bluuebunny/crossref_metadata_2025 huggingface dataset:
Competition for iron shapes metabolic antagonism betweenBacillus subtilisandPseudomonas marginalis
Authors: Lyng Mark , Jørgensen Johan P B , Schostag Morten D , Jarmusch Scott A , Aguilar Diana K C , Lozano-Andrade Carlos N , Kovács Ákos T
Published: January 2024

Siderophores have long been implicated in sociomicrobiology as determinants of bacterial interrelations. For plant-associated genera, like Bacillus and Pseudomonas, siderophores are well known for their biocontrol functions. Here, we explored the functional role of the Bacillus subtilis siderophore bacillibactin (BB) in an antagonistic interaction with Pseudomonas marginalis. The presence of BB strongly influenced the outcome of the interaction in an iron-dependent manner. The BB producer B. subtilis restricts colony spreading of P. marginalis by repressing the transcription of histidine kinase-encoding gene gacS, thereby abolishing production of secondary metabolites such as pyoverdine and viscosin. By contrast, lack of BB restricted B. subtilis colony growth. To explore the specificity of the antagonism, we cocultured B. subtilis with a collection of fluorescent Pseudomonas spp. and found that the Bacillus–Pseudomonas interaction is conserved, expanding our understanding of the interplay between two of the most well-studied genera of soil bacteria.
Protist predation selects for the soil resistome
Authors: Jiang Gaofei , Liu Chen , Xiong Wu , Shen Qirong , Wei Zhong
Published: January 2024

A key aspect of “One Health” is to comprehend how antibiotic resistomes evolve naturally. In this issue, Nguyen and colleagues pioneered an in situ investigation on the impact of protist predations on the soil microbial community and its antibiotic resistance genes (ARGs). They found that bacterivorous protists consistently increased the abundance of ARGs, such as tetracycline resistant genes. Indeed, antibiotic production is a common strategy for bacteria to evade protist predation. The rise of ARGs can be explained by the balance between antibiotic producers and resisters shaped by predatory selection. This work suggests that ARG enrichment due to biotic interactions may be less worrisome than previously thought. Unless, these ARGs are carried by or disseminated among pathogens. Therefore, it is essential to monitor the occurrence, dissemination and pathogenic hosts of ARGs, enhancing our capacity to combat antibiotic resistance.
Unexpected carbon utilization activity of sulfate-reducing microorganisms in temperate and permanently cold marine sediments
Authors: Yin Xiuran , Zhou Guowei , Wang Haihua , Han Dukki , Maeke Mara , Richter-Heitmann Tim , Wunder Lea C , Aromokeye David A , Zhu Qing-Zeng , Nimzyk Rolf , Elvert Marcus , Friedrich Michael W
Published: January 2024

Significant amounts of organic carbon in marine sediments are degraded, coupled with sulfate reduction. However, the actual carbon and energy sources used in situ have not been assigned to each group of diverse sulfate-reducing microorganisms (SRM) owing to the microbial and environmental complexity in sediments. Here, we probed microbial activity in temperate and permanently cold marine sediments by using potential SRM substrates, organic fermentation products at very low concentrations (15–30 μM), with RNA-based stable isotope probing. Unexpectedly, SRM were involved only to a minor degree in organic fermentation product mineralization, whereas metal-reducing microbes were dominant. Contrastingly, distinct SRM strongly assimilated 13C-DIC (dissolved inorganic carbon) with H2 as the electron donor. Our study suggests that canonical SRM prefer autotrophic lifestyle, with hydrogen as the electron donor, while metal-reducing microorganisms are involved in heterotrophic organic matter turnover, and thus regulate carbon fluxes in an unexpected way in marine sediments.
Inter-plasmid transfer of antibiotic resistance genes accelerates antibiotic resistance in bacterial pathogens
Authors: Wang Xiaolong , Zhang Hanhui , Yu Shenbo , Li Donghang , Gillings Michael R , Ren Hongqiang , Mao Daqing , Guo Jianhua , Luo Yi
Published: January 2024

Antimicrobial resistance is a major threat for public health. Plasmids play a critical role in the spread of antimicrobial resistance via horizontal gene transfer between bacterial species. However, it remains unclear how plasmids originally recruit and assemble various antibiotic resistance genes (ARGs). Here, we track ARG recruitment and assembly in clinically relevant plasmids by combining a systematic analysis of 2420 complete plasmid genomes and experimental validation. Results showed that ARG transfer across plasmids is prevalent, and 87% ARGs were observed to potentially transfer among various plasmids among 8229 plasmid-borne ARGs. Interestingly, recruitment and assembly of ARGs occur mostly among compatible plasmids within the same bacterial cell, with over 88% of ARG transfers occurring between compatible plasmids. Integron and insertion sequences drive the ongoing ARG acquisition by plasmids, especially in which IS26 facilitates 63.1% of ARG transfer events among plasmids. In vitro experiment validated the important role of IS26 involved in transferring gentamicin resistance gene aacC1 between compatible plasmids. Network analysis showed four beta-lactam genes (blaTEM-1, blaNDM-4, blaKPC-2, and blaSHV-1) shuffling among 1029 plasmids and 45 clinical pathogens, suggesting that clinically alarming ARGs transferred accelerate the propagation of antibiotic resistance in clinical pathogens. ARGs in plasmids are also able to transmit across clinical and environmental boundaries, in terms of the high-sequence similarities of plasmid-borne ARGs between clinical and environmental plasmids. This study demonstrated that inter-plasmid ARG transfer is a universal mechanism for plasmid to recruit various ARGs, thus advancing our understanding of the emergence of multidrug-resistant plasmids.
Members of the class Candidatus Ordosarchaeia imply an alternative evolutionary scenario from methanogens to haloarchaea
Authors: Zhao Dahe , Zhang Shengjie , Chen Junyu , Zhao Juanjuan , An Peng , Xiang Hua
Published: January 2024

The origin of methanogenesis can be traced to the common ancestor of non-DPANN archaea, whereas haloarchaea (or Halobacteria) are believed to have evolved from a methanogenic ancestor through multiple evolutionary events. However, due to the accelerated evolution and compositional bias of proteins adapting to hypersaline habitats, Halobacteria exhibit substantial evolutionary divergence from methanogens, and the identification of the closest methanogen (either Methanonatronarchaeia or other taxa) to Halobacteria remains a subject of debate. Here, we obtained five metagenome-assembled genomes with high completeness from soda-saline lakes on the Ordos Plateau in Inner Mongolia, China, and we proposed the name Candidatus Ordosarchaeia for this novel class. Phylogenetic analyses revealed that Ca. Ordosarchaeia is firmly positioned near the median position between the Methanonatronarchaeia and Halobacteria–Hikarchaeia lineages. Functional predictions supported the transitional status of Ca. Ordosarchaeia with the metabolic potential of nonmethanogenic and aerobic chemoheterotrophy, as did remnants of the gene sequences of methylamine/dimethylamine/trimethylamine metabolism and coenzyme M biosynthesis. Based on the similarity of the methyl-coenzyme M reductase genes mcrBGADC in Methanonatronarchaeia with the phylogenetically distant methanogens, an alternative evolutionary scenario is proposed, in which Methanonatronarchaeia, Ca. Ordosarchaeia, Ca. Hikarchaeia, and Halobacteria share a common ancestor that initially lost mcr genes. However, certain members of Methanonatronarchaeia subsequently acquired mcr genes through horizontal gene transfer from distantly related methanogens. This hypothesis is supported by amalgamated likelihood estimation, phylogenetic analysis, and gene arrangement patterns. Altogether, Ca. Ordosarchaeia genomes clarify the sisterhood of Methanonatronarchaeia with Halobacteria and provide new insights into the evolution from methanogens to haloarchaea.
Detection of CTX-M-15 ESBL in XDR Haemophilus parainfluenzae from a urethral swab
Authors: Caméléna François , Merimèche Manel , Liberge Mathilde , Maubaret Clara , Donay Jean-Luc , Taha Muhamed-Kheir , Fouéré Sébastien , Berçot Béatrice
Published: January 2024

Objectives

Haemophilus parainfluenzae is an opportunistic pathogen causing respiratory tract infection and sexually transmitted diseases. The emergence of multidrug resistance in this species is particularly worrisome, especially since the recent description of CTX-M-15 ESBL-producing isolates in Spain. The aim of this study was to characterize a CTX-M-15-producing H. parainfluenzae clinical isolate, HP01, obtained from a urethral swab.

Methods

MICs were determined with gradient strips for this isolate. Hydrolysis assays were performed with the β LACTA test. Genomic DNA from HP01 was subjected to Illumina and Oxford Nanopore sequencing to investigate the genetic environment of blaCTX-M-15. Phylogenetic analysis was performed with available H. parainfluenzae genomes from the NCBI database, including CTX-M-15 producers.

Results

HP01, an XDR isolate, was resistant to penicillin, third-generation cephalosporins, fluoroquinolones, macrolides, cyclines and co-trimoxazole and susceptible only to carbapenems and rifampicin. HP01 carried blaTEM-1, blaCTX-M-15, tet(M), catS and mef(E)/mel and harboured amino acid substitutions in PBP3, PBP5, GyrA, ParC and FolA implicated in resistance. Genomic analysis revealed that blaCTX-M-15 was carried by a Tn3-like transposon inserted into a novel integrative and conjugative element (ICE), ICEHpaSLS, present on the chromosome and belonging to the ICEHin1056 family described in Haemophilus influenzae. The tet(M)-MEGA element was also detected on the chromosome. No plasmid was found. The phylogenetic analysis showed that four H. parainfluenzae producing CTX-M-15 clustered in the same clade.

Conclusions

Here we report the description of an XDR H. parainfluenzae producing blaCTX-M-15 isolated from a urethral swab. The blaCTX-M-15 gene was inserted into an ICE structure similar to those recently described in CTX-M-15 producers in Spain. The emergence of XDR H. parainfluenzae producing blaCTX-M-15 is a matter of great concern. Careful surveillance is required to prevent its spread.
Effect of short photoperiod on the development of Haemaphysalis longicornis (Ixodida: Ixodidae)
Authors: González Julia , Fonseca Dina M , Toledo Alvaro
Published: January 2024

The invasive tick, Haemaphysalis longicornis Neumann, is now present across most of the mid-Atlantic States in the eastern United States. This tick ends its seasonal activity in late October to early November, with larvae being the last life-stage observed questing. Previous research has revealed that the activity of H. longicornis is influenced by photoperiod: short daylight lengths trigger diapause in nymphs, marking it as the primary overwintering stage. However, whether engorged larvae can enter diapause or are affected by short daylight is unclear. In this study, we tested in the laboratory whether the photoperiod Affects the development of H. longicornis engorged larvae and engorged nymphs under constant temperature and humidity. The results showed that engorged larvae molted significantly faster (3 days faster) when the photoperiod was 9 h of light as opposed to 14 h. In contrast, changes in the photoperiod did not affect the molting of engorged nymphs. Our results demonstrate that engorged larvae respond to short daylight length, by molting faster. These results suggest that engorged larvae are unlikely to overwinter under field conditions and support the expectation that nymphs are the primary overwintering stage for H. longicornis in the United States.
Relative position of seeds driven the seedling growth are mediated by root–leaf traits
Authors: Zhu Jing , Wang Xue-Lin , Jin Xing , Jiang Lan , Lin Hong-Yu , Hu Yang , Liu Jin-Fu , He Zhong-Sheng
Published: January 2024

Variations in plant traits are indicative of plant adaptations to forest environments, and studying their relationships with tree growth provides valuable insights into forest regeneration. The spatial arrangement of plant seeds within the forest litter or soil critically influences the variations of root–leaf traits, thereby affecting the adaptive strategies of emerging seedlings. However, our current understanding of the impacts of individual root–leaf traits on seedling growth in different relative position, and whether these traits together affect growth, remains limited. This study focuses on the dominant tree species, Castanopsis kawakamii, within the Sanming C. kawakamii Nature Reserve of China. The present experiment aimed to examine the variations in root–leaf traits of seedling, focus on the relative positions of seeds within different layers: beneath or above the litter layer, or within the bare soil layer (without litter). Our findings provided evidence supporting a coordinated relationship between root and leaf traits, wherein leaf traits varied in conjunction with root traits in the relative positions of seeds. Specifically, we observed that seedlings exhibited higher values for specific leaf area and average root diameter, while displaying lower root tissue density. The mixed model explained 86.1% of the variation in root–leaf traits, surpassing the variation explained by the relative positions. Furthermore, soil nitrogen acted as a mediator, regulating the relationship between seedling growth and root–leaf traits, specifically leaf dry matter content and root tissue density. Therefore, future studies should consider artificially manipulating tree species diversity based on root–leaf traits characteristics to promote forest recovery.
Multifunctional 5-hydroxyconiferaldehyde O-methyltransferases (CAldOMTs) in plant metabolism
Authors: Lam Lydia Pui Ying , Lui Andy C W , Bartley Laura E , Mikami Bunzo , Umezawa Toshiaki , Lo Clive
Published: January 2024

Lignin, flavonoids, melatonin, and stilbenes are plant specialized metabolites with diverse physiological and biological functions, supporting plant growth and conferring stress resistance. Their biosynthesis requires O-methylations catalyzed by 5-hydroxyconiferaldehyde O-methyltransferase (CAldOMT; also called caffeic acid O-methyltransferase, COMT). CAldOMT was first known for its roles in syringyl (S) lignin biosynthesis in angiosperm cell walls and later found to be multifunctional. This enzyme also catalyzes O-methylations in flavonoid, melatonin, and stilbene biosynthetic pathways. Phylogenetic analysis indicated the convergent evolution of enzymes with OMT activities towards the monolignol biosynthetic pathway intermediates in some gymnosperm species that lack S-lignin and Selaginella moellendorffii, a lycophyte which produces S-lignin. Furthermore, neofunctionalization of CAldOMTs occurred repeatedly during evolution, generating unique O-methyltransferases (OMTs) with novel catalytic activities and/or accepting novel substrates, including lignans, 1,2,3-trihydroxybenzene, and phenylpropenes. This review summarizes multiple aspects of CAldOMTs and their related proteins in plant metabolism and discusses their evolution, molecular mechanism, and roles in biorefineries, agriculture, and synthetic biology.
On the origin of accretion bursts in FU Ori
Authors: Nayakshin Sergei , Elbakyan Vardan
Published: January 2024

Accretion luminosity of young star FU Ori (FUOR) increased from undetectable levels to hundreds of L⊙ in 1937 and remains nearly as high at the present time. In a recent paper, we showed how Extreme Evaporation (EE) of a young gas giant planet that migrated to a ∼10 d orbit around the star may power FUOR. However, our model assumed a power-law mass–radius relation for the evaporating planet. Here, we employ a stellar evolution code to model mass losing planets. We find that adiabatic planets expand rapidly, which results in runaway FUOR bursts. Superadiabatic planets contract while losing mass; their outbursts are dimming with time. Long steadily declining bursts such as FUOR require relatively fine-tuned internal planetary structure, which may be rare. More commonly we find that superadiabatic planets contract too rapidly and their EE falters, leading to FUOR burst stutter. This stutter allows a single planet to produce many short repeating bursts, which may be relevant to bursts observed in V346 Nor, V899, and V1647. We compute broad-band spectra of our best-fitting scenario for FUOR. Since the outburst is triggered behind the planet location, the mid-infrared (mid-IR) emission rises many months before the optical, similar to bursts in Gaia-17bpi and Gaia-18dvy. We show that in outbursts powered by the classic thermal instability, mid-IR lags the optical, whereas the dead zone activation models predict mid-IR light precede the optical burst by many years to decades. We comment on the stellar flyby scenario for FUOR.
Determining cosmological growth parameter for stellar-mass black holes
Authors: Mlinar Ema , Zwitter Tomaž
Published: January 2024

It has recently been suggested that black holes (BHs) may grow with time, so that their mass is proportional to the cosmological scale factor to the power n, with suggested values n ≈ 3 for supermassive BHs in elliptical galaxies. Here, we test these predictions with stellar-mass BHs in X-ray binaries using their masses and ages. We perform two sets of tests to assess the compatible values of n. First, we assume that no compact object grows over the Tolman–Oppenheimer–Volkoff limit which marks the borderline between neutron stars and BHs. We show that half of BHs would be born with a mass below this limit if n = 3 applies. The possibility that all BHs were born above the limit is rejected at $4\, \sigma$ if n = 3 applies. In the second test, we assume that masses of BHs at their formation stay the same over cosmic history. We compare the mass distribution of the youngest BHs, which could have not grown yet, to their older counterparts. Distributions are compatible for $n = -0.9^{+1.3}_{-4.6}$, with n = 3 excluded formally with 87 per cent confidence. This result may be biased, because massive BHs tend to have a massive companion. Correcting for this bias yields n ≈ 0. We can therefore conclude that while our results are not a clear rejection of BH scaling with n = 3, we show that n = 0 is much more consistent with the data.
Disc corona radii and QPO frequencies in black hole binaries: testing Lense– Thirring precession origin
Authors: Kubota Aya , Done Chris , Tsurumi Kazuki , Mizukawa Ryuki
Published: January 2024

Stellar-mass black hole binary systems in the luminous X-ray states show a strong quasi-periodic oscillation (QPO) in their Comptonized emission. The frequency of this feature correlates with the ratio of a disc to Comptonized emission rather than with total luminosity. Hence, it changes dramatically during spectral transitions between the hard and soft states. Its amplitude is also strongest in these intermediate states, making them an important test of QPO models. However, these have complex spectra which generally require a disc and two separate Comptonization components, making it difficult to uniquely derive the spectral parameters. We build a new energy-conserving model of the accretion flow, SSsed model, which assumes a fixed radial emissivity but with a changing emission mechanism. This is similar to the agnsed model in xspec but tuned to be more suitable for stellar mass black holes. It uses a combination of the disc luminosity and temperature to constrain the inner radius of the (colour temperature corrected) blackbody disc, separating this from the more complex Comptonization spectra emitted inwards of this radius. We show a pilot study of this model fit to hundreds of RXTE spectra of the black hole binary XTE J1550 − 564. We show that the derived disc radius tightly anticorrelates with the central frequencies of the low-frequency QPO detected in the same observations. The relation is consistent with the quantitative predictions of Lense–Thirring precession of the entire inner Comptonization regions for the assumed system parameters. This supports the scenario that low-frequency QPOs are caused by Lense–Thirring precession.
The missing part: the Archaeoglobus fulgidus Argonaute forms a functional heterodimer with an N-L1-L2 domain protein
Authors: Manakova Elena , Golovinas Edvardas , Pocevičiūtė Reda , Sasnauskas Giedrius , Silanskas Arunas , Rutkauskas Danielis , Jankunec Marija , Zagorskaitė Evelina , Jurgelaitis Edvinas , Grybauskas Algirdas , Venclovas Česlovas , Zaremba Mindaugas
Published: January 2024

Argonaute (Ago) proteins are present in all three domains of life (bacteria, archaea and eukaryotes). They use small (15–30 nucleotides) oligonucleotide guides to bind complementary nucleic acid targets and are responsible for gene expression regulation, mobile genome element silencing, and defence against viruses or plasmids. According to their domain organization, Agos are divided into long and short Agos. Long Agos found in prokaryotes (long-A and long-B pAgos) and eukaryotes (eAgos) comprise four major functional domains (N, PAZ, MID and PIWI) and two structural linker domains L1 and L2. The majority (∼60%) of pAgos are short pAgos, containing only the MID and inactive PIWI domains. Here we focus on the prokaryotic Argonaute AfAgo from Archaeoglobus fulgidus DSM4304. Although phylogenetically classified as a long-B pAgo, AfAgo contains only MID and catalytically inactive PIWI domains, akin to short pAgos. We show that AfAgo forms a heterodimeric complex with a protein encoded upstream in the same operon, which is a structural equivalent of the N-L1-L2 domains of long pAgos. This complex, structurally equivalent to a long PAZ-less pAgo, outperforms standalone AfAgo in guide RNA-mediated target DNA binding. Our findings provide a missing piece to one of the first and the most studied pAgos.
NELF focuses sites of initiation and maintains promoter architecture
Authors: Santana Juan F , Spector Benjamin M , Suarez Gustavo A , Luse Donal S , Price David H
Published: January 2024

Many factors control the elongation phase of transcription by RNA polymerase II (Pol II), a process that plays an essential role in regulating gene expression. We utilized cells expressing degradation tagged subunits of NELFB, PAF1 and RTF1 to probe the effects of depletion of the factors on nascent transcripts using PRO-Seq and on chromatin architecture using DFF-ChIP. Although NELF is involved in promoter proximal pausing, depletion of NELFB had only a minimal effect on the level of paused transcripts and almost no effect on control of productive elongation. Instead, NELF depletion increased the utilization of downstream transcription start sites and caused a dramatic, genome-wide loss of H3K4me3 marked nucleosomes. Depletion of PAF1 and RTF1 both had major effects on productive transcript elongation in gene bodies and also caused initiation site changes like those seen with NELFB depletion. Our study confirmed that the first nucleosome encountered during initiation and early elongation is highly positioned with respect to the major TSS. In contrast, the positions of H3K4me3 marked nucleosomes in promoter regions are heterogeneous and are influenced by transcription. We propose a model defining NELF function and a general role of the H3K4me3 modification in blocking transcription initiation.
Sustaining work ability amongst female professional workers with long COVID
Authors: Lunt J , Hemming S , Elander J , Burton K , Hanney B
Published: January 2024

Background

Long COVID (LC) compromises work ability (WA). Female worker WA has been more adversely impacted than WA in men. Exploration of lived experiences could elucidate the WA support required.

Aims

To explore the working conditions and circumstances experienced as affecting sustained WA amongst female workers with LC, to help mitigate worklessness risks.

METHODS

Online semi-structured qualitative interviews were conducted with 10 female workers self-reporting or formally diagnosed with LC who had made some attempt to return to work (RTW). Interviews were analysed using template analysis to map themes informing WA enablers and obstacles onto a biopsychosocial model of rehabilitation.

RESULTS

All participants were professionals working in an employed or self-employed capacity. Key themes reflecting circumstances that afforded sustained WA included the autonomy over where, when and how to work indicated as facilitated by a professional role, rapid health care access, predominantly sedentary work, competent colleagues able to cover for transient reduced WA, a strong interface between specialist health and management support, and accessible organizational policies that steer health management according to equity rather than equality. Highly flexible, iterative, co-produced RTW planning, tolerant of fluctuating symptom expression appears vital. In return for providing such flexibility, participants felt that employers’ workforce diversity and competence would be protected and that workers would need to reciprocate flexibility.

Conclusions

These qualitatively derived findings of workers’ lived experiences add to existing guidance on supporting WA for people struggling with LC. Moreover, the same principles seem appropriate for tackling worklessness amongst working-age adults with complex long-term health conditions.
Five considerations about memory processes for child investigative interviewers
Authors: Danby Meaghan C
Published: January 2024

In cases of child abuse, children are required to retrieve details from their memory as accurately as possible. Previous research has shown that children’s memory reports can be heavily influenced by an interviewer, but many interviewers do not understand memory processes or know how their practices impact children’s memories. While interviewers are commonly recommended to adhere to expert guidelines, the current article aims to explain the memory-related reasons underlying why some interview practices are recommended and further aims to dispel some misconceptions about memory. Five considerations about children’s memory are described: (1) the rate that details are forgotten from memory cannot justify rushed interview planning, (2) considerations for eliciting details from different subsystems of long-term memory, (3) how question phrasing impacts children’s memory retrieval processes, (4) the inaccuracies caused by the reconstructive nature of memory, and (5) the memory challenges for children reporting multiple incidents of abuse.
Public expectations of police education in England and Wales
Authors: Andrews Tom
Published: January 2024

The current Police Entry Qualifications Framework in England and Wales has undergone much debate since its inception in 2018. Recently the Home Secretary backtracked on over a decade’s worth of party policy and undid the requirement for all new police officers to hold or obtain a degree in Professional Policing. This has been immediately followed by several chief constables and elected police and crime commissioners (PCC’s) dropping the requirement for a degree completely. Some have been quoted as saying “the public don’t want police officers sat in classrooms” or words to that effect. Yet no studies exist that do examine what the English and Welsh public do expect educationally of their police force. This study fills that gap by surveying n = 520 members of the public to ascertain their views. It finds that whilst a two-thirds majority of the public ostensibly say they don’t believe police officers need a degree, more than nine out of ten expect them to have some kind of police-specific higher education qualification. They would also feel overwhelmingly more confident if an officer investigating a crime they were a victim of, held a relevant policing-related degree qualification. This dichotomy is then analysed against the wider background of HE and vocational qualifications. It concludes that the problem is not with a requirement for higher education in policing, but the ‘d word’ itself and the marketing of the degree as a ‘requirement’ versus a degree as an ‘achievement’.
Escalating competition in NHS: implications for healthcare quality and workforce sustainability
Authors: Ferreira Tomas
Published: January 2024

The UK’s National Health Service (NHS) faces escalating competition ratios for specialty training positions, with application rates dramatically outpacing the growth in available posts. This trend contributes to systemic bottlenecks and challenges traditional career progression pathways within medicine. In this evolving landscape, the once-certain career progression within medicine is now increasingly uncertain. This commentary explores the complex dynamics of increased medical school admissions against stagnant specialty training placements and the broader strategic implications for workforce planning within the NHS. It critically evaluates the implications of current funding policies, which seem to prioritise an expansion of nondoctor healthcare roles over the development of specialist training, raising concerns about the long-term patient care quality and safety. Key recommendations include a reassessment of medical education expansion, a review of funding allocation, increased support for specialty training, and government accountability for healthcare workforce planning. The urgent need for strategic policy reform is underscored to ensure that NHS can sustain a high-quality, specialist-led healthcare provision in the face of rising competition and workforce pressures
High-resolution magnetic resonance imaging visualizes intracranial large artery involvement in giant cell arteritis
Authors: Guggenberger Konstanze V , Vogt Marius L , Song Jae W , Fröhlich Matthias , Schmalzing Marc , Venhoff Nils , Werner Rudolf A , Hillenkamp Jost , Pham Mirko , Meckel Stephan , Bley Thorsten A
Published: January 2024

Objective

Giant cell arteritis (GCA) is a large vessel vasculitis, typically involving the aorta and its branches with predilection for the scalp arteries. Intracranial involvement is still part of ongoing research. We assessed inflammation of the intracranial arteries on 3D compressed sensing black-blood MRI (3D-CS-BB-MRI) in patients with GCA and age-matched controls.

Methods

One hundred and five patients with 3D-CS-BB-MRI of the brain were included in this retrospective dual-centre case–control study, 55 with diagnosed GCA and 50 age-matched controls. High-resolution 3D-CS-BB-MRI was performed on a 3 T MR scanner with a post-contrast 3D-compressed-sensing MR pulse sequence, specifically a T1-weighted sampling perfection, application-optimized contrasts using different flip angle evolution (SPACE) pulse sequence with whole-brain coverage and isotropic resolution of 0.55 mm3. Two neuroradiologists blinded to clinical data independently scored the cerebral arteries qualitatively for inflammation; circumferential vessel wall thickening and contrast enhancement were scored positive for vasculitis.

Results

Eight of 55 GCA patients (14.5%) showed inflammation of at least one intracranial artery. The internal carotid artery (ICA) was affected in 6/55 (10.9%), the vertebral artery in 4/55 (7.3%) and the basilar artery and posterior cerebral artery in 1/55 (1.8%). All patients with inflammatory changes reported headaches and none showed any focal neurological deficit. Besides headache and general weakness, there was no significant correlation between inflammation of the intracranial arteries and clinical symptoms. No age-matched control patient showed inflammatory changes of the intracranial arteries.

Conclusion

High-resolution 3D-CS-BB-MRI revealed inflammatory changes of intracranial arteries in 14.5% of GCA patients, with the intradural ICA as the most frequently affected vessel.
A preliminary study on determination of radioactivity levels and estimation of the annual effective dose in dried fruits consumed in Albania
Authors: Spahiu Erjon , Shyti Manjola , Bërdufi Irma
Published: January 2024

This work aimed to support Albania’s food safety monitoring regime. In this context, the natural and artificial radioactivity was measured in 20 samples of dried fruits collected randomly in different markets of Tirana. The activity concentration of 40K, 226Ra, 232Th and 137Cs was determined by using the high-purity germanium detector. The maximum values of activity concentration in dried fruits were calculated as 517 ± 22 Bq kg−1 for 40K, 11.10 ± 0.93 Bq kg−1 for 226Ra, 4.38 ± 0.26 Bq kg−1 for 232Th and 0.83 ± 0.14 Bq kg−1 for 137Cs. The average values of activity concentration of 40K and 226Ra were 269and 6.05 Bq kg−1 and the average effective dose to individuals from the intake of the dried fruits was 44 μSv y−1. All average values in this study were lower than recommended values by reports United Nations Scientific Committee on the Effect of Atomic Radiation, World Health Organization and International Commission on Radiological Protection for all age groups. Therefore, all dried fruit samples in this study are safe for consumption with acceptable radiological risk and none of them pose any significant radiological impact. The obtained data in this paper and information for levels of radioactivity and ingestion absorbed dose from dried fruits can be used to be the basic data for future comparative analysis of the other studies.
Cohort-Specific Experiences of Industrial Decline and Intergenerational Income Mobility
Authors: Seltzer Nathan
Published: January 2024

The United States manufacturing industry has long been regarded as the economic engine that built and sustained the middle class. In recent decades, this pillar of economic opportunity has eroded substantially. Though much has been written about the decline of manufacturing sectors in United States communities, the potential consequences for economic mobility, and stratification processes more generally, remain largely unexplored. In this study, I develop a conceptual framework linking the study of labor market change to economic stratification. I examine how structural changes to United States labor markets have altered opportunities for economic advancement in the United States. I focus the analysis on birth cohorts in the 1980s, whose labor market entry spans the large-scale erosion of the manufacturing industry in the 2000s. I find strong evidence that declines in manufacturing employment have contributed to growing geographic disparities in upward intergenerational income mobility. Children raised in counties that experienced large contractions in manufacturing industries throughout adolescence experienced large economic penalties in adulthood via reduced levels of upward mobility. The results demonstrate how long-term macroeconomic changes can disrupt and redistribute opportunities within societies.
Influence of metabolizable protein and methionine supplementation on growth-performance of Holstein steer calves during the initial 112-d feedlot growing phase
Authors: Salinas-Chavira Jaime , Carvalho Pedro H V , Latack Brooke C , Ferraz Marcos V C , Montano Martin , Zinn Richard A
Published: January 2024

The objective was to examine the effects of metabolizable protein (MP) and ruminal-protected methionine supplementation on growth performance of Holstein steer calves during the initial feedlot growing phase (112 d). One hundred eighty Holstein steer calves (122 ± 7 kg) were blocked by weight and assigned to 30 pens (6 steers per pen). Five treatments were applied: 1) control, a diet based on steam-flaked corn containing urea and dry distillers grains plus solubles as supplemental N sources with no amino acid addition; 2) control diet plus blood meal supplementation; 3) diet from treatment 2, with 0.064% Smartamine M (70% methionine; Adisseo, Alpharetta, GA) supplementation; 4) diet from treatment 2 with 0.096% Smartamine M supplementation; 5) diet from treatment 2 with 0.128% Smartamine M supplementation. All diets were formulated to exceed the estimated MP requirements. The estimated metabolizable lysine, as well as methionine, was deficient in the control diet. Blood meal was added to the control diet to meet estimated lysine requirements (diet 2), the other diets had increasing concentrations of supplemental methionine. Supplemental MP enhanced (10%, P < 0.02) interim and overall 112-d average daily gain (ADG). Additional effects of supplemental methionine on ADG were not appreciable (P > 0.10). Supplemental MP did not affect (P > 0.10) dry matter intake (DMI) during the first 56-d period; however, it tended to increase (P = 0.08) DMI during the subsequent 56-d period. Overall, supplemental MP or methionine had no appreciable effect (P > 0.10) on DMI. Supplemental MP improved (P < 0.01) gain efficiency and estimated dietary net energy (NE) values during the initial 56-d period (11 and 7%, respectively) and overall (7 and 4%, respectively). Supplemental MP did not affect (P > 0.10) gain efficiency during the second 56-d period, although it tended to enhance (P = 0.08) estimated dietary NE. Supplemental methionine did not appreciably affect (P > 0.10) gain efficiency or estimated dietary NE. Therefore, adding MP to cover the estimated limiting amino acid supply in diets may enhance the gain efficiency and dietary energetics of growing Holstein calves. However, amino acid addition supplementation beyond the requirements may not produce extra productive performance of steer calves.
Bayesian Network Modelling for the Clinical Diagnosis of Alzheimer’s Disease
Authors: Bate St Cliere Amber-Rose , Fenton Norman
Published: January 2024

Alzheimer’s disease (AD) is a progressively debilitating disease commonly affecting the elderly. Correct diagnosis is important for patients to access suitable therapies and support that can help improve or manage symptoms of the condition. Reports of misdiagnosis and difficulty diagnosing AD highlight existing clinical challenges. Here we propose a Bayesian network as a preliminary model for a complementary clinical diagnostic tool for dementia due to AD and mild cognitive impairment due to AD. The model structure was built based on medical reasoning patterns which help bridge the gap between clinical professionals and algorithmic decision making. The parameters of the model were specified from a combination of learning from data (using the NACC Uniform Data Set), extracting data from literature, and knowledge-based judgment. The resulting model includes variables laid out in NIA-AA diagnostic criteria and differentiates actual AD cases from formal AD diagnoses. The model is validated against a range of real-world data. Unlike machine-learnt (black box) AI models, this model provides a visible and auditable justification for its predictions and can be used for multiple types of ‘what if analysis’. An easy-to-use web accessible version of the model has been made available.
The decline of renal function aggravates arterial stiffness: a large-scale cross-sectional and longitudinal study
Authors: Zhao Qiuping , Wang Wei , Leng Yiming , Wang Jie , Rujia Miao , Chen Zhiheng , Wang Jiangang , Cai Jingjing , Yuan Hong , Li Fei , Lu Yao
Published: January 2024

Purpose

Many studies investigated the one-single-direction relationship between arterial stiffness and chronic kidney dysfunction, particularly in patients with end-stage renal disease. The bidirectional relevance between kidney function decline and arterial stiffness in general population remains unknown. This study aimed to address the temporary relationship between arterial stiffness and renal function.

Materials and Methods

This large-scale observational study comprised one cross-sectional and one longitudinal population sample totalling 67,060 individuals aged over 18 years with brachial-ankle pulse wave velocity (baPWV) and estimated glomerular filtration rate (eGFR) measurements available. Associations with potential risk conditions were analysed using multiple regression analyses. Cox proportional model was used to investigate the association of arterial stiffness and incident chronic kidney disease (CKD). Cross-lagged path analysis was further conducted to analyze the temporal relationship between baPWV and eGFR.

Results

Multiple regression analyses showed that baPWV was inversely associated with eGFR. Compared with the lower baPWV tertile group, higher baPWV was a predictor of CKD risk, with increased HRs for three baPWV tertile groups [HR=2.17 (1.26-3.76), P for trend <0.05]. Accordingly, lower eGFR was significantly associated with higher arterial stiffness risk, even after full-adjusted [HR=1.21 (1.02-1.44), P for trend <0.05]. In the path analysis, the coefficient of the association between baseline baPWV and follow-up eGFR was lower than the effect of baseline eGFR for follow-up baPWV (−0.063 Vs. −0.077, P <0.001).

Conclusions

Decrease of eGFR appeared to aggravate arterial stiffness, which unravelling a new understanding of the role kidney dysfunction played in arterial stiffening.
Measuring progress on health and well-being in the Eastern Mediterranean Region via voluntary national reviews, 2016 - 2021: what does the data reveal?
Authors: Mabry RM , Doctor HV , Khair MN , Abdelgalil M , Rashidian A
Published: January 2024

Background

Countrysubmission of Voluntary National Reviews (VNRs) is the formal mechanism to report on progress of the Sustainable Development Goals (SDGs). Despite strong political commitment to strong information systems, large data gaps exist in the Eastern Mediterranean Region.

Methods

This study aims to review VNRs submitted by countries in the region to assess the comprehensiveness of reporting on the health-reported SDG targets and indicators. We conducted a content analysis of VNRs of 18 countries of the region submitted between 2016 and 2021. The review focused on progress on the SDGs by assessing i) the reporting on the 50 health-related targets and indicators ii) data availability using the WHO reporting framework, and iii) data availability based on source of information. Spreadsheets were developed and used to extract data and facilitate content analysis.

Results

All VNRs confirmed that SDG monitoring and reporting mechanisms have been established, however, only 11 VNRs reported on all 17 SDGs and 8 explicitly mentioned country specific 2030 targets. Many VNRs identified data availability as a key challenge to SDG monitoring; for the health SDG, data availability ranged from 48% to 93% among the five countries reporting this figure. Comprehensiveness of reporting varied by type of indicator (maternal, child and infant mortality were the most common) and by country income level (greater reporting by high income countries).

Conclusions

Significant work remains to enhance information systems across the region to monitor progress and guide actions to achieve the health-related SDGs. Strengthening health information systems regulatory frameworks, data collection capacities including strengthening civil registration and vital statistics and population-based surveys are key steps to enhancing access to quality data which in turn can contribute to achieving the health-related SDGs.
Are personal health literacy and school health literacy environment important to schoolteachers’ health outcomes?
Authors: Liu Rongmei , Yu Mingyang , Zhao Qiuping , Wang Junfang , Bai Yuxi , Chen Hui , Yang Xiaomo , Liu Shuaibin , Okan Orkan , Chen Xinghan , Xing Yuhan , Guo Shuaijun
Published: January 2024

Background

While the relationship between an individual’s personal health literacy and health outcomes is well-established, the role of the health literacy environment is often overlooked. This study aimed to examine the associations of personal health literacy and the school health literacy environment with health outcomes among schoolteachers.

Methods

A cross-sectional study was conducted in 11 schools in Zhengzhou, Henan, China. Using a self-administered questionnaire, teachers (N=7364) were surveyed collecting data on their sociodemographics, personal health literacy, the school health literacy environment, and four types of health outcomes (health status, health-compromising behaviours, health service use, and healthcare cost). Besides descriptive statistics, a series of logistic regression analyses were conducted.

Results

Overall, more than half of teachers (56.9%) had inadequate or problematic health literacy, while more than three-fifths (69.0%) perceived their school health literacy environment was less supportive. Teachers with inadequate health literacy had higher odds of poor health status (odds ratio (OR)=5.79, 95% CI=3.84, 8.73), at least one health-compromising behaviour (OR=2.90, 95% CI=2.29, 3.68), at least one health service use (OR=2.73, 95% CI=2.07, 3.61), and more healthcare cost (OR=2.51, 95% CI=2.00, 3.16) than those with excellent health literacy, after adjusting for sociodemographics and school health literacy environment. Similarly, teachers who perceived low levels of supportive school health literacy environment had higher odds of poor health outcomes (ORs ranging from 1.13 to 1.78), after adjusting for sociodemographics and personal health literacy.

Conclusion

Both personal health literacy and school health literacy environment are important to schoolteachers’ health outcomes. Educational programs and organisational change are needed to improve personal health literacy and school environments to improve teachers’ health and well-being.
MMFP-Tableau: Enabling Precision Mitochondrial Medicine through Integration, Visualization, and Analytics of Clinical and Research Health System Electronic Data
Authors: George-Sankoh Ibrahim , MacMullen Laura E. , Chinwalla Asif T. , Taylor Deanne , Ganetzky Rebecca D. , Stanley Katelynn , McCormick Elizabeth M. , Zolkipli-Cunningham Zarazuela , Falk Marni J
Published: January 2024

Purpose

To describe a novel data integration workflow developed to automate clinical and research electronic health system data integration and harmonization from siloed sources for centralized access, visualization and analysis by clinicians and researchers in an end user-friendly customized analytic platform.

Methods

A centralized, semi-automated framework provides data provenance and user access to integrated data sources. Data models are implemented leveraging a centralized server (Alteryx) for high-level analytics including scheduling, integration and modeling. A secure Tableau instance hosts end-user visualizations, with minimal software development required.

Results

MMFP-Tableau, named for its origin in the Mitochondrial Medicine Frontier Program (MMFP) at Children’s Hospital of Philadelphia, facilitates direct access to integrated, highly robust health system datasets. This scalable data solution enables integration of clinical and research parameters with research samples; enhances external biopharma collaborations for clinical trial design, subject recruitment and data tracking; accelerates retrospective clinical cohort data analysis; and improves complex data visualization for clinicians and researchers.

Conclusion

MMFP-Tableau promotes complex data integration, visibility, and advanced analytic capabilities to facilitate seamless multidisciplinary research, benefitting clinical care and research in rare disease patients and cohorts. This approach represents a generalizable workflow concept readily adaptable to implement across diverse fields of medicine