bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of the Revised 2022 European LeukemiaNet Risk Stratification in Adult Patients with Acute Myeloid Leukemia
Authors: Ruhnke Leo , Bill Marius , Zukunft Sven , Eckardt Jan-Niklas , Schäfer Silvia , Stasik Sebastian , Hanoun Maher , Schroeder Thomas , Fransecky Lars , Steffen Björn , Krause Stefan W , Scholl Sebastian , Hochhaus Andreas , Sauer Tim , Kraus Sabrina , Schäfer-Eckart Kerstin , Kaufmann Martin , Jost Edgar , Brümmendorf Tim H. , Schliemann Christoph , Mikesch Jan-Henrik , Krug Utz , Hänel Mathias , Morgner Anke , Schaich Markus , Neubauer Andreas , Repp Roland , Niemann Dirk , Seggewiss-Bernhardt Ruth , Meinhardt Achim , Kullmer Johannes , Kaiser Ulrich , Blau Wolfgang , Kiani Alexander , Grigoleit Götz Ulrich , Giagounidis Aristoteles , Wurm Alexander Arthur , Altmann Heidi , Middeke Jan Moritz M , Schetelig Johannes , Müller-Tidow Carsten , Stölzel Friedrich , Baldus Claudia D. , Platzbecker Uwe , Serve Hubert , Bornhäuser Martin , Thiede Christian , Röllig Christoph
Published: November 2024

In 2022, the European LeukemiaNet (ELN) risk stratification for patients with AML has been updated. We aimed to validate the prognostic value of the 2022 ELN classification (ELN22) evaluating 1,570 newly diagnosed AML patients (median age, 56 years) treated with cytarabine-based intensive chemotherapy regimens. As compared to the 2017 ELN classification (ELN17), allocating 595 (38%), 413 (26%) and 562 (36%) patients to the favorable, intermediate and adverse risk category, ELN22 risk was favorable, intermediate, and adverse in 575 (37%), 410 (26%), and 585 (37%) patients, respectively. Risk group allocation was revised in 340 patients (22%). Most patients were re-classified into ELN22 intermediate or ELN22 adverse risk group. The allocation of patients according to the ELN22 risk categories resulted in a significantly distinct event-free survival (EFS), relapse-free survival (RFS), and overall survival (OS). As compared to ELN17, reallocation according to the ELN22 recommendations resulted in a significantly improved prognostic discrimination for OS (3-year area under the curve (AUC) 0.71 vs. 0.67). In patients with ELN22 favorable risk AML, co-occurring MR gene mutations did not significantly impact outcome. Within the ELN22 adverse risk group, we observed marked survival differences across mutational groups (5-year OS rate of 21% and 3% in patients with myelodysplasia-related (MR) gene mutations and TP53-mutated patients, respectively). In patients harboring MR gene mutations, EZH2-, STAG2- and ZRSR2-mutated patients showed an intermediate-like OS. In patients with secondary AML and those who underwent allogeneic HCT, EFS and OS significantly differed between ELN22 risk groups, while prognostic abilities of ELN17 and ELN22 classifications were similar. In conclusion, the ELN22 risk stratification improves prognostic discrimination in a large cohort of intensively treated AML patients. Given the heterogeneous outcome in patients with MR gene alterations, ranging between those of intermediate and adverse risk patients, we suggest reevaluation of risk allocation in these patients.
Use of Affimer technology for inhibition of α2-antiplasmin and enhancement of fibrinolysis
Authors: Pechlivani Nikoletta , Alsayejh Basmah , Almutairi Mansour , Simmons Katie , Gaule Thembaninkosi , Phoenix Fladia , Kietsiriroje Noppadol , Ponnambalam Sreenivasan , Duval Cédric , Ariëns Robert A.S. , Tiede Christian , Tomlinson Darren C. , Ajjan Ramzi A.
Published: November 2024

Hypofibrinolysis is a documented abnormality in conditions with high risk of vascular occlusion. A key inhibitor of fibrinolysis is α2-antiplasmin (α2AP), and we hypothesize that the Affimer technology, comprising small conformational proteins with 2 9-amino-acid variable regions, can be used to modulate α2AP activity and facilitate fibrinolysis. Using a phage display system, a library of Affimers was screened against α2AP. A total of 28 α2AP-specific Affimers were isolated, of which 1, termed Affimer A11, inhibited protein function and enhanced fibrinolysis. Affimer A11 displayed a monomeric form and consistently reduced the lysis time of clots made from plasma samples of individuals with type 2 diabetes mellitus (n = 15; from 150.8 ± 100.9 to 109.8 ± 104.8 minutes) and those with cardiovascular disease (n = 15; 117.6 ± 40.6 to 79.7 ± 33.3 minutes; P < .01 for both groups). The effects of A11 on fibrinolysis were maintained when clots were made from whole blood samples. Mechanistic studies demonstrated that A11 did not affect clot structure or interfere with the incorporation of α2AP into fibrin networks but significantly enhanced plasmin activity and accelerated plasmin generation. Affimer A11 reduced α2AP binding to plasmin(ogen), whereas molecular modeling demonstrated interactions with α2AP in an area responsible for binding to plasminogen, explaining the effects on both plasmin activity and generation. Affimer A11, at 0.15 to 0.60 mg/mL, had the ability to bind 70% to 90% of plasma α2AP. In conclusion, we demonstrate that Affimers are viable tools for inhibiting α2AP function and facilitating fibrinolysis, making them potential future therapeutic agents to reduce thrombosis risk.
Donor age contributes more to the rheological properties of stored red blood cells than donor sex and biological age distribution
Authors: Mykhailova Olga , Brandon-Coatham Mackenzie , Hemmatibardehshahi Sanaz , Yazdanbakhsh Mahsa , Olafson Carly , Yi Qi-Long , Kanias Tamir , Acker Jason P.
Published: November 2024

The quality of stored red cell concentrates (RCCs) has been linked to the biological age distribution of red blood cell (RBC) subpopulations. Teenage male RCCs contain higher proportions of biologically old RBCs, with poorer quality. This study sought to assess the contribution of donor sex and age on the deformability characteristics of RBC subpopulations in stored RCCs. On days 5, 14, 28, and 42 of hypothermic storage, RCCs from healthy teenage male (n = 15), senior male (n = 15), teenage female (n = 15), and senior female (n = 15) donors were biologically age profiled. The deformability of the resulting young RBCs and old RBCs (O-RBCs) was assessed using ektacytometry. Over storage, donor age was the biggest factor influencing the rheology of RBC subpopulations. Teenage male RCCs had the largest reduction in Ohyper (osmolality in the hypertonic region corresponding to 50% of the maximum RBC elongation [EImax]). The strongest correlations between Ohyper and mean corpuscular hemoglobin content (R2 > 0.5) were witnessed with O-RBCs from senior donors, and to a lesser extent with teenage males. Teen O-RBCs, particularly from males, had higher elongation indices, both under isotonic conditions and in the presence of an increasing osmotic gradient. Teen RBCs, regardless of biological age, were discovered to be more rigid (higher shear stress required to reach half the EImax). Donor variation in the age distribution of RBC subpopulations and its downstream effect on deformability serves as further evidence that factors beyond storage could potentially affect RCC quality and transfusion outcomes.
A systematic review of poeciliid fish invasions in Africa
Authors: Pritchard Cairns Joshua , de Bragança Pedro Henrique Negreiros , South Josie
Published: November 2024

Background

This review compiles and synthesises the existing information concerning non-native poeciliid introductions to Africa. The recent upsurge in research on invasive poeciliids has revealed their widespread occurrence in Africa.

Results

Within the 87 relevant articles, 74% reported on the presence of Gambusia spp., 33% on P. reticulata, 19% on X. hellerii, 11% on X. maculatus, and 5% on other ornamental poeciliids. Overall, poeciliids have been documented as introduced to 25 different countries in Africa. With Gambusia spp. being introduced to 16 countries and P. reticulata to 19 countries. Our results are representative of the current state of research on invasive poeciliids in Africa. There was a concentration of studies in South Africa, with limited research elsewhere. Current distribution data is relatively patchy, although widespread surveys of multiple river systems in Morocco and South Africa, confirmed widespread and abundant established poeciliid populations. The ecological impacts of invasive poeciliids in Africa remain understudied but evidence indicates deleterious effects on native fish, invertebrates, and amphibians, many of which are critically endangered or endemic.

Conclusion

Current research is limited in reporting from certain countries and ecological impacts. An increased effort to monitor species composition in vulnerable waterbodies, especially in the many African countries where invasive poeciliids are reported, should be completed to reveal further established populations. Future research should prioritise quantifying the ecological impacts of invasive poeciliids in the field and identifying both vulnerable and resistant native ecosystems to guide future management decisions.
Mobile brain imaging in butoh dancers: from rehearsals to public performance
Authors: Theofanopoulou Constantina , Paez Sadye , Huber Derek , Todd Eric , Ramírez-Moreno Mauricio A. , Khaleghian Badie , Sánchez Alberto Muñoz , Barceló Leah , Gand Vangeline , Contreras-Vidal José L.
Published: November 2024

Background

Dissecting the neurobiology of dance would shed light on a complex, yet ubiquitous, form of human communication. In this experiment, we sought to study, via mobile electroencephalography (EEG), the brain activity of five experienced dancers while dancing butoh, a postmodern dance that originated in Japan.

Results

We report the experimental design, methods, and practical execution of a highly interdisciplinary project that required the collaboration of dancers, engineers, neuroscientists, musicians, and multimedia artists, among others. We explain in detail how we technically validated all our EEG procedures (e.g., via impedance value monitoring) and minimized potential artifacts in our recordings (e.g., via electrooculography and inertial measurement units). We also describe the engineering details and hardware that enabled us to achieve synchronization between signals recorded at different sampling frequencies, along with a signal preprocessing and denoising pipeline that we used for data re-sampling and power line noise removal. As our experiment culminated in a live performance, where we generated a real-time visualization of the dancers’ interbrain synchrony on a screen via an artistic brain-computer interface, we outline all the methodology (e.g., filtering, time-windows, equation) we used for online bispectrum estimations. Additionally, we provide access to all the raw EEG data and codes we used in our recordings. We, lastly, discuss how we envision that the data could be used to address several hypotheses, such as that of interbrain synchrony or the motor theory of vocal learning.

Conclusions

Being, to our knowledge, the first study to report synchronous and simultaneous recording from five dancers, we expect that our findings will inform future art-science collaborations, as well as dance-movement therapies.
The cognitive neuroscience and neurocognitive rehabilitation of dance
Authors: Hackney Madeleine Eve , Burzynska Agnieszka Zofia , Ting Lena H.
Published: November 2024

Creative movement, in the form of music- and dance-based exercise and rehabilitation, can serve as a model for learning and memory, visuospatial orientation, mental imagery, and multimodal sensory-motor integration. This review summarizes the advancement in cognitive neuroscience aimed at determining cognitive processes and brain structural and functional correlates involved in dance or creative movement, as well as the cognitive processes which accompany such activities. We synthesize the evidence for the use of cognitive, motor, and cognitive-motor function in dance as well as dance’s potential application in neurological therapy and neurorehabilitation. Finally, we discuss how partnered interaction and sensorimotor integration in dance, and “dancing robots” could shed light on future application of dance as rehabilitation, of dance used in technology and potential mechanisms of benefit from dance-based activities.
Antimicrobial stewardship programs in a Mexican private healthcare system: a self-assessment of core elements
Authors: Bejarano José Iván Castillo , Ondarza Dzoara Laura Lugo , Galindo Juan O Galindo , Rodríguez Daniel Siller , Rosales-González Sara Paulina , González Susana Patricia Cantú , Delgado Jorge Alberto Vera
Published: November 2024

Background

Antimicrobial stewardship programs (ASPs) refer to a set of coordinated actions that improve the quality of care and combat antimicrobial resistance. Currently, information regarding the status of ASPs in Mexico is scarce. We aimed to describe the status of ASPs in 12 hospitals from Christus Muguerza Healthcare System.

Methods

A cross-sectional study was conducted in 12 hospitals, with a previously developed self-assessment tool to calculate each hospital’s ASP development score. The self-assessment tool includes 7 standards with 23 items. Score categories were defined as; high, medium, low, or none. The overall ASP development score was calculated using the proportional weight of each standard. Participating hospitals were divided into 2 groups according to their bed count. Statistical analysis was conducted in Excel program (Microsoft, Redmont, Washington).

Results

12 hospitals completed the self-assessment survey. The median overall ASP development score was 32.3%. The highest overall development scores were observed for hospitals with > 40 beds. The core elements with the lowest development scores were Education and training, and Reporting and feedback. Unlike hospitals with over 40 beds, those with 40 beds or less had a low development score for Hospital leadership support. The core element with the highest development score was Infection prevention and control.

Conclusions

This is the first multicenter assessment of ASPs in Mexico, revealing a high proportion of low-score hospitals. National implementation of ASPs is required to combat antimicrobial resistance.
Description of clinical cases and available diagnostic tools of oropharyngeal syphilis: a systematic review of the literature
Authors: Guarino Pierre , Chiari Francesco , Carosi Carlo , Parruti Giustino , Caporale Claudio Donadio , Presutti Livio , Molteni Gabriele
Published: November 2024

Introduction

Syphilis is a systemic bacterial infection caused by the spirochete Treponema pallidum. Head and neck mucosal manifestations of syphilis can be observed in each and all of primary, secondary and tertiary syphilis, especially in the secondary one. Therefore, oropharynx is an unusual localization of syphilitic lesions, mainly represented by ulcerous lesions, tissue hypertrophy, mucosal patches and cancer-like lesions. Serology is routinely considered the gold standard for the screening and diagnosis of syphilis. However, direct detection is routinely used during polymerase chain reaction (PCR) of oropharyngeal tissue and suspicious cervical lymphadenopathies.

Methods

PRISMA 2020 guidelines were applied to make a systematic literature review with the aim to make an overview of clinical manifestations and diagnostic tools of oropharyngeal syphilitic infection. A computerized MEDLINE search was performed using the PubMed, Web of Science and Cochrane databases.

Results

The intended analysis was based on 38 papers, including a total of 55 cases. The main localization of oropharyngeal infection was the tonsil (71%), followed by lateral and posterior wall of oropharynx (16%). Ulcerous lesions were the most frequently encountered lesions in the primary syphilis (56%) and secondary syphilis (36%), whereas gumma’s lesions were encountered in the tertiary syphilis (57%). Diagnosis based on serological assays was used in combination with non-treponemal methods to determine disease activity (80% cases).

Conclusions

Oropharyngeal syphilis has historically been referred to as the “great imitator” due to its highly variable manifestations, which can resemble malignancies. Physicians have to recognize oropharyngeal luetic features early, in order to set up an effective diagnostic and therapeutic work-up.
Experiences of undergoing internet-delivered cognitive behavioural therapy for climate change-related distress: a qualitative study
Authors: Lindhe Nike , Berg Matilda , Andersson Kali , Andersson Gerhard
Published: November 2024

Background

Internet-delivered cognitive behavioural therapy (ICBT) has previously shown promise in effectively treating climate change-related distress. The aim of the present study was to investigate participants’ experiences of undergoing a novel ICBT program targeting psychological symptoms associated with climate change.

Methods

Telephone interviews were conducted with nine participants who had received eight weeks of ICBT for climate change-related distress. A semi-structured interview guide was used to gather information about participants’ experiences of undergoing treatment. Data were transcribed and analyzed using thematic analysis.

Results

The thematic analysis resulted in three overarching themes: (1) Same old feelings, brand new strategies, (2) Bumps in the road, and (3) Personalized climate engagement. Participants experienced that they had developed new coping strategies for handling their emotions, encountered challenges during the treatment period, and adapted their pro-environmental behaviour to their individual needs and circumstances.

Conclusions

The results indicate that participants were able to utilize the treatment material in different ways, resulting in a variety of emotional, cognitive, and behavioural changes. While the treatment was generally described as helpful, participants also raised some concerns regarding the treatment format. These findings can inform further development of ICBT targeting psychological symptoms associated with climate change.
Intimate partner violence, behaviours associated with risk of HIV acquisition and condom use in married women in Manicaland, East Zimbabwe: An HIV prevention cascade analysis
Authors: Cordeiro Alexandra A. , Moorhouse Louisa , Dadirai Tawanda , Maswera Rufurwokuda , Chang Angela Y. , Nyamukapa Constance , Gregson Simon
Published: November 2024

Background

Intimate partner violence (IPV) is widespread in the WHO African region with generalised HIV epidemics and may contribute to ongoing HIV transmission through its associations with behaviours associated with HIV acquisition risk and low use of prevention methods particularly in marital relationships.

Methods

We conducted a male condom HIV prevention cascade analysis using data from a general-population survey in Manicaland, Zimbabwe (July 2018-December 2019) to develop an understanding of how interventions that reduce IPV might be built upon to also reduce HIV incidence. Multivariable logistic regression was used to measure associations between currently-married HIV-negative women’s experience of IPV and: (1) being in the priority population for HIV prevention methods (i.e. married women engaging in behaviours associated with HIV acquisition risk or with a spouse who engages in similar behaviours or is living with HIV), and (2) male condom use by women in this priority population. Male condom HIV prevention cascades, with explanatory barriers for gaps between successive cascade bars (motivation, access and effective use), were compared for women in the priority population reporting and not reporting IPV.

Results

We found a positive association between IPV and being in the priority population for HIV prevention methods (72.3% versus 58.5%; AOR = 2.26, 95% CI:1.74–2.93). Condom use was low (< 15%) for women in the priority population and did not differ between those reporting and not reporting IPV. The HIV prevention cascades for women reporting and not reporting IPV were similar; both showing large gaps in motivation and capacity to use male condoms effectively. Women reporting motivation and access to male condoms were more likely to report their partner being a barrier to condom use if they experienced IPV (84.8% versus 75.5%; AOR = 2.25, 95% CI:1.17–4.31).

Conclusion

The findings of this study support the case for trials of integrated IPV/HIV prevention interventions that are tailored to improve HIV risk perception among HIV-negative married women and to make condom provision more acceptable for this group.
Inherited privilege? First vs. continuing-generation medical students in Egypt, academic performance, extracurricular training and expectations: a cross-sectional study
Authors: Aboudeif Ayten , Elaraby Youssef , Hany Mohamed , Nasser Sara , Refaat Nadine , Mohamed Yara Gamal , Khalil Reem Youssry , Khabiry Hashim , Raafat Fatma Hussein , Ghazy Nour , Boulos Dina N.K. , Yosef Mostafa
Published: November 2024

Background

The transition to college life is a highly demanding period for all students, especially when enrolling into an academically-challenging field as that of medicine. First-generation medical students represent an overlooked demographic and are thought to be more vulnerable to the stressors of college. This study’s aim is to explore the differences between first and continuing-generation medical students in Egypt regarding their academic performance, extracurricular training opportunities and future expectations.

Methods

Two identical 24-item online questionnaires, in English and Arabic were distributed with five main themes: general demographics, academic performance, extracurricular training opportunities (outpatient clinics, hospitals and operating rooms), future expectations and if participants have relatives in the medical field.

Results

Responses from 1652 eligible respondents from all 36 medical universities in Egypt were received. Continuing-generation medical students achieved a higher cumulative grade, with 46.1% getting an “Excellent” grade compared to only 38.4% in the first-generation. The gap between the two groups was best noted in Year 1 (p-value < 0.001), as continuing-generation medical students were almost twice more likely to score an “Excellent” grade [Odds Ratio = 1.85 (1.48–2.31)]. First-generation group had less training opportunities in clinics (p < 0.001) and operating rooms (p < 0.001). There was a significant difference (p < 0.001) across all three clinical settings in regard to how the training opportunity was acquired. The majority of continuing-generation medical students credited their family members for it. Amongst those who wish to travel, the majority of the first-generation medical students plan to pursue their career in the United States; whereas, most of continuing-generation medical students aimed for the Middle East and Western Europe.

Conclusion

First-generation medical students had lower grades at first mainly due to their lack of awareness of proper resources that were provided by the families of continuing-generation medical students. However, the challenges posed to first-generation medical students prompted the development of higher resilience, enabling them to catch up and even surpass their continuing-generation counterparts. Continuing-generation medical students obtained further extracurricular training (outpatient clinics and operating rooms), accessed mainly through their family members and connections; whereas, first-generation medical students received most of their training by searching for it themselves.
A case study of the development of a valid and pragmatic implementation science measure: the Barriers and Facilitators in Implementation of Task-Sharing Mental Health interventions (BeFITS-MH) measure
Authors: Yang Lawrence H. , Bass Judy K. , Le PhuongThao D , Singh Ritika , Gurung Dristy , Velasco Paola R. , Grivel Margaux M. , Susser Ezra , Cleland Charles M. , Alvarado Rubén , Kohrt Brandon A. , Bhana Arvin
Published: November 2024

Background

Few implementation science (IS) measures have been evaluated for validity, reliability and utility – the latter referring to whether a measure captures meaningful aspects of implementation contexts. We present a real-world case study of rigorous measure development in IS that assesses Barriers and Facilitators in Implementation of Task-Sharing in Mental Health services (BeFITS-MH), with the objective of offering lessons-learned and a framework to enhance measurement utility.

Methods

We summarize conceptual and empirical work that informed the development of the BeFITS-MH measure, including a description of the Delphi process, detailed translation and local adaptation procedures, and concurrent pilot testing. As validity and reliability are key aspects of measure development, we also report on our process of assessing the measure’s construct validity and utility for the implementation outcomes of acceptability, appropriateness, and feasibility.

Results

Continuous stakeholder involvement and concurrent pilot testing resulted in several adaptations of the BeFITS-MH measure’s structure, scaling, and format to enhance contextual relevance and utility. Adaptations of broad terms such as “program,” “provider type,” and “type of service” were necessary due to the heterogeneous nature of interventions, type of task-sharing providers employed, and clients served across the three global sites. Item selection benefited from the iterative process, enabling identification of relevance of key aspects of identified barriers and facilitators, and what aspects were common across sites. Program implementers’ conceptions of utility regarding the measure’s acceptability, appropriateness, and feasibility clustered across several common categories.

Conclusions

This case study provides a rigorous, multi-step process for developing a pragmatic IS measure. The process and lessons learned will aid in the teaching, practice and research of IS measurement development. The importance of including experiences and knowledge from different types of stakeholders in different global settings was reinforced and resulted in a more globally useful measure while allowing for locally-relevant adaptation. To increase the relevance of the measure it is important to target actionable domains that predict markers of utility (e.g., successful uptake) per program implementers’ preferences. With this case study, we provide a detailed roadmap for others seeking to develop and validate IS measures that maximize local utility and impact.
Adoption and perception of prescribable digital health applications (DiGA) and the advancing digitalization among German internal medicine physicians: a cross-sectional survey study
Authors: Cirkel Lasse , Lechner Fabian , Schlicker Nadine , Leipe Jan , Mühlensiepen Felix , Grgic Ivica , Hirsch Martin C. , Kuhn Sebastian , Knitza Johannes
Published: November 2024

Background

Therapeutic digital health applications (DiGAs) are expected to significantly enhance access to evidence-based care. Since 2020, German physicians and psychotherapists have been able to prescribe approved DiGAs, which are reimbursed by statutory health insurance. This study investigates the usage, knowledge and perception of DiGAs as well as the growing digitalization among internal medicine physicians in Germany.

Methods

A web-based survey was distributed at the 2024 annual congress of the German Society for Internal Medicine. Participants could respond by scanning a QR code or directly on a tablet.

Results

A total of 100 physicians completed the survey, with a mean age of 43.4 years. The majority were internal medicine physicians (85%). Of the respondents, 31% had already prescribed DiGAs, and 29% had tested one. Self-rated knowledge of DiGAs was low (median score 3.17/10). The main barriers identified were lack of knowledge about effective implementation (60%), lack of time for patient onboarding (27%), and concerns about patient adherence (21%). However, 92% believed that DiGAs could improve care, and 88% expressed interest in specific digital health training. The majority (64%) stated that digitalization had a positive impact on medical care and 39% of physicians expected their daily workload to decrease due to digitalization. In addition, 38% believed that the physician-patient relationship would improve as a result of digitalization.

Conclusions

While physicians widely acknowledged the potential benefits of DiGAs, adoption and understanding remain limited. Specific training in digital health is crucial to accelerate digitalization in internal medicine.
Sex-specific dietary habits and their association with weight change in healthy adults
Authors: Rein Michal , Elkan Matan , Godneva Anastasia , Dolev Noa Cohen , Segal Eran
Published: November 2024

Background

Dietary intake plays a pivotal role in the prevalence and management of obesity. While women and men exhibit differences in dietary habits and food-related behaviors, sex-based weight loss recommendations are lacking. This study aims to examine the impact of specific foods and food categories on weight reduction in men and women over a two-year period.

Methods

A total of 8,548 participants from the 10K cohort, from 2019 to 2023, were included in the analysis (53.1% women, mean age 51.7 years). Anthropometric measurements and laboratory results were collected at baseline and at the two-year follow-up visit. Dietary assessment was based on daily food intake digitally logged through an application for at least 3 consecutive days at both timepoints. We compared intake of macronutrients, micronutrients, food groups and daily energy consumption between sex and body mass index (BMI) categories at baseline and weight change categories at follow-up. Using linear regression, we assessed the associations between food categories or specific foods and BMI at baseline as well as weight change percentage at follow-up.

Results

Dietary habits varied by BMI and sex. Women and men living with obesity (BMI > 30 kg/m2) reported a greater intake of animal-based protein and lower intake of plant-based proteins and fats at baseline, as compared to participants with normal weight. In linear regression models predicting two-year weight change, including age, income, and baseline weight, the explained variance was 5.6% for men and 5.8% for women. Adding food categories and specific foods increased the explained variance to 20.6% for men and 17.5% for women. Weight reduction in men was linked to daily consumption of an egg (1.2% decrease) and beef (1.5% decrease), while in women, the most pronounced reductions were associated with an apple (1.2% decrease) and cashew nuts (3.4% decrease). Notably, total energy intake changes significantly impacted weight outcomes only in women.

Conclusions

Sex-specific dietary habits significantly influence weight change over time. In men, weight loss was primarily associated with the addition of animal-based protein, while in women, it was linked to caloric deficit and plant-based fat, suggesting that sex-based nutritional interventions may demonstrate greater efficacy.

Trial registration

NCT05817734 (retrospectively registered January 31, 2023).
Societal costs of older adults with low back pain seeking chiropractic care: findings from the BACE-C cohort study
Authors: Maas Esther T. , van der Vossen Brenda L. , van Dongen Johanna M. , Jenks Alan D. , Rubinstein Sidney M.
Published: November 2024

Background

To describe the societal costs during one year of follow-up among older adults seeking chiropractic care due to a new episode of low back pain (LBP), and to determine what factors predict high societal costs in this population.

Methods

Prospective cohort study, within chiropractic private practices (n = 38) in the Netherlands. 223 people ≥ 55 years of age with a new episode of LBP seeking chiropractic care participated. The primary outcome was total societal costs. High societal costs were defined as patients with costs in the top 20th percentile. The final prediction models were obtained using forward selection. Results were presented for the total population and stratified for retirement status. The model’s prognostic accuracy (Hosmer–Lemeshow X2, Nagelkerke’s R2) and discriminative ability [area under the receiver operating curve (AUC)] were assessed, and the models were internally validated using bootstrapping.

Results

The mean total annual societal cost per patient was €5297 [95% confidence interval (CI): 4191–6403]. The biggest cost driver was presenteeism (65% of total costs), and costs were higher among non-retired participants (€7759; 95% CI 6047–9470) than retired participants (€1892; 95% CI 1088–2695). In the total population, younger age [odds ratio (OR): 0.87 for each additional year; 95% CI 0.80–0.95], being male instead of female (OR 2.96; 95% CI 1.19–7.44), less alcohol intake (OR 0.49; 95% CI 0.20–1.19), working instead of retirement (OR 9.37; 95% CI 1.83–48.04), and more disability at baseline (OR 1.08; 95% CI 1.00–1.16) were found to be predictive of high societal costs. Working was found to be the strongest predictor for high societal costs. After internal validation, the model’s fit was good, it’s explained variance was moderate (28%) and their AUCs could be interpreted as moderate (0.85). For non-pensioners, the same predictive factors were identified as for the entire population. The costs for the retired participants showed too little variation to be able to predict high costs.

Conclusions

This study estimated the mean total annual societal cost of older adults seeking chiropractic care due to a new episode of LBP at €5297 (95% CI 4191–6403).These costs were mainly due to high levels of presenteeism, and extensively differed based upon work status.
Applying an osteopathic intervention to improve mild to moderate mental health symptoms: a mixed-methods feasibility randomised trial
Authors: Hope-Bell Josh , Draper-Rodi Jerry , Edwards Darren J.
Published: November 2024

Background

The increasing prevalence of mental health disorders in the United Kingdom necessitates the exploration of novel treatment modalities. This study aimed to assess the feasibility and acceptability of conducting a randomised controlled trial (RCT) evaluating the efficacy of four osteopathic interventions on psychophysiological and mental health outcomes.

Methods

A mixed-methods feasibility study with an explanatory sequential design was implemented. The quantitative phase involved randomising 42 participants into four intervention groups: (1) high-velocity and articulation techniques (HVAT), (2) soft-tissue massage (STM), (3) craniosacral therapy (CST), and (4) a combination approach. Primary outcome measures encompassed recruitment rate, assessment duration, questionnaire completion, intervention attrition, and adverse events. Secondary outcomes included validated assessments of depression, anxiety, stress, psychological flexibility, heart rate variability (HRV), and interoception, administered pre- and post-intervention. Analysis of variance (ANOVA) was employed to evaluate pre-post intervention changes. The qualitative phase comprised semi-structured interviews analysed using thematic analysis.

Results

The study achieved a recruitment rate of 21 eligible participants per month, with 54.8% of respondents meeting eligibility criteria. All 33 participants who completed the study underwent interventions and assessments within the allocated one-hour timeframe, with full questionnaire completion. The attrition rate was 21%. No adverse events were reported. Qualitative analysis revealed positive participant experiences, with themes highlighting good practitioner communication, intervention accessibility, and increased bodily awareness. Some participants found the questionnaire battery burdensome. Exploratory quantitative analyses showed variations in effects across interventions for heart rate variability, interoceptive accuracy, and mental health measures, but these results should be interpreted cautiously due to the small sample size.

Conclusions

This study provides evidence supporting the feasibility and acceptability of a larger-scale RCT investigating osteopathic interventions for individuals presenting with mild psychological symptoms. The preliminary findings suggest potential efficacy in improving mental health outcomes, warranting further investigation.

Trial registration NCT05674071, registered 06/01/2023.
Racing against time: Emergency ambulance dispatches and response times, a register-based study in Region Zealand, Denmark, 2013–2022
Authors: Jensen Josefine Tangen , Møller Thea Palsgaard , Blomberg Stig Nikolaj Fasmer , Ersbøll Annette Kjær , Christensen Helle Collatz
Published: November 2024

Background

The global strain on Emergency Medical Services (EMS) is reflected in the increasing number of emergency ambulance dispatches. Shorter EMS response times have demonstrated some effect on very specific and rare conditions. It is unknown if the increased number of ambulance dispatches compromises response times.

This study aimed to describe trends in emergency ambulance dispatches and response times from 2013 to 2022 in Region Zealand, Denmark. Additionally, it aimed to outline the demographic profile of emergency ambulance patients, including age and comorbidities.

Methods

Using administrative data from the Region Zealand emergency medical dispatch center, a register-based study spanning from January 1, 2013, to December 31, 2022, was conducted. Data were linked with nationwide registries and priority A (emergency), or B (urgent) ambulance dispatches were included.

Trends were examined overall and stratified by catchment areas corresponding to the hospitals with emergency departments in the region. Poisson and ordinal logistic regressions were used to analyze data.

Results

The study encompassed 678,789 emergency ambulance dispatches, with 55.0% priority A and 45.0% priority B. Among these, 667,788 had a valid personal identification number allowing for further analysis. Within the study population, females comprised 48.5%, while 49.1% of patients were 65 years or more. Overall, 47.5% of patients had no comorbidities, while 7.7% and 44.8% had mild and severe comorbidities, respectively.

Emergency ambulance dispatches increased from 56,867 in 2013 to 81,080 in 2022 (143%). Correspondingly, the dispatch incidence rate per 1,000 residents per year increased from 69.2 to 95.5. Stratification by catchment areas revealed significant disparities.

The median response time for priority A dispatches increased from 7 min:14 s in 2013 to 8 min:20 s in 2022 and for priority B dispatches from 12 min:23 s to 15 min:6 s.

Conclusions

From 2013 to 2022, emergency ambulance dispatches both priorities A and B increased in absolute numbers and per 1000 residents per year. Ambulance response times also increased for both priorities during the study period. The study shows regional disparities regarding to the rate of emergency ambulance dispatches and response times indicating challenges in resource distribution in the future for maintaining emergency care standards.
Pre and post diagnostic dementia care in four Scottish prisons
Authors: MacRae Rhoda , Chalmers Natalie , Tolson Debbie , Taylor James , Anderson Kirstin , Thomson Lindsay , Russ Tom
Published: November 2024

Background and purpose

The number of older people in prisons is increasing across the globe. Many have poor physical and mental health, higher prevalence of head injury, cognitive impairment and dementia than found in community populations. Meeting the complex needs of this vulnerable group has become an increasing concern for prison and prison healthcare services. The aim of this multi method qualitative study was to investigate how men with diagnosed or suspected dementia were identified, assessed, and cared for in Scottish prisons. It also explored the lived experience of individuals being assessed for or diagnosed with dementia within four prisons. The data from twenty nine interviews was thematically analysed and used to collaboratively propose principles for dementia care in prison and present the resultant co-designed care pathway.

Results

At the time of data collection almost all the men known to have a dementia diagnosis or suspected dementia had complex health and social care needs, and some were living with advanced dementia. Prison healthcare staff reported taking a ‘case by case’ approach to their pre- and post-diagnostic care. Meeting these prisoner’s needs was complicated by the absence of organisational leads for care of older adults or people with dementia and there was no pathway or model in place to guide staff. Prison healthcare teams often had difficulty accessing specialist community services to support diagnosis. There was a lack of dementia education and knowledge about how to provide pre and post diagnostic dementia care in this setting amongst staff. The findings arising from this research have informed the co-production of two important evidence informed innovations namely a Model of Care and a pre- and post-diagnostic Care Pathway.

Conclusion

This research adds insights critical to understanding the adequacy of current approaches to meeting dementia related needs within the prison setting. To our knowledge this paper offers the first co-produced evidence informed pre- and post- diagnostic dementia care pathway and model of care for use in prisons. These could serve as tools for change that could enable prison healthcare staff to deliver the right care, at the right time, by the right people, and provide an opportunity to assess risk and plan care for the future.
The impact of co-occurring chronic pain and mental health symptoms on adolescent functioning, a cross-sectional survey
Authors: Bateman Sharon , Jordan Abbie , Noel Melanie , Loades Maria , Caes Line
Published: November 2024

Adolescents who experience poor mental health may develop chronic pain. Similarly, those with chronic pain may develop mental health symptoms. Little is known concerning how these co-occurring symptoms are associated with adolescent functioning. Our online cross-sectional quantitative study compared the specific nature of challenges to psychosocial functioning, across 4 groups: (1) adolescents with co-occurring chronic pain and mental health symptoms; (2) adolescents who only experience chronic pain symptoms; (3) adolescents who only experience mental health symptoms, and (4) adolescents who do not report either symptom. Participants completed self-report questionnaires assessing pain experiences, mental health symptoms and psychosocial functioning. After controlling for pain intensity, findings revealed significant differences, in physical, social, and family functioning across all groups. Significantly worse physical functioning was reported by adolescents with co-occurring pain and mental health symptoms and those with pain-only symptoms compared with adolescents with mental health-only symptoms and those without symptoms. Social functioning was significantly worse for adolescents who experienced co-occurring chronic pain and mental health symptoms compared with adolescents who experienced pain-only symptoms, and those with no symptoms. Significantly worse family functioning was reported by adolescents with mental health-only symptoms compared with adolescents reporting pain-only symptoms and no symptoms. Results suggest the combined impact of pain and mental health symptoms mainly influences adolescent social functioning. Future research is needed to develop standardised assessment and treatment plans to facilitate a thorough understanding of symptoms presented by adolescents who experience co-occurring pain and mental health symptoms.

This study identifies that the combined impact of pain and mental health symptoms influences adolescent social functioning when compared to adolescents who experience pain-only or those without symptoms. Research is needed to develop standardised assessment and treatment plans to fully understand the symptoms presented by adolescents with co-occurring symptoms.
Advances in CAR-T therapy for central nervous system tumors
Authors: Zhou Delian , Zhu Xiaojian , Xiao Yi
Published: November 2024

The application of chimeric antigen receptor T-cell therapy in central nervous system tumors has significantly advanced; however, challenges pertaining to the blood-brain barrier, immunosuppressive microenvironment, and antigenic heterogeneity continue to be encountered, unlike its success in hematological malignancies such as acute lymphoblastic leukemia and diffuse large B-cell lymphomas. This review examined the research progress of chimeric antigen receptor T-cell therapy in gliomas, medulloblastomas, and lymphohematopoietic tumors of the central nervous system, focusing on chimeric antigen receptor T-cells targeting antigens such as EGFRvIII, HER2, B7H3, GD2, and CD19 in preclinical and clinical studies. It synthesized current research findings to offer valuable insights for future chimeric antigen receptor T-cell therapeutic strategies for central nervous system tumors and advance the development and application of this therapeutic modality in this domain.
Levodopa is associated with reduced development of new-onset geographic atrophy in patients with age-related macular degeneration
Authors: Chan Kyle S. , Aggarwal Nitika , Lawson Shannon , Boucher Nick , MacCumber Mathew W. , Lavine Jeremy A.
Published: November 2024

Background

Geographic atrophy (GA) is a significant cause of vision loss in patients with age-related macular degeneration (AMD). Current treatments are limited to anti-complement drugs, which have limited efficacy to delay progression with significant risk of complications. Levodopa (L-DOPA) is a byproduct of melanin synthesis that is associated with reduced development of neovascular AMD. In this study, we determined if L-DOPA was associated with a reduced likelihood of new-onset GA.

Methods

We performed a retrospective analysis in the Vestrum Health Retina Database. We included eyes with non-neovascular AMD without GA and 1–5 years of follow-up. Eyes were divided into two groups. Exposed to L-DOPA before or on the date of non-neovascular AMD without GA diagnosis, and eyes not exposed to L-DOPA. We extracted age, sex, AREDS2 status, dry AMD stage, smoking history, and conversion rate to GA at years 1 through 5. Propensity score matching was used to match L-DOPA and control groups. Cox proportional hazard regression, adjusting for age, sex, AMD severity, AREDS2 use, smoking status, and L-DOPA use was employed to calculate hazard ratios for new-onset GA detection.

Results

We identified 112,089 control and 844 L-DOPA exposed eyes with non-neovascular AMD without GA. After propensity score matching, 2532 control and 844 L-DOPA exposed eyes remained that were well-matched for age, sex, AMD severity, AREDS2 use, and smoking status. We found that L-DOPA exposure was associated with a significantly reduced likelihood (HR = 0.68, 95% CI: 0.48–0.95, P = 0.025) of new-onset GA detection.

Conclusion

L-DOPA use was associated with reduced detection of new-onset GA.
Color fastness and antimicrobial activity of Gardenia jasminoides extract against antimicrobial-resistant Staphylococcus aureus
Authors: Kim Eunsook , Kang Jooyi , Lee Jinhee , Choi Nayoung
Published: November 2024

This study investigated the antimicrobial efficacies of fabrics (100% cotton and 100% silk) dyed with an ethanol extract of Gardenia jasminoides (G. jasminoides). More specifically, these fabrics were dyed using a G. jasminoides extract with a dye bath ratio of 1:20 at 40–60 °C for 60 min, followed by post-mordanting. The concentrations of the aluminum sulfate, copper sulfate, and ferrous sulfate mordants were each set to 3% (o.w.f.). The samples were mordanted using a mordant bath ratio of 1:30 at 40 °C for 20 min. The iron mordant slightly increased the dye uptake (K/S) of the cotton fabric but did not increase the dye uptake (K/S) of the silk fabric. The antimicrobial efficacies of the dyed fabrics against methicillin-resistant Staphylococcus aureus (MRSA) ATCC 33591 were determined to be 99.8 and 87.8% for the cotton and silk fabrics, respectively. The inhibitory effects of the cotton and silk fabrics against MRSA were 30.5 × and 167.3 × the inoculum size, respectively, indicating the superior inhibitory effect of the dyed cotton fabric. These results suggest that the fabrics dyed with G. jasminoides extract may possess antibacterial activity against antimicrobial-resistant bacteria.