bluuebunny/crossref_metadata_2025 huggingface dataset:
Financial burden of complications following lung resection: a scoping review protocol
Authors: Flinkier Ariane , Chu Fabien , Berman Jordan , Slifirski Hugh , Barnett Stephen , Caragata Rebecca , Weinberg Laurence
Published: December 2024

Introduction

Global healthcare expenditures are rising, driven largely by increased spending in both high- and low-income countries with hospitalisation as a primary contributor. Respiratory diseases, particularly lung cancer, pose significant public health and economic challenges with thoracic surgery as the standard curative treatment. Complications post resection, such as arrhythmias, infections and respiratory failure, result in substantial healthcare costs and resource demands. Although studies have explored the economic impact of surgeries, there is a limited comprehensive analysis of the financial burden of postoperative complications after lung resection surgery. To address this gap, this scoping review aims to map existing literature on lung resection complications and associated costs, providing insights for future research and healthcare policy.

Methods and analysis

This scoping review will be conducting according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews standards. Eligible peer-reviewed articles and grey literature will be identified across Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database and Cochrane Central Register of Controlled Trials. Cost data will be converted into US dollars as per the Federal Reserve Bank of St Louis and adjusted for inflation as per the US Bureau of Labor Statistics Consumer Price Index inflation calculator.

Ethics and dissemination

Ethics approval was not required. The results will be communicated through established professional networks, conference presentations and publication in peer-reviewed journals.
Uptake of HIV pre-exposure prophylaxis and contraception in South African hair salons: a study protocol for a pilot cluster randomised controlled trial
Authors: Govere Sabina Medal , Jarolimova Jana , Yan Joyce , Shezi Sthabile , Ngcobo Lungile M , Sagar Shruti , Zionts Dani , Dube Nduduzo , Parker RA , Psaros Christina , Bassett Ingrid
Published: December 2024

Introduction

Young women are disproportionately affected by HIV in South Africa and have a high incidence of unintended pregnancies. Access to sexual and reproductive health (SRH) services, including HIV pre-exposure prophylaxis (PrEP), contraception and screening for seally transmitted infections (STIs), remains limited in South Africa, in part due to inadequate infrastructure and individual barriers to care. Integrated, community-based SRH services have the potential to overcome barriers to clinic-based care for women at risk of HIV, unintended pregnancy and STIs. We are evaluating the feasibility, acceptability and preliminary effectiveness of a novel intervention offering PrEP, contraception and STI screening in hair salons.

Methods and analysis

We will conduct a pilot cluster randomised controlled trial in hair salons in urban KwaZulu-Natal, South Africa. Salons serving primarily female clients will be randomised either to an SRH service package (offer of PrEP, contraception, STI screening and health education) or to health education only. Interested female salon clients≥18 years old will be referred by trained stylists. In intervention salons, women who meet inclusion criteria will be offered HIV and pregnancy testing; if eligible, they will be offered oral PrEP, contraception (oral or injectable) and STI screening. Follow-up visits including monitoring side effects will be conducted at baseline and 3, 6, 9 and 12 months. We will measure intervention uptake as the proportion of eligible women who agree to salon-based PrEP and separately to salon-based contraception. We will assess feasibility by collecting process measures and evaluate retention as continued use of PrEP and contraception separately, defined as one additional visit within 6 months with continued use of PrEP and/or contraception.

Ethics and dissemination

The study has been approved by the University of KwaZulu-Natal Biomedical Research Ethics Committee and the Massachusetts General Brigham Institutional Review Board. The results will be disseminated to local and provincial Departments of Health, at scientific conferences and in peer-reviewed scientific journals.

Trial registration number

NCT04222504. Registered January 2020.
A phase II double-blind multicentre, placebo-controlled trial to assess the efficacy and safety of alpelisib (BYL719) in paediatric and adult patients with Megalencephaly-CApillary malformation Polymicrogyria syndrome (MCAP): the SESAM study protocol
Authors: Luu Maxime , Vabres Pierre , Espitalier Aurélie , Maurer Agnès , Garde Aurore , Racine Caroline , Carpentier Maud , Rega Adélaide , Loffroy Romaric , Hadouiri Nawale , Boddaert Nathalie , Curie Aurore , Guibaud Laurent , Chebbi Mouna , Charligny Julie , Kuentz Paul , Canaud Guillaume , Bahi-Buisson Nadia , Fleck Camille , Cransac Amelie , Bardou Marc , Faivre Laurence
Published: December 2024

Introduction

The megalencephaly capillary malformation polymicrogyria (MCAP syndrome) results from mosaic gain-of-function
PIK3CA
variants. The main clinical features are macrocephaly, somatic overgrowth, neurodevelopmental delay and brain anomalies. Alpelisib (Vijoice) is a recently FDA-approved PI3Kα-specific inhibitor for patients with PIK3CA-related overgrowth spectrum (PROS). During its development, in patients with the MCAP subgroup of PROS, there was no specific, standardised evaluation of the effect on neuro-cognitive functioning. Moreover, it remains unknown if the molecule crosses the blood-brain barrier. Our objective is to evaluate the efficacy of a 24 month treatment with alpelisib on adaptive behaviour in patients with MCAP syndrome.

Methods and analysis

SESAM is an industry-sponsored two-period multicentre French academic phase II trial, with a 6-month double-blind, placebo-controlled period followed by an open-label period. The primary endpoint is a ≥4-point improvement in the Vineland II Adaptive Behaviour Scale (VABS), 24 months after treatment initiation. Secondary objectives are safety, VABS improvement at 6 months, impact on the quality of life, epilepsy and hypotonia. 20 patients aged 2 to 40 years with an MCAP diagnosis and neurodevelopmental disorders of various degrees, will be followed monthly in local centres, centrally assessed (clinical, biological, neuropsychological and functional evaluation) at baseline and every 6 months. Patients will be evaluated by volumetric MRI at baseline and at 24 months. An optional lumbar puncture will be performed to investigate blood-brain barrier crossing. Inclusions were completed by April 2024, with the end of follow-up in November 2026.

Given the efficacy of alpelisib in patients with PROS, if the drug crosses the blood-brain barrier, we can expect a clinical benefit for patients with neurocognitive disorders.

Ethics and dissemination

Ethical approval was given by CPP Sud-Ouest et Outre-Mer I (reference: 2022-500197-34-01). Findings from this study will be disseminated via publication, reports and conference presentations.

Trial registration number

NCT05577754
Effects of high-intensity interval and moderate-intensity continuous training on ambulatory blood pressure and cardiovascular outcomes in older adults with hypertension (HEXA Study): study protocol for a randomised trial
Authors: Dalton-Alves Francisco , Araújo Maria Beatriz F , Lucena Bruno Erick B , Souto Gabriel C , Lopes Daniele Samara D , Lucena Maria Isabel S , de Melo Silva Raíssa , Cabral Ludmila L P , Freire Yuri A , Golveia Fabíola L , Lemos Telma Maria Araújo , Browne Rodrigo A V , Costa Eduardo Caldas
Published: December 2024

Introduction

Approximately two-thirds of Brazilian older adults have hypertension. Aerobic training is the first-line non-pharmacological therapy for hypertension. However, the effects of different aerobic training approaches on ambulatory blood pressure in older adults are uncertain. Here, we present the study protocol for the HEXA Study, which aims to investigate the effects of high-intensity interval (HIIT) and moderate-intensity continuous training (MICT) on 24-hour ambulatory blood pressure and cardiovascular outcomes in older adults with hypertension.

Methods and analysis

This is a single-centre, randomised, three-arm, parallel superiority trial with a 1:1:1 ratio. The trial is conducted with blinded outcome assessors and statistical analysts. 66 inactive older adults with hypertension aged 60–80 years without a history of major adverse cardiovascular events will be randomly assigned to one of the following groups: (1) HIIT (3 months; 3× week); (2) MICT (3 months; 3× week); (3) health education programme (control; 3 months; 1× week). Exercise training sessions involve rating of perceived exertion-based outdoor moderate walking, brisk walking and/or jogging. The primary outcome is 24-hour ambulatory blood pressure. Secondary cardiovascular outcomes are resting blood pressure, cardiorespiratory fitness, pulse wave velocity, carotid intima-media thickness, heart rate variability and cardiac function/structure. All outcomes are measured at baseline and after a 3-month period. In addition, feelings of pleasure/displeasure, adherence and safety are reported.

Ethics and dissemination

All procedures were approved by the Research Ethics Committee of the Onofre Lopes University Hospital (protocol, CAAE 07191019.8.0000.5292) and are executed in compliance with the Declaration of Helsinki. Additionally, the procedures adhered to Resolution 466/2012 issued by the Brazilian National Health Council for research involving human subjects.

Trial registration number

Brazilian Registry of Clinical Trials (ID: RBR-4ntszb).
Frequency, demographics, diagnoses and consultation patterns associated with low-acuity attendances in German emergency departments: a retrospective routine healthcare data analysis from the INDEED project
Authors: Fischer-Rosinský Antje , Slagman Anna , Legg David , Wu Yves-Noel , King Ryan , Roll Stephanie , Keil Thomas , Möckel Martin
Published: December 2024

Objective

Evidence suggests interventions targeting low-acuity attendances have been hampered by insufficient characterisation of potential target groups. This study aimed to estimate the frequency of low-acuity emergency department (ED) attendances and to provide an overview of their demographic, diagnosis and consultation patterns.

Design

Observational analyses of routine healthcare data.

Setting

German EDs.

Participants

Adult patients with statutory health insurance who visited the ED of 16 participating hospitals in 2016.

Main outcome measures

Frequency, demographics, diagnoses and consultation patterns of low-acuity and high-acuity attendees.

Main results

Of the 454 747 ED visits, 370 756 visits (50.1% female) were included for analysis. Four participating hospitals had to be excluded due to the lack of data that were necessary for the stepwise approach to define low and high acuity. We identified 101 337 visits as low acuity (27.3%) and 256 876 as high acuity (69.3%), whereas 12 543 (3.4%) could not be classified. The proportion of attendees classified as low acuity decreased with age (highest at 40.6% in the age group <35 years). The proportion of women and men was 50% in both acuity categories, respectively (50 654 of all low-acuity and 128 427 of all high-acuity contacts). The highest proportion of low-acuity presentations was observed during the weekend (average of 18.6% per day), compared with an average of 12.5% on weekdays. The most common diagnoses (back pain, abdominal and pelvic pain) were similar in both low-acuity and high-acuity groups.

Conclusion

Our study provides further evidence that younger age is associated with low-acuity presentation in German EDs. Age-specific intervention strategies are needed to ease the burden on urgent care facilities. The similar spectrum of diagnoses between low-acuity and high-acuity patients suggests a so far under-recognised higher importance of severity.

Trial registration number

DRKS00022969.
Vestibular Infant Screening-Rehabilitation (VIS-REHAB): protocol for a randomised controlled trial on Vestibular Rehabilitation Therapy (VRT) in vestibular-impaired children
Authors: Fontaine Marieke , Dhooge Ingeborg , Dhondt Cleo , Van Hecke Ruth , Acke Frederic , Van den Bossche Lena , Van Hoecke Helen , De Leenheer Els , Maes Leen
Published: December 2024

Introduction

A vestibular deficit can have a substantial impact on the overall development of children. Therefore, it is of utmost importance that vestibular-impaired problems are treated early and effectively through Vestibular Rehabilitation Therapy (VRT). Although VRT is sufficiently proven and standardised in adults, there remains a lack of research examining its efficacy in children. To assess the effectiveness of VRT in vestibular-impaired children, the Vestibular Infant Screening-Rehabilitation (VIS-REHAB) protocol was developed with the following objectives: (1) to investigate the short-term effect of a combined postural control and gaze stabilisation protocol, compared with receiving no therapy and (2) to investigate the most important factors that may influence the effect of and outcome after application of the VIS-REHAB protocol in a group of vestibular-impaired children. This study aims to address lingering questions in the existing literature in a standardised manner, with the ultimate objective to establish evidence-based rehabilitation guidelines.

Methods and analysis

The VIS-REHAB study is a two-parallel group, superiority, randomised controlled crossover trial with 1:1 allocation ratio. The study includes patients aged 3–17 years old with identified peripheral vestibular dysfunction. Primary and secondary outcome measures assess gaze stability, postural stability, motor performance and quality of life. The effectiveness of the VIS-REHAB protocol will be evaluated through parallel group and crossover analyses using analysis of covariance (ANCOVA). Additionally, prespecified subgroup analyses will be conducted to assess influencing factors that may impact the outcome and effect of VIS-REHAB.

Ethics and dissemination

At the start of the VIS-REHAB study, an amendment will be submitted to the ethics committee of Ghent University Hospital for the following applications: (EC2018/0435), (EC2018/0959), (EC2015/1441) and (EC2015/1442). The trial is registered at Clinical Trials (clinicaltrials.gov) with registry name VIS-REHAB and identifierNCT06177132. All research findings will be disseminated in peer-reviewed journals.

Trial registration number

NCT06177132.
Heavy slow resistance training, radial extracorporeal shock wave therapy or advice for patients with tennis elbow in the Norwegian secondary care: a randomised controlled feasibility trial
Authors: Sveinall Håkon , Brox Jens Ivar , Engebretsen Kaia B , Hoksrud Aasne Fenne , Røe Cecilie , Johnsen Marianne Bakke
Published: December 2024

Objectives

To evaluate the feasibility of recruitment, appointment adherence, intervention compliance, acceptance and comprehensibility, in addition to retention rate and data completeness. An ancillary aim was to describe within-group changes in the secondary outcome measures (patient-reported and performance-based).

Design

A single-centre, three-armed, randomised controlled feasibility trial with a parallel design, with follow-up after 3 and 6 months.

Setting

Participants were recruited from the outpatient clinic at Oslo University Hospital.

Participants

Patients with lateral epicondylalgia, commonly known as tennis elbow.

Interventions

Participants were randomised in a 1:1:1 ratio to heavy slow resistance training, radial extracorporeal shock wave therapy or information and advice.

Main outcome measures

Feasibility was assessed according to a priori criteria for success.

Results

In total, 89 patients were screened for eligibility, and 69 (78%) patients were eligible for randomisation. 60 (92%) participants were randomised which gave a recruitment rate of 3.4 per month (against an a priori success cut-off of 3.75). The participants rated all the interventions as acceptable and comprehensive. Only 6 of 19 (32%) did comply with heavy slow resistance training. Retention rate and completeness of data were successful at 3 months. At 6 months, the retention rate was below the criteria for success. Patient-reported and performance-based outcomes improved in all groups.

Conclusion

The current study shows that the process of recruitment and the retention rate at follow-up can be feasible with minor amendments. Participants had low compliance with heavy slow resistance training mainly due to pain aggravation, which suggests that this intervention was not suitable for patients with tennis elbow. Shock wave therapy and information and advice should be investigated further in a full-scale randomised controlled trial including sham shock wave therapy.

Trial registration number

NCT04803825.
Incremental cost of treating antimicrobial-resistant infections among hospitalised patients in India: a cohort study
Authors: Kadam Abhijit , Mamulwar Megha , Bhambure Gayatri , Bembalkar Shilpa , Bapat Shraddha , Mane Arati , Rajure Shobha , Mathaiyan Jayanthi , Shafiq Nusrat , Prinja Shankar , Ramanathan Yamunadevi , Mehendale Sanjay M , Deotale Vijayshri Suresh , Khadanga Sagar , Bhattacharya Sanjay , Gogoi Gourangie , Walia Kamini , Panda Samiran , Gangakhedkar Raman , Attal Ruchita , Mandal Jharna , Ramanathan Venkateswaran , Ray Pallab , Chatterjee Susmita
Published: December 2024

Background

Accurate estimates of incremental cost (IC) attributable to antimicrobial resistance (AMR) provide information of immense public health importance to the policy makers. Here, we present the IC from patient perspective for treating antimicrobial-resistant pathogens in India.

Methods

This cohort study was conducted in eight hospitals including government (GH), private (PH) and trust hospitals (TH), considering their ownership, geographical location and categories of cities. This study had a retrospective component, which calculated the direct cost of treating resistant and susceptible blood stream infections caused by selected WHO priority pathogens. The prospective component estimated indirect cost and financial coping strategies for the treatment of AMR. In the retrospective component, 1723 records were included and 170 patients were recruited in the prospective component.

Results

The median total cost for management of antimicrobial-resistant infections was US$199 (IQR 89, 377) as opposed to US$109 (IQR 55, 229) for susceptible infection in GH. Our study has revealed that the ICs forEnterobacteriaceae(53.9%),Acinetobacter(43.8%) andStaphylococcus(49.7%) at GHs were higher for resistant pathogens. Pharmaceutical cost was the major contributor to IC at GHs (61.5%) and PHs (27.1%). In the prospective component, 46.5% of patients resorted to borrowing money for hospitalisation expenses and the per day median total cost for resistant and sensitive infection was estimated to be US$65 and US$35, respectively.

Conclusions

The current study concluded that the presence of any critical or high priority pathogens led to an increase in the direct and indirect medical costs. The IC varied with hospital type, length of stay, pathogen, comorbidities and diagnosis. Prospective studies are needed for precise understanding of variations in the costs of treating AMR infections.
Exploring the relationship between personal and cohabiting family members’ COVID-19 infection experiences and fear of COVID-19: a longitudinal study based on the Japan COVID-19 and Society Internet Survey (JACSIS)
Authors: Ishikawa Akira , Tachikawa Hirokazu , Midorikawa Haruhiko , Tabuchi Takahiro
Published: December 2024

Objectives

This study aims to explore the relationship between the combined experiences of COVID-19 infection in individuals and their family members and the resulting fear of COVID-19, with a focus on the severity of symptoms and various sociodemographic factors.

Design

Longitudinal survey study.

Setting

The Japan COVID-19 and Society Internet Survey (JACSIS), a large-scale web panel survey administered in Japan.

Participants

Analysis was based on responses from 15 542 individuals who participated in all three waves of JACSIS conducted between 2020 and 2022.

Main outcome measures

The primary measure was the fear of COVID-19, assessed using the Fear of COVID-19 Scale. The study employed a two-way analysis of variance without repetition, Games-Howell post hoc tests and ordinary least-squares linear regression analysis, with time points treated as fixed effects.

Results

The study revealed significant differences in fear levels based on the combined COVID-19 infection experiences of respondents and their family members, with variations observed across different time points. Mild symptoms in either the respondents or their family members correlated with reduced fear (β=−0.584, SE=0.181, p=0.001), while severe symptoms were associated with increased fear (β=1.244, SE=0.217, p<0.001). Gender, age, marital status and a history of respiratory disease or mental illness were also significant factors. For instance, females reported higher fear levels compared with males (β=0.707, SE=0.049, p<0.001), and those with a history of respiratory diseases showed increased fear (β=1.632, SE=0.286, p<0.001). Over time, the general fear of COVID-19 decreased, with the sharpest decline observed at T3 compared with T1 (β=−1.399, SE=0.061, p<0.001).

Conclusion

The study highlights the significant influence of the combined COVID-19 infection experiences of individuals and their family members (the severity of symptoms, in particular) on the fear of COVID-19. These results underscore the need for tailored mental health interventions that consider both personal and familial infection experiences, as well as other sociodemographic factors. The findings also reflect the evolving public response to the changing dynamics of the pandemic.
Development of evidence-based standards for inpatient physiotherapy services: a systematic review and content analysis of clinical practice guidelines
Authors: Plater Jacqueline Claire , Baxter G David , Wood Lincoln C , Mueller Janice , Fisher Thelma
Published: December 2024

Objective

Performance standards are critical to service design and quality improvement. There are no published standards defining the care inpatients should receive from physiotherapists in Aotearoa New Zealand. This study aims to explore the potential of using clinical practice guidelines (CPGs) to develop a set of evidence-based standards for physiotherapy in inpatient settings.

Design

A systematic review and content analysis of CPGs.

Data sources

Scholarly databases (Web of Science, CINAHL and Scopus, PEDro) and grey literature (guideline databases – NICE, SIGN, ECRI guideline trust, Guidelines International Network (GIN)) were searched between July and September 2021.

Eligibility criteria

CPGs related to conditions and treatments common to physiotherapy in a secondary care setting were included. Mental health conditions, paediatrics, COVID-19 and conditions common to tertiary care were excluded.

Data extraction and synthesis

A pragmatic approach was taken to group guidelines aligned with common physiotherapy services and select only the most recent and comprehensive guidelines for final analysis. The quality of CPGs was assessed using the Appraisal of Guidelines for Research and Evaluation Instrument (AGREE II). Data from guideline recommendations of relevance to inpatient physiotherapy were grouped into themes. Summative ‘statements’ were drafted to represent the content of each theme; these were given a confidence rating based on the number of supporting guidelines and the strength or grade of evidence awarded by the guideline group.

Results

The recommendations of 32 CPGs yielded 27 statements.

Conclusion

Twenty-seven statements represent a distillation of the best evidence-based practice recommendations from CPGs in inpatient physiotherapy. Statements of physiotherapy dosage (frequency, intensity and duration) are not available for many areas of practice; researchers and CPG groups should consider the importance of these data for service commissioning.
Use of complementary and alternative medicine among females with polycystic ovary syndrome in Jordan: a cross-sectional study
Authors: Awwad Oriana , Saleh Mais , Bardaweel Sanaa K , Alsamydai Ali , Afifi Fatma U , Akour Amal , Abu Tarboosh Renad , Hamdan Manar , Basha Asma Sa’d
Published: December 2024

Background and objectives

Polycystic ovary syndrome (PCOS) is a prevalent female reproductive and metabolic disorder. Among patients with chronic conditions, an increasing number have approached complementary and alternative medicine (CAM) to cope with their disease. This study aimed to assess the use of CAM among females with PCOS in Jordan.

Design, settings and participants

A cross-sectional study was conducted at one of the largest tertiary centres in Jordan. Adult females with PCOS were interviewed using a data collection tool.

Outcome measures

CAM use and the factors associated with its use.

Results

A total of 402 women participated in the study, the median-IQR age was 25 (31–21) years. Common PCOS signs/symptoms included menses irregularity (81.8%), fatigue (71.6%) and hyperandrogenism (77.6%). Among all participants, 63.2% used CAM with the most common being herbs (60.4%). The primary sources of information were family and friends (46.1%).

Longer duration since diagnosis, having more PCOS signs/symptoms and a higher level of education were factors significantly associated with CAM use (β=1.257, 95% CI=1.018 to 2.552, p=0.034;β=1.146, 95% CI=1.052 to 1.250, p=0.002 andβ=1.584, 95% CI=1.054 to 2.379, p=0.027, respectively). Of all the CAM users, 57.5% reported an amelioration in PCOS symptoms; this was significantly associated with the long-term use of CAM (β=12.759, 95% CI=6.789 to 23.976, p<0.001). Just a few participants (9.4%) reported side effects.

Conclusion

A variety of CAM approaches were reported by the study population; herbs were the most widely used and accepted by the patients. Considering the primary source of information and the potential interactions of herbal medicine with the standard PCOS treatment, efforts are needed by healthcare providers to better understand the use of CAM among their patients with PCOS.
Sexual health and healthy relationships for Further Education (SaFE) in Wales and England: results from a pilot cluster randomised controlled trial
Authors: Williams-Thomas Rhys , Townson Julia , Lewis Ruth , Copeland Lauren , Madan Jason , Melendez-Torres G J , Lugg-Widger Fiona V , Pallmann Philip , Riaz Muhammad , Brown Rachel , Bonell Chris , Morgan Gemma S , White James , Young Honor
Published: December 2024

Objectives

To examine the acceptability of implementing, trialling and estimating the cost of the Sexual health and healthy relationships for Further Education (SaFE) intervention.

Design

Two-arm repeated cross-sectional pilot cluster randomised controlled trial (cRCT) of SaFE compared with usual practice, including a process evaluation and an economic assessment.

Setting

Eight further education (FE) settings in South Wales and the West of England, UK.

Participants

FE students, staff and sexual health nurses.

Intervention

SaFE had three components: (1) onsite access to sexual health and relationship services provided by sexual health nurses available for 2 hours on 2 days per week; (2) publicity about onsite sexual health and relationship services and (3) FE staff training on how to promote sexual health, and recognise, prevent and respond to dating and relationship violence (DRV) and sexual harassment.

Primary and secondary outcome measures

The primary outcome was feasibility, assessing whether the study met progression criteria relating to: (a) FE setting and student recruitment; (b) the acceptability of the intervention and (c) qualitative data, and documentary evidence from students, staff and sexual health nurses on acceptability, fidelity of implementation and receipt. We also assessed the completeness of primary, secondary and intermediate outcome measures and estimated cost of the intervention.

Results

Three of the four progression criteria were met. Eight FE settings were recruited, randomised and retained. Of the students approached, 60.7% (1124/1852 students) at baseline and 51.9% (1139/2193 students) at 12 month follow-up completed the questionnaire (target 60%). Over 80% of onsite sexual health services were attended by a nurse; onsite publicity about sexual health services was observed at all intervention settings and 137 staff were trained. SaFE was viewed positively by FE students, FE staff and nurses but needed more time to embed. The prevalence of self-reported unprotected sex at last intercourse was 15.5% at baseline and 18.7% at follow-up. There was evidence of floor effects in the measure of DRV victimisation in the last 12 months. We found low rates of missing data for almost all variables with no discernible differences across arms. The estimated cost per FE setting was £38,363.09.

Conclusions

SaFE was implemented and well received by students, staff and nurses. If strategies to boost student recruitment to the survey can be identified, progression to a phase III effectiveness trial of SaFE is warranted.

Trial registration number

ISRCTN54793810
.
Designing a multicomponent intervention to support caregivers of persons with dementia in primary care in Spain: a qualitative study of family and professional carers
Authors: Curto Romeu Claudia , Mora López Gerard , Gavaldà Espelta Ester , Brunet Reverté Núria , Gonçalves Alessandra Queiroga , Jacques-Aviñó Constanza , Lleixà Fortuño Maria del Mar , Ferre Ferrate Maria , Aguilar Martín Carina , Pozo Ariza Macarena , Ferre Grau Carme
Published: December 2024

Objective

The purpose of this study was to explore experiences of family and professional caregivers of persons with dementia in order to design a tailored community-based support programme.

Design

A two-stage study was deployed. First, qualitative research draws on three focus groups. Two of these comprised family caregivers and the third was made up of care provision professionals. Thematic content analysis was conducted by interpretative description for applied practice. Second, an experience-based codesign methodology was applied to design a tailored support programme in accordance with carers’ demands and contextual realities.

Setting and study period

Rural region in Catalonia, at northeast of Spain. March–June 2019.

Participants

We interviewed 12 family caregivers and 8 primary care providers.

Results

10 main themes were identified: caregivers’ feelings, repercussions of caregiving in caregivers’ lives, education about dementia and caring skills, education about time management and self-care, caregivers’ needs to receive more information and training, improved patients’ follow-up and social assistance and more psychologic support. Finally, three themes related to caregivers’ demands: social services resources, multidisciplinary approach programmes and support from other caregivers. From these results, a multicomponent, professionally led community-based intervention was designed. The main components were the following: education and caring skills, professional psychological support, and social and community resources.

Conclusion

This study allowed the design of a multicomponent support intervention for family caregivers of persons with dementia aimed at reducing their burden and improving their quality of life in ways consistent with their actual needs and the available local resources.
Are there any sociodemographic factors associated with non-uptake of HPV vaccination of girls in high-income countries with school-based vaccination programmes? A systematic review
Authors: Dema Emily , Osman Roeann , Soldan Kate , Field Nigel , Sonnenberg Pam
Published: December 2024

Background

Uptake of human papillomavirus (HPV) vaccination is generally high in high-income countries with school-based vaccination programmes; however, lower uptake in certain population subgroups could continue pre-immunisation inequalities in cervical cancer.

Methods

Six electronic databases were searched for quantitative articles published between 1 September 2006 and 20 February 2023, which were representative of the general population, with individual-level data on routine school-based vaccination (with >50% coverage) and sociodemographic measures. Titles, abstracts and full-text articles were screened for eligibility criteria and assessed for bias. A second independent reviewer randomly screened 20% of articles at each stage. A narrative synthesis summarised findings.

Results

24 studies based in eight countries (Australia, Belgium, Canada, New Zealand, Norway, Sweden, Switzerland, UK) were included. Studies reported vaccination uptake by individual-level and area-level socioeconomic status (SES), parental education, religion, ethnicity and/or country of birth. 19 studies reported that more than 70% were vaccinated (range: 50.7%–93.0%). Minority ethnic groups and migrants were more likely to have lower vaccination uptake than White groups and non-migrants (11/11 studies). Lower SES was also associated with lower uptake of vaccination (11/17 studies). Associations with other sociodemographic characteristics, such as parental education and religion, were less clear.

Conclusions

Even in high-income countries with high coverage school-based vaccination programmes, inequalities are seen. The totality of available evidence suggests girls from lower SES and minority ethnic groups tend to be less likely to be vaccinated. Findings could inform targeted approaches to mop-up vaccination and cervical cancer screening amidst changing HPV epidemiology in a vaccine era.

Trial registration number

CRD42023399648.
Is framing of treatment options misleading? Maybe, but not because of a lower-bound reading
Authors: Al Pepijn
Published: December 2024

In a recent paper, Yeo argues that the framing of treatment options by physicians in the contexts of patient’s decision-making conflicts with a physician’s duty of disclosure. I argue that this conclusion is drawn too quickly, as it is questionable whether the empirical research on which Yeo relies is applicable to the framing of treatment options. This means that Yeo’s main assumption is undermined, and we should hold off on concluding that the framing of treatment options is misleading.
Real-world treatment patterns, healthcare resource utilisation and costs in patients with SLE in the USA
Authors: Masurkar Prajakta P , Reckleff Jennifer , Princic Nicole , Limone Brendan , Schwartz Hana , Karis Elaine , Zollars Eric , Costenbader Karen
Published: December 2024

Objective

To evaluate the treatment patterns, medication adherence, concomitant corticosteroid use, factors influencing sequence of therapies (SOTs), healthcare resource utilisation (HCRU) and associated costs in adults with SLE in the USA.

Methods

Claims data from the Merative MarketScan Commercial and Medicare Supplemental Database between 2011 and 2019 were used to identify patients with incident SLE. The date of first claim with SLE was defined as the index date, with a 24-month pre-index and ≥24-month post-index period. Descriptive statistics were used to evaluate patient demographics and baseline clinical characteristics, treatment patterns, adherence, HCRU and cost. Multivariable-adjusted logistic regression models were used to identify factors associated with transition between SOTs.

Results

Overall, 2476 patients received SLE treatment. The mean (SD) age was 46.9 (14.1) years and the mean (SD) follow-up duration was 47.8 (15.7) months. High corticosteroid use was prevalent in all SOTs (≥1 corticosteroid; average dose, 16.8–19.3 mg/day; 50%–60% patients). Antimalarials were most commonly prescribed in SOT 1 (85.7%), and immunosuppressants in SOT 2 and 3 (85.4% and 77.5%, respectively). Transition frequency from SOT 1–2 (38.4%) and SOT 2–3 (16.9%) was influenced by immunosuppressant prescription, concomitant corticosteroid use, sex, severe disease activity, non-persistence and age. Adherence was highest for biologics, followed by antimalarials and immunosuppressants. SLE-related HCRU and associated costs increased with SOT progression (mean (SD) at baseline vs SOT 3, US$19 489 (US$45 336) vs US$23 201 (US$39 628)).

Conclusion

SLE treatment regimens with greater adherence and reduced corticosteroid use, HCRU and associated costs are needed.
Charged superradiant instability in a spherical regular black hole
Authors: Zhan Yizhi , Xu Hengyu , Zhang Shao-Jun
Published: December 2024

We examine the stability of a spherically symmetric regular black hole when subjected to perturbations from a charged scalar field. This particular black hole is constructed by deforming the Minkowski spacetime. It has been observed that the charged superradiant instability arises only within a specific range of the deformation parameter, potentially resulting in an instability growth rate with a maximum magnitude of approximately

$$\text {Im} (M \omega ) \sim 10^{-3}$$

Im

(
M
ω
)

∼

10

-
3

. This growth rate significantly exceeds the instability identified in ABG black holes discussed in prior research, suggesting a notable timescale for detecting this phenomenon in astrophysical scenarios. Additionally, we conduct a thorough investigation into how the three parameters of the model influence the onset and intensity of the instability. Our analysis offers further insights into the possible emergence of this instability in spherical regular black holes and its association with the nonlinear effects of the electromagnetic field.
Analysis of Elites’ Characteristics and the Environmental Performance in the People’s Republic of China: A Focus on the New Environmental Protection Law
Authors: HONG MINJUN , YOON JIHYE
Published: December 2024

In 2014, the People’s Republic of China (PRC) strengthened local government responsibilities for environmental protection by amending the Environmental Protection Law and strengthening its associated performance management system. Considering the limitations and inefficiencies of the PRC’s performance management system, this study explores how local elites’ traits influence environmental performance, both before and after the amendment to the Environmental Protection Law. The study found that the effects of local elites’ characteristics on environmental performance changed after the amendment of the Environmental Protection Law, particularly with regard to the administrative leader’s (i) birth year and (ii) year of joining the Chinese Communist Party. Additionally, there were discrepancies in the results between administrative leaders and party secretaries, highlighting the distinctions in their respective roles. This study emphasizes the importance of appointing administrative leaders to enhance environmental performance at the local level in the PRC.
Algorithm xxx:
ellipFor
, a Fortran software library for Legendre elliptic integrals and Jacobi elliptic functions with generalized input arguments
Authors: Trim Sean J. , Spiteri Raymond J.
Published: December 2024

Legendre elliptic integrals and Jacobi elliptic functions arise in multiple applications within the physical sciences, including oscillations, celestial mechanics, and geodynamics. In this study, we describe the Fortran library
ellipFor
capable of evaluating the following for generalized input values: 1) the complete Legendre elliptic integrals of the first and second kinds, 2) the incomplete Legendre elliptic integrals of the first and second kinds, and 3) the principal Jacobi elliptic functions. Our software builds upon previously developed Fortran routines, which were designed with restrictions on input parameters that may be limiting in applications. Our routines apply multiple transformations to allow for more general input values, such as elliptic moduli greater than unity for points 1–3, arbitrary real Jacobi amplitudes for points 1–2, and complex first arguments for point 3. In addition, our routines are thread-safe, allowing for parallel computations. Our routines were compared with values from the computer algebra system SageMath over a wide range of input parameters. Values from
ellipFor
and SageMath agreed to within tolerances commensurate with the limitations of floating-point arithmetic used for the elliptic integrals and Jacobi elliptic functions listed in points 1, 2, and 3 above for generalized input arguments.
TCKT: Tree-Based Cross-domain Knowledge Transfer for Next POI Cold-Start Recommendation
Authors: He Xi , Liu Yilin , He Weikang , Xing Xin , Lu Xingyu , Liu Yanbing
Published: December 2024

The next point of interest (POI) recommendation task recommends POIs to users that they may be interested in next time based on their historical trajectories. This task holds value for both users and businesses. However, it has consistently faced the issue of cold-start caused by sparse user check-in data. Existing research mainly focuses on knowledge transfer among cities within the same data source, but these data are very rare. The abundance of available third-party data presents opportunities to improve cold-start performance, but it is not easy. This third-party data contains numerous entities, such as POIs and users, which have different representations and distributions across different data domains, making knowledge transfer difficult. To address these challenges, we propose the Tree-Based Cross-domain Knowledge Transfer (TCKT) model. First, we construct a multi-granularity Geographical Frequency Tree (GF-Tree), transforming the POI recommendation problem into a path generation problem. Second, we design a pre-training model to mine general user behavior patterns and spatio-temporal features among POIs from large-scale third-party data. Finally, we propose a dual-channel domain adaptation model to facilitate cross-domain knowledge transfer and improve cold-start performance. Experimental results on three public datasets demonstrate that our method outperforms state-of-the-art (SOTA) baseline methods.
CogProg: Utilizing Large Language Models to Forecast In-the-moment Health Assessment
Authors: Sprint Gina , Schmitter-Edgecombe Maureen , Weaver Raven , Wiese Lisa , Cook Diane J.
Published: December 2024

Forecasting future health status is beneficial for understanding health patterns and providing anticipatory support for cognitive and physical health difficulties. In recent years, generative large language models (LLMs) have shown promise as forecasters. Though not traditionally considered strong candidates for numeric tasks, LLMs demonstrate emerging abilities to address various forecasting problems. They also provide the ability to incorporate unstructured information and explain their reasoning process. In this paper, we explore whether LLMs can effectively forecast future self-reported health state. To do this, we utilized in-the-moment assessments of mental sharpness, fatigue, and stress from multiple studies, utilizing daily responses (
N
=106 participants) and responses that are accompanied by text descriptions of activities (
N
=32 participants). With these data, we constructed prompt/response pairs to predict a participant’s next answer. We fine-tuned several LLMs and applied chain-of-thought prompting evaluating forecasting accuracy and prediction explainability. Notably, we found that LLMs achieved the lowest mean absolute error (MAE) overall (0.851), while gradient boosting achieved the lowest overall root mean squared error (RMSE) (1.356). When additional text context was provided, LLM forecasts achieved the lowest MAE for predicting mental sharpness (0.862), fatigue (1.000), and stress (0.414). These multimodal LLMs further outperformed the numeric baselines in terms of RMSE when predicting stress (0.947), although numeric algorithms achieved the best RMSE results for mental sharpness (1.246) and fatigue (1.587). This study offers valuable insights for future applications of LLMs in health-based forecasting. The findings suggest that LLMs, when supplemented with additional text information, can be effective tools for improving health forecasting accuracy.
From Today’s Code to Tomorrow’s Symphony: The AI Transformation of Developer’s Routine by 2030
Authors: Qiu Ketai , Puccinelli Niccolò , Ciniselli Matteo , Di Grazia Luca
Published: December 2024

In the rapidly evolving landscape of software engineering, the integration of Artificial Intelligence (AI) into the Software Development Life-Cycle (SDLC) heralds a transformative era for developers. Recently, we have assisted to a pivotal shift towards AI-assisted programming, exemplified by tools like GitHub Copilot and OpenAI’s ChatGPT, which have become a crucial element for coding, debugging, and software design. In this paper we provide a comparative analysis between the current state of AI-assisted programming in 2024 and our projections for 2030, by exploring how AI advancements are set to enhance the implementation phase, fundamentally altering developers’ roles from manual coders to orchestrators of AI-driven development ecosystems. We envision
HyperAssistant
, an augmented AI tool that offers comprehensive support to 2030 developers, addressing current limitations in mental health support, fault detection, code optimization, team interaction, and skill development. We emphasize AI as a complementary force, augmenting developers’ capabilities rather than replacing them, leading to the creation of sophisticated, reliable, and secure software solutions. Our vision seeks to anticipate the evolution of programming practices, challenges, and future directions, shaping a new paradigm where developers and AI collaborate more closely, promising a significant leap in SE efficiency, security and creativity.
Neoadjuvant Chemotherapy VI-RADS Scores for Assessing Muscle-invasive Bladder Cancer Response to Neoadjuvant Immunotherapy with Multiparametric MRI
Authors: Brembilla Giorgio , Basile Giuseppe , Cosenza Michele , Giganti Francesco , Del Prete Andrea , Russo Tommaso , Pennella Renato , Lavalle Salvatore , Raggi Daniele , Mercinelli Chiara , Tateo Valentina , Cigliola Antonio , Patanè Damiano , Crupi Emanuele , Giannatempo Patrizia , Messina Antonella , Calareso Giuseppina , Martini Alberto , Bandini Marco , Moschini Marco , Cardone Gianpiero , Briganti Alberto , Montorsi Francesco , Necchi Andrea , De Cobelli Francesco
Published: December 2024

Neoadjuvant chemotherapy Vesical Imaging Reporting and Data System scores were accurate and reproducible for the assessment of muscle-invasive bladder cancer response to neoadjuvant immunotherapy.
1H and 31P MR Spectroscopy to Assess Muscle Mitochondrial Dysfunction in Long COVID
Authors: Finnigan Lucy E. M. , Cassar Mark Philip , Jafarpour Mehrsa , Sultana Antonella , Ashkir Zakariye , Azer Karim , Neubauer Stefan , Tyler Damian J. , Raman Betty , Valkovič Ladislav
Published: December 2024

MR spectroscopy showed altered phosphocreatine recovery and mitochondrial capacity in participants with post–COVID-19 condition, also called long COVID, compared with controls, suggesting mitochondrial dysfunction; however, these changes did not correlate with fatigue severity.
MRI-directed Micro-US–guided Transperineal Focal Laser Ablation for Localized Prostate Cancer: A 1-year Follow-up Study
Authors: Cornud Franҫois , de Bie Katelijne , van Riel Luigi , Lefèvre Arnaud , Camparo Philippe , Galiano Marc
Published: December 2024

Multifiber micro-US–guided focal laser ablation in participants with localized prostate cancer was safe and feasible, with 18% recurrence at 1-year follow-up.
Assessing Lung Ventilation and Bronchodilator Response in Asthma and Chronic Obstructive Pulmonary Disease with 19F MRI
Authors: Pippard Benjamin J. , Neal Mary A. , Holland Charlotte W. , Maunder Adam M. , Forrest Ian , Lawson Rod A. , Fisher Holly F. , Matthews John N. S. , Wild James M. , Simpson A. John , Thelwall Peter E.
Published: December 2024

Fluorine 19 MRI of inhaled perfluoropropane enabled quantification of lung ventilation defects in participants with asthma and chronic obstructive pulmonary disease before and after bronchodilator therapy.