bluuebunny/crossref_metadata_2025_split huggingface dataset:
An implementation framework and a feasibility evaluation of a clinical decision support system for diabetes management in secondary mental healthcare using CogStack
Authors: Patel Dipen , Msosa Yamiko J , Wang Tao , Mustafa Omar G , Gee Siobhan , Williams Julie , Roberts Angus , Dobson Richard JB , Gaughran Fiona 
Published: April 2022

Abstract
Background
Improvements to the primary prevention of physical health illnesses like diabetes in the general population have not been mirrored to the same extent in people with serious mental illness (SMI). This work evaluates the technical feasibility of implementing an electronic clinical decision support system (eCDSS) for supporting the management of dysglycaemia and diabetes in patients with serious mental illness in a secondary mental healthcare setting.

Methods
A stepwise approach was taken as an overarching and guiding framework for this work. Participatory methods were employed to design and deploy a monitoring and alerting eCDSS. The eCDSS was evaluated for its technical feasibility. The initial part of the feasibility evaluation was conducted in an outpatient community mental health team. Thereafter, the evaluation of the eCDSS progressed to a more in-depth in silico validation.

Results
A digital health intervention that enables monitoring and alerting of at-risk patients based on an approved diabetes management guideline was developed. The eCDSS generated alerts according to expected standards and in line with clinical guideline recommendations.

Conclusions
It is feasible to design and deploy a functional monitoring and alerting eCDSS in secondary mental healthcare. Further work is required in order to fully evaluate the integration of the eCDSS into routine clinical workflows. By describing and sharing the steps that were and will be taken from concept to clinical testing, useful insights could be provided to teams that are interested in building similar digital health interventions.
Ranked determinants of telemedicine diabetic retinopathy screening performance in the United States primary care safety-net setting: an exploratory CART analysis
Authors: Ware S. Lee , Studts Christina R. , Lei Feitong , Bush Heather , Higgins Eric B. , Studts Jamie L. , Bastos de Carvalho Ana 
Published: April 2022

Abstract
Background
Diabetic retinopathy (DR) is a leading cause of blindness worldwide, despite easy detection and effective treatment. Annual screening rates in the USA remain low, especially for the disadvantaged, which telemedicine-based DR screening (TDRS) during routine primary care has been shown to improve. Screening rates from such programs have varied, however, pointing to inconsistent implementation and unaddressed barriers. This work seeks to identify and prioritize modifiable barriers for targeted intervention.

Methods
In this final phase of an exploratory mixed-methods study, we developed, validated, and administered a 62-item survey to multilevel stakeholders involved with TDRS in primary care safety-net clinics. Survey items were aligned with previously identified determinants of clinic-level screening and mapped to the Consolidated Framework for Implementation Research (CFIR). Classification and Regression Tree (CART) analyses were used to identify and rank independent variables predictive of individual-level TDRS screening performance.

Results
Overall, 133 of the 341 invited professionals responded (39%), representing 20 safety-net clinics across 6 clinical systems. Respondents were predominately non-Hispanic White (77%), female (94%), and between 31 and 65 years of age (79%). Satisfaction with TDRS was high despite low self-reported screening rates. The most important screening determinants were: provider reinforcement of TDRS importance; explicit instructions by providers to staff; effective reminders; standing orders; high relative priority among routine diabetic measures; established TDRS workflows; performance feedback; effective TDRS champions; and leadership support.

Conclusions
In this survey of stakeholders involved with TDRS in safety-net clinics, screening was low despite high satisfaction with the intervention. The best predictors of screening performance mapped to the CFIR constructs Leadership Engagement, Compatibility, Goals & Feedback, Relative Priority, Champions, and Available Resources. These findings facilitate the prioritization of implementation strategies targeting determinants of TDRS performance, potentially increasing its public health impact.
Rapidly improving acute respiratory distress syndrome in COVID-19: a multi-centre observational study
Authors: Gavrielatou Evdokia , Vaporidi Katerina , Tsolaki Vasiliki , Tserlikakis Nikos , Zakynthinos George E. , Papoutsi Eleni , Maragkuti Aikaterini , Mantelou Athina G. , Karayiannis Dimitrios , Mastora Zafeiria , Georgopoulos Dimitris , Zakynthinos Epaminondas , Routsi Christina , Zakynthinos Spyros G. , Schenck Edward J. , Kotanidou Anastasia , Siempos Ilias I. 
Published: April 2022

AbstractBackgroundBefore the pandemic of coronavirus disease (COVID-19), rapidly improving acute respiratory distress syndrome (ARDS), mostly defined by early extubation, had been recognized as an increasingly prevalent subphenotype (making up 15–24% of all ARDS cases), associated with good prognosis (10% mortality in ARDSNet trials). We attempted to determine the prevalence and prognosis of rapidly improving ARDS and of persistent severe ARDS related to COVID-19.MethodsWe included consecutive patients with COVID-19 receiving invasive mechanical ventilation in three intensive care units (ICU) during the second pandemic wave in Greece. We defined rapidly improving ARDS as extubation or a partial pressure of arterial oxygen to fraction of inspired oxygen ratio (PaO2:FiO2) greater than 300 on the first day following intubation. We defined persistent severe ARDS as PaO2:FiO2 of equal to or less than 100 on the second day following intubation.ResultsA total of 280 intubated patients met criteria of ARDS with a median PaO2:FiO2 of 125.0 (interquartile range 93.0–161.0) on day of intubation, and overall ICU-mortality of 52.5% (ranging from 24.3 to 66.9% across the three participating sites). Prevalence of rapidly improving ARDS was 3.9% (11 of 280 patients); no extubation occurred on the first day following intubation. ICU-mortality of patients with rapidly improving ARDS was 54.5%. This low prevalence and high mortality rate of rapidly improving ARDS were consistent across participating sites. Prevalence of persistent severe ARDS was 12.1% and corresponding mortality was 82.4%.ConclusionsRapidly improving ARDS was not prevalent and was not associated with good prognosis among patients with COVID-19. This is starkly different from what has been previously reported for patients with ARDS not related to COVID-19. Our results on both rapidly improving ARDS and persistent severe ARDS may contribute to our understanding of trajectory of ARDS and its association with prognosis in patients with COVID-19.
Factors that influence scope of practice of the chiropractic profession in Australia: a scoping review
Authors: Wiggins Desmond , Downie Aron , Engel Roger , Brown Benjamin T. 
Published: April 2022

Abstract
Introduction
The World Health Organization describes chiropractic as a health profession that treats the musculoskeletal system and the effects of that system on the function of the nervous system and general health. Notwithstanding such descriptions, scope of practice remains a contentious issue in Australia chiropractic with various authors defining it differently. To date, the peak governing body, the Chiropractic Board of Australia, has focused on title protection rather than defining a scope of practice for the profession. A well-defined scope of practice is important, as it helps to identify what is acceptable in the profession and the role chiropractic has in the broader healthcare system.

Objective
The objective of this scoping review was to explore the literature on the factors that influence scope of practice of chiropractic in Australia.

Methods
This study employed scoping review methodology to document the current state of the literature on factors that influence scope of practice of the chiropractic profession in Australia.

Results
A total of 1270 articles were identified from the literature search. Six studies fulfilled the inclusion criteria and were included in the final analysis. Four factors that influence scope of practice were identified: education, professional identity, patient safety, and organisational structure.

Conclusion
The results of this study will inform future discussions around establishing a framework for a more comprehensive scope of practice for the chiropractic profession in Australia. Such a framework has the potential to benefit patient safety, professional identity, public perception, education, and regulation of the profession.
Closed-loop oxygen control improves oxygen therapy in acute hypoxemic respiratory failure patients under high flow nasal oxygen: a randomized cross-over study (the HILOOP study)
Authors: Roca Oriol , Caritg Oriol , Santafé Manel , Ramos Francisco J. , Pacheco Andrés , García-de-Acilu Marina , Ferrer Ricard , Schultz Marcus J. , Ricard Jean-Damien 
Published: April 2022

Abstract
Background
We aimed to assess the efficacy of a closed-loop oxygen control in critically ill patients with moderate to severe acute hypoxemic respiratory failure (AHRF) treated with high flow nasal oxygen (HFNO).

Methods
In this single-centre, single-blinded, randomized crossover study, adult patients with moderate to severe AHRF who were treated with HFNO (flow rate ≥ 40 L/min with FiO2 ≥ 0.30) were randomly assigned to start with a 4-h period of closed-loop oxygen control or 4-h period of manual oxygen titration, after which each patient was switched to the alternate therapy. The primary outcome was the percentage of time spent in the individualized optimal SpO2 range.

Results
Forty-five patients were included. Patients spent more time in the optimal SpO2 range with closed-loop oxygen control compared with manual titrations of oxygen (96.5 [93.5 to 98.9] % vs. 89 [77.4 to 95.9] %; p < 0.0001) (difference estimate, 10.4 (95% confidence interval 5.2 to 17.2). Patients spent less time in the suboptimal range during closed-loop oxygen control, both above and below the cut-offs of the optimal SpO2 range, and less time above the suboptimal range. Fewer number of manual adjustments per hour were needed with closed-loop oxygen control. The number of events of SpO2 < 88% and < 85% were not significantly different between groups.

Conclusions
Closed-loop oxygen control improves oxygen administration in patients with moderate-to-severe AHRF treated with HFNO, increasing the percentage of time in the optimal oxygenation range and decreasing the workload of healthcare personnel. These results are especially relevant in a context of limited oxygen supply and high medical demand, such as the COVID-19 pandemic.
Trial registration The HILOOP study was registered at www.clinicaltrials.gov under the identifier NCT04965844.
The impacts of COVID-19 on cattle traders and their response in agro-pastoral and pastoral regions in Uganda: A case of Karamoja and Teso cattle traders
Authors: Ilukor John , Joyce Akello , Okiror Simon Peter 
Published: April 2022

AbstractThe study assessed the economic impact of COVID-19 on cattle traders in the Karamoja and Teso pastoral and agro-pastoral areas in Uganda and their response after the COVID-19 lockdown in 2020. The results reveal that cattle traders were negatively affected by COVID-19 in many ways including reduction in cattle sales, erosion in operating capital, and failure to sell animals while others have diversified or moved to other businesses. Twenty-five per cent of the cattle traders did not sell any animal during the lockdown. A majority of these were from Karamoja (43%) compared to those in Teso sub-region. The decline in cattle sales was significantly higher in Karamoja than in Teso sub-region. However, their recovery was significantly higher in Karamoja than in Teso sub-region because traders in Teso greatly diversified to other economic activities compared to traders in Karamoja sub-region. The traders who lost capital were mainly in Teso sub-region (63%). As expected, there was a sharp decline in the number of cattle buyers from markets outside the study area, mainly from Juba, Kampala, Busia, and Kenya. Coping strategies by cattle traders included crop cultivation (80%), burning charcoal (15%), selling food items (8%), and boda-boda riding (12%), while others did not engage in any economic activity (25%). To mitigate against the pandemic, traders were observing some of the standard operating procedures (SOPs) such as wearing face masks (76.1%), handwashing (19.3%), sanitising (2.3%), and social distancing (2.3%). Traders from Karamoja performed poorly in both diversification and mitigation measures. Based on our findings, recommendations to mitigate the impact of COVID-19 on cattle traders include offering loans to cattle traders through their Village Savings and Loan Association (VSLA), reducing transaction costs, offering mobile phones especially for Karamoja traders, and promoting the adoption of enforcing SOPs to reduce the need for lockdowns and cattle market closures which are detrimental to pastoral livelihood.
Effects of wearing knee-guards on skin pressure and skin blood flow during dynamic motions
Authors: Baek Yoon Jeong , Ju Heeyoung , Lee Joo-Young , Oh Kyung Wha 
Published: April 2022

AbstractThe purpose of the present study was to explore the effects of wearing knee guards on skin blood flow and skin pressure during dynamic soccer motions. Twenty-one male subjects participated in the following two experimental conditions: wearing knee guards (KG) and no knee guards (Control). Subjects performed several consecutive soccer motions along with a standing position between each motion. Skin blood flow and skin pressure on the thigh, knee, and calf were monitored. The results showed that skin pressure had the greatest value in a sitting position for both the KG condition and Control, but the smallest during instep kicking and switching directions (P < 0.001). The rear calf had the greatest skin pressure for the KG condition (P < 0.001), while the side knee showed the greatest for the Control (P < 0.001). Normalized skin blood flow based on values from their standing position was the greatest during the jump motion among the various soccer motions. Interestingly, skin blood flow decreased by wearing the knee guards on the front thigh and calf (r = − 0.859; r = − 0.835; P < 0.001), while the blood flow increased on the side knee (r = 0.295, P < 0.001). Subjects felt greater skin pressure sensation during the jump motion and switching directions than other soccer positions/motions (P < 0.001). These results indicate that the knee guards result in relatively lighter pressure for dynamic motions (e.g., kick, switching directions, or jump) than for static positions (e.g., sitting or standing), and the skin blood flows for the thigh, knee, and calf are redistributed by wearing the knee guards, especially during jumping.
Coping styles to vitiate the risk of psychological morbidities among pre/para-clinical and clinical undergraduate medical students: a comparative cross-sectional study in India
Authors: Garg Sunny , Chauhan Alka , Sharma Devesh , Sharma Anchal , Singh Sanjeet 
Published: April 2022

AbstractBackgroundPsychological morbidities are high among undergraduate medical students. They experience the transition between pre/para-clinical and clinical training as a stressful period and cope differently. Research from India in this regard are lacking. The aim of this study is to assess and compare the prevalence of psychological morbidities, associated factors and coping styles between pre/para-clinical and clinical undergraduate medical students. This institution-based cross-sectional observational design study was conducted among pre/para-clinical and clinical group of undergraduate medical students (a total of 382) by using a questionnaire in the period between April and June 2021. Stratified random sampling technique was used to select the study participants. The survey included standard self-administered questionnaires like GHQ-28 and Lin-Chen’s coping inventory to assess psychological morbidities and coping styles, respectively. Associated factors for psychological morbidities, and coping styles between two groups, were compared using chi-square test, independentt-test and binary logistic regression analysis.ResultsOut of the 382 responders, psychological morbidities (GHQ-28 score > 23) were found in 61% participants. Both groups reported high level, a slightly higher preponderance in clinical (61.5%) than pre/para-clinical students (60.6%) and with nonsignificant difference of psychological morbidities. Compared to pre/para-clinical group, clinical group was found to have more substance consumption behavior (p< 0.001), dissatisfaction with academic performance (p< 0.001), sought psychiatric consultation (p< 0.004) and currently on psychiatric treatment (p< 0.04). Overall, coping was found to be average and good among the participants. Active problem coping behavior was more significantly used by pre/para-clinical group, while passive problem coping and passive emotional coping behaviors were positively significantly correlated with psychological morbidities in clinical group.ConclusionsThis study established a significant correlation between psychological morbidities and passive coping styles in clinical group. These students need interventions to encourage the use of more active coping styles during the training to provide advances in future career. A strong correlation with dissatisfied academic performance may be a call for an efficient and more student-friendly curriculum.
Improved Survival With Enzalutamide in Patients With Metastatic Hormone-Sensitive Prostate Cancer
Authors: Armstrong Andrew J. , Azad Arun A. , Iguchi Taro , Szmulewitz Russell Z. , Petrylak Daniel P. , Holzbeierlein Jeffrey , Villers Arnauld , Alcaraz Antonio , Alekseev Boris , Shore Neal D. , Gomez-Veiga Francisco , Rosbrook Brad , Zohren Fabian , Yamada Shunsuke , Haas Gabriel P. , Stenzl Arnulf 
Published: April 2022

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. In primary analysis, enzalutamide plus androgen deprivation therapy (ADT) improved radiographic progression-free survival (rPFS) in patients with metastatic hormone-sensitive prostate cancer (mHSPC); however, overall survival data were immature. In the phase III, double-blind, global ARCHES trial (ClinicalTrials.gov identifier: NCT02677896 ), 1,150 patients with mHSPC were randomly assigned 1:1 to enzalutamide (160 mg once daily) plus ADT or placebo plus ADT, stratified by disease volume and prior docetaxel use. Here, we report the final prespecified analysis of overall survival (key secondary end point) and an update on rPFS, other secondary end points, and safety. After unblinding, 180 (31.3%) progression-free patients randomly assigned to placebo plus ADT crossed over to open-label enzalutamide plus ADT. As of May 28, 2021 (median follow-up, 44.6 months), 154 of 574 patients randomly assigned to enzalutamide plus ADT and 202 of 576 patients randomly assigned to placebo plus ADT had died. Enzalutamide plus ADT reduced risk of death by 34% versus placebo plus ADT (median not reached in either group; hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P < .001). Enzalutamide plus ADT continued to improve rPFS and other secondary end points. Adverse events were generally consistent with previous reports of long-term enzalutamide use. In conclusion, enzalutamide plus ADT significantly prolongs survival versus placebo plus ADT in patients with mHSPC.
Metabolomic Profiling of Peripheral Plasma by GC-MS and Correlation With Size of Uterine Leiomyomas
Authors: Barison Gustavo Anderman Silva , D’Amora Paulo , Izidoro Mário Augusto , Corinti Mariana , Martins Luísa Marcella , Bonduki Claudio Emílio , Castro Rodrigo de Aquino , Girão Manoel João Batista Castello , Gomes Mariano Tamura Vieira 
Published: April 2022

Abstract

Background
Uterine leiomyomas are benign monoclonal tumors originating from the myometrium. Little information exists concerning metabolomics and the presence of leiomyomas.

Objective
The present study evaluated circulating metabolites in the plasma and their correlation with the presence and size of leiomyomas.

Study Design
Cross-sectional observational study, including women divided into 3 groups: 37 with leiomyomas and uterus &gt;500 cm3, 17 with leiomyomas and uterus ≤150 cm3, and 21 leiomyoma-free. Patients underwent peripheral blood collection using untargeted metabolic assessment by gas chromatography coupled to mass spectrometer.

Results
There was no statistical difference between patients’ anthropometric and demographic features and laboratory tests. Statistical differences in uterus volume (P &lt; 0.0001) were found. Forty-six metabolites were identified (35% amino acids and derivatives, 22% fatty acids, and 18% carbohydrates). Statistically significant metabolic distinction (P &lt; 0.05, false discovery rate&lt; 0.05) was observed for 14 metabolites. Most amino acids (L-isoleucine, L-valine, and pyroglutamic acid) were significantly reduced in plasma levels of patients with large leiomyomas. The only exception was L-glutamine, with a significant increase. Fatty acids (arachidonic acid, alfa-tocopherol, palmitic acid, and stearic acid) were similarly reduced in large leiomyomas patients, except for alpha-linolenic acid, which increased. For carbohydrates (myo-inositol, D-threitol, and D-ribose), there was a decrease in the plasma of patients with leiomyomas.

Conclusion
There are different plasma metabolites levels of amino acids, fatty acids, and carbohydrates among patients with leiomyomas, most of them reduced, but some significantly increased in large leiomyomas, compared to leiomyoma-free patients.
The GBA1 D409V mutation exacerbates synuclein pathology to differing extents in two alpha-synuclein models
Authors: Polinski Nicole K. , Martinez Terina N. , Ramboz Sylvie , Sasner Michael , Herberth Mark , Switzer Robert , Ahmad Syed O. , Pelligrino Lee J. , Clark Sean W. , Marcus Jacob N. , Smith Sean M. , Dave Kuldip D. , Frasier Mark A. 
Published: April 2022

ABSTRACT
Heterozygous mutations in the GBA1 gene – encoding lysosomal glucocerebrosidase (GCase) – are the most common genetic risk factors for Parkinson's disease (PD). Experimental evidence suggests a correlation between decreased GCase activity and accumulation of alpha-synuclein (aSyn). To enable a better understanding of the relationship between aSyn and GCase activity, we developed and characterized two mouse models that investigate aSyn pathology in the context of reduced GCase activity. The first model used constitutive overexpression of wild-type human aSyn in the context of the homozygous GCase activity-reducing D409V mutant form of GBA1. Although increased aSyn pathology and grip strength reductions were observed in this model, the nigrostriatal system remained largely intact. The second model involved injection of aSyn preformed fibrils (PFFs) into the striatum of the homozygous GBA1 D409V knock-in mouse model. The GBA1 D409V mutation did not exacerbate the pathology induced by aSyn PFF injection. This study sheds light on the relationship between aSyn and GCase in mouse models, highlighting the impact of model design on the ability to model a relationship between these proteins in PD-related pathology.