bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, attitudes and practices regarding antimicrobial use and resistance among healthcare seekers in two tertiary hospitals in Ghana: a quasi-experimental study
Authors: Otieku Evans , Fenny Ama Pokuaa , Labi Appiah-Koran , Owusu-Ofori Alex Kwame , Kurtzhals Jørgen , Enemark Ulrika 
Published: February 2023

ObjectiveTo evaluate knowledge of antimicrobial resistance (AMR), to study how the judgement of health value (HVJ) and economic value (EVJ) affects antibiotic use, and to understand if access to information on AMR implications may influence perceived AMR mitigation strategies.DesignA quasi-experimental study with interviews performed before and after an intervention where hospital staff collected data and provided one group of participants with information about the health and economic implications of antibiotic use and resistance compared with a control group not receiving the intervention.SettingKorle-Bu and Komfo Anokye Teaching Hospitals, Ghana.ParticipantsAdult patients aged 18 years and older seeking outpatient care.Main outcome measuresWe measured three outcomes: (1) level of knowledge of the health and economic implications of AMR; (2) HVJ and EVJ behaviours influencing antibiotic use and (3) differences in perceived AMR mitigation strategy between participants exposed and not exposed to the intervention.ResultsMost participants had a general knowledge of the health and economic implications of antibiotic use and AMR. Nonetheless, a sizeable proportion disagreed or disagreed to some extent that AMR may lead to reduced productivity/indirect costs (71% (95% CI 66% to 76%)), increased provider costs (87% (95% CI 84% to 91%)) and costs for carers of AMR patients/societal costs (59% (95% CI 53% to 64%)). Both HVJ-driven and EVJ-driven behaviours influenced antibiotic use, but the latter was a better predictor (reliability coefficient >0.87). Compared with the unexposed group, participants exposed to the intervention were more likely to recommend restrictive access to antibiotics (p<0.01) and pay slightly more for a health treatment strategy to reduce their risk of AMR (p<0.01).ConclusionThere is a knowledge gap about antibiotic use and the implications of AMR. Access to AMR information at the point of care could be a successful way to mitigate the prevalence and implications of AMR.
Changes of health-related quality of life 6 months after high-risk oncological upper gastrointestinal and hepatobiliary surgery: a single-centre prospective observational study (ChangeQol Study)
Authors: Maillard Julien , Elia Nadia , Ris Frédéric , Courvoisier Delphine S , Zekry Dina , Labidi Galy Intidhar , Toso Christian , Mönig Stefan , Zaccaria Isabelle , Walder Bernhard 
Published: February 2023

IntroductionPostoperative health-related quality of life (HRQoL) is an essential outcome in oncological surgery, particularly for elderly patients undergoing high-risk surgery. Previous studies have suggested that, on average, HRQoL returns to premorbid normal levels in the months following major surgery. However, the averaging of effect over a studied cohort may hide the variation of individual HRQoL changes. The proportions of patients who have a varied HRQoL response (stable, improvement, or a deterioration) after major oncological surgery is poorly understood. The study aims to describe the patterns of these HRQoL changes at 6 months after surgery, and to assess the patients and next-of-kin regret regarding the decision to undergo surgery.Methods and analysisThis prospective observational cohort study is carried out at the University Hospitals of Geneva, Switzerland. We include patients over 18 years old undergoing gastrectomy, esophagectomy, pancreas resection or hepatectomy. The primary outcome is the proportion of patients in each group with changes in HRQoL (improvement, stability or deterioration) 6 months after surgery, using a validated minimal clinically important difference of 10 points in HRQoL. The secondary outcome is to assess whether patients and their next-of-kin may regret their decision to undergo surgery at 6 months. We measure the HRQoL using the EORTC QLQ-C30 questionnaire before and 6 months after surgery. We assess regret with the Decision Regret Scale (DRS) at 6 months after surgery. Key other perioperative data include preoperative and postoperative place of residence, preoperative anxiety and depression (HADS scale), preoperative disability (WHODAS V.2.0), preoperative frailty (Clinical Frailty Scale), preoperative cognitive function (Mini-Mental State Examination) and preoperative comorbidities. A follow-up at 12 months is planned.Ethics and disseminationThe study was first approved by the Geneva Ethical Committee for Research (ID 2020-00536) on 28 April 2020. The results of this study will be presented at national and international scientific meetings, and publications will be submitted to an open-access peer-reviewed journal.Trial registration numberNCT04444544.
Identifying barriers and facilitators to deprescribing benzodiazepines and sedative hypnotics in the hospital setting using the Theoretical Domains Framework and the Capability, Opportunity, Motivation and Behaviour (COM-B) Model: a qualitative study
Authors: Keller Michelle S , Carrascoza-Bolanos Johan , Breda Kathleen , Kim Linda Y , Kennelty Korey A , Leang Donna W , Murry Logan T , Nuckols Teryl K , Schnipper Jeffrey L , Pevnick Joshua M 
Published: February 2023

ObjectivesGeriatric guidelines strongly recommend avoiding benzodiazepines and non-benzodiazepine sedative hypnotics in older adults. Hospitalisation may provide an important opportunity to begin the process of deprescribing these medications, particularly as new contraindications arise. We used implementation science models and qualitative interviews to describe barriers and facilitators to deprescribing benzodiazepines and non-benzodiazepine sedative hypnotics in the hospital and develop potential interventions to address identified barriers.DesignWe used two implementation science models, the Capability, Opportunity and Behaviour Model (COM-B) and the Theoretical Domains Framework, to code interviews with hospital staff, and an implementation process, the Behaviour Change Wheel (BCW), to codevelop potential interventions with stakeholders from each clinician group.SettingInterviews took place in a tertiary, 886-bed hospital located in Los Angeles, California.ParticipantsInterview participants included physicians, pharmacists, pharmacist technicians, and nurses.ResultsWe interviewed 14 clinicians. We found barriers and facilitators across all COM-B model domains. Barriers included lack of knowledge about how to engage in complex conversations about deprescribing (capability), competing tasks in the inpatient setting (opportunity), high levels of resistance/anxiety among patients to deprescribe (motivation), concerns about lack of postdischarge follow-up (motivation). Facilitators included high levels of knowledge about the risks of these medications (capability), regular rounds and huddles to identify inappropriate medications (opportunity) and beliefs that patients may be more receptive to deprescribing if the medication is related to the reason for hospitalisation (motivation). Potential modes of delivery included a seminar aimed at addressing capability and motivation barriers in nurses, a pharmacist-led deprescribing initiative using risk stratification to identify and target patients at highest need for deprescribing, and the use of evidence-based deprescribing education materials provided to patients at discharge.ConclusionsWhile we identified numerous barriers and facilitators to initiating deprescribing conversations in the hospital, nurse- and pharmacist-led interventions may be an appropriate opportunity to initiate deprescribing.
Self-harm in adolescence and risk of crash: a 13-year cohort study of novice drivers in New South Wales, Australia
Authors: Cullen Patricia , Mőller Holger , Baffsky Rachel , Martiniuk Alexandra , Senserrick Teresa , Rogers Kris , Woodward Mark , Stevenson Mark R , McLean Rebecca , Sawyer Susan , Patton George , Ivers Rebecca Q 
Published: February 2023

IntroductionSelf-harm and suicide are leading causes of morbidity and death for young people, worldwide. Previous research has identified self-harm is a risk factor for vehicle crashes, however, there is a lack of long-term crash data post licensing that investigates this relationship. We aimed to determine whether adolescent self-harm persists as crash risk factor in adulthood.MethodsWe followed 20 806 newly licensed adolescent and young adult drivers in the DRIVE prospective cohort for 13 years to examine whether self-harm was a risk factor for vehicle crashes. The association between self-harm and crash was analysed using cumulative incidence curves investigating time to first crash and quantified using negative binominal regression models adjusted for driver demographics and conventional crash risk factors.ResultsAdolescents who reported self-harm at baseline were at increased risk of crashes 13 years later than those reporting no self-harm (relative risk (RR) 1.29: 95% CI 1.14 to 1.47). This risk remained after controlling for driver experience, demographic characteristics and known risk factors for crashes, including alcohol use and risk taking behaviour (RR 1.23: 95% CI 1.08 to 1.39). Sensation seeking had an additive effect on the association between self-harm and single-vehicle crashes (relative excess risk due to interaction 0.87: 95% CI 0.07 to 1.67), but not for other types of crashes.DiscussionOur findings add to the growing body of evidence that self-harm during adolescence predicts a range of poorer health outcomes, including motor vehicle crash risks that warrant further investigation and consideration in road safety interventions. Complex interventions addressing self-harm in adolescence, as well as road safety and substance use, are critical for preventing health harming behaviours across the life course.
Effectiveness of social prescribing for chronic disease prevention in adults: a systematic review and meta-analysis of randomised controlled trials
Authors: Htun Htet Lin , Teshale Achamyeleh Birhanu , Cumpston Miranda S , Demos Lisa , Ryan Joanne , Owen Alice , Freak-Poli Rosanne 
Published: February 2023

BackgroundSocial prescribing (SP) enables healthcare professionals to link patients with non-medical interventions available in the community to address underlying socioeconomic and behavioural determinants. We synthesised the evidence to understand the effectiveness of SP for chronic disease prevention.MethodsA systematic literature search was conducted using five databases and two registries. Eligible studies included randomised controlled trials of SP among community-dwelling adults recruited from primary care or community setting, investigating any chronic disease risk factors defined by the WHO (behavioural factors: smoking, physical inactivity, unhealthy diet and excessive alcohol consumption; metabolic factors: raised blood pressure, overweight/obesity, hyperlipidaemia and hyperglycaemia). Random effect meta-analyses were performed at two time points: completion of intervention and follow-up after trial.ResultsWe identified nine reports from eight trials totalling 4621 participants. All studies evaluated SP exercise interventions which were highly heterogeneous regarding the content, duration, frequency and length of follow-up. Majority of studies had some concerns for risk of bias. Meta-analysis revealed that SP likely increased physical activity (completion: mean difference (MD) 21 min/week, 95% CI 3 to 39, I2=0%; follow-up ≤12 months: MD 19 min/week, 95% CI 8 to 29, I2=0%). However, SP may not improve markers of adiposity, blood pressure, glucose and serum lipid. There were no eligible studies that primarily target unhealthy diet, smoking and excessive alcohol drinking behaviours.ConclusionsSP exercise interventions probably increased physical activity slightly; however, no benefits were observed for metabolic factors. Determining whether SP is effective in modifying the determinants of chronic diseases and promotes sustainable healthy behaviours is limited by the current evidence of quantification and uncertainty, warranting further rigorous studies.PROSPERO registration numberCRD42022346687.
Endovascular stroke therapy outside core working hours in a nationwide stroke system
Authors: Fandler-Höfler Simon , Mikšová Dominika , Deutschmann Hannes , Kneihsl Markus , Mutzenbach Sebastian , Killer-Oberpfalzer Monika , Gizewski Elke R , Knoflach Michael , Kiechl Stefan , Sonnberger Michael , Vosko Milan R , Weber Jörg , Hausegger Klaus A , Serles Wolfgang , Werner Philipp , Staykov Dimitre , Sykora Marek , Lang Wilfried , Ferrari Julia , Enzinger Christian , Gattringer Thomas 
Published: February 2023

BackgroundEndovascular therapy (EVT) has been established as a major component in the acute treatment of large vessel occlusion stroke. However, it is unclear whether outcome and other treatment-related factors differ if patients are treated within or outside core working hours.MethodsWe analyzed data from the prospective nationwide Austrian Stroke Unit Registry capturing all consecutive stroke patients treated with EVT between 2016 and 2020. Patients were trichotomized according to the time of groin puncture into treatment within regular working hours (08:00–13:59), afternoon/evening (14:00–21:59) and night-time (22:00–07:59). Additionally, we analyzed 12 EVT treatment windows with equal patient numbers. Main outcome variables included favorable outcome (modified Rankin Scale scores of 0–2) 3 months post-stroke as well as procedural time metrics, recanalization status and complications.ResultsWe analyzed 2916 patients (median age 74 years, 50.7% female) who underwent EVT. Patients treated within core working hours more frequently had a favorable outcome (42.6% vs 36.1% treated in the afternoon/evening vs 35.8% treated at night-time; p=0.007). Similar results were found when analyzing 12 treatment windows. All these differences remained significant in multivariable analysis adjusting for outcome-relevant co-factors. Onset-to-recanalization time was considerably longer outside core working hours, which was mainly explained by longer door-to-groin time (p<0.001). There was no difference in the number of passes, recanalization status, groin-to-recanalization time and EVT-related complications.ConclusionsThe findings of delayed intrahospital EVT workflows and worse functional outcomes outside core working hours in this nationwide registry are relevant for optimization of stroke care, and might be applicable to other countries with similar settings.
COVID-19 impact on an oncologic emergency department visits: observational study
Authors: Ram Aurélie , Pagès Arnaud , Cubilier Edouard , Daoudi Nesrine , Vandergheynst Frederic , Scotte Florian , Antoun Sami , Merad Mansouriah 
Published: February 2023

ObjectiveThis study aimed at evaluating the impact of COVID-19 on emergency department (ED) visits in a tertiary cancer centre and providing information on the features of the unplanned events during the first wave of COVID-19 pandemic.MethodsThis retrospective observational study based on data from ED reports was divided into three periods of 2 months each around the first lockdown announcement of 17 March 2020: pre-lockdown, lockdown and post-lockdown.ResultsA total of 903 ED visits were included in the analyses. The mean (±SD) daily number of ED visits did not change during the lockdown period (14.6±5.5) when compared with the periods before (13.6±4.5) and after lockdown (13.7±4.4) (p=0.78). The proportion of ED visits for fever and respiratory disorders increased significantly to 29.5% and 28.5%, respectively (p<0.01) during lockdown. Pain, the third most frequent motive, remained stable with 18.2% (p=0.83) throughout the three periods. Symptom severity also showed no significant differences in the three periods (p=0.31).ConclusionOur study shows that ED visits during the first wave of the COVID-19 pandemic remained stable for our patients regardless of the symptom’s severity. The fear of an in-hospital viral contamination appears weaker than the need for pain management or for the treatment of cancer-related complications. This study highlights the positive impact of cancer ED in the first-line treatment and supportive care of patients with cancer.
Unmet palliative care service needs: a patient-centred metric
Authors: Safabakhsh Nusha , Lippe Megan P , Govahi Shahrooz , Gonzales Matthew J , Byock Ira 
Published: February 2023

ObjectivesFinancial pressures and competing demands for limited resources highlight the importance of defining the unmet need for specialty inpatient palliative care (PC), demonstrating the value of the service line and making decisions about staffing. One measure of access to specialty PC is penetration, the percentage of hospitalised adults receiving PC consultations. Although useful, additional means of quantifying programme performance are required for evaluating access by patients who would benefit. The study sought to define a simplified method of calculating unmet need for inpatient PC.MethodsThis retrospective observational study analysed electronic health records from six hospitals in one health system in Los Angeles County.Unmet need for PC was defined by the number of hospitalised patients with four or more chronic serious comorbidities without a PC consultation divided by a denominator of all patients with one or more chronic serious conditions (CSCs) without a PC during the hospitalisation.ResultsThis calculation identified a subset of patients with four or more CSCs that accounts for 10.3% of the population of adults with one or more CSCs who did not receive PC services during a hospitalisation (unmet need). Monthly internal reporting of this metric led to significant PC programme expansion with an increase in average penetration for the six hospitals from 5.9% in 2017 to 11.2% in 2021.ConclusionsHealth system leadership can benefit from quantifying the need for specialty PC among seriously ill inpatients. This anticipated measure of unmet need is a quality indicator that complements existing metrics.
Online Metric Algorithms with Untrusted Predictions
Authors: Antoniadis Antonios , Coester Christian , Eliáš Marek , Polak Adam , Simon Bertrand 
Published: February 2023

Machine-learned predictors, although achieving very good results for inputs resembling training data, cannot possibly provide perfect predictions in all situations. Still, decision-making systems that are based on such predictors need not only benefit from good predictions, but should also achieve a decent performance when the predictions are inadequate. In this article, we propose a prediction setup for arbitrary
metrical task systems (MTS)
(e.g.,
caching
,

k
-server,

and
convex body chasing
) and
online matching on the line
. We utilize results from the theory of online algorithms to show how to make the setup robust. Specifically, for caching, we present an algorithm whose performance, as a function of the prediction error, is exponentially better than what is achievable for general MTS. Finally, we present an empirical evaluation of our methods on real-world datasets, which suggests practicality.
circFNDC3B Accelerates Vasculature Formation and Metastasis in Oral Squamous Cell Carcinoma
Authors: Li Xiang , Wang Chenxing , Zhang Hang , Li Yangjie , Hou Deqiang , Liu Dingshan , Xu Rongyao , Cheng Jie , Liu Laikui , Fu Yu , Ye Jinhai , Jiang Hongbing 
Published: February 2023

Abstract

Emerging evidence has demonstrated that circular RNAs (circRNA) are involved in cancer metastasis. Further elucidation of the role of circRNAs in oral squamous cell carcinoma (OSCC) could provide insights into mechanisms driving metastasis and potential therapeutic targets. Here, we identify a circRNA, circFNDC3B, that is significantly upregulated in OSCC and is positively associated with lymph node (LN) metastasis. In vitro and in vivo functional assays showed that circFNDC3B accelerated the migration and invasion of OSCC cells and the tube-forming capacity of human umbilical vein endothelial cells and human lymphatic endothelial cells. Mechanistically, circFNDC3B regulated ubiquitylation of the RNA-binding protein FUS and the deubiquitylation of HIF1A through the E3 ligase MDM2 to promote VEGFA transcription, thereby enhancing angiogenesis. Meanwhile, circFNDC3B sequestered miR-181c-5p to upregulate SERPINE1 and PROX1, which drove epithelial–mesenchymal transition (EMT) or partial-EMT (p-EMT) in OSCC cells and promoted lymphangiogenesis to accelerate LN metastasis. Overall, these findings uncovered the mechanistic role of circFNDC3B in orchestrating cancer cell metastatic properties and vasculature formation, suggesting circFNDC3B could be a potential target to reduce OSCC metastasis.

Significance:
Dual functions of circFNDC3B in enhancing the metastatic ability of cancer cells and promoting vasculature formation through regulation of multiple pro-oncogenic signaling pathways drive lymph node metastasis of OSCC.
Potential Loss of Predictability in the Numerical Weather Prediction from the Reduced Spatial Coverage of the Polar-Orbiting Satellite Observing System
Authors: Noh Young-Chan , Huang Hung-Lung , Goldberg Mitchell D. , Choi Yonghan 
Published: February 2023

Abstract
To provide global coverage for the hyperspectral infrared (IR) and microwave (MW) sounders, the low-Earth-orbiting (LEO) satellite constellation is in operation in three temporally well-spaced sun-synchronous orbits. However, the satellite program can be altered as a result of aging satellites needing to deorbit and/or termination of the legacy program, resulting in less spatiotemporal coverage. In this study, to stress the contribution of IR and MW sounder observations from the LEO satellite constellation on numerical weather prediction (NWP) system performance, the change of the analysis impact is assessed under two assumptions: 1) the loss of the IR and MW sounder observations in each of three sun-synchronous orbits and 2) the loss of the secondary LEO satellite in two orbits, using a 2017 version of the National Centers for Environmental Prediction Global Forecast System (GFS). In the analysis verification, it is found that the analysis field is degraded due to the loss of the IR and MW sounders in each of the three primary orbits. In particular, the satellites in the afternoon orbit significantly contribute to improving the analysis as compared with the satellites in the other two orbits. In addition, the loss of the secondary satellite results in significant degradation of the analysis, resulting from reduced spatial coverage by the IR and MW sounders. These results suggest that the LEO satellite constellation, consisting of the LEO satellites in three primary sun-synchronous orbits, should be maintained in terms of the contribution to the NWP.

Significance Statement
Hyperspectral infrared (IR) and microwave (MW) sounders from low-Earth-orbiting (LEO) satellites significantly contribute to improving numerical weather forecasting. Nevertheless, the resiliency of the LEO satellite programs, operating in three sun-synchronous orbits, can be compromised by aging satellites needing to deorbit and/or termination of legacy satellite systems. Thus, to highlight the importance of the IR and MW sounder observations from LEO satellites in terms of numerical weather forecasting, we assessed the analysis impact of these observations with diverse satellite data availability scenarios. In the trial experiments, it is demonstrated that analysis performance is significantly degraded if the IR and MW sounders are lost, suggesting that the satellite programs carrying the IR and MW sounders should be maintained seamlessly in the future.