bluuebunny/crossref_metadata_2025 huggingface dataset:
An ecological exploration of the intersection between English language teachers’ agency and social justice instruction
Authors: Karimpour Sedigheh , De Costa Peter I. , Ranjbar Mohammadali , Nazari Mostafa
Published: February 2025

Although recent research on both agency and social justice has paid attention to the role of these constructs in teachers’ professionalism, the scope of research on how language teachers’ agency and social justice intersect is limited. Drawing on an ecological perspective that captured teachers’ temporal and spatial perceptions, and how structural forces shape teacher agency, we explored agency and social justice among Iranian English language teachers. Data were collected from open-ended questionnaires, narrative frames, and semi-structured interviews. The analysis of the data revealed that teachers used their personal histories and experiences, present sense-making processes, and future-oriented perspectives as agentive tools to promote social justice in their educational practices. The findings also showed that teachers used the affordances of their educational setting as a tool for fostering students’ criticality and activism. The study concludes with a discussion of implications for teacher educators in how to build on agency in teacher education courses to develop understandings of social justice.
Effects of whole-head 810 nm near-infrared therapy on cognitive and neuropsychiatric symptoms in Alzheimer's disease: A pilot study
Authors: Guo Rong , Li Deyu , Li Fang , Ji Linna , Liu Hongying , Qiao Huiting , Lv Zeping , Tang Yi , Wang Daifa
Published: February 2025

Background

Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by significant cognitive and behavioral impairments. Near-infrared (NIR) light treatment has shown potential in cognitive improvement in previous studies. However, clinical trials of NIR for AD remain limited.

Objective

This study investigated the safety and effects of whole-head 810 nm NIR therapy in AD patients, including long-term efficacy.

Methods

An open-label pilot study on whole-head NIR treatment for AD patients was conducted. Nine AD patients completed 4-month treatment (810 nm, 100 mW/cm², 30 min/session, 6 sessions weekly). Safety and efﬁcacy were evaluated at baseline, months 2 and 4, and 2-month post-treatment.

Results

After four months of whole-head NIR treatment, mean changes from baseline on the Mini-Mental State Examination were 3.2 ( p = 0.02). Mean changes from baseline on the Alzheimer's Disease Assessment Scale-Cognitive were −5.0 ( p = 0.05), mean changes from baseline on the Montreal Cognitive Assessment were 1.9 ( p = 0.12). Mean changes from baseline on the Neuropsychiatric Inventory were −4.2 ( p = 0.47). These benefits were sustained two months at least. With no device-related adverse effects were reported.

Conclusions

Whole-head 810 nm NIR light is safe and offers promising benefits for AD patients. To fully confirm its efficacy, durability, and underlying mechanisms, further large-scale randomized controlled trials are necessary.
Dynamical behavior analysis and control of time-varying lifting system based on fuzzy adaptive back-stepping controller
Authors: Lei Wang , Guohua Cao
Published: February 2025

In this article, considering uncertainty and nonlinearity factors, the resonance phenomenon of conveyance is studied and a fuzzy adaptive back-stepping controller is proposed for rope lifting system with time-varying length and distributed parameters. Firstly, the dynamic model is constructed and derived by continuum mechanics, and the dynamical behavior is obtained by time-frequency analysis method. Secondly, the fuzzy adaptive back-stepping control method is proposed to suppress nonstationary vibration. Thirdly, based on Lyapunov function, the asymptotic stability of the system under the proposed control algorithm is verified. Finally, compared with proportion–integration–differentiation (PID) back-stepping controller, the efficiency of the proposed controller is proven by applying excitation with different frequency and uncertain parameters, and the adaptability and robustness are illustrated to validate under mixed frequency disturbance by simulation compared with PID back-stepping controller. Based on the dynamical behavior analysis and control method proposed in this article, the robustness of vibration controller of time-varying lifting system under uncertain nonlinear time-varying disturbance will be greatly improved.
TROPION-Breast04: a randomized phase III study of neoadjuvant datopotamab deruxtecan (Dato-DXd) plus durvalumab followed by adjuvant durvalumab versus standard of care in patients with treatment-naïve early-stage triple negative or HR-low/HER2− breast cancer
Authors: McArthur Heather L. , Tolaney Sara M. , Dent Rebecca , Schmid Peter , Asselah Jamil , Liu Qiang , Meisel Jane Lowe , Niikura Naoki , Park Yeon Hee , Werutsky Gustavo , Bianchini Giampaolo , Andersen Jay C. , Kozarski Robert , Rokutanda Nana , Pistilli Barbara , Loibl Sibylle
Published: February 2025

Background:

Despite treatment advances for patients with early-stage triple-negative breast cancer (TNBC) and hormone receptor (HR)-low/human epidermal growth factor receptor 2-negative (HER2−) breast cancer, treatments that improve clinical outcomes while mitigating toxicity are needed. Datopotamab deruxtecan (Dato-DXd), a TROP2-directed antibody-drug conjugate consisting of a humanized IgG1 monoclonal antibody attached via a plasma-stable cleavable linker to a topoisomerase-I inhibitor payload, has shown efficacy alone or in combination with durvalumab, a selective, high-affinity anti-programmed cell death ligand 1 antibody, in early-phase clinical studies.

Objectives:

The primary objective of TROPION-Breast04 is to evaluate the efficacy and safety of neoadjuvant Dato-DXd plus durvalumab followed by adjuvant durvalumab with or without chemotherapy versus standard of care in patients with previously untreated early-stage TNBC or HR-low/HER2− breast cancer.

Design:

This is an ongoing, international, phase III, open-label, randomized controlled study.

Methods and analysis:

Approximately 1728 patients (aged ⩾18 years) will be randomized 1:1 to eight cycles of neoadjuvant Dato-DXd (6 mg/kg intravenously (IV) every 3 weeks (Q3W)) plus durvalumab (1120 mg IV Q3W) followed by nine cycles of adjuvant durvalumab (1120 mg IV Q3W) with or without chemotherapy versus eight cycles of pembrolizumab (200 mg IV Q3W) plus chemotherapy followed by nine cycles of adjuvant pembrolizumab (200 mg IV Q3W) with or without chemotherapy. Dual primary endpoints are pathological complete response by blinded central review and event-free survival by investigator assessment. Secondary endpoints include overall survival (key), distant disease-free survival, patient-reported outcomes, and safety.

Ethics:

The study is approved by independent ethics committees and/or institutional review boards at each study site. All patients will provide written informed consent.

Discussion:

This study will evaluate the potential use of neoadjuvant Dato-DXd plus durvalumab followed by adjuvant durvalumab with or without chemotherapy versus standard of care in patients with previously untreated early-stage TNBC or HR-low/HER2− breast cancer. The findings of this trial could lead to promising treatment options for these patients.

Trial registration:

ClinicalTrials.gov identifier: NCT06112379.
Regnum Spiriti: The Kingdom of God and Spiritual Formation
Authors: Saucy Mark
Published: February 2025

The kingdom of God was central to the proclamation of Jesus. However, in recent discussion of spiritual formation the kingdom theme remains sidelined as a mere cipher for the end of the formation process or the overall domain in which formation takes place. In three parts this essay argues that the kingdom of God is indeed the end of the believer’s formation, but also, in the person of the Holy Spirit, the means to the goal of spiritual formation as well. Part I establishes the kingdom story of Scripture, noting features of the kingdom life particularly germane to human spirituality. Part II takes up Jesus’ person and practice of the kingdom in the Spirit as the paradigm for all true, human, spiritual formation. Part III concludes with a sketch of kingdom priorities in the spirituality of the Holy Spirit, the power of the kingdom in the present age.
What if Hard Work Cannot Pay Off? Perceived Low Social Mobility Increases Passive Procrastination Among Students
Authors: Dong Yijia , Wang Xijing
Published: February 2025

Social mobility refers to individuals’ movement through a social hierarchy. We examine the effect of perceived low social mobility on passive procrastination among a specific group—students. Across five studies ( N = 1,042) using a mixed-method approach, including a three-wave longitudinal survey (Study 1), a cross-sectional survey (Study 2), and three fully controlled experiments (Studies 3A, 3B, and 4), we consistently found that students perceiving low social mobility exhibit a greater tendency to procrastinate passively. Notably, perceiving low social mobility was only causally related to passive, not active, procrastination (Study 4). Our findings add to the literature on both social mobility perceptions and procrastination, and identify a new approach to understanding passive procrastination among students.
An evidence-based tailored eHealth patient education tool for patients with knee osteoarthritis: A randomized controlled trial
Authors: Li Chong , Zhu Chuanmei , Song Kangping , Xiang Xiaona , Wang Xiaoyi , Hu Jing , Li Zhao , Deng Yi , Jiang Daoxin , Guo Lixin , Ren Ting , Zhu Luwen , Ai Haibo , Zhang Shaojun , Liu Zhongliang , Yang Yonghong , Zhu Siyi , He Chengqi
Published: February 2025

Background

An evidence-based eHealth education tool was developed for patients with knee osteoarthritis (KOA). This study aimed to evaluate the long-term effectiveness on patient knowledge level and analyzed the patient's satisfaction with the proposed tool.

Methods

A two-arm randomized controlled trial was performed, with 218 KOA patients allocated 1:1 to two groups by balanced block randomization. Both groups received usual care and additionally, the eHealth group used the proposed eHealth tool during the process. The primary outcome measure was the validated osteoarthritis patient knowledge questionnaire (PKQ-OA). The secondary outcome was patients’ satisfaction with the eHealth tool. Measurements were taken at baseline, post-intervention (T1), 1-month (T2), 3-month (T3), and 6-month (T4) follow-up. Statistical analyses, including ANOVA and chi-square tests, were employed to compare outcomes between the groups.

Results

The results of the PKQ-OA indicated that patients in the eHealth group (38.7% ± 25%, 95% confidence interval (CI), 33.9%–43.4%) performed significantly better than the usual care group (28.8% ± 21.1%, 95% CI, 24.9%–32.9%) in terms of correct responses to the knowledge assessment in T1( P = 0.001). In addition, a higher percentage of patients in the eHealth group (39.4%) achieved a score of at least 50% on the knowledge assessment compared to the usual care group (14.6%). Patients who received eHealth education perceived it as a valuable tool for education. The analysis of follow-up data showed that the knowledge level of the eHealth group was higher than that of the control group at 6 months ( F = 0.727, P = 0.471), but there was no significant difference.

Conclusion

Patients educated using an evidence-based eHealth education tool showed significant improvements in knowledge and were more likely to achieve an adequately informed status. The evidence-based eHealth tool could offer a low-cost, effective educational device.
Impact of TBL-Based CSR Disclosure on Financial Performance in Halal Food Companies: A System GMM Analysis
Authors: Ahmad Zaki , Bin Hidthiir Mohammad Helmi , Rahman Md Mahfujur , Junoh Mohd Zukime Mat , Yusof Mohd Faizal Bin
Published: February 2025

The goal of this study is to evaluate the relationship between corporate social responsibility disclosure and financial performance (Return on Equity and Tobin’s Q) in Halal food companies. The sample consists of 75 listed Halal food companies on the Bursa Malaysia Stock Exchange for the period between 2012 and 2021. Based on the empirical results using a generalized moment of method (GMM), the dimensions of triple bottom line-based corporate social responsibility—economic, environmental, and social—have a significant effect on return on assets. Furthermore, findings indicate that economic factors have an insignificant effect on Tobin’s Q in static models; however, it is significant in the dynamic model of the system GMM. Whereas environmental factor has a highly significant impact on Tobin’s Q in the static model and it has also significant impact in the GMM’s dynamic model. Nonetheless, social factors have a significant effect on Tobin’s Q in both static and dynamic models. The outcome of the study suggests that policymakers must comprehend the significance of corporate social responsibility disclosure, and it is imperative to determine whether Halal food companies must engage in corporate social responsibility disclosure a priori for short and long-term growth.
Engaging People With Lived Experience of Psychological Disorders: Current Research and Future Directions for Community-Engaged Measure Development in Psychological Science
Authors: Boness Cassandra L. , Hebden Hanna M. , Lardier David T. , Spurgeon Liliana , Timmons Ashli , Simms Leonard J. , Venner Kamilla L. , Witkiewitz Katie
Published: February 2025

The ability to make valid conclusions in psychological science rests on rigorous measure development. People with lived experience of psychological disorders can make invaluable contributions to the measure-development process, but they are often excluded from this process by researchers. When people with lived experience are included, their contributions are limited to consultation early in the process. In this review, we advocate for shared decision-making with people with lived experience throughout the measure-development process. We provide an overview of the phases and steps involved in the development of self-report measures, highlighting the critical contributions of people with lived experience at each step. Next, guided by the continuum of community engagement in research, we review studies from the psychological-science literature that embrace community-engaged measure-development approaches inclusive of people with lived experience of psychological disorders. We conclude with a discussion of opportunities and challenges to community-engaged measure development in psychological science.
The Coherence of Analogue Traumatic and Nontraumatic Memories Over Repeated Recall
Authors: Taylor Andrea , Takarangi Melanie K. T. , Zajac Rachel , Garry Maryanne
Published: February 2025

In therapy, clients sometimes repeatedly recall their traumatic memories to, among other things, resolve the incoherence said to underlie distress. But the literature is silent on the extent to which people’s memories for traumatic and nontraumatic memories cohere over repeated recall compared with similar “control” memories not repeatedly recalled. We asked people to watch two films portraying traumatic or nontraumatic events and then to repeatedly describe their memory for one of those films over 5 days. Our data suggest repeatedly recalling traumatic and nontraumatic memories prevents the loss of coherence that occurs when memories are not repeatedly recalled. There was little evidence of incoherent traumatic memories or of a relation between the coherence of traumatic memories and posttraumatic-stress-disorder (PTSD) symptoms. These findings suggest that when it comes to PTSD, the effectiveness of exposure therapy is not easily explained by the notion that therapy resolves incoherent traumatic memories.
Examining Symptom Management and Quality of Life of Loop Diuretic-Induced Overactive Bladder Among Heart Failure Patients: Physician and Patient Perspectives
Authors: Pan Xin , Wilcox Christopher S , Pitt Bertram , Shah Salim , Law Anandi V
Published: February 2025

Loop diuretics are strongly recommended in patients with chronic congestive heart failure (HF) to alleviate signs and symptoms of fluid overload. Loop diuretics help relieve congestive symptoms and reduce mortality, but may have side effects. This survey study examined the impact of loop diuretic-induced overactive bladder (LD-OAB) symptoms on quality of life (QOL) in HF patients; and management of OAB by HF patients and physicians. We found that (1) HF patients noted less severity of symptoms but similar QOL with non-HF. (2) HF patients (58.8%) self-managed and underreported symptoms to physicians compared to non-HF (74.8%); accordingly 65% of physicians noticed and managed symptoms. (3) Patients used mechanical solutions (pads/diapers, Kegel exercises, and fluid reduction), and physicians adjusted diuretic doses or prescribed medications for OAB. Our study highlighted that HF patients' QOL associated with bladder symptoms was not better than the non-HF group despite milder symptoms. Many HF patients either did not report or coped with/self-managed their loop diuretic-induced bladder symptoms, pointing to a need for better awareness of patient experiences and patient-physician communication.
The 6-months follow-up of the TREAT-CAD trial: Aspirin versus anticoagulation for stroke prevention in patients with cervical artery dissection
Authors: Engelter Stefan T , Enz Lukas S , Ravanelli Flavia , Kaufmann Josefin E , Gensicke Henrik , Schaedelin Sabine , Luft Andreas R , Globas Christoph , Goeggel-Simonetti Barbara , Fischer Urs , Strambo Davide , Kägi Georg , Nedeltchev Krassen , Kahles Timo , Kellert Lars , Rosenbaum Sverre , von Rennenberg Regina , Brehm Alex , Seiffge David , Renaud Susanne , Brandt Tobias , Sarikaya Hakan , Zietz Annaelle , Wischmann Johannes , Polymeris Alexandros A , Fischer Sandro , Bonati Leo H , De Marchis Gian Marco , Peters Nils , Nolte Christian H , Christensen Hanne , Wegener Susanne , Psychogios Marios-Nikos , Arnold Marcel , Lyrer Philippe , Traenka Christopher
Published: February 2025

Introduction:

Cervical artery dissection is a major cause of stroke in the young. The optimal choice and duration of antithrombotic treatment for stroke prevention are debated, particularly beyond 3 months after symptom onset.

Patients and methods:

TREAT-CAD (TREATment of Cervical Artery Dissection) was a randomized controlled trial with blinded outcome assessment comparing non-inferiority of aspirin to anticoagulation (Vitamin-K-antagonists) in participants with symptomatic, Magnetic-Resonance-(MR)-imaging-verified cervical artery dissection. TREAT-CAD could not establish non-inferiority of aspirin to anticoagulation at 3 months. Thereafter participants could continue antithrombotic medication and obtained a standardized assessment of clinical and MR-Imaging outcomes between 3 and 6 months. As crossover to the other treatment arm was possible, we performed an as-treated analysis as main analysis. The main outcomes were new clinical (ischemic stroke, intracranial/major extracranial bleeding, or death) and new MR-Imaging outcomes (ischemic or hemorrhagic brain lesions).

Results:

Among the 122 participants in the as-treated analysis, 3/93 (3.2%) aspirin-treated participants had new clinical ( n = 1) and MRI-outcomes ( n = 2) between 3 and 6 months while 1/29 (3.4%) anticoagulated participants had an MRI-outcome ( n = 1). All outcome events were hemorrhagic while ischemic events were absent. No deaths occurred. This yields an absolute difference of 0.2% (95% CI −8.0% to 7.5%, p = 1.0).

Discussion and conclusion:

During the extended follow-up period of a controlled randomized trial comparing aspirin to anticoagulation in cervical artery dissection, outcomes between 3 and 6 months after randomization occurred rarely, similarly often in both groups and were exclusively hemorrhagic events. Thus, studies balancing benefits versus harms of antithrombotic treatment beyond 3 months are warranted. Registration: ClinicalTrials.gov: NCT02046460. https://clinicaltrials.gov/ct2/show/NCT02046460 .
Rural Livelihood Transformation in Uttarakhand: An In-depth Analysis of the Livelihood Enhancement in Nainital and Pithoragarh
Authors: Joshi Amit , Chib Shagun , Singh Shashank
Published: February 2025

India inhabitants in villages. Almost 65% of India’s population resides in rural areas; their main livelihood generation activities are dominated by agriculture and allied activities. The livelihood conditions in the hill areas are Agri-based but not uniform for the whole year. The present study explores the current livelihood status in the Nainital and Pithoragarh districts of Uttarakhand, one of the northern states of India. The present study also explores key factors influencing the successful adoption of sustainable agricultural practices, resource management, and access to essential services, such as education and healthcare in Livelihood promotion in Nainital and Pithoragarh. The study intends to provide a complete picture of residents’ livelihoods in these districts by carefully examining both quantitative and qualitative data. This paper recommends some suggestions for sustainable livelihood activities not only from the state of Uttarakhand by examining important factors such as income levels, access to education and healthcare, and the adoption of new farming techniques but also to the other regions with the same geographical terrain.
Substance Use Disorder and Harm Reduction Curriculum in United States and Canadian Undergraduate Medical Education: An Online Survey
Authors: Avra Tucker , Nelson Andrew , Friedman Joseph , Limbach Willow , Sarkisian Mary , Nesley Tamiko , Chu Tiffany , Truman Kyla , Moghanian Brandon , Yazditabar Joshua , Ahluwalia Tamanna , Shover Chelsea , Goodman-Meza David
Published: February 2025

Background:

Substance use disorders (SUD) are a significant public health challenge, necessitating that clinicians are trained in SUD treatment and harm reduction (HR) strategies. Despite this, no studies have assessed the extent of SUD and HR training across all medical schools. This study assesses the current state of SUD and HR curriculum among medical students in the United States and Canada.

Methods:

From May to July 2023, we conducted an anonymous online survey via email invitation to student affairs’ offices of all 220 accredited US and Canadian medical schools. The survey assessed the curricula students were exposed to related to SUD treatment, HR, and stigmatizing attitudes.

Results:

A sample of 568 students from 52 medical schools (23.6% of all US and Canadian medical schools) completed the survey. Participants reported that in their medical school they were taught about: recognition of an opioid overdose (80.0%), identifying and treating opioid withdrawal (68.2%), principles and practices of HR (60.6%), administering naloxone (56.6%), the importance of syringe service programs (51.8%), prescribing methadone and/or buprenorphine (29.5%), and counseling patients on safe injection practices (11.4%). In addition, participants reported that they were taught: how to identify drug-seeking behavior (36.4%), that people who use heroin are “drug abusers” (24.4%), to withhold opioid pain medication from patients who are known or suspected to use drugs (15.9%), and that medication for opioid use disorder is another form of addiction (12.6%).

Discussion:

We found large curricular gaps related to the administration of medications for opioid use disorder and treating opioid overdose and withdrawal, as well as a significant prevalence of stigmatizing attitudes. Renewed efforts are needed to implement comprehensive and destigmatizing SUD curricula. The study is limited by response bias and is expected to overestimate the extent of HR related curriculum, indicating the true gap is likely higher than reported.
Exertional inspiratory capacity and operating lung volumes in health: a population-based study
Authors: Stubbe Beate , Muller Paulo T. , Obst Anne , Kaczmarek Sabine , Mick Robina , Neder J. Alberto , Ewert Ralf
Published: February 2025

Rationale

Inspiratory capacity (IC) should increase during exercise to allow unrestrained tidal volume expansion, mitigating uncomfortable respiratory sensations. However, preliminary evidence suggests that this is not universally seen in healthy individuals. Whether this negatively impacts on inspiratory reserves and dyspnoea remains unclear.

Objectives

To gain novel insights on the regulation of operating lung volumes in community-dwelling individuals, we determined the association of a lack of increase in IC during incremental cardiopulmonary exercise testing (ICdyn) with demographic, anthropometric, and respiratory functional data in a large population-based study.

Methods

We reviewed general characteristics, pulmonary function, and cycle ergometer data from 1065 healthy individuals (51.5% women, aged 20–86 years) with normal lung function.

Measurements and Main Results

ICdynremained unchanged or decreased from rest to peak exercise (ΔICdyn≤0 L) in 245/1065 individuals (23.0%). Tidal volume increased to a lower extent after the ventilatory threshold compared to earlier exercise in these subjects; thus, peak end-inspiratory lung volume (EILV) and EILV/total lung capacity were similar to subjects showing ICdyn>0 L despite higher end-expiratory lung volumes. Albeit statistically significant, between-group differences in peak dyspnea scores were modest (p=0.049). Multivariable regression revealed that age (particularly in women), higher body mass index, and higher resting airway resistance were independently associated with ΔICdyn≤0 L (p<0.001).

Conclusions

Elderly women and overweight/obese individuals may fail to increase ICdynduring incremental exercise due to dynamic hyperinflation. Careful regulation of tidal volume, however, avoids critically high inspiratory constraints and limiting exertional dyspnea.
Type 2 inflammation and cardiometabolic disease in middle-aged adults
Authors: Haglund Johanna , Sundbom Fredrik , Malinovsch Andrei , Janson Christer
Published: February 2025

Background

Asthma has been associated with a higher risk for cardiometabolic disease. One possible explanation is the activation of type 2 inflammation. We aimed to investigate whether there is an association between type 2 inflammation and cardiometabolic disease and whether the association varies between different biomarkers.

Methods

This cross-sectional study included a total of 4277 non-smoking participants with data on cardiometabolic disease and type 2 inflammation (blood eosinophil count (B-Eos), exhaled nitric oxide (FeNO), and IgE sensitisation). The cut-off values of the biomarkers were ≥0.3×109·l−1for B-Eos, ≥25 ppb for FeNO and ≥0.35 PAU·l−1for IgE sensitisation, respectively.

Results

There was a higher prevalence of cardiometabolic disease among participants with any type-2-biomarker: diabetes (5.2versus3.3%, p=0.002), CVD (3.3versus1.8%, p=0.002) and hypertension (23.7versus20.2%, p=0.007). Diabetes had the strongest association with having all three biomarkers elevated (OR 4.03 (95% CI 1.84–8.87), followed by elevation of both B-Eos count and FeNO (OR 2.38 (1.15–4.91)) and of only B-Eos (2.02 (1.21–3.36), p=0.007). CVD was associated with the combination of elevated B-Eos and IgE sensitisation (OR 4.77 (2.11–10.79)) and with elevated FeNO (OR 2.57 (1.31–5.06)). Hypertension was associated with elevated B-Eos (OR 1.65 (1.26–2.18)).

Conclusion

We found an association between type 2 inflammation and cardiometabolic disorder, but the association with the combination of markers varied between the diseases.
Pseudomonas aeruginosainfection is linked to increases in cardiovascular events post exacerbation in bronchiectasis
Authors: L Engin , Owen Caroline A. , Reid Fred , Cabrera Claudia , Haworth Charles S. , Hughes Rod
Published: February 2025

Introduction

Pseudomonas aeruginosa(PsA) infection contributes to disease progression in bronchiectasis (BE), particularly exacerbations which are known to increase the risk of cardiovascular (CV) events. However, the link between PsA infection and CV events in BE is unknown. Thus, we investigated whether there is an association between PsA airway infection and the risk of CV events post-exacerbation.

Methods

This was a US retrospective cohort study using the TriNetX platform between 2008–2019. Adult patients with or without PsA airway infection (wPsA; w/oPsA) were included. Date of first exacerbation corresponded to the index date and patients were followed for up to 5 years post-index. Risk ratios (RR) for hospitalisation, subsequent exacerbation, mortality and incidence of pre-specified CV events were estimated. Propensity score matching (PSM) was used to balance baseline characteristics.

Results

After PSM, patients wPsA infection were at a greater risk of hospitalisation (RR:1.40; 95% CI:1.19–1.64), subsequent exacerbation (RR:1.70; 95% CI:1.53–1.90) and mortality (RR:1.37; 95% CI:1.20–1.56) than patients w/oPsA. PsA infection was associated with a higher risk of dysrhythmias (RR:1.32; 95% CI:1.13–1.54), inflammatory heart disease (RR:2.09; 95% CI:1.29–3.37), other cardiac disorders (RR:1.40; 95% CI:1.14–1.72), thrombotic disorders (RR:1.31; 95% CI:1.01–1.68), major adverse cardiovascular events (RR:1.35; 95% CI:1.19–1.52), and any CV outcome (RR:1.42; 95% CI:1.24–1.62).

Conclusion

PsA infection in patients with BE is associated with an increased risk of CV events following a baseline exacerbation. These data highlight the multisystemic nature of BE and the need to raise awareness of the potential increased risk of CV events in patients with BE experiencing exacerbations.
Respiratory infections after elexacaftor/tezacaftor/ivacaftor treatment in people with cystic fibrosis: analysis of the European Cystic Fibrosis Society Patient Registry
Authors: Pollak Mordechai , Gambazza Simone , Orenti Annalisa , De Rose Virginia , Prais Dario , Kerem Eitan , Mei Zahav Meir ,   on behalf of ECFSPR Steering Group
Published: February 2025

Background

Elexacaftor/tezacaftor/ivacaftor (ETI) has improved outcomes for people with cystic fibrosis (pwCF). This study evaluated changes in airway microbiological infection status after initiating ETI.

Methods

Using the ECFS registry, pwCF who started ETI between 2019 and 2021 were identified. The changes in microbiological status from one year before to one year after ETI initiation, were compared with the changes seen from three to one years before starting ETI. Mixed-effect regression models were used to analyse changes. Data from two years after initiation were examined for those starting ETI in 2019–2020.

Results

Included were 15 739 pwCF from 30 countries. In the year before ETI, 38.4% were positive forPseudomonas aeruginosa(PsA) and 36.4% for methicillin-sensitiveStaphylococcus aureus(MSSA). After ETI, 38.7% of PsA-positive and 47.2% of MSSA-positive patients transitioned to negative status, compared to 14.8% and 29.1%, respectively, in the previous years. The adjusted difference in transitioning to negative was 14.6% (PsA) and 17.1% (MSSA), both p<0.001. Similar improvements were seen forBurkholderia cepaciacomplex andStenotrophomonas maltophilia. For those starting ETI in 2019–2 020, PsA positivity remained low over two years, decreasing from 46.8% pre-ETI to 30.4% and 27.7% at one and two years post ETI treatment.

Conclusion.

One year after starting ETI, many pwCF who were initially positive for various CF related pathogens, shifted to a negative status, a change less common before ETI. These findings suggest that ETI reduces airway infections, with benefits extending into the second year of treatment, though some pwCF continue to carry these pathogens despite treatment.
Increased loop gain and upper airway collapsibility among smoking patients with obstructive sleep apnoea
Authors: Hang Liang-Wen , Finnsson Eysteinn , Ágústsson Jón S. , Sands Scott A. , Cheng Wan-Ju
Published: February 2025

Background

Smoking is a known risk factor for obstructive sleep apnea (OSA). However, the specific pathological mechanism linking smoking to OSA remains unclear. This study aims to explore the endotypic traits of OSA among current and former smokers.

Methods

We prospectively collected polysomnographic data from 980 patients with an apnea-hypopnea index (AHI)≥15 h−1from a single clinical sleep center. Smoking status was determined through self-reported questionnaires completed prior to polysomnography. Endotypic traits—including arousal threshold, collapsibility, loop gain, circulatory delay, ventilatory response to arousal, and upper airway compensation—were estimated using polysomnographic signals. Adjusted multivariate linear regression analysis was conducted to investigate the association between smoking and endotypic traits.

Results

Compared to non-smokers, current smokers were associated with a 7.6 h−1higher AHI, an 8.8%eupnea higher arousal threshold, a 4.0%eupnea lower Vpassive, a 6.7%eupnea lower Vactive, a 0.03 higher loop gain, and a 0.64 lower delay during non-rapid eye movement (NREM) sleep. During REM sleep, current smokers showed an 11.1%eupnea higher arousal threshold, a 6.5%eupnea lower Vactive, a 4.6%eupnea lower Vmin, a 0.05 higher loop gain, and a 0.57 lower delay. Former smokers exhibited a 5.7%eupnea lower upper airway compensation and a 6.7%eupnea lower Vactiveduring REM sleep compared to non-smokers. Smoking amount and duration since quitting were not linearly associated with AHI or endotypic traits.

Conclusions

Smoking is associated with increased upper airway collapsibility and loop gain among patients with OSA. These effects may be reversible following smoking cessation.
Top ten priorities for chronic cough: Canadian James Lind Alliance Priority Setting Partnership (CAN-COUGH)
Authors: Samari Saif , Oliveira Ana , Brister Danica , Kum Elena , Aaron Shawn D. , Adamko Darryl , Bhalla Anurag , Carlsten Christopher , Cormier Maxime , Ellis Anne K. , Field Stephen K. , Godbout Krystelle , Hernandez Paul , Hirota Jeremy A. , Kaplan Alan , Kovesi Tom , Mancopes Renata , Sedeno Maria , Smith Maeve , Newman Robert , King Philip , Gallagher Tiffany , Butson Sarah , Brooks Dina , Satia Imran ,   on behalf of the CAN-COUGH Committee Members
Published: February 2025

Background

Chronic cough significantly impacts individuals' quality of life and poses challenges for healthcare providers due to limited licensed treatments, side effects of available medications, and difficulty accessing non-pharmacologic interventions. Understanding priorities for research, education, and knowledge dissemination from the perspectives of individuals with chronic cough and healthcare providers can guide future efforts. This study aimed to identify these key priorities in Canada.

Study design and methods

We conducted a cross-sectional study using the James Lind Alliance (JLA) method to set priorities. Chronic cough was identified as the healthcare problem. Participants rated items related to research, education, and knowledge dissemination in an online survey using a 7-point Likert scale. Results of the survey were reviewed by the Canadian Thoracic Society's (CTS) multidisciplinary working group and patient partners who engaged in a face-to-face Priority Setting Partnership, to establish a “Top 10” Priorities list for chronic cough.

Results

Seventy-four individuals with chronic cough and 62 healthcare providers completed the scoping survey. The top-rated priorities included enhancing knowledge of existing treatments, developing new treatments, and improving diagnostic testing. The final “Top 10” priorities list emphasized the need for developing infrastructure for evaluating new treatments, improving understanding of biological mechanisms, and raising awareness among the public and policymakers.

Conclusion

This is the first priority-setting project for chronic cough, highlighting key areas to address in research, education, and dissemination. The identified priorities will serve as a foundation for future efforts to improve the management and care of individuals with chronic cough.
The AFFIRM Framework for gender-affirming care: qualitative findings from the Transgender and Gender Diverse Health Equity Study
Authors: Quint Meg , Bailar Schuyler , Miranda Alexis , Bhasin Shalender , O’Brien-Coon Devin , Reisner Sari L.
Published: February 2025

Background

Transgender, nonbinary, and gender diverse (TGD) people experience stigma in healthcare settings impacting healthcare utilization, including avoidance of care due to anticipated discrimination. Gender-affirming care refers to care for medical gender affirmation, such as gender-affirming hormones and surgery, as well as general care that affirms and respects TGD patients. This study sought to explore the experiences of TGD adults to inform gender-affirming care delivery and develop an actionable framework for practice.

Methods

Between May–October 2021, one-time individual in-depth interviews were conducted with 27 TGD adults receiving any healthcare in the greater Boston Massachusetts area to gather data about gender-affirming care. Interviews were semi-structured, explored prior and current experiences in healthcare and ideal gender-affirming care models, and conducted virtually via a secure Zoom platform. Analyses were conducted using immersion crystallization and reflexive thematic analysis; interview transcripts were double coded by two coders.

Results

Participants had a mean age of 28.5, ranging 18–45 years, and were: 7 transgender men, 6 transgender women, 8 nonbinary, 3 genderqueer, 1 agender, and 2 gender not specified. Themes about gender-affirming care coalesced into the acronym AFFIRM: (1) Affirms in individual interactions: Participants called for affirmation of TGD identity, lived expertise, and competent TGD providers and staff. (2) Flexible and accessible: Participants expressed the need for gender-affirming care to be available beyond urban population-specific clinics, in a timely fashion without long wait lists, and in a community-centered manner such as offering non-traditional times and settings. (3) Fights systemic oppression: Participants emphasized the need for providers and health systems to eliminate gatekeeping practices for gender-affirming care and create care models that resist intersecting oppressive systems such as racism and cisgenderism. (4) Interacts with community: Patients desired intentional interaction with TGD community to holistically address health and unmet gender affirmation needs. (5) Retains patients in care: Patients shared the need to collaboratively identify and problem-solve obstacles to gender-affirming care with providers and healthcare systems to optimize TGD-specific retention strategies. (6) Multidisciplinary: Patients called for interdisciplinary teams with co-located services such as primary care and mental healthcare with letter-writing for surgical care, and incorporation of peer navigators to meet the broader social, health, and well-being needs of TGD people.

Conclusions

Findings from this study and the AFFIRM Framework which emerged from TGD patient narratives can be applied to improve current care and set benchmarks for high-quality gender-affirming care delivery and practice.
Barriers faced by undergraduate dental students when conducting research: a qualitative study
Authors: Sarhan Mohammed Mahmoud , Aljohani Lama Nasser , Alsaleh Raghad Ibrahim , Mubaraki Roze Abdulaziz , Almozaen Malak Abdulaziz , Alharbi Rimas Sabih
Published: February 2025

Background

Research is an important part of dental education. While several quantitative studies have examined the barriers that undergraduate dental students face when conducting research, qualitative studies exploring the details and contexts of these barriers are rare. To bridge this gap, this research qualitatively explores the barriers faced by undergraduate dental students when conducting research.

Methods

The present qualitative study employs what is known as the “performative knowledge strategy.” The 14 study participants were dental trainees included 10 undergraduate students and 4 interns who participated in research projects that were not part of their mandatory curriulum requirements. Diaries and semi-structured virtual (online) interviews were used to collect the data. Finally, using an inductive strategy, a thematic analytical approach was conducted to analyze the data.

Results

Six key themes emerged from the data analysis. The themes of “inadequate knowledge,” “time constraints” and “lack of resources” confirm and align with the findings of previous studies, while the themes “misaligned schedules,” “delayed response” and “lack of orientation” represent new insights into the barriers to research faced by undergraduate dental students.

Conclusion

This study identified six factors that posed substantial barriers to research by undergraduate dental students. Analysis of these barriers can lead to the design and implementation of strategies to enhance and improve research experience. Additional qualitative research in this area would help to reveal further details of the barriers to research, while additional quantitative studies are required to assess the frequency and trends of the newly revealed barriers.

Clinical trial number

Not applicable.
An idiopathic left internal iliac artery aneurysm in an 11-year-old boy: a case report
Authors: Gorji Meghdad Ghasemi , Baratinezhad Amirhossein , Mirali Rojan Abdollahzadeh
Published: February 2025

Background

Idiopathic isolated aneurysms in pediatric patients are rare and present significant diagnostic and therapeutic challenges owing to their low incidence, small anatomical size, and the associated risks of injury to surrounding structures. Timely diagnosis and the selection of the most appropriate intervention require careful consideration.

Case presentation

An 11-year-old Persian boy presenting with abdominal pain for 2 months before admission was diagnosed with an isolated left internal iliac artery aneurysm through computed tomography imaging. He underwent open surgery for excision of the aneurysm. The iliac vein was adherent to the aneurysmal sac and significantly compressed, complicating the dissection and exploration. Nevertheless, proximal control was achieved, and the iliac vein was gradually separated and decompressed, allowing for the safe excision of the aneurysmal sac. The surgery was completed without intraoperative or postoperative complications.

Conclusion

Successful surgical intervention in pediatric patients with iliac artery aneurysms is achievable with careful planning and technique. This case report demonstrates the effectiveness of surgical management, with the patient remaining asymptomatic and showing no signs of recurrence during follow-up.
Dietary steviol glycosides mixture supplementation modulates the gene expression of gut chemoreceptors and enhances the antioxidant capacity in weaned piglets
Authors: Xiong Yunxia , He Zhentao , Wu Qiwen , Xiao Hao , Cao Shuting , Yang Xuefen , Li Yajing , Jiang Zongyong , Zhu Cui , Wang Li
Published: February 2025

Background

Stevia glycosides (SGs) have been widely used as an ideal sugar alternative in the food industry. However, the potential application of SGs mixture in the diets of weaned piglets remains unexplored. This study aimed to investigate the effect of dietary SGs mixture supplementation on growth performance, gene expression of gut chemoreceptors, and antioxidant capacity in weaned piglets.

Methods

A total of 216 weaned piglets (Duroc × Landrace × Yorkshire, 7.36 ± 0.04 kg body weight) were randomly assigned to 6 groups (6 pens/group with 6 piglets/pen), and were fed with the basal diet supplemented with 0, 100, 150, 200, 250, or 300 mg/kg SGs mixture for 42 days. The serum, liver, longissimus thoracis, and jejunal samples were collected on day 43.

Results

The results showed that inclusion the SGs mixture in the diet did not have a significant impact on growth performance from days 1 to 28 (P > 0.05). But increasing the concentration of SGs mixture tended to linearly decrease the average daily gain from days 1 to 42 (P = 0.052). However, 150 mg/kg SGs mixture supplementation significantly increased the mRNA expression of taste receptor family 1 member 2 (T1R2) and glucose transporters 2 (GLUT2) in the jejunum (P < 0.05), while 150 and 200 mg/kg SGs mixture supplementation significantly increased T1R3 mRNA expression (P < 0.05). Moreover, 150 mg/kg SGs mixture supplementation significantly reduced serum malondialdehyde content (P < 0.05). Increasing the concentration of SGs mixture linearly and quadratically increased serum total superoxide dismutase (T-SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) activity, as well as hepatic T-SOD, GSH-Px activity, and muscle total antioxidant capacity contents (P < 0.05). Furthermore, piglets fed a diet supplemented with 100 mg/kg SGs mixture had higher serum T-SOD, CAT, and GSH-Px activities compared with the other treatments (P < 0.05).

Conclusions

Therefore, our results suggest that dietary 100 ~ 150 mg/kg SGs mixture supplementation modulates gene expression of sweet taste recognition receptors and glucose transporters, while also enhancing the antioxidant capacity of weaned piglets.
Vestibular and balance dysfunction in attention deficit hyperactivity disorder and cognitive disengagement syndrome risk groups
Authors: Koc Apaydın Zuhal , Soylemez Emre , Demir Nefise
Published: February 2025

Background

In the past, cognitive disengagement syndrome (CDS) and attention deficit hyperactivity disorder (ADHD) were considered similar concepts. However, many differences have recently been identified between the two disorders, and they have been separated from each other. This study aims to investigate balance and vestibular function in individuals at high risk for ADHD and CDS.

Materials and methods

This study involved 60 college students. Participants were given the Adult ADHD Self-Report Scale and the Adult Concentration Inventory. Using the applied indices, participants with high and low risk for CDS and ADHD were identified. Every participant underwent static posturography, the video head impulse test (vHIT), and cervical vestibular myogenic-evoked potentials (cVEMP).

Results

People with low and high risk for CDS did not differ in terms of static posturography or cVEMP (p > 0.05). Similarly, no differences were found in ADHD (p > 0.05). While right ear lateral vHIT responses were worse in individuals with high-risk CDS (p > 0.05), bilateral posterior vHIT rates were worse in individuals with high-risk ADHD (p > 0.05).

Conclusion

The fact that individuals at high risk for CDS and ADHD show different vestibular involvement strengthens the fact that there are different clinical pictures.