bluuebunny/crossref_metadata_2025 huggingface dataset:
The Factors Influencing Early Ambulation in Patients With Gastrointestinal Neoplasms
Authors: Wu Zhiying , Liu Dun , Huang Yanfang , Ye Yafang , Ma Qiumei , Huang Jiahua , Wu Liping
Published: January 2025

Background

Early ambulation helps improve postoperative recovery in gastrointestinal neoplasm patients. However, compliance with early ambulation remains low.

Objective

This study aimed to explore the influencing factors and experiences of early ambulation in gastrointestinal neoplasm patients and to provide suggestions for subsequent intervention programs.

Methods

A convergent mixed-method design was used, which was based on the Health Belief Model. Gastrointestinal neoplasm patients were invited to participate in the quantitative and qualitative investigations. The demographic data, early activity awareness, self-efficacy, disease treatment data, and social psychological data of 405 gastrointestinal neoplasm patients were collected and analyzed in a nested case-control study. A semistructured interview on early ambulation was conducted for 16 patients. Finally, the results of the 2 studies were integrated.

Results

Quantitative analysis revealed that age, education level, exercise habits, nutritional status, pulmonary disease status, activity awareness, and social support were the influencing factors (P < .05). Five themes were extracted from the qualitative research results: insufficient recognition of perceived threat, perceived barriers and benefits, cues to action (internal/external factors), self-efficacy (success/failure), and needs.

Conclusions

Patients’ perceptions of early ambulation and social support influenced early ambulation. Perceptions of benefits/barriers, age, education level, and humanized nursing may affect early postoperative movement. Self-efficacy and behavioral cues, such as pulmonary disease status, nutritional status, and pain status, still need further exploration.

Implication for Practice

Reinforcing perceived severity, perceived benefits, and social support; removing possible barriers; and providing individualized health education according to the age and educational level of patients are recommended.
2024 Visionary Leader Crystal Lawson
Authors: Wong Valerie
Published: January 2025

The following article is the winning 2024 Richard Hader Visionary Leader Award entry submitted to Nursing Management in recognition of Crystal Lawson, DNP, RN, CENP, during her tenure as interim director of education at Cedars-Sinai Marina del Rey Hospital in Marina del Rey, Calif. She currently serves as CEO and founder of We Rise Up, an organization dedicated to equipping, inspiring, and empowering nurse leaders, and continues working in a leadership development consultant capacity for Cedars Sinai.
Prevalence and genotype distribution of human papillomavirus among women with cervical or vaginal lesions in Jiangsu, China: 2 cross-sectional studies (2012–2013 and 2020–2021)
Authors: Han Weiwei , Wang Wenjuan , Chu Kai , Bi Zhaofeng , Chen Qi , Li Jingxin , Zhu Fengcai
Published: January 2025

Background

Human papillomavirus (HPV) infection is a major risk factor of cervical cancer. This study assessed the prevalence and distribution of HPV genotypes in women with cervical or vaginal lesions in Jiangsu Province, China.

Methods

A total of 2120 healthy women aged 18–45 years were screened between 2012 and 2013 and 6171 healthy women aged 18–45 years were screened between 2020 and 2021 in Jiangsu Province. Cervical specimens collected from each woman were first tested using the HPV DNA enzyme immunoassay method, and positive samples were further tested using the reverse hybridization line probe assay. Differences in HPV prevalence and genotype distribution were compared between women with cervical and vaginal lesions identified during 2 rounds of cross-sectional screening. To account for differences in age composition between the 2 studies, the standardized prevalence of HPV positivity was calculated using the sum of the total number of women diagnosed with cervical or vaginal lesions during both periods as the standard group.

Results

Overall, 40 women (1.89%) were diagnosed with cervical or vaginal lesions through biopsy during 2012–2013, and 110 (1.78%) were diagnosed during 2020–2021. Among women with lesions, the standardized HPV positivity rates were 98.41% in 2012–2013 and 99.24% in 2020–2021. Most cases were caused by high-risk HPV, which accounted for 87.18% of the total infections during 2012–2013 and 89.91% of those in 2020–2021, with standardized positivity rates of 86.44% and 88.75%, respectively. The standardized positivity rates for single infections were 62.35% in 2012–2013 and 74.95% in 2020–2021. The top 5 high-risk HPV genotypes were HPV type 16 (HPV16; 29.01%), 52 (20.63%), 18 (14.28%), 58 (13.71%), and 33 (12.12%) in 2012–2013, and HPV16 (36.95%), 58 (22.18%), 52 (13.25%), 31 (7.63%), and 51 (6.81%) in 2020–2021. The standardized positivity rate for HPV18 decreased from 14.28% in 2012–2013 to 1.15% in 2020–2021. Among women with cervical or vaginal lesions, the highest proportion was observed in the 36- to 45-year group during 2012–2013, reaching 52.50%, and in the 26- to 35-year group during 2020–2021, peaking at 59.10%.

Conclusions

In Jiangsu Province, no significant changes in HPV prevalence among women with cervical or vaginal lesions were observed during 2012–2013 and 2020–2021; however, the distribution of HPV genotypes had changed.
Platelet-Rich Plasma Versus Corticosteroids in the Treatment of Plantar Fasciitis: A Systematic Review and Meta-Analysis
Authors: Zuo Ankai , Gao Chengfei , Jia Qiufeng , Zhang Meirong , Fu Ting , Li Tieshan , Wang Lin
Published: January 2025

Objective

This study aims to compare the efficacy of platelet-rich plasma (PRP) and corticosteroids (CS) in treating plantar fasciitis, focusing on pain relief, foot function, and plantar fascia thickness to identify the optimal treatment approach.

Design

A comprehensive search of medical databases was conducted following PRISMA guidelines, utilizing an extensive keyword strategy. Inclusion criteria encompassed prospective RCTs involving adult patients with plantar fasciitis treated with local PRP or CS injections, specifically assessing outcomes such as the Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) scores, and plantar fascia thickness.

Results

The meta-analysis included 24 RCTs with 1653 participants. PRP injections yielded significantly better VAS scores compared to CS injections at 3 months (P = 0.03) and 6 months (P < 0.001), with no significant differences at 1 month (P = 0.12) and 12 months (P = 0.08). AOFAS scores demonstrated that PRP was superior to CS at 3 (P = 0.05), 6 (P < 0.001), and 12 months (P < 0.001), with no significant differences at 1 month (P = 0.31). Regarding plantar fascia thickness, there were no significant differences between PRP and CS at 1-1.5 months (P = 0.18), 3 months (P = 0.64), and 6 months (P = 0.05).

Conclusions

PRP injections offer superior pain control compared to corticosteroids in the medium term (3-6 months) but not in the short term or at one year.
Effectiveness of amnion allograph injections in patients with degenerative musculoskeletal diseases: a systematic review and meta-analysis
Authors: Hou Wen-Hsuan , Lin Pi-Chu , Tung Kuang-Mou , Chen Su-Ru
Published: January 2025

Objective

Amnion allograft injections have emerged as potential regenerative therapy for degenerative musculoskeletal diseases. In this study, we conducted a systematic review and meta-analysis to evaluate the effectiveness of amnion allograph injections in patients with degenerative musculoskeletal diseases.

Design

A search was conducted across the PubMed, Embase, Cochrane, and Web of Science databases to identify studies reporting on amnion allograft injections in patients with degenerative musculoskeletal diseases. The outcomes assessed were pain reduction at different time points, physical functional improvements, and quality of life (QoL).

Results

In total, seven studies were included. The quality assessment indicated that only three studies had a low overall risk of bias. Pooled effect sizes indicated significant improvements in overall pain of -0.959 (95% confidence interval (CI): -1.483 ~ -0.435, p < 0.001), pain at 2–4 weeks of -2.609 (95% CI: -3.334 ~ -1.884, p < 0.001), at 3–6 months of 0.834 (95% CI: -1.077 ~ -0.590, p < 0.001), and at 1–2 years of -0.518 (95% CI: -1.025 ~ -0.011, p = 0.045), physical function of 0.679 (95% CI: 0.202 ~ 1.156, p = 0.005), and QoL of 1.407 (95% CI: 0.273 ~ 2.541, p = 0.015). No significant covariant was identified by subgroup analyses.

Conclusions

Results indicated that amnion allograft injections produced significant pain reduction, functional improvement, and QoL enhancement in patients receiving injections compared to control groups, particularly in terms of pain reduction.
A Quality Improvement Initiative to Reduce Surgical Site Infections in Pediatric Patients Undergoing Cardiothoracic Surgery
Authors: Golden Cassidy , Murphy Kathy , Rosenblum Joshua M. , Eriksson Charlotta , Dunaway Parker , Lukacs Mary , Newberry Lisa , Gleason Michelle E. , Calamaro Christina J. , Basu Mohua , Chanani Nikhil K. , Shashidharan Subhadra , Fundora Michael P.
Published: January 2025

Introduction:

This project aimed to decrease surgical site wound infections (SSIs) to less than 1 per 100 cases in pediatric patients after cardiothoracic surgery.

Methods:

A multidisciplinary workgroup was established to identify perioperative risk factors, and educational gaps and create a bedside quality improvement (QI) rounding group to monitor wounds. SSIs were defined according to the Centers for Disease Control National Healthcare Safety Network guidelines. Infection preventionists adjudicated infections as SSIs after an SSI huddle evaluated the case. A QI bundle was developed more than 2 eras: 2015 criteria included an enhanced hygiene bundle, scripted discharge telephone calls about wound care, and 2019 criteria identified SSI risk factors, developed an SSI-QI rounding team, created additional wound care education, and standardized wound care. Data were collected from January 2014 to December 2022 to assess SSI rates per 100 surgical cases, as well as clinically relevant short- and long-term outcomes.

Results:

From December 2014 to December 2022, there were 5,610 surgical cases evaluated in SSI-QI rounds. Compared with the preintervention cohort, SSI rates decreased significantly during the intervention (SSI per 100 cases 2.82; 95% confidence interval, 1.94–4.09) and postintervention (SSI per 100 cases 0.55; 95% confidence interval, 0.24–1.26). There were no increases in reoperations, postoperative major complications, or discharge mortality throughout the study.

Conclusions:

SSI rates decreased below the goal of 1 per 100 surgical cases. Standardized wound dressings, improving hygiene compliance including bath compliance from 80% to 96.1%, multidisciplinary collaboration, bedside rounds, and postdischarge procedures contributed to lowering and sustaining low SSI rates.
A Standardized Approach to Transition Improves Care of Young Adults with Inflammatory Bowel Disease
Authors: Katz Daphna , Lee Stephanie , Sathananthan Vidiya , Bayes Santos Liz , Langshaw Amber
Published: January 2025

Introduction:

Young adults with inflammatory bowel disease (IBD) are at the risk of poor outcomes when transferring to adult providers. We aimed to increase the percentage of patients with 14–17 years of age undergoing the transition of care and the percentage of patients 18–21 years of age initiating the transfer of care to 50% for 12 months. Our goal was also to improve patient satisfaction with the transfer process. Our balancing measure was not to increase the duration of IBD visits.

Methods:

We implemented 3 interventions through iterative plan-do-study-act cycles. To understand the impact of the interventions for 12 months, we used statistical process control charts. The duration of IBD visits was used as a balancing measure. We administered an anonymous satisfaction survey through the electronic health record.

Results:

Total transition discussions increased to a mean of 38% (n = 68). Transition discussions with patients 14–17 years of age increased from baseline, though not consistently. Patients 18–21 years of age initiating transfer of care increased to a mean of 5% (n = 1) following the first intervention and to a mean of 30% (n = 13) following our second and third interventions with special cause variation. There was no significant difference in the duration of IBD visits before and after the intervention period (P = 0.54). No patients were dissatisfied following our interventions.

Conclusions:

We saw improved transition discussions and transfer initiation rates by implementing the first steps of a new process to transition young adults with IBD.
Challenges of continuous cropping obstacles in Panax ginseng: Formation and response mechanisms
Authors: Chen Kang , Tong Yuru , Wang Tielin , Zhou Xiuteng , Zhou Junhui , Ge Yang , Zheng Han , Yu Muyao , Luo Yunfeng , Ji Ruifeng
Published: January 2025

Panax ginseng, a perennial herbaceous plant and a representative of the Panax genus, is renowned for its exceptional medicinal value and economic benefits, often referred to as the “King of Herbs.” With the increasing market demand and the limited availability of suitable cultivation land, the issue of continuous cropping obstacles for P. ginseng has become increasingly prominent, directly hindering the sustainable development of the ginseng industry. This article summarizes the concept and hazards of continuous cropping obstacles and, drawing on the latest research, provides an in-depth analysis of the causes and response mechanisms. This work aims to establish a solid foundation for future research into the mechanisms of continuous cropping obstacles in P. ginseng.
Gene expression comparisons between captive and wild shrew brains reveal captivity effects
Authors: Bedoya Duque Maria Alejandra , Thomas William R. , Dechmann Dina K. N. , Nieland John , Baldoni Cecilia , von Elverfeldt Dominik , Muturi Marion , Corthals Angelique P. , Dávalos Liliana M.
Published: January 2025

Compared with their free-ranging counterparts, wild animals in captivity experience different conditions with lasting physiological and behavioural effects. Although shifts in gene expression are expected to occur upstream of these phenotypes, we found no previous gene expression comparisons of captive versus free-ranging mammals. We assessed gene expression profiles of three brain regions (cortex, olfactory bulb and hippocampus) of wild shrews (
Sorex araneus
) compared with shrews kept in captivity for two months and undertook sample dropout to examine robustness given limited sample sizes. Consistent with captivity effects, we found hundreds of differentially expressed genes in all three brain regions, 104 overlapping across all three, that enriched pathways associated with neurodegenerative disease, oxidative phosphorylation and genes encoding ribosomal proteins. In the shrew, transcriptomic changes detected under captivity resemble responses in several human pathologies, including major depressive disorder and neurodegeneration. While interpretations of individual genes are tempered by small sample sizes, we propose captivity influences brain gene expression and function and can confound analyses of natural processes in wild individuals under captive conditions.
Growing up with chronic traffic noise exposure leads to transient but not long-term noise tolerance in a songbird
Authors: Liu Quanxiao , Slabbekoorn Hans , Riebel Katharina
Published: January 2025

Noise pollution is on the rise worldwide. An unresolved issue regarding the mitigation of noise pollution is whether and at which timescales animals may adapt to noise pollution. Here, we tested whether continuous highway noise exposure perinatally and during juvenile development increased noise tolerance in a songbird, the zebra finch (
Taeniopygia castanotis
). Breeding pairs were exposed to highway noise recordings from pre-egg-laying until their offspring reached subadulthood. Subsequently, offspring were tested for noise tolerance both as subadults and adults in a spatial preference test, where birds could choose to enter aviaries with different levels of highway noise. Unlike control birds that preferentially chose the quiet aviaries, noise-reared birds exhibited no spatial preferences for quiet in the first test. However, when the experimental birds were retested after two months without noise exposure, they now avoided the previously tolerated noise levels and preferred the quieter aviary. The increased noise tolerance observed directly after the release from the noise treatment was thus only transient. Growing up with chronic highway noise exposure did thus not increase subjects’ noise tolerance, meaning that at least in this songbird species, adaptation to noise pollution is unlikely to arise on a developmental time scale.
Study on wettability of water stemming for blasting dust adjusted by surfactants and inorganic salts
Authors: Chen Fengjie , Zhou Zejun , Liang Ying , Liu Xiaowen , Wang Xiaoguang , Wang Pu , Chen Bolei , Liang Yong , Wang Yawei
Published: January 2025

Water stemming is an efficient method of removing blasting dust by wetting. There is still a lack of methods for rapid optimization of water stemming components with high wettability. Herein, blasting dust was collected from a tunnel in Chongqing (China) to investigate its removal performance by different water stemmings. The two most important components of blasting dust were SiO
2
and CaCO
3
by characterization analysis. Notably, hydrophilic blasting dust has significantly more SiO
2
than hydrophobic blasting dust. The density functional theory calculation predicted the wettability of water stemming containing sucrose fatty acid ester (SE) higher than that of water stemming containing other surfactants. Moreover, the water contact angle and surface tension experiments determined the addition of inorganic salts to the water stemming containing SE could increase its wettability, with the addition of Al
3+
giving the best performance. The sink test and water retention experiment further prove that our synthesized water stemming has a good wetting ability on both hydrophobic and hydrophilic blasting dust. The findings of this study advance the development of reliable methods for optimizing water stemming with high wettability for removing the blasting dust.
Four novel nontuberculous mycobacteria species: Mycobacterium wendilense sp. nov., Mycobacterium burgundiense sp. nov., Mycobacterium kokjensenii sp. nov. and Mycobacterium holstebronense sp. nov. revived from a historical Danish strain collection
Authors: Iversen Xenia Emilie Sinding , Rasmussen Erik Michael , Folkvardsen Dorte Bek , Svensson Erik , Meehan Conor J. , Jørgensen René , Norman Anders , Lillebaek Troels
Published: January 2025

Four novel nontuberculous mycobacteria were discovered from a historical strain collection at the International Reference Laboratory of Mycobacteriology at Statens Serum Institut in Copenhagen, Denmark. Phylogenetic analysis combining the 16S rrs, internal transcribed spacer and 23S rrl elements, as well as a single-copy core-gene (hsp65, rpoB+C, secA and tuf) analysis of these freeze-dried mycobacteria, clinically isolated from gastric lavage samples between 1948 and 1955, showed to be associated with type strains grouping within the Terra and Fortuitum-Vaccae clade. Phenotypic characteristics, biochemical properties and fatty acid and mycolic acid profiles supported the classification as novel strains. A genomic comparison to the closest related type strain was done by calculating average nucleotide identity and in silico DNA:DNA hybridization values, which showed 87.9% and 33.0% for Mu0050, 85.2% and 27.4% for Mu0053, 85.3% and 27.6% for Mu0083 and 93.3% and 50.1% for Mu0102, respectively. The names proposed for the new species are Mycobacterium wendilense sp. nov. (Mu0050T=ITM 501390T=CCUG 77525T), Mycobacterium burgundiense sp. nov. (Mu0053T=ITM 501391T=CCUG 77526T), Mycobacterium kokjensenii sp. nov. (Mu0083T=ITM 501392T=CCUG 77527T) and Mycobacterium holstebronense sp. nov. (Mu0102T=ITM 501393T=CCUG 77528T).
Comparison of WHO laboratory-based and non-laboratory-based CVD risk Charts among Hypertensive Adults Attending Primary Healthcare Centers in West Africa Sub-region
Authors: Hutton-Mensah Kojo Awotwi , Ibrahim Olayinka Rasheed , Nwankwo Adaku M , Nketia George Bediako , Adeniyi Funmi Temidayo , Natogmah Abukari Yakubu , Ogunmodede James Ayodele , Ojji Dike , Adesola Olumide , Alabi Biodun Sulyman , Mokuolu Olugbenga Ayodeji , Sarpong Daniel
Published: January 2025

Background

The World Health Organization (WHO) non-laboratory cardiovascular disease (CVD) risk chart is sub-region-specific and is advocated in resource-constrained settings. However, the extent of agreement with laboratory-based assessment among hypertensive adults attending primary health centers (PHCs) in the West Africa sub-region remains unknown. This study compared 10-year CVD risk among adults with hypertension attending PHCs in Ghana and Nigeria.

Materials and Methods

This cross-sectional study recruited 319 adults with hypertension at PHCs in Ghana and Nigeria. All participants had their blood pressures, anthropometrics, fasting blood sugar, and fasting cholesterol measured following standard procedures. WHO laboratory and non-laboratory CVD risks were assessed and compared using Kappa’s statistics, correlation, and Bland-Altman Plot.

Results

The median (interquartile range) for laboratory-based and non-laboratory-based CVD risk scores were comparable [7.0 (4.0 11.0) vs. 7.0 (4.0 to 11.0), p = 0.914]. Of the 319 participants, laboratory-based assessment classified 214 (67.1%) as low risk, while 210 (65.8%) were classified as low risk using the non-laboratory method. Eleven (3.4%) and 14 (4.4%) participants were classified as high-risk using laboratory- and non-laboratory-based methods, respectively. Overall, there was a very good positive correlation between the CVD risk assessment methods (r = 0.948, p<0.001). For all participants combined, there was substantial agreement (Kappa statistics), with K = 0.766. Bland-Altman showed a mean bias of 0.15 (SD = 1.74) in favor of non-laboratory-based assessment of CVD with an upper limit of 3.57 and a lower limit of -3.26.

Conclusion

There was substantial agreement between laboratory- and non-laboratory-based WHO CVD risk charts in this study. In low-resource settings, such as Ghana and Nigeria, the WHO non-laboratory CVD risk prediction model offers a huge opportunity for primary CVD prevention in adults with hypertension.
Development and Implementation of a Minority Health International Infectious Diseases Research Training Program
Authors: Sy Angela , Taylor Diane , Leaungwutiwong Pornsawan , Phanupak Nittaya , Sirida Youngchim , Leke Rose , Humphrey Peter S. , Tandon Ravi , Kulkarni Madhur , Madhivanan Purnima , Kaholokula Joseph Keawe‵aimoku , Nerurkar Vivek R.
Published: January 2025

From 2014-2019, the University of Hawai‵i (UH) at Manoa offered a National Institutes of Health funded Minority Health International Research Training (MHIRT) Program for undergraduate research experiences in infectious diseases. The goal of the program was to immerse undergraduate students in conducting global infectious diseases research to train a new generation of scientists to combat future global pandemics. The MHIRT program trained educationally underrepresented groups unique in Hawai‵i: Native Hawai‵ians and other Pacific Islanders, and underrepresented Asian Americans, e.g., Filipinos and Vietnamese. A 12-member Advisory Committee guided the program development, implementation, recruitment strategies, recruitment, retention, and program evaluation. The program provided an eight-month classroom and field based international research training. Students learned about “8 steps of research” and cultural competency, experienced a hands-on research project abroad, and presented their results to the research community in the host country and at UH. Students’ research topics focused on ongoing projects of UH faculty including those with international collaborations in infectious disease and tropical medicine. Students spent two months on an international research mentor’s project at an international site under the mentorship of a Hawai‵i based research faculty. After eight months, students graduated from the program by presenting their research to family, friends, mentors, and UH faculty and administrators. Trainees in this program pursued academic graduate or professional health degrees. The majority of students pursued further studies related to infectious diseases contributing to workforce development in infectious disease health research. The UH-MHIRT program provides an example of student immersion in international infectious disease research to foster future interest in global health research providing potential benefits for the student and faculty and their research efforts.
Assessing Knowledge, Uptake and Factors associated with cervical cancer screening among women in selected communities of Wakiso District in Uganda: A population-based study
Authors: Bulamba Robert. M. , Kyasanku Emmanuel , Nalugoda Fred , Daama Alex , Nkale James Menya , Miller Amanda P. , Byansi William , Namutundu Juliana , Kigozi Godfrey , Nalwoga Grace K. , Balwanaki Chris , Watya Stephen , Ekström Anna Mia , Mugamba Steven , Ndejjo Rawlance , Nakigozi Gertrude
Published: January 2025

Background

Uganda has the highest prevalence and incidence of cervical cancer in the East African region, with 80% of women diagnosed at advanced stage when survival is minimal. Literature on uptake of cervical cancer screening is limited in Uganda and thus womens’ knowledge and uptake of cervical cancer screening in the general population remains unknown. This study examined this gap of knowledge among women aged 25-65 years, across rural, urban and semi urban communities in a Ugandan district to inform design of targeted future cervical cancer screening programs in the country.

Methods

This descriptive cross-sectional study was conducted in Wakiso district, Uganda in May 2024 among 783 eligible women. Face-to-face interviews were conducted. Uptake of cervical cancer screening (outcome of interest)) was dichotomously (yes/no) assessed. Knowledge of cervical cancer disease was assessed using the AWACAN validated tool, knowledge of cervical cancer screening was assessed using a set of ten (10) questions adapted from previous studies elsewhere, and all were measured on a Likert scale. Univariate, bivariate, and multivariable Poisson regression models with robust variance were performed using Stata software version 17.

Results

Respondents’ median age was 31 years (IQR 27-39 years). Majority (89.5%, 701/783) had heard of cervical cancer, and 90.6% (635/701) were aware of screening. Median knowledge score on signs and symptoms, risk factors and cervical cancer screening was 8.0 (IQR= 5-10), 8.0 (IQR= 5-11) and 7.0 (IQR= 4-10) respectively, and 54.3% had high knowledge about cervical cancer screening. Uptake of cervical cancer screening was 33.4%. Living in urban areas (aPR = 1.41, 95% CI: 1.05 – 1.88), being the ages 40-49 years (aPR = 1.76, 95% CI: 1.36 – 2.27), 50 years and above (APR = 2.16, 95% CI: 1.53 – 3.04), smoking (aPR = 1.39, 95% CI: 1.05 – 1.86), partner involvement (aPR = 2.61, 95% CI: 2.12–3.21), high knowledge about cervical cancer screening (aPR = 3.29, 95% CI: 2.35–4.60), and living with HIV (aPR = 1.66, 95% CI: 1.66–2.13) were significantly associated with higher uptake of cervical cancer screening among women in this setting.

Conclusion

Knowledge of cervical cancer screening was high, but the uptake of cervical cancer screening was lower than the recommended population coverage by WHO and Uganda national guidelines. There is need to improve accessibility to cervical cancer screening, increase nationwide cervical cancer awareness campaigns focusing on high-risk age groups and design targeted, tailored, culturally and socially sensitive interventions for young women aged 25-39 years to improve cervical cancer screening in Uganda.
AIRWAY-XR: Augmented Instruction to Refine Wayfinding and Yielding Skills in Emergency Medicine Residents for Intubation using Mixed Reality Technology
Authors: Bhavsar Neil , Sriram Sandhya , Balasubramanian Shriman , Davidson Christian , Piechowski Wojciech , Zimm Jordan , Sanapala Sowmya , Fortenko Alexander , Lame Maria , Greenwald Peter Wagoner , St. George Jonathan , Sigaras Alexandros
Published: January 2025

The goal of this study was to assess if mixed reality technology (MR) is a feasible training tool for educating new learners in endotracheal intubation. This is a feasibility trial to establish the feasibility of an MR airway education module compared to traditional airway teaching. The study participants were twenty-one postgraduate year one (PGY1) physicians accepted to an emergency medicine residency program located in a large, urban setting. The residency program is located in New York City, and has academic affiliations with two large, urban, academic emergency departments (ED) that each treat over seventy thousand patients per year. We enrolled 20 Emergency Medicine (EM) first-year residents into two research arms. Group A consisted of 10 first-year residents who utilized a novel MR education module containing self-guided training and real-time feedback via the Microsoft HoloLens 2. Group B consisted of 10 first year residents who trained on a phone-based module containing the same self-guided content and received real-time training via iPad, which is the traditional didactic format. Both groups had remote Senior EM Residents (PGY3) coaches who provided feedback and direction to the participants. Groups were subsequently assessed by Attending EM Physicians on a 10-point scale and given a post-survey to provide feedback on their experience. There was no difference in scores between the HoloLens 2 users and iPad users (HoloLens score [8.6] v. iPad score [8.5]; p = 0.56) or in completion time between the two groups (HoloLens = [3.4 +/− 0.9 min] v. iPad = [3.3 +/− 1.4 min]; p = 0.45). Out of the Group A participants, 70% rated their overall experience between good and excellent. We concluded that using the HoloLens 2 as a didactic model for intubation is feasible, with possible evidence for noninferiority to traditional didactic models if explored further in a larger standardized trial.
‘It’s only a flesh wound’ – understanding the safety culture in equine, production animal and mixed veterinary practices
Authors: Tulloch John S.P. , Schofield Imogen , Jackson Rebecca , Whiting Martin
Published: January 2025

The veterinary industry has some of the highest rates of non-fatal work-related injuries, yet safety culture remains unexplored. Utilising a survey, this study aimed to describe the prevalence of work-related injuries in equine, production animal, and mixed veterinary practices, and to understand the behaviours of injured persons.

There were 144 respondents. Over 90% of clinicians experienced injury during their careers, versus a third of non-clinical staff. Injuries to equine veterinarians were predominately kicks to the leg or head, and usually involved the examination of a horse’s distal limb, most were not wearing hard hats. Production animal veterinarians’ injuries included crushed hands and feet, and kicks to legs. Injuries often lead to hospital attendance (>25% equine, >40% production animal), yet few took time off work.

Veterinarians avoided taking time off work after injuries, reasons included; minimisation of injury severity, not wanting to ‘let the team down’, and feelings of guilt. Many planned behaviour change post-injury, including using protective headwear, increasing awareness of surroundings, and using better restraint. Most injuries went unreported due to lack of awareness, acceptance of injury risk, time constraints, and believing reporting would have no impact.

This study exposes a culture in large animal veterinary workplaces that normalises injuries and undervalues safety. The lack of protective measures and the tendency to continue working despite serious injuries, highlight a need for urgent cultural and systemic change. Improved safety practices, leadership commitment, and comprehensive training are essential to address this deep-seated issue and fostering a safer work environment.
Approaches to self-management integration and influencing factors in everyday life after spinal cord injury: A qualitative narrative analysis
Authors: Qama Enxhi , Diviani Nicola , Haefliger Clara , Jordan Xavier , Scheel-Sailer Anke , Zanini Claudia , Rubinelli Sara
Published: January 2025

Objective: This study explores how individuals with spinal cord injury (SCI) integrate self-management (SM) into their everyday lives post-discharge from initial rehabilitation. It focuses on identifying the approaches they employ in balancing health tasks with personal and societal roles and the influencing factors. Methods: We conducted semi-structured interviews with 32 participants, recruited from four rehabilitation centers across Switzerland, three months post-rehabilitation. Data collection spanned from November 2022 to May 2024. We used thematic analysis to identify the challenges and strategies associated with SM integration. Results: Three distinct approaches to SM integration emerged: The compartmentalizing approach, where individuals focused on one aspect at a time; The mixing approach, where both health and other tasks were prioritized but adjusted; and The embedding approach, where there was equal prioritization with no adjustment on either side. Different factors such as mind and body dynamics, which encompass physical and emotional aspects; environmental and informational dynamics, which include external support, accessible facilities, and information; and society and perception dynamics, which include social stigma and misconceptions, influenced these approaches. Conclusions: This study contributes to a more nuanced understanding of how to balance both medical and role management in SCI post-discharge. Self-management integration is achieved through different approaches and influenced by a wide range of factors, internal and external ones. Further research should longitudinally explore whether the approach one individual employs changes with the time and what aspects reinforce one or the other. Practical implications: Our findings highlight the need for flexible, personalized SM interventions in SCI that are contextually grounded but also adaptive and resilient. Rehabilitation settings should assess different SM integration approaches, using feedback to guide individuals in refining their strategies. Communication guidelines and tailored education sessions are recommended to help align SM practices with patients' evolving goals, including family, social, and leisure priorities.
Elevated Atherogenicity in Long COVID: A Systematic Review and Meta-Analysis
Authors: Almulla Abbas F. , Thipakorn Yanin , Zhang Yingqian , Maes Michael
Published: January 2025

Background

Long COVID (LC) is a complex, multi-organ syndrome that persists following recovery from the acute phase of coronavirus infection. Cardiovascular involvement is frequently reported in LC, often accompanied by a spectrum of related symptoms. Dysregulated lipid profiles and elevated atherogenic indices have been implicated in LC, yet no comprehensive systematic review and meta-analysis has specifically addressed these biomarkers.

Objective

This study aims to systematically evaluate atherogenic indices and lipid-related biomarkers in individuals with LC compared to healthy controls.

Methods

A systematic search was conducted in databases including PubMed, Google Scholar, SCOPUS, and SciFinder from September to November 2024. Eligible studies reported lipid biomarker data for LC patients and controls, yielding 44 studies encompassing 8,114 participants (3,353 LC patients and 4,761 controls).

Results

LC patients exhibited significant elevations in Castelli Risk Indexes 1 (standardized mean difference, SMD = 0.199; 95% confidence intervals, CI: 0.087–0.312) and 2 (SMD = 0.202; 95% CI: 0.087–0.318). Atherogenic ratios, including triglyceride (TG)/high-density lipoprotein (HDL) (SMD = 0.294; 95% CI: 0.155–0.433), (TG + low-density lipoprotein, LDL + very low-density lipoprotein, VLDL)/(HDL + apolipoprotein, ApoA) (SMD = 0.264; 95% CI: 0.145–0.383), and ApoB/ApoA (SMD = 0.515; 95% CI: 0.233–0.796), were also significantly elevated. Additionally, LC patients demonstrated increased levels of LDL, total cholesterol, triglycerides, and ApoB, alongside reduced HDL and ApoA levels. Results were free from publication bias.

Conclusion

LC is associated with a pro-atherogenic lipid profile, marked by increased atherogenic components and decreased protective lipid biomarkers. These findings highlight a potential heightened risk for cardiovascular complications in LC patients, warranting further clinical and mechanistic investigations.
Sequence-dependent co-condensation of Lsr2 with DNA elucidates the mechanism of genome compaction inMycobacterium tuberculosis
Authors: Satheesh Thejas , Singh Rohit Kumar , Gaur Prakshi , Shahu Sneha , Ramakrishnan Saminathan , Srivastava Mansi , Neogi Shreyasi , Choubey Sandeep , Ganji Mahipal
Published: January 2025

The xenogeneic silencer protein Lsr2 fromMycobacterium tuberculosisplays a critical role in its survival and pathogenesis. Lsr2 is a nucleoid-associated protein that interacts with DNAin vivoand regulates many genes. Purified Lsr2 forms nucleoprotein filaments with DNA molecules leading to highly compacted DNA conformations. However, the physical mechanism underlying Lsr2-mediated DNA compaction, resulting in gene regulation, remains elusive. We employed a combination of biochemical assay, single-molecule imaging, and molecular dynamics simulations to investigate the governing principles of Lsr2-mediated DNA compaction. We show that, while Lsr2 alone undergoes phase separation, addition of DNA substantially lowers the required concentration for its phase separation. Strikingly, our single-molecule and simulation data establish that Lsr2 forms condensates with long stretches of AT-rich DNA, providing strong evidence for sequence-dependent co-condensation. This observation is contrary to the classical view of sequence-dependent binding of individual protein molecules to DNA, our findings rather suggest that protein-DNA co-condensates ‘sense’ the average binding energy landscape. We present a physical model for Lsr2-mediated DNA compaction and gene regulation, describing a novel mechanism for NAP-mediated genome organization in bacteria.
Navigating uncertainty: reward location variability induces reorganization of hippocampal spatial representations
Authors: Tessereau Charline , Xuan Feng , Mellor Jack R. , Dayan Peter , Dombeck Daniel
Published: January 2025

Navigating uncertainty is crucial for survival, with the location and availability of reward varying in different and unsignalled ways. Hippocampal place cell populations over-represent salient locations in an animal’s environment, including those associated with rewards; however, how the spatial uncertainties impact the cognitive map is unclear. We report a virtual spatial navigation task designed to test the impact of different levels and types of uncertainty about reward on place cell populations. When the reward location changed on a trial-by-trial basis, inducing expected uncertainty, a greater proportion of place cells followed along, and the reward and the track end became anchors of a warped spatial metric. When the reward location then unexpectedly moved, the fraction of reward place cells that followed was greater when starting from a state of expected, compared to low, uncertainty. Overall, we show that different forms of potentially interacting uncertainty generate remapping in parallel, task-relevant, reference frames.
A mechanistic understanding of the effect ofStaphylococcus aureusVraS histidine kinase single point mutation on antibiotic resistance
Authors: Ali Liaqat , Karki Salima , Boorgula Gunavanthi D , Mekakda Amir , Cagle-White Brittnee , Bhattarai Shrijan , Beaudoin Robert , Blakeney Aryanna , Singh Sanjay , Srivastava Shashikant , Abdelaziz May H.
Published: January 2025

Bacterial genomic mutations inStaphylococcus aureus (S. aureus)have been detected in isolated resistant clinical strains, yet their mechanistic effect on the development of antimicrobial resistance remains unclear. The resistance-associated regulatory systems acquire adaptive mutations under stress conditions that may lead to a gain of function effect and contribute to the resistance phenotype. Here, we investigate the effect of a single-point mutation (T331I) in VraS histidine kinase, part of the VraSR two-component system inS. aureus.VraSR senses and responds to environmental stress signals by upregulating gene expression for cell wall synthesis. A combination of enzyme kinetics, microbiological, and transcriptomic analysis revealed the mechanistic effect of the mutation on VraS andS. aureus. Michaelis Menten’s kinetics show that the VraS mutation caused an increase in the autophosphorylation rate of VraS and enhanced its catalytic efficiency. The introduction of the mutation through recombineering coupled with CRISPR-Cas9 counterselection to the Newman strain wild-type (WT) genome doubled the minimum inhibitory concentration of three cell wall-targeting antibiotics. The mutation caused an enhancedS. aureusgrowth rate at sub-lethal doses of the antibiotics, confirming the causative effect of mutation on bacterial persistence. Transcriptomic analysis showed a genome-wide alteration in gene expression levels and protein-protein interaction network of the mutant compared to the WT strain after exposure to vancomycin. The results suggest thatvraSmutation causes several mechanistic changes at the protein and cellular levels that favor bacterial survival under antibiotic stress and cause the mutation-harboring strains to become the dominant population during infection.

Importance

Rising antimicrobial resistance (AMR) is a global health problem. Mutations in the two- component system have been linked to drug- resistance inStaphylococcus aureus, yet the exact mechanism through which these mutations work is understudied. We investigated the T331I mutation in thevraSgene linked to sensing and responding to cell wall stress. The mutation caused changes at the protein level by increasing the catalytic efficiency of VraS kinase activity. Introducing the mutation to the genome of anS. aureusstrain resulted in changes in the phenotypic antibiotic susceptibility, growth kinetics, and genome-wide transcriptomic alterations. By a combination of enzyme kinetics, microbiological, and transcriptomic approaches, we highlight how small genetic changes can significantly impact bacterial physiology and survival under antibiotic stress. Understanding the mechanistic basis of antibiotic resistance is crucial to guide the development of novel therapeutic agents to combat AMR.
Unraveling the plasmidome ofHelicobacter pylori: an unexplored source of potential pathogenicity
Authors: Mendoza-Guido Bradd , Romero-Carpio Juan D. , Molina-Castro Silvia
Published: January 2025

2.

Helicobacter pyloriis a significant human pathogen associated with gastric diseases, yet the role of plasmids in its pathogenicity remains underexplored. This study provides a comprehensive genomic and functional characterization of theH. pyloriplasmidome using publicly available plasmid sequences. Of 335 plasmids analyzed, 127 non-redundant representatives were selected for downstream analysis. MobMess network and Mash distance-based analyses suggest two major plasmid groups (G1 and G2) with distinct genomic and functional profiles. G1 plasmids were enriched in genes related to the Fic protein family and ABC transporters, potentially contributing to pathogenicity through post-translational modification and antibiotic extrusion, respectively. In contrast, G2 plasmids were predominantly associated with the Type IV Secretion System (T4SS) and conjugative elements, indicating a role in horizontal gene transfer. Notably, compound genes were linked to pathogenic proteins, including ClpP, VapD, and a putative vacuolating cytotoxin-related gene. This study underscores the functional diversity of theH. pyloriplasmidome and highlights the need for experimental validation to clarify its role in pathogenicity, antimicrobial resistance, and adaptability.

3.

Impact statement

AlthoughHelicobacter pyloriis well-studied as the primary etiologic agent of gastric diseases, information about the role of plasmids in this species remains limited. This study contributes to microbial genomics by characterizing the genomic and functional diversity of theH. pyloriplasmidome available in public databases. Our findings highlight the importance of monitoring and conducting experimental assays to better understand the role of plasmids in pathogenic bacteria likeH. pylori, which may harbor genes related to pathogenicity and antimicrobial resistance.

4.

Data summary

The authors confirm all supporting data, and protocols have been provided within the article or through supplementary data files. The code employed for bioinformatic analyses can be obtained from the corresponding author upon request.
Engineering of CRISPR-Cas PAM recognition using deep learning of vast evolutionary data
Authors: Nayfach Stephen , Bhatnagar Aadyot , Novichkov Andrey , Estevam Gabriella O. , Kim Nahye , Hill Emily , Ruffolo Jeffrey A. , Silverstein Rachel , Gallagher Joseph , Kleinstiver Benjamin , Meeske Alexander J. , Cameron Peter , Madani Ali
Published: January 2025

CRISPR-Cas enzymes must recognize a protospacer-adjacent motif (PAM) to edit a genomic site, significantly limiting the range of targetable sequences in a genome. Machine learning-based protein engineering provides a powerful solution to efficiently generate Cas protein variants tailored to recognize specific PAMs. Here, we present Protein2PAM, an evolution-informed deep learning model trained on a dataset of over 45,000 CRISPR-Cas PAMs. Protein2PAM rapidly and accurately predicts PAM specificity directly from Cas proteins across Type I, II, and V CRISPR-Cas systems. Usingin silicodeep mutational scanning, we demonstrate that the model can identify residues critical for PAM recognition in Cas9 without utilizing structural information. As a proof of concept for protein engineering, we employ Protein2PAM to computationally evolve Nme1Cas9, generating variants with broadened PAM recognition and up to a 50-fold increase in PAM cleavage rates compared to the wild-type underin vitroconditions. This work represents the first successful application of machine learning to achieve customization of Cas enzymes for alternate PAM recognition, paving the way for personalized genome editing.