bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of aquatic exercise compared with land-based exercise on the body composition and function of older adults with sarcopenia: protocol for a randomised controlled trial
Authors: Sun PeiJie , Yang Jinfeng , Li Na , Yang Weicheng , Yang Jinqi , Ran Jianxin , Cheng Fang , Liao Yuanpeng
Published: January 2025

Introduction

Sarcopenia is a condition that occurs more frequently in older adults. Although many types of exercise have been used in the treatment of sarcopenia, few studies have been conducted on different interventional environments for sarcopenia. The purpose of this study is to investigate the effects of aquatic exercise and land-based exercise on the body composition and function of participants with sarcopenia.

Methods and analysis

This randomised, controlled, single-blinded trial will enrol 45 participants (≥ 65 years) following the diagnostic criteria set by the Asian Working Group for Sarcopenia 2019. Participants will be randomised and assigned to one of three groups (aquatic exercise group, land-based exercise group and control group). Assessments will be conducted four times: initially (before intervention), after 8 weeks (intermediate), after 16 weeks (final) and 16 weeks after the end of intervention (follow-up). The primary outcomes are appendicular skeletal muscle index and handgrip strength, while the secondary outcomes include the Short Physical Performance Battery, 6-minute walk test and the Chinese version of the 36-item short-form of health-related quality of life.

Ethics and dissemination

Ethics approval was obtained from the Ethics Committee of Chengdu Sport University, with permission number CDSUEC2023-125. This study has been registered with the Chinese Clinical Trial Registry (ChiCTR2300077457). All participants will provide written informed consent.

Trial registration number

Chinese Clinical Trial Registry ChiCTR2300077457.
Tracking Persistent Symptoms in Scotland (TraPSS): a longitudinal prospective cohort study of COVID-19 recovery after mild acute infection
Authors: Sculthorpe Nicholas F , McLaughlin Marie , Cerexhe Luke , Macdonald Eilidh , Dello Iacono Antonio , Sanal-Hayes Nilihan E M , Ingram Joanne , Meach Rachel , Carless David , Ormerod Jane , Hayes Lawrence D
Published: January 2025

Background

COVID-19 disease results in disparate responses between individuals and has led to the emergence of long coronavirus disease (Long-COVID), characterised by persistent and cyclical symptomology. To understand the complexity of Long-COVID, the importance of symptom surveillance and prospective longitudinal studies is evident.

Methods

A 9-month longitudinal prospective cohort study was conducted within Scotland (n=287), using a mobile app to determine the proportion of recovered individuals and those with persistent symptoms and common symptoms, and associations with gender and age.

Results

3.1% of participants experienced symptoms at month 9, meeting the criteria for Long-COVID, as defined by the National Institute for Health and Care Excellence terminology. The random effects model revealed a significant time (month) effect for infection recovery (p<0.001, estimate=0.07). Fatigue, cough and muscle pain were the most common symptoms at baseline, with fatigue persisting the longest, while symptoms like cough improved rapidly. Older age increased the likelihood of reporting pain (p=0.028, estimate=0.07) and cognitive impairment (p<0.001, estimate=0.93). Female gender increased the likelihood of headaches (p=0.024, estimate=0.53) and post-exertional malaise (PEM) frequency (p=0.05, estimate=137.68), and increased time x gender effect for PEM frequency (p=0.033, estimate=18.96).

Conclusions

The majority of people fully recover from acute COVID-19, although often slowly. Age and gender play a role in symptom burden and recovery rates, emphasising the need for tailored approaches to Long-COVID management. Further analysis is required to determine the characteristics of the individuals still reporting ongoing symptoms months after initial infection to identify risk factors and potential predictors for the development of Long-COVID.
Towards a common definition of hospital-acquired deconditioning in adults: a scoping review
Authors: Westlake Meri , Cowley Alison , Robinson Katie , Gordon Adam L.
Published: January 2025

Background

Hospital-acquired deconditioning is a term used in clinical practice, describing a loss of physical and/or cognitive function associated with hospitalisation. Previous reviews have addressed interventions, its prevalence in older adults and potential assessment tools. However, each review has reported a core limitation, the need for an agreed-upon definition and diagnostic criteria for hospital-acquired deconditioning.

Objective

We aimed to identify key components used to define hospital-acquired deconditioning in adults. We sought to do this by identifying diagnostic criteria, describing how authors operationalised Hospital- Acquired Deconditioning (HAD), and describing differences between HAD and other immobility-linked syndromes. This article focuses on how hospital-acquired deconditioning is understood and operationalised.

Design

A scoping review using the Joanna Briggs Institute methodology for evidence synthesis.

Eligibility criteria

Published in English after 1 January 1990, investigating adults over 18, set in inpatient rehabilitation or acute care settings, and including either a definition or description of hospital-acquired deconditioning or an outline of strategies to assess, prevent or manage hospital-acquired deconditioning.

Sources of evidence

Published and grey literature, no restriction was placed on study design.

Charting methods

Relevant data, where available, was extracted from each source using a proprietary data extraction template.

Results

One hundred and three articles were included from 2403 retrieved results. Thirty-three were from rehabilitation or post-acute care settings, 53 from acute care, 15 from intensive care and two from other settings. The literature was diverse in methodology and research question addressed. Hospital-acquired deconditioning was poorly defined, no consistent patterns were identified in aetiology and sequelae; diagnostic criteria were not fully agreed on.

Conclusions

The literature on hospital-acquired deconditioning is large, diverse and incomplete. Further work is required to develop a shared definition of hospital-acquired deconditioning, enabling researchers to coalesce for better understanding of the phenomenon, and clinicians, in turn, to better treat and mitigate against it.

Review registration

OSF:https://osf.io/b5sgw/
Association between early ondansetron use and the risk of sepsis in intensive care unit patients: a secondary data of the Medical Information Mart for Intensive Care IV database
Authors: Liu Xuan , Liu Enhe , Kou Qiuye
Published: January 2025

Objective

This study planned to analyse the association between ondansetron use within 24 hours before intensive care unit (ICU) admission to within 48 hours after ICU admission and the risk of sepsis in ICU patients.

Design

A cohort study.

Setting and participants

Data of 65 366 participants in Medical Information Mart for Intensive Care IV from ICU in the Beth Israel Deaconess Medical Center.

Primary and secondary outcome measures

Sepsis was the primary outcome, which indicated patients with documented or suspected infection and acute change in total Sequential Organ Failure Assessment (SOFA) score ≥2 points. In-hospital mortality was the secondary outcome.

Results

There were 6737 patients with early ondansetron use. In total, 1646 patients suffered sepsis. According to the data from multivariate cox regression model, compared with participants without early ondansetron use, the risk of sepsis was reduced in participants with early ondansetron use relative to those without HR (HR=0.84, 95% CI: 0.76 to 0.93). The risk of in-hospital mortality was reduced in those with early ondansetron use (HR=0.63, 95% CI: 0.55 to 0.72). Subgroup analysis revealed that the association between early ondansetron use and decreased risk of sepsis was significant in participants aged <65 years, men, not complicated with trauma, no surgery, systemic inflammatory response syndrome ≥2, Charlson Comorbidity Index ≥2, with ventilation use, without antibiotics use or without insulin use. In both patients with SOFA <3 or SOFA ≥3, early ondansetron use was correlated with a reduced risk of sepsis.

Conclusion

Patients with early ondansetron use had lower odds of experiencing sepsis than patients without early ondansetron use, which might provide a reference for the management of sepsis in ICU patients.
Knowledge translation in Anglo-American paramedicine: a scoping review
Authors: Hanson Ashley , Burton Christopher
Published: January 2025

Objective

To map what is currently known about knowledge translation (KT) in Anglo-American paramedicine. The review focuses on reported barriers and facilitators to the implementation of new knowledge, and the use of models, theories and frameworks to guide implementation practice.

Design

Scoping review reported as per both the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guidelines.

Data sources

CINAHL (EBSCO Host) and Medline (OVID interface) were searched from January 2000 to May 2023. Reference lists of all included papers were reviewed, and several key professional journals were hand-searched.

Eligibility criteria for selecting studies

Primary sources that focused on KT models, theories or frameworks, or barriers and facilitators to KT implementation, involving paramedics or Emergency Medical Technicians (Paramedic in America) working in an out-of-hospital, Anglo-American Emergency Medical Service (EMS) system were eligible for inclusion.

Data extraction and synthesis

One reviewer used a data extraction template developed for this review and 10% of the papers were checked by the second author. Findings were summarised in tables and synthesised both quantitatively and qualitatively.

Results

The search yielded 1268 primary sources, of which 48 were included in the review. Thirty-two papers examining KT interventions and 16 papers examining the barriers and facilitators to KT were found. Only one randomised controlled trial was found, and only one paper made explicit use of any KT framework. Overall, eight themes describing barriers and facilitators to KT arose from the qualitative literature, with clinicians’ perception of the evidence being the dominant theme. All 32 papers describing KT interventions included some form of educational intervention.

Conclusions

Overall, there is little depth and breadth in the literature, with many papers focusing on trauma and airway management. There are large gaps in the evidence surrounding the use of KT theories and frameworks in Anglo-American EMS. Further research is needed to identify appropriate KT models and frameworks that are contextualised to EMS to ensure that paramedic-led research finds its way to the clinicians needing to use it.
Classifications of haemodialysis vascular access stenosis: a scoping review
Authors: Lawrie Katerina , O’Neill Stephen , Malik Jan , Janousek Libor , Corr Michael , Maly Stepan , Chlupac Jaroslav , Waldauf Petr
Published: January 2025

Objectives

Vascular access (VA) stenoses play a significant role in the morbidity of the haemodialysed population. Classifications for diagnosis, assessment and proposal of treatment strategies can be useful clinical and methodological tools. This review aims to present a comprehensive summary and propose further methodological approaches.

Design

A systematic review of the literature, evaluating classifications for dialysis-related VA stenosis.

Data sources

Web of Science, Scopus, PubMed, Google Scholar and the ClinicalTrials.gov registry were searched from inception to 7 December 2024.

Eligibility criteria

All articles containing classifications regarding dialysis VA were eligible, with no restrictions on the study type or language of the full text.

Data extraction and synthesis

Two independent researchers performed the search and initial screening. Four vascular surgeons assessed the included classifications using a modified Buchbinder’s critical appraisal tool to evaluate quality.

Results

From 4771 screened papers, 59 full-text papers were retrieved and 24 articles contained classifications. Three classifications were dedicated to VA stenosis, all based on the anatomical location of lesions. According to the modified Buchbinder’s appraisal, the classifications were assessed as moderate-to-good quality. The literature disposes of immense inconsistency in terms of the definition of significant stenosis indicated for treatment.

Conclusions

VA significant stenosis and its classification is a non-uniformly understood issue with many different criteria and categorisations. This basic methodological problem leads to inconsistent results. We recommend the unification of the criteria and their validation in prospective studies.
Personal, occupational and cardiovascular risk factors associated with elevated blood pressure in Brazilian firefighters: a cross-sectional study
Authors: Sales Igor Magalhães , Damacena Fernanda Camargo , Zandonade Eliana , Sampaio Karla Nívea
Published: January 2025

Objective

Our study evaluated the prevalence of hypertension in a population of Brazilian firefighters and the association of elevated blood pressure (BP) with personal, occupational, and cardiovascular risk factors.

Design

This was a cross-sectional study.

Setting

Our study was based on health inspections of the Military Fire Brigade of the Espírito Santo State, Brazil, performed in 2019.

Participants

The study participants were 859 male Brazilian firefighters.

Outcome measures

Data collected included sociodemographic (age, ethnicity, educational level, health insurance coverage), occupational (city of work, type of current activity, main operational activity), lifestyle (smoking and alcohol consumption), and health status (fasting glucose, total cholesterol and triglycerides, blood pressure, and anthropometric composition). All firefighters in the pre-hypertension and hypertension range and/or using antihypertensive medication were considered as having BP above normal, and the association of this outcome with sociodemographic, occupational, lifestyle, and health status variables was analysed by a logistic regression model.

Results

We found that 45.6% of firefighters presented elevated BP levels. A higher chance of elevated BP was observed for firefighters with high school (1.5; 95% confidence interval (CI) 1.02 to 2.19) and postgraduate (1.54; 95% CI 1.03 to 2.30) educational levels, those self-declared as black (1.98; 95% CI 1.03 to 3.78), those working in countryside cities (ie, locations outside the metropolitan circuit; 2.32; 95% CI 1.14 to 4.71), and those with hypertriglyceridemia (1.92; 95% CI 1.19 to 3.11), hyperglycaemia (1.5; 95% CI 1.01 to 2.22), and central obesity (2.34; 95% CI 1.47 to 3.70).

Conclusion

We found an association between elevated BP and personal, occupational, and cardiovascular risk factors. Awareness of risk factors may grant implementation of more effective intervention and prevention strategies.
Preferences of pregnant women and obstetric healthcare professionals on using noninvasive prenatal testing to predict adverse pregnancy outcomes: a discrete choice experiment
Authors: Becking Ellis , Akkerman Elisabeth , Scheffer Peter , Smith Ian , Stemkens Daphne , Bax Caroline J , Bekker Mireille N , Crombag Neeltje , Schuit Ewoud , Henneman Lidewij
Published: January 2025

Objectives

Noninvasive prenatal testing (NIPT) to screen for fetal aneuploidies by analysing cell-free DNA in maternal plasma is available to pregnant women worldwide. In the future, the scope of NIPT could potentially be expanded to the prediction of adverse pregnancy outcomes. The objective of this study was to assess and compare the preferences of pregnant women and obstetric healthcare professionals on this new test purpose of NIPT.

Design

A discrete choice experiment was designed to assess participants’ preferences on the use of NIPT to predict adverse pregnancy outcomes regarding three attributes on test characteristics: test accuracy rate, unnecessary intervention rate and false reassurance rate. A questionnaire assessed general attitudes towards using noninvasive prenatal testing to predict adverse pregnancy outcomes.

Setting

Dutch prenatal healthcare system.

Participants

Pregnant women with singleton pregnancies and obstetric healthcare professionals.

Results

In total, 1580 pregnant women and 308 obstetric healthcare professionals participated in the discrete choice experiment. Higher test accuracy, fewer unnecessary interventions and less false reassurance all had a statistically significant (p<0.05) impact on the preference for a test. For pregnant women, the most important test characteristic when choosing a preferred test was the test accuracy rate, while for obstetric healthcare professionals, the most important test characteristic was the unnecessary intervention rate. The false reassurance rate was the least important test characteristic for both groups. Overall, 74% (n=1181) of pregnant women (strongly) agreed that NIPT to predict adverse pregnancy outcomes should be offered to pregnant women compared with 49% (n=151) of obstetric healthcare professionals.

Conclusions

Most pregnant women have a positive attitude towards using NIPT to predict adverse pregnancy outcomes compared with slightly less than half of the obstetric healthcare professionals. Pregnant women prioritise a prognostic test with higher test accuracy, while obstetric healthcare professionals prioritise a test that results in fewer unnecessary interventions.
Symptom-related experience and sexual health of female patients with pulmonary arterial hypertension: protocol for a systematic review and qualitative meta-synthesis
Authors: Ma Fangfang , Yang Lixiao , He Ye , Yang Zhu
Published: January 2025

Introduction

Pulmonary arterial hypertension (PAH) is a complex condition affecting quality of life, characterised by high blood pressure in the pulmonary arteries leading to heart strain. PAH’s impact extends beyond physical symptoms, influencing emotional and social well-being, particularly in women where it affects sexual health and pregnancy outcomes. Despite medical advancements, the disease’s full impact on women’s lives is under-researched, especially regarding sexual experiences and health. This systematic review and qualitative meta-synthesis aim to address this gap by examining women’s experiences with PAH, informing clinical practice and patient-centred care. The protocol outlines a methodology for synthesising qualitative research to amplify women’s voices and enhance our understanding of PAH’s impact on female patients.

Methods and analysis

Search strategy: A systematic review and thematic meta-synthesis of qualitative research studies and qualitative components of mixed-methods studies will be conducted. The systematic review will be guided by the Joanna Briggs Institute methodological framework. A comprehensive search will encompass seven electronic databases and search engines (Ovid Medline, CINAHL, EMBASE, APA PsycINFO, Cochrane Database of Systematic Reviews, PubMed, Scopus) and grey literature sources (ProQuest Dissertations, ClinicalTrials.gov). Building on insights from previous reviews centred on symptom-related experience and sexual health. Two review authors will independently conduct the screening and data extraction processes. Discrepancies will be resolved through consensus or discussion with a third review author. The review will include English studies from database inception. Findings will be presented graphically and tabularly, together with a narrative description.

Assessment of confidence and data synthesis: The meta-synthesis used thematic analysis, importing study transcripts and notes into NVivo software. Data-derived codes formed categories, which were then iteratively refined into broader themes reflecting women’s experiences with sex and childbirth while living with PAH.

Ethics and dissemination

External ethical approval is not required as this review is a retrospective review, which is undertaking secondary analysis of publicly available primary data. The results will be disseminated in peer-reviewed journals and presented in conference papers and elsewhere. This protocol is registered with PROSPERO prospective database of systematic review.

PROSPERO registration number

CRD42024529342.
Opioid agonist therapy discontinuation in British Columbia: a cross-sectional study of people who access harm reduction services
Authors: Ziafat Kimia , Liu Lisa , Kievit Bradley , Papamihali Kristi , Graham Brittany , Otterstatter Michael , Buxton Jane A
Published: January 2025

Objectives

This study evaluates the prevalence and correlates of opioid agonist therapy (OAT) discontinuation across British Columbia (BC), using a sample of individuals who used substances and accessed harm reduction sites.

Design

This study uses data from the 2019 cross-sectional Harm Reduction Client Survey (HRCS).

Setting

The 2019 survey was administered from October to December at 22 harm reduction supply distribution sites across the 5 Regional Health Authorities of BC.

Participants

The 2019 HRCS was administered among individuals who used illicit substances in the past 6 months and were aged 19 years and above.

Primary and secondary outcome measures

The primary outcome was defined as self-reported discontinuation of OAT in the past 6 months. Measures of association (χ2and Fisher’s exact tests) and logistic regression models were used to assess the strength of association between OAT discontinuation and demographic, socioeconomic, accessibility, drug use and harm reduction correlates.

Results

Of the 194 participants included, 59.8% self-identified as cis man, 37.6% self-identified as Indigenous, 38.1% were aged 30–39 years and 43.8% had discontinued OAT in the past 6 months. Multivariable logistic regression analyses identified that those aged ≥50 years (AOR=0.12, 95% CI (0.03 to 0.45)) and those who took the survey in medium/large urban areas (AOR=0.27, 95% CI (0.07 to 0.98)) were significantly less likely to discontinue OAT, while those who experienced an overdose in the past 6 months were significantly more likely (AOR=3.77, 95% CI (1.57 to 9.03)) to have discontinued OAT in the past 6 months. Substance use, including opioids and stimulants, was similar among those who continued and discontinued OAT. Of the 73 participants who discontinued OAT and provided a reason, one-third reported discontinuing OAT because treatment was not effective, 27.4% could not get to the pharmacy during open hours, 23.3% could not make their clinic appointment and 15.1% reported challenges with transportation/travel.

Conclusions

OAT discontinuation prevention efforts for individuals using substances in BC need to address disparities in healthcare accessibility, especially in rural areas and among younger individuals. Continued access to harm reduction services can allow for safer consumption of substances for individuals enrolled in OAT programs.
Estimating the need for diabetic retinopathy services in north India: evidence from a population-based survey in the catchment population of an eye care provider in central Uttar Pradesh
Authors: Sabherwal Shalinder , McCormick Ian , Javed Mohd , Sood Ishaana , B R Shamanna , Buttan Sandeep , Majumdar Atanu , Chandi Simrat , Lakhani Basitali , Tyagi Shreya , Deep Utsav , Jain Vaibhav , Bastawrous Andrew
Published: January 2025

Objective

The aim of this study was to assess the prevalence of diabetic retinopathy (DR) and retina screening coverage among people with diabetes in the catchment area of a high-volume eye care organisation in north India.

Design

A population-based cross-sectional study using Rapid Assessment of Avoidable Blindness survey, including the DR module.

Setting

A customised rural district in the catchment of Dr Shroff’s Charity Eye Hospital in Uttar Pradesh in north India.

Participants

4095 people of age 50 years and above were enrolled using a two-staged cluster sampling, 3867 (94.4%) participated; 2167 (52.9%) were women. 3803 of 4095 (92.9%) participants were assessed for diabetes. People with already diagnosed diabetes and anyone with a random blood glucose ≥200 mg/dL were offered dilated fundus examination.

Primary and secondary outcomes

Primary and secondary outcomes were the prevalence of DR and screening coverage for DR, respectively.

Results

The prevalence of diabetes was 7.0% (95% CI 5.9% to 8.0%). 50.2% of all people with diabetes were newly detected. The prevalence of any DR among people with diabetes who consented to dilated pupillary examination was 22.8% (51 of 224), (95% CI 18.2% to 27.3%). 5.8% (13/224) of people with diabetes were found to have sight-threatening DR and only 15.4% (2/13) had received treatment. 84.8% of people with previously diagnosed diabetes had never had their eyes tested for DR; this was significantly higher in women (90.2% vs 76.0%, respectively, p<0.001). 76% of people with previously diagnosed diabetes had poorly controlled diabetes; this was significantly higher for those on non-allopathic treatment (p<0.01). The odds of DR were higher with duration of diabetes >10 years and poor glycaemic control (OR of 1.8 and 1.6, respectively), but this was not found to be statistically significant.

Conclusion

The prevalence of DR in this predominantly rural setting was found to be higher than the national average. Coverage of retinal screening and treatment was found to be very low. Working with general health providers to increase detection of people with diabetes and leveraging vision centres to improve DR screening coverage is needed in this region.
Intratumoral oncolytic virus OH2 injection in patients with locally advanced or metastatic sarcoma: a phase 1/2 trial
Authors: Tan Zhichao , Wu Yan , Fan Zhengfu , Gao Tian , Ding Sijuan , Han Liang , Luo Suxia , Fan Qingxia , Shi Jianhua , Bai Chujie , Xue Ruifeng , Li Shu , Zhang Lu , Wang Xinyu , Jia Ling , Zhou Lixin , Liu Binlei , Huang Jing , Liu Jiayong
Published: January 2025

Background

Intratumoral oncolytic herpes simplex virus 2-GM CSF (OH2) injection has shown safety and antitumor efficacy in patients with solid tumors. Here, we examined the safety and efficacy of OH2 as a single agent or in combination with HX008, an NMPA-approved PD-1 inhibitor, in locally advanced or metastatic sarcoma patients.

Methods

This multicenter, phase 1/2 trial enrolled patients with injectable sarcoma lesions, who had failed at least 1 or more lines of standard treatment. Patients were treated with OH2 at three dose levels (106, 107and 108CCID50/mL) as single agent or in combination with a fixed dose of HX008. The primary endpoints were safety and tolerability in phase 1 and objective response rate determined by RECIST (V.1.1) criteria and immune-RECIST in phase 2.

Results

Between October 20, 2020 and December 30, 2023, 26 patients were enrolled. Seven patients were treated with single-agent OH2 and 19 with HX008 and OH2 combination. No dose-limiting toxicities were observed during the dose escalation. We documented four partial or complete responses in injected lesions, and one partial response in non-injected lesions, which were all from the combination group. Hence, the overall response rate was 0% and 16.7% in the single agent and combination groups, respectively. The duration of response was 3.9–6.5 months. The most frequent treatment-related adverse events (TRAEs) were fever (n=9). Grade 3 or 4 TRAEs were reported in four patients (15.4%). A clear increase in CD8+cell density in the tumor microenvironment was observed in the patients’ post-treatment specimens compared with baseline.

Conclusions

Intratumoral injection of oncolytic virus OH2 is well tolerable in patients with sarcoma. Further investigation of OH2 with HX008 in select sarcoma subtypes is warranted.
PURA-related neurodevelopmental disorders: a systematic review on genotype-phenotype correlations
Authors: Taniguchi Noritaka , Watanuki Keisuke , Nakato Daisuke , Takenouchi Toshiki , Kosaki Kenjiro , Koga Hiroshi
Published: January 2025

Introduction

Genotype-phenotype correlations inPURA-related neurodevelopmental disorders (PURA-NDDs) remain unclear. This systematic review aimed to clarify these correlations.

Methods

Searches of PubMed and Embase were conducted on 8 August 2024 to identify studies that had investigated genetically diagnosedPURA-NDDs (5q31.3 deletion syndrome and PURA syndrome). All types and languages of studies were included. Study quality was assessed using a 20-item criterion checklist. Genetic and clinical data were extracted from each article and genotype-phenotype correlations were explored.

Results

Our analysis included 46 studies encompassing 230 patients withPURA-NDDs (5q31.3 deletion syndrome 18 (8%) and PURA syndrome 212 (92%)). Patients with 5q31.3 deletion syndrome exhibited more congenital defects (50% vs 12%, p<0.0001), respiratory difficulties (94% vs 63%, p=0.013) and walking disability (94% vs 55%, p=0.0026) than patients with PURA syndrome. In PURA syndrome, protein-truncating (nonsense or frameshift) variants were associated with more speech deficits (93% vs 80%, p=0.014) than non-protein-truncating (missense or in-frame) variants.PURAvariant location had no effect on congenital defect occurrence or neurodevelopmental outcome. Overall, respiratory difficulties, walking disability and speech deficits were more commonly observed in the following order: 5q31.3 deletion (94%, 94% and 100%, respectively), multiple PUR-repeat deletions (68%, 60% and 95%, respectively), single PUR-repeat deletion or alteration (61%, 53% and 85%, respectively), and deletion or alteration located outside PUR repeats (38%, 33% and 43%, respectively).

Conclusion

The clinical severity ofPURA-NDDs appears to be associated with the deletion/alteration size including PUR repeats rather than the location ofPURAvariants.
MRDACE: An Intelligent Architecture For Secure Sharing And Traceability Of The Medical Images And Patients’ Records
Authors: Verma Poonam , Tripathi Vikas , Pant Bhaskar
Published: January 2025

Health Insurance Portability and Accountability Act (HIPAA) has laid down several ethical and legal obligations on healthcare providers to preserve the privacy and confidentiality of patient information. Digitization in healthcare has been of great help to the medical fraternity and the patients, however, digital-based services in healthcare have also widened the spectrum of vulnerabilities. In this paper, we propose a blockchain-based system to trace the data collection, storing, and sharing process for medical records. We present an Architecture of Medical Records Data Accountability and Compliance (MRDACE) which is a decentralized permissioned data-sharing platform. The Medical Images and Information of a patient will be under the sole ownership of the patient. Logs of any access made to the Medical Images and Information of a patient will be maintained and cannot be modified, leading to a transparent traceability mechanism. This architecture utilizes the Proof-of-Authority consensus algorithm and further introduces a new automated incentive function to decide upon the access rights of the Data requestors. In comparison to the existing state-of-art solutions, it performs with 56.71% less gas since the automated function introduced removes the need for the patient consent to share the health records with the Data requestors.
Exploring Large Language Models for Personalized Recipe Generation and Weight-Loss Management
Authors: Ataguba Grace , Orji Rita
Published: January 2025

The emergence of large language models is transforming various health-related domains, including approaches to obesity management. Obesity remains one of the world’s leading health issues, prompting the research community to develop various weight loss applications focused on physical activity, dietary planning, and related interventions. In this study, we explore the capability of the large language model (LLM) ChatGPT for personalized dietary planning. We conducted two case studies: Case Study 1 examined self-supervised recipe generation using ChatGPT alone, while Case Study 2 investigated a self-supervised approach combining National Institute of Health standards with ChatGPT recipe recommendations. We also performed a user study to evaluate recipe recommendations from ChatGPT. Our results show that ChatGPT recommends appropriate recipes based on comparisons with the United States Department of Agriculture’s (USDA) recipe calculator. We found no significant difference between ChatGPT-generated recipe recommendation calories and USDA standards for either Case Study 1 (
p = .8530
) or Case Study 2 (
p = .0687
). In addition, we found significant weight loss in participants following these recipes in both Case Study 1 (
p < .00001
) and Case Study 2 (
p = .0014
). Furthermore, the user study with potential weight loss participants revealed varying levels of satisfaction (
p = .001
) and identified themes related to meal preferences, effective prompt generation, and mixed concerns regarding privacy, trust, user consent, and data storage. We conclude by discussing additional findings from our case and user studies, and present opportunities, challenges, and design and ethical considerations for the research community..
The effect of high-fiber diet based on gut microbiota in patients with chronic heart failure
Authors: Li Liwei , Yang Li , Liu Mingrong
Published: January 2025

Traditional heart failure (HF) treatment primarily focuses on medications and surgery, whereas this study explores the improvement effects of a diet high in dietary fiber on patients with chronic HF from the perspective of gut microbiota, providing a new perspective for HF treatment.
Method Development and Clinical Utility for Simultaneous Measurement of 21‐Deoxycortisol, 17‐Hydroxyprogesterone, Cortisol, and Cortisone Levels in Human Plasma Using UHPLC‐MS/MS
Authors: Alvi Syed N. , dgither Saleh Al , Al-Odaib Ali
Published: January 2025

A simple and efficient validated assay for quantifying 21‐deoxycortisol (21‐DOC), 17‐hydroxyprogesterone (17‐OHP), cortisol, and cortisone in human plasma has been developed using ultra‐high performance liquid chromatography coupled with tandem mass spectrometry (UHPLC‐MS/MS). Analysis of plasma samples were performed on Atlantis dC18 (3 μm) column using a mobile phase of 20.0 mM ammonium acetate and acetonitrile (50:50, v : v) that was delivered at isocratic flow rate 0.3 mL/minute. After addition of d4‐cortisol as an internal standard (IS), plasma samples containing 21‐DOC, 17‐OHP, cortisol, and cortisone were extracted with mixture of dichloromethane and tert‐butylmethyl ether 1:2 (v/v). Analytes were detected and quantified in the positive ion mode of electrospray ionization using multiple reaction monitoring transition set at mass to charge (m/z): 347.17 ⟶ 311.12, 331.17 ⟶ 96.97, 363.11 ⟶ 121.00, 361.18 ⟶ 163.11, and 367.19 ⟶ 121.24 for 21‐DOC and 17‐OHP, cortisol, cortisone, and cortisol‐d4 (IS), respectively. The relationship between concentration and peak area response (analyte/IS) were linear over the range of 0.25–50, 0.5–100, 1–200, and 2–400 ng/mL for 21‐DOC, 17‐OHP, cortisone, and cortisol, respectively. The mean extraction recovery of the analytes was in the range of 83%–96%. The coefficient of variation within and between days was less than 13.6%, and the bias ranged from −9.2% to 12%. The measured level of cortisol, cortisone, and 17‐OHP was in the range of 21.9–110, 4.33–12.71, and 0.37–1.4 ng/mL, respectively. Furthermore, the measured value of cortisone–cortisol ratio was in the range of 0.08–0.21.
Development and Evaluation of an Automated Multimodal Mobile Detection of Oral Cancer (mDOC) Imaging System to Aid in Risk-based Management of Oral Mucosal Lesions
Authors: Mitbander Ruchika , Brenes David , Coole Jackson B. , Kortum Alex , Vohra Imran S. , Carns Jennifer , Schwarz Richard A. , Varghese Ida , Durab Safia , Anderson Sean , Bass Nancy E. , Clayton Ashlee D. , Badaoui Hawraa , Anandasivam Loganayaki , Giese Rachel A. , Gillenwater Ann M. , Vigneswaran Nadarajah , Richards-Kortum Rebecca
Published: January 2025

Oral cancer is a major global health problem. It is commonly diagnosed at an advanced stage although often preceded by clinically visible oral mucosal lesions, termed oral potentially malignant disorders associated with an increased risk for oral cancer development. There is an unmet clinical need for effective screening tools to assist front-line healthcare providers to determine which patients should be referred to an oral cancer specialist for evaluation. This study reports the development and evaluation of the mobile Detection of Oral Cancer (mDOC) imaging system and an automated algorithm that generates a referral recommendation from mDOC images. mDOC is a smartphone-based autofluorescence and white light imaging tool that captures images of the oral cavity. Data were collected with mDOC from a total of 332 oral sites in a study of 29 healthy volunteers and 120 patients seeking care for an oral mucosal lesion. A multimodal image classification algorithm was developed to generate a recommendation of “Refer” or “Do Not Refer” from mDOC images, using expert clinical referral decision as the ground truth label. A referral algorithm was developed using cross-validation methods on 80% of the dataset, then retrained and evaluated on a separate holdout test set. Referral decisions generated in the holdout test set had a sensitivity of 93.9% and a specificity of 79.3% with respect to expert clinical referral decisions. The mDOC system has the potential to be utilized in community physicians’ and dentists’ offices to help identify patients who need further evaluation by an oral cancer specialist.
Figure S2 from RNA-encoded Interleukin 2 with Extended Bioavailability Amplifies RNA Vaccine–Induced Antitumor T-cell Immunity
Authors: Peters Daniel , Kranz Lena M. , Eisel David , Diken Mustafa , Kreiter Sebastian , Türeci Özlem , Sahin Ugur , Vormehr Mathias
Published: January 2025

Expansion of nonvaccine antigen-specific CD8+ T cells in response to RNA-LPX and Alb-IL2 RNA-NP. Number of nonvaccine antigen-specific CD8+ T cells per spleen (gp70 (A), OVA (B)) or per 4 x 106 splenocytes (TRP-1 (C)) 7 days after the last of three weekly i.v. vaccinations with gp70 RNA-LPX (A), OVA RNA-LPX (B) or TRP-1 RNA-LPX (C) combined with Alb-IL2 RNA-NP or Alb RNA-NP (gp70: n=6 mice/group for Alb RNA-NP, n=7 mice/group for Alb-IL2 RNA-NP; OVA, TRP-1: n=5 mice/group). Mean + SEM. Two-tailed Student t-test (A). **P≤0.01.
Figure S11 from RNA-encoded Interleukin 2 with Extended Bioavailability Amplifies RNA Vaccine–Induced Antitumor T-cell Immunity
Authors: Peters Daniel , Kranz Lena M. , Eisel David , Diken Mustafa , Kreiter Sebastian , Türeci Özlem , Sahin Ugur , Vormehr Mathias
Published: January 2025

Representative dot plots corresponding to flow cytometry data displayed in Figure 6.
RNA Viruses, Toll-Like Receptors, and Cytokines: The Perfect Storm?
Authors: Stegeman Sophia K. , Kourko Olena , Amsden Heather , Pellizzari Delano Isabella E. , Mamatis John E. , Roth Madison , Colpitts Che C. , Gee Katrina
Published: January 2025

Background: The interactions between viruses and the host immune response are nuanced and intricate. The cytokine response arguably plays a central role in dictating the outcome of virus infection, balancing inflammation, and healing, which is crucial to resolving infection without destructive immunopathologies. Summary: Early innate immune responses are key to the generation of a beneficial or detrimental immune response. These initial responses are regulated by a plethora of surface bound, endosomal, and cytoplasmic innate immune receptors known as pattern recognition receptors. Of these, the Toll-like receptors (TLRs) play an important role in the induction of cytokines during virus infection. Recognizing pathogen-associated molecular patterns (PAMPs) such as viral proteins and/or nucleotide sequences, the TLRs act as sentinels for the initiation and propagation of immune responses. Key Messages: TLRs are important receptors for initiating the innate response to single-stranded RNA (ssRNA) viruses like influenza A virus (IAV), severe acute respiratory syndrome coronavirus-1 (SARS-CoV-1), SARS-CoV-2, Middle East respiratory syndrome coronavirus, dengue virus, and Ebola virus. Infection with these viruses is also associated with aberrant expression of proinflammatory cytokines that contribute to a harmful cytokine storm response. Herein we discuss the connections between these ssRNA viruses, cytokine storm, and the roles of TLRs.
Angina Severity and Symptom Improvement Are Associated With Diagnostic Acetylcholine Provocation Dose in Vasospastic Angina
Authors: Crooijmans C. , Jansen Tijn P. J. , Meeder Joan G. , Paradies Valeria , de Vos Annemiek M. J. , Woudstra Pier , Vossenberg Tessel N. E. , van de Hoef Tim P. , Vos Nicola S. , Olde Bijvank Els G. M. , van den Oord Stijn C. H. , Winkler Patty , Meuwissen Martijn , Widdershoven Jos W. M. G. , Arkenbout E. Karin , Stoel Martin G. , Appelman Yolande , Beijk Marcel A. M. , Cetinyurek‐Yavuz Aysun , den Ruijter Hester M. , Elias‐Smale Suzette E. , van Royen Niels , Dimitriu‐Leen Aukelien C. , Damman Peter ,   for NL‐CFT
Published: January 2025

Background

A coronary function test (CFT) is the recommended diagnostic test to identify coronary vasomotor dysfunction as a cause of symptoms in patients with angina and nonobstructive coronary arteries (ANOCA). Acetylcholine is the commonly used pharmacological agent for spasm provocation. We aimed to investigate an association between severity of symptoms and provocative acetylcholine dose.

Methods and Results

We included ANOCA patients undergoing clinically indicated CFT from the Netherlands Registry of Invasive Coronary Vasomotor Function Testing: NL‐CFT. Patients with epicardial spasm (n=251) were divided according to acetylcholine spasm triggering dose: low (2–20 mcg, EpiLOW), middle (100 mcg, EpiMIDDLE) or high (200 mcg, EpiHIGH). Patients with microvascular spasm (n=157) were analyzed irrespective of triggering dose. The patient groups were compared to each other and to a control group with negative CFT results (n=101). We assessed mean Seattle Angina Questionnaire angina frequency and summary scores at baseline and follow‐up and the proportion of patients improving or deteriorating. An inverse relationship between provocation dosage and angina frequency at baseline was found in epicardial spasm: the lower the triggering dose, the more frequently patients experienced angina (EpiLOW 48±20, EpiMIDDLE 53±21, EpiHIGH 57±19, microvascular spasm 61±21, controls 64±21, overall
P
=0.003). A trend was seen toward most patients improving in the high triggering dose group, and most patients deteriorating in the low triggering dose group.

Conclusions

A significant dose‐dependent relationship between spasm provocation and anginal complaints exists. Acetylcholine provocation dose could be incorporated as a risk stratification factor or surrogate outcome in future clinical trials.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT06083155.
Language and Attention Networks Have Distinct Roles in Language Improvement Following an Intensive Comprehensive Aphasia Program
Authors: Houldin Evan , Babbitt Edna M. , Hurwitz Rosalind , Baliki Marwan N. , Cherney Leora R.
Published: January 2025

BACKGROUND:

Attention is known to play an important role in language, and attentional deficits have been associated with language impairments in people with aphasia (PWA). A prior study by our laboratory indicated that behavioral measures for PWA participating in an intensive comprehensive aphasia program (ICAP) clustered into 1 language and 1 attention-related factor, with each factor correlated with independent resting state functional connectivity (rsFC) networks. The present study includes additional attention measures and participants to better assess the relationship between attention, language, and rsFC.

METHODS:

PWA participated in 120 hours of ICAP therapy over 4 weeks, between April 2018 and August 2022. Participants were evaluated with the Western Aphasia Battery and Conners’ Continuous Performance Test, pre- and post-ICAP. rsFC data were collected during functional magnetic resonance imaging scans pre- and post-ICAP. Principal component analysis identified behavioral score associations pre- and post-ICAP. FC matrices and graph measures were evaluated for both PWA and healthy controls.

RESULTS:

Twenty-three PWA participated (19 included in the final analysis). Data for 179 age and sex-matched healthy controls were taken from a public data set. The principal component analysis indicated 1 language and 2 attention-related principal components (PCs). The attention PCs were labeled Attention Accuracy and Attention Rate, in accordance with their best-associated behavioral measures. Importantly, each PC was associated with distinct networks, including higher-order networks, so-called because of their involvement in higher-order cognition. Notably, the language PC was significantly correlated with the ventral attention-memory–retrieval network rsFC (
r
=0.67,
P
=0.003) and the default mode–frontoparietal network rsFC (
r
=−0.56,
P
=0.019). Attention Accuracy was significantly correlated with cingulo-opercular–subcortical network rsFC (
r
=0.60,
P
=0.011). Attention Rate was significantly negatively correlated with visual-somatomotor network rsFC (
r
=−0.74,
P
=0.0007).

CONCLUSIONS:

This study supports the notion that language improvements for PWAs participating in an ICAP are associated with distinct network changes. Importantly, these networks are not restricted to language networks but also include attention, and task-control networks.
Immersive Scientific Communication: A Multidimensional Theoretical Model for Approaching Extended Reality as a Medium
Authors: Rubio-Tamayo Jose Luis , Gertrudix Manuel , Wuebben Daniel
Published: January 2025

Extended reality (XR) promises to dramatically change the framework of scientific communication. XR offers new possibilities for creating engaging scientific content, presenting complex information, and designing immersive experiences. Scientists and communicators need to better understand interactive and immersive narratives to harness these potentials of XR. This essay proposes a multidimensional theoretical model for immersive scientific communication that evaluates the interface models of XR, analyses its levels of reality and interaction, and identifies the dominant characteristics of the narrative. This model promotes the critical and reflective application of XR to science communication, especially Citizen Science projects.
Charting the Transformative Journey of Augmented Reality in Graphic Design Education: A Comprehensive Overview of the Period 2016–2022
Authors: Wang Jiawei , Mokmin Nur Azlina Mohamed , Ji Shaorong
Published: January 2025

Continuous innovation in instructional technology has propelled augmented reality (AR) to the forefront of educational tools that universities and research institutions promote globally. Graphic design, an art discipline requiring high-dimensional interaction, benefits from AR's ability to enhance interactivity in virtual and physical teaching environments. This study explores trends in AR development within graphic design education, focusing on college students. A systematic literature review from 2016 to 2022 investigates AR applications in art teaching and their impact on students. Findings indicate limited use of AR in graphic design education, predominantly focusing on marker-based AR, highlighting a research gap in exploring other AR types. This study contributes to the field by identifying the need for diverse AR applications and providing insights into their potential to enhance student engagement, creativity, and learning outcomes in graphic design.