bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers to adherence of posttreatment follow-up after positive primary cervical cancer screening in Ethiopia: a mixed-methods study
Authors: Alemayehu Rahel , Stroetmann Clara Yolanda , Wondimagegnehu Abigiya , Rabe Friedemann , Addissie Adamu , Kantelhardt Eva Johanna , Gizaw Muluken
Published: November 2024

Background

Even though it is preventable, cervical cancer contributes significantly to cancer-related mortality among Ethiopian women. Follow-up visits after treatment of precancerous lesions are essential to monitor lesion recurrence. In our previous study, we found a level of adherence to follow-up of 44.7%, but the reasons for low adherence have not been comprehensively explored within the Ethiopian context. This study aimed to identify these reasons by interviewing 167 women who had missed their follow-up appointments as well as 30 health professionals with experience in the field.

Methods

The study employed a mixed-methods approach: Quantitative data were collected through a telephone questionnaire conducted with 167 women who had a positive visual inspection with acetic acid (VIA) and had missed their follow-up appointments. Subsequently, in-depth interviews were conducted with 30 healthcare professionals, and an inductive content analysis was carried out.

Results

In the patient interviews, the reasons given most often were “lack of information about the follow-up” (35; 21.1%), “forgetting the appointment” (30; 18.1%), and “not seeing the need for follow-up” (24; 14.5%). Healthcare professionals identified various reasons such as lack of knowledge, living in a remote area/changing living area, forgetfulness, fear, poor counseling, a shortage of trained healthcare providers to give counseling and follow-up, and reminder-related barriers.

Conclusion

Lack of knowledge, forgetfulness, poor health-seeking behavior, and a lack of reminders were identified as barriers contributing to the low uptake of rescreening. Further interventions should target these by creating community awareness, improving patient counseling, tracing patients in need of follow-up, and making reminder calls or using SMS.
A systematic review and qualitative evidence synthesis of factors affecting mHealth adoption in India
Authors: Thomas Verghese , Jenkins Judy , George Jomin
Published: November 2024

mHealth implementations are increasing in low- and middle-income countries to strengthen health systems and improve health outcomes. Following the proliferation of mobile internet use, Indian health systems have deployed mHealth widely. However, there is little evidence that mHealth has improved health outcomes in India across settings and at scale. The aim of this study was to review current evidence on perceptions and experiences of end users of mHealth in India and synthesize qualitative data to determine the factors influencing mHealth use to inform mHealth design, development, and implementation. A systematic review and qualitative synthesis of studies on mHealth in India was conducted by searching the Web of Science, Medline and CINAHL databases for qualitative studies on mHealth users including both health system beneficiaries and healthcare personnel. Findings from the studies were synthesized using thematic synthesis. The synthesis generated the themes of the Environment, the Users and the mHealth system. The data indicate that mHealth use improves when the environment supports its use; when users are motivated and have the ability to use mHealth systems; and when mHealth systems are aligned with the environmental context and fulfill users’ needs and desires. mHealth adoption in India can be improved through human centered design and by addressing the disparities in digital literacy between socio economic strata. These approaches are required to close the design reality gaps facing mHealth systems, to improve mHealth implementation for health system strengthening, and therefore, to improve health outcomes in India.
Epistemic Practices and Blurred Boundaries
Authors: Dias Nélia
Published: November 2024

This chapter examines the changing status, role, and uses of human remains in the history of archaeology. By focusing on the epistemic and material practices, it seeks to emphasize connections and tensions between archaeology and anthropology, as well as blurred boundaries between these two fields of inquiry. This chapter explores the processes through which human remains were progressively considered as material evidence of human differences and of the human past in spite of disagreements on what counted as evidence in archaeology and in anthropology. The chapter also considers nationalistic and political attempts to establish past–present continuities and correspondences (by means of craniology) between presumed “races” and prehistoric periods. Finally, the chapter examines diverse meanings and ethical implications of the term “human remains” and argues that different values involved in the current debates on human remains need to be situated in a broad comparative and historical perspective.
Democratic Republic of Congo Music
Authors: Trapido Joe
Published: November 2024

This chapter looks at some aspects of the music industry in the popular music of the Democratic Republic of Congo (DRC). It argues that music exemplified, and on occasion led, political-economic trends in an economy in which the formal sector almost entirely disappeared, and in which gross domestic product contracted every year from 1975 until the early 2000s. In the middle of this political-economic turmoil, the DRC remained a center of cultural production. The capital Kinshasa in particular was a vector for new styles, and Congolese popular music was for some time the most widely listened to music on the African continent and remains important. During the 1980s and 1990s, with piracy and economic contraction in full swing, the record industry saw a very dramatic decline in official music sales as well as a decline in “professional” producers and the familiar infrastructure of production and distribution of a “music industry.” But while there was a drastic contraction in the production of tangible units for the market, in other ways, it is not entirely clear that the industry “shrunk,” or even what this might mean in this context where the economic transformation was such that what “the economy” itself meant shifted radically. This chapter describes this transformation, drawing on a wider contextual understanding of the political economy of the DRC. Notable among these changes is the rise of a form of patronage known as mabanga (lit. “stones”). From the 1980s, such patronage payments became the most significant source of income to most musicians.
Adorno and Post-Colonial Critique
Authors: Sonderegger Ruth
Published: November 2024

After a brief discussion of the seemingly rival concepts of post-colonial and decolonial critique, this chapter first engages with approaches that make Adorno productive for post-colonial as well as decolonial critique. In the next section, the chapter discusses immanent critiques of Adorno (i.e., forms of critique) that acknowledge Adorno’s fine sensorium for some kinds of racism but, nevertheless, appears to be deaf to colonial variants of racism, nationalism, and imperialism. Moreover, the theorists that are discussed in the second part claim that Adorno’s neglect of colonialism also affects the rather convincing elements of his theory. Based on such critique, the chapter will then focus on Adorno’s questionably racist account of autonomy in art and beyond. It will do so, however, in conversations with theorists who work with Adorno to devise lines of flight that lead beyond the impasses of Adornian autonomy. In conclusion, the chapter contends that it is only in some respects that Adorno can become an ally of decolonial thinking. Regarding other respects, however, he refused to listen and learn and, therefore, he remained deaf to decolonial alternatives to his seemingly relentless critique of Enlightenment (autonomy).
Adorno, Nāgārjuna, and the Logic of Negativity
Authors: Nelson Eric S.
Published: November 2024

This chapter examines the logic of contradiction, negation, and negativity in relation to non-identity in Adorno’s Negative Dialectics and emptiness in Nāgārjuna’s Root Verses of the Middle Way. The heterogeneous non-identity of Adorno and the emptying emptiness (śūnyatā) of Nāgārjuna suggest radical alternatives to conventional, dialectical, and dialetheist conceptions of logic. Their respective strategies contest positive assertions about self-identity by unfixing and undoing what is posited and fixated as a standpoint, perspective, or view. Non-identity in mediation and emptiness in dependent origination indicate constellations of problems. Non-identity and “emptied emptiness” do not thereby aim at a new affirmation, even if it is purified or realized through negativity in dialectical sublation or conceived as the affirmation of both sides of a contradiction. These two works express disintegrative and therapeutic critical models and skillful means that have a critical, diagnostic, and potentially curative function in response to the conditions and circumstances of the sufferer (the Buddhist dharma) or contemporary capitalist society (critical social theory).
Bones Matter
Authors: Gil García Francisco M.
Published: November 2024

According to Andean oral traditions, the chullpas lived in a time before the appearance of the sun. The archaeological ruins, and the mummies and other human remains that appear in them, serve to construct the humanized representation of those who are really nonhuman people. For today’s Indigenous people, the chullpas and their world were similar to but different from their own so that, with a few exceptions in Bolivia and northern Chile, the communities do not feel that they are heirs to the nonhumanity of the mytho-historical past. However, the chullpas are also entities of the underworld, which can cause harm and illness to those who do not respect the spaces they inhabit or the material evidence of their existence. In this way, rules of social and moral conduct and of specific relationship with the remains of the past are generated. In this sense, in the ways of relating to these nonhuman people, the construction of the body and the person (both chullpas and present-day Andean peoples) converge. Thus, this chapter proposes an ontology of the inhabitants of the past through the connection between the immaterial dimension of orality and the material dimension of the archaeological record, an ontological exercise in which bones matter.
Russian Metafiction and Global Realisms
Authors: Vaysman Margarita
Published: November 2024

Metafiction, also known as self-conscious fiction, is a narrative technique that forces readers to be aware that they are reading a work of fiction. From early critical approaches to metanarrative in literature to more recent enquiries into meta-descriptive strategies in historiography, metafiction has enjoyed significant critical attention. First fully conceptually explored in landmark studies by theorists in the 1980s, it was initially considered to be an almost exclusively twentieth-century and specifically postmodernist phenomenon. As the theory has developed, the geographical and chronological scope of the texts it aimed to describe has expanded, prompting a series of questions about metafiction’s hidden pasts and locations. In Russia, metafiction flourished not only, predictably, in the 1990s (roughly in step with the late stage of literary postmodernist writing in anglophone fiction) but also in the middle of the nineteenth century, during the period associated with the rise of the realist novel. It was exactly this focus on realist poetics—and its supposed incompatibility with metafictional narratives—that caused previous historical accounts of metafiction as a global phenomenon to skip over the nineteenth-century Russian realist novel. This chapter focuses on metafiction’s complex correlation with the Russian realist tradition, as a part of the larger global history of narratives that can be considered metafictional and realist at the same time. It charts the global rise of theories of metafiction from the 1980s to this day and applies these theoretical insights to review the timeline of the development of the Russian realist novel.
Theorizing Global Realism from Lukács to Climate Crisis Literature
Authors: De Loughry Treasa
Published: November 2024

This chapter discusses György Lukács’s theory of realism and puts it in dialogue with contemporary literary theories of crisis, climate change, and global literatures. It initially explores Lukács’s concepts of realism, totality, and standpoint, before examining how these have become important to postcolonial and world-literary scholarship concerned with “peripheral” realisms, discussing how this has been articulated in relation to global literature. Realism is then examined as an apt mode capable of grappling with the current era of compound or “poly” crises, given its commitment to highlighting various kinds of inequality across the Global South, and cathecting solidarity from below, at a time of accelerating climate crisis. The chapter then applies a Lukácsian-informed definition of realism to short stories by Tahmima Anam, Pitchaya Sudbanthad, and Yasmine El Rashidi from John Freeman’s collection, Tales of Two Planets: Stories of Climate Change and Inequality in a Divided World (2020). Focusing on the short story is a corrective, this chapter argues, to the dominant focus in theories of realism on the novel. It also highlights how short stories can, given their registration of peripherality through attention to underrepresented regions, characters, and condensation of historical tendencies as fragments, articulate some of the subversive and critical potential of realism at an emergent moment of climate crisis.
Authoritarian Bureaucracy
Authors: Szakonyi David
Published: November 2024

Autocrats do not rule alone. Leaders depend particularly on state bureaucracies to carry out their preferred policies, provide public goods, maintain social order, and organize repression and propaganda. Yet autocratic regimes often lack many key mechanisms, such as a strong civil society, independent media, and regular elections, that help leaders resolve principal–agent problems in bureaucracies. This chapter analyzes the structure and incentives at play in autocratic bureaucracies. Although early literature emphasized a trade-off between loyalty and competence, more recent work has shown that autocrats can at times prioritize meritocracy in bureaucratic systems, in particular for positions not seen as posing a significant threat to their hold on power. Moreover, lacking institutions that provide accountability from below means that autocratic bureaucracies may rely instead more on indoctrination, rotation, and digitalization, to monitor and ensure compliance among subordinates. The chapter concludes with a discussion of unanswered questions surrounding how these bureaucracies work as well as avenues for future research.
Authoritarian Regimes in the Global Economy
Authors: Heathershaw John , Pitcher Anne , Soares de Oliveira Ricardo
Published: November 2024

Scholars have argued that a more open international economy would encourage authoritarian regimes to liberalize politically to build better relationships with more democratic trade and investment partners. Yet, thirty years after many previously closed economies across Europe, Asia, and Africa embraced free trade and foreign investment, authoritarian regimes—particularly those with institutionalized party systems and access to resources—seem to be thriving. This chapter explores the ways in which formal and informal changes in the international economy have catered to the economic demands of authoritarian regimes. It shows that autocratic leaders receive financial, technological, and reputational resources through their international linkages, which they redeploy domestically to coopt supporters and repress opponents. This chapter also examines the professional enablers that assist autocrats in the conduct of transnational business. The chapter concludes with a discussion on how best to study practices which are, at times, opaque and secretive.
Fair Trial, Fair Judge
Authors: Quattrocolo Serena
Published: November 2024

This chapter aims to identify the major risks to fair criminal trial from the interference of digital tools and, more specifically, from AI applications. In fact, it is necessary to understand the values which are at stake in order to determine how legal orders should react. Actually, the focus is, not only on the crucial principle of the ‘equality of arms’, which has already been addressed, in the literature, as potentially endangered by the massive digital turn. This chapter tries to go deeper, reflecting also on the basic concepts of the jurisdiction, such as the ‘right to access to a judge’ and the notion of ‘judge’ itself, to confront them with an evolution that the future situation may imply. A neutral approach is crucial in performing such a task, as biases may either lead to the underestimation of serious risks to fundamental rights or to overprotection against digital solutions, which may, instead, present potential benefits to tackle the persistent problems of criminal justice such as a backlog of cases, long and unreasonable lengths of proceedings, and the inconsistency and unpredictability of decisions.
Failure to Drain: Expert Resistance and Environmental Thought in the Seventeenth-Century Dutch Republic
Authors: Post Anna-Luna
Published: November 2024

Historical scholarship has long highlighted the extensive landscape interventions initiated by state agents, early capitalists and experts in the early modern period, and pointed to the fierce, often violent resistance they evoked from local and rural communities. Such an approach risks narrowly aligning expertise with intervention in the service of states or capitalist elites and positioning experts in direct opposition to people. This article uses the history of land reclamation in the seventeenth-century Dutch Republic, usually told as a harmonious success story of premodern human intervention in nature, to explore the nature and politics of expertise and environmental thought as different elites clashed. Focusing on the proposed but not executed drainage of the Haarlemmermeer, it demonstrates how experts came to act as agents of resistance who argued for conservation and caution rather than intervention, and shows we can use expert exchanges to gain better insight into the divisive nature of environmental thought in the early modern period.
CELL DIVISION CYCLE 5 controls floral transition by regulating flowering gene transcription and splicing in Arabidopsis
Authors: Xin Xin , Ye Linhan , Zhai Tingting , Wang Shu , Pan Yunjiao , Qu Ke , Gu Mengjie , Wang Yanjiao , Zhang Jiedao , Li Xiang , Yang Wei , Zhang Shuxin
Published: November 2024

CELL DIVISION CYCLE 5 (CDC5) is a R2R3-type MYB transcription factor, serving as a key component of modifier of snc1, 4-associated complex/NineTeen complex, which is associated with plant immunity, RNA splicing, and miRNA biogenesis. In this study, we demonstrate that mutation of CDC5 accelerates flowering in Arabidopsis (Arabidopsis thaliana). CDC5 activates the expression of FLOWERING LOCUS C (FLC) by binding to and affecting the enrichment of RNA polymerase II on FLC chromatin. Moreover, genetic analysis confirmed that CDC5 regulates flowering in an FLC-dependent manner. Furthermore, we characterized the interaction of CDC5 with the RNA polymerase-associated factor 1 (Paf1) complex and confirmed that CDC5, as part of the spliceosome, mediates genome-wide alternative splicing, as revealed by RNA-seq. CDC5 affected the splicing of flowering-associated genes such as FLC, SEF, and MAFs. Additionally, we also demonstrated that CDC5 contributes to the regulation of histone modification of FLC chromatin, which further promotes FLC expression. In summary, our results establish CDC5 as a key factor regulating flowering. This provides valuable insight for future research into plant flowering.
Cyclic and pseudo-cyclic electron pathways play antagonistic roles during nitrogen deficiency in Chlamydomonas reinhardtii
Authors: Dao Ousmane , Burlacot Adrien , Buchert Felix , Bertrand Marie , Auroy Pascaline , Stoffel Carolyne , Madireddi Sai Kiran , Irby Jacob , Hippler Michael , Peltier Gilles , Li-Beisson Yonghua
Published: November 2024

Nitrogen (N) scarcity frequently constrains global biomass productivity. N deficiency halts cell division, downregulates photosynthetic electron transfer (PET), and enhances carbon storage. However, the molecular mechanism downregulating photosynthesis during N deficiency and its relationship with carbon storage are not fully understood. Proton gradient regulator-like 1 (PGRL1) controlling cyclic electron flow (CEF) and flavodiiron proteins (FLV) involved in pseudo-CEF (PCEF) are major players in the acclimation of photosynthesis. To determine the role of PGRL1 or FLV in photosynthesis under N deficiency, we measured PET, oxygen gas exchange, and carbon storage in Chlamydomonas reinhardtii pgrl1 and flvB knockout mutants. Under N deficiency, pgrl1 maintained higher net photosynthesis and O2 photoreduction rates and higher levels of cytochrome b6f and PSI compared with the control and flvB. The photosynthetic activity of flvB and pgrl1 flvB double mutants decreased in response to N deficiency, similar to the control strains. Furthermore, the preservation of photosynthetic activity in pgrl1 was accompanied by an increased accumulation of triacylglycerol in certain genetic backgrounds but not all, highlighting the importance of gene–environment interaction in determining traits such as oil content. Our results suggest that in the absence of PGRL1-controlled CEF, FLV-mediated PCEF maintains net photosynthesis at a high level and that CEF and PCEF play antagonistic roles during N deficiency. This study further illustrate how a strain's nutrient status and genetic makeup can affect the regulation of photosynthetic energy conversion in relation to carbon storage and provide additional strategies for improving lipid productivity in algae.
Accuracy prompts protect professional content moderators from the illusory truth effect
Authors: Lin Hause , Savio Marlyn Thomas , Huang Xieyining , Steiger Miriah , Guevara Rachel L , Szostak Dali , Pennycook Gordon , Rand David G
Published: November 2024

Content moderators review problematic content for technology companies. One concern is that repeated exposure to false claims could cause moderators to come to believe the very claims they are supposed to moderate, via the “illusory truth effect.” In a first lab-in-field experiment (N = 199) with a global content moderation company, we found that exposure to false claims while working as moderators increased subsequent belief among (mostly Indian and Philippine) employees by 7.1%. We tested an intervention to mitigate this effect: inducing an accuracy mindset. In both general population samples (NIndia = 997; NPhilippines = 1,184) and a second lab-in-field experiment with professional moderators (N = 239), inducing participants to consider accuracy when first exposed to the claims eliminates the negative effects of exposure on belief in falsehoods. Our results show that the illusory truth effect and the protective power of an accuracy mindset generalize to non-Western populations and professional moderators.
Exploring cultures of evidence in energy policymaking in the UK, Germany, and the Netherlands
Authors: McDowall Will
Published: November 2024

This paper explores different “cultures of evidence” in energy policymaking in the UK, Germany, and the Netherlands. The urgent energy system transformation needed to respond to the climate crisis depends on policies informed by technical and engineering expertise, and particularly energy modeling. Such expertise had traditionally been poorly represented in the energy ministries of the Dutch, German, and UK governments. There is limited understanding of how policy advisory systems have evolved to respond to these emerging evidence needs. This paper presents a framework for describing how cultures of evidence differ, and applies this to a comparative study of energy policymaking in the UK, Netherlands, and Germany. I show clear differences in how evidence is understood and used. The Dutch and German governments have sought technical and modeling evidence from consultants or independent agencies. In doing so, the Dutch and German ministries appear to place stronger value on the “independence” of such evidence, while the UK system builds credibility through adherence to formal procedures. A second clear difference in the cultures of evidence relates to different beliefs about the extent to which expert knowledge can be impartial and value-free. The cases suggest that different cultures of evidence have coevolved with each country’s institutional history and shaped the energy policy advisory system.
An Axiomatic Theory Of Normed Modules Via Riesz Spaces
Authors: Lučić Danka , Pasqualetto Enrico
Published: November 2024

We introduce and study an axiomatic theory of V-normed U-modules, where V is a Riesz space and U is an f-algebra; the spaces U and V also have some additional structure and are required to satisfy a compatibility condition. Roughly speaking, a V-normed U-module is a module over U that is endowed with a pointwise norm operator taking values in V. The aim of our approach is to develop a unified framework, which is tailored to the differential calculus on metric measure spaces, where U and V can take many different spaces of functions.
Trained mesenchymal stromal cell-based therapy HXB-319 for treating diffuse alveolar hemorrhage in a pristane-induced murine model
Authors: Bukulmez Hulya , Dennis Adrienne T , Reese-Koc Jane , Sieg Scott F , Clagett Brian , Kleinsorge-Block Sarah , Somoza-Palacios Rodrigo , Singer Nora , Chance Mark , Highland Kristin B , Emancipator Steven N
Published: November 2024

Introduction

Mesenchymal stromal cells (MSCs) can modulate immune responses and suppress inflammation in autoimmune diseases. Although their safety has been established in clinical trials, the efficacy of MSCs is inconsistent due to variability in potency among different preparations and limited specificity in targeting mechanisms driving autoimmune diseases.

Methods

We utilized high-dimensional design of experiments methodology to identify factor combinations that modulate gene expression by MSCs to mitigate inflammation. This led to a novel MSC-based cell therapy, HXB-319. Its anti-inflammatory properties were validated in vitro by flow cytometry, RT-PCR, and mass spectrophotometry. To evaluate in vivo efficacy, we treated a diffuse alveolar hemorrhage (DAH) mouse model (C57Bl/6). Seven days post-DAH induction with pristane, mice received either MSCs or HXB-319 (2X106 cells, IP). On day 14, peritoneal lavage fluid (PLF) and lung tissue were collected for flow cytometry, histopathological examination, and mRNA.

Results

HXB-319 increased gene expression levels of anti-inflammatory, angiogenic, and anti-fibrotic factors (eg, TSG-6, VEGF, and HGF). KEGG pathway analysis confirmed significant activation of relevant anti-inflammatory, angiogenic, and anti-fibrotic proteins, corroborating RT-PCR results. In the DAH model, HXB-319 significantly reduced lung inflammation and alveolar hemorrhage compared to MSC-treated and untreated DAH mice. HXB-319 treatment also significantly decreased neutrophils, plasmacytoid dendritic cells, and RORγT cells, increased FoxP3+ cells in PLF, and reversed alterations in mRNA encoding IL-6, IL-10, and TSG-6 in lung tissue compared to DAH mice.

Conclusion

HXB-319 effectively controls inflammation and prevents tissue damage in pristine-induced DAH, highlighting its therapeutic potential for autoimmune inflammatory diseases.
miR-361-3p overexpression promotes apoptosis and inflammation by regulating the USP49/IκBα/NF-κB pathway to aggravate sepsis-induced myocardial injury
Authors: Geng Huan , Qi Luyao , You Lijiao , Feng Wentao , Yang Xiaofang , Lei Ming
Published: November 2024

Background

Sepsis is a major cause of in-hospital death, particularly in the intensive care unit. A huge amount of effort has been put into identifying reliable biomarkers to improve the prognosis of patients with sepsis. Among the numerous candidates, microRNAs have attracted attention because of their promising prognostic value. Multiple miRNAs have been suggested to play vital roles in manipulating the nuclear factor-kappa B (NF-κB) pathway, a key factor involved in sepsis. In this study, we attempted to elucidate the potential functions of miR-361-3p in sepsis-induced myocardial injury in vivo and in vitro.

Methods

A sepsis model was established by cecal ligation and puncture (CLP) in rats and by lipopolysaccharide (LPS) in H9c2 cells. The functions of miR-361-3p were revealed by assessing the level of biomarkers of myocardial injury and inflammation by Enzyme-linked immunosorbent assay, as well as the apoptosis by terminal deoxynucleotidyl transferase dUTP nick-end labeling staining and flow cytometry. Binding of miR-361-3p and the 3′ untranslated region of ubiquitin-specific peptidase 49 (Usp49) was revealed by Dual luciferase reporter gene assay. The interaction of USP49 and its downstream target NF-κB inhibitor alpha (IκBα) was revealed by Co-immunoprecipitation and western blot analysis.

Results

miR-361-3p antagomir inhibited myocardial injury and inflammation in CLP-induced rats, as evidenced by a decrease in the serum levels of cardiac troponin I, creatine kinase-MB, interleukin-1 beta (IL-1β), IL-6, and tumor necrosis factor-alpha and cell apoptosis. However, miR-361-3p agomir aggravated sepsis-induced myocardial injury. Moreover, miR-361-3p inhibition induced the inhibition of LPS-induced apoptosis and inflammation in H9c2 cells. miR-361-3p could inhibit the expression of Usp49 by binding to its 3′ untranslated region. Furthermore, we demonstrated that Usp49 binds to IκBα and mediates its deubiquitination, leading to the stabilization of IκBα, which results in the cytoplasmic accumulation of NF-κB and eventually the suppression of NF-κB activity.

Conclusion

Taken together, our data demonstrate that miR-361-3p overexpression promotes apoptosis and inflammation by regulating the USP49/IκBα/NF-κB pathway to aggravate sepsis-induced myocardial injury.
The dynamics of household sanitation services and faeco-oral diseases externalities in Osun State, southwest Nigeria
Authors: Aluko O O
Published: November 2024

Background

Maintaining human dignity through sanitation is a perennial challenge and highlights the externalities of sanitation and hygiene services (SHS). In Nigeria, 23.2% practise open defecation, and 45.5% use basic sanitation services, although conventional sewerage systems are rare. This study determines SHS and their predictors in the context of local governance in southwest Nigeria.

Methods

The cross-sectional study applied a five-stage sampling technique and elicited information from 542 respondents using a validated semistructured questionnaire. The study results are presented by descriptive and inferential statistics.

Results

The mean age of respondents was 48.2±0.8 y. Of these, 64.2% were homeowners, and 40.0% were in the lower wealth quartiles. While 76.9% of respondents had access to toilets, only 16.6% and 18.1% benefitted from safely managed and basic sanitation services, respectively, with 21.2% practising open defecation. Open defecation (42.6%) was prevalent primarily in the Ayedaade local government area (LGA), while safely managed sanitation services (27.6%) and limited sanitation services (54.1%) were predominant in the Olorunda and Ilesa-West LGAs. The predictors influencing household sanitation services included residence, ethnicity and wealth.

Conclusions

There were significant inequalities in sanitation access and critical infrastructure, and sanitation quality gaps exist among respondents. The prevalence of open defecation was high, and there was variation in access to sanitation services across different LGAs.
Neuroimmune signalling pathways in chronic rhinosinusitis with nasal polyps
Authors: Jama Guled M. , Kariyawasam Harsha H.
Published: November 2024

Purpose of review

To evaluate the role of neuroimmune signalling pathways in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP).

Recent findings

The sinonasal mucosa is densely infiltrated by immune cells and neuronal structures that share an intimate spatial relationship within tissue compartments. Together, such neuroimmune units play a critical role in airway defence and homeostatic function. CRSwNP is primarily driven by a type 2 immune endotype in the majority of patients. So far, central and peripheral neuronal mechanisms that promote, regulate and enhance immune responses have not been investigated to any detail within this disease group. Neurogenic inflammation, mediated by neuropeptides such as substance P and calcitonin gene-related peptide (CGRP), has been shown to modulate immune responses. Emerging evidence now suggests a bidirectional communication between immune cells and neurons, with inflammatory cytokines directly activating sensory neurons and influencing their function alongside the nervous system directly modulating immune cells.

The complex interplay between epithelial cells, immune cells and neurons in CRSwNP presents both challenges and opportunities for therapeutic intervention. Understanding these neuroimmune interactions not only provides valuable insights into the pathogenesis of CRSwNP but also may open up new avenues for therapeutic strategies targeting both the inflammatory and neuronal components of the disease.
Clinical Outcomes of Revision Lumbar Fusion in the Aging Population
Authors: Narayanan Rajkishen , Tarawneh Omar H. , Dalton Jonathan , Oris Robert J. , Miller Mark , Pohl Nicholas B. , Issa Tariq Z. , Meade Matthew , Opara Olivia , Berthiaume Emily , Lee Yunsoo , Reddy Yashas , Bowen Grace , Lightsey Harry , Kaye Ian D. , Kurd Mark F. , Canseco Jose A. , Hilibrand Alan S. , Vaccaro Alexander R. , Kepler Christopher K. , Schroeder Gregory D.
Published: November 2024

Study Design.

Retrospective Cohort

Objective.

To examine the profile of older patients undergoing revision lumbar fusion and to evaluate the impact that advancing age may have on outcomes following revision lumbar fusion.

Summary of Background Data.

The proportion of older patients undergoing revision lumbar fusion is increasing, however, the benefit of revision lumbar fusion in an aging demographic is not well documented.

Methods.

Patients aged 55+ who underwent revision lumbar between 2011 and 2022 were included and were stratified into age groups: 55-64, 65-74, and 75+. Primary outcomes consisted of postoperative emergency department (ED) visits, 30- and 90-day readmissions, all-cause reoperations, and the need for secondary revisions. Secondary outcomes included patient-reported outcome measures (PROMs) obtained preoperatively, and at three months and one year postoperatively.

Results.

A total of 914 patients were included: 55-64 years (n=512, mean: 61.1 years), 65-74 years (n=296, mean:69.1 years), and 75+ (n=106, mean:78.9 years). Adjacent segment disease as a revision indication significantly increased with age(P=0.001). A circumferential approach was used most (N=200, 39.7%) in patients 55-64, while a posterior-only approach was used in 86.3% of patients 75+(P<0.001). Levels decompressed increased with age, from 1.67 in the youngest group to 2.04 in the oldest (P<0.001). The number of levels fused showed no significant difference (P=0.068). 90-day readmissions and the need for secondary revisions did not vary by age. Age groups were not independently associated with ΔPROMs at one year, but the oldest groups continued to experience improvement in PROMs in line with their younger counterparts.

Conclusion.

Patients 75 years and older derive similar benefits from revision lumbar fusion compared to their younger counterparts with no increased risk of ED visits, readmissions, or reoperations. Clinicians should be advised that there remains significant value in revising older patients when indicated.

Level of Evidence.

3
Use of stool DNA for colorectal cancer screening: a meta-analysis and systematic review
Authors: Mostafa Mariam , Eltaher Basant , Egiza Hebat-Allah , Gouli Sugam , Mahmoud Amir , Kharel Himal , Singh Harkarandeep , Niu Chengu
Published: November 2024

Colorectal cancer is the third most common malignancy in the USA and accounts for more than 1 million deaths worldwide with screening shown to reduce CRC mortality. This meta-analysis analyzed the use of stool DNA for screening average risk, asymptomatic subjects for colorectal cancer and advanced precancerous lesions and compared sDNA to FOBT tests (gFOBT and FIT). Eight studies were included from four different countries with a total of 39 665 subjects. Pooled sensitivity and specificity for sDNA for detecting CRC was 83.3% (95% CI: 60.8–94.2) and 92.4% (95% CI: 90.1–94.1), respectively, compared with FOBT, which had a lower sensitivity at 70.2% (95% CI: 45.5–86.9) but higher specificity 95.7% (95% CI: 95.1–96.2). Further analysis showed improved sensitivity of sDNA to 92.6% when only the studies employing sDNA tests that incorporate hemoglobin immunochemical test were used. Both sDNA and FOBT tests had low sensitivity for detecting advanced precancerous lesions. sDNA tests are sensitive and specific for the detection of CRC but show low sensitivity compared with colonoscopy for the detection of advanced precancerous lesions.
Experiences and Challenges for Critical Care Nurses in Work Related to Medical Device Alarms
Authors: Li Mingzhen , He Shaohua , Peng Meihua , Liu Huan , Chen Cheng , Liu Xiaofang , Tan Liming
Published: November 2024

Critical care nurses, who are at the frontline of recognizing and answering alarms, face various challenges while undertaking this task. The purpose of this qualitative study is to gain more insight into the experiences of critical care nurses working with medical equipment alarms. A qualitative, descriptive design was used to explore this area. Fifteen critical care nurses, recruited using purposive sampling, participated in semistructured interviews. These were recorded and coded, and data were analyzed using content analysis. Four themes and fifteen related subthemes emerged, including: (1) emotional experience (sub: anxiety/dysphoria, helplessness, worry, ambivalence); (2) physical symptoms (sub: hearing disorder, sleep disturbances, exhaustion, inattention); (3) new challenges (sub: multiple nursing roles, inconsistent practice guidelines, unsatisfactory human-machine interaction, nurse attribute); and (4) coping strategies (sub: positive alarm culture, effective teamwork, development of technology). Healthcare administrators should focus not only on the nurses themselves, but also on objective factors such as organization and technology, which contribute to the empowerment of ICU nurses and can encourage them to participate in clinical alarm management.
Caregiving
Authors: Hermanns Melinda , Greer Danice
Published: November 2024

Caregiving is a fundamental nursing role. However, when providing care to parents, the nurse experiences caregiving in a completely different way. The stresses and challenges the nurse experiences can be used to support others in similar caregiving experiences. In this article, caregiver role strain is discussed, and spiritual interventions are offered along with insight into the physical, mental, and emotional requirements of caregiving.
Mpox Keratouveitis: A Clinical Analysis of Host Immune Responses
Authors: Carrubba Steven , Jennings Erin , Guttha Samyuktha , Ostrovsky Ann , Sperber Laurence , Haberman Ilyse , Goyal Himani
Published: November 2024

Purpose:

To describe 2 patients with mpox keratouveitis and evaluate their contrasting clinical phenotypes in the context of baseline immune function.

Methods:

Both patients were subject to longitudinal care by providers at our institution. Qualitative polymerase chain reaction (PCR) analysis was used to confirm their diagnoses, and interval slit-lamp photography was used to document their clinical progression. For case 2, histologic analysis was performed on a corneal biopsy specimen.

Results:

Case 1 describes a 31-year-old immunocompetent man with cutaneous mpox who developed a unilateral keratouveitis after a cutaneous lesion of the ipsilateral eyelid. His keratitis resolved over 1 week with application of trifluridine eye drops. An anterior uveitis persisted but resolved by 2 weeks after treatment with topical prednisolone and oral tecovirimat. Case 2 describes a 27-year-old man with HIV and a declining CD4+ count who was coinfected with monkeypox virus. Over 3 months, he developed a progressive unilateral keratouveitis that resulted in corneal melt requiring tectonic keratoplasty to preserve globe integrity. On histology, the patient's corneal biopsy specimen was devoid of lymphocytes.

Conclusions:

Contrary to immunocompetent patients, individuals with profound cell-mediated immunodeficiencies may be unable to mount sufficient lymphocytic responses in corneal tissue to contain mpox lesions. A progressive keratouveitis can develop, leading to corneal melt with an atypical local immune signature. The clinical and histologic phenotype of the cornea in this scenario is analogous to progressive vaccinia of the skin, a rare clinical entity that develops after smallpox vaccination of immunocompromised hosts.
Viral and immune predictors of HIV posttreatment control
Authors: Mesquita Flavio S. , Li Yijia , Li Jonathan Z.
Published: November 2024

Purpose of review

This review focuses on the viral and immune factors influencing HIV posttreatment control (PTC), a rare condition where individuals maintain viral suppression after discontinuing antiretroviral therapy (ART).

Recent findings

Studies demonstrate that early ART initiation leads to smaller HIV reservoirs and delayed viral rebound in PTCs. Virologically, PTCs harbor smaller HIV reservoirs and show lower levels of reservoir transcriptional activity compared with posttreatment noncontrollers. Immunologically, PTCs exhibit distinct T-cell dynamics, with reduced CD4+ and CD8+ T-cell activation and exhaustion, enhanced natural killer (NK) cell activity, and enhanced proliferative responses of HIV-specific CD8+ T cells post-ART interruption. Additionally, humoral immunity, particularly the development of autologous neutralizing antibodies (aNAbs), plays a role in viral control, though broadly neutralizing antibodies (bnAbs) are rare.

The mechanisms behind posttreatment control are multifactorial, involving virological and immunological factors. Early ART initiation, a smaller and less transcriptionally active HIV reservoir, and immune responses including proliferative T-cell activity and NK cell function are key contributors to achieving ART-free HIV remission.
Use of long-acting injectable cabotegravir/rilpivirine in people with HIV and adherence challenges
Authors: Christopoulos Katerina A. , Hickey Matthew D. , Rana Aadia
Published: November 2024

Purpose of review

Recent changes in US Department of Health and Human Services and International AIDS Society USA guidelines now endorse use of long-acting injectable cabotegravir and rilpivirine (LA-CAB/RPV) in people with HIV (PWH) who have adherence challenges, including those with viremia. We sought to summarize clinical trial and real-world study data on outcomes and implementation strategies, highlight key unanswered questions, and provide recommendations for best practices.

Recent findings

Studies of LA-CAB/RPV in PWH with adherence challenges demonstrate excellent virologic outcomes, although the rate of virologic failure is higher than that in registrational trials conducted in PWH with stable viral suppression. However, viral suppression is attainable on alternate antiretroviral regimen, including those that employ lenacapavir, another long-acting injectable antiretroviral drug, even after virologic failure on LA-CAB/RPV. Successful implementation strategies for long-acting programs include centralized multidisciplinary clinic teams (ideally with pharmacist/pharmacy technician involvement), small incentives to promote patient retention on injections, allowing for drop-in injections, outreach after late injections, and partnerships with home nursing, street medicine, and harm reduction sites.

Creating programs that can support PWH with adherence challenges, their providers, and their clinics to use LA-CAB/RPV in service of sustained viral suppression is an urgent priority, particularly for PWH with CD4+ cell count <200 cells/mm3.
What Are the Perceived and Experienced Barriers to Health Care Access for Low-Income, Rural Communities of Color in the Southern United States?
Authors: Blackburn Christine Crudo
Published: November 2024

Objective:

Examines the perceived and experienced barriers to healthcare access for low-income, rural communities of color in the Southern United States.

Design:

This study used focus groups to examine barriers to healthcare access in each community. The transcripts from the focus groups were analyzed using thematic analysis and description-focused coding in MAXQDA 2022© software to determine the barriers that were common across all four communities of study.

Setting:

One community in Louisiana, one community in Mississippi, one community in Alabama, and one community in South Carolina (total of 4 communities).

Participants:

37 adults participated in the study.

Results:

Three primary themes were identified: 1) long distances to hospitals and clinics prevent people from seeking and receiving healthcare; 2) people will not access healthcare out of a fear that they are sick; and 3) medical costs after insurance are a deterrent to accessing healthcare and medications.

Conclusions:

Fear associated with finding out that they are sick is a significant obstacle for participants to access healthcare. The study also confirms previous research findings that distance and medical costs are a major barrier to healthcare access. Importantly, the findings regarding distance demonstrate a lack of acceptance for local health services rather than a lack of availability, suggesting that a lack of acceptance creates a perceived lack of availability and need to travel for care.