bluuebunny/crossref_metadata_2025 huggingface dataset:
Stimulating solidarity to improve knowledge on medications used during pregnancy
Authors: Hollestelle Marieke J , van der Graaf Rieke , Sturkenboom Miriam CJM , van Delden Johannes JM
Published: June 2023

Background

Pregnant people have been overlooked or excluded from clinical research, resulting in a lack of scientific knowledge on medication safety and efficacy during pregnancy. Thus far, both the opportunities to generate evidence-based knowledge beyond clinical trials and the role of pregnant people in changing their status quo have not been discussed. Some scholars have argued that for rare disease patients, for whom, just like pregnant people, a poor evidence base exists regarding treatments, solidarity has played an important role in addressing the evidence gap. This paper explores whether and how the enactment of solidarity among pregnant people can be stimulated to help address the poor evidence base on medications used during pregnancy.

Method

We use the concept of solidarity formulated by Prainsack and Buyx and enrich their concept by providing an account for stimulating the enactment of solidarity. Then we apply this account to the case of pregnant people who use medication.

Results

Solidarity means enacted commitment on the part of an individual to assisting others with whom the person recognizes a similarity in a relevant respect. Although solidarity cannot be imposed, we argue that the empowerment of people is a crucial concept in understanding how solidarity can be stimulated. Empowerment in the context of pregnant people means creating awareness about their status quo, explaining how scientific research can help close the knowledge gap, and how pregnant people can themselves contribute. In particular, how pregnant people can contribute to the collection of health data to strengthen the evidence base for medications used during pregnancy.

Conclusions

We conclude that acting in solidarity can help change the status quo for pregnant people. Furthermore, we argue that the empowerment of pregnant people and other relevant stakeholders is a way to stimulate the enactment of solidarity. The process of empowerment starts by raising awareness about the lack of evidence on medications used during prengnacy and by explaining to pregnant people how they can contribute to changing the way knowledge is being generated by, for example, sharing data on the health effects of medications.
Reimagining mental health care for newcomer children and families: a qualitative framework analysis of service provider perspectives
Authors: Sim Amanda , Ahmad Afreen , Hammad Lina , Shalaby Yasmine , Georgiades Katholiki
Published: June 2023

Background

Persistent disparities in access to mental health care for refugee and immigrant children and their families pose unique challenges to policy and practice. This study examined service provider perspectives on the barriers and opportunities for improving mental health supports for newcomer children and families in Canada.

Methods

Semi-structured individual and group interviews were conducted with 33 leadership and frontline staff from 14 organizations in the health, education, settlement, and social service sectors in Hamilton, Ontario. Interview data were analyzed using the framework method.

Results

Participants described barriers at the systems, provider, and individual and family levels that prevented newcomer families from accessing and benefiting from mental health supports. Structural barriers included inadequate services and funding, complexity of systems, cultural tensions, and, lack of prevention and early identification. Provider-level barriers included lack of representation, mental health knowledge and cultural competency, and staff shortages and burnout. Individual and family-level barriers included lack of mental health literacy, primacy of settlement needs, stigma, fear, and the high threshold for help-seeking. Participants’ recommendations for “reimagining care” related to newcomer engagement, person- and family-centered care, cultural responsiveness, mental health promotion and prevention, workforce diversity and development, collaborative and integrated care, and knowledge generation and uptake.

Conclusions

The intersection of structural, provider, and individual/family-level barriers reduce newcomer families’ access to and effectiveness of mental health supports. Reducing disparities in mental health and access to care will require a paradigm shift in the way that mental health care is conceptualized and delivered to newcomer children and families.
Burden and unmet need for specialist care in poorly controlled and severe childhood asthma in a Danish nationwide cohort
Authors: Håkansson Kjell Erik Julius , Guerrero Silvia Cabrera , Backer Vibeke , Ulrik Charlotte Suppli , Rastogi Deepa
Published: June 2023

Background

Asthma is a common disease in childhood and adolescence with lifelong consequences particularly among those at risk of severe disease, poor control and/or frequent exacerbations. Specialist care is recommended for at-risk children and adolescents, yet access to specialist management in free-to-access healthcare settings remains poorly understood.

Methods

A Danish nationwide cohort of children and adolescents aged 2–17 years with persistent asthma, defined as repeated redemption of inhaled corticosteroids (ICS) during 2015, were followed for two years, to identify at-risk children and adolescents comprising those with severe asthma (classified according to GINA 2020 guidelines), poor control (defined as use of 400/600 (ages 2–11/12 +) annual doses of short-acting bronchodilators), or frequent exacerbations (defined as use of oral steroids or hospitalization), and access to specialist care. The population is chosen due to detailed medical records in the setting of universal health care.

Results

The cohort comprised of 29,851 children and adolescents (59% boys), with a median age of 9 years. While 17% of children were on high dose ICS, 22% were on daily ICS below GINA low dose cut-off. Prevalence of severe asthma (3.0–6.5%) was lower than poor asthma control (6.4–25%); both declined from childhood to adolescence. Exacerbations occurred in 7.1–9.0% of children, with median number of exacerbations being 1 (IQR 1–1). Despite being classified as having mild-to-moderate asthma, 15% had poor asthma control and 3.8% experienced exacerbation(s), respectively. While 61% of children with severe asthma and 58% with exacerbation-prone disease were in specialist care, only 24% with uncontrolled disease were receiving specialist care. Of children and adolescents using high-dose ICS, 71% were managed in primary care, while the use of additional controllers was more common in specialist care.

Conclusions

Throughout childhood and adolescence, there was a high prevalence of severe asthma and poor control, although their prevalence declined with age. We demonstrate a large unmet need for specialist care among children with at-risk asthma, particularly among those with poorly controlled asthma, even in a system with free-to-access, tax-funded healthcare.
Promptness in seeking treatment from Village Health workers for children under five years with malaria, diarrhoea and pneumonia in rural southwestern Uganda
Authors: Mulogo Edgar , Baguma Stephen , Ntaro Moses , Bwambale Shem , Matte Michael , Wesuta Andrew , Ayebare David , Bagenda Fred , Kawungezi Peter
Published: June 2023

Background

Village Health Workers (VHWs) in Uganda provide treatment for the childhood illness of malaria, pneumonia, and diarrhoea through the integrated community case management (iCCM) strategy. Under the strategy children under five years receive treatment for these illnesses within 24 h of onset of illness. This study examined promptness in seeking treatment from VHWs by children under five years with malaria, pneumonia, and diarrhoea in rural southwestern Uganda.

Methods

In August 2022, a database containing information from the VHWs patient registers over a 5-year study period was reviewed (2014–2018). A total of 18,430 child records drawn from 8 villages of Bugoye sub-county, Kasese district were included in the study. Promptness was defined a caregiver seeking treatment for a child from a VHW within 24 h of onset of illness.

Results

Sixty-four percent (64%) of the children included in the study sought treatment promptly. Children with fever had the highest likelihood of seeking prompt treatment (aOR = 1.93, 95% CI 1.80–2.06, p < 0.001) as compared to those with diarrhoea (aOR = 1.43, 95% CI 1.32–1.52, p < 0.001) and pneumonia (aOR = 1.33, 95% CI 1.24–1.42, p < 0.001).

Conclusion

The findings provide further evidence that VHWs play a critical role in the treatment of childhood illness in rural contexts. However, the proportion of children seeking prompt treatment remains below the target set at the inception of the iCCM strategy, in Uganda. There is a need to continually engage rural communities to promote modification of health-seeking behaviour, particularly for children with danger signs. Evidence to inform the design of services and behaviour change communication, can be provided through undertaking qualitative studies to understand the underlying reasons for decisions about care-seeking in rural settings. Co-design with communities in these settings may increase the acceptability of these services.
Evaluation of the frequency of attention deficit hyperactivity disorder in patients with asthma
Authors: Nirouei Matineh , Kouchekali Mona , Sadri Homa , Qorbani Mostafa , Montazerlotfelahi Hadi , Eslami Narges , Tavakol Marzieh
Published: June 2023

Background

Asthma is the most prevalent respiratory disease caused by chronic airway inflammation. Attention Deficit Hyperactivity Disorder (ADHD) is children's most common psychological and neurodevelopmental disorder. Increased risk for ADHD in patients with inflammatory and autoimmune diseases supports the role of inflammatory mechanisms in the occurrence of ADHD. However, the association between asthma and ADHD remains unclear.

Objective

This study was designed to evaluate the prevalence of ADHD in patients with asthma who were referred to the clinic of allergy and clinical immunology.

Methods

This cross-sectional study was conducted on children aged 6 to 18 with asthma at Imam Ali hospital, Karaj, Iran. The patient's demographic data, history of childbirth delivery type, premature birth, hospital admission, family income, birth rate, and family history information related to the patient's asthma and medicines were recorded. ADHD diagnosis was made using the Persian version of Conners Parent Behavioral Problems Rating Scale (CPRS-26).

Results

In this study, 677 asthmatic patients were enrolled; 46 patients (6.8%) had ADHD. The probability of ADHD in asthmatic patients inhabited in a rural area, males, and patients with a history of food allergy, allergic rhinitis, urticaria, and eczema was significantly higher (p < 0.05). In addition, our result demonstrated that the likelihood of ADHD in patients with asthma and a history of PICU admission was significantly higher (p < 0.05).

Conclusions

The present study showed that severe asthma, was the risk factor for ADHD in patients with asthma. Physicians should be aware of this co-morbidity to refer asthmatic patients who have the symptoms of ADHD to a psychologist.
Hemodynamic parameters in patients undergoing surgery for pheochromocytoma/paraganglioma: a retrospective study
Authors: De Filpo Giuseppina , Parenti Gabriele , Sparano Clotilde , Rastrelli Giulia , Rapizzi Elena , Martinelli Serena , Amore Francesca , Badii Benedetta , Paolo Prosperi , Ercolino Tonino , Mannelli Massimo , Maggi Mario , Canu Letizia
Published: June 2023

Background

Pheochromocytoma (PHEO) and paraganglioma (PGL) are rare neuroendocrine tumors characterized by hemodynamic instability, caused by the paroxysmal release of catecholamines. Patients may develop cardiovascular complications in the perioperative phase due to the massive release of catecholamines, particularly during anesthetic induction and surgical manipulation of the tumor. The aim of this retrospective study was to evaluate the risk factors involved in perioperative hemodynamic instability in patients who underwent surgery for chromaffin tumors.

Methods

Forty patients (median age 55 [36.50–64.50]) undergone surgery for PHEO/abdominal PGL from January 2011 to December 2016 at the AOU Careggi (Florence, Italy) were retrospectively evaluated. Systolic, diastolic, and mean blood pressure were considered at baseline and during surgery. Patients with blood pressure steadily < 140/90 mmHg before surgery were considered “adequately prepared”. A preoperative therapy with doxazosin, a selective alpha-1 blocker, was started in all patients for at least 14 days prior to the surgery. The presence of hemodynamic instability was reported.

Results

Comparing males and females, a significant difference in doxazosin daily dose (p = 0.018), systolic blood pressure (p = 0.048), and in the proportion of adequately prepared patients (p = 0.031) emerged. A positive correlation between preoperative daily dose of doxazosin, tumor size (B = 0.60, p < 0.001), and urinary normetanephrine levels (B = 0.64, p < 0.001) was also observed. Hemodynamic instability occurred in 30.0% of patients. The absence of adequate preparation (p = 0.012) before surgery, urinary normetanephrine levels (NMNur p = 0.039), and surgery time (minutes) (p = 0.021) resulted as risk factors of hemodynamic instability in our series. The use of intraoperative drugs was higher in patients with hemodynamic instability (p < 0.001). A pre-surgical SBP level of > 133 mmHg (OR = 6 CI95% 1.37–26.20, p = 0.017) and an intraoperative SBP and MBP levels of > 127 mmHg (OR = 28.80 CI95% 2.23–371.0, p = 0.010) and > 90 mmHg (OR = 18.90 CI95% 1.82–196.0, p = 0.014), respectively, were identified as effective thresholds to recognize patients at higher risk of HI.

Conclusions

A preoperative therapy with alpha-blockers is useful, but not sufficient to avoid surgical risks. Patients with higher pre-surgical levels of NMNur, pre-surgical SBP > 133 mmHg, and/or intraoperative SBP > 127 mmHg and MBP > 90 mmHg, should be carefully monitored. A multidisciplinary approach is indispensable to optimize the management of PHEOs/abdominal PGLs in order to reduce surgical complications.
Timing of interval debulking surgery and postoperative chemotherapy after neoadjuvant chemotherapy in advanced epithelial ovarian cancer: a multicenter real-world study
Authors: Liu Xingyu , Zhao Yingjun , Jiao Xiaofei , Yu Yang , Li Ruyuan , Zeng Shaoqing , Chi Jianhua , Ma Guanchen , Huo Yabing , Li Ming , Peng Zikun , Liu Jiahao , Zhou Qi , Zou Dongling , Wang Li , Li Qingshui , Wang Jing , Yao Shuzhong , Chen Youguo , Ma Ding , Hu Ting , Gao Qinglei
Published: June 2023

Background

To investigate the prognostic relevance of the time to interval debulking surgery (TTS) and the time to postoperative adjuvant chemotherapy (TTC) after the completion of neoadjuvant chemotherapy (NACT).

Methods

A retrospective real-word study included 658 patients with histologically confirmed advanced epithelial ovarian cancer who received NACT at seven tertiary hospitals in China from June 2008 to June 2020. TTS was defined as the time interval from the completion of NACT to the time of interval debulking surgery (IDS). TTC was defined as the time interval from the completion of NACT to the initiation of postoperative adjuvant chemotherapy (PACT).

Results

The median TTS and TTC were 25 (IQR, 20–29) and 40 (IQR, 33–49) days, respectively. Patients with TTS > 25 days were older (55 vs. 53 years, P = 0.012) and received more NACT cycles (median, 3 vs. 2, P = 0.002). Similar results were observed in patients with TTC > 40 days. In the multivariate analyses, TTS and TTC were not associated with PFS when stratified by median, quartile, or integrated as continuous variables (all P > 0.05). However, TTS and TTC were significantly associated with worse OS when stratified by median (P = 0.018 and 0.018, respectively), quartile (P = 0.169, 0.014, 0.027 and 0.012, 0.001, 0.033, respectively), or integrated as continuous variables (P = 0.018 and 0.011, respectively). Similarly, increasing TTS and TTC intervals were associated with a higher risk of death (Ptrend = 0.016 and 0.031, respectively) but not with recurrence (Ptrend = 0.103 and 0.381, respectively).

Conclusion

The delays of IDS and PACT after the completion of NACT have adverse impacts on OS but no impacts on PFS, which indicates that reducing delays of IDS and PACT might ameliorate the outcomes of ovarian cancer patients treated with NACT.
A premature luteinizing hormone surge without elevated progesterone levels has no adverse effect on cumulative live birth rate in patient undergoing a flexible GnRH antagonist protocol: a retrospective study
Authors: Zhang Yangyang , Xu Yang , Yu Jiao , Wang Xi , Xue Qing , Shang Jing , Yang Xiuli , Shan Xuemin
Published: June 2023

Background

A premature luteinizing hormone (LH) surge refers to an endogenous LH peak that occurs before follicle maturation or human chorionic gonadotropin injection in the process of controlled ovarian hyperstimulation. The effect of premature LH surge on pregnancy outcomes in fresh embryo transfer cycles is still controversial. The aim of this study was to explore the effect of a premature LH surge without elevated progesterone levels on the cumulative pregnancy rate (CPR) and cumulative live birth rate (CLBR) of patients during a flexible GnRH antagonist protocol.

Methods

A total of 730 infertile women undergoing IVF/ICSI were recruited for this retrospective study. Only women who either delivered a live infant or had no remaining frozen embryos after a single stimulation cycle were included in the analysis. During the study period, each patient underwent a flexible GnRH antagonist protocol. Women were divided into two groups according to the presence or absence of a premature LH surge. The primary outcome measures were the CPR and CLBR per ovarian stimulation cycle. The secondary outcome measures were the number of oocytes retrieved, fertilization rate, good-quality embryo rate, and clinical pregnancy rate.

Results

Ninety-one women (12.47%) experienced a premature LH surge without elevated progesterone levels, and the other 639 (87.53%) women were assigned to the control group. The numbers of oocytes retrieved and fertilization rate were significantly greater in the premature LH surge group than in the control group. There was no significant difference between groups in the good-quality embryo rate, clinical pregnancy rate or live birth rate in the fresh embryo transfer cycle. The primary outcome measures, the CPR and CLBR per ovarian stimulation cycle, were not significantly different between the premature LH surge group and the control group. According to the analysis stratified by ovarian response (normal or high), there were no significant differences in pregnancy outcomes between the groups with and without a premature LH surge.

Conclusions

The retrospective study demonstrated that the patients experiencing a transient premature LH surge without progesterone elevation had equivalent pregnancy outcomes with those without a premature LH surge on a flexible GnRH antagonist protocol. The present conclusions need to be further validated in a prospective well-designed large-scale study.
Panhematopoietic RNA barcoding enables kinetic measurements of nucleate and anucleate lineages and the activation of myeloid clones following acute platelet depletion
Authors: Wojtowicz Edyta E. , Mistry Jayna J. , Uzun Vladimir , Hellmich Charlotte , Scoones Anita , Chin Desmond W. , Kettyle Laura M. , Grasso Francesca , Lord Allegra M. , Wright David J. , Etherington Graham J. , Woll Petter S. , Belderbos Mirjam E. , Bowles Kristian M. , Nerlov Claus , Haerty Wilfried , Bystrykh Leonid V. , Jacobsen Sten Eirik W. , Rushworth Stuart A. , Macaulay Iain C.
Published: June 2023

Background

Platelets and erythrocytes constitute over 95% of all hematopoietic stem cell output. However, the clonal dynamics of HSC contribution to these lineages remains largely unexplored.

Results

We use lentiviral genetic labeling of mouse hematopoietic stem cells to quantify output from all lineages, nucleate, and anucleate, simultaneously linking these with stem and progenitor cell transcriptomic phenotypes using single-cell RNA-sequencing. We observe dynamic shifts of clonal behaviors through time in same-animal peripheral blood and demonstrate that acute platelet depletion shifts the output of multipotent hematopoietic stem cells to the exclusive production of platelets. Additionally, we observe the emergence of new myeloid-biased clones, which support short- and long-term production of blood cells.

Conclusions

Our approach enables kinetic studies of multi-lineage output in the peripheral blood and transcriptional heterogeneity of individual hematopoietic stem cells. Our results give a unique insight into hematopoietic stem cell reactivation upon platelet depletion and of clonal dynamics in both steady state and under stress.
A preoperative ultrasound-based protocol for optimisation of fluid therapy to prevent early intraoperative hypotension: a randomised controlled study
Authors: Szabó Marcell , Pleck András Péter , Soós Sándor Árpád , Keczer Bánk , Varga Balázs , Széll János
Published: June 2023

Background

Intraoperative hypotension is a risk factor for postoperative complications. Preoperative dehydration is a major contributor, although it is difficult to estimate its severity. Point-of-care ultrasound offers several potential methods, including measurements of the inferior vena cava. The addition of lung ultrasound may offer a safety limit. We aimed to evaluate whether the implication of an ultrasound-based preoperative fluid therapy protocol can decrease the incidence of early intraoperative hypotension.

Methods

Randomised controlled study in a tertiary university department involves elective surgical patients of ASA 2–3 class, scheduled for elective major abdominal surgery under general anaesthesia with intubation. We randomised 40–40 patients; 38–38 were available for analysis. Conventional fluid therapy was ordered on routine preoperative visits. Ultrasound-based protocol evaluated the collapsibility index of inferior vena cava and lung ultrasound profiles. Scans were performed twice: 2 h and 30 min before surgery. A high collapsibility index (≥ 40%) indicated a standardised fluid bolus, while the anterior B-profile of the lung ultrasound contraindicated further fluid. The primary outcome was the incidence of postinduction and early intraoperative (0–10 min) hypotension (MAP < 65 mmHg and/or ≥ 30% of decrease from baseline). Secondary endpoints were postoperative lactate level, urine output and lung ultrasound score at 24 h.

Results

The absolute criterion of postinduction hypotension was fulfilled in 12 patients in the conventional group (31.6%) and 3 in the ultrasound-based group (7.9%) (p = 0.0246). Based on composite criteria of absolute and/or relative hypotension, we observed 17 (44.7%) and 7 (18.4%) cases, respectively (p = 0.0136). The incidence of early intraoperative hypotension was also lower: HR for absolute hypotension was 2.10 (95% CI 1.00–4.42) in the conventional group (p = 0.0387). Secondary outcome measures were similar in the study groups.

Conclusion

We implemented a safe and effective point-of-care ultrasound-based preoperative fluid replacement protocol into perioperative care.

Trial registration

The study was registered to ClinicalTrials.gov on 10/12/2021, registration number: NCT05171608 (registered prospectively on 10/12/2021).
MetaPro: a scalable and reproducible data processing and analysis pipeline for metatranscriptomic investigation of microbial communities
Authors: Taj Billy , Adeolu Mobolaji , Xiong Xuejian , Ang Jordan , Nursimulu Nirvana , Parkinson John
Published: June 2023

Background

Whole microbiome RNASeq (metatranscriptomics) has emerged as a powerful technology to functionally interrogate microbial communities. A key challenge is how best to process, analyze, and interpret these complex datasets. In a typical application, a single metatranscriptomic dataset may comprise from tens to hundreds of millions of sequence reads. These reads must first be processed and filtered for low quality and potential contaminants, before being annotated with taxonomic and functional labels and subsequently collated to generate global bacterial gene expression profiles.

Results

Here, we present MetaPro, a flexible, massively scalable metatranscriptomic data analysis pipeline that is cross-platform compatible through its implementation within a Docker framework. MetaPro starts with raw sequence read input (single-end or paired-end reads) and processes them through a tiered series of filtering, assembly, and annotation steps. In addition to yielding a final list of bacterial genes and their relative expression, MetaPro delivers a taxonomic breakdown based on the consensus of complementary prediction algorithms, together with a focused breakdown of enzymes, readily visualized through the Cytoscape network visualization tool. We benchmark the performance of MetaPro against two current state-of-the-art pipelines and demonstrate improved performance and functionality.

Conclusions

MetaPro represents an effective integrated solution for the processing and analysis of metatranscriptomic datasets. Its modular architecture allows new algorithms to be deployed as they are developed, ensuring its longevity. To aid user uptake of the pipeline, MetaPro, together with an established tutorial that has been developed for educational purposes, is made freely available at https://github.com/ParkinsonLab/MetaPro. The software is freely available under the GNU general public license v3.
Applying 4IRs in education technology to science pedagogy: effects and students’ experience
Authors: Ojetunde Segun Michael , Ramnarain Umesh
Published: June 2023

Education, technology, and economic growth are not only linked but synchronised to achieve holistic global development. An instance is the adoption of online platforms for learning and promoting economic activities during the COVID-19 pandemic lockdown. However, the lingering question among education stakeholders in Nigeria borders on what constitutes students’ experiences and how teaching in an online platform can foster basic learning outcomes in science. The study used a mixed method of explanatory concurrent design to investigate the innovation of online platforms for learning during the COVID-19 lockdown. The idea was to compare the innovation’s effects on participant and non-participant respondents. Of the 120 students studied, sixty students were selected from schools that adopted online learning platforms. They were comparatively paired with their contemporaries that did not adopt a similar innovation for analysis of their skills in problem-solving and critical thinking. Ten students who learned via online platforms were interviewed. Fallibilities associated with teaching–learning using online platforms were observed, coupled with the fact that the efficacy of online platforms in enhancing basic learning outcomes in science does not embrace critical thinking, but problem-solving. Therefore, actionable strategies by education stakeholders to design responsive and strictly academic online learning platforms were recommended.
Barriers and facilitators to implementation of nutrition-related actions in school settings in low- and middle-income countries (LMICs): a qualitative systematic review using the Consolidated Framework for Implementation Research (CFIR)
Authors: Meshkovska Biljana , Gebremariam Mekdes Kebede , Atukunda Prudence , Iversen Per Ole , Wandel Margareta , Lien Nanna
Published: June 2023

Background

Low- and middle-income countries (LMICs) are particularly vulnerable to the double burden of malnutrition: co-existence of underweight, overweight, obesity, and/or diet-related non-communicable diseases. Nutrition-related double-duty actions in school settings have been identified as one of the ways to address this challenge. However, to be able to take full advantage of the potential impact, it is important to understand their implementation as well. The aim of this paper is to systematically review qualitative research on barriers and facilitators to the implementation of nutrition-related actions in the school settings in LMICs.

Methods

The following databases were searched: EMBASE, ERIC, MEDLINE, Global Health and PsycInfo (all on Ovid), Scopus (Elsevier), the Web of Science Social Sciences Citation Index, and Global Index Medicus from the World Health Organization. Of the 4253 identified records, 4030 were excluded after the abstract and title screen, leaving 223 for the full-text screen. A final 36 papers were included in this review. The consolidated framework for implementation research (CFIR) was used in the analysis.

Results

We identified barriers and facilitators to implementation linked to the following CFIR constructs/sub-constructs: design quality and packaging, cost (intervention characteristics); target group needs and resources, cosmopolitanism, external policy and incentives (outer setting); structural characteristics, readiness for implementation (inner setting); knowledge and beliefs (characteristics of individuals) and engaging, executing (process). All identified constructs apart from target group needs and resources, knowledge and beliefs, and engaging were predominantly barriers. Available resources were the most prevalent barriers across studies.

Conclusion

This review identified barriers and facilitators to the implementation of nutrition-related actions based on qualitative articles in the school setting in LMICs, using the CFIR. Schools face continuous challenges in regard to funding and the government sector may have a role to play not only by offering financial assistance, but also through policy-making that would support healthy eating practices on school grounds.

Registration

PROSPERO ID: CRD42022296159.
Enfortumab Vedotin With or Without Pembrolizumab in Cisplatin-Ineligible Patients With Previously Untreated Locally Advanced or Metastatic Urothelial Cancer
Authors: O'Donnell Peter H. , Milowsky Matthew I. , Petrylak Daniel P. , Hoimes Christopher J. , Flaig Thomas W. , Mar Nataliya , Moon Helen H. , Friedlander Terence W. , McKay Rana R. , Bilen Mehmet A. , Srinivas Sandy , Burgess Earle F. , Ramamurthy Chethan , George Saby , Geynisman Daniel M. , Bracarda Sergio , Borchiellini Delphine , Geoffrois Lionnel , Maroto Rey Jose Pablo , Ferrario Christiano , Carret Anne-Sophie , Yu Yao , Guseva Maria , Homet Moreno Blanca , Rosenberg Jonathan E.
Published: June 2023

PURPOSE

Patients with locally advanced or metastatic urothelial cancer (la/mUC) who are ineligible for cisplatin-based therapy have limited first-line (1L) treatment options and significant need for improved therapies. Enfortumab vedotin (EV) and pembrolizumab (Pembro) individually have shown a survival benefit in urothelial cancer in second-line + la/mUC settings. Here, we present data from the pivotal trial of EV plus Pembro (EV + Pembro) in the 1L setting.

PATIENTS AND METHODS

In Cohort K of the EV-103 phase Ib/II study, cisplatin-ineligible patients with previously untreated la/mUC were randomly assigned 1:1 to receive EV as monotherapy or in combination with Pembro. The primary end point was confirmed objective response rate (cORR) per blinded independent central review. Secondary end points included duration of response (DOR) and safety. There were no formal statistical comparisons between treatment arms.

RESULTS

The cORR was 64.5% (95% CI, 52.7 to 75.1) and 45.2% (95% CI, 33.5 to 57.3) for patients treated with EV + Pembro (N = 76) and EV monotherapy (N = 73), respectively. The median DOR was not reached for the combination and was 13.2 months for monotherapy; 65.4% and 56.3% of patients who responded to the combination and monotherapy, respectively, maintained a response at 12 months. The most common grade 3 or higher treatment-related adverse events (TRAEs) in patients treated with the combination were maculopapular rash (17.1%), fatigue (9.2%), and neutropenia (9.2%). EV TRAEs of special interest (any grade) in the combination arm included skin reactions (67.1%) and peripheral neuropathy (60.5%).

CONCLUSION

EV + Pembro showed a high cORR with durable responses as 1L treatment in cisplatin-ineligible patients with la/mUC. Patients who received EV monotherapy had a response and safety profile consistent with previous studies. Adverse events for EV + Pembro were manageable, with no new safety signals observed.
Afternoons in the Tower of Babel
Authors: Meisenberg Barry R.
Published: June 2023

Oncologists and families of ICU patients lack common language when discussing status and prognosis. Harmful jargon abounds.
Superior Hypophyseal Artery Intraoperative Indocyanine Green Angiogram as a Predictor of Postoperative Visual Function After Endoscopic Endonasal Surgery
Authors: Osorio Robert C. , Aabedi Alexander A. , El-Sayed Ivan H. , Gurrola Jose , Goldschmidt Ezequiel
Published: June 2023

BACKGROUND AND OBJECTIVES:

To date, there are no tools to intraoperatively predict postoperative visual function after endoscopic endonasal surgery (EES) for suprasellar lesions. The objective of this study was to retrospectively evaluate the utility of indocyanine green (ICG) angiography as an intraoperative tool to measure optic chiasm perfusion and determine its relationship with postoperative visual function.

METHODS:

Videos of patients undergoing EES for resection of suprasellar lesions were reviewed, where 5 mg of ICG was diluted in 10 mL of saline and administered. Time between luminescence of the anterior cerebral artery and the superior hypophyseal artery branches supplying the optic chiasm was noted, and the percentage of optic chiasm vessels that luminesced was recorded. Postoperative examinations and imaging studies were used to assess visual function. Patients with and without new deficits were compared with examination of trends in ICG findings.

RESULTS:

A total of 7 trials were reviewed on 6 patients, with no complications occurring from ICG administration. Mean time to chiasm peak luminescence was 3.8 seconds, and 81.8% of chiasm vessels luminesced. Patients with stable or improved vision after resection demonstrated over 90% chiasm luminescence in every case, and mean chiasm time in these postresection ICG administrations was 4.0 seconds. One patient experienced new postoperative visual deficits; on review of their ICG administration, 11.5% of chiasm vessels luminesced, and the chiasm itself failed to display robust luminescence after 30 seconds of direct observation.

CONCLUSION:

This pilot study showed the capability of intraoperative ICG angiography to demonstrate perfusion of the optic chiasm during EES for resection of suprasellar lesions. While larger studies are required, preliminary results suggest chiasm times under 5 seconds and over 90% chiasm vessel illumination may reflect adequate chiasm perfusion, while those with delayed or absent chiasm luminescence may have compromised chiasm perfusion.
SIX1+PAX3+ identify a progenitor for myogenic lineage commitment from hPSCs
Authors: Jaime Olga G. , Arias Jessica , Pavani Shreya , Pyle April D. , Hicks Michael R.
Published: June 2023

The earliest skeletal muscle progenitor cells (SMPCs) derived from human pluripotent stem cells (hPSCs) are often identified by factors expressed by a diverse number of progenitors. An early transcriptional checkpoint that defines myogenic commitment could improve hPSC differentiation to skeletal muscle. Analysis of several myogenic factors in human embryos and early hPSC differentiations found SIX1+PAX3+ co-expression was most indictive of myogenesis. Using dCas9-KRAB hPSCs, we demonstrate that early inhibition of SIX1 alone significantly decreased PAX3 expression, reduced PAX7+ SMPCs, and myotubes later in differentiation. Emergence of SIX1+PAX3+ precursors can be improved by manipulating seeding density, monitoring metabolic secretion and altering the concentration of CHIR99021. These modifications resulted in the co-emergence of hPSC-derived sclerotome, cardiac and neural crest that we hypothesized enhanced hPSC myogenic differentiation. Inhibition of non-myogenic lineages modulated PAX3 independent of SIX1. To better understand SIX1 expression, we compared directed differentiations to fetal progenitors and adult satellite cells by RNA-seq. Although SIX1 continued to be expressed across human development, SIX1 co-factor expression was dependent on developmental timing. We provide a resource to enable efficient derivation of skeletal muscle from hPSCs.
RBP-Tar – a searchable database for experimental RBP binding sites
Authors: Gresova Katarina , Racek Tomas , Martinek Vlastimil , Cechak David , Svobodova Radka , Alexiou Panagiotis
Published: June 2023

Background: RNA-binding proteins (RBPs) play a critical role in regulating gene expression by binding to specific sites on RNA molecules. Identifying these binding sites is crucial for understanding the many functions of RBPs in cellular function, development and disease. Current experimental methods for identifying RBP binding sites, such as ultra-violet (UV) crosslinking and immunoprecipitation (CLIP), and especially the enhanced CLIP (eCLIP) protocol, were developed to identify authentic RBP binding sites experimentally.

Methods: To make this data more accessible to the scientific community, we have developed RBP-Tar (https://ncbr.muni.cz/RBP-Tar), a web server and database that utilises eCLIP data for 167 RBPs mapped on the human genome. The web server allows researchers to easily search and retrieve binding site information by genomic location and RBP name.

Use case: Researchers can produce lists of all known RBP binding sites on a gene of interest, or produce lists of binding sites for one RBP on different genomic loci.

Conclusions: Our future goal is to continue to populate the web server with additional experimental datasets from CLIP experiments as they become available and processed, making it an increasingly valuable resource for the scientific community.
Comparative evaluation of antimicrobial efficacy of 3C antibiotic paste with triple antibiotic paste as root canal filling material for primary teeth: An in-vitro study
Authors: Chandra Aakriti , Thosar Nilima
Published: June 2023

Root canal infection in primary teeth is polymicrobial in nature. Most resistant micro-organisms, such as E.faecalis survive in chronic infection of the root canal at the periapical area and are difficult to remove by various root canal irrigants. C.albicans has been found in chronic infections of root canals of primary teeth due to its ability to invade dentinal tubules. The multiple bacteria strains which cause endodontic infections, make it difficult to clean root canals with a single effective antibiotic. Hence Triple Antibiotic Paste (TAP) has been previously introduced, consisting of ciprofloxacin, metronidazole, and minocycline. Although this mixture aids in pulp regeneration and has been used to disinfect root canal systems, it is linked to tooth discolouration. The aim of this study is to evaluate and compare the antimicrobial efficacy of a newly formulated 3C antibiotic paste (consisting of Ciprofloxacin, Clindamycin, and Cefaclor) with conventional TAP against E. faecalis and C. albicans. In this in-vitro laboratory study, pure culture of C. albicans and E. faecalis will be grown on Sabouraud’s dextrose agar (SD) agar and Brain heart infusion agar (BHI) agar respectively and will be suspended for 24 hours at 37°C. For comparison of antimicrobial efficacy, the zone of inhibition will be for the 3C antibiotic paste against conventional TAP (control) for E. faecalis and C. albicans, and will be determined using digital calliper in millimetre after every 24 and 72 hours. We hypothesise that the newly formulated 3C paste will have better antimicrobial efficacy when compared with conventional TAP. It is expected that a newly formulated 3C paste will prove to be the successful as root canal filling material for primary teeth.
Comparative study on scenarios for rotating gantry mechanical structures
Authors: Piacentini Luca , Dassa Luca , Perini Diego , Ratkus Andris , Torims Toms , Uberti Stefano , Vilcans Janis , Vretenar Maurizio
Published: June 2023

Background: This paper outlines a comparative study on scenarios of gantries mechanical design for ion-therapy of cancer, which is a crucial step toward the development of the next ion medical machine.

Methods: Multiple scenarios were considered based on robustness of the design, size, weight and complexity, deformation and precision performances and costs, as well as environmental impact. Four prospective scenarios were identified, each of them capable of providing beam to at least 220° around the patient. One scenario is capable of providing treatment angles of 360°. This report will describe the unified methodology performed during the study in order to achieve unbiased results in a comprehensive manner.

Results: Results show that in statically balanced scenarios, considerable improvements can be reached in terms of safety, deformation, precision performances, complexity and costs of implementation.

Conclusions: All scenarios are deemed suitable for further gantry design development.
Pontine and extrapontine myelinolysis associated with rapid correction of hyponatremia - a review
Authors: Dominik Hanna , Pawęska Wojciech , Radwański Jan , Czudy Zuzanna , Polatowska Marika , Gadomska Anna , Kurek Justyna , Gorzyński Rafał , Garstka Michał , Molczyk-Sieńczak Justyna
Published: June 2023

Pontine myelinolysis was first described in 1959 by Adams, Victor and Mancall and reported in alcoholic patients.[1]  It is characterized, above all, by acute non-inflammatory symmetrical lesion of myelin sheath and apoptosis of oligodendrocytes affecting the central part of thebasis pontis.[5] Demyelination may also appear in other parts of central nervous system such as thalamus, basal nuclei and cerebellum. Involvement of the regions beyond pons is called extrapontine myelinolysis. These two manifestations- pontine and extrapontine myelinolysis are combined in one neurological entity- osmotic demyelination syndrome.Pontine and extrapontine myelinolysis are mainly caused by rapid increase in extracellular fluid osmolarity; usually in situation of iatrogenic correction of chronic hyponatremia.[7]The other causes include severe electrolyte disturbances other than hyponatremia (hypokalemia, hypophosphatemia, hypernatremia), anorexia nervosa, AIDS, acute alcoholic hepatitis, liver transplantation, Vernickes syndrome, chemotherapy, chronic renal failure. [11,12] Osmotic demyelination syndrome vary in clinical manifestations. The most common presentations include encephalopathies, pareses, dystonias. The method of choice in diagnostic process is MRI imaging. Treatment of osmotic demyelination syndrome is still in an experimental phase.
The Influence of Competence in Utilizing Learning Media, Managing Class, and Diagnosis of Students' Learning Difficulties on Teaching Performance of Visual Communication Design Teachers of Vocational Schools in Yogyakarta
Authors: Sasongko Djarot Wahyu , Kuat Tri , Sayuti Muhammad
Published: June 2023

This study aims to analyze the influence; teacher competence in utilizing instructional media, teacher competence in managing classes, teacher competence in diagnosing student learning difficulties and analyzing the influence of teacher competence simultaneously on teaching performance of Visual Communication Design teachers at vocational school (SMK) in Yogyakarta, namely at SMK Negeri 3 Kasihan Bantul, SMK Negeri 5 Yogyakarta , SMK Negeri 2 Sewon Bantul, SMK Koperasi Yogyakarta and SMK Muhammadiyah 2 Yogyakarta. Research using quantitative methods. The technique of collecting data is done by questionnaire. Data processing analysis by means of validity test, reliability test. Statistical prerequisite tests were carried out through the normality test, linearity test, multicollinearity test and heteroscedasticity test. Data analysis was carried out through correlation tests, coefficient of determination tests and F tests. The results showed that; 1) there are positive and significant effects of all the variables teacher competence: in utilizing instructional media, in managing the class, and in diagnosing student learning difficulties on teachers teaching performance of Visual Communication Design teachers at vocational school (SMK) in Yogyakarta. It is hoped that teachers will always be able to develop themselves, maintain and improve their teaching performance by increasing their competence.
Development of Integrated Welding Jobsheet Production Based Learning in Vocational High School
Authors: Amanulloh Rivkih , Santosa Budi , Sayuti Muhammad
Published: June 2023

This study aims to analyze the use of integrated welding jobsheets that are usually done at SMK Muhammadiyah 2 Ajibarang. After analyzing and then developing the use of an integrated welding jobsheet commonly used at SMK Muhammadiyah 2 Ajibarang, it becomes an integrated jobsheet that is combined with existing work orders in the industry. The use of the jobsheet was developed to increase the knowledge and competence of students in the Machining Engineering skill competency. This research is research and development (R&D). Stages of research using the design Analysis, Design, Development, Implementation, Evaluation. This research was conducted at SMK Muhammadiyah 2 Ajibarang. The subjects in this study were grade 12 students of Machining Engineering Skills at SMK Muhammadiyah 2 Ajibarang. This study uses a quasi-experimental nonequivalent control group design research method. Collecting data using a questionnaire, pretest, posttest. This study uses expert validators to validate the integrated jobsheet that will be developed, where the average validation result of the three expert validators is 4.25 or 80.5% which can be declared valid. Analysis of research data was done by using the validity of the questionnaire and T-test. To compare the achievement results in the class before being given practical treatment using an integrated worksheet and after being given treatment. We can test this comparison by means of different power testing carried out by pretest and posttest. The result of this research is that the use of integrated welding jobsheet can increase students' knowledge and competence. This study shows an increase in knowledge and competence, after being treated three times by using the use of an integrated worksheet that has been combined with a work order with (Tcount = 11.224 and Sig. = 0.000). The results presented in the form of data analysis are the results of research that has gone through several stages. Integrated jobsheet development research is able to increase students' knowledge and competence of Machining Engineering skills. The Integrated Jobsheet is declared valid to assist the learning process of welding practice in production-based learning in order to increase knowledge and competence.