bluuebunny/crossref_metadata_2025 huggingface dataset:
The Wood-rot Basidiomycete Candolleomyces eurysporus VAST02.52 Produces a Versatile Peroxidase that Catalyses the Biotransformation of α-Pinene to Release Verbenone
Authors: Nghi Do Huu , Hong Minh Pham Thi , Hong Van Nguyen Thi , Quynh Dang Thu
Published: October 2024

Background

Versatile peroxidase (VP; EC 1.11.1.16) has recently emerged as a novel peroxidase highly valued in biotechnology due to its exceptional ability to oxidize a diverse range of substrates into value-added products.

Objectives

To gain insight into the versatile peroxidase system from fungi, this study was designed to purify and characterize a CeuVP from the newly isolated fungus Candolleomyces eurysporus and to investigate its involvement in the biotransformation of plant α-pinene.

Materials and methods

The fungal isolate was identified by analysis of the internal transcribed spacer region. VP-active protein was purified from liquid culture of C. eurysporus VAST02.52 by using fast protein liquid chromatography. The catalytic properties and stability of enzyme were studied for various substrates, different pH- and temperatures. Moreover, its involvement in the biotransformation of plant α-pinene was assessed by HPLC chromatography.

Results

CeuVP was successfully purified with 27.3-fold purity and a 20.9% yield by using three steps of anion exchange and size exclusion chromatography. The molecular weight of CeuVP was determined to be 40 kDa by SDS-PAGE electrophoresis. This pure enzyme exhibited optimal activity at pH 4.0 and 35 °C. CeuVP showed the highest specific activity of 231.6 U/mg against ABTS, followed by Mn2+ (205.8 U/mg), veratryl alcohol (112.7 U/mg), cathecol (77.8 U/mg), p-aminophenol (68.9 U/mg), RBBR (56.2 U/mg), 4-methoxyphenol (31.1 U/mg), guaiacol (18.3 U/mg), and Reactive Black 5 (12.9 U/mg). Moreover, CeuVP catalyzed the oxidation of α-pinene derived from the essential oil of Eucalyptus robusta to release verbenone as the sole metabolite after a 7 h incubation.

Conclusions

Versatile peroxidase ( CeuVP) from C. eurysporus VAST02.52 exhibits the highest specific activity against ABTS while also catalyzing oxidation of various substrates tested. Moreover, this study indicated that CeuVP could be effective in the bioconversion of α-pinene into verbenone, a promising compound with numerous applications in the flavors and fragrances industry.
Healing Havens: How Evidence-Based Design is Transforming Medical Spaces Into Therapeutic Environments
Authors: Sabet Cameron , Hammond Alessandro , Marzouk Sammer
Published: October 2024

Objectives

To explore how evidence-based design is transforming healthcare environments into transforming spaces that improve patient outcomes and staff experiences.

Background

Traditional hospital designs often prioritize functionality over patient and staff well-being. This editorial examines the shift toward evidence-based design in healthcare facilities.

Methods

We review recent studies and case examples demonstrating the impact of thoughtful healthcare design on infection rates, patient recovery, and staff performance.

Results

Evidence shows that elements such as private rooms, access to nature, and improved lighting can significantly reduce infections, accelerate healing, and enhance staff satisfaction.

Conclusions

Implementing evidence-based design principles in healthcare environments can lead to measurable improvements in patient outcomes, staff performance, and overall healthcare quality.
Letters of Love: Engaging Memory Work in Qualitative Research
Authors: Furlong Darcy E. , Haus Katie , Layton Danielle , Lesser Renae , Lester Jessica Nina , Li Pei-Jung , Miao Xinqing Dorcas , Romero Anna , Vellanki Vivek
Published: October 2024

This article examines the role of memory and remembering in qualitative research, proposing a reflective practice where memories serve not only as a backdrop but as active participants in shaping inquiry. By revisiting and engaging in remembering, we, as qualitative inquirers, forge deeper connections with subjects, encompassing the human, the natural world, and the more-than-human. Drawing inspiration from Bridges-Rhoads et al.’s invitation to explore “readings that rock our world,” we extend this metaphor to memories that challenge and invigorate our academic and personal perspectives. We interrogate the types of memories that compel us to rethink our approaches to qualitative inquiry and recognize the often-excluded voices and narratives that emerge from personal and communal histories. Through a heartfelt compilation of love letters addressing people, objects, travels, and moments, this article champions the inclusion of marginal and overlooked memories within academic discourse. These narratives serve as points of departure for inquiry, challenging the boundaries of what is deemed academically valuable, legitimate, and legible. We extend this invitation to our readers to engage in a collective re-imagining and remembering of research practices, emphasizing the significance of memory work in shaping our way of being qualitative researchers and doing qualitative research.
Patterns of Arterial Wall Lesions in Eagle Syndrome: Case Series and Literature Review
Authors: Constant dit Beaufils Pacôme , Gaalon Solène de , Ferron Christophe , Marc Guillaume , Auffray-Calvier Elisabeth , Daumas-Duport Benjamin , Guillon Benoît
Published: October 2024

Background: Impingement of an elongated styloid process (ESP) or calcified stylohyoid ligament on surrounding neck structures defines Eagle syndrome. The vascular variant, also called stylocarotid syndrome, results from impingement of vascular structures and remains poorly known among physicians.

Research Design: We report our own experience and review the literature in order to clarify the diagnostic and therapeutic management. Patients with vascular events in relation to an ESP and hospitalized at our institution were extracted from our databank and retrospectively reviewed. We also performed a comprehensive review of the literature on Eagle syndrome using PubMed® and Google Scholar, analysing the presentation, management, and follow-up.

Results: We report five cases of the vascular variant of Eagle syndrome: one carotid perforation, one focal arteriopathy, one with both acute and chronic dissection and two acute internal carotid dissection. Vascular compression, whether permanent or transient, is also reported in the literature. Management varies, although styloidectomy is deemed appropriate for symptomatic compression, while stenting is preferred in cases of perforation.

Conclusions: A common definition of Eagle syndrome is required for better diagnosis and management. The choice of styloidectomy is understandable for compression but remains to be investigated in other cases.
Parental Influences on Substance Use Among First-Year College Students: A Latent Profile Analysis and Racial/Ethnic Differences
Authors: Su Jinni , Jamil Belal , Ghazoul Marilyn , Wernik Sofia , Trevino Angel
Published: October 2024

This study took a person-centered approach to examine parental influences on alcohol and cannabis use among White and Hispanic/Latinx college students. 704 college students (74.4% female; 34.7% Hispanic/Latinx) completed an online survey. Latent profile analysis identified four parenting profiles characterized by different patterns of perceived parent-child relationship quality, parental monitoring, and parental disapproval of substance use: low disapproval (4.1%), low paternal quality and monitoring (25.8%), low quality and monitoring (12.5%), and high quality monitoring and disapproval (57.6%). Students in the High Quality Monitoring and Disapproval profile had the lowest levels of alcohol consumption and alcohol use disorder (AUD) symptoms. Students in the Low Disapproval profile had the highest frequency of cannabis use than students in other parenting profiles. Among Hispanic/Latinx students only, the High-Quality Monitoring and Disapproval profile was associated with fewer AUD symptoms compared to the Low Paternal Quality and Monitoring profile and the Low Quality and Monitoring profile.
Relationship of Forearm-Hand Inertia With Throwing Motion Patterns and Elbow Valgus Load in Adolescent Baseball Players
Authors: Tsutsui Toshiharu , Sakamaki Wataru , Maemichi Toshihiro , Torii Suguru
Published: October 2024

Background:

Growth-specific physical characteristics in adolescence may mediate throwing-related loads and movement patterns associated with elbow injuries. In a previous study, the authors calculated the forearm-hand inertia, which is the moment of inertia centered at the elbow joint.

Purpose:

To determine the relationship of forearm-hand inertia values with throwing motion patterns and elbow valgus load in adolescent baseball players.

Study Design:

Descriptive laboratory study.

Methods:

A total of 35 adolescent baseball players underwent measurements by dual-energy x-ray absorptiometry (DXA) scans and a throwing trial. Forearm-hand inertia was determined as the joint moment around the elbow using the subregion analysis mode of DXA. Elbow valgus torque and ball speed during throwing were measured using a dedicated sensor and speed gun, and throwing efficiency was calculated by dividing the elbow valgus load by the ball speed. Players were divided according to the throwing motion pattern in which maximum acceleration occurred: pelvis–upper arm–forearm (proximal-to-distal sequencing [PDS] group; n = 19) or pelvis-forearm–upper arm (proximal upper extremity [PUE] group; n = 16). The groups were compared in terms of ball speed, elbow valgus torque, throwing efficiency, and forearm-hand inertia using t tests and analysis of covariance, with forearm-hand inertia as covariates. The chi-square test was used to examine the relationship between throwing motion patterns and forearm-hand inertia.

Results:

The PUE group had a higher elbow valgus load (effect size [ES] = 0.65; P = .03), throwing efficiency (ES = 0.63; P = .02), and forearm-hand inertia values (ES = 0.64; P = .04) than the PDS group. In addition, a significant relationship was observed with throwing patterns when forearm-hand inertia values were 350 kg·m2 (OR, 2.36; 95% CI, 1.09-5.12; P = .012) and 400 kg·m2 (OR, 1.68; 95% CI, 0.99-2.85; P = .037).

Conclusion:

Study results indicated that growth-specific physical characteristics in adolescent baseball players exhibited in forearm-hand inertia mediated the relationship between high elbow valgus and poor throwing efficiency caused by poor throwing motion patterns.

Clinical Relevance:

A better understanding of the details in muscle function with throwing mechanics may prevent future injuries.
Long-term Outcomes of Complete Tears of the Distal Biceps Tendon: An Analysis of Surgical Management at a Median Follow-up of 14.7 Years
Authors: Tagliero Adam J. , Till Sara E. , Pan Xuankang , Reinholz Anna K. , Johnson Adam C. , Sanchez-Sotelo Joaquin , Barlow Jonathan D. , Camp Christopher L.
Published: October 2024

Background:

Surgical repair of full thickness biceps tears has demonstrated adequate outcomes in short and mid-term studies. However, data on the long-term outcomes of full thickness distal biceps injuries and their treatment are currently lacking.

Purpose/Hypothesis:

The purpose of this study was to report on patient demographics, injury characteristics, and long-term outcomes for patients with full-thickness distal biceps tears. It was hypothesized that complete distal biceps tears managed operatively would demonstrate robust clinical success at long-term follow-up.

Study Design:

Case series; Level of evidence, 4.

Methods:

Patients with magnetic resonance imaging–confirmed, complete distal biceps tendon rupture sustained between 1996 and 2016 were identified. Patients were cross-referenced with a regional geographic database.

Results:

A total of 66 patients (3 female, 63 male) with a median age of 50.8 years (IQR, 41.5-60.4) and a median clinical follow-up of 14.7 years (IQR, 9.6-17.9 years) were included. Patients who sustained a full-thickness distal biceps tendon tear were likely to be in their early 50s, male, right-hand dominant, current/former smokers, and laborers with a history of traumatic injury during an intentional movement. Most of these patients had pain and supination weakness but no loss of range of motion. All included tears were treated operatively. At final follow-up, patients maintained a majority of near-normal range of motion (median total arc of flexion/extension 140° and supination/pronation 80°), excellent elbow flexion strength (91% of patients had full strength), and adequate elbow supination strength (76% of patients had full strength). The overall complication rate was 24%, with 16 out of 66 patients experiencing some type of complication between infection, rerupture, heterotopic ossification, reoperation, and nerve complications. Overall return to work was 98%, and 85% of those who returned to work did so without restrictions.

Conclusion:

Complete tears of the distal biceps were most common in patients 50 years of age, male sex, right-hand dominant, and current/former smokers. The most common profession was laborer, and injuries were primarily traumatic in nature during intentional activity. Patients managed operatively demonstrated high rates of success at long-term follow-up with respect to elbow function and clinical outcomes.
Benefit of Hearing-Aid Amplification and Signal Enhancement for Speech Reception in Complex Listening Situations
Authors: Jansen Theresa , Hartog Laura , Oetting Dirk , Hohmann Volker , Kayser Hendrik
Published: October 2024

A major goal of hearing-device provision is to improve communication in daily life. However, there is still a large gap between the user's daily-life aided listening experience and hearing-aid benefit as assessed with established speech reception measurements in the laboratory and clinical practice. For a more realistic assessment, hearing-aid provision needs to be tested in suitable acoustic environments. In this study, using virtual acoustics, we developed complex acoustic scenarios to measure speech-intelligibility and listening-effort benefit obtained from hearing-aid amplification and signal enhancement strategies. Measurements were conducted using the participants’ own devices and a research hearing aid, the Portable Hearing Laboratory (PHL). On the PHL, in addition to amplification, a monaural and a binaural directional filter, as well as a spectral filter were employed. We assessed the benefit from different signal enhancement strategies at the group and the individual level. At the group level, signal enhancement including directional filtering provided a higher hearing-aid benefit in challenging acoustic scenarios in terms of speech intelligibility compared to amplification alone or combined with spectral filtering. However, no difference between monaural and binaural signal enhancement occurred. On an individual level, we found large differences in hearing-aid benefit between participants. While some benefitted from signal-enhancement algorithms, others benefitted from amplification alone, but additional signal enhancement had a detrimental effect. This shows the importance of an individual selection of signal enhancement strategies as a part of the hearing-aid fitting process.
Conceptualizing Domestic Violence Within Clinical Documentation
Authors: Atiénzar-Prieto María , Dhollande Shannon , Meyer Silke , Sapkota Diksha , Clarke Karen-Ann
Published: October 2024

Domestic and family violence (DFV) is a global issue with significant impacts on victim-survivors. The emergency department (ED) serves as the initial point of contact for victim-survivors. Given the significant role that clinical notes play in the management of patients and the communication between healthcare professionals, understanding how healthcare practitioners describe and document abuse reported in emergency settings is crucial. Yet, there remains a gap in understanding how health professional document DFV in the medical records of women presenting to the ED. Therefore, this qualitative descriptive study explored how DFV is documented in patient records of women presenting to the ED. Clinical notes from healthcare workers, including medical practitioners, nurses, social workers, mental health clinicians and ambulance officers, were qualitatively analyzed. Overall, the study included 43 presentations from 32 women (aged 18–56 years old) who visited a regional ED, during which instances of DFV were noted. An inductive content analysis resulted in the identification of four categories, including (a) DFV articulated in direct speech, (b) Unambiguous DFV, (c) Unconfirmed DFV, and (d) Problematic relationship. Although most references to DFV in the clinical notes included direct quotations from the patient’s descriptions of abuse or were documented unambiguously by healthcare professionals, a notable number of clinical notes exhibited a degree of caution or reluctance to acknowledge DFV dynamics when describing these events. These findings support the need for sustained and consistent professional training among healthcare professionals concerning the identification, documentation, and response to disclosures, suspicions, and allegations of DFV to better support victim-survivors presenting to the ED and other hospital settings.
Nurses’ Perceptions of Nurse–Physician Collaboration and Quality of Care in Public Hospitals
Authors: Al-Bustanji Muhammad Fuad , Rayan Ahmad , Eshah Nidal F. , Masa'deh Rami , Baqeas Manal Hassan , Rayyan Nadin , Rayyan Deema , ALBashtawy Mohammed
Published: October 2024

Introduction

Nurse–physician collaboration is a fundamental part of the healthcare information flow, while poor or improper collaboration could result in poor healthcare outcomes and increased medical errors.

Objective

This study investigated the relationship between nurse–physician collaboration and the perceived quality of healthcare services offered in Jordanian public hospitals, and associated factors.

Methods

A descriptive correlational research design was used. A sample of 385 nurses employed in five Jordanian public hospitals was recruited. Nurse–Physician Collaboration Scale was used to assess collaboration, while the HEALTHQUAL scale was used to evaluate healthcare service quality. The IBM SPSS software (version 26) was used to analyze the data.

Results

There was a positive correlation between nurse–physician collaboration and the perceived quality of healthcare services provided to patients ( r = 0.778, p < .01). There was variability in the perception of nurse–physician collaboration based on gender, RN-to-patient staffing ratios, age, and income level ( p < .05). No association was found between nurses’ demographics and their perceptions of the quality of healthcare services provided to patients.

Conclusions

Healthcare organizations should implement effective practices to promote nurse–physician collaboration, which could subsequently improve the quality of tangible services provided to patients.
The presence of a ghost infarct core is associated with fast core growth in acute ischemic stroke
Authors: Saito Mikito , Kawano Hiroyuki , Adachi Takuya , Gomyo Miho , Yokoyama Kenichi , Shiokawa Yoshiaki , Hirano Teruyuki
Published: October 2024

Introduction:

The overestimation of ischemic core volume by CT perfusion (CTP) is a critical concern in the selection of candidates for reperfusion therapy. This phenomenon is termed a ghost infarct core (GIC). Core growth rate (CGR) is an indicator of ischemic severity. We aimed to elucidate the association between GIC and CGR.

Patients and methods:

Consecutive patients with acute ischemic stroke who underwent mechanical thrombectomy in our institute from March 2017 to July 2022 were enrolled. The initial ischemic core volume (IICV) was measured by pretreatment CTP, and the final infarct volume (FIV) was measured by diffusion-weighted imaging. A GIC was defined by IICV minus FIV > 10 ml. The CGR was calculated by dividing the IICV by the time from onset to CTP. Univariable analysis and a multivariable logistic regression model were used to evaluate the association between GIC-positive and CGR.

Results:

Of all 91 patients, 21 (23.1%) were GIC-positive. The GIC-positive group had higher CGR (14.2 [2.6–46.7] vs 4.8 [1.6–17.1] ml/h, p = 0.02) and complete recanalization ( n = 15 (71.4%) vs 29 (41.4%), p = 0.02) compared to the GIC-negative group. On receiver-operating characteristic curve analysis, the optimal cutoff point of CGR to predict GIC-positive was 22 ml/h (sensitivity, 0.48; specificity, 0.85; AUC, 0.67). Multivariable logistic regression analysis showed that CGR ⩾ 22 ml/h (OR 6.44, 95% CI [1.59–26.10], p = 0.01) and complete recanalization (OR 3.72, 95% CI [1.14–12.08], p = 0.02) were independent predictors of GIC-positive.

Conclusions:

A GIC was associated with fast CGR in acute ischemic stroke. Overestimation of the initial ischemic core may be determined by core growth speed.
Innovation and possibility of various coating materials with microwave hybrid heating
Authors: Verma Yudhveer Kumar , Singh Kanwarjeet , Arora Gaurav
Published: October 2024

Cavitation wear is causing considerable financial losses for a range of industries, such as chemical, food processing and hydropower plants. Microwave cladding process involves the application of a coating of another material over the surface of a specific material, which offers properties beneficial for high electrical conductivity, low loss tangent and excellent thermal stability. This review article is intended to provide a basic understanding of the properties of various types of microwave cladding materials. This chapter also emphasises on the characterisation of the samples produced through the microwave cladding on various substrate materials. Furthermore, this chapter describes the potential applications of the microwave cladding process in numerous engineering and industrial sectors. Additionally, this chapter also reports the potential future technological advancements in the field of microwave cladding process.
Endoscopic ultrasound-guided placement of lumen-apposing metal stent for transgastric drainage of loculated malignant ascites
Authors: Reuangrith Jacqueline , Scott Stephanie A. , Kohansal Ali
Published: October 2024

Endoscopic ultrasound-guided drainage of loculated malignancy-related ascites has been reported in limited case series with success in achieving symptomatic relief. In this case report, we detail the successful drainage of a loculated paragastric ascites with insertion of a lumen-apposing metal stent (LAMS) in a patient diagnosed with metastatic ovarian cancer.
Utilization of Diabetes Self-Management Education and Support Among Medicare Beneficiaries Newly Diagnosed With Diabetes in Arkansas, 12 Months Postdiagnosis (2015-2018)
Authors: Rezaeiahari Mandana , Acharya Mahip , Henske Joseph , Owsley Kelsey , Bodenhamer Jodi
Published: October 2024

Purpose

The purpose of the study was to determine the rate of diabetes self-management education and support (DSMES) utilization among Medicare fee-for-service (FFS) and Medicare Advantage (MA) populations with type 2 diabetes in Arkansas.

Methods

The Arkansas All-Payer Claims Database was used to identify Medicare FFS and MA beneficiaries diagnosed with type 2 diabetes from 2015 to 2018. Claims from 2013 to 2020 were analyzed to determine newly diagnosed individuals from 2015 to 2018. The criteria included 1 outpatient diabetes claim in the index year and at least 1 inpatient or outpatient claim in the 2 years following the initial claim. A total of 15 648 Medicare FFS individuals and 7520 MA individuals with newly diagnosed type 2 diabetes were identified. The use of DSMES 1 year following the diagnosis dates for both Medicare FFS and MA populations was assessed. Descriptive statistics and multiple logistic regression analyses were conducted to understand the factors associated with DSMES utilization.

Results

DSMES utilization consistently remained lower in the MA population compared to Medicare FFS (2.3% vs 4.9%). The adjusted analysis indicated that factors such as older age, living in a rural area, belonging to a racial group other than White, and MA enrollment were associated with a lower likelihood of receiving DSMES.

Conclusions

DSMES utilization in Arkansas, where the prevalence of diabetes is higher than the national average, is notably low. There is a need for coordinated efforts at various levels to enhance access to DSMES.
Differentiation in General Music
Authors: Hatch Emily
Published: October 2024

Differentiation means creating different pathways through content to show mastery. Learning can be differentiated by process, product, and content. This article will define characteristics of differentiation and explore how general music teachers can be intentional about planning differentiated tasks and activities for each Artistic Process from the National Arts Standards.
Mosaic loss of chromosome Y, tobacco smoking and risk of age-related lung diseases: insights from two prospective cohorts
Authors: Weng Chenghao , Zhao Yuxuan , Song Mingyu , Shao Zilun , Pang Yuanjie , Yu Canqing , Pei Pei , Yang Ling , Millwood Iona Y. , Walters Robin G. , Chen Yiping , Du Huaidong , Chen Junshi , Chen Zhengming , Genovese Giulio , Terao Chikashi , Lv Jun , Li Liming , Sun Dianjianyi
Published: October 2024

Background

Little is known about the underlying relationship between mosaic loss of chromosome Y (mLOY), the most common chromosomal alterations in older men, and the risk of age-related lung diseases.

Methods

We included 217 780 participants from the UK Biobank (UKB) and 42 859 participants from the China Kadoorie Biobank. The mLOY events were detected using the Mosaic Chromosomal Alterations (MoChA) pipeline. Outcomes included all lung diseases, COPD, lung cancer and idiopathic pulmonary fibrosis (IPF). Cox proportional hazard models were fitted to estimate the hazard ratios and 95% confidence intervals of mLOY with lung diseases in both cohorts. The combined hazard ratios were derived from meta-analysis.

Results

Results from the two cohorts showed that expanded mLOY was associated with increased risks of all lung diseases (HR 1.19 (95% CI 1.04–1.36)), COPD (HR 1.20 (95% CI 1.13–1.28)), lung cancer (HR 1.34 (95% CI 1.21–1.48)) and IPF (HR 1.34 (95% CI 1.16–1.56) in the UKB). There was evidence of positive interactions between mLOY and smoking behaviour (relative excess risk due to interaction (97.5% CI) >0). Additionally, we observed that current smokers with expanded mLOY had the highest risk of incident lung diseases in both cohorts.

Conclusions

mLOY may be a novel predictor for age-related lung diseases. For current smokers carrying mLOY, adopting quitting smoking behaviour may contribute to substantially reducing their risk of incident lung diseases.
Machine learning classification of archaea and bacteria identifies novel predictive genomic features
Authors: Bobbo Tania , Biscarini Filippo , Yaddehige Sachithra K. , Alberghini Leonardo , Rigoni Davide , Bianchi Nicoletta , Taccioli Cristian
Published: October 2024

Background

Archaea and Bacteria are distinct domains of life that are adapted to a variety of ecological niches. Several genome-based methods have been developed for their accurate classification, yet many aspects of the specific genomic features that determine these differences are not fully understood. In this study, we used publicly available whole-genome sequences from bacteria ($$N=2546$$

N
=
2546

) and archaea ($$N=109$$

N
=
109

). From these, a set of genomic features (nucleotide frequencies and proportions, coding sequences (CDS), non-coding, ribosomal and transfer RNA genes (ncRNA, rRNA, tRNA), Chargaff’s, topological entropy and Shannon’s entropy scores) was extracted and used as input data to develop machine learning models for the classification of archaea and bacteria.

Results

The classification accuracy ranged from 0.993 (Random Forest) to 0.998 (Neural Networks). Over the four models, only 11 examples were misclassified, especially those belonging to the minority class (Archaea). From variable importance, tRNA topological and Shannon’s entropy, nucleotide frequencies in tRNA, rRNA and ncRNA, CDS, tRNA and rRNA Chargaff’s scores have emerged as the top discriminating factors. In particular, tRNA entropy (both topological and Shannon’s) was the most important genomic feature for classification, pointing at the complex interactions between the genetic code, tRNAs and the translational machinery.

Conclusions

tRNA, rRNA and ncRNA genes emerged as the key genomic elements that underpin the classification of archaea and bacteria. In particular, higher nucleotide diversity was found in tRNA from bacteria compared to archaea. The analysis of the few classification errors reflects the complex phylogenetic relationships between bacteria, archaea and eukaryotes.
Comparative analysis of MitraClip/TriClip and PASCAL in transcatheter tricuspid valve repair for tricuspid regurgitation: a systematic review and meta-analysis
Authors: Balata Mahmoud , Gbreel Mohamed Ibrahim , Hassan Marwa , Becher Marc Ulrich
Published: October 2024

Background

The edge-to-edge transcatheter tricuspid valve repair (TTVR) has emerged as a promising technique for the treatment of tricuspid regurgitation (TR). Despite its potential, comparative data on the performance of the novel edge-to-edge devices—MitraClip, PASCAL, and TriClip—remain controversial. In this study, we aim to evaluate the safety and efficacy of these devices in treating TR.

Methods

Five databases were systematically searched up to May 2023, with an updated search conducted in May 2024. Only original studies were included in the analysis and were critically evaluated using an adapted version of the Newcastle-Ottawa Scale (NOS) for observational cohort studies and the Cochrane Risk of Bias (ROB) tool for randomized controlled trials.

Results

The database search yielded 2239 studies, out of which 21 studies were included in the final analysis. These studies encompassed a total of 2178 patients who underwent TTVR using either the MitraClip, TriClip, or PASCAL devices. The risk of bias across these studies ranged from moderate to high. No significant differences were found among the three devices in terms of effective regurgitant orifice area (EROA) and tricuspid regurgitant volume. However, TriClip demonstrated statistically superior efficacy in reducing vena contracta compared to both MitraClip and PASCAL (P < 0.01) [TriClip: (MD = -7.4; 95% CI: -9.24, -5.56), MitraClip: (MD = -4.04; 95% CI: -5.03, -3.05), and PASCAL: (MD = -6.56; 95% CI: -7.76, -5.35)]. The procedural success rates and incidence of single leaflet device attachment (SLDA) were similar across all devices. Furthermore, there were no significant differences in mortality, stroke rates, or major bleeding events among the three devices.

Conclusion

The TriClip outperforms the MitraClip and PASCAL in reducing vena contracta width, indicating greater effectiveness for severe tricuspid regurgitation. All devices show similar safety profiles and procedural success rates. Further research is needed to confirm these results.
The feasibility and acceptability of engaging older adults living with multiple long-term conditions, frailty, and a recent deterioration in health in research: Findings from the Lifestyle in Later Life – Older People’s Medicine (LiLL-OPM) study
Authors: Hurst Christopher , Dismore Lorelle , Granic Antoneta , Noble Jane M. , Hillman Susan J. , Witham Miles D. , Sayer Avan A. , Dodds Richard M. , Robinson Sian M.
Published: October 2024

Background

Older adults living with multiple long-term conditions (MLTC, also known as multimorbidity) and frailty are more likely to experience a deterioration in their health requiring specialist referral or hospital admission than individuals without these syndromes. However, this group of older people are underserved by research meaning that there is a limited evidence base for their care. This study therefore aimed (1) to determine if it is feasible to recruit and collect quantitative data to describe the health and lifestyle of older adults living with MLTC, frailty and a recent deterioration in health and (2) to assess if taking part in research is acceptable to this group of older adults.

Methods

Participants were approached and recruited for this study via an Older People’s Medicine Day Unit in Newcastle upon Tyne, UK. The study took a mixed methods approach, involving quantitative and qualitative data collection. To determine the feasibility of carrying out research in this group, we quantified recruitment rate and collected data on the health and lifestyle, including diet and physical activity, of the participants. Qualitative semi-structured interviews were undertaken to assess acceptability. Two separate interviews were carried out focusing on involving older adults in research and the participants’ experiences of taking part in the research. Interviews were analysed using thematic analysis.

Results

Fifty patients were approached to participate in the study with twenty-nine (58%) successfully recruited. It was feasible to collect information to describe the health and lifestyle of these older adults who demonstrated very low levels of physical activity. Participants reported that taking part in the research was acceptable to them with interview analysis generating three themes (1) developing a meaningful partnership, (2) enabling factors to participation: research at home with flexible delivery and (3) social and psychological benefits of research participation.

Conclusions

It is feasible and acceptable to recruit and carry out research with this underserved group of older adults. Participants found taking part in this research to be acceptable and reported overall positive experiences of their involvement in the study and indicated that they would be willing to contribute to further research in the future.
Outcomes of an adapted prolonged exposure psychotherapy for people with early phase psychosis, substance misuse, and a history of adversity: the PE + trial
Authors: Patterson Victoria C , Tibbo Philip G , Stewart Sherry H , Town Joel , Crocker Candice E , Ursuliak Zenovia , Lee Siranda , Morrison Jason , Abidi Sabina , Dempster Kara , Alexiadis Maria , Henderson Neal , Pencer Alissa
Published: October 2024

Background

Several adversity-focused treatment trials have reported improvements to adversity sequelae (e.g., PTSD symptoms) and decreases in psychotic symptoms among individuals with psychotic disorders. Yet, no trials have examined the impact of adversity-focused treatment on substance use or examined the outcomes among an early phase psychosis population. These gaps in both the research literature and clinical practice have resulted in less knowledge about the outcomes of adversity-focused treatment at this stage of illness, including the impact on substance use.

Methods

The outcomes of an adapted prolonged exposure protocol (PE+) among an early phase psychosis population were examined using a multiple-baseline design. Nineteen adults with a psychotic disorder, current substance misuse, and a history of adversity were recruited from an early psychosis program. Participants were randomized to treatment start time and participated in a 15-session course of PE + therapy. Ten assessments were completed focusing on primary outcomes (i.e., adversity sequelae, negative psychotic symptoms, substance misuse) and secondary outcomes (i.e., functioning, hopelessness, experiential avoidance). The Reliable Change Index (RCI) was used to establish whether there were clinically significant changes to primary or secondary outcomes.

Results

Half or more of treatment completers experienced clinically significant changes to most domains of adversity sequelae, no participants experienced improvements in negative psychotic symptoms, and substance misuse increased for several participants. In terms of secondary outcomes, functioning and experiential avoidance were improved for a number of participants, while hopelessness decreased for only one participant. Participants reported high satisfaction with the PE + treatment, and exposure and coping skills were rated as the most helpful elements of treatment.

Conclusions

Reductions in adversity sequelae were observed following PE + treatment, suggesting that adversity-focused treatment may be beneficial for an early psychosis population. Yet, few positive changes to psychotic symptoms or substance use were observed. Further integrating treatment strategies for psychosis and substance use into PE + may be required to effectively treat the links between psychosis, adversity sequelae, and substance use. Future studies should make efforts to integrate substance use strategies into adversity treatment trials for people with psychotic disorders.

Trial registration

Clinicaltrials.gov, NCT04546178; registration posted 11/09/2020, https://clinicaltrials.gov/ct2/show/NCT04546178?term=NCT04546178&draw=2&rank=1.
Gender differences in preferences for mental health apps in the general population – a choice-based conjoint analysis from Germany
Authors: Jagemann Inga , Stegemann Manuel , von Brachel Ruth , Hirschfeld Gerrit
Published: October 2024

Background

Men and women differ in the mental health issues they typically face. This study aims to describe gender differences in preferences for mental health treatment options and specifically tries to identify participants who prefer AI-based therapy over traditional face-to-face therapy.

Method

A nationally representative sample of 2,108 participants (53% female) aged 18 to 74 years completed a choice-based conjoint analysis (CBCA). Within the CBCA, participants evaluated twenty choice sets, each describing three treatment variants in terms of provider, content, costs, and waiting time.

Results

Costs (relative importance [RI] = 55%) emerged as the most critical factor when choosing between treatment options, followed by provider (RI = 31%), content (RI = 10%), and waiting time (RI = 4%). Small yet statistically significant differences were observed between women and men. Women placed greater importance on the provider, while men placed greater importance on cost and waiting time. Age and previous experience with psychotherapy and with mental health apps were systematically related to individual preferences but did not alter gender effects. Only a minority (approximately 8%) of participants preferred AI-based treatment to traditional therapy.

Conclusions

Overall, affordable mental health treatments performed by human therapists are consistently favored by both men and women. AI-driven mental health apps should align with user preferences to address psychologist shortages. However, it is uncertain whether they alone can meet the rising demand, highlighting the need for alternative solutions.
Health impact assessment in two planning projects in England: reflections on normative effectiveness
Authors: Fischer Thomas B. , Chang Michael , Muthoora Tara
Published: October 2024

Background

This article reports on research commissioned by (what was at the time) Public Health England (PHE). The objective is to reflect on the normative effectiveness of Health Impact Assessment (HIA) applied to two planning projects; (a) the new town at Cranbrook, Devon (HIA prepared in 2007), and (b) the regeneration of the Marsh farm area in Luton (HIA prepared in 2009). In this context, the focus is on the contribution of HIA to actions that are intended to lead to good or improved health and wellbeing.

Methods

Normative HIA effectiveness criteria derived from a literature review were used to guide the analysis. The two included HIA cases were previously identified as good practice examples with regards to procedure and report quality. Semi-structured interviews with public health, planning and other actors originally involved in the HIAs were conducted in 2021. This was followed up by web-searches for evidence on actual developments in 2023.

Results

Interviews indicated that normative effectiveness initially appeared to be high, but that the longer-term effects of the financial crash of 2008 reduced this. Delays in initially anticipated timelines and HIA actors moving elsewhere or retiring meant that HIAs were not followed-up and connections between developments and the HIAs were no longer made. However, web-based searches conducted in 2023 found that key HIA suggestions were eventually implemented, albeit with delay. There is also evidence for improved IMD (index of multiple deprivation) rankings in the Marsh farm regeneration case.

Conclusion

A mismatch is observed with regards to HIA exercises appearing to be largely ‘forgotten’ after over a decade of their publication, but recommendations still being implemented, possibly as a result of ‘institutional memory’. Making monitoring and follow-up of HIA binding rather than advisory would allow for direct linkages to be made.
How, why and when are delayed (back-up) antibiotic prescriptions used in primary care? A realist review integrating concepts of uncertainty in healthcare
Authors: Mcleod Monsey , Campbell Anne , Hayhoe Benedict , Borek Aleksandra J. , Tonkin-Crine Sarah , Moore Michael V. , Butler Christopher C. , Walker A. Sarah , Holmes Alison , Wong Geoff ,   on behalf of the STEP-UP study team, Anyanwu Philip E , Bright Nicole , Buchanan James , Costelloe Ceire , Hopkins Susan , Majeed Azeem , Morrell Liz , Pouwels Koen B , Robotham Julie V , Roope Laurence S J , Wordsworth Sarah , Wright Carla , Yadav Sara , Zalevski Anna
Published: October 2024

Background

Antimicrobial resistance is a global patient safety priority and inappropriate antimicrobial use is a key contributing factor. Evidence have shown that delayed (back-up) antibiotic prescriptions (DP) are an effective and safe strategy for reducing unnecessary antibiotic consumption but its use is controversial.

Methods

We conducted a realist review to ask why, how, and in what contexts general practitioners (GPs) use DP. We searched five electronic databases for relevant articles and included DP-related data from interviews with healthcare professionals in a related study. Data were analysed using a realist theory-driven approach – theorising which context(s) influenced (mechanisms) resultant outcome(s) (context-mechanism-outcome-configurations: CMOCs).

Results

Data were included from 76 articles and 41 interviews to develop a program theory comprising nine key and 56 related CMOCs. These explain the reasons for GPs’ tolerance of risk to different uncertainties and how these may interact with GPs’ work environment, self-efficacy and perceived patient concordance to make using DP as a safety-net or social tool more or less likely, at a given time-point. For example, when a GP uses clinical scores or diagnostic tests: a clearly high or low score/test result may mitigate scientific uncertainty and lead to an immediate or no antibiotic decision; an intermediary result may provoke hermeneutic (interpretation-related) uncertainty and lead to DP becoming preferred and used as a safety net. Our program theory explains how DP can be used to mitigate some uncertainties but also provoke or exacerbate others.

Conclusion

This review explains how, why and in what contexts GPs are more or less likely to use DP, as well as various uncertainties GPs face which DP may mitigate or provoke. We recommend that efforts to plan and implement interventions to optimise antibiotic prescribing in primary care consider these uncertainties and the contexts when DP may be (dis)preferred over other interventions to reduce antibiotic prescribing. We also recommend the following and have included example activities for: (i) reducing demand for immediate antibiotics; (ii) framing DP as an ‘active’ prescribing option; (iii) documenting the decision-making process around DP; and (iv) facilitating social and system support.
The roles of employment status and income in the mental health of informal caregivers in Germany
Authors: Scheuermann Julia-Sophia , Pendergrass Anna , Diehl Katharina , Herr Raphael M.
Published: October 2024

Background

Informal caregivers often experience multiple negative consequences as a result of the informal care they provide. Among other factors, employment status, financial resources, and mental health are related to informal caregiving. This analysis examined the association between informal caregivers’ employment status and their mental health, as well as the moderating effect of net household income on this relationship.

Methods

The research question was addressed with data from the German Socio-Economic Panel (SOEP) survey, comprising 3,053 informal caregivers (1,007 male; 2,046 female). Data were obtained through self-reports, and mental health was measured with the Summary Scale Mental Score. Stepwise adjusted multiple linear regression models were used to examine the association between employment status and mental health. The moderating effects were tested with interaction terms. All analyses were also stratified for gender.

Results

Informal caregivers with full-time jobs reported better mental health than unemployed or marginally employed caregivers (β = 0.077, p < 0.001). The significant interaction term for full-time (β=-0.066, p = 0.001) and part-time workers (β=-0.066, p = 0.003) indicated a moderating effect of net household income on the association between employment status and mental health. This finding was especially evident in women.

Conclusions

Employment appears to be a relevant protective factor for informal caregivers’ mental health. However, if informal caregivers are not employed, a low net household income might additionally restrict their mental health. Therefore, welfare policy structures must be created to reduce the negative financial consequences for informal caregivers and enable them to achieve work-life-care balance.
Persistent deficits in knee joint kinematics and kinetics during gait following tibial plateau fractures – a longitudinal study
Authors: Fändriks Anna , Zügner Roland , Karlsson Jón , Möller Michael , Tranberg Roy
Published: October 2024

The recovery process after tibial plateau fractures varies, with some patients experiencing persistent gait asymmetries for a long period of time. The aim of this study is to analyse knee joint kinematics and kinetics post-fracture using a linear mixed-effects model, assessing 26 participants over 24 months (aged 45, range 26–63), and an age-matched control group (aged 47, range 26–62). Participants underwent three-dimensional gait analysis at 6-, 12- and 24-months post-injury. Controls participated in the gait analysis on one occasion. Six gait variables related to knee joint kinematics and kinetics were analysed with a linear mixed-effects model. The model was constructed to determine if there was a differential improvement over time between the injured and the non-injured legs across the six variables, referred to as an interaction effect. If no interaction effect was observed, the model assessed whether there was a side difference between the legs and if there was any improvement over time in both legs. Additionally, non-parametric tests were performed to assess differences between the non-injured leg and the control group across the six variables 24 months after injury. The findings revealed an interaction effect in terms of cumulative absorbed power (p = 0.02, side difference p = 0.06). Other variables showed no interaction effects. Although a side difference between legs was observed for all variables (p < 0.001), only the variables regarding generated power exhibited improvements over time (p = 0.02 respectively). Minimal knee flexion, range of motion, and maximal extending knee joint moment showed no improvements over time. At the 24-month follow-up, the maximal extending knee joint moment was the only variable that differed between the non-injured leg and controls, with increased moment observed for the non-injured leg compared with the controls (p = 0.03). Taken together, two years post-fracture, patients demonstrated pronounced side differences between the injured and non-injured legs with worse ability to extend the knee joint and to generate power in the injured leg. While the kinetic variables improved over time, there were no improvements observed in kinematic variables. Moreover, the non-injured leg performed similarly to healthy controls in terms of minimal knee flexion, range of motion, and generated and absorbed power.