bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of model-overfit on model-assisted forest inventory in boreal forests with remote sensing data
Authors: Cosenza Diogo N , Saarela Svetlana , Strunk Jacob , Korhonen Lauri , Maltamo Matti , Packalen Petteri
Published: November 2024

While remote sensing can be an effective tool in building a forest inventory, field measurements and model fitting can be both expensive and challenging. One strategy to reduce forest inventory costs is to leverage forest inventory models fitted to a different population (external models), although the effectiveness of external models is poorly understood. One concern is that models may predict well to the sample data, but poorly to the population—which is termed ‘overfitting’. The effect of overfit may be especially problematic in attempts to predict for a different population (a forest area not covered by any sample plots). Assessing overfit is difficult and its consequence for estimation are not well understood, especially in the context of prediction using external models. This study assesses how overfitting affects model-assisted forest inventory estimation when using internal and external models. We used field and remotely sensed data (Sentinel-2 images and airborne laser scanning data) from two forest areas in Finland. We evaluated four modeling approaches: ordinary least square regression (OLS), random forest, k-nearest neighbors, and gaussian process regression. Both analytical and bootstrap variance estimators were used to evaluate model-assisted estimation performance. Internal models, especially OLS, were the most affected by model overfitting, leading to bias in the population means and underestimation of variance. Estimates using external models provided unbiased means and realistic intervals except in the case of deliberate excessive overfitting. The bootstrap variance estimator was found to be more robust to overfit than the analytical variance estimator for the internal model, but was not helpful for the external model. Internal models should be parsimonious to generalize well to the population and avoid bias. The bootstrap estimator of variance is recommended for internal models, especially if there is concern about model overfitting.
The effect of health education on symptom severity in patients with fibromyalgia: a systematic review and meta-analysis
Authors: Huang Huan-Xi , Apriliyasari Renny Wulan , Tsai Pei-Shan
Published: November 2024

Fibromyalgia (FM) is a complex chronic disorder characterized by widespread pain as the primary symptom. To evaluate the effect of health education on the severity of various symptoms in patients with FM, seven databases were searched from inception to August 2024 to identify randomized controlled trials evaluating the effects of health education for FM. The primary outcome was overall symptom severity, and the secondary outcomes were pain, depression, anxiety, sleep quality, fatigue, physical function and self-efficacy. The Cochrane Risk-of-Bias tool for randomized trials and the Grading of Recommendations, Assessment, Development, and Evaluations were used to assess the quality of the included studies and the certainty of evidence, respectively. Treatment effects were estimated by calculating Hedges’ g and the corresponding 95% confidence intervals. Meta-analysis included a total of 13 trials. The results revealed that health education significantly reduced overall symptom severity, depression and anxiety and increased sleep quality and physical function among patients with FM (all P values < 0.05). However, no significant effects were observed on pain, fatigue and self-efficacy. Health education may be a beneficial intervention for FM patients, particularly for mitigating symptom severity. Health-care providers should implement health education interventions to empower patients to effectively manage their symptoms.
Understanding the features and effectiveness of randomized controlled trials in reducing COVID-19 misinformation: a systematic review
Authors: Miri Arman , Karimi-Shahanjarini Akram , Afshari Maryam , Bashirian Saeed , Tapak Leili
Published: November 2024

This systematic review aimed to assess the features and effectiveness of individual-level randomized controlled trials targeting COVID-19 misinformation. The selection process included rigorous criteria, resulting in the inclusion of 24 individual studies from 21 papers. The majority of studies were conducted in high-income countries, with the accuracy/credibility of information as the primary outcome. Debunking and boosting interventions were the most common interventions while nudging and content labeling interventions were examined in a few studies. This study highlights that further research is needed to enhance the effectiveness of boosting strategies and to explore the impact of combined interventions. Addressing bias concerns and standardizing intervention assessment measures will contribute to the development of evidence-based approaches in this critical area.
Performance evaluation of a fully automated deep sequencing platform for hepatitis B genotyping and resistance testing
Authors: Ortonne Valérie , Bouvier-Alias Magali , Vo-Quang Erwan , Cappy Pierre , Ingiliz Patrick , Leroy Vincent , Pawlotsky Jean-Michel , Chevaliez Stéphane
Published: November 2024

Background

Treatment of chronic hepatitis B infection requires lifelong administration of nucleos(t)ide analogues with a high barrier to resistance and effective viral suppression. The major limitation of lifelong therapy is the possible selection of drug-resistant hepatitis B virus (HBV) strains. International Liver Society guidelines recommend that hepatitis B resistance testing must be performed by a reference laboratory.

Objectives

Performance of the deep sequencing-based ViroKey® SQ FLEX Genotyping Assay for the determination of HBV genotypes and resistance profiles were evaluated.

Patients and methods

Plasma samples collected from patients with chronic hepatitis B have been sequenced by two methods including Sanger (population) sequencing of a portion of the P/S overlapping gene and the deep sequencing-based ViroKey® SQ FLEX Genotyping Assay (Vela Diagnostics).

Results

A high concordance rate with population sequencing was found regardless of HBV genotypes. Deep sequencing with the Sentosa platform was more sensitive than population sequencing in detecting minor variant populations.

Conclusions

The deep sequencing-based ViroKey® SQ FLEX Genotyping Assay can be confidently used in clinical practice for hepatitis B genotyping and resistance testing.
External validation of the Epic sepsis predictive model in 2 county emergency departments
Authors: Ostermayer Daniel G , Braunheim Benjamin , Mehta Amit M , Ward Jeremy , Andrabi Sara , Sirajuddin Anwar Mohammad
Published: November 2024

Objective

To describe the diagnostic characteristics of the proprietary Epic sepsis predictive model best practice advisory (BPA) alert for physicians in the emergency department (ED).

Materials and Methods

The Epic Sepsis Predictive Model v1.0 (ESPMv1), a proprietary algorithm, is intended to improve provider alerting of patients with a likelihood of developing sepsis. This retrospective cohort study conducted at 2 county EDs from January 1, 2023 to December 31, 2023 evaluated the predictive characteristics of the ESPMv1 for 145 885 encounters. Sepsis was defined according to the Sepsis-3 definition with the onset of sepsis defined as an increase in 2 points on the Sequential Organ Function Assessment (SOFA) score in patients with the ordering of at least one blood culture and antibiotic. Alerting occurred at an Epic recommended model threshold of 6.

Results

The ESPMv1 BPA alert was present in 7183 (4.9%) encounters of which 2253 had sepsis, and not present in 138 702 encounters of which 3180 had sepsis. Within a 6-hour time window for sepsis, the ESPMv1 had a sensitivity of 14.7%, specificity of 95.3%, positive predictive value of 7.6%, and negative predictive value of 97.7%. Providers were alerted with a median lead time of 0 minutes (80% CI, −6 hours and 42 minutes to 12 hours and 0 minutes).

Discussion

In our population, the ESPMv1 alerted providers with a median lead time of 0 minutes (80% CI, −6 hours and 42 minutes to 12 hours and 0 minutes) and only alerted providers in half of the cases prior to sepsis occurrence. This suggests that the ESPMv1 alert is adding little assistance to physicians identifying sepsis. With clinicians treating sepsis 50% of the time without an alert, pop-ups can only marginally assist in disease identification.

Conclusions

The ESPMv1 provides suboptimal diagnostic characteristics for undifferentiated patients in a county ED.
“I Learned as I Went”: an online distance education case study
Authors: Meek David R , Skyer Michael E , Donaldson Maggie M
Published: November 2024

Interactions between deaf and hard of hearing (DHH) students and instructors in online distance education (ODE) increased exponentially during the COVID pandemic. To understand this phenomena, we conducted a comprehensive literature review about evolving ODE formats customized for deaf student’s needs. This literature shows increasing multimodal, multilingual, and interactive features. Next, we examined empirical data from a collective case study implemented to better understand ODE phenomena from the perspectives of DHH students and faculty in higher education. We used 4 data collection strategies: (1) in-depth, semi-structured faculty interviews, (2) observations of teaching-learning interactions, (3) focus-groups featuring undergraduate and graduate DHH students, and (4) curriculum document analyses. We coded the dataset using MAXQDA software and uncovered 10 triangulated themes; 4 focus on instructors, 4 center students, and 2 describe student–faculty interactions. Overall, this qualitative analysis is a particularizing account of our participant’s lifeworlds; however, we close with general recommendations for improving ODE practices through research.
Phenotypic homogenization and potential fitness constraints following non-native introgression in an endemic sportfish
Authors: Gunn Joe C , Clements Sarah J , Adams Grant , Sterling Edward M , Moore Michael J , Volkers Taylor N , Eggert Lori S
Published: November 2024

Introgressive hybridization may lead to contrasting evolutionary outcomes that are difficult to predict since they depend on the fitness effects of endogenous genomic interactions and environmental factors. Conservation of endemic biodiversity may be more effective with require direct measurement of introgressed ancestry and fitness in wild populations, especially for keystone taxa at risk of hybridization following species introductions. We assessed the relationship of non-native ancestry with growth and body condition in the basin-restricted Neosho Bass (Micropterus velox; NB), focussing on two streams in the NB native range that are admixed extensively with non-native Smallmouth Bass (M. dolomieu; SMB). We quantified the genetic composition of 116 fish from Big Sugar Creek (N = 46) and Elk River (N = 70) at 14 microsatellite loci. Using back-calculated total length-at-age estimated from sagittal otoliths, we assessed whether genetic ancestry explained variation in von Bertalanffy growth model parameters, accounting for sex and stream effects. We then assessed the relationship between ancestry and body condition. We found no differences in growth parameters by sex, stream, or ancestry, suggesting phenotypic homogenization which could be mediated by selection on body size. We found a negative correlation between SMB ancestry and condition, including lower condition in Big Sugar Creek, possibly reflecting a trade-off between maximum length and condition with respect to overall fitness. We show that ongoing non-native introgression, which may be augmented by anthropogenic SMB introductions, may attenuate evolutionary differentiation between species and directly influence fitness, possibly having critical implications for long-term persistence and management of adaptive potential in a popular and ecologically important endemic sportfish.
A larval expressed chemosensory protein involved in recognition of anthocyanins in Spodoptera litura (Lepidoptera: Noctuidae)
Authors: Dong Xiaolin , Huang Yaling , Pei Yanfang , Chen Ling , Tan Tianliang , Xiang Fayun , Li Chuanren , Fu Lijun
Published: November 2024

Anthocyanins are secondary metabolites which act as diverse functions during plant growth. Insects can discriminate host plants by their sensitive gustatory systems. It is hypothetical that chemosensory proteins (CSPs) play a crucial role in regulating this behavioral process. However, the underlying molecular mechanisms remain obscure. In the present study, we characterized a CSP SlitCSP8 from the Spodoptera litura (Fabricius) (Lepidoptera: Noctuidae). Quantitative real-time-polymerase chain reaction analysis demonstrated that SlitCSP8 was mainly expressed in the head of the 7th S. litura larvae, especially labrum. Further, recombinant SlitCSP8 was obtained using bacterial expression system. Fluorescence competitive binding assays demonstrated that the purified SlitCSP8 exhibited a strong binding affinity to anthocyanins, a natural compound derived from the host plant. Silencing SlitCSP8 through RNAi significantly reduced the sensitivity of S. litura larvae to anthocyanins-treated leaf disks, the development from larva to pupae was not affected. These data provide insight into the molecular basis that CSP8 can detect anthocyanins in host plants by chemosensory system of insects. It can be further used in designing novel optimal food attractant targeting to the CSPs for pest control.
Characterization of insecticide resistance and their mechanisms in field populations of the German cockroach (Blattodea: Ectobiidae) in Taiwan under different treatment regimes
Authors: Kruaysawat Panida , Chen Mei-Er , Lee Shao-Hung , Lee Chow-Yang , Neoh Kok-Boon
Published: November 2024

This study investigated how management strategies influence resistance profiles in German cockroach (Blattella germanica (L.)) populations and their impact on the performance of commercial gel baits containing fipronil, imidacloprid, and indoxacarb. Field populations from premises managed under 3 different strategies: Baiting, random insecticide (RI) used, and insecticide rotation (IR) were tested. Almost all populations under RI and IR were resistant to deltamethrin, but low to moderate resistance was observed under the Baiting approach. Cytochrome P450 monooxygenases (P450) were involved in deltamethrin resistance in these resistant populations. All individuals under Baiting and RI were homozygous for the L993F mutation, but the populations under IR lacked homozygous-resistant individuals. Eighty-three percent of field populations with complete homozygosity for the Rdl mutation displayed low mortality upon exposure to 3× LD95 fipronil. The effect of P450 and the Rdl mutation conferred high fipronil resistance in populations under the Baiting approach, recording moderate performance indices (PI) of 44–67 in fipronil bait. By contrast, those populations under RI and IR, in which involve glutathione S-transferases in fipronil resistance, had high PIs of 78–93. Almost 80% of populations exhibited over 90% mortality at 3× LD95 indoxacarb treatment, accompanied by high PIs of 90–100 in indoxacarb bait. Partial mortality from 1× LD95 imidacloprid occurred across all field populations due to the involvement of P450. PIs of imidacloprid bait ranged 5–57 and 20–94 in populations under RI and IR, respectively. Field populations demonstrate different resistance profiles depending on the treatment regimes, and the resistance mechanisms involved influenced gel bait’s effectiveness.
Public access to the register of the Unified Patent Court: unprecedented transparency with unfounded limitations
Authors: Galeotta Giorgia , Khuchua Tamar , Stierle Martin
Published: November 2024

This paper addresses the approach of the Court of Appeal of the Unified Patent Court (UPC) towards the principle of transparency focusing on the standards set for public access to written pleadings and evidence lodged at the UPC and recorded by its Registry. We argue that the UPC Court of Appeal shapes a concept of openness with its decision in the case Ocado v Stothers, which goes way beyond the known standards for public access to such documents in the major national forums for patent litigation in the European Union. Although this tendency is most welcome, at the same time, the Court of Appeal also limited the open access to documents in an unfounded manner by holding that the general interest of justice and public order can restrict the right to access and by requiring representation for access to court documents by the public.
The race for global FRAND rate setting: where does the Unified Patent Court stand?
Authors: Jagdev Rajvinder , Robinson Claire
Published: November 2024

In this article, we take stock of the Unified Patent Court (UPC)’s approach to fair, reasonable and non-discriminatory (FRAND) issues in its first 16 months of operation and place this in the context of the rapidly developing international FRAND jurisprudence, where cases are increasingly focusing on FRAND rate setting. As the number of standard-essential patent actions filed in the UPC grows, developments are occurring on an almost weekly basis.
Novo plant-based mosquito repellent shows promise for exclusion of Aedes mosquitoes from “window” entry
Authors: Yavasoglu Sare I , Wood Martyn J , Bull James C , Alkış Nergis , Doğan Emrecan , Alkhaibari Abeer M , Butt Tariq M
Published: November 2024

Mosquitoes threaten over half of the world’s population through vectored diseases such as malaria, zika, yellow fever, dengue, and chikungunya. Mosquitoes have a highly developed olfactory system attuned to chemotaxis relating to host-seeking, mating, and oviposition behavior. In this study, we aimed to determine the spatial efficacy of 2 plant-based repellent blends (Blend3 and Blend4 that had previously been found to successfully repel Aedes, Anopheles and Culex mosquitoes in wind tunnel assays) in excluding Aedes aegypti from the window entry. A new cage system was developed for parallel “no-choice” and “choice” olfactometric assays. In the no-choice trial, Blends 3 and 4, as well as commercial products (N, N-diethyl-3-methylbenzamide, p-menthane-3,8-diol [PMD], 3-(N-n-butyl-N-acetyl)-amino-propionic acid ethyl ester, and 2-(2-hydroxyethyl)-1-methylpropylstyrene 1-piperidine carboxylate), were adsorbed into filter papers of different sizes and placed in a window created between 2 attached bug dorms. Then, the number of mosquitoes entering the window was counted through a 6-min period. In choice olfactometric assays, Blends 3, 4, and PMD were adsorbed into filter paper and the number of mosquitoes moving away from Blend 3 and PMD were compared. No-choice assays showed that Blend3 (P < 0.001) and Blend4 (P = 0.0012) were more repellent than the best commercial product PMD. Additionally, while Blend 4 was significantly more repellent than Blend 3 (P = 0.012) in the choice assay, overall, these 2 blends show promise as new repellents for the spatial exclusion of Aedes aegypti from window entry alone or as part of a “push-pull’’ strategy.
Resolution of historically discordant Ames test negative/rodent carcinogenicity positive N-nitrosamines using a sensitive, OECD-aligned design
Authors: Thomas Dean N , Wills John W , Burman Mark , Williams Abbie N , Harte Danielle S G , Buckley Ruby A , Urquhart Mike W , Bretonnet Anne-Sophie , Jeffries Benjamin , White Angela T , Harvey James S , Howe Jonathan R , Lynch Anthony M
Published: November 2024

The in vitro bacterial reverse mutation (Ames) test is crucial for evaluating the mutagenicity of pharmaceutical impurities. For N-nitrosamines (NAs) historical data indicated that for certain members of this chemical class, the outcomes of the Ames test did not correlate with their associated rodent carcinogenicity outcomes. This has resulted in negative outcomes in an OECD (Organization for Economic Cooperation and Development)-aligned Ames test alone (standard or enhanced) no longer being considered sufficient by regulatory authorities to assess potential carcinogenic risk of NAs if present as impurities in drug products. Consequently, extensive follow-up in vivo testing can be required to characterize the potential mutagenicity and genotoxic carcinogenicity of NA impurities (i.e. beyond that defined in the ICH M7 guideline for non-NA impurities). We previously demonstrated that the mutagenicity of alkyl-nitrosamines can be detected by the appropriately designed, OECD-aligned Ames test and identified those conditions that contributed most to assay sensitivity. This OECD-aligned Ames test design was used to assess seven NAs, i.e. (methyl(neopentyl)nitrosamine, N-methyl-N-nitroso-2-propanamine, N-nitrosodiisopropylamine, bis(2-methoxyethyl)nitrosoamine, N-nitroso-N-methyl-4-fluoroaniline, dinitrosoethambutol, (R,R)- and mononitrosocaffeidine) that were reported to be negative in historical Ames tests but positive in rodent carcinogenicity studies. All seven of the NAs were demonstrated to be mutagenic in the OECD-aligned Ames test and therefore these compounds should no longer be considered as discordant (false negatives) with respect to the correlation of the Ames test and rodent carcinogenicity. These results confirm the sensitivity of the OECD-aligned Ames test for the detection of NA mutagenicity and provides further support of its pivotal placement within the ICH M7 framework for the assessment of mutagenic impurities in pharmaceuticals to limit potential carcinogenic risk. In addition, we present data for 1-cyclopentyl-4-nitrosopiperazine, that indicates it could serve as a suitable positive control to provide further confidence in the sensitivity of the Ames test for the NA chemical class.
Principles of ion binding to RNA inferred from the analysis of a 1.55 Å resolution bacterial ribosome structure – Part I: Mg2+
Authors: Leonarski Filip , Henning-Knechtel Anja , Kirmizialtin Serdal , Ennifar Eric , Auffinger Pascal
Published: November 2024

The importance of Mg2+ ions for RNA structure and function cannot be overstated. Several attempts were made to establish a comprehensive Mg2+ binding site classification. However, such descriptions were hampered by poorly modelled ion binding sites as observed in a recent cryo-EM 1.55 Å Escherichia coli ribosome structure where incomplete ion assignments blurred our understanding of their binding patterns. We revisited this model to establish general binding principles applicable to any RNA of sufficient resolution. These principles rely on the 2.9 Å distance separating two water molecules bound in cis to Mg2+. By applying these rules, we could assign all Mg2+ ions bound with 2–4 non-water oxygens. We also uncovered unanticipated motifs where up to five adjacent nucleotides wrap around a single ion. The formation of such motifs involves a hierarchical Mg2+ ion dehydration process that plays a significant role in ribosome biogenesis and in the folding of large RNAs. Besides, we established a classification of the Mg2+…Mg2+ and Mg2+…K+ ion pairs observed in this ribosome. Overall, the uncovered binding principles enhance our understanding of the roles of ions in RNA structure and will help refining the solvation shell of other RNA systems.
Structural basis of transcriptional regulation by UrtR in response to uric acid
Authors: Song Wan Seok , Ki Dong Uk , Cho Hye Yeon , Kwon Oh Hyun , Cho Hongbaek , Yoon Sung-il
Published: November 2024

Uric acid (UA)-responsive transcriptional regulators (UrtRs), which belong to the multiple antibiotic resistance regulator (MarR) superfamily, transcriptionally coordinate virulence and metabolism in bacteria by modulating interactions with operator DNA in response to UA. To elucidate the transcriptional regulatory mechanism of UrtR, we structurally analyzed UrtR proteins, including PecS, MftR, and HucR, alone and in complex with UA or DNA. UrtR contains a dimerization domain (DD) and a winged helix-turn-helix domain (wHTHD) and forms a homodimer primarily via the DD, as observed for other MarR superfamily proteins. However, UrtRs are characterized by a unique N-terminal α-helix, which contributes to dimerization and UA recognition. In the absence of UA, the UrtR dimer symmetrically binds to the operator double-stranded DNA (dsDNA) by inserting its α4 recognition helix and β-stranded wing within the wHTHD into the major and minor grooves of dsDNA, respectively. Upon exposure to UA, UrtR accommodates UA in the intersubunit pocket between the DD and wHTHD. UA binding induces a conformational change in the major groove-binding core element of the UrtR wHTHD, generating a DNA binding-incompatible structure. This local allosteric mechanism of UrtR completely differs from that generally observed in other MarR superfamily members, in which the entire wHTHD undergoes effector-responsive global shifts.
Effects of E-cigarettes on Combustible Cigarette Smoking Among Adults With Opioid Use Disorder on Buprenorphine: Single Arm ERASER Pilot Trial
Authors: Pericot-Valverde Irene , Heo Moonseong , Nahvi Shadi , Barron Justin , Voss Sarah , Ortiz Erik G , Gaalema Diann , Thrasher James F , Batchelder Abigail W , Byrne Kaileigh A , Kunkel Deborah , Litwin Alain H
Published: November 2024

Introduction

People with opioid use disorder (OUD) on buprenorphine smoke at high rates and have low cessation rates, even with evidence-based medications. Electronic cigarettes (EC) are a promising harm reduction strategy for combusted cigarette (CC) smokers unable to quit. Unfortunately, people with OUD are underrepresented in EC research.

Aims and Methods

A pilot study assessed the feasibility, acceptability, and preliminary effectiveness of EC as a harm reduction tool among CC smokers with OUD on buprenorphine (N = 30). Participants were provided with an EC and freebase nicotine liquid (6 mg/mL) with a choice of flavor and a brief training session. Research visits were scheduled in person at baseline, week 4, and week 8 (follow-up). Daily diary assessments were completed during the 4-week EC period.

Results

Most visits (>74%) and 61.4% of daily diary assessments were completed. During the 4-week study period, 90% of participants used the EC at least one day, 66.7% used the EC for at least 16 days, and 43.3% used the EC every day. Significant reductions were observed between baseline and both weeks 4 and 8 in cigarettes smoked per day (CPDbaseline = 16.2[8.3], CPDweek4 = 9.6[9.3], CPDweek8 = 8.4[8.3]) carbon monoxide (CO) levels (CObaseline = 21.5[15.0], COweek4 = 16.9[9.6], COweek8 = 15.7[10.0]), and nicotine dependence measured using the Fagerström Test for Nicotine Dependence (FTNDbaseline = 5.4[2.5], FTNDweek4 = 4.2[2.6], FTNDweek8 = 4.4[2.6]), with all p-values < .05.

Conclusions

Implementing an EC protocol in outpatient maintenance treatment programs is feasible and acceptable. Preliminary results suggest that ECs may facilitate reductions in cigarettes per day, CO levels, and nicotine dependence. Future research should explore the effect of prolonged EC use on harm reduction and cessation milestones.

Implications

EC are a potentially promising harm reduction strategy for adult CC smokers with OUD on buprenorphine who are unable to quit using evidence-based medications. However, previous studies have largely overlooked people with OUD on buprenorphine with recent drug use. This study addresses this gap through a pilot trial investigating the feasibility, acceptability, and preliminary effects of EC on CC behavior. The brief and standardized nature of the protocol and its implementation in outpatient settings highlights its potential for widespread implementation in facilities providing care to people with OUD on buprenorphine.
Evolution of stressors for healthcare workers over the COVID-19 pandemic
Authors: Labrèche F , Durand-Moreau Q , Adisesh A , Galarneau J- M , Ruzycki S M , Zadunayski T , Cherry N
Published: November 2024

Background

Many studies have documented exposure to psychosocial factors in healthcare workers (HCWs) during the coronavirus disease 2019 (COVID-19) pandemic. Few have done it prospectively with open-ended questions.

Aims

To describe the evolution of stress factors reported by HCWs during the pandemic.

Methods

A prospective cohort of 4964 HCWs (physicians, nurses, healthcare aides and personal support workers), from four Canadian provinces, received four online questionnaires between the spring 2020 and 2022. Responses to an open-ended question on stressful events were coded into 25 stressors. Multilevel logistic regressions assessed trends in stressors, and the effect of gender, occupation and age.

Results

In 2020, 91% of participants reported at least one stressor compared to 51% in spring 2022. Overall, eight stressors were reported 1000 times or more among 16 786 questionnaires. Five stressors decreased over time: fear of COVID-19, problems with personal protective equipment, changing guidelines, management of difficult cases and changes to work routine. Conversely, an increasing trend was noted for volume of work, and poor behaviour from the public or colleagues. Difficulties managing patients’ deaths remained steady. Changes in stressors over time were similar by gender, professional role and age group, although the reporting of some stressors varied within subgroups.

Conclusions

Reporting of most stressors decreased over the pandemic, except for stressors arising from the changing demands on staff and patients as the pandemic progressed. Such changes in workplace psychosocial factors need to be addressed by prevention programmes to ensure an appropriate support response to the needs of HCWs.
Working at home: Individual level drivers of MEPs’ focus on constituency work
Authors: Laloux Thomas , Laloux Clement
Published: November 2024

This article investigates how Members of the European Parliament (MEPs) allocate resources between their parliamentary and constituency work, focusing on their staffing decisions. Specifically, it examines the distribution of MEPs’ staff between accredited assistants, based in the European Parliament (EP), and local staff working in their constituency. The study seeks to explain why some MEPs allocate a larger share of their staff to constituency work compared to others by testing several hypotheses related to the individual characteristics of MEPs while controlling for variations across Member States. Using a newly developed database with data on MEP assistants at three points during the 9th EP, the analysis reveals that Member State differences do not solely explain the variation in staff distribution. While there is no evidence that staff allocation is driven by strategic considerations to secure re-election, it depends significantly on their ideology and past political experience.
A simplified Agrobacterium tumefaciens–mediated transformation protocol accelerates plant molecular breeding
Authors: Li Qianqian , Zhang Xingli , Li Haiyun , Zhang Huihui , Hao Hongyan , Yu Wenjie , Sun Jinbian , Fan Yinglun , Lyu Shanhua
Published: November 2024

An improved Agrobacterium tumefaciens–mediated genetic transformation protocol shortens the growth period by ∼6 to 9 wk.
Auditory processing up to cortex is maintained during sleep spindles
Authors: Jourde Hugo R , Coffey Emily B J
Published: November 2024

Sleep spindles are transient 11–16 Hz brain oscillations generated by thalamocortical circuits. Their role in memory consolidation is well established, but how they play a role in sleep continuity and protection of memory consolidation against interference is unclear. One theory posits that spindles or a neural refractory period following their offset act as a gating mechanism, blocking sensory information en route to the cortex at the level of the thalamus. An alternative model posits that spindles do not participate in the suppression of neural responses to sound, although they can be produced in response to sound. We present evidence from three experiments using electroencephalography and magnetoencephalography in humans that examine different evoked responses in the presence of and following sleep spindles. The results provide convergent empirical evidence suggesting that auditory processing up to cortex is maintained during sleep spindles, and their refractory periods.
Associations of mixed metals exposure with cognitive impairment risk: a cross-sectional study in Chinese adults
Authors: Wang Jierui , Wang Weixuan , Zheng Gang , Shi Fan , Wu Shouling , Zhang Yanshu
Published: November 2024

Background

Associations between exposure to single metals and cognitive impairment or related outcomes have been reported in many previous studies. However, co-exposure to more than one metal is common situation. In recent years, studies on the effects of exposure to multiple metals on cognitive impairment or related outcomes have increased, but remain very limited, with a focus on populations with occupational exposure to metals, children, and adolescents. The potential relationships between exposure to metal mixtures and risk of cognitive impairment in adults remain to be clarified.

Objective

To determine the associations between blood metal mixtures and cognitive impairment risk.

Methods

Inductively coupled plasma mass spectrometry (ICP-MS) was utilized to detect the blood levels of lead (Pb), iron (Fe), copper (Cu), calcium (Ca), magnesium (Mg), and zinc (Zn). Multivariable logistic regression and Bayesian kernel machine regression (BKMR) models were employed to assess the relationships of exposure to these blood metal mixtures with the risk of cognitive impairment.

Results

It was found that four metals (Pb, Fe, Cu, and Mg) were positively correlated with cognitive impairment in each single metal model. The association of Pb and Cu remained significant after adjusting for these six metals, with the odds ratios (95% confidence intervals) in the highest quartiles of 9.51 (4.41–20.54, p-trend <0.01) and 4.87 (2.17–10.95, p-trend <0.01), respectively. The BKMR models indicated that co-exposure levels of Ca, Cu, Fe, Mg, Pb, and Zn were related to increased risk of cognitive impairment at ≥25th percentile compared with median, and Pb and Cu mainly contributed to the joint effect. In addition, the interaction effects of Mg and Pb/Pb and Cu on the risk of cognitive impairment were observed.

Significance

Co-exposure of six metals (Pb, Fe, Cu, Ca, Mg, and Zn) increased the risk of cognitive impairment in Chinese adults, with Pb and Cu likely to have greater impact. Potential interaction effects of Mg and Pb, Pb and Cu on the risk of cognitive impairment may exist.
Temporal and regional variation in the use of biologic and targeted synthetic DMARDs for rheumatoid arthritis: a nationwide cohort study
Authors: Russell Mark D , Yang Zijing , Dooley Niamh , Gibson Mark , Zuckerman Benjamin , Adas Maryam A , Alveyn Edward , Patel Samir , Bechman Katie , Price Elizabeth , Gallagher Sarah , Coalwood Callum , Cope Andrew P , Norton Sam , Galloway James B
Published: November 2024

Objective

The objective of this study was to evaluate temporal and regional variation in biologic and targeted synthetic DMARD (b/tsDMARD) initiation for RA in England and Wales.

Methods

An observational cohort study was conducted for people with RA enrolled in the National Early Inflammatory Arthritis Audit (NEIAA) between May 2018 and April 2022 who had 12-month follow-up data available. Temporal trends in escalation to b/tsDMARDs within 12 months of initial rheumatology assessment were explored, including comparisons before and after publication (July 2021) of national guidelines that lowered the threshold for b/tsDMARD initiation to include moderate-severity RA. Case-mix–adjusted, mixed-effects regression was used to evaluate regional and hospital-level variation in b/tsDMARD initiation.

Results

Of 6098 RA patients with available follow-up, 508 (8.3%) initiated b/tsDMARDs within 12 months of initial assessment. b/tsDMARD escalation increased marginally towards the end of the study period (9.2% in May 2021/22); however, no significant differences were evident after guidelines were published permitting b/tsDMARD use for moderate-severity RA. The proportion of individuals escalated to b/tsDMARDs varied considerably between regions, ranging from 5.1% in Wales to 10.7% in North-West England. Following case-mix adjustment, the intraclass correlation (ICC) for hospitals within regions was 0.17, compared with a between-region ICC of 0.0, suggesting that the observable regional variation reflected hospital-level differences rather than systematic differences between regions themselves.

Conclusion

There is marked variation in escalation to b/tsDMARDs for people newly diagnosed with RA throughout England and Wales, despite a universal health-care system. These disparities must be addressed if we are to deliver equitable access to b/tsDMARDs, regardless of geography.
Rapid Evolution of Host Repertoire and Geographic Range in a Young and Diverse Genus of Montane Butterflies
Authors: Mo Shifang , Zhu Yaowei , Braga Mariana P , Lohman David J , Nylin Sören , Moumou Ashraf , Wheat Christopher W , Wahlberg Niklas , Wang Min , Ma Fangzhou , Zhang Peng , Wang Houshuai
Published: November 2024

Evolutionary changes in geographic distribution and larval host plants may promote the rapid diversification of montane insects, but this scenario has been rarely investigated. We studied the rapid radiation of the butterfly genus Colias, which has diversified in mountain ecosystems in Eurasia, Africa, and the Americas. Based on a data set of 150 nuclear protein-coding genetic loci and mitochondrial genomes, we constructed a time-calibrated phylogenetic tree of Colias species with broad taxon sampling. We then inferred their ancestral geographic ranges, historical diversification rates, and the evolution of host use. We found that the most recent common ancestor of Colias was likely geographically widespread and originated ~3.5 Ma. The group subsequently diversified in different regions across the world, often in tandem with geographic expansion events. No aspect of elevation was found to have a direct effect on diversification. The genus underwent a burst of diversification soon after the divergence of the Neotropical lineage, followed by an exponential decline in diversification rate toward the present. The ancestral host repertoire included the legume genera Astragalus and Trifolium but later expanded to include a wide range of Fabaceae genera and plants in more distantly related families, punctuated with periods of host range expansion and contraction. We suggest that the widespread distribution of the ancestor of all extant Colias lineages set the stage for diversification by isolation of populations that locally adapted to the various different environments they encountered, including different host plants. In this scenario, elevation is not the main driver but might have accelerated diversification by isolating populations.
La régulation des compétences juridictionnelles dans la CEMAC
Authors: Nkili Mbida Eugène Pascal Parfait
Published: November 2024

Le 23 décembre 2021, le Tribunal Administratif du Littoral a rendu le Jugement n°416/QD/2021 dans l’affaire AYINDA Germain contre Organe de Gestion de la Carte Rose CEMAC.

 Par cette décision, le juge national procède à la reconnaissance nationale d’un principe général du Droit CEMAC, celui de la séparation des fonctions entre la Cour de justice communautaire et les juridictions nationales. Pour cela, elle mobilise sa fonctionnalité communautaire issue de la subsidiarité juridictionnelle ontologique à l’ordre juridique de la CEMAC.

 Cependant, s’il s’agit d’une décision inédite par la symbolique juridique qu’elle contient, elle a aussi le mérite de révéler l’appropriation insuffisante du Droit CEMAC par les justiciables communautaires.
Species level hidden diversity within morphospecies: Anatolia-based evolution and cryptic species diversity in the Simulium (Wilhelmia) equinum species group (Diptera: Simuliidae)
Authors: Kaya Sarp , Fidan Ebru Ceren , Küçükyetim Merve , Şirin Davut Ümit
Published: November 2024

Cryptic species are black boxes of taxonomy and need to be addressed with an integrative taxonomic approach. Simulium (Diptera: Simuliidae) may contain a substantial amount of cryptic species diversity due to its large cross-continental distribution and habitat-based canalization in taxonomic characters. Except for Simulium sergenti, the following six species Simulium equinum, Simulium paraequinum, Simulium pseudequinum, Simulium turgaicum, Simulium balcanicum, and Simulium lineatum are the most widely distributed species of the subgenus Wilhelmia in the Palearctic region. However, the conspecific diversity and evolutionary history of these species are not yet well understood. In this study, therefore, we used mitochondrial COI and nuclear ITS1-2 sequences to perform species delimitation tests, and demographic and phylogeographic analyses to understand candidate species and evolutionary history of the seven species. While our results did not support the species status of S. balcanicum, S. turgaicum, and S. lineatum, it did suggest several candidate species within S. equinum and S. pseudequinum. Molecular clock analysis revealed that significant branching events occurred in the Pliocene, and demographic fluctuations in the populations occurred intensely during the Pleistocene. Overall, the results indicated that Anatolia has served as a significant refugium for ancestral haplotypes, and it is an important dispersal corridor between the eastern and western Palearctic for Wilhelmia species.
Outcome of Locking Plate Fixation Adjunctive to Intramedullary Rodding in Osteogenesis Imperfecta Patients
Authors: Shuhiamy Norsaidatul N.A. , Lee Wonik , Didi Faris I. , Song Mi Hyun , Shin Chang Ho , Cho Tae-Joon
Published: November 2024

Background:

An intramedullary rodding is the preferred fixation method in limb stabilization of OI patients. However, the intramedullary rod may not provide adequate fixation and rotational stability, especially in adolescents and adults. The incorporation of adjunctive plate fixation alongside intramedullary rodding has been introduced to enhance this stability, although its complications remain insufficiently understood. The goal of this study was to explore the outcomes of adjunctive plating in conjunction with intramedullary rodding for limb stabilization in OI patients, emphasizing the complications related to the plates during the healing phase and following plate removal.

Methods:

This retrospective study examined 74 limb segments from 45 patients with OI who underwent intramedullary rodding and adjunctive plating from 2008 to 2022. Criteria for inclusion comprised surgical treatment followed by a minimum of 2 years of follow-up or complication before that time point. The need for adjunctive plating arose from inadequate fixation, rotational instability, and persistent cortical gaps with intramedullary rodding alone. Medical records and follow-up radiographs were reviewed to assess the healing of the target lesion and any complications.

Results:

The study encompassed 30 males and 15 females, ranging in age from 4 to 38 years, with 51 femoral and 23 tibial segments receiving treatment. Union was successfully achieved in 63 cases (85.3%), with an average union time of 14.4 months. Plates were subsequently removed in 62 cases after an average duration of 18.0 months. Before union, 11 revision surgeries were performed in 4 peri-implant fractures, 1 screw pull-out, and 6 failure of union. One sustained peri-implant fracture after the union. Following the removal of plates, complications included 10 refractures at screw sites, 3 progressive angulations at the previously targeted lesions, and 1 osteomyelitis. Kaplan-Meier analysis revealed that half of the refractures occurred within 1.8 years postplate removal. The overall complication showed borderline significance (P=0.056) among age groups. All the plate-related complications occurred at the diaphyseal, unicortical screws.

Conclusions:

Plate fixation, when used as an adjunct to intramedullary rodding, effectively stabilizes limbs in OI patients when intramedullary rods alone are inadequate. Nevertheless, given the significant risks associated with plate-related complications, adjunctive plating should be employed selectively only in instances where the union is unlikely to be achieved with intramedullary rodding alone.

Level of Evidence:

Level IV—case series.
Risk Factors for Postoperative Shoulder Imbalance in Patients With Lenke Type 1 and 2 Scoliosis Treated Using the Vertebral Coplanar Alignment Technique
Authors: Shimura Arihisa , Nojiri Hidetoshi , Ishijima Muneaki , Moridaira Hiroshi , Arai Hidekazu , Takada Satoshi , Yamada Katsutaka , Kondo Naoya , Morino Tadao , Nakamura Eiichiro , Tomori Masaki , Otani Kazuyuki , Akeda Koji , Nagai Takuya , Toyoda Hiromitsu , Ito Kenyu , Katayanagi Junya , Taneichi Hiroshi
Published: November 2024

Study Design.

This was a multicenter retrospective cohort study.

Objective.

We investigated the incidence of postoperative shoulder imbalance (PSI) and its risk factors in patients with Lenke types 1 and 2 scoliosis corrected using vertebral coplanar alignment (VCA).

Summary of Background Data.

PSI in scoliosis affects patient quality of life. While other correction methods have reported a high correction rate for the main thoracic curve (MTC) in relation to PSI, this correlation has not been confirmed for the VCA technique.

Materials and Methods.

We studied 176 patients with Lenke types 1 and 2 scoliosis who underwent posterior corrective fusion surgery using the VCA technique at 11 institutions. At 2 years postoperatively, patients were divided into two groups based on radiographic shoulder height (RSH): PSI− (RSH<2 cm) and PSI+ (RSH ≥2 cm) groups. We analyzed the risk factors for PSI.

Results.

The overall incidence of PSI 2 years postoperatively was 11.4% (20/176), with 9.2% (11/119) and 15.8% (9/57) in patients with Lenke types 1 and 2, respectively. Contrary to a previous study, a high MTC correction rate did not emerge as a risk factor for PSI. Instead, preoperative left shoulder elevation, low postoperative thoracic kyphosis, greater T1 tilt, and high apical vertebral body-to-rib ratio were associated with PSI in patients with Lenke type 1. Preoperative left shoulder elevation and a low postoperative proximal thoracic curve (PTC) correction rate were identified as risk factors for PSI in patients with Lenke type 2.

Conclusion.

Our results suggest that proper PTC correction, rather than compromising MTC correction, may help prevent PSI in the VCA technique. This method is particularly advantageous for addressing Lenke type 1 scoliosis and yields favorable outcomes in shoulder balance. Patients with preoperative left shoulder elevation, especially Lenke type 2, are at high risk of developing PSI.

Level of Evidence.

Level 4.