bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers and facilitators to the implementation of mandatory folate fortification as an evidence-based policy to prevent neural tube defects
Authors: Ghotme Kemel A. , Arynchyna-Smith Anastasia , Maleknia Pedram , Kancherla Vijaya , Pachon Helena , J. Van der Wees Philip , Bocchino Joseph M. , Rosseau Gail L. 
Published: May 2023

Abstract

Background
Neural tube defects continue to be one of the main congenital malformations affecting the development of the nervous system and a significant cause of disability and disease burden to individuals living with these conditions. Mandatory food fortification with folic acid is, by far, one of the most efficacious, safe, and cost-effective interventions to prevent neural tube defects. However, most countries fail to effectively fortify staple foods with folic acid, impacting public health and healthcare systems and generating dismal disparities.

Aim
This article discusses the main barriers and facilitators for implementing mandatory food fortification as an evidence-based policy to prevent neural tube defects worldwide.

Methods
A comprehensive review of the scientific literature allowed the identification of the determinant factors acting as barriers or facilitators for the reach, adoption, implementation, and scaling up of mandatory food fortification with folic acid as an evidence-based policy.

Results
We identified eight barriers and seven facilitators as determinant factors for food fortification policies. The identified factors were classified as individual, contextual, and external, inspired by the Consolidated Framework for Implementation of Research (CFIR). We discuss mechanisms to overcome obstacles and seize the opportunities to approach this public health intervention safely and effectively.

Conclusions
Several determinant factors acting as barriers or facilitators influence the implementation of mandatory food fortification as an evidence-based policy worldwide. Notoriously, policymakers in many countries may lack knowledge of the benefits of scaling up their policies to prevent folic acid-sensitive neural tube defects, improve the health status of their communities, and promote the protection of many children from these disabling but preventable conditions. Not addressing this problem negatively affects four levels: public health, society, family, and individuals. Science-driven advocacy and partnerships with essential stakeholders can help overcome the barriers and leverage the facilitators for safe and effective food fortification.
Not obtaining a medication the first time it is prescribed: primary non-adherence to cardiovascular pharmacotherapy
Authors: Schulz Martin , Laufs Ulrich 
Published: May 2023

AbstractPrimary medication non-adherence describes the situation when a first prescription for a new medication is never filled. Primary non-adherence is an important, yet understudied aspect of reduced effectiveness of pharmacotherapy. This review summarizes the frequency, impact, reasons, predictors, and interventions regarding primary non-adherence to cardiovascular/cardiometabolic drugs. The current literature reveals a high prevalence of primary non-adherence. The individual risk of primary non-adherence is determined on multiple factors, e.g., primary non-adherence of lipid-lowering drugs is higher compared to antihypertensive medications. However, the overall rate of primary non-adherence is > 10%. Additionally, this review identifies specific areas for research to better understand why patients forgo evidence-based beneficial pharmacotherapy and to explore targeted interventions. At the same time, measures to reduce primary non-adherence—once proven to be effective—may represent an important new opportunity to reduce cardiovascular diseases.
Impact of a brochure and empathetic physician communication on patients’ perception of breast biopsies
Authors: Machacek Martina , Urech Corinne , Tschudin Sibil , Werlen Laura , Schoenenberger Cora-Ann , Zanetti-Dällenbach Rosanna 
Published: May 2023

Abstract
Purpose
This study investigated the effect of an intervention designed to reduce patients’ emotional distress associated with breast biopsy.

Methods
125 breast biopsy patients receiving standard of care (control group, CG) were compared to 125 patients (intervention group, IG) who received a brochure with information prior to the biopsy and were biopsied by physicians trained in empathic communication. Anxiety was assessed by the State-Anxiety Inventory (STAI-S) at four time points (pre- and post-procedural, pre- and post-histology). All participants completed pre- and post-procedural questionnaires addressing worries, pain and comprehension. We evaluated the impact of the intervention on STAI-S levels using a log-transformed linear mixed effects model and explored patients’ and physicians’ perceptions of the procedure descriptively.

Results
Post-procedural and post-histology timepoints were associated with 13% and17% lower with STAI-S levels than at the pre-procedural timepoint on average. The histologic result had the strongest association with STAI-S: malignancy was associated with 28% higher STAI-S scores than a benign finding on average. Across all time points, the intervention did not affect patient anxiety. Nevertheless, IG participants perceived less pain during the biopsy. Nearly all patients agreed that the brochure should be handed out prior to breast biopsy.

Conclusion
While the distribution of an informative brochure and a physician trained in empathic communication did not reduce patient anxiety overall, we observed lower levels of worry and perceived pain regarding breast biopsy in the intervention group. The intervention seemed to improve patient’s understanding of the procedure. Moreover, professional training could increase physicians’ empathic communication skills.

Trial registration number
NCT 02796612 (March 19, 2014).
What distinguishes patients with mass social media-induced illness presenting with Tourette-like behavior from those with Tourette syndrome? Results of a prospective cohort study
Authors: Fremer Carolin , Szejko Natalia , Pisarenko Anna , Haas Martina , Laudenbach Luise , Wegener Claudia , Müller-Vahl Kirsten R. 
Published: May 2023

AbstractSince 2019, a global increase in patients presenting with functional Tourette-like behaviors (FTB) has been observed. This has been related to the exposure of tic-related content in social media, although other factors seem to further fuel this phenomenon. Recently, we, therefore, proposed the term mass social media-induced illness (MSMI) as, in our opinion, this phenomenon constitutes a new type of mass sociogenic illness (MSI) that is in contrast to all recent outbreaks spread solely via social media. In accordance with this hypothesis, we were able to identify the host of the German YouTube channel "Gewitter im Kopf" (“Thunderstorm in the brain”) as the initial virtual index case. The purpose of this paper is to present clinical characteristics of a sample of 32 patients diagnosed with MSMI-FTB compared to a large sample of patients with Tourette syndrome (TS) and other chronic tic disorders (CTD) (n = 1032) from the same center in Germany indicating clinical factors helpful to distinguish between tics in TS/CTD and MSMI-FTB. Our main findings were: in patients with MSMI-FTB compared to those with TS/CTD we found (i) a significantly higher age at onset, (ii) a significantly higher rate of females, (iii) a significantly higher rate of obscene and socially inappropriate symptoms, (iv) a significantly lower rate of comorbid ADHD, and (v) a significantly lower rate of OCD/OCB. In contrast, rates of comorbid anxiety and depression as well as reported frequencies of premonitory urges/sensations and suppressibility of symptoms did not differ between groups.
Truncated nonsmooth Newton multigrid for phase-field brittle-fracture problems, with analysis
Authors: Gräser Carsten , Kienle Daniel , Sander Oliver 
Published: May 2023

AbstractWe propose the truncated nonsmooth Newton multigrid method (TNNMG) as a solver for the spatial problems of the small-strain brittle-fracture phase-field equations. TNNMG is a nonsmooth multigrid method that can solve biconvex, block-separably nonsmooth minimization problems with linear time complexity. It exploits the variational structure inherent in the problem, and handles the pointwise irreversibility constraint on the damage variable directly, without regularization or the introduction of a local history field. In the paper we introduce the method and show how it can be applied to several established models of phase-field brittle fracture. We then prove convergence of the solver to a solution of the nonsmooth Euler–Lagrange equations of the spatial problem for any load and initial iterate. On the way, we show several crucial convexity and regularity properties of the models considered here. Numerical comparisons to an operator-splitting algorithm show a considerable speed increase, without loss of robustness.
Fatigue in fluctuating Parkinson’s disease patients: possible impact of safinamide
Authors: Pauletti Caterina , Locuratolo Nicoletta , Mannarelli Daniela , Maffucci Andrea , Petritis Alessia , Menini Elisa , Fattapposta Francesco 
Published: May 2023

AbstractFatigue is a common non-motor symptom in Parkinson’s disease (PD). Among other pathophysiological mechanisms, neuroinflammation, a pathological PD hallmark associated with changes in glutamatergic transmission in basal ganglia, has been proposed as a crucial factor closely related to fatigue. To test the hypothesis that safinamide could represent an effective treatment of fatigue in PD patients, given its dual mechanism of action (it selectively and reversibly inhibits MAOB and modulates glutamate release), we administered the validated versions of fatigue severity scale (FSS) and Parkinson fatigue scale-16 (PFS-16) to 39 fluctuating PD patients with fatigue before and after a 24-week treatment period with safinamide as add-on therapy. An assessment of secondary variables such as depression, quality of life (QoL), and motor and non-motor symptoms (NMS) was conducted. After 24 weeks of treatment with safinamide, both FSS (p < 0.001) and PF-S16 (p = 0.02) scores were significantly lower than at baseline. Moreover, 46.2% and 41% of patients scored below the cut-off for the presence of fatigue according to FSS and PFS-16, respectively (responders). At follow-up, a significant difference emerged between responders and non-responders in mood, QoL, and NMS. Fatigue improved in fluctuating PD, and more than 40% of patients were “fatigue-free” after a 6 month treatment with safinamide. Patients without fatigue at follow-up displayed significantly better scores in QoL domains, such as mobility or activities of daily living, although disease severity remained stable, supporting the hypothesis that fatigue could considerably affect QoL. Drugs that interact with multiple neurotransmission systems, such as safinamide, could be useful in reducing this symptom.
Isolation and genetic characterization of a mammalian orthoreovirus from Vespertilio sinensis in Japan
Authors: Ichikawa Ayano , Katayama Misa , Lai Hayden , Wataru Sekine , Takenaka-Uema Akiko , Horimoto Taisuke , Murakami Shin 
Published: May 2023

AbstractThroughout East Asia, Europe, and North America, mammalian orthoreovirus (MRV), for which bats have been proposed to be natural reservoirs, has been detected in a variety of domestic and wild mammals, as well as in humans. Here, we isolated a novel MRV strain (designated as Kj22-33) from a fecal sample from Vespertilio sinensis bats in Japan. Strain Kj22-33 has a 10-segmented genome with a total length of 23,580 base pairs. Phylogenetic analysis indicated that Kj22-33 is a serotype 2 strain, the segmented genome of which has undergone reassortment with that of other MRV strains.
Effect of nintedanib in patients with progressive pulmonary fibrosis associated with rheumatoid arthritis: data from the INBUILD trial
Authors: Matteson Eric L. , Aringer Martin , Burmester Gerd R. , Mueller Heiko , Moros Lizette , Kolb Martin 
Published: May 2023

Abstract
Objectives
Some patients with rheumatoid arthritis develop interstitial lung disease (RA-ILD) that develops into progressive pulmonary fibrosis. We assessed the efficacy and safety of nintedanib versus placebo in patients with progressive RA-ILD in the INBUILD trial.

Methods
The INBUILD trial enrolled patients with fibrosing ILD (reticular abnormality with traction bronchiectasis, with or without honeycombing) on high-resolution computed tomography of >10% extent. Patients had shown progression of pulmonary fibrosis within the prior 24 months, despite management in clinical practice. Subjects were randomised to receive nintedanib or placebo.

Results
In the subgroup of 89 patients with RA-ILD, the rate of decline in FVC over 52 weeks was −82.6 mL/year in the nintedanib group versus −199.3 mL/year in the placebo group (difference 116.7 mL/year [95% CI 7.4, 226.1]; nominal p = 0.037). The most frequent adverse event was diarrhoea, which was reported in 61.9% and 27.7% of patients in the nintedanib and placebo groups, respectively, over the whole trial (median exposure: 17.4 months). Adverse events led to permanent discontinuation of trial drug in 23.8% and 17.0% of subjects in the nintedanib and placebo groups, respectively.

Conclusions
In the INBUILD trial, nintedanib slowed the decline in FVC in patients with progressive fibrosing RA-ILD, with adverse events that were largely manageable. The efficacy and safety of nintedanib in these patients were consistent with the overall trial population. A graphical abstract is available at: https://www.globalmedcomms.com/respiratory/INBUILD_RA-ILD.

Key Points• In patients with rheumatoid arthritis and progressive pulmonary fibrosis, nintedanib reduced the rate of decline in forced vital capacity (mL/year) over 52 weeks by 59% compared with placebo.• The adverse event profile of nintedanib was consistent with that previously observed in patients with pulmonary fibrosis, characterised mainly by diarrhoea.• The effect of nintedanib on slowing decline in forced vital capacity, and its safety profile, appeared to be consistent between patients who were taking DMARDs and/or glucocorticoids at baseline and the overall population of patients with rheumatoid arthritis and progressive pulmonary fibrosis.
Relaxation measurements of an MRI system phantom at low magnetic field strengths
Authors: Martin Michele N. , Jordanova Kalina V. , Kos Anthony B. , Russek Stephen E. , Keenan Kathryn E. , Stupic Karl F. 
Published: May 2023

Abstract
Objective
Temperature controlled T1 and T2 relaxation times are measured on NiCl2 and MnCl2 solutions from the ISMRM/NIST system phantom at low magnetic field strengths of 6.5 mT, 64 mT and 550 mT.

Materials and methods
The T1 and T2 were measured of five samples with increasing concentrations of NiCl2 and five samples with increasing concentrations of MnCl2. All samples were scanned at 6.5 mT, 64 mT and 550 mT, at sample temperatures ranging from 10 °C to 37 °C.

Results
The NiCl2 solutions showed little change in T1 and T2 with magnetic field strength, and both relaxation times decreased with increasing temperature. The MnCl2 solutions showed an increase in T1 and a decrease in T2 with increasing magnetic field strength, and both T1 and T2 increased with increasing temperature.

Discussion
The low field relaxation rates of the NiCl2 and MnCl2 arrays in the ISMRM/NIST system phantom are investigated and compared to results from clinical field strengths of 1.5 T and 3.0 T. The measurements can be used as a benchmark for MRI system functionality and stability, especially when MRI systems are taken out of the radiology suite or laboratory and into less traditional environments.
An integrated target field framework for point-of-care halbach array low-field MRI system design
Authors: de Vos Bart , Remis Rob F. , Webb Andrew G. 
Published: May 2023

AbstractObjectiveLow-cost low-field point-of-care MRI systems are used in many different applications. System design has correspondingly different requirements in terms of imaging field-of-view, spatial resolution and magnetic field strength. In this work an iterative framework has been created to design a cylindrical Halbach-based magnet along with integrated gradient and RF coils that most efficiently fulfil a set of user-specified imaging requirements.MethodsFor efficient integration, target field methods are used for each of the main hardware components. These have not been used previously in magnet design, and a new mathematical model was derived accordingly. These methods result in a framework which can design an entire low-field MRI system within minutes using standard computing hardware.ResultsTwo distinct point-of-care systems are designed using the described framework, one for neuroimaging and the other for extremity imaging. Input parameters are taken from literature and the resulting systems are discussed in detail.DiscussionThe framework allows the designer to optimize the different hardware components with respect to the desired imaging parameters taking into account the interdependencies between these components and thus give insight into the influence of the design choices.
Considerations on using MCS and EMS-98 macroseismic scales for the intensity assessment of contemporary Italian earthquakes
Authors: Del Mese S. , Graziani L. , Meroni F. , Pessina V. , Tertulliani A. 
Published: May 2023

AbstractThe concept of macroseismic intensity arose with the purpose of measuring the strength of an earthquake by the effects it causes on buildings, people, and domestic furnishings. From this perspective, buildings can be considered seismic sensors that record the shaking. Early scales were conceived at a time when buildings were mainly in masonry and therefore they could be used as markers of the intensity in case of earthquakes. Indeed, since they were fairly homogeneous, their level of damage could be considered as an indicator of the shaking level. In recent decades, the evolution of construction techniques have made the MCS scale unsuitable for damage assessment of buildings of various resistance. To overcome this problem the EMS-98 scale was designed. Because the MCS scale is still used in Italy, even in the presence of many reinforced concrete buildings, the purpose of this work is to show that the EMS-98 is the most suitable tool for assessing intensity as it is more consistent with the built environment. Theoretical and real intensity assessments, by both MCS and EMS-98, have been determined and compared, showing that nowadays intensity is a function of the vulnerability. MCS and EMS-98 would be comparable only when the building stock is composed of very vulnerable edifices (generally class A). Finally, thanks to the similarity of the two scales for old and vulnerable buildings, EMS-98 appears fully adequate to investigate historical earthquakes and represents a powerful tool to ensure continuity among earthquakes of different epochs.
Quantification of subtype purity in Luminal A breast cancer predicts clinical characteristics and survival
Authors: Kumar Neeraj , Gann Peter H. , McGregor Stephanie M. , Sethi Amit 
Published: May 2023

Abstract
Purpose
PAM50 profiling assigns each breast cancer to a single intrinsic subtype based on a bulk tissue sample. However, individual cancers may show evidence of admixture with an alternate subtype that could affect prognosis and treatment response. We developed a method to model subtype admixture using whole transcriptome data and associated it with tumor, molecular, and survival characteristics for Luminal A (LumA) samples.

Methods
We combined TCGA and METABRIC cohorts and obtained transcriptome, molecular, and clinical data, which yielded 11,379 gene transcripts in common and 1,178 cases assigned to LumA. We used semi-supervised non-negative matrix factorization (ssNMF) to compute the subtype admixture proportions of the four major subtypes—pLumA, pLumB, pHER2, and pBasal—for each case and measured associations with tumor characteristics, molecular features, and survival.

Results
Luminal A cases in the lowest versus highest quartile for pLumA transcriptomic proportion had a 27% higher prevalence of stage > 1, nearly a threefold higher prevalence of TP53 mutation, and a hazard ratio of 2.08 for overall mortality. We found positive associations between pHER2 and HER2 positivity by IHC or FISH; between pLumB and PR negativity; and between pBasal and younger age, node positivity, TP53 mutation, and EGFR expression. Predominant basal admixture, in contrast to predominant LumB or HER2 admixture, was not associated with shorter survival.

Conclusion
Bulk sampling for genomic analyses provides an opportunity to expose intratumor heterogeneity, as reflected by subtype admixture. Our results elucidate the striking extent of diversity among LumA cancers and suggest that determining the extent and type of admixture holds promise for refining individualized therapy. LumA cancers with a high degree of basal admixture appear to have distinct biological characteristics that warrant further study.
Emerging Digital Practices Supporting Student-Centered Learning Environments in Higher Education: A Review of Literature and Lessons Learned from the Covid-19 Pandemic
Authors: Otto Sofie , Bertel Lykke Brogaard , Lyngdorf Niels Erik Ruan , Markman Anna Overgaard , Andersen Thomas , Ryberg Thomas 
Published: May 2023

AbstractThe aim of this paper is two-fold: firstly, to provide an overview of emerging digital practices that support collaborative learning, competency development, and digital literacy for student-centered learning environments in higher education during the rapid digital transition caused by pandemic-related lockdowns across the world, and secondly, to analyze and discuss how systematic reviews of generalized themes and trends can be combined with contextualized experiences and the lessons learned from the Covid-19 crisis to inform the digital transformation of higher education, with a particular focus on bridging the gap between campus-based teaching and online learning and on the identification of the digital competencies that teachers and students must acquire during the continuing shift into a ‘new normal’ for post-pandemic educational practices. This study was motivated by questions and findings emerging from an early reactive case study conducted by three of this paper’s co-authors (Lyngdorf et al., 2021a). By reviewing the full texts of 18 articles, this study provides a systematic literature review which maps the general landscape of the online, hybrid, and blended digital practices applied in existing student-centered learning environments in higher education since the onset of the pandemic. Furthermore, this mapping is used to revisit data and findings from the earlier reactive study of emerging digital practices in a specific problem- and project-based learning (PBL) environment. This study’s findings highlight critical factors and barriers related to emerging practices which support students’ interactions with teachers, content, and each other, as well as the emerging competencies that these practices will require. The paper concludes with a discussion of the main findings and their implications for further research and practice.