bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sexual behaviours and sexual health among middle-aged and older adults in Britain
Authors: Khan Junead , Greaves Emily , Tanton Clare , Kuper Hannah , Shakespeare Thomas , Kpokiri Eneyi , Wang Yun , Ong Jason J , Day Suzanne , Pan Stephen W , Tang Weiming , Wang Bingyi , Peng Xin , Liang Bowen , Zou Huachun , Tucker Joseph D , Wu Dan 
Published: August 2022

ObjectivesPopulation-representative studies of the sexual health of middle-aged and older adults are lacking in ageing societies. This study aimed to identify latent patterns of sexual behaviours and health of people aged 45–74 years.MethodsWe conducted a latent class analysis of the National Attitudes and Sexual Lifestyles Survey (Natsal-3), a nationally representative survey conducted in Britain in 2011.ResultsOf the 5260 respondents aged 45–74 years, 48.86% of men and 44.91% of women belonged to the Content Caseys class who reported good sexual health. The Infrequent Indigos (30.94% of men, 44.38% of women) were characterised by a lack of sexual activity, reported some dissatisfaction, and were more likely to have a disability. The Low-Functioning Lees (11.65% of men, 8.41% of women) reported some more disability and had issues with sexual functioning and higher levels of distress. The Multiple-Partnered Morgans (8.62% of men, 2.30% of women) were characterised by a greater number of sexual partners and several risk behaviours.ConclusionsThe use of these four classes can aid in improved targeting of tailored sexual health services to improve sexual function, sexual satisfaction, reduce distress and risky behaviours among middle-aged and older adults. These services should be inclusive of the disabled community.
Minimum important difference of the Epworth Sleepiness Scale in obstructive sleep apnoea: estimation from three randomised controlled trials
Authors: Crook Sarah , Sievi Noriane A , Bloch Konrad E , Stradling John R , Frei Anja , Puhan Milo A , Kohler Malcolm 
Published: August 2022

BackgroundThe Epworth Sleepiness Scale (ESS) is a widely used tool for assessing sleepiness in patients with obstructive sleep apnoea (OSA). We aimed to estimate the minimal important difference (MID) in patients with OSA.MethodsWe used individual data from three randomised controlled trials (RCTs) in patients with OSA where the preintervention to postintervention change in ESS was used as a primary outcome. We used anchor-based linear regression and responder analysis approaches to estimate the MID. For anchors, we used the change in domains of the Functional Outcomes of Sleep Questionnaire and 36-Item Short Form Health Survey. We also used the distribution-based approaches Cohen’s effect size, SE of measurement and empirical rule effect size to support the anchor-based estimates. The final MID was determined by triangulating all estimates to a single MID.FindingsA total of 639 patients with OSA were included in our analyses across the three RCTs with a median (IQR) baseline ESS score of 10 (6–13). The median (IQR) ESS change score overall was −2 (−5 to 1). The anchor-based estimates of the MID were between −1.74 and −4.21 points and estimates from the responder analysis were between −1 and −3 points. Distribution-based estimates were smaller, ranging from −1.46 to −2.36.InterpretationWe propose an MID for the ESS of 2 points in patients with OSA with a disease severity from mild to severe. This estimate provides the means to plan trials and interpret the clinical relevance of changes in ESS.Trial registration numberProvent, NCT01332175; autoCPAP trial, NCT00280800; MOSAIC,ISRCTN (3416388).
Artificial Intelligence–Enabled Model for Early Detection of Left Ventricular Hypertrophy and Mortality Prediction in Young to Middle-Aged Adults
Authors: Liu Chih-Min , Hsieh Ming-En , Hu Yu-Feng , Wei Tzu-Yin , Wu I-Chien , Chen Pei-Fen , Lin Yenn-Jiang , Higa Satoshi , Yagi Nobumori , Chen Shih-Ann , Tseng Vincent S. 
Published: August 2022

Background:
Concealed left ventricular hypertrophy (LVH) is a prevalent condition that is correlated with a substantial risk of cardiovascular events and mortality, especially in young to middle-aged adults. Early identification of LVH is warranted. In this work, we aimed to develop an artificial intelligence (AI)–enabled model for early detection and risk stratification of LVH using 12-lead ECGs.

Methods:
By deep learning techniques on the ECG recordings from 28 745 patients (20–60 years old), the AI model was developed to detect verified LVH from transthoracic echocardiography and evaluated on an independent cohort. Two hundred twenty-five patients from Japan were externally validated. Cardiologists’ diagnosis of LVH was based on conventional ECG criteria. The area under the curve (AUC), sensitivity, and specificity were applied to evaluate the model performance. A Cox regression model estimated the independent effects of AI-predicted LVH on cardiovascular or all-cause death.

Results:
The AUC of the AI model in diagnosing LVH was 0.89 (sensitivity: 90.3%, specificity: 69.3%), which was significantly better than that of the cardiologists’ diagnosis (AUC, 0.64). In the second independent cohort, the diagnostic performance of the AI model was consistent (AUC, 0.86; sensitivity: 85.4%, specificity: 67.0%). After a follow-up of 6 years, AI-predicted LVH was independently associated with higher cardiovascular or all-cause mortality (hazard ratio, 1.91 [1.04–3.49] and 1.54 [1.20–1.97], respectively). The predictive power of the AI model for mortality was consistently valid among patients of different ages, sexes, and comorbidities, including hypertension, diabetes, stroke, heart failure, and myocardial infarction. Last, we also validated the model in the international independent cohort from Japan (AUC, 0.83).

Conclusions:
The AI model improved the detection of LVH and mortality prediction in the young to middle-aged population and represented an attractive tool for risk stratification. Early identification by the AI model gives every chance for timely treatment to reverse adverse outcomes.
International Legal Principles, Penal Populism and Criminalisation of ‘Unwanted Migration’
Authors: Minetti Marta 
Published: August 2022

Abstract
The criminalisation of migration is one of the most explicit ways in which law generates, sustains, and even legitimizes hostility towards “unwanted migrants”. This article will take into examination the criminalisation of “unwanted migration” by the Italian authorities and its relation to internationally established legal principles in the area of human mobility, arguing that the expansion of penal populism constitutes a danger for the balance among them. The article starts with an analysis of human mobility in international law and the “protection through prosecution” paradigm to highlight an inherent harmony of the aims of the legal systems dealing with human mobility from the humanitarian and criminal law perspective. Section two scrutinises the Italian case and the populistic distortion of the provisions and principles entailed in the field of transnational criminal law to counter human mobility. Section three reconnects the national criminalisation of migration with the international legal dimension and argues that the misuse of the transnational organised crime framework ultimately legitimises the violation of human and refugee rights and contravenes key international law principles.
VWF-targeted thrombolysis to overcome rh-tPA resistance in experimental murine ischemic stroke models
Authors: van Moorsel Marc V. A. , de Maat Steven , Vercruysse Kristof , van Leeuwen Esther M. , Jacqmarcq Charlène , Bonnard Thomas , Vivien Denis , van der Worp H. Bart , Dijkhuizen Rick M. , Maas Coen 
Published: August 2022

Abstract
Recombinant human tissue plasminogen activator (rh-tPA) is an important thrombolytic agent for treatment of acute ischemic stroke. It requires fibrin binding for plasminogen activation. In contrast, Microlyse, a novel thrombolytic agent, requires von Willebrand factor (VWF) binding for plasminogen activation. We compared rh-tPA with Microlyse, administered 20 minutes after inducing thrombosis, in 2 randomized blinded acute ischemic stroke mouse models. Thrombosis was induced in the middle cerebral artery with different experimental triggers. Where thrombin infusion generates fibrin-rich thrombi, topical FeCl3 application generates platelet-rich thrombi. In the fibrin-rich model, both rh-tPA and Microlyse increased cortical reperfusion (determined by laser speckle imaging) 10 minutes after therapy administration (35.8 ± 17.1%; P = .001 39.3 ± 13.1%; P &lt; .0001; 15.6 ± 7.5%, respectively, vs vehicle). In addition, both thrombolytic agents reduced cerebral lesion volume (determined by magnetic resonance imaging) after 24 hours (18.9 ± 11.2 mm3; P = .033; 16.1 ± 13.9 mm3; P = .018; 26.6 ± 5.6 mm3, respectively, vs vehicle). In the platelet-rich model, neither rh-tPA nor Microlyse increased cortical reperfusion 10 minutes after therapy (7.6 ± 8.8%; P = .216; 16.3 ± 13.9%; P = .151; 10.1 ± 7.9%, respectively, vs vehicle). However, Microlyse, but not rh-tPA, decreased cerebral lesion volumes (13.9 ± 11.4 mm3; P &lt; .001; 23.6 ± 11.1 mm3; P = .188; 30.3 ± 10.9 mm3, respectively, vs vehicle). These findings support broad applicability of Microlyse in ischemic stroke, irrespective of the thrombus composition.
Patient-centered care in the emergency department: a systematic review and meta-ethnographic synthesis
Authors: Walsh Anna , Bodaghkhani Elnaz , Etchegary Holly , Alcock Lindsay , Patey Christopher , Senior Dorothy , Asghari Shabnam 
Published: August 2022

AbstractBackgroundPatient-centered care (PCC) is an emerging priority in many healthcare settings but lacks clarity in the emergency department (ED). It is of interest to know what PCC practices are most important to patients to better their experience. The objective of this study was to conduct a mixed-methods systematic review of PCC in the ED.MethodsWe used stakeholder and patient engagement to consult with clinicians, subject-matter experts, patient partners, and community organizations to determine patient needs. We examined all articles in the ED context with PCC as the intervention. Two independent reviewers screened 3136 articles and 13 were included. A meta-ethnographic analysis was conducted to determine common themes of PCC.ResultsThemes included emotional support, communication, education, involvement of patient/family in information sharing and decision making, comfort of environment, respect and trust, continuity, and transition of care. Challenges in the ED reflected a lack of PCC. Moreover, implementation of PCC had many benefits including higher patient satisfaction with their care. Though there were commonalities of PCC components, there was no consistently used definition for PCC in the ED.ConclusionThe findings of this review support the evidence that PCC is of high value to the ED setting and should be standardized in practice.
Learning to detect boundary information for brain image segmentation
Authors: Khaled Afifa , Han Jian-Jun , Ghaleb Taher A. 
Published: August 2022

AbstractMRI brain images are always of low contrast, which makes it difficult to identify to which area the information at the boundary of brain images belongs. This can make the extraction of features at the boundary more challenging, since those features can be misleading as they might mix properties of different brain regions. Hence, to alleviate such a problem, image boundary detection plays a vital role in medical image segmentation, and brain segmentation in particular, as unclear boundaries can worsen brain segmentation results. Yet, given the low quality of brain images, boundary detection in the context of brain image segmentation remains challenging. Despite the research invested to improve boundary detection and brain segmentation, these two problems were addressed independently, i.e., little attention was paid to applying boundary detection to brain segmentation tasks. Therefore, in this paper, we propose a boundary detection-based model for brain image segmentation. To this end, we first design a boundary segmentation network for detecting and segmenting images brain tissues. Then, we design a boundary information module (BIM) to distinguish boundaries from the three different brain tissues. After that, we add a boundary attention gate (BAG) to the encoder output layers of our transformer to capture more informative local details. We evaluate our proposed model on two datasets of brain tissue images, including infant and adult brains. The extensive evaluation experiments of our model show better performance (a Dice Coefficient (DC) accuracy of up to $$5.3\%$$

5.3
%

compared to the state-of-the-art models) in detecting and segmenting brain tissue images.
Prediction of Back-splicing sites for CircRNA formation based on convolutional neural networks
Authors: Shen Zhen , Shao Yan Ling , Liu Wei , Zhang Qinhu , Yuan Lin 
Published: August 2022

Abstract
Background
Circular RNAs (CircRNAs) play critical roles in gene expression regulation and disease development. Understanding the regulation mechanism of CircRNAs formation can help reveal the role of CircRNAs in various biological processes mentioned above. Back-splicing is important for CircRNAs formation. Back-splicing sites prediction helps uncover the mysteries of CircRNAs formation. Several methods were proposed for back-splicing sites prediction or circRNA-realted prediction tasks. Model performance was constrained by poor feature learning and using ability.

Results
In this study, CircCNN was proposed to predict pre-mRNA back-splicing sites. Convolution neural network and batch normalization are the main parts of CircCNN. Experimental results on three datasets show that CircCNN outperforms other baseline models. Moreover, PPM (Position Probability Matrix) features extract by CircCNN were converted as motifs. Further analysis reveals that some of motifs found by CircCNN match known motifs involved in gene expression regulation, the distribution of motif and special short sequence is important for pre-mRNA back-splicing.

Conclusions
In general, the findings in this study provide a new direction for exploring CircRNA-related gene expression regulatory mechanism and identifying potential targets for complex malignant diseases. The datasets and source code of this study are freely available at: https://github.com/szhh521/CircCNN.
Prevalence and correlates of anxiety and depression in caregivers to assisted living residents during COVID-19: a cross-sectional study
Authors: Lane Natasha E. , Hoben Matthias , Amuah Joseph E. , Hogan David B. , Baumbusch Jennifer , Gruneir Andrea , Chamberlain Stephanie A. , Griffith Lauren E. , McGrail Kimberlyn M. , Corbett Kyle , Maxwell Colleen J. 
Published: August 2022

Abstract
Background
Family and friend caregivers play significant roles in advocating for and ensuring quality health and social care of residents in Assisted Living (AL) homes. However, little is known about how the COVID-19 pandemic and related visitor restrictions affected their health and mental well-being. We examined the prevalence and correlates of anxiety and depressive symptoms among caregivers of AL residents during the initial wave of COVID-19 in two Canadian provinces.

Methods
A cross-sectional web-based survey was conducted among family/friend caregivers of AL residents in Alberta and British Columbia (Oct 28, 2020—Mar 31, 2021) to collect data on their sociodemographic, health and caregiving characteristics, as well as concerns about residents’ health and social care before and during the first wave of the pandemic. A clinically significant anxiety disorder and depressive symptoms were assessed with the GAD-7 and CES-D10 instruments, respectively. Separate multivariable (modified) Poisson regression models identified caregiver correlates of each mental health condition.

Results
Among the 673 caregivers completing the survey (81% for Alberta residents), most were women (77%), white (90%) and aged ≥ 55 years (81%). Clinically significant anxiety and depression were present in 28.6% and 38.8% of caregivers respectively. Both personal stressors (comorbidity level, income reduction, low social support) and caregiving stressors exacerbated by the pandemic were independently associated with caregiver anxiety and depression. The latter included increased concern about the care recipients’ depression (adjusted risk ratio [adjRR] = 1.84, 95% confidence interval [CI] 1.19–2.85 for caregiver anxiety and adjRR = 1.75, 95% CI 1.26–2.44 for caregiver depressive symptoms) and reported intention to withdraw the resident from AL because of COVID-19 (adjRR = 1.24, 95%CI 0.95–1.63 for caregiver anxiety and adjRR = 1.37, 95%CI 1.13–1.67 for caregiver depressive symptoms).

Conclusions
Caregivers of residents in AL homes reported significant personal and caregiving-related stressors during the initial wave of COVID-19 that were independently associated with an increased likelihood of experiencing clinically significant anxiety and depressive symptoms. Healthcare providers and AL staff should be aware of the prevalence and varied correlates of caregivers’ mental health during public health crises so that appropriate screening and support may identified and implemented.
Antimicrobial resistance of Neisseria gonorrhoeae isolated from patients attending sexually transmitted infection clinics in Urban Hospitals, Lusaka, Zambia
Authors: Sarenje Kelvin L. , Ngalamika Owen , Maimbolwa Margaret C. , Siame Amon , Munsaka Sody M. , Kwenda Geoffrey 
Published: August 2022

AbstractBackgroundNeisseria gonorrhoeae, the causative agent for sexually transmitted infection (STI) gonorrhoea, has emerged with a significant public health impact on acquiring resistance to antimicrobials available for treatment. The resistance ofN. gonorrhoeaelimit treatment options and contributed to high morbidity associated with gonorrhoea. Data on antimicrobial resistance (AMR) profiles inN. gonorrhoeaeis scares in Zambia. This study aimed to determine the antibiotic susceptibilities inN. gonorrhoeaeisolates from Lusaka, Zambia.MethodsA prospective cross-sectional study was conducted on 630 STI patients who presented with urethral or vaginal discharge from 2019 to 2020. Urethral and endocervical secretions were cultured on Modified Thayer Martin agar and incubated at 36 °C ± 1 °C in 5% CO2for 24 h. Identification ofN. gonorrhoeaeisolates was achieved by Gram stain, oxidase, nitrocefin disk, BactiCardNeisseria, and Viteck® Compact. The AMR profiles were determined using E-test. Statistical significant was determined by Pearson’s Chi-square test, Mann-Whitney U test, or logistic regression withp-values of < 0.05 indicating significance.ResultsA total of 630 patients were recruited of which 46% (290/630) with the median of 29 years and interquartile range (IQR) of 19–39 years were male. The median of the females was 26 years and IQR of 15–37 years.Neisseria gonorrhoeaewas isolated from 19.4% (122/630) patients of which 72.9% (89/122) were male, with highest prevalence of isolation in the age category of 25–34 years. The prevalence of resistance was high to penicillin (85.2%), tetracycline (68.9%) and ciprofloxacin (59.8%) with MIC90of 32 µg/mL, 8 µg/mL, and 8 µg/mL respectively. The isolates had reduced susceptibility to cefixime (1.6%), spectinomycin (4.9%) and (4.9%) for azithromycin. All isolates were susceptible to ceftriaxone. Risk factors associated with AMR were douching in females (AOR 6.69, 95% CI; 1.11–40.31,p = 0.039), female gender (AOR 7.64, 95% CI; 1.11–52.33,p = 0.048), HIV-positivity (AOR 26.59, 95% CI; 3.67–192.7,p = 0.005), no condom use or unprotected sex (AOR 5.48, 95% CI; 1.17–22.75p = 0.026), sex trading (AOR 4.19, 95% CI; 1.55–11.33,p = 0.010), and over-counter treatment of ciprofloxacin (AOR 3.44, 95% CI; 1.17–22.75,p = 0.023).ConclusionTheN. gonorrhoeaeresistance to penicillin, tetracycline and ciprofloxacin was high necessitating revision of the treatment guidelines. However, no resistance to ceftriaxone was detected. Therefore, monitoring of antibiotic resistance remains critical in Zambia.
Large scale application of pulse oximeter and auscultation in screening of neonatal congenital heart disease
Authors: Huang Yuqiang , Zhong Shiqing , Zhang Xianmei , Kong Linghui , Wu Wenli , Yue Shixia , Tian Ning , Zhu Guanghua , Hu Aiqin , Xu Juan , Zhu Haijan , Sun Airong , Qin Fangling , Wang Ziwen , Wu Shiqiang 
Published: August 2022

Abstract
Purpose
To conduct a retrospective evaluation of a large clinical implementation of combined pulse oximeter (POX) and cardiac auscultation as a fast-screening device for congenital heart disease (CHD).

Methods
Every newborn in a large maternity healthcare center received auscultation and POX screening within 24 hours after delivery. When an abnormal heart murmur or SpO2 level was detected, an echocardiogram was ordered to confirm the diagnosis of CHD.

Results
From January 1, 2018 to December 31, 2019, there were 44,147 livebirths at the studied hospital where 498 suspected CHD were identified: 27 newborns by POX screening and 471 by cardiac auscultation. The diagnosis was further confirmed in 458 neonates through echocardiogram. This result put forth an overall diagnosis rate of 92.0%. Cardiac auscultation detected the majority of CHD cases 438 (95.6%) while POX only screened 20 (4.4%) cases. Interestingly, no CHD case was detected by both auscultation examination and POX screening. Auscultation detected most of the common types of CHD, but POX excelled in identifying rare and critical cases. POX screening alone had a very low accuracy of 74.07% in positive predict value (PPV). On the other hand, auscultation functioned well in terms of PPV and negative predict value (NPV) (92.99 and 99.95%, respectively), but the addition of POX improved the overall screening performance resulting in 100% NPV. We also validate the finding with the data 6 months after the study period.

Conclusion
Our study demonstrated that addition of pulse oximetry to routine cardiac auscultation could be used as an accurate and feasible screening for early screening of CHD in newborns in large-scale clinical practice.