bluuebunny/crossref_metadata_2025_split huggingface dataset:
Foster Care in India from 2010 to 2024—Policy and Humanity Lens
Authors: Forber-Pratt Ian 
Published: August 2024

The feature article explores the journey of foster care in India from 2010 to 2024 as an analysis and commentary on the substantive changes between the foster care 2016 model guidelines and the newly released foster care 2024 guidelines. The article highlights the historical context of foster care in India, acknowledging the efforts of pioneers over the past decades. It discusses the challenges of scaling up foster care nationwide, emphasising the need for proper support systems and cultural sensitivity. Reflecting on the journey since 2016, the article acknowledges the slow progress and instances of corruption in foster care implementation. It underscores the importance of trained oversight and social work expertise in ensuring the well-being of children in foster care. Looking ahead to 2024, with the release of new foster care guidelines, the article suggests a shift towards a child-centred approach and emphasises the need for robust monitoring and evaluation mechanisms. In summary, the article advocates for a comprehensive approach to foster care implementation in India, encompassing cultural sensitivity, capacity building, community engagement, legal framework alignment, child-centred practices and effective monitoring and evaluation.
Global Health Competency of Nursing Personnel: A Cross-Sectional Study
Authors: Kang Jiwon , Song Jeongeun , Noh Wonjung 
Published: August 2024

Introduction As global health issues become more important, nursing education is undergoing change to reflect the changing global health environment and new knowledge. Nurses are required to be able to understand and interact with patients of diverse cultural backgrounds and characteristics and have relevant global health competencies. Objectives The aims of this study were to determine the GHC status of nurses and to analyze the association between GHC and nurse characteristics. Methods This study was a cross-sectional descriptive survey using a convenience sampling method. Data were collected from 473 nurses to collect information about participants’ GHC and general characteristics, including gender, age, nursing experience (years), experience of caring for foreign patients, English communication skills, learning experience in global health, and global preparedness. Multiple regression analysis was used to determine the relationship between GHC and nurse characteristics. Results The mean GHC score of nurses was 2.21 out of 4. “Nursing practice in globalization” was the most important global health competency, while “resource management in globalization” was the one that was most necessary. In addition, “Resource management in globalization” was the highest priority for global health competency. Global preparedness ( β = .25, p < .001) and the perceived necessity of GHC in nursing practice ( β = .28, p < .001) were statistically significant factors influencing the global health competency of nurses. Conclusion Based on the relationship identified between GHC and the characteristics of nurses, it is essential to develop an education program for enhancing global preparedness and perception of the necessity of GHC.
Validation of the follicular and ovarian thresholds by an 18-MHz ultrasound imaging in polycystic ovary syndrome: a pilot cutoff for North African patients
Authors: Ach Taieb , Guesmi Ayoub , Kalboussi Maha , Ben Abdessalem Fatma , Mraihi Emna , El Mhabrech Houda 
Published: August 2024

Background: Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrinopathies among young women. Ultrasound evidence of polycystic ovaries is one of its crucial diagnostic criteria. Objectives: Our main objective is to study the contribution of ultrasound data in diagnosing PCOS. In addition, we aim to establish a new cutoff point for the use of ultrasound and to determine its sensitivity as well as its specificity. Design: It was a prospective study, including all patients presenting with clinical hyperandrogenism. Methods: The ultrasound examination of these patients was performed using a novel ultrasound machine (18 MHz) compared to an older ultrasound machine (2 Hz–8 MHz). Inclusion criteria encompassed adult female patients over 18 years presenting symptoms suggestive of PCOS, particularly hyperandrogenism and oligo-anovulation, meeting Rotterdam’s diagnostic criteria. Prior to inclusion, assessments were conducted to eliminate other potential causes explaining hyperandrogenism or menstrual disorders in both groups. Results: We examined 92 patients diagnosed with PCOS. Menstrual disorders were the main symptoms, with amenorrhea being more frequent in the PCOS group (G1) (48.9% vs the control group (G2): 11.1%). The follicle number was significantly lower in the control group, as assessed by both ultrasound machines ( p < 10−3). The accuracy of the new ultrasound device was evaluated compared to the old one using the receiver operating characteristic (ROC) curve, revealing a cutoff of 18 follicles (sensitivity of 68.1%, specificity of 100%) and an area under the curve of 0.955. We found a significant difference between the median values of the number of follicles (NF) by both ultrasound machines (18 vs 12). It was positively correlated with an index of r = 0.916. For the volume, it was distinctively higher in G1 ( p < 10−3). ROC curve analysis revealed an ovarian volume cutoff of 9.25 ml with a sensitivity of 48.9% and a specificity of 100%. Both ultrasound machines were positively correlated with an index of r = 0.979 ( p < 10−3). Conclusion: In conclusion, we were able to establish significant correlations between the new and the old ultrasound devices for both the NF and ovarian volume. Our study is distinctive as it represents the first on the African continent to re-evaluate the ultrasound criterion for PCOS.
Out-of-pocket healthcare expenditure in emerging economies: Evidence from panel data analysis
Authors: Kaladharan Sanju , Manayath Dhanya 
Published: August 2024

Background: Achieving universal health coverage is one of the prominent targets of the United Nations’ sustainable development goals. Reducing out-of-pocket expenditure (OOPE) is essential because high OOPE can deter the use of healthcare services, which can lead to poor health outcomes and medical impoverishment. Objectives: The study sought to determine the effects of various factors such as Domestic General Government Health Expenditure, Gross Domestic Product, Government schemes and compulsory contributory healthcare financing schemes, and Voluntary health insurance schemes on OOPE per Capita in emerging economies. Design: Econometric methods using panel data Data Sources and Methods: The study analyzed the publicly available panel data from the World Health Organization using fixed, random, and dynamic models. Results: Domestic General Government Health Expenditure and Gross Domestic Product are associated with an increase in OOPE. Government schemes, compulsory contributory healthcare financing schemes, and voluntary health insurance programs are linked to a reduction in OOPE. Conclusion: In conclusion, this study, conducted through econometric methods on panel data, sheds light on the critical importance of reducing OOPE to achieve universal health coverage, aligning with the United Nations’ sustainable development goals. Countries shall implement a holistic approach focusing on preventive healthcare and health promotion, providing comprehensive health insurance, strengthening public health systems, and regulating medicine prices.
Identifying disease-modifying potential in myelofibrosis clinical trials
Authors: Ross David M. , Lane Steven W. , Harrison Claire N. 
Published: August 2024

Abstract
The ultimate goal of bringing most new drugs to the clinic in hematologic malignancy is to improve overall survival. However, the use of surrogate end points for overall survival is increasingly considered standard practice, because a well validated surrogate end point can accelerate the outcome assessment and facilitate better clinical trial design. Established examples include monitoring minimal residual disease in chronic myeloid leukemia and acute leukemia, and metabolic response assessment in lymphoma. However, what happens when a clinical trial end point that is not a good surrogate for disease-modifying potential becomes ingrained as an expected outcome, and new agents are expected or required to meet this end point to demonstrate “efficacy”? Janus kinase (JAK) inhibitors for myelofibrosis (MF) have a specific impact on reducing symptom burden and splenomegaly but limited impact on the natural history of the disease. Since the introduction of ruxolitinib more than a decade ago there has been modest incremental success in clinical trials for MF but no major leap forward to alter the natural history of the disease. We argue that the clinical development of novel agents for MF will be accelerated by moving away from using end points that are specifically tailored to measure the beneficial effects of JAK inhibitors. We propose that specific measures of relevant disease burden, such as reduction in mutation burden as determined by molecular end points, should replace established end points. Careful reanalysis of existing data and trials in progress is needed to identify the most useful surrogate end points for future MF trials and better serve patient interest.
Decreasing chronic graft-versus-host disease rates in all populations
Authors: Carpenter Paul A. , Gooley Ted A. , Boiko Julie , Lee Catherine J. , Burroughs Lauri M. , Mehta Rohtesh , Salit Rachel B. , Bhatt Neel S. , Krakow Elizabeth , Dahlberg Ann E. , Yeh Albert C. , Summers Corinne N. , Ueda Oshima Masumi , Petersdorf Effie W. , Vo Phuong , Connelly-Smith Laura , Lee Stephanie J. 
Published: August 2024

Abstract
Since 2005, there has been a steady decline in chronic graft-versus-host disease (cGVHD) at the Fred Hutchinson Cancer Center. To better understand this phenomenon, we studied the risk of cGVHD requiring systemic immunosuppression (cGVHD-IS) as a function of hematopoietic cell transplantation (HCT) date in 3066 survivors from 2005 through 2019. Cox regression models were fit to assess associations of HCT date (as a continuous linear variable) with cause-specific hazards of cGVHD using unadjusted and adjusted models. Median follow-up for study subjects was 7.0 years (range, 1.0-17.2). Two-year probabilities of cGVHD-IS declined among all survivors from 45% to 52% (2005-2007) to ∼40% (2008-2012) and then further to ∼26% by 2017. A decline was also observed when the analysis was restricted to 502 pediatric survivors, with cGVHD-IS probabilities &lt;10% since 2013. Among 305 adult and pediatric survivors who underwent transplantation for nonmalignant diseases, cGVHD rates showed greater fluctuation but remained &lt;20% after 2016. Each 5-year increase in HCT date was associated with a 27% decrease in the cause-specific hazard of cGVHD (unadjusted hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.68-0.78; P &lt; .0001); the HR was 0.81 (95% CI, 0.75-0.87; P &lt; .0001) even after adjusting for various factors (age, donor/stem-cell source, race, sex, conditioning intensity, GVHD prophylaxis, among others) that could lead to cGVHD reduction. The decline in cGVHD was not fully explained by demographic shifts and greater use of HCT approaches that are generally associated with lower cGVHD rates. This observation underscores that single-cohort cGVHD prevention studies should use contemporaneous and not historical controls for comparison.
Health-related quality of life with gilteritinib vs placebo posttransplant for FLT3-ITD
+ acute myeloid leukemia
Authors: Hamilton Betty K. , Pandya Bhavik J. , Ivanescu Cristina , Elsouda Dina , Hamadani Mehdi , Chen Yi-Bin , Levis Mark J. , Ueda Oshima Masumi , Litzow Mark R. , Soiffer Robert J. , Ustun Celalettin , Perl Alexander E. , Singh Anurag K. , Geller Nancy , Hasabou Nahla , Rosales Matt , Cella David , Corredoira Laura , Pestana Carolina , Horowitz Mary M. , Logan Brent 
Published: August 2024

Abstract
The Blood and Marrow Transplant (BMT) Clinical Trials Network conducted a phase 3 randomized trial comparing gilteritinib with placebo after allogeneic hematopoietic cell transplantation (HCT) for FLT3-ITD+ acute myeloid leukemia (AML). The primary analysis demonstrated no statistically significant difference in relapse-free survival (RFS); however, patients with FLT3-ITD measurable residual disease (MRD) peri-HCT had significantly longer RFS with gilteritinib. This analysis investigates the effect of post-HCT gilteritinib vs placebo on health-related quality of life (HRQOL). HRQOL was measured with Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT), FACT-Leukemia (FACT-Leu), and EuroQOL-5 Dimensions (EQ-5D-5L) at post-HCT randomization; day 29; months 3, 6, 12, 18, 24; and/or end of therapy. HRQOL and clinically meaningful differences were summarized using descriptive statistics and compared using mixed model repeated measures to evaluate longitudinal change from baseline and stratified Cox model to evaluate time to improvement. HRQOL completion rate was acceptable (&gt;70%) across all time points and measures. There were no differences in HRQOL scores at any time point between cohorts. Clinically meaningful and time to improvement in HRQOL were similar in both arms. Despite higher treatment-emergent adverse effects with gilteritinib, response to the question of being “bothered by side effects of treatment” did not differ between groups. Subgroup analysis of MRD-positive and negative patients demonstrated no differences in HRQOL between arms. For patients with FLT3-ITD+ AML undergoing HCT, gilteritinib maintenance was not associated with any difference in HRQOL or patient-reported impact of side effects. This trial was registered at www.ClinicalTrials.gov as #NCT02997202.
Pharmacological and pre-clinical safety profile of rSIV.F/HN, a hybrid lentiviral vector for cystic fibrosis gene therapy
Authors: Moiseenko Alena , Sinadinos Anthony , Sergijenko Ana , Pineault Kyriel , Saleh Aarash , Nekola Konradin , Strang Nathalie , Eleftheraki Anastasia , Boyd A. Christopher , Davies Jane C. , Gill Deborah R. , Hyde Stephen C. , McLachlan Gerry , Rath Tim , Rothe Michael , Schambach Axel , Hobbie Silke , Schuler Michael , Maier Udo , Thomas Matthew J. , Mennerich Detlev , Schmidt Manfred , Griesenbach Uta , Alton Eric W.F.W. , Kreuz Sebastian 
Published: August 2024

Rationale and objectiveCystic fibrosis (CF) is caused by mutations in the CF transmembrane conductance regulator (CFTR) gene. CFTR modulators offer significant improvements, but ∼10% of patients remain nonresponsive or are intolerant. This study provides an analysis of rSIV.F/HN, a lentiviral vector optimised for lung delivery, including CFTR protein expression, functional correction of CFTR defects and genomic integration site analysis in preparation for a first-in-human clinical trial.MethodsAir–liquid interface cultures of primary human bronchial epithelial cells (HBECs) from CF patients (F508del/F508del), as well as a CFTR-deficient immortalised human lung epithelial cell line mimicking class I (CFTR-null) homozygous mutations, were used to assess transduction efficiency. Quantification methods included a novel proximity ligation assay for CFTR protein expression. For assessment of CFTR channel activity, Ussing chamber studies were conducted. The safety profile was assessed using integration site analysis andin vitroinsertional mutagenesis studies.ResultsrSIV.F/HN expressed CFTR and restored CFTR-mediated chloride currents to physiological levels in primary F508del/F508del HBECs as well as in a class I cells. In contrast, the latter could not be achieved by small-molecule CFTR modulators, underscoring the potential of gene therapy for this mutation class. Combination of rSIV.F/HN-CFTR with the potentiator ivacaftor showed a greater than additive effect. The genomic integration pattern showed no site predominance (frequency of occurrence ≤10%), and a low risk of insertional mutagenesis was observed in anin vitroimmortalisation assay.ConclusionsThe results underscore rSIV.F/HN as a promising gene therapy vector for CF, providing a mutation-agnostic treatment option.
High-frequency percussive ventilation in acute respiratory failure
Authors: Bruni Andrea , Neri Giuseppe , Cammarota Gianmaria , Bosco Vincenzo , Biamonte Eugenio , Troisi Letizia , Boscolo Annalisa , Navalesi Paolo , Longhini Federico , Garofalo Eugenio 
Published: August 2024

IntroductionHigh-frequency percussive ventilation (HFPV) is a ventilation mode characterised by high-frequency breaths. This study investigated the impact of HFPV on gas exchange and clinical outcomes in acute respiratory failure (ARF) patients during spontaneous breathing, noninvasive ventilation (NIV) and invasive mechanical ventilation (iMV).MethodsThis systematic review included randomised and nonrandomised studies up to August 2023. Inclusion criteria focused on adult ARF patients, HFPV application, comparisons with other ventilation modes, and outcomes related to oxygenation and clinical parameters. A pooled data analysis was performed comparing HFPV with iMV concerning gas exchange, pulmonary infection and mortality.ResultsOf the 51 identified records, 29 met the inclusion criteria. HFPV was safely and effectively applied to ARF patients during spontaneous breathing or NIV, improving oxygenation. For patients who underwent iMV, HFPV significantly enhanced oxygenation and the arterial partial pressure of carbon dioxide, reduced pulmonary infection occurrence and improved survival. Barotrauma rates were not elevated with HFPV, and haemodynamic stability remained unaffected. HFPV was also utilised in patients undergoing extracorporeal membrane oxygenation, resulting in improved lung recruitment and oxygenation.ConclusionHFPV had favourable effects on physiological and certain clinical outcomes in ARF patients. However, the overall evidence quality remains weak, necessitating large-scale randomised controlled trials for definitive conclusions.
DElaying disease Progression In COPD with early escalation to Triple therapy – A Modelling Study (DEPICT-2)
Authors: Singh Dave , Litewka Diego Fabian , Soriano Joan B , Rendon Adrian , Fernandes Frederico Leon Arrabal , Páramo-Arroyo Rafael , Trinidad Tim , Günen Hakan , Acharya Sudeep , Aggarwal Bhumika , Levy Gur , Compton Chris , El Hasnaoui Abdelkader , Daley-Yates Peter 
Published: August 2024

IntroductionIn patients with chronic obstructive pulmonary disease (COPD), dual bronchodilator (long-acting muscarinic antagonist (LAMA)/long-acting beta2-agonist (LABA)) and triple therapy (inhaled corticosteroid (ICS)/LAMA/LABA) reduce risk of exacerbations and lung function decline in short-mid-term, but their long-term impact is unknown. This modelling study explores long-term impact of these therapies on lung function decline, quality of life (QoL) and all-cause mortality.MethodsThis modelling approach used a longitudinal non-parametric superposition model using published data regarding exacerbations, QoL (assessed by St. George's Respiratory Questionnaire (SGRQ)), and mortality. The model simulated disease progression from 40 to 75 years of age and assessed the impact of initiating dual bronchodilator at age 45 years (“LAMA/LABA only” group) and escalation to triple therapy at age 50 years (“Escalation to triple” group) on forced expiratory volume in 1 s (FEV1) decline, QoL, and mortality.ResultsModel simulation predicted that by 75 years of age: “LAMA/LABA only” preserves 159.1 mL of FEV1versusno treatment, “Escalation to triple” preserves an additional 376.5 mL and 217.3 mL of FEV1versusno pharmacotherapy and “LAMA/LABA only”, respectively. In “LAMA/LABA only”, SGRQ score reduces (−3.2)versusno treatment, which further reduces to −7.5 therapy in “Escalation to triple”. In “LAMA/LABA only”, mortality reduces by 5.4% by 75 yearsversusno treatment, while the “Escalation to triple” shows further decrease in mortality by 12.0%.ConclusionEarly pharmacotherapy initiation and escalation from dual bronchodilator to triple therapy could slow disease progression by preserving lung function and improving QoL and survival in patients with COPD.
Role of pulmonary rehabilitation in extracellular matrix protein expression in vastus lateralis muscle in atrophic and nonatrophic patients with COPD
Authors: Kritikaki Efpraxia , Terzis Gerasimos , Soundararajan Meera , Vogiatzis Ioannis , Simoes Davina C.M. 
Published: August 2024

BackgroundIn response to exercise-based pulmonary rehabilitation (PR), the type of muscle fibre remodelling differs between COPD patients with peripheral muscle wasting (atrophic patients with COPD) and those without wasting (nonatrophic patients with COPD). Extracellular matrix (ECM) proteins are major constituents of the cell micro-environment steering cell behaviour and regeneration. We investigated whether the composition of ECM in atrophic compared to nonatrophic patients with COPD differs in response to PR.MethodsVastus lateralis muscle biopsies from 29 male COPD patients (mean±semforced expiratory volume in 1 s: 43±6% predicted) classified according to their fat-free mass index as atrophic (<17 kg·m−2, n=10) or nonatrophic (≥17 kg·m−2, n=19) were analysed before and after a 10-week PR programme for myofibre distribution and size, whereas a selection of ECM molecules was quantified using ELISA and real-time PCR.ResultsIn nonatrophic patients with COPD PR was associated with increased myofibre type I distribution (by 6.6±2.3%) and cross-sectional area (CSA) (by 16.4±4.8%), whereas in atrophic patients with COPD, PR induced increased myofibre type IIa distribution (by 9.6±2.8%) and CSA (by 12.1±3.2%). PR induced diverse intramuscular ECM adaptations in atrophic compared to nonatrophic patients with COPD. Accordingly, following PR there was a significant increase in protein levels of ECM biomarkers (collagen type I by 90 pg·mL−1; collagen type IV by 120 pg·mL−1; decorin by 70 pg·mL−1) only in nonatrophic patients with COPD. Conversely, post-PR, osteopontin, a protein known for its dystrophic effects, and tenacin C, a necroptosis compensatory factor facilitating muscle regeneration, were upregulated at protein levels (by 280 pg·mL−1and 40 pg·mL−1, respectively) in atrophic patients with COPD, whereas fibronectin protein levels were decreased.ConclusionsThese findings suggest that the differential PR-induced myofibre adaptations in atrophic compared to nonatrophic patients with COPD could be associated with inadequate remodelling of the intramuscular ECM environment.
Incremental high power radiofrequency ablation with multi-electrodes for small hepatocellular carcinoma: a prospective study
Authors: Hwang Sungjun , Kim Jae Hyun , Yu Su Jong , Lee Jeong Min 
Published: August 2024

Abstract
Radiofrequency ablation (RFA) offers a minimally invasive treatment for small hepatocellular carcinoma (HCC), but it faces challenges such as high local recurrence rates. This prospective study, conducted from January 2020 to July 2022, evaluated a novel approach using a three-channel, dual radiofrequency (RF) generator with separable clustered electrodes to improve RFA’s efficacy and safety. The study employed a high-power, gradual, stepwise RFA method on HCCs (≤ 4 cm), utilizing real-time ultrasound-computed tomography (CT)/magnetic resonance imaging (MRI) fusion imaging. Involving 110 participants with 116 HCCs, the study reported no major complications. Local tumor progression (LTP) and intrahepatic remote recurrence (IRR) rates were low, with promising cumulative incidences at 1, 2, and 3 years for LTP (0.9%, 3.6%, 7.0%) and IRR (13.9%, 20.5%, 31.4%). Recurrence-free survival (RFS) rates were similarly encouraging: LTP (99.1%, 96.4%, 93.0%) and IRR (86.1%, 79.5%, 68.6%). This innovative gradual, incremental high-power RFA technique, featuring a dual switching monopolar mode and three electrodes, represents an effective and safer management option for small HCCs.

Trial registration
clinicaltrial.gov identifier: NCT05397860, first registered on 26/05/2022.