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Automated information extraction for behavioural interventions: evaluation and reflections on interdisciplinary AI development

Background The HBCP knowledge system identifies and extracts entities from randomised controlled trials of behaviour change interventions organised by a behaviour change intervention ontology (BCIO) to populate: 1) an outcome prediction tool; and 2) a research browser tool. This knowledge system requires automated information extraction algorithms to query and interpret evidence from behaviour change intervention (BCI) reports. This paper reports the results of an evaluation of the automated information extraction and reflects on the results in relation to the challenges of interdisciplinary working and collaboration. Methods The evaluation used a dataset of 117 previously unseen BCI reports to assess its performance. The automatically extracted information was compared to the full text PDF by trained annotators on essential BCIO entities required for the outcome prediction tool and research browser tool and whether the extracted information was assigned to the correct arm of the randomised trial. Essential entities were the outcome value, a selection of the most common Behaviour Change Techniques (BCTs), the mode of intervention delivery, and key population characteristics. Results The evaluation found an outcome value present in 53.85% (n=63) of the output from the information extraction system but it never extracted both the correct outcome values (interventions and control arms) and assigned them to the correct study arms (intervention and control). Although 84.62% (n=99) of the papers contained information relevant to Behaviour Change Techniques (BCTs), the information extraction algorithm correctly extracted only 58.59% (n=58) of BCTs. Conclusions The evaluation found that the information extraction algorithm did not extract the outcome values and key BCIO entities correctly against the correct arms in any of the papers in our sample, making it unsuitable for deployment in the outcome prediction and research browser tools. Several challenges with working in interdisciplinary teams were identified and discussed along with lessons learned for future work.

Vocal Self-Perception of Singers During COVID-19 Pandemic.

to compare the self-perception of vocal fatigue and use of singing voice during the COVID-19 pandemic between professional and amateur singers and to relate this self-perception with vocal use characteristics during this period. Participants were 121 singers divided into professional singers group (PSG) (12 men and 20 women) comprising singers who depended exclusively on singing as a profession and an amateur singers group (ASG) (37 men and 52 women) of singers who did not depend exclusively on singing for their livelihood. All answered online questionnaires through Google Forms ®. Sociodemographic and vocal characteristics were investigated before and during the pandemic; symptoms of vocal fatigue were assessed through the vocal fatigue index (VFI); and self-perception of use of singing voice through the evaluation of the ability to sing easily protocol for Brazil (EASE-Br). In the comparison between groups, the PSG presented higher scores of vocal fatigue in fatigue and vocal limitation (P=0.045), vocal restriction (P=0.002), and recovery with vocal rest (P=0.008) domains than did the ASG. There was no difference between the groups regarding the use of singing voice. Based on the relationship between self-perception and vocal use characteristics during the pandemic, it was observed that the presence of vocal complaint was the only factor associated with self-perception of fatigue symptomatology in both groups. Regarding the self-perception of the current status of the singing voice, singing time, the presence of vocal complaints, the need to increase visual concentration, and the perception of vocal worsening during the pandemic were considered predictive for amateur singers. For professional singers, vocal complaints and vocal training were predictors for self-perception of the current status of the singing voice. Professional singers presented with higher scores of vocal fatigue than did amateur singers. The symptomatology of vocal fatigue was associated with the presence of vocal complaints in both groups. However, self-perception of the current status of the singing voice was different between the groups and was associated with vocal training for professional singers and characteristics of vocal demand of singing voice during the pandemic period for amateur singers.

Development of a Multi-site Curriculum for Inequities in Newborn Care (CINC) Informed by Pediatric Resident and Community Engagement.

Inequities in health care are a well-identified contributor to adverse outcomes in neonates of vulnerable populations. 1 2022 March of Dimes Report Card. Accessed March 8, 2023. 〈https://www.marchofdimes.org/report-card〉 Google Scholar , 2 Warren M.D. Hirai A.H. Lee V. Accelerating Upstream Together: Achieving Infant Health Equity in the United States by 2030. Pediatrics. Published online January. 2022; 3e2021052800https://doi.org/10.1542/peds.2021-052800 Crossref Scopus (2) Google Scholar , 3 Sigurdson K. Morton C. Mitchell B. Profit J. Disparities in NICU quality of care: a qualitative study of family and clinician accounts. Journal of Perinatology. 2018; 38: 600-607https://doi.org/10.1038/s41372-018-0057-3 Crossref PubMed Scopus (61) Google Scholar Societal and institutional inequities rooted within implicit biases and racism result in variable quality of care in the nursery, such as differences in time spent skin-to-skin with infants, clinical resource allocation based on racial background, and a lack of motivation to establish a therapeutic alliance with families who have differing social and cultural needs. 3 Sigurdson K. Morton C. Mitchell B. Profit J. Disparities in NICU quality of care: a qualitative study of family and clinician accounts. Journal of Perinatology. 2018; 38: 600-607https://doi.org/10.1038/s41372-018-0057-3 Crossref PubMed Scopus (61) Google Scholar Most significantly, this inequitable care results in the increased mortality of non-Hispanic black and Hispanic infants as compared to infants of non-Hispanic white backgrounds. 4 National Vital Statistics Reports Volume 69, Number 7 July 16, 2020, Infant Mortality in the United States, 2018 : Data From the Period Linked Birth/Infant Death File. Google Scholar In light of these inequities, the Academic Pediatrics Association (APA) implemented initiatives rooted in active anti-racism to dismantle oppressive power structures across pediatric organizations. 5 Cohen A. et al. Changing Who Has a Seat and Voice at the Table: How the Academic Pediatric Association is Responding to Systemic Racism. Academic Pediatrics. 2022; 22: 352-355https://doi.org/10.1016/j.acap.2022.01.002 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar This urgent commitment to action is further supported by the Association of Pediatric Program Directors (APPD) which maintains that anti-racism involves actively dismantling racism in all that we do. 6 Blankenburg B. et al. Dismantling Racism: Association of Pediatric Program Directors’ Commitment to Action. Academic Pediatrics. 2020; 20: 1051-1053https://doi.org/10.1016/j.acap.2020.08.017 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar Focus groups of trainees at 4 Bay Area academic medical centers explored gaps in education on newborn health inequities to best understand how to support providers in actively practicing anti-racism in clinical care. Trainees spotlight inequities in their rotations, but feel helpless to address them given a lack of action-based tools, education on inequities, protected time for reflection, and faculty role-modeling. 7 Hume P. , Bowers K. , Robertson L. , et al. Residents’ Perspectives on Neonatal Health Inequities to Guide an Innovative Curriculum. Poster Presentation presented at: APPD; March 2023; Atlanta, Georgia. Google Scholar Given these highlighted gaps, we sought to provide our pediatrics faculty and trainees with action-oriented education to address inequities.

Health Equity in the Neonatal Intensive Care Unit Rounds: A Multidisciplinary Educational Conference.

Despite improving pregnancy-related morbidity and mortality in other high-income countries, birthing people and infants in the United States have disparate and worsening outcomes influenced by structural, political, and moral determinants of health including racism. 1 2021 Annual Report. America's Health Rankings, United Health Foundation. 〈https://www.americashealthrankings.org/learn/reports/2021-annual-report/international-comparison〉. Published 2021. Accessed2022. Google Scholar , 2 Clark A. Wescott P. Mitchell N. Mahdi I. Crear-Perry J. Centering equity: Addressing structural and social determinants of health to improve maternal and infant health outcomes. Semin Perinatol. 2022; 46151661 Crossref PubMed Scopus (3) Google Scholar As clinicians in the neonatal intensive care unit (NICU), we are professionally obligated to enact structural and individual changes to mitigate disparities. 3 Cohen A. Montez K. Orr C. et al. Changing Who Has a Seat and Voice at the Table: How the Academic Pediatric Association is Responding to Systemic Racism. Acad Pediatr. 2022; 22: 352-355 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar Therefore, recognizing and understanding how structural determinants of health (SDoH) and racism affect our patients is paramount.

Improving Diversity, Equity, and Inclusion Content in Pediatrics Grand Rounds.

Grand rounds (GR) is a quintessential component of medical education across the spectrum from undergraduate medical education to continuing medical education for established physicians with a goal of enhancing knowledge, changing physician behavior, and improving patient outcomes. The purpose and scope of GR has undergone many iterations over the hundreds of years of its practice and previous work has aimed to enhance its educational impact, 1 Van Hoof, Thomas MD, EdD, J. Monson, Robert PhD, J. et al. A Case Study of Medical Grand Rounds: Are We Using Effective Methods?. Academic Medicine. 2009; Volume 84 (August): 1144-1151https://doi.org/10.1097/ACM.0b013e3181ad1c0e Crossref Scopus (33) Google Scholar including innovations that seek to educate about the origin and ongoing consequences of the health crises of systemic racism and other structural inequities. 2 Perdomo J. Tolliver D. Hsu H. et al. Health Equity Rounds: An Interdisciplinary Case Conference to Address Implicit Bias and Structural Racism for Faculty and Trainees. MedEdPORTAL. 2019; 15: 10858https://doi.org/10.15766/mep_2374-8265.10858 Crossref PubMed Scopus (39) Google Scholar A primary audience for GR is established mid- and late-career faculty, an educational target group perhaps more in need of DEI pedagogy than our earliest medical career learners. 3 Rosenkranz Kari M. Arora Tania K. Termuhlen Paula M. et al. Diversity, Equity and Inclusion in Medicine: Why It Matters and How do We Achieve It?. Journal of Surgical Education. 2021; Volume 78 (ISSN 1931-7204): 1058-1065https://doi.org/10.1016/j.jsurg.2020.11.013 Crossref Scopus (34) Google Scholar Previous work on improving anti-racist content in medical education recognizes this group as in need of particular focus. 4 Blankenburg R. et al. Dismantling racism: Association of Pediatric Program Directors’ Commitment to Action. Academic Pediatrics. 2020; 20: 1051-1053 Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar Development of presentations that consistently and specifically address aspects of DEI is essential to sustainably re-orienting medical education to address health equity.

Realizing Inclusion and Systemic Equity in Medicine: Upstanding in the Medical Workplace-A Curriculum Update.

Racism is a public health crisis. Bias towards patients adversely affects health outcomes 1 FitzGerald C. Hurst S. Implicit bias in healthcare professionals: a systematic review. BMC Med Ethics. 2017; 18 (Mar 1) (PMID: 28249596; PMCID: PMC5333436.): 19https://doi.org/10.1186/s12910-017-0179-8 Crossref PubMed Scopus (984) Google Scholar and access to care while structural racism in medicine has led to decreased diversity of the healthcare workforce, burnout, and negative career outcomes. 2 Filut A. Alvarez M. Carnes M. Discrimination Toward Physicians of Color: A Systematic Review. J Natl Med Assoc. 2020; 112 (Apr): 117-140https://doi.org/10.1016/j.jnma.2020.02.008 Crossref PubMed Scopus (46) Google Scholar Growing evidence shows that curricula addressing racism within medical education can increase providers’ perceived capacity to address racism and limit its impact on patients and staff. 3 Jindal M. Mistry K.B. McRae A. Unaka N. Johnson T. Thornton R.L.J. "It Makes Me a Better Person and Doctor": A Qualitative Study of Residents' Perceptions of a Curriculum Addressing Racism. Acad Pediatr. 2022; 22 (Mar): 332-341https://doi.org/10.1016/j.acap.2021.12.012 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar

2023 CCS/CSE Standards for Physician Training and Maintenance of Competence in Adult Echocardiography: Executive Summary.

Echocardiography is an imaging modality essential to the provision of contemporary cardiovascular care. Since the publication of the 2010 CCS/CSE Guidelines, 1 Burwash IG, Basmadjian A, Bewick D, Choy JB, Cujec B, Jassal DS, MacKenzie S, Nair P, Rudski L, Yu E, Tam JW. 2010 Canadian Cardiovascular Society/Canadian Society of Echocardiography Guidelines for Training and Maintenance of Competency in Adult Echocardiography. Can J Cardiol 2010;27:862-864. Google Scholar clinical echocardiography has expanded with respect to both technologies and applications. At the same time there has been a shift in emphasis away from quantity of training (duration and case volumes) to actual demonstration of competency to determine successful completion of training. 2 Royal College of Physicians and Surgeons of Canada “Competency by Design: Reshaping Medical Education” 2014 https://www.royalcollege.ca/rcsite/documents/educational-strategy-accreditation/royal-college-competency-by- design-ebook-e.pdf Accessed 8 March 2023. Google Scholar Concurrently, there is growing evidence of considerable variability in echocardiography competence among general cardiology trainees. 3 Nair P. Siu S.C. Sloggett C.E. Biclar L. Sidhu R.S. Yu E.H.C. The assessment of technical and interpretative proficiency in echocardiography. J Am Soc Echocardiogr. 2006; 19: 924-931 Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar , 4 Bierowski M.J. Qureshi U. Ramedani S. Grewal S. Shah R. Park B. Peterson B.R. Variable exposure to echocardiography core competencies when applying minimum recommended procedural numbers of cardiology fellows in training. Cardiovasc Ultrasound. 2022; 20: 24-32 Crossref Scopus (0) Google Scholar , 5 Yu C.C.W. Pendrith C. Chun S. Echocardiographic interpretation skills of graduating cardiology trainees. Can J Cardiol. 2022; 38: 1304-1306 Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar

Implementation of Higher-Order Thinking Skills in Elementary School Using Learning Model, Media, and Assessment

The present learning process should be directed at higher-order thinking skills (HOTS). However, there are still many teachers in elementary schools who have not implemented hots learning as a whole, both in terms of learning models, media, and assessments, because there are no guidelines or modules related to the implementation of HOTS, especially at the elementary school level. This condition certainly requires an adaptation process that is not easy and also includes synthesizing, analyzing, reasoning, comprehending, applying, and evaluating. Therefore, this study aims to determine the implementation of HOTS in elementary schools, using learning models, media, and assessment. In this experiment, a narrative review was used with a database search and thematic analysis. The criteria used also emphasized the articles from various sources, such as national and international scientific journals, related topics, the last 5 years of publication within 2018-2022, and full-text pdf versions in ERIC and Mendeley. From this process, a total of 11 articles were subsequently analyzed. Based on the results, the following was obtained, (1) several learning models stimulated, trained, developed, and improved HOTS in elementary school students, using project and problem-based learning, STEM (Science, Technology, Engineering, and Mathematics), inquiry, problem determination and solution, concept construction and analysis, as well as RADEC (Read, Answer, Discuss, Explain, and Create). (2) Learning media capable of developing HOTS include question-based fun thinkers, Android-based word search educational games, and a related crossword puzzle. (3) HOTS assessments were carried out using the Two-Level Multiple Choices Test (TTMCT) instrument. This led to the establishment of the criteria for students’ product evaluations, using formative and summative assessments, self, peer, and teacher-evaluation incorporation, as well as HOTS question development. From these results, teachers need to use various learning models, media, and assessments. Teacher should also initiate the aspects of higher-order thinking skills, including learning analysis, evaluation, and development.

Chronic or recurrent Campylobacter enteritis in primary immunodeficiency: a UK national case-series and review of the literature.

Chronic or recurrent Campylobacter enteritis in primary immunodeficiency: a UK national case-series and review of the literature.

Open reconstruction of severe superior vena cava syndrome with right internal jugular-Superior vena cava bypass using femoral vein.

Current treatment of chronic benign superior vena cava syndrome (SVCS) is endovascular with angioplasty/stenting1Rizvi A.Z. Kalra M. Bjarnason H. Bower T.C. Schleck C. Gloviczki P. Benign superior vena cava syndrome: Stenting is now the first line of treatment.J Vasc Surg. 2008; 47: 372-380Abstract Full Text Full Text PDF PubMed Scopus (153) Google Scholar,2Wilson L.D. Detterbeck F.C. Yahalom J. Clinical practice. Superior vena cava syndrome with malignant causes.N Engl J Med. 2007; 356: 1862-1869Crossref PubMed Scopus (355) Google Scholar. Open surgical bypass is typically considered for patients who fail endovascular therapy3Picquet J. Blin V. Dussaussoy C. Jousset Y. Papon X. Enon B. Surgical reconstruction of the superior vena cava system: Indications and results.Surgery. 2009; 145: 93-99Abstract Full Text Full Text PDF PubMed Scopus (36) Google Scholar,4Kalra M. Sen I. Gloviczki P. Endovenous and Operative Treatment of Superior Vena Cava Syndrome.Surg Clin North Am. 2018; 98: 321-335Abstract Full Text Full Text PDF Scopus (20) Google Scholar. This report illustrates the surgical treatment of symptomatic SVCS. The patient consented to the publication. A 31-year-old male patient presented with recurrent edema and dilated veins of the upper extremities, head, neck, and chest, with concomitant severe headache. His history was significant for previous left lower extremity osteomyelitis six years before, being treated with antibiotics through a left upper extremity peripherally inserted central catheter (PICC). Symptoms of SVCS developed three years later. He was treated with bilateral subclavian and innominate vein stenting extending into the superior vena cava (SVC). Despite oral anticoagulation since the first intervention, the patient had multiple in-stent reocclusions and seven reinterventions with only temporary symptom improvement. Physical examination evidenced facial edema, plethoric facies, and dilated veins in the chest and abdomen. Computed tomography venogram (CTV) demonstrated occlusion of all stents. The right internal jugular vein (RIJV) was patent at the upper-neck level, close to the carotid bifurcation and the SVC was also patent caudally to the azygos vein. A left upper extremity and central venogram were performed and attempts were made to cross the occluded stents, without success. The patient then agreed to proceed with an open reconstruction. A RIJV to SVC bypass was performed using the patient´s right femoral vein, which had 8 mm in diameter, via a median sternotomy and a right neck incision (01:39). The suitable diameter of the vein-graft relies upon the main vessels’ diameter and patient´s anatomy, although a minimum dimeter of 6 mm is generally accepted. After the SVC anastomosis, a Valsalva maneuver was performed, and the clamp was opened with the patient in Trendelenburg position to minimize the risk of air embolism. At the two-year follow-up, a patent bypass was demonstrated with symptoms resolution. Annual follow-up with duplex ultrasound will be pursued. Open surgical treatment of SVC syndrome is associated with long-term symptoms relief and is an excellent option for patients who fail endovascular treatment. The femoral vein-graft was an excellent conduit with a good size-match to the RIJV, durable results and symptoms resolution. eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiI3OTBmNTRkMDM4ODYxZjBkNTkxYTBlMWZlNDc5OGU3NyIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjg3NTk5NzY2fQ.cmFN_OFbjDH4lOiwl1zKkjrgnyVQ2yXQnj_hVfumqU1CX0DvODIdqDnFjP8WKhsd08e_hL8cEQf62356emnlqTr0YQ3Taf7QzqEzXDSXdshLabCLWCJSBJImuFBTwhSNEbChKp9VtQEQaGgQFyoxmim8ywtDZOp91FbZKEyqSzPRGpQZ1TaQTnYdofXOPWy6HWHwpA7L72nUSdtDa6DKZAo-7fV2qqKuAhpR-b2_-TYFZ5QDsM4894KbXMoSfpiuH1MyYN3E2RcS1dja_5IiR_wUucRBjC65wTnhE2xRmiUL_0CZXxMNdfGKpq8bBaTg1GNl69QgdXWvXJkmViQ8Mw Download .mp4 (86.14 MB) Help with .mp4 files

Obesity wars: hypothalamic sEVs a new hope.

There are currently several pharmacological therapies available for the treatment of obesity, targeting both the central nervous system (CNS) and peripheral tissues. In recent years, small extracellular vesicles (sEVs) have been shown to be involved in many pathophysiological conditions. Because of their special nanosized structure and contents, sEVs can activate receptors and trigger intracellular pathways in recipient cells. Notably, in addition to transferring molecules between cells, sEVs can also alter their phenotypic characteristics. The purpose of this review is to discuss how sEVs can be used as a CNS-targeted strategy for treating obesity. Furthermore, we will evaluate current findings, such as the sEV-mediated targeting of hypothalamic AMP-activated protein kinase (AMPK), and discuss how they can be translated into clinical application.

Cone repair after tricuspid valve replacement in Ebstein anomaly.

Cone repair after tricuspid valve replacement in Ebstein anomaly.

Attrition From the US Emergency Medicine Workforce During Early Stages of the COVID-19 Pandemic.

Attrition From the US Emergency Medicine Workforce During Early Stages of the COVID-19 Pandemic.

Efficacy of a novel self-assembling peptide gel for hemostasis in refractory neoplastic bleeding.

Video 1Outline of how self-assembling peptide gel can be used exvivo.

Tunneling-free peroral endoscopic septotomy for Zenker diverticulum.

Video 1Tunneling-free peroral endoscopic Zenker myotomy.

Pediatrician-Delivered Smoking-Cessation Messages for Parents: An Update.

Clinicians who care for children and adolescents are well positioned to help parents quit smoking – the leading preventable cause of disease and death in the US. Understanding parents’ preferences for smoking-cessation messages may help clinicians tailor interventions to increase the likelihood of quitting. A concept from behavioral economics, called message framing, can be leveraged to motivate adult smokers to quit and may help motivate parents to quit. 1 Jenssen B.P. Kelly M.K. Faerber J. et al. Pediatrician Delivered Smoking Cessation Messages for Parents: A Latent Class Approach to Behavioral Phenotyping. Acad Pediatr. 2021; 21: 129-138https://doi.org/10.1016/j.acap.2020.07.018 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar In our study, “Pediatrician Delivered Smoking Cessation Messages for Parents: A Latent Class Approach to Behavioral Phenotyping,” using a discrete choice experiment and latent class analysis, we identified subgroups of parents who smoke with preferences for certain types of motivational messages: messages focused on the impact of smoking on the child, messages that were gain-framed rather than loss-framed messages (emphasizing benefits of engaging over costs of failing to engage in treatment), and messages focused on the financial impact of smoking. 1 Jenssen B.P. Kelly M.K. Faerber J. et al. Pediatrician Delivered Smoking Cessation Messages for Parents: A Latent Class Approach to Behavioral Phenotyping. Acad Pediatr. 2021; 21: 129-138https://doi.org/10.1016/j.acap.2020.07.018 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar We proposed that future work should explore how to best incorporate these messages into clinical practice as well as examine the relationship between tailored messages and subsequent behavior change. Since the publication of our study, others have expanded work in this field. In this progress report, we consider our study’s findings within the context of other studies published since January 2021, when we submitted our manuscript for publication, and discuss: 1) tailored content to help individuals who smoke quit, 2) methods to create a new system for smoking cessation for parents of pediatric patients, and 3) preliminarily evaluation of this new system in clinical practice.

The use of GRADE-CERQual in qualitative evidence synthesis: an evaluation of fidelity and reporting

BackgroundGRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative Research) is a methodological approach to systematically and transparently assess how much confidence decision makers can place in individual review findings from qualitative evidence syntheses. The number of reviews applying GRADE-CERQual is rapidly expanding in guideline and other decision-making contexts. The objectives of this evaluation were, firstly, to describe the uptake of GRADE-CERQual in qualitative evidence synthesis by review authors and, secondly, to assess both reporting of and fidelity to the approach.MethodsThe evaluation had two parts. Part 1 was a citation analysis and descriptive overview of the literature citing GRADE-CERQual. Authors worked together to code and chart the citations, first by title and abstract and second by full text. Part 2 was an assessment and analysis of fidelity to, and reporting of, the GRADE-CERQual approach in included reviews. We developed fidelity and reporting questions and answers based on the most recent guidance for GRADE-CERQual and then used NVivo12 to document assessments in a spreadsheet and code full-text PDF articles for any concerns that had been identified. Our assessments were exported to Excel and we applied count formulae to explore patterns in the data. We employed a qualitative content analysis approach in NVivo12 to sub-coding all the data illustrating concerns for each reporting and fidelity criteria.Results233 studies have applied the GRADE-CERQual approach, with most (n = 225, 96.5%) in the field of health research. Many studies (n = 97/233, 41.6%) were excluded from full fidelity and reporting assessment because they demonstrated a serious misapplication of GRADE-CERQual, for example interpreting it as a quality appraisal tool for primary studies or reviews. For the remaining studies that applied GRADE-CERQual to assess confidence in review findings, the main areas of reporting concern involved terminology, labelling and completeness. Fidelity concerns were identified in more than half of all studies assessed.ConclusionsGRADE-CERQual is being used widely within qualitative evidence syntheses and there are common reporting and fidelity issues. Most of these are avoidable and we highlight these as gaps in knowledge and guidance for applying the GRADE-CERQual approach.

Long COVID in inflammatory rheumatic diseases-what's in a name?

Long COVID in inflammatory rheumatic diseases-what's in a name?

Medicate or operate: epilepsy surgery could save lives.

Drug-resistant epilepsy is a complex neurological disorder with a significant impact on the lives of affected children and their families. A child is diagnosed with drug-resistant epilepsy if seizure control is not achieved despite receiving the maximally optimised doses of two appropriately chosen antiepileptic medications. 1 Kwan P Arzimanoglou A Berg AT et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. 2010; 51: 1069-1077 Crossref PubMed Scopus (2851) Google Scholar Mortality risk is seven times higher in children with epilepsy than in the general population. 2 Callenbach PM Westendorp RG Geerts AT et al. Mortality risk in children with epilepsy: the Dutch study of epilepsy in childhood. Pediatrics. 2001; 107: 1259-1263 Crossref PubMed Scopus (98) Google Scholar One contributor to the mortality associated with drug-resistant epilepsy is sudden unexpected death in epilepsy (SUDEP); ie, unexpected death with no obvious cause. 3 Nashef L So EL Ryvlin P Tomson T Unifying the definitions of sudden unexpected death in epilepsy. Epilepsia. 2012; 53: 227-233 Crossref PubMed Scopus (397) Google Scholar One in 833 children with drug-resistant epilepsy is estimated to die from SUDEP every year. 4 Ryvlin P Rheims S Lhatoo SD Risks and predictive biomarkers of SUDEP. Curr Opin Neurol. 2019; 32: 205-212 Crossref PubMed Scopus (0) Google Scholar The most common risk factors for SUDEP are high seizure frequency, early age of seizure onset, and multiple antiseizure drugs. 5 Abdel-Mannan O Taylor H Donner EJ Sutcliffe AG A systematic review of sudden unexpected death in epilepsy (SUDEP) in childhood. Epilepsy Behav. 2019; 90: 99-106 Summary Full Text Full Text PDF PubMed Scopus (46) Google Scholar Other causes of death include status epilepticus, injury related to seizures, and suicide. Comparison of long-term survival with continued medical therapy, vagus nerve stimulation, and cranial epilepsy surgery in paediatric patients with drug-resistant epilepsy in the USA: an observational cohort studyPaediatric patients with drug-resistant epilepsy who underwent cranial epilepsy surgery or VNS had a higher survival rate than those who received only medical treatment. These findings highlight the importance of a multidisciplinary comprehensive team approach to the treatment of epilepsy, which includes tailored evaluation and deployment of medical and surgical treatment options for patients with this challenging disease. Full-Text PDF

Transcriptional regulatory network of high-value active ingredients in medicinal plants

In Figure 2 in this Review article, the two end products, Artemisinin and Arteannuin B, of the pathways shown are reversed. The solid lines of ORA and NAC1 regulating the downstream genes are changed into dotted lines. The corrected figure is shown below. The authors apologize for the error. Transcriptional regulatory network of high-value active ingredients in medicinal plantsZheng et al.Trends in Plant ScienceJanuary 6, 2023In BriefMany active ingredients have been isolated and identified from medicinal plants, including terpenoids, alkaloids, saponins, and phenolic acids, which have crucial roles in the development of drugs and promotion of human health (Figure 1). Many environmental responses and specific accumulation of active ingredients in medicinal plants depend on transcriptional regulatory networks of hormone signals. Here, we review the transcriptional regulation of artemisinin, tanshinone, salvianolic acid, Taxol, vinblastine, and ginsenoside biosyntheses, which mainly involve jasmonic acid (JA) [1], abscisic acid (ABA) [2], salicylic acid (SA) [3], gibberellic acid (GA) [4], ethylene (Eth) [5], and indole acetic acid (IAA) [6] signaling. Full-Text PDF