bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of problematic pharmaceutical opioid use in patients with chronic non‐cancer pain: A systematic review and meta‐analysis
Authors: Thomas Kyla H. , Dalili Michael N. , Cheng Hung‐Yuan , Dawson Sarah , Donnelly Nick , Higgins Julian P. T. , Hickman Matthew 
Published: August 2024

AbstractBackground and aimsChronic non‐cancer pain (CNCP) is one of the most common causes of disability globally. Opioid prescribing to treat CNCP remains widespread, despite limited evidence of long‐term clinical benefit and evidence of harm such as problematic pharmaceutical opioid use (POU) and overdose. The study aimed to measure the prevalence of POU in CNCP patients treated with opioid analgesics.MethodA comprehensive systematic literature review and meta‐analysis was undertaken using MEDLINE, Embase and PsycINFO databases from inception to 27 January 2021. We included studies from all settings with participants aged ≥ 12 with non‐cancer pain of ≥ 3 months duration, treated with opioid analgesics. We excluded case–control studies, as they cannot be used to generate prevalence estimates. POU was defined using four categories: dependence and opioid use disorder (D&OUD), signs and symptoms of D&OUD (S&S), aberrant behaviour (AB) and at risk of D&OUD. We used a random‐effects multi‐level meta‐analytical model. We evaluated inconsistency using the I2 statistic and explored heterogeneity using subgroup analyses and meta‐regressions.ResultsA total of 148 studies were included with > 4.3 million participants; 1% of studies were classified as high risk of bias. The pooled prevalence was 9.3% [95% confidence interval (CI) = 5.7–14.8%; I2 = 99.9%] for D&OUD, 29.6% (95% CI = 22.1–38.3%, I2 = 99.3%) for S&S and 22% (95% CI = 17.4–27.3%, I2 = 99.8%) for AB. The prevalence of those at risk of D&OUD was 12.4% (95% CI = 4.3–30.7%, I2 = 99.6%). Prevalence was affected by study setting, study design and diagnostic tool. Due to the high heterogeneity, the findings should be interpreted with caution.ConclusionsProblematic pharmaceutical opioid use appears to be common in chronic pain patients treated with opioid analgesics, with nearly one in 10 experiencing dependence and opioid use disorder, one in three showing signs and symptoms of dependence and opioid use disorder and one in five showing aberrant behaviour.
Cannabis policy bundles and traffic fatalities in the American States over time
Authors: Park Mingean , Mallinson Daniel J. , Altaf Shazib , Richardson Lilliard E. 
Published: August 2024

AbstractBackground and AimSince 1996, 38 US states have legalized access to cannabis (medical and/or adult‐use recreational). We aimed to estimate the effect of three dimensions of state cannabis policy design – pharmaceutical, permissive and fiscal – on levels of overall, alcohol‐impaired, occupant, light truck and pedestrian fatality rates.Design and settingObservational study of US states' overall, alcohol‐impaired, occupant, light truck and pedestrian fatalities between 1994 and 2020.CasesThe unit of analysis was at the state level, consisting of 50 states and 27 years of time series data, resulting in a total of 1350 state‐year observations.MeasurementsFatality rates associated with alcohol‐impaired, pedestrian, total occupant, passenger car and light truck fatality rates were obtained from the Fatality Analysis Reporting System of the National Highway Traffic Safety Administration and normalized per 10 billion vehicle miles traveled. State cannabis policies are measured in three bundles (scales): pharmaceutical, permissive and fiscal.FindingsThe pharmaceutical bundle was associated with increases in all fatality rates [β = 0.145; 95% confidence interval (CI) = 0.116–0.173; P < 0.000]. The permissive bundle was associated with lower overall fatality rates (β = −0.319; 95% CI = −0.361 to −0.277; P < 0.000). The fiscal bundle was generally associated with higher fatality rates (β = 0.062; 95% CI = 0.043–0.081; P < 0.000), occupant (β = 0.070; 95% CI = 0.042–0.098; P < 0.000), light trucks (β = 0.049; 95% CI = 0.026–0.072; P < 0.000).ConclusionsUS state cannabis regulations influence traffic safety. Greater permissiveness in US state cannabis regulations does not appear to correlate with traffic fatality rate increases, but greater medicalization and fiscal operation does.
Real‐world data show sustained therapeutic effects of dupilumab in chronic rhinosinusitis with nasal polyps (CRSwNP) over 3 years
Authors: Huber Patrick , Förster‐Ruhrmann Ulrike , Olze Heidi , Becker Sven , Bärhold Friederike , Cuevas Mandy , Gunder Nadine , Hagemann Jan , Matthias Christoph , Klimek Ludger , Gröger Moritz 
Published: August 2024

AbstractBackgroundChronic rhinosinusitis with nasal polyps (CRSwNP) is a prevalent chronic inflammatory condition affecting the nose and paranasal sinuses, posing a significant socio‐economic impact with substantial challenges in management. Biologics targeting type 2 inflammation such as dupilumab, have emerged as promising options. This study addresses a critical knowledge gap by comprehensively evaluating the 3‐year impact of sustained dupilumab therapy in CRSwNP.MethodsA multicentric, retrospective collection of real‐world data from five tertiary referral centers in Germany was conducted, enrolling 150 adult patients. The study investigated patient‐reported outcomes, disease‐specific indices and clinical measures, focusing on therapeutic response persistence, adverse events, and factors influencing treatment continuity.ResultsResults indicate significant improvements in clinical parameters from baseline (n = 150) with sustained effectiveness after 36 months (n = 138) as indicated in mean score ± standard deviation. Dupilumab treatment significantly improved overall disease‐related impairment (VAS score: 7.5 ± 2.5 to 1.6 ± 1.3) and rhinosinusitis symptoms (SNOT‐22: 59.4 ± 19.4 to 18.0 ± 15.0). Nasal Polyp Scores (NPS) decreased (5.3 ± 1.8 to 0.7 ± 1.1), and olfactory function improved (3.2 ± 2.5 to 8.4 ± 2.8), with three out of four patients achieving normosmia or hyposmia after 36 months. An “Excellent” treatment response according to EUFOREA23 criteria was observed in 76.5% of patients after 36 months. Sixteen patients discontinued Dupilumab, 12 permanently. Adverse events totaled 69 in 48 patients, commonly self‐limiting.ConclusionThe study highlights the enduring effectiveness and lack of habituation to dupilumab after a sustained therapy of 3 years, providing valuable insights into its long‐term therapeutic implications for CRSwNP patients.
Impact of a drug allergy education course for non‐specialists: Findings from ADAPT—A randomized crossover trial
Authors: Lucas Michaela , Mak Hugo W. F. , Lee Jasmine T. Y. , Kulkarni Rishabh , Chan Sophia S. C. , Li Philip H. 
Published: August 2024

AbstractBackgroundThe consequences of drug allergy remain a global health concern. Drug allergy is often a neglected topic and many non‐specialists lack sufficient knowledge or confidence in evaluating or managing this common condition. Evidence‐based interventions to better equip non‐specialists to tackle drug allergy are needed. The aim of the study is to evaluate the effectiveness of an intensive educational course on drug allergy knowledge and practice of non‐specialists.MethodsA randomized crossover trial (NCT06399601) was conducted among practicing physicians and nurses participating in an intensive drug allergy course—Advances in Drug Allergy & Penicillin Testing (ADAPT). Participants' baseline knowledge and self‐reported practices were assessed with standardized questionnaires (scored from 0 to 100, with “satisfactory” defined as ≥60/100). Participants were randomized into two cohorts and attended ADAPT at different time points. Serial responses before and after the course were compared within and between cohorts.ResultsSeventy participants (25 physicians, 45 nurses) randomized into two groups completed the course. Baseline drug allergy knowledge (58.0 ± 19.9) and self‐reported practice (36.9 ± 24.3) were unsatisfactory among non‐specialists, with significantly lower scores from nurses than physicians in both domains (knowledge: 49.0 ± 17.4 vs. 74.0 ± 12.7; practice: 32.1 ± 21.3 vs. 53.3 ± 23.1; all p < 0.001).Following completion of ADAPT, participants demonstrated significant improvements in knowledge (58.0 ± 19.9 vs. 77.7 ± 15.9, p < 0.001) and self‐reported practice (36.9 ± 24.3 vs. 71.0 ± 20.2, p < 0.001). All participants (100%) and 99% of participants agreed that the course improved their clinical knowledge and practice, respectively.ConclusionsADAPT, an intensive drug allergy educational course was effective in improving drug allergy knowledge and practice for non‐specialists. Further longitudinal studies are required to evaluate long‐term impact.
Lung ultrasound to predict the duration of respiratory support in newborn infants with respiratory distress
Authors: Gross Maximilian , Engel Corinna , Esser Michael , Spogis Jakob , Schäfer Jürgen F. , Poets Christian F. , Haase Bianca 
Published: August 2024

AbstractAimLung ultrasound (LU) and clinical parameters evaluated during the first postnatal hour potentially predict the length of CPAP therapy in newborns with respiratory distress.MethodsIn a single‐centre, prospective observational pilot study, 130 newborns ≥36 weeks gestational age were assessed using standardised LU at 30 and 60 min postnatally. Various clinical parameters were evaluated influencing CPAP duration (<1 vs. ≥1 h) using univariate and multivariate analyses.ResultsLung ultrasound score >5, FiO2 > 0.21 and respiratory acidosis 30 min postnatally were associated with CPAP ≥1 h. Our model showed good diagnostic quality (ROC AUC = 0.87) and was confirmed by classification and regression tree (CART) analysis. Additional LU findings like double lung point and pleural line abnormalities were frequently observed, with good interrater reliability for LU interpretation (ICC = 0.76–0.77).ConclusionNewborns with postnatal respiratory distress at risk for prolonged CPAP therapy can be identified based on specific LU and clinical parameters assessed 30 min postnatally. Despite the need for validation in an independent sample, these findings may lay the groundwork for a prediction tool. LU proved feasible and reliable for assessing respiratory status in this population, highlighting potential utility in clinical practice.
Letter: Light in the lumen—The expanding role of intestinal ultrasound for functional symptoms in inflammatory bowel disease. Authors' reply
Authors: Mujagic Zlatan , Aliu Arta , Bosch Daan H. C. A. , Keszthelyi Daniel 
Published: August 2024

LINKED CONTENTThis article is linked to Aliu et al papers. To view these articles, visit https://doi.org/10.1111/apt.17988 and https://doi.org/10.1111/apt.18161
The price of capital goods, investment and labour: Micro‐evidence from a trade liberalization
Authors: Meleshchuk Sergii , Timmer Yannick 
Published: August 2024

AbstractIn this paper, we show that a reduction in capital goods prices induced by trade policies can stimulate both investment and labour. We exploit a quasi‐natural experiment in the form of a trade reform in Colombia to study how firms with differential exposure to reductions in capital goods tariffs react in terms of their investment and labour decision. Firms that see a larger decline in the input tariff for capital goods increase investment and labour for production, as well as their labour share. Reductions in input tariffs are passed through to input prices for all goods. However, only lower prices for capital, not for other goods, translate into more investment and employment of production workers.
Understanding the physical literacy development of 8‐ to 12‐year‐old children living with chronic medical conditions: A comprehensive, mixed methods inquiry
Authors: Blais Angelica , Katz Sherri Lynne , Klaassen Robert J. , Lougheed Jane , Reisman John J. , Pohl Daniela , Lawrence Sarah , Lai Lillian , Lee Suzie , Gardin Letizia , Wong Derek , Sell Erick , Longmuir Patricia 
Published: August 2024

AbstractBackgroundPhysical literacy is a concept used to describe the combined physical, affective and cognitive capacities facilitating an active lifestyle. Physical activity participation is essential for children living with chronic medical conditions, but knowledge of physical literacy among this group is scarce.MethodsAn explanatory, sequential mixed methods design was used to comprehensively describe the physical literacies of children with chronic medical conditions (CMCs). Participants were recruited from paediatric cardiology, respirology/cystic fibrosis, neurology, haematology and endocrinology outpatient clinics. All participants completed the Canadian Assessment of Physical Literacy (2nd Edition), and those with higher and lower scores were invited to a semi‐structured interview. A deductive‐inductive thematic analysis was applied using Margaret Whitehead's conceptualization of physical literacy.ResultsUsing normative strata, 80.0% of the 99 children assessed (mean age = 9.97 ± 1.3 years, 48% girls) were considered beginning or progressing in their overall physical literacy (mean score = 56.5 ± 13.8/100). Meanwhile, physical literacy informed participants' approach to new, active experiences and may have contributed to a strong sense of self. There was a significant difference between endocrinology and haematology patients on total physical literacy score (p = 0.03) but not domain scores. Participants scored high on motivation/confidence (mean = 22.9 ± 5.0/30) but obtained low physical competence (mean = 11.8 ± 5.6/30) and daily behaviour scores (n = 72, mean = 15.5 ± 7.1/30). Main themes represent salient experiences of children with CMCs within the domains of physical literacy, including their need to evaluate active contexts, self‐regulate activity intensity and manage physical limitations.ConclusionsChildren with CMCs can achieve recommended levels of physical literacy without meeting normative standards for physical competence. Participants would benefit from a physical literacy intervention that targets the development of bodily self‐regulation skills and risk evaluation in active settings.
Astragalin improves cognitive disorder in Alzheimer's disease: Based on network pharmacology and molecular docking simulation
Authors: Du Rui , Pei Hongyan , He Zhongmei , Wang Jin , Zhou Xiaohong , Li Wenyan , Zhu Diwei , Zhang Caiqun 
Published: August 2024

AbstractWe investigate the mechanism of action of astragalin (AST) in the treatment of Alzheimer's disease (AD). Network pharmacology was conducted to analyze the relationships among AST, AD, and neuroinflammation, The APP/PS1 transgenic mice with AD were used in the experiments; to be specific, the influence of AST on the behavior of mice was analyzed by Morris water maze and eight‐arm radial maze tests, the tissue inflammatory factor levels were detected by ELISA, and pathological changes were analyzed by H&E and immunohistochemical staining. Analysis results of network pharmacology suggested that AST exerted the multi‐target effect on neuroinflammation in AD. Through molecular docking and dynamics analyses, COX2 might be the target of AST. Moreover, animal experimental results demonstrated that AST improved the behavior of AD mice, and enhanced the motor and memory abilities, meanwhile, it suppressed the expression of inflammatory factors in tissues and the activation of microglial cells. this study discovers that AST can suppress microglial cell activation via COX2 to improve neuroinflammation in AD.
Abnormal large‐scale brain functional network dynamics in social anxiety disorder
Authors: Zhang Xun , Wu Baolin , Yang Xun , Kemp Graham J. , Wang Song , Gong Qiyong 
Published: August 2024

AbstractAimsAlthough static abnormalities of functional brain networks have been observed in patients with social anxiety disorder (SAD), the brain connectome dynamics at the macroscale network level remain obscure. We therefore used a multivariate data‐driven method to search for dynamic functional network connectivity (dFNC) alterations in SAD.MethodsWe conducted spatial independent component analysis, and used a sliding‐window approach with a k‐means clustering algorithm, to characterize the recurring states of brain resting‐state networks; then state transition metrics and FNC strength in the different states were compared between SAD patients and healthy controls (HC), and the relationship to SAD clinical characteristics was explored.ResultsFour distinct recurring states were identified. Compared with HC, SAD patients demonstrated higher fractional windows and mean dwelling time in the highest‐frequency State 3, representing “widely weaker” FNC, but lower in States 2 and 4, representing “locally stronger” and “widely stronger” FNC, respectively. In State 1, representing “widely moderate” FNC, SAD patients showed decreased FNC mainly between the default mode network and the attention and perceptual networks. Some aberrant dFNC signatures correlated with illness duration.ConclusionThese aberrant patterns of brain functional synchronization dynamics among large‐scale resting‐state networks may provide new insights into the neuro‐functional underpinnings of SAD.
An extraperitoneal single‐port robotic approach to low anterior resection—Cadaveric experience
Authors: Hany Tarek S. , Stein Hubert , Bhowmick Arnab K. 
Published: August 2024

AbstractAimA minimally invasive surgery (MIS) extraperitoneal (XP) approach to left‐sided colorectal resection utilizing the laparoscopic approach has recently been shown to be safe and feasible and to have potential advantages over the transperitoneal approach, especially in high‐risk surgical patients. The aim of this article is to provide a first cadaveric demonstration of the use of a single‐port robotic platform in performing XP low anterior resection by MIS.MethodA single‐port robotic platform (DaVinci®SP™) was used to perform XP single‐port low anterior resection in two cadavers with body mass indexes (BMIs) of 19 and 40 kg/m2.ResultsThe single‐port robotic platform with versatile arms was successfully used to perform a complete low anterior resection with splenic flexure mobilization and total mesorectal excision through a single port.ConclusionsA single‐port robotic platform enhances complete XP dissection in the supine patient in extreme BMI ranges. Clinical studies are necessary to confirm these findings.
Unplanned Perioperative Reoperation Following Pulmonary Resection in Lung Cancer Patients: A Report of a Single‐Center Experience
Authors: Feng Hongxiang , Zhao Yue , Liang Chaoyang , Shi Yuhui , Liu Deruo , Zhang Jin , Zhang Zhenrong 
Published: August 2024

ABSTRACTBackgroundPulmonary resection is an important part of comprehensive treatment of lung cancer. Despite the progress in recent thoracic surgery, reoperation is occasionally inevitable for managing severe perioperative complications. This study aimed to investigate the incidence and causes of perioperative reoperation in lung cancer patients.MethodsWe retrospectively collected patients who underwent reoperation following pulmonary resection from January 2010 to February 2021 in China‐Japan Friendship Hospital.ResultsAmong the 5032 lung cancer patients who received primary pulmonary resection in our institute, 37 patients underwent perioperative reoperation with the rate being 0.74%. Lobectomy was the most frequently executed procedure (56.8%). The mean duration of the primary surgery was 143.6 ± 65.1 min. About half of the cases received secondary surgery within 24 h of the primary surgery, whereas only one case underwent secondary surgery 30 days after the primary surgery (due to chylous leakage). The major causes of the reoperation were bleeding (73.0%), chylous leakage (13.5%), lobar torsion (5.4%), air leakage (2.7%), atelectasis (2.9%), and cardiac herniation (2.7%).ConclusionThe most prevalent reasons for unplanned reoperation following pulmonary resection in lung cancer patients include bleeding, chylous leakage, and lobar torsion. The strict control of the surgical indications and standardization of surgical procedures are fundamental to reduce unplanned secondary operations after pulmonary resections. Timely identification of the need to secondary surgery is also important to ensure patients' safety.
Identification of Biomarkers for Lung Adenocarcinoma With Qi Deficiency and Phlegm Dampness
Authors: Chen Jiabin , Wang Sheng , Yang Qiaolei , Zhang Yongjun , Shen Jianfei , Chai Kequn 
Published: August 2024

ABSTRACTBackgroundQi deficiency and phlegm dampness (QPD) is one of the most common traditional Chinese medicine (TCM) syndromes in lung adenocarcinoma (LUAD). This study aimed to identify syndrome‐specific biomarkers for LUAD with QPD syndrome.MethodsPeripheral blood mononuclear cells (PBMCs) from LUAD patients with QPD, LUAD patients with non‐QPD (N‐QPD), and healthy control (H) were collected and analyzed with RNA‐seq to identify differentially expressed genes (DEGs). The area under the receiver operator characteristic curve (AUC) of each DEG was calculated, and the top 10 highest AUC DEGs were validated by qRT‐PCR. Logistic regression analysis was used to develop a diagnostic model evaluated with AUC.ResultsA total of 135 individuals were enrolled in this study (training set: 15 QPD, 15 N‐QPD, 15 H; validation set: 30 QPD, 30 N‐QPD, 30 H). A total of 1480 DEGs were identified between QPD and N‐QPD. The qRT‐PCR results showed that the expression of DDR2 was downregulated, and PPARG was upregulated, which was in line with the finding of the training set. We developed a diagnostic model with these two genes. The AUC of the diagnostic model in the training cohort and validation cohort was 0.891 and 0.777, respectively.ConclusionsWe identified the two genes (DDR2 and PPARG) as syndrome‐specific biomarkers for LUAD with QPD syndrome and developed a novel diagnostic model, which may help to improve the accuracy and sensibility of clinical diagnosis and provide a new target for natural drug treatment of LUAD.
Efficacy and threshold dose of intensive training targeting mobility for children with cerebral palsy: A systematic review and meta‐analysis
Authors: Sudati Isabella Pessóta , Sakzewski Leanne , Fioroni Ribeiro da Silva Carolina , Jackman Michelle , Haddon Matthew , Pool Dayna , Patel Maharshi , Boyd Roslyn N. , de Campos Ana Carolina 
Published: August 2024

AbstractAimTo systematically review the evidence for intensive mobility training in cerebral palsy (CP) and to determine the minimum effective dose to improve mobility.MethodRandomized controlled trials (RCTs) or quasi‐RCTs that included participants with CP, and which used intensive task‐oriented training (TOT) mobility interventions and reported mobility outcomes, were included. Five databases were searched; two independent reviewers selected studies and extracted data. The Grading of Recommendations Assessment, Development, and Evaluation system and the Cochrane Risk of Bias 2 tool were used to rate the certainty of evidence at the outcomes level and to determine the risk of bias respectively. Meta‐analyses were conducted with clinically homogeneous studies. Threshold dose was analysed through meta‐regression.ResultsForty‐six RCTs with 1449 participants (mean age range 1 year 2 months to 16 years 4 months) were included. TOT had statistically and clinically significant effects on walking speed (p = 0.001), cadence (p = 0.02), gross motor function (p = 0.03), and functional mobility (p = 0.009) compared with control interventions. The threshold dose was undeterminable owing to the high heterogeneity of studies.InterpretationTOT may improve walking speed, walking endurance, and balance. Studies with homogeneous samples and outcomes are needed to support clinical recommendations for intensive mobility interventions.