bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trajectories of depressive symptoms in systemic lupus erythematosus over time
Authors: Chawla Seerat , Su Jiandong , Touma Zahi , Katz Patricia 
Published: June 2022

Abstract

Objectives
The objectives of this study were to determine the trajectories of depressive symptoms in patients with SLE and to identify baseline characteristics that are associated with a patient’s trajectory of depression.

Methods
Data from the Lupus Outcomes Study at the University of California, San Francisco were analysed. Depressive symptomatology was assessed in years two through seven using the Center for Epidemiologic Studies Depression Scale (CES-D), with higher scores representing more severe depressive symptoms. Group-based trajectory modelling was used to determine latent classes of CES-D scores over time. Ordinal logistic regression analyses were performed to identify baseline characteristics associated with worse classes of depressive symptoms.

Results
CES-D scores for 763 individuals with SLE over 6 years were mapped into four distinct classes. Class 1 (36%) and class 2 (32%) comprised the largest proportion of the cohort and were defined by the lowest and low CES-D scores (no depression), respectively. Class 3 (22%) and class 4 (10%) had high and the highest scores (depression), respectively. Greater age [odds ratio (OR): 0.97, 95% CI: 0.96, 0.99] and higher education level (OR: 0.79, 95% CI: 0.70, 0.89) at baseline were associated with lower odds of membership in worse classes of depressive symptoms. Conversely, lower income (OR: 1.73, 95% CI: 1.03, 2.92), worse SF-36 physical functioning scores (OR: 1.12, 95% CI: 1.12, 1.13) and worse SF-36 bodily pain scores (OR: 1.58, 95% CI: 1.55, 1.61) were positively associated with membership in worse classes of depressive symptoms.

Conclusion
Four classes of depressive symptoms were identified in patients with SLE. Understanding the trajectories of depressive symptoms and the associated risk factors can aid in the management of these symptoms in individuals living with SLE.
Psychological Acceptance in Adults With Hearing Loss—Psychometric Evaluation and Validation of the Hearing Acceptance Questionnaire
Authors: Molander Peter , Andersson Gerhard , Hesser Hugo 
Published: June 2022

Objectives:
Hearing loss is common and a major contributor to the global number of years lived with disability. An increasing number of studies have begun to consider the specific psychological processes by which distressing thoughts, emotional experiences and non-adaptive behaviours exert an influence on functioning and health among those who suffer from audiological disorders. Psychological acceptance has recently been proposed to be a core process but has to date not been systematically examined among individuals with hearing problems. This study examined the reliability, factor structure and the validity of the Hearing Acceptance Questionnaire (HAQ).

Design:
The HAQ was developed from similar questionnaires for other chronic health conditions and was evaluated using data from an online screening of hearing ability (N=1351). Measures included a hearing test (speech-in-noise), standardized and validated self-report measurements of anxiety and depression symptoms (the Hospital Anxiety and Depression scale), hearing related disability (the Amsterdam Inventory of Hearing Disability and Handicap), and quality of life (the Quality of Life Inventory). Factor structure of the HAQ was evaluated with confirmatory factor analysis, and the unique contribution of psychological acceptance in accounting for variance in hearing disability was examined by hierarchical multiple regression analyses.

Results:
Findings supported the reliability, factor structure and validity of the HAQ. Confirmatory factor analysis supported a two-factor model with one subscale measuring Avoidance with 9 items; alpha = 0.84) and the other Activity Engagement (3 items; alpha = 0.76). Both subscales of the HAQ explained unique variance in disability after hearing ability, depression and anxiety symptoms were statistically taken into account. Theoretical and clinical implications of psychological acceptance in adults with hearing problems are discussed.

Conclusions:
This paper evaluated the psychometric properties of a new measure of hearing loss acceptance, the HAQ, to measure psychological acceptance among individuals with hearing problems. Regression analysis revealed that lack of psychological acceptance was strongly positively correlated with hearing disability, even after accounting for other psychological factors and hearing ability. Taken together, the findings provide preliminary support for HAQ as a psychometrically sound measure of psychological acceptance among individuals with hearing problems.
Early Titration of Oxygen During Mechanical Ventilation Reduces Hyperoxemia in a Pilot, Feasibility, Randomized Control Trial for Automated Titration of Oxygen Levels
Authors: Pannu Sonal R. , Exline Matthew , Klamer Brett , Brock Guy , Crouser Elliott D. , Christman John W. , Diaz Philip 
Published: June 2022

OBJECTIVES:
Timely regulation of oxygen (Fio
2) is essential to prevent hyperoxemia or episodic hypoxemia. Exposure to excessive Fio
2 is often noted early after onset of mechanical ventilation. In this pilot study, we examined the feasibility, safety, and efficacy of a clinical trial to prioritize Fio
2 titration with electronic alerts to respiratory therapists.

STUDY DESIGN:
Open-labeled, randomized control pilot trial.

SETTING:
Medical ICU.

SUBJECTS:
Adults requiring mechanical ventilation.

INTERVENTIONS:
Protocolized oxygen titration was initiated one hour after initiation of mechanical ventilation. When Spo2 exceeded 92% while on Fio2 ≥ 0.5, an electronic alert to respiratory therapists was triggered at 30-minute intervals. In the control arm, respiratory therapists titrated Fio
2 by standard physician’s orders.

MEASUREMENTS AND MAIN RESULTS:
The primary end point was to determine if early Fio
2 titration based on automated alerts was feasible in terms of reducing hyperoxemia. Secondary analyses included the number and frequency of alerts, mechanical ventilation duration, and ICU length of stay. Among 135 randomized patients, 72 were assigned to the intervention arm and 63 to the control arm. A total 877 alerts were sent. Exposure to hyperoxemia was significantly reduced in the intervention group by a median of 7.5 hours (13.7 [interquartile range (IQR), 2.9–31.1] vs 21.2 [IQR, 10.9–64.4]; p < 0.0004). Maximal Fio
2 titration during the first quartile resulted in significant reduction in mechanical ventilation duration and ICU stay. Minor hypoxemic events (Spo
2 < 88%) represented 12% of alerts, 9% were transient and responded to a single Fio
2 increase, whereas 3% of alerts were associated with recurrent transient hypoxemia.

CONCLUSIONS:
Our pilot study indicates that early Fio
2 titration driven by automated alerts is feasible in the ICU, as reflected by a statistically significant reduction of hyperoxemia exposure, limited consequential hypoxemia, and reduced ICU resource utilization. The encouraging results of this pilot study need to be validated in a larger ICU cohort.
Research Letter: Impact of Obstructive Sleep Apnea Disease Duration on Neuropsychological Functioning After Traumatic Brain Injury: A Veterans Affairs TBI Model Systems Study
Authors: Silva Marc A. , Lee Jaylene M. , Garcia Amanda , Dams-O'Connor Kristen , Nakase-Richardson Risa 
Published: June 2022

Objective:
To examine the relationship between obstructive sleep apnea (OSA) disease duration and cognitive functioning in those with a history of traumatic brain injury (TBI). We hypothesized that longer OSA duration would predict poorer cognitive performance.

Setting:
Inpatient brain injury units at a Veterans Affairs (VA) Polytrauma Rehabilitation Center.

Participants:
Participants in the VA TBI Model Systems multicenter longitudinal study who enrolled in a modular substudy (April 15, 2018, to January 15, 2021) examining cognition following TBI. All participants had received inpatient rehabilitation for TBI and reported a diagnosis of OSA (n = 89, mean age = 40.8 years, 97% male, 81% White). Reported duration of OSA ranged from 2 to 7 years (mean = 4.2; SD = 3.9).

Design:
Retrospective analysis of prospective cohort, cross-sectional.

Main Measures:
Brief Test of Adult Cognition by Telephone (BTACT).

Results:
Controlling for age, education, and time to follow commands, OSA disease duration was negatively associated with delayed verbal memory (R
2
Δ = 0.053, F
(1,84) = 5.479, P = .022). Performance in other cognitive domains was not significantly associated with OSA disease duration.

Conclusion:
This study provides preliminary evidence that longer duration of OSA (ie, time since diagnosis) has a negative impact on verbal memory in those with a history of hospitalized TBI. This finding extends the literature (which focused on the general population) on the cognitive impact of OSA and is consistent with hypothesized mechanisms such as hippocampal damage and secondary impact of fatigue. Findings suggest that early OSA identification and treatment may be prudent for persons with TBI.
Associations of Preexisting Vascular Risk Factors With Outcomes After Traumatic Brain Injury: A TRACK-TBI Study
Authors: Schneider Andrea L. C. , Barber Jason , Temkin Nancy , Gardner Raquel C. , Manley Geoffrey , Diaz-Arrastia Ramon , Sandsmark Danielle 
Published: June 2022

Objective:
To evaluate associations of preinjury vascular risk factors with traumatic brain injury (TBI) outcomes.

Setting:
The level 1 trauma center-based Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Study.

Participants:
A total of 2361 acute TBI patients 18 years or older who presented to the emergency department within 24 hours of head trauma warranting clinical evaluation with a noncontrast head CT between February 26, 2014, and August 8, 2018.

Design:
A multicenter prospective cohort study.

Main Measures:
Vascular risk factors (hypertension, diabetes, hyperlipidemia, and smoking) were assessed at baseline by self- or proxy-report and chart review. The primary outcome was the 6-month Glasgow Outcome Scale-Extended TBI version (GOSE-TBI). Secondary 6-month outcomes included the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), the Satisfaction with Life Scale (SWLS), and the 18-item Brief Symptom Inventory Global Severity Index (BSI-18-GSI).

Results:
Mean age of participants was 42 years, 31% were women, and 16% were Black. Current smoking was the most common vascular risk factor (29%), followed by hypertension (17%), diabetes (8%), and hyperlipidemia (6%). Smoking was the only risk factor associated with worse scores on all 4 outcome indices. Hypertension and diabetes were associated with worse RPQ scores, and hypertension was associated with worse BSI-18-GSI scores (all P < .05). Compared with individuals with no vascular risk factors, individuals with 1 but not 2 or more vascular risk factors had significantly worse GOSE-TBI and SWLS scores, while a higher burden of vascular risk factors was significantly associated with worse RPQ and BSI-18-GSI scores.

Conclusion:
Our study found that preinjury vascular risk factors, especially smoking, are associated with worse outcomes after TBI. Aggressive postinjury treatment of vascular risk factors may be a promising strategy to improve TBI outcomes.
Family Needs After Traumatic Brain Injury: A VA TBI Model Systems Study
Authors: Finn Jacob A. , Klocksieben Farina A. , Smith Austin N. , Bernstein John , O'Neil-Pirozzi Therese M. , Kreutzer Jeff S. , Sander Angelle M. , Dreer Laura E. , Niemeier Janet P. , Cotner Bridget A. , Nakase-Richardson Risa 
Published: June 2022

Objective:
To describe the self-reported needs of family caregivers of service members and veterans (SMVs) who sustained a traumatic brain injury (TBI) and to identify predictors of the unmet family caregiver needs.

Setting:
Five Department of Veterans Affairs (VA) Polytrauma Rehabilitation Centers (PRCs).

Participants:
Family caregivers of SMVs enrolled in the VA PRC TBI Model Systems (TBIMS) national database who were within their first 5 years post-TBI (n = 427).

Design:
Observational study.

Main Outcome Measure:
The Family Needs Questionnaire-Revised (FNQ-R) was completed by each SMV's designated caregiver.

Analyses:
Descriptive analyses were conducted on the FNQ-R responses at the item, domain, and total score levels. Unadjusted univariable and adjusted multivariable regression models were fitted to identify predictors of total unmet needs and unmet family need domains.

Results:
FNQ-R item-level and domain-level descriptive results indicated that health information was the most frequently met need domain. In contrast, emotional and instrumental support domains were the least often met. On average, family caregivers reported that 59.2% of the 37 FNQ-R needs were met at the time of the follow-up assessment. Regression models indicated that both the number of SMV-perceived environmental barriers and whether the SMV received mental health treatment within the past year predicted the number of unmet FNQ-R needs. SMV-reported environmental barriers predicted increased unmet needs in all 6 family caregiver domains, and SMV mental health treatment in the past year predicted more unmet family caregiver emotional support, community support, and professional support needs.

Conclusions:
The current findings can be used to inform policy and programming for VA and Department of Defense to proactively address the specific needs of families and caregivers experienced in the first 5 years post-TBI.
Psychometrics of the Multiple Sclerosis and Magnetic Resonance Imaging Knowledge Patient Questionnaire: A Pilot Study
Authors: Ben-Zacharia Aliza Bitton , Blessing Opeyemi , Eckardt Patricia A. 
Published: June 2022

ABSTRACT

BACKGROUND: In the last few decades, the revised diagnostic criteria for multiple sclerosis (MS) and the development of numerous new MS therapies have created the possibility of early diagnosis and opportune MS management. However, these changes, and the mounting emphasis on patient choice and shared decision making, have not been accompanied by improvements in information provided to patients with MS (PwMS). Information provision for PwMS increases disease-related knowledge that may assist them in decision making and quality of life. The purpose of this study was to validate the Multiple Sclerosis and Magnetic Resonance Imaging Knowledge Questionnaire (MSMRIKQ) to improve patients' shared decision-making capabilities. METHODS: In this methodological study, the instrument development process was completed in 4 stages using principles of measurement theory: (1) establishing a pool of items after patient and clinician panels' review, (2) evaluating the validity of the scale—both face and content validity, (3) pilot testing the scale, and (4) post–pilot testing statistical analysis of items and scale reliability and validity. RESULTS: The 20-item instrument was finalized based on a panel of MS experts' and patients' comments. The final version of the MSMRIKQ was pilot tested with a sample of 46 PwMS. Face validity was established on all MSMRIKQ items. Individual item-level and scale-level content validity indices for universal agreement estimates were acceptable at item-level content validity index = 1 and scale-level content validity index = 1 for the 20 items. The Kuder-Richardson 20 reliability estimate for the entire scale was 0.58; the Kuder-Richardson 20 estimates for the subscales of MS and magnetic resonance imaging knowledge were 0.35 and 0.51, respectively. The split-half reliability with Spearman-Brown correction for the total scale was 0.60. The Poisson regression model was significant for predicting MS knowledge within this population. CONCLUSION: The MSMRIKQ is a basic knowledge instrument for clinical and research use.
A bibliometric analysis of research on herbal medicine for obesity over the past 20 years
Authors: Seo Yeonho , Park Han-Song , Kim Hyungsuk , Kim Koh-Woon , Cho Jae-Heung , Chung Won-Seok , Song Mi-Yeon 
Published: June 2022

AbstractBackground:The aim of this study was to analyze published papers on the use of herbal medicine in obesity research over the past 20 years using bibliometric methods and present an overview of global research trends.Methods:English articles on herbal medicine for obesity published from 2001 to 2020 were retrieved from the Web of Science Core Collection database using the search terms “herbal” AND “obesity”. Microsoft Office Excel was used to sort and analyze the statistical data. Bibliographic analysis and data visualization were performed using visualization of similarities viewer based on publication year, country of publication, journal, research area, author, affiliated institution, and keywords.Results:A total of 463 English articles were retrieved, and we observed a trend in which the number of publications on herbal medicine for obesity has gradually increased over the past 20 years. The most productive countries and research organizations in this field were Korea and Kyunghee University, respectively. Many papers have been published in research areas, such as pharmacology pharmacy and integrative complementary medicine, and the journals with the most published articles in this field were Journal of Ethnopharmacology and Evidence-Based Complementary and Alternative Medicine. The main research keywords formed 3 clusters, and keywords with the most occurrences were “obesity,” “adipose-tissue,” and “insulin resistance.”Conclusion:This study presents an overview of the global research trend of herbal medicine for obesity from the bibliographic analysis. An increased understanding of the recently changing research topics provides a new perspective on future research directions. This study may help guide the research in the field of obesity in the future.
Development of a Novel Scar Screening System with Machine Learning
Authors: Ito Hiroyuki , Nakamura Yutaka , Takanari Keisuke , Oishi Mayumi , Matsuo Keitaro , Kanbe Miki , Uchibori Takafumi , Ebisawa Katsumi , Kamei Yuzuru 
Published: June 2022

Background:
Hypertrophic scars and keloids tend to cause serious functional and cosmetic impediments to patients. As these scars are not life threatening, many patients do not seek proper treatment. Thus, educating physicians and patients regarding these scars is important. The authors aimed to develop an algorithm for a scar screening system and compare the accuracy of the system with that of physicians. This algorithm was designed to involve health care providers and patients.

Methods:
Digital images were obtained from Google Images (Google LLC, Mountain View, Calif.), open access repositories, and patients in the authors’ hospital. After preprocessing, 3768 images were uploaded to the Google Cloud AutoML Vision platform and labeled with one of the four diagnoses: immature scars, mature scars, hypertrophic scars, and keloid. A consensus label for each image was compared with the label provided by physicians.

Results:
For all diagnoses, the average precision (positive predictive value) of the algorithm was 80.7 percent, the average recall (sensitivity) was 71 percent, and the area under the curve was 0.846. The algorithm afforded 77 correct diagnoses with an accuracy of 77 percent. Conversely, the average physician accuracy was 68.7 percent. The Cohen kappa coefficient of the algorithm was 0.69, while that of the physicians was 0.59.

Conclusions:
The authors developed a computer vision algorithm that can diagnose four scar types using automated machine learning. Future iterations of this algorithm, with more comprehensive accuracy, can be embedded in telehealth and digital imaging platforms used by patients and primary doctors. The scar screening system with machine learning may be a valuable support tool for physicians and patients.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Diagnostic, II.
Spatiotemporal bias of the human gaze toward hierarchical visual features during natural scene viewing
Authors: Akamatsu Kazuaki , Nishino Tomohiro , Miyawaki Yoichi 
Published: June 2022

AbstractThe human gaze is directed at various locations from moment to moment in acquiring information necessary to recognize the external environment at the fine resolution of foveal vision. Previous studies showed that the human gaze is biased to particular locations in the visual field at a particular timing, but it remains unclear what visual features produce such spatiotemporal bias. In this study, we used a deep convolutional neural network model to extract hierarchical visual features from natural scene images and evaluated how much the human gaze is attracted to the visual features in space and time. Eye movement measurement and visual feature analysis using the deep convolutional neural network model showed that the gaze was strongly attracted to spatial locations containing higher-order visual features than lower-order visual features and conventional saliency. Analysis of the gaze time course revealed that the bias to higher-order visual features was prominent within a short period after the beginning of observation of the natural scene images. These results demonstrate that higher-order visual features are a strong gaze attractor in both space and time, suggesting that the human visual system uses foveal vision resources to extract information from higher-order visual features with higher spatiotemporal priority.
Transcriptome-wide analysis suggests piRNAs preferentially recognize the coding region of mRNAs in C. elegans
Authors: Wu Wei-Sheng , Brown Jordan S. , Shiue Sheng-Cian , Lee Dong-En , Zhang Donglei , Lee Heng-Chi 
Published: June 2022

AbstractBackgroundPIWI-interacting RNAs (piRNAs) protect genome integrity by silencing transposon mRNAs and some endogenous mRNAs in various animals. However, C. elegans piRNAs fail to trigger gene silencing at many sequence-based predicted targeting sites.ResultsTo gain insights into the mechanisms that control piRNA silencing capability, we compared the transcriptome-wide predicted piRNA targeting sites to the in vivo piRNA binding sites. Surprisingly, while predicted piRNA targeting sites are enriched in 3’ UTRs, we found that C. elegans piRNAs preferentially bind to coding regions (CDS) of target mRNAs, leading to preferential production of secondary silencing small RNAs in the CDS. Furthermore, our analyses suggest that Argonaute protein CSR-1 protects mRNAs from piRNA silencing through two distinct mechanisms – by inhibiting piRNA binding across the entire CSR-1 targeted transcript, and by inhibiting secondary silencing small RNA production locally at CSR-1 bound sites. However, CSR-1 is not responsible for the piRNA binding preference for the CDS.ConclusionsOur work identifies the CDS as the critical region that is uniquely competent for piRNA silencing in C. elegans. We speculate that the preference for CDS recognition by piRNAs may represent a mechanism to counteract the evolution of foreign protein-coding RNAs that evade piRNA surveillance.