bluuebunny/crossref_metadata_2025 huggingface dataset:
Single-session gamma sensory stimulation entrains real-time electroencephalography but does not enhance perception, attention, short-term memory, or long-term memory
Authors: Wu Cai-Syuan , Lin Ting-Xuan , Lo Yu-Hui , Ke Shih-Chiang , Sahu Prangya Parimita , Tseng Philip
Published: January 2025

Background

Studies have shown that gamma (40 Hz) audiovisual stimulation can enhance gamma oscillations and improve cognitive functioning in patients with Alzheimer's disease. However, despite promising long-term results, the efficacy of short-duration or single-session 40 Hz entrainment in humans has been questioned by behavioral studies that fail to find observable cognitive aftereffects, for two possible reasons: 1) lack of validated gamma entrainment, as most studies lacked concurrent electroencephalography (EEG) data to verify that gamma neural entrainment did take place, and 2) lack of diverse cognitive tests, as most studies did not test a wide range of cognitive factors.

Objective

This study aimed to increase sensitivity for detecting single-session gamma entrainment. We employed 1) mid- and post-stimulation EEG monitoring to ensure entrainment worked, and 2) a comprehensive cognitive battery that probes perception, attention, working memory, and long-term memory.

Methods

Participants received 30 min of synchronized 40 Hz light and sound stimulation, followed by a visual perceptual task, attentional network task, change detection working memory task, and long-term picture memory task, with concurrent EEG.

Results

We observed robust 40 Hz EEG entrainment during stimulation but no significant 40 Hz oscillation after stimulation, and no significant cognitive improvements.

Conclusions

Despite robust 40 Hz online entrainment, gamma sensory entrainment requires consistent long-term exposure to induce cognitive and neurological changes. Future research should determine the optimal duration and frequency of 40 Hz stimulation to maximize its therapeutic potential.
Pivotal trial of low-intensity pulsed ultrasound therapy for early Alzheimer's disease: Rationale and design
Authors: Shimokawa Hiroaki , Akishita Masahiro , Ihara Masafumi , Teramukai Satoshi , Ishiki Aiko , Nagai Yoji , Fukushima Masanori
Published: January 2025

Background

There are lines of evidence suggesting that cerebral microcirculatory dysfunction is involved in the pathogenesis of Alzheimer's disease (AD). We have developed a low-intensity pulsed ultrasound (LIPUS) therapy that upregulates endothelial NO synthase with therapeutic angiogenesis. We demonstrated that the LIPUS therapy ameliorates cognitive declines in mouse models of AD and tended to do so in patients with early AD (mild AD and mild cognitive impairment due to AD) in the pilot trial. Thus, the Japanese government has designated our LIPUS device as the first breakthrough medical device in Japan.

Objective

We are performing a pivotal clinical trial (LIPUS-AD) to finally address the efficacy and safety of our LIPUS therapy in patients with early AD in Japan.

Methods

LIPUS-AD is a randomized, double-blind, placebo-controlled trial, in which a total of 220 patients with early AD, who are positive for amyloid-β (Aβ) PET, will be randomized in a 1:1 fashion. The LIPUS therapy is performed for the whole brain for one hour 3 times a week as one session under the special conditions (32 cycles, 0.5 MHz, 0.25 W/cm2). It is performed for 6 sessions with 3-month intervals in the LIPUS group for 72 weeks, while the placebo group receives placebo therapy. Before and at 72 weeks of the trial, all subjects undergo brain Aβ PET and MRI and 9 cognitive functions tests. The primary efficacy endpoint is the changes in ADAS-J-cog-14 scores from baseline to 72 weeks.

Conclusions

LIPUS-AD addresses efficacy and safety of the LIPUS therapy in patients with early AD. Clinical Trial Gov. No.: NCT05983575
From Intent to Inaction: Factors Conditioning Cultural Institutions From Embracing Crowdfunding as a Fundraising Tool
Authors: Rykkja Anders , Bonet Lluís
Published: January 2025

Purpose

The article explores factors explaining cultural institutions’ intentions to adopt and circumstances that lead to inaction in terms of launching a crowdfunding campaign.

Study Design

The study is a single-case study of a Norwegian museum consortium. It combines thematic analysis of qualitative data from interviews and non-parametric tests of quantitative survey data to examine differences between four categories of employees: leadership, curators, technical staff, and support staff.

Findings

The study identifies three key factors contributing to the inaction and failure to launch the crowdfunding campaign: (1) the added value of funding and non-monetary benefits; (2) legitimacy concerns surrounding crowdfunding; and (3) the leadership and management of implementing what proved to be a non-routine activity.

Contributions

The paper provides insights into the drivers and barriers that influence the intention to use institutional cultural crowdfunding. It adds to the literature by demonstrating that cultural institutions’ internal organisational dynamics influence decision-making. The derived propositions provide a basis for further empirical research into how cultural institutions approach crowdfunding.

Implications

The findings hold practical implications for cultural institutions, policymakers, and scholars. They underscore the importance of leadership in navigating legitimacy concerns, fostering intra-organisational collaboration, and supporting institutional cultural crowdfunding efforts from intent to action.
A systemic approach to identifying sustainable community-based interventions for improving adolescent mental health: a participatory group model building and design protocol
Authors: Keenan Megan , Freeman Leanne , Santana de Lima Ediane , Potter Katie , Hobbs Tim , Ballard Ellis , Fonagy Peter
Published: January 2025

Background

The deteriorating mental health of children and young people in the United Kingdom poses a challenge that services and policy makers have found difficult to tackle. Kailo responds to this issue with a community-based participatory and systemically informed strategy, perceiving mental health and well-being as a dynamic state shaped by the interplay of broader health determinants. The initiative works to explore, define and implement locally relevant solutions to challenges shaping the mental health and well-being of young people. Kailo unfolds in three stages within each locale. These stages encompass: “early discovery”, “deeper discovery and co-design” and “implementation”. This document delves into the participatory group model building and design protocol occurring in the “deeper discovery and co-design” stage of the project.

Methods

Participatory methods, such as group model building, are effective in articulating and building consensus on complex issues like the social determinants of adolescent mental health. This paper describes the protocol for application of group model building within the Kailo design process to develop causal loop diagrams and pinpoint leverage points for improving adolescent mental health. It also suggests a method for considering modifications to delivery within a unique project context and in alignment with participants’ needs. This paper sets out to define the approach and clarify the objectives these engagements aim to fulfil. The method adapts existing group model building (GMB) protocols for use in a community setting. The engagements will involve groups of local young people and existing community members. To assess the success of the session’s implementation post-delivery, the study utilizes existing frameworks for fidelity evaluations, which define a core and flex model.

Discussion

The method described enables an integration of diverse local understandings of complex processes which provides a platform for creating co-designed interventions. This protocol can be used to further strengthen research and design through incorporating complexity and participation into the formulation of contextually relevant policies and practices. The strengths and limitations of the approach are discussed.
SARS-CoV-2 excretion and genetic evolution in nasopharyngeal and stool samples from primary immunodeficiency and immunocompetent pediatric patients
Authors: Khemiri Haifa , Ben Fraj Ilhem , Lorusso Alessio , Mekki Najla , Mangone Iolanda , Gdoura Mariem , Di Pasqual Adriano , Cammà Cesare , Di Lollo Valeria , Cherni Asma , Touzi Henda , Sadraoui Amel , Meddeb Zina , Hogga Nahed , Ben Mustapha Imen , Barbouche Mohamed-Ridha , Ouederni Monia , Triki Henda , Haddad-Boubaker Sondes
Published: January 2025

Background

Primary Immunodeficiency disorders (PID) can increase the risk of severe COVID-19 and prolonged infection. This study investigates the duration of SARS-CoV-2 excretion and the genetic evolution of the virus in pediatric PID patients as compared to immunocompetent (IC) patients.

Materials and methods

A total of 40 nasopharyngeal and 24 stool samples were obtained from five PID and ten IC children. RNA detection was performed using RT-qPCR, and whole-genome sequencing was conducted with the NexSeq 1000 platform. Data analysis used the nextflow/viralrecon pipeline. Hotspot amino acid frequencies were investigated using GraphPad Prism v10. Phylodynamic analysis was conducted with BEAST software.

Results

In IC children, the viral excretion period lasted up to 14 days in nasopharyngeal swabs, with an average duration of 7 days, and ranged from 7 to 14 days in stool samples. In PID patients, the viral RNA was detected in nasopharyngeal for periods between 7 and 28 days, with an average duration of 15 days, and up to 28 days in stool samples. Two SARS-CoV-2 variants were detected in PID patients: Delta (AY.122) and Omicron (BA.1.1). Patients with antibody and combined deficiencies, exhibited the most prolonged shedding periods in both nasopharyngeal and stool samples and one patient presented complications and fatal outcome. Specific Hotspot amino acid changes were detected in PID: A2821V and R550H (ORF1ab).

Conclusion

Our findings underscore the prolonged excretion of SARS-CoV-2 RNA in patients with antibody and combined deficiencies. Thus, specialized care is essential for effectively managing PID patients.
Optical coherence tomography angiography reveals abnormal retinal vascular density and perfusion in patients with X-linked adrenoleukodystrophy: a cross-sectional study
Authors: Zhang Lujie , Yu Yongqiu , Liu Ting , Li Chongyi , Tan Liang , Wen Shuiqian
Published: January 2025

Purpose

X-linked adrenoleukodystrophy (XALD) can affect the eyes. Existing therapies are hampered by early quantitative examination methods. This study used an optical coherence tomography angiography system (OCTA) to investigate retinal microvascular density and perfusion in XALD patients.

Methods

Fifty-two patients and 47 age-matched controls were included in this cross-sectional study. The patients were divided into three groups (symptomatic, less symptomatic, and controls). We compared the foveal avascular zone area, vascular density and perfusion area at the superficial vascular complex (SVC) and deep vascular complex (DVC) of the peripapillary and macular between the groups. We correlated these measurements with scale scores.

Results

Compared with the controls, the symptomatic group had significantly lower vascular density in the superior nasal sector of the peripapillary SVC (MD − 4.940884; 95% CI − 9.655061 to − 0.226707; p = 0.036), lower vascular density (MD − 4.259225; 95% CI − 8.248627  to  − 0.269823; p = 0.032) and lower perfusion area (MD − 0.180304; 95% CI − 0.337135  to  − 0.023472; p = 0.018) in the peripheral ring superior quadrant of the macular SVC. Compared with the less symptomatic group, the symptomatic group exhibited a significantly lower vascular density (MD − 5.635483; 95% CI − 10.450009  to  − 0.820957; p = 0.015) and perfusion area (MD − 0.063351; 95% CI − 0.116611  to  − 0.010091; p = 0.013) in the superior nasal sector of the peripapillary SVC; lower vascular density (MD − 4.817846; 95% CI − 8.924294  to  − 0.711399; p = 0.015) and perfusion area (MD − 0.202707; 95% CI − 0.369499  to  − 0.035915; p = 0.011) in the peripheral ring superior quadrant of the macular SVC; and greater vascular density (MD 7.209401; 95% CI 0.818716–13.600086; p = 0.021) and perfusion area (MD 0.047320; 95% CI 0.001685–0.092956; p = 0.039) in the inferior nasal sector of the peripapillary DVC. Among the 52 patients, the expanded disability status score (EDSS) was moderately negatively correlated with the vascular density (p = 0.001) and perfusion area (p = 0.002) in the peripheral ring superior quadrant of the macular SVC.

Conclusion

Changes in retinal vascular density and perfusion exist in XALD patients and are correlated with disease severity. OCTA has the potential to monitor the progression of XALD.
Validity, reliability and clinical utility of ASSIST-Y in assessing risk of substance-related harm and dependence in Spanish male adolescents
Authors: Ibáñez-Martínez Núria , Stevens Matthew William Richard , Civit-Bel Núria , Moreno-Ferrer Noemí , Lopez-Ferré Sandra , Olivares-Casado Ana , Claramunt-Mendoza Juame , Holmwood Chris , Ali Robert
Published: January 2025

Background

Substance use among adolescents is strongly associated with adverse physical, mental health, and social outcomes. Prevention and early intervention can reduce the likelihood of future problems, but requires valid and reliable screening tools capable of assessing risk across a range of substances. This study assessed the validity, reliability, and clinical utility of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-Y) for adolescents aged 15–17 years.

Methods

A sample of adolescent males (N = 101), aged 15–17 years, held in a juvenile detention facility on substance-related offences in Barcelona, Spain were eligible. Participants were administered a battery of standardized substance-use screening tools by a clinical psychologist, and underwent a diagnostic interview assessing DSM-IV-TR substance abuse and dependence by an addiction medicine specialist. Scores on the various assessments were compared to establish validity (concurrent with interview, convergent with other measures), reliability, and clinical utility of ASSIST-Y.

Results

Majority of participants (n = 77) completed assessments. While tobacco was not assessed as part of the interview, concurrent validity in detecting substance abuse was established for all remaining substances. Concurrent validity for detecting dependence was established for alcohol, cannabis, cocaine, stimulants and sedatives. Fewer numbers in higher-risk groups for inhalants, opioids and hallucinogen use limited confirmation of validity for those substances. ASSIST-Y also demonstrated good convergent validity with the other screening tools for all substances, except hallucinogens. Reliability for each subscale was established, except for tobacco (too few items), sedatives, and hallucinogens. Finally, clinical utility indices were significant for most substances (except sedatives and opioids); whilst clinical utility indices were significant for ruling out cases of non-dependence (all substances).

Conclusions

As a screening tool, the purpose of ASSIST-Y is designed to help identify adolescents who may be at-risk of substance-related harm. While the instrument was found to be valid and reliable in identifying risky use across a variety of substances, further research is needed to validate the instrument in other population groups, and for other substances. Future research should investigate the effect of the linked brief intervention to reduce risk of harm, especially for non-specialist clinicians.
Stabilizing milk-derived extracellular vesicles (mEVs) through lyophilization: a novel trehalose and tryptophan formulation for maintaining structure and Bioactivity during long-term storage
Authors: Dogan Alan B. , Marsh Spencer R. , Tschetter Rachel J. , E. Beard Claire , Amin Md R. , Jane Jourdan L. , Gourdie Robert G.
Published: January 2025

Extracellular vesicles (EVs) are widely investigated for their implications in cell-cell signaling, immune modulation, disease pathogenesis, cancer, regenerative medicine, and as a potential drug delivery vector. However, maintaining integrity and bioactivity of EVs between Good Manufacturing Practice separation/filtration and end-user application remains a consistent bottleneck towards commercialization. Milk-derived extracellular vesicles (mEVs), separated from bovine milk, could provide a relatively low-cost, scalable platform for large-scale mEV production; however, the reliance on cold supply chain for storage remains a logistical and financial burden for biologics that are unstable at room temperature. Herein, we aim to characterize and engineer a freeze-dried, mEV formulation that can be stored at room temperature without sacrificing structure/bioactivity and can be reconstituted before delivery. In addition to undertaking established mEV assays of structure and function on our preparations, we introduce a novel, efficient, high throughput assay of mEV bioactivity based on Electric Cell Substrate Impedance Sensing (ECIS) in Human dermal fibroblast monolayers. By adding appropriate excipients, such as trehalose and tryptophan, we describe a protective formulation that preserves mEV bioactivity during long-term, room temperature storage. Our identification of the efficacy of tryptophan as a novel additive to mEV lyophilization solutions could represent a significant advancement in stabilizing small extracellular vesicles outside of cold storage conditions.
Inter-rater agreement and characterization of pleural line and subpleural fields in canine lung ultrasound: a comparative pilot study between high-frequency linear and curvilinear transducers using B- and M-mode ultrasonographic profiles
Authors: Granger Kyle L. , Guieu Liz , Boysen Søren R.
Published: January 2025

Background

Lung ultrasound (LUS) is increasingly utilized in veterinary medicine to assess pulmonary conditions. However, the characterization of pleural line and subpleural fields using different ultrasound transducers, specifically high-frequency linear ultrasound transducers (HFLUT) and curvilinear transducers (CUT), remains underexplored in canine patients. This study aimed to evaluate inter-rater agreement in the characterization of pleural line and subpleural fields using B- and M-mode ultrasonography in dogs with and without respiratory distress.

Results

Eighty-eight ultrasound clips from nine dogs were analyzed. HFLUT demonstrated strong inter-rater agreement in B-mode (κ = 0.89) and near-perfect agreement in M-mode (κ = 1.00) for pleural line homogeneity. In contrast, CUT showed minimal agreement in both B-mode (κ = 0.34) and M-mode (κ = 0.37). Homogeneous pleural lines were predominantly observed in control dogs or those with cardiogenic pulmonary edema (CPE), while non-homogeneous pleural lines were more common in dogs with non-cardiogenic alveolar-interstitial syndrome (NCAIS). Vertical subpleural fields identified in M-mode were associated with both CPE and NCAIS, whereas horizontal fields were more often observed in control dogs.

Conclusions

HFLUT offers superior inter-rater reliability for characterizing pleural and subpleural features in canine LUS compared to CUT, particularly in M-mode. These findings suggest HFLUT may enhance diagnostic accuracy for pulmonary conditions in dogs. Further studies are needed to explore the diagnostic potential of LUS in differentiating vertical artifact (e.g., B-lines) etiologies in veterinary patients.
Real-time ultrasound for umbilical venous catheter insertion in neonates- a systematic review and meta-analysis
Authors: Anne Rajendra Prasad , Rahiman Emine A. , Aradhya Abhishek Somashekara
Published: January 2025

Objective

There has been an increase in real-time ultrasonography use in central venous catheterisation. This systematic review and meta-analysis aimed to assess the role of real-time ultrasound use in umbilical venous catheterisation in neonates.

Data sources

PubMed, Embase, Web of Science and Cochrane Library were searched on July 11, 2024. We followed the Cochrane Handbook for Systematic Reviews of Interventions (for study conduct), GRADE methodology (for certainty of evidence), and PRISMA guidelines (for reporting).

Study selection

All randomised controlled trials/RCTs and non-randomised studies of interventions/NRSIs comparing real-time ultrasound with the conventional technique of umbilical venous catheterisation were included.

Data extraction

The outcomes of interest were malposition rates, procedure duration, mortality, sepsis, and cost. Data extraction and quality assessment were done in duplicate.

Data synthesis

Six studies (three RCTs and three NRSI), including 863 participants, were included. Data were analysed separately for RCTs and NRSIs. The RCTs were at low risk of bias, but NRSIs were at moderate to serious risk. The pooled estimates from RCTs showed a decrease in malposition rates (2 studies, 165 participants, risk ratio/RR 0.45, 95% confidence interval/CI 0.23, 0.90) and procedure duration (3 studies, 196 participants, mean difference −6.1 min, 95% CI −8.4, −3.8 min) with real-time ultrasound use. There was no reduction in sepsis. Mortality was not reported. The certainty of evidence was low for malposition rates and procedure duration. The data from NRSIs showed a reduction in malposition rates (3 studies, 667 participants, risk ratio/RR 0.10, 95% confidence interval/CI 0.07, 0.14) without an impact on procedure duration and sepsis. However, these findings did not improve the evidence.

Conclusions

Low certainty evidence suggests that using real-time ultrasound for umbilical venous catheterisation reduces malposition rates. There is a clinically insignificant reduction in procedure duration. There is no sufficient data to come to a conclusion on the critical outcomes of sepsis and mortality.

PROSPERO registration number: CRD42024567895.
Validation of a tele-robotic ultrasound system for abdomen and thyroid gland explorations: a comparison with standard ultrasound
Authors: Antolin Andreu , Roson Nuria , Planes Marina , Castillo Mar , Alberti Anna , Escobar Manuel
Published: January 2025

Background

Tele-robotic ultrasound (US) is a novel technique that might help overcome the current shortage of radiologists and poor access to radiologists and/or sonographers in remote or rural areas. Despite the promising results of this technology in the past two decades, there is still insufficient data about its advantages and limits, as well as the implementation in routine clinical practice and the learning curve for the user. The purpose of this prospective cohort-based study is to evaluate the performance of a 5G-based tele-robotic US system for abdominal and thyroid gland assessment in a cohort of healthy volunteers and outpatients, as well as assessing the learning curve and patient satisfaction.

Results

64 participants (23 male, 41 female) were consecutively included during the recruitment period, for a total of 51 abdominal and 37 thyroid gland US studies. The mean age was 45.23 ± 18.90 years old, and the body mass index of the abdominal cohort was 22.97 ± 2.95 kg/m2. The learning curve estimated a minimum of 20 patients for abdominal tele-robotic US training, being almost non-existent in the thyroid gland cohort. All the variables showed no-statistical differences between standard US and tele-robotic US in the abdominal post-trained cohort except the visualization of the left kidney short axis and its interpolar length. Thyroid gland variables showed no statistical differences. The mean time of exploration for the tele-robotic US for abdomen and thyroid gland examinations were 18.33 ± 6.26 min and 4.64 ± 0.97 min respectively. Most participants (> 70%) felt comfortable and safe while being examined by the tele-robotic US.

Conclusion

Tele-robotic US achieves equal performance in comparison with the standard US when evaluating abdominal structures in this cohort of patients, as well as a relatively fast learning curve and good patient satisfaction. The performance when assessing the thyroid gland is almost identical to the standard US, which makes it a strong first candidate for a future clinical implementation.
Enhancing safety in CT-guided lung biopsies: correlation of MinIP imaging with pneumothorax risk prediction
Authors: Brönnimann Michael P. , Manser Leonie , Gebauer Bernhard , Auer Timo A. , Schnapauff Dirk , Collettini Federico , Pöllinger Alexander , Komarek Alois , Krokidis Miltiadis E. , Heverhagen Johannes T.
Published: January 2025

Objectives

This study aimed to evaluate whether minimum-intensity projection (MinIP) images could predict complications in CT-guided lung biopsies.

Methods

We retrospectively analyzed 72 procedures from January 2019 to December 2023, categorizing patients by pneumothorax and the severity of hemorrhage (grade 2 or higher). Radiodensity measurements were performed using lung window (LW) and MinIP (10-mm slab) images. Regions of interest (ROIs) were placed at sites of the lowest density along the biopsy pathway. Absolute values were recorded, categorized by a radiodensity level of −850 HU, and assessed using our bridged radiological observations with measurement-optimized model (BROM-OLB) model with validation from three additional ROIs. Emphysema was visually scored. Statistical analysis included univariate analysis (Fisher’s exact and Mann–Whitney U-tests) and binomial logistic regression to identify confounders.

Results

Lower radiodensity values in MinIP images in the access route, particularly with the BROM-OLB MinIP method, were significantly associated with a higher risk of pneumothorax (5/39, 13% vs 27/33, 82%, p < 0.01; Sensitivity 81.8% and Specificity 87.2%). Pneumothorax was more common with longer procedures (p < 0.05). Lower LW density values correlated with higher pulmonary hemorrhage rates (p < 0.01). Binomial logistic regression identified positive BROM-OLB MinIP results (OR 28.244, 95% CI: 7.675–103.9, p < 0.01) and lower LW density (OR 0.992, 95% CI: 0.985–0.999, p = 0.025) as independent risk factors. The optimal threshold values to predict pneumothorax were −868 HU in MinIP images and −769 HU in LW.

Conclusion

The assessment of MinIP images is superior, and in combination with relative quantitative measurement of radiodensity for access route planning, it can reduce the risk of pneumothorax in CT-guided lung biopsies.

Critical relevance statement

This article critically evaluates the risk factors for complications in CT-guided lung biopsies, highlighting the potential of MinIP images for predicting pneumothorax risk, thereby advancing clinical radiology practices to improve patient safety and reduce healthcare costs.

Key Points

This work investigates if MinIP images efficiently predict CT-guided lung biopsy complications.

MinIP imaging identified higher pneumothorax risk post-CT lung biopsy with superior accuracy.

Our method detects high-risk lung changes linked to pneumothorax without additional software.

Graphical Abstract
Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsis
Authors: Opper Hernando Maria Isabel , Witham Denis , Stahl Ann-Christine , Steinhagen Peter Richard , Angermair Stefan , Bauer Wolfgang , Compton Friederike , Edel Andreas , Kruse Jan Matthias , Kühnle York , Lachmann Gunnar , Marz Susanne , Müller-Redetzky Holger , Nee Jens , Paul Oliver , Praeger Damaris , Skurk Carsten , Stegemann Miriam , Uhrig Alexander , Wolf Stefan , Bolanaki Myrto , Rubarth Kerstin , Seybold Joachim , Zimmermann Elke , Dewey Marc , Pohlan Julian
Published: January 2025

Objectives

To survey physicians’ views on the risks and benefits of computed tomography (CT) in the management of septic patients and indications for and contraindications to contrast media use in searching for septic foci.

Methods

A web-based questionnaire was administered to physicians at a large European university medical center in January 2022. A total of 371 questionnaires met the inclusion criteria and were analyzed with physicians’ work experience, workplace, and medical specialty as independent variables. Chi-square tests were used for exploratory analysis.

Results

While physicians with all levels of work experience were included, the largest group (35.0%, n = 130/371) had 3–7 years of experience. Most physicians agreed that the benefits of CT outweigh its potential adverse effects in septic patients (90.5%, n = 336/371). Responders saw the strongest indication for contrast media administration in septic patients for (1) CT examinations of the abdomen (92.7%, n = 333/359) and (2) combined CT examinations of the chest, abdomen, and pelvis (94.1%, n = 337/358). While radiologists were most likely to consider manifest hyperthyroidism an absolute contraindication to contrast media administration (43.8%, n = 14/32), most other groups of physicians opted for appropriate preparation before contrast media administration in this subset of septic patients.

Conclusion

In this survey, most participating physicians considered CT an essential diagnostic modality to detect an infectious focus in septic patients. Whereas the risk of ionizing radiation was regarded as justifiable by most physicians, different specialties varied in their assessment of the risks of contrast media administration.

Key Points

Physicians recognize CT as a relevant imaging modality in the diagnostic management of patients with sepsis.

There is an interdisciplinary consensus that the use of ionizing radiation is justified in septic patients.

There is disagreement about indications for and contraindications to contrast media administration among physicians from different medical specialties.

Graphical Abstract
Uncomplicated Amyand’s hernia in a setting of abdominal wall insufficiency: a case report
Authors: Upadrasta Vasishtha Avadhani , Koul Avinash , Chauhan Vikrant Singh
Published: January 2025

Introduction

Amyand’s hernia, an uncommon condition characterized by the presence of the appendix within an inguinal hernial sac (< 1% incidence), poses diagnostic and therapeutic challenges. Often it is an intraoperative finding, with almost no clinical symptoms.

Case presentation

This is a case of an Indian male in his early 80 years, diagnosed with bilateral direct inguinal hernias, one of which contained a noninflamed appendix. Given the thinned out abdominal wall, dense adhesions, and no demarcation between layers, the decision to proceed with a modified Bassini’s with Lichtenstein mesh repair without appendectomy, guided by intraoperative findings and the Losanoff–Basson Classification, reflecting the complex interplay between individual patient factors and intraoperative considerations. The patient did well during his postoperative stay and was in good health on a 45 day follow-up, with no complaints suggestive of recurrence or obstruction.

Conclusion

This case underscores the importance of tailored management strategies and highlights, especially in cases where recurrence and postoperative wall integrity are in question, the ongoing need for research to refine treatment guidelines for Amyand's hernia, especially in cases of appendicitis not diagnosed preoperatively.
Fragmenstein: predicting protein–ligand structures of compounds derived from known crystallographic fragment hits using a strict conserved-binding–based methodology
Authors: Ferla Matteo P. , Sánchez-García Rubén , Skyner Rachael E. , Gahbauer Stefan , Taylor Jenny C. , von Delft Frank , Marsden Brian D. , Deane Charlotte M.
Published: January 2025

Current strategies centred on either merging or linking initial hits from fragment-based drug design (FBDD) crystallographic screens generally do not fully leaverage 3D structural information. We show that an algorithmic approach (Fragmenstein) that ‘stitches’ the ligand atoms from this structural information together can provide more accurate and reliable predictions for protein–ligand complex conformation than general methods such as pharmacophore-constrained docking. This approach works under the assumption of conserved binding: when a larger molecule is designed containing the initial fragment hit, the common substructure between the two will adopt the same binding mode. Fragmenstein either takes the atomic coordinates of ligands from a experimental fragment screen and combines the atoms together to produce a novel merged virtual compound, or uses them to predict the bound complex for a provided molecule. The molecule is then energy minimised under strong constraints to obtain a structurally plausible conformer. The code is available at https://github.com/oxpig/Fragmenstein.

Scientific contribution

This work shows the importance of using the coordinates of known binders when predicting the conformation of derivative molecules through a retrospective analysis of the COVID Moonshot data. This method has had a prior real-world application in hit-to-lead screening, yielding a sub-micromolar merger from parent hits in a single round. It is therefore likely to further benefit future drug design campaigns and be integrated in future pipelines.

Graphical Abstract
Scoring of swine lung images: a comparison between a computer vision system and human evaluators
Authors: Valeris-Chacin Robert , Garcia-Morante Beatriz , Sibila Marina , Canturri Albert , Ballarà Rodriguez Isaac , Bernal Orozco Ignacio , Jordà Casadevall Ramon , Muñoz Pedro , Pieters Maria
Published: January 2025

Cranioventral pulmonary consolidation (CVPC) is a common lesion observed in the lungs of slaughtered pigs, often associated with Mycoplasma (M.) hyopneumoniae infection. There is a need to implement simple, fast, and valid CVPC scoring methods. Therefore, this study aimed to compare CVPC scores provided by a computer vision system (CVS; AI DIAGNOS) from lung images obtained at slaughter, with scores assigned by human evaluators. In addition, intra- and inter-evaluator variability were assessed and compared to intra-CVS variability. A total of 1050 dorsal view images of swine lungs were analyzed. Total lung lesion score, lesion score per lung lobe, and percentage of affected lung area were employed as outcomes for the evaluation. The CVS showed moderate accuracy (62–71%) in discriminating between non-lesioned and lesioned lung lobes in all but the diaphragmatic lobes. A low multiclass classification accuracy at the lung lobe level (24–36%) was observed. A moderate to high inter-evaluator variability was noticed depending on the lung lobe, as shown by the intraclass correlation coefficient (ICC: 0.29–0.6). The intra-evaluator variability was low and similar among the different outcomes and lung lobes, although the observed ICC slightly differed among evaluators. In contrast, the CVS scoring was identical per lobe per image. The results of this study suggest that the CVS AI DIAGNOS could be used as an alternative to the manual scoring of CVPC during slaughter inspections due to its accuracy in binary classification and its perfect consistency in the scoring.
Implementation strategies: lessons learned during an e-learning intervention to improve dietary behaviors and feeding practices in early childhood education and care
Authors: Lian Henrik , Øverby Nina Cecilie , Vik Frøydis Nordgård , Medin Anine Christine , Osorio Natalie Garzon , Helle Christine , Bjørkkjær Tormod , Love Penelope , Rutter Harry , Barker Mary Elizabeth , Hillesund Elisabet Rudjord , Helland Sissel Heidi
Published: January 2025

Background

Early Childhood Education and Care (ECEC) centers play an important role in fostering healthy dietary habits. The Nutrition Now project focusing on improving dietary habits during the first 1000 days of life. Central to the project is the implementation of an e-learning resource aimed at promoting feeding practices among staff and healthy dietary behaviours for children aged 0–3 years in ECEC. Implementing new interventions often presents challenges. This study explores ECEC staff views and experiences with selected strategies for implementing an e-learning resource in ECEC centers in a municipality in Southern Norway.

Methods

The study is a part of the Nutrition Now study, a hybrid type 1 non-randomized controlled trial. The implementation process followed the Dynamic Integrated Evaluation Model (DIEM). Implementation strategies were selected from the Expert Recommendations for Implementing Change (ERIC) project and included identify and prepare champions, conduct educational meetings, distribute educational materials, create a learning collaborative, and remind clinicians. ECEC teachers from participating ECEC centers in the intervention municipality were recruited as champions. Brief (5–7 min minutes), semi-structured phone interviews, covering key points, were conducted with the champions 8 times, evenly distributed over six months. The interviews were analysed using qualitative thematic analysis.

Results

In total, 29 of the invited ECEC centers (53%) participated, and 260 brief interviews (88%) were conducted with champions (n = 37). An evaluation of the feedback from the champions suggests that the five selected implementation strategies were acceptable. Five main themes were developed by qualitative analysis: 1) Being a champion resembles what I already do. 2) Educational meetings are fine but take time. I prefer when peers share experiences. 3) Newsletters were helpful and reminded me, but I do not always have enough time to read. 4) Evaluations have increased my awareness, and we do them informally and formally. 5) The regular phone calls reminded me I could receive support and express my opinion.

Conclusion

This study’s findings suggest that several implementation strategies are acceptable for stakeholders in an ECEC e-learning healthy eating intervention. However, time constraints among champions may hinder deep engagement. These results provide valuable insights into how the selected implementation strategies may function in practice and how they are perceived and experienced by the ECECs staff.

Trial registration

Trial registration on June 6, 2022: ISRCTN10694967.
Risk prediction tools for pressure injury occurrence: an umbrella review of systematic reviews reporting model development and validation methods
Authors: Hillier Bethany , Scandrett Katie , Coombe April , Hernandez-Boussard Tina , Steyerberg Ewout , Takwoingi Yemisi , Velickovic Vladica , Dinnes Jacqueline
Published: January 2025

Background

Pressure injuries (PIs) place a substantial burden on healthcare systems worldwide. Risk stratification of those who are at risk of developing PIs allows preventive interventions to be focused on patients who are at the highest risk. The considerable number of risk assessment scales and prediction models available underscores the need for a thorough evaluation of their development, validation, and clinical utility.

Our objectives were to identify and describe available risk prediction tools for PI occurrence, their content and the development and validation methods used.

Methods

The umbrella review was conducted according to Cochrane guidance. MEDLINE, Embase, CINAHL, EPISTEMONIKOS, Google Scholar, and reference lists were searched to identify relevant systematic reviews. The risk of bias was assessed using adapted AMSTAR-2 criteria. Results were described narratively. All included reviews contributed to building a comprehensive list of risk prediction tools.

Results

We identified 32 eligible systematic reviews only seven of which described the development and validation of risk prediction tools for PI. Nineteen reviews assessed the prognostic accuracy of the tools and 11 assessed clinical effectiveness. Of the seven reviews reporting model development and validation, six included only machine learning models. Two reviews included external validations of models, although only one review reported any details on external validation methods or results. This was also the only review to report measures of both discrimination and calibration. Five reviews presented measures of discrimination, such as the area under the curve (AUC), sensitivities, specificities, F1 scores, and G-means. For the four reviews that assessed the risk of bias assessment using the PROBAST tool, all models but one were found to be at high or unclear risk of bias.

Conclusions

Available tools do not meet current standards for the development or reporting of risk prediction models. The majority of tools have not been externally validated. Standardised and rigorous approaches to risk prediction model development and validation are needed.

Trial registration

The protocol was registered on the Open Science Framework (https://osf.io/tepyk).
Implication of the endogenous midgut microbiota on cell genotoxicity and biological fitness of Culex pipiens complex (Diptera: Culicidae)
Authors: Fouaad Alaa , Rashdan Nagwa A. , Gabre Refaat M. , Abdel-Samie Emtithal M.
Published: January 2025

Background

Culex pipiens is one of the most important mosquito transmitter of diseases that attains its greatest impact as a vector through spreading out several serious arboviral, protozoal and filarial diseases. Furthermore, it is a native in Europe, Asia and Africa.

Results

The current study aimed to find a new mosquito biocontrol agents through using the isolated endogenous midgut microbiota, Atlantibacter hermannii, Klebsiella sp. and Enterobacter cloacae, that were isolated from Culex pipiens complex females’ gut. The genotoxical effect of the isolated bacteria was estimated through using alkaline comet assay and related to the impact on mosquito longevity and reproductive potential that might be observed. A distinguish increase in cell DNA damage accompanied with an outstanding effect on life span and reproductive fitness was clear in case of vectors under investigation.

Conclusions

Data in this research suggest the use of the endogenous bacteria as a potential control techniques that could be integrated in to the environmentally friendly mosquito control strategies.
Functional and aesthetic outcomes of alar base reduction
Authors: Ali Abd ELAziz Ali Fahem , Shehata Emad Mohammed , Hegazy Hassan Mustafa , Ebeid Kamal Abd Elmonem
Published: January 2025

Background

The surgical step of alar base reduction (ABR) is often done as the last stage of rhinoplasty surgery. However, it may also be done independently if the main concern is alar flare. This work was designed to assess the functional as well as aesthetic results among cases who undergo ABR which is so important to find out a better way to increase the functional, aesthetic consequences of patients.

Methods

This prospective study included 20 consecutive cases arranged for reduction rhinoplasty. All cases were categorized into three groups: group A (n = 6): patients with thick alar base had ABR, group B (n = 5): patients with wide nostrils had nostril size reduction, and group C (n = 9): patients with thick alar base with wide nostrils had combined alar base and nostril size reduction.

Results

Regarding nasal score post 1 month, levels of trouble sleeping, unable to get enough air through my nose during exercise, and total nasal obstruction symptom evaluation (NOSE) score was significantly different among all groups. Regarding nasal score post 3 month, trouble sleeping, unable to get enough air through my nose during exercise, and total NOSE score showed a significant variance among all groups (p < 0.05). Regarding standardized cosmesis and health nasal outcomes survey (SCHNOS) score post 1 month, breathing through my nose during sleep and how well my nose suits my face were significantly different among all groups (p < 0.05).

Conclusions

Effectiveness of ABR in improving nasal function and alleviating symptoms associated with congestion, blockage, and trouble breathing. The procedure resulted in significant improvements in various dimensions, including nasal breathing during sleep, mood, self-esteem related to the nose, and overall symmetry of the nose, as assessed by the SCHNOS score.
Healthy at home for COPD: an integrated digital monitoring, treatment, and pulmonary rehabilitation intervention
Authors: O’Connor Laurel , Behar Stephanie , Tarrant Seanan , Stamegna Pamela , Pretz Caitlin , Wang Biqi , Savage Brandon , Scornavacca Thomas , Shirshac Jeanne , Wilkie Tracey , Hyder Michael , Zai Adrian , Toomey Shaun , Mullen Marie , Fisher Kimberly , Tigas Emil , Wong Steven , McManus David D. , Alper Eric , Lindenauer Peter K. , Dickson Eric , Broach John P. , Kheterpal Vik , Soni Apurv
Published: January 2025

Background

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality in the United States. Frequent exacerbations result in higher use of emergency services and hospitalizations, leading to poor patient outcomes and high costs. The objective of this study is to demonstrate the feasibility of a multimodal, community-based intervention in treating acute COPD exacerbations.

Results

Over 18 months, 1,333 patients were approached and 100 (7.5%) were enrolled (mean age 66, 52% female). Ninety-six participants (96%) remained in the study for the full enrollment period. Fifty-five (55%) participated in tele-pulmonary-rehabilitation. Participants wore the smartwatch for a median of 114 days (IQR 30–210) and 18.9 h/day (IQR16-20) resulting in a median of 1034 min/day (IQR 939–1133). The rate at which participants completed scheduled survey instruments ranged from 78–93%. Nearly all participants (85%) performed COPD ecological momentary assessment at least once with a median of 4.85 recordings during study participation. On average, a 2.48-point improvement (p = 0.03) in COPD Assessment Test Score was observed from baseline to study completion. The adherence and symptom improvement metrics were not associated with baseline patient activation measures.

Conclusions

A multimodal intervention combining preventative care, symptom and biometric monitoring, and MIH services was feasible in adults living with COPD. Participants demonstrated high protocol fidelity and engagement and reported improved quality of life.

Trial Registration

The study is registered at Clinicaltrials.gov NCT06000696 (Registered on 08/14/2023).