bluuebunny/crossref_metadata_2025 huggingface dataset:
Systematic in vitro evolution in
Plasmodium falciparum
reveals key determinants of drug resistance
Authors: Luth Madeline R. , Godinez-Macias Karla P. , Chen Daisy , Okombo John , Thathy Vandana , Cheng Xiu , Daggupati Sindhu , Davies Heledd , Dhingra Satish K. , Economy Jan M. , Edgar Rebecca C. S. , Gomez-Lorenzo Maria G. , Istvan Eva S. , Jado Juan Carlos , LaMonte Gregory M. , Melillo Bruno , Mok Sachel , Narwal Sunil K. , Ndiaye Tolla , Ottilie Sabine , Palomo Diaz Sara , Park Heekuk , Peña Stella , Rocamora Frances , Sakata-Kato Tomoyo , Small-Saunders Jennifer L. , Summers Robert L. , Tumwebaze Patrick K. , Vanaerschot Manu , Xia Guoqin , Yeo Tomas , You Ashley , Gamo Francisco-Javier , Goldberg Daniel E. , Lee Marcus C. S. , McNamara Case W. , Ndiaye Daouda , Rosenthal Philip J. , Schreiber Stuart L. , Serra Gloria , De Siqueira-Neto Jair Lage , Skinner-Adams Tina S. , Uhlemann Anne-Catrin , Kato Nobutaka , Lukens Amanda K. , Wirth Dyann F. , Fidock David A. , Winzeler Elizabeth A.
Published: November 2024

Surveillance of drug resistance and the discovery of novel targets—key objectives in the fight against malaria—rely on identifying resistance-conferring mutations in
Plasmodium
parasites. Current approaches, while successful, require laborious experimentation or large sample sizes. To elucidate shared determinants of antimalarial resistance that can empower in silico inference, we examined the genomes of 724
Plasmodium falciparum
clones, each selected in vitro for resistance to one of 118 compounds. We identified 1448 variants in 128 recurrently mutated genes, including drivers of antimalarial multidrug resistance. In contrast to naturally occurring variants, those selected in vitro are more likely to be missense or frameshift, involve bulky substitutions, and occur in conserved, ordered protein domains. Collectively, our dataset reveals mutation features that predict drug resistance in eukaryotic pathogens.
Aromatic-aliphatic hydrocarbon separation with oriented monolayer polyhedral membrane
Authors: Sun Hao , Wang Naixin , Xu Yinghui , Wang Fengkai , Lu Jun , Wang Huanting , An Quan-Fu
Published: November 2024

Aromatic
-
aliphatic hydrocarbon separation is a challenging but important industrial process. Pervaporation membrane technology has the potential for separating these mixtures. We developed an oriented monolayer polyhedral (OMP) membrane that consists of a monolayer of ordered polyhedral particles and is anchored by hyperbranched polymers. It contains a high density of straight, selective nanochannels, enabling the preferential transport of aromatic molecules. Compared with traditional mixed-matrix membranes with random orientations, the OMP membrane improves the pervaporation separation index for aromatic-aliphatic hydrocarbon mixtures with C
6
and C
7
compounds, surpassing the performance of existing membranes by 3 to 10 times. This high performance demonstrates the potential of OMP membranes for hydrocarbon molecular separation and their application in the value-added separation of naphtha feedstocks.
DNA and deli sandwiches
Authors: Campos Luis A.
Published: November 2024

On the anniversary of a pivotal patent, a historian probes biotechnology’s origin story
Micrometer-sized robotic chameleons
Authors: Coulais Corentin , van de Groep Jorik
Published: November 2024

A multifunctional metamaterial can change shape and steer light simultaneously
Fake papers compromise research syntheses
Authors: Else Holly
Published: November 2024

“Systematic reviews” that aim to extract broad conclusions from many studies are in peril
Determinants of Leptomeningeal Collateral Status in Acute Ischemic Stroke: A Systematic Review and Meta‐Analysis of Observational Studies
Authors: Li Kunyi , Jiang Hua , Yu Jianping , Liu Yong , Zhang Lili , Ma Bi , Zhu Shu , Qi Yinkuang , Li Shuang , Huang Yan , Yang Yuhan , Xia Xun , Wen Lan
Published: November 2024

Background

Leptomeningeal collateral status is a major determinant of outcomes in patients with acute ischemic stroke; however, the factors that determine collateral status are not well understood. We conducted a comprehensive systematic review and meta‐analysis to identify determinants associated with collateral status in patients with anterior circulation infarction.

Methods and Results

The PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials databases were searched for studies that reported the determinants of leptomeningeal collateral status in acute ischemic stroke between January 2000 and June 2023. A random‐effects meta‐analysis model was used to pool the determinants of leptomeningeal collateral status. Eighty‐one studies with 17 366 patients met the inclusion criteria. We analyzed 31 potential risk factors, and the results indicated that worse leptomeningeal collateral status was significantly associated with older age (weighted mean difference, 1.22 [95% CI, 0.69 to 1.76]), male sex (odds ratio [OR], 1.12 [95% CI, 1.02 to 1.23]), hypertension (OR, 1.27 [95% CI, 1.15 to 1.40]), diabetes (OR, 1.21 [95% CI, 1.10 to 1.33]), atrial fibrillation (OR, 1.26 [95% CI, 1.09 to 1.46]), cardioembolic stroke (OR, 1.27 [95% CI, 1.04 to 1.55]), internal carotid artery occlusion (OR, 1.84 [95% CI, 1.50 to 2.25]), and higher admission blood glucose (weighted mean difference, 8.74 [95% CI, 2.52 to 18.51]).

Conclusions

Hypertension and diabetes could be modifiable risk factors associated with leptomeningeal collateral status. Older age and male sex could be nonmodified risk factors. Further high‐quality therapeutic studies focusing on controlling risk factors are needed to support our findings.
Clonal Hematopoiesis in Chronic Thromboembolic Pulmonary Hypertension
Authors: Momoi Mizuki , Katsumata Yoshinori , Kunimoto Hiroyoshi , Inami Takumi , Miya Fuyuki , Anzai Atsushi , Goto Shinichi , Miura Ayaka , Shinya Yoshiki , Hiraide Takahiro , Shirakawa Kohsuke , Endo Jin , Fukuda Keiichi , Ieda Masaki , Kosaki Kenjiro , Nakajima Hideaki , Kataoka Masaharu
Published: November 2024

Background

The cause of chronic thromboembolic pulmonary hypertension (CTEPH) remains largely unknown. Recently, clonal hematopoiesis (CH) has been reported to be associated with cardiovascular and thromboembolic diseases. Here, we investigated the prevalence and clinical impact of CH in patients with CTEPH.

Methods and Results

Whole‐exome sequencing and deep‐panel sequencing were performed in 214 patients with CTEPH. Clinical data before and after treatment were compared between patients with and without CH. RNA sequencing and serum analysis were performed to explore the pathogenesis that CH contributes to CTEPH. Among the enrolled patients, 20.1%, notably 44.4% who were 80 to 89 years old, had variants in CH‐associated genes. In regard to clinical impact, B‐type natriuretic peptide levels and home oxygen therapy rate were significantly higher, and 6‐minute walk distance was significantly shorter after treatment in patients with CH than in those without CH. Moreover, novel clot reformation in the pulmonary artery despite the use of anticoagulants and additional angioplasty events after treatment completion were more frequent in patients with CH. RNA sequencing analysis revealed that blood coagulation and neutrophil extracellular trap formation pathways were enriched in patients with CH. Additionally, serum citrullinated histone H3 levels were higher in patients with CH than those without CH. These results were consistent in the subgroup of patients who did not have the history of hematological disorders.

Conclusions

The findings in this study raise the possibility that CH will induce a more prothrombotic state through neutrophil activation and neutrophil extracellular trap formation, contributing to pathogenesis and poor treatment response in patients with CTEPH.
Left Ventricular 3‐Dimensional Global Longitudinal Strain Predicts All‐Cause Mortality in Patients With Heart Transplant
Authors: Zhu Shuangshuang , Wu Chun , Zhang Yiwei , Qiao Weihua , Dong Nianguo , Li Yuman , Xie Mingxing , Zhang Li
Published: November 2024

Background

The prognostic value of 3‐dimensional (3D)‐left ventricular global longitudinal strain (LVGLS) in recipients of heart transplant (HT) reremains unknown. This study aimed to determine whether 3D‐LVGLS was the more powerful predictor of poor outcomes in recipients of HT compared with 2‐dimensional (2D)‐LVGLS.

Methods and Results

All consecutive adult patients who received HT and underwent at least 1 comprehensive 2D and 3D transthoracic echocardiographic examination for clinical surveillance were retrospectively enrolled. The end point was all‐cause mortality. Prognostic model performance was assessed according to the C‐statistic. The 3D‐LVGLS measurements were feasible in 294 of 342 patients with HT (86%). The median follow‐up time was 53 months, and 44 HT redied. Receiver operating characteristic curves revealed that the area under the curve for predicting all‐cause mortality was greater for 3D‐LVGLS than 2D‐LVGLS (0.77 versus 0.67,
P
=0.012). When HT stratified patients with HT into tertiles according to 3D‐LVGLS values, patients with lower 3D‐LVGLS had worse outcome (
P
<0.001). The multivariable Cox analysis showed that the model with 3D‐LVGLS (hazard ratio [HR],1.44 [95% CI,1.24–1.68];
P
<0.001; C‐statistic=0.814) was better in predicting death than the model with 2D‐LVGLS (HR, 1.19 [95% CI, 1.06–1.32];
P
=0.002; C‐statistic=0.772). The best cutoff value of 3D‐LVGLS for detecting all‐cause mortality was −16.1%, with a sensitivity of 63.6% and a specificity of 84.0%.

Conclusions

The 3D‐LVGLS was a powerful predictor of all‐cause mortality in patients receiving HT and provided greater prognostic value than 2D‐LVGLS. Our study highlighted the potential of evaluating 3D‐LVGLS for risk stratification in recipients of HT.
Urinary Dickkopf‐3 as a Potential Marker for Estimated Glomerular Filtration Rate Decline in Patients With Heart Failure
Authors: Pieper Dennis , Sandek Anja , Schäfer Ann‐Kathrin , Dihazi Hassan , Dihazi Gry Helene , Leha Andreas , Zeisberg Michael , Lüders Stephan , Koziolek Michael , Wallbach Manuel
Published: November 2024

Background

Patients with chronic heart failure (HF) show an increased risk for the occurrence of chronic kidney disease and cardiorenal syndrome. Urinary Dickkopf‐3 (uDKK3), a stress‐induced, tubular profibrotic glycoprotein, may be elevated in HF as early as in New York Heart Association class I HF and may indicate subsequent decline in estimated glomerular filtration rate (eGFR).

Methods and Results

uDKK3 levels in patients with HF and controls were measured by enzyme‐linked immunosorbent assay. eGFR was determined up to 5 years in HF. Change in eGFR was assessed with respect to baseline uDKK3 using (mixed‐effect) linear and logistic regression models. A total of 488 patients with chronic HF and 45 control patients were included. Patients with HF showed higher median uDKK3 levels than controls (259.6 pg/mg creatinine [interquartile range (IQR), 119.2–509.4 pg/mg creatinine] versus 107.5 pg/mg creatinine [IQR, 60.5–181.2 pg/mg creatinine],
P
<0.001). Regression models demonstrated a significant association between log uDKK3 and the decline in eGFR during a median of 13 months (IQR, 12–59 months) (estimated higher eGFR loss, 0.8039 mL/min per 1.73 m
2
/year [95% CI, 0.002–1.606 mL/min per 1.73 m
2
/year],
P
=0.049; odds ratio, 1.345 [95% CI, 1.049–1.741],
P
=0.021). uDKK3 levels ≥354 pg/mg creatinine were associated with a significantly higher risk for eGFR decline at 1‐year follow‐up (estimated higher eGFR loss, 4.538 mL/min per 1.73 m
2
[95% CI, 1.482–9.593 mL/min per 1.73 m
2
]),
P
=0.004). Even patients with HF without chronic kidney disease (n=334) had higher uDKK3 levels compared with controls (233.4 [IQR, 109.0–436.9 pg/mg creatinine] versus 107.5 [IQR, 60.5–181.2 pg/mg creatinine],
P
<0.001).

Conclusions

The present findings indicate that uDKK3 is a promising prognostic biomarker for subsequent eGFR decline in patients with HF, irrespective of the presence of chronic kidney disease and even in the early stages of HF. This potential allows for early intervention to mitigate the deterioration of kidney function. Further investigation is warranted to validate its clinical utility.
Multimodal Data‐Driven Prognostic Model for Predicting Long‐Term Prognosis in Patients With Ischemic Cardiomyopathy and Heart Failure With Preserved Ejection Fraction After Coronary Artery Bypass Grafting: A Multicenter Cohort Study
Authors: Wang Jun , Wang Yijun , Duan Shoupeng , Xu Li , Xu Yanan , Yin Wenyuan , Yang Yi , Wu Bing , Liu Jinjun
Published: November 2024

Background

Limited data from the literature are available to assess the efficacy of coronary artery bypass grafting in patients with ischemic cardiomyopathy and heart failure with preserved ejection fraction. Therefore, our objective was to use machine learning techniques integrating clinical features, biomarker data, and echocardiography data to enhance comprehension and risk stratification in patients diagnosed with ischemic cardiomyopathy and heart failure with preserved ejection fraction who have undergone coronary artery bypass grafting surgery.

Methods and Results

For this study, 294 patients with ischemic cardiomyopathy and heart failure with preserved ejection fraction who underwent coronary artery bypass grafting surgery were assigned to the development cohort (n=176) and the independent validation cohort (n=118). A total of 52 clinical variables were extracted for each patient. The principal clinical end point was the incidence of major adverse cardiovascular events, encompassing cardiac mortality, acute myocardial infarction, acute heart failure, and graft failure. From least absolute shrinkage and selection operator regression, 4 predictors were selected for the final prediction nomogram: diabetes, hypertension, the systemic immune‐inflammation index, and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide). The prediction nomogram achieved satisfactory prediction performance in both the development cohort (C index, 0.768 [95% CI, 0.701–0.835]) and independent validation cohort (C index, 0.633 [95% CI, 0.521–0.745]). Adequate calibration was noted for the likelihood of major adverse cardiovascular events in both the development and independent validation cohorts. Decision curve analysis confirmed the clinical usefulness of the established prediction nomogram.

Conclusions

A clinically feasible prognostic model, based on preoperative multimodal data, was developed for risk stratification of patients with ischemic heart and heart failure with preserved ejection fraction who receive coronary artery bypass grafting surgery.

Registration

https://www.chictr.org.cn
; Unique identifier: ChiCTR2300074439.
Coronary Microvascular Dysfunction Is Associated With Augmented Lysosomal Signaling in Hypercholesterolemic Mice
Authors: Wang Yun‐Ting , Moura Alexandra K. , Zuo Rui , Zhou Wei , Wang Zhengchao , Roudbari Kiana , Hu Jenny Z. , Li Pin‐Lan , Zhang Yang , Li Xiang
Published: November 2024

Background

Accumulating evidence indicates that coronary microvascular dysfunction (CMD) caused by hypercholesterolemia can lead to myocardial ischemia, with or without obstructive atherosclerotic coronary artery disease. However, the molecular pathways associated with compromised coronary microvascular function before the development of myocardial ischemic injury remain poorly defined. In this study, we investigated the effects of hypercholesterolemia on the function and integrity of the coronary microcirculation in mice and the underlying mechanisms.

Methods and Results

Mice were fed a hypercholesterolemic Paigen's diet for 8 weeks. Echocardiography data showed that Paigen's diet caused CMD, characterized by significant reductions in coronary blood flow and coronary flow reserve, but did not affect cardiac remodeling or dysfunction. Immunofluorescence studies revealed that Paigen's diet–induced CMD was associated with activation of coronary arterioles inflammation and increased myocardial inflammatory cell infiltration. These pathological changes occurred in parallel with the upregulation of lysosomal signaling pathways in endothelial cells (ECs). Treating hypercholesterolemic mice with the cholesterol‐lowering drug ezetimibe significantly ameliorated Paigen's diet–induced adverse effects, including hypercholesterolemia, steatohepatitis, reduced coronary flow reserve, coronary endothelial cell inflammation, and myocardial inflammatory cell infiltration. In cultured mouse cardiac ECs, 7‐ketocholesterol increased mitochondrial reactive oxygen species and inflammatory responses. Meanwhile, 7‐ketocholesterol induced the activation of transcriptional factor EB and lysosomal signaling in mouse cardiac ECs, whereas the lysosome inhibitor bafilomycin A1 blocked 7‐ketocholesterol–induced transcriptional factor EB activation and exacerbated 7‐ketocholesterol–induced inflammation and cell death. Interestingly, ezetimibe synergistically enhanced 7‐ketocholesterol–induced transcriptional factor EB activation and attenuated 7‐ketocholesterol–induced mitochondrial reactive oxygen species and inflammatory responses in mouse cardiac ECs.

Conclusions

These results suggest that CMD can develop and precede detectable cardiac functional or structural changes in the setting of hypercholesterolemia and that upregulation of transcriptional factor EB–mediated lysosomal signaling in endothelial cells plays a protective role against CMD.
Is Bündnis Sahra Wagenknecht A New Alternative for Populist Voters?
Authors: Thomeczek Jan Philipp
Published: November 2024

In just five months, Bündnis Sarah Wagenknecht (BSW) progressed from its foundation to winning six seats in the European Parliament. Research has indicated that the party has significant potential, particularly among voters of Germany’s two populist parties: Alternative for Germany (AfD) and Die Linke. Since BSW is also classified as a populist party, this article explores the extent to which populist attitudes influence the vote choice preference for BSW. The analysis employs a three-dimensional populism scale, using data from a VAA-like website. The results reveal that voters intending to vote for BSW exhibit strong anti-elitist and people-centric views, but do not hold Manichean outlooks. This positions BSW voters ideologically between Die Linke and AfD voters in terms of populist ideation – albeit closer to the AfD, reflecting the party-level populism of BSW. Additionally, populist attitudes, particularly anti-elitism, are significant predictors of vote-switching from other parties to BSW.
Chenzhilinus, a new subgenus of Euconnus Thomson (Coleoptera: Staphylinidae: Scydmaeninae) from southern China
Authors: YIN ZI-WEI , ZHOU DE-YAO
Published: November 2024

A new subgenus of Euconnus Thomson, Chenzhilinus subgen. nov., is erected for E. (C.) huapingensis sp. nov. collected from Huaping National Nature Reserve in the southern Chinese province of Guangxi. The new subgenus is morphologically most similar to Euconnus s. str. and appears to represent a derived form of the nominotypical subgenus. Chenzhilinus is primarily characterized by two putatively apomorphic traits: the submentum is clearly demarcated laterally by an additional pair of posteriorly convergent hypostomal carinae; and the aedeagus is devoid of parameres.
Host resistance responses against Puccinia striiformis f. sp. tritici in wheat cultivars with different resistance levels: molecular, biochemical, and ultrastructural studies
Authors: El-Sharkawy Hany H. A. , Rashad Younes M. , Baka Zakaria A. M. , Madbouly Adel K. , Badeea Osama E. Abd El
Published: November 2024

Background

Yellow (stripe) rust of wheat, caused by Puccinia striiformis, is a serious disease that results in great economic losses. This study aimed to investigate the variation in plant responses in three wheat cultivars with different resistance levels against yellow rust.

Results

The highest disease severity was recorded for cv. Gemmieza-11 (95%), followed by cv. Shandweel 1 (60%), while the lowest was recorded for cv. Misr-3 (3%). qPCR results of the yellow rust-resistance genes Yr5, Yr10, Yr15, and Yr18 showed that the infection did not affect the expression of Yr5 and Yr15 in the infected Gemmieza-11 plants when compared to the non-infected control. In contrast, the infection significantly overexpressed Yr5 and Yr15 in cvs. Shandweel 1 and Misr-3. However, Misr-3 was superior in this regard, recording 3.85- and 4.07-fold for Yr5 and Yr15, respectively. In addition, the infection significantly upregulated Yr10 and Yr18 in the three tested cultivars, with the superiority for the cultivar Misr-3, followed by Shandweel 1. Activity of the antioxidant enzymes peroxidase, polyphenol oxidase, and catalase was significantly higher in the infected plants of cv. Misr-3 than in cv. Shandweel-1, while the lowest values were recorded in cv. Gemmieza-11. The increment in this activity was associated with a reduction in the lipid peroxidation in the three tested cultivars. The phenolic content considerably increased also upon infection in cv. Misr-3 followed by Shandweel-1 but not in cv. Gemmieza-11, compared to the non-infected plants. Transmission electron microscopy demonstrated that the infected mesophyll cells in cv. Gemmieza-11 showed abnormalities in the chloroplasts and thick-walled haustoria. On the contrary, the mesophyll cells in cv. Misr-3 showed no haustoria and well organized chloroplasts. The mesophyll cells in cv. Shandweel-1 displayed highly degenerated haustoria, a degenerated granulated cytoplasm, and a thick host cell wall, indicating intermediate defense responses against the invading pathogen. Plant growth, yield, and photosynthetic pigments were higher in cv. Misr-3, followed by cv. Shandweel-1, and the lowest values were recorded in cv. Gemmieza-11.

Conclusions

The obtained results displayed that Yr5 and Yr15 were more effective than Yr10 and Yr18, indicating their main roles in regulating multiple defense mechanisms and hypersensitive responses.
Stressors for farmworker parents during wildfire season
Authors: D’Evelyn Savannah M , Nerenberg Isabel , Blancas Maria , Rivera Laura , Suarez Alyssa , Drury Dennise O , Kasner Edward J
Published: November 2024

Background

The severity of wildfire seasons amplify stressors that farmworker families in the Pacific Northwest face as they balance childcare, work, and personal wellbeing. A lack of safe and attainable childcare has been a challenge for farmworker parents since before the Covid-19 pandemic and is of particular concern during wildfire season when parents must weigh the risks and benefits of leaving children at home, taking them to work, or sending them to childcare. This study describes how stressors of balancing childcare, work, and concerns about children’s exposure to smoke during wildfire season impact the wellbeing and workplace absenteeism and presenteeism for farmworker parents.

Methods

To understand the impact of this balancing act on farmworker parents, researchers from the University of Washington partnered with Wenatchee’s Community for the Advancement of Family Education to conduct interviews with 20 farmworker parents, and co-host two town hall discussion meetings within the community.

Results

Six qualitative themes emerged from our interviews including that farmworker parents feel both ill-prepared at home to protect their families, and also do not feel as though they are being provided with adequate resources at work to protect their own personal health. Through the town hall events, we learned that verbal messaging and storytelling are effective and appreciated routes of communication.

Conclusions

Overall, we found that messaging and effective communication around how to prepare for the worsening levels of smoke is lacking among the farmworker community. Future research will address the messaging and communication gaps that must be filled to protect the health of both workers and their families during smoke season and beyond.
The association of different types of stress, and stress accumulation with low back pain in call-center workers - a cross-sectional observational study
Authors: Brenner-Fliesser Michael , Houtenbos Sanne , Ewerton Marie , Bontrup Carolin , Visscher Rosa , Taylor William R. , Zemp Roland , Wippert Pia-Maria
Published: November 2024

Background

Low back pain (LBP) is a common health complaint and a prominent factor in the development of LBP among the working population is stress. Mostly, stress is addressed as a general problem, which is why LBP prevention programs are often imprecise. Accordingly, a closer look at the association between specific stress types and the development of LBP is necessary. Therefore, this paper aims (1) to identify the stress types most closely associated with LBP; (2) to examine the relationship between stress accumulation and LBP.

Methods

n = 100 call-center workers were approached for participation. Stress levels and LBP were assessed with questionnaires (TICS, ERI, CPG, BPI) and hair cortisol levels were measured (ELISA-KIT, 3-months period). Mann-Whitney U tests were used to identify stress types most closely associated with LBP. Further, ANCOVA analysis was conducted to determine the association of the number of experienced stress types with LBP intensity and impairment.

Results

Finally, data from n = 68 participants (mean age: 43.2 (± 12.8) years; 62% female) were used for presented analysis. Participants, who were affected by work-related stress showed higher pain severity (excessive demands at work: 23.6 ± 21.8 vs. 42.4 ± 25.0 (p = 0.005)) and more impairment (excessive demands at work: 13.7 ± 17.6 vs. 28.7 ± 22.3 (p = 0.003); work overload: 15.4 ± 20.4 vs. 26.3 ± 17.4 (p = 0.009)) than their less affected colleagues. Other stress types (e.g. Effort, Reward) showed no significant association with LBP. Furthermore, participants who experienced two or more of the most associated stress types simultaneously suffered from stronger pain and more impairment (p < 0.01).

Conclusions

The results suggest that it is essential to divide and evaluate stress in specific domains. Furthermore, the accumulation of different stress types and the resulting physiological load should be taken into account when designing prevention and intervention programs. Results may be of high relevance for the development of LBP prevention programs for people within a predominantly sitting working context.
How to establish and sustain a disease registry: insights from a qualitative study of six disease registries in the UK
Authors: Stubbs Edmund , Exley Josephine , Wittenberg Raphael , Mays Nicholas
Published: November 2024

Background

The advent of new chronic conditions such as long COVID-19 raises the question of whether and, if so, how best to establish new disease registries for such conditions. Prompted by the potential need for a long COVID-19 registry, we examined experiences of existing UK disease registries to understand barriers and enablers to establishing and sustaining a register, and how these have changed over time.

Methods

We undertook semi-structured interviews between November 2022 and April 2023 with individuals representing six disease registries that collect individual-level longitudinal data on people diagnosed with a chronic condition.

Results

Registries examined were developed by a few individuals, usually clinicians, to gain a greater understanding of the disease. Patient voices were largely absent from initial agenda setting processes, but, over time, all registries sought to increase patient involvement.

Securing long-term funding was cited as the biggest challenge; due to limited funds, one of the registries examined no longer actively recruits patients. Charities devoted to the diseases in question were key funders, though most registries also sought commercial opportunities. Inclusion on the NIHR Clinical Research Network Portfolio was also considered a vital resource to support recruitment and follow-up of participants.

All registries have sought to minimise the primary data collected to reduce the burden on clinicians and patients, increasingly relying on linkage to other data sources. Several registries have developed consent procedures that enable participants to be contacted for additional data collection. In some cases, the initial patient consent and data sharing permissions obtained had limited the flexibility to adapt the registry to changing data needs. Finally, there was a need to foster buy-in from the community of patients and clinicians who provide and/or use the data.

Conclusion

We identified six key considerations when establishing a sustainable disease registry: (1) include a diverse set of stakeholders; (2) involve patients at every stage; (3) collect a core data set for all participants; (4) ensure the data system is flexible and interoperable with the wider data landscape; (5) anticipate changing data needs over time; and (6) identify financial opportunities to sustain the registry’s activities for the long term.
Bridging cultural gaps in end-of-life care: the experiences of international charge nurses in Saudi Arabia
Authors: MANI Zakaria A.
Published: November 2024

Introduction

This qualitative study explores the experiences and perspectives of international intensive care unit charge nurses providing end-of-life care to Muslim patients in Saudi Arabia. It examines how these nurses navigate the complexities of delivering culturally sensitive care, particularly regarding Islamic beliefs and practices. The study also investigates the challenges encountered by international nurses due to differing healthcare expectations between themselves and patients’ families, highlighting the interplay between cultural sensitivity and effective end-of-life care in this unique context.

Method

A qualitative descriptive design was employed, using semi-structured interviews to gather data from eight international ICU charge nurses working in a tertiary hospital in Saudi Arabia. Thematic analysis was used to analyze the interview transcripts.

Results

This qualitative study explored the experiences of international ICU charge nurses in Saudi Arabia regarding culturally sensitive end-of-life care within Islamic traditions. Analysis revealed nine key themes and 31 subthemes reflecting the multifaceted nature of this sensitive domain. These themes encompassed intercultural anxieties, emotional burdens on families and nurses, the importance of bridging cultural divides, advocating for change in end-of-life care practices, and honoring diverse spiritual needs. Key findings emphasized the significance of family presence, honoring faith in the absence of family, and ensuring peaceful and compassionate passings, highlighting nurses’ commitment to holistic, patient-centered care that respects both cultural and individual beliefs..

Conclusion

This study provides valuable insights into the cultural nuances of end-of-life care in Saudi Arabia. The findings underscore the importance of culturally sensitive practices that respect Islamic beliefs, prioritize family involvement, and address the holistic needs of patients and their families.

Implications

This study underscores the need for culturally sensitive communication training for healthcare providers working with diverse patient populations. Hospitals and healthcare institutions should prioritize educational initiatives that equip staff with the skills to engage in open dialogues about death and dying, navigate cultural differences in end-of-life preferences, and address the use of traditional healing practices. By fostering greater cultural understanding and communication competency, healthcare systems can better support both patients and families in navigating the complexities of end-of-life care.
Patient pathways in primary health care – an interview study across various health care personnel in a Canadian and a Norwegian county
Authors: Nystrøm Vivian , Ohinmaa Arto , Leonardsen Ann-Chatrin Linqvist
Published: November 2024

Background

Due to demographic changes in the Western world governments emphasize the need for viable solutions, e.g. through decentralization of specialist health care services and better coordination within and between health care services. Both Norway and Canada have been through health care reforms and initiatives aiming to improve continuity and coordination of services. Organizational change to primary care in both countries encompasses both team-based service delivery involving allied health professionals, and new blended payment models. The objective of this study was to explore patient pathways in primary healthcare from various health personnel’s perspectives, and across various primary care organizations in Norway and Canada.

Methods

The study had a qualitative design, including interviews with physicians, nurses and managers (n = 19) in primary care, from a county in Norway and a region in Canada. Data were analyzed with a thematic approach, in line with recommendations from Braun & Clarke.

Results

Three themes were identified: 1) Structural challenges, 2) Towards a more specialized primary health care and 3) Dedication could improve continuity. Findings indicate that coordinating health care services was assumed difficult due to different health care levels, funding systems, managements, electronic record systems and organizations. Hospitals were assumed more task oriented, while primary health care services were considered more care oriented, and this challenged the coordination across organizations. Primary care services were perceived to be more and more specialized, also representing a threat for coordination and continuity. Health care personnel in both countries perceived that dedicated personnel for each patient could improve information flow and continuity across services.

Conclusions

Achieving continuity and coordination of health care services seems challenging. Integration strategies seem essential for reducing silo thinking and fragmentation of health care services.
Biomechanical analysis of a magnesium plantar plate prototype system for the first tarsometatarsal joint fusion: a cadaveric study
Authors: Zhou Peng , Ribeiro Marx , Greven Johannes , Praster Maximilian , Seitz Jan-Marten , Habicht Simon , Hildebrand Frank , Balmayor Elizabeth R. , Lichte Philipp
Published: November 2024

Background

Titanium plantar plates have proven successful in the fixation of the first tarsometatarsal arthrodesis (TMT). However, a second surgery is typically needed for implant removal, and potential adverse effects, carried by the conventional implantations, are not uncommon. The purpose of this study was to determine whether a novel magnesium-based plantar plate system provides similar fusion stability to a titanium-based plantar plate system under various loading conditions.

Methods

Six matched-pair human cadaveric specimens underwent TMT fusions using either a magnesium plantar plate system prototype or a titanium plantar plate system. Specimens were cyclically loaded with a force ranging from 5 N to 50 N for 5,000 cycles, and displacement was recorded. Axial stiffness (N/mm) was calculated from load-displacement curves. Each specimen was loaded to failure at a rate of 5 mm/min, and the ultimate load was recorded.

Results

No significant difference was found in the vertical displacement between Ti group and Mg group after 100 cycles (2.4 ± 1.0 mm vs. 1.3 ± 1.4 mm, p = 0.196), 500 cycles (3.3 ± 1.3 mm vs. 1.7 ± 1.7 mm, p = 0.142), 1,000 cycles (3.7 ± 1.5 mm vs. 1.9 ± 1.9 mm, p = 0.128), 2,500 cycles (4.2 ± 1.7 mm vs. 2.3 ± 2.2 mm, p = 0.172) and 5,000 cycles (4.5 ± 1.8 mm vs. 2.3 ± 3.3 mm, p = 0.125), Additionally, no significant differences were observed in initial stiffness (53.1 ± 19.2 N/mm vs. 82.2 ± 53.9 N/mm, p = 0.257), final stiffness (90.6 ± 48.9 N/mm vs. 120.0 ± 48.3 N/mm, p = 0.319), or maximum load-to-failure (259.8 ± 98.2 N vs. 323.9 ± 134.9 N, p = 0.369).

Conclusions

Based on the performed biomechanical testing, the magnesium plantar plate system provides mechanical stability equivalent to the titanium plantar plate system in fixation for the first TMT joint fusion.
Support by telestroke networks is associated with increased intravenous thrombolysis and reduced hospital transfers: A german claims data analysis
Authors: Janßen Andreas , Pardey Nicolas , Zeidler Jan , Krauth Christian , Blaser Jochen , Oedingen Carina , Worthmann Hans
Published: November 2024

Background

Acute stroke treatment is time-critical. To provide qualified stroke care in areas without 24/7 availability of a stroke neurologist, the concept of teleneurology was established, which is based on remote video communication through telemedicine organized by telestroke networks. Data on the effectiveness and efficiency of stroke treatment via teleneurology is very scarce and is therefore partly questioned in the healthcare sector. The aim was to evaluate stroke care in hospitals with and without teleneurology in Northern Germany.

Methods

We conducted a retrospective case–control data analysis using health insurance claims data for the years 2018 to 2021. Based on pre-defined criteria, two models were defined and clinical as well as health economic parameters were compared. In model 1, we compared patients from hospitals with and without support by a telestroke network, while in model 2, we compared patients from hospitals with and without support by a telestroke network, including only districts without a certified stroke unit. Assessed parameters were age, length of stay, patients’ comorbidities, inpatient costs, reasons for discharge, qualified stroke care treatment according to operation and procedure codes (OPS) and intravenous thrombolysis (IVT) rates.

Results

Hospitals supported by a telestroke network improved their rate of stroke care according to OPS and increased more than three-fold their IVT rate (p = 0.042). In comparison, patients from hospitals with support by a telestroke network had a higher number and rate of qualified stroke care according to OPS (model 1: 73.6% vs 2.2%, p < 0.001 and model 2: 57.0% vs 3.8%, p < 0.001), higher rate of IVT (model 1: 9.5% vs. 0.0%, p = 0.027 and model 2: 10.3% vs 0.0%, p = 0.056) and a lower rate of secondary transfers to another hospital (model 1: 5.9% vs. 28.9%, p < 0.001 and model 2: 5.6% vs 30.1%, p < 0.001). Inpatient costs were lower in cases treated in hospitals with support by a telestroke network (model 1: 4,476€ vs. 5,549€, p = 0.03 and model 2: 4,374€ vs. 5,309€, p = 0.02). In multivariate analysis costs were independently associated with length of stay and patient transfer to another hospital but not with support by a telestroke network.

Conclusion

Hospitals with support by a telestroke network are associated with improved qualified stroke care resulting in higher rates of IVT and stroke care according to OPS codes as well as lower rates of onward transfers. Costs per patient were independently associated with transfer rates and length of hospital stay.
Routine use of patient-reported experience and outcome measures for children and young people: a scoping review
Authors: Alarilla Anne , Terrell Katharine , Kelly Paula , Chesters Heather , Gibson Faith , Oldham Geralyn , Sell Debbie , Davies Gwyneth , Wray Jo
Published: November 2024

Background

Patient-reported outcome measures (PROMs) measure people’s views of their health status whereas patient-reported experience measures (PREMs) are questionnaires measuring perceptions of their experience whilst receiving healthcare. PROMs/PREMs have the potential to enable children and young people (CYP) to be involved in decisions about their care and improve the quality of their care but it is not clear how often PROMs/PREMs are incorporated as part of standard care of CYP in the hospital setting. The aims of this scoping review were to understand the extent of the literature and map available evidence on the use, benefits, barriers and facilitators of PROMs/PREMs as part of standard care and treatment of CYP in hospitals.

Methods

The Joanna Briggs Institute review process was used to map existing evidence on the use of PROMs/PREMs in routine care of CYP in different hospital settings worldwide. Key search terms were developed and Ovid (Emcare, Embase MEDLINE, APA PsychInfo), Scopus and Web of Science were searched. Data were analysed using frequency counts and basic content analysis for thematic mapping according to the research questions. We undertook an initial search in February 2021 and updated this in April 2023.

Results

The search yielded 68,004 studies, 388 were eligible for full text review and 172 met the inclusion criteria. PROMs were more commonly used than PREMs in routine care of CYP in hospitals; these were mostly collected using electronic collection and concentrated in specific specialities, settings, contexts and countries. The findings mapped the use of PROMs/PREMs, including how data are applied in clinical practice and used for service development, but this was not consistently reported. There are specific challenges in the implementation of PROMs/PREMs in routine care of CYP that need to be considered.

Conclusion

PROMs/PREMs have the potential to improve care for CYP in hospital settings contributing to different aspects of care. A better understanding of their use, how results can be applied in clinical practice and contribute to service development will enable meaningful employment. The popularity of electronically collected and captured PROMS/PREMs warrants further investigation to enable their meaningful use in routine care of CYP.

Systematic review registration

Not pre-registered.
Identification of immune-related mitochondrial metabolic disorder genes in septic shock using bioinformatics and machine learning
Authors: Cui Yu-Hui , Wu Chun-Rong , Huang Li-Ou , Xu Dan , Tang Jian-Guo
Published: November 2024

Purpose

Mitochondria are involved in septic shock and inflammatory response syndrome, which severely affects the life security of patients. It is necessary to recognize and explore the immune-mitochondrial genes in septic shock.

Methods

The GSE57065 dataset was acquired from the Gene Expression Omnibus (GEO) database and filtered by limma and the weighted correlation network analysis (WGCNA) to identify mitochondrial-related differentially expressed genes (MitoDEGs) in septic shock. The function of MitoDEGs was analyzed using the Gene Ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSEA), respectively. The Protein-Protein Interaction (PPI) network composed of MitoDEGs was established using Cytoscape. Support Vector Machine Recursive Feature Elimination (SVM-RFE), Random Forest (RF), and Least Absolute Shrinkage and Selection Operator (LASSO) were used to identify diagnostic MitoDEGs, which were validated using receiver operating characteristic (ROC) analysis and Quantitative Real-time Reverse Transcription Polymerase Chain Reaction (qRT-PCR). Furthermore, the infiltration of immunocytes was analyzed using CIBERSORT, and the correlation between diagnostic MitoDEGs and immunocytes was explored using Spearman.

Results

A total of 44 MitoDEGs were filtered, and functional enrichment analysis showed they were associated with mitochondrial function, and the PPI network had 457 nodes and 547 edges. Four diagnostic genes, MitoDEGs, PGS1, C6orf136, THEM4, and EPHX2, were identified by three machine learning algorithms, and qRT-PCR results obtained similar expression levels as bioinformatics analysis. Furthermore, the diagnostic model constructed by the diagnostic genes had fine diagnostic efficacy. Immunocyte infiltration analysis showed that activated immunocytes were abundant and correlated with hub genes, with neutrophils accounting for the largest proportion in septic shock.

Conclusions

In this study, we recognized four immune-mitochondrial key genes (PGS1, C6orf136, THEM4, and EPHX2) in septic shock and designed a novel gene diagnosis model that provided a new and meaningful way for the diagnosis of septic shock.
Role of pentoxifylline in neonatal hypoxic ischaemic encephalopathy: a systematic review of animal studies
Authors: Wong Florence , Rath Chandra , Gowda Bhanu B. , Patole Sanjay
Published: November 2024

We systematically reviewed the evidence from animal studies assessing the effects of pentoxifylline on neonatal hypoxic-ischemic encephalopathy (HIE). The PubMed, EMBASE, EMCARE, MEDLINE, Cochrane Library, and Google Scholar databases were searched for randomized and quasi randomized controlled trials (RCTs) in December 2023 to determine the effects of pentoxifylline in animal models of HIE. The quality of the included studies was assessed via the SYRCLE risk of bias (ROB) tool. The certainty of evidence was assessed via the GRADE methodology. All seven included studies (n = 248) involved a rat HIE model in which pentoxifylline (25–150 mg/kg) was administered intraperitoneally. The majority had unclear ROB. All the studies reported a protective effect of pentoxifylline on HIE-induced organ injury. Mortality was comparable at pentoxifylline doses between 25 and 75 mg/kg but higher at 150 mg/kg than in the control group. Three studies reported macroscopic changes in HIE-affected organs. There was a significant reduction in cerebral infarction (40 and 75 mg/kg), hippocampal atrophy, and visible gut injury (60 mg/kg). A significantly lower number of Caspase 3 immunoreactive cells and necrotic cells were observed at the 60 mg/kg dose, whereas the 100 mg/kg dose had a deleterious effect. Three other studies reported significantly reduced levels of proinflammatory markers including IL-6 and TNF-alpha. Current evidence (with low uncertainty) from a rat model suggests that pentoxifylline has the potential to improve mortality and attenuate organ injury following HIE. Adequately powered, well-designed human RCTs are needed to confirm our findings.
O Canto da SereIA: inovação ou ilusão tecnológica?
Authors: Campagnolli Juliana Narj ara Libório , Carvalho Lilian Linhares de , Athayde Caroline Cunha de Oliveira , Farias Frank Douglas Cruz de
Published: November 2024

Informamos que as notas de ensino dos casos possuem acesso restrito e são exclusivas para docentes e instrutores vinculados à uma instituição acadêmica. Saiba mais.