bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of the Impact of Knowledge on Sustainable Travel Choices: an Empirical Study with Informational Videos and Gamified Quizzes
Authors: Murad Syed , Law Effie Lai-Chong
Published: December 2024

Carbon emissions from transport are increasing on a global scale with transport accounting for the largest portion. While there is greater awareness of climate change, few people are willing to change their travel habits. To gain a better understanding of this phenomenon, we were motivated to conduct a study to identify the obstacles encountered by travellers when opting for sustainable transport modes, assess their knowledge of carbon emissions from various transport modes and explore how this knowledge affects their decision-making process. The study employed mixed-method approaches, including the use of informational videos and gamified quizzes for intervention, pre- and post-intervention knowledge assessment tests, semi-structured interviews, observations, Self-Assessment Manikin for emotion measures and card sorting. The findings primarily derived from thematic analysis indicated that knowledge-based intervention can be a strong catalyst to encourage sustainable attitude and behaviour change. Insights so gained have important theoretical and practical implications for designing sustainable behaviour change in the future, especially the deployment of persuasive technology.
Temocillin efficacy against AmpC β-lactamase-producing Enterobacterales: a relevant alternative to cefepime?
Authors: Brousse Xavier , Andry Fanny , Lahouati Marin , Desmoulin Anissa , Lehours Philippe , Rignol Laurine , Petitgas Paul , Leroy Anne-Gaëlle , Charroyer Quentin
Published: December 2024

Introduction

Temocillin is a semi-synthetic β-lactam with a narrow spectrum but high stability against hydrolysis by β-lactamases, including AmpC. Despite its favourable properties, data regarding its clinical value in the treatment of AmpC β-lactamase-producing Enterobacterales (ABPE) infections are scarce. Most recent guidelines do not include temocillin in the therapeutic strategy for ABPE infection.

Objectives

This study investigated (i) the proportion of ABPE isolates susceptible to temocillin and (ii) the clinical outcomes of patients treated with temocillin for ABPE infections.

Materials and Methods

This retrospective multicentre (Bordeaux and Reunion Island) study was performed in two parts. First, all the antimicrobial susceptibility test (AST) results of ABPE isolated from May 2021 to August 2023 were included in the analysis. Second, all patients who had received at least one dose of temocillin for ABPE infection between 2017 and 2023 were analysed. The electronic clinical records of these patients were reviewed to determine their treatment outcomes. Therapeutic success was defined as the absence of relapse one month after the end of temocillin treatment (3 months in the case of bone and joint infection) and the absence of treatment modification following an unfavourable outcome.

Results

During the microbiologic period of investigation (2021–23), 5166 ABPE strains were included. Of these, 4253 (82%) were susceptible to temocillin, whereas 4564 (88%) were susceptible to cefepime. After restriction to third-generation cephalosporin-resistant (3GCR) ABPE strains (n = 1446), the proportion of strains susceptible to temocillin was 66% (n = 1227) versus 59% (n = 1092) for cefepime. Temocillin treatment was initiated in 67 patients with ABPE infection during the study period (2017–23). The main infections were complicated urinary tract infections (n = 32, 48%) and bone and joint infections (n = 15, 22%). The estimated overall success rate for patients who underwent complete follow-up was 89% (n = 56/63).

Conclusions

Temocillin appears to be reliable for ABPE infections. Our data showed a high therapeutic success rate. Its high tolerability, narrow spectrum and ease of administration could make temocillin a relevant alternative to cefepime, the current standard for ABPE infection.
A New Conceptual Framework for African Sovereign Debt: Finding an Optimal Outcome that Addresses Five Challenges
Authors: Bradlow Daniel
Published: December 2024

The current arrangements through which African sovereigns raise and manage the external finance for sustainable and inclusive development in their countries are functioning sub-optimally. This troubling situation suggests that Africa needs a new approach to managing its sovereign debt and to restructuring the debt when servicing it becomes too burdensome. This paper argues that Africa is currently facing five challenges in regard to its sovereign debt and that addressing them requires a new conceptual framework that facilitates reaching an Optimal Outcome. This is defined as an outcome that, taking into account the circumstances in which the sovereign debtor and its creditors are negotiating their transaction and their respective rights, obligations and responsibilities, offers each of them the best possible mix of economic, financial, environmental, social, human rights and governance benefits.To make this case, the paper will focus on the case of sovereign debt restructurings. These transactions most clearly demonstrate the complexities and the challenges involved in reaching an Optimal Outcome in sovereign debt transactions. The paper is divided into 3 sections. The first section focuses on the five challenges that African countries are facing in managing and, when necessary, restructuring their sovereign debts. The second proposes eight principles, the DOVE (Debts of Vulnerable Economies) Fund Principles, that together offer a new conceptual framework for negotiating and drafting both new and restructured sovereign debt agreements. This new framework will help the sovereign and its creditors reach an Optimal Outcome. The third section draws some conclusions.
Loss-of-function of DDR1 is responsible for a chondrodysplasia with multiple dislocations
Authors: Villegas Villarroel Miriam , Huber Céline , Baujat Geneviève , Bonnard Adeline , Collet Corinne , Cormier-Daire Valérie
Published: December 2024

Chondrodysplasias with multiple dislocations are rare skeletal disorders characterized by hyperlaxity, joint dislocations, and growth retardation. Chondrodysplasias with multiple dislocations have been linked to pathogenic variants in genes encoding proteins involved in the proteoglycan (PG) biosynthesis. In this study, by exome sequencing analysis, we identified a homozygous nonsense variant (NM_001297654.2: c.1825C>T, p.Arg609*) in the discoidin domain receptor 1 (DDR1) gene in a patient presenting joint dislocations, hyperlaxity, and cerebellar hypoplasia. Functional studies revealed decreased PG production in patient fibroblasts. We further demonstrated that DDR1 inhibition impaired the Indian Hedgehog signaling pathway in chondrocytes, decreased differentiation and mineralization in osteoblasts, and disrupted p38 MAPK signaling in both cell types. Additionally, we showed that DDR1 inhibition affected the noncanonical WNT signaling pathway in human skeletal cells and decreased PG production in chondrocytes. These findings suggest that DDR1 is a new gene involved in the group of chondrodysplasias with multiple dislocations and highlights its essential role in human skeletal and brain development.
Development of a new primer cocktail for improved DNA barcoding of brachyuran crabs (Decapoda: Brachyura)
Authors: Yoon Moongeun , Woo Jiyoung , Lee Sang-Hui , Kim Keun-Yong , Heo Jung Soo , Jo So Eun , Tran Biet Thanh
Published: December 2024

DNA barcoding has revolutionized species identification and molecular phylogeny, offering immense potential for elucidating the diversity of brachyuran crabs. We explored the utility of a new primer cocktail-based approach for amplifying DNA barcode regions of mitochondrial cytochrome c oxidase I (CO1) from 28 specimens representing brachyuran species across 21 major families collected along the Korean coast. The primer cocktail, comprising three forward and two reverse degenerate primers with M13 adapter tails, exhibited superior PCR amplification efficiency, being 100% successful. Sequencing of the PCR products yielded high-quality, 726 bp, DNA barcode sequences, facilitating accurate species identification with 23 out of 28 specimens matching precisely with their morphological taxonomy. Barcoding gap analysis revealed a clear gap between mean intra- and interspecific K2P distances, with a 148-fold difference, confirming the reliability of CO1 barcodes for achieving 100% success in species identification within the dataset. The study highlights the effectiveness and reliability of the new primer cocktail as a robust molecular marker for DNA barcoding of brachyuran crabs, essential for ecological investigations and conservation endeavors, and elucidating the taxonomic complexities among them.
Use of Polymerase Chain Reaction to Characterize the Etiology of Culture-Negative Empyema and Parapneumonic Effusion Among Alaska Native Children—2018-2023
Authors: Steinberg Jonathan , DeByle Carolynn , Westley Benjamin , Gotcsik Marah , Geis Jesse , Velusamy Srinivasan , Fischer Marc
Published: December 2024

We used polymerase chain reaction (PCR) to identify bacterial infections in culture-negative pleural fluid specimens from Alaska Native children hospitalized with empyema. PCR identified ≥1 organism in 11 (79%) of 14 specimens. Streptococcus pneumoniae serotype 3 was detected in 6 specimens; all 6 participants had received 13-valent pneumococcal conjugate vaccine.
Effect of nebivolol on erectile function: a systematic review and meta-analysis of randomized controlled trials
Authors: Lu Youyi , Li Lin , Li Qi , Sun Guoqin
Published: December 2024

Background

Historically, β-blockers have been associated with erectile dysfunction (ED). Nebivolol, a third-generation β-blocker, may have had no negative effect on erectile function because of its vasodilating properties. However, the evidence level was considered either as low or very low.

Aim

A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to determine the effect of nebivolol on erectile function.

Methods

All published RCTs were searched through PubMed, Cochrane Library, Web of Science, and Embase until October 2023. Review Manager version 5.3.0 was used for statistical analysis. Sensitivity analyses were performed by excluding each study using Stata 17 software.

Outcomes

The primary outcome was the International Index of Erectile Function (IIEF)-5 score. We excluded publication types, including letters, reviews, and meta-analyses.

Results

We identified four RCTs in this meta-analysis. All included studies compared the effects of nebivolol vs metoprolol on erectile function. Eight parallel groups with 397 individuals reported IIEF-5 scores. A random-effect model revealed that the IIEF-5 score was significantly higher in the nebivolol group (MD 1.81, 95%CI 0.95-2.68, P < .0001, I2 = 99%). We conducted a sensitivity analysis by removing each individual study and observed that there was no significantly different result. Furthermore, we conducted a prespecified subgroup analysis based on the dosage of metoprolol, patients with ED at the time of enrollment, and disease type. Subgroup analysis revealed that heterogeneity significantly decreased, and the result of the IIEF-5 score was stable and consistent.

Clinical Implications

Our results provides stronger evidence that nebivolol significantly reduced the risk of ED occurrence or progression.

Strengths and Limitations

Our meta-analysis included high-quality RCTs and conducted a predetermined subgroup analysis. However, the main limitations are the limited number of included studies and their heterogeneity.

Conclusion

Our meta-analysis provided stronger evidence that nebivolol significantly reduced the risk of ED occurrence or progression compared with metoprolol, irrespective of whether the patient had ED or not. This meta-analysis could serve as an important reference for future studies in this field.
Quantitative Determination of High-Frequency Voltage Attenuation in an Electric-Pulse-Excited Stroboscopic Transmission Electron Microscope
Authors: Zhu Feng , Li Wanpeng , Yeung Man Chun , Zhang Yuxuan , Du Congcong , Lin Bin , Wang Qi , Guo Xiaofeng , Hsueh Yu-Chun , Chen Fu-Rong , Zhong Xiaoyan
Published: December 2024

High-frequency electric pulse signals are often applied to stimulate functional materials in devices. To investigate the relationship between materials structure and dynamic behavior under high-frequency electric excitation, the stroboscopic imaging mode is widely used in a transmission electron microscope (TEM). From a technical point of view, it is crucial to quantitatively determine high-frequency attenuation in an electric-pulse-excited stroboscopic TEM. Here, we propose the quantitative method to evaluate the voltage attenuation by using magnification variation of defocused bright-field transmission electron microscopy images in a stroboscopic mode when applying high-frequency electric pulse signals onto a model system of two opposite tungsten tips. The negative voltage excitation possesses higher high-frequency voltage attenuation than the positive voltage excitation due to the possible nonreciprocal transmission of the triangle waves within the circuit between the biasing sample holder and the arbitrary waveform generator. Our approach of high-frequency attenuation determination provides the experimental foundation for quantitative analysis on the dynamic evolution of materials structure and functionality under electric pulse stimuli.
VGLL fusions define a new class of intraparenchymal central nervous system schwannoma
Authors: Schmid Simone , Mirchia Kanish , Tietze Anna , Liu Ilon , Siewert Christin , Nückles Jakob , Schittenhelm Jens , Behling Felix , Snuderl Matija , Hartmann Christian , Brandner Sebastian , Paine Simon M L , Korshunov Andrey , Hasselblatt Martin , Coras Roland , Epari Sridhar , Stadelmann Christine , Zechel Sabrina , Simon Michèle , Wilson Yelena , Gianno Francesca , Lucas Calixto-Hope G , Zherebitskiy Viktor , Kaimaktchiev Vassil B , Robinson Lorraina , Aldape Kenneth , Hoving Eelco W , Tops Bastiaan B J , Perera Ashwyn Augustine , Göller Pauline , Hernáiz Driever Pablo , Wesseling Pieter , Koch Arend , Perry Arie , Sahm Felix , Jones David T W , Capper David
Published: December 2024

Background

Intracerebral schwannomas are rare tumors resembling their peripheral nerve sheath counterparts but localized in the central nervous system (CNS). They are not classified as a separate tumor type in the 2021 World Health Organization classification. This study aimed to compile and characterize these rare neoplasms morphologically and molecularly.

Methods

We analyzed 20 tumor samples by histology, RNA next-generation sequencing, DNA-methylation profiling, copy number analyses, and single-nucleus RNA sequencing (snRNA-seq). Clinical data, including age, sex, and disease progression, were collected. Magnetic resonance imaging (MRI) series were included when available.

Results

All cases with tissue available for histology review (n = 13) were morphologically consistent with intracerebral schwannoma, but differed in their extent of glial fibrillary acidic protein staining. All (n = 20) shared DNA-methylation profiles distinct from other CNS tumors, as well as from Vestigial-like family (VGLL)-altered peripheral nerve sheath tumors. Most cases (n = 14/17) harbored fusions of either Vestigial-like family member 3 (VGLL3) or Vestigial-like Family member 1 (VGLL1) (CHD7::VGLL3 [n = 9/17] and EWSR1::VGLL1 [n = 5/17]). In 2 cases, the presence of a VGLL3 fusion was also confirmed by copy number analyses (n = 2/17). MRI (n = 4) showed well-defined, nodular tumors with strong, homogeneous enhancement and no diffusion restriction. Tumors were located throughout the neuroaxis (supratentorial [n = 15], infratentorial [n = 4], and spinal [n = 1]). snRNA-seq of a VGLL1-fused tumor indicated VGLL1 upregulation in 28.6% of tumor cells (n = 1). During a median follow-up of 1.8 years (range 3 months-9 years), none of the tumors recurred (n = 10).

Conclusions

We identify and define a new benign tumor class, designated VGLL-altered intraparenchymal CNS schwannomas. These tumors feature VGLL alterations and a specific DNA-methylation profile, with schwannoma-like histopathology and CNS localization, akin to previously classified intracerebral schwannomas.
Challenges in implementing 2021 WHO CNS tumor classification in a resource-limited setting
Authors: Gilani Ahmed , Altaf Ahmed , Shakir Muhammad , Minhas Khurram , Enam Syed Ather
Published: December 2024

Background

The 2021 World Health Organization classification of Central Nervous System tumors (CNS5) includes molecular biomarkers in the necessary diagnostic criteria for many tumors. Identifying these markers often requires next-generation sequencing (NGS) and/or DNA methylation profiling, presenting challenges in diagnosing these tumors in low or middle-income countries (LMICs) and other resource-limited settings. Here, we will illustrate the real-world scope of the problem by presenting a neuropathologist’s experience with implementing the CNS5 criteria in an academic medical center in Karachi, Pakistan.

Methods

CNS tumor biopsies received by a single neuropathologist (AG) in Karachi during a 6-month period (October 2022 to March 2023) were included in the study. Routine histologic processing, H&E and immunohistochemistry were performed.

Results

A total of 443 tumor cases were received, 87 of those (19.64% of total, 36.86% of glial, embryonal, and glioneuronal tumors) could not be assigned a CNS5 diagnosis. Top reasons for failure to reach a CNS5 diagnosis were low-grade gliomas or infiltrative glioma in pediatric/ adolescent young adults not further classifiable on histology, IDH-mutant tumors requiring 1p/19q testing to rule out oligodendroglioma, undifferentiated tumors with unclear lineage and adult grade 2 or 3 IDH-wildtype astrocytomas suspicious for glioblastoma, IDH-wildtype. Send-out DNA methylation testing in 22 cases resolved the diagnostic questions in all except one case.

Conclusions

Without access to molecular testing, up to a third of all glial, embryonal, and glioneuronal tumors could not be assigned a CNS5 diagnosis, leading to diagnostic ambiguity and therapeutic confusion. Until affordable molecular assays are available, CNS5 diagnostic criteria have limited applicability in resource-limited settings.
Effectiveness of Health Education Interventions in Enhancing Iron-Folic Acid Supplement Utilization Among Pregnant Women: Systematic Review and Meta-analysis
Authors: Feyisa Jira Wakoya , Siu Judy Yuen-Man , Bai Xue
Published: December 2024

Context

During pregnancy, the underutilization of iron-folic acid supplements (IFAS) remains a considerable maternal and child health issue. Hence, health education intervention trials were conducted following the recommendation of the World Health Organization and epidemiological studies to enhance the utilization level of the supplements during pregnancy.

Objective

The objective of this meta-analysis was to evaluate the effectiveness of health education interventions in enhancing IFAS utilization during pregnancy.

Data Sources

A thorough search was conducted across PubMed, EMBASE, Scopus, CINAHL, Web of Science, Medline, the Cochrane Library, and Google Scholar from August 28 until October 31, 2023.

Data Extraction

This study incorporated randomized and quasi-experimental studies that examined the effectiveness of health education interventions in enhancing IFAS utilization during pregnancy.

Data Analysis

Comprehensive Meta-Analysis, version 4, which includes the prediction interval, was used for the analysis.

Results

In this meta-analysis and systematic review, 21 articles comprising 6643 pregnant women from different countries were included. The random-effects model was applied to determine the pooled standardized differences in means (0.786; 95% CI: 0.551, 1.021). The prediction interval shows the range of true standardized differences in means (95% CI: −0.168, 1.740), which indicates the variations in the true effect size of health education interventions in enhancing IFAS utilization during pregnancy.

Conclusion

In addition to pooled effect size, another significant advantage of this meta-analysis is conducting the prediction interval to determine the range of the true effect size, which ranges from −0.168 to 1.740 across the groups of different pregnant women, indicating variability in the effectiveness of the interventions in enhancing IFAS utilization during pregnancy. This might occur because most of the primary studies in this meta-analysis were conducted at healthcare facilities and mostly focused on anemic pregnant women attending antenatal care, which did not control for sociocultural determinants. Therefore, future researchers should consider these limitations.
Trends of paediatric hypertension screening and management in primary care before and during the coronavirus disease 2019 pandemic: A retrospective cohort study
Authors: Kosowan Leanne , Chanchlani Rahul , Dart Allison , Wu Michael , Costa Rita , Singer Alexander
Published: December 2024

Objectives

We assessed trends in primary care paediatric blood pressure (BP) screening, follow-up, and treatment before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

Retrospective cohort study using electronic medical records from the Canadian Primary Care Sentinel Surveillance Network to capture paediatric visits (aged 3 to 18) between January 1, 2011, and December 31, 2020. Time-series analysis was performed using documentation of monthly BP, high BP, follow-up of abnormal BP, and antihypertensive prescribing. We assessed differences between pre (January 1, 2011 to March 11, 2020) and during COVID-19 (March 12, 2020 to December 31, 2020).

Results

Of 343,191 paediatric patients, 30.9% had ≥1 paediatric BP documented. Documentation of BP increased each year from 17.3% in 2011 to 19.8% in 2019 (β = 0.05, 95% CI 0.04, 0.07, P < 0.001), with a decrease in trend in 2020 to 11.0% (β = −16.95, 95% CI −18.91, −14.99, P < 0.001). There was an increasing pre-pandemic trend for laboratory screening and prescribing (β = 0.12, 95% CI 0.1, 0.14, P < 0.0001; β = 0.02, 95% CI 0.02, 0.02, P < 0.0001). During the COVID-19 pandemic, laboratory screening further increased (24.5% to 31.1%; β = 5.19, 95% CI 2.03, 8.35, P = 0.002), whereas there was no significant change in prescribing trends (1.3% to 1.4%; β = 0.15, 95% CI −0.01, 0.32, P = 0.07).

Conclusions

Documentation of BP increased annually, then declined precipitously during the COVID-19 pandemic. Despite lower BP screening and follow-up, the prevalence of hypertension and antihypertensive prescribing remained stable. Clinical practice trends in primary care highlight areas to improve the care and management of hypertensive paediatric patients.
Candidate for the Double Gamow–Teller Giant Resonance in 48Ca Studied by the (12C, 12Be(0+2)) Reaction at 250 MeV/Nucleon
Authors: Sakaue A , Yako K , Ota S , Baba H , Chillery T , Doornenbal P , Dozono M , Ebina N , Fukuda N , Fukunishi N , Furuno T , Hanai S , Harada T , Hayakawa S , Hijikata Y , Horikawa K , Huang S W , Imai N , Itahashi K , Kobayashi N , Kondo Y , Li J , Maeda Y , Matsui T , Matsumoto S Y , Matsumura R , Michimasa S , Nakatsuka N , Nishi T , Sakanashi K , Sasano M , Sekiya R , Shimizu N , Shimizu Y , Shimoura S , Sumikama T , Suzuki D , Suzuki H , Takaki M , Takeshige S , Takeda H , Tanaka J , Tanaka Y K , Togano Y , Tsuji R , Yang Z H , Yoshida K , Yoshimoto M , Zenihiro J , Uesaka T
Published: December 2024

A new experimental method to search for the double Gamow–Teller giant resonance using the double charge exchange ($^{12}$C, $^{12}$Be(0$^{+}_{2}$)) reaction is proposed and applied, for the first time, to a ${}^{48}$Ca target at 250 MeV/nucleon using a $^{12}$C primary beam at the RIKEN RI Beam Factory. The events with double isospin- and spin-flip in ${}^{48}$Ca were selected by measuring decay $\gamma$-rays from ${}^{12}$Be(0$^{+}_{2}$). A forward-peaking component in the measured double-differential cross sections was observed with an integrated $0^\circ$ cross section of $1.33 \pm 0.12$ μb/sr in the excitation energy region below 34 MeV in ${}^{48}$Ti. Reaction analyses based on distorted-wave Born approximation calculations and the multipole decomposition based thereon indicate that $\sim$40% of the forward-peaking component originates from the double Gamow–Teller transitions. The transition strength of the double Gamow–Teller transition is evaluated from the extracted forward-peaking cross section.
Frailty Is Strongest Need Factor among Predictors of Prehabilitation Utilization for Total Hip or Knee Arthroplasty in Fee-for-Service Medicare Beneficiaries
Authors: Stern Brocha Z , Sabo Graham C , Balachandran Uma , Agranoff Raquelle , Hayden Brett L , Moucha Calin S , Poeran Jashvant
Published: December 2024

Objective

Prehabilitation may have benefits for total hip arthroplasty (THA) and total knee arthroplasty (TKA), given an aging population with multimorbidity and the growth of value-based programs that focus on reducing postoperative costs. We aimed to describe prehabilitation use and examine predictors of utilization in fee-for-service Medicare beneficiaries.

Methods

This retrospective cohort study using the Medicare Limited Data Set included fee-for-service Medicare beneficiaries who were ≥ 66 years old and who underwent inpatient elective THA or TKA between January 1, 2016, and September 30, 2021. We assessed predictors of receiving preoperative physical therapist services within 90 days of surgery (prehabilitation) using a mixed-effects generalized linear model with a binary distribution and logit link. We report adjusted odds ratios (ORs).

Results

Of 24,602 THA episodes, 18.5% of patients received prehabilitation; of 38,751 TKA episodes, 17.8% of patients received prehabilitation. For both THA and TKA, patients with medium or high (vs low) frailty were more likely to receive prehabilitation (OR = 1.72–2.64). Male (vs female) patients, Black (vs White) patients, those with worse county-level social deprivation, those with dual eligibility, and those living in rural areas were less likely to receive prehabilitation before THA or TKA (OR = 0.65–0.88). Patients who were ≥ 85 years old (vs 66–69 years old) and who underwent THA were also less likely to receive services (OR = 0.84). Additionally, there were geographic differences in prehabilitation utilization and increased utilization in more recent years.

Conclusion

The need factor of frailty was most strongly associated with increased prehabilitation utilization. The variation in utilization by predisposing factors (eg, race) and enabling factors (eg, county-level social deprivation) suggests potential disparities.

Impact

The findings describe prehabilitation use in a large cohort of fee-for-service Medicare beneficiaries. Although services seem to be targeted to those at greater risk for adverse outcomes and high spending, potential disparities related to access warrant further examination.
Influence of Race and Ethnicity on Application to Doctor of Physical Therapy Programs
Authors: Tombers Nicole , Pfeifer Rachel , Froemke Kaitlyn
Published: December 2024

Objective

This study uses data from the Physical Therapist Centralized Application Service (PTCAS) to compare influences on application to Doctor of Physical Therapy (DPT) programs between White applicants and people of color (POC) — applicants who identified as Black, American Indian, Asian, Hispanic, or Pacific Islander.

Methods

This is a retrospective study using holistic narrative analysis. PTCAS data for the 2020 to 2021 application cycle were obtained, including essays and demographic data. Random samples were drawn such that 736 total applicants to PTCAS were included: 372 White applicants and 364 POC applicants. Using categories previously described in the literature, 3 reviewers coded application essays into as many influence categories as applied. Interrater reliability was evaluated on a sample of 12 essays, using Cohen kappa between reviewer pairs and a total arithmetic mean. Chi-square was used to test for difference between groups, based on Bonferroni correction.

Results

Personal experience with physical therapy (53.8% for White applicants, 54.9% for POC applicants), observation of the field (68.5% for White applicants, 71.2% for POC applicants), and alignment with values and interests (62.9% for White applicants, 67.3% for POC applicants) were the most common influences. Applicants of color were more likely to indicate a desire to bring services back to their community of origin, formative experience in health care based on race, and paid work experience in the field. Interrater reliability was excellent (.869).

Conclusion

Applicants in the POC group were primarily influenced toward pursuing DPT education by personal interaction with physical therapy and alignment of the field with their values. They were more likely than their White peers to have racially based health care experiences, paid work in the physical therapy field, and a desire to provide services to their community.
Withdrawn as duplicate: Effectiveness of pharmacological therapies for fibromyalgia syndrome in adults: an overview of Cochrane Reviews
Authors: Moore Andrew , Bidonde Julia , Fisher Emma , Häuser Winfried , Bell Rae Frances , Perrot Serge , Makri Souzi , Straube Sebastian
Published: December 2024

“This article has been withdrawn due to an error that caused the article to be duplicated. The definitive version of this article is published under https://doi.org/10.1093/rheumatology/keae707.”
Teratogenicity, cardiac toxicity, neurotoxicity and genotoxicity in zebrafish embryo-larvae exposed to 4-bromodiphenyl ether
Authors: Kumar Shiv , Chadha Pooja
Published: December 2024

Polybrominated diphenyl ethers (PBDEs) have been classified as a new class of persistent organic pollutants by the United Nations Environment Programs in 2009. In environment, PBDEs can undergo the degradation process to form less brominated diphenyl ethers. In the present study, the 96 h LC50 value for 4-bromodiphenyl ether (BDE-3) was found to be 3.18 mg/L in zebrafish embryo-larvae. Further, zebrafish embryo-larvae was exposed to sublethal concentrations i.e. 0.79 mg/L and 1.59 mg/L of BDE-3 to evaluate the developmental toxicity. BDE-3 significantly increased the mortality rate and decreased hatchability rate in a concentration and time-dependent manner at sublethal concentrations compared to control. Heart rate was found to be significantly decreased whereas the sinus venosus- bulbus arteriosus (SV-BA) distance found to be significantly increased in both BDE-3 exposed groups. The sensorimotor response and spontaneous movement were significantly decreased in BDE-3 exposed larvae compared to control group. A significant DNA damage was also found to be caused in BDE-3 exposed groups after the acute exposure. The current report highlights the toxicity potential of BDE-3 in the early life stages of zebrafish and hence puts up to their environmental risk assessment.

Highlights  4-bromodiphenyl ether (BDE-3) caused developmental toxicity and morphological deformities and decreased hatchability rate in zebrafish larvae. The heart rate was found to be significantly decreased in BDE-3 exposed zebrafish larvae. The total body length and eye size was found to be reduced in exposed zebrafish larvae. Significant DNA damage was caused by acute exposure of BDE-3 in zebrafish larvae.
Photobiomodulation Therapy for Non-exudative Age-related Macular Degeneration
Authors: Rodriguez Daniel A. , Song Alex , Bhatnagar Anshul , Weng Christina Y.
Published: December 2024

Age-related macular degeneration (AMD) is a chronic condition that causes gradual central vision loss, most commonly in patients 50 years or older. This disease is commonly classified as either dry (non-exudative) or wet (exudative). Most patients with AMD have the non-exudative form, characterized by the presence of drusen in the macula. These patients can be further subclassified based on drusen size into early, intermediate, or late stages. The pathogenesis of this disease is quite complex and has been linked to genetic variations, dysfunction of normal retinal homeostasis, chronic inflammation, and mitochondrial dysfunction. Current treatment options for patients with intermediate dry AMD are limited to lifestyle modifications and vitamin supplementation. Photobiomodulation therapy (PBT) has been proposed as an additional therapy for this disease. Early animal and human studies have shown that PBT can alter many of the pathways implicated in the pathogenesis of AMD including improving mitochondrial function, decreasing inflammation, and promoting wound healing. Clinical trials investigating the use of PBT in patients with non-exudative AMD have shown promising results. Many of these trials showed improvement in both clinical (visual acuity and contrast sensitivity) as well as anatomic (drusen volume and area geographic atrophy) variables. Most, however, are limited by sample size, differences in treatment algorithm, and populations tested. Ongoing clinical trials aim to expand on this work with longer follow-up, larger sample sizes, and studying a global population. Further work is needed to determine ideal treatment algorithms and patient populations that may benefit the most from this technology.
Evaluating pathological complete response as an surrogate endpoint for long-term survival in patients with non-small cell lung cancer: a systematic review and meta-analysis
Authors: Li Chao , Kadeerhan Gaohaer , Zhang Tongtong , Yeerjiang Zaiwuli , Yang Yikun , Meng Jun , Wang Dongwen
Published: December 2024

Purpose:

Pathologic complete response (pCR) is deemed to associate with event-free survival (EFS) and overall survival (OS), however, whether it is suitable to serve as a surrogate endpoint for long-term survival in clinical trials of neo-adjuvant treatment for resectable NSCLC trials is still controversy. We aim to evaluate the role of pCR and its viability as a surrogate endpoint for EFS and OS in NSCLC.

Methods:

To investigate the association of pCR and EFS and OS, we performed a meta-analysis involving randomized clinical trials that have reported complete information on pCR rates with hazard ratios (HRs) for EFS and OS. A standard meta-analysis was conducted to determine the relationship between pCR rates and EFS and OS. Additionally, weighted regression analysis was performed to assess the associations between log relative risk (RR) for pCR and log HRs for EFS and OS, with the coefficient of determination (R2) being used to quantify the correlations. Furthermore, the surrogate threshold effect (STE) was also used to evaluate the minimum value of the RR for pCR necessary to confidently predict a non-null effect on HRs for EFS and OS.

Results:

The meta-analysis included 14 randomized clinical trials. The high pCR rate group had significant improvement of EFS (HR = 0.69, 95%CI 0.55-0.86) and OS (HR = 0.82, 95%CI 0.72-0.94). A strong association was found between log RR for pCR and log HR for EFS (R2 = 0.76; 95%CI 0.48-1.00) and a moderate correlation between log RR for pCR and log HR for OS (R2 = 0.54; 95%CI 0.04-1.00). The STEs for pCR were 4.534 and 10.278 for EFS and OS, respectively. In the subgroup analysis, similar results were only observed in a partial set of comparisons.

Conclusions:

A high pCR rate was associated with a long-term survival outcome. Strong association and moderate association were found between pCR and EFS, pCR and OS, respectively, which supports the application of pCR as a surrogate endpoint for long-term survival in RCTs for resectable NSCLC.
The efficacy and safety of robot-assisted surgery in cancer patients: a systematic review of randomized controlled trials
Authors: Yu Kai , Zeng Baoqi , Zhou Qingxin , Sun Feng
Published: December 2024

Background:

The utilization of robot-assisted surgery (RAS) has been increasing among cancer patients. However, evidence supporting the use of RAS remains uncertain. The availability of randomized controlled trials (RCTs) for each surgical procedure is limited. This study aimed to assess the safety and efficacy of RAS in cancer patients.

Materials and Methods:

A comprehensive search was performed in Embase, PubMed, the Cochrane Library, and ClinicalTrials.gov from the inception of the databases until 1 April 2023. We included RCTs of RAS in cancer patients compared with laparoscopic, thoracoscopic, or open surgery, and random-effects meta-analyses were performed.

Results:

A total of 32 trials (6092 patients) met the eligibility criteria. Among these, 22 trials had a low risk of bias, seven trials had some concerns, and three trials were at high risk. Most trials were conducted for bladder cancer (n = 8), rectal cancer (n = 5), prostate cancer (n = 4), and endometrial cancer (n = 4). In all cancers, RAS likely resulted in a slight reduction in the length of hospital stay (31 comparisons; mean difference [MD], − 0.91 days; 95% CI, − 1.33 to − 0.49), but resulted in little to no difference in overall survival (11 comparisons; hazard ratio [HR], 0.96; 95% CI, 0.78 to 1.17). Compared with open surgery, RAS was found to reduce estimated blood loss (MD, − 239.1 mL; 95% CI, − 172.0 to − 306.2) and overall complication (relative risk [RR] 0.88; 95% CI, 0.81 to 0.96), but increase total operative time (MD, 55.4 minutes; 95% CI, 30.9 to 80.0). Additionally, RAS seemed to be not associated with positive surgical margin, any recurrence, disease-free survival, and quality of life.

Conclusion:

RAS has demonstrated small favorable effects on short-term outcomes, particularly when compared to open surgery. However, these effects may vary across different cancers. Additionally, RAS may not impact long-term survival, oncological outcomes, or quality of life in cancer patients.
Procedural sedation in the emergency department by Italian emergency physicians: results of the SEED SIMEU registry
Authors: Lison Davide , Lorenzati Bartolomeo , Segre Elisabetta , Bernardi Emanuele , Nazerian Peiman , Gianno Adriana , Bruno Alice , Baldassa Federico , Tizzani Maria , Stefanone Valerio T. , Borselli Matteo , Dutto Luca , Veglio Maria Grazia , Landi Andrea , Soardo Flavia , Cibinel Gian A.
Published: December 2024

Background and importance

Effective and safe procedural sedation is pivotal for the quality of care in the emergency department (ED).

Objectives

The aim of this work is to evaluate the feasibility, effectiveness, and safety procedural sedation performed by emergency physicians in the ED setting in Italy.

Design/setting and participants/intervention

Following a specific training of the staff and with the adoption of a standardized protocol, a registry of procedural sedations performed on adult patients in 10 Italian EDs was compiled from 2019 to 2022; the following basic data were recorded: demographic and clinical information, procedure’s indication, administered drugs, predefined, and actual sedation level.

Outcome measures and analysis

Effectiveness was evaluated considering three parameters: successful completion of the procedure, absence of procedural pain, and no memory of the procedure; adverse events were classified according to the World Society of Intravenous Anaesthesia criteria and evaluated taking into account clinical and procedural variables.

Main results

The study included 1349 patients (median age 68 years, male 64%). Sedation was performed for electrical cardioversion (66.3%), orthopedic procedures (23.2%), or other procedures (10.5%). Propofol (67%) and midazolam (24.2%) were the two most frequently used sedatives and 70.6% of the patients achieved a deep level of sedation.

Procedural failure occurred in 4.6% of cases, with no significant differences between procedure types or drugs used. Recall of the procedure and procedural related pain were reported by 2.9% and 2.6% of patients, respectively, and were more frequently related to orthopedic procedures, midazolam use – if compared with propofol, and lower levels of sedation.

A total of 135 adverse events were observed, with an overall incidence of 10%: 38 minimal adverse events (2.8%), 38 minor adverse events (2.8%), and 59 moderate adverse events (4.4%). There were no adverse events requiring unplanned hospital admission or escalation of care, and no sentinel adverse events were observed. All adverse events were resolved with simple and noninvasive treatments. The incidence of adverse events was greater with higher American Society of Anesthesiologists class, intermediate/difficult airway, and deeper sedation levels.

Conclusion

Procedural sedation performed in Italian EDs by emergency physicians, with propofol as main sedative, was effective and safe, and has comparable adverse event rates with previous international studies.
Contributions of Pediatric Hematology/Oncology to the Diagnosis, Treatment, and Cure of Acute Lymphoblastic Leukemia: Part 2a (Numbers 11 to 15)
Authors: Miller Denis R.
Published: December 2024

Pediatric hematology/oncology as a subspecialty has made major contributions to the diagnosis and treatment of acute lymphoblastic leukemia, the most common malignancy in the pediatric population. This impressive progress has yielded complete response rates of 98%, median durations of complete continuous remissions of over 5 years, and long-term leukemia-free survival and probable cure in 80% to 85% of patients. Sixty-five years ago, such data could only be imagined as future goals. This offering, part 2 of a planned trilogy, represents the second historical review from an admittedly elderly investigator, proud to have witnessed firsthand many of these advances. Part 2a contains numbers 11 to 15 and Part 2b consists of numbers 16 to 20. In consecutive order from the first 10: (11) more clues to the causation of ALL relating to in utero events and after birth, very early responses to infection; (12) the superiority of pediatric-inspired ALL trials for adolescents and young adults; (13) L-asparaginase; (14) chimeric antigen receptor T-cell therapy (CART); and (15) aggressive multiagent therapy for high-risk ALL introduced by BFM and CCG. My involvement with colleagues in some of these advances has provided a 65-year odyssey and its accompanying gratification and sense of accomplishment. Mostly, our goals have been achieved and have benefitted substantially our patients.
Incidence and risk factors of postoperative nausea and vomiting in Africa among patient under gone surgery: a systematic review and meta-analysis
Authors: Bacho Mebratu Tila , Wolda Getahun Dendir , Demssie Wondu Reta , Awoke Nefsu , Temsgen Ashagrie Sintayehu , Sulieman Elias Habtu , Geberemedin Tsegaye Demeke , Gemechu Ashebir Debalkie , Wosene Naol Gorde , Endebirku Andualem Assefa , Negash Wogayehu Abera , Alemu Afwork , Kussie Alemu Urmle , Kusie Wondafrsh , Obsa Mohammed Suleiman
Published: December 2024

Background:

Patients who experience postoperative nausea and vomiting are not happy with their surgical outcomes. Preventing this problem expedites the patients’ return to normal activities following surgery and significantly increases their satisfaction. There are no condensed results that show the prevalence and contributing variables of postoperative nausea and vomiting in Africa. Thus, the purpose of this meta-analysis and comprehensive review was to ascertain the prevalence and contributing variables of postoperative nausea and vomiting in Africa.

Methods:

Studies were retrieved from the PubMed, EMBASE, Cochrane Database, CINAHL, Scopus, Mednar, and Google Scholar databases using combinations of searching terms and Boolean operators. I-squared (I
2) statistics is used for evaluating study heterogeneity. Every publication is assessed for methodological quality using the Joanna Briggs Institute (JBI) Critical Appraisal criteria. Using a funnel plot, publication bias is visually assessed. Subgroup analyses investigate the source of heterogeneity. To determine whether publication bias exists, the Eggers weighted regression test is employed. STATA software version 14 was used to perform statistical analyses.

Results:

In Africa, the combined incidences of nausea 24.96 % (95% CI: 17.903-32.018), vomiting 23.655 % (95% CI: 17.542-29.769) and nausea with vomiting 15.27 % (95% CI: 9.118-21.424) . History of motion sickness (odds ratio [OR]: 3.19 (95% CI 1.08–9.42), P < 0.036) and history of postoperative nausea and vomiting (OR: 4.33 (95% CI 2.654–7.07), P < 0.001) were factors linked to postoperative nausea and vomiting. Compared to their counterparts, patients who underwent more risky surgical procedures had a 1.4-fold increased chance of developing postoperative nausea and vomiting. Patients who skipped the use of prophylactic medication for nausea and vomiting had a 59% higher risk of experiencing postoperative nausea and vomiting than those who did [OR: 1.39 (95% CI (1.074–1.769), P < 0.012) and OR: 0.194 (95% CI (0.04–0.935), P < 0.001)], respectively.

Conclusion:

Postoperative nausea and vomiting were more common in surgically treated African individuals. Clinical interventions are needed to prevent, diagnose, and treat postoperative nausea and vomiting (PONV), with a focus on patients who have experienced motion sickness, high-risk surgery, or PONV in the past. It is advisable to use whole intravenous anesthesia based on Propofol for surgery, if feasible.
The limits of artificial intelligence: prospects and challenges in the clinical workplace
Authors: Schneider-Kamp Anna , Askegaard Søren
Published: December 2024

Purpose of review

Artificial intelligence (AI) is increasingly prevalent in the clinical workplace, a trend that is likely to continue with the amount of attention and resources these technologies receive. This review of 22 articles from the last 18 months takes stock of not only the prospects but also the challenges for clinicians resulting from AI integration.

Recent findings

While the technology matures rapidly, insights into organizational processes and user readiness and involvement in AI development, implementation, and deployment lag behind. AI impact assessments often focus narrowly on task efficiency, overlooking the derived effect of additional workload elsewhere. Additionally, the issue of the distribution of responsibility between humans and AIs poses a fundamental ethical, legal, and political challenge. Research acknowledges the need to consider healthcare professionals’ diverse roles and sociocultural backgrounds to avoid AI exacerbating existing inequalities among the clinical workforce and, ultimately, the patients cared for.

Decision-makers should involve users throughout the entire AI life cycle, from the early stages of AI development to continuous postdeployment impact assessment on workload. More research is needed on AI's cost-effectiveness, integration into clinical practice, and the role of diversity-aware facilitation in realizing its potential.