bluuebunny/crossref_metadata_2025 huggingface dataset:
A scoping review and theory‐informed conceptual model of professional identity formation in medical education
Authors: Sarraf‐Yazdi Shiva , Pisupati Anushka , Goh Chloe Keyi , Ong Yun Ting , Toh You Ru , Goh Suzanne Pei Lin , Krishna Lalit Kumar Radha
Published: April 2024

Introduction

Professional identity formation (PIF) is a central tenet of effective medical education. However, efforts to support, assess and study PIF are hindered by unclear definitions and conceptualisations of what it means to ‘think, act, and feel like a physician’. Gaps in understanding PIF, and by extension, its support mechanisms, can predispose individuals towards disengaged or unprofessional conduct and institutions towards short‐sighted or reactionary responses to systemic issues.

Methods

A Systematic Evidence‐Based Approach‐guided systematic scoping review of PIF theories was conducted related to medical students, trainees and practising doctors, published between 1 January 2000 and 31 December 2021 in PubMed, Embase, ERIC and Scopus databases.

Results

A total of 2441 abstracts were reviewed, 607 full‐text articles evaluated and 204 articles included. The domains identified were understanding PIF through the lens of pivotal theories and characterising PIF by delineating the underlying factors that influence it and processes that define it.

Conclusions

Based on regnant theories and frameworks related to self‐concepts of identity and personhood, the relationships between key PIF influences, processes and outcomes were examined. A theory‐backed integrated conceptual model was proposed to delineate the interconnected relationships among these, aiming to untangle some of the complexities inherent to PIF, to shed light on existing practices and to identify shortcomings in our understanding so as to develop mechanisms in support of its multifaceted, interlinked components.
Aligning goals with care: Advance directives in older adults with implantable cardioverter‐defibrillators
Authors: Backman Warren D. , DiCaro Michael V. , Zuo Xintong , Peralta Adelqui , Orkaby Ariela R.
Published: April 2024

Background

Patients ≥80 with implantable cardioverter‐defibrillators (ICDs) have high rates of hospitalization and mortality, yet few have documented advance directives. We sought to determine the prevalence of advance directives in adults ≥80 years with ICDs, focusing on those with frailty and cognitive impairment.

Methods

Prospective cohort study (July 2016–May 2019) in an electrophysiology clinic. Presence of advance directives (health care proxies [HCP] and living wills [LW], or medical orders for life‐sustaining treatment [MOLST]) was determined by medical record review. Frailty and cognitive impairment were screened using 4‐m gait speed and Mini‐Cog.

Results

77 Veterans were evaluated. Mean age 84 years, 100% male, 70% frail. Overall, 52 (68%) had an HCP and 37 (48%) had a LW/MOLST. Of 67 with cognitive testing, 36% were impaired. HCP documentation was similar among frail and non‐frail (69% vs. 65%). LW/MOLST was more prevalent among frail versus non‐frail (52% vs. 39%). There was no difference in HCP documentation by cognitive status (67%). A LW/MOLST was more frequent for cognitively impaired versus non‐impaired (50% vs. 42%). Among 19 Veterans who were frail and cognitively impaired, 14 (74%) had an HCP and 11 (58%) had a LW/MOLST.

Conclusions

Most Veterans had a documented advance directive, but a significant minority did not. Simple frailty and cognitive screening tools can rapidly identify patients for whom discussion of advance directives is especially important.
Radiofrequency for chronic lumbosacral and cervical pain: Results of a consensus study using the RAND/UCLA appropriateness method
Authors: de Andrés Ares Javier , Eldabe Sam , Helsen Nicky , Baranidharan Ganesan , Barat Jean‐Luc , Bhaskar Arun , Cassini Fabrizio , Gillner Sebastian , Kallewaard Jan Willem , Klessinger Stephan , Mavrocordatos Philippe , Occhigrossi Felice , Van Zundert Jan , Huygen Frank , Stoevelaar Herman
Published: April 2024

Background

Despite the routine use of radiofrequency (RF) for the treatment of chronic pain in the lumbosacral and cervical region, there remains uncertainty on the most appropriate patient selection criteria. This study aimed to develop appropriateness criteria for RF in relation to relevant patient characteristics, considering RF ablation (RFA) for the treatment of chronic axial pain and pulsed RF (PRF) for the treatment of chronic radicular pain.

Methods

The RAND/UCLA Appropriateness Method (RUAM) was used to explore the opinions of a multidisciplinary European panel on the appropriateness of RFA and PRF for a variety of clinical scenarios. Depending on the type of pain (axial or radicular), the expert panel rated the appropriateness of RFA and PRF for a total of 219 clinical scenarios.

Results

For axial pain in the lumbosacral or cervical region, appropriateness of RFA was determined by the dominant pain trigger and location of tenderness on palpation with higher appropriateness scores if these variables were suggestive of the diagnosis of facet or sacroiliac joint pain. Although the opinions on the appropriateness of PRF for lumbosacral and cervical radicular pain were fairly dispersed, there was agreement that PRF is an appropriate option for well‐selected patients with radicular pain due to herniated disc or foraminal stenosis, particularly in the absence of motor deficits. The panel outcomes were embedded in an educational e‐health tool that also covers the psychosocial aspects of chronic pain, providing integrated recommendations on the appropriate use of (P)RF interventions for the treatment of chronic axial and radicular pain in the lumbosacral and cervical region.

Conclusions

A multidisciplinary European expert panel established patient‐specific recommendations that may support the (pre)selection of patients with chronic axial and radicular pain in the lumbosacral and cervical region for either RFA or PRF (accessible via https://rftool.org). Future studies should validate these recommendations by determining their predictive value for the outcomes of (P)RF interventions.
Designing an observation protocol for professional development providers and mentors working with scientific inquiry‐supported classroom settings
Authors: Unver Ayse Oguz , Okulu Hasan Zuhtu , Bektas Onur , Yilmaz Yasemin Ozdem , Muslu Nilay , Senler Burcu , Arabacioglu Sertac
Published: April 2024

Several observation protocols in different theoretical frameworks and components have been designed and validated by teacher trainers and professional development providers to capture and categorize observational data on the characteristics and level of inquiry in science practices. However, certain constraints limit their wide use, such as the neglect of certain indicators of scientific inquiry, the scoring of just summative goals, or the necessity for extensive observer training. The present study, therefore, aims to propose a tool that assists professional development providers and mentors in diagnosing the closeness of practices to scientific inquiry in the context of various settings, from traditional didactic lectures to scientific inquiry, making it easily operational for self and peer evaluations as well as 360‐degree video feedback. The method concentrated on multiple observations provides supportive evidence about the tool's internal consistency coefficient, the relationship between its components, and the inter‐rater reliability coefficient between multiple scorers. The results highlight that the tool, which includes the components of course structure, course overview, and teacher–student communication, has the potential to contribute to the growing library of observation protocols.
Applicability of spatial planning system package for the LADM Turkey country profile
Authors: Yılmaz Okan , Alkan Mehmet
Published: April 2024

Spatial planning plays a crucial role in shaping the future of urban development and land administration. While land registration information is necessary for spatial planning processes, it is also probable that changes in land registration data occur in line with spatial plan decisions. Development of the Land Administration Domain Model (LADM) Edition II It also aimed to extend its existing conceptual model with spatial plan data, considering the close connection between the two systems. The study aims to design a conceptual model for Turkey's spatial planning system within the LADM Turkey country profile context. This article researches the capability of the proposed conceptual model for representing spatial planning data with instance‐level diagrams and the implementation opportunities of a technical model. To demonstrate the functionality of the proposed model, the zoning status certificate, which contains spatial plan and land registration data and is provided to inform about the legal conditions before development, is chosen as the mission. The results show that the LADM Turkey country profile extended with spatial planning system data can represent spatial plan data and be implemented in a technical model to support land administration applications.
EpMYB2 positively regulates chicoric acid biosynthesis by activating both primary and specialized metabolic genes in purple coneflower
Authors: Jin Ge , Deng Zongbi , Wang Hsihua , Zhang Yang , Fu Rao
Published: April 2024

Chicoric acid is the major active ingredient of the world‐popular medicinal plant purple coneflower (Echinacea purpurea (L.) Menoch). It is recognized as the quality index of commercial hot‐selling Echinacea products. While the biosynthetic pathway of chicoric acid in purple coneflower has been elucidated recently, its regulatory network remains elusive. Through co‐expression and phylogenetic analysis, we found EpMYB2, a typical R2R3‐type MYB transcription factor (TF) responsive to methyl jasmonate (MeJA) simulation, is a positive regulator of chicoric acid biosynthesis. In addition to directly regulating chicoric acid biosynthetic genes, EpMYB2 positively regulates genes of the upstream shikimate pathway. We also found that EpMYC2 could activate the expression of EpMYB2 by binding to its G‐box site, and the EpMYC2–EpMYB2 module is involved in the MeJA‐induced chicoric acid biosynthesis. Overall, we identified an MYB TF that positively regulates the biosynthesis of chicoric acid by activating both primary and specialized metabolic genes. EpMYB2 links the gap between the JA signaling pathway and chicoric acid biosynthesis. This work opens a new direction toward engineering purple coneflower with higher medicinal qualities.
Multiple transcription factors of Arabidopsis thaliana that are activated by LEAFY COTYLEDON 2 regulate triacylglycerol biosynthesis
Authors: Kim Inyoung , Do Hyungju , Park Mid‐Eum , Kim Hyun Uk
Published: April 2024

Plant triacylglycerols (TAG) are used in food and various industrial feedstocks. LEAFY COTYLEDON 2 (LEC2), a master positive regulator of TAG biosynthesis, regulates a complex network of transcription factors (TFs) during seed development. Aside from WRINKLED1 (WRI1), the TFs regulated by LEC2 related to TAG biosynthesis have not yet been identified. Previously, we identified 25 seed‐expressing TFs that were upregulated in Arabidopsis leaves that overexpressed senescence‐induced LEC2. In this study, each of the 25 TFs was transiently expressed in the leaves of Nicotiana benthamiana to identify unknown TFs that regulate TAG biosynthesis. The TAG content of the transformed leaves was analyzed using thin layer chromatography and gas chromatography. We observed that five TFs, ARABIDOPSIS RESPONSIVE REGULATOR 21 (ARR21), AINTEGUMENTA‐LIKE 6 (AIL6), APETALA2/ETHYLENE RESPONSIVE FACTOR 55 (ERF55), WRKY DNA‐BINDING PROTEIN 8 (WRKY8), and ARABIDOPSIS NAC DOMAIN CONTAINING PROTEIN 38 (ANAC038) increased TAG synthesis in the leaves. Among these, the promoters of AIL6, ERF55, WRKY8, and ANAC038 contain RY motifs, which are LEC2‐binding sites activated by LEC2. AIL6 overexpression in Arabidopsis increased the total fatty acid (FA) content in seeds and altered the FA composition, with increases in 16:0, 18:1, and 18:2 and decreases in 18:0, 18:3, and 20:1 compared with those in the wild type (WT). AIL6 overexpression activates several FA and TAG biosynthesis genes. Therefore, our study successfully identified several new TFs regulated by LEC2 in TAG biosynthesis and showed that AIL6 increased the TAG content in seeds.
Chemical ciliary body ablation in dogs with chronic glaucoma and anterior lens luxation: A retrospective review from 2017 to 2022
Authors: King Cristina , Stine Jessica M. , Welihozkiy Anja , Baldwin Terri L.
Published: April 2024

Objectives

To evaluate the clinical outcomes of chemical ciliary body ablation (CBA) in dogs with chronic glaucoma and concurrent anterior lens luxation and to investigate adverse ocular effects of this procedure.

Procedures

Retrospective review of 17 dogs (18 eyes) with chronic glaucoma and concurrent anterior lens luxation treated with intravitreal gentamicin with or without dexamethasone sodium phosphate or triamcinolone acetonide. Data collected included signalment, concurrent ocular disease, topical medications prescribed, follow‐up duration, and intraocular pressure (IOP) pretreatment, posttreatment, and at the last follow‐up visit. Success was defined as an IOP <25 mmHg with no additional procedures or ocular hypotensive medications at the last examination to date.

Results

The success rate for CBA in dogs with chronic glaucoma and concurrent anterior lens luxation was 88.9% without the need of additional surgical or ocular hypotensive therapies. Glaucoma was suspected to be secondary to lens luxation in 72.2% of cases. The most common postoperative complications were phthisis bulbi (50.0%), keratoconjunctivitis sicca (27.8%), and uveitis (27.8%). Long‐term management with topical nonsteroidal anti‐inflammatories, corticosteroids, and/or immunomodulators was needed in 70.6% of cases.

Conclusions

CBA with intravitreal injection of gentamicin is effective at maintaining an IOP <25 mmHg in dogs with chronic glaucoma and concurrent anterior lens luxation. Management of postoperative sequelae commonly requires continued use of topical medications.
Characteristics, enablers, and barriers to the community health and well-being assessment component of the health promotion practice cycle: a scoping review protocol
Authors: Gamble Tara , Taylor Jane , O’Hara Lily , Cole Rachel
Published: April 2024

Objective:

The proposed review will describe the characteristics, enablers, and barriers to the community health and well-being assessment (CHWA) component of the health promotion practice cycle.

Introduction:

CHWA guides health promotion action in communities and populations. A “critical” approach to CHWA can be adopted, which addresses the social, political, cultural, economic, commercial, and environmental determinants of health and well-being to enhance health equity for priority communities and populations. Although tools exist to guide such a critical approach, little is known about the extent to which these tools are being used or the barriers and enablers to applying best practice CHWA. Such evidence is needed to inform future health promotion CHWA and research.

Inclusion criteria:

This review will consider literature that describes CHWA conducted in health promotion practice, focusing on an organizational, social, or geographical community or population. Literature that focuses on clinical practice or a specific health condition will be excluded.

Methods:

Scopus, PubMed, Web of Science, and CINAHL (EBSCOhost) will be searched to identify peer-reviewed articles. Google Scholar and Google, as well as Public Health, Health and Medical, and Nursing and Allied Health (ProQuest) databases will be searched for gray literature. Articles will be screened and data extracted by 2 or more independent reviewers. The data extraction tool will be developed by the reviewers based on the JBI template and a critical health promotion approach to CHWA. Data will be analyzed and presented as frequency tables and narrative summaries of the characteristics, enablers, and barriers to CHWA.

Review registration:

Open Science Framework osf.io/jq8th/
Experimental Investigation of the Effect of Heat Pipe Tilting on a Concentrated Photovoltaic/Heat Pipe Passive Cooling System
Authors: Lashin Abdelrahman , Sabry Mohamed
Published: April 2024

To maintain the concentrated photovoltaic systems (CPV) output, effective cooling is necessary. In contrast to costly and complicated active cooling methods, passive cooling is static, simple, and maintenance-free. Among passive techniques, Heat Pipes (HPs) are devices that efficiently transfer heat from the evaporator to the condenser. The inclination angle of wicked, liquid-filled HP's long-axis determines how well it cools, as an effect of the gravitational force acting on the condensed liquid. This study investigates the effect of tilting the HP long-axis on the performance of the different parameters of the CPV, which is passively cooled by thermal attachment to its back side. Two similar HPs except for their lengths were attached alternatively. Different concentrated illumination levels are then allowed to be incident on the CPV. At each illumination level, the inclination of the HP long-axis was varied from −90 deg (completely vertical with condenser up) to 90 deg (completely vertical with condenser down), passing through 0 deg (HP is completely horizontal) with a step of 15 deg. The effect of such variations on the inclinations has been tested on the two systems. The system incorporating the long HP was found to have a higher cooling performance at an angle of −15 deg, compared to the short HP system, which has its highest cooling capacity at an angle of −60 deg, with an increase of about 7% for the maximum power in case of using the former system compared to the latter.
Sustainability Neighborhood
Authors: Lawrence Demi
Published: April 2024

This project explores the opportunities for not only for individuals aiming to increase sustainability in their lifestyles, but, for other landlords and universities nationally to incorporate the grassroots innovation of Sustainable Neighbourhood/s to their practices. Connecting innovation and community action enables a new lens on individual and community-level sustainability efforts, further highlighting the importance of community action which is often as an overlooked source of innovation (Seyfang & Smith, 2007). Otago University’s Sustainability Neighbourhoods fosters a sense of environmental responsibility, community engagement, and lifelong learning, contributing to a more resilient and eco-conscious future for both the residents and the broader community. The practical aspect of this project has been conducted through providing an interactive and locally specific online platform with resources, information, and tools to enhance for both residents and other students understanding and commitment to sustainable living. By enabling open online platform to the University of Otago’s Sustainability Neighbourhoods, this concurrently acts as a manual for other universities and landlords seeking to establish similar Sustainability initiatives, communities and/or neighbourhoods.

Supervised by: Ray O’Brien & Jesikah Triscott
Carbon Loss from Earthquake Induced Landslides in Fiordland
Authors: Cox Charlie
Published: April 2024

Landslides triggered by two earthquakes in Fiordland, New Zealand, were mapped using Google Earth Pro retro satellite imagery (eye altitude of 1.5-2.5 km, enabling ± 50 m precision), then catalogued and classified in a GIS inventory. Ground acceleration during the 2003 Mw 7.2 Secretary Island Earthquake resulted in at least 1852 landslides, but the larger Mw 7.8 2009 Dusky Sound Earthquake had lower accelerations and produced only 313. Both events dislodged large swaths of native forest, grassland vegetation and soil from Fiordland’s steep slopes in similar proportions, some landing in rivers and fiords.  The landslide maps and magnitude-frequency distributions show close similarity to a published Global Forest Loss dataset derived from 2001-2022 satellite imagery. Assuming forest loss in this wilderness is predominantly landslide-related, it enables the more-precise earthquake-induced landslide mapping to be placed in a longer-term context of other vegetation loss, mostly rainfall-induced landslides, during the past two decades. The total area of forest loss during the 2003 earthquake was anomalous, whereas during 2009 the earthquake losses were similar to areas of forest loss assumed to be rainfall-induced landslides throughout Fiordland each year. Carbon concentrations of landslide vegetation and soil were calculated by defining vegetation types from a published Land Cover Database, and soil organic carbon concentration from a 1 km resolution raster dataset. Total carbon loss from earthquake-induced landslides amounts to 2.05E+06 tonnes for the 2003 Mw7.2 and 2.17E+05 tonnes for the 2009 Mw 7.8. By way of comparison, New Zealand’s total annual carbon sequestration was 6.3E+06 tonnes in 2020. Earthquake-induced and rainfall-induced landslides are shown to account for significant changes in stored carbon and available carbon sequestration, especially in areas of densely vegetated land, such as Fiordland. Processes of landscape disturbance should be included in carbon accounting and estimates of national greenhouse gas emissions.

 

Supervised by: Caroline Orchiston

Scholarship Project Funded by: Centre for Sustainability
Are You Ready to Shake, Dunedin?
Authors: Latton Rhys
Published: April 2024

In 1974, I was one and a half years old. We didn’t own a TV in my family’s home, but if we had, we would have perhaps been watching Coronation Street on the evening of the 9th of April (there was only one channel - black and white). My mother remembers the quake quite vividly - the sound like a train roaring outside confused her for a moment. Once she realised what was happening, Mum rushed her little family under the strong, oaken kitchen table as our little bungalow shook.

I have been making a short film in which we find out about Dunedin’s moderate intensity 1974 earthquake through the firsthand memories of residents of the time and through our local earthquake experts. How did the earthquake manifest in our city? What damage was caused? How prepared were we?

Taking this experience further: what is the potential for a larger quake to happen here - could nearby fault lines deliver an earthquake to Dunedin of catastrophic proportions? Have we learned from 1974 enough to be prepared for such an event?In my presentation, I’ll discuss my process for finding a narrative approach to this documentary in order to bring about audience engagement and even entertainment to this communication resource, thus amplifying retention of the important messaging of resilience and preparedness.

Supervised by: Caroline Orchiston

Scholarship Project Funded by: The Centre for Sustainability
Food Waste Initiatives Across Tertiary Sectors in the Pacific Region
Authors: Gibson Ana
Published: April 2024

Preventing food waste is becoming a global priority, with approximately 1.3 billion tonnes of food wasted annually contributing to 10% of the world’s carbon emissions. The United Nations has established the Sustainable Development Goal (SDG) target 12.3, aiming to halve food waste by 2050. Pacific nations are at risk of becoming food insecure, due in part to their hot climate and limited resources to store food properly. This research paper investigates food waste initiatives at universities across the Pacific region. The aim of this project was to identify current proactive measures addressing food waste, assess the effectiveness of existing initiatives, and pinpoint actions that could enhance sustainable food consumption. This project involved both primary and secondary data collection, to investigate the practices of 34 universities from 17 islands in the Pacific Region.

Supervised by: Miranda Mirosa

Scholarship Project Funded by: Riddet Summer
Transforming the E-waste Management System
Authors: Ibrahim Sarah
Published: April 2024

The aim of this research is to inform the transformation of the e-waste management in Dunedin by shifting the focus from recycling to activities higher in the waste hierarchy (for example, redesigning, reducing and refurbishing). Previous research has identified the importance and potential solutions of creating a circular economy for e-waste, but few have addressed the context of Dunedin's social and environmental economy. To gain insight into how Dunedin’s climate influences the e-waste management system, semi-structured interviews were conducted with stakeholders involved in the production, processing and diversion of e-waste.

The interviews focused on understanding current e-waste management practices, identified barriers and explored opportunities for collaboration with other stakeholders. This research hopes to generate recommendations to improve e-waste management in Dunedin that may be adopted in other areas to support sustainable consumption and production patterns. 

Supervised by: Craig Cliff, Ray O’Brien

Scholarship Project Funded by: Dunedin City Council
Supplier Perceptions Towards Providing Surplus Food to a Social Enterprise
Authors: Collins Cinamin
Published: April 2024

Social enterprises are organisations that adopt business models to achieve their social and/or environmental goals. The use of surplus food by a social enterprise may help support de-growth, lessen food insecurity, create community spaces, and/or be more environmentally friendly. In the case of acquiring surplus food, social enterprises may either receive donated surplus food from producers or manufacturers, or they can purchase the surplus food thereby creating a secondary market for food that would have otherwise gone to waste. The purpose of this project was to explore food producers' and manufacturers' perceptions on the provision of surplus food to a social enterprise, to provide a better understanding of the opportunities to grow this beneficial practice. The project consisted of a series of semi-structured interviews with food producers and manufacturers in the Otago region. These interviews were transcribed and then thematically analysed, to identify themes in the data.

The report found that the food suppliers interviewed, though they did not currently have systems in place, were open to the idea of providing surplus food to a social enterprise. In terms of opportunities, frequently mentioned were “capacity”, “public perception”, “community” and "attitude". In terms of barriers, frequently mentioned were “capacity”, "logistics", “cost/benefit”, “current use” and “communication”." These results will form the basis of recommendations on how social enterprises can more effectively source surplus food from the region.

Supervised by: Miranda Mirosa, Food Waste Innovation
Structure and replication cycle of a virus infecting climate-modulating alga
Emiliania huxleyi
Authors: Homola Miroslav , Büttner Carina R. , Füzik Tibor , Křepelka Pavel , Holbová Radka , Nováček Jiří , Chaillet Marten L. , Žák Jakub , Grybchuk Danyil , Förster Friedrich , Wilson William H. , Schroeder Declan C. , Plevka Pavel
Published: April 2024

The globally distributed marine alga
Emiliania huxleyi
has cooling effect on the Earth’s climate. The population density of
E. huxleyi
is restricted by
Nucleocytoviricota
viruses, including
E. huxleyi
virus 201 (EhV-201). Despite the impact of
E. huxleyi
viruses on the climate, there is limited information about their structure and replication. Here, we show that the dsDNA genome inside the EhV-201 virion is protected by an inner membrane, capsid, and outer membrane. EhV-201 virions infect
E. huxleyi
by using fivefold vertices to bind to and fuse the virus’ inner membrane with the cell plasma membrane. Progeny virions assemble in the cytoplasm at the surface of endoplasmic reticulum–derived membrane segments. Genome packaging initiates synchronously with the capsid assembly and completes through an aperture in the forming capsid. The genome-filled capsids acquire an outer membrane by budding into intracellular vesicles. EhV-201 infection induces a loss of surface protective layers from
E. huxleyi
cells, which enables the continuous release of virions by exocytosis.
Developing nucleoside tailoring strategies against SARS-CoV-2 via ribonuclease targeting chimera
Authors: Min Yuanqin , Xiong Wei , Shen Wei , Liu Xingyu , Qi Qianqian , Zhang Yuanyuan , Fan Ruochen , Fu Fang , Xue Heng , Yang Hang , Sun Xiulian , Ning Yunjia , Tian Tian , Zhou Xiang
Published: April 2024

In response to the urgent need for potent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) therapeutics, this study introduces an innovative nucleoside tailoring strategy leveraging ribonuclease targeting chimeras. By seamlessly integrating ribonuclease L recruiters into nucleosides, we address RNA recognition challenges and effectively inhibit severe acute respiratory syndrome coronavirus 2 replication in human cells. Notably, nucleosides tailored at the ribose 2′-position outperform those modified at the nucleobase. Our in vivo validation using hamster models further bolsters the promise of this nucleoside tailoring approach, positioning it as a valuable asset in the development of innovative antiviral drugs.
Ultrasoft platelet-like particles stop bleeding in rodent and porcine models of trauma
Authors: Nellenbach Kimberly , Mihalko Emily , Nandi Seema , Koch Drew W. , Shetty Jagathpala , Moretti Leandro , Sollinger Jennifer , Moiseiwitsch Nina , Sheridan Ana , Pandit Sanika , Hoffman Maureane , Schnabel Lauren V. , Lyon L. Andrew , Barker Thomas H. , Brown Ashley C.
Published: April 2024

Uncontrolled bleeding after trauma represents a substantial clinical problem. The current standard of care to treat bleeding after trauma is transfusion of blood products including platelets; however, donated platelets have a short shelf life, are in limited supply, and carry immunogenicity and contamination risks. Consequently, there is a critical need to develop hemostatic platelet alternatives. To this end, we developed synthetic platelet-like particles (PLPs), formulated by functionalizing highly deformable microgel particles composed of ultralow cross-linked poly (
N
-isopropylacrylamide) with fibrin-binding ligands. The fibrin-binding ligand was designed to target to wound sites, and the cross-linking of fibrin polymers was designed to enhance clot formation. The ultralow cross-linking of the microgels allows the particles to undergo large shape changes that mimic platelet shape change after activation; when coupled to fibrin-binding ligands, this shape change facilitates clot retraction, which in turn can enhance clot stability and contribute to healing. Given these features, we hypothesized that synthetic PLPs could enhance clotting in trauma models and promote healing after clotting. We first assessed PLP activity in vitro and found that PLPs selectively bound fibrin and enhanced clot formation. In murine and porcine models of traumatic injury, PLPs reduced bleeding and facilitated healing of injured tissue in both prophylactic and immediate treatment settings. We determined through biodistribution experiments that PLPs were renally cleared, possibly enabled by ultrasoft particle properties. The performance of synthetic PLPs in the preclinical studies shown here supports future translational investigation of these hemostatic therapeutics in a trauma setting.
Comparison of lumefantrine, mefloquine, and piperaquine concentrations between capillary plasma and venous plasma samples in pregnant women with uncomplicated falciparum and vivax malaria
Authors: Saito Makoto , Wilaisrisak Pornpimon , Pimanpanarak Mupawjay , Viladpai-Nguen Jacher , Paw Moo Kho , Koesukwiwat Urairat , Tarning Joel , White Nicholas J. , Nosten Francois , McGready Rose
Published: April 2024

Capillary samples offer practical benefits compared with venous samples for the measurement of drug concentrations, but the relationship between the two measures varies between different drugs. We measured the concentrations of lumefantrine, mefloquine, piperaquine in 270 pairs of venous plasma and concurrent capillary plasma samples collected from 270 pregnant women with uncomplicated falciparum or vivax malaria. The median and range of venous plasma concentrations included in this study were 447.5 ng/mL (8.81–3,370) for lumefantrine (day 7,
n
= 76, median total dose received 96.0 mg/kg), 17.9 ng/mL (1.72–181) for desbutyl-lumefantrine, 1,885 ng/mL (762–4,830) for mefloquine (days 3–21,
n
= 90, median total dose 24.9 mg/kg), 641 ng/mL (79.9–1,950) for carboxy-mefloquine, and 51.8 ng/mL (3.57–851) for piperaquine (days 3–21,
n
= 89, median total dose 52.2 mg/kg). Although venous and capillary plasma concentrations showed a high correlation (Pearson’s correlation coefficient: 0.90–0.99) for all antimalarials and their primary metabolites, they were not directly interchangeable. Using the concurrent capillary plasma concentrations and other variables, the proportions of venous plasma samples predicted within a ±10% precision range was 34% (26/76) for lumefantrine, 36% (32/89) for desbutyl-lumefantrine, 74% (67/90) for mefloquine, 82% (74/90) for carboxy-mefloquine, and 24% (21/89) for piperaquine. Venous plasma concentrations of mefloquine, but not lumefantrine and piperaquine, could be predicted by capillary plasma samples with an acceptable level of agreement. Capillary plasma samples can be utilized for pharmacokinetic and clinical studies, but caution surrounding cut-off values is required at the individual level.

CLINICAL TRIALS

This study is registered with ClinicalTrials.gov as
NCT01054248
.
Cefadroxil and cephalexin pharmacokinetics and pharmacodynamics in children with musculoskeletal infections
Authors: Haynes Andrew S. , Wei Zixuan , Anderson Peter , Scheetz Marc H. , Parker Sarah K. , Fish Douglas N.
Published: April 2024

Cephalexin, a first-generation cephalosporin, is the first-line oral therapy for children with musculoskeletal infections due to methicillin-susceptible
Staphylococcus aureus
(MSSA). Cefadroxil, a similar first-generation cephalosporin, is an attractive alternative to cephalexin given its longer half-life. In this study, we describe the comparative pharmacokinetics (PK) and pharmacodynamics (PD) of cephalexin and cefadroxil in children with musculoskeletal infections. Children aged 6 months to 18 years with a musculoskeletal infection were enrolled in a prospective, open-label, crossover PK study and given single oral doses of cefadroxil (50–75 mg/kg up to 2,000 mg) and cephalexin (50 mg/kg up to 1,375 mg). Population PK models were developed and used for dosing simulations. Our primary PD target was the achievement of free antibiotic concentrations above the minimum inhibitory concentration (
f
T >MIC) for 40% of the day for MICs ≤ 4 mg/L. PK of cephalexin (
n
= 15) and cefadroxil (
n
= 14) were best described using a one-compartment, first-order absorption model, with a lag time component for cefadroxil. PK parameters were notable for cefadroxil’s longer half-life (1.61 h) than cephalexin’s (1.10 h). For pediatric weight bands, our primary PD target was achieved by cephalexin 25 mg/kg/dose, maximum 750 mg/dose, administered three times daily and cefadroxil 40 mg/kg/dose, maximum 1,500 mg/dose, administered twice daily. More aggressive dosing was required to achieve higher PD targets. Among children with musculoskeletal infections, oral cephalexin and cefadroxil achieved PD targets for efficacy against MSSA. Given less frequent dosing, twice-daily cefadroxil should be further considered as an alternative to cephalexin for oral step-down therapy for serious infections due to MSSA.
Draft genome sequence of
Yersinia pseudotuberculosis
isolated from a wild rat in Japan
Authors: Okutani Akiko , Taira Masakatsu , Iida Shun , Park Eun-Sil , Tokuyoshi Mikuni , Watari Yuya , Suzuki Tadaki , Maeda Ken
Published: April 2024

We report a draft genome sequence of
Yersinia pseudotuberculosis
isolated from the spleen of a wild rat from Mikura-shima Island, Japan. The bacterium was identified as serotype O:4b using PCR-based O-genotyping. These genomic data provide insights into the pathogenic potential of this strain in spontaneous outbreaks among wild animals.
Kinetic Regularities of the Synthesis of Silica Nanoparticles by Heterogeneous Hydrolysis of Tetraethoxysilane Using L-Arginine as a Catalyst
Authors: Masalov V. M. , Sukhinina N. S. , Sovyk D. N. , Ralchenko V. G. , Emel’chenko G. A.
Published: April 2024

The kinetics of the synthesis of silica nanoparticles (<50 nm) has been studied under the conditions of heterogeneous hydrolysis of tetraethoxysilane (TEOS) using L-arginine as an alkaline catalyst. The rates of silica formation have been determined in a temperature range of 10–95°C at catalyst concentrations of 6–150 mM. It has been shown that the activation energy of the process depends on catalyst concentration and varies in a range of 21.5–13.9 kJ/mol, while decreasing linearly with increasing concentration of L-arginine in the system. The criterion of maintaining the monodispersity has been estimated for SiO2 particles being grown “onto seeds.” The density of submicron-sized silica particles has been experimentally determined as depending on the annealing temperature. Within a temperature range of 200–1000°C, the particle density varies from 2.04 to 2.20 g/cm3.
Impact of social transition in relation to gender for children and adolescents: a systematic review
Authors: Hall Ruth , Taylor Jo , Hewitt Catherine Elizabeth , Heathcote Claire , Jarvis Stuart William , Langton Trilby , Fraser Lorna
Published: April 2024

Background

Increasing numbers of children and adolescents experiencing gender dysphoria or incongruence are being referred to specialist gender services. Historically, social transitioning prior to assessment was rare but it is becoming more common.

Aim

To identify and synthesise studies assessing the outcomes of social transition for children and adolescents (under 18) experiencing gender dysphoria/incongruence.

Methods

A systematic review and narrative sythesis. Database searches (Medline, Embase, CINAHL, PsycINFO, Web of Science) were perfomed in April 2022. Studies reporting any outcome of social transition (full or partial) for children and adolescents experiencing gender dysphoria/incongruence were included. An adapted version of the Newcastle-Ottawa Scale for cohort studies was used to appraise study quality.

Results

Eleven studies were included (children (n=8) and adolescents (n=3)) and most were of low quality. The majority were from the US, featured community samples and cross-sectional analyses. Different comparator groups were used, and outcomes related to mental health and gender identity reported. Overall studies consistently reported no difference in mental health outcomes for children who socially transitioned across all comparators. Studies found mixed evidence for adolescents who socially transitioned.

Conclusions

It is difficult to assess the impact of social transition on children/adolescents due to the small volume and low quality of research in this area. Importantly, there are no prospective longitudinal studies with appropriate comparator groups assessing the impact of social transition on mental health or gender-related outcomes for children/adolescents. Professionals working in the area of gender identity and those seeking support should be aware of the absence of robust evidence of the benefits or harms of social transition for children and adolescents.

PROSPERO registration number

CRD42021289659.
Clinical guidelines for children and adolescents experiencing gender dysphoria or incongruence: a systematic review of guideline quality (part 1)
Authors: Taylor Jo , Hall Ruth , Heathcote Claire , Hewitt Catherine Elizabeth , Langton Trilby , Fraser Lorna
Published: April 2024

Background

Increasing numbers of children and adolescents experiencing gender dysphoria/incongruence are being referred to specialist gender services. There are various guidelines outlining approaches to the clinical care of these children and adolescents.

Aim

To examine the quality and development of published guidelines or clinical guidance containing recommendations for managing gender dysphoria/incongruence in children and/or adolescents (age 0-18). A separate paper reports the synthesis of guideline recommendations.

Methods

A systematic review and narrative synthesis. Databases (Medline, Embase, CINAHL, PsycINFO, Web of Science) were searched to April 2022 and web-based searches and contact with international experts continued to December 2022, with results assessed independently by two reviewers. The Appraisal of Guidelines for Research and Evaluation tool was used to examine guideline quality.

Results

Twenty-three guidelines/clinical guidance publications (1998–2022) were identified (4 international, 3 regional and 16 national). The quality and methods reporting in these varied considerably. Few guidelines systematically reviewed empirical evidence, and links between evidence and recommendations were often unclear. Although most consulted with relevant stakeholders, including 10 which involved service users or user representatives, it was often unclear how this influenced recommendations and only two reported including children/adolescents and/or parents. Guidelines also lacked clarity about implementation. Two international guidelines (World Professional Association for Transgender Health and Endocrine Society) formed the basis for most other guidance, influencing their development and recommendations.

Conclusions

Most clinical guidance for managing children/adolescents experiencing gender dysphoria/incongruence lacks an independent and evidence-based approach and information about how recommendations were developed. This should be considered when using these to inform service development and clinical practice.

PROSPERO registration number

CRD42021289659.
Tracheal Schwannoma Presenting as Subcutaneous Emphysema and Pneumomediastinum
Authors: Mohamad Rayan , Koubaissi Salwa A , Bou Khalil Pierre , Sfeir Pierre
Published: April 2024

Primary tracheal schwannomas are rare benign tumours. This is a case report, and therefore, no specific methods or results are applicable. We here report a case of a tracheal schwannoma in an early adolescent girl presenting with subcutaneous emphysema and symptoms of airway obstruction. Tracheal resection and reconstruction by primary anastomosis were performed. Pathology confirmed the diagnosis of tracheal schwannoma. This is an unusual life-threatening presentation of a benign rare tracheal tumour with a challenging approach to management.
Total pancreatectomy, splenectomy and remnant gastrectomy for invasive intraductal papillary mucinous neoplasm (IPMN) after prior Roux-en-Y gastric bypass
Authors: Buchheit Joanna T , Joshi Isha , Dixon Matthew E , Peng June S
Published: April 2024

A female patient in her 50s presented with abdominal pain, nausea and jaundice. She had a history of prior Roux-en-Y gastric bypass and her body mass index was 52.5 kg/m2. Biochemical testing revealed a total bilirubin level of 14.3 mg/dL (normal<1.2 mg/dL) and carbohydrate antigen 19–9 of 38.3 units/mL (normal<36.0 units/mL). CT demonstrated a 3.2 cm pancreatic head mass, biliary and pancreatic duct dilation and cystic replacement of the pancreas. The findings were consistent with a diagnosis of mixed-type intraductal papillary mucinous neoplasm (IPMN) with invasive malignancy. The patient’s Roux-en-Y anatomy precluded endoscopic biopsy, and she underwent upfront resection with diagnostic laparoscopy, open total pancreatectomy, splenectomy and remnant gastrectomy with reconstruction. Pathology confirmed T2N1 pancreatic adenocarcinoma, 1/29 lymph nodes positive and diffuse IPMN. She completed adjuvant chemotherapy. IPMNs have malignant potential and upfront surgical resection should be considered without biopsy in the appropriate clinical setting.
Percutaneous biliary stent removal for benign biliary stricture post hepaticojejunostomy
Authors: Nadeem Arsalan , Salei Aliaksei
Published: April 2024

This case report presents the percutaneous extraction of a biliary stent in a patient with a history of liver transplant and Whipple procedure, suffering from benign biliary stricture post hepaticojejunostomy. After failed management with conventional benign biliary protocol, a fully covered WallFlex biliary stent was percutaneously placed and later removed using a balloon catheter technique. The procedure demonstrated anastomosis patency without complications, providing a drain-free option for complex anatomy where endoscopic management was not feasible. This case contributes valuable insights to the limited literature on percutaneous stent removal for benign biliary strictures, emphasising the importance of considering alternative approaches in challenging clinical scenarios.
Vertebral artery dissection as the underlying cause of ventral spinal epidural haematoma
Authors: Tavares Joana , Freire Inês , Branco Cristina , Luís Ana
Published: April 2024

Spontaneous spine epidural haematoma is a rare occurrence, with an incidence of 0.1/100 000 inhabitants/year. The anterior location of the haematoma is very uncommon since the dural sac is firmly attached to the posterior longitudinal ligament. Vertebral artery dissection as its underlying cause is an exceptionally rare event, with only two documented cases.

This article presents the case of young woman who arrived at the emergency room with a spinal ventral epidural haematoma extending from C2 to T10, caused by a non-traumatic dissecting aneurysm of the right vertebral artery at V2–V3 segment. Since the patient was tetraparetic, she underwent emergent laminectomy, and the vertebral artery dissection was subsequently treated endovascularly with stenting.

Vertebral artery dissection with subsequent perivascular haemorrhage is a possible cause of spontaneous spine epidural haematoma, particularly when located ventrally in the cervical and/or high thoracic column. Hence the importance of a thorough investigation of the vertebral artery integrity.
Building confidence in the COVID-19 vaccine in a polio-endemic country: strategic communication lessons from Pakistan
Authors: Haq Zaeem Ul , Yunus Soofia , Jafri Naveed
Published: April 2024

In a health emergency, governments rely on public trust in their policy, and anticipate its compliance to protect health and save lives. Vaccine hesitancy compromises this process when an emergency involves infections. The prevailing discourse on vaccine hesitancy often describes it as a static phenomenon, ignoring its expanse and complexity, and neglecting the exploration of tools to address it. This article diverges from the conventional perspective by explaining the case of Pakistan and its communication strategy for the COVID-19 vaccine. Decades of polio vaccine hesitancy, rooted in the country’s fight against terrorism, constitute its history. On the other hand, the first-ever launch of typhoid conjugate vaccine involving 35 million kids during 2019–2021 was a success. Against this backdrop, the country considered vaccine hesitancy as a dynamic phenomenon, interwoven with the social ecology and the responsiveness of the healthcare system. Its communication strategy facilitated those willing to receive the vaccine, while being responsive to the information needs of those still in the decision-making process. In the face of both hesitancy and a scarcity of vaccine doses, the country successfully inoculated nearly 70% (160 million) of its population in just over 1 year. People’s perceptions about the COVID-19 vaccine also improved over time. This achievement offers valuable insights and tools for policymakers and strategists focused on the demand side of vaccine programmes. The lessons can significantly contribute to the global discourse on improving vaccine confidence and bolstering global health security.