bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Confidence, Certification, and Connectedness: Impact of a Journal Club for Inpatient Psychiatry Faculty
Authors: Im David S. , Brelje Andrea , Raghunandan Christina , Stchur Laura , Lyden Angela , Hong Allison , Bornheimer Lindsay A. 
Published: January 2025

INTRODUCTION Inpatient psychiatry faculty manage complex clinical, administrative, and legal issues amid increasing mental health service utilization rates, limiting time for (1) focusing on lifelong learning and (2) connecting. We examined the impact of a monthly journal club on inpatient psychiatry faculty's (1) confidence that their practice is evidence informed, (2) stress related to board recertification, and (3) sense of connectedness with peers. METHODS We employed a primarily qualitative approach using semi-structured interviews and brief survey questions to elicit input from inpatient psychiatry faculty at an academic medical center on their experience participating in a monthly journal club, including perceived changes in one's practice of evidence-based medicine, recertification stress, and connectedness with peers. RESULTS Thirteen faculty who participated in the journal club responded to at least one survey or interview. Many faculty reported feeling more confident that their clinical practice was evidence informed, less stressed about board recertification, and more connected to peers at 6 and 12 months following the commencement of the journal club. Following in-person attendance, video-based learning (an innovative method of participating in the journal club) was found to be the second most preferred method of participation among respondents. All respondents noted that the journal club was a valuable use of their time and enjoyable. CONCLUSION A monthly journal club has the potential to increase hospital psychiatry faculty confidence in evidence-based clinical practice, reduce board recertification stress, and improve sense of peer connectedness. Future research should examine the journal club experience and impact among a larger number of faculty and incorporate additional measures of learning outcomes.
Development, validation, and usage of metrics to evaluate the quality of clinical research hypotheses
Authors: Jing Xia , Zhou Yuchun , Cimino James J. , Shubrook Jay H. , Patel Vimla L. , De Lacalle Sonsoles , Weaver Aneesa , Liu Chang 
Published: January 2025

Abstract

Objectives
Metrics and instruments can provide guidance for clinical researchers to assess their potential research projects at an early stage before significant investment. Furthermore, metrics can also provide structured criteria for peer reviewers to assess others’ clinical research manuscripts or grant proposals. This study aimed to develop, test, validate, and use evaluation metrics and instruments to accurately, consistently, systematically, and conveniently assess the quality of scientific hypotheses for clinical research projects.

Materials and methods
Metrics development went through iterative stages, including literature review, metrics and instrument development, internal and external testing and validation, and continuous revisions in each stage based on feedback. Furthermore, two experiments were conducted to determine brief and comprehensive versions of the instrument.

Results
The brief version of the instrument contained three dimensions: validity, significance, and feasibility. The comprehensive version of metrics included novelty, clinical relevance, potential benefits and risks, ethicality, testability, clarity, interestingness, and the three dimensions of the brief version. Each evaluation dimension included 2 to 5 subitems to evaluate the specific aspects of each dimension. For example, validity included clinical validity and scientific validity. The brief and comprehensive versions of the instruments included 12 and 39 subitems, respectively. Each subitem used a 5-point Likert scale.

Conclusion
The validated brief and comprehensive versions of metrics can provide standardized, consistent, systematic, and generic measurements for clinical research hypotheses, allow clinical researchers to prioritize their research ideas systematically, objectively, and consistently, and can be used as a tool for quality assessment during the peer review process.
Detection of low frequency artemisinin resistance mutations, C469Y, P553L and A675V, and fixed antifolate resistance mutations in asymptomatic primary school children in Kenya
Authors: Osoti Victor , Wamae Kevin , Ndwiga Leonard , Gichuki Paul M. , Okoyo Collins , Kepha Stella , Keitany Kibor , Kandie Regina , Aricha Stephen , Kiplagat Rosebella , Mwandawiro Charles , Bejon Philip , Snow Robert W. , Ochola-Oyier Lynette Isabella 
Published: January 2025

Abstract

Background
To understand the emergence and spread of drug-resistant parasites in malaria-endemic areas, accurate assessment and monitoring of antimalarial drug resistance markers is critical. Recent advances in next-generation sequencing (NGS) technologies have enabled the tracking of drug-resistant malaria parasites.

Methods
In this study, we used Targeted Amplicon Deep Sequencing (TADS) to characterise the genetic diversity of the Pfk13, Pfdhfr, Pfdhps, and Pfmdr1 genes among primary school-going children in 15 counties in Kenya (Bungoma, Busia, Homa Bay, Migori, Kakamega, Kilifi, Kirinyaga, Kisii, Kisumu, Kwale, Siaya, Tana River, Turkana, Vihiga and West Pokot). A total of 920 dried blood spot (DBS) samples collected from 121 selected primary schools within the country were used to extract genomic DNA. A nested polymerase chain reaction (PCR) was used to generate amplicons that were sequenced to determine the prevalence of known and novel polymorphisms.

Results

Pfk13 mutations associated with artemisinin resistance were present as mixed genotype infections for the C469Y mutation in 23 samples (4%), the A675V mutation in 2 samples (1.7%), and the P553L mutation in 7 samples (1.2%). The A578S mutation, was also identified in mixed infections, appearing in 15.2% of the 87 samples analysed. The Pfdhfr 51I and 108 N pyrimethamine-resistance mutations were at fixation (100% frequency), and the Pfmdr1 Y184F mutation, which is linked to reduced susceptibility to several antimalarial drugs, especially those used in combination therapies for malaria treatment, was detected in 97.5% of the samples as mixed-genotype infections.

Conclusion
The genomic surveillance of asymptomatic school children in Kenya provides an early warning signal of at least 1 of the 3 validated artemisinin resistance mutations circulating in all regions in Western Kenya sampled except Homa Bay and Kisii Counties. These signals in asymptomatic and mixed infections would have been missed without deep sequencing.
Toward a Computable Phenotype for Determining Eligibility of Lung Cancer Screening Using Electronic Health Records
Authors: Yang Shuang , Huang Yu , Lou Xiwei , Lyu Tianchen , Wei Ruoqi , Mehta Hiren J. , Wu Yonghui , Alvarado Michelle , Salloum Ramzi G. , Braithwaite Dejana , Huo Jinhai , Shih Ya-Chen Tina , Guo Yi , Bian Jiang 
Published: January 2025

PURPOSE
Lung cancer screening (LCS) has the potential to reduce mortality and detect lung cancer at its early stages, but the high false-positive rate associated with low-dose computed tomography (LDCT) for LCS acts as a barrier to its widespread adoption. This study aims to develop computable phenotype (CP) algorithms on the basis of electronic health records (EHRs) to identify individual's eligibility for LCS, thereby enhancing LCS utilization in real-world settings.

MATERIALS AND METHODS
The study cohort included 5,778 individuals who underwent LDCT for LCS from 2012 to 2022, as recorded in the University of Florida Health Integrated Data Repository. CP rules derived from LCS guidelines were used to identify potential candidates, incorporating both structured EHR and clinical notes analyzed via natural language processing. We then conducted manual reviews of 453 randomly selected charts to refine and validate these rules, assessing CP performance using metrics, for example, F1 score, specificity, and sensitivity.

RESULTS
We developed an optimal CP rule that integrates both structured and unstructured data, adhering to the US Preventive Services Task Force 2013 and 2020 guidelines. This rule focuses on age (55-80 years for 2013 and 50-80 years for 2020), smoking status (current, former, and others), and pack-years (≥30 for 2013 and ≥20 for 2020), achieving F1 scores of 0.75 and 0.84 for the respective guidelines. Including unstructured data improved the F1 score performance by up to 9.2% for 2013 and 12.9% for 2020, compared with using structured data alone.

CONCLUSION
Our findings underscore the critical need for improved documentation of smoking information in EHRs, demonstrate the value of artificial intelligence techniques in enhancing CP performance, and confirm the effectiveness of EHR-based CP in identifying LCS-eligible individuals. This supports its potential to aid clinical decision making and optimize patient care.
Frequency and Impact of Constitutional Mismatch Repair Deficiency in Patients With High-Grade Glioma, a Retrospective Analysis of 7 Years in Pakistan: an IRRDC Study
Authors: Mushtaq Naureen , Minhas Khurram , Bashir Farrah , Zahid Soha , Qureshi Bilal Mazhar , Javed Gohar , Resham Shahzadi , Das Anirban , Hawkins Cynthia , Tabori Uri , Bouffet Eric 
Published: January 2025

PURPOSE
Constitutional mismatch repair deficiency (CMMRD) is a genetic cancer predisposition syndrome among children and young adults. This study aimed to evaluate the frequency of CMMRD among patients with pediatric high-grade glioma (pHGG) in a single tertiary care center in Pakistan, a country with high consanguinity rates.

PATIENTS AND METHODS
We reviewed the data of patients age <18 years with pHGG, anaplastic astrocytoma, and diffuse midline glioma (DMG) with CMMRD testing between 2016 and 2023. CMMRD testing was done using the Aronson et al criteria. A few patients were sent to Sick Kids, Toronto, to review the mismatch repair protein stains via multigene panels.

RESULTS

Forty-seven patients were identified, with a median age of 11 years (IQR, 8-16). Headache (89.4%) was the most common symptom. Thirty-seven patients had hemispheric tumors; 12.8% and 8.5% had posterior fossa and midline tumors, respectively. Histopathology revealed 70.2% glioblastoma, 23.4% anaplastic astrocytoma, and 6.4% DMG. CMMRD was positive in 15 of 47 patients (31.9%). Eight patients had loss of
PMS2
. Three had loss of
PMS2
and
MLH1
; two had loss of
MSH6
, one had loss of
MSH6
and
MSH2
, and only one patient had loss of
MSH2
. Consanguinity and family history of malignancy correlated with CMMRD (
P
= .009,
P
= .031, respectively). Two-year overall survival of all patients was 23.4% (median follow-up, 0.59 years [95% CI, 0.000 to 1.171]). Two-year overall survival of mismatch repair deficiency–positive patients was 20% (median follow-up, 0.910 years [95 CI, 0.380 to 1.440]).

CONCLUSION
We found a high frequency of CMMRD among patients with pHGG, particularly with positive consanguinity. Our study highlights the significance of genetic testing and surveillance. It is essential to develop low and middle income country-tailored protocols due to limited access and financial constraints associated with using immune checkpoint inhibitors.
Multicentric Cross-Sectional Survey to Assess the Variation of Fractionation Strategies Used in the Management of Head and Neck Cancers in the Asian Region (INNOCENCE-ASIA)
Authors: Gandhi Ajeet Kumar , Chopra Supriya , Rastogi Madhup , Mallick Indranil , Cruz Misael C. , Yasuda Koichi , Sum Ying Ying , Nagata Yasushi , Wu Hong-Gyun , Prajogi Gregorius B. , Kodrat Henry , Ma Mingwei , Nisar Asif , Chitapanarux Imjai 
Published: January 2025

PURPOSE
Head and neck cancers (HNCs) are in general treated with conventional fractionation regimen of 1.8-2 Gy per fraction. Altered fractionation (ALFT) strategies such as hypofractionation radiotherapy (HYPO-RT), accelerated fractionation radiotherapy (AFRT), and hyperfractionation radiotherapy (HFRT) have not been practiced uniformly across centers in different parts of the world. Countries in Asia share common cancer demographics, and we designed this survey for Federation of Asian Radiation Oncology (FARO) member countries to understand the usage and challenges in the delivery of ALFT in HNCs.

MATERIALS AND METHODS
A 21-point electronic survey (Federation of Asian Radiation Oncology Research Network [FERN]-S-005) was designed by the FERN and was circulated through the FARO research secretariat to the FARO council member countries and the responses were collected between August and November 2023.

RESULTS
Twelve of 14 member countries (85.7%) responded to the survey. Twenty-seven responses were received and 78% of the respondents belonged to government/teaching academic institute. 4/27 (14.8%) reported never using HYPO-RT for any of the clinical subsite of HNCs, while the majority (85.2%) used it for glottic cancers and 22% also used it for postoperative setting. Majority (77.7%) used a fractionation schedule with dose per fraction ranging between 2.2 and 2.5 Gy. 6/27 (22.2%) used AFRT for definitive setting and five of these also used concurrent chemoradiotherapy. 4/27 (14.8%) centers reported using HFRT. The most common reason (62.9%) for the limited usage of AFRT/HFRT was reported to be logistical, such as unavailability of machine slots, patient load, and so on.

CONCLUSION
The result of the survey suggests that among the ALFT strategies for HNCs, HYPO-RT schedules have common interest and feasibility among the FARO member countries and also highlights the challenges in the delivery of AFRT/HFRT in the Asian region.
Efficacy and Safety of Short Intravenous Hydration for Preventing Nephrotoxicity From High-Dose Cisplatin: A Randomized, Open-Label, Phase II Trial
Authors: Jantarat Apichart , Thamlikitkul Lucksamon , Thephamongkhol Kullathorn , Setakornnukul Jiraporn , Phisalprapa Pochamana , Kositamongkol Chayanis , Srithongkul Thatsaphan , Ithimakin Suthinee 
Published: January 2025

PURPOSE
The use of short hydration (SH) to prevent cisplatin-induced nephrotoxicity lacks substantive prospective evaluation. The aim of this study was to evaluate the safety and efficacy of SH, including those with head and neck cancer (HNC) who are at higher risks of mucositis that causes diminished oral intake.

METHODS

This phase II randomized noncomparative trial included patients with cancer who were scheduled to receive high-dose cisplatin (≥60 mg/m
2
) in combination with another chemotherapy or concurrently with radiotherapy. Patients were randomly assigned to receive either the SH or conventional hydration (CH) protocol. The primary end point was the proportion of patients with increased serum creatinine (SCr) after undergoing SH. Secondary end points included the severity of SCr elevation, adverse events, cisplatin modification as a result of nephrotoxicity, duration of hospital stay, quality of life (QoL), and cost.

RESULTS
Among 100 enrolled patients, 64 and 36 patients underwent the SH and CH protocols, respectively. The median duration of chemotherapy infusion and intravenous hydration were 5.79 and 27.58 hours with SH and CH, respectively. A total of 32.8% and 33.3% of the SH and CH groups, respectively, experienced SCr elevation. Grade 2 SCr elevations were rarely observed in both groups (1.6% in SH, 2.8% in CH). Rate of cisplatin modification was similar between the two groups. Out of 82 patients with HNC, the rate of SCr elevation was comparable for both hydration protocols. The QoL scores were meaningfully higher in the SH group during the second cycle of cisplatin, although the overall direct medical costs were similar.

CONCLUSION
The SH protocol is feasible and safe, with a remarkably reduced duration of administration. Thus, SH can be an alternative to CH in the prevention of cisplatin-related nephrotoxicity.
Supports for informal caregivers of people living with dementia in the Middle East and North Africa Region: realist review
Authors: Alyafei Amani , Swarbrick Caroline , Holland Carol 
Published: January 2025

In the Middle East and North Africa (MENA) region, the commitment to honour parents and keep private ‘issues’ within the home combine to shape caregiving styles and needs. Evidence on the effectiveness of interventions for informal caregivers for people living with dementia in the MENA region is lacking. This study offers an overview of interventions for caregivers. It also explores informal caregivers’ needs, preferences and views on addressing intervention through online content. A middle-range programme theory is developed to provide insight into the mechanisms underpinning the interventions.
A realist review approach was used to explore what intervention types and features support the informal caregivers of people living with dementia throughout the MENA region and to examine in which contexts and how these interventions worked. The realist synthesis included 23 articles and eight interviews with health professionals. Eight context–mechanism–outcome configurations (CMOCs) were extrapolated to build and iteratively refine a middle-range programme theory and finalise it for testing. Contextual conditions that emerged include stigma, long care duration, culture, lack of support and the effect of this on intervention uptake. Mechanisms reported include feeling supported and empowering caregivers with the skills, knowledge and support they need, which led to outcomes such as improved quality of life for people living with dementia and caregivers and reduction in stress for caregivers.
This article contributes to the limited literature by addressing an identified gap in knowledge, providing insights into informal caregivers of people living with dementia in the MENA region to understand why particular interventions work or not, and in what contexts.
Integrating post-validation surveillance of lymphatic filariasis with the WHO STEPwise approach to non-communicable disease risk factor surveillance in Niue, a study protocol
Authors: Craig Adam T. , Lawford Harriet , Mokoia Grizelda , Ikimau Minerva , Fetaui Peter , Marqardt Tonia , Lau Colleen L. 
Published: January 2025

Background
Lymphatic filariasis (LF), a mosquito-borne parasitic disease caused by three species of filarial worms, was first detected in Niue, a small Pacific Island nation of approximately 1,600 people, in 1954. After extensive efforts involving multiple rounds of Mass Drug Administration, Niue was validated by the World Health Organization (WHO) as having e4liminated LF as a public health problem in 2016. However, no surveillance has been conducted since validation to confirm infection rates have remained below WHO’s elimination threshold. WHO has encouraged an integrated approach to disease surveillance and integrating LF post-validation surveillance (PVS) with existing surveys is an anticipated recommendation of the upcoming WHO LF-PVS guidelines. This paper describes a protocol for the implementation of an integrated approach to LF-PVS in Niue as cost-efficient and operationally feasible means of monitoring the disease in the population.

Methods
The LF-PVS will be implemented as part of a planned national population-based WHO STEPwise approach to non-communicable disease (NCD) risk factor surveillance (STEPS) in Niue. Integration between the LF-PVS and STEPS will occur at multiple points, including during pre-survey community awareness raising and engagement, when obtaining informed consent, during the collection of demographics, risk factor, and location data, and when collecting finger-prick blood samples (for glucose as part of the STEPS survey and LF as part of the LF-PVS). The primary outcome measure for LF transmission will be antigen positivity. Microfilaria slides will be prepared for any antigen-positive cases. Dried blood spots will be prepared for all participants for Multiplex Bead Assays-based analysis to detect anti-filarial antibodies. We estimate a total sample size of 1,062 participants aged 15–69, representing approximately 66% of the population.

Conclusions
The results of this study will provide insight into the status of LF in Niue and evaluate the advantages, challenges, and opportunities offered by integrated approaches to disease surveillance.
Environmental maternal exposures and the risk of premature birth and intrauterine growth restriction: The Generation Gemelli study protocol of newborn exposome
Authors: Villani Leonardo , Pezzullo Angelo Maria , Pastorino Roberta , Maio Alessandra , Stollagli Francesca , Tirone Chiara , Barba Marta , Cozzolino Angela Maria , Pires Marafon Denise , Porcelli Martina , Sbordone Annamaria , Patti Maria Letizia , Bottoni Anthea , Paladini Angela , Fattore Simona , Romeo Domenico Marco , Parolini Ornella , Lattanzi Wanda , Rindi Guido , Tamagnone Luca , Marazza Marco , Genuardi Maurizio , Tabolacci Elisabetta , Mercuri Eugenio Maria , Chiaretti Antonio , Pasciuto Tina , Sanguinetti Maurizio , Valentini Vincenzo , Scambia Giovanni , Ricciardi Walter , Vento Giovanni , Lanzone Antonio , Boccia Stefania 
Published: January 2025

Background
The study of women exposures and child outcomes occurring in the first 1,000 days of life since conception enhances understanding of the relationships between environmental factors, epigenetic changes, and disease development, extending beyond childhood and spanning the entire lifespan. Generation Gemelli is a recently launched case-control study that enrolls mother-newborns pairs in one of the largest university hospitals in Italy, in order to examine the association between maternal environmental exposures and intrauterine growth restriction (IUGR) and the risk of premature birth. The study will also evaluate the association of maternal exposures and the health and growth of infants and children up to 24 months of age.

Methods
The study entails the set-up of a case-control study within a birth cohort. With approximately 4,000 annual deliveries, we aim to enroll 140 cases (newborns with IUGR and premature birth) and 280 controls per year, from September 2022. A comprehensive questionnaire will be used to gather information about various types of maternal environmental exposures before and during pregnancy. We will collect biological samples from both mothers and newborns (including vaginal swab, placenta sample, blood, saliva, meconium, and bronchoalveolar lavage fluid) at birth and within the early hours of the newborn’s life. We will perform laboratory examinations including dosage of heavy metals and essential elements, investigation of placental distress and fetal brain damage of biomarkers, analysis of microbiota and of DNA methylation profile. We will conduct clinical follow-up assessments in both cases and controls at months 12 and 24 and we will collect anthropometric data, feeding types with particular reference to breastfeeding and its duration, pediatric emergency room visits, hospitalizations, medication usage, known allergies, and neuropsychological development.

Discussion
The Generation Gemelli case-control study holds the promise of significantly enhancing our comprehension of how maternal environmental exposures relate to the health of children and the broader population. The study of the exposome will provide insights into the relationships between environmental exposures, epigenetic changes and health outcomes during the first 1000 days of life and onward.