bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality assessment of clinical practice guidelines in Kenya using the AGREE II tool: a methodological review
Authors: Sagam Caleb Kimutai , Were Lisa M , Otieno Jenifer A , Mulaku Mercy N , Kariuki Simon , Ochodo Eleanor 
Published: July 2023

ObjectiveTo assess the quality of available and accessible national Clinical Practice Guidelines (CPGs) in Kenya using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool.MethodsWe searched the websites of the Kenyan Ministry of Health, professional associations and contacted experts in relevant organisations. Our scope was guidelines on maternal, neonatal, nutritional disorders, injuries, communicable and non-communicable diseases in Kenya published in the last 5 years until 30 June 2022. Study selection and data extraction were done by three independent reviewers with disagreements resolved via discussion or with a senior reviewer. We conducted a quality assessment using the online English version of AGREE II tool across six domains. Descriptive statistics were analysed using Stata software V.17. The primary outcome was the methodological quality of the included CPGs assessed by the AGREE II tool score.ResultsWe retrieved 95 CPGs and included 24 in the analysis after screening for eligibility. The CPGs scored best in clarity of presentation and least in the rigour of development. In descending order, the appraisal scores (mean and CI) per domain were as follows: Clarity of presentation 82.96% (95% CI 78.35% to 87.57%) with all guidelines scoring above 50%. Scope and purpose 61.75% (95% CI 54.19% to 69.31%) with seven guidelines scoring less than 50%. Stakeholder involvement 45.25% (95% CI 40.01% to 50.49%) with 16 CPGs scoring less than 50%. Applicability domain 19.88% (95% CI 13.32% to 26.43%) with only one CPG scoring above 50%. Editorial independence 6.92% (95% CI 3.47% to 10.37%) with no CPG scoring above 50% and rigour of development 3% (95% CI 0.61% to 5.39%) with no CPG scoring at least 50%.ConclusionOur findings suggest that the quality of CPGs in Kenya is limited mainly by the rigour of development, editorial independence, applicability and stakeholder involvement. Training initiatives on evidence-based methodology among guideline developers are needed to improve the overall quality of CPGs for better patient care.
Physician engagement in organisational patient safety through the implementation of a Medical Safety Huddle initiative: a qualitative study
Authors: Rotteau Leahora , Othman Dalia , Dunbar-Yaffe Richard , Fortin Chris , Go Katharyn , Mayo Amanda , Pelc Jordan , Wolfstadt Jesse , Guo Meiqi , Soong Christine 
Published: July 2023

BackgroundEfforts to increase physician engagement in quality and safety are most often approached from an organisational or administrative perspective. Given hospital-based physicians’ strong professional identification, physician-led strategies may offer a novel strategic approach to enhancing physician engagement. It remains unclear what role medical leadership can play in leading programmes to enhance physician engagement. In this study, we explore physicians’ experience of participating in a Medical Safety Huddle initiative and how participation influences engagement with organisational quality and safety efforts.MethodsWe conducted a qualitative study of the Medical Safety Huddle initiative implemented across six sites. The initiative consisted of short, physician focused and led, weekly meetings aimed at reviewing, anticipating and addressing patient safety issues. We conducted 29 semistructured interviews with leaders and participants. We applied an interpretive thematic analysis to the data using self-determination theory as an analytic lens.ResultsThe results of the thematic analysis are organised in two themes, (1) relatedness and meaningfulness, and (2) progress and autonomy, representing two forms of intrinsic motivation for engagement that we found were leveraged through participation in the initiative. First, participation enabled a sense of community and a ‘safe space’ in which professionally relevant safety issues are discussed. Second, participation in the initiative created a growing sense of ability to have input in one’s work environment. However, limited collaboration with other professional groups around patient safety and the ability to consistently address reported concerns highlights the need for leadership and organisational support for physician engagement.ConclusionThe Medical Safety Huddle initiative supports physician engagement in quality and safety through intrinsic motivation. However, the huddles’ implementation must align with the organisation’s multipronged patient safety agenda to support multidisciplinary collaborative quality and safety efforts and leaders must ensure mechanisms to consistently address reported safety concerns for sustained physician engagement.
An efficient strategy for evaluating new non-invasive screening tests for colorectal cancer: the guiding principles
Authors: Bresalier Robert S , Senore Carlo , Young Graeme P , Allison James , Benamouzig Robert , Benton Sally , Bossuyt Patrick M M , Caro Luis , Carvalho Beatriz , Chiu Han-Mo , Coupé Veerle M H , de Klaver Willemijn , de Klerk Clasine Maria , Dekker Evelien , Dolwani Sunil , Fraser Callum G , Grady William , Guittet Lydia , Gupta Samir , Halloran Stephen P , Haug Ulrike , Hoff Geir , Itzkowitz Steven , Kortlever Tim , Koulaouzidis Anastasios , Ladabaum Uri , Lauby-Secretan Beatrice , Leja Mārcis , Levin Bernard , Levin Theodore Robert , Macrae Finlay , Meijer Gerrit A , Melson Joshua , O'Morain Colm , Parry Susan , Rabeneck Linda , Ransohoff David F , Sáenz Roque , Saito Hiroshi , Sanduleanu-Dascalescu Silvia , Schoen Robert E , Selby Kevin , Singh Harminder , Steele Robert J C , Sung Joseph J Y , Symonds Erin Leigh , Winawer Sidney J 
Published: July 2023

ObjectiveNew screening tests for colorectal cancer (CRC) are rapidly emerging. Conducting trials with mortality reduction as the end point supporting their adoption is challenging. We re-examined the principles underlying evaluation of new non-invasive tests in view of technological developments and identification of new biomarkers.DesignA formal consensus approach involving a multidisciplinary expert panel revised eight previously established principles.ResultsTwelve newly stated principles emerged. Effectiveness of a new test can be evaluated by comparison with a proven comparator non-invasive test. The faecal immunochemical test is now considered the appropriate comparator, while colonoscopy remains the diagnostic standard. For a new test to be able to meet differing screening goals and regulatory requirements, flexibility to adjust its positivity threshold is desirable. A rigorous and efficient four-phased approach is proposed, commencing with small studies assessing the test’s ability to discriminate between CRC and non-cancer states (phase I), followed by prospective estimation of accuracy across the continuum of neoplastic lesions in neoplasia-enriched populations (phase II). If these show promise, a provisional test positivity threshold is set before evaluation in typical screening populations.Phase IIIprospective studies determine single round intention-to-screen programme outcomes and confirm the test positivity threshold.Phase IVstudies involve evaluation over repeated screening rounds with monitoring for missed lesions. Phases III and IV findings will provide the real-world data required to model test impact on CRC mortality and incidence.ConclusionNew non-invasive tests can be efficiently evaluated by a rigorous phased comparative approach, generating data from unbiased populations that inform predictions of their health impact.
Influence of cardiorespiratory fitness and MRI measures of neuroinflammation on hippocampal volume in multiple sclerosis
Authors: Morozumi Tetsu , Preziosa Paolo , Meani Alessandro , Albergoni Matteo , Margoni Monica , Pagani Elisabetta , Filippi Massimo , Rocca Maria A 
Published: July 2023

BackgroundThe hippocampus is a clinically relevant region where neurogenesis and neuroplasticity occur throughout the whole lifespan. Neuroinflammation and cardiorespiratory fitness (CRF) may influence hippocampal integrity by modulating the processes promoting neurogenesis and neuroprotection that contribute to the preservation of functions. This study aimed to investigate the effects of neuroinflammation and CRF on hippocampal volume in multiple sclerosis (MS) patients with relapsing-remitting (RR) and progressive (P) clinical phenotypes. The influence of neuroinflammation and CRF on brain, grey matter (GM) and thalamic volumes was also assessed to determine whether the effects were specific for the hippocampus.MethodBrain 3T structural MRI scans and maximum oxygen consumption (VO2max), a proxy of CRF, were acquired from 81 MS patients (27 RR and 54 P) and 45 age-matched and sex-matched healthy controls. T2-hyperintense white matter lesion volume (T2-LV) and choroid plexuses volume (CPV) were quantified as neuroinflammatory measures. Associations of demographic, clinical, neuroinflammatory and CRF measures with normalised brain, GM, hippocampal and thalamic volumes in relapsing-remitting MS (RRMS) and progressive MS patients were assessed using Shapley and best subset selection regression.ResultsFor most volumetric measures, the largest portions of variance were explained by T2-LV (variable importance (VI)=9.4–39.4) and CPV (VI=4.5–26.2). VO2max explained the largest portion of variance of normalised hippocampal volume only in RRMS patients (VI=16.9) and was retained as relevant predictor (standardised β=0.374, p=0.023) with T2-LV (standardised β=−0.330, p=0.016).ConclusionsA higher CRF may play a specific neuroprotective role on MS patients’ hippocampal integrity, but only in the RR phase of the disease.
Running vacuum in QFT in FLRW spacetime: the dynamics of $$\rho _{\textrm{vac}}(H)$$ from the quantized matter fields
Authors: Moreno-Pulido Cristian , Peracaula Joan Solà , Cheraghchi Samira 
Published: July 2023

AbstractPhenomenological work in the last few years has provided significant support to the idea that the vacuum energy density (VED) is a running quantity with the cosmological evolution and that this running helps to alleviate the cosmological tensions afflicting the $$\Lambda $$
Λ
CDM. On the theoretical side, recent devoted studies have shown that the properly renormalized $$\rho _{\textrm{vac}}$$

ρ
vac

in QFT in FLRW spacetime adopts the ‘running vacuum model’ (RVM) form. While in three previous studies by two of us (CMP and JSP) such computations focused solely on scalar fields non-minimally coupled to gravity, in the present work we compute the spin-1/2 fermionic contributions and combine them both. The calculation is performed using a new version of the adiabatic renormalization procedure based on subtracting the UV divergences at an off-shell renormalization point M. The quantum scaling of $$\rho _{\textrm{vac}}$$

ρ
vac

with M turns into cosmic evolution with the Hubble rate, H. As a result the ‘cosmological constant’ $$\Lambda $$
Λ
appears in our framework as the nearly sustained value of $$8\pi G(H)\rho _{\textrm{vac}}(H)$$

8
π
G

(
H
)

ρ
vac

(
H
)

around (any) given epoch H, where G(H) is the gravitational coupling, which is also running, although very mildly (logarithmically). We find that the VED evolution at present reads $$\delta \rho _\textrm{vac}(H)\sim \nu _{\textrm{eff}}\, m_{\textrm{Pl}}^2 \left( H^2-H_0^2 \right) \ (|\nu _{\textrm{eff}}|\ll 1)$$

δ

ρ
vac

(
H
)

∼

ν
eff

m

Pl

2

H
2

-

H
0
2

(
|

ν
eff

|
≪
1
)

. The coefficient $$\nu _{\textrm{eff}}$$

ν
eff

receives contributions from all the quantized fields, bosons and fermions, which we compute here for an arbitrary number of matter fields. Remarkably, there also exist higher powers $$\mathcal{O}(H^{6})$$

O
(

H
6

)

which can trigger inflation in the early universe. Finally, the equation of state (EoS) of the vacuum receives also quantum corrections from bosons and fermion fields, shifting its value from − 1. The striking consequence is that the EoS of the quantum vacuum may nowadays effectively appears as quintessence.
Morphological surveys of the sagittal otolith of marine gobiid fish (Teleostei: Gobioidei)
Authors: Iranmanesh Mahdi , Askari Hesni Majid , Lashkari Mohammadreza 
Published: July 2023

Abstract
The challenges fish face in intraspecific communication has resulted in adaptation in different parts of their sensory system, including the auditory system. Evidence suggests that the sensory capability is specific for each species. The otolith is a part of the auditory system of teleost fish, and plays an important role in maintaining balance and in hearing. According to previous research, the morphological variation of otoliths is a result of a synergy between genetic and environmental factors such as depth, diet, swimming, and substrates. In this research we focused to explain (1) morphological variations of the otolith of gobiid fish as an animal inhabiting both aquatic and terrestrial environments; (2) the use of this morphological variations for distinguishing gobiid fish; and (3) how communication systems adapt to the local environment. The sagittal otoliths of six species of gobiid fish were extracted and described. In the next step, we studied the sagittal otoliths using the geometric morphometrics method and shape indices. The most common characteristics of the sagitta in the studied gobies fish were the median and mesial sulcus and the absence of a clear rostrum and antirostrum. A comparison between the examined methods showed that the geometric morphometric approach was able to detect the subtle differences between gobies species. Moreover, it seems that lifestyle and vision could affect the efficiency of the auditory system, in particular the otolith shape. For example, it seems the specific otolith shape of Periophthalmus waltoni (a species that unlike other fish spends most of its time out of the water) perhaps is a result of adaptation to land and water.
MiR-128-3p promotes the progression of deep venous thrombosis through binding SIRT1
Authors: Han Jinan , Hao Wanjiang , Ma Yanping , Hou Yanqiu 
Published: July 2023

Objectives This research aimed to study the effect of microRNA-128-3p (miR-128-3p) on deep venous thrombosis (DVT). Method The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, Transwell chamber method, and flow cytometry technique were used in the cell experiments. Potential interconnection between miR-128-3p and silent information regulator sirtuin 1 (SIRT1) was revealed by luciferase activity. The concentration of miR-128-3p and mRNA SIRT1 was assessed by quantitative reverse transcription polymerase chain reaction (qRT-PCR). The receiver operating characteristic (ROC) curve was used to test the predictive effect of miR-128-3p in DVT. Results Decreased miR-128-3p expression was beneficial to cell proliferation and migration and inhibited inflammation, apoptosis, and adhesion of human umbilical vein endothelial cells (HUVECs). The impacts of miR-128-3p on HUVECs were achieved by targeting SIRT1. MiR-128-3p was upregulated in patients with DVT, and it was of great significance in differentiating patients with DVT. Conclusion Overexpression of miR-128-3p might become a biomarker for patients with DVT.
MRI reliability in pediatric abdominal lymph node metastases?
Authors: Gülçin Bozbeyoğlu Sabriye , Perçem Orhan Söylemez Umut , Gündüz Nesrin 
Published: July 2023

Background Although positron emission tomography-computed tomography (PET-CT) is an effective imaging method used in the detection of lymph node metastases, repeated imaging increases X-ray exposure, especially in pediatric patients. Magnetic resonance imaging (MRI) may detect abdominal lymph nodes and provide subtle anatomic detail, and functional information without radiation. Purpose To evaluate the reliability of MRI in detecting lymph node metastases in pediatric abdominal malignancies and to determine whether X-ray dose can be reduced by comparing its effectiveness with PET-CT. Material and Methods Patients aged <18 years, diagnosed with abdominal malignant solid lesions between January 2015 and 2022 were included in this retrospective single-center study. A total of 14 A total of 14 different anatomic locations were defined for lymph nodes in MRI and PET-CT examinations. Cohen's kappa test was used to evaluate the consistency between PET-CT and MRI. P < 0.05 was considered statistically significant. Results In total, 25 patients (18 [72%] girls, 7 [28%] boys; mean age = 9.32 ± 16.9 years; age range = 1–18 years) with abdominal solid malignant tumors were included. The reliability of MRI and inter-observer reliability differed depending on the location of the lymph nodes. The reliability was almost perfect for the internal iliac (k = 0.915), porta hepatis, and aortocaval lymph node stations, while fair reliability was observed for the mesenteric lymph nodes (k = 0.525). Conclusion The results showed that MRI was as reliable as PET-CT in detecting some intra-abdominal metastatic lymph nodes, while its reliability was lower in some lymph node stations.
Adverse Childhood Experiences and Quality of Life: A Mediating Role of Physical Activity
Authors: Parrish Loni J. , Chroust Alyson J. 
Published: July 2023

Purpose Examine whether barriers to physical activity (PA) and PA level serve as serial mediators to the relationship between adverse childhood experiences (ACEs) and perceived quality of physical health. Design: Cross-sectional. Setting: A public university in Southeast United States. Subjects Seventy-five participants (18- 49 years). Measures: Self-report measures related to ACEs, barriers to PA, amount of PA, and perceived quality of physical health. Analysis Serial mediation analysis. Barriers to PA was a first-order mediator, and PA level was a second-order mediator between ACEs and perceived quality of physical health. Results Barriers to PA and PA levels serially mediated the relationship between ACEs and perceived quality of physical health (c = −1.01, SE = .251, P = .0002, 95% CI [−1.50, −.499]). The direct effect of ACEs on perceived quality of physical health was nonsignificant when mediators were controlled (c’ = −.383, SE = .252, P = .133, 95% CI [−.886, .120]). Higher ACE scores were associated with more barriers to PA, lower PA levels, and in turn, lower perceived quality of physical health. Conclusion The current study highlights specific pathways that contribute to the relationship between ACEs and perceived quality of physical health. Albeit limited by the sample size, preliminary data support prioritization of interventions that reduce barriers to PA when trying to increase PA in populations that are prone to early adversity.
Physician Modification of a Custom-Made Fenestrated Endograft By Closure of a Fenestration With Bovine Patch
Authors: Becker D. , Ali A. , Prendes C. , Stavroulakis K. , Stana J. , Tsilimparis N. 
Published: July 2023

Purpose: Ruptured mycotic pararenal aortic aneurysms are rare and serious condition that requires prompt treatment. Open surgery with aortic resection and in-situ or extra-anatomic reconstruction is the standard treatment. The aim of this technical note is to report urgent endovascular treatment using a readily available custom-made device (created for another patient), with a back-table modification using pericardium patch and a new fenestration. Technique: In preoperative measurements on centerline-based workstation, aortic diameter in proximal and distal landing zone and target vessel position matched the measurements of graft plan of custom-made device (CMD) besides left renal artery. To address current patient`s anatomy, closure of the nonsuitable fenestration with pericardial patch and creation of new fenestration (1 cm above and 1:15 hours posterior to original fenestration) for the respective target vessel have been performed. Postoperative computed tomography angiography (CTA) scan showed complete exclusion of aneurysm, perfused target vessels, and no endoleak. Under resistance-based antibiotic therapy, the patient was asymptomatic and showed normal infection parameters in blood samples postoperatively. Conclusion: In the hands of an experienced endovascular aortic surgeon modification of a custom-made device is a quick and feasible technique in this emergency situation. Long-term follow-up must confirm the durability and reliability of this new technique. Clinical Impact: The described technique of modification of a custom-made endograft can provide an alternative endovascular treatment option for urgent complex abdominal aortic pathologies. Compared to the current available treatment modalities, like physician modified endografts, off-the-shelf branched devices, parallel grafts and in-situ fenestration, it can save considerable time and provides reasonable sealing in ruptured cases. The technique offers a valuable add-on to the armamentarium of experienced endovascular physicians.
Assessing Diet and Musculoskeletal Pain in Adults: Results From a Cross-Sectional Analysis of the National Health and Nutrition Examination Survey (NHANES)
Authors: Tonelli Enrico Valerio , Hébert James R. , Mugford Gerald , Gao Zhiwei , Wang Peter , Shivappa Nitin , Sowa Gwendolyn 
Published: July 2023

Musculoskeletal (MSK) pain is highly prevalent worldwide and is associated with high levels of disability. Systemic inflammation may contribute to MSK pain, and diet is a crucial modulator of systemic inflammation. The Dietary Inflammatory Index (DII®) assesses the tendency of diets to cause inflammation. Higher DII scores, indicating pro-inflammatory diets, were hypothesized to be associated with a higher prevalence of MSK pain symptoms and duration. Data from 4118 subjects from the 2003-2004 NHANES survey were included to assess the association between DII scores and the presence and duration of osteoarthritis symptoms and neck and low back pain. After adjusting for potential confounders, the multivariable analysis showed that DII scores were significantly associated ( P < .05) with increased risk of osteoarthritis symptoms (joint pain, aching, and stiffness) in the past year (OR = 1.099; 95% CI 1.029,1.174), low back pain (OR = 1.070; 95% CI 1.003,1.142), and any pain lasting longer than 24 hours (OR = 1.128; 95% CI 1.046,1.216). Neck pain and pain duration were not significantly associated with DII scores. These findings suggest a significant association between a pro-inflammatory diet and the presence of different MSK pains (joint pain and low back pain) and with pain lasting longer than 24 hours.