bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of physiotherapy interventions on enhancing wound healing post knee osteoarthritis surgery: A meta‐analysis
Authors: Yang Jun , Chu Ruzai , Chen Zhengbin , Qiu Jianbiao , Pang Zhengbao , Yang Huiming
Published: February 2024

In knee osteoarthritis surgery, managing postoperative wound healing and minimizing scar formation are pivotal for patient recovery and satisfaction. These aspects are particularly challenging due to the nature of the surgical procedure and patient demographics. Physiotherapy interventions are increasingly recognized for their role in improving these postoperative outcomes. This meta‐analysis sought to evaluate the efficacy of physiotherapy in enhancing wound healing, as measured by REEDA scores, and reducing scar formation, as indicated by Manchester Scar Scale (MSS) scores, following knee osteoarthritis surgery. Analysing data from eight studies, we found that physiotherapy significantly improved wound healing, evidenced by lower REEDA scores (SMD = −19.58, 95% CI: [−22.49, −16.66], p < 0.01), and reduced scar formation, reflected in lower MSS scores (SMD = −24.79, 95% CI: [−30.03, −19.55], p < 0.01). These findings highlight the crucial role of physiotherapy in postoperative care for knee osteoarthritis patients, emphasizing its impact on enhancing recovery and improving surgical outcomes.
Treatment of diabetic foot with moxibustion: Clinical evidence from meta‐analysis
Authors: Ji Yue , Zhang Yalan , Wu Ruoxi , Wang Tuoran , Wang Jiayi , Liu Zhongjie , Liu Weijing
Published: February 2024

To assess the efficacy of moxibustion for diabetic foot, and compile the findings of randomised clinical trials. China National Knowledge Infrastructure Database, Medicine, WanFang Database, Embase, Chinese Scientific Journal Database and Web of Science were from the establishment to January, 2024 were searched. Randomised controlled trials, which evaluated the effects of moxibustion were included. A total of 12 randomised controlled trials involving 1196 patients were included. According to the pooled results of this meta‐analysis, effective rate (relative risk 1.16, 95% confidence intervals, CI [1.11, 1.22]), healing time (mean difference [MD] −6.27, 95% CI [−8.68, −3.86]), wound area (MD 3.46, 95% CI [0.84, 6.09]), and ankle brachial index (MD 0.14, 95% CI [0.03, 0.24]) were statistically significant compared to the control group. This study suggests that moxibustion treatment has the potential for improving symptoms of diabetic foot. However, future in‐depth research on the benefits and harms of moxibustion for the diabetic foot is needed before it can be accepted as an evidence‐based treatment.
Sustainability of an outcome measure in outpatient stroke rehabilitation: A realist evaluation
Authors: Ataman Rebecca , Ahmed Sara , Berta Whitney , Thomas Aliki
Published: February 2024

Rationale

Only half of newly implemented evidence‐based practices are sustained. Though poor sustainment can lead to negative consequences for clinical teams, organizations and patients, the causal explanations of sustainment are largely unknown.

Aims and Objectives

We aimed to ascertain how (mechanisms) and in what circumstances (context) a newly implemented outcome measure in rehabilitation was sustained or not (outcome).

Methodology

Informed by an integrated knowledge translation approach, we conducted a realist evaluation using a mixed method, embedded single case study design with data collection up to 18 months following the implementation of the Mayo‐Portland Adaptability Inventory ‐ version 4 (MPAI‐4), a rehabilitation outcome measure. Quantitative data (survey and patient charts) was analysed using descriptive statistics, then integrated with qualitative data (interviews with 10 key informants) and analysed using inductive and deductive retroduction. We integrated the data to develop a case description and ultimately, to refine the programme theory to better understand the sustainability of the MPAI‐4.

Results

We linked context, mechanisms and outcomes, and also emphasized sustainability strategies in 18 explanations of how sustainability works. These explanations provide evidence for four overarching patterns: (1) implementation and sustainability phases are interconnected, (2) outcomes build on each other recursively, with patient benefits as the keystone outcome, (3) sustainment is achieved to varying levels across different sustainability outcomes [e.g., high level (e.g., rate of MPAI‐4 scoring: 77.7%) to low level (e.g., rate of MPAI‐4 application to clinical decision‐making: 3.7%)] and (4) the work of sustaining the MPAI‐4 is shared amongst different stakeholders.

Conclusion

Implementation teams can draw from this programme theory to improve the sustainment of outcomes measures while researchers could continue to refine the theory. Continued investigation of sustainability, including diverse and continuous sustainability outcomes, is needed to understand how to maintain improvements in quality of care and patient outcomes.
The Rationality Bias
Authors: HAGENHOFF TIM , LUSTENHOUWER JOEP , TSIONAS MIKE
Published: February 2024

We analyze differences in consumption and wealth in an estimated New Keynesian model with rational and boundedly rational households. Shocks are shown to cause consumption and wealth heterogeneity due to the “rationality bias” of boundedly rational households. This bias can be decomposed into three components, which, for certain specifications of monetary policy, can exactly offset each other. Moreover, a more hawkish response to inflation leads to more volatility in consumption and wealth heterogeneity, which makes it optimal for the central bank to set lower coefficients in the Taylor rule than would have been the case under homogeneous rational expectations.
Dendrobium officinale flowers' topical extracts improve skin oxidative stress and aging
Authors: He Xing‐Li‐Shang , Wang Ning , Teng Xi , Wang Nan‐Nan , Xie Zhi‐Yi , Dong Ying‐Jie , Lin Min‐Qiu , Zhang Ze‐Hua , Rong Mei , Chen Yi‐Gong , Li Bo , Lv Gui‐Yuan , Chen Su‐Hong
Published: February 2024

Background

Dendrobium officinale flowers (DOF) have the effects of antiaging and nourishing yin, but it lacks pharmacological research on skin aging.

Objective

Confirming the role of DOF in delaying skin aging based on the “in vitro animal–human” model.

Methods

In this experiment, three kinds of free radical scavenging experiments in vitro, D‐galactose‐induced aging mouse model, and human antiaging efficacy test were used to test whether DOF can improve skin aging through anti‐oxidation.

Results

In vitro experiment shows that DOF has certain scavenging effect on 2,2‐diphenyl‐1‐picrylhydrazyl (DPPH) free radical, hydroxyl free radical, and superoxide free radical, and its IC50 is 0.2090 μg/mL, 15.020, and 1.217 mg/mL respectively. DOF can enhance the activities of T‐AOC, SOD, CAT, and GSH Px in the serum of aging mice, increase the content of GSH, and reduce the content of MDA when administered with DOF of 1.0, 2.0, and 4.0 g/kg for 6 weeks. In addition, it can enhance the activity of SOD in the skin of aging mice, increase the content of Hyp, and decrease the content of MDA, activated Keap1/Nrf2 pathway in the skin of aging mice. Applying DOF with a concentration of 0.2 g/mL on the face for 8 weeks can significantly improve the skin water score and elasticity value, reduce facial wrinkles, pores, acne, and UV spots, and improve the facial brown spots and roughness.

Conclusion

DOF can significantly improve skin aging caused by oxidative stress, and its mechanism may be related to scavenging free radicals in the body and improving skin quality.
Genetic Anti‐Blackness: Exploring the Use of Analogies in Understanding Contemporary Racism
Authors: Nnamdi Akinshimaya
Published: February 2024

Since slavery, racism and discrimination have continued to impact the social outcomes of Blacks despite efforts and laws put into place to alleviate the disadvantages. A contemporary project developed by Nikole Hannah‐Jones and the New York Times called for the re‐examination of the legacy of slavery. With re‐examining the consequence of slavery, the lens has been widened, resulting in a more robust interpretation of racism. Social issues have historic roots and thus require a multilayered approach to map out and examine the culminated effects of phenomenon. In this paper, the author uses Beckert and Rockman’s DNA analogy (2016) to merge biology, history, and sociology to provide a critical overview of theories of racism that have emerged since slavery, and to detail the phenomenon of contemporary racism. By connecting past eras of racism using something familiar, racial discourse can potentially move beyond the frustration of racism being a permanent entity in society.
Diagnostic and predictive ability of hyperbilirubinemia severity in cats: A multicenter retrospective study
Authors: Salord Torres Xavier , Jeevaratnam Kamalan , Schofield Imogen , Taylor Samantha , Stallwood Jennifer , Heyes Menai , Hughes Daniel , Defauw Pieter
Published: February 2024

Background

Total serum bilirubin concentration (TBIL) can provide useful information on several pathophysiological conditions in cats. Nevertheless, whether the variable severity classification of hyperbilirubinemia can reliably indicate certain disease processes or predict a biliary obstruction (BO) has not been investigated.

Hypothesis/Objective

Determine if hyperbilirubinemia of variable severity can assist clinicians to identify BO, which often is considered a surgical emergency.

Animals

Two‐hundred sixteen client‐owned cats.

Methods

Data were retrospectively collected from all cats (January 2015‐August 2022) with an increased TBIL (>0.58 mg/dL [>10 μmol/L]) presented to 3 referral centers in the United Kingdom (UK). Presenting clinical features and diagnostic outcomes were collected. The predictive ability of TBIL to indicate BO was evaluated by multivariable binary logistic regression modeling and receiver operating characteristic (ROC) curves.

Results

Median TBIL was 1.73 mg/dL (range, 0.59‐26.15; 29.5 μmol/L; range, 10.1‐447.1) with severity classification of hyperbilirubinemia categorized as mild (>0.58‐2.92 mg/dL; >10‐50 μmol/L; 68.1%), moderate (>2.92‐5.85 mg/dL; >50‐100 μmol/L; 17.6%), severe (>5.85‐11.70 mg/dL; >100‐200 μmol/L; 9.7%) and very severe (>11.70 mg/dL; >200 μmol/L; 4.6%). Biliary obstruction was present in 17 (7.9%) cats, all of which received recommendation for emergency surgery. Median TBIL in cats with BO (9.69 mg/dL; 165.7 μmol/L) differed significantly from those without obstruction (1.51 mg/dL; 25.8 μmol/L; P < .01). The optimal TBIL cut‐off to discriminate between cats with and without BO was ≥3.86 mg/dL (≥66 μmol/L) with a sensitivity of 94.1% and specificity of 82.4%. Using multivariable logistic regression, as age increased, the odds of BO increased significantly (odds ratio, 1.20; 95% confidence interval, 1.01‐1.42; P = .04).

Conclusions and Clinical Importance

As part of a thorough clinical assessment, the severity classification of hyperbilirubinemia has the potential to predict the likelihood of a BO and to discriminate between cats that may or may not require surgery for BO at a suggested cut‐off of ≥3.86 mg/dL (≥66 μmol/L). Alongside TBIL, age is also useful when assessing for the likelihood of BO in a cat presented with hyperbilirubinemia.
Sex‐specific effects of inbreeding in juvenile brown trout
Authors: Bylemans Jonas , Marques da Cunha Lucas , Sarmiento Cabello Sonia , Nusbaumer David , Uppal Anshu , Wedekind Claus
Published: February 2024

Inbreeding depression, that is, the reduction of health and vigour in individuals with high inbreeding coefficients, is expected to increase with environmental, social, or physiological stress. It has therefore been predicted that sexual selection and the associated stress usually lead to higher inbreeding depression in males than in females. However, sex‐specific differences in life history may reverse that pattern during certain developmental stages. In some salmonids, for example, female juveniles start developing their gonads earlier than males who instead grow faster. We tested whether the sexes are differently affected by inbreeding during that time. To study the effects of inbreeding coefficients that may be typical for natural populations of brown trout (Salmo trutta), and also to control for potentially confounding maternal or paternal effects, we sampled males and females from the wild, used their gametes in a block‐wise full‐factorial breeding design to produce 60 full‐sib families, released the offspring as yolk‐sac larvae into the wild, sampled them 6 months later, identified their genetic sex, and used microsatellites to assign them to their parents. We used whole‐genome resequencing to calculate the kinship coefficients for each breeding pair and hence the expected average inbreeding coefficient per family. Juvenile growth could be predicted from these expected inbreeding coefficients and the genetic sex: Females reached lower body sizes with increasing inbreeding coefficient, while no such link could be found in males. This sex‐specific inbreeding depression led to the overall pattern that females were on average smaller than males by the end of their first summer.
Factors influencing the early neurological deterioration in intracranial branch atheromatous diseases
Authors: Deguchi Ichiro , Fujiwara Shinako , Arai Noriko , Nakagami Toru , Kimura Ryutaro , Oryu Kiichiro , Watanabe Kaito , Kato Yuji , Hayashi Takeshi , Takahashi Shinichi , Suda Satoshi
Published: February 2024

Background

Intracranial branch atheromatous disease (BAD)‐type cerebral infarction is often associated with a progressive worsening of neurological symptoms in the acute phase.

Aim

To investigate the factors influencing the occurrence of early neurological deterioration (END) in patients with BAD.

Methods

We included and evaluated 198 consecutive patients (150 patients with lenticulostriate artery [LSA‐BAD] and 48 patients with paramedian pontine artery [PPA‐BAD]) with onset within 24 h and with a modified Rankin scale score of ≤1 before admission for END retrospectively out of 235 patients with BAD‐type cerebral infarction admitted to our hospital from January 2019 to March 2023.

Results

END was observed in 26 (17%) and 15 (31%) patients with LSA‐BAD and PPA‐BAD, respectively. Patients in the END group with LSA‐BAD had significantly higher rates of diabetes mellitus and blood glucose (BG) levels on admission and lower rates of initial clopidogrel loading therapy than those in the non‐END group. Patients in the END group with PPA‐BAD had significantly higher BG levels on admission than those in the non‐END group. In LSA‐BAD multivariate analysis, the BG level on admission and initial clopidogrel loading were identified as factors influencing END (BG level [per 10 mg/dL], odds ratio [OR] 1.084, 95% confidence interval [CI] 1.008–1.166; initial clopidogrel loading, OR 0.302, 95% CI 0.101–0.901).

Conclusions

Higher BG levels at stroke onset were associated with END in patients with LSA‐BAD and PPA‐BAD. Additionally, initial clopidogrel loading therapy suppressed END in patients with LSA‐BAD.
Leptin‐Melanocortin pathway variants and gastric emptying in patients with obesity
Authors: Cifuentes Lizeth , Ghusn Wissam , Campos Alejandro , Bublitz Joshua T. , Hurtado Maria Daniela , Olson Janet , Acosta Andres
Published: February 2024

Background

Accelerated gastric emptying (GE) is a trait seen in obesity. Mutations in the hypothalamic leptin‐melanocortin 4 receptor (Leptin‐MC4R) pathway have been associated with obesity. We sought to investigate the association of leptin‐MC4R pathway variants and GE in patients with obesity.

Methods

This is a cross‐sectional study of patients with a history of severe obesity that were genotyped and completed a GE test by scintigraphy. We evaluated the percentage of GE (GE %) at 2 and 4 h between both groups using ANCOVA with weight and sex as covariates. We subdivide patients into carriers based on the location of the identified variants (i.e., upstream or downstream of the Leptin‐MC4R pathway) and compared them with noncarriers using ANOVA. Results are presented as mean and standard deviation (± SD).

Key Results

A total of 95 patients; nine carriers (67% females; 39.78 ± 12.33 years; BMI: 49.14 ± 12.96 kg/m2) and 86 noncarriers (87% female; 49.98 ± 13.74 years; BMI: 40.75 ± 6.29 kg/m2) were included. At 2 and 4 h, carriers had a delayed GE when compared noncarriers (p = 0.03 and p = 0.005, respectively). In carriers, when compared upstream carriers vs. downstream carriers vs. noncarriers by location there was a significant difference in GE among groups at 2 h and at 4 h (p = 0.02 and p = 0.01, respectively).

Conclusions & Inferences

Carriers of heterozygous variants in the Leptin‐MC4R pathway had a delayed GE compared to noncarriers. These findings point the important relationship between the Leptin‐MC4R pathway and gastric motility.
High‐quality chromosome‐level genome assembly and multi‐omics analysis of rosemary (Salvia rosmarinus) reveals new insights into the environmental and genome adaptation
Authors: Lai Yong , Ma Jinghua , Zhang Xuebin , Xuan Xiaobo , Zhu Fengyun , Ding Shen , Shang Fude , Chen Yuanyuan , Zhao Bing , Lan Chen , Unver Turgay , Huo George , Li Ximei , Wang Yihan , Liu Yufang , Lu Mengfei , Pan Xiaoping , Yang Deshuang , Li Mingwan , Zhang Baohong , Zhang Dangquan
Published: February 2024

High‐quality genome of rosemary (Salvia rosmarinus) represents a valuable resource and tool for understanding genome evolution and environmental adaptation as well as its genetic improvement. However, the existing rosemary genome did not provide insights into the relationship between antioxidant components and environmental adaptability. In this study, by employing Nanopore sequencing and Hi‐C technologies, a total of 1.17 Gb (97.96%) genome sequences were mapped to 12 chromosomes with 46 121 protein‐coding genes and 1265 non‐coding RNA genes. Comparative genome analysis reveals that rosemary had a closely genetic relationship with Salvia splendens and Salvia miltiorrhiza, and it diverged from them approximately 33.7 million years ago (MYA), and one whole‐genome duplication occurred around 28.3 MYA in rosemary genome. Among all identified rosemary genes, 1918 gene families were expanded, 35 of which are involved in the biosynthesis of antioxidant components. These expanded gene families enhance the ability of rosemary adaptation to adverse environments. Multi‐omics (integrated transcriptome and metabolome) analysis showed the tissue‐specific distribution of antioxidant components related to environmental adaptation. During the drought, heat and salt stress treatments, 36 genes in the biosynthesis pathways of carnosic acid, rosmarinic acid and flavonoids were up‐regulated, illustrating the important role of these antioxidant components in responding to abiotic stresses by adjusting ROS homeostasis. Moreover, cooperating with the photosynthesis, substance and energy metabolism, protein and ion balance, the collaborative system maintained cell stability and improved the ability of rosemary against harsh environment. This study provides a genomic data platform for gene discovery and precision breeding in rosemary. Our results also provide new insights into the adaptive evolution of rosemary and the contribution of antioxidant components in resistance to harsh environments.
Prevalence and risk factors of suicide attempts among Chinese elderly patients over 50 years with schizophrenia
Authors: Fu Zejin , Zhang Xiangyang , Xiao Jing
Published: February 2024

Background

Several research efforts have found that older schizophrenia patients are at higher risk for suicide. Related risk factors for suicide attempts in the elderly with schizophrenia are poorly understood. This study sought to assess the prevalence of suicide attempts and related risk variables in schizophrenia patients over the age of 50.

Methods

We recruited 591 elderly patients over the age of 50. Demographic, clinical and blood parameters of all patients were collected. Patients with schizophrenia were evaluated for psychopathological symptoms using the Positive and Negative Syndrome Scale (PANSS).

Results

The rate of suicide attempts among elderly Chinese schizophrenia patients was 15.2%. In these elderly schizophrenia patients, those who with suicide attempts had significantly higher scores for insomnia, depression and smoking addiction, and higher levels of red blood cells, Hc1 glycosylated hemoglobin and free T3, but significantly lower levels of hypersensitive C‐reactive protein and ‐globulin. Binary logistic regression analysis showed that higher depression scores and smoking addiction were risk factors for suicide attempts in these patients. Additionally, multiple regression analyses showed that higher BMI and insomnia scores were associated with suicide risk scores in elderly schizophrenia patients.

Conclusions

Our research shows that there is a high incidence of suicide attempts in people over 50 years of age with schizophrenia. A number of clinically relevant factors and metabolic markers are associated with suicide attempts among elderly patients with schizophrenia.
The effects of unsupervised home‐based exercise training during pregnancy: A systematic review
Authors: Weng Min‐Hsueh , Chou Hung‐Chieh , Liaw Jen‐Jiuan
Published: February 2024

Background

Pregnant women may experience physical and emotional distress. Exercise is recommended for healthy pregnant women and is beneficial for their mental and physical health. Unsupervised home‐based exercise is cost‐effective for pregnant women as an occasional solution for their discomfort. However, no synthesis of randomized trials on this topic has been conducted.

Aims

The aim of this study was to evaluate the effectiveness of unsupervised home‐based exercise during pregnancy.

Methods

A systematic search for randomized controlled trials was performed in electronic databases. The review extracted eligibility criteria based on unsupervised home‐based exercise intervention. The quality of the included studies was performed using the Cochrane Risk of Bias Tool 2.0. This review was registered a priori in PROSPERO (CRD42023452966).

Results

In total, seven studies were selected for systematic review. Participant adherence rates for the three reported studies varied considerably, ranging from 33% to 75%. Two studies revealed that unsupervised home‐based exercise improved symptom severity in relation to long‐term adherence to exercise. Two studies suggested that maternal aerobic fitness increased due to exercise. One study revealed improved sleep quality. However, none of the studies supported the positive effects of exercise on fatigue, maternal insulin sensitivity, prenatal weight gain, postnatal weight loss, birth pain, and cesarean section.

Linking evidence to action

Unsupervised home‐based exercise improves discomfort symptoms during pregnancy but requires a long intervention period. This finding suggests that the evaluation period needs to be longer to identify the effects of exercise. In addition, a theoretical‐based integrity exercise plan should be considered to promote the effectiveness of unsupervised home‐based exercise.
A microscopic investigation of the effect of random envelope fluctuations on phoneme-in-noise perception
Authors: Osses Alejandro , Varnet Léo
Published: February 2024

In this study, we investigated the effect of specific noise realizations on the discrimination of two consonants, /b/ and /d/. For this purpose, we collected data from twelve participants, who listened to /aba/ or /ada/ embedded in one of three background noises. All noises had the same long-term spectrum but differed in the amount of random envelope fluctuations. The data were analyzed on a trial-by-trial basis using the reverse-correlation method. The results revealed that it is possible to predict the categorical responses with better-than-chance accuracy purely based on the spectro-temporal distribution of the random envelope fluctuations of the corresponding noises, without taking into account the actual targets or the signal-to-noise ratios used in the trials. The effect of the noise fluctuations explained on average 8.1% of the participants' responses in white noise, a proportion that increased up to 13.3% for noises with a larger amount of fluctuations. The estimated time-frequency weights revealed that the measured effect originated from confusions between noise fluctuations and relevant acoustic cues from the target sounds. Similar conclusions were obtained from simulations using an artificial listener.
A numerical extension of White's theory of P-wave attenuation to non-isothermal poroelastic media
Authors: Zapata Naddia D. Arenas , Santos Juan E. , Savioli Gabriela B. , Carcione José M. , Ba Jing
Published: February 2024

Mesoscopic P-wave attenuation in layered, partially saturated thermo-poroelastic media is analyzed by combining the theories of Biot poroelasticity and Lord–Shulman thermoelasticity (BLS). The attenuation is quantified by estimating the quality factor Q. The mesoscopic attenuation effect, commonly referred to as wave-induced fluid flow (WIFF), is the process that converts fast compressional and shear waves into slow diffusive Biot waves at mesoscopic heterogeneities larger than the pore scale, but much smaller than the dominant wavelengths. This effect was first modeled in White's isothermal theory by quantifying the seismic response of a periodic sequence of planar porous layers that are alternately saturated with gas or water. This work presents a numerical extension of White's theory for the non-isothermal case in this type of sequence. For this purpose, an initial-boundary-value problem (IBVP) for the BLS wave propagation equations is solved using the finite element method, where the particle velocity field is recorded at uniformly distributed receivers. The quality factor is estimated using spectral-ratio and frequency-shift methods. The Q-estimates show that thermal effects influence the attenuation of the P-wave and the velocity dispersion compared to the isothermal case.
Exploring 24-Hour Movement Behaviors in Early Years: Findings From the SUNRISE Pilot Study in Tunisia
Authors: Ltifi Mohamed Amine , Turki Olfa , Ben-Bouzaiene Ghaith , Pagaduan Jeffrey Cayaban , Okely Anthony , Chelly Mohamed Souhaiel
Published: February 2024

Purpose: The International Study of Movement Behaviors in the Early Years (SUNRISE) was conducted in Tunisia to assess the proportion of preschoolers who met the World Health Organization guidelines for physical activity, sedentary behavior, and sleep. The study also evaluated the feasibility of the methods for the SUNRISE study. Methods: Five kindergartens were recruited from urban and rural areas in Tunisia. Physical activity and sleep duration were assessed using a waist-worn ActiGraph. Screen time and sleep quality were assessed via an interview-administered parent questionnaire. The NIH Toolbox was used. Results: A total of 112 preschoolers were assessed (50 boys, age = 4.1 [0.58]). Only 18% of children met all recommendations of the World Health Organization guidelines, while 53% met the sedentary screen time (in minutes per day), and 41% met physical activity recommendation (in minutes per day). Eighty-one percent of children met the sleep duration recommendation (in minutes per day). There was good compliance with the ActiGraph protocol. Conclusions: This pilot study provided important insights into the feasibility of the study and the movement behaviors of Tunisian preschool children. The results suggest there is a need to promote healthy levels of physical activity and sedentary screen time in children, which should be a priority in public health initiatives, including preschool curricula, in Tunisia.
The Experiences of Women Leaders in the Higher Education Sport Sector: Examining the Gendered Organization Through Bourdieu’s Model of Field, Capital and Habitus
Authors: Naidu-Young Shamira , May Anthony , Pope Stacey , Gérard Simon
Published: February 2024

This article is the first to examine experiences of women with leadership roles in the U.K. Higher Education sport sector. We carried out detailed interviews with women leaders. We utilized Bourdieu’s model of habitus, capital, and field; Acker’s concept of “gendered organizations;” and Shilling’s concept of physical capital. Our findings show Higher Education operates more inclusively than the wider sport sector, which has the potential to advance gender equality. However, gendered practices remain with women working harder to accumulate and convert capital. Motherhood negatively impacts conversion of capital and respondents without children felt this benefitted their career. Finally, we discuss the impact of menopause on the careers of women and suggest this can impact self-perception.
Glycolytic state of aortic endothelium favors hematopoietic transition during the emergence of definitive hematopoiesis
Authors: PV Anu , Mehatre Shubham Haribhau , Verfaillie Catherine M. , Alam Mohammad Tauqeer , Khurana Satish
Published: February 2024

The first definitive hematopoietic progenitors emerge through the process of endothelial-to-hematopoietic transition in vertebrate embryos. With molecular regulators for this process worked out, the role of metabolic pathways used remains unclear. Here, we performed nano–LC-MS/MS–based proteomic analysis and predicted a metabolic switch from a glycolytic to oxidative state upon hematopoietic transition. Mitochondrial activity, glucose uptake, and glycolytic flux analysis supported this hypothesis. Systemic inhibition of lactate dehydrogenase A (LDHA) increased oxygen consumption rate in the hemato-endothelial system and inhibited the emergence of intra-aortic hematopoietic clusters. These findings were corroborated using
Tie2-Cre
–mediated deletion of
Ldha
that showed similar effects on hematopoietic emergence. Conversely, stabilization of HIF-1α via inhibition of oxygen-sensing pathway led to decreased oxidative flux and promoted hematopoietic emergence in mid-gestation embryos. Thus, cell-intrinsic regulation of metabolic state overrides oxygenated microenvironment in the aorta to promote a glycolytic metabolic state that is crucial for hematopoietic emergence in mammalian embryos.
Antibacterial activity of ibezapolstat against antimicrobial-resistant clinical strains of
Clostridioides difficile
Authors: Bassères Eugénie , Eubank Taryn A. , Begum Khurshida , Alam M. Jahangir , Jo Jinhee , Le Thanh M. , Lancaster Chris K. , Gonzales-Luna Anne J. , Garey Kevin W.
Published: February 2024

Antimicrobial resistance is emerging in clinical strains of
Clostridioides difficile
. Ibezapolstat (IBZ) is a DNA polymerase IIIC inhibitor that has completed phase II clinical trials. IBZ has potent
in vitro
activity against wild-type, susceptible strains but its effect on
C. difficile
strains with reduced susceptibility to metronidazole (MTZ), vancomycin (VAN), or fidaxomicin (FDX) has not been tested. The primary objective of this study was to test the antibacterial properties of IBZ against multidrug-resistant
C. difficile
strains. The
in vitro
activity, bactericidal, and time-kill activity of IBZ versus comparators were evaluated against 100 clinical strains of which 59 had reduced susceptibility to other
C. difficile
antibiotics. Morphologic changes against a multidrug resistance strain were visualized by light and scanning electron microscopy. The overall IBZ MIC
50/90
values (µg/mL) for evaluated
C. difficile
strains were 4/8, compared with 2/4 for VAN, 0.5/1 for FDX, and 0.25/4 for MTZ. IBZ MIC
50/90
values did not differ based on non-susceptibility to antibiotic class or number of classes to which strains were non-susceptible. IBZ bactericidal activity was similar to the minimum inhibitory concentration (MIC) and maintained in wild-type and non-susceptible strains. Time-kill assays against two laboratory wild-type and two clinical non-susceptible strains demonstrated sustained IBZ activity despite reduced killing by comparator antibiotics for IBZ and VAN non-susceptible strains. Microscopy visualized increased cell lengthening and cellular damage in multidrug-resistant strains exposed to IBZ sub-MIC concentrations. This study demonstrated the potent antibacterial activity of IBZ against a large collection of
C. difficile
strains including multidrug-resistant strains. This study highlights the therapeutic potential of IBZ against multidrug-resistant strains of
C. difficile
.
Drug-induced stress mediates
Plasmodium falciparum
ring-stage growth arrest and reduces
in vitro
parasite susceptibility to artemisinin
Authors: Platon Lucien , Leroy Didier , Fidock David A. , Ménard Didier
Published: February 2024

During blood-stage infection,
Plasmodium falciparum
parasites are constantly exposed to a range of extracellular stimuli, including host molecules and drugs such as artemisinin derivatives, the mainstay of artemisinin-based combination therapies currently used as first-line treatment worldwide. Partial resistance of
P. falciparum
to artemisinin has been associated with mutations in the propeller domain of the
Pfkelch13
gene, resulting in a fraction of ring stages that are able to survive exposure to artemisinin through a temporary growth arrest. Here, we investigated whether the growth arrest in ring-stage parasites reflects a general response to stress. We mimicked a stressful environment
in vitro
by exposing parasites to chloroquine or dihydroartemisinin (DHA). We observed that early ring-stage parasites pre-exposed to a stressed culture supernatant exhibited a temporary growth arrest and a reduced susceptibility to DHA, as assessed by the ring-stage survival assay, irrespective of their
Pfkelch13
genotype. These data suggest that temporary growth arrest of early ring stages may be a constitutive,
Pfkelch13
-independent survival mechanism in
P. falciparum
.

IMPORTANCE

Plasmodium falciparum
ring stages have the ability to sense the extracellular environment, regulate their growth, and enter a temporary growth arrest state in response to adverse conditions such as drug exposure. This temporary growth arrest results in reduced susceptibility to artemisinin
in vitro
. The signal responsible for this process is thought to be small molecules (less than 3 kDa) released by stressed mature-stage parasites. These data suggest that Pfkelch13-dependent artemisinin resistance and the growth arrest phenotype are two complementary but unrelated mechanisms of ring-stage survival in
P. falciparum
. This finding provides new insights into the field of
P. falciparum
antimalarial drug resistance by highlighting the extracellular compartment and cellular communication as an understudied mechanism.
Cultivar was more influential than bacterial strain and other experimental factors in recovery of
Escherichia coli
O157:H7 populations from inoculated live Romaine lettuce plants
Authors: Ding Qiao , Gu Ganyu , Nou Xiangwu , Micallef Shirley A.
Published: February 2024

The varied choice of bacterial strain, plant cultivar, and method used to inoculate, retrieve, and enumerate
Escherichia coli
O157:H7 from live plants could affect comparability among studies evaluating lettuce–enterobacterial interactions. Cultivar, bacterial strain, incubation time, leaf side inoculated, and sample processing method were assessed for their influence in recovering and quantifying
E. coli
O157:H7 from live Romaine lettuce. Cultivar exerted the strongest effect on
E. coli
O157:H7 counts, which held up even when cultivar was considered in interactions with other factors. Recovery from the popularly grown green Romaine “Rio Bravo” was higher than from the red variety “Outredgeous.” Other modulating variables were incubation time, strain, and leaf side inoculated. Sample processing method was not significant. Incubation for 24 hours post-lettuce inoculation yielded greater counts than 48 hours, but was affected by lettuce cultivar, bacterial strain, and leaf side inoculated. Higher counts obtained for strain EDL933 compared to a lettuce outbreak strain 2705C emphasized the importance of selecting relevant strains for the system being studied. Inoculating the abaxial side of leaves gave higher counts than adaxial surface inoculation, although this factor interacted with strain and incubation period. Our findings highlight the importance of studying interactions between appropriate bacterial strains and plant cultivars for more relevant research results, and of standardizing inoculation and incubation procedures. The strong effect of cultivar exerted on the
E. coli
O157:H7-lettuce association supports the need to start reporting cultivar information for illness outbreaks to facilitate the identification and study of plant traits that impact food safety risk.

IMPORTANCE

The contamination of Romaine lettuce with
Escherichia coli
O157:H7 has been linked to multiple foodborne disease outbreaks, but variability in the methods used to evaluate
E. coli
O157:H7 association with live lettuce plants complicates the comparability of different studies. In this study, various experimental variables and sample processing methods for recovering and quantifying
E. coli
O157:H7 from live Romaine lettuce were assessed. Cultivar was found to exert the strongest influence on
E. coli
O157:H7 retrieval from lettuce. Other modulating factors were bacterial incubation time on plants, strain, and leaf side inoculated, while sample processing method had no impact. Our findings highlight the importance of selecting relevant cultivars and strains, and of standardizing inoculation and incubation procedures, in these types of assessments. Moreover, results support the need to start reporting cultivars implicated in foodborne illness outbreaks to facilitate the identification and study of plant traits that impact food safety risk.
Nanobody engineering for SARS-CoV-2 neutralization and detection
Authors: Hannula Liina , Kuivanen Suvi , Lasham Jonathan , Kant Ravi , Kareinen Lauri , Bogacheva Mariia , Strandin Tomas , Sironen Tarja , Hepojoki Jussi , Sharma Vivek , Saviranta Petri , Kipar Anja , Vapalahti Olli , Huiskonen Juha T. , Rissanen Ilona
Published: February 2024

In response to the ongoing COVID-19 pandemic, the quest for coronavirus inhibitors has inspired research on a variety of small proteins beyond conventional antibodies, including robust single-domain antibody fragments, i.e., “nanobodies.” Here, we explore the potential of nanobody engineering in the development of antivirals and diagnostic tools. Through fusion of nanobody domains that target distinct binding sites, we engineered multimodular nanobody constructs that neutralize wild-type SARS-CoV-2 and the Alpha and Delta variants at high potency, with IC
50
values as low as 50 pM. Despite simultaneous binding to distinct epitopes, Beta and Omicron variants were more resistant to neutralization by the multimodular nanobodies, which highlights the importance of accounting for antigenic drift in the design of biologics. To further explore the applications of nanobody engineering in outbreak management, we present an assay based on fusions of nanobodies with fragments of NanoLuc luciferase that can detect sub-nanomolar quantities of the SARS-CoV-2 spike protein in a single step. Our work showcases the potential of nanobody engineering to combat emerging infectious diseases.

IMPORTANCE

Nanobodies, small protein binders derived from the camelid antibody, are highly potent inhibitors of respiratory viruses that offer several advantages over conventional antibodies as candidates for specific therapies, including high stability and low production costs. In this work, we leverage the unique properties of nanobodies and apply them as building blocks for new therapeutic and diagnostic tools. We report ultra-potent SARS-CoV-2 inhibition by engineered nanobodies comprising multiple modules in structure-guided combinations and develop nanobodies that carry signal molecules, allowing rapid detection of the SARS-CoV-2 spike protein. Our results highlight the potential of engineered nanobodies in the development of effective countermeasures, both therapeutic and diagnostic, to manage outbreaks of emerging viruses.
Supplemental Material: Magnetite-apatite ores record widespread involvement of molten salts
Authors: Xu Xinyue , Steele-MacInnis Matthew , al. et
Published: February 2024

Materials and methods, geologic settings, results, Figures S1–S21, and Tables S1–S2.  
Post-COVID-19 condition at 6 months and COVID-19 vaccination in non-hospitalised children and young people
Authors: Pinto Pereira Snehal M , Nugawela Manjula D , Rojas Natalia K , Shafran Roz , McOwat Kelsey , Simmons Ruth , Ford Tamsin , Heyman Isobel , Ladhani Shamez N , Cheung Emily Y , Fox-Smith Lana , Dalrymple Emma , Stephenson Terence
Published: February 2024

Objectives

To describe the physical and mental health of children and young people (CYP) 6 months after infection with SARS-CoV-2 and explore whether this varies by COVID-19 vaccination.

Design

A non-hospitalised, national cohort of people aged 11–17 years old with PCR-confirmed SARS-CoV-2 infection and PCR negatives matched at study invitation, by age, sex, region and date of testing who completed questionnaires 6 months after PCR testing. The questionnaire included 21 symptoms and standardised scales (eg, EQ-5D-Y and Chalder Fatigue Scale).

Results

6407 test-positive and 6542 test-negative CYP completed the 6-month questionnaire: 60.9% of test-positive vs 43.2% of test-negative CYP reported at least one symptom 6 months post-test; 27.6% of test-positive vs 15.9% of test-negative CYP reported 3+ symptoms. Common symptoms at 6 months were tiredness and shortness of breath among both test-positive and test-negative CYP; however, the prevalence of both was higher in test-positive (38.4% and 22.8%, respectively) compared with test-negative CYP (26.7% and 10.9%, respectively). 24.5% test-positive vs 17.8% test-negative CYP met the Delphi research definition of long COVID. Mental health, well-being, fatigue and health-related quality of life scores were similar among test-positive and test-negative CYP 6 months post-test. Similarly, symptomatology was similar among COVID-19-vaccinated and COVID-19-unvaccinated test-positive and test-negative CYP.

Conclusions

Six-months post-PCR testing, CYP who tested positive for SARS-CoV-2 had similar symptoms to those who tested negative, but test-positive CYP had higher symptom prevalence. Mental health, well-being, fatigue and health-related quality of life were similar among test-positive and test-negative CYP, and symptoms at 6 months were similar in COVID-19 vaccinated and unvaccinated.

Trial registration number

ISRCTN 34804192.
Continuous 24-hour intraocular pressure monitoring in normal Chinese adults using a novel contact lens sensor system
Authors: Zhang Yuning , Wei Yifan , Lee Ching Hymn Christopher , OR Ping Wai , Karunaratne Isuru Kaweendra , Deng Mingjie , Yang Wenxin , Chong Iok Tong , Yang Yangfan , Chen Zidong , Fan Yanmei , Lam David C C , Yu Minbin
Published: February 2024

Aims

To investigate the physiological nyctohemeral intraocular pressure (IOP) rhythms of normal Chinese adults using a novel contact lens sensor system (CLS) that can output IOP in millimetres of mercury (mm Hg) continuously.

Methods

Fifty-nine eyes of 59 normal Chinese adults completed 24-hour IOP monitoring using the novel CLS. A descriptive analysis was conducted on the 24-hour IOP mean, peak and acrophase, trough and bathyphase, fluctuation, and mean amplitude of intraocular pressure excursion (MAPE). The continuous data were analysed at several periods (diurnal period, 08:00–20:00 hours; nocturnal period, 22:00–06:00 hours; sleep time, 0:00–06:00 hours), and compared between right and left eyes, males and females, and different age ranges (<30, and ≥30), respectively.

Results

Normal adults had a lower peak, higher trough, smaller fluctuation and smaller MAPE (p<0.05 for all comparisons) but non-significantly different mean (p=0.695) in the nocturnal period or sleep time compared with the diurnal period. The 24-hour IOP peak and trough showed the frequency of occurrence ranging from 1.69% to 15.25% at an interval of 2 hours. No IOP parameter showed significant difference between right and left eyes (p>0.1 for all comparisons). The male group had larger 24-hour and diurnal IOP fluctuation and MAPE (p<0.05 for all comparisons). Subjects aged 30 or over had higher 24-hour and diurnal mean, higher peak, and larger MAPE (p<0.05 for all comparisons).

Conclusion

Continuous 24-hour IOP output from the CLS in normal Chinese was stable with a comparable mean level between day and night, as well as scattered acrophase and bathyphase. The 24-hour IOP mean increased with age, and IOP variations were positively correlated to age and male sex.
Increased incidence of adult gonococcal keratoconjunctivitis at two tertiary eye hospitals in Western Europe: clinical features, complications and antimicrobial susceptibility
Authors: Milligan Alice L , Randag Anna C , Lekkerkerk Sybren , Fifer Helen
Published: February 2024

Background

Gonorrhoea is on the rise: between 2021 and 2022, a 50% and a 33% increase in diagnoses was seen, respectively, in England and the Netherlands. A concurrent rise in gonococcal keratoconjunctivitis (GKC) is a serious concern due to the potentially devastating visual complications.

Methods

This is a retrospective case series of adult GKC from two Western European tertiary ophthalmology centres between 2017 and July 2023. The clinical features, ocular complications and antimicrobial susceptibilities are reported within.

Results

An increased incidence was recorded at both centres, with 11 confirmed cases in the first 7 months of 2023, compared with ≤3 per year in 2017–2022.

Conclusion

The notable increase of GKC cases in our centres in 2023 may indicate a rise across Western Europe. Enhanced, sustained, national surveillance of GKC is essential to establish incidence and antimicrobial susceptibility, to inform treatment guidelines and guide appropriate public health response.
Characteristics and outcomes of patients with COVID-19 who return to the emergency department: a multicentre observational study by the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN)
Authors: Rosychuk Rhonda J , Khangura Jaspreet K , Ortiz Sylvia S , Cheng Ivy , Bielska Iwona A , Yan Justin , Morrison Laurie J , Hayward Jake , Grant Lars , Hohl Corinne M
Published: February 2024

Objective

Unplanned return emergency department (ED) visits can reflect clinical deterioration or unmet need from the original visit. We determined the characteristics and outcomes of patients with COVID-19 who return to the ED for COVID-19-related revisits.

Methods

This retrospective observational study used data for all adult patients visiting 47 Canadian EDs with COVID-19 between 1 March 2020 and 31 March 2022. Multivariable logistic regression assessed the characteristics associated with having a no return visit (SV=single visit group) versus at least one return visit (MV=return visit group) after being discharged alive at the first ED visit.

Results

39 809 patients with COVID-19 had 44 862 COVID-19-related ED visits: 35 468 patients (89%) had one visit (SV group) and 4341 (11%) returned to the ED (MV group) within 30 days (mean 2.2, SD=0.5 ED visit). 40% of SV patients and 16% of MV patients were admitted at their first visit, and 41% of MV patients not admitted at their first ED visit were admitted on their second visit. In the MV group, the median time to return was 4 days, 49% returned within 72 hours. In multivariable modelling, a repeat visit was associated with a variety of factors including older age (OR=1.25 per 10 years, 95% CI (1.22 to 1.28)), pregnancy (1.86 (1.46 to 2.36)) and presence of comorbidities (eg, 1.72 (1.40 to 2.10) for cancer, 2.01 (1.52 to 2.66) for obesity, 2.18 (1.42 to 3.36) for organ transplant), current/prior substance use, higher temperature or WHO severe disease (1.41 (1.29 to 1.54)). Return was less likely for females (0.82 (0.77 to 0.88)) and those boosted or fully vaccinated (0.48 (0.34 to 0.70)).

Conclusions

Return ED visits by patients with COVID-19 within 30 days were common during the first two pandemic years and were associated with multiple factors, many of which reflect known risk for worse outcomes. Future studies should assess reasons for revisit and opportunities to improve ED care and reduce resource use.

Trial registration number

ClinicalTrials.gov,NCT04702945.