bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of different treatments for chronic pain on cognitive function: A systematic review
Authors: Brennecke Allan Botura , Barreto Eduardo Silva Reis , Lins-Kusterer Liliane , Maria Torres de Araujo Azi Liana , Kraychete Durval
Published: January 2025

Introduction

Experimental evidence supports the hypothesis of reciprocal influence between neural systems involved in cognition and central pain processing circuits. Furthermore, studies have demonstrated bidirectional communication between central pain processing areas and the immune system, leading to changes in behaviour, sensory perception, mood, and cognition. However, the academic community has not yet reached a consensus on whether effective analgesic interventions can mitigate or reverse cognitive deterioration.

Methods

This systematic review evaluated the effectiveness of various therapeutic interventions in improving cognitive functions (primary outcome) and altering the profile of immunological markers (secondary outcome) in chronic pain patients. The review was limited to randomised controlled trials addressing chronic pain of any aetiology, with searches conducted in PubMed, EMBASE, and Scopus databases.

Results

The qualitative synthesis of twelve studies conducted between 2003 and 2021, involving 1432 participants in experimental ( n = 950) and control ( n = 482) groups, revealed some interesting patterns. Only half of the studies (6/12) reported cognitive improvement, with attention being the most analysed cognitive domain, followed by memory and executive function. Fibromyalgia was the most studied aetiology of chronic pain. The strategies of intervention/treatment and durations varied widely; however, milnacipran versus placebo emerged as the most frequently employed intervention. Only one study reported immunological markers, limiting the evaluation of this outcome.

Conclusion

Based on this analysis, it is not possible to affirm that interventions targeting chronic pain improve cognition. This review suggests new research directions and calls for more robust methodological approaches.
Appropriateness of Antiplatelet Therapy and Proton Pump Inhibitor Prescribing in End-Stage Kidney Disease: A Retrospective Quality Investigation Study
Authors: Che Michael , Ahmed Sumaiya , Chan Ryan , Akbari Ayub , Zimmerman Deborah
Published: January 2025

Background:

Patients with end-stage kidney disease (ESKD) have high rates of gastrointestinal bleeding due to several risk factors including platelet dysfunction, comorbid illness, and use of antiplatelet medications. Proton pump inhibitors (PPIs) reduce gastrointestinal bleeding and are recommended for high-risk patients such as those prescribed dual antiplatelet therapy (DAPT). Whether inappropriate duration of DAPT therapy and/or lack of appropriate PPI use contribute to the known elevated risk of gastrointestinal bleeding in hemodialysis patients is not known.

Objectives:

To determine whether patients with ESKD are appropriately prescribed DAPT and PPI therapy.

Design:

Retrospective cross-sectional, quality investigation.

Setting:

Satellite hemodialysis unit of a tertiary care center in Ontario, Canada.

Patients:

All patients with ESKD treated at a satellite hemodialysis unit of a tertiary care hospital.

Measurements:

Number of patients prescribed antiplatelets, PPIs, anticoagulants, non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroids; indications for aforementioned medications.

Methods:

A chart review was performed to elucidate patients’ medical history and pertinent medications. Patients’ indications for PPI and DAPT were extracted from their electronic medical records.

Results:

Out of 88 patients with ESKD treated with hemodialysis, 44 were on antiplatelet therapy (4 on DAPT), 1 on NSAID, 12 on corticosteroids, 7 on oral anticoagulants, 2 on histamine H2-receptor antagonists, and 39 on PPIs. Fourteen percent of PPI users had absolute indication for therapy. One patient in whom PPI therapy was indicated was not prescribed one. Out of 4 patients on DAPT, 3 had current indications for DAPT, whereas 1 had a prior indication.

Limitations:

Single-center study; medication lists obtained from electronic medical records not confirmed by patient interview.

Conclusions:

At the time of this study, 3% of patients with ESKD treated with hemodialysis had a current indication for DAPT. One patient prescribed DAPT no longer met indication for therapy and was reduced to single antiplatelet therapy. Only one patient with an absolute indication for PPI therapy had not been prescribed one. Overall, it appears that prescribing patterns of DAPT and PPI at our center are unlikely to be a major contributor to the known increased risk of gastrointestinal bleeding in patients treated with hemodialysis. However, this may not be true of all units; ensuring regular medication reviews are undertaken may enhance appropriate prescribing.
Let’s Not Tempt Fate: The Influence of Future Time-Orientation, Fatalism, and Superstition on Willingness to Report Expectations about Future Health
Authors: Baruh Lemi , Sen Celia K. Naivar , Cemalcilar Zeynep , Kumkale G. Tarcan
Published: January 2025

This article examines individuals’ likelihood of engaging in future health prediction as a function of their fatalism, future time orientation, superstition, and history of chronic disease. Using a multistage cluster sample of 33 urban cities in Turkey, we asked respondents ( N = 1,467), to report their past and current health and predict their future (expected) health status (i.e., future self-rated health). While less than 1% failed to report past or current health, 23% of respondents provided no prediction for their future health status. We employed a moderated-mediation analysis to identify the predictors of this avoidance of reporting future health status expectations. Our analyses point to two potentially distinct mechanisms influencing individuals’ likelihood of providing future self-rated health. First, individuals suffering from a chronic disease were more likely to have higher fatalism, which, in turn, decreased their likelihood of providing a rating for their future health. Second, more superstitious individuals were less likely to report expectations about future health. This association was moderated by future time orientation such that for individuals with higher future time orientation (vs. present time orientation), higher superstition was associated with a steeper increase in the probability of avoidance of future health predictions. This finding suggests that some individuals might avoid sharing predictions about their future health because they fear talking about future outcomes can invite negative outcomes by “tempting fate.”
The Impact of Shared Auditors and Same Signing Auditors on Merger and Acquisition Decision-making
Authors: Du Lin
Published: January 2025

This research examines how shared auditors and signing auditors influence the decision-making process in M&A. Using a comprehensive sample of Chinese A-share market M&A transactions from 2004 to 2020, we analyze how sharing the same audit firm or signing auditor influences the likelihood of completing an acquisition. The regression results reveal that firms with common auditors are more likely to achieve successful acquisitions. The effect is particularly pronounced for large acquirers, non-state-owned enterprises, cross-industry M&As, cross-province M&As, and those involving non-Big 4 audit firms. These findings are robust to various model specifications and adjustments. This paper extends the literature by demonstrating the dual-level (firm-level and individual-level) role of auditors as information intermediaries in M&A transactions. The results suggest that organizations and audit teams should consider the potential benefits of shared auditors in enhancing the quality and success of M&A deals.

JEL Classification: M42
The Influence of Perceived Sacrifices on Behavioral Intentions in The LGBT Tourism Sector
Authors: Madinga Nkosivile W. , van Eyk Marle , Amoah Felix
Published: January 2025

This study aims to investigate the perceived sacrifices associated with visiting an LGBT-friendly destination and its impact on customer value. Specifically, we sought to explore the relationship between customer value, tourist loyalty, and willingness to pay among LGBT tourists. Using a self-administered electronic questionnaire, we collected data from 406 LGBT tourists and employed partial least squares structural equation modelling (PLS-SEM) to analyze the data. The findings of this study reveal that perceived sacrifices, both monetary and non-monetary, are significant antecedents of customer value in the context of LGBT tourism. Moreover, our results demonstrate that customer value has a significant positive impact on tourist loyalty and willingness to pay, highlighting the importance of creating a positive customer experience for this niche market. This study contributes to the growing body of literature on LGBT tourism by providing insights into the factors that drive customer value in this sector. Moreover, our findings offer valuable implications for the tourism industry, highlighting the need to prioritize LGBT-friendly policies and initiatives to attract and retain this significant customer segment. This study sheds light on the perceived sacrifices and customer value in LGBT tourism, offering valuable insights for industry stakeholders seeking to better understand and serve this diverse and growing market.
Incidence and Predictors of Meditation-Related Unusual Experiences and Adverse Effects in a Representative Sample of Meditators in the United States
Authors: Van Dam Nicholas T. , Targett Jessica , Davies Jonathan N. , Burger Alex , Galante Julieta
Published: January 2025

Estimates suggest that meditation use is comparable to mental-health-service access in the United States. Understanding meditation-related adverse effects (AEs) is therefore critical. We aimed to (a) estimate the incidence of meditation-related unusual experiences and AEs using different methods and (b) identify sociodemographic and health-related characteristics predicting their incidence. We conducted a cross-sectional, population-based survey of 886 U.S. adults (approximately representing population age, gender, and race/ethnicity) stratified by lifetime meditation experience and type. Of the participants, 96.6% reported an unusual experience, 58.4% reported an AE (Inventory of Meditation Experiences), 78.3% endorsed one or more items on the Meditation-Related Adverse Effects Scale, 31.4% endorsed experiencing a challenging/difficult/distressing experience, and 9.1% reported functional impairment because of AEs. In a robust multiple regression, psychological distress, psychoticism, unusual beliefs, and meditation-retreat participation were positively associated with unusual experiences and AEs. It is essential that (a) potential meditators are informed about possible experiences, (b) providers consider risk factors, and (c) AEs are routinely and actively monitored.
Transnationalizing Reception: Racial Scripts, Institutional Logics, and Congolese Refugee Processing in the United States and Brazil
Authors: Jensen Katherine , Watson Jake
Published: January 2025

While national reception contexts formatively shape immigration possibilities and experiences, we argue that transnational racial dynamics play an underappreciated role. Juxtaposing two independent ethnographies of the U.S. resettlement program and Brazilian asylum system, we show that Congolese refugees encounter strikingly similar racialized logics of reception as they move through these formerly distinct national institutions. Bridging transnational perspectives in immigration research and critical race theory, we argue that frontline practitioners tasked with implementing credibility and vulnerability assessments diffuse across the global refugee regime draw on shared racial scripts to interpret, process, and receive Congolese refugees. Although manifest within local contexts, these scripts stem from ongoing global and transnational histories that undergird common views about Blackness and African migrants across the Americas. Our findings have three implications. First, we demonstrate the importance of transnational analytics in understanding dynamics of immigrant reception. Second, we show how racial notions permeate these dynamics through the entanglement of globalized racial orders and institutional logics across disconnected national contexts. Finally, we identify the cultural work of policy administrators as a mechanism through which transnational dynamics of racial domination are instantiated in everyday life.
How does delivery service change food accessibility: A modified 2-step floating catchment area method
Authors: Jia Grace , Pendyala Ram , Chen Cynthia
Published: January 2025

Existing methodology on food accessibility predominately focuses on on-premise services, that is, dine-in and shopping at stores, which assumes a linear distance decay property (the closer, the higher accessibility). Access to delivery services is fundamentally different from that to on-premise stores. Stores with close proximity (within an inner boundary) are less desirable for delivery due to delivery fees, and there is an outer boundary beyond which deliveries are unavailable, both challenging the assumption of increasing impediment with distance. These two boundaries form a donut shape for delivery services. We propose a modified 2-step floating catchment area method that incorporates the donut shape, accounts for both demand and supply, and examines the diversity of food options. Using Seattle as a case study, our results show that delivery services increase restaurant and fast-food accessibility in areas where there is already good accessibility (e.g., downtown Seattle for restaurants and South Seattle for fast-food). Given South Seattle is where low-income and low-access households concentrate, the increase in accessibility to fast-food may not be desired. Interestingly, with delivery services, more low-income or low-access households (those who live far from grocery stores) have better accessibility to fresh produce from grocery stores compared to the rest of the population. And the newly created Supplemental Nutrition Assistance Program (SNAP) online program appears to miss low-access households. These findings have important implications for policymakers and stakeholders seeking to improve food accessibility in urban areas through delivery services.
Tubercular Meningoencephalitis with  Longitudinal Extensive Transverse Myelitis  (LETM): A Clinical Dilemma
Authors: Pandit Sanjay , Dharra Gaurav , Kumar Kishore , Khan Ulma , Aggarwal Rupal , Garg Sagar
Published: January 2025

Tuberculosis remains a significant global health challenge with various clinical presentations. In this case, we present a rare occurrence of disseminated tuberculosis with meningoencephalitis with longitudinally extensive transverse myelitis (LETM) in an immunocompetent person, which illustrates its complex clinical course and the challenges associated with diagnosis.

A 24-year-old male patient presented with progressive weakness in the proximal lower limbs which was associated with acute urinary retention, followed by fever, headache, neck pain, and projectile vomiting. Neurological examination revealed neck rigidity, decreased sensations, paraparesis, and absent deep tendon reflexes. Cerebrospinal fluid analysis indicated lymphocytic pleocytosis and elevated protein levels. Radiological findings confirmed the presence of meningoencephalitis with LETM. However, the magnetic resonance imaging (MRI) findings in the brain and LETM in the spinal cord were suggestive of an autoimmune association, and neuromyelitis optica spectrum disorder (NMOSD) could not be ruled out.

Based on the clinical, laboratory, and radiological evidence, a diagnosis of disseminated tuberculosis was established. The patient was promptly initiated on steroids and antitubercular treatment. This case serves as a reminder of the diverse clinical spectrum associated with tuberculosis, highlighting the importance of considering unusual presentations. Early diagnosis is an important predictor for prognosis which prevents complications and improves patient outcomes.
Community Engagement in the BE SAGE Project: Reducing COVID-19 in Hispanic and Low-Income Preschoolers via Testing and Open-Air Garden-Based Education
Authors: Valdez Hector J. , Santana Michelle , Genis Sandra , Gonzalez Edny , Kramer Joanna L. , Lee Rebecca E.
Published: January 2025

Objective

Back to Early Care and Education Safely With Sustainability via Active Garden Education (BE SAGE) involved COVID-19 testing and a free garden-based physical activity and nutrition program at early care and education centers with primarily Hispanic/Latino enrollment. This article describes the project community engagement plan, process, and outcomes focusing on deliberate and intentional staffing, an extensive online presence, and focused outreach.

Methods

BE SAGE purposefully hired bilingual (English/Spanish) and bicultural staff; developed and maintained a large bilingual online presence (website, newsletters, social media), and fostered community partnerships with community health workers (CHWs) and dedicated staff. Hiring records, online internet records, staff calendars, and field notes were coded and tabulated.

Results

84% of the 13-member research team and all CHWs identified as Hispanic or Latino. Predominantly US users accessed the website ( N = 3,108), 36.9% of received electronic newsletters were opened, and 1126 followed social media across four platforms. The Outreach Specialist fostered existing relationships and created new partnerships. With the help of CHWs, 562 research participants completed at least one COVID-19 test.

Conclusions

By prioritizing representative staffing hires, expending substantial resources on an online presence, and establishing and nurturing our community partnerships, our BE SAGE community engagement approach helped to achieve study aims and create lasting community impact. Community engagement and partnerships to forward research requires ample funding and dedicated representative hiring polices to cultivate and maintain community relationships with asset-driven outcomes.

Policy Implications

Funding agencies must prioritize community engagement in research outcomes to ensure robust, meaningful scientific discovery and innovation.
The evolution of treatment-free remission
Authors: Hughes Timothy P. , Yong Agnes S. M. , Ross David M.
Published: January 2025

One of the most remarkable achievements of the tyrosine kinase inhibitor (TKI) era has been the capacity to induce deep molecular remissions that are sustainable off therapy in patients with chronic myeloid leukemia (CML), that is, treatment-free remission (TFR). TFR was first described in a handful of patients within 3 to 4 years of imatinib approval. In 2004, TFR was tested in a small French pilot study, followed soon after by the French STIM and Australasian TWISTER studies. These early trials demonstrated that TFR was achievable but also showed that rapid relapse was equally likely. Perhaps the most critical observation was that relapsing patients could be rapidly and safely returned to deep molecular remission after restarting therapy, minimizing the risk associated with TFR attempts. Consensus criteria for TFR eligibility were established soon after those studies were reported. Over the past decade, TFR criteria have been broadened, key predictive markers of success identified, and overall safety of TFR in the wider clinical community confirmed. Despite this progress, TFR is still only achieved in a fraction of patients with CML globally. Over the next decade, the focus will be making TFR the mainstream pathway for as many patients as possible as well as scaling back the duration of therapy required. More potent, better targeted TKIs, and immune modulation will likely have a significant impact. Predictive assays should enable most patients who attempt TFR to do so with a high probability of success. Ultimately TFR should be seen as the first step on an ambitious pathway toward cure for patients with CML.
Systematic and comprehensive insights into HIF-1 stabilization under normoxic conditions: implications for cellular adaptation and therapeutic strategies in cancer
Authors: Zhang Jiayi , Yao Mingxuan , Xia Shiting , Zeng Fancai , Liu Qiuyu
Published: January 2025

Hypoxia-inducible factors (HIFs) are essential transcription factors that orchestrate cellular responses to oxygen deprivation. HIF-1α, as an unstable subunit of HIF-1, is usually hydroxylated by prolyl hydroxylase domain enzymes under normoxic conditions, leading to ubiquitination and proteasomal degradation, thereby keeping low levels. Instead of hypoxia, sometimes even in normoxia, HIF-1α translocates into the nucleus, dimerizes with HIF-1β to generate HIF-1, and then activates genes involved in adaptive responses such as angiogenesis, metabolic reprogramming, and cellular survival, which presents new challenges and insights into its role in cellular processes. Thus, the review delves into the mechanisms by which HIF-1 maintains its stability under normoxia including but not limited to giving insights into transcriptional, translational, as well as posttranslational regulation to underscore the pivotal role of HIF-1 in cellular adaptation and malignancy. Moreover, HIF-1 is extensively involved in cancer and cardiovascular diseases and potentially serves as a bridge between them. An overview of HIF-1-related drugs that are approved or in clinical trials is summarized, highlighting their potential capacity for targeting HIF-1 in cancer and cardiovascular toxicity related to cancer treatment. The review provides a comprehensive insight into HIF-1’s regulatory mechanism and paves the way for future research and therapeutic development.
Potential mutagenicity of aflatoxin B1 in Egyptian spices
Authors: Geoshi Basma El , El-Akabawy Gehan , Metwally Mohammed El , Soliman Magda I.
Published: January 2025

The current study aimed to detect the mutagenic impacts of aflatoxin B1 (AFB1), which is produced by Aspergillus group fungi, via a high-plant genotoxicity test. Different durations of treatment (3 h, 6 h, and 12 h) were used to treat the Vicia faba root tips with varying concentrations of Aflatoxin B1 (AFB1) following the approved protocol for plant assays published by the International Program on Chemical Safety (IPCS) and the World Health Organization (WHO). The data obtained indicated that AFB1 not only has the ability to induce various alterations in the process of mitosis, ranging from increasing to decreasing mitotic and phase indices but also leads to many mitotic aberrations. The abnormalities observed varied on the basis of the ratio of AFB1 to treatment time. The aberrations included micronuclei in interphase, stickiness; two groups ring star disturbed and oblique metaphase late separation diagonal bridge and laggard and disturbed. anaphase and telophase. This study showed that biomonitoring Vicia faba is a sustainable method for estimating the cytotoxicity and genotoxicity of applied AFB1. Additionally, AFB1 caused changes in the protein profile detected by SDS‒PAGE, with each treated sample displaying a unique electrophoretic pattern due to the formation and disappearance of certain bands. The ISSR and RAPD assays changes in band numbers in all samples compared with the untreated control, and a decrease in genetic template stability (GTS) ratios was observed with higher levels of AFB1. The image cytometric data revealed a correlation between the dosage of AFB1 and its impact on cell cycle components in the meristematic cells of Vicia faba roots. Furthermore, an increase in AFB1 concentrationled to a decrease in B-cell lymphoma 2 (Bcl2) levels, an increase in chromatin condensation levels, and an increase in poly ADP‒ribose polymorphism (PARP) levels.
The Dutch version of the Dignity Therapy Question Protocol for individual Dutch nursing home residents without cognitive impairments (during COVID-19): a pilot study
Authors: van Dammen Herman , Vissers Kris , van der Putten Gert-Jan , Engels Yvonne
Published: January 2025

Background

Dignity therapy is a brief, structured psychotherapeutic intervention originally designed to help last-stage cancer patients maintain their dignity. It consists of a semi-structured interview encouraging patients to talk about their lives. The recorded session are transcribed and edited, after which the patient has the opportunity to make further changes to the final document. It can be shared with whom the patient likes. We cross-culturally translated dignity therapy into Dutch and explored its feasibility of applying it to Dutch cognitively capable nursing home residents.

Method

Beaton’s Guidelines for Good Clinical Practice were used to cross-culturally translate dignity therapy. Next, a pilot study was conducted with 12 nursing home residents in which the original English-language questionnaire was transculturally translated according to the method of Beaton. After the interviews were completed, feasibility was examined by open-ended questions and a five-point Likert scale questionnaire.

Results

We translated the questionnaire. The translated questions were well understood and resulted in an appropriate Dutch version of the English-language dignity therapy questions. However, the words ‘dignity’ and ‘therapy’ caused confusion. The mean number of words in the legacy document was 1078 words, which appeared shorter than in a community-based hospice setting or patients with metastatic cancer or terminally ill people. The reading aloud was much appreciated and was an emotional experience for some.

Conclusion

We successfully translated the DTQP into the Dutch language and tested it in 12 nursing home residents. The questions posed by this therapy appeared suitable and acceptable. Furthermore, participants all accepted the therapy and gave no suggestions to adapt the procedure. Follow-up research in the form of an impact study is needed to show whether and how this therapy can strengthen the sense of dignity of Dutch nursing home residents.
Automatic image generation and stage prediction of breast cancer immunobiological through a proposed IHC-GAN model
Authors: Saad Afaf , Ghatwary Noha , Gasser Safa M. , ElMahallawy Mohamed S.
Published: January 2025

Invasive breast cancer diagnosis and treatment planning require an accurate assessment of human epidermal growth factor receptor 2 (HER2) expression levels. While immunohistochemical techniques (IHC) are the gold standard for HER2 evaluation, their implementation can be resource-intensive and costly. To reduce these obstacles and expedite the procedure, we present an efficient deep-learning model that generates high-quality IHC-stained images directly from Hematoxylin and Eosin (H&E) stained images. We propose a new IHC-GAN that enhances the Pix2PixHD model into a dual generator module, improving its performance and simplifying its structure. Furthermore, to strengthen feature extraction for HE-stained image classification, we integrate MobileNetV3 as the backbone network. The extracted features are then merged with those generated by the generator to improve overall performance. Moreover, the decoder’s performance is enhanced by providing the related features from the classified labels by incorporating the adaptive instance normalization technique. The proposed IHC-GAN was trained and validated on a comprehensive dataset comprising 4,870 registered image pairs, encompassing a spectrum of HER2 expression levels. Our findings demonstrate promising results in translating H&E images to IHC-equivalent representations, offering a potential solution to reduce the costs associated with traditional HER2 assessment methods. We extensively validate our model and the current dataset. We compare it with state-of-the-art techniques, achieving high performance using different evaluation metrics, showing 0.0927 FID, 22.87 PSNR, and 0.3735 SSIM. The proposed approach exhibits significant enhancements over current GAN models, including an 88% reduction in Frechet Inception Distance (FID), a 4% enhancement in Learned Perceptual Image Patch Similarity (LPIPS), a 10% increase in Peak Signal-to-Noise Ratio (PSNR), and a 45% reduction in Mean Squared Error (MSE). This advancement holds significant potential for enhancing efficiency, reducing manpower requirements, and facilitating timely treatment decisions in breast cancer care.
Prognostic value of systemic immune-inflammation index in patients with small-cell lung cancer treated with immune checkpoint inhibitors
Authors: Hamakawa Yusuke , Hirahara Ayumi , Hayashi Akiko , Ito Kota , Shinohara Hiroyuki , Shiba Aya , Higashi Yuko , Aga Masaharu , Miyazaki Kazuhito , Taniguchi Yuri , Misumi Yuki , Agemi Yoko , Nakamura Yukiko , Shimokawa Tsuneo , Okamoto Hiroaki
Published: January 2025

Introduction

The systemic immune-inflammation index (SII) has emerged as a promising prognostic marker in various malignancies. However, its prognostic significance in patients with small-cell lung cancer (SCLC) treated with immune checkpoint inhibitors (ICIs) remains unclear. In this study, we evaluated the prognostic impact of the SII in patients with SCLC after ICI use.

Methods

Of 62 patients with SCLC who received chemoimmunotherapy at our institution between September 2019 and July 2024, we retrospectively analyzed 36 patients who subsequently received ICI maintenance therapy following the initial chemoimmunotherapy treatment. The SII was calculated at the start of the second cycle of the ICI maintenance therapy. Patients were stratified into high (≥ 570) and low (< 570) SII groups. Overall survival (OS) and progression-free survival (PFS) were compared between the groups using the Kaplan–Meier method and log-rank test. Multivariate analysis using the Cox proportional hazards model was performed to identify independent prognostic factors.

Results

The high SII group exhibited a significantly shorter OS (median 12.1 vs. 24.1 months, P = 0.010) and PFS (median 5.2 vs. 8.1 months, P = 0.026) than those in the low SII group. A multivariate analysis identified SII ≥ 570 as an independent negative prognostic factor for OS (hazard ratio 3.83, 95% confidence interval 1.38–10.6, P = 0.010).

Conclusions

Elevated SII in the initial phase of ICI maintenance therapy was associated a with poor prognosis in patients with SCLC, supporting its utility as a prognostic biomarker in this setting. Therefore, prospective validation is required to confirm these findings.
Effect of negotiation skills training program on head nurses’ knowledge and behavior
Authors: Moustafa Hanaa M. , Hassan Rabab M. , Badran Fawzia M.
Published: January 2025

Background

Negotiating is a common occurrence and a significant part of everyday tasks for head nurses. The ability of the head nurse to effectively negotiate is a crucial management tool for work management in healthcare facilities.

Aim

The present study aimed to assess the effect of negotiation skills training program on head nurses’ knowledge and behavior.

Methods

A pretest–posttest, one-group quasi-experimental design was conducted at Menoufia University Hospitals. It is located in Shebeen, Elkom City, Cairo, Egypt. All head nurses and their assistants and their number 64 head nurses.

Results

The results indicated that a minority of head nurses had satisfactory knowledge regarding negotiation in the pretest phase and obviously increased in the posttest to be more than three quarters and slightly decreased in the follow-up phase. Also, a minority had a high negotiation behavior level in the pretest phase and increased to be more than half in the posttest with a slight decrease in the follow-up stage. There was a highly statistically significant difference between pre-, post-, and follow-up results regarding negotiation knowledge and behavior.

Conclusion

The study revealed that the head nurse’s knowledge and behavior increased markedly after implementing the negotiation skills training program.

Recommendations

Conduct continuous education and training programs for stimulating and developing head nurses’ knowledge, behavior regarding negotiation, and hospital administration should support the importance of negotiation skills to both head nurses and organizations.

Trial Registration Number [TRN]

The study protocol was approved by the Research Ethics Committee of the Faculty of Nursing, Ain Shams University (code number: NUR 23.10.131).
War-related continuous traumatic stress as a potential mediator of associations between moral distress and professional quality of life in nurses: a cross-sectional study in Ukraine
Authors: Zasiekina Larysa , Martyniuk Anastasiia
Published: January 2025

Background

At the beginning of 2022, Central Europe entered a state of emergency due to the Russian invasion of Ukraine. Nurses were particularly vulnerable to a decline in their professional quality of life, facing repeated exposure to military trauma, ethical dilemmas, prolonged working hours, and increased stress and fatigue. This study aimed to contribute to our understanding of the potential mediating effect of war-related continuous traumatic stress on the association between moral distress and professional quality of life, including compassion satisfaction and compassion fatigue, represented by burnout and secondary traumatic stress.

Methods

This study used the Professional Quality of Life (ProQOL) Scale to assess compassion fatigue, including burnout, secondary traumatic stress, and compassion satisfaction; the Moral Distress Questionnaire for Nurses to examine everyday moral distress in healthcare facilities and everyday ethical dilemmas of nurses; and the Continuous Traumatic Stress Response (CTSR) Scale to assess ongoing threats, resulting in exhaustion/rage, and fear/betrayal. The sample consisted of 130 female nurses (mean age 40.20 ± 12.15 years) from general surgery, neurosurgery, trauma and orthopaedic surgery, and urgent care who had been undergoing advanced training to work with injured military personnel at the Volyn Medical Institute (Ukraine) from March to May 2023. All nurses had experienced direct and indirect exposure to military trauma, and 105 participants were working with injured military personnel.

Results

The results of the mediation analysis indicated that war-related continuous traumatic stress fully mediated the relationship between moral distress and different components of professional quality of life, namely, compassion fatigue, including burnout and secondary traumatic stress, and compassion satisfaction.

Conclusion

Research has shown that continuous traumatic stress has a significant effect on the relationship between moral distress and various aspects of professional quality of life, underscoring the need for targeted interventions for nurses facing war-related trauma.
Multimorbidity latent classes in relation to 11-year mortality, risk factors and health-related quality of life in Malaysia: a prospective health and demographic surveillance system study
Authors: Tan Michelle M. C. , Hanlon Charlotte , Muniz-Terrera Graciela , Benaglia Tatiana , Ismail Roshidi , Mohan Devi , Konkoth Ann Breeze Joseph , Reidpath Daniel , Pinho Pedro José M. Rebello , Allotey Pascale , Kassim Zaid , Prina Matthew , Su Tin Tin
Published: January 2025

Background

We aimed to identify specific multimorbidity latent classes among multi-ethnic community-dwelling adults aged ≥ 18 years in Malaysia. We further explored the risk factors associated with these patterns and examined the relationships between the multimorbidity patterns and 11-year all-cause mortality risk, as well as health-related quality of life (HRQoL).

Methods

Using data from 18,101 individuals (aged 18–97 years) from the baseline Census 2012, Health Round 2013, and Verbal Autopsies 2012–2023 of the South East Asia Community Observatory (SEACO) health and demographic surveillance system, latent class analysis was performed on 13 chronic health conditions to identify statistically and clinically meaningful groups. Multinomial logistic regression and Cox proportional hazards regression models were conducted to investigate the adjusted association of multimorbidity patterns with the risk factors and mortality, respectively. HRQoL was analyzed by linear contrasts in conjunction with ANCOVA adjusted for baseline confounders.

Results

Four distinct multimorbidity latent classes were identified: (1) relatively healthy (n = 10,640); (2) cardiometabolic diseases (n = 2428); (3) musculoskeletal, mobility and sensory disorders (n = 2391); and (4) complex multimorbidity (a group with more severe multimorbidity with combined profiles of classes 2 and 3) (n = 699). Significant variations in associations between socio-demographic characteristics and multimorbidity patterns were discovered, including age, sex, ethnicity, education level, marital status, household monthly income and employment status. The complex multimorbidity group had the lowest HRQoL across all domains compared to other groups (p < 0.001), including physical health, psychological, social relationships and environment. This group also exhibited the highest mortality risk over 11 years even after adjustment of confounders (age, sex, ethnicity, education and employment status), with a hazard of death of 1.83 (95% CI 1.44–2.33), followed by the cardiometabolic group (HR 1.42, 95% CI 1.18–1.70) and the musculoskeletal, mobility and sensory disorders group (HR 1.29, 95% CI 1.04–1.59).

Conclusions

Our study advances the understanding of the complexity of multimorbidity and its implications for health outcomes and healthcare delivery. The findings suggest the need for integrated healthcare approaches that account for the clusters of multiple conditions and prioritize the complex multimorbidity cohort. Further longitudinal studies are warranted to explore the underlying mechanisms and evolution of multimorbidity patterns.
Provider kinematic strategies during the delivery of spinal manipulation and mobilization: a scoping review of the literature
Authors: Svoboda Katie , Howarth Samuel J. , Funabashi Martha , Gorrell Lindsay M.
Published: January 2025

Background

Spinal manipulation (MAN) and mobilization (MOB) are biomechanically different yet both elicit pain reduction and increased range of motion. Previous investigations have focused on quantifying kinetics (e.g., applied forces) or, recipient kinematics (i.e., movements) during MAN and MOB. While these studies provide valuable information, they do not report on the strategies adopted by providers when performing the complex motor tasks of MAN and MOB. This review sought to synthesise the literature reporting on provider kinematics during the delivery of MAN and MOB.

Methods

This scoping literature review is reported following the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) statement. MEDLINE (Ovid), PsychINFO, Cochrane Library, Web of Science, Embase, Scopus, PEDro, ICL and CINAHL databases were searched from inception to September 2023 for terms relating to provider kinematics during the delivery of MAN and MOB. Data were extracted and reported descriptively, including: general study characteristics, number and characteristics of individuals who delivered/received MAN and/or MOB, region treated, equipment used and kinematic parameters of the individual delivering the procedure.

Results

Of 4,844 records identified, five (0.1%) fulfilled the eligibility criteria and were included in the analysis. Of these, provider kinematics were reported for the delivery of MAN in four (80%) and for the delivery of MOB in one (20%) article. Practitioners applied the procedure in all (100%) and students in one (20%) study. Spinal regions treated were: lumbar (n = 4), thoracic (n = 2) and cervical (n = 1). Data were reported heterogeneously but were most commonly captured using either video or motion capture equipment (n = 4, 80%). The direction of applied force was fully reported in one (20%) and only partially reported (one spinal region) in another study.

Conclusions

There are a small number of studies reporting heterogeneously on provider kinematics during the delivery of MAN and MOB. Clear reporting of the procedure from a biomechanical perspective and of the measurement equipment used could enable future meta-analysis of provider kinematic data, the use of provider kinematic data in the development of technique skills curricula and could feasibly be used to mitigate risk of injury for providers.
Companion animal and equine clinical research: a Nordic perspective
Authors: Holst Bodil Ström , Engelmann Alejandro , Gröndahl Gittan , Gunnarsson Lotta , Haug Haaland Anita , Hielm-Björkman Anna , Moe Lars , Rhodin Marie , Rönnberg Henrik , Stråhle Marie , Toljander Ylva , Kristensen Annemarie Thuri , Hagberg Gustavsson Malin
Published: January 2025

Background

The societal value of cats, dogs and horses is high, and the companion and sport animal health care sector is growing. Clinical research concerning cats, dogs and horses is crucial for the development of evidence-based medical care that benefits animals and their owners, and has implications for human and environmental health from a One Health perspective. Basic information on companion animal and equine research enables more directed measures to improve conditions for research within the area. The aim of the present study was to describe Nordic companion animal and equine clinical research from 2010 to 2019, including bibliometrics, human resources and funding.

Results

There were 2 042 published research publications originating from Nordic countries on cats (n = 282), dogs (n = 1 086), and horses (n = 781) from 2010 to 2019. The majority (83%) of the publications came from the four Nordic universities with veterinary programs. Seven percent of the publications were collaborations between two or more Nordic universities. Approximately 18% of the PhD theses (178 out of 970) from veterinary faculties or corresponding units concerned these species, most of them dogs (n = 86), followed by horses (n = 64), cats (n = 15) or a combination of these species (n = 13). The scientific areas cardiology, infectious diseases, reproduction, and surgery were prominent for all three species. A large proportion of grants were received from small- to medium-sized funding bodies, mainly funding running costs and only to a limited degree salaries. During 2010–2019, costs for veterinary and other services for cats and dogs steadily increased. The growth of the veterinary healthcare sector was not reflected in an increasing number of clinical research publications, for which no increase was seen after 2014.

Conclusions

Despite a high societal value of the species, veterinary clinical research on sports and companion animals has not increased, in contrast to the veterinary healthcare sector. Activities stimulating the research area, e.g. funding bodies enabling coverage of salaries, are needed. The development of Nordic veterinary clinical care may benefit from strengthened research cooperation between countries.
Core Outcome Set development for LEPtospirosis trials (COS-LEP): a study protocol to develop a core outcome set for the evaluation of clinical therapeutic interventions for human leptospirosis
Authors: Lee Nathaniel , Smith Chris , Bailey Robin , Ariyoshi Koya , Smith Sarah , Black Nick , Edwards Tansy
Published: January 2025

Background

Leptospirosis is a zoonotic bacterial infection occurring worldwide. It is of particular public health concern due to its global distribution, epidemic potential and high mortality without appropriate treatment. The method for the management of leptospirosis, particularly in severe disease, is clouded by methodological inconsistency and a lack of standardized outcome measures.

The study this protocol details aims to develop a core outcome set (COS) for leptospirosis research. A COS is a set of outcomes with international consensus as a minimum for reporting in future studies focusing on leptospirosis. Establishing a COS will contribute to harmonizing Leptospirosis treatment research and will be instrumental in constructing a high-quality evidence base to feed into a planned future rigorous international clinical trial on leptospirosis.

Methods

The COS-LEP study will employ a COS development methodology standardized by the COMET initiative framework. This includes (1) a systematic review of available quantitative and qualitative literature reporting therapeutic response and safety outcomes and measures; (2) focused interviews with healthcare professional and people treated for leptospirosis exploring outcomes of interests using qualitative methodology; (3) narrowing the choice of outcomes by international consensus using a Delphi survey process; and (4) undertaking a hybrid consensus meeting with key stakeholders to build the final COS.

Discussion

This protocol describes the method to develop the first core outcome set for use in human leptospirosis studies. This will not only be a key feature in the design of a future definitive randomized controlled trial, but also provide a structure for clinicians and researchers collecting treatment cohort data in the various settings where leptospirosis is a public health issue.
An integrative taxonomic approach reveals two putatively novel species of phlebotomine sand fly (Diptera: Psychodidae) in Thailand
Authors: Soomro Samiullah , Tuangpermsub Siwaporn , Ngamprasertwong Thongchai , Kaewthamasorn Morakot
Published: January 2025

Background

The subfamily Phlebotominae comprises 1028 species of sand fly, of which only 90 are recognized as vectors of pathogenic agents such as Trypanosoma, Leishmania, and Bartonella. In Thailand, leishmaniasis—a sand fly-borne disease—is currently endemic, with 36 documented sand fly species. However, many cryptic species likely remain unidentified. To improve our understanding of the distribution, habitat preferences, and role in disease transmission of these sand flies, further research is necessary.

Methods

Sand flies were collected using CDC light traps from 13 locations across four provinces in Thailand between October 2022 and October 2023. Initially, species identification was based on morphological characteristics, employing identification keys, and subsequently confirmed through mitochondrial cytochrome oxidase c subunit I (COI) and cytochrome b (Cytb) sequencing. Species identities were verified using BLASTN and BOLD searches. Species delimitation was conducted using Automatic Barcode Gap Discovery (ABGD) and Assemble Species by Automatic Partitioning (ASAP) with three substitution models. Additionally, intraspecific and interspecific genetic variation, neutrality tests (including Tajima’s and Fu and Li’s D* tests), phylogenetic analyses, and TCS haplotype network analysis were performed using the obtained sequences.

Results

A total of 3693 phlebotomine sand flies were collected, with 2261 (61.22%) identified as female. Integrative analyses combining morphological data, BLASTN searches, phylogenetic assessments, and species delimitation confirmed the identification of four genera: Sergentomyia, Grassomyia, Phlebotomus, and Idiophlebotomus, encompassing 12 species: Sergentomyia anodontis, Se. sylvatica, Se. perturbans, Se. barraudi, Se. hivernus, Se. khawi, Se. siamensis, Grassomyia indica, Phlebotomus barguesae, Ph. stantoni, Idiophlebotomus asperulus, and Id. longiforceps. Furthermore, molecular analysis revealed cryptic and complex species, including two putatively novel species, Se. sp. 1 and Se. sp. 2, as well as a unique haplotype.

Conclusions

This study, which integrated genetic and morphological identification techniques, identified 12 sand fly species and unveiled cryptic and complex species, including two putatively novel species (Se. sp. 1 and Se. sp. 2) and a unique haplotype. The findings underscore the utility of mitochondrial genes, combined with species delimitation methodologies, as reliable approaches for identifying diverse sand fly species.

Graphical Abstract