bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medically-attended anxiety and depression is increased among newly diagnosed patients with cold agglutinin disease: Analysis of an integrated claim-clinical cohort in the United States
Authors: Broome Catherine M. , Hooda Naushin , Su Jun , Jiang Xiaohui , Nicholson Gina , Frankenfeld Cara L. , Iglesias-Rodriguez Melitza , Fryzek Jon , Patel Parija 
Published: December 2022

Background
Cold agglutinin disease (CAD) is a rare, chronic form of autoimmune hemolytic anemia. Clinical manifestations can include classical complement pathway-mediated chronic hemolysis, anemia, and profound fatigue. Research has shown that patients with other anemias may develop anxiety and depression, but this has not been studied previously in patients with CAD.

Methods
CAD patients were identified in the Optum Claims-Clinical dataset (between January 1, 2006–June 30, 2016) and matched to comparison patients without CAD by patient factors. Adjusted Cox regression models estimated time to anxiety and depression, defined by three different outcomes: medication use, hospitalization, and therapy related to anxiety and depression. Subset analyses were performed for primary CAD. Patients were followed until they had anxiety and depression, they left the Optum system, death, or the study period ended (June 30, 2016).

Results
Patients with CAD (n = 384) were more likely to have medically attended anxiety and depression (adjusted hazard ratio [aHR]: 1.6; 95% confidence interval [CI]: 1.3–2.1), to be prescribed antidepressants or psychotherapy after their CAD diagnosis (aHR: 1.8; 95% CI: 1.2–2.9), or to be hospitalized for an anxiety and depression-related event along with medication or psychotherapy (aHR: 2.0; 95% CI: 1.4–2.9) relative to matched comparisons (n = 2789), during the follow-up period. Patients with primary CAD were at increased risk for medically attended anxiety and depression (aHR: 1.8; 95% CI: 1.4–2.4), with the highest risk for prescription medication or therapy (aHR: 2.7; 95% CI: 1.6–4.6).

Conclusions
Our study indicates that medically attended anxiety and depression manifest at a higher rate in CAD patients than in a matched non-CAD cohort. Study findings suggest that CAD patients may experience a greater burden on mental health that may negatively contribute to their overall quality of life. Further investigation on this topic is warranted.
Effectiveness of 13-valent pneumococcal conjugate vaccine on radiological primary end-point pneumonia among cases of severe community acquired pneumonia in children: A prospective multi-site hospital-based test-negative study in Northern India
Authors: Awasthi Shally , Kohli Neera , Agarwal Monika , Pandey Chandra Mani , Rastogi Tuhina , Pandey Anuj Kumar , Roy Chittaranjan , Mishra Kripanath , Verma Neelam , Kumar Chandra Bhushan , Jain Pankaj Kumar , Yadav Rajesh , Dhasmana Puneet , Chauhan Abhishek , Mohindra Namita , Shukla Ram Chandra 
Published: December 2022

IntroductionCommunity acquired pneumonia (CAP) is a leading cause of under-five mortality in India andStreptococcus pneumoniaeis the main bacterial pathogen for it. Pneumococcal Conjugate Vaccine 13 (PCV13) has been introduced in a phased manner, in the national immunization program of India since 2017/2018. The primary objective of this study was to evaluate the effectiveness of PCV13 on chest radiograph (CXR)-confirmed pneumonia, in children hospitalized with WHO-defined severe CAP.MethodsThis prospective, multi-site test-negative study was conducted in a hospital-network situated in three districts of Northern India where PCV13 had been introduced. Children aged 2–23 months, hospitalized with severe CAP and with interpretable CXR were included after parental consent. Clinical data was extracted from hospital records. CXRs were interpreted by a panel of three independent blinded trained radiologists. Exposure to PCV13 was defined as ≥2 doses of PCV13 in children aged ≤ 12 months and ≥ 1 dose(s) in children > 12 months of age. Our outcome measures were CXR finding of primary endpoint pneumonia with or without other infiltrates (PEP±OI); vaccine effectiveness (VE) and hospital mortality.ResultsFrom 1stJune 2017-30thApril 2021, among 2711 children included, 678 (25.0%) were exposed to PCV1. CXR positive for PEP±OI on CXR was found in 579 (21.4%), of which 103 (17.8%) were exposed to PCV. Adjusted odds ratio (AOR) for PEP±OI among the exposed group was 0.69 (95% CI, 0.54–0.89, p = 0.004). Adjusted VE was 31.0% (95% CI: 11.0–44.0) for PEP±OI. AOR for hospital mortality with PEP±OI was 2.65 (95% CI: 1.27–5.53, p = 0.01).ConclusionIn severe CAP, children exposed to PCV13 had significantly reduced odds of having PEP±OI. Since PEP±OI had increased odds of hospital mortality due to CAP, countrywide coverage with PCV13 is an essential priority.
Improvement of cervical spine mobility and stance stability by wearing a custom-made mandibular splint in male recreational athletes
Authors: Herzog Johanna , Göttfert Florian , Maurer-Grubinger Christian , Holzgreve Fabian , Oremek Gerhard , Groneberg David A. , Ohlendorf Daniela 
Published: December 2022

ObjectivesThe range of motion (ROM) of the cervical spine and postural stability are important for an economical and motorically adequate adaptation of the body to any situation. Therefore, this study aims to analyze whether these two components of postural and movement control can be influenced by means of a splint in a centric position compared to habitual occlusion.Methods38 recreational male athletes volunteered. Cervical spine ROM was recorded using an ultrasound system and the a pressure measuring plate for postural stability (length of center of pressure (CoP) movement, area of CoP). The two dental occlusion conditions employed were the habitual occlusion and wearing a splint in an idealized, condylar position close to the centric position. Level of significance was set at ρ ≤ 0.05.ResultsThe cervical spine mobility increased significantly by wearing the splint regarding rotation to the left (+3.9%) and right (+2.7%) and lateral flexion to the left (+4.4%) and right (+6.7%). Wearing the splint reduced the area of sway deflections by about 31.5% in the bipedal stance and by about 2.4% (left) and 28.2% (right) in the unipedal stance. The CoP trace was reduced in the sagittal plane by approximately 8.2% in the right single-leg stance.ConclusionsThe major findings seem to demonstrate that wearing a splint that keeps the jaw close to the centric relation may increase the cervical ROM and may improve balance stability in male recreational athletes. Changing the jaw relation in athletes can possibly aid the release of performance potentials by improving coordination skills.
Trends and characteristics of attempted and completed suicides reported to general practitioners before vs during the COVID-19 pandemic in France: Data from a nationwide monitoring system, 2010–2022
Authors: Pouquet Marie , Launay Titouan , Rivière Mathieu , Chan-Chee Christine , Urbain Frédéric , Coulombel Nicolas , Bardoulat Isabelle , Pons Romain , Guerrisi Caroline , Blanchon Thierry , Hanslik Thomas , Younes Nadia 
Published: December 2022

Background
Most studies published to date have investigated the impact of the COVID-19 pandemic on suicidal acts using hospital data. Trends from primary care in a country such as France are crucial, as individuals may not consult hospital services after suicide attempts (SAs) but rather see their general practitioner (GP).

Objectives
We aimed to evaluate whether the incidence and characteristics of SAs and completed suicides (CSs) reported to French GPs were different during the COVID-19 pandemic than those of before.

Methods and findings
We conducted a retrospective observational study using data from a nationwide monitoring system, the French Sentinel Network (FSN). All SAs and CSs reported by GPs to the FSN from January 1, 2010, to March 10, 2022 were included. The annual incidence rates (IRs) and the characteristics of SAs and CSs during the pandemic (March 11, 2020, to March 10, 2022) were compared to those of before. In total, 687 SAs and 169 CSs were included. The IRs remained stable for SAs and CSs before and during the pandemic (overlap in confidence intervals). The mean IRs were 52 (95%CI = 44; 57) per 100,000 inhabitants for SAs during the pandemic versus 47 [36; 57] during the pre-pandemic period (p = 0.49), and 5 (95%CI = 2; 9) for CSs versus 11 [6; 16] (p = 0.30). During the pandemic, SA were slightly different from those before in terms of age and occupational status (young/students and older/retirees over-represented), history of consultation and expression of suicidal ideas to GP (more frequent), and CS in terms of occupational status (students over-represented) (p<0.05).

Conclusion
The COVID-19 pandemic had no major effect on the overall incidence of SAs and CSs reported to French GPs. However, more suicidal acts were reported among younger and older individuals. Suicidal patients and GPs have adapted by improving the expression of suicidal ideas.
Middle-aged and older adults’ acceptance of mobile nutrition and fitness apps: A systematic mixed studies review
Authors: Baer Nadja-Raphaela , Vietzke Julia , Schenk Liane 
Published: December 2022

Background
To promote healthy aging, the support of digital mobile health tools such as mobile applications (apps) addressing a healthy diet or physical activity appears promising, particularly when initiated before entering old age. For such tools to be effective, middle-aged and older adults’ acceptance need to be studied in depth.

Objective
The aim of this systematic review was to provide an integrative synthesis of the current state of research regarding the question in how far middle-aged and older adults (people aged 50 years and above) accept mobile nutrition and fitness apps to gain a deeper understanding of the influencing factors shaping this target group’s usage behaviour and needs.

Methods
The review process followed the PRISMA guidelines. The databases Medline, Embase, Web of Science as well as reference lists were systematically searched. Study quality was assessed using the MMAT and AXIS appraisal tools. Data of the included studies were extracted and thereupon narratively synthesized, involving thematic analysis.

Results
Of N = 8823 articles screened, n = 7 studies could be identified–five quantitative, cross-sectional ones and two qualitative studies. Overall, the synthesized findings showed a lower acceptance among middle-aged and older adults compared to younger populations, which was particularly reflected in lower usage rates and more negative attitudes towards such apps (e.g., Perceived usefulness, Ease of use). The target group’s acceptance of fitness apps was greater compared to nutrition apps. Findings on contextual factors and social determinants were inconsistent (e.g., regarding gender differences).

Conclusion
While cross-study comparability was limited, the synthesized evidence underscores the importance to target mobile nutrition and fitness apps to the distinctive and heterogeneous needs of middle-aged and, particularly, of older adults. The scarcity of the existing body of knowledge highlights the need of further (longitudinal) research.

PROSPERO protocol register number
CRD42020159409.
A systematic review with meta-analysis of the effects of smoking cessation strategies in patients with rheumatoid arthritis
Authors: Lopez-Olivo Maria A. , Sharma Gaurav , Singh Gagandeep , James Justin , Krause Kate J. , Cinciripini Paul , Volk Robert J. , Suarez-Almazor Maria E. 
Published: December 2022

Objective
Smoking rates among patients with rheumatoid arthritis (RA) exceed those in the general population. This study identified smoking cessation strategies used in patients with RA and synthesized data on their effects.

Methods
We conducted a systematic review of studies that reported effects of interventions for smoking cessation in patients with RA. We searched 5 electronic databases until March 2022. Screening, quality appraisal, and data collection were done independently by 2 reviewers.

Results
We included 18 studies reporting interventions for patients or providers: 14 evaluated strategies for patients (5 education on cardiovascular risk factors including smoking, 3 educational interventions on smoking cessation alone, 3 education with nicotine replacement and counseling, and 1 study each: education with nicotine replacement, counseling sessions alone, and a social marketing campaign). Smoking cessation rates ranged from 4% (95% CI: 2%-6%, 24 to 48 weeks) for cardiovascular risk education to 43% (95% CI: 21%-67%, 104 weeks) for counseling sessions alone. The pooled cessation rate for all interventions was 22% (95% CI: 8%-41%, 4 weeks to 104 weeks; 9 studies). Four interventions trained providers to ascertain smoking status and provide referrals for smoking cessation. The pooled rates of referrals to quit services increased from 5% in pre-implementation populations to 70% in post-implementation populations.

Conclusion
Studies varied in patient characteristics, the interventions used, and their implementation structure. Only 3 studies were controlled clinical trials. Additional controlled studies are needed to determine best practices for smoking cessation for patients with RA.
Exploration of spatial clustering in maternal health continuum of care across districts of India: A geospatial analysis of demographic and health survey data
Authors: Usman Mohd , Reddy Umenthala Srikanth , Siddiqui Laeek Ahemad , Banerjee Adrita 
Published: December 2022

Introduction
The continuum of care (CoC) throughout pregnancy, delivery and post-delivery has recently been highlighted as an integrated intervention programme for maternal, new-born, and child health. Existing literature suggests the importance of continuum of care (CoC) for improved maternal and child health outcomes. However due to unavailability of data at the lowest administrative levels, literature on spatial pattern of uptake of full CoC is lacking. The present study attempts to focus on the spatial analysis of CoC in maternal health care in India.

Data and methods
The study is based on the fourth round of National Family Health Survey data conducted in 2015–16 in India. The outcome variable used is maternal health continuum of care which includes- at least 4 ANC visits, delivery through skilled birth attendant and postnatal check-up within 48 hours of delivery. Univariate and bivariate Local Indicator of Spatial Association (LISA) maps have been generated to show the spatial pattern of CoC across 640 districts in India. We also employed spatial regression techniques to explore the determinants of CoC.

Findings
Percentage of women who followed full CoC was observed to be least for East Kameng (0.0%) district of Arunachal Pradesh and highest in North Goa district (90.4%). Majority of districts where uptake of full CoC was more than 80 percent were found concentrated in southern region on India. Equivalently, findings indicated a strong spatial clustering of full CoC with high-high clusters mostly concentrated in southern districts. Low-low district clusters are concentrated in the states of Uttar Pradesh, Bihar and Madhya Pradesh. For complete CoC the global Moran’s I is 0.73 indicating the spatial dependence. The spatial regression analysis suggested that modern contraceptive use, meeting with health worker, urbanization and secondary or above education for women have positive impact on the utilisation of CoC.

Conclusion
The spatial pattern indicates district level clustering in uptake of CoC among women. The study suggests policymakers and stakeholders to implement comprehensive interventions at sub-regional levels for ensuring the completion of CoC for women which acts as a preventive measure for adverse outcomes such as-maternal and child mortality.
Cost-effectiveness analysis of carbetocin for prevention of postpartum hemorrhage in a low-burden high-resource city of China
Authors: You Joyce H. S. , Leung Tak-yeung 
Published: December 2022

Background
Postpartum hemorrhage (PPH) is a major cause of maternal morbidity, and oxytocin is the first-line uterotonic agent for PPH prevention. Clinical findings have reported carbetocin to reduce PPH risk without increasing risk of important side effects. Hong Kong is a low PPH burden and high-resource city in China. We aimed to examine the cost-effectiveness of PPH prevention with carbetocin from the perspective of Hong Kong public healthcare provider.

Methods
A decision-analytic model was developed to simulate clinical and economic outcomes of carbetocin and oxytocin for PPH prevention in a hypothetical cohort of women at the third stage of labor following vaginal birth or Caesarean section (C-section). The model inputs were retrieved from literature and public data. Base-case analysis and sensitivity analysis were performed. The model time horizon was the postpartum hospitalization period. Primary model outcomes included PPH-related direct medical cost, PPH, hysterectomy, maternal death, and quality-adjusted life-year (QALY) loss.

Results
In base-case analysis, carbetocin (versus oxytocin) reduced PPH-related cost (by USD29 per birth), PPH ≥500 mL and ≥1,500 mL (by 13.7 and 1.9 per 1,000 births), hysterectomy (by 0.15 per 1,000 births), maternal death (by 0.02 per 1,000 births), and saved 0.00059 QALY per birth. Relative risk of PPH ≥500 mL with carbetocin versus oxytocin, and proportion of child births by C-section were two influential parameters identified in deterministic sensitivity analysis. In probabilistic sensitivity analysis, carbetocin was accepted as cost-effective in >99.7% of the 10,000 Monte Carlo simulations at a willingness-to-pay threshold of zero USD/QALY.

Conclusion
PPH prevention with carbetocin appeared to reduce major unfavorable outcomes, and save cost and QALYs.
Socioeconomic and sociodemographic factors associated with food expense insufficiency during the COVID-19 pandemic in Japan
Authors: Katagiri Ryoko , Tabuchi Takahiro , Katanoda Kota 
Published: December 2022

ObjectiveTo examine the status of food expense insufficiency in Japan during the coronavirus disease 2019 (COVID-19) pandemic and the socioeconomic and sociodemographic factors associated with food expense insufficiency.DesignFood expense insufficiency before and after the pandemic was assessed. The multivariable-adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated for the association between food expense insufficiency and socioeconomic and sociodemographic factors.SettingA large-scale, cross-sectional online questionnaire survey.ParticipantsFrom August to September 2020, 25,482 participants aged 15–79 years completed the questionnaire (JACSIS 2020 study; Group 1). In October 2020, 917 single parents were surveyed for oversampling purposes. There were 179 single parents in Group 1 and a total of 1096 single parents in Group 2.ResultsGroup 1 and Group 2 had 747 (2.9%) and 55 (5.0%) participants, respectively, who experienced food expense insufficiency for the first time after April 2020. Young age, part-time employment, being a single parent (in Group 1), and the number of people in the household (five or more in Group 1 and child/children alone in Group 2) were significantly associated with food expense insufficiency. As being a single parent was significantly associated with food expense insufficiency in Group 1 (AOR [95% CI] = 7.23 [5.40–9.68]), we further examined it in Group 2. Single parents who exhibited multiple factors (young age, part-time employment, living only with child/children) were likely to experience food expense insufficiency (15.3–15.8%).ConclusionsTriggered by the pandemic, a small percentage of individuals experienced food expense insufficiency. We identified that factors such as young age, part-time employment, and being a single parent were significantly associated with food expense insufficiency, and discovered that a multiplicity of these factors further increased the risk. Our findings suggest an urgent need to support individuals with a potentially high risk of food expense insufficiency.
Artificial Intelligence and Anorectal Manometry: Automatic Detection and Differentiation of Anorectal Motility Patterns—A Proof-of-Concept Study
Authors: Saraiva Miguel Mascarenhas , Pouca Maria Vila , Ribeiro Tiago , Afonso João , Cardoso Hélder , Sousa Pedro , Ferreira João , Macedo Guilherme , Junior Ilario Froehner 
Published: December 2022

INTRODUCTION:
Anorectal manometry (ARM) is the gold standard for the evaluation of anorectal functional disorders, prevalent in the population. Nevertheless, the accessibility to this examination is limited, and the complexity of data analysis and report is a significant drawback. This pilot study aimed to develop and validate an artificial intelligence model to automatically differentiate motility patterns of fecal incontinence (FI) from obstructed defecation (OD) using ARM data.

METHODS:
We developed and tested multiple machine learning algorithms for the automatic interpretation of ARM data. Four models were tested: k-nearest neighbors, support vector machines, random forests, and gradient boosting (xGB). These models were trained using a stratified 5-fold strategy. Their performance was assessed after fine-tuning of each model's hyperparameters, using 90% of data for training and 10% of data for testing.

RESULTS:
A total of 827 ARM examinations were used in this study. After fine-tuning, the xGB model presented an overall accuracy (84.6% ± 2.9%), similar to that of random forests (82.7% ± 4.8%) and support vector machines (81.0% ± 8.0%) and higher that of k-nearest neighbors (74.4% ± 3.8%). The xGB models showed the highest discriminating performance between OD and FI, with an area under the curve of 0.939.

DISCUSSION:
The tested machine learning algorithms, particularly the xGB model, accurately differentiated between FI and OD manometric patterns. Subsequent development of these tools may optimize the access to ARM studies, which may have a significant impact on the management of patients with anorectal functional diseases.
Impact of the Second Examination of the Proximal Colon on the Adenoma Detection Rate: A Prospective Randomized Controlled Trial
Authors: Yang Qinyu , Zhu Xiaojia , Wu Zhangxuan , Leng Fang , Shu Xu , Yang Li 
Published: December 2022

INTRODUCTION:
Interval colorectal cancer identified before the next surveillance colonoscopy was more likely to be located in the proximal colon. This study aimed to determine whether a second examination of the proximal colon could increase the adenoma detection rate (ADR).

METHODS:
Patients undergoing colonoscopy for any indications were recruited for the study. After the colonoscopy was completed with the first standard forward view examination of the proximal colon, patients were randomized to either the intervention group, in which the proximal colon was once again inspected, or the control group, in which the proximal colon was inspected once. The primary outcome was the proximal colon ADR.

RESULTS:
A total of 840 patients were enrolled for intention-to-treat analysis (intervention group, n = 420; control group, n = 420). The proximal colon ADR in the intervention group was significantly higher than that in the control group (35.7% vs 25.2%, P = 0.001). The whole-colon ADR was also higher in the intervention group than in the control group (44.0% vs 34.0%, P = 0.003). The higher ADR in the intervention group was also confirmed by the per-protocol analysis. Older age, adenoma detected on the first proximal colon examination, and longer total proximal colon withdrawal time were independent factors for detecting ≥1 adenoma on the second withdrawal from the proximal colon.

DISCUSSION:
The second examination of the proximal colon significantly increased the proximal colon ADR and whole-colon ADR in patients undergoing colonoscopy for any indication.