older adults interact with VR is limited, however, since this is an emerging area and the related research literature is still rather slim. The current study focused specifically on older adults’ reactions to a social-VR environment, examining participant’s views about the possibility of meaningful interactions in this format, the impacts of social-VR immersion on mood and attitude, and features of the VR environment that affected these outcomes.

Research Design and Methods
The researchers designed a novel social-VR environment with features intended to prompt conversation and collaborative problem-solving among older adults. Participants were recruited from 3 diverse geographic locations (Tallahassee, FL; Ithaca, NY; and New York City, NY), and were randomly assigned to a partner from one of the other sites for social-VR interaction. The sample consisted of 36 individuals aged 60 and older.

Results
Reactions to the social VR were quite positive. Older adults reported high levels of engagement in the environment and perceived the social VR to be enjoyable and usable. Perceived spatial presence was found to be a central driver of positive outcomes. A majority of the participants indicated a willingness to reconnect with their VR partner in the future. The data also identified important areas for improvement that were of concern to older adults, such as the use of more realistic avatars, larger controllers more suited to aging hands, and more time for training/familiarization.

Discussion and Implications
Overall, these findings suggest that VR can be an effective format for social engagement among older adults.
441 Understanding the unintended consequences of new healthcare technologies aimed at supporting patient safety: a qualitative study
Authors: Abdelaziz S , Garfield S , McLeod M , Norton J , Lloyd J , Wheeler C , Neves A L , van Dael J , Franklin B D 
Published: April 2023

Abstract

Introduction
Technologies such as electronic prescribing, clinical decision support systems, and electronic medication dispensers, are increasingly being introduced into healthcare. Existing toolkits focus on the implementation of such technologies, rather than identifying and mitigating any unintended consequences technologies may have on patient safety. They also focus on high-level organisational issues instead of those faced by end-users: frontline staff, patients and carers.

Aim
To identify and classify types of unintended consequences that may be encountered by technologies’ end-users, in order to inform development of a tool for identifying and preventing technology-related risks on patient safety.

Methods
Five focus group discussions with healthcare professionals, patients and carers were conducted through video-conferencing. Healthcare professionals with experience of using/implementing healthcare technologies and known to the research team via professional networks were invited to participate. Patient/carer participants were recruited using convenience sampling via an external research-participant organisation. Participants were asked to identify patient safety risks associated with the use of healthcare technologies, drawn from their own experiences and through consideration of hypothetical risks. Discussions were audio-recorded and transcribed verbatim. Transcripts were analysed by two researchers (NVivo R1.6) and two public partners (manually), using iterative inductive thematic analysis.

Results
Eleven healthcare professionals and 29 patients and carers participated in focus groups. Three focus groups comprised patients, carers, and healthcare professionals. Two involved solely patients and carers. Analysis revealed five areas of unintended consequences (Table 1). Most unintended consequences identified by patients and carers were similar to those described by healthcare professionals. Healthcare professionals also described additional unintended consequences associated with technologies designed specifically for their use.

Conclusion
A limitation of the study is that many of the unintended consequences identified related to virtual health technologies used during the COVID-19 pandemic, which may affect generalisability. A strength is that unintended consequences that have been overlooked in existing literature, such as the build-up of patients’ psychological dependence on technologies, were identified. Developing a tool based on these will allow implementers and users of healthcare technologies to consider such issues and address the potential risks they may have on patient safety before healthcare technologies are fully implemented in practice.
A pressure-robust HHO method for the solution of the incompressible Navier–Stokes equations on general meshes
Authors: Castanon Quiroz Daniel , Di Pietro Daniele A 
Published: April 2023

Abstract
In a recent work (Castanon Quiroz & Di Pietro (2020) A hybrid high-order method for the incompressible Navier–Stokes problem robust for large irrotational body forces. Comput. Math. Appl., 79, 2655–2677), we have introduced a pressure-robust hybrid high-order method for the numerical solution of the incompressible Navier–Stokes equations on matching simplicial meshes. Pressure-robust methods are characterized by error estimates for the velocity that are fully independent of the pressure. A crucial question was left open in that work, namely whether the proposed construction could be extended to general polytopal meshes. In this paper, we provide a positive answer to this question. Specifically, we introduce a novel divergence-preserving velocity reconstruction that hinges on the solution inside each element of a mixed problem on a subtriangulation, then use it to design discretizations of the body force and convective terms that lead to pressure robustness. An in-depth theoretical study of the properties of this velocity reconstruction, and their reverberation on the scheme, is carried out for arbitrary polynomial degrees $k\geq 0$ and meshes composed of general polytopes. The theoretical convergence estimates and the pressure robustness of the method are confirmed by an extensive panel of numerical examples.
Burnout Among Breast Radiologists: How Can We Restore Fulfillment?
Authors: Dwan Dennis , Dialani Vandana 
Published: April 2023

Abstract
Physician burnout is increasing in prevalence and has negative implications for the quality of patient care and the health and wellbeing of physicians. Surveys before the COVID-19 pandemic showed high rates of burnout among breast radiologists, and the COVID-19 pandemic has further increased stress. This article summarizes strategies to combat burnout, including improving individual resilience by increasing mindfulness about handling stress, making goals, and noting personal accomplishments. However, more effective change is likely to occur when there is change at both a personal and an organizational level, which includes identifying the stakeholders in a workplace and determining what changes must occur to increase joy and decrease rates of burnout. Despite the increasing rates of burnout, breast radiologists report high rates of personal career satisfaction. Self-reflection and positive steps to increase joy at work are important in maintaining career fulfillment in these challenging times.
Diversity and dynamics of endosymbionts in a single population of sweet potato weevil,Cylas formicarius(Coleoptera: Brentidae): a preliminary study
Authors: Xu Jin , Tan Jian-Bin , Li Yi-Dan , Xu Yuan-Hao , Tang An , Zhou Hong-Kai , Shi Pei-Qiong 
Published: April 2023

AbstractEndosymbionts live symbiotically with insect hosts and play important roles in the evolution, growth, development, reproduction, and environmental fitness of hosts. Weevils are one of the most abundant insect groups that can be infected by various endosymbionts, such as Sodalis, Nardonella, and Wolbachia. The sweet potato weevil, Cylas formicarius (Coleoptera: Brentidae), is a notorious pest in sweet potato (Ipomoea batatas L.) cultivation. Currently, little is known about the presence of endosymbionts in C. formicarius. Herein, we assessed the endosymbiont load of a single geographic population of C. formicarius. The results showed that Nardonella and Rickettsia could infect C. formicarius at different rates, which also varied according to the developmental stages of C. formicarius. The relative titer of Nardonella was significantly related to C. formicarius developmental stages. The Nardonella-infecting sweet potato weevils were most closely related to the Nardonella in Sphenophorus levis (Coleoptera, Curculionidae). The Rickettsia be identified in bellii group. These results preliminarily revealed the endosymbionts in C. formicarius and helped to explore the diversity of endosymbionts in weevils and uncover the physiological roles of endosymbionts in weevils.
Lessons from Canada’s notice of compliance with conditions policy for the life-cycle regulation of drugs
Authors: McPhail Melanie , Zhang Howard , Bhimani Zohra , Bubela Tania 
Published: April 2023

Abstract
Innovative health technologies are not well regulated under current pathways, leading regulators to adopt contextual, life-cycle regulatory models, which authorize drugs based on earlier clinical evidence subject to the conduct of post-market trials that confirm clinical benefit and safety. In this paper, we evaluate all drugs authorized in Canada under the Notice of Compliance with conditions (NOC/c) policy from 1998 to 2021 to analyze its function, identify challenges and areas for improvement, and make recommendations to inform Health Canada’s regulatory reforms. We analyzed a sample of 148 drugs authorized between 1998 and 2021, including characteristics about the pre- and post-market clinical trials, finding that most NOC/c authorizations are based on one, single-arm clinical trial using a surrogate endpoint. Post-market trials are more likely to be randomized, Phase III trials but mostly use surrogate endpoints. Based on our findings, we recommend increasing decision-making transparency throughout the regulatory process, developing comprehensive eligibility criteria for selecting appropriate health technologies, modernizing pre-market evidence requirements, adopting a more active role in designing post-market trials, and utilizing automatic expiry, stronger penalties, and ongoing disclosure of the status of post-market trials to promote compliance.
Effectiveness of Booster Doses of Monovalent mRNA COVID-19 Vaccine Against Symptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children, Adolescents, and Adults During Omicron Subvariant BA.2/BA.2.12.1 and BA.4/BA.5 Predominant Periods
Authors: Ciesla Allison Avrich , Wiegand Ryan E , Smith Zachary R , Britton Amadea , Fleming-Dutra Katherine E , Miller Joseph , Accorsi Emma K , Verani Jennifer R , Shang Nong , Derado Gordana , Pilishvili Tamara , Link-Gelles Ruth 
Published: April 2023

Abstract

Background
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) BA.2/BA.2.12.1 and BA.4/BA.5 subvariants have mutations associated with increased capacity to evade immunity when compared with prior variants. We evaluated mRNA monovalent booster dose effectiveness among persons ≥5 years old during BA.2/BA.2.12.1 and BA.4/BA.5 predominance.

Methods
A test-negative, case-control analysis included data from 12 148 pharmacy SARS-CoV-2 testing sites nationwide for persons aged ≥5 years with ≥1 coronavirus disease-2019 (COVID-19)-like symptoms and a SARS-CoV-2 nucleic acid amplification test from April 2 to August 31, 2022. Relative vaccine effectiveness (rVE) was estimated comparing 3 doses of COVID-19 mRNA monovalent vaccine to 2 doses; for tests among persons ≥50 years, rVE estimates also compared 4 doses to 3 doses (≥4 months since third dose).

Results
A total of 760 986 test-positive cases and 817 876 test-negative controls were included. Among individuals ≥12 years, rVE of 3 versus 2 doses ranged by age group from 45% to 74% at 1-month post vaccination and waned to 0% by 5–7 months post vaccination during the BA.4/BA.5 period.
Adults aged ≥50 years (fourth dose eligible) who received 4 doses were less likely to have symptomatic SARS-CoV-2 infection compared with those with 3 doses; this rVE remained &gt;0% through at least 3 months since last dose. For those aged ≥65 years, rVE of 4 versus 3 doses 1-month post vaccination was higher during BA.2/BA.2.12.1 (rVE = 49%; 95% confidence interval [CI], 43%–53%) than BA.4/BA.5 (rVE = 40%; 95% CI, 36%–44%). In 50- to 64-year-olds, rVE estimates were similar.

Conclusions
Monovalent mRNA booster doses provided additional protection against symptomatic SARS-CoV-2 infection during BA.2/BA.2.12.1 and BA.4/BA.5 subvariant circulation, but protection waned over time.
Cis mutagenesis in vivo reveals extensive noncanonical functions of Dscam1 isoforms in neuronal wiring
Authors: Zhang Shixin , Yang Xi , Dong Haiyang , Xu Bingbing , Wu Lili , Zhang Jian , Li Guo , Guo Pengjuan , Li Lei , Fu Ying , Du Yiwen , Zhu Yanda , Shi Jilong , Shi Feng , Huang Jianhua , He Haihuai , Jin Yongfeng 
Published: April 2023

Abstract
Drosophila Down syndrome cell adhesion molecule 1 (Dscam1) encodes tens of thousands of cell recognition molecules via alternative splicing, which are required for neural function. A canonical self-avoidance model seems to provide a central mechanistic basis for Dscam1 functions in neuronal wiring. Here, we reveal extensive noncanonical functions of Dscam1 isoforms in neuronal wiring. We generated a series of allelic cis mutations in Dscam1, encoding a normal number of isoforms, but with an altered isoform composition. Despite normal dendritic self-avoidance and self-/nonself-discrimination in dendritic arborization (da) neurons, which is consistent with the canonical self-avoidance model, these mutants exhibited strikingly distinct spectra of phenotypic defects in the three types of neurons: up to ∼60% defects in mushroom bodies, a significant increase in branching and growth in da neurons, and mild axonal branching defects in mechanosensory neurons. Remarkably, the altered isoform composition resulted in increased dendrite growth yet inhibited axon growth. Moreover, reducing Dscam1 dosage exacerbated axonal defects in mushroom bodies and mechanosensory neurons but reverted dendritic branching and growth defects in da neurons. This splicing-tuned regulation strategy suggests that axon and dendrite growth in diverse neurons cell-autonomously require Dscam1 isoform composition. These findings provide important insights into the functions of Dscam1 isoforms in neuronal wiring.
Is symptom duration before DMARD therapy a determinant of direct and indirect costs in DMARD-naïve RA patients? A systematic review
Authors: Sahbudin Ilfita , Singh Ruchir , Trickey Jeanette , Baranskaya Aliaksandra , Tracy Alexander , Raza Karim , Filer Andrew , Jowett Sue , Boonen Annelies 
Published: April 2023

AbstractObjectiveEarly treatment of RA improves clinical outcomes; however, the impact on health economic outcomes is unclear. This review sought to investigate the relationship between symptom/disease duration and resource utilization/costs and the responsiveness of costs following RA diagnosis.MethodsA systematic search was performed on Pubmed, EMBASE, CINAHL and Medline. Studies were eligible if patients were DMARD-naïve and fulfilled 1987 ACR or 2010 ACR/EULAR RA classification criteria. Studies had to report symptom/disease duration and resource utilization or direct/indirect costs as health economic outcomes. The relationships between symptom/disease duration and costs were explored.ResultsThree hundred and fifty-seven records were identified in a systematic search; nine were eligible for analysis. The mean/median of symptom/disease duration in studies ranged between 25 days and 6 years. Annual direct costs of RA following diagnosis showed a U-shaped distribution in two studies. Longer symptom duration before starting a DMARD (&gt;180 days) was associated with lower health-care utilization in the first year of RA diagnosis in one study. Annual direct and indirect costs 6 months before RA diagnosis were higher in patients with shorter symptom duration (&lt;6 months) in one study. Given the clinical and methodological heterogeneities, the association between symptom/disease duration and costs after diagnosis was not computed.ConclusionThe association between symptom/disease duration at the time of DMARD initiation and resource utilization/cost in patients with RA remains unclear. Health economic modelling with clearly defined symptom duration, resource utilization and long-term productivity is vital to address this evidence gap.
Sodium oxybate in treatment-resistant rapid-eye-movement sleep behavior disorder
Authors: During Emmanuel H , Hernandez Beatriz , Miglis Mitchell G , Sum-Ping Oliver , Hekmat Anahid , Cahuas Ana , Ekelmans Adrian , Yoshino Fuyumi , Mignot Emmanuel , Kushida Clete A 
Published: April 2023

AbstractStudy ObjectivesSymptomatic therapies for rapid-eye-movement (REM) sleep behavior disorder (RBD) are limited. Sodium oxybate (SXB), a gamma-aminobutyric acid (GABA)-B agonist, could be effective but has not been evaluated against placebo.MethodsThis double-blind, parallel-group, randomized, placebo-controlled trial in 24 participants was conducted at the Stanford Sleep Center. Patients were adults with definite iRBD or Parkinson’s disease and probable RBD (PD-RBD), and persistence of ≥ 2 weekly episodes despite standard therapy. Patients were randomized 1:1 to receive SXB during a 4-week titration followed by a 4-week stable dosing period. Primary outcome was number of monthly RBD episodes according to a diary filled by patients and partners. Secondary outcomes were severity, number of severe RBD episodes, and objective RBD activity on video polysomnography.ResultsTwelve iRBD and 12 PD-RBD participated (mean 65.8 years), and 22 (n = 10 SXB, 12 placebo) completed the study. Although no significant between-group difference was found, SXB showed reduction of monthly RBD episodes by 23.1 (95% CI −36.0, −10.2; p = 0.001) versus 10.5 with placebo (95% CI, −22.6, 1.6; p = 0.087). Improvement from baseline was similarly observed for RBD overall severity burden (each episode weighted for severity), number of severe episodes, and objective RBD activity per video-polysomnography. Two participants receiving SXB withdrew due to anxiety and dizziness. The majority of adverse events are otherwise resolved with dose adjustment.ConclusionSXB could reduce RBD symptoms; however, response was inconsistent and a large placebo effect was observed across patient-reported outcomes. Larger studies using objective endpoints are needed.Clinical TrialTreatment of REM Sleep Behavior Disorder (RBD) With Sodium Oxybatehttps://clinicaltrials.gov/ct2/show/NCT04006925 ClinicalTrials.gov identifier: NCT04006925
The pandemic, telemedicine, and andrology: what have we learned?
Authors: Moukhtar Hammad Muhammed A , El-Achkar Adnan , Nguyen Tuan , Barham David W , Tran Joshua , Jenkins Lawrence , Yafi Faysal A 
Published: April 2023

Abstract

Background
Telemedicine gained wide acceptance during the COVID-19 pandemic, as it was deemed critical for patient care when lockdowns were implemented worldwide. While there is evidence to suggest that urology patients were receptive to telemedicine, no systematic review has been done to date on andrology patients and their perception of telemedicine.

Methods
Three electronic databases, PubMed, Scopus, and Web of Science, were searched from their inception until June 2022 for relevant articles. Two independent teams reviewed abstracts and extracted data from the selected manuscripts. A meta-analysis was completed in line with PRISMA 2020 and AMSTAR Guidelines. For our study, we limited telemedicine to communication through videoconferencing or telephone encounters between patients and medical professionals. Positive response to telemedicine was defined as patients “wishing for telemedicine consultation”, “preferring telemedicine over in person”, “accepting the current telemedicine arrangement”, “having needs addressed with teleconsultation”, or “willingness to do a teleconsultation”.

Results
Of the 1128 retrieved abstracts, 56 underwent full-text review and 12 were included in the final analysis, comprising a total cohort of &gt;4021 cases. Video visits were evaluated in 5 studies, telephone encounters were analyzed in 2 studies, and both methods were examined in 1 randomized control study. Three studies showed that andrology and sexual medicine are compatible with telemedicine, with few 30- and 90-day in-person revisit rates. Telemedicine was shown to save an average cost of US$149-$252 per patient, and 8 studies that directly assessed andrology patient perceptions of telemedicine showed that most patients had a “positive perception.”
Pooled analyses of the positive responses to telemedicine were 68.7% (95% CI, 49.4%-83.1%, P = 0.057), and those of patients who recommended telemedicine were 65.1% (95% CI, 18.4%-93.9%, P = 0.577). While the percentage of patients recommending telemedicine was high among studies using videoconferencing, the percentage dropped in studies using telephone visits only. The difference between recommending video and telephone practices was statistically significant, with 84.6% pooled proportion for recommending video practice compared to 38.9% pooled proportion for recommending telephone practice, P = 0.035. In the telephone-only encounters, up to 27.1% of patients preferred in-person visits, as security and privacy of any mode of telecommunication were of concern.

Conclusions
Most patients have a positive perception of telemedicine, particularly with videoconferencing and less so with telephone visits. These results suggest that telemedicine will likely continue to play a pivotal role in andrology and sexual medicine practices.
The role of Gel‐Ppy‐modified nerve conduit on the repair of sciatic nerve defect in rat model
Authors: Jiang Liangfu , Ouyang Xingyu , Zhang Dupiao , Wang Gang , Zhang Zhe , Wang Wei , Yan Hede 
Published: April 2023

AbstractThe serious clinical challenge of peripheral nerve injury (PNI) is nerve regeneration. Nerve conduit represents a promising strategy to contribute to nerve regeneration by bridging injured nerve gaps. However, due to a unique microenvironment of nerve tissue, autologous nerves have not been substituted by nerve conduit. Nerve regeneration after nerve conduit implantation depends on many factors, such as conductivity and biocompatibility. Therefore, Gelatin (Gel) with biocompatibility and polypyrrole (Ppy) with conductivity is highly concerned. In this paper, Gel‐Ppy modified nerve conduit was fabricated with great biocompatibility and conductivity to evaluate its properties of enhancing nerve regeneration in vivo and in vitro. The proliferation of Schwann cells on Gel‐Ppy modified nerve conduit was remarkably increased. Consistent with in vitro results, the Gel‐Ppy nerve conduit could contribute to the regeneration of Schwann cell in vivo. The axon diameters and myelin sheath thickness were also enhanced, resulting in the amelioration of muscle atrophy, nerve conduction, and motor function recovery. To explain this interesting phenomenon, western blot results indicated that the Gel‐Ppy conduit facilitated nerve regeneration via upregulating the Rap1 pathway to induce neurite outgrowth. Therefore, the above results demonstrated that Gel‐Ppy modified nerve conduit could provide an acceptable microenvironment for nerve regeneration and be popularized as a novel therapeutic strategy of PNI.