bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in the critical nutrient content of packaged foods and beverages after the full implementation of the Chilean Food Labelling and Advertising Law: a repeated cross-sectional study
Authors: Rebolledo Natalia , Ferrer-Rosende Pedro , Reyes Marcela , Smith Taillie Lindsey , Corvalán Camila
Published: January 2025

Background

Chile’s Food Labelling Law was implemented in three phases with increasingly stricter limits. After initial implementation, sugars and sodium decreased in packaged foods, with no significant changes for saturated fats. It is unclear whether full implementation is linked with further reformulation or if producers reversed changes due to consumers’ preferences. This study examines changes in the proportion of “high in” products and the nutrient content of packaged foods during the Law’s three phases.

Methods

This repeated cross-sectional study included the best-selling packaged foods and beverages during 2015–2020. We analyzed the proportion of products classified as “high in” critical nutrients using the final phase cutoffs and examined changes in the content of calories, sugars, sodium, and saturated fats in the three phases. To assess the changes in proportions, we used Firth’s bias-reduced logistic regression models and the Cochran-Armitage test for trends. Quantile regression was used to evaluate changes in nutrient content.

Results

The proportion of “high in” products decreased from 70.8 to 52.5% after the final phase (p < 0.001). The proportion of “high in” sugars products decreased across all sweet food and beverage groups (p < 0.001), except for candies (− 4.5 percentage points (pp), p = 0.09). The largest reductions occurred in sweet spreads and breakfast cereals (− 44.3 and − 40.4 pp, respectively, p < 0.001). For the proportion of “high in” sodium, reductions occurred in all savory food groups (p < 0.001), except cheeses and ready-to-eat meals (p < 0.24), with the largest decreases in savory baked products and non-sausage meat products (− 40.4 and − 38.9 pp, respectively, p < 0.001). Reductions in “high in” saturated fats and energy were less consistent, with the largest decreases in nuts and snacks and savory spreads (− 22.2 and − 20.0 pp, respectively, p < 0.001) and savory baked products and breakfast cereals (− 32.8 and − 25.7 pp, respectively, p < 0.001), respectively. After full implementation, most sweet categories showed left shifts in sugars distribution, except for candies. Similarly, most savory categories showed left shifts for sodium, except savory spreads and ready-to-eat meals. Changes increased as regulation limits tightened (p for trend < 0.001).

Conclusions

After fully implementing Chile’s law, the proportion of “high in” products and the content of critical nutrients decreased in all food and beverage categories. The largest changes occurred for sodium in savory foods and sugars in sweet foods/beverages. Stricter regulatory limits were associated with decreases in critical nutrient content over time.
Relationship between social support, functional outcomes and health-related quality of life in working-aged adults at three months after ischemic stroke: results from the FRAILTY study
Authors: Gurková Elena , Bartoníčková Daniela , Šaňák Daniel , Šaňáková Šárka , Zapletalová Jana , Štureková Lenka
Published: January 2025

Background

The relationship between social support and functional outcomes and health-related quality of life (HRQoL) after ischemic stroke (IS) remains unclear, especially in working-aged patients.

Aim

To assess the relationship between perceived social support, functional outcomes, post-stroke psychosocial symptoms, and HRQoL in working-aged adults three months after IS.

Methods

A prospective and correlational design was used. Patients of working age (18–65 years) admitted for first-ever IS were enrolled in the prospective FRAILTY (Factors Affecting the Quality of Life After Ischemic Stroke in Young Adults) study (NCT04839887). HRQoL (using the Stroke Impact Scale, Quality of Life in Neurological Disorders), social support (using the Multidimensional Scale of Perceived Social Support), functional outcomes (using a modified Rankin Scale—mRS), and post-stroke psychosocial symptoms were assessed three months after IS. Descriptive statistics, Wilcoxon signed-rank test, Spearman’s correlations and multiple linear regression were used for analysis.

Results

A total of 121 (54.5% males, mean age 51.7 ± 8.4 years) IS patients were analyzed. Of those, 87.7% had excellent clinical outcomes (mRS 0–1) after three months. Patients reported significant improvement in all domains of self-reported HRQoL except memory and communication after three months. The overall perceived social support was not associated with HRQoL domains. Post-stroke depression was negatively associated with all domains of HRQoL. Living arrangements (living alone) and post-stroke depression were negatively associated with perceived social support after IS.

Conclusions

More insight into the relationship between variables of HRQoL in working-aged adults might increase their social participation, strengthen supportive relationships, and promote their recovery and rehabilitation process. Focusing on the management of emotional problems and supporting functional outcomes may be modifiable factors that may represent targets for strategies to improve the HRQoL. Further research is needed to clarify the relationship between pre-stroke perceived social support and its types and post-stroke psychosocial symptoms in the long term.
Single-cell analyses of intestinal epithelium reveal the dysregulation of gut immune microenvironment in systemic lupus erythematosus
Authors: Wang Qiaolin , Wu Yutong , Ouyang Lianlian , Min Xiaoli , Zheng Meiling , Gao Lingyu , Chen Xiaoyun , Hu Zhi , Yang Shuang , Jiang Wenjuan , Jia Sujie , Lu Qianjin , Zhao Ming
Published: January 2025

Background

The small intestine harbors a rich array of intestinal intraepithelial lymphocytes (IELs) that interact with structural cells to collectively sustain gut immune homeostasis. Dysregulation of gut immune homeostasis was implicated in the pathogenesis of multiple autoimmune diseases, however, whether this homeostasis is disrupted in a lupus autoimmune background remains unclear.

Methods

We performed single-cell RNA sequencing (scRNA-seq) analyses to elucidate immune and structural milieu in the intestinal epithelium of MRL/Lpr lupus mice (Lpr mice) and MRL/Mpj control mice (Mpj mice). Comprehensive analyses including unsupervised clustering, trajectories, and cellular communication were performed. The primary findings from scRNA-seq were further validated by quantitative polymerase chain reaction (qPCR), flow cytometry, and in vivo experiments including selenium supplementation.

Results

We observed a significant reduction in CD8αα + IELs, accompanied by a marked increase in CD8αβ + IELs in Lpr mice. Additionally, subsets of CD8 + IELs exhibiting significantly enhanced effector functions were found to be markedly enriched in Lpr mice. Intercellular communication patterns within intestinal epithelial immune and structural cells were found to be specifically altered in Lpr mice. Moreover, scRNA-seq revealed significantly decreased intestinal TCRγδ T cells (γδT) associated with reduced aryl-hydrocarbon receptor repressor (AHRR) expression and subsequent oxidative stress and ferroptosis in Lpr mice. Antioxidant selenium effectively reversed the loss of γδT in Lpr mice, improved the gut barrier, and alleviated lupus symptoms.

Conclusions

Our high-resolution single-cell atlas enhances the understanding of the immune and structural milieu of intestinal epithelium in lupus and provides new insights into lupus pathogenesis mediated by intestinal immune dysregulation.
Exploring the clinical profiles and management of juvenile dermatomyositis in Africa: a survey of African rheumatology care providers
Authors: Perfetto Jessica , Lewandowski Laura B. , Wahezi Dawn M. , Ogega Vanessa , Ahimbisibwe Joan , Webb Kate , Scott Christiaan , Migowa Angela
Published: January 2025

Background

There are limited studies of juvenile dermatomyositis (JDM) in low and middle-income countries (LMIC). Many demonstrate delays to care, high prevalence of severe manifestations, and high mortality. Given the disease-associated damage with JDM, understanding JDM in Africa further is critical. Our objectives are to understand the burden of JDM in Africa and provider access to diagnostic tools and therapy through survey methodology.

Methods

A survey (available in English and French) was distributed via WhatsApp to 363 total members of the African League of Associations for Rheumatology (AFLAR; n = 233) and Paediatric Society of the African League Against Rheumatism (PAFLAR; n = 130) from November 2022-January 2023. Topics included respondent specialty, number of JDM patients followed, severe manifestations, and available diagnostic tools and medications (with and without considering cost).

Results

Forty-three (12%) of the 363 providers who received the survey started it. Among the 43 who started the survey, 37 (86%) provided consent and manage JDM patients; of these 37 providers, 4 (11%) partially and 16 (43%) fully completed the survey. Most were adult and/or pediatric rheumatologists (n = 19; 95%). Respondents represented all 5 African regions and described 216 children with JDM within the last 10 years. There was high prevalence of calcinosis (as high as 100%) and interstitial lung disease (ILD) (as high as 32%); mortality rates in Kenya (6/42; 14%) and Zambia (2/7; 29%) exceeded the 1–3% mortality reported in studies of high-income countries. Thirteen of 27 diagnostic tools and medications were accessible to ≤ 50% of respondents after considering cost, mostly in Northern or Southern Africa (9/13; 69%). Despite being cost-free, disease assessment tools and physical exam to assess calcinosis were not reported as universally available or accessible.

Conclusions

This is the first study to explore experiences of providers caring for children with JDM in Africa. Respondents identified 216 children with JDM seen within the last 10 years, exceeding the 196 children with JDM reported within the last 25 years but likely still underestimating prevalence. Our findings align with reports of severe manifestations and poor outcomes in African children with JDM. Access to many diagnostics and medications is limited, and differences in accessibility parallel regional healthcare disparities. The potential differences in JDM severity warrant systematic study and highlight the need to include patients and providers from LMIC in collaborative research efforts.
Increased interferon I signaling, DNA damage response and evidence of T-cell exhaustion in a patient with combined interferonopathy (Aicardi-Goutières Syndrome, AGS) and cohesinopathy (Cornelia de Lange Syndrome, CdLS)
Authors: Boiu Sorina , Paschalidis Nikolaos , Sentis George , Manolakou Theodora , Nezos Andrianos , Gialitakis Manolis , Grigoriou Maria , Atsali Erato , Giorgi Melpomeni , Ntinopoulos Argirios , Mavragani Clio , Makrythanasis Periklis , Boumpas Dimitrios T. , Banos Aggelos
Published: January 2025

Background

Type I interferonopathies including Aicardi-Goutiéres Syndrome (AGS) represent a heterogeneous group of clinical phenotypes. Herein, we present a Case with combined AGS and Cornelia de Lange Syndrome (CdLS)—a cohesinopathy—with comprehensive analysis of the immune and genomic abnormalities.

Case and methods

A 20-year old man presented with chilblain lesions and resorption of distal phalanges of fingers and toes, somatic and psychomotor retardation, microcephaly, synophrys, hearing losing and other aberrancies consistent with the phenotype of CdLS. We used whole exome sequencing to genetically map the associated mutations and performed transcriptome profiling and enrichment analysis in CD14+ monocytes of the patient and immune phenotyping by mass cytometry (CyToF), comparing to healthy individuals and lupus patients as disease controls. DNA damage response was assayed by confocal microscopy in the peripheral blood of this patient.

Results

Next generation exome sequencing confirmed a homozygous SAMHD1 gene mutation and a hemizygous non-synonymous mutation on SMC1A gene, responsible for the AGS and CdLS, respectively. Transcriptome profiling of CD14+ monocytes of the patient showed enrichment of type I IFN signaling and enhanced DNA damage response pathway. Broad immune phenotype of the peripheral blood of the patient revealed absence of activated T cell populations, increased frequency of NK cells and plasmablasts and enhanced granulocytic lineage. Further analysis suggested activation of the ATM branch of DNA damage response and increased apoptosis in the periphery of the patient.

Conclusions

A rare case of a patient bearing two genetic lesions (responsible for AGS/CdLS syndromes) exhibits distinctive features of genomic damage and interferon responses. Immune phenotype revealed granulocytic skewing and absence of activated T cells compatible with chronic antigenic stimulation and/or homing of these cells at sites of inflammation.
Decoding airway granulogenesis in children: unveiling risk factors for tracheobronchial foreign body aspiration and complications
Authors: You Yuting , Shen Meili , Zeng Li’e , Zheng Jingyang
Published: January 2025

Background

Exogenous foreign body aspiration is a common high-risk condition in children. In a few cases, foreign body aspiration can lead to airway granulomas that interfere with tracheoscopic foreign body removal and threaten the life of the child.

Methods

This study was a retrospective analysis of the clinical data of 184 pediatric patients who were admitted to Quanzhou Children’s Hospital from 2018 to 2021 with exogenous tracheobronchial foreign bodies.

Results

Respiratory foreign bodies tend to occur during the winter and spring seasons. The solid foreign bodies were mostly nut foreign bodies, the location of implantation was the left lung rather than the right lung in many patients, and complications such as pulmonary atelectasis, emphysema, mediastinal and subcutaneous emphysema, and granulomatous tissue formation were noted in these patients. Statistical models suggested that the time of foreign body impaction and the release of oil were risk factors for tracheal granulation, with the logistic model presenting an AUC of 0.948, precision of 0.676, and sensitivity of 0.895, whereas the XGBoost model presented an AUC of 0.902, precision of 0.912, and sensitivity of 0.875.

Conclusions

Tracheobronchial foreign bodies primarily develop in male children under the age of 3 and often lead to various complications. The time of foreign body insertion and the release of oil from the obstructed foreign body have been identified as high-risk factors for the development of tracheobronchial granulation tissue. When the time of foreign body insertion without oil release exceeds 99.98 h or when the time of foreign body insertion with oil release exceeds 47.94 h, tracheobronchial granulation formation strongly suggests that the child is at high risk of developing airway granulation. In such cases, family members must implement increased supervision of the child to prevent choking. Medical professionals should obtain a detailed medical history of the affected child and accordingly select the most appropriate method to promptly remove the foreign body to resolve the issue of airway obstruction and reduce the likelihood of pulmonary complications in the child.
Heterogeneity of Clostridioides difficile asymptomatic colonization prevalence: a systematic review and meta-analysis
Authors: De-la-Rosa-Martínez Daniel , Villaseñor-Echavarri Rodrigo , Vilar-Compte Diana , Mosqueda-Larrauri Virna , Zinser-Peniche Paola , Blumberg Seth
Published: January 2025

Background

Asymptomatic carriers significantly influence the transmission dynamics of C. difficile. This study aimed to assess the prevalence of toxigenic C. difficile asymptomatic colonization (tCDAC) and investigate its heterogeneity across different populations. We searched MEDLINE, Web of Science, and Scopus for articles published between 2000 and 2023 on tCDAC. Studies including asymptomatic adults with laboratory-confirmed tCDAC were eligible. We performed a random-effects meta-analysis to estimate the pooled prevalence by clinical characteristics, settings, and geographic areas. In addition, we used outlier analyses and meta-regression to explore sources of prevalence variability.

Results

Fifty-one studies involving 39,447 patients were included. The tCDAC prevalence ranged from 0.5 to 51.5%. Among pooled estimates, a high prevalence was observed in patients with cystic fibrosis, outbreak settings, and cancer patients, whereas the lowest rates were found in healthy individuals and healthcare workers. Similar colonization rates were observed between admitted and hospitalized patients. Our meta-regression analysis revealed lower rates in healthy individuals and higher rates in cystic fibrosis patients and studies from North America. Additionally, compared with that among healthy individuals, the prevalence significantly increased by 15–47% among different populations and settings.

Conclusion

Our study revealed that tCDAC is a common phenomenon. We found high prevalence estimates that showed significant variability across populations. This heterogeneity could be partially explained by population characteristics and settings, supporting their role in the pathogenesis and burden of this disease. This highlights the need to identify high-risk groups to improve infection control strategies, decrease transmission dynamics, and better understand the natural history of this disease.
The ABC transporter A7 modulates neuroinflammation via NLRP3 inflammasome in Alzheimer’s disease mice
Authors: Santos-García Irene , Bascuñana Pablo , Brackhan Mirjam , Villa María , Eiriz Ivan , Brüning Thomas , Pahnke Jens
Published: January 2025

Background

Specific genetic variants in the ATP-binding cassette transporter A7 locus (ABCA7) are associated with an increased risk of Alzheimer’s disease (AD). ABCA7 transports lipids from/across cell membranes, regulates Aβ peptide processing and clearance, and modulates microglial and T-cell functions to maintain immune homeostasis in the brain. During AD pathogenesis, neuroinflammation is one of the key mechanisms involved. Therefore, we wanted to investigate the specific role of ABCA7 in microglial activation via the NLRP3 inflammasome.

Methods

We developed the first humanized, Cre-inducible ABCA7

flx
knock-in mouse model, crossbred it with the APPPS1-21 β-amyloidosis model, and generated constitutive ABCA7ko and microglia Cx3cr1-specific conditional ABCA7ko AD mice. The role of ABCA7 was analyzed using histological, biochemical, molecular and mass spectrometry methods.

Results

Constitutive knockout of the Abca7 gene in APPPS1 mice increased the levels of Aβ42 and the number of IBA1+ (microglia) and GFAP+ (astrocytes) cells. Changes in the levels of astrocytes and microglia are associated with the activation of the NLRP3 inflammasome and increased levels of proinflammatory cytokines, such as IL1β and TNFα. Interestingly, microglia-specific ABCA7ko restored Aβ42 peptide levels and IBA1+ and GFAP+ and NLRP3-related gene expression to the original APPPS1 mouse levels. In primary glial cell cultures of APPPS1-hA7ko microglia and APPPS1 astrocytes from newborn pups, we observed that conditioned media from LPS-stimulated microglia was able to induce NLRP3 inflammasome expression and proinflammatory cytokine release in astrocytes.

Conclusions

Our data suggest that ABCA7 transporters regulate the communication between microglia and astrocytes through the NLRP3 inflammasome and the release of proinflammatory cytokines. This regulation implicates ABCA7 as a key driver ultimately involved in the persistence of the inflammatory response observed in AD.
Telomeres, telomerase, and cancer: mechanisms, biomarkers, and therapeutics
Authors: Shou Songting , Maolan Ayidana , Zhang Di , Jiang Xiaochen , Liu Fudong , Li Yi , Zhang Xiyuan , Geer En , Pu Zhenqing , Hua Baojin , Guo Qiujun , Zhang Xing , Pang Bo
Published: January 2025

Telomeres and telomerase play crucial roles in the initiation and progression of cancer. As biomarkers, they aid in distinguishing benign from malignant tissues. Despite the promising therapeutic potential of targeting telomeres and telomerase for therapy, translating this concept from the laboratory to the clinic remains challenging. Many candidate drugs remain in the experimental stage, with only a few advancing to clinical trials. This review explores the relationship between telomeres, telomerase, and cancer, synthesizing their roles as biomarkers and reviewing the outcomes of completed trials. We propose that changes in telomere length and telomerase activity can be used to stratify cancer stages. Furthermore, we suggest that differential expression of telomere and telomerase components at the subcellular level holds promise as a biomarker. From a therapeutic standpoint, combining telomerase-targeted therapies with drugs that mitigate the adverse effects of telomerase inhibition may offer a viable strategy.
Comparing social stigma of anorexia nervosa, bulimia nervosa, and binge-eating disorder: A quantitative experimental study
Authors: Aird Carlye S. , Reisinger Bennett A. A. , Webb Stephanie N. , Gleaves David H.
Published: January 2025

Background

Currently, we know little regarding how stigma attributed to eating disorders compares to that of other psychological disorders and additionally within different types of eating disorders. In the current study, we aimed to explore the stigmatisation of eating disorders by comparing the stigma attributed to anorexia nervosa, bulimia nervosa, and binge-eating disorder, utilising depression as a comparative control.

Methods

A total of 235 participants from the general population were randomly assigned to an anorexia nervosa, bulimia nervosa, binge-eating disorder, or depression condition. Participants responded to a questionnaire consisting of several adapted versions of pre-existing subscales that measured levels of stigma associated with psychological disorders generally, as well as stigma associated with eating disorders specifically. We used several one-way analyses of variance to investigate the differences in stigma attributed towards the aforementioned psychological disorders.

Results

Results suggested that all three eating disorders were significantly more stigmatised than was depression. Between the eating disorders, the three were generally equivalent except that binge-eating disorder was significantly more stigmatised than both anorexia nervosa and bulimia nervosa on a subscale measuring trivialness.

Conclusions

These findings indicate that individuals with eating disorders, including binge-eating disorder, may be at a higher risk of experiencing the negative implications of stigma when compared to other psychological disorders, such as depression. To our knowledge, this study is one of few that directly quantify and compare stigma attributed towards anorexia nervosa, bulimia nervosa, and binge-eating disorder. Through further research, a better understanding around the expression of stigma towards specific eating disorders could inform the development of targeted interventions to help reduce the stigma associated with these disorders. This knowledge could also advance the understanding of the lived experience of individuals living with eating disorders, subsequently informing treatment practices.
Can responsible leaders transmute sustainability & OCBE among manufacturers in developing economy? A mediated moderated approach for organizational sustainability
Authors: Wang Guohua , Ain Aslam Qurat ul , Mushtaq Naveed , Liaqat Ayesha , Asmi Fahad
Published: January 2025

This study examined the link among environmentally conscious organizational citizenship behavior (OCBE) and responsible leadership among 167 management-level workers in manufacturing plants of arts industry in a developing economy. The study explored the impact of responsible leadership on OCBE, both directly and indirectly through colleague exchange. It also explored the role of a green organizational environment, employee goal orientation, and supervisory support in regulating the link between coworker exchange and OCBE. The findings indicated that responsible leadership held a substantial and favorable influence on organizational citizenship behavior and that this link was mediated via colleague interchange. Workers who exhibited high degrees of goal orientation and were exposed to a sustainable work environment exhibited higher organizational citizenship behavior towards the environment (OCBE), suggesting a connection between colleague contact and OCBE. However, the support from supervisors did not have any moderating effect on this association. The study offers practical and management insights into how to encourage eco-behavior in the workplace.
Experimental paradigm to test the effects of providing social support: study protocol of the PROSPECT trial (Study 2)
Authors: Hajak Vivien , Grimm Simone , Gruszczyńska Ewa , Kroemeke Aleksandra , Józefacka Natalia , Warner Lisa Marie
Published: January 2025

Background

A growing body of research suggests that the provision of social support can have benefits not only for the recipients but also for the provider. Although initial evidence for affective, self-evaluative and physiological outcomes has been established, the beneficial effects of support provision do not occur consistently across all support interactions, and some interactions may even have detrimental effects on providers. The aim of our experimental paradigm is to enable researchers to test the conditions under which the provision of social support to dyadic partners affects affective, self-evaluative, physiological, and relationship outcomes for the provider. In line with self-determination theory, it is proposed that the provision of support is only beneficial to the provider if it satisfies the three basic psychological needs of autonomy, competence and relatedness. The paradigm allows for the manipulation of the provider's levels of competence (feedback on the effectiveness of their support to the other person) and relatedness (feedback on the alleged level of relatedness perceived by the partner person following the provision of support).

Methods

A priori power analyses resulted in a planned sample size of 250 participants randomized to four conditions: 1) no support provision, 2) support provision without feedback, 3) support provision with feedback on competence, 4) support provision with feedback on relatedness. Primary outcomes are immediate physiological (saliva cortisol, heart rate, heart rate variability, blood pressure), affective (positive and negative affect, anxiety), self-evaluative (e.g., self-esteem) and relationship outcomes. Generalized linear models will be used to compare the four conditions.

Discussion

In a controlled laboratory experiment, this new experimental paradigm manipulates the conditions under which social support is provided. Insights into the conditions under which the provision of social support is detrimental or beneficial to the provider can inform the development of preventive and interventional approaches across a range of life domains, motivational and developmental research across the lifespan (e.g. prevention of care-giver burnout), and applied clinical contexts (e.g. therapeutic interventions).

Trial registration

Pre-registration (2023-11-10): https://doi.org/10.17605/OSF.IO/8SPZW, retrospective registration with more details (2024-10-23): https://www.drks.de/DRKS00034287
Adverse childhood experiences, sleep quality/duration and later-life lower extremity function among older adults in China: evidence from CHARLS
Authors: Xiao Jiaqiang , Dong Xiaosheng , Ding Meng , Kong Tao
Published: January 2025

Objective

This study aimed to explore the relationship between adverse childhood experiences (ACEs), sleep, and lower extremity function in older adults using a nationally representative cohort.

Methods

This study included 4,439 participants aged 60 years or older (mean age: 67.2 ± 5.7 years) from the China Health and Retirement Longitudinal Study (CHARLS) 2015 national survey and the 2014 Life History Survey. ACEs, sleep duration, and sleep quality were assessed through self-report, and lower extremity function was measured using the Short physical performance battery (SPPB). The relationships between ACEs, sleep, and lower extremity function were analyzed using multivariate linear regression model and restricted cubic splines.

Results

After adjusting for covariates, older adults with four or more ACEs exhibited worse lower extremity function compared to those with no ACEs (β: -0.175). 6–8 h of sleep was associated with improved lower extremity function (β: 0.119), while good sleep quality was also associated with higher lower extremity function scores (β: 0.177). Age-related differences revealed that the association between four or more ACEs and reduced lower extremity function (β: -0.431) was significant only in individuals aged 70 years and older. In the 60–69 years age group, the sleep duration of 6–8 h was significantly related to better lower extremity function (β: 0.150), however, in those aged 70 years and older, more than 8 h of sleep was associated with poorer function (β: -0.378). Furthermore, good sleep quality was associated with better lower extremity function in individuals aged 70 years and older (β: 0.246).

Conclusion

ACEs, particularly household mental illness and parental disability, are associated with poorer lower extremity function in older adults. Normal sleep duration and good sleep quality are linked to better lower extremity function and may mitigate the negative effects of ACEs. However, these associations vary by age.
Assessing the impact of climate and land use change on flood vulnerability: a machine learning approach in coastal region of Tamil Nadu, India
Authors: Abijith Devanantham , Saravanan Subbarayan , Parthasarathy K S S , Reddy Nagireddy Masthan , Niraimathi Janardhanam , Bindajam Ahmed Ali , Mallick Javed , Alharbi Maged Muteb , Abdo Hazem Ghassan
Published: January 2025

Flooding and other natural disasters threaten human life and property worldwide. They can cause significant damage to infrastructure and disrupt economies. Tamil Nadu coast is severely prone to flooding due to land use and climate changes. This research applies geospatial tools and machine learning to improve flood susceptibility mapping across the Tamil Nadu coast in India, using projections of Land Use and Land Cover (LULC) changes under current and future climate change scenarios. To identify flooded areas, the study utilised Google Earth Engine (GEE), Sentinel-1 data, and 12 geospatial datasets from multiple sources. A random forest algorithm was used for LULC change and flood susceptibility mapping. The LULC data are classified for the years 2000, 2010, and 2020, and from the classified data, the LULC for years 2030, 2040, and 2050 are projected for the study. Four future climate scenarios (SSP 126, 245, 370, and 585) were used for the average annual precipitation from the Coupled Model Intercomparison Project 6 (CMIP6). The results showed that the random forest model performed better in classifying LULC and identifying flood-prone areas. From the results, it has been depicted that the risk of flooding will increase across all scenarios over the period of 2000–2100, with some decadal fluctuations. A significant outcome indicates that the percentage of the area transitioning to moderate and very high flood risk consistently rises across all future projections. This study presents a viable method for flood susceptibility mapping based on different climate change scenarios and yields estimates of flood risk, which can provide valuable insights for managing flood risks.
Toxic epidermal necrolysis with thrombocytopenia induced by intravenous immunoglobulin: a case report and mini review
Authors: Nishita Yoshihiro , Taga Masatoshi , Arakawa Nozomi , Ishida Tomoki , Ochiai Sawako , Ono Hiroto , Taga Fumiaki , Masauji Togen
Published: January 2025

Background

Toxic epidermal necrolysis (TEN), a severe cutaneous hypersensitivity reaction induced particularly by drugs, is diagnosed when there is a fever of ≥ 38 °C, mucocutaneous symptoms, a rash with multiple erythema, and skin peeling of ≥ 30% of the body surface area. The mortality rate of TEN is high, and thrombocytopenia during treatment can lead to severe outcomes. Intravenous immunoglobulin (IVIg) is used when steroids are ineffective in TEN and may improve mortality; however, thrombocytopenia is a rare adverse event associated with IVIg use. We report the case of thrombocytopenia during IVIg therapy for TEN. We also reviewed previous reports to learn more about the clinical course and mechanism of IVIg-induced thrombocytopenia.

Case presentation

An 83-year-old man with end-stage renal failure on hemodialysis was diagnosed with TEN. After an inadequate response to pulse methylprednisolone therapy, IVIg (400 mg/kg/day) was administered for 5 days. He developed thrombocytopenia after IVIg administration, leading to the diagnosis of thrombocytopenia due to IVIg after excluding other diseases. The platelet count began to increase approximately 10 days after IVIg administration.

Conclusions

When IVIg is administered for TEN, the risk of thrombocytopenia should be recognized and the platelet count should be carefully monitored.
Acute Concurrent Exercise Improves Inhibitory Control Without Mediating the Role of Lactate: An Event-Related Potential Study
Authors: Li Ruei-Hong , Chen Tai-Rui , Gilson Nicholas D. , Brazaitis Marius , Cheng Yi-Ting , Wu Hui-Fang , Lee Ji-Hang , Chang Yu-Kai
Published: January 2025

Background

Concurrent exercise (CE), an emerging exercise modality characterized by sequential bouts of aerobic (AE) and resistance exercise (RE), has demonstrated acute benefits on executive functions (EFs) and neuroelectric P3 amplitude. However, the effect of acute CE on inhibitory control, a sub-component of EFs, and P3 amplitude remains inconclusive. Moreover, exploring the mechanisms underlying the effects of acute exercise on EFs contributes to scientific comprehension, with lactate recognized as a crucial candidate positively correlated with EFs. Therefore, this study aimed to determine the effects of acute CE on inhibitory control via behavioral and event-related potential approaches and to examine its potential mediational role on lactate.

Methods

Seventy-eight adults (mean age = 22.95, SD = 1.75 years) were randomly assigned to either a CE, AE, or control (CON) group. Participants in the CE group engaged in 12-min of AE (40–59% of heart rate reserve [HRR]) coupled with 13-min of RE (1 set, with 75% of 10-repetition maximum, and 12 repetitions of 8 movements). The AE group participated in 25 min of AE (40–59% HRR). Prior to and following exercise onset, participants in both the CE and AE groups completed a 5-min warm-up and cool-down. Participants in the CON group read books for 35 min. Lactate concentrations were measured at timepoints of 0-, 17-, and 30-min relative to the treatment onset. Response time (RT) and accuracy in the Stroop test, as well as P3 amplitude, were assessed before and after the treatment.

Results

The results revealed that both the CE and AE groups had significantly shorter RTs compared to the CON group, with no significant differences in accuracy among groups. A decrease in P3 amplitude was observed for the CE group compared to the AE and CON groups. The mediating effects of lactate between acute exercise and inhibitory control were insignificant.

Conclusions

The findings suggest that both CE and AE improve inhibitory control and CE potentially enhances the efficient allocation of attention resources. The lack of a significant mediating effect of lactate warrants further investigation.

Trial registration: ClinicalTrials.gov, NCT06370286. Registered 12 April 2024—Retrospectively registered, https://clinicaltrials.gov/study/NCT06370286.
Echocardiographic assessment of aortic regurgitation: a practical guideline from the British Society of Echocardiography
Authors: Victor Kelly , Ring Liam , Tsampasian Vasiliki , Oxborough David , Bhattacharyya Sanjeev , Hahn Rebecca T.
Published: January 2025

Aortic regurgitation is the third most common valve lesion with increasing prevalence secondary to an ageing population. Transthoracic echocardiography plays a vital role in the identification and assessment of aortic regurgitation and proves essential in monitoring severity and determining the timing of intervention. Building on the foundations of previous British Society of Echocardiography (BSE) recommendations, this BSE guideline presents an update on how to approach an echocardiographic assessment of aortic regurgitation. It provides a practical, step-by-step guide to facilitate a comprehensive, high-quality echocardiographic assessment of aortic regurgitation. It discusses commonly encountered echocardiography-based challenges with suggestions regarding how this information is relevant in the interpretation and grading of regurgitation severity. Additionally, the value of other cardiac imaging modalities is discussed. The guideline concludes with an overview of aortic regurgitation in the clinical context, addressing chronic versus acute aortic regurgitation, which features prompt referral for intervention, and the consequences of combined valve disease.
Post-migration seismic data conditioning workflow on a merged dataset
Authors: Blanco Dufau Pamela , Bedle Heather , Marfurt Kurt , Carpenter Brett M.
Published: January 2025

Analyzing amplitude anomalies in seismic data requires a comprehensive understanding of the geological context and the accuracy of the seismic image. Over the past four decades, numerous surveys in mature basins like the US Gulf of Mexico have undergone reprocessing and merging to enhance imaging quality. The merging of seismic data volumes demands careful attention during processing, as the different volumes are often acquired at different times with different hardware, acquisition geometries, and exploration objectives. If insufficient care is taken, significant differences in the amplitude and spectra of the merged survey components can pose challenges when used as input for machine learning techniques or seismic attribute interpretation and studies. We implemented spectral balancing followed by structure-oriented filtering to address the abovementioned discrepancies in a merged survey. Spectral balancing equalizes high and low frequencies, creating a more uniform frequency spectrum. Structure-oriented filtering eliminates random and cross-cutting coherent noise while preserving structural and stratigraphic features. This workflow ameliorates the discrepancies between the areas covered by the individual surveys, resulting in a more consistent interpretation across the seam between the two surveys. This study found that these two processes improved vertical resolution and lateral delineation of fault and stratigraphic edges. However, we also observed in our data that increasing the spectrum runs the risk of increasing the effect of both low and high-frequency noise, including acquisition footprint. Surprisingly, we found that spectral balancing can diminish the appearance of stratigraphic edges that were fortuitously imaged by the original narrowband data volume. Finally, because both spectral balancing and structure-oriented filtering are set to not damage relative amplitudes, we need to apply amplitude gain control to balance them on the shallower parts of the merged survey.
Mind–body treatments for children with functional gastrointestinal disorders
Authors: Stein Kate , Howarth Lucy , Zucker Nancy L.
Published: January 2025

Paediatric functional gastrointestinal disorders (P-FGIDs) are common, affecting up to 25% of children worldwide. They are characterised by chronic abdominal pain and/or altered bowel habits without an underlying disease pathology. P-FGIDs are often associated with co-occurring anxiety and depression across all ages and treating P-FGIDs may provide an opportunity to develop a young person's wider emotion regulation capacities. Using a fictitious case vignette, we outline the range of psychosocial and biomedical treatments for the disorder and the need for an integrated and holistic approach. We propose that by intervening early and enabling children to be curious about, rather than fearful of, their bodily sensations, clinicians may be able to alter harmful illness trajectories in both pain and psychiatric domains.
Assessing a clinical vital sign in severe mental illness: validation study of the 5 sit-to-stand test for monitoring muscle strength – The PsychiActive Project
Authors: Lopez-Moral Alvaro , Munguia-Izquierdo Diego , Bueno-Antequera Javier
Published: January 2025

Background

In individuals with severe mental illness (SMI), low muscle strength heightens the risk of mortality and chronic disease development. Routine muscle strength assessments could identify vulnerabilities, thereby reducing the growing burden associated with SMI. However, integration into clinical settings faces obstacles because of limited resources and inadequate healthcare staff training. The 5 sit-to-stand (5-STS) test offers an alternative for measuring muscle strength compared with more complex or demanding tests. Nevertheless, its validity in individuals with SMI remains unexplored.

Aims

This study aimed to analyse the criterion validity of the 5-STS test in SMI, considering potential age, gender and body mass index influences.

Method

In a cross-sectional study following the ‘STrengthening the Reporting of OBservational studies in Epidemiology’ (STROBE) guidelines, 82 adults with SMI (aged 18–65, 24 women) were assessed. Participants underwent both the 5-STS test and the isometric knee extension strength (KES) test.

Results

Analysis revealed a significant moderate correlation coefficient and intraclass correlation coefficient (−0.58 for both) for all participants, indicating that the measures are valid and assess related aspects of the same construct. Strong agreement was observed in women and the older age groups. The 5-STS test demonstrated accuracy, with a standard error of estimate lower than the within-subject variability on the KES test. Bland–Altman plots showed limits of agreement values of −3.39 and 3.52 for the entire sample, and heteroscedasticity analyses indicated consistent differences between the 5-STS and KES tests across all groups analysed, except in the women's group.

Conclusions

The 5-STS test seems to be a valid test for assessing muscle strength in individuals with SMI, supporting its usefulness for routine assessment in clinical settings, facilitating detection and intervention in critical situations.
Frequency of surveillance CT scan ordering in patients with stage II/III colorectal cancer.
Authors: Silverstein William , Murray Samuel , Raphael Michael J. , Weinerman Adina S
Published: January 2025

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Background:
Patients with stage II/III colorectal cancer (CRC) undergo surveillance CT scans to detect early asymptomatic oligometastatic spread, which can be treated with curative intent. However, randomized clinical trials show no difference in 5-year mortality in those that undergo low intensity surveillance (annual) compared a higher intensity strategy (every 6 months). In Ontario, the Program in Evidence-Based Care (PEBC), Ontario Health (Cancer Care Ontario) guidelines recommend surveillance CT scan for patients with stage II/III CRC every 12 months. We aimed to determine the frequency at which clinicians in our Ontario-based hospital system ordered surveillance CT scans for patients with stage II/III CRC.
Methods:
This single centre retrospective cohort study included all patients that underwent surgical resection for CRC from April 1, 2018 – March 31, 2019 at our academic tertiary care centre in Ontario, Canada. We excluded patients that were followed at an outside hospital, had stage IV disease, had disease recurrence, had a concurrent neoplasm, or did not have CRC. The primary outcome was the proportion of surveillance CT scans completed 10+ months after the previous scan. We also described sociodemographic and medical characteristics of included patients. Follow-up was until August 2023.
Results:
We included 200 patients. The median age was 62 years (IQR: 52-70), 48% (N=96) were female, the rectum was the most commonly involved disease site (43%, N=86), 38% (N=76) had stage III disease, and 54% (N=107) received adjuvant chemotherapy. A total of 1286 scans were ordered during the study period. Of these, 67% (N=860) were ordered as surveillance. Of these, 18% (n=155) were completed 10 months or longer from the previous scan. The median time interval between surveillance scans was 6.6 months (IQR: 5.9-7.9). Approximately 20% (n=137 of 630) of surveillance scans ordered by general surgeons were completed 10 months or longer from the previous scan, whereas only 9% (n=18 of 205) of scans ordered by medical oncologists were completed 10 months or longer from the previous scan. Less than 1% of surveillance scans (n=3) identified new metastatic disease.
Conclusions:
The minority of surveillance CT scans ordered in patients with stage II/III CRC in our hospital were timed in concordance with Ontario-based guidelines. Future studies should seek to standardize ordering habits such that they align with best practices.