bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel device for assisted vaginal birth: using integrated qualitative case study methodology to optimise Odon Device use within a feasibility study in a maternity unit in the Southwest of England
Authors: Hotton Emily J , Blencowe Natalie S , Bale Nichola , Lenguerrand Erik , Draycott Tim J , Crofts Joanna F , Wade Julia 
Published: August 2022

ObjectiveWhen novel devices are used ‘in human’ for the first time, their optimal use is uncertain because clinicians only have experience from preclinical studies. This study aimed to investigate factors that might optimise use of the Odon Device for assisted vaginal birth.DesignWe undertook qualitative case studies within the ASSIST Study, a feasibility study of the Odon Device. Each ‘case’ was defined as one use of the device and included at least one of the following: observation of the attempted assisted birth, and an interview with the obstetrician, midwife or woman. Data collection and thematic analysis ran iteratively and in parallel.SettingTertiary referral National Health Service maternity unit in the Southwest of England.ParticipantsWomen requiring a clinically indicated assisted vaginal birth.InterventionThe Odon Device, an innovative device for assisted vaginal birth.Primary and secondary outcome measuresDetermining the optimal device technique, device design and defining clinical parameters for use.ResultsThirty-nine cases involving an attempted Odon-assisted birth were included in this study, of which 19 resulted in a successful birth with the device. Factors that improved use included optimisation of device technique, device design and clinical parameters for use. Technique adaptations included: applying the device during, rather than between, contractions; having a flexible approach to the application angle; and deflating the air cuff sooner than originally proposed. Three design modifications were proposed involving the deflation button and sleeve. Although use of the device was found to be appropriate in all fetal positions, it was considered contraindicated when the fetal station was at the ischial spines.ConclusionsCase study methodology facilitated the acquisition of rapid insights into device function in clinical practice, providing key insights regarding use, design and key clinical parameters for success. This methodology should be considered whenever innovative devices are introduced into clinical practice.Trial registration numberISRCTN10203171.
COVID-19 pandemic and vitamin D: rising trends in status and in daily amounts of vitamin D provided by supplements
Authors: McKenna Malachi J , Lyons Oonagh C , Flynn Mary AT , Crowley Rachel K , Twomey Patrick J , Kilbane Mark T 
Published: August 2022

ObjectivesSince the onset of the COVID-19 pandemic in 2020, there have been plausible suggestions about the need to augment vitamin D intake by supplementation in order to prevent SARS-CoV2 infection and reduce mortality. Some groups have advocated supplementation for all adults, but governmental agencies have advocated targeted supplementation. We sought to explore the effect of the COVID-19 pandemic on both vitamin D status and on the dose of new-to-market vitamin D supplements.SettingUniversity hospital, Dublin, Ireland.ParticipantsLaboratory-based samples of circulating 25-hydroxyvitamin D (25OHD) (n=100 505).Primary and secondary outcome measuresPrimary outcomes: comparing yearly average 25OHD prior to the pandemic (April 2019 to March 2020) with during the pandemic (April 2020 to March 2021) and comparing the dose of new-to-market vitamin D supplements between 2017 and 2021 (n=2689). Secondary outcome: comparing prevalence of vitamin D deficiency and vitamin D excess during the two time periods.ResultsThe average yearly serum 25OHD measurement increased by 2.8 nmol/L (61.4, 95% CI 61.5 to 61.7 vs 58.6, 95% CI 58.4 to 58.9, p<0.001), which was almost threefold higher than two similar trend analyses that we conducted between 1993 and 2016. There was a lower prevalence of low 25OHD and a higher prevalence of high 25OHD. The dose of new-to-market vitamin D supplements was higher in the years 2020–2021 compared with the years 2017–2019 (p<0.001).ConclusionsWe showed significant increases in serum 25OHD and in the dose of new-to-market vitamin D supplements. The frequency of low vitamin D status reduced indicating benefit, but the frequency of vitamin D excess increased indicating risk of harm. Rather than a blanket recommendation about vitamin D supplementation for all adults, we recommend a targeted approach of supplementation within current governmental guidelines to at-risk groups and cautioning consumers about adverse effects of high dose supplements on the market.
DNA Methylation Analysis to predict Regression of high-grade anal Intraepithelial Neoplasia in HIV+ men (MARINE): a cohort study protocol
Authors: Dias Gonçalves Lima Fernando , van der Zee Ramon P , Dick Stèfanie , van Noesel Carel J M , Berkhof Johannes , Schim van der Loeff Maarten F , Prins Jan M , Steenbergen Renske D M , de Vries Henry J C 
Published: August 2022

IntroductionAnal cancer precursors, or high-grade anal intraepithelial neoplasia (HGAIN), are highly prevalent in HIV-seropositive (HIV+) men who have sex with men (MSM). Around 30% of lesions regress within 1 year, but current histopathological assessment is unable to distinguish between HGAIN likely to regress and HGAIN likely to persist or progress to cancer. We aim to assess if host cell DNA methylation markers can predict regression of HGAIN, thus determining the need for immediate treatment or active surveillance. This could reduce overtreatment and the associated anal and psycho-sexual morbidity.Methods and analysisThis is an active surveillance cohort study in three centres located in Amsterdam, the Netherlands, in 200 HIV+ MSM diagnosed with HGAIN. Participants will not be treated, but closely monitored during 24 months of follow-up with 6 monthly visits including cytology, and high-resolution anoscopy with biopsies. The primary study endpoint is histopathological regression of each baseline HGAIN lesion at the end of the study. Regression is defined as ≤low grade anal intraepithelial neoplasia in the exit biopsy at 24 months. Regression proportions in lesions with low versus high methylation levels (ASCL1,ZNF582), other biomarkers (HPV genotype, HPV-E4, p16INK4A, Ki-67) and immunological markers at baseline will be compared. Main secondary endpoints are the histological and clinical outcome (ie, the number of octants affected by HGAIN) of each baseline HGAIN lesion and overall HGAIN disease (i.e., all lesions combined) after each visit. The health-related quality of life of the study group will be compared with that of a control group of 50 HIV+ MSM receiving regular HGAIN treatment.Ethics and disseminationEthics approval was obtained from the Institutional Review Board of the Academic Medical Center (Amsterdam, The Netherlands; reference no. 2021_099). Participants are required to provide written informed consent. Findings will be disseminated through publication in peer-reviewed scientific journals and presentations at international scientific conferences; dissemination to policy makers and the target patient group will be achieved through our (inter-)national network, professional associations and collaboration with a patient representative organisation.Trial registration numberNL9664.
Scoping review to evaluate the effects of peer support on the mental health of young adults
Authors: Richard Jérémie , Rebinsky Reid , Suresh Rahul , Kubic Serena , Carter Adam , Cunningham Jasmyn E A , Ker Amy , Williams Kayla , Sorin Mark 
Published: August 2022

ObjectivesYoung adults report disproportionality greater mental health problems compared with the rest of the population with numerous barriers preventing them from seeking help. Peer support, defined as a form of social-emotional support offered by an individual with a shared lived experience, has been reported as being effective in improving a variety of mental health outcomes in differing populations. The objective of this scoping review is to provide an overview of the literature investigating the impact of peer support on the mental health of young adults.DesignA scoping review methodology was used to identify relevant peer-reviewed articles in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across six databases and Google/Google Scholar. Overall, 17 eligible studies met the inclusion criteria and were included in the review.ResultsOverall, studies suggest that peer support is associated with improvements in mental health including greater happiness, self-esteem and effective coping, and reductions in depression, loneliness and anxiety. This effect appears to be present among university students, non-student young adults and ethnic/sexual minorities. Both individual and group peer support appear to be beneficial for mental health with positive effects also being present for those providing the support.ConclusionsPeer support appears to be a promising avenue towards improving the mental health of young adults, with lower barriers to accessing these services when compared with traditional mental health services. The importance of training peer supporters and the differential impact of peer support based on the method of delivery should be investigated in future research.
Effects of remote learning during the COVID-19 lockdown on children’s visual health: a systematic review
Authors: Cortés-Albornoz María Camila , Ramírez-Guerrero Sofía , Rojas-Carabali William , de-la-Torre Alejandra , Talero-Gutiérrez Claudia 
Published: August 2022

ObjectivesIncreased exposure to digital devices as part of online classes increases susceptibility to visual impairments, particularly among school students taught using e-learning strategies. This study aimed to identify the impact of remote learning during the COVID-19 lockdown on children’s visual health.DesignSystematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesScopus, PubMed and ScienceDirect databases from the year 2020 onwards.Eligibility criteriaWe included cross-sectional, case–control, cohort studies, case series and case reports, published in English, Spanish or French, that approached the effects of remote learning during the COVID-19 lockdown on visual health in neurotypical children.Data extraction and synthesisWe included a total of 21 articles with previous quality assessments using the Joanna Briggs checklist. Risk of bias assessment was applied using the National Institutes of Health quality assessment tool for before-and-after studies with no control group; the tool developed by Hoyet alto assess cross-sectional studies; the Muradet altool to evaluate the methodological quality of case reports and case series; and the Newcastle-Ottawa Scale for cohort studies.ResultsAll but one study reported a deleterious impact of the COVID-19 lockdown on visual health in children. Overall, the most frequently identified ocular effects were refractive errors, accommodation disturbances and visual symptoms such as dry eye and asthenopia.ConclusionsIncreased dependence on digital devices for online classes has either induced or exacerbated visual disturbances, such as rapid progression of myopia, dry eye and visual fatigue symptoms, and vergence and accommodation disturbances, in children who engaged in remote learning during the COVID-19 lockdown.PROSPERO registration numberCRD42022307107.
Working from home during COVID-19 in a Danish hospital research setting: experiences of researchers and healthcare providers, explored by Group Concept Mapping
Authors: Specht Ina Olmer , Winckler Karoline , Christensen Robin , Bomhoff Claus , Raffing Rie , Wæhrens Eva Ejlersen 
Published: August 2022

ObjectivesThe COVID-19 pandemic has changed the working environment, how we think of it and how it stands to develop into the future. Knowledge about how people have continued to work on-site and adjusted to working from home during the COVID-19 lockdown will be vital for planning work arrangements in the post-pandemic period. Our primary objective was to investigate experiences of working from home or having colleagues working from home during a late stage of the COVID-19 lockdown among researchers and healthcare providers in a hospital research setting. Second, we aimed to investigate researchers’ productivity through changes in various proxy measures during lockdown as compared with pre-lockdown.DesignMixed-method participatory Group Concept Mapping (GCM).Setting and participantsGCM, based on a mixed-method participatory approach, was applied involving researchers’ and healthcare providers’ online sorting and rating experiences working from home during the COVID-19 pandemic. At a face-to-face meeting, participants achieved consensus on the number and labelling of domains—the basis for developing a conceptual model.ResultsThrough the GCM approach, 47 participants generated 125 unique statements of experiences related to working from home, which were organised into seven clusters. Using these clusters, we developed a conceptual model that illustrated the pros and cons of working from home.ConclusionThe future work setting, the role of the office and the overall work environment need to respond to workers’ increased wish for flexible work arrangements and co-decision.
Quality improvement initiative to improve infant safe sleep practices in the newborn nursery
Authors: Shaikh Sophie Kay , Chamberlain Lauren , Nazareth-Pidgeon Kristina Marie , Boggan Joel C 
Published: August 2022

The American Academy of Pediatrics recommends that healthcare professionals model their safe infant sleeping environment recommendations, yet adherence to safe sleep practices within our community hospital mother–baby unit was low. We used quality improvement (QI) methodology to increase adherence to infant safe sleep practices, with a goal to improve the proportion of infants sleeping in an environment that would be considered ‘perfect sleep’ to 70% within a 1-year period. The project occurred while the hospital was preparing for Baby Friendly certification, with increased emphasis on rooming in and skin to skin at the same time.Multiple Plan–Do–Study–Act cycles were performed. Initial cycles targeted nurse and parental education, while later cycles focused on providing sleep sacks/wearable blankets for the infants.While we did not meet our goal, the percentage of infants with ‘perfect sleep’ increased from a baseline of 41.9% to 67.3%, and we also saw improvement in each of the individual components that contribute to this composite measure. Improvements were sustained over 12 months later, suggesting that QI interventions targeting infant safe sleep in this inpatient setting can have long-lasting results. This project also suggests that infant safe sleep QI initiatives and preparation towards Baby Friendly Hospital Certification can be complementary.
National estimates of emergency department visits for medication-related self-harm: United States, 2016–2019
Authors: Geller Andrew I , Ehlman Daniel C , Lovegrove Maribeth C , Budnitz Daniel S 
Published: August 2022

BackgroundMedication poisoning is a common form of self-harm injury, and increases in injuries due to self-harm, including suicide attempts, have been reported over the last two decades.MethodsCross-sectional (2016–2019) data from 60 emergency departments (EDs) participating in an active, nationally representative public health surveillance system were analysed and US national estimates of ED visits for medication-related self-harm injuries were calculated.ResultsBased on 18 074 surveillance cases, there were an estimated 269 198 (95% CI 222 059 to 316 337) ED visits for medication-related self-harm injuries annually in 2016–2019 compared with 1 404 090 visits annually from therapeutic use of medications. Population rates of medication-related self-harm ED visits were highest among persons aged 11–19 years (58.5 (95% CI 45.0 to 72.0) per 10 000) and lowest among those aged ≥65 years (6.6 (95% CI 4.4 to 8.8) per 10 000). Among persons aged 11–19 years, the ED visit rate for females was four times that for males (95.4 (95% CI 74.2 to 116.7) vs 23.0 (95% CI 16.4 to 29.6) per 10 000). Medical or psychiatric admission was required for three-quarters (75.1%; 95% CI 70.0% to 80.2%) of visits. Concurrent use of alcohol or illicit substances was documented in 40.2% (95% CI 36.8% to 43.7%) of visits, and multiple medication products were implicated in 38.6% (95% CI 36.8% to 40.4%). The most frequently implicated medication categories varied by patient age.ConclusionsMedication-related self-harm injuries are an important contributor to the overall burden of ED visits and hospitalisations for medication-related harm, with the highest rates among adolescent and young adult females. These findings support continued prevention efforts targeting patients at risk of self-harm.
Asthma exacerbations are associated with a decline in lung function: a longitudinal population-based study
Authors: Soremekun Seyi , Heaney Liam G , Skinner Derek , Bulathsinhala Lakmini , Carter Victoria , Chaudhry Isha , Hosseini Naeimeh , Eleangovan Neva , Murray Ruth , Tran Trung N , Emmanuel Benjamin , Garcia Gil Esther , Menzies-Gow Andrew , Peters Matthew , Lugogo Njira , Jones Rupert , Price David B 
Published: August 2022

RationaleProgressive lung function (LF) decline in patients with asthma contributes to worse outcomes. Asthma exacerbations are thought to contribute to this decline; however, evidence is limited with mixed results.MethodsThis historical cohort study of a broad asthma patient population in the Optimum Patient Care Research Database, examined asthma patients with 3+eligible post-18th birthday peak expiratory flow rate (PEF) records (primary analysis) or records of forced expiratory flow in 1 s (FEV1) (sensitivity analysis). Adjusted linear growth models tested the association between mean annual exacerbation rate (AER) and LF trajectory.ResultsWe studied 1 09 182 patients with follow-up ranging from 5 to 50 years, of which 75 280 had data for all variables included in the adjusted analyses. For each additional exacerbation, an estimated additional −1.34 L/min PEF per year (95% CI −1.23 to –1.50) were lost. Patients with AERs >2/year and aged 18–24 years at baseline lost an additional −5.95 L/min PEF/year (95% CI −8.63 to –3.28) compared with those with AER 0. These differences in the rate of LF decline between AER groups became progressively smaller as age at baseline increased. The results using FEV1were consistent with the above.ConclusionTo our knowledge, this study is the largest nationwide cohort of its kind and demonstrates that asthma exacerbations are associated with faster LF decline. This was more prominent in younger patients but was evident in older patients when it was related to lower starting LF, suggesting a persistent deteriorating phenotype that develops in adulthood over time. Earlier intervention with appropriate management in younger patients with asthma could be of value to prevent excessive LF decline.
Data Sharing and Information Platforms in Crisis Response and Preparedness: Exploring the Role of Open Data Sharing Platforms and Collective Intelligence in COVID-19 Response Efforts, and Preparedness for Future Pandemics
Authors: Lungati Angela Oduor 
Published: August 2022

COVID-19 has wreaked unprecedented havoc in the world. Response efforts have also made huge evident gaps in preparedness and governments around the world's capacity to respond to a health crisis of this magnitude adequately. As a result, local communities have taken matters into their own hands and turned to technology platforms to coordinate mutual aid efforts, shed light on response gaps, and hold governments accountable. This paper explores the role of open data sharing platforms and collective intelligence in COVID-19 response efforts by studying two examples of community-led initiatives from Spain and Japan. Frena La Curva (Spain) and Safecast (Japan) utilized the Ushahidi platform, an open-source technology tool born out of Kenya's post-election violence that has been widely used in over 160 countries for crisis response since its inception in 2008. Research reports have been warning of pandemic breakouts for decades. However, the response to COVID-19 was inadequate, with healthcare systems buckling under the pressure of the spread of the disease.
Moreover, existing social protection programs could not shield citizens despite having experienced similar economic impacts in the years that have passed. Data hugging and suppression of information regarding the pandemic outbreak led to significant delays in measures being put in place to curb the spread of COVID-19. This paper proposes that governments would benefit from leveraging open data and technology platforms to engage with ordinary citizens and eliminate data blind spots in the design of social protection programs. It also posits that we need to invest in interoperable data exchange systems to increase the speed of response and learning. Finally, it also proposes the need for internet freedom and access as a critical tool for preparedness by enabling the free flow of information.
Learning Strong Substitutes Demand via Queries
Authors: Lock Edwin , Goldberg Paul W. , Marmolejo-Cossío Francisco 
Published: August 2022

This article addresses the computational challenges of learning strong substitutes demand when given access to a demand (or valuation) oracle. Strong substitutes demand generalises the well-studied gross substitutes demand to a multi-unit setting. Recent work by Baldwin and Klemperer shows that any such demand can be expressed in a natural way as a finite list of weighted bid vectors. A simplified version of this bidding language has been used by the Bank of England.
Assuming access to a demand oracle, we provide an algorithm that computes the unique list of weighted bid vectors corresponding to a bidder’s demand preferences. In the special case where their demand can be expressed using positive bids only, we have an efficient algorithm that learns this list in linear time. We also show super-polynomial lower bounds on the query complexity of computing the list of bids in the general case where bids may be positive and negative. Our algorithms constitute the first systematic approach for bidders to construct a bid list corresponding to non-trivial demand, allowing them to participate in “product-mix” auctions.
LW-GCN: A Lightweight FPGA-based Graph Convolutional Network Accelerator
Authors: Tao Zhuofu , Wu Chen , Liang Yuan , Wang Kun , He Lei 
Published: August 2022

Graph convolutional networks (GCNs) have been introduced to effectively process non-Euclidean graph data. However, GCNs incur large amounts of irregularity in computation and memory access, which prevents efficient use of traditional neural network accelerators. Moreover, existing dedicated GCN accelerators demand high memory volumes and are difficult to implement onto resource limited edge devices.
In this work, we propose LW-GCN, a lightweight FPGA-based accelerator with a software-hardware co-designed process to tackle irregularity in computation and memory access in GCN inference. LW-GCN decomposes the main GCN operations into Sparse Matrix-Matrix Multiplication (SpMM) and Matrix-Matrix Multiplication (MM). We propose a novel compression format to balance workload across PEs and prevent data hazards. Moreover, we apply data quantization and workload tiling, and map both SpMM and MM of GCN inference onto a uniform architecture on resource limited hardware. Evaluation on GCN and GraphSAGE are performed on Xilinx Kintex-7 FPGA with three popular datasets. Compared to existing CPU, GPU, and state-of-the-art FPGA-based accelerator, LW-GCN reduces latency by up to 60×, 12×, and 1.7× and increases power efficiency by up to 912×, 511×, and 3.87×, respectively. Furthermore, compared with NVIDIA’s latest edge GPU Jetson Xavier NX, LW-GCN achieves speedup and energy savings of 32× and 84×, respectively.