bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultraviolet radiation inhibits mitochondrial bioenergetics activity
Authors: Perez Aline S. , Inada Natalia M. , Mezzacappo Natasha F. , Vollet‐Filho Jose D. , Bagnato Vanderlei S.
Published: October 2024

Mitochondria play an important role in cellular function, not only as a major site of adenosine triphosphate (ATP) production but also by regulating energy expenditure, apoptosis signaling, control of the cell cycle, cellular growth, cell differentiation, transportation of metabolites, and production of reactive oxygen species. Interaction with electromagnetic waves can lead to dysregulation or alterations in the patterns of energy activities in the mitochondria. Ultraviolet light (UV) can be found in sunlight and artificial sources, such as lamps. UV radiation can cause damage to DNA, proteins, and lipids. Besides that, UV radiation is largely used in microorganism disinfection. To establish possible alterations in mitochondrial bioenergetics, this study proposes to investigate the UV (at two distinct intervals) effects on isolated mitochondria from mice liver to obtain direct responses and selective permeability of the internal membrane information. UVA‐371 and UVC‐255 nm lamps were used to irradiate, at different doses varying from 22.5 to 756 mJ/cm2, isolated mitochondria samples. Mitochondrial respiration pathways were investigated by high‐resolution respirometry, and possible mitochondrial membrane damages were evaluated by mitochondrial swelling by spectrophotometer analysis. UVC irradiation results (in the higher dose) indicate decrease in 75% of mitochondrial bioenergetics capacity, such as limitation of oxidative phosphorylation in 60% and increased energy dissipation in 30%. Mitochondrial swelling experiments (spectrophotometer) indicated inner membrane damage, and consequently a loss of selective permeability. Direct correlation between irradiation and effect responses was observed, mitochondrial bioenergetics is severely affected by UVC radiation, but (UVA) radiation did not present bioenergetic alterations. These alterations can contribute to improving the knowledge behind the cell death mechanism in disinfection UV light and UV therapy such as phototherapy.
Different drought‐tolerance strategies of tree species to cope with increased water stress under climate change in a mixed forest
Authors: Aranda I. , Martin‐Benito D. , Sánchez‐Gómez D. , de Simón B. Fernández , Gea‐Izquierdo G.
Published: October 2024

Trees' functional strategies to cope with extreme drought are essential under climate change. In a mixed Mediterranean forest, we analyzed the functional strategy in response to drought of four co‐occurring species (Pinus pinea, Pinus pinaster, Juniperus oxycedrus, and Quercus ilex) during two years. Specifically, we assessed functional traits related to tree water status, leaf water relations, and gas exchange. Different trait‐syndrome metrics and the functional strategies under water stress observed suggested a species drought‐tolerance differentiation, with the more anysohidric Q. ilex and J. oxycedrus showing a much higher drought tolerance than the more isohydric P. pinea and P. pinaster. All species recovered from negative leaf turgor reached during peak water stress in summer. Q. ilex and J. oxycedrus kept lower leaf osmotic potentials and lower sensitivity of leaf gas exchange and leaf photochemistry to water stress. In contrast, the pine species exhibited more drought‐avoidant and water‐conservative strategies, yet this behavior was less effective in mitigating water stress's impact on their physiology. The pine species were the most affected by drought, with prolonged near‐zero net photosynthesis during summer. P. pinaster was more isohydric than P. pinea and exhibited a lower capacity to maintain leaf turgor. Physiological processes regulating leaf turgor under drought constitute a key functional strategy involved in the carbon and water‐related mechanisms, ultimately inducing mortality under hot drought. The currently observed mortality dynamics for P. pinaster, and to a lower extent in P. pinea, may be exacerbated by loss of functional homeostasis.
When “symbolic” policy is anything but: Policy design and feedbacks from California's human right to water law
Authors: Rempel Jenny Linder , Dobbin Kristin Babson
Published: October 2024

Despite the reality that advocates frequently expend significant resources to pass symbolic policies, this policy design has often been neglected by policy studies scholarship. We combine policy design and policy feedback theory to examine this oft overlooked policy design in practice using the case of California's human right to water law (Assembly Bill 685, or AB 685). Through semi‐structured interviews, archival research, and document analysis, we reveal how grassroots advocates deliberately and effectively pursued AB 685 to build power across the water justice movement and catalyze narrative change about drinking water access, while also building state responsiveness on the topic. These interpretive policy feedback effects then accelerated the policy's resource effects through formal policy changes in funding allocations, administrative structures, and regulatory systems. Collectively, feedbacks from AB 685 have transformed the sociopolitics of drinking water access. Contrary to prevailing wisdom, the policy's ambiguity proved key to building the broad coalition necessary to accomplish these changes, and it facilitated work across policy venues and governance scales through time, which is critical to enacting transformational change. Based on these findings, we argue that symbolic policies merit attention as a potentially advantageous policy design for social movements seeking social change and transformation.
Non‐native invasive plants in tropical dry forests: a global review of presence, impacts, and management
Authors: Hardy Nora G. , Kuebbing Sara E. , Duguid Marlyse C. , Ashton Mark S. , Sheban Karam C. , Inman Seth E. , Martin Meredith P.
Published: October 2024

Tropical dry forests (TDF) are among the most‐threatened terrestrial ecosystems, experiencing ongoing conversion to agricultural fields, pasture, and human settlements. Human disturbances are often precursors to invasion of ecosystems by non‐native species, but research on invasion patterns in tropical ecosystems is sparse, and there is no comprehensive synthesis of invasive species in TDF. We conducted a review of published scientific literature to catalog and synthesize information about invasion by non‐native plants in TDF ecosystems across the globe, drawing out patterns in the invasion of these ecosystems. We found that 130 invasive plant species were documented as present in TDF, but only 25 of these species were mentioned in three or more articles. Almost all 25 of these more‐studied invasive species—mostly pasture grasses, woody legumes, and climbers—have been intentionally cultivated for agricultural or ornamental purposes. Many of these plants are native to open‐canopy savanna or forest edge habitats and benefit from human‐altered disturbance regimes (burning, grazing, and fuelwood and timber harvesting) of TDF fragments within agricultural landscapes. Field studies show that management approaches incorporating invasive removal, native plantings, and reduction in agricultural disturbance (e.g. ungulate fencing and fire control) simultaneously are often the most successful at reducing invasive plant cover. However, management studies in TDF have focused on a limited number of invasive species, and most were conducted in India and Hawaii. Global differences in TDF soils, natural fire regimes, and historic and current land use by humans influence modern biogeographic patterns of invasion and the feasibility of restoration options.
Multifunctionality, social benefits, and engagement: insights for forest restoration success from a study case in Brazil
Authors: da Silva Bruna A. , de Oliveira Renata E. , Domingues Tomas F.
Published: October 2024

Social, economic, and ecological aspects must be considered for ecological restoration projects to be successful. Multifunctionality, achieved when restored ecosystems have multiple uses, is the desired goal for these projects. Understanding people's perceptions of forest restoration is essential to advance the debate on stakeholder acceptance and engagement. Based on a 30‐year case study of forest restoration on a university campus in Brazil, we assessed (1) how project objectives relate to contemporary multifunctionality and social attributes; (2) how the current state of the forest meets social goals; and (3) how stakeholders perceive the importance of the forest and the project itself. We used documents, interviews, and questionnaires, applying content analysis and narrative interpretation with the “social benefits wheel” and the “five‐star social system” to assess how the initial project objectives corresponded to contemporary social development goals and its progress toward social goals. The results revealed that socioecological goals were incorporated from the beginning of the project, ensuring a multifunctional approach. Respondents highlighted ecological, social, and cultural functions, with 84% expressing positive feelings toward the forest. Ecosystem services, especially regulatory and cultural benefits, were recognized as the most valuable. Although academic use was significant, nonmaterial values, such as cultural and emotional connections, were more prominent. The study concludes that a well‐planned restoration project involving the local community generates lasting support for ecological restoration. This information strongly supports Brazil's voluntary reforestation targets proposed in the Paris Agreement.
‘Playing the tourist card’: Clandestine solidarity in occupied Timor‐Leste
Authors: Lundry Chris
Published: October 2024

Concepts of solidarity and justice have become salient in relation to tourism. This article describes clandestine activity in the name of solidarity but under the guise of tourism. When Indonesia opened Timor‐Leste to tourism in 1988, solidarity activists entered as tourists to obtain information and media that would contradict the official Indonesian position on the status of the territory and its people. Maintaining personae, these activists simulated tourist behaviour in order to avoid detection by the authorities. The information and media they gathered was critical in bringing pressure to bear on Indonesia to resolve the conflict.
Trainees as teachers: Building evaluative judgement through peer teaching
Authors: Bearman Margaret , Castanelli Damian J. , Molloy Elizabeth , Ward Natalie
Published: October 2024

Introduction

While peer teaching is often seen as benefiting learners, it can also benefit peer teachers. One possible mechanism is by building peer teachers' evaluative judgement or their ability to judge the quality of work of selves and others. This qualitative interview study explores how specialty medical trainees build evaluative judgement through peer teaching. It also acts as an illustrative example of researcher positionality within a special series exploring facets of qualitative methodologies.

Methods

Seventeen interviews with specialty trainees were recorded and thematically analysed, using qualitative description to stay close to the trainees' views of their experiences. We reflect on our positionality throughout.

Results

Two thematic categories are interpreted: (1) Peer teaching as uni‐directional. (2) Reflecting on one's own practice through peer teaching develops evaluative judgement.

Discussion

Findings suggest the significance of self‐scrutiny in response to teaching dialogues, learner cues or fixing problems, in order to develop evaluative judgement. With respect to positionality, reflection suggests the value of diverse teams, and the need for reflexivity due to the sensitising nature of expertise.
Contesting the American Scripture: The Qur'an as a Critical Foundation of the Liberal Arts in the 21st Century
Authors: von Doetinchem de Rande Raissa A.
Published: October 2024

This article focuses on recent changes in Rhodes College's Foundations in the Liberal Arts curriculum that were motivated by a desire to help students become competent and engaged debaters of meaning and value in the trying times of the 21st century. I focus on how my own two foundational liberal arts classes—“The Bible* and Nationalism” and “The Bible* and Comparative Ethics”—sought to widen the category of scripture for college students in their value discussions, as well as the benefits and potential limitations of moving away from the Bible as the sole source of moral formation in the American classroom.
Le Ton beau de Xuanzang: Translation as Epistemological Journey
Authors: Taylor Andrew S.
Published: October 2024

This essay shows how one professor teaching “Introduction to Buddhism” sought to counteract his students' view that Chinese and Tibetan forms of Buddhism represented a deviation from a “pure” Indian Buddhism rather than worthwhile forms of creativity and religiosity in themselves. A simple comparative assignment that asked a group of primarily monolingual students from Minnesota to translate a 500‐year‐old French ditty into English helped illustrate the inextricability of form and content, that all translation is interpretation, that translations target specific audiences, and that religious systems that might be intuitively conceptualized as perversions of a pure original can be more charitably understood as valuable systems of thought and practice in their own right. The assignment shows that linguistic translation can be a valuable form of comparative pedagogy in the undergraduate classroom beyond language classes, especially as a proxy for simulating the challenges and possibilities of intercultural translation.
Perspective on donor‐derived infections in Italy
Authors: Grossi Paolo Antonio , Lombardini Letizia , Donadio Raffaele , Peritore Daniela , Feltrin Giuseppe
Published: October 2024

Background

Expected and unexpected donor‐derived infections (DDI) are a rare event in solid organ transplant (SOT) recipients but are potentially associated with significant morbidity and mortality. To assure the microbial safety of transplantation, both national guidelines and the current, regional, and local epidemiology of infectious diseases must be considered.

Methods

In the present paper the strategies adopted by the Italian National Center for Transplantation (CNT) since 2003 and their evolution to guarantee the safety of organ transplantation are reported. Starting in 2012 mandatory reporting to the CNT of all adverse reactions was started. The number and type of DDI reported to the CNT are currently being analyzed.

Results

The infectious diseases second opinion has written and updated the guidelines on the safety of organs for transplantation and supported the Italian transplant network for the use of organs from donors with suspected or documented potentially transmissible infections.

Conclusion

A transplant safety network was developed in Italy in 2003 and has been updated according to the evolving knowledge and the changing epidemiology. This is an evolving field, and a continuous update of the recommendation is needed.
Is Allosensitization Detrimental to Pig Organ Xenotransplantation, and Is Xenosensitization Detrimental to Subsequent Organ Allotransplantation? A Debate Organized by the International Xenotransplantation Association (IXA)
Authors: Knechtle Stuart , Jackson Annette , Ladowski Joseph , Kwun Jean , Mangiola Massimo , Tector A. Joseph , Bühler Léo H. , Cozzi Emanuele , Cooper David K. C.
Published: October 2024

This report summarizes the content of a debate sponsored by eGenesis Bio, organized by the International Xenotransplantation Association (IXA), and attended by more than 150 delegates in the context of the IPITA‐IXA‐CTRMS Joint Congress held in San Diego in October 2023. The debate centered around two important immunological topics relating to xenotransplantation. The first was a debate relating to the statement that “HLA‐sensitized patients are at higher risk for rejecting a pig xenograft.” Stuart Knechtle provided evidence to support this statement and Massimo Mangiola opposed it. Before the debate, a majority (>80%) of the audience agreed with this statement. After listening to the debate, this percentage was reduced to approximately 60%. The second debated statement was “Recipients of pig xenografts who develop anti‐pig antibodies are at higher risk for rejecting a subsequent allograft.” This was proposed by A. Joseph Tector and opposed by Léo H. Bühler. Before the debate, once again a majority of the audience (approximately 60%) believed that prior sensitization to a pig xenograft would be detrimental to the survival of a subsequent allograft. However, after listening to the debate, only about 40% believed this statement to be correct.

The topics discussed remain complex and answers are not yet conclusive. However, the present evidence suggests that allosensitization may prove detrimental to subsequent xenotransplantation, whilst sensitization to pig antigens may not be detrimental to subsequent allotransplantation.
Muscle fatigue, pedalling technique and the V̇O2${{\dot{V}}_{{{{\mathrm{O}}}_{\mathrm{2}}}}}$ slow component during cycling
Authors: MacDougall Keenan B. , Aboodarda Saied J. , Westergard Paulina H. , MacIntosh Brian R.
Published: October 2024

Above the first lactate threshold, the steady‐state is delayed or prevented due to the slow component (). This phenomenon has been associated with muscle fatigue, but evidence for a causal relationship is equivocal. Moreover, little is known about the contribution of pedalling technique adjustments to during fatiguing cycling exercise. Eleven participants completed constant power trials at 10% above the second lactate threshold. Muscle fatigue was assessed, utilizing femoral nerve stimulation and instrumented pedals, while , quadriceps oxygenation, electromyography (EMG) and pedal force components were measured. Correlations between physiological and mechanical variables were estimated at group and individual levels. Group correlations revealed moderate values for with quadriceps twitch force (r = −0.51) and muscle oxygenation (r = −0.52), while weak correlations were observed for EMG amplitude (r = 0.26) and EMG mean power frequency (r = −0.16), and with pedalling mechanical variables such as peak total downstroke force (r = −0.16), minimum total upstroke force (r = −0.16) and upstroke index of effectiveness (r = 0.16). The findings here align with prior literature reporting significant correlations between the magnitude of muscle fatigue and that of , although there was large interindividual variability for all the reported correlations. Considering the heterogeneity in the data, it is difficult to determine the relative impact of pedalling technique adjustments on overall, but the present study opens the possibility that in some cases, increases in secondary to technical adjustments may be ‘superimposed’ on the underlying .
La Integración de la Producción Esbelta y la Producción Verde en el Rendimiento Sustentable de una Economía Emergente
Authors: Maldonado Guzmán Gonzalo , Juárez del Toro Raymundo
Published: October 2024

La producción esbelta y la producción verde son dos conceptos que generalmente se analizan por separado en la literatura. Sin embargo, la relación entre ambos conceptos no es clara para los investigadores y académicos, y menos aún el papel que juega la producción verde como una variable mediadora entre la producción esbelta y rendimiento sustentable. Así, el objetivo de este estudio es analizar la relación existente entre la producción esbelta y la producción verde en el rendimiento sustentable, a través de una investigación cuantitativa, explicativa y correlacional. Los resultados obtenidos muestran que la producción esbelta influye positivamente tanto en la producción verde como en el rendimiento sustentable, y que la producción verde actúa como variable mediadora entre ambas variables.
Why aquaculture may not conserve wild fish
Authors: Longo Stefano B. , York Richard
Published: October 2024

We review literature on the displacement paradox and the Jevons paradox, with consideration of their implications for the potential effects of aquaculture on wild fisheries. The Jevons paradox refers to circumstances where improvements in the efficiency of resource use lead to growth in consumption and therefore undermine conservation. The displacement paradox refers to circumstances where increasing use of a potential substitute for a resource (e.g., farmed fish) does not lead to proportionate reduction in consumption of the other resource (e.g., wild fish). The literature on the displacement paradox and the Jevons paradox suggests that there may be unanticipated consequences from the rise of aquaculture that may be detrimental for fisheries conservation. Here, we present theoretical explanations, drawing on the tragedy of the commodity, for understanding the tendencies for these technological paradoxes to occur and emphasize their relevance for concerns associated with fisheries and aquaculture systems.
Stimulator of interferon gene facilitates recruitment of effector CD8 T cells that drive neurofibromatosis type 1 nerve tumor initiation and maintenance
Authors: Pundavela Jay , Dinglasan Samantha Anne , Touvron Melissa , Hummel Sarah A. , Hu Liang , Rizvi Tilat A. , Choi Kwangmin , Hildeman David A , Ratner Nancy
Published: October 2024

Plexiform neurofibromas (PNFs) are benign nerve tumors driven by loss of the
NF1
tumor suppressor in Schwann cells. PNFs are rich in immune cells, but whether immune cells are necessary for tumorigenesis is unknown. We show that inhibition of stimulator of interferon gene (STING) reduces plasma CXCL10, tumor T cell and dendritic cell (DC) recruitment, and tumor formation. Further, mice lacking XCR-1
+
DCs showed reduced tumor-infiltrating T cells and PNF tumors. Antigen-presenting cells from tumor-bearing mice promoted CD8
+
T cell proliferation in vitro, and PNF T cells expressed high levels of CCL5, implicating T cell activation. Notably, tumors and nerve-associated macrophages were absent in Rag1
−/−
; Nf1
f/f
; DhhCre mice and adoptive transfer of CD8
+
T cells from tumor-bearing mice restored PNF initiation. In this setting, PNF shrunk upon subsequent T cell removal. Thus, STING pathway activation contributes to CD8
+
T cell–dependent inflammatory responses required for PNF initiation and maintenance.
Targeting VPS18 hampers retromer trafficking of PD-L1 and augments immunotherapy
Authors: Dong Ting , Niu Huanmin , Chu Zhaojun , Zhou Chengjun , Gao Yinghui , Jia Mengqi , Sun Bin , Zheng Xiaoxue , Zhang Wenru , Zhang Jiaozhen , Luo Yanhai , Sun Yong , Wang Chan , Lu Qiqi , Liu Changhong , Shao Guangfeng , Lou Hongxiang , Yuan Huiqing
Published: October 2024

Immune checkpoint inhibitors targeting programmed cell death 1 (PD-1) or programmed cell death-ligand 1 (PD-L1) have achieved impressive antitumor clinical outcomes. However, the limited response rates suggest the incomplete understanding of PD-L1 regulation. Here, we demonstrate that vacuole protein sorting 11 and 18 (VPS11/18), two key players in vesicular trafficking, positively regulate PD-L1 and confer resistance to immune checkpoint blockade therapy. VPS11/18 interact with PD-L1 in endosome recycling accompanied by promoting PD-L1 glycosylation and protein stability. VPS18 deficiency enhances antitumor immune response. Pharmacological inhibition by VPS18 inhibitor RDN impaired PD-L1 member trafficking and protein stability. Combination treatment of RDN and anti-cytotoxic T lymphocyte–associated antigen 4 synergistically enhances antitumor efficacy in aggressive and drug-resistant tumors. RDN exerted lung-preferred distribution and good bioavailability, suggesting a favorable drug efficacy. Together, our study links VPS18/11-mediated trans-Golgi network recycling of PD-L1 and points to a promising treatment strategy for the enhancement of antitumor immunity.
Fish farming and beyond: Moral reckoning required
Authors: Safina Carl
Published: October 2024

Problems in animal aquaculture stem from failures of care and conscience. Solutions require not “balanced” goals but moral reckonings overhauling economic valuations and policies.
Shining a light on
Candida
-induced epithelial damage with a luciferase reporter
Authors: Tesfamariam Millen , Vij Raghav , Trümper Verena , Hube Bernhard , Brunke Sascha
Published: October 2024

Host cell damage is a key parameter for research in infection biology, drug testing, and substance safety screening. In this study, we introduce a luciferase reporter system as a new and reliable assay to measure cell damage and validate it with the pathogenic yeast,
Candida albicans
, as a test case. We transduced human epithelial cell lines with a lentiviral vector to stably express an optimized luciferase enzyme, Nanoluc. Upon cell damage, the release of cytoplasmic luciferase into the extracellular space can be easily detected by a luminometer. We used the luciferase reporter system to investigate the damage caused by
C. albicans
to different newly generated epithelial reporter cell lines. We found that fungus-induced cell damage, as determined by established methods, correlated tightly with the release of the luciferase. The new luciferase reporter system is a simple, sensitive, robust, and inexpensive method for measuring host cell damage and has a sensitivity comparable to the standard assay, release of lactate dehydrogenase. It is suitable for high-throughput studies of pathogenesis mechanisms of any microbe, for antimicrobial drug screening, and many other applications.

IMPORTANCE

We present a quick, easy, inexpensive, and reliable assay to measure damage to mammalian cells. To this end, we created reporter cell lines which artificially express luciferase, an enzyme that can be easily detected in the supernatant when these cells are damaged. We used infections with the well-investigated fungal pathogen of humans,
Candida albicans
, as a test case of our system. Using our reporter, we were able to recapitulate the known effects of strain variability, gene deletions, and antifungal treatments on host cell damage. This easily adaptable reporter system can be used to screen for damage in infection models with different microbial species, assay cell-damaging potential of substances, discover new non-toxic antibiotics, and many other damage-based applications.
Caregivers’ perceptions of feeding practices and diet diversity among children aged 12–59 months in a rural district of South India: an analytical cross-sectional study
Authors: George Neethu , George Meera , Dharmaraj Rock Britto , Rangasamy Madeshwaran Chitra , Gandhi Kaviya , Mahadeavan Lenin , Dhanasekaran Kowsika Suveda , Venkatachalam Keerthanaa , Ramesh Madumitha , Subbhaiyaa Muthu Raaj Kumar Rukmani
Published: October 2024

Objective

The primary objective of this study was to assess caregivers’ perceptions of feeding practices (breastfeeding and complementary feeding) and diet diversity among children aged 12–59 months in a rural district of South India. The secondary objective was to identify potential predictors of these perceptions and diet diversity.

Design

An analytical cross-sectional study was performed from March 2023 to May 2023.

Setting

In a rural district of Tamil Nadu, South India.

Participants

This study included 301 mothers/caregivers of children between 12 and 59 months of age in a rural district of Tamil Nadu. The research gathered demographic information from caregivers, including details such as age, educational background, occupation, relationship with the child and place of residence. Additionally, the caregivers’ perspectives were evaluated through a questionnaire focused on breastfeeding/complementary feeding, and the diet diversity of the children was also assessed.

Outcome measures

The primary outcome was the perceptions of mothers/caregivers of children between 12 and 59 months of age about breastfeeding/complementary feeding practices, and the diet diversity of the children was measured. Additionally, predictors associated with these perceptions were evaluated through regression analysis.

Results

In the present study, 188 (62.5%) and 179 (59.5%) of the participants had good perceptions of breastfeeding practices and complementary feeding practices, respectively. This binomial regression revealed that subjects with unstable occupations (adjusted OR=2.24, 95% CI 1.25 to 4.01), schooling (7.71, 95% CI 2.73 to 8.9) and higher education (38.32, 95% CI 4.63 to 316.85) had increased chances of having good perceptions of breastfeeding practices. Subjects with unstable occupations (0.23, 95% CI 0.06 to 0.85), stable occupations (0.13, 95% CI 0.04 to 0.51), schooling (0.43, 95% CI 0.25 to 0.74), higher education (0.15, 95% CI 0.04 to 0.50) and increased birth weights (2.54, 95% CI 1.35 to 4.78) had increased chances of having good perceptions of complementary feeding practices (p<0.05). This study revealed that 86.4% of the children had adequate diet diversity.

Conclusion

The study revealed that most caregivers, particularly mothers, possess a strong understanding of breastfeeding and complementary feeding practices, with education and occupation exerting a notable influence. However, there is a crucial necessity to translate this knowledge into practical applications to effectively obtain feeding indicators.
Advancing health equity and the role of digital health technologies: a scoping review protocol
Authors: Bitomsky Laura , Pfitzer Estelle Celine , Nißen Marcia , Kowatsch Tobias
Published: October 2024

Introduction

Healthcare systems around the world exhibit inherent systemic inequities that disproportionately impact marginalised populations. Digital health technologies (DHTs) hold promising potential to address these inequities and to play a pivotal role in advancing health equity. However, there is a notable gap regarding a comprehensive and structured overview of existing frameworks and guidelines on advancing health equity and a clear understanding of the potential of DHTs in their implementation. To this end, our primary objectives are first to identify prevalent frameworks and guidelines that promote health equity and second to pinpoint the contemporary role of DHTs as an avenue for implementing these frameworks and guidelines. This synthesis will guide future DHTs, ensuring equitable accessibility and effectiveness and ultimately contributing to enhancing health equity among marginalised populations.

Methods and analysis

This work adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Reviews. To identify pertinent evidence, we will employ seven electronic databases (PubMed, EMBASE, Cochrane, PsycINFO, Scopus, Web of Science and WISO) encompassing the fields of medicine, healthcare and social sciences. Moreover, selected grey literature will be considered. We will include primary and secondary studies published in English between 2010 and 2023 that focus on (technology and non-technology-based) frameworks and guidelines for health equity improvement. Each article will undergo an independent assessment for eligibility, followed by the extraction of pertinent data from eligible sources. Subsequently, the extracted data will be subjected to qualitative and quantitative analyses, and findings will be presented using narrative and descriptive formats.

Ethics and dissemination

Ethical approval is deemed unnecessary for this scoping review, as it involves synthesising existing knowledge. The findings from this study will be disseminated through peer-reviewed publications.

Protocol registration

https://osf.io/94pht.
Level of eye healthcare utilisation and associated factors in Gamo and Gofa Zones, Southern Ethiopia: a community-based, cross-sectional study
Authors: Alemu Tsegaye , Seyum Dawit , Gebre Mulate , Sisay Alemayehu , Sorato Mende Mensa
Published: October 2024

Objective

About 90% of eye health problems are preventable or curable with existing cost-effective interventions. There is limited evidence on eye healthcare utilisation (ECU) and the factors influencing it in the study area. This study aimed to determine the level of ECU and the associated factors in Southern Ethiopia.

Design

A community-based, cross-sectional study was conducted in Southern Ethiopia from 1 June to 15 July 2023. Data were analysed using SPSS V.27.

Setting

Two selected districts (Dita and Uba Debretsehay) in Southern Ethiopia.

Participants

Permanent residents living in randomly selected kebeles.

Outcome measure

The level of ECU was the outcome measure. A binary logistic regression model was used to check the association between explanatory variables and the dependent variable. To avoid many variables and unstable estimates and to control for possible confounders in the subsequent model, only variables that reached a p value of less than 0.25 on binary analysis were used in the multivariate logistic regression analysis to identify factors independently associated with ECU.

Results

992 respondents participated in this study, with a response rate of 95.4%. The prevalence of ECU within the past 2 years was 21.6% (95% CI 19.0, 24.3). The reported barriers to ECU were lack of awareness (123, 40.6%) and lack of money (58, 19.2%). Age <30 years (adjusted OR (AOR)=2.7; 95% CI 1.5, 4.6), being male (AOR=2.2; 95% CI 1.4, 3.6), shorter travel time (AOR=2.0; 95% CI 1.3, 3.1), undergoing regular vision check-ups (AOR=5.4; 95% CI 3.47, 8.37), history of eye diseases (AOR=4.8; 95% CI 2.5, 9.1) and having trichiasis (AOR=1.5; 95% CI 1.1, 2.3) were positively associated with eye care service utilisation. Low wealth quantile (AOR=0.62; 95% CI 0.39, 0.98) and poor knowledge (AOR=0.26; 95% CI 0.16, 0.44) were negatively associated with eye care service utilisation.

Conclusions

The ECU within the past 2 years was a quarter. Socioeconomic factors, disease-related factors and respondent knowledge are independently associated with ECU. Designing strategies that can improve the capacity of healthcare facilities and patient awareness is important in order to reduce barriers and improve service utilisation. Researchers interested in working in the area should focus on community-specific approaches that can improve community health literacy by using stronger study designs.
Comparative effects of behaviour change techniques using eHealth and mHealth in promoting dietary behaviour: protocol for a systematic review and component network meta-analysis
Authors: Fukuda Takafumi , Matsuura Nozomi , Noma Hisashi , Mihara Takahiro
Published: October 2024

Introduction

Globally, it is estimated that dietary habits contribute to 22% of adult deaths and 15% of disability-adjusted life years, highlighting the critical role of dietary behaviour in public health. Despite the known benefits of healthy eating, many individuals find it challenging to change their diet for disease prevention. eHealth and mHealth interventions using behaviour change techniques (BCTs) have emerged as promising strategies to address this issue. However, the specific BCTs that are most effective in promoting dietary behaviour are not well established. This systematic review and component network meta-analysis (CNMA) aims to estimate the effect size of each BCT on fostering healthy eating.

Methods and analysis

We will include randomised controlled trials that assess the effects of eHealth and mHealth interventions on promoting changes in dietary behaviours among healthy adults. Studies with a minimum follow-up period of 3 weeks will be considered. Searches will be conducted in MEDLINE [PubMed], Embase [Dialogue], Cochrane Central Register of Controlled Trials, PsycInfo [Dialogue], ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform and the University Hospital Medical Information Network Clinical Trials Registry on 27 January 2024. Two independent reviewers will conduct title and abstract screening followed by a full-text review. Disagreements will be resolved through discussion or consultation with a third reviewer. The primary outcome is dietary behaviour, as measured by changes in the diet quality score and the intake of a specific food. Our data synthesis will apply a frequentist random-effects model for pairwise meta-analysis, network meta-analysis and an additive CNMA model to compute the effect size of each BCT. This methodological approach will reveal the positive and negative effects of each BCT and provide a ranking of these techniques, considering both direct and indirect evidence.

Ethics and dissemination

Ethical approval is not required for this systematic review because it uses existing published data. These results will be submitted for publication in a peer-reviewed journal. The current protocol was submitted to PROSPERO on 16 January 2024 (CRD 42024502217).
Analysis of factors associated with public attitudes towards salt reduction: a multicountry cross-sectional survey
Authors: Tanoue Yuta , Rauniyar Santosh Kumar , Uchibori Manae , Ghaznavi Cyrus , Tomoi Hana , Ueta Mami , Prommas Prapichaya , Cao Alton , Yoneoka Daisuke , Kawashima Takayuki , Eguchi Akifumi , Nomura Shuhei
Published: October 2024

Objective

This paper provides an in-depth examination of public attitudes towards salt reduction across seven culturally diverse countries: the USA, the UK, France, Japan, Indonesia, Thailand, and Brazil.

Design

Cross-sectional regression analysis with questionnaire data.

Setting

An analysis of questionnaire study in seven countries.

Participants

The study’s questionnaire collected responses from 7090 participants across seven countries with the mean age of respondents being 46.06 years (SD 16.96). The gender distribution encompassed 3473 men (49.12%), 3582 women (50.66%), 24 non-binary individuals (0.34%) and 11 who identified as ‘other’ (0.16%).

Primary and secondary outcome measures

Attitudes toward sodium reduction were measured on a seven-point Likert scale.

Results

Regression analysis revealed significant associations between attitudes towards sodium reduction and various factors across countries. Gender was a significant factor in France, with women showing less awareness than men (coefficient −0.123, 95% CI −0.237 to −0.008). Age was a significant factor in Japan and Thailand, with older generations exhibiting stronger awareness. Occupation was a significant factor in France (grocery, 0.678, 0.229 to 1.127) and Japan (food service, 0.792, 0.300 to 1.283). In France (0.090, 0.033 to 0.146) and Brazil (0.092, 0.040 to 0.144), attitudes towards reducing sugar intake were positively associated with sodium reduction attitudes. Government interventions showed varying impacts, with positive associations in Thailand (0.004, 0.001 to 0.008) and negative associations in France (−0.003 –0.005 to −0.000).

Conclusion

Our study reveals a complex array of factors shaping attitudes towards sodium reduction across seven countries. These findings support the need for nuanced, country-specific approaches in formulating sodium reduction strategies. Future research should validate these findings, explore further determinants and understand how attitudes translate into dietary behaviours.
Cryptosporidiosis in individuals with inflammatory bowel disease: a scoping review protocol
Authors: Liu Belinda , Schnider Alexander , DeArmond Megan , Banach David B , Haubrich Brad A
Published: October 2024

Introduction

Cryptosporidiosis is a leading cause of moderate-to-severe diarrhoea globally, and, while it is often self-limited, in immunocompromised individuals, the infection can be associated with significant morbidity and mortality. Diagnosis might be missed or delayed in patients with inflammatory bowel disease (IBD) due to similar presentation, and these patients may also be on immunosuppressive therapies, increasing their risk of infection. Additionally, gastrointestinal infection and dysbiosis may be a risk factor for IBD. Diagnosis, presentation and treatment of cryptosporidiosis in individuals with IBD, as well as any epidemiologic correlations between the two diseases, will be investigated.

Methods and analysis

MEDLINE, Embase, Cochrane Library, CINAHL, Dissertations and Theses Global and grey literature will be searched. Joanna Briggs Institute (JBI) methodology for scoping reviews was used for the protocol and will be for the review. Two reviewers will independently screen studies and extract data. The evidence and presentation of the results will be analysed with input from the review team. Studies of cryptosporidiosis in patients with IBD will be included. Paediatric, adolescent and adult studies in all patient environments will be included. Cases in which Crohn’s disease does not affect the intestine and cases in which cryptosporidial infection is not in the intestine will be excluded.

Ethics and dissemination

Published clinical literature will be systematically reviewed, and this work does not directly involve patients. Consequently, ethical review by an institutional review board is not required. Data will be presented at academic conferences, and a culminating report will be published in a peer-reviewed journal.

Open Science Framework registration

https://osf.io/j47mb.
Impact of primary care and public health integration of chronic conditions in China: a protocol for a prospective multicentre cohort study
Authors: Qing Hua , Huang Yang-Zhen , Yang En , Wei Yi-Lin , Wang Chun-ying , Dong Heng , Song Jia , Tang Shangfeng
Published: October 2024

Introduction

The prevalence of chronic conditions is increasing. Given that the majority of chronic patients are managed by primary healthcare providers, there is a need to integrate primary care with public health to address the prevailing situation and enhance patient outcomes. The purpose of this study is to establish, implement and evaluate an integrated primary care and public health model in China for patients with chronic conditions.

Methods

This prospective, multicentre and observational study will be conducted at 12 township hospitals on patients (n=7200) diagnosed with chronic conditions (hypertensive, diabetic or stroke). Participants were divided into two groups: pilot areas and mainstream areas follow-up groups. The primary outcome will be the difference in the proportion of controlled chronic conditions among the two groups. Secondary outcomes will be the differences in mean change in diastolic and systolic blood pressures, fasting glucose, total cholesterol and triglyceride, death from any cause and participant-reported physical and psychological health status.

Ethics and dissemination

Ethics approval was obtained from the Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology. We plan to publish the results of this study in a peer-reviewed journal article.
Psychometric validation of the Cardiac Rehabilitation Barriers Scale Revised (CRBS-R) for hybrid delivery
Authors: Grace Sherry L , Ghanbari Mahdieh , Cruz Mayara Moura Alves da , Vanderlei Luiz Carlos Marques , Ghisi Gabriela Lima de Melo
Published: October 2024

Objective

To test the measurement properties of the revised version of the English Cardiac Rehabilitation Barriers Scale (CRBS-R), suitable for hybrid delivery, structural validity, internal reliability, as well as face, cross-cultural, construct and criterion validity were assessed.

Design

Cross-sectional study, where participants completed an online survey via Qualtrics (2023–2024).

Setting

Multicentre, with cardiac rehabilitation (CR) programmes recruiting patients globally; most patients stemmed from a hybrid programme in Iran and supervised programme in Brazil.

Participants

Participants include inpatients or outpatients with a cardiovascular diagnosis or procedure that is indicated for participation in CR.

Measures

In addition to sociodemographic and CR use items, the 21-item CRBS-R was administered. It assesses multilevel barriers and was revised based on a literature review. Responses range from 1 to 5, with higher scores indicating greater barriers.

Results

235 patients participated from all 6 WHO regions. Items were rated as highly applicable, and open-ended responses revealing no key barriers were omitted, supporting face and cross-cultural validity. Cronbach’s α for the total CRBS-R was 0.82. Principal components analysis resulted in the extraction of 4 components, which collectively accounted for 60.5% of the variance and were all internally consistent. Construct validity was supported by associations of total CRBS scores with work status (p=0.04), exercise history (p=0.01) and social support (p=0.03). Total CRBS-R scores were significantly lower in patients who were referred and enrolled versus those who were not (both p≤0.01), confirming criterion validity.

Conclusions

The CRBS-R is a reliable and valid scale comprising four subscales, applicable to hybrid CR across diverse settings. It can serve as a valuable tool to support identification of patient’s CR barriers, to optimise secondary prevention utilisation globally.
First-in-human clinical outcomes with NG-350A, an anti-CD40 expressing tumor-selective vector designed to remodel immunosuppressive tumor microenvironments
Authors: Naing Aung , Khalil Danny , Rosen Oliver , Camidge D Ross , Lillie Tom , Ji Rui-Ru , Stacey Andrea , Thomas Matthew , Rosen Lee
Published: October 2024

Background

Tumor-selective oncolytic viral vectors are promising anticancer therapeutics; however, challenges with dosing and potency in advanced/metastatic cancers have limited efficacy and usage. NG-350A is a next-generation blood-stable adenoviral vector engineered to express an agonist anti-cluster of differentiation (CD)40 antibody without affecting tumor-selectivity and oncolytic potency.

Methods

Intravenous and intratumoral (IT) administration of NG-350A was assessed in a phase Ia/Ib study in patients with metastatic/advanced epithelial tumors (NCT03852511). Dose-escalation was performed separately for intravenous (four dose levels available, each with infusions on Days 1, 3 and 5 of a 57-day treatment period) and IT (single injection on D1 only or injections on Days 1, 8, 15 and 22) administration. The primary objective was safety and tolerability; secondary objectives included determining a recommended dose, pharmacokinetics, and immunogenicity.

Results

In total, 25 heavily pretreated patients received NG-350A (16 with intravenous and 9 with IT administration). Intravenous and IT dosing were both well tolerated, with no evidence of transgene-related or off-target viral toxicity. Intravenous and IT dosing resulted in dose-dependent increases in systemic NG-350A Cmax. Despite both routes of administration inducing anti-virus antibodies, sustained persistence of NG-350A in blood samples was observed up to 7 weeks after the last dose, particularly with higher intravenous dose levels. Delivery of NG-350A to tumors was demonstrated in biopsy samples following both routes of administration; a dose-dependent pattern was seen with intravenous infusion, with four patients remaining positive for vector DNA in biopsies at Day 57. Transgene messenger RNA from replicating NG-350A was detected in 5/12 patients with intravenous treatment and 1/9 patients with IT injection, and sustained increases in inflammatory cytokines were observed following dosing, particularly with higher intravenous dose levels.

Conclusions

This phase 1a study provided initial proof-of-mechanism for NG-350A, with strong evidence of tumor delivery, viral replication and transgene expression—particularly after intravenous dosing. The lack of transgene-related or off-target viral toxicity was consistent with the highly selective delivery and replication of NG-350A, even after systemic delivery. The efficacy of intravenous-dosed NG-350A will now be evaluated in combination with pembrolizumab (NCT05165433), as well as with chemoradiotherapy (NCT06459869).

Trial registration number

NCT05165433,NCT06459869.