bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Minimal Important Difference for Patient-Reported Outcome Measures in Plastic Surgery: A Systematic Review
Authors: Zhou Ted , Zeng Aisling , Levit Tal , Gallo Lucas , Kim Patrick , Chen Andrew , Cohen Dalya , Dunn Emily , Thoma Achilles 
Published: August 2024

Background:
The minimal important difference (MID) is vital to consider when interpreting the clinical importance of observed changes from surgical interventions assessed by patient-reported outcome measures (PROMs). There is no accepted standard for how to calculate MIDs, and uptake in the plastic surgery literature is unknown, leading to methodologic and interpretation issues.

Methods:
Medline and Embase were searched to identify all plastic surgery randomized controlled trials (RCTs) using PROMs as outcomes and MID estimation studies for PROMs used by RCTs. Included studies were assessed for uptake and application of MIDs, and MID estimation methodology and values were categorized.

Results:
A total of 554 RCTs using PROMs as outcomes were identified. Of these, 419 RCTs had the possibility of incorporating a previously published MID. The uptake rate of MIDs was 11.5% (n = 48 of 419). The most common ways MIDs were applied were to calculate sample size (37.5%) or to determine whether results were clinically important (35.4%). A total of 99 studies estimating MID values for the most common PROMs in plastic surgery, based on our review, were analyzed. The most common estimation methodologies were receiver operating characteristic curve analysis (49%), change difference (31%), and SD (25%).

Conclusions:
This review highlights limited uptake and application of MIDs in plastic surgery. The authors propose 4 major barriers: (1) no repository of published MIDs for PROMs used in plastic surgery exists; (2) available MIDs are not specific to plastic surgery populations; (3) high heterogeneity in MID estimation methodology was present; and (4) there are wide ranges in MID values, with no superior choice identified.
177Lu-PSMA With Olaparib Radiosensitization Potentiates Response and Toxicity in Extensive Castration-Resistant Metastatic Prostate cancer
Authors: Kao Yung Hsiang , Falzone Nadia , Pearson Michael , Pook David , Sivaratnam Dinesh 
Published: August 2024

Abstract
A patient with widespread intensely prostate-specific membrane antigen–expressing, BRCA gene mutation–positive bone metastases at the time of prostate cancer diagnosis had progressed on multiple lines of standard therapy. He received 177Lu–prostate-specific membrane antigen 8.5 GBq augmented by a short course of olaparib radiosensitization and achieved 90% decrease in serum PSA level after a single treatment. His tumor response was much better than expected by predictive dosimetry. However, his marrow radiotoxicity was worse than anticipated and required hospitalization. This suggests radiosensitizing agents to be a double-edged sword that must be carefully considered and balanced during activity prescription.
Medical Students Cannot Assess Robotic Surgeons Performing Radical Prostatectomy
Authors: Olsen Rikke Groth , Konge Lars , Hayatzaki Khalilullah , Mortensen Mike Allan , Røder Andreas , Bjerrum Flemming 
Published: August 2024

Introduction
Medical students have previously been shown to be just as effective for video rating as experts. We want to compare medical students to experienced surgeons as video assessors of simulated robot-assisted radical prostatectomy (RARP) performance.

Materials and Methods
Video recordings of three RARP modules on the RobotiX (formerly Simbionix) simulator from a previous study were used. Five novice surgeons, five experienced robotic surgeons, and five experienced robotic surgeons in RARP performed a total of 45 video-recorded procedures. The videos were assessed with the modified Global Evaluative Assessment of Robotic Skills tool as both full-length and an edited edition that only included the first 5 minutes of the procedure.

Results
Fifty medical students and two experienced RARP surgeons (ES) performed a total of 680 video ratings of full-length videos and 5-minute videos (2–9 ratings per video). Medical students and ES showed poor agreement for both full-length videos and 5-minute videos (0.29 and −0.13, respectively). Medical students could not discriminate between the skill level of the surgeons in either full-length videos or 5-minute videos (P = 0.053–0.36 and P = 0.21–0.82), whereas ES could discriminate between novice surgeons and experienced surgeons (full-length, P < 0.001, and 5 minutes, P = 0.007) and intermediate and experienced surgeons (full-length, P = 0.001, and 5 minutes, P = 0.01) in both full-length videos and 5-minute videos.

Conclusion
We found that medical students cannot be used to assess RARP because they showed poor agreement with the ES rating for both full-length videos and 5-minute videos. Medical students could not discriminate between surgical skill levels.
Diagnosis and management of blunt cerebrovascular injuries: What you need to know
Authors: Biffl Walter L. , Moore Ernest E. , Kansagra Akash P. , Flores Bruno C.C.R. , Weiss Jeffrey S. 
Published: August 2024

ABSTRACT
Blunt cerebrovascular injuries are not as rare as they were once thought to be—but they still have the same potential for disastrous outcomes. They may occur following any trauma, but more common with higher energy transfer mechanisms. If stroke occurs, prompt recognition and treatment offers the best chance for optimal outcome. Early diagnosis and provision of antithrombotic therapy may prevent strokes, so screening of asymptomatic patients is recommended. Herein we will present what you need to know to diagnose and manage blunt cerebrovascular injury.
How to Set up and Run a Bad Bugs Bookclub group
Authors: Verran Joanna 
Published: August 2024

The Bad Bugs Bookclub is a public engagement initiative that enables scientists (microbiologists) and non-scientists to discuss the role of infectious disease and microorganisms in novels of fiction. The bookclub began in 2009 but since 2020 the meetings have taken place online, enabling international membership and occasional author participation. The bookclub has been shown through peer-reviewed publications to have impact and value to its members. For each book (the number now exceeds 100) a reading guide (questions to provoke discussion) and a meeting report (narrative of the discussion) have been produced. Previously hosted on a website, the reading guides from this rich archive and resource are now presented alongside this paper which provides tips on how to run a similar reading group.
Antimicrobial resistance patterns of isolates from bloodstream infections at Jinja Regional Referral Hospital: A cross-sectional study
Authors: Lwigale Fahad 
Published: August 2024

Background
Bloodstream infections are common acute syndromes of variable origin with high chances for extreme health effects including death. This underscores the essence for their quick management to expedite better outcomes. In this study settings, therapy is predominantly empirical using majorly cefriaxone and/or metronindazole. Agents for empirical therapy are liable to antimicrobial resistance and their choice ought to be routinely guided by microbiology laboratory data. This study determined the most frequent aetiologic agents responsible for bloodstream infections, their antimicrobial susceptibility patterns, and infection sources in Eastern-central Uganda.
Patients and methods:
The analysis involved all non-duplicate blood culture reports from 2019 to 2021 using World Health Organization Network (WHONET) 2022 desktop software and Microsoft Excel.
Results:
The 1364 reports showed a diagnostic yield of 114(6.8%) and a 1.5% contamination rate. Over 37% and 13% of infections were hospital-acquired and community-acquired respectively. Most etiologic agents were Gram-positive bacteria dominated by Staphylococcus aureus 39(34.2%). Polymicrobial growth existed in 4(0.3%) cases. S. aureus was mainly resistant to penicillin G(100%) but most susceptible to gentamicin(%S=74.1, 95%C.I:53.4-88.1). Escherichia coli and unspecified Coliforms together showed high resistance to ampicillin(87.5%) and third-generation cephalosporins(100%). The least resistance was to chloramphenicol and carbapenems.
Conclusion:
As the most frequent explanatory for septicaemia, S. aureus suspected cases in this region could have higher success with gentamicin involved in the empirical therapy combination for their management. The heightened resistance against ceftriaxone requires its limited use. Microbiology services should be routinely utilized to guide targeted antimicrobial use, monitor blood culture contamination rates and resistance trends to strengthen regional antimicrobial stewardship.
Discovering methylation markers and development of a sense-antisense and dual-MGB probe PCR assay in plasma for colorectal cancer early detection
Authors: Zhao Yanteng , Wang Zhijie , Yu Qiuning , Liu Xin , Liu Xue , Dong Shuling , Lv Xianping , Zhang Tiao , Zhou Dihan , Yang Qiankun 
Published: August 2024

AbstractScreening for colorectal cancer (CRC) using plasma methylation is challenging due to the low abundance of cell-free DNA (cfDNA). Therefore, the development of signal amplification assays based on appropriate markers is essential to increase sensitivity. In this study, we employed an epigenome-wide approach for de novo identification differentially methylated CpGs (DMCs) common to CRC and adenoma using 17 public datasets. A sense-antisense and dual MGB probe (SADMP) assay was then developed. Subsequently, the biomarkers were validated in 712 plasma samples based on SADMP. A total of 2237 DMCs showed overlap between CRC and adenoma. Of these, 75 were hypomethylated in 30 other non-CRC cancers. Following LASSO regression, WBC validation and primer/probe design evaluation,NTMT1andMAP3K14-AS1were identified as the most informative candidate biomarkers. At preset template concentrations, the SADMP assay forNTMT1orMAP3K14-AS1could reduce the cycle threshold by 1. TheNTMT1andMAP3K14-AS1dual-target SADMP assay demonstrated a sensitivity of 84.8% for CRC (stage I: 75.0%), a sensitivity of 32.0% for advanced adenomas (AA), and a specificity of 91.5% in controls. The dual-target assay showed high performance for CRC early detection in plasma, suggesting that it may serve as a promising noninvasive tool for CRC screening.
Investigating the Role of Neighborhood Socioeconomic Status and Germline Genetics on Prostate Cancer Risk
Authors: Judd Jonathan , Spence Jeffrey P. , Pritchard Jonathan K. , Kachuri Linda , Witte John S. 
Published: August 2024

ABSTRACTBackgroundGenetic factors play an important role in prostate cancer (PCa) development with polygenic risk scores (PRS) predicting disease risk across genetic ancestries. However, there are few convincing modifiable factors for PCa and little is known about their potential interaction with genetic risk. We analyzed incident PCa cases (n=6,155) and controls (n=98,257) of European and African ancestry from the UK Biobank (UKB) cohort to evaluate the role of neighborhood socioeconomic status (nSES)–and how it may interact with PRS–on PCa risk.MethodsWe evaluated a multi-ancestry PCa PRS containing 269 genetic variants to understand the association of germline genetics with PCa in UKB. Using the English Indices of Deprivation, a set of validated metrics that quantify lack of resources within geographical areas, we performed logistic regression to investigate the main effects and interactions between nSES deprivation, PCa PRS, and PCa.ResultsThe PCa PRS was strongly associated with PCa (OR=2.04; 95%CI=2.00-2.09; P<0.001). Additionally, nSES deprivation indices were inversely associated with PCa: employment (OR=0.91; 95%CI=0.86-0.96; P<0.001), education (OR=0.94; 95%CI=0.83-0.98; P<0.001), health (OR=0.91; 95%CI=0.86-0.96; P<0.001), and income (OR=0.91; 95%CI=0.86-0.96; P<0.001). The PRS effects showed little heterogeneity across nSES deprivation indices, except for the Townsend Index (P=0.03).ConclusionsWe reaffirmed genetics as a risk factor for PCa and identified nSES deprivation domains that influence PCa detection and are potentially correlated with environmental exposures that are a risk factor for PCa. These findings also suggest that nSES and genetic risk factors for PCa act independently.
Requirements for the delivery of an Australian Rapid Access Chest Pain Clinic
Authors: Wilson Annika , Sutton Laura , Nash Rose , Black J. Andrew , Jayasinghe Senali , Sharman James E. , Chapman Niamh 
Published: August 2024

AbstractBackgroundRapid Access Chest Pain Clinics (RACPCs) are outpatient cardiac services designed to promptly assess and manage patients experiencing chest pain. Despite the establishment of 25 RACPCs across Australia, a standardised implementation framework has yet to be developed. This study aimed to identify the core components of successful delivery of an existing RACPC.MethodsA qualitative process evaluation study was conducted at a RACPC in a metropolitan, tertiary hospital in Tasmania, Australia, from November 2022 to July 2023. Clinical observations and semi-structured interviews were conducted with seven RACPC clinicians. Deductive data analysis was undertaken according to a Context-Mechanism-Outcome framework.ResultsCore components of successful RACPC delivery included: (1) a multidisciplinary team-based approach to care with discreet clinical roles; (2) timely patient review by RACPC clinicians within 30 days of referral; (3) embedded patient education; (4) ongoing clinical team training and education; and (5) a shared understanding of the RACPC service’s identity and purpose. Challenges to RACPC delivery were also identified and included resource constraints and administrative burdens.ConclusionsSuccessful delivery of a RACPC model of care relies on a range of interrelated factors. These findings align with the broader theme of ongoing health service evaluation as a driver for continuous quality improvement and care standards within RACPCs. Further research aimed at developing and implementing effective strategies to enhance service delivery is needed to determine a national model of care.
Interrupted Time Series Design and Analyses in Health Policy Assessment
Authors: Jiang Huan , Rehm Jürgen , Tran Alexander , Lange Shannon 
Published: August 2024

AbstractInterrupted time series design is a quasi-experimental study design commonly used to evaluate the impact of a particular intervention (e.g., a health policy implementation) on a specific outcome. Two of the most often recommended analytical approaches to interrupted time series analysis are autoregressive integrated moving average (ARIMA) and Generalized Additive Models (GAM). We conducted simulation tests to determine the performance differences between ARIMA and GAM methodology across different policy effect sizes, with or without seasonality, and with or without misspecification of policy variables. We found that ARIMA exhibited more consistent results under certain conditions, such as with different policy effect sizes, with or without seasonality, while GAM were more robust when the model was misspecified. Given these findings, the variation between the models underscores the need for careful model selection and validation in health policy studies.
Prevalence of Low Visual Acuity in children from public schools in Northeast of Brazil
Authors: Oliveira Lucas Neves de , Costa Matheus Gomes Reis , Pereira Isadora Oliveira Santiago , Tokumoto Isabela Carolina , Moreira Joao Lucas de Magalhaes Leal , Freitas Matheus Carneiro Leal , Sampaio Clarissa Silva , Oliveira Mateus Neves de , Bessa Junior Jose de , Oliveira Neto Hermelino Lopes de 
Published: August 2024

ABSTRACTOBJECTIVETo describe the prevalence of Low Visual Acuity (LVA) in public school students in Feira de Santana (FSA), Bahia (BA).METHODSThis was an observational, cross-sectional, exploratory study. The sample consisted of schoolchildren from the 2nd to the 4th grade of five public schools in FSA/BA. Data collection was carried out in the schools themselves, with a sociodemographic and clinical questionnaire applied and Visual Acuity (VA) measured using the Snellen “E” optotype chart. LVA was defined as uncorrected VA < 20/25 in at least one eye.RESULTSThe sample consisted of 358 children, with a median age of 9 [8-10] years, of which 189 (52.9%) were female. 248 (69.3%) individuals had never been to an ophthalmologist. LVA was found in 105 (29.3%) schoolchildren, and of these, 7.6% (8/105) current used glasses. Factors associated with LVA were female gender and white ethnicity. LVA was evidenced in 60 (31.7%) schoolchildren with excessive screen use and in 35 (25.5%) without excessive use (OR 1.35; 95% CI 0.83 - 2.19, p = 0.222), and excessive screen use was associated with visual signs/symptoms such as tearing and eye itching.CONCLUSIONLVA was observed in approximately 30% of children in public schools in the interior of Bahia, and less than 10% of these current used glasses. Our study reinforces the importance of visual screening of schoolchildren through active search in our region and the creation of strategies to facilitate access to ophthalmological consultations and glasses.
Exploring the role of nicotine and smoking in sleep behaviours: A multivariable Mendelian Randomisation study
Authors: Page Stephanie , Gibson Mark , Munafò Marcus R. , Khouja Jasmine , Richmond Rebecca C. 
Published: August 2024

AbstractResearch has shown bidirectional relationships between smoking and adverse sleep behaviours, including late chronotype and insomnia, but the underlying mechanisms are not understood. One potential driver is nicotine, but its role in sleep is unclear. For this study, we estimated the direct effect of nicotine on six sleep behaviours measured in UK Biobank (chronotype, ease of getting up in the morning, insomnia symptoms, napping, daytime sleepiness and sleep duration). We conducted a Mendelian randomisation (MR) study to explore whether nicotine metabolism has a causal effect on these sleep behaviours. We explored whether the effects could be explained by regular nicotine exposure using genetic proxies of the nicotine metabolite ratio (NMR) and cigarettes per day (CPD) in a multivariable MR design. We found a higher NMR (indicating lower levels of circulating nicotine per cigarette smoked) decreased the likelihood of being an evening person when accounting for CPD in current (β = −0.04, 95%CI −0.06 to −0.02, p < 0.001) and ever smokers (β = −0.03 95%CI −0.04 to −0.01, p = 0.003). A higher NMR also increased the ease of getting up (β = 0.02, 95%CI 0.01 to 0.04, p = 0.015) and likelihood of napping (β = 0.02, 95%CI CI 0.002 to 0.03, p = 0.029) in current smokers. Increased nicotine exposure may directly affect sleep and could underlie relationships between smoking and sleep behaviours identified previously. Sleep could also be impacted in individuals using nicotine delivery systems or using nicotine replacement therapies. Further research is warranted to strengthen this conclusion.
Glucagon-Like Peptide 1 Receptor Agonist Use in Hospital: A Multicentre Observational Study
Authors: Ray Prachi , Moggridge Jason A. , Weisman Alanna , Tadrous Mina , Drucker Daniel J. , Perkins Bruce A. , Fralick Michael 
Published: August 2024

AbstractIntroductionGlucagon-like peptide 1 receptor agonists (GLP-1RA) are effective medications for type 2 diabetes mellitus (T2DM) and obesity, yet their uptake among patients most likely to benefit has been slow.MethodsWe conducted a cross-sectional analysis of medication exposure in adults hospitalized at 16 hospitals in Ontario, Canada between 2015 and 2022. We estimated the proportion with T2DM, obesity, and cardiovascular disease. We identified the frequency of GLP-1RA use, and conducted multivariable logistic regression to identify factors associated with their use.ResultsAcross 1,278,863 hospitalizations, 396,084 (31%) patients had T2DM and approximately 327,844 (26%) had obesity. GLP-1RA use (n=1,274) was low among those with T2DM (0.3%) and those with obesity (0.7%), despite high prevalence of cardiovascular disease (36%). In contrast, use of diabetes medications lacking cardiovascular benefits was high, with 60% (n=236,612) receiving insulin and 14% (n=54,885) receiving sulfonylureas. Apart from T2DM (OR=29.6, 95% CI 23.5, 37.2), characteristics associated with greater odds of receiving GLP-1RA were age 50-70 years (OR=1.71, 95% CI 1.38, 2.11) compared to age < 50 years, hemoglobin A1C > 9% (OR=1.83, 95% CI 1.36, 2.47) compared to < 6.5%, and highest income quintile (OR=1.73, 95% CI 1.45, 2.07) compared to lowest income quintile.ConclusionKnowledge translation interventions are needed to address the low adoption of GLP-1RA among hospitalized patients with T2DM and obesity, who are the most likely to benefit.
The gut microbiota-immune-brain axis in a wild vertebrate: dynamic interactions and health impacts
Authors: Pereira Hugo , Hoffamn Joseph I. , Krüger Oliver , Czirják Gábor Á. , Rinaud Tony , Ottensmann Meinolf , Gladow Kai-Philipp , Caspers Barbara A. , Maraci Öncü , Kaiser Sylvia , Chakarov Nayden 
Published: August 2024

ABSTRACTThe gut microbiota-immune-brain axis is a feedback network which influences diverse physiological processes and plays a pivotal role in overall health and well-being. Although research in humans and laboratory mice has shed light into the associations and mechanisms governing this communication network, evidence of such interactions in wild, especially in young animals, is lacking. We therefore investigated these interactions during early development in a population of common buzzards (Buteo buteo) and their effects on individual condition. In a longitudinal study, we used a multi-marker approach to establish potential links between the bacterial and eukaryotic gut microbiota, a panel of immune assays and feather corticosterone measurements as a proxy for long-term stress. Using Bayesian structural equation modelling, we found no support for feedback between gut microbial diversity and immune or stress parameters. However, we did find strong relationships in the feedback network. Immunity was negatively correlated with corticosterone levels, and microbial diversity was positively associated with nestling body condition. Furthermore, corticosterone levels and eukaryotic microbiota diversity decreased with age while immune activity increased. The absence of conclusive support for the microbiota-immune-brain axis in common buzzard nestlings, coupled with the evidence for stress mediated immunosuppression, suggests a dominating role of stress-dominated maturation of the immune system during early development. Confounding factors inherent to wild systems and developing animals might override associations known from adult laboratory model subjects. The positive association between microbial diversity and body condition indicates the potential health benefits of possessing a diverse and stable microbiota.