bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of communications in enhancing adherence to public health behavioural interventions: a COVID-19 evidence review
Authors: Williams Simon N. , Dienes Kimberly , Jaheed Jemma , Wardman Jamie K. , Petts Judith 
Published: August 2023

Health communication has relevance for virtually every aspect of health and well-being, including disease prevention. This review explored the effectiveness of communications in enhancing the adoption of or adherence to behavioural interventions (non-pharmaceutical interventions (NPIs)) related to COVID-19. The review takes the UK as a case study and focuses on self-reported behaviours (e.g. social distancing). It also reviews the psychosocial determinants of adherence. Searches were conducted using PubMed, Scopus, CINAL, ASSIA and iCite databases. Eleven thousand five hundred records were identified and 13 were included in the final sample. Included studies suggest that NPI adoption or adherence was generally high, and communication had significant impacts, with key themes including clarity and consistency, trust and control. Based on the evidence in this review, features of effective communication in the context of NPI adoption or adherence are (i) information should be conveyed clearly and conflicting (mixed) messages should be avoided; (ii) information should be conveyed by trusted sources (e.g. health authorities) and (iii) communication should strike a balance between being authoritative but avoiding language seen as controlling (e.g. ‘you must’). Future research should prioritize quantitative, experimental and longitudinal study designs, that focus specifically on communication as an intervention, and which measure behaviour.
This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.
A Systematic Background Check of TRICARE Provider Names
Authors: Bychkov David 
Published: August 2023

AbstractDuring Covid-19, the Defense Health Agency’s TRICARE insurance plan expanded its coverage to include 30.1% additional civilian healthcare providers. The DHA’s Annual Report, however, states that TRICARE’s provider directories are only 80% accurate. Although the DHA’s 9.6 million beneficiaries need expanded access to care, they also require protection from misleading information, medical fraud, patient abuse, and identity theft. Since 2013, the Department of Health and Human Services’ Office of the Inspector General has excluded 17,706 physicians from federal health programs due to misconduct. Patients who receive care from excluded providers experience worse medical outcomes. To determine if any excluded provider names were found on TRICARE’s website, we performed background checks on TRICARE West’s healthcare provider directory between January 1 and March 2023. Out of 39,463 provider names sampled from 22 states, there were 2,398 matches (6.08%) with individuals and businesses found in the OIG List of Excluded Individuals and Entities (OIG-LEIE), the GSA-SAM, the HHS HIPAA Breach Report, the International Trade Administration’s Consolidated Screening List, the OIG-HHS Fugitive List, the FBI’s January 6th Capitol Violence List of Charged Defendants, State Medicaid Exclusion Lists, and FDA Debarment Lists. Our study includes demographic analysis of the matching names and recommendations for an Insider Threat Management model. We recommend that DHA officials publish the National Provider Identification (NPI) numbers of all TRICARE providers. NPI numbers facilitate more accurate background checks of healthcare providers.
High proportions of post-exertional malaise and orthostatic intolerance in people living with post-COVID-19 condition: the PRIME post-COVID study
Authors: Pagen Demi M. E. , Herck Maarten Van , van Bilsen Céline J. A. , Brinkhues Stephanie , Konings Kevin , den Heijer Casper D. J. , Spruit Martijn A. , Hoebe Christian J. P. A. , Dukers-Muijrers Nicole H. T. M. 
Published: August 2023

AbstractBackgroundExercise-based treatments can be harmful in people who were SARS-CoV-2 positive and living with post-COVID-19 condition (PL-PCC) and who have post-exertional malaise (PEM) or orthostatic intolerance (OI). Nevertheless, PEM and OI are not routinely assessed by clinicians. We estimated PEM and OI proportions in PL-PCC, as well in people not living with PCC (PnL-PCC) and negatives (i.e., never reported a SARS-CoV-2 positive test), and identified associated factors.MethodsParticipants from the PRIME post-COVID study were included. PEM and OI were assessed using validated questionnaires. PCC was defined as feeling unrecovered after SARS-CoV-2 infection. Multivariable regression analyses to study PEM and OI were stratified for sex.ResultsData from 3,783 participants was analyzed. In PL-PCC, proportion of PEM was 48.1% and 41.2%, and proportion of OI was 29.3% and 27.9% in women and in men, respectively. Proportions were higher in PL-PCC compared to negatives, for PEM in women OR=4.38 [95%CI:3.01-6.38]; in men OR=4.78 [95%CI:3.13-7.29]; for OI in women 3.06 [95%CI:1.97-4.76]; in men 2.71 [95%CI:1.75-4.21]. Associated factors were age ≤60 years, ≥1 comorbidities and living alone.ConclusionsHigh proportions of PEM and OI are observed in PL-PCC. Standard screening for PEM and OI is recommended in PL-PCC, to promote appropriate therapies.Trial registration ClinicalTrials.gov identifier:NCT05128695
A Machine Learning Model Integrated with the Clinical Workflow Detects Sepsis Early with High Sensitivity and Specificity
Authors: Mahyoub Mohammed A. , Yadav Ravi R. , Doughetry Kacie , Shukla Ajit 
Published: August 2023

AbstractBackgroundSepsis is a life-threatening condition caused by a dysregulated response to infection, affecting millions of people worldwide. Early diagnosis and treatment are critical for managing sepsis and reducing morbidity and mortality rates.Materials and MethodsA systematic design approach was employed to build a model that predicts sepsis, incorporating clinical feedback to identify relevant data elements. XGBoost was utilized for prediction, and interpretability was achieved through the application of Shapely values. The model was successfully deployed within a widely used Electronic Medical Record (EMR) system.ResultsThe developed model demonstrated robust performance pre-operations, with a sensitivity of 92%, specificity of 93%, and a false positive rate of 7%. Following deployment, the model maintained comparable performance, with a sensitivity of 91% and specificity of 94%. Notably, the post-deployment false positive rate of 6% represents a substantial reduction compared to the currently deployed commercial model in the same health system, which exhibits a false positive rate of 30%.ConclusionsThese findings underscore the effectiveness and potential value of the developed model in improving timely sepsis detection and reducing unnecessary alerts in clinical practice. Further investigations should focus on its long-term generalizability and impact on patient outcomes.
Whole-of-School Physical Activity Implementation in the Context of the Dubai Fitness Challenge
Authors: McMahon Chris , Webster Collin A. , Weaver R. Glenn , Haber Christophe El , Demir Gönül Tekkurşun , Ismail Zainab Mohamed , Fatima Naqvi Syeda Zoha , Ghani Mehnaz , Kepenek Şevval , Kherraf Manel , Krishnakumar Thrisha , Prakash Pranati , Seo Yeowon 
Published: August 2023

AbstractIntroductionPhysical activity (PA) promotion among school-aged youth is a global health priority. Recommendations for such promotion include implementing whole-of-school approaches that maximize resources across the school environment. This study examined schools’ participation in an annual, government-led, and emirate-wide initiative in Dubai, called the Dubai Fitness Challenge, in which the goal is to accrue 30 minutes of PA every day for 30 days (as such, the initiative is colloquially referred to as “Dubai 30×30”).MethodsA mixed-methods design was employed for this study. Three schools were recruited using convenience sampling. Participants were 18 physical education teachers, 20 classroom teachers, 2 principals and 45 students. Data sources included surveys, focus groups, and interviews. Data were analyzed using descriptive statistics, multinomial logistic regression, and open and axial coding to develop themes.ResultsSchool staff reported that most Dubai 30×30 activities were provided in physical education, at break times during school, and before and after school. Students reported that they mainly participated in Dubai 30×30 activities during physical education and occasionally participated in activities after school and on weekends. During school, students were more likely to reach higher PA intensity levels when they were in contexts other than the regular classroom setting. Among school staff, physical education teachers were most involved and classroom teachers were least involved in promoting Dubai 30×30. Parent engagement was high. Staff perceived that Dubai 30×30 brought the community together, but physical education teachers also indicated there was a lack of implementation guidance and they felt burdened. Participants believed Dubai 30×30 increased PA participation and helped to promote their schools.DiscussionThis study provides an initial glimpse into schools’ participation in Dubai 30×30 and suggests that a whole-of-school PA lens is useful in gleaning information that could help to increase and optimize PA opportunities for students.
Impact of preexisting dementia on in-hospital outcomes in patients with intracerebral hemorrhage stroke in China
Authors: Zuo Lijun , Hu Yang , Dong YanHong , Gu Hongqiu , Seet Raymond CS , Li Zixiao , Wang Yongjun , Zhao Xingquan 
Published: August 2023

AbstractObjectiveWe assessed the impact of preexisting dementia on in-hospital mortality, home discharge and complications of Chinese patients with intracerebral hemorrhage (ICH).MethodsConsecutive in-hospital data were extracted from the China Stroke Center Alliance database from August 2015 to July 2019. Patient characteristics, in-hospital mortality, and complications were compared between ICH patients with and without preexisting dementia.ResultsOut of the eligible 72,318 patients with ICH, we identified 328 patients with pre-existing dementia. Compared with patients without dementia, those in the dementia group were older, more females and a higher proportion of individuals with lower education, and a history of diabetes, myocardial infarction, stroke, heart failure, peripheral vascular disease and cigarette smoking. Those with pre-existing dementia group were more prone to a greater stroke severity as measured by the National Institute of Health Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS) at presentation. In the adjusted models, the presence of preexisting dementia was associated with an increased risk of in-hospital mortality (OR 2.31, 95% CI 1.12-4.77) and more frequent in-hospital complications of pulmonary embolism (OR 5.41, 95% CI 1.16-25.14), pneumonia (OR 1.58, 95% CI 1.08-2.33), urinary tract infection (OR 2.37; 95% CI 1.21-4.64), and gastrointestinal bleeding (OR 2.39, 95% CI 1.27-4.49).ConclusionsICH patients with pre-existing dementia are more prone to more severe strokes and poorer outcomes. Future studies should evaluate the value of intensive risk factor control among individuals with pre-existing dementia for stroke prevention.
Behavioral Factors Associated with Blood Pressure Control in Hypertensive Adults 35 to 64 Years of Age at Risk of Future Stroke: A cross-sectional survey study
Authors: Masson Patricia Railsback , Mawn Barbara Ellen , Leslie-Mazwi Thabele (Bay) , Sethares Kristen A. , Caruso Alyson , Rydberg Jason 
Published: August 2023

ABSTRACTBACKGROUNDThe incidence of stroke has increased for those < 64 years of age over the last decade. Control of hypertension is one of the greatest modifiable risk factors for preventing stroke but remains elusive. In 2017, the American College of Cardiology and American Heart Association national blood pressure guidelines tightened the definition of a normal blood pressure to <120/80 mm Hg, which if achieved would reduce stroke incidence by up to 21%.METHODSThis IRB approved cross-sectional study utilized stratified random sampling to recruit adults, 35 to 64 years of age with an active diagnosis of hypertension, no prior history of stroke or transient ischemic attack (TIA) and under current primary care. Blood pressure was dichotomized into controlled blood pressure (≤120/80 mm Hg) and uncontrolled blood pressure (>120/80 mm Hg). Guided by a modified Health Belief Model, electronic surveys assessing individual medication compliance and beliefs about future stroke risk were distributed. Bivariate and multivariate logistic regression models analyzed the data with α set at 0.05 and observational cohort guidelines were followed.RESULTSOf the 304 subjects, 83% (n=253) had uncontrolled blood pressure, 78% of women and 89% of men, (77% of total subjects) classified as stage 1 or stage 2 hypertension. Men and women had mean composite compliancy scores below the 50thpercentile (21.53 +/-2.89). Women with uncontrolled hypertension were statistically less likely to be compliant (p= 0.040), with lower perceived susceptibility (p= 0.04) and severity of stroke (p=0.037) and less likely to see barriers to initiating exercise (p=0.04)but did not view exercise as beneficial in preventing stroke (p=0.039).CONCLUSIONUncontrolled blood pressure remains problematic for both men and women. Women are known to have greater longevity and this study has identified targeted beliefs and behaviors that may more effectively address uncontrolled blood pressure in women at risk for future stroke.
Ischemic Stroke Risk in Patients on Direct Oral Anticoagulants with Levetiracetam: A Pharmacovigilance Study
Authors: Abou Kaoud Mohammed , Nissan Ran , Segev Amitai , Sabbag Avi , Orion David , Maor Elad 
Published: August 2023

AbstractBackgroundLevetiracetam is widely used in post stroke epilepsy. However, it is suspected to possess P-glycoprotein induction properties and therefore a potential significant interaction with DOACs. Our aim was to search for ischemic stroke signals with levetiracetam and the DOACs.MethodsIn this retrospective, pharmacovigilance study, we used the Food and Drug Administration adverse event reporting system to identify ischemic stroke events associated with DOACs and concomitant use of levetiracetam. We evaluated disproportionate reporting by the reporting odds ratio adjusted to age and sex (adj.ROR) and the lower bound of the shrinkage 95% confidence interval (Ω025> 0 is deemed significant for an interaction).ResultsWe identified 1,841 (1.5%), 3,731 (5.3%), 338 (4.9%), and 1,723 (1.3%), ischemic stroke reports with apixaban, dabigatran, edoxaban, and rivaroxaban respectively. When heparin/enoxaparin was used as the comparator the adjusted ROR of the interaction effect was 3.57 (95%CI, 2.81–4.58) between DOACs and levetiracetam. The shrinkage analysis detected an interaction between each of the DOACs and levetiracetam resulting in higher reports of ischemic stroke with the combination compared to each drug alone. The logistic model and shrinkage analysis failed to detect an interaction when queried for hemorrhagic stroke.ConclusionsWe show a strong signal for the levetiracetam interaction with apixaban, dabigatran, edoxaban, and rivaroxaban leading to a 3-5 folds increased reporting risk of ischemic stroke. Our findings suggest the need for pharmacodynamic monitoring, while concomitantly prescribing levetiracetam with the DOACs.
Volumetric trans-scale imaging of massive quantity of heterogeneous cell populations in centimeter-wide tissue and embryo
Authors: Ichimura Taro , Kakizuka Taishi , Taniguchi Yoshitsugu , Ejima Satoshi , Sato Yuki , Itano Keiko , Seiriki Kaoru , Hashimoto Hitoshi , Sugawara Ko , Itoga Hiroya , Onami Shuichi , Nagai Takeharu 
Published: August 2023

AbstractWe established a volumetric trans-scale imaging system with an ultra-large field-of-view (FOV) that enables simultaneous observation of millions of cellular dynamics in centimeter-wide three-dimensional (3D) tissues and embryos. Using a custom-made giant lens system with a magnification of 2× and a numerical aperture (NA) of 0.25, and a CMOS camera with more than 100 megapixels, we built a trans-scale scope AMATERAS-2, and realized fluorescence imaging with a transverse spatial resolution of approximately 1.1 µm across an FOV of approximately 1.5 × 1.0 cm2. The 3D resolving capability was realized through a combination of optical and computational sectioning techniques tailored for our low-power imaging system. We applied the imaging technique to 1.2 cm-wide section of mouse brain, and successfully observed various regions of the brain with sub-cellular resolution in a single FOV. We also performed time-lapse imaging of a 1-cm-wide vascular network during quail embryo development for over 24 hours, visualizing the movement of over 4.0 × 105vascular endothelial cells and quantitatively analyzing their dynamics. Our results demonstrate the potential of this technique in accelerating production of comprehensive reference maps of all cells in organisms and tissues, which contributes to understanding developmental processes, brain functions, and pathogenesis of disease, as well as high-throughput quality check of tissues used for transplantation medicine.
Heterologous sarbecovirus receptor binding domains as scaffolds for SARS-CoV-2 receptor binding motif presentation
Authors: Hauser Blake M. , Sangesland Maya , Lam Evan C. , Denis Kerri J. St. , Sheehan Maegan L. , Vu Mya L. , Cheng Agnes H. , Balazs Alejandro B. , Lingwood Daniel , Schmidt Aaron G. 
Published: August 2023

AbstractStructure-guided rational immunogen design can generate optimized immunogens that elicit a desired humoral response. Design strategies often center upon targeting conserved sites on viral glycoproteins that will ultimately confer potent neutralization. For SARS-CoV-2 (SARS-2), the surface-exposed spike glycoprotein includes a broadly conserved portion, the receptor binding motif (RBM), that is required to engage the host cellular receptor, ACE2. Expanding humoral responses to this site may result in a more potently neutralizing antibody response against diverse sarbecoviruses. Here, we used a “resurfacing” approach and iterative design cycles to graft the SARS-2 RBM onto heterologous sarbecovirus scaffolds. The scaffolds were selected to vary the antigenic distance relative to SARS-2 to potentially focus responses to RBM. Multimerized versions of these immunogens elicited broad neutralization against sarbecoviruses in the context of preexisting SARS-2 immunity. These validated engineering approaches can help inform future immunogen design efforts for sarbecoviruses and are generally applicable to other viruses.
Contribution of bacterial and host factors to pathogen “blooming” in a gnotobiotic mouse model forSalmonella entericaserovar Typhimurium-induced enterocolitis
Authors: Beutler Markus , Eberl Claudia , Garzetti Debora , Herp Simone , Münch Philipp , Ring Diana , Dolowschiak Tamas , Brugiroux Sandrine , Schiller Patrick , Hussain Saib , Basic Marijana , Bleich Andre , Stecher Barbel 
Published: August 2023

AbstractInflammation has a pronounced impact on the intestinal ecosystem by driving an expansion of facultative anaerobic bacteria at the cost of obligate anaerobic microbiota. This pathogen “blooming” is also a hallmark of entericSalmonellaenterica serovar Typhimurium (S. Tm) infection. Here, we analyzed the contribution of bacterial and host factors toS. Tm “blooming” in a gnotobiotic mouse model forS.Tm-induced enterocolitis. Mice colonized with the Oligo-Mouse-Microbiota (OMM12), a minimal bacterial community, develop fulminant colitis by day 4 after oral infection with wild typeS. Tm but not with an avirulent mutant. Inflammation leads to pronounced reduction in overall intestinal bacterial loads, distinct microbial community shifts and pathogen blooming (relative abundance >50%).S.Tm mutants attenuated in inducing gut inflammation generally elicit less pronounced microbiota shifts and reduction in total bacterial loads. In contrast,S.Tm mutants in nitrate respiration, salmochelin production and ethanolamine utilization induced strong inflammation andS. Tm “blooming”. Therefore, individualSalmonella-specific inflammation-fitness factors seem to be of minor importance for competition against this minimal microbiota in the inflamed gut. Finally, we show that antibody-mediated neutrophil depletion normalized gut microbiota loads but not intestinal inflammation or microbiota shifts. This suggests that neutrophils equally reduce pathogen and commensal bacterial loads in the inflamed gut.
AI-based antibody discovery platform identifies novel, diverse and pharmacologically active therapeutic antibodies against multiple SARS-CoV-2 strains
Authors: Moldovan Loomis Cristina , Lahlali Thomas , Van Citters Danielle , Sprague Megan , Neveu Gregory , Somody Laurence , Siska Christine C. , Deming Derrick , Asakawa Andrew J. , Amimeur Tileli , Shaver Jeremy M. , Carbonelle Caroline , Ketchem Randal R. , Alam Antoine , Clark Rutilio H. 
Published: August 2023

ABSTRACTA critical aspect of a successful pandemic response is expedient antibody discovery, manufacturing and deployment of effective lifesaving treatments to patients around the world. However, typical drug discovery and development is a lengthy multi-step process that must align drug efficacy with multiple developability criteria and can take years to complete. In this context, artificial intelligence (AI), and especially machine learning (ML), have great potential to accelerate and improve the optimization of therapeutics, increasing their activity and safety as well as decreasing their development time and manufacturing costs. Here we present a novel, cost-effective and accelerated approach to therapeutic antibody discovery, that couples AI-designed human antibody libraries, biased for improved developability attributes with high throughput and sensitive screening technologies. The applicability of our platform for effective therapeutic antibody discovery is demonstrated here with the identification of a panel of human monoclonal antibodies that are novel, diverse and pharmacologically active. These first-generation antibodies, without the need for affinity maturation, bind to the SARS-CoV-2 spike protein with therapeutically-relevant specificity and affinity and display neutralization of SARS-CoV-2 viral infectivity across multiple strains. Altogether, this platform is well suited for rapid response to infectious threats, such as pandemic response.IMPORTANCEExpedient discovery and manufacturing of lifesaving therapeutics is critical for pandemic response. The recent COVID pandemic has highlighted the current inefficiencies and the need for improvements. To this end, we present our therapeutic antibody discovery platform that couples artificial intelligence (AI) and innovative high throughput technologies, and we demonstrate its applicability to rapid response. This platform enabled the isolation, characterization, and rapid identification of effective broadly neutralizing SARS-CoV-2 antibodies with good developability attributes, anticipated to fit our current process development and manufacturing platform. As such, this would benefit cost-of-goods and improve therapeutic access to patients. The AI-derived antibodies represent an advantageous therapeutic modality that can be developed and deployed fast, thus well suited for rapid response to infectious threats, such as pandemic response.