bluuebunny/crossref_metadata_2025 huggingface dataset:
Moral minds: How and when does servant leadership influence employees to benefit multiple stakeholders?
Authors: Lemoine G. James , Hartnell Chad A. , Hora Snehal , Watts Daniel I.
Published: June 2023

Servant leadership's unique focus on care and concern for multiple stakeholders has caught the attention of academic and practitioners alike. Its theoretical novelty, however, remains underutilized as a means to contribute unique insights to the leadership literature. We draw on servant leadership's moral foundation—utilitarian consequentialism—and social learning theory to identify cognitive mechanisms (follower other‐orientation and cognitive reflection) through which servant leadership affects employee behavior benefiting two stakeholder groups: a community nonprofit organization and the employing organization. Furthermore, we evaluate the degree to which an employee's moral identity internalization acts as a boundary condition of servant leadership's effects. Data were collected from 274 employee‐supervisor dyads across three waves with objective cognitive reflection scores and objective measures of workplace charitable giving and employee performance. Results supported all hypothesized predictions even after accounting for three alternative mediators. In particular, servant leadership had a positive indirect effect on workplace charitable giving through follower other‐orientation; it also had a positive indirect effect on objective follower financial performance through other‐orientation and cognitive reflection. Both indirect effects were significant at low levels of moral identity internalization but not at high levels. We discuss the implications of these findings and delineate directions for future research.
A systematic review of measurement uncertainty visualizations in the context of standardized assessments
Authors: Heltne Aleksander , Frans Niek , Hummelen Benjamin , Falkum Erik , Germans Selvik Sara , Paap Muirne C. S.
Published: June 2023

This systematic review summarized findings of 29 studies evaluating visual presentation formats appropriate for communicating measurement uncertainty associated with standardized clinical assessment instruments. Studies were identified through systematic searches of multiple databases (Medline, Embase, PsycInfo, ERIC, Scopus, and Web of Science). Strikingly, we found no studies which were conducted using samples of clinicians and included clinical decision‐making scenarios. Included studies did however find that providing participants with information about measurement uncertainty may increase awareness of uncertainty and promote more optimal decision making. Formats which visualize the shape of the underlying probability distribution were found to promote more accurate probability estimation and appropriate interpretations of the underlying probability distribution shape. However, participants in the included studies did not seem to benefit from the additional information provided by such plots during decision‐making tasks. Further explorations into how presentations of measurement uncertainty impact clinical decision making are needed to examine whether findings of the included studies generalize to clinician populations. This review provides an important overview of pitfalls associated with formats commonly used to communicate measurement uncertainty in clinical assessment instruments, and a potential starting point for further explorations into promising alternatives. Finally, our review offers specific recommendations on how remaining research questions might be addressed.
Phylogenomics resolves major relationships ofCatocalaunderwing moths
Authors: Homziak Nicholas T. , Storer Caroline G. , Gall Lawrence F. , Borth Robert J. , Kawahara Akito Y.
Published: June 2023

Underwing moths in the genusCatocalaSchrank are among the most charismatic of Lepidoptera.Catocalais also one of the most diverse genera worldwide in the speciose family Erebidae, but a phylogenetic framework for the genus is lacking. Here we reconstruct the first comprehensive molecular phylogeny for the genus based on 685 anchored hybrid enrichment loci sampled from 161Catocalaspecies (99 Nearctic, 62 Palearctic), four species ofUlotrichopusWallengren and 33 outgroups. Phylogenetic analysis unambiguously recoversCatocalaandCatocala + Ulotrichopusas monophyletic with strong support and resolves many backbone relationships withinCatocala.Our results confirm the classification of previously proposed taxonomic subgroups ofCatocala, including seven based on recent molecular/morphological evidence, and ten based on early twentieth‐century morphological research. Mapping of larval host plant use onto the tree shows Fabaceae to be the likely ancestral host plant family forCatocalaandCatocala + Ulotrichopus. There appear to have been at least 18 independent larval host plant shifts to nine plant families, the most common shift being from Fabaceae to Fagaceae. Larval host plant use has likely played an important role in the evolutionary history ofCatocala, with several rapid diversification events propelled by shifts to novel larval host plants, particularly in the North AmericanCatocalafauna.
Seismic and medical ultrasound imaging of velocity and density variations by nonlinear vectorial inverse scattering
Authors: Jakobsen Morten , Xiang Kui , van Dongen Koen W. A.
Published: May 2023

We present an iterative nonlinear inverse scattering algorithm for high-resolution acoustic imaging of density and velocity variations. To solve the multi-parameter nonlinear direct scattering problem, the acoustic wave equation for inhomogeneous media in the frequency domain is transformed into a vectorial integral equation of the Lippmann–Schwinger type for the combined pressure and pressure-gradient field. To solve the multi-parameter nonlinear inverse scattering problem, we use the Newton–Kantorovich method in conjunction with matrix-free representations of the Fréchet derivative operators and their adjoints. The approximate Hessian information that is accounted for in our iterative solution of the (nonlinear) multi-parameter inverse scattering problem is essential for the mitigation of multi-parameter cross talk effects. Numerical examples related to seismic and medical ultrasound breast imaging illustrate the performance of the new algorithm for multi-parameter acoustic imaging.
Measurement of swept level distortion product otoacoustic emission growth functions at multiple frequencies simultaneously
Authors: Glavin Courtney Coburn , Dhar Sumitrajit , Goodman Shawn S.
Published: June 2023

Otoacoustic emissions (OAEs) are low-level sounds generated by the inner ear that provide a non-invasive assessment of cochlear health. Advanced applications require recording OAEs across a wide range of frequencies and stimulus levels. Detailed here is a method for efficiently measuring distortion product otoacoustic emissions (DPOAEs) across an expansive stimulus space. Specifically, DPOAEs are recorded by sweeping the evoking stimuli in level across multiple frequencies simultaneously. This method generates DPOAE growth functions at multiple f2 frequencies in several minutes. Results indicate the swept level method yields DPOAEs equivalent to those measured in a traditional (discrete stimulus) paradigm, but with several advantages.
FIRRM/C1orf112 mediates resolution of homologous recombination intermediates in response to DNA interstrand crosslinks
Authors: Mazouzi Abdelghani , Moser Sarah C. , Abascal Federico , van den Broek Bram , Del Castillo Velasco-Herrera Martin , van der Heijden Ingrid , Hekkelman Maarten , Drenth Anne Paulien , van der Burg Eline , Kroese Lona J. , Jalink Kees , Adams David J. , Jonkers Jos , Brummelkamp Thijn R.
Published: May 2023

DNA interstrand crosslinks (ICLs) pose a major obstacle for DNA replication and transcription if left unrepaired. The cellular response to ICLs requires the coordination of various DNA repair mechanisms. Homologous recombination (HR) intermediates generated in response to ICLs, require efficient and timely conversion by structure-selective endonucleases. Our knowledge on the precise coordination of this process remains incomplete. Here, we designed complementary genetic screens to map the machinery involved in the response to ICLs and identified FIRRM/C1orf112 as an indispensable factor in maintaining genome stability. FIRRM deficiency leads to hypersensitivity to ICL-inducing compounds, accumulation of DNA damage during S-G
2
phase of the cell cycle, and chromosomal aberrations, and elicits a unique mutational signature previously observed in HR-deficient tumors. In addition, FIRRM is recruited to ICLs, controls MUS81 chromatin loading, and thereby affects resolution of HR intermediates. FIRRM deficiency in mice causes early embryonic lethality and accelerates tumor formation. Thus, FIRRM plays a critical role in the response to ICLs encountered during DNA replication.
An AAV-CRISPR/Cas9 strategy for gene editing across divergent rodent species: Targeting neural oxytocin receptors as a proof of concept
Authors: Boender Arjen J. , Boon Marina , Albers H. Elliott , Eck Samantha R. , Fricker Brandon A. , Kelly Aubrey M. , LeDoux Joseph E. , Motta Simone C. , Shrestha Prerana , Taylor Jack H. , Trainor Brian C. , Triana-Del Rio Rodrigo , Young Larry J.
Published: May 2023

A major issue in neuroscience is the poor translatability of research results from preclinical studies in animals to clinical outcomes. Comparative neuroscience can overcome this barrier by studying multiple species to differentiate between species-specific and general mechanisms of neural circuit functioning. Targeted manipulation of neural circuits often depends on genetic dissection, and use of this technique has been restricted to only a few model species, limiting its application in comparative research. However, ongoing advances in genomics make genetic dissection attainable in a growing number of species. To demonstrate the potential of comparative gene editing approaches, we developed a viral-mediated CRISPR/Cas9 strategy that is predicted to target the oxytocin receptor (
Oxtr
) gene in >80 rodent species. This strategy specifically reduced OXTR levels in all evaluated species (
n
= 6) without causing gross neuronal toxicity. Thus, we show that CRISPR/Cas9-based tools can function in multiple species simultaneously. Thereby, we hope to encourage comparative gene editing and improve the translatability of neuroscientific research.
Manipulation of an electron by photoirradiation in the electron-catalyzed cross-coupling reaction
Authors: Shirakawa Eiji , Ota Yuki , Yonekura Kyohei , Okura Keisho , Mizusawa Sahiro , Sarkar Sujan Kumar , Abe Manabu
Published: May 2023

An electron has recently been shown to catalyze the cross-coupling reaction of organometallic compounds with aryl halides. In terms of green and sustainable chemistry, the electron catalysis is much more desirable than the inevitably used transition metal catalysis but a high temperature of more than 100°C is required to achieve it. Here, we disclose that visible light photoirradiation accelerates the electron-catalyzed reaction of arylzinc reagents with aryl halides with the aid of a photoredox catalysis. Photoexcitation of a photoredox catalyst and an anion radical intermediate respectively affects the supply and transfer of the electron catalyst, promoting the cross-coupling reaction to proceed at room temperature. The supply of the electron catalyst by the photoredox catalysis makes the scope of aryl halides wider.
Hybrid origin of a primate, the gray snub-nosed monkey
Authors: Wu Hong , Wang Zefu , Zhang Yuxing , Frantz Laurent , Roos Christian , Irwin David M. , Zhang Chenglin , Liu Xuefeng , Wu Dongdong , Huang Song , Gu Tongtong , Liu Jianquan , Yu Li
Published: June 2023

Hybridization is widely recognized as promoting both species and phenotypic diversity. However, its role in mammalian evolution is rarely examined. We report historical hybridization among a group of snub-nosed monkeys (
Rhinopithecus
) that resulted in the origin of a hybrid species. The geographically isolated gray snub-nosed monkey
Rhinopithecus brelichi
shows a stable mixed genomic ancestry derived from the golden snub-nosed monkey (
Rhinopithecus roxellana
) and the ancestor of black-white (
Rhinopithecus bieti
) and black snub-nosed monkeys (
Rhinopithecus strykeri
). We further identified key genes derived from the parental lineages, respectively, that may have contributed to the mosaic coat coloration of
R. brelichi
, which likely promoted premating reproductive isolation of the hybrid from parental lineages. Our study highlights the underappreciated role of hybridization in generating species and phenotypic diversity in mammals.
Adaptations to a cold climate promoted social evolution in Asian colobine primates
Authors: Qi Xiao-Guang , Wu Jinwei , Zhao Lan , Wang Lu , Guang Xuanmin , Garber Paul A. , Opie Christopher , Yuan Yuan , Diao Runjie , Li Gang , Wang Kun , Pan Ruliang , Ji Weihong , Sun Hailu , Huang Zhi-Pang , Xu Chunzhong , Witarto Arief B. , Jia Rui , Zhang Chi , Deng Cheng , Qiu Qiang , Zhang Guojie , Grueter Cyril C. , Wu Dongdong , Li Baoguo
Published: June 2023

The biological mechanisms that underpin primate social evolution remain poorly understood. Asian colobines display a range of social organizations, which makes them good models for investigating social evolution. By integrating ecological, geological, fossil, behavioral, and genomic analyses, we found that colobine primates that inhabit colder environments tend to live in larger, more complex groups. Specifically, glacial periods during the past 6 million years promoted the selection of genes involved in cold-related energy metabolism and neurohormonal regulation. More-efficient dopamine and oxytocin pathways developed in odd-nosed monkeys, which may have favored the prolongation of maternal care and lactation, increasing infant survival in cold environments. These adaptive changes appear to have strengthened interindividual affiliation, increased male-male tolerance, and facilitated the stepwise aggregation from independent one-male groups to large multilevel societies.
A global catalog of whole-genome diversity from 233 primate species
Authors: Kuderna Lukas F. K. , Gao Hong , Janiak Mareike C. , Kuhlwilm Martin , Orkin Joseph D. , Bataillon Thomas , Manu Shivakumara , Valenzuela Alejandro , Bergman Juraj , Rousselle Marjolaine , Silva Felipe Ennes , Agueda Lidia , Blanc Julie , Gut Marta , de Vries Dorien , Goodhead Ian , Harris R. Alan , Raveendran Muthuswamy , Jensen Axel , Chuma Idrissa S. , Horvath Julie E. , Hvilsom Christina , Juan David , Frandsen Peter , Schraiber Joshua G. , de Melo Fabiano R. , Bertuol Fabrício , Byrne Hazel , Sampaio Iracilda , Farias Izeni , Valsecchi João , Messias Malu , da Silva Maria N. F. , Trivedi Mihir , Rossi Rogerio , Hrbek Tomas , Andriaholinirina Nicole , Rabarivola Clément J. , Zaramody Alphonse , Jolly Clifford J. , Phillips-Conroy Jane , Wilkerson Gregory , Abee Christian , Simmons Joe H. , Fernandez-Duque Eduardo , Kanthaswamy Sree , Shiferaw Fekadu , Wu Dongdong , Zhou Long , Shao Yong , Zhang Guojie , Keyyu Julius D. , Knauf Sascha , Le Minh D. , Lizano Esther , Merker Stefan , Navarro Arcadi , Nadler Tilo , Khor Chiea Chuen , Lee Jessica , Tan Patrick , Lim Weng Khong , Kitchener Andrew C. , Zinner Dietmar , Gut Ivo , Melin Amanda D. , Guschanski Katerina , Schierup Mikkel Heide , Beck Robin M. D. , Umapathy Govindhaswamy , Roos Christian , Boubli Jean P. , Rogers Jeffrey , Farh Kyle Kai-How , Marques Bonet Tomas
Published: June 2023

The rich diversity of morphology and behavior displayed across primate species provides an informative context in which to study the impact of genomic diversity on fundamental biological processes. Analysis of that diversity provides insight into long-standing questions in evolutionary and conservation biology and is urgent given severe threats these species are facing. Here, we present high-coverage whole-genome data from 233 primate species representing 86% of genera and all 16 families. This dataset was used, together with fossil calibration, to create a nuclear DNA phylogeny and to reassess evolutionary divergence times among primate clades. We found within-species genetic diversity across families and geographic regions to be associated with climate and sociality, but not with extinction risk. Furthermore, mutation rates differ across species, potentially influenced by effective population sizes. Lastly, we identified extensive recurrence of missense mutations previously thought to be human specific. This study will open a wide range of research avenues for future primate genomic research.
Genome-wide coancestry reveals details of ancient and recent male-driven reticulation in baboons
Authors: Sørensen Erik F. , Harris R. Alan , Zhang Liye , Raveendran Muthuswamy , Kuderna Lukas F. K. , Walker Jerilyn A. , Storer Jessica M. , Kuhlwilm Martin , Fontsere Claudia , Seshadri Lakshmi , Bergey Christina M. , Burrell Andrew S. , Bergman Juraj , Phillips-Conroy Jane E. , Shiferaw Fekadu , Chiou Kenneth L. , Chuma Idrissa S. , Keyyu Julius D. , Fischer Julia , Gingras Marie-Claude , Salvi Sejal , Doddapaneni Harshavardhan , Schierup Mikkel H. , Batzer Mark A. , Jolly Clifford J. , Knauf Sascha , Zinner Dietmar , Farh Kyle K.-H. , Marques-Bonet Tomas , Munch Kasper , Roos Christian , Rogers Jeffrey
Published: June 2023

Baboons (genus
Papio
) are a morphologically and behaviorally diverse clade of catarrhine monkeys that have experienced hybridization between phenotypically and genetically distinct phylogenetic species. We used high-coverage whole-genome sequences from 225 wild baboons representing 19 geographic localities to investigate population genomics and interspecies gene flow. Our analyses provide an expanded picture of evolutionary reticulation among species and reveal patterns of population structure within and among species, including differential admixture among conspecific populations. We describe the first example of a baboon population with a genetic composition that is derived from three distinct lineages. The results reveal processes, both ancient and recent, that produced the observed mismatch between phylogenetic relationships based on matrilineal, patrilineal, and biparental inheritance. We also identified several candidate genes that may contribute to species-specific phenotypes.
Microbial Pathogenesis in the Era of Spatial Omics
Authors: Lempke Samantha , May Dana , Ewald Sarah E.
Published: May 2023

The biology of a cell, whether it is a unicellular organism or part of a multicellular network, is influenced by cell type, temporal changes in cell state, and the cell’s environment. Spatial cues play a critical role in the regulation of microbial pathogenesis strategies.
Azospirillum brasilense AerC and Tlp4b Cytoplasmic Chemoreceptors Are Promiscuous and Interact with the Two Membrane-Bound Chemotaxis Signaling Clusters Mediating Chemotaxis Responses
Authors: Ganusova Elena E. , Rost Madison , Aksenova Anastasia , Abdulhussein Mustafa , Holden Alisha , Alexandre Gladys
Published: May 2023

Cytoplasmic chemoreceptors represent about 14% of all chemoreceptors encoded in bacterial and archaeal genomes, but little is known about how they interact with and function in large polar assemblies of membrane-bound chemotaxis signaling clusters. Here, we show that two soluble chemoreceptors with a role in chemotaxis are promiscuous and interact with two distinct membrane-bound chemotaxis signaling clusters that control all chemotaxis responses in
Azospirillum brasilense
.
Promoting RAPID Vaccine Science Education at the Onset of the COVID-19 Pandemic
Authors: Smyth Davida S. , Jordan Trace , Seiser Robert , Moran Meghan , Hasager Ulla , Sorby Sheryl , Kahl Nathan , Shachter Amy , Oates Karen
Published: June 2023

At the onset of the 2019 coronavirus disease (COVID-19) pandemic, it was clear that we needed to support public education on the science of vaccines. This project was born of that need and led to the development of comprehensive educational materials that addressed the process of science, severe acute respiratory syndrome coronavirus 2 biology, vaccine development, and science communication and outreach.
Complete Genome Sequence of Lopsy, a B1 Cluster Mycobacteriophage
Authors: Ealand Christopher , Machowski Edith Erika , Jacobs Olivia , Kana Bavesh
Published: June 2023

Lopsy is a siphovirus mycobacteriophage that is capable of lytic infection in
Mycobacterium smegmatis
. It is classified as a subcluster B1 mycobacteriophage and was isolated from soil in Estcourt, South Africa. The 68,542-bp double-stranded DNA genome is circularly permuted, has a GC content of 66.4%, and is predicted to contain 98 genes.
Longitudinal Gut Microbiota Dysbiosis Underlies Olanzapine-Induced Weight Gain
Authors: Qian Li , He Xiaoyan , Liu Yixin , Gao Fengjie , Lu Wen , Fan Yajuan , Gao Yuan , Wang Wei , Zhu Feng , Wang Yanan , Ma Xiancang
Published: June 2023

Olanzapine is one of the most effective second-generation antipsychotics for stabilizing schizophrenia spectrum disorders. However, olanzapine has multiple drug-induced metabolic side effects, including weight gain.
Prevalence and Persistence of Antibiotic Resistance Determinants in the Gut of Travelers Returning to the United Kingdom is Associated with Colonization by Pathogenic Escherichiacoli
Authors: Dallman Timothy J. , Neuert Saskia , Fernandez Turienzo Cristina , Berin Michelle , Richardson Emily , Fuentes-Utrilla Pablo , Loman Nicholas , Gharbia Saheer , Jenkins Claire , Behrens Ron H. , Godbole Gauri , Brown Michael
Published: May 2023

A future where antimicrobial therapy is severely compromised by the increase in resistant organisms is of grave concern. Given the variability in prevalence and diversity of antimicrobial resistance determinants in different geographical settings, international travel is a known risk factor for acquisition of resistant organisms into the gut microbiota.
Bronchodilator response by interrupter technique to guide management of preschool wheeze
Authors: Seddon Paul C , Willson Rhian , Olden Catherine , Symes Elizabeth , Lombardi Enrico , Beydon Nicole
Published: May 2023

Objective

We examined relationships between clinical features and pulmonary function before and after inhaled corticosteroid (ICS) treatment in wheezy preschool children, and specifically, whether measuring bronchodilator response (BDR) could predict benefit from ICS.

Design

Clinical non-randomised intervention study

Setting

Secondary care.

Patients

Preschool children (2 years to <6 years) with recurrent wheeze.

Interventions

Inhaled beta-agonist, ICS.

Outcome measures

We measured prebronchodilator and postbronchodilator interrupter resistance (Rint) and symptom scores at 0 (V1), 4 (V2) and 12 (V3) weeks. At V2, those with a predetermined symptom level commenced ICS. Modified Asthma Predictive Index (mAPI) and parental perception of response to bronchodilator were recorded. Response to ICS was defined as a reduction in daily symptom score of >0.26. Positive BDR was defined as fall in Rint of ≥0.26 kPa.s/L, ≥35% predicted or ≥1.25 Z Scores.

Results

Out of 138 recruited children, 67 completed the full study. Mean (SD) prebronchodilator Rint at V2 was 1.22 (0.35) kPa.s/L, and fell after starting ICS (V3) to 1.09 (0.33) kPa.s/L (p<0.001), while mean (SD) daily symptom score fell from 0.56 (0.36) to 0.28 (0.36) after ICS (p<0.001). Positive Rint BDR before ICS (at V1 and/or V2), using all three threshold criteria, was significantly associated with response to ICS on symptom scores at V3 (p<0.05). mAPI was not significantly associated with response to ICS, and parents’ perception of response to bronchodilator was not related to measured Rint BDR .

Conclusions

Rint BDR may be helpful in selecting which wheezy preschool children are likely to benefit from ICS.
Iatrogenic Kaposi’s sarcoma from induction therapy for myeloma: to transplant or not to transplant?
Authors: Farrugia Daniel , Sultana Erika , Babic Darko , Grech Mark
Published: June 2023

We present the case of an HIV-negative man in his 50s who developed a generalised nodular rash while having first-line bortezomib–cyclophosphamide–dexamethasone chemotherapy for multiple myeloma. The rash was biopsied and proven to be Kaposi’s sarcoma. The patient’s treatment was interrupted at the sixth cycle of chemotherapy, by which time the rash had also spread to the oral mucosa and eyelid. The rash regressed spontaneously on stopping treatment. We were reluctant to restart myeloma treatment, but on the other hand, we wished to consolidate the very good partial response achieved. An autologous marrow transplant was done months later without any recurrence of his Kaposi’s with the initiation of bortezomib maintenance. Bortezomib has putative activity against Kaposi’s. The patient could benefit from imid-based (thalidomide, lenalidomide, pomalidomide) combination chemotherapy once his myeloma progresses or if there is a recurrence of Kaposi’s sarcoma.
Laterally extended endopelvic resection as part of the surgical management of disseminated retroperitoneal leiomyomatosis mimicking low-grade sarcoma in a patient with a solitary kidney
Authors: Khan Maaedah , Eltawab Sally , Gietzmann William , Soleymani majd Hooman
Published: June 2023

Leiomyomas are common benign uterine smooth muscle tumours. Rarer subsets may demonstrate aggressive extrauterine growth which mimic metastatic disease. We discuss the case of a female patient in her 40s, with a long-standing atrophic right kidney, presenting with a 17 cm uterine mass demonstrating bilateral para-aortic and pelvic sidewall spread. Although biopsies favoured the diagnosis of a benign tumour, a leiomyosarcoma could not be excluded. The surgical complexity of the case was compounded by a tumour residing close to the only functioning kidney and engulfment of the inferior mesenteric artery. The surgical procedures indicated were a radical hysterectomy, the laterally extended endopelvic resection procedure to achieve clear margins in the pelvic sidewall and a left hemicolectomy. In the absence of formal guidelines, we present this challenging case to provide clarity into the histological assessment and surgical management of rare leiomyomas, as well as an overview of the current literature.
Clinicopathological and immunological characteristics and outcome of concomitant coeliac disease and non-alcoholic fatty liver disease in adults: a large prospective longitudinal study
Authors: Kamal Sanaa , Aldossari Khaled K , Ghoraba Dhalia , Abdelhakam Sara Mahmoud , Kamal Amgad H , Bedewi Mohamad , Nabegh Leila , Bahnasy Khaled , Hafez Tamer
Published: May 2023

Objective

Concomitant non-alcoholic fatty liver disease (NAFLD) and coeliac disease (CD) have not been adequately studied. This study investigated the frequency of CD among NAFLD patients and the clinicopathological and immunological patterns and outcome of concomitant NAFLD and CD.

Design

This prospective longitudinal study screened patients with NAFLD for CD (tissue transglutaminase antibodies (TTGA); anti-TTGA and antiendomysial antibodies (EMA)). Patients with concomitant NAFLD and CD and patients with either NAFLD or CD were enrolled and followed. Duodenal biopsy, transient elastography, tumour necrosis factor (TNF)-alpha, transforming growth factor-beta, interleukins (ILs) 1, 6, 10, 15 and 17, folic acid and vitamins B12 and D were performed at baseline and 1 year after gluten-free diet (GFD).

Results

CD was confirmed in 7.2% of patients with NAFLD. Refractory anaemia and nutritional deficiencies were frequent in patients with concomitant NAFLD and CD who had advanced intestinal and hepatic lesions, higher levels of TNF-α, IL-15 and IL-17 compared with patients with CD and NAFLD. Patients concomittant CD and NAFLD showed clinical response to GFD, but intestinal histological improvement was suboptimal. Combining EMA-IgA or anti-TTGA with either IL-15 or IL-17 enhances the prognostic performance of both tests in predicting histological response to GFD.

Conclusion

Concomitant NAFLD and CD is not uncommon. Recurrent abdominal symptoms, refractory anaemia, nutritional deficiencies in patients with NAFLD warrant screening for CD. The study has important clinical implications since failure in diagnosing CD in patients with NAFLD patients results in marked intestinal and hepatic damage and suboptimal response to GFD that can be alleviated by early diagnosis and initiation of GFD.
A community-based contact isolation strategy to reduce the spread of Ebola virus disease: an analysis of the 2018–2020 outbreak in the Democratic Republic of the Congo
Authors: Keita Mory , Polonsky Jonathan A , Ahuka-Mundeke Steve , Ilumbulumbu Michel Kalongo , Dakissaga Adama , Boiro Hamadou , Anoko Julienne Ngoundoung , Diassy Lamine , Ngwama John Kombe , Bah Houssainatou , Tosalisana Michel Kasereka , Kitenge Omasumbu Richard , Chérif Ibrahima Sory , Boland Samuel T , Delamou Alexandre , Yam Abdoulaye , Flahault Antoine , Dagron Stéphanie , Gueye Abdou Salam , Keiser Olivia , Fall Ibrahima Socé
Published: June 2023

Introduction

Despite tremendous progress in the development of diagnostics, vaccines and therapeutics for Ebola virus disease (EVD), challenges remain in the implementation of holistic strategies to rapidly curtail outbreaks. We investigated the effectiveness of a community-based contact isolation strategy to limit the spread of the disease in the Democratic Republic of Congo (DRC).

Methods

We did a quasi-experimental comparison study. Eligible participants were EVD contacts registered from 12 June 2019 to 18 May 2020 in Beni and Mabalako Health Zones. Intervention group participants were isolated to specific community sites for the duration of their follow-up. Comparison group participants underwent contact tracing without isolation. The primary outcome was measured as the reproduction number (R) in the two groups. Secondary outcomes were the delay from symptom onset to isolation and case management, case fatality rate (CFR) and vaccination uptake.

Results

27 324 EVD contacts were included in the study; 585 in the intervention group and 26 739 in the comparison group. The intervention group generated 32 confirmed cases (5.5%) in the first generation, while the comparison group generated 87 (0.3%). However, the 32 confirmed cases arising from the intervention contacts did not generate any additional transmission (R=0.00), whereas the 87 confirmed cases arising from the comparison group generated 99 secondary cases (R=1.14). The average delay between symptom onset and case isolation was shorter (1.3 vs 4.8 days; p<0.0001), CFR lower (12.5% vs 48.4%; p=0.0001) and postexposure vaccination uptake higher (86.0% vs 56.8%; p<0.0001) in the intervention group compared with the comparison group. A significant difference was also found between intervention and comparison groups in survival rate at the discharge of hospitalised confirmed patients (87.9% vs 47.7%, respectively; p=0.0004).

Conclusion

The community-based contact isolation strategy used in DRC shows promise as a potentially effective approach for the rapid cessation of EVD transmission, highlighting the importance of rapidly implemented, community-oriented and trust-building control strategies.
Association of access to water, sanitation and handwashing facilities with undernutrition of children below 5 years of age in Bangladesh: evidence from two population-based, nationally representative surveys
Authors: Hasan Md Mehedi , Asif Chowdhury Abdullah Al , Barua Alina , Banerjee Archis , Kalam Md Abul , Kader Abdul , Wahed Tasnuva , Noman Mohammad Wali , Talukder Aminuzzaman
Published: June 2023

Objective

To examine the association between household access to water, sanitation and handwashing (WaSH) facilities and child undernutrition in Bangladesh.

Design, setting and participants

Cross-sectional study of children less than 5 years using data collected from the 2019 Multiple Indicator Cluster Survey (MICS) and the 2017–2018 Bangladesh Demographic and Health Survey (BDHS).

Outcome measures

Stunting, wasting and underweight, defined as a Z-score <−2 SD for height-for-age, weight-for-height and weight-for-age, respectively. We applied hierarchical multiple binary logistic regression models.

Results

Among 30 514 children 0–59 months, there was a high prevalence of child undernutrition (MICS: 28.0% stunted, 9.8% wasted, 22.6% underweight; BDHS: 30.8% stunted, 8.4% wasted, 21.7% underweight). Most children came from households lacking basic sanitation (MICS: 39.1%, BDHS: 55.3%) or handwashing facilities (MICS: 43.8%, BDHS: 62.6%). Children from households without access to WaSH facilities experienced the highest rates of undernutrition. Exposure-specific adjusted logistic regression models showed that a lack of access to improved water sources was associated with greater odds of wasting (MICS: adjusted OR (AOR) 1.36, 95% CI 1.00 to 1.85, p<0.05); basic sanitation facility with higher rates of stunting (MICS: 1.13, 1.04 to 1.23, p<0.01) and underweight (BDHS: 1.18, 1.02 to 1.37, p<0.05); and a lack of handwashing facilities with stunting (BDHS: 1.27, 1.10 to 1.48, p<0.01) and underweight (MICS: 1.10, 1.01 to 1.19, p<0.05). In fully adjusted models, no basic sanitation facility was associated with higher odds of stunting (MICS: AOR 1.12, 1.03 to 1.22, p<0.01) and a lack of handwashing facilities with higher odds of underweight (BDHS: AOR 1.30, 1.10 to 1.54, p<0.01;MICS: AOR 1.09, 1.01 to 1.19, p<0.05).

Conclusion

These findings demonstrate a significant association between poor household WaSH facilities and high prevalence of child undernutrition. Improving WaSH may help reduce child undernutrition in Bangladesh.
Association between toileting and falls in older adults admitted to the emergency department and hospitalised: a cross-sectional study
Authors: Zou Min , Lu Rong , Jiang Yijun , Liu Ping , Tian Bingjie , Liang Yuqi , Wang XiaoLing , Jiang Liping
Published: June 2023

Objectives

This study aimed to explore the potential risk factors associated with toileting-related falls in community-dwelling older adults who presented to the emergency department and were subsequently hospitalised.

Design

This was a cross-sectional study.

Setting and participants

This study was conducted in two teaching hospitals in Shanghai, China between October 2019 and December 2021 among community-dwelling adults aged ≥60 years.

Methods

In-person interviews, physical assessment and medical record review were performed to collect data on the characteristics and risk factors of falls. Associations of toileting-related falls with demographic characteristics and geriatric syndromes were examined using logistic regression models.

Main outcome measures

Potential risk factors for toileting-related falls.

Results

This study included 419 older patients with a mean age of 73.8±9.7 years. Among 60 (14.3%) patients with toileting-related falls (mean age: 78.8±9.2 years), 63.3% of toileting-related falls, mainly occurred between 00:00 and 05:59 hours, compared with 17.3% of non-toileting-related falls, which primarily occurred during the daytime. The rate of recurrent falls (35%) was significantly higher in the toileting-related falls group than in the non-toileting-related falls group (21.2%) (p=0.02). Logistic regression showed that visual impairment (OR 2.7, 95% CI 1.1 to 7.1), cognitive impairment (OR 3.3, 95% CI 1.3 to 8.4), gait instability (OR 3.1, 95% CI 1.1 to 8.8) and urinary incontinence (OR 3.4, 95% CI 1.2 to 9.9) were strongly associated with toileting-related falls. Twenty-three (38.3%) patients in the toileting-related falls group had moderate and severe injuries, compared with 71.7% in the non-toileting-related falls group (p<0.05).

Conclusions

This study revealed that patients who reported toileting-related falls were more likely to have cognitive impairment, urinary incontinence, gait instability, visual impairment than patients who fell during other activities. Social and healthcare professionals should prioritise the management of toileting activities in older patients and provide targeted interventions to those in the high-risk group.
Acute exercise as active inference in chronic musculoskeletal pain, effects on gait kinematics and muscular activity in patients and healthy participants: a study protocol for a randomised controlled laboratory trial
Authors: Westergren Jens , Sjöberg Veronica , Vixner Linda , Nyberg Roger G , Moulaee Conradsson David , Monnier Andreas , LoMartire Riccardo , Enthoven Paul , Äng Björn O
Published: May 2023

Introduction

Chronic musculoskeletal pain is a highly prevalent, complex and distressing condition that may negatively affect all domains of life. In view of an active inference framework, and resting on the concept of allostasis, human movement per se becomes a prerequisite for health and well-being while chronic pain becomes a sign of a system unable to attenuate an allostatic load. Previous studies on different subgroups of chronic pain conditions have demonstrated alterations in gait kinematics and muscle activity, indicating shared disturbances in the motor system from long-term allostatic load. We hypothesise that such alterations exist in heterogenous populations with chronic musculoskeletal pain, and that exposure to acute and controlled exercise may attenuate these alterations. Therefore, the main aim of this study is to investigate the acute effects of exercise on gait kinematics and activity of the back and neck muscles during diverse walking conditions in patients with chronic musculoskeletal pain compared with a reference sample consisting of healthy participants.

Methods and analysis

This two-sample two-armed parallel randomised controlled laboratory trial will include 40 participants with chronic musculoskeletal pain (>3 months) and 40 healthy participants. Participants will be randomly allocated to either 30 min of aerobic exercise or rest. Primary outcomes are gait kinematics (walking speed, step frequency, stride length, lumbar rotation, gait stability) and muscular activity (spatial and temporal) of the back and neck during diverse walking conditions. Secondary outcomes are variability of gait kinematics and muscle activity and subjective pain ratings assessed regularly during the trial.

Ethics and dissemination

The study has been approved by the Regional Ethics Review Board in Uppsala, Sweden (#2018/307). Findings will be disseminated via conference presentations, publications in peer-reviewed journals and engagement with patient support groups and clinicians.

Trial registration number

NCT03882333.
Novel application of multi-facility process map analysis for rapid injury care health system assessment in Northern Malawi
Authors: Whitaker John , Amoah Abena S , Dube Albert , Chirwa Lindani , Munthali Boston , Rickard Rory F , Leather Andrew J M , Davies Justine
Published: June 2023

Objectives

We used the process mapping method and Three Delays framework, to identify and visually represent the relationship between critical actions, decisions and barriers to access to care following injury in the Karonga health system, Northern Malawi.

Design

Facilitated group process mapping workshops with summary process mapping synthesis.

Setting

Process mapping workshops took place in 11 identified health system facilities (one per facility) providing injury care for a population in Karonga, Northern Malawi.

Participants

Fifty-four healthcare workers from various cadres took part.

Results

An overall injury health system summary map was created using those categories of action, decision and barrier that were sometimes or frequently reported. This provided a visual summary of the process following injury within the health system. For Delay 1 (seeking care) four barriers were most commonly described (by 8 of 11 facilities) these were ‘cultural norms’, ‘healthcare literacy’, ‘traditional healers’ and ‘police processes’. For Delay 2 (reaching care) the barrier most frequently described was ‘transport’—a lack of timely affordable emergency transport (formal or informal) described by all 11 facilities. For Delay 3 (receiving quality care) the most commonly reported barrier was that of ‘physical resources’ (9 of 11 facilities).

Conclusions

We found our novel approach combining several process mapping exercises to produce a summary map to be highly suited to rapid health system assessment identifying barriers to injury care, within a Three Delays framework. We commend the approach to others wishing to conduct rapid health system assessments in similar contexts.
Protocol for the OCAY study: a cohort study of orphanhood and caregiver loss in the COVID-19 era to explore the impact on children and adolescents
Authors: Steventon Roberts Kathryn J , Du Toit Stefani , Mawoyo Tatenda , Tomlinson Mark , Cluver Lucie D , Skeen Sarah , Laurenzi Christina A , Sherr Lorraine
Published: June 2023

Introduction

Globally, no person has been untouched by the COVID-19 pandemic. Yet, little attention has been given to children and adolescents in policy, provision and services. Moreover, there is a dearth of knowledge regarding the impact of COVID-19-associated orphanhood and caregiver loss on children. This study aims to provide early insights into the mental health and well-being of children and adolescents experiencing orphanhood or caregiver loss in South Africa.

Methods and analysis

Data will be drawn from a quantitative longitudinal study in Cape Town, South Africa. A sample of children and adolescents between the ages of 9 and 18 years, experiencing parental or caregiver loss from COVID-19, will be recruited together with a comparison group of children in similar environments who did not experience loss. The study aims to recruit 500 children in both groups. Mental health and well-being among children will be explored through the use of validated and study-specific measures. Participants will be interviewed at two time points, with follow-up data being collected 12–18 months after baseline. A combination of analytical techniques (including descriptive statistics, regression modelling and structural equation modelling) will be used to understand the experience and inform future policy and service provision.

Ethics and dissemination

This study received ethical approval from the Health Research Ethics Committee at Stellenbosch University (N 22/04/040). Results will be disseminated via academic and policy publications, as well as national and international presentations including high-level meetings with technical experts. Findings will also be disseminated at a community level via various platforms.
Joint British Societies’ position statement on bullying, harassment and discrimination in cardiology
Authors: Camm Christian Fielder , Joshi Abhishek , Eftekhari Helen , O'Flynn Rachael , Dobson Rebecca , Curzen Nick , Lloyd Guy , Greenwood John Pierre , Allen Christopher
Published: May 2023

Inappropriate behaviour is an umbrella term including discrimination, harassment and bullying. This includes both actions and language and can affect any member of the cardiovascular workforce/team. Evidence has suggested that such behaviour is regularly experienced within UK cardiology departments, where inappropriate behaviour may represent longstanding cultural and practice issues within the unit. Inappropriate behaviour has negative effects on the workforce community as a whole, including impacts on recruitment and retention of staff and patient care. While only some members of the cardiology team may be directly impacted by inappropriate behaviour in individual departments, a wider group are significantly impacted as bystanders. As such, improving the culture and professional behaviours within UK cardiology departments is of paramount importance. As a negative workplace culture is felt to be a major driver of inappropriate behaviour, all members of the cardiovascular team have a role to play in ensuring a positive workplace culture is developed. Episodes of inappropriate behaviour should be challenged by cardiovascular team members. Informal feedback may be appropriate where ‘one-off’ episodes of inappropriate behaviour occur, but serious events or repeated behaviour should be escalated following formal human resources protocols.
Clinical, pathological, genetics and intratumoural immune milieu of micropapillary carcinoma of the colon
Authors: Deshpande Vikram , Lee Soo Hyun , Crabbe Andrew , Pankaj Amaya , Neyaz Azfar , Ono Yuho , Rickelt Steffen , Sonal Swati , Ferrone Cristina R , Ting David T , Patil Deepa , Yilmaz Omer , Berger David , Yilmaz Osman
Published: May 2023

Aim

Micropapillary carcinoma (MPC) is a recognised WHO variant of colonic carcinoma (CC), although little is known about its prognosis, immune microenvironment and molecular alterations. We investigated its clinical, pathological and immunological characteristics.

Methods

We assessed 903 consecutive CCs and used the WHO definition to identify MPC. We recorded serrated and mucinous differentiation and mismatch repair (MMR) status. We performed immunohistochemistry and quantification on tissue microarrays for HLA class I/II proteins, beta-2-microglobulin (B2MG), CD8, CD163, LAG3, PD-L1, FoxP3, PD-L1and BRAF V600E.

Results

We classified 8.6% (N=78) of CC as MPC. Relative to non-MPC, MPC was more often high grade (p=0.03) and showed serrated morphology (p<0.01); however, we found no association with extramural venous invasion (p=0.41) and American Joint Committee on Cancer stage (p=0.95). MPCs showed lower numbers of CD8 positive lymphocytes (p<0.01), lower tumour cell B2MG expression (p=0.04) and lower tumour cell PD-L1 expression (p<0.01). There was no difference in HLA class I/II, LAG3, FOXP3, CD163 and PD-L1 positive histiocytes. There was no association with MMR status or BRAF V600E relative to non-MPC. MPC was not associated with decreased disease-specific survival (p=0.36).

Conclusion

MPCs are associated with high-grade differentiation and a less active immune microenvironment than non-MPC. MPC is not associated with inferior disease-specific survival.
Gender distribution in surgical pathology journal publications and editorial boards
Authors: Nguyen Minh Anh , Yousef Samer , Gupta Ruta , McKenzie Catriona
Published: May 2023

Aims

To investigate trends in representation of women among authors and editorial boards of surgical pathology journals over the last two decades.

Secondary aims: to identify barriers and potential solutions.

Methods

The names and gender of first, middle, last authors and editorial board members were obtained from original articles from seven pathology journals from various geopolitical regions in 2002, 2011 and 2021. The proportion of women first, middle, last authors and editorial board members were compared over time.

Results

1097 publications and 8012 individual authors were extracted. In 2002, 2011 and 2021, respectively, the percentage of women first authors were 28.3% (257 of 907), 31.9% (566 of 1773) and 41.1% (1421 of 3457); women middle authorship rates were 30.0% (159 of 530), 32.8% (375 of 1145) and 40.9% (1067 of 2609) and women last authors were 18.0% (34 of 188), 26.0% (82 of 315) and 36.0% (152 of 422). Women representation on editorial boards has increased (11.3%, 15.8%, 26.5%), but of the chief editors, there was only one woman in 2021, while all were men in 2002 and 2011.

Conclusions

To our knowledge, this study is the first to document under-representation of women among authors and editorial boards of surgical pathology journals. While women representation has increased over time, predominance of men remains relative to workforce proportions. Our findings are comparable to those from other medical fields and prompt the need to investigate the underlying causes for this imbalance and implement strategies to promote diversity, equity and inclusion in academic surgical pathology.