bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic review and indirect treatment comparisons of ritlecitinib against baricitinib in alopecia areata
Authors: Aceituno D. , Fawsitt C. G. , Power G. M. , Law E. , Vaghela S. , Thom H. 
Published: October 2024

AbstractRitlecitinib and baricitinib are recently approved systemic treatments for severe alopecia areata (AA). Both demonstrated superiority over placebo in hair regrowth measured by the Severity of Alopecia Tool (SALT), but they have not been directly compared in randomized controlled trials (RCTs). We conducted a systematic review of RCTs evaluating treatments in AA and estimated the efficacy and safety of ritlecitinib and baricitinib at Week 24 using Bayesian network meta‐analysis. To adjust and explore effect modifiers, population‐adjusted indirect comparison was performed via multilevel network meta‐regression (ML‐NMR) using ritlecitinib individual patient data (IPD). Co‐primary endpoints were SALT ≤20 and SALT ≤10 at Week 24. Unanchored population adjusted ITCs were also computed to evaluate SALT ≤10 and SALT ≤20 endpoints at Week 48/52. Four RCTs (ALLEGRO 2a [NCT02974868], ALLEGRO 2b/3 [NCT03732807], BRAVE‐AA1 [NCT03570749] and BRAVE‐AA2 [NCT03899259]) were included. No evidence of a difference between ritlecitinib 50 mg and baricitinib 4 mg on SALT ≤10 (odds ratio, OR: 0.96, 95% credible interval, CrI: 0.18–7.21) and SALT ≤20 (OR: 2.16, 95% CrI: 0.48–16.46) at Week 24 was found. ML‐NMR using ALLEGRO IPD adjusted for sex, SALT score at baseline, duration of current episode and disease duration found evidence of effect modification, although relative efficacy between ritlecitinib 50 mg and baricitinib 4 mg remained unchanged. Unanchored population‐adjusted ITC at Week 48/52 was consistent with previous results. We found similar efficacy between ritlecitinib 50 mg and baricitinib 4 mg. These ITCs was informed by only four RCTs, uncertainty was considerable, and there was evidence of effect modification, highlighting the need for further quality research in AA.
Native Parasitoids Recruitment as Potential Controllers of Dryocosmus kuriphilus (Hymenoptera; Cynipidae) in Recently Colonised Areas
Authors: Vinagrero‐Conde Juan Carlos , Muñoz‐Adalia E. Jordán , Pujade‐Villar Juli , Fernández‐Fernández M. Mercedes 
Published: October 2024

ABSTRACTIn this work, we investigate the native parasitoid community colonising galls by an invasive pest: the oriental chestnut gall wasp (OCGW), Dryocosmus kuriphilus (Hymenoptera; Cynipidae). We tried to understand how native parasitoids react after the arrival of the pest (two‐year sampling period) in the province of Zamora (Castilla & León region, N‐W Spain). For this purpose, we collected both, chestnut galls from six stands and oak galls from surrounding oak groves. Our results highlight the response to D. kuriphilus provided by the oak gall wasps that naturally inhabit Quercus pyrenaica. The parasitoid community showed a core assemblage composed of Eurytoma brunniventris, Torymus flavipes and T. sinensis in OCGW galls, and Baryscapus diaphantus, Bootanomyia dorsalis, Eupelmus urozonus, E. brunniventris, Mesopolobus lichtensteini, T. affinis, and T. flavipes in oak galls. We identified the torymid T. flavipes as one of the most common parasitoids of OCGW, in addition to the exotic parasitoid T. sinensis, never officially released in the region but present in the study area. In addition, we intend to know its possible incidence on non‐target cynipids. We have found an intense connection in the food web with some chalcids that establish interactions with the gall wasp, both in adult instar (emerging from reared galls) and larval (presence of larvae in OCGW gall chambers, identified by dissection). We also describe the flight phenology of D. kuriphilus in our study area (as far as we know, the first one focused in Castilla & León region) and evaluate the overlap between OCGW and native and exotic parasitoids showing a promising role of native guild as biocontrollers.
Evaluation of the psychometric properties of the Turkish version of the Skin‐to‐Skin Contact Scale for nurses
Authors: Bektas Ilknur , Özalp Gerçeker Gülçin , Bektas Murat 
Published: October 2024

AbstractRationaleSkin‐to‐skin contact is the practice with the highest level of evidence that increases the growth, development, and healing rate of the newborn. Neonatal nurses are also the best practitioners of skin‐to‐skin contact.AimsThis study examined the psychometric properties of the Turkish version of the Skin‐to‐Skin Contact Scale for nurses.MethodsThis descriptive, correlational, and cross‐sectional study was carried out with 226 neonatal and pediatric nurses between July 2022 and July 2023. The data were collected using an online questionnaire, including a descriptive information form and a skin‐to‐skin contact scale for nurses. Data were analyzed by explanatory and confirmatory factor analysis, Cronbach's alpha, and item‐total score analysis.ResultsIt was determined that the scale consisted of 20 items and four sub‐dimensions and that those four sub‐dimensions explained 53.01% of the total variance. All factor loads were higher than 0.30 in the explanatory and confirmatory factor analyses. All the fit indices were higher than 0.80, and the Root Mean Square Error of Approximation (RMSEA) was less than 0.080 in the confirmatory factor analysis. Cronbach's alpha was determined to be 0.89 for the total scale and greater than 0.70 for all sub‐dimensions.ConclusionsThe Skin‐to‐Skin Contact Scale for nurses was determined to be a valid and reliable measurement tool for Turkish nurses. It is recommended that the scale be used regularly in clinics to determine nurses' attitudes towards skin‐to‐skin contact.
Use and impact of clinical pathways across various healthcare settings: A protocol for an umbrella review of global evidence
Authors: Chandra Rishita , Unwin Maria , Tran Viet , Neil Amanda 
Published: October 2024

AbstractAimThe proposed umbrella review aims to assess the use and impact of clinical pathways on professional practice, patient outcomes, length of hospital stay, hospital costs, patient satisfaction, and hospital staff satisfaction through a synthesis of existing systematic reviews and meta‐analyses.MethodsFollowing PRIOR guidelines, a systematic search will be conducted in MEDLINE, Epistemonikos, and the Cochrane Library to identify relevant systematic reviews and meta‐analyses, from inception till March 2024. Two reviewers will independently screen titles and abstracts, with a third resolving any disagreements. Full‐text articles considered potentially relevant will be assessed for eligibility by the same process. The data extraction form will cover information about the review methods, characteristics of the included primary studies, the types of interventions evaluated, and the reported outcomes. This standardized data extraction form will be piloted by the review team on five to ten articles to ensure all relevant information is recorded. The quality of included systematic reviews and meta‐analyses will be evaluated using AMSTAR 2. PROSPERO registration number is CRD42024529371.ResultsThe study will present a narrative synthesis of the findings, addressing the clinical and methodological heterogeneity and assessing the impact of clinical pathways on various healthcare outcomes.Conclusion and ImplicationsThis umbrella review will provide evidence‐based insights into the effectiveness, challenges, and best practices of clinical pathways, guiding healthcare decision‐making and identifying areas for future research. Results will be disseminated widely to inform policy and improve healthcare service delivery.Patient or Public ContributionNo patient or public contribution, as this paper is a protocol of an umbrella review.
Development and validation of knowledge, attitude, and practice scale regarding antibiotic use for Chinese medical students
Authors: Sun Hui , Xiang Linghui , Zhang Jiajia , Xiong Xin , Sun Xuemei , Gao Yinyan , Song Jinlu , Luo Han , Sun Dingkui , Lin Xiangfeng , Xu Boya , Wu Irene X. Y. , Dai Wenjie 
Published: October 2024

AbstractAims and ObjectivesThis study aimed to develop and validate a knowledge, attitude, and practice scale of antibiotic use for Chinese medical students.MethodA five‐phased procedure was adopted: (a) A item pool was constructed after literature review; (b) Delphi method was used to refine the items; (c) A pilot study was conducted to clarify the item; (d) Item analysis and exploratory factor analysis were used to finalize the scale; (e) Content validity, construct validity and reliability of the scale were analysed.ResultsThe scale of 32 items, respectively 15, 9, and 8 for knowledge, attitude, and practice, was finalized. The item‐level content validity ranged from 0.80 to 1.00. The scale‐level content validity of the scale was 0.90. Model fit indices of total scale and the three dimensions met the criteria. Cronbach's α and the split‐half coefficient were respectively 0.81 and 0.65 for the total scale. For each dimension, Cronbach's α varied from 0.68 to 0.89 and the split‐half coefficient varied from 0.64 to 0.83.ConclusionThe scale can be used as a whole or separately, serving as an effective tool to measure medical students' knowledge, attitude, or practice regarding antibiotic use.
Misconceptions about randomisation harm validity of randomised controlled trials
Authors: Mastnak Wolfgang 
Published: October 2024

AbstractRationaleThe coherence theory of truth, the epistemology of evidence‐based medicine, mathematical statistics, and axiomatic mathematics.Aims and ObjectivesTo explore mathematical misconceptions inhering in randomised controlled trial designs, suggest improvements, encourage meta‐methodological discussions and call for further interdisciplinary studies.MethodMathematical‐statistical analyses and science‐philosophical considerations.ResultsRandomisation does not (necessarily) generate equal samples, ergo, outcomes of usual RCTs are not as reliable as they claim. Moreover, ignoring initial sample discrepancies may cause inaccuracies similar to type I and type II errors. Insufficient awareness of these flaws harms final RCT statements about significance and evidence levels, hence their loss of trustworthiness. Statistical parameters such as the standard error of the mean may help to estimate the expected distinction between random samples.ConclusionResearchers in EBM should be aware of systemic misconceptions in RCT standards. Pre‐measurement can reduce shortcomings, e.g. through calculation how sample differences impact on usual RCT processing, or randomisation is given up in favour of mathematical minimisation of sample differences, i.e. optimising statistical sample equality. Moreover, the promising future of dynamic simulation models is highlighted.
Cirrhosis in primary practice: many patients remain potentially undiagnosed and are not receiving liver cancer surveillance
Authors: Prince David S , Hoque Shakira , Kim Christy , Maher Salim , Miller Jane , Chomley Phoebe , Pritchard‐Jones Janice , Spruce Sally , McGarry Nathan , Baker David , Elix Penelope , Liu Ken , Strasser Simone I , Goodger Brendan , Zekry Amany , McCaughan Geoffrey W 
Published: October 2024

AbstractBackground and AimMost patients with cirrhosis have compensated disease and are cared for in primary care; however, the exact epidemiology within Australia remains largely unknown. The aim of this study was to assess cirrhosis care in an Australian primary care setting by evaluating rates of cirrhosis diagnosis, appropriate hepatocellular carcinoma (HCC) surveillance and specialist communication.MethodsElectronic medical records in consenting general practices were reviewed using the “Liver Toolkit” to identify patients with an existing cirrhosis diagnosis. Individual cases were reviewed to identify outcomes of interest.ResultsOne hundred seventy‐one patients with confirmed cirrhosis across nine general practices were identified (74% male, mean age: 61.2 years). There was significant variation in the rate of cirrhosis diagnosis between practices (range 31.7–637.9 per 100 000 patients, P < 0.0001). Patients with cirrhosis had predominately compensated disease (75% Child–Pugh A) and common etiologies of cirrhosis were alcohol (49%), hepatitis C (47%), and metabolic dysfunction‐associated steatotic liver disease (29%). Forty‐two patients (25%) had received appropriate HCC surveillance. Predictors of inadequate HCC surveillance were time from last specialist correspondence (odds ratio [OR] = 1.06 per month increase, 95% confidence interval [CI]: 1.02–1.10, P = 0.002) and hepatitis B (OR = 0.24, 95% CI: 0.06–0.98, P = 0.047). Specialist correspondence with primary care was older than 2 years or absent in 37% of cases.ConclusionsThere was a 20‐fold difference in the rate of cirrhosis diagnosis between general practices within Sydney, suggesting a large proportion of patients remain undiagnosed. Three quarters of patients with diagnosed cirrhosis are not receiving appropriate HCC surveillance.
The Life Cycle of Systemic Risk and Crises
Authors: BERGER ALLEN N. , SEDUNOV JOHN 
Published: October 2024

AbstractWe present a life cycle view of systemic risk and crises that incorporates and synthesizes a number of views and organizes the theoretical and empirical research evidence in a clear fashion. We illustrate how systemic risks build during the boom, are realized during the following crisis, and are well addressed or not in the aftermath, which helps determine how well or poorly the following cycle will likely evolve. We aim to improve current understanding of systemic risk and crises, the roles of the different economic segments of society, highlight key issues of measurement, and provide guidance for future academic research and policy analysis. We address several controversies—the outsized role of the banking sector in creating and resolving systemic risks, its exclusive role in systemic risk measurement, and seemingly irrational behavior in which the same or similar costly mistakes are repeated every cycle.
The “4.3,” A New Filler Lips Technique
Authors: Castellaneta Francesco , Lombardi Mariagiovanna , D'Antonio Santolo , Fabrizio Tommaso 
Published: October 2024

ABSTRACTBackgroundThe “4.3” technique is a hybrid lip augmentation approach that combines the aesthetic benefits of the vertical‐lip technique with the fewer entry points of the retrograde linear technique. This method aims to create natural‐looking, harmonious, and defined lips using hyaluronic acid (HA)‐based fillers, to enhance volume and contour.AimsThe objective of this study is to evaluate the effectiveness, safety, and reproducibility of the “4.3” technique in achieving natural lip augmentation with minimal filler volume and reduced injections. This technique is applied to improve the shape and volume of the lips while minimizing the risk of complications.Patients/MethodsThe technique was applied to male and female patients with standard anatomical features who desired subtle enhancements in lip contour, projection, and volume. The procedure involved four injections in the upper lip and three in the lower lip, using a combination of retrograde linear and vertical techniques. A total of 0.7 mL of HA filler were used for each patient.ResultsThe “4.3” technique achieved consistent and aesthetically pleasing results across all patients, with improvements in lip volume, shape, and definition. The reduced number of injections minimized discomfort and risk of vascular complications. The use of Tri‐Hyal technology contributed to smooth, plump lips with harmonious proportions.ConclusionsThe “4.3” technique is a standardized, intuitive, and reproducible method suitable for most patients, regardless of sex. It allows for natural‐looking lip augmentation using a reduced volume of filler and fewer injections, making it a safe and effective option for enhancing lip aesthetics.
Association of Fusobacterium nucleatum Levels by ddPCR in Oral Rinse Samples With Periodontal Disease in Oral Squamous Cell Carcinoma Patients and in Controls
Authors: Fernandes Bárbara Borella , Datorre Jose Guilherme , Vazquez Fabiana de Lima , Peters Ana Carolina de Carvalho , Coracin Fabio Luiz , Reis Rui Manuel , Arantes Lidia Maria Rebolho Batista , Gama Ricardo Ribeiro 
Published: October 2024

ABSTRACTBackgroundThe role of microbiome, particularly Fusobacterium nucleatum (Fn), in periodontal disease and oral squamous cell carcinoma (OSCC) has been recently explored. This study aimed to evaluate the Fn presence and its levels in oral rinse samples from Brazilian OSCC patients and healthy individuals and its association with sociodemographic, clinical, and oral health features.MethodsIn this case–control study, 80 participants were included, 31 OSCC patients and 49 individuals without a cancer history. Clinical data were collected, and an oral exam was done on a subset of the cohort. Fn levels were evaluated by droplet digital PCR (ddPCR) in oral rinse samples and were categorized as Fn‐high or Fn‐low based on the median number of copies per reaction.ResultsOSCC patients showed higher levels of Fn (68%, p = 0.03) than controls, and all OSCC cases were diagnosed with periodontal disease (100%, p = 1.0). In the univariate analysis, Fn‐high level was more frequently present in OSCC cases compared to controls (p = 0.01). It was also observed that Fn‐high level OSCC cases were significantly associated with self‐reported non‐white ethnicity (71.4%, p = 0.01) and had more infiltrative lesions (57.1%, p = 0.02) than Fn‐low OSCC cases. Fn‐high levels in oral rinse samples, were significantly more prevalent among OSCC than in controls.ConclusionsIn OSCC patients, Fn‐high levels were associated with non‐white ethnicity and lesions with infiltrative clinical aspects. Among OSCC cases, all had periodontal disease.
Creating Lasting Conditions for Meaningful Recess Reform: A 5‐School Exploration
Authors: London Rebecca A. , Alvarez Gabriella , Massey William V. , Farello Anna , Santos Betania 
Published: October 2024

ABSTRACTBACKGROUNDWhen well implemented, recess is a critical part of the school day for children's healthy development. We explored the implementation of a recess improvement process in 5 elementary schools across 3 states.METHODSWe conducted a mixed‐methods implementation study in which we visited each school 3 times over 1 school year, collecting observational, interview, survey, and focus group data. Qualitative data were coded thematically and analyzed across schools. Quantitative data were tabulated and aggregated over time and across schools.RESULTSWe observed improvements in aspects of recess quality at each school, with three schools demonstrating the most progress. Quantitative data showed null effects in aggregate; however one school demonstrated significant improvements. Four criteria contributed to the quality and sustainability of recess reform: staff engagement, integration with other programs, student leadership, and recess communications.IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITYProgram implementation research often refers to “buy‐in” as a key ingredient to successful adoption. We provide a tool that helps to operationalize buy‐in in the recess context.CONCLUSIONSChanging the recess environment requires individual and institutional commitment to valuing recess as an important learning environment. School administrators must lead the change process and create institutional infrastructure to support success.
Towards equitable reporting of Indigenous status, ethnicity, language and country of birth in Australian paediatric clinical studies: A scoping review
Authors: Cunninghame Jacqueline , Holland Lorelle , Takashima Mari , Nguyen Linda , Diaz Abbey , Guo Shuaijun , Dufficy Mitchell , Munns Craig F , Ullman Amanda 
Published: October 2024

AimThis scoping review aims to expansively review the reporting of Indigenous status, ethnicity, culture, language and country of birth in Australian paediatric clinical studies.MethodsScoping review of Australian clinical studies, including randomised controlled trials, non‐randomised controlled trials, cluster randomised controlled trials and quasi‐experimental studies, with paediatric participants (<18 years) or mixed adult and paediatric participants. PubMed, Cumulated Index to Nursing and Allied Health Literature and Embase databases were searched for clinical studies published 1 January 2018 to 28 November 2022.ResultsOf the 2717 studies identified in the search, 209 clinical studies were included. Overall, 131 (62.7%) clinical studies captured in this review did not report any of the variables of interest. When reported, terms used by study authors varied extensively and subsequently five study‐defined categories emerged ‘Indigenous status’, ‘race’, ‘race and ethnicity’, ‘ethnicity’, or ‘natural skin colour’. ‘Indigenous status’ was most reported (n = 37, 17.7%), followed by ‘ethnicity and/or cultural background’ (n = 15, 7.2%), ‘race and ethnicity’ (n = 4, 1.9%), race (n = 1, 0.5%) and ‘natural skin colour’ (n = 1, 0.5%). Furthermore, language used at home was reported in 27 studies (12.9%) and country of birth in 23 studies (11.0%).ConclusionsThis review demonstrated very low reporting of Indigenous status, ethnicity, culture, language and country of birth in Australian paediatric clinical studies. Poor reporting has raised concerns surrounding generalisability of findings from these trials in addition to equity. The recent international shift encompassing improved clinical trial reporting requirements, for ethnicity and race, require prompt establishment in the Australian clinical trial domain.
Assessing climatic conditions and biotic interactions shaping the success of Cystoseira foeniculacea early‐life stages
Authors: Bernal‐Ibáñez Alejandro , Cacabelos Eva , Triay‐Portella Raul , Ramalhosa Patrício , Gestoso Ignacio 
Published: October 2024

AbstractEarly‐life stages of canopy‐forming macroalgae are critical for the maintenance of natural populations and the success of restoration actions. Unfortunately, the abiotic conditions and biotic interactions shaping the success of these stages have received less attention than the interactions shaping the success of adults. Here, we combined field and mesocosm experiments to explore the effects of temperature, herbivory, and canopy presence on the development of early‐life stages of the brown seaweed Cystoseira foeniculacea. We assessed these effects by examining changes in recruit density and size. After recruiting zygotes under laboratory conditions, we conducted one laboratory and three field experiments. In the first field experiment, the density of recruits decreased over time in all rockpools and was negatively affected by rising temperatures and turf cover. Additionally, a marine heatwave (MHW; 11 days >25°C) was recorded in the donor pools, producing strong decay in the density of transplanted recruits and a significant reduction of the mature canopy. The second field experiment tested the survival of recruits based on their positioning within the canopy. We observed a higher density of recruits when placed at the edge or outside the canopy compared to recruits placed under the canopy. In the third field experiment, an herbivory‐exclusion experiment, we show how density of recruits decreased in less than 48 h in noncaged treatments. In the laboratory, we conducted a thermotolerance experiment under controlled conditions, exposing the recruits to 19, 22, 25, 28, and 31°C for 7 weeks to assess thermal impacts on their survival and growth. Temperatures above the 25°C threshold reduced the density and size of the recruits. This study sheds light on the performance of the early‐life stages of a Cystoseira spp. in Macaronesia, showing a low survival ratio against the current pressures even in the context of the potential refuge provided by the intertidal rockpools.