bluuebunny/crossref_metadata_2025 huggingface dataset:
Mediating role of psychological well‐being in the effect of spirituality on attitudes toward death in the elderly
Authors: Sarpdaği Yakup , Yiğit Muhammet Faruk , Aydin Muhammet Ali , Yildirim Mehmet Salih , Çiftci Necmettin , Yildiz Metin
Published: January 2025

Background

Spirituality and psychological well‐being are important in shaping attitudes toward death.

Objective

This study was conducted to determine the mediating role of psychological well‐being in the effect of spirituality on attitudes toward death in the elderly.

Method

This cross‐sectional descriptive study was conducted in a province of Turkey between February 2024 and June 2024 with 467 individuals aged 65 years and older. The variables affecting attitudes toward death were identified by conducting mediation analysis and predictive analysis with a machine learning approach. Data were analyzed using SPSS 22.0, G*Power 3.1, R programming language 4.1.3 programs.

Results

In our study, the effect of spirituality on psychological well‐being was found to be positive and statistically significant (coefficient = 0.660, P < 0.001). The direct effect of spirituality on neutrality and approaching acceptance, sub‐dimensions of attitude toward death, was significant (coefficient = 1.603, P < 0.001), and its indirect effect through psychological well‐being was also significant (coefficient = 0.179, lower limit confidence interval (LLCI) = 0.085, upper limit CI (ULCI) = 0.309). The direct effect of spirituality on escape acceptance (coefficient = 0.571, P < 0.001), one of the attitudes toward death sub‐dimensions, was significant, but the mediation effect of psychological well‐being was not significant (LLCI = −0.049, ULCI = 0.0438). The direct effect of spirituality on fear and avoidance of death, one of the attitudes toward death sub‐dimensions, was not statistically significant at the 95% confidence level (coefficient = 0.094, P = 0.433). The indirect effect of psychological well‐being on fear and avoidance of death was negative and significant (coefficient = −0.136, LLCI = −0.233, ULCI = −0.031).

Conclusion

In this study, as spirituality increases, attitudes toward death also increase positively. It was found that as spirituality increases, people tend to have a more positive acceptance and approach toward death. This study suggests that spirituality may influence emotional responses to death and shape attitudes toward death, particularly neutral acceptance and escape acceptance. As psychological well‐being increases in the elderly, acceptance of death increases and fear of death decreases. In the study, prediction with different machine learning approaches is proposed. Longitudinal studies on attitudes toward death are recommended.
Marital satisfaction and its impact on frailty in Korean older adults: a longitudinal analysis
Authors: Hwang In Cheol , Lee Jae Hyuck , Ahn Hong Yup , Park Yujin
Published: January 2025

Background

Despite a wealth of literature on marital dissatisfaction and adverse health outcomes, little is known about the relationship between marital dissatisfaction and frailty in older adults.

Methods

This longitudinal study utilised the data of 11 174 individuals who participated in the biennial Korean Longitudinal Study of Ageing survey from 2006 to 2020 and were aged ≥45 during the initial wave. Frailty was measured using a frailty instrument, which utilised exhaustion, social isolation, and handgrip strength weakness. Marital dissatisfaction was defined as a decrease in marital satisfaction of at least 10 points compared to the previous wave. Lagged generalised estimating equation analyses were conducted to investigate the impact of marital dissatisfaction on frailty.

Results

Frail participants were more likely to be older, female, have higher rates of depression, lower socioeconomic status (as indicated by lower household income and education level), and with more comorbidities. Multivariate logistic model analysis revealed that individuals who became dissatisfied with their marriage had higher odds ratios for being frail than those who did not, and this trend was true in women and individuals with a low socioeconomic status. However, the development of frailty was not significantly associated with dissatisfaction with marriage.

Conclusion

The findings of this study suggest that marital dissatisfaction is a robust predictor of frailty in older adults. Efforts aimed at addressing marital dissatisfaction have the potential to prevent frailty in women and individuals of low socioeconomic status.
Impact of fertilization and crop type on horticultural soil quality: A 3‐year, open‐field experiment
Authors: Sokolowski Ana Clara , Barrios Mónica B. , Wolski José E. , Mónaco Henke Juan M. , Rodríguez Hernán A. , Navas Mauro , De Grazia Javier , Prack McCormick Barbara
Published: January 2025

In many regions worldwide, horticulture is a soil‐based production system closely tied to small family farmers who often face socio‐economic challenges. In the peri‐urban area of Buenos Aires (Argentina), horticultural soils face significant degradation because of inadequate agricultural practices. At the same time, efforts are underway to design and implement alternative sustainable practices. Evaluating the effect of current and alternative practices on soil quality under controlled conditions is essential for ensuring food security and supporting the livelihoods of family farmers. In this area, family farmers commonly use poultry litter (PL) as a sole nutrient source or combined with mineral fertilizers (MF). Agroecological practices such as crop rotation, intercropping, and diversification with legumes and flowers are also being adopted. This study aimed to assess the effects of fertilization strategies and crop types on the physical, chemical and biological quality of an Aquic Argiudol soil under continuous horticultural use. A 3‐year open field experiment compared the impacts of the fertilization strategies, PL, MF and no fertilization (CRL), and the crop types, vegetables (lettuce, beet and fava beans) and flowers (snapdragon and stock). Treatments were assigned to 4 m2 plots, and soil samples (0–10 cm deep) were collected annually at harvest. Key indicators were monitored, including bulk density, aggregate stability (AS), pH, electrical conductivity, soil organic carbon (SOC), total nitrogen (TN), extractable phosphorus (EP), basal respiration (BR) and microbial biomass (MCB). Compared to CRL, PL significantly improved (p < .05) SOC (15.8%), TN (18.0%), BR (53.6%) and MCB (76.4%), but also elevated EP (180.9%) to excessive levels and increased pH. In contrast, MF caused soil acidification. Legume inclusion improved (p < .05) AS (18.6%) and MCB (31.0%), while reducing the pH (3.7%). These findings highlight the benefits of organic amendments and crop diversification for soil quality in intensive horticultural systems, while also underscoring the need for careful management to address risks such as nutrient accumulation and environmental impacts.
Financial Stress Impact of Covid-19 Pandemic: Lessons Learned from Strategies Adopted by Low-Income Households
Authors: Siddik Md. Nur Alam
Published: January 2025

This research examined the impact of the Covid-19 pandemic on financial stress of households and strategies adopted by low-income households to deal with such financial stress. A survey on 577 respondents was carried out using a simple random sampling technique to acquire data. Binary logit model and probit model were applied to achieve the research objectives. Findings demonstrate that during Covid-19 pandemic low-income people had escalated financial stress and that respondents' age, income volatility, family financial efficiency, medication cost, and creditors’ pressure all have substantial influences on financial stress. Findings of gender based analysis indicate that male respondents had experienced more financial stress compared to female respondents. Results of robustness check confirm the main findings of the study. This study also discovered that low-income households had adopted several strategies, mostly changing eating habits, taking loans and selling personal properties to deal with financial stress caused by Covid-19 pandemic. Based on the findings, this study offers policy recommendations that may alleviate financial stress by reducing the financial constraints of extreme poor individuals.
Critical cluster volumes in hierarchical percolation
Authors: Hutchcroft Tom
Published: January 2025

We consider long‐range Bernoulli bond percolation on the ‐dimensional hierarchical lattice in which each pair of points and are connected by an edge with probability , where is fixed and is a parameter. We study the volume of clusters in this model at its critical point , proving precise estimates on the moments of all orders of the volume of the cluster of the origin inside a box. We apply these estimates to prove up‐to‐constants estimates on the tail of the volume of the cluster of the origin, denoted as , at criticality, namely,
In particular, we compute the critical exponent to be when is below the upper‐critical dimension and establish the precise order of polylogarithmic corrections to scaling at the upper‐critical dimension itself. Our work also lays the foundations for the study of the scaling limit of the model: In the high‐dimensional case , we prove that the sized‐biased distribution of the volume of the cluster of the origin inside a box converges under suitable normalization to a chi‐squared random variable, while in the low‐dimensional case , we prove that the suitably normalized decreasing list of cluster sizes in a box is tight in if and only if .
Effect of aspiration during intramuscular injection on the occurrence of adverse effects in adults: a systematic review protocol
Authors: Godinho Marluce Rodrigues , Carbogim Fábio da Costa , Coelho Angélica da Conceição Oliveira , Araujo Gabriela Do Nascimento Martins de , Souza Amanda Damasceno de , Gomes Helen Vaz da Silva , Sousa Alice Maria Das Graças de , Rodrigues Herlander Jesus Borges Tomás , Santos Kelli Borges Dos , Pereira Rui Pedro Gomes
Published: January 2025

Objective:

The objective of this review is to evaluate the effect of prior aspiration vs no aspiration during intramuscular injection on the occurrence of adverse effects in adult patients.

Introduction:

Aspiration is a procedure conducted prior to the administration of intramuscular medications that aims to ensure that the needle tip is inserted in the proper place. Although aspiration is a common procedure, questions have been raised about adverse effects.

Inclusion criteria:

This review will consider experimental and observational studies that include or evaluate the occurrence of any adverse effects following intramuscular injection, either with or without prior syringe aspiration, in adult patients. Adverse effects will include local pain, induration, puncture of blood vessels, decreased drug effect, hematoma, or abscess. The review will exclude studies on venipuncture, aspiration biopsies, or other invasive punctures of a diagnostic nature.

Methods:

This review will be conducted in accordance with the JBI methodology for systematic reviews of effectiveness. Databases to be searched will include PubMed, Embase, CINAHL, Scopus, LILACS, and Web of Science Core Collection, as well as sources of unpublished/gray literature, with no date or language limitations. Two independent reviewers will conduct study selection, critical appraisal, and data extraction. Studies will, where possible, be pooled in statistical meta-analysis. The grading of the certainty of evidence will be determined using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Registration number:

PROSPERO CRD42021270432
Fathers’ lived experiences of fatherhood during the child’s first 1000 days: a qualitative systematic review protocol
Authors: Vidinha Telma , Santos Diana , Pinto Daniela , Duque Filipa Margarida , Cardoso Daniela , Cardoso Ana Filipa , Magalhães Maria José , Moura Tatiana , Neto Maria
Published: January 2025

Objective:

The objective of this review will be to synthesize the best available evidence on fathers’ lived experiences of fatherhood during the child’s first 1000 days of life.

Introduction:

Involved and caring fatherhood is crucial for the healthy cognitive, physical, social, and emotional development of children; however, fatherhood is a challenging process for most men. It is characterized by profound changes that require the development of a new identity and the assumption of new roles within the family. Understanding adult fathers’ lived experiences during this stage of life can provide valuable knowledge to families, health care professionals, and policymakers.

Inclusion criteria:

This review will include studies on the experiences of fatherhood during the child’s first 1000 days of life. It will include heterosexual biological fathers of healthy infants, who are 18 years or over, and belong to an intact family.

Methods:

This review will be conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence. The search strategy will aim to locate both published and unpublished qualitative studies published in English, Spanish, and Portuguese. Ten databases or gray literature sources will be searched, with no date limitations. Study selection, critical appraisal, and data extraction will be performed by 2 independent reviewers. Any disagreements that arise between the reviewers will be resolved through discussion or with an additional reviewer. Data will be presented in narrative format, and data synthesis will follow the JBI meta-aggregation approach. A ConQual Summary of Findings will be presented.

Review registration:

PROSPERO (CRD42023487167)
Facilitator development for pre-registration health professions simulation: a scoping review protocol
Authors: Gordon Renée , Riley Jaime , Dupont Diana , Rogers Beth , Witherspoon Richelle , Day Kelly , Horsley Elizabeth , Killam Laura
Published: January 2025

Introduction:

The growing demand for health professional education intensifies the need for learning innovations such as simulation: facilitating predictable, realistic, experiential learning that prepares students for practice. To achieve this, facilitators must provide pedagogically sound, psychologically safe simulation. High-quality simulation enhances students’ self-efficacy, critical thinking, and clinical reasoning. Despite increasing integration of simulation into curricula, best practices for facilitator development remain unknown, risking the quality and safety of simulations.

Objective:

This scoping review will identify the extent and type of evidence guiding the development of simulation facilitators in pre-registration health professional programs for any type and stage of simulation.

Inclusion criteria:

This review will consider reports on simulation facilitator development for educators of pre-registration health professional students in academic settings. The simulation may be delivered using any delivery modality and any language. Reports focused on simulation facilitators working in professional settings, within graduate programs, or with already licensed learners will be excluded.

Methods:

The review will follow the JBI methodology for scoping reviews. The databases to be searched will include CINAHL (EBSCOhost), Embase, ERIC (EBSCOhost), MEDLINE (Ovid), and ProQuest Dissertation and Theses, from 2005 to the present. Titles and abstracts, followed by full-text articles, will be screened by 2 independent reviewers using Covidence. Data will be extracted using a pre-defined extraction form and content analysis will be conducted. Extracted data will be presented using tables, charts, and a narrative summary.

Review registration:

Details of this review project can be found in Open Science Framework: https://doi.org/10.17605/OSF.IO/WF9ZC
The Association of Social Ability With the Outcomes of a Motor Program in Children With Autism Spectrum Disorders—Preliminary Findings
Authors: Bo Jin , Shen Bo , Pang YanLi , Zhang Mingting , Xiang Yuan , Dong Liangsan , Song Yu , Lasutschinkow Patricia , Dillahunt Alina , Shen Jiayou , Li Dan
Published: January 2025

Social functioning plays a crucial role in motor performance for children with autism spectrum disorders. In this study, we investigated whether the social abilities of children with autism spectrum disorders influence their acquisition of trained fundamental motor skills and their capacity to transfer learning to untrained fundamental motor skills within a 9-week motor program. The training regimen targeted 13 locomotor and ball skills outlined in the Test of Gross Motor Development-3. Evaluation of the transfer of learning was conducted using the Movement Assessment Battery for Children-2, including manual dexterity, aiming and catching, and balance. Notable improvements were found in not only trained locomotor and ball skills but also in untrained balance tasks. Furthermore, individuals with more pronounced social challenges exhibited greater improvements in both the trained ball skills and the untrained aiming and catching compared with those with milder social difficulties. These findings underscore the significance of social dynamics in shaping the effectiveness of motor programs, illuminating the intricate interplay between social and motor domains within treatments tailored for autism spectrum disorders.
Qualitative Elicitation of Physical Activity Salient Beliefs Among Turkish Adolescent Girls
Authors: Yıldızer Günay , Eren Gonca , Türkyılmaz Ahmet Sinan , Lee Chung Gun
Published: January 2025

Background: This study aims to investigate salient beliefs toward physical activity by gathering qualitative data through open-ended questions among high school-aged female adolescents in Turkey. Methods: A sample of 259 Turkish high school students, aged between 14 and 17, were randomly selected to participate in this study. Open-ended questions address 3 main components of the Theory of Planned Behavior, attitudes, perceived control, and social norms. Content analysis is employed to categorize the data according to themes, during the elicitation process. Results: The results were categorized as variables of the Theory of Planned Behavior. Positive attitude contributors included health expectations, emotions, fitness expectations, learning, and socialization, while negative attitude contributors encompassed adverse health outcomes and emotions. Second, perceived competence and efficacy emerged as positive contributors to perceived behavior control, whereas factors, such as time constraints, health-related barriers, fitness barriers, environmental and economic barriers, and perceived negative competence and efficacy were identified as negative influencers of perceived behavior control. Last, it was found that families, friends, and teachers played significant roles in shaping social norms. Conclusions: Offering attractive choices for physical activities while explaining the positive impact on both physical, and mental health, as well as physical fitness is important for positive attitudes. Providing positive experiences and emphasizing the aspects of physical activity that support academic productivity are important factors in supporting perceived behavioral control. Finally, advocating for environments that promote physical activity behaviors among peers and ensure comprehensive support from families and educators is valuable in terms of subjective norms to increase physical activity intentions.
Teaching Physical Education Teacher Education Online: Reconciling With “Emergency Remote Delivery”
Authors: Morrison Hayley J. , Stoddart Alexandra L.
Published: January 2025

Purpose: Physical education teacher education is one of the most difficult subjects to transition online due to its inherent embodiedness in nature. Anticipating the challenges of transitioning courses during COVID-19, we explored our experiences teaching physical education teacher education online during emergency remote delivery. Method: Using a collaborative self-study of teacher education practice methodology, we interrogated our assumptions, actions, and lived experiences of teaching physical education teacher education online. Journal reflections and responses, recorded meetings, and documents/artifacts were analyzed using inductive reflexive thematic analysis and Dewey’s theory of experience. Results: Our reflections on tensions and new learnings generated four themes: (a) lifting us up and bringing us down, (b) (no more) show and tell, (c) creating bonds through relationships and community, and (d) finding joy without movement. Conclusion: Although this adventure of emergency remote teaching did cause stress and uncertainty, it also pushed us to become innovators and provided professional development.
Nitrogen source type modulates heat stress response in coral symbiont (
Cladocopium goreaui
)
Authors: Huang Yulin , He Jiamin , Wang Yujie , Li Ling , Lin Senjie
Published: January 2025

Ocean warming due to climate change endangers coral reefs, and regional nitrogen overloading exacerbates the vulnerability of reef-building corals as the dual stress disrupts coral–Symbiodiniaceae mutualism. Different forms of nitrogen may create different interactive effects with thermal stress, but the underlying mechanisms remain elusive. To address the gap, we measured and compared the physiological and transcriptional responses of the Symbiodiniaceae
Cladocopium goreaui
to heat stress (31°C) when supplied with different types of nitrogen (nitrate, ammonium, or urea). Under heat stress (HS), cell proliferation and photosynthesis of
C. goreaui
declined, while cell size, lipid storage, and total antioxidant capacity increased, both to varied extents depending on the nitrogen type. Nitrate-cultured cells exhibited the most robust acclimation to HS, as evidenced by the fewest differentially expressed genes (DEGs) and less ROS accumulation, possibly due to activated nitrate reduction and enhanced ascorbate biogenesis. Ammonium-grown cultures exhibited higher algal proliferation and ROS scavenging capacity due to enhanced carotenoid and ascorbate quenching, but potentially reduced host recognizability due to the downregulation of N-glycan biosynthesis genes. Urea utilization led to the greatest ROS accumulation as genes involved in photorespiration, plant respiratory burst oxidase (RBOH), and protein refolding were markedly upregulated, but the greatest cutdown in photosynthate potentially available to corals as evidenced by photoinhibition and selfish lipid storage, indicating detrimental effects of urea overloading. The differential warming nitrogen-type interactive effects documented here has significant implication in coral–Symbiodiniaceae mutualism, which requires further research.

IMPORTANCE

Regional nitrogen pollution exacerbates coral vulnerability to globally rising sea-surface temperature, with different nitrogen types exerting different interactive effects. How this occurs is poorly understood and understudied. This study explored the underlying mechanism by comparing physiological and transcriptional responses of a coral symbiont to heat stress under different nitrogen supplies (nitrate, ammonium, and urea). The results showed some common, significant responses to heat stress as well as some unique, N-source dependent responses. These findings underscore that nitrogen eutrophication is not all the same, the form of nitrogen pollution should be considered in coral conservation, and special attention should be given to urea pollution.
Structural insights into hybridoma-derived neutralizing monoclonal antibodies against Omicron BA.5 and XBB.1.16 variants of SARS-CoV-2
Authors: Hu Hengrui , Leng Chao , Shu Yanni , Peng Lu , Wu Fan , Liu Jia , Zhang Xiaolu , Zhou Wei , Xiao Qinghong , Li Yufeng , Wu Bihao , Shen Jiamei , Li Jiang , Gong Rui , Yan Bing , Deng Fei , Hu Zhihong , Cao Sheng , Wang Manli
Published: January 2025

The emergence of novel variants of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) continues to pose an ongoing challenge for global public health services, highlighting the urgent need for effective therapeutic interventions. Neutralizing monoclonal antibodies (mAbs) are a major therapeutic strategy for the treatment of COVID-19 and other viral diseases. In this study, we employed hybridoma technology to generate mAbs that target the BA.5 receptor-binding domain (RBD) of the SARS-CoV-2 spike protein. Through a comprehensive screening process, we identified four mAbs capable of effectively neutralizing BA.5, XBB.1.16, and related variant infections
in vitro
, among which ORB10 was found to neutralize BA.5 variants with a plaque reduction neutralization test (PRNT
50
) of 8.7 ng/mL. Additionally, competitive binding assays, sequencing of heavy and light chain variable regions, and binding kinetics characterization provided insights into the epitopes and binding affinities of the identified mAbs. Moreover,
in vivo
experiments in the K18-hACE2 mouse model demonstrated the protective efficacy of ORB10 against both BA.5 and XBB.1.16 variants. Finally, cryo-electron microscopy structural analysis of the ORB10–RBD complex identified key residues involved in the antibody–antigen interactions, providing insights into the molecular mechanisms of neutralization and immune escape of SARS-CoV-2 Omicron variants from mAbs.

IMPORTANCE

The ongoing evolution of SARS-CoV-2 has led to the emergence of variants capable of evading immune responses elicited by natural infection and vaccination, especially the highly transmissible and immune-evasive Omicron variants. This study generated and characterized a panel of monoclonal antibodies (mAbs) specifically targeting the RBD of the Omicron BA.5 variant, of which the ORB10 showed efficacy against Omicron BA.5 and XBB.1.16 variants both
in vitro
and
in vivo
. Cryo-EM structural analysis further elucidated the binding epitope interactions and neutralization mechanism between ORB10 and the BA.5 RBD protein. This study enhances our understanding of antibody-mediated neutralization of SARS-CoV-2 and provides valuable insights into the development of effective therapeutic strategies to combat ongoing SARS-CoV-2 variant infections.
HCMV infection downregulates GPX4 and stimulates lipid peroxidation but does not induce ferroptosis
Authors: Martin Madison , Kumar Rinki , Buchkovich Nicholas J. , Norbury Christopher C.
Published: January 2025

Human cytomegalovirus (HCMV) modulates numerous cellular pathways to facilitate infection, including key components in cellular iron homeostasis. Iron is essential to many cellular processes but, if present in excess, drives cell death through ferroptosis. Ferroptosis is a process that is dependent upon the accumulation of oxidatively damaged phospholipids (lipid peroxides); when these lipid peroxides accumulate in membranes, this culminates in plasma membrane rupture and eventual cell lysis. Here, we demonstrate that HCMV infection downregulates the expression of a key modulator of lipid peroxidation, glutathione peroxidase 4 (GPX4). HCMV infection also markedly increased levels of lipid peroxides within infected cells. Despite the marked downregulation of GPX4 by HCMV, further inhibition of GPX4 impaired virus replication. Interestingly, overexpression of GPX4 did not reduce the production of lipid peroxides within infected cells. In contrast, lipid peroxide levels were reduced by treatment with ferrostatin-1, a ferrous iron-dependent scavenger of alkoxyl radicals, indicating a role for iron in the production of lipid peroxides. HCMV-infected cells became less sensitive to GPX4 inhibition as infection progressed, requiring substantially higher levels of GPX4 inhibitors to induce ferroptosis compared to uninfected cells. This observed difference in sensitivity to ferroptosis upon infection correlated with a large increase in lipid production by infected cells. Therefore, the marked stimulation of lipid peroxidation by HCMV likely proceeds through a pathway that is independent of GPX4 regulation, but the ability of lipid peroxides to stimulate ferroptosis by modulating plasma membrane rupture is likely blunted by the massive increase in lipid production during HCMV infection.

IMPORTANCE

Human cytomegalovirus (HCMV) infection is intimately linked with countless host cell pathways that are modulated in a coordinated fashion to facilitate infection. Here, we describe HCMV-induced regulation of lipid peroxidation, a precursor of the iron-regulated cell death pathway known as ferroptosis, during human cytomegalovirus infection. These studies reveal hitherto unidentified changes in metabolism mediated by HCMV that decrease sensitivity to ferroptosis, despite increases in lipid peroxidation and transient increases in intracellular iron levels in infected cells.
Complete genome sequence of
Bacillus pumilus
X14-67 with antimicrobial properties isolated from aged
Pericarpium citri reticulatae
“Chachiensis”
Authors: He Qianxian , Xiong Shijie , Chen Gu
Published: January 2025

Bacillus pumilus
X14-67 was isolated from
Pericarpium citri reticulatae
“Chachiensis,” the natural aged pericarps of
Citrus reticulata
Blanco. It had inhibitory activity against
Staphylococcus aureus
,
Escherichia coli
,
Salmonella paratyphi
, and
Candida albicans
. Here, its genome was sequenced and annotated to understand its antimicrobial properties.
System-based insights into parasitological and clinical treatment failure in Chagas disease
Authors: Ernst Luis , Macedo Giovana C. , McCall Laura-Isobel
Published: January 2025

Infectious disease treatment success requires symptom resolution (clinical treatment success), which often but not always involves pathogen clearance. Both of these treatment goals face disease-specific and general challenges. In this review, we summarize the current state of knowledge in mechanisms of clinical and parasitological treatment failure in the context of Chagas disease, a neglected tropical disease causing cardiac and gastrointestinal symptoms. Parasite drug resistance and persistence, drug pharmacokinetics and dynamics, as well as persistently altered host immune responses and tissue damage are the most common reasons for Chagas disease treatment failure. We discuss the therapeutics that failed before regulatory approval, limitations of current therapeutic options and new treatment strategies to overcome persistent parasites, inflammatory responses, and metabolic alterations. Large-scale omics analyses were critical in generating these insights and will continue to play a prominent role in addressing the challenges still facing Chagas disease drug treatment.
Endometriosis presenting as catamenial pneumothorax, pneumopericardium and pneumoperitoneum
Authors: Suriya S Siva , Shetty Adarsha
Published: January 2025

A nulliparous woman in her late 30s with a history of pericardial patch repair for atrial septal defect and completed treatment for pulmonary tuberculosis 9 years ago presented with chest pain, breathlessness and abdominal pain. Radiological imaging revealed right-sided pneumothorax, pneumopericardium and pneumoperitoneum for which an intercostal drain (ICD) was placed. A contrast-enhanced CT of the abdomen showed a distal stomach perforation, which was managed conservatively. The ICD was removed after complete lung expansion. She returned twice with similar symptoms coinciding with her perimenstrual period. Imaging suggested a right hemidiaphragm defect, indicating a pleuroperitoneal fistula. Definitive treatment involved laparoscopic diaphragmatic repair and pleurodesis. Histopathology of tissue from a supra-umbilical nodule confirmed endometriosis. Postsurgery, she was initiated on hormonal therapy and has had no recurrence. This case underscores the need to consider endometriosis in women of childbearing age with recurrent pneumothorax.
Massive haemoperitoneum from an unidentified source in a woman with vWD
Authors: Vatsa Richa , Kulshrestha Vidushi , Malhotra Neena , Dhiman Soniya
Published: January 2025

Von Willebrand’s disease (vWD) is an inherited coagulopathy. In women, this condition can present as periovulatory intra-abdominal bleeding or bleeding from the corpus luteum. A diagnosed case of vWD presented as an emergency with nausea, acute abdominal pain and dizziness. There was no history of amenorrhoea, abdominal trauma or bleeding from any other site. Urine pregnancy test was negative. Intra-abdominal bleeding was suspected as her repeat blood counts showed progressive fall in haemoglobin. Emergency laparoscopy was performed with provisional diagnosis of a ruptured ovarian cyst, which confirmed haemoperitoneum. However, both ovaries were normal and no bleeder was identified despite thorough intraoperative exploration. This case highlights that Von Willebrand factor replacement may suffice as the treatment even if the cause of haemorrhage remains unidentified in vWD. The challenges of undertaking surgery in patients with coagulopathy and perioperative management are discussed.
Risk factors for brain metastasis in lung cancer: an umbrella review of systematic reviews and meta-analyses
Authors: Wan Xinliang , Mo Handan , Chen Jixin , Zhou Qichun , Qiu Shenghong , Zou Yongchun , Wu Wanyin , Tang Qing , Wang Sumei
Published: January 2025

Objectives

To conduct an umbrella review to extensively evaluate and summarise the evidence regarding the relationship between risk factors and the occurrence of brain metastasis in lung cancer.

Design

Umbrella review of systematic reviews and meta-analyses.

Data sources

Four databases (PubMed, EMBASE, Web of Science and Cochrane Library) were searched from inception to 10 November 2024.

Eligibility criteria

Systematic reviews and meta-analyses that assessed the relationship between risk factors and brain metastasis in lung cancer were included. Only English language studies were considered.

Data extraction and synthesis

Two authors independently extracted data and assessed the methodological quality and risk of bias of the included studies. Certainty of evidence was evaluated and summarised for each identified risk factor.

Results

Six systematic reviews/meta-analyses were included. The quality of these studies varied, with most having low or critically low methodological quality. Epidermal growth factor receptor mutations, female gender, lung adenocarcinoma and advanced tumour stage were associated with an increased risk of brain metastasis. Prophylactic cranial irradiation and older age were associated with reduced risk.

Conclusions

This umbrella review suggests that several risk factors may be associated with brain metastasis in lung cancer, but the overall quality of evidence is low. Future studies with improved methodologies are needed to validate these findings.

PROSPERO registration number

CRD42023484563
Prevalence of piriformis syndrome and its associated risk factors among university students in Pakistan: a cross-sectional study
Authors: Batool Nusrat , Azam Naila , Moafa Hassan N , Hafeez Azka , Mehmood Humaira , Imtiaz Nimbal , Shehzad Waqas A , Malik Asaad Saleem , Alhazmi Ajiad , Almalki Manal , Moafa Almutasim B , Moshi Jobran M
Published: January 2025

Objective

To determine the prevalence of piriformis syndrome (PS) among undergraduate university health sciences students aged 18 to 25 and assess the significant predictors of PS regardless of its type and severe PS in particular.

Design

A cross-sectional study.

Setting

The study was conducted at a tertiary care hospital of a public university in Pakistan from December 2023 to May 2024.

Participants

A total of 190 subjects enrolled in the study who met the eligibility criteria, which included being an undergraduate health sciences student (medical and allied health specialities), aged 18 up to 25 years, and willing to participate in the study. Participants were selected using multistage random sampling.

Primary and secondary outcome measures

The prevalence of PS in addition to associated risk factors as a primary outcome measures. Secondary outcome measures included the severity of PS.

Results

Of the total, 119 (62.6%) were female, 114 (60.0%) were between 22 and 25 years old, and 125 (65.8%) had standard body mass index. The prevalence of PS was (61.1%), whereas half suffered from severe PS, and the remaining half had mild and moderate PS. We found that factors such as casual sitting positions, sitting duration and International Physical Activity Questionnaire (IPAQ) score (physical activity) were associated with odds of PS in the crude and adjusted regression analyses. When stratified by severity of PS, factors such as writing positions, casual sitting positions, sitting duration and IPAQ score (physical activity) were associated with odds of severe PS in the crude and adjusted regression analyses.

Conclusions

Students have a high prevalence of PS, with an increased likelihood of buttock pain associated with prolonged sitting, poor posture and physical inactivity. Future research that includes several factors related to students’ social and psychological backgrounds is required.
Effect of early establishment of full enteral feeding with exclusive mother’s own milk in preterm babies: a retrospective cohort study
Authors: Umasekar Urmila , Amboiram Prakash , Balakrishnan Umamaheswari , Sirala Jagadeesh Nalini
Published: January 2025

Background

Human milk, especially the mother’s own milk (MOM), is highly recommended for preterm babies considering its numerous benefits. Prioritising the use of exclusive MOM in enteral feeding plans is essential for maximising the health and development of preterm babies. This study evaluated the effect of early establishment of full enteral feed (FEF) with exclusive MOM on feeding rate and neonatal nutritional outcomes at discharge among preterm babies.

Methods

A retrospective cohort study was conducted using medical records of single preterm babies born between 27 and 33+6weeks of gestational age and admitted to a single tertiary care hospital in South India between June 2019 and May 2022. The primary exposure was the establishment of FEF with exclusive MOM. The outcomes assessed were the exclusive MOM feeding rate and neonatal nutritional outcomes at discharge.

Results

A total of 160 preterm babies met the inclusion criteria. Among these 104 (65%) achieved FEF with exclusive MOM. The exclusive MOM feeding rate at discharge was significantly higher among preterm babies who achieved FEF with exclusive MOM, 91.3% vs 62.5% (RR: 1.46 (95% CI: 1.18 to 1.81)). Preterm babies who achieved FEF with exclusive MOM were five times more likely to continue exclusive MOM feeding at discharge (aOR: 5.37, 95% CI: 2.04 to 14.16). The median time taken to achieve exclusive MOM among the exposure group was 6 days (95% CI: 5.6 to 6.3) compared with 12 days (95% CI: 10.2 to 13.8) for the unexposed group (HR: 0.26 (95% CI: 0.17 to 0.38; p<0.001)). There was no significant difference in growth and neonatal complications between the groups. Availability of MOM within 48 hours was strongly associated with achieving FEF with exclusive MOM, with an adjusted OR of 6.12 (95% CI: 2.81 to 13.30).

Conclusions

Early establishment of FEF with exclusive MOM increases the exclusive MOM feeding rate at discharge. Early access to MOM within 48 hours significantly enhances the likelihood of achieving FEF with exclusive MOM.
Analysis of 19 439 lower limb amputations in children in Brazilian health system over 14 years
Authors: Portela Felipe Soares Oliveira , Louzada Andressa Cristina Sposato , da Silva Marcelo Fiorelli Alexandrino , Portugal Maria Fernanda Cassino , Galvão Fernando Ayroza , Teivelis Marcelo Passos , Junior Edson Amaro , Wolosker Nelson
Published: January 2025

Background

Amputations in children represent significant events. Few studies analyse amputations in this specific population, and most of them are old, regionalised and with small sample sizes. Besides, there are no large studies in low-income and middle-income countries. This study aims to analyse a large sample of amputations (19 439 procedures performed in the Brazilian public health system) in children aged 0–14 over 14 years.

Methods

Retrospective cross-sectional population-based analysis of all lower limb amputations performed in the Brazilian public health system between 2008 and 2021 in children up to 14. Using a public database, all types of amputations were selected, defining the number of procedures, their main aetiologies, trends over the years, patient demographics and regional distribution.

Results

19 439 lower limb amputations were performed in the Brazilian public health system between 2008 and 2021, mainly at the toe level (85%). Amputations occurred predominantly in males (64%) and children aged 0–4 (47%). The global trend is a non-significant decrease in the total number of amputations over the period (p=0.427), but we observe a significant decrease (p<0.001) in amputations in older children (aged 10–14). Amputations are more concentrated in the most populated regions, while the highest mortality is found in the least densely populated areas. Trauma is the main aetiology associated with lower limb amputations in Brazilian children (60%).

Conclusion

The epidemiology of amputations in Brazil differs from the rest of the world. Trauma is the main aetiology.
Construction of a ‘civilised smoking environment’: a novel strategy undermining tobacco control efforts in China
Authors: Deng Hui , Fang Ling , Mao Yimeng , Zhao Yuchen , Qian Chenyu , Guo Wenjie , Zhu Weiyun , Yan Xiaotao , Wen Sisi , Zhang Shuai , Wang Fan , Zheng Pinpin
Published: January 2025

Objective

In 2018, the Chinese tobacco industry initiated the nationwide ‘civilised smoking environment’ campaign via a 5-year action plan. The goal of this study was to analyse content of reports regarding this topic as evidence to policy-makers to prevent interference from the tobacco industry.

Methods

A search of WiseNews, a Chinese media information service provider, for reports regarding the ‘civilised smoking environment’ between January 2018 and December 2022. Reports were coded separately by two trained researchers using a codebook developed by the team, including four sections with 19 items.

Results

A total of 1062 reports were included, of which 66.5% were from general media. Key themes include mention of approaches to promote the civilised smoking environment (59.8%), primarily by establishing civilised smoking areas (86.1%). A majority of reports (72.9%) disclosed key promoters of these initiatives, including the Tobacco Monopoly Administration (69.5%), Tobacco Corporation (52.3%) and other government agencies (20.4%). Funders were mentioned in 252 reports (23.7%), primarily the Tobacco Monopoly Administration (60.3%) and Tobacco Corporation (50.8%). Most reports (92.8%) supported these initiatives, while only 45 (4.2%) opposed it.

Conclusions

‘Civilised smoking environment’ in China was promoted and financed primarily by tobacco industry and widely supported by media. This undermines smoke-free environments and violates the WHO Framework Convention on Tobacco Control. China’s government should cease its involvement in these initiatives, and government agencies should refrain from agreeing, supporting, cooperating or participating in these activities.
Scalable Subsampling Inference for Deep Neural Networks
Authors: Wu Kejin , Politis Dimitris N.
Published: January 2025

Deep neural networks (DNN) have received increasing attention in machine learning applications in the past several years. Recently, a non-asymptotic error bound has been developed to measure the performance of the fully connected DNN estimator with ReLU activation functions for estimating regression models. The article at hand gives a small improvement on the current error bound based on the latest results on the approximation ability of (forward) DNN. More importantly, however, a non-random subsampling technique—scalable subsampling—is applied to construct a “subbagged” DNN estimator. Under regularity conditions, it is shown that the subbagged DNN estimator is computationally efficient without sacrificing accuracy for either estimation or prediction tasks. Beyond point estimation/prediction, we propose different approaches to build confidence and prediction intervals based on the subbagged DNN estimator. In addition to being asymptotically valid, the proposed confidence/prediction intervals appear to work well in finite samples. All in all, the scalable subsampling DNN estimator offers the complete package in terms of statistical inference, i.e., (a) computational efficiency; (b) point estimation/prediction accuracy; and (c) allowing for the construction of practically useful confidence and prediction intervals.
US-Guided Thermal Ablation for Secondary Hyperparathyroidism: A Prospective Multicenter Study
Authors: Liu Yang , Peng Cheng-zhong , Chai Hui-hui , Qian Lin-xue , Wu Song-song , Yu Ming-an , Li Shui-ping , Zhang Jian-tang , Shan Yue , Liu Fang-yi , Sun Chong-bing , Yang Zhi-wei , Zhang Rui , Che Ying , Gao Shu-hang , Yu Jie , Liang Ping
Published: January 2025

US-guided microwave and radiofrequency ablation were effective and relatively safe for the treatment of secondary hyperparathyroidism in a multicenter prospective cohort of participants.
Endovascular Thrombectomy for Acute Vertebrobasilar Artery Occlusion with Mild Deficits: A Multicenter Registry Study
Authors: Sun Wen , Zhang Pan , Hu Miaomiao , Zhong Jinghui , Zhang Wanqiu , Dong Yiran , Chao Xian , Huang Hongmei , Wen Jie , Xiao Lulu , Xu Yingjie
Published: January 2025

In patients with vertebrobasilar artery occlusion and National Institutes of Health Stroke Scale score of 10 or less, endovascular thrombectomy did not outperform best medical management alone; however, prompt thrombectomy after admission could improve patient outcomes.
ALKBH5 promotes autophagy and progression by mediating m6A methylation of lncRNA UBOX5-AS1 in endometriosis
Authors: Liu Hengwei , Liang Jiaxin , Wang Xiaoli , Xiong Wenqian , Zhang Ling , Dai Xin , Wang Xiuping , Wang Xiwen , Xu Ying , Liu Yi
Published: January 2025

In the present study, we investigated the role and potential molecular mechanism of long noncoding RNA (lncRNA) UBOX5-AS1 in ovarian endometriosis progression. Combined with the aforementioned, we proposed the hypothesis that lncRNA UBOX5-AS1 regulated by Alk B homologous protein 5 (ALKBH5)-mediated N6-methyladenosine (m6A) modification contributes to the progression of ovarian endometriosis progression.
Plasticity of enteric neurotransmission varies during day-night cycles and with feeding state
Authors: Leembruggen Anita J. L. , Yildiz Gunes S. , Hardee Justin P. , Stamp Lincon A. , Bornstein Joel C. , Hao Marlene M.
Published: January 2025

Neuronal activity in the enteric nervous system changes during the 24-h day/night cycle, with increased neuronal function detected at night when mice are feeding and active. However, following an acute fast, neuronal sensitivity becomes more pronounced during the day. These changes in neuronal function did not correlate with changes in neurotransmitter receptor gene expression levels.
Pregnancy-specific shifts in the maternal microbiome and metabolome in the BPH/5 mouse model of superimposed preeclampsia
Authors: Beckers Kalie F. , Schulz Christopher J. , Flanagan Juliet P. , Blair Robert V. , Liu Chin-Chi , Childers Gary W. , Sones Jenny L.
Published: January 2025

This is the first time the pregnant fecal microbiome has been identified in the BPH/5 spontaneous mouse model of superimposed PE. Community composition changed with the onset of pregnancy in this model. BPH/5 showed an altered colonic signaling with decreased GPR41 expression, suggesting that gut dysbiosis may link SCFA signaling to the PE phenotype. This data highlights the importance of the maternal obesogenic gut microbiome in pregnancy.