bluuebunny/crossref_metadata_2025_split huggingface dataset:
Keeping it simple: mental health assessment in the Gastroenterology Department – using the Hospital Anxiety and Depression Scale (HADS) for IBD patients in Israel
Authors: Avinir Asia , Dar Shira , Taler Michal , Haj Ola , Gothelf Doron , Kopylov Uri , Ben-Horin Shomron , Mekori-Domachevsky Ehud 
Published: March 2022

Background: Depression and anxiety are common among inflammatory bowel disease (IBD) patients. Not only do they worsen quality of life, but also worsen the prognosis of the IBD. Yet, there are no widely accepted guidelines for screening for depression or anxiety in this population. The Hospital Anxiety and Depression Scale (HADS) is a self-administered questionnaire designed to measure anxiety and depression in the physically ill. The purpose of this study was to establish the utility of the HADS as a screening tool in IBD patients. Methods: Seventy-nine IBD patients (age 29.86 ± 8.36, 51.9% female, 77.2% Crohn’s disease) were recruited consecutively at the day treatment unit, Gastroenterology Department, Sheba Medical Center. They were asked to complete the HADS, the Beck Depression Inventory (BDI), and the State-Trait Anxiety Inventory (STAI). The scores of the HADS depression and anxiety subscales were correlated with the BDI and STAI scores, and the rates of above-threshold scores were calculated and compared between the three questionnaires and findings from previous studies. Results: The two HADS subscales significantly correlated with and the BDI ( rs = .69, p < 0.001) and STAI state and trait anxiety ( rs = .853, p < 0.001; rs = .744, p < 0.001, respectively). The usual HADS cut-off scores yielded adequate rate of anxiety but lower than expected depression rates. Conclusions: Our findings suggest the HADS as a valid screening tool for anxiety and depression in IBD patients. We recommend administering it routinely in gastrointestinal (GI) follow-ups using a lower cut-off score for depression than anxiety (greater than 7 vs greater than 11, respectively).
Role of Telemedicine in Diabetes Management
Authors: Dhediya Rajnish , Chadha Manoj , Bhattacharya Arpan D. , Godbole Shreerang , Godbole Shreeharsh 
Published: March 2022

Introduction: Telemedicine is a growing arena that may increase access to care for patients with diabetes. It has more relevance for rural populations or those with limited physical access to health care, for improving diabetes care. Telemedicine can also be used to offer diabetes self-education and transportation barriers for patients living in under-resourced areas or with disabilities. Method "This review explores the landscape of telemedicine approaches and evidence for incorporation into general practice. Results & Discussion: Telehealth platforms have been shown to be both feasible and effective for health care delivery in diabetes, although there are many caveats that require tailoring to the institution, clinician, and patient population. Research in diabetes telehealth should focus next on how to increase access to patients who are known to be marginalized from traditional models of health care.
Evaluation of a New Clinical Tool to Enhance Clinical Care of Control-IQ Users
Authors: Messer Laurel H. , Berget Cari , Centi Sophia , Mcnair Bryan , Forlenza Gregory P. 
Published: March 2022

Background: The purpose of this study was to develop and test a new Clinic Tool to assist health care professionals with clinical care of persons with diabetes using the Control-IQ system. Methods: A Clinic Tool was iteratively developed with input from diabetes clinicians, which outlined a systematic process for assessing data, reviewing insulin settings, providing education, and documenting the encounter. Diabetes clinicians were recruited to trial the Clinical Tool in up to five clinical encounters (in-person, telehealth, or telephone). Quantitative surveys and free-text responses, including a knowledge quiz and the System Usability Scale (SUS), were administered to determine clinician satisfaction, confidence, knowledge, and implications for practice. Results: Twenty-nine clinicians (43% endocrinologists, mean 10.7 years in practice) enrolled in the study and completed 89 encounters using the Control-IQ Clinic Tool. Participants spent an average of 10 minutes using the Tool and reported excellent SUS scores within the 90%-95% percentile for usability. Knowledge quiz scores increased in 42% of participants. Both familiarity with Control-IQ and confidence providing clinical care to Control-IQ users significantly improved ( P = .009 and P < .001 respectively). Ninety percent of participants agreed that the Tool will change their clinical care going forward. Conclusion: The Control-IQ Clinical Tool is highly usable and impacted clinical care delivery to Control-IQ users. Tools that serve to improve clinician confidence in delivery of care to diabetes device users should be expanded, leveraged, and studied to assess the impact on adherence and glycemic control for persons with diabetes.
Artificial Learning and Machine Learning Applications in Spine Surgery: A Systematic Review
Authors: Lopez Cesar D. , Boddapati Venkat , Lombardi Joseph M. , Lee Nathan J. , Mathew Justin , Danford Nicholas C. , Iyer Rajiv R. , Dyrszka Marc D. , Sardar Zeeshan M. , Lenke Lawrence G. , Lehman Ronald A. 
Published: March 2022

Objectives This current systematic review sought to identify and evaluate all current research-based spine surgery applications of AI/ML in optimizing preoperative patient selection, as well as predicting and managing postoperative outcomes and complications. Methods A comprehensive search of publications was conducted through the EMBASE, Medline, and PubMed databases using relevant keywords to maximize the sensitivity of the search. No limits were placed on level of evidence or timing of the study. Findings were reported according to the PRISMA guidelines Results After application of inclusion and exclusion criteria, 41 studies were included in this review. Bayesian networks had the highest average AUC (.80), and neural networks had the best accuracy (83.0%), sensitivity (81.5%), and specificity (71.8%). Preoperative planning/cost prediction models (.89,82.2%) and discharge/length of stay models (.80,78.0%) each reported significantly higher average AUC and accuracy compared to readmissions/reoperation prediction models (.67,70.2%) ( P < .001, P = .005, respectively). Model performance also significantly varied across postoperative management applications for average AUC and accuracy values ( P < .001, P < .027, respectively). Conclusions Generally, authors of the reviewed studies concluded that AI/ML offers a potentially beneficial tool for providers to optimize patient care and improve cost-efficiency. More specifically, AI/ML models performed best, on average, when optimizing preoperative patient selection and planning and predicting costs, hospital discharge, and length of stay. However, models were not as accurate in predicting postoperative complications, adverse events, and readmissions and reoperations. An understanding of AI/ML-based applications is becoming increasingly important, particularly in spine surgery, as the volume of reported literature, technology accessibility, and clinical applications continue to rapidly expand.
Structural insights into the non-inhibitory mechanism of the anti-EGFR EgB4 nanobody
Authors: Zeronian Matthieu R. , Doulkeridou Sofia , van Bergen en Henegouwen Paul M. P. , Janssen Bert J. C. 
Published: March 2022

Abstract
Background
The epidermal growth factor receptor (EGFR) is involved in various developmental processes, and alterations of its extracellular segment are associated with several types of cancers, in particular glioblastoma multiforme (GBM). The EGFR extracellular region is therefore a primary target for therapeutic agents, such as monoclonal antibodies and variable domains of heavy chain antibodies (VHH), also called nanobodies. Nanobodies have been previously shown to bind to EGFR, and to inhibit ligand-mediated EGFR activation.

Results
Here we present the X-ray crystal structures of the EgB4 nanobody, alone (to 1.48 Å resolution) and bound to the full extracellular EGFR-EGF complex in its active conformation (to 6.0 Å resolution). We show that EgB4 binds to a new epitope located on EGFR domains I and II, and we describe the molecular mechanism by which EgB4 plays a non-inhibitory role in EGFR signaling.

Conclusion
This work provides the structural basis for the application of EgB4 as a tool for research, for targeted therapy, or as a biomarker to locate EGFR-associated tumors, all without affecting EGFR activation.
Contrasting effects of plant inter- and intraspecific variation on community trait responses to nitrogen addition and drought in typical and meadow steppes
Authors: Guo Aixia , Zuo Xiaoan , Zhang Senxi , Hu Ya , Yue Ping , Lv Peng , Li Xiangyun , Zhao Shenglong , Yu Qiang 
Published: March 2022

Abstract
Background
Inter- and intraspecific variation in plant traits play an important role in grassland community assembly under global change scenarios. However, explorations of how these variations contribute to the responses of community traits to nitrogen (N) addition and drought in different grassland types are lacking. We measured the plant height, leaf area (LA), specific leaf area (SLA), leaf dry matter content (LDMC), leaf N content (LNC) and the ratio of leaf carbon (C) to leaf N (C:N) in a typical and a meadow steppe after three years of N addition, drought and their interaction. We determined the community-weighted means (CWMs) of the six traits to quantify the relative contribution of inter- and intraspecific variation to the responses of community traits to N addition and drought in the two steppes.

Results
The communities in the two steppes responded to N addition and the interaction by increasing the CWM of LNC and decreasing C:N. The community in the meadow steppe responded to drought through increased CWM of LNC and reduced C:N. Significant differences were observed in SLA, LDMC, LNC and C:N between the two steppes under different treatments. The SLA and LNC of the community in the meadow steppe were greater than those of the typical steppe, and the LDMC and C:N exhibited the opposite results. Moreover, variation in community traits in the typical steppe in response to N addition and drought was caused by intraspecific variation. In contrast, the shifts in community traits in the meadow steppe in response to N addition and drought were influenced by both inter- and intraspecific variation.

Conclusions
The results demonstrate that intraspecific variation contributed more to community functional shifts in the typical steppe than in the meadow steppe. Intraspecific variation should be considered to understand better and predict the response of typical steppe communities to global changes. The minor effects of interspecific variation on meadow steppe communities in response to environmental changes also should not be neglected.
Computed tomography findings and prognosis in older COVID-19 patients
Authors: Okoye Chukwuma , Finamore Panaiotis , Bellelli Giuseppe , Coin Alessandra , Del Signore Susanna , Fumagalli Stefano , Gareri Pietro , Malara Alba , Mossello Enrico , Trevisan Caterina , Volpato Stefano , Zia Gianluca , Monzani Fabio , Incalzi Raffaele Antonelli 
Published: March 2022

Abstract
Background
In older and multimorbid patients, chronic conditions may affect the prognostic validity of computed tomography (CT) findings in COVID-19. This study aims at assessing to which extent CT findings have prognostic implications in COVID-19 older patients.

Methods
Hospitalized COVID-19 patients aged 60 years or more enrolled in the multicenter, observational and longitudinal GeroCovid study who underwent chest CT were included. Patients were stratified by tertiles of age and pneumonia severity to compare CT findings. Hierarchical clustering based on CT findings was performed to identify CT-related classificatory constructs, if any. The hazard ratio (HR) of mortality was calculated for individual CT findings and for clusters, after adjusting for potential confounders.

Results
380 hospitalized COVID-19 patients, with a mean age of 78 (SD:9) years, underwent chest CT scan. Ground glass opacity (GGO), consolidation, and pleural effusion were the three most common CT findings, with GGO prevalence decreasing from younger to older patients and pleural effusion increasing. More severe the pneumonia more prevalent were GGO, consolidation and pleural effusion. HR of mortality was 1.94 (95%CI 1.24–3.06) for pleural effusion and 13 (95%CI 6.41–27) for cluster with a low prevalence of GGO and a high prevalence of pleural effusion (“LH”), respectively. Out of the three CT based clusters, “LH” was the only independent predictor in the multivariable model.

Conclusions
Pleural effusion qualifies as a distinctive prognostic marker in older COVID-19 patients. Research is needed to verify whether pleural effusion reflects COVID-19 severity or a coexisting chronic condition making the patient at special risk of death.

Trial registration
ClinicalTrials.gov: NCT04379440
Single-center experience with perioperative antibiotic prophylaxis and surgical site infections in kidney transplant recipients
Authors: Ostaszewska Agata , Domagała Piotr , Zawistowski Michał , Karpeta Edyta , Wszoła Michał 
Published: March 2022

Abstract
Background
Infections in kidney transplant recipients are particularly challenging owing to the immunosuppressive treatment, usually long history of chronic illness, comorbidities and prior exposures to antibiotics. Among the most common complications early after surgery are surgical site infections. The aim of this study was to identify risk factors and evaluate epidemiological data regarding surgical site infections. Moreover, we were able to compare the current results with historical data from our institution when different perioperative antibiotic prophylaxis was practiced.

Methods
We conducted a retrospective case–control study in a group of 254 deceased donor renal graft recipients transplanted in a single Central European institution. We evaluated epidemiological findings and resistance patterns of pathogens causing surgical site infections. We used multivariable logistic regression to determine risk factors for surgical site infections.

Results
We revealed no differences in baseline characteristics between patients with and without surgical site infections. Ten surgical site infections (3.9%) were diagnosed (six superficial incisional, two deep incisional, and two organ/space). Eight species (19 strains) were identified, most of which were multi-drug resistant (63%). The most common was extended-spectrum β-lactamase producing Klebsiella pneumoniae (26%). We showed that statistically significant differences were present between reoperated and non-reoperated patients (adjusted odds ratio: 6.963, 95% confidence interval 1.523–31.842, P = .012).

Conclusions
Reoperation is an individual risk factor for surgical site infection after kidney transplantation. According to our experience, cefazolin-based prophylaxis can be safe and is associated with relatively low prevalence of surgical site infections.
Metacognitions and brooding predict depressive symptoms in a community adolescent sample
Authors: Pedersen Helene , Grønnæss Ingrid , Bendixen Mons , Hagen Roger , Kennair Leif Edward Ottesen 
Published: March 2022

AbstractDepressive symptoms are prevalent in adolescence, and girls have higher levels of depressive symptoms and depressive disorder than boys. Rumination and especially brooding, seem to be a central maintaining factor of depressive symptoms, where metacognitions about rumination play a prominent role in maintaining depressive rumination. There is a sex difference in adults in depressive disorder. The current investigation of a high school / community sample of adolescents aged 16–20 from Norway (N = 1198, 62.2% women) found that adolescent women had higher scores than men on all relevant measures: Depressive symptoms, negative and positive metacognitions, pondering, and brooding. A path model for predicting depressive symptoms showed that the major factors for both sexes were negative metacognitions and brooding. The predictors of depressive symptoms were invariant across sex and age groups, suggesting similar underlying mechanisms across these groups. The overall findings suggest that metacognitive therapy may be an efficient intervention for depressive symptoms among adolescents.
Capturing and analysing the working conditions of employees with disabilities in German social firms using focus groups
Authors: Efimov Ilona , Lengen Julia C. , Kordsmeyer Ann-Christin , Harth Volker , Mache Stefanie 
Published: March 2022

Abstract
Background
Social firms – a type of social enterprise – provide job opportunities to people with mental or intellectual, sensory, physical or multiple disabilities who are disadvantaged on the general labour market. Given the limited number of studies on working conditions of employees in inclusive workplaces, the aim of this study was to explore job demands and resources experienced by employees with disabilities in German social firms.

Methods
Three focus groups were conducted between September and October 2020 with 14 employees with disabilities from social firms in the catering and cleaning sector in Germany. The Job Demands-Resources model was used as a theoretical basis for developing the semi-structured interview guide. Audiotaped data were transcribed verbatim, analysed deductively and inductively using the qualitative content analysis according to Mayring.

Results
The results show that employees of social firms experience specific job demands and resources regarding work content, work organisation, social relations and work environment. Job demands were mainly reported with respect to work organisation, e.g. high workload, time pressure or challenges in collaboration, whereas social relationships with colleagues and supervisors were most frequently mentioned as important resources at the workplace.

Conclusion
First exploratory study results on the working conditions of employees in social firms in Germany were obtained. Given the pivotal importance of employment for people with disabilities, the identified job demands and resources of this study highlight the relevance of a healthy workplace, especially for employees in social firms. Future interventional research is needed regarding the development, implementation and evaluation of workplace health promotion measures in social firms.
Establishing CREATE: lessons learned in setting up a training environment for early-career researchers in respiratory medicine
Authors: Christian Katherine , Hey-Cunningham Alison , Corte Tamera , Goh Nicole , Jaffar Jade , Reynolds Paul , Teoh Alan , Troy Lauren 
Published: March 2022

Abstract
Background
The purpose of the National Health and Medical Research Council Centre of Research Excellence in Pulmonary Fibrosis (CRE-PF) is to improve and extend the lives of patients living with pulmonary fibrosis through the development of a comprehensive and integrated program of basic and clinical research and education across Australia. A key objective of the CRE-PF was establishment of a unique national training scheme, CREATE, for early-career researchers (ECRs) in respiratory research. CREATE ECRs are broadly drawn from two main fields of researchers: clinicians and scientists, where clinicians tend to be involved in part-time translational research and scientists are involved in broad scientific research including laboratory or genetic research, health economics or population research.

Methods
We describe the CREATE Program which, with limited budget and the assistance of key organisations, has provided funding opportunities (scholarships, fellowships, prizes, travel and collaboration grants), professional development (mentoring program, symposia, presentation opportunities and on-line training) and fostered a connected, supportive research community for respiratory ECRs.

Results
The CREATE program has successfully fostered the development of the supported researchers, contributing substantially to the future of pulmonary fibrosis research in Australia. During the life of the program the CRE-PF has offered 10 PhD scholarships and five postdoctoral fellowships, awarded 13 travel grants and three grants to promote collaboration between ECRs from different institutes. A mentoring program has been established and CREATE Symposia have been held in association with key meetings. During COVID-19 restrictions, a series of virtual research meetings has offered 12 CREATE ECRs from seven universities the opportunity to present their research to a national audience.
CREATE research-related achievements are impressive, including over 80 first-author publications by ECRs, and many conference presentations. Contributions to the research community, measured by committee membership, is also strong.

Conclusions
In spite of a very limited budget, wide geographic distribution of participants and the multi-disciplinary nature of the cohort, we have succeeded in providing a unique, supportive academic development environment for CREATE ECRs. Lessons learned in the process of developing this program include the importance of leveraging funding, being flexible, building networks and seeking and responding to ECR input.
Workshop with medical students on physicians’ earning opportunities, workload and job satisfaction increases the attractiveness of working self-employed and working in general practice
Authors: Heine Alexander , Geier Anne-Kathrin , Lippmann Stefan , Bleckwenn Markus , Frese Thomas , Deutsch Tobias 
Published: March 2022

Abstract
Background
Among the various factors identified as relevant for primary care career choice, financial considerations have been consistently shown to have an impact. In Germany, reliable and easily understandable information on physicians’ earning opportunities in self-employed settings is difficult to obtain for medical students, leading to substantial misperceptions that may negatively affect respective career considerations. This study investigated medical students’ evaluation of a 45-min evidence-based workshop on earning opportunities, workload and job satisfaction in different specialties and settings to examine its effect on the perceived attractiveness of working self-employed and working in general practice.

Methods
The workshop was implemented as part of a mandatory general practice clerkship in the fourth study year (of six). Post-hoc evaluations of all participants between October 2017 and September 2018 (one cohort) were analysed cross-sectionally including descriptive statistics, subgroup comparisons and qualitative analysis of free-text answers regarding students’ main insights.

Results
Response rate was 98.1% (307/313). Participants were on average 25.0 years old, and 68.3% were women. Based on a ten-point scale ranging from 1 = ’no influence’ to 10 = ’very big influence’, 91.9% confirmed at least some (> = 2) and 57.3% a rather high (> = 5) influence of earning expectations on their career choice process. Regarding the workshop, 86.1% were overall satisfied, and 89.5% indicated they had gained new insights, primarily regarding earning opportunities in different specialties and work settings, and frequently regarding job satisfaction, workload and the structure of revenues and expenditures in a doctor’s office (according to qualitative analysis). In the opinion of 89.8% of students, the provided learning content should be part of the undergraduate curriculum. More than half of participants reported an increase regarding the attractiveness of working self-employed and working as a general practitioner, most frequently regarding earning opportunities, but also in general and in respect to job satisfaction, cost–benefit ratio and workload. This increase was significantly higher among students favouring or at least considering a general practice career.

Conclusions
The workshop and its content were appreciated by the students and showed clear potential to usefully complement undergraduate curricula aiming at increasing or reinforcing students’ interest in working self-employed and working in general practice.