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Abstract Evidence-based policymaking has increased policymakers’ capacity to make scientifically informed health policy decisions. However, reaping the benefits of this approach requires avoiding untrustworthy research – potential sources of which are predatory journals. In this study, we sought to understand how research cited in policy documents is sourced and evaluated, and identify factors that may be contributing to the citation of predatory journals or other less trustworthy evidence. To this end, we conducted semi-structured interviews with individuals who have prepared public health policy documents. These interviews were thematically analysed, and five key overarching themes were generated regarding the process of deciding how to develop policy documents (e.g. which individuals to involve) and how this may impact which information is included; obstacles such as limited evidence that may hinder policy document development; and concerns around transparency throughout the development process. Our findings highlight that in many cases, information cited in policy documents is sourced and evaluated with variable rigour. This may contribute to the citation of untrustworthy research in policy documents. Certain steps can be taken to help minimize any potential negative impact of relying on such sources (e.g. improving transparency), but a better understanding of policymakers’ perspectives regarding how taking these steps would impact their decision-making process may be required to ensure successful implementation.

Introduction Early diagnosis of acute kidney injury (AKI) is limited with current tools. MicroRNAs (miRNAs) are implicated in AKI pathogenesis in preclinical models, but less is known about their role in humans. We conducted a systematic review to identify dysregulated miRNAs in humans with AKI.Methods We searched Ovid MEDLINE, Embase, Web of Science, and CENTRAL (August 21, 2023) for studies of human subjects with AKI. We excluded reviews and pre-clinical studies without human data. The primary outcome was dysregulated miRNAs in AKI. Two reviewers screened abstracts, reviewed full texts, performed data extraction and quality assessment (Newcastle Ottawa Scale).Results We screened 2,456 reports and included 92 for synthesis without meta-analysis. All studies except one were observational. Studies were grouped by etiology of AKI: cardiac surgery-associated (CS-AKI, n = 13 studies), sepsis (n = 25), nephrotoxic (n = 9), kidney transplant (n = 26), and other causes (n = 19). In total, 128 miRNAs were identified to be dysregulated across AKI studies (45 miRNAs upregulated, 55 downregulated, 28 both). miR-21 was the most frequently reported (n = 17 studies) and it was increased in all etiologies except CS-AKI where it was decreased (n = 3 studies). Study limitations included bias due to targeted approaches, absence of clinical data/controls, and miRNA normalization methods. Overall study quality was fair (median 5/9, range 2-8 points).Conclusion Dysregulated miRNAs, particularly miR-21, have potential as AKI biomarkers. These results should be interpreted cautiously due to methodological limitations. Standardized methods and unbiased approaches are needed to validate candidate miRNA biomarkers.Registration: International Prospective Register of Systematic Reviews (PROSPERO CRD42020201253)

Background: Embracing patient viewpoints can enhance the translation of novel therapeutics to clinical settings. This study evaluated the acceptability of using extracellular vesicles (EVs) as a biological therapy for preventing postoperative atrial fibrillation (AF), through engagement with patients, providing insights into their attitudes and information needs. Methods: Patients participated in prerecorded presentations, virtual focus groups, and surveys to assess their perspectives on EV therapy and determine the factors influencing their acceptance of the intervention. Results: Participants with postoperative AF experienced prolonged intensive care unit and hospital stays, compared to those of patients with normal heart rhythm. Prior to the presentation, a number of participants were unfamiliar with postoperative AF and biological therapies. However, postpresentation and post–focus group activities resulted in enhanced understanding of the research, with high levels of comprehension reported by all participants. The level of acceptance of EV therapy tended to increase, with a majority expressing willingness to participate in clinical trials and accept the therapy. The focus groups identified and addressed common questions regarding the potential risks and side effects of EVs, their source, dosing, utility for patients with preexisting AF, and the risk of human immunodeficiency virus (HIV) contraction or allergic reactions. Conclusions: The study highlights the importance of providing education, involving the patient's circle of care, and addressing patient concerns, to promote acceptance of therapies such as EV therapy for postoperative AF. Clinical Trial Registration: NCT05032495. Résumé: Contexte: Adopter le point de vue des patients permet de faciliter l’introduction de nouveaux traitements en milieu clinique. Cette étude visait à évaluer l’acceptabilité des vésicules extracellulaires comme traitement biologique dans la prévention de la fibrillation auriculaire postopératoire en favorisant un rapprochement avec les patients, en comprenant leurs attitudes et leurs besoins d’information. Méthodologie: Les patients ont assisté à des présentations préenregistrées, ont participé à des groupes de discussion virtuels et ont rempli des questionnaires. L’objectif était d’évaluer leur point de vue sur les vésicules extracellulaires et de déterminer les facteurs influençant l’acceptation de l’intervention. Résultats: Les participants atteints de fibrillation auriculaire postopératoire sont restés plus longtemps à l’unité des soins intensifs et à l’hôpital par comparaison aux patients ayant un rythme cardiaque normal. Avant la présentation, un certain nombre de participants ne connaissaient pas la fibrillation auriculaire postopératoire et les traitements biologiques. Cependant, après la présentation et le groupe de discussion, les participants ont pu mieux comprendre la recherche, et tous ont indiqué un niveau de compréhension élevé. Le degré d’acceptation des vésicules extracellulaires avait tendance à augmenter. En effet, la majorité des patients se disait prête à participer à des essais cliniques et à accepter le traitement. Les groupes de discussion ont relevé et abordé des questions communes concernant les risques et effets secondaires des vésicules extracellulaires, leur source, leur dose, leur utilité pour les patients présentant une fibrillation auriculaire préexistante et le risque d’infection par le virus de l’immunodéficience humaine (VIH) ou de réactions allergiques. Conclusions: L’étude souligne l’importance de l’éducation, de la participation du réseau de soins du patient et de la prise en compte des préoccupations du patient pour favoriser l’acceptation de traitements comme les vésicules extracellulaires pour la fibrillation auriculaire postopératoire. Enregistrement de l’essai clinique: NCT05032495.

Introduction Home-based, virtually-supported care models may represent the most efficient and scalable approach to delivering prehabilitation services. However, virtual approaches to prehabilitation are understudied. This manuscript describes the protocol for an internal pilot randomised controlled trial of a virtually-delivered, multimodal prehabilitation intervention.Methods and analysis We will conduct a pragmatic, individual patient, internal pilot randomised controlled trial of home-based, virtually supported, multimodal prehabilitation compared with standard perioperative care in adults undergoing elective, inpatient thoracic, abdominal, pelvic and vascular surgery at five Canadian hospitals. Participants will be partially blinded; clinicians and outcome assessors will be fully blinded. The intervention consists of 3–12 weeks of a home-based, multimodal (exercise, nutrition and psychosocial support) prehabilitation programme supported through an online platform. The primary feasibility outcomes and their progression targets are (1) monthly recruitment of>6 participants at each centre, (2) intervention adherence of>75%, (3) retention of>90% of participants at the patient-reported primary outcome point of 30-days after surgery and (4) elicitation of patient, clinician and researcher-identified barriers to our pragmatic trial. A sample size of 144 participants will be adequate to estimate recruitment, adherence and retention rates with acceptable precision. All participants will be followed to either death or up to 1 year. As an internal pilot, if no substantive changes to the trial or intervention design are required, pilot participant outcome data will migrate, unanalysed by allocation, to the future full-scale trial.Ethics and dissemination Ethical approval has been granted by Clinical Trials Ontario (Project ID: 4479) and our ethics review board (Protocol Approval #20230399–01T). Results will be disseminated through presentations at scientific conferences, peer-reviewed publications, partner organisations and engagement of social and traditional media.Trial registration number ClinicalTrials.gov identifier NCT06042491. Protocol, V.1.2, dated 6 June 2024.

A Two-Source Energy Balance (TSEB) model computes surface energy fluxes using soil surface temperature and canopy temperature. An experiment was carried out in a research farm near the agrometeorological observatory, at Anand, India to parameterize the TSEB model for the mustard (Brassica Juncea) crop, to estimate surface energy fluxes and validate the TSEB-2T model. The TSEB-2T model was validated using net radiation measurements. Results revealed that modeled net radiation under all sowings. Very late sowing had comparatively high dr 0.61, r 0.78** and low RMSE 58.12 Wm−2, MAE 46.47 Wm−2 and low MBE 1.66. Net radiation over mustard ranged from 269 to 538 Wm−2 with relatively high peaks in the second sowing date. Sensible heat flux was relatively high during early growth and after the seed development phase. Latent heat flux and sensible heat flux had inverse partitioning patterns during the crop cycle of the mustard. Ground heat flux had negligible partitioning from net radiation after the seed initiation stage. During vegetative to pod initiation phases, the net radiation fraction for latent heat was high compared to sensible heat. Peak daily evapotranspiration based on modeled latent heat during the flowering to pod initiation phase was about 3.7 mm day−1. HIGHLIGHTS A Two-Source Energy Balance (TSEB) model was used to estimate surface energy fluxes over mustard crops.; The TSEB-2T model was validated using net radiation measurements. The model performed well under all sowings.; Latent heat flux was high during the vegetative and pod initiation phases, while sensible heat flux was high during early growth and after the seed development.; Peak evapotranspiration (3.7 mm day-1) was estimated during flowering and pod initiation.; The seasonal evapotranspiration of mustrard varied between 192.51 and 316.74 mm under different growing environments.;