bluuebunny/crossref_metadata_2025 huggingface dataset:
Isometric and isokinetic strength of lower-limb muscles in female athletes during different phases of menstrual cycle: a causal-comparative study
Authors: Pournasiri Fatemeh , Zarei Mostafa , Mainer-Pardos Elena , Nobari Hadi
Published: December 2023

Background

Muscle strength is affected by different stages of the menstrual cycle in women. Since the strength of the lower limb muscles plays a significant role in the occurrence of anterior cruciate ligament injury, it seems necessary to study the strength of the lower limb muscles at different stages of this cycle to take preventive measures. Therefore, this study aimed to compare the isometric and isokinetic strength of lower limb muscles in female athletes at different menstrual cycle stages.

Methods

The present study is of a causal-comparative type. Thirty-seven female athletes in anterior cruciate ligament injury high-risk disciplines participated in this study. Isometric and isokinetic knee extensors and flexors muscle strength status, including the traditional hamstrings/quadriceps (H/Q) ratios, were recorded at different stages of the menstrual cycle (follicular, ovulatory, luteal) by Biodex isokinetic dynamometry system 4. Then, the obtained results were analyzed by repeated measure analysis of variance.

Results

Analysis of variance with repeated measures showed isokinetic and isometric strength in the knee flexor and extensor muscles at an angular velocity of 60˚/s in the ovulatory phase are higher than the follicular and luteal ones. The strength of the muscles declined during the follicular and luteal phases (p ≤ 0.05).

Conclusions

Due to the negative effect of the follicular and luteal stages of the menstrual cycle on the strength of the flexor and extensor muscles of the knee, the risk of anterior cruciate ligament injury may increase during this period. Therefore, it is recommended that all female coaches and athletes take preventive measures during this period.
Influence of a sexism and sexual harassment prevention course on medical students’ perceptions of and responses to problematic situations
Authors: Evéquoz Yves , Pichonnaz Lauriane , Dubois Julie
Published: December 2023

Background

Issues of sexism and sexual harassment within the medical field are widespread. The aim of his study was to describe the influence of a training course on the prevention of sexism and sexual harassment on medical students’ perceptions and responses to problematic situations in the workplace.

Methods

We performed a secondary analysis of the transcripts of 16 medical students’ interviews. The data were initially gathered as part of an external evaluation of the course. We decided to further explore these with a focus on potential changes about sexism and sexual harassment awareness induced by the course. Data were analyzed using qualitative thematic analysis.

Results

Most medical students were aware of the existence of sexism and sexual harassment in the medical environment before the course but were not always able to delineate what could be considered as such or not. The course allowed them to broaden their ability to identify problematic situations, that were somewhat “trivialized” before, and to set a lower cut-off when judging what constitutes sexism or sexual harassment. It also provided them with tools on how to react when confronted to these situations, as well as resources to seek help. However, students stressed the importance of such courses also being offered to medical staff higher up in the hierarchy, as they are the ones in a position of power.

Conclusions

The course helped students to better identify and react to sexism and sexual harassment. However, given students’ lack of power within the hierarchy, efforts to prevent sexism and sexual harassment must be undertaken at an institutional level to allow for change in the system as a whole.
Patterns and predictors of cultural competence practice among Nigerian hospital-based healthcare professionals
Authors: Ogunlana Michael O. , Oyewole Olufemi O. , Aderonmu Joseph A. , Onyeso Ogochukwu Kelechi , Faloye Ayobamigbe Y. , Govender Pragashnie
Published: December 2023

Background

Being culturally competent would enhance the quality of care in multicultural healthcare settings like Nigeria, with over 200 million people, 500 languages, and 250 ethnic groups. This study investigated the levels of training and practice of cultural competence among clinical healthcare professionals in two purposively selected Nigerian tertiary hospitals.

Methods

The research was a cross-sectional study. A multi-stage sampling technique was used to recruit participants who completed the adapted version of Cultural Competence Assessment Instrument (CCAI-UIC). Data were analysed using descriptive statistics, Pearson’s correlation, ANOVA, and multivariate linear regression.

Results

The participants were mainly women (66.4%), aged 34.98 ± 10.18 years, with ≤ 5 years of practice (64.6%). Personal competence had a positive weak correlation with age (p < 0.001), practice years (p = 0.01), training (p = 0.001), practice (p < 0.001), and organisational competence (p < 0.001). There were significant professional differences in the level of training (p = 0.005), and differences in training (p = 0.005), and personal competence (p = 0.015) across levels of educational qualifications. Increasing practise years (p = 0.05), medical/dental profession relative to nursing (p = 0.029), higher personal (p = 0.013), and organisational (p < 0.001) cultural competences were significant predictors of the level of training. Male gender (p = 0.005), higher years in practice (p = 0.05), local language ability (p = 0.037), rehabilitation professionals relative to nursing (p = 0.05), high culturally competent practice (p < 0.001), higher training opportunities (p = 0.013), and higher organisational competence (p = 0.001) were significant predictors of higher personal competence.

Conclusion

About a third of the participants had no formal training in cultural competence. Incorporating cultural competence in the Nigerian healthcare professionals’ education curricula may enhance the quality of care in the multicultural setting.
Feasibility and acceptability of the use of flash glucose monitoring encountered by Indigenous Australians with type 2 diabetes mellitus: initial experiences from a pilot study
Authors: Eer Audrey Sing Yi , Ho Rebecca Chia Yee , Hearn Tracey , Hachem Mariam , Freund Megan , Burchill Luke James , Atkinson-Briggs Sharon , Singh Satpal , Eades Sandra , O’Brien Richard Charles , Furler John Stuart , O’Neal David Norman , Story David Andrew , Zajac Jeffrey David , Braat Sabine , Brown Alex , Clarke Phillip , Sinha Ashim Kumar , McLean Anna Gerardina , Twigg Stephen Morris , Ekinci Elif Ilhan
Published: December 2023

Background

Type 2 diabetes mellitus (T2DM) is highly prevalent within the Indigenous Australian community. Novel glucose monitoring technology offers an accurate approach to glycaemic management, providing real-time information on glucose levels and trends. The acceptability and feasibilility of this technology in Indigenous Australians with T2DM has not been investigated.

Objective

This feasibility phenomenological study aims to understand the experiences of Indigenous Australians with T2DM using flash glucose monitoring (FGM).

Methods

Indigenous Australians with T2DM receiving injectable therapy (n = 8) who used FGM (Abbott Freestyle Libre) for 6-months, as part of a clinical trial, participated in semi-structured interviews. Thematic analysis of the interviews was performed using NVivo12 Plus qualitative data analysis software (QSR International).

Results

Six major themes emerged: 1) FGM was highly acceptable to the individual; 2) FGM’s convenience was its biggest benefit; 3) data from FGM was a tool to modify lifestyle choices; 4) FGM needed to be complemented with health professional support; 5) FGM can be a tool to engage communities in diabetes management; and 6) cost of the device is a barrier to future use.

Conclusions

Indigenous Australians with T2DM had positive experiences with FGM. This study highlights future steps to ensure likelihood of FGM is acceptable and effective within the wider Indigenous Australian community.
Association of genetic risk and lifestyle with pancreatic cancer and their age dependency: a large prospective cohort study in the UK Biobank
Authors: Zeng Liangtang , Wu Zhuo , Yang Jiabin , Zhou Yu , Chen Rufu
Published: December 2023

Background

Pancreatic cancer (PC) is influenced by both genetic and lifestyle factors. However, further research is still needed to comprehensively clarify the relationships among lifestyle, genetic factors, their combined effect on PC, and how these associations might be age-dependent.

Methods

We included 340,631 participants from the UK Biobank. Three polygenic risk score (PRS) models for PC were applied, which were derived from the previous study and were categorized as low, intermediate, and high. Two healthy lifestyle scores (HLSs) were constructed using 9 lifestyle factors based on the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) lifestyle score and the American Cancer Society (ACS) guidelines and were categorized as unfavorable, intermediate, and favorable. Data were analyzed using Cox proportional hazards models.

Results

There were 1,129 cases of incident PC during a median follow-up of 13.05 years. Higher PRS was significantly associated with an increased risk of PC (hazard ratio [HR], 1.58; 95% confidence intervals [CI], 1.47–1.71). Adhering to a favorable lifestyle was associated with a lower risk (HR, 0.48; 95% CI, 0.41–0.56). Participants with an unfavorable lifestyle and a high PRS had the highest risk of PC (HR, 2.84; 95% CI, 2.22–3.62). Additionally, when stratified by age, a favorable lifestyle was most pronounced associated with a lower risk of PC among participants aged ≤ 60 years (HR, 0.35; 95% CI, 0.23–0.54). However, the absolute risk reduction was more pronounced among those aged > 70 years (ARR, 0.19%, 95% CI, 0.13%–0.26%). A high PRS was more strongly associated with PC among participants aged ≤ 60 years (HR, 1.89; 95% CI, 1.30–2.73). Furthermore, we observed a significant multiplicative interaction and several significant additive interactions.

Conclusions

A healthy lifestyle was associated with a lower risk of PC, regardless of the participants' age, sex, or genetic risk. Importantly, our findings indicated the age-dependent association of lifestyle and genetic factors with PC, emphasizing the importance of early adoption for effective prevention and potentially providing invaluable guidance for setting the optimal age to start preventive measures.
Prediction of BMI traits in the Chinese population based on the gut metagenome
Authors: Liang Yu , Dou Shujie , Zhao Guangzhong , Shen Jie , Fu Guangping , Fu Lihong , Li Shujin , Cong Bin , Dong Chunnan
Published: December 2023

Background

Identifying individual characteristics based on trace evidence left at a crime scene is crucial in forensic identification. Microbial communities found in fecal traces have high individual specificity and could serve as potential markers for forensic characterization. Previous research has established that predicting body type based on the relative abundance of the gut microbiome is relatively accurate. However, the long-term stability and high individual specificity of the gut microbiome are closely linked to changes at the genome level of the microbiome. No studies have been conducted to deduce body shape from genetic traits. Therefore, in this study, the vital role of gut bacterial community characteristics and genetic traits in predicting body mass index (BMI) was investigated using gut metagenomic data from a healthy Chinese population.

Results

Regarding the gut microbial community, the underweight group displayed increased α-diversity in comparison to the other BMI groups. There were significant differences in the relative abundances of 19 species among these three BMI groups. The BMI prediction model, based on the 31 most significant species, showed a goodness of fit (R2) of 0.56 and a mean absolute error (MAE) of 2.09 kg/m2. The overweight group exhibited significantly higher α-diversity than the other BMI groups at the level of gut microbial genes. Furthermore, there were significant variations observed in the single-nucleotide polymorphism (SNP) density of 732 contigs between these three BMI groups. The BMI prediction model, reliant on the 62 most contributing contigs, exhibited a model R2 of 0.72 and an MAE of 1.56 kg/m2. The model predicting body type from 44 contigs correctly identified the body type of 93.55% of the study participants.

Conclusion

Based on metagenomic data from a healthy Chinese population, we demonstrated the potential of genetic traits of gut bacteria to predict an individual’s BMI. The findings of this study suggest the effectiveness of a novel method for determining the body type of suspects in forensic applications using the genetic traits of the gut microbiome and holds great promise for forensic individual identification.
Leveraging a disulfidptosis‑related lncRNAs signature for predicting the prognosis and immunotherapy of glioma
Authors: Chen Di , Li Qiaoqiao , Xu Yuan , Wei Yanfei , Li Jianguo , Zhu Xuqiang , Li Hongjiang , Lu Yan , Liu Xianzhi , Yan Dongming
Published: December 2023

Background

Gliomas, a prevalent form of primary brain tumors, are linked with a high mortality rate and unfavorable prognoses. Disulfidptosis, an innovative form of programmed cell death, has received scant attention concerning disulfidptosis-related lncRNAs (DRLs). The objective of this investigation was to ascertain a prognostic signature utilizing DRLs to forecast the prognosis and treatment targets of glioma patients.

Methods

RNA-seq data were procured from The Cancer Genome Atlas database. Disulfidptosis-related genes were compiled from prior research. An analysis of multivariate Cox regression and the least absolute selection operator was used to construct a risk model using six DRLs. The risk signature’s performance was evaluated via Kaplan-Meier survival curves and receiver operating characteristic curves. Additionally, functional analysis was carried out using GO, KEGG, and single-sample GSEA to investigate the biological functions and immune infiltration. The research also evaluated tumor mutational burden, therapeutic drug sensitivity, and consensus cluster analysis. Reverse transcription quantitative PCR was conducted to validate the expression level of DRLs.

Results

A prognostic signature comprising six DRLs was developed to predict the prognosis of glioma patients. High-risk patients had significantly shorter overall survival than low-risk patients. The robustness of the risk model was validated by receiver operating characteristic curves and subgroup survival analysis. Risk model was used independently as a prognostic indicator for the glioma patients. Notably, the low-risk patients displayed a substantial decrease in the immune checkpoints, the proportion of immune cells, ESTIMATE and immune score. IC50 values from the different risk groups allowed us to discern three drugs for the treatment of glioma patients. Lastly, the potential clinical significance of six DRLs was determined.

Conclusions

A novel six DRLs signature was developed to predict prognosis and may provide valuable insights for patients with glioma seeking novel immunotherapy and targeted therapy.
Single-cell RNA sequencing in cancer research: discovering novel biomarkers and therapeutic targets for immune checkpoint blockade
Authors: Sun Boyu , Xun Ziyu , Zhang Nan , Liu Kai , Chen Xiangqi , Zhao Haitao
Published: December 2023

Immune checkpoint blockade (ICB) has become a promising strategy in treating advanced cancers, providing significant survival benefits for patients with various cancer types. However, among the vast population of cancer patients, only a small fraction are able to respond to and derive benefits from ICB therapy. Numerous factors contribute to the diminished efficacy of ICB, with the complex tumor microenvironment (TME) playing an important role. Therefore, comprehensively understanding the intricate composition of the TME is critical for elucidating the mechanisms that underlie distinct responses to ICB in patients. Single-cell RNA sequencing (scRNA-seq) is a novel technique that reveals gene expression profiles of individual cells, facilitating the investigation of TME heterogeneity at a high resolution and the identification of key cell subsets participating in the response to ICB. This review emphasizes the importance of scRNA-seq in studying ICB and summarizes recent findings in the discovery of biomarkers that predict ICB response and novel potential therapeutic targets for immunotherapy. These findings suggest future directions for the clinical implementation of cancer immunotherapy, facilitating further advancements in precision medicine.
Association of air pollution exposure and increased coronary artery disease risk: the modifying effect of genetic susceptibility
Authors: Fu Zuqiang , Ma Yuanyuan , Yang Changjie , Liu Qian , Liang Jingjia , Weng Zhenkun , Li Wenxiang , Zhou Shijie , Chen Xiu , Xu Jin , Xu Cheng , Huang Tao , Zhou Yong , Gu Aihua
Published: December 2023

Background

Both genetic factors and air pollution are risk factors for coronary artery disease (CAD), but their combined effects on CAD are uncertain. The study aimed to comprehensively investigate their separate, combined and interaction effects on the onset of CAD.

Methods

We utilized data from the UK Biobank with a recruitment of 487,507 participants who were free of CAD at baseline from 2006 to 2010. We explored the separate, combined effect or interaction association among genetic factors, air pollution and CAD with the polygenic risk score (PRS) and Cox proportional hazard models.

Results

The hazard ratios (HRs) [95% confidence interval (CI)] of CAD for 10-µg/m3 increases in PM2.5, NO2 and NOx concentrations were 1.25 (1.09, 1.44), 1.03 (1.01, 1.05) and 1.01 (1.00, 1.02), respectively. Participants with high PRS and air pollution exposure had a higher risk of CAD than those with the low genetic risk and low air pollution exposure, and the HRs (95% CI) of CAD in the PM2.5, PM10, NO2 and NOx high joint exposure groups were 1.56 (1.48, 1.64), 1.55(1.48, 1.63), 1.57 (1.49, 1.65), and 1.57 (1.49, 1.65), respectively. Air pollution and genetic factors exerted significant additive effects on the development of CAD (relative excess risk due to the interaction [RERI]: 0.12 (0.05, 0.19) for PM2.5, 0.17 (0.10, 0.24) for PM10, 0.14 (0.07, 0.21) for NO2, and 0.17 (0.10, 0.24) for NOx; attributable proportion due to the interaction [AP]: 0.09 (0.04, 0.14) for PM2.5, 0.12 (0.07, 0.18) for PM10, 0.11 (0.06, 0.16) for NO2, and 0.13 (0.08, 0.18) for NOx).

Conclusion

Exposure to air pollution was significantly related to an increased CAD risk, which could be further strengthened by CAD gene susceptibility. Additionally, there were positive additive interactions between genetic factors and air pollution on the onset of CAD. This can provide a more comprehensive, precise and individualized scientific basis for the risk assessment, prevention and control of CAD.
Geographical and practical challenges in the implementation of digital health passports for cross-border COVID-19 pandemic management: a narrative review and framework for solutions
Authors: Towett Gideon , Snead R. Sterling , Grigoryan Knarik , Marczika Julia
Published: December 2023

The rapid global spread of infectious diseases, epitomized by the recent COVID-19 pandemic, has highlighted the critical need for effective cross-border pandemic management strategies. Digital health passports (DHPs), which securely store and facilitate the sharing of critical health information, including vaccination records and test results, have emerged as a promising solution to enable safe travel and access to essential services and economic activities during pandemics. However, the implementation of DHPs faces several significant challenges, both related to geographical disparities and practical considerations, necessitating a comprehensive approach for successful global adoption. In this narrative review article, we identify and elaborate on the critical geographical and practical barriers that hinder global adoption and the effective utilization of DHPs. Geographical barriers are complex, encompassing disparities in vaccine access, regulatory inconsistencies, differences across countries in data security and users' privacy policies, challenges related to interoperability and standardization, and inadequacies in technological infrastructure and limited access to digital technologies. Practical challenges include the possibility of vaccine contraindications and breakthrough infections, uncertainties surrounding natural immunity, and limitations of standard tests in assessing infection risk. To address geographical disparities and enhance the functionality and interoperability of DHPs, we propose a framework that emphasizes international collaboration to achieve equitable access to vaccines and testing resources. Furthermore, we recommend international cooperation to establish unified vaccine regulatory frameworks, adopting globally accepted standards for data privacy and protection, implementing interoperability protocols, and taking steps to bridge the digital divide. Addressing practical challenges requires a meticulous approach to assessing individual risk and augmenting DHP implementation with rigorous health screenings and personal infection prevention measures. Collectively, these initiatives contribute to the development of robust and inclusive cross-border pandemic management strategies, ultimately promoting a safer and more interconnected global community in the face of current and future pandemics.
Pre-treatment optimisation with pulmonary rehabilitation of elderly lung cancer patients with frailty for surgery
Authors: Goldsmith Ira , Chesterfield-Thomas Gemma , Toghill Hannah
Published: December 2023

Objective

Frailty develops as a result of age-related decline in many physiological systems and is associated with increased vulnerability to adverse outcomes following thoracic surgery. We prospectively tested our hypothesis that pre-operative pulmonary rehabilitation (Prehab) improves frailty, as suggested by a frailty index > 3 (FI > 3) and fitness, and thereby reduces the risk of post-surgical complications and death in vulnerable elderly lung cancer patients.

Methods

221 surgical patients, 80 with FI > 3 vs. 141 patients with FI < 3, following Prehab proceeded to surgery. Their Frailty index (FI), dyspnoea scores, performance status (PS), level of activity (LOA) and six-minute walk test (6MWT) prior to and following Prehab were determined. The post-operative length of hospital stay (LOHS), complications, mortality and mid-term survival at 1100 days were compared. Similarly, outcomes for elderly patient ≥ 70 years with FI > 3 (≥ 70,FI > 3) were compared with younger patients < 70 years with FI ≤ 3 (< 70,FI ≤ 3).

Results

Patients with FI > 3 were significantly older, had lower 6MWT and higher thoracoscores hence, 82.5% of patients with FI > 3 vs. 33.3% (p = 0.02) with FI ≤ 3 were considered high risk for surgery and postoperative adverse events. With Prehab there was significant improvement in the FI, dyspnoea scores, PS, LOA and 6MWT. Following surgery, there were no differences in major complication rates (8.8% vs. 9.2% p = ns); LOHS median (IQR) [7 (6.8) vs. 8 (5.5) days]; mortality at 30-days (3.7% vs. 0.7%, p = ns); 90-days (6.3% vs. 2.8%, p = ns) and 1-year survival (81.1% vs. 83.7% p = ns). Survival at 1100 days was (63.2% vs. 71.1%, p = 0.19). Likewise, 87.7% elderly ≥ 70,FI > 3 patients were considered high-risk for surgery and postoperative adverse events vs. 35.1% younger patients < 70,FI ≤ 3 (p = 0.0001). Following Prehab and surgery, there were no significant differences in complications, LOHS, mortality at 365 days between the two groups. Survival at 1100 days for ≥ 70,FI > 3 was 55.2% vs. 79.96% for < 70,FI ≤ 3; (p = 0,01).

Conclusion

Our study suggests that Prehab optimises vulnerable high-risk elderly lung cancer patients with frailty allowing them to undergo surgery with outcomes of post-surgical complications, LOHS and mortality at 365 days no different to patients with no frailty. However, mid-term survival was lower for elderly patients with frailty.
Quality of reporting of integrative Chinese and Western medicine intervention in randomized controlled trials of ulcerative colitis: a review
Authors: Zhang Jialing , Deng Jiashuai , Wang Nana , Wang Ping , Li Ji , Wang Yunhai , Cui Wanting , Liang Feng , Chen Peijin , Wang Juan , Han Fei , Chan Chun Pong , Lyu Aiping , Bian Zhaoxiang , Zhang Xuan
Published: December 2023

Background

Integrative Chinese and Western medicine (ICWM) is commonly used for the treatment of ulcerative colitis (UC) in clinical practice. However, it is unclear whether the details of ICWM interventions, such as selection rationale, implementation design, and potential interactions, were adequately reported. Therefore, this study aimed to assess the quality of reporting in the ICWM interventional randomized controlled trials (RCTs) of UC and to identify the common problems if any.

Methods

Through a search of 10 international electronic databases, we identified RCTs of UC with ICWM interventions published in English or Chinese from the inception date of each database up to 16 June 2023. Literature screening was strictly conducted based on the inclusion and exclusion criteria of the Population, Concept, and Context (PCC) framework. The general characteristics of the included studies were described. The quality of reporting was assessed according to three checklists, including the CONSORT (Consolidated Standards of Reporting Trials) with 36 items (except for one item 1b about abstract), the CONSORT for Abstracts (17 items), and a self-designed ICWM-related checklist (27 items covering design rationale, intervention details, outcome assessments, and analysis). The reporting scores of RCTs published before and after 2010 were compared.

Results

A total of 1458 eligible RCTs were included. For the reporting compliance, the median score (interquartile ranges) of the CONSORT (72 score in total), the CONSORT for Abstract (34 score), and ICWM-related (54 score) items was 21 (18–25), 13 (12–15), and 18 (15–21), respectively. Although the time period comparisons showed that reporting quality of included publications improved significantly after the CONSORT 2010 issued (P < 0.01), more than 50% of items were evaluated as poor quality (reporting rate < 65%) among each checklist, especially in the CONSORT for Abstract and ICWM-specific items.

Conclusion

Although CONSORT appears to have enhanced the reporting of RCTs in UC, the quality of ICWM specifics is variable and in need of improvement. Reporting guidelines of the ICWM recommendations should be developed to improve their quality.
The role of Green Public Procurements in energy transition: the case of Western Macedonia
Authors: Kilintzis Pavlos , Samara Elpida , Topaloglou Lefteris , Avlogiaris Giorgos , Kafetzopoulos Dimitrios
Published: December 2023

This paper aims to assess the level of implementation of Green Public Procurements (GPP) in the Region of Western Macedonia—Greece, which is currently under energy transition from lignite to a RES-based energy model. By that assessment, a linkage between the GPP framework and energy transition is created, revealing the distinct GPP criteria that should be adopted by energy-transition regions, which have the potential to strengthen the transition process. Rather than implementing the total number of the GPP criteria, literature and methodology findings indicated that specific GPP criteria are directly connected to energy transition and should be primarily adopted by policymakers in comparison to the rest. These criteria are Electricity, Road Transport, Waste Water Infrastructure and Road Lighting and Traffic Signals. By assessing a sample of 31 procurement officials and scientific experts in the five major municipalities of the region, the implementation level of GPP criteria was measured average-to-low, implying that there is a considerable scope by the region’s main municipal authorities to adopt them to a greater extent. Statistical correlations using Spearman’s rank correlation analysis between specific GPP criteria were also identified, indicating distinct interconnections between the criteria pairs that imply commonalities in the implementation framework of GPP. The paper’s implications for future research led to the identification of specific GPP criteria in the public procurement process, that have the potential to enhance green sustainability and boost energy transition.
Satellite telemetry reveals space use of diamondback terrapins
Authors: Lamont Margaret M. , Price Melissa E. , Catizone Daniel J.
Published: December 2023

Movement and space use information of exploited and imperiled coastal species is critical to management and conservation actions. While satellite telemetry has been successfully used to document movements of marine turtles, the large tag sizes available have limited use on smaller turtle species. We used small Argos-based satellite tags to document movement patterns of diamondback terrapins (Malaclemys terrapin), the only estuarine turtle species in North America. Movement data from ten terrapins in St. Joseph Bay, Florida were gathered between July 13, 2018 and July 22, 2021. We estimated seasonal space use using the daily locations generated from a Bayesian hierarchical state-space model to calculate minimum convex polygons (95% MCP) and kernel density estimates (50% and 95% KDE). Mean tracking duration was 125 days and mean home range size was 9.4 km2(95% MCP) and 8.1 km2(95% KDE). Seagrass habitat comprised 55.8% of all home ranges on average, whereas salt marsh comprised a mean of 3.0%. Mean elevation used by terrapins was − 0.13 m (95% MCP) and -0.35 m (95% KDE). Satellite telemetry provided broad-scale spatiotemporal movement and space use data; however, Argos error produced considerable noise relative to true terrapin movements given their size, speed, and behavior. Terrapin home ranges were greater than previously reported and three of the ten terrapins exhibited repeated long-distance, directed movements within the bay. Small patches of salt marsh habitat were centralized within home ranges, despite comprising only a small percentage for each terrapin. Moreover, the percentage of salt marsh present in each core use area was positively correlated with terrapin mass. Although considered an estuarine species, seagrass habitat comprised a large portion of terrapin home ranges; however, our data did not provide the detail necessary to understand how terrapins were using this habitat. As northward-expanding mangroves continue to infringe upon salt marsh habitat, there is potential for negative impacts to terrapin populations across the northern Gulf of Mexico. As salt marsh habitat continues to be infringed upon by northward-expanding mangroves impacts to terrapins across the northern Gulf of Mexico.
Baseline presentation of atypical anorexia nervosa in Singaporean adolescents: a retrospective cohort study
Authors: Chew Chu Shan Elaine , Tay E. Eric , Lie Mei En Hannah Marian , Khaider Khairunisa Binte , Davis Courtney
Published: December 2023

Background

While atypical anorexia nervosa (AAN) has been found to present with significant physical and psychological complications, the presentation of AAN has not been described in a multi-ethnic Singaporean population.

Methods

This retrospective cohort analysis aimed to characterize the baseline presentation of adolescents with anorexia nervosa (AN) (N = 317) and AAN (N = 141) in a Singaporean cohort that presented to a specialist paediatric eating disorder program between January 2010 and October 2020 for assessment.

Results

In patients with AAN, there were increased proportions of males (16% vs. 7%) and of Malay ethnicity (11% vs. 4%) compared to AN. Compared to adolescents with AN, adolescents with AAN had lower rates of admission (61% vs. 81%), bradycardia (45% vs. 75%), and hypotension (7% vs. 21%) but had a higher rate of syncope (13% vs. 7%). Likewise, adolescents with AAN had higher rates of self-harm and drug overdose (14% vs. 1.5%) requiring admission, more purging (45.1% vs. 14.8%) and more shape concerns.

Conclusion

Highlighting the severity of the illness, Singaporean adolescents with AAN presented with physical complications of malnutrition and had more severe eating disorder psychopathology and a higher frequency of other psychological comorbidities than did adolescents with AN.
Factors associated with suicide attempts in the antecedent illness trajectory of bipolar disorder and schizophrenia
Authors: Miola Alessandro , Gardea-Reséndez Manuel , Ortiz-Orendain Javier , Nunez Nicolas A. , Ercis Mete , Coombes Brandon J. , Salgado Manuel Fuentes , Gruhlke Peggy M. , Michel Ian , Bostwick J. Michael , McKean Alastair J. , Ozerdem Aysegul , Frye Mark A.
Published: December 2023

Background

Factors associated with suicide attempts during the antecedent illness trajectory of bipolar disorder (BD) and schizophrenia (SZ) are poorly understood.

Methods

Utilizing the Rochester Epidemiology Project, individuals born after 1985 in Olmsted County, MN, presented with first episode mania (FEM) or psychosis (FEP), subsequently diagnosed with BD or SZ were identified. Patient demographics, suicidal ideation with plan, self-harm, suicide attempts, psychiatric hospitalizations, substance use, and childhood adversities were quantified using the electronic health record. Analyses pooled BD and SZ groups with a transdiagnostic approach given the two diseases were not yet differentiated. Factors associated with suicide attempts were examined using bivariate methods and multivariable logistic regression modeling.

Results

A total of 205 individuals with FEM or FEP (BD = 74, SZ = 131) were included. Suicide attempts were identified in 39 (19%) patients. Those with suicide attempts during antecedent illness trajectory were more likely to be female, victims of domestic violence or bullying behavior, and have higher rates of psychiatric hospitalizations, suicidal ideation with plan and/or self-harm, as well as alcohol, drug, and nicotine use before FEM/FEP onset. Based on multivariable logistic regression, three factors remained independently associated with suicidal attempts: psychiatric hospitalization (OR = 5.84, 95% CI 2.09–16.33, p < 0.001), self-harm (OR = 3.46, 95% CI 1.29–9.30, p = 0.014), and nicotine use (OR = 3.02, 95% CI 1.17–7.76, p = 0.022).

Conclusion

Suicidal attempts were prevalent during the antecedents of BD and SZ and were associated with several risk factors before FEM/FEP. Their clinical recognition could contribute to improve early prediction and prevention of suicide during the antecedent illness trajectory of BD and SZ.
Post-COVID exercise intolerance is associated with capillary alterations and immune dysregulations in skeletal muscles
Authors: Aschman Tom , Wyler Emanuel , Baum Oliver , Hentschel Andreas , Rust Rebekka , Legler Franziska , Preusse Corinna , Meyer-Arndt Lil , Büttnerova Ivana , Förster Alexandra , Cengiz Derya , Alves Luiz Gustavo Teixeira , Schneider Julia , Kedor Claudia , Bellmann-Strobl Judith , Sanchin Aminaa , Goebel Hans-Hilmar , Landthaler Markus , Corman Victor , Roos Andreas , Heppner Frank L. , Radbruch Helena , Paul Friedemann , Scheibenbogen Carmen , Dengler Nora F. , Stenzel Werner
Published: December 2023

The SARS-CoV-2 pandemic not only resulted in millions of acute infections worldwide, but also in many cases of post-infectious syndromes, colloquially referred to as “long COVID”. Due to the heterogeneous nature of symptoms and scarcity of available tissue samples, little is known about the underlying mechanisms. We present an in-depth analysis of skeletal muscle biopsies obtained from eleven patients suffering from enduring fatigue and post-exertional malaise after an infection with SARS-CoV-2. Compared to two independent historical control cohorts, patients with post-COVID exertion intolerance had fewer capillaries, thicker capillary basement membranes and increased numbers of CD169+ macrophages. SARS-CoV-2 RNA could not be detected in the muscle tissues. In addition, complement system related proteins were more abundant in the serum of patients with PCS, matching observations on the transcriptomic level in the muscle tissue. We hypothesize that the initial viral infection may have caused immune-mediated structural changes of the microvasculature, potentially explaining the exercise-dependent fatigue and muscle pain.

Graphical Abstract
A role for orbital eccentricity in Earth’s seasonal climate
Authors: Chiang John C. H. , Broccoli Anthony J.
Published: December 2023

The seasonality of Earth’s climate is driven by two factors: the tilt of the Earth’s rotation axis relative to the plane of its orbit (hereafter the tilt effect), and the variation in the Earth–Sun distance due to the Earth’s elliptical orbit around the Sun (hereafter the distance effect). The seasonal insolation change between aphelion and perihelion is only ~ 7% of the annual mean and it is thus assumed that the distance effect is not relevant for the seasons. A recent modeling study by the authors and collaborators demonstrated however that the distance effect is not small for the Pacific cold tongue: it drives an annual cycle there that is dynamically distinct and ~ 1/3 of the amplitude from the known annual cycle arising from the tilt effect. The simulations also suggest that the influence of distance effect is significant and pervasive across several other regional climates, in both the tropics and extratropics. Preliminary work suggests that the distance effect works its influence through the thermal contrast between the mostly ocean hemisphere centered on the Pacific Ocean (the ‘Marine hemisphere’) and the hemisphere opposite to it centered over Africa (the ‘Continental hemisphere’), analogous to how the tilt effect drives a contrast between the northern and southern hemispheres. We argue that the distance effect should be fully considered as an annual cycle forcing in its own right in studies of Earth’s modern seasonal cycle. Separately considering the tilt and distance effects on the Earth’s seasonal cycle provides new insights into the workings of our climate system, and of direct relevance to paleoclimate where there are outstanding questions for long-term climate changes that are related to eccentricity variations.
Giant ionospheric density hole near the 2022 Hunga-Tonga volcanic eruption: multi-point satellite observations
Authors: Choi Jong-Min , Lin Charles Chien-Hung , Rajesh P. K. , Lin Jia-Ting , Chou Marty , Kwak Young-Sil , Chen Shih-Ping
Published: December 2023

A giant ionospheric hole was simultaneously detected in the in situ measurements of FORMOSAT-7/COSMIC-2 (F7/C2), Ionospheric Connection Explorer (ICON), Swarm missions, and ground-based total electron content (TEC) by global navigation satellite system receivers, and F7/C2 Global Ionosphere Specification (GIS) data near Tonga, following the explosive volcano eruption on 15 January 2022. The TEC maps displayed the huge depletions that developed near Tonga after the eruption and gradually evolved. The ICON IVM, F7/C2 IVM and Swarm-LP detected large depletions not only near Tonga, but also in the EIA trough region. The GIS observations clearly show the ionospheric hole that extends spatially near Tonga, especially strongly south/southward. The simultaneous observations showed that the ionosphere hole near Tonga combined with the EIA trough and finally evolved into a giant ionosphere hole around 07 UT. The ionospheric hole, which occurred at 05 UT near Tonga, extended over a wide area of 160°-200°E and 25°S-20°N and lasted for about 11 h. The F7/C2 and ICON satellites overpasses showed large ion density depletions by the hole at orbit altitudes, accompanied by enhancements in ion temperature and field-aligned and perpendicular ion drift. Such a long-lasting giant ionospheric hole by a seismic event has not been reported earlier, creating a unique ionospheric environment near Tonga after the eruption. The strong successive impulses by multiple volcano eruptions, together with O/N2 decrease in the summer hemisphere, interhemispheric wind, and water vapor injection into high altitudes apparently yielded such a giant ionospheric hole, 4–6 times larger than that observed during the Tohoku earthquake.

Graphical Abstract
No difference in Oxford Knee Score between medial and lateral unicompartmental knee arthroplasty after two years of follow‐up: a clinical trial
Authors: Migliorini Filippo , Cocconi Federico , Prinz Julia , Ursino Nicola , Mangiavini Laura , D’Ambrosi Riccardo
Published: December 2023

Purpose

In patients with monocompartmental knee osteoarthritis, unicompartmental knee arthroplasty (UKA) can be performed. This study compared the medial versus lateral UKA in patients with monocompartimental knee arthroplasty. It was hypothesised that both implants achieve a similar outcome in OKS.

Methods

The UKAs were fixed‐bearing medial PPK (Zimmer‐Biomet, Warsaw, Indiana, USA) and fixed‐bearing lateral Zuk (Lima Corporate, Udine, Italy). An intraarticular drain was placed and removed on the first postoperative day. Enoxaparin sodium 4000 units subcutaneously daily for 45 days was used as thromboembolic prophylaxis. The Italian version of the OKS was used for the clinical assessment. The following complications were also recorded: anterior knee pain, infection and revision surgeries.

Results

Data from 203 patients were collected. The mean age of the patients was 68.9 ± 6.7 years and the mean BMI was 28.1 ± 4.1 kg/m2. The mean OKS on admission was 22.1 ± 4.5 points. On admission, women, patients older than 70 years, and those with a BMI lower than 28 kg/m2 who underwent lateral UKA evidenced lower OKS. At the last follow‐up, 26.7 and 26.9 months for the lateral and medial UKA, respectively, no between groups difference in OKS was evidenced. No patients experienced complications.

Conclusion

Medial and lateral UKA achieve similar outcomes in OKS at a minimum of two years of follow‐up.
Interobserver reliability for manual analysis of sidestream darkfield videomicroscopy clips after resizing in ImageJ
Authors: Lala Raushan C. B. , Homes Ryan A. P. , Lipman Jeffrey , Midwinter Mark J.
Published: December 2023

Background

Direct assessment of microcirculatory function remains a critical care research tool but approaches for analysis of microcirculatory videomicroscopy clips are shifting from manual to automated algorithms, with a view to clinical application in the intensive care unit. Automated analysis software associated with current sidestream darkfield videomicroscopy systems is demonstrably unreliable; therefore, semi-automated analysis of captured clips should be undertaken in older generations of software. We present a method for capture of microcirculatory clips using current version videomicroscope hardware and resizing of clips to allow compatibility with legacy analysis software. The interobserver reliability of this novel approach is examined, in addition to a comparison of this approach with the current generation of automated analysis software.

Results

Resizing microcirculatory clips did not significantly change image quality. Assessment of bias between observers for manual analysis of resized clips; and between manually analysed clips and automated software analysis was undertaken by Bland–Altman analysis. Bias was demonstrated for all parameters for manual analysis of resized clips (total vessel density = 6.8, perfused vessel density = 6.3, proportion of perfused vessels = − 8.79, microvascular flow index = − 0.08). Marked bias between manual analysis and automated analysis was also evident (total vessel density = 16.6, perfused vessel density = 16.0, proportion of perfused vessels = 1.8). The difference between manual and automated analysis was linearly related to the magnitude of the measured parameter.

Conclusions

Poor reliability of automated analysis is a significant hurdle for clinical translation of microcirculatory monitoring. The method presented here allows capture of microcirculatory clips using current hardware that are backwards compatible with older versions of manual analysis software. We conclude that this approach is appropriate for research applications in the intensive care unit, however the time delay to results limits utility for clinical translation.
Constructing Escherichia coli co-display systems for biodegradation of polyethylene terephthalate
Authors: Hu Jiayu , Chen Yijun
Published: December 2023

Background

The accumulation of fast-growing polyethylene terephthalate (PET) wastes has posed numerous threats to the environments and human health. Enzymatic degradation of PET is a promising approach for PET waste treatment. Currently, the efficiency of various PET biodegradation systems requires further improvements.

Results

In this work, we engineered whole cell systems with co-display of strong adhesive proteins and the most active PETase for PET biodegradation in E. coli cells. Adhesive proteins of cp52k and mfp-3 and Fast-PETase were simultaneously displayed on the surfaces of E. coli cells, and the resulting cells displaying mfp-3 showed 50% increase of adhesion ability compared to those without adhesive proteins. Consequently, the degradation rate of E. coli cells co-displaying mfp-3 and Fast-PETase for amorphous PET exceeded 15% within 24 h, exhibiting fast and thorough PET degradation.

Conclusions

Through the engineering of co-display systems in E. coli cells, PET degradation efficiency was significantly increased compared to E. coli cells with sole display of Fast-PETase and free enzyme. This feasible E. coli co-display system could be served as a convenient tool for extending the treatment options for PET biodegradation.

Graphical Abstract
Multi-professional teamwork in Finnish early childhood education and care
Authors: Karila Kirsti , Kupila Päivi
Published: December 2023

This article analyses the theoretical, practical, and political interpretations of multi-professional teamwork in Finnish early childhood education and care during the last two decades. A semi-systematic approach was used to provide an overview of teams, teamwork, team composition, and multi-professionalism. The data were drawn from two main sources: key Finnish policy documents that regulate or guide multi-professional teamwork and a systematic literature review of multi-professional teamwork in Finnish research studies over the past 20 years. The data were examined through the lens of thematic analysis. In the final phase of the analysis, we constructed a narrative timeline. The timeline indicates two main themes: one is an emphasis on multi-professional teamwork as a resource combined with the challenges in implementing it, the other is an emphasis on pedagogy and the clarification of professional profiles. The timeline illustrates changes in the ways multi-professional teamwork has been interpreted, guided, and studied.