Notable Research Articles

Insomnia and its treatments—trend analysis and publication profile of randomized clinical trials

This study aimed to describe the publication profile of randomized controlled trials (RCTs) for insomnia. A systematic review of RCTs regarding interventions for non-comorbid insomnia in adults retrieved 132 RCTs: 58 related to pharmacological treatments, 71 to non-pharmacological treatments, and 3 to both interventions. The treatments with the biggest publication profile were digital CBT-I (dCBT-I) (n = 35), in-person CBT-I (n = 28) and zolpidem (n = 22). Regarding dCBT-I, the median publication year is 2019, with 1.13 ± 1.91 RCTs published per year. Regarding zolpidem, the median publication year is 2008, with 0.71 ± 0.97 RCTs per year. Regarding in-person CBT-I, the median publication year is 2018, with 0.90 ± 1.14 RCTs per year. The majority of the available RCTs are on non-pharmacological interventions, particularly CBT-I (mostly in the 2000s) and dCBT-I (mostly in the last decade), although presenting a reduced methodological quality in comparison to pharmacological interventions. These data suggest an increasing focus on non-pharmacological interventions for insomnia.

Study of the Characteristics and Functions Astrocytes of the Nervous System

Astrocytes are glial cells located in the central nervous system, that is, in the brain and spinal cord. Like the rest of the glia, astrocytes play supporting roles concerning neurons, the main cells of the nervous system from a functional point of view. Astrocytes are formed from cells of the ectoderm, the layer of the embryonic disc from which the nervous system and epidermis arise, during the organism's early development. Like most glia, astrocytes start from undifferentiated cells similar to those that give rise to neurons. This article aims to relate the characteristics and functions of astrocytes in the brain nutrition function, in the memory and learning process of stroke. Concerned with outlining a public profile of quality research in the area, we sought to answer these questions based on a literature review in the main journals in the area (national and international) classified by the Coordination for the Improvement of Higher Education Personnel (CAPES). To complement this analysis with other types of documents such as books, scientific journals, documents, and digital platforms, the following analysis steps were followed: (1) exhaustive reading of each article aiming at a global understanding and discovery of the approach used by its authors; (2) identification of the central ideas of each article; (3) classification of the ideas around core meanings; (4) comparison between the different core meanings present in the articles studied; (5) classification of the core meanings into broader axes (themes) around which the authors' discussions revolved; and (6) writing of interpretative summaries of each theme. After analyzing the content of the articles, we sought to establish a dialogue between the themes found and the literature that served as a basis for introducing the present study.

Co-Designing a Digital App to Support Young People's Patient and Public Involvement and Engagement (VoiceIn): Development and Usability Study.

While patient and public involvement and engagement (PPIE) is now seen as a cornerstone of mental health research, young people's involvement in PPIE faces limitations. Work and school demands and more limited independence can make it challenging for young people to engage with PPIE. Lack of ability or desire to attend face-to-face meetings or group discussions can further compound this difficulty. The VoiceIn app and digital platform were codeveloped by a multidisciplinary team of young people, mental health researchers, and software designers, and enables young people to engage directly with PPIE opportunities via a mobile app. This paper aims to describe how VoiceIn was developed through a series of co-design workshops with relevant stakeholders, specifically (1) how the initial design of VoiceIn was informed and driven by focus groups with young people, mental health professionals, and PPIE leads; (2) how VoiceIn was refined through collaboration with the aforementioned stakeholders; (3) the priorities for an app to support PPIE; (4) the key features necessary in the PPIE app; and (5) the recommended next steps in testing and deploying the digital platform. Initial co-design workshops took place with young people, mental health professionals, and PPIE leads to identify key features of an app to support PPIE. A series of VoiceIn design prototypes were developed and iterated based on the priorities and preferences of the stakeholders. The MoSCoW (must have, should have, could have, won't have) prioritization method was used throughout the process to identify priorities across the different stakeholder groups. Co-design with young people, mental health professionals, and PPIE leads supported the successful development and improvement of the VoiceIn app. As a result of this process, key features were identified, including allowing for various modes of providing feedback (eg, polls and comments), reviewing project updates, and expressing interest in categories of research. The researcher platform was developed to support multimedia uploads for project descriptions; a jargon detector; a dedicated section for providing project updates; and a visually appealing, user-friendly design. While all stakeholder groups emphasized the importance of allowing app users to engage with the app in various ways and for there to be ongoing progress updates, group differences were also noticed. Young people expressed a desire for incentives and rewards for engaging with the app (eg, to post on their public social media profiles), and mental health professionals and PPIE leads prioritized flexibility in describing the project and its PPIE needs. A co-design approach was pivotal to the development of the VoiceIn app. This collaborative approach enabled the app to meet the divergent needs of young people, mental health professionals, and PPIE leads. This process mirrored the aspirations of PPIE initiatives by cocreating a digital health research tool with key stakeholders.

Terminology of medicines used to control seizure disorders: 2024 ILAE Recommendations and profile of real-world term use

Background. The International League Against Epilepsy (ILAE) has provided recommendations on the terminology of medicines for control of seizure disorders, which should be adapted into different languages.Objective: to evaluate the usage profile of terms describing the effects of medicines used in patients with epilepsy.Material and methods. The search query analysis systems Google Trends and Yandex Wordstat as well as PubMed/MEDLINE, Google Scholar and eLibrary databases were used to evaluate the general public and professional usage profile, respectively.The following terms in Russian and English were studied: “antiepileptic”, “antiepileptic drug”, “antiseizure”, “antiseizure drug”. In order to ascertain a prevailing opinion within professional and patient communities, a questionnaire survey was conducted on the public online resources of the non-profit partnership “The Association of Epileptologists and Patients” carried out via the cloud-based cross-platform social media as well as instant messaging service Telegram and the social media platform VK.Results. In the English-speaking internet segment, the term “antiepileptic” is used more than 5 times frequently than “antiseizure” by the general public. Conversely, in the Russian-language segment, the term “antiseizure” is almost 2.5 times more common. The term “antiepileptic” is more prevalent in scientific community in both segments. This finding aligns with the profile of terminology usage observed among epileptologists and epilepsy patients. The questionnaire survey results revealed that 56.42% of 179 respondents were in favor of the terms “antiepileptic drug”, “AED” and “antiepileptic therapy”, whereas as few as 17.32% of those endorsed the ILAE-proposed terminology.Conclusion. In light of the established practice of terminology use in both professional scientific community and among practicing epileptologists and epileptic patients, as well as the differences in the semantics of English- and Russian-language terms and the identified lack of precision in the ILAE definition of epilepsy, it can be concluded that for the Russian-speaking population, the terms “antiepileptic drug”, “AED” are more preferable rather than the terms “antiseizure medication”, “ASM”. Additionally, it is preferable to use the terms “convulsive ictus” and “epileptic ictus” due to negative connotation with term “seizure” in Russian. The terms “antiseizure” and “antiepileptic” should not be regarded as mutually exclusive in the context of treatment that has a direct impact on epilepsy course. Finally, it is necessary to further refine epilepsy definition and classification.

Correction of Batch Effect in Gut Microbiota Profiling of ASD Cohorts from Different Geographical Origins.

To date, there have been numerous metataxonomic studies on gut microbiota (GM) profiling based on the analyses of data from public repositories. However, differences in study population and wet and dry pipelines have produced discordant results. Herein, we propose a biostatistical approach to remove these batch effects for the GM characterization in the case of autism spectrum disorders (ASDs). An original dataset of GM profiles from patients with ASD was ecologically characterized and compared with GM public digital profiles of age-matched neurotypical controls (NCs). Also, GM data from seven case-control studies on ASD were retrieved from the NCBI platform and exploited for analysis. Hence, on each dataset, conditional quantile regression (CQR) was performed to reduce the batch effects originating from both technical and geographical confounders affecting the GM-related data. This method was further applied to the whole dataset matrix, obtained by merging all datasets. The ASD GM markers were identified by the random forest (RF) model. We observed a different GM profile in patients with ASD compared with NC subjects. Moreover, a significant reduction of technical- and geographical-dependent batch effects in all datasets was achieved. We identified Bacteroides_H, Faecalibacterium, Gemmiger_A_73129, Blautia_A_141781, Bifidobacterium_388775, and Phocaeicola_A_858004 as robust GM bacterial biomarkers of ASD. Finally, our validation approach provided evidence of the validity of the QCR method, showing high values of accuracy, specificity, sensitivity, and AUC-ROC. Herein, we proposed an updated biostatistical approach to reduce the technical and geographical batch effects that may negatively affect the description of bacterial composition in microbiota studies.

Multimodal Spatial Profiling Reveals Immune Suppression and Microenvironment Remodeling in Fallopian Tube Precursors to High-Grade Serous Ovarian Carcinoma.

High-Grade Serous Ovarian Cancer (HGSOC) originates from fallopian tube (FT) precursors. However, the molecular changes that occur as precancerous lesions progress to HGSOC are not well understood. To address this, we integrated high-plex imaging and spatial transcriptomics to analyze human tissue samples at different stages of HGSOC development, including p53 signatures, serous tubal intraepithelial carcinomas (STIC), and invasive HGSOC. Our findings reveal immune modulating mechanisms within precursor epithelium, characterized by chromosomal instability, persistent interferon (IFN) signaling, and dysregulated innate and adaptive immunity. FT precursors display elevated expression of MHC-class I, including HLA-E, and IFN-stimulated genes, typically linked to later-stage tumorigenesis. These molecular alterations coincide with progressive shifts in the tumor microenvironment, transitioning from immune surveillance in early STICs to immune suppression in advanced STICs and cancer. These insights identify potential biomarkers and therapeutic targets for HGSOC interception and clarify the molecular transitions from precancer to cancer.

Educational research on medical residency programs in Chile: a scoping review and analysis of the impact of the new accreditation policy

BackgroundAccrediting medical specialties programs are expected to influence and standardize training program quality, align curriculum with population needs, and improve learning environments. Despite global agreement on its necessity, methods vary widely. In the Chilean context, a recent new accreditation criteria includes research productivity in relation to educational research on resident programs, so we aimed to define it. What is the profile of publications in educational research produced by Chilean medical specialty residency programs in the last five years? Based on these results, we intend to analyze the potential impact of the new accreditation policy on medical specialty programs in Chile.MethodsWe performed a preliminary bibliometric search to identify the use of the term “resident” in literature. After that, we conducted a literature search, using a six-step approach to scoping reviews, including the appraisal of the methodological quality of the articles.ResultsBetween 2019 and 2023, an average of 6.2 articles were published yearly (19%). The bibliometric analysis revealed that the dominant thematic area of the journals was clinical, accounting for 78.1%. Most articles focused on residents (84.38%), with only two articles including graduates as participants. One university was responsible for 62.50% of the articles and participated in all multicenter studies (9.38%). Surgical specialties produced 15 research articles focused on procedural training using simulation. Psychiatry was the second most productive specialty, with 5 articles (15.63%) covering standardized patients, well-being, and mental health assessment. The most frequent research focus within residency programs over the five-year period was teaching and learning methodologies, with 19 articles representing almost 60% of the total analyzed.ConclusionsResearch on medical education in Chile’s postgraduate residency programs is limited, with most studies concentrated in a few universities. The new accreditation criteria emphasize educational research, posing challenges for many institutions to meet higher standards. Understanding unexplored areas in educational research and learning from successful programs can enhance research productivity and align efforts with accreditation expectations. Continuous evaluation and new research on residents’ satisfaction, skills acquisition, and well-being are needed to ensure training quality and accountability.

Silencing the Rainbow: The Territorial Effects of Pride Cancellation

The pause in Pride parades, particularly highlighted during the pandemic, reminds us of the importance of actively including and celebrating nonheteronormative communities. It emphasizes the need to cultivate understanding and acceptance of diverse sexual orientations. This study navigates through the landscape of Madrid Pride, focusing on understanding how its unforeseen cancellation in 2020 due to the pandemic has influenced the LGBTQIA+ communities’ sense of space, openness, safety, visibility, acceptance, and equality. The research is centered on examining the connection between Pride parades and the appropriation of spaces that are typically seen as conforming to heterosexual norms. It takes into account the viewpoints of the LGBTQIA+ community (including activists, organizations, and potential attendees) as well as the perspectives of event stakeholders (such as organizations, local community members, and tourism professionals). A social representation theory‐based inductive approach was utilized, drawing from queer and feminist perspectives. The cancellation of Pride events in recent times has caused significant disruption to the de‐ and reterritorialization of space. This has had far-reaching implications in both the political and social realms for the LGBTQIA+ community and its public profile.

Exploring Diversity in North American Academic Pediatric Otolaryngology.

Representation of women and minority groups is traditionally low in Otolaryngology-Head & Neck Surgery (OHNS). This cross-sectional study aims to assess the difference in gender and racial/ethnic representation within Academic North American pediatric OHNS. Cross-sectional study of North American pediatric OHNS faculty websites. North America. Canadian and American residency program registries were searched for accredited OHNS programs. Pediatric OHNS faculty were identified through program websites. Information regarding gender, race/ethnicity, time in practice, research productivity, academic title, and leadership positions was extracted from public profiles and Scopus. Demographic and academic data was also extracted for OHNS and pediatric OHNS department/division chairs. North American academic pediatric OHNS websites listed 516 surgeons, of whom 39.9% were women. Most surgeons were perceived as White (69.0%), followed by Asian (24.0%), Hispanic (3.7%), and Black (3.3%). Women surgeons had lower h-indices, less publications, and less citations than men (P < .001). Despite women surgeons having fewer years in practice (median 8.0 vs 13.0, P < .001), gender-differences in h-index persisted when controlling for years in practice (P < .05). Men surgeons had higher academic titles (P < .001), but there was no gender difference in leadership roles while accounting for years in practice (P = .559). White surgeons had higher academic titles than non-White surgeons (P = .018). There was no racial/ethnic difference in leadership roles (P = .392). Most pediatric OHNS surgeons are men and/or White. Significant gender-differences in research productivity and academic title exist, however surgeons of racial/ethnic minority have similar research productivity as their racial/ethnic majority counterparts.

Women speaker representation at SAGES annual meetings: a cross-sectional analysis

BackgroundGender representation trends at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Annual Meetings and the effect of the 2018 ‘We R SAGES’ initiatives are unknown. We assessed gender trends in oral presentations at the SAGES Annual Meeting between 2012 and 2022 with a focus on assessing the impact of the 2018 initiatives.Methodss selected for oral presentations from 2012 to 2022 were reviewed for presenter and first, second, and senior author gender. Gender was categorized as woman, man, or unknown using public professional profiles. Subsequent publications were identified using search engines. The primary outcome was the temporal trend of proportion of women in each role using interrupted time series analysis. Secondary outcomes included publication rates based on first and senior author genders in 2012–2018 versus 2019–2022.Results1605 abstracts were reviewed. The proportion of women increased linearly in all categories: presenter (2.4%/year, R2 = 0.91), first author (2.4%/year, R2 = 0.90), senior author (2%/year, R2 = 0.65), and overall (2.2%, R2 = 0.91), (p < 0.01 for all). Prior to 2018, the proportion of women increased annually for presenters (coefficient: 0.026, 95% CI [0.016, 0.037], p = 0.002) and first authors (coefficient: 0.026, 95% CI [0.016, 0.037], p = 0.002), but there was no significant increase after 2018 (p > 0.05). Female second author proportion increased annually prior to 2018 (coefficient: 0.012, 95% CI [0.003, 0.021], p = 0.042) and increased by 0.139 (95% CI [0.070, 0.208], p = 0.006) in 2018. Annual female senior author proportion did not significantly change after 2018 (p > 0.05). 1198 (75.2%) abstracts led to publications. Women were as likely as men to be first (79% vs 77%, p = 0.284) or senior author (79% vs 77%, p = 0.702) in abstracts culminating in publications. There was no difference in woman first author publication rate before and after 2018 (80% vs 79%, p = 1.000), but woman senior author publication rate increased after 2018 (71% vs 83%, p = 0.032).ConclusionThere was an upward trend in women surgeons’ presentations and associated publications in the SAGES Annual Meetings over the last decade.

Leading through the COVID-19 pandemic: Experiences of UK Executive Nurse Directors.

To explore the challenges experienced by Executive Nurse Directors during the COVID-19 pandemic, and to inform future nursing leadership strategies. A qualitative research project involving interviews with 21 Executive Nurse Directors from England and Wales. Participants were purposively sampled and recruited through Chief Nursing Officers and nursing leadership networks. Semi-structured interviews were conducted and recorded online via Teams. Braun and Clarke's approach to thematic reflexive analysis was applied to data analysis. Executive Nurse Directors played a critical role during the COVID-19 pandemic. Six themes are explored: tensions, and adaptive response to personal leadership styles; uncertainty and support at the board level; responding to national political decision-making; the personal and emotional impact of the role and the sources of effective support; the voice and public profile of nursing; lessons learnt and strategies for future leadership development. Enablers of decision-making included effective multidisciplinary working, freedom from normal organizational constraints, support for innovation, and the development of stronger bonds with colleagues. Barriers to decision-making included limited knowledge of the virus and its impact and lack of guidance, particularly at a national level. Priorities, strategies and actions for recovery include recognizing the emotional impact of being in a high-level decision-making role, protecting staff from burnout and understanding the long-term implications of pandemic work for nurse leaders. Future strategies for nursing leadership during public health, national and global emergencies are recommended. This study contributes to the literature exploring the Executive Nurse Director role and their experiences of leading through the COVID-19 pandemic, and identifies priorities, strategies and actions for recovery and learning for the future of senior leadership. The study adhered to the Consolidated Criteria for Reporting Qualitative Research. No patient or public contribution.

Brand Silence in Protest Movements: Commercial Brands Discursive Indifference During a Social Protest in Peru

The study aims to politically analyze the narrative traits of protesting the indifference of commercial brands toward Peru’s political mobilization in November 2020 via Facebook. From a multiple-case qualitative focus, the corpus was gathered through the semiotic pertinence of representation by the isotopic saturation. The object of the study comprises 110 comments from protesters posted on the public profiles of brands that did not participate in the political protest. The pertinence of their election corresponded to the level of affinity and affection Peruvian consumers had with the brands. Based on the post-Greimasian theory, we have identified four narrative traits of protesting—exclaiming, complaining, repudiating, and wavering—over the brands. Consequently, data showed that consumers exclaimed against “their” brand, complained about the brand, repudiated the institution, and wavered over institutionality (something undefined). We identified three forms of dissemination: i) those enunciated from the Self and concerning the brands, (ii) those enunciated toward the brands, and (iii) those enunciated toward the collective self, concerning the brands. This study seeks to contribute to the literature about the narrative relationship between political consumers and brands, protests and consumption, and corporate crisis management.

'Follow the science': Popular trust in scientific experts during the coronavirus pandemic.

The coronavirus pandemic increased the role played by scientific advisers in counselling governments and citizens on issues around public health. This raises questions about how citizens evaluate scientists, and in particular the grounds on which they trust them. Previous studies have identified various factors associated with trust in scientists, although few have systematically explored a range of judgements and their relative effects. This study takes advantage of scientific advisers' heightened public profile during the pandemic to explore how people's trust in scientists is shaped by perceptions of their features and traits, along with evaluations of their behaviour and role within the decision-making process. The study also considers people's trust in politicians, thereby enabling us to identify whether trust in scientists reflects similar or distinctive considerations to trust in partisan actors. Data are derived from specially designed conjoint experiments and surveys of nationally representative samples in Britain and the United States.

‘I Have a Folder in My Email Called Hate Mail’: Academic Public Engagement, Digital Hate and the Unequally Distributed Risks of Visibility

Public engagement through ‘traditional’ and social media is an increasingly important way for scholars to communicate research with wider audiences, with academics encouraged to maintain a public profile to disseminate work. This has important activist potential for radical knowledge production, but only if all voices can participate on equal, safe terms. Existing work on digital hate rarely accounts for the diversity of the academic community, and therefore we cannot adequately account for how certain voices are being excluded from public debate. Drawing on data from eighty-five survey responses and thirteen in-depth interviews with UK academics across disciplines, this article argues that the risks of visibility are unevenly distributed in ways that exacerbate harm to already marginalised groups. Our data challenges popular notions that visibility is its own reward. We demonstrate how visibility exposes academics to the kinds of online misogyny, racism, ableism, classism, xenophobia, homophobia, fatphobia and transphobia that characterise cultures of online hate. We reflect upon how academics in the ‘wrong’ body are denied intellectual authority in public debate through abuse targeting their intersectional identities and right to belong. Our data finds that digital hate not only affects academics’ careers, but also causes significant physical and mental harms that seep into academics’ personal lives. There cannot be meaningful, radical potential in public knowledge sharing if we cannot protect those most at risk of harm in the process.

The good transsexual? The Buck Angel dilemmas

ABSTRACT The often-told Buck Angel bio is that of a female-to-male transsexual who became a ground-breaking and award-winning porn star, documentary producer, sex educator, commentator, dating site host, and entrepreneur. Such a bio is tantalizing and inevitably explains ongoing cultural fascination: Angel has a high public profile and strong following on social media. More interesting than the facts of his bio, however, are his contributions to understanding sexual cultures. Drawing on Angel’s own remarks as well as the many thousand words spilled analyzing them, I explore the relationship between Angel and trans discourse, as well as, more broadly, with contemporary gender and sexuality debates. I begin with a brief discussion of Angel as an ‘expert’, and as a man, and then examine his ‘man with a pussy’ brand. I discuss his contributions to creating the genre of transmasculine porn, and I examine the ways that his bodily display has been interpreted. I explore debates that Angel has become embroiled in, including those around language, biology, and trans children, and I end with a discussion of the tensions around his desire to be an elder to a community which he often exhibits disdain for.

Bioecology of Electric Fish (Actinopterygii: Gymnotiformes)

The poraquê has an elongated and cylindrical body, with just one anal fin, which extends across almost the entire abdomen it resembles the shape of an eel. Its head is flat and its mouth is equipped with a row of sharp, conical teeth. The color of this animal is always very dark, but the ventral part of the body is yellowish and they have poor vision. This group of fish is known for their ability to generate and detect electrical fields in the environment in which they occur, and these characteristics are used in communication, prey detection, defense, reproduction and even to help these animals move in the absence of light. This manuscript aims to describe the biology, ecology, morphology, geographic distribution, life cycle, habitat, and therapeutic use of electric fish (Chordata: Actinopterygii: Gymnotiformes). Concerned with establishing a public profile of quality research in the area, we sought to answer these questions based on a literature review in the main journals (national and international) classified by the Coordination for the Improvement of Higher Education Personnel (CAPES). Complement this analysis with other documents such as books, theses, dissertations, scientific journals, documents, and digital platforms.

Towards determining perceived audience intent for multimodal social media posts using the theory of reasoned action

Increasing use of social media has resulted in many detrimental effects in youth. With very little control over multimodal content consumed on these platforms and the false narratives conveyed by these multimodal social media postings, such platforms often impact the mental well-being of the users. To reduce these negative effects of multimodal social media content, an important step is to understand creators’ intent behind sharing content and to educate their social network of this intent. Towards this goal, we propose Intent-o-meter, a perceived human intent prediction model for multimodal (image and text) social media posts. Intent-o-meter models ideas from psychology and cognitive modeling literature, in addition to using the visual and textual features for an improved perceived intent prediction model. Intent-o-meter leverages Theory of Reasoned Action (TRA) factoring in (i) the creator’s attitude towards sharing a post, and (ii) the social norm or perception towards the multimodal post in determining the creator’s intention. We also introduce Intentgram, a dataset of 55K social media posts scraped from public Instagram profiles. We compare Intent-o-meter with state-of-the-art intent prediction approaches on four perceived intent prediction datasets, Intentonomy, MDID, MET-Meme, and Intentgram. We observe that leveraging TRA in addition to visual and textual features—as opposed to using only the latter–results in improved prediction accuracy by up to 7.5%\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$7.5\\%$$\\end{document} in Top-1 accuracy and 8%\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$8\\%$$\\end{document} in AUC on Intentgram. In summary, we also develop a web browser application mimicking a popular social media platform and show users social media content overlaid with these intent labels. From our analysis, around 70%\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$70\\%$$\\end{document} users confirmed that tagging posts with intent labels helped them become more aware of the content consumed, and they would be open to experimenting with filtering content based on these labels. However, more extensive user evaluation is required to understand how adding such perceived intent labels mitigate the negative effects of social media.

Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis.

Although career choices are often shaped by training and mentors, it is not clear how training backgrounds have influenced whether plastic surgeons pursue leadership positions. Analysis of these training pathways can serve as a key component of career planning for future leaders. The American Board of Plastic Surgery's annual Newsletter to Diplomates was used to collate surgeons receiving board certification between 2002 and 2013. Online public profiles were used to collect training background data about each surgeon, including fellowship training, board certification year, MBA degree, otolaryngology or maxillofacial surgery training before commencing plastic surgery training, and leadership positions in surgery. A logistic multinomial regression was used to test the effect of training backgrounds on different types of leadership positions. In total, 2190 plastic surgeons were included in the analysis. Factors increasing the probability of holding any type of position included fellowships in microsurgery, craniofacial, and hand; an international fellowship; multiple fellowships; a fellowship not otherwise specified; and MBA degree. Training background factors affected probabilities differently for each of the studied positions including chair/chief, vice chair/vice chief, program director, plastic surgery medical director, other institutional positions, and national society positions. Training backgrounds of plastic surgeons in leadership positions are multifaceted, involving a mix of intrinsic and extrinsic factors such as additional educational pursuits, subspecialty training, duration of practice, and practice setting. This analysis can help direct current trainees who aspire to future leadership in plastic surgery.

Understanding the Nigerian Domestic Debt

The portion of a country's overall public debt that is owed to domestic lenders is known as its internal or domestic debt. The public debt profile of a nation is comprised of its external and domestic debt stock. This article provides insights into the various components and major holders of the country's domestic debt. The Country’s domestic debt profile, which is currently on the rise, has led to numerous challenges in the economy such as debt overhang, higher debt servicing costs, unstable currency rates, and crowding out impacts on the private sector, among others. Therefore, measures have been recommended to curtail the level of increasing borrowings. The goal of setting up a distinct public debt management agency such as the Debt Management Office (DMO) by the government was to continuously accomplish the benefits of cautiously sourcing financing to cover for government deficits at reasonable rates and with manageable medium to long-term risks.

The development of a Core Outcome Set for clinical trials targeting interventions aiming to improve adherence to appropriate polypharmacy in older people – A Delphi consensus study

Abstract Introduction Older people encounter challenges when taking polypharmacy. Different interventions have been applied to improve adherence to polypharmacy. However, there are few high-quality studies, and little consideration has been given to the outcomes selected to measure the effectiveness of interventions.[1] To produce high-quality studies and accurately report adherence-related outcomes, developing a Core Outcome Set (COS) is important.[2] A COS is the minimum number of outcomes that should be reported and measured in future trials in a specific health field to reduce outcomes’ inconsistencies across trials.[2] Aim This study aimed to develop a COS for use in clinical trials aiming at improving adherence to appropriate polypharmacy in older patients. Methods A list of outcomes related to adherence to polypharmacy (n=13) was compiled from previous semi-structured interviews with stakeholders. The Delphi panel consisted of experts in adherence, polypharmacy and gerontology, including journal editors, academics, non-National Health Service doctors, nurses and pharmacists who were identified by searching researchers’ publication profiles using Google Scholar and Scopus. Senior editors and editor-in-chief of peer-reviewed journals were identified by searching journal information. Public members were identified by searching for contact emails of staff members in public charities/organisations representing older people’s healthcare needs (e.g. AgeUK). Additionally, identified participants received invitation emails asking them to forward the email to other participants and experts who might be interested in this study (i.e. snowball sampling). The 13 outcomes were distributed in three online Delphi questionnaires between February and April 2023 using an online SoGoSurvey® platform. All outcomes were rated according to their degree of importance using a nine-point Likert scale (1 to 3 = unimportant; 4 to 6 = important but not critical; 7 to 9 = critical). Following each round, response rates and the distribution of scores were calculated to classify outcomes into ‘consensus in’, ‘consensus out’ and ‘no consensus’. An outcome was considered very important if ≥80% of participants scored it as ‘critical’ and ≤15% scored it as ‘unimportant’. Results The Delphi panel (Round 1, n=57; Round 2, n=53; Round 3, n=50) comprised different professionals, including 38 academics, 23 pharmacists, 12 doctors, six journal editors, three nurses and four public members, some of whom had multiple roles, e.g. doctor and academic. Participants were distributed over four continents, mostly from Europe (n=39). Both Australia and America had identical representation (n=8), while two participants represented Asia. Consensus was reached following the third round on seven outcomes, namely: medication adherence across multiple medications (100.0%), treatment burden (96.2%), health-related quality of life (96.2%), healthcare utilisation (83.0%), adverse events and side effects (83.0%), patient-carer satisfaction (82%), and cost-effectiveness (81.1%). Conclusion Seven outcomes were considered of critical importance to stakeholders. This study is the first to develop a COS for interventions targeting adherence to appropriate polypharmacy in older patients. However, most of our participants were academics and pharmacists from Europe, whilst other participant categories and continents were less well-represented. A future nominal group technique study will be conducted to discuss the results obtained from previous Delphi questionnaires, followed by selecting the appropriate outcome measurement instruments to measure these outcomes.