bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of the walking and turning test to accurately discriminate between independently ambulatory community-dwelling older Thai adults with and without a history of falls: a retrospective diagnostic study
Authors: Duangsanjun Winut , Poncumhak Puttipong 
Published: November 2024

ObjectivesThis study developed and investigated the possibility of using the walking and turning test (WTT) to indicate fall risk in community-dwelling older adults.DesignRetrospective diagnostic study.SettingThe study was carried out in a community setting.ParticipantsThe study focused on community-dwelling older Thai adults.Primary and secondary outcome measuresThe participants were assessed based on demographics, fear of falls using a ‘yes/no’ question and the Short Falls Efficacy Scale International, as well as fall data in the previous 6 months. The participants then performed the WTT, timed up and go test, five times sit-to-stand test and handgrip strength test (HG) in random order.ResultsThere were a total of 86 participants with an average age of 69.95±6.10 years (range from 60 to 88 years), most of whom were female (67.44%). 40 participants (46.51%) reported that they had fallen at least once in the previous 6 months. A comparison of various physical ability tests revealed significant differences between faller and non-faller participants (p<0.001). The outcomes of the WTT showed significant correlations with fall variables, balance and muscle strength (0.394 to 0.853, p<0.001). Based on sensitivity, specificity and area under the curve, the cut-off score of 6.40 s showed the highest level of ability to indicate falls among community-dwelling older adults, with a sensitivity of 92.50% and a specificity of 78.26%.ConclusionsThe study suggests the clinical usefulness of the WTT in determining falls in older individuals. WTT is a physical ability measurement that indicates balance ability and muscle strength. The test is practical, requires little space and equipment and can be used in large populations.
Median nerve electrical stimulation for restoring consciousness in patients with traumatic brain injury: study protocol for a systematic review and meta-analysis
Authors: Yang Ying , Luo Yulan , Feng Mei , Luo Ping , Zeng Jiarong , Shi Xinmao , Tang Menglin 
Published: November 2024

IntroductionTraumatic brain injury (TBI) is one of the prevalent critical illnesses encountered in clinical practice, often resulting in a spectrum of consciousness disorders among survivors. Prolonged states of impaired consciousness can significantly elevate the susceptibility to complications such as urinary tract infections and pulmonary issues, consequently leading to a compromised prognosis and substantially impacting the quality of life for affected individuals. Clinical studies have reported that median nerve electrical stimulation (MNES) may have a therapeutic effect in the treatment of disorders of consciousness (DOC). We plan to conduct a systematic review and meta-analysis to evaluate the efficacy and safety of MNES in the management of DOC subsequent to TBI.Methods and analysisWe will conduct a comprehensive literature search in the following electronic databases: Web of Science, Embase, PubMed, Cochrane Library, China Biology Medicine, China National Knowledge Infrastructure, Wan Fang Database and Chinese Scientific Journal Database. The search will be performed from the inception of the databases until 30 September 2024. Furthermore, we will search for relevant ongoing trials in the International Clinical Trial Registry Platform, ClinicalTrials.gov and China Clinical Trial Registry. Grey literature will also be sourced from reputable sources like GreyNet International, Open Grey and Google Scholar. We will include eligible randomised controlled trials. The primary outcome of interest will be the assessment of consciousness disorder severity. To ensure rigour and consistency, two independent reviewers will screen the studies for inclusion, extract relevant data and assess the risk of bias. Any discrepancies will be resolved through discussion or consultation with a third reviewer. The quality of evidence will be evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Data synthesis and meta-analysis will be conducted using STATA 15.1 software.Ethics and disseminationThis systematic review and meta-analysis do not involve the collection or use of any individual patient data, thereby obviating the necessity for ethical review. The research findings will be disseminated through publication in peer-reviewed scientific journals.PROSPERO registration numberCRD42024533359.
‘We listened and supported and depended on each other’: a qualitative study of how leadership influences implementation of QI interventions
Authors: Ginsburg Liane , Easterbrook Adam , Geerts Ariane , Berta Whitney , van Dreumel Lynda , Estabrooks Carole A , Norton Peter G , Wagg Adrian 
Published: November 2024

BackgroundThere is growing recognition in the literature of the ‘Herculean’ efforts required to bring about change in healthcare processes and systems. Leadership is recognised as a critical lever for implementation of quality improvement (QI) and other complex team-level interventions; however, the processes by which leaders facilitate change are not well understood. The aim of this study is to examine ‘how’ leadership influences implementation of QI interventions.MethodsWe drew on the leadership literature and used secondary data collected as part of a process evaluation of the Safer Care for Older Persons in residential Environments (SCOPE) QI intervention to gain insights regarding the processes by which leadership influences QI implementation. Specifically, using detailed process evaluation data from 31 unit-based nursing home teams we conducted a thematic analysis with a codebook developed a priori based on the existing literature to identify leadership processes.ResultsEffective leaders (ie, those who care teams felt supported by and who facilitated SCOPE implementation) successfully developed and reaffirmed teams’ commitment to the SCOPE QI intervention (theme 1), facilitated learning capacity by fostering follower participation in SCOPE and empowering care aides to step into team leadership roles (theme 2) and actively supported team-oriented processes where they developed and nurtured relationships with their followers and supported them as they navigated relationships with other staff (theme 3). Together, these were the mechanisms by which care aides were brought on board with the intervention, stayed on board and, ultimately, transplanted the intervention into the facility. Building learning capacity and creating a culture of improvement are thought to be the overarching processes by which leadership facilitates implementation of complex interventions like SCOPE.ConclusionsResults highlight important, often overlooked, relational and sociocultural aspects of successful QI leadership in nursing homes that can guide the design, implementation and scaling of complex interventions and can guide future research.
Endocrine pathology in young rabbits with cystic fibrosis
Authors: Liang Xiubin , Hou Xia , Chen Y Eugene , Jin Jian-Ping , Zhang Kezhong , Xu Jie 
Published: November 2024

BackgroundCystic fibrosis (CF) is an autosomal recessive genetic disorder caused by loss-of-function mutations in the CF transmembrane conductance regulator gene. CF-related pancreatic lesions are known to cause exocrine dysfunctions such as pancreatic insufficiency, and endocrine dysfunctions, including CF-related diabetes. In a previous study, we generated rabbits with CF using CRISPR/Cas9 (Clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9)-mediated gene editing.MethodsRabbits with CF were subjected to histological analysis with a focus on CF-associated pancreatic lesions. Endocrine function-related assays were conducted to evaluate CF-related pancreatic endocrine disorders in these animals.ResultsWe report that rabbits with CF develop spontaneous pancreatic lesions at a young age, characterised by pancreatic inflammation and fibrosis, vacuolar degeneration, epithelium mucus-secretory cell metaplasia and pancreatic duct dilation. The size of the pancreatic islets in the rabbits with CF is significantly smaller than that of the wild-type animals. Consistent with these pathological findings, young rabbits with CF exhibited signs of pancreatic endocrine-related disorders such as lower insulin levels and impaired glucose metabolism.ConclusionsOur results suggest that the CF rabbit could serve as a valuable model for translational research on CF-related pancreatic endocrine dysfunction.
Bowel cancer diagnosis experiences as a predictor of overall care rating: evidence from the English Cancer Patient Experience Survey
Authors: Owais Syeda Somyyah , Arnolda Gaston , Lamprell Klay , Liauw Winston , Delaney Geoff P , Olver Ian , Karnon Jonathan , Braithwaite Jeffrey 
Published: November 2024

ObjectiveTo investigate whether and which negative diagnosis-related experiences of patients newly diagnosed with colorectal cancer (CRC) are associated with a poorer overall rating of care, to help prioritise interventions.MethodsA secondary data analysis was conducted using the English National Cancer Patient Experience Survey 2018. Analysis was restricted to responses by patients with CRC diagnosed within 12 months of survey, through pathways other than population screening. Nine diagnosis-related questions were selected (six objective and three feelings-based). The primary analysis used multivariable logistic regression to predict poorer overall care rating from negative experience responses to the six objective questions, adjusted for confounders. The sensitivity analysis additionally included the three feelings-based questions. Predictors of poorer overall rating with a significance level at p<0.01 were retained in the final models.Results4069 CRC patient survey responses were analysed. In the primary analysis, negative experiences were reported between 4% (‘Enough information about diagnostic test’) and 21% (‘Given written information about your cancer type’) of respondents. In multivariable analysis, all six objective questions were predictive of poorer overall rating, with ORs ranging from 1.6 to 3.5. In the multivariable sensitivity analysis, eight of nine negative experiences were predictive.ConclusionNegative experiences reported on diagnosis-related questions were almost always associated with a higher likelihood of a poorer overall care rating. To reduce negative diagnostic experiences, the most apt interventions to incorporate into workflows may be informing patients to bring someone to their diagnosis consultation and routine provision of tumour-specific information relevant to patient circumstances.
Prevalence of epilepsy: a population-based cohort study in Denmark with comparison to Global Burden of Disease (GBD) prevalence estimates
Authors: Christensen Jakob , Trabjerg Betina B , Wagner Ryan G , Newton Charles R , Kwon Churl-Su , Aaberg Kari Modalsli , Trinka Eugen , Wiebe Samuel , Cross Judith Helen , Vegrim Håkon Magne , Vos Theo , Steinmetz Jaimie , Dreier Julie Werenberg 
Published: November 2024

BackgroundThe Global Burden of Disease Study (GBD) produces prevalence estimates for ‘idiopathic epilepsy’ (ie, of unknown aetiology) and ‘secondary epilepsy’ (ie, with known aetiology) but does not report prevalence by underlying aetiologies for ‘secondary epilepsy’.MethodsWe used nationwide, population-based register data from Denmark to identify underlying causes of epilepsy and their contribution to prevalence of ‘secondary epilepsy’ and compared with global prevalence data from GBD 2019. We identified all persons with a hospital-based epilepsy diagnosis and a filled prescription for antiseizure medication between 1 January 2009 and 31 December 2018. Epilepsy was categorised into ‘idiopathic’ or ‘secondary’ and ‘total epilepsy’ as the sum of the two epilepsy categories.ResultsOn 31 December 2018, a total of 5 784 284 individuals (49.7% males) were living in Denmark including 40 336 with epilepsy (51.5% males). Perinatal conditions, traumatic brain injury, brain tumours and stroke were prominent underlying causes of ‘secondary epilepsy’. The prevalence of ‘total epilepsy’ in Denmark was 697 (95% CI 691 to 704) per 100 000 population (264 (95% CI 260 to 269) for ‘secondary epilepsy’ and 433 (95% CI 428 to 438) for ‘idiopathic epilepsy’). In the GBD 2019 Study, the prevalence of ‘total epilepsy’ in 2018 was 682 (95% uncertainty interval (UI) 586 to 784) per 100 000 population (359 (95% UI 324–397) for ‘secondary epilepsy’ and 324 (95% UI 249 to 404) for ‘idiopathic epilepsy’).ConclusionsPrevalence estimates of ‘total epilepsy’, ‘idiopathic epilepsy’ and ‘secondary epilepsy’ in Denmark align with the GBD 2019 estimates. In future studies, it is suggested to explicitly include all types of epilepsy, including ‘secondary epilepsy’, which is currently estimated as sequelae (consequences) of underlying diseases.
Skeletal muscle relaxant for the treatment of fibromyalgia: a systematic review and meta-analysis of randomized controlled trials
Authors: Shing Chung Hin , Wang Fengfeng , Lau Lai Ning Lydia , Lam Pui Ming , Ho Hung Chak , Wong Stanley Sau Ching 
Published: November 2024

Background/importanceFibromyalgia is a complex chronic pain disorder that significantly impairs patient well-being. Evaluating the efficacy of muscle relaxants for treating fibromyalgia is crucial for improving patient care.ObjectiveThis study aimed to evaluate the analgesic efficacy of muscle relaxants in patients with fibromyalgia.Evidence reviewA comprehensive literature search was conducted using PubMed, EMBASE, Web of Science, ClinicalTrials.gov, and the Cochrane Library. The search included randomized controlled trials (RCTs) comparing skeletal muscle relaxants with placebo/active analgesics for fibromyalgia. The primary outcome was pain intensity, measured by standardized mean difference (SMD) in pain scores. The risk of bias of included RCTs was assessed using the Cochrane Risk of Bias Assessment Instrument for Randomized Controlled Trials.Findings14 RCTs (1851 participants) were included. Muscle relaxants were associated with a small but statistically significant reduction in pain scores compared with placebo or active treatment (SMD=–0.24, 95% CI=–0.32 to –0.15, p<0.001, 95% prediction interval=–0.40 to –0.08), with no significant inconsistency (I2=0, 95% CI=0% to 50.79%) and a moderate Grading of Recommendation, Assessment, Development and Evaluation rating. Secondary outcomes showed small, but statistically significant improvements in depression, fatigue and sleep quality. Muscle relaxants were associated with increased incidence of overall adverse effects, fatigue, abnormal taste, and drug withdrawal due to adverse effects.ConclusionsModerate quality evidence showed that muscle relaxants were associated with a small reduction in pain intensity for patients with fibromyalgia.
KANQAS: Kolmogorov-Arnold Network for Quantum Architecture Search
Authors: Kundu Akash , Sarkar Aritra , Sadhu Abhishek 
Published: November 2024

AbstractQuantum architecture Search (QAS) is a promising direction for optimization and automated design of quantum circuits towards quantum advantage. Recent techniques in QAS emphasize Multi-Layer Perceptron (MLP)-based deep Q-networks. However, their interpretability remains challenging due to the large number of learnable parameters and the complexities involved in selecting appropriate activation functions. In this work, to overcome these challenges, we utilize the Kolmogorov-Arnold Network (KAN) in the QAS algorithm, analyzing their efficiency in the task of quantum state preparation and quantum chemistry. In quantum state preparation, our results show that in a noiseless scenario, the probability of success is 2× to 5× higher than MLPs. In noisy environments, KAN outperforms MLPs in fidelity when approximating these states, showcasing its robustness against noise. In tackling quantum chemistry problems, we enhance the recently proposed QAS algorithm by integrating curriculum reinforcement learning with a KAN structure. This facilitates a more efficient design of parameterized quantum circuits by reducing the number of required 2-qubit gates and circuit depth. Further investigation reveals that KAN requires a significantly smaller number of learnable parameters compared to MLPs; however, the average time of executing each episode for KAN is higher.
Conditional Activation of c-MYC in Distinct Catecholaminergic Cells Drives Development of Neuroblastoma or Somatostatinoma
Authors: Wang Tingting , Liu Lingling , Fang Jie , Jin Hongjian , Natarajan Sivaraman , Sheppard Heather , Lu Meifen , Turner Gregory , Confer Thomas , Johnson Melissa , Steinberg Jeffrey , Ha Larry , Yadak Nour , Jain Richa , Picketts David J. , Ma Xiaotu , Murphy Andrew , Davidoff Andrew M. , Glazer Evan S. , Easton John , Chen Xiang , Wang Ruoning , Yang Jun 
Published: November 2024

Abstract
c-MYC is an important driver of high-risk neuroblastoma. A lack of c-MYC–driven genetically engineered mouse models (GEMM) has hampered the ability to better understand mechanisms of neuroblastoma oncogenesis and to develop effective therapies. In this study, we showed that conditional c-MYC induction via Cre recombinase driven by a tyrosine hydroxylase promoter led to a preponderance of PDX1+ somatostatinoma, a type of pancreatic neuroendocrine tumor. However, c-MYC activation via an improved Cre recombinase driven by a dopamine β-hydroxylase promoter resulted in neuroblastoma development. The c-MYC murine neuroblastoma tumors recapitulated the pathologic and genetic features of human neuroblastoma and responded to anti-GD2 immunotherapy and difluoromethylornithine, an FDA-approved inhibitor targeting the MYC transcriptional target ODC1. Thus, c-MYC overexpression results in different but related tumor types depending on the targeted cell. The GEMMs represent valuable tools for testing immunotherapies and targeted therapies for these diseases.
Significance: The development of c-MYC–driven genetically engineered neuroblastoma and somatostatinoma mouse models provides useful tools for understanding the tumor cell origin and investigating treatment strategies.
Mutant PP2A Induces IGFBP2 Secretion to Promote Development of High-Grade Uterine Cancer
Authors: Haanen Terrance J. , Boock Sophie , Callahan Catherine G. , Peris Irene , Zawacki Kaitlin P. , Raines Brynne , Nino Charles A. , Tran Brian , Harold Alexis , Hodges Onishi Gabrielle , Hinderman Matthew , Dowdican Amanda , Huang Wei , Taylor Derek J. , Taylor Sarah E. , Jackson Mark W. , DiFeo Analisa , O’Connor Caitlin M. , Narla Goutham 
Published: November 2024

Abstract
Uterine serous carcinoma (USC) and uterine carcinosarcoma (UCS) tumors are uniquely aggressive, suggesting that the primary tumor is intrinsically equipped to disseminate and metastasize. Previous work identified mutational hotspots within PPP2R1A, which encodes the Aα scaffolding subunit of protein phosphatase 2A (PP2A), a heterotrimeric serine/threonine phosphatase. Two recurrent heterozygous PPP2R1A mutations, P179R and S256F, occur exclusively within high-grade subtypes of uterine cancer and can drive tumorigenesis and metastasis. Elucidation of the mechanisms by which PP2A Aα mutants promote tumor development and progression could help identify therapeutic opportunities. Here, we showed that expression of these mutants in USC/UCS cell lines enhanced tumor-initiating capacity, drove a hybrid epithelial-to-mesenchymal plasticity phenotype, and elevated secretion of the tumorigenic cytokine insulin growth factor (IGF) binding protein 2 (IGFBP2). Therapeutic targeting of the IGFBP2/IGF receptor 1 signaling axis using small molecules and genetic approaches resulted in marked tumor growth inhibition. Mechanistically, PP2A regulated IGFBP2 expression through the transcription factor, NF-κB, which harbors a B56 recognition motif. Collectively, these results identify a role for PP2A in regulating paracrine cancer cell signaling that can be targeted to block the initiation and metastasis of high-grade uterine cancer.
Significance: Elevated IGFBP2 secretion by uterine cancer cells with heterozygous PPP2R1A mutations supports tumor progression and confers a vulnerability to IGFBP2/IGF1R inhibition as a therapeutic approach for this highly aggressive cancer subtype.
Phase II Trial of Induction Chemotherapy for Advanced Sinonasal Squamous Cell Carcinoma
Authors: Contrera Kevin J. , Ferrarotto Renata , Gunn Brandon , Su Shirley Y. , Kies Merrill S. , Glisson Bonnie S. , Garden Adam S. , Roberts Dianna , Habna Curtis , Hoff Camilla O. , El-Naggar Adel , Williams Michelle D. , Raza Shaan M. , DeMonte Franco , Chen Melissa M. , Chambers Mark S. , Hanna Ehab Y. 
Published: November 2024

Abstract

Purpose:
Outcomes after primary surgery for advanced sinonasal squamous cell carcinoma (SCC) are poor. We tested whether induction chemotherapy (IC) can improve disease control or organ preservation.

Patients and Methods:
A phase II trial evaluated previously untreated patients with stage II to IV, M0 sinonasal SCC. Patients received IC with docetaxel, cisplatin, and fluorouracil, followed by chemoradiotherapy (CRT) for responders and surgery with adjuvant radiotherapy or CRT for nonresponders. The primary endpoints were overall response rate and locoregional control. Secondary endpoints included progression-free survival (PFS), overall survival (OS), organ preservation, and treatment toxicity.

Results:
Of the 31 patients enrolled between 2008 and 2020, 28 were evaluated for efficacy. Disease was T4a, T4b, and N+ in 57%, 21%, and 36% of patients, respectively. The overall response rate was 82.1%; 17.9% of patients had stable disease, and 0% had progressive disease. Grade 3 and 4 adverse events occurred in 54% and 18% of patients, respectively; there were no grade 5 adverse events. The 2-year locoregional control and PFS rates were 64.3% [95% confidence interval (CI), 40.4–77.6) and 52.4% (95% CI, 32.3–69.0), respectively. The median PFS was 25.8 months. The median OS was 47.4 months, with a 2-year OS rate of 69.4% (95% CI, 44.9–80.4). No survival difference was observed between surgery versus CRT (HR, 1.07; 95% CI, 0.9–3.84). Of patients alive at 2 years, 63% achieved organ preservation, avoiding maxillectomy (38%), craniotomy (13%), or orbital exenteration (38%).

Conclusions:
IC and response-directed local treatment achieved promising disease control and added organ preservation for patients with advanced sinonasal SCC.