bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human assumed central sensitisation (HACS) in patients with chronic low back pain radiating to the leg (CLaSSICO study)
Authors: Schuttert Ingrid , Timmerman Hans , Groen Gerbrand J , Petersen Kristian Kjær , Arendt-Nielsen Lars , Wolff Andre P 
Published: January 2022

IntroductionPatients with chronic low back pain radiating to the leg (CLBPr) are sometimes referred to a specialised pain clinic for a precise diagnosis based, for example, on a diagnostic selective nerve root block. Possible interventions are therapeutic selective nerve root block or pulsed radiofrequency. Central pain sensitisation is not directly assessable in humans and therefore the term ‘human assumed central sensitisation’ (HACS) is proposed. The possible existence and degree of sensitisation associated with pain mechanisms assumed present in the human central nervous system, its role in the chronification of pain and its interaction with diagnostic and therapeutic interventions are largely unknown in patients with CLBPr. The aim of quantitative sensory testing (QST) is to estimate quantitatively the presence of HACS and accumulating evidence suggest that a subset of patients with CLBPr have facilitated responses to a range of QST tests.The aims of this study are to identify HACS in patients with CLBPr, to determine associations with the effect of selective nerve root blocks and compare outcomes of HACS in patients to healthy volunteers.Methods and analysisA prospective observational study including 50 patients with CLBPr. Measurements are performed before diagnostic and therapeutic nerve root block interventions and at 4 weeks follow-up. Data from patients will be compared with those of 50 sex-matched and age-matched healthy volunteers. The primary study parameters are the outcomes of QST and the Central Sensitisation Inventory. Statistical analyses to be performed will be analysis of variance.Ethics and disseminationThe Medical Research Ethics Committee of the University Medical Center Groningen, Groningen, the Netherlands, approved this study (dossier NL60439.042.17). The results will be disseminated via publications in peer-reviewed journals and at conferences.Trial registration numberNTR NL6765.
Understanding the cost of care of type 2 diabetes mellitus - a value measurement perspective
Authors: Doyle Gerardine Anne , O'Donnell Shane , Cullen Kate , Quigley Etáin , Gibney Sarah 
Published: January 2022

ObjectivesWe explore the cost of care of type 2 diabetes mellitus (T2DM) using time-driven activity-based costing (TDABC) and connect that cost to resulting patient health outcomes.DesignWe construct six care pathways varying from low-risk to high-risk patients over a 12-month cycle of care. We collect time, resource and cost data on activities in each care pathway and compute a time-driven estimate of cost. Use of patient outcome data highlights the health outcomes achieved.SettingPrimary, secondary and tertiary care.ParticipantsMedical staff involved in the care of patients with T2DM.Primary and secondary measuresPrimary: resources consumed to provide T2DM care. Secondary: health outcomes for representative patient within each patient category.ResultsBy computing cost of T2DM care and associated complications of chronic kidney disease, active foot disease, moderate risk of active foot disease and myocardial infarction, we show that when patients develop acute complications, significant costs are incurred, as compared with the cost of maintaining a patient at low or moderate risk. Variance analysis further informs decision making by showing the need to have the right personnel doing the right tasks at the right time to control costs.ConclusionsA TDABC approach facilitates an understanding of the drivers of cost in chronic illness care. Our paper highlights the stages in the care pathway where different settings, decision making and a more optimal use of resources could assist with achievement of better patient outcomes.
Quantifying within-city inequalities in child mortality across neighbourhoods in Accra, Ghana: a Bayesian spatial analysis
Authors: Bixby Honor , Bennett James E , Bawah Ayaga A , Arku Raphael E , Annim Samuel K , Anum Jacqueline D , Mintah Samilia E , Schmidt Alexandra M , Agyei-Asabere Charles , Robinson Brian E , Cavanaugh Alicia , Agyei-Mensah Samuel , Owusu George , Ezzati Majid , Baumgartner Jill 
Published: January 2022

ObjectiveCountries in sub-Saharan Africa suffer the highest rates of child mortality worldwide. Urban areas tend to have lower mortality than rural areas, but these comparisons likely mask large within-city inequalities. We aimed to estimate rates of under-five mortality (U5M) at the neighbourhood level for Ghana’s Greater Accra Metropolitan Area (GAMA) and measure the extent of intraurban inequalities.MethodsWe accessed data on >700 000 women aged 25–49 years living in GAMA using the most recent Ghana census (2010). We summarised counts of child births and deaths by five-year age group of women and neighbourhood (n=406) and applied indirect demographic methods to convert the summaries to yearly probabilities of death before age five years. We fitted a Bayesian spatiotemporal model to the neighbourhood U5M probabilities to obtain estimates for the year 2010 and examined their correlations with indicators of neighbourhood living and socioeconomic conditions.ResultsU5M varied almost five-fold across neighbourhoods in GAMA in 2010, ranging from 28 (95% credible interval (CrI) 8 to 63) to 138 (95% CrI 111 to 167) deaths per 1000 live births. U5M was highest in neighbourhoods of the central urban core and industrial areas, with an average of 95 deaths per 1000 live births across these neighbourhoods. Peri-urban neighbourhoods performed better, on average, but rates varied more across neighbourhoods compared with neighbourhoods in the central urban areas. U5M was negatively correlated with multiple indicators of improved living and socioeconomic conditions among peri-urban neighbourhoods. Among urban neighbourhoods, correlations with these factors were weaker or, in some cases, reversed, including with median household consumption and women’s schooling.ConclusionReducing child mortality in high-burden urban neighbourhoods in GAMA, where a substantial portion of the urban population resides, should be prioritised as part of continued efforts to meet the Sustainable Development Goal national target of less than 25 deaths per 1000 live births.
User interface approaches implemented with automated patient deterioration surveillance tools: protocol for a scoping review
Authors: Wan Yik-Ki Jacob , Del Fiol Guilherme , McFarland Mary M , Wright Melanie C 
Published: January 2022

IntroductionEarly identification of patients who may suffer from unexpected adverse events (eg, sepsis, sudden cardiac arrest) gives bedside staff valuable lead time to care for these patients appropriately. Consequently, many machine learning algorithms have been developed to predict adverse events. However, little research focuses on how these systems are implemented and how system design impacts clinicians’ decisions or patient outcomes. This protocol outlines the steps to review the designs of these tools.Methods and analysisWe will use scoping review methods to explore how tools that leverage machine learning algorithms in predicting adverse events are designed to integrate into clinical practice. We will explore the types of user interfaces deployed, what information is displayed, and how clinical workflows are supported. Electronic sources include Medline, Embase, CINAHL Complete, Cochrane Library (including CENTRAL), and IEEE Xplore from 1 January 2009 to present. We will only review primary research articles that report findings from the implementation of patient deterioration surveillance tools for hospital clinicians. The articles must also include a description of the tool’s user interface. Since our primary focus is on how the user interacts with automated tools driven by machine learning algorithms, electronic tools that do not extract data from clinical data documentation or recording systems such as an EHR or patient monitor, or otherwise require manual entry, will be excluded. Similarly, tools that do not synthesise information from more than one data variable will also be excluded. This review will be limited to English-language articles. Two reviewers will review the articles and extract the data. Findings from both researchers will be compared with minimise bias. The results will be quantified, synthesised and presented using appropriate formats.Ethics and disseminationEthics review is not required for this scoping review. Findings will be disseminated through peer-reviewed publications.
Emergency department use for mental and substance use disorders: descriptive analysis of population-based, linked administrative data in British Columbia, Canada
Authors: Lavergne M Ruth , Shirmaleki Mehdi , Loyal Jackson P , Jones Wayne , Nicholls Tonia L , Schütz Christian G , Vaughan Adam , Samji Hasina , Puyat Joseph H , Kaoser Ridhwana , Kaulius Megan , Small Will 
Published: January 2022

ObjectivesInformation on emergency department (ED) visits for mental and substance use disorders (MSUDs) is important for planning services but has not been explored in British Columbia (BC), Canada. We describe all MSUD ED visits for people ages 15 and older in the province of BC in 2017/2018 and document trends in MSUD ED visits between 2007/2008 and 2017/2018 by disorder group.DesignPopulation-based linked administrative data comprised of ED records and physician billings capturing all MSUD ED visits in BC.SettingBC is Canada’s westernmost province with a population of approximately 5 million. Permanent residents receive first-dollar coverage for all medically necessary services provided by licensed physicians or in hospitals, including ED services.PopulationAll people age >15 with MSUD ED visits during the study period.MeasuresAll claims with a service location in the ED or corresponding to fee items billed only in the ED were examined alongside ED visits reported through a national reporting system. Patient characteristics (sex/gender, age, location of residence, income, treated disorders and comorbidities) and previous outpatient service use for all ED visits by visit diagnosis are also described.ResultsA total of 72 363 people made 134 063 visits to the ED in 2017/2018 for needs related to MSUD. MSUD ED visits have increased since 2010, particularly visits for substance use and anxiety disorders. People with more frequent visits were more likely to be male, on public prescription drug plans for income assistance, prescribed psychiatric medications, and living in lower-income neighbourhoods. They used more community-based primary care and psychiatry services and had lower continuity of primary care.ConclusionsMSUD ED visits are substantial and growing in BC. Findings underscore a need to strengthen and target community healthcare services and adequately resource and support EDs to manage growing patient populations.
Clinical Utility of Reflex Testing with Cancer Biomarkers to Improve Diagnostic Accuracy of Primary Human Papillomavirus Screening
Authors: Johnson Lauren G. , Saidu Rakiya , Svanholm-Barrie Cecilia , Boa Rosalind , Moodley Jennifer , Tergas Ana , Persing David , Campbell Scott A. , Tsai Wei-Yann , Wright Thomas C. , Denny Lynette , Kuhn Louise 
Published: January 2022

Abstract

Background:
Human papillomavirus (HPV) testing is the cornerstone of cervical cancer screening, with outstanding sensitivity but only moderate specificity. We evaluated whether reflex testing for cancer biomarkers improves the sensitivity/specificity balance of screening.

Methods:
Cervical samples from women in Cape Town, South Africa, ages 30–65 years, were collected and tested with Xpert HPV and with real-time PCR to detect mRNA for cyclin-dependent kinase inhibitor 2A (CDKN2A), topoisomerase 2 alpha (TOP2A), and Ki67 (MKi67). Women with histologically confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+; 85 women without and 166 with HIV) and women with no cervical disease (331 without and 257 with HIV) were included.

Results:
When used as reflex tests after a positive HPV result, biomarkers discriminated well between women with and without CIN2+. The inclusion of both CDKN2A and MKi67 had the best performance, with area under the curve (AUC) of 0.9171 and 0.8734 in women without and with HIV, respectively. Although excellent, these performance parameters did not improve on an approach utilizing only HPV testing with more stringent cycle threshold cutoffs and HPV genotype selection, which achieved AUC of 0.9059 and 0.8705 in women without and with HIV, respectively.

Conclusions:
Biomarkers can be used as triage after positive HPV results but do not outperform an approach utilizing higher viral load cutoffs on selected high-risk genotypes.

Impact:
A screening approach using HPV testing alone can be more easily implemented at the point of care.
Progress in Transplants for Acute Lymphoblastic Leukemia
Authors: Gale Robert Peter 
Published: January 2022

SummaryHematopoietic cell transplants are used to treat some adults with acute lymphoblastic leukemia, especially those with high-risk features, such as those with BCR::ABL1. This strategy may be changing given the safety and efficacy of modern tyrosine kinase inhibitors. Although these transplants are often successful, leukemia relapse remains the dominant cause of transplant failure. There are several approaches to this problem discussed by the authors of a recent article in the journal. The good news is therapy of recurrent leukemia posttransplant seems increasingly successful and for diverse reasons, survival is increasing substantially.See related article by Bazarbachi et al., p. 1004
Disturbance of Mangrove Forest Due To Climate Change: The Prospects of Sundarban
Authors: Gupta Shimul 
Published: January 2022

Mangrove forest has a significant importance in protecting natural disaster, environmental sustainability and in local economy. In Bangladesh, only mangrove forest Sundarban also servicing for environmental sustainability, protecting tropical cyclone, local employment generation and so on. Thus, its natural properties are being hampered through people involvement and natural calamities. Moreover, Rapid population growth and climate change stimulating these disturbances of natural properties of Sundarbans. This paper aim at how climate change is disturbing mangrove forest in Bangladesh and how this disturbance may be threatful for future environmental sustainability. Interrelation between climate change and disturbance of Sundarbans has been established through various exiting literature review and for quantifying the amount of disturbance remote sensing data has been applied and future threat of environmental sustainability has been assessed by comparing regeneration capacity of Sundarban after a tropical cyclone and amount of disturbance by a tropical cyclone. Result found that climate change increasing the frequency of natural calamities and affecting significantly on mangrove forest due to its complex bio-diversity and strategic location before regeneration of disturbance. On the other hand, threat of mangroves as well as environment is associated with temperature rising, ice melting and sea level rising are increasing because of frequent occurrence, magnitude as comparing with regeneration capacity.
Experience of Science Teachers in Practicing Rewards System to Increase Students’ Participation in Class
Authors: Tolero Josue A. , Tabile Delyn O. , Achacoso Jal M. 
Published: January 2022

The study aimed to determine the Experience of Science teachers’ in practicing rewards system to increase student’s participation in class. A qualitative - phenomenology research design was adopted in this study. Interview guide question was used to examine the Experience of Science teachers’ in practicing rewards system to increase student’s participation in class. Data was collected through an interview. Total of 10 teachers were selected as a sample from 8 secondary schools in the Botolan District. The results of this study showed that reward system is effective in the performance of the students and encouragement to give the students good motivation in the learning process. Most of the participant find the rewards system as an effective tool in increasing student’s participation. Recognition such as giving praise and compliments is the usual form of rewards given by the teacher. In addition to extra grades, scores and test or homework exemptions. Preferred rewards of the teachers aside from giving praise and additional grades, are useful rewards such as school supplies, candies, and other food treats. Effective motivation of the student’s in participating in learning activities is the foreseen effects of rewards system.
Endothelial Tyrosine Kinase Tie1 Is Required for Normal Schlemm’s Canal Development—Brief Report
Authors: Du Jing , Thomson Benjamin R. , Onay Tuncer , Quaggin Susan E. 
Published: January 2022

Background:
Schlemm’s canal (SC) is a large vessel residing in the iridocorneal angle and is required to regulate aqueous humor outflow. Normal SC structure and function is indispensable for maintaining normal intraocular pressure, and elevated intraocular pressure is a risk factor for development of glaucoma. Recent reports have identified a key role of the angiopoietin-Tie2 pathway for SC development and function; however, the role of the orphan receptor Tie1 has not been clarified.

Methods:
We used Tie1 knock out mice to study the function of Tie1 in SC development and function. Real-time quantitative polymerase chain reaction and Western blot analyses were used to verify Tie1 deletion. High-resolution microscopy of mouse SC whole mount and cross sections were used to study SC morphology. Measurement of intraocular pressure in live mice was used to study the impact of Tie1 on SC function.

Results:
Tie1 is highly expressed in both human and mouse SC. Tie1 knock out mice display hypomorphic SC and elevated intraocular pressure as a result of attenuated SC development.

Conclusions:
Tie1 is indispensable for SC development and function, supporting it as a novel target for future SC-targeted glaucoma therapies and a candidate gene for glaucoma in humans.
Carotid Artery Stiffness Mechanisms Associated With Cardiovascular Disease Events and Incident Hypertension: the Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Pewowaruk Ryan J. , Korcarz Claudia , Tedla Yacob , Burke Gregory , Greenland Philip , Wu Colin , Gepner Adam D. 
Published: January 2022

Background:
Elastic arteries stiffen via 2 main mechanisms: (1) load-dependent stiffening from higher blood pressure and (2) structural stiffening due to changes in the vessel wall. It is unknown how these different mechanisms contribute to incident cardiovascular disease (CVD) events.

Methods:
The MESA (Multi-Ethnic Study of Atherosclerosis) is a longitudinal study of 6814 men and women without CVD at enrollment, from 6 communities in the United States. MESA participants with B-mode carotid ultrasound and brachial blood pressure at baseline Exam in (2000–2002) and CVD surveillance (mean follow-up 14.3 years through 2018) were included (n=5873). Peterson’s elastic modulus was calculated to represent total arterial stiffness. Structural stiffness was calculated by adjusting Peterson’s elastic modulus to a standard blood pressure of 120/80 mm Hg with participant-specific models. Load-dependent stiffness was the difference between total and structural stiffness.

Results:

In Cox models adjusted for traditional risk factors, load-dependent stiffness was significantly associated with higher incidence of CVD events (hazard ratio/100 mm Hg, 1.21 [95% CI, 1.09–1.34]
P
<0.001) events while higher structural stiffness was not (hazard ratio, 1.03 [95% CI, 0.99–1.07]
P
=0.10). Analysis of participants who were normotensive (blood pressure <130/80, no antihypertensives) at baseline exam (n=2122) found higher load-dependent stiffness was also associated with significantly higher incidence of hypertension (hazard ratio, 1.53 [95% CI, 1.35–1.75]
P
<0.001) while higher structural stiffness was not (hazard ratio, 1.03 [95% CI, 0.99–1.07]
P
=0.16).

Conclusions:
These results provide valuable new insights into mechanisms underlying the association between arterial stiffness and CVD. Load-dependent stiffness was significantly associated with CVD events but structural stiffness was not.
Respective Mediating Effects of Social Position and Work Environment on the Incidence of Common Cardiovascular Risk Factors
Authors: Hoertel Nicolas , Sanchez Rico Marina , Limosin Frédéric , Ménard Joël , Ribet Céline , Bonenfant Sébastien , Goldberg Marcel , Zins Marie , Meneton Pierre 
Published: January 2022

Background
Social position and work environment are highly interrelated and their respective contribution to cardiovascular risk is still debated.

Methods and Results
In a cohort of 20 625 French workers followed for 25 years, discrete‐time survival analysis with reciprocal mediating effects, adjusted for sex, age, and parental history of early coronary heart disease, was performed using Bayesian structural equation modeling to simultaneously investigate the extent to which social position mediates the effect of work environment and, inversely, the extent to which work environment mediates the effect of social position on the incidence of common cardiovascular risk factors. Depending on the factor, social position mediates 2% to 53% of the effect of work environment and work environment mediates 9% to 87% of the effect of social position. The mediation by work environment is larger than that by social position for the incidence of obesity, hypertension, dyslipidemia, diabetes, sleep complaints, and depression (mediation ratios 1.32–41.5, 6.67 when modeling the 6 factors together). In contrast, the mediation by social position is larger than that by work environment for the incidence of nonmoderate alcohol consumption, smoking, and leisure‐time physical inactivity (mediation ratios 0.16–0.69, 0.26 when modeling the 3 factors together).

Conclusions
The incidence of behavioral risk factors seems strongly dependent on social position whereas that of clinical risk factors seems closely related to work environment, suggesting that preventive strategies should be based on education and general practice for the former and on work organization and occupational medicine for the latter.