Digital Commons Network^™

Field Validation Of Multiple Species Distribution Models Shows Variation In Performance For Predicting Aedes Albopictus Distributions At The Invasion Edge, Anna V. Shattuck, Brandon D. Hollingsworth Ph.D., Jared Skrotzki, Scott R. Campbell, Christopher L. Romano, Courtney C. Murdock

Faculty Publications

Background

Climate and land use changes have resulted in range expansion of many species. In this shifting disease landscape, it is important to leverage tools that can predict the distributions of invading vectors to target surveillance and control efforts and identify at-risk populations. Species distribution models (SDMs) are used to predict ranges of invasive species; however, invasive species often violate assumptions of equilibrium and niche conservatism. Moreover, these studies are rarely validated using independent data.

Methods 

We use long-term surveillance data for Aedes albopictus, a highly invasive mosquito capable of transmitting several arboviruses, at its range edge to evaluate a …

Bathyal Gastropod (Mollusca) Species From The Turkish Levantine And Aegean Seas, Bi̇lal Öztürk

Turkish Journal of Zoology

This study assigns 35 gastropod specimens and 23 shells collected from two sites on the Turkish Levantine and Aegean coasts at depths of 432 and 702 m, respectively, to 13 species. Among the species identified, Alvania subsoluta (Aradas, 1847), Protatlanta souleyeti (Smith, 1888), Pagodula echinata (Kiener, 1839), Pleurotomella gibbera Bouchet & Warén, 1980, Ringicula gianninii Nordsieck, 1974 and Diaphana marshalli (Sykes, 1904) are new records for the Turkish molluscan fauna; Anatoma aspera (Philippi, 1844) and Acteon monterosatoi Dautzenberg, 1889 are new records for the Levantine coast of Türkiye; and Crenilabium exile (Jeffreys, 1870) is a new record for the Turkish …

Advances In Artificial Intelligence For Glioblastoma Radiotherapy Planning And Treatment, Reid Master, Nesha Rubin, James Sampson, Kamlesh K Yadav, Shruti Pandita, Aria Sabbagh, Anika Krishnan, Patrick J Silva, Kenneth S Ramos, Vincent Gregoire, Nikos Paragios, Sunil Krishnan, Tej K Pandita

The Brown Foundation: Institute of Molecular Medicine

Glioblastoma is an aggressive central nervous system tumor characterized by diffuse infiltration. Despite substantial advances in oncology, survival outcomes have shown little improvement over the past three decades. Radiotherapy remains a cornerstone of treatment; however, it faces several challenges, including considerable inter-observer variability in clinical target volume delineation, dose constraints associated with adjacent organs at risk, and the persistently poor prognosis of affected patients. Recent advances in artificial intelligence, particularly deep learning, have shown promise in automating radiation therapy mapping to improve consistency, accuracy, and efficiency. This narrative review explores current auto segmentation frameworks, dose mapping, and biologically informed radiotherapy …

Preservice Teachers’ Preconception Of Student Voice In Their Teacher Education, Joan Belfon

Walden Dissertations and Doctoral Studies

A 2022 Jamaican education report highlighted that student-centered pedagogy is crucial to educational outcomes. A problem exists in that there is limited research on how student voice practices within student-centered pedagogy are incorporated into teacher training. Before preservice teachers’ praxis can be transformed, greater understanding of their preconceptions about student voice is essential. Guided by conceptual change theory, the purpose of this generic qualitative study was to explore the preconceptions of preservice teachers in rural central Jamaica about student voice in their teacher education. Eight preservice teachers preparing for the secondary level in three Jamaican higher education institutions were purposefully …

Exploring The Experiences Of Bahamian Men Diagnosed With Hypertension And Medication Adherence, Bianca Edwards

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is associated with significant health complications, including stroke, myocardial infarction, heart failure, and kidney disease. Despite advances in the treatment and management of HTN, a lack of medication adherence contributes to the persistence of HTN-related morbidity and mortality affecting men in The Bahamas. The purpose of this qualitative descriptive phenomenological study, guided by Pender’s health promotion model and Bandura’s social cognitive theory, was to explore the lived experiences of Bahamian men diagnosed with hypertension regarding their adherence to prescribed medications. Using Giorgi’s descriptive phenomenological method, in-depth, semistructured interviews were conducted with 11 participants. Data were analyzed through repeated …

Exploring Future Educators’ Roles In Classroom Aac Use: Insight Into Knowledge, Skills, And Attitudes, Katrina M. King

Honors College Theses

The United States public school system requires the provision of a free and appropriate public education (FAPE) in the least restrictive environment (LRE) for qualifying students with disabilities (U.S. Department of Education, n.d.). Speech, language, and hearing related disabilities are among the qualifying categories (U.S. Department of Education, n.d.). Students with these disabilities may have complex communication needs (CCN), or significant limitations in their speech, language, and communication abilities (Communication Rights Australia, 2018). Augmentative and alternative communication (AAC), a type of assistive technology, offers support for these students, however, several barriers inhibit full communicative participation (American Speech-Language-Hearing Association [ASHA], n.d.-a). …

Leaping Between Branches: Hybridisation And The Tangled Evolutionary History Of True Lemurs, Lukas F K Kuderna, Jeffrey Rogers, Tomàs Marques-Bonet, Giuseppe Donati, Riccardo Percudani, Cristian Capelli

Faculty, Staff and Students Publications

The true lemurs (genus Eulemur) are a genetically diverse and spatially widespread group of species inhabiting most of Madagascar's forests. Including 12 recognized species, the genus can be divided into four major evolutionary groups: E. rubriventer, E. mongoz, the Brown Lemur Species Complex (BLSC), and the coronatus-macaco-flavifrons complex (CMFC), although monophyly for the CMFC is not always supported. Recent genome-based studies highlighted topological and chronological differences between nuclear and mitochondrial phylogenies of true lemurs, which could be explained by events of hybridisation. In order to reconstruct the evolutionary history of the genus, we test for gene-flow between Eulemur clades using …

Hemorrhage-Related Maternal Morbidity Of Secondary Compared To Primary Postpartum Hemorrhage, Susan M Leong-Kee, Laurie S Swaim, Mark A Turrentine

Faculty, Staff and Students Publications

Objectives: To compare a composite hemorrhage-related maternal morbidity in individuals with secondary to primary postpartum hemorrhage and treatment interventions utilized.

Methods: A retrospective case-control study of deliveries complicated by secondary postpartum hemorrhage was performed at a tertiary care center. To estimate a clinically relevant increase of 50 % in the composite maternal hemorrhage-related maternal morbidity (35-53 % absolute increase) in individuals with secondary postpartum hemorrhage, a correlation coefficient of 0.2, at an 80 % power with a p < 0.05 with a two-sided test would require 95 individuals with secondary postpartum hemorrhage be matched to 95 individuals with a primary postpartum hemorrhage. Logistic regression analysis was used to evaluate the outcome of the composite of hemorrhage-related maternal morbidity.

Results: From January 2018 through December 2022, 33,026 deliveries occurred, and 94 individuals were identified that were admitted with secondary postpartum hemorrhage, …

An Analysis Of Diagnostic Metabolomic Profiles Associated With Hepatotoxicity During Childhood All Induction Therapy, Philip J Lupo, Karen R Rabin, Olga A Taylor, Marley Roberts, John P Woodhouse, Ashley Chavana, Kathleen Ludwig, Laura Klesse, Kenneth Heym, Timothy Griffin, Rodrigo Erana, Juan Carlos Bernini, M Monica Gramatges, Joanna S Yi, Sandi L Pruitt, M Brooke Bernhardt, Hong Zhu, Steven D Mittelman, Van Huynh, Etan Orgel, Jeremy M Schraw, Austin L Brown

Faculty, Staff and Students Publications

Hepatotoxicity is a well-documented complication of induction chemotherapy for acute lymphoblastic leukemia (ALL), but our understanding of its biological mechanisms is limited. We identified 314 patients with ALL (aged 1-19 years) treated at Texas Children’s Hospital (2008-2019) with diagnostic bone marrow plasma available for metabolomic profiling: 234 for discovery and 80 for replication. Hepatotoxicity during induction was defined as follows: (1) transaminitis: grade ≥3 aspartate aminotransferase or alanine aminotransferase or (2) conjugated hyperbilirubinemia: conjugated bilirubin (c.bili) >3 mg/dL. Untargeted profiling detected 519 metabolites. Adjusted odds ratios (aORs) for each metabolite were calculated with logistic regression, accounting for sex, age, body …

Turning Patients' Open-Ended Narratives Of Chronic Pain Into Quantitative Measures: Natural Language Processing Study, Anika Tahsin, Chadi G Abdallah, John Markman, Zhiyao Duan, Guillermo Cecchi, Paul Geha

Faculty, Staff and Students Publications

Background: Subjective report of pain remains the gold standard for assessing symptoms in patients with chronic pain and their response to analgesics. This subjectivity underscores the importance of understanding patients' personal narratives, as they offer an accurate representation of the illness experience.

Objective: In this pilot study involving 20 patients with chronic low back pain (CLBP), we applied emerging tools from natural language processing (NLP) to derive quantitative measures that captured patients' pain narratives.

Methods: Patients' narratives were collected during recorded semistructured interviews in which they spoke about their lives in general and their experiences with CLBP. Given that NLP …

Hemolysis Detection Using The Gem 7000 At The Point Of Care In A Pediatric Hospital Setting: Does It Affect Outcomes?, Hanna Uhrova, Brandy D Recio, Sridevi Devaraj

Faculty, Staff and Students Publications

No abstract provided.

Single-Cell Transcriptomic Analysis Of Peripheral Blood Mononuclear Cells Reveals Key Immune Responses In St-Segment Elevation Myocardial Infarction, Zheng Zhang, Shengfang Wang, Yahui Liu, Gaohan Li, Qianqian Cheng, Wei Yang, Gan-Xin Yan, Chuanyu Gao

Department of Medicine Faculty Papers

BACKGROUND: Inflammation plays a crucial role in the pathogenesis of ST-segment elevation myocardial infarction (STEMI). However, the precise immunological mechanisms remain incompletely understood. Single-cell RNA sequencing (scRNA-seq) provides a powerful approach to dissect immune cell heterogeneity and dynamic changes at single-cell resolution.

METHODS: Peripheral blood mononuclear cells (PBMCs) were collected from 7 STEMI patients (within 6h after primary percutaneous coronary intervention) and 3 healthy controls. Single-cell suspensions were prepared and subjected to scRNA-seq using the 10x Genomics Chromium platform and Illumina NovaSeq 6000. Data were processed using Cell Ranger and analyzed with Seurat for quality control, clustering, and annotation. Differentially …

Nivolumab Plus Ipilimumab Induce Hyper-Progression In Renal Medullary Carcinoma: Results Of A Phase Ii Trial And Preclinical Evidence, Jing Qian, Menuka Karki, Fei Duan, Hania Khan, Li Zhang, David H Peng, Mariah Williams, Rong He, Ziheng Chen, Luigi Perelli, Jianfeng Chen, Rebecca S Tidwell, Pankaj K Chauhan, Courtney N Le, Truong N A Lam, Nirjar Bhattacharya, Rutvi Shah, I-Lin Ho, Jason P Gay, Caroline C Carrillo, Ningping Feng, Kang Le, Guang Gao, Teresa L Perry, Faika Mseeh, Yongying Jiang, Quanyun A Xu, Niki Marie Zacharias, Rahul A Sheth, Tharakeswara K Bathala, Priya Rao, Najat C Daw, Durga N Tripathi, Cheryl L Walker, Mohammad M Mohammad, Jianhua Zhang, Guangchun Han, Yanshuo Chu, Ruiping Wang, Minghao Dang, Enyu Dai, Fuduan Peng, Yunhe Liu, Akshaya Jadhav, Wenhua Lang, Claudio A Arrechedera, Leticia Campos Clemente, Edwin R Parra, Hsinyi Lu, Cara L Haymaker, Ignacio I Wistuba, Andrew Futreal, Andrea Viale, Michael J Soth, Philip Jones, Joseph R Marszalek, Timothy Heffernan, Giulio F Draetta, Nizar M Tannir, Jianjun Gao, Linghua Wang, Giannicola Genovese, Pavlos Msaouel

Faculty, Staff and Students Publications

Therapeutic options for patients with renal medullary carcinoma (RMC) are limited. Here we report the results of a phase II clinical trial (NCT03274258) of anti-PD1 nivolumab plus anti-CTLA4 ipilimumab in patients with RMC, with objective response rate as primary outcome. Enrollment was halted for futility at a prespecified interim analysis as all 10 treated patients experienced rapid disease progression. 5/10 met radiological criteria for hyperprogression and median progression-free survival (secondary outcome) was 1.38 months (95% confidence interval: 1.28, 1.60). In a post-hoc single-cell RNA sequencing analysis, data from patients with RMC before and after nivolumab plus ipilimumab treatment indicated that …

The Current Of Anxieties: Ghosts And Capital For The Liminal Bride In Hiroko Oyamada’S The Hole, Maliha Kabir

Electronic Theses and Dissertations 2020 - Present

This thesis offers a reading of Hiroko Oyamada’s The Hole as discourse surrounding modern neoliberalism’s dissolution and transformation of boundaries between socio-political domains, such as the public/private, and its consequent effects on individual subjectivity and interpersonal relationships. Within the novella’s depictions of the mundane, I also seek to argue that Oyamada’s employment of the liminal, through distortions of space and time, is used to depict the precarity of marginalization as an always present force due to the pervasiveness of capitalism, but purposefully hidden to maintain security in illusion.

Rhode Islanders Worried About Prices Of Everyday Goods, Winter Energy Costs 11/25/2025, Unh Survey Center

All UNH Survey Center Polls

A majority of Rhode Islanders believe prices have increased on regularly purchased items over the past year and will continue to increase in the coming year. Ahead of the winter heating season, more than three-quarters of state residents are concerned about winter heating costs. Rhode Islanders' assessment of their personal finances remains largely negative but has ticked up slightly since May. Regarding holiday shopping, four in ten Rhode Islanders expect to spend less this year and a quarter feel they don't have enough money to cover their holiday shopping. Rhode Islanders are generally downbeat on the state and national economies, …

Interview No. 1806, Loraine L. Fresquez

Combined Interviews

On November 25, 2025, at their family home in Socorro, Texas, Eddie Fresquez interviewed his mother, Loraine Fresquez, about her background and the cooking traditions that shaped her life. Loraine explains that cooking has long been a way for her family to spend time together, especially during Christmas and New Year’s, holidays closely tied to the dishes passed down through generations. She recalls making tamales as a child alongside uncles, aunts, grandparents, her mother, stepfather, and siblings, remembering the experience most for the time spent together. She also notes that her father attended culinary school and loved to cook, a …

Simulating Realistic Lyman-𝛼 Emitters Including The Effect Of Radiative Transfer, Hasti Khoraminezhad, Shun Saito, Max Gronke, Chris Byrohl

Research Data

We present an empirical yet physically motivated simulation of realistic Lyman-𝛼 emitters (LAEs) at 𝑧 ∼ 2 − 3, crucial for ongoing and forthcoming cosmological LAE surveys. We combine an empirical UniverseMachine galaxy-halo model with a simple spherical expanding shell model for the Lyman-𝛼 radiative transfer, calibrating only three free parameters to simultaneously reproduce the observed Lyman-𝛼 luminosity function and the angular clustering. Our LAE model is further supported by its consistency with other observables such as the Lyman-𝛼 equivalent width distribution, the Lyman-𝛼 escape fraction as a function of stellar mass and dust reddening, and the systemic velocity offsets. …

Intro To Ai Literacies Discussion, Miranda Rectenwald

Generative AI Teaching Activities

Students consider and dicuss key literacies when using generative AI tools.

Divorcees’ Experiences Of Hubristic Pride In Communication In Previous Marital Relationships, Amanda Harms

Walden Dissertations and Doctoral Studies

Poor communication practices have significantly strained marital relationships, contributing to increased divorce rates in the United States. As a self-conscious emotion, hubristic pride often leads to poor communication, which in turn exacerbates marital discord and contributes to the breakdown of families. The purpose of this basic qualitative study was to explore how divorcees perceive the impact of hubristic pride on communication in their previous marriages. The theoretical framework underpinning this study was Homans’s social exchange theory. Data were obtained from eight divorced participants not actively involved in ongoing custody proceedings through semistructured interviews and analyzed using Saldaña’s descriptive coding methodology. …

A Critical Analysis Of Women’S Experiences Of Sport Participation In Saudi Arabia, Nouf Bamuhair, Richard Giulianotti, Carolynne Mason, Amer Alajmi

Journal of Global South Sport Studies

This study investigates Saudi women's experiences in sports participation within the context of the country's evolving social reforms. It addresses a major research gap on participation and policy issues, alongside a dearth of in-depth empirical studies on women and sport in Saudi Arabia. Traditionally, cultural norms, policies, and conservative interpretations of Islam have restricted women's involvement in sports in Saudi Arabia. However, recent reforms under Vision 2030, aim to enhance women's participation in sport. Using an intersectionality framework, the study examines how age, socioeconomic status, and geographical location shape women's sports experiences. Through semi-structured interviews with women in Riyadh and …

Cover And Contents

Turkish Journal of Zoology

No abstract provided.

Morphological Variability And Systematics Of Ponto-Caspian Cladocerans Of The Genus Cercopagis Sars, 1897 (Branchiopoda: Onychopoda: Cercopagidae), Larisa F. Litvinchuk, Spartak N. Litvinchuk

Turkish Journal of Zoology

In recent decades, significant changes have occurred in the composition of zooplankton, especially in the Ponto-Caspian Basin. An important component of zooplankton in this region is cladocerans of the genus Cercopagis. However, the introduction of invasive species means that many species of this genus have probably become extinct. Because their disappearance molecular study of these organisms is no longer possible. Therefore, a comparative analysis of morphological variability has become more important. We studied the morphological variability of all 12 currently known species of the genus. Samples from the Caspian, Azov, Black, and Baltic Seas were analyzed. The number of species …

Indigenous Invisibility: Gaps In Education About Indigenous Peoples Among Environmental Decision-Makers, Brittany D. Hunt, Ryan E. Emanuel, David E. Wilkins, Shelly H. Wilkins

Jepson School of Leadership Studies articles, book chapters and other publications

Millions of Indigenous people belong to hundreds of Tribal nations and self-determined communities throughout the United States. Many of these groups continue to steward lands and waters that have shaped their distinct cultural and political identities since time immemorial. Increasingly, environmental professionals acknowledge the need to respect, understand, and defer to Indigenous knowledge about Earth's stewardship, but substantial barriers prevent full realization of these goals. One deep-seated barrier is a widespread deficiency in basic education about Indigenous peoples. Education on Indigenous peoples in schools is often fraught with two problems: erasure and stereotypes. Thus, students who pursue environmental careers often …

Associate Professor Of Linguistics, Tasbeeh Yasser Elessaily Tye, Wessam Morsi Wm

English Language and Literature

Code-mixing occurs when speakers alternate between two or more languages within a single utterance, and it is used

in different social contexts such as academic, media, and daily conversations. Given the paucity of studies conducted on code-

mixing phenomenon at the university level in Egypt, the current study aims to examine the perception of phycology Department

students toward English-Arabic code-mixing at a private university in Egypt. The participants of the study were 70 Egyptian female

and male students that aged from 17-23 years old. A survey of 18 questions was distributed to the participants. The qualitative and

quantitative methods were …

Nasa Sts-119: Should We Launch? Actividad De Estudio De Caso Con Alumnos Internacionales En El Erasmus Bip 2025 “Creativity In A Digital World” En [Ponencia] Iii Congreso Internacional De Innovación Docente En Estudios Universitarios (Cideu 2025), Rafael Conde Melguizo, Sandra Garrido‑Romero, Fernando Blázquez Piñeiro

Congresos y Conferencias

Estudio de caso donde los estudiantes analizan la toma de decisiones en un entorno de alto riesgo, como es el despegue de una misión de la NASA. Se trabaja la cuestión esencial de quién debe tomar la decisión final: managers, ingenieros o astronautas.

Patient-Reported Outcomes After Ipsilateral Radiation Therapy For N2b Tonsillar Squamous Cell Carcinoma, Chike O Abana, Adam S Garden, G Brandon Gunn, Gregory M Chronowski, Abdallah S R Mohamed, Natalie Geier, Carly E A Barbon, Kate Hutcheson, Vinita Takiar, Clifton D Fuller, Steven J Frank, David I Rosenthal, Jack Phan

Faculty, Staff and Student Publications

Background: Previous studies have reported excellent disease control and survival in patients with well-lateralized, American Joint Committee on Cancer (AJCC)-7 T1-2N2b tonsillar squamous cell carcinoma (SCC). The reduced treatment volume is associated with lower rates of physician-assessed toxicity. Patient-reported outcomes (PROs) have been proposed as a similarly reliable measure, but the body of literature is limited for unilaterally treated patients. Our goal was to review PROs of such patients who had reduced treatment volumes.

Methods: We reviewed PROs of patients with AJCC-7 T1-2N2b disease treated with ipsilateral radiation therapy (RT), with or without surgery or chemotherapy before RT. PROs were …

Optimizing Lower Intensity Triplet Therapy In Acute Myeloid Leukemia: A Practical Guide, Wei-Ying Jen, Curtis A Lachowiez, Jennifer Marvin-Peek, Jessica K Altman, Musa Yilmaz, Yasmin Abaza, Joshua F Zeidner, Naval G Daver, Andrew H Wei, Ghayas C Issa, Courtney D Dinardo

Faculty, Staff and Student Publications

Venetoclax-based doublets with azacitidine or low dose cytarabine are the standard of care for the treatment of acute myeloid leukemia (AML) in older patients or those unfit for intensive chemotherapy. However, some patients do not attain complete remission, and over time, most patients relapse. Frontline triplet therapy incorporating a targeted therapy (FLT3, IDH or menin inhibitor) is an emerging treatment concept under investigation for this population. Initial triplet regimens have yielded encouraging composite complete remission and measurable residual disease negativity rates, enabling the transition to allogeneic stem cell transplantation for eligible patients. While effective, triplets are associated with myelosuppression and …

Targeting The Hepatic Circadian Clock Concomitant With Tyrosine Kinase Inhibition Reverses Late-Stage Hepatocellular Carcinoma, Baharan Fekry, Savera Aggarwal, Rachel Van Drunen, Rafael Bravo, Andy Escalante, Sheng Pan, Kai Sun, David R Hall, Mamoun Younes, Kristin Eckel-Mahan

Faculty, Staff and Student Publications

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths. Most patients present at advanced stages, and the effectiveness of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors is constrained by limited patient response. A subset of HCC shows elevated expression of the promoter 2 ("P2")-driven hepatocyte nuclear factor 4 alpha (HNF4α) isoform, which directly transcriptionally represses the circadian brain and muscle ARNT-like protein 1 (BMAL1) transcription factor. This subtype of HCC is robustly inhibited by the plant-based flavonoid nobiletin (NOB), a circadian-fortifying compound. Using patient-matched human HCC and serum, we show that BMAL1-deficient HCC shows exaggerated carnitine palmitoyl transferase …

Coordinated Transfer Of Dna Between Pol Θ And Pol Δ Resets Microhomology Choice During Double-Strand Break Repair, Yuzhen Li, Mark Returan, Adele T Guerin, April M Averill, Dorcas Oladapo, Richard D Wood

Faculty, Staff and Student Publications

DNA polymerase theta (Pol θ)-mediated end joining (TMEJ) initiates DNA double-strand break repair by using short homologies (microhomologies) between single-stranded DNA tails. This repair process is particularly important in cancer cells defective in homologous recombination. The exonuclease function of DNA polymerase delta (Pol δ) has been identified as an essential component for TMEJ, functioning to remove unpaired bases flanking a microhomology (MH). It is not known if the exonuclease removes all unpaired bases at once and how this removal might affect subsequent MH selection. Here, we reconstituted a functional TMEJ repair process using purified human Pol θ and Pol δ. …

Botulinum Toxin Combined With Robot-Assisted Therapy For Post-Stroke Spasticity: A Systematic Review, Salvatore Facciorusso, Stefania Spina, Mirko Filippetti, Rajiv Reebye, Gerard E Francisco, Andrea Santamato

Faculty, Staff and Student Publications

Background: Post-stroke spasticity limits motor recovery and independence. Combining botulinum toxin type-A (BoNT-A) injection with intensive, task-specific robot-assisted therapy (RAT) might enhance neuroplasticity and functional gains, but its additive effect and optimal timing are uncertain. (

Methods: We systematically searched major medical databases and trial registries up to April 2025 for randomized controlled trials in adults with post-stroke spasticity comparing botulinum toxin type-A injection plus RAT with toxin injection plus conventional therapy, or RAT alone with RAT combined with toxin injection. Risk of bias was assessed using the RoB 2 tool, and findings were synthesized narratively.

Results: Seven trials ( …