bluuebunny/crossref_metadata_2025 huggingface dataset:
Toxoplasma gondii
harbors a hypoxia-responsive coproporphyrinogen dehydrogenase-like protein
Authors: Key Melanie , Baptista Carlos Gustavo , Bergmann Amy , Floyd Katherine , Blader Ira J. , Dou Zhicheng
Published: February 2024

Toxoplasma gondii
is an apicomplexan parasite that is the cause of toxoplasmosis, a potentially lethal disease for immunocompromised individuals. During
in vivo
infection, the parasites encounter various growth environments, such as hypoxia. Therefore, the metabolic enzymes in the parasites must adapt to such changes to fulfill their nutritional requirements.
Toxoplasma
can
de novo
biosynthesize some nutrients, such as heme. The parasites heavily rely on their own heme production for intracellular survival. Notably, the antepenultimate step within this pathway is facilitated by coproporphyrinogen III oxidase (CPOX), which employs oxygen to convert coproporphyrinogen III to protoporphyrinogen IX through oxidative decarboxylation. Conversely, some bacteria can accomplish this conversion independently of oxygen through coproporphyrinogen dehydrogenase (CPDH). Genome analysis found a CPDH ortholog in
Toxoplasma
. The mutant
Toxoplasma
lacking CPOX displays significantly reduced growth, implying that
T. gondii
CPDH (TgCPDH) potentially functions as an alternative enzyme to perform the same reaction as CPOX under low-oxygen conditions. In this study, we demonstrated that TgCPDH exhibits CPDH activity by complementing it in a heme synthesis-deficient
Salmonella
mutant. Additionally, we observed an increase in TgCPDH expression in
Toxoplasma
when it grew under hypoxic conditions. However, deleting
TgCPDH
in both wild-type and heme-deficient parasites did not alter their intracellular growth under both ambient and low-oxygen conditions. This research marks the first report of a CPDH-like protein in eukaryotic cells. Although TgCPDH responds to hypoxic conditions and possesses enzymatic activity, our findings revealed that it does not directly affect acute
Toxoplasma
infections
in vitro
and
in vivo
.

IMPORTANCE

Toxoplasma gondii
is a ubiquitous parasite capable of infecting a wide range of warm-blooded hosts, including humans. During its life cycle, these parasites must adapt to varying environmental conditions, including situations with low-oxygen levels, such as intestine and spleen tissues. Our research, in conjunction with studies conducted by other laboratories, has revealed that
Toxoplasma
primarily relies on its own heme production during acute infections. Intriguingly, in addition to this classical heme biosynthetic pathway, the parasites encode a putative oxygen-independent coproporphyrinogen dehydrogenase (CPDH), suggesting its potential contribution to heme production under varying oxygen conditions, a feature typically observed in simpler organisms like bacteria. Notably, so far, CPDH has only been identified in some bacteria for heme biosynthesis. Our study discovered that
Toxoplasma
harbors a functional enzyme displaying CPDH activity, which alters its expression in the parasites when they face fluctuating oxygen levels in their surroundings.
Membrane fluidity homeostasis is required for tobramycin-enhanced biofilm in
Pseudomonas aeruginosa
Authors: David Audrey , Tahrioui Ali , Duchesne Rachel , Tareau Anne-Sophie , Maillot Olivier , Barreau Magalie , Feuilloley Marc G. J. , Lesouhaitier Olivier , Cornelis Pierre , Bouffartigues Emeline , Chevalier Sylvie
Published: February 2024

Pseudomonas aeruginosa
is an opportunistic pathogen, which causes chronic infections, especially in cystic fibrosis (CF) patients where it colonizes the lungs via the build-up of biofilms. Tobramycin, an aminoglycoside, is often used to treat
P. aeruginosa
infections in CF patients. Tobramycin at sub-minimal inhibitory concentrations enhances both biofilm biomass and thickness
in vitro
; however, the mechanism(s) involved are still unknown. Herein, we show that tobramycin increases the expression and activity of SigX, an extracytoplasmic sigma factor known to be involved in the biosynthesis of membrane lipids and membrane fluidity homeostasis. The biofilm enhancement by tobramycin is not observed in a
sigX
mutant, and the
sigX
mutant displays increased membrane stiffness. Remarkably, the addition of polysorbate 80 increases membrane fluidity of
sigX
-mutant cells in biofilm, restoring the tobramycin-enhanced biofilm formation. Our results suggest the involvement of membrane fluidity homeostasis in biofilm development upon tobramycin exposure.

IMPORTANCE

Previous studies have shown that sub-lethal concentrations of tobramycin led to an increase biofilm formation in the case of infections with the opportunistic pathogen
Pseudomonas aeruginosa
. We show that the mechanism involved in this phenotype relies on the cell envelope stress response, triggered by the extracytoplasmic sigma factor SigX. This phenotype was abolished in a
sigX
-mutant strain. Remarkably, we show that increasing the membrane fluidity of the mutant strain is sufficient to restore the effect of tobramycin. Altogether, our data suggest the involvement of membrane fluidity homeostasis in biofilm development upon tobramycin exposure.
Screening potential biomarkers associated with insulin resistance in high-fat diet-fed mice by integrating metagenomics and untargeted metabolomics
Authors: Zhou Yunyan , Tang Jiahui , Du Wei , Zhang Yong , Ye Bang-Ce
Published: February 2024

Insulin resistance is the primary pathophysiological basis for metabolic syndrome and type 2 diabetes. Gut microbiota and microbiota-derived metabolites are pivotal in insulin resistance. However, identifying the specific microbes and key metabolites with causal roles is a challenging task, and the underlying mechanisms require further exploration. Here, we successfully constructed a model of insulin resistance in mice induced by a high-fat diet (HFD) and screened potential biomarkers associated with insulin resistance by integrating metagenomics and untargeted metabolomics. Our findings showed a significant increase in the abundance of 30 species of
Alistipes
in HFD mice compared to normal diet (ND) mice, while the abundance of
Desulfovibrio
and
Candidatus Amulumruptor
was significantly lower in HFD mice than in ND mice. Non-targeted metabolomics analysis identified 21 insulin resistance-associated metabolites, originating from the microbiota or co-metabolized by both the microbiota and the host. These metabolites were primarily enriched in aromatic amino acid metabolism (tryptophan metabolism, tyrosine metabolism, and phenylalanine metabolism) and arginine biosynthesis. Further analysis revealed a significant association between the three distinct genera and 21 differentiated metabolites in the HFD and ND mice. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of representative genomes from 12 species of the three distinct genera further revealed the functional potential in aromatic amino acid metabolism and arginine biosynthesis. This study lays the groundwork for future investigations into the mechanisms through which the gut microbiota and its metabolites impact insulin resistance.

IMPORTANCE

In this study, we aim to identify the microbes and metabolites linked to insulin resistance, some of which have not been previously reported in insulin resistance-related studies. This adds a complementary dimension to existing research. Furthermore, we establish a correlation between alterations in the gut microbiota and metabolite levels. These findings serve as a foundation for identifying the causal bacterial species and metabolites. They also offer insights that guide further exploration into the mechanisms through which these factors influence host insulin resistance.
The production of parallel world-class W and Cu metallogenic belts linked to an asymmetric slab window
Authors: Wu Shenghua , Mao Jingwen , Hetherington Callum J.
Published: February 2024

The ca. 150–135 Ma magmatic belts in the Middle–Lower Yangtze River Valley and its southern adjacent parallel northeastern Jiangnan Orogen in China experienced large-scale Cu and W metallogenesis, respectively. The magmatic belts interrupted contemporaneous magmatism along the east China continental margin and are an ideal locality to verify if Cu and W metallogenesis could be linked to a slab window. Oceanic plate subduction, intracontinental extension, lower crustal delamination, or ridge subduction models have been debated for the Cu and W belts. However, these models have weaknesses that cannot explain unique features of the belts such as the belts being coeval and intersecting with the trend of the paleo-trench, or the asymmetric distribution of the magmatic-metallogenic belts along both sides of the Middle–Lower Yangtze River Valley. Based on the configurative, compositional, and isotopic evidences, the magmatic belts record the fingerprints of the slab window generated by disassembly of the paleo-ridge between the Paleo-Pacific and Izanagi plates at ca. 150–135 Ma. During this time, the Paleo-Pacific plate rolled back beneath the eastern margin of the South China block and the Izanagi plate experienced flat-slab subduction that reached beneath the intracontinental regions of the North China block. The distinct and contrasting behaviors of the slabs produced a slab window that caused and promoted upwelling mantle to flow farther southward, inducing the asymmetric magmatic-metallogenic belts along the Middle–Lower Yangtze River Valley on both sides. The Middle–Lower Yangtze River Valley Cu-enriched magmatic belt was formed by melting of the lower crust and oceanic slab edge along the ridge by upwelling asthenospheric mantle. However, the Jiangnan Orogen W-enriched magmatic belt was induced by melting of the accretionary belt and mixing the melting of accretionary belt and the same hybrid mantle materials, during which the upwelling asthenospheric mantle tongue infiltrated southward due to the asymmetric structure of the slab window.
On the Water Striders (Heteroptera, Gerridae) of the Fauna of Russia: History of Study, Erroneous Identifications, and Features of Biology
Authors: Kanyukova E. V.
Published: February 2024

The history of study in Russia is reviewed and the distribution ranges are clarified for water striders of the genus Gerris: G. (s. str.) costae, G. (s. str.) thoracicus, G. (Gerriselloides) asper, G. (Gerriselloides) brachynotus, and G. (Gerriselloides) lateralis. A critical review of the faunistic literature and erroneous records of these species from Russia is given. Distribution maps with new locations are provided for G. (Gerriselloides) asper and G. (Gerriselloides) brachynotus. The preference of species of the subgenera Gerris, Gerriselloides, and Macrogerris with a brownish dorsum for the shady parts of water bodies is discussed.
Staff experiences of wearing the Rainbow Badge in a paediatric hospital setting: a mixed-methods survey
Authors: O'Dwyer Claire , Kehoe Anne , Shanahan Dee , O'Brien Warren , Hall Dani
Published: February 2024

Objective

This study aimed to assess staff’s experience of wearing the Health Service Executive (HSE) Rainbow Badge, a symbol of inclusion for LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning; + signifying inclusivity of all sexual and gender identities) people, in a paediatric hospital setting.

Design

This was a cross-sectional multisite observational study. Participants completed an anonymous online survey, consisting of open and closed-ended questions covering domains of: responses to the badge from staff and patients; experience and impact of wearing the badge; and further training needs.

Setting

All five sites (four clinical and one non-clinical) pertaining to the Children’s Health Ireland healthcare group.

Participants

All staff, clinical and non-clinical, who had signed up the HSE Rainbow Badge initiative were eligible to participate.

Results

A total of 151 eligible participants across a mix of disciplines participated, 29 (19.2%) of whom were members of the LGBTQ+ community. Over half (58.9%, n=89) of respondents said they learnt something new about barriers to care for LGBTQ+ young people from the initiative. Staff reported mostly positive responses to the badge; 5.1% reported mixed/negative responses from colleagues, 4.5% reported mixed/negative responses from young people and 3.7% reported mixed/negative responses from families. Open-ended questions were analysed using a thematic analysis framework. Five themes emerged: pride, a symbol of safety and inclusion, impact on workplace culture, awareness of LGBTQ+ issues and more to do for LGBTQ+ patients.

Conclusions

This study demonstrates that the Rainbow Badge initiative increases staff awareness of LGBTQ+ issues and helps to create a safe, inclusive environment for staff, young people and families.
Adult-onset mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS): a diagnostic challenge
Authors: Acquaah Jason , Ferdinand Phillip , Roffe Christine
Published: February 2024

Rare causes of stroke-like presentations can be difficult to diagnose. We report a case of a man in his 40s who first presented with stroke symptoms, but whose clinical course was not typical for a stroke. A detailed investigation of the patient’s medical history revealed bilateral sensorineural hearing loss which prompted a wider diagnostic assessment.

Furthermore, lack of vascular risk factors and a normal angiogram strengthened our suspicion of an unusual underlying condition. Raised lactic acid levels and genetic analysis confirmed a diagnosis of mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes syndrome.
Cancer risk according to fasting blood glucose trajectories: a population-based cohort study
Authors: Khong Thi Minh Thu , Bui Thi Tra , Kang Hee-Yeon , Lee Jinhee , Park Eunjung , Oh Jin-Kyoung
Published: February 2024

Introduction

Diabetes mellitus is known to increase the risk of cancer. Fasting blood glucose (FBG) levels can be changed over time. However, the association between FBG trajectory and cancer risk has been insufficiently studied. This research aims to examine the relationship between FBG trajectories and cancer risk in the Korean population.

Research design and methods

We analyzed data from the National Health Insurance Service–National Health Screening Cohort collected between 2002 and 2015. Group-based trajectory modeling was performed on 256,271 Koreans aged 40–79 years who had participated in health examinations at least three times from 2002 to 2007. After excluding patients with cancer history before 2008, we constructed a cancer-free cohort. The Cox proportional hazards model was applied to examine the association between FBG trajectories and cancer incidence by cancer type, after adjustments for covariates. Cancer case was defined as a person who was an outpatient thrice or was hospitalized once or more with a cancer diagnosis code within the first year of the claim.

Results

During the follow-up time (2008–2015), 18,991 cancer cases were identified. Four glucose trajectories were found: low-stable (mean of FBG at each wave <100 mg/dL), elevated-stable (113–124 mg/dL), elevated-high (104–166 mg/dL), and high-stable (>177 mg/dL). The high-stable group had a higher risk of multiple myeloma, liver cancer and gastrointestinal cancer than the low-stable group, with HR 4.09 (95% CI 1.40 to 11.95), HR 1.68 (95% CI 1.25 to 2.26) and HR 1.27 (95% CI 1.11 to 1.45), respectively. In elevated-stable trajectory, the risk increased for all cancer (HR 1.08, 95% CI 1.02 to 1.16) and stomach cancer (HR 1.24, 95% CI 1.07 to 1.43). Significant associations were also found in the elevated-high group with oral (HR 2.13, 95% CI 1.01 to 4.47), liver (HR 1.50, 95% CI 1.08 to 2.08) and pancreatic cancer (HR 1.99, 95% CI 1.20 to 3.30).

Conclusions

Our study highlights that the uncontrolled high glucose level for many years may increase the risk of cancer.
Use of machine learning to identify characteristics associated with severe hypoglycemia in older adults with type 1 diabetes: a post-hoc analysis of a case–control study
Authors: Freeman Nikki L B , Muthukkumar Rashmi , Weinstock Ruth S , Wickerhauser M Victor , Kahkoska Anna R
Published: February 2024

Introduction

Severe hypoglycemia (SH) in older adults (OAs) with type 1 diabetes is associated with profound morbidity and mortality, yet its etiology can be complex and multifactorial. Enhanced tools to identify OAs who are at high risk for SH are needed. This study used machine learning to identify characteristics that distinguish those with and without recent SH, selecting from a range of demographic and clinical, behavioral and lifestyle, and neurocognitive characteristics, along with continuous glucose monitoring (CGM) measures.

Research design and methods

Data from a case–control study involving OAs recruited from the T1D Exchange Clinical Network were analyzed. The random forest machine learning algorithm was used to elucidate the characteristics associated with case versus control status and their relative importance. Models with successively rich characteristic sets were examined to systematically incorporate each domain of possible risk characteristics.

Results

Data from 191 OAs with type 1 diabetes (47.1% female, 92.1% non-Hispanic white) were analyzed. Across models, hypoglycemia unawareness was the top characteristic associated with SH history. For the model with the richest input data, the most important characteristics, in descending order, were hypoglycemia unawareness, hypoglycemia fear, coefficient of variation from CGM, % time blood glucose below 70 mg/dL, and trail making test B score.

Conclusions

Machine learning may augment risk stratification for OAs by identifying key characteristics associated with SH. Prospective studies are needed to identify the predictive performance of these risk characteristics.
Disseminating information on acute public health events globally: experiences from the WHO’s Disease Outbreak News
Authors: Lata Harsh , Saad Duque Neil Jan , Togami Eri , Miglietta Alessandro , Perkins Devin , Corpuz Aura , Kato Masaya , Babu Amarnath , Dorji Tshewang , Matsui Tamano , Almiron Maria , Cheng Ka Yeung , MacDonald Lauren E , Pukkila Jukka Tapani , Williams George Sie , Andraghetti Roberta , Dolea Carmen , Mahamud Abdirahman , Morgan Oliver , Olowokure Babatunde , Fall Ibrahima Socé , Awofisayo-Okuyelu Adedoyin , Hamblion Esther
Published: February 2024

WHO works, on a daily basis, with countries globally to detect, prepare for and respond to acute public health events. A vital component of a health response is the dissemination of accurate, reliable and authoritative information. The Disease Outbreak News (DON) reports are a key mechanism through which WHO communicates on acute public health events to the public. The decision to produce a DON report is taken on a case-by-case basis after evaluating key criteria, and the subsequent process of producing a DON report is highly standardised to ensure the robustness of information. DON reports have been published since 1996, and up to 2022 over 3000 reports have been published. Between 2018 and 2022, the most frequently published DON reports relate to Ebola virus disease, Middle East respiratory syndrome, yellow fever, polio and cholera. The DON web page is highly visited with a readership of over 2.6 million visits per year, on average. The DON report structure has evolved over time, from a single paragraph in 1996 to a detailed report with seven sections currently. WHO regularly reviews the DON report process and structure for improvements. In the last 25 years, DON reports have played a unique role in rapidly disseminating information on acute public health events to health actors and the public globally. They have become a key information source for the global public health response to the benefit of individuals and communities.
Global approaches to tackling antimicrobial resistance: a comprehensive analysis of water, sanitation and hygiene policies
Authors: Weets Ciara M , Katz Rebecca
Published: February 2024

Background

Unsafe water, sanitation and hygiene (WASH) contributes to a high burden of disease and exacerbates factors that promote the development of antimicrobial resistance (AMR). Enforceable policies are foundational to curbing inappropriate use of antimicrobials and providing safe WASH. While many countries have established National Action Plans for AMR that include provisions for WASH, few have codified these plans into legally enforceable policy. Here, we provide a comprehensive map and describe the current regulatory environment for WASH.

Methods

We conducted a comprehensive analysis of the WASH-related policies in 193 countries. Policies were identified, collated, and categorised into a publicly available repository.

Results

A total of 672 policies met the criteria for inclusion in the dataset. No category of WASH-related policies had been adopted by all countries included in the study. Policy categories that were potentially more difficult to enforce in light of economic and governance limitations tended to be more prevalent and diverse, whereas policies in categories that were highly resource intensive and specific were less universal. Countries with gaps in policy categories also tended to be regionally clustered. While countries in the South Asian and European WHO regions had nearly universal policy coverage across all countries, the presence of policies was inconsistent across countries in the African and Eastern Mediterranean regions.

Conclusion

While decision-makers should rely on knowing which policies work best to mitigate the burden of WASH-related disease and AMR development, they must first have a comprehensive understanding of the current regulatory environment. Researchers and decision-makers need to know which policies work best and under what circumstances. The global mapping of WASH policies, which may have implications for AMR development, serves as a foundation for future policy analysis for AMR.
Malaria trends in districts that were targeted and not-targeted for seasonal malaria chemoprevention in children under 5 years of age in Guinea, 2014–2021
Authors: Bisanzio Donal , Keita Mamadou Sitan , Camara Alioune , Guilavogui Timothée , Diallo Thierno , Barry Hamidou , Preston Adam , Bangoura Lamine , Mbounga Eliane , Florey Lia S , Taton Jean-Luc , Fofana Aissata , Reithinger Richard
Published: February 2024

Background

Seasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC targeting children aged 3–59 months (CU5) in districts with high and seasonal malaria transmission.

Objective

We assessed the programmatic impact of SMC in Guinea’s context of scaled up malaria intervention programming by comparing malaria-related outcomes in 14 districts that had or had not been targeted for SMC.

Methods

Using routine health management information system data, we compared the district-level monthly test positivity rate (TPR) and monthly uncomplicated and severe malaria incidence for the whole population and disaggregated age groups (<5 years and ≥5 years of age). Changes in malaria indicators through time were analysed by calculating the district-level compound annual growth rate (CAGR) from 2014 to 2021; we used statistical analyses to describe trends in tested clinical cases, TPR, uncomplicated malaria incidence and severe malaria incidence.

Results

The CAGR of TPR of all age groups was statistically lower in SMC (median=−7.8%) compared with non-SMC (median=−3.0%) districts. Similarly, the CAGR in uncomplicated malaria incidence was significantly lower in SMC (median=1.8%) compared with non-SMC (median=11.5%) districts. For both TPR and uncomplicated malaria incidence, the observed difference was also significant when age disaggregated. The CAGR of severe malaria incidence showed that all age groups experienced a decline in severe malaria in both SMC and non-SMC districts. However, this decline was significantly higher in SMC (median=−22.3%) than in non-SMC (median=−5.1%) districts for the entire population, as well as both CU5 and people over 5 years of age.

Conclusion

Even in an operational programming context, adding SMC to the malaria intervention package yields a positive epidemiological impact and results in a greater reduction in TPR, as well as the incidence of uncomplicated and severe malaria in CU5.
Prescriptions of antidepressants and anxiolytics in France 2012–2022 and changes with the COVID-19 pandemic: interrupted time series analysis
Authors: De Bandt David , Haile Sarah R , Devillers Louise , Bourrion Bastien , Menges Dominik
Published: February 2024

Background

Depression and anxiety have increased in prevalence since the start of the COVID-19 pandemic.

Objective

To evaluate the consumption of antidepressants and anxiolytics from 2012 to 2022 and the pandemic’s potential impact in France.

Methods

We conducted an interrupted time series analysis of routine drug sales data (Medic'AM) from all French outpatient pharmacies from 2012 to 2022. We investigated trends in defined daily doses of antidepressants and anxiolytics sold per 1000 inhabitants (DDD/TID) and related expenditures before and after pandemic onset and in relation with stringency of pandemic mitigation measures. Analyses were performed descriptively and using segmented linear regression, autoregressive and autoregressive integrated moving average models.

Findings

From 2012 to 2019, overall monthly antidepressant sales increased (+0.02 DDD/TID) while monthly anxiolytic sales decreased (−0.07 DDD/TID). With pandemic onset, there was a relevant and persisting trend increase (+0.20 DDD/TID per month) for antidepressant sales overall, with an estimated excess of 112.6 DDD/TID sold from May 2020 until December 2022. Anxiolytic sales were elevated from February 2020 throughout the pandemic but returned to expected levels by December 2022, with an estimated excess of 33.8 DDD/TID. There was no evident association between stringency and antidepressant or anxiolytic sales.

Conclusions

This study showed a protracted trend increase in the consumption of antidepressants since pandemic onset, while increases in anxiolytic consumption were temporary.

Clinical implications

We provide evidence that the COVID-19 pandemic may have had long-lasting consequences on the prevalence and treatment of depression and anxiety disorders, requiring further actions by researchers and policy-makers to address this potential public mental health crisis.
Prescribing practices in the treatment of wasting: secondary analysis from a randomised trial
Authors: Rattigan Susan M , Grantz Kyra H , Hanson Kerstin , Langendorf Celine , Berthé Fatou , Grais Rebecca , Isanaka Sheila
Published: February 2024

Introduction

Current guidelines for the outpatient treatment of severe acute malnutrition (SAM) recommend the provision of routine medications to all children at admission and prescribed medications as clinically indicated thereafter. The objective of this study was to describe the amount and purpose of medications prescribed during outpatient SAM treatment and explore the effect of routine antibiotics at admission on subsequent medication prescription.

Methods

Medications prescribed during outpatient treatment were described by medication category, time from admission, and diagnoses among children with SAM in a placebo-controlled, double-blind trial of 7-day amoxicillin use. Total medications were compared by parent trial intervention arm (amoxicillin vs placebo) and differences assessed using Χ2and two-sample t-tests.

Results

Of the 2399 children enrolled, 74.6% of children received ≥1 prescribed medication during outpatient treatment. Antipyretics/analgesics (44.1% of children), antimalarials (56.6%) and antibiotics (30.0%) were prescribed most frequently. Children who received placebo in the parent trial received fewer total medications (mean difference: −0.80, 95% CI: −0.96 to –0.65) and oral antibiotics (mean difference: −0.96, 95% CI: −0.99 to –0.92) during treatment compared with children who received routine amoxicillin.

Conclusions

We found high rates of medication prescription during outpatient treatment for SAM, but fewer total medications and oral antibiotics prescribed to children receiving placebo in the parent trial. Our findings underscore the role of outpatient treatment programmes as an important source of medicine prescription and suggest that provision of antibiotics on a clinically indicated basis for outpatient SAM cases may be a strategy to support prudent antibiotic use in certain settings.

Trial registration number

ClinicalTrials.gov Registry (NCT01613547;https://clinicaltrials.gov/ct2/show/NCT01613547).
Evaluation of planned number of children, the well-being of the couple and associated factors in a prospective cohort in Yokohama (HAMA study): study protocol
Authors: Hara Koji , Kuroki Makoto , Shiraishi Sayuri , Matsumura Shingo , Ito Shuichi , Kurasawa Kentaro , Arimoto Azusa , Matsuzaki Yohei
Published: February 2024

Introduction

Many developed countries including Japan are experiencing declining birth rates, particularly in urban areas. A gap between the planned number of children and the actual number of children exists, that is attributed to various factors such as: childcare leave and employment policies, childcare services, financial support, husbands’ contributions to household chores and childcare, marriage support, community, and couples’ well-being. Therefore, we propose HAMA study for having a baby, parenting, and marriage life (HAMA = ‘H’aving ‘A’ baby, parenting, and ‘MA’rriage life) in Yokohama (an urban area) to examine these issues.

Methods and analysis

In this large-scale cohort study, we will elucidate the actual situation of families and child-rearing in Yokohama, evaluate the current policies and propose future measures to prevent a decline in the birth rate. Overall, 10 000 young married couples (wives aged 20–39 years as of 2022) will be randomly selected, and a survey form will be sent to them annually. They will be followed-up for 5 years to examine the factors associated with the planned number of children, well-being of the couple, childcare support policies, externalisation of housework and childcare, fathers’ participation in housework and childcare, wives’ free time, loneliness and social connectedness, relationship with the spouse and if they are working, questions regarding their work style and work-life balance will also be included. Ultimately, a conceptual model of the planned number of children and associated factors will be developed.

Ethics and dissemination

This study has been approved by the Ethics Committee of Yokohama City University (reference number: 2022–10) and will be conducted following appropriate ethical guidelines. Opportunities to withdraw consent to participate in the survey are provided to participants. The results of this survey will be published as research papers in relevant journals and will be reported to the administration of Yokohama city and other agencies.
Evaluating a stepped care model of psychological support for adults affected by adversity: study protocol for a randomised controlled trial in Jordan
Authors: Keyan Dharani , Habashneh Rand , Akhtar Aemal , El-Dardery Hafsa , Faroun Muhannad , Abualhaija Adnan , Aqel Ibrahim Said , Dardas Latefa Ali , Bryant Richard
Published: February 2024

Background

The burden of common mental disorders in low and middle-income countries (LMICs) is growing with little known about how to allocate limited resources to reach the greatest number of people undergoing instances of significant psychological distress. We present a study protocol for a multicentre, parallel-group, superiority, randomised controlled trial.

Methods and analysis

Adults with significant psychological distress (K10 score ≥20) will be randomised to receive a stepped care programme involving a self-guided course (Doing What Matters) followed by a more intensive group programme (Problem Management Plus) or the self-guided course alone, both of which will take place in addition to enhanced treatment as usual comprising of a follow-up referral session to available services within the community. We will include 800 participants. An intent-to-treat and completer analysis will explore the impact of the stepped model of care on anxiety and depression symptoms (as measured by the Hopkins Symptom Checklist; HSCL-25) at 24 weeks from baseline. Secondary outcomes include positive psychological well-being, agency, changes in patient-identified problems, quality of life and cost-effectiveness. Linear mixed models will be used to assess the differential impact of the conditions over time. Analyses will focus on the primary outcome (HSCL-25) and secondary outcomes (agency subscale, WHO Well-Being Index, WHO Disability Assessment Schedule V.2.0, EQ-5D, Psychological Outcomes Profiles Scale) for both conditions, with the main outcome time point being the 3-month follow-up, relative to baseline.

Ethics and dissemination

This will be the first randomised controlled trial to assess the benefits of a stepped model of care to addressing psychological distress in a LMIC setting. Results will provide important insights for managing limited resources to mental healthcare in these settings and will be accordingly disseminated to service providers and organisations via professional training and meetings, and via publication in relevant journals and conference presentations. We will also present these findings to the Jordanian Ministry of Health, where this institute will guide us on the most appropriate format for communication of findings, including written reports, verbal presentations and/or brochures. Ethical approval was obtained from the University of Jordan School of Nursing Research Ethics Committee (number: PF.22.10).

Trial registration number

ACTRN12621000189820p; Australian New Zealand Clinical Trials Registry.
Prototype development of the Mental Health benchmarking Industry Tool for residential aged Care (MHICare Tool): a protocol paper of a two-stage sequential and mixed methods codesign study
Authors: Brimelow Rachel , Brooks Deborah , Sriram Deepa , Burley Claire , Beattie Elizabeth , Byrne Gerard , Dissanayaka Nadeeka
Published: February 2024

Objectives

Current mental health practices for people living in residential aged care (RAC) facilities are poor. In Australia, there are no mechanisms to monitor and promote mental health for people living in RAC, including those who experience changed behaviours and psychological symptoms. The aim of this study is to improve current practices and mental health outcomes for people living in RAC facilities by codesigning a Mental Health benchmarking Industry Tool for residential aged Care (MHICare Tool).

Methods

A two-stage sequential and mixed methods codesign methodology will be used. Stage 1 will include qualitative interviews and focus groups to engage with residents, family/care partners and RAC staff to ascertain mental healthcare practices and outcomes of greatest significance to them. Adapted concept mapping methods will be used to rank identified issues of concern in order of importance and changeability, and to generate draft quality indicators. Stage 2 will comprise a Delphi procedure to gain the wider consensus of expert panel views (aged care industry, academic, clinical) on the performance indicators to be included, resulting in the codesigned MHICare Tool.

Ethics and dissemination

This study has been reviewed and approved by the University of Queensland Human Research Ethics Committee (HREC/2019002096). This project will be carried out according to the National Statement on Ethical Conduct in Human Research (2007). The study’s findings will be published in peer-reviewed journals and disseminated at national and international conferences and through social media.

Conclusion

This protocol reports structured methods to codesign and develop a mental health performance indicator tool for use in Australian RAC.
Great expectations? GPs’ estimations of time required to deliver BMJ’s ‘10 minute consultations’
Authors: Bradley Stephen Henry , Harper Alice M , Smith Lesley , Taylor Nigel , Delap Harriet , Pyke Helen , Girkin James , Sinnott Carol , Watson Jessica
Published: February 2024

Objectives

To estimate the time required to undertake consultations according to BMJ’s 10-minute consultation articles.

To quantify the tasks recommended in 10-minute consultation articles.

To determine if, and to what extent, the time required and the number of tasks recommended have increased over the past 22 years.

Design

Analysis of estimations made by four general practitioners (GPs) of the time required to undertake tasks recommended inBMJ’s10-minute consultationarticles.

Setting

Primary care in the UK.

Participants

Four doctors with a combined total of 79 years of experience in the UK National Health Service following qualification as GPs.

Main outcome measures

Median minimum estimated consultation length (the estimated time required to complete tasks recommended for all patients) and median maximum estimated consultation length (the estimated time required to complete tasks recommended for all patientsandthe additional tasks recommended in specific circumstances). Minimum, maximum and median consultation lengths reported for each year and for each 5-year period.

Results

Data were extracted for 44 articles. The median minimum and median maximum estimated consultation durations were 15.7 minutes (IQR 12.6–20.9) and 28.4 minutes (IQR 22.4–33.8), respectively. A median of 17 tasks were included in each article. There was no change in durations required over the 22 years examined.

Conclusions

The approximate times estimated by GPs to deliver care according to10-minute consultationsexceed the time available in routine appointments. ‘10 minute consultations’ is a misleading title that sets inappropriate expectations for what GPs can realistically deliver in their routine consultations. While maintaining aspirations for high-quality care is appropriate, practice recommendations need to take greater account of the limited time doctors have to deliver routine care.
Underdiagnosis in clinical documentation of community-acquired sepsis among children admitted to hospitals in two rural provinces: Thailand, October–December 2017
Authors: Choudhary Rewa , Watakulsin Peeriya , Promduangsi Pitiphon , Chuenchom Nuttagarn , Khemla Supachoke , Lurchachaiwong Woradee , Mock Philip , Heffelfinger James D , MacArthur John R , Bloss Emily , Thamthitiwat Somsak , Rao Carol Y
Published: February 2024

Paediatric sepsis prevalence data from low-income and middle-income countries are lacking. In a cross-sectional study, we assessed clinician recognition and documentation of non-neonatal community-acquired paediatric sepsis in two rural border provinces in Thailand among children admitted between October and December 2017. Of the 152 children meeting sepsis criteria (26.9 paediatric sepsis patients per 1000 admissions), 15 (9.9%) had a clinician-documented admission diagnosis of sepsis or septic shock and 18 (11.8%) had a discharge diagnosis with International Classification of Diseases-10 codes related to sepsis. Clinician underdocumentation may cause challenges in global paediatric sepsis surveillance.
Long-term effectiveness of a lifestyle intervention for rheumatoid arthritis and osteoarthritis: 1-year follow-up of the ‘Plants for Joints’ randomised clinical trial
Authors: Wagenaar Carlijn A , Walrabenstein Wendy , van der Leeden Marike , Turkstra Franktien , Gerritsen Martijn , Twisk Jos W R , Boers Maarten , van der Esch Martin , van Middendorp Henriët , Weijs Peter J M , van Schaardenburg Dirkjan
Published: February 2024

Objectives

In two randomised controlled trials, the Plants for Joints (PFJ) multidisciplinary lifestyle intervention reduced signs and symptoms of rheumatoid arthritis (RA), or metabolic syndrome-associated hip or knee osteoarthritis (MSOA) compared with usual care. The current study investigated long-term outcomes.

Methods

After completion of two 16-week trials in people with (1) RA or (2) MSOA, control groups switched to the active PFJ intervention. At the end of the intervention, all participants were followed up in a 1-year observational extension study. Primary outcomes were 28-joint Disease Activity Score (DAS28) (RA) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (MSOA). Secondary outcomes included body composition, metabolic outcomes, medication changes and intervention adherence. An intention-to-treat analysis with a linear mixed model was used to analyse within-group changes.

Results

65 (84%) of 77 RA participants and 49 (77%) of 64 MSOA participants completed the extension study. The effects of the PFJ intervention were replicated in the original control groups and sustained within the RA group a year after intervention completion (mean DAS28 –0.9 points; p<0.001), while in the MSOA group mean WOMAC increased towards but remained well under the starting value (–7.8 points, p<0.001). Improvements in C-reactive protein, waist circumference (RA and MSOA); low-density lipoprotein cholesterol (RA); and weight, haemoglobin A1c, blood pressure (MSOA) were also sustained. Participants had a net decrease of medication, and intervention adherence was largely sustained.

Conclusions

A year after the PFJ lifestyle intervention, improvements of disease activity and metabolic outcomes within RA and MSOA groups were largely sustained and related to sustained adherence, with a net decrease of medication.

Trial registration numbers

NL7800, NL7801.
Combining lattice QCD and phenomenological inputs on generalised parton distributions at moderate skewness
Authors: Riberdy Michael Joseph , Dutrieux Hervé , Mezrag Cédric , Sznajder Paweł
Published: February 2024

We present a systematic study demonstrating the impact of lattice QCD data on the extraction of generalised parton distributions (GPDs). For this purpose, we use a previously developed modelling of GPDs based on machine learning techniques fulfilling the theoretical requirements of polynomiality, a form of positivity constraint and known reduction limits. A special care is given to estimate the uncertainty stemming from the ill-posed character of the connection between GPDs and the experimental processes usually considered to constrain them, like deeply virtual Compton scattering (DVCS). Moke lattice QCD data inputs are included in a Bayesian framework to a prior model based on an Artificial Neural Network. This prior model is fitted to reproduce the most experimentally accessible information of a phenomenological extraction by Goloskokov and Kroll. We highlight the impact of the precision, correlation and kinematic coverage of lattice data on GPD extraction at moderate $$\xi $$
ξ
which has only been brushed in the literature so far, paving the way for a joint extraction of GPDs.
Holographic Einstein rings of non-commutative black holes
Authors: Hu Xin-Yun , Zeng Xiao-Xiong , Li Li-Fang , Xu Peng
Published: February 2024

With the help of AdS/CFT correspondence, we derive the desired response function of QFT on the boundary of the non-commutative black hole. Using the virtual optical system with a convex lens, we obtain the Einstein rings of the black hole from the response function. All the results show that the holographic ring always appears with the concentric stripe when the observer located at the north pole. With the change of the observation position, the ring changes into a luminosity-deformed ring, or bright spot. We also investigate the effect of the non-commutative parameter on the ring and find the ring radius becomes larger as the parameter increases. The effect of the temperature on the ring radius is also investigated, it is found that the higher the temperature, the smaller the ring radius. In addition, we also obtain the ingoing angle of the photon via geometric optics, as expected, this angle is consistent well with the angle of the Einstein ring obtained via holography.
THREE PROPERTIES OF FRACTAL NETWORKS BASED ON BEDFORD–MCMULLEN CARPET
Authors: ZHENG JIAN , ZENG CHENG , XUE YUMEI , LI XIAOHAN
Published: February 2024

In this paper, we consider the networks modeled by several self-affine sets based on the Bedford–Mcmullen carpet. We calculate three properties of the networks, including the cumulative degree distribution, the average clustering coefficient and the average path length. We show that such networks have scale-free and small-world effects.
About the shock formation in multi-dimensional scalar conservation laws
Authors: Serre Denis
Published: February 2024

We establish a space-time integral estimate of the difference of solutions of non-degenerate scalar conservation laws. It is valid over the maximal domain [Formula: see text] in which the solutions are shock-free, and it fails beyond [Formula: see text]. When comparing a solution with its shifts, we deduce a Besov-like estimate at the development of its first singularity.
The wave equation on the Schwarzschild spacetime with small non-decaying first-order terms
Authors: Holzegel Gustav , Kauffman Christopher
Published: February 2024

In this paper, we present an elementary physical space argument to establish local integrated decay estimates for the perturbed wave equation [Formula: see text] on the exterior of the Schwarzschild geometry [Formula: see text]. Here [Formula: see text] is a regular vector field on [Formula: see text] decaying suitably in space but not necessarily in time. The proof is formulated to cover also perturbations of the Regge–Wheeler equation.
Strichartz estimates for Maxwell equations in media: The fully anisotropic case
Authors: Schippa Robert , Schnaubelt Roland
Published: February 2024

We consider Maxwell equations in media in the uniformly fully anisotropic case in three dimensions and prove Strichartz estimates for Hölder-continuous material coefficients. To this end, we use the FBI transform to conjugate the problem to phase space. After reducing to a scalar estimate by means of a matrix symmetrizer, we show oscillatory integral estimates for a variable-coefficient Fourier extension operator. The characteristic surface has conical singularities for any non-vanishing time frequency. As a consequence of the Strichartz estimates, we improve the local well-posedness for certain fully anisotropic quasilinear Maxwell equations. For these we establish local well-posedness for initial data with Sobolev regularity, which could previously not be covered with energy methods.
Linear decay property for the hyperbolic-parabolic coupled systems of thermoviscoelasticity
Authors: Dharmawardane Priyanjana M. N. , Kawashima Shuichi , Ogawa Takayoshi , Segata Jun-ichi
Published: February 2024

We consider the initial value problem of a linearized hyperbolic-parabolic coupled systems of thermoviscoelasticity around the constant state with arbitrary spatial dimensions ([Formula: see text]) and study the decay property of the systems. In the first place, we construct the fundamental solutions in Fourier space. Then we prove the decay property for the linearized systems provided that the initial data are in [Formula: see text].
Leveraging Bidirectionl LSTM with CRFs for Pashto Tagging
Authors: Zaman Farooq , Maqbool Onaiza , Kanwal Jaweria
Published: February 2024

Part-of-speech tagging plays a vital role in text processing and natural language understanding. Very few attempts have been made in the past for tagging Pashto Part-of-Speech. In this work, we present a Long Short-term Memory–based approach for Pashto part-of-speech tagging with special focus on ambiguity resolution. Initially, we created a corpus of Pashto sentences having words with multiple meanings and their tags. We introduce a powerful sentences representation and new architecture for Pashto text processing. The accuracy of the proposed approach is compared with state-of-the-art Hidden Markov Model. Our Model shows 87.60% accuracy for all words excluding punctuation and 95.45% for ambiguous words; however, Hidden Markov Model shows 78.37% and 44.72% accuracy, respectively. Results show that our approach outperforms Hidden Markov Model in Part-of-Speech tagging for Pashto text.