bluuebunny/crossref_metadata_2025_split huggingface dataset:
564 Tackling tobacco dependency in surgical patients
Authors: Songra Lalana , Pratheepan Ponnuthurai 
Published: August 2023

Abstract

Aims
Smoking is associated with an increased risk of developing post-operative complications and is a risk factor for abscess development. We aimed to audit our performance in delivering very brief advice (VBA) to surgical patients, and establish a smoking cessation pathway to promote smoking cessation particularly within elective and ambulatory care patients.

Methods
A retrospective audit was undertaken to identify whether smoking status was documented for all surgical inpatients on admission over a 24 hour period, and those attending the surgical ambulatory care unit with an abscess over a 3 week period. Data was collected on whether very brief advice and referral to smoking cessation service or nicotine replacement therapy was offered.

Results
In total, 36 inpatients were identified. 4 reported smoking (11.1%), 26 (72.2%) reported no smoking and 6 had no documentation (16.7%). Of those identified as smokers, 50% had documented VBA and 75% were offered NRT. Of the 51 ambulatory patients attending with abscesses, 13 (25.4%) reported smoking, 10 (19.6%) reported no smoking and 28 had no documented smoking status (54.5%). Only 1/13 had VBA documented (7.7%)

Conclusions
Smoking status is poorly documented in surgical patients presenting to ambulatory care in particular, and there is a high rate of smoking in patients presenting with abscesses. Ambulatory care represents a good opportunity to deliver VBA and direct patients to smoking cessation services. A combined effort between the surgical department and the tobacco dependency service that is present in many hospitals represents a good opportunity to advocate for smoking cessation, primarily in pre operative assessment clinic or surgical ambulatory care.
587 #ILookLikeASurgeon: How Social Media Can Help Change the Face of Surgery
Authors: Lowe Chloe 
Published: August 2023

Abstract

Aim
This study was conducted to assess the benefit of using Twitter hashtags in campaigns that promote diversity and inclusivity amongst the medical workforce, specifically the surgical gender disparity discourse. Hashtags were assessed by their ability to establish the main issues faced by current female-identifying trainees and in promoting engagement with the movement.

Method
Five Twitter hashtags, specific to the surgical gender inclusivity discourse were examined: #ILookLikeASurgeon, #MedBikini, #WomenInSurgery, #OperateWithRespect, and #HammerItOut. Phase One involved the manual collection and thematic analysis of tweets to identify the main areas of gender disparity affecting trainees. Phase Two consulted TweetBinder to yield analytical information on hashtag engagement.

Results
Three-hundred-and-fifteen tweets were collected, with five main themes of gender-based disparity identified: sexism, bullying, sexual harassment, patients’ perceptions, and pay and job disparity. Female-identifying students and trainees describe experiencing exclusionary microaggressions, whilst bullying practices, and incidences of sexual harassment, have made surgery a hostile work environment for some. Structurally, the surgical curriculum remains limited in the support of non-clinical caring responsibilities, resulting in great pay disparity and global under-representation in the field. Hashtags increased the scale of the online discourse and outreach of the tweets, helping to promote the movement and increase engagement.

Conclusion
Following topical hashtags, thematic analysis of tweets can establish the main areas of gender disparity in surgery. Hashtags promote engagement from users globally and outside of the field, generating an impactful online discourse. The findings of this study reflect contemporary literature but personalise the statistics reported to further drive cultural change.
Transcatheter thrombectomy of acute pulmonary embolism in an adult Fontan patient: a case report
Authors: Benjamin Christina , Franklin Wayne J , Garn Byron , Awerbach Jordan D 
Published: August 2023

Abstract

Background
The Fontan operation is a well-described palliative procedure for functional single-ventricle patients. This population has an increased risk of thrombo-embolic events. Adequate imaging, and therefore diagnosis, requires an understanding of the unique anatomy and physiology of a Fontan. Optimal strategies for the prevention and treatment of thrombo-embolic complications in the Fontan population are poorly defined.

Case summary
A 28-year-old female with a history of Ebstein anomaly of the tricuspid valve status post-Fontan presented with chest pain and acute hypoxia. Computed tomographic angiography (CTA) reported a submassive pulmonary embolism (PE). She was initiated on a heparin drip. Catheterization demonstrated elevated Fontan pressures and a large thrombus in the right lower pulmonary artery that was removed with an aspiration device. The patient was transitioned to a direct oral anticoagulant (DOAC) following the procedure.

Discussion
Thrombotic complications are common in the adult Fontan population. Given the morbidity and mortality associated with this complication, the use of proper imaging techniques is imperative. Traditional CTA imaging for PE in Fontan patients often has contrast filling defects related to their anatomy and physiology. Utilization of adequate imaging techniques helps decrease cost and additional radiation exposure. In addition, it avoids inappropriate hospitalization, need for anticoagulation, and potential need for catheterization toconfirm or exclude the presence of PE. For Fontan patients with a thrombus, prior event, and no contraindications, current guidelines recommend oral anticoagulation with a vitamin K antagonist; however, there are increasing data on the use of DOACs in this population.
Economic evaluation of self-help group interventions for health in LMICs: a scoping review
Authors: Ochalek Jessica , Gibbs Naomi K , Faria Rita , Darlong Joydeepa , Govindasamy Karthikeyan , Harden Melissa , Meka Anthony , Shrestha Dilip , Napit Indra Bahadur , Lilford Richard J , Sculpher Mark 
Published: August 2023

Abstract
This scoping review aims to identify and critically appraise published economic evaluations of self-help group (SHG) interventions in low- and middle-income countries (LMICs) that seek to improve health and potentially also non-health outcomes. Through a systematic search of MEDLINE ALL (Ovid), EMBASE Ovid, PsychINFO, EconLit (Ovid) and Global Index Medicus, we identified studies published between 2014 and 2020 that were based in LMICs, included at least a health outcome, estimated intervention costs and reported the methods used. We critically analysed whether the methods employed can meaningfully inform decisions by ministries of health and other sectors, including donors, regarding whether to fund such interventions, and prioritized the aspects of evaluations that support decision-making and cross-sectoral decision-making especially. Nine studies met our inclusion criteria. Randomized controlled trials were the most commonly used vehicle to collect data and to establish a causal effect across studies. While all studies clearly stated one or more perspectives justifying the costs and effects that are reported, few papers clearly laid out the decision context or the decision maker(s) informed by the study. The latter is required to inform which costs, effects and opportunity costs are relevant to the decision and should be included in the analysis. Costs were typically reported from the provider or health-care sector perspective although other perspectives were also employed. Four papers reported outcomes in terms of a generic measure of health. Contrary to expectation, no studies reported outcomes beyond health. Our findings suggest limitations in the extent to which published studies are able to inform decision makers around the value of implementing SHG interventions in their particular context. Funders can make better informed decisions when evidence is presented using a cross-sectoral framework.
Can a private sector engagement intervention that prioritizes pro-poor strategies improve healthcare access and quality? A randomized field experiment in Kenya
Authors: Boone Claire E , Gertler Paul J , Barasa Grace Makana , Gruber Joshua , Kwan Ada 
Published: August 2023

Abstract
Private sector engagement in health reform has been suggested to help reduce healthcare inequities in sub-Saharan Africa, where populations with the most need seek the least care. We study the effects of African Health Markets for Equity (AHME), a cluster randomized controlled trial carried out in Kenya from 2012 to 2020 at 199 private health clinics. AHME included four clinic-level interventions: social health insurance, social franchising, SafeCare quality-of-care certification programme and business support. This paper evaluates whether AHME increased the capacity of private health clinics to serve poor clients while maintaining or enhancing the quality of care provided. At endline, clinics that received AHME were 14.5 percentage points (pp) more likely to be empanelled with the National Health Insurance Fund (NHIF), served 51% more NHIF clients and served more clients from the middle three quintiles of the wealth distribution compared to control clinics. Comparing individuals living in households near AHME treatment and control clinics (N = 8241), AHME led to a 6.7-pp increase in the probability of holding any health insurance on average. We did not find any additional effect of AHME on insurance holding among poor households. We measured quality of care using a standardized patient (SP) experiment (N = 596 SP–provider interactions) where recruited and trained SPs were randomized to present as either ‘not poor’, and able to afford all services provided, or ‘poor’ by telling the provider they could only afford ∼300 Kenyan Shillings (US$3) in fees. We found that poor SPs received lower levels of both correct and unnecessary services, and AHME did not affect this. More work must be done to ensure that clients of all wealth levels receive high-quality care.
Implication of Inflammatory Bowel Disease Diagnosed Before the Age of 18 for Achieving an Upper Secondary Education: A Nationwide Population-Based Cohort Study
Authors: Rasmussen Julie , Nørgård Bente Mertz , Nielsen Rasmus Gaardskær , Bøggild Henrik , Qvist Niels , Brund René Børge Korsgaard , Bruun Niels Henrik , Fonager Kirsten 
Published: August 2023

Abstract

Background
Educational achievement may be adversely affected by chronic conditions in childhood and adolescence. This study aimed to examine the effect of being diagnosed with IBD on achievement of an upper secondary education and the influence of disease severity and psychiatric comorbidity.

Methods
This cohort study was based on nationwide Danish administrative registries. We compared a cohort of patients with IBD with a matched population-based cohort. The IBD cohort included patients born between 1970 and 1994 who were diagnosed with IBD (age &lt;18 years). The outcome was achieving an upper secondary education and was analyzed using Cox regression. The impact of disease severity (expressed by surgery or corticosteroid prescriptions) or psychiatric comorbidity within the IBD cohort was assessed using Poisson regression.

Results
We identified 3178 patients with IBD (Crohn’s disease [CD] n = 1344, ulcerative colitis [UC] n = 1834) and matched them with 28 204 references. The hazard ratio of achieving an upper secondary education was 1.14 (95% confidence interval, 1.07-1.21) for CD and 1.16 (95% confidence interval, 1.10-1.23) for UC. In the IBD cohort, having surgery, a steroid prescription, or a comorbid psychiatric condition was associated with a lower chance of achieving an upper secondary education.

Conclusion
Being diagnosed with IBD before 18 years of age increased the chance of achieving an upper secondary education. However, patients with more severe disease or psychiatric comorbidity were at higher risk of not achieving an upper secondary education than patients with milder disease.
Children and Young Adults With Inflammatory Bowel Disease Have an Increased Incidence and Risk of Developing Mental Health Conditions: A UK Population-Based Cohort Study
Authors: Cooney Rachel , Tang Daniel , Barrett Kevin , Russell Richard K 
Published: August 2023

Abstract

Background
The burden of mental health conditions in children and young adults with inflammatory bowel disease remains unclear. We assessed this using a primary care database in the United Kingdom.

Methods
A retrospective, observational study compared children and young adults with incident inflammatory bowel disease 5 to 25 years of age (2010-2020) against population control subjects. Outcomes comprised incident depression, anxiety disorder, eating disorders, body image disorders, attention-deficit disorders, behavioral disorders, adjustment disorders, acute stress disorder, schizophrenia, bipolar disorder, posttraumatic stress disorder, self-harm, parasuicide (including suicide), and sleep disturbance. The any mental health condition category comprised any of these conditions.

Results
A total of 3898 young patients with incident inflammatory bowel disease were matched to 15 571 control subjects. Inflammatory bowel disease patients were significantly more likely to develop new posttraumatic stress disorder (adjusted hazard ratio [aHR], 2.47; 95% confidence interval [CI], 1.23-4.94), eating disorders (aHR, 1.85; 95% CI, 1.05-3.26), self-harm (aHR, 1.49; 95% CI, 1.00-2.21), sleep disturbance (aHR, 1.40; 95% CI, 1.15-1.71), depression (aHR, 1.34; 95% CI, 1.16- 1.56), anxiety (aHR, 1.25; 95% CI, 1.06-1.48), and any mental health condition (aHR, 1.28; 95% CI, 1.12-1.46). Male inflammatory bowel disease patients aged 12 to 17 years, and patients with Crohn’s disease appear to have the highest risk for developing new mental health conditions.

Conclusions
Young inflammatory bowel disease patients have a significantly higher incidence and risk of new mental health conditions. Mental health remains a critically overlooked aspect of inflammatory bowel disease patient management. Further research into identifying optimal monitoring tools and support for these patients is required to improve patient care. The study protocol was specified and registered a priori.
ClinicalTrials.gov study identifier: NCT05206734.
A Treat-to-Target Strategy Guided by Pan-Enteric Evaluation in Children With Crohn’s Disease Improves Outcomes at 2 Years
Authors: D’Arcangelo Giulia , Russo Giusy , Aloi Marina , Ruggiero Cosimo , Maccioni Francesca , Hassan Cesare , Papoff Paola , Cohen Stanley Allen , Oliva Salvatore 
Published: August 2023

Abstract

Background and Aims
It is uncertain whether a treat-to-target approach could be an effective strategy for improving outcomes in children with Crohn’s disease (CD). Previously, we reported mucosal healing (MH) and deep remission rates throughout the intestinal tract by performing 3 pan-enteric capsule assessments and using a treat-to-target strategy over 52 weeks in children with CD. This report describes the outcomes of this approach at 104 weeks.

Methods
Children with known CD who completed the 52-week protocol repeated pan-enteric capsule endoscopy (PCE) at 104 weeks. Results at weeks 52 and 104 were compared, and long-term outcomes between patients, with and without MH, were calculated using an intention-to-treat analysis of clinical relapse, need for steroids, treatment escalation, hospitalization, and surgery.

Results
Of the previous study cohort of 48 patients, 46 (96%) were available for this extension study (28 [61%] of 46 with MH and 18 [39%] of 46 without MH at 52 weeks). When evaluated at 104 weeks, MH was maintained in 93% of patients with MH at 52 weeks. In the intention-to-treat analysis, complete MH at 52 weeks was associated with reduced risk of steroid use (log-rank P &lt; .0001), treatment escalation (log-rank P &lt; .0001), hospitalization (log-rank P &lt; .0001), and clinical relapse (log-rank P &lt; .0001).

Conclusions
When a PCE-based, treat-to-target strategy is employed, MH is sustainable (93%) over a 1-year period and is correlated with improved patient outcomes, including reduced need for steroids, treatment escalation, hospitalization, and clinical relapses at 104 weeks.
ClinicalTrials.gov number: NCT03161886.
Inflammatory Bowel Diseases-related Disability: Risk Factors, Outcomes, and Interventions
Authors: Tse Chung Sang , Hunt Melissa G , Brown Lily A , Lewis James D 
Published: August 2023

Abstract
The diagnosis of inflammatory bowel disease (IBD) is a life-changing moment for most adults. Biomedical advances over the past 2 decades have resulted in unprecedented growth of therapeutic options for IBD. However, due to the incurable nature of IBD, medical and surgical intervention alone may not be adequate to completely normalize health status and prevent long-term disability. In the biopsychosocial model of health and disease, a person’s health and function result from complex physical, psychosocial, and environmental interactions. Adapting the World Health Organization definition, IBD-related disability encompasses limitations in educational and employment opportunities, exclusions in economic and social activities, and impairments in physical and psychosocial function. Although the concept of IBD-related disability is a long-term treatment end point in the updated Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE-II) treatment guideline, it has received limited attention in the literature. This review article explores an etiological framework of the physical and psychosocial aspects that contribute to IBD-related disability. We also explore the impact of IBD-related disability on the direct and indirect costs of IBD. Lastly, we present the available evidence for interventions with the potential to improve function and reduce IBD-related disability.
The architecture of global knowledge production – do low-income countries get more involved?
Authors: Cantner Uwe , Grebel Thomas , Zhang Xijie 
Published: August 2023

Abstract
In this paper, we analyze the extent to which low-income countries integrate into the global knowledge production network. We develop an (undirected) research collaboration model based on which we identify the drivers of global research collaboration using publication data of the field Business and Economics from the Web of Science and macroeconomic data from the United Nations Educational, Scientific and Cultural Organization Institute for Statistics. Network and dynamic panel regression techniques are employed. Our results show that (i) reciprocal preferential attachment and the homophily between countries reinforce scientific collaboration, (ii) there is no evidence that low-income countries are becoming better integrated into the global knowledge production over the years, despite their active participation in international reserach collaboration, while (iii) high-income countries show a basic willingness to cooperate with them, which, in turn, promotes the integration of low-income countries, although this willingness seems to decline; and (iv) as to low-income countries, they have little choice but to invest more in education and R&D in order to advance in the global knowledge production network.
Applications of machine learning to identify and characterize the sounds produced by fish
Authors: Barroso V R , Xavier F C , Ferreira C E L 
Published: August 2023

Abstract
Aquatic ecosystems are constantly changing due to anthropic stressors, which can lead to biodiversity loss. Ocean sound is considered an essential ocean variable, with the potential to improve our understanding of its impact on marine life. Fish produce a variety of sounds and their choruses often dominate underwater soundscapes. These sounds have been used to assess communication, behaviour, spawning location, and biodiversity. Artificial intelligence can provide a robust solution to detect and classify fish sounds. However, the main challenge in applying artificial intelligence to recognize fish sounds is the lack of validated sound data for individual species. This review provides an overview of recent publications on the use of machine learning, including deep learning, for fish sound detection, classification, and identification. Key challenges and limitations are discussed, and some points to guide future studies are also provided.
Bridging photosynthesis and crop yield formation with a mechanistic model of whole-plant carbon–nitrogen interaction
Authors: Chang Tian-Gen , Wei Zhong-Wei , Shi Zai , Xiao Yi , Zhao Honglong , Chang Shuo-Qi , Qu Mingnan , Song Qingfeng , Chen Faming , Miao Fenfen , Zhu Xin-Guang 
Published: August 2023

Abstract
Crop yield is determined by potential harvest organ size, source organ photosynthesis and carbohydrate partitioning. Filling the harvest organ efficiently remains a challenge. Here, we developed a kinetic model of rice grain filling, which scales from the primary biochemical and biophysical processes of photosynthesis to whole-plant carbon and nitrogen dynamics. The model reproduces the rice yield formation process under different environmental and genetic perturbations. In silico screening identified a range of post-anthesis targets—both established and novel—that can be manipulated to enhance rice yield. Remarkably, we pinpointed the stability of grain-filling rate from flowering to harvest as a critical factor for maximizing grain yield. This finding was further validated in two independent super-high-yielding rice cultivars, each yielding approximately 21 t ha−1 of rough rice at 14% moisture content. Furthermore, we revealed that stabilizing the grain-filling rate could lead to a potential yield increase of 30–40% in an elite rice cultivar. Notably, the instantaneous grain-filling rates around 15- and 38-day post-flowering significantly influence grain yield; and we introduced an innovative in situ approach using ear respiratory rates for precise quantification of these rates. We finally derived an equation to predict the maximum dried brown rice yield (Y, t ha−1) of a cultivar based on its potential gross photosynthetic accumulation from flowering to harvest (Apc, t CO2 ha−1): Y = 0.74 × Apc + 1.9. Overall, this work establishes a framework for quantitatively dissecting crop physiology and designing high-yielding ideotypes.
“Globalization and Social Identities at the Individual Level: Populism from Shifting at the Top?”
Authors: Bearce David H , McLeer Andrew , Stallman Ken 
Published: August 2023

Abstract
This paper reconsiders the proposition that globalization leads to more transnational and less national identities. Providing an argument specifying how these various international processes could shift identities at the individual level, it hypothesizes that globalization should be associated with more transnational/less national identities for people toward the top of society based on their experience with and information about globalization, but not for those at the bottom. Based on the identity shift happening at the top but not at the bottom, globalization should also be associated with a larger identity difference between the elite and the mass public. Using data from the sixth wave of the World Values Survey conducted across fifty-six countries from 2010 to 2014 and the seventh wave across forty-four countries from 2017 to 2020, it presents results consistent with these hypotheses. These results help explain the current “anti-global” backlash, providing evidence consistent with populist theories but inconsistent with rising nationalism.