bluuebunny/crossref_metadata_2025 huggingface dataset:
SHoes for Adolescent PatEllofemoral pain: study protocol for the SHAPE Australian community-based, randomised clinical trial
Authors: Paterson Kade L , Shearer Sam , Bennell Kim L , Bryant Adam , Li Peixuan , De Silva Anurika P , Lamb Karen Elaine , Manski-Nankervis Jo-Anne , Hinman Rana S
Published: February 2025

Introduction

Patellofemoral pain affects one-third of adolescents, with most experiencing symptoms into adulthood. Guidelines recommend exercise and foot orthoses based on clinical trials in adults; however, these approaches have been found to be ineffective and have poor adherence in adolescents. ‘Minimalist’ shoes can reduce patellofemoral joint forces in adults; and may therefore be a promising low burden management approach for patellofemoral pain. This article outlines the protocol for a randomised clinical trial (RCT) that aims to determine if minimalist footwear improves pain, function and other symptoms compared with motion control shoes, in adolescents with patellofemoral pain.

Methods and analysis

This is a 3-month, pragmatic, two-arm parallel group, comparative effectiveness, superiority RCT conducted in Melbourne, Australia. We are recruiting 158 participants aged between 12 and 19 years with patellofemoral pain from the community. Following baseline assessment, participants are randomised to receive either minimalist shoes (intervention group) or motion control shoes (control group, given that clinicians typically advocate motion control shoes for patellofemoral pain). Participants choose one pair of shoes in their allocated group from two colour options. They are advised to wear their study shoes for all planned sports and exercise-based activities over the subsequent 3 months and are also advised that they may wear them as much as desired at other times. The primary outcomes are the 3-month change in (1) severity of the worst knee pain experienced over the past week, measured using a Numerical Rating Scale, and (2) the function in sport and play subscale of the Knee Injury and Osteoarthritis Outcome Score for Children. The secondary outcomes include changes in other parameters of knee pain, symptoms, function in daily activities, health-related and knee-related quality of life, global improvement and fear of movement. Other measures include cointervention use, adherence, adverse events, shoe comfort, descriptive characteristics, physical activity levels, footwear characteristics and objective foot measures.

Ethics and dissemination

This study has been approved by the University of Melbourne Greater than Low Risk Human Research Ethics Committee (reference: 2022-25470-35344-4). Written informed consent is obtained from each participant prior to enrolment. The SHoes for Adolescent PatEllofemoral pain trial will provide the first RCT evidence on the efficacy of minimalist shoes compared with motion control shoes in adolescents with patellofemoral pain. Outcomes will be presented at national and international scientific conferences and published in peer-review journals.

Trial registration number

Australian New Zealand Clinical Trials Registry reference: ACTRN12623000042640.
Prediction of postoperative myocardial injury in patients undergoing laparoscopic pheochromocytoma/paraganglioma resection: protocol for an ambispective cohort study
Authors: Lan Ling , Ma Ye , Zhao Yifei , Li Yaohan , Zhang Yi , Shen Le , Zhang Yuelun , Huang Yuguang
Published: February 2025

Introduction

Pheochromocytoma/paraganglioma (PPGL) resection remains a high-risk surgical procedure owing to severe haemodynamic instability, which can lead to myocardial injury after non-cardiac surgery (MINS). MINS is the most common and easily overlooked cardiovascular complication and results in increased postoperative mortality and prolonged inpatient hospitalisation. We aimed to develop and validate a predictive model for MINS in patients undergoing laparoscopic PPGL resection.

Methods and analysis

The PPGL-MINS study is a single-centre, observational, ambispective cohort study that includes patients undergoing elective laparoscopic PPGL resection under general anaesthesia at the Peking Union Medical College Hospital (PUMCH) between 1 January 2013 and 31 May 2025. We expect to enrol 700 patients, including at least 550 patients retrospectively and 150 patients prospectively. A prediction model will be developed for the retrospective cohort (training cohort) of patients from 1 January 2013 to 31 December 2022. Possible clinically relevant variables, particularly intraoperative blood pressure and heart rate, will be selected as candidate predictors. Stepwise and least absolute shrinkage and selection operator regression will be used for predictor selection. Multivariate logistic regression will be used to develop the prediction model, which will be presented as a nomogram. The developed model will be used to assess discrimination with the receiver operating characteristic curve and area under the curve value, calibration with the Hosmer-Lemeshow test and calibration curve, and clinical usefulness with decision curve analysis. Internal validation will be assessed with bootstrap. For external validation, we will use an independent prospective cohort (validation cohort) of patients from 1 March 2023 to 31 May 2025.

Ethics and dissemination

The study protocol has been approved by the Research Ethics Committee of PUMCH (IRB-K2893). Written informed consent will be obtained from all participants in the prospective cohort before enrolment in the study. We aim to publish and disseminate the findings in peer-reviewed journals and at scientific conferences.

Trial registration number

NCT05752773.
Roles of physiotherapists in primary care teams: a scoping review
Authors: Champoux Megan , Poirier Amélie , Hudon Catherine
Published: February 2025

Objectives

We aimed to provide an overview of the existing knowledge regarding the roles of physiotherapists in primary care teams.

Design

Scoping review based on the methodological framework provided by Arksey and O’Malley (2005) and updated by Levacet al(2010). 

Data sources and study selection

A search strategy was carried out across the Medline, CINAHL, Academic Search Complete and AMED databases in June 2023. Selected articles, based on qualitative or mixed design studies, had to report on the roles of physiotherapists working in team-based primary care organisations and be published in the last 10 years.

Data extraction and analysis

Data were extracted by one team member and further validated by a second team member. A mixed thematic analysis based on theCompetency Profile for Physiotherapists in Canadawas used to identify all the roles undertaken by physiotherapists. 

Results

The database search yielded 2324 articles. From the 13 included articles, 6 main themes emerged: conduct client assessment for musculoskeletal conditions, participate in health promotion and prevention, promote self-management support, communicate with patients, collaborate with other primary care providers and partners, and provide holistic care.

Conclusions

The review identified a wide variety of roles, primarily related to the treatment of musculoskeletal patients. In primary care settings, interprofessional collaboration can be hindered by a lack of knowledge regarding the roles of physiotherapists. Future studies should aim to develop effective strategies to ensure that all primary care team members have a comprehensive understanding of the roles of physiotherapists and to explore roles associated with non-traditional forms of physiotherapy practice.
Advancing Alzheimer’s disease risk prediction: development and validation of a machine learning-based preclinical screening model in a cross-sectional study
Authors: Wang Bingsheng , Xie Ruihan , Qi Wenhao , Yao Jiani , Shi Yankai , Lou Xiajing , Dong Chaoqun , Zhu Xiaohong , Wang Bing , He Danni , Chen Yanfei , Cao Shihua
Published: February 2025

Objectives

Alzheimer’s disease (AD) poses a significant challenge for individuals aged 65 and older, being the most prevalent form of dementia. Although existing AD risk prediction tools demonstrate high accuracy, their complexity and limited accessibility restrict practical application. This study aimed to develop a convenience, efficient prediction model for AD risk using machine learning techniques.

Design and setting

We conducted a cross-sectional study with participants aged 60 and older from the National Alzheimer’s Coordinating Center. We selected personal characteristics, clinical data and psychosocial factors as baseline predictors for AD (March 2015 to December 2021). The study utilised Random Forest and Extreme Gradient Boosting (XGBoost) algorithms alongside traditional logistic regression for modelling. An oversampling method was applied to balance the data set.

Interventions

This study has no interventions.

Participants

The study included 2379 participants, of whom 507 were diagnosed with AD.

Primary and secondary outcome measures

Including accuracy, precision, recall, F1 score, etc.

Results

11 variables were critical in the training phase, including educational level, depression, insomnia, age, Body Mass Index (BMI), medication count, gender, stenting, systolic blood pressure (sbp), neurosis and rapid eye movement. The XGBoost model exhibited superior performance compared with other models, achieving area under the curve of 0.915, sensitivity of 76.2% and specificity of 92.9%. The most influential predictors were educational level, total medication count, age, sbp and BMI.

Conclusions

The proposed classifier can help guide preclinical screening of AD in the elderly population.
Aetiopathogenesis, clinico-epidemiological and diagnostic aspects of human ocular trematode infections: a scoping review protocol
Authors: Kodithuwakku Piyumi , Weerakoon Harshi , Silva Anjana , Wickramasinghe Susiji , Weerakoon Kosala
Published: February 2025

Introduction

Human ocular trematode infections, caused by parasitic flatworms, are a significant public health concern worldwide. It can lead to mild-to-severe consequences if untreated. This protocol outlines a scoping review methodology, which aims to explore the knowledge on the aetiopathogenesis, clinico-epidemiological and diagnostic aspects, and patient perspectives related to ocular trematode infections in humans.

Methods and analysis

The review, including the development of the review protocol, will be conducted over 2 years from January 2024. The Joanna Briggs Institute Reviewers’ Manual and the framework developed by Arksey and O’Malley will be used as the guidelines for the scoping review that is suggested in this protocol. Accordingly, the PCC (Population, Concept, Context) framework and three-stage search strategy will be used to develop the research question and to conduct the search respectively. Publications up to December 2024 will be searched across multiple databases, including MEDLINE/PubMed, Scopus, Science Direct, CINAHL and Google Scholar.

Ethics and dissemination

Since the study will make use of secondary data, ethical approval will not be required. The scoping review’s findings will be published in a scientific journal and presented at relevant conferences, aiming to improve the disease outcomes through guiding future research in ocular trematode infections and informing potential strategies to uplift the disease control and prevention measures and patient care.
Clinical outcomes after immune checkpoint inhibitor-associated acute kidney injury: a cohort study
Authors: Yang Ting-Ya , Chuang Min-Hsiang , Lin Hong-Min , Wu Vin-Cent , Pan Heng-Chih , Chou Yun , Chen Jui-Yi
Published: February 2025

Objectives

Immune checkpoint inhibitors (ICPi) have significantly improved survival for patients with advanced cancers. However, the occurrence of ICPi-associated acute kidney injury (AKI) and its clinical impact remains unclear. This study evaluates the effects of ICPi-associated AKI (ICPi-AKI) on mortality, kidney and cardiovascular outcomes in patients undergoing ICPi treatments.

Design

This multicentre retrospective cohort study with propensity score matching to balance baseline characteristics. The International Classification of Diseases, 10th Revision codes were used to identify individuals with cancer and treated with ICPi concurrently. Kaplan-Meier analyses coupled with log-rank tests were conducted to estimate the survival probabilities.

Setting

Data were sourced from the TriNetX database spanning records from 25 March 2011 to 5 April 2024.

Participants

Patients with cancer aged ≥18 years treated with ICPi with or without AKI occurrence.

Primary and secondary outcome measures

The primary outcome was all-cause mortality, and secondary outcomes included major adverse kidney events (MAKE), major adverse cardiovascular events (MACE), the composite of MAKE or MACE with death, and end-stage renal disease.

Results

The study identified 926 patients with cancer who developed ICPi-AKI (mean age, 67.1±11.8 years; 57.4% men). The control group consisted of 48 147 patients treated with ICPi but did not develop AKI (mean age, 65.3±13.1 years; 53.7% men). After matching, the ICPi-AKI group exhibited a higher risk of all-cause mortality (HR=1.27; 95% CI 1.02 to 1.61), MAKE (HR=3.83; 95% CI 1.72 to 8.40), MACE (HR=1.35; 95% CI 1.03 to 1.75)) compared with the non-ICPi-AKI group. Subgroup analyses confirmed these findings across various patient’s characteristics.

Conclusion

Individuals with ICPi-AKI are associated with an increased risk of all-cause mortality, MAKE and MACE. Enhancing awareness and timely intervention for ICPi-AKI are crucial for improving prognosis and reducing complications among patients with cancer.
Influence of social support on technophobia in older adults in urban communities: the mediating role of self-efficacy and e-health literacy, a cross-sectional study
Authors: Luo Dan , Li Jin , Wang Chen , Shi Yan , Guo Hua Qing , Guang Duan Zhi
Published: February 2025

Objectives

To explore the chained mediating role of self-efficacy and e-health literacy in the association between social support and technophobia in older adults in urban communities.

Design

A cross-sectional study conducted from June 2023 to April 2024.

Setting

This study was conducted in three districts of Taiyuan City, Shanxi Province, China.

Participants

The study enrolled 1658 older adults (> 60 years old) in urban communities in Taiyuan.

Methods

The analyses included assessments using the technophobia, e-health, self-efficacy and social support scales, and the mediating effects of these indices were investigated using Model 6 in SPSS V.26.

Results

The level of technophobia in older adults was found to be moderately high. Technophobia was negatively correlated with social support, self-efficacy and e-health literacy. Stepwise regression analysis showed that age, residential situation, health and the frequency of electronic device use were risk factors for technophobia (p<0.05). Social support could influence technophobia directly (β=−0.266). In addition, self-efficacy (β=−0.080) and e-health literacy (β=−0.098) significantly mediated the relationship between social support and technophobia.

Conclusion

Social support was found to affect technophobia in older adults via the independent or chained mediating effects of self-efficacy and e-health literacy.
Screening, diagnosis, treatment and outcomes of developmental dysplasia of the hip in Brazilian population: a scoping review
Authors: Jaleca Patrícia Eduarda Conrado Martins Ro , Liggio Daniel Frank , Arora Sana , Lam Sheila , Schaeffer Emily , Grangeiro Patricia Moreno
Published: February 2025

Objective

This study aims to map the literature on screening, diagnosis, treatment and outcomes of developmental dysplasia of the hip (DDH) in the Brazilian population aged 0–18 years, to describe regional variations in its presentation and management.

Design

Scoping review.

Data sources

PubMed/MEDLINE, Web of Science, Scopus, “Biblioteca Virtual em Saúde” and “Biblioteca Digital Brasileira de Teses e Dissertações”. The journals, Revista Brasileira Ortopedia and Acta Ortopédica Brasileira, were manually searched for non-indexed issues. Databases were searched from their inception to February 2024.

Eligibility criteria

This scoping review included studies on Brazilian patients aged 0–18 years diagnosed with or being assessed for DDH. No language or date restrictions were applied.

Data extraction and synthesis

Studies were assessed based on title, authors, publication year, study design, sample size, level of evidence, region of Brazil and healthcare setting (public or private). The articles were then analysed across four categories: screening, diagnosis, treatment and outcomes.

Results

52 studies, published between 1951 and 2023, were included. Reported prevalence rates ranged from 0.75 to 56.4 cases per 1000 children. No study examined the effectiveness of specific screening programmes or compared their outcomes. The most common diagnostic methods were the Ortolani manoeuvre and ultrasonography using the Graf method. Of the 27 articles on treatment, 17 focused exclusively on surgical interventions, with the Salter osteotomy being the most frequent procedure.

Conclusions

There should be a greater focus on understanding the prevalence of DDH in Brazil, the availability of ultrasound devices and trained operators, and the follow-up of conservative treatments. More information on DDH in Brazil is essential for designing and implementing effective screening and treatment programmes. Future research should be done to understand the prevalence of the disease, optimal forms of screening and early treatment.
Challenges and barriers to physician decision-making for prescribing and deprescribing among patients with multimorbidity in eastern China’s primary care settings: a qualitative study
Authors: Zhou Xinmei , Han Liyan , Farmer Andrew , Yao Mi , Xia Yu , Yan Ming , Wu Lingyan , Xu Zhijie
Published: February 2025

Objectives

Patients with multimorbidity have an increased risk of medication-related problems. Physicians face the dilemmas of multimorbidity management with multiple medications in primary care settings. We aimed to investigate the experiences and perceptions of primary care physicians (PCPs) regarding their decision-making processes in prescribing and deprescribing medications for patients with multimorbidity, and identify the challenges and barriers they face.

Design

From 5 October 2023 to 27 January 2024, this qualitative study was conducted through semi-structured interviews that encouraged in-depth exploration of the participants’ experiences and perspectives. The interviews were audio-recorded, transcribed verbatim, and independently coded by two investigators. Themes were developed using a conventional content analysis approach.

Setting

12 community health centers and 8 township health centers across four regions in eastern China were included.

Participants

26 PCPs from 20 primary care institutions in eastern China were interviewed through purposive sampling, representing a mix of urban and rural healthcare settings.

Results

Of the 26 participants in this study, 14 (53.8%) were women, and the mean age was 36.3 years old. When prescribing and stopping medications for patients with multimorbidity, they often encounter complex challenges. These challenges stemmed from three key areas: (1) difficulties in identifying drug-disease and drug-drug interactions; (2) cognitive biases in medication benefit-risk evaluation and (3) heavy treatment burden. The challenges were further compounded by multiple barriers, including clinical inertia among physicians, patient resistance to medication changes, inadequate decision support and training, and time constraints in clinical consultation.

Conclusions

The complexity of prescribing and deprescribing decisions faced by PCPs in treating patients with multimorbidity in China is influenced by interconnected factors related to physicians, patients, technology and working environment. Future research could develop and evaluate implementation strategies to address specific challenges and barriers to allow PCPs to make effective medication decisions for patients with multimorbidity.
Microsimulation models on child and adolescent health: a scoping review protocol
Authors: de Oliveira Claire , Sampaio Filipa
Published: February 2025

Introduction

Microsimulation models are computer-based models, which can be employed to simulate the behaviour of microagents, such as children and adolescents, to understand the potential behavioural and economic effects of health interventions or policies. As a result, these models can be useful tools to help guide decision-making. A comprehensive review of the literature on child and adolescent microsimulation models has yet to be undertaken. Moreover, an evaluation of the quality of the existing models can be useful to understand their strengths and limitations and thus inform the development of future models. The aim of this scoping review will be to retrieve, synthesise and critically appraise the literature on existing microsimulation models focused on child and adolescent health.

Methods and analysis

We will conduct a scoping review using established methods. We will search PubMed (until 23 September 2024), Embase (until 18 September 2024), CINAHL (until 9 September 2024), PsyclNFO (11 September 2024), EconLit (until 9 September 2024) and Scopus (until 10 September 2024), with an update closer to the time of manuscript submission. We will also undertake snowballing, Google searches and searches on specific journal (eg,International Journal of Microsimulation) and websites (eg,https://www.microsimulation.ac.uk/) to complement database searches. We will extract relevant data on all studies retrieved and use the Quality Assessment Reporting for Microsimulation Models checklist to assess the reporting quality of each model. We will use a narrative synthesis with summary tables to describe our findings. Findings will be synthesised by type of health condition, if/where possible.

Ethics and dissemination

Given that primary data will not be collected in this study, research ethics approval is not required. We will present our findings at relevant conferences and publish our results in an appropriate peer-reviewed academic journal. In addition, we will use this information to guide the development of a microsimulation model on child and adolescent health for use in the Swedish context.

Registration details

https://osf.io/a8txn/
Energy management education for persons living with long COVID-related fatigue (EMERGE): protocol of a two-parallel arms target trial emulation study in a multicentre outpatient intervention setting with an online control group register
Authors: Hersche Ruth , Weise Andrea , Riggi Emilia , Di Tanna Gian Luca , Barbero Marco
Published: February 2025

Introduction

Energy management education (EME) is a manualised, evidence-based self-management education programme developed and delivered by occupational therapists for persons living with chronic disease-related fatigue. Studies have shown that EME can positively affect self-efficacy, fatigue impact and quality of life in persons with chronic conditions, while data on persons with long COVID are lacking.

The primary aim is to evaluate if adding EME to the standard care improves outcomes in persons with long COVID-related fatigue. The secondary aim is to explore the energy management behavioural strategies applied in daily routines and investigate the influencing factors of implementing behavioural changes. The third aim is to perform a cost-effectiveness analysis of EME.

Methods and analysis

Using observational data, we will emulate a prospective two-parallel arms target trial to assess whether adding EME to the standard care is associated with improved outcomes in patients with long COVID-related fatigue. The estimated sample size to detect a post-intervention difference of 1.5 points in self-efficacy to implement energy conservation strategies with 90% power (0.05 alpha) is 122 people (1:1 ratio).

Persons with long COVID-related fatigue who follow EME as part of their standard care will be recruited and included in the experimental group (EG), while potential participants for the control group (CG) will be recruited from a register and prospectively matched to a participant in the EG by applying the propensity score technique. The ‘standard of care’ of the CG will include any intervention, except occupational therapy-based EME in peer groups. The causal contrast of interest will be the per-protocol effect. Four self-reported questionnaires (fatigue impact, self-efficacy in performing energy management strategies, competency in performing daily activities, health-related quality of life) will be administered at baseline (T0; week 0), after lesson 7 (T1; week 6), post-intervention (T2; week 14) and follow-up (T3, week 24). Our main assessment will be at T2. Disease-related and productivity cost data will be collected, and a cost-effectiveness profile of the EME intervention will be compared with standard care.

Ethics and dissemination

Ethical approval has been obtained from the competent Swiss ethics commission.

Findings will be reported (1) to the study participants; (2) to patient organisations and hospitals supporting EMERGE; (3) to funding bodies; (4) to the national and international occupational therapy community and healthcare policy; (5) will be presented at local, national, and international conferences and (6) will be disseminated by peer-review publications.
Evaluating the implementation of a multicomponent intervention to improve faecal immunochemical test-based (FIT) colorectal cancer screening in primary care
Authors: Adhikari Kamala , Mughal Muhammad Kashif , Whitworth James , Hignell Danica , Moysey Barbara , Chishtie Jawad , Teare Gary F
Published: February 2025

Screening has proven effective at reducing the incidence and mortality of colorectal cancer (CRC). The faecal immunochemical test (FIT) is recommended for screening people aged 50–74 years at average risk of CRC in Alberta, Canada. This project implemented a multicomponent intervention in real-world, primary care settings in Alberta to improve the FIT participation rate and evaluated the reach, effectiveness and implementation outcomes.

The multicomponent intervention comprised of in-clinic FIT kit distribution, patient education and reminder calls, was implemented in four primary care clinics. Reach was measured as the proportion of patients receiving the intervention. Effectiveness was measured by comparing the proportion of patients completing FIT during preintervention and perintervention periods. Implementation was measured by the perceived acceptability, appropriateness and feasibility of providers in implementing the intervention. Data were collected from electronic medical records and validated survey tools.

Four clinics implemented the intervention during an 8-month study period (September 2021 to April 2022); 99% of eligible patients received a FIT kit. The baseline FIT completion rate across participating clinics was 62%, which increased by 13 percentage points to 75% during the intervention period. Of the 75% who completed the FIT, 56% did without a reminder call, whereas 19% did so after receiving one or more reminders. More than 90% of providers perceived the intervention implementation as acceptable, feasible and appropriate.

The multicomponent FIT intervention was perceived as acceptable, feasible, and appropriate and improved the FIT screening rates in pilot clinics. An implementation guidance document has been developed and tested to communicate the implementation process for use by other primary care clinics and aid in the spread of the intervention across Alberta. Implementing this intervention in routine practice can help decrease the incidence and mortality of CRC.
Air pollution exposures in early life and brain development in children (ABC): protocol for a pregnancy cohort study
Authors: Benki-Nugent Sarah , Were Faridah H , Riederer Anne M , Gatari Michael , Karr CJ , Seto Edmund YW , Mutai Beatrice C , Wamithi Susan , Collett Brent R , Kinuthia John , Edemba Priscilla Wanini , Richardson Barbra A , McClelland R Scott , Larson Timothy V , Marshall Julian D , Maleche-Obimbo Elizabeth
Published: February 2025

Introduction

Air pollution is linked with poor neurodevelopment in high-income countries. Comparable data are scant for low-income countries, where exposures are higher. Longitudinal pregnancy cohort studies are optimal for individual exposure assessment during critical windows of brain development and examination of neurodevelopment. This study aims to determine the association between prenatal ambient air pollutant exposure and neurodevelopment in children aged 12, 24 and 36 months through a collaborative, capacity-enriching research partnership.

Methods and analysis

This observational cohort study is based in Nairobi, Kenya. Eligibility criteria are singleton pregnancy, no severe pregnancy complications and maternal age 18 to 40 years. At entry, mothers (n=400) are administered surveys to characterise air pollution exposures reflecting household features and occupational activities and provide blood (for lead analysis) and urine specimens (for polycyclic aromatic hydrocarbon (PAH) metabolites). Mothers attend up to two additional antenatal study visits, with urine collection, and infants are followed through age 36 months for annual neurodevelopment and caregiving behaviour assessment, and child urine and blood collection. Primary outcomes are child motor skills, language and cognition at 12, 24 and 36 months, and executive function at 36 months. The primary exposure is urinary PAH metabolite concentrations. Additional exposure assessment in a subset of the cohort includes residential indoor and outdoor air monitoring for fine particulate matter (PM2.5), carbon monoxide (CO), ultrafine particles (UFP) and black carbon (BC).

Ethics and dissemination

This study was approved by the Kenyatta National Hospital - University of Nairobi Ethics and Research Committee, and the University of Washington Human Subjects Division. Results are shared at annual workshops.
Performance of current tools used for on-the-day assessment and diagnosis of mild traumatic brain injury in sport: a systematic review
Authors: Haste Phoebe , de Almeida e Bueno Leonardo , Jérusalem Antoine , Bergmann Jeroen
Published: February 2025

Objective

The monitoring and diagnosis of sports-related mild traumatic brain injury (SR-mTBI) remains a challenge. This systematic review summarises the current monitoring tools used for on-the-day assessment and diagnosis of SR-mTBI and their performance.

Design

Systematic review, using Quality Assessment of Diagnostic Accuracy Studies assessment.

Data sources

Embase via Ovid, IEEEXplore, Medline via Ovid, Scopus and Web of Science were searched up to June 2024.

Eligibility criteria

Peer-reviewed English-language journal articles which measured athletes using the index test within a day of injury and provided a performance measure for the method used. Studies of all designs were accepted, and no reference methods were required.

Results

2534 unique records were retrieved, with 52 reports included in the review. Participants were 76% male, when reported, and the mean injury-to-measurement time was reported in 10% of reports. 46 different methods were investigated. 38 different reference methods were used, highlighting the lack of gold standard within the field. Area under the curve (AUC), sensitivity and specificity were the most frequent outcome metrics provided. The most frequent index test was the King-Devick (KD) test. However, there were large variations in accuracy metrics between reports for the KD test, for instance, the range of AUC: 0.51–0.92.

Conclusion

Combinations of existing methods and the KD test were most accurate in assessing SR-mTBI, despite the inconsistent accuracy values related to the KD test. The absence of a gold-standard measurement hampers our ability to diagnose or monitor SR-mTBI. Further exploration of the mechanisms and time-dependent pathophysiology of SR-mTBI could result in more targeted diagnostic and monitoring techniques. The Podium Institute for Sports Medicine and Technology funded this work.

PROSPERO registration number

CRD42022376560.
Clinical decision fatigue: a systematic and scoping review with meta-synthesis
Authors: Grignoli Nicola , Manoni Greta , Gianini Jvan , Schulz Peter , Gabutti Luca , Petrocchi Serena
Published: February 2025

Objective

Decision fatigue (DF) can lead to impaired judgement, decreased diagnostic accuracy and increased likelihood of medical errors. Research on DF is scarce, and little is known about its nature in the clinical context. The objective of the present review was to provide a comprehensive framework to understand how the construct of DF in medical settings has been defined and measured. This review aimed to understand DF determinants and consequences and capture motivational factors overlooked in the existing reviews.

Design

Systematic and scoping review (ScR) with meta-synthesis.

Eligibility criteria

Empirical and non-empirical papers on clinical DF or related constructs directly impacting clinical decision-making were considered, with doctors of all ages, sexes and nationalities as participants. The Preferred Reporting Item for Systematic Reviews and Meta-analyses scoping review checklist has been applied and checked.

Information sources

Six databases were systematically searched by two independent researchers according to a predefined set of keywords.

Results

43 papers were included, of which 25 were empirical. The quantitative studies outnumber the qualitative ones and primarily involved residents in Europe/UK and North America. Internal medicine and primary care were the most studied disciplines. Only one sequential cross-sectional study measured DF in the medical setting, and all other studies addressed the construct indirectly. A conceptual analysis of clinical DF, including narrative contributions, a thematic analysis of the data extracted and a meta-synthesis, is provided. Clinical DF was investigated mostly by individual risk factors analysed through multiple intertwined determinants involving cognitive, emotional, behavioural, social and ethical aspects. Relevant risks, protective factors and negative outcomes circularly increasing DF are outlined.

Conclusions

The review gives solid arguments for developing a clear and coherent definition of clinical DF that allows the implementation of preventive targeted intervention.

PROSPERO registration number

This systematic review was pre-registered in PROSPERO on 8 November 2023 (available online at:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023476190, registration number CRD4202347619).
Geometric distribution of plaque calcification is associated with postprocedural hypotension after carotid artery stenting
Authors: Chen Zhicai , Cheng Hui , Zhang Qiongyin , Yu Shufeng , Wang Peng , Xu Chao
Published: February 2025

Background

Our study aimed to investigate the relationship between the geometric distribution of plaque calcification and the occurrence of postprocedural hypotension following carotid artery stenting (CAS).

Methods

We retrospectively analyzed data from CAS patients between April 2018 and February 2023. Plaque calcification was evaluated using cross-sectional images obtained from multiplanar reconstructions perpendicular to the longitudinal axis of the internal carotid artery (ICA). The cross-sectional image of the most stenotic ICA was segmented into four quadrants: interior, exterior, ventral, and dorsal. We innovatively defined the geometric classification of plaque calcification based on physiological anatomy as modified calcification location. Postprocedural hypotension was defined as persistent systolic blood pressure at <90 mmHg, requiring intravenous vasopressor infusions that lasted more than 1 hour.

Results

A total of 477 patients were included in the final analysis. Among them, 41 (8.6%) patients experienced postprocedural hypotension after CAS. For the modified geometric method, plaque calcification was found significantly more frequently in the hypotension group compared with the non-hypotension group in the dorsal quadrant. Binary logistic regression analysis showed that modified calcification location on the dorsal side (OR 3.520, 95% CI 1.497 to 8.274, p=0.004) were independently associated with postprocedural hypotension after CAS.

Conclusions

The presence of plaque calcification on the dorsal side, using the modified geometric method, was found to be associated with a three-fold increased risk of postprocedural hypotension after CAS. These findings may have implications for patient screening, procedure planning, and hospitalization duration expectations.
Carotid revascularization and circle of Willis in ocular ischemic syndrome: association with neovascular glaucoma and visual prognosis
Authors: Cheng Xue-ru , Meng Zhao-yang , Zhao Lu , Wang Yan-ling , Wang Jia-lin
Published: February 2025

Background

Ocular ischemic syndrome (OIS) and subsequent neovascular glaucoma (NVG) lead to irreversible visual impairment. This study aimed to investigate the association of carotid artery revascularization and the collateral circulation types via the circle of Willis (CoW) with NVG and visual prognosis in patients with OIS.

Methods

This retrospective cohort study included 22 patients with OIS, with a median follow-up of 12 months. The collateral circulation patterns via the CoW were classified into five types. The association of the carotid artery revascularization, collateral circulation types via the CoW, and morphological characteristics of the CoW with the presence of NVG and visual outcomes was assessed.

Results

The median time interval from baseline to visual decline during follow-ups in patients with carotid artery revascularization was longer than that in patients without carotid artery revascularization (13 months vs 9.5 months, P=0.041). Lacking collateral inflow via the CoW to the hemisphere ipsilateral to OIS was associated with NVG (odds ratio (OR), 11.000; P=0.022). The diameters of the C6 and C7 segments of the internal carotid artery, the A1 segment of the anterior cerebral artery, and the ophthalmic artery in OIS eyes were smaller than those in the contralateral eyes.

Conclusion

Early carotid artery revascularization should be considered in patients with OIS, with or without NVG, as it may contribute to an improved visual prognosis. Patients without collateral inflow via the CoW to the hemisphere ipsilateral to OIS may have a higher risk of NVG.
Influence of sacroiliac joint variation on clinical features of axial spondyloarthritis: a comparative analysis
Authors: Aleixo Carolina Dominguez , Ziegeler Katharina , Ulas Sevtap Tugce , Diekhoff Torsten , Greese Juliane , Lindholz Maximilian , Rademacher Judith , Rios Rodriguez Valeria , Poddubnyy Denis , Proft Fabian
Published: February 2025

Objectives

Anatomical variation of the sacroiliac (SI) joints is common and specific variants are associated with erosions and bone marrow oedema on imaging. Our investigation aims to evaluate whether anatomical variations influence the clinical presentation of axial spondyloarthritis (axSpA).

Methods

In this propensity score matched post hoc analysis documented clinical data from four prospective clinical cohorts was assessed. Classification of back pain as inflammatory (=IBP), human leucocyte antigen-B27 positivity, family history, disease activity according to Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), symptom duration, elevated acute phase reactants, peripheral and extramusculoskeletal manifestations were evaluated. Statistical analyses were done using (generalised) linear models, t-tests, χ2tests and analysis of variances. Multiple testing was corrected according to Bonferroni.

Results

A total of 165 patients (86 women) were included. Atypical SI joints, defined by the presence of accessory joint facets, iliosacral complex or crescent-shaped ilii on MRI, were identified in 61 out of 165 patients with axSpA. Disease activity, assessed by BASDAI and symptom duration were similar in both groups (adjusted ß=−0.118 (95% CI -0.713, 0.476), p=0.696 and 120.0 (107.4) vs 116.5 (98.3) months, p=0.838, respectively). There was no significant difference in IBP between the groups (adjusted OR=0.614 (95% CI 0.274, 1.377), p=0.236). Sex-stratified analysis revealed no statistically significant results.

Conclusion

Our analysis suggests that clinical phenotypes do not significantly differ between patients with axSpA with and without atypical joints.
Dietary nitrate supplementation enhances exercise capacity in WHO Group 3 pulmonary hypertension: a double-blind, placebo-controlled, randomised crossover study (EDEN-OX2)
Authors: Alsulayyim Abdullah S , Alasmari Ali M , Price Laura C , McCabe Colm , Alghamdi Saeed M , Philip Keir Elmslie James , Buttery Sara C , Pavitt Matthew J , Polkey Michael I , Rickman Matthew J , Ahmetaj-Shala Blerina , Mitchell Jane A , Alyami Rami A , Hopkinson Nicholas S
Published: February 2025

Dietary nitrate supplementation, which improves skeletal muscle oxygen utilisation, vascular endothelial function and exercise capacity in people with chronic obstructive pulmonary disease, may benefit other lung conditions. In a double-blind, placebo-controlled, crossover study, in 19 adults with Group 3 pulmonary hypertension who desaturated during exercise, 140 mL of nitrate-rich beetroot juice improved endurance shuttle walk time compared with nitrate-depleted beetroot juice placebo (median (IQR) ESWT NR-BRJ 197 (140–273) s vs PL-BRJ 174 (107–229) s; median difference (MD) (95% CI) 30 (6.19 to 91.07) s, p=0.0281), endothelial function, flow-mediated dilatation (+3.40±5.47% vs −1.33±4.78; MD (95% CI) 4.73 (1.44 to 8.02), p=0.007) and lowered mean arterial blood pressure (−3.9 (−7.4 to −0.4) mm Hg, p=0.028).
Adult asthma hospitalisations decreased markedly in Finland and Sweden between 2006 and 2022
Authors: Kivistö Juho E , Protudjer Jennifer L P , Ekstrom Sandra , Karjalainen Jussi , Huhtala Heini , Lehtimäki Lauri , Kull Inger
Published: February 2025

A decreasing trend in asthma hospitalisations among Finnish and Swedish children has been reported. However, possible changes in asthma hospitalisations among adults are incompletely characterised. We aimed to investigate the incidence of adult asthma hospitalisations in Finland and Sweden from 2006 to 2022 using Finland’s National Hospital Discharge Register and Sweden’s National Patient Register. During the study period, the incidence of asthma hospitalisations decreased by 65.8% in Finland (from 84.9 to 29.0 per 100 000 person-years) and by 52.5% in Sweden (from 31.4 to 14.9 per 100 000 person-years). The incidences of asthma hospitalisations were distinctly higher in Finland compared with Sweden at the start of the study period but approached parity among both sexes.
Negative moments as the signature of the radial density at small distances
Authors: Atoui M. , Hoballah M. , Lassaut M. , Van de Wiele J.
Published: February 2025

The present paper proposes a robust evaluation of any radial density at small distances using negative-order radial moments evaluated in momentum space. This evaluation provides a valuable insight into the behavior of a given radial density in the vicinity of

$$r=0$$

r
=
0

, and puts strong emphasis on the importance of measuring form factors at large squared four-momentum transfer, a domain essential for the determination of negative order moments. A specific attention is paid to the regularization scheme directly affecting the numerical determination of the radial density’s parametrization. The proposed method is applied to non-relativistic study cases of the nucleon electric (

$$G_{En}, G_{Ep}$$

G

En

,

G

Ep

), and proton magnetic

$$G_{Mp}$$

G

Mp

form factors. The validation is performed through comparison of the results of the approach to the analytically determined Maclaurin expansion - in the vicinity of

$$r=0$$

r
=
0

- of the radial density function. The method is also applied to the relativistic Dirac form factor

$${{F_{1p}}}$$

F

1
p

of the proton. In such a non-trivial case, the Maclaurin development might not exist for the radial density, rendering the determination from the proposed method extremely important.
Optical features and thermal properties of charged AdS Euler–Heisenberg black hole surrounded by perfect fluid dark matter
Authors: Shahzad M. R. , Abbas G. , Zhu Tao , Ali R. H. , Ashraf Asifa , Al-Kahtani Badr S.
Published: February 2025

In this article, motivated by the high interest in Euler–Heisenberg nonlinear electrodynamic theory, we investigated several thermal aspects of the charged Euler–Heisenberg black hole surrounded by perfect fluid dark matter. To ensure the validity of the first law of thermodynamics, we measured the conserved thermal quantities. Furthermore, the local and global thermal stability of the charged Euler–Heisenberg black hole surrounded by perfect fluid dark matter is also discussed in canonical and grand canonical ensembles and reveals how the coupling parameter affects the stability regions. We also examined the extended second-order phase transition via P–V criticality. Finally, we extend our study to the optical features of the charged Euler–Heisenberg black hole surrounded by perfect fluid dark matter, such as the black hole shadow and energy emission rate and observe the impact of the coupling parameter.
Study some two loop contribution to muon anomalous MDM in the N-B-LSSM
Authors: Han Xing-Yu , Zhao Shu-Min , Ruan Long , Wang Xi , Dong Xing-Xing
Published: February 2025

It is well known that the muon magnetic dipole moment (MDM) has close relation with the new physics (NP) in the development of the Standard Model (SM). Combined with the Fermilab National Accelerator Laboratory (FNAL) and the Brookhaven National Laboratory (BNL) E821 result, the departure from the SM prediction is about 5.0

$$\sigma .$$

σ
.

We study the electroweak corrections from several type two-loop SUSY diagrams and the virtual SUSY particles include chargino, neutralino, scalar lepton and scalar neutrino. Based on the latest experimental constraints, we study the muon anomalous MDM under the next to the minimal supersymmetric extension of the SM with local B-L gauge symmetry (N-B-LSSM). The abundant numerical results verify that

$$\tan {\beta },$$

tan
β
,

$$T_{e22}$$

T

e
22

,

$$~M^2_L,~M^2_e,~M_{BB'}$$

M
L
2

,

M
e
2

,

M

B

B
′

play an important role in muon anomalous MDM.

$$M^2_e,~\tan {\beta }$$

M
e
2

,

tan
β

and

$$~T_{e22}$$

T

e
22

are sensitive parameters to muon anomalous MDM. From the data obtained in all the figures of the numerical results, most of the values of

$$a_{\mu }^{NBL}$$

a

μ

NBL

are in 2

$$\sigma $$

σ

interval, which can compensate the departure between the experiment data and the SM prediction.