bluuebunny/crossref_metadata_2025 huggingface dataset:
Cruz City 1 Mauritius Holdings v Unitech Limited and others, Isle of Man, CHP 13/0066
Authors: Rimmer John
Published: October 2024

Courts sometimes seem willing to find that a trust exists in circumstances that enable them to do justice between the parties immediately before them. In Petrodel v Prest, for example, a bare trust finding enabled the court to ensure, in its view, that justice was done without disturbing the virtually immutable separation of corporate personality from its members. Doing so might, however, risk creating an injustice elsewhere by depriving a company of sufficient assets to meet its own obligations. The Manx court recently balanced these considerations with the imperative of assisting a creditor to obtain satisfaction from a debtor.
Predicting Poverty
Authors: Verme Paolo
Published: October 2024

Poverty prediction models are used to address missing data issues in a variety of contexts such as poverty profiling, targeting with proxy-means tests, cross-survey imputations such as poverty mapping, top and bottom income studies, or vulnerability analyses. Based on the models used by this literature, this paper conducts a study by artificially corrupting data clear of missing incomes with different patterns and shares of missing incomes. It then compares the capacity of classic econometric and machine-learning models to predict poverty under different scenarios with full information on observed and unobserved incomes, and the true counterfactual poverty rate. Random forest provides more consistent and accurate predictions under most but not all scenarios.
Medium‐chain fatty acid receptor GPR84 deficiency leads to metabolic homeostasis dysfunction in mice fed high‐fat diet
Authors: Nishida Akari , Ohue‐Kitano Ryuji , Masujima Yuki , Nonaka Hazuki , Igarashi Miki , Ikeda Takako , Kimura Ikuo
Published: October 2024

Overconsumption of food, especially dietary fat, leads to metabolic disorders such as obesity and type 2 diabetes. Long‐chain fatty acids, such as palmitoleate are recognized as the risk factors for these disorders owing to their high‐energy content and lipotoxicity. In contrast, medium‐chain fatty acids (MCFAs) metabolic benefits; however, their underlying molecular mechanisms remain unclear. GPR84 is an MCFA receptor, particularly for C10:0. Although evidence from in vitro experiments and oral administration of C10:0 in mice suggests that GPR84 is related to the metabolic benefits of MCFAs via glucose metabolism, its precise roles in vivo remain unclear. Therefore, the present study investigated whether GPR84 affects glucose metabolism and metabolic function using Gpr84‐deficient mice. Although Gpr84‐deficient mice were lean and had increased endogenous MCFAs under high‐fat diet feeding conditions, they exhibited hyperglycemia and hyperlipidemia along with lower plasma insulin and glucagon‐like peptide‐1 (GLP‐1) levels compared with wild‐type mice. Medium‐chain triglyceride (C10:0) intake suppressed obesity, and improved plasma glucose and lipid levels, and increased plasma GLP‐1 levels in wild‐type mice; however, these effects were partially attenuated in Gpr84‐deficient mice. Our results indicate that long‐term MCFA‐mediated GPR84 activation improves the dysfunction of glucose and lipid homeostasis. Our findings may be instrumental for future studies on drug development with GPR84 as a potential target, thereby offering new avenues for the treatment of metabolic disorders like obesity and type 2 diabetes.
Reverse Total Shoulder Arthroplasty for Acute Proximal Humerus Fractures: Is Delay Associated With an Increased Rate of Reoperation?
Authors: Tat Jimmy , Nam Diane , Thiruchelvam Deva , Paterson J. Michael , Sheth Ujash
Published: October 2024

OBJECTIVES:

To compare reoperation rates of acute versus delayed reverse total shoulder arthroplasty (RTSA) following a period of nonoperative treatment for proximal humerus fractures (PHFs). We also aimed to identify an optimal time interval from PHF to RTSA before the risk of reoperation significantly increased.

METHODS:

 

Design:

Database review.

Setting:

Ontario, Canada.

Patient Selection Criteria:

Adults aged 50 years and older who sustained a PHF (OTA/AO 11A-C) between 2004 and 2019 were included. Exclusion criteria included polytrauma, open fractures, non-Ontario residents, invalid health insurance, and any operative treatment before RTSA.

Outcome Measures and Comparisons:

The primary outcome measure was reoperation within 2 years following RTSA. A risk-adjusted, restricted cubic spline was used to model the probability of reoperation according to the time elapsed between PHF and RTSA to identify a time point at which the risk of reoperation significantly increased. A multivariate logistics regression was used to identify predictors.

RESULTS:

In total, 891 patients (685 acute, 206 delayed) underwent RTSA for PHF. The acute cohort had a significantly lower reoperation rate (3.9%) compared with the delayed cohort (8.3%) (P = 0.02). The odds of reoperation increased with a delay to RTSA greater than 28 days and continued to rise until 100 days after fracture. Patients who underwent RTSA 28 days after PHF were found to have a significantly higher odds of reoperation by 2 years (P = 0.03).

CONCLUSIONS:

Among patients undergoing RTSA for acute PHFs, a delay to surgery greater than 28 days is associated with a greater odds of reoperation and may be useful when counseling patients.

LEVEL OF EVIDENCE:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Occupational Radiation Exposure During Intraoperative 3-Dimensional Fluoroscopy in Pelvis and Acetabular Surgery
Authors: Gosselin Michelle M. , Ngo Daniel H. , Levack Ashley E. , Kutzler Michael A. , Osunbayo Olaolu , Feng Janet Ching-Mei , Gary Joshua L. , Warner Stephen J. , Routt Milton L. Chip
Published: October 2024

OBJECTIVES:

To quantify the occupational radiation exposure with a 3-dimensional (3D) fluoroscopic machine during routine use in pelvic and acetabular surgery and to determine whether the additional radiation exposure encountered with the 3D fluoroscopic spin is within previously accepted limits.

METHODS:

Design:

Prospective cohort study.

Setting:

Level I trauma center.

Patient Selection Criteria:

All patients undergoing 3D fluoroscopy intraoperatively during pelvis (OTA/AO 61B,C) or acetabular (OTA/AO 62A-C) surgery between April 2021 and July 2021.

Outcome Measures and Comparisons:

Radiation dose at standardized locations around the operating room during the spin portion of the 3D fluoroscopy.

RESULTS:

Seventy-six 3D spins were performed on 69 patients during the study period. The average emitted radiation dose from the machine for the routine fluoroscopy portion of the case was 74.5 mGy. The average displayed radiation dose in the air for the spin portion of the case was 39.9 mGy, an average of 53.6% less radiation than the routine fluoroscopy portion. For the spin portion, the average radiation exposure seen by the patient was 3.42 mGy (centered on the patient) and the average maximal exposure in the room was 0.062 mGy. Minimal radiation was detected outside the operating room doors.

CONCLUSIONS:

The radiation exposure encountered by operating room personnel with 3D fluoroscopy appears to be within safe occupational limits. The marginal increase in radiation exposure during pelvic and acetabular surgery should not discourage the use of 3D imaging intraoperatively.

LEVEL OF EVIDENCE:

Level IV, Case Series.
An investigation of economic interactions between social reinforcement and heroin or cocaine in rats
Authors: Bird Toni , Beasley Madeline M. , Pilz Emma M. , Amantini Sarah , Chavez Lopez Kevin , Silberberg Alan , Kearns David N.
Published: October 2024

The primary goal of the present study was to determine the economic relationship between heroin and social reinforcement in rats: are they substitutes, independents, or complements? In Experiment 1, one group of rats was given a budget of responses that they could allocate between heroin and social reinforcement offered at various combinations of prices. A second group chose between two levers that each resulted in social reinforcement at varying prices when pressed. There was no relationship between the relative allocation of responses between heroin and social reinforcement and changes in their relative prices, indicating that these reinforcers are best viewed as independents. In contrast, when choosing between two sources of social reinforcement, rats increased the allocation of behavior to the cheaper option, confirming that the method used here was sensitive to detecting substitution effects. In Experiment 2, the same method was used to compare one group that chose between heroin and social reinforcement with a second group that chose between cocaine and social reinforcement. The finding that heroin and social reinforcement were independents was replicated. Additionally, there was some evidence that cocaine and social reinforcement were substitutes, at least when the first few minutes of the session were excluded. These results add to our knowledge of how drug and nondrug reinforcers interact in choice situations in rats and may model factors that influence drug use in humans.
The Current State—or Lack Thereof—of Screening and Prevention for Gynecologic Malignancies for Patients With Lynch Syndrome
Authors: Holtzman Sharonne , Cox Madison , Blank Stephanie V.
Published: October 2024

Lynch syndrome (LS) is an autosomal dominant genetic disorder that results in an increased risk of ovarian and endometrial cancers. The aim of this paper was to explore the management of this risk through screening and prevention. Published materials and evidence were explored and summarized. This paper demonstrated that while there has been increased awareness and advances in the identification and diagnosis of patients with LS, recommendations for screening and prevention remain less evidence-based. In decisions of management of patients with LS, a shared decision-making model should be used considering individual patient goals.
Practical Evaluation of the Fetal Cardiac Function
Authors: Hernandez-Andrade Edgar , Valentini Beatrice , Gerulewicz Donatella
Published: October 2024

The fetal heart adapts dynamically to nutrient and oxygen needs from all fetal organs. These continuous changes make it difficult to define normal/abnormal cardiac function based only on the evaluation of a few cycles. Many signs of fetal cardiac dysfunction have been suggested; however, very few can stand as true manifestations of cardiac deterioration, and none has emerged as a single reliable marker of cardiac dysfunction. It is the combination of abnormal findings that provides a more accurate assessment of the status of the fetal heart function
Disparities in screening and risk stratification for Hispanic adults with metabolic dysfunction–associated steatotic liver disease
Authors: Tincopa Monica A. , Díaz Luis Antonio , Huang Daniel Q. , Arab Juan Pablo , Arrese Marco , Gadano Adrian , Oliveira Claudia P. , Bettencourt Richele , Madamba Egbert , Kim Susy , Siddiqi Harris , Barreyro Fernando Javier , Marciano Sebastián , Martínez Morales Jorge , Villela-Nogueira Cristiane , Leite Nathalie , Couto Claudia Alves , Theodoro Rafael , Joyner de Sousa Dias Monteiro Mísia , Pessoa Mario G. , Alvares-da-Silva Mario Reis , Higuera de la Tijera Fatima , Sabate Constanza D. , Mendizabal Manuel , Richards Lisa , Sirlin Claude B. , Loomba Rohit
Published: October 2024

Background and Aims:

Cut-points for noninvasive tests for risk stratification in metabolic dysfunction–associated steatotic liver disease were derived from predominantly non-Hispanic populations. It is unknown if these cut-points perform adequately in Hispanic individuals. We assessed the performance characteristics of current noninvasive test cut-points among Hispanic patients and determined whether they could be further optimized.

Approach and Results:

We prospectively enrolled 244 adults with biopsy-proven metabolic dysfunction–associated steatotic liver disease. Participants underwent a research visit with magnetic resonance elastography (MRE) and vibration-controlled transient elastography (VCTE). Histology and imaging assessments were conducted centrally. Diagnostic performance was evaluated by AUROC and optimal cut-points were identified by Youden J analysis. The mean (±SD) age and body mass index were 52.6 (±13) and 31.6 (±4.6) kg/m2. Overall, 40% had diabetes, and 31% (N = 75) were Hispanic. Forty percent of Hispanic and 28.4% of non-Hispanic patients had significant fibrosis. To detect significant fibrosis, MRE and VCTE exhibited significantly lower accuracy in Hispanic versus non-Hispanic participants (AUROC: MRE, 0.87 vs. 0.98, p = 0.01; VCTE, 0.78 vs. 0.92, p = 0.02). Clinical care algorithms yielded high false-negative rates among Hispanic participants (14% with low-risk fibrosis-4 index and 21% with low-risk VCTE had advanced fibrosis on biopsy). Cut-points of 2.73 kPa for MRE and 6.9 kPa for VCTE were optimal for detecting significant fibrosis in Hispanic individuals. Findings were validated in a Latin American cohort.

Conclusions:

Lower noninvasive test cut-points may be needed to optimize surveillance for significant fibrosis due to metabolic dysfunction–associated steatotic liver disease in Hispanic populations commensurate with their higher burden and severity of disease.
Mortality trends, sex, and racial disparities in older adults due to abdominal aortic aneurysm: a nationwide cross-sectional analysis
Authors: Goyal Aman , Saeed Humza , Shahnoor Syeda , Arshad Muhammad Khubaib , Wasay Abdul , Abdullah  , Daoud Mohamed , Sohail Amir Humza
Published: October 2024

Abdominal aortic aneurysms (AAAs) are a significant vascular pathology in older adults, often asymptomatic but with high mortality upon rupture. Despite advancements in diagnostic imaging and surgical interventions, AAAs remain a public health concern. This research letter analyzed CDC WONDER data on AAA-related deaths (ICD-10 I71.3 and I71.4) among US adults aged 65+ from 1999 to 2020. Age-adjusted mortality rates (AAMRs) and annual percent change (APC) were calculated by year, sex, age group, race/ethnicity, geography, and urbanization status. Between 1999 and 2020, there were 180 037 reported deaths in older adults due to AAA. The overall AAMR decreased from 32.6 to 13.2 per 100 000, with a significant decline from 2014 to 2020 (APC: −1.66; 95% CI: −2.48 to −0.48). Older men had a significantly higher AAMR than older women (31.2 vs. 12). Among racial and ethnic groups, Non-Hispanic (NH) Whites had the highest AAMR at 21.7, followed by NH American Indian or Alaska Native (14.5), NH Black (12.6), NH Asian or Pacific Islander (10.1), and Hispanic populations (8.4). Additionally, non-metropolitan areas exhibited higher AAMRs compared to metropolitan areas (23.9 vs. 18.7). While mortality rates have declined, disparities remain, with higher rates among older men, NH Whites, and non-metropolitan residents, highlighting the need for targeted and equitable interventions.
Self-Report and Performance-Based Measures for Pelvic Girdle Pain During Pregnancy
Authors: Stevermer Catherine A. , Smith Kari N. , Buhrow Courtney , Butz Lindsey N. , Garces Mary , Williams Britney S.
Published: October 2024

Purpose:

The purpose of this cross-sectional study was to quantify functional mobility in pregnant individuals during the second and third trimesters, both with and with no pelvic girdle pain, using performance-based measures as compared with self-report tools.

Methods:

Study participants included 58 individuals between 18 and 45 years of age in the second or third trimesters of pregnancy who were categorized by pelvic girdle pain ratings and positive screening results. Participants completed the Pelvic Girdle Questionnaire (PGQ) and the Pelvic Floor Impact Questionnaire (PFIQ), and were evaluated by accelerometry during quiet standing, straight-line walking, and the Timed Up and Go (TUG) test.

Results:

The majority of performance measures captured using accelerometry were not statistically different between the Pain and Control groups. However, turning velocities were lower in the third trimester group during turning phases of the TUG (P < .006). Pain and No Pain groups differed in the distribution of PFIQ responses on Chores (P < .001), Exercise (P < .001), Travel (P = .012), and Frustration (P < .001). A statistical difference was present between the Pain and Control groups in PGQ total score (P < .001), and response distributions were statistically different on multiple PGQ items.

Discussion:

For pregnant individuals, accelerometry-based performance measures do not appear to detect difficulty with mobility, which may begin to be reported during the second trimester. Patient-report outcome tools may help clinicians capture movement difficulty and address biopsychosocial factors that impact pelvic girdle pain associated with pregnancy.
Clinical features and surgical outcomes of membranous subaortic stenosis in three siblings: a case series and literature review
Authors: Alaswad Mohammed , Almohamed Ahmad , Alsmoudi Hasan , Haydar Hasan , Karaja Saja , Barakat Lyne , Takkem Saleh
Published: October 2024

Introduction:

Subvalvular aortic stenosis (SAS) is a rare heart condition that can cause LVOT obstruction and lead to serious complications. While surgery is the main treatment, recurrence is a concern. This case series highlights the challenges in managing SAS in young patients.

Case Series:

Three young brothers presented with symptoms of shortness of breath and chest tightness. All were diagnosed with membranous SAS through echocardiography and Doppler ultrasound. Surgical intervention was performed to remove the obstruction, but all three patients experienced recurrence within 2 years.

Discussion:

This case series of three brothers suggests a genetic predisposition. Symptoms included exertional dyspnea and chest tightness, diagnosed via echocardiography. Surgical intervention is the primary treatment, but its timing is debated due to recurrence risks and complications.

Conclusions:

This case series suggests a possible genetic predisposition to SAS. Despite successful initial surgery, the high recurrence rate highlights the need for improved management strategies and long-term follow-up. Further research is crucial to understand the causes of recurrence and optimize treatment for children with SAS.
Safety and efficacy of sertraline in depression among adults undergoing dialysis: a systematic review and meta-analysis
Authors: Qammar Asfia , Azeem Bazil , Kumar Sateesh , Kumari Madhurta , Hassan Farhad , Khurram Laiba , Kumar Sumet , Fasih Abdul , Khan Arwa , Basit Azeem Muhammad , Sadiq Nimra , Dibaj Ramsha , Sharma Varsha
Published: October 2024

Background:

Depression is prevalent among patients with end-stage renal disease (ESRD) undergoing dialysis, with significant implications for their quality of life and treatment compliance. Traditional treatments for depression, including various therapies and pharmacological interventions, have limitations due to their adverse effects. Sertraline, a selective serotonin re-uptake inhibitor (SSRI), offers a promising alternative, but its efficacy and safety in this population require thorough evaluation.

Objective:

This meta-analysis aims to assess the effectiveness and adverse effects of sertraline in treating depressive episodes in dialysis patients compared to placebo.

Methods:

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the authors conducted a comprehensive search of databases, including PubMed, Cochrane Library, and Science Direct, up to 20 June 2024. The authors included randomized controlled trials (RCTs) that compared sertraline with placebo in dialysis patients with depression. Two researchers independently performed data extraction and risk of bias assessment. Statistical analysis was conducted using ReviewManager 5.4.1, employing a random effects model.

Results:

Four RCTs involving 468 participants were included. Sertraline significantly reduced depressive symptoms, as measured by the Quick Inventory of Depressive Symptomatology (QIDS) and Beck Depression Inventory-II (BDI-II) scores, at 6 and 12 weeks compared to placebo. Improvements in kidney disease-specific quality of life (KDQOL-36) scores were also noted. However, sertraline was associated with a higher risk of adverse events compared to placebo.

Conclusions:

Sertraline effectively reduces depressive symptoms and improves the quality of life in dialysis patients with ESRD. Despite the increased risk of adverse events, the overall benefits make sertraline a viable treatment option for this population. Larger, more comprehensive studies are needed to confirm these findings and optimize sertraline use in clinical practice.
Relationships Between Nursing Professional Development Department Structures in Hospital Systems and Patient Outcomes
Authors: Harper Mary G. , Maloney Patsy , MacDonald Ryan
Published: October 2024

Although positive correlations between nursing professional development (NPD) staffing and organizational outcomes have been demonstrated, no evidence of optimal NPD department structures was found. Using an organizational participatory research method, NPD department structures in acute care hospital systems and their relationships to publicly reported patient outcomes and satisfaction were explored. Hospitals with centralized NPD departments had significantly fewer unplanned readmissions for pneumonia than hospitals with hybrid structures. No other significant differences were found.
Effect of a Financial Incentive Scheme for Medication Review on Polypharmacy in Elderly Inpatients With Dementia: A Retrospective Before-and-After Study
Authors: Morita Takahito , Sasabuchi Yusuke , Yamana Hayato , Hosoi Tatsuya , Ogawa Sumito , Ohbe Hiroyuki , Matsui Hiroki , Fushimi Kiyohide , Yasunaga Hideo
Published: October 2024

Objectives

Polypharmacy is an important healthcare issue, especially in elderly patients with dementia. As an incentive to reduce polypharmacy, a health insurance reimbursement scheme was introduced in 2016 for medication review and the reduction of medications for inpatients in Japan. However, the effects of these incentive schemes were not evaluated.

Methods

We identified 1,465,881 inpatients aged ≥65 years with dementia. An interrupted time-series analysis was conducted by fitting a Prais-Winsten linear regression model. The outcome measure was the number of classes of medications prescribed during discharge.

Results

No significant changes were observed in the average number of medication classes at discharge immediately after the introduction of the scheme (coefficient: −0.022, 95% confidence interval [CI]: −0.17 to 0.13). The slope change, representing the effect of the intervention over time, was also not significant (coefficient: −0.00053, 95% confidence interval: −0.0012 to 0.00018).

Conclusions

The incentive scheme was not associated with a reduction in the number of medication classes at discharge among older inpatients with dementia.
Transforming Lives with Group Fitness
Authors: Jones Dustin , Musgrave Jeff
Published: October 2024

It is clear that clinicians transform lives in the context of rehabilitation, but how can clinicians continue to positively influence patients once they leave rehabilitation and potentially enter into fitness. Group fitness has been shown to be beneficial for older persons in many health outcomes. Clinicians have a tremendous opportunity to ensure success for their patients as they enter into fitness. In this article, we discuss considerations and tactics for clinicians to maximize the potential for their patients’ success in group fitness.
Predicting the effectiveness of binaural beats on working memory
Authors: Rao Ahmad Zahid , Mujib Muhammad Danish , Qazi Saad Ahmed , Alokaily Ahmad O. , Ikhlaq Ayesha , Mirza Eraj Humayun , Aldohbeyb Ahmed Ali , Hasan Muhammad Abul
Published: October 2024

Working memory is vital for short-term information processing. Binaural beats can enhance working memory by improving attention and memory consolidation through neural synchronization. However, individual differences in cognitive and neuronal functioning affect effectiveness of binaural beats, necessitating personalized approaches. This study aimed to develop a machine learning model to predict binaural beats’s effectiveness on working memory using electroencephalography. Sixty healthy participants underwent a 5-min electroencephalography recording, an initial working memory evaluation, 15 min of binaural beats stimulation, and a subsequent working memory evaluation using digit span tests of increasing difficulty. Recall accuracy and response times were measured. Differential scores from pre-evaluation and post-evaluation labeled participants as active or inactive to binaural beats stimulation. electroencephalography data, recorded using 14 electrodes, provided brain activity estimates across theta, alpha, beta, and gamma frequency bands, resulting in 56 features (14 channels × 4 bands) for the machine learning model. Several classifiers were tested to identify the most effective model. The weighted K-nearest neighbors model achieved the highest accuracy (90.0%) and area under the receiver operating characteristic curve (92.24%). Frontal and parietal electroencephalography channels in theta and alpha bands were crucial for classification. This study’s findings offer significant clinical insights, enabling informed interventions and preventing resource inefficiency.
Factors that influence the uptake of virtual care solutions in Australian primary care practice: a systematic scoping review
Authors: Delaforce Alana , Maddock Emma , Wheeler Pamela , Jayasena Rajiv , Parkinson Joy
Published: October 2024

Introduction:

Uptake of virtual care solutions in primary care settings has increased exponentially, and current evidence suggests high patient satisfaction but mixed clinician views.

Aims:

This paper aimed to identify factors influencing its’ implementation to support delivery to the right patient, in the right clinical context, at the right time. Further, this paper evaluates how the updated Consolidated Framework for Implementation Research (CFIR) can be used to assess these factors that contribute to the uptake of virtual care innovations.

Methods:

This systematic scoping review identified empirical research on factors influencing the uptake of virtual care solutions in the Australian primary care setting. Searches were undertaken in Embase, PubMed, Scopus, and Web of Science. The CFIR was used to code factors influencing the implementation of virtual care solutions. Inductive coding was used to generate new constructs where no appropriate CFIR construct could be identified.

Results:

Fourteen eligible studies were identified as eligible for inclusion. Five common influencing factors were identified. Three are from the existing CFIR framework, and two are newly developed constructs. CFIR constructs included innovation relative advantage, capability, and IT infrastructure. New constructs included accessibility and suitability. A further six new constructs were identified (trust, privacy, governance, unintended consequences, preference, and choice) but these were not prominently mentioned.

Conclusions:

Common factors influence virtual care uptake in Australian primary care. The CFIR assisted in conceptualizing these but was not sufficient for capturing factors unique to virtual care. Newly developed constructs are noted to be of importance in the literature, but further research is needed to understand whether they are applicable in multiple contexts.

Spanish abstract:

http://links.lww.com/IJEBH/A286
Improving the nursing quality of non-pharmacological interventions for elderly constipation patients in the hospital: a best practice implementation project
Authors: Li Jingjing , Zhang Dahua , Zhang Yaqian , Li Chunyang , Fan Xueyan , Yu Qiushuang , Yang Ming , Du Jian , Li Xuejing , Hao Yufang , Han Liu
Published: October 2024

Introduction:

Non-pharmacological interventions are the preferred treatment for constipation; however, health care professionals in clinical settings tend to focus more on pharmacological treatments.

Objectives:

This best practice implementation project aimed to integrate the best evidence on non-pharmacological interventions for elderly patients with constipation in clinical care practice and to promote the use of non-pharmacological interventions for such patients in the hospital setting.

Methods:

This project is based on the JBI Evidence Implementation Framework, which follows three stages. The first stage involved a baseline audit using two audit criteria derived from the best available evidence. This audit evaluated current clinical scenarios, guided by the i-PARIHS framework. The second stage involved analyzing the results of the baseline audit, identifying barriers to compliance, and developing and implementing strategies to overcome those barriers. Strategies included nursing education, development of constipation information booklets for nurses and patients, establishment of a nursing workflow, and modification of the department environment. In the third stage, a follow-up audit was conducted to evaluate the implementation, using the same data collection indicators and methods as in the baseline audit. Sixty patients participated in the project.

Results:

Compliance for Criterion 1 (patient education) increased from 0% to 60% (p < 0.001), while compliance for Criterion 2 (monitoring patients’ bowel health) increased from 0% to 100% (p < 0.001).

Conclusions:

The results indicate that this evidence-based implementation project facilitated the application of non-pharmacological interventions for elderly patients with constipation. Nurses played a significant role in developing regular defecation habits in patients and monitoring their defecation.

Spanish abstract:

http://links.lww.com/IJEBH/A284
Mechanisms of brain self-regulation: psychological factors, mechanistic models and neural substrates
Authors: Sitaram Ranganatha , Sanchez-Corzo Andrea , Vargas Gabriela , Cortese Aurelio , El-Deredy Wael , Jackson Andrew , Fetz Eberhard
Published: October 2024

While neurofeedback represents a promising tool for neuroscience and a brain self-regulation approach to psychological rehabilitation, the field faces several problems and challenges. Current research has shown great variability and even failure among human participants in learning to self-regulate target features of brain activity with neurofeedback. A better understanding of cognitive mechanisms, psychological factors and neural substrates underlying self-regulation might help improve neurofeedback’s scientific and clinical practices. This article reviews the current understanding of the neural mechanisms of brain self-regulation by drawing on findings from human and animal studies in neurofeedback, brain–computer/machine interfaces and neuroprosthetics. In this article, we look closer at the following topics: cognitive processes and psychophysiological factors affecting self-regulation, theoretical models and neural substrates underlying self-regulation, and finally, we provide an outlook on the outstanding gaps in knowledge and technical challenges.

This article is part of the theme issue ‘Neurofeedback: new territories and neurocognitive mechanisms of endogenous neuromodulation’.
Psilocybin-assisted neurofeedback for the improvement of executive functions: a randomized semi-naturalistic-lab feasibility study
Authors: Enriquez-Geppert S. , Krc J. , O’Higgins F. J. , Lietz M.
Published: October 2024

Executive function deficits, common in psychiatric disorders, hinder daily activities and may be linked to diminished neural plasticity, affecting treatment and training responsiveness. In this pioneering study, we evaluated the feasibility and preliminary efficacy of psilocybin-assisted frontal-midline theta neurofeedback (NF), a neuromodulation technique leveraging neuroplasticity, to improve executive functions (EFs). Thirty-seven eligible participants were randomized into an experimental group (
n
= 18) and a passive control group (
n
= 19). The experimental group underwent three microdose sessions and then three psilocybin-assisted NF sessions, without requiring psychological support, demonstrating the approach’s feasibility. NF learning showed a statistical trend for increases in frontal-midline theta from session to session with a large effect size and non-significant but medium effect size dynamical changes within sessions. Placebo effects were consistent across groups, with no tasks-based EF improvements, but significant self-reported gains in daily EFs—working memory, shifting, monitoring and inhibition—showing medium and high effect sizes. The experimental group’s significant gains in their key training goals underscored the approach’s external relevance. A thorough study with regular sessions and an active control group is crucial to evaluate EFs improvement and their specificity in future. Psilocybin-enhanced NF could offer significant, lasting benefits across diagnoses, improving daily functioning.

This article is part of the theme issue ‘Neurofeedback: new territories and neurocognitive mechanisms of endogenous neuromodulation’.
Has the design quality of randomized controlled trials of Acupotomy improved over the past 18 years? -- CONSORT statement-based literature study from 2006 to 2024
Authors: Li Junjie , Zhou Yantong , Lu Xinzhu , Bian Ying
Published: October 2024

Acupotomy, originally named ‘Nine Needles’ inLing Shu, was invented as a new type of TCM instrument in 1976, an innovative combination of acupuncture and surgical treatment. Its forward development is related to the Clinical effectiveness and safety. RCTs are gold standards in clinical practice and were welcomed in Acupotomy recently. The CONSORT Statement is set to guide the designing, analysis and interpretation of trials. But there haven’t been many Acupotomy RCTs until now, with few on quality evaluation, therefore design quality of Acupotomy RCTs is still weakness. This study aims to assess design quality of acupotomy RCTs by CONSORT statement, to analyze the overall quality status and influencing factors.

PubMed database was used to search keywords like ‘Acupotomy’ and ‘Randomized Controlled Trial’. All 48 Acupotomy RCTs published from January 2006 to January 2024 were included. The CONSORT(2010) was used for quality assessment.

48 studies were included for analysis, with 39 articles from Grade 3A hospitals and 9 from non-Grade 3A hospitals. Scores of RCTs ranged from 33 to 82, the mean score of 53.1 and median of 49. Grade 3A and non-Grade 3A hospitals differed significantly only in item 8, no studies reported item 18, and items 11, 14, and 23 had the highest frequency of reporting as failed.

Based on 48 Acupotomy RCTs included, the publication time associated with the quality of reports. The number of authors and possession of funding were the most important factors affecting the total score. Number of beds, hospitals’ grade, sample sizes, and region GDP/PP did not relate to the total score. Among 25 items, Ancillary analyses, Blinding, Recruitment were the worst-performing items. Therefore, updating and standardizing the use of CONSORT can help to improve quality of RCTs, and cross-team communication and cooperation could promote the use of CONSORT.
Dark Microglia Are Abundant in Normal Postnatal Development, where they Remodel Synapses via Phagocytosis and Trogocytosis, and Are Dependent on TREM2
Authors: Vecchiarelli Haley A. , Bisht Kanchan , Sharma Kaushik , Weiser Novak Sammy , Traetta Marianela E. , Garcia-Segura Monica Emili , St-Pierre Marie-Kim , Savage Julie C. , Willis Cory , Picard Katherine , Bordeleau Maude , Vernoux Nathalie , Khakpour Mohammadparsa , Garg Rishika , Loewen Sophia M. , Murray Colin J. , Grinberg Yelena Y. , Faustino Joel , Halvorson Torin , Lau Victor , Pluchino Stefano , Vexler Zinaida S. , Carson Monica J. , Manor Uri , Peruzzotti-Jametti Luca , Tremblay Marie-Ève
Published: October 2024

This study examined dark microglia—a state linked to central nervous system pathology and neurodegeneration—during postnatal development in the mouse ventral hippocampus, finding that dark microglia interact with blood vessels and synapses and perform trogocytosis of pre-synaptic axon terminals. Furthermore, we found that dark microglia in development notably expressed C-type lectin domain family 7 member A (CLEC7a), lipoprotein lipase (LPL) and triggering receptor expressed on myeloid cells 2 (TREM2) and required TREM2, differently from other microglia, suggesting a link between their role in remodeling during development and central nervous system pathology. Together, these results point towards a previously under-appreciated role for dark microglia in synaptic pruning and plasticity during normal postnatal development.
Human Topoisomerase IIα Promotes Chromatin Condensation Via a Phase Transition
Authors: Wu Meiling , Beck Curtis , Lee Joyce H. , Fulbright Robert M. , Jeong Joshua , Inman James T. , Woodhouse Mitchell V. , Berger James M. , Wang Michelle D.
Published: October 2024

Topoisomerase II (topo II) enzymes are essential enzymes known to resolve topological entanglements during DNA processing. Curiously, while yeast expresses a single topo II, humans express two topo II isozymes, topo IIα and topo IIβ, which share a similar catalytic domain but differ in their intrinsically disordered C-terminal domains (CTDs). During mitosis, topo IIα and condensin I constitute the most abundant chromosome scaffolding proteins essential for chromosome condensation. However, how topo IIα enables this function is poorly understood. Here, we discovered a new and functionally distinct role for human topo IIα – it condenses DNA and chromatin at a low topo IIα concentration (100 pM or less) during a polymer-collapse phase transition. The removal of the topo IIα CTDs effectively abolishes its condensation ability, indicating that the condensation is mediated by the CTDs. Although topo IIβ can also perform condensation, it is about 4-fold less effective. During the condensation, topo IIα-DNA condensates form along DNA, working against a DNA tension of up to 1.5 pN, greater than that previously reported for yeast condensin. In addition, this condensation does not require ATP and thus is independent of topo IIα’s catalytic activity. We also found that condensation and catalysis can concurrently proceed with minimal mutual interference. Our findings suggest topo IIα may directly participate in chromosome condensation during mitosis.
Adhesion G protein-coupled receptor ADGRG1 promotes protective microglial response in Alzheimer’s disease
Authors: Zhu Beika , Wangzhou Andi , Yu Diankun , Li Tao , Schmidt Rachael , De Florencio Stacy L. , Chao Lauren , Perez Yonatan , Grinberg Lea T. , Spina Salvatore , Ransohoff Richard M. , Kriegstein Arnold R. , Seeley William W. , Nowakowski Tomasz , Piao Xianhua
Published: October 2024

Germline genetic architecture of Alzheimer’s disease (AD) indicates microglial mechanisms of disease susceptibility and outcomes. However, the mechanisms that enable microglia to mediate protective responses to AD pathology remain elusive.Adgrg1is specifically expressed in yolk-sac-derived microglia. This study reveals the role of yolk-sac-derived microglia in AD pathology, highlighting the function of ADGRG1 in modulating microglial protective responses to amyloid deposition. Utilizing both constitutive and inducible microglialAdgrg1knockout 5xFAD models, we demonstrate thatAdgrg1deficiency leads to increased amyloid deposition, exacerbated neuropathology, and accelerated cognitive impairment. Transcriptomic analyses reveal a distinct microglial state characterized by downregulated genes associated with homeostasis, phagocytosis, and lysosomal functions. Functional assays in mouse models and human embryonic stem cells-derived microglia support that microglial ADGRG1 is required for efficient Aβ phagocytosis. Together, these results uncover a GPCR-dependent microglial response to Aβ, pointing towards potential therapeutic strategies to alleviate disease progression by enhancing microglial functional competence.
DEMINERS enables clinical metagenomics and comparative transcriptomic analysis by increasing throughput and accuracy of nanopore direct RNA sequencing
Authors: Song Junwei , Lin Li-an , Tang Chao , Chen Chuan , Yang Qingxin , Zhang Dan , Zhao Yuancun , Wei Han-cheng , Linghu Kepan , Xu Zijie , Chen Tingfeng , He Zhifeng , Liu Defu , Zhong Yu , Zhu Weizhen , Zeng Wanqin , Chen Li , Song Guiqin , Chen Mutian , Jiang Juan , Zhou Juan , Wang Jing , Chen Bojiang , Ying Binwu , Wang Yuan , Geng Jia , Lin Jing-wen , Chen Lu
Published: October 2024

Nanopore direct RNA sequencing (DRS) advances RNA biology but is limited by relatively low basecalling accuracy, low throughput, yet high RNA input and costs. Here we introduce a novel DRS toolkit, DEMINERS, which integrates an RNA multiplexing experimental workflow, a machine-learning barcode classifier based on Random Forest and a novel basecaller built on an optimized convolutional neural network providing an additional species-specific training module. With the increased accuracy in barcode classification and basecalling, DEMINERS can demultiplex up to 24 samples and the required RNA input and running time are both substantially reduced. We demonstrated the applications of DEMINERS in clinical metagenomics, cancer transcriptomics and parallel comparison of transcriptomic features in different biological conditions, revealing altered airway microbial diversity in COVID-19 and a potential role of m6A in increasing transcriptomic diversity in glioma and the mature blood-stage of malaria parasites. Overall, DEMINERS is a simple, robust, high-throughput DRS method for accurately estimating transcript levels, poly(A) lengths, and mutation and RNA modification heterogeneity at single-read level, with minimal sequencing biases.
14C-age of carbon used to grow fine roots reflects tree carbon status
Authors: Hilman Boaz , Solly Emily F. , Hagedorn Frank , Kuhlman Iris , Herrera-Ramírez David , Trumbore Susan
Published: October 2024

“Bomb”14C ages in trees indicate the time elapsed between carbon fixation into nonstructural carbon (NSC) and its use for metabolism and growth. It remains unknown why newly grown aboveground tissues have a narrow range of young14C-ages, while fine root ages can span decades.

We measured14C in tissues of two coniferous species along an alpine treeline ecotone and used a mixing model to estimate the fraction of NSC that is metabolically active. We expected that greater growth limitation higher in the ecotone would supply more freshly fixed NSC to respiration, active NSC, carbohydrates, and roots, resulting in younger14C-ages of NSC used to grow tissues.

Results confirmed an increase in fresh NSC supply with elevation. Needle and branch growth was supported by young NSC (< 2 yr) with little elevation influence, while root growth was supported by older NSC that declined from 10 to 6 yr with elevation.

Massive allocation of fresh NSC to needles and branches could explain their young14C-ages. Variable fine root14C-ages reflect tree C status, with older ages when aboveground growth limits the contribution of new C belowground, while young ages represent greater delivery of fresh NSC to roots.
How do gepotidacin and zoliflodacin stabilize DNA-cleavage complexes with bacterial type IIA topoisomerases? 1. Experimental definition of metal binding sites
Authors: Morgan Harry , Nicholls Robert A. , Warren Anna J. , Ward Simon E. , Evans Gwyndaf , Long Fei , Murshudov Garib N. , Duman Ramona , Bax Benjamin D.
Published: October 2024

One of the challenges for experimental structural biology in the 21st century is to see chemical reactions happen.Staphylococcus aureus(S. aureus) DNA gyrase is a type IIA topoisomerase that can create temporary double-stranded DNA breaks to regulate DNA topology. Drugs, such as gepotidacin, zoliflodacin and the quinolone moxifloxacin, can stabilize these normally transient DNA-strand breaks and kill bacteria. Crystal structures of uncleaved DNA with a gepotidacin precursor (2.1Å GSK2999423) or with doubly cleaved DNA and zoliflodacin (or with its progenitor QPT-1) have been solved in the same P61space-group (a=b≈93Å, c≈412Å). This suggests it may be possible to observe the two DNA-cleavage steps (and two DNA-religation steps) in this P61space-group. Here a 2.58Å anomalous manganese dataset in this crystal form is solved, and four previous crystal structures (1.98Å, 2.1Å, 2.5Å and 2.65Å) in this crystal form are re-refined to clarify crystal contacts. The structures clearly suggest a single moving metal mechanism - presented in an accompanying (2nd) paper. A previously published 2.98Å structure of a yeast topoisomerase II, which has static disorder around a crystallographic twofold axis, was published as containing two metals at one active site. Re-refined coordinates of this 2.98Å yeast structure are consistent with other type IIA topoisomerase structures in only having one metal ion at each of the two different active sites.
Benchmarking alternative polyadenylation detection in single-cell and spatial transcriptomes
Authors: Li Sida , Wang Zixuan , Hu Yanshi , Ni Qingyang , Feng Cong , Hu Yueming , Zhang Shilong , Chen Ming
Published: October 2024

Background

3’-tag-based sequencing methods have become the predominant approach for single-cell and spatial transcriptomics, with some protocols proven effective in detecting alternative polyadenylation (APA). While numerous computational tools have been developed for APA detection from these sequencing data, the absence of comprehensive benchmarks and the diversity of sequencing protocols and tools make it challenging to select appropriate methods for APA analysis in these contexts.

Results

We systematically compared seven 3’-tag-based sequencing protocols and identified key peak features affecting APA detection performance. We developed a simulation pipeline that generates realistic datasets preserving protocol-specific characteristics. Using simulated and real data, we comprehensively assessed six computational tools for their ability to identify polyA sites, quantify polyA site expression, detect differentially expressed (DE) APA genes, filter sequencing artifacts, and their computational efficiency. We also investigated factors influencing APA detection. Our evaluation revealed that SCAPE and scAPAtrap generally outperformed other tools across various performance metrics and protocols.

Conclusion

Our systematic evaluation provides guidance for tool selection, experiment design, and future tool development in APA analysis for singlecell and spatial transcriptomics, paving the way for investigating APA in these contexts.