bluuebunny/crossref_metadata_2025 huggingface dataset:
Could the minimum wage directive weather future financial storms? studying the potential to ensure upward convergence of minimum wages
Authors: Dôme Félix , Aranguiz Ane
Published: January 2025

The Minimum Wage Directive undoubtedly symbolises the EU's will to guarantee decent wage standards throughout all Member States. However, the question remains as to whether it also fulfils the role of a sufficiently compelling instrument which, in times of significant economic downturn, could prevent minimum wages from being frozen or even cut in order to achieve macroeconomic objectives. A similar question is whether the Directive entails an obligation to keep up with decent wages, particularly in times of higher inflation. With these questions in mind, this article looks at several key provisions of the Directive and analyses their potential to legally guarantee adequate minimum wages at all times. In this regard, we found that the most impactful provisions would be Article 4 on the promotion of collective agreements, Article 7 on the involvement of social partners in statutory minimum wage-setting, Article 5 on adequate statutory minimum wages, and Article 16 on non-regression. Even though these Articles bring some significant improvements, they are, according to our understanding, insufficient in respect of preventing Member States from adopting policies which can compromise decent minimum wage standards. Considering this, this article also discusses how several legal or policy instruments could potentially strengthen the Directive when it comes to guaranteeing decent minimum wage levels. These instruments include Article 4 of the Revised Social Charter and its interpretation by the European Committee of Social Rights, a Social Progress Protocol, and a Social Imbalance Procedure. While the Social Charter could bring stricter legal standards regarding minimum wage levels, the Social Progress Protocol and the Social Imbalance Procedure could both leverage more socially based EU policies which would, ultimately, enforce an unobstructed implementation of the Directive. However, none of these instruments is currently being used by the EU, and their implementation faces significant obstacles.
Successful treatment of severe acrodermatitis continua of hallopeau with Bimekizumab: A case report
Authors: Xu Lily , Li Kaiyang , Mutter Eric , Langley Annie
Published: January 2025

Acrodermatitis continua of Hallopeau is a rare form of pustular psoriasis affecting the acral fingers and toes, characterized by recurrent eruptions of sterile pustules that lead to significant pain and potentially irreversible destruction of the nail apparatus. Symptoms are often refractory to topical and systemic therapies for psoriasis. This case report presents a healthy 23-year-old female with severe acrodermatitis continua of Hallopeau, destructing all 10 fingernails. Treatment with Bimekizumab, a monoclonal antibody that inhibits interleukin-17, led to 50% improvement by 2 months, and complete normal regrowth of all fingernails by 1 year. The medication was tolerated well without any reported side effects. This is the second reported case of successful acrodermatitis continua of Hallopeau treatment with Bimekizumab, highlighting its potential as an effective and safe option for this challenging and recalcitrant condition.
Systematic optimization and evaluation of a Dutch sexual health intervention: Role model stories for chlamydia prevention, testing, and treatment
Authors: Metz Gido , Thielmann Rosa RLC , Roosjen Hanneke , Stutterheim Sarah E. , Crutzen Rik
Published: January 2025

Background

The rapidly evolving nature of eHealth necessitates regular optimization and subsequent evaluation. Within the Dutch sexual health intervention Sense.info, we utilized a mixed-methods cyclic evaluation process to assess and optimize the potential impact of the chlamydia page. This paper reports on the page's optimization through the development of role model stories for chlamydia prevention and the subsequent evaluation of these stories.

Method

The experiences of 10 young individuals served as the basis of role model stories using the behavior change principle modeling based on social cognitive theory. These stories aimed to motivate young individuals to undergo sexually transmitted infection testing, use condoms, and notify sexual partners. Once the stories were posted online, we tracked use data between July and September 2022 and investigated end-user perspectives through a think-aloud study combined with semistructured interviews ( N = 20, Mage = 19.7, SDage = 2.65). Template analyses were used for the analysis of the think-aloud study.

Results

Use data revealed that all stories were accessed by website visitors, yet other page elements on the chlamydia page interacted with more. The exploration of end-user perspectives indicated a positive impact of the personal stories on normalization, self-efficacy, and skills related to chlamydia preventive behaviors. Mixed results were found regarding some conditions for the effectiveness of the behavior change principle modeling.

Discussion and conclusion

This study provided valuable insights into the cyclic evaluation process for evaluating and optimizing web-based public health interventions, as well as the potential impact of role model stories on sexual health prevention. Also, aspects of the stories that could be optimized in future optimization rounds were identified. Overall, this research contributes to enhancing the impact of eHealth interventions through iterative evaluation and optimization processes.
Development and implementation of a digiphysical screening model with nationwide reach to diagnose familial hypercholesterolemia
Authors: Littmann Karin , Kindborg Gustav , Lidin Matthias , Mellbin Linda , Hogling Daniel Eriksson , Brinck Jonas
Published: January 2025

Background

Familial hypercholesterolemia (FH) is a hereditary dyslipidemia that confers a severely elevated risk for development of early atherosclerotic cardiovascular disease if left untreated. FH is underdiagnosed in most countries including Sweden.

Aim

To develop and evaluate the implementation of a digiphysical screening model to diagnose FH in the clinical routine.

Methods

A digiphysical screening model for FH, containing digital and physical related activities was developed and fully implemented in routine clinical care in the Stockholm region, Sweden 2022. The centerpiece of the model is a tailormade interactive web-based platform designed to facilitate communication and secure medical information exchange between its participants and the healthcare professionals. The screening model includes, (i) cascade screening of relatives to patients with a confirmed FH diagnosis and (ii) systematic selective screening of patients with established atherosclerotic coronary artery disease.

Results

Until October 2023, 338 index patients were included in the cascade screening. They invited 954 relatives nationwide, 616 (64.6%) accepted participation, 346 (36.3%) were completely screened, and 141 (14.8%) have received a FH diagnosis (40.8% of all completely screened). Selective screening was performed in 2867 patients with coronary artery disease, 355 (12.4%) were identified with increased risk for FH and underwent a genetic test. Of these, 153 (3.8%) had a genetic test result and 52 (1.8%) were diagnosed with FH.

Conclusions

A digiphysical screening model with a nationwide reach to diagnose FH was successfully implemented in routine clinical care. The model has potential to facilitate FH screening and provide health economic benefits long term.
Comparing the performance of ChatGPT and ERNIE Bot in answering questions regarding liver cancer interventional radiology in Chinese and English contexts: A comparative study
Authors: Yuan Xue-ting , Shao Chen-ye , Zhang Zhen-zhen , Qian Duo
Published: January 2025

Introduction

This study aims to critically assess the appropriateness and limitations of two prominent large language models (LLMs), enhanced representation through knowledge integration (ERNIE Bot) and chat generative pre-trained transformer (ChatGPT), in answering questions about liver cancer interventional radiology. Through a comparative analysis, the performance of these models will be evaluated based on their responses to questions about transarterial chemoembolization and hepatic arterial infusion chemotherapy in both English and Chinese contexts.

Methods

A total of 38 questions were developed to cover a range of topics related to transarterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC), including foundational knowledge, patient education, and treatment and care. The responses generated by ERNIE Bot and ChatGPT were rigorously evaluated by 10 professionals in liver cancer interventional radiology. The final score was determined by one seasoned clinical expert. Each response was rated on a five-point Likert scale, facilitating a quantitative analysis of the accuracy and comprehensiveness of the information provided by each language model.

Results

ERNIE Bot is superior to ChatGPT in the Chinese context (ERNIE Bot: 5, 89.47%; 4, 10.53%; 3, 0%; 2, 0%; 1, 0% vs ChatGPT: 5, 57.89%; 4, 5.27%; 3, 34.21%; 2, 2.63%; 1, 0%; P = 0.001). However, ChatGPT outperformed ERNIE Bot in the English context (ERNIE Bot: 5, 73.68%; 4, 2.63%; 3, 13.16; 2, 10.53%；1, 0% vs ChatGPT: 5, 92.11%; 4, 2.63%; 3, 5.26%; 2, 0%; 1, 0%; P = 0.026).

Conclusions

This study preliminarily demonstrated that ERNIE Bot and ChatGPT effectively address questions related to liver cancer interventional radiology. However, their performance varied by language: ChatGPT excelled in English contexts, while ERNIE Bot performed better in Chinese. We found that choosing the appropriate LLMs is beneficial for patients in obtaining more accurate treatment information. Both models require manual review to ensure accuracy and reliability in practical use.
The development of a wearable goggle echolocation device to support people who are visually impaired with unhindered and unaided movement
Authors: Oduah Uzoma Ifeanyi , Adewumi Oluwasegun , Uche Kingsley Agbakansi , Oluwole Daniel
Published: January 2025

The mobility of people with severe visual impairment is limited affecting their comfort and productivity. There are about 45 million people who are blind with global financial burden and annual global cost of productivity estimated to be USD411 billion according to World Health Organization report of 2024. The contributions of the people who are visually impaired to the gross domestic product (GDP) can be enhanced deploying technology. A novel sensory substitution device that enables people who are visually impaired or blind to fairly hear objects in place of seeing objects is proposed. The wearable echolocation device was developed using three ultrasonic sensors, one placed in the right, left, and middle of the goggle with each connected to a buzzer. Audible compass is implemented in the circuitry to guide the user on the direction while walking. In this configuration, the user is guided and alerted of any obstacle within the field of coverage and so can navigate to any desired destination unaided without relying on internet. The developed prototype is easy to use and does not require complex training. The echolocation device was tested by ten enrolled people that are visually impaired or blind who validated its effectiveness and efficiency. The device is comparatively low cost, noninvasive, energy efficient and mass producible.
Evaluation of Environmental and Neighborhood Satisfaction Across the Socio-demographic Gradients Using in-situ and Geospatial Data
Authors: Nzimande Ntombifuthi , Royimani Lwando , Lephoto Thabo
Published: January 2025

Residential satisfaction assessment has exponentially grown over the past decades, yet scant attention has focused on inferring geospatial methods to statistical tools based on residential satisfaction questionnaire data. This has resulted in urban planning strategies neglecting environmental structures to improve residents’ overall wellbeing as geospatial data allows for objective characterization of these physical, environmental characteristics rather than relying on subjective estimates of the residential determinants. We hypothesized that the heterogeneity in residents' perceptions pertaining to their environmental and neighborhood satisfaction is largely informed by differences in their socio-economic and demographic factors. Structured questionnaires were administered in housing estates found in Budapest, Hungary and analyzed using residential satisfaction indices, multiple linear regression. NDVI was calculated using the Sentinel 2 data and employed to assess the environmental quality in each district. Regression results found education level, gender, ethnic group, and tenureship to be the socio-demographics variables that significantly affect overall residential satisfaction. The habitability index was developed comprising of the neighborhood and environmental components with the majority of the variables in both components contributing above 70% across all the study areas, except Újpalota. Results further showed that the use of geospatial data provides an objective mechanism for estimating residents’ environmental satisfaction. Hence, this study has shown the importance and advantages of integrating several fields to produce comprehensive solutions to the problems at hand. Specifically, the integration of geospatial tools with residential satisfaction questionnaires allows for innovative and practical solutions that urban planning decision-makers can utilize to identify, predict and mitigate residential dissatisfaction.
Risk and Causative Factors of Psychological Harm Among Construction Workers: A Systematic Review
Authors: Rahman Azizur , Leifels Katrin , Adakporia Kennedy Osakwe
Published: January 2025

Background:

The construction industry, known for its high-risk environment, increasingly acknowledges the psychological risks to workers. Despite well-documented physical hazards, mental health challenges within this workforce have garnered attention. This systematic review provides a scholarly synthesis of literature on psychological risks and their causative factors affecting construction workers, adhering to PRISMA protocols.

Methods:

An exhaustive literature search was conducted across PubMed, Scopus, PsycINFO, and Google Scholar using relevant keywords. Rigorous screening of selected studies focused on the psychological aspects of construction work, with systematic data extraction and analysis.

Findings:

From 1992 to 2022, 68 studies met inclusion criteria, identifying key psychological harm factors: job insecurity, long working hours, high demands, poor work-life balance, and workplace bullying. A lack of mental health support and awareness in the sector was noted, with a significant correlation between these factors and increased stress, anxiety, and depression levels among workers.

Conclusions:

The review highlights the urgent need for industry recognition of psychological hazards and the relationship between work conditions and mental health issues. It calls for supportive policies, awareness programs, and counseling services, with a suggestion for future longitudinal research on the long-term impacts and intervention efficacy.

Application to Practice:

This study provides an overview of psychological risks in the construction sector from 1994 to 2022, aiming to identify causative factors for mental health issues. It seeks to pave the way for targeted interventions and policy changes to improve mental health outcomes in the industry.
A Cross-Sectional Examination of Missed Infection Control Practices Among Nurses in the Jordanian Hospitals
Authors: Alshyyab Muhammad Ahmed , Albsoul Rania Ali , FitzGerald Gerard , Arabiat Diana
Published: January 2025

Background:

Missed infection control practices may negatively impact quality healthcare and patient safety in acute health care settings. Hence, more research is urgently needed especially in Arab countries. To investigate the elements and reasons of missed infection control activities among nurses in Jordan. The sociodemographic correlates with missed infection control activities were also examined.

Methods:

A cross sectional design was utilized in this study. A convenience sample of 960 nurses from seven hospitals in the North of Jordan was used. The Missed Nursing Care Infection Prevention and Control (MNCIPC) Survey was employed to collect the data. Data were analyzed using descriptive inferential, and multivariate regression analysis.

Findings:

The majority of the participants worked as registered nurses (78.4%). The highest missed infection control activities were: screening new admissions for Multi Resistant Organisms (MRO), wearing gloves for both preparing and administration of all antibiotics, and informing staff and visitors for the need for transmission-based precautions (when managing a patient with a MRO). The least missed infection control activities reported by nurses were performing hand hygiene after touching patients, and before drug administration. The reasons of missed infection control measures most frequently reported by nurses were: urgent patient situation, followed by inadequate number of clerical staff, and unexpected rise in patient volume and or acuity.

Conclusion:

This research suggests that interventions to reduce missed infection control measures should focus on the education and training of nursing staff as well as a adopting nurse: patient ratio in managing nursing workload, which should not exceed 1:4.
Engaging Patients with Headache in the Veterans Health Administration (VHA): ACTIvated Veterans Engagement Group (ACTIVE) to Improve Delivery of Patient-Centered Headache Services
Authors: Datre Olivia M. , Baird Sean A. , Lindsey Hayley M. , Goldman Roberta E. , Sico Jason J. , Damush Teresa M.
Published: January 2025

In 2018, the Veterans Health Administration (VHA) established the original 19 Headache Centers of Excellence (HCoE) program, and an evaluation center. This study utilized a Veteran engagement group method to elicit input from Veteran patients living with chronic headache on daily needs, social determinants of health, and preferences and suggestions for headache programs, services, and research priorities. Four engagement groups were conducted between July 13th and August 22nd of 2022 with Veterans who experience headache and received care at a VHA HCoE. Engagement groups were audio-recorded, de-identified, transcribed, and analyzed using rapid qualitative content matrix analysis. Participants also completed a baseline survey on demographics, technology use, headache history, and health. Patients perceived care coordination, social support, gender specific preferences and access to complementary and integrative therapies to be important aspects of headache care delivered by HCoEs. Participants expressed strong interest in effective, interactive peer support groups to share and learn from each other's experiences with headaches and treatments. Findings underscore the demand for coordinated, interdisciplinary headache care integrating complementary health approaches and addressing gender-specific needs.
Observations of Score Changes Between USMLE Step 1 and Step 2 Among Students of Different Demographic Groups in a Longitudinal Clinical Curriculum
Authors: Novotny Kaitlyn , Levine Daniel , Netski Dale , Simanton Edward
Published: January 2025

BACKGROUND

The transition of the United States Medical Licensing Examination Step 1 to a pass/fail scoring system is reshaping its role in medical students’ residency placements. This compels institutions to rethink Step 2 preparation strategies, raising concerns about a clerkship's impact on various student groups. Traditionally, medical schools followed the traditional block rotation model for clerkships, which limits longitudinal learning, and many schools are switching to longitudinal integrated clerkships and longitudinal interleaved clerkships (LInCs). The growth in longitudinal popularity sparks concern for the success of diverse medical student groups as there is minimal research regarding LInC students’ USMLE performance. Our study aims to identify which student groups at Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (KSOM) saw the greatest improvement in their USMLE Step scores after completing the LInC clerkship model.

METHOD

Utilizing institutional data from KSOM, 145 students from 3 KSOM cohorts’ Step 1 and Step 2 3-digit scores and their self-identified demographic information prior to the change in Step 1 grading were categorized by admissions and initial performance factors. Binary groups were created for each variable. Descriptive statistics and t-tests (including Levene’s test) gauged score change significance ( P < .05) within these groups. Changes were assessed by subtracting Step 1 from Step 2 scores, identifying groups showing significant score improvements after completing the LInC clerkship.

RESULTS

Analysis revealed significant score improvements between Step 1 and Step 2 for the following groups: females, students with low socioeconomic status, and students who originally received lower Step 1 scores.

CONCLUSION

This study underscores the significance of gender, socioeconomic status, and prior exam performance in clerkship model development given the changes to Step 1 scoring. Further research should discern whether the observed score changes are attributed to the LInC model or its associated testing model.
Risk factors, mechanisms, and clinical outcomes of stroke in young adults presenting to a North Central London stroke service: UCL Young Stroke Systematic Evaluation Study (ULYSSES)
Authors: Mussa Raafiah , Ambler Gareth , Ozkan Hatice , Thiankhaw Kitti , Aboughdir Maryam , Smedley Imogen , Mitchell John , Banerjee Gargi , Jäger Hans Rolf , Leff Alex , Perry Richard , Simister Robert J , Chandratheva Arvind , Werring David J
Published: January 2025

Introduction:

Stroke incidence in younger adults is increasing worldwide yet few comprehensive studies exist from a UK population. We investigated the risk factors, mechanisms, functional outcome and stroke recurrence rate in a cohort of young adults with stroke.

Patients and methods:

We included consecutive patients (<55 years) with ischaemic stroke or intracerebral haemorrhage (ICH) admitted to the University College London Hospitals Hyperacute Stroke Unit between 2017 and 2020. Ischaemic stroke was classified using Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria and ICH using modified CLAS-ICH criteria. Multivariable logistic regression was performed to identify predictors of unfavourable functional outcome (modified Rankin Scale [mRS] > 1) at 6 months.

Results:

Five hundred fifty-two patients were included (median age 47, IQR 41–51; 33% female; 76% ischaemic stroke). Common risk factors included dyslipidaemia (57%), hypertension (40%), and cigarette smoking (34%). Ischaemic stroke was mostly due to cardioembolism (22%). Probable cerebral small vessel disease was the most frequent ICH aetiology (53%). Unfavourable functional outcome was prevalent in 50% at 6 months and was associated with ICH (OR 2.02, 95%CI 1.14–3.58, p = 0.017), female sex (OR 1.62, 95%CI 1.03–2.55, p = 0.037), admission stroke severity (per point increase, OR 1.11, 95%CI 1.07–1.16, p < 0.001) and pre-morbid mRS 2-5 (OR 3.16; 95%CI 1.11–9.03, p = 0.032). 4.4% had a recurrent stroke within 6 months.

Discussion and conclusion:

Traditional cardiovascular risk factors are common in young adults with stroke. Unfavourable functional outcome is associated with female sex, ICH, severe stroke and pre-morbid disability. These findings can inform national stroke prevention and rehabilitation strategies.
Empirical regressions for distributed faulting of dip-slip earthquakes
Authors: Visini Francesco , Boncio Paolo , Valentini Alessandro , Scotti Oona , Nurminen Fiia , Baize Stéphane , Pace Bruno
Published: January 2025

Probabilistic Fault Displacement Hazard Analysis (PFDHA) is pivotal in assessing the probability of surface fault displacement during seismic events, with critical implications for infrastructure systems like pipelines and lifelines. Recent earthquakes have underscored the importance of fault displacement as a cause of damage. This study aims to improve predictive models and regression analyses to assess the probability and expected amount of throw on distributed ruptures (DR) from normal and reverse earthquakes. The research leverages the SURE 2.0 database, which classifies ruptures into different ranks, including primary and various typologies of distributed ruptures. Logistic regression models are employed to assess the probability of DR occurrence, considering factors such as earthquake magnitude, proximity to the principal fault, faulting style, and DR location (hanging wall/footwall) as predictor variable. In addition, a fault displacement model is formulated to estimate the median throw on DRs based on these parameters and on a mean throw on the principal fault. The outcomes offer valuable insights into the characteristics and likelihood of DRs, carrying implications for PFDHA applications. The study introduces a decision-tree algorithm designed to assist PFDHA practitioners in selecting the most suitable approach based on the available geological knowledge. This study contributes to an improved understanding of fault displacement hazard analysis and provides a versatile framework for its application across diverse geological contexts.
Serial cerebrospinal fluid concentrations of high mobility group box 1 in bacterial meningitis: a retrospective cohort study
Authors: Matsushige Takeshi , Inoue Hirofumi , Hoshide Madoka , Kohno Fumitaka , Kobayashi Hikaru , Ichihara Kiyoshi , Ichiyama Takashi , Hasegawa Shunji
Published: January 2025

Background

Bacterial meningitis (BM) is a life-threatening central nervous system infection with potential for severe neurological sequelae. High mobility group box 1 (HMGB1) is known as a late inflammatory mediator associated with lethal pathology. This study aims to investigate the serial cerebrospinal fluid (CSF) concentrations of HMGB1 in children with BM and its relationship to neurological prognosis.

Methods

This retrospective cohort study included children with BM, aseptic meningitis (AM), and controls. CSF samples were collected serially from patients with BM and once from those with AM and controls. HMGB1 and interleukin-6 (IL-6) concentrations were measured using ELISA and bead-based multiplex assays, respectively. Statistical analyses included Mann–Whitney U tests, Kruskal–Wallis tests, and three-way ANOVA to evaluate differences among groups and over time.

Results

HMGB1 levels in the CSF of children with BM were significantly higher than in those with AM and controls (p < 0.001). Inflammatory cytokine IL-6 levels decreased after treatment; however, HMGB1 levels remained elevated in half of the BM patients. Notably, a patient with neurological sequelae exhibited a delayed elevation of HMGB1 until the latest time points. Three-way ANOVA revealed significant differences in the time course of IL-6 and HMGB1 among individuals (p = 0.018).

Conclusions

Elevated CSF HMGB1 levels persist in some children with BM even after treatment, particularly in those with poor neurological outcomes. These findings suggest that delayed elevation of HMGB1 may contribute to severe inflammation and poor prognosis in BM. Further research into HMGB1 as a potential therapeutic target in BM is warranted.
Survival in patients with CKD 3–5 after 12 months of exercise training – a post-hoc analysis of the RENEXC trial
Authors: Denguir Sara , Hellberg Matthias , Almquist Martin , Clyne Naomi
Published: January 2025

Background

Physical performance is low and physical activity declines in people with chronic kidney disease (CKD). Both factors are associated with decreased survival. Our hypothesis was that improved physical performance after 12 months of exercise training would result in better survival in patients with CKD stages 3 to 5 not on kidney replacement therapy (KRT). Our aims in this study were to investigate the survival effects of (1) baseline physical performance and (2) physical performance after 12 months of exercise training.

Methods

This is a post-hoc analysis of the RENEXC trial, a randomized controlled study comparing 12 months of strength- and balance training both in combination with aerobic training. Both groups improved physical performance with no between group differences. Patients were categorized into five groups: improved ≥ 5%, unchanged, deteriorated ≥ 5%, non-completers, missing data. Univariate and multivariate Cox regression analyses were used and adjusted for age, sex, comorbidity, time on dialysis and time with a kidney transplant.

Results

151 patients participated, mean age 66 ± 14 years, 65% men, eGFR 22.5 ± 8.2 ml/min/1.73m2, average follow-up 60 months.

Multivariate analyses

The baseline 6-minute walk test (6MWT) (HR 0.996; 95% CI [0.993–0.998]) and 30-second sit-to-stand (30s-STS) (HR 0.94 CI [0.89–1.0]) were positively associated with survival. After 12 months of exercise improved handgrip strength (HGS) right (HR 2.66; 95% CI [1.07–6.59]) was associated with better survival compared with deterioration. Improvement compared with noncompletion was associated with better survival (6MWT (HR 2.88; 95% CI [1.4–5.88]), HGS right (HR 4.44; 95% CI [1.79–10.98]), functional reach (HR 3.69; 95% CI [1.82–7.48]), isometric quadriceps strength right (HR 2.86; 95% CI [1.43–5.72]), 30s-STS (HR 3.44; 95% CI [1.66–7.11]).

Conclusion

Baseline walking distance, muscular strength and endurance in the legs were independently associated with survival in people with CKD stages 3–5 without KRT. After completing 12 months of exercise training improved walking distance, muscular strength and endurance, and balance were positively associated with survival, compared with noncompleters. Better physical performance at baseline and the ability to complete 12 months of exercise training conferred survival benefits. There are probably several factors affecting better survival. These factors require elucidation in future studies.

Trial registration

ClinicalTrials.gov NCT02041156. Registration date 20,240,107.
Optimization of chemical transfection in airway epithelial cell lines
Authors: Guo Tony J. F. , Liang Wan Yi , Singhera Gurpreet K. , Memar Vaghri Jasmine , Leung Janice M. , Dorscheid Del R.
Published: January 2025

Background

Chemical transfection is a widely employed technique in airway epithelium research, enabling the study of gene expression changes and effects. Additionally, it has been explored for its potential application in delivering gene therapies. Here, we characterize the transfection efficiency of EX-EGFP-Lv105, an EGFP-expressing plasmid into three cell lines commonly used to model the airway epithelium (1HAEo-, 16HBE14o-, and NCI-H292).

Results

We used six common and/or commercially available reagents with varying chemical compositions: Lipofectamine 3000 (L3000), FuGENE HD, ViaFect, jetOPTIMUS, EndoFectin, and calcium phosphate. Using L3000, 1HAEo- exhibited the highest transfection efficiency compared to 16HBE14o- and NCI-H292 (1HAEo-: 76.1 ± 3.2%, 16HBE14o-: 35.5 ± 1.2%, NCI-H292: 28.9 ± 2.23%). L3000 yielded the greatest transfection efficiency with the lowest impact on cellular viability, normalized to control, with a 11.3 ± 0.16% reduction in 1HAEo-, 16.3 ± 0.08% reduction in 16HBE14o-, and 17.5 ± 0.09% reduction in NCI-H292 at 48-hour post-transfection. However, jetOPTIMUS had a similar transfection efficiency in 1HAEo- (90.7 ± 4.2%, p = 0.94), but had significantly reduced cellular viability of 37.4 ± 0.11% (p < 0.0001) compared to L3000. In 16HBE14o-, jetOPTIMUS yielded a significantly higher transfection efficiency compared to L3000 (64.6 ± 3.2%, p < 0.0001) but significantly reduced viability of 33.4 ± 0.09% (p < 0.0001) compared to L3000. In NCI-H292, jetOPTIMUS yielded a lower transfection efficiency (22.6 ± 1.2%) with a significant reduction in viability (28.3 ± 0.9%, p < 0.0001). Other reagents varied significantly in their efficiency and impact on cellular viability in other cell lines. Changing the transfection mixture-containing medium at 6-hour post-transfection did not improve transfection efficiency or viability. However, pre-treatment of cell cultures with two rinses of 0.25% trypsin-EDTA improved transfection efficiency in 1HAEo- (85.2 ± 1.1% vs. 71.3 ± 1.0%, p = 0.004) and 16HBE14o- (62.6 ± 4.3 vs. 35.5 ± 1.2, p = 0.003).

Conclusions

Transfection efficiencies can differ based on airway epithelial cell line, reagents, and optimization techniques used. Consideration and optimization of cell line and transfection conditions may be useful for improving nonviral genetic techniques in vitro.
Assessing the effect of On-site supportive communication training (On-site SCT) on doctor burnout: a randomized controlled trial
Authors: Antonsen K.K. , Lyhne J.D. , Johnsen A.T. , Eßer-Naumann S. , Poulsen L.Ø. , Lund L. , Timm S. , Jensen L.H.
Published: January 2025

Background

Burnout is a critical factor that can influence the quality of care that doctors provide to their patients. Previous research suggests a link between inadequate communication skills training and burnout, and various approaches to enhance communication skills have been explored as a means to address this issue. However, evidence of the effect of these approaches is lacking. The aim of this study is to assess the effect of the novel On-site Supportive Communication Training (On-site SCT) in enhancing communication skills among oncologists and thereby addressing burnout.

Methods

This randomized, controlled, multicenter study was conducted across three oncological departments in Denmark. Doctors were eligible if they worked in the outpatient clinic at least four days per month and provided informed consent. Doctors in the intervention group underwent a two-hour introduction followed by three full days of On-site SCT facilitated by in-house psychologists, while those in the control group continued standard practices. Pre- and post-intervention assessments on burnout (Copenhagen Burnout Inventory) were conducted, as were assessments of related constructs (job satisfaction and communication self-efficacy). Differences in pre- and post- assessments were analyzed using a paired t-test. Feasibility was assessed descriptively by comparing intervention days with planned schedule, and doctors’ satisfaction with the intervention was assessed systematically by questionnaire.

Results

Of 101 screened doctors, 89 (88%) consented and were randomized. 65% were female, and the mean age was 46 (range 27 to 75). Due to nine exclusions, data from 39 doctors in the intervention group and 41 doctors in the control group were available for analysis. At baseline, doctors exhibited lower levels of burnout than reported in international literature. No statistically significant improvements in burnout (p > 0.05) were demonstrated post-intervention. Despite non-significant changes, the doctors reported an improvement in communication self-efficacy. The program showed high feasibility and received positive feedback from participating doctors.

Conclusions

Our findings caution against assuming a causal relationship between short-term interventions and a complex phenomenon like burnout. On-site SCT demonstrated high feasibility, participation rate and acceptance. This underscores its potential value in clinical settings. Consequently, On-site SCT will be implemented at the Department of Oncology, Vejle University Hospital, to facilitate further refinement based on ongoing feedback and to explore long-term outcomes.

Trial registration

December 2022– The Region of Southern Denmark (22/57137). April 2023– ClinicalTrials.gov (NCT05842083). April 2023– The Research Ethics Committee at the University of Southern Denmark (23/19397).
Triggering final follicular maturation for IVF cycles
Authors: Orvieto Raoul
Published: January 2025

As part of a conventional controlled ovarian hyperstimulation (COH) regimen, final follicular maturation is usually triggered by a single bolus dose of human chorionic gonadotropin (hCG). COH, which combines GnRH antagonist co-treatment with GnRH agonist(GnRHa) trigger, is often used in attempts to eliminate severe early ovarian hyperstimulation syndrome and to improve oocyte/embryo yield and quality. Recently, the combination of GnRHa, with hCG trigger has also been implemented into clinical practice. Here, we analyze and discuss published studies on various ways of triggering final follicular maturation, seeking to elucidate the appropriateness of each approach for specific patient subgroups.
Fecal microbiota changes associated with pathogenic and non-pathogenic diarrheas in foals
Authors: Shi Yijun , Maga Elizabeth A. , Mienaltowski Michael J.
Published: January 2025

Objectives

Diarrhea is a common disease that could threaten the welfare of newborn foals. While there are several forms of foal diarrhea, the etiologies can be considered known pathogenic or non-pathogenic in nature. Moreover, there are likely differences in the composition of microbial populations in the gastrointestinal tracts of foals depending upon the etiology of diarrhea. Our study aims to examine the microbial population in the feces of foals with both pathogenic and non-pathogenic diarrheas to discern differences in their microbial compositions.

Results

Foal diarrhea samples tested positive or negative for common equine neonatal diarrhea pathogens by diagnostic polymerase chain reaction (PCR), which allowed for samples to be segregated as pathogenic or non-pathogenic. Pathogenic samples tested positive for combinations of Clostridium perfringens and/or Clostridioides difficile toxins. As a result, significantly higher alpha diversity was seen in the non-pathogenic samples than in pathogenic ones. Sequencing of the V4 domains of bacterial 16 S rRNA genes demonstrated that non-pathogenic samples had more alpha diversity. Furthermore, eight microbial families and eleven genera showed significant differences in their abundances between pathogenic and non-pathogenic diarrhea samples.
Life expectancy and years of life lost for adults with diagnosed ADHD in the UK: matched cohort study
Authors: O'Nions Elizabeth , El Baou Céline , John Amber , Lewer Dan , Mandy Will , McKechnie Douglas G.J. , Petersen Irene , Stott Josh
Published: January 2025

Background

Nearly 3% of adults have attention-deficit and hyperactivity disorder (ADHD), although in the UK, most are undiagnosed. Adults with ADHD on average experience poorer educational and employment outcomes, worse physical and mental health and are more likely to die prematurely. No studies have yet used mortality data to examine the life expectancy deficit experienced by adults with diagnosed ADHD in the UK or worldwide.

Aims

This study used the life-table method to calculate the life-expectancy deficit for people with diagnosed ADHD using data from UK primary care.

Method

A matched cohort study using prospectively collected primary care data (792 general practices, 9 561 450 people contributing eligible person-time from 2000–2019). We identified 30 039 people aged 18+ with diagnosed ADHD, plus a comparison group of 300 390 participants matched (1:10) by age, sex and primary care practice. We used Poisson regression to estimate age-specific mortality rates, and life tables to estimate life expectancy for people aged 18+ with diagnosed ADHD.

Results

Around 0.32% of adults in the cohort had an ADHD diagnosis, ~1 in 9 of all adults with ADHD. Diagnoses of common physical and mental health conditions were more common in adults with diagnosed ADHD than the comparison group. The apparent reduction in life expectancy for adults with diagnosed ADHD relative to the general population was 6.78 years (95% CI: 4.50 to 9.11) for males, and 8.64 years (95% CI: 6.55 to 10.91) for females.

Conclusions

Adults with diagnosed ADHD are living shorter lives than they should. We believe that this is likely caused by modifiable risk factors and unmet support and treatment needs in terms of both ADHD and co-occurring mental and physical health conditions. This study included data from adults with diagnosed ADHD; the results may not generalise to the entire population of adults with ADHD, the vast majority of whom are undiagnosed.
Survival Outcomes for Adolescent and Young Adults With Cancer in Low- and Middle-Income Countries: A Systematic Review
Authors: Ariello Krista , Hadi Abdel-Nabi , Denburg Avram , Gupta Sumit
Published: January 2025

PURPOSE

Patients with adolescent and young adult (AYA) cancer are recognized as a vulnerable subpopulation in high-income countries (HICs). Although survival gaps between HIC and low- and middle-income country (LMIC) children with cancer are well described, LMIC AYAs have been neglected. We conducted a systematic review to describe cancer outcomes among LMIC AYAs.

METHODS

We captured English language studies published from 2010 onward reporting LMIC AYA cancer survival outcomes. LMICs were defined according to World Bank 2019 classifications, whereas AYAs were defined as diagnosed between age 15 and 39 years. Cohorts were considered AYA if >75% of patients were AYA, the mean/median age and standard deviation were between 15 and 39 years, or the range was within 5 years of the AYA range (ie, 10-45 years). Cohort characteristics were abstracted, including country, cancer type, and cancer outcomes.

RESULTS

Of 6,207 studies identified by the search strategy, 658 underwent full-text review; 60 met inclusion criteria. No low-income countries were represented. Forty-four (73.3%) studies were conducted in upper-middle–income countries (UMICs) although these represented only 12 of 55 countries currently classified as UMICs. The most common cancers studied were acute lymphoblastic leukemia (n = 13 studies), breast cancer (n = 5), and osteosarcoma (n = 3). Five-year overall survival was highly variable, ranging from 39% to 63% for ALL, 60%-85% for breast cancer, and 47%-83% for osteosarcoma.

CONCLUSION

Although three billion AYAs reside in LMICs, their cancer outcomes are neglected in the current literature. Existing data indicate variable survival, ranging from comparable with HIC outcomes to substantially inferior. These studies, however, represent only a limited number of LMICs and are biased toward UMICs. Systematic efforts to describe and improve LMIC AYA cancer outcomes are required.
Precision Oncology: A Global Perspective on Implementation and Policy Development
Authors: Horgan Denis , Tanner Marcel , Aggarwal Charu , Thomas David , Grover Surbhi , Basel-Salmon Lina , Dienstmann Rodrigo , Tan Tira Jing Ying , Park Woong-Yang , Abu Rasheed Hadi Mohamad , Siu Lillian L. , Ma Brigette , Ortiz-López Rocío , Van den Bulcke Marc , Taucher Silvia Castillo , Ferris Andrea , Starling Naureen , Malapelle Umberto , Longshore John , Saldaña Hugo Alberto Barrera , Subbiah Vivek
Published: January 2025

Despite the acknowledged merits of precision oncology (PO) and its increasing global implementation, its full potential for advancing care and prevention remains unrealized. The benefits are currently accessible to only limited patient segments because of multifaceted barriers. Successful implementation hinges on various factors—scientific complexities not limited to technical, clinical, regulatory, economic, administrative, and health care policy–related challenges. From building infrastructure to the associated costs, including research and development, testing, processing, and trained personnel, a lack of alignment persists. Administrative alignment with regulatory and payor acceptance is crucial. Health care policy must adapt to the ongoing shift from a one-size-fits-all treatment to a personalized approach. Without official endorsement of long-term gains over short-term costs and the health establishment's readiness for innovation, PO prospects, even in prosperous economies, may stagnate. Lower-income countries face exacerbated challenges, intensifying barriers to adoption. Nevertheless, growing awareness and utilization, driven by recognized potential for patients and public health, along with successful examples and advocacy, are progressively influencing policy for a more inclusive and beneficial approach to PO adoption.
Patient and Health Care Professional Perspectives on Barriers to and Facilitators of Healthy Eating and Exercise Among Patients With Cancer at a Safety-Net Oncology Clinic: A Qualitative Exploration
Authors: Kizub Darya A. , Raber Margaret , Baum Miranda , Ma Hilary Y. , Patel Tejal Amar , Rechis Ruth , LaRue Denise M. , Ho-Pham Thy T. , Oestman Katherine , Walsh Michael T. , Galvan Esperanza , Basen-Engquist Karen
Published: January 2025

PURPOSE

Previous studies have described barriers to and facilitators of healthy eating and being physically active among patients with cancer, but few have done so in a safety-net community oncology setting.

MATERIALS AND METHODS

To understand multiple perspectives on the factors that influence diet and exercise in patients with cancer treated in safety-net settings, we conducted semistructured interviews between June and November 2021 with patients and oncology clinic medical professionals at a safety-net hospital in Houston, TX.

RESULTS

Thirty-one patients with cancer were interviewed, including 11 patients on active treatment and 20 survivors, as well as 21 care health care professionals. Most patients thought that they had a healthy diet but did not exercise enough, mainly because of cancer-related symptoms. The majority stated that they would like to participate in healthy living programs and follow their doctor's recommendations although only half noted receiving any recommendations from their provider. Health care professionals perceived patients' barriers to healthy diet and exercise as lack of knowledge, low access to resources, and low motivation, potentially impacting adherence to lifestyle recommendations.

CONCLUSION

Patients with cancer in a safety-net oncology clinic were motivated to participate in healthy living activities. However, health care professionals believed that patients faced barriers with the potential to impact adherence to health care professional recommendations. Further research is needed to better understand and optimize lifestyle counseling in a safety-net oncology setting and explore potential referral pathways to healthy living programs for patients.