bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency red cell exchange for the management of acute complications in sickle cell disease: Automated versus manual
Authors: Mihalca Diana , Ahmad Adeel , Mehta Dipal , Freeman Tanya , Orebayo Funmilayo , Bello‐Sanyaolu Oloruntoyin , Lewis Natasha , Chatterjee Basabi , Tsitsikas Dimitris A. 
Published: March 2023

AbstractBackgroundRed blood cell exchange is the cornerstone of the management for acute complications of sickle cell disease. It improves anaemia and improvesperipheral tissue oxygen delivery while at the same time reduces the proportion of circulating sickle erythrocytes. Even though automated red cell exchange is very effective in rapidly lowering the Hb S level, 24‐h availability is currently not feasible for most specialist centres including our own.ObjectiveHere, we describe our experience using both automated and manual red cell exchange for the management of acute sickle cell complications.MethodsEighty‐six such episodes have been recorded between June 2011 and June 2022 comprising of 68 episodes of automated and 18 episodes of manual red cell exchange.ResultsThe post procedure Hb S/S + C level was 18% after automated and 36% after manual red cell exchange. The platelet count dropped by 41% and 21% after automated and manual red cell exchange respectively. The clinical outcomes including need for organ support, duration of stay in the intensive care unit and overall length of hospitalisation was comparable between the two groups.ConclusionIn our experience, manual red cell exchange is a safe and effective alternative to an automated procedure that can be used while specialist centres are building up their capacity to offer automated red cell exchange for all patients requiring the intervention.
Development of a Novel 4-DOF Flexible Endoscopic Robot Using Cable-Driven Multisegment Continuum Mechanisms
Authors: Wang Zhengyu , Bao Shiyang , Zi Bin , Jia Zirui , Yu Xiang 
Published: March 2023

Abstract
This paper presents the design, analysis, and development of a novel four degrees of freedom (4-DOF) endoscopic robot with cable-driven multisegment flexible continuum mechanisms. The endoscopic robot is mainly composed of the passive positioning arm, cable-pulley system, and 3-DOF flexible continuum mechanism. The forward and inverse kinematics of the endoscopic robot are derived based on the constant curvature assumption, and its working space, flexibility, and preoperative incision determination method are analyzed as well. Based on the hardware structure of the robot system, a control strategy and a control software are developed, and the continuum mechanism is kinematically calibrated to carry out the trajectory planning experiment and simulated surgery experiment. The experimental results show that the calibrated constant curvature model can be used for the motion control of the continuum mechanism, and the 4-DOF endoscopic robot can meet the visual field requirements of minimally invasive surgery.
Ferroptosis MRI for early detection of anticancer drug–induced acute cardiac/kidney injuries
Authors: Zeng Fantian , Nijiati Sureya , Liu Yangtengyu , Yang Qinqin , Liu Xiaomin , Zhang Qianyu , Chen Shi , Su Anqi , Xiong Hehe , Shi Changrong , Cai Congbo , Lin Zhongning , Chen Xiaoyuan , Zhou Zijian 
Published: March 2023

Ferroptosis has been realized in anticancer drug–induced acute cardiac/kidney injuries (ACI/AKI); however, molecular imaging approach to detect ferroptosis in ACI/AKI is a challenge. We report an artemisinin-based probe (Art-Gd) for contrast-enhanced magnetic resonance imaging of ferroptosis (feMRI) by exploiting the redox-active Fe(II) as a vivid chemical target. In vivo, the Art-Gd probe showed great feasibility in early diagnosis of anticancer drug–induced ACI/AKI, which was at least 24 and 48 hours earlier than the standard clinical assays for assessing ACI and AKI, respectively. Furthermore, the feMRI was able to provide imaging evidence for the different mechanisms of action of ferroptosis-targeted agents, either by blocking lipid peroxidation or depleting iron ions. This study presents a feMRI strategy with simple chemistry and robust efficacy for early evaluation of anticancer drug–induced ACI/AKI, which may shed light on the theranostics of a variety of ferroptosis-related diseases.
Internal consistency reliability of mental health questionnaires in college student athletes
Authors: Taylor Daniel J , Huskey Alisa , Kim Kelly N , Emert Sarah E , Wardle-Pinkston Sophie , Auerbach Alex , Ruiz John M , Grandner Michael A , Webb Rachel , Skog Michelle , Milord Thomas 
Published: March 2023

ObjectivesTo examine the internal consistency reliability and measurement invariance of a questionnaire battery designed to identify college student athletes at risk for mental health symptoms and disorders.MethodsCollege student athletes (N=993) completed questionnaires assessing 13 mental health domains: strain, anxiety, depression, suicide and self-harm ideation, sleep, alcohol use, drug use, eating disorders, attention deficit hyperactivity disorder (ADHD), bipolar disorder, post-traumatic stress disorder (PTSD), gambling and psychosis. Internal consistency reliability of each measure was assessed and compared between sexes as well as to previous results in elite athletes. Discriminative ability analyses were used to examine how well the cut-off score on the strain measure (Athlete Psychological Strain Questionnaire) predicted cut-offs on other screening questionnaires.ResultsStrain, anxiety, depression, suicide and self-harm ideation, ADHD, PTSD and bipolar questionnaires all had acceptable or better internal consistency reliability. Sleep, gambling and psychosis questionnaires had questionable internal consistency reliability, although approaching acceptable for certain sex by measure values. The athlete disordered eating measure (Brief Eating Disorder in Athletes Questionnaire) had poor internal consistency reliability in males and questionable internal consistency reliability in females.ConclusionsThe recommended mental health questionnaires were generally reliable for use with college student athletes. To truly determine the validity of the cut-off scores on these self-report questionnaires, future studies need to compare the questionnaires to a structured clinical interview to determine the discriminative abilities.
Let’s talk about sex (and gender) after ACL injury: a systematic review and meta-analysis of self-reported activity and knee-related outcomes
Authors: Bruder Andrea M , Culvenor Adam G , King Matthew G , Haberfield Melissa , Roughead Eliza A , Mastwyk John , Kemp Joanne L , Ferraz Pazzinatto Marcella , West Thomas J , Coburn Sally L , Cowan Sallie M , Ezzat Allison M , To Laura , Chilman Karina , Couch Jamon L , Whittaker Jackie L , Crossley Kay M 
Published: March 2023

ObjectiveInvestigate sex/gender differences in self-reported activity and knee-related outcomes after anterior cruciate ligament (ACL) injury.DesignSystematic review with meta-analysis.Data sourcesSeven databases were searched in December 2021.Eligibility criteriaObservational or interventional studies with self-reported activity (including return to sport) or knee-related outcomes after ACL injury.ResultsWe included 242 studies (n=123 687, 43% females/women/girls, mean age 26 years at surgery). One hundred and six studies contributed to 1 of 35 meta-analyses (n=59 552). After ACL injury/reconstruction, very low-certainty evidence suggests females/women/girls had inferior self-reported activity (ie, return to sport, Tegner Activity Score, Marx Activity Scale) compared with males/men/boys on most (88%, 7/8) meta-analyses. Females/women/girls had 23%–25% reduced odds of returning to sport within 1-year post-ACL injury/reconstruction (12 studies, OR 0.76 95% CI 0.63 to 0.92), 1–5 years (45 studies, OR 0.75 95% CI 0.69 to 0.82) and 5–10 years (9 studies, OR 0.77 95% CI 0.57 to 1.04). Age-stratified analysis (<19 years) suggests female athletes/girls had 32% reduced odds of returning to sport compared with male athletes/boys (OR 0.68, 95% CI 0.41 to 1.13, I20.0%). Very low-certainty evidence suggests females/women/girls experienced inferior knee-related outcomes (eg, function, quality of life) on many (70%, 19/27) meta-analyses: standardised mean difference ranging from −0.02 (Knee injury and Osteoarthritis Outcome Score, KOOS-activities of daily living, 9 studies, 95% CI −0.05 to 0.02) to −0.31 (KOOS-sport and recreation, 7 studies, 95% CI −0.36 to –0.26).ConclusionsVery low-certainty evidence suggests inferior self-reported activity and knee-related outcomes for females/women/girls compared with males/men/boys after an ACL injury. Future studies should explore factors and design targeted interventions to improve outcomes for females/women/girls.PROSPERO registration numberCRD42021205998.
Mediation of an association between neighborhood socioeconomic environment and type 2 diabetes through the leisure-time physical activity environment in an analysis of three independent samples
Authors: Moon Katherine A , Nordberg Cara M , Orstad Stephanie L , Zhu Aowen , Uddin Jalal , Lopez Priscilla , Schwartz Mark D , Ryan Victoria , Hirsch Annemarie G , Schwartz Brian S , Carson April P , Long D Leann , Meeker Melissa , Brown Janene , Lovasi Gina S , Adhikari Samranchana , Kanchi Rania , Avramovic Sanja , Imperatore Giuseppina , Poulsen Melissa N 
Published: March 2023

IntroductionInequitable access to leisure-time physical activity (LTPA) resources may explain geographic disparities in type 2 diabetes (T2D). We evaluated whether the neighborhood socioeconomic environment (NSEE) affects T2D through the LTPA environment.Research design and methodsWe conducted analyses in three study samples: the national Veterans Administration Diabetes Risk (VADR) cohort comprising electronic health records (EHR) of 4.1 million T2D-free veterans, the national prospective cohort REasons for Geographic and Racial Differences in Stroke (REGARDS) (11 208 T2D free), and a case–control study of Geisinger EHR in Pennsylvania (15 888 T2D cases). New-onset T2D was defined using diagnoses, laboratory and medication data. We harmonized neighborhood-level variables, including exposure, confounders, and effect modifiers. We measured NSEE with a summary index of six census tract indicators. The LTPA environment was measured by physical activity (PA) facility (gyms and other commercial facilities) density within street network buffers and population-weighted distance to parks. We estimated natural direct and indirect effects for each mediator stratified by community type.ResultsThe magnitudes of the indirect effects were generally small, and the direction of the indirect effects differed by community type and study sample. The most consistent findings were for mediation via PA facility density in rural communities, where we observed positive indirect effects (differences in T2D incidence rates (95% CI) comparing the highest versus lowest quartiles of NSEE, multiplied by 100) of 1.53 (0.25, 3.05) in REGARDS and 0.0066 (0.0038, 0.0099) in VADR. No mediation was evident in Geisinger.ConclusionsPA facility density and distance to parks did not substantially mediate the relation between NSEE and T2D. Our heterogeneous results suggest that approaches to reduce T2D through changes to the LTPA environment require local tailoring.
Examining non-linearity in the association between age and reported opioid use in different socioeconomic strata: cohort study using Health Survey for England waves from 1997 to 2014
Authors: Nowakowska Magdalena , Zghebi Salwa S , Chen Li-Chia , Ashcroft Darren M , Kontopantelis Evangelos 
Published: March 2023

BackgroundAge and socioeconomic status (SES) predict several health-related outcomes, including prescription opioid use. Contrasting findings from previous literature found higher prevalence of opioid use in both people over 65 years old and the working-age population of 35–55 years old. This study aimed to analyse if the association between age and opioid use is non-linear and differs in adults with different SES levels.MethodsThis cohort study used the Health Survey for England waves 1997–2014 data to investigate the shape of the correlation between reported opioid use and income decile, employment status and educational level. A semiparametric Generalised Additive Model was employed, so that linearity of correlation was not assumed. The shape of the relationship was assessed using the effective degrees of freedom (EDF).ResultsPositive correlation between age and reported opioid use, more linear in people in the highest income decile (EDF: 1.01, p<0.001) and higher education (EDF: 2.03, p<0.001) was observed. In people on lower income and with lower levels of education, the highes probability of reported opioid use was at around 40–60 years old and slowly decreased after that. Higher income decile and higher levels of education were predictors of a lower probability of reported opioid use (OR: 0.27, 95% CI: 0.21 to 0.36 and OR: 0.48, 95% CI: 0.41 to 0.57, respectively). There was no statistically significant difference in opioid use between employed and unemployed people.ConclusionThe relationship between age and the probability of prescribed opioid use varies greatly across different income and educations strata, highlighting different drivers in opioid prescribing across population groups. More research is needed into exploring patterns in opioid use in older people, particularly from disadvantaged socioeconomic backgrounds.
Education mediating the associations between early life factors and frailty: a cross-sectional study of the UK Biobank
Authors: Maharani Asri , Didikoglu Altug , O'Neill Terence W , Pendleton Neil , Canal Maria Mercè , Payton Antony 
Published: March 2023

ObjectivesExposures in utero and during infancy may impact the development of diseases later in life. They may be linked with development of frailty, although the mechanism is unclear. This study aims to determine the associations between early life risk factors and development of frailty among middle-aged and older adults as well as potential pathways via education, for any observed association.DesignA cross-sectional study.SettingsThis study used data from UK Biobank, a large population-based cohort.Participants502 489 individuals aged 37–73 years were included in the analysis.Primary and secondary outcome measuresEarly life factors in this study included being breast fed as a baby, maternal smoking, birth weight, the presence of perinatal diseases, birth month and birth place (in or outside the UK). We developed a frailty index comprising 49 deficits. We used generalised structural equation modelling to examine the associations between early life factors and development of frailty and whether any observed association was mediated via educational attainment.ResultsA history of breast feeding and normal birth weight were associated with a lower frailty index while maternal smoking, the occurrence of perinatal diseases and birth month with a longer day length were associated with a higher frailty index. Educational level mediated the relationship between these early life factors and frailty index.ConclusionsThis study highlights that biological and social risk occurring at different stages of life are related to the variations in frailty index in later life and suggests opportunities for prevention across the life course.
Diagnostic value of PET with different radiotracers and MRI for recurrent glioma: a Bayesian network meta-analysis
Authors: Xiaoxue Tian , Yinzhong Wang , Meng Qi , Lu Xingru , Lei Junqiang 
Published: March 2023

ObjectiveThe purpose of this study was to evaluate the diagnostic accuracy of 6 different imaging modalities for differentiating glioma recurrence from postradiotherapy changes by performing a network meta-analysis (NMA) using direct comparison studies with 2 or more imaging techniques.Data sourcesPubMed, Scopus, EMBASE, the Web of Science and the Cochrane Library were searched from inception to August 2021. The Confidence In Network Meta-Analysis (CINeMA) tool was used to evaluate the quality of the included studies with the criterion for study inclusion being direct comparison using 2 or more imaging modalities.Data extraction and synthesisThe consistency was evaluated by examining the agreement between direct and indirect effects. NMA was performed and the surface under the the cumulative ranking curve (SUCRA) values was obtained to calculate the probability of each imaging modality being the most effective diagnostic method. The CINeMA tool was used to evaluate the quality of the included studies.Main outcomes and measuresDirect comparison, inconsistency test, NMA and SUCRA values.ResultsA total of 8853 potentially relevant articles were retrieved and 15 articles met the inclusion criteria.18F-FET showed the highest SUCRA values for sensitivity, specificity, positive predictive value and accuracy, followed by18F-FDOPA. The quality of the included evidence is classified as moderate.Conclusion and relevanceThis review indicates that18F-FET and18F-FDOPA may have greater diagnostic value for glioma recurrence relative to other imaging modalities (Grading of Recommendations, Assessment, Development and Evaluations B).PROSPERO registration numberCRD42021293075.
Association between burnout and adherence with mask usage and additional COVID-19 prevention behaviours: findings from a large-scale, demographically representative survey of US adults
Authors: Czeisler Mark É , Wolkow Alexander P , Czeisler Charles A , Howard Mark E , Rajaratnam Shantha M W , Lane Rashon I 
Published: March 2023

ObjectivesStudies have found associations between occupational burnout symptoms and reduced engagement with healthy behaviours. We sought to characterise demographic, employment and sleep characteristics associated with occupational burnout symptoms, and to evaluate their relationships with adherence to COVID-19 prevention behaviours (mask usage, hand hygiene, avoiding gatherings, physical distancing, obtaining COVID-19 tests if potentially infected).MethodsDuring December 2020, surveys were administered cross-sectionally to 5208 US adults (response rate=65.8%). Quota sampling and survey weighting were employed to improve sample representativeness of sex, age and race and ethnicity. Among 3026 employed respondents, logistic regression models examined associations between burnout symptoms and demographic, employment and sleep characteristics. Similar models were conducted to estimate associations between burnout and non-adherence with COVID-19 prevention behaviours.ResultsWomen, younger adults, unpaid caregivers, those working more on-site versus remotely and those with insufficient or impaired sleep had higher odds of occupational burnout symptoms. Burnout symptoms were associated with less frequent mask usage (adjusted odds ratio (aOR)=1.7, 95% CI 1.3–2.1), hand hygiene (aOR=2.1, 95% CI 1.7–2.7), physical distancing (aOR=1.3, 95% CI 1.1–1.6), avoiding gatherings (aOR=1.4, 95% CI 1.1–1.7) and obtaining COVID-19 tests (aOR=1.4, 95% CI 1.1–1.8).ConclusionsDisparities in occupational burnout symptoms exist by gender, age, caregiving, employment and sleep health. Employees experiencing occupational burnout symptoms might exhibit reduced adherence with COVID-19 prevention behaviours. Employers can support employee health by addressing the psychological syndrome of occupational burnout.
Quality contract ‘prevention of postoperative delirium in the care of elderly patients’ study protocol: a non-randomised, pre–post, monocentric, prospective trial
Authors: Yürek Fatima , Zimmermann Julian-Dominic , Weidner Elisa , Hauß Armin , Dähnert Enrico , Hadzidiakos Daniel , Kruppa Jochen , Kiselev Joern , Sichinava Natia , Retana Romero Oscar Andrés , Hoff Laerson , Mörgeli Rudolf , Junge Lennart , Scholtz Kathrin , Piper Sophie K , Grüner Luzie , Harborth Antonia Eva Maria , Eymold Lisa , Gülmez Tuba , Falk Elke , Balzer Felix , Treskatsch Sascha , Höft Moritz , Schmidt Dieter , Landgraf Franziska , Marschall Ursula , Hölscher Andreas , Rafii Mani , Spies Claudia 
Published: March 2023

IntroductionPostoperative delirium (POD) is seen in approximately 15% of elderly patients and is related to poorer outcomes. In 2017, the Federal Joint Committee (Gemeinsamer Bundesausschuss) introduced a ‘quality contract’ (QC) as a new instrument to improve healthcare in Germany. One of the four areas for improvement of in-patient care is the ‘Prevention of POD in the care of elderly patients’ (QC-POD), as a means to reduce the risk of developing POD and its complications.The Institute for Quality Assurance and Transparency in Health Care identified gaps in the in-patient care of elderly patients related to the prevention, screening and treatment of POD, as required by consensus-based and evidence-based delirium guidelines. This paper introduces the QC-POD protocol, which aims to implement these guidelines into the clinical routine. There is an urgent need for well-structured, standardised and interdisciplinary pathways that enable the reliable screening and treatment of POD. Along with effective preventive measures, these concepts have a considerable potential to improve the care of elderly patients.Methods and analysisThe QC-POD study is a non-randomised, pre–post, monocentric, prospective trial with an interventional concept following a baseline control period. The QC-POD trial was initiated on 1 April 2020 between Charité-Universitätsmedizin Berlin and the German health insurance company BARMER and will end on 30 June 2023. Inclusion criteria: patients 70 years of age or older that are scheduled for a surgical procedure requiring anaesthesia and insurance with the QC partner (BARMER). Exclusion criteria included patients with a language barrier, moribund patients and those unwilling or unable to provide informed consent. The QC-POD protocol provides perioperative intervention at least two times per day, with delirium screening and non-pharmacological preventive measures.Ethics and disseminationThis protocol was approved by the ethics committee of the Charité-Universitätsmedizin, Berlin, Germany (EA1/054/20). The results will be published in a peer-reviewed scientific journal and presented at national and international conferences.Trial registration numberNCT04355195.
Heatwaves, hospitals and health system resilience in England: a qualitative assessment of frontline perspectives from the hot summer of 2019
Authors: Brooks Katya , Landeg Owen , Kovats Sari , Sewell Mark , OConnell Emer 
Published: March 2023

ObjectiveTo critically assess the impacts of very hot weather on (i) frontline staff in hospitals in England and (ii) on healthcare delivery and patient safety.Study designA qualitative study design using key informant semi-structured interviews, preinterview survey and thematic analysis.SettingEngland.Participants14 health professionals in the National Health Service (clinicians and non-clinicians, including facilities managers and emergency preparedness, resilience and response professionals).ResultsHot weather in 2019 caused significant disruption to health services, facilities and equipment, staff and patient discomfort, and an acute increase in hospital admissions. Levels of awareness varied between clinical and non-clinical staff of the Heatwave Plan for England, Heat-Health Alerts and associated guidance. Response to heatwaves was affected by competing priorities and tensions including infection control, electric fan usage and patient safety.ConclusionsHealthcare delivery staff experience difficulty in managing heat risks in hospitals. Priority should be given to workforce development and strategic, long-term planning, prevention and investment to enable staff to prepare and respond, as well as to improve health system resilience to current and future heat-health risks. Further research with a wider, larger cohort is required to develop the evidence base on the impacts, including the costs of those impacts, and to assess the effectiveness and feasibility of interventions. Forming a national picture of health system resilience to heatwaves will support national adaptation planning for health, in addition to informing strategic prevention and effective emergency response.