bluuebunny/crossref_metadata_2025_split huggingface dataset:
Socioeconomic Influence on Physical Therapist Student Financial Literacy, Self-Efficacy, Stress, and Anxiety
Authors: Mulligan Edward P. , Pabian Patrick S. , Dickson Tara 
Published: May 2024

Introduction:
Doctor of Physical Therapy (DPT) students have considerable educational debt upon graduation with suspected low levels of financial literacy, limited financial self-efficacy, and elevated stress and anxiety. The purpose of this study was to determine the relationships between financial knowledge, financial anxiety, financial stress, and financial self-efficacy with socioeconomic determinants in DPT students.

Subjects:
Five hundred seventy-eight DPT students, surveyed through a cross-sectional sample of convenience.

Methods:
Participants responded to a 40-item demographic questionnaire providing a self-assessment of their current financial literacy, financial self-efficacy, financial anxiety, financial stress, and level of general social support. Pairwise correlations were used to determine the relationship between independent variables and composite scores on self-assessment tools. Multiple regression analyses were conducted to predict financial knowledge, self-efficacy, anxiety, stress, and social support by socioeconomic indicators and educational debt status.

Results:
While there was a moderate, positive association between presence of debt and financial self-efficacy and financial anxiety for all students (r = .55), there was no statistically significant difference in financial knowledge, self-efficacy, anxiety, stress, or social support for students based on race/ethnicity. There was a negligible to weak correlation between financial knowledge, financial self-efficacy, and level of financial anxiety based on age, race/ethnicity, gender, socioeconomic background, debt load, risk tolerance, and retirement reflection. When subjected to multiple regression analysis, the level of education-related debt could explain a large proportion of the variance in multiple measures, including financial self-efficacy, anxiety, and stress. Economic background explained a large proportion of variance in the general social support students felt.

Discussion and Conclusion:
We found a strong, positive correlation between the presence of debt and financial stress and anxiety for all DPT student respondents. While there is no difference in financial literacy and self-efficacy based on race and ethnic background, there is a moderate correlation between self-efficacy and financial anxiety for all students. Education on strategies to manage debt load may reduce both factors.
Performance of race-neutral eGFR equations in patients with decompensated cirrhosis
Authors: Fallahzadeh Mohammad Amin , Allegretti Andrew S. , Nadim Mitra K. , Mahmud Nadim , Patidar Kavish R. , Cullaro Giuseppe , Saracino Giovanna , Asrani Sumeet K. 
Published: May 2024

The 2021 Chronic Kidney Disease Epidemiology Collaboration equation [CKD-EPI 2021] is a race-neutral equation recently developed and rapidly implemented as a reference standard to estimate glomerular filtration rate(GFR). However, its role in cirrhosis has not been examined especially in low GFR. We analyzed the performance of CKD-EPI 2021 compared to other equations with protocol-measured GFR (mGFR) in cirrhosis. We analyzed 2090 unique adult patients with cirrhosis undergoing protocol GFR measurements using iothalamate clearance from 1985 to 2015 when listed for liver transplantation at Baylor University in Dallas and Fort Worth, Texas. Using mGFR as a reference standard, the CKD-EPI 2021 was compared to CKD-EPI 2012, Modification of Diet in Renal Disease-4, Modification of Diet in Renal Disease-6, Royal Free Hospital, and GFR Assessment in Liver disease overall and in certain subgroups (ascites, mGFR ≤ 30 mL/min/1.73 m2, diagnosis, Model for End-Stage Liver Disease and gender). We examined bias (difference between eGFR and mGFR), accuracy (p30: eGFR within ± 30% of mGFR) and agreement between eGFR and mGFR categories. CKD-EPI 2021 had the second lowest bias across the entire range of GFR after GFR Assessment in Liver disease (6.6 vs. 4.6 mL/min/1.73 m2, respectively, p < 0.001). The accuracy of CKD-EPI 2021 was similar to CKD-EPI 2012 (p30 = 67.8% vs. 67.9%, respectively) which was higher than the other equations (p < 0.001). It had a similar performance in patients with ascites, by diagnoses, Model for End-Stage Liver Disease subgroups, by gender, and in non-Black patients. However, it had a relatively higher overestimation in mGFR ≤ 30 mL/min/1.73 m2 than most equations (18.5 mL/min/1.73m2, p < 0.001). Specifically, 64% of patients with mGFR ≤ 30 mL/min/1.73m2 were incorrectly classified as a less severe CKD stage by CKD-EPI 2021. In Blacks, CKD-EPI 2021 underestimated eGFR by 17.9 mL/min/1.73 m2, which was higher than the alternate equations except for Royal Free Hospital (p < 0.001). The novel race-neutral eGFR equation, CKD-EPI 2021, improves the GFR estimation overall but may not accurately capture true kidney function in cirrhosis, specifically at low GFR. There is an urgent need for a race-neutral equation in liver disease reflecting the complexity of kidney function physiology unique to cirrhosis, given implications for organ allocation and dual organ transplant.
A randomized trial of ‘fresh start’ text messaging to improve return to care in people with HIV who missed appointments in South Africa
Authors: Njuguna Christine , Long Lawrence , Mistri Preethi , Chetty-Makkan Candice , Maughan-Brown Brendan , Buttenheim Alison , Schmucker Laura , Pascoe Sophie , Thirumurthy Harsha , O’Connor Cara , Mutyambizi Chipo , Mutasa Barry , Rees Kate 
Published: May 2024

Objective:
Treatment interruptions are a barrier to successful antiretroviral therapy (ART). ‘Fresh start messages’, which leverage significant days on the calendar (e.g., new year, public holiday) in order to prompt action, have the potential to encourage people with HIV (PWH) to return to care. We evaluated a ‘fresh start’ intervention (text messages) to increase return to care in PWH who had missed their last appointment.

Design:
A three arm 1 : 1:1 individual randomised controlled trial.

Methods:
We randomized adults in Capricorn District who had missed ART appointments by >28 days to: no text message; unframed messages (fresh start not mentioned); or framed messages (fresh start mentioned). Randomization was stratified by treatment interruption duration and across two holidays (Youth Day, Mandela Day). The primary outcome was an ART-related clinic visit at ≤45 days of the first message.

Results:
9143 participants were randomised. For Youth Day, 1474 and 1468 were sent unframed and framed messages respectively, with 13.4% sent these messages having an ART visit vs. 11.9% not sent a message [adjusted odds ratio (aOR) 1.2; 95% confidence interval (CI): 1.0–1.4, P-value = 0.075]. For Mandela Day, 1336 and 1334 were sent unframed and framed messages respectively, with 6.7% sent these messages having an ART-related clinic visit vs. 5.4% not sent a message (aOR 1.2; 95% CI: 1.0–1.6; P-value = 0.100).

Conclusions:
Low-cost text messages sent around a ‘fresh start’ date may increase the likelihood that patients who miss appointments return to care. This study suggests the potential of text messaging for motivating return to care.
Is Polyetheretherketone an Effective Alloplastic Material in Comparison to Titanium in Calvarial Reconstruction
Authors: McGinnity-Hamze Gráinne , Hatamleh Muhanad M. 
Published: May 2024

Introduction and Aim:
Polyetheretherketone (PEEK) and titanium (Ti) cranioplasty implants ideal outcomes are good esthetics, long-term stability, and protection of the fragile brain tissue. However, it is unclear whether PEEK implants can offer an equal alternative to Ti implants. This work aimed to critically review papers and case series published on both Ti and PEEK Cranioplasty regarding complications, clinical outcomes, ease of use, esthetics, manufacture and availability, cost and time-saving factors, postoperative quality of life (QOL), as well as their suitability for the fronto-orbito region reconstruction.

Methods:
PubMed database was sourced for published literature in the period 2007 to the end of 2023; a further manual search for articles was carried out on the reference lists of each paper.

Results:
A total of 48980 papers were found during the initial search, but only 33 articles met the inclusion criteria. A total of 6023 cranial implants, with 3879 being Ti and 1205 PEEK. Titanium was the material of choice in over 64.4% of cases; however, Ti has been in application for many years compared to PEEK. Out of the 33 papers, there was 27 retrospective cohort/analysis/case series and reviews: 1 meta-analysis, 2 systematic reviews and 3 randomized control trials. Four articles commented on the QOL, 15 on esthetics, 7 discussed cost and time-saving without measurable variables, and 7 articles looked explicitly at the complex fronto-orbito region, of which 49% were primary 1-stage surgical reconstructions, 54% were reconstructed with PEEK and 7% Ti (CAD/CAM).

Conclusion:
There is no absolute consensus for the preference of either material, however, in the fronto-orbito region, PEEK is the material of choice for ease of use, esthetics, and time-saving. However, there are no long-term studies on PEEK cranioplasty, and fewer in comparison with Ti implants. Further research is required in this field. No reliable or measurable data was found to determine the QOL, esthetics, cost, or time-saving elements.
Red line the red line: Optimizing emergency medicine physicians and surgeons collaborative roles on trauma teams
Authors: Givens Melissa , Holcomb John B. 
Published: May 2024

ABSTRACT
It has long been the standard for surgical and EM teams to both be present upon patient arrival and work together for the sickest trauma patients, yielding improved outcomes. It is important to dismantle divisive perceptions, confront system constraints, and promote new strategies that optimize the engagement of trauma team members. The focus should be on the patient, whose injury care starts with prevention and extends seamlessly through prehospital, hospital and rehabilitation.
The authors address several myths that impact collaborative teamwork among emergency medicine physician and surgeons.
Leaders, especially at GME sites, need to foster collaborative relationships, rather than adversarial. The red line mentality is a divisive construct that should be dismantled.
Clinical Implications and Risk Factors of Dilatation of Remnant Pancreatic Duct at 1 Year after Pancreatoduodenectomy: A Prospective, Japanese, Multicenter, Observational Cohort Study (DAIMONJI Study)
Authors: Narita Masato , Hatano Etsuro , Kitamura Koji , Terajima Hiroaki , Kitagawa Hirohisa , Mitsuoka Eisei , Machimoto Takafumi , Morita Satoshi , Nishitai Ryuta , Masui Toshihiko ,   for the Kyoto University Hepato-Biliary-Pancreatic Surgery (KUHBPS) Group
Published: May 2024

BACKGROUND:
To determine the precise frequency of main pancreatic duct (MPD) dilatation within the remnant pancreas at 1 year after pancreatoduodenectomy (PD) and its clinical implications, a prospective multicenter cohort study was performed in patients without MPD dilatation before PD (registry number: UMIN000029662).

STUDY DESIGN:
Between October 2017 and July 2020, patients with an MPD diameter less than 3 mm who were planned to undergo PD for periampullary lesions at 21 hospitals were enrolled. The primary endpoints were frequency of MPD dilatation at 1 year after PD, and the relationship between MPD dilatation and pancreatic endo- and exocrine function, nutritional status, and fatty liver. Secondary endpoints were risk factors for MPD dilatation at 1 year after PD and time-course change in MPD diameter.

RESULTS:
Of 200 registered patients, 161 patients were finally analyzed. Pancreatic fistula was the most frequent complication (76; 47.2%). MPD dilatation (MPD > 3 mm) at 1 year after PD was seen in 35 patients (21.7%). Pancreatic exocrine function, assessed by steatorrhea, was significantly impaired in patients with MPD dilatation. However, endocrine function, nutrition status, and fatty liver development were comparable between the 2 groups. In multivariate analysis, the serum total protein level 7.3 g/dL or more was an independent predictor for MPD dilatation at 1 year after PD (odds ratio 3.12, 95% CI 1.31 to 7.15). A mean MPD diameter significantly increased at 6 months after PD and kept plateau thereafter.

CONCLUSIONS:
MPD dilatation at 1 year after PD was seen in 21.7% of patients and significantly associated with exocrine function impairment but not with endocrine function, nutrition status, or development of fatty liver.
Impact of health systems interventions in primary health settings on type 2 diabetes care and health outcomes among adults in West Africa: a systematic review
Authors: Bondzie Eugene Paa Kofi , Amarteyfio Kezia , Jahan Yasmin , Afun Nana Efua Enyimayew , Agyekum Mary Pomaa , Tapsoba Ludovic , Balabanova Dina , Mirzoev Tolib , Ayepong Irene 
Published: May 2024

AbstractType 2 diabetes is ambulatory care sensitive and adequate outpatient primary care supported by strong functional health systems can reduce avoidable complications and related mortality. A large body of published evidence exists on pharmacological agents and non-pharmacological interventions for the management of type 2 diabetes. However, the evidence on health systems’ ability to support patients’ primary care needs, especially in West Africa, where non-communicable disease (NCD) is an increasingly important part of the disease burden is uncertain. This systematic review explores the current published evidence on health systems interventions to support primary health facilities for type 2 diabetes care and impact on health outcomes, service access and quality in West Africa. The World Health Organization health systems building blocks and other post building blocks health systems frameworks guided our search and analysis. Only three pilot studies, including two randomized controlled trials and one pre-post study, met all our first inclusion criteria. However, we included 12 other studies which did not meet all the inclusion criteria but reported on a health system intervention for complete analysis: (The criteria were expanded to include studies conducted outside primary care settings. The rationale was that findings from such studies may influence primary care. Also, non-randomized control trials were later included). Our results showed that interventions with significant impact on glycemic control, treatment adherence, health literacy, and other associated outcomes addressed intersections between the individual health system blocks/areas. Thus, four cross-cutting themes related to the building blocks were found during analysis. The first theme was on interventions targeting the availability of trained health workers and the quality of their services; the second was on interventions targeting institutional infrastructure and resources for management; the third was on interventions targeting leadership and organizational culture and; the fourth was interventions targeting relationships among stakeholders. A fifth theme highlighting patients and family empowerment for type 2 diabetes control was also found in most of the interventions.ConclusionThese findings confirm that the rising burden of non-communicable diseases in West Africa, particularly type 2 diabetes, can be tackled by strong functional primary healthcare systems.
Cost-Effectiveness of Platelet Function Testing in Dual Antiplatelet Therapy Decision-Making after Intracranial Aneurysm Treatment with Flow Diversion
Authors: Wadhwa Aryan , Ramirez-Velandia Felipe , Mensah Emmanuel , Salih Mira , Enriquez-Marulanda Alejandro , Young Michael , Taussky Philipp , Ogilvy Christopher S. 
Published: May 2024

AbstractIntroductionDual antiplatelet therapy (DAPT) use is the standard of practice after flow diversion (FD) for intracranial aneurysms (IAs). Yet, no consensus exists in the literature regarding the optimal regimen. Certain institutions utilize various platelet function testing (PFT) to asses patient responsiveness to DAPT. Clopidogrel is the most commonly prescribed drug during DAPT, yet up to 52% of patients can be non-responders justifying PFT. Additionally, prices vary significantly among antiplatelet drugs, often further complicated by insurance restrictions. We aimed to determine the most cost-effective strategy for deciding DAPT regimens for patients after ICA treatment.MethodsA decision tree with Monte Carlo simulations was performed to simulate patients undergoing various three-month postoperative DAPT regimens. Patients were either universally administered aspirin alongside Clopidogrel, Ticagrelor, or Prasugrel without PFT, or administered one of the former thienopyridine medications based on platelet reactivity unit (PRU) results after Clopidogrel. Input data for the model were extracted from the current literature, and the willingness-to-pay threshold (WTP) was defined as $100,000 per QALY as per standard practice in the US. The baseline comparison was with universal Clopidogrel DAPT without any PFT. Probabilistic and deterministic sensitivity analyses were performed to evaluate the robustness of the model.ResultsPFT-Prasugrel was the most cost-effective regimen compared to universal Clopidogrel, with a base-case incremental cost-effectiveness ratio (ICER) of $-35,255 (cost $2336.67, effectiveness 0.85). PFT-Ticagrelor (ICER $-4,671; cost $2,995.06, effectiveness 0.84), universal Prasugrel (ICER $5,553; cost $3,097.30, effectiveness 0.84), and universal Ticagrelor (ICER $75,969; cost $3,801.36, effectiveness 0.84) were all more cost-effective than treating patients with universal Clopidogrel (cost $3,041.77, effectiveness 0.83). These conclusions remain robust in probabilistic and deterministic sensitivity analyses.ConclusionThe most cost-effective strategy for DAPT after FD for intracranial aneurysms is administering PFT-Prasugrel alongside aspirin. The cost of PFT is strongly justified and recommended when deciding patient-specific DAPT regimens.
Robust inducible gene expression in intracellularListeria monocytogenes in vivo
Authors: Pham Huong Giang , Tran Kiet N. , Gomelsky Larissa , Roy Tathagato , Gigley Jason P. , Gomelsky Mark 
Published: May 2024

AbstractAttenuated strains of the intracellular pathogenListeria monocytogenescan deliver genetically encoded payloads inside tumor cells.L. monocytogenespreferentially accumulates and propagates inside immune-suppressed tumor microenvironments. To maximize the payload impact in tumors and minimize damage to healthy tissues, it is desirable to induce payload synthesis when bacteria are eliminated from the healthy tissues but are grown to high numbers intratumorally. Here, we have engineered a tightly controlled gene expression system for intracellularL. monocytogenesinducible with a cumin derivative, cumate. Upon cumate addition, expression of a reporter gene is increased inL. monocytogenesgrowingin vitroby 80-fold, and in intracellularL. monocytogenesin murine tumors by 10-fold. This study demonstrates the feasibility of activating gene expression in intracellular bacteria in live animals using an edible inducer. The system is expected to enhance the efficacy and safety of the attenuatedL. monocytogenesstrains as antitumor payload delivery bacterial drones.
WITHDRAWN: SYNERGISM OF BACTERIOPHAGE AND ANTIBIOTICS IN THE REDUCTION OFPseudomonas aeruginosaBIOFILM
Authors: Timilsina Sudip , Karna Suruchi , Napit Rajindra , Upadhyaya Elisha , Malla Rajani 
Published: May 2024

Withdrawal StatementThe authors have withdrawn this manuscript because of some fundamental errors in the article. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.
Data-driven brain atrophy staging in spinocerebellar ataxia type 3
Authors: Baumeister Hannah , Schaprian Tamara , Wegner Philipp , Ferreira Monica , Kuegler David , Franca Marcondes Cavalcante , Rezende Thiago Junqueira Ribeiro de , Martinez Alberto Rolim Muro , Jiang Hong , Grobe-Einsler Marcus , Koyak Berkan , Önder Demet , van de Warrenburg Bart , van Gaalen Judith , Durr Alexandra , Coarelli Giulia , Synofzik Matthis , Schöls Ludger , Giunti Paola , Garcia-Moreno Hector , Öz Gülin , Joers James M. , Timmann Dagmar , Jacobi Heike , de Vries Jeroen , Barker Peter , Ratai Eva-Maria , Reetz Kathrin , Infante Jon , Hübener-Schmid Jeannette , Klockgether Thomas ,   ESM MRI study group, DANCER/DELCODE, Berron David , Faber Jennifer 
Published: May 2024

AbstractSpinocerebellar ataxia type 3 (SCA3) is the most common autosomal dominant ataxia worldwide. First targeted gene therapy trials have started, offering the intriguing scenario of preventive treatment. SCA3 is associated with progressive regional brain atrophy that starts before clinical manifestation. We aimed to identify the spatiotemporal progression pattern of brain atrophy of SCA3 with a focus on early disease stages.T1-weighted MRI scans of 300 SCA3 mutation carriers and 317 controls were analyzed. Subtype and Stage Inference (SuStaIn) was used to identify the sequence of volume loss across selected brain regions.We observed one distinct sequence of brain atrophy events in SCA3 without evidence for the existence of alternative cascades. Atrophy started in the most caudal parts of the brainstem. Almost all preataxic SCA3 mutation carriers clustered in the first atrophy stages. Certainty of sequence estimation was highest for early atrophy stages with prominent involvement of the pons and cerebellar white matter.Brain atrophy in SCA3 follows a clear and distinct sequence ascending from the lower brainstem with an early involvement of white matter. Knowledge of this sequence might support the stratification of SCA3 mutation carriers with an imminent clinical onset for early interventions.
Recurrent SARS-CoV-2 spike mutations confer growth advantages to select JN.1 sublineages
Authors: Wang Qian , Mellis Ian A. , Bowen Anthony , Kowalski-Dobson Theresa , Valdez Riccardo , Katsamba Phinikoula S. , Shapiro Lawrence , Gordon Aubree , Guo Yicheng , Ho David D. , Liu Lihong 
Published: May 2024

AbstractThe recently dominant SARS-CoV-2 Omicron JN.1 has evolved into multiple sublineages, with recurrent spike mutations R346T, F456L, and T572I, some of which exhibit growth advantages, such as KP.2. We investigated these mutations in JN.1, examining their individual and combined effects on immune evasion, ACE2 receptor affinity, and in vitro infectivity. F456L increased resistance to neutralization by human sera, including those after JN.1 breakthrough infections, and by RBD class-1 monoclonal antibodies, significantly altering JN.1 antigenicity. R346T enhanced ACE2-binding affinity, without a discernible effect on serum neutralization. Individually, R346T and T572I modestly enhanced infectivity of each pseudovirus. Importantly, expanding sublineages such as KP.2 containing R346T, F456L, and V1104L, showed similar neutralization resistance as JN.1 with R346T and F456L, suggesting V1104L does not appreciably affect antibody evasion. Our findings illustrate how certain JN.1 mutations confer growth advantages in the population and could inform the design of the next COVID-19 vaccine booster.