bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complex and alternate consent pathways in clinical trials: methodological and ethical challenges encountered by underserved groups and a call to action
Authors: Russell Amy M. , Shepherd Victoria , Woolfall Kerry , Young Bridget , Gillies Katie , Volkmer Anna , Jayes Mark , Huxtable Richard , Perkins Alexander , Noor Nurulamin M. , Nickolls Beverley , Wade Julia 
Published: February 2023

Abstract
Background
Informed consent is considered a fundamental requirement for participation in trials, yet obtaining consent is challenging in a number of populations and settings. This may be due to participants having communication or other disabilities, their capacity to consent fluctuates or they lack capacity, or in emergency situations where their medical condition or the urgent nature of the treatment precludes seeking consent from either the participant or a representative. These challenges, and the subsequent complexity of designing and conducting trials where alternative consent pathways are required, contribute to these populations being underserved in research. Recognising and addressing these challenges is essential to support trials involving these populations and ensure that they have an equitable opportunity to participate in, and benefit from, research. Given the complex nature of these challenges, which are encountered by both adults and children, a cross-disciplinary approach is required.

Discussion
A UK-wide collaboration, a sub-group of the Trial Conduct Working Group in the MRC-NIHR Trial Methodology Research Partnership, was formed to collectively address these challenges. Members are drawn from disciplines including bioethics, qualitative research, trials methodology, healthcare professions, and social sciences. This commentary draws on our collective expertise to identify key populations where particular methodological and ethical challenges around consent are encountered, articulate the specific issues arising in each population, summarise ongoing and completed research, and identify targets for future research. Key populations include people with communication or other disabilities, people whose capacity to consent fluctuates, adults who lack the capacity to consent, and adults and children in emergency and urgent care settings. Work is ongoing by the sub-group to create a database of resources, to update NIHR guidance, and to develop proposals to address identified research gaps.

Conclusion
Collaboration across disciplines, sectors, organisations, and countries is essential if the ethical and methodological challenges surrounding trials involving complex and alternate consent pathways are to be addressed. Explicating these challenges, sharing resources, and identifying gaps for future research is an essential first step. We hope that doing so will serve as a call to action for others seeking ways to address the current consent-based exclusion of underserved populations from trials.
Clinical research for life-threatening illnesses requiring emergency hospitalisation: a critical interpretive synthesis of qualitative data related to the experience of participants and their caregivers
Authors: Lawrence David S. , Ssali Agnes , Jarvis Joseph N. , Seeley Janet 
Published: February 2023

Abstract
Background
Research into life-threatening illnesses which require emergency hospitalisation is essential. This group of patients is unique in that they are experiencing an unfolding emergency when they are approached, enrolled, and followed up in a research study. We aimed to synthesise qualitative data from trial participants and surrogate decision-makers to deepen our understanding and inform the design and conduct of future clinical trials for life-threatening illnesses.

Methods
We conducted a critical interpretive synthesis of qualitative data from trial participants and surrogate decision-makers related to the experience of participating in a clinical research study when suffering from a life-threatening illness. A scoping review informed a systematic review of published data. We searched research databases and reviewed papers for inclusion. Primary data and interpretations of data were extracted from each paper. Data were analysed using reciprocal translational analysis, refutational synthesis, and lines of argument synthesis to develop a synthetic construct.

Results
Twenty-two papers were included. Most individuals had no previous knowledge or experience with clinical research. Individuals making decisions were directly experiencing or witness to an unfolding emergency which came with a myriad of physical and psychological symptoms. It was difficult to differentiate clinical research and routine care, and understanding of core concepts around research, particularly randomisation and equipoise, was limited. We found that this led to an underestimation of risk, an overestimation of benefit, and an expectation of being allocated to the intervention arm. The decision-making process was heavily influenced by trust in the research team. Individuals suggested that abbreviated information, presented in different ways and continuously throughout the research process, would have increased knowledge and satisfaction with the research process.

Conclusion
Individuals suffering from a life-threatening illness who are being invited to participate in clinical research need to be managed in a way that adapts to the severity of their illness and there is a need to tailor research processes, including informed consent, accordingly. We provide suggestions for further research and implementation work around research participation for individuals suffering from a life-threatening illness.

Trial registration
PROSPERO CRD42020207296
ABT-MPNN: an atom-bond transformer-based message-passing neural network for molecular property prediction
Authors: Liu Chengyou , Sun Yan , Davis Rebecca , Cardona Silvia T. , Hu Pingzhao 
Published: February 2023

AbstractGraph convolutional neural networks (GCNs) have been repeatedly shown to have robust capacities for modeling graph data such as small molecules. Message-passing neural networks (MPNNs), a group of GCN variants that can learn and aggregate local information of molecules through iterative message-passing iterations, have exhibited advancements in molecular modeling and property prediction. Moreover, given the merits of Transformers in multiple artificial intelligence domains, it is desirable to combine the self-attention mechanism with MPNNs for better molecular representation. We propose an atom-bond transformer-based message-passing neural network (ABT-MPNN), to improve the molecular representation embedding process for molecular property predictions. By designing corresponding attention mechanisms in the message-passing and readout phases of the MPNN, our method provides a novel architecture that integrates molecular representations at the bond, atom and molecule levels in an end-to-end way. The experimental results across nine datasets show that the proposed ABT-MPNN outperforms or is comparable to the state-of-the-art baseline models in quantitative structure–property relationship tasks. We provide case examples of Mycobacterium tuberculosis growth inhibitors and demonstrate that our model's visualization modality of attention at the atomic level could be an insightful way to investigate molecular atoms or functional groups associated with desired biological properties. The new model provides an innovative way to investigate the effect of self-attention on chemical substructures and functional groups in molecular representation learning, which increases the interpretability of the traditional MPNN and can serve as a valuable way to investigate the mechanism of action of drugs.
A cross-sectional survey on fruit bat-human interaction in Pakistan; one health perspective
Authors: Ahmed Touseef , Amjad Osama Bin , Ahmed Haseeb , Ahmed Shafique , Ansari Jamil Ahmed , Ricketson Robert , Tahir Muhammad Farooq 
Published: February 2023

Abstract
Objective
Several factors, such as residential area topography, population density, and lack of infrastructure, were hypothesized to contribute toward respondents’ knowledge, attitude, and practice regarding disease transmission. The present study was designed to investigate the knowledge, attitudes, and perception of human-fruit bat interaction by student respondents located in ten districts within the Punjab and Khyber Pakhtunkhwa provinces in Pakistan.

Method
A cross-sectional survey was conducted by trained enumerators in academic institutions using a structured questionnaire among student respondents (n = 1466), living in two topographically distinct (Mountainous and Plain) residential regions of the Punjab and Khyber Pakhtunkhwa (KPK) provinces in Pakistan regarding their history of bat encounters.

Results
Our study revealed that 71.4% of the 1466 respondents had observed bats in their geographic region. 21% of our survey respondents reported bat bites incidents over their lifetime, but only 40% actively sought medical care for wound management despite reporting they had a close family member that had contracted rabies (27–35%). Our generalized linear models (GLMs) highlighted that a respondent residing in a residential region had a greater association with reporting a suspected bat bite over their lifetime and reported rabies victims in both near and extended family members (OR = −0,85, p-value = 0.03, 95% CI). This appeared to be due to delaying consulting a doctor or medical facility for treatment following a suspected bat bite in the topographic residential group as compared to the respondents in the provincial residential group (OR 1.12, p-value = 0.04, 95% CI).

Conclusion
Our findings indicate the necessity of a One Health comprehensive surveillance system in Pakistan for emerging and re-emerging zoonotic pathogens in Pteropodidae.
Quinolone-resistant Escherichia coli at the interface between humans, poultry and their shared environment- a potential public health risk
Authors: Aworh Mabel Kamweli , Kwaga Jacob K. P. , Hendriksen Rene S. , Okolocha Emmanuel C. , Harrell Erin , Thakur Siddhartha 
Published: February 2023

Abstract
Background
Commensal Escherichia coli residing in the guts of humans and animals are reservoirs of multidrug resistance (MDR) genes, including quinolone resistance genes, in humans and poultry. This study aimed to characterize quinolones resistance in E. coli recovered from poultry workers, chickens, and poultry farm/market environments in Abuja, Nigeria.

Methods
This was a cross-sectional study conducted between December 2018 and April 2019 comprising poultry workers, chickens and their poultry farm/market environments. This study characterized E. coli isolates from stool, faecal and environmental samples using antimicrobial susceptibility testing and whole-genome sequencing methods. Core-genome multilocus sequences-based phylogeny was used to determine the relatedness between quinolone-resistant E. coli isolates. Data were analyzed using descriptive statistics.

Results
Of 110 E. coli isolates, quinolone-resistant phenotypes were observed in 68.2% (n = 75) isolates. Whole-genome sequencing detected plasmid-mediated quinolone resistance (PMQR) genes in 63.6% (n = 70) isolates. The most prevalent PMQR gene detected in 56 of these 70 E. coli isolates was qnrS1, followed by qnrB19 in 14 isolates and aac(6’)-lb-cr in two isolates. Fifteen ciprofloxacin and 19 nalidixic acid-resistant isolates respectively showed double mutations in the quinolone-resistance determining regions (QRDRs) of gyrA, with single or double mutations in parC, and a single mutation in parE. The most prevalent amino-acid substitutions observed were S83L + D87N in gyrA (46.5%, n = 20), S80I in parC (51.2%, n = 22) and S458A in parE (14%, n = 6). About 2.9% (2/70) of PMQR isolates were extended-spectrum beta-lactamase (ESBL) producers while 2.9% (2/70) had plasmid-mediated colistin resistance (PMCR) genes.

Conclusions
PMQR genes were prevalent in E. coli isolates recovered from healthy humans, chickens and poultry farm/market environments. PMCR genes (mcr-1.1) occurred in PMQR-positive isolates recovered from manure and drinking water originating from poultry farm/market environments. It was found that the gene encoding ESBL coexisted with qnrS-positive isolates of human and avian origin. Horizontal transfer of PMQR genes among E. coli isolates in the human-poultry-environment interface has public health implications for the spread of antimicrobial resistance. Relevant government agencies should enforce regulations to restrict the use of critically important antimicrobials in poultry production.
Application of multi-gene genetic programming technique for modeling and optimization of phycoremediation of Cr(VI) from wastewater
Authors: Sarkar Biswajit , Sen Sushovan , Dutta Susmita , Lahiri Sandip Kumar 
Published: February 2023

Abstract
Background
Removal of Cr(VI) from wastewater is essential as it is potentially toxic and carcinogenic in nature. Bioremediation of heavy metals using microalgae is a novel technique and has several advantages such as microalgae remove metals in an environmentally friendly and economic manner. The present study deals with modeling and optimization of the phycoremediation of Cr(VI) from synthetic wastewater. The initial concentration of Cr(VI), initial pH, and inoculum size were considered as input factors, and the percentage removal of Cr(VI) was chosen as a response.

Results
An accurate data-driven genetic programming model was developed with the experimental data of other scientists to find a relation between the percentage removal of Cr(VI) and all input parameters. To maximize the removal of Cr(VI), the grey wolf optimization technique was applied to determine the optimal values of input parameters.

Conclusion
These optimum input parameters are difficult to get through experimentation using the trial-and-error method. The established modelling and optimization technique is generic and can be applied to any other experimental study.

Graphical Abstract
Factors Associated With Diabetes Distress Among Patients With Poorly Controlled Type 2 Diabetes
Authors: German Jashalynn , Kobe Elizabeth A , Lewinski Allison A , Jeffreys Amy S , Coffman Cynthia , Edelman David , Batch Bryan C , Crowley Matthew J 
Published: February 2023

AbstractObjectiveExamine factors associated with increased diabetes distress (DD) among patients with type 2 diabetes with DD assessed by Diabetes Distress Scale (DDS) total and subscale scores (emotional burden, physician-related distress, regimen-related distress, and interpersonal distress).MethodsCross-sectional analysis of data from veterans with persistently poorly controlled diabetes mellitus. Multivariable linear regression models included baseline patient characteristics (independent variables) and DDS total and subscale scores (dependent variable).ResultsThe cohort's (N = 248) mean age was 58 years (SD 8.3); 21% were female, 79% were non-White, and 5% were Hispanic/Latinx. Mean hemoglobin A1c (HbA1c) was 9.8%, and 37.5% had moderate to high DD. Hispanic/Latinx ethnicity (β=0.41; 95% CI 0.01, 0.80), baseline HbA1c (0.07; 95% CI 0.01,0.13), and higher Personal Health Questionnaire-8 (PHQ-8) scores (0.07; 95% CI 0.05, 0.09) were associated with higher total DD. Hispanic/Latinx ethnicity (0.79; 95% CI 0.25, 1.34) and higher PHQ-8 (0.05; 95% CI 0.03, 0.08) were associated with higher interpersonal-related distress. Higher HbA1c (0.15; 95% CI 0.06, 0.23) and higher PHQ-8 scores (0.10; 95% CI 0.07, 0.13) were associated with higher regimen-related distress. The use of basal insulin (0.28; 95% CI 0.001, 0.56) and higher PHQ-8 (0.02; 95% CI 0.001, 0.05) were associated with higher physician-related distress. Higher PHQ-8 (0.10; 95% CI 0.07, 0.12) was associated with higher emotional burden.ConclusionHispanic/Latinx ethnicity, depressive symptoms, uncontrolled hyperglycemia, and insulin use were associated with higher risk for DD. Future research should explore these relationships, and interventions designed to reduce diabetes distress should consider accounting for these factors.
Cerebral Microbleeds—Long-Term Outcome After Cerebrospinal Fluid Shunting in Idiopathic Normal Pressure Hydrocephalus
Authors: Hansson William , Johansson Elias , Birgander Richard , Eklund Anders , Malm Jan 
Published: February 2023

BACKGROUND:
Cerebral microbleeds (CMBs) are common in idiopathic normal pressure hydrocephalus (INPH) and have been suggested as radiological markers of a brain prone to bleeding. The presence of CMBs might be relevant when selecting patients for shunt surgery.

OBJECTIVE:
To evaluate whether CMBs increases long-term risk of hemorrhagic complications and mortality or affects outcomes after cerebrospinal fluid shunt surgery in a cohort of patients with INPH.

METHODS:
One hundred and forty nine shunted patients with INPH (mean age, 73 years) were investigated with MRI (T2* or susceptibility-weighted imaging sequences) preoperatively. CMBs were scored with the Microbleed Anatomic Rating Scale. Patients were observed for a mean of 6.5 years (range 2 weeks to 13 years) after surgery. Hemorrhagic events and death were noted. Improvement in gait was evaluated 3 to 6 months after surgery.

RESULTS:
At baseline, 74 patients (50%) had CMBs. During follow-up, 7 patients (5%) suffered a hemorrhagic stroke and 43 (29%) suffered a subdural hematoma/hygroma with a median time from surgery of 30.2 months (IQR 50). Overall, having CMBs was not associated with suffering a subdural hematoma/hygroma or hemorrhagic stroke during follow-up with 1 exception that an extensive degree of CMBs (≥50 CMB) was more common in patients suffering a hemorrhagic stroke (P = .03). CMBs were associated with increased mortality (P = .02, Kaplan-Meier, log-rank test). The presence of CMBs did not affect gait outcome (P = .28).

CONCLUSION:
CMBs were associated with hemorrhagic stroke and mortality. CMBs do not seem to reduce the possibility of gait improvement after shunt surgery or contribute to the risk of hemorrhagic complications regarding subdural hematoma or hygroma.
Effects of Unilateral Eccentric versus Concentric Training of Nonimmobilized Arm during Immobilization
Authors: CHEN TREVOR C. , WU SHANG-HEN , CHEN HSIN-LIAN , TSENG WEI-CHIN , TSENG KUO-WEI , KANG HSING-YU , NOSAKA KAZUNORI 
Published: February 2023

ABSTRACT

Introduction
The present study tested the hypothesis that eccentric training (ET) of nonimmobilized arm would attenuate negative effects of immobilization and provide greater protective effects against muscle damage induced by eccentric exercise after immobilization, when compared with concentric training (CT).

Methods
Sedentary young men were placed to ET, CT, or control group (n = 12 per group), and their nondominant arms were immobilized for 3 wk. During the immobilization period, the ET and CT groups performed five sets of six dumbbell curl eccentric-only and concentric-only contractions, respectively, at 20%–80% of maximal voluntary isometric contraction (MVCiso) strength over six sessions. MVCiso torque, root-mean square (RMS) of electromyographic activity during MVCiso, and bicep brachii muscle cross-sectional area (CSA) were measured before and after immobilization for both arms. All participants performed 30 eccentric contractions of the elbow flexors (30EC) by the immobilized arm after the cast was removed. Several indirect muscle damage markers were measured before, immediately after, and for 5 d after 30EC.

Results
ET increased MVCiso (17% ± 7%), RMS (24% ± 8%), and CSA (9% ± 2%) greater (P < 0.05) than CT (6% ± 4%, 9% ± 4%, 3% ± 2%) for the trained arm. The control group showed decreases in MVCiso (−17% ± 2%), RMS (−26% ± 6%), and CSA (−12% ± 3%) for the immobilized arm, but these changes were attenuated greater (P < 0.05) by ET (3% ± 3%, −0.1% ± 2%, 0.1% ± 0.3%) than CT (−4% ± 2%, −4% ± 2%, −1.3% ± 0.4%). Changes in all muscle damage markers after 30EC were smaller (P < 0.05) for the ET and CT than the control group, and ET than the CT group (e.g., peak plasma creatine kinase activity: ET, 860 ± 688 IU·L−1; CT, 2390 ± 1104 IU·L−1; control, 7819 ± 4011 IU·L−1).

Conclusions
These results showed that ET of the nonimmobilized arm was effective for eliminating the negative effects of immobilization and attenuating eccentric exercise–induced muscle damage after immobilization.
Qualitative analysis of HIV and AIDS disease transmission: impact of awareness, testing and effective follow up
Authors: Abiodun Oluwakemi E. , Adebimpe Olukayode , Ndako James , Oludoun Olajumoke , Aladeitan Benedicta , Adeniyi Michael 
Published: February 2023

Background: Since the early 1980s, human immunodeficiency virus (HIV) and its accompanying acquired immunodeficiency syndrome (AIDS) have spread worldwide, becoming one of the world's major global health issues. From the beginning of the epidemic until 2020, about 79.3 million people became infected, with 36.3 million deaths due to AIDS illnesses. This huge figure is a result of those unaware of their status due to stigmatization and invariably spreading the virus unknowingly. Methods: Qualitative analysis through a mathematical model that will address HIV unaware individuals and the effect of an increasing defaulter on the dynamics of HIV/AIDS was investigated. The impact of treatment and the effect of inefficient follow-up on the transmission of HIV/AIDS were examined. The threshold for the effective reduction of the unaware status of HIV through testing, in response to awareness, and the significance of effective non-defaulting in treatment commonly called defaulters loss to follow-up as these individuals contribute immensely to the spread of the virus due to their increase in CD4+ count was determined in this study. Stability analysis of equilibrium points is performed using the basic reproduction number $R_0$, an epidemiological threshold that determines disease eradication or persistence in viral populations. We tested the most sensitive parameters in the basic reproduction numbers. Results: The results portray that early identification and treatment only are inadequate for the illness to be eradicated, but effectively used of condom, strict adherence to treatment and counseling of and testing of pregnant women contribute to a decrease in infected HIV individuals. Conclusions: Other control techniques, such as treatment adherence and effective condom usage, and reduction in vertical transmission cannot be over-emphasis to lessen the disease's burden. Policymakers must address these strategies through a series of public awareness campaigns about the dangers of not adhering to treatment procedures and patterns.