bluuebunny/crossref_metadata_2025 huggingface dataset:
Building a socially accountable medical school: A layered analysis of the Hackensack Meridian School of Medicine
Authors: Hoffman Miriam , Metzger Keith , Martinez Ofelia
Published: May 2024

Background

If medicine fundamentally exists to care for the wellbeing of individuals and societies, there should be a direct and comprehensive link between a medical school's social mission and its educational programme. We have not found a description of development or reform that utilises social mission to guide the comprehensive development of the educational programme. As a new school, we utilised a systematic mission‐driven approach to develop the curriculum, pedagogical methods and structure of the programme. Using layered analysis, this paper demonstrates how a school's mission can drive all aspects of the educational programme. This supports the transferability of this work to other schools so that they can achieve their unique missions.

Approach

Layered analysis is used for reporting an intervention through three tiered lenses: philosophies, principles and techniques. This provides a structure to guide implementation and evaluation. It can also be used to transfer the innovation to other contexts.

Evaluation

Each principle guiding the school's development is linked to context specific techniques and drives the focus of programme evaluation. Evaluation approaches using these principles are described, including an example of composite student performance data in a core area of focus.

Implications

Through layered analysis of a medical school that developed and implemented a mission‐driven curriculum, this can enable other schools to transfer this approach to achieve their missions through the design and implementation of their programmes.
DePNR: A DeBERTa‐based deep learning model with complete position embedding for place name recognition from geographical literature
Authors: Li Weirong , Sun Kai , Wang Shu , Zhu Yunqiang , Dai Xiaoliang , Hu Lei
Published: May 2024

Place names play an important role in linking physical places to human perception and are highly frequently used in the daily lives of people to refer to places in natural language. However, many place names may not be recorded in typical gazetteers due to their new establishment, colloquial nature, and different concerns. These unrecorded toponyms are often discussed in geographical literature; thus, it is necessary to automatically identify them from geographical literature and update existing gazetteers using computational approaches. Currently, the most advanced approaches are deep learning‐based models. However, existing models used only partial position information rather than complete position information of words in a sentence, which limits their performance in recognizing toponyms. To this end, we develop DePNR, a DeBERTa‐based deep learning model with complete position embedding for place name recognition from geographical literature. We train DePNR on two datasets and test it on a real dataset from geographical literature to evaluate its performance. The results show that DePNR achieves an F‐score of 0.8282, outperforming previous approaches, and can recognize new toponyms from literature text, potentially enriching existing gazetteers.
Managing infectious challenges in the age of molecular‐targeted therapies for adult hematological malignancies
Authors: Shah Manan , El Chaer Firas , Ho Dora Y. , El Boghdadly Zeinab
Published: May 2024

Over the last decade, the therapeutic landscape for hematological malignancies (HMs) has witnessed a remarkable surge in the development of novel biological and small‐molecule‐targeted immunomodulatory agents. These therapies have drastically improved survival, but some come at the cost of increased risk of bacterial, viral, and/or fungal infections and on‐target off‐tumor immunological side effects. To mitigate such risks, physicians must be well informed about infectious complications and necessary preventive measures, such as screening, vaccinations, and antimicrobial prophylaxis. Furthermore, physicians should be vigilant about the noninfectious side effects of these agents that can mimic infections and understand their potential drug–drug interactions with antimicrobials. Strengthening and harmonizing the current surveillance and reporting system for drug‐associated infections in real‐world settings is essential to better ascertain the potential infections associated with these agents. In this review, we aimed to summarize the infection risks associated with novel agents used for specific HMs and outline recommended strategies for monitoring and prophylaxis.
Impact Dynamics Simulation for Magnetorheological Fluid Saturated Fabric Barriers
Authors: Son Kwon Joong , Fahrenthold Eric P.
Published: May 2024

Experimental research has investigated the non-Newtonian fluid augmentation of fabric barrier materials, aimed at adding impact energy dissipation mechanisms and thereby improving ballistic performance. Published experimental results on the effectiveness of these augmentations are mixed, and numerical models supporting complimentary modeling research are lacking, primarily due to the multiple geometric and material nonlinearities present in the system. The combination of Hamiltonian mechanics with hybrid particle-element kinematics offers a very general modeling approach to impact simulation for these systems, one which includes interstitial fluid–structure interactions, the yarn level dynamics of projectile impacts, and yarn fracture without the introduction of slidelines and without mass or energy discard. Three-dimensional (3D) impact simulations show good agreement with published experiments for magnetorheological (MR) fluid-saturated Kevlar, including fabric tested under bulk field excitation of the target region and magnetomechanically edge-clamped fabric sliding in an excited air gap. The Hamiltonian method employed to develop the system-level model allows for computationally efficient partitioning of the modeled physics while maintaining a thermodynamically consistent formulation.
The Sport Experience Measure for Children and Youth (SEM:CY): A Rasch Validation Study
Authors: Jefferies Philip , Kwan Matthew Y.W. , Brown Denver M.Y. , Bruner Mark W. , Tamminen Katherine A. , Cairney John
Published: May 2024

This study employed Rasch analyses to validate a novel measure of sport experience: the Sport Experience Measure: Children and Youth (SEM:CY). Analyses were applied to self-reported data of n = 503 young people (age 9–18 years, M = 12.91, 50% female) in Canada who were engaging in sport during the previous 12 months. The revised measure, consisting of 24 items on a 3-point response scale, demonstrated good fit statistics (e.g., item fit residual: M = −0.50, SD = 0.94 and person fit residual: M = −0.62, SD = 2.33), an ability to reliably discriminate between levels of sport experience, and an absence of differential item functioning for various groups (males and females, older and younger individuals, solo and team sports, and those playing at various competitive levels, including recreation). The SEM:CY is a succinct tool that can serve as a valuable means to gauge the quality of an individual’s sport experience, which can facilitate positive youth development and sustain participation across the life span.
Complex dislocation loop networks as natural extensions of the sink efficiency of saturated grain boundaries in irradiated metals
Authors: He Sicong , Mang Emily H. , El Atwani Osman , Nathanie James , Leff Asher C. , Zhou Xinran , Taheri Mitra L. , Marian Jaime
Published: May 2024

The development of radiation-tolerant structural materials is an essential element for the success of advanced nuclear energy concepts. A proven strategy to increase radiation resistance is to create microstructures with a high density of internal defect sinks, such as grain boundaries (GBs). However, as GBs absorb defects, they undergo internal transformations that limit their ability to capture defects indefinitely. Here, we show that, as the sink efficiency of GBs becomes exhausted with increasing irradiation dose, networks of irradiation loops form in the vicinity of saturated or near-saturated GB, maintaining and even increasing their capacity to continue absorbing defects. The formation of these networks fundamentally changes the driving force for defect absorption at GB, from “chemical” to “elastic.” Using thermally-activated dislocation dynamics simulations, we show that these networks are consistent with experimental measurements of defect densities near GB. Our results point to these networks as a natural continuation of the GB once they exhaust their internal defect absorption capacity.
Stony coral tissue loss disease indirectly alters reef communities
Authors: Swaminathan Sara D. , Lafferty Kevin D. , Knight Nicole S. , Altieri Andrew H.
Published: May 2024

Many Caribbean coral reefs are near collapse due to various threats. An emerging threat, stony coral tissue loss disease (SCTLD), is spreading across the Western Atlantic and Caribbean. Data from the U.S. Virgin Islands reveal how SCTLD spread has reduced the abundance of susceptible coral and crustose coralline algae and increased cyanobacteria, fire coral, and macroalgae. A Caribbean-wide structural equation model demonstrates versatility in reef fish and associations with rugosity independent of live coral. Model projections suggest that some reef fishes will decline due to SCTLD, with the largest changes on reefs that lose the most susceptible corals and rugosity. Mapping these projected declines in space indicates how the indirect effects of SCTLD range from undetectable to devastating.
FOXP1 regulates the development of excitatory synaptic inputs onto striatal neurons and induces phenotypic reversal with reinstatement
Authors: Khandelwal Nitin , Kulkarni Ashwinikumar , Ahmed Newaz I. , Harper Matthew , Konopka Genevieve , Gibson Jay R.
Published: May 2024

Long-range glutamatergic inputs originating from the cortex and thalamus are indispensable for striatal development, providing the foundation for motor and cognitive functions. Despite their significance, transcriptional regulation governing these inputs remains largely unknown. We investigated the role of a transcription factor encoded by a high-risk autism-associated gene,
FOXP1
, in sculpting glutamatergic inputs onto spiny projection neurons (SPNs) within the striatum. We find a neuron subtype-specific role of FOXP1 in strengthening and maturing glutamatergic inputs onto dopamine receptor 2–expressing SPNs (D2 SPNs). We also find that FOXP1 promotes synaptically driven excitability in these neurons. Using single-nuclei RNA sequencing, we identify candidate genes that mediate these cell-autonomous processes through postnatal FOXP1 function at the post-synapse. Last, we demonstrate that postnatal FOXP1 reinstatement rescues electrophysiological deficits, cell type–specific gene expression changes, and behavioral phenotypes. Together, this study enhances our understanding of striatal circuit development and provides proof of concept for a therapeutic approach for FOXP1 syndrome and other neurodevelopmental disorders.
Nitrogen dioxide exposure, health outcomes, and associated demographic disparities due to gas and propane combustion by U.S. stoves
Authors: Kashtan Yannai , Nicholson Metta , Finnegan Colin J. , Ouyang Zutao , Garg Anchal , Lebel Eric D. , Rowland Sebastian T. , Michanowicz Drew R. , Herrera Janet , Nadeau Kari C. , Jackson Robert B.
Published: May 2024

Gas and propane stoves emit nitrogen dioxide (NO
2
) pollution indoors, but the exposures of different U.S. demographic groups are unknown. We estimate NO
2
exposure and health consequences using emissions and concentration measurements from >100 homes, a room-specific indoor air quality model, epidemiological risk parameters, and statistical sampling of housing characteristics and occupant behavior. Gas and propane stoves increase long-term NO
2
exposure 4.0 parts per billion volume on average across the United States, 75% of the World Health Organization’s exposure guideline. This increased exposure likely causes ~50,000 cases of current pediatric asthma from long-term NO
2
exposure alone. Short-term NO
2
exposure from typical gas stove use frequently exceeds both World Health Organization and U.S. Environmental Protection Agency benchmarks. People living in residences <800 ft
2
in size incur four times more long-term NO
2
exposure than people in residences >3000 ft
2
in size; American Indian/Alaska Native and Black and Hispanic/Latino households incur 60 and 20% more NO
2
exposure, respectively, than the national average.
The immunoglobulin superfamily ligand B7H6 subjects T cell responses to NK cell surveillance
Authors: Kilian Michael , Friedrich Mirco J. , Lu Kevin Hai-Ning , Vonhören David , Jansky Selina , Michel Julius , Keib Anna , Stange Saskia , Hackert Nicolaj , Kehl Niklas , Hahn Markus , Habel Antje , Jung Stefanie , Jähne Kristine , Sahm Felix , Betge Johannes , Cerwenka Adelheid , Westermann Frank , Dreger Peter , Raab Marc S. , Meindl-Beinker Nadja M. , Ebert Matthias , Bunse Lukas , Müller-Tidow Carsten , Schmitt Michael , Platten Michael
Published: May 2024

Understanding the mechanisms that regulate T cell immunity is critical for the development of effective therapies for diseases associated with T cell dysfunction, including autoimmune diseases, chronic infections, and cancer. Co-inhibitory “checkpoint molecules,” such as programmed cell death protein-1, balance excessive or prolonged immune activation by T cell–intrinsic signaling. Here, by screening for mediators of natural killer (NK) cell recognition on T cells, we identified the immunoglobulin superfamily ligand B7H6 to be highly expressed by activated T cells, including patient-infused CD19-targeting chimeric antigen receptor (CAR) T cells. Unlike other checkpoint molecules, B7H6 mediated NKp30-dependent recognition and subsequent cytolysis of activated T cells by NK cells. B7H6
+
T cells were prevalent in the tissue and blood of several diseases, and their abundance in tumor tissue positively correlated with clinical response in a cohort of patients with immune checkpoint inhibitor–treated esophageal cancer. In humanized mouse models, NK cell surveillance via B7H6 limited the persistence and antitumor activity of CAR T cells, and its genetic deletion enhanced T cell proliferation and persistence. Together, we provide evidence of B7H6 protein expression by activated T cells and suggest the B7H6-NKp30 axis as a therapeutically actionable NK cell–dependent immune checkpoint that regulates human T cell function.
Assessment of the hypothetical protein BB0616 in the murine infection of
Borrelia burgdorferi
Authors: Thompson Christina , Waldron Connor , George Sierra , Ouyang Zhiming
Published: May 2024

bb0616
of
Borrelia burgdorferi
, the Lyme disease pathogen, encodes a hypothetical protein of unknown function. In this study, we showed that BB0616 was not surface-exposed or associated with the membrane through localization analyses using proteinase K digestion and cell partitioning assays. The expression of
bb0616
was influenced by a reduced pH but not by growth phases, elevated temperatures, or carbon sources during
in vitro
cultivation. A transcriptional start site for
bb0616
was identified by using 5′ rapid amplification of cDNA ends, which led to the identification of a functional promoter in the 5′ regulatory region upstream of
bb0616
. By analyzing a
bb0616
-deficient mutant and its isogenic complemented counterparts, we found that the infectivity potential of the mutant was significantly attenuated. The inactivation of
bb0616
displayed no effect on borrelial growth in the medium or resistance to oxidative stress, but the mutant was significantly more susceptible to osmotic stress. In addition, the production of global virulence regulators such as BosR and RpoS as well as virulence-associated outer surface lipoproteins OspC and DbpA was reduced in the mutant. These phenotypes were fully restored when gene mutation was complemented with a wild-type copy of
bb0616
. Based on these findings, we concluded that the hypothetical protein BB0616 is required for the optimal infectivity of
B. burgdorferi
, potentially by impacting
B. burgdorferi
virulence gene expression as well as survival of the spirochete under stressful conditions.
Counterclockwise rotation of the flagellum promotes biofilm initiation in
Helicobacter pylori
Authors: Liu Xiaolin , Lertsethtakarn Paphavee , Mariscal Vanessa T. , Yildiz Fitnat , Ottemann Karen M.
Published: May 2024

Motility promotes biofilm initiation during the early steps of this process: microbial surface association and attachment. Motility is controlled in part by chemotaxis signaling, so it seems reasonable that chemotaxis may also affect biofilm formation. There is a gap, however, in our understanding of the interactions between chemotaxis and biofilm formation, partly because most studies analyzed the phenotype of only a single chemotaxis signaling mutant, e.g.,
cheA
. Here, we addressed the role of chemotaxis in biofilm formation using a full set of chemotaxis signaling mutants in
Helicobacter pylori
, a class I carcinogen that infects more than half the world’s population and forms biofilms. Using mutants that lack each chemotaxis signaling protein, we found that chemotaxis signaling affected the biofilm initiation stage, but not mature biofilm formation. Surprisingly, some chemotaxis mutants elevated biofilm initiation, while others inhibited it in a manner that was not tied to chemotaxis ability or ligand input. Instead, the biofilm phenotype correlated with flagellar rotational bias. Specifically, mutants with a counterclockwise bias promoted biofilm initiation, e.g., ∆
cheA
, ∆
cheW
, or ∆
cheV1
; in contrast, those with a clockwise bias inhibited it, e.g., ∆
cheZ
, ∆
chePep
, or ∆
cheV3
. We tested this correlation using a counterclockwise bias-locked flagellum, which induced biofilm formation independent of the chemotaxis system. These CCW flagella, however, were not sufficient to induce biofilm formation, suggesting there are downstream players. Overall, our work highlights the new finding that flagellar rotational direction promotes biofilm initiation, with the chemotaxis signaling system operating as one mechanism to control flagellar rotation.

IMPORTANCE

Chemotaxis signaling systems have been reported to contribute to biofilm formation in many bacteria; however, how they regulate biofilm formation remains largely unknown. Chemotaxis systems are composed of many distinct kinds of proteins, but most previous work analyzed the biofilm effect of loss of only a few. Here, we explored chemotaxis’ role during biofilm formation in the human-associated pathogenic bacterium
Helicobacter pylori
. We found that chemotaxis proteins are involved in biofilm initiation in a manner that correlated with how they affected flagellar rotation. Biofilm initiation was high in mutants with counterclockwise (CCW) flagellar bias and low in those with clockwise bias. We supported the idea that a major driver of biofilm formation is flagellar rotational direction using a CCW-locked flagellar mutant, which stays CCW independent of chemotaxis input and showed elevated biofilm initiation. Our data suggest that CCW-rotating flagella, independent of chemotaxis inputs, are a biofilm-promoting signal.
16S rRNA gene amplicon sequencing data from an Australian wastewater treatment plant
Authors: Romanis C. S. , Timms V. J. , Crosbie N. D. , Neilan B. A.
Published: May 2024

Amplicon sequencing data of the 16S rRNA (V1-V3) gene from 56 effluent and sediment samples from an Australian wastewater treatment plant are reported. Proteobacteria (3.50%–90.09%), Actinobacteria (0.02%–45.71%), and Cyanobacteria (0.05%–63.73%) were dominant in the effluent. The sediment samples were dominated by Proteobacteria (13.14%–84.83%), Chloroflexi (0.84%–42.52%), and Firmicutes (1.54%–17.21%).
Preclinical validation of an
Escherichia coli
O-antigen glycoconjugate for the prevention of serotype O1 invasive disease
Authors: Chorro Laurent , Ndreu Duston , Patel Axay , Kodali Srinivas , Li Zhenghui , Keeney David , Dutta Kaushik , Sasmal Aniruddha , Illenberger Arthur , Torres C. Lynn , Pan Rosalind , Silmon de Monerri Natalie C. , Chu Ling , Simon Raphael , Anderson Annaliesa S. , Donald Robert G. K.
Published: May 2024

A US collection of invasive
Escherichia coli
serotype O1 bloodstream infection (BSI) isolates were assessed for genotypic and phenotypic diversity as the basis for designing a broadly protective O-antigen vaccine. Eighty percent of the BSI isolate serotype O1 strains were genotypically ST95 O1:K1:H7. The carbohydrate repeat unit structure of the O1a subtype was conserved in the three strains tested representing core genome multi-locus sequence types (MLST) sequence types ST95, ST38, and ST59. A long-chain O1a CRM
197
lattice glycoconjugate antigen was generated using oxidized polysaccharide and reductive amination chemistry. Two ST95 strains were investigated for use in opsonophagocytic assays (OPA) with immune sera from vaccinated animals and in murine lethal challenge models. Both strains were susceptible to OPA killing with O1a glycoconjugate post-immune sera. One of these, a neonatal sepsis strain, was found to be highly lethal in the murine challenge model for which virulence was shown to be dependent on the presence of the K1 capsule. Mice immunized with the O1a glycoconjugate were protected from challenges with this strain or a second, genotypically related, and similarly virulent neonatal isolate. This long-chain O1a CRM
197
lattice glycoconjugate shows promise as a component of a multi-valent vaccine to prevent invasive
E. coli
infections.

IMPORTANCE

The
Escherichia coli
serotype O1 O-antigen serogroup is a common cause of invasive bloodstream infections (BSI) in populations at risk such as newborns and the elderly. Sequencing of US BSI isolates and structural analysis of O polysaccharide antigens purified from strains that are representative of genotypic sub-groups confirmed the relevance of the O1a subtype as a vaccine antigen. O polysaccharide was purified from a strain engineered to produce long-chain O1a O-antigen and was chemically conjugated to CRM
197
carrier protein. The resulting glycoconjugate elicited functional antibodies and was protective in mice against lethal challenges with virulent K1-encapsulated O1a isolates.
Direct Multiphoton Femtosecond Infrared Laser Excitation of a Diamond Lattice in the Two-Phonon Region and Modification of Color Centers
Authors: Smirnov N. A. , Gulina Y. S. , Busleev N. I. , Pakholchuk P. P. , Gorevoi A. V. , Vins V. G. , Kudryashov S. I.
Published: May 2024

The nonlinear absorption of ultrashort laser pulses with intensities of 0.17–1.7 TW/cm2 at an intrinsic two-photon absorption wavelength of 4673 nm in type IIb diamond has been studied experimentally. It has been shown that the main absorption mechanism in the studied sample is two-photon absorption with a coefficient of β2 = (72 ± 7) cm/TW. Transmission microspectroscopy, visible photoluminescence, and infrared Fourier-transform microspectroscopy have demonstrated the possibility of laser-induced transformation of nitrogen impurity centers in synthetic type Ib diamond at higher radiation intensities.
Polymyxin B-induced Bartter syndrome
Authors: Mohan Lal Bhavesh , Musthafa Hafeesa Nimisha , Vikram Naval Kishore , Ray Animesh
Published: May 2024

Bartter syndrome is a genetic disorder characterised by chloride-unresponsive metabolic alkalosis, hypokalaemia, hypomagnesaemia and hypercalciuria. While it commonly presents antenatally or in early infancy, sometimes, drugs can induce a state similar to Bartter syndrome in any age group, called acquired Bartter syndrome. Polymyxins and aminoglycosides are the most commonly implicated drugs. Polymyxin B and polymyxin E (popularly known as colistin) are the two chemically similar polymyxins that are commonly used clinically. While colistin is frequently associated with nephrotoxicity, polymyxin B is generally considered less nephrotoxic. This difference is due to the way these two drugs are handled by the kidneys. In this case report, we discuss a middle-aged male who developed Bartter syndrome due to polymyxin B, which resolved on discontinuation of the drug, and re-appeared after its re-introduction later. This case exemplifies the nephrotoxicity caused by polymyxin B and the need for vigilance when using this drug.
Utilisation of the health belief model to study the behavioural intentions relating to obesity management among university students: a cross-sectional study
Authors: Albasheer Osama , Hakami Nasser , Abdelwahab Siddig Ibrahim , Alqassim Ahmad Y , Alharbi Abdullah , Abdelmola Amani Osman , Altraifi Ahmed Abdallah Ahmed , Medani Isameldin E , Hakami Ahlam Mohammed S , Moafa Mnar H , Abuhadi Rana I , Hobani Alhassan H
Published: May 2024

Background

Overweight and obesity are excessive fat accumulations linked with many health problems, including heart diseases, type 2 diabetes and cancer. Multiple studies have demonstrated that beliefs about overweight, obesity and self-efficacy play essential roles in the success of interventions for obesity management.

Objectives

This study aimed to identify the perceptions of university students of overweight and obesity using the health belief model (HBM) and to analyse their association with the body mass index (BMI) categories of the students.

Design

A cross-sectional questionnaire-based study and a multistage sampling technique were used to ensure the recruitment of students from selected colleges of Jazan University—Saudi Arabia.

Setting

Six colleges of Jazan University were randomly selected to ensure equal representation of health sciences, sciences and humanities colleges.

Participants

A total of 579 students completed an online survey between January and April 2023.

Primary and secondary outcome measures

The primary outcome measures were demographic characteristics and HBM constructs. Secondary outcome measures were behavioural intentions relating to obesity management.

Results

This study demonstrated that gender and self-reported family history of obesity were significantly correlated with the BMI categories of the students (p <0.001). Students in the underweight category showed the highest mean score for perceived severity (3.62 ±0.08). Perceived self-efficacy in exercise and diet was significantly associated with BMI categories, with adjusted ORs of 2.82 (2.10 to 3.79) and 1.51 (1.09 to 2.09), respectively. Perceived barriers to healthy eating and regular physical activity were significantly related to the behavioural intentions of obesity management. Multivariate logistic regression showed that perceived severity, perceived cues to action, perceived barriers and self-efficacy in dieting and exercise were significant predictors of behavioural intentions for the management of obesity.

Conclusion

This study underscores the need for tailored health promotion strategies that consider the perceptions and beliefs of people about the management of obesity.
Burden of COVID-19 pandemic on tuberculosis hospitalisation patterns at a tertiary care hospital in Rajasthan, India: a retrospective analysis
Authors: Rajotiya Sumit , Mishra Shivang , Singh Anurag Kumar , Debnath Sourav , Raj Preeti , Singh Pratima , Bareth Hemant , Nakash Prashant , Sharma Anupama , Singh Mahaveer , Nathiya Deepak , Joshi Nalin , Tomar Balvir Singh
Published: May 2024

Objective

This study aimed to investigate the burden of the COVID-19 pandemic on tuberculosis (TB) trends, patient demographics, disease types and hospitalisation duration within the Respiratory Medicine Department over three distinct phases: pre-COVID-19, COVID-19 and post-COVID-19.

Design

Retrospective analysis using electronic medical records of patients with TB admitted between June 2018 and June 2023 was done to explore the impact of COVID-19 on patients with TB. The study employed a meticulous segmentation into pre-COVID-19, COVID-19 and post-COVID-19 eras.

Setting

National Institute of Medical Science Hospital in Jaipur, Rajasthan, India.

Primary and secondary outcome measures

Primary outcome includes patients admitted to the Respiratory Medicine Department of the hospital and secondary outcome involves the duration of hospital stay.

Results

The study encompassed 1845 subjects across the three eras, revealing a reduction in TB incidence during the post-COVID-19 era compared with the pre-COVID-19 period (p<0.01). Substantial demographic shifts were observed, with 5.2% decline in TB incidence among males in the post-COVID-19 era (n=529) compared with the pre-COVID-19 era (n=606). Despite the decrease, overall TB incidence remained significantly higher in males (n=1460) than females (n=385), with consistently elevated rates in rural (65.8%) as compared with the urban areas (34.2%). Extended hospital stays were noted in the post-COVID-19 era compared with the pre-COVID-19 era (p<0.01).

Conclusion

The study underscores the influence of the COVID-19 pandemic on the TB landscape and hospitalisation dynamics. Notably, patient burden of TB declined during the COVID-19 era, with a decline in the post-COVID-19 era compared with the pre-COVID-19 era. Prolonged hospitalisation in the post-COVID-19 period indicates the need for adaptive healthcare strategies and the formulation of public health policies in a post-pandemic context. These findings contribute to a comprehensive understanding of the evolving TB scenario, emphasising the necessity for tailored healthcare approaches in the aftermath of a global health crisis.
Acute watery diarrhoea cases during cholera outbreak in Syria: a cohort study
Authors: Arnaout Ahmad Yamen , Nerabani Yaman , Sawas Mohamad Nabhan , Alhejazi Tala Jouma , Farho Mohamad Ali , Arnaout Khaled , Alshaker Hassan , Shebli Baraa , Helou Mostafa , Mobaied Bashir Badawi , Mouti Mohamad Bassel , Kady Fares , Aljarad Ziad
Published: May 2024

Objectives

The aim of this study is a descriptive presentation of cases of acute watery diarrhoea (AWD) that were presented to Aleppo University Hospital (AUH) during the recent cholera outbreak in Syria.

Design

Prospective, observational, cohort study.

Setting and participants

A total of 1061 patients with AWD were admitted to AUH during the timeframe of 20 September 2022 to 20 October 2022. The data collection was done through a structured questionnaire. This includes comprehensive clinical observation, laboratory analyses, therapeutic interventions and holistic case evaluations.

Results

The analysis has revealed notable insights: a predominant proportion of patients (58.6%) were residents from urban areas and 40.3% were residents from rural areas. Intriguingly, a diverse range of potential infection sources emerged from patient data within our hospital, including uncontrolled well water, vegetables and faecal-oral transmission through contaminated street/fast food. At discharge, most patients were in good health (79.7%), followed by moderate health (17.6%) and poor health (2.3%), with a minimal percentage dying before discharge (0.4%). The most common complications reported at admission and during hospitalisation included electrolyte imbalance (28.2%), followed by severe dehydration (16.3%). In the follow-up period, the majority of patients exhibited good health (81.0%). Older patients (>60 years) had poorer outcomes, with 8.4% having poor health and 4.2% death rate.

Conclusions

The study found results consistent with previous AWD outbreaks in developing countries like Yemen, Nigeria and Lebanon. Preventative measures like improving water sanitation and hygiene practices are essential to prevent future outbreaks and ease the strain on healthcare systems. Therefore, future studies must investigate the risk factors that increase the spread and the severity of the disease and investigate the best management method.
High time to enhance dancer welfare: a call to action to improve safeguarding and abuse prevention in dance
Authors: Cumming Jennifer , Nordin-Bates Sanna M , Johnson Carrie , Sanchez Erin N , Karageanes Steven J
Published: May 2024

While there is a lack of research into abuse in elite dance, numerous allegations of emotional, sexual and physical abuse of dancers can be found anecdotally in the media, legal convictions and personal accounts. As more dancers speak out, the scale of the problem within preprofessional schools and professional companies is becoming apparent. Accordingly, effective safeguarding mechanisms for preventing, identifying and reporting abuse are urgently needed. This viewpoint is intended to raise health professionals’ awareness of factors contributing to abusive practices found in dance environments and the potential clinical implications of abuse to dancers’ health and well-being. We also call for research and policy engagement on safeguarding and abuse prevention designed and implemented in partnership with stakeholders, aiming to promote safe and positive dance environments for all.
Recent insights about autophagy in pancreatitis
Authors: Ding Wen-Xing , Ma Xiaowen , Kim Sydney , Wang Shaogui , Ni Hong-Min
Published: May 2024

Acute pancreatitis is a common inflammatory gastrointestinal disease without any successful treatment. Pancreatic exocrine acinar cells have high rates of protein synthesis to produce and secrete large amounts of digestive enzymes. When the regulation of organelle and protein homeostasis is disrupted, it can lead to endoplasmic reticulum (ER) stress, damage to the mitochondria and improper intracellular trypsinogen activation, ultimately resulting in acinar cell damage and the onset of pancreatitis. To balance the homeostasis of organelles and adapt to protect themselves from organelle stress, cells use protective mechanisms such as autophagy. In the mouse pancreas, defective basal autophagy disrupts ER homoeostasis, leading to ER stress and trypsinogen activation, resulting in spontaneous pancreatitis. In this review, we discuss the regulation of autophagy and its physiological role in maintaining acinar cell homeostasis and function. We also summarise the current understanding of the mechanisms and the role of defective autophagy at multiple stages in experimental pancreatitis induced by cerulein or alcohol.
Environmental PM2.5-triggered stress responses in digestive diseases
Authors: Zhang Kezhong
Published: May 2024

Airborne particulate matter in fine and ultrafine ranges (aerodynamic diameter less than 2.5 µm, PM2.5) is a primary air pollutant that poses a serious threat to public health. Accumulating evidence has pointed to a close association between inhalation exposure to PM2.5and increased morbidity and mortality associated with modern human complex diseases. The adverse health effect of inhalation exposure to PM2.5pollutants is systemic, involving multiple organs, different cell types and various molecular mediators. Organelle damages and oxidative stress appear to play a major role in the cytotoxic effects of PM2.5by mediating stress response pathways related to inflammation, metabolic alteration and cell death programmes. The organs or tissues in the digestive tract, such as the liver, pancreas and small intestines, are susceptible to PM2.5exposure. This review underscores PM2.5-induced inflammatory stress responses and their involvement in digestive diseases caused by PM2.5exposure.
Impact of molecular ciprofloxacin resistance testing in management of gonorrhoea in a large urban clinic
Authors: Goldstein Emily , Moss Elizabeth , Bennett-Slater Susan , Ferguson Lynne , McInally Carol , McHugh Martin , Maxwell Alexandra , Winter Andrew , Gunson Rory N
Published: May 2024

Objectives

Antibiotic resistance in gonorrhoea is of significant public health concern with the emergence of resistance to last-line therapies such as ceftriaxone. Despite around half of
Neisseria gonorrhoeae
isolates tested in the UK being susceptible to ciprofloxacin, very little ciprofloxacin is used in clinical practice. Testing for the S91F mutation associated with ciprofloxacin resistance is now available in CE-marked assays and may reduce the requirement for ceftriaxone, but many patients are treated empirically, or as sexual contacts, which may limit any benefit. We describe the real-world impact of such testing on antimicrobial use and clinical outcomes in people found to have gonorrhoea in a large urban UK sexual health clinic.

Methods

Molecular ciprofloxacin resistance testing (
ResistancePlus
GC assay (SpeeDx)) was undertaken as an additional test after initial diagnosis (
m
2000 Realti
m
e CT/NG assay (Abbott Molecular)) in those not already known to have had antimicrobial treatment. Data from a 6-month period (from March to September 2022) were analysed to determine treatment choice and treatment outcome.

Results

A total of 998 clinical samples tested positive for
N. gonorrhoeae
in 682 episodes of infection. Of the 560 (56%) samples eligible for resistance testing, 269 (48.0%) were reported as wild-type, 180 (32.1%) were predicted to be resistant, 63 (11.3%) had an indeterminate resistance profile, and in 48 (8.6%) samples,
N
.
 gonorrhoeae
was not detected. Ciprofloxacin was prescribed in 172 (75%) of 228 episodes in which the wild-type strain was detected. Four (2%) of those treated with ciprofloxacin had a positive test-of-cure sample by NAAT, with no reinfection risk. All four had ciprofloxacin-susceptible infection by phenotypic antimicrobial susceptibility testing.

Conclusions

In routine practice in a large UK clinic, molecular ciprofloxacin resistance testing led to a significant shift in antibiotic use, reducing use of ceftriaxone. Testing can be targeted to reduce unnecessary additional testing. Longer term impact on antimicrobial resistance requires ongoing surveillance.
Conjugate shear model for emplacement of mid-crustal plutons during dextral transpression, southern Nova Scotia, Canada: tectonic and petrological consequences
Authors: Collins William J. , Murphy J. Brendan
Published: May 2024

The South Mountain Batholith (SMB) is a syn-tectonic composite batholith emplaced in the upper crust within the Meguma terrane between 380 and 370 Ma during the later stages of the Neoacadian orogeny. Coeval plutons in southern Nova Scotia are surrounded by mid-crustal (∼4 kbar) andalusite–staurolite aureoles and are discordant to northeast-trending, regional Neoacadian folds. Detailed field studies, combined with published results, indicate emplacement within a dextral transpressional regime during the transition from distributed (D1) to focused heterogeneous strain (D2), which provided vertical conduits that facilitated magma ascent. The Port Mouton Pluton intruded along P-orientated crustal-scale fractures as a series of subvertical granitic sheets, which were progressively rotated and folded with ongoing dextral shearing. By contrast, the Barrington Passage Pluton intruded between crustal-scale, antithetic (sinistral) P-shear fractures and spread laterally between them as pulsed increments to form a layered, subhorizontal, and sill-like complex resembling the laccolithic structure of the SMB. The SMB was emplaced below the Meguma Supergroup, with magma derived from underthrust Avalon terrane and Silurian Rockville Notch Group. The lack of mantle components in the SMB suggests transpressional orogenesis facilitated conductive crustal heating without significant mantle addition, consistent with low p-wave velocities of Meguma lower crust. 400–355 Ma zircons, recorded either as inherited grains in granites or in felsic granulite xenoliths, imply the Neoacadian thermal anomaly extended for 45 Ma, but magmatism represented only ∼40% of that perturbation.
Bogomol’nyi-like equations in gravity theories
Authors: Atmaja Ardian Nata
Published: May 2024

Using the Bogomol’nyi–Prasad–Sommerfield Lagrangian method, we show that gravity theory coupled to matter in various dimensions may possess Bogomol’nyi-like equations, which are first-order differential equations, satisfying the Einstein equations and the Euler–Lagrange equations of classical fields (U(1) gauge and scalar fields). In particular we consider static and spherically symmetric solutions by taking proper ansatzes and then we find an effective Lagrangian density that can reproduce the Einstein equations and the Euler–Lagrange equations of the classical fields. We consider the BPS Lagrangian density to be linear function of first-order derivative of all the fields. From these two Lagrangian desities we are able to obtain the Bogomol’nyi-like equations whose some of solutions are well-known such as Schwarzschild, Reissner–Nordström, Tangherlini black holes, and the recent black holes with scalar hair in three dimensions (Phys. Rev. D 107, 124047). Using these Bogomol’nyi-like equations, we are also able to find new solutions for scalar hair black holes in three and four dimensional spacetime. Furthermore we show that the Bogomol’nyi–Prasad–Sommerfield Lagrangian method can provide a simple alternative proof of black holes uniqueness theorems in any dimension.
Image of Kerr–de Sitter black holes illuminated by equatorial thin accretion disks
Authors: Wang Ke , Feng Chao-Jun , Wang Towe
Published: May 2024

To explore the influence of the cosmological constant on black hole images, we have developed a comprehensive analytical method for simulating images of Kerr–de Sitter black holes illuminated by equatorial thin accretion disks. Through the application of explicit equations, we simulate images of Kerr–de Sitter black holes illuminated by both prograde and retrograde accretion disks, examining the impact of the cosmological constant on their characteristic curves, relative sizes, and observed intensities. Our findings reveal that, in comparison to Kerr black holes, the cosmological constant not only diminishes the relative size of a black hole but also amplifies its luminosity. Moreover, an observer’s relative position in the universe ($$r_0/r_C$$

r
0

/

r
C

) can influence both the relative size and luminosity of a black hole, where $$r_0$$

r
0

is the distance from the observer to the black hole, $$r_C$$

r
C

is the cosmological horizon determined by the value of the cosmological constant $$\Lambda $$
Λ
.
Higher-order gravity, finite action, and a safe beginning for the universe
Authors: Lehners Jean-Luc , Stelle K. S.
Published: May 2024

General relativity allows for inhomogeneous and anisotropic universes with finite action. By contrast, in quadratic gravity such solutions obtain infinite action and are thus eliminated. What remains are homogeneous and isotropic solutions undergoing accelerated expansion, thereby automatically inducing an early inflationary phase. In this manner, semi-classical consistency may explain some of the basic, coarse-grained features of the early universe. This includes suitable initial conditions for the second law of thermodynamics, in the spirit of the Weyl curvature hypothesis. We note that quadratic gravity is a renormalisable theory and may admit an asymptotically safe regime at high energies, rendering the theory trustworthy to high energies. We also comment on theories containing curvature terms up to infinite derivative order, and on the contrast with no-boundary initial conditions.
Conditions on detecting tripartite entangled state in psychophysical experiments
Authors: Gassab Lea , Pedram Ali , Müstecaplıoğlu Özgür E.
Published: May 2024

This paper explores the sensitivity of the human visual system to quantum entangled light. We examine the possibility of human subjects perceiving multipartite entangled state through psychophysical experiments. Our focus begins with a bipartite entangled state to make a comparative study with the literature by taking into account additive noise for false positive on bipartite entanglement perception by humans. After that, we limit our similar investigation to a tripartite entangled state for simplicity in higher dimensions. To model the photodetection by humans, we employ the probability of seeing determined for coherently amplified photons in Fock number states, including an additive noise. Our results indicate that detecting bipartite and tripartite entanglement with the human eye is possible for a certain range of additive noise levels and visual thresholds. Finally, we discuss several alternative amplification methods.

Graphical abstract
Panax notoginseng Saponins Activate Nuclear Factor Erythroid 2-Related Factor 2 to Inhibit Ferroptosis and Attenuate Inflammatory Injury in Cerebral Ischemia–Reperfusion
Authors: Wang Lin-Lin , Kang Man-Lin , Liu Can-Wen , Liu Liang , Tang Biao
Published: May 2024

Panax notoginseng saponins (PNS), the primary medicinal ingredient of Panax notoginseng, mitigates cerebral ischemia–reperfusion injury (CIRI) by inhibiting inflammation, regulating oxidative stress, promoting angiogenesis, and improving microcirculation. Moreover, PNS activates nuclear factor erythroid 2-related factor 2 (Nrf2), which is known to inhibit ferroptosis and reduce inflammation in the rat brain. However, the molecular regulatory roles of PNS in CIRI-induced ferroptosis remain unclear. In this study, we aimed to investigate the effects of PNS on ferroptosis and inflammation in CIRI. We induced ferroptosis in SH-SY5Y cells via erastin stimulation and oxygen glucose deprivation/re-oxygenation (OGD/R) in vitro. Furthermore, we determined the effect of PNS treatment in a rat model of middle cerebral artery occlusion/reperfusion and assessed the underlying mechanism. We also analyzed the changes in the expression of ferroptosis-related proteins and inflammatory factors in the established rat model. OGD/R led to an increase in the levels of ferroptosis markers in SH-SY5Y cells, which were reduced by PNS treatment. In the rat model, combined treatment with an Nrf2 agonist, Nrf2 inhibitor, and PNS-Nrf2 inhibitor confirmed that PNS promotes Nrf2 nuclear localization and reduces ferroptosis and inflammatory responses, thereby mitigating brain injury. Mechanistically, PNS treatment facilitated Nrf2 activation, thereby regulating the expression of iron overload and lipid peroxidation-related proteins and the activities of anti-oxidant enzymes. This cascade inhibited ferroptosis and mitigated CIRI. Altogether, these results suggest that the ferroptosis-mediated activation of Nrf2 by PNS reduces inflammation and is a promising therapeutic approach for CIRI.
A note on matrix-valued orthonormal bases over LCA groups
Authors: Jyoti  , Vashisht Lalit Kumar
Published: May 2024

It is well known that orthonormal bases for a separable Hilbert space [Formula: see text] are precisely collections of the form [Formula: see text], where [Formula: see text] is a linear unitary operator acting on [Formula: see text] and [Formula: see text] is a given orthonormal basis for [Formula: see text]. We show that this is not true for the matrix-valued signal space [Formula: see text], [Formula: see text] is a locally compact abelian group which is [Formula: see text]-compact and metrizable, and [Formula: see text] and [Formula: see text] are positive integers. This problem is related to the adjointability of bounded linear operators on [Formula: see text]. We show that any orthonormal basis of the space [Formula: see text] is precisely of the form [Formula: see text], where [Formula: see text] is a linear unitary operator acting on [Formula: see text] which is adjointable with respect to the matrix-valued inner product and [Formula: see text] is a matrix-valued orthonormal basis for [Formula: see text].