bluuebunny/crossref_metadata_2025_split huggingface dataset:
Probing the past: historical case study analysis to inform more just and sustainable global health partnerships in education
Authors: Vorobej Lucy , Wondimagegn Dawit , Baheretibebe Yonas , Bizuneh Belete , Hodges Brian , Petros Adane , Jobin Stephane , Whitehead Cynthia Ruth 
Published: November 2024

IntroductionDisparities of power between high-income (HICs) and low- and middle-income countries (LMICs) have long characterised the structures of global health, including knowledge production and training. Historical case study analysis is an often-overlooked tool to improve our understanding of how to mitigate inequalities.MethodsDrawing from the contemporary experience of collaborators from Canada and Ethiopia, we chose to examine the historical relationship between Ethiopian Emperor Haile Selassie and Canadian Jesuit Lucien Matte as a case study for international collaborations based on the model of an ‘invited guest’. We used critical historical context and qualitative content analysis methodologies to assess written correspondence between them from the 1940s to the 1970s and drew from postcolonial theory to situate this case study in a broader context.ResultsThe respectful and responsive relationship that developed between Emperor Haile Selassie and Lucien Matte reveals important characteristics needed for meaningful collaborations in global health education. Matte came to Ethiopia fully cognizant of the imperial context of his work and prepared to take on the position of invited guest. As a result, many of both Matte and Haile Selassie’s goals were achieved. At the same time, however, this case study also revealed how problematic constructions of authoritative power can arise even when productive partnerships among individuals occur. Matte and Haile Selassie’s collaboration reinscribed belief in the superiority of western theories of intellectual and social development. In addition, their prescriptive vision for education in Ethiopia repeatedly dismissed competing local positions.ConclusionAs international partnerships in global health education continue to exist and form, historical case studies offer valuable insights to guide such work. Among the most crucial arenas of knowledge is the need to understand powerful dynamics that have and continue to shape HIC-LMIC interaction. The historical case study of Matte and Haile Selassie reveals how problematic power differentials can be reinforced or mitigated.
Effects of using wearable devices on reducing sedentary time and prolonged sitting in healthy adults: a network meta-analysis
Authors: He Zihao , Zhao Guanggao , Li Chao , Xing Yachen , Xu Anjie , Yang Junchao , Wang Ronghui 
Published: November 2024

ObjectivesThis study aimed to compare the effectiveness of different wearable intervention strategies in reducing sedentary time (ST) and prolonged sitting (PS) on healthy adults.DesignA network meta-analysis (NMA).Data sourcesPubMed, Web of Science, SPORTDiscus, ProQuest, Opengrey, Medline and Cochrane Central Register of Controlled Trials were searched up to 1 June 2024.Eligibility criteria for selecting studiesRandomised controlled trials (RCTs) that examined the effect of wearable device interventions on ST and PS among healthy adults were included.Data extraction and synthesisTwo independent reviewers used standardised methods to search, screen and code included studies. Bias risks were assessed using Cochrane tools (Risk of Bias 2.0). Data were analysed using a frequentist framework NMA to directly and indirectly compare the effects of the five different intervention strategies (comparators). The results were reported as standardised mean differences (SMDs) with 95% CI and surface under cumulative ranking curve (SUCRA) was used to rank the best interventions. The five comparators were as follows: (1) wearable-only intervention (only using wearable devices for self-monitoring); (2) wearable combined with online intervention (ie, online coaching and social media support); (3) wearable combined with offline intervention (ie, face-to-face seminars and courses); (4) comparison group (ie, traditional, non-wearable interventions); (5) control group (ie, maintaining daily routine, waitlist).Results12 RCTs with a total of 2957 participants were included. Results of NMA showed that the ‘wearable+online’ has significantly better effects in reducing ST compared with control group, comparison group and ‘wearable only’, with moderate to large effect sizes (SMD=0.96, 95% CI 0.65 to 1.27; SMD=0.87, 95% CI 0.21 to 1.53; SMD=0.78, 95% CI 0.14 to 1.42, respectively). However, no significant differences were identified between the groups in reducing PS. The SUCRA values were ranked as wearable+online (98.1%), wearable+offline (64.4%,), ‘wearable only’ (40.5%), comparison group (25.9%) and control group (21.1%) for ST reduction. Similar rankings were observed for PS reduction, with probabilities of 69.9%, 61.1%, 59.7%, 37.1% and 22.1%, respectively.ConclusionsWearable+online is the best intervention strategy for reducing ST in healthy adults. Additionally, none of the wearable-based interventions effectively reduced PS in healthy adults, but as there is little research on PS, it should receive more attention in the future.PROSPERO registration number:CRD42021290017.
Post-COVID in healthcare workers and its consequences on quality of life, activities, participation, need for rehabilitation and care experiences: protocol of a cohort study
Authors: Luedtke Laura , Haller-Wolf Julia , Kriston Levente , Koch Uwe , Nienhaus Albert , Härter Martin 
Published: November 2024

IntroductionHealthcare workers (HCWs) have been of particular relevance for overcoming the SARS-CoV-2 pandemic. At the same time they have been affected by SARS-CoV-2 infections with above average probability. Around 6.5% of the overall infected persons are likely to develop persistent symptoms resulting from the infection, known as long-COVID or post-COVID syndrome (PCS). The aim of this study is (1) to investigate the prevalence, course and characteristics of PCS in German HCWs, (2) to examine its effects on psychosocial variables, (3) to identify rehabilitation and healthcare needs and (4) to analyse treatment experiences.Methods and analysisIn a cohort study with a randomised selection of participants (N=20 000) from the Employer’s Liability Insurance Association for Health and Welfare Care, the health status of HCWs, who had COVID-19 in their professional context will be examined. There will be two measurement points: baseline (T1) and a 12-month follow-up (T2). The outcome measures are the health status with a particular focus on persistent or newly occurring symptoms after a SARS-CoV-2 infection, health-related quality of life, functional capacity, the subjective need for and utilisation of healthcare services. Pre-existing conditions, the course of the acute infection and sociodemographic factors are considered as predictors. An advisory board made up of affected HCWs supports the study by contributing to the surveys’ contents.Ethics and disseminationThe study has been approved by the Local Ethics Committee of the Center for Psychosocial Medicine at the University Hospital Hamburg-Eppendorf (LPEK-0518). For dissemination, the results will be published in peer-reviewed journals, presented at conferences and communicated to relevant stakeholders in general and rehabilitation medicine.Trail registration numberhttps://drks.de/search/de/trial/DRKS00029314
Behavioural economics to improve and motivate vaccination in primary care using nudges through the electronic health record: rationale and design of the BE IMMUNE randomised clinical trial
Authors: Waddell Kimberly , Mehta Shivan J , Navathe Amol , Linn Kristin , Park Sae-Hwan , White Andrew , Staloff Jonathan , Rhodes Corinne , Couzens Chaylin , Goel Keshav , McDonald Caitlin , Reitz Catherine , Williams Keyirah , Liao Joshua M 
Published: November 2024

IntroductionAnnual influenza vaccination reduces disease burden but vaccination rates are suboptimal, with persistent disparities among subpopulations. The purpose of this trial is to evaluate multicomponent behavioural economic nudge interventions to clinicians and patients to increase influenza vaccination. This trial also includes an intensification nudge to reduce disparities in vaccination among older adult, primary care patients.MethodsThis is a two-part, multisite cluster randomised, pragmatic clinical trial. In the first part, a multicomponent nudge intervention will be tested over approximately 6 months (September 2023–February 2024). The second part consists of a replication trial conducted at an additional site during the following influenza season (September 2024–February 2025). Primary care clinics will be randomised to the nudge intervention or usual care. Eligible clinicians and patients at intervention clinics will receive the intervention, and patients deemed high risk for not receiving a vaccine will be further randomised to receive an intensification nudge. The primary outcome is vaccine completion during the eligible visit and the secondary outcome is vaccine completion within 3 months of the eligible visit.AnalysisThe effect of the clinic-level nudge intervention on the primary and secondary outcomes will be evaluated using generalised estimating equations (GEEs) with a clinic-level exchangeable working correlation to account for clustering of observations within the clinic. GEE models with an independent working correlation will be used to evaluate the impact of the additional intensification nudge on the primary and secondary outcomes.Ethics and disseminationThe University of Pennsylvania Institutional Review Board (IRB) approved this trial and serves as the single IRB of record (IRB #851838). Results will be disseminated via peer-reviewed publication and conference presentations.Trial registration numberNCT06057727.
Extended-duration work shifts among care workers: a scoping review protocol
Authors: Xu Mengjiao , Song Yuting , Lan Caifeng , Xu Yong , Liu Xueying , Dong Sihan , Weeks Lori E 
Published: November 2024

IntroductionThe available literature reviews of shift work among care workers are almost exclusively focused on 8-hour shifts and 12-hour shifts or 24-hour on-call shifts for physicians. We do not yet know the scope of evidence regarding extended-duration work shifts (defined as on-duty shifts of 16 or more hours per shift) in diverse healthcare settings, such as the impact on care workers and recipients of care. In this proposed scoping review, we aim to provide an overview of the current research regarding extended-duration work shifts among care workers in various healthcare settings.Methods and analysisWe will conduct this scoping review in accordance with the Joanna Briggs Institute scoping review methodology. Comprehensive searches will be conducted in PubMed, Embase, MEDLINE, Web of Science and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases and grey literature sources. We will include empirical studies that focus on extended-duration work shifts among care workers working in different healthcare settings, including home care, community, acute care settings, long-term care homes and assisted living facilities. We will not apply language restrictions. We will conduct searches in August 2024, followed by screening of records. We will exclude research on on-call work shifts and investigations that solely focus on interns. The included literature will be screened independently by pairs of reviewers at the title and abstract review phase, followed by a full-text review for relevant literature. Any disagreement will be resolved by consensus or discussion with a third reviewer. The results will be extracted and summarised in the final report in tabular form, when possible, along with narrative synthesis.Ethics and disseminationAll data for this study will come from published literature, so an ethics review is not necessary. The findings will be disseminated through conference presentations and publication in peer-reviewed journals, with the expectation that they will guide future research and inform future management of work shifts in care workers.
Risk factors for incidence of interstitial lung disease in patients with rheumatoid arthritis: a systematic review and meta-analysis
Authors: Yu Chen , Zhang Yupei , Jin Shangyi , Wang Yanhong , Wang Qian , Li Mengtao , Zeng Xiaofeng , Tian Xinping , Jiang Nan 
Published: November 2024

ObjectivesThis study aimed at identifying risk factors for the incidence of interstitial lung disease in patients with rheumatoid arthritis (RA-ILD) by a systematic review and meta-analysis.MethodsInformation sources: studies published by March 2021 were searched in PubMed, Web of Science, MEDLINE, EMBASE, Cochrane Library and Scopus databases.Eligibility criteria: cohort studies or nested case-control studies that reported OR or HR of risk factors for RA-ILD were included. Two researchers independently screened the studies and extracted data.Synthesis of results: the relative risks (RRs) were introduced to measure the association across studies.Risk bias: quality assessments of included studies were performed using the Newcastle-Ottawa Scale. Based on the result of heterogeneity, the random-effects model or fixed-effects model was chosen in the meta-analysis. Furthermore, a sensitivity analysis was conducted to identify the origins of heterogeneity, and publication bias was evaluated for the factors with no less than five included studies by funnel plots and Egger’s test.ResultsAmong 3075 identified articles, 12 studies met the inclusion criteria. 17 risk factors were included in the meta-analysis. Male (RR 1.94, 95% CI 1.33 to 2.85, p<0.001), elder age (>60 years, RR 1.42, 95% CI 1.05 to 1.94, p=0.02), older RA onset age (RR 1.05, 95% CI 1.01 to 1.10, p=0.02), smoking (RR 1.37, 95% CI 1.09 to 1.71, p=0.006), lung complications (RR 2.72, 95% CI 1.24 to 5.95, p=0.01), rheumatoid nodule (RR 1.85, 95% CI 1.36 to 2.51, p<0.001), leflunomide usage (RR 1.41, 95% CI 1.02 to 1.96, p=0.04) were identified as risk factors of RA-ILD.ConclusionPhysicians should be aware that patients with RA with the above risk factors are likely to develop RA-ILD, and perform close ILD screening during follow-ups so that the patients can be early diagnosed and treated, and achieve improved prognosis.
Phase I study of a recombinant attenuated oncolytic virus, MEDI5395 (NDV–GM-CSF), administered systemically in combination with durvalumab in patients with advanced solid tumors
Authors: Davar Diwakar , Carneiro Benedito A , Dy Grace K , Sheth Siddharth , Borad Mitesh J , Harrington Kevin J , Patel Sandip P , Galanis Evanthia , Samson Adel , Agrawal Sonia , Chen Zhongying , Fan Chunling , Gong Maozhen , Burton Jenny , Tu Eric , Durham Nicholas , Laubscher Kevin , Arnaldez Fernanda , Zamarin Dmitriy 
Published: November 2024

BackgroundMEDI5395 is a recombinant attenuated Newcastle disease virus engineered to express a human granulocyte-macrophage colony-stimulating factor transgene. Preclinically, MEDI5395 demonstrated broad oncolytic activity, augmented by concomitant programmed cell death-1/programmed cell death ligand-1 (PD-L1) axis blockade. Durvalumab is an anti-PD-L1 immune checkpoint inhibitor approved for the treatment of various solid tumors. We describe the results of the first-in-human study combining intravenous MEDI5395 with durvalumab in patients with advanced solid tumors.MethodsThis phase I, open-label, multicenter, dose-escalation, dose-expansion study recruited adult patients with advanced solid tumors, who had relapsed or were refractory or intolerant to ≥1 prior line of standard treatment. MEDI5395 was administered intravenously as six doses over 15–18 days. The dose-escalation phase assessed four-dose levels (108, 109, 1010, 1011focus forming units (FFU)) of MEDI5395, with sequential or delayed durvalumab. Durvalumab 1500 mg was administered intravenously every 4 weeks up to 2 years. The dose-expansion phase was not initiated. The primary objectives were to evaluate safety and tolerability, dose-limiting toxicities (DLTs) and the dose and schedule of MEDI5395 plus durvalumab administration. Secondary objectives included the assessment of the efficacy, pharmacokinetics, pharmacodynamics, and immunogenicity of MEDI5395.Results39 patients were treated with MEDI5395; 36 patients also received durvalumab. All 39 patients experienced ≥1 treatment-emergent adverse event (TEAE), most commonly fatigue (61.5%), nausea (53.8%) and chills (51.3%). Grade 3–4 TEAEs occurred in 27 (69.2%) patients; these were deemed MEDI5395-related in 12 (30.8%) patients. Two patients experienced a DLT, and the maximum tolerated dose of MEDI5395 with sequential and delayed durvalumab at study termination was 1011and 1010FFU, respectively. Four patients (10.3%) achieved a partial response (PR). Patients with PR or stable disease tended to have higher baseline PD-L1 and CD8+ levels in their tumor tissue. A tendency to dose-dependent pharmacokinetics of the viral genome was observed in whole blood and a tendency to dose-dependent viral shedding was observed in saliva and urine. Neutralizing antibodies were observed in all patients but did not appear to impact efficacy negatively.ConclusionThis study demonstrates the feasibility, safety and preliminary efficacy of MEDI5395 with durvalumab in patients with advanced solid tumors.Trial registration numberNCT03889275
Comparison of CAR T-cell and bispecific antibody as third-line or later-line treatments for multiple myeloma: a meta-analysis
Authors: Liang Xiaojie , Wang Yufan , Luo Baiwei , Lin Bingyu , Lu WeiXiang , Tian Shengyu , Liu Dan , Wang Liang 
Published: November 2024

BackgroundCAR-T-cell therapy and bispecific antibody have revolutionized the treatment landscape for multiple myeloma. However, there is currently a lack of studies comparing the efficacy and safety of these two approaches. This meta-analysis assesses the efficacy and safety of B-cell maturation antigen (BCMA)-directed CAR-T-cell therapies and BCMA×CD3 bispecific antibodies as third-line or later interventions for relapsed/refractory multiple myeloma (RRMM).MethodsWe searched PubMed, Embase, Web of Science, and Cochrane databases up to May 31, 2024, identifying 11 eligible studies encompassing 1269 participants. Random-effects models evaluated the primary (complete response (CR) rate) and secondary (overall response rate (ORR)) outcomes, while meta-regression analyses adjusted for relevant covariates.ResultsCAR-T-cell therapy achieved significantly higher pooled CR rate (0.54 (95% CI 0.42–0.69) vs bispecific antibodies 0.35 (0.30–0.41), p<0.01) and pooled ORR (0.83 (0.76–0.90) vs 0.65 (0.59–0.71), p<0.01). However, CAR-T therapy had a higher incidence of adverse events, particularly cytokine release syndrome (CRS 0.83 (0.70–0.97) vs bispecific antibodies 0.59 (0.43–0.74), p<0.05). Severe CRS (grade ≥3) occurred at a rate of 0.07 (0.03–0.14) in the CAR-T cell group, contrasting with a negligible rate of 0.01 (0.00–0.02) in the bispecific antibody group (p<0.01). Hematologic adverse events, including neutropenia (grade ≥3; 0.88 (0.81–0.95) vs 0.48 (0.30–0.67), p<0.01) and anemia (grade≥3; 0.55 (0.47–0.62) vs 0.34 (0.28 to 0.40), p<0.01), were also more frequent in the CAR-T-cell group. Furthermore, differences in efficacy were observed among various CAR-T products, with ciltacabtagene autoleucel showing greater efficacy in CR rate (0.77 (0.71–0.84) vs 0.37 (0.32–0.41), p<0.01) and ORR (0.91 (0.83–0.99) vs 0.73 (0.68–0.77), p<0.01) compared with idecabtagene vicleucel.ConclusionCAR-T-cell therapy demonstrated superior CR rates compared with bispecific antibodies, although with an increase in severe adverse events.
YAP enhances mitochondrial OXPHOS in tumor-infiltrating Treg through upregulating Lars2 on stiff matrix
Authors: Bai Jingchao , Yan Meinan , Xu Yihan , Wang Youhui , Yao Yuan , Jin Peng , Zhang Yuhan , Qu Yang , Niu Liling , Li Hui 
Published: November 2024

BackgroundTumor-infiltrating regulatory T cells (TI-Tregs) are well-adapted to thrive in the challenging tumor microenvironment (TME) by undergoing metabolic reprogramming, notably shifting from glycolysis to mitochondrial oxidative phosphorylation (OXPHOS) for energy production. The extracellular matrix is an important component of the TME, contributing to the regulation of both tumor and immune cell metabolism patterns by activating mechanosensors such as YAP. Whether YAP plays a part in regulating TI-Treg mitochondrial function and the underlying mechanisms are yet to be elucidated.MethodsTo gain insights into the effect of matrix stiffness on YAP activation in Tregs, alterations in stiffness were performed bothin vitroandin vivo. YAP conditional knockout mice were used to determine the role of YAP in TI-Tregs. RNA-seq, quantitative PCR, flow cytometry, lentivirus infection and mitochondrial function assay were employed to uncover the mechanism of YAP modulating mitochondrial function in TI-Tregs. A YAP inhibitor and a low leucine diet were applied to tumor-bearing mice to seek the potential antitumor strategy.ResultsIn this study, we found that YAP, as a mechanotransducer, was activated by matrix stiffness in TI-Tregs. A deficiency in YAP significantly hindered the immunosuppressive capability of TI-Tregs by disrupting mitochondrial function. Mechanically, YAP enhanced mitochondrial OXPHOS by upregulating the transcription ofLars2(Leucyl-tRNA synthetase 2, mitochondrial), which was essential for mitochondrial protein translation in TI-Tregs. Since Lars2 relied much on its substrate amino acid, leucine, the combination of a low leucine diet and YAP inhibitor synergistically induced mitochondrial dysfunction in TI-Tregs, ultimately restraining tumor growth.ConclusionsThis finding uncovered a new understanding of how YAP shapes mitochondrial function in TI-Tregs in response to mechanical signals within the TME, making the combined strategy of traditional medicine and diet adjustment a promising approach for tumor therapy.
Enhancing variant of uncertain significance (VUS) interpretation in neurogenetics: collaborative experiences from a tertiary care centre
Authors: Horowitz Kayla , Fotopoulos Nellie H , Mistry Alana J , Simo Justin , Medeiros Miranda , Bucco Isabela D , Ginsberg Mia , Dwosh Emily , La Piana Roberta , Rouleau Guy A , Dilliott Allison A , Farhan Sali M K 
Published: November 2024

Background
The findings of variants of uncertain significance (VUS) on a clinical genetic testing report pose a challenge for attending healthcare professionals (HCPs) in patient care. Here, we describe the outcomes of multidisciplinary VUS Rounds, implemented at a neurological disease tertiary care centre, which aid in interpreting and communicating VUS identified in our neurogenetics patient population.

Methods
VUS Rounds brought together genetic counsellors, molecular geneticists and scientists to evaluate VUS against genomic and phenotypic evidence and assign an internal temperature classification of ‘VUS Hot’, ‘True VUS’ or ‘VUS Cold’, corresponding to potential pathogenicity. Biweekly meetings were held among the committee to deliberate variant classifications, determine additional clinical management actions and discuss nuances of VUS result communication.

Results
In total, 143 VUS identified in 72 individuals with neurological disease were curated between October 2022 and December 2023. Of these, 12.6% were classified as VUS Hot, carried by 22.2% of the individuals, allowing for prioritisation of additional evaluation to determine potential pathogenicity of the variants, such as clinical follow-up or segregation analysis. In contrast, 45.4% of VUS were Cold and could be eliminated from further consideration in the carrier’s care. We thoroughly evaluated the various evidence that contributed to our VUS classifications and resulting clinical actions.

Conclusions
The assessment of VUS leveraging multidisciplinary collaboration allowed us to delineate required follow-up analyses for our neurology patient population. Integration of VUS Rounds into healthcare practices ensures equitable knowledge dissemination among HCPs and effective incorporation of uncertain genetic results into patient care.