bluuebunny/crossref_metadata_2025_split huggingface dataset:
CT validation of intraoperative imageless navigation (Naviswiss) for component positioning accuracy in primary total hip arthroplasty in supine patient position: A prospective observational cohort study in a single-surgeon practice
Authors: Scholes Corey , Schwagli Tobias , Ireland John 
Published: July 2023

AbstractThe aim of this study was to report on the validity of the Naviswiss handheld image-free navigation device for accurate measurement of THA component positioning intraoperatively, in comparison with the three-dimensional (3D) reconstruction of computed tomography (CT) images as gold standard.MethodsA series of patients presenting to a single-surgeon clinic with end-stage hip osteoarthritis received primary hip arthroplasty with anterolateral muscle-sparing surgical approach in the supine position. Imageless navigation was applied during the procedure with bone-mounted trackers applied to the greater trochanter and ASIS. Patients underwent routine CT scans before and after surgery and these were analysed using three-dimensional reconstruction to generate cup orientation, offset and leg length changes which were compared to the intraoperative measurements provided by the navigation system. Estimates of agreement between the intraoperative and image-derived measurements were assessed with and without correction for bias and declared cases with potential measurement issues.ResultsThe mean difference between intraoperative and postoperative CT measurements was within 2° for angular measurements and 2mm for leg length. Absolute differences for the two indices were within 5° and 4mm. Mean bias was 1.9 - 3.6° underestimation for cup orientation and up to 2mm overestimation for leg length change, but absolute thresholds of 10° and 10mm were not exceeded by 95% limits of agreement (LOA), especially after correction for bias. Four cases (12%) were declared intraoperatively for issues with fixation on the greater trochanter. Inclusion of these cases generated acceptable accuracy overall and their omission failed to improve between-case variability in accuracy or LOA for both offset and leg length.ConclusionsThe accuracy of the Naviswiss system applied during primary THA in supine patient position and anterolateral surgical approach falls within clinically acceptable recommendations for acetabular cup placement, femoral offset and length length. With refinements to surgical technique to adapt to the navigation hardware, the system could be further improved with regression-based bias correction.
The effect of combining antibiotics on resistance: A systematic review and meta-analysis
Authors: Siedentop Berit , Kachalov Viacheslav N. , Witzany Christopher , Egger Matthias , Kouyos Roger D. , Bonhoeffer Sebastian 
Published: July 2023

AbstractWhen and under which conditions antibiotic combination therapy decelerates rather than accelerates resistance evolution is not well understood. We examined the effect of combining antibiotics on within-patient resistance development across various bacterial pathogens and antibiotics.We searched CENTRAL, EMBASE and PubMed for (quasi)-randomised controlled trials (RCTs) published from database inception to November 24th, 2022. Trials comparing antibiotic treatments with different numbers of antibiotics were included. A patient was considered to have acquired resistance if, at the follow-up culture, a resistant bacterium (as defined by the study authors) was detected that had not been present in the baseline culture. We combined results using a random effects model and performed meta-regression and stratified analyses. The trials’ risk of bias was assessed with the Cochrane tool.42 trials were eligible and 29, including 5054 patients, were qualified for statistical analysis. In most trials, resistance development was not the primary outcome and studies lacked power. The combined odds ratio (OR) for the acquisition of resistance comparing the group with the higher number of antibiotics with the comparison group was 1.23 (95% CI 0.68-2.25), with substantial between-study heterogeneity (I2=77%). We identified tentative evidence for potential beneficial or detrimental effects of antibiotic combination therapy for specific pathogens or medical conditions.The evidence for combining a higher number of antibiotics compared to fewer from RCTs is scarce and overall, is compatible with both benefit or harm. Trials powered to detect differences in resistance development or well-designed observational studies are required to clarify the impact of combination therapy on resistance.
Automatic Detection and Assessment of Freezing of Gait Manifestations
Authors: Yang Po-Kai , Filtjens Benjamin , Ginis Pieter , Goris Maaike , Nieuwboer Alice , Gilat Moran , Slaets Peter , Vanrumste Bart 
Published: July 2023

AbstractFreezing of gait (FOG) is an episodic and highly disabling symptom of Parkinson’s disease (PD). Although described as a single phenomenon, FOG is not univocal and can express as different manifestations, such as trembling in place or complete akinesia. We aimed to analyze the utility of deep learning trained on inertial measurement unit data to classify FOG into both manifestations. We developed a temporal convolutional neural network, which we compared to three state-of-the-art FOG detection algorithms that were adapted to the FOG manifestation detection task. Next, we investigated its performance in distinguishing between the two manifestations and other forms of movement cessation (e.g., volitional stopping and sitting) based on gold-standard video annotations. Experiments were conducted on a dataset of twelve PD patients with FOG that completed a FOG-provoking protocol, including the timed-up-and-go and 360-degree turning-in-place tasks during ON and OFF anti-Parkinsonian medication. The results showed that our model enables accurate detection of FOG manifestations with an 11.43% higher F1 score than the second-best model. Assessment of FOG manifestation severity was moderately strong for trembling in place (Intra-class Correlation Coefficient (ICC)=0.64, [0.16,0.88]) and strong for complete akinesia (ICC=0.87, [0.63,0.96]). Remarkably, our results show that complete akinesia can be distinguished from volitional stopping. In conclusion, we established that FOG manifestations could be accurately detected and assessed with deep learning. Future work should establish whether these results hold firm for a more extensive and varied verification cohort.
CSF proteome profiling reveals highly specific biomarkers for dementia with Lewy bodies
Authors: del Campo Marta , Vermunt Lisa , Peeters Carel FW , Hok-A-Hin Yanaika S. , Lleó Alberto , Alcolea Daniel , van Nee Mirrelijn , Engelborghs Sebastiaan , Sieben Anne , Chen-Plotkin Alice , Irwin David J , van der Flier Wiesje M , Lemstra Afina W , Teunissen Charlotte E 
Published: July 2023

ABSTRACTDiagnosis of dementia with Lewy bodies (DLB) is challenging and biofluid biomarkers specific for DLB are highly needed. Here we use proximity extension-based multiplex assays to establish the specific cerebrospinal fluid (CSF) proteomic changes that underlie DLB in an unprecedented well-characterized cohort of 109 DLB patients, 235 patients with Alzheimeŕs disease (AD) and 190 controls. We identified more than 50 CSF proteins dysregulated in DLB, which were especially related to myelination processes. An enzyme involved in dopamine biosynthesis (L-amino acid decarboxylase, DDC) was the strongest dysregulated protein in DLB (>1.5 fold-change vs.CON or AD; q<1E-16) and could discriminate DLB from controls and AD patients with high accuracy (AUC: 0.91 and 0.81 respectively). We modelled a CSF protein panel containing only seven of these markers, which discriminate DLB from AD with higher performance (AUC: 0.93, 95%CI: 0.86-0.98). We developed custom multiplex assays for six of these markers (DDC, CRH, MMP-3, ABL1, MMP-10 and THOP1); and validated their performance in independent cohorts (n=329; AUCs: 0.68-0.90), including an autopsy cohort (n=76; AUCs: 0.90-0.95). This extensive and unique DLB CSF proteome study depicts specific protein changes underlying DLB pathophysiology. It translates these findings into a custom CSF biomarker panel able to identify DLB patients with high accuracy in different independent cohorts, providing new testing opportunities for diagnostic settings and clinical trials.
Same-day versus rapid ART initiation in HIV-positive individuals presenting with symptoms of tuberculosis: protocol for an open-label randomized non-inferiority trial in Lesotho and Malawi
Authors: Gerber Felix , Semphere Robina , Lukau Blaise , Mahlatsi Palesa , Mtenga Timeo , Lee Tristan , Kohler Maurus , Glass Tracy R. , Amstutz Alain , Molatelle Mamello , MacPherson Peter , Marake Nthuseng Bridgett , Nliwasa Marriot , Ayakaka Irene , Burke Rachael , Labhardt Niklaus 
Published: July 2023

AbstractBackgroundIn absence of contraindications, same-day initiation (SDI) of antiretroviral therapy (ART) is recommended for people testing HIV-positive who are ready to start treatment. Until 2021, World Health Organization (WHO) guidelines considered the presence of TB symptoms (presumptive TB) a contraindication to SDI due to the risk of TB-immune reconstitution inflammatory syndrome (TB-IRIS). To reduce TB-IRIS risk, ART initiation was recommended to be postponed until results of TB investigations were available, and TB treatment initiated if active TB was confirmed. In 2021, the WHO guidelines changed to recommending SDI even in the presence of TB symptoms without awaiting results of TB investigations based on the assumption that TB investigations often unnecessarily delay ART initiation, increasing the risk for pre-ART attrition from care, and noting that the clinical relevance of TB- IRIS outside the central nervous system remains unclear. However, this guideline change was not based on conclusive evidence, and it remains unclear whether SDI of ART or TB test results should be prioritized in people with HIV (PWH) and presumptive TB.Design and methodsSaDAPT is an open-label, pragmatic, parallel, 1:1 individually randomized, non-inferiority trial comparing two strategies for the timing of ART initiation in PWH with presumptive TB (“ART first” versus “TB results first”). PWH in Lesotho and Malawi, aged 12 years and older (re)initiating ART who have at least one TB symptom (cough, fever, night sweats or weight loss) and no signs of intracranial infection are eligible. After a baseline assessment, participants in the “ART first” arm will be offered SDI of ART, while those in the “TB results first” arm will be offered ART only after active TB has been confirmed or refuted. We hypothesize that the “ART first” approach is safe and non-inferior to the “TB results first” approach with regard to HIV viral suppression (<400 copies/ml) six months after enrolment. Secondary outcomes include retention in care and adverse events consistent with TB-IRIS.Expected outcomesSaDAPT will provide evidence on the safety and effects of SDI of ART in PWH with presumptive TB in a pragmatic clinical trial setting.Trial registrationThe trial has been registered onclinicaltrials.gov(NCT05452616; July 11 2022).
Implications ofDobbs v.Jackson for patients and providers: a scoping review
Authors: Zhu David T. , Zhao Lucy , Alzoubi Tala , Shenin Novera , Baskaran Teerkasha , Tikhonov Julia , Wang Catherine 
Published: July 2023

AbstractIntroductionOn June 24, 2022, the U.S. Supreme Court’s decision inDobbs v. Jacksonoverturned the right to abortion set forth byRoe v. Wade, granting states the authority to regulate access to abortion services. This has led to widespread bans, threatening patients’ access to, and healthcare providers’ abilities to provide, the full spectrum of reproductive health services. The ruling disproportionately affects marginalized groups, exacerbating existing social disparities in health and is an emerging public health crisis.MethodsWe conducted a scoping review to evaluate the impact ofDobbson patients’ health outcomes and access to health services, as well as on medical trainees’ and healthcare providers’ ability to access abortion training and provide reproductive health services. The search was based on the PRISMA Extension for Scoping Reviews (PRSIMA-ScR) guidelines. We searched eight bibliographic databases (PubMed, Scopus, Embase, PsycINFO, Google Scholar, Science Direct, JSTOR, and Web of Science) and three preprint servers (medRxiv, bioRxiv, and Europe PMC) using various combinations of keywords related to ‘abortion’ and ‘Dobbs v. Jackson’ on March 22, 2023. Four reviewers independently screened the studies based on pre-specified eligibility criteria and one reviewer performed data extraction for pre-identified themes.ResultsA total of 18 studies met the inclusion criteria. We found thatDobbsled to a surge in demand for contraception, compounded existing travel- and cost-related barriers to access, increased polarizing views on social media (e.g., Twitter), and evoked significant fears and concerns among medical trainees regarding their scope of practice and fears of legal repercussions for offering standard-of-care and related services to patients seeking abortions.ConclusionOur study offers valuable insights into the clinical implications ofDobbson patients’ health outcomes and access to health services, as well as providers’ reproductive health practices.
A Preliminary Investigation Of Repetitive Transcranial Magnetic Stimulation Applied To The Left Dorsolateral Prefrontal Cortex In Treatment Seeking Participants With Cannabis Use Disorder
Authors: Sahlem Gregory L. , Kim Bohye , Baker Nathaniel L. , Wong Brendan L. , Caruso Margaret A. , Campbell Lauren A. , Kaloani Irakli , Sherman Brian J. , Ford Tiffany J. , Musleh Ahmad H. , Kim Jane P. , Williams Nolan R. , Manett Andrew J. , Kratter Ian H. , Short Edward B. , Killeen Terese K. , George Mark S. , McRae-Clark Aimee L. 
Published: July 2023

AbstractBackgroundCannabis use disorder (CUD) is a common and consequential disorder. When applied to the dorsolateral prefrontal cortex (DLPFC), repetitive transcranial magnetic stimulation (rTMS) reduces craving across substance use disorders and may have a therapeutic clinical effect when applied in serial sessions. The present study sought to preliminarily determine whether serial sessions of rTMS applied to the DLPFC had a therapeutic effect in CUD.MethodsThis study was a two-site, phase-2, double-blind, randomized-controlled-trial. Seventy-two treatment-seeking participants (37.5% Women, mean age 30.2±9.9SD) with ≥moderate-CUD were randomized to active or sham rTMS (Beam-F3, 10Hz, 20-total-sessions, with cannabis cues) while undergoing a three-session motivational enhancement therapy intervention. The primary outcome was the change in craving between pre- and post- treatment (Marijuana Craving Questionnaire Short-Form—MCQ-SF). Secondary outcomes included the number of weeks of abstinence and the number of days-per-week of cannabis use during 4-weeks of follow-up.ResultsThere were no significant differences in craving between conditions. Participants who received active rTMS reported numerically, but not significantly, more weeks of abstinence in the follow-up period than those who received sham rTMS (15.5%-Active; 9.3%-Sham; rate ratio = 1.66 [95% CI: 0.84, 3.28];p=0.14). Participants who received active rTMS reported fewer days-per-week of cannabis use over the final two-weeks of the follow-up period (Active vs. Sham: -0.72; Z=-2.33,p=0.02).ConclusionsThis trial suggests rTMS is safe and feasible in individuals with CUD and may have a therapeutic effect on frequency of cannabis use, though further study is needed with additional rTMS-sessions and a longer follow-up period.HighlightsThis phase-2 RCT tested the efficacy of prefrontal rTMS for cannabis use disorderThe study paradigm was safe and feasible, and participants tolerated rTMS wellThe active-group had numerically more weeks of abstinence during follow-upThe active-group had fewer days-per-week of cannabis use during follow-upMore rTMS and a longer follow-up may result in a larger effect in future studies
Dimensions, social and healthcare setting determinants of client satisfaction for HIV/AIDS services: a systematic review
Authors: Endalamaw Aklilu , Gilks Charles F , Ambaw Fentie , Chatfield Mark D. , Assefa Yibeltal 
Published: July 2023

AbstractIntroductionQuality HIV/AIDS care affects clients’ health-seeking behaviour and adherence to services, which can be evaluated through the patient’s satisfaction with the services. There was an information gap on the status and contributors to HIV/AIDS clients satisfaction, which supports comprehending universal health coverage. This review presented dimensions and comprehensive determinants of HIV/AIDS clients satisfaction.MethodsWe conducted a systematic review based on articles from Web of Science, EMBASE, PubMed, Google Scholar, and grey literature sources. Studies that have reported satisfaction of people living with HIV or at least one determinant and are written in English with full-text available were included. Findings from each study were described in a narrative description.ResultsThere was a heterogeneous level of HIV/AIDS clients’ satisfaction in different settings and countries. Accessibility of services, confidentiality, waiting time to receive care, technical competency, knowledge, and attitude of health care workers were frequently reported determinants. Educational and employment status were common modifiable social factors.ConclusionsPublic health programmes should follow a multi-pronged approach to fulfil people living with HIV clients’ healthcare needs. It is vital to improve HIV care integration with primary healthcare, improve financing of HIV care, digitalise healthcare settings, invest in pre-service education and in-service training, provide culturally sensitive services, strengthen social works and behavioural change communication services.
How do perceptions of Covid-19 risk impact pregnancy-related health decisions? A convergent parallel mixed-methods study protocol
Authors: Vanstone Meredith , Correia Rebecca H. , Howard Michelle , Darling Elizabeth , Bayrampour Hamideh , Carruthers Andrea , Davis Amie , Hadid Dima , Hetherington Erin , Jones Aaron , Kandasamy Sujane , Kuyvenhoven Cassandra , Liauw Jessica , McDonald Sarah D. , Mniszak Caroline , Molinaro Monica L. , Pahwa Manisha , Patel Tejal , Sadik Marina , Sanya Njideka , Shen Katrina , Greyson Devon 
Published: July 2023

AbstractIntroductionPregnant people have a higher risk of severe COVID-19 disease. They have been disproportionately impacted by COVID-19 infection control policies, which exacerbated conditions resulting in intimate partner violence, healthcare access, and mental health distress. This project examines the impact of accumulated individual health decisions and describes how perinatal care and health outcomes changed during the COVID-19 pandemic.ObjectivesQuantitative strand:Describe differences between 2019, 2021, and 2022 birth groups related to maternal vaccination, perinatal care, and mental health care. Examine the differential impacts on racialized and low-income pregnant people.Qualitative strand:Understand how pregnant people’s perceptions of COVID-19 risk influenced their decision-making about vaccination, perinatal care, social support, and mental health.Methods and analysisThis is a Canadian convergent parallel mixed-methods study. Thequantitative stranduses a retrospective cohort design to assess birth group differences in rates of Tdap and COVID-19 vaccination, gestational diabetes screening, length of post-partum hospital stay, and onset of depression, anxiety, and adjustment disorder, using administrative data from ICES, formerly the Institute for Clinical Evaluative Sciences (Ontario) and PopulationData BC (PopData) (British Columbia). Differences by socioeconomic and ethnocultural status will also be examined. Thequalitative strandemploys qualitative description to interview people who gave birth between May 2020-December 2021 about their COVID-19 risk perception and health decision-making process. Data integration will occur during design and interpretation.Ethics and disseminationThis study received ethical approval from McMaster University and the University of British Columbia. Findings will be disseminated via manuscripts, presentations, and patient-facing infographics.Strengths and limitations of this studyPopulation-based administrative data cohorts are very large, ensuring that analyses are high-powered.Mixed-methods design will allow us to offer explanation for changes in healthcare use observed through administrative data.Cross-provincial design permits examination of the potential impacts of COVID-19 infection prevention and control policies on pregnant people’s health.Use of Canadian Index of Multiple Deprivation will allow us to examine differences in healthcare use according to economic, racial, and immigration factors.Team includes 5 co-investigators with lived experience of pandemic pregnancies.
Associations of Very Low Lipoprotein(a) Levels With Risks Of New-Onset Diabetes And Non-Alcoholic Liver Disease
Authors: Yeung Ming Wai , Said M. Abdullah , van de Vegte Yordi J. , Verweij Niek , Dullaart Robin P.F. , van der Harst Pim 
Published: July 2023

AbstractBackground and aimsWe aimed to study the association of very low serum Lipoprotein(a) [Lp(a)] concentrations with new-onset type 2 diabetes (T2D) and non-alcoholic liver disease (NAFLD) in the context of statin usage in the UK Biobank, a large prospective population cohort.MethodsUsing an extended biomarker dataset, we identified 47,362 participants with very low Lp(a) concentrations (<3.8 nmol/L) from a total of 451,479 participants. With a median follow-up of 12.3 years, we assessed the risk of new-onset cardiometabolic diseases in participants stratified by statin usage with Cox proportional hazards models. We performed two-sample Mendelian randomization MR analyses to test causal relationship between genetically predicted Lp(a) and T2D and NAFLD.ResultsTaking the participants with Lp(a) within reportable range as the reference group, the hazard ratios (HR) for T2D were 1.06 (95% confidence interval, CI 1.01-1.12) and for NAFLD 1.35 (95% CI 1.26-1.45) respectively for participants with very low Lp(a) (<3.8 nmol/L). The risk for new-onset T2D was higher in participants using statin (adjusted HR 1.14; 95% CI 1.05-1.24). This was contrasted by higher risk of NAFLD in participants not on statin (HR 1.40; 95%CI 1.28-1.53). There was no evidence for causal links between genetically predicted Lp(a) and T2D nor NAFLD in two-sample MR analyses.ConclusionsVery low Lp(a) was associated with higher risks of T2D and NAFLD in a prospective analysis of the UK Biobank. These associations were influenced by lipid lowering medication usage. MR analyses did not support causality for these inverse associations.