bluuebunny/crossref_metadata_2025 huggingface dataset:
Logbook of a researcher in sociology in times of crisis: Investigating Jews and Muslims after the 7th of October and the following days
Authors: Hathroubi Samia
Published: January 2025

This article examines the profound impact of the 7 October 2023 events and their aftermath, particularly in the context of Jewish-Muslim relations in Europe. Drawing on personal reflections and academic research, it explores the sense of rupture experienced by individuals and organizations engaged in interfaith dialogue, emphasizing the emotional and political challenges of navigating a polarized geopolitical and intercommunal climate. The events are framed as a moment of heightened tension, intensifying long-standing narratives of conflict, particularly around antisemitism and its intersection with perceptions of Muslim communities. While these developments amplify existing dynamics, the article questions whether they represent a rupture, continuation or repetition of historical patterns. Situating this analysis within broader sociological frameworks, the article advocates for reflexive and engaged scholarship to address the complexities of identity, political discourse and social boundaries in times of crisis.
Remote assessment of exercise capacity in adults with chronic respiratory disease: Safety, reliability and acceptability
Authors: Cox Narelle S , Dal Corso Simone , Burge Angela T , Bondarenko Janet , Perryman Jaycie , Holland Anne E
Published: January 2025

Objectives

To assess the safety, reliability and acceptability of the modified incremental step test (MIST) supervised remotely via videoconferencing in adults with chronic respiratory disease.

Methods

Adults with chronic respiratory disease undertaking pulmonary rehabilitation were invited to undertake the MIST under two testing conditions: in-person supervision and remote supervision via video-conferencing. Test order was randomised.

Results

38 participants ( n = 18 Female; mean (SD) age 68 (10) years; 56% chronic obstructive pulmonary disease) undertook two MIST evaluations. There was excellent agreement between tests for total step count (ICC2,1 0.93, 95%CI 0.86 to 0.96), despite higher counts with in-person supervision (MD 12 steps, 95%CI 1 to 24). There was very good agreement, and no difference between tests, for nadir oxygen saturation (ICC2,1 0.797, 95%CI 0.643 to 0.889) and peak heart rate (ICC2,1 0.782, 95%CI 0.620 to 0.880). Participant satisfaction with telehealth was high, and confidence was not different between testing conditions. There were no adverse events and remote testing was acceptable to participants.

Discussion

In this single centre cohort study MIST supervised remotely via video-conferencing was safe, reliable and acceptable to people with chronic respiratory disease.
Long-term Recurrence Risk of Diabetic Foot Ulcers After Healing: A 5-Year Retrospective Cohort Study on the Influence of Hemodialysis and Amputation Levels
Authors: Kitano Toyoaki , Sakakibara Shunsuke , Kitano Ikuro , Tsuji Yoriko , Takekawa Akira , Terashi Hiroto
Published: January 2025

This retrospective study aimed to evaluate diabetic foot ulcer (DFU) recurrence rates and associated risk factors, focusing on hemodialysis and specific amputation levels. Patients with diabetes treated for DFU between 2003 and 2019 at a wound-care center in Japan were studied. The primary outcome was DFU recurrence, and the factors evaluated included age, sex, hemodialysis treatment, revascularization type, and amputation level. Among 236 participants (mean age: 65 years; male: 73%; 33% on hemodialysis), DFU recurrence rates were 40.3% and 77.1% at 1 and 5 years, respectively. Hemodialysis was significantly associated with an increased DFU recurrence risk (hazard ratio: 1.92; 95% confidence interval: 1.40-2.64, P < .001). Revascularization did not significantly impact DFU recurrence rates after ulcer healing. Contralateral DFU recurrence was the most frequent, occurring in 45% of cases. Higher DFU recurrence rates were observed at adjacent toes on the same side in patients who underwent great toe amputation and at the treated site in patients who underwent transmetatarsal, Lisfranc, or Chopart amputations. These findings indicate that DFU recurrence poses a higher risk in patients undergoing hemodialysis. Tailored postoperative management focusing on both contralateral and ipsilateral recurrences is essential to minimize recurrence and improve long-term outcomes.
Long-Term Intracranial Progression-Free Survival in Lung Cancer Brain Metastases Extended Beyond 50 Months with Gubenxiaoyi Formula (GBXY): A Groundbreaking Case Study
Authors: Yang Zhengzheng , Li Haiming , Chen Lei , Li Shujiao , Chen Dong , Lu Taicheng , Ding Tongjing , Han Ruiyang , Cheng Peiyu , Wang Xiaomin
Published: January 2025

Background:

The prevalence of brain metastases (BM) in lung cancer patients is notably high and is associated with poor prognoses. The efficacy of standard treatment regimens in improving intracranial progression-free survival (IPFS) for lung cancer BM is markedly limited. While traditional Chinese medicine (TCM) has been effective in enhancing the quality of life and prognosis of lung cancer patients, its efficacy in treating BM remains unreported.

Case presentation

Here, we present a case of a middle-aged female with lung cancer BM, whose condition was assessed as progressive post-standard treatment including two local surgeries (both involving resection of cerebellar space-occupying lesions), stereotactic radiotherapy, chemotherapy and EGFR-TKIs. Subsequently, she underwent treatment with the traditional Chinese herbal formula gubenxiaoyi (GBXY). The patient was treated with GBXY for a total duration of 55 months. After treatment, a significant reduction of about 50% in intracranial lesions was observed, accompanied by an extension of both Intracranial Progression-Free Survival (IPFS) and Cognitive Deterioration-Free Survival (CDFS) exceeding 50 months.

Conclusion

These results demonstrate that in patients with lung cancer brain metastases (BM) unresponsive to standard treatments, GBXY not only has the potential to effectively prolong IPFS and decelerate cognitive decline, but may also contribute to a reduction in intracranial tumor burden. This suggests that GBXY could be a promising therapeutic option that warrants further investigation.
Marching Backward? Conservative Civil Society, Freedom of Religion, and the Peace Process in Northern Ireland
Authors: Belloni Roberto
Published: January 2025

This paper examines the role of the Orange Order, a prominent Protestant civil society organization, throughout the period following the signing of the 1998 Good Friday Agreement in Northern Ireland. By linking the defense of civil and religious liberties to the preservation of the Union with the United Kingdom, the Orange Order plays both an important religious and political role which has embroiled it in a number of disputes. This paper discusses the Order's parades across Catholic neighborhoods, its involvement in the so-called “culture wars” and its stand vis-à-vis Brexit. Overall, the actions of the Orange Order are a sober reminder of the diversity of civil society in conflict areas, where civic and progressive groups coexist with associations with conservative religious and political values. The Orange Order's actions demonstrate the controversial role religious freedom may play in the context of peace processes.
A megastudy of lexico-semantic effects in single-word shadowing
Authors: Qian Zongyu , Goh Winston D.
Published: January 2025

Lexico-semantic effects in lexical decision and semantic categorisation tasks have been investigated using the megastudy approach, but not with other traditional spoken word recognition tasks. To address this gap, this megastudy examined the single-word shadowing task, where 96 native English speakers repeated aloud each word they heard as quickly and as accurately as possible. Item-level hierarchical regression and linear mixed-effects analyses produced identical results: Words with longer token duration were associated with slower response times while high-frequency and phonologically distinctive words were repeated faster. These findings were consistent with previous studies and other tasks, which suggests that lexical effects are task-general in spoken word recognition. However, after controlling for lexical variables, six semantic variables did not account for any additional unique variance in response times. These results suggest that the single-word shadowing task is heavily dependent on lexical processing and can be completed without activating semantics. Cross-task comparisons with another megastudy’s data on auditory lexical decision and semantic categorisation tasks further suggest that lexical effects are task-general, while semantic richness effects are task-specific in spoken word recognition.
A fiscally sound, evidenced-based solution to conquering the complexity of physician billing guidelines: A physician-centric note template
Authors: Howard-Williams Escher , Knight Rachel , Ossman Paul , Younce Danicela , Donohoe Andrew , Marucci Leonardo , Mock Clare
Published: January 2025

Background: Effective documentation and coding in health care are crucial for patient care, safety, workflow improvement and accurate billing. Objectives: This quality improvement study aimed to enhance History and Physical (H&P) note documentation and charge capture processes to integrate coding and billing aspects, capture authentic work, preserve the H&P’s integrity and align H&P-related revenue with actual performance. Method: A multidisciplinary team, including divisional leadership and specialists in documentation improvement, electronic health records, lean/six sigma methodology, a nocturnist and a senior-level physician coding auditor, initiated a quality improvement project. Educational efforts targeted approximately 50 hospitalists at a Departmental meeting in January 2023 (Department of Medicine, University of North Carolina School of Medicine), followed by the development and iterative testing of a standardised H&P note template in March 2023, officially disseminated to the entire Department in June 2023. Results: Despite limited impact from education alone, the implementation of an updated H&P template in May 2023 and department-wide distribution in June led to an immediate increase in average work relative value units (wRVU) per encounter, driven by enhanced capture of prolonged time codes and key medical decision-making phrases. The sustained correlation between template usage and increased wRVUs demonstrated a consistent, elevated plateau compared to the education phase. Conclusion: Collaboratively designed and user-informed note templates, balancing usability, efficiency and revenue-generating elements, proved more effective than education alone in integrating complex changes into clinical practice and enhancing coding and billing accuracy. Implications: Results of this study underscore the benefits of standardised documentation tools in enhancing both clinical and financial outcomes, suggesting that healthcare institutions could improve revenue capture, and documentation accuracy by adopting similar approaches.
Orthopaedic Sports Injuries in an Aging Population: Current Trends and Future Projections
Authors: Zaifman Jay M. , Megalla Martinus , Grace Zachary , Imam Nareena , Koerner John D. , Kohan Eitan , Alberta Francis G.
Published: January 2025

Background

The elderly US population is growing quickly and staying active longer. However, there is limited information on sports-related injuries in older adults.

Hypotheses

(1) National estimate and incidence of sports-related orthopaedic injuries in the US elderly population have increased over the last 10 years, (2) types and causes of sports-related injuries in the elderly have changed, and (3) elderly sports-related injuries will increase more than the number of treating physicians by 2040.

Study Design

Descriptive epidemiology study.

Level of Evidence

Level 4.

Methods:

The National Electronic Injury Surveillance System database was used to identify all patients aged ≥65 years with sports-related orthopaedic injuries in US emergency departments from 2012 to 2021. Surgeon and physician estimates were calculated using the Physician Compare database. Population data were obtained from US Census estimates and used to calculate annual incidence rates of injuries and to project total injuries through 2040. Injury characteristics were analyzed using Wilcoxon Rank-Sum tests and Chi-square or Fisher exact tests.

Results

An estimated 444,078 sports-related orthopaedic injuries occurred in the elderly from 2012 to 2021. There were significant increases in injuries (from 32,573 in 2012 to 50,909 in 2021; P < 0.01) and in the national incidence of injuries (from 78 per 100,000 in 2012 to 91 per 100,000 in 2021; P = 0.01). The number of sports-related injuries in the elderly is projected to reach 111,245 by 2040, an increase of 119% from 2021. The number of orthopaedic surgeons and sports medicine physicians is projected to increase by only 19.7% over the same timeperiod.

Conclusion:

Sports-related orthopaedic injuries in the elderly are increasing in both number and incidence.

Clinical Relevance

Orthopaedic surgeons and other practitioners should be prepared to treat an increasing number of active elderly patients.
Evaluating the Corrected Femoroepiphyseal Acetabular Roof Index in Patients With Borderline Dysplasia Undergoing Periacetabular Osteotomy or Hip Arthroscopy
Authors: Dimitriou Dimitris , Neopoulos Georgios , Jud Lukas , Zingg Patrick O.
Published: January 2025

Background:

Identifying hip instability in symptomatic patients with borderline dysplasia of the hip (BDH) is of paramount importance, as it can influence both surgical decision-making and surgical outcomes. The femoroepiphyseal acetabular roof (FEAR) index is strongly affected by the hip adduction/abduction angle during the pelvic radiograph, which has not yet been considered in the recommended threshold values.

Purpose:

To compare the corrected FEAR index in symptomatic patients with BDH treated with pelvic periacetabular osteotomy (PAO) or hip arthroscopy.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients with symptomatic hips and radiographical BDH were categorized into 2 cohorts. The first cohort included patients treated with PAO (n = 42) and the second cohort consisted of patients treated with hip arthroscopy due to symptomatic femoroacetabular impingement (n = 50). All patients presented with good patient-reported outcomes at the final follow-up. The FEAR index was measured on the pelvic radiograph at the initial hip adduction/abduction angle (uncorrected FEAR index) and after correcting the hip abduction angle to 0° (corrected FEAR index). Negative values of the FEAR index represent a lateral closing angle, whereas positive values represent a lateral opening angle. As for the hip adduction/abduction angle, negative values represent adduction, whereas positive values represent abduction.

Results:

The corrected FEAR index varied significantly from the uncorrected FEAR index in both groups with a mean difference of 6°± 4° in patients treated with PAO and 5°± 5° in patients treated with hip arthroscopy. The corrected FEAR index in patients with BDH treated with hip arthroscopy (−11°± 8°) was significantly lower ( P < .001) compared with the patients with BDH treated with PAO (−7°± 7°) (Table 1). The optimal threshold for the corrected FEAR index was −13° (odds ratio, 7.8 [95% CI, 2.6-23.1]; P < .001), which yielded a sensitivity of 85% and a specificity of 52%, distinguishing the 2 surgical cohorts.

Conclusion:

The corrected FEAR index might vary significantly from the uncorrected FEAR index, which is highly dependent on the hip adduction/abduction angle during the pelvic radiograph. Symptomatic patients with BDH treated with PAO exhibit a corrected FEAR index of ≥–13° compared with those with BDH treated with hip arthroscopy for impingement symptomatology.
CircUCK2(2,3) promotes cancer progression and enhances synergistic cytotoxicity of lenvatinib with EGFR inhibitors via activating CNIH4–TGFα–EGFR signaling
Authors: Wei Xindong , Si Anfeng , Zhao Shuai , Fu Yi , Li Jilei , Aishanjiang Kedeerya , Ma Yujie , Yu Chang , Yu Bo , Cui Chunhong , Wang Hui , Kong Xianming , Li Shibo , Kong Xiaoni , Tong Ying , Wu Hailong
Published: January 2025

Background

Circular (circ)RNAs have emerged as crucial contributors to cancer progression. Nonetheless, the expression regulation, biological functions, and underlying mechanisms of circRNAs in mediating hepatocellular carcinoma (HCC) progression remain insufficiently elucidated.

Methods

We identified circUCK2(2,3) through circRNA sequencing, RT–PCR, and Sanger sequencing. CircUCK2(2,3) levels were measured in two independent HCC cohorts using quantitative real-time PCR (qRT–PCR). We explored the functions of circUCK2(2,3) using gain- and loss-of-function assays. Techniques such as RNA-sequencing, RNA immunoprecipitation (RIP), polysome fractionation, RNA pulldown, dual luciferase reporter assay, inhibitors of EGFR downstream signaling, CRISPR–Cas9, and medium transfer assays were employed to investigate the regulatory mechanisms and the protumoral activities of circUCK2(2,3). Additionally, in vitro cytotoxic assays and patient-derived xenograft (PDX) models assessed the effects of circUCK2(2,3) on the cytotoxic synergy of lenvatinib and EGFR inhibitors.

Results

CircUCK2(2,3) is upregulated in HCC tissues and serves as an independent risk factor for poor recurrence-free survival. The expression of circUCK2(2,3) is independent on its host gene, UCK2, but is regulated by its upstream promoter and flanking inverted complementary sequences. Functionally, circUCK2(2,3) enhances HCC proliferation, migration, and invasion, both in vitro and in vivo. Mechanistically, by sponging miR-149-5p, circUCK2(2,3) increases CNIH4 levels, which in turn amplifies TGFα secretion, resulting in the activation of EGFR and downstream pAKT and pERK signaling pathways. Moreover, circUCK2(2,3) overexpression sensitizes HCC cells to EGFR inhibitors, and increases the synergistic cytotoxicity of combined lenvatinib and EGFR inhibitor treatment.

Conclusions

CircUCK2(2,3) regulates a novel oncogenic pathway, miR-149-5p–CNIH4–TGFα–EGFR, in HCC, presenting a viable therapeutic target and biomarker for the precision treatment of HCC.

Graphical Abstract
Effect of cisplatin/gold chitosan nanocomposite on oral squamous cell carcinoma and oral epithelial cells
Authors: Ahmed Basma Abdelrahman , Mohsen Rania Osama M. , Sharaky Marwa , Ramadan Marwa A. , Faid Amna H. , Mohamed Mai Hafez
Published: January 2025

Background

Oral squamous cell carcinoma (OSCC) treatment represents a great challenge, since platinum-based therapeutic agents have deleterious effects on normal cells and tissues. Employing gold nanoparticles (AuNps) as carriers for cisplatin have proved effective in reducing cisplatin doses. Green synthesis of AuNps from eco-friendly agents like chitosan improves the AuNps’ biocompatibility and cytotoxicity. Thus, we synthesized a novel agent of cisplatin coupled to gold chitosan nanoparticles (Cis/AuCh nanocomposite) and examined its effect in addition to the effect of chitosan-reduced gold nanoparticles (AuCh Nps) on (HNO97) OSCC cell line and normal oral epithelial cells (OEC).

Results

Ultraviolet–visible spectroscopic analysis, transmission electron microscope, X-ray diffraction, and Fourier transform infrared spectroscopy confirmed the successful synthesis of AuCh Nps and Cis/AuCh nanocomposite. The cytotoxicity assay showed that the IC50 doses of AuCh Nps and Cis/AuCh nanocomposite after 48 h were 12.5 μg/ml, and 6.2 μg/ml, respectively, on the HNO97 cell line. On the other hand, the IC50 doses were 40 μg/ml and 44.5 μg/ml on OEC, respectively. After treating both cell lines with the HNO97–IC50 doses, Cis/AuCh nanocomposite-treated HNO97 cell line revealed a significant rise in Caspase 3 immunohistochemical apoptotic index, besides a significant elevation in pro-apoptotic proteins and reduction in Bcl-2 compared to cisplatin. Conversely, opposite results were detected in AuCh Nps and Cis/AuCh nanocomposite-treated OEC. Flow cytometry results revealed S and G2/M shifts in HNO97 and OEC with more shift in the cisplatin-treated group than AuCh Nps and Cis/AuCh nanocomposite-treated groups in both cell lines. The expressions of the reactive oxygen species (ROS) markers; malondialdehyde and nitric oxide were the highest in Cis/AuCh nanocomposite-treated HNO97, while the reduced glutathione expression was the lowest. However, AuCh Nps and Cis/AuCh nanocomposite-treated groups did not display any significant changes in ROS markers expression from the untreated group in the OEC.

Conclusions

AuCh NPs can be considered a good alternative way of cisplatin transportation for OSCC treatment. Cis/AuCh nanocomposite stimulates apoptosis, cell cycle arrest, and ROS production in oral cancer cells with less undesired effects on normal oral epithelial cells.
Charlson comorbidity index has no incremental value for mortality risk prediction in nursing home residents with COVID-19 disease
Authors: Zahra Anum , van Smeden Maarten , Elders Petra J. M. , Festen Jan , Gussekloo Jacobijn , Joling Karlijn J. , van Loon Anouk , Luijken Kim , Melis René J. F. , Mooijaart Simon P. , Moons Karel G. M. , Peeters Geeske , Polinder-Bos Harmke A. , Wouters Fenne , de Hond Anne
Published: January 2025

Background

During the COVID-19 pandemic, nursing home (NH) residents faced the highest risk of severe COVID-19 disease and mortality. Due to their frailty status, comorbidity burden can serve as a useful predictive indicator of vulnerability in this frail population. However, the prognostic value of these cumulative comorbidity scores like the Charlson comorbidity index (CCI) remained unclear in this population. We evaluated the incremental predictive value of the CCI for predicting 28-day mortality in NH residents with COVID-19, compared to prediction using age and sex only.

Methods

We included older individuals of ≥ 70 years of age in a large retrospective observational cohort across NHs in the Netherlands. Individuals with PCR-confirmed COVID-19 diagnosis from 1 March 2020 to 31 December 2021 were included. The CCI score was computed by searching for the comorbidities recorded in the electronic patient records. All-cause mortality within 28 days was predicted using logistic regression based on age and sex only (base model) and by adding the CCI to the base model (CCI model). The predictive performance of the base model and the CCI model were compared visually by the distribution of predicted risks and area under the receiver operator characteristic curve (AUROC), scaled Brier score, and calibration slope.

Results

A total of 4318 older NH residents were included in this study with a median age of 88 years [IQR: 83–93] and a median CCI score of 6 [IQR: 5–7]. 1357 (31%) residents died within 28 days after COVID-19 diagnosis. The base model, with age and sex as predictors, had an AUROC of 0.61 (CI: 0.60 to 0.63), a scaled brier score of 0.03 (CI: 0.02 to 0.04), and a calibration slope of 0.97 (CI: 0.83 to 1.13). The addition of CCI did not improve these predictive performance measures.

Conclusion

The addition of the CCI as a vulnerability indicator did not improve short-term mortality prediction in NH residents. Similar (high) age and number of comorbidities in the NH population could reduce the effectiveness of these predictors, emphasizing the need for other population-specific predictors that can be utilized in the frail NH residents.

Graphical Abstract
COVID-19 status and utilisation of essential maternal and child healthcare services during the pandemic in Ahmedabad, India
Authors: Yasobant Sandul , Lekha K Shruti , Tadvi Ravina , Solanki Bhavin , Bruchhausen Walter , Saxena Deepak
Published: January 2025

Background

Access to essential healthcare services is pertinent to the achievement of universal health coverage in any nation. The COVID-19 lockdown was used to mitigate the spread of the pandemic. Consequently, there was a reduction in the Utilisation of Basic Healthcare Services (UBHS) in diverse dimensions. However, variation existed in the UBHS by COVID-19 status, but the extent of this disparity has not been extensively addressed in Ahmedabad, India. Therefore, this study explores the relationship between COVID-19 status and utilisation of essential maternal and child healthcare services during the pandemic in Ahmedabad, India.

Methods

A mixed-method approach was used for the data (both quantitative and qualitative) collection from November 2021 to October 2022. Four zones were purposefully selected from the 6 zones in Ahmedabad. The quantitative part of the study included pregnant women or those who had a baby delivery from April 2020 to October 2021 (n = 278), while 10 of these women participated in the qualitative part. Data were analysed using descriptive statistics, Chi-square test, and binomial logistic regression (α = 0.05). A deductive approach was used to analyse the qualitative data.

Results

Of the total 278, almost 43% of the women were infected with COVID-19 during their pregnancy. Women who tested positive availed lesser antenatal care (ANC), and Postnatal care (PNC). There were diverse experiences documented regarding access to essential maternal and child healthcare services during the pandemic. Women without COVID-19 are more likely to receive maternal healthcare services, such as visits of any healthcare workers [aOR = 2.59 (1.03- 6.49)], counseling services [aOR = 1.92 (0.61- 6.06)], delivery at the planned place [aOR = 1.98 (0.99- 3.92)] as compared to those who are positive. Women without COVID-19 were more likely to be accompanied by healthcare workers during labor ([aOR = 2.91(1.04- 8.11) and to receive appropriate birth spacing counselling [aOR = 1.38 (0.7–2.71)].

Conclusion

Utilisation of essential maternal and child healthcare services was lower among women who were COVID-19 positive compared to those who were not. Social and health system determinants for disrupting healthcare services during the pandemic were fear of infection and unavailability of the health workforce. Health planners and policymakers are encouraged to take into consideration of these findings while building resilient health care for managing future pandemics.
Benefits of the Global Integration Method (Método de Integração Global - MIG) in functional priorities of parents of Brazilian children and adolescents with autism spectrum disorder
Authors: Nascimento Amanda Aparecida Alves Cunha , Souto Deisiane Oliveira , Cruz Thalita Karla Flores , de Lima Arthur Felipe Barroso , Oliveira Gabriela Silva , Haase Vitor Geraldi
Published: January 2025

Background

Understanding the priorities of parents of children and adolescents with autism spectrum disorder (ASD) is crucial for implementing evidence-based programs. This study aims to identify the functional priorities of parents of Brazilian children and adolescents with ASD, analyze variations in priorities according to the levels of support and age groups of the participants, and categorize the goals according to the categories of the International Classification of Functioning, Disability, and Health (ICF). Additionally, this study aimed to evaluate changes in parents’ performance and satisfaction with functional priorities after intervention with the Global Integration Method (Métodode Integração Global - MIG).

Methods

A total of 241 children/adolescents with ASD (mean age, 6.92 ± 3.61 years) were recruited from different regions of Brazil. 76% (76%) were male, and 40.7% were classified as having support level 2. The Canadian Occupational Performance Measure was administered to parents/caregivers to identify their priorities for their children and to assess changes in performance and satisfaction with priorities after intervention with MIG. The MIG protocol consisted of functional task training in a naturalistic environment (City of Tomorrow) combined with the use of a flexible therapeutic suit (MIG Flex) and was conducted for 3 months, five times a week, for 3–4 h per day. Descriptive statistics were used to provide the priority profile. Pre- and post-intervention data were analyzed using paired t-test.

Results

Parents established 1,203 functional priorities. Activities of daily living, behavioral difficulties, communication, play, and social interactions were the main functional priorities in the perception of parents/caregivers. The profiles of functional priorities were similar between the different levels of support and age groups. Approximately 64% of the priorities were classified in the activity domain of the ICF. In general, the MIG program resulted in significant improvements in performance and satisfaction for the majority of functional priorities (p < 0.05).

Conclusion

Activities of daily living appear to be the main priority of parents of children and adolescents with ASD, regardless of the level of support or age group. The MIG program has been associated with improvements in performance and satisfaction across several of the functional priorities identified by parents.
Joint spatiotemporal modelling of tuberculosis and human immunodeficiency virus in Ethiopia using a Bayesian hierarchical approach
Authors: Debusho Legesse Kassa , Gemechu Leta Lencha
Published: January 2025

Background

The aim of this paper was to evaluate the distribution of HIV and TB in Ethiopia during four years (2015-2018) at the district level, considering both spatial and temporal patterns.

Methods

Consolidated data on the count of TB case notifications and the number of patients with HIV for four years, 2015-2018, were provided by the Ethiopian Federal Ministry of Health. The data was analyzed using the Bayesian hierarchical approach, employing joint spatiotemporal modelling. The integrated nested Laplace approximation available in the R-INLA package was used to fit six models, each with different priors, for the precision parameters of the random effects variances. The best-fitting model with the best predictive capacity was selected using the Deviance Information Criterion and the negative sum of cross-validatory predictive log-likelihood.

Results

According to the findings of the selected model, about 53% of the variability in TB and HIV incidences in the study period was explained by the shared temporal component, disease-specific spatial effect of HIV, and space-time interaction effect. The shared temporal trend and disease-specific temporal trend of HIV risk showed a slight upward trend between 2015 and 2017, followed by a slight decrease in 2018. However, the disease-specific temporal trend of TB risk had almost constant trend with minimal variation over the study period. The distribution of the shared relative risks was similar to the distribution of disease-specific TB relative risk, whereas that of HIV had more districts as high-risk areas.

Conclusions

The study showed the spatial similarity in the distribution of HIV and TB case notifications in specific districts within various provinces. Moreover, the shared relative risks exhibit a temporal pattern and spatial distribution that closely resemble those of the relative risks specific to HIV illness. The existence of districts with shared relative risks implies the need for collaborative surveillance of HIV and TB, as well as integrated interventions to control the two diseases jointly.
A digital intervention to reduce home-office workers’ sedentary behaviour: protocol for the evaluation of the Click2Move programme, a cluster randomised controlled trial
Authors: Bort-Roig Judit , Parés-Salomón Iris , Loef Bette , Vaqué-Crusellas Cristina , Coffey Alan , Gustems-Morral Arnau , Señé-Mir Anna M. , Luznik Izabela , Pajek Maja , Dowd Kieran P. , Puig-Ribera Anna , Proper Karin I.
Published: January 2025

Background

A new paradigm of hybrid working exists, with most office workers sharing their work between the office and home office environment. Working from home increases time spent or prolonged sitting, which is associated with an increased risk of chronic disease. Interventions to reduce sitting time, specifically designed for both the office and home-office environments, are required to address this growing public health issue. This study presents a protocol to evaluate the effectiveness of a digital intervention (Click2Move) to reduce sitting time and improve employees’ health and occupational wellbeing among hybrid office workers.

Methods

A two-arm cluster randomised controlled trial will be undertaken among hybrid office employees. In total, 200 employees will be recruited across four companies across Europe (The Netherlands, Spain, Ireland, and Slovenia). Participants within each company will be randomly allocated to the intervention or control group at the unit/cluster level. The intervention group will receive the novel multicomponent Click2Move intervention (including environmental, organisational, and individual strategies) for 12 months, and the control groups will maintain their usual work practices. The primary outcome will be occupational sedentary time measured via activPAL3TM at baseline and at 3, 6 and 12 months follow-up. Secondary outcomes will include device-based (activPAL3TM) and self-reported (Global Physical Activity Questionnaire and Workforce Sitting Questionnaire) physical activity and sedentary behaviour; self-reported musculoskeletal disorders (Standardised Nordic Questionnaire) and pain (Numeric Rating Scale); self-reported presenteeism and absenteeism (Health and Work Performance Questionnaire), job satisfaction (Need for Recovery scale) and fatigue (single-item 5-point Likert scale). Focus groups will be conducted with employees post-intervention. Linear mixed models, accounting for covariates, will be employed to determine the effects of the intervention. Additionally, we will perform a full process evaluation analysis.

Discussion

The proposed study will offer a comprehensive evaluation of a digital intervention aimed at reducing sedentary behaviour among hybrid office workers, offering practical solutions to enhance the health, wellbeing and productivity of a growing segment of the workplace.

Trial registration

ClinicalTrials.gov NCT06247228. Registered 30 January 2024.
Increasing the resolution of malaria early warning systems for use by local health actors
Authors: Evans Michelle V. , Ihantamalala Felana A. , Randriamihaja Mauricianot , Herbreteau Vincent , Révillion Christophe , Catry Thibault , Delaitre Eric , Bonds Matthew H. , Roche Benjamin , Mitsinjoniala Ezra , Ralaivavikoa Fiainamirindra A. , Razafinjato Bénédicte , Raobela Oméga , Garchitorena Andres
Published: January 2025

Background

The increasing availability of electronic health system data and remotely-sensed environmental variables has led to the emergence of statistical models capable of producing malaria forecasts. Many of these models have been operationalized into malaria early warning systems (MEWSs), which provide predictions of malaria dynamics several months in advance at national and regional levels. However, MEWSs rarely produce predictions at the village-level, the operational scale of community health systems and the first point of contact for the majority of rural populations in malaria-endemic countries.

Methods

This study developed a hyper-local MEWS for use within a health-system strengthening intervention in rural Madagascar. It combined bias-corrected, village-level case notification data with remotely sensed environmental variables at spatial scales as fine as a 10 m resolution. A spatio-temporal hierarchical generalized linear regression model was trained on monthly malaria case data from 195 communities from 2017 to 2020 and evaluated via cross-validation. The model was then integrated into an automated workflow with environmental data updated monthly to create a continuously updating MEWS capable of predicting malaria cases up to three months in advance at the village-level. Predictions were transformed into indicators relevant to health system actors by estimating the quantities of medical supplies required at each health clinic and the number of cases remaining untreated at the community level.

Results

The statistical model was able to accurately reproduce village-level case data, performing nearly five times as well as a null model during cross-validation. The dynamic environmental variables, particularly those associated with standing water and rice field dynamics, were strongly associated with malaria incidence, allowing the model to accurately predict future incidence rates. The MEWS represented an improvement of over 50% compared to existing stock order quantification methods when applied retrospectively.

Conclusion

This study demonstrates the feasibility of developing an automatic, hyper-local MEWS leveraging remotely-sensed environmental data at fine spatial scales. As health system data become increasingly digitized, this method can be easily applied to other regions and be updated with near real-time health data to further increase performance.
Association of serum magnesium and calcium with metabolic syndrome: a cross-sectional study from the Qatar-biobank
Authors: Alsheikh Raneem , Aldulaimi Haneen , Hinawi Rami , Al-Sadi Fatima , Al-Baker Alanoud , Alkuwari Aldana , Sameer Muhammad , Al-Abdulla Ghalya , Shi Zumin , Rathnaiah Babu Giridhara
Published: January 2025

Background and objectives

Metabolic syndrome (MetS) and its constituent comorbidities, along with mineral imbalances, pose a significant health burden in the Qatari population. Although Magnesium (Mg) and Calcium (Ca) have been individually linked to MetS, the impact of the calcium-to-magnesium ratio (Ca: Mg) on MetS remains unclear, especially in the adult population of Qatar. In this study, we aim to investigate the association between the total serum concentrations of Ca, Mg and Ca: Mg ratio with the outcome of MetS.

Methods

This comprehensive cross-sectional study included data on 9693 participants collected by Qatar Biobank (QBB). The serum levels of Mg and Ca, in addition to recorded metabolic parameters for the study participants, were used in the analyses. The presence of MetS was deemed as our primary outcome and its components as secondary outcomes. Logistic regression models were run to examine these associations.

Results and conclusion

MetS was present in more than 19% of the population. The mean serum Mg was higher in the non-MetS group 0.83 ± 0.06 mmol/L compared to the MetS group 0.81 ± 0.08 mmol/L. Conversely, the mean serum Ca and Ca: Mg ratio were higher in the MetS group (2.33 ± 0.09 mmol/L, 2.92 ± 0.36 mmol/L) compared to the non-MetS group (2.30 ± 0.08 mmol/L, 2.77 ± 0.23 mmol/L) respectively. In the context of MetS, we observed a negative dose-response relationship between Mg quartiles and MetS. In contrast, we found a positive association between Ca as well as Ca: Mg ratio and MetS.
Diagnostic performance of optical spectral transmission compared to magnetic resonance imaging in patients with inflammatory arthritis
Authors: Triantafyllias Konstantinos , Alhaddad Mohammed , Schwarting Andreas , Balaklytska Veronika , Baraliakos Xenofon
Published: January 2025

Background

Optical spectral transmission (OST) is a modern diagnostic method capable of quantifying inflammation in the finger and wrist joints of arthritis patients by assessing the blood-specific absorption of light transmitted through a tissue. The diagnostic performance of this modality has not been adequately examined and data regarding OST associations with magnetic resonance imaging (MRI) are limited. Aim of this study was therefore to investigate the performance of OST in assessing joint inflammation as compared to MRI in patients with inflammatory arthritis (IA).

Methods

Data from patients who underwent MRI and OST for suspected IA were analyzed. For comparison, a historical healthy control (HC) group with OST was also accounted. MRI findings were quantified using the Rheumatoid Arthritis MRI Score (RAMRIS). Diagnostic accuracy of OST was evaluated using Receiver Operating Characteristics (ROC), while correlation analyses were conducted to explore relationships between OST and MRI, as well as disease activity markers.

Results

Overall, 71 patients with known rheumatic diseases (n = 1,542 wrist and finger joints) and 114 HC (n = 2,508 joints) subjects were included. 51 patients showed inflammatory signs on MRI (MRI+). These also showed significantly higher OST scores (16.41 ± 5.53) than subjects without MRI inflammation (MRI-) (11.52 ± 5.03) or HC (10.78 ± 4.19) (all; p < 0.001). OST showed significant correlations with RAMRIS-synovitis and tenosynovitis scores in the MRI + group (rho = 0.541, p < 0.001; rho = 0.341, p = 0.01, respectively). Significant correlations were observed between OST and clinical parameters for disease activity. Using MRI as a reference, the best diagnostic value of OST was observed at the wrist level in the MRI + group, by an AUC of 0.833 (95%CI 0.700-0.966).

Conclusion

OST showed an excellent performance compared to MRI and correlated significantly with RAMRIS scores and clinical parameters in IA patients, also differentiating IA from HC.
Unleashing the beast: the impact of big data and data analytics on the auditing profession—Evidence from a developing country
Authors: Abdelwahed Ahmed S. , Abu-Musa Ahmad A. , Badawy Hebatallah A. , Moubarak Hosam
Published: January 2025

This study attempts to obtain an understanding of the impact of adopting big data and data analytics (BD&A) on various dimensions of the audit profession. This study aims to examine the effect of adopting BD&A on the audit process, auditor competence, and audit fees in a developing context, Egypt. It also examines the mediating effect of auditor competence on the association between BD&A, audit process, and audit fees. A questionnaire was developed and distributed among financial auditors, IT/IS auditors, and data analytics specialists working for audit firms with different sizes in Egypt. Responses from 205 audit practitioners were collected. Partial least square structural equation modeling was employed to test the research hypotheses. It was revealed that BD&A has a significant positive impact on the audit process and auditor competence. However, an insignificant association between BD&A and audit fees was found. Also, the results indicated that there is a positive significant relationship between auditor competence and audit process, and between auditor competence and audit fees. The mediation analysis reveals that auditor competence partially mediates the relationship between BD&A and the audit process. This indicates that while BD&A directly enhances the audit process, its full potential is realized when auditors possess advanced competencies. In contrast, the relationship between BD&A and audit fees is fully mediated by auditor competence, reflecting the critical role of skill development in justifying fee adjustments.
Current and Future Role of Circulating DNA in the Diagnosis and Management of Urothelial Carcinoma
Authors: Bellmunt Joaquim , Russell Brian M. , Szabados Bernadett , Valderrama Begoña P. , Nadal Rosa
Published: January 2025

The growing sophistication of tumor molecular profiling has helped to slowly transition oncologic care toward a more personalized approach in different tumor types, including in bladder cancer. The National Comprehensive Cancer Network recommends that all patients with stage IVA and stage IVB urothelial carcinoma have molecular analysis that integrates at least
FGFR3
testing to help facilitate the selection of future therapeutic options. Sequencing of tumor-derived tissue is the mainstay to obtain this genomic testing, but as in other cancers, there has been extensive research into the integration of liquid biopsies in longitudinal management. Liquid biopsies broadly refer to the isolation of both cellular and noncellular tumor components including proteins and nucleic acids such as mRNA and circulating free DNA within a liquid sample. Although protein-based testing and testing of circulating tumor cells are options, the bulk of promising research in bladder cancer is investigating the role of plasma-based circulating tumor DNA (ctDNA). Currently, a universal consensus on optimal preanalytic and analytic approaches has not been fully defined, and the exact role that liquid biopsies should have in screening, diagnosis, prognostication, treatment selection, and monitoring is not yet known. Still, it can be expected that ctDNA testing will be a part of appropriate management of muscle-invasive bladder cancer and metastatic bladder cancer in the near future. In this review, the goal is to provide a practical overview of the current and future role of ctDNA in bladder cancer including ongoing trials.
Radiofrequency Ablation for Thyroid Nodules (RATED Study)—Analysis of a Learning Curve and Predictors of Success
Authors: van der Meeren Manon M D , Boers Tim , de Graaf Pim , Duvivier Katya M , Dreijerink Koen M A , Deden Laura N , Veendrick Peter , Cernohorsky Paul , Joosten Frank B M , Savelberg Angelique B M C , Braak Sicco J , Roerink Sean H P P , Versluis Michel , Manohar Srirang , Oyen Wim J G
Published: January 2025

Context

Radiofrequency ablation (RFA) is used as treatment for symptomatic thyroid nodules. Factors influencing the volume reduction ratio (VRR) at 12 months are not yet fully understood.

Objective

The primary objective of this work was evaluating the VRR at 12 months after RFA. Secondary objectives were the assessment of a learning curve and factors influencing the VRR at 12 months.

Methods

A retrospective observational cohort study was conducted at 3 Dutch referral hospitals of patients who underwent RFA for symptomatic thyroid nodules with available ultrasound (US) follow-up. Main outcome measures included US-based VRR at 12 months and chronologically numbered RFA procedures. All patients’ baseline, treatment, and early follow-up factors were assessed for correlation with VRR at 12 months.

Results

A total of 337 patients with 356 nodules were included in the learning curve analysis. VRR at 12 months increased for the first 20 treatments per center and stabilized thereafter, indicating a plateau phase after a learning curve. These initial cases were removed from further analysis. In the remaining 299 nodules, median VRR at 3, 6, and 12 months was 57.1%, 65.6%, and 70.8%. Baseline nodule volume negatively correlated with VRR at 12 months but VRR was high for every volume category. Energy delivered per volume did not correlate with VRR.

Conclusion

In RFA for thyroid nodules, a stable treatment efficacy is achieved after 20 treatments, with a median VRR of 70.8%. Baseline nodule volume, energy delivered, and prolonged follow-up 6 months after treatment may not be clinically relevant to predict treatment success.
Modelling a pathological GSX2 variant that selectively alters DNA binding reveals hypomorphic mouse brain defects
Authors: Tweedie Laura , Riccetti Matthew R. , Cain Brittany , Qin Shenyue , Salomone Joseph , Webb Jordan A. , Riesenberg Amy , Ehrman Lisa A. , Waclaw Ronald R. , Kovall Rhett A. , Gebelein Brian , Campbell Kenneth
Published: January 2025

Gsx2 is a homeodomain transcription factor critical for development of the ventral telencephalon and hindbrain in mouse. Loss of Gsx2 function results in severe basal ganglia dysgenesis and defects in the nucleus tractus solitarius (nTS) of the hindbrain, together with respiratory failure at birth. De Mori et al. (2019) reported two patients with severe dystonia and basal ganglia dysgenesis that encode distinct recessive GSX2 variants, including a missense variant within the homeodomain (GSX2Q251R). Hence, we modelled the homologous Gsx2 mutation (i.e. Gsx2Q252R) in mouse, and our biochemical analysis revealed that this variant selectively altered DNA binding. Moreover, mice carrying the Gsx2Q252R allele exhibited basal ganglia dysgenesis, albeit to a lesser extent than did Gsx2 null mice. A notable difference between Gsx2Q252R and Gsx2 null mice was that Gsx2Q252R mice survived, and hindbrain analysis revealed relative sparing of the glutamatergic nTS neurons and catecholaminergic A1/C1 and A2/C2 groups. Thus, the Gsx2Q252R variant is a hypomorph that compromises a subset of Gsx2-dependent neuronal subtypes and highlights a critical role for distinct thresholds of catecholaminergic and/or glutamatergic nTS neurons for viability.