bluuebunny/crossref_metadata_2025 huggingface dataset:
A deprescribing programme aimed to optimise blood glucose-lowering medication in older people with type 2 diabetes mellitus, the OMED2-study: the study protocol for a randomised controlled trial
Authors: Andriessen Charlotte , Blom Marieke T. , van Hoek Beryl A. C. E. , de Boer Anna W. , Denig Petra , de Wit G. Ardine , Swart Karin , de Rooij-Peek Angela , van Marum Rob J. , Hugtenburg Jacqueline G. , Slottje Pauline , van Raalte Daniël , van Bloemendaal Liselotte , Herings Ron , Nijpels Giel , Vos Rimke C. , Elders Petra J. M.
Published: July 2024

Background

Older patients with type 2 diabetes mellitus (T2D) have an increased risk of hypoglycaemic episodes when using sulphonylureas or insulin. In the Netherlands, guidelines exist for reducing glucose-lowering medication in older patients. However, evidence is lacking that a medication reduction in older patients can be safely pursued. Here, we will examine if promoting the deprescribing of insulin/sulphonylureas with a deprescribing programme (DPP) in general practice affects T2D-complications in older overtreated patients.

Methods

We will perform a 1:1 cluster randomised controlled trial in 86 general practices in the Netherlands. The DPP will consist of education sessions with general practitioners and practice nurses about reducing glucose-lowering medication in older patients (≥ 70 years). Topics of the sessions include the necessity of deprescribing, tools to initiate deprescribing and strategies to discuss deprescribing with patients (shared decision making). The DPP further includes a support programme with practice visits. The study will employ a selection tool to identify possibly overtreated older patients from the electronic medical records of the general practitioner. Eligibility for enrolment in the study will be based on HbA1c targets indicated by the Dutch guidelines, which depend on age, diabetes duration, presence of frailty, and life expectancy. The control group will provide usual care. We aim to include 406 patients. The follow-up period will be 2 years. For the primary outcome, the effect of the DPP on T2D-complications will be assessed by counting the cumulative incidence of events related to under- and overtreatment in T2D as registered in the electronic medical records. We shall perform an intention-to-treat analysis and an analysis including only patients for whom deprescribing was initiated. The implementation of the DPP in general practice will be evaluated quantitatively and qualitatively using the Extended Normalisation Process Theory (ENPT) and the Reach, Efficacy – Adoption, Implementation and Maintenance (RE-AIM) model. Other secondary outcomes include quality of life, cognitive functioning, events related to overtreatment or undertreatment, biomarkers of health, amount of blood glucose-lowering medication prescriptions, and cost-effectiveness.

Discussion

This study will provide insight into the safety and feasibility of a programme aimed at deprescribing sulphonylureas/insulin in older people with T2D who are treated in general practice.

Trial registration

ISRCTN Registry, ISRCTN50008265, registered 09 March, 2023.
Future support on evidence-informed priority setting and situational analysis of the potential role of Health Technology Assessment in Africa to support future pandemic preparedness and response: protocol for a scoping review
Authors: Uzochukwu Benjamin S. C. , Okeke Chinyere , Ruiz Francis , Torres-Rueda Sergio , Kazibwe Joseph , Uzochukwu Adaora , Vassall Anna
Published: July 2024

Background

The COVID-19 pandemic has highlighted the importance of evidence-informed priority setting and situational analysis in pandemic preparedness and response. Health Technology Assessment (HTA) has been identified as an essential tool for evidence-informed decision-making in healthcare. However, the potential role of HTA in pandemic preparedness and response in Africa has yet to be explored. The objective of this scoping review is to ascertain the current understanding of the possible role of HTA in Africa to support future pandemic preparedness and response.

Methods

We will conduct a scoping review of literature published between 2010 and 2024. Electronic databases like Embase, PubMed, Scopus, Web of Science, and Google Scholar will be utilized to perform the search. We will also search grey literature sources such as websites of relevant organizations and government agencies. The search will only include studies that were conducted in the English language. Two reviewers will evaluate the titles and abstracts of the publications independently to determine their eligibility using Covidence. Full-text articles will be reviewed for eligibility and data extraction. The data will be extracted using a standardized form. The extracted data will include information on the study design, objectives, methods, findings, and conclusions. The thematic analysis approach will guide the data analysis. Themes and sub-themes will be identified and reported. The review will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines.

Discussion

This scoping review will identify the existing knowledge on the potential role of HTA in Africa to support future pandemic preparedness and response. The findings will aid in identifying deficiencies in knowledge and provide valuable insights for future study. Additionally, they will inform policy-makers and other stakeholders about the potential contribution of the Health Technology Assessment (HTA) in enhancing Africa’s readiness and response to pandemics.
Gut microbiota-derived metabolites: implications for metabolic syndrome and therapeutic interventions
Authors: Olalekan Samuel Oluwadare , Bakare Olalekan Olanrewaju , Osonuga Ifabunmi Oduyemi , Faponle Abayomi Samson , Adegbesan Bukunola Oluyemisi , Ezima Esther Nkechi
Published: July 2024

Background

The gut microbiota (GM) and their metabolites have garnered significant attention for their roles in metabolic syndrome (MetS) and associated conditions. MetS, characterized by a cluster of metabolic abnormalities, significantly increases the risk of cardiovascular disease (CVD), obesity, insulin resistance, and type 2 diabetes mellitus (T2DM). The dysbiosis of gut microbiota, marked by changes in microbial composition and function, has been implicated in the pathogenesis of MetS.

Main body

This review synthesizes recent findings elucidating the influence of GM composition and microbiota-derived metabolites on MetS pathogenesis and progression. Notably, alterations in GM composition and dysregulation of metabolites such as short-chain fatty acids (SCFAs), trimethylamine N-oxide (TMAO), polyamines, amino acids, and indole derivatives have been implicated in MetS development. These metabolites play crucial roles in metabolic processes, and their imbalance can trigger or exacerbate metabolic disturbances associated with MetS. Various therapeutic approaches, including dietary interventions, probiotics, prebiotics, and precision medicine targeting specific metabolites, offer promising strategies for managing MetS. These interventions aim to restore a healthy GM balance and regulate the production of beneficial metabolites.

Conclusion

The complexity of GM interactions and their systemic effects necessitate more standardized research methodologies. Future investigations focusing on personalized therapeutic interventions and non-invasive diagnostic tools are warranted to address the complexities of MetS management. Advancing our understanding of the GM-metabolite-MetS axis will be crucial for developing effective, targeted treatments and improving patient outcomes in MetS.
Psychophysical correlates of musicality in musically untrained children: evidence for musical sleepers in children
Authors: Sampath Sridhar , Neelamegarajan Devi
Published: July 2024

Background

Music learning induces significant neural changes, enhancing auditory, verbal, and visuospatial skills, IQ, and speech perception. Research studies reveal structural and functional brain plasticity due to music training in adults and children. While musical abilities are linked to formal training, the existence of “musical sleepers” with heightened speech perception without formal training is noteworthy in adults. This study addresses the gap in understanding such phenomena in children, exploring psychophysical abilities in musically adept children, and aiming to impact rehabilitation models.

Materials and method

A pre-experimental study involved 164 typically developing children (mean age: 9.93) without musical training. Musical abilities were evaluated using the abbreviated version of Montreal Battery for Evaluation of Musical Abilities (MBEMA) test in DMDX software, covering melody, rhythm, and memory subtests. Psychophysical tests in MATLAB assessed temporal, frequency, intensity, timbre, and binaural resolution.

Results

Using a median split based on MBEMA test scores (median: 42), 84 children exhibited poor musical abilities, while 80 showed good ones. Descriptive statistics for MBEMA scores and psychophysical tests were conducted. As data did not follow normal distribution, non-parametric inferential statistics were employed.

Mann–Whitney U tests revealed significant differences favouring good musical abilities in all assessments: gap deduction (p = 0.01), pitch discrimination at 500 Hz and 4 kHz (p = 0.00), intensity discrimination at 500 Hz (p = 0.00) and 4 kHz (p = 0.01), profile analysis (p = 0.01), interaural level difference (p = 0.023), and interaural time difference (p = 0.038). Spearman correlation showed highest correlation with pitch discrimination at 500 Hz (r =  − 0.538), 4 kHz (− 0.416), intensity discrimination at 4 kHz (r =  − 0.367), and 500 Hz (r =  − 0.311), profile analysis (r =  − 0.313), interaural level difference (r =  − 0.276), and gap deduction (r =  − 0.235). All were significant (p < 0.01), except for the interaural time difference.

Conclusion

Children excelling in music surpassed those with weaker abilities in psychophysical tasks. This echoes past research, underscoring auditory discrimination’s influence on musical skills in untrained children. These results potentially support the concept of musical sleepers in children. Key predictors include pitch discrimination, while interaural time difference exhibited minimal correlation. Utilising such assessments may predict musical training outcomes for children with auditory disorders, but additional robust statistical investigation is necessary.
Anesthetic approach to pregnant patients with malaria: a narrative review of the literature
Authors: Zahavi Itay , Fons Meir , Meir Michal , Volevich Mark , Guasch Emilia , Nunnally Mark , Einav Sharon
Published: July 2024

Introduction

Anesthesiologists play an important role in the management of labor and delivery during acute malaria infection. The peripartum anesthesia considerations for such cases remain unclear.

Findings

Important peripartum considerations include the severity of thrombocytopenia and coagulopathy, hemodynamic status and cardiac disease, and the likelihood of central nervous system (CNS) involvement. Several antimalarial drugs may interact with perioperative medications, causing hypoglycemia, methemoglobinemia, or QT prolongation. Labor should usually not be induced. Patient volume status should be optimized pre-induction, but fluids should be administered with caution given the risk of cerebral edema. In case of CNS involvement intracranial pressure should be maintained. Case reports describe the successful use of neuraxial anesthesia but this approach requires further confirmation of safety. Despite the risks accompanying airway management in pregnancy, in some cases, general anesthesia was preferred due to the chance of CNS infection and disease complications. Tight postoperative assessments of neurological and bleeding status are indicated regardless of the mode of delivery.

Conclusions

Despite the prevalence of malaria, the perioperative risk and preferred mode of anesthesia for pregnant patients with acute malaria remain under-researched and outcome data are limited.
2023 Korean Society of Echocardiography position paper for diagnosis and management of valvular heart disease, part I: aortic valve disease
Authors: Lee Sun Hwa , Yoon Se-Jung , Sun Byung Joo , Kim Hyue Mee , Kim Hyung Yoon , Lee Sahmin , Shim Chi Young , Kim Eun Kyoung , Cho Dong-Hyuk , Park Jun-Bean , Seo Jeong-Sook , Son Jung-Woo , Kim In-Cheol , Lee Sang-Hyun , Heo Ran , Lee Hyun-Jung , Park Jae-Hyeong , Song Jong-Min , Lee Sang-Chol , Kim Hyungseop , Kang Duk-Hyun , Ha Jong-Won , Kim Kye Hun ,   on the behalf of the Korean Valve Survey Investigators, Chung Wook-Jin , Ahn Hyo-Suk , Chung Woo-Baek , Cho Eun Joo , Cho Jung Sun , Ryu Dong Ryeol , Yang Dong Heon , Park Jeong Rang , Kim Woo-Shik , Sohn Il Suk , Na Jin Oh , Park Seong-Mi , Hwang Sun Ho , Choi Ji-Yong , Park Tae-Ho , Park Yong Hyun , Choi Jung Hyun , Kim Hack-Lyoung , Park Jun-Bean , Park Jin-Sun , Choi Eui-Young , Son Jang-Won , Kim Shin-Jae , Rhee Sang Jae , Cho In-Jeong , Byun Young Sup , Seo Jeong-Sook , Shin Sung-Hee , Beom Jong Wook , Lee Ju-Hee , Bae Dae-Hwan , Kim Sung-Ai , Park Dae Gyun , Kang Min-Kyung , Hong Kyung-Soon , Heo Ran
Published: July 2024

This manuscript represents the official position of the Korean Society of Echocardiography on valvular heart diseases. This position paper focuses on the clinical management of valvular heart diseases with reference to the guidelines recently published by the American College of Cardiology/American Heart Association and the European Society of Cardiology. The committee tried to reflect the recently published results on the topic of valvular heart diseases and Korean data by a systematic literature search based on validity and relevance. In part I of this article, we will review and discuss the current position of aortic valve disease in Korea.
Regionalized multiple-point statistical simulation for calibrating process-based geologic models to seismic data
Authors: Hu Lin Ying , Li Yupeng
Published: July 2024

Calibrating process-based geologic models to seismic data is critical and has been challenging for decades. The traditional approach to data calibration involves tuning the model input parameters by trial-and-error or through an automated inverse procedure. This can improve the model calibration to data but can hardly reach a fully satisfactory result. We adopt a multiple-point statistics (MPS) approach where a process-based geologic model is used as a training image for statistical pattern recognition. First, we define a rock-physics model from the process-based geologic model and derive its seismic attributes through seismic forward modeling. Then, we use the process-based model and its seismic attributes as coupled training images for geologic pattern recognition and regeneration under seismic data constraints. The method differs from the conventional MPS method in several ways: (1) the training image is a process-based geologic model of the reservoir of interest, thus defined on the same grid of the reservoir model; (2) the training image is generally nonstationary but there is no need to partition the nonstationary training image into pseudostationary ones; (3) the geologic facies and seismic constraint are related through seismic forward modeling instead of statistical inference, thus there is no need to convert seismic data to facies proportion or probability; (4) multiple-point statistics are based on Bayes’ law and Gaussian kernel approximation of conditional probability instead of a somehow arbitrary probability combination scheme or a heuristic rule; and (5) the method does not involve an iterative optimization procedure. Therefore, it also differs from the neural-network-based machine-learning approach, where the data conditioning is achieved through an iterative optimization procedure. These differences make our method advantageous for calibrating process-based geologic models. The two examples with synthetic data illustrate the effectiveness of the method. The first one is derived from a satellite image of a river delta, and the second one from the Stanford VI reservoir model.
Feasibility of a Smartphone Application for Education and Symptom Management of Patients With Renal Cell Carcinoma on Combined Tyrosine Kinase and Immune Checkpoint Inhibitors
Authors: Roman Souza Gabriel , Turner Kea , Gullapalli Keerthi , Paravathaneni Mahati , Ionescu Filip , Semaan Adele , DeJesus Amayla Budet , Trujillo Gillian , Le Casey , Kim Youngchul , Sun Xiaoqi , Raymond Sarah , Schneider Amy , Manley Brandon , Jain Rohit , Gilbert Scott , Jim Heather S.L. , Spiess Philippe E. , Chahoud Jad
Published: July 2024

PURPOSE

Patients with advanced renal cell carcinoma (RCC) face significant challenges, stemming both from the complexities of the disease itself and the adverse effects of treatments. This study evaluated the feasibility and acceptability of a mobile health (mHealth) application tailored for education and symptom management of patients with advanced RCC receiving combined immune checkpoint inhibitor and tyrosine kinase inhibitor (ICI-TKI) therapy.

METHODS

The primary end points were acceptability and feasibility. Acceptability was defined as the proportion of patients approached who consented to participate, setting a benchmark of at least 50% for this metric. Feasibility was gauged by the completion rate of the intervention among the participants; it required at least 50% of participants to fully complete the intervention and at least 70% to finish half of the administered questionnaires. The secondary end points included knowledge assessment and patient-reported outcomes (PROs). PROs were evaluated using validated instruments. To discern the changes between pre- and post-educational module quiz scores, we used the Wilcoxon signed-rank test. Time-course data of PROs were visualized using line plots and then compared using paired t-tests.

RESULTS

From November 2022 to July 2023, 20 of 22 (90%) patients approached for the study consented and enrolled. Of the enrolled patients, 60% completed all questionnaires and knowledge assessments at every time point and 75% completed at least half of the surveys and questionnaires. Significant pre/post differences were noted in two of six quizzes in the knowledge assessment. This study population did not experience a significant change in PRO scores after starting therapy.

CONCLUSION

The mHealth application designed for education and symptom management in patients with advanced RCC undergoing combination ICI-TKI has proven to be both acceptable and feasible, meeting previous research benchmarks.
An Overview of the Project ECHO—Cervical Cancer Prevention in Mozambique
Authors: Salcedo Mila P. , Cabrera Giovana A. , David Ernestina , Osman Nafissa , Saldanha Virginia A. , Cotiro Manuel F. , Baker Ellen , Neves Andrea , Rangerio Ricardina , Changule Dercia , Varon Melissa L. , Milan Jessica , Uratani Fernanda , Fontes-Cintra Georgia , Lorenzoni Cesaltina , Schmeler Kathleen
Published: July 2024

PURPOSE

Cervical cancer is the most common cancer among women in Mozambique, a Portuguese-speaking country in sub-Saharan Africa. There is a shortage of health care providers to diagnose and treat preinvasive cervical disease. Therefore, training and mentoring to perform colposcopy, cervical biopsy, ablation and loop electrosurgical excision procedure (LEEP) is imperative. The purpose of this study is to describe our program to date.

METHODS

Our team of physicians, nurses and other health professionals from the United States (US) and Brazil provides in-person training for clinicians in Mozambique supplemented with Project ECHOÂ® (Extension for Community Healthcare Outcomes), a telementoring program to provide virtual support and reinforce and amplify knowledge and skills to build capacity. In-person trainings are held 2-4 times per year. ECHO videoconferences are held monthly with Mozambican clinicians presenting de-identified patient cases for discussion with specialists from the US and Brazil and their peers. Training, lectures and discussions are held in Portuguese. In 2023 we launched a survey to assess the impact of Project ECHO to the participants. The survey covered the applicability of the content discussed in their practice and the content learned during case presentations. Data from the survey were stored in REDcap.

RESULTS

Since February 2019, we have held nine in-person and 16 virtual trainings supplemented with 59 ECHO telementoring sessions, with an average of 53 participants per session. Forty-eight cases were presented and discussed. Respondents included 182 participants. Of the 139 who answered their profession, the majority were nurses (83, 59.8%), followed by doctors (33, 23.7%) and others (23, 16.5%). When asked about applicability of the content discussed in ECHO, the majority agreed/strongly agreed that the content was applicable to their practice (78/79, 98.7%) and that they learned something new during the case presentations (114/116, 98.3%). Lastly, 93.2% (68/73) of responders said that they would make changes to their practice as a result of the Project ECHO participation.

CONCLUSION

Well-trained clinicians for the management of women with abnormal screening tests is critical for improving cervical cancer prevention. The ECHO project model facilitates and extends mentoring and training of healthcare professionals and keeps providers engaged in learning.
Deciphering the Nuclear Role of Heme Oxygenase-1 in Prostate Cancer: Transcriptional Reprogramming and Neuroendocrine Differentiation
Authors: Seniuk Rocio , Sabater Agustina , Pascual Gaston , Sanchis Pablo , Lechuga Julia , Cotignola Javier , Anselmino Nicolas , Vazquez Elba , Labanca Estefania , Toro Ayelén , Gueron Geraldine
Published: July 2024

PURPOSE

This study probes the role of Heme Oxygenase-1 (HO-1) and its nuclear interactors in prostate cancer (PCa). Previous results, demonstrated the anti-tumoral role of HO-1 in PCa and its nuclear translocation, hinting at its potential regulatory roles within the nucleus. Thus, we postulate that HO-1, alongside its interactors, can reprogram PCa cells to a less aggressive phenotype.

METHODS

From the 11 HO-1 nuclear interacting proteins previously identified, 4 were transcription factors Using ChIP Atlas we evaluated the binding affinity of these factors to their downstream gene targets. Gene ontology and KEGG pathway analyses were then performed to associate these targets with specific biological processes and pathologies. Additionally, RNA-seq data from patient-derived xenografts (PDXs) at MD Anderson Cancer Center (MDA PCa PDXs) were analyzed to evaluate the clinical relevance of these genes in the context of PCa heterogeneity. These PDXs offer a clinically relevant model due to their representation of the disease's heterogeneity. We scrutinized the expression of the gene clusters of interest in PDXs, including their association with neuroendocrine (NE) phenotypes.

RESULTS

The transcription factors among the HO-1 interactors previously described, were found to bind genes enriched in processes related to histone modification, acetylation, and transcription termination, implicating their role in gene expression regulation. KEGG pathways linked these genes to neurodegenerative diseases (including Parkinson's, Huntington's, and Alzheimer's disease), mirroring the neuroendocrine (NE) phenotype in advanced PCa, which typically emerges in advanced stages and is characterized by the transdifferentiating of epithelial cells into NE cells lacking androgen receptor expression. The unsupervised clustering of gene expression from PDXs showed that high expression of these genes is associated with an AR-negative NE histopathology, suggesting a potential for these interactors in prostate cancer subtyping.

CONCLUSION

HO-1 nuclear interactors, especially transcription factors, appear to influence gene transcription associated with NE differentiation and cancer aggressiveness. The therapeutic relevance of modulating HO-1's interaction with its nuclear partners warrants further investigation to ascertain its role in mitigating the NE of PCa.
Enhancing Cancer Care in Ukraine: Insights From Doctor Perspectives on Diagnosis and Treatment Quality
Authors: Liakh Anastasiia , Dzhemiliev Ali , Antoniv Marta , Naumova Marta , Kopetskyi Viacheslav , Huivaniuk Inesa , Beznosenko Andriy , Melnitchouk Nelya , Kizub Darya
Published: July 2024

PURPOSE

Optimizing cancer care, including during the time of war, often begins with a needs assessment. We surveyed oncologists in Ukraine to evaluate existing gaps and describe strategies to address them.

METHODS

In January 2024, medical and surgical oncologists in Ukraine completed electronic surveys that were designed together with oncologists at the National Cancer Institute of Ukraine. These surveys included an open-ended question about how to improve the efficiency and quality of cancer care in one's practice. Surveys were distributed through oncology-focused social media in Ukraine. Data was analyzed using thematic analysis and descriptive statistics.

RESULTS

Fifty-three medical oncologists completed the survey. The most common suggestion for optimizing cancer care is improving provision of targeted cancer treatments and immunotherapy, cited by 19 (35.8%). Eighteen (34.0%) suggested ameliorating personnel shortages), while 10 (18.9%) desired an increased number of machines for chemotherapy infusion and 6 (11.3%) requested greater hospital bed capacity. Eighty-eight surgical oncologists completed the survey. The most common suggestion for improvement was increasing availability of disposable surgical kits and instruments, catheters, and drainage systems, cited by 23 (26.1%). Other common recommendations included more consistent provision of surgical equipment cited by 20 (22.72%), increasing the number of number of surgical staff cited by 13 (14.77%), improved healthcare facility funding cited by 12 (13.64%), increasing the quantity of operating rooms by 9 (10.23%), improved surgical staff training cited by 9 (10.23%), and reduced paperwork for surgeons recommended by 2 (2.27%).

CONCLUSION

We identified important gaps in medical and surgical oncology care in Ukraine, as well as strategies to address these from the point of view of physicians working in these areas. Results are limited by online convenience sampling.
Exploring the Lived Experiences of Colorectal Cancer Patients With Diagnosis and Treatment in Egypt: A Qualitative Interview Study
Authors: Gebreal Assem , Helmi Muhammed , Kolkas Samr , Khaled Aya , Tarek Omar , Hesham Omar , Foaud Omnia , Adel Yara , Hussin Omnia , Mahmoud Hamza , Khamess Somaia , Hansen Barbara , Abdeltawab Karim , Arafat Waleed , Foaud Mona , Ebied Mahmoud , Mansour Maryam , Bassiony Mahmoud , Mikhail Karim , Bateman Lori
Published: July 2024

PURPOSE

Colorectal cancer (CRC) is a major health challenge in Egypt with an alarming 46.4% early-onset rate in people younger than 50 years and an overall 2 years of survival post-diagnosis. Understanding patient's experiences is necessary to enhance health outcomes. This study aims to explore patients' lived experiences of diagnoses, treatment, and perceptions of a healthy diet and physical activity.

METHODS

The Social Ecological Model (SEM), exploring variable-specific barriers and facilitators at individual, interpersonal, organizational, community, and policy levels, served as our theoretical framework. One-hour, face-to-face, semi-structured interviews were conducted with CRC patients in Alexandria, Egypt, between August and September 2023. Audio recorded interviews were transcribed and analyzed by thematic analysis.

RESULTS

Our study involved 19 participants;12 males and 7 females with a mean age of 53 years. All participants came from low-income backgrounds, 70% were urban residents, 80% were unemployed, and 52% were either illiterate or had not completed their primary education. Nearly half of the participants were in advanced cancer stage (stage 3 or higher). We identified facilitators and barriers to optimal care in patients experiences at several levels of the SEM. The main barriers were as follows: at the individual level, lack of CRC awareness and neglect of symptoms, fear of colonoscopy, loss of appetite, decreased physical activity, and being unemployed during treatment; at the health services organization level, misdiagnosis, negative colonoscopy experiences, and a lack of comprehensive treatment guidance. The main facilitators perceived by the participants were as follows: at the individual level, resilience in accepting diagnosis and treatment, and appreciation of the healthcare team; at the interpersonal level, social support from family, neighbors, and other patients; at the health services organization level, seamless and free access to oncology care, provider recommendations for a healthy diet and physical activity; and at the community level, religious faith in accepting one's destiny.

CONCLUSION

The findings of this study emphasize the need for early detection of CRC through screening programs and health campaigns for cancer symptoms awareness. It is also crucial to improve healthcare teams' communication with patients to ensure a higher likelihood of a positive experience.
Longitudinal Health-Related Quality of Life Among Patients With High-Risk Pediatric Hodgkin Lymphoma Treated on the Children's Oncology Group AHOD 1331 Study
Authors: Williams AnnaLynn M. , Rodday Angie Mae , Pei Qinglin , Henderson Tara O. , Keller Frank G. , Punnett Angela , Kelly Kara M. , Castellino Sharon M. , Parsons Susan K.
Published: July 2024

PURPOSE

There have been no previous longitudinal assessments of health-related quality of life (HRQoL) during treatment for pediatric Hodgkin lymphoma (HL). The addition of brentuximab vedotin (BV) to a multidrug chemotherapy backbone demonstrated superior efficacy to standard chemotherapy for patients with pediatric high-risk HL in the AHOD 1331 trial. However, the impact on HRQoL is unknown.

PATIENTS AND METHODS

After treatment random assignment, 268 participants older than 11 years were enrolled in a prespecified, longitudinal, patient-reported outcomes substudy. HRQoL was assessed using the seven-item Child Health Ratings Inventories (CHRIs)–Global scale before treatment (T1) and at cycle 2 (T2), cycle 5 (T3), and end of treatment (T4). A clinically meaningful increase in HRQoL was considered 7 points on the CHRIs-Global. Multivariable linear regression estimated associations between demographic/clinical variables and HRQoL at T1. Linear mixed models estimated changes in HRQoL across the treatment arm.

RESULTS

Participant characteristics were balanced by treatment arm. Ninety-three percent of participants completed the CHRIs at T1, 92% at T2, 89% at T3, and 77% at T4. At T1, female sex and fever (
P
< .05) were each associated with worse HRQoL. By T2, participants in the BV arm experienced a statistically and clinically significant improvement in HRQoL (β = 7.3 [95% CI, 3.2 to 11.4];
P
≤ .001), which was greater than the change in the standard arm (difference in change β = 5.1 [95% CI, −0.2 to 10.3];
P
= .057). The standard arm did not experience a statistically or clinically significant increase in HRQoL until T4 (β = 9.3 [95% CI, 4.7 to 11.5];
P
< .001).

CONCLUSION

These data demonstrate successful collection of serial HRQoL from youth with high-risk pediatric HL and improvement in HRQoL over the course of initial therapy, sooner and to a greater extent in the group receiving the novel agent BV.
Use of a Smartphone Application to Promote Adherence to Oral Medications in Patients With Breast Cancer
Authors: Sathe Claire , Raghunathan Rohit , Ulene Sophie , McAuley Fiona , Bhatt Kishan A. , McGuinness Julia E. , Trivedi Meghna S. , Vasan Neil , Kalinsky Kevin M. , Crew Katherine D. , Faheem Khadija F. , Harden Erik , Law Cynthia , Hershman Dawn L. , Accordino Melissa K.
Published: July 2024

PURPOSE

Medication nonadherence is common among patients with breast cancer (BC) and increases BC mortality and complications from comorbidities. There is growing interest in mobile health interventions such as smartphone applications (apps) to promote adherence.

METHODS

Use of Medisafe, a medication reminder and tracking app, was tested over 12 weeks among patients on BC treatment and at least one oral medication. Study participants were instructed to generate adherence reports every 4 weeks through Medisafe and were deemed to have completed the intervention if >50% of reports were generated. The primary end point was feasibility of the intervention, defined as a completion rate of ≥75% of consented patients. Secondary end points included changes in self-reported nonadherence from baseline to 12 weeks and patient-reported outcomes including reasons for nonadherence and satisfaction with Medisafe. We conducted univariable and multivariable analyses to evaluate demographic and clinical factors associated with intervention completion.

RESULTS

Among 100 patients enrolled, 78 (78.0%) completed the intervention. Age, race, ethnicity, clinical stage, and type of medication were not associated with odds of intervention completion. Self-reported nonadherence rates did not improve from baseline to postintervention in the overall study population. However, among patients with self-reported nonadherence at baseline, 26.3% reported adherence postintervention; these patients frequently reported logistical barriers to adherence. Study participants reported high levels of satisfaction with Medisafe, noting that the app was highly functional and provided high-quality information.

CONCLUSION

Smartphone apps such as Medisafe are feasible and associated with high patient satisfaction. They may improve adherence in nonadherent patients and those who face logistical challenges interfering with medication-taking. Future trials of mobile health interventions should target patients at high risk for medication nonadherence.
Both orbital and spin torques originate from r × g
Authors: Crimin Frances , Barnett Stephen M.
Published: July 2024

Does the cross-product of the position and the electromagnetic momentum density, g, include the optical spin momentum? We answer this long-standing question in the affirmative by evaluating, explicitly, the torque exerted on a particle by a beam of light carrying angular momentum.
Clinical and Biochemical Data for the Diagnosis of Endogenous Hypercortisolism: The “Cushingomic” Approach
Authors: Ceccato Filippo , Bavaresco Alessandro , Ragazzi Eugenio , Barbot Mattia , Boscaro Marco , Basso Daniela , Scaroni Carla , Antonelli Giorgia
Published: July 2024

Context

The clinical presentation of Cushing syndrome (CS) overlaps with common conditions. Recommended screening tests are serum cortisol after 1-mg overnight dexamethasone suppression test (DST), urinary free cortisol (UFC), and late-night salivary cortisol (LNSC).

Objective

We analyzed the diagnostic accuracy of screening tests in 615 patients without CS (263 suspected CS, 319 adrenal and 33 pituitary incidentaloma) and 40 with CS.

Methods

Principal component analysis, K-means clustering, and neural network were used to compute an integrated analysis among tests, comorbidities, and signs/symptoms of hypercortisolism.

Results

The diagnostic accuracy of screening tests for CS was high; DST and UFC were slightly superior to LNSC. The threshold of DST should be adapted to the population considered, especially in adrenal incidentaloma (AI) with mild autonomous cortisol secretion: The cutoff to differentiate CS should be increased to 196 nmol/L. Diabetes, hypertension, and obesity were more common in patients without CS: The direction of their vectors was not aligned and their correlation with screening tests was poor. Clustering allowed us to differentiate those patients without CS into cluster 1 (aged osteoporotic patients with impaired screening tests), cluster 2 (hypertensive and metabolic phenotype), and cluster 3 (young individuals with a low likelihood of overt CS). A neural network model that combined screening tests and clinical presentation was able to predict the CS diagnosis in the validation cohort with 99% precision and 86% accuracy.

Conclusion

Despite the high diagnostic accuracy of screening tests to detect CS, cortisol-related comorbidities or AI should be considered when interpreting a positive test.
Cardiometabolic Risk Markers in Children With Obesity and Variants in MC4R Pathway-related Genes
Authors: Salama Mostafa , Pinto e Vairo Filippo , Hentz Roland , Al Nofal Alaa , Hassan Sara , Ibrahim Samar H , Lteif Aida , Creo Ana , Pittock Siobhan , Kumar Seema
Published: July 2024

Context

Variants in melanocortin 4 receptor (MC4R) pathway-related genes have been associated with obesity. The association of these variants with cardiometabolic parameters are not fully known.

Objective

We compared the severity of obesity and cardiometabolic risk markers in children with MC4R pathway-related clinically reported genetic variants relative to children without these variants.

Methods

A retrospective chart review was performed in children with obesity who underwent multigene panel testing for monogenic obesity.

Results

Data on a total of 104 children were examined, with 93 (89%) identified as White. Thirty-nine (37.5%) patients had clinically reported variants in the MC4R pathway, and the remaining 65 patients did not have reported MC4R pathway-related variants. Among the MC4R-related variants, PCSK1 risk alleles were most common, reported in 15 children (14%). The maximum body mass index percent of the 95th percentile was not different between groups (P = .116). Low-density lipoprotein cholesterol (LDL-C) was not different between groups (P = .132). However, subgroup analysis demonstrated higher LDL cholesterol in children with the PCSK1 c.661A>G risk allele relative to those with MC4R-related variant of uncertain significance (P = .047), negative genetic testing (P = .012), and those with non-MC4R related variants (P = .048). The blood pressure, fasting glucose, hemoglobin A1C, total cholesterol, alanine transaminase, and high-density lipoprotein cholesterol were not different between groups.

Conclusion

Variants in the MC4R pathway-related genes were not associated with severity of obesity and cardiometabolic risk markers except for the c.661A>G PCSK1 risk allele, which was associated with higher LDL-C levels.
Integrative multi-omics increase resolution of the sea urchin posterior gut gene regulatory network at single-cell level
Authors: Voronov Danila , Paganos Periklis , Magri Marta S. , Cuomo Claudia , Maeso Ignacio , Gómez-Skarmeta Jose Luis , Arnone Maria Ina
Published: July 2024

Drafting gene regulatory networks (GRNs) requires embryological knowledge pertaining to the cell type families, information on the regulatory genes, causal data from gene knockdown experiments and validations of the identified interactions by cis-regulatory analysis. We use multi-omics involving next-generation sequencing to obtain the necessary information for drafting the Strongylocentrotus purpuratus (Sp) posterior gut GRN. Here, we present an update to the GRN using: (1) a single-cell RNA-sequencing-derived cell atlas highlighting the 2 day-post-fertilization (dpf) sea urchin gastrula cell type families, as well as the genes expressed at the single-cell level; (2) a set of putative cis-regulatory modules and transcription factor-binding sites obtained from chromatin accessibility ATAC-seq data; and (3) interactions directionality obtained from differential bulk RNA sequencing following knockdown of the transcription factor Sp-Pdx1, a key regulator of gut patterning in sea urchins. Combining these datasets, we draft the GRN for the hindgut Sp-Pdx1-positive cells in the 2 dpf gastrula embryo. Overall, our data suggest the complex connectivity of the posterior gut GRN and increase the resolution of gene regulatory cascades operating within it.
Spatial resolution and optical sensitivity in the compound eyes of two common European wasps, Vespula germanica and Vespula vulgaris
Authors: Gutiérrez Daniel , Rigosi Elisa , Nagloo Nicolas , O'Carroll David , Warrant Eric J.
Published: July 2024

Vespula germanica and Vespula vulgaris are two common European wasps that have ecological and economic importance as a result of their artificial introduction into many different countries and environments. Their success has undoubtedly been aided by their capacity for visually guided hunting, foraging, learning and using visual cues in the context of homing and navigation. However, the visual systems of V. germanica and V. vulgaris have not received any deep attention. We used electrophysiology, together with optical and anatomical techniques, to measure the spatial resolution and optical sensitivity of the compound eyes of both species. We found that both wasps have high anatomical spatial resolution with narrow interommatidial angles (Δϕ between 1.0 and 1.5 deg) and a distinct acute zone in the fronto-ventral part of the eye. These narrow interommatidial angles are matched to photoreceptors having narrow angular sensitivities (acute zone acceptance angles Δρ below 1.3 deg), indicating eyes of high spatial resolution that are well suited to their ecological needs. Additionally, we found that both species possess an optical sensitivity that is typical of other day-flying hymenopterans.
Wind gradient exploitation during foraging flights by black skimmers (Rynchops niger)
Authors: Mendez Laura X. , Hedrick Tyson L.
Published: July 2024

Birds commonly exploit environmental features such as columns of rising air and vertical windspeed gradients to lower the cost of flight. These environmental subsidies may be especially important for birds that forage via continuous flight, as seen in black skimmers. These birds forage through a unique behavior, called skimming, where they fly above the water surface with their mandible lowered into the water, catching fish on contact. Thus, their foraging flight incurs costs of moving through both air and water. Prior studies of black skimmer flight behavior have focused on reductions in flight cost due to ground effect, but ignored potential beneficial interactions with the surrounding air. We hypothesized a halfpipe skimming strategy for skimmers to reduce the foraging cost by taking advantage of the wind gradient, where the skimmers perform a wind gradient energy extraction maneuver at the end of a skimming bout through a foraging patch. Using video recordings, wind speed and wind direction measurements, we recorded 70 bird tracks over 4 days at two field sites on the North Carolina coast. We found that while ascending, the skimmers flew more upwind and then flew more downwind when descending, a pattern consistent with harvesting energy from the wind gradient. The strength of the wind gradient and flight behavior of the skimmers indicate that the halfpipe skimming strategy could reduce foraging cost by up to 2.5%.
Η ανάπτυξη της ενσυνειδητότητας και της ψυχολογικής ευημερίας
Authors: Κυβέλου Αγγελική
Published: July 2024

Η έρευνα, η οποία πραγματοποιήθηκε στο πλαίσιο της παρούσας διδακτορικής διατριβής αποσκοπούσε στο να διερευνήσει αν ένα Πρόγραμμα Παρέμβασης, βασισμένο στην προσέγγιση Gestalt και σε ασκήσεις mindfulness (ενσυνειδητότητας), επιφέρει ευεργετικές επιδράσεις στην ψυχολογική ευημερία φοιτητικού πληθυσμού. Το Πρόγραμμα Παρέμβασης αφορούσε στην υλοποίηση «Ομάδας Προσωπικής Ανάπτυξης» και αποσκοπούσε στην ανάπτυξη της επίγνωσης των συμμετεχόντων. Στην έρευνα συμμετείχαν 208 φοιτητές/τριες του Χαροκοπείου Πανεπιστημίου, από της/ές οι 148 αποτέλεσαν την Ομάδα Παρέμβασης και οι 60 την Ομάδα Ελέγχου. Όλοι/ες οι συμμετέχοντες/ουσες συναίνεσαν και συμπλήρωσαν ερωτηματολόγια μια εβδομάδα πριν την έναρξη καθώς και μια εβδομάδα μετά τη λήξη του δέκα εβδομάδων Προγράμματος Παρέμβασης. Στόχος της έρευνας ήταν να εξετάσει αν το εν λόγω πρόγραμμα παρέμβασης βελτιώνει: α) την επίγνωση των συμμετεχόντων/ουσών σε αυτό και β) της δείκτες ψυχολογικής ευημερίας των φοιτητών της: την Ενσυνειδητότητα, Επίγνωση και Προσοχή, τη Συναισθηματική Νοημοσύνη, την Αυτοσυμπόνια, την Υποκειμενική Ευτυχία, την Ικανοποίηση από τη Ζωή, το Στρες, το Άγχος και την Κατάθλιψη, το Θετικό και Αρνητικό Συναίσθημα, τη Ρύθμιση Συναισθήματος και την Περιέργεια και την Ενεργητική Διερεύνηση. Τα αποτελέσματα της έρευνας δείχνουν ότι οι συμμετέχοντες/ουσες στην «Ομάδα Προσωπικής Ανάπτυξης» βελτίωσαν το επίπεδο ενσυνειδητότητας και όλους σχεδόν της δείκτες που χρησιμοποιήσαμε για να αξιολογήσουμε την ψυχολογική ευημερία. Επιπλέον, φαίνεται ότι παρουσιάζεται θετική συσχέτιση της Ενσυνειδητότητας, Επίγνωσης και Προσοχής με τη συνολική Συναισθηματική Νοημοσύνη και την Ικανοποίηση από τη Ζωή. Τα ευρήματα της παρούσας έρευνας μπορούν να συμβάλλουν στην ανάπτυξη και εφαρμογή μελλοντικών παρεμβάσεων, στηρίζοντας την ακαδημαϊκή ζωή και την ανάπτυξη της ευημερίας των φοιτητών/τριών.
The genome sequence of the Hungarian meadow viper, Vipera ursinii rakosiensis Méhely, 1893
Authors: Halpern Bálint , Vörös Judit , Mc Cartney Ann M. , Formenti Giulio , Mouton Alice ,   Wellcome Sanger Institute Tree of Life Management, Samples and Laboratory team,   Wellcome Sanger Institute Scientific Operations: Sequencing Operations,   Wellcome Sanger Institute Tree of Life Core Informatics team,   Tree of Life Core Informatics collective
Published: July 2024

We present a genome assembly from an individual female Vipera ursinii rakosiensis (the Hungarian meadow viper; Chordata; Lepidosauria; Squamata; Viperidae). The genome sequence is 1,625.0 megabases in span. Most of the assembly is scaffolded into 19 chromosomal pseudomolecules, including the W and Z sex chromosomes. The mitochondrial genome has also been assembled and is 17.38 kilobases in length.
The genome sequence of the Common February Red Stonefly, Brachyptera risi (Morton, 1896)
Authors: Skipp Susan J. , Macadam Craig R. ,   Natural History Museum Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life Management, Samples and Laboratory team,   Wellcome Sanger Institute Scientific Operations: Sequencing Operations,   Wellcome Sanger Institute Tree of Life Core Informatics team,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium, Price Benjamin W.
Published: July 2024

We present a genome assembly from an individual male Brachyptera risi (the Common February Red Stonefly; Arthropoda; Insecta; Plecoptera; Taeniopterygidae). The genome sequence spans 680.20 megabases. Most of the assembly is scaffolded into 14 chromosomal pseudomolecules, including the X sex chromosome. The mitochondrial genome has also been assembled and is 15.58 kilobases in length.
The genome sequence of the Northern Bottlenose Whale, Hyperoodon ampullatus (Forster, 1770)
Authors: Feyrer Laura Joan , de Greef Evelien ,   Wellcome Sanger Institute Tree of Life Management, Samples and Laboratory team,   Wellcome Sanger Institute Scientific Operations: Sequencing Operations,   Wellcome Sanger Institute Tree of Life Core Informatics team,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: July 2024

We present a genome assembly from an individual female Hyperoodon ampullatus (the Northern Bottlenose Whale; Chordata; Mammalia; Artiodactyla; Ziphiidae). The genome sequence spans 2,828.70 megabases. Most of the assembly is scaffolded into 21 chromosomal pseudomolecules, including the X sex chromosome. The mitochondrial genome has also been assembled and is 16.34 kilobases in length.