bluuebunny/crossref_metadata_2025 huggingface dataset:
Operationalising routinely collected patient data in research to further the pursuit of social justice and health equity: a team-based scoping review
Authors: Chadd Katie , Caute Anna , Pettican Anna , Enderby Pam
Published: January 2025

Background

Vast volumes of routinely collected data (RCD) about patients are collated by health professionals. Leveraging this data – a form of real-world data - can be valuable for quality improvement and contributing to the evidence-base to inform practice. Examining routine data may be especially useful for examining issues related to social justice such as health inequities. However, little is known about the extent to which RCD is utilised in health fields and published for wider dissemination.

Objectives

The objective of this scoping review is to document the peer-reviewed published research in allied health fields which utilise RCD and evaluate the extent to which these studies have addressed issues pertaining to social justice.

Methods

An enhanced version of the Arksey and O’Malley’s framework, put forth by Westphalm et al. guided the scoping review. A comprehensive literature search of three databases identified 1584 articles. Application of inclusion and exclusion criteria was piloted on 5% of the papers by three researchers. All titles and abstracts were screened independently by 2 team members, as were full texts. A data charting framework, developed to address the research questions, was piloted by three researchers with data extraction being completed by the lead researcher. A sample of papers were independently charted by a second researcher for reliability checking.

Results

One hundred and ninety papers were included in the review. The literature was diverse in terms of the professions that were represented: physiotherapy (33.7%) and psychology/mental health professions (15.8%) predominated. Many studies were first authored by clinicians (44.2%), often with clinical-academic teams. Some (33.25%) directly referenced the use of their studies to examine translation of research to practice. Few studies (14.2%) specifically tackled issues pertaining to social justice, though many collected variables that could have been utilised for this purpose.

Conclusion

Studies operationalising RCD can meaningfully address research to practice gaps and provide new evidence about issues related to social justice. However, RCD is underutilised for these purposes. Given that vast volumes of relevant data are routinely collected, more needs to be done to leverage it, which would be supported by greater acknowledgement of the value of RCD studies.
Barriers and facilitators to the implementation of PHAROS, a perioperative pharmaceutical management intervention for older adults – a qualitative interview study from the perspective of healthcare providers
Authors: Schönfeld Moritz Sebastian , Rinke Julia , Langebrake Claudia , Kriston Levente , Olotu Cynthia , Kiefmann Rainer , Bergelt Corinna
Published: January 2025

Background

Number of drugs are increasing with older age and present a risk factor for various adverse health outcomes. A comprehensive medication therapy management (MTM) before admission for elective surgery may help reduce unnecessary and potentially inadequate medications (PIM) and thus improve patient health. Our goal was to evaluate the implementation of PHAROS, a perioperative MTM intervention study, from the perspective of health care providers. The PHAROS intervention aimed to improve medication appropriateness in older inpatients at the outpatient / inpatient interface.

Methods

We performed a qualitative interview study within a pilot intervention study comparing a comprehensive MTM with standard care in older inpatients (≥ 65 years) in Germany. Semi-structured interviews with health care professionals were performed from March to July 2021. The Consolidated Framework for Implementation Research (CFIR) was used to guide development of interview guide, data coding, analysis, and reporting of findings.

Results

Ten health care professionals involved in the implementation of PHAROS were interviewed. Based on CFIR-constructs, facilitators included need for and meaningfulness of the intervention as well as positive and supportive cooperation within the project team. Implementation of MTM at the interface of inpatient to outpatient care before elective surgery was hampered by personal and organizational barriers as well as barriers resulting from broader health care structures in Germany. In particular, lack of documentation standards, missing compatibility with clinical workflow, difficulties in stakeholder engagement, as well as communication barriers between outpatient and inpatient care interfaces hindered implementation of the intervention.

Conclusions

Further studies should consider focusing on facilitators to pharmaceutical implementations such as transparent and clear communication structures between stakeholders, standardization of medication documentation, and intervention structures that are adapted to hospital workflows.

Trial registration

https://drks.de Identifier: DRKS00014621, this study was part of the PHAROS study.
Network analysis of caffeine use disorder, withdrawal symptoms, and psychiatric symptoms
Authors: Davoudi Mohammadreza , Abdoli Fatemeh , Momeni Fereshte , Asgarabad Mojtaba Habibi
Published: January 2025

Objective

Caffeine Use Disorder (CUD) is not currently recognized as a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). However, recent studies within the DSM-5 context have explored this issue. Also, this disorder is closely associated with caffeine withdrawal symptoms, which are formally recognized as a diagnosis in the DSM-5. Additionally, there is limited evidence regarding the connection between caffeine-related issues and psychiatric symptoms. The main aim of the present study was to determine the network structure of CUD and caffeine withdrawal symptoms among the general population. Also, the bridge symptoms among CUD, psychiatric symptoms, and caffeine withdrawal have been estimated.

Method

Participants were 1228 adults (50.3% females, Mean age (x̄±sd) 35.49 ± 11.70 years) who completed Caffeine Use Disorder Questionnaire (CUDQ), Caffeine Withdrawal Symptoms Questionnaire (CWSQ), and Symptom Checklist-25 (SCL-25). All estimations were conducted according to the Gaussian Graphical Model.

Results

“Excessive consumption” and “role obligations” were central symptoms in the CUD network. Difficulty in concentration was the most central node in the caffeine withdrawal network. Also, the obsessive-compulsive symptom emerged as a central and highly influential node in the relationship between caffeine-related nodes and psychiatric symptoms.

Conclusions

Mental health providers should target these specific symptoms in clinical interventions to mitigate caffeine-related problems among individuals in the general population effectively.
Pilot study of a ketogenic diet in bipolar disorder: a process evaluation
Authors: P. Rigby Benjamin , Needham Nicole , Grossi Helen , Kamenska Ivana , H. Campbell Iain , Meadowcroft Ben , Creasy Frances , Fisher Cheryl , Bahuguna Pankaj , Norrie John , Thompson Gerard , C. Gibbs Melissa , Mitchell-Grigorjeva Maja , McLellan Ailsa , Moses Tessa , Burgess Karl , Brown Rachel , J. Thrippleton Michael , Campbell Harry , J. Smith Daniel , A. Simpson Sharon
Published: January 2025

Background

Bipolar disorder is a serious mental illness, which requires new strategies for prevention and management. Recent evidence suggests that a ketogenic diet may be an effective intervention. This research aimed to explore the feasibility and acceptability of a ketogenic diet intervention for bipolar disorder, fidelity to its behavioural components and the experiences of the participants and research clinicians involved.

Methods

A mixed-methods process evaluation was conducted. Semi-structured telephone interviews were carried out with 15 participants 1–2 months after completing a 6–8 week modified ketogenic diet intervention, and 4 research clinicians from the study team following the completion of data collection. Data were thematically analysed. Fidelity checklists completed by research dietitians were analysed using descriptive count and percentage statistics. Findings are reported post-hoc, following the analysis and publication of the main pilot study findings. Reporting was guided by the COREQ checklist.

Results

Five themes were identified in the qualitative data: (1) ‘Encouraging entry and supporting exit’ (e.g. recognising and managing participants’ varied motives and expectations, including around weight loss and symptom alleviation); (2) ‘Challenging but potentially transformational,’ which reflects that while it can be difficult to initiate and maintain a ketogenic diet day-to-day, many participants perceived physical and psychological benefits (e.g. significant weight loss, mood stability and enhanced ability to focus); (3) ‘Intervention facilitators,’ including a range of behavioural (e.g. goal setting), social (e.g. family and dietitians) and technological (e.g. apps for monitoring) support mechanisms; (4) ‘Intervention barriers’ (e.g. dietary preferences, concerns about the diet and its impact, the testing burden and capacity of the delivery team); and (5) ‘The wider context’ (e.g. the cost of living and sociocultural expectations) was a crucial factor explaining differential experiences. Overall, descriptive analyses indicated moderate-to-good fidelity to the behaviour change components of the study.

Conclusion

We provide novel insight into the experiences of people living with bipolar disorder initiating and following a ketogenic diet, as well as those of research clinicians who support the intervention. Future trials may benefit from increased clinical research capacity, better-defined entry and exit routes, additional interpersonal support, and greater understanding of how social and societal factors impact participation.

Trial registration

Study registration number: ISRCTN61613198 (02/03/22).
Deep learning for the classification of atrial fibrillation using wavelet transform-based visual images
Authors: Sun Ling-Chun , Lee Chia-Chiang , Ke Hung-Yen , Wei Chih-Yuan , Lin Ke-Feng , Lin Shih-Sung , Hsiu Hsin , Chen Ping-Nan
Published: January 2025

Background

As the incidence and prevalence of Atrial Fibrillation (AF) proliferate worldwide, the condition has become the epicenter of a plethora of ECG diagnostic research. In recent diagnostic methodologies, Morse Continuous Wavelet Transform (MsCWT) is a feature extraction technique utilized to draw out distinctive attributes of ECG signals. In our study, we explore the employment of MsCWT in the classification of AF with ECG signals in a continuum.

Results

We present a MsCWT image-based deep learning machine for AF differentiation. For the training, validation, and test sets, we achieved average accuracies of 97.94%, 97.84%, and 91.32%; and overall F1 scores of 97.13%, 96.86%, and 89.41% respectively. Moreover, AUC ROC curves of over 0.99 were obtained for all classes in the training and validation sets; and were over 0.9679 for the test set.

Conclusions

Training deep learning machines for the classification of AF with MsCWT-based images demonstrated to yield favorable outcomes and achieved superior performance amongst studies utilizing the same dataset. Though minimal, the conversion of signals into wavelet form with MsCWT may drastically improve outcomes not only in future ECG signal studies; but all signal-based diagnostics.
Qualitative evaluation of the implementation and national roll-out of the NHS App in England
Authors: Reidy Claire , Papoutsi Chrysanthi , KC Sukriti , Gudgin Bernard , Laverty Anthony A. , Greaves Felix , Powell John
Published: January 2025

Background

The NHS App launched in 2019 as the ‘digital front door’ to the National Health Service in England with core features including General Practitioner (GP) appointment booking, repeat prescriptions, patient access to records and, later on, COVID-19 vaccination certification. Similar patient portals have been adopted in different formats and with variable levels of success. In this longitudinal study (2021–2023) we examined how the NHS App became implemented in the pandemic context and beyond.

Methods

We recruited 88 participants in 62 qualitative interviews and four focus groups. Participants included patients, carers, members of the public, clinical/non-clinical NHS staff from five GP practices (where we also conducted over 60 h of observations) across England, as well as other industry, policy and civil rights stakeholders. Document analysis also contributed to participant recruitment and data interpretation. Data collection and analysis was informed by the Non-Adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework.

Results

Our study identified the various ways in which complexity manifested as part of the implementation, use and roll-out of the NHS App. Patients had diverse (positive and negative) user experiences as the app evolved, with some of its features described as more useful than others (e.g. prescription ordering, COVID Pass). As the app primarily provided a gateway to general practice systems and infrastructures, not all features were available by default or consistently to all users, with information often appearing fragmented or system-facing (e.g. coded). NHS staff viewed the app as constituting core NHS infrastructure in the long term which made it appealing, even though initially there was less recognition of its immediate value. There was variable organisational capacity to enable implementation and to put in place processes and staff roles required to support patient adoption. Shifting emphasis towards in-person care, challenges with digital inclusion and controversies related to features such as patient access to own records further complicated roll-out.

Conclusions

As the NHS App remains a complex innovation in a shifting landscape, it is clear ongoing work is needed to ensure its potential can be sustained to meet patient, service and policy needs.

Clinical study registration

ISRCTN72729780.
Patterns of pharmacological treatment in patients with atrial fibrillation: an analysis from the prospective GLORIA-AF Registry Phase III
Authors: Corica Bernadette , Romiti Giulio Francesco , Boriani Giuseppe , Olshansky Brian , Chao Tze-Fan , Huisman Menno V. , Proietti Marco , Lip Gregory Y. H. ,   on behalf of the GLORIA-AF Investigators
Published: January 2025

Background

Polypharmacy (i.e., treatment with ≥ 5 drugs) is common in patients with atrial fibrillation (AF) and has been associated with suboptimal management and worse outcomes. Little is known about how prescribed drug patterns affect management and prognosis in patients with AF.

Methods

Based on data from the prospective global GLORIA-AF Registry Phase III (recruiting patients with AF and CHA2DS2-VASc score ≥ 1), we performed a latent class analysis to identify treatment patterns based on 14 drug classes including cardiovascular (CV) and non-CV drugs. We analysed associations with oral anticoagulant (OAC) use and risk of a composite primary outcome (all-cause death and major adverse cardiovascular events (MACE)) and secondary outcomes.

Results

Among 21,245 patients (mean age 70.2 ± 10.3 years, 44.9% females), we identified 6 patterns: i) Low Medicated pattern (18.3%); ii) Hypertension pattern (21.1%); iii) Heart Failure pattern (20.0%); iv) CV Prevention pattern (21.0%); v) Mixed Morbidity pattern (4.5%); and vi) High Medicated pattern (15.0%). All groups had higher odds of OAC use vs the Low Medicated pattern, with highest prevalences in the Heart Failure pattern (OR [95%CI]: 2.17 [1.90–2.48]) and the High Medicated pattern (OR [95%CI]: 2.08 [1.77–2.44]). Over 3-year follow-up, Heart Failure, Mixed Morbidity and High Medicated patterns were associated with higher risk of the primary composite outcome (aHR [95%CI]: 1.32 [1.14–1.53]; 1.45 [1.17–1.80] and 1.35 [1.14–1.60], respectively). Similar results were observed for all-cause mortality.

Conclusions

In patients with AF, different treatment patterns can be identified. Each pattern was associated with unique OAC use and long-term clinical outcomes.
Engineering probiotic Escherichia coli for inflammation-responsive indoleacetic acid production using RiboJ-enhanced genetic circuits
Authors: Woo Seung-Gyun , Kim Seong Keun , Lee Seung-Goo , Lee Dae-Hee
Published: January 2025

Background

As our understanding of gut microbiota’s metabolic impacts on health grows, the interest in engineered probiotics has intensified. This study aimed to engineer the probiotic Escherichia coli Nissle 1917 (EcN) to produce indoleacetic acid (IAA) in response to gut inflammatory biomarkers thiosulfate and nitrate.

Results

Genetic circuits were developed to initiate IAA synthesis upon detecting inflammatory signals, optimizing a heterologous IAA biosynthetic pathway, and incorporating a RiboJ insulator to enhance IAA production. The engineered EcN strains demonstrated increased IAA production in the presence of thiosulfate and nitrate. An IAA-responsive genetic circuit using the IacR transcription factor from Pseudomonas putida 1290 was also developed for real-time IAA monitoring.

Conclusions

Given IAA’s role in reducing gastrointestinal inflammation, further refinement of this strain could lead to effective, in situ IAA-based therapies. This proof-of-concept advances the field of live biotherapeutic products and offers a promising approach for targeted therapy in inflammatory bowel diseases.
Measuring social integration, treatment, and mortality after substance use treatment: methodological elaborations in a 20-year follow-up study
Authors: Sohlberg Tove , Storbjörk Jessica , Wennberg Peter
Published: January 2025

Objective

Alcohol and Other Drug (AOD) disorders cause substantial harm. Effective Substance Use Treatment (SUT) exists, but long-term outcomes remain inconclusive. This study used a 20-year prospective follow-up of 1248 service users entering SUT in Stockholm, Sweden, in 2000–2002 to elaborate on how different dimensions of long-term outcomes may be measured by register-based indicators. Baseline characteristics and attrition bias were explicated, and register-based outcomes were examined.

Results

Register-based indicators are valuable, but they also have inherent limitations such as the lack of substance use data and inability to differentiate between un/met treatment needs and access. Significant variations in long-term outcomes were evident depending on which register-based indicator was used, and whether used in isolation or combinations. Six out of 10 service users were still alive after 20 years, but as many as 8 out of 10 of the survivors remained in treatment, and only two out of 10 had a stable economic situation. Hence, the register indicators identified only a few survivors, with stable economic and social situations, and without recent treatment contacts 20 years after treatment entry. The long-term outcomes were concerning and even more so when combining outcome dimensions.
Historical bias in palaeontological collections: Stylophora (Echinodermata) as a case study
Authors: Guenser Pauline , El Hariri Khadija , Jalil Nour-Eddine , Lefebvre Bertrand
Published: January 2025

Scientific colonialism (sensu Galtung, 1967) has grown in interest for the last decades in all scientific disciplines, including Palaeontology. In particular, Raja et al. (2022) showed that the Paleobiology Database (PBDB) was mostly based on research investigations from and/or in higher-income countries (i.e., the Global North). This scientific practice, better known as “parachute science”, often implies a transfer of material from their country of origin (in the Global South) to another country of collection (in the Global North). We show that this global pattern can also be observed at a lower taxonomic scale by focusing on Stylophora, an extinct class of echinoderms. Based on a database gathering the 129 stylophoran holotypes including information of their year of description, country of origin, country of collection and author affiliation, we show comparable results to those of Raja et al. (2022). Indeed, 85% of stylophoran species originated from the Global North. Transferred material represents 17% of the holotypes and none of the corresponding publications included local collaboration. We detail the most highlighting example of parachute science, the duo Morocco-France, to understand the consequences of the colonial history between these two countries in the scientific practice of French researchers in Morocco, as well as the solution brought by Moroccan researchers and government. These results, while not surprising, mean that scientific colonialism is indeed observed not only in global databases, but also in our daily work. Researchers from the Global North then can act to decolonize their problematic practice to rebalance knowledge producing to build a true Global Research Community.
Transcriptomic and enzymatic analysis of peroxidase families at the early growth stage of halophyte ice plant (Mesembryanthemum crystallinum L.) under salt stress
Authors: Hsieh Li-Ching , Lee Chia-Che , Zhang Kai-Fu , Chang Hui-Hsien , Li Cheng-Hsun , Huang Hsuan-Jung , Yen Hungchen Emilie
Published: January 2025

Ice plant (Mesembryanthemum crystallinum L.) is a halophyte and an inducible CAM plant. Ice plant seedlings display moderate salt tolerance, with root growth unaffected by 200 mM NaCl treatments, though hypocotyl elongation is hindered in salt-stressed etiolated seedlings. Superoxide anion accumulation was prominent in cotyledons and primary leaves but decreased in root tissues over time, with no significant effect from salt treatment. Hydrogen peroxide levels initially surged in both control and salt-treated seedlings, with higher and more persistent accumulation in the salt-treated seedlings. The activities of H2O2-scavenging ascorbate-glutathione cycle enzymes ascorbate peroxidase (APX), monodehydroascorbate reductase, and dehydroascorbate reductase increased, while guaiacol-dependent peroxidase activity decreased and catalase activity showed no change, indicating APX activity as the primary response to salt stress. Salt-induced APX activities were detected mainly in the microsomal fraction for light-grown seedlings and the cytosolic fraction for etiolated seedlings, highlighting plastids as the primary site of ROS accumulation under salt stress. An RNA-seq analysis of etiolated seedlings revealed about 8% unigenes showing more than a four-fold change in expression after a 6-h 200 mM NaCl treatment. GO enrichment analysis indicated that differentially expressed genes (DEGs) with increased transcript abundance were associated with ion transport, antioxidant activity, and stress responses, while DEGs with decreased transcript abundance were linked to metabolic and biosynthesis processes such as ribosomal protein synthesis and cell wall formation. This indicates that salt stress hinders growth but enhances ion homeostasis and stress response mechanisms. The expression of all eight APX genes were induced by a 48-hour salt treatment, with varying expression patterns. For class III peroxidase family, 14 out of 53 identified unigenes qualified as DEGs. The time-course expression patterns revealed that the transcript levels of McPrx4.1, McPrx12.1, and McPrx12.3 increased, while McPrx60.3 decreased. These findings highlight the distinct roles of class III peroxidases in balancing plant growth and stress responses, advancing our understanding of the mechanisms behind salt tolerance in halophytes. This study comprehensively analyzed changes in gene expression, antioxidant enzyme activity, and ROS accumulation in ice plant seedlings. Unveiling these responses will advance our understanding of the growth–stress balance in the intrinsic salt tolerance in halophytes.
Peer-review Blinded Assay Test (P-BAT): a framework for trustless laboratory quality assurance for state-regulated cannabis markets
Authors: Procter Stuart , Baird Grayson L. , Iannuccilli Jason
Published: January 2025

The purpose of laboratory testing in the cannabis industry is to ensure public safety by preventing products that exceed hazardous limits of contaminants from reaching consumers, and to provide consumers with transparent and accurate label information so that they can make informed decisions when purchasing and using products. However, cannabis testing does not exist in a vacuum of incentives—some incentives exist that are in direct conflict with what is best for consumers. For example, cultivators and distributors will prefer to use the services of laboratories that find the highest THC concentrations or lowest contaminant concentrations, regardless of the accuracy of their testing results. Laboratories will, therefore, be incentivized to serve the cultivators and distributors over the end consumer. The present essay proposes a framework for quality assurance that combats these perverse incentives. The following proposed framework called the Peer-review Blinded Assay Test (P-BAT), is a validation process where each laboratory tests products from competing labs and their own lab, but in a blinded fashion to ensure that the label values of said products and the labs that produced said labels, are unknown. This system of blinded self-review and peer-review is designed to be cost-efficient, transparent, nearly self-funded, can be implemented in any state with two or more laboratories, and most importantly, it is trustless—there is no need to trust the behavior of any one actor or laboratory to serve as a “gold standard”. While the primary objective of this process is to focus on laboratory performance, it will also highlight other common problems in the industry such as product adulteration by distributors and poor storge practices. Data from P-BAT should be publicly available so consumers can make informed decisions about their purchases based on the quality data derived from P-BAT. Doing so would further incentivize laboratories to serve and be accountable to the end consumer instead of cultivators and distributors.
The added role of Doppler ultrasound evaluation of sickle cell disease vasculopathy as a state of arterial stiffness and decreased nitric oxide bioavailability
Authors: Onsy Marwa Mohammed Mohammed , El-Saiedi Sonia Ali , Elsheshtawy Douaa Mohammed Mohammed , Abd-Elsamad Marwa Abd-Elhady
Published: January 2025

Background

Sickle cell disease is an inherited hemoglobinopathy resulting in chronic hemolysis and painful vaso-occlusive crises. Sickle vasculopathy caused by impaired nitric oxide bioavailability and arterial stiffness and associated with multiple complications.

Results

Mean age of patients was 13.85 ± 2.53 SD, 50% were males, 77.5% were homozygous sickle cell disease (SS). Brachial artery parameters showed that baseline diameter was significantly higher (p < 0.001) and flow mediated dilatation (FMD) was significantly lower in patients than control (p < 0.001). Carotid artery parameters showed that carotid intima-media thickness (CIMT) and cross-sectional distensability were significantly higher in sickle group than control (p 0.001, p 0.007). Diastolic shear stress and elastic modulus showed no significant difference between sickle and control group (p 0.071, p 0.083). Regarding sickle subgroups, carotid intima-media thickness was higher and cross-sectional compliance and distensability were lower in subgroup II than subgroup I (p < 0.001, p < 0.018, p < 0.035), respectively.

Conclusion

Doppler assessment of brachial and carotid elastic properties may be helpful for early detection of sickle cell vasculopathy and sickle-related complications.
Neuroplasticity and activity-based rehabilitation of a patient with post-surgical chronic Pott’s spine: a case report
Authors: Kini Raveena , Walankar Prachita , Minocha Aman , Panhale Vrushali
Published: January 2025

Background

India has a widespread prevalence of Pott’s disease, with an increased affection seen in young males. The common complications associated with it are spinal deformity and sensory-motor deficits in the limbs, which are based on the level of spinal affection.

Case presentation

We present a case of a 17-year-old male, with a history of Pott’s spine for 14 years. He has reported with anterior wedge compression and resorption of T7, T8, and T9 vertebral bodies along with Gibbus spine deformity and subsequent spinal cord compression. He underwent posterior decompression and spinal fixation with rods and pedicular screws and was referred to physiotherapy post-operatively. There is limited evidence about the emerging benefits of neuroplasticity in sequentially progressed sensorimotor skill retraining and activity-based learning as a part of rehabilitation. The patient underwent sequentially progressed mobility, balance, strength training, and activity-based relearning, which positively impacted the patient's recovery and improved quality of life.

Conclusion

Neuroplasticity and activity-based learning assisted in improving the functional status and quality of life in a patient surgically managed with decompression and spinal fusion post-Potts spine.
Life With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency: Challenges and Burdens
Authors: Witchel Selma Feldman , Miller Tahlyn , McCann Erika , Gupta Anshu
Published: January 2025

Context

Congenital adrenal hyperplasia (CAH) is an autosomal recessive genetic condition requiring daily medication(s) and attention to details. In addition to daily medications and regular visits with healthcare providers, families may live with perpetual angst regarding unpredictable occurrences of acute adrenal insufficiency. Despite numerous barriers and challenges imposed by this chronic condition, caregivers and healthcare professionals can empower our patients to achieve a good quality of life.

Evidence Synthesis

CAH is a global condition for which access to health care widely varies depending on local resources. Major treatment aims include good health, good quality of life, and achievement of personal goals for affected persons. To achieve these aims, patients, caregivers, and healthcare professionals interact to promote health maintenance and encourage positive outcomes for individuals with CAH. This article describes aspects of daily living with CAH through the perspective of 1 family and their healthcare team living in the United States. A young adult patient, nurse educator, and physicians provide their perspectives regarding patient health care, general well-being, and safety emphasizing that patients with CAH can thrive. Nevertheless, remembering and recognizing that many individuals with CAH live in areas with limited resources and enduring sociocultural barriers is essential.

Conclusion

With access to knowledgeable healthcare providers, sufficient resources, and psychosocial support, “children with CAH can thrive and live normal lives.” The future challenge is securing mechanisms to decrease the financial, sociocultural, and health access barriers in other communities throughout the world.
Microbiome transplants may not improve health and longevity in Drosophila melanogaster
Authors: Levine Benjamin H. , Hoffman Jessica M.
Published: January 2025

The gut microbiome, which is composed of bacteria, viruses, and fungi, and is involved in multiple essential physiological processes, changes measurably as a person ages, and can be associated with negative health outcomes. Microbiome transplants have been proposed as a method to improve gut function and reduce or reverse multiple disorders, including age-related diseases. Here, we take advantage of the laboratory model organism, Drosophila melanogaster, to test the effects of transplanting the microbiome of a young fly into middle-aged flies, across multiple genetic backgrounds and both sexes, to test whether age-related lifespan could be increased, and late-life physical health declines mitigated. Our results suggest that, overall, microbiome transplants do not improve longevity and may even be detrimental in flies, and the health effects of microbiome transplants were minor, but sex- and genotype-dependent. This discovery supports previous evidence that axenic flies, those with no gut microbiome, live healthier and longer lives than their non-axenic counterparts. The results of this study suggest that, at least for fruit flies, microbiome transplants may not be a viable intervention to improve health and longevity, though more research is still warranted.
Diagnostic Certainty in Characterizing Liver Lesions in Rectal Cancer: Abbreviated Liver MRI versus CT
Authors: Wale Anita , Harris Heather , Brown Gina
Published: January 2025

Background

Early diagnosis of metastases is crucial but routine staging with contrast-enhanced multidetector computed tomography (ceMDCT) is suboptimal. A total of 20% will have indeterminate or too small to characterize (TSTC) liver lesions on CT, requiring formal characterization by magnetic resonance imaging (MRI). This UK cross-sectional study reports our experience undertaking routine abbreviated liver MRI (MRI).

Patients and Methods

A total of 99 patients with rectal cancer had ceMDCT, abbreviated liver MRI, and rectal MRI at diagnosis. Liver imaging was scored for liver metastases, benign or indeterminate/TSTC lesions on a per patient basis. Primary rectal cancer was risk scored on MRI.

Results

A total of 42/99 (42%) had liver lesion(s) on ceMDCT versus 55/99 (56%) by MRI, and 46/99 (46%) had high-risk rectal cancer. ceMDCT showed 5 patients with liver metastases, 14 with benign lesions, and 23 with indeterminate/TSTC lesions. MRI showed 6 with liver metastases, 45 with benign lesions, and 4 with indeterminate/TSTC lesions. All liver metastases were in high-risk rectal cancer, OR 17.18 (p = 0.06), with 12.5% conversion rate of TSTC lesions to metastases in high-risk rectal cancer and 0% in low-risk rectal cancer. Diagnostic certainty of the liver findings was achieved in 93% of patients by MRI compared with 45% by ceMDCT (p < 0.0001).

Discussion

Abbreviated liver MRI diagnosed fewer indeterminate/TSTC lesions and provided greater diagnostic certainty than ceMDCT, p < 0.0001. High-risk rectal cancer is associated with a higher conversation rate of TSTC lesions to metastases than low-risk rectal cancers. Risk stratified; routine abbreviated liver MRI sequences should be investigated as part of the patient pathway for high-risk rectal cancer.
Um modelo para gestão de riscos e resiliência em compras
Authors: Barbosa Lilian Cristina Vieira , Laczynski de Souza Miguel Priscila
Published: January 2025

Objetivo: analisar a mudança na gestão de riscos e resiliência em Compras em função da pandemia e propor um modelo para profissionais se prepararem para novos eventos.
Estado da arte: durante a pandemia, Compras teve que gerir fornecedores para assegurar produtos e serviços e desenvolver resiliência. Apesar disso, não se sabe a extensão desta mudança em diferentes empresas.
Escopo: foi realizada pesquisa quantitativa utilizando metodologia survey com 110 profissionais de diferentes setores operando no Brasil.
Originalidade: o estudo avaliou, de forma quantitativa, a mudança nos processos de gestão de riscos e resiliência em Compras após uma crise, e traz um modelo para gestão de riscos e aumento da resiliência.
Impactos: o modelo proposto sugere como gestores podem implementar a gestão de riscos em Compras e as competências de resiliência necessárias para enfrentar eventos extremos.
Seus clientes estão mesmo no centro das atenções?
Authors: Machado Luiz Fernando , Guissoni Leandro Angotti
Published: January 2025

Objetivo: mostrar como desacoplar a experiência do cliente para analisar cada atividade da sua cadeia de valor no B2B.
Estado da arte: mudanças no comportamento dos clientes ocasionadas por tecnologias, startups e novos modelos de negócios desafiam a experiência ao cliente oferecida pelas empresas tradicionais. A literatura mostra que estas devem encontrar sinergias para o cliente em vez de apenas enfatizar sinergias para a empresa. Mas pouco se sabe sobre como fazer isso em negócios B2B.
Escopo: foi realizada pesquisa-ação com mapeamento da cadeia de valor do cliente e intervenções na área comercial em uma indústria químicofarmacêutica.
Originalidade: este artigo apresenta uma sequência de etapas entre entendimento e avaliação da experiência do cliente, desenho de experimentos de campo e intervenções nas práticas comerciais com ênfase nas oportunidades de crescimento nas vendas via inovações a partir das sinergias para o cliente. Enquanto a literatura neste tema enfatiza negócios direcionados ao consumidor final, este estudo aplica-se no setor empresarial.
Impactos: as etapas das aplicações propostas no artigo podem ajudar gestores a identificarem vulnerabilidades na relação entre suas empresas e os clientes, balanceando fontes de criação e de captura de valor no modelo de negócios centrado no cliente.
Teias empreendedoras
Authors: Silva Maria Janayna Alves de Lima , Paiva Luis Eduardo Brandão , Costa Filho Francisco Carlos da
Published: January 2025

Este estudo identifica as estratégias utilizadas por empreendedores digitais palmarenses nas redes sociais. Realizou-se uma pesquisa quantitativa e descritiva, com uma amostra de 42 empreendedores. Constatou-se que mais de 35 deles utilizam ativamente as redes sociais para expandir seus negócios. Os principais desafios enfrentados incluem a concorrência, as questões de preço e a falta de programas de fidelização. Apesar desses obstáculos, os empreendedores mantêm otimismo em relação ao futuro e buscam, constantemente, novas estratégias para melhorar sua presença online. Os resultados deste estudo oferecem insights valiosos para profissionais interessados no uso de redes sociais como ferramenta de negócios. Fornecem, também, uma base prática que pode servir como guia e fonte de capacitação para empreendedores digitais, especialmente os de Palmares. O estudo visa ajudar esses empreendedores a navegarem pelas complexidades do universo das redes sociais e aprimorar suas estratégias para alcançar o sucesso. A pesquisa destaca a importância de se adaptar às mudanças constantes do mercado digital e sugere a implementação de programas de fidelização como uma forma eficaz de enfrentar a concorrência e melhorar o desempenho comercial. Espera-se contribuir para o desenvolvimento do empreendedorismo digital na região, capacitando os empreendedores a usarem as redes sociais de forma mais eficaz para o crescimento de seus negócios.
Conducting longitudinal cohort research in secondary schools: Insights from the Born in Bradford Age of Wonder study
Authors: A. Shire Katy , Newsham Alex , Rahman Atif , Mason Dan , Ryan David , A. Lawlor Deborah , Opio-Te Gail , Nutting Hannah , Ojewande Ifeoluwa , Steward Isobel , Pickavance John , Lightfoot Kate , E. Pickett Kate , Jackson Laura , Lennon Laura , Gunning Lydia , Mon-Williams Mark , Dawkins Nathan , A Khan Nilam , Kerr Rosslyn , Ali Sanah , Gilbody Simon , Abid Dogra Sufyan , Walsh Theresa , Mirza Zarina , R. C. McEachan Rosemary , Wright John
Published: January 2025

Background Adolescence is a critical period of development which paves the way for longer term health trajectories and lifestyles. Understanding the variety of factors which influence adolescent health is crucial to developing interventions and services which have the potential to influence health across the life-course. Collecting representative, longitudinal data with adolescents at scale is difficult. Secondary school settings offer an excellent opportunity to collect such data with adolescents, however, there are inherent challenges in working with these settings. The Born in Bradford Age of Wonder (AoW) study aims to capture the health and wellbeing trajectories of up to 30,000 adolescents living in the diverse and multi-ethnic city of Bradford, UK. Methods This paper presents key challenges and associated lessons from the first three years of implementing the AoW programme across Bradford secondary schools. Challenges and lessons are described across seven thematic areas, with illustrative examples of how these learnings subsequently fed back into the programme design. These reflections later inform key recommendations to help guide future researchers. Results Notable challenges in implementing the research programme included collecting data for opt-in measures, providing tailored approaches for individual schools with differing facilities and needs, fitting data collection within school timings, and returning tangible value to schools and students in a responsive way. Key lessons included engaging schools as partners, enacting rigorous ethical processes and balancing flexibility with programme fidelity. Co-production and regular stakeholder engagement (including parents, teachers, students) ensured alignment between the programme delivery and local needs and priorities. Our recommendations describe successful implementation as a three-phased iterative process of preparation, implementation, and sustained engagement. Conclusions Conducting longitudinal health research in secondary schools is a highly dynamic and complex process. By embracing co-production, operational flexibility, and cohesive working practices, AoW offers a model for conducting large-scale research in UK secondary schools.
Budgetary Risk and the Role by Internal Financial Audit in it is Management
Authors: Kovalev Nikolai
Published: January 2025

The paper reveals key aspects of the essence of budgetary risk from the point of view of the operational approach, analyzes methodological aspects of budgetary risk management by individual participants of the budgetary process. The author has developed a system of budgetary risk management, defined the role of the subject of internal financial audit at each stage of risk management, and systematized the distribution of budgetary procedures and stages of the budgetary process of the federal budget. In addition, proposals have been prepared to adjust the wording of the concept of “measure to minimize (eliminate) budgetary risk” and the gap in terms of applicability of certain risk management mechanisms in the budgetary sphere has been eliminated. The results of the study can be applied by subjects of budgetary procedures and subjects of internal financial audit in the execution of budgetary powers, including the implementation of internal financial audit.
Russia's foreign trade under sanctions
Authors: Rudnyeva Anastasiya , Altuhov Artem , Butenko Natal'ya , Gavrilova Yuliya , Komonov Egor , Milyukov Kirill , Peratinskaya Dar'ya , Yurchenko Alevtina
Published: January 2025

The monograph is devoted to the assessment of quantitative and qualitative indicators of Russia's foreign trade under the influence of the sanctions shocks. The change in the commodity and the geographical structure is considered in the context of the profound transformation of the entire economic mechanism, which is based on the mobilization of own resources and the search for new areas of strategic partnership. The article analyzes the state, dynamics and prospects of development of various industries, including the defense industry complex, in the context of modern challenges and threats, from the perspective of not only risks, but also the opportunities for the development of domestic production, including in the context of import substitution, and increasing export potential of the country.
Efectos de una intervención de aprendizaje autorregulado en Educación Primaria sobre la responsabilidad, la motivación y la autorregulación.
Authors: Menéndez Santurio José Ignacio
Published: January 2025

La investigación sobre nuevas formas y estrategias de aprendizaje ha cobrado gran relevancia en los últimos años. En
ese sentido, una de las que más interés ha adquirido por parte de docentes e investigadores es el aprendizaje
autorregulado, que constituye un tipo de proceso psicológico que se centra en desarrollar la capacidad del alumnado de
planificar, ejecutar y evaluar las tareas escolares de manera autónoma. Así pues, el objetivo de este estudio fue analizar
el impacto de una intervención de aprendizaje autorregulado sobre la responsabilidad, la motivación interna y la
autorregulación. En el estudio participaron un total de 125 alumnos (61 niños y 64 niñas) de tres centros educativos
públicos del Principado de Asturias (España) que cursaban entre 4º y 6º de Educación Primaria (entre 9 y 12 años). Se
siguió un diseño de estudio cuasiexperimental con medidas pretest-postest y grupo control y experimental. Se evaluaron
la responsabilidad, la motivación interna y las estrategias autorreguladas a través de cuestionarios que presentaron
buenos índices de fiabilidad y de ajuste del modelo en los análisis factoriales realizados con la muestra del estudio. Los
resultados derivados de los análisis univariados (ancovas) reflejaron cambios positivos y significativos en el grupo que
vivió la experiencia autorregulada en todas las variables del estudio, a excepción de la responsabilidad de tipo social. Se
sugiere que la aplicación de intervenciones basadas en aprendizaje autorregulado ayuda al alumnado a potenciar
importantes variables en el contexto escolar.
Qualitative Study on the Experience of Pilgrimage Meditation through the Pilgrimage of Master Huineng of the Sixth Patriarch
Authors: Choi Youngim
Published: January 2025

The purpose of this study is to explore what participants in the pilgrimage meditation program of the Sixth Patriarch Huineng Pilgrimage experienced through the pilgrimage. The research questions of this study are as follows. First, what are the vows made by participants in the pilgrimage meditation program through pilgrimage? Second, what are the experiences of participants in the pilgrimage meditation program through pilgrimage? Third, what are the changes experienced by participants in the pilgrimage meditation program through the pilgrimage? This study conducted unstructured written interviews with 85 research subjects who participated in the pilgrimage to the shrine of Master Huineng of the Sixth Patriarch and analyzed them using a modified consensual qualitative research method. The results of this study are as follows. Eight categories and 38 subcategories were derived from three areas: pilgrimage meditation program participants' vows through pilgrimage, experience through pilgrimage, and change through pilgrimage. Each category and subcategory was carefully categorized, the ratio was calculated, presented in order of frequency, and specific examples were clearly presented. The results of this study are expected to be significant in that they empirically confirmed the profound effect of the meaning of pilgrimage meditation.
Low harmonic distortion demodulation scheme for PMDI-TDM structure fiber-optic sensor array
Authors: Zhang Jianxiang , Huang Wenzhu , Zhang Wentao , Li Fang , Wang Yaxin , Xiong Yan , Wu Yun
Published: January 2025

The fiber-optic sensor array based on path-matched differential interferometry (PMDI)-time division multiplexing (TDM) offers the advantages of minimal channel crosstalk and high sensitivity. The 3 × 3 optical fiber coupler demodulation is the commonly employed scheme for PMDI-TDM. However, due to the non-ideal characteristics of the 3 × 3 optical fiber coupler and inconsistencies in multi-channel photodetectors, harmonic distortion occurs during signal demodulation. This paper proposes a low harmonic distortion signal demodulation scheme for PMDI-TDM structure fiber-optic sensor arrays based on multi-channel parameter fitting and tracking. This scheme utilizes the random sample consensus (RANSAC) algorithm to accurately obtain the parameters of the ellipse formed by the interference fringes of each element sensor in the system. Furthermore, the multi-channel parallel extended Kalman filter (MPEKF) is used to realize the real-time tracking of multi-channel demodulation parameters. The RANSAC-MPEKF scheme can suppress the influence of outliers, and effectively eliminate the non-ideal characteristics of 3 × 3 coupler and the non-consistency of photodetector, thereby suppressing harmonic distortion of the demodulation results of each channel. The experimental results demonstrate that the proposed scheme can suppress the influence of outliers, .and achieves a demodulation rate ≥500 kHz with minimal resource consumption, making it particularly suitable for large-scale multiplexing systems with a THD value better than 0.12%.