bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges in implementing 2021 WHO CNS tumor classification in a resource-limited setting
Authors: Gilani Ahmed , Altaf Ahmed , Shakir Muhammad , Minhas Khurram , Enam Syed Ather 
Published: December 2024

Abstract

Background
The 2021 World Health Organization classification of Central Nervous System tumors (CNS5) includes molecular biomarkers in the necessary diagnostic criteria for many tumors. Identifying these markers often requires next-generation sequencing (NGS) and/or DNA methylation profiling, presenting challenges in diagnosing these tumors in low or middle-income countries (LMICs) and other resource-limited settings. Here, we will illustrate the real-world scope of the problem by presenting a neuropathologist’s experience with implementing the CNS5 criteria in an academic medical center in Karachi, Pakistan.

Methods
CNS tumor biopsies received by a single neuropathologist (AG) in Karachi during a 6-month period (October 2022 to March 2023) were included in the study. Routine histologic processing, H&E and immunohistochemistry were performed.

Results
A total of 443 tumor cases were received, 87 of those (19.64% of total, 36.86% of glial, embryonal, and glioneuronal tumors) could not be assigned a CNS5 diagnosis. Top reasons for failure to reach a CNS5 diagnosis were low-grade gliomas or infiltrative glioma in pediatric/ adolescent young adults not further classifiable on histology, IDH-mutant tumors requiring 1p/19q testing to rule out oligodendroglioma, undifferentiated tumors with unclear lineage and adult grade 2 or 3 IDH-wildtype astrocytomas suspicious for glioblastoma, IDH-wildtype. Send-out DNA methylation testing in 22 cases resolved the diagnostic questions in all except one case.

Conclusions
Without access to molecular testing, up to a third of all glial, embryonal, and glioneuronal tumors could not be assigned a CNS5 diagnosis, leading to diagnostic ambiguity and therapeutic confusion. Until affordable molecular assays are available, CNS5 diagnostic criteria have limited applicability in resource-limited settings.
Effectiveness of Health Education Interventions in Enhancing Iron-Folic Acid Supplement Utilization Among Pregnant Women: Systematic Review and Meta-analysis
Authors: Feyisa Jira Wakoya , Siu Judy Yuen-Man , Bai Xue 
Published: December 2024

Abstract

Context
During pregnancy, the underutilization of iron-folic acid supplements (IFAS) remains a considerable maternal and child health issue. Hence, health education intervention trials were conducted following the recommendation of the World Health Organization and epidemiological studies to enhance the utilization level of the supplements during pregnancy.

Objective
The objective of this meta-analysis was to evaluate the effectiveness of health education interventions in enhancing IFAS utilization during pregnancy.

Data Sources
A thorough search was conducted across PubMed, EMBASE, Scopus, CINAHL, Web of Science, Medline, the Cochrane Library, and Google Scholar from August 28 until October 31, 2023.

Data Extraction
This study incorporated randomized and quasi-experimental studies that examined the effectiveness of health education interventions in enhancing IFAS utilization during pregnancy.

Data Analysis
Comprehensive Meta-Analysis, version 4, which includes the prediction interval, was used for the analysis.

Results
In this meta-analysis and systematic review, 21 articles comprising 6643 pregnant women from different countries were included. The random-effects model was applied to determine the pooled standardized differences in means (0.786; 95% CI: 0.551, 1.021). The prediction interval shows the range of true standardized differences in means (95% CI: −0.168, 1.740), which indicates the variations in the true effect size of health education interventions in enhancing IFAS utilization during pregnancy.

Conclusion
In addition to pooled effect size, another significant advantage of this meta-analysis is conducting the prediction interval to determine the range of the true effect size, which ranges from −0.168 to 1.740 across the groups of different pregnant women, indicating variability in the effectiveness of the interventions in enhancing IFAS utilization during pregnancy. This might occur because most of the primary studies in this meta-analysis were conducted at healthcare facilities and mostly focused on anemic pregnant women attending antenatal care, which did not control for sociocultural determinants. Therefore, future researchers should consider these limitations.
Trends of paediatric hypertension screening and management in primary care before and during the coronavirus disease 2019 pandemic: A retrospective cohort study
Authors: Kosowan Leanne , Chanchlani Rahul , Dart Allison , Wu Michael , Costa Rita , Singer Alexander 
Published: December 2024

Abstract

Objectives
We assessed trends in primary care paediatric blood pressure (BP) screening, follow-up, and treatment before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods
Retrospective cohort study using electronic medical records from the Canadian Primary Care Sentinel Surveillance Network to capture paediatric visits (aged 3 to 18) between January 1, 2011, and December 31, 2020. Time-series analysis was performed using documentation of monthly BP, high BP, follow-up of abnormal BP, and antihypertensive prescribing. We assessed differences between pre (January 1, 2011 to March 11, 2020) and during COVID-19 (March 12, 2020 to December 31, 2020).

Results
Of 343,191 paediatric patients, 30.9% had ≥1 paediatric BP documented. Documentation of BP increased each year from 17.3% in 2011 to 19.8% in 2019 (β = 0.05, 95% CI 0.04, 0.07, P &lt; 0.001), with a decrease in trend in 2020 to 11.0% (β = −16.95, 95% CI −18.91, −14.99, P &lt; 0.001). There was an increasing pre-pandemic trend for laboratory screening and prescribing (β = 0.12, 95% CI 0.1, 0.14, P &lt; 0.0001; β = 0.02, 95% CI 0.02, 0.02, P &lt; 0.0001). During the COVID-19 pandemic, laboratory screening further increased (24.5% to 31.1%; β = 5.19, 95% CI 2.03, 8.35, P = 0.002), whereas there was no significant change in prescribing trends (1.3% to 1.4%; β = 0.15, 95% CI −0.01, 0.32, P = 0.07).

Conclusions
Documentation of BP increased annually, then declined precipitously during the COVID-19 pandemic. Despite lower BP screening and follow-up, the prevalence of hypertension and antihypertensive prescribing remained stable. Clinical practice trends in primary care highlight areas to improve the care and management of hypertensive paediatric patients.
Candidate for the Double Gamow–Teller Giant Resonance in 48Ca Studied by the (12C, 12Be(0+2)) Reaction at 250 MeV/Nucleon
Authors: Sakaue A , Yako K , Ota S , Baba H , Chillery T , Doornenbal P , Dozono M , Ebina N , Fukuda N , Fukunishi N , Furuno T , Hanai S , Harada T , Hayakawa S , Hijikata Y , Horikawa K , Huang S W , Imai N , Itahashi K , Kobayashi N , Kondo Y , Li J , Maeda Y , Matsui T , Matsumoto S Y , Matsumura R , Michimasa S , Nakatsuka N , Nishi T , Sakanashi K , Sasano M , Sekiya R , Shimizu N , Shimizu Y , Shimoura S , Sumikama T , Suzuki D , Suzuki H , Takaki M , Takeshige S , Takeda H , Tanaka J , Tanaka Y K , Togano Y , Tsuji R , Yang Z H , Yoshida K , Yoshimoto M , Zenihiro J , Uesaka T 
Published: December 2024

Abstract
A new experimental method to search for the double Gamow–Teller giant resonance using the double charge exchange ($^{12}$C, $^{12}$Be(0$^{+}_{2}$)) reaction is proposed and applied, for the first time, to a ${}^{48}$Ca target at 250 MeV/nucleon using a $^{12}$C primary beam at the RIKEN RI Beam Factory. The events with double isospin- and spin-flip in ${}^{48}$Ca were selected by measuring decay $\gamma$-rays from ${}^{12}$Be(0$^{+}_{2}$). A forward-peaking component in the measured double-differential cross sections was observed with an integrated $0^\circ$ cross section of $1.33 \pm 0.12$ μb/sr in the excitation energy region below 34 MeV in ${}^{48}$Ti. Reaction analyses based on distorted-wave Born approximation calculations and the multipole decomposition based thereon indicate that $\sim$40% of the forward-peaking component originates from the double Gamow–Teller transitions. The transition strength of the double Gamow–Teller transition is evaluated from the extracted forward-peaking cross section.
Frailty Is Strongest Need Factor among Predictors of Prehabilitation Utilization for Total Hip or Knee Arthroplasty in Fee-for-Service Medicare Beneficiaries
Authors: Stern Brocha Z , Sabo Graham C , Balachandran Uma , Agranoff Raquelle , Hayden Brett L , Moucha Calin S , Poeran Jashvant 
Published: December 2024

Abstract

Objective
Prehabilitation may have benefits for total hip arthroplasty (THA) and total knee arthroplasty (TKA), given an aging population with multimorbidity and the growth of value-based programs that focus on reducing postoperative costs. We aimed to describe prehabilitation use and examine predictors of utilization in fee-for-service Medicare beneficiaries.

Methods
This retrospective cohort study using the Medicare Limited Data Set included fee-for-service Medicare beneficiaries who were ≥ 66 years old and who underwent inpatient elective THA or TKA between January 1, 2016, and September 30, 2021. We assessed predictors of receiving preoperative physical therapist services within 90 days of surgery (prehabilitation) using a mixed-effects generalized linear model with a binary distribution and logit link. We report adjusted odds ratios (ORs).

Results
Of 24,602 THA episodes, 18.5% of patients received prehabilitation; of 38,751 TKA episodes, 17.8% of patients received prehabilitation. For both THA and TKA, patients with medium or high (vs low) frailty were more likely to receive prehabilitation (OR = 1.72–2.64). Male (vs female) patients, Black (vs White) patients, those with worse county-level social deprivation, those with dual eligibility, and those living in rural areas were less likely to receive prehabilitation before THA or TKA (OR = 0.65–0.88). Patients who were ≥ 85 years old (vs 66–69 years old) and who underwent THA were also less likely to receive services (OR = 0.84). Additionally, there were geographic differences in prehabilitation utilization and increased utilization in more recent years.

Conclusion
The need factor of frailty was most strongly associated with increased prehabilitation utilization. The variation in utilization by predisposing factors (eg, race) and enabling factors (eg, county-level social deprivation) suggests potential disparities.

Impact
The findings describe prehabilitation use in a large cohort of fee-for-service Medicare beneficiaries. Although services seem to be targeted to those at greater risk for adverse outcomes and high spending, potential disparities related to access warrant further examination.
Influence of Race and Ethnicity on Application to Doctor of Physical Therapy Programs
Authors: Tombers Nicole , Pfeifer Rachel , Froemke Kaitlyn 
Published: December 2024

Abstract

Objective
This study uses data from the Physical Therapist Centralized Application Service (PTCAS) to compare influences on application to Doctor of Physical Therapy (DPT) programs between White applicants and people of color (POC) — applicants who identified as Black, American Indian, Asian, Hispanic, or Pacific Islander.

Methods
This is a retrospective study using holistic narrative analysis. PTCAS data for the 2020 to 2021 application cycle were obtained, including essays and demographic data. Random samples were drawn such that 736 total applicants to PTCAS were included: 372 White applicants and 364 POC applicants. Using categories previously described in the literature, 3 reviewers coded application essays into as many influence categories as applied. Interrater reliability was evaluated on a sample of 12 essays, using Cohen kappa between reviewer pairs and a total arithmetic mean. Chi-square was used to test for difference between groups, based on Bonferroni correction.

Results
Personal experience with physical therapy (53.8% for White applicants, 54.9% for POC applicants), observation of the field (68.5% for White applicants, 71.2% for POC applicants), and alignment with values and interests (62.9% for White applicants, 67.3% for POC applicants) were the most common influences. Applicants of color were more likely to indicate a desire to bring services back to their community of origin, formative experience in health care based on race, and paid work experience in the field. Interrater reliability was excellent (.869).

Conclusion
Applicants in the POC group were primarily influenced toward pursuing DPT education by personal interaction with physical therapy and alignment of the field with their values. They were more likely than their White peers to have racially based health care experiences, paid work in the physical therapy field, and a desire to provide services to their community.
Withdrawn as duplicate: Effectiveness of pharmacological therapies for fibromyalgia syndrome in adults: an overview of Cochrane Reviews
Authors: Moore Andrew , Bidonde Julia , Fisher Emma , Häuser Winfried , Bell Rae Frances , Perrot Serge , Makri Souzi , Straube Sebastian 
Published: December 2024

Abstract
“This article has been withdrawn due to an error that caused the article to be duplicated. The definitive version of this article is published under https://doi.org/10.1093/rheumatology/keae707.”
Teratogenicity, cardiac toxicity, neurotoxicity and genotoxicity in zebrafish embryo-larvae exposed to 4-bromodiphenyl ether
Authors: Kumar Shiv , Chadha Pooja 
Published: December 2024

Abstract
Polybrominated diphenyl ethers (PBDEs) have been classified as a new class of persistent organic pollutants by the United Nations Environment Programs in 2009. In environment, PBDEs can undergo the degradation process to form less brominated diphenyl ethers. In the present study, the 96 h LC50 value for 4-bromodiphenyl ether (BDE-3) was found to be 3.18 mg/L in zebrafish embryo-larvae. Further, zebrafish embryo-larvae was exposed to sublethal concentrations i.e. 0.79 mg/L and 1.59 mg/L of BDE-3 to evaluate the developmental toxicity. BDE-3 significantly increased the mortality rate and decreased hatchability rate in a concentration and time-dependent manner at sublethal concentrations compared to control. Heart rate was found to be significantly decreased whereas the sinus venosus- bulbus arteriosus (SV-BA) distance found to be significantly increased in both BDE-3 exposed groups. The sensorimotor response and spontaneous movement were significantly decreased in BDE-3 exposed larvae compared to control group. A significant DNA damage was also found to be caused in BDE-3 exposed groups after the acute exposure. The current report highlights the toxicity potential of BDE-3 in the early life stages of zebrafish and hence puts up to their environmental risk assessment.
Highlights 4-bromodiphenyl ether (BDE-3) caused developmental toxicity and morphological deformities and decreased hatchability rate in zebrafish larvae. The heart rate was found to be significantly decreased in BDE-3 exposed zebrafish larvae. The total body length and eye size was found to be reduced in exposed zebrafish larvae. Significant DNA damage was caused by acute exposure of BDE-3 in zebrafish larvae.
Evaluating pathological complete response as an surrogate endpoint for long-term survival in patients with non-small cell lung cancer: a systematic review and meta-analysis
Authors: Li Chao , Kadeerhan Gaohaer , Zhang Tongtong , Yeerjiang Zaiwuli , Yang Yikun , Meng Jun , Wang Dongwen 
Published: December 2024

Purpose:
Pathologic complete response (pCR) is deemed to associate with event-free survival (EFS) and overall survival (OS), however, whether it is suitable to serve as a surrogate endpoint for long-term survival in clinical trials of neo-adjuvant treatment for resectable NSCLC trials is still controversy. We aim to evaluate the role of pCR and its viability as a surrogate endpoint for EFS and OS in NSCLC.

Methods:
To investigate the association of pCR and EFS and OS, we performed a meta-analysis involving randomized clinical trials that have reported complete information on pCR rates with hazard ratios (HRs) for EFS and OS. A standard meta-analysis was conducted to determine the relationship between pCR rates and EFS and OS. Additionally, weighted regression analysis was performed to assess the associations between log relative risk (RR) for pCR and log HRs for EFS and OS, with the coefficient of determination (R2) being used to quantify the correlations. Furthermore, the surrogate threshold effect (STE) was also used to evaluate the minimum value of the RR for pCR necessary to confidently predict a non-null effect on HRs for EFS and OS.

Results:
The meta-analysis included 14 randomized clinical trials. The high pCR rate group had significant improvement of EFS (HR = 0.69, 95%CI 0.55-0.86) and OS (HR = 0.82, 95%CI 0.72-0.94). A strong association was found between log RR for pCR and log HR for EFS (R2 = 0.76; 95%CI 0.48-1.00) and a moderate correlation between log RR for pCR and log HR for OS (R2 = 0.54; 95%CI 0.04-1.00). The STEs for pCR were 4.534 and 10.278 for EFS and OS, respectively. In the subgroup analysis, similar results were only observed in a partial set of comparisons.

Conclusions:
A high pCR rate was associated with a long-term survival outcome. Strong association and moderate association were found between pCR and EFS, pCR and OS, respectively, which supports the application of pCR as a surrogate endpoint for long-term survival in RCTs for resectable NSCLC.
The efficacy and safety of robot-assisted surgery in cancer patients: a systematic review of randomized controlled trials
Authors: Yu Kai , Zeng Baoqi , Zhou Qingxin , Sun Feng 
Published: December 2024

Background:
The utilization of robot-assisted surgery (RAS) has been increasing among cancer patients. However, evidence supporting the use of RAS remains uncertain. The availability of randomized controlled trials (RCTs) for each surgical procedure is limited. This study aimed to assess the safety and efficacy of RAS in cancer patients.

Materials and Methods:
A comprehensive search was performed in Embase, PubMed, the Cochrane Library, and ClinicalTrials.gov from the inception of the databases until 1 April 2023. We included RCTs of RAS in cancer patients compared with laparoscopic, thoracoscopic, or open surgery, and random-effects meta-analyses were performed.

Results:
A total of 32 trials (6092 patients) met the eligibility criteria. Among these, 22 trials had a low risk of bias, seven trials had some concerns, and three trials were at high risk. Most trials were conducted for bladder cancer (n = 8), rectal cancer (n = 5), prostate cancer (n = 4), and endometrial cancer (n = 4). In all cancers, RAS likely resulted in a slight reduction in the length of hospital stay (31 comparisons; mean difference [MD], − 0.91 days; 95% CI, − 1.33 to − 0.49), but resulted in little to no difference in overall survival (11 comparisons; hazard ratio [HR], 0.96; 95% CI, 0.78 to 1.17). Compared with open surgery, RAS was found to reduce estimated blood loss (MD, − 239.1 mL; 95% CI, − 172.0 to − 306.2) and overall complication (relative risk [RR] 0.88; 95% CI, 0.81 to 0.96), but increase total operative time (MD, 55.4 minutes; 95% CI, 30.9 to 80.0). Additionally, RAS seemed to be not associated with positive surgical margin, any recurrence, disease-free survival, and quality of life.

Conclusion:
RAS has demonstrated small favorable effects on short-term outcomes, particularly when compared to open surgery. However, these effects may vary across different cancers. Additionally, RAS may not impact long-term survival, oncological outcomes, or quality of life in cancer patients.
Procedural sedation in the emergency department by Italian emergency physicians: results of the SEED SIMEU registry
Authors: Lison Davide , Lorenzati Bartolomeo , Segre Elisabetta , Bernardi Emanuele , Nazerian Peiman , Gianno Adriana , Bruno Alice , Baldassa Federico , Tizzani Maria , Stefanone Valerio T. , Borselli Matteo , Dutto Luca , Veglio Maria Grazia , Landi Andrea , Soardo Flavia , Cibinel Gian A. 
Published: December 2024

Background and importance
Effective and safe procedural sedation is pivotal for the quality of care in the emergency department (ED).

Objectives
The aim of this work is to evaluate the feasibility, effectiveness, and safety procedural sedation performed by emergency physicians in the ED setting in Italy.

Design/setting and participants/intervention
Following a specific training of the staff and with the adoption of a standardized protocol, a registry of procedural sedations performed on adult patients in 10 Italian EDs was compiled from 2019 to 2022; the following basic data were recorded: demographic and clinical information, procedure’s indication, administered drugs, predefined, and actual sedation level.

Outcome measures and analysis
Effectiveness was evaluated considering three parameters: successful completion of the procedure, absence of procedural pain, and no memory of the procedure; adverse events were classified according to the World Society of Intravenous Anaesthesia criteria and evaluated taking into account clinical and procedural variables.

Main results
The study included 1349 patients (median age 68 years, male 64%). Sedation was performed for electrical cardioversion (66.3%), orthopedic procedures (23.2%), or other procedures (10.5%). Propofol (67%) and midazolam (24.2%) were the two most frequently used sedatives and 70.6% of the patients achieved a deep level of sedation.
Procedural failure occurred in 4.6% of cases, with no significant differences between procedure types or drugs used. Recall of the procedure and procedural related pain were reported by 2.9% and 2.6% of patients, respectively, and were more frequently related to orthopedic procedures, midazolam use – if compared with propofol, and lower levels of sedation.
A total of 135 adverse events were observed, with an overall incidence of 10%: 38 minimal adverse events (2.8%), 38 minor adverse events (2.8%), and 59 moderate adverse events (4.4%). There were no adverse events requiring unplanned hospital admission or escalation of care, and no sentinel adverse events were observed. All adverse events were resolved with simple and noninvasive treatments. The incidence of adverse events was greater with higher American Society of Anesthesiologists class, intermediate/difficult airway, and deeper sedation levels.

Conclusion
Procedural sedation performed in Italian EDs by emergency physicians, with propofol as main sedative, was effective and safe, and has comparable adverse event rates with previous international studies.