bluuebunny/crossref_metadata_2025 huggingface dataset:
Snare‐Assisted Flexion of 27‐French Leadless Pacemaker Delivery Sheath: A Case Report
Authors: Shah Hemal , Winner Marshall , Patel Dilesh , Gandhi Gaurang , Canterbury Ann , Athar Muhammad Waqas , Daoud Emile G.
Published: January 2025

Introduction

A leadless pacemaker (LLPM) was recommended for a patient with intermittent complete heart block and near‐syncope.

Methods and Results

Delivery of LLPM is through a large sheath that has limited deflection and steerability. This report describes the successful deployment of a ventricular LLPM in a patient with prior surgical correction of AV septal defect with subsequent significant right atrial enlargement. The LLPM could not traverse the tricuspid valve. A snare was advanced to the right atrium and used to create greater tip deflection of the delivery sheath. Importantly, once the delivery sheath crosses the tricuspid valve, the snare is loosened to allow directing the sheath to the right ventricular septum rather than the initial direction that was toward the right ventricular apex. The ventricular LLPM was successfully fixated.

Conclusion

In the presence of complex anatomy, deployment of a LLPM delivery sheath can be facilitated with use of a snare to assist with increased deflection then subsequent guidance to the preferred right ventricular location of the septum.
Permanent Left Bundle Branch Area DF‐4 Defibrillator Lead Implantation—Feasibility, Procedural Caveats, Safety, and Follow‐Up
Authors: Ghosh Anindya , Sriram Chenni S. , Manu Nibin , Sankaradas Mullasari Ajit , Upadhyay Gaurav M. , Pandurangi Ulhas M.
Published: January 2025

Introduction

Permanent implantation of a DF‐4 implantable cardiac defibrillator (ICD) lead in the left bundle branch area (LBBA‐ICD) is the next paradigm in amalgamating cardiac resynchronization therapy (CRT) and defibrillation. We systematically investigated feasibility/success rate, procedural caveats, and complications associated with a permanent DF‐4 LBBA ICD implant and pertinent data at short‐term follow‐up.

Methods

We prospectively attempted implantation of 7 Fr Durata (Abbott, Chicago, IL, USA) single coil DF‐4 ICD lead at the LBBA using a fixed‐curve non‐deflectable CPS locator delivery sheath. Standard criteria defined LBBA capture. Relevant sensing/pacing, defibrillation, radiographic, and echocardiographic parameters testing were recorded at implant, discharge and 5‐month follow‐up.

Results

We enrolled 12 consecutive cardiac device‐naïve patients (median age 67.5 years, male 91.7%, median LVEF 30%, median septal thickness 9 mm, median QRS duration 140 ms, class I CRT indication 58.3%, primary prevention ICD indication 75%). Minor complications (two transeptal perforations and one micro‐dislodgment) were noted in 3/12 (25%) patients. Successful permanent LBBA ICD implant with adequate sensing/pacing was achieved in 9/12 (75%) subjects. Sustained ventricular fibrillation (VF) was inducible in 7/9 patients with successful implants with effective sensing and defibrillation in all. Follow‐up device‐related and echocardiographic parameters were similar at discharge and 5‐month follow‐up.

Conclusion

Permanent DF‐4 LBBA ICD implant is feasible and successful in 75% of patients with an indication for ICD. With dedicated toolkits, higher volumes, and an obligate learning curve, the higher‐than‐expected frequency (25%) of minor complications may be ameliorated. Short‐term data regarding lead and selected RV parameters remained favorable.
Epidemiological characteristics and risk factors for heart failure in Japanese patients with type 2 diabetes: A retrospective analysis of the J‐DREAMS database
Authors: Ohsugi Mitsuru , Nitta Daisuke , Naito Yusuke , Ueki Kohjiro
Published: January 2025

Aim

To determine the epidemiological characteristics and risk factors for heart failure (HF) among Japanese patients with type 2 diabetes.

Methods

A retrospective cohort analysis, using J‐DREAMS database, was conducted from December 2015 to January 2020 with type 2 diabetes. The primary objectives were to describe patient characteristics stratified by HF history at baseline and new HF events during follow‐up. The secondary objectives were to clarify the association between HF history or new HF events and clinical characteristics. The association between renal disease stage and HF was also studied.

Results

Among 18,250 adult patients with type 2 diabetes, 3,613 (19.8%) patients had HF history and the mean age was 68.46 years, predominantly male (66.4%) with 13.32 years of mean duration of type 2 diabetes. Patients with HF history had a higher proportion of patients with nephropathy (51.2%) and coronary heart disease (55.6%) than those without HF history. Coronary heart disease (CHD) and deteriorating renal function were strongly associated with both HF history (CHD adjusted odds ratio [OR]: 7.41, 95% confidence interval [CI]: 6.05–9.08; eGFR G5 stage adjusted OR: 6.56, 95% CI: 2.97–14.49) and new HF events (CHD adjusted OR: 1.63, 95% CI: 1.17–2.29; eGFR G4 stage adjusted OR: 3.42, 95% CI: 1.81–6.47).

Conclusions

Comorbidities, especially CHD and deteriorating renal function, were strongly associated with HF history and new HF events among Japanese patients with type 2 diabetes. The study results suggested the importance of early intervention to treat comorbidities and maintain renal function.
Proteomic Analysis Reveal Differential Protein Expressions of Bacillus cereus Spore Under Electrolyzed Water Treatment
Authors: Chen Yi , Qi Yajin , Wang Wenjun , Zhou Jianwei , Liu Donghong , Lv Ruiling
Published: January 2025

In order to uncover the molecular regulatory mechanisms of spore inactivation under electrolyzed water (EW), the overall regulation of proteins of Bacillus cereus spores was investigated by the data‐independent‐acquisition method. It was found that there was a remarkable difference in the expression of 164 proteins in 30 min after exposure to 30 ppm acid electrolyzed water, including 131 downregulated and 33 upregulated proteins. Differentially expressed proteins (DEPs) were mainly enriched in the cytoplasm and the cytoplasmic membrane. Besides, the protein expressions related to a series of crucial biomolecular processes were influenced by electrolyzed water, including carbohydrate metabolism, transportation, and energy metabolism. DEPs involved in the tricarboxylic acid cycle were 18 downregulated after EW treatment, including the key enzymes. Moreover, the ability of both carbohydrate catabolism and energy production of spores decreased after EW treatment. Key proteins of the phosphotransferase system were upregulated, indicating that EW enhanced carbohydrate transportation and phosphorylation. These results presented novel insights into the interactions between electrolyzed water conversion and cellular metabolism at the pathway and network levels. This work focused on the molecular mechanisms of the B. cereus spores under EW stress, clarified the key proteins that played a critical role in spores under environmental stress, and revealed the inactivation mechanism of EW to B. cereus spores.
Impact of Positive Glucose, Lactose, and Fructose Hydrogen Breath Tests on Symptoms and Quality of Life in Irritable Bowel Syndrome
Authors: Loo Qing Yuan , Chuah Kee Huat , Hian Wen Xuan , Khoo Xin Hui , Lee Yeong Yeh , Mahadeva Sanjiv
Published: January 2025

Background

Gas production due to fermentation from fructose malabsorption (FM) or lactose malabsorption (LM) and small intestinal bacterial overgrowth (SIBO) contribute to the development of gastrointestinal symptoms in patients with irritable bowel syndrome (IBS). However, the impact of the carbohydrate malabsorption, unlike SIBO, is relatively unknown.

Methodology

A multicenter, prospective study of consecutive adults with IBS who underwent a hydrogen breath test (HBT) (glucose, 75 g; lactose, 25 g; or fructose, 25 g) was conducted. The proportion of patients who tested positive for glucose, fructose and lactose HBT were evaluated. The symptom severity, psychology, and quality of life of subjects with SIBO were compared with those having LM and/or FM. Independent factors associated with severe IBS (IBS‐symptom severity scale: IBS‐SSS > 300) were explored.

Results

A total of 116 subjects were included (median age 56 years, male 35.3%). Of these, 23.3% (27/116), 85.7% (24/28), and 44.4% (16/36) of them tested positive for glucose, lactose, and fructose HBT, respectively. Among those with a positive HBT (n = 65), patients with SIBO were more likely to have the diarrhea‐predominant subtype of IBS (77.8% vs. 47.4%, p = 0.014). Severe IBS was associated with SIBO, compared with LM/FM (SIBO: 36.4% vs. LM: 9.1%/FM 13.3%, p = 0.016). With multivariate analysis, SIBO (OR 5.25, p = 0.028) and depression (OR 5.59, p = 0.030) were independently associated with severe IBS.

Conclusion

Although LM and FM commonly co‐exist in IBS, their clinical relevance appears to be less significant than that of SIBO. The connection between SIBO with depression reinforces the importance of the microbiome–gut–brain axis in IBS.
Enhancing surface energy and characterizing optical properties of ultra‐high translucency zirconia via an innovative heat treatment process
Authors: Kang Chien‐Ming , Wu Sheng‐Han , Feng Sheng‐Wei , Wei Chenxuan , Peng Tzu‐Yu
Published: January 2025

Purpose

Ultra‐high translucency zirconia (UT‐Zr) is known for its high esthetic quality; however, its inert surface results in low hydrophilicity and surface energy (SE). To address this limitation, this study proposes an innovative zirconia heat treatment process (ZHTP) and aims to evaluate the effects of ZHTP on the surface characteristics of UT‐Zr, offering a novel and practical approach for surface pretreatment in dental practice.

Material and Methods

The plate‐shaped UT‐Zr samples were fabricated. After sintering, the samples without additional staining or polishing were divided into the following nine groups: NT (no additional pretreatment), AB (airborne‐particle abrasion), PL (nonthermal plasma), PO (polishing), HPO (fine‐polishing), NTH (treat with ZHTP), POPL (PL followed by PO), POH (ZHTP followed by PO), and HPOH (ZHTP followed by HPO). The surface roughness (Ra), microstructure, transmittance, glossiness, wettability, and SE of the samples (n = 10), and statistical analyses were conducted.

Results

AB showed the highest Ra and lowest glossiness (P < 0.05), while HPO and HPOH yielded the smoothest surfaces, with HPOH achieving the highest glossiness (P < 0.05). Although the ZHTP approach slightly improved transmittance, it did not affect the microstructure. PO reduced hydrophilicity and SE (P < 0.05), and HPO slightly increased them. PL significantly enhanced both properties (P < 0.05), and ZHTP also increased them (P < 0.05) to levels similar to PL. Notably, hydrophilicity in nonthermal plasma and ZHTP‐treated samples decreased similarly after 24 h.

Conclusions

The ZHTP approach enhances UT‐Zr wettability and SE, with slight transmittance improvement. HPOH achieves hydrophilicity and SE comparable to PL, validating ZHTP as a promising strategy for UT‐Zr surface optimization in dental applications.
A new model‐based approach for estimating rural hospital markets
Authors: Malone Tyler L. , Pink George H. , Holmes George M.
Published: January 2025

Purpose

To provide a new approach for defining rural hospital markets.

Methods

First, we estimated models of hospital choice. We defined hospitals in the choice set using nationwide hospital data from the Healthcare Cost Report Information System (HCRIS). We modeled hospital choice using conditional logit regression and 2019 Medicare Fee‐for‐Service (FFS) claims data from the Centers for Medicare & Medicaid Services (CMS) Virtual Research Data Center. Next, we calculated estimated inpatient and emergency department utilization by patient ZIP code. We then estimated the total Medicare FFS volume for each hospital as well as the percent of each hospital's volume attributable to each ZIP code. We sorted ZIP codes by the patient volume attributable to the given hospital (from most volume to least volume) and then added ZIP codes to the market until at least 50% of the hospital's total patient volume was represented.

Findings

The average rural hospital market included three ZIP codes, an estimated population total of 37,221, and an estimated 5385 Medicare FFS beneficiaries. Furthermore, the average rural hospital had an estimated market share of 29%. A lower estimated market population was found for Critical Access Hospitals, hospitals unaffiliated with a system, hospitals with a smaller number of acute beds, and hospitals with fewer staff.

Conclusions

We developed a new approach for defining rural hospital markets. This approach can be used to inform health services researchers, policymakers, and communities about key market predictors of rural hospital financial distress, populations adversely affected by rural hospital closure, and more.
Impact of delirium on post‐discharge mortality in coronary care unit patients: A retrospective cohort study
Authors: Xu Hong‐Bo , Shu Min , Wu Jia‐Jun , Li Rui‐Fa , Lin Xiao‐Hua , Zhang Hai‐Gang
Published: January 2025

Background

Coronary care unit (CCU) patients surviving to discharge still face significant mortality. Delirium is common in CCU patients and has been associated with poorer CCU and in‐hospital outcomes.

Aim

To assess the association between delirium and mortality after hospital discharge in CCU survivors.

Study Design

This was a retrospective observational study that included patients admitted to CCU. All data were extracted from the Medical Information Mart for Intensive Care IV database. The exposure was delirium during CCU stay. The primary outcome was mortality 180 days after hospital discharge. Secondary outcomes included post‐hospital discharge mortality at 90 days, length of CCU and hospital stays, and hospital discharge disposition.

Results

Of the 3609 CCU patients included, 891 were considered delirium‐positive during their CCU stay. Delirium was associated with an increased risk of mortality at 180 days after hospital discharge (adjusted hazard ratio [HR], 1.33; 95% confidence interval (CI), 1.08–1.64). Similar results were observed for 90‐day post‐discharge mortality (adjusted HR,1.43; 95% CI, 1.13–1.83). CCU patients who experienced delirium had longer stays in both the CCU and hospital (adjusted β, 2.11; 95% CI, 1.79–2.43 and 3.87; 95% CI, 3.06–4.69, respectively). They were also more likely to require nursing care after hospital discharge (adjusted odds ratio [OR], 1.65; 95% CI, 1.22–2.22).

Conclusion

Delirium during CCU stay was associated with an increased risk of all‐cause mortality up to 180 days in CCU patients who survived hospital discharge.

Relevance to Clinical Practice

Delirium places CCU patients at a higher risk of post‐discharge mortality and increased health care resource requirements. Given the high prevalence of delirium in CCU patients and its significantly deleterious impact on both short‐term and long‐term post‐discharge mortality, nurses and physicians should enhance the post‐discharge management of patients who experience delirium in order to improve prognosis. This also highlights the importance of preventing and managing delirium during hospitalization.
Abiotic Stress‐Induced Chloroplast and Cytosolic Ca2+ Dynamics in the Green Alga Chlamydomonas reinhardtii
Authors: Pivato Matteo , Costa Alex , Wheeler Glen , Ballottari Matteo
Published: January 2025

Calcium (Ca2+)‐dependent signalling plays a well‐characterised role in the perception and response mechanisms to environmental stimuli in plant cells. In the context of a constantly changing environment, it is fundamental to understand how crop yield and microalgal biomass productivity are affected by external factors. Ca2+ signalling is known to be important in different physiological processes in microalgae but many of these signal transduction pathways still need to be characterised. Here, compartment‐specific Ca2+ dynamics were monitored in Chlamydomonas reinhardtii cells in response to environmental stressors, such as nutrient availability, osmotic stress, temperature fluctuations and carbon sensing. An in vivo single‐cell imaging approach was adopted to directly visualise changes of Ca2+ concentrations at the level of specific subcellular compartments, using C. reinhardtii lines expressing a genetically encoded ratiometric Ca2+ indicator. Hyper‐osmotic shock caused cytosolic and chloroplast Ca2+ elevations, whereas high temperature and inorganic carbon availability primarily induced Ca2+ transients in the chloroplast. In contrast, hypo‐osmotic stress only induced Ca2+ elevations in the cytosol. The results herein reported show that in Chlamydomonas cells compartment‐specific Ca2+ transients are closely related to specific external environmental stimuli, providing useful guidance for studying signal transduction mechanisms exploited by microalgae to respond to specific natural conditions.
Public Health Simulation‐Infused Program (PHSIP) for Nursing Education
Authors: Hill Peggy P. , Anderson Mindi , Peralta Heather , Díaz Desiree A.
Published: January 2025

Introduction

Recent health crises, like COVID‐19, have increased the need for nurses with public health competencies, but students lack knowledge and are unconvinced of the importance of the field.

Methods

Pre‐licensure nursing students (n = 341) engaged with a public health simulation‐infused program (PHSIP) that scaffolded throughout the curriculum. Public health knowledge was tested pre‐ and post‐simulation‐based education (SBE), and the simulation effectiveness tool‐modified (SET‐M) was used to evaluate Learners’ perception of the SBE experience.

Results

Learners’ overall mean SET‐M scores were 47.1/57 (83%), ranging from 49.5 to 54 out of 57. Post‐test knowledge scores were found to be significantly higher than pre‐test (p < 0.001), with an average overall mean knowledge score of 70% (±0.25) and an effect size of 0.82.

Discussion

Scaffolding public health SBEs across the curriculum allowed continuous exposure to public health content. Lessons learned include the need to chunk pre‐SBE training to prevent cognitive overload, and the time and resources needed to create a PHSIP.

Conclusion

Nursing educators should embrace the PHSIP curriculum to provide an opportunity for students to gain an appreciation for the field and gain the knowledge, skills, and resources needed to care for the public's health.
Psychosocial problems observed in older adults after disaster
Authors: Güngörmüş Zeynep , Özgüç Safiye
Published: January 2025

Natural disasters are large‐scale catastrophic events that seriously disrupt the functioning of a community or society. The frequency and severity of disasters are increasing and involve widespread human, material, economic, or environmental impacts that exceed the ability of the society affected by them to cope using its resources. In addition, disasters significantly affect the physical, emotional, and psychological health of individuals and cause numerous deaths, injuries, and economic losses. One of the most vulnerable groups to the negative effects of disasters is the elderly. The increase in the elderly population worldwide brings with it the problems specific to this period and the service needs for these problems. The population consists of older adults, who are among the most vulnerable groups to the negative effects of natural disasters. During the social traumatisation process triggered by natural disasters, elderly people experience intense feelings of anxiety, fear, anger, helplessness, loneliness, hopelessness, futurelessness, and insecurity. Reactions such as unresponsiveness, alienation, inability to focus, and inability to remember are normal during this process. The normality of these feelings and responses in the acute period, which can last up to 3 months, will give way to abnormality unless the necessary physical and psychosocial conditions are provided. When the necessary psychosocial conditions are not provided, elderly individuals who experience a disaster may experience mental problems such as post‐traumatic stress disorder, depression, somatisation disorder, anxiety disorders, and substance use disorders. In this context, providing the necessary psychosocial support for older adults to cope with psychosocial problems after a disaster and facilitating access to this support is very important in terms of adapting to the post‐disaster period.
Computing 3‐Step Theory of Suicide Factor Scores From Veterans Health Administration Clinical Progress Notes
Authors: Meerwijk Esther L. , Shotqara Asqar S. , Finlay Andrea K. , Reeves Ruth M. , Tamang Suzanne R. , Ilgen Mark A. , Harris Alex H. S.
Published: January 2025

Background

Literature on how to translate information extracted from clinical progress notes into numeric scores for 3‐step theory of suicide (3ST) factors is nonexistent. We determined which scoring option would best discriminate between patients who will attempt or die by suicide and patients with neither suicidal ideation nor attempts, and we tested hypotheses related to the 3ST.

Methods

We used terminology‐driven natural language processing (NLP) to extract information from Veterans Health Administration (VHA) clinical progress notes. Counts of those extractions served as input to evaluate candidate scoring options for each 3ST factor (psychological pain, hopelessness, connectedness, capability for suicide). Logistic regression models adjusted for common demographic characteristics were used to test the 3ST hypotheses.

Results

Optimal contrasts between groups were obtained with P − A for psychological pain, hopelessness, and capability for suicide, and for connectedness, where P and A, respectively, indicate the patient‐level number of extractions indicating presence and absence of the factor.

Limitations

Additional research is necessary to verify whether our conclusions hold in a cohort that is more reflective of the general VHA population.

Conclusion

Terminology‐driven 3ST factor scores discriminate patients who attempt or die by suicide from patients without suicidal ideation or attempts. Our results corroborate the validity of the 3ST for VHA patients.
Syphilis in a blood bank in Argentina: Prevalence trends and risk factors
Authors: Rios Trevisan Ana , Fernandez Carolina , Puppo Mónica , Remesar Mirta Cristina , Roel Macarena , Kuperman Silvina
Published: January 2025

Background

Worldwide, there has been a worrying increase in the prevalence of syphilis. Blood banks have a major role in monitoring the trend of these events, despite the bias due to the altruistic donation strategy.

Objectives

To determine the seroprevalence of syphilis and analyse its association with defined risk factors among blood donors at the regional blood center at Hospital Prof. Dr. J. P. Garrahan, period 2016–2022.

Materials and Methods

Donor screening was performed with treponemal and non‐treponemal tests to determine the prevalence of active and past syphilis. Sociodemographic characteristics of donors were analysed and the association with potential risk factors was assessed.

Results

A total of 72 874 donations were processed during the study period. The overall prevalence of specific anti‐Treponema pallidum antibodies was 0.69% (95% CI = 0.63–0.75). Active syphilis seroprevalence was 0.30% (95% CI = 0.25–0.33). Not active syphilis seroprevalence was 0.39% (95% CI = 0.35–0.44). Anti‐T. pallidum seroprevalence among first‐time donations was 1.26% (95% CI = 1.14–1.38) while in repeat donations it was 0.16% (95% CI = 0.12–0.21). In univariate analysis, we found an association between syphilis and having a history of any sexually transmitted infection (OR: 5.09, 95% CI = 2.20–11.70, p < 0.01) and being first‐time donors (OR: 3.48, 95% CI = 1.70–7.09, p = 0.0001).

Conclusion

Although the overall prevalence of syphilis is 0.69%, among repeat donors prevalence as low as 0.16% was found. This demonstrates the need to maintain and improve screening strategies and promotion of voluntary, altruistic and repeat donation.
Mining an Anthropocene in Japan: On the making and work of geological imaginaries
Authors: Dixon Deborah P. , Fearnley Carina J. , Pendleton Mark
Published: January 2025

Geology firmly underpins Anthropocene debate, and in particular an Earth Systems Science (ESS) rendering of how lithic and yet‐to‐be‐lithified (or ‘drift’) material, including the tangible evidence of a state‐sponsored carbon capitalism, is reconstituted by anthropogenically ‘forced’ physical processes. The prevalence of this approach hinges in large part on the authority afforded Geology as a science that names, classifies and explains these materials and their spatio‐temporalities (such as the stratigraphies that undergird eras and epochs). We argue that this deployment can: (1) simplify how Geology has diversely framed and explained a planetary history, while glossing over the complex power relations that Geology drew upon as the authoritative narrator of this history, and which it enabled and furthered; and (2) foreclose how the lithic and the drift might be otherwise imagined as part of an Anthropocene condition. We ground this argument by introducing a particular moment of Geological practice: the discovery of a fossil floating fern in a Hashima (Japan) Prospecting Pit. Following an outline of Geology’s place within Anthropocene debate we provide an expanded sense of this science by situating this moment within a series of Geological imaginaries, from a state‐sponsored extractive gaze and ‘romantic’ idioms to a grassroots, practice‐based Geological movement in Japan. Our own practice draws on the latter, and adapts two well established Geological mapping techniques, the Geological Cross‐section and the Geological Stereonet, to visualise not the ordering of materials out of chaos, but their transmogrification. Such speculation as to how the lithic and the drift might be reworked as an Anthropocene material outside of a chronostratigraphy helps create space, we suggest, for a Critical Geology that delves into the dynamic relations between people, the lithic and the drift, identifying not only key problematics but also the resources that can be drawn on to help build a response.
Revisiting Trade and Income in the New Era of Globalisation—Distance, Big Boats and Natural Barriers to Trade
Authors: Gogebakan Anil
Published: January 2025

This paper investigates the relationship between international trade and income, exploiting a dynamic distance measure generated by the growth of container ships and Panama Canal capacity. Employing a version of the gravity model, this paper constructs an instrument for trade that accounts for bilateral trade flow differences driven by the Panama Canal and big ships. I exploit the created instrument, given its purely geography‐based nature, to estimate the impact of trade on income between 2002 and 2022. This paper finds a trade elasticity of income at 0.4, indicating that a one‐dollar increase in trade translates into a 40‐cent higher income on average. Compared to earlier studies, this indicates a more pronounced impact of trade on income in the recent era of globalisation.
Potential Zoonotic Infections Transmitted by Free‐Ranging Macaques in Human–Monkey Conflict Areas in Thailand
Authors: Suwanpakdee Sarin , Bhusri Benjaporn , Saechin Aeknarin , Mongkolphan Chalisa , Tangsudjai Siriporn , Suksai Parut , Kaewchot Supakarn , Sariwongchan Rattana , Sereerak Piya , Sariya Ladawan
Published: January 2025

Introduction

Nonhuman primates (NHPs) can transmit zoonotic diseases to humans because of their close genetic relationship, facilitating the cross‐species transmission of certain pathogens. In Thailand, Macaca is the most common NHP genus and their inhabits area are in close proximity of human, particularly in urban and suburban areas, where frequent interactions with humans increase the risk of pathogen transmission. The risk is influenced by factors such as the type of pathogen, the mode of transmission (e.g. direct contact or vector‐borne), and the density of human and macaque populations in the regions. This study aims to investigate potential zoonotic infections in free‐ranging macaques residing in human–monkey conflict areas.

Methods

From 2014 to 2023, 2703 macaques across 29 provinces in Thailand were tested for 18 pathogens using PCR, RT‐PCR, or real‐time PCR. The associations between disease occurrence, demographic variables, and sample types of macaques were analysed using univariable and multivariable regression.

Results

The overall pathogen infection percentage was 35.7% (965/2703). Simian foamy virus (SFV) had the highest infection percentage at 52.5% (759/1446), followed by Herpesviridae at 41.4% (353/852), Plasmodium spp. at 1.8% (14/758), and hepatitis B virus at 0.1% (2/1403). Significant differences were observed among different sampling sites, macaque age groups, and species in infection proportion of SFV, and Herpesviridae.

Conclusions

Identifying the pathogens carried by macaques is crucial for preparing for potential disease epidemics and outbreaks.
Abandonment of Agricultural Lands, Reasons and Sustainability: Evidence from Turkey
Authors: Erbaş Nizamettin , Çınarer Gökalp
Published: January 2025

The land is one of the key factors of production for the agriculture sector, which provides food and shelter to the people. Land abandonment leads to decreased farm diversity, low production, and underutilization, as well as threatening the cultural heritage. Land abandonment has reached 41.06% in the region in the last two decades. Thereby, this study focuses on exploring the abandonment reasons of agricultural lands, which is one of the main production factors. The study was performed in the Yozgat province of Turkey. A well-structured questionnaire was used to collect the data from 181 farms through stratified random sampling. Questionnaires consisted of both open-ended and closed-ended questions. The research results showed that the principal causes of land abandonment in the region were low profit reaped from field crop cultivation and farms' weak administrative profiles. The majority of the farmers had not done soil analysis but were using cropping systems. In the study, in addition, it was tested statistically if producers’ administrative competencies differed among the strata and so it was determined there were no significant differences among the strata. To effectively mitigate the negative effects of land abandonment, the government should improve production conditions, improve agricultural yields, and strengthen food and agricultural product promotion and guidance.
A regional road network traffic noise limit prediction method based on design elements
Authors: Wang Xiaoxia , Lin Junshan , Liang Hongjian , Wang Haibo
Published: January 2025

Since traffic flow has not been generated, a traffic noise prediction model based on actual traffic state data cannot be directly applied to the planned road network. Therefore, a regional traffic noise prediction method is proposed to find the upper limit of network noise emission based on design elements. The model is developed with noise predictions of the basic road section, interrupted/continuous intersections, and regional network. Meanwhile, ranges of traffic flow speed and volume are inferred by design elements and constraints between road units are obeyed. A four-scenes experiment to verify the method's accuracy is organized and the average noise difference between the upper limit calculated value and maximum measurement value is 1.53 dBA. All noise differences are positive as the measured noise values may not reach the upper limit of network emission in the experimental state. The method is applied to a network under design elements, and the results show that the model is suitable for the predicting upper limits of noise under design constraints; under the same design elements, noise emission at interrupted intersections is higher than that at continuous intersections. The method can provide a theoretical and data basis for planning network noise protection.
Triassic stratigraphy of the Saddlebag Lake pendant, California, USA: Implications for the character of earliest arc volcanism and the role of upper-plate lithosphere in a young-arc subduction setting
Authors: Riggs N.R. , Barth A.P. , Savage J.A. , Roberts S. , Berglin S.K. , Walker J.D. , Wooden J.L. , Bogle S.R.
Published: January 2025

Basal Triassic strata in the Saddlebag Lake pendant in the eastern Sierra Nevada, California, preserve a record of magmatism and sedimentation that marks the maturation of the early Mesozoic Cordilleran arc at this latitude. Facies analysis, geochemistry, and U-Pb geochronology provide the basis for a model that shows ways in which the types of volcanism and the geochemistry of magmatism reflect the presence and evolution of continental crust in the upper plate of a young subduction zone.

Facies analysis of the breccia of Frog Lakes, an andesitic dome complex within the Saddlebag Lake pendant, demonstrates a subaqueous environment of deposition that is inferred to be characteristic of the interbedded tuff of Greenstone Lake and underlying rhyolitic tuff of Saddlebag Lake and conglomerate of Cooney Lake. This subaqueous volcanism and sedimentation suggest that subduction drag on the continental upper plate had greater effect than the buoyancy imparted by the felsic crust. Geochemistry of ignimbrites and dome deposits together with U-Pb isotopic and geochemical analyses of zircon from ignimbrites and the conglomerate of Cooney Lake and from similar-age strata from the Mount Morrison pendant to the south demonstrate the nature of upper-plate continental crust in the period between ca. 250 and ca. 220 Ma. Breccia clasts are medium-K tholeiitic arc basalt, basaltic andesite, and andesite, and they broadly overlap in bulk composition with underlying mafic hypabyssal intrusions. Minor- and trace-element geochemistry of tuff and detrital zircon grains indicates that Triassic silicic melts were relatively cool and fractionated, consistent with late zircon saturation in Zr-poor melts. We infer that the eruption and welding of thick, rhyolitic ignimbrites are, to first order, unique to magmas derived from subduction under continental crust.
‘Letting him know that we love him’: the experiences of young people who question their gender and the parents who support them
Authors: Jackson-Taylor Christine , Atkin Karl
Published: January 2025

Background

Gender identity services for children and young people are currently being reorganised in England and Wales. Provision is required to negotiate clinical uncertainty and a public debate that cannot agree on what care should look like.

Objectives

To explore how young people, parents and young adults respond to gender dysphoria, distress or discomfort; and to understand how they negotiate referral, assessment and possible interventions.

Design

Qualitative study, using narrative interviews with young people, aged between 12 and 18 years old (n=14), referred to a gender identity service; their parents (n=12); and young adults, aged between 19 and 30 years old (n=18), who sought gender affirming care. The study took place between March 2022 and December 2023.

Results

Young people in our study describe supportive relationships with parents, but regard them as too cautious when discussing medical pathways. Young people enter specialist care with a sense of urgency. They are disappointed when realising that access to medical pathways does not occur immediately. They do, however, come to appreciate talking about their experiences. Parents face considerable anxieties and, like young people, value the support they receive from specialist clinicians.

Conclusions

Young people who question their gender require access to safe and effective treatments, alongside respectful therapeutic support. Young people and their parents emphasise the importance of an open-minded approach, where they are given space to explore and understand their experiences, before making decisions about the future. The young adults we spoke to confirmed the importance of this.
Non-communicable diseases and their associations with outpatient services utilisation: insight from a population-based survey in Malaysia
Authors: Amer Nordin Awatef , Jawahir Suhana , Manual Adilius , Ab Hamid Jabrullah , Ab Rahim Iqbal , Mohd Noh Sarah Nurain , Ab Mutalib Nur Elina , Abu Bakar Nurul Salwana
Published: January 2025

Objectives

Multimorbidity has been recognised as a global public health issue, and individuals with multimorbidity have been found to have high healthcare utilisation. This study aims to estimate the prevalence of non-communicable diseases among adults in Malaysia, identify factors associated with multimorbidity, and assess the association between the number of non-communicable diseases and outpatient services utilisation.

Design and setting

A retrospective secondary data analysis using data from the National Health and Morbidity Survey 2019, a cross-sectional household survey among the population in Malaysia.

Participants

All adults aged 18 years and above.

Outcome measures

The two outcome variables were multimorbidity and outpatient services utilisation. Characteristics of respondents and those having multimorbidity were described using complex sample descriptive statistics. We used multivariable logistic regression to determine the associated factors of having multimorbidity and the association between the number of non-communicable diseases and outpatient services utilisation.

Results

Overall, 11 347 respondents were included in the analysis. This study found a prevalence of 11.4 (95% CI=10.43–12.39) for multimorbidity. Age, marital status and working status were the factors associated with multimorbidity. Adults with multimorbidity were high users of outpatient services (20.4%, 95% CI=17.5–23.7), approximately threefold of adults with no non-communicable diseases. In the final model, multimorbidity showed an adjusted OR of 3.28 (95% CI=2.48–4.32) for outpatient services utilisation.

Conclusion

Understanding factors associated with multimorbidity and the magnitude of the impact of having multimorbidity towards outpatient services utilisation could help in future planning for healthcare system transformation. The recently launched Health White Paper for Malaysia has emphasised primary healthcare as a critical component to achieve aspirations of the health system, which includes equity and responsiveness. Strengthening primary care services and improving patient navigation across healthcare levels are critical to supporting individuals with multimorbidity. Avenues for further research include exploring a wider range of conditions and assessing the longitudinal impact of multimorbidity on healthcare utilisation and health outcomes.
Challenges of healthcare financing in the world’s largest refugee camp: a mixed-method study among healthcare stakeholders for Rohingya refugees in Bangladesh
Authors: Talukdar Imdadul Haque , Tarannum Sayeeda , Smith Isabel , Rifat M A , Boga Priyanka , Mumin Jubayer , Veronés Pablo André , Mahdi Ziba , Alam Syeda Saima , Khan Arif Faysal
Published: January 2025

Objectives

This study aimed to increase the understanding of healthcare stakeholders’ viewpoints on the challenges and potential solutions regarding healthcare financing for the Rohingya refugees in Cox’s Bazar.

Design

A mixed-method approach, containing semi-structured interviews with healthcare stakeholders and review of financial documents, was employed. Thematic analysis was performed to analyse the transcripts. Financial documents (available online) and reports from respective coordinating agencies were also reviewed.

Setting

Online key informant interviews (KIIs) were conducted from Stockholm with participants residing in Bangladesh between June 2022 and September 2022.

Participants

Eight KIIs were conducted with professional health programme managers, executives and personnel involved in policy coordination and implementation in refugee camps in Cox’s Bazar district of Bangladesh.

Results

We identified four themes and three subthemes outlining key challenges in healthcare funding, including decreasing funds (supported by a quantitative assessment) due to macroglobal issues, conflicting short-term and long-term priorities between implementing partners, insufficient efficacy due to challenges with collaborative priority-setting and implementing common processes, and a lack of consensus regarding equity between host and refugee communities.

Conclusions

The study identified unique challenges beyond the commonly discussed health financing issues in a resource-deficient setting: stakeholders’ conflicting priorities regarding funding and undecided equity issues among the host and refugee communities are worth scholarly and policy focus. A needs-based, equitable and effective action plan might ensure the proper utilisation of resources.
Impact of interpregnancy weight change on the risk of gestational diabetes mellitus during a second pregnancy in Chinese population: a retrospective cohort study
Authors: Yang Ao , Wang Ying , Liu Yuzhen , Yang Juan , Xu Chang , Zhong Shilin
Published: January 2025

Objectives

This study aimed to investigate the impact of interpregnancy weight changes (IPWC) on the gestational diabetes mellitus (GDM) in the second pregnancy.

Design

A single-centre retrospective cohort study was conducted in China.

Setting

Data were collected in Peking University Shenzhen Hospital from 2013 January to 2021 February.

Participants

Participants include women who had two consecutive singleton deliveries after 28 gestational weeks (n=2372).

Outcomes

The GDM in the second pregnancy (s-GDM) was set as the outcome.

Methods

IPWC was defined as the change in body mass index between the first trimester of the second pregnancy and that of the first pregnancy, categorised into four groups with −1 kg/m² to <1 kg/m² as the reference. Adjusted ORs (aORs) with 95% CIs attained from multivariable logistic regression were used to assess the association between IPWC and s-GDM, in both total subjects and stratified subgroups.

Results

In the overall analysis, s-GDM was found to be significantly associated with IPWC value (aOR 1.111; 95% CI 1.038 to 1.190) and an IPWC category of ≥3 kg/m² (aOR 1.821; 95% CI 1.197 to 2.772). In the stratified analysis, the significant association between IPWC ≥3 kg/m² and s-GDM was evident only in the subgroups of an interpregnancy interval (IPI) of less than 36 months (aOR 2.210, 95% CI 1.251 to 3.904), under the age of 35 (aOR 1.854, 95% CI 1.204 to 2.857), non-diabetic status in the first pregnancy (f-ND) (aOR 1.872, 95% CI 1.143 to 3.065) and those with normal weight in the first pregnancy (aOR 1.936, 95% CI 1.174 to 3.193). The significant association between IPWC value and s-GDM was also shown only in these subgroups (p<0.05). In f-DN subgroup, even an IPWC category of 1 kg/m² to <3 kg/m² was significantly associated with s-GDM (aOR 1.486, 95% CI 1.044 to 2.117). IPWC < −1 kg/m² was not significantly associated with s-GDM either in the overall analysis or in the stratified analysis (p>0.05).

Conclusion

An IPWC of 3 kg/m² or higher may increase the risk of s-GDM, particularly among women with an IPI of less than 36 months, those under 35 years old, individuals without diabetes, or those with normal weight during their first pregnancy. The potential influence of prior GDM on the relationship between IPWC and s-GDM warrants further investigation.
Factors associated with cervical cancer screening among women of reproductive age in Moshi municipality, Kilimanjaro, Tanzania: a cross-sectional study
Authors: Hhera Jeremiah John , Dahaye Regina , Zakayo Witness Erasto , Kazula Yohana Z , Abdul Seif , Mamseri Redempta , Msuya Sia E
Published: January 2025

Objective

Screening for cervical cancer has been a globally advocated preventive strategy to reduce cervical cancer morbidity and mortality. This study aimed to describe the prevalence and barriers of cervical cancer screening, and to determine factors associated with cervical cancer screening among women of reproductive age in Moshi municipality, northern Tanzania.

Design

We conducted a cross-sectional study between August and September 2020.

Setting

Moshi municipality, Kilimanjaro, Tanzania.

Participants

Women of ages 15–49 years who live in Moshi municipality.

Results

A total of 300 women participated in the study and 22.7% had ever been screened for cervical cancer. Women below the age of 30 years had 87% lower odds of screening for cervical cancer compared with those aged 30 years and above (OR 0.13; 95% CI 0.04, 0.43). Women who had never heard about cervical cancer had 94% (OR 0.06; 95% CI 0.01, 0.51) lower odds of screening compared with those who ever heard about the disease. In comparison to married women, those who identified as single had 71% lower odds of screening for cervical cancer (OR 0.29; 95% CI 0.10, 0.73). Women without formal education or with only primary-level education had 72% lower odds of screening for cervical cancer compared with those with college or university education (OR 0.28; 95% CI 0.08, 0.98). A lack of awareness on where to screen and a lack of comprehensive knowledge about cervical cancer were reported as screening barriers among those who had never been tested.

Conclusion

Only one in five women have ever been screened for cervical cancer, despite the majority having heard about the disease. Overall knowledge of cervical cancer was low, with many women unaware of its causes, risk factors and preventive measures. Key barriers to screening included a lack of awareness and insufficient medical advice. Factors significantly associated with lower odds of screening were being under age of 30 years, not having heard about cervical cancer, having no formal or only primary education and being single. There is an urgent need for community-based interventions to increase awareness and education about cervical cancer and to improve access to screening services, especially for younger, less educated and single women.