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Representativeness in randomized clinical trials remains a critical concern, affecting the external validity of trial results, equitable access to the risks and benefits of research participation, and public trust in clinical research. Although representative participation by members of groups traditionally underrepresented in clinical trials is just a surrogate for true diversity, equity, inclusion, and belonging in clinical trials, it can be quantified, allowing stakeholders to add empirical rigor to diversity, equity, inclusion, and belonging efforts. Multiple ways to measure representativeness have been proposed, including the participation-to-prevalence ratio, raw participation proportions or numbers for relevant subgroups, and enrollment fraction for relevant subgroups. These methods have strengths and weaknesses and may be appropriate to report in certain circumstances, depending on why stakeholders seek to assess representativeness. Stakeholders—including regulatory agencies, journal editors, clinical trial investigators, and trial sponsors—may use quantitative measures of representativeness to establish trial enrollment standards, monitor equitable participation in ongoing trials, and condition funding or drug or device approval on achieving specific representativeness targets. However, using quantitative measures of representativeness in this way could have unintended consequences, including researchers "gaming" recruitment strategies to meet target numbers, overlooking nuanced variations within communities, and potentially incentivizing problematic and exploitative recruitment strategies. Although no single method of measuring representativeness offers a comprehensive solution for increasing diversity, equity, inclusion, and belonging in all randomized clinical trials, a carefully designed, multifaceted approach to measuring representativeness may provide stakeholders with useful perspectives for measuring progress in increasing the diversity of clinical trial participation. For stakeholders seeking a single number to assess the representativeness of a trial enrolling patients with a disease state with well-delineated demographics, the participation-to-prevalence ratio is ideal; however, for a more nuanced view of representativeness, the combination of enrollment fraction in subgroups of relevance plus a full report of the demographics of patients approached for enrollment may be more appropriate. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and MethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONIdentify priorities for adult cerebral palsy (CP) research by engaging individuals with lived experience, clinical investigators, and community leaders.Qualitative descriptive study using iterative focus groups, followed by inductive thematic analysis. Participants included adults with CP and caregivers, clinical investigators, and community leaders in the CP and disability spaces. We explored research priorities among three research areas identified a priori– bone health, kidney health, and preventive care.We conducted four focus groups (20 participants with lived experience; 10 clinical investigators; 9 community leaders). Most participants felt all topic areas were very important, though preventive care emerged as the top priority. We identified three overarching themes that cut across the various research areas discussed: patient and provider knowledge gaps; a precision medicine approach for adult CP care; and the need to address ableism.Adults with CP face unique healthcare needs and risks as they age, and the evidence base to guide their care lags significantly behind. Our study identified preventive care as the top research priority for the adult CP research agenda. Next steps in this line of research should focus on interventions to facilitate primary and preventive care interactions for adults with CP.Participants identified preventive care as the top research priority for the adult cerebral palsy (CP) research agenda.Ableism is a barrier to care for adults with CP, and rehabilitation professionals should provide and advocate for equitable care and access for adults with CP.Adults with CP, caregivers, clinical investigators, and community leaders highlighted significant knowledge gaps among patients and providers alike regarding the unique health risks and needs facing adults with CP.When possible, rehabilitation professionals should use a precision medicine approach to adult CP care, which takes into account an individual’s risk factors to guide care.Participants identified preventive care as the top research priority for the adult cerebral palsy (CP) research agenda.Ableism is a barrier to care for adults with CP, and rehabilitation professionals should provide and advocate for equitable care and access for adults with CP.Adults with CP, caregivers, clinical investigators, and community leaders highlighted significant knowledge gaps among patients and providers alike regarding the unique health risks and needs facing adults with CP.When possible, rehabilitation professionals should use a precision medicine approach to adult CP care, which takes into account an individual’s risk factors to guide care. [ABSTRACT FROM AUTHOR]

Background: Descriptive phenomenological research is crucial in nursing for understanding individuals' experiences, perceptions, and relationships, which are essential for person-centered healthcare. However, a common critique is that researchers often use phenomenological methods without fully comprehending their historical and philosophical foundations. Existing literature highlights discrepancies in the application of phenomenological principles by nurse researchers, particularly in their presentation of philosophical underpinnings and methodological details. Aim: This article aims to provide a comprehensive methodological framework for descriptive phenomenological research in nursing, addressing both theoretical and practical aspects to guide novice researchers. Data Sources: This framework synthesizes existing scholarship on descriptive phenomenology. Discussion: Starting from Husserl, this article provides a detailed overview of the history, foundations, and philosophical assumptions of the methodology. It also includes key terms and a comprehensive detailing of all aspects of the research process. Conclusion: This framework enriches existing scholarship by offering a streamlined, step-by-step methodological guide for researchers embarking on descriptive phenomenological studies. It emphasizes the importance of establishing minimum, yet critical criteria for publishing research employing this methodology. Implications for Research: Future nurse researchers are encouraged to enhance methodological transparency in their descriptive phenomenological studies to facilitate rigorous evaluation of method effectiveness and study quality. This framework aims to alleviate potential apprehensions and provide clarity and structure to novice researchers in the field. [ABSTRACT FROM AUTHOR]

Introduction: Infertility is a growing issue globally, particularly in industrialized cultures, affecting 13%–18% of couples of reproductive ages. In recent years, numerous studies have aimed to identify prognostic factors for infertility and abnormal semen analysis. To date, no study has examined the relationship between the number of infertile siblings and abnormal sperm parameters. This study aims to investigate whether the number of infertile siblings can be considered a prognostic factor for abnormal sperm parameters. Method: Semen samples were collected from the male partners of couples experiencing infertility issues. Study participants completed a questionnaire detailing demographic information including age and family history of infertility. Each participant provided two semen samples, with a minimum 15-day interval between collections. Sperm concentration, motility, and morphology were assessed for each sample. Clinical investigators conducted physical examinations, using an orchidometer to measure testicular size. Results: The number of infertile brothers and testis volume were prognostic factors for abnormal sperm count (OR = 1.374, p -value = 0.03; OR = 0.786, p -value < 0.001; respectively) and abnormal motility (OR = 1.514, p -value = 0.018; OR = 26.74, p -value < 0.001, respectively). There was no significant association between the percentage of abnormal morphology of sperm cells and the mentioned prognostic factors. The optimal cut-off point of the number of infertile brothers for both abnormal sperm count and abnormal sperm motility was one. Conclusion: It is recommended that males with at least one infertile brother, undergo sperm analysis to identify individuals at risk of infertility. [ABSTRACT FROM AUTHOR]

Survivors of pediatric brain tumours are at a high risk of cognitive morbidity. Reliable individual-level predictions regarding the likelihood, degree, and affected domains of cognitive impairment would be clinically beneficial. While established risk factors exist, quantitative MRI analysis may enhance predictive value, above and beyond current clinical risk models. This systematic review addresses the question: "Do MRI markers predict future cognitive functioning in pediatric brain tumour survivors?" We conducted a comprehensive search for studies published up to March 2024 that assessed MRI variables as predictors of later neuropsychological outcomes in pediatric brain tumour patients. Only studies that acquired MRI scans at an earlier timepoint to predict subsequent cognitive test performance were included. Surprisingly, few studies met these criteria, with identified research focusing primarily on MRI measures of cerebellar and white matter damage as features in predicting cognitive outcomes. Ultimately, this review reveals a limited literature, characterized by small sample sizes and poor-quality studies, placing findings at high risk of bias. Consequently, the quality and conclusions drawn from the existing research are constrained, especially in the context of prediction studies. Given the significant implications for this clinical population, this review highlights the urgent need for further investigation and a 'call to action' for medical imaging researchers in pediatric neuro-oncology. [ABSTRACT FROM AUTHOR]

Critical thinking is required for successful nursing outcomes. For evidence-based practice, there is a need to understand and apply quantitative methods of research and statistical analysis in order to obtain evidence. However, the literature shows that the use of quantitative methods among nurse researchers can be problematic. This article aims to enhance understanding and implementation of one of the most frequently used statistical tests, the independent samples t-test, with the use of a nursing practice example. Guidance for the most used statistical software for social sciences (SPSS) and graphical representations are provided. [ABSTRACT FROM AUTHOR]

This study makes a comprehensive assessment of the predominant Transfer Learning (TL) techniques employed for the classification of COVID-19 cases in Chest X-rays (CXR) images. The methodologies have been selected on the basis of their merits and demerits, suitability, and possible impact on the development of the region being studied. The study examines the various methods of TL employed in the classification of COVID-19 cases with the objective to gain a deeper understanding about all the aspects of these methodologies. It can be of great significance for the researchers and medical professionals in making well-informed decisions about the implementation of these techniques to improve the precision and effectiveness of COVID-19 diagnosis. The practical consequences of these techniques help in early identification of such cases for having a suitable intervention. As many as 48 studies conducted during the period 2020–2023 have been included in the current research work for having an assessment about the problem under investigation. The study has specifically focused on transfer learning-based models utilized for the identification of COVID-19 through CXR pictures. It highlights the challenges posed by dataset dynamics, methodological variations, and performance metrics of different models. [ABSTRACT FROM AUTHOR]

The article explores the history of pediatric nursing in the U.S. from November 23, 1855 through 2024 and discusses implications for the future. Topics include the earliest children's hospital in the U.S., evolution of the art and science of the care of children, and the introduction of penicillin and sulfa in the 1930s and 1940s leading to improvements in communicable diseases, better survival rates for children afflicted with serious illnesses and childhood chronicle illnesses.

Identifying and assessing the magnitude of direct threats to ecosystems and species are critical steps to prioritizing, planning, implementing, and assessing conservation actions. Just as medical clinicians and researchers need a standard way to talk about human diseases, conservation practitioners and scientists need a common and comprehensive language to talk about the threats they are facing to facilitate joint action, evaluation, and learning. To meet this need, in 2008 the IUCN Species Survival Commission and the Conservation Measures Partnership produced the first version of a common threats classification with the understanding that it would be periodically updated to take into account new information and learning. We present version 4.0 of this classification. For this latest update, we reviewed existing versions and derivatives of the original classification, over 1000 citations of the classification, threats data from over 2900 real‐world conservation projects, and comments from many users. Based on our findings, we made changes to the threats classification scheme, including addition of a level 0 threat class, refinement of levels 1 and 2 threat categories, and addition of the threat “Fencing & walls” to level 2. Also added were level 3 threat types and modifiers that provide a more detailed description of different types of direct threats and thus allow users to fine‐tune analyses and actions. The update also clarifies how to treat various stressors, including natural disaster events and climate change. As a result of these changes, we revised the formal definition of direct threats. They include human actions that are the direct cause of ecosystem or species‐population degradation and loss, such as agriculture, transport, natural resource use, and ecosystem management. They also include ultimate stressors in natural systems whose dynamics have been altered by the effects of current or historical human actions, such as invasive or problematic native species, pollution, natural disasters, and climate change. [ABSTRACT FROM AUTHOR]

This research is imperative due to the pressing need for improved patient recruitment in clinical trials, addressing challenges such as delays and high costs. By introducing a classification model and a game theoretic approach for clinical trial setting, we aim to boost trial efficiency, advance healthcare research, and enhance patient outcomes. Patient recruitment for clinical trials is a critical aspect of advancing medical research but has traditionally relied on manual or semi-automated methods, such as advertisements, referrals, and eligibility screening through databases. These approaches often suffer from inefficiencies, including high costs, prolonged timelines, and suboptimal participant matching, leading to delays in trial completion. These challenges highlight the limitations of traditional methods in meeting the growing demand for efficient and effective recruitment. Motivated by these shortcomings, this study proposes an advanced AI-driven system leveraging a Random Forest Classifier within a hybrid framework to address these issues. The proposed model integrates Logistic Regression, Support Vector Machines, Decision Trees, and Random Forests through a stacking classifier and employs Autoencoders for feature extraction to enhance predictive accuracy. Additionally, a game-theoretic approach involving Patients, Clinical Investigators, and Research Firms optimizes recruitment strategies through strategic interaction, providing equilibrium-seeking solutions for balanced payoffs among stakeholders. This AI-based approach offers a transformative solution, addressing inefficiencies in traditional recruitment methods and significantly advancing the field of healthcare research by streamlining the recruitment process. [ABSTRACT FROM AUTHOR]

Purpose: Work-life balance (WLB) refers to the ability to combine work with other aspects of life, such as family life, social activities, or personal interests. The topic of WLB appears to be particularly relevant for medical personnel, who face exceptionally high levels of stress, irregular working hours, and emotional strain. Maintaining a balance between work and personal life can contribute to improving employees' well-being, quality of life, and patient care, as well as help reduce staff turnover in the healthcare system, which is a significant sector in the European Union economy. The aim of this article is to identify the factors that are positively and negatively influencing the balance between work and private life of medical staff. Design/methodology/approach: The study was conducted in the first quarter of 2024 in Polish medical institutions. A paper-based survey questionnaire was used as a research tool to collect data consisting of answers to closed questions. The questionnaire was discussed during interviews with experts, i.e., medical staff. Also, literature review was a key to understand the topic and point out the positive and negative factors. Findings: Based on the conducted empirical research, we can conclude that medical personnel appreciate a wide range of solutions supporting work-life balance, such as additional days off, reduced working hours, flexible hours tailored to individual needs, accommodations for pregnant women, training to enhance skills, and attention to employees' mental health. The greatest negative impact on work-life balance among medical personnel comes from mobbing and hate. Research limitations/implications: The limitations of the study stem mainly from the sample selection and the design of the research tool, which allowed for quick completion but may have overlooked important issues. In the future, it would be beneficial to increase the sample size and focus on a single medical profession. Nevertheless, the analysis of factors affecting work-life balance provides a foundation for further research among medical personnel. Originality/value: The article provides a new outlook on factors affecting maintaining work-life balance. It is a valuable analysis for managers, HR professionals, medical organization leaders and medical staff who want to raise awareness about maintaining work-life balance in their companies and discover new ways to achieve WLB. [ABSTRACT FROM AUTHOR]

Background: Pragmatic clinical trials evaluate the effectiveness of health interventions in real-world settings. Negative spillover can arise in a pragmatic trial if the study intervention affects how scarce resources are allocated across patients in the intervention and comparison groups. Main body: Negative spillover can lead to overestimation of treatment effect and harm to patients assigned to usual care in trials of diverse health interventions. While this type of spillover has been addressed in trials of social welfare and public health interventions, there is little recognition of this source of bias in the medical literature. In this commentary, I examine what causes negative spillover and how it may have led clinical trial investigators to overestimate the effect of patient navigation, AI-based physiological alarms, and elective induction of labor. Trials discussed here are a convenience sample and not the result of a systematic review. I also suggest ways to detect negative spillover and design trials that avoid this potential source of bias. Conclusion: As new clinical practices and technologies that affect care delivery are considered for widespread adoption, well-designed trials are needed to provide valid evidence on their risks and benefits. Understanding all sources of bias that could affect these trials, including negative spillover, is a critical part of this effort. Future guidance on clinical trial design should consider addressing this form of spillover, just as current guidance often discusses bias due to lack of blinding, differential attrition, or contamination. [ABSTRACT FROM AUTHOR]

Background: Anoikis disrupts the normal apoptotic process in cells, leading to abnormal proliferation and migration, thereby promoting tumor formation and development. However, the role of anoikis in bladder urothelial carcinoma (BLCA) still requires further exploration. Methods: Anoikis-related genes (ARGs) were retrieved from the GeneCards and Harmonizome databases to distinguish various subtypes of BLCA and develop a predictive model for BLCA. The immune microenvironment and enrichment pathways between various subtypes were also analyzed using consensus clustering. Potential medications were screened by utilizing drug sensitivity analysis. In vitro and vivo, the character of the independent prognostic gene in BLCA was confirmed through cell studies and mouse xenograft models. Results: One hundred thirty differentially expressed genes (DEGs) were identified, and nine of them were chosen to construct predictive models that can accurately forecast the prognosis of BLCA patients. K = 2 was correctly identified as the optimal clustering type for BLCA, showing prominent differences in survival rates between the two subgroups. The immune-related functional studies manifested that the two subtypes' immune cell expressions differed. It was verified that RAC3 is an independent prognostic gene for BLCA. RAC3 shows high expression levels in BLCA, as indicated by its consistent mRNA and protein levels across different gene expressions. The functional verification results of RAC3 in BLCA showed that silencing RAC3 can significantly inhibit BLCA cell proliferation, colony formation, and migration. RAC3 knockdown inhibited the growth and migration of BLCA in vivo. SB505124 exhibited a significant inhibitory effect on the proliferation of BLCA cells. Conclusion: Based on the predictive model developed in this study, BLCA patients' prognoses can be accurately predicted. SB505124 could become an important drug in the treatment of BLCA patients. RAC3 is essential in prognosis, immune microenvironment, and malignant behavior of BLCA in vitro and in vivo. It will also offer the potential for personalized treatment for BLCA patients and generate new research avenues for clinical investigators. [ABSTRACT FROM AUTHOR]

Uveal and conjunctival melanomas are relatively rare tumors; nonetheless, they pose a significant risk of mortality for a large number of affected individuals. The pathogenesis of melanoma at different sites is very similar, however, the prognosis for patients with ocular melanoma remains unfavourable, primarily due to its distinctive genetic profile and tumor microenvironment. Regardless of considerable advances in understanding the genetic characteristics and biological behaviour, the treatment of uveal and conjunctival melanoma remains a formidable challenge. To enhance the prospect of success, collaborative efforts involving medical professionals and researchers in the fields of ocular biology and oncology are essential. Current data show a lack of well-designed randomized clinical trials and limited benefits in current forms of treatment for these tumors. Despite advancements in the development of effective melanoma therapeutic strategies, all current treatments for uveal melanoma (UM) and conjunctival melanoma (CoM) remain unsatisfactory, resulting in a poor long-term prognosis. Ongoing trials offer hope for positive outcomes in advanced and metastatic tumors. A more comprehensive understanding of the genetic and molecular abnormalities involved in the development and progression of ocular melanomas opens the way for the development of personalized therapy, with various potential therapeutic targets currently under consideration. Increased comprehension of the molecular pathogenesis of UM and CoM and their specificities may aid in the development of new and more effective systemic therapeutic agents, with the hope of improving the prognosis for patients with metastatic disease. Graphic Abstract [ABSTRACT FROM AUTHOR]

Why you should read this article: • To gain an understanding of the stepped-wedge methodology for randomised controlled trials (SW-RCTs). • To enhance your research skills through practical step-by-step guidance on designing and implementing SW-RCTs • To apply this knowledge in future SW-RCTs. Background: Designing effective health interventions and evaluating their impact is crucial to improving the health of the population. To ensure interventions are of high quality and effective, evidence-based research is essential, particularly studies that use randomised controlled trials (RCTs) or systematic reviews. However, RCTs may not be feasible or ethical in certain situations, such as in intensive care units. Cluster or stepped-wedge RCTs are alternative ways to assess interventions that also address these ethical concerns. Aim: To explain the stepped-wedge design and its main features as well as how to use it to evaluate nursing interventions. Discussion: Understanding stepped-wedge designs empowers nurses to implement evidence-based interventions and improve patient outcomes. The use of stepped-wedge designs has increased in nursing research over the past two decades, indicating growing recognition of its advantages: efficient evaluation of healthcare interventions, ensuring all clusters receive treatment over time; smaller sample sizes; ethical considerations; and time control. However, challenges remain: ensuring nurse researchers’ understanding and application of it is consistent, extended duration and logistical complexities. Methodological rigour, collaboration and understanding of secular trends are crucial, and nurses’ involvement in RCTs enhances cluster selection, data collection and dissemination. Conclusion: The stepped-wedge design offers an ethical and adaptable method for studying interventions, considering healthcare complexities and allocating resources. Its versatility assists the advancement of nursing care delivery and in promoting evidence-based practice. Implications for practice: Understanding stepped-wedge designs in nursing practice enhances evidence-based care, decision-making, collaboration and professional development, benefiting patient outcomes. [ABSTRACT FROM AUTHOR]

Why you should read this article: • It offers a timely reflection on the relevance and impact of case study research (CSR) in nursing, highlighting its value in understanding complex healthcare issues and application in real-life situations. • It discusses the evolution and methodological diversity of CSR, making it a crucial read for those looking to deepen their knowledge in this area. • It includes practical examples, as well as recent studies that have used CSR, highlighting the method’s flexibility and adaptability in studying dynamic healthcare environments.. Background: Case study research (CSR) has gained popularity across disciplines due to its ability to provide detailed insights into specific phenomena. Aim: To explore the philosophy and methodology of CSR, drawing from notable authors who have contributed to its development. Discussion: This article discusses the characteristics of CSR in terms of design and method in both quantitative and qualitative approaches. It examines CSR’s advantages and disadvantages as a research method. It draws on two example case studies to emphasise the use of CSR for exploring complex healthcare and social care settings. Conclusion: CSR has proven valuable in nursing research for investigating complex clinical problems, patient-care scenarios, and organisational dynamics and phenomena. Implications for practice: CSR provides a methodological framework for nursing research that offers a unique lens for exploring multifaceted, complex issues. This ultimately improves patient care outcomes. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To support the use of reflexive thematic analysis (RTA) in analysing qualitative systematic reviews and empirical data. • To review your understanding of RTA to analyse nursing research within the context of wider methodological and methods considerations. • To explore practical examples of RTA in nursing research.. Background: A researcher must consider their research question within their world view before selecting a technique appropriate for analysing their data. This will affect their choices of methodology and methods for collecting and analysing data. Reflexive thematic analysis (RTA) has become a go-to technique for qualitative nurse researchers. However, the justifications for using it and its application in the context of a wider approach are under-discussed. Aim: To rationalise the use of RTA within a wider philosophical-methodological-methods-analysis approach and provide nurse researchers with practical guidance about how to apply it to qualitative data. Discussion: This article conceptually grounds the seminal work of Braun and Clarke (2006) and provides a process for rigorously and systematically analysing qualitative data. Researchers undertaking qualitative research must use a rigorous philosophical-methodological-method-analysis approach. Before selecting a technique appropriate for analysing their data, they must consider their research question within their own world view. This has implications for their choice of methodology and consequently the data collection methods and analysis techniques they use. Researchers should be mindful of RTA’s conceptual roots when applying it. Conclusion: Transparent and rigorous data analysis leads to credible findings, supports evidence-based practice and contributes to the growing body of nursing research. Within the context of the wider philosophical-methodological-methods-analysis approach, RTA produces high-quality, credible findings when applied well. Implications: for practice This article can guide nursing students and novice researchers in choosing and applying RTA to their research. [ABSTRACT FROM AUTHOR]

Objectives: With the increased use of 3D‐generated images in biological research, there is a critical need to adapt classical anatomical measurements, traditionally conducted with calipers, to a virtual environment. We present detailed protocols for measuring bicondylar length, a critical dimension of the femur, using three different imaging software programs—3D Slicer™, Amira™, and Simpleware™. These protocols provide researchers and practitioners in radiology, orthopedics, biomechanics, and biological anthropology with accurate and reproducible measurement techniques. The objective is to standardize and support virtual osteology in biomechanical research, stature estimation, and related medical and anthropological studies. Materials and Methods: Adhering to standardized protocols, we adapted femoral bicondylar length measurements for computed tomography images from a New Mexican collection (n = 10). The method was designed for applicability and reproducibility across three software platforms. By comparing measurements from the same sample across different observers and different platforms, this study validates the accuracy and consistency of the adapted protocol, demonstrating its utility for research and clinical assessments. Results: We present a step‐by‐step guide for each program, detailing bone alignment and measurement. We illustrate each step and provide video tutorials via links for an enhanced understanding of the process. Discussion: Bicondylar length can be measured effectively in each software program following the provided instructions. However, ease of measurement varied among the programs, with some offering a more straightforward process. This variability underscores the importance of choosing appropriate software for the user's needs and proficiency. It also suggests areas for improvement and standardization in software design and instructional clarity. Research Highlights: The study introduces a detailed protocol for measuring femoral bicondylar length in 3D bone renderings using three different software programs: 3D Slicer™, Amira™, and Simpleware™.Comprehensive step‐by‐step descriptions, accompanied by illustrative images and video tutorials, are available to researchers to replicate the measurement process easily.Error testing across all three software programs and among different observers on the same software program demonstrated low variability, indicating that this measurement protocol is precise and reliable across all three platforms and with different observers. [ABSTRACT FROM AUTHOR]

The article discusses the efficacy of garadacimab in preventing hereditary angioedema (HAE) attacks, with protection starting as early as Week 1 after the first administration. The study shows that garadacimab significantly reduces the monthly number of attacks compared to a placebo, with a high percentage of patients remaining attack-free throughout the study. The data support garadacimab as a long-term prophylactic therapy for HAE, providing early and durable protection against attacks, in line with the latest guidelines for HAE treatment. [Extracted from the article]

In the last decade, large technology companies have started many initiatives to stimulate and innovate in the sphere of medical research. A prominent example is the ResearchKit software framework launched by tech giant Apple in 2015. This software framework enables medical researchers to develop research apps on the iPhone that collect and access diverse types of research data. The 'sphere transgressions' theoretical lens (Sharon, 2021a; 2021b) draws attention to the risks associated with such initiatives. For instance, that large technology companies could utilize the initiatives to change the sphere of medical research in line with their own values and interests. However, the theoretical lens risks portraying a simplistic one-directional understanding of Big Tech colonizing the sphere of medical research. This paper draws attention to medical researchers and their everyday interactions. Based on interviews with medical researchers using Apple's ResearchKit in the Netherlands and the United States, the paper shows that researchers are not passive recipients of Big Tech's initiatives. Instead, they respond to their initiatives in a variety of ways: not simply by welcoming or resisting Apple's ResearchKit, but also by 'making do' using a variety of tactics (de Certeau, 1984). Thinking in terms of tactics, it is argued in the discussion, helps to identify needs and interests that are of crucial importance to researchers and the broader sphere of medical research. These insights can be used to strengthen the sphere of medical research and promote responsible innovation. [ABSTRACT FROM AUTHOR]

Background: Pediatric workforce shortages became more apparent with coronavirus disease 2019 (COVID-19) and the rise in other viruses. Among factors affecting these shortages are undergraduate and graduate curricula that include pediatric content and clinical experiences. Method: A narrative review was conducted to examine the state of the pediatric nursing workforce, describe curricular models in undergraduate and graduate programs, and determine the effects of these models on pediatric content and clinical experiences as well as subsequent employment in pediatric nursing. Results: Curricula affect knowledge of pediatric content and clinical ability to practice, potentially resulting in direct care pediatric workforce shortages and subsequently the number of pediatric nurse practitioners, nurse scientists, and faculty. Conclusion: Research is needed on specific shortages in the pediatric workforce, standardization of required pediatric content and clinical hours, and simulation versus in-person clinical experience to prepare graduates for practice, as well as practice perspectives of new graduates' ability to practice. [J Nurs Educ. 2024;63(12):806–812.] [ABSTRACT FROM AUTHOR]

Objective: There are limited data on researchers' attitudes and beliefs on returning and managing incidental research findings from whole body 18F‐fluorodeoxyglucose–positron emission tomography/computed tomography (FDG PET/CT) imaging. Methods: Site principal investigators (PIs) who enrolled participants for the Treatments Against Rheumatoid Arthritis and Effect on FDG PET/CT (TARGET) trial were surveyed. Results: Of the 28 TARGET site PIs eligible for the study, 18 consented to participate (response rate: 64%). Many site PIs returned incidental findings to participants (61%), and the most common finding that was returned was serious (but not life‐threatening) and treatable (54.5%). More than half of the investigators believed that adequacy of clinical follow up (58.8%) and legal liability if incidental findings are not disclosed (55.6%) were extremely important factors in returning incidental research findings from whole body FDG PET/CT. All investigators felt very obligated to return incidental research findings if scans revealed a treatable, high‐risk medical condition. Most investigators felt very obligated to disclose incidental findings with important health implications (94.4%), for which proven preventive or therapeutic interventions exist (77.8%), that provide early detection of a health problem (72.2%), if participants ask for their incidental findings (72.2%), and if scans have established validity for a particular medical condition (61.1%). Conclusion: Although it is recommended that researchers report and manage incidental research findings, our data show differing views and uncertainties on what and how to return, and the extent of follow up needed to manage, incidental findings from whole body FDG PET/CT; this highlights the need for more specific and standardized guidance. [ABSTRACT FROM AUTHOR]

Background and Purpose: Only a limited number of scales are available, which include a section measuring the reasons for implicit rationing of care. There is no single scale to assess the reasons for implicit rationing of nursing care. The main aim was to develop and psychometrically test a scale assessing the reasons for implicit rationing of nursing care. Methods: The sample comprises 8,027 nurses. Data were collected from the Czech Republic from September 2019 to October 2020. The construct validity of the instrument was assessed using exploratory factor analysis (EFA). To test reliability, Cronbach's alpha was used. Results: The Reasons for Implicit Rationing of Nursing Care Scale consists of 10 items and an 11-point Likert-type scale. The EFA identified two main factors with eigenvalues greater than 1.0 (3.815; 2.689) that explain a total of 99.91% of variance. Factor 1 (communication and material resources) contains six items, and Factor 2 (labor resources) contains four items. Cronbach's coefficient (α) of the scale was.908. Conclusions: The Reasons for Implicit Rationing of Nursing Care Scale is a short, valid, and reliable scale for routine use in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Broad-scale, rapid health care change is critically needed to improve value-based, effective health care. Health care providers and systems need to address common barriers and facilitators across the evidence to implementation pathway, across diverse specialties. However, most evidence translation / implementation research evaluates single topic areas, and may be of limited value for informing comprehensive efforts. This project's objective was to identify, characterize, and illustrate common trans-topic facilitators and barriers of translating new health care evidence results to clinical implementation across multiple medical specialties. Methods: This study was an evaluation of all evidence-based innovation projects completed during 2019–2021. Each project was created with medical group clinical leaders and was intended to inform clinical care. The evaluation took place in a large community-based integrated health care system, and an embedded delivery science and applied research program. Clinical investigators, scientific investigators, and clinical operational leaders received structured questionnaires regarding barriers and facilitators for the operational implementation of new research findings for each project. Responses were mapped to the Consolidated Framework for Implementation Research to identify perceived implementation barriers and facilitators. Results: All 48 projects completed between 2019 and 2021 were evaluated; responses were received for 45 (94%) and 34 had comments mappable to framework domains. Potential barriers and facilitators to clinical implementation of new research results were identified across all five framework domains and, within these, the 38 constructs or sub-constructs. Among 245 total comments, the most commonly cited facilitators were how the new research evidence generated, compelled change (n = 29), specialty communication networks for disseminating results and initiating change (n = 20), leadership engagement in the project (n = 19), and the innovation's relative advantage over existing practices (n = 11). The most commonly cited barriers were inadequate resource commitment for next-step implementation (n = 15), insufficient learning/implementation culture (n = 5), and insufficient individual-level willingness/ability for change (n = 5). Conclusions: A novel large-scale evaluation of barriers and facilitators across the evidence to implementation pathway identified common factors across multiple topic areas and specialties. These common potentially replicable facilitators and modifiable barriers can focus health systems and leaders pursuing large-volume evidence-to-implementation initiatives on those areas with the likely greatest benefit-for-effort, for accelerating health care change. [ABSTRACT FROM AUTHOR]

AbstractIntroductionMethodsResultsConclusionBibliographic databases are essential research tools. In medicine, key databases are MEDLINE/PubMed, Embase, and Cochrane Central (MEC). In education, the Education Resource Information Center (ERIC) is a major database. Medical education, situated between medicine and education, has no dedicated database of its own. Many medical education researchers use MEC, some use ERIC and some do not.We performed a descriptive analysis using search strategies to retrieve medical education references from MEC and ERIC. ERIC references which were duplicates with MEC references were removed. Unique ERIC references were tallied.Between 1977 and 2022, MEC has 359,354 unique references relevant to medical education. ERIC provided 3925 unique references for the same period, all of which would be missed by searching only MEC. The mean unique ERIC medical education references per year for all 46 years is 85 (SD = ±29), or 119 (SD = ±15) for the last 10 years from 2013 to 2022.ERIC consistently offered a small yet significant number of unique references relevant to medical education for decades. We recommend the use of ERIC for medical education research when comprehensive literature searches are required, such as in systematic reviews, scoping reviews, evidence synthesis, or guideline development. [ABSTRACT FROM AUTHOR]

Background: Clinical data warehouses provide harmonized access to healthcare data for medical researchers. Informatics for Integrating Biology and the Bedside (i2b2) is a well-established open-source solution with the major benefit that data representations can be tailored to support specific use cases. These data representations can be defined and improved via an iterative approach together with domain experts and the medical researchers using the platform. To facilitate these discussions, it is important to understand how users interact with the system. Objective: The objective of this work was to develop metrics for describing user interactions with clinical data warehouses in general and i2b2 in particular. Moreover, we aimed to develop a dashboard featuring interactive visualizations that inform data engineers and data stewards about potential improvements. Methods: We first identified metrics for different data usage dimensions and extracted the relevant metadata about previous user queries from the i2b2 database schema for further analysis. We then implemented associated visualizations in Python and integrated the results into an interactive dashboard using Dash. Results: The identified categories of metrics include frequency of use, session duration, and use of functionality and features. We created a dashboard that extends our local i2b2 data warehouse platform, focusing on the latter category, further broken down into the number of queries, frequently queried concepts, and query complexity. The implementation is available as open-source software. Conclusion: A range of metrics can be derived from metadata logged in the i2b2 database schema to provide data engineers and data stewards with a comprehensive understanding of how users interact with the platform. This can help to identify the strengths and limitations of specific instances of the platform for specific use cases and aid their iterative improvement. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusionsLack of recruitment to clinical academic careers is of concern, and may be linked to lack of awareness and promotion of this pathway in undergraduate medical education. Our study explored undergraduate experiences which support academic career progression and potential barriers to pursuing Specialised Foundation roles in the United Kingdom.We adopted a constructivist lens and conducted interviews with specialised foundation programme (SFP) doctors and final year students who had applied for SFP positions. We analysed interview transcripts using reflexive thematic analysis.We recognised four key stages which stimulated and supported students in pursuing a clinical academic career: (1) Lighting the inner spark; (2) Igniting the fire; (3) Feeding the fire; and (4) Seeing through the smoke. Although students showed a strong inner drive, meaningful undergraduate experiences and positive interactions with academics were crucial for sparking academic interests. Participants were more often inspired by their extra-curricular activities than core undergraduate education.Early positive experiences are needed for students to overcome stereotypes and consider clinical academic careers. Medical schools should raise awareness of clinical academic careers early on, ensure all students have opportunities to participate in relevant activities with academic teams, and develop medical educators and researchers who can engage and inspire others. [ABSTRACT FROM AUTHOR]

BACKGROUND: Since the early 2000s, human fibroblast conditioned media (HFCM) has been used in topical growth factor skincare to support skin regeneration and skin rejuvenation. Human fibroblast conditioned media contains the fibroblast secretome including growth factors as well as exosomes. The potential benefits of topically applied exosomes are gaining interest in the medical aesthetic field. OBJECTIVE: This article aims to summarize the preclinical and clinical data available on regenerative HFCM-based topical skincare with a focus on studies investigating products applied to improve overall facial skin rejuvenation and/or after inoffice cosmetic procedures. In addition, available data on fibroblast-derived exosomes will be covered. METHODS: A focused literature review was conducted to provide an overview of evidence on HFCM-based topical skincare. RESULTS: Human fibroblast conditioned media-based skincare significantly reduces signs of skin aging including photodamage, coarse lines and wrinkles, and sagging. After in-office cosmetic procedures, HFCM-based skincare can stimulate skin recovery and reduce downtime as well as provide skin quality benefits to enhance overall treatment outcomes. Application of purified exosomes from HFCM also demonstrated significant improvements in multiple skin aging parameters. CONCLUSION: Human fibroblast conditioned media combines naturally secreted fibroblast-derived growth factors and exosomes that stimulate skin regeneration and rejuvenation as evidenced by a variety of assays and assessments including in vitro preclinical studies, clinical investigator grading, instrumentation measurements, biopsy analyses, and patient-reported outcomes. [ABSTRACT FROM AUTHOR]

AbstractPhenomenon. The language of medicine (i.e., biomedical discourse) represents queerness as pathological, yet it is this same discourse medical education researchers use to resist that narrative. To be truly inclusive, we must examine and disrupt the biomedical discourse we use. The purpose of this study is to disrupt oppressive biomedical discourses by examining the language and structures medical educators use in their publications about queerness in relation to physicians and physician trainees. Approach. We searched PubMed, Web of Science, CINAHL, PsycINFO, and ERIC in October 2021 and again in June 2023 using a combination of controlled vocabulary (select terms designated by a database to enhance and reduce ambiguity in search) and keywords to identify articles related to sexuality, gender, identity, diversity and medical professionals. Searches were limited to articles published from 2013 to the present to align with the passage of The Respect for Marriage Act. Articles were included if they focused on the experiences and paths of physicians and physician trainees identifying with or embodying queerness, were authored by individuals based in the United States, and presented empirical studies. We excluded articles only discussing attitudes of cisgender heterosexual individuals about queerness. Two authors independently screened all articles for inclusion. We then used narrative techniques to “re-story” included articles into summaries, which we analyzed with four guiding questions, using queer theory as a sensitizing concept. Finally, we sought recurrent patterns in these summaries. Findings. We identified 2206 articles of which 23 were included. We found that biomedical discourse often: characterized individuals associated with queerness as a single homogenous group rather than as individuals with a breadth of identities and experiences; implied queer vulnerability without naming–and making responsible–the causes or agents of this vulnerability; and relied minimally on actual intervention, instead speculating on potential changes without attempting to enact them. Reflections. Authors each reflect on these findings from their positionalities, discussing: disrupting essentializing categories like “LGBT”; addressing harm through allyship around queerness; editorial responsibility to disrupt structures supporting oppressive biomedical discourse; the importance of program evaluation and interventions; and shifting the focus of medical education research toward queerness using QuantCrit theory. [ABSTRACT FROM AUTHOR]

Institutions are increasingly employing algorithms to provide performance feedback to individuals by tracking productivity, conducting performance appraisals, and developing improvement plans, compared to traditional human managers. However, this shift has provoked considerable debate over the effectiveness and fairness of algorithmic feedback. This study investigates the effects of negative performance feedback (NPF) on the attitudes, cognition and behavior of medical researchers, comparing NPF from algorithms versus humans. Two scenario-based experimental studies were conducted with a total sample of 660 medical researchers (algorithm group: N1 = 411; human group: N2 = 249). Study 1 analyzes the differences in scientific misconduct, moral disengagement, and algorithmic attitudes between the two sources of NPF. The findings reveal that NPF from algorithms shows higher levels of moral disengagement, scientific misconduct, and negative attitudes towards algorithms compared to NPF from humans. Study 2, grounded in trait activation theory, investigates how NPF from algorithms triggers individual's egoism and algorithm aversion, potentially leading to moral disengagement and scientific misconduct. Results indicate that algorithm aversion triggers individuals' egoism, and their interaction enhances moral disengagement, which in turn leads to increased scientific misconduct among researchers. This relationship is also moderated by algorithmic transparency. The study concludes that while algorithms can streamline performance evaluations, they pose significant risks to scientific misconduct of researchers if not properly designed. These findings extend our understanding of NPF by highlighting the emotional and cognitive challenges algorithms face in decision-making processes, while also underscoring the importance of balancing technological efficiency with moral considerations to promote a healthy research environment. Moreover, managerial implications include integrating human oversight in algorithmic NPF processes and enhancing transparency and fairness to mitigate negative impacts on medical researchers' attitudes and behaviors. [ABSTRACT FROM AUTHOR]

Background/Objectives: Imaging studies have transformed the diagnosis of large vessel vasculitis (LVV) involvement in giant cell arteritis (GCA). A positron emission tomography/computed tomography (PET/CT) scan with 18-fluorodeoxyglucose (18F-FDG) has emerged as a valuable tool for assessing LVV. We aimed to determine the utility of an 18F-FDG-PET/CT scan in detecting LVV in GCA in the ARTESER registry. Methods: The ARTESER study is a large multicenter, retrospective, longitudinal, and observational study, promoted by the Spanish Society of Rheumatology. It included patients newly diagnosed with GCA across 26 tertiary hospitals from 1 June 2013 to 29 March 2019. Patients with a diagnosis of incidental GCA were included if they fulfilled specific criteria, including the ACR 1990 criteria, positive imaging examinations, or the expert clinical opinion of investigators. Differences between patients with positive and negative 18F-FDG-PET/CT scan results were analyzed using a bivariate model. A regression model assessed associations in patients with a positive scan, and the predictive capacity of the cumulative dose of glucocorticoids (GC) on PET scan outcomes was evaluated using ROC curve analysis. Results: Out of 1675 GCA patients included in the registry, 377 met the inclusion criteria of having an 18F-FDG-PET/CT scan. The majority were diagnosed with a cranial GCA phenotype, and 65% had LVV. The thoracic aorta was the most frequently affected. Cardiovascular disease, diabetes, and older age had a negative association with a positive scan outcome. The OR for having a positive 18F-FDG-PET/CTC scan was lower as the number of days increased. Depending on the cumulative dosage of the GC, the 18F-FDG-PET/CT scan showed an AUC of 0.74, with a Youden index > 60 mg/day. Conclusions: Younger patients showed a higher probability of presenting LVV as detected by the 18F-FDG-PET/CT scan. The timing of the examination and the cumulative dosage of the GC influenced the likelihood of a positive result, with earlier tests being more likely to detect inflammation. [ABSTRACT FROM AUTHOR]

We envision this work to assist researchers and medical device developers (beside other stakeholders) to better understand biomaterial‐based medical device development and its approval process proposed by the new MDR and IVDR in the European Union, as more complex biomaterials emerge, with the MDR reflecting the progress in biomaterial discoveries. Additionally, insufficient international harmonization in regulatory laws and poor‐quality data reporting contribute to the problem. This review describes the possible reasons for a slowing biomaterials translational trend observed over the past decades, focusing on the European Market, and suggests a feasible approach for biomaterials‐based medical device translation into the clinic. Suitable solutions to upgrade biomaterial translation to the clinic have not yet been provided by the field: no additional hurdles should be imposed for researchers, clinicians, the medical device industry, and insurance companies, which all should collaborate on bringing innovative solutions to patients. The new MDR and IVDR represent a substantial advancement in ensuring patient safety and reflect a major step forward in healthcare. However, they should not constrain innovation in biomaterials‐based medical device development. Incorporating reverse engineering from patient safety and a ‘safe by design’ (SbD) strategy early into medical device development might lead to a smoother and successful approval process. A solid R&D phase, with an emphasis on device safety and performance assessment, is fundamental to ensure an effective transition into the clinic. We offer an overview of the recently implemented regulations on medical devices and in vitro diagnostics across the EU, describing a shifting paradigm in the field of biomaterials discovery. As more complex biomaterials emerge, suitable regulations will be necessary to keep bringing safe and well‐performing medical solutions to patients. [ABSTRACT FROM AUTHOR]

Background: Over the past decade, ultrasound utilization has increased within anesthesia and intensive care medicine, enhancing patient safety and diagnostic accuracy. However, the frequency of ultrasound usage and operator training in the Nordic countries remain unclear. This project aims to perform a survey on ultrasound availability, daily clinical use, and how ultrasound skills are trained and assessed, among anesthesiologists. Methods: This online cross‐sectional survey will include anesthesiologists from the Nordic countries. The survey will adhere to the CROSS checklist. Survey items will be developed based on a formative model with a conceptual model, consisting of three main parts, including demographics, ultrasound machines and use, and skills development and assessment. The clinical relevance of items will be secured by including anesthesiologists of various levels of experience in the development of the survey. Furthermore, experienced researchers in medical education will participate in the development, contributing with relevant medical educational perspectives. Data will be summarized using a non‐parametric descriptive approach. A chi‐squared test will examine relevant relationships between certain answers. Results: Results will be published in a peer‐reviewed journal and presented at relevant scientific conferences and meetings. Conclusion: This study may find a high availability of ultrasound machines and frequent use in the clinical departments. Despite this expected daily use of ultrasound, missing standardized structured skills acquisition and assessment could be uncovered. The results of this study may contribute to mapping various aspects of clinical ultrasound and skills development for further use in research. [ABSTRACT FROM AUTHOR]

Purpose: In 2024, medical researchers in the Republic of Korea were invited to amend the health and medical data utilization guidelines (Government Publications Registration Number: 11-1352000-0052828-14). This study aimed to show the overall impact of the guideline revision, with a focus on clinical genomic data. Materials and Methods: This study amended the pseudonymization of genomic data defined in the previous version through a joint study led by the Ministry of Health and Welfare, the Korea Health Information Service, and the Korea Genome Organization. To develop the previous version, we held three conferences with four main medical research institutes and seven academic societies. We conducted two surveys targeting special genome experts in academia, industry, and institutes. Results: We found that cases of pseudonymization in the application of genome data were rare and that there was ambiguity in the terminology used in the previous version of the guidelines. Most experts (>~90%) agreed that the 'reserved' condition should be eliminated to make genomic data available after pseudonymization. In this study, the scope of genomic data was defined as clinical next-generation sequencing data, including FASTQ, BAM/SAM, VCF, and medical records. Pseudonymization targets genomic sequences and metadata, embedding specific elements, such as germline mutations, short tandem repeats, single-nucleotide polymorphisms, and identifiable data (for example, ID or environmental values). Expression data generated from multi-omics can be used without pseudonymization. Conclusion: This amendment will not only enhance the safe use of healthcare data but also promote advancements in disease prevention, diagnosis, and treatment. [ABSTRACT FROM AUTHOR]

Contrary to the expectations and intentions of inpatient mental healthcare, reports of adverse experiences by people admitted to inpatient settings are common and on the rise. Such experiences negatively impact individuals' mental health and recovery and incur costs to their networks, mental health providers, the healthcare system, and society at large. Research indicates ongoing challenges in understanding and addressing the complex interplay of factors that contribute to a diverse range of adverse experiences, from seclusion, restraint, and coercion, to boredom, loneliness, and lack of therapeutic relationships. There is a pressing need to better understand the mechanisms of adverse inpatient mental health experiences and identify frameworks to aid in more efficient and effective translation of knowledge into practice. This paper proposes self-determination theory (SDT) as a framework that can assist nurse researchers and practitioners elucidate the nature of adverse experiences and guide developments to mitigate adverse outcomes. Critically, SDT prioritises human psychological needs and wellbeing, and thus has potential to inform rights-based, person-centred, recovery-oriented research and development. This paper provides an overview of recent literature on adverse experiences before introducing SDT. It then considers adverse inpatient mental health experiences through the lens of SDT, providing actionable guidance for nursing research and development. [ABSTRACT FROM AUTHOR]

In this paper, we present a set of recommendations for using social media as a tool for participant recruitment in survey‐based medical education research. Drawing from a limited but growing body of literature, we discuss the opportunities and challenges inherent to social media recruitment. This article builds on the authors' previous educator's blueprints about survey design and administration. We highlight the advantages of social media, including its wide reach, cost‐effectiveness, and capability to access diverse and geographically dispersed populations, which can significantly enhance the representativeness of research samples. However, we also caution against potential pitfalls, such as ethical concerns, sampling bias, and the fluid nature of social media platforms. Our recommendations are informed by both empirical evidence and best practices, aiming to provide researchers with practical advice for effectively leveraging social media in survey‐based medical education research. We emphasize the importance of selecting suitable platforms and engaging with targeted demographics thoughtfully. By sharing our insights, we hope to assist fellow medical education researchers in navigating the complexities of social media recruitment, thereby enriching the quality and impact of survey‐based research in this field. [ABSTRACT FROM AUTHOR]

The U.S. Food and Drug Administration (FDA) has broadly supported quality by design initiatives for clinical trials – including monitoring and data validation – by releasing two related guidance documents (FDA 2013 and 2019). Centralized statistical monitoring (CSM) can be a component of a quality by design process. In this article, we describe our experience with a CSM platform as part of a Cooperative Research and Development Agreement between CluePoints and FDA. This agreement's approach to CSM is based on many statistical tests performed on all relevant subject-level data submitted to identify outlying sites. An overall data inconsistency score is calculated to assess the inconsistency of data from one site compared to data from all sites. Sites are ranked by the data inconsistency score ($ - {\log _{10}}\left(p \right), $ − log 10 p , where $p$ p is an aggregated p-value). Results from a deidentified trial demonstrate the typical data anomaly findings through Statistical Monitoring Applied to Research Trials analyses. Sensitivity analyses were performed after excluding laboratory data and questionnaire data. Graphics from deidentified subject-level trial data illustrate abnormal data patterns. The analyses were performed by site, country/region, and patient separately. Key risk indicator analyses were conducted for the selected endpoints. Potential data anomalies and their possible causes are discussed. This data-driven approach can be effective and efficient in selecting sites that exhibit data anomalies and provides insights to statistical reviewers for conducting sensitivity analyses, subgroup analyses, and site by treatment effect explorations. Messy data, data failing to conform to standards, and other disruptions (e.g. the COVID-19 pandemic) can pose challenges. [ABSTRACT FROM AUTHOR]

Phenomenological researchers are obliged to grasp the epistemological and ontological differences between the Husserlian and Heideggerian branches of phenomenology to avoid misappropriating phenomenological terms or mischaracterizing study design. To that end, we spell out the key differences between both phenomenological traditions as background for describing the indelible role that the researcher's background assumptions, or fore‐structure, play in interpretive studies. We draw on our four studies to illustrate how we traversed the hermeneutic circle to disclose, challenge, and refine the personal, cultural, clinical, and scientific assumptions hidden in our fore‐structures. Our reflections highlight how understanding evolves, not by bracketing or disengaging ourselves from the phenomena we study, but by engaging in an open dialog that seeks understanding as lived by patients and families. [ABSTRACT FROM AUTHOR]

A rapid expansion of the computer technology industry, particularly in the field of artificial intelligence, has ignited a global concern that warrants our immediate action. As nurses, our professional values frameworks compel us to protect public health and address national and global health issues. When industry activities adversely affect the social wellbeing of civil society and social institutions, it is important to evaluate them against their industry's 'social license to operate,' which is a measure of public trust, credibility, and the legitimacy of their industrial and corporate citizenship status. The central question is, do computer technology companies continue to have a social license to operate in civil society? Nurses are encouraged to evaluate the computer technology industry's recent 'generative artificial intelligence' chatbot activities against its tacit undertaking to be good corporate citizens in return for social acceptance of their operations and behaviour. An evidence-based overview of chatbot impacts on societies, environmental sustainability and human rights provide a basis for evaluation. Basic computer technology terminology and relevant concepts are explained. This article is a direct call to action for clinical nurses and those involved in research, education, management, and policy. We have a duty to critically assess the claims made by chatbot technology vendors in both practice and social contexts. If these vendors integrate chatbot technologies with existing machine learning used in nursing and healthcare technologies it could result in detrimental effects beyond user control. By influencing decisions on technology adoption, we can ensure the implementation of safeguards, protect patient safety and social well-being, and uphold the integrity of nursing values. A closing discussion of impacts of computer industry trust deficits on healthcare and research reflects the author's concerns and conclusions about the central question. Readers may draw other conclusions and perhaps use the issues and evidence presented here to stimulate further investigations. [ABSTRACT FROM AUTHOR]

The article published in Clinical & Experimental Dermatology explores the repigmentation rates in facial vitiligo, highlighting the variability in improvement across different facial areas. The study conducted a retrospective analysis of 36 patients with facial vitiligo treated with topical treatment and methotrexate, with some patients also receiving phototherapy. Results showed that the periocular/perioral region had the lowest improvement in repigmentation, while the central part of the face showed less improvement compared to noncentral facial areas. The study provides valuable predictive information for patients with vitiligo, emphasizing the need for further research to understand the underlying mechanisms affecting repigmentation in different facial areas. [Extracted from the article]

Over the past decades, single-molecule and super-resolution microscopy have advanced and represent essential tools for life science research. There is, however, a growing gap between the state of the art and what is accessible to biologists, biochemists, medical researchers, or labs with financial constraints. To bridge this gap, we introduce Brick-MIC, a versatile and affordable open-source 3D-printed microspectroscopy and imaging platform. Brick-MIC enables the integration of various fluorescence imaging techniques with single-molecule resolution within a single platform and exchange between different modalities within minutes. We here present variants of Brick-MIC that facilitate single-molecule fluorescence detection, fluorescence correlation spectroscopy, time-correlated single-photon counting and super-resolution imaging (STORM and PAINT). Detailed descriptions of the hardware and software components, as well as data analysis routines, are provided, to allow non-optics specialists to operate their own Brick-MIC with minimal effort and investments. We foresee that our affordable, flexible, and open-source Brick-MIC platform will be a valuable tool for many laboratories worldwide. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Publishing medical metadata stored in case report forms (CRFs) is a prerequisite for the development of a learning health system (LHS) by fostering reuse of metadata and standardization in health research. The aim of our study was to investigate medical researchers' (MRs) willingness to share CRFs, to identify reasons for and against CRF sharing, and to determine if and under which conditions MRs might consider sharing CRF metadata via a public registry.We examined CRF data sharing commitments for 1842 interventional trials registered on the German Clinical Trials Registry (DRKS) from January 1, 2020, to December 31, 2021. We invited 1360 individuals registered as contacts on DRKS to participate in a web‐based survey between May 10, 2022, and June 30, 2022.Only 0.3% (5/1842) of data sharing commitments in DRKS included a plan to share blank CRFs. Survey results showed high support for CRF sharing. More than 70% of respondents (223/301) were willing to share their CRFs, and 83.7% (252/301) were interested in CRF reuse. The most frequently reported reason for CRF sharing was improvement of comparability and interpretability of patient data (244/301; 81.0%). The most frequently reported reason against CRF sharing was missing approval by the sponsor (160/301; 53.2%). Researchers conducting commercial trials were significantly less likely to share CRFs than those conducting noncommercial trials (63.3% vs. 76.2%, OR 0.54, 95% CI 0.32–0.92) and they were less likely to reuse CRFs (78.5% vs. 84.6%, OR 0.66, 95% CI 0.35–1.24). The most frequently mentioned prerequisite for publication of CRFs in a public registry was its trustworthiness (244/301, 81.1%).Data sharing commitments in DRKS revealed a low awareness of CRF sharing. Survey results showed generally strong support for CRF sharing, including the willingness to publish CRFs in a public registry, although legal and practical barriers were identified. [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed neurodevelopmental disorders. This article aims to identify the risk factors for ADHD, with a particular focus on its genetic basis. The complex etiology of ADHD results from the interplay of both environmental and genetic factors, making it challenging to pinpoint specific determinants contributing to the disorder's phenotype. Among the most significant genetic risk factors are genes regulating the dopaminergic and serotoninergic pathways. Genetic factors involved in various biological processes, such as neuronal transmission, neural cell migration, and neurotransmitter energy metabolism, also warrant attention. Despite advancements in ADHD research, understanding the pathomechanism of this disorder remains a significant challenge for medical professionals and researchers. The limited knowledge of the biological foundations of ADHD hampers the recognition of risk variants for this disorder. Therefore, further research is necessary to identify at-risk groups and develop more effective diagnostic tests and therapeutic methods in the future. [ABSTRACT FROM AUTHOR]

This article critically analyzes the debate surrounding methodological naturalism (MN) within the context of scientific inquiry, focusing on the arguments put forth by Andrew Torrance on the one hand and John Perry and Sarah Lane Ritchie on the other. It begins with the medical mystery known as the spontaneous remission of cancer--sometimes identified as a "miracle"--posing the question of how Christian medical researchers should approach this anomaly. Thereafter, I consider how Torrance's rejection of MN, due to its perceived conflict with faith, would expect the Christian scientist to respond. Conversely, Perry and Ritchie defend MN, emphasizing its importance in maintaining scientific rigor and avoiding a "God of the gaps" approach. Subsequently, I demonstrate how both science and MN are conceived of differently between the two parties, indicating that this is primarily a semantic debate. Finally, after examining Torrance's response to Perry and Ritchie, I propose a more nuanced approach, advocating for methodological flexibility wherein the nature of the question being asked determines the appropriate method one should employ. [ABSTRACT FROM AUTHOR]

It is a commonly accepted idea that complex structural challenges can be solved if private actors, NGOs, and the public authorities collaborate (Brogaard in Politica 47(4):541–560, 2015), a view that has come to frame several publicly funded network activities in Denmark. This article takes its point of departure in one such project aimed at setting up a collaborative network between researchers, patient associations, and life science partners to stimulate growth in research and development. We analyse this project as a social arena with a focus on what is at stake for patient organisations in such a collaboration. Using social worlds and arena theory, we map the negotiation of discourses, images, and positions, thereby answering the questions: What kind of relationships emerge as patient organisations network with researchers and the life science industry in the name of patient centricity and how do patient organisations balance legitimacy, representation, and independence in such collaboration? We argue that patient organisations' positions are expanding and taking new forms as they perform a balancing act, from which a 'multiplayer position' seems to have emerged. Lastly we propose that patient organisations' complex interdependencies should be acknowledged, and introduce an understanding of 'cumulative drives' to capture the nature of these complexities. [ABSTRACT FROM AUTHOR]

Background: For years, nurse researchers have been called upon to engage with "big data" in the electronic health record (EHR) by leading studies focusing on nurse-centric patient outcomes and providing clinical analysis of potential outcome indicators. However, the current gap in nurses' data science education and training poses a significant barrier. Objectives: We aimed to evaluate the viability of conducting nurse-led, big-data research projects within a custom-designed computational laboratory and examine the support required by a team of researchers with little to no big-data experience. Methods: Four nurse-led research teams developed a research question reliant on existing EHR data. Each team was given its own virtual computational laboratory populated with raw data. A data science education team provided instruction in coding languages--primarily structured query language and R--and data science techniques to organize and analyze the data. Results: Three research teams have completed studies, resulting in one manuscript currently undergoing peer review and two manuscripts in progress. The final team is performing data analysis. Five barriers and five facilitators to big-data projects were identified. Discussion: As the data science learning curve is steep, organizations need to help bridge the gap between what is currently taught in doctoral nursing programs and what is required of clinical nurse researchers to successfully engage in big-data methods. In addition, clinical nurse researchers require protected research time and a data science infrastructure that supports novice efforts with education, mentorship, and computational laboratory resources. [ABSTRACT FROM AUTHOR]

The Chronic Angioedema Registry (CARE) is an international disease registry that aims to improve patient care for recurrent angioedema. It collects data through questionnaires completed by physicians and patients to assess disease control, quality of life, and treatment responses. However, the outcomes may not apply to less severe cases typically seen in primary care or community settings, and the findings may not be generalizable to patients from diverse ethnic backgrounds. The document also lists conflicts of interest for authors involved in the CARE study, who have disclosed financial relationships with pharmaceutical companies and other organizations. The study received approval from the Ethics Committee of Charité—Universitätsmedizin Berlin. [Extracted from the article]

Introduction: Investigations of responses of animals and humans to changes of plasma volume are usually reported as average responses of groups of individuals. This ignores considerable quantitative variation between individuals. We examined the hypothesis that individual responses follow a common temporal pattern with variations reflecting different parameters describing that pattern. Methods: We illustrate this approach using data of Hahn, Lindahl and Drobin (Acta Anaesthesiol Scand.2011, 55:987‐94) who measured urine volume and haemoglobin dilution of 10 female subjects during intravenous Ringer infusions for 30 min and subsequent 3.5 h. The published time courses were digitised and analysed to determine if a family of mathematical functions accounted for the variation in individual responses. Results: Urine excretion was characterised by a time delay (Td) before urine flow increased and a time course of cumulative urine excretion described by a logarithmic function. This logarithmic relation forms the theoretical basis of a family of linear relations describing urine excretion as a function of Td. Measurement of Td enables estimation of subsequent values of urine excretion and thereby the fraction of infused fluid retained in the body. Conclusion: The approach might be useful for physiologists and clinical investigators to compare the response to infusion protocols when both test and control responses can be described by linear relations between cumulative urine volume at specific times and Td. The approach may also be useful for clinicians by complementing strategies to guide fluid therapy by enabling the later responses of an individual to be predicted from their earlier response. [ABSTRACT FROM AUTHOR]

Over the past decade, medical researchers in China have debated whether the Pi (脾) corresponds to the biomedical spleen or pancreas. This debate exemplifies a broader phenomenon of "anatomical retrofitting", or the anachronistic imposition of contemporary categories onto living historical objects. "Anatomical retrofitting" as a means of rectifying cases of mistranslation further positions the biomedical spleen and pancreas as representing ahistorical, universal truths. This framework gives rise to a conceptual binary: while the biomedical spleen is universalized as what philosophers may describe as "logical" ontology, the Pi connects to a different nature of reality, or "metaphysical" ontology. Far from being an object of imprecision, the Pi was a dynamic vessel that also shared characteristics with the humoral spleen. Given that scholars in China have already subjected Pi to historical scrutiny, this paper urges scholars to do the same with biomedical anatomy. For instance, historically situating the humoral spleen demonstrates that it became less known and less articulated as it transformed into the biomedical spleen. Meanwhile, the pancreas remained an unstable epistemic object that took on the dynamic functions of the humoral spleen in nineteenth-century organotherapy. Through primary source analysis and literature review, this paper contends that the apparent ontological incommensurability between Pi and spleen is neither mutually exclusive nor irreconcilable. Instead, the dynamic nature of internal viscera, their many functions, and their participation in epistemic practices contribute to an ongoing ontological ambivalence that persists despite the forced certainty of anatomical retrofitting. [ABSTRACT FROM AUTHOR]