bluuebunny/crossref_metadata_2025_split huggingface dataset:
Training and education provided to local change champions within implementation trials: a rapid systematic review
Authors: Jolliffe Laura , Lannin Natasha A. , Larcombe Stacy , Major Brendan , Hoffmann Tammy , Lynch Elizabeth 
Published: February 2025

Abstract

Background
Translating research into clinical practice is challenging. One implementation intervention that supports translation is employment of a change champion. It is important to understand how individuals are prepared for the change champion role. This rapid systematic review aimed to identify the education, training, and support provided to individuals in change champion roles within implementation trials.

Method
Rapid review approach. We searched the Scopus database to identify systematic reviews on champions, knowledge brokers, facilitators, and implementation support practitioners. The most recent reviews on each topic were screened to find eligible studies. To identify studies published after these reviews, we searched Medline, PsycINFO, OVID, CINAHL, ProQuest, SCOPUS, and EBSCO. We included randomised and cluster randomised controlled trials that reported on implementation interventions in healthcare settings involving a local change champion.

Results
Fifteen cluster randomised controlled trials were included. Specific champion training was provided in 12 studies (80%), but none reported incorporating adult learning principles into their education program. Some form of post-training support was reported in 11 studies (73%). Only two studies included content on behaviour or organizational change in the champion preparation program. Most programs were not individualized, and details of training and support were poorly reported.

Conclusions
Training needs and educational outcomes of change champions are poorly reported in implementation trials. Training tends not to align with adult learning. More rigorous development and reporting of programs to prepare change champions to support implementation of evidence in healthcare is recommended.

Registration
PROSPERO registration number CRD42022368276.
The mutational landscape of ARMC5 in Primary Bilateral Macronodular Adrenal Hyperplasia: an update
Authors: Bouys Lucas , Vaczlavik Anna , Cavalcante Isadora P. , Violon Florian , Jouinot Anne , Berthon Annabel , Vaduva Patricia , Espiard Stéphanie , Perlemoine Karine , Kamenicky Peter , Vantyghem Marie-Christine , Tabarin Antoine , Raverot Gérald , Ronchi Cristina L. , Dischinger Ulrich , Reincke Martin , Fragoso Maria C. , Stratakis Constantine A. , Chansavang Albain , Pasmant Eric , Ragazzon Bruno , Bertherat Jérôme ,   for the COMETE and ENSAT Networks
Published: February 2025

Abstract

Background
Primary Bilateral Macronodular Adrenal Hyperplasia (PBMAH) is a rare cause of Cushing’s syndrome due to bilateral adrenocortical macronodules. Germline inactivating variants of the tumor suppressor gene ARMC5 are responsible for 20–25% of apparently sporadic PBMAH cases and 80% of familial presentations. ARMC5 screening is now routinely performed for PBMAH patients and families. Based on literature review and own observation, this study aims to give an overview of both published and unpublished ARMC5 genetic alterations and to compile the available evidence to discriminate pathogenic from benign variants.

Results
146 different germline variants (110 previously published and 36 novel) are identified, including 46% missense substitutions, 45% truncating variants, 3% affecting splice sites, 4% in-frame variants and 2% large deletions. In addition to the germline events, somatic 16p loss-of-heterozygosity and 104 different somatic events are described. The pathogenicity of ARMC5 variants is established on the basis of their frequency in the general population, in silico predictions, familial segregation and tumor DNA sequencing.

Conclusions
This is the first extensive review of ARMC5 pathogenic variants. It shows that they are spread on the whole coding sequence. This is a valuable resource for genetic investigations of PBMAH and will help the interpretation of new missense substitutions that are continuously identified.
Pain assessment and management of adult patients in the Swedish EMS: a nationwide registry study
Authors: Larsson Glenn , Wennberg Pär , Wibring Kristoffer 
Published: February 2025

Abstract

Background
Pain is a frequent reason for contacting the Emergency Medical Services (EMS), and effective pain management constitutes one of its cornerstones. The aims of this study have been: (a) to describe the prevalence of pain intensity ratings in EMS care of patients with pain-related conditions; (b) to describe pain treatment in the EMS setting in terms of drugs administered and the proportion of patients receiving analgesics and (c) to investigate the relationship between patients’ self-reported pain intensity and vital signs.

Methods
This is a retrospective observational cohort study using data from 394,700 EMS missions conducted 2021 and 2022, as recorded in the Swedish Ambulance Registry. The study focused on patients who contacted the EMS due to pain, trauma, or injury. Pain intensity was recorded using the Numeric Rating Scale (NRS). NRS scores of 5–10 were considered as high-level pain and NRS ≤ 4 as low-level. Descriptive statistics were used to present categorical and continuous variables. Chi-square tests were applied for dichotomous variables, while Kruskal–Wallis tests were used for ordinal data. Logistic regression analysis was carried out to identify factors associated with pain intensity and analgesic treatment. p value < 0.001 was considered statistically significant.

Results
Pain intensity was recorded in 23.6% of cases. Most patients rated their pain as high-level (NRS 5–10, 57.4% of those assessed). Analgesics were administered in 27.5% of cases, with higher administration rates observed when pain intensity was documented. Female sex, higher breathing rates, and higher systolic blood pressure were associated with higher pain intensity, while increasing age was associated with lower odds of reporting high-level pain intensity. No significant association was found between heart rate and pain intensity.

Conclusion
This 2-year cohort study highlights significant deficiencies in recorded pain assessment and management in the Swedish EMS. Only 22.5% of the patients had their pain assessed with a validated scale, while 27.5% received analgesics, although pain-related conditions were a common reason for contacting the EMS. The findings indicate a lack of systematic pain assessment which puts many patients at risk of insufficient pain relief.
Effect of an intensive care unit virtual reality intervention on relatives´ mental health distress: a multicenter, randomized controlled trial
Authors: Drop Denzel L. Q. , Vlake Johan H. , Wils Evert-Jan , Van Bommel Jasper , Jung Christian , Hilling Denise E. , Bienvenu O. Joseph , Korevaar Tim I. M. , Schut Anna F. C. , van Mol Margo M. C. , Gommers Diederik , van Genderen Michel E. 
Published: February 2025

Abstract

Background
Relatives of intensive care unit (ICU) patients often endure symptoms of post-traumatic stress, anxiety, and depression during and after treatment of a family member’s hospitalization. The aim of this study was to evaluate the effect of ICU-specific virtual reality (ICU-VR) on mental health among relatives, 6 months after patient’s ICU discharge.

Methods
This multicenter, randomized controlled trial included relatives of ICU patients who were assigned to receive either standard care or standard care plus ICU-VR, by randomizing the ICU patients. Relatives were assessed up to 6 months after patient discharge from the ICU for post-traumatic stress, anxiety, depression, quality of life, relatives’ understanding of ICU care, and appreciation of ICU-VR.

Results
One hundred relatives of 81 patients and 89 relatives of 80 patients were randomized to the intervention and control groups, respectively. Relatives’ median age was 48 years and 53% were female. Compared to the control group, relatives who received ICU-VR did not experience a decrease in post-traumatic stress (23% vs. 18%; p = 0.99), anxiety (22% vs. 30%; p = 0.35), or depression (17% vs. 23%; p = 0.44). There was no significant difference between median mental quality of life (50.2 vs. 52.6; p = 0.51), physical quality of life (56.1 vs. 54.3; p = 0.16), or understanding of ICU care between groups. Patients in the intervention group highly endorsed ICU-VR (90%), favoring it over traditional informational brochures and the majority (82%) stated it improved their understanding of ICU treatment.

Conclusion
ICU-VR did not significantly improve mental health distress symptoms among relatives 6-months after a patient’s discharge. Relatives highly endorsed ICU-VR and self-reported that it improved their understanding of ICU treatment.
A novel protein encoded by porcine circANKRD17 activates the PPAR pathway to regulate intramuscular fat metabolism
Authors: He Xiao , Xie Fang , Nie Ying , Wang Xuefeng , Luo Junyi , Chen Ting , Xi Qianyun , Zhang Yongliang , Sun Jiajie 
Published: February 2025

Abstract

Background
Intramuscular fat is an important factor in evaluating pork quality and varies widely among different pig breeds. However, the regulatory mechanism of circular RNAs (circRNAs) in lipid metabolism remains largely unexplored.

Results
We combined circRNA-seq and Ribo-seq data to screen a total of 18 circRNA candidates with coding potential, and circANKRD17 was found to be significantly elevated in the longissimus dorsi muscle of Lantang piglets, with a length of 1,844 nucleotides. Using single-cell sequencing, we identified 477 differentially expressed genes in IMF cells between Lantang and Landrace piglets, with enrichment in the PPAR signaling pathway. These genes included FABP4, FABP5, CPT1A, and UBC, consistent with the high levels of acylcarnitines observed in the longissimus dorsi muscles of the Lantang breed, as determined by lipidomic analysis. Further in vitro and in vivo experiments indicated that circANKRD17 can regulate lipid metabolism through various mechanisms involving the PPAR pathway, including promoting adipocyte differentiation, fatty acid transport and metabolism, triglyceride synthesis, and lipid droplet formation and maturation. In addition, we discovered that circANKRD17 has an open reading frame and can be translated into a novel 571-amino-acid protein that promotes lipid metabolism.

Conclusions
Our research provides new insights into the role of protein-coding circANKRD17, especially concerning the metabolic characteristics of pig breeds with higher intramuscular fat content.
A large elevation in 15N/14N of collagenous amino acids: an insight from starvation experiments of marine organisms
Authors: Choi Hyuntae , Takizawa Yuko , Park Nayeon , Chikaraishi Yoshito 
Published: February 2025

Abstract
Nitrogen isotope ratios of amino acids (δ15NAA) have widely been employed as a powerful tool for estimating the trophic position of organisms in food webs. This estimation is based on an elevation pattern in the δ15NAA value, a large elevation for the trophic amino acids (e.g., 8.0‰ for glutamic acid) while a little elevation for the source amino acids (e.g., 0.4‰ for phenylalanine), associated with the deamination of amino acids in consumers. However, several elevation patterns can be found in natural environments, one of which may be caused by the hydrolysis of specific protein under nutritional stress. In the present study, we identified ‘protein-specific elevation pattern’ for collagen, which connected to muscle tissues of fish and gastropods under nutritional stress. Time-series starvation for 45 days results in that collagen is consumed by 86% for the fish Girella punctata and by 50% for the gastropod Turbo sazae. Moreover, during the starvation, although a little change in the δ15NAA value is found in muscle fibers, a gradual elevation in the δ15NAA value is found in collagen for both trophic and source amino acids (e.g., by up to 11‰ for glutamic acid and up to 3‰ for phenylalanine, respectively, which can be explained by the Rayleigh fractionation model). We thus demonstrate that the consumption of collagen in organisms under starvation shows a unique elevation pattern in the δ15NAA value, which is consistent with the observation that collagen is degraded non-quantitatively by the collagenase reaction, whereas muscle is degraded quantitatively by the chaperone-mediated autophagy. The effect of δ15N elevation in all amino acids of collagen is negligible for G. punctata and diluted for T. sazae to the elevation in whole muscle tissue (i.e., = muscle fibers + collagen) even under long-term starvation, because the collagen proportion in the whole muscle is relatively small and is considerably decreased under the nutritional stress. Based on these results, we predict that the difference in the δ15NAA value between collagen and muscle fibers can be useful for evaluating the nutritional stress of fishes. However, great care will be required if studying food webs where collagen-rich organisms (i.e., gelatinous zooplankton) are abundant or if using collagen-rich materials in our studies.
Discordance between 90Y-PET/CT(MR)-estimated activity and dose calibrator measured administered activity: an international study in SIRT patients treated with resin and glass microspheres
Authors: Carlier Thomas , Gnesin Silvano , Mikell Justin K. , Conti Maurizio , Prior John O. , Schaefer Niklaus , Pérez Lago Maria del Sol , Bailly Clément , Dewaraja Yuni K. , Lima Thiago V. M. 
Published: February 2025

Abstract

Purpose
Therapeutic administration of 90Y-loaded microspheres is routinely used for primary and secondary liver tumours. For activity-based therapeutic prescription the activity must be within 10% of the intended activity. Previous studies reported significant discrepancies between manufacturer-declared vial activities and both experimental and Monte-Carlo assessments, greater than 10%, for resin/glass 90Y-microspheres. The objective of this work was to investigate whether these discrepancies were also seen in patients.

Methods
We analysed patient 90Y-PET reconstructions (99 glass and 15 resin microspheres) from 4 different institutions and 4 different systems. We considered tail-fitting background scaling (TFBS) and absolute scaling (ABS), for scatter correction. Residuals after therapeutic injection were measured. Eighty-one patients were imaged with PET/CT and 33 with PET/MR. The PET measured activity (APET) was assessed in the whole liver. The ratio APET/Acalibrator was calculated for each patient, where Acalibrator was the injected activity measured by the dose calibrator corrected for residual and lung shunt.

Results
Quantification ratio between calibrators and PET was significantly different from 1, regardless of the scatter correction used. In glass microspheres, the mean APET/CT/Acalibrator was 0.84 ± 0.06 for TFBS and 0.90 ± 0.06 for ABS (0.66 ± 0.09 and 0.76 ± 0.07 for (APET/MR/Acalibrator)). The mean APET/CT/Acalibrator ratio for resin microspheres was 1.16 ± 0.09 for TFBS and 1.30 ± 0.12 for ABS.

Conclusions
We observed in patients similar activity discrepancies as reported for vials, with a relative difference of 44 ± 16% between glass and resin 90Y-loaded microspheres. In 90Y hepatic radioembolization, the 10% accuracy prerequisite on knowing the administered therapeutic activity is then unlikely to be met.
Assessing the impact on mode competitiveness of improvements of the Trans-Eurasian railway network
Authors: Mohseni Seyed , van Hassel Edwin , Vanelslander Thierry 
Published: February 2025

Abstract
This paper deals with the potential of the different modes of transport on the Eurasian connection, focusing on rail, and comparing with sea and air. Since 2008, a substantial uptake of the rail connection has been observed. The main question then is whether the competitiveness of this land bridge is actual and sustainable or not. First, the paper focuses on the latest developments of the actual physical capacity on the Eurasian connection. Mainly under Chinese impetus, substantial improvements of rail connections but also border crossings have been made. Second, the paper focuses on the actual competitiveness of the different modes on the Eurasian connection in the current-day transport volumes. It can be observed that also the transport on the Eurasian connection has been growing, especially by rail. However, by far the largest volumes of transport still happen by maritime transport. The third and main question of the paper is on whether the land bridge by rail would cost-wise be competitive enough to favour a large shift from sea to land. An adapted version of a chain cost model applied to seven city pairs shows that the cost of the maritime solution is notably higher the further away from the coast origin and/or destination are located. For rail, such significant cost differences are not found. Furthermore, the value of the goods plays a bigger role for rail than for maritime transport. Air transport, due to its higher charges, typically is only used by higher-value goods. When comparing the (combinations of) transport modes, it turns out that the rail costs are on average 1.5 times to twice as high as when using maritime transport, but the more westward the origin on the Chinese territory, the closer the ratio gets to 1. The sensitivity analysis shows that in particular using longer trains will allow strongly further reducing generalized rail chain costs, easily over a third of the base case costs. Substantially less generalized chain cost reductions are achieved when shortening transit times, even when the latter goes up to half the initial transit time. Fourth, looking at what would be needed to make a further shift to rail materialize on the Eurasian connection, three items pop up: rail border crossing capacity, traffic balance between both directions and backups to the TEN-T rail network.
Validity and reliability of the Manchester Oxford Foot Questionnaire (MOXFQ) in one-year postoperative ankle fracture patients—a validation study
Authors: Nguyen Michael Quan , Iversen Marjolein Memelink , Harboe Knut , Dalen Ingvild , Paulsen Aksel 
Published: February 2025

Abstract

Background
Ankle fracture patients are a heterogenous group with differences in age, sex, fracture morphology, and treatment provided. With the increased focus on patient-centered treatment, patient-reported outcome measures (PROMs) are increasingly adopted by clinicians to facilitate best clinical practice. The Manchester Oxford Foot Questionnaire (MOXFQ) has demonstrated good measurement properties when used in patients with foot or ankle disease. The PROM has three domains: (1) Pain; (2) Walking/Standing; and (3) Social Interaction. One study found sufficient content validity for the Pain and Walking/Standing domains when used in the evaluation of ankle fracture patients. Another validation study demonstrated acceptable structural validity and reliability for the MOXFQ in ankle fracture patients 12 weeks after injury. The aim of this study is to assess the structural validity and reliability of the Norwegian version of the MOXFQ in the context of an ankle fracture patients one year after surgery and provide patient acceptable symptom state (PASS) estimates.

Methods
A pragmatic cross-sectional study design was used to collect the one-year MOXFQ follow-up data from patients surgically treated for an ankle fracture in the period 2017 to 2020 at (Stavanger University Hospital). The structural validity and internal consistency were assessed using confirmatory factor analysis. A separate test-retest study including patients at least one year since ankle surgery was used in the assessment of reliability and measurement error.

Results
A confirmatory factor analysis of the three-factor model of the MOXFQ had a good model fit (TLI 0.94; CFI 0.95; RMSEA 0.094; SRMR 0.039). However, the measurement model demonstrated poor discriminant validity of the three factors. A unidimensional model of the 16 items had worse model fit, while a second-order factor model demonstrated strong factor loadings for a second-order factor. A bi-factor model also revealed a strong general factor but also unique variance in the Pain and Social Interaction domain. The domains had good internal consistency (McDonald’s omega 0.80 to 0.95) and test-retest reliability (ICC 0.80 to 0.92). The standard errors of measurements for the three domains were between 6.5 and 7.5, and 5.5 for the MOXFQ-Index (scale 0 to 100). PASS estimates for the (sub)scales were: Pain 45; Walking/Standing 39; Social Interaction 19; and MOXFQ-Index 34.

Conclusion
The MOXFQ with three domains demonstrated sufficient structural validity and reliability when used in the evaluation of a one-year postoperative ankle fracture population. Reporting the scores of the Pain and Walking/Standing domains was best supported.
Associated adverse outcomes with tumor treating fields when combined to temozolomide versus temozolomide alone for the treatment of glioblastoma: a meta-analysis of randomized trials
Authors: Chen Yuanyuan , Chen Yan , Zhen Hong , Lou Danhua 
Published: February 2025

Abstract

Background
Glioma is a brain tumor and glioblastoma represents its most common type, accounting for almost 40% of primary tumors of the central nervous system, and is associated with the worst prognosis. Glioblastoma remains one of the major challenges in neurooncology. Recently, the Food and Drug Administration (FDA) has approved tumor treating fields (TTF) for the treatment of glioblastoma. In this analysis, we aimed to systematically assess the adverse outcomes associated with TTF when combined to temozolamide versus temozolamide alone for the treatment of glioblastoma.

Methods
MEDLINE (subset PubMed), EMBASE, Web of Science, Cochrane databases, Google scholar, and http://www.ClinicalTrials.gov were searched for publications comparing TTF in combination with temozolomide versus temozolomide alone for the treatment of glioblastoma. The adverse outcomes were considered as the endpoints in this analysis. The statistical analysis was carried out by the latest version of the RevMan software (version 5.4). Risk ratios (RR) with 95% confidence intervals (CI) were used to represent the data following assessment. A random effect model was used during the statistical analysis.

Results
A total number of 994 participants were included in this analysis whereby 572 participants were assigned to TTF + temozolomide, whereas 422 participants were assigned to temozolomide alone. All the studies were randomized trials. The majority of the participants were males (68.0–75.0%) with a mean age of the varying from 54.0 to 69.0 years. Results of this analysis showed that TTF in combination with temozolomide was not associated with significantly higher adverse outcomes related to blood and lymphatic system disorders (RR:0.87, 95% CI 0.30–2.48; P = 0.79), gastrointestinal disorders (RR: 0.83, 95% CI 0.14–4.72; P = 0.83), general deterioration and malaise (RR: 1.43, 95% CI 0.90–2.25; P = 0.13), infections and infestations (RR: 1.21, 95% CI 0.33–4.45; P = 0.78), injury/poison and procedural complications (RR: 1.78, 95% CI 0.88–3.61; P = 0.11), metabolic and nutritional disorders (RR: 0.61, 95% CI 0.34–1.08; P = 0.09), central nervous system disorders (RR: 1.14, 95% CI 0.89–1.46; P = 0.31), musculoskeletal and connective tissue disorders (RR: 0.99, 95% CI 0.48–2.07; P = 0.99), respiratory/thoracic/mediastinal disorders (RR: 0.85, 95% CI 0.44–1.62; P = 0.62), and psychiatric disorders (RR: 1.27, 95% CI 0.42–3.79; P = 0.67). Similar adverse effects were observed.

Conclusion
TTF in combination with temozolomide was not associated with significantly worse adverse outcomes for the treatment of patients with glioblastoma. Hence, future trials should focus on the cost-effectiveness of TTF for the treatment of glioblastoma.