bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ten years later: A portrait of the implementation of the advanced access model in Quebec
Authors: Breton Mylaine , Gaboury Isabelle , Beaulieu Christine , Deville-Stoetzel Nadia , Martin Elisabeth 
Published: June 2023

Since 2012, implementation of the advanced access model in primary care has been highly recommended across Canada to improve timely access. We present a portrait of the implementation of the advanced access model 10 years after its large-scale implementation across the province of Quebec. In total, 127 clinics participated in the study, with 999 family physicians and 107 nurse practitioners responding to the survey. Results show that opening schedules for appointments over a period of 2 to 4 weeks has largely been implemented. However, reserving consultation time for urgent or semi-urgent conditions was implemented by less than half and planning supply and demand for 20% or more of the upcoming year by fewer than one fifth of respondents. More strategies need to be put in place to react to imbalances when they occur. We demonstrate that strategies based on individual practice change are more often implemented than those requiring changes at the clinic.
Impact of COVID-19 vaccination or infection on disease activity in a radiologically isolated syndrome cohort: The VaxiRIS study
Authors: Cohen Mikael , Thomel-Rocchi Océane , Siva Aksel , Okuda Darin T , Karabudak Rana , Efendi Hüsnü , Terzi Murat , Carra-Dalliere Clarisse , Durand-Dubief Francoise , Thouvenot Eric , Ciron Jonathan , Zephir Helene , Bourre Bertrand , Casez Olivier , De Seze Jérôme , Moreau Thibault , Neau Jean-Philippe , Pelletier Daniel , Kantarci Orhun , Tutuncu Melih , Derache Nathalie , Bensa Caroline , Louapre Celine , Benoit Jeanne , Landes-Chateau Cassandre , Lebrun-Frenay Christine 
Published: June 2023

Background: Vaccination in patients with multiple sclerosis (MS) treated with immunosuppressive drugs is highly recommended. Regarding COVID-19 vaccination, no specific concern has been raised. Objectives: We aimed to evaluate if COVID-19 vaccination or infection increased the risk of disease activity, either radiological or clinical, with conversion to MS in a cohort of people with a radiologically isolated syndrome (RIS). Methods: This multicentric observational study analyzed patients in the RIS Consortium cohort during the pandemic between January 2020 and December 2022. We compared the occurrence of disease activity in patients according to their vaccination status. The same analysis was conducted by comparing patients’ history of COVID-19 infection. Results: No difference was found concerning clinical conversion to MS in the vaccinated versus unvaccinated group (6.7% vs 8.5%, p > 0.9). The rate of disease activity was not statistically different (13.6% and 7.4%, respectively, p = 0.54). The clinical conversion rate to MS was not significantly different in patients with a documented COVID-19 infection versus non-infected patients. Conclusion: Our study suggests that COVID-19 infection or immunization in RIS individuals does not increase the risk of disease activity. Our results support that COVID-19 vaccination can be safely proposed and repeated for these subjects.
Sex life and low back pain: The impact of intradiscal ozone therapy in patients with herniated lumbar disc
Authors: Somma Francesco , Negro Alberto , Tortora Mario , Gemini Laura , Pace Gianvito , Fasano Fabrizio , Piscitelli Valeria , Sicignano Carmine , Prudente Mariaevelina , Falco Arturo De , Villa Alessandro , Lugarà Marina , Pezzullo Giovanna , D'Agostino Vincenzo , Gatta Gianluca 
Published: June 2023

Study Design Retrospective cohort study. Objectives To assess the improvement of sexual impairment after percutaneous intradiscal ozone therapy in patients complaining of low back pain (LBP) due to lumbar disc herniation. Methods Between January 2018 and June 2021, 157 consecutive imaging-guided percutaneous intradiscal ozone therapies were performed on 122 patients with LBP and/or sciatic pain due to lumbar disc herniation. Oswestry Disability Index (ODI) was administered before the treatment and at 1-month and 3-month follow-ups and the ODI Section 8 (ODI-8/sex life) values were retrospectively reviewed to evaluate the improvement of sexual impairment and disability. Results Mean age of patients was 54.63 ± 12.40. Technical success was achieved in all cases (157/157). Clinical success was registered in 61.97% (88/142) of patients at 1-month follow-up and in 82.69% (116/142) at 3-month follow-up. The mean ODI-8/sex life was 3.73 ± 1.29 before the procedure, 1.71 ± 1.37 at 1-month follow up and 0.44 ± 0.63 at 3-month follow-up. Compared to older patients, subjects under 50 years showed a significantly slower recovery of sexual impairment ( p = 0.003). The treated levels were L3–L4, L4–L5, and L5–S1 in 4, 116, and 37 patients, respectively. Patients with L3–L4 disc herniation showed less sexual disability at presentation, with a significantly faster improvement of sexual life ( p = 0.03). Conclusions Percutaneous intradiscal ozone therapy is highly effective in reducing sexual impairment due to lumbar disc herniation, and the improvement is faster in older patients and in the case of L3–L4 disc involvement.
Patterns of use of medications used to treat urinary incontinence and potentially inappropriate prescriptions
Authors: Valladales-Restrepo Luis Fernando , Bedoya-Arias Hugo Alejandro , Aristizábal-Carmona Brayan Stiven , Machado-Alba Jorge Enrique 
Published: June 2023

Background: The pharmacological treatment of urinary incontinence (UI) may involve bladder antimuscarinics, which can generate risks in the elderly. Objective: The aim was to determine the treatment patterns of a group of patients with UI and possible potentially inappropriate prescriptions. Design and methods: This was a cross-sectional study that identified prescription patterns of medications for outpatient use in patients with UI between December 2020 and November 2021 based on a population database of members of the Colombian Health System. Patients were identified based on the codes of the international classification of diseases, version-10. Sociodemographic and pharmacological variables were considered. Results: A total of 9855 patients with UI were identified, with a median age of 72 years, and 74.6% were women. Unspecified UI was the most frequent form (83.2%), followed by specified UI (7.9%), stress UI (6.7%), and UI associated with an overactive bladder (2.2%). A total of 37.2% received pharmacological treatment, mainly with bladder antimuscarinics (22.6%), mirabegron (15.6%), and topical estrogens (7.9%). Pharmacological management predominated in UI associated with overactive bladder, in women and in patients between 50 and 79 years of age. Of the patients who received bladder antimuscarinics, 54.5% were 65 years old or older, and 21.5% also had benign prostatic hyperplasia, sicca syndrome, glaucoma, constipation, or dementia. A total of 2.0% of women had been prescribed systemic estrogens and 1.7% had been prescribed peripheral α-adrenergic antagonists. Conclusion: Differences in the prescriptions were found according to the type of UI, sex, and age group. Potentially inappropriate or risky prescriptions were common.
Management of Partial-Thickness Tears of the Distal Bicep Tendon: Evaluation of 111 Patients With 10-Year Follow-up
Authors: Tagliero Adam J. , Till Sara E. , Wilbur Ryan R. , Song Bryant M. , Reinholz Anna K. , Johnson Adam C. , Sanchez-Sotelo Joaquin , Barlow Jonathan D. , Camp Christopher L. 
Published: June 2023

Background: There is a paucity of research on the management of partial-thickness tears of the distal bicep tendon, and even less is known about the long-term outcomes of this condition. Purpose: To identify patients with partial-thickness distal bicep tendon tears and determine (1) patient characteristics and treatment strategies, (2) long-term outcomes, and (3) any identifiable risk factors for progression to surgery or complete tear. Study Design: Case-control study; Level of evidence, 3. Methods: A fellowship-trained musculoskeletal radiologist identified patients diagnosed with a partial-thickness distal bicep tendon tear on magnetic resonance imaging between 1996 and 2016. Medical records were reviewed to confirm the diagnosis and record study details. Multivariate logistic regression models were created using baseline characteristics, injury details, and physical examination findings to predict operative intervention. Results: In total, 111 patients met inclusion criteria (54 treated operatively, 57 treated nonoperatively), with 53% of tears in the nondominant arm and a mean follow-up time after surgery of 9.7 ± 6.5 years. Only 5% of patients progressed to full-thickness tears during the study period, at a mean of 35 months after the initial diagnosis. Patients who were nonoperatively treated were less likely to miss time from work (12% vs 61%; P < .001) and missed fewer days (30 vs 97 days; P < .016) than those treated surgically. Multivariate regression analyses demonstrated increased risk of progression to surgery with older age at initial consult (unit odds ratio [OR], 1.1), tenderness to palpation (OR, 7.5), and supination weakness (OR, 24.8). Supination weakness at initial consult was a statistically significant predictor for surgical intervention (OR, 24.8; P = .001). Conclusion: Clinical outcomes were favorable for patients regardless of treatment strategy. Approximately 50% of patients were treated surgically; patients with supination weakness were 24 times more likely to undergo surgery than those without. Progression to full-thickness tear was a relatively uncommon reason for surgical intervention, with only 5% of patients progressing to full-thickness tears during the study period and the majority occurring within 3 months of initial diagnosis.
The Emerging Potential of Bile Acids as a Modulator of Psoriatic Inflammation
Authors: Wei Grace , Shi Zhenrui , Wu Xuesong , Hwang Samuel T. 
Published: June 2023

Background Bile acids (BAs) are cholesterol-based amphipathic surfactants that are most widely known for their contributions to lipid metabolism, but more recently have been increasingly recognized as a key signaling molecule in inflammatory diseases as well as, potentially, psoriatic disease. Objective This brief review reviews relevant literature in order to briefly describe the synthesis of bile acids and their subsequent metabolism and to analyze recent animal and human data that supports anti-inflammatory activity of some BAs in psoriasiform dermatitis. Methods Pubmed and other public sources were used to survey the literature relevant to the topic of bile acids and their potential use in psoriasis. Conclusion There is clinical and preclinical evidence to support a potential role for BA Supplementation (or modulation BA metabolism and signaling) in the treatment of psoriasis.
‘Send everyone, it’s my son’ – Combined Glaserian grounded theory and thematic analysis of paramedics attending their own families
Authors: Wilkinson-Stokes Matt , Kellermeier Merianne , Whitfield Steve 
Published: June 2023

Introduction Medical clinicians treating relatives is ethically complex; in paramedicine, the time-critical nature of pathologies often precludes alternative treatment without risking morbidity or mortality. Aims This project had three aims: firstly, to retrieve baseline data for thematic analysis on the experiences of paramedics who have attended their own families; secondly, to generate explanatory grounded theory; and finally, to translate these findings into recommendations for practice. Methods Glaserian grounded theory and thematic analysis methods were both undertaken using a realist perspective. Acquiescence, wording, and habituation heuristics were mitigated in the interview design. There were 44 responses ( n = 93 instances of treating family), with 21 participants ( n = 34) from three countries interviewed. Saturation was determined using both Guest et al.'s and Thorne's criterion. Semantic and latent themes were generated inductively via a five-step process, with grounded theory generated simultaneously via a three-step Glaserian process. Cohen's kappa ranged from 0.82 to 0.93. Results Incidents were both traumatic (hangings, stabbings, traumatic arrests) and medical (paediatric arrests, cardiac arrests, overdoses). The core concept-category was ‘conflict between the roles of clinician and relative’. Paramedics reported a sympathetic hyperarousal response that they quickly suppressed, a rapid transition into ‘work mode’, and difficulty obtaining their normal state of flow, balancing dual roles as clinician and relative, transitioning out of work mode and into becoming a carer, and simultaneously processing the event. Organisational responses were frequently described as inadequate. Paramedics reported short-term experiences consistent with an acute stress response, and a large proportion suffered long-term, life-altering consequences. It is theorised that this phenomenon disrupts professional detachment, increases outcome self-expectations, interrupts normal routines, and promotes overmedicalisation. Conclusion This research provides baseline data and theory on the experiences of paramedics attending their own families. Five themes and 24 subthemes were identified, an explanatory theorem proposed, and a preliminary set of eight recommendations for translation into practice provided.
Applicability of 2022 classifications of acute myeloid leukemia in the real-world setting
Authors: Attardi Enrico , Savi Arianna , Borsellino Beatrice , Piciocchi Alfonso , Cipriani Marta , Ottone Tiziana , Fabiani Emiliano , Divona Mariadomenica , Travaglini Serena , Pascale Maria Rosaria , Awada Hussein , Durmaz Arda , Visconte Valeria , Della Porta Matteo Giovanni , Venditti Adriano , Maciejewski Jaroslaw P. , Gurnari Carmelo , Voso Maria Teresa 
Published: June 2023

Abstract
The increasing knowledge of molecular genetics of acute myeloid leukemia (AML) necessitated the update of previous diagnostic and prognostic schemes, which resulted in the development of the World Health Organization (WHO), the International Consensus Classification (ICC), and the new European LeukemiaNet (ELN) recommendations in 2022. We aimed to provide a real-world application of the new models, unravel differences and similarities, and test their implementation in clinical AML diagnosis. A total of 1001 patients diagnosed with AML were reclassified based on the new schemes. The overall diagnostic changes between the WHO 2016 and the WHO 2022 and ICC classifications were 22.8% and 23.7%, respectively, with a 13.1% difference in patients’ distribution between ICC and WHO 2022. The 2022 ICC “not otherwise specified” and WHO “defined by differentiation” AML category sizes shrank when compared with that in WHO 2016 (24.1% and 26.8% respectively, vs 38.7%), particularly because of an expansion of the myelodysplasia (MDS)-related group. Of 397 patients with a MDS-related AML according to the ICC, 55.9% were defined by the presence of a MDS-related karyotype. The overall restratification between ELN 2017 and ELN 2022 was 12.9%. The 2022 AML classifications led to a significant improvement of diagnostic schemes. In the real-world setting, conventional cytogenetics, usually rapidly available and less expensive than molecular characterization, stratified 56% of secondary AML, still maintaining a powerful diagnostic role. Considering the similarities between WHO and ICC diagnostic schemes, a tentative scheme to generate a unified model is desirable.
Design of Linear Functional Noncircular Gear with High Contact Ratio Used in Continuously Variable Transmission
Authors: Hu Yanan , Lin Chao , He Chunjiang , Yu Yongquan , Cai Zhiqin 
Published: June 2023

AbstractContinuously variable transmission (CVT) of noncircular gear has the technical advantages of large bearing capacity and high transmission efficiency. The key technology of CVT with noncircular gear has been broken through some countries, and is in the stage of deep application research. Although the characteristics and design methods of noncircular gear pairs have been continuously studied in China, the noncircular gear CVT is still in the preliminary exploration and research stage. The linear functional noncircular gear pair, whose transmission ratio is a linear function in the working section, to realize continuously variable transmission was the research object in this paper. According to the required transmission ratio in the working section, the transmission ratio function in the non-working section was constructed by using a polynomial. And then the influence of pitch curve parameters in the working section on which in the non-working section was also analyzed to obtain the pitch curve suitable for transmission of this gear pair. In addition, for improving the stability and bearing capacity of gear transmission, the noncircular gear pair transmission with high contact ratio was designed. Furthermore, the accurate value of the contact tooth length was calculated based on the gear principle and the characteristics of the involute tooth profile, from this the contact tooth length error was calculated by comparing the accurate value with its actual value obtained by the rolling experiment. Finally, an indirect method to verify the contact ratio by detecting the contact length error of the tooth profile was proposed.
The physical and psychiatric health conditions related to autism genetic scores, across genetic ancestries, sexes and age-groups in electronic health records
Authors: Niarchou Maria , Miller-Fleming Tyne , Malow Beth A. , Davis Lea K. 
Published: June 2023

Abstract
Background
Although polygenic scores (PGS) for autism have been related to various psychiatric and medical conditions, most studies to date have been conducted in research ascertained populations. We aimed to identify the psychiatric and physical conditions associated with autism PGS in a health care setting.

Methods
We computed PGS for 12,383 unrelated participants of African genetic ancestry (AF) and 65,363 unrelated participants of European genetic ancestry (EU) from Vanderbilt’s de-identified biobank. Next, we performed phenome wide association studies of the autism PGS within these two genetic ancestries.

Results
Seven associations surpassed the Bonferroni adjusted threshold for statistical significance (p = 0.05/1374 = 3.6 × 10−5) in the EU participants, including mood disorders (OR (95%CI) = 1.08(1.05 to 1.10), p = 1.0 × 10−10), autism (OR (95%CI) = 1.34(1.24 to 1.43), p = 1.2 × 10–9), and breast cancer (OR (95%CI) = 1.09(1.05 to 1.14), 2.6 × 10−5). There was no statistical evidence for PGS-phenotype associations in the AF participants. Conditioning on the diagnosis of autism or on median body mass index (BMI) did not impact the strength of the reported associations. Although we observed some sex differences in the pattern of associations, there was no significant interaction between sex and autism PGS. Finally, the associations between autism PGS and autism diagnosis were stronger in childhood and adolescence, while the associations with mood disorders and breast cancer were stronger in adulthood.

Discussion
Our findings indicate that autism PGS is not only related to autism diagnosis but may also be related to adult-onset conditions, including mood disorders and some cancers.

Conclusions
Our study raises the hypothesis that genes associated with autism may also increase the risk for cancers later in life. Future studies are necessary to replicate and extend our findings.
The key values and factors identified by older adults to promote physical activity and reduce sedentary behaviour using co-production approaches: a scoping review
Authors: Ioannou Elysa , Chen Henglien Lisa , Bromley Vicky , Fosker Sam , Ali Khalid , Fernando Avanka , Mensah Ekow , Fowler-Davis Sally 
Published: June 2023

Abstract
Background
Inactivity and sedentary behaviour in older adults adversely impacts physical function, reduces social networks, and could contribute to population healthcare costs. To encourage and support the planning and uptake of physical activity by older adults, it is important to understand what physical activity means to older adults. Therefore, the aim of this scoping review was to collate what older adults have self-identified as the key factors for sustaining and increasing their physical activities.

Methods
Arksey and O’Malley’s Scoping Review framework was used to guide the review process. SCOPUS, ASSIA, PsychINFO and MEDLINE databases were searched. Studies were eligible for inclusion if they were peer-reviewed, the target population were older adults (aged 55 and above), co-production related research approaches were explicitly stated in the methods and there was a focus on design of physical activity interventions or products to support or enhance physical activity. Assets and values important for physical activity were first extracted from included studies and were subsequently thematically analysed. Themes are presented to provide an overview of the literature synthesis.

Results
Sixteen papers were included in the analysis. Data from these papers were gathered via designing interventions or services (n = 8), products (n = 2), ‘exergames’ (n = 2) or mobile applications (n = 4). Outcomes were varied but common themes emerged across papers. Overarching themes identified by older adults were associated with a desire to increase activity when it was accessible, motivational, and safe. In addition, older adults want to enjoy their activities, want independence and representation, want to stay connected with families and friends, be outdoors, familiarity, activities to be tailored and resulting in measurable/observed progress.

Conclusions
Population demographics, personal attributes, and life experiences all affect preferences for physical activity. However, the key factors identified by older adults for increasing physical activity were common—even in separate co-production contexts. To promote physical activities in older adults, activities must fundamentally feel safe, provide a sense of social connectedness, be enjoyable and be accessible in terms of cost and ability.