bluuebunny/crossref_metadata_2025_split huggingface dataset:
Standards for model-based early bactericidal activity analysis and sample size determination in tuberculosis drug development
Authors: Mockeliunas Laurynas , Faraj Alan , van Wijk Rob C. , Upton Caryn M. , van den Hoogen Gerben , Diacon Andreas H. , Simonsson Ulrika S. H. 
Published: April 2023

Background: A critical step in tuberculosis (TB) drug development is the Phase 2a early bactericidal activity (EBA) study which informs if a new drug or treatment has short-term activity in humans. The aim of this work was to present a standardized pharmacometric model-based early bactericidal activity analysis workflow and determine sample sizes needed to detect early bactericidal activity or a difference between treatment arms.Methods: Seven different steps were identified and developed for a standardized pharmacometric model-based early bactericidal activity analysis approach. Non-linear mixed effects modeling was applied and different scenarios were explored for the sample size calculations. The sample sizes needed to detect early bactericidal activity given different TTP slopes and associated variability was assessed. In addition, the sample sizes needed to detect effect differences between two treatments given the impact of different TTP slopes, variability in TTP slope and effect differences were evaluated.Results: The presented early bactericidal activity analysis approach incorporates estimate of early bactericidal activity with uncertainty through the model-based estimate of TTP slope, variability in TTP slope, impact of covariates and pharmacokinetics on drug efficacy. Further it allows for treatment comparison or dose optimization in Phase 2a. To detect early bactericidal activity with 80% power and at a 5% significance level, 13 and 8 participants/arm were required for a treatment with a TTP-EBA0-14 as low as 11 h when accounting for variability in pharmacokinetics and when variability in TTP slope was 104% [coefficient of variation (CV)] and 22%, respectively. Higher sample sizes are required for smaller early bactericidal activity and when pharmacokinetics is not accounted for. Based on sample size determinations to detect a difference between two groups, TTP slope, variability in TTP slope and effect difference between two treatment arms needs to be considered.Conclusion: In conclusion, a robust standardized pharmacometric model-based EBA analysis approach was established in close collaboration between microbiologists, clinicians and pharmacometricians. The work illustrates the importance of accounting for covariates and drug exposure in EBA analysis in order to increase the power of detecting early bactericidal activity for a single treatment arm as well as differences in EBA between treatments arms in Phase 2a trials of TB drug development.
Advanced intraoperative MRI in pediatric brain tumor surgery
Authors: Jellema Pien E. J. , Wijnen Jannie P. , De Luca Alberto , Mutsaerts Henk J. M. M. , Obdeijn Iris V. , van Baarsen Kirsten M. , Lequin Maarten H. , Hoving Eelco W. 
Published: April 2023

Introduction: In the pediatric brain tumor surgery setting, intraoperative MRI (ioMRI) provides “real-time” imaging, allowing for evaluation of the extent of resection and detection of complications. The use of advanced MRI sequences could potentially provide additional physiological information that may aid in the preservation of healthy brain regions. This review aims to determine the added value of advanced imaging in ioMRI for pediatric brain tumor surgery compared to conventional imaging.Methods: Our systematic literature search identified relevant articles on PubMed using keywords associated with pediatrics, ioMRI, and brain tumors. The literature search was extended using the snowball technique to gather more information on advanced MRI techniques, their technical background, their use in adult ioMRI, and their use in routine pediatric brain tumor care.Results: The available literature was sparse and demonstrated that advanced sequences were used to reconstruct fibers to prevent damage to important structures, provide information on relative cerebral blood flow or abnormal metabolites, or to indicate the onset of hemorrhage or ischemic infarcts. The explorative literature search revealed developments within each advanced MRI field, such as multi-shell diffusion MRI, arterial spin labeling, and amide-proton transfer-weighted imaging, that have been studied in adult ioMRI but have not yet been applied in pediatrics. These techniques could have the potential to provide more accurate fiber tractography, information on intraoperative cerebral perfusion, and to match gadolinium-based T1w images without using a contrast agent.Conclusion: The potential added value of advanced MRI in the intraoperative setting for pediatric brain tumors is to prevent damage to important structures, to provide additional physiological or metabolic information, or to indicate the onset of postoperative changes. Current developments within various advanced ioMRI sequences are promising with regard to providing in-depth tissue information.
Better decision-making skills support tactical behaviour and reduce physical wear under physical fatigue in soccer
Authors: Dambroz Felipe , Teoldo Israel 
Published: April 2023

The purpose of this study was to verify whether decision-making skills influence the tactical behavior and physical performance of soccer players under acute physical fatigue, assessed in an actual game-play. The sample was comprised of 24 trained soccer players (18.25 ± 1.48 years old) from two Brazilian clubs grouped into two categories with 12 players each (with high and low decision-making skills). The assessment of decision making, tactical behavior, and physical performance were carried out using TacticUP®, FUT-SAT, and GPSports®, respectively. Acute physical fatigue was induced through the T-SAFT90 test. Results showed that under acute physical fatigue players with high decision-making skills maintained tactical behavior efficiency and had their paces reduced, in addition to displaying reduced total distance covered (p &lt; 0.001), number of accelerations (p &lt; 0.001), and decelerations (p &lt; 0.001), and average movement speed (p &lt; 0.001). On the other hand, players with low decision-making skills displayed reduced tactical behavior efficiency (p = 0.002) and maintained their movement pace under physical fatigue. It is concluded that decision-making skills contribute to players’ tactical behavior efficiency under acute physical fatigue, besides promoting reduced physical strain in movement actions throughout the field.
Effect of unilateral training and bilateral training on physical performance: A meta-analysis
Authors: Zhang Wenfeng , Chen Xing , Xu Kun , Xie Hezhi , Li Duanying , Ding Shicong , Sun Jian 
Published: April 2023

Background:In Unilateral (UNI) exercises are more effective than bilateral (BI) exercises in improving athletic performance is debatable.Objectives:this meta-analysis investigated the effects of UNI and BI exercises on different effect indicators of jump ability, sprint ability, maximal force, change of direction ability, and balance ability.Data Sources:PubMed, Google Scholar, Web of science, CNKI, Proquest, Wan Fang Data.Study Eligibility Criteria:To be eligible for inclusion in the meta-analysis, the study had to be: 1) athletes; 2) UNI training and BI training; 3) the intervention period had to be more than 6 weeks and the intervention frequency had to be more than 2 times/week; 4) the outcome indicators were jumping ability, sprinting ability, maximum strength, and change of direction and balance.Study Appraisal and Synthesis Method:We used the random-effects model for meta-analyses. Effect sizes (standardized mean difference), calculated from measures of horizontally oriented performance, were represented by the standardized mean difference and presented alongside 95% confidence intervals (CI).Results:A total of 28 papers met the inclusion criteria, and Meta-analysis showed that UNI training was more effective than BI training in improving jumping ability (ES = 0.61.0.23 to 0.09; Z = 3.12,p= 0.002 &lt; 0.01), sprinting ability (ES = −0.02, −0.03 to −0.01; Z = 2.73,p= 0.006 &lt; 0.01), maximum strength (ES = 8.95,2.30 to 15.61; Z = 2.64,p= 0.008 &gt; 0.05), change of direction ability (ES = −0.03, −0.06 to 0.00; Z = 1.90,p= 0.06 &gt; 0.01) and balance ability (ES = 1.41,-0.62 to 3.44; Z = 1.36,p= 0.17 &gt; 0.01). The results of the analysis of moderating variables showed that intervention period, intervention frequency and intervention types all had different indicators of effect on exercise performance.Conclusion:UNI training has a more significant effect on jumping and strength quality for unilateral power patterns, and BI training has a more significant effect on jumping and strength quality for bilateral power patterns.
Associations of Physical Activity and Television Viewing With Depressive Symptoms of the European Adults
Authors: Santos João , Ihle Andreas , Peralta Miguel , Domingos Christophe , Gouveia Élvio R. , Ferrari Gerson , Werneck André , Rodrigues Filipe , Marques Adilson 
Published: April 2023

Background: While mentally passive sedentary behavior such as television viewing (TV) is often related with depressive symptoms, some research shows that physical activity (PA) may attenuate this association. Thus, this study aimed to examine the associations between TV, PA, and depressive symptoms, considering sociodemographic covariates.Methods: A sample of 29,285 adults (13,943 men; 15,342 women) with a mean age of 50.9 ± 17.4 years (50.6 ± 17.3 men; 51.1 ± 17.5 women) from the European Social Survey agreed to be respondents for this study. Data for sociodemographic variables, TV watching, PA, and depressive symptoms were self-reported. Different statistical procedures were conducted to provide evidence for the association between study variables. ANCOVA was used to analyze the association between TV watching and depressive symptoms. Linear regression analysis was conducted to analyze the association between PA and depressive symptoms. General Linear Model was performed to analyze the association of TV watching and on depressive symptoms, controlling for PA.Results: European adults who responded watching more than 2 h per day showed higher scores for depressive symptoms. Higher participation in PA was negatively and significantly associated with depressive symptoms in men (β = −0.15, 95% CI: −0.18, −0.13), and women (β = −0.23, 95% CI: −0.26, −0.21). Men spending 1–2 h/day TV watching and engaging in PA ≥ 5 days/week presented the lowest scores on depressive symptoms. The lowest scores on depressive symptoms was observed in women engaging 2–4 days/week in PA and spending &lt;1 h/day in TV watching.Conclusions: More time spent in TV watching is related with increased scores on depressive symptoms. However, regular PA participation can weaken this association.
Health needs and perception of health care quality among Asylum Seekers and Refugees in an Italian local health authority: A qualitative study
Authors: Marchetti Francesca , Preziosi Jessica , Zambri Francesca , Tambascia Gabriella , Di Nolfi Annachiara , Scardetta Paola , Splendore Flavia , Colaceci Sofia , Coia Maura , Caredda Emanuele , Masi Loredana , De Luca Vittorio , Perra Alberto , Giusti Angela 
Published: April 2023

BackgroundMigrants, Asylum Seekers and Refugees (ASRs) represent a vulnerable diversified population with increased risks of developing health problems, and in the hosting countries several barriers often hamper their access to the health services. Gathering information about ASRs’ experiences and perceptions of host country health care systems may contribute to improve the quality of health care provided. The aim of this study was to explore the health needs in their bio-psycho-social meaning, and the quality of health care as perceived from the ASRs’ perspective.MethodsThe qualitative descriptive study was conducted as part of the Project “G-START – testing a governance model of receiving and taking care of the Asylum Seekers and Refugees.” Through purposeful and snowball sampling, four Focus Groups conducted in English, Italian and French were carried out between July and August 2019, involving 50 ASRs hosted by four reception centers located on the territory pertaining to an Italian Local Health Authority covering a general population of 500.000 people. The analysis of data was categorical, and was performed using N-Vivo software.ResultsThe macro-categories emerged were the ASRs’ bio-psycho-social health needs, including mental health, sexual and reproductive health, food and nutrition, knowledge of the health care system, need for inclusion; healthcare services access, including barriers before and after the access and the ability of the local health system to respond to existing and evolving demands; strengths of the healthcare and reception systems, and suggestions for improving them in the future.Discussion and conclusionsASRs present vulnerabilities and specific health needs, and the health care system is not always able to guarantee access or to respond to these needs. Several obstacles have been highlighted, such as linguistic barriers and lack of cultural mediation, bureaucratic and administrative barriers, lack of knowledge of the Italian health care system. An effective reorganization of services driven by a more detailed output analysis of the target population needs, together with the use of cultural mediation, peer to peer education and support, and the training of health professionals are recommended to ensure a more accessible, equitable and effective health care system at local level.
Diplomatic response to global health challenges in recognizing patient needs: A qualitative interview study
Authors: Karačić Zanetti Jasna , Brown Matthew , Viđak Marin , Marušić Ana 
Published: April 2023

BackgroundGlobal health diplomacy is the applied practice of foreign affairs to further national goals that focus on health issues requiring international cooperation and collective action. We aimed to determine how international diplomats and health policy-related professionals in the EU understand the concept of health diplomacy, which impacts both diplomatic relations as well as patients' rights.MethodsIn a qualitative interview study, we used a heterogeneous stratified purposeful sampling to reach participants from different countries and different practitioners from the Pyramid of Health Diplomacy: core, multi-stakeholder, and informal. Reflexive thematic analysis was used to identify the main themes.FindingsWe contacted 131 practitioners of GHD, of which 37 responded, and nine agreed to be interviewed. From 11 interview questions, four main themes emerged from the analysis of the individual interview. The participants reported limited knowledge about the definition of GHD but also that they engaged in daily activities and decisions of inter-governmental bodies. They were not aware of existing special education and training for health attachés and made suggestions for improving the field and practice of GHD. They were not fully familiar with the European Charter of Patients' Rights. There was a consensus from all participants that patient rights need to improve as a fundamental right. They stressed the fact that the hospital lockdown and the right access to healthcare were impaired during the COVID pandemic.InterpretationThe role of health diplomacy in linking public health and foreign affairs is key to respecting patients' rights. Health over other interests is becoming an increasingly critical element in foreign policy. Establishing a clear career path for health attachés is necessary to foster effective global health agreements and coordination across countries.
Applying an equity lens to assess context and implementation in public health and health services research and practice using the PRISM framework
Authors: Fort Meredith P. , Manson Spero M. , Glasgow Russell E. 
Published: April 2023

Dissemination and implementation science seeks to enhance the uptake, successful implementation, and sustainment of evidence-based programs and policies. While a focus on health equity is implicit in many efforts to increase access to and coverage of evidence-based programs and policies, most implementation frameworks and models do not explicitly address it. Disparities may in fact be increased by emphasizing high intensity interventions or ease of delivery over meeting need within the population, addressing deep-rooted structural inequities, and adapting to local context and priorities. PRISM (Practical, Robust Implementation and Sustainability Model), the contextual expansion of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework has several elements that address health equity, but these have not been explicated, integrated, or illustrated in one place. We present guidance for applying PRISM with an equity lens across its four context domains (external environment; multi-level perspectives on the intervention; characteristics of implementers and intended audience; and the implementation and sustainability infrastructure—as well as the five RE-AIM outcome dimensions. We then present an example with health equity considerations and discuss issues of representation and participation, representativeness and the importance of ongoing, iterative assessment of dynamic context and structural drivers of inequity. We also elaborate on the importance of a continuous process that requires addressing community priorities and responding to capacity and infrastructure needs and changes. We conclude with research and practice recommendations for applying PRISM with an increased emphasis on equity.
Dietary diversity of women from soybean and non-soybean farming households in rural Zambia
Authors: Kapulu Ndashe , Chomba Christian , Nkonde Chewe , Holmes Melvin , Manda Simon , Smith Harriet E. , Macdiarmid Jennie I. , Orfila Caroline 
Published: April 2023

IntroductionSoybean farming in Zambia is promoted to increase farm productivity and diversification away from maize, and improve cash income and livelihoods for farmers. However, the impact of soybean farming on women's dietary intake is not clear. This study compares the dietary diversity of women from soybean (S) and non-soybean (NS) farming households as a pathway to understanding policy efficacy.MethodsA cross-sectional survey involving 268 women of reproductive age from 401 rural households was conducted in two soybean-producing districts of Central Province, Zambia. Data from a qualitative 7-day food frequency questionnaire (FFQ) was used to calculate dietary diversity scores (DDS), women's dietary diversity scores (WDDS-10) and assess dietary patterns. Information on household sociodemographic and agricultural characteristics was used to explore determinants of dietary diversity.ResultsResults show there were no significant differences in the mean DDS (S: 10.3 ± 2.4; NS:10.3 ± 2.6) and WDDS-10 (S:6.27 ± 1.55; NS:6.27 ± 1.57) of women from soybean and non-soybean farming households. Both cohorts had similar dietary patterns, plant-based food groups with additional fats and oils. Agricultural diversity was not associated with dietary diversity. Household wealth status was the most important determinant of dietary diversity, as women from wealthier households were more likely to have higher DDS (β = 0.262, 95% CI = 0.26 to 0.70, P &lt; 0.001) and WDDS-10 (β = 0.222, 95% CI = 0.08 to 0.37, P &lt; 0.003) compared to those from poorer households. Women from households that spent more on food had a higher DDS (β = 0.182, 95% CI = 0.002 to 0.07), but not WDDS-10 (β = 0.120, 95% CI = −0.01 to 0.03); for every additional dollar spent on food in the past 7 days, the DDS increased by 0.18. Meanwhile, soyabean farming was not statistically associated with higher wealth.ConclusionsPolicymakers and promoters of agricultural diversification and nutrition-sensitive agriculture need to consider how women can benefit directly or indirectly from soybean farming or other interventions aimed at smallholder farmers.
Land tenure, land use antecedents, and willingness to embrace resilient farming practices among smallholders in Nigeria
Authors: Kehinde Mojisola Olanike , Shittu Adebayo Musediku , Oriade Opeyemi Abosede , Edewor Sarah Edore 
Published: April 2023

IntroductionShifting to Resilient Farming Practices (RFPs) is crucial in building resilience to climate change and reducing greenhouse gas emissions. This study seeks to assess how land tenure and land-use antecedents affect the willingness of smallholder farmers (SHFs) to embrace RFPs in Nigeria.MethodsThe respondents were selected in a multi-stage random sampling process across 16 States and 192 farming communities, yielding a final sample of 1,344 SHFs that cultivate maize and/or rice. The RFPs include a set of good agricultural practices (GAPs), GAPs with manure application and GAPs with agroforestry as against the status quo of conventional agricultural practices. Data were analyzed using descriptive and regression methods.Results and discussionThe results show that 20% of the respondents were willing to adopt agroforestry while 25% and 37% were willing to adopt GAPs with and without manure application respectively. On the other hand, about 18% preferred to stick to the status quo. The multinomial logit result shows that RFPs were significantly influenced by age, education and gender of the household head, membership of the cooperative, household size, land acquisition through inheritance and purchase, newly deforested land, mechanical clearing, and bush burning. The study suggests that land titling and some level of perceived tenure security are necessary conditions for smallholder farmers to embrace RFPs in Nigeria.
Repair of fingertip defect with reverse digital artery island flap and repair of donor site with digital dorsal advancement flap
Authors: Ma Junwei , Ding Yunqi , Xu Lina , Zou Haibo , Wu Jinsheng , Shen Lin , Xing Changtai , Liu Yue , Zhou Zehui , Zhan Jie 
Published: April 2023

ObjectiveThe reverse digital artery island flap (RDAF) is widely used in repairing fingertip skin defects based on its good appearance and practicability. However, the donor area of the flap needs skin grafting, which can lead to complications. This retrospective study explored the clinical application of digital dorsal advance flap (DDAF) in repairing the donor site of the reverse digital artery island flap.MethodFrom June 2019 to February 2022, 17 patients with a soft tissue defect of the finger had been restored with the reverse digital artery island flap, and at the same time, the donor area was repaired with digital dorsal advance flap (DDAF). The sensitivity, the active range of motion (ROM) and patient satisfaction were assessed after the operation.ResultsAll flaps survived completely without skin grafting with only one linear scar. The sensory and motor functions of all patients recovered well. Assessment based on the Michigan Hand Outcomes Questionnaire (MHQ) showed satisfactory functional recovery for all patients.ConclusionsReconstruction using RDAF combined with DDAF represents an effective alternative for repairing fingertip skin defects.