bluuebunny/crossref_metadata_2025 huggingface dataset:
Ambiguous apparent motion in exchanging disks
Authors: Anstis Stuart , Alp Nihan
Published: October 2024

A large and a small disk with radii R and r, side by side, exchange positions repetitively at 1.33 Hz. The motion is ambiguous. If r/ R < 0.8 then observers perceive a single large disk jumping back and forth across a small static disk. But if r/ R > 0.8, observers perceive two static disks that expand and contract in counter phase, with no motion across the gap between the disks. Observers respond to the movement of the centroid, which is greatest when r/ R < 0.8.
Scaffold-mediated liver regeneration: A comprehensive exploration of current advances
Authors: Bhatt S Supriya , Krishna Kumar Jayanthi , Laya Shurthi , Thakur Goutam , Nune Manasa
Published: October 2024

The liver coordinates over 500 biochemical processes crucial for maintaining homeostasis, detoxification, and metabolism. Its specialized cells, arranged in hexagonal lobules, enable it to function as a highly efficient metabolic engine. However, diseases such as cirrhosis, fatty liver disease, and hepatitis present significant global health challenges. Traditional drug development is expensive and often ineffective at predicting human responses, driving interest in advanced in vitro liver models utilizing 3D bioprinting and microfluidics. These models strive to mimic the liver’s complex microenvironment, improving drug screening and disease research. Despite its resilience, the liver is vulnerable to chronic illnesses, injuries, and cancers, leading to millions of deaths annually. Organ shortages hinder liver transplantation, highlighting the need for alternative treatments. Tissue engineering, employing polymer-based scaffolds and 3D bioprinting, shows promise. This review examines these innovative strategies, including liver organoids and liver tissue-on-chip technologies, to address the challenges of liver diseases.
Web-based telemedicine approach for treatment of post-COVID-19 in Thuringia (WATCH)
Authors: Reuken Philipp A , Besteher Bianca , Bleidorn Jutta , Brockmann Dirk , Finke Kathrin , Freytag Antje , Lehmann-Pohl Katja , Lemhöfer Christiana , Mikolajczyk Rafael , Puta Christian , Scherag André , Wiedermann Marc , Zippel-Schultz Bettina , Stallmach Andreas
Published: October 2024

Objective

After infection with SARS-CoV-2, a substantial proportion of patients develop long-lasting sequelae. These sequelae include fatigue (potentially as severe as that seen in ME/CFS cases), cognitive dysfunction, and psychiatric symptoms. Because the pathophysiology of these sequelae remains unclear, existing therapeutic concepts address the symptoms through pacing strategies, cognitive training, and psychological therapy.

Methods

Here, we present a protocol for a digital multimodal structured intervention addressing common symptoms through three intervention modules: BRAIN, BODY, and SOUL. This intervention includes an assessment conducted via a mobile “post-COVID-19 bus” near the patient's home, as well as the use of wearable devices and mobile applications to support pacing strategies and collection of data, including ecological momentary assessment.

Results

We will focus on physical component subscore of the SF36 as Quality of Life parameter as the primary outcome parameter for WATCH to take into account the holistic approach that is necessary for care of post-COVID patients

Conclusion

In the current project, we present a protocol for a holistic and multimodal structured therapeutic concept which is easily accessible, and scalable for post-COVID patients.
Pragmatism as the foundation of cognitive enactivism
Authors: Wu Jianfeng
Published: October 2024

The current prevailing embodied cognitive science is essentially the result of the pragmatic turn of cognitive science, and enactivism is the epitome of this turn. For a long time, most advocates of enactivism have consciously regarded phenomenology as their important source of thought but ignored its pragmatic roots. In fact, there are many similarities between enactivism and pragmatism, and pragmatism has foreshadowed some core ideas and principles of enactivism. In particular, enactivism contains a pragmatic assumption that there is interaction between organisms and their environment, and cognitive ability is evolved and developed by organisms in the history of interactions with their environment. Their interpretations of cognition both rely on the theoretical support of biology and emphasize the basic role of organisms’ active capacities and environment in the formation of cognition. They hold a neutral monism position ontologically. Undoubtedly, pragmatism is the precursor of cognitive enactivism. Pragmatism not only provides rich conceptual resources for the development of enactivism, but also provides a unique perspective and method to solve some problems in its theory. Pragmatism is a rich mine for enactivists to further explore.
Anomalous Aortic Origin of a Coronary Artery: Results from a Single Surgical Team in Spain
Authors: Barca Laura Varela , Hernández-Estefanía Rafael , Orejas Miguel Orejas , Miñambres Alicia Donado , Mallebrera Marta Tomás , Romero Pilar Calderón , Yung Angeles Heredero , Aldámiz-Echevarría Gonzalo
Published: October 2024

Objectives

Anomalous aortic origin of a coronary artery is a rare congenital lesion in which a coronary artery arises from an anomalous location within the aorta. Anomalous aortic origin of a coronary artery has been associated with myocardial ischemia and it is considered the second most common cause of sudden cardiac arrest in young athletes. When surgical repair is indicated, surgical unroofing is the most commonly employed technique. Our objective is to describe the outcomes of our surgically treated patients.

Methods

We present a series of 16 adult patients who underwent surgical repair of anomalous aortic origin of a coronary artery. Patients were treated in three different institutions by the same surgeon. Surgical unroofing of the anomalous coronary artery was the surgical technique chosen in the majority of the patients. Follow-up was performed.

Results

Unroofing of an intramural anomalous coronary artery was the procedure performed in 11 patients. Three patients underwent neo-ostium creation; one patient underwent a David procedure with coronary reimplantation; and one patient was treated with coronary bypass grafting due to severe coronary atheromatous lesions. There were no perioperative deaths, and no major postoperative complications. Follow-up period was 73.8 months, the survival rate was 100%, and there were neither ischemia or heart failure reports.

Conclusions

The surgical repair of anomalous aortic origin of a coronary artery by coronary unroofing or neo-ostium creation has demonstrated excellent early and late outcomes. Late survival was excellent. The follow-up period revealed no significant morbidity or complications.
Bothered More by Acquaintances’ Appearance than Celebrities’ on Social Networks: An Investigation of Comparison Targets’ Effect under Social Comparison Theory with a Chinese Student Sample
Authors: Yayun Tong , Xi Chen , Jiayong Cui , Na Zhao , Xiling Wang
Published: October 2024

In times of the rise of the “A4 waist” trend on social networks (SNs), concerns have been raised over appearance-related content’s adverse effects on body image and well-being in parasocial relationships. We conducted a survey on Chinese college students ( N = 333) to examine the effects of comparison targets (same-gender acquaintances, celebrities, and online strangers) based on social comparison theory. The results indicate that, in line with construal-level theory, students paid more attention to the appearance-related content of same-gender acquaintances than that of the other two target groups. Surprisingly, small gaps in physical attraction between the students and acquaintances generated more appearance concern than the huge gaps between the students and celebrities, which could be explained by the “narcissism of small differences” theory. We developed existing comparison target studies by including the impact of online strangers to adapt to the current SN environment. Although the students paid the least attention to strangers’ SN appearance-related content, exposure to such content had a positive correlation with appearance concern. Regarding gender differences, females devoted more to SN appearance-related content than males across all three target groups, but the concern generated from viewing such content differed only when the targets were celebrities (females > males). The present study expands social comparison theory by introducing a two-dimensional (similarity and interaction forms) concept of “social distance.” Our findings suggest that socially close targets received more attention and comparisons and generated more concern about appearance.
Impacts of Family Environment on Chinese University Students’ English Language Proficiency: The Mediating Effect of Parenting Styles
Authors: Xu Ling , Abdullah Tina , Tang Xiongying
Published: October 2024

English as a foreign language education is a top national priority in China, and improving learners’ English language proficiency is a concern. However, most research focuses on how to enhance English proficiency in the educational environment. Investigations of the impacts of family environment on English language development are limited. This study explored the relationship between family environment and English language proficiency among 975 first-year Chinese undergraduate students. One-way ANOVA, regression analysis, and mediation analysis were performed to determine the variations in English proficiency among Chinese university students based on their family socioeconomic status and parenting styles, how well these predicted Chinese university students’ English achievement, and whether parenting styles mediated the link between family socioeconomic status and English proficiency. The results indicated that although the effect of family socioeconomic status on English proficiency appeared minimal, neglectful parenting, rather than authoritative parenting, had a significantly positive influence on English proficiency. This study also provided evidence of the mediating role of parenting styles between family socioeconomic status and English outcomes.
ADT Network: A Novel Nonlinear Method for Decoding Speech Envelopes From EEG Signals
Authors: Liu Ruixiang , Liu Chang , Cui Dan , Zhang Huan , Xu Xinmeng , Duan Yuxin , Chao Yihu , Sha Xianzheng , Sun Limin , Ma Xiulan , Li Shuo , Chang Shijie
Published: October 2024

Decoding speech envelopes from electroencephalogram (EEG) signals holds potential as a research tool for objectively assessing auditory processing, which could contribute to future developments in hearing loss diagnosis. However, current methods struggle to meet both high accuracy and interpretability. We propose a deep learning model called the auditory decoding transformer (ADT) network for speech envelope reconstruction from EEG signals to address these issues. The ADT network uses spatio-temporal convolution for feature extraction, followed by a transformer decoder to decode the speech envelopes. Through anticausal masking, the ADT considers only the current and future EEG features to match the natural relationship of speech and EEG. Performance evaluation shows that the ADT network achieves average reconstruction scores of 0.168 and 0.167 on the SparrKULee and DTU datasets, respectively, rivaling those of other nonlinear models. Furthermore, by visualizing the weights of the spatio-temporal convolution layer as time-domain filters and brain topographies, combined with an ablation study of the temporal convolution kernels, we analyze the behavioral patterns of the ADT network in decoding speech envelopes. The results indicate that low- (0.5–8 Hz) and high-frequency (14–32 Hz) EEG signals are more critical for envelope reconstruction and that the active brain regions are primarily distributed bilaterally in the auditory cortex, consistent with previous research. Visualization of attention scores further validated previous research. In summary, the ADT network balances high performance and interpretability, making it a promising tool for studying neural speech envelope tracking.
Undignified Maternity Care During Childbirth: An Ethnographic Study on Midwives’ Perspectives in a Community Healthcare Centre in South Africa
Authors: Mayisela Thandazile Adjunia , Wanko Keutchafo Esther Lydie , Baloyi Olivia Baorapetse
Published: October 2024

Undignified care of women during labor has been associated with increased preventable maternal morbidity and mortality. The purpose of this study was to explore midwives’ perspectives on undignified care of women in a midwife’s obstetric unit within a rural community healthcare center in South Africa. Using ethnographic methods, seven midwives were recruited to participate in individual interviews and participant observations were conducted in the unit. Three main themes describing undignified care were identified based on an inductive analysis of observations and interview data. These included a lack of respect for women’s bodily autonomy during labor, structural challenges in the provision of quality maternity care, and the lack of confidential care for women in labor and delivery. The study findings show that obstetric violence remains a serious crisis in the well-being of women during childbirth. Policy development by stakeholders in maternity care, including operational healthcare practitioners, should prioritize training, monitoring, and peer support on dignified care and curbing disrespect and abuse of women during childbirth, which seemed to be deeply rooted in the routine unorthodox treatment of childbirth.
The Problems and Needs of Self-Management Among Indonesian Older Adults With Hypertension: A Qualitative Study
Authors: Khasanah Uswatun , Kelliat Budi Anna , Afiyanti Yati , Besral Besral , Sari Dianis Wulan
Published: October 2024

Introduction

Hypertension is the most common older adults’ health problem in Indonesia. Older adults experience various changes in their life that often contribute to their ability to manage health problems, especially in chronic diseases.

Objectives

This study aimed to understand the problems and needs of self-management of older adults with hypertension.

Methods

This was a qualitative exploratory descriptive design. Data collection was conducted among 62 participants. Participants were 15 older adults with hypertension and 11 older adults’ families, 12 primary care nurses, seven medical doctors, 11 health volunteers, three heads of primary care, and three district health officials selected by purposeful sampling. Data were collected using semistructured, face-to-face interviews (older adults and their families) and focus group discussion (healthcare workers). Data analysis was carried out qualitatively descriptively using an inductive thinking process; Colaizzi's measures were used for analysis.

Results

This study identified eight main themes: (1) complaints related to aging and hypertension, (2) knowledge and beliefs about hypertension, (3) behavior changes after hypertension, (4) disease management support; access to health services for older adults, (5) the need to manage hypertension for older adults, (6) disease management support, (7) hypertension self-management behavior, and (8) compliance with medication.

Conclusion

This study provided evidence regarding older adults’ problems and needs in managing hypertension. These findings should be considered while providing nursing care at the community level to initiate the self-management of hypertension in older adults.
Getting Back on Track: Meanings of Recovery After Critical Illness Caused by COVID-19
Authors: Juuso Päivi , Engström Åsa , Strömbäck Ulrica , Andersson Maria , Nordin Anna
Published: October 2024

Introduction

Being critically ill in need of intensive care, lead to a challenging way back after survival, so also for survivors of COVID-19. The process to recovery can be long.

Objectives

The aim of our qualitative study was to elucidate meanings of recovery for people who were once critically ill with COVID-19.

Method

We conducted qualitative individual interviews with 13 individuals who had been critically ill with COVID-19, following a narrative approach. The data collected from the interviews, were analyzed according to phenomenological hermeneutic interpretation.

Results

The participants, although feeling alone in the process of recovery, had willpower to return to normal life but struggled to keep pace with others. They strived for balance in everyday life and to regain strength despite being exhausted after having COVID-19. The participants were grateful for their survival but displayed a need to understand what had happened. They longed for social contact, expressed feelings of abandonment, and wished for follow-up dialogues with healthcare professionals to better understand their situation. However, because support from healthcare was insufficient, the participants ultimately needed to develop their own strategies to cope with their questions, fears, and weakness.

Conclusion

Meanings of recovery for people once critically ill with COVID-19, is to strive for balance in everyday life. In their recovery process, healthcare professionals should seek to understand what the illness means for the ill person, and in mutual understanding support them based on their needs.
Guideline-recommended basic parameter adherence in neurocritical care stroke patients: Observational multicenter individual participant data analysis
Authors: Mrochen Anne , Alhaj Omar Omar , Pelz Johann O , Michalski Dominik , Neugebauer Hermann , Lehrieder Dominik , Knier Benjamin , Ringmaier Corinna , Stetefeld Henning , Schönenberger Silvia , Chen Min , Schneider Hauke , Alonso Angelika , Lesch Hendrik , Totzeck Andreas , Erdlenbruch Friedrich , Hiller Benedikt , Diel Norma J , Worm André , Claudi Christian , Gerner Stefan T , Huttner Hagen B , Schramm Patrick
Published: October 2024

Introduction:

Neurocritical care patients with neurovascular disease often face poor long-term outcomes, highlighting the pivotal role of evidence-based interventions. Although International Guidelines emphasize managing basic physiological parameters like temperature, blood glucose, blood pressure, and oxygen levels, physician adherence to these targets remains uncertain. This study aimed to assess adherence to guideline-based treatment targets for basic physiological parameters in neurocritical care.

Patients and Methods:

This multicenter observational study was conducted across eight tertiary University Hospitals in Germany analyzed 474 patients requiring mechanical ventilation (between January 1st and December 31st, 2021). Adherence was defined as the rate of measurements within therapeutic ranges for systolic blood pressure (situation-adapted), mean blood pressure (MAP, 60–90 mmHg), glucose levels (80–180 mg/dl), body temperature (<37.5°C), partial arterial pressure of oxygen (PaO2) 80–120 mmHg und partial arterial pressure of carbon dioxide (PaCO2) 35–45 mmHg during the initial 96 h of hospitalization in 4 hour-intervals.

Results:

Overall, 70.7% of all measurements were within the predetermined therapeutic ranges including SBP (71.3%), temperature (68.3%), MAP (71.4%), PaO2 (65.2%), PaCO2 (75.0%) and blood glucose (80.7%).

Discussion and Conclusion:

This multicenter study demonstrates adherence to guideline-based treatment targets, underscoring the high standards maintained by neurological intensive care units. Our study offers valuable insights into adherence to guideline-based treatment targets for neurocritical care patients in Germany. To improve patient care and optimize therapeutic strategies in neurovascular diseases, further research is needed to examine the impact of these adherence parameters on long-term outcomes.
Stroke-heart syndrome and early mortality in patients with acute ischaemic stroke using hierarchical cluster analysis: An individual patient data pooled analysis from the VISTA database
Authors: Ishiguchi Hironori , Huang Bi , El-Bouri Wahbi K. , Lip Gregory Y. H. , Abdul-Rahim Azmil H. , Lees (Chair) K.R. , Alexandrov A. , Bath P.M. , Bluhmki E. , Bornstein N. , Chen C. , Claesson L. , Curram J. , Davis S.M. , Diener H-C. , Donnan G. , Fisher M. , Ginsberg M. , Gregson B. , Grotta J. , Hacke W. , Hennerici M.G. , Hommel M. , Kaste M. , Lyden P. , Marler J. , Muir K. , Roffe C. , Sacco R. , Shuaib A . , Teal P. , Venketasubramanian N. , Wahlgren N.G. , Warach S.
Published: October 2024

Background:

The patient clinical phenotypes at particularly high risk for early cardiac complications after a recent acute ischaemic stroke (AIS), that is, stroke-heart syndrome (SHS), remain poorly defined. We utilised hierarchical cluster analysis to identify specific phenotypic profiles associated with this risk.

Methods:

We gathered data on patients with AIS from the Virtual International Stroke Trials Archive, a global repository of clinical trial data. We examined cardiac complications within 30 days post-stroke, including acute coronary syndrome, heart failure, arrhythmias and cardiorespiratory arrest. We employed hierarchical cluster analysis to define distinct phenotypic risk profiles. The incidence/risk of SHS and 90-day mortality were compared across these profiles.

Results:

We included 12,482 patients (mean age 69 ± 12 years; 55% male), yielding five phenotypes: Profile 1 (‘ elderly and AF’), Profile 2 (‘ young and smoker’), Profile 3 (‘ young’), Profile 4 (‘ cardiac comorbidities’) and Profile 5 (‘ hypertension with atherosclerotic comorbidities’). Profiles 4 and 1 exhibited the highest risk for SHS (adjusted HR (95% CI): 2.01 (1.70–2.38) and 1.26 (1.05–1.51), respectively, compared to Profile 3), while Profiles 5 and 2 showed moderate risk and Profile 3 had the lowest risk. Although Profiles 1 and 4 were at the highest risk for most SHS presentations, Profile 5 had the highest risk for cardiorespiratory arrest (adjusted HR (95% CI): 2.99 (1.22–7.34)). The 90-day mortality risk was stratified by phenotype, with the highest risk observed in Profiles 5, and 4.

Conclusions:

Hierarchical cluster analysis effectively identified phenotypes with the highest risk of SHS and early mortality in patients with AIS.
Long-term validation of inner-urban mobility metrics derived from Twitter/X
Authors: Knoblauch Steffen , Groß Simon , Lautenbach Sven , de Aragão Rocha Antonio Augusto , González Marta C , Resch Bernd , Arifi Dorian , Jänisch Thomas , Morales Ivonne , Zipf Alexander
Published: October 2024

Urban mobility analysis using Twitter as a proxy has gained significant attention in various application fields; however, long-term validation studies are scarce. This paper addresses this gap by assessing the reliability of Twitter data for modeling inner-urban mobility dynamics over a 27-month period in the metropolitan area of Rio de Janeiro, Brazil. The evaluation involves the validation of Twitter-derived mobility estimates at both temporal and spatial scales, employing over 1.6 × 1011 mobile phone records of around three million users during the non-stationary mobility period from April 2020 to June 2022, which coincided with the COVID-19 pandemic. The results highlight the need for caution when using Twitter for short-term modeling of urban mobility flows. Short-term inference can be influenced by Twitter policy changes and the availability of publicly accessible tweets. On the other hand, this long-term study demonstrates that employing multiple mobility metrics simultaneously, analyzing dynamic and static mobility changes concurrently, and employing robust preprocessing techniques such as rolling window downsampling can enhance the inference capabilities of Twitter data. These novel insights gained from a long-term perspective are vital, as Twitter - rebranded to X in 2023 - is extensively used by researchers worldwide to infer human movement patterns. Since conclusions drawn from studies using Twitter could be used to inform public policy, emergency response, and urban planning, evaluating the reliability of this data is of utmost importance.
The Long Tail of Conflicts in Innovation Projects: Conflicts and Their Impact on Strategic Renewal
Authors: Cattaneo Giacomo , Carugati Andrea , Frederiksen Lars , Hacklin Fredrik
Published: October 2024

Conflicts in projects are often resolved at the project level; however, if handled properly, resolving conflicts creates learning opportunities of great impact for the wider organization. In this article, we investigate the relationship between conflicts, their resolution, and the effect on the strategic renewal of the organization. We draw on a three-year case study at Bang & Olufsen to develop a process model that shows that conflict resolution can have a positive “long tail” that can lead to strategic renewal.
Distinct trajectories of treatment response to mepolizumab toward remission in patients with severe eosinophilic asthma
Authors: Hamada Yuto , Thomas Dennis , Harvey Erin S. , Stevens Sean , Fricker Michael , Lewthwaite Hayley , McDonald Vanessa M. , Gillman Andrew , Hew Mark , Kritikos Vicky , Upham John W. , Gibson Peter G.
Published: October 2024

Background

Patients with severe eosinophilic asthma, characterised by a high disease burden, benefit from mepolizumab, which improves symptoms and reduces exacerbations, potentially leading to clinical remission in a subgroup. This study aimed to identify treatment response trajectories to mepolizumab for severe eosinophilic asthma and to assess the achievement of clinical remission.

Methods

Data from the Australian Mepolizumab Registry were used to assess treatment responses at 3, 6 and 12 months. The treatment response trajectories were identified using a group-based trajectory model. The proportions achieving clinical remission at 12 months, which was defined as well-controlled symptoms, no exacerbations and no oral corticosteroid (OCS) use for asthma management, were compared between trajectories, and baseline predictors of the trajectories were identified using logistic regression analysis.

Results

We identified three trajectory groups: Group 1, “Responsive asthma with less OCS use” (n=170); Group 2, “Responsive late-onset asthma” (n=58); and Group 3, “Obstructed and less responsive asthma” (n=70). Groups 1 and 2 demonstrated higher proportions achieving clinical remission at 36.5% and 25.9%, respectively, compared to Group 3 with 5.7% (p<0.001). Baseline predictors for assigned groups included lower OCS dose in Group 1; greater forced expiratory volume in 1 s percentage predicted, higher Asthma Quality of Life Questionnaire score, higher OCS dose and nasal polyps in Group 2; with Group 3 as the reference.

Conclusions

Treatment response to mepolizumab in severe eosinophilic asthma follows three trajectories with varying proportions achieving clinical remission and differing baseline characteristics. Treatment response variability may influence the achievement of clinical remission with mepolizumab therapy.
Effect of CPAP therapy on blood pressure in patients with obstructive sleep apnoea: a worldwide individual patient data meta-analysis
Authors: Pengo Martino F. , Schwarz Esther I. , Barbé Ferran , Cistulli Peter A. , Drager Luciano F. , Fava Cristiano , Fuchs Flávio D. , Ip Mary S.M. , Loffler Kelly A. , Lui Macy M.S. , Martínez-García Miguel Ángel , McEvoy Doug , Peker Yüksel , Phillips Craig L. , Quinnell Tim , Soranna Davide , Steier Joerg , Stradling John R. , Zambon Antonella , Parati Gianfranco
Published: October 2024

Background

Obstructive sleep apnoea (OSA) is associated with hypertension, and OSA treatment can reduce systolic blood pressure (SBP) and diastolic blood pressure (DBP), but with a modest mean effect size and vast heterogeneity among studies. The aim of this individual patient data (IPD) meta-analysis was to understand which OSA phenotypes could benefit the most in terms of BP reduction.

Methods

A systematic review of randomised controlled trials that compared continuous positive airway pressure (CPAP) with either passive or active treatment was conducted. Studies were eligible if they included adult patients with OSA diagnosed by full polysomnography or cardiorespiratory polygraphy (defined as apnoea–hypopnoea index >5 events·h−1) and if BP was measured both before and after CPAP treatment.

Results

In total, 36 parallel studies (n=9434 patients) were included. CPAP treatment was associated with BP reduction in patients with uncontrolled office SBP only, while BP was not reduced by CPAP in patients with controlled BP (SBP −2.6versus0 mmHg; p<0.0001; DBP −1.7versus−1 mmHg; p=0.091). Differences were seen also when BP changes were compared between patients aged ≤60versus>60 years after multiple imputation only (p=0.0127 for SBP and p=0.017 for DBP). No differences were seen in terms of BP reduction when comparing patients with/without severe nocturnal hypoxia.

Conclusions

This IPD meta-analysis of the BP effects of OSA treatment with CPAP shows that OSA patients with uncontrolled BP at baseline benefit the most from CPAP therapy in terms of BP reduction. These results have important implications for the decision on how to best manage arterial hypertension associated with OSA.
Ansa cervicalis stimulation effects on upper airway patency: a structure-based analysis
Authors: Li Yike , Schwartz Alan R. , Zealear David , Shotwell Matthew S. , Hall Megan E. , Lindsell Christopher J. , Budnick Holly A. , Bellotto Silvana , Kent David T.
Published: October 2024

Rationale

Ansa cervicalis stimulation (ACS) of the infrahyoid muscles has been proposed as a neurostimulation therapy for obstructive sleep apnoea (OSA). ACS stabilises the pharynx by pulling it caudally, but its specific effects on flow limitation caused by palatal, oropharyngeal lateral wall, tongue base, or epiglottis collapse remains unclear.

Objectives

To quantify the effect of ACS on collapsibility of different pharyngeal flow-limiting structures.

Methods

Participants with OSA underwent bilateral ACS during drug-induced sleep endoscopy. Maximum inspiratory airflow was assessed over a range of positive airway pressures while ACS was applied. The flow-limiting structure for each breath was classified based on manometric and endoscopic findings and a linear mixed-effects model characterised their response to ACS. The influence of patient characteristics was explored with univariate models.

Measurements and main results

41 participants yielded 1761 breaths for analysis. On average, bilateral ACS decreased the observed pharyngeal critical closing (PCRIT) and opening (POPEN) pressures by −3.0 (95% CI −3.6–−2.3) and −3.7 (−4.4–−3.0) cmH2O, respectively (p<0.001). During tongue base obstruction, modelled ACS effects forPCRITandPOPENwere −2.0 (−2.7–−1.4) and −3.1 (−3.8–−2.4) cmH2O, respectively (p<0.001). Greater reductions were generally observed for other flow-limiting structures. A lower apnoea–hypopnea index was associated with a greater decrease inPOPEN(p<0.01). Other patient characteristics, including body mass index, did not influencePCRITorPOPEN(p>0.05).

Conclusions

Bilateral ACS decreased collapsibility of all airway flow-limiting structures. ACS generally had greater effects on palatal, oropharyngeal lateral wall and epiglottic collapse than the tongue base.
Metagenomic assemblies tend to break around antibiotic resistance genes
Authors: Abramova Anna , Karkman Antti , Bengtsson-Palme Johan
Published: October 2024

Background

Assembly of metagenomic samples can provide essential information about the mobility potential and taxonomic origin of antibiotic resistance genes (ARGs) and inform interventions to prevent further spread of resistant bacteria. However, similar to other conserved regions, such as ribosomal RNA genes and mobile genetic elements, almost identical ARGs typically occur in multiple genomic contexts across different species, representing a considerable challenge for the assembly process. Usually, this results in many fragmented contigs of unclear origin, complicating the risk assessment of ARG detections. To systematically investigate the impact of this issue on detection, quantification and contextualization of ARGs, we evaluated the performance of different assembly approaches, including genomic-, metagenomic- and transcriptomic-specialized assemblers. We quantified recovery and accuracy rates of each tool for ARGs both from in silico spiked metagenomic samples as well as real samples sequenced using both long- and short-read sequencing technologies.

Results

The results revealed that none of the investigated tools can accurately capture genomic contexts present in samples of high complexity. The transcriptomic assembler Trinity showed a better performance in terms of reconstructing longer and fewer contigs matching unique genomic contexts, which can be beneficial for deciphering the taxonomic origin of ARGs. The currently commonly used metagenomic assembly tools metaSPAdes and MEGAHIT were able to identify the ARG repertoire but failed to fully recover the diversity of genomic contexts present in a sample. On top of that, in a complex scenario MEGAHIT produced very short contigs, which can lead to considerable underestimation of the resistome in a given sample.

Conclusions

Our study shows that metaSPAdes and Trinity would be the preferable tools in terms of accuracy to recover correct genomic contexts around ARGs in metagenomic samples characterized by uneven coverages. Overall, the inability of assemblers to reconstruct long ARG-containing contigs has impacts on ARG quantification, suggesting that directly mapping reads to an ARG database should be performed as a complementary strategy to get accurate ARG abundance and diversity measures.
Outcome of laparoscopic feeding jejunostomy, comparison of a pure laparoscopic technique with Witzel’s tunnel to open technique: a retrospective cohort study
Authors: Komek Sumet , Limpakan Sirikan , Tanprasert Peticha , Chakrabandhu Bandhuphat
Published: October 2024

Introduction

Obstructive upper GI cancer commonly uses feeding jejunostomy as a standard procedure. Surgeons implemented laparoscopic feeding jejunostomy via minimally invasive surgery, employing a variety of techniques. This study assessed the perioperative results, safety, and costs associated with laparoscopic versus open jejunostomy surgeries. We used only Witzel’s tunnel and standard laparoscopic instruments.

Patients and methods

We collected data from all patients who underwent feeding jejunostomy between January 2016 and June 2018. We recorded pertinent data on baseline, surgical outcomes, postoperative results, complications, and costs. The study excluded patients with jejunostomy as a conversion or an addition.

Result

We divided the 74 patients into 2 groups: 30 underwent laparoscopy and 44 underwent open surgery. The mean operational times were 89.67 and 91.64 min and showed no statistically significant difference (p = 0.678). The mean morphine dosage was significantly lower in the laparoscopic group (3.3 vs. 7.19, p = < 0.001). Laparoscopic surgery lowered the median time of feeding initiation, feeding accomplished, and postoperative stay, although none of these reached statistical significance. There were significantly higher surgical expenses in the laparoscopic group (16,410 vs. 11,685 Thai Baht) (p < 0.001); however, median overall expenditures did not significantly differ (105,147 vs. 116,198 Thai Baht) (p = 0.387). Laparoscopic versus open surgery had similar incidences of postoperative complications (20% vs. 25%, p = 0.846). The feeding tube catheter location was infection-free in all patients in our study.

Conclusion

Laparoscopic jejunostomy feeding was safe, and postoperative morphine consumption was lower. Increasing operational costs did not have a significant impact on overall expenditures. Witzel’s tunnel may reduce jejunostomy site infections.
Perceptions and attitudes about the contribution of the environment to childhood cancer: a pilot study in a medical guild and undergraduate students
Authors: Jarquin-Yañez Lizet , Cruz Eunice Tello , Martinez-Acuña Monica Imelda , Calderon-Hernandez Jaqueline
Published: October 2024

Background

Identifying and recognizing environmental risk factors for childhood cancer is crucial to prevent it. Medical guild are the first contact to monitor children’s health. Therefore, courses about the contribution of chemical toxins in the environment and health outcomes such as cancer should be included in their professional training. This study aimed to evaluate the perceptions and attitudes of a medical guild and undergraduate students in health sciences about the contribution of the environment to childhood cancer.

Methods

A pilot study was conducted, an online survey including thirteen questions was shared among medical guild members and undergraduate students in health sciences. Frequencies, percentages, and chi-square homogeneity tests were calculated to compare groups.

Results

Genetic factors ranked as the first possible cause of childhood cancer (88.2% medical guild and 97.7% undergraduate students). However, 70.6% of medical guild and 64.6% of undergraduate students reported that they have ever suspected that childhood cancer could be related to the environmental conditions in which children live. More than 95% of the participants reported that they would find it useful to have more knowledge about environmental risks and cancer. When data were analyzed by profession (medical guild) and academic year (undergraduate students), no significant differences were observed. Nonetheless, comparisons by academic discipline between undergraduate students, showed that a higher percentage of medicine and environmental sciences and health (over 98%) reported environmental exposure as risk factors associated with childhood cancer compared to 75% from physiotherapy, (p = 0.001).

Conclusions

In this study, the environmental contribution to childhood cancer is not clear among the medical guild and undergraduate students. They should be trained on the topic of cancer and the environment.
Combined associations of physical activity, diet quality and their changes over time with mortality: findings from the EPIC-Norfolk study, United Kingdom
Authors: Aryannezhad Shayan , Mok Alexander , Imamura Fumiaki , Wareham Nicholas J. , Brage Soren , Forouhi Nita G.
Published: October 2024

Background

Physical activity (PA) and diet quality have each been shown to be inversely associated with mortality but their combined impact on longevity has been less explored, particularly when considering their changes over time. This study aimed to examine the separate and combined associations of PA, diet quality and their changes over time with mortality outcomes.

Methods

A prospective cohort study was performed on 9349 adults aged 40 to 79 years from the population-based European Prospective Investigation into Cancer in Norfolk Study, with repeated measurements of PA and diet (from 1993 till 2004) and subsequent follow-up till 2022 (median follow-up 18.8 years). Validated questionnaires were used to derive physical activity energy expenditure (PAEE) as a proxy of total PA and adherence to the Mediterranean diet score (MDS, range 0–15 points) as an indicator of overall diet quality, and their changes over time (∆PAEE and ∆MDS). Cox regression models adjusted for potential confounders and mediators were used to estimate hazard ratios (HRs) and 95% CIs.

Results

Over 149,681 person-years of follow-up, there were 3534 deaths. In adjusted models, for each 1-SD difference in baseline PAEE (4.64 kJ/kg/day), ∆PAEE (0.65 kJ/kg/day per year), baseline MDS (1.30 points) and ∆MDS (0.32 points per year), HRs (95% CI) for all-cause mortality were 0.90 (0.86 to 0.94), 0.89 (0.85 to 0.93), 0.95 (0.91 to 0.99) and 0.93 (0.90 to 0.97), respectively. Compared with participants with sustained low PAEE (< 5 kJ/kg/day) and low MDS (< 8.5 points), those with sustained high PAEE and high MDS had lower all-cause mortality (HR 0.78; 95% CI: 0.68–0.91), as did those who improved both PAEE and MDS (0.60; 0.44–0.82). There was no evidence of interaction between PA and diet quality exposures on mortality risk. Population impact estimates suggested that if all participants had maintained high levels of PA and diet quality consistently, cumulative adjusted mortality rate would have been 8.8% (95% CI: 2.4 to 15.3%) lower.

Conclusions

These findings suggest that adopting and maintaining higher levels of PA and diet quality are associated with lower mortality. Significant public health benefits could be realised by enabling active living and healthy eating through adulthood.
The role of two major nucleoid-associated proteins in Streptomyces, HupA and HupS, in stress survival and gene expression regulation
Authors: Strzałka Agnieszka , Mikołajczyk Jakub , Kowalska Klaudia , Skurczyński Michał , Holmes Neil A. , Jakimowicz Dagmara
Published: October 2024

Background

Streptomyces are sporulating soil bacteria with enormous potential for secondary metabolites biosynthesis. Regulatory networks governing Streptomyces coelicolor differentiation and secondary metabolites production are complex and composed of numerous regulatory proteins ranging from specific transcriptional regulators to sigma factors. Nucleoid-associated proteins (NAPs) are also believed to contribute to regulation of gene expression. Upon DNA binding, these proteins impact DNA accessibility. Among NAPs, HU proteins are the most widespread and abundant. Unlike other bacteria, the Streptomyces genomes encode two HU homologs: HupA and HupS, which differ in structure and expression profile. However, it remained unclear whether the functions of both homologs overlap. Additionally, although both proteins have been shown to bind the chromosome, their rolesin transcriptional regulation have not been studied so far.

Results

In this study, we explore whether HupA and HupS affect S. coelicolor growth under optimal and stressful conditions and how they control global gene expression. By testing both single and double mutants, we address the question of the complementarity of both HU homologs. We show that the lack of both hup genes led to growth and sporulation inhibition, as well as increased spore fragility. We also demonstrate that both HU homologs can be considered global transcriptional regulators, influencing expression of between 2% and 6% genes encoding among others proteins linked to global regulatory networks and secondary metabolite production.

Conclusions

We identify the independent HupA and HupS regulons, as well as genes under the control of both HupA and HupS proteins. Our data indicate a partial overlap between the functions of HupA and HupS during S. coelicolor growth. HupA and HupS play important roles in Streptomyces regulatory network and impact secondary metabolite clusters.
Biosensor-based growth-coupling as an evolutionary strategy to improve heme export in Corynebacterium glutamicum
Authors: Krüger Aileen , Göddecke Janik , Osthege Michael , Navratil Luis , Weber Ulrike , Oldiges Marco , Frunzke Julia
Published: October 2024

The iron-containing porphyrin heme is of high interest for the food industry for the production of artificial meat as well as for medical applications. Recently, the biotechnological platform strain Corynebacterium glutamicum has emerged as a promising host for animal-free heme production. Beyond engineering of complex heme biosynthetic pathways, improving heme export offers significant yet untapped potential for enhancing production strains. In this study, a growth-coupled biosensor was designed to impose a selection pressure on the increased expression of the hrtBA operon encoding an ABC-type heme exporter in C. glutamicum. For this purpose, the promoter region of the growth-regulating genes pfkA (phosphofructokinase) and aceE (pyruvate dehydrogenase) was replaced with that of PhrtB, creating biosensor strains with a selection pressure for hrtBA activation. Resulting sensor strains were used for plate-based selections and for a repetitive batch f(luorescent)ALE using a fully automated laboratory platform. Genome sequencing of isolated clones featuring increased hrtBA expression revealed three distinct mutational hotspots: (i) chrS, (ii) chrA, and (iii) cydD. Mutations in the genes of the ChrSA two-component system, which regulates hrtBA in response to heme levels, were identified as a promising target to enhance export activity. Furthermore, causal mutations within cydD, encoding an ABC-transporter essential for cytochrome bd oxidase assembly, were confirmed by the construction of a deletion mutant. Reversely engineered strains showed strongly increased hrtBA expression as well as increased cellular heme levels. These results further support the proposed role of CydDC as a heme transporter in bacteria. Mutations identified in this study therefore underline the potential of biosensor-based growth coupling and provide promising engineering targets to improve microbial heme production.
Planning for and Assessing Rigor in Rapid Qualitative Analysis (PARRQA): a consensus-based framework for designing, conducting, and reporting
Authors: Kowalski Christine P. , Nevedal Andrea L. , Finley Erin P. , Young Jessica P. , Lewinski Allison A. , Midboe Amanda M. , Hamilton Alison B.
Published: October 2024

Background

The use of rapid qualitative methods has increased substantially over the past decade in quality improvement and health services research. These methods have gained traction in implementation research and practice, wherein real-time adjustments are often made to optimize processes and outcomes. This brisk increase begs the questions: what does rigor entail in projects that use rapid qualitative analysis (RQA)? How do we define a pragmatic framework to help research teams design and conduct rigorous and valid rapid qualitative projects? How can authors articulate rigor in their methods descriptions? Lastly, how can reviewers evaluate the rigor of rapid qualitative projects?.

Methods

A team of seven interdisciplinary qualitative methods experts developed a framework for ensuring rigor and validity in RQA and methods suitable for this analytic approach. We conducted a qualitative evidence synthesis to identify gaps in the literature and then drew upon literature, standard procedures within our teams, and a repository of rapid qualitative training materials to create a planning and reporting framework. We iteratively refined this framework through 11 group working meetings (60-90 minutes each) over the course of one year and invited feedback on items to ensure their completeness, clarity, and comprehensibility.

Results

The Planning for and Assessing Rigor in Rapid Qualitative Analysis (PARRQA) framework is organized progressively across phases from design to dissemination, as follows: 1) rigorous design (rationale and staffing), 2) semi-structured data collection (pilot and planning), 3) RQA: summary template development (accuracy and calibration), 4) RQA: matrix analysis (matrices), and 5) rapid qualitative data synthesis. Eighteen recommendations across these sections specify best practices for rigor and validity.

Conclusions

Rapid qualitative methods play a central role in implementation evaluations, with the potential to yield prompt information and insights about context, processes, and relationships. However, guidance on how to assess rigor is nascent. The PARRQA framework enhances the literature by offering criteria to ensure appropriate planning for and assessment of rigor in projects that involve RQA. This framework provides a consensus-based resource to support high-level qualitative methodological rigor in implementation science.