bluuebunny/crossref_metadata_2025 huggingface dataset:
SlMYC2 promotes SlLBD40‐mediated cell expansion in tomato fruit development
Authors: Liu Lun , Zhang Jialong , Xu Jiayi , Li Yafei , Lv Hongmei , Wang Fei , Guo Junxin , Lin Tao , Zhao Bing , Li Xin‐Xu , Guo Yang‐Dong , Zhang Na
Published: March 2024

As a plant‐specific transcription factor, lateral organ boundaries domain (LBD) protein was reported to regulate plant growth and stress response, but the functional research of subfamily II genes is limited. SlMYC2, a master regulator of Jasmonic acid response, has been found to exhibit high expression levels in fruit and has been implicated in the regulation of fruit ripening and resistance to Botrytis. However, its role in fruit expansion remains unknown. In this study, we present evidence that a subfamily II member of LBD, namely SlLBD40, collaborates with SlMYC2 in the regulation of fruit expansion. Overexpression of SlLBD40 significantly promoted fruit growth by promoting mesocarp cell expansion, while knockout of SlLBD40 showed the opposite result. Similarly, SlMYC2 knockout resulted in a significant decrease in cell expansion within the fruit. Genetic analysis indicated that SlLBD40‐mediated cell expansion depends on the expression of SlMYC2. SlLBD40 bound to the promoter of SlEXPA5, an expansin gene, but did not activate its expression directly. While, the co‐expression of SlMYC2 and SlLBD40 significantly stimulated the activation of SlEXPA5, leading to an increase in fruit size. SlLBD40 interacted with SlMYC2 and enhanced the stability and abundance of SlMYC2. Furthermore, SlMYC2 directly targeted and activated the expression of SlLBD40, which is essential for SlLBD40‐mediated fruit expansion. In summary, our research elucidates the role of the interaction between SlLBD40 and SlMYC2 in promoting cell expansion in tomato fruits, thus providing novel insights into the molecular genetics underlying fruit growth.
Entity's Communication Strategy in the Selected Segment Targeted at Gen Z
Authors: Kusá Alena , Matúšová Jana Galera , Pátík Ladislav
Published: March 2024

Generation Z has many attributes and if we were to sum them up in one word, it is certainly specific. Although we also discuss few commonalities with Millennials in our article, Z generation presents a big challenge for brands to reach them, as their expectations of brands, as well as their own lifestyle, are diametrically opposed. At the same time, Generation Z is entering the labour market, so they are also starting to become economically active, although their behaviours and expectations in this area are also different. In our article, we looked at reaching Generation Z via the communication strategy of brands. Thus, based on the characteristics of Generation Z and primary and secondary research, the aim of the article is to look at the possible methods of reaching this target group via communication strategy in specific segments. The primary research focuses on how the representatives of Generation Z perceive brands, why they pay their attention to them and what is their approach to advertising. We will point out the results of secondary research on marketing communications and consumer behaviour of a generational cohort of young people and the impact of marketing communications and communication strategy on their lives. At the same time, with the partial results of our own survey, we will point out the preferences of factors in purchasing decisions.
Form-Finding and Evaluation of Spherical Tensegrity Toward Applying in Locomotive Robots
Authors: Wang Meijia , Wang Yafeng , Xu Xian
Published: March 2024

A tensegrity-based robot is a locomotive robot that operates on the principle of tensegrity, allowing it to change its shape by adjusting its internal prestress. Tensegrity-based robots can be categorized into different types based on their shape, with the spherical tensegrity-based robot garnering the most attention. However, existing designs for spherical tensegrity-based robots tend to be relatively simple and lack standardized criteria for evaluating their performance. This paper proposes an optimization approach using the force density method to design new spherical regular tensegrity configurations. This is achieved by parameterizing the topology and configuration of the structure, taking into account structural symmetry and the even distribution of internal forces. The proposed approach generates not only classical tensegrities but also novel configurations suitable for locomotive robots. To preliminarily evaluate the suitability of classical tensegrities and novel tensegrities to be used as a rolling robot, a set of performance indexes, including inner space, compactability, prestress evenness, gait repeatability, tilt stability ratio, stride length, and path efficiency, are proposed. The proposed indexes can be quickly determined based on the geometry of the tensegrity and thus are useful in the conceptual selection of the spherical tensegrities for rolling robots. They are used to evaluate a set of six spherical tensegrities. Numerical simulations are carried out to verify the feasibility of geometry-based approximating the gait-dependent indexes. Through the evaluation, a novel spherical tensegrity consisting of 15 struts and 60 tendons is identified as a promising candidate for rolling robots.
Type Synthesis of a 3DOF Wrist Applying the Coupled-Input Cable-Driven Parallel Robot
Authors: Liu Shibo , Mei Jiangping , Wang Panfeng , Guo Fan , Li Jiaxing , Wang Shuai , Wang Ruizhi
Published: March 2024

The spatial cable-driven parallel robots (CDPRs) with low DOF (degree-of-freedom; n < 6) are like the physiological structure of bone and muscles, which are suitable for designing humanoid joints. Therefore, the type synthesis of the CDPR is of great interest for the design of new humanoid wrist joints. In this paper, we present a type synthesis of the coupled-input CDPRs to design a 3DOF wrist. Coupled input means that one actuator controls more than one cable. First, the Yamanouchi symbols of the coupled-input CDPRs are listed using the permutation group. In addition, two winding methods for the cable and the actuator are defined in the coupled-input CDPRs. Finally, a topology configuration of the coupled-input CDPR suitable for the 3DOF wrist model is determined based on a comparative analysis of the workspaces of a class of coupled-input CDPRs. It is shown that type synthesis of the coupled-input CDPRs is an effective way to innovate low DOF CDPRs.
The effects of variability on context effects and psychometric function slopes in speaking rate normalization
Authors: King Caleb J. , Sharpe Chloe M. , Shorey Anya E. , Stilp Christian E.
Published: March 2024

Acoustic context influences speech perception, but contextual variability restricts this influence. Assgari and Stilp [J. Acoust. Soc. Am. 138, 3023–3032 (2015)] demonstrated that when categorizing vowels, variability in who spoke the preceding context sentence on each trial but not the sentence contents diminished the resulting spectral contrast effects (perceptual shifts in categorization stemming from spectral differences between sounds). Yet, how such contextual variability affects temporal contrast effects (TCEs) (also known as speaking rate normalization; categorization shifts stemming from temporal differences) is unknown. Here, stimuli were the same context sentences and conditions (one talker saying one sentence, one talker saying 200 sentences, 200 talkers saying 200 sentences) used in Assgari and Stilp [J. Acoust. Soc. Am. 138, 3023–3032 (2015)], but set to fast or slow speaking rates to encourage perception of target words as “tier” or “deer,” respectively. In Experiment 1, sentence variability and talker variability each diminished TCE magnitudes; talker variability also produced shallower psychometric function slopes. In Experiment 2, when speaking rates were matched across the 200-sentences conditions, neither TCE magnitudes nor slopes differed across conditions. In Experiment 3, matching slow and fast rates across all conditions failed to produce equal TCEs and slopes everywhere. Results suggest a complex interplay between acoustic, talker, and sentence variability in shaping TCEs in speech perception.
Diversity begets stability: Sublinear growth and competitive coexistence across ecosystems
Authors: Hatton Ian A. , Mazzarisi Onofrio , Altieri Ada , Smerlak Matteo
Published: March 2024

The worldwide loss of species diversity brings urgency to understanding how diverse ecosystems maintain stability. Whereas early ecological ideas and classic observations suggested that stability increases with diversity, ecological theory makes the opposite prediction, leading to the long-standing “diversity-stability debate.” Here, we show that this puzzle can be resolved if growth scales as a sublinear power law with biomass (exponent <1), exhibiting a form of population self-regulation analogous to models of individual ontogeny. We show that competitive interactions among populations with sublinear growth do not lead to exclusion, as occurs with logistic growth, but instead promote stability at higher diversity. Our model realigns theory with classic observations and predicts large-scale macroecological patterns. However, it makes an unsettling prediction: Biodiversity loss may accelerate the destabilization of ecosystems.
The DTC microbiome testing industry needs more regulation
Authors: Hoffmann Diane E. , von Rosenvinge Erik C. , Roghmann Mary-Claire , Palumbo Francis B. , McDonald Daniel , Ravel Jacques
Published: March 2024

Tests lack analytical and clinical validity, requiring more federal oversight to prevent consumer harm
Continuous evolution of compact protein degradation tags regulated by selective molecular glues
Authors: Mercer Jaron A. M. , DeCarlo Stephan J. , Roy Burman Shourya S. , Sreekanth Vedagopuram , Nelson Andrew T. , Hunkeler Moritz , Chen Peter J. , Donovan Katherine A. , Kokkonda Praveen , Tiwari Praveen K. , Shoba Veronika M. , Deb Arghya , Choudhary Amit , Fischer Eric S. , Liu David R.
Published: March 2024

Conditional protein degradation tags (degrons) are usually >100 amino acids long or are triggered by small molecules with substantial off-target effects, thwarting their use as specific modulators of endogenous protein levels. We developed a phage-assisted continuous evolution platform for molecular glue complexes (MG-PACE) and evolved a 36–amino acid zinc finger (ZF) degron (SD40) that binds the ubiquitin ligase substrate receptor cereblon in complex with PT-179, an orthogonal thalidomide derivative. Endogenous proteins tagged in-frame with SD40 using prime editing are degraded by otherwise inert PT-179. Cryo–electron microscopy structures of SD40 in complex with ligand-bound cereblon revealed mechanistic insights into the molecular basis of SD40’s activity and specificity. Our efforts establish a system for continuous evolution of molecular glue complexes and provide ZF tags that overcome shortcomings associated with existing degrons.
Oral administration of obeldesivir protects nonhuman primates against
Sudan ebolavirus
Authors: Cross Robert W. , Woolsey Courtney , Chu Victor C. , Babusis Darius , Bannister Roy , Vermillion Meghan S. , Geleziunas Romas , Barrett Kimberly T. , Bunyan Elaine , Nguyen Anh-Quan , Cihlar Tomas , Porter Danielle P. , Prasad Abhishek N. , Deer Daniel J. , Borisevich Viktoriya , Agans Krystle N. , Martinez Jasmine , Harrison Mack B. , Dobias Natalie S. , Fenton Karla A. , Bilello John P. , Geisbert Thomas W.
Published: March 2024

Obeldesivir (ODV, GS-5245) is an orally administered prodrug of the parent nucleoside of remdesivir (RDV) and is presently in phase 3 trials for COVID-19 treatment. In this work, we show that ODV and its circulating parent nucleoside metabolite, GS-441524, have similar in vitro antiviral activity against filoviruses, including Marburg virus, Ebola virus, and Sudan virus (SUDV). We also report that once-daily oral ODV treatment of cynomolgus monkeys for 10 days beginning 24 hours after SUDV exposure confers 100% protection against lethal infection. Transcriptomics data show that ODV treatment delayed the onset of inflammation and correlated with antigen presentation and lymphocyte activation. Our results offer promise for the further development of ODV to control outbreaks of filovirus disease more rapidly.
Electron injection and defect passivation for high-efficiency mesoporous perovskite solar cells
Authors: Liu Jiale , Chen Xiayan , Chen Kaizhong , Tian Wenming , Sheng Yusong , She Bin , Jiang Youyu , Zhang Deyi , Liu Yang , Qi Jianhang , Chen Kai , Ma Yongmin , Qiu Zexiong , Wang Chaoyang , Yin Yanfeng , Zhao Shengli , Leng Jing , Jin Shengye , Zhao Wenshan , Qin Yanyang , Su Yaqiong , Li Xiaoyu , Li Xiaojiang , Zhou Yang , Zhou Yinhua , Ling Furi , Mei Anyi , Han Hongwei
Published: March 2024

Printable mesoscopic perovskite solar cells (p-MPSCs) do not require the added hole-transport layer needed in traditional p-n junctions but have also exhibited lower power conversion efficiencies of about 19%. We performed device simulation and carrier dynamics analysis to design a p-MPSC with mesoporous layers of semiconducting titanium dioxide, insulating zirconium dioxide, and conducting carbon infiltrated with perovskite that enabled three-dimensional injection of photoexcited electrons into titanium dioxide for collection at a transparent conductor layer. Holes underwent long-distance diffusion toward the carbon back electrode, and this carrier separation reduced recombination at the back contact. Nonradiative recombination at the bulk titanium dioxide/perovskite interface was reduced by ammonium phosphate modification. The resulting p-MPSCs achieved a power conversion efficiency of 22.2% and maintained 97% of their initial efficiency after 750 hours of maximum power point tracking at 55 ± 5°C.
Grid-plainification enables medium-temperature PbSe thermoelectrics to cool better than Bi
2
Te
3
Authors: Qin Yongxin , Qin Bingchao , Hong Tao , Zhang Xiao , Wang Dongyang , Liu Dongrui , Wang Zi-Yuan , Su Lizhong , Wang Sining , Gao Xiang , Ge Zhen-Hua , Zhao Li-Dong
Published: March 2024

Thermoelectric cooling technology has important applications for processes such as precise temperature control in intelligent electronics. The bismuth telluride (Bi
2
Te
3
)–based coolers currently in use are limited by the scarcity of Te and less-than-ideal cooling capability. We demonstrate how removing lattice vacancies through a grid-design strategy switched PbSe from being useful as a medium-temperature power generator to a thermoelectric cooler. At room temperature, the seven-pair device based on n-type PbSe and p-type SnSe produced a maximum cooling temperature difference of ~73 kelvin, with a single-leg power generation efficiency approaching 11.2%. We attribute our results to a power factor of >52 microwatts per centimeter per square kelvin, which was achieved by boosting carrier mobility. Our demonstration suggests a path for commercial applications of thermoelectric cooling based on Earth-abundant Te-free selenide-based compounds.
Switching on generalized fear
Authors: Hen Rene , Schacher Samuel
Published: March 2024

Stress induces a neurotransmitter switch that leads to fear in harmless situations
Accelerating 2D materials discovery
Authors: Thakur Anupma , Anasori Babak
Published: March 2024

A large-scale theory-driven approach predicts many new 2D materials
A trans-Iapetus transform fault control for the evolution of the Rheic Ocean: Implications for an early Paleozoic transition of accretionary tectonics: Comment
Authors: Barosh Patrick J.
Published: March 2024

The premise put forth by Wu et al. (2022) that the late Proterozoic and early Paleozoic development of the Appalachian Orogen was controlled by transform faults finds no support in the geology of the region. Such faults have been well studied on and offshore over the past century and a quarter by many federal and private agencies because of the seismic hazard they pose to nuclear power plants and dams and their significance in offshore exploration. The northwest-trending transform faults developed in the Middle Jurassic across early oceanic crust as the Atlantic Basin began to open, to offset the initial northeast-trending Late Triassic–Early Jurassic rifts and extended landward. These young transform faults, which were accompanied by north-trending rifts, could have played no part in the development of the Appalachian Orogen, Laurentia, Iapetus, or the Rheic Ocean. Furthermore, the presented plate reconstructions cannot be reconciled with the well-controlled geologic history revealed in southern New England (USA), where the Appalachian Collision Zone is exposed. Relations there demonstrate that northwest Africa and Laurentia had first collided during the late Proterozoic Pan African Orogeny, long before the times shown on the reconstructions by Wu et al. (2022).
Erratum to: Capabilities of Surface Enhanced Raman Spectroscopy for Identifying Multiple Pigments in a Complex Organic Mixture
Authors: Oleynik E. A. , Kozhina E. P. , Bedin S. A. , Naumov A. V.
Published: March 2024

An Erratum to this paper has been published: https://doi.org/10.1134/S1062873824010039
25 year trends in cancer incidence and mortality among adults aged 35-69 years in the UK, 1993-2018: retrospective secondary analysis
Authors: Shelton Jon , Zotow Ewa , Smith Lesley , Johnson Shane A , Thomson Catherine S , Ahmad Amar , Murdock Lars , Nagarwalla Diana , Forman David
Published: March 2024

Objective

To examine and interpret trends in UK cancer incidence and mortality for all cancers combined and for the most common cancer sites in adults aged 35-69 years.

Design

Retrospective secondary data analysis.

Data sources

Cancer registration data, cancer mortality and national population data from the Office for National Statistics, Public Health Wales, Public Health Scotland, Northern Ireland Cancer Registry, NHS England, and the General Register Office for Northern Ireland.

Setting

23 cancer sites were included in the analysis in the UK.

Participants

Men and women aged 35-69 years diagnosed with or who died from cancer between 1993 to 2018.

Main outcome measures

Change in cancer incidence and mortality age standardised rates over time.

Results

The number of cancer cases in this age range rose by 57% for men (from 55 014 cases registered in 1993 to 86 297 in 2018) and by 48% for women (60 187 to 88 970) with age standardised rates showing average annual increases of 0.8% in both sexes. The increase in incidence was predominantly driven by increases in prostate (male) and breast (female) cancers. Without these two sites, all cancer trends in age standardised incidence rates were relatively stable. Trends for a small number of less common cancers showed concerning increases in incidence rates, for example, in melanoma skin, liver, oral, and kidney cancers. The number of cancer deaths decreased over the 25 year period, by 20% in men (from 32 878 to 26 322) and 17% in women (28 516 to 23 719); age standardised mortality rates reduced for all cancers combined by 37% in men (−2.0% per year) and 33% in women (−1.6% per year). The largest decreases in mortality were noted for stomach, mesothelioma, and bladder cancers in men and stomach and cervical cancers and non-Hodgkin lymphoma in women. Most incidence and mortality changes were statistically significant even when the size of change was relatively small.

Conclusions

Cancer mortality had a substantial reduction during the past 25 years in both men and women aged 35-69 years. This decline is likely a reflection of the successes in cancer prevention (eg, smoking prevention policies and cessation programmes), earlier detection (eg, screening programmes) and improved diagnostic tests, and more effective treatment. By contrast, increased prevalence of non-smoking risk factors are the likely cause of the observed increased incidence for a small number of specific cancers. This analysis also provides a benchmark for the following decade, which will include the impact of covid-19 on cancer incidence and outcomes.
A static glucose-stimulated insulin secretion (sGSIS) assay that is significantly predictive of time to diabetes reversal in the human islet bioassay
Authors: Molano Ruth Damaris , Pileggi Antonello , Tse Hubert M , Stabler Cherie L , Fraker Christopher A
Published: March 2024

Introduction

Static incubation (static glucose-stimulated insulin secretion, sGSIS) is a measure of islet secretory function. The Stimulation Index (SI; insulin produced in high glucose/insulin produced in low glucose) is currently used as a product release criterion of islet transplant potency.

Research design and methods

Our hypothesis was that the Delta, insulin secreted in high glucose minus insulin secreted in low glucose, would be more predictive. To evaluate this hypothesis, sGSIS was performed on 32 consecutive human islet preparations, immobilizing the islets in a slurry of Sepharose beads to minimize mechanical perturbation. Simultaneous full-mass subrenal capsular transplants were performed in chemically induced diabetic immunodeficient mice. Logistic regression analysis was used to determine optimal cut-points for diabetes reversal time and the Fisher Exact Test was used to assess the ability of the Delta and the SI to accurately classify transplant outcomes. Receiver operating characteristic curve analysis was performed on cut-point grouped data, assessing the predictive power and optimal cut-point for each sGSIS potency metric. Finally, standard Kaplan-Meier-type survival analysis was conducted.

Results

In the case of the sGSIS the Delta provided a superior islet potency metric relative to the SI.

Conclusions

The sGSIS Delta value is predicitive of time to diabetes reversal in the full mass human islet transplant bioassay.
The Lasting impact of the COVID-19 pandemic on outpatient neurology consultations
Authors: Tan Sean YW , Gunawardana Nushan , Roberts Rhys C
Published: March 2024

Background

The COVID-19 pandemic prompted rapid changes in outpatient neurology services and there remain unanswered questions regarding its long-term impact. First, what are the lasting changes of the pandemic on demographics and outcomes of new referrals and patients reviewed at outpatient neurology clinics? Safety concerns about virtual consultations during the initial stages of the pandemic were also raised. Has the continual adoption of virtual consultations led to negative outcomes for patients?

Methods

New referrals and first clinic appointments in 2019 (prepandemic baseline) and 2022 (postpandemic) in a tertiary referral centre were compared retrospectively. 7294 referrals (4946 clinic appointments) in 2019 and 6989 referrals (3976 clinic appointments) in 2022 were assessed. Outcomes investigated were rates of referrals accepted, time to clinic consultation, number of outpatient investigations per appointment, rates of discharge and the risk of reassessment.

Results

There was a change in triaging practice postpandemic, with more patients being offered virtual assessments. Virtual appointments were offered to a specific suitable cohort of patients. This resulted in a faster time to consultation, fewer investigations, higher rates of discharge, with a reduced risk of reassessment compared with prepandemic patients, and patients postpandemic who were seen face to face.

Conclusion

Outpatient neurology services have adapted postpandemic by effectively triaging referrals and allocating new patients appropriately to face-to-face or virtual clinics, improving patient outcomes and safety.
Effectiveness of video-assisted teaching on prevention of constipation among postpartum women admitted in postnatal ward at a tertiary care hospital: a randomised controlled trial
Authors: C Tamil Selvi , M J Kumari , S Vahitha , N S Kubera
Published: March 2024

Background

The postpartum period is a vital phase for a mother as she undergoes a role transition in her life, in addition to physiological changes. Among all discomforts experienced during this period, constipation is more common and it can cause lifelong complications such as haemorrhoids, rectal prolapse and anal fissures if left untreated. Adequate care, education and compliance with proper postpartum diet and exercise can prevent it.

Aim and objective

This study intended to assess the effect of video-assisted teaching in preventing constipation among postpartum women in comparison with routine care.

Settings and design

Antenatal outpatient department and postnatal ward. Experimental research design—randomised controlled trial.

Methods and material

Totally, 160 antenatal women in the III trimester were selected by convenience sampling and randomised into study and control groups. Data were collected using a semistructured questionnaire. Postpartum women in the study group received video-assisted teaching regarding the postnatal diet and exercise for the prevention of constipation developed by the researcher with reference from books, journals, Indian council of medical research Recommended dietary allowances table and expert opinion. Postpartum women in the control group received routine care as a pamphlet regarding the care of women after delivery which was routinely given to all mothers along with the discharge slip. Constipation Assessment Scale was used to assess the presence of constipation at the end of second week of post partum.

Statistical analysis used

Descriptive and inferential statistics were used.

Results

Data showed 27% of postpartum women in control group had constipation comparing to only 6.1% of the women in the study group (p<0.05). There was a significant association between consumption of fruits, green leafy vegetables, increased fluid intake, regular walking and the status of constipation (p<0.001).

Conclusions

Video-assisted teaching was effective in preventing constipation among postpartum women.
Country uptake of WHO recommendations on differentiated HIV testing services approaches: a global policy review
Authors: Kadye Tafadzwa , Jamil Muhammad S , Johnson Cheryl , Baggaley Rachel , Barr-DiChiara Magdalena , Cambiano Valentina
Published: March 2024

Objectives

In 2015 and 2016, WHO issued guidelines on HIV testing services (HTS) highlighting recommendations for a strategic mix of differentiated HTS approaches. The policy review examines the uptake of differentiated HTS approaches recommendations in national policies.

Methods

Data were extracted from national policies published between January 2015 and June 2019. The WHO-recommended HTS approaches included facility-based testing, community-based testing, HIV self-testing and provider-assisted referral (or assisted partner notification). Other supportive recommendations include pre-test information, post-test counselling, lay provider testing and rapid testing. Descriptive analyses were conducted to examine inclusion of recommendations in national policies.

Results

Of 194 countries worldwide, 65 published policies were identified; 24 WHO Africa region (AFR) countries (51%, 24/47), 21 WHO European region (EUR) (40%, 21/53), 6 WHO Eastern Mediterranean region (EMR) (29%, 6/21), 5 Pan-American region (AMR) (14%, 5/35), 5 Western Pacific Region (WPR) (19%, 5/27) and 4 WHO South East Asia Region (SEAR) (36%, 4/11). Only five countries included all recommendations. 63 included a minimum of one. 85% (n=55) included facility-based testing for pregnant women, 75% (n=49) facility-based testing for key populations, 74% (n=48) community-based testing for key populations, 69% (n=45) rapid testing, 57% (n=37) post-test counselling, 45% (n=29) lay provider testing, 38% (n=25) HIV self-testing, 29% (n=19) pre-test information and 25% (n=16) provider-assisted referral. The proportion in each region that included at least one recommendation were: 100% AFR (24/47), 100% EMR (6/6), 100% AMR (5/5), 100% WPR (5/5), 100% SEAR (4/4) and 95% EUR (20/21). AFR followed by EMR included the highest number of reccomendations.

Conclusion

There was substantial variability in the uptake of the WHO-differentiated HTS recommendations. Those in EMR included the most WHO-differentiated HTS recommendation followed by AFR. Countries within AMR included the least number of recommendations. Ongoing advocacy and efforts are needed to support the uptake of the WHO-differentiated HTS recommendations in country policies as well as their implementation.
Prevalence and determinants of pregnancy termination in Ethiopia: a systematic review and meta-analysis
Authors: Kumsa Henok , Mislu Esuyawkal Kasahun , Arage Mulugeta Wodaje , Kidie Atitegeb Abera , Hailu Tilahun , Tenaw Lebeza Alemu
Published: March 2024

Objective

This review aims to determine the prevalence of pregnancy termination and its determinant factors in Ethiopia.

Design

Systematic review and meta-analysis.

Data sources

Relevant articles were retrieved from databases such as PubMed, EMBASE, Medline and other search engines.

Eligibility criteria for selecting studies

The research design for this study had no restrictions, allowing for the inclusion of cross-sectional and case–control studies that examined the prevalence or determinants of pregnancy termination. However, case reports, case series, reviews, editorials and studies published as abstracts only were excluded from the analysis.

Data extraction and synthesis

The review was precisely in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria, and the quality of the review was assessed using the Joanna Briggs Institute critical appraisal checklist. Heterogeneity was indicated by the p value for I2statistics less than 0.05. Data were entered into Microsoft Excel, and the analysis was conducted by using Stata V.16.

Results

The pooled prevalence of pregnancy termination in Ethiopia was 21.52% (95% CI 15.01% to 28.03%). Women who had their first sexual initiation before the age of 18 (OR 1.78; 95% CI 1.13 to 2.82, p=0.14), had irregular menstrual bleeding (OR 1.86; 95% CI 1.25 to 2.77, p=0.76), being a student (OR 4.85; 95% CI 1.98 to 11.91, p=0.20) and had multiple sexual partners (OR 4.88; 95% CI 3.43 to 6.93, p=0.33) were significantly associated with pregnancy termination.

Conclusions

One in five women terminated their pregnancies, which is higher than in other sub-Saharan countries. Being a student, irregular menstrual bleeding, early initiation of sexual intercourse and multiple sexual partners were determinants of pregnancy termination. Special attention is needed in avoiding early sexual initiation and in reducing sexual risk behaviours.
Exploring the feasibility and acceptance of an optimised physiotherapy approach for lateral elbow tendinopathy: a qualitative investigation within the OPTimisE trial
Authors: Bateman Marcus , Saunders Benjamin , Cooper Karin , Littlewood Chris , Hill Jonathan C
Published: March 2024

Objectives

To explore the acceptability of an optimised physiotherapy (OPTimisE) intervention for people with lateral elbow tendinopathy (LET) and feasibility of comparing it to usual care in a randomised controlled trial.

Design

Semistructured interviews, analysed using thematic analysis and mapped onto the COM-B model of behaviour change.

Setting

Conducted as part of the OPTimisE Pilot & Feasibility randomised controlled trial within physiotherapy departments in the United Kingdom National Health Service.

Participants

17 patients with LET (purposively sampled to provide representativeness based on age, sex, ethnicity, deprivation index and treatment allocation) and all 8 physiotherapists involved as treating clinicians or site principal investigators.

Results

Four themes were identified. First, participants reported the OPTimisE intervention as acceptable. Second, differences between the OPTimisE intervention and usual care were identified, including the use of an orthosis, holistic advice/education including modifiable risk factors, forearm stretches, general upper body strengthening and a more prescriptive exercise-dosing regimen. Third, participants provided feedback related to the trial resources, which were viewed positively, but identified language translation as a need. Fourth, feedback related to trial processes identified the need for changes to outcome collection and reduction of administrative burden. From the perspective of adopting the OPTimisE intervention, we found evidence that participants were able to change their behaviour. Considering the findings through the lens of the COM-B model, the intervention is likely to be deliverable in practice and the trial can be delivered at scale with some additional support for physiotherapists.

Conclusions

Overall, the OPTimisE intervention was found to be different to usual care and acceptable to patients and physiotherapists. The study highlighted the need to refine trial processes and resources prior to a full-scale trial, to reduce administrative burden, increase support for physiotherapists, improve return rate of outcome questionnaires and provide language translation.

Trial registration number

ISRCTN database 19 July 2021.https://www.isrctn.com/ISRCTN64444585.
Investigating patient engagement associations between a postdischarge texting programme and patient experience, readmission and revisit rates outcomes
Authors: Bruce Courtenay , Pinn-Kirkland Theresa , Meyers Adam , Javaluyas Emmanuel , Osborn John , Kelkar Sayali , Bruchhaus Lindsey , McLaury Kristen , Sauceda Katherine , Carr Karen , Garcia Claudia , Arabie Lee Ann , Williams Terrell , Vozzella Gail , Nisar Tariq , Schwartz Roberta L , Sasangohar Farzan
Published: March 2024

Objectives

This study aimed (1) to examine the association between patient engagement with a bidirectional, semiautomated postdischarge texting programme and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey outcomes, readmissions and revisit rates in a large health system and (2) to describe operational and clinical flow considerations for implementing a postdischarge texting programme.

Setting

The study involved 1 main academic hospital (beds: 2500+) and 6 community hospitals (beds: 190–400, averaging 300 beds per hospital) in Houston, Texas.

Methods

Retrospective, observational cohort study between non-engaged patients (responded with 0–2 incoming text messages) and engaged patients (responded with 3+ incoming, patient-initiated text messages) between December 2022 and May 2023. We used the two-tailed t-test for continuous variables and χ2test for categorical variables to compare the baseline characteristics between the two cohorts. For the binary outcomes, such as the revisit (1=yes, vs 0=no) and readmissions (1=yes vs 0=no), we constructed mixed effect logistic regression models with the random effects to account for repeated measurements from the hospitals. For the continuous outcome, such as the case mix index (CMI), a generalised linear quantile mixed effect model was built. All tests for significance were two tailed, using an alpha level of 0.05, and 95% CIs were provided. Significance tests were performed to evaluate the CMI and readmissions and revisit rates.

Results

From 78 883 patients who were contacted over the course of this pilot implementation, 49 222 (62.4%) responded, with 39 442 (50%) responded with 3+ incoming text messages. The engaged cohort had higher HCAHPS scores in all domains compared with the non-engaged cohort. The engaged cohort used significantly fewer 30-day acute care resources, experiencing 29% fewer overall readmissions and 20% fewer revisit rates (23% less likely to revisit) and were 27% less likely to be readmitted. The results were statistically significant for all but two hospitals.

Conclusions

This study builds on the few postdischarge texting studies, and also builds on the patient engagement literature, finding that patient engagement with postdischarge texting can be associated with fewer acute care resources. To our knowledge, this is the only study that documented an association between a text-based postdischarge programme and HCAHPS scores, perhaps owing to the bidirectionality and ease with which patients could interact with nurses. Future research should explore the texting paradigms to evaluate their associated outcomes in a variety of postdischarge applications.
Comparison of ultrasound-guided subtransverse process interligamentary plane block with paravertebral block for postoperative analgesia in thoracic surgery: protocol for a randomised non-inferiority trial
Authors: Wu Wei , Wang Danyang , Liu Yang , Zhu Tianyi , He Wenxin , Shi Hong
Published: March 2024

Introduction

The subtransverse process interligamentary (STIL) plane block is an emerging interfascial plane block that has garnered attention for its potential to provide effective postoperative analgesia for breast and thoracic surgeries. However, a direct comparative assessment between the STIL plane block and the paravertebral block is currently lacking. Consequently, our study aims to assess the analgesic efficacy of the STIL block in comparison to paravertebral block for patients undergoing video-assisted thoracoscopic surgery (VATS).

Methods and analysis

This study is a randomised, parallel-controlled, double-blind, non-inferiority trial, with the goal of enrolling 114 participants scheduled for uniportal VATS at Shanghai Pulmonary Hospital. Participants will be randomly assigned in a 1:1 ratio through block randomisation to receive either the STIL plane block (n=57) or the paravertebral block (n=57). The primary outcome of the study is the area under the curve of Numerical Rating Scale(NRS) scores recorded over a 48-hour period following the surgical procedure. Secondary outcomes encompass the evaluation of Quality of Recovery-40, cumulative sufentanil consumption, serum inflammatory factors, rescue medication usage, the incidence of adverse events and the patient satisfaction scores.

Ethics and dissemination

This study has received approval from the Medical Ethics Committee of Shanghai Pulmonary Hospital (approval no. L22-329). Written informed consent will be obtained from all participants. The findings will be submitted for publication in peer-reviewed journals.

Trial registration number

ChiCTR2200066909.
What makes health systems resilient? An analytical framework drawing on European learnings from the COVID-19 pandemic based on a multitiered approach
Authors: Reiss Miriam , Kraus Markus , Riedel Monika , Czypionka Thomas
Published: March 2024

Introduction

The COVID-19 pandemic posed an unprecedented challenge, which caught many health systems widely unprepared. The aim of this research was to develop a comprehensive analytical framework on health system resilience in the context of pandemics. In addition to serving as a tool to analyse the preparedness and resilience of health systems, the framework is intended to provide guidance to decision-makers in health policy.

Methods

The analytical framework was developed based on a multitiered approach. A comprehensive review of the existing literature was conducted to identify relevant frameworks on health system resilience (published between 1 January 2000 and 30 November 2021) and determinants of resilience that emerged during the COVID-19 pandemic. Input was then gathered in several rounds of consultations with designated field experts and stakeholders, drawing on their experiences from the pandemic. Finally, the framework was empirically validated in several case studies.

Results

The framework distinguishes between prerequisites of resilience, pertaining to precautions to be taken in ‘normal’ times, and response strategies in the face of shocks. Both sections are further divided into six building blocks that were adapted from the WHO health system framework: governance and leadership, information and research, financing, physical resources, human resources, and service delivery. An overarching component on contextual factors—subdivided into situational, structural, cultural and international factors—represents an important addition to the existing spectrum of resilience frameworks.

Conclusions

Foundations for a resilient health system must be laid in ‘normal’ times and in all areas of the health system. In the face of a shock, adequate response strategies need to be developed. An essential learning from the COVID-19 pandemic has been that contextual factors of societies and subgroups play a major role in the ability of health systems to overcome a shock, as they impact the implementation and effectiveness of crisis management policies.
Factors associated withEntamoeba histolyticaproctocolitis in men who have sex with men: a systematic review
Authors: Hughes Robbie , Richardson Daniel , Fitzpatrick Colin
Published: March 2024

Objective

Entamoeba histolyticais parasitic infection that can cause a proctocolitis (amoebiasis) and extraintestinal sequelae (eg, liver abscess) and can be sexually transmitted in men who have sex with men (MSM). We aimed to identify factors associated withE. histolyticain MSM to provide insight for future control strategies.

Design/methods

We searched MEDLINE, Embase, CINAHL and Web of Science Core Collections for manuscripts published up to November 2022. One author screened abstracts; two authors independently conducted a full-text review. We included manuscripts that contained primary data on factors associated with transmission in MSM. Quality and risk of bias were assessed independently by two authors using the Joanna Briggs Institute critical appraisal tools. We used the nine-point synthesis method to synthesise narrative data.

Results

Nine manuscripts consisting of 832 individuals withE. histolyticawere included; six cross-sectional studies, two case-control studies and one cohort study.E. histolyticain MSM was associated with: increasing age, transmission in warm seasons, lower educational achievement, concurrent sexually transmitted infection (STI) (Treponema pallidum,Neisseria gonorrhoeae,Chlamydia trachomatis), hepatitis B core antibody positivity, hepatitis C antibody positivity, concurrent sexually transmitted enteric infection (Shigellaspp,Giardia duodenalis), having a previous STI (T. pallidum, N. gonorrhoeae), oral-anal sex, exclusively/majority receptive anal sex and having an increased number of sexual partners.

Conclusion

This review has highlighted some important demographic, biological and behavioural factors associated withE. histolyticain MSM which can inform future clinical guidelines and public health control strategies.

PROSPERO registration number

CRD42022366168.
Efficacy, safety, and biomarker analyses of bintrafusp alfa, a bifunctional fusion protein targeting TGF-β and PD-L1, in patients with advanced non-small cell lung cancer
Authors: Rajan Arun , Abdul Sater Houssein , Rahma Osama , Agajanian Richy , Lassoued Wiem , Marté Jennifer L , Tsai Yo-Ting , Donahue Renee N , Lamping Elizabeth , Bailey Shania , Weisman Andrew , Walter-Rodriguez Beatriz , Ito Rena , Vugmeyster Yulia , Sato Masashi , Machl Andreas , Schlom Jeffrey , Gulley James L
Published: March 2024

Background

Bintrafusp alfa, a first-in-class bifunctional fusion protein targeting transforming growth factor-β (TGF-β) and programmed cell death ligand 1, has demonstrated encouraging efficacy as second-line treatment in patients with non-small cell lung cancer (NSCLC) in a dose expansion cohort of the phase 1, open-label clinical trial (NCT02517398). Here, we report the safety, efficacy, and biomarker analysis of bintrafusp alfa in a second expansion cohort of the same trial (biomarker cohort).

Methods

Patients with stage IIIb/IV NSCLC who were either immune checkpoint inhibitor (ICI)-naïve (n=18) or ICI-experienced (n=23) were enrolled. The primary endpoint was the best overall response. Paired biopsies (n=9/41) and peripheral blood (n=14/41) pretreatment and on-treatment were studied to determine the immunological effects of treatment and for associations with clinical activity.

Results

Per independent review committee assessment, objective responses were observed in the ICI-naïve group (overall response rate, 27.8%). No new or unexpected safety signals were identified. Circulating TGF-β levels were reduced (>97%; p<0.001) 2 weeks after initiation of treatment with bintrafusp alfa and remained reduced up to 12 weeks. Increases in lymphocytes and tumor-associated macrophages (TAMs) were observed in on-treatment biospies, with an increase in the M2 (tumor trophic TAMs)/M1 (inflammatory TAMs) ratio associated with poor outcomes. Specific peripheral immune analytes at baseline and early changes after treatment were associated with clinical response.

Conclusions

Bintrafusp alfa was observed to have modest clinical activity and manageable safety, and was associated with notable immunologic changes involving modulation of the tumor immune microenvironment in patients with advanced NSCLC.
Prevalence of abnormal left ventricular global longitudinal strain by speckle tracking echocardiography and its prognostic value in patients with COVID-19
Authors: Hegde Shruti , Shnoda Mina , Alkhadra Yasser , Bhattacharya Adhiraj , Nikolaeva Maria , Maysky Michael
Published: March 2024

Importance

Although cardiac injury is a known complication of COVID-19 infection, there is no established tool to predict cardiac involvement and in-hospital mortality in this patient population.

Objective

To assess if left ventricular global longitudinal strain (LV-GLS) can detect cardiac involvement and be used as a risk-stratifying parameter for hospitalised patients with COVID-19.

Main outcomes and measures

In-hospital mortality.

Results

We found a statistically significant association between LV-GLS and in-hospital mortality (adjusted OR (aOR)=1.09; 95% CI 1.0 to 1.19, p=0.050). Furthermore, right ventricular fractional area change was significantly associated with in-hospital mortality (aOR=1.04; 95% CI 1.0 to 1.08, p=0.043). Troponin level had no statistically significant association with in-hospital mortality (aOR=3.43; 95% CI 0.78 to 15.03, p=0.101).

Conclusion and relevance

LV-GLS can be a useful parameter for cardiovascular risk assessment in hospitalised patients with COVID-19 infection.
Incidence, presentation and outcome of acute aortic dissection: results from a population-based study
Authors: Smedberg Christian , Hultgren Rebecka , Olsson Christian , Steuer Johnny
Published: March 2024

Objectives

To describe the incidence of acute aortic dissection in a clearly defined population, to assess onset symptoms and admission biochemical marker levels and to analyse variables potentially associated to mortality.

Methods

Medical records and CT angiograms of all patients hospitalised for acute aortic dissection in the Stockholm County during the 5-year period 2012–2016 were reviewed. The patients were followed until date of death or until 31 December 2020. The annual incidence was determined. Associations between clinical and biochemical variables and 30-day mortality, respectively, were analysed using multivariable logistic regression models.

Results

A total of 344 patients were included. The mean annual incidence of acute aortic dissection was 4.1 per 100 000. Median age was 67 years (range 24–91) and 34% (n=118) were women. Type A dissection was predominant; 220 patients (64%) had type A and 124 (36%) had type B. Painless dissection was more common in type A than in type B (18% vs 15%, p=0.003). Type A dissection patients also more commonly had elevated plasma troponin T (44% vs 21%, p<0.001) and thrombocytopenia (26% vs 15%, p=0.010) than type B dissection patients on admission. Overall, 30-day mortality was 28% in type A and 11% in type B (p<0.001). Both painless dissection (OR 4.30, 95% CI 1.80 to 10.28, p=0.001) and elevated troponin T (OR 3.78, 95% CI 2.01 to 7.12, p<0.001), respectively, were associated with increased 30-day mortality in all acute aortic dissection patients. Thrombocytopenia was associated with elevated 30-day mortality only in patients with type A (OR 3.09, 95% CI 1.53 to 6.21, p=0.002).

Conclusions

Nearly two-thirds of acute aortic dissection patients had type A. Levels of troponin T and platelets, respectively, paired with presence or absence of typical symptoms may become useful adjuncts in risk stratification of patients with acute aortic dissection.