bluuebunny/crossref_metadata_2025_split huggingface dataset:
Honoring the voices of families: An interpretive description of parents’ understandings of, and insights into preventing type 2 diabetes in adolescents
Authors: Spurr Shelley , Bally Jill , Nalwooga Nahia 
Published: July 2022

AbstractBackgroundThe incidence of type 2 diabetes (T2D) in adolescents is increasing, affecting the overall health and quality of life of adolescents and their families. Despite the serious health consequences of T2D, few studies have explored the role of parents in the prevention of prediabetes and T2D in adolescents. Thus, the purpose was to better understand parents’ insights into strategies needed for the development of interventions to prevent prediabetes and T2D in their adolescents and families.MethodsThorne’s Interpretive Description approach was used to guide this second phase of a two-phase study. Using purposeful sampling, parents (n = 12) of adolescents at high risk for developing T2D were interviewed. This study was conducted in accordance with the standards for reporting qualitative research.ResultsTwo themes and multiple subthemes emerged: Parents’ Understanding of T2D (High Blood Sugar, Severe Health Impacts, and Managing Your Diet) and It Takes a Village (The Onus is on the Adolescent, Starts at Home with the Parents, We Need More Support, and Getting the Message in Their Face).ConclusionsThese qualitative data were insightful as findings highlighted the parents’ predominant lack of basic knowledge, life skills, and/or resources to prevent prediabetes and T2D in adolescents. The results provided target areas for education and emphasized the importance of using social media as an approach to disseminate important information to adolescents. Parents also identified strategies for prevention interventions for adolescents surrounding prediabetes and T2D that may be effective. Given the increased prevalence of T2D in adolescents, these results are timely and confirm the urgent need for interventions to prevent pediatric prediabetes and T2D. Future research will include the co-design, piloting, and evaluation of feasible family-centered interventions grounded in participants’ experiences and suggestions that are reflective of person-centred goals and needs of adolescents.
What is the impact of a novel DEPDC5 variant on an infant with focal epilepsy: a case report
Authors: Gu Chunyu , Lu Xiaowei , Ma Jinhui , Pu Linjie , Zhi Xiufang , Shu Jianbo , Li Dong , Cai Chunquan 
Published: July 2022

Abstract
Background
Variants in the DEPDC5 have been proved to be main cause of not only various dominant familial focal epilepsies, but also sporadic focal epilepsies. In the present study, a novel variant in DEPDC5 was detected in the patient with focal epilepsy and his healthy father. We aimed to analyze the pathogenic DEPDC5 variant in the small family of three.

Case presentation
A 5-month-old male infant presented with focal epilepsy. Whole exome sequencing identified a novel heterozygous variant c.1696delC (p.Gln566fs) in DEPDC5, confirmed by Sanger sequencing. The variant was inherited from healthy father.

Conclusions
Our study expands the spectrum of DEPDC5 variants. Moreover, We discuss the relation between the low penetrance of DEPDC5 and the relatively high morbidity rate of DEPDC5-related sporadic focal epilepsy. Besides, due to interfamilial phenotypic and genetic heterogeneity, we speculate the prevalence of familial focal epilepsy with variable foci might be underestimated in such small families. We emphasize the importance of gene detection in patients with sporadic epilepsy of unknown etiology, as well as their family members. It can identify causative mutations, thus providing help to clinicians in making a definitive diagnosis.
“I did whatever they wanted me to do”: a qualitative secondary analysis using reproductive justice to explore sexual violence among justice-involved Latina mothers
Authors: Crawford A. D. , McGlothen-Bell K. , Cleveland L. M. 
Published: July 2022

Abstract
Background
One in three women experience sexual violence during their lifetime; however, little is known about this phenomenon with respect to justice-involved Latina mothers. Using the reproductive justice framework as a theoretical lens, we examined sexual violence in Latina mothers who had experienced incarceration and were thus involved in the justice system.

Methods
This was a secondary analysis of a qualitative data set. The reproductive justice framework provided a theoretical lens for examining the women’s rights to bodily autonomy, to have or not have children, and to live in safe, sustainable environments given the intersection of incarceration and sexual violence.

Results
Women (N = 12) recounted their experiences of sexual violence after having been incarcerated. Incarceration and resulting sexual violence led to discrimination, limited bodily autonomy, sexual exploitation, substance use, depression, anxiety, re-traumatization, recidivism, underreporting of violence, underutilization of healthcare resources, strained relationships, family separation, and unsafe environments.

Conclusions
More research is needed to understand the social, economic, and political contexts that perpetuate sexual violence among justice-involved women. Universal healthcare, participatory research, changing cultural mindsets, decriminalization of sex work, and more comprehensive tracking and prosecution of sexual predators may be key to ending sexual violence in justice-involved mothers.
The relationship between foot and ankle joint flexibility measures and barefoot plantar pressures in healthy older adults: a cross-sectional study
Authors: McNab Bonnie , Sadler Sean , Lanting Sean , Chuter Vivienne 
Published: July 2022

Abstract
Background
Restriction in foot and ankle joint range of motion, such as an ankle equinus, has been associated with increased plantar pressure and its complications. However, previous research is limited by its scope of measures and study populations. The aim of this study was to investigate the relationship between foot and ankle joint range of motion on barefoot plantar pressures during walking in healthy older adults.

Methods
This cross-sectional study recruited 49 older adults. Participants underwent measures of foot (first metatarsophalangeal dorsiflexion range of motion, and navicular drop and drift) and ankle joint range of motion, foot posture, body mass index, and plantar pressure during barefoot walking. Spearman Rank Order Correlations were used to explore the relationship between foot and ankle measures, body mass index, and plantar pressure, with significant correlations explored in a hierarchical regression analysis. A Mann-Whitney U test was performed to compare plantar pressure values between those with and without ankle equinus per region of the foot.

Results
Mean (SD) age and BMI were 72.4 years (5.2) and 29.8 kg/m2 (5.9) respectively. A total of 32 of the 49 participants (65%) identified as female sex. Mean (SD) ankle joint range of motion was 32.7 (6.4) degrees with 17/49 (34.7%) participants classified as having an ankle equinus (defined as < 30 degrees of ankle joint dorsiflexion range of motion). We found that an ankle equinus predicted a statistically significant amount of peak forefoot plantar pressure (p = 0.03). Participants with an ankle equinus displayed significantly higher forefoot peak pressure 677.8 kPa (589.9 to 810.4) compared to those with no equinus 565.58 kPa (447.3 to 651.2), p = 0.02. A statistically significant correlation was found between body mass index and midfoot peak pressure (p < 0.01) and pressure-time integral (p < 0.01). No other significant correlations were found.

Conclusion
Clinicians should consider screening for an ankle equinus and body mass index as a simple way to identify which healthy older adults may be at risk of pressure-related complications in the mid- and forefoot.
Hemangiopericytoma/solitary fibrous tumor of the cranial base: a case series and literature review
Authors: Peng Zhouying , Wang Yumin , Wang Yaxuan , Li Qinxuan , Fang Yan , Fan Ruohao , Zhang Hua , Jiang Weihong 
Published: July 2022

Abstract
Background
Hemangiopericytomas (HPCs) are uncommon soft tissue tumors. HPCs that grow in the cranial base are rare. Therefore, skull-base surgeons tend to overlook this disease. This study aimed to increase the awareness of HPCs by summarizing case data from our institution and related publications. We also aimed to contribute to the number of reported cases for future systematic reviews of HPCs.

Methods
This study included all patients who underwent surgery for HPC/solitary fibrous tumor (SFT) between August 2015 and August 2019. All surgeries were performed at Xiangya Hospital Central South University. We analyzed clinical characteristics, surgical highlights, treatment modalities, and outcomes.

Results
We included six patients, aged 32–64 years. Lesions were located in the parapharyngeal space in three patients, pterygopalatine fossa in two, and saddle area in one. All patients underwent nasal endoscopic endonasal surgery. In five patients, tumors involved the internal carotid artery (ICA). The exposure and protection of the ICA during surgery are challenging but critical to complete tumor removal. The 3-year overall survival(OS) rate was 66.7%.

Conclusions
HPC/SFTs are rare tumors of the cranial base that are prone to recurrence. Cranial base HPC/SFTs are often closely associated with the ICA. To our knowledge, this case series reports the largest number of cases of HPCs associated with the ICA. We believe that there is a strong relationship between patient prognosis and whether the tumor encircles the ICA and whether the tumor is completely resected. To confirm this suggestion, more cases are needed for further analysis.
Dental needs in palliative care and problems in dental hygienist education: survey study of palliative care ward homepage, university syllabus, and academic conference abstracts
Authors: Funahara Madoka , Soutome Sakiko , Otsuru Mitsunobu , Sakamoto Yuki , Honda Hiromi , Ikegami Yumiko , Natsume Nagato , Umeda Masahiro , Nakamichi Atsuko 
Published: July 2022

Abstract
Background
Although end-of-life patients have a variety of oral-related symptoms, the involvement of dentists and dental hygienists in the palliative care teams is limited. This study investigates the current state of palliative care education in universities that train dentists and dental hygienists and the need for dentistry in the clinical setting of palliative medicine in Japan.

Methods
First, we investigated the involvement of dentistry in hospitals with palliative care units from a website. The number of reports on palliative care presented by dental hygienists at academic conferences around 2016, when the public medical insurance system in Japan covered oral care for patients with terminal illnesses, were examined. We also surveyed the syllabuses of the university that trained nurses, dentists, and dental hygienists to determine their education regarding palliative care.

Results
Of the 376 hospitals with palliative care units, 176 (46.8%) had dentistry in the hospital. Additionally, 321 hospitals (85.4%), which included those without dentistry, responded that they provided oral care by dentists and dental hygienists in the palliative care unit. There were only two presentations on palliative care in the annual meetings of the two major academic societies by dental hygienists between 2012 and 2016. However, this number increased rapidly to 47 between 2017 and 2020. The syllabus surveys showed that, compared to nursing universities, universities that trained dentists or dental hygienists had lesser education in palliative care. Furthermore, education in the universities that trained dental hygienists was mostly related to the oral care of patients with terminal illnesses, while the physical and mental conditions of end-of-life patients were not well educated.

Conclusion
Considering that society requires the involvement of dental hygienists in the field of palliative care, it is necessary to enhance basic and clinical education of palliative care in universities that train dentists and dental hygienists to provide good oral care to patients with terminal illnesses and contribute to improving their quality of life.
Race, ethnicity, and gender representation in clinical case vignettes: a 20-year comparison between two institutions
Authors: Lee Courtney R. , Gilliland Kurt O. , Beck Dallaghan Gary L. , Tolleson-Rinehart Sue 
Published: July 2022

Abstract
Background
The medical case vignette has long been used in medical student education and frequently includes demographic variables such as race, ethnicity and gender. However, inclusion of demographic variables without context may reinforce assumptions and biases. Yet, the absence of race, sexual orientation, and social determinants of health may reinforce a hidden curriculum that reflects cultural blindness. This replication study compared proportions of race, ethnicity, and gender with University of Minnesota (UMN) findings. This study sought to determine if there has been progress in the representation of demographic characteristics in case vignettes. Methods: University of North Carolina (UNC) case vignettes from 2015–2016 were analyzed and compared to UMN case vignettes from 1996–1998. Data included mentions of race, ethnicity, gender and social determinants of health. Results: In the 278 UNC vignettes, white race was noted in 19.7% of cases, black race was in 7.9% cases, and 76.6% of cases were unspecified. In the 983 UMN vignettes, white race was recorded in 2.85% cases, and black race in 0.41% cases. The institutions were significantly different in the proportion of their cases depicting race (0.20; 95% CI (0.15, 0.25)). Males were represented in the majority of vignettes. Discussion: Comparing case vignettes results from two medical schools suggests that reporting explicit demographic diversity was not significantly different. The findings illustrate that sex was the demographic characteristic consistently described, where males were over-represented. Based on these findings, greater cultural diversity as it intersects with social determinants of health is needed in medical student education.
Automatic text classification of actionable radiology reports of tinnitus patients using bidirectional encoder representations from transformer (BERT) and in-domain pre-training (IDPT)
Authors: Li Jia , Lin Yucong , Zhao Pengfei , Liu Wenjuan , Cai Linkun , Sun Jing , Zhao Lei , Yang Zhenghan , Song Hong , Lv Han , Wang Zhenchang 
Published: July 2022

AbstractBackgroundGiven the increasing number of people suffering from tinnitus, the accurate categorization of patients with actionable reports is attractive in assisting clinical decision making. However, this process requires experienced physicians and significant human labor. Natural language processing (NLP) has shown great potential in big data analytics of medical texts; yet, its application to domain-specific analysis of radiology reports is limited.ObjectiveThe aim of this study is to propose a novel approach in classifying actionable radiology reports of tinnitus patients using bidirectional encoder representations from transformer BERT-based models and evaluate the benefits of in domain pre-training (IDPT) along with a sequence adaptation strategy.MethodsA total of 5864 temporal bone computed tomography(CT) reports are labeled by two experienced radiologists as follows: (1) normal findings without notable lesions; (2) notable lesions but uncorrelated to tinnitus; and (3) at least one lesion considered as potential cause of tinnitus. We then constructed a framework consisting of deep learning (DL) neural networks and self-supervised BERT models. A tinnitus domain-specific corpus is used to pre-train the BERT model to further improve its embedding weights. In addition, we conducted an experiment to evaluate multiple groups of max sequence length settings in BERT to reduce the excessive quantity of calculations. After a comprehensive comparison of all metrics, we determined the most promising approach through the performance comparison of F1-scores and AUC values.ResultsIn the first experiment, the BERT finetune model achieved a more promising result (AUC-0.868, F1-0.760) compared with that of the Word2Vec-based models(AUC-0.767, F1-0.733) on validation data. In the second experiment, the BERT in-domain pre-training model (AUC-0.948, F1-0.841) performed significantly better than the BERT based model(AUC-0.868, F1-0.760). Additionally, in the variants of BERT fine-tuning models, Mengzi achieved the highest AUC of 0.878 (F1-0.764). Finally, we found that the BERT max-sequence-length of 128 tokens achieved an AUC of 0.866 (F1-0.736), which is almost equal to the BERT max-sequence-length of 512 tokens (AUC-0.868,F1-0.760).ConclusionIn conclusion, we developed a reliable BERT-based framework for tinnitus diagnosis from Chinese radiology reports, along with a sequence adaptation strategy to reduce computational resources while maintaining accuracy. The findings could provide a reference for NLP development in Chinese radiology reports.
Operations management solutions to improve ED patient flows: evidence from the Italian NHS
Authors: Marsilio Marta , Roldan Eugenia Tomas , Salmasi Luca , Villa Stefano 
Published: July 2022

AbstractBackgroundOvercrowding occurs when the identified need for emergency services outweighs the available resources in the emergency department (ED). Literature shows that ED overcrowding impacts the overall quality of the entire hospital production system, as confirmed by the recent COVID-19 pandemic. This study aims to identify the most relevant variables that cause ED overcrowding using the input-process-output model with the aim of providing managers and policy makers with useful hints for how to effectively redesign ED operations.MethodsA mixed-method approach is used, blending qualitative inquiry with quantitative investigation in order to: i) identifying and operationalizing the main components of the model that can be addressed by hospital operation management teams and ii) testing and measuring how these components can influence ED LOS.ResultsWith a dashboard of indicators developed following the input-process-output model, the analysis identifies the most significant variables that have an impact on ED overcrowding: the type (age and complexity) and volume of patients (input), the actual ED structural capacity (in terms of both people and technology) and the ED physician-to-nurse ratio (process), and the hospital discharging process (output).ConclusionsThe present paper represents an original contribution regarding two different aspects. First, this study combines different research methodologies with the aim of capturing relevant information that by relying on just one research method, may otherwise be missed. Second, this study adopts a hospitalwide approach, adding to our understanding of ED overcrowding, which has thus far focused mainly on single aspects of ED operations.
Detecting and describing heterogeneity in health care cost trajectories among asylum seekers
Authors: Tzogiou Christina , Spycher Jacques , Bize Raphaël , Sanchis Zozaya Javier , Blaser Jeremie , Pahud Vermeulen Brigitte , Felappi Andrea , Bodenmann Patrick , Marti Joachim 
Published: July 2022

AbstractBackgroundThe mechanism underlying the health care cost trajectories among asylum seekers is not well understood. In the canton of Vaud in Switzerland, a nurse-led health care and medical Network for Migrant Health (“Réseau santé et migration” RESAMI) has established a health care model focusing on the first year after arrival of asylum seekers, called the “community health phase”. This model aims to provide tailored care and facilitate integration into the Swiss health care system. The aim of this study is to explore different health care cost trajectories among asylum seekers during this phase and identify the associated factors.MethodsWe detected different patterns of health care cost trajectories using time-series clustering of longitudinal data of asylum seekers in the canton of Vaud in Switzerland. These data included all adult asylum seekers and recipients of emergency aid who entered the canton between 2012 and 2015 and were followed until 2018. The different clusters of health care cost trajectories were then described using a multinomial logistic regression model.ResultsWe identified a concave, an upward trending, and a downward trending cluster of health care cost trajectories with different characteristics being associated with each cluster. The likelihood of being in the concave cluster is positively associated with coming from the Eastern Mediterranean region or Africa rather than Europe and with a higher share of consultations with an interpreter. The likelihood of being in the upward trending cluster, which accrued the highest costs, is positively associated with 20–24-year-olds rather than older individuals, coming from Europe than any other region and having a mental disorder. In contrast to the other two clusters, the likelihood of being in the downward trending cluster is positively associated with having contacted the RESAMI network within the first month after arrival, which might indicate the potential of early intervention. It is also positively associated with older age and living in a group lodge.ConclusionsAsylum seekers are heterogeneous in terms of health care cost trajectories. Exploring these differences can help point to possible ways to improve the care and supporting services provided to asylum seekers. Our findings could indicate that early and patient-centered interventions might be well-suited to this aim.
Full-length transcriptomic analysis in murine and human heart reveals diversity of PGC-1α promoters and isoforms regulated distinctly in myocardial ischemia and obesity
Authors: Oehler Daniel , Spychala André , Gödecke Axel , Lang Alexander , Gerdes Norbert , Ruas Jorge , Kelm Malte , Szendroedi Julia , Westenfeld Ralf 
Published: July 2022

Abstract
Background
Peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α) acts as a transcriptional coactivator and regulates mitochondrial function. Various isoforms are generated by alternative splicing and differentially regulated promoters. In the heart, total PGC-1α deficiency knockout leads to dilatative cardiomyopathy, but knowledge on the complexity of cardiac isoform expression of PGC-1α remains sparse. Thus, this study aims to generate a reliable dataset on cardiac isoform expression pattern by long-read mRNA sequencing, followed by investigation of differential regulation of PGC-1α isoforms under metabolic and ischemic stress, using high-fat-high-sucrose-diet-induced obesity and a murine model of myocardial infarction.

Results
Murine (C57Bl/6J) or human heart tissue (obtained during LVAD-surgery) was used for long-read mRNA sequencing, resulting in full-length transcriptomes including 58,000 mRNA isoforms with 99% sequence accuracy. Automatic bioinformatic analysis as well as manual similarity search against exonic sequences leads to identification of putative coding PGC-1α isoforms, validated by PCR and Sanger sequencing. Thereby, 12 novel transcripts generated by hitherto unknown splicing events were detected. In addition, we postulate a novel promoter with homologous and strongly conserved sequence in human heart. High-fat diet as well as ischemia/reperfusion (I/R) injury transiently reduced cardiac expression of PGC-1α isoforms, with the most pronounced effect in the infarcted area. Recovery of PGC-1α-isoform expression was even more decelerated when I/R was performed in diet-induced obese mice.

Conclusions
We deciphered for the first time a complete full-length transcriptome of the murine and human heart, identifying novel putative PGC-1α coding transcripts including a novel promoter. These transcripts are differentially regulated in I/R and obesity suggesting transcriptional regulation and alternative splicing that may modulate PGC-1α function in the injured and metabolically challenged heart.