bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality improvement dashboard for healthcare providers and targeted client communication to pregnant women to improve timely attendance and quality of antenatal care: A multi-arm cluster randomized trial (the eRegCom trial)
Authors: Mørkrid Kjersti , Ghanem Buthaina , Abbas Eatimad , Khader Khadija Abu , Ward Itimad Abu , Ataallah Amjad , Baniode Mohammad , Bogale Binyam , Hijaz Taghreed , Frost Kimberly Suzanne , Frost Michael James , Isbeih Mervett , Issawi Sally , Nazzal Zaher A S , O’Donnell Brian , Papadopoulou Eleni , Qaddomi Sharif E , Rabah Yousef , Rose Christopher J , Venkateswaran Mahima , Frøen J Frederik 
Published: August 2023

Abstract
Background: Digital health interventions can strengthen coverage and quality of care. Our aim was to assess the effectiveness of targeted client communication (TCC) to pregnant women via text messages, health care provider communication via a quality improvement dashboard (QID) and the combination of TCC and QID—generated and delivered from a digital maternal and child health registry (MCH eRegistry), running on the District Health Information Software 2 (DHIS2) platform in West Bank and Gaza. The control was the regular MCH eRegistry.
Methods: We included 137 clusters in a four-arm cluster randomized controlled trial. Primary outcomes were appropriate screening and management of anemia, hypertension and diabetes during pregnancy, and timely attendance to routine antenatal care (ANC).
Results: The COVID-19 pandemic interrupted the trial, which failed to achieve the estimated sample size. Between 1 December 2019 and 23 March 2020, 4138 women attended ANC in the TCC, 3553 in the QID, 4223 in the TCC & QID and 3324 in the control arm. In the TCC arm, 76.5% of the visits were attended timely versus 73.4% in the control arm, (adjusted odds ratio, 1.2; 95% confidence interval, 0.90–1.61). We found no difference between QID and control, or between TCC & QID control in the proportion of visits where anemia, hypertension and diabetes were appropriately screened and managed.
Conclusion: The routine individual-level data of the MCH eRegistry enabled the implementation of theory-driven TCC and QID. However, the COVID-19 pandemic interrupted this trial of TCC and QID, and we were unable to observe any significant effect.
Trial registration: ISRCTN Registry, ISRCTN10520687.
The Amount of Zeaxanthin Epoxidase But Not the Amount of Violaxanthin De-Epoxidase Is a Critical Determinant of Zeaxanthin Accumulation in Arabidopsis thaliana and Nicotiana tabacum
Authors: Küster Lukas , Lücke Rebecca , Brabender Christin , Bethmann Stephanie , Jahns Peter 
Published: August 2023

Abstract
The generation of violaxanthin (Vx) de-epoxidase (VDE), photosystem II subunit S (PsbS) and zeaxanthin (Zx) epoxidase (ZEP) (VPZ) lines, which simultaneously overexpress VDE, PsbS and ZEP, has been successfully used to accelerate the kinetics of the induction and relaxation of non-photochemical quenching (NPQ). Here, we studied the impact of the overexpression of VDE and ZEP on the conversion of the xanthophyll cycle pigments in VPZ lines of Arabidopsis thaliana and Nicotiana tabacum. The protein amount of both VDE and ZEP was determined to be increased to about 3- to 5-fold levels of wild-type (WT) plants for both species. Compared to WT plants, the conversion of Vx to Zx, and hence VDE activity, was only marginally accelerated in VPZ lines, whereas the conversion of Zx to Vx, and thus ZEP activity, was strongly increased in VPZ lines. This indicates that the amount of ZEP but not the amount of VDE is a critical determinant of the equilibrium of the de-epoxidation state of xanthophyll cycle pigments under saturating light conditions. Comparing the two steps of epoxidation, particularly the second step (antheraxanthin to Vx) was found to be accelerated in VPZ lines, implying that the intermediate Ax is released into the membrane during epoxidation by ZEP.
Deep Learning from Phylogenies for Diversification Analyses
Authors: Lambert Sophia , Voznica Jakub , Morlon Hélène 
Published: August 2023

Abstract
Birth–death (BD) models are widely used in combination with species phylogenies to study past diversification dynamics. Current inference approaches typically rely on likelihood-based methods. These methods are not generalizable, as a new likelihood formula must be established each time a new model is proposed; for some models, such a formula is not even tractable. Deep learning can bring solutions in such situations, as deep neural networks can be trained to learn the relation between simulations and parameter values as a regression problem. In this paper, we adapt a recently developed deep learning method from pathogen phylodynamics to the case of diversification inference, and we extend its applicability to the case of the inference of state-dependent diversification models from phylogenies associated with trait data. We demonstrate the accuracy and time efficiency of the approach for the time-constant homogeneous BD model and the Binary-State Speciation and Extinction model. Finally, we illustrate the use of the proposed inference machinery by reanalyzing a phylogeny of primates and their associated ecological role as seed dispersers. Deep learning inference provides at least the same accuracy as likelihood-based inference while being faster by several orders of magnitude, offering a promising new inference approach for the deployment of future models in the field.
A car-following model based on the optimized velocity and its security analysis
Authors: Fei Rong , Yang Lu , Hei Xinhong , Hu Bo , Li Aimin 
Published: August 2023

Abstract
An enhanced optimal velocity model (EOVM) that considers driving safety is established to alleviate traffic congestion and ensure driving safety. Time headway is introduced as a criterion for determining whether the car is safe. When the time headway is less than the minimum time headway (THmin ) or more than the most comfortable time headway (THcom), the acceleration constraints are discussed to ensure the model’s safety and maintain the following state. A stability analysis of the model was carried out to determine the stability conditions of the model. The EOVM is compared with the optimal velocity model (OVM) and fuzzy car-following model using the real dataset. Experiments show that the EOVM model has the smallest error in average, maximum and median with the real dataset. To confirm the model’s safety, design fleet simulation experiments were conducted for three actual scenarios of starting, stopping and uniform process.
Hmga1‐overexpressing lentivirus protects against osteoporosis by activating the Wnt/β‐catenin pathway in the osteogenic differentiation of BMSCs
Authors: Wu Zhixin , Zhu Jiayong , Wen Yinxian , Lei Pengfei , Xie Jie , Shi Haifei , Wu Ronghuan , Lou Xianfeng , Hu Yihe 
Published: August 2023

AbstractPostmenopausal osteoporosis is associated with bone formation inhibition mediated by the impaired osteogenic differentiation potential of bone marrow mesenchymal stem cells (BMSCs). However, identifying and confirming the essential genes in the osteogenic differentiation of BMSCs and osteoporosis remain challenging. The study aimed at revealing the key gene that regulated osteogenic differentiation of BMSCs and led to osteoporosis, thus exploring its therapeutic effect in osteoporosis. In the present study, six essential genes related to the osteogenic differentiation of BMSCs and osteoporosis were identified, namely, fibrillin 2 (Fbn2), leucine‐rich repeat‐containing 17 (Lrrc17), heat shock protein b7 (Hspb7), high mobility group AT‐hook 1 (Hmga1), nexilin F‐actin‐binding protein (Nexn), and endothelial cell‐specific molecule 1 (Esm1). Furthermore, the in vivo and in vitro experiments showed that Hmga1 expression was increased during the osteogenic differentiation of rat BMSCs, while Hmga1 expression was decreased in the bone tissue of ovariectomized (OVX) rats. Moreover, the expression of osteogenic differentiation‐related genes, the activity of alkaline phosphatase (ALP), and the number of mineralized nodules were increased after Hmga1 overexpression, which was partially reversed by a Wnt signaling inhibitor (DKK1). In addition, after injecting Hmga1‐overexpressing lentivirus into the bone marrow cavity of OVX rats, the bone loss, and osteogenic differentiation inhibition of BMSCs in OVX rats were partially reversed, while osteoclast differentiation promotion of BMSCs in OVX rats was unaffected. Taken together, the present study confirms that Hmga1 prevents OVX‐induced bone loss by the Wnt signaling pathway and reveals that Hmga1 is a potential gene therapeutic target for postmenopausal osteoporosis.
Anaphylaxis due to antiallergic and antiasthmatic biologics
Authors: Furci Fabiana , Luxi Nicoletta , Senna Gianenrico , Trifirò Gianluca 
Published: August 2023

Purpose of review
To provide a better understanding of the risk of anaphylaxis due to antiallergic and antiasthmatic biologics through an analysis of data reported in literature and in clinical trials, and by conducting a retrospective descriptive analysis of individual case safety reports on VigiBase, the WHO International Pharmacovigilance database.

Recent findings
Analysis of the data, as described, demonstrated safety of the antiallergic and antiasthmatic biologics with a low incidence of anaphylaxis.

Summary
Biologic therapies have revolutionized the treatment of many diseases, such as atopic dermatitis, nasal polyps, spontaneous chronic urticarial and severe asthma with a precise immunological action, in the sphere of precision medicine.
Albeit these drugs are generally well tolerated, generating real-world evidence is crucial to re-evaluate clinically relevant adverse events, such as anaphylaxis, allowing to confirm their safety profile in particular in special populations such as paediatric patients.
Transition to Residency: National Study of Factors Contributing to Variability in Learner Milestones Ratings in Emergency Medicine and Family Medicine
Authors: Park Yoon Soo , Ryan Michael S. , Hogan Sean O. , Berg Katherine , Eickmeyer Adam , Fancher Tonya L. , Farnan Jeanne , Lawson Luan , Turner Laurah , Westervelt Marjorie , Holmboe Eric , Santen Sally A. ,   for the Medical School Outcomes Milestones Study Group
Published: August 2023

Purpose
The developmental trajectory of learning during residency may be attributed to multiple factors, including variation in individual trainee performance, program-level factors, graduating medical school effects, and the learning environment. Understanding the relationship between medical school and learner performance during residency is important in prioritizing undergraduate curricular strategies and educational approaches for effective transition to residency and postgraduate training. This study explores factors contributing to longitudinal and developmental variability in resident Milestones ratings, focusing on variability due to graduating medical school, training program, and learners using national cohort data from emergency medicine (EM) and family medicine (FM).

Method
Data from programs with residents entering training in July 2016 were used (EM: n=1,645 residents, 178 residency programs; FM: n=3,997 residents, 487 residency programs). Descriptive statistics were used to examine data trends. Cross-classified mixed-effects regression were used to decompose variance components in Milestones ratings.

Results
During postgraduate year (PGY)-1, graduating medical school accounted for 5% and 6% of the variability in Milestones ratings, decreasing to 2% and 5% by PGY-3 for EM and FM, respectively. Residency program accounted for substantial variability during PGY-1 (EM=70%, FM=53%) but decreased during PGY-3 (EM=62%, FM=44%), with greater variability across training period in patient care (PC), medical knowledge (MK), and systems-based practice (SBP). Learner variance increased significantly between PGY-1 (EM=23%, FM=34%) and PGY-3 (EM=34%, FM=44%), with greater variability in practice-based learning and improvement (PBLI), professionalism (PROF), and interpersonal communication skills (ICS).

Conclusions
The greatest variance in Milestone ratings can be attributed to the residency program and to a lesser degree, learners, and medical school. The dynamic impact of program-level factors on learners shifts during the first year and across the duration of residency training, highlighting the influence of curricular, instructional, and programmatic factors on resident performance throughout residency.
From Eggshells to Action: A Qualitative Study of Faculty Experience Responding to Microaggressions Targeting Medical Students
Authors: O’Brien Meghan T. , Bullock Justin L. , Minhas Prabhjot K. , Roman Sanziana A. , Joshi Priya , Lupton Katherine L. , Hauer Karen E. 
Published: August 2023

Purpose
Microaggressions targeting clinical learners cause harm and threaten learning. Clinical supervisors can be powerful allies by intervening when microaggressions occur. This study explored general and student-nominated skilled supervisors’ perspectives on responding to microaggressions targeting clinical learners.

Method
This single-institution, qualitative study within a constructivist paradigm explored faculty supervisor experiences with bystander response to microaggressions targeting learners. Clinical supervisors in medicine and surgery departments and those across departments nominated by students as skilled microaggression responders were invited to discuss microaggression scenarios targeting students in semistructured focus groups in the U.S. in 2020–2021. Investigators applied the framework method of thematic analysis to identify themes.

Results
Forty-two faculty (31 medicine and surgery [“general”], 11 “student-nominated” as skilled responders) joined 10 focus groups (6 “general,” 3 “student-nominated,” 1 mixed). Four themes characterized experiences responding to microaggressions targeting learners: bystander goals, noticing, acting, and continuous learning. Participants’ response goals were protecting learners, safeguarding learning, and teaching microaggression response skills. Noticing was influenced by past experiences with microaggressions and acculturation to clinical environments. Bystander action stemmed from (1) microaggression type, (2) personal emotional vulnerability, (3) knowledge of student preferences for supervisor response, and (4) clinical and educational context. Bystander action was more common when participants regarded all microaggressions as harmful, understood student preferences for faculty response, expected to err (growth mindset), and framed microaggressions as opportunities for humble reflection, intellectual candor, and teaching. Microaggression response required continuous learning through informal and formal skills development.

Conclusions
Complex factors govern faculty bystander response to microaggressions targeting clinical learners. Efforts to strengthen faculty bystander response should incorporate skill-building around preemptive discussions with learners and using intellectual candor to promote psychological safety, learning, and bystander action. Additional investigation is needed on how to incorporate these skills into team workflows and to assess outcomes of specific response strategies.
Hearing Aids Reduce Self-Perceived Difficulties in Noise for Listeners With Normal Audiograms
Authors: Mealings Kiri , Valderrama Joaquin T. , Mejia Jorge , Yeend Ingrid , Beach Elizabeth F. , Edwards Brent 
Published: August 2023

Objectives:
This study assessed hearing aid benefits for people with a normal audiogram but hearing-in-noise problems in everyday listening situations.

Design:
Exploratory double-blinded case-control study whereby participants completed retrospective questionnaires, ecological momentary assessments, speech-in-noise testing, and mental effort testing with and without hearing aids. Twenty-seven adults reporting speech-in-noise problems but normal air conduction pure-tone audiometry took part in the study. They were randomly separated into an experimental group that trialed mild-gain hearing aids with advanced directional processing and a control group fitted with hearing aids with no gain or directionality.

Results:
Self-reports showed mild-gain hearing aids reduce hearing-in-noise difficulties and provide a better hearing experience (i.e., improved understanding, participation, and mood). Despite the self-reported benefits, the laboratory tests did not reveal a benefit from the mild-gain hearing aids, with no group differences on speech-in-noise tests or mental effort measures. Further, participants found the elevated cost of hearing aids to be a barrier for their adoption.

Conclusions:
Hearing aids benefit the listening experience in some listening situations for people with normal audiogram who report hearing difficulties in noise. Decreasing the price of hearing aids may lead to greater accessibility to those seeking remediation for their communication needs.
Effect of Chronic Rhinitis Treatment in Children with Attention-Deficit/Hyperactivity Disorder
Authors: Suntiwes Ruaywan , Chirdkiatgumchai Vilawan , Roongpraiwan Rawiwan , Kuptanon Teeradej , Kiatrungrit Komsan , Manuyakorn Wiparat 
Published: August 2023

ABSTRACT:

Objective:
The purpose of this study is to examine the effect of chronic rhinitis treatment on attention-deficit/hyperactivity disorder (ADHD) symptoms in children with ADHD.

Methods:
Children and adolescents with ADHD were screened for chronic rhinitis symptoms. Participants with positive chronic rhinitis screening underwent the skin prick test and received rhinitis treatment for 3 months. All participants were evaluated using the parent's and teacher's Vanderbilt ADHD rating scales, total nasal symptom score, and Quality of Life Questionnaire (OSA-18) for pediatric obstructive sleep apnea at pretreatment and posttreatment.

Results:
Overall, 140 children and adolescents with ADHD were enrolled and screened for chronic rhinitis. Fifty-four children and adolescents with positive screening results underwent the skin prick test and received rhinitis treatment. After 3 months of treatment, inattentive, hyperactive/impulsive, and total ADHD symptom scores were significantly decreased as reported by parents (p = 0.031 to <0.001) and teachers (p = 0.001 to <0.001) compared with those before treatment. A subgroup analysis also showed improvement in ADHD symptoms as reported by parents and teachers in the allergic and nonallergic rhinitis groups. Pearson's correlation coefficient analyses showed positive correlations between improvement in the ADHD symptom scores reported by parents and improvement in the quality of life related to sleep problems from the OSA-18 questionnaire (r = 0.377–0.387).

Conclusion:
Treating chronic rhinitis can improve ADHD symptoms in children and adolescents with ADHD. Pediatricians should be aware of and treat chronic rhinitis to maximize ADHD symptom control.
The Dynamic Lymphaticovenular Anastomosis for Breast Cancer–related Lymphedema without Compression: Salvaging Lymphedema Patients Who Lost Conservative Treatment Opportunity
Authors: Seki Yukio , Kajikawa Akiyoshi , Asai Rintaro , Tomochika Mayo , Nemoto Hitoshi , Terashima Takahiro , Kurogi Norimitsu 
Published: August 2023

Background:
In conservative treatment for breast cancer–related lymphedema (BCRL), compression therapy has a crucial role. However, some BCRL patients are unable to use compression, and then their lymphedema continues to worsen as they miss treatment opportunity. Although lymphaticovenular anastomosis (LVA) is an effective and minimally invasive surgical treatment for BCRL, compression therapy is still important to enhance lymphatic fluid flow in LVA. The authors previously reported the dynamic LVA method for BCRL, in which patient's natural hand movements theoretically propel lymph to the anastomosed vein. This study is conducted to clarify whether dynamic LVA can salvage BCRL patients without pre- and postoperative compression therapy.

Methods:
The study involved 17 BCRL patients, 18 limbs. All patients had International Society of Lymphology stage-2 lymphedema, but they had no compression: six patients had difficulty by other diseases to undergo compression, and other 11 patients refused any compression usage because of the burden of the treatment itself. Three dynamic LVAs were performed in each patient.

Results:
Patients’ mean age was 60.4 ± 10.1, and mean body mass index was 24.0 ± 3.3. The mean follow-up period was 25.5 ± 9.2 months. The volume of the lymphedematous limb, according to the upper extremity lymphedema (UEL) index, was reduced in all 18 limbs postoperatively (postoperative UEL index 101.8 ± 9.4 versus preoperative UEL index 116.0 ± 20.1; P < 0.01). Twelve of the 18 limbs were cured without edema.

Conclusion:
Even without compression therapy, International Society of Lymphology stage-2 BCRL patients can be treated by the dynamic LVA method.
Disparity issues in coronary artery surgery
Authors: Dahle Gry 
Published: August 2023

Purpose of review
Coronary artery disease is the third leading cause of mortality worldwide. Coronary artery surgery is an important treatment option. Certain groups such as people of color, those from lower socioeconomic backgrounds and women tend to have lower rates of receiving the surgery they need (Fig. 1).

Recent findings
Still there are disparities in treatment options for coronary artery disease among different groups, due to geographic location, economical situation, institutional tradition and sex.

Summary
Through continued research, awareness and utilization of innovative technologies, we can improve access and equity in healthcare for all patients, including patients in need of coronary surgery.
Strategic use of tobacco treatment specialists as an innovation for tobacco cessation health systems change within health care organizations
Authors: Burns Ashlyn , Gutta Jyotsna , Kooreman Harold , Spitznagle Miranda , Yeager Valerie A. 
Published: August 2023

Background
Tobacco screening interventions have demonstrated effectiveness at improving population health, yet many people who want to quit using tobacco lack access to professional assistance. One way to address this gap is to train members of the clinical team as tobacco treatment specialists (TTSs).

Purpose
The purpose of this study was to understand how TTSs have been used across a variety of health care organizations implementing health systems change for tobacco treatment and examine the sustainability of TTSs as a health systems change innovation for tobacco cessation.

Methodology
This study used qualitative interviews (n = 25) to identify themes related to implementing TTSs as a health systems change innovation and examined these themes within the constructs of the theory of innovation implementation.

Results
Insights about implementing TTSs as an innovation primarily aligned with four theoretical constructs: implementation policies and practices, implementation climate, innovation-values fit, and implementation effectiveness. Specific themes were perceived to facilitate the sustainability of TTSs including team-based TTS efforts, widespread awareness of TTS roles, leadership buy-in, and recognized value of TTS services. Barriers to sustainability included inadequate resources (e.g., time and staff), lack of tracking outcomes, inappropriate referrals, and lack of reimbursement.

Practice Implications
Health care organizations planning to implement health systems change for tobacco cessation can encourage committed use of TTSs as an innovation by considering the insights provided in this study. These primarily related to five overarching implementation considerations: staff selection and training, tracking and dissemination of impacts, adequate resources, referrals and workflow, and billing and reimbursement.