bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hollow-core fiber delivery of broadband mid-infrared light for remote spectroscopy
Authors: Johnson Kerr , Castro-Marin Pablo , Farrell Carl , Davidson Ian A. , Fu Qiang , Jasion Gregory T. , Wheeler Natalie V. , Poletti Francesco , Richardson David J. , Reid Derryck T. 
Published: January 2022

High-resolution multi-species spectroscopy is achieved by delivering broadband 3–4-μm mid-infrared light through a 4.5-meter-long silica-based hollow-core optical fiber. Absorptions from H37Cl, H35Cl, H2O and CH4 present in the gas within the fiber core are observed, and the corresponding gas concentrations are obtained to 5-ppb precision using a high-resolution Fourier-transform spectrometer and a full-spectrum multi-species fitting algorithm. We show that by fully fitting the narrow absorption features of these light molecules their contributions can be nulled, enabling further spectroscopy of C3H6O and C3H8O contained in a Herriott cell after the fiber. As a demonstration of the potential to extend fiber-delivered broadband mid-infrared spectroscopy to significant distances, we present a high-resolution characterization of the transmission of a 63-meter length of hollow-core fiber, fully fitting the input and output spectra to obtain the intra-fiber gas concentrations. We show that, despite the fiber not having been purged, useful spectroscopic windows are still preserved which have the potential to enable hydrocarbon spectroscopy at the distal end of fibers with lengths of tens or even hundreds of meters.
Denoising of pediatric low dose abdominal CT using deep learning based algorithm
Authors: Park Hyoung Suk , Jeon Kiwan , Lee JeongEun , You Sun Kyoung 
Published: January 2022

Objectives
To evaluate standard dose-like computed tomography (CT) images generated by a deep learning method, trained using unpaired low-dose CT (LDCT) and standard-dose CT (SDCT) images.

Materials and methods
LDCT (80 kVp, 100 mAs, n = 83) and SDCT (120 kVp, 200 mAs, n = 42) images were divided into training (42 LDCT and 42 SDCT) and validation (41 LDCT) sets. A generative adversarial network framework was used to train unpaired datasets. The trained deep learning method generated virtual SDCT images (VIs) from the original LDCT images (OIs). To test the proposed method, LDCT images (80 kVp, 262 mAs, n = 33) were collected from another CT scanner using iterative reconstruction (IR). Image analyses were performed to evaluate the qualities of VIs in the validation set and to compare the performance of deep learning and IR in the test set.

Results
The noise of the VIs was the lowest in both validation and test sets (all p<0.001). The mean CT number of the VIs for the portal vein and liver was lower than that of OIs in both validation and test sets (all p<0.001) and was similar to those of SDCT. The contrast-to-noise ratio of portal vein and the signal-to-noise ratio (SNR) of portal vein and liver of VIs were higher than those of SDCT (all p<0.05). The SNR of VIs in test sets was the highest among three images.

Conclusion
The deep learning method trained by unpaired datasets could reduce noise of LDCT images and showed similar performance to SAFIRE. It can be applied to LDCT images of older CT scanners without IR.
Effectiveness of various cleaning strategies in acute and long-term care facilities during novel corona virus 2019 disease pandemic-related staff shortages
Authors: Lesho Emil , Newhart Donna , Reno Lisa , Sleeper Scott , Nary Julia , Gutowski Jennifer , Yu Stephanie , Walsh Edward , Vargas Roberto , Riedy Dawn , Mayo Robert 
Published: January 2022

Background
Cleanliness of hospital surfaces helps prevent healthcare-associated infections, but comparative evaluations of various cleaning strategies during COVID-19 pandemic surges and worker shortages are scarce.

Purpose and methods
To evaluate the effectiveness of daily, enhanced terminal, and contingency-based cleaning strategies in an acute care hospital (ACH) and a long-term care facility (LTCF), using SARS-CoV-2 RT-PCR and adenosine triphosphate (ATP) assays. Daily cleaning involved light dusting and removal of visible debris while a patient is in the room. Enhanced terminal cleaning involved wet moping and surface wiping with disinfectants after a patient is permanently moved out of a room followed by ultraviolet light (UV-C), electrostatic spraying, or room fogging. Contingency-based strategies, performed only at the LTCF, involved cleaning by a commercial environmental remediation company with proprietary chemicals and room fogging. Ambient surface contamination was also assessed randomly, without regard to cleaning times. Near-patient or high-touch stationary and non-stationary environmental surfaces were sampled with pre-moistened swabs in viral transport media.

Results
At the ACH, SARS-CoV-2 RNA was detected on 66% of surfaces before cleaning and on 23% of those surfaces immediately after terminal cleaning, for a 65% post-cleaning reduction (p = 0.001). UV-C enhancement resulted in an 83% reduction (p = 0.023), while enhancement with electrostatic bleach application resulted in a 50% reduction (p = 0.010). ATP levels on RNA positive surfaces were not significantly different from those of RNA negative surfaces. LTCF contamination rates differed between the dementia, rehabilitation, and residential units (p = 0.005). 67% of surfaces had RNA after room fogging without terminal-style wiping. Fogging with wiping led to a -11% change in the proportion of positive surfaces. At the LTCF, mean ATP levels were lower after terminal cleaning (p = 0.016).

Conclusion
Ambient surface contamination varied by type of unit and outbreak conditions, but not facility type. Removal of SARS-CoV-2 RNA varied according to cleaning strategy.

Implications
Previous reports have shown time spent cleaning by hospital employed environmental services staff did not correlate with cleaning thoroughness. However, time spent cleaning by a commercial remediation company in this study was associated with cleaning effectiveness. These findings may be useful for optimizing allocation of cleaning resources during staffing shortages.
Self-reported health status and mortality from all-causes of death, cardiovascular disease and cancer in an older adult population in Spain
Authors: Torres-Collado Laura , García de la Hera Manuela , Compañ-Gabucio Laura María , Oncina-Cánovas Alejandro , González-Palacios Sandra , Notario-Barandiaran Leyre , Vioque Jesús 
Published: January 2022

Aim
To assess the association between self-reported health (SRH) and mortality from all-causes, cardiovascular disease (CVD) and cancer, in adults 65 years and older in Spain.

Methods
We analysed data of 894 adults (504 women, 390 men) aged 65 years and above from two population-based studies, the EUREYE-Spain study and the Valencia Nutritional Survey (VNS). SRH was assessed at baseline using a single question which is widely used in epidemiological studies: “Overall, how would you consider your health at present?” and the response options were: 1. Very good, 2. Good, 3. Fair, 4. Poor, 5. Very poor. Deaths were ascertained during a 12-year follow-up period, and we used Cox proportional hazards regression models to obtain adjusted hazard ratios (HR).

Results
During the 12 years of follow-up (8566.2 person-years), we observed 400 deaths, 158 (39.5%) due to CVD and 89 (22.3%) due to cancer. Fair and poor/very poor SRH were significantly associated with higher all-cause mortality after 12-years of follow-up, HR = 1.29 (95% CI, 1.03–1.61) and HR 1.53 (95% CI, 1.09–2.15), respectively. We observed evidence of higher CVD mortality among those who reported fair and poor/very poor SRH, although the association was attenuated and lost statistical significance in the fully adjusted models.

Conclusion
This study suggests that a poor SRH status is associated with a higher all-cause mortality risk among older adults in Spain. Checking SHR status may be useful to plan health care in older adults.
Key risk factors for substance use among female sex workers in Soweto and Klerksdorp, South Africa: A cross-sectional study
Authors: Yeo Ellis Jaewon , Hlongwane Khuthadzo , Otwombe Kennedy , Hopkins Kathryn L. , Variava Ebrahim , Martinson Neil , Strathdee Steffanie A. , Coetzee Jenny , Milovanovic Minja 
Published: January 2022

Introduction
Sex workers in South Africa experience high levels of trauma and mental health issues, but little is known about their drug and alcohol use. This study assessed the prevalence of substance use and its key risk factors amongst female sex workers (FSWs) at two sites in South Africa.

Methods
Two cross-sectional studies were conducted, in Soweto and Klerksdorp, South Africa. Using respondent-driven sampling (RDS) 508 FSWs in Soweto and 156 in Klerksdorp were enrolled. A study-specific survey was used to collect social and demographic information, substance use, mental ill-health, and HIV status. Raw and RDS-adjusted data were analyzed using Chi-squared tests of association. Weighted and unweighted Poisson regression models were used to assess key risk factors for alcohol and drug use at both univariate and multivariate levels.

Results
Of the 664 FSWs, 56.2% were binge drinkers and 29.4% reported using drugs within the last year. Living in a home with regular food (RR: 1.2597, 95% CI: 1.1009–1.4413) and being HIV positive (RR: 1.1678, 95% CI: 1.0227–1.3334) were associated with a higher risk of binge drinking. Having symptoms suggestive of post-traumatic stress disorder (RR: 1.1803, 95% CI: 1.0025–1.3895) and past year physical/sexual abuse from either intimate (RR: 1.3648, 95% CI: 1.1522–1.6167) or non-intimate partners (RR: 1.3910, 95% CI: 1.1793–1.6407) were associated with a higher risk of drug use.

Discussion
In conclusion, our findings demonstrate a high prevalence of alcohol and drug use among FSWs in Soweto and Klerksdorp with site-specific contextual dynamics driving substance use. Site differences highlight the importance of tailoring site-specific substance use harm mitigation for this key population.
Development and Validation of Clinical Diagnostic Model for Girls with Central Precocious Puberty: Machine-learning Approaches
Authors: Huynh Quynh Thi Vu , Le Nguyen Quoc Khanh , Huang Shih-Yi , Ho Ban Tran , Vu Tru Huy , Pham Hong Thi Minh , Pham An Le , Hou Jia-Woei , Nguyen Ngan Thi Kim , Chen Yang Ching 
Published: January 2022

Background
A brief gonadotropin-releasing hormone analogues (GnRHa) stimulation test which solely focused on LH 30-minute post-stimulation was considered to identify girls with central precocious puberty (CPP). However, it was tested using traditional statistical methods. With advanced computer science, we aimed to develop a machine learning-based diagnostic model that processed baseline CPP-related variables and a brief GnRHa stimulation test for CPP diagnosis.

Methods
We recruited girls suspected of precocious puberty and underwent a GnRHa stimulation test at Children Hospital 2, Vietnam, and Cathay General Hospital, Taiwan. Clinical data, bone age measurement, and 30-min post-stimulation blood test were used to build up the predictive model. The candidate model was developed by different machine learning algorithms that were mainly evaluated by sensitivity, specificity, the area under the receiver operator characteristic curve (AUC), and F1-score in internal and external validation data to classify girls as CPP and non-CPP at different time-points (0-min, 30-min, 60-min, and 120-min post-stimulation).

Results
Among the 614 girls diagnosed with PP, 524 (85.3%) had CPP. The random forest algorithm yielded the highest value of F1-score (0.976), specificity (0.893), positive predicted value (0.987), and relatively high value of AUC (0.972) that contributed to high probability to identify CPP. The performance metrics of the 30-min post-stimulation diagnostic model including sensitivity and specificity surpassed those of the 0-minute model (0-min) and were equivalent to those of the model obtained 60-min and 120-min post-stimulation. Hence, our machine learning-based model helps shorten the stimulation test to 30 minutes after GnRHa injection, in general, it requires 120 minutes for a completed GnRHa stimulation test.

Conclusions
We developed a diagnostic model based on clinical features and a single sample 30-minute post-stimulation to identify CPP in girls that can reduce distress for children caused by multiple blood samplings.
The acceptability of delayed consent for prehospital emergency care research in the Western Cape province of South Africa
Authors: Stassen Willem , Rambharose Sanjeev , Wallis Lee , Moodley Keymanthri 
Published: January 2022

Background
Informed consent is an essential prerequisite for enrolling patients into a study. Obtaining informed consent in an emergency is complex and often impossible. Delayed consent has been suggested for emergency care research. This study aims to determine the acceptability of prehospital emergency care research with delayed consent in the Western Cape community of South Africa.

Methods
This study was an online survey of a stratified, representative sample of community members in the Western Cape province of South Africa. We calculated a powered sample size to be 385, and a stratified sampling method was employed. The survey was based on similar studies and piloted. Data were analysed descriptively.

Results
A total of 807 surveys were returned. Most respondents felt that enrolment into prehospital research would be acceptable if it offered direct benefit to them (n = 455; 68%) or if their condition was life-threatening and the research would identify improved treatment for future patients with a similar condition (n = 474; 70%). Similar results were appreciable when asked about the participation of their family member (n = 445; 66%) or their child (n = 422; 62%) regarding direct prospects of benefit. Overwhelmingly, respondents indicated that they would prefer to be informed of their own (n = 590; 85%), their family member’s (n = 593; 84%) or their child’s (n = 587; 86%) participation in a study immediately or as soon as possible. Only 35% (n = 283) agreed to retention data of deceased patients without the next of kin’s consent.

Conclusion
We report majority agreement of respondents for emergency care research with delayed consent if the interventions offered direct benefit to the research participant, if the participant’s condition was life-threatening and the work held the prospect of benefit for future patients, and if the protocol for delayed consent was approved by a human research ethics committee. These results should be explored using qualitative methods.
Patient perspectives of the Self-management and Educational Technology tool for Atrial Fibrillation (SETAF): A mixed-methods study in Singapore
Authors: Nathania Jennifer , Woo Brigitte Fong Yeong , Cher Boon Piang , Toh Kai Yee , Chia Wei-Yan Aloysius , Lim Yee Wei , Vrijhoef Hubertus J. M. , Lim Toon Wei 
Published: January 2022

Background
Atrial fibrillation (AF) is the most common arrythmia and is associated with costly morbidity such as stroke and heart failure. Mobile health (mHealth) has potential to help bridge the gaps of traditional healthcare models that may be poorly suited to the sporadic nature of AF. The Self-management and Educational technology support Tool for AF patients (SETAF) was designed based on the preferences and needs of AF patients but more study is required to assess the acceptance of this novel tool.

Objective
Explore the usability and acceptance of SETAF among AF patients in Singapore.

Methods
A mixed methods study was conducted with AF patients who were purposively sampled from an outpatient cardiology clinic in Singapore. After 6 weeks of using SETAF, semi-structured interviews were performed, and data were analyzed inductively following a thematic analysis approach. Results from a short 4-item survey and application usage data were also analyzed descriptively. Both qualitative and quantitative results were organized and presented following the Technology Acceptance Model (TAM) framework.

Results
A total of 37 patients participated in the study and 19 were interviewed. Participants perceived SETAF as useful for improving AF knowledge, self-management and access to healthcare providers and was easy to use due to the guided tutorial and user-friendly interface. They also identified the need for better personalization of content, psychosocial support features and reduction of language barriers. Application usage data revealed preference for AF related content and decreased interaction with the motivational message component of SETAF over time. Overall, most of the participants would continue using SETAF and were willing to pay for it.

Conclusions
AF patients in Singapore found SETAF useful and acceptable as a tool for AF management. The insights from this study not only support the potential of mHealth but may also inform the design and implementation of future mHealth tools for AF patients.
TGF-β1 in plasma and cerebrospinal fluid can be used as a biological indicator of chronic pain in patients with osteoarthritis
Authors: Liu Yen-Chin , Hsiao Hung-Tsung , Wang Jeffrey Chi-Fei , Wen Tzu-Cheng , Chen Shiou-Lan 
Published: January 2022

Introduction
Previous studies have demonstrated that cytokines, transforming growth factor (TGF-β1), and brain-derived neurotrophic factor (BDNF) can impact the intensity of pain in rodents. However, the roles of cytokines, TGF-β1 and BDNF in humans with chronic pain in osteoarthritis remains unclear, and no comparison between plasma and central cerebral spinal fluid (CSF) has been conducted.

Methods
Patients with osteoarthritis who were scheduled to receive spinal anesthesia were enrolled. The intensity of pain was evaluated with a visual analogue scale (VAS). In addition, patients with genitourinary system (GU) diseases and without obvious pain (VAS 0–1) were included as a comparison (control) group. The levels of TGF-β1, BDNF, tumor necrosis factor-α (TNF-α), and interleukin (IL)-8 within the CSF and plasma were collected and evaluated before surgery.

Results
The plasma and CSF TGF-β1 levels were significantly lower in the osteoarthritis patients with pain (VAS ≥ 3) than in the GU control patients. Downregulation of plasma BDNF was also found in osteoarthritis patients with pain. The Spearman correlation analysis showed that the VAS pain scores were significantly negatively correlated with the levels of TGF-β1 in the CSF of patients with osteoarthritis. However, there was no significant correlations between the pain scores and the levels of BDNF, TNF-α, and IL-8 in either the CSF or plasma.

Conclusions
TGF-β1 but not BDNF, TNF-α, or IL-8 may be an important biological indicator in the CSF of osteoarthritis patients with chronic pain.
How informative were early SARS-CoV-2 treatment and prevention trials? a longitudinal cohort analysis of trials registered on ClinicalTrials.gov
Authors: Hutchinson Nora , Klas Katarzyna , Carlisle Benjamin G. , Kimmelman Jonathan , Waligora Marcin 
Published: January 2022

BackgroundEarly in the SARS-CoV-2 pandemic, commentators warned that some COVID trials were inadequately conceived, designed and reported. Here, we retrospectively assess the prevalence of informative COVID trials launched in the first 6 months of the pandemic.MethodsBased on prespecified eligibility criteria, we created a cohort of Phase 1/2, Phase 2, Phase 2/3 and Phase 3 SARS-CoV-2 treatment and prevention efficacy trials that were initiated from 2020-01-01 to 2020-06-30 using ClinicalTrials.gov registration records. We excluded trials evaluating behavioural interventions and natural products, which are not regulated by the U.S. Food and Drug Administration (FDA). We evaluated trials on 3 criteria of informativeness: potential redundancy (comparing trial phase, type, patient-participant characteristics, treatment regimen, comparator arms and primary outcome), trials design (according to the recommendations set-out in the May 2020 FDA guidance document on SARS-CoV-2 treatment and prevention trials) and feasibility of patient-participant recruitment (based on timeliness and success of recruitment).ResultsWe included all 500 eligible trials in our cohort, 58% of which were Phase 2 and 84.8% were directed towards the treatment of SARS-CoV-2. Close to one third of trials met all three criteria and were deemed informative (29.9% (95% Confidence Interval 23.7–36.9)). The proportion of potentially redundant trials in our cohort was 4.1%. Over half of the trials in our cohort (56.2%) did not meet our criteria for high quality trial design. The proportion of trials with infeasible patient-participant recruitment was 22.6%.ConclusionsLess than one third of COVID-19 trials registered on ClinicalTrials.gov during the first six months met all three criteria for informativeness. Shortcomings in trial design, recruitment feasibility and redundancy reflect longstanding weaknesses in the clinical research enterprise that were likely amplified by the exceptional circumstances of a pandemic.
Wading through Molasses: A qualitative examination of the experiences, perceptions, attitudes, and knowledge of Australian medical practitioners regarding medical billing
Authors: Faux Margaret , Adams Jon , Dahiya Simran , Wardle Jon 
Published: January 2022

Background
Medical billing errors and fraud have been described as one of the last “great unreduced healthcare costs,” with some commentators suggesting measurable average losses from this phenomenon are 7% of total health expenditure. In Australia, it has been estimated that leakage from Medicare caused by non-compliant medical billing may be 10–15% of the scheme’s total cost. Despite a growing body of international research, mostly from the U.S, suggesting that rather than deliberately abusing the health financing systems they operate within, medical practitioners may be struggling to understand complex and highly interpretive medical billing rules, there is a lack of research in this area in Australia. The aim of this study was to address this research gap by examining the experiences of medical practitioners through the first qualitative study undertaken in Australia, which may have relevance in multiple jurisdictions.

Method
This study interviewed 27 specialist and general medical practitioners who claim Medicare reimbursements in their daily practice. Interviews were recorded, transcribed, and analysed using thematic analysis.

Results
The qualitative data revealed five themes including inadequate induction, poor legal literacy, absence of reliable advice and support, fear and deference, and unmet opportunities for improvement.

Conclusion
The qualitative data presented in this study suggest Australian medical practitioners are ill-equipped to manage their Medicare compliance obligations, have low levels of legal literacy and desire education, clarity and certainty around complex billing standards and rules. Non-compliant medical billing under Australia’s Medicare scheme is a nuanced phenomenon that may be far more complex than previously thought and learnings from this study may offer important insights for other countries seeking solutions to the phenomenon of health system leakage. Strategies to address the barriers and deficiencies identified by participants in this study will require a multi-pronged approach. The data suggest that the current punitive system of ensuring compliance by Australian medical practitioners is not fit for purpose.