bluuebunny/crossref_metadata_2025 huggingface dataset:
Cognitive behavior therapy for autistic adolescents, awareness and care for my autistic traits program: a multicenter randomized controlled trial
Authors: Oshima Fumiyo , Mandy William , Seto Mikuko , Hongo Minako , Tsuchiyagaito Aki , Hirano Yoshiyuki , Sutoh Chihiro , Guan Siqing , Nitta Yusuke , Ozawa Yoshihito , Kawasaki Yohei , Ohtani Toshiyuki , Masuya Jiro , Takahashi Noriko , Sato Noriyuki , Nakamura Shizuka , Nakagawa Akiko , Shimizu Eiji
Published: September 2023

Background

Autistic people demonstrate focused interests, sensitivity to sensory stimulation, and, compared with the general population, differences in social communication and interaction. We examined whether a combination of the Awareness and Care for My Autistic Traits (ACAT) program and treatment-as-usual is more effective than only treatment-as-usual in increasing the understanding of autistic attributes, reducing treatment stigma, and improving mental health and social adaptation among autistic adolescents and their parents/guardians.

Methods

Forty-nine adolescents and their parents/guardians were randomly assigned to either a combination of ACAT and treatment-as-usual or only treatment-as-usual. The combined group received six weekly 100-minute ACAT sessions, while the treatment-as-usual group received no additional intervention. The primary outcome was the change in understanding of autistic attributes (Autism Knowledge Quiz-Child), administered from pre- to post-intervention. The secondary outcomes included the change in Autism Knowledge Quiz-Parent, reduced treatment stigma, and improved mental health and social adaptation among autistic adolescents and their parents/guardians. A primary outcome measure scale was scored by assessors who were blind to the group assignment.

Results

The combined group (both autistic adolescents and their parents/guardians) showed an increase in Autism Knowledge Quiz scores compared to those in the treatment-as-usual group. Autistic adolescents in the combined group also demonstrated a decrease in treatment-related stigma and an improvement in general mental health compared to those in the treatment-as-usual group, while there were no group differences in the change in social adaptation. For parents/guardians, there were no group differences in the change in treatment-related stigma, general mental health, adaptive skills, or attitudes toward their children.

Conclusions

The ACAT program could be an effective treatment modality to increase the understanding of autistic attributes among both autistic adolescents and their parents/guardians. The ACAT program positively affects self-understanding, reduces treatment stigma, and stabilizes behavioral issues for autistic adolescents as a part of mental health measures, but it does not effectively reduce treatment barriers or improve mental health for parents/guardians. Further research should consider whether additional support for parents/guardians could be beneficial.

Trial registration

: The study was registered in UMIN (UMIN000029851, 06/01/2018).
A scoping review of resilience among transition-age youth with serious mental illness: tensions, knowledge gaps, and future directions
Authors: Nesbitt Amy E. , Sabiston Catherine M. , deJonge Melissa L. , Barbic Skye P. , Kozloff Nicole , Nalder Emily J.
Published: September 2023

Introduction

The study of resilience among transition-age youth (aged 16–29 years) living with serious mental illness (SMI) has provided a promising new direction for research with the capacity to explore individuals’ strengths and resources. However, variability in how resilience is defined and measured has led to a lack of conceptual clarity. A comprehensive synthesis is needed to understand current trends and gaps in resilience research among this population. The purpose of the current study was to map how resilience has been conceptualized and operationalized among transition-age youth with SMI, explore resilience factors and outcomes that have been studied, and recommend areas for future research.

Methods

A six-stage scoping review methodology was used to systematically identify relevant empirical literature across multiple databases (MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, Scopus), addressing transition-age youth diagnosed with SMI and resilience. Topic consultation and reaction meetings were conducted to gather feedback from transition-age youth with SMI, researchers, and clinicians during the review process to enhance the applicability of the review findings. A meta-narrative approach was used to organize included studies into research traditions (i.e., paradigms of inquiry with similar storylines, theoretical and methodological orientations). Resilience factors and outcomes, and the consultative meetings, were analyzed using content analysis.

Results

Twenty-four studies met inclusion criteria (14 quantitative, 9 qualitative, 1 mixed-method). Four research traditions were identified, each contributing a unique storyline which conceptualized and operationalized resilience in slightly different ways: Stress Adaptation, Person-Environment Interactions, Recovery-Focused, and Critical and Cultural Perspectives. Resilience factors and outcomes were most commonly evaluated at the individual-level or within the immediate environment (e.g., personal characteristics, social support networks). Limited research has explored the influence of macro-level systems and health inequalities on resilience processes. Results from the consultative meetings further demonstrated the importance of health services and sociocultural factors in shaping processes of resilience among youth.

Conclusion

The present results may be used to inform future work, as well as the development of age-appropriate, strengths-based, and resilience-oriented approaches to service delivery. Interdisciplinary and intersectional research that prioritizes community and youth engagement is needed to advance current understandings of resilience among transition-age youth with SMI.
A predictive model for hyperuricemia among type 2 diabetes mellitus patients in Urumqi, China
Authors: Abudureyimu Palizhati , Pang Yuesheng , Huang Lirun , Luo Qianqian , Zhang Xiaozheng , Xu Yifan , Jiang Liang , Mohemaiti Patamu
Published: September 2023

Background

Patients with type 2 diabetes Mellitus (T2DM) are more likely to suffer from a higher uric acid level in blood—hyperuricemia (HUA). There are no conclusive studies done to predict HUA among T2DM patients. Therefore, this study aims to explore the risk factors of HUA among T2DM patients and finally suggest a model to help with its prediction.

Method

In this retrospective research, all the date were collected between March 2017 and October 2019 in the Medical Laboratory Center of the First Affiliated Hospital of Xinjiang Medical University. The information included sociodemographic factors, blood routine index, thyroid function indicators and serum biochemical markers. The least absolute shrinkage and selection operator (LASSO) and multivariate binary logistic regression were performed to screen the risk factors of HUA among T2DM patients in blood tests, and the nomogram was used to perform and visualise the predictive model. The receiver operator characteristic (ROC) curve, internal validation, and clinical decision curve analysis (DCA) were applied to evaluate the prediction performance of the model.

Results

We total collected the clinical date of 841 T2DM patients, whose age vary from 19-86. In this study, the overall prevalence of HUA in T2DM patients was 12.6%. According to the result of LASSO-logistic regression analysis, sex, ethnicity, serum albumin (ALB), serum cystatin C (CysC), serum inorganic phosphorus (IPHOS), alkaline phosphatase (ALP), serum bicarbonate (CO2) and high-density lipoprotein (HDLC) were included in the HUA risk prediction model. The nomogram confirmed that the prediction model fits well (χ2 = 5.4952, P = 0.704) and the calibration curve indicates the model had a good calibration. ROC analysis indicates that the predictive model shows the best discrimination ability (AUC = 0.827; 95% CI: 0.78–0.874) whose specificity is 0.885, and sensitivity is 0.602.

Conclusion

Our study reveals that there were 8 variables that can be considered as independent risk factors for HUA among T2DM patients. In light of our findings, a predictive model was developed and clinical advice was given on its use.
Definitions and assessments of physical literacy among children and youth: a scoping review
Authors: Grauduszus Martin , Wessely Stefanie , Klaudius Marlen , Joisten Christine
Published: September 2023

Background

Despite the recognised health benefits of physical activity, the physical activity levels of children and adolescents continue to decline. The concept of physical literacy (PL) is a promising holistic approach to physical activity promotion that addresses affective and cognitive domains in addition to physical and motor domains. In Germany, however, no uniform or widely used method exists for assessing PL in children. This research was conducted to compile information on international PL assessment systems for children and adolescents (up to 18 years of age), including their underlying definitions, structural designs and development processes, for the purpose of developing such a tool in Germany.

Methods

A scoping review was conducted using PubMed, Web of Science and SPORTDiscus database entries. The initial search was conducted in July 2022, with a follow-up search performed in May 2023. Articles that operationalised the construct of PL and at least two of the three domains were identified and included. The procedure and assessment tools used to evaluate the individual domains and the overall PL construct were extracted from all selected articles.

Results

A total of 882 articles were identified; five were added after a manual search. After duplicates were removed, 563 articles were screened by title and abstract, and 40 articles met the inclusion criteria and were included in the review. In a review of these articles, 23 different assessment procedures were identified. Eight assessment procedures included PL as a superordinate construct. Twenty-two of the 23 procedures assessed the affective and physical domains, only 14 assessed the cognitive domain.

Conclusion

Approximately half of the identified PL assessment systems addressed all three domains. Motor performance was most frequently integrated into the test procedures. Future developments in Germany should integrate all domains in the assessment to produce a holistic conceptualisation as the basis for appropriate funding.
Developing an effective and comprehensive communication curriculum for undergraduate medical education in Poland – the review and recommendations
Authors: Borowczyk Martyna , Stalmach-Przygoda Agata , Doroszewska Antonina , Libura Maria , Chojnacka-Kuraś Marta , Małecki Łukasz , Kowalski Zbigniew , Jankowska Aldona K.
Published: September 2023

Background

The recognition of the importance of effective communication in the healthcare system has been growing. Given that communication courses must be adjusted to the specificity of a particular culture, language, and other contextual issues, many countries and communities sharing a common language have proposed their recommendations for a communication curriculum for undergraduate medical education. To date, no recommendations have been developed for either any Central and Eastern Europe countries or for regions where Slavic languages are spoken. Their specificity of post-communist transformation should be acknowledged. This study aims to review communication curriculums and offer recommendations for medical communication training for undergraduate medical students in Poland.

Methods

The recommendations were developed through an iterative consultation process with lecturers, faculty members of medical schools, and education coordinators. PubMed and Google Scholar databases were searched to identify full text English and Polish language articles on communication curriculum for undergraduate medical education. Additionally, the new Regulation of the Polish Minister of Science and Higher Education, defining educational standards for undergraduate medical education was analysed in search of learning outcomes that could be applied in communication skills teaching. The authors extracted the most relevant communication skill competencies, as determined by the process participants, discussed current challenges, including those of the COVID-19 pandemic era, and indicated best practices.

Results

A review was conducted, and a set of recommendations was developed pertaining to the scope and methodology of teaching communication skills. The study included: (1) definition, (2) education content, (3) learning outcomes, (4) the recommended teaching methods. The recommendations are in concord with the graduate profile, as well as the current structure of medical studies. The authors listed and discussed the basic communication competencies expected of medical graduates, as well as medical communication course content viewed from different perspectives, including clinical, psychological, sociological, legal, and linguistic.

Conclusions

Detailed recommendations aimed at integrating best practices into a comprehensive communication curriculum may promote successful teaching, learning, and assessment of medical communication.
Self-reported critical gaps in the essential knowledge and capacity of spatial epidemiology between the current university education and competency-oriented professional demands in preparing for a future pandemic among public health postgraduates in China: a nationwide cross-sectional survey
Authors: Lan Tao , Cheng Man , Lin Yue-Dong , Jiang Long-Yan , Chen Ning , Zhu Man-Tong , Li Qiao , Tang Xian-Yan
Published: September 2023

Background

Spatial epidemiology plays an important role in public health. Yet, it is unclear whether the current university education in spatial epidemiology in China could meet the competency-oriented professional demands. This study aimed to understand the current situation of education and training, practical application, and potential demands in spatial epidemiology among public health postgraduates in China, and to assess the critical gaps in a future emerging infectious diseases (EID) pandemic preparedness and response.

Methods

This study was divided into three parts. The first part was a comparative study on spatial epidemiology education in international public health postgraduate training. The second part was a cross-sectional survey conducted among public health professionals. The third part was a nationwide cross-sectional survey conducted among public health postgraduates at Chinese universities from October 2020 to February 2021. Data was collected by the WeChat-based questionnaire star survey system and analyzed using the SPSS software.

Results

International education institutions had required public health postgraduates to master the essential knowledge and capacity of spatial epidemiology. A total of 198 public health professionals were surveyed, and they had a median of 4.00 (IQR 3.13–4.53) in demand degree of spatial epidemiology. A total of 1354 public health postgraduates were surveyed from 51 universities. Only 29.41% (15/51) of universities offered spatial epidemiology course. Around 8.05% (109/1354) of postgraduates had learned spatial epidemiology, and had a median of 1.05 (IQR 1.00–1.29) in learning degree and a median of 1.91 (IQR 1.05–2.78) in practical application degree of spatial epidemiology. To enhance professional capacity, 65.95% (893/1354) of postgraduates hoped that universities would deliver a credit-course of spatial epidemiology.

Conclusions

A huge unmet education and training demand in spatial epidemiology existed in the current education system of public health postgraduates in China. To enhance the competency-oriented professional capacity in preparedness and response to a future pandemic, it is urgent to incorporate the teaching and training of spatial epidemiology into the compulsory curriculum system of public health postgraduates in China.
Teaching approaches and satisfaction of medical students during anesthesia rotations: a multicenter cross-sectional study
Authors: Shawahna Ramzi , Jaber Mohammad , Maqboul Iyad , Khaleel Mansour , Abo-Mokh Jenan , Sabbah Hisham , Assi Sudqi , Zuhd Jehad
Published: September 2023

Background

Anesthesia training is an important component of medical education. This multicenter study was conducted to determine the teaching approaches used during anesthesia training or rotations and to assess the satisfaction of the medical students.

Methods

This multicenter study was conducted in a cross-sectional design. The study was conducted among 5th and 6th year medical students who completed their anesthesia rotations in different training centers in Palestine. The data were collected using a questionnaire in adherence to the strengthening the reporting of observational studies in epidemiology statement.

Results

Questionnaires were returned by 385 medical students. The mean anesthesia rotation length was 12.4 ± 2.1 days. On average, the students witnessed 7.8 ± 4.9 procedures performed under general, regional, and local anesthesia in a week. Of the students, 135 (35.1%) and 126 (32.8%) stated that the educators always or often explained how and why they did procedures or techniques during the anesthesia rotation and assessed their baseline level of knowledge before giving new knowledge or explaining things. On the other hand, stepping back and allowing the trainees to work through, presenting articles or literature relevant to the case, and being open to trying new or different procedures or techniques were less often reported by the medical students. Less than half of the students were satisfied with their competencies gained through the anesthesia rotation.

Conclusion

Educators used active and effective teaching or training approaches less frequently during the anesthesia rotations. The findings of this study also showed that the medical students were not satisfied with their competencies after their anesthesia rotations. More studies are still needed to determine the best ways to improve anesthesia rotations and medical education or training in Palestine.
Academic emotions and attitudes regarding interprofessional collaboration in health care activities: a prospective study among newly arrived physicians participating in a fourteen-week course
Authors: Lachmann Hanna , Löfvenmark Caroline
Published: September 2023

Background

One way of facilitating entrance into the Swedish health care system, for newly arrived physicians from outside the European Union/European Economic Area, could be to set up and offer a course aimed to enhance understanding of it. This course was offered to increase insight about clinical practices, interprofessional teamwork and topics such as, Swedish health care laws, culture, and ethics. Acceptance of, and a flexible attitude towards, interprofessional teamwork are important for maintaining both the physician’s professional identity and a high quality of patient care.

The aim of this study was to investigate newly arrived physicians’, academic emotions, experience of stress and flow during a fourteen-week course, as well as attitudes to interprofessional collaboration, both before and after.

Method

A prospective study was conducted, with participants asked to respond on one questionnaire every course day, by using the Contextual Activity Sampling System methodology. The participants were asked to complete a questionnaire comprising ten questions about ongoing activity and in what way they experience, e.g., collaboration, interprofessional teamwork, academic emotions, flow, and stress. Furthermore, the participants were asked to score their attitude towards interprofessional teamwork by using the interdisciplinary education perception scale both before and after the course.

Results

The total sample comprised 27 qualified physicians, from outside the European Union/European Economic Area. In the interdisciplinary education perception scale category, “perception of actual cooperation¨, the participants had significantly higher scores after the course. Flow and academic emotions were felt mostly during own periods of study, seminars, and lectures. The academic emotions were apathy, anxiety, and boredom. The most frequently experienced academic emotion was apathy. Course participants rated stress highest in connection with the examination.

Conclusion

The results show that the course had a positive impact on the participants perception of actual cooperation. It appears that participating in this kind of course was a positive experience for the participants, since they mostly experienced high levels of flow. Collaborating with others was experienced as positive, with participants reporting a high degree of flow in activities during collaboration.
Matching of advanced undergraduate medical students’ competence profiles with the required competence profiles of their specialty of choice for postgraduate training
Authors: Jebram Lea , Prediger Sarah , Oubaid Viktor , Harendza Sigrid
Published: September 2023

Background

Matching between undergraduate students and their chosen specialty has implications for their personal job satisfaction and performance as well as societies’ needs regarding health care quality. Knowledge regarding student-specialty fit can help improve students’ decisions and detect potential deficiencies in specific competences. In this study, we compare self-assessed competence profiles of medical students close to graduation with the competence profiles of their specialty of choice for postgraduate training.

Methods

Self-assessed competence profiles were collected with the modified requirement-tracking (R-Track) questionnaire from 197 final-year medical students close to graduation in 2022. To determine student-specialty fit, difference scores between students’ self-assessed competences and physicians’ requirements for specific specialties were calculated across the R-Track’s six competence areas “Motivation”, “Personality traits”, “Social interactive competences”, “Mental abilities”, “Psychomotor & multitasking abilities”, and “Sensory abilities”, which were assessed on a 5-point Likert scale (1: “very low” to 5: “very high”). Mean difference scores across competence areas were calculated and compared between specialties with multivariate analysis of variance. Student-specialty fit was also calculated independent of students’ choices.

Results

The competence area “Motivation” scored highest for both students and physicians across specialties. However, students’ scores were lower than physicians’ requirements for “Motivation” as well as “Personality traits” across all specialties. Difference scores for “Social interactive competences” were either close to zero or showed higher scores for students. A similar competence pattern for internal medicine, general medicine, paediatrics, and gynaecology was identified with higher than required student scores for “Mental abilities”, “Psychomotor & multitasking abilities”, and “Sensory abilities”. All other specialties showed higher physicians’ requirements for at least one of these competence areas. Independent of students’ specialty choice, we found the highest difference score in favour of student scores for general medicine (0.31) and the lowest difference score for internal medicine (-0.02).

Conclusions

Students’ competence profiles overall show better fit with person-oriented specialties. “Mental abilities”, “Psychomotor & multitasking abilities”, and “Sensory abilities” show higher requirement scores for more technique-oriented specialties. Students interested in such specialties could focus more on basic skill development in undergraduate training or will develop specific skills during residency.
Perception towards the implementation of telemedicine during COVID-19 pandemic: a cross-sectional study
Authors: Assaye Bayou Tilahun , Belachew Muluken , Worku Aynadis , Birhanu Sefefe , Sisay Ayenew , Kassaw Mitiku , Mekonen Habtamu
Published: September 2023

Background

The COVID-19 pandemic has led to a surge in the use of telemedicine as a means of delivering healthcare services remotely. Healthcare providers play a key role in the adoption and implementation of telemedicine for its effectiveness. Despite its benefits, there have been unclear concerns about its effectiveness and acceptance in the process of implementing telemedicine. The objective of the study was to assess health professionals’ perceptions towards the implementation of telemedicine during the COVID-19 pandemic.

Methods

A cross-sectional study design was conducted among eight hundred forty-five study participants from December 2020 to February 2021. A pre-test was performed on 5% of the total sample size, and the quality of the data was ensured by checking its completeness and consistency. Descriptive statistics and bivariable and multivariable logistic regression were used. The Variables with a P-value equal to or less than 0.25 in bivariable logistic regression were entered into a multivariable logistic regression, and model fitness was assessed.

Result

The study revealed that 60.9% of professionals had a good perception toward telemedicine implementation, with an 87.2% response rate. Health professionals with IT support staff, ICT training, who use social media platforms regularly, and availability of computer or smartphone within/outside their health facility were 4.7, 3.3, 3.7, and 13.2 times more likely to have a positive association towards telemedicine implementation respectively.

Conclusion

More than half of the health professionals had a good perception of telemedicine. Social media use, ICT training, computer accessibility, and the presence of IT support staff were all found to have positive associations with the telemedicine perception. In the era of the COVID-19 pandemic, the government should take the initiative to strengthen opportunities for health professionals to learn and apply telemedicine in their medical practice by providing ICT training, IT infrastructure and support staff, improving computer access, and recommending health professionals’ positive use of social media in the health facility.
Urban-rural disparities in immunization coverage among children aged 12–23 months in Ethiopia: multivariate decomposition analysis
Authors: Asresie Melash Belachew , Fekadu Gedefaw Abeje , Dagnew Gizachew Worku
Published: September 2023

Background

Immunization is one of the most cost-effective public health interventions for improving children’s health and survival. In Ethiopia, low immunization coverage and disparity across residences are major public health problems. However, the factors that contributed to the urban-rural disparity have not been thoroughly investigated. Therefore, the objective of this study was to examine the change and contributing factors in full immunization coverage across geographic locations (urban-rural) in Ethiopia.

Methods

We analyzed data on children aged 12 to 23 months obtained from the 2019 mini-Ethiopian demographic and health survey. A total of 996 weighted samples (299 in urban and 697 in rural areas) were included in the analysis. A multivariate decomposition analysis technique was used to determine the disparity and identify factors that contribute to the disparity across geographical locations. Statistical significance was defined at a 95% confidence interval with a p-value of less than 0.05.

Results

The percentage of children aged 12–23 months who received full immunization increased from 36.84% (95% CI:31.59, 42.41) in rural areas to 64.59% (95% CI:47.10, 78.89) in urban areas. The decomposition analysis showed that the observed urban-rural disparity was attributed to a change in the effect of population characteristics (coefficient) across residences. Specifically, receiving 1–3 (β = 0.0895, 95% CI: 0.0241, 0.1550) and 4 or more (β = 0.1212, 95% CI: 0.0224, 0.2199) antenatal care visits, delivering at a health facility (β = 0.1350, 95% CI: 0.0227, 0.2472), and the source of information about immunization status from vaccination cards (β = 0.2666, 95% CI:0.1763, 0.3569) significantly contributed to the widening urban-rural disparity. On the other hand, being of high wealth status (β=-0.141, 95% CI: -0.1945, -0.0876), receiving postnatal care (β=-0.0697, 95% CI: -0.1344, -0.0051), and having four or more living children (β=-0.1774, 95% CI: -0.2971, -0.0577) significantly contributed to narrowing the urban-rural disparity.

Conclusions

There was a significant urban-rural disparity in immunization coverage in Ethiopia, with urban children more likely to complete immunization. The change in the composition of population characteristics was not significant for the observed disparity. The observed disparity in full immunization coverage was mainly driven by the coefficients related to maternal healthcare utilization, household wealth status, the number of living children, and the source of immunization information. Therefore, strengthening maternal health services utilization, encouraging mothers to maintain their children’s immunization records, and addressing economic inequality, particularly in rural areas, may narrow the urban-rural disparity and enhance immunization coverage nationwide.
Exploring the impact of the national tender system on the use of costly drugs treating rheumatoid arthritis patients in ten rheumatology centers in Norway (2010–2019)
Authors: Brkic Alen , Diamantopoulos Andreas P , Hoff Mari , Haavardsholm Espen Andre , Fevang Bjørg Tilde Svanes , Brekke Lene Kristin , Loli Liz , Zettel Camilla , Bakland Gunnstein , Mielnik Pawel , Haugeberg Glenn
Published: September 2023

Background

Biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) are highly effective in treating rheumatoid arthritis (RA), albeit high drug cost has restricted their use in many countries. As a countermeasure, Norway implemented pharmaceutical tendering as a cost-reducing strategy. The aim of this study was to assess the annual proportion of different b/tsDMARDs registered to treat RA patients under the influence of a Norwegian pharmaceutical tendering between 2010 and 2019.

Method

The data is collected from ten Norwegian outpatient centers. The included patients are categorized as naïve, non-naïve, and current b/tsDMARD users. 13 individual b/tsDMARDs are assessed and compared with the tender rankings from each year. Overview of subcutaneous (sc) with per oral vs. intravenous (iv) and biosimilars vs. non-biosimilar are also described.

Result

The tender-winning b/tsDMARD was the most or second most used drug in nine out of ten years for naïve users, seven for non-naïve users, and twice for current users. The average sum of the highest and second highest proportion among naïve, non-naïve, and current b/tsDMARD users were 75%, 53%, and 50% during the ten years, respectively. The tender-winning drug was iv in eight out of ten years. However, the average total proportion of sc and per oral b/tsDMARDs was about 70% for naïve b/tsDMARD users, 50% for non-naïve b/tsDMARD users, and 60% for current b/tsDMARD users. The main contributors to sc and per oral b/tsDMARD were etanercept (reference and biosimilar) and certolizumab pegol. The main contributors to iv b/tsDMARD were rituximab reference and infliximab biosimilar. Despite low-ranking offers, rituximab reference (offered as a second-line drug) often achieved a high proportion among non-naïve and current b/tsDMARD users. After the introduction of biosimilars, their average proportion was about 40%, 40%, and 20% for naïve, non-naïve, and current b/tsDMARD users, respectively.

Conclusion

Based on observed data, a higher tender rank was associated with a higher proportion among naïve and non-naïve b/tsDMARD users. However, in most cases, sc b/tsDMARDs achieved a higher proportion with lower tender ranks than iv b/tsDMARDs with higher tender ranks.
The Automated Systematic Search Deduplicator (ASySD): a rapid, open-source, interoperable tool to remove duplicate citations in biomedical systematic reviews
Authors: Hair Kaitlyn , Bahor Zsanett , Macleod Malcolm , Liao Jing , Sena Emily S.
Published: September 2023

Background

Researchers performing high-quality systematic reviews search across multiple databases to identify relevant evidence. However, the same publication is often retrieved from several databases. Identifying and removing such duplicates (“deduplication”) can be extremely time-consuming, but failure to remove these citations can lead to the wrongful inclusion of duplicate data. Many existing tools are not sensitive enough, lack interoperability with other tools, are not freely accessible, or are difficult to use without programming knowledge. Here, we report the performance of our Automated Systematic Search Deduplicator (ASySD), a novel tool to perform automated deduplication of systematic searches for biomedical reviews.

Methods

We evaluated ASySD’s performance on 5 unseen biomedical systematic search datasets of various sizes (1845–79,880 citations). We compared the performance of ASySD with EndNote’s automated deduplication option and with the Systematic Review Assistant Deduplication Module (SRA-DM).

Results

ASySD identified more duplicates than either SRA-DM or EndNote, with a sensitivity in different datasets of 0.95 to 0.99. The false-positive rate was comparable to human performance, with a specificity of > 0.99. The tool took less than 1 h to identify and remove duplicates within each dataset.

Conclusions

For duplicate removal in biomedical systematic reviews, ASySD is a highly sensitive, reliable, and time-saving tool. It is open source and freely available online as both an R package and a user-friendly web application.
Re: Molecular testing to deliver personalised chemotherapy recommendations
Authors: Gibbs Peter , Hong Wei , Tie Jeanne
Published: September 2023

Background

There is an increasing focus over time on the discovery and validation of biomarkers in cancer medicine, which can inform the identification of patients that are most likely to benefit from treatment, which therapy is most likely to be effective, and treatments that may not be safe.

Body

Creating the necessary evidence base for biomarker-informed management is a different challenge to developing a new therapy, and many biomarkers have been adopted into routine clinical practice without phase III randomised studies where the primary endpoint was to evaluate the direct impact of a biomarker-informed approach. This has generated a robust discussion in the research and clinical community regarding the most appropriate trial methodologies for biomarker validation, and the level of evidence required to support the incorporation of individual biomarker-driven approaches as a standard of care. This ongoing debate is key to optimising clinical trial design and ultimately delivering the best possible care to patients in an environment increasingly focused on personalised and patient-focused management.

Conclusion

Ongoing deliberation as to the optimal design of biomarker-driven clinical trials is critical to informing future clinical trial design and will ultimately greatly benefit patients and the clinicians that care for them.
Detection of diabetic patients in people with normal fasting glucose using machine learning
Authors: Lv Kun , Cui Chunmei , Fan Rui , Zha Xiaojuan , Wang Pengyu , Zhang Jun , Zhang Lina , Ke Jing , Zhao Dong , Cui Qinghua , Yang Liming
Published: September 2023

Background

Diabetes mellitus (DM) is a chronic metabolic disease that could produce severe complications threatening life. Its early detection is thus quite important for the timely prevention and treatment. Normally, fasting blood glucose (FBG) by physical examination is used for large-scale screening of DM; however, some people with normal fasting glucose (NFG) actually have suffered from diabetes but are missed by the examination. This study aimed to investigate whether common physical examination indexes for diabetes can be used to identify the diabetes individuals from the populations with NFG.

Methods

The physical examination data from over 60,000 individuals with NFG in three Chinese cohorts were used. The diabetes patients were defined by HbA1c ≥ 48 mmol/mol (6.5%). We constructed the models using multiple machine learning methods, including logistic regression, random forest, deep neural network, and support vector machine, and selected the optimal one on the validation set. A framework using permutation feature importance algorithm was devised to discover the personalized risk factors.

Results

The prediction model constructed by logistic regression achieved the best performance with an AUC, sensitivity, and specificity of 0.899, 85.0%, and 81.1% on the validation set and 0.872, 77.9%, and 81.0% on the test set, respectively. Following feature selection, the final classifier only requiring 13 features, named as DRING (diabetes risk of individuals with normal fasting glucose), exhibited reliable performance on two newly recruited independent datasets, with the AUC of 0.964 and 0.899, the balanced accuracy of 84.2% and 81.1%, the sensitivity of 100% and 76.2%, and the specificity of 68.3% and 86.0%, respectively. The feature importance ranking analysis revealed that BMI, age, sex, absolute lymphocyte count, and mean corpuscular volume are important factors for the risk stratification of diabetes. With a case, the framework for identifying personalized risk factors revealed FBG, age, and BMI as significant hazard factors that contribute to an increased incidence of diabetes. DRING webserver is available for ease of application (http://www.cuilab.cn/dring).

Conclusions

DRING was demonstrated to perform well on identifying the diabetes individuals among populations with NFG, which could aid in early diagnosis and interventions for those individuals who are most likely missed.
Erythritol alters gene transcriptome signatures, cell growth, and biofilm formation in Staphylococcus pseudintermedius
Authors: Fujii Tadashi , Tochio Takumi , Nishifuji Koji
Published: September 2023

Background

Erythritol was found to inhibit the growth of microorganisms. The present study aimed to demonstrate the growth inhibition of Staphylococcus pseudintermedius by erythritol and to define the changes in gene transcription signatures induced by erythritol. Changes in the gene transcription profiles were analysed by RNA sequencing and quantitative reverse transcription PCR. Gene ontology analysis was performed to assign functional descriptions to the genes.

Results

Erythritol inhibited S. pseudintermedius growth in a dose-dependent manner. We then performed a transcriptome analysis of S. pseudintermedius with and without 5% (w/w) erythritol exposure to validate the mechanism of growth inhibition. We revealed that erythritol induced up-regulation of three genes (ptsG, ppdK, and ppdkR) that are related to the phosphoenolpyruvate-dependent sugar phosphotransferase system (PTS). Glucose supplementation restored the up-regulation of the PTS-related genes in response to erythritol. In addition, erythritol down-regulated eleven genes that are located in a single pur-operon and inhibited biofilm formation of S. pseudintermedius.

Conclusions

These findings indicated that erythritol antagonistically inhibits PTS-mediated glucose uptake, thereby exerting a growth inhibitory effect on S. pseudintermedius. Moreover, erythritol inhibits the ‘de novo’ IMP biosynthetic pathway that may contribute to biofilm synthesis in S. pseudintermedius.
Smoking, alcohol consumption and risk of Dupuytren’s disease: a Mendelian randomization study
Authors: Wang Zifeng , Wang Zhenyu , Yan Zijian , Xu Zhujie , Gao Aiguo
Published: September 2023

Background

The correlation between smoking and alcohol consumption and the development of Dupuytren’s disease (DD) has been acknowledged. However, the definitive causal relationship between these two factors and DD remains elusive. In order to establish a causal connection, we employed the two-sample Mendelian randomization method to evaluate the relationship between smoking and alcohol consumption and DD.

Methods

Based on publicly available genome-wide association studies (GWAS), two-sample univariate MR analyses were performed to assess the causal effects of drinks per week, cigarettes per day, smoking initiation, age of initiation, and smoking cessation on DD. We used inverse variance weighted (IVW) to generate the primary results for the MR analysis. Furthermore, we performed sensitivity MR analyses based on various methods to assess the robustness of estimations. Bidirectional MR analyses were used to study the interaction between smoking and alcohol consumption. Multivariate MR analyses were used to obtain independent causal effects of smoking or drinking on DD.

Results

Our two-sample MR, which was predominately based on IVW, revealed a causal relationship between drinks per week and DD (OR = 2.948, 95%CI: 1.746–4.975,P = 5.16E-05). In addition, there is no causal association between cigarettes per day, smoking initiation, age of initiation, smoking cessation and DD. Similar conclusions were reached by other MR methods. The results of the bidirectional MR analyses showed that the causal relationships between age of initiation and drinks per week were robust and significant. Multivariate MR results indicated that the causal effect of alcohol consumption on DD was independent of smoking.

Conclusion

Our Mendelian Randomization study indicated that there is a causality between drinking alcohol and DD, but no such causality was found between smoking and DD. This is the first study to prove that drinking alcohol could cause DD. This could help people who are trying to prevent DD from happening in the first place.
Endogenous estradiol contributes to vascular endothelial dysfunction in premenopausal women with type 1 diabetes
Authors: Simon Abigayle B. , Derella Cassandra C. , Blackburn Marsha , Thomas Jeffrey , Layman Lawrence C. , Nicholson Matthew S. , Waller Jennifer , Elmarakby Ahmed , Saad Karim M. , Harris Ryan A.
Published: September 2023

Background

Endogenous estrogen is cardio-protective in healthy premenopausal women. Despite this favorable action of estrogen, animal models depict a detrimental effect of estradiol on vascular function in the presence of diabetes. The present study sought to determine the role of endogenous estradiol on endothelial function in women with type 1 diabetes.

Method

32 women with type 1 diabetes (HbA1c = 8.6 ± 1.7%) and 25 apparently healthy women (HbA1c = 5.2 ± 0.3%) participated. Flow-mediated dilation (FMD), a bioassay of nitric-oxide bioavailability and endothelial function was performed during menses (M) and the late follicular (LF) phase of the menstrual cycle to represent low and high concentrations of estrogen, respectively. In addition, a venous blood sample was collected at each visit to determine circulating concentrations of estradiol, thiobarbituric acid reactive substances (TBARS), and nitrate/nitrite (NOx), biomarkers of oxidative stress and nitric oxide, respectively. Data were collected in (1) 9 additional women with type 1 diabetes using oral hormonal birth control (HBC) (HbA1c = 8.3 ± 2.1%) during the placebo pill week and second active pill week, and (2) a subgroup of 9 demographically matched women with type 1 diabetes not using HBC (HbA1c = 8.9 ± 2.1%).

Results

Overall, estradiol was significantly increased during the LF phase compared to M in both type 1 diabetes (Δestradiol = 75 ± 86 pg/mL) and controls (Δestradiol = 71 ± 76 pg/mL); however, an increase in TBARS was only observed in patients with type 1 diabetes (ΔTBARS = 3 ± 13 µM) compared to controls (ΔTBARS = 0 ± 4 µM). FMD was similar (p = 0.406) between groups at M. In addition, FMD increased significantly from M to the LF phase in controls (p = 0.024), whereas a decrease was observed in type 1 diabetes. FMD was greater (p = 0.015) in patients using HBC compared to those not on HBC, independent of menstrual cycle phase.

Conclusion

Endogenous estradiol increases oxidative stress and contributes to endothelial dysfunction in women with diabetes. Additionally, HBC use appears to be beneficial to endothelial function in type 1 diabetes.
Triglyceride-glucose index and heart failure: a systematic review and meta-analysis
Authors: Khalaji Amirmohammad , Behnoush Amir Hossein , Khanmohammadi Shaghayegh , Ghanbari Mardasi Kimiya , Sharifkashani Sourena , Sahebkar Amirhossein , Vinciguerra Caterina , Cannavo Alessandro
Published: September 2023

Background

Insulin resistance (IR) is a major metabolic disorder observed in heart failure (HF) and is tightly associated with patients’ poor prognosis. The triglyceride-glucose index (TyG) has been proposed as a surrogate marker of IR in HF. Yet, whether TyG is a reliable clinical marker is still under debate. Hence, we aimed to respond to this relevant question via a systematic review and meta-analysis of existing studies.

Methods

A systematic search was conducted in PubMed, Embase, Scopus, and Web of Science to find studies investigating the TyG index in patients with HF or its association with the incidence of HF. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were pooled through random-effect meta-analysis. HRs were calculated using TyG as a continuous variable (1 unit increase) and by comparing the group with the highest TyG to the lowest TyG group.

Results

Thirty studies, involving 772,809 participants, were included in this systematic review. Meta-analysis of seven studies comparing the highest-TyG to the lowest-TyG group showed a significantly increased risk of HF in the former group (HR 1.21, 95% CI 1.14 to 1.29, P < 0.01). The same result was found when pooling the HRs for a one-unit increase in the TyG index (HR 1.17, 95% CI 1.08 to 1.26). Similarly, a more elevated TyG index was associated with a higher incidence of HF in patients with type 2 diabetes or coronary artery disease. Additionally, the incidence of adverse events (readmission and mortality) in patients with HF was associated with TyG.

Conclusion

Our findings support the TyG index as a valuable marker to assess the risk of HF incidence in different populations and as a prognostic marker in patients with HF. Further studies should be conducted to confirm these associations and investigate the clinical utility of the TyG index.
Streamlining N-terminally anchored yeast surface display via structural insights into S. cerevisiae Pir proteins
Authors: Martinić Cezar Tea , Lozančić Mateja , Novačić Ana , Matičević Ana , Matijević Dominik , Vallée Béatrice , Mrša Vladimir , Teparić Renata , Žunar Bojan
Published: September 2023

Surface display co-opts yeast’s innate ability to embellish its cell wall with mannoproteins, thus converting the yeast’s outer surface into a growing and self-sustaining catalyst. However, the efficient toolbox for converting the enzyme of interest into its surface-displayed isoform is currently lacking, especially if the isoform needs to be anchored to the cell wall near the isoform’s N-terminus, e.g., through a short GPI-independent protein anchor. Aiming to advance such N-terminally anchored surface display, we employed in silico and machine-learning strategies to study the 3D structure, function, genomic organisation, and evolution of the Pir protein family, whose members evolved to covalently attach themselves near their N-terminus to the β-1,3-glucan of the cell wall. Through the newly-gained insights, we rationally engineered 14 S. cerevisiae Hsp150 (Pir2)-based fusion proteins. We quantified their performance, uncovering guidelines for efficient yeast surface display while developing a construct that promoted a 2.5-fold more efficient display of a reporter protein than the full-length Hsp150. Moreover, we developed a Pir-tag, i.e., a peptide spanning only 4.5 kDa but promoting as efficient surface display of a reporter protein as the full-length Hsp150. These constructs fortify the existing surface display toolbox, allowing for a prompt and routine refitting of intracellular proteins into their N-terminally anchored isoforms.

Graphical abstract