bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of sleep on factual memory retention over 24 hr
Authors: Gasparello Aurora , Baldassarri Angie , Degasperi Giorgia , Cellini Nicola
Published: May 2024

Although a period of sleep seems to benefit the retention of declarative memories, recent studies have challenged both the size of this effect and its active influence on memory consolidation. This study aimed to further investigate the effect of sleep and its time dependency on the consolidation of factual information. In a within‐subjects design, 48 participants (Mage = 24.37 ± 4.18 years, 31F) were asked to learn several facts in a multi‐sensory “flashcard‐like” memory task at 21:00 hours (sleep first condition) or at 09:00 hours (wake first condition). Then, in each condition, participants performed an immediate recall test (T0), and two delayed tests 12 hr (T1) and 24 hr (T2) later. Participants' sleep was recorded at their homes with a portable device. Results revealed that memory retention was better after a night of sleep compared with wakefulness, regardless of the delay from encoding (a few hr versus 12+ hr), but the sleep effect was modest. The decline in memory during the wake period following sleep was smaller compared with the decline observed during the 12 hr of wakefulness after encoding. However, after 24 hr from the encoding, when all participants experienced a period of both sleep and wakefulness, memory performance in the two conditions was similar. Overall, our data suggest that sleep exerts a small, yet beneficial, influence on memory retention by likely reducing interference and actively stabilizing memory traces.
Accelerometer‐measured sleep behaviour and parent–child sleep guideline adherence and sleep quality in Czech families with children aged 3–8 years: the FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study
Authors: Voráčová Jaroslava , Sigmund Erik , Vorlíček Michal , Dygrýn Jan , Sigmundová Dagmar
Published: May 2024

Assessing parent–child relationship in sleep behaviours is important for facilitating changes in the sleep guideline compliance in preschool age children. The aim of this study was to examine accelerometer‐measured sleep quantity and quality in families with children aged 3–8 years and investigate the parents’ influence on the child's sleep. The data were obtained from the Czech cross‐sectional FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study, with a final sample of 374 families. Families were recruited through the enrolment of their children in kindergartens/primary schools between March 2022 and May 2023. The sleep time window and total sleep time were assessed using a wrist‐worn ActiGraph accelerometer. Participants wore this device continuously for 24 h/day over a period of 7 consecutive days. Demographic data and potential correlates were obtained via questionnaires completed by parents. Statistical analyses were completed using logistic regression and independent‐samples Mann–Whitney U test. In all, 65.5% of children (60% boys, 70.9% girls) and 58.3% of parents (52.4% fathers, 64.3% mothers) achieved the recommended sleep duration. Greater sleep quantity and duration in good‐quality sleep were significantly higher in girls/mothers, compared to boys/fathers. Preschoolers were more likely to comply with sleep guidelines if their mother (but not father) met the sleep recommendation and their mothers did not have a higher education level. Adhering to sleep guidelines in children was also associated with children's female gender, absence of screen device in the bedroom, and being more active. Given the high concurrence in mother–child sleep quantity, it is important to promote healthy sleep behaviours in the whole family.
The conundrum of turtle and tortoise basking: A critical review
Authors: Chessman B. C.
Published: May 2024

Behaviours designated as basking span a broad array of ectothermic and endothermic animals. Understanding the role that basking plays in thermal biology is important because maintaining body temperatures within certain limits is essential to survival, growth and reproduction, and may affect responses to climate change. In the case of turtles and tortoises, behaviours designated as basking may occur out of water, at the surface of a water body or deep in a water body, during the day or at night, and with or without exposure to solar radiation or another heat source. On the available evidence, the primary function of most nominal chelonian basking is thermoregulatory warming, which provides numerous benefits including expediting gonadal recrudescence, enhancing foraging, feeding, digestion and growth, and amelioration of infectious disease and endoparasitism. Substantial evidence supports conditioning of the skin and shell as a common additional function of chelonian basking. Other functions of nominal chelonian basking with some supporting evidence for particular species and environments are thermoregulatory cooling, leech removal, vitamin D synthesis and osmotic control. Nominal chelonian basking may sometimes be undertaken for resting or avoiding aggression, but supporting evidence is scant. The only uniting feature of all chelonian behaviours designated as basking is quiescence, but not all quiescent chelonian behaviours are labelled as basking. Consequently, the general meaning of chelonian basking is indeterminate. Avoiding ambiguity requires the provision of explicit criteria by which basking can be distinguished from other quiescent behaviours, and the attachment of qualifiers that specify the applicable time of day, medium and environmental exposure.
A multi‐agent reinforcement learning model for maintenance optimization of interdependent highway pavement networks
Authors: Yao L. , Leng Z. , Jiang J. , Ni F.
Published: May 2024

Pavement segments are functionally interdependent under traffic equilibrium, leading to interdependent maintenance and rehabilitation (M&R) decisions for different segments, but it has not received significant attention in the pavement management community yet. This study developed a maintenance optimization model for interdependent pavement networks based on the simultaneous network optimization (SNO) framework and a multi‐agent reinforcement learning algorithm. The established model was demonstrated on a highway pavement network in the real‐world, compared to a previously built two‐stage bottom‐up (TSBU) model. The results showed that, compared to TSBU, SNO produced a 3.0% reduction in total costs and an average pavement performance improvement of up to 17.5%. It prefers concentrated M&R schedules and tends to take more frequent preventive maintenance to reduce costly rehabilitation. The results of this research are anticipated to provide practitioners with quantitative estimates of the possible impact of ignoring segment interdependencies in M&R planning.
Variation of terpene alkaloids in Daphniphyllum macropodum across plants and tissues
Authors: Eljounaidi Kaouthar , Radzikowska Barbara A. , Whitehead Caragh B. , Taylor Danielle J. , Conde Susana , Davis William , Dowle Adam A. , Langer Swen , James Sally , Unsworth William P. , Ezer Daphne , Larson Tony R. , Lichman Benjamin R.
Published: May 2024

Daphniphyllum macropodum produces alkaloids that are structurally complex with polycyclic, stereochemically rich carbon skeletons. Understanding how these compounds are formed by the plant may enable exploration of their biological function and bioactivities.

We employed multiple metabolomics techniques, including a workflow to annotate compounds in the absence of standards, to compare alkaloid content across plants and tissues.

Different alkaloid structural types were found to have distinct distributions between genotypes, between tissues and within tissues. Alkaloid structural types also showed different isotope labelling enrichments that matched their biosynthetic relationships.

The work suggests that mevalonate derived 30‐carbon alkaloids are formed in the phloem region before their conversion to 22‐carbon alkaloids which accumulate in the epidermis. This sets the stage for further investigation into the biosynthetic pathway.
The nucleotide‐binding domain of NRC‐dependent disease resistance proteins is sufficient to activate downstream helper NLR oligomerization and immune signaling
Authors: Contreras Mauricio P. , Pai Hsuan , Thompson Rebecca , Marchal Clemence , Claeys Jules , Adachi Hiroaki , Kamoun Sophien
Published: May 2024

Nucleotide‐binding domain and leucine‐rich repeat (NLR) proteins with pathogen sensor activities have evolved to initiate immune signaling by activating helper NLRs. However, the mechanisms underpinning helper NLR activation by sensor NLRs remain poorly understood. Although coiled coil (CC) type sensor NLRs such as the Potato virus X disease resistance protein Rx have been shown to activate the oligomerization of their downstream helpers NRC2, NRC3 and NRC4, the domains involved in sensor–helper signaling are not known.

Here, we used Agrobacterium tumefaciens‐mediated transient expression in Nicotiana benthamiana to show that the nucleotide‐binding (NB) domain within the NB‐ARC of Rx is necessary and sufficient for oligomerization and immune signaling of downstream helper NLRs. In addition, the NB domains of the disease resistance proteins Gpa2 (cyst nematode resistance), Rpi‐amr1, Rpi‐amr3 (oomycete resistance) and Sw‐5b (virus resistance) are also sufficient to activate their respective downstream NRC helpers.

Using transient expression in the lettuce (Lactuca sativa), we show that Rx (both as full length or as NB domain truncation) and its helper NRC2 form a minimal functional unit that can be transferred from solanaceous plants (lamiids) to Campanulid species.

Our results challenge the prevailing paradigm that NLR proteins exclusively signal via their N‐terminal domains and reveal a signaling activity for the NB domain of NRC‐dependent sensor NLRs. We propose a model in which helper NLRs can perceive the status of the NB domain of their upstream sensors.
Impact of a mindfulness‐based intervention on neurobehavioral functioning and its association with large‐scale brain networks in preterm young adolescents
Authors: Siffredi Vanessa , Liverani Maria Chiara , Fernandez Natalia , Freitas Lorena G. A. , Borradori Tolsa Cristina , Van De Ville Dimitri , Hüppi Petra Susan , Ha‐Vinh Leuchter Russia
Published: May 2024

Aim

Adolescents born very preterm (VPT; <32 weeks of gestation) face an elevated risk of executive, behavioral, and socioemotional difficulties. Evidence suggests beneficial effects of mindfulness‐based intervention (MBI) on these abilities. This study seeks to investigate the association between the effects of MBI on executive, behavioral, and socioemotional functioning and reliable changes in large‐scale brain networks dynamics during rest in VPT young adolescents who completed an 8‐week MBI program.

Methods

Neurobehavioral assessments and resting‐state functional magnetic resonance imaging were performed before and after MBI in 32 VPT young adolescents. Neurobehavioral abilities in VPT participants were compared with full‐term controls. In the VPT group, dynamic functional connectivity was extracted by using the innovation‐driven coactivation patterns framework. The reliable change index was used to quantify change after MBI. A multivariate data‐driven approach was used to explore associations between MBI‐related changes on neurobehavioral measures and temporal brain dynamics.

Results

Compared with term‐born controls, VPT adolescents showed reduced executive and socioemotional functioning before MBI. After MBI, a significant improvement was observed for all measures that were previously reduced in the VPT group. The increase in executive functioning, only, was associated with reliable changes in the duration of activation of large‐scale brain networks, including frontolimbic, amygdala‐hippocampus, dorsolateral prefrontal, and visual networks.

Conclusion

The improvement in executive functioning after an MBI was associated with reliable changes in large‐scale brain network dynamics during rest. These changes encompassed frontolimbic, amygdala‐hippocampus, dorsolateral prefrontal, and visual networks that are related to different executive processes including self‐regulation, attentional control, and attentional awareness of relevant sensory stimuli.
Biotin labeling allows for post‐transfusion functional assessment of stored human platelets in mice
Authors: Bailey S. Lawrence , Bochenek Martin , Chauhan Aastha , Miller Brandon , Stolla Moritz
Published: May 2024

Background

Platelet radiolabeling with radioisotopes is currently used for human platelet recovery and survival studies. Biotinylation enables ex vivo post‐transfusion platelet function testing. Whether platelet biotinylation itself affects platelet function is controversial.

Study Design and Methods

Platelet concentrates from healthy humans were stored for 6 days. Samples were obtained at 1 or 2 and 6 days, and platelets were labeled following a radiolabeling protocol using saline instead of radioactive indium‐111 (sham radiolabeling [sham‐RL]). Alternatively, a newly developed biotinylation protocol, a washing protocol, or an unmanipulated control sample were used. Platelet function was assessed by flow cytometry after stimulation with platelet agonists and labeling of platelets with platelet activation markers. To test whether platelets can be activated after transfusion, labeled platelets were transfused into nonobese diabetic/severe combined immunodeficiency mice, and samples were obtained 1 h after transfusion.

Results

The activation profile of biotinylated platelets was comparable to sham‐RL platelets before transfusion except for significantly less α‐degranulation and more phosphatidyl serine exposure on storage day 1/2. There was no significant difference between sham‐RL and biotinylated platelets on storage day 6. Sham‐RL and biotinylated platelets were significantly less activatable than washed and unmanipulated control platelets. After transfusion, the activation profile of biotinylated platelets was largely indistinguishable from unmanipulated ones.

Discussion

The decrease in activation level in biotinylated platelets we and others observed appears mainly due to the physical manipulation during the labeling process. In conclusion, biotinylated platelets allow for post‐transfusion function assessment, a major advantage over radiolabeling.
Improving Output Power of a Torsional-Flutter Harvester in Stochastic Thunderstorms by Duffing—Van Der Pol Restoring Torque
Authors: Caracoglia Luca
Published: May 2024

Wind energy harvesters are usually designed to operate in the low wind speed range. They rely on smaller swept areas, as a complement to larger horizontal-axis wind turbines. A torsional-flutter-based apparatus is investigated herein to extract wind energy. A nonlinear hybrid restoring toque mechanism, installed at equally spaced supports, is used to produce energy through limit-cycle vibration. Energy conversion and storage from the wind flow are enabled by eddy currents. The apparatus is used during thunderstorm outflows to explore its efficiency in nonideal wind conditions. The thunderstorm flow model accounts for both nonstationary turbulence and slowly varying mean wind speed, replicating thunderstorm's intensification and decay stages. This paper evolves from a recent study to examine stochastic stability. More specifically, the output power is derived as a random process that is found numerically. Various thunderstorm features and variable apparatus configurations are evaluated. Numerical investigations confirm the detrimental effect of nonideal, thunderstorms on harvester performance with, on average, an adverse increment of operational speed (about +30%). Besides nonlinear damping, the “benign” flutter-prone effect is controlled by the square value of the flapping angle. Since flapping amplitudes are moderate at sustained flutter, activation of the apparatus is delayed and exacerbated by the nonstationary outflow and aeroelastic load features. Finally, efficiency is carefully investigated by quantification of output power and “quality factor.”
Influence of spraying power on microstructure and wear resistance of plasma spray Ni-10 wt. %Al coatings with a sound vibration
Authors: Wang Jichun , Wang Haibo , Mu Xunxun , Ma Xixi , Qian Jiaming , Gao Pengfei
Published: May 2024

The effect of spraying power on the microstructure and wear resistance of Ni-10 wt. %Al coating plasma sprayed with a 500 Hz sound vibration has been investigated. With the application of sound vibration, the compactness, cohesive bonding strength, and wear resistance of the coatings are all much higher. Meanwhile, with the increase of spraying power, the enhancement degree of the compactness, cohesive bonding strength, and wear resistance of the coatings are all increased. The sound vibration effects, which contain sound pressure, acoustic streaming, and heat effect, on the molten droplets are increased for their increasing melting induced by increasing spraying power. The wetting, flowing, and solidification of the molten droplets are all affected. Better wetting and flowing of the molten droplets promote their bonding on the surface of substrates and the solidified molten droplets, and their filling in the gaps of the solidified droplets.
A Bi-CMOS electronic photonic integrated circuit quantum light detector
Authors: Tasker Joel F. , Frazer Jonathan , Ferranti Giacomo , Matthews Jonathan C. F.
Published: May 2024

Complimentary metal-oxide semiconductor (CMOS) integration of quantum technology provides a route to manufacture at volume, simplify assembly, reduce footprint, and increase performance. Quantum noise–limited homodyne detectors have applications across quantum technologies, and they comprise photonics and electronics. Here, we report a quantum noise–limited monolithic electronic-photonic integrated homodyne detector, with a footprint of 80 micrometers by 220 micrometers, fabricated in a 250-nanometer lithography bipolar CMOS process. We measure a 15.3-gigahertz 3-decibel bandwidth with a maximum shot noise clearance of 12 decibels and shot noise clearance out to 26.5 gigahertz, when measured with a 9–decibel-milliwatt power local oscillator. This performance is enabled by monolithic electronic-photonic integration, which goes below the capacitance limits of devices made up of separate integrated chips or discrete components. It exceeds the bandwidth of quantum detectors with macroscopic electronic interconnects, including wire and flip chip bonding. This demonstrates electronic-photonic integration enhancing quantum photonic device performance.
Early infiltrating NKT lymphocytes attenuate bone regeneration through secretion of CXCL2
Authors: Lin Weimin , Li Qiwen , Liu Linfeng , Wang Qian , Zhang Danting , Wang Feiyu , Xu Ruoshi , Fan Yi , Xing Malcolm , Zhou Chenchen , Yuan Quan
Published: May 2024

Trauma rapidly mobilizes the immune response of surrounding tissues and activates regeneration program. Manipulating immune response to promote tissue regeneration shows a broad application prospect. However, the understanding of bone healing dynamics at cellular level remains limited. Here, we characterize the landscape of immune cells after alveolar bone injury and reveal a pivotal role of infiltrating natural killer T (NKT) cells. We observe a rapid increase in NKT cells after injury, which inhibit osteogenic differentiation of mesenchymal stem cells (MSCs) and impair alveolar bone healing.
Cxcl2
is up-regulated in NKT cells after injury. Systemic administration of CXCL2-neutralizing antibody or genetic deletion of
Cxcl2
improves the bone healing process. In addition, we fabricate a gelatin-based porous hydrogel to deliver NK1.1 depletion antibody, which successfully promotes alveolar bone healing. In summary, our study highlights the importance of NKT cells in the early stage of bone healing and provides a potential therapeutic strategy for accelerating bone regeneration.
Brightening deep-blue perovskite light-emitting diodes: A path to Rec. 2020
Authors: Lee Seungjae , Kim Junho , Kim Hyojun , Kim Changwon , Kim Siin , Kim Changjo , Lee Heeseung , Choi Bongjun , Muthu Chinnadurai , Kim Taehyun , Lee Jihyung , Lee Seungbok , Ihee Hyotcherl , Lee Jung-Yong
Published: May 2024

Deep-blue perovskite light-emitting diodes (PeLEDs) of high purity are highly sought after for next-generation displays complying with the Rec. 2020 standard. However, mixed-halide perovskite materials designed for deep-blue emitters are prone to halide vacancies, which readily occur because of the low formation energy of chloride vacancies. This degrades bandgap instability and performance. Here, we propose a chloride vacancy–targeting passivation strategy using sulfonate ligands with different chain lengths. The sulfonate groups have a strong affinity for lead(II) ions, effectively neutralizing vacancies. Our strategy successfully suppressed phase segregation, yielding color-stable deep-blue PeLEDs with an emission peak at 461 nanometers and a maximum luminance (
L

max

) of 2707 candela per square meter with external quantum efficiency (EQE) of 3.05%, one of the highest for Rec. 2020 standard–compliant deep-blue PeLEDs. We also observed a notable increase in EQE up to 5.68% at
L

max

of 1978 candela per square meter with an emission peak at 461 nanometers by changing the carbon chain length.
Ketogenic diet induces p53-dependent cellular senescence in multiple organs
Authors: Wei Sung-Jen , Schell Joseph R. , Chocron E. Sandra , Varmazyad Mahboubeh , Xu Guogang , Chen Wan Hsi , Martinez Gloria M. , Dong Felix F. , Sreenivas Prethish , Trevino Rolando , Jiang Haiyan , Du Yan , Saliba Afaf , Qian Wei , Lorenzana Brandon , Nazarullah Alia , Chang Jenny , Sharma Kumar , Munkácsy Erin , Horikoshi Nobuo , Gius David
Published: May 2024

A ketogenic diet (KD) is a high-fat, low-carbohydrate diet that leads to the generation of ketones. While KDs improve certain health conditions and are popular for weight loss, detrimental effects have also been reported. Here, we show mice on two different KDs and, at different ages, induce cellular senescence in multiple organs, including the heart and kidney. This effect is mediated through adenosine monophosphate–activated protein kinase (AMPK) and inactivation of mouse double minute 2 (MDM2) by caspase-2, leading to p53 accumulation and p21 induction. This was established using p53 and caspase-2 knockout mice and inhibitors to AMPK, p21, and caspase-2. In addition, senescence-associated secretory phenotype biomarkers were elevated in serum from mice on a KD and in plasma samples from patients on a KD clinical trial. Cellular senescence was eliminated by a senolytic and prevented by an intermittent KD. These results have important clinical implications, suggesting that the effects of a KD are contextual and likely require individual optimization.
Increased resistance against tellurite is conferred by a mutation in the promoter region of uncommon tellurite resistance gene
tehB
in the
ter
-negative Shiga toxin-producing
Escherichia coli
O157:H7
Authors: Matsumoto Yuko , Lee Kenichi , Akasaka Ryuya , Honjo Hayato , Koizumi Mitsumasa , Sato Toshio , Kubomura Akiko , Ishijima Nozomi , Akeda Yukihiro , Ohnishi Makoto , Iyoda Sunao
Published: May 2024

Resistance to potassium tellurite (PT) is an important indicator in isolating Shiga toxin-producing
Escherichia coli
(STEC) O157:H7 and other major STEC serogroups. Common resistance determinant genes are encoded in the
ter
gene cluster. We found an O157:H7 isolate that does not harbor
ter
but is resistant to PT. One nonsynonymous mutation was found in another PT resistance gene,
tehA
, through whole-genome sequence analyses. To elucidate the contribution of this mutation to PT resistance, complementation of
tehA
and the related gene
tehB
in isogenic strains and quantitative RT‒PCR were performed. The results indicated that the point mutation not only changed an amino acid of
tehA
, but also was positioned on a putative internal promoter of
tehB
and increased PT resistance by elevating
tehB
mRNA expression. Meanwhile, the amino acid change in
tehA
had negligible impact on the PT resistance. Comprehensive screening revealed that 2.3% of O157:H7 isolates in Japan did not harbor the
ter
gene cluster, but the same mutation in
tehA
was not found. These results suggested that PT resistance in
E. coli
can be enhanced through one mutational event even in
ter
-negative strains.

IMPORTANCE

Selective agents are important for isolating Shiga toxin-producing
Escherichia coli
(STEC) because the undesirable growth of microflora should be inhibited. Potassium tellurite (PT) is a common selective agent for major STEC serotypes. In this study, we found a novel variant of PT resistance genes,
tehAB
, in STEC O157:H7. Molecular experiments clearly showed that one point mutation in a predicted internal promoter region of
tehB
upregulated the expression of the gene and consequently led to increased resistance to PT. Because
tehAB
genes are ubiquitous across
E. coli
, these results provide universal insight into PT resistance in this species.
The whole genome sequence of Polish vaccine strain
Mycobacterium bovis
BCG Moreau
Authors: Krysztopa-Grzybowska Katarzyna , Lach Jakub , Polak Maciej , Strapagiel Dominik , Dziadek Jaroslaw , Olszewski Marcin , Zasada Aleksandra A. , Darlińska Aniela , Lutyńska Anna , Augustynowicz-Kopeć Ewa
Published: May 2024

Currently, tuberculosis immunoprophylaxis is based solely on Bacillus Calmette-Guérin (BCG) vaccination, and some of the new potential tuberculosis vaccines are based on the BCG genome. Therefore, it is reasonable to analyze the genomes of individual BCG substrains. The aim of this study was the genetic characterization of the BCG-Moreau Polish (PL) strain used for the production of the BCG vaccine in Poland since 1955. Sequencing of different BCG lots showed that the strain was stable over a period of 59 years. As a result of comparison, BCG-Moreau PL with BCG-Moreau Rio de Janeiro (RDJ) 143 single nucleotide polymorphisms (SNPs) and 32 insertion/deletion mutations (INDELs) were identified. However, the verification of these mutations showed that the most significant were accumulated in the BCG-Moreau RDJ genome. The mutations unique to the Polish strain genome are 1 SNP and 2 INDEL. The strategy of combining short-read sequencing with long-read sequencing is currently the most optimal approach for sequencing bacterial genomes. With this approach, the only available genomic sequence of BCG-Moreau PL was obtained. This sequence will primarily be a reference point in the genetic control of the stability of the vaccine strain in the future. The results enrich knowledge about the microevolution and attenuation of the BCG vaccine substrains.

IMPORTANCE

The whole genome sequence obtained is the only genomic sequence of the strain that has been used for vaccine production in Poland since 1955. Sequencing of different BCG lots showed that the strain was stable over a period of 59 years. The comprehensive genomic analysis performed not only enriches knowledge about the microevolution and attenuation of the BCG vaccine substrains but also enables the utilization of identified markers as a reference point in the genetic control and identity tests of the stability of the vaccine strain in the future.
Millennial-scale climate cycles modulated by Milankovitch forcing in the middle Cambrian (ca. 500 Ma) Marjum Formation, Utah, USA
Authors: Pas Damien , Elrick Maya , Da Silva Anne-Christine , Hinnov Linda , Jamart Valentin , Thaureau Marion , Arts Michiel
Published: May 2024

Middle Cambrian offshore deposits of the Marjum Formation, Utah, USA, are characterized by four scales of superimposed cyclicity defined by varying fine siliciclastic versus limestone abundances; these include limestone-marl couplets (rhythmites; 5–10 cm), which are bundled into parasequences (1–2 m) and small-scale (5–10 m) and large-scale (20–40 m) sequences. Time series analysis of SiO2 and lithologic rank stratigraphic series reveal cycles consistent with Milankovitch periods corresponding to Cambrian orbital eccentricity (20 m, 405 k.y.; 6 m, 110 k.y.), obliquity (1.8 m, 30 k.y.), climatic precession (1.15 m, 18 k.y.), and half-precession (0.64 m, 7 k.y.). Astronomical calibration of the lithologic rank series indicates that the main sub-Milankovitch cycle at 0.065 m represents ~1 k.y. and corresponds to the basic rhythmite couplet. All scales of cyclicity are interpreted as the result of wet versus dry monsoonal climate oscillations controlling the abundance of fine siliciclastic sediment influx to the basin. A plausible millennial-scale climate driver is solar activity. These results describe one of the oldest known geological candidates for solar-influenced climate change modulated by Milankovitch forcing.
Prospective economic evaluation of an electronic discharge communication tool: analysis of a randomised controlled trial
Authors: Sevick Laura K , Santana Maria-Jose , Ghali William A , Clement Fiona
Published: May 2024

Objective

To complete an economic evaluation within a randomised controlled trial (RCT) comparing the use of an electronic discharge communication tool (eDCT) compared with usual care.

Setting

Patients being discharged from a single tertiary care centre’s internal medicine Medical Teaching Units.

Participants

Between January 2012 and December 2013, 1399 patients were randomised to a discharge mechanism. Forty-five patients were excluded from the economic evaluation as they did not have data for the index hospitalisation cost; 1354 patients contributed to the economic evaluation.

Intervention

eDCT generated at discharge containing structured content on reason for admission, details of the hospital stay, treatments received and follow-up care required. The control group was discharged via traditional dictation methods.

Primary and secondary outcome measures

The primary economic outcome was the cost per quality-adjusted life year (QALY) gained. Secondary outcomes included the cost per death avoided and the cost per readmission avoided.

Results

The average transcription cost was $C22.28 per patient, whereas the estimated cost of the eDCT was $C13.33 per patient. The cost per QALY gained was $C239 933 in the eDCT arm compared with usual care due to the very small gains in effectiveness and approximately $C800difference in resource utilisation costs. The bootstrap analyses resulted in eDCT being more effective and more costly in 29.2% of samples, less costly and more effective in 29.2% of samples, less effective and more costly in 23.9% of samples and finally, less costly and less effective in 17.7% of samples.

Conclusions

The eDCT reduced per patient costs of the generation of discharge summaries. The bootstrap estimates demonstrate considerable uncertainty supporting the finding of neutrality reported in the clinical component of the RCT. The immediate transcription cost savings and previously documented provider and patient satisfaction may increase the impetus for organisations to invest in such systems, provided they have a foundation of eHealth infrastructure and readiness.

Trial registration number

NCT01402609.
Azithromycin to prevent post-discharge morbidity and mortality in Kenyan children: a protocol for a randomised, double-blind, placebo-controlled trial (the Toto Bora trial)
Authors: Pavlinac Patricia B , Singa Benson O , John-Stewart Grace C , Richardson Barbra A , Brander Rebecca L , McGrath Christine J , Tickell Kirkby D , Amondi Mary , Rwigi Doreen , Babigumira Joseph B , Kariuki Sam , Nduati Ruth , Walson Judd L
Published: May 2024

Introduction

Child mortality due to infectious diseases remains unacceptably high in much of sub-Saharan Africa. Children who are hospitalised represent an accessible population at particularly high risk of death, both during and following hospitalisation. Hospital discharge may be a critical time point at which targeted use of antibiotics could reduce morbidity and mortality in high-risk children.

Methods and analysis

In this randomised, double-blind, placebo-controlled trial (Toto Bora Trial), 1400 children aged 1–59 months discharged from hospitals in Western Kenya, in Kisii and Homa Bay, will be randomised to either a 5-day course of azithromycin or placebo to determine whether a short course of azithromycin reduces rates of rehospitalisation and/or death in the subsequent 6-month period. The primary analysis will be modified intention-to-treat and will compare the rates of rehospitalisation or death in children treated with azithromycin or placebo using Cox proportional hazard regression. The trial will also evaluate the effect of a short course of azithromycin on enteric and nasopharyngeal infections and cause-specific morbidities. We will also identify risk factors for postdischarge morbidity and mortality and subpopulations most likely to benefit from postdischarge antibiotic use. Antibiotic resistance inEscherichia coliandStreptococcus pneumoniaeamong enrolled children and their primary caregivers will also be assessed, and cost-effectiveness analyses will be performed to inform policy decisions.

Ethics and dissemination

Study procedures were reviewed and approved by the institutional review boards of the Kenya Medical Research Institute, the University of Washington and the Kenyan Pharmacy and Poisons Board. The study is being externally monitored, and a data safety and monitoring committee has been assembled to monitor patient safety and to evaluate the efficacy of the intervention. The results of this trial will be published in peer-reviewed scientific journals and presented at relevant academic conferences and to key stakeholders.

Trial registration number

NCT02414399.
What is the relationship between physical activity and cardiovascular risk factors in stroke survivors post completion of rehabilitation? Protocol for a longitudinal study
Authors: Fini Natalie A , Bernhardt Julie , Holland Anne E
Published: May 2024

Introduction

Physical activity (PA) can modify cardiovascular and other health risks in people with stroke, but we know little about long-term PA in this group. This study aims to describe PA levels and investigate relationships between PA, cardiovascular risk factors, mobility and participant characteristics (eg, age, mood and fatigue) in the 2 years following rehabilitation discharge after first stroke.

Methods and analysis

This is a longitudinal observational study with follow-up at 6, 12 and 24 months after rehabilitation discharge. Inclusion criteria are broad; excluding only those with previous stroke, palliative diagnosis, living more than 2 hours from the centre or admitted less than 5 days.

The primary outcome of interest is duration of moderate to vigorous PA (min/day) measured by the Sensewear MF Armband (SWAB). Secondary outcomes include other PA measures measured with the SWAB; cardiovascular risk factors (eg, systolic blood pressure, fasting lipid profile and smoking status), mobility (10 m walk test), the Hospital Anxiety and Depression Scale and the Fatigue Severity Scale. All outcomes, except blood tests, are gathered at each time point.

The target sample size is 77. We will explore associations between PA levels, cardiovascular risk factors, mobility and participant characteristics at baseline compared with 6, 12 and 24 months using random-effects regression modelling.

The long-term PA of stroke survivors is largely unknown. We hope to identify factors that influence PA and cardiovascular risk in this population, which may help health professionals target the stroke survivors most at risk and implement appropriate treatment, preventative strategies and education.

Ethics and dissemination

Approval was granted from Alfred Hospital and La Trobe University Research Ethics Committees. The study results will be disseminated in a number of ways including journal publication and international conference presentations.

Trial registration number

ACTRN12613000196741.
Protocol for a feasibility study and randomised pilot trial of a low-intensity psychological intervention for depression in adults with autism: the Autism Depression Trial (ADEPT)
Authors: Russell Ailsa , Cooper Kate , Barton Stephen , Ensum Ian , Gaunt Daisy , Horwood Jeremy , Ingham Barry , Kessler David , Metcalfe Chris , Parr Jeremy , Rai Dheeraj , Wiles Nicola
Published: May 2024

Introduction

High rates of co-occurring depression are reported in autism spectrum disorder (ASD), a neurodevelopmental condition characterised by social communication impairments and repetitive behaviours. Cognitive-behavioural interventions adapted for ASD have been effective for anxiety problems. There have been evaluation studies of group cognitive-behavioural therapy for co-occurring depression, but no randomised trials investigating low-intensity psychological interventions as recommended in clinical guidelines for mild-moderate depression.

Methods and analysis

A feasibility study comprising a randomised controlled trial (RCT) and nested qualitative evaluation is under way as preparation for a definitive RCT. Participants (n=70) will be randomised to Guided Self-Help: a low-intensity psychological intervention based on behavioural activation adapted for ASD or treatment as usual. Outcomes including depression symptoms, anxiety, social function and service use will be measured at 10, 16 and 24 weeks postrandomisation and will be blind to group allocation for measures that are not self-administered. The analysis will aim to establish the rates of recruitment and retention for a larger-scale RCT as well as the most appropriate measure of depression to serve as primary outcome. The qualitative study will purposively sample up to 24 participants from each treatment group to consider the acceptability and feasibility of the intervention and the trial design.

Ethics and dissemination

Ethical approval has been received from WALES REC 3 (IRAS project ID: 191558) and the Health Research Authority with R&D approval from Avon and Wiltshire Mental Health Partnership and Northumberland, Tyne and Wear Foundation NHS Trusts. To our knowledge, this is the first study of a low-intensity intervention for depression in adults with autism. The results will inform the design of a definitive RCT. Dissemination will include peer-reviewed journal publications reporting the quantitative and qualitative research findings of the study and presentations at national and international conferences.

Trial registration number

ISRCTN54650760; Pre-results.
Patterns of routine primary care for osteoarthritis in the UK: a cross-sectional electronic health records study
Authors: Jackson Holly , Barnett Lauren A , Jordan Kelvin P , Dziedzic Krysia S , Cottrell Elizabeth , Finney Andrew G , Paskins Zoe , Edwards John J
Published: May 2024

Objective

To determine common patterns of recorded primary care for osteoarthritis (OA), and patient and provider characteristics associated with the quality of recorded care.

Design

An observational study nested within a cluster-randomised controlled trial.

Setting

Eight UK general practices who were part of the Management of Osteoarthritis in Consultations study.

Participants

Patients recorded as consulting within the eight general practices for clinical OA.

Primary outcomes

Achievement of seven quality indicators of care (pain/function assessment, information provision, exercise/weight advice, analgesics, physiotherapy), recorded through an electronic template or routinely recorded in the electronic healthcare records, was identified for patients aged ≥45 years consulting over a 6-month period with clinical OA. Latent class analysis was used to cluster patients based on care received. Clusters were compared on patient and clinician-level characteristics.

Results

1724 patients (median by practice 183) consulted with clinical OA. Common patterns of recorded quality care were: cluster 1 (38%,High) received most quality indicators of care; cluster 2 (11%,Moderate) had pain and function assessment, and received or were considered for other indicators; cluster 3 (17%,Low) had pain and function assessment, and received or were considered for paracetamol or topical non-steroidal anti-inflammatory drugs; cluster 4 (35%,None) had no recorded quality indicators. Patients with higher levels of recorded care consulted a clinician who saw more patients with OA, consulted multiple times and had less morbidity. Those in theHighcluster were more likely to have recorded diagnosed OA and have knee/hip OA.

Conclusions

Patterns of recorded care for OA fell into four natural clusters. Appropriate delivery of core interventions and relatively safe pharmacological options for OA are still not consistently recorded as provided in primary care. Further research to understand clinical recording behaviours and determine potential barriers to quality care alongside effective training for clinicians is needed.

Trial registration number

ISRCTN06984617; Results.
Risk analysis of noise-induced hearing loss of workers in the automobile manufacturing industries based on back-propagation neural network model: a cross-sectional study in Han Chinese population
Authors: Ruan Yanmei , Huang Guanhao , Zhang Jinwei , Mai Shiqi , Gu Chunrong , Rong Xing , Huang Lili , Zeng Wenfeng , Wang Zhi
Published: May 2024

Objectives

This study aims to predict the risk of noise-induced hearing loss (NIHL) through a back-propagation neural network (BPNN) model. It provides an early, simple and accurate prediction method for NIHL.

Design

Population based, a cross sectional study.

Setting

Han, China.

Participants

This study selected 3266 Han male workers from three automobile manufacturing industries.

Primary outcome measures

Information including personal life habits, occupational health test information and occupational exposure history were collected and predictive factors of NIHL were screened from these workers. BPNN and logistic regression models were constructed using these predictors.

Results

The input variables of BPNN model were 20, 16 and 21 important factors screened by univariate, stepwise and lasso-logistic regression. When the BPNN model was applied to the test set, it was found to have a sensitivity (TPR) of 83.33%, a specificity (TNR) of 85.92%, an accuracy (ACC) of 85.51%, a positive predictive value (PPV) of 52.85%, a negative predictive value of 96.46% and area under the receiver operating curve (AUC) is: 0.926 (95% CI: 0.891 to 0.961), which demonstrated the better overall properties than univariate-logistic regression modelling (AUC: 0.715) (95% CI: 0.652 to 0.777). The BPNN model has better predictive performance against NIHL than the stepwise-logistic and lasso-logistic regression model in terms of TPR, TNR, ACC, PPV and NPV (p<0.05); the area under the receiver operating characteristics curve of NIHL is also higher than that of the stepwise and lasso-logistic regression model (p<0.05). It was a relatively important factor in NIHL to find cumulative noise exposure, auditory system symptoms, age, listening to music or watching video with headphones, exposure to high temperature and noise exposure time in the trained BPNN model.

Conclusions

The BPNN model was a valuable tool in dealing with the occupational risk prediction problem of NIHL. It can be used to predict the risk of an individual NIHL.
What is current care for people with Long COVID in England? A qualitative interview study
Authors: Sunkersing David , Ramasawmy Mel , Alwan Nisreen A , Clutterbuck Donna , Mu Yi , Horstmanshof Kim , Banerjee Amitava , Heightman Melissa
Published: May 2024

Objective

To investigate current care for people with Long COVID in England.

Design

In-depth, semistructured interviews with people living with Long COVID and Long COVID healthcare professionals; data analysed using thematic analysis.

Setting

National Health Service England post-COVID-19 services in six clinics from November 2022 to July 2023.

Participants

15 healthcare professionals and 21 people living with Long COVID currently attending or discharged (18 female; 3 male).

Results

Health professionals and people with lived experience highlighted the multifaceted nature of Long COVID, including its varied symptoms, its impact on people’s lives and the complexity involved in managing this condition. These impacts encompass physical, social, mental and environmental dimensions. People with Long COVID reported barriers in accessing primary care, as well as negative general practitioner consultations where they felt unheard or invalidated, though some positive interactions were also noted. Peer support or support systems proved highly valuable and beneficial for individuals, aiding their recovery and well-being. Post-COVID-19 services were viewed as spaces where overlooked voices found validation, offering more than medical expertise. Despite initial challenges, healthcare providers’ increasing expertise in diagnosing and treating Long COVID has helped refine care approaches for this condition.

Conclusion

Long COVID care in England is not uniform across all locations. Effective communication, specialised expertise and comprehensive support systems are crucial. A patient-centred approach considering the unique complexities of Long COVID, including physical, mental health, social and environmental aspects is needed. Sustained access to post-COVID-19 services is imperative, with success dependent on offering continuous rehabilitation beyond rapid recovery, acknowledging the condition’s enduring impacts and complexities.
Challenges and support experienced by family caregivers seeking antiretroviral therapy services for children living with HIV/AIDS: a phenomenological study in Ghana
Authors: Yiryuo Lilian , Kpekura Stephen , Osman Wahab , Kukeba Margaret Wekem , Mumuni Najart Deborah , Mwinbam Mavis Mallory , Dery Anthony
Published: May 2024

Background

Family caregivers of children living with HIV/AIDS in most cases are found to be overwhelmed and under-resourced, yet they are believed to be the primary source of support for children living with HIV/AIDS. Family caregivers experience different challenges that affect their children’s antiretroviral therapy (ART) adherence.

Aim

This study explored the lived experiences of family caregivers of children living with HIV/AIDS who sought ART services for these children at the St Joseph’s Hospital of Jirapa, Ghana.

Method

Using a qualitative phenomenology design and a semistructured in-depth interview guide and using purposive sampling, data were gathered from 13 family caregivers of children living with HIV/AIDS receiving ART treatment at St Joseph’s Hospital, Jirapa following ethical approval. All interviews were audio-taped and transcribed verbatim. Reflexive thematic analysis was used to analyse the transcribed data.

Findings

Six themes were generated: five challenges and one support. Family caregivers of children living with HIV/AIDS experienced: (1) Financial challenges, (2) Human-related challenges, (3) Challenges at HIV testing and counselling (HTC) centres, (4) Challenges with transportation, (5) Challenges in disclosing children’s HIV status to them and (6) Support received from HTC and their family members.

Conclusion and recommendation

Family caregivers of children living with HIV/AIDS experience daunting challenges in their quest to care for their children. Governmental and non-governmental HIV/AIDS programme support should include small business skills training and acquisition including capital to help set up small-scale businesses for such caregivers to reduce their financial challenges. Access to ART at clinics closer to caregivers is also key to promoting adherence. Family and community support has been recognised as key to enhancing ART adherence. Education of caregivers on policy regarding disclosure of the HIV/AIDS status of children, the need to work to reduce the time spent by caregivers at HTC, and ensuring privacy by limiting access to HTCs to only caregivers and their children, are important to enhancing adherence.