bluuebunny/crossref_metadata_2025_split huggingface dataset:
Liver steatosis and metabolic dysfunction-associated fatty liver disease among HIV-positive and negative adults in urban Zambia
Authors: Chihota Belinda Varaidzo , Riebensahm Carlotta , Muula Guy , Sinkala Edford , Chilengi Roma , Mulenga Lloyd , Bosomprah Samuel , Vinikoor Michael J , Bolton-Moore Carolyn , Egger Matthias , Rauch Andri , Berzigotti Annalisa , Wandeler Gilles 
Published: July 2022

IntroductionThe growing importance of non-communicable diseases (NCDs) and high HIV prevalence in urban African settings may increase the burden of metabolic dysfunction-associated fatty liver disease (MAFLD). We assessed liver steatosis among HIV-positive and negative adults in urban Zambia.MethodsAdults 30 years and older who were newly diagnosed with HIV, or tested HIV-negative at two primary care clinics in Lusaka, Zambia, were assessed for liver steatosis. Cardiometabolic data were collected through comprehensive clinical and laboratory assessments. Transient elastography was performed to measure controlled-attenuation parameter (≥248 dB/m). We used multivariable logistic regression models to determine the factors associated with the presence of steatosis.ResultsWe enrolled 381 patients, including 154 (40%) antiretroviral therapy-naïve people living with HIV (PLWH) with a median CD4+ count of 247 cells/mm3and a mean body mass index (BMI) of 23.8 kg/m2. Liver steatosis was observed in 10% of participants overall and was more common among HIV-negative adults than in PLWH (15% vs 3%). The proportion of patients with steatosis was 25% among obese (BMI ≥30 kg/m2) participants, 12% among those overweight (BMI 25–29.9 kg/m2), and 7% among those with a BMI <25 kg/m2. Among patients with a fasting glucose ≥7 mmol/L or confirmed diabetes, 57% had liver steatosis. In multivariable analyses, HIV status (adjusted odds ratio (aOR) 0.18, 95% CI 0.06 to 0.53), confirmed diabetes or elevated fasting glucose (aOR 3.92, 95% CI 1.57 to 9.78) and elevated blood pressure (aOR 2.95, 95% CI 1.34 to 6.48) were associated with steatosis. The association between BMI>25 kg/m2and liver steatosis was attenuated after adjustment for potential confounders (aOR 1.96, 95% CI 0.88–4.40). Overall, 21 (9%) participants without HIV and 4 (3%) with HIV met the criteria for MAFLD. Among individuals with liver steatosis, 65% (95% CI 49% to 80%) fulfilled criteria of MAFLD, whereas 15 (39%) of them had elevated transaminases and 3 (8%) F2–F4 fibrosis.ConclusionsThe prevalence of liver steatosis in this urban cohort of HIV-positive and negative adults in Zambia was low, despite a large proportion of patients with high BMI and central obesity. Our study is among the first to report data on MAFLD among adults in Africa, demonstrating that metabolic risk factors are key drivers of liver steatosis and supporting the adoption of the criteria for MAFLD in African populations.
Developing a global practice-based framework of person-centred care from primary data: a cross-national qualitative study with patients, caregivers and healthcare professionals
Authors: Giusti Alessandra , Pukrittayakamee Panate , Alarja Ghadeer , Farrant Lindsay , Hunter Joy , Mzimkulu Olona , Gwyther Liz , Williams Nokuzola , Wannarit Kamonporn , Abusalem Lana , Alajarmeh Sawsan , Alrjoub Waleed , Thongchot Lakkana , Janwanishstaporn Satit , Edilbi Adib , Al-Ani Ruba , Shamieh Omar , Guo Ping , Bashan Nkhoma Kennedy , Venkatapuram Sridhar , Harding Richard 
Published: July 2022

IntroductionPerson-centred care (PCC) is internationally recognised as a critical component of high-quality healthcare. However, PCC evolved in a few high-income countries and there are limited data exploring this concept across the vast majority of countries which are low- and middle-income. This study aimed to appraise and adapt a PCC model across three serious physical conditions in three middle-income countries and generate an evidence-based framework and recommendations for globally relevant PCC.MethodsCross-national, cross-sectional qualitative study. In depth, semistructured interviews conducted with: advanced cancer patients in Jordan (n=50), their caregivers (n=20) and healthcare professionals (HCPs) (n=20); chronic obstructive pulmonary disease patients in South Africa (n=22), their caregivers (n=19) and HCPs (n=22); heart failure patients in Thailand (n=14), their caregivers (n=10) and HCPs (n=12). Data were analysed using framework analysis. Santanaet al’s PCC model (2018) and Giustiet al’s systematic review (2020) were used to construct an a priori coding frame for deductive analysis, with additional inductive coding for coding that did not fit the frame.ResultsThe findings both reveal specific practical actions that contribute towards delivering PCC and highlight new cross-national domains of person-centredness: interdependency and collectivism; bringing care into the home and community; equity and non-discrimination; addressing health and illness within the context of limited resources; and workforce well-being.ConclusionThe data suggest that PCC requires particular structural features of the healthcare system to be in place, such as professional education in PCC values and partnerships with community-based workers. These structures may better enable PCC processes, including tailored information sharing and providing genuine opportunities for patients to do the things that matter to them, such as making informed care decisions and sustaining social relationships. PCC must also accommodate a collectivist perspective and support the well-being of the workforce.
Different Approaches to requesting Consent for Routine data linkage in Neonatal follow-up (ACORN): protocol for a 2×2 factorial randomised trial
Authors: Harding Jane E , Rajay Aakash Bajirao , Alsweiler Jane Marie , Brown Gavin , Crowther Caroline Anne , Franke Nike , Gamble Greg , McKinlay Christopher , Milne Barry , Rogers Jenny , Wouldes Trecia 
Published: July 2022

IntroductionRoutinely collected data can be linked to research data to create a rich dataset and inform practice. However, consent is normally required to link identifiable data. Reported rates of consent to data linkage for children ranged from 21% to 96%, but no studies have investigated different approaches to seeking consent for data linkage for school-age children.Methods and analysisThe Approaches to Consent for Routine Data Linkage in Neonatal Follow-up (ACORN) trial is a 2×2 factorial randomised trial to assess whether, for children who participated in neonatal randomised trials (pre-hypoglycaemia Prevention with Oral Dextrose Gel (hPOD), hPOD and The Impact of Protein Intravenous Nutrition on Development in Extremely Low Birth Weight Babies (ProVIDe)) and are approached to participate in an in-person assessment at 6–7 years of age, parental consent to data linkage is higher if consent is sought (1) after the in-person assessment (delayed) or concurrently and (2) for health and education data combined or separately. The primary outcomes will be rates of consent to linkage of (1) either health or education data and (2) both health and education data. A pilot study indicates the potentially available cohort size of 2110 (80% follow-up of the neonatal trial cohorts) would be adequate to detect an absolute difference of 6%–5%–4% from a baseline consent rate of 70%–85%–90%, respectively (2-tailed alpha 0.05, 90% power). With at least 1136 participants, the ACORN trial would have 90% power to detect an absolute difference of 5% in the primary outcome for each factor, assuming a consent rate of 90% in the control groups and alpha 0.05. Data are categorical and will be presented as number and per cent. The effects of factors will be tested using generalised linear models and presented as ORs and 95% CIs.Ethics and disseminationEthics approval by the New Zealand Health and Disability Ethics Committee (19/STH/202). Dissemination will be via peer-reviewed publications, scientific meetings, educational sessions and public fora.Trial registration numberACTRN12621000571875 (Australian New Zealand Clinical Trials Registry).
Effectiveness of universal school-based mindfulness training compared with normal school provision on teacher mental health and school climate: results of the MYRIAD cluster randomised controlled trial
Authors: Kuyken Willem , Ball Susan , Crane Catherine , Ganguli Poushali , Jones Benjamin , Montero-Marin Jesus , Nuthall Elizabeth , Raja Anam , Taylor Laura , Tudor Kate , Viner Russell M , Allwood Matthew , Aukland Louise , Dunning Darren , Casey Tríona , Dalrymple Nicola , De Wilde Katherine , Farley Eleanor-Rose , Harper Jennifer , Hinze Verena , Kappelmann Nils , Kempnich Maria , Lord Liz , Medlicott Emma , Palmer Lucy , Petit Ariane , Philips Alice , Pryor-Nitsch Isobel , Radley Lucy , Sonley Anna , Shackleford Jem , Tickell Alice , Team MYRIAD , Blakemore Sarah-Jayne , Ukoumunne Obioha C , Greenberg Mark T , Ford Tamsin , Dalgleish Tim , Byford Sarah , Williams J Mark G 
Published: July 2022

BackgroundEducation is broader than academic teaching. It includes teaching students social–emotional skills both directly and indirectly through a positive school climate.ObjectiveTo evaluate if a universal school-based mindfulness training (SBMT) enhances teacher mental health and school climate.MethodsThe My Resilience in Adolescence parallel group, cluster randomised controlled trial (registration:ISRCTN86619085; funding: Wellcome Trust (WT104908/Z/14/Z, WT107496/Z/15/Z)) recruited 85 schools (679 teachers) delivering social and emotional teaching across the UK. Schools (clusters) were randomised 1:1 to either continue this provision (teaching as usual (TAU)) or include universal SBMT. Data on teacher mental health and school climate were collected at prerandomisation, postpersonal mindfulness and SBMT teacher training, after delivering SBMT to students, and at 1-year follow-up.FindingSchools were recruited in academic years 2016/2017 and 2017/2018. Primary analysis (SBMT: 43 schools/362 teachers; TAU: 41 schools/310 teachers) showed that after delivering SBMT to students, SBMT versus TAU enhanced teachers’ mental health (burnout) and school climate. Adjusted standardised mean differences (SBMT minus TAU) were: exhaustion (−0.22; 95% CI −0.38 to −0.05); personal accomplishment (−0.21; −0.41, −0.02); school leadership (0.24; 0.04, 0.44); and respectful climate (0.26; 0.06, 0.47). Effects on burnout were not significant at 1-year follow-up. Effects on school climate were maintained only for respectful climate. No SBMT-related serious adverse events were reported.ConclusionsSBMT supports short-term changes in teacher burnout and school climate. Further work is required to explore how best to sustain improvements.Clinical implicationsSBMT has limited effects on teachers’ mental and school climate. Innovative approaches to support and preserve teachers’ mental health and school climate are needed.
School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial?
Authors: Montero-Marin Jesus , Allwood Matthew , Ball Susan , Crane Catherine , De Wilde Katherine , Hinze Verena , Jones Benjamin , Lord Liz , Nuthall Elizabeth , Raja Anam , Taylor Laura , Tudor Kate ,   MYRIAD Team, Blakemore Sarah-Jayne , Byford Sarah , Dalgleish Tim , Ford Tamsin , Greenberg Mark T , Ukoumunne Obioha C , Williams J Mark G , Kuyken Willem 
Published: July 2022

BackgroundPreventing mental health problems in early adolescence is a priority. School-based mindfulness training (SBMT) is an approach with mixed evidence.ObjectivesTo explore for whom SBMT does/does not work and what influences outcomes.MethodsThe My Resilience in Adolescence was a parallel-group, cluster randomised controlled trial (K=84 secondary schools; n=8376 students, age: 11–13) recruiting schools that provided standard social–emotional learning. Schools were randomised 1:1 to continue this provision (control/teaching as usual (TAU)), and/or to offer SBMT (‘.b’ (intervention)). Risk of depression, social–emotional–behavioural functioning and well-being were measured at baseline, preintervention, post intervention and 1 year follow-up. Hypothesised moderators, implementation factors and mediators were analysed using mixed effects linear regressions, instrumental variable methods and path analysis.FindingsSBMT versus TAU resulted in worse scores on risk of depression and well-being in students at risk of mental health problems both at post intervention and 1-year follow-up, but differences were small and not clinically relevant. Higher dose and reach were associated with worse social–emotional–behavioural functioning at postintervention. No implementation factors were associated with outcomes at 1-year follow-up. Pregains−postgains in mindfulness skills and executive function predicted better outcomes at 1-year follow-up, but the SBMT was unsuccessful to teach these skills with clinical relevance.SBMT as delivered in this trial is not indicated as a universal intervention. Moreover, it may be contraindicated for students with existing/emerging mental health symptoms.Clinical implicationsUniversal SBMT is not recommended in this format in early adolescence. Future research should explore social−emotional learning programmes adapted to the unique needs of young people.
The impact of mindfulness training in early adolescence on affective executive control, and on later mental health during the COVID-19 pandemic: a randomised controlled trial
Authors: Dunning Darren , Ahmed S , Foulkes L , Griffin C , Griffiths K , Leung J T , Parker J , Piera Pi-Sunyer Blanca , Sakhardande A , Bennett M , Haag C , Montero-Marin Jesus , Packman D , Vainre Maris , Watson P ,   The MYRIAD Team, Kuyken Willem , Williams J Mark G , Ukoumunne Obioha C , Blakemore Sarah-Jayne , Dalgleish Tim 
Published: July 2022

BackgroundPrevious research suggests that mindfulness training (MT) appears effective at improving mental health in young people. MT is proposed to work through improving executive control in affectively laden contexts. However, it is unclear whether MT improves such control in young people. MT appears to mitigate mental health difficulties during periods of stress, but any mitigating effects against COVID-related difficulties remain unexamined.ObjectiveTo evaluate whether MT (intervention) versus psychoeducation (Psy-Ed; control), implemented in after-school classes: (1) Improves affective executive control; and/or (2) Mitigates negative mental health impacts from the COVID-19 pandemic.MethodsA parallel randomised controlled trial (RCT) was conducted (Registration:https://osf.io/d6y9q/; Funding: Wellcome (WT104908/Z/14/Z, WT107496/Z/15/Z)). 460 students aged 11-16 years were recruited and randomised 1:1 to either MT (N=235) or Psy-Ed (N=225) and assessed preintervention and postintervention on experimental tasks and self-report inventories of affective executive control. The RCT was then extended to evaluate protective functions of MT on mental health assessed after the first UK COVID-19 lockdown.FindingsResults provided no evidence that the version of MT used here improved affective executive control after training or mitigated negative consequences on mental health of the COVID-19 pandemic relative to Psy-Ed. No adverse events were reported.ConclusionsThere is no evidence that MT improves affective control or downstream mental health of young people during stressful periods.Clinical implicationsWe need to identify interventions that can enhance affective control and thereby young people’s mental health.
Do mindfulness-based programmes improve the cognitive skills, behaviour and mental health of children and adolescents? An updated meta-analysis of randomised controlled trials
Authors: Dunning Darren , Tudor Kate , Radley Lucy , Dalrymple Nicola , Funk Julia , Vainre Maris , Ford Tamsin , Montero-Marin Jesus , Kuyken Willem , Dalgleish Tim 
Published: July 2022

QuestionMindfulness-based programmes (MBPs) are an increasingly popular approach to improving mental health in young people. Our previous meta-analysis suggested that MBPs show promising effectiveness, but highlighted a lack of high-quality, adequately powered randomised controlled trials (RCTs). This updated meta-analysis assesses the-state-of the-art of MBPs for young people in light of new studies. It explores MBP’s effectiveness in active vs passive controls; selective versus universal interventions; and studies that included follow-up.Study selection and analysisWe searched for published and unpublished RCTs of MBPs with young people (<19 years) in PubMed Central, PsycINFO, Web of Science, EMBASE, ICTRP, ClinicalTrials.gov, EThOS, EBSCO and Google Scholar. Random-effects meta-analyses were conducted, and standardised mean differences (Cohen’s d) were calculated.FindingsSixty-six RCTs, involving 20 138 participants (9552 receiving an MBP and 10 586 controls), were identified. Compared with passive controls, MBPs were effective in improving anxiety/stress, attention, executive functioning, and negative and social behaviour (d from 0.12 to 0.35). Compared against active controls, MBPs were more effective in reducing anxiety/stress and improving mindfulness (d=0.11 and 0.24, respectively). In studies with a follow-up, there were no significant positive effects of MBPs. No consistent pattern favoured MBPs as a universal versus selective intervention.ConclusionsThe enthusiasm for MBPs in youth has arguably run ahead of the evidence. While MBPs show promising results for some outcomes, in general, the evidence is of low quality and inconclusive. We discuss a conceptual model and the theory-driven innovation required to realise the potential of MBPs in supporting youth mental health.
Left atrial appendage preservation versus closure during surgical ablation of atrial fibrillation
Authors: Kim Ho Jin , Chang Dong-Hee , Kim Seon-Ok , Kim Jin Kyoung , Kim Kiyun , Jung Sung-Ho , Lee Jae Won , Kim Joon Bum 
Published: July 2022

ObjectiveThere is limited evidence regarding the effectiveness of left atrial appendage (LAA) closure during surgical ablation of atrial fibrillation (AF) in yielding superior clinical outcomes. This study aimed to evaluate the association of LAA closure versus preservation with the risk of adverse clinical outcomes among patients undergoing surgical ablation during cardiac surgery.MethodsWe evaluated 1640 patients (aged 58.8±11.5 years, 898 women) undergoing surgical ablation during cardiac surgery (including mitral valve (MV), n=1378; non-MV, n=262) between 2001 and 2018. Of these, 804 had LAA preserved, and the remaining 836 underwent LAA closure. Comparative risks of stroke and mortality between the two groups were evaluated after adjustments with inverse-probability-of-treatment weighting (IPTW). Longitudinal echocardiographic data (n=9674, 5.9/patient) on transmitral A-wave and E/A-wave ratio were analysed by random coefficient models.ResultsAdjustment with IPTW yielded patient cohorts well-balanced for baseline profiles. During a median follow-up of 43.5 months (IQR 19.0–87.3 months), stroke and death occurred in 87 and 249 patients, respectively. The adjusted risk of stroke (HR 0.85; 95% CI 0.52–1.39) and mortality (HR 0.80; 95% CI 0.61 to 1.05) did not differ significantly between the two groups. Echocardiographic data demonstrated higher transmitral A-wave velocity (group-year interaction, p=0.066) and lower E/A-wave ratio (group-year interaction, p=0.045) in the preservation group than in the closure group.ConclusionsLAA preservation during surgical AF ablation was not associated with an increased risk of stroke or mortality. Postoperative LA transport functions were more favourable with LAA preservation than with LAA closure.
The equivalence and/or the effacing principle in $$ f\left( R\right) $$ theories of gravity
Authors: Bhattacharyya Soham 
Published: July 2022

AbstractThe Einstein–Hilbert action of the general theory of relativity (GR) is the integral of the scalar curvature R. It is a theory that is drawn from the Equivalence principle and has predictions that come out as a consequence of the principle, in observables. Testing such observables to find confirmation/infirmation of the principle has formed a significant chunk of tests of GR itself. It is expected that quantum corrections to GR may add additional higher powers of R to the Einstein–Hilbert action, or more generally, modifying the action into a generic class of functions of the Ricci scalar. Testing the fate of the prized equivalence principle, in such modified theories of gravity, hence become important in order to obtain a more generic theory of gravitation, and consequently, of gravitating objects. In this study, it is shown that a Post-Newtonian (PN) expansion of a class of $$ f\left( R\right) $$

f

R

theories lead to a sequence of solutions to the two-body problem, which follows the equivalence principle (EP) at the Newtonian order, and generalizes to the ‘effacing principle’ at a higher PN order.
A Spatially Resolved Mechanistic Growth Law for Cancer Drug Development Predicting Tumor Growing Fractions
Authors: Nasim Adam , Yates James , Derks Gianne , Dunlop Carina 
Published: July 2022

Mathematical models used in preclinical drug discovery tend to be empirical growth laws. Such models are well suited to fitting the data available, mostly longitudinal studies of tumor volume; however, they typically have little connection with the underlying physiologic processes. This lack of a mechanistic underpinning restricts their flexibility and potentially inhibits their translation across studies including from animal to human. Here we present a mathematical model describing tumor growth for the evaluation of single-agent cytotoxic compounds that is based on mechanistic principles. The model can predict spatial distributions of cell subpopulations and account for spatial drug distribution effects within tumors. Importantly, we demonstrate that the model can be reduced to a growth law similar in form to the ones currently implemented in pharmaceutical drug development for preclinical trials so that it can integrated into the current workflow. We validate this approach for both cell-derived xenograft and patient-derived xenograft (PDX) data. This shows that our theoretical model fits as well as the best performing and most widely used models. However, in addition, the model is also able to accurately predict the observed growing fraction of tumours. Our work opens up current preclinical modeling studies to also incorporating spatially resolved and multimodal data without significant added complexity and creates the opportunity to improve translation and tumor response predictions.Significance:This theoretical model has the same mathematical structure as that currently used for drug development. However, its mechanistic basis enables prediction of growing fraction and spatial variations in drug distribution.