bluuebunny/crossref_metadata_2025_split huggingface dataset:
Causal inference did not detect any effect of jump load on knee complaints in elite men's volleyball
Authors: Bache‐Mathiesen Lena Kristin , Bahr Roald , Sattler Tine , Fagerland Morten Wang , Whiteley Rod , Skazalski Christopher 
Published: April 2024

AbstractThe aim was to determine how jump load affects knee complaints in elite men's volleyball. We collected data from four men's premier league volleyball teams through three seasons in a prospective cohort study (65 players, 102 player‐seasons). Vert inertial measurement devices captured the jump load (jump frequency and jump height) from 21 088 daily player sessions, and knee complaints were reported in 3568 weekly OSTRC‐O questionnaires. Mixed complementary log–log regression models described the probability of (i) experiencing symptoms if players were currently asymptomatic, (ii) worsening symptoms if players had symptoms, and (iii) recovery from knee complaints. Based on our causal assumptions, weekly jump load was modeled as the independent variable, adjusted for age (years), weight (kg), position on volleyball team, and past jump load. No certain evidence of an association was found between weekly jump load and probability of (i) knee complaints (p from 0.10 to 0.32 for three restricted cubic splines of load), (ii) worsening symptoms if the player already had symptoms (p from 0.11 to 0.97), (iii) recovery (p from 0.36 to 0.63). The probability of knee complaints was highest for above‐average weekly jump load (~1.2% for an outside hitter with mean age and height) compared with low loads (~1%) and very high loads (→ ~ 0%). The association between jump load and knee complaints risk remains unclear. Small differences in risk across observed jump load levels were observed. It would likely require substantially increased sample sizes to detect this association with certainty.
The effect of a brief educational programme for improving attitudes about purified recycled water
Authors: Rouse Steven V. , Trammell Janet P. , Bucciarelli Gary M. , Roberts Dave , Kats Lee B. 
Published: April 2024

AbstractWith a growing need for efficient use of water in a large metropolitan community, a municipal water district has developed an experiential educational programme to help customers develop acceptance of purified recycled water (PRW). This programme involves touring a small‐scale working purification facility that does not provide consumer drinking water but serves as a demonstration centre. Two empirical studies demonstrated the positive impact of this educational program. In Study 1, a pre‐/post‐research design was used to examine scores on a measure of attitudes about PRW for 70 undergraduate students who were asked to tour the demonstration centre. These participants expressed more favourable attitudes after the tour than they expressed before the tour (t = 8.76, df = 68, p < 0.001, d = 1.06), suggesting that the demonstration centre positively impacted attitudes about PRW. In Study 2, an experimental design allowed for a comparison of attitudes about PRW for undergraduate students who were given an informational tour of the demonstration centre (n = 27), compared to students who did not tour the demonstration centre until after their data were collected (n = 30). Participants who toured the demonstration centre expressed more positive attitudes on a self‐report measure of PRW attitudes than those who had not completed the tour (t = 2.24, df = 50.0, p = 0.03, d = 0.60); however, the two groups did not differ in the amount of water they sampled (t = 0.29, df = 55.65, p = 0.77, d = 0.08) or in facial expressions associated with happiness (t = 1.34, df = 53.89, p = 0.19, d = 0.38) or disgust (t = 0.86, df = 53.14, p = 0.40, d = 0.39) when drinking a sample of water. Together, these studies demonstrate the effectiveness of an experiential demonstration centre in increasing positive attitudes towards purified recycled water.
Safety and tolerability of OP-724 in patients with haemophilia and liver cirrhosis due to HIV/HCV coinfection: an investigator-initiated, open-label, non-randomised, single-centre, phase I study
Authors: Kimura Kiminori , Tanuma Junko , Kimura Masamichi , Imamura Jun , Yanase Mikio , Ieiri Ichiro , Kurosaki Masayuki , Watanabe Tsunamasa , Endo Tomoyuki , Yotsuyanagi Hiroshi , Gatanaga Hiroyuki 
Published: April 2024

ObjectivePatients with haemophilia and HIV who acquire hepatitis C virus (HCV) after receiving contaminated blood products can experience accelerated progression of liver fibrosis and a poor prognosis, making liver disease a prominent cause of mortality among these patients. In the current study, we aimed to evaluate the safety and tolerability of the potential antifibrotic agent OP-724—a CREB-binding protein/β-catenin inhibitor—in this patient subset.DesignIn this single-centre, open-label, non-randomised, phase I trial, we sequentially enrolled patients with cirrhosis following HIV/HCV coinfection classified as Child-Pugh (CP) class A or B. Five patients received an intravenous infusion of OP-724 at doses of 140 or 280 mg/m2for 4 hours two times weekly over 12 weeks. The primary endpoint was the incidence of serious adverse events (SAEs). Secondary endpoints included the incidence of AEs and improved liver stiffness measure (LSM), as determined by vibration-controlled transient elastography. This study was registered at ClinicalTrials.gov (NCT04688034).ResultsBetween 9 February 2021 and 5 July 2022, five patients (median age: 51 years) were enrolled. All five patients completed 12 cycles of treatment. SAEs were not observed. The most common AEs were fever (60%) and gastrointestinal symptoms (diarrhoea: 20%, enterocolitis: 20%). Improvements in LSM and serum albumin levels were also observed.ConclusionIn this preliminary assessment, intravenous administration of 140 or 280 mg/m2/4 hours OP-724 over 12 weeks was well tolerated by patients with haemophilia combined with cirrhosis due to HIV/HCV coinfection. Hence, the antifibrotic effects of OP-724 warrant further assessment in patients with cirrhosis.Trial registration numberNCT04688034.
Interferon-gamma signature as prognostic and predictive marker in macroscopic stage III melanoma
Authors: Versluis Judith M , Blankenstein Stephanie A , Dimitriadis Petros , Wilmott James S , Elens Robert , Blokx Willeke A M , van Houdt Winan , Menzies Alexander Maxwell , Schrage Yvonne M , Wouters Michel W J M , Sanders Joyce , Broeks Annegien , Scolyer Richard A , Suijkerbuijk Karijn P M , Long Georgina V , Akkooi Alexander C J van , Blank Christian U 
Published: April 2024

BackgroundA substantial proportion of patients with macroscopic stage III melanoma do not benefit sufficiently from adjuvant anti-PD-1 therapy, as they either recur despite therapy or would never have recurred. To better inform adjuvant treatment selection, we have performed translational analyses to identify prognostic and predictive biomarkers.Patients and methodsTwo cohorts of patients with macroscopic stage III melanoma from an ongoing biobank study were included. Clinical data were compared between an observation cohort (cohort 1) and an adjuvant intention cohort (cohort 2). RNA sequencing for translational analyses was performed and treatment subgroups (cohort 1A and cohort 2A) were compared for possible biomarkers, using a cut-off based on the treatment-naïve patients. In addition, two validation cohorts (Melanoma Institute Australia (MIA) and University Medical Centre Utrecht (UMCU)) were obtained.ResultsAfter a median follow-up of 26 months of the 98 patients in our discovery set, median recurrence-free survival (RFS) was significantly longer for the adjuvant intention cohort (cohort 2, n=49) versus the observation cohort (cohort 1, n=49). Median overall survival was not reached for either cohort, nor significantly different. In observation cohort 1A (n=24), RFS was significantly longer for patients with high interferon-gamma (IFNγ) score (p=0.002); for adjuvant patients of cohort 2A (n=24), a similar trend was observed (p=0.086). Patients with high B cell score had a longer RFS in cohort 1A, but no difference was seen in cohort 2A. The B cell score based on RNA correlated with CD20+cells in tumor area but was not independent from the IFNγ score. In the MIA validation cohort (n=44), longer RFS was observed for patients with high IFNγ score compared with low IFNγ score (p=0.046), no difference in RFS was observed according to the B cell score. In both the observation (n=11) and the adjuvant (n=11) UMCU validation cohorts, no difference in RFS was seen for IFNγ and B cell.ConclusionsIFNγ has shown to be a prognostic marker in both patients who were and were not treated with adjuvant therapy. B cell score was prognostic but did not improve accuracy over IFNγ. Our study confirmed RFS benefit of adjuvant anti-PD-1 for patients with macroscopic stage III melanoma.
TNIK Inhibition Sensitizes TNIK-Overexpressing Lung Squamous Cell Carcinoma to Radiotherapy
Authors: Nguyen Triet , Carrieri Francesca A. , Connis Nick , Lafargue Audrey , Chang Jinhee , Chan Aaron , Shetty Amol C. , Song Yang , Hoang Tung , Jagtap Shreya , Chowdhury Dipanwita D. , Khan Muhammad A. , Gabrielson Kathleen L. , Rezaee Mohammad , Torres-Ayuso Pedro , Brognard John , Hann Christine L. , Tran Phuoc T. 
Published: April 2024

Abstract
Most patients with lung squamous cell carcinoma (LSCC) undergo chemotherapy, radiotherapy, and adjuvant immunotherapy for locally advanced disease. The efficacy of these treatments is still limited because of dose-limiting toxicity or locoregional recurrence. New combination approaches and targets such as actionable oncogenic drivers are needed to advance treatment options for patients with LSCC. Moreover, other options for chemotherapy-ineligible patients are limited. As such, there is a critical need for the development of selective and potent chemoradiosensitizers for locally advanced LSCC. In this study, we investigated inhibiting TRAF2- and NCK-interacting protein kinase (TNIK), which is amplified in 40% of patients with LSCC, as a strategy to sensitize LSCC tumors to chemotherapy and radiotherapy. Employing a range of human LSCC cell lines and the TNIK inhibitor NCB-0846, we investigated the potential of TNIK as a chemo- and radiosensitizing target with in vitro and in vivo preclinical models. The combination of NCB-0846 with cisplatin or etoposide was at best additive. Interestingly, pre-treating LSCC cells with NCB-0846 prior to ionizing radiation (IR) potentiated the cytotoxicity of IR in a TNIK-specific fashion. Characterization of the radiosensitization mechanism suggested that TNIK inhibition may impair the DNA damage response and promote mitotic catastrophe in irradiated cells. In a subcutaneous xenograft in vivo model, pretreatment with NCB-0846 significantly enhanced the efficacy of IR and caused elevated necrosis in TNIKhigh LK2 tumors but not TNIKlow KNS62 tumors. Overall, these results indicate that TNIK inhibition may be a promising strategy to increase the efficacy of radiotherapy in patients with LSCC with high TNIK expression.
Blunt Abdominal Trauma in Pregnancy: Higher Rates of Severe Abdominal Injuries
Authors: Skochko Shannon , Nahmias Jeffry , Lekawa Michael , Kong Allen , Schubl Sebastian , Swentek Lourdes , Grigorian Areg 
Published: April 2024

Background Previous studies suggest increased abdominal girth in obese individuals provides a “cushion effect,” against severe abdominal trauma. In comparison, the unique anatomic/physiological condition of pregnancy, such as the upward displacement of organs by an expanding uterus, may decrease risk of abdominal injury. However, increased overall blood volume and vascularity of organs during pregnancy raise concerns for increased bleeding and potentially more severe injuries. Therefore, this study aimed to elucidate whether the “cushion effect” observed in obese patients extends to pregnant trauma patients (PTPs). We hypothesized a lower risk of blunt solid organ injury (BSOI) (liver, spleen, and kidney) in pregnant vs non-pregnant blunt trauma patients. Methods The 2020-2021 Trauma Quality Improvement Program was queried for all female blunt trauma patients (age<50 years) involved in motor vehicle collisions (MVCs). We compared pregnant vs non-pregnant patients. The primary outcomes were incidence of BSOI, and severity of abdominal trauma defined by abbreviated injury scale (AIS). Results From 94,831 female patients, 2598 (2.7%) were pregnant. When compared to non-pregnant patients, PTPs had lower rates of liver (5.5% vs 7.6%, P < .001) and kidney (1.8% vs 2.6%, P = .013) injury. However, PTPs had higher rates of serious (13.4% vs 9.0%, P < .001) and severe abdominal injury (7.5% vs 4.3%, P < .001). Discussion BSOI occurred at a lower rate in PTPs compared to non-PTPs; however, contrary to the “cushion effect” observed in obese populations, pregnant women had a higher rate of severe abdominal injuries. These data support comprehensive evaluations for PTPs presenting after a MVC. Level of Evidence IV (therapeutic).
Neoadjuvant Chemotherapy and Radiation Improves Recurrence-free and Overall Survival in Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma
Authors: Kelley Jesse K. , Kolbeinsson Hordur , Chandana Sreenivasa , Eastburg Benjamin , Frisch Austin , Parker Jessica , Wright G. Paul , Assifi M. Mura , Chung Mathew 
Published: April 2024

Objective The objective of this study is to analyze the outcomes of patients with resectable/borderline resectable PDAC who receive total neoadjuvant therapy vs upfront surgery. Methods and Analysis Patients who were treated at a single institution from 2006 to 2021 were included. The primary outcome was overall survival (OS). Secondary outcomes included disease free survival (DFS), rates of lymph node positivity, and R0 resection. All survival analyses were performed with intention-to-treat. Results 26 patients received neoadjuvant chemotherapy and radiation (TNT), 28 received neoadjuvant chemotherapy only (NAC), and 168 received upfront surgery. Demographics were comparable across all three groups. Patients who received TNT or NAC had longer OS and DFS compared to the surgery first patients ( P < .01). Patients who received TNT had a lymph node positivity rate of 0% at time of surgery compared to 5.3% and 13.3% in the NAC and surgery-first groups, respectively ( P < .01). The rate of R0 resection did not differ between groups ( P = .17). Conclusion Patients with resectable/borderline resectable PDAC who receive neoadjuvant therapy have longer OS and RFS relative to those who receive upfront surgery.
Evaluating Clinical Reasoning in Undergraduate Medical Education: The Value of a Virtual Oral Assessment
Authors: Jeffery Michelle , Kar A. Reema , Pradhan Archana , Brannigan Samantha , Terregino Carol , Rashid Hanin , Salisbury Rick , Johnson Conrad , Jagpal Sugeet 
Published: April 2024

Background Oral assessments are essential components of board certification in numerous fields, as they provide insight into problem-solving capacity and clinical reasoning. The development of clinical reasoning often begins in undergraduate medical education and remains a challenge to assess. Objective We developed a pilot oral assessment to evaluate medical student oral presentations and systematically assess clinical reasoning. This was incorporated into a previously existing cumulative assessment at the conclusion of the third year of medical school, with the intent to demonstrate feasibility and future reliability of this exam format. Methods This pilot oral assessment was developed using content taught during third year clerkships. A modified Assessment of Reasoning Tool (ART) was used as the evaluation metric. It was conducted virtually to include faculty members from multiple disciplines and accommodate schedules and space limitations. Results A total of 152 third year medical students completed the exam, with a total of 15 faculty examiners. 89% of medical students scored as complete in hypothesis directed history, 93% in problem representation, 86% in prioritized differential diagnoses, and 67% in effectively directing management. Most examiners felt an oral assessment is effective to determine a medical student’s clinical reasoning ability. Conclusions Virtual oral assessments of clinical reasoning can be incorporated in undergraduate medical education to identify students struggling with components of clinical reasoning, while also allowing maximum flexibility for the clinician educator workforce as examiners. Longitudinal use of these exams would be valuable to track the development of clinical reasoning across the medical school curriculum.
Educating nursing home residents about stroke using the FAST Heroes programme
Authors: Orologa Emilia , Tsakpounidou Kalliopi , van der Merwe Jan , Pyrrou Myrto , Proios Hariklia 
Published: April 2024

Objective: Using the FAST (Face, Arms, Speech, Time) Heroes educational programme, this intervention sought to educate residents in a nursing home to recognise and recall the three main stroke symptoms and prepare them to act in an appropriate way, in the event of a stroke emergency. Design: Participatory action research. Setting: A nursing home in Northern Greece. Method: Fifteen residents ( n = 15, aged 78–92, mean age = 86.6 ± 4.4) were enrolled and educated through a series of FAST Heroes activities, specially tailored for this new target population. Stroke awareness was measured before, after and 3 weeks post-programme implementation. Fourteen residents completed the programme. Results: Participants demonstrated significant increases in stroke definition, stroke symptom knowledge, appropriate course of action and emergency number knowledge after completing the programme. Notably, 64.3% of participants could accurately identify stroke symptoms, and all participants (100%) correctly knew to call an ambulance in case of witnessing a stroke; 78.6% of the participants correctly identified the European emergency number 112. In the follow-up period, knowledge gain was retained as residents scored significantly higher in three out of four sections of the questionnaire. Conclusion: This study is the first attempt to utilise the FAST Heroes educational intervention in target populations which hitherto have had limited or no access to such educational programmes. This initial intervention showed promising results and could form the basis for extension to a wider population.
Three-year follow-up analysis of automated microfoam preparation system for great saphenous vein incompetence and varicose veins sclerotherapy treatment
Authors: Alongi Giovanni , Bissacco Daniele , Cervi Edoardo 
Published: April 2024

Background To describe the treatment of patients with great saphenous vein (GSV) incompetence and varicose veins (VVs), utilizing an Automated Microfoam Preparation System (AMPS, Varixio®, VB Devices, Barcelona, Spain). Methods Adults between January and June 2021 were included. The AMPS system was used for foam preparation. Sclerotherapy treatment followed international recommendations. The primary endpoint was GSV closure rate after 36 months. Results 164 patients were enrolled. During the 7-day follow-up period, all GSVs showed complete closure, which was maintained at the 1-year mark. No major complications were reported. A cumulative complete GSV recanalization rate of 6.1% and a partial recanalization rate of 26.8% after 36 months were noted. Some patients (9.7%) required additional treatment. A higher BMI was associated with complete recanalization. Conclusion The AMPS offers an easy-to-use and standardized procedure, potentially enhancing treatment outcomes if compared with manual preparation. Caution is advised when treating obese patients.
CLOCK gene circannual expression in cluster headache
Authors: Oliveira Renato , Neves-Costa Ana , Pedroso Dora , Paixão Tiago , Barros André B. , Moita Luís F. , Gil-Gouveia Raquel 
Published: April 2024

Background Cluster headache is a primary headache disorder characterized by bouts with circadian and circannual patterns. The CLOCK gene has a central role in regulating circadian rhythms. Here, we investigate the circannual CLOCK expression in a population of cluster headache patients in comparison to matched controls. Methods Patients with cluster headache were sampled two to four times over at least one year, both in or outside bouts, one week after each solstice and equinox. The expression of CLOCK was measured by quantitative real-time polymerase chain reaction (RT-PCR) in the peripheral blood. Results This study included 50 patients and 58 matched controls. Among the patient population, composed of 42/50 males (84%) with an average age of 44.6 years, 45/50 (90%) suffered from episodic cluster headache. Two to four samples were collected from each patient adding up to 161 samples, 36 (22.3%) of which were collected within a bout. CLOCK expression for cluster headache patients was considerably different from that of the control population in winter (p-value mean = 0.006283), spring (p-value mean = 0.000006) and summer (p-value mean = 0.000064), but not in autumn (p-value mean = 0.262272). For each season transition, the variations in CLOCK expression were more pronounced in the control group than in the cluster headache population. No statistically significant differences were found between bout and non-bout samples. No individual factors (age, sex, circadian chronotype, smoking and coffee habits or history of migraine) were related to CLOCK expression. Conclusions We observed that CLOCK expression in cluster headache patients fluctuates less throughout the year than in the control population. Bout activity and lifestyle factors do not seem to influence CLOCK expression.
Posterior Positioning of Levator Veli Palatini with Intact Nasal Layer and Side-by-Side Bilateral Buccinator Flaps: Modified Approach for Palatal Lengthening
Authors: Hoghoughi Mohammad Ali , Kamran Hooman , Shahriarirad Reza , Salimi Maryam , Hosseinpour Hamidreza 
Published: April 2024

Objective To introduce a modified surgical method using bilateral buccinator flaps with posterior positioning of levator veli palatini muscles to treat velopharyngeal insufficiency. Design Cross-sectional clinical study Patients Non-syndromic patients with velopharyngeal insufficiency Intervention We performed a modified surgical method using posterior positioning of levator veli palatini muscles and side-by-side bilateral buccinator flaps. Main outcome measures Patients’ characteristics, severity of hypernasality, palatal lengthening size, and operative complications were recorded and described. The severity of hypernasality was determined by a speech therapist before and after the operation. Results A total of 26 non-syndromic patients, with a median age of 8.5 years, were enrolled. All patients presented with severe hypernasality. Following the operation and during the follow-up period, 12 patients showed a complete resolution of hypernasality, while 9, 3, and 2 patients exhibited mild, moderate, and severe hypernasality, respectively. In addition, the mean palatal lengthening was measured to be 25.3 ± 3.5 mm. Overall, three patients experienced partial flap loss in one flap, which was successfully repaired with a secondary intention without the development of a fistula. In five cases, complete closure of the donor sites couldn’t be achieved and thus were treated with secondary intention. Additionally, postoperative food restrictions were observed in seven cases but were resolved within one month. No other complications were noted in the remaining patients. Conclusion This modified palatal lengthening technique results in a significant lengthening of the palate while maintaining favorable speech outcomes. Future randomized clinical trials are warranted to validate our findings.