bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of Patient and Public Involvement (PPI) in pre-clinical spinal cord research: an interview study
Authors: Carroll Pádraig , Dervan Adrian , McCarthy Ciarán , Woods Ian , Beirne Cliff , Harte Geoff , O’Flynn Dónal , O’Connor Cian , McGuire Tara , Leahy Liam M. , Gonzalez Javier Gutierrez , Stasiewicz Martyna , Maughan Jack , Quinlan John , Smith Éimear , Moriarty Frank , O’Brien Fergal J. , Flood Michelle 
Published: July 2023

AbstractBackgroundPatient and public involvement in research (PPI) has many benefits including increasing relevance and impact. While using PPI in clinical research is now an established practice, the involvement of patients and the public in pre-clinical research, which takes place in a laboratory setting, has been less frequently described and presents specific challenges. This study aimed to explore the perspectives of seriously injured rugby players’ who live with a spinal cord injury on PPI in pre-clinical research.MethodsSemi-structured interviews were conducted via telephone with 11 male seriously injured rugby players living with spinal cord injury on the island of Ireland. A purposive sampling approach was used to identify participants. Selected individuals were invited to take part via gatekeeper in a charitable organisation that supports seriously injured rugby players. Interviews were transcribed verbatim and analysed thematically.FindingsSix themes were identified during analysis: ‘limited knowledge of PPI’, ‘connecting pre-clinical research with the day-to-day realities of spinal cord injury’, ‘making pre-clinical research accessible for non-scientific audiences’, ‘barriers to involvement include disinterest, accessibility issues, and fear of losing hope if results are negative’, ‘personal contact and dialogue facilitate PPI’, and ‘collaborating on dissemination builds trust in research.’ConclusionPeople affected by spinal cord injury in this study desire further involvement in pre-clinical spinal cord injury research through dialogue and contact with researchers. Sharing experiences of spinal cord injury can form the basis of PPI for pre-clinical spinal cord injury research.
Several Mathematical Aspects on Daily Number of COVID-19 Infection Cases in Eight Southeast Asian Places
Authors: Chow C.L. , Cheng C.H. , Chow W.K. 
Published: July 2023

AbstractThe number of daily confirmed infected cases is a key parameter to determine emergency management actions to take. The mathematical characteristics of the daily infection number should be explored for working out appropriate control scheme. Several mathematical aspects on the daily number of infected cases will be discussed in 8 Southeastern Asian places using the confirmed daily infection numbers available in public websites. Phase space diagrams of plotting the daily infection rate estimated numerically against daily infection number on those tests are presented first. Modeling parameters including the Farr’s Law are also discussed. A parameter is proposed to describe the extent of infection by estimating the transient daily infection number divided by the time.
icognition: a smartphone-based cognitive screening battery
Authors: Denissen Stijn , Van Laethem Delphine , Baijot Johan , Costers Lars , Descamps Annabel , Van Remoortel Ann , Van Merhaegen-Wieleman Annick , D’hooghe Marie B , D’Haeseleer Miguel , Smeets Dirk , Sima Diana Maria , Van Schependom Jeroen , Nagels Guy 
Published: July 2023

AbstractBackgroundTelemedicine is feasible and well-accepted by people with multiple sclerosis (MS).ObjectiveThe aim of this study is to validate a smartphone-based cognitive screening battery, icognition, to faster signal cognitive deterioration.Methodsicognitionconsists of three tests (Symbol Test, Dot Test and visual Backwards Digit Span (vBDS)) that are equivalents of validated paper-pencil tests. These are the Symbol Digit Modalities Test (SDMT), the 10/36 Spatial Recall Test (SPART) and the auditory Backwards Digit Span (aBDS), respectively. To establish the validity of icognition, 101 people with MS and 82 healthy subjects completed all tests. 21 healthy subjects repeated testing 2 to 3 weeks later.ResultsAll tests in icognitioncorrelate well with their paper-pencil equivalent (Symbol Test: r=.63, p<.001; Dot Test: r=.31, p=0.002; vBDS: r=.71, p<.001), negatively correlate with the Expanded Disability Status Scale (EDSS: Symbol Test: rho=-.27, p=.01; Dot Test: rho=-.29, p=.006; vBDS: rho=- .23, p=.027) and show high test-retest reliability (Symbol Test: r=.81, p<.001; Dot Test: r=.75, p<.001; vBDS: r=.84, p<.001). Test performance was not significantly different between people with MS and healthy subjects for all cognitive tests, both in icognitionand their paper-pencil equivalents.Conclusionicognitionis a valid and reliable tool to remotely screen for cognitive functioning in persons with MS.
Admissions for eating disorders and other mental health diagnoses during the COVID-19 pandemic
Authors: Jones Sydney C. , Jacobs Megan , Latour Emile , Marshall Rebecca , Noelck Michelle , Foster Byron A. 
Published: July 2023

AbstractObjectiveTo examine how hospital admissions for mental health and eating disorders changed at the beginning of the COVID-19 pandemic and with the return to fully in-person school with increased vaccine availability.MethodsData from a tertiary care children’s hospital were examined for admissions to the hospital from March 2018 through March 2022, including children 6-20 years old admitted with ICD-10 codes for mental health and eating disorders. Interrupted time series (ITS) analyses were used to examine for changes at specific time points.ResultsIn the time between March 2018 through March 2022, 851 admissions met inclusion criteria for eating disorders and 1,505 admissions for other mental health diagnoses. In the first year of the pandemic, the ITS analysis showed a significant increase in admissions per month for eating disorders with a slope of 1.2 (95% CI: 0.2, 2.2) and for other mental health diagnoses, a slope of 1.9 (95% CI: 1.1, 2.7). In a longer-term ITS analysis, return to fully in-person school was associated with a subsequent decrease in admissions over time at -1.0 per month (95% CI: - 2.1, 0.1). For other mental health diagnoses, return to school was associated with an initial drop and then an increase in admissions over time, slope of 2.2 (95% CI: -0.5, 3.8).ConclusionThe COVID-19 pandemic had an initial impact on admissions for eating disorders and other mental health that attenuated over time. We note differences in the association of return to school on eating disorders compared with other mental health diagnoses.
Infection, inflammation and post-stroke cognitive impairment
Authors: Milosevich Elise , Demeyere Nele , Pendlebury Sarah T. 
Published: July 2023

ABSTRACTBackgroundInfection and inflammation are risk factors for dementia in population-based cohorts, however studies in stroke are scarce. We determined the prevalence of stroke-associated infection and routinely measured inflammatory biomarkers during hospitalization for stroke, and their associations with global and domain-specific cognition acutely and at 6-months.MethodsA prospective stroke cohort completed the Oxford Cognitive Screen ≤2 weeks and at 6 months. Global post-stroke cognitive impairment (PSCI) was defined as proportion of domains impaired and domain-specific impairment was binarized as present/absent. Infection, inflammatory markers (C-reactive protein-CRP, white cell count-WCC, and neutrophil/lymphocyte ratio-NLR), and systemic inflammatory response syndrome-SIRS, were ascertained throughout admission through linkage to electronic patient records-EPRs supplemented by hand-searches. Associations of infection, inflammatory markers, and SIRS, with acute and 6-month global and domain-specific cognitive impairment were analyzed using multivariable regression adjusting for demographic/vascular factors and stroke severity.ResultsAmong 255 patients (mean/SD age=73.9/12.6 years, 46.3% female, mean/SD education=12.6/3.7 years, median NIHSS=5, range 0–30), infection was present in 90 (35.3%) patients at mean/SD 4.4/6.9 days post-stroke, most commonly pneumonia (47/90, 52%) and urinary tract infection (39/90, 43%). Admission WCC was elevated in 64 (25.1%, mean/SD=9.5/3.2×109/L), CRP in 105 (41.2%, mean/SD=27.5/50.9 mg/L), NLR in 97 (55.7%, mean/SD=5.5/4.5) and SIRS in 53 (26.6% with 45.2% positive overall during admission). Infection was associated with acute and 6-month PSCI (p<0.05adj) with stronger associations acutely for severe infection (infection+SIRS,p=0.02adj). Acute impairments in language, executive function and attention domains and 6-month impairment in number processing (allp<0.05adj) were associated with infection. No significant relationships were found for any biomarker and cognitive impairment.ConclusionInfection and elevations in routinely measured inflammatory biomarkers are common after stroke, however only infection is a risk factor for PSCI, suggesting that the rise in these biomarkers may be non-specific. Infection may present a tractable target for reducing PSCI.
Randomized attention-placebo controlled trial of a digital self-management platform for adult asthma
Authors: Kandola Aaron , Edwards Kyra , Straatman Joris , Dührkoop Bettina , Hein Bettina , Hayes Joseph F 
Published: July 2023

AbstractBackgroundAsthma is one of the most common chronic conditions worldwide, with a substantial individual, societal and healthcare burden. Digital apps hold promise as a highly accessible, low-cost method of enhancing self-management in asthma, which is critical to effective asthma control.ObjectiveWe conducted a fully remote trial to assess the efficacy of juli, a commercially available smartphone self-management platform for asthma.MethodsWe conducted a pragmatic single-blind, randomized controlled trial of juli for asthma management. Our study included participants aged 18 and above with asthma and had an asthma control test (ACT) score of 19 or less (indicating poorly controlled asthma) at the beginning of the trial. Participants were randomized (1:1 ratio) to receive juli for eight weeks or a limited attention-placebo control version of the app. The primary endpoint was the difference in ACT scores after eight weeks. Secondary endpoints included eight-week remission (ACT score greater than 19), minimal clinically important difference (an improvement of three or more points on the ACT), worsening of asthma, and health-related quality of life. The primary analysis included participants using the app for eight weeks (per-protocol), a secondary analysis used modified intention-to-treat.ResultsWe randomized 411 participants between May 2021 and April 2023: 152 engaged with the app for eight weeks and were included in the per-protocol analysis, 262 completed the week two outcome assessment and were included in the modified intention-to-treat analysis.In the per-protocol analysis, the intervention group had a higher mean ACT score (17.93, standard deviation = 4.72) than the control group (16.24, standard deviation = 5.78) by week eight (baseline adjusted β-coefficient 1.91, 95% confidence intervals = 0.31 to 3.51, p=0.020). Participants using juli had greater odds of achieving or exceeding the minimal clinically important difference at eight weeks (adjusted odds ratio = 2.38, 95% confidence intervals = 1.20 to 4.70, p=0.013). There were no between-group differences in the other secondary outcomes at eight weeks. The results from the modified intention-to-treat analysis were similar.ConclusionsUsers of juli had improved asthma symptom control over eight weeks compared with users of a version of the app with limited functionality. These findings suggest that juli is an effective digital self-management platform that could augment existing care pathways for asthma.Trial RegistrationThe trial was pre-registered (ISRCTN87679686).
Adoption of policies to improve respectful maternity care in Timor-Leste
Authors: Fernandes Angelina da Costa , Supriyanto Stefanus , Wahyuni Chatarina Umbul , Notobroto Hari Basuki , Gregory Alexandra , Wild Kayli 
Published: July 2023

AbstractIntroductionThere are now well-established global standards for supporting improvement in women’s experience of maternity services, including frameworks for the prevention of mistreatment during childbirth. Given the ongoing reports from Timor-Leste outlining poor quality of care in maternal health services and the low use of health facilities for birth, we aimed to examine the adoption of global respectful maternity care standards in intrapartum care policies in Timor-Leste.MethodsFrom May to July 2022, we conducted a desk review of the Timor-Leste National Intrapartum Care Standards and Clinical Protocols for Referral Facilities and Community Health Centres. This was followed by a health-facility audit of policies, guidelines and procedures in three main maternity facilities in the capital, Dili to examine the extent to which the WHO (2016) standards for women’s experiences of care have been adopted.ResultsDespite the availability of global guidelines, key standards to improve women’s experience of care have been omitted from the National Intrapartum Care guidelines in Timor-Leste. There was no mention of avoiding mistreatment of women, needing informed consent for procedures, or strengthening women’s own capability and confidence. In the policy wording, women tended to be distanced from the care ‘procedures’ and their involvement was framed around being told what to do during the birth process. The results of the health facility assessment showed extremely low use of standards that improve women’s experiences of care. Health Facility 1 and 2 met two of the 21 quality measures, while Health Facility 3 met none of them.ConclusionThe discourse communicated through policy fundamentally affects how health care issues are framed and how policies are enacted. Given the findings of this study, combined with the widespread documentation of poor quality of care, low satisfaction with maternal health services, and emerging stories of physical and verbal abuse of women during birth, there is a need for a fundamental shift in the culture of care for women in Timor-Leste. This will require an immediate focus on leadership, training and policy-frameworks to stop mistreatment of women in health facilities. It will also require a longer-term focus on addressing the power imbalances that drive disrespect and abuse of women within and across social systems, and understanding how to support relationship-based models of care that inherently foster understanding and compassion.
JOINT APPLICATION OF BRAIN MRI AND GENE EXPRESSION ATLAS TO RECONSTRUCT NMOSD PATHOPHYSIOLOGY
Authors: Cacciaguerra Laura , Storelli Loredana , Pagani Elisabetta , Mesaros Sarlota , Martinelli Vittorio , Moiola Lucia , Radaelli Marta , Ivanovic Jovana , Tamas Olivera , Drulovic Jelena , Filippi Massimo , Rocca Maria A. 
Published: July 2023

AbstractObjectiveBrain lesions in aquaporin-4-antibody-positive neuromyelitis optica spectrum disorder (AQP4+NMOSD) occur at areas of high AQP4 expression. However, the pathophysiological cascade requires additional factors such as complement. We sought to investigate the spatial association between brain damage and gene expression in AQP4+NMOSD.MethodsIn this multicenter cross-sectional study, we enrolled 90 patients and 94 age-matched healthy controls who underwent a 3.0/1.5 T brain MRI. In patients, brain damage was assessed through (i) T2-hyperintense lesion probability maps, (ii) white matter (WM) and grey matter (GM) atrophy on 3D T1-weighted sequences, and (iii) WM microstructural abnormalities on diffusion-tensor imaging. The association between imaging maps and the expression of 266 candidate genes in the Allen Human Brain Atlas was obtained and overrepresented biological processes were investigated with a functional-enrichment analysis.ResultsIn AQP4+NMOSD, T2-hyperintense lesions were mainly located in the periventricular WM. GM and WM atrophy involved the visual pathway, while WM microstructural abnormalities were represented by a widespread increase of mean diffusivity. The expression of AQP4, C4a and C5 elements of complement resulted associated with all types of brain damage. Complement activation and the regulation and uptake of insulin-like growth factor were the most relevant enriched pathways. Non-specific pathways related to DNA synthesis and repair were associated with brain atrophy.InterpretationA joint application of quantitative MRI and gene expression atlas can identify in vivo the key elements of AQP4+NMOSD pathophysiology. This may pave the way to a novel type of imaging analysis helpful in understanding the pathophysiology of antibody-mediated autoimmune disorders.
Medical Students’ Attitudes toward AI in Medicine and their Expectations for Medical Education
Authors: Kimmerle Joachim , Timm Jasmin , Festl-Wietek Teresa , Cress Ulrike , Herrmann-Werner Anne 
Published: July 2023

AbstractObjectivesArtificial intelligence (AI) is used in a variety of contexts in medicine. This involves the use of algorithms and software that analyze digital information to make diagnoses and suggest adapted therapies. It is unclear, however, what medical students know about AI in medicine, how they evaluate its application, and what they expect from their medical training accordingly. In the study presented here, we aimed at providing answers to these questions.MethodsIn this survey study, we asked medical students about their assessment of AI in medicine and recorded their ideas and suggestions for considering this topic in medical education. Fifty-eight medical students completed the survey.ResultsAlmost all participants were aware of the use of AI in medicine and had an adequate understanding of it. They perceived AI in medicine to be reliable, trustworthy, and technically competent, but did not have much faith in it. They considered AI in medicine to be rather intelligent but not anthropomorphic. Participants were interested in the opportunities of AI in the medical context and wanted to learn more about it. They indicated that basic AI knowledge should be taught in medical studies, in particular, knowledge about modes of operation, ethics, areas of application, reliability, and possible risks.ConclusionsWe discuss the implications of these findings for the curricular development in medical education. Medical students need to be equipped with the knowledge and skills to use AI effectively and ethically in their future practice. This includes understanding the limitations and potential biases of AI algorithms by teaching the sensible use of human oversight and continuous monitoring to catch errors in AI algorithms and ensure that final decisions are made by human clinicians.
Service Retention Among Coast Guard Members Seeking Behavioral Healthcare
Authors: Allen John , Vance Mary , Mahlau-Heinert Jerry , Ahluwalia Jaspal , Thomas Dana , Singh Swati , Iskander John 
Published: July 2023

AbstractIntroductionBehavioral health conditions (BHC) can reduce service member retention. This analysis sought to identify demographic and diagnostic factors among BHC care-seeking Active-Duty United States Coast Guard (ADCG) that were predictive of discharge before completion of obligated service.MethodsA four-year retrospective cohort study of ADCG personnel was conducted. Five machine-learning (ML) algorithms and logistic regression were applied to data on ADCG who sought outpatient care for BHC in 2016. Covariates examined as possible mediators of early service termination included diagnosis group, gender, rank grouping, and race.ResultsOnly 26.4 of every 1,000 members who sought BHC care did not complete their service obligation. Diagnosis group did not predict early service termination, whereas senior enlisted rank was associated with early termination. The ML algorithms best predictive of early discharge from service were bagging classifier and decision tree classifier. Logistic regression performed as well as the two leading algorithms.ConclusionsSpecific ML models can be used to identify personnel groups at risk for early separation, such as senior enlisted personnel. Traditional epidemiologic methods demonstrate value in predicting service member separation.
Effect of household use of multiple micronutrient-fortified bouillon on micronutrient status among women and children in two districts in the Northern Region of Ghana: Protocol for the Condiment Micronutrient Innovation Trial (CoMIT), a community-based randomized controlled trial
Authors: Engle-Stone Reina , Wessells K Ryan , Haskell Marjorie J. , Kumordzie Sika M. , Arnold Charles D. , Davis Jennie N. , Becher Emily R. , Fuseini Ahmed D. , Nyaaba Kania W. , Tan Xiuping (Jenny) , Adams Katherine P. , Lietz Georg , Vosti Stephen A. , Adu-Afarwuah Seth 
Published: July 2023

IntroductionMicronutrient deficiencies are prevalent in West Africa, particularly among women of reproductive age (WRA) and young children. Bouillon is a promising food fortification vehicle due to its widespread consumption. This study aims to evaluate the impact of multiple micronutrient-fortified bouillon cubes, compared to control bouillon cubes (fortified with iodine only), on micronutrient status and hemoglobin concentrations among lactating and non-lactating WRA and young children in northern Ghana.MethodsThis randomized, controlled doubly-masked trial will be conducted in the Kumbungu and Tolon districts in the Northern Region of Ghana, where prior data indicate multiple micronutrient deficiencies are common. Participants will be: 1) non-pregnant non-lactating WRA (15-49 y), 2) children 2-5 y, and 3) non-pregnant lactating women 4-18 months postpartum. Eligible participants will be randomly assigned to receive household rations of one of two types of bouillon cubes: 1) a multiple micronutrient-fortified bouillon cube containing vitamin A, folic acid, vitamin B12, iron, zinc, and iodine, or 2) a control cube containing iodine only.Each participant’s household will receive a ration of bouillon cubes every 2 weeks, and households will be advised to prepare meals as usual, using the study-provided cubes. The trial duration will be 9 months for non-pregnant non-lactating WRA and children, and 3 months for lactating women. The primary outcomes will be changes in biomarkers of micronutrient status and hemoglobin. Secondary outcomes will include change in prevalence of micronutrient deficiency and anemia; dietary intake of bouillon and micronutrients; inflammation, malaria, and morbidity symptoms; and child growth and development.DiscussionEvidence from this study will inform discussions about bouillon fortification in Ghana and West Africa.