bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retinal microvascular changes in systemic lupus erythematosus assessed by optical coherence tomography angiography
Authors: Ferreira André , Viveiros Luísa , Faria Raquel , Bragança Francisca , Abreu Ana Carolina , Santos Daniela , Furtado Maria João , Lume Miguel , Menéres Pedro , Andrade José P. 
Published: December 2024

Abstract
Purpose
To assess the retinal microvasculature of Systemic Lupus Erythematosus (SLE) patients using Optical Coherence Tomography Angiography (OCTA).

Methods
Twenty adult SLE patients without disease activity and no ocular manifestations were recruited and cross-sectionally assessed. A demographically similar cohort of healthy subjects was used for comparison. The main outcome is vascular density (VD). As secondary outcomes, foveal avascular zone (FAZ) parameters, total vessel length (TVL), vessel length density (VLD), vessel diameter and tortuosity, branchpoint density (BD) and fractal dimension (FD) were evaluated.

Results
Forty eyes of 40 women (20 SLE patients and 20 healthy subjects) were enrolled with a mean ± SD age of 36.7 ± 9.9 years. In both the superficial and deep capillary plexuses, SLE patients presented significantly lower VD and TVL values, mean vessel diameter and FD (all p < 0.005). No significant differences were found in FAZ values. A negative correlation was found between age and FAZ parameters and between age and TVL, VLD and FD in the superficial capillary plexus (all p < 0.05).

Conclusions
This study supports the evidence of subclinical retinal microvascular changes in adult SLE patients, providing a more comprehensive characterization of vascular changes. We found vessel diameter and length and FD are decreased in SLE.

Trial registration
NCT05863689, 2023-10-19.
Barriers and facilitators of school-based obesity prevention interventions: a qualitative study from the perspectives of primary school headteachers
Authors: Saleh Mohamed , Ba-Break Maryam , Abahussin Asma 
Published: December 2024

Abstract
Background
Childhood obesity is a growing global health issue. The World Health Organization identifies obesity as a significant risk factor for Non-Communicable Diseases and considers it a pandemic. This study aimed to investigate headteachers' perspectives and practices concerning childhood obesity prevention interventions in primary schools highlighting the barriers and facilitators for those interventions.

Methods
This qualitative study used a phenomenological approach and semi-structured interviews with headteachers of primary schools in the West Yorkshire area, UK. The collected data was transcribed and analysed using inductive thematic analysis.

Results
A total of 32 interviews with headteachers were conducted. The data indicated that interventions meant to prevent childhood obesity in schools are influenced by a range of barriers and facilitators that are organized under the following seven key themes: (1) staff perception of obesity prevention at school; (2) school policies on eating at schools; (3) School curriculum on healthy diets and physical activities; (4) role models at school; (5) partnership with parents; (6) extra-curricular activities on healthy diets and physical activities; (7) School capacity and resources.

Conclusions
Childhood obesity prevention interventions vary across UK schools depending on staff and head teachers' beliefs, awareness, commitments, school resources, parents' involvement and parents’ awareness, income, and culture. The study suggests raising awareness of childhood obesity among parents and staff, involving external partners like school nurses for training, making all primary pupils eligible for free meals, and providing schools with guidance on securing government funding. It provides a foundation for improving school-based strategies that indirectly contribute to better health outcomes for children.
Virtual reality simulation for facilitating critical reflection and transformative learning: pedagogical, practical, and ethical considerations
Authors: Soilis Niki , Bhanji Farhan , Kinsella Elizabeth Anne 
Published: December 2024

Abstract There is growing recognition that preparing health professionals to work with complex social issues in the delivery of healthcare requires distinct theoretical and pedagogical approaches. Recent literature highlights the significance of employing simulated environments which aim to immerse learners in the experiences of diverse populations and bridge the gap between academic learning and lived realities across a diverse society. Virtual Reality (VR) is gaining traction as a promising pedagogical approach in this context. VR has been argued to offer distinct advantages over traditional educational methods by allowing learners to see the world through the eyes of diverse populations, and to learn about social injustices while immersed in a mediated environment. It also has practical benefits in its capacity to expose large number of students to these topics with relatively modest resources compared to other approaches. This debate article explores VR as an innovative pedagogical approach for facilitating critical reflection, dialogue and transformative learning about social issues in health professions education (HPE). It examines the potential affordances as well as risks and dangers of integrating VR into educational programs and highlights key pedagogical, practical, and ethical considerations. Emphasis is placed on the importance of these considerations in efforts toward ethical, safe, and respectful use of VR in educational settings. This paper contributes to the ongoing dialogue on VR simulation as an innovative approach to HPE and highlights the importance of creating conditions that maximize its educational benefits and minimize potential harms.
PEARLS debriefing for social justice and equity: integrating health advocacy in simulation-based education
Authors: Soilis Niki , Kinsella Elizabeth Anne , Eppich Walter , Cheng Adam , Beavers Lindsay , Bhanji Farhan 
Published: December 2024

AbstractAddressing health inequities in health professions education is essential for preparing healthcare workers to meet the demands of diverse communities. While simulation has become a widely recognized and effective method for providing safe and authentic clinical learning experiences, there has been limited attention towards the power of simulation in preparing health practitioners to work with groups who experience health disparities due to systems of inequality. Balancing technical proficiency with educational approaches that foster critical reflection and inform action oriented towards social accountability is essential. Transformational learning promotes the development of critical consciousness through critical reflection. Debriefing plays a crucial role in fostering learning in this direction by providing a structured opportunity to critically reflect on taken for granted assumptions, examine power and privilege embedded within systems and structures, and empower learners to take action toward changing those conditions. Building on the Promoting Excellence and Reflective Learning in Simulation (PEARLS) Healthcare Debriefing Tool, we propose a PEARLS Debriefing for Social Justice and Equity (DSJE) Tool that specifically directs attention to systems of inequality that contribute to health disparities for vulnerable groups across a range of simulation scenarios. This approach has two aims: (a) to transform debriefings into a critically reflective space by engaging learners in dialogue about social and structural determinants of health that may create or perpetuate inequities and (b) to foster critical reflection on what actions can be taken to improve the health and well-being of identified at risk and vulnerable groups. From this perspective, we can use the adapted PEARLS Tool to incorporate conversations about systems of inequality, equity, diversity, and inclusion (EDI) into our existing educational practices, and make concentrated efforts towards community-driven and socially conscious simulation-based education (SBE).
First preclinical SPECT/CT imaging and biodistribution of [165Er]ErCl3 and [165Er]Er-PSMA-617
Authors: Saeedi Saghez Behrad , Rodríguez-Rodríguez Cristina , Esquinas Pedro Luis , Merkens Helen , Bénard François , Radchenko Valery , Yang Hua 
Published: December 2024

Abstract
Background
165Er (t1/2 = 10.4 h, Ex-ray = 47.1 keV (59.4%) and 54.3 keV (14.3%)) is a promising radionuclide suitable for targeted Auger electron therapy of cancer. 165Er can be produced at a relatively low cost, high yield, and high purity using small medical cyclotrons. As a late lanthanide, 165Er is easy to label and can be used as a surrogate for other lanthanides or Ac in proof-of-concept studies. In this report, we explore the radiochemistry, in vitro, and in vivo behavior of [165Er]ErCl3 and [165Er]Er-PSMA-617 to showcase the application of this radionuclide. Particularly, we report the first phantom and preclinical SPECT imaging of this radionuclide leveraging its characteristic X-ray photon emissions.

Results
The 165Ho(p,n)165Er nuclear reaction using a 13 MeV cyclotron demonstrated production yields of up to 25 ± 5 MBq. µA−1 h−1 at the end of the bombardment. After the purification (4.0 ± 0.5 h) using a sequential combination of cation exchange and extraction chromatography, 4-h irradiation produced up to 1.5 GBq of [165Er]ErCl3. High molar activity [165Er]Er-PSMA-617 was prepared (~ 200 MBq/nmol). [165Er]Er-PSMA-617 showed a LogD7.4 value of -2.34 ± 0.24 meaning high hydrophilicity of the complex as expected. The stability of [165Er]Er-PSMA-617 in saline, human, and mouse serum was studied and showed intact tracer after 12 h in all three cases. [165Er]ErCl3 and [165Er]Er-PSMA-617 were both taken up by LNCaP cells. PSMA-617 has IC50 at nanomolar range for [165Er]Er-PSMA-617 in LNCaP cells. SPECT images with preclinical phantoms showed good uniformity, spatial resolution, and quantitative accuracy. SPECT/CT imaging in LNCaP tumor-bearing mice injected with [165Er]Er-PSMA-617 showed high tumor uptake and quantitative accuracy when comparing the results to ex vivo biodistribution %IA/g values. Mice injected with [165Er]ErCl3 showed uptake in bone structures and excretion through both liver and kidneys.

Conclusions
This study demonstrated the preclinical use of 165Er for the first time. Using [165Er]ErCl3 and [165Er]Er-PSMA-617 as examples, the radiochemistry, cell, and animal studies showed that 165Er can be used as a tool for evaluating targeted radiopharmaceuticals. The X-ray emission from 165Er can be used for quantitative SPECT imaging in mice.
[89Zr]Zr-DFO-TOC: a novel radiopharmaceutical for PET imaging of somatostatin receptor positive neuroendocrine tumors
Authors: Sanwick Alexis M. , Haugh Katherine N. , Williams Evan J. , Perry Kala A. , Thiele Nikki A. , Chaple Ivis F. 
Published: December 2024

Abstract
Background
Neuroendocrine tumors (NETs) are clinically diverse types of tumors that can arise anywhere in the body. Previous studies have shown that somatostatin receptors (SSTRs) are overexpressed on NET cell membranes relative to healthy tissue, allowing for tumor targeting through radiolabeled somatostatin analogs (SSAs). This work aims to develop a novel 89Zr-labeled tracer incorporating the SSA, octreotide (TOC), for positron emission tomography (PET) imaging of SSTR + NETs and predictive dosimetry calculations, leveraging the excellent nuclear (t½ = 3.27 days, β+ = 22.3%, β+avg = 395.5 keV) and chemical characteristics (+ 4 oxidation state, preferential coordination number of 7/8, favorable aqueous chemistry) of 89Zr. In combination with 89Zr, the known radiochemistry with the chelator deferoxamine (DFO) gives reason to believe that this radiopharmaceutical incorporating an octreotide conjugate will be successful in studying the suitability of detecting SSTR + NETs.

Results
Radiochemical tracer assessment indicated that amounts as low as 0.1 nmol DFO-TOC can be effectively radiolabeled with 89Zr, while maintaining ≥ 95% radiochemical yield. The stability of the compound was found to maintain radiochemical yields of 89.6% and 88.7% on the benchtop and in mouse serum, respectively, after 9 days. Receptor binding and competitive receptor blocking assays compared AR42J (high SSTR expression), PC-3 (moderate SSTR expression), and PANC-1 (minimal SSTR expression) cell lines at time points up to 6 days. In vitro studies demonstrated highest uptake in AR42J cells, and statistically significant differences in tracer uptake were seen after 1 h. Internalization assays showed maximum internalization after 3 h for all cell lines.

Conclusions
In this work, [89Zr]Zr-DFO-TOC was synthesized with radiochemical yields ≥ 95% and was found to remain stable in vitro at extended time points. In vitro cell studies demonstrated a statistically significant difference between receptor binding and blocking experiments. The development of this work shows potential to positively impact patient care through the predictive dosimetry calculations for the FDA-approved therapeutic agent [177Lu]Lu-DOTA-TATE, while allowing for imaging at extended timepoints and should be studied further.
Control of dengue larvae of Aedes aegypti and Aedes albopictus using the larvicidal bioactive compounds in different plant extracts and plant extract-mediated nanoparticles
Authors: Nawarathne Madhawa Pradeepa , Dharmarathne Chathuranga 
Published: December 2024

Abstract
Background
Dengue is a devastating viral disease transmitted by mosquito vectors of Aedes aegypti and Aedes albopictus. Mosquito populations thrive in favourable breeding conditions, making mosquito control vital. Eliminating larval populations is the most effective method compared with other mosquito control methods. Synthetic chemicals such as organochlorine, organophosphate, carbamate and growth regulators are available for mosquito control, but their use is limited due to health and environmental concerns. Biologically synthesized insecticides are preferable to synthetic insecticides as they are eco-friendly, low cost, target-specific and less toxic for non-target organisms.

Mainbody
Plant-derived bioassays are commonly used to control virally transmitted vectors, as plants contain bioactive compounds such as phytochemicals and essential oils that have high larvicidal efficacy against various mosquito vectors. In addition, nanomaterials are garnering attention in mosquito control due to their eco-friendliness, cost-effectiveness and safety. Commonly used nanomaterials include metal nanoparticles, such as silver nanoparticles, known for their potent larvicidal effect. Nanomaterials can be biologically synthesized through the combination with plant materials and encapsulation of bioactive compounds to maintain their stability and efficacy.

Conclusion
Various plant species and parts, as well as plant-derived nanoparticles, show diverse larvicidal activities against Aedes mosquitos. Among these, plant-mediated nanoparticles demonstrate excellent larvicidal properties against mosquito larvae, including Aedes species.
Plasmodium falciparum with pfhrp2 and pfhrp3 gene deletions in asymptomatic malaria infections in the Lake Victoria region, Kenya
Authors: Okai Takatsugu , Chan Chim W. , KC Achyut , Omondi Protus , Musyoka Kelvin , Kongere James , Kagaya Wataru , Okomo Gordon , Kanoi Bernard N. , Kido Yasutoshi , Gitaka Jesse , Kaneko Akira 
Published: December 2024

AbstractMalaria rapid diagnostic tests (RDTs) targeting the Plasmodium falciparum histidine-rich protein 2 (PfHRP2) are widely used to diagnose P. falciparum infection. However, reports of P. falciparum strains lacking PfHRP2 and the structurally similar PfHRP3 have raised concerns about the utility and reliability of PfHRP2-based RDTs. This study investigated the presence of P. falciparum with pfhrp2 and/or pfhrp3 gene deletions among infected residents in the Lake Victoria region, Kenya. Four cross-sectional malaria, surveys were conducted in four sites (Suba South, Mfangano, Kibuogi, and Ngodhe) from September 2018 to January 2020. P. falciparum infections were detected using a PfHRP2-based RDT, microscopy, and PCR on 9120 finger-prick blood samples. Samples negative by RDT but positive by PCR were selected for PCR amplification of pfmsp1 and pfmsp2 to confirm the quality and quantity of P. falciparum DNA. Samples positive for both pfmsp1 and pfmsp2 were included for detection of deletions of exons 1 and 2 in pfhrp2 and pfhrp3 PCR. The multiplicity of infection (MOI) was determined as the higher allele count between pfmsp1 and pfmsp2. Logistic regression analysis was performed to analyze the association between pfhrp2 and/or pfhrp3 deletions and demographic and infection variables. Of the 445 RDT-negative and PCR-positive samples, 125 (28.1%) were analyzed for pfhrp2 and pfhrp3 deletions. Single pfhrp2 deletion, single pfhrp3 deletion, and pfhrp2/3 double deletions were detected in 13 (10.4%), 19 (15.2%), and 36 (28.8%) samples, respectively. Single pfhrp2 deletion was found in all sites while single pfhrp3 deletion was found in all sites except Kibuogi. The majority of samples with pfhrp2 and/or pfhrp3 deletions were submicroscopic (73.5%), asymptomatic (80.9%), and monoclonal (80.9%). Polyclonal infection was significantly (p = 0.022) associated with a lower odds of pfhrp2/3 double deletion, suggesting detection of intact pfhrp2/3 in mixed infections. We report the presence of P. falciparum with pfhrp2/pfhrp3 double deletions among asymptomatic and submicroscopic infections in Kenya. Our findings highlight the need for active monitoring of pfhrp2 and pfhrp3 deletions at the community level to improve malaria detection and control in the region.
Validation of prognostic models predicting mortality or ICU admission in patients with COVID-19 in low- and middle-income countries: a global individual participant data meta-analysis
Authors: Damen Johanna A. A. , Arshi Banafsheh , van Smeden Maarten , Bertagnolio Silvia , Diaz Janet V. , Silva Ronaldo , Thwin Soe Soe , Wynants Laure , Moons Karel G. M. 
Published: December 2024

Abstract
Background
We evaluated the performance of prognostic models for predicting mortality or ICU admission in hospitalized patients with COVID-19 in the World Health Organization (WHO) Global Clinical Platform, a repository of individual-level clinical data of patients hospitalized with COVID-19, including in low- and middle-income countries (LMICs).

Methods
We identified eligible multivariable prognostic models for predicting overall mortality and ICU admission during hospital stay in patients with confirmed or suspected COVID-19 from a living review of COVID-19 prediction models. These models were evaluated using data contributed to the WHO Global Clinical Platform for COVID-19 from nine LMICs (Burkina Faso, Cameroon, Democratic Republic of Congo, Guinea, India, Niger, Nigeria, Zambia, and Zimbabwe). Model performance was assessed in terms of discrimination and calibration.

Results
Out of 144 eligible models, 140 were excluded due to a high risk of bias, predictors unavailable in LIMCs, or insufficient model description. Among 11,338 participants, the remaining models showed good discrimination for predicting in-hospital mortality (3 models), with areas under the curve (AUCs) ranging between 0.76 (95% CI 0.71–0.81) and 0.84 (95% CI 0.77–0.89). An AUC of 0.74 (95% CI 0.70–0.78) was found for predicting ICU admission risk (one model). All models showed signs of miscalibration and overfitting, with extensive heterogeneity between countries.

Conclusions
Among the available COVID-19 prognostic models, only a few could be validated on data collected from LMICs, mainly due to limited predictor availability. Despite their discriminative ability, selected models for mortality prediction or ICU admission showed varying and suboptimal calibration.
Impact of eptinezumab on work productivity beyond reductions in monthly migraine days: post hoc analysis of the DELIVER trial
Authors: Barbanti Piero , Awad Susanne F. , Rae-Espinoza Heather , Regnier Stephane A. , Lee Xin Ying , Goadsby Peter J. 
Published: December 2024

Abstract
Background
Eptinezumab’s impact on self-reported work productivity in adults with migraine and 2‒4 prior preventive migraine treatment failures is not fully understood.

Methodology
Electronic diaries captured monthly migraine days (MMDs) reported by patients enrolled in the randomized, double-blind, placebo-controlled DELIVER trial (NCT04418765). The migraine-specific Work Productivity and Activity Impairment questionnaire, administered at baseline and each monthly visit, was a secondary outcome of DELIVER and used to model changes from baseline in self-reported monthly hours of absenteeism (decreased work attendance) and presenteeism (reduced work efficiency while at work with a migraine) in Canada, as the base case. Path analysis illustrated eptinezumab’s impact on work productivity beyond MMDs.

Results
As MMDs increased, monthly hours of absenteeism increased linearly while those of presenteeism increased quadratically. Best-fit models were improved after including an eptinezumab treatment effect, showing benefit over placebo after controlling for MMD frequency. Compared to placebo, patients treated with eptinezumab (pooled) had a modeled reduction from baseline of 7.2 h/month (absenteeism) (95% CI: −9.9, −4.5; P < 0.001) and 21.4 h/month (presenteeism) (95% CI: −26.3, −16.5; P < 0.001) over weeks 1‒24. Beyond MMD reductions, improvements in patient-identified most bothersome symptom (PI-MBS) and reductions in percent of severe migraine attacks contributed to eptinezumab’s effect.

Conclusions
Eptinezumab decreased absenteeism and presenteeism based on patient reports, with data highlighting the importance of considering the PI-MBS. The greater change from baseline than placebo in self-reported absenteeism and presenteeism was only partly explained by changes in MMDs, presenting a potential opportunity to decrease the cost of migraine in the workplace.

Trial registration
ClinicalTrials.gov (Identifier: NCT04418765); EudraCT (Identifier: 2019-004497-25)