bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strategies for de-implementation of low-value care—a scoping review
Authors: Ingvarsson Sara , Hasson Henna , von Thiele Schwarz Ulrica , Nilsen Per , Powell Byron J. , Lindberg Clara , Augustsson Hanna 
Published: October 2022

Abstract
Background
The use of low-value care (LVC) is a persistent problem that calls for knowledge about strategies for de-implementation. However, studies are dispersed across many clinical fields, and there is no overview of strategies that can be used to support the de-implementation of LVC. The extent to which strategies used for implementation are also used in de-implementing LVC is unknown. The aim of this scoping review is to (1) identify strategies for the de-implementation of LVC described in the scientific literature and (2) compare de-implementation strategies to implementation strategies as specified in the Expert Recommendation for Implementing Change (ERIC) and strategies added by Perry et al.

Method
A scoping review was conducted according to recommendations outlined by Arksey and O’Malley. Four scientific databases were searched, relevant articles were snowball searched, and the journal Implementation Science was searched manually for peer-reviewed journal articles in English. Articles were included if they were empirical studies of strategies designed to reduce the use of LVC. Two reviewers conducted all abstract and full-text reviews, and conflicting decisions were discussed until consensus was reached. Data were charted using a piloted data-charting form. The strategies were first coded inductively and then mapped onto the ERIC compilation of implementation strategies.

Results
The scoping review identified a total of 71 unique de-implementation strategies described in the literature. Of these, 62 strategies could be mapped onto ERIC strategies, and four strategies onto one added category. Half (50%) of the 73 ERIC implementation strategies were used for de-implementation purposes. Five identified de-implementation strategies could not be mapped onto any of the existing strategies in ERIC.

Conclusions
Similar strategies are used for de-implementation and implementation. However, only a half of the implementation strategies included in the ERIC compilation were represented in the de-implementation studies, which may imply that some strategies are being underused or that they are not applicable for de-implementation purposes. The strategies assess and redesign workflow (a strategy previously suggested to be added to ERIC), accountability tool, and communication tool (unique new strategies for de-implementation) could complement the existing ERIC compilation when used for de-implementation purposes.
Hybrid approach for long-standing persistent atrial fibrillation: immediate versus staged treatment
Authors: Nasso Giuseppe , Lorusso Roberto , Di Bari Nicola , Condello Ignazio , Agró Felice Eugenio , Fiore Flavio , Bonifazi Raffaele , Santarpino Giuseppe , Speziale Giuseppe 
Published: October 2022

Abstract
Background
The hybrid approach has become the most effective treatment option for restoring sinus rhythm and reducing the risk of atrial fibrillation (AF) recurrence. However, several issues remain to be clearly defined, including the appropriate timing of the staged procedure and the most effective strategy.

Methods
Over a 12-year period of activity, we performed 609 AF ablation procedures via a right mini-thoracotomy. From this general population, 60 patients underwent a hybrid procedure with catheter ablation performed at least 4 weeks after the surgical procedure to confirm if effective complete electrical isolation of pulmonary veins was achieved. In 20 patients, the second stage procedure was performed during the same hospitalization due to patient’s electrical instability. The results obtained in immediate versus staged patients were compared.

Results
All patients were discharged after the first stage procedure in sinus rhythm. The 20 immediate patients had a shorter hospital stay compared with the staged patients, in whom the two hospitalizations resulted in a longer hospital stay (immediate 5.5 ± 1.6 days versus staged 8.7 ± 1.4, P < 0.001). A significantly higher number of immediate patients had an associated ablation of the Bachmann’s bundle (n = 16 in the immediate group [80%] versus n = 14 in the staged group [45%]; P = 0.001). After a mean follow-up of 74 months, there was no significant difference in the risk of AF relapse between groups (immediate 1/20 [5%] versus staged 7/40 [17.5%]; P = 0.18).

Conclusion
The hybrid approach for the treatment of AF was safe and effective in immediate restoring sinus rhythm and in its maintenance at follow-up. Our preliminary results show that both immediate and staged procedures show similar efficacy but this result is strongly influenced by the concomitant ablation of the Bachmann’s bundle, which appears to be the most important component of the treatment strategy in order to reduce the risk of recurrent AF.
Mutation analysis of SUOX in isolated sulfite oxidase deficiency with ectopia lentis as the presenting feature: insights into genotype–phenotype correlation
Authors: Li Jia-Tong , Chen Ze-Xu , Chen Xiang-Jun , Jiang Yong-Xiang 
Published: October 2022

Abstract
Background
Isolated sulfite oxidase deficiency (ISOD) caused by sulfite oxidase gene (SUOX) mutations is a rare neurometabolic disease associated with ectopia lentis (EL). However, few genotype–phenotype correlations have been established yet.

Methods
Potentially pathogenic SUOX mutations were screened from a Chinese cohort of congenital EL using panel-based next-generation sequencing and analyzed with multiple bioinformatics tools. The genotype–phenotype correlations were evaluated via a systematic review of SUOX mutations within our data and from the literature.

Results
A novel paternal missense mutation, c.205G > C (p.A69P), and a recurrent maternal nonsense mutation, c.1200 C > G (p.Y400*), of SUOX were identified in a 4-year-old boy from 312 probands. The biochemical assays manifested elevated urine sulfite and S-sulfocysteine accompanied by decreased homocysteine in the blood. The patient had bilateral EL and normal fundus, yet minimal neurological involvement and normal brain structure. Molecular modeling simulation revealed the p.A69P mutant had an unstable structure but an unchanged affinity for sulfite, while the truncated p.Y400* mutant showed decreased binding capacity. Genotype–phenotype analysis demonstrated patients with biallelic missense mutations had milder symptoms (P = 0.023), later age of onset (P < 0.001), and a higher incidence of regression (P = 0.017) than other genotypes. No correlations were found regarding EL and other neurological symptoms.

Conclusion
The data from this study not only enrich the known mutation spectrum of SUOX but also suggest that missense mutations are associated with mild and atypical symptoms.
Continuous glucose monitoring for detection of glycemic variability, hypoglycemia, and hyperglycemia in women with eating disorders
Authors: Uotani Nao , Noma Shun’ichi , Akamine Momoko , Miyawaki Takashi 
Published: October 2022

Abstract
Background
The aim of this study was to investigate the relationships between hypoglycemia, hyperglycemia, glycemic variability (GV), and eating behavior by measuring daily glucose levels through an intermittently scanned continuous glucose monitoring (isCGM) system in outpatients classified according to eating disorder subtypes.

Methods
We analyzed data for 18 patients (four ANR, nine ANBP, and five BN cases). A FreeStyle Libre Pro® device was attached to the posterior aspect of the upper arm for glucose monitoring. This device conducted measurements every 15 min for five consecutive days. We estimated the mean amplitude of glycemic excursions (MAGE), hypoglycemia, and hyperglycemia.

Results
The mean glucose levels were 91.1 ± 2.2 mg/dL in the ANR group, 94.8 ± 7.5 mg/dL in the ANBP group, and 87.1 ± 8.0 mg/dL in the BN group (P = 0.174). The overall mean MAGE index was 52.8 ± 20.5 mg/dL. The mean MAGE values according to the subtypes were 42.2 ± 5.6 mg/dL in the ANR group, 57.4 ± 23.7 mg/dL in the ANBP group, and 53.0 ± 21.8 mg/dL in the BN group (P = 0.496). Over the course of five days, the frequency of hypoglycemia was as follows: three occurrences in the ANBP group, five occurrences in the BN group, and no occurrences in the ANR group (P = 0.016). Moreover, the occurrence of hypoglycemia was statistically significantly higher in the BN group than in the ANR group (P = 0.013). In the BN group, the frequency of hypoglycemia was highest between 2 and 6 AM, while hypoglycemia was observed throughout the day in the ANBP group. The frequency of hyperglycemia was one occurrence in the ANR group, one occurrence in the BN group, and zero occurrences in the ANBP group (P = 0.641).

Conclusions
Varying GV, hypoglycemia, and hyperglycemia were observed in all subtypes of eating disorders. Our findings suggest that eating behaviors such as binge eating and purging are associated with GV and hypoglycemia. We showed the importance of developing different nutritional approaches tailored to the subtype of eating disorder to prevent hypoglycemia. Additional studies are needed to explore the relationship between glucose levels and eating behaviors in patients with eating disorders.
A practical guide to implementing a successful social media recruitment strategy: lessons from the Eczema Monitoring Online trial
Authors: Baker Arabella , Mitchell Eleanor J. , Thomas Kim S. 
Published: October 2022

Abstract
Background
Participant recruitment into clinical trials remains challenging. The global increase in the number of social media users has accelerated the use of social media as a modality of recruitment, particularly during the COVID-19 pandemic when traditional recruitment methods were reduced. However, there is limited evidence on the performance of social media recruitment strategies into eczema clinical trials.

Methods
From September 2021 to January 2022, we recruited participants with eczema into an online randomised controlled trial using free advertising on Twitter, Facebook, Instagram and Reddit (unpaid methods), followed by paid Facebook advertisements (paid method). Unpaid methods were used periodically for 63 days, whilst the paid method for 16 days. Interested individuals who clicked on the advertisement link were directed to the study website, where they could sign up to participate. Consenting, randomisation and data collection occurred exclusively online, using a database management web platform. Evaluation of the social media recruitment methods was performed, including the number of expression of interests, enrolment yield, cost, baseline characteristics and retention.

Results
Our multi-platform based social media recruitment strategy resulted in 400 expressions of interests, leading to 296 participants. Unpaid methods accounted for 136 (45.9%) of participants, incurring no financial cost. Paid Facebook adverts reached 154,370 individuals, resulting in 123 (41.6%) trial participants for a total cost of £259.93 (£2.11 per participant) and other recruitment methods resulted in 37 (12.5%) enrolments. Paid advertisements predominantly attracted younger participants below the age of 20, whereas unpaid methods mainly drew in participants between 20–29 years of age. The social media platforms recruited an ethnically diverse participant population. Completion rate of follow-up was slightly higher for the paid method (n = 103, 83.7%) compared with the unpaid methods (n = 111, 81.6%).

Conclusions
Unpaid social media posts recruited the most participants; however, it was time consuming for the researcher. Paid Facebook adverts rapidly recruited a large number of participants for a low cost and provided flexibility to target specific audiences. Our findings indicate that social media is an efficient tool that can potentially support recruitment to clinical trials.

Trial registration
ISRCTN45167024. Registered on 29 June 2021.
Indigenous weather forecasting among Gujii pastoralists in southern Ethiopia: Towards monitoring drought
Authors: Guye Mekuria , Legesse Abiyot , Mohammed Yimer 
Published: October 2022

AbstractIndigenous weather forecasting (IWF) is practised by various communities around the world. Access to meteorological weather forecasting is limited in eastern Africa’s pastoral regions. As a result, pastoralists frequently rely on indigenous weather forecasting indicators. This paper investigates the use of IWF in drought forecasting among Gujii pastoralists in southern Ethiopia. To collect data, household surveys, focus group discussions, and key informant interviews were used. Furthermore, meteorological data were used to determine the frequency of drought events in the area. A comparison was made between IWF and data from the Ethiopian National Metrological Service Agency to ensure consistency of the results of IWF and climatic data. For quantitative data analysis, descriptive statistics was used, while hermeneutic and narrative analyses were used for qualitative data analysis. Pastoralists have used a variety of weather forecasting indicators, such as reading livestock intestines, observing animal and insect behaviours, and interpreting the star and moon alignment. Both the indigenous drought event forecasting result and the drought history result from the meteorological agency indicate the presence of drought in the area. However, several internal and external factors are contributing to IWF’s gradual decline. Religious teachings, technology, and education were identified as external factors, while the growing generation gap was identified as an internal factor. Thus, to increase the accuracy of forecasting of weather events and improve pastoralist’s prediction capacity, the integration of this knowledge is highly appreciated.
The prevalence of insufficient iodine intake in pregnancy in Africa: a systematic review and meta-analysis
Authors: Businge Charles Bitamazire , Musarurwa Hannibal Tafadzwa , Longo-Mbenza Benjamin , Kengne Andre Pascal 
Published: October 2022

AbstractBackgroundFortification of foodstuffs with iodine, mainly through iodization of salt, which commenced in several African countries after 1995 is the main method for mitigating iodine deficiency in Africa. We assessed the degree of iodine nutrition in pregnancy across Africa before and after the implementation of national iodine fortification programs (CRD42018099434).MethodsElectronic databases and gray literature were searched for baseline data before implementation of population-based iodine supplementation and for follow-up data up to September 2020. R-metamedian and metamean packages were used to pool country-specific median urinary iodine concentration (UIC) estimates and derived mean UIC from studies with similar features.ResultsOf 54 African countries, 23 had data on iodine nutrition in pregnancy mostly from subnational samples. Data before 1995 showed that severe iodine deficiency was prevalent in pregnancy with a pooled pregnancy median UIC of 28.6 μg/L (95% CI 7.6–49.5). By 2005, five studies revealed a trend towards improvement in iodine nutrition state in pregnancy with a pooled pregnancy median UIC of 174.1 μg/L (95% CI 90.4–257.7). Between 2005 and 2020 increased numbers of national and subnational studies revealed that few African countries had sufficient, while most had mildly inadequate, and some severely inadequate iodine nutrition in pregnancy. The pooled pregnancy median UIC was 145 μg/L (95% CI 126–172).ConclusionImprovement in iodine nutrition status in pregnancy following the introduction of fortification of foodstuffs with iodine in Africa is sub-optimal, exposing a large proportion of pregnant women to the risk of iodine deficiency and associated disorders.Systematic review registrationPROSPERO CRD42018099434
The relationship between lipoprotein(a) and risk of cardiovascular disease: a Mendelian randomization analysis
Authors: Wang Shiyue , Zha Li , Chen Jian , Du Dongjie , Liu Danyang , Zhong Ming , Shang Rongfang , Sun Dongxue , Sun Chang , Jin Enze 
Published: October 2022

Abstract
Background
Lipoprotein(a) [Lp(a)] is one of the residual risk factors for cardiovascular disease (CVD) in the setting of optimal low-density lipoprotein cholesterol (LDL-C). The association between Lp(a) and CVD is still in the exploratory phase, with few studies indicating a causal connection between Lp(a) and various CVD.

Methods
Lp(a) (n = 377,590) was a genome-wide association study (GWAS) based on European populations from Neale Lab. Large GWAS datasets for CVD, including aortic aneurysm(AA) (n = 209,366), atrial fibrillation(AF) (n = 1,030,836), coronary heart disease(CHD) (n = 361,194), secondary hypertension(HBP) (n = 164,147), heart failure(HF) (n = 208,178), ischemic stroke (IS) (n = 218,792), large artery atherosclerosis stroke(ISL) (n = 150, 765), small vessel stroke(ISS) (n = 198,048), lacunar stroke(LIS) (n = 225,419), and pulmonary embolism(PE) (n = 218,413) were also based on European populations. We performed separate univariate two-sample Mendelian randomization (MR) analysis for Lp(a) and CVD as described above. We evaluated this connection mainly using the random-effects inverse variance weighted technique(IVW1) with a 95% confidence interval (CI) for the odds ratio (OR). This was supplemented by MR-Egger, weighted median, maximum likelihood, penalized weighted median, and fixed-effects inverse variance weighted methods. MR-PRESSO offers another means of statistical detection.

Results
Our two-sample MR, which was predominately based on IVW1, revealed a causal relationship between Lp(a) and AA (OR = 1.005, 95%CI: 1.001–1.010, P = 0.009), CHD (OR = 1.003, 95%CI 1.001–1.004, P = 0.010), and ISL (OR = 1.003, 9 5%CI 1.002–1.004, P = 9.50E−11), in addition, there is no causal association with AF, HBP, HF, IS, ISS, LIS, or PE. Similar conclusions were reached by the MR-PRESSO method.

Conclusion
This MR study suggested a causal relationship between Lp(a) and CHD, AA, and ISL, but not associated with AF, HF, IS, LIS, ISS, HBP, or PE. Our work further verifies the association between Lp(a) and various CVD, resulting in improved Lp(a) management and a reduction in the prevalence of CVD.
Use of social networks, video games and violent behaviour in adolescence among secondary school students in the Basque Country
Authors: Moro Álvaro , Ruiz-Narezo Marta , Fonseca Janire 
Published: October 2022

AbstractThis article is aimed at exploring the relationship between abusive use of the internet and social media and involvement in violent behavior in adolescence. This analysis used a sample of 2549 participants of students enrolled in secondary education in the Basque Country, including lower secondary education, baccalaureate studies and vocational training courses. The results of this study show that the antisocial behaviour and bullying variables are associated with the different categories of use of information and communication technology. Gender differences appear to be irrelevant in this correlation as it is similar in both boys and girls. These data must be taken into consideration by the educational community, which has been shown to have a protective influence and by school guidance departments in particular, which are designed specifically to tackle these kinds of situations.
Seasonal and inter-annual  variation  in exposure to peregrines (Falco peregrinus) for southbound western sandpipers (Calidris mauri)
Authors: Ydenberg Ronald C. 
Published: October 2022

Abstract
Background
The western sandpiper (Calidris mauri) is an early southbound migrant species in North America. The ‘peregrine avoidance’ hypothesis proposes that this timing evolved to reduce exposure to their main predator, the peregrine (Falco peregrinus), along the Pacific flyway.

Methods
I evaluate this hypothesis based on 16 years of near-daily (June – October) measures of peregrine presence made on the Fraser River estuary, a major stopover in the Pacific northwest.

Results
Exposure to peregrines is lowest for the earliest southbound western sandpipers, and rises steeply as peregrines en route from northern breeding areas begin to arrive in late July or August. Peregrine arrival timing varies greatly between years, shifting in step with the onset of spring along coastal Alaska. Peregrine presence on the Fraser estuary on any date is higher in years with earlier spring onset. On the median adult sandpiper passage date (day-of-year 198) this increases 17-fold over the inter-annual range between the earliest and latest peregrine arrival dates.

Conclusion
The pattern of strong and predictable changes in the seasonal pattern of danger quantified here provides a further test of the hypothesis that danger affects migratory timing. Western sandpipers appear to anticipate the exposure level of southward migration, perhaps because they are able to observe spring onset on their Alaskan breeding grounds. They adjust the duration of parental care and length of the breeding season to keep the date of migratory departure from the Arctic relatively invariant in spite of large interannual variation in spring onset. While underway they also adjust aspects of migratory behavior. These observations support the ‘peregrine avoidance’ hypothesis, and suggest that western sandpipers are able to counter, at least partially, the higher migratory danger of early spring years.
Practices and challenges of cultural heritage conservation in historical and religious heritage sites: evidence from North Shoa Zone, Amhara Region, Ethiopia
Authors: Mekonnen Habtamu , Bires Zemenu , Berhanu Kassegn 
Published: October 2022

Abstract
Cultural heritage treasures are precious communal assets that show the past human legacy. It depicts present and future way of life as well as cultural values of a society, and enhances solidarity and social integration of communities. This study is designed to investigate the practices and challenges of cultural heritage conservations in North Shoa Zone, Central Ethiopia. The research employed a mixed research approach and cross-sectional descriptive and explanatory research design. The researchers applied multiple data gathering instruments including questionnaire survey, interview, focus group discussion and observation. Concerning sampling techniques, systematic random sampling technique was applied to select samples from local communities, and purposive sampling was designed to choose interviewees from government authorities, and culture and tourism office experts of North Shoa Zone and respective districts. The actual and valid sample size of the study is 236. The findings of the study revealed that the cultural heritage properties in North Shoa are not safeguarded from being damaged and found in a poor status of conservation. The major conclusion sketched from the study is that the principal factors affecting heritage conservation are lack of proper management, monitoring and evaluation, lack of funds and stakeholder involvement, urbanization, settlement programs and agricultural practice, poor government concern and professional commitment, poor attitude towards cultural heritage and low level of community concern, vandalism and illicit trafficking, low promotions of cultural heritage, and natural catastrophes such as invasive intervention, climate change (humidity and frost, excessive rainfall and flood, heat from the sun). The study implied that the sustainability of cultural heritage in the study area are endanger unless conservation practice is supported by conservation guidelines, heritage site management plans and research outputs, stakeholders’ integration, and community involvement. Most importantly, the study recommends the integration of heritage conservation and sustainable development, and the promotion of conservation is a way of achieving economic and social sustainability.