bluuebunny/crossref_metadata_2025 huggingface dataset:
WRKY transcription factors: Hubs for regulating plant growth and stress responses
Authors: Yang Lu , Fang Siyu , Liu Lei , Zhao Lirong , Chen Wanqin , Li Xia , Xu Zhiyu , Chen Shidie , Wang Houping , Yu Diqiu
Published: January 2025

As sessile organisms, plants must directly face various stressors. Therefore, plants have evolved a powerful stress resistance system and can adjust their growth and development strategies appropriately in different stressful environments to adapt to complex and ever‐changing conditions. Nevertheless, prioritizing defensive responses can hinder growth; this is a crucial factor for plant survival but is detrimental to crop production. As such, comprehending the impact of adverse environments on plant growth is not only a fundamental scientific inquiry but also imperative for the agricultural industry and for food security. The traditional view that plant growth is hindered during defense due to resource allocation trade‐offs is challenged by evidence that plants exhibit both robust growth and defensive capabilities through human intervention. These findings suggest that the growth‒defense trade‐off is not only dictated by resource limitations but also influenced by intricate transcriptional regulatory mechanisms. Hence, it is imperative to conduct thorough investigations on the central genes that govern plant resistance and growth in unfavorable environments. Recent studies have consistently highlighted the importance of WRKY transcription factors in orchestrating stress responses and plant‐specific growth and development, underscoring the pivotal role of WRKYs in modulating plant growth under stressful conditions. Here, we review recent advances in understanding the dual roles of WRKYs in the regulation of plant stress resistance and growth across diverse stress environments. This information will be crucial for elucidating the intricate interplay between plant stress response and growth and may aid in identifying gene loci that could be utilized in future breeding programs to develop crops with enhanced stress resistance and productivity.
Leveraging descriptor learning and functional map‐based shape matching for automated anatomical Landmarking in mouse mandibles
Authors: Thomas Oshane O. , Maga A. Murat
Published: January 2025

Geometric morphometrics is used in the biological sciences to quantify morphological traits. However, the need for manual landmark placement hampers scalability, which is both time‐consuming, labor‐intensive, and open to human error. The selected landmarks embody a specific hypothesis regarding the critical geometry relevant to the biological question. Any adjustment to this hypothesis necessitates acquiring a new set of landmarks or revising them significantly, which can be impractical for large datasets. There is a pressing need for more efficient and flexible methods for landmark placement that can adapt to different hypotheses without requiring extensive human effort. This study investigates the precision and accuracy of landmarks derived from functional correspondences obtained through the functional map framework of geometry processing. We utilize a deep functional map network to learn shape descriptors, which enable us to achieve functional map‐based and point‐to‐point correspondences between specimens in our dataset. Our methodology involves automating the landmarking process by interrogating these maps to identify corresponding landmarks, using manually placed landmarks from the entire dataset as a reference. We apply our method to a dataset of rodent mandibles and compare its performance to MALPACA's, a standard tool for automatic landmark placement. Our model demonstrates a speed improvement compared to MALPACA while maintaining a competitive level of accuracy. Although MALPACA typically shows the lowest RMSE, our models perform comparably well, particularly with smaller training datasets, indicating strong generalizability. Visual assessments confirm the precision of our automated landmark placements, with deviations consistently falling within an acceptable range for MALPACA estimates. Our results underscore the potential of unsupervised learning models in anatomical landmark placement, presenting a practical and efficient alternative to traditional methods. Our approach saves significant time and effort and provides the flexibility to adapt to different hypotheses about critical geometrical features without the need for manual re‐acquisition of landmarks. This advancement can significantly enhance the scalability and applicability of geometric morphometrics, making it more feasible for large datasets and diverse biological studies.
Dorsal raphe nucleus receives retinal projections of morphologically distinct fibers in the common marmoset (Callithrix jacchus): A subunit B cholera labeling
Authors: Santana Nelyane N. M. , Escarião Wellydo K. M. , Silva Eryck H. A. , Fiuza Felipe P. , Nascimento Júnior Expedito S. , Costa Miriam S. M. O. , Engelberth Rovena Clara , Cavalcante Jeferson S.
Published: January 2025

Non‐image forming (NIF) pathways, a specialized branch of retinal circuitry, play a crucial role supporting physiological and behavioral processes, including circadian rhythmicity. Among the NIF regions, the dorsal raphe nucleus (DRN), a midbrain serotonergic cluster of neurons, is also devoted to circadian functions. Despite indirectly send photic inputs to circadian centers and modulating their activities, little is known about the organization of retina‐DRN circuits in primate species. To enhance our understanding of the intrinsic organization of NIF circuits and identify retinoraphe innervation in the common marmoset (Callithrix jacchus), a diurnal non‐human primate model, we employed an anterograde tract‐tracing method to labeling terminal/fibers with cholera toxin subunit B (CTb) and characterized the morphology of their projections. Our analysis revealed that sparse CTb+ retinal terminals are predominantly located in dorsal subdomain of the DRN, displaying two morphological types, such as simple en passant and R2‐like terminals. This anatomical evidence suggests a phylogenetic stability of the retina‐DRN projections in diurnal primate species, potentially serving as a significant source of photic modulation on the serotonergic profile in the DRN. However, functional significance in primate models remains uncertain. Our data provide a crucial anatomical foundation for understanding the functional aspect of this circuitry in primates, contributing to the comprehension of the phylogenetic pathways used by NIF functions, such as circadian rhythmicity.
Acute and chronic systemic inflammation associated with canine nodular splenic lesions composed of heterogeneous cell components: four cases (2020‐2024)
Authors: Mourou K. , Abou Monsef Y. , Belluco S. , Penent M. , Delverdier M. , Hugonnard M. , Granat F. , Lavoue R. , Mantelli M.
Published: January 2025

Objectives

To describe the clinical presentation and clinicopathological findings of dogs with nodular splenic lesions composed of heterogeneous cell components associated with systemic inflammation and to provide information on the outcome after surgical resection.

Materials and Methods

Medical records were searched for dogs with histologically and immunohistochemically characterised nodular splenic lesions with mixed stromal, histiocytic and lymphoid cells and the presence of systemic inflammatory markers at the time of diagnosis.

Results

Four dogs were included, of which three had an undifferentiated splenic stromal sarcoma and one had a splenic leiomyosarcoma. Fever and abdominal pain were reported in three and four cases, respectively. All dogs showed hyperglobulinaemia and marked changes in the serum protein electrophoresis profile. C‐reactive protein and fibrinogen concentrations were both increased in three cases. These abnormalities completely resolved after splenectomy. Moreover, two dogs had concomitant glomerular disease and one dog had liver amyloidosis. Three dogs were still alive and asymptomatic 1, 6 and 9 months after surgery. One dog died 16 months after the initial presentation due to complications related to progressive renal failure.

Clinical Significance

Based on this report, nodular splenic lesions with heterogeneous cell components may directly be associated with a pro‐inflammatory state and should be considered as part of the differential diagnosis of fever and hyperglobulinaemia in dogs. Furthermore, early recognition and treatment of these lesions could reduce the risk of systemic complications potentially associated with amyloid deposit and organ failure.
Identification of Rickettsia species in cattle ticks in selected regions of urban Ghana
Authors: Tawiah‐Mensah Christopher Nii Laryea , Addo Seth Offei , Ansah‐Owusu Jane , Malm Richard Odoi‐Teye , Salley Selma Nurudeen , Koffi Millie‐Cindy Aba Aude , Abudu Mufeez , Ladzekpo Danielle , Oduro Daniel , Akorli Jewelna , Dadzie Samuel K.
Published: January 2025

Ticks continue to invade new regions spreading pathogens of zoonotic and veterinary importance. Diverse tick species have been reported in Ghana due to the continuous trade of livestock. In this study, ticks were collected from cattle in three sites within Southern Ghana. The 1489 ticks collected were morphologically identified and further confirmed using a molecular assay that amplifies the 660‐bp segment of the mitochondrial cytochrome c oxidase subunit 1 (COI) gene. These ticks were pooled and screened for pathogens of zoonotic importance. From the 215 tick pools screened, Rickettsia DNA was detected in 34 (15.81%). Sanger sequencing revealed the occurrence of Rickettsia africae (14.42%), the causative agent of African tick‐bite fever, and Rickettsia aeschlimannii (1.39%). Regular monitoring of tick populations is essential to generate data for creating effective control and preventive measures.
Charting New Courses to Adulthood in the Global South
Authors: Clark Shelley , Agnant Khandys
Published: January 2025

Growing up in an increasingly global world offers the youth of today unprecedented opportunities and novel challenges. This paper uses data from 47 countries to examine recent trends in how young men and women in the Global South navigate five key transitions to adulthood. Despite some similarities, we find little evidence of convergence across or within regions with respect to finishing school, becoming sexually active, forming a union, having a child, and working for pay. Further, although there have been impressive gains in education for both men and women over the past 20 years, labor force participation, particularly among women, has stalled or declined in most regions. Similarly, the steady increase in women's age of union formation was accompanied by relatively modest gains in their age of first childbirth and marriage continues to be incompatible with paid employment for many women. Overall, men and women follow strikingly different paths to adulthood and, with the exception of education, there are few signs of diminishing gender inequalities. Maximizing the economic and demographic potential of these better educated cohorts of youth will require increasing the availability of skilled jobs and helping women reconcile the competing demands of family and paid employment.
Mobilizing fears? How proximity to deportation threat affects political participation
Authors: Israel‐Trummel Mackenzie , Shortle Allyson , Bracic Ana
Published: January 2025

Policies often provoke political changes, which are collectively known as feedback effects. Studying state variation in immigration policy, scholars have shown that proximity to hostile policy tends to mobilize Latinos. But not every member of the Latino community is likely to perceive the same proximity to anti‐immigrant policies. We argue that when people worry that deportation is a risk to them, they are likely to withdraw politically, but when they worry about their close social network's risk of deportation, they are likely to mobilize. We use the 2016 Collaborative Multiracial Post‐Election Survey to test these relationships during a time of heightened anti‐immigrant policy proposals from then‐candidate Donald Trump. We find mixed evidence for our hypotheses. While perceived threat of deportation to one's network is negatively related to validated voter turnout, there is a substantial positive relationship between network threats and non‐voting participation. We also show that personal threats of deportation have no effect on mobilization once network threats and ties to undocumented people are accounted for. Our findings advance the literature on how proximity affects policy feedback effects by directly capturing perceived proximity to policy threat, net of objective proximity, and including forms of participation open to noncitizens.
Health locus of control and associated factors among community‐dwelling older adults: a cross‐sectional descriptive study
Authors: Deng Mengying , Lv Jinghong , Guo Chenming , Yang Yufan , Song Hongdan , Wang Zhiwen , Yu Mingming
Published: January 2025

Background

To know the level of health locus of control (HLC) and investigate the factors associated with HLC among community‐dwelling older adults.

Method

A total of 470 older adults completed the Multidimensional Health Locus of Control Scale, the Activities of Daily Living Scale, the Geriatric Depression Scale, and the Lubben Social Network Scale. Hierarchical multiple regression was used to explore the factors associated with HLC.

Results

Gender, marital status, income and the number of chronic diseases were associated with internal HLC; age, educational level, income, activities of daily living and social networks were associated with powerful others HLC; social networks were associated with chance HLC (P < 0.05).

Conclusion

As modifiable factors, physical function and social support are essential for improving HLC in older adults and interventional programs aiming at changing them could help older adults maintain acceptable levels of HLC.
Challenges faced by the caregivers of the elderly: a cross‐sectional survey from India
Authors: Saini Ruchi , Mittal Vanshika , Chaudhary Amandeep , Simar Priyanka , Gopera Shivani , Kapoor Vasudha , Kaur Sukhpal
Published: January 2025

Background

Older people often require support due to age‐related health issues, thereby increasing their dependency on caregivers. The caregivers often experience burdens of varying nature.

Objective

To assess the dependency level of the elderly and the challenges faced by their caregivers.

Materials and Method

A total of 1265 elderly and 1000 caregivers were enrolled consecutively from an urban locality. After obtaining informed consent, the elderly were interviewed using the Lawton Independent Activities of Daily Living Scale to assess their dependency levels while the caregivers were interviewed using the Zarit Caregiver Burden Scale to assess their burden related to caregiving. The study was approved by the Ethics Committee of the Institute.

Results

About half (52.7%) of the elderly were aged between 60 and 70 years old and were female (54%). Sixty percent of the elderly were affected by a single illness. Among caregivers, 46% were aged between 31 and 40 years, 60% were female, and 44% were unemployed. The mean per capita family income was Rs 12 202.06 ± 7025.16 per month. It was found that about half (51.4%) of the elderly were independent, 48.1% were partially dependent and 0.5% were fully dependent. Zarit Caregiver Burden Scale revealed that 58.6% of caregivers experienced no to mild burden, 39.4% had mild to moderate burden, 2.0% had moderate to severe burden while none of them experienced severe burden. Significant association was found between the elderly's dependency level and their age, gender, education, occupation, and number of illnesses. It was also observed that an increase in the independence status of the elders reduces the caregiver's burden (r = −0.454, P < 0.01).

Conclusion

The caregiver burden increases with the dependency level of the elderly, highlighting the need for adequate support for caregivers.
The effect of art therapy on cognitive status and psychological well‐being in elderly people in institutional care
Authors: Demirel Özge , Orak Oya Sevcan
Published: January 2025

Background

Cognitive decline seen in old age manifests itself as a decrease in reasoning ability that is not related to intelligence. This situation, together with many other problems, can affect the psychological well‐being of the elderly. Especially the elderly living in institutional care constitute a special group that needs to be protected. It is important that the psychotherapy interventions to be carried out with this group are determined according to the characteristics of the group. The aim of this study is to determine the effect of art therapy on cognitive status and psychological well‐being in the elderly living in institutional care.

Methods

This single‐blind randomised controlled study was conducted with 42 elderly individuals living in three nursing homes in Türkiye. In the study, the sample group was assigned to the experimental (n = 21) and control (n = 21) groups by simple randomisation. Art therapy intervention was applied to the elderly individuals in the experimental group, and no special intervention was applied to the control group. The sociodemographic information form, standardised mini mental test (MMT) and Psychological Well‐being Scale for the Elderly (PWBS) were used as data collection tools in the study.

Results

It was found that there was a statistically significant difference between the pre‐test and post‐test total scores of the PWBS and MMT in favour of the post‐test (P < 0.001). In the study, the effect of the art therapy intervention applied to the elderly individuals in the experimental group was evaluated and it was determined that the difference between the PWBS ( = 0.75) and MMT ( = 0.52) scores had a medium effect level.

Conclusions

The results showed that art therapy has a positive effect on the psychological well‐being and cognitive status of the elderly in institutional care and can be used as a moderate developmental intervention.
R&D Management Under Disruption and Uncertainty
Authors: Li Daitian , Fu Xiaolan , Narula Rajneesh , von Zedtwitz Max , Wagner Beverly
Published: January 2025

Disruption and uncertainty are distinct but related concepts with fundamental impact on firms' R&D. Management of R&D under disruption and uncertainty has become a critical issue in innovation management. With the advent of the fourth industrial revolution, firms are increasingly facing disruptions along multiple dimensions: technological, market, environmental, and institutional. Such disruptions increase the level of uncertainty firms perceive, bringing about both challenges and opportunities. What will be the impact of such disruption and uncertainty on firms? How can they navigate and mitigate its consequences? In this special issue, we present seven research articles and one commentary that address different aspects of R&D management under disruption and uncertainty in the context of a conceptual framework describing how firms might address different types of disruption and uncertainty through an open innovation system approach.
A comprehensive framework for evaluating time to event predictions using the restricted mean survival time
Authors: Cwiling Ariane , Perduca Vittorio , Bouaziz Olivier
Published: January 2025

The restricted mean survival time (RMST) is a widely used quantity in survival analysis due to its straightforward interpretation. For instance, predicting the time to event based on patient attributes is of great interest when analyzing medical data. In this paper, we propose a novel framework for evaluating RMST estimations. A criterion that estimates the mean squared error of an RMST estimator using Inverse Probability Censoring Weighting (IPCW) is presented. A model‐agnostic conformal algorithm adapted to right‐censored data is also introduced to compute prediction intervals and to evaluate local variable importance. Finally, a model‐agnostic statistical test is developed to assess global variable importance. Our framework is valid for any RMST estimator that is asymptotically convergent and works under model misspecification.
Perinatal mental health: an overview of pathology, services and the law
Authors: Medland Victoria , Nechowska Aoife , Prevezanos Panos
Published: January 2025

Key content

Perinatal mental health problems are the commonest complication of pregnancy, with adjustment disorder affecting as many as one in four, and maternal suicide the leading direct cause of death in the first postnatal year. Plans are in place to expand Perinatal Mental Health (PNMH) Services.

The team structure of PNMH services available in primary and secondary care.

Psychopathology, referencing pre‐pregnancy counselling, antenatal and postnatal care, with an overview of adjustment disorder, depressive and anxiety disorders, OCD, schizophrenia, personality disorder, bipolar affective disorder and puerperal psychosis.

Commonly‐used medications and associated considerations.

‘Red flags’ requiring urgent psychiatric input, and how to escalate appropriately.

Learning objectives

Understand key features of the common and serious psychiatric complications presenting in and around pregnancy.

Understand the perinatal implications of commonly‐used psychotropics.

Recognise features of emergency presentations, and how to refer urgently.

Ethical issues

Safeguarding considerations are complex: the mother and unborn/ neonate must be protected; however, fear of referral can inhibit disclosure of mental illness.

Use of the Mental Health Act limits personal freedoms but must be balanced with patients' risk to themselves and others.
Skin disease‐associated GJB4 variants differentially influence connexin stability, cell viability and channel function
Authors: Lucaciu Sergiu A. , Leighton Stephanie E. , Wong Robert S. , Sekar Varun , Hauser Alexandra , Lai Nhu‐An , Johnston Danielle , Stathopulos Peter B. , Bai Donglin , Laird Dale W.
Published: January 2025

Here we characterize seven Cx30.3 gene variants (R22H, S26Y, P61R, C86S, E99K, T130M and M190L) clinically associated with the rare skin disorder erythrokeratodermia variabilis et progressiva (EKVP) in tissue‐relevant and differentiation‐competent rat epidermal keratinocytes (REKs). We found that all variants, when expressed alone or together with wildtype (WT) Cx30.3, had the capacity to traffic and form gap junctions with an efficiency like WT Cx30.3. Cx30.3 was found to have a slower relative turnover than Cx43. However, turnover was more rapid for the R22H and P61R variants relative to Cx30.3. Furthermore, REKs that expressed the P61R variant exhibited reduced viability and were more permeable to fluorescent dyes, indicative of leaky hemichannels and/or the loss of membrane integrity associated with cell death. In connexin‐null AD‐293 cells, dual patch clamp studies revealed that the variants had either reduced (C86S) or no (S26Y and T130M) gap junction channel function. The remaining variants formed functional gap junction channels with enhanced transjunctional voltage (Vj)‐dependent gating. Moreover, WT Cx30.3 and functional variant gap junction channels had similar unitary conductance of ∼34–42 pS, though variant channels appeared to have lower open probability than WT Cx30.3 channels at high Vjs. In conclusion, EKVP‐associated Cx30.3 variants each alter one or more Cx30.3 characteristics although the molecular changes identified for E99K were limited to enhanced Vj gating. The breadth of molecular changes identified may all be sufficient to cause EKVP, but this remains to be firmly established as more familial patients are genotyped for these variants.

image

Key points

Here we characterize seven Cx30.3 variants (R22H, S26Y, P61R, C86S, E99K, T130M and M190L) that have been clinically associated with the rare skin disorder erythrokeratodermia variabilis et progressiva (EKVP).

We discovered human Cx30.3 undergoes relatively slow turnover compared with Cx43 and exhibits kinetically slow and limited voltage gating.

Wildtype Cx30.3 and all variants localized to intracellular compartments and gap junctions in rat epidermal keratinocytes.

Each EKVP‐associated Cx30.3 variant altered one or more Cx30.3 characteristics related to protein stability, cell viability and/or channel function.

The breadth of molecular changes identified for each Cx30.3 variant may independently be sufficient to cause EKVP, but this remains to be firmly established through additional genetic and molecular analysis.
Configuration Synthesis of Weakly-Coupled Parallel Hip Exoskeletons With Large Workspace
Authors: Xu Jilong , Liu Fucai
Published: January 2025

To address the issues of strong motion coupling, high control difficulty, and insufficient degrees of freedom (DoFs) in existing bio-syncretic parallel hip exoskeletons, a design scheme characterized by weak-coupling is proposed. A configuration synthesis method for weakly-coupled parallel hip exoskeletons is introduced by deriving the conditions that the transmission wrench screws (TWSs) in each limb must satisfy. Furthermore, to tackle the problem of limited workspace in parallel hip exoskeletons, a design method aimed at increasing the operational workspace is presented. By applying the proposed methods to the configuration synthesis of the hip exoskeleton, several weakly-coupled configurations with expanded workspaces are generated. Finally, the correctness and effectiveness of the proposed methods are validated through case analyses.
First Data on Cyanotoxins and Genes of Their Biosynthesis in the Phytoplankton of the Mesotrophic Lake Pleshcheyevo (Russia) during the Bloom Formation of Cyanobacterium Gloeotrichia echinulata
Authors: Sidelev S. I. , Korneva L. G. , Chernova E. N. , Sakharova E. G.
Published: January 2025

Data on cyanobacterial toxins and the genes of their biosynthesis in the phytoplankton of the mesotrophic Lake Pleshcheyevo (Yaroslavl oblast) during the blooming period of cyanobacterium Gloeotrichia echinulata (Smith et Sowebry) Richter are given for the first time. In the phytoplankton of the lake, the presence of hepatotoxins of microcystins (MC) was recorded using chromatography–mass spectrometry; in DNA isolated from plankton, the mcyE gene for the biosynthesis of these cyanotoxins was detected using PCR. No other types of cyanotoxins (cylindrospermopsin, anatoxin-a, and saxitoxins) or the presence of genes for their synthesis in the phytoplankton are identified during the study period. MC biosynthesis genes mcyA and mcyE were absent in thirty colonies of Gloeotrichia echinulata isolated from the lake, which is consistent with their inability to produce cyanotoxin. Using molecular methods, the potential ability to biosynthesize MC in Microcystis aeruginosa and species of the genus Dolichospermum inhabiting in the lake is demonstrated. This paper discusses the toxicity of Gloeotrichia echinulata and the need for the further long-term monitoring of toxigenic cyanobacteria in Lake Pleshcheyevo.
Prognostic models for depression and post-traumatic stress disorder symptoms following traumatic brain injury: a CENTER-TBI study
Authors: Mikolić Ana , van Klaveren David , Jost Mathilde , Maas Andrew IR , Shi Shuyuan , Silverberg Noah D , Wilson Lindsay , Lingsma Hester F , Steyerberg Ewout W
Published: January 2025

Background

Traumatic brain injury (TBI) is associated with an increased risk of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). We aimed to identify predictors and develop models for the prediction of depression and PTSD symptoms at 6 months post-TBI.

Methods

We analysed data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury study. We used linear regression to model the relationship between predictors and depression (Patient Health Questionnaire-9) and PTSD symptoms (PTSD Checklist for Diagnostic and Statistical Manual for Mental Health Disorders Fifth Edition). Predictors were selected based on Akaike’s Information Criterion. Additionally, we fitted logistic models for the endpoints ‘probable MDD’ and ‘probable PTSD’. We also examined the incremental prognostic value of 2–3 weeks of symptoms.

Results

We included 2163 adults (76% Glasgow Coma Scale=13–15). Depending on the scoring criteria, 7–18% screened positive for probable MDD and about 10% for probable PTSD. For both outcomes, the selected models included psychiatric history, employment status, sex, injury cause, alcohol intoxication and total injury severity; and for depression symptoms also preinjury health and education. The performance of the models was modest (proportion of explained variance=R28% and 7% for depression and PTSD, respectively). Symptoms assessed at 2–3 weeks had a large incremental prognostic value (delta R2=0.25, 95% CI 0.24 to 0.26 for depression symptoms; delta R2=0.30, 95% CI 0.29 to 0.31 for PTSD).

Conclusion

Preinjury characteristics, such as psychiatric history and unemployment, and injury characteristics, such as violent injury cause, can increase the risk of mental health problems after TBI. The identification of patients at risk should be guided by early screening of mental health.
Prevalence and patient characteristics associated with cardiovascular disease risk factor screening in UK primary care for people with severe mental illness: an electronic healthcare record study
Authors: Launders Naomi , Jackson Caroline Anne , Hayes Joseph F , John Ann , Stewart Robert , Iveson Matthew H , Bramon Elvira , Guthrie Bruce , Mercer Stewart William , Osborn David P J
Published: January 2025

Background

People with severe mental illness (SMI) are at increased risk of cardiovascular disease (CVD), and initiatives for CVD risk factor screening in the UK have not reduced disparities.

Objectives

To describe the annual screening prevalence for CVD risk factors in people with SMI from April 2000 to March 2018, and to identify factors associated with receiving no screening and regular screening.

Methods

We identified adults with a diagnosis of SMI (schizophrenia, bipolar disorder or ‘other psychosis’) from UK primary care records in Clinical Practice Research Datalink. We calculated the annual prevalence of screening for blood pressure, cholesterol, glucose, body mass index, alcohol consumption and smoking status using multinomial logistic regression to identify factors associated with receiving no screening and complete screening.

Results

Of 216 136 patients with SMI, 55% received screening for all six CVD risk factors at least once during follow-up and 35% received all six within a 1-month period. Our findings suggest that patient characteristics and financial incentivisation influence screening prevalence of individual CVD risk factors, the likelihood of receiving screening for all six CVD risk factors annually and risk of receiving no screening.

Conclusions

The low proportion of people with SMI receiving regular comprehensive CVD risk factor screening is concerning. Screening needs to be embedded as part of broad physical health checks to ensure the health needs of people with SMI are being met. If we are to improve cardiovascular health, interventions are needed where risk of receiving no screening or not receiving regular screening is highest.
How can more women with pre-existing type 1 and type 2 diabetes be supported to prepare for pregnancy after a baby loss? A qualitative exploration of lived experiences in the UK
Authors: Dyer Eleanor , Bell Ruth , Graham Ruth , Rankin Judith
Published: January 2025

Objectives

Explore, understand and analyse how women with pre-existing diabetes can be better supported during the inter-pregnancy interval—the time after a baby loss and before a subsequent pregnancy.

Design

Qualitative, semi-structured online interviews took place between November 2020 and July 2021. Data were analysed using Reflexive Thematic Analysis.

Setting

Participants reflected on care received at primary and secondary centres across the UK.

Participants

Twelve predominantly White, British women with type 1 (n=9) and type 2 (n=3) diabetes with experience of baby loss and subsequent pregnancy were recruited through social media.

Results

Three interrelated themes: (1) decisions around becoming pregnant after baby loss, (2) the triple burden of baby loss, diabetes and preparing for pregnancy, (3) gaps in the inter-pregnancy interval. Most (n=10) participants wanted to become pregnant again as soon as possible. The short inter-pregnancy interval (median=7 months) highlights a potentially small window of opportunity to support women to grieve and prepare for pregnancy. Providing timely access to care and support in the inter-pregnancy interval without overburdening women might be challenging due to structural issues in services and gaps in referral pathways.

Conclusion

Women with pre-existing diabetes may experience challenges in accessing appropriate pre-pregnancy care in the inter-pregnancy interval. Our findings suggest that one-size-fits-all approaches are likely to be less effective in meeting diverse needs of this group and that more personalised, targeted support is needed. All healthcare professionals across the different parts of the care provision structure need greater awareness of the issues faced by this group to maximise timely access to the appropriate pre-pregnancy care and support.
How many stroke survivors develop problematic spasticity requiring pharmacological therapy? An international (Europe and USA) observational study protocol
Authors: Zorowitz Richard D , Barrenechea Laura Serrano , Butet Simon , Groppa Sergiu , Hernández Herrero David , Prasad Rama , Sandars Susan , Meloni Seema , Page Simon , Maisonobe Pascal , Picelli Alessandro
Published: January 2025

Introduction

Current care plans for stroke survivors typically focus on acute management, resulting in many stroke survivors being discharged to their communities without adequate follow-up, despite their often experiencing significant post-stroke complications, such as post-stroke spasticity (PSS). While studies have explored the incidence and prevalence of PSS, little is known about how early PSS develops and how many stroke survivors develop ‘problematic’ PSS that would benefit from pharmacological treatment.

Methods and analysis

EPITOME is a prospective, international, observational, epidemiological study of participants (aged 18–90 years) who develop paresis within days 3–14 of a first-ever stroke that occurred within the past 4 weeks. Participants at sites across seven different countries are monitored remotely at 2 weeks and 1, 2, 3, 6, 9 and 12 months post-stroke to detect the possible onset of PSS using the Post-stroke Spasticity Monitoring Questionnaire (PSMQ). If the PSMQ indicates the possible presence of PSS, participants undergo a full in-clinic assessment to confirm the presence of PSS. For participants with confirmed PSS, the severity and distribution of spasticity is documented, and the investigator assesses whether the participant has spasticity that could benefit from pharmacological therapy. Participants without clinically confirmed PSS return to remote monitoring.

Ethics and dissemination

Ethics approval was obtained in all seven participating countries. Results will be published at international meetings and in an international peer-reviewed journal. Lay summaries will be prepared to accompany the primary paper and will also be provided to study participants.

Trial registration number

ClinicalTrials.govNCT06055725.
Impact of warning pictorials and size on perceived effectiveness of cigar warning labels in a nationally representative between-subjects experiment
Authors: Goldstein Adam O , Yang Michelle Z , Jarman Kristen L , Queen Tara L , Clark Sonia A , Ranney Leah M , Cornacchione Ross Jennifer , Sheeran Paschal , Enyioha Chineme , Thrasher James F , Jenson Desmond , Kowitt Sarah D
Published: January 2025

Background

People who smoke cigars often have misperceptions about the associated risks, contributing to rises in smoking rates. This study investigates the perceived warning effectiveness (PWE) of health warning labels (HWLs) on cigar packages. We tested the impact of warning type and warning size in the HWLs on PWE and other health outcomes.

Data and methods

In a between-subjects experimental design, participants (n=809) who used little cigars or cigarillos in the past 30 days were randomly assigned to one of four conditions: text-only at 30% size, pictorial+text warning at 30% size, text-only at 50% size and pictorial+text warning at 50% size. In each condition, participants rated six cigarillo HWLs on PWE, self-reported learning, thinking about risks, new knowledge, perceived enjoyment and negative affect. Reactance to the labels was also measured. Data were analysed with mixed-effects models.

Results

Pictorial+text cigarillo HWLs were deemed more effective than text-only HWLs in PWE (b=0.34, SE=0.08, p<0.001), self-reported learning (b=0.20, SE=0.08, p=0.01), thinking about risks (b=0.18, SE=0.08, p=0.03) and new knowledge (b=0.34, SE=0.12, p<0.01). They also elicited more negative affect than text-only warnings (b=0.39, SE=0.08, p<0.001). Warning size did not impact outcomes, and neither warning type nor size predicted perceived enjoyment of smoking cigarillos or reactance to the warnings.

Conclusion

Including images with text warning statements for cigarillos can increase PWE. Our findings provide important insights for the US Food and Drug Administration and international regulatory agencies in designing new HWLs for cigars that can more effectively communicate smoking risks, address misinformation and potentially reduce cigar smoking.
Identification of serum metabolite biomarkers in premature infants with bronchopulmonary dysplasia: protocol for a multicentre prospective observational cohort study
Authors: Guo Yanping , He Wanxiang , Xu Songzhou , Yan XuDong , He Shengnan , Zhou Ping , Chen Cheng , Guo Xin , Chen Jun , Zhang Ruolin , Liu Jiebo , Rao Dan Dan , Yu Zhangbin , Liu Ying
Published: January 2025

Introduction

Bronchopulmonary dysplasia (BPD) is one of the most common and significant complications of preterm birth. It ultimately leads to a decrease in the quality of life for preterm infants and impacts their long-term health. Early prediction and timely intervention are crucial to halting the development of BPD. This study aims to identify the biomarkers that can predict the early occurrence and development of BPD by screening serum metabolites in preterm infants. This will provide strong support for the early prediction of BPD and targeted interventions in future research.

Methods and analysis

This is a prospective, multicentre, open-label, observational cohort study spanning 3 years. It will be conducted in six major neonatal intensive care units in Shenzhen, China, involving preterm infants born at gestational ages <32 weeks. Demographic data and treatment information will be collected prospectively. Serum samples will be collected at five distinct time points: within 24 hours after birth, at 1 week, 2 weeks, 28 days and at 36 weeks postmenstrual age. These samples will undergo analysis using liquid chromatography-tandem mass spectrometry for untargeted metabolomics studies. Participants will be categorised into BPD and non-BPD groups based on their final diagnosis, and metabolite differences between these groups will be analysed. The study aims to enrol 1500 preterm infants with gestational ages <32 weeks over 3 years. A three-step analysis strategy—discovery, validation and clinical testing—will be used to identify and validate the clinical utility of novel biomarkers. Additionally, a nested case-control study will be conducted, matching participants 1:1 with a control group sharing similar BPD risk factors.

Ethics and dissemination

Our protocol has been approved by the Medical Ethics Committees of all participating hospitals, including Peking University Shenzhen Hospital, Shenzhen People’s Hospital, Shenzhen Baoan Women’s and Children’s Hospital, Longgang District Maternity and Child Healthcare Hospital, Nanshan Maternity and Child Healthcare Hospital and Shenzhen Luohu People’s Hospital. We will disseminate our study results through academic conferences and peer-reviewed public journals.

Trial registration number

ChiCTR2400081615.
Cross-sectional survey on public attitudes and factors related to physician-assisted dying in Taiwan
Authors: Chen Duan-Rung , Kuo Chun-Tung , Wu Kevin Chien-Chang
Published: January 2025

Objective

To examine the public’s stance on physician-assisted dying (PAD) in Taiwan across different PAD scenarios and identify demographic and psychosocial factors associated with the levels of support.

Design

Cross-sectional survey design. Independent variables included individual sociodemographic characteristics, healthcare professionals, perceived quality of life, formal caregiver experience, Patient Right to Autonomy Act (PRAA) awareness and advance care planning (ACP) preparedness.

Setting

An online survey of the general population in Taiwan was conducted in 2022.

Participants

A total of 3922 Taiwanese adults who completed all survey questions.

Outcome measures

Agreement levels with PAD in three scenarios: terminal illnesses, unbearable non-terminal pain and severe cognitive impairments. Multivariate logistic regression was used to examine agreement with each PAD scenario as separate dependent variables in the first three models and overall agreement across all scenarios as the dependent variable in the fourth model.

Results

High levels of public support for PAD were observed, with 86.2% supporting PAD for terminal illnesses, 79.2% for unbearable non-terminal pain and 72.6% for severe cognitive impairments. Support for PAD was associated with factors including younger age, male gender, lack of religious affiliation, a non-healthcare professional background, employment as a formal caregiver, lack of awareness of PRAA and higher preparedness in ACP.

Conclusions

The results indicate a potential cultural shift in Taiwan towards greater emphasis on individual autonomy in end-of-life decisions. There appears to be significant public support for developing legal frameworks in favour of PAD, carefully considering the psychosocial factors that highlight the importance of individual rights in end-of-life care.
Cross-sectional patient survey of biological medicine users in Finland to investigate the types of guidance needed by patients in order to carry out their treatment successfully
Authors: Pölkki Mari , Prami Tuire
Published: January 2025

Background

The use of new biological medicines as standard treatment is expected to increase substantially and cover new therapeutic indications in the near future. Interchange of biological medicines in pharmacies increases the need for patient guidance.

Objectives

The study aims to gain a patient perspective on biological medicine users’ needs and wishes regarding patient guidance by exploring what kind of information patients wish to receive and to further investigate the potential differences in needs between originator biological medicine users and biosimilar users.

Design

A cross-sectional patient survey.

Setting

Anonymous electronic patient survey was conducted in 88 community pharmacies and via two patient organisations in Finland in 2022.

Participants

Users of originators and biosimilars of adalimumab, etanercept, filgrastim and pegfilgrastim.

Results

The majority of the 199 respondents had received instructions from a nurse or a public health nurse on how to use their self-injected medicine. According to the patients, the main factors affecting treatment persistence, apart from treatment effectiveness, were few adverse effects, access to treatment support and an easy-to-use administration device. At treatment initiation, the optimal types of guidance were face-to-face instruction, hands-on practice with injecting the medicine, using the administration device and information on adverse effects. Even though 79% of respondents indicated that they would not have wanted more instruction on using their self-injected medicine, these respondents also expressed that, at the time of treatment initiation, additional information or help would have been needed concerning adverse effects, biosimilars, and biological medicines in general. In general, biosimilar users were more concerned about adverse effects than users of originator products.

Conclusion

Patients consider information about adverse effects an important part of patient guidance when starting and maintaining self-administered biological therapy. The results highlight the importance of ensuring that up-to-date evidence-based information is readily available to patients from reliable sources.
Building knowledge to improve access to inclusive and equitable care for trans and gender-diverse survivors of sexual assault and intimate partner violence: a qualitative research protocol
Authors: Toccalino Danielle , Jonsa Sav , Yakubovich Alexa R , Davies Adam , Kosa Sarah Daisy , Kelly C Emma , Macdonald Sheila , Du Mont Janice
Published: January 2025

Introduction

Intimate partner violence (IPV) and sexual assault are pervasive public health and human rights concerns that disproportionately impact trans and gender-diverse (TGD) individuals. Experiences of cisgenderism and transphobia, compounded by racism and other forms of discrimination and structural violence, can hinder access to appropriate supports in a safe and non-stigmatising environment across a variety of sectors, including but not limited to healthcare, social services, criminal justice, and legal. TGD individuals may also have unique health and social needs requiring support that is not yet in place. Recent research has identified the need to better understand barriers to accessing support for TGD survivors of IPV and sexual assault as a top priority. This study aims to address this need for evidence to facilitate improved access to inclusive and equitable services for TGD survivors.

Methods and analysis

This qualitative study will involve semi-structured interviews with approximately 60 adult TGD survivors of IPV and/or sexual assault who wanted to access, attempted to access, or used services. A diverse array of participants from across Canada will be recruited via purposeful and snowball sampling through partner organisations, Peer Leader Advisors and their networks, as well as promotion in physical and virtual spaces (eg, flyers and social media). An interview guide was developed based on Levesque’s access to care model. Virtual interviews will be thematically analysed using Braun and Clarke’s iterative phases of reflexive thematic analysis. An intersectionality lens will be applied throughout the research process.

Ethics and dissemination

Research Ethics Board approval was obtained from Women’s College Hospital (WCH REB #: 2023-0033-E). Findings will be shared in peer-reviewed publications, at academic conferences, and through the burgeoning trans-LINK Canada Network WebPortal (https://www.translinknetwork.com/) using a variety of media, including newsletters, infographics, and webinars.