bluuebunny/crossref_metadata_2025 huggingface dataset:
Unveiling the mutual dynamics: Institutions, education and economic growth over 138 years in OECD countries
Authors: Röthel Tim , Leschke Martin
Published: September 2024

Many articles examine the effect of institutions and education on economic growth in growth models or empirical settings. However, the opposite effect of economic development on institutions and education is less researched. Systematic evidence is scarce when looking at the interplay of education and institutions. Most of the literature focuses on post‐war evidence starting in the 1960s only. However, institutions and education, both, only change slowly over time and, thus, should be analysed over a longer period. In this article, we try to close a gap by examining the relationship between all three variables over 138 years. By estimating a vector error correction model for a sample of 20 Organisation for Economic Co‐operation and Development (OECD) countries, we are additionally able to differentiate between short‐ and long‐run results. We find positive effects of institutions and education on growth and vice versa. In contrast, institutions and education do not significantly affect each other. Our results are robust to several robustness tests and extensions.
Food security during pregnancy: A qualitative content analysis study in Iran
Authors: Bagheri Maryam , Lamyian Minoor , Sadighi Jila , Ahmadi Fazlollah , Mohammadi‐Nasrabadi Fatemeh
Published: September 2024

Food security during pregnancy is crucial for safeguarding the health of expectant mothers and optimizing prenatal outcomes. Food insecurity can manifest in varying degrees, ranging from moderate disruptions to the quality and diversity of diet to severe cases that disrupt dietary patterns and reduce overall food intake. Limited information exists regarding food security among pregnant women in Iran. Therefore, this qualitative study aims to investigate food security during pregnancy from the perspectives of pregnant women (n = 17) and experts in food security (n = 6). Data were collected through purposeful sampling and 23 semi‐structured interviews. The data analysis process occurred concurrently with data collection, employing a conventional content analysis approach. The findings underwent rigorous evaluation based on credibility, confirmability, dependability, transferability and authenticity. The results revealed that access to quality foods in pregnancy depends on the sustainability of food resources, economic access to food, the family's food budget, pregnant women's utilization of food due to pregnancy conditions, their nutritional literacy and cultural practices. Pregnant women employ various strategies to cope with food insecurity and require social and governmental support to manage it effectively. Therefore, it is suggested that health care authorities initially assess the level of food security among pregnant women and subsequently, through equitable food distribution, reform culture and increase food literacy, providing practical and informative educational programmes, and structured support, improve their food security.
Exploring institutional stratification: Minority‐serving institutional pathways to medical school acceptance in the United States
Authors: Burbage Amanda K. , Hewitt Eushekia Y.
Published: September 2024

Introduction

Recruiting and training a diverse pool of physicians from historically excluded groups is vital to solving complex scientific problems and increasing access to patient care. Disparate educational and health outcomes of COVID‐19 amplified this need. In stratified higher education systems, underfunded institutions that serve greater numbers of underrepresented in medicine (URM) students face unique barriers to entering physician training. However, pathways from historically underfunded minority‐serving institutions (MSIs) in the United States to medical school (MD) are not well understood.

Method

A hierarchical logistic regression analysis of 328 488 de‐identified applicants to US MD‐granting medical schools for academic years 2017–2018 through 2022–2023 was used to determine predictors of acceptance based on MSI attendance compared to predominantly White institutions (PWI) and other literature‐informed predictors. An interrupted time series analysis determined the significance in changes in observed differences in application acceptance before and after the COVID‐19 pandemic.

Results

In model 1, MSI attendance was associated with significantly lower odds of acceptance, with a 42% to 52% chance of acceptance compared to PWI applicants. Adding MCAT and GPA significantly increased odds of acceptance for most MSI applicants in model 2. MSI attendance, MCAT, GPA and socio‐economic status indicators were useful predictors, improving the acceptance model by 39% better than the null model. Although some predictors showed a change in odds over time, none changed significantly when comparing before and after COVID‐19.

Discussion

MSI attending students were less likely to be admitted to MD programmes, highlighting systemic stratification until other academic factors were introduced to the model that alleviated lower odds, and the COVID‐19 pandemic did not substantially change these trends. Improved pathways and strengthened institutional relationships between institutions that have greater proportions of underrepresented students and medical schools may help improve MSI applicant odds furthering diversity within the physician‐trained workforce.
Enhancing ICU care with nurse‐written diaries
Authors: Bosco Vincenzo , Mercuri Caterina , Giordano Vincenza , Froio Anna Maria , Commisso Daniele , Nocerino Rita , Guillari Assunta , Rea Teresa , Mastrangelo Helenia , Uchmanowicz Izabella , Simeone Silvio
Published: September 2024

Background

Patient diaries are a supportive intervention aiding intensive care unit (ICU) survivors and their families post‐critical illness. Despite their growing acceptance, ICU diary usage varies across settings.

Aim

This study explored themes in nurse‐written ICU diaries and their impact on nursing work and communication.

Study Design

This qualitative study employed an interpretative narrative methodology to explore the experiences of ICU nurses. The narrative approach enabled the synthesis of diverse events and impressions into coherent stories, facilitating a deeper understanding of participants' perspectives. Data collection involved thematic analysis of diaries following Braun and Clarke's methodology. The analysis included familiarization, coding, theme identification and validation by the research team. The findings were reviewed by participants and translated into English using the WHO's cultural adaptation guidelines, ensuring reliability and credibility in the study's outcomes.

Results

The sample consisted of 28 ICU nurses, each with professional experience ranging from 1 to 23 years. The hospitalized subjects for whom our sample wrote the diary consist of 13 participants aged 23–79 years. Two main themes emerged from the analysis: (1) simplifying the intensive care situation with specific minimization strategies and (2) attention to nonverbal communication.

Conclusions

This study highlights the role of nurse‐written ICU diaries in making the ICU environment more understandable and less intimidating for patients. Nurse‐written ICU diaries contribute to improved communication and emotional support within the ICU environment. Further research is needed to explore these effects more fully and to assess the broader implications of ICU diaries on patient outcomes.

Relevance to Clinical Practice

Nurse‐written intensive care unit (ICU) diaries have a significant impact on both patient care and nursing practice in ICUs. ICU diaries serve as a crucial tool for enhancing communication, emotional support and empathetic care within these high‐stress environments. By simplifying complex medical information and focusing on nonverbal communication, nurses can make the ICU experience more comprehensible and less intimidating for patients. This approach reduces patient anxiety and psychological stress while fostering a stronger nurse–patient relationship, ultimately improving care quality.
Sterile water and regional citrate anticoagulation: A simple CRRT strategy for safe correction of severe hyponatraemia
Authors: Shi An , Liu Xin , Jia Zheng , Lu Xinyi , Teng Shuang , Zhang Lili , Li Jiao , Li Chengcheng , Peng Ying , Huang Yue , Tang Jianhua , Zhang Hanfeng , Liu Zhenjun
Published: September 2024

Background

Hyponatraemia is a prevalent electrolyte disturbance observed in critically ill patients. The rapid correction of low plasma sodium levels by continuous renal replacement therapy (CRRT) carries the risk of developing osmotic demyelination syndrome (ODS), which can be prevented by implementing an individualized CRRT method.

Aim

This study aims to introduce a CRRT protocol for the safe and gradual correction of severe hyponatraemia.

Study Design

This retrospective case series study was conducted in an intensive care unit (ICU). All four patients with severe hyponatraemia (<125 mmol/L) and renal failure between October 1, 2022, and September 30, 2023, were treated by CRRT with sterile water and regional citrate anticoagulation (RCA). Data on patient demographics, laboratory biochemical parameters, urine outputs and CRRT‐related adverse events were collected. Laboratory parameters and urine outputs were compared by paired t‐tests before and after CRRT.

Results

After CRRT, sodium levels were significantly increased (112.7 ± 6.7 vs. 141.9 ± 2.8 mmol/L, p = .005). Abnormal urine outputs, potassium, creatinine and bicarbonate were corrected (p for all <.05). Safe and gradual correction of hyponatraemia and internal environmental dysregulation was achieved in all patients without any complications related to CRRT, particularly ODS.

Conclusion

It is a novel and simple strategy to correct severe hyponatraemia effectively while ensuring the safety of patients that can be easily implemented by experienced nurse staff.

Relevance to Clinical Practice

The sterile water‐based protocol for postfilter dilution is safe to correct severe hyponatraemia with RCA and can be easily performed by experienced critical care nurses according to the precalculated formula. CRRT‐trained, experienced ICU nurses are competent to initiate and adjust sterile water infusion discretely to prevent overcorrection of hyponatraemia.
Artificial intelligence and psychedelic medicine
Authors: Sarris Jerome , Halman Andreas , Urokohara Anna , Lehrner Mathew , Perkins Daniel
Published: September 2024

Artificial intelligence (AI) and psychedelic medicines are among the most high‐profile evolving disruptive innovations within mental healthcare in recent years. Although AI and psychedelics may not have historically shared any common ground, there exists the potential for these subjects to combine in generating innovative mental health treatment approaches. In order to inform our perspective, we conducted a scoping review of relevant literature up to late August 2024 via PubMed intersecting AI with psychomedical use of psychedelics. Our perspective covers the potential application of AI in psychedelic medicine for: drug discovery and clinical trial optimization (including pharmacodynamics); study design; understanding psychedelic experiences; personalization of treatments; clinical screening, delivery, and follow‐up (potentially delivered via chatbots/apps); application of psychological preparation, integration, and general mental health support; its role in enhancing treatment via brain modulatory devices (including virtual reality and haptic suits); and the consideration of ethical and security safeguards. Challenges include the need for sufficient data protection and security, and a range of necessary ethical protections. Future avenues of exploration could involve directly administering psychedelics (or providing algorithm‐generated effects) to inorganic AI‐interfaced neural networks that may exceed human brain activity (i.e., cognitive capacity) and intelligence.
Density dependent survival drives variation in density dependent population growth of an insect pest
Authors: Buddh Shyamsunder , Krishna Sandeep , Agashe Deepa
Published: September 2024

Several ecological processes – from population dynamics to species co‐existence – are driven by density dependence (DD) in population growth rate. Thus, to predict and manage ecological outcomes, we need a deep understanding of which factors and demographic traits drive variation in DD. In the insect pest Tribolium castaneum, we found large variation in DD across habitats but not across source populations. We modeled DD in population growth as the product of DD in fecundity and survival, experimentally estimating each parameter. Across habitats, survival parameters varied more than fecundity, including in simulations with varying parameter values. Thus, DD in survival drives variation in density‐dependent population growth. Hence, under strong density‐dependent selection, we expect evolutionary change in density‐dependent survival, provided sufficient genetic variance. Our general framework combining detailed experiments and simulations with a simple model can be used for other species to better understand the causes and consequences of density dependent population growth.
Additional Scapular Spine Bone Grafting Combined with Bankart and Remplissage for Off‐Track Hill–Sachs Lesions with Subcritical Glenoid Bone Loss: Provides Better Stability
Authors: Dai Fei , Xiang Ming , Wu Zonghong , Zhang Qing , Yang Jinsong
Published: September 2024

Purpose

Arthroscopic Bankart repair combined with remplissage and autologous scapular spine bone grafting have been described as a treatment for off‐track Hill–Sachs lesions with subcritical glenoid bone defects in the anterior shoulder instability. However, whether these two techniques can achieve satisfactory postoperative outcomes is unclear, and there are few comparative studies between them. Therefore, this study compared the postoperative efficacy of the two techniques for off‐track Hill–Sachs lesions with subcritical glenoid bone loss.

Method

Between June 2017 and December 2020, 62 patients with shoulder instability due to Off‐Track Hill–Sachs lesions with subcritical glenoid bone loss underwent surgical treatment and were included in this regression study. Thirty‐two patients underwent arthroscopic Bankart repair combined with remplissage (B + R group), and 30 patients underwent additional autologous scapular glenoid bone grafting (additional bone grafting group). The general information of the patients was recorded. The patient's activity before and after surgery was recorded. The DASH score and Constant–Murley (CM) score were used to assess the patient's functional status; the Rowe score was used to evaluate the patient's shoulder stability. The shoulder function and stability before and after surgery were analyzed and compared between the two groups.

Results

The final DASH scores of the B + R group and the additional bone grafting group were significantly lower than those before surgery, with a statistically significant difference (9.76 ± 4.32 vs. 27.89 ± 6.63, 8.50 ± 3.32 vs. 28.0 ± 4.27, p = 0.000); the final CM scores of the two groups were significantly higher than those before surgery (88.71 ± 3.74 vs. 73.68 ± 3.74, 87.16 ± 2.29 vs. 71.37 ± 2.68, p = 0.000). There was no statistical difference in the final DASH score and final CM score between the two groups (p > 0.05). In terms of postoperative stability, the final Rowe scores of the two groups were significantly higher than those before surgery, with a statistically significant difference (89.06 ± 9.19 vs. 41.71 ± 4.13; 93.16 ± 4.99 vs. 42.33 ± 2.53, p = 0.000). Compared with the control group, the additional bone graft group achieved higher final Rowe scores (93.16 ± 4.99 vs. 89.06 ± 9.19, p = 0.032).

Conclusion

For patients with anterior shoulder instability due to off‐track Hill–Sachs lesions with subcritical glenoid bone loss, although Bankart and remplissage can achieve satisfactory clinical results, additional autogenous scapular spine bone grafting can provide better stability of the shoulder, especially for patients with high sports demands.
Leishmania donovani Modulates Macrophage Lipidome During Infection
Authors: Tabrez Shams , Fatima Zeeshan , Akand Sajjadul Kadir , Rahman Areeba , Hameed Saif , Saleem Mohammed , Akhter Yusuf , Yadav Subhash Kumar , Ahmed Mohammad Z. , Kumar Yashwant , Bhattacharjee Surajit , Rub Abdur
Published: September 2024

Obligate intracellular protozoan parasite, Leishmania donovani, causative agent of visceral leishmaniasis, led to impaired macrophage functions. It is well documented that many of these changes were induced by parasite‐mediated reduction in macrophage cholesterol content. Leishmania‐mediated alteration in the other lipids has not been explored in detail yet. Here, we found that the expression of key cholesterol biosynthetic genes and total cellular cholesterol were reduced during L. donovani infection. Further, we have also identified that this reduction in the cholesterol led to increased membrane fluidity and inhibition of antigen‐presenting potential of macrophages. In addition to this, we studied the relative changes in different lipids in THP‐1‐derived macrophages during L. donovani infection through liquid chromatography‐mass spectrometry. We found that Sphingomyelin (16:0) and ceramide (20:1, 26:0 and 26:1) were significantly reduced in infected macrophages. We further observed that the majority of different sub‐classes of phospholipids were downregulated significantly. Overall ratio of phosphatidylcholine versus phosphotidylethanolamine was decreased which indicated the compensatory mechanism of cell in response to cholesterol reduction. The observed Leishmania‐mediated alteration in macrophage‐lipidome provided the novel insights into mechanism of host‐pathogen interactions.
Why do flowers wilt?
Authors: Pyke G. H. , Ren Z.‐X. , Kalman J. R. M.
Published: September 2024

Resources salvaged when flowers wilt on a perennial plant could promote reproduction by, in preference order, the same flowers (Hypothesis 1), adjacent flowers on the same plant (Hypothesis 2), or during the next flowering season by the same plant (Hypothesis 3).

We tested the above hypotheses for Blandfordia grandiflora, a perennial species, where some plants included flowers that were allowed to wilt, while equivalent flowers on other plants were prevented from wilting. The abilities of these plants to produce seed were determined by liberally pollinating all flowers. To test Hypotheses 1 and 2, seed set per flower and per plant were compared between plants with and without wilting flowers. To specifically test Hypothesis 3, reproduction was prevented in all flowers. For each experiment, flowering was monitored in the same plants during the next flowering season, thus also enabling Hypothesis 3 to be tested.

The results were consistent with Hypothesis 3, but not with Hypotheses 1 and 2.

Hence, we verified, for the first time, that plants may benefit from salvaging resources from wilting flowers and re‐using these resources for subsequent reproduction. However, contrary to expectations, plants re‐used these resources to promote reproduction during subsequent flowering, and not during current flowering by either the same flowers or other flowers on the same plant. The plants must have transferred resources from wilting flowers to underground corms and roots, which provided resources necessary for subsequent flowering. This is likely part of a general plant strategy to salvage resources invested in reproduction during one flowering season and reuse these resources during subsequent flowering.
From performance to morality: How politicians frame bureaucracy, its organizations, and public sector employees
Authors: Hendriks Jessy , Damhuis Koen , Overman Sjors
Published: September 2024

Politicians frequently voice criticisms vis‐à‐vis bureaucracy, its organizations, and its employees. Previous studies point at the negative impact of this “bureaucratic bashing” on public sector morale, recruitment, retention, and citizen perceptions. Yet, systematic evidence on bashing remains sparse, with even less known about its counterpart: bureaucratic praising. This article aims to fill this gap by conceptualizing both phenomena as forms of framing, by distinguishing macro‐, meso‐, and micro‐levels, and by innovatively using organizational reputation theory to develop a multidimensional framework for the systematic analysis of bureaucratic framing. Empirically, we apply this framework to a novel dataset of 70,853 hand‐coded tweets posted by 33 Dutch politicians, covering a wide range of ideological viewpoints. We find that politicians do not so much frame the civil service performatively, in terms of being lazy (or hard working), but rather bash or praise bureaucratic organizations for their (im)morality, whereby four moral subdimensions can be identified.
Hypericum sampsonii ameliorates radiodermatitis by inhibiting NLRP3 inflammasome activation
Authors: Liao Jiayu , Liu Zhihong , Wu Sumei
Published: September 2024

Background

Radiodermatitis (RD) is an inflammatory lesion of skin mucosa caused by radiation, which causes itching and pain in patients' skin. Hypericum sampsonii has an anti‐inflammatory effect. This study aims to explore the potential effect and mechanism of H. sampsonii on RD.

Materials and Methods

The RD model was established using X‐ray irradiation of mice and the pain response of mice under different treatment methods. Serum levels of IL‐1β, IL‐6, and TNF‐α were measured by ELSA. The RD cell model was constructed by RAW264.7 cell, H. sampsonii intervention was conducted, and the changes of the NLRP3 inflammasome in the cells were detected by qRT‐PCR. The cells were stimulated with LPS and the protein changes of TLR4/NF‐κB were investigated by Western Blotting.

Results

H. sampsonii can better improve the skin status of RD mice, relieve pain, and reduce the secretion of serum inflammatory factors IL‐1β, IL‐6, and TNF‐α. H. sampsonii significantly down‐regulated the expression of NLRP3, Caspase‐1, pro IL‐1β, and IL‐1β. Lps‐induced activation of the TLR4/NF‐κB pathway promotes the expression of NLRP3 and pro‐IL‐1β, and H. sampsonii can inhibit this promotion.

Conclusion

H. sampsonii may inhibit NLRP3 inflammatory vesicle activation via interfering with TLR4/NF‐κB signaling to reduce the inflammatory response in macrophages and thus play a role in the treatment of RD.
Trial‐and‐error: Securing field access for qualitative research in Vietnam
Authors: Lainez Nicolas , Pannier Emmanuel
Published: September 2024

Field access is frequently regarded as a mere practical step in the research process, with insufficient attention given to its broader implications. Numerous writings that focus on gaining field access offer just a collection of practical tips. While these recommendations are valuable, they are specific to each setting and individual experiences. Such an ad hoc approach fosters a limited understanding of the research permit application process and limits the discussion of access by disregarding its inherent uncertainty and its manifold consequences. In authoritarian contexts, obtaining field access remains highly uncertain and can be further complicated by arbitrary decision‐making. This article demonstrates that in Vietnam, social scientists, including anthropologists, must navigate ambiguous processes of trial‐and‐error to secure field access. With the term ‘trial‐and‐error’ we refer to an approach to problem‐solving in which various methods are attempted. Proceeding through trial‐and‐error involves familiarisation, networking, and improvisation. Based on 15 years of experience working in Vietnam we provide evidence that the process of trial‐and‐error is inherent in all three aspects. Beyond the issues surrounding access for foreign researchers, our observations also underscore the pivotal role of trial‐and‐error as a mechanism that Vietnamese citizens employ to navigate the uncertainties and arbitrariness associated with bureaucracy.
Perspectives on donor‐derived infections from Germany
Authors: Barreiros Ana Paula , Böhler Klaus , Mönch Kerstin , Fischer‐Fröhlich Carl‐Ludwig , Rahmel Axel
Published: September 2024

Aim

Often, organ transplantation is the only option to improve the life expectancy and quality of life of patients with terminal organ failure. Despite improved donor and organ assessment, a residual risk remains for transmitting infection, tumor, or other disease from the donor to recipients. Analysis, reporting, and managing of donor‐derived diseases through a vigilance and surveillance system (V&S) is mandatory in many countries. We report on suspected and proven/probable donor‐derived infections (DDI) in Germany over a period of 8 years (2016–2023).

Methods

All incoming serious‐adverse‐event and serious‐adverse‐reaction (SAE/SAR) reports from 01.01.2016 to 31.12.2023 were evaluated for suspected DDI. Analysis of imputability followed the definition of the US Disease Transmission Advisory Committee (DTAC). Only probable and proven cases according to DTAC classification were defined as DDI.

Results

During the study period, 9771 donors in Germany donated post‐mortem organs to 27 919 recipients. In that period 612 SAE/SAR cases were reported, 377 (62%) involved infections. 41 cases were proven/probable DDI affecting 58 recipients (seven recipients died, 12%). Suspected infections were bacterial (182/377, 48%), fungal (135/377, 36%), viral (55/377, 15%), and parasitic (5/377, 1%). In case of bacterial DDI, no recipient died, but organ loss occurred in six recipients. In case of fungal or viral DDI, 19% (3/16) and 21% (3/14) of the recipients died, respectively.

Conclusions

DDI are rare in solid organ transplantation (58/27 919, 0.21%), but when they occur, they are associated with high morbidity and mortality in affected recipients. Careful and detailed donor evaluation and a reliable V&S help improve recipient safety.

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The power of arts‐based film interventions to encourage Black blood donors
Authors: Mills Richard , Okubanjo Abiola , Acheampong Natasha , Croucher Mark , Eaton Nadine , Kazi Altaf , Di Angelantonio Emanuele , Wood Angela , Masser Barbara , Ferguson Eamonn
Published: September 2024

Background

Blood services must consider innovative ways to encourage more Black people to donate to enhance the efficacy of treatments. We evaluate how two innovative arts‐based approaches (co‐designed and locally produced films and a large‐scale Marvel Studios'/NHSBT collaboration) can achieve this by generalizing to a wider audience from their target audiences.

Study Design and Methods

Four co‐designed short community films were produced in the United Kingdom: Comedy, Reciprocity, Donor‐Recipient, and Sliding Doors. In Study 1 (N = 44: Black people), these films were evaluated in the target community in which they were produced. In Study 2 (N = 1237: Black = 638, White = 599), the community and Marvel Black Panther/NHSBT films were evaluated in a nontarget general population sample. Evaluations were in terms of campaign behavioral efficacy (e.g., willingness to donate, encourage others to donate) and affect. These analyses were segmented by donor status, age, and gender.

Results

Study 1 shows that the community groups rated the films very positively, with over 90% stating that they would be convinced to donate blood. Study 2 shows the results from the community films generalized to the general population, with the Black Panther film also rated positively in the general population. Three community films and the Black Panther film were rated equally positively. There were notable differences across generations and by donor status.

Discussion

The results highlight the power of arts‐based approaches (both locally co‐produced community films and franchise collaborations) in encouraging donors within their target audiences and, importantly, on the broader population.
Acid–base and electrolyte changes in dogs after packed red blood cell transfusion
Authors: Bou P. , Mesa I. , Ferreira R. F. , Torrente C. , Manzanilla E. G. , Bosch L.
Published: September 2024

Background

Packed RBC (pRBC) transfusions are often necessary to enhance organ perfusion and tissue oxygenation in cases of severe anemia.

Objectives

We aimed to describe changes in acid–base and biochemical parameters in dogs after transfusion of pRBC and potential effects on the outcome.

Methods

The prospective observational study included anemic dogs requiring pRBC transfusions. Venous blood gas and electrolytes were measured pre‐transfusion and repeated within 1 h post‐transfusion. Signalment, pre‐existing conditions and underlying disease(s), number of days spent of hospitalization, the quantity of transfused pRBC units, and the outcome were also recorded. Associations between analytical values and all other parameters before and after transfusion were assessed using the Wilcoxon test. A generalized linear model was generated for each of the blood gas parameters post‐transfusion, including the pre‐transfusion values and the characteristics of the animal as fixed effects. The effect of the blood gas parameters on the mortality and hospitalization length was assessed using logistic regression and generalized linear models, respectively.

Results

Twenty‐six dogs with different causes of anemia were included in the study, with dogs remaining hospitalized for a median of 3 days (range: 0–11). Pre‐transfusion heart rate, respiratory rate, Angap, base excess, and lactate were higher than post‐transfusion values. Post‐transfusion results showed an increase in hematocrit, hemoglobin, HCO3‐, PCO2, tCO2, and chloride. Pre‐transfusion hypophosphatemia and receiving an increased volume of transfused pRBC were associated with a longer hospital stay, while higher pre‐transfusion lactate values were associated with higher mortality.

Conclusions

pRBC transfusion in anemic dogs was associated with an improvement in perfusion and acid–base parameters. Pre‐transfusion lactate may be an indicator of mortality in dogs.
Multiplicity results for nonlocal critical elliptic problems
Authors: Manouni Said El , Perera Kanishka
Published: September 2024

We prove new multiplicity results for some nonlocal critical growth elliptic problems in bounded domains. More specifically, we show that the problems considered here have arbitrarily many solutions for all sufficiently large values of a certain parameter . In particular, the number of solutions goes to infinity as . We also give an explicit lower bound on in order to have a given number of solutions. This lower bound is in terms of a sequence of eigenvalues of the associated nonlocal elliptic operator. The proofs are based on an abstract critical point theorem.
Insights into small-molecule compound CY-158-11 antibacterial activity against
Staphylococcus aureus
Authors: Shen Li , Shi Junhong , Han Weihua , Yu Jingyi , Yuan Xinru , Gao Haojin , Huang Yu , Lv Jianbo , Wan Cailing , Zhou Peiyao , Xiao Yanghua , Zhang Jiao , Wang Bingjie , Hu Rongrong , Yu Fangyou
Published: September 2024

The widespread prevalence and dissemination of antibiotic-resistant bacteria, coupled with the diminishing supply of new antibiotics, emphasize the pressing necessity for the exploration of innovative antibacterial agents. Previously, we detailed the impact of the small-molecule compound CY-158-11 on
S. aureus
biofilm. By hindering adhesion and PIA-mediated biofilm formation, subinhibitory concentrations of CY-158-11 exhibit antibiofilm activity toward
S. aureus
. Here, we sought to elucidate the antibacterial activity and mode of action of this compound. Upon CY-158-11 treatment in culture, the inhibition of bacterial growth, coupled with MBC to MIC of >4, indicated that CY-158-11 exerted a bacteriostatic effect. Particularly, CY-158-11 showed strong antibacterial activity against a wide variety of
S. aureus
, including multidrug-resistant bacteria. We found that CY-158-11 promoted the permeability of cell membrane and propidium iodide absorption as well as caused the dissipation of membrane potential. The effect of CY-158-11 on the mammalian cytoplasmic membrane was measured using hemolytic and cytotoxicity assays, and the skin irritation and systemic toxicity of the drug were measured by injecting the compound into the skin and tail vein of mice. Moreover, CY-158-11 exhibited considerable efficacy in a subcutaneous abscess mouse model of
S. aureus
infection. In conclusion, CY-158-11 possesses antibacterial properties, including inhibition of bacterial growth, damage to cell membranes, and treatment of skin abscesses, which can be a promising therapeutic option for combating
S. aureus
.

IMPORTANCE

The combination of the rising incidence of antibiotic resistance and the shrinking antibiotic pipeline has raised concern about the postantibiotic era. New antibacterial agents and targets are required to combat
S. aureus
-associated infections. In this study, we identified a maleimide-diselenide hybrid compound CY-158-11 exhibiting antibacterial activity against
S. aureus in vitro
and
in vivo
at relatively low concentrations. Furthermore, the investigation of its mode of action revealed that CY-158-11 can selectively perturb the cytoplasmic membrane of bacteria without harming mammalian cells or mouse organs. Thus, CY-158-11 is a compelling novel drug for development as a new therapy for
S. aureus
infections.
Mycobacterium tuberculosis
VII secretion system effector molecule Rv2347c blocks the maturation of phagosomes and activates the STING/TBK1 signaling pathway to inhibit cell autophagy
Authors: Jiang Zhiyong , Zhen Junfeng , Abulikena Yuerigu , Gao Chaoyun , Huang Lingxi , Huang Tingting , Xie Jianping
Published: September 2024

The VII secretion system is the main channel for
Mycobacterium tuberculosis
(
MTB
) to secrete virulence proteins. The ESAT-like proteins EsxA/B and EsxW/V in the RD region of its genome have been used as targets for vaccine antigens. However, the function of EsxO/P has not been explored, although it was predicted to potentially induce Th1 cell responses as a vaccine development target. In this study, the VII secretion system effector molecule Rv2347c was heterologously expressed in
Mycobacterium smegmatis
and found to inhibit the expression of the early marker RAB5 of phagosomes, thus preventing the maturation process of phagosomes toward lysosomes, and activated the host cytoplasmic sensing pathway. It inhibited autophagy and activated IFNβ transcription through the STING/TBK1 pathway promoting the host’s survival. Therefore, Rv2347c plays an important role in the pathogenesis of
MTB
with the potential to be utilized as a new target for tuberculosis vaccine development.

IMPORTANCE

We found that the ESAT-like protein Rv2347c (EsxP) can inhibit the maturation of phagosomes, leading to mycobacterium escape from phagosomes into the cytoplasm, which triggers the host’s cytoplasmic sensing pathway STING/TBK1, inhibiting autophagy and upregulating IFNβ transcription, which contributes to the survival of mycobacterium in the host cell. We also found that Rv2347c was able to activate host immunity by activating NF-κB via STING and promoting the transcription of downstream pro-inflammatory factors. Meanwhile, the host also produces IL-1β to repair phagosome maturation arrest via the STING-mediated non-NF-κB pathway.
An integrated strain-level analytic pipeline utilizing longitudinal metagenomic data
Authors: Zhou Boyan , Wang Chan , Putzel Gregory , Hu Jiyuan , Liu Menghan , Wu Fen , Chen Yu , Pironti Alejandro , Li Huilin
Published: September 2024

With the development of sequencing technology and analytic tools, studying within-species variations enhances the understanding of microbial biological processes. Nevertheless, most existing methods designed for strain-level analysis lack the capability to concurrently assess both strain proportions and genome-wide single nucleotide variants (SNVs) across longitudinal metagenomic samples. In this study, we introduce LongStrain, an integrated pipeline for the analysis of large-scale metagenomic data from individuals with longitudinal or repeated samples. In LongStrain, we first utilize two efficient tools, Kraken2 and Bowtie2, for the taxonomic classification and alignment of sequencing reads, respectively. Subsequently, we propose to jointly model strain proportions and shared haplotypes across samples within individuals. This approach specifically targets tracking a primary strain and a secondary strain for each subject, providing their respective proportions and SNVs as output. With extensive simulation studies of a microbial community and single species, our results demonstrate that LongStrain is superior to two genotyping methods and two deconvolution methods across a majority of scenarios. Furthermore, we illustrate the potential applications of LongStrain in the real data analysis of The Environmental Determinants of Diabetes in the Young study and a gastric intestinal metaplasia microbiome study. In summary, the proposed analytic pipeline demonstrates marked statistical efficiency over the same type of methods and has great potential in understanding the genomic variants and dynamic changes at strain level. LongStrain and its tutorial are freely available online at
https://github.com/BoyanZhou/LongStrain
.

IMPORTANCE

The advancement in DNA-sequencing technology has enabled the high-resolution identification of microorganisms in microbial communities. Since different microbial strains within species may contain extreme phenotypic variability (e.g., nutrition metabolism, antibiotic resistance, and pathogen virulence), investigating within-species variations holds great scientific promise in understanding the underlying mechanism of microbial biological processes. To fully utilize the shared genomic variants across longitudinal metagenomics samples collected in microbiome studies, we develop an integrated analytic pipeline (LongStrain) for longitudinal metagenomics data. It concurrently leverages the information on proportions of mapped reads for individual strains and genome-wide SNVs to enhance the efficiency and accuracy of strain identification. Our method helps to understand strains’ dynamic changes and their association with genome-wide variants. Given the fast-growing longitudinal studies of microbial communities, LongStrain which streamlines analyses of large-scale raw sequencing data should be of great value in microbiome research communities.
Heterogeneous effects of Medicaid coverage on cardiovascular risk factors: secondary analysis of randomized controlled trial
Authors: Inoue Kosuke , Athey Susan , Baicker Katherine , Tsugawa Yusuke
Published: September 2024

Objectives

To investigate whether health insurance generated improvements in cardiovascular risk factors (blood pressure and hemoglobin A
1c
(HbA
1c
) levels) for identifiable subpopulations, and using machine learning to identify characteristics of people predicted to benefit highly.

Design

Secondary analysis of randomized controlled trial.

Setting

Medicaid insurance coverage in 2008 for adults on low incomes (defined as lower than the federal-defined poverty line) in Oregon who were uninsured.

Participants

12 134 participants from the Oregon Health Insurance Experiment with in-person data for health outcomes for both treatment and control groups.

Interventions

Health insurance (Medicaid) coverage.

Main outcomes measures

The conditional local average treatment effects of Medicaid coverage on systolic blood pressure and HbA
1c
using a machine learning causal forest algorithm (with instrumental variables). Characteristics of individuals with positive predicted benefits of Medicaid coverage based on the algorithm were compared with the characteristics of others. The effect of Medicaid coverage was calculated on blood pressure and HbA
1c
among individuals with high predicted benefits.

Results

In the in-person interview survey, mean systolic blood pressure was 119 (standard deviation 17) mm Hg and mean HbA
1c
concentrations was 5.3% (standard deviation 0.6%). Our causal forest model showed heterogeneity in the effect of Medicaid coverage on systolic blood pressure and HbA
1c
. Individuals with lower baseline healthcare charges, for example, had higher predicted benefits from gaining Medicaid coverage. Medicaid coverage significantly lowered systolic blood pressure (−4.96 mm Hg (95% confidence interval −7.80 to −2.48)) for people predicted to benefit highly. HbA
1c
was also significantly reduced by Medicaid coverage for people with high predicted benefits, but the size was not clinically meaningful (−0.12% (−0.25% to −0.01%)).

Conclusions

Although Medicaid coverage did not improve cardiovascular risk factors on average, substantial heterogeneity was noted in the effects within that population. Individuals with high predicted benefits were more likely to have no or low prior healthcare charges, for example. Our findings suggest that Medicaid coverage leads to improved cardiovascular risk factors for some, particularly for blood pressure, although those benefits may be diluted by individuals who did not experience benefits.
Interdisciplinary perspectives on ‘what matters most’ in the cultural shaping of health-related stigma in Indonesia
Authors: Santosa Adibah , Sopamena Yoslien , Visser Marlies , Dadun Dadun , Damayanti Rita , Yang Lawrence , Zweekhorst Marjolein , Peters Ruth
Published: September 2024

Health-related stigma plays a significant role in the burden of various health conditions such as neglected tropical diseases and mental illnesses, and undermines successful health outcomes. Stigmatised individuals can face lifelong socioeconomic consequences because of their condition. It is broadly recognised that culturally salient factors interact with the way stigma is expressed in different local contexts. This study aimed to capture cultural capabilities that shape health-related stigma in Indonesia, using the ‘what matters most’ (WMM) stigma framework. In this qualitative research, 15 in-depth interviews with experts in the field of Indonesian culture and health studies were conducted, followed by a group discussion. Data were collected between April and September 2021, and analysed using thematic content analysis. The analysis shows that cultural values such as communal participation in local networks and the ‘shame culture’ shapes experiences of stigma in Indonesia. Moreover, the participants explained that achieving full standing in the Indonesian context meant contributing to the collective interest and maintaining the family reputation. Personhood is also related to socially defined gender roles. For example, community participation was often influenced by patriarchal values, which lead to differences in access to life opportunities, while recognition in the family was often connected to complying with gender roles. This study contributes to research on the cultural shaping of health-related stigma involving the WMM framework in the Indonesian context. Future research should focus on the perspectives of those who are affected by stigmatised conditions and on integrating these insights in the assessment and reduction of health-related stigma.
Public attitudes to emergency care treatment plans: a population survey of Great Britain
Authors: Underwood Martin , Noufaily Angela , Bain Chris , Harlock Jenny , Griffiths Frances , Huxley Caroline , Perkins Gavin , Rees Sophie , Slowther Anne-Marie
Published: September 2024

Objectives

To measure community attitudes to emergency care and treatment plans (ECTPs).

Design

Population survey.

Setting

Great Britain.

Participants

As part of the British Social Attitudes Survey, sent to randomly selected addresses in Great Britain, 1135 adults completed a module on ECTPs. The sample was nationally representative in terms of age and location, 619 (55%) were female and 1005 (89%) were of white origin.

Outcome measures

People’s attitudes having an ECTP for themselves now, and in the future; how comfortable they might be having a discussion about an ECTP and how they thought such a plan might impact on their future care.

Results

Predominantly, respondents were in favour of people being able to have an ECTP, with 908/1135 (80%) being at least somewhat in favour. People in good health were less likely than those with activity-limiting chronic disease to want a plan at present (52% vs 64%, OR 1.78 (95% CI 1.30 to 2.45) p<0.001). Developing a long-term condition or becoming disabled would lead 42% (467/1112) and 43% (481/1112) of individuals, respectively, to want an ECTP. More, 634/1112 (57%) would want an ECTP if they developed a life-threatening condition. Predominantly, 938/1135 (83%) respondents agreed that an ECTP would help avoid their family needing to make difficult decisions on their behalf, and 939/1135 (83%) that it would ensure doctors and nurses knew their wishes. Nevertheless, a small majority—628/1135 (55%)—agreed that there was a serious risk of the plan being out of date when needed. A substantial minority—330/1135 (29%)—agreed that an ECTP might result in them not receiving life-saving treatment.

Conclusions

There is general support for the use of ECTPs by people of all ages. Nevertheless, many respondents felt these might be out of date when needed and prevent people receiving life-saving treatment.
Mapping resilience: a scoping review on mediators and moderators of childhood adversity with a focus on gender patterns
Authors: Bornscheuer Lisa , Gauffin Karl , Almquist Ylva B
Published: September 2024

Background

Childhood adversity is associated with a host of negative health and socioeconomic outcomes far into adulthood. The process of avoiding such outcomes is often referred to as resilience. Mapping resilience comprehensively and across contexts is highly relevant to public health, as it is a step towards understanding environments and interventions that contribute to preventing or reversing negative outcomes after early adverse experiences.

Objectives

This review scoped out the literature on resilience factors in relation to adulthood outcomes as diverse as mental health and educational attainment. Our aim was to understand where there is untapped research potential, by examining the current evidence base on resilience factors in terms of (a) resources that can buffer the impact of childhood adversity and (b) the pathways linking adversity to long-term outcomes. Furthermore, we aimed to identify gender patterns in these resources and pathways, which has not been a primary interest of reviews on resilience to date, and which can add to our understanding of the different ways in which resilience may unfold.

Eligibility criteria

Studies had to include an adversity experienced in childhood, an outcome considered indicative of resilience in adulthood, and at least one putative resilience factor, which had to be approached via mediation or moderation analysis. We considered cohort, case–control and cross-sectional studies.

Sources of evidence

We searched PubMed, Scopus and PsycINFO and included original, peer-reviewed articles published before 20 July 2023 in English, German, French, Spanish, Dutch and Swedish.

Charting methods

All three authors collaborated on the extraction of information relevant to answering the research questions. The results were visually and narratively summarised.

Results

We included 102 studies. Traditionally anchored in the field of psychology, the resilience literature focuses heavily on individual-level resilience factors. Gender was considered in approximately 22% of included studies and was always limited to comparisons between men and women. There is no evidence that childhood adversity impacts men and women differently in the long term, but there is some evidence for gender differences in resilience factors.

Conclusions

There is untapped potential in resilience research. By considering structural-level factors simultaneously with individual-level factors, and including gender as one of the elements that shape resilience, we can map resilience as a heterogeneous, multilevel process from a public health perspective. This would complement the extensive existing literature on individual-level factors and help reframe resilience as a concept that can be intervened on at a structural level, and that is subject to societal norms and forces, such as gender. There is a lack of quantitative studies including transgender and gender-non-conforming persons.