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A cross-sectional online survey on oncologists’ attitudes toward and experiences with providing patients with audio recordings of their medical encounters

Abstract Providing patients with audio recordings of their medical encounters, termed consultation recordings, has shown promising benefits, especially for patients with cancer. While patients favor these recordings, international research indicated that physicians have mixed feelings. To date, research specific to Germany remains limited. This study investigated German oncologists’ attitudes and experiences through a nationwide cross-sectional quantitative online survey, informed by semi-structured interviews. Attitudes, prior experiences and desire for consultation recordings were assessed. Data was analyzed using descriptive statistics and subgroup analyses. Ninety-four physicians participated, with about half expressing a generally positive attitude, though overall attitudes were mixed. Expected benefits included improved patient recall and communication, while concerns centered around potential misuse of recordings, data confidentiality, and increased legal risks. Experiences were limited, with 12% reporting previous use. Fourteen percent expressed a willingness to offer recordings in future and 31% were undecided. This study highlights cautious openness among German oncologists, tempered by concerns over data security and legal implications, which may hinder adoption. This could be addressed by providing sound evidence regarding benefits and concerns, and enabling positive experiences. Further research should include feasibility testing in routine cancer care and re-evaluation of these results in representative samples and other specialties.

Pre-transplant residual diuresis and oxalic acid concentration influence kidney graft survival

Background and hypothesis Oxalic acid, a toxic metabolic end product, accumulates when kidney function deteriorates. Apart from its direct tubulotoxicity, it crystallizes at concentrations above 30–40 µmol/L. High oxalic acid concentrations at transplantation might negatively influence kidney transplant function. The influence of the concentrations of oxalic acid and its precursors and residual diuresis on kidney transplant outcomes was studied. Methods In this prospective cohort study, patients who received a kidney transplant between September 2018 and January 2022 participated. Concentrations of oxalic acid and precursors were determined in pre-transplant blood samples. Data on residual diuresis and other recipient, donor or transplant related variables were collected. Follow-up lasted until July 1st 2023. Results 496 patients were included, 154 were not on dialysis. Median residual diuresis was 1000 mL/day (IQR 200; 2000 mL/day). There were 230 living donor transplantations. Oxalic acid concentrations exceeded the upper normal concentration in 99% of patients, glyoxylic acid in all patients. There were 52 (10%) graft failures. As the influence of oxalic acid on the risk of graft failure censored for death was non-linear, it was categorized into two groups: ≤ 60 and > 60 μmol/L. In multivariable Cox analysis the graft failure censored for death risk was significantly influenced by residual diuresis, donor type (living versus deceased), donor age and oxalic acid. In 180 patients oxalic acid concentration shortly after transplantation was significantly lower than pre-transplant concentrations, suggesting excretion by the new graft. A better eGFR at day 7 was associated with lower oxalic acid concentration. Oxalic acid and residual diuresis did not influence patient survival. Conclusion Residual diuresis and oxalic acid concentration are important and independent predictors of graft survival censored for death. These results underline the importance of pre-emptive transplantation, or optimizing the pre-transplant patients’ condition regarding waste product concentrations.

Three-dimensional optical trapping with a low-NA objective using a flat-top beam

Efficacy and safety of rifaximin in preventing hepatic encephalopathy: A systematic review and meta-analysis

Rifaximin (RFX) is recommended for the treatment of hepatic encephalopathy (HE). However, evidence on whether RFX application could yield additional benefits for preventing HE in patients with cirrhosis is limited. In this study, we aimed to assess the safety and efficacy of RFX in preventing HE. We conducted a systematic search of randomized controlled trials to evaluate the use of RFX by analyzing HE incidence, hospitalization, all-cause mortality, and adverse events. Compared with the control group, RFX had a beneficial effect on the primary prevention of HE (RR = 0.58, 95% CI: 0.50–0.68), with noncomparable effects to NADs (including lactulose and lactitol, RR = 0.65, 95% CI: 0.38–1.11), but more effective than placebo (RR = 0.57, 95% CI: 0.47–0.69). After more than 1 month of RFX treatment, the risk of HE decreased significantly (RR = 0.55, 95% CI: 0.47–0.65). In secondary prevention of HE, RFX decreased the recurrence risk (RR = 0.49, 95% CI: 0.40–0.61). RFX helped to reduce the incidence of HE after transjugular intrahepatic portosystemic stent shunt (TIPSS) (RR = 0.70, 95% CI: 0.51–0.96). In terms of adverse effects, RFX was associated with a lower risk of diarrhea than NADs (RR = 0.04, 95% CI: 0.00–0.25). So, RFX therapy is effective and well-tolerated in preventing HE, and can be used as the first choice in the prophylaxis of HE after TIPSS.

Sleep architecture characteristics in patients with acute ischemic stroke

Studying the decontamination process of an irradiated beryllium reflector in a chlorine environment

Beryllium, possessing unique nuclear physical properties, is currently widely used as a material for reflector and neutron moderator blocks of research nuclear reactors. It can also be applied in fusion energy as a first-wall material and neutron multiplier. However, when beryllium is irradiated, its physical-mechanical properties deteriorate due to radiation-induced microstructural damage, the generation of tritium and helium, the activation of impurities under the radiation exposure, and the absorption of fission products, which determines the need for periodic replacement of the beryllium components in nuclear installations. Moreover, due to the relatively low abundance of beryllium, a relevant problem is its purification from radioactive isotopes for potential reuse. To date, chlorination has emerged as one of the most promising methods for purifying irradiated beryllium. This study addresses the optimization of the chemical process parameters and the isolation of the beryllium component from the resulting mixture of chlorination products, including the most active radionuclides: 3H, 60Co, 108mAg, and 137Cs. Laboratory-scale experiments confirmed the effectiveness of the irradiated beryllium chlorination technology for its purification. The reduction in the activity level of beryllium and its compounds was objectively monitored using gamma and beta spectrometry methods.

Gene expression and agent-based modeling improve precision prognosis in breast cancer

Abstract Breast cancer survival is hard to predict because of the complex ways genes and cells interact. This study offers a new method to improve these predictions by combining gene expression profiling (GEP) with agent-based modeling (ABM). First, GEP will pinpoint genes that are important in breast cancer development. Then, a mathematical model will be built to show how these genes influence cell behavior. This data will be used in ABM to simulate tumor growth and treatment response. The ABM allows us to virtually test different treatments and see how they might affect patient survival. Finally, the model’s accuracy will be checked against real patient data and compared to other models. By combining the strengths of GEP and ABM, this research could significantly improve breast cancer survival prediction. ABM’s ability to analyze interactions mathematically could pave the way for more personalized and effective treatments.

Protocol: Weight-adjusted effective volume of 0.5% ropivacaine for combined costoclavicular brachial plexus block–cervical plexus blocks undergoing arthroscopic shoulder surgery: A dose-finding study protocol

Introduction Rotator cuff injuries are common clinically, and arthroscopic repair is widely applied. Postoperative analgesia can be assisted by the interscalene brachial plexus block; however, it comes with side effects, among which a high incidence of hemidiaphragmatic paralysis (HDP) is included. Costoclavicular brachial plexus–cervical plexus blocks (CCB–CPBs) offer comparable analgesia with lower HDP risk, yet local anesthetic volume issues can affect outcomes. In patients undergoing arthroscopic shoulder surgeries under general anesthesia with CCB–CPBs, the aim is to determine the optimal dose of ropivacaine for postoperative analgesia while avoiding hemidiaphragmatic paralysis (HDP), Methods and analysis This trial will be a prospective, single-arm, double-blind dose finding study. We plan to enroll 40 patients who will be scheduled to undergo arthroscopic shoulder surgeries under anesthesia that combines general anesthesia with CCB–CPBs. The volume of the local anesthetic will be determined by adopting the Up-and-Down sequential allocation study design. The primary outcome will be the numerical rating scale (NRS) scores of the patients prior to their departure from the post-anesthesia care unit (PACU). As for the secondary outcomes, they will include the ipsilateral diaphragmatic excursion, the characteristics of the sensory–motor block, the occurrence of complications, as well as the consumption of fentanyl during the operation. Ethics and dissemination Approval for the protocol of this study was granted by the Ethics Committee of Ningbo No. 6 Hospital in Zhejiang Province, China, on July 29, 2024 (Approval No. 2024-67L). Once the study is completed, we are committed to guaranteeing that the results will be accessible to the public, irrespective of the outcome. This will involve either publishing them in an appropriate journal or presenting them orally at academic conferences. Trial registration Trial registration number ChiCTR2400090292

The addition of natural clay and industrial and agricultural waste on the performance of green and sustainable concrete

Scoping review of evidence synthesis: Concepts, types and methods

Objectives To systematically explore the concepts, types, and methodologies related to literature reviews and evidence synthesis. Methods We conducted a scoping review using PubMed, Embase, Biblioteca Virtual da Saúde, grey literature, and websites of key international and national institutions, including the Cochrane Collaboration, Joanna Briggs Institute, Center for Reviews and Dissemination, Campbell Collaboration, and REBRATS, with searches completed through November 13, 2024. Studies were included if they identified or proposed theories and/or methodologies for evidence synthesis at international or national levels, with eligibility limited to studies published in English, Spanish, or Portuguese and no restrictions on publication year. Title and abstract screening was conducted independently by ten reviewers working in pairs, with a third reviewer resolving conflicts as needed, and full-text copies of potentially relevant articles were retrieved for further analysis. Results The review included 99 studies employing a variety of evidence synthesis methods. A total of 71 terminologies for types of evidence synthesis were identified and grouped by conceptual and methodological similarities, resulting in 16 categories of evidence synthesis, each with clear differences in concepts and methods. Conclusions The lack of standardization in defining and classifying review types challenges the scientific community by hindering study comparisons and appropriate methodology selection. Future research should explore the relationships between different review types and their outcomes, as well as the applicability of new methodologies across various fields.

Metabolomics and machine learning identify urine metabolic characteristics and potential biomarkers for severe Mycoplasma pneumoniae pneumonia

Bacterial profile and antimicrobial susceptibility pattern of community and hospital-acquired urinary tract infections among UTI suspected geriatrics in Gondar town, Northwest Ethiopia

Background Bacterial urinary tract infection (UTI) is the second most frequent infection next to respiratory tract infection within the geriatric population both in the community and hospital settings. There is a limited data regarding geriatrics UTI in this study area. Therefore, the current study aimed to assess the status of the community and hospital-acquired urinary tract infections, and antimicrobial susceptibility patterns among UTI suspected geriatrics which is essential to physicians and health care workers to implement appropriate intervention. Methods A comparative cross-sectional study was conducted among 460 UTI suspected geriatrics admitted at the University of Gondar Comprehensive Specialized Hospital and attended in Gondar town (Kallen Bnakafl and Menna Geriatrics Support Center Clinics) from 1st May 2022–14th July 2022. Socio-demographic data were collected using structured questionnaires. Urine culture was performed and isolates were counted for significant growth by a colony counter, and their antibiotic susceptibility was done by the Kirby–Bauer disc diffusion method. Data were entered using Epi Data version 4.0.0 and analyzed by Stata/IC version 14.0. P-value < 0.05 at 95% CI was considered statistically significant. Result The overall prevalence of UTI in geriatrics was 44.4%. The prevalence of UTI among community and hospitalized suspected patients was 38.7% and 50%, respectively. Escherichia coli (E. coli) (38.6%) predominated across the two groups, followed by Klebsiella spp. (15.8%), S. saprophyticus (12.2%), P. mirabilis (9.1%), S. aureus (5.9%), and Citrobacter spp. (2.8%). Pseudomonas spp. (7.1%), K. rhinoscleromatis (5.1%), and P. vulgaris (2.8%), were isolated from only hospitalized patients. Piperacillin-tazobactam susceptibly was 100% in both study groups. Nalidixic acid resistance was 50% to 87.5% and 50% to 100% in the isolates from community and hospitalized UTI suspects, respectively. Conclusion This study found a high prevalence of bacterial UTI in geriatrics and a high rate of bacterial resistance was observed to most antimicrobial drugs tested. Piperacillin-tazobactam and meropenem were the most active antimicrobials for UTI. Therefore, expanding routine bacterial culture and antimicrobial susceptibility testing and strengthening regular surveillance systems are essential for appropriate patient care.

Simulating metabolic pathways to enhance interpretations of metabolome genome-wide association studies

Expected length of stay in residential aged care facilities in Australia: Assessing the impact of dementia using machine learning

Residual self-attention vision transformer for detecting acquired vitelliform lesions and age-related macular drusen

Effectiveness of care coordination interventions delivered to stroke survivors in low and middle-income countries: Systematic review and meta-analysis protocol

Background Stroke survivors have complex and long-term care needs requiring navigation of multiple care services and providers. Care coordination interventions provide wholistic care that meets the needs of the patient and improves their clinical outcomes and expectations. This systematic review will identify the key components of stroke care coordination interventions implemented in low and middle-income countries (LMICs) and assess their effectiveness on stroke outcomes such as motor recovery, cognitive function, mental health, stroke type and the role of stroke severity, type, and the nature of the interventions in influencing these outcomes. Methods Electronic databases, trial registries and non-database sources will be searched for published and unpublished studies. PubMed, LILACS, CINAHL via EBSCOhost, Scopus, Web of Science Core Collection, Cochrane CENTRAL and Google Scholar will be searched from 2000 to 31st May 2025, without language restriction. Trial registries including the WHO International Clinical Trials Registry Platform (ICTRP) and Clinicaltrials.gov will also be searched. Grey literature including dissertations, preprint repositories and conference proceedings will be searched. The key search terms include “stroke”, “care integration”, “continuity of care”, “information exchange”, “patient-centred care”, “multidisciplinary care”, “case management” and “low and middle-income countries”, together with their alternative terms and synonyms, singular and plural forms and American and British spelling. Hand search of references of relevant studies will be carried out and experts in the field of stroke care coordination interventions will be contacted for their knowledge about any study missed by our searches. The studies will be collated in Rayyan and duplicates removed. Study selection will be done using a study selection flow chart developed from the pre-specified eligibility criteria defined by the PICOS elements (P ─ patient, I ─ intervention, C ─ comparator, O ─ outcomes and S ─study). Quality in the included studies will be assessed for risk of bias using the Cochrane Risk of Bias tool (version 2) for Randomized Controlled Trials (RoB 2) and ROBINS-I for Non-randomized Studies of Intervention. Data will be extracted using a pre-tested data extraction form developed from Microsoft Excel. Study selection, data extraction and risk of bias assessment will be conducted independently by two reviewers (SKJO and ADA). Disagreements between the reviewers will be resolved through discussion. Risk ratio (RR) will be used as the effect measure for binary/dichotomous outcomes. For continuous outcomes mean difference (MD) with standard deviation (SD) or standardized mean difference (SMD) for outcomes measured on different instruments or scales will be used as effect measures for expressing effectiveness of care coordination interventions. Random-effects meta-analyses will be employed to pool studies, and all effects estimates will be reported with their 95% confidence interval (CI). Heterogeneity will be assessed using the I2 statistic. The overall certainty of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Expected outcomes This review will attempt to identify the components of stroke-coordinated care interventions in low- and middle-income countries. It will assess whether these interventions improve clinical outcomes such as motor and cognitive functioning, mental wellbeing, mortality, and disability-adjusted life years (DALYs) of stroke survivors. The review will also explore how factors —such as stroke type, severity, and the nature of care coordination interventions (including the specific components) influence clinical, functional and psychosocial outcomes. The findings will help in determining the most effective care coordination interventions that should be adopted as care models to improve patient outcomes, whilst identifying evidence gaps for future research. Protocol registration and dissemination This systematic review and meta-analysis protocol has been registered in PROSPERO [CRD42024587311]. The findings of the study will be shared with the relevant stakeholders and disseminated through scientific conferences and peer review publications.

The working mechanism of biomarkers related to sumoylation modification in coronary artery disease

Correction: Recency and rarity effects in disambiguating the focus of utterance: A developmental study

Development of a cornea-equivalent phantom in the terahertz frequency region for 3D temperature rise assessment

Abstract As the next generation of mobile communication systems (Beyond 5G/6G) is expected to extend into the terahertz (THz) frequency region, it is essential to ensure human safety from electromagnetic waves. For this purpose, the evaluation of the temperature rise caused by the electromagnetic wave energy absorbed by the human body is required. However, there have been no reports on the development of phantoms with dielectric properties equivalent to biological tissues that can be used to measure temperature rise in the THz frequency region by experimental methods. Therefore, in this study, a glycerin-based semisolid phantom was developed to match the dielectric properties of the cornea between 0.1 and 0.6 THz; the cornea is one of the most important tissues for exposure assessment in the THz frequency region. In addition, fluorescent thermoprobes were included in the phantom to measure the temperature rise induced by the absorption of THz waves. The results show that temperature measurements using confocal laser microscopy can be used to obtain temperature distributions in the phantom with a high spatial resolution [2 µm in the transverse direction (xy) and 20 µm in the axial direction (z)] and a high-temperature resolution (0.04 °C).

Autonomous adaptive optimization of NMR experimental conditions for precise inference of minor conformational states of proteins based on chemical exchange saturation transfer

In scientific experiments where measurement sensitivity is a major limiting factor, the optimization of experimental conditions, such as measurement parameters, is essential to maximize the information obtained per unit time and the number of experiments performed. When optimization in advance is not possible because of limited prior knowledge of the system, autonomous, adaptive optimization must be implemented during the experiment. One approach to this involves sequential Bayesian optimal experimental design, which adopts mutual information as the utility function to be maximized. In this study, we applied this optimization method to the chemical exchange saturation transfer (CEST) experiment in nuclear magnetic resonance (NMR) spectroscopy, which is used to study minor but functionally important invisible states of certain molecules, such as proteins. Adaptive optimization was utilized because prior knowledge of minor states is limited. To this end, we developed an adaptive optimization system of 15 N-CEST experimental conditions for proteins using Markov chain Monte Carlo (MCMC) to calculate the posterior distribution and utility function. To ensure the completion of MCMC computations within a reasonable period with sufficient precision, we developed a second-order approximation of the CEST forward model. Both simulations and actual measurements using the FF domain of the HYPA/FBP11 protein with the A39G mutation demonstrated that the adaptive method outperformed the conventional one in terms of estimation precision of minor-state parameters based on equal numbers of measurements. Because the algorithm used for the evaluation of the utility function is independent of the type of experiment, the proposed method can be applied to various spectroscopic measurements in addition to NMR, if the forward model or its approximation can be calculated sufficiently quickly.