bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient preferences for drug therapy in inflammatory arthritis: protocol for a living systematic review and evidence map to inform clinical practice guidelines
Authors: Saadat Pakeezah , Bansback Nick , Falahee Marie , Hiligsmann Mickaël , Tugwell Peter , Buchbinder Rachelle , Whittle Samuel , Richards Dawn P , Proulx Laurie , Schunemann Holger , Alonso-Coello Pablo , Nieuwlaat Robby , Wiercioch Wojtek , Kuper Simon , Pardo Pardo Jordi , Hazlewood Glen
Published: January 2025

Introduction

The pharmacological management of inflammatory arthritis often requires choices that involve trade-offs between benefits, risks and other attributes such as administration route, frequency and cost. This living systematic review aims to inform international clinical guidelines on inflammatory arthritis by creating an evidence map of patient preference studies concerning the trade-offs in pharmacological management of inflammatory arthritis.

Methods and analysis

We will include published and peer-reviewed full-text studies in any language that quantitatively assess preferences of patients for the pharmacological management of inflammatory arthritis (rheumatoid arthritis, spondyloarthritis and juvenile idiopathic arthritis). Studies must use either stated or revealed preference methods to assess preferences and provide a quantitative assessment of relevant characteristics, such as benefits, risks, costs and process attributes. Articles will identified through Medline and EMBASE database searches from inception using search terms that combine keywords and subject headings for inflammatory arthritis and preference-based methods, and a search in the Health Preference Study and Technology Registry using keywords for the populations of interest. Two independent reviewers will perform abstract and full-text screening. Risk of bias will be assessed using the GRADE risk of bias tool. An evidence map will be generated to summarise included studies and their assessments of each trade-off. The search will be conducted every 6 months with new studies added to the inventory.

Ethics and dissemination

Ethics approval is not required. Results from the base review will be published in a peer-reviewed journal and findings will be presented at conferences. In the living model, we will publish updates and datasets on an Open Science Framework page, with periodic updates in peer-reviewed journals.
Development of a core patient-reported outcome set for use in HIV care at the individual patient level in Montreal: protocol for a two-phased multimethod project
Authors: Engler Kim , Lessard David , Lacombe Karine , Palich Romain , Lebouché Bertrand
Published: January 2025

Introduction

There is international interest in using patient-reported outcome measures in HIV care to improve the well-being of people with HIV, but the prioritisation of specific outcomes and measures remains unclear. This project’s objective is to engage both people with HIV and healthcare, social and community service providers to develop a French and English-language core set of patient-reported outcomes and measures for use in HIV care at the patient level in Montreal (Canada).

Methods and analysis

This multimethod project will follow guidance from the Core Outcome Measures in Effectiveness Trials Initiative and involve two phases. Phase 1 will see the selection of the core set of outcomes (ie, the health concepts to target) and include a rapid scoping review to inform a Delphi study with a panel of 50 people with HIV and providers in Montreal. It will end with a multidisciplinary consensus meeting to make final decisions on the outcomes. Phase 2 will be devoted to choosing the measures to assess the selected outcomes. It will include a systematic search for instruments, an appraisal of the quality and feasibility of the identified instruments and a consensus meeting for the final selection.

Ethics and dissemination

Research ethics board (REB) approval was obtained on 9 December 2024, from the institutional REB of the Research Institute of the McGill University Health Centre (reference number: 2024-9695). Findings will primarily be disseminated to (1) healthcare and social service providers through academic rounds and a provincial continuing education programme for HIV clinicians; (2) to people with HIV through partner community organisations and (3) a range of stakeholders at local, national and international conferences and through peer-reviewed publications.
mHealth knowledge and usage in maternal healthcare delivery: perspectives and experiences of healthcare practitioners in Ghana
Authors: Ameyaw Edward Kwabena , Amoah Padmore Adusei , Asiama Aikins Amoako , Agbadi Pascal
Published: January 2025

Objectives

This study explored the knowledge and experiences of health practitioners regarding the use of mobile health (mHealth) for maternal healthcare delivery.

Design

Underpinned by the Unified Theory of Acceptance and Use of Technology, this study was an exploratory qualitative design involving in-depth interviews. Data collection occurred between July 2023 and January 2024.

Setting

The study was conducted in three administrative regions in Ghana: Ashanti, Northern and Upper West regions. In each of these regions, one urban and one rural setting were selected to ascertain pertinent data from a wide range of maternity health practitioners and directors of health services operating within these regions.

Participants

Purposive sampling technique was used to recruit 32 participants, who fall into two primary groups: directors of health services (n=9) and maternity health practitioners (23).

Results

The findings revealed that maternal healthcare providers were familiar with and frequently used mHealth technologies (typically video calls/conferences and text messages). mHealth was considered a useful tool in maternal healthcare as it enhanced the efficiency of service delivery and improved practitioners’ performance. mHealth facilities eased access to digital medical information, user-friendly interfaces and the ability to facilitate remote consultations. The willingness and ability of health professionals to use mHealth were conditioned by the nature of organisational and infrastructural support they received, including technical guidance and equipment availability. Thus, mHealth knowledge and use among maternal healthcare providers are predicated on personal, social and institutional conditions.

Conclusions

Maternal healthcare providers are generally aware of the benefits of mHealth and are ready to use it when available. Thus, it is imperative that the Government of Ghana prioritise incorporation of mHealth into the existing and future maternal healthcare model to enhance care delivery and increase the prospects of achieving the first and second targets of the third Sustainable Development Goals. To ascertain greater gains from mHealth, it is worth acknowledging the varying factors that drive the adoption and effective use of mHealth, such as performance expectancy, ease of use, social influences and organisational support. Interventions aimed at enhancing mHealth integration should address these factors in a context-specific manner.
Updating the Scottish national cardiovascular risk score: ASSIGN version 2.0
Authors: Welsh Paul , Kimenai Dorien M , Woodward Mark
Published: January 2025

Background

The Assessing cardiovascular risk using Scottish Intercollegiate Guidelines Network (ASSIGN) risk score, developed in 2006, is used in Scotland for estimating the 10-year risk of first atherosclerotic cardiovascular disease (ASCVD). Rates of ASCVD are decreasing, and an update is required. This study aimed to recalibrate ASSIGN (V.2.0) using contemporary data and to compare recalibration with other potential approaches for updating the risk score.

Methods

Data from Scotland-resident participants from UK Biobank (2006–2010) and the Generation Scotland Scottish Family Health Study (2006–2010), aged 40–69 and without previous ASCVD, were used for the derivation of scores. External evaluation was conducted on UK Biobank participants who were not residents of Scotland. The original ASSIGN predictor variables and weights formed the basis of the new sex-specific risk equation to predict the 10-year risk of ASCVD. Different approaches for updating ASSIGN (recalibration, rederivation and regression adjustment) were tested in the evaluation cohort.

Results

The original ASSIGN score overestimated ASCVD risk in the evaluation cohort, with median predicted 10-year risks of 10.6% for females and 15.1% for males, compared with observed risks of 6% and 11.4%, respectively. The derivation cohort included 44 947 (57% females and a mean age of 55) participants. The recalibrated score, ASSIGN V.2.0, improved model fit in the evaluation cohort, predicting median 10-year risk of 4% for females and 8.9% for males. Similar improvements were achieved using the regression-adjusted model. Rederivation of ASSIGN using new beta coefficients offered only modest improvements in calibration and discrimination beyond simple recalibration. At the current risk threshold of

20% 10-year risk, the original ASSIGN equation yielded a positive predictive value (PPV) of 16.3% and a negative predictive value (NPV) of 94.4%. Recalibrated ASSIGN V.2.0 showed similar performance at a 10% threshold, with a PPV of 16.8% and an NPV of 94.6%.

Conclusions

The recalibrated ASSIGN V.2.0 will give a more accurate estimation of contemporary ASCVD risk in Scotland.
Investigating the soft and hard limits in transverse momentum spectra in pp collisions
Authors: Bíró Gábor , Serkin Leonid , Paić Guy , Barnaföldi Gergely Gábor
Published: January 2025

The transverse momentum spectra and their multiplicity dependence serve as key tools for extracting parameters to be compared with theoretical models. Over the past decade, the scientific community has extensively studied the possibility of a system analogous to quark-gluon plasma, predicted in heavy nuclei collisions, also existing in collisions involving light nuclei and protons. We have reanalysed the data published by the ALICE Collaboration at the LHC. We present the dependence of the mean transverse momenta obtained in the soft and soft+hard (mixed) parts. Finally, we also discuss possible refinements of the analyses concerning the use of statistical parameters of higher order, aimed at a more detailed way of comparing the models with data.
Structure-Aware Conversational Legal Case Retrieval
Authors: Liu Bulou , Hu Yiran , Ai Qingyao , Wu Yueyue , Liu Yiqun , Li Chenliang , Zhang Fan , Shen Weixing , Chen Chong , Tian Qi
Published: January 2025

Legal case retrieval is an important task in information retrieval that aims to retrieve relevant cases for given query cases. Conversational search paradigms have been shown to improve the search experience in legal case retrieval. However, there are two challenges in applying conversational search to legal scenarios. Firstly, legal search conversations often focus on different parts of legal case documents, but existing models struggle to capture the complex structural information and extract accurate relevance signals. Secondly, collecting large-scale conversational search datasets is costly, making it difficult to build reliable conversational legal case retrieval models. To address these challenges, we propose a Structure-Aware Matching Model (SAMM) for conversational legal case retrieval. SAMM extracts matching signals between conversational utterances and segments of the legal cases to incorporate structural information. We decouple the conversational search task into three subtasks and design pretraining tasks to overcome the lack of training data. Additionally, we create ConvLegal, the largest conversational legal case retrieval dataset to the best of our knowledge, for better evaluation of different methods. We train and evaluate SAMM and baselines on both a public dataset (CLCR) and ConvLegal. Experimental results demonstrate that SAMM outperforms existing models in legal case retrieval and conversational search.
Revered and Reviled: The Plight of the Vanishing Sea Cucumbers
Authors: Mercier Annie , Purcell Steven W. , Montgomery Emaline M. , Kinch Jeff , Byrne Maria , Hamel Jean-François
Published: January 2025

Sea cucumbers paradoxically suffer from being both highly prized and commonly disregarded. As an Asian medicine and delicacy, they command fabulous prices and are thus overfished, poached, and trafficked. As noncharismatic animals, many are understudied and inadequately protected. Despite presenting a rich diversity of life histories, members of this broad taxonomic group (class Holothuroidea) are often managed simply as “sea cucumbers” in fisheries worldwide. One cannot imagine fishes (class Pisces) being given the same universal treatment. Yet this may happen for species of sea cucumber that differ on the same fundamental level as tilapia and tuna. As more sea cucumbers reach an endangered status and wild populations become depleted to the point of collapse, critical questions arise about the relevance of established conservation and governance strategies. This article reviews the main threats faced by exploited sea cucumbers, outlines conservation and governance effectiveness, identifies gaps in knowledge, and explores management and research perspectives in the context of climate change and booming fisheries crime. We stress the perilous state of harvested sea cucumbers globally and the urgent need for action.
Reevaluating Anti-Inflammatory Therapy: Targeting Senescence to Balance Anti-Cancer Efficacy and Vascular Disease
Authors: Casso-Chapa Bernardo , Vazquez González Norma Alicia , Le Nhat-Tu , Palaskas Nicolas L. , Nead Kevin T. , Eutsey Lydia P. , Samanthapudi Venkata S.K. , Osborn Abigail M. , Lee Jonghae , Mejia Gilbert , Hoang Oanh , Lin Steven H. , Deswal Anita , Herrmann Joerg , Wang Guangyu , Kirkland James L. , Krishnan Sunil , Wehrens Xander H.T. , Chini Eduardo N. , Yusuf Syed Wamique , Iliescu Cezar A. , Jain Abhishek , Burks Jared K. , Seeley Erin , Lorenzi Philip L. , Chau Khanh M. , Ostos-Mendoza Keila C. , Grumbach Isabella M. , Brookes Paul S. , Hanssen Nordin M.J. , de Winther Menno P.J. , Yvan-Charvet Laurent , Kotla Sivareddy , Schadler Keri , Abe Jun-ichi
Published: January 2025

Modulating immune function is a critical strategy in cancer and atherosclerosis treatments. For cancer, boosting or maintaining the immune system is crucial to prevent tumor growth. However, in vascular disease, mitigating immune responses can decrease inflammation and slow atherosclerosis progression. Anti-inflammatory therapy, therefore, presents a unique dilemma for cancer survivors: while it may decrease cardiovascular risk, it might also promote cancer growth and metastasis by suppressing the immune response. Senescence presents a potentially targetable solution to this challenge; senescence increases the risk of both cancer therapy resistance and vascular disease. Exercise, notably, shows promise in delaying this premature senescence, potentially improving cancer outcomes and lowering vascular disease risk post-treatment. This review focuses on the long-term impact of cancer therapies on vascular health. We underscore the importance of modulating senescence to balance cancer treatment’s effectiveness and its vascular impact, and we emphasize investigating the role of exercise-mediated suppression of senescence in improving cancer survivorship.
The Strange Case of Herbert Silberer (1882–1923)
Authors: Priviero Tommaso
Published: January 2025

The case of the Viennese thinker and psychoanalyst Herbert Silberer represents an almost completely forgotten piece in the history of psychology and psychoanalysis. However, the connections between his work and C.G. Jung’s are striking and hitherto overlooked, despite Jung once referring to Silberer’s work as a “very important” contribution to the non-reductive interpretation of symbol-formation. Similarly involved in practices of visioning and self-experimentation around the time that Jung was engaged with the Red Book, Silberer directly contributed to Jung’s longstanding interest in alchemy and his ideas around “constructive” and teleological functions of the mind. He formulated the hypothesis of collective symbols known as “elementary types”, ahead of Jung’s own archetypal formulation. He proposed methods of analysis “beyond” dream interpretation and akin to active imagination, before Jung’s similar suggestions. Last but not least, he distanced himself from Freud’s psychoanalytic circle to pursue his own path, although, unlike Jung, he did not found an alternative psychotherapy school and eventually met with a tragic fate. This paper dissects the story of Silberer’s oblivion and recounts it through Jung’s remarkable, yet still unknown encounter with his life and work.
Politics and the Nigerian Army (1965–1966)
Authors: Omeni Akali
Published: January 2025

Four years after Nigeria’s Independence (1960), its army remained headed by a British General Officer Commanding (GOC). Seeking to change this in April 1965, the government’s ‘Nigerianisation’ agenda saw Major-General Aguiyi-Ironsi, an Igbo from Eastern Nigeria, appointed Army GOC by Prime Minister Balewa. Months later, in January 1966, military coupists assassinated Balewa, and Ironsi emerged as Nigeria’s first military Head of State. Whereas Ironsi’s brief but disastrous rule (January–July 1966) is well-discussed, his selection as GOC from a highly-politicised shortlist of four senior officers—and the short-term significance of that appointment—remains under-illuminated. Offering a historical corrective, I centrally relocate the Army’s ‘Nigerianisation’ and Ironsi’s appointment within the debate on ethnic politics and Nigeria’s descent into violence (1966–1967). Against this backdrop, I argue that Ironsi’s appointment was made by a cautious government seeking to preserve a precarious ethnic power balance across the Army’s ranks.
Neotropical bees of the genus Heriades Spinola, 1808 (Hymenoptera: Megachilidae: Osmiini) with description of nine new species
Authors: ROJAS-ARIAS LAURA , GRISWOLD TERRY , HINOJOSA-DÍAZ ISMAEL , MORRONE JUAN J. , BARAJAS RICARDO AYALA
Published: January 2025

Heriades is a genus of solitary bees of the family Megachilidae. It is a monophyletic group divided into eight subgenera, of which Neotrypetes is the only one distributed in the Americas. The revisions by Michener (1938) and by Griswold (1984) are the only ones known for Heriades in the region. An updated revision of Heriades for the Neotropical region, based on external morphology and male genitalia, is presented here. 15 species recognized for the genus, nine of which are new to science. The species are: Heriades amanda sp. nov., H. briceida sp. nov., H. viridiana sp. nov., H. danuncia sp. nov., H. cristina sp. nov., H. vulcanica sp. nov., H. nora sp. nov., H. mariana sp. nov., H. luisa. sp. nov., H. bruneri Titus, H. crucifera Cockerell, H. currani Michener, H. leavitti Crawford, H. micheneri Timberlake, and H. texana Michener. A new synonym is proposed, Heriades tayrona Gonzalez & Griswold as synonym of H. currani syn. nov. Diagnoses, descriptions, illustrations and distributional maps of the species are included, as well as identification keys for the group in the region.
The puzzling genus Xenomyia Malloch (Diptera, Muscidae): taxonomic notes, key to species and redescription of Xenomyia hirtibasis (Bigot)
Authors: COURI MÁRCIA SOUTO , SOUSA VIVIANE RODRIGUES DE , GOMES MARINA , GIL-AZEVEDO LEONARDO H.
Published: January 2025

Xenomyia Malloch (Diptera, Muscidae) is a very interesting genus that includes predacious species with unusual combinations of characters. It is exclusively found in the Afrotropical region and currently comprises 16 species. The recent collection of the species Xenomyia hirtibasis (Bigot) in South Africa, has prompted this study, in which the species is redescribed, including, for the first time, the morphology of male and female terminalia, until now known only for Xenomyia natalensis Zielke (cercal plate and surstyli) and Xenomyia osculata Pont & Werner (male and female). Additionally, a key for the identification of all 16 species is provided, along with diagnoses for each species. Besides the original illustrations, we have gathered all available illustrations of the species from the literature, to facilitate the identification of them. Finally, we provide a map with the known geographical distribution of the species.
Description of two synanthropic silverfish (Insecta: Zygentoma), Ctenolepisma longicaudatum (Escherich, 1905) and Ctenolepisma rothschildi (Silvestri, 1907), from Kerala, India
Authors: RAPHEL SHEEBA , JOSE JOYCE
Published: January 2025

Two silverfish species, Ctenolepisma longicaudatum Escherich, 1905 and Ctenolepisma rothschildi Silvestri, 1907 (Insecta: Zygentoma: Lepismatidae), are reported for the first time from Kerala, India, with the report of C. rothschildi being the first for India. The report presents morphological, meristic and molecular details of the specimens and compares them with reports of the species from other parts of the world. The paper also discusses the presence of distinct populations in C. longicaudatum and advises further studies.
Paramedic Judgment as a Basis for Trauma Triage: Is it an Effective Strategy?
Authors: Schaefer Matthew P. , Lamy Chrisnel , Mederos-Rodriguez Dalier , Berne John D.
Published: January 2025

Introduction

American College of Surgeons-Committee on Trauma (ACS-COT) defines minimum Standard Criteria (SC) for Level 1 trauma. In our hospital, discretion of prehospital personnel (“Paramedic Judgment” [PJ]) can initiate Full Trauma Triage Activation (FTTA) in the absence of ACS-COT criteria. The aim of this study was to evaluate overtriage and undertriage for PJ vs SC.

Methods

1846 patients met criteria from 1/1/19 to 1/5/23. This study utilized the Cribari Matrix to define under, over, and appropriate triage, and utilizes Chi-Squared Test to determine significance. We performed an adjusted binomial logistic regression comparing overtriage and undertriage for PJ vs SC. We analyzed the Need for Emergent Intervention-6 (NEI-6) model to see if it could be a way to accurately assess triage.

Results

Overtriage for the PJ group was 68.9%, compared to 54.8% for SC, with a P-value ≤.05, and undertriage for the PJ group was 1.23% compared to 0.13%. After adjusting for confounders, the risk of overtriage by the PJ group was 2.04 times as likely compared to the SC group (OR 2.04; P < .01). The OR for undertriage was not calculated due to lack of power. The odds of needing a blood transfusion for the PJ patients compared to the SC patients is approximately one-third (OR 0.33; P < .01). The other variables were lacking in power.

Conclusion

The aim of this study is to evaluate over and undertriage for PJ and SC at our large urban center. We found that overtriage was 2 times as likely when using PJ compared with the SC.
K12 Superintendent Awareness of Critical Race Theory: Perspectives, Perceptions, and Presumptions
Authors: Lowery Charles L. , Gautam Chetanath
Published: January 2025

Purpose: In this mixed methods study, we delve into the complex realm of perceptions of critical race theory (CRT) in the United States. The public perspective of CRT has implications for K12 education, particularly as it relates to teaching literature and social studies. In our investigation, we focus on school district superintendents’ perception of the impact on schools and education. Research Approach: Using quantitative (a Likert-type survey with open-ended items) and qualitative instruments (a semi-structured interview protocol), the study aims to unravel superintendents’ awareness, views, and understanding of CRT. Findings: Data revealed a range of superintendent perceived familiarity levels, with some leaders possessing an in-depth understanding of CRT while others are less acquainted. Concerns surrounding the potential divisiveness, politicization, and suitability for CRT in K12 settings emerged as significant themes. Implications: The research underscores the need for professional development and reliable information to enhance educational leaders’ comprehension of CRT. It also highlights the importance of approaching CRT cautiously in light of its complex and contested nature. The study advocates for inclusive and accurate history education and recommends effective integration of CRT, leader preparation, and policy implications. The recommendations consider the intricate landscape of CRT in K-12 educational leadership. It emphasizes the significance of promoting inclusive environments to address racial disparities and promote equitable learning.
Emerging therapies in Multiple Myeloma: Leveraging immune checkpoint inhibitors for improved outcomes
Authors: Mandavkar Anuja Anil , Padakanti Suraj Sai Nikhil , Gupta Srajan , Akram Samiyah , Jaffar Nida , Chauhan Jugalkishor , Allu Likhita Reddy , Saini Pulkit , Nasrallah Jamil , Omar Mohamed Abdullahi , Mugibel Muna Ali , Syed Saif , Ravindran Kumaran Ottilingam , Dwivedi Ayush , Dhingra Gurneet Singh , Dhingra Avleen , Kakadiya Jay , Kotaich Jana , Beniwal Shreya Singh
Published: January 2025

Background: 

Multiple Myeloma is a hematological malignancy characterized by the proliferation of clonal plasma cells and associated with severe clinical manifestations. Despite advancements in diagnosis and management, Multiple Myeloma remains incurable, necessitating further research into more effective therapies.

Aim: 

The primary objective of this review is to provide an informative and critical summary of the Multiple Myeloma microenvironment, and emerging revolutionary therapeutic approaches with potential combination therapy to improve the quality of life for Multiple Myeloma patients.

Emerging approaches: 

Recent advancements in immunotherapy, particularly immune checkpoint inhibitors (ICIs), have shown improvements in immune response against Multiple Myeloma. ICIs target inhibitory pathways such as PD-1/PD-L1 and CTLA-4, potentially overcoming tumor-induced immunosuppression. Combination therapies integrate ICIs with proteasome inhibitors, immunomodulators, and monoclonal antibodies to enhance the anti-tumor immune response. Additionally, Chimeric Antigen Receptor T-cell (CAR-T) therapy has demonstrated effectiveness against Multiple Myeloma, particularly when coupled with ICIs to decrease resistance and relapse.

Challenges: 

Although the efficacy of ICIs in treating Multiple Myeloma has been hindered by the complexity of the tumor microenvironment and immune evasion mechanisms, this challenge has led to the exploration of combination therapies. Potential side effects are still a big challenge for newly recognized ICIs and combination treatment.

Future directions: 

Investigations of new immune checkpoints and the development of targeted therapies against these markers are in progress, creating possibilities for more personalized and effective treatment strategies. Continuous research and robust clinical trials are needed to comprehend the complex dynamics of the Multiple Myeloma microenvironment to develop revolutionary therapeutic targets.
Subjective motoric cognitive risk syndrome: Preliminary prevalence from an online survey of a German cohort aged 50+
Authors: Theobald Paula , Herold Fabian , Gronwald Thomas , Müller Notger G
Published: January 2025

The motoric cognitive risk syndrome (MCR) is a novel and clinically relevant pre-dementia syndrome indicating a higher dementia risk (e.g., for Alzheimer's disease). Given that MCR prevalence is unknown in Germany, we conducted a cross-sectional study, in which 208 participants from Germany aged 50 and 82 years answered an online survey including questions to assess subjective MCR (sMCR). The adjusted sMCR prevalence was 25.3%. Adults with sMCR reported more diseases and showed negative associations with physical activity, sedentary behavior, and sleep, suggesting that lifestyle modifications can play a significant role in MCR prevention. Further research is required to complement our preliminary findings on sMCR prevalence in Germany.
Clinical Confidence, Certification, and Connectedness: Impact of a Journal Club for Inpatient Psychiatry Faculty
Authors: Im David S. , Brelje Andrea , Raghunandan Christina , Stchur Laura , Lyden Angela , Hong Allison , Bornheimer Lindsay A.
Published: January 2025

INTRODUCTION

Inpatient psychiatry faculty manage complex clinical, administrative, and legal issues amid increasing mental health service utilization rates, limiting time for (1) focusing on lifelong learning and (2) connecting. We examined the impact of a monthly journal club on inpatient psychiatry faculty's (1) confidence that their practice is evidence informed, (2) stress related to board recertification, and (3) sense of connectedness with peers.

METHODS

We employed a primarily qualitative approach using semi-structured interviews and brief survey questions to elicit input from inpatient psychiatry faculty at an academic medical center on their experience participating in a monthly journal club, including perceived changes in one's practice of evidence-based medicine, recertification stress, and connectedness with peers.

RESULTS

Thirteen faculty who participated in the journal club responded to at least one survey or interview. Many faculty reported feeling more confident that their clinical practice was evidence informed, less stressed about board recertification, and more connected to peers at 6 and 12 months following the commencement of the journal club. Following in-person attendance, video-based learning (an innovative method of participating in the journal club) was found to be the second most preferred method of participation among respondents. All respondents noted that the journal club was a valuable use of their time and enjoyable.

CONCLUSION

A monthly journal club has the potential to increase hospital psychiatry faculty confidence in evidence-based clinical practice, reduce board recertification stress, and improve sense of peer connectedness. Future research should examine the journal club experience and impact among a larger number of faculty and incorporate additional measures of learning outcomes.
Development, validation, and usage of metrics to evaluate the quality of clinical research hypotheses
Authors: Jing Xia , Zhou Yuchun , Cimino James J. , Shubrook Jay H. , Patel Vimla L. , De Lacalle Sonsoles , Weaver Aneesa , Liu Chang
Published: January 2025

Objectives

Metrics and instruments can provide guidance for clinical researchers to assess their potential research projects at an early stage before significant investment. Furthermore, metrics can also provide structured criteria for peer reviewers to assess others’ clinical research manuscripts or grant proposals. This study aimed to develop, test, validate, and use evaluation metrics and instruments to accurately, consistently, systematically, and conveniently assess the quality of scientific hypotheses for clinical research projects.

Materials and methods

Metrics development went through iterative stages, including literature review, metrics and instrument development, internal and external testing and validation, and continuous revisions in each stage based on feedback. Furthermore, two experiments were conducted to determine brief and comprehensive versions of the instrument.

Results

The brief version of the instrument contained three dimensions: validity, significance, and feasibility. The comprehensive version of metrics included novelty, clinical relevance, potential benefits and risks, ethicality, testability, clarity, interestingness, and the three dimensions of the brief version. Each evaluation dimension included 2 to 5 subitems to evaluate the specific aspects of each dimension. For example, validity included clinical validity and scientific validity. The brief and comprehensive versions of the instruments included 12 and 39 subitems, respectively. Each subitem used a 5-point Likert scale.

Conclusion

The validated brief and comprehensive versions of metrics can provide standardized, consistent, systematic, and generic measurements for clinical research hypotheses, allow clinical researchers to prioritize their research ideas systematically, objectively, and consistently, and can be used as a tool for quality assessment during the peer review process.
Detection of low frequency artemisinin resistance mutations, C469Y, P553L and A675V, and fixed antifolate resistance mutations in asymptomatic primary school children in Kenya
Authors: Osoti Victor , Wamae Kevin , Ndwiga Leonard , Gichuki Paul M. , Okoyo Collins , Kepha Stella , Keitany Kibor , Kandie Regina , Aricha Stephen , Kiplagat Rosebella , Mwandawiro Charles , Bejon Philip , Snow Robert W. , Ochola-Oyier Lynette Isabella
Published: January 2025

Background

To understand the emergence and spread of drug-resistant parasites in malaria-endemic areas, accurate assessment and monitoring of antimalarial drug resistance markers is critical. Recent advances in next-generation sequencing (NGS) technologies have enabled the tracking of drug-resistant malaria parasites.

Methods

In this study, we used Targeted Amplicon Deep Sequencing (TADS) to characterise the genetic diversity of the Pfk13, Pfdhfr, Pfdhps, and Pfmdr1 genes among primary school-going children in 15 counties in Kenya (Bungoma, Busia, Homa Bay, Migori, Kakamega, Kilifi, Kirinyaga, Kisii, Kisumu, Kwale, Siaya, Tana River, Turkana, Vihiga and West Pokot). A total of 920 dried blood spot (DBS) samples collected from 121 selected primary schools within the country were used to extract genomic DNA. A nested polymerase chain reaction (PCR) was used to generate amplicons that were sequenced to determine the prevalence of known and novel polymorphisms.

Results

Pfk13 mutations associated with artemisinin resistance were present as mixed genotype infections for the C469Y mutation in 23 samples (4%), the A675V mutation in 2 samples (1.7%), and the P553L mutation in 7 samples (1.2%). The A578S mutation, was also identified in mixed infections, appearing in 15.2% of the 87 samples analysed. The Pfdhfr 51I and 108 N pyrimethamine-resistance mutations were at fixation (100% frequency), and the Pfmdr1 Y184F mutation, which is linked to reduced susceptibility to several antimalarial drugs, especially those used in combination therapies for malaria treatment, was detected in 97.5% of the samples as mixed-genotype infections.

Conclusion

The genomic surveillance of asymptomatic school children in Kenya provides an early warning signal of at least 1 of the 3 validated artemisinin resistance mutations circulating in all regions in Western Kenya sampled except Homa Bay and Kisii Counties. These signals in asymptomatic and mixed infections would have been missed without deep sequencing.
Toward a Computable Phenotype for Determining Eligibility of Lung Cancer Screening Using Electronic Health Records
Authors: Yang Shuang , Huang Yu , Lou Xiwei , Lyu Tianchen , Wei Ruoqi , Mehta Hiren J. , Wu Yonghui , Alvarado Michelle , Salloum Ramzi G. , Braithwaite Dejana , Huo Jinhai , Shih Ya-Chen Tina , Guo Yi , Bian Jiang
Published: January 2025

PURPOSE

Lung cancer screening (LCS) has the potential to reduce mortality and detect lung cancer at its early stages, but the high false-positive rate associated with low-dose computed tomography (LDCT) for LCS acts as a barrier to its widespread adoption. This study aims to develop computable phenotype (CP) algorithms on the basis of electronic health records (EHRs) to identify individual's eligibility for LCS, thereby enhancing LCS utilization in real-world settings.

MATERIALS AND METHODS

The study cohort included 5,778 individuals who underwent LDCT for LCS from 2012 to 2022, as recorded in the University of Florida Health Integrated Data Repository. CP rules derived from LCS guidelines were used to identify potential candidates, incorporating both structured EHR and clinical notes analyzed via natural language processing. We then conducted manual reviews of 453 randomly selected charts to refine and validate these rules, assessing CP performance using metrics, for example, F1 score, specificity, and sensitivity.

RESULTS

We developed an optimal CP rule that integrates both structured and unstructured data, adhering to the US Preventive Services Task Force 2013 and 2020 guidelines. This rule focuses on age (55-80 years for 2013 and 50-80 years for 2020), smoking status (current, former, and others), and pack-years (≥30 for 2013 and ≥20 for 2020), achieving F1 scores of 0.75 and 0.84 for the respective guidelines. Including unstructured data improved the F1 score performance by up to 9.2% for 2013 and 12.9% for 2020, compared with using structured data alone.

CONCLUSION

Our findings underscore the critical need for improved documentation of smoking information in EHRs, demonstrate the value of artificial intelligence techniques in enhancing CP performance, and confirm the effectiveness of EHR-based CP in identifying LCS-eligible individuals. This supports its potential to aid clinical decision making and optimize patient care.
Frequency and Impact of Constitutional Mismatch Repair Deficiency in Patients With High-Grade Glioma, a Retrospective Analysis of 7 Years in Pakistan: an IRRDC Study
Authors: Mushtaq Naureen , Minhas Khurram , Bashir Farrah , Zahid Soha , Qureshi Bilal Mazhar , Javed Gohar , Resham Shahzadi , Das Anirban , Hawkins Cynthia , Tabori Uri , Bouffet Eric
Published: January 2025

PURPOSE

Constitutional mismatch repair deficiency (CMMRD) is a genetic cancer predisposition syndrome among children and young adults. This study aimed to evaluate the frequency of CMMRD among patients with pediatric high-grade glioma (pHGG) in a single tertiary care center in Pakistan, a country with high consanguinity rates.

PATIENTS AND METHODS

We reviewed the data of patients age <18 years with pHGG, anaplastic astrocytoma, and diffuse midline glioma (DMG) with CMMRD testing between 2016 and 2023. CMMRD testing was done using the Aronson et al criteria. A few patients were sent to Sick Kids, Toronto, to review the mismatch repair protein stains via multigene panels.

RESULTS

Forty-seven patients were identified, with a median age of 11 years (IQR, 8-16). Headache (89.4%) was the most common symptom. Thirty-seven patients had hemispheric tumors; 12.8% and 8.5% had posterior fossa and midline tumors, respectively. Histopathology revealed 70.2% glioblastoma, 23.4% anaplastic astrocytoma, and 6.4% DMG. CMMRD was positive in 15 of 47 patients (31.9%). Eight patients had loss of
PMS2
. Three had loss of
PMS2
and
MLH1
; two had loss of
MSH6
, one had loss of
MSH6
and
MSH2
, and only one patient had loss of
MSH2
. Consanguinity and family history of malignancy correlated with CMMRD (
P
= .009,
P
= .031, respectively). Two-year overall survival of all patients was 23.4% (median follow-up, 0.59 years [95% CI, 0.000 to 1.171]). Two-year overall survival of mismatch repair deficiency–positive patients was 20% (median follow-up, 0.910 years [95 CI, 0.380 to 1.440]).

CONCLUSION

We found a high frequency of CMMRD among patients with pHGG, particularly with positive consanguinity. Our study highlights the significance of genetic testing and surveillance. It is essential to develop low and middle income country-tailored protocols due to limited access and financial constraints associated with using immune checkpoint inhibitors.
Multicentric Cross-Sectional Survey to Assess the Variation of Fractionation Strategies Used in the Management of Head and Neck Cancers in the Asian Region (INNOCENCE-ASIA)
Authors: Gandhi Ajeet Kumar , Chopra Supriya , Rastogi Madhup , Mallick Indranil , Cruz Misael C. , Yasuda Koichi , Sum Ying Ying , Nagata Yasushi , Wu Hong-Gyun , Prajogi Gregorius B. , Kodrat Henry , Ma Mingwei , Nisar Asif , Chitapanarux Imjai
Published: January 2025

PURPOSE

Head and neck cancers (HNCs) are in general treated with conventional fractionation regimen of 1.8-2 Gy per fraction. Altered fractionation (ALFT) strategies such as hypofractionation radiotherapy (HYPO-RT), accelerated fractionation radiotherapy (AFRT), and hyperfractionation radiotherapy (HFRT) have not been practiced uniformly across centers in different parts of the world. Countries in Asia share common cancer demographics, and we designed this survey for Federation of Asian Radiation Oncology (FARO) member countries to understand the usage and challenges in the delivery of ALFT in HNCs.

MATERIALS AND METHODS

A 21-point electronic survey (Federation of Asian Radiation Oncology Research Network [FERN]-S-005) was designed by the FERN and was circulated through the FARO research secretariat to the FARO council member countries and the responses were collected between August and November 2023.

RESULTS

Twelve of 14 member countries (85.7%) responded to the survey. Twenty-seven responses were received and 78% of the respondents belonged to government/teaching academic institute. 4/27 (14.8%) reported never using HYPO-RT for any of the clinical subsite of HNCs, while the majority (85.2%) used it for glottic cancers and 22% also used it for postoperative setting. Majority (77.7%) used a fractionation schedule with dose per fraction ranging between 2.2 and 2.5 Gy. 6/27 (22.2%) used AFRT for definitive setting and five of these also used concurrent chemoradiotherapy. 4/27 (14.8%) centers reported using HFRT. The most common reason (62.9%) for the limited usage of AFRT/HFRT was reported to be logistical, such as unavailability of machine slots, patient load, and so on.

CONCLUSION

The result of the survey suggests that among the ALFT strategies for HNCs, HYPO-RT schedules have common interest and feasibility among the FARO member countries and also highlights the challenges in the delivery of AFRT/HFRT in the Asian region.
Efficacy and Safety of Short Intravenous Hydration for Preventing Nephrotoxicity From High-Dose Cisplatin: A Randomized, Open-Label, Phase II Trial
Authors: Jantarat Apichart , Thamlikitkul Lucksamon , Thephamongkhol Kullathorn , Setakornnukul Jiraporn , Phisalprapa Pochamana , Kositamongkol Chayanis , Srithongkul Thatsaphan , Ithimakin Suthinee
Published: January 2025

PURPOSE

The use of short hydration (SH) to prevent cisplatin-induced nephrotoxicity lacks substantive prospective evaluation. The aim of this study was to evaluate the safety and efficacy of SH, including those with head and neck cancer (HNC) who are at higher risks of mucositis that causes diminished oral intake.

METHODS

This phase II randomized noncomparative trial included patients with cancer who were scheduled to receive high-dose cisplatin (≥60 mg/m
2
) in combination with another chemotherapy or concurrently with radiotherapy. Patients were randomly assigned to receive either the SH or conventional hydration (CH) protocol. The primary end point was the proportion of patients with increased serum creatinine (SCr) after undergoing SH. Secondary end points included the severity of SCr elevation, adverse events, cisplatin modification as a result of nephrotoxicity, duration of hospital stay, quality of life (QoL), and cost.

RESULTS

Among 100 enrolled patients, 64 and 36 patients underwent the SH and CH protocols, respectively. The median duration of chemotherapy infusion and intravenous hydration were 5.79 and 27.58 hours with SH and CH, respectively. A total of 32.8% and 33.3% of the SH and CH groups, respectively, experienced SCr elevation. Grade 2 SCr elevations were rarely observed in both groups (1.6% in SH, 2.8% in CH). Rate of cisplatin modification was similar between the two groups. Out of 82 patients with HNC, the rate of SCr elevation was comparable for both hydration protocols. The QoL scores were meaningfully higher in the SH group during the second cycle of cisplatin, although the overall direct medical costs were similar.

CONCLUSION

The SH protocol is feasible and safe, with a remarkably reduced duration of administration. Thus, SH can be an alternative to CH in the prevention of cisplatin-related nephrotoxicity.
Functional Tests and Surveys Used to Assess Nervous System Dysfunction in Patients with Fabry Disease – A Review
Authors: Jesionek Stanislaw , Parys Jakub , Mikosińska Agnieszka , Kaźmierczak Martyna , Kałuziak Partycja , Jajczak Marta , Mossakowski Maciej , Witek Aleksandra , Litwin Mateusz , Jankowska Justyna
Published: January 2025

Introduction and Purpose:
Fabry disease (FD) is a rare, X-linked lysosomal storage disorder caused by a deficiency of the enzyme alpha-galactosidase A, leading to progressive multi-organ damage. Among the various complications, autonomic nervous system dysfunction has been suggested as a significant aspect of the disease’s pathophysiology. This review aims to evaluate functional tests and surveys used to assess nervous system dysfunction, focusing on the autonomic nervous system in FD patients.
State of Knowledge:
Fabry disease presents with classical and non-classical phenotypes, with early symptoms in males often involving pain, skin lesions, and gastrointestinal disturbances, progressing to more severe manifestations like heart failure and renal disease. The autonomic nervous system, which regulates various physiological processes, may be impaired in Fabry patients, potentially contributing to the disease’s symptoms. Functional tests such are frequently used to assess autonomic function. Studies on autonomic dysfunction in FD have provided mixed results, challenging the assumption that autonomic neuropathy plays a central role in disease progression.
Methods: A comprehensive search of references related to FDe and the autonomic nervous system was conducted on PubMed using the following search terms: “Fabry disease, autonomic nervous system, blood pressure, cold pressor test, vascular manifestations.”
Conclusions:
The findings of this review suggest that while autonomic dysfunction may be present in certain subsets of FD patients. Functional tests revealed limited evidence of widespread autonomic dysfunction. QSART showed reduced sweating responses in pain patients but no differences in non-pain patients. These results challenge the widely accepted notion that autonomic neuropathy is a major contributor to Fabry disease symptoms and emphasize the need for further research into the specific mechanisms underlying the disease's clinical manifestations.
Potato Leaf Insight: An AI-Driven System for Detection of Potato Leaf Disease
Authors: Thalor Meenakshi , Pathak Mrunal , Jamadar Riyazahemed , Khan Shahbaz
Published: January 2025

Agricultural productivity is crucial for global economic development and growth. Crop diseases can severely risk to Nation’s food security, economic resources, environmental sustainability and agricultural output. Crop disease detection at early stage not only reduce losses for farmers but also improve crop yields. As agricultural technology and artificial intelligence advance, research into sustainable agricultural development becomes increasingly crucial. Plant diseases significantly impact the yield and quality of potatoes, and manually diagnosing these diseases can be both time-consuming and complex due to the required expertise. This paper introduces PotatoLeaf Insight System that employs U-Net technique for image segmentation followed by VGG19, for feature extraction through transfer learning. The model is trained and evaluated using a dataset of potato leaf images, covering early blight disease, late blight disease, leaf roll disease, Verticillium wilt disease, and healthy leaves. This AI driven system provide overall accuracy of 94% and useful for farmers to take necessary care of their crops in case detected with disease.