bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence-based practice confidence and behavior throughout the curriculum of four physical therapy education programs: a longitudinal study
Authors: Romney Wendy , Salbach Nancy M. , Perry Susan B. , Deutsch Judith E.
Published: November 2023

Background

Evidence-based practice (EBP) is a foundational process taught in health professional education, yet it is unclear when EBP confidence and skills are obtained. Increases in EBP confidence and behaviors from the start of physical therapy programs to post graduation have been reported in studies that evaluated a single program or used non-valid questionnaires. This study aimed to describe changes in EBP confidence and behavior using validated questionnaires of students from four physical therapy education programs throughout their curriculum and one year post graduation.

Methods

One hundred and eighty-one students from a potential pool of 269 (67.3%) consented to participate. Students completed the Evidence-Based Practice Confidence (EPIC) Scale and the Evidence-Based Practice Implementation Scale (EBPIS) at 6 timepoints: start of the program, prior to first clinical experience, after first clinical experience, at the end of classroom instruction, graduation, and one year post. Medians (Mdn) and 25th and 75th percentiles (P25, P75) were calculated for 42 (23.2%) students with complete data across all timepoints. Change between timepoints was assessed using Friedman’s test and Wilcoxon signed rank test with a Bonferroni correction for post hoc analysis.

Results

There were significant changes in EPIC scores (p < 0.001) from enrollment (Mdn 50.0, P25, P75 35.5, 65.9) to prior to first clinical experience (Mdn 65.5, P25, P75 57.3, 72.5) and after the first clinical experience (Mdn 67.3, P25, P75, 58.9, 73.2) to the end of classroom instruction (Mdn 78.6, P25, P75, 72.0, 84.1). Significant increases on the EBPIS (p < 0.01) were only seen from after the first year of training (Mdn 15, P25, P75, 10.0, 22.5) to end of the first clinical experience (Mdn 21.5, P25, P75 12.0, 32.0).

Conclusions

EBP confidence increased significantly after classroom instruction but remained the same after clinical experiences and at one year post graduation. EBP behavior significantly increased only after the first clinical experience and remained the same through graduation. Confidence and behavior scores were higher than were previously reported in practicing professionals. Ongoing assessment of EBP confidence and behavior may help instructors build appropriate curricula to achieve their outlined EBP objectives.
Study on a job competence evaluation system for resident physicians (including integrated postgraduates) receiving standardized training
Authors: Fu Yuanzheng , Zhao Guoxiang , Shan Jie , Zeng Luxian
Published: November 2023

Background

Standardized training for resident physicians is the primary form of postgraduate medical education, and it plays a pivotal role in healthcare safety and industry stability. Currently, it has garnered significant attention from healthcare institutions.

Methods

By conducting a comprehensive literature review and a Delphi consultation in June 2022 for which 40 experts in clinical medicine, public health, and other related fields in China were invited. The indicators were adjusted according to the results of the consultation, and the final indicator weights were determined through an analytic hierarchy process.

Results

The response rate was 100%, and the expert authority coefficient was 0.879. The consistency among the experts on the tertiary indicators, as measured by Kendall’s W, was 0.675 (χ2 = 42.516, p < 0.001). Based on the results of the expert consultation, a job competence evaluation system for resident physicians (including integrated postgraduates) receiving standardized training was established, which included 6 primary indicators, 18 secondary indicators, and 116 tertiary indicators. The weights for the primary indicators, namely professional quality, skills and knowledge, patient care, communication and collaboration, teaching skills, and lifelong learning, were 0.313, 0.248, 0.181, 0.083, 0.066, and 0.110, respectively. The top three secondary indicators in terms of combined weights were clinical skills (0.122), professional ethics (0.120), and professional dedication (0.109). The three tertiary indicators with the highest scores were “maintains collaboration with peers and colleagues in patient treatment,” “has clinical thinking skills, makes diagnosis and treatment decisions based on analysis of evidence, and has the ability to administer suitable treatments,” and “abides by laws and discipline and refuses to seek personal gains in medical practice”; their combined weights were 0.035, 0.028, and 0.027, respectively.

Conclusion

This study has established a concrete, objective, and quantifiable competency assessment index system for standardized training of clinical resident physicians (including integrated postgraduates). This system provides a foundation for the quantitative evaluation of the competency of clinical resident physicians (including integrated postgraduates) undergoing standardized training.
Becoming a physician for older patients: exploring the professional identity formation of medical students during a nursing home clerkship. A qualitative study
Authors: Moll-Jongerius Annemarie , Langeveld Kirsten , Helmich Esther , Masud Tahir , Kramer Anneke W.M. , Achterberg Wilco P.
Published: November 2023

Background

To prepare medical students for the growing population of older patients, an appropriate professional identity formation is desirable. The community of practice of medical school is primarily hospital-based and disease-oriented which will lead to the development of a physician who is mainly focused on cure. This focus alone however is not always appropriate for older persons’ health care. The aim of this study is to explore the influence of participating in a nursing home community of practice on the professional identity formation of medical students.

Methods

A qualitative study based on a constructivist research paradigm was conducted, using individual semi-structured, in-depth interviews and a visual narrative method (drawing) as a prompt. Thematic analysis was applied to structure and interpret the data. The study population consisted of fifth-year medical students participating in a six-week nursing home clerkship. Thirteen participants were purposefully sampled. The clerkship took place in nursing homes in the South-West of the Netherlands.

Results

The medical students described the nursing home as the living environment of the patients. Actively participating in the patients’ care and experiencing the daily life of the patients was meaningful for the physician the students want to become in five ways: (1) a physician with a complete picture; (2) a physician who is close; (3) a physician who is in dialogue; (4) a physician who is able to let go and (5) a physican who collaborates.

Conclusions

Caring for older patients in the nursing home influences the professional identity formation of medical students. Patient-centeredness, personal, holistic and tailored care, approachability and collaboration are important characteristics in becoming a physician for older persons’ health care. The context of this care provides relevant learning experiences for this development and the becoming of a physician in general.
Effects of private health insurance on medical expenditure and health service utilization in South Korea: a quantile regression analysis
Authors: Kwon Kristine Namhee , Chung Wankyo
Published: November 2023

Background

Despite universal health insurance, South Korea has seen a sharp increase in the number of people enrolled in supplemental private health insurance (PHI) during the last decade. This study examined how private health insurance enrollment affects medical expenditure and health service utilization.

Methods

Unbalanced panel data for adults aged 19 and older were constructed using the 2016–2018 Korea Health Panel Survey. Quantile regression for medical cost, and quantile count regression for health service utilization were utilized using propensity score-matched data. We included 17 variables representing demographic, socioeconomic, and health information, as well as medical costs and use of outpatient and inpatient care.

Results

We discovered that PHI enrollees’ socioeconomic and health status is more likely to be better than PHI non-enrollees’. Results showed that private health insurance had a greater effect on the lower quantiles of the conditional distribution of outpatient costs (coefficient 0.149 at the 10th quantile and 0.121 at the 25th quantile) and higher quantiles of inpaitent care utilization (coefficient 0.321 at the 90th quantile for days of hospitalization and 0.076 at the 90th quantile for number of inpatient visits).

Conclusions

PHI enrollment is positively correlated with outpatient costs and inpatient care utilization. Government policies should consider these heterogeneous distributional effects of private health insurance.
Associations between maternal metabolic conditions and neurodevelopmental conditions in offspring: the mediating effects of obstetric and neonatal complications
Authors: Chen Shuyun , Wang Xi , Lee Brian K. , Gardner Renee M.
Published: November 2023

Background

Maternal pre-gestational diabetes (PGDM), gestational diabetes mellitus (GDM), and overweight/obesity have been associated with increased risks of offspring neurodevelopmental conditions (NDCs) including autism, intellectual disability (ID), and attention deficit/hyperactivity disorder (ADHD). Less is known about whether and how obstetric and neonatal complications (e.g., preterm birth, neonatal asphyxia) could mediate these associations.

Methods

In this Swedish register-based cohort study, we examined complications during pregnancy, delivery, and the neonatal period as potential mediators of the relationships between maternal metabolic conditions and offspring NDCs. We quantified the extent to which these obstetric and neonatal factors could mediate the associations of maternal metabolic conditions with offspring NDCs by applying parametric regression models for single mediation analyses and weighting-based methods for multiple mediation analyses under counterfactual frameworks.

Results

The study sample included 2,352,969 singleton children born to 1,299,692 mothers from 1987–2010 who were followed up until December 31, 2016, of whom 135,832 children (5.8%) were diagnosed with at least one NDC. A substantial portion of the association between maternal PGDM and children’s odds of NDCs could be explained by the combined group of obstetric and neonatal complications in the multiple mediation analysis. For instance, these complications explained 44.4% of the relationship between maternal PGDM and offspring ID risk. The proportion of the relationship between maternal overweight/obesity and children’s risk of NDCs that could be explained by obstetric and neonatal complications was considerably smaller, ranging from 1.5 to 8.1%. Some complications considered on their own, including pregnancy hypertensive diseases, preterm birth, neonatal asphyxia, and hematological comorbidities, could explain at least 10% of the associations between maternal PGDM and offspring NDCs. Complications during the neonatal period showed a stronger joint mediating effect for the relationship between PGDM and offspring NDCs than those during pregnancy or delivery.

Conclusions

Obstetric and neonatal complications could explain nearly half of the association between maternal PGDM and offspring risk of NDCs. The mediating effects were more pronounced for complications during the neonatal period and for specific complications such as pregnancy hypertensive diseases, preterm birth, neonatal asphyxia, and hematological comorbidities. Effective preventive strategies for offspring NDCs should holistically address both the primary metabolic issues related to PGDM and the wide array of potential complications, especially those in the neonatal period.

Graphical Abstract
Spatiotemporal roles of AMPK in PARP-1- and autophagy-dependent retinal pigment epithelial cell death caused by UVA
Authors: Wu Anthony Yan-Tang , Sekar Ponarulselvam , Huang Duen-Yi , Hsu Shu-Hao , Chan Chi-Ming , Lin Wan-Wan
Published: November 2023

Background

Although stimulating autophagy caused by UV has been widely demonstrated in skin cells to exert cell protection, it remains unknown the cellular events in UVA-treated retinal pigment epithelial (RPE) cells.

Methods

Human ARPE-19 cells were used to measure cell viability, mitochondrial reactive oxygen species (ROS), mitochondrial membrane potential (MMP), mitochondrial mass and lysosomal mass by flow cytometry. Mitochondrial oxygen consumption rate (OCR) was recorded using Seahorse XF flux analyzer. Confocal microscopic images were performed to indicate the mitochondrial dynamics, LC3 level, and AMPK translocation after UVA irradiation.

Results

We confirmed mitochondrial ROS production and DNA damage are two major features caused by UVA. We found the cell death is prevented by autophagy inhibitor 3-methyladenine and gene silencing of ATG5, and UVA induces ROS-dependent LC3II expression, LC3 punctate and TFEB expression, suggesting the autophagic death in the UVA-stressed RPE cells. Although PARP-1 inhibitor olaparib increases DNA damage, ROS production, and cell death, it also blocks AMPK activation caused by UVA. Interestingly we found a dramatic nuclear export of AMPK upon UVA irradiation which is blocked by N-acetylcysteine and olaparib. In addition, UVA exposure gradually decreases lysosomal mass and inhibits cathepsin B activity at late phase due to lysosomal dysfunction. Nevertheless, cathepsin B inhibitor, CA-074Me, reverses the death extent, suggesting the contribution of cathepsin B in the death pathway. When examining the role of EGFR in cellular events caused by UVA, we found that UVA can rapidly transactivate EGFR, and treatment with EGFR TKIs (gefitinib and afatinib) enhances the cell death accompanied by the increased LC3II formation, ROS production, loss of MMP and mass of mitochondria and lysosomes. Although AMPK activation by ROS-PARP-1 mediates autophagic cell death, we surprisingly found that pretreatment of cells with AMPK activators (A769662 and metformin) reverses cell death. Concomitantly, both agents block UVA-induced mitochondrial ROS production, autophagic flux, and mitochondrial fission without changing the inhibition of cathepsin B.

Conclusion

UVA exposure rapidly induces ROS-PARP-1-AMPK-autophagic flux and late lysosomal dysfunction. Pre-inducing AMPK activation can prevent cellular events caused by UVA and provide a new protective strategy in photo-oxidative stress and photo-retinopathy.
Proteomic biomarkers for survival in systemic sclerosis-associated pulmonary hypertension
Authors: Mismetti Valentine , Delavenne Xavier , Montani David , Bezzeghoud Souad , Delezay Olivier , Hodin Sophie , Launay David , Marchand-Adam Sylvain , Nunes Hilario , Ollier Edouard , Reynaud-Gaubert Martine , Pastre Jean , Traclet Julie , Quetant Sébastien , Zeghmar Sabrina , Bertoletti Laurent , Cottin Vincent
Published: November 2023

Background

Interstitial lung disease (ILD) and pulmonary hypertension (PH) represent the major causes of mortality in systemic sclerosis (SSc). Patients with systemic sclerosis and combined PH and ILD (SSc-PH-ILD) generally have a poor prognosis. Predictors of survival and of potential benefit of treatment are lacking in patients with SSc-PH-ILD.

Objective

To identify specific plasma protein expression patterns associated with survival in patients with SSc-PH-ILD.

Materials and methods

Post-hoc analysis of a prospective multicenter French study in patients with PH-ILD. An untargeted proteomic analysis using mass spectrometry was performed to identify plasma protein changes associated with long-term overall survival in patients with SSc-PH-ILD.

Results

Thirty two patients were included in the analysis, of whom 13 died during follow-up (median survival: 76.5 months). At baseline, survivors had less severe hemodynamic impairment [pulmonary vascular resistance of 4.4 Wood Units (IQR 3–5.2) vs. 6.2 Wood Units (IQR 4.2–10.7)] and higher carbon monoxide diffusing capacity [median 39% (IQR 35–44%) vs. 25% (IQR 22–30.5%)], than the 13 patients who died. Seven proteins, associated with haemostasis and fibrosis, were differentially expressed according to patients’ survival. In the survivor group, two proteins were increased (ADAMTS13, SERPIND1) and five were decreased (PTGDS, OLFM1, C7, IGFBP7, FBN1) compared to the non-survivor groups.

Conclusion

The prognosis of SSc-PH-ILD patients is poor. This proteomic approach found 7 plasma proteins (involved in haemostasis and fibrosis pathways) associated with survival. These potential biomarkers may be good candidates to prognostic enrichment.
Potential persistence mechanisms of the major Anopheles gambiae species complex malaria vectors in sub-Saharan Africa: a narrative review
Authors: Mwima Rita , Hui Tin-Yu J. , Nanteza Ann , Burt Austin , Kayondo Jonathan K.
Published: November 2023

The source of malaria vector populations that re-establish at the beginning of the rainy season is still unclear yet knowledge of mosquito behaviour is required to effectively institute control measures. Alternative hypotheses like aestivation, local refugia, migration between neighbouring sites, and long-distance migration (LDM) are stipulated to support mosquito persistence. This work assessed the malaria vector persistence dynamics and examined various studies done on vector survival  via these hypotheses; aestivation, local refugia, local or long-distance migration across sub-Saharan Africa, explored a range of methods used, ecological parameters and highlighted the knowledge trends and gaps. The results about a particular persistence mechanism that supports the re-establishment of Anopheles gambiae, Anopheles coluzzii or Anopheles arabiensis in sub-Saharan Africa were not conclusive given that each method used had its limitations. For example, the Mark-Release-Recapture (MRR) method whose challenge is a low recapture rate that affects its accuracy, and the use of time series analysis through field collections whose challenge is the uncertainty about whether not finding mosquitoes during the dry season is a weakness of the conventional sampling methods used or because of hidden shelters. This, therefore, calls for further investigations emphasizing the use of ecological experiments under controlled conditions in the laboratory or semi-field, and genetic approaches, as they are known to complement each other. This review, therefore, unveils and assesses the uncertainties that influence the different malaria vector persistence mechanisms and provides recommendations for future studies.
Multimeric immunotherapeutic complexes activating natural killer cells towards HIV-1 cure
Authors: Schober Rafaëla , Brandus Bianca , Laeremans Thessa , Iserentant Gilles , Rolin Camille , Dessilly Géraldine , Zimmer Jacques , Moutschen Michel , Aerts Joeri L. , Dervillez Xavier , Seguin-Devaux Carole
Published: November 2023

Background

Combination antiretroviral therapy (cART) has dramatically extended the life expectancy of people living with HIV-1 and improved their quality of life. There is nevertheless no cure for HIV-1 infection since HIV-1 persists in viral reservoirs of latently infected CD4+ T cells. cART does not eradicate HIV-1 reservoirs or restore cytotoxic natural killer (NK) cells which are dramatically reduced by HIV-1 infection, and express the checkpoint inhibitors NKG2A or KIR2DL upregulated after HIV-1 infection. Cytotoxic NK cells expressing the homing receptor CXCR5 were recently described as key subsets controlling viral replication.

Methods

We designed and evaluated the potency of “Natural killer activating Multimeric immunotherapeutic compleXes”, called as NaMiX, combining multimers of the IL-15/IL-15Rα complex with an anti-NKG2A or an anti-KIR single-chain fragment variable (scFv) to kill HIV-1 infected CD4+ T cells. The oligomerization domain of the C4 binding protein was used to associate the IL-15/IL-15Rα complex to the scFv of each checkpoint inhibitor as well as to multimerize each entity into a heptamer (α form) or a dimer (β form). Each α or β form was compared in different in vitro models using one-way ANOVA and post-hoc Tukey’s tests before evaluation in humanized NSG tg-huIL-15 mice having functional NK cells.

Results

All NaMiX significantly enhanced the cytolytic activity of NK and CD8+ T cells against Raji tumour cells and HIV-1+ ACH-2 cells by increasing degranulation, release of granzyme B, perforin and IFN-γ. Targeting NKG2A had a stronger effect than targeting KIR2DL due to higher expression of NKG2A on NK cells. In viral inhibition assays, NaMiX initially increased viral replication of CD4+ T cells which was subsequently inhibited by cytotoxic NK cells. Importantly, anti-NKG2A NaMiX enhanced activation, cytotoxicity, IFN-γ production and CXCR5 expression of NK cells from HIV-1 positive individuals. In humanized NSG tg-huIL-15 mice, we confirmed enhanced activation, degranulation, cytotoxicity of NK cells, and killing of HIV-1 infected cells from mice injected with the anti-NKG2A.α NaMiX, as compared to control mice, as well as decreased total HIV-1 DNA in the lung.

Conclusions

NK cell-mediated killing of HIV-1 infected cells by NaMiX represents a promising approach to support HIV-1 cure strategies.
Fibro-adipose vascular anomaly (FAVA) - diagnosis, staging and management
Authors: Wang Huaijie , Xie Chong , Lin Weilong , Wang Peihua , Yang Weijia , Guo Zhengtuan
Published: November 2023

Background

The diagnosis and treatment of fibro-adipose vascular anomaly (FAVA) of the limb remains challenging since this entity is rare and complex. This paper is aimed to describe the clinical and imaging features, staging and management of this underrecognized disease of the limb.

Material and method

Patients diagnosed with FAVA and managed between September 2019 and May 2022 in department of pediatric surgery & vascular anomalies of Xi’an international medical center hospital were retrospectively reviewed. Data extracted include age at presentation, previous diagnosis, affected muscles, symptoms, previous treatment, our management, and follow-up.

Results

Thirty-two patients with FAVA were diagnosed and managed in our center. There was a female sex predominance, with 23 female (72%) and 9 male (28%) in the cohort. Only one lesion was noticed during infancy; the remaining presented at age 1 to 20 years (median, 7 years). The most commonly involved muscles were gastrocnemius (14/32, 44%) and soleus (13/32, 40%). Swelling (mass), pain and contractures were the most common presentations. MRI featured a heterogeneous and ill-defined intramuscular high signal intensity. Diseases were staged according to clinical features: stage I (pain stage, n = 4), stage II (contracture stage, n = 20) and stage III (deformity stage, n = 8). Patients with stage I disease underwent radical resection and obtained a cure. Patients with stage II disease received radical resection and possible Achilles lengthening, having an outcome of cure. Personalized treatment was required in patients with stage III disease, including radical/partial/staged resection, Achilles lengthening/tenotomy, joint capsulotomy, neurolysis/neurectomy, tendon transfer, stretching exercises, and oral sirolimus/alpelisib. Significant improvement of symptoms was achieved in most.

Conclusion

The most distinct features of FAVA include enlarging mass, severe pain and contracture. Based on distinct clinical and radiologic features, it is not difficult to make the diagnosis of FAVA. Earlier awareness of this disease can reduce misdiagnoses. Surgery-based comprehensive management can typically improve pain and contracture. Oral sirolimus or alpelisib plays an important role in treatment of unresectable lesions and major nerve involvement. Surgery alone can be curative in early stage FAVA.
Phytochromes transmit photoperiod information via the evening complex in Brachypodium
Authors: Gao Mingjun , Lu Yunlong , Geng Feng , Klose Cornelia , Staudt Anne-Marie , Huang He , Nguyen Duy , Lan Hui , Lu Han , Mockler Todd C. , Nusinow Dmitri A. , Hiltbrunner Andreas , Schäfer Eberhard , Wigge Philip A. , Jaeger Katja E.
Published: November 2023

Background

Daylength is a key seasonal cue for animals and plants. In cereals, photoperiodic responses are a major adaptive trait, and alleles of clock genes such asPHOTOPERIOD1 (PPD1)andEARLY FLOWERING3 (ELF3)have been selected for in adapting barley and wheat to northern latitudes. How monocot plants sense photoperiod and integrate this information into growth and development is not well understood.

Results

We find thatphytochrome C (PHYC)is essential for flowering inBrachypodium distachyon. Conversely, ELF3 acts as a floral repressor andelf3mutants display a constitutive long day phenotype and transcriptome. We find that ELF3 and PHYC occur in a common complex. ELF3 associates with the promoters of a number of conserved regulators of flowering, includingPPD1andVRN1. Consistent with observations in barley, we are able to show thatPPD1overexpression accelerates flowering in short days and is necessary for rapid flowering in response to long days. PHYC is in the active Pfr state at the end of the day, but we observe it undergoes dark reversion over the course of the night.

Conclusions

We propose that PHYC acts as a molecular timer and communicates information on night-length to the circadian clock via ELF3.
Adhesion and virulence properties of native Metarhizium fungal strains from Burkina Faso for the control of malaria vectors
Authors: Sare Issiaka , Baldini Francesco , Viana Mafalda , Badolo Athanase , Djigma Florencia , Diabate Abdoulaye , Bilgo Etienne
Published: November 2023

Background

Local strains of the entomopathogenic fungus Metarhizium pingshaense in Burkina Faso have demonstrated remarkable virulence against malaria vectors, positioning them as promising candidates for inclusion in the future arsenal of malaria control strategies. However, the underlying mechanisms responsible for this virulence remain unknown. To comprehend the fungal infection process, it is crucial to investigate the attachment mechanisms of fungal spores to the mosquito cuticle and explore the relationship between virulence and attachment kinetics. This study aims to assess the adhesion and virulence properties of native Metarhizium fungal strains from Burkina Faso for controlling malaria vectors.

Methods

Fungal strains were isolated from 201 insects and 1399 rhizosphere samples, and four strains of Metarhizium fungi were selected. Fungal suspensions were used to infect 3-day-old female Anopheles coluzzii mosquitoes at three different concentrations (106, 107, 108 conidia/ml). The survival of the mosquitoes was measured over 14 days, and fungal growth was quantified after 1 and 24 h to assess adhesion of the fungal strains onto the mosquito cuticle.

Results

All four fungi strains increased mosquito mortality compared to control (Chi-square test, χ2 = 286.55, df = 4, P < 0.001). Adhesion of the fungal strains was observed on the mosquito cuticle after 24 h at high concentrations (1 × 108 conidia/ml), with one strain, having the highest virulent, showing adhesion after just 1 h.

Conclusion

The native strains of Metarhizium spp. fungi found in Burkina Faso have the potential to be effective biocontrol agents against malaria vectors, with some strains showing high levels of both virulence and adhesion to the mosquito cuticle.

Graphical Abstract
Changes in contributions of different Anopheles vector species to malaria transmission in east and southern Africa from 2000 to 2022
Authors: Msugupakulya Betwel J. , Urio Naomi H. , Jumanne Mohammed , Ngowo Halfan S. , Selvaraj Prashanth , Okumu Fredros O. , Wilson Anne L.
Published: November 2023

Background

Malaria transmission in Africa is facilitated by multiple species ofAnophelesmosquitoes. These vectors have different behaviors and vectorial capacities and are affected differently by vector control interventions, such as insecticide-treated nets and indoor residual spraying. This review aimed to assess changes in the contribution of different vector species to malaria transmission in east and southern Africa over 20 years of widespread insecticide-based vector control.

Methods

We searched PubMed, Global Health, and Web of Science online databases for articles published between January 2000 and April 2023 that provided species-specific sporozoite rates for different malaria vectors in east and southern Africa. We extracted data on study characteristics, biting rates, sporozoite infection proportions, and entomological inoculation rates (EIR). Using EIR data, the proportional contribution of each species to malaria transmission was estimated.

Results

Studies conducted between 2000 and 2010 identified theAnopheles gambiaecomplex as the primary malaria vector, while studies conducted from 2011 to 2021 indicated the dominance ofAnopheles funestus. From 2000 to 2010, in 57% of sites,An. gambiaedemonstrated higher parasite infection prevalence than otherAnophelesspecies.Anopheles gambiaealso accounted for over 50% of EIR in 76% of the study sites. Conversely, from 2011 to 2021,An. funestusdominated with higher infection rates than otherAnophelesin 58% of sites and a majority EIR contribution in 63% of sites. This trend coincided with a decline in overall EIR and the proportion of sporozoite-infectedAn. gambiae. The main vectors in theAn. gambiaecomplex in the region wereAnopheles arabiensisandAn. gambiaesensu stricto (s.s.), while the important member of theAn. funestusgroup wasAn. funestuss.s.

Conclusion

The contribution of different vector species in malaria transmission has changed over the past 20 years. As the role of An. gambiaehas declined, An. funestusnow appears to be dominant in most settings in east and southern Africa. Other secondary vector species may play minor roles in specific localities. To improve malaria control in the region, vector control should be optimized to match these entomological trends, considering the different ecologies and behaviors of the dominant vector species.

Graphical Abstract
Spinal cord stimulator explant caused by post-incisional cellulitis secondary to Varicella Zoster Virus (shingles) infection: a case report
Authors: Mohabbati Vahid , Papan Mohammadkazem
Published: November 2023

Introduction

Spinal Cord Stimulation (SCS) is a well-established therapy for refractory neuropathic pain, known for its safety and minimally-invasive nature. However, complications, including surgical site infections (SSIs), can arise post-implantation. SCS-related SSIs occur in 3.4% to 4.6% of cases within 90 days post-implant, often requiring device removal and impacting pain management and healthcare costs. The impulse generator, electrode implant site and lumbar/thoracic surgical site are commonly affected, with local skin flora and circulating organisms being the primary causes of infection.

Case presentation

An 80-year-old Lebanese male with chronic neuropathic lower back and bilateral leg pain, significantly impairing function, underwent prolonged hospitalizations for COVID-19 infection and acute-on-chronic pain with Urinary Tract Infection (UTI). Considering SCS as a therapeutic option, a successful trial led to permanent implantation, resulting in improved pain severity and functional capacity. However, three months later, the patient developed post-incisional cellulitis and wound dehiscence secondary to Varicella Zoster Virus (shingles) Infection directly over the Implantable Pulse Generator (IPG) incision line. Despite antibiotic treatment, the infection progressed, necessitating SCS system explantation.

Discussion

This represents the first reported case of VZV infection causing wound dehiscence and SCS explantation post-implantation. Contributing factors may include itching around the IPG site, facilitating deeper tissue inoculation. Laboratory and imaging tests may not reliably detect SSIs, and superficial infections may respond to antibiotics, while deep infections typically require implant removal. Early identification and intervention are vital to minimize complications.

Conclusion

This unique case emphasizes the need for heightened vigilance and monitoring in patients with viral infections near medical devices. A standardized approach to assessing and managing SCS-related infections is critical. Sharing such experiences contributes to improved understanding and treatment of these rare incidents.
Efficacy of pharmacological and non-pharmacological therapy on pain intensity and disability of older people with chronic nonspecific low back pain: a protocol for a network meta-analysis
Authors: Fonseca Letícia Soares , Silva Juliana Pereira , Souza Mateus Bastos , Mascarenhas Rodrigo de Oliveira , Silva Hytalo de Jesus , Campos Mariana Gabrich Moraes , Pereira Leani Souza Máximo , Oliveira Murilo Xavier , Oliveira Vinicius Cunha
Published: November 2023

Background

The purpose of this network meta-analysis (NMA) is to investigate the efficacy of pharmacological and non-pharmacological therapy on pain intensity and disability of older people with chronic nonspecific low back pain, providing comprehensive evidence for an informed decision-making.

Methods

We will perform a systematic search to identify randomized controlled trials of pharmacological and non-pharmacological interventions for older people with chronic nonspecific low back pain. MEDLINE, Cochrane Library, Embase, AMED, PsycINFO, and PEDro will be searched without language or date restrictions. Our primary outcomes are pain intensity and disability. Risk of bias will be assessed for all studies using the revised Cochrane risk-of-bias (RoB) tool 2.0. For each pairwise comparison between the different interventions, estimated mean differences and their 95% confidence intervals will be presented. Standard pairwise meta-analyses will be performed using random effects models in STATA version 16. The competing interventions will be ranked using the surface under the cumulative ranking curve (SUCRA) for the outcomes of interest at short and long terms. The confidence in the results from NMA will be assessed using the Confidence in Network Meta‐Analysis (CINeMA) framework.

Discussion

This NMA compares efficacy of interventions for nonspecific chronic low back pain in older people. It will provide reliable evidence for patients, clinicians, stakeholders, and researchers in this field where competing therapies, many of extraordinarily little value, are commonly used in clinical practice.

Systematic review registration

PROSPERO CRD42022312565
Identification of quantitative trait loci and associated candidate genes for pregnancy success in Angus–Brahman crossbred heifers
Authors: Hoorn Quinn A. , Zayas Gabriel A. , Rodriguez Eduardo E. , Jensen Laura M. , Mateescu Raluca G. , Hansen Peter J.
Published: November 2023

Background

In beef cattle, more than 50% of the energy input to produce a unit of beef is consumed by the female that produced the calf. Development of genomic tools to identify females with high genetic merit for reproductive function could increase the profitability and sustainability of beef production.

Results

Genome-wide association studies (GWAS) were performed using a single-step genomic best linear unbiased prediction approach on pregnancy outcome traits from a population of Angus–Brahman crossbred heifers. Furthermore, a validation GWAS was performed using data from another farm. Heifers were genotyped with the Bovine GGP F250 array that contains 221,077 SNPs. In the discovery population, heifers were bred in winter breeding seasons involving a single round of timed artificial insemination (AI) followed by natural mating for 3 months. Two phenotypes were analyzed: pregnancy outcome to first-service AI (PAI; n = 1,481) and pregnancy status at the end of the breeding season (PEBS; n = 1,725). The heritability was estimated as 0.149 and 0.122 for PAI and PEBS, respectively. In the PAI model, one quantitative trait locus (QTL), located between 52.3 and 52.5 Mb on BTA7, explained about 3% of the genetic variation, in a region containing a cluster of γ-protocadherin genes and SLC25A2. Other QTLs explaining between 0.5% and 1% of the genetic variation were found on BTA12 and 25. In the PEBS model, a large QTL on BTA7 was synonymous with the QTL for PAI, with minor QTLs located on BTA5, 9, 10, 11, 19, and 20. The validation population for pregnancy status at the end of the breeding season were Angus–Brahman crossbred heifers bred by natural mating. In concordance with the discovery population, the large QTL on BTA7 and QTLs on BTA10 and 12 were identified.

Conclusions

In summary, QTLs and candidate SNPs identified were associated with pregnancy outcomes in beef heifers, including a large QTL associated with a group of protocadherin genes. Confirmation of these associations with larger populations could lead to the development of genomic predictions of reproductive function in beef cattle. Moreover, additional research is warranted to study the function of candidate genes associated with QTLs.
Adolescent sadfishing on social media: anxiety, depression, attention seeking, and lack of perceived social support as potential contributors
Authors: Shabahang Reza , Shim Hyejin , Aruguete Mara S. , Zsila Ágnes
Published: November 2023

Background

Sympathy-seeking negative online self-disclosure, or “sadfishing,” has proliferated in social media. This study investigates sadfishing by developing and validating a brief self-report questionnaire of the construct and exploring potential psychological correlates.

Methods

A total of 345 Iranian adolescent social media users (Mage = 16.29, SDage = 1.52) participated in the study. Participants completed the newly constructed Social Media Sadfishing Questionnaire, in addition to measures of anxiety, depression, attention seeking, perceived social support, and social media use integration.

Results

Factor analyses revealed a unidimensional structure of the 5-item Social Media Sadfishing Questionnaire. The questionnaire yielded sound construct validity and internal consistency. Anxiety, depression, and attention seeking were positively associated with sadfishing, while perceived social support from family and friends was negatively associated with sadfishing. Negative online reactions to sadfishing were rare. Boys reported higher sadfishing tendencies than girls at age 12; however, sadfishing in boys declined at a higher rate than in girls with age.

Conclusions

The findings suggest that negative affect and attention seeking, combined with feelings of low social support, can be associated with adolescent sadfishing on social media. The quantitative results shed new light on the contribution of psychosocial factors to sadfishing.
Closing a chapter? A protocol for a longitudinal mixed methods study on retirement from elite sport
Authors: Ronkainen Noora J. , Schmid Michael J. , Hlasová Helena , Örencik Merlin , Schmid Jürg , Conzelmann Achim
Published: November 2023

Retirement from elite sport represents a major life transition for athletes and requires them to redefine their central life projects, identities, and perhaps even sources of meaning in life. Although an extensive body of literature has identified risk and protective factors in career termination, little is known about the more subjective processes and individual pathways of athletes as they establish their new relationship with work-life and sport. The planned longitudinal mixed methods study follows Swiss elite athletes’ transition with a focus on understanding (1) the relationship between psychological resources, life situations at the end of the sports career, and the retirement process; (2) how athletes’ post-retirement vocational careers interact with their subjective careers and sense of meaningful work; (3) how athletes reconstruct their identities and relationship with sport over time; and (4) how gender shapes athletes’ pathways and reorientation of their life design.

Using a person-oriented approach combined with narrative inquiry, we expect to identify specific types and stories which demonstrate individual differences in career and personal development throughout the transitional period, an understanding of which can be targeted towards support programmes for retiring elite athletes. As the study centralises dimensions of positive psychological functioning (meaning and purpose in life/sport/work, resilience, life satisfaction), it complements previous studies focused on psychological distress and provides much needed knowledge that can be used to foster well-being in athletic retirement. Collaborating with the Swiss Olympic Association helps to ensure that the research findings will be disseminated to relevant end-users and used towards developing socially sustainable elite sport for the future generations.
Trust in information sources as a moderator of the impact of COVID-19 anxiety and exposure to information on conspiracy thinking and misinformation beliefs: a multilevel study
Authors: Khalaf Mustafa Ali , Shehata Ahmed Maher
Published: November 2023

This study investigates the intricate relationship between exposure to information sources, trust in these sources, conspiracy and misinformation beliefs, and COVID-19 anxiety among 509 Omani citizens aged 11 to 50, representing 11 governorates. Employing structural equation modeling, we not only examine these associations but also explore how trust and COVID-19 anxiety act as moderating variables in this context. Additionally, we delve into demographic factors such as age group, educational level, gender, and place of residence (governorate) to discern potential variations.

Our findings reveal that trust in health experts is inversely related to belief in conspiracy theories, while trust in health experts negatively correlates with exposure to conspiracy and misinformation. Intriguingly, trust in health experts exhibits divergent effects across governorates: it diminishes conspiracy and misinformation beliefs in some regions but not in others. Exposure to personal contacts and digital media, on the other hand, is associated with heightened beliefs in misinformation and conspiracy theories, respectively, in select governorates. These distinctions may be attributed to proximity to Muscat, the capital city of Oman, where various media outlets and policy-making institutions are situated. Furthermore, lower educational attainment is linked to greater belief in conspiracy and misinformation. Females reported higher levels of conspiracy theory beliefs and COVID-19 anxiety while no significant differences were detected in misinformation beliefs.

This study sheds light on the intricate dynamics of misinformation and conspiracy theories in the context of COVID-19 in Oman, highlighting the pivotal roles of trust and COVID-19 anxiety as moderating factors. These findings offer valuable insights into understanding and addressing the spread of misinformation and conspiracy theories during a public health crisis.
MSLFuzzer: black-box fuzzing of SOHO router devices via message segment list inference
Authors: Cheng Yixuan , Fan Wenqing , Huang Wei , Yang Jingyu , Yu Gaoqing , Liu Wen
Published: November 2023

The popularity of small office and home office routers has brought convenience, but it also caused many security issues due to vulnerabilities. Black-box fuzzing through network protocols to discover vulnerabilities becomes a viable option. The main drawbacks of state-of-the-art black-box fuzzers can be summarized as follows. First, the feedback process neglects to discover the missing fields in the raw message. Secondly, the guidance of the raw message content in the mutation process is aimless. Finally, the randomized validity of the test case structure can cause most fuzzing tests to end up with an invalid response of the tested device. To address these challenges, we propose a novel black-box fuzzing framework called MSLFuzzer. MSLFuzzer infers the raw message structure according to the response from a tested device and generates a message segment list. Furthermore, MSLFuzzer performs semantic, sequence, and stability analyses on each message segment to enhance the complementation of missing fields in the raw message and guide the mutation process. We construct a dataset of 35 real-world vulnerabilities and evaluate MSLFuzzer. The evaluation results show that MSLFuzzer can find more vulnerabilities and elicit more types of responses from fuzzing targets. Additionally, MSLFuzzer successfully discovered 10 previously unknown vulnerabilities.
A phase 1 trial of claudin 18.2-specific antibody-drug conjugate CMG901 in patients with advanced gastric/gastroesophageal junction cancer.
Authors: Xu Rui-Hua , Ruan Dan-Yun , Zhang Dong-Sheng , Liu Fu-Rong , Luo Su-Xia , Zhuang Zhi-Xiang , Wang Zhen-Ning , Liu Fu-Nan , Zhang Yan-Qiao , Yang Jian-Wei , Chen Zhen-Dong , Wang Yong-Sheng , Wang Jun-Ye , Liang Xiao-Hua , Wu Xiao-Jie , Zheng Yu-Long , Liu Jian , Shi Xi , Liu Wei , Chen Bo
Published: November 2023

434420

Background: Claudin 18.2 (CLDN18.2) is a promising therapeutic target for advanced gastric/gastroesophageal junction (G/GEJ) cancer. CMG901, a potential first-in-class CLDN18.2-targeted antibody-drug conjugate carrying monomethyl auristatin E (MMAE), has demonstrated potent anti-tumor activity in preclinical studies. Methods: This phase 1 trial included a dose-escalation phase (part A; 0.3-3.4 mg/kg) and a dose-expansion phase (part B; 2.2, 2.6, and 3.0 mg/kg) to evaluate safety, tolerability, and anti-tumor activity of CMG901 in patients (pts) with advanced G/GEJ cancer and other solid tumors. CLDN18.2 expression was not required for study entry in part A, but CLDN18.2 expression of ≥2+ membrane staining intensity in ≥5% tumor cells was required for G/GEJ cancer in part B. CMG901 was administrated intravenously every 3 weeks until disease progression or unacceptable toxicity. Primary endpoints were safety/tolerability and maximum tolerated dose (MTD) for part A, and objective response rate (ORR, per RECIST v1.1) and recommended phase 2 dose in part B. Here we present the G/GEJ cancer data from this ongoing trial. Results: MTD was not reached during dose escalation. As of July 24, 2023, 113 G/GEJ cancer pts received CMG901 at doses of 2.2-3.0 mg/kg (6 pts from part A and 107 pts from part B). The median prior lines of systemic therapy were 2 (range 1-6). Most common TEAEs were anaemia (62.8%), vomiting (57.5%), and hypoalbuminaemia (57.5%). Neutrophil count decreased (18.6%) and anaemia (13.3%) were the most frequent grade ≥3 TEAEs. Of 89 evaluable (≥1 post-treatment scan) CLDN18.2-positive pts, confirmed ORR was 32.6% (Table). For all 93 CLDN18.2-positive pts, the median progression-free survival was 4.76 months (95%CI 3.35-6.14) after a median follow-up of 5.98 months. The median overall survival (OS) was not reached, with an OS rate of 56.4% at 9 months. Conclusions: CMG901 demonstrated promising clinical efficacy in CLDN18.2-positive G/GEJ cancer pts, with a manageable safety profile. These results support further evaluation of CMG901 in CLDN18.2-positive G/GEJ cancer. Clinical trial information: NCT04805307 .[Table: see text]