bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stakeholder perspectives on a patient-centred intervention (DIALOG+) for adolescents with common mental disorders in Colombia: A qualitative study
Authors: Gómez-Restrepo Carlos , Marroquín-Rivera Arturo , Calvo-Valderrama María Gabriela , Ospina-Pinillos Laura , Stanislaus Sureshkumar Diliniya , Bird Victoria Jane 
Published: August 2022

BackgroundPatient and stakeholders’ involvement in the development of mental health interventions is a central part of the research process as end-user’s input can improve the design of patient-centered interventions. This is particularly important when developing interventions directed towards improving the mental health of children and adolescents. The rising prevalence of mental health disorders in this population requires special attention and the development of interventions that include them as active participants is crucial.ObjectiveOur aim is to explore the perspectives and opinions of adolescents, parents, educators/youth workers, and clinicians regarding the appeal and usability of an existing patient-centered digital intervention (DIALOG+), which aims to improve quality of life.MethodsAs part of a broader study aiming to adapt and test DIALOG+, we conducted Online Focus Groups (OFGs) with adults and adolescents in two cities in Colombia. The existing DIALOG+ intervention was introduced to participants, followed by a structured discussion regarding the opinions and views of stakeholders. A framework approach was used to identify the main themes followed by content analysis to aid adaptation.ResultsWe conducted 10 OFGs with a total of 45 participants. A positive feature highlighted by all groups was the innovation of including a digital intervention in a traditional medical visit. Additionally, participants considered that the active role that adolescents have when using the intervention empowers them. Barriers identified included concerns from clinicians related to the time required during consultations and confusion with terminology. Furthermore, additional domains that are particularly relevant for the adolescent population were suggested.ConclusionsData obtained suggest that overall, the DIALOG+ intervention and supporting app are seen as innovative and appealing to adolescents as well as adult stakeholders. However, concerns raised about the availability of time to apply the intervention, the app interface and the language and terminology require modification.
Obesity and outcomes in patients undergoing upper airway surgery for obstructive sleep apnea
Authors: Du Austin L. , Tully Jeffrey L. , Curran Brian P. , Gabriel Rodney A. 
Published: August 2022

Objective
Obesity is frequently debated as a factor associated with increased postoperative complications. Specifically, upper airway surgeries for obstructive sleep apnea (OSA), a common comorbidity among obese patients, may be complicated by obesity’s impact on intraoperative ventilation. The aim of this retrospective study was to analyze the association of various degrees of obesity with postoperative outcomes in patients undergoing surgery for OSA.

Methods
The American College of Surgeons National Surgical Quality Improvement database between 2015 and 2019 was used to create a sample of patients diagnosed with OSA who underwent uvulopalatopharyngoplasty, tracheotomy, and surgeries at the base of tongue, maxilla, palate, or nose/turbinate. Inverse probability-weighted logistic regression and unadjusted multivariable logistic regression were used to compare outcomes of non-obese and obesity class 1, class 2, and class 3 groups (World Health Organization classification). Primary outcome was a composite of 30-day readmissions, reoperations, and/or postoperative complications, and a secondary outcome was all-cause same-day hospital admission.

Results
There were 1929 airway surgeries identified. The inverse probability-weighted regression comparing class 1, class 2, and class 3 obesity groups to non-obese patients showed no association between obesity and composite outcome and no association between obesity and hospital admission (all p-values > 0.05).

Conclusion
These results do not provide evidence that obesity is associated with poorer outcomes or hospital admission surrounding upper airway surgery for OSA. While these data points towards the safety of upper airway surgery in obese patients with OSA, larger prospective studies will aid in elucidating the impact of obesity.
Assessing the progress on the implementation of policy and legislation actions to address the Non-Communicable Diseases crisis in the Pacific
Authors: Win Tin Si Thu , Kubuabola Ilisapeci , Snowdon Wendy , Cash Haley L. , Na’ati Elisiva , Waqa Gade D. , Moadsiri Ada , Bertrand Solene , Ravuvu Amerita 
Published: August 2022

Aim
To assess the progress on the implementation of Non-Communicable Diseases (NCD) related policies and legislations in the Pacific Island Countries and Territories (PICTs).

Materials and methods
The Pacific Monitoring Alliance for NCD Action (MANA) Dashboard was used to assess the progress on the implementation. The MANA Dashboard includes 31 indicators across four different domains such as leadership and governance; preventative policies and legislations; health system response programs; and monitoring This progress assessment was conducted between 2019 and 2020 for all 21 PICTs. The data were analyzed and compared with the baseline status (2018) report and presented across four different domains of the MANA dashboard.

Results
This progress assessment found that PICTs overall have made advancements in a number of areas, particularly the establishment of a national multi-sectoral NCD taskforce; implementation of referenced approaches to restrict trans-fat in the food supply in national documents; and fiscal measures to affect access and availability to less healthy foods and drinks. However, the strengths of actions varied across PICTs, and most are categorised as low strengths. Measures which had the most limited progress in implementation include policy and legislation that restrict alcohol advertising; tobacco industry interference; marketing of foods and non-alcoholic beverages to children; and marketing for breast milk substitutes.

Conclusions
This progress assessment further highlights that while PICTs continue to make progress, NCD policy and legislation gaps still exist, both in terms of weaknesses of existing measures and areas that have had little attention to-date. These require urgent actions to scale up NCD related policies and legislation at regional and national level.
Association between median household income, state Medicaid expansion status, and COVID-19 outcomes across US counties
Authors: Apenyo Tsikata , Vera-Urbina Antonio Elias , Ahmad Khansa , Taveira Tracey H. , Wu Wen-Chih 
Published: August 2022

Objective
To study the relationship between county-level COVID-19 outcomes (incidence and mortality) and county-level median household income and status of Medicaid expansion of US counties.

Methods
Retrospective analysis of 3142 US counties was conducted to study the relationship between County-level median-household-income and COVID-19 incidence and mortality per 100,000 people in US counties, January-20th-2021 through December-6th-2021. County median-household-income was log-transformed and stratified by quartiles. Multilevel-mixed-effects-generalized-linear-modeling adjusted for county socio-demographic and comorbidities and tested for Medicaid-expansion-times-income-quartile interaction on COVID-19 outcomes.

Results
There was no significant difference in COVID-19 incidence-rate across counties by income quartiles or by Medicaid expansion status. Conversely, for non-Medicaid-expansion states, counties in the lowest income quartile had a 41% increase in COVID-19 mortality-rate compared to counties in the highest income quartile. Mortality-rate was not related to income in counties from Medicaid-expansion states.

Conclusions
Median-household-income was not related to COVID-19 incidence-rate but negatively related to COVID-19 mortality-rate in US counties of states without Medicaid-expansion.
In the eye of the beholder: Decision-making of lawyers in cases of sexual harassment
Authors: Zvi Liza , Shechory-Bitton Mally 
Published: August 2022

ObjectiveThe purpose of the present study was to examine the effect of deliberative vs. intuitive thinking styles on forensic judgments of legal professionals. Two hypotheses were tested: (a) that low deliberative thinking would be related to judgmental biases (b) that lawyers would report a greater tendency and preference toward deliberative thinking in comparison to students and make more rational judgments.MethodNinety-one lawyers and 120 undergraduate students, who served as controls, were asked to read a criminal case depicting sexual harassment (SH) and judge victim and offender blame, whether the case constitutes SH, and the damage for the victim.ResultsDeliberative thinking of lawyers was higher than students, and higher than their intuitive thinking style, supporting the more rational blame attributions of the former. In addition, higher deliberative thinking was related to a stronger perception of the event as SH. Nevertheless, all the participants were more inclined to perceive the case as SH when the victim was a woman instead of a man.ConclusionsThe results suggest that gender stereotypes and bias may persist despite high deliberative thinking and may even be manifested through deliberative thinking processes. Awareness of legal professionals of these biases as well as the development of more objective tools which will help make the judging process less subjective—will ensure more accurate assessment of victims, offenders, and cases.
Trends in nephrology referral patterns for patients with chronic kidney disease: Retrospective cohort study
Authors: Ghimire Anukul , Ye Feng , Hemmelgarn Brenda , Zaidi Deenaz , Jindal Kailash K. , Tonelli Marcello A. , Cooper Matthew , James Matthew T. , Khan Maryam , Tinwala Mohammed M. , Sultana Naima , Ronksley Paul E. , Muneer Shezel , Klarenbach Scott , Okpechi Ikechi G. , Bello Aminu K. 
Published: August 2022

IntroductionInformation on early, guideline discordant referrals in nephrology is limited. Our objective was to investigate trends in referral patterns to nephrology for patients with chronic kidney disease (CKD).MethodsRetrospective cohort study of adults with ≥1 visits to a nephrologist from primary care with ≥1 serum creatinine and/or urine protein measurement <180 days before index nephrology visit, from 2006 and 2019 in Alberta, Canada. Guideline discordant referrals were those that did not meet ≥1 of: Estimated glomerular filtration rate (eGFR) ˂ 30 mL/min/1.73m2, persistent albuminuria (ACR ≥ 300 mg/g, PCR ≥ 500 mg/g, or Udip ≥ 2+), or progressive and persistent decline in eGFR until index nephrology visit (≥ 5 mL/min/1.73m2).ResultsOf 69,372 patients with CKD, 28,518 (41%) were referred in a guideline concordant manner. The overall rate of first outpatient visits to nephrology increased from 2006 to 2019, although guideline discordant referrals showed a greater increase (trend 21.9 per million population/year, 95% confidence interval 4.3, 39.4) versus guideline concordant referrals (trend 12.4 per million population/year, 95% confidence interval 5.7, 19.0). The guideline concordant cohort were more likely to be on renin-angiotensin system blockers or beta blockers (hazard ratio 1.14, 95% confidence interval 1.12, 1.16), and had a higher risk of CKD progression (hazard ratio 1.09, 95% confidence interval 1.06, 1.13), kidney failure (hazard ratio 7.65, 95% confidence interval 6.83, 8.56), cardiovascular event (hazard ratio 1.40, 95% confidence interval 1.35,1.45) and mortality (hazard ratio 1.58, 95% confidence interval 1.52, 1.63).ConclusionsA significant proportion nephrology referrals from primary care were not consistent with current guideline-recommended criteria for referral. Further work is needed to identify quality improvement initiatives aimed at enhancing referral patterns of patients with CKD.
Integrating hypertension and HIV care in Namibia: A quality improvement collaborative approach
Authors: Basenero Apollo , Neidel Julie , Ikeda Daniel J. , Ashivudhi Hilaria , Mpariwa Simbarashe , Kamangu Jacques W. N. , Mpalang Kakubu Mireille A. , Hans Linea , Mutandi Gram , Jed Suzanne , Tjituka Francina , Hamunime Ndapewa , Agins Bruce D. 
Published: August 2022

BackgroundHypertension (HTN) is highly prevalent among people with HIV (PWH) in Namibia, but screening and treatment for HTN are not routinely offered as part of HIV care delivery. We report the implementation of a quality improvement collaborative (QIC) to accelerate integration of HTN and HIV care within public-sector health facilities in Namibia.MethodsTwenty-four facilities participated in the QIC with the aim of increasing HTN screening and treatment among adult PWH (>15 years). HTN was defined according to national treatment guidelines (i.e., systolic blood pressure >140 and/or diastolic blood pressure >90 across three measurements and at least two occasions), and decisions regarding initiation of treatment were made by physicians only. Teams from participating hospitals used quality improvement methods, monthly measurement of performance indicators, and small-scale tests of change to implement contextually tailored interventions. Coaching of sites was performed on a monthly basis by clinical officers with expertise in QI and HIV, and sites were convened as part of learning sessions to facilitate diffusion of effective interventions.ResultsBetween March 2017 and March 2018, hypertension screening occurred as part of 183,043 (86%) clinical encounters at participating facilities. Among 1,759 PWH newly diagnosed with HTN, 992 (56%) were initiated on first-line treatment. Rates of treatment initiation were higher in facilities with an on-site physician (61%) compared to those without one (51%). During the QIC, facility teams identified fourteen interventions to improve HTN screening and treatment. Among barriers to implementation, teams pointed to malfunctions of blood pressure machines and stock outs of antihypertensive medications as common challenges.ConclusionsImplementation of a QIC provided a structured approach for integrating HTN and HIV services across 24 high-volume facilities in Namibia. As rates of HTN treatment remained low despite ongoing facility-level changes, policy-level interventions—such as task sharing and supply chain strengthening—should be pursued to further improve delivery of HTN care among PWH beyond initial screening.
Treatment thresholds and minimal clinically important effect sizes of antiosteoporotic medication–Survey among physicians and lay persons in Germany
Authors: van der Keylen Piet , Zeschick Nikoletta , Schlenz Anna Ruth , Kühlein Thomas 
Published: August 2022

Background
Patient decisions to take preventative treatments for osteoporosis depend on their perceptions of fracture risk, medication effect sizes (ES) of benefits and harms. However, physicians and lay persons may have differing perceptions of risks and medication efficacy. Both tend to overestimate medication benefits. This study surveyed at what risk physicians would prescribe and lay persons would be willing to take bisphosphonates, the minimum ES both groups do demand and the physicians estimates of the actual benefit of bisphosphonates.

Design
Cross-sectional online questionnaire survey.

Methods
Respondents were confronted with a case vignette with an osteoporotic patient (10-year femoral fracture risk: 32%). They were asked at what threshold of 10-year-risk of femoral neck fracture they would prescribe or take a drug. They were asked for the minimum ES (absolute risk reduction, ARR) they demand from bisphosphonates to prescribe or take them. Physicians were asked to provide their estimate of the actual ARR of bisphosphonates.

Results
114 physicians and 140 lay persons answered (convenience sample/snowball distribution). The 10-year-risk threshold of lay persons (Mdnlay = 60%) willing to take medication was twice as high as the physicians’ threshold (Mdnphy = 30%) to prescribe it (p < .001). The median minimum ARR physicians demanded for bisphosphonates prescription was 17%, whereas lay persons demanded 22% (p < .001). Physicians estimated the actual ARR of bisphosphonates to be 12%. This estimated effect size was below their own minimum threshold for prescription.

Conclusions
Lay persons tolerate a higher fracture risk and demand a larger benefit of antiosteoporotic medication for fracture prevention than physicians. Physicians demand higher minimum benefits than their own estimates which in turn are above the benefit evidence suggests. Physicians should be more familiar with ES of antiosteoporotic drugs concerning patient outcomes and actively advise lay persons before preventive treatment decisions are taken.
Predicting curve progression for adolescent idiopathic scoliosis using random forest model
Authors: Alfraihat Ausilah , Samdani Amer F. , Balasubramanian Sriram 
Published: August 2022

Background
Adolescent Idiopathic Scoliosis (AIS) is a three-dimensional (3D) spinal deformity characterized by coronal curvature and rotational deformity. Predicting curve progression is important for the selection and timing of treatment. Although there is a consensus in the literature regarding prognostic factors associated with curve progression, the order of importance, as well as the combination of factors that are most predictive of curve progression is unknown.

Objectives
(1) create an ordered list of prognostic factors that most contribute to curve progression, and (2) develop and validate a Machine Learning (ML) model to predict the final major Cobb angle in AIS patients.

Methods
193 AIS patients were selected for the current study. Preoperative PA, lateral and lateral bending radiographs were retrospectively obtained from the Shriners Hospitals for Children. Demographic and radiographic features, previously reported to be associated with curve progression, were collected. Sequential Backward Floating Selection (SBFS) was used to select a subset of the most predictive features. Based on the performance of several machine learning methods, a Random Forest (RF) regressor model was used to provide the importance rank of prognostic features and to predict the final major Cobb angle.

Results
The seven most predictive prognostic features in the order of importance were initial major Cobb angle, flexibility, initial lumbar lordosis angle, initial thoracic kyphosis angle, age at last visit, number of levels involved, and Risser "+" stage at the first visit. The RF model predicted the final major Cobb angle with a Mean Absolute Error (MAE) of 4.64 degrees.

Conclusion
A RF model was developed and validated to identify the most important prognostic features for curve progression and predict the final major Cobb angle. It is possible to predict the final major Cobb angle value within 5 degrees error from 2D radiographic features. Such methods could be directly applied to guide intervention timing and optimization for AIS treatment.
A novel SLC8A1-ALK fusion in lung adenocarcinoma confers sensitivity to alectinib: A case report
Authors: Deng Ling , Tian Panwen , Qiu Zhixin , Wang Ke , Li Yalun 
Published: August 2022

Abstract

ALK fusion genes are diverse. Approximately 30 different ALK fusion protein partners have been described previously, and some of these fusion proteins have been reported to be effective against ALK-tyrosine kinase inhibitor (TKI). ALK rearrangements often occur at a common breakpoint in exon 20 of the genome. SLC8A1-ALK, a novel fusion protein partner, comes from exon 2 of the SLC8A1 gene rearranged with exon 20 of the ALK gene. Here, we reported a patient with advanced lung adenocarcinoma harboring a SLC8A1-ALK fusion who benefited from first-line treatment with alectinib. After 2 months of taking alectinib, the targeted lung lesions and intrahepatic metastases regressed significantly. To date, the patient has achieved nearly 1 year of progression-free survival while taking the drug. Given the diversity of ALK fusion genes and the different efficacy of ALK-TKIs, we believe that this case report has an important clinical reference.
Explaining uncertainty and defectivity of inflectional paradigms
Authors: Nikolaev Alexandre , Bermel Neil 
Published: August 2022

AbstractThe current study investigates how native speakers of a morphologically complex language (Finnish) handle uncertainty related to linguistic forms that have gaps in their inflectional paradigms. We analyze their strategies of dealing with paradigmatic defectivity and how these strategies are motivated by subjective contemporaneousness, frequency, acceptability, and other lexical and structural characteristics of words. We administered a verb production (inflection) task with Finnish native speakers using verbs from a small non-productive inflectional type that has many paradigmatic gaps and asked participants to inflect the verbs in a given context. Inflectional uncertainty was measured by the number of different forms the participants produced for each verb. We classified produced forms that were not expected as either synonymous or novel and measured their optimal string alignment distance to expected forms. Our analyses revealed that a usage-based approach to paradigmatic defectivity fits better with the obtained results than a classical approach typically met in dictionaries and descriptive grammars. Thus, we argue, that paradigmatic defectivity can be better described as a dynamic rather than a static system, where gaps represent a continuum of possible inflectional choices rather than a lack of an inflectional variant.
The journey from blue to pink–a rare cause for self-limiting methemoglobinemia in an Indian baby
Authors: Chandran Shanu , Ross Benjamin J. , Kumar Manish 
Published: August 2022

Abstract

Objectives
To describe a rare case of methemoglobinemia in a newborn baby with excellent prognosis. Methemoglobinemia in the neonatal period is very rare and when present is usually caused by environmental toxicity from strong oxidizing agents and rarely due to enzyme deficiency or inherited disorders of hemoglobin metabolism.

Case presentation
We report a newborn baby presented with cyanosis and desaturation right from birth, later found to have methemoglobinemia and started medication. Genetic evaluation revealed a mutation in the gamma chain of fetal haemoglobin (HbF) causing abnormal hemoglobin. Physiologically significant mutations in gamma-globin genes cause symptoms in the fetus and neonate that gradually abate in the first few months of life.

Conclusions
Genetic evaluation is advisable in babies with unexplained methemoglobinemia as the prognosis of the condition depends on the underlying mutation. Early diagnosis of methemoglobinemia due to gamma chain mutation in HbF as in our case helps in reassuring the parents and also in preventing unnecessary aggressive investigations.