bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of health technology assessments for digital therapeutics in Germany, the United Kingdom and France
Authors: Arcà Emanuele , Heldt Dorothea , Smith Martina 
Published: January 2025

Objective Digital therapeutics (DTx) are promising technologies. However, current assessment and access frameworks, when they exist, are heterogeneous and fragmented. We analysed and compared health technology assessment (HTA) criteria for DTx across European countries that had assessed the same DTx products. This allowed us to conduct a direct comparison of these countries’ DTx assessment frameworks. Methods A scoping review identified HTA DTx documents from European HTA bodies with specific DTx frameworks in place. The HTAs of the same DTx products assessed across multiple countries were then extracted and analysed. Results Deprexis and Velibra were the only DTx products assessed by multiple countries: Deprexis, indicated for depression, was assessed by Germany, the United Kingdom (UK) and France; and Velibra, indicated for anxiety, was assessed by Germany and the UK. There are notable differences among those frameworks, but what they share is an emphasis on the context-specific positioning of products within the disease landscape, choice of comparators and usage and usability data. Safety data are not a major focus in DTx assessments in these countries, but a request is often made for the addition and evaluation of risk-flagging systems. Conclusion The majority of European countries do not have a specific framework in place for the assessment of DTx, and major differences exist among recently implemented frameworks. The current policy landscape at the European Union level offers an opportunity to establish a harmonized framework for the assessment of DTx and possibly faster access and integration of such promising technologies.
The engagement of healthcare providers in implementing the selfBACK randomised controlled trial – A mixed-methods process evaluation
Authors: Stochkendahl Mette Jensen , Nicholl Barbara I , Wood Karen , Mair Frances S , Mork Paul Jarle , Søgaard Karen , Rasmussen Charlotte DN 
Published: January 2025

Background People with low back pain (LBP) are often recommended to self-manage their condition, but it can be challenging without support. Digital health interventions (DHIs) have shown promise in supporting self-management of LBP, but little is known about healthcare providers’ (HCPs) engagement in implementing these. Aims We aimed to examine HCPs’ engagement in patient recruitment for the selfBACK app clinical trial and explore their perceptions of the app. Methods In a mixed-methods design, we conducted a process evaluation alongside the selfBACK trial, triangulating quantitative data from trial recruitment logs and a vignette-based survey, and qualitative data from trial procedure documents, interviews with HCPs, and survey free-text responses. From 2019 to 2020, we recruited 57 HCPs from Norway and 39 health clinics in Denmark and collected quantitative and qualitative data in parallel. Results were integrated using displays. Results Overall, 825 patients were recruited by the HCPs. The vignette-based survey showed high agreement among HCPs (n = 62) with the self-management plans generated by the app (84.1–88.9%) but also highlighted concerns about tailoring and content. Interviews with HCPs (n = 19) revealed challenges with recruitment due to busy schedules, competing tasks, and varying levels of interest and engagement in the study. Conclusions The study identified factors that impact HCPs’ engagement in recruiting patients for the selfBACK trial and highlighted overall positive views of the selfBACK app, although some concerns about the content and tailoring of the app were raised. Understanding HCP motivations and workload is crucial for the successful implementation of DHIs in clinical practice.
Sexual Dysfunction in Cervical Spondylomyelopathy and Its Prognosis Following Surgical Decompression: A Systematic Review
Authors: Viswanathan Vibhu Krishnan , Muthu Sathish 
Published: January 2025

Study Design Systematic review. Objective While the occurrence of sexual dysfunction in patients sustaining traumatic cervical or thoracic injuries is well acknowledged, the evidence regarding its prevalence and outcome in individuals with degenerative cervical myelopathy (DCM) is still limited. The current systematic review was planned to comprehensively evaluate the existing literature regarding the prevalence, patterns, presentation, and outcome of sexual dysfunction in patients presenting with DCM. Methods A thorough search of the literature was performed on October 15, 2024, using 5 different databases (Google Scholar, Embase, PubMed, Web of Science and Cochrane Library). Studies on sexual dysfunction in DCM published until 2024 were scrutinized. Narrative or systematic reviews, opinions, letters to the editor, and manuscripts published in non-English languages were excluded. Results Overall, the literature search yielded a total of 384 articles of which 7 articles with 910 patients were included in the analysis. The overall prevalence of erectile dysfunction (ED) in CSM ranges between 3 and 6%. 82% of patients with preoperative ED had an abnormal psychogenic erection while the remaining had an abnormal reflexogenic erectile function. The erectile function was reported to improve substantially following decompressive surgery (68% recovery rate; P = 0.05). The presence of preoperative sexual dysfunction has been associated with poorer neurological outcomes (50% recovery rate; including poorer gait recovery). The data regarding ejaculatory disturbances and female sexual dysfunction in DCM patients are still limited. Conclusion ED occurs in 3 to 6% of patients with DCM, with a majority of patients suffering from ED from psychogenic origin. Surgical decompression can significantly improve the sexual recovery in these patients. Patients with ED have overall poorer neurological recovery.
Chinese Translation and Validation of the Oslo Sports Trauma Research Center Questionnaires on Overuse Injuries and Health Problems
Authors: Lu Yi , Chiu Joe Chih-Hao , Chen Alvin C. , Hsu Kuo-Yao , Chan Yi-Sheng , Zhang En-Chong , Sheu Huan 
Published: January 2025

Background: The importance of monitoring both physical and mental health in athletes across different levels of sport is increasingly acknowledged due to potential injury risks. However, for the Chinese-speaking population, there has not yet been an appropriate assessment tool available. Purpose: To translate, culturally adapt, and assess the validity and reliability of the Chinese versions of the updated Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O2) and the Health Problems Questionnaire (OSTRC-H2) among Taiwanese collegiate athletes. Study Design: Cohort study (diagnosis); Level of evidence: 3. Methods: The OSTRC-O2 and OSTRC-H2 questionnaires were translated from English to Chinese following international guidelines. Subsequently, 80 and 84 collegiate athletes, respectively, were invited to complete these questionnaires on a weekly basis for 8 weeks. Internal consistency was evaluated using Cronbach alpha coefficient, while test-retest reliability was assessed with the intraclass correlation coefficient (ICC). Severity scores from the questionnaires were also documented. Results: High response rates of 90% (n = 72/80) and 90.5% (n = 76/84) were achieved in the OSTRC-O2.CH and OSTRC-H2.CH groups, respectively, demonstrating strong acceptance among athletes, with no significant issues in back-translation. High content validity was observed across the different body parts in the translated OSTRC-O2, with Cronbach alpha values of .82, .83, .82, and .83 for the knee, shoulder, elbow, and lower back, respectively. The translated OSTRC-H2 also showed excellent internal consistency, with a Cronbach alpha of .95. The ICC values for test-retest reliability were 0.88, 0.82, 0.92, and 0.92 for the knee, shoulder, elbow, and lower back in the OSTRC-O2, and the ICC for the OSTRC-H2 was 0.90, indicating very good reliability for both questionnaires. Conclusion: The Chinese versions of the OSTRC questionnaires were found to be valid and reliable for monitoring overuse injuries and health issues among Chinese-speaking collegiate athletes.
Cultivation of Grit in Nursing Students: A Qualitative Descriptive Study “Cultivation of Grit”
Authors: Muchna Carolyn Spriggs 
Published: January 2025

Background Predicted nursing deficits and low nursing student retention rates highlighted the need to investigate cultivation of grit, a malleable trait involving perseverance and passion to achieve long-term goals amidst challenges and difficulties. Objective The objective of this study was to identify how cultivation of grit and additional academic and non-academic strategies aided gritty second-year associate degree-seeking nursing students in addressing nursing program challenges and completing their nursing program. Methods Twenty-two second-year associate degree-seeking nursing students in rural central Arizona completed demographic and Grit-O Scale questions using Survey Monkey™ and participated in semi-structured interviews or focus group discussions held from September through December 2022. Research questions provided study foundation: RQ1: How do second-year nursing students with high levels of self-perceived grit of greater than 3.5 out of 5 as measured on the Grit-O Scale describe how grit was cultivated during their associate degree-seeking nursing program? RQ2: How do second-year nursing students with high levels of self-perceived grit describe how additional academic and non-academic strategies added to them in dealing with the challenges of their associate degree-seeking nursing program? Design Qualitative Descriptive Research Results Inductive thematic analysis revealed six themes: importance of perseverance and passion, facets of grit; identification of program challenges and strategies used to deal with challenges; and the significance of support from nursing cohort, family, and friends, and nursing instructors. Conclusions Effective strategies for participating nursing student retention and program completion involved cultivation of grit and its facets of perseverance and passion and additional academic and non-academic strategies of nursing cohort and instructor support aided students in dealing with challenges faced during their associate degree-seeking nursing program at a rural, central Arizonan community college.
Lateral Extra-Articular Tenodesis as an Adjunct to ACL Reconstruction
Authors: McGovern Madeline M. , Yalcin Sercan , Lowenstein Natalie A. , Mazzocca Jillian L. , Matzkin Elizabeth G. , Medina Giovanna 
Published: January 2025

Background: Lateral extra-articular tenodesis (LET) is a surgical technique used to decrease the risk of anterior cruciate ligament reconstruction (ACLR) failure by supplementing internal rotational stability and reducing pivot shift. Indications: A growing body of literature indicates that LET should be performed for patients under 25 years, those with increased posterior tibial slope and ligamentous laxity, and elite athletes in cutting and/or pivoting sports. Additional indications include patients with grade 2 pivot shift or greater and those with a history of anterior cruciate ligament graft failure. Technique Description: Surgeon preference determines LET and ACLR sequence. Anatomic landmarks are identified and marked. A 5-cm incision is made in line with the iliotibial (IT) band from Gerdy's tubercle toward the lateral epicondyle. Dissection is carried to the IT band. Approximately 1 cm from the posterior border of the IT band, a full-thickness graft of 7 to 8 cm in length and 1 cm in width is harvested proximally and then whipstitched. A varus stress applies ligamentous tension and aids in lateral collateral ligament (LCL) identification. The LCL is dissected out, and the graft is passed underneath it. An all-suture anchor placed approximately 1 to 2 cm proximal and posterior to the lateral epicondyle and the knee is positioned in neutral rotation and at approximately 60° of flexion. The graft is passed inside the suture loop with an additional knot tied over the top using the needled suture. The IT band is then repaired side to side. Remaining subcutaneous tissue and skin are closed in standard fashion based on the order of the surgery. Results: In the STABILITY randomized controlled trial, 2-year outcomes demonstrated a clinically and statistically significant decrease in clinical failure from 40% to 25% and graft rupture rate from 11% to 4% with the addition of LET to ACLR with hamstring autograft. Similar return-to-sport rate was seen between cohorts. A meta-analysis of 6 studies examining ACLR versus ACLR + LET in individuals undergoing primary ACLR reported a reduced incidence of graft failure and postoperative anterolateral rotatory instability. Discussion/Conclusion: LET is a technique that can help reduce the risk of ACLR failure. Our technique employs a knotless suture anchor to confer anterolateral rotatory stability in the setting of ACLR. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Content, uptake and adherence of exercise interventions after an acute exacerbation of COPD: a scoping review
Authors: Wuyts Marieke , Demeyer Heleen , Vandendriessche Thomas , Cui Yiting , Mellaerts Paulien , Janssens Wim , Troosters Thierry 
Published: January 2025

IntroductionPulmonary rehabilitation is underutilised in patients after an acute exacerbation of COPD (AECOPD). Retrieving information regarding the setting, training modalities and the uptake and adherence to exercise interventions for these individuals in a vulnerable state could potentially guide future research.AimTo provide a comprehensive review of the existing literature on the content, uptake and adherence of different exercise interventions for patients after an AECOPD.MethodsEight different databases were searched for 1) patients experiencing an AECOPD and 2) performing any form of exercise intervention. Information on content, uptake and adherence was collected and the Consensus on Exercise Reporting Template (CERT) checklist was performed for each included record.Results59 distinct interventions were identified between 1998 and 2023 including a total of 9238 patients. All studies included patients requiring hospitalisation for the AECOPD, four studies additionally included patients not requiring hospitalisation for the AECOPD. Nine different settings were identified, with the majority of studies conducted in an inpatient setting (n=26) and including whole-body and strength exercises. The overall uptake was mentioned in 38 (62%) studies and was 70% with a 13% dropout rate. No paper reported the full CERT checklist. Adherence was defineda prioriin 16 (27%) studies, with the most common definition being attendance of >80% of sessions.ConclusionStudies properly reporting on the uptake and adherence of well-described interventions, including information regarding fidelity, are needed to further investigate suitable programmes for patients experiencing an AECOPD.
Airway clearance techniques for people with acute exacerbation of COPD: a scoping review
Authors: Poncin William , Schrøder Christine , Oliveira Ana , Herrero Beatriz , Cnockaert Pierre , Gely Lucile , Osadnik Christian , Reychler Gregory , Mechlenburg Inger , Spinou Arietta 
Published: January 2025

IntroductionAcute exacerbations of COPD (AECOPD) often involve mucus hypersecretion. Thus, management of sputum retention is critical. However, the use of airway clearance techniques (ACTs) in people with AECOPD across different healthcare settings and factors influencing their selection remain unclear.ObjectiveTo identify and map ACTs used for AECOPD in different healthcare settings and the factors influencing clinical decision-making worldwide.MethodsFour electronic databases and grey literature were searched from 1995 to December 2023, with hand-searching of eligible records. The Joanna Briggs Institute methodology for scoping reviews was followed.Results25 articles were included: 14 clinical studies, five guidelines/statements and six surveys/audits. Clinical studies reported the use of a wide range of single or combined ACTs, with no clear pattern in using particular ACTs in different parts of the world. Recent guidelines advise using ACTs for certain patients with AECOPD, particularly those with hypersecretion, with most guidelines recommending positive expiratory pressure (PEP) therapy. According to surveys, the most used ACTs in Australia and Europe are active cycle of breathing techniques, PEP or forced expiratory technique, while vibrations are most frequently used in Canada. Factors influencing the selection of specific ACTs include the presence of contraindications, level of dyspnoea, access to resources/equipment and ease of learning/performing the technique. All information was derived from hospital settings.ConclusionsThis scoping review identified and mapped ACTs used for people with AECOPD worldwide and their decision-making factors. Future work should focus on community settings.
Tousled-like kinase loss confers PARP inhibitor resistance in BRCA1-mutated cancers by impeding non-homologous end joining repair
Authors: Kim Min-ah , Kim Banseok , Jeon Jihyeon , Lee Jonghyun , Jang Hyeji , Baek Minjae , Seo Sang-Uk , Shin Dongkwan , Dutta Anindya , Lee Kyung Yong 
Published: January 2025

Abstract

Background
Double-strand breaks (DSBs) are primarily repaired through non-homologous end joining (NHEJ) and homologous recombination (HR). Given that DSBs are highly cytotoxic, PARP inhibitors (PARPi), a prominent class of anticancer drugs, are designed to target tumors with HR deficiency (HRD), such as those harboring BRCA mutations. However, many tumor cells acquire resistance to PARPi, often by restoring HR in HRD cells through the inactivation of NHEJ. Therefore, identifying novel regulators of NHEJ could provide valuable insights into the mechanisms underlying PARPi resistance.

Methods
Cellular DSBs were assessed using neutral comet assays and phospho-H2AX immunoblotting. Fluorescence-based reporter assays quantified repair via NHEJ or HR. The recruitment of proteins that promote NHEJ and HR to DSBs was analyzed using immunostaining, live-cell imaging following laser-induced microirradiation, and FokI-inducible single DSB generation. Loss-of-function experiments were performed in multiple human cancer cell lines using siRNA-mediated knockdown or CRISPR-Cas9 gene knockout. Cell viability assays were conducted to evaluate resistance to PARP inhibitors. Additionally, bioinformatic analyses of public databases were performed to investigate the association between TLK expression and BRCA1 status.

Results
We demonstrate that human tousled-like kinase (TLK) orthologs are essential for NHEJ-mediated repair of DSBs and for PARPi sensitivity in cells with BRCA1 mutation. TLK1 and TLK2 exhibit redundant roles in promoting NHEJ, and their deficiency results in a significant accumulation of DSBs. TLKs are required for the proper localization of 53BP1, a key factor in promoting the NHEJ pathway. Consequently, TLK deficiency induces PARPi resistance in triple-negative breast cancer (TNBC) and ovarian cancer (OVCA) cell lines with BRCA1 deficiency, as TLK deficiency in BRCA1-depleted cells, impairs 53BP1 recruitment to DSBs and reduces NHEJ efficiency, while restoring HR.

Conclusions
We have identified TLK proteins as novel regulators of NHEJ repair and PARPi sensitivity in BRCA1-depleted cells, suggesting that TLK repression may represent a previously unrecognized mechanism by which BRCA1 mutant cancers acquire PARPi resistance.
Integrating functional proteomics and next generation sequencing reveals potential therapeutic targets for Taiwanese breast cancer
Authors: Ku Wei-Chi , Liu Chih-Yi , Huang Chi-Jung , Liao Chen-Chung , Huang Yen-Chun , Kong Po-Hsin , Chen-Chan Hsieh , Tseng Ling-Ming , Huang Chi-Cheng 
Published: January 2025

Abstract
Integrating functional proteomics and next-generation sequencing (NGS) offers a comprehensive approach to unraveling the molecular intricacies of breast cancer. This study investigates the functional interplay between genomic alterations and protein expression in Taiwanese breast cancer patients. By analyzing 61 breast cancer samples using tandem mass tag (TMT) labeling and mass spectrometry, coupled with whole-exome sequencing (WES) or targeted sequencing, we identified key genetic mutations and their impact on protein expression. Notably, pathogenic variants in BRCA1, BRCA2, PTEN, and PIK3CA were found to be clinically relevant, potentially guiding targeted therapy decisions. Additionally, we discovered trans correlations between specific gene alterations (FANCA, HRAS, PIK3CA, MAP2K1, JAK2) and the expression of 22 proteins, suggesting potential molecular mechanisms underlying breast cancer development and progression. These findings highlight the power of integrating proteomics and NGS to identify potential therapeutic targets and enhance personalized medicine strategies for Taiwanese breast cancer patients.
Physalis peruviana calyces extract ameliorate oxidative stress, inflammation, and immune loss in rats-exposed to hexaflumuron
Authors: Hashem Mona M. , Hassanen Eman I. , Hassan Neven H. , Ibrahim Marwa A. , Issa Marwa Y. , Farag Mohamed A. , Hamdy Sherif A. 
Published: January 2025

Abstract

Background
Hexaflumuron (HFM), a common pesticide, can disrupt the immune system and cause oxidative stress. This study investigated the potential of Physalis peruviana L. calyces extract (PP) to counteract these effects in rats.

Methods
Rats were divided into 6 groups including control, PP-treated, HFM-exposed, and co-treated (HFM + PP) groups. Immune function, antioxidant activity, and organ damage were assessed. Furthermore, UPLC-MS/MS analysis identified potential bioactive compounds in PP extract.

Results
HFM exposure suppressed immune responses and caused organ damage. Notably, the co-administration of PP extract with HFM reversed these effects, indicating its ability to reduce oxidative stress and protect the immune system. UPLC-MS/MS analysis of PP calyces ethanolic extract revealed its richness in various health-promoting metabolites, including acyl sucrose sugar, withanolides, and flavonoids, which may provide valuable insight into the underlying mechanisms of PP’s calyces protective effects against HFM toxicity.

Conclusions
This study provides novel insights into the potential of P. peruviana L. calyces ethanolic extract as a natural agent to counteract the harmful effects of HFM exposure. These findings have significant implications for developing effective strategies to mitigate pesticide-induced toxicity and promote human health.