bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolution of interorganismal strigolactone biosynthesis in seed plants
Authors: Zhou Anqi , Kane Annalise , Wu Sheng , Wang Kaibiao , Santiago Michell , Ishiguro Yui , Yoneyama Kaori , Palayam Malathy , Shabek Nitzan , Xie Xiaonan , Nelson David C. , Li Yanran
Published: January 2025

Strigolactones (SLs) are methylbutenolide molecules derived from β-carotene through an intermediate carlactonoic acid (CLA). Canonical SLs act as signals to microbes and plants, whereas noncanonical SLs are primarily plant hormones. The cytochrome P450 CYP722C catalyzes a critical step, converting CLA to canonical SLs in most angiosperms. Using synthetic biology, we investigated the function of
CYP722A
, an evolutionary predecessor of
CYP722C
. CYP722A converts CLA into 16-hydroxy-CLA (16-OH-CLA), a noncanonical SL detected exclusively in the shoots of various flowering plants. 16-OH-CLA application restores control of shoot branching to SL-deficient mutants in
Arabidopsis thaliana
and is perceived by the SL signaling pathway. We hypothesize that biosynthesis of 16-OH-CLA by CYP722A was a metabolic stepping stone in the evolution of canonical SLs that mediate rhizospheric signaling in many flowering plants.
Climate change and the cost-of-living squeeze in desert lizards
Authors: Wild Kristoffer H. , Huey Raymond B. , Pianka Eric R. , Clusella-Trullas Susana , Gilbert Anthony L. , Miles Donald B. , Kearney Michael R.
Published: January 2025

Climate warming can induce a cost-of-living “squeeze” in ectotherms by increasing energetic expenditures while reducing foraging gains. We used biophysical models (validated by 2685 field observations) to test this hypothesis for 10 ecologically diverse lizards in African and Australian deserts. Historical warming (1950–2020) has been more intense in Africa than in Australia, translating to an energetic squeeze for African diurnal species. Although no net impact on Australian diurnal species was observed, warming generated an energetic “relief” (by increasing foraging time) for nocturnal species. Future warming impacts will be more severe in Africa than in Australia, requiring increased rates of food intake (+10% per hour active for diurnal species). The effects of climate warming on desert lizard energy budgets will thus be species-specific but potentially predictable.
AI-designed miniproteins neutralize snake toxins
Authors: Wilcox Christie
Published: January 2025

Scientists are turning to AI to make antivenoms cheaper, faster, and more effective
Chinese firm’s large language model makes a splash
Authors: Normile Dennis
Published: January 2025

DeepSeek’s open-source model appears to be cheaper and faster to train and run than many others
University of Michigan ends joint effort in China
Authors: Stone Richard
Published: January 2025

Republican lawmakers had criticized decades-old ties with Shanghai Jiao Tong University
Comparing field and lab quantitative stable isotope probing for nitrogen assimilation in soil microbes
Authors: Reed Kinsey , Dang Chansotheary , Walkup Jeth , Purcell Alicia , Hungate Bruce , Morrissey Ember
Published: January 2025

Soil microbial communities play crucial roles in nutrient cycling and can help retain nitrogen in agricultural soils. Quantitative stable isotope probing (qSIP) is a useful method for investigating taxon-specific microbial growth and utilization of specific nutrients, such as nitrogen (N). Typically, qSIP is performed in a highly controlled lab setting, so the field relevance of lab qSIP studies remains unknown. We conducted and compared tandem lab and field qSIP to quantify the assimilation of
15
N by maize-associated soil prokaryotic communities at two agricultural sites. Here, we show that field qSIP with
15
N can be used to measure taxon-specific microbial N assimilation. Relative
15
N assimilation rates were generally lower in the field, and the magnitude of this difference varied by site. Rates differed by method (lab vs field) for 19% of the top N assimilating genera. The field and lab measures were more comparable when relative assimilation rates were weighted by relative abundance to estimate the proportion of N assimilated by each genus with only ~10% of taxa differing by method. Of those that differed, the taxa consistently higher in the lab were inclined to have opportunistic lifestyle strategies, whereas those higher in the field had niches reliant on plant roots or in-tact soil structure (biofilms, mycelia). This study demonstrates that
15
N-qSIP can be successfully performed using field-incubated soils to identify microbial allies in N retention and highlights the strengths and limitations of field and lab qSIP approaches.

IMPORTANCE

Soil microbes are responsible for critical biogeochemical processes in natural and agricultural ecosystems. Despite their importance, the functional traits of most soil organisms remain woefully under-characterized, limiting our ability to understand how microbial populations influence the transformation of elements such as nitrogen (N) in soil. Quantitative stable isotope probing (qSIP) is a powerful tool to measure the traits of individual taxa. This method has rarely been applied in the field or with
15
N to measure nitrogen assimilation. In this study, we measured genus-specific microbial nitrogen assimilation in two agricultural soils and compared field and lab
15
N qSIP methods. Our results identify taxa important for nitrogen assimilation in agricultural soils, shed light on the field relevance of lab qSIP studies, and provide guidance for the future application of qSIP to measure microbial traits in the field.
Draft genomes of fluoroquinolone-resistant
Salmonella enterica
subspecies
enterica
strains isolated from Cambodian poultry marketplaces
Authors: Goh Evelyn C. , Hu Dalong , Chea Rortana , Low Adrian , Koh Xiu Qi , Tum Sothyra , Boucher Yann Felix
Published: January 2025

High-quality draft genomes of six
Salmonella enterica
subspecies
enterica
strains from Cambodian poultry marketplaces were sequenced. The strains were identified as Corvallis-, Monschaui-, and Kentucky-serovars. The fluoroquinolone resistance gene,
qnrS,
was found in three strains in different Cambodian provinces. These genomes serve as references for antibiotic resistance genotypes.
A probabilistic model for coseismic vertical displacement hazard in coastal settings
Authors: Delano Jaime , Howell Andy , Clark Kate , Stahl Tim , Rollins Chris , Seebeck Hannu , McGrath Jack
Published: January 2025

Characterizing coastal multihazards in tectonically active regions requires consideration of the possible coseismic vertical deformation. Coseismic uplift or subsidence can cause near-instantaneous meter-scale relative sea-level changes that can exacerbate or reverse the effects of ongoing global sea-level rise. In this study, we developed a probabilistic model that forecasts coseismic vertical displacement over 100 years in the Wellington Region of Aotearoa New Zealand. This model builds upon fault source, earthquake rupture, and epistemic uncertainty data from the 2022 New Zealand National Seismic Hazard Model−Te Tauira Matapae Pūmate Rū i Aotearoa (NZ NSHM 2022) to quantify the amount, direction, and likelihood of vertical displacement from both crustal fault and subduction interface earthquakes. The results of the model show that both crustal fault and subduction sources pose significant (>0.2 m) vertical displacement hazard at most sites. In general, the subduction interface contributes more to subsidence hazard, while crustal faults contribute more to uplift hazard but also contribute to subsidence hazard at specific sites. We find that fault geometry and slip extent play a significant role in forecasted uplift and subsidence hazard. Future versions of both the NZ NSHM 2022 and our probabilistic model may benefit from refinements to fault geometry and simulated earthquake ruptures. The framework developed here can be used to harness regional-scale hazard models for coastal multihazard analysis, particularly in regions with many overlapping seismic sources.
Eco-anxiety, climate change and the ‘bottom billion’: a plea for better understanding
Authors: Butler Colin David
Published: January 2025

Climate change poses enormous, rapidly increasing risks to human well-being that remain poorly appreciated. The growing understanding of this threat has generated a phenomenon often called ‘eco-anxiety’. Eco-anxiety (and its synonyms) is best documented in the Global North, mostly among people who are better educated and whose reasons for concern are both altruistic and self-interested. However, the populations who are most vulnerable to climate change are disproportionately poor and live in the Global South, where evidence for eco-anxiety (or climate) anxiety is limited, especially among those who have been called the ‘bottom billion’, approximately the global population’s poorest decile. Here, I postulate reasons for this research gap as both ethical and practical. Additionally, the bottom billion experience many disadvantages, some of which plausibly lower their recognition of anthropogenic climate change. These disadvantages include nutritional and health factors that can reduce learning capacity, even if access to formal education exists. Many in this population have limited or no electronic access to information. Furthermore, the relationship between the stresses faced by such populations and climate change is often indirect, potentially also disguising recognition of the role of climate change. The world is characterised by many distressing forms of inequality, one of which is the effective ‘invisibilisation’ of the bottom billion. This group faces many challenges; some of these may exceed climate change as rational causes for anxiety. However, it is here argued that policy makers should act on their behalf, irrespective of evidence that they experience eco-anxiety.
Association between poor drug adherence and undernutrition among adult HIV patients in southern Ethiopia: an institution based cross sectional study
Authors: Belete Nigus Kabtu , Gadore Tesfaye Feleke , Assefa Darik Temesgen , Teshale Manaye Yihune , Sorrie Muluken Bekele , Tariku Eshetu Zerihun
Published: January 2025

Objective

Undernutrition is a common issue for HIV and other immune suppressed patients. Approximately 462 million people worldwide living with HIV are experiencing undernutrition, with sub-Saharan Africa having the highest prevalence. Good adherence to antiretroviral therapy (ART) indirectly helps prevent undernutrition by suppressing viral load, increasing CD4 count, preventing viral resistance, enhancing immune reconstitution and delaying disease progression in HIV patients. This study aims to assess the association between poor drug adherence and undernutrition among adult HIV patients in southern Ethiopia.

Study design

An institution based cross sectional study design was used.

Setting and participants

The study was conducted in 406 randomly selected adult HIV patients from Gamo zone public health facilities.

Primary and secondary outcomes

The data were collected by a trained data collector using a structured interviewer administered questionnaire, patient record review and physical measurements. Binary logistic regression was run to select candidate variables, and a multivariable logistic regression model was used to assess the association between undernutrition and poor drug adherence, as well as other variables. A p value <0.05 with 95% CI was considered statistically significant.

Results

The magnitude of undernutrition was 28% (95% CI 24.0 to 33). Being a male patient (AOR 2.0, 95% CI 1.243 to 3.573), poor ART drug adherence (AOR 3.6, 1.815 to 7.428) and consuming <5 food groups (AOR 4.8, 2.901 to 8.265) were significantly associated with undernutrition among adult HIV patients.

Conclusions

Poor drug adherence was significantly associated with undernutrition. Also, sex and dietary diversity were identified as predictors for undernutrition among adult HIV patients. Therefore, effectively managing poor drug adherence, nutritional supplements and communicating behavioural change implications are critical for successfully preventing undernutrition.
Research investigating patient and carer psychoeducation needs regarding post-stroke cognition: a scoping review
Authors: Hobden Georgina , Tabone Faye , Demeyere Nele
Published: January 2025

Objectives

To search the literature systematically in order to map and identify gaps in research investigating patient and family member psychoeducation needs regarding post-stroke cognition.

Design

Scoping review conducted in line with Joanna Briggs Institute (JBI) recommendations and PRISMA-ScR checklist.

Methods

MEDLINE, PsycINFO, Embase, CINAHL and Scopus were searched on 25 August 2023 for peer-reviewed studies conducted in a high-income country, describing cognition-related psychoeducation needs in stroke survivors and/or family members aged ≥18 years (≥50% of the study population). Two reviewers independently screened titles, abstracts and then full-text articles. One reviewer extracted pre-defined study characteristics and findings. These data were verified by a second reviewer. Synthesis involved descriptive statistics and thematic analysis.

Results

Searches identified 8115 articles, of which 30 were included. Articles were published between 1996 and 2023. Studies were conducted in Australia (n=7), USA (n=6), UK (n=5), Canada (n=3), New Zealand (n=3), Ireland (n=2), Netherlands (n=2), South Korea (n=1) and Sweden (n=1). Most studies (n=21) used an exclusively qualitative approach but six combined qualitative and quantitative methods. The post-stroke period under investigation varied, including the acute/subacute stage (n=10) and the chronic stage (n=3), though many articles did not state the timepoint explicitly. Research was conducted with stroke survivors only (n=7), family members only (n=12) and both stroke survivors and family members (n=11). Qualitative analysis suggested participants wanted psychoeducation about cognitive impairment, including recovery expectations, treatment/therapy options and signposting to services/resources available. Hopeful information was important. Factors potentially impacting cognition-related psychoeducation needs were identified as time since stroke and family member relationship. Most articles focused on aphasia with very few studies considering other cognitive domains (eg, memory, attention, executive function).

Conclusions

The need for psychoeducation regarding cognition is well evidenced throughout the post-stroke care continuum, though most research has focused on language impairments. Further research investigating other cognitive impairments (eg, impairments in memory, attention and executive function) is required.
What is the current scope of research assessing patients’ and clinicians’ perspectives on clozapine treatment? A comprehensive scoping review
Authors: Jakobsen Michelle Iris , Schaug Julie Perrine , Storebø Ole Jakob , Austin Stephen F , Nielsen Jimmi , Simonsen Erik
Published: January 2025

Objectives

Clozapine is continuously underused. The existing systematic reviews addressing barriers to clozapine prescribing primarily focus on clinical staff’s attitudes and perceived barriers to prescribing. However, a preliminary literature search revealed additional literature on the subject not previously included in systematic reviews, including literature on patient perspectives. A scoping review is warranted to map the scope of primary studies on patients’ and/or clinicians’ perspectives on clozapine treatment and to identify gaps in research.

Design

A scoping review was designed and reported in accordance with established guidelines for scoping reviews.

Data sources

The electronic databases Cochrane Library, CINAHL, Web of Science, PsycINFO, MEDLINE, EMBASE, Google Scholar and two grey literature databases were searched. Furthermore, citation tracking of selected studies was undertaken.

Eligibility criteria

We included primary, empirical studies reporting clinicians’ and/or patients’ perspectives on clozapine treatment. No limitation was set for the year of publication or type of primary study.

Data extraction and synthesis

Two researchers independently screened for studies, extracted the data and coded the content. Findings were summarised visually and narratively.

Results

146 studies were included. Most studies reported on patients’ or clinicians’ perspectives on active clozapine treatment or on clinicians’ perspectives on barriers to clozapine initiation in general. Three gaps in research were identified: (1) clozapine-eligible, yet clozapine-naïve, patients’ attitudes towards clozapine commencement, (2) clinicians’ reasons for clozapine withholding and perceived facilitators of clozapine treatment in specific patient-cases and (3) patient and clinician perspectives on clozapine discontinuation, continuation and rechallenge in specific patient cases.

Conclusions

Research on clozapine perspectives tends to repeat itself. Future studies addressing the identified gaps in evidence could provide the insights needed to optimise clozapine utilisation.
Association of preoperative blood biomarkers with postoperative major adverse cardiac events and mortality in major orthopaedic surgery: a systematic review and meta-analysis
Authors: Ren Yi , Wen Zhenghao , Zhou Suzhen , Lu Lin , Hua Zhen , Sun Yanxia
Published: January 2025

Objective

The association between preoperative blood biomarkers and major adverse cardiac events (MACEs) as well as mortality after major orthopaedic surgery remains unclear. This study aimed to assess the association between preoperative blood biomarkers and postoperative MACEs as well as all-cause mortality in patients undergoing major orthopaedic surgery.

Design

A systematic review and meta-analysis.

Data sources

PubMed, EMBASE, the Cochrane Controlled Trials Register and Cochrane Database of Systematic Reviews from inception to 20 October 2024 were searched.

Eligibility criteria

Observational or experimental studies reporting the correlation between preoperative blood biomarkers and postoperative MACEs—categorised as short-term (within 3 months) or long-term (beyond 3 months)—and all-cause mortality in patients undergoing major orthopaedic surgery.

Data extraction and synthesis

Data from studies reporting OR or HR and its 95% CI were pooled for analysis using random-effects model.

Results

21 preoperative blood-based biomarkers from 80 studies with 226 468 patients were analysed. Elevated preoperative cardiac biomarkers were correlated with a heightened risk of MACEs within 3 months (natriuretic peptide: OR 3.37, 95% CI 2.07 to 5.47, I2=87.9%; cardiac troponin: OR 4.89, 95% CI 1.52 to 15.75, I2=69.5%) with significant heterogeneity. Only natriuretic peptide was associated with a high-risk long-term MACEs (>3 months) (OR 3.52, 95% CI 1.73 to 7.17, I2=86.2%). In contrast, cardiac biomarkers were not identified as having prognostic value for all-cause mortality in this patient cohort. Additionally, an increased risk of all-cause mortality was associated with preoperative abnormal levels of albumin (OR 1.15, 95% CI 1.06 to 1.24, I2=84.8%), creatinine (OR 1.54, 95% CI 1.12 to 1.95, I2=0), 25(OH)D (OR 1.58, 95% CI 1.01 to 2.14, I2=0) and glomerular filtration rate (GFR) (OR 1.12, 95% CI 1.06 to 1.17, I2=0), rather than cardiac biomarkers.

Conclusions

The study proposed that cardiac biomarkers assessed before surgery could offer prognostic insight into short-term MACEs, while preoperative abnormal levels of albumin, creatinine, 25 (OH)D and GFR might be prognostic valuable for all-cause mortality following major orthopaedic surgery.

PROSPERO registration number

CRD42022352091.
Rationale and design for the thoracic Paravertebral Adjunctive Dexamethasone Palmitate Reducing chronic pain After cardiac surgery (PANDORA) trial: a parallel-group, double-blinded, randomised controlled, single-centre study
Authors: Zhang Hui , Zhang Taoyuan , Zheng Ziyu , Gao Jiao , Gao Baobao , Hou Lihong , Zhao Jing , Wang Lini , Dong Hailong , Lei Chong
Published: January 2025

Introduction

Minimally invasive cardiac surgery (MICS) is important for enhanced recovery in cardiac surgery. However, the incidence of chronic postsurgical pain (CPSP) is high and is associated with worsened quality of recovery and life, as well as raised short-term or long-term mortality. The mechanism is not clear, and there is still a lack of safe and effective preventive measures.

Methods and analysis

The Paravertebral Adjunctive Dexamethasone Palmitate Reducing chronic pain After cardiac surgery (PANDORA) trial is a parallel-group, double-blinded, randomised controlled, single-centre study recruiting 902 participants undergoing MICS. Participants will be randomised in a 1:1 ratio to dexamethasone palmitate (D-PAL) emulsion group and dexamethasone (DSP) group. To investigate the effect of a single bolus perineural administration of D-PAL as an adjuvant treatment to a standard thoracic paravertebral block (TPVB) with ropivacaine decreases the incidence of CPSP in adult patients as compared with single bolus perineural administration of DSP combined with ropivacaine in TPVB. The primary endpoint is the incidence of chronic postoperative pain at 3 months following surgery defined as per the updated International Classification of Diseases. CPSP is defined as a new development of pain or increase in the intensity of pain at the surgical area or projected onto the innervation area of a nerve in this area after a surgical procedure that persists for at least 3 months. The nature and intensity of pain will be evaluated with a Brief Pain Inventory Short Form (BPI-SF) questionnaire.

Ethics and dissemination

The trial was approved by the Ethics Committee of Xijing Hospital, the First Affiliated Hospital of Air Force Military Medical University (KY20232194-C-1). Results will be submitted for publication in peer-reviewed journals and presented at academic meetings.

Trial registration number

ClinicalTrials.gov,NCT05920967.
Adaptive coping mechanisms use and associated factors among adult glaucoma patients attending the University of Gondar Comprehensive Specialized Hospital, Tertiary Eye Care and Training Center, Northwest Ethiopia: an institution-based cross-sectional study
Authors: Geremew Bisrat Misganaw , Sisay Mahtot Leykun , Alemayehu Biruk Fanta , Melese Woretaw Endalew , Mekonenne Abebe Tilahun , Birhan Getenet Shumet , Eticha Biruk Lelisa
Published: January 2025

Objective

Adaptive coping mechanisms (ACMs) are effective ways to cope with stress and anxiety in patients with chronic illnesses, such as glaucoma. This study aimed to assess the proportion of ACM and associated factors among adult glaucoma patients enrolled at the tertiary eye care and training centre in Northwest Ethiopia.

Design

An institution-based cross-sectional study.

Setting

This study was conducted at a tertiary eye care and training centre in Northwest Ethiopia from 15 May 2022 to 30 June 2022.

Participants

The study included a sample of 398 adult glaucoma patients selected using a systematic random sampling technique.

Primary and secondary outcome measures

The participants were diagnosed with glaucoma by ophthalmologists. Optometrists conducted interviews, reviewed medical records and administered a pretested, structured questionnaire based on the Brief Coping Orientation to Problems Experienced inventory. Binary logistic regression was performed to identify associated factors, with significance considered at a p<0.05 and 95% CI.

Results

The prevalence of ACM use among glaucoma patients was 45.7% (95% CI 41.2% to 50.3%). Factors significantly associated with ACM included urban residence (adjusted OR, AOR 2.57, 95% CI 1.25 to 5.28), higher average family monthly income (AOR 3.83, 95% CI 1.37 to 10.70), moderate to severe visual impairment (AOR 2.24, 95% CI 1.06 to 4.74), duration of diagnosis between 11 and 16 months (AOR 3.94, 95% CI 1.84 to 8.44) and more than 24 months (AOR 3.75, 95% CI 1.59 to 8.81) and the presence of ocular comorbidities (AOR 4.28, 95% CI 2.28 to 8.05).

Conclusions

About half of adult glaucoma patients used ACM to manage their condition. Older age, urban residence, higher average family monthly income, moderate to severe visual impairment and the presence of ocular comorbidities were significantly associated with ACM. Implementing an integrated approach that incorporates biopsychosocial strategies aimed at reducing ACM and promoting the adaptive one is essential.
Comparative effects of dual-task training versus combined exercise training in water and on land on patients with multiple sclerosis: a study protocol of a randomised factorial trial
Authors: Nazary Soltan Ahmad Sahar , Shojaedin Seyed Sadredin , Tazji Mehdi Khaleghi
Published: January 2025

Introduction

People with multiple sclerosis (PwMS) experience cognitive and motor impairments, including cognitive training and exercise training. This study compares dual task and combined exercise training in water and on land. Water-based training may enhance cognitive and motor function more effectively than land-based training, presenting a promising intervention for PwMS. We explore dual-task training (DTT), including cognitive and motor exercise, with combined exercise in water and on land on the cognition, balance and gait PwMS.

Methods and analysis

This is a double-blind 3*2*2 factorial randomised trial. Participants will be randomly allocated to one of six groups: four intervention groups and two control groups. All patients will receive supervised 12-week training sessions, two times per week, and will be assessed by a blinded outcome assessor before and at the end of the 12-week programme. The primary outcome includes the Symbol Digit Modalities Test. The secondary outcomes involve the California Verbal Learning Test-II, the Brief Visuospatial Memory Test—Revised, kinetics and kinematics throughout the balance and gait cycle. All the data will be analysed by a blinded data analyst.

Ethics and dissemination

Ethical approval was granted by the Sports Science Research Institute (No. IR.SSRC.REC.1401.082). The results of the trial will be submitted for publication in journals and distributed to PwMS and physiotherapists.

Trial registration number

The trial is prospectively registered on 22 March 2024, athttps://www.umin.ac.jp/with an identification number (UMIN000053947).
Healthcare-seeking delays and associated factors among immigrant patients with acute ischaemic stroke in Shenzhen: a retrospective observational study
Authors: Li Changyu , Wu Zongbi , Jiang Youli , Zhao Qingshi , Li Yanfeng
Published: January 2025

Objective

To examine healthcare-seeking delays among immigrant patients with acute ischaemic stroke (AIS), identifying key factors contributing to these delays and proposing evidence-based interventions for policy formulation and research.

Design

A retrospective observational study analysing healthcare-seeking behaviours and delay times among immigrant patients with AIS treated at the Department of Neurology, Longhua District People’s Hospital, Shenzhen, from December 2021 to October 2023. The study included 1356 patients with AIS, all part of the immigrant population as defined by Shenzhen Statistical Yearbook criteria. The study investigated sociodemographic, clinical data and stroke-specific scales (modified Rankin Scale, National Institutes of Health Stroke Scale, Glasgow Coma Scale) to identify factors influencing delays.

Setting

The study was conducted in Shenzhen, a city characterised by a significant immigrant population, providing insights applicable to urban regions with similar demographics.

Results

Of the 1356 patients studied, 82.6% (n=1120) experienced healthcare-seeking delays, with a median delay of 12.67 hours (IQR: 3.5–28.8). Factors associated with prolonged delays included lack of stroke awareness (92.96% delay rate), low educational attainment, self-transportation to the hospital (adjusted OR (aOR): 2.36, 95% CI: 1.57 to 3.54) and wake-up strokes (aOR: 4.37, 95% CI: 2.28 to 8.36). Conversely, factors associated with shorter delays included cardioembolic strokes (aOR: 0.50, 95% CI: 0.28 to 0.90) and atrial fibrillation (aOR: 0.45, 95% CI: 0.23 to 0.89). Delay rates were significantly lower among patients referred by emergency medical services compared with those self-transporting. These findings highlight the influence of clinical, socioeconomic and demographic factors on delays in seeking care.

Conclusion

Healthcare-seeking delays in stroke care among immigrants, shaped by awareness, socioeconomic and clinical factors, necessitate urgent educational, policy and healthcare reforms. Enhancing early symptom recognition and promoting emergency service utilisation are essential for improving access to care and outcomes in this vulnerable group.
Cohort profile: Swedish families of the 1990s (SWIFT90)
Authors: Straatmann Viviane S. , Rajesh Tanishta , Jackisch Josephine , Almquist Ylva B.
Published: January 2025

Purpose

The Swedish Families of the 1990s (SWIFT90) is a population-based national register cohort that follows everyone born between 1990 and 1999, their parents and siblings. The cohort was set up primarily to investigate factors associated with biological parents’ involvement with child welfare services and their outcomes following child(ren) placement in out-of-home care (OHC) under the research project ‘Drivers of inequalities of families involved in child welfare services (DRIVERS)’.

Participants

This cohort is defined as families consisting of parents and their children, of which at least one was born between 1990 and 1999 in Sweden, which totals 1 075 037 children. The children are linked to both (adoptive or biological) parents and their siblings, so the total number of individuals in the SWIFT90 yields a total sample of n=3 292 417. These families are followed through multiple national registers including information on income, education, inpatient care, mortality and criminal offences. SWIFT90 compiles administrative data spanning from 1960 to 2022, which reflects the most recent data available at the time of the data request.

Findings to date

SWIFT90 provides information on 61 982 parents (fathers=31 028; mothers=30 954) with children placed in OHC and their respective children (38,084). Several covariates could be assessed for the parental generation, therefore, providing a comprehensive picture of socioeconomic and health-related aspects of families with children born in the 1990s and placed in OHC in Sweden.

Future plans

SWIFT90 will be used to investigate the socioeconomic and health trajectories of families involved with the child welfare system. With this cohort study ia possible to examine whether the inclusion of certain covariates alters the association between parental characteristics and child welfare outcomes. Future studies could also guide initiatives to prevent vulnerable circumstances among biological parents from escalating to the point where child placement into OHC becomes necessary. Additionally, they could help enhance the conditions of biological families and support opportunities for reunification after placement has occurred.
Association between the intensity of statin therapy and physical activity 1 year after acute coronary syndrome: a multicentre prospective cohort study in Switzerland
Authors: Boudon Alex , Locatelli Isabella , Gencer Baris , Carballo David , Klingenberg Roland , Räber Lorenz , Windecker Stephan , Rodondi Nicolas , Lüscher Thomas , Matter Christian M , Mach François , Muller Olivier , Nanchen David
Published: January 2025

Objectives

To assess the association between the intensity of statin therapy and the level of physical activity in patients 1 year after an acute coronary syndrome (ACS).

Design

Prospective cohort study from the Special Program University Medicine-Acute Coronary Syndromes.

Setting

Four university hospital centres in Switzerland.

Participants

2274 patients with a main diagnosis of ACS between 2009 and 2017 who were available for a 1-year follow-up visit 1 year after hospital discharge.

Outcome measures

Self-reported physical activity was assessed with the International Physical Activity Questionnaire. The level of physical activity in metabolic equivalent-minutes per week (MET-min/week) was first stratified into sedentary and physically active categories and then analysed continuously among physically active patients. Analyses were performed using a propensity score weighting approach.

Results

One year after ACS, 1222 (53.7%) patients were on high-intensity statin therapy, 890 (39.1%) were on low/moderate-intensity statin therapy and 162 (7.1%) were not on statin therapy. Compared with non-statin users, low-/moderate-intensity statin users and high-intensity statin users were more likely to be physically active than sedentary, with a fully adjusted OR of 2.86 (95% CI 1.12 to 7.26) and 4.52 (95% CI 1.68 to 12.20), respectively. Among physically active patients, physical activity level was similar across all statin user categories, with median levels of 2792.5, 2712.0 and 2839.5 MET-min/week in non-statin, moderate/low-statin and high-statin users, respectively (p=0.307).

Conclusions

One year after ACS, neither low-/moderate-intensity nor high-intensity statin uses were associated with reduced self-reported physical activity compared with non-statin use. The concern that statin therapy may impair physical activity among ACS patients was not confirmed in this study.
Development and external validation of the SMA2SH2ERS risk prediction model for aneurysmal subarachnoid haemorrhage in the general population: a population-based prospective cohort study
Authors: Klieverik Vita M. , Kanning Jos P. , Rissanen Ina L. , Rannikmae Kristiina , Martinsen Amy E. , Winsvold Bendik S. , Geerlings Mirjam I. , Ruigrok Ynte M.
Published: January 2025

Objectives

Aneurysmal subarachnoid haemorrhage (ASAH) is a severe stroke type, preventable by screening for intracranial aneurysms followed by treatment in high-risk individuals. We aimed to develop and validate a risk prediction model for ASAH in the general population to identify high-risk individuals.

Design

We used the population-based prospective cohort studies of the United Kingdom (UK) Biobank for model development and the Trøndelag Health (HUNT) Study for model validation.

Participants

Participants missing data were excluded. A total of 456 856 individuals from the UK Biobank and 46 483 individuals from the HUNT Study were included.

Primary and secondary outcome measures

Incident ASAH identified using the International Classification of Diseases codes, ICD-9 430 and ICD-10 I600 to I609 codes.

Results

In the development cohort, ASAH occurred in 738 (0.2%) during 5 407 909 person-years of follow-up. We developed a multivariable Cox regression model to identify predictors for ASAH. Predictive performance was assessed using discrimination and calibration, and we corrected for overfitting using bootstrapping techniques. Predictors for ASAH were sex (S), diabetes mellitus (M), age and alcohol consumption (A2), smoking (S), hypertension and hypercholesterolaemia (H2), educational attainment (E), regular physical activity (R) and family history of stroke (S; SMA2SH2ERS), and multiple interactions between these predictors. The concordance statistic (c-statistic) of the model in the development cohort was 0.62 (95% CI 0.60 to 0.64). Predicted absolute 10-year ASAH risk varied from 0.042% to 0.52%. In the validation cohort, 220 individuals developed ASAH, and the c-statistic of this model was 0.64 (95% CI 0.58 to 0.69). Both models showed reasonable calibration.

Conclusions

Our SMA2SH2ERS model provides ASAH risk estimates between 0.042% and 0.52% for the general population. While overall ASAH risk is low, the model identifies individuals with up to 12 times increased risk compared with those at the lowest risk.
Effect of metformin on the clinical outcomes of stroke in patients with diabetes: a systematic review and meta-analysis
Authors: Liu Jianyi , Huang Zhihua , Luo Fuqun , Guo Yizhi , Li Yandeng , Wen Jun , Zhu Jianming
Published: January 2025

Objectives

Stroke is a major cause of death and disability globally, especially among diabetic patients. In this study, we aim to scrutinise the effects of metformin on the clinical outcomes of stroke in diabetic patients.

Design

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources

PubMed, Embase and Web of Science databases were searched between their inception and 5 December 2023.

Eligibility criteria for selecting studies

Studies investigating the effect of metformin on the clinical outcomes of stroke in patients with diabetes were included.

Data extraction and synthesis

The effect of metformin on the clinical outcomes of stroke in patients with diabetes was identified using combined ORs and 95% CIs.

Results

A total of 11 studies involving 18 525 participants were included in this review. Pooled analysis has demonstrated that prestroke metformin use could reduce the probability of poor course after stroke by 34% in diabetes mellitus (DM) patients (OR=0.66, 95% CI: 0.61 to 0.72) and reduce the probability of death by 43% (OR=0.57, 95% CI: 0.51 to 0.64).

Conclusions

Prestroke metformin use is beneficial for the improvement of clinical outcomes in patients who had a stroke with DM, although the potential bias should be carefully considered.

PROSPERO registration number

CRD42024496056.
Subnational trends and inequalities of under-immunisation and zero-dose among children aged 12–23 months in Uganda: a national population-based cross-sectional study
Authors: Wasswa Ronald , Kananura Rornald Muhumuza , Waiswa Peter , Requejo Jennifer Harris , Santos Thiago M , Barros Aluisio J D
Published: January 2025

Objective

Despite the Global Vaccine Action Plan’s goal of at least 90% vaccine coverage for all children, Uganda has made limited progress in vaccination over the past decade. The objective of this study was to examine the subnational trends in the prevalence and inequalities in under-immunisation and zero-dose among children aged 12–23 months in Uganda.

Study design

A retrospective national cross-sectional study.

Setting

Uganda

Participants

Uganda Demographic and Health Survey secondary data of only children aged 12–23 months. The samples selected for analyses were 1507 in 2006, 1409 in 2011 and 2650 children in 2016.

Outcome measure

The primary outcomes were under-immunisation and zero-dose vaccination.

Absolute and relative inequality measures were used in the analysis.

Results

From 2006 to 2016, the under-vaccination rate decreased by 21%, but remained high at 40.8%. The zero-dose vaccination rate dropped by 82%, affecting 1.2% of children in 2016. Subnational inequalities in under-vaccination increased over time with widening gaps between regions. While inequalities across wealth quintiles, maternal education levels and places of residence narrowed, children of mothers with lower education levels continued to have the highest under-vaccination rates. The rural–urban gap for zero-dose vaccination remained unchanged, with rural children disproportionately impacted.

Conclusion

While some progress was made in reducing under-vaccination rates in Uganda within the study period, no region achieved an under-vaccination rate below 20%. This indicates significant challenges in reaching the Sustainable Development Goal target of at least 80% immunisation coverage. Targeted interventions are necessary to improve healthcare access, enhance public health communication and strengthen the health system, particularly in underserved communities and among vulnerable populations.
Experiences and opinions of adults with type 1 diabetes on the android-based open-source closed-loop system in China: a qualitative study
Authors: Huang Qingying , Ni Ying , Lei Mengyun , Ling Ping , Yan Jinhua , Guo Xiaodi , Yang Daizhi , Wang Chaofan
Published: January 2025

Objective

As an emerging technology, Android-based open-source closed-loop system also called Android Artificial Pancreas System (AAPS), has been increasingly validated by evidence for its effectiveness in improving glycaemic outcomes, positioning it as a crucial option for managing type 1 diabetes (T1D). However, there are still only a few studies examining the experiences of using AAPS, and relevant qualitative studies have not been conducted in Asia so far. This study aimed to explore the experiences and opinions of adult patients with T1D on the AAPS.

Design

Semi-structured interviews and the Insulin Dosing Systems: Perceptions, Ideas, Reflections and Expectations questionnaires were conducted among patients. The questionnaire was scored on a 100-point scale. Thematic analysis was adopted to analyse the transcribed text. Recruitment of interviewees would be halted when no new themes emerged. The scores of the questionnaire on AAPS satisfaction were calculated, and the Mann-Whitney U test was used to compare the results of different sections of the questionnaire.

Setting

Guangdong Province in China.

Participants

This study recruited patients with T1D from the Guangdong T1D translational medicine study and the ‘Tang Tang Quan’ T1D online community in China, who participated in a clinical trial on the efficacy and safety of AAPS.

Results

The study interviewed 20 adults with T1D aged 32±9.94 years. The T1D duration was 10.93±6.26 years and the glycated haemoglobin was 7.38±0.53%. Five main themes were identified: (1) expectations and feedback on AAPS; (2) impact on quality of life; (3) impact on blood glucose management; (4) user experiences; (5) suggestions for AAPS. The average score of AAPS satisfaction was 73.69 (65.94, 85.94). Mann-Whitney U test suggested that the satisfaction derived from glucose management with AAPS surpassed the satisfaction attributed to the enhancement of their overall quality of life (p<0.05).

Conclusions

Adults with T1D had generally positive experiences with AAPS. The future focus of AAPS research and development should be on optimising glycaemic management, improving device experience and reducing costs.

Trial registration number

NCT05726461; Pre-results
.
Passive Heat Therapy for Cardiovascular Disease: Current Evidence and Future Directions
Authors: Rodrigues Saniya , O'Connor Fergus , Morris N. , Chaseling Georgia , Sabapathy Surendran , Bach Aaron
Published: January 2025

Passive heat therapy is gaining popularity as an intervention to promote cardiovascular, physiological, and to a lesser degree, thermoregulatory, adaptations in patients with cardiovascular disease. Despite this, the efficacy of heat therapy to elicit these adaptations remains unknown. We searched 5 databases for original research, screening 2,913 studies and identifying 18 eligible studies. Heat therapies included Waon therapy, balneotherapy, water perfused trousers, Finnish sauna, and foot immersion. Interventions were administered across various time frames (20- to 90-min) and performed 3 to 7 times per week, for durations of 2- to 8-weeks. The studies collectively involved a diverse population (mean age: 67 (10) years) with cardiovascular diseases. Heat therapy was consistently shown to improve ejection fraction, flow-mediated dilation, brain natriuretic peptide levels, New York Heart Association classification, and six-minute walk distance. However, positive effects on resting heart rate and blood pressure were infrequently observed, and thermoregulatory responses scarcely reported. Heat therapy may increase sweat rate during heat exposure and reduce resting core temperature, but adaptive skin blood flow responses were not observed. Passive heat therapy shows promising utility in patients with cardiovascular disease, while secondary benefits such as markers of thermoregulatory adaptation may also be observed, these require further investigation.
Risk of imidacloprid to soil invertebrates when applied as basal bark spray for the control of Hemlock Woolly Adelgid
Authors: Edge Christopher , Heartz Shane , Lagalante Anthony , Lewis Andrew , Sweeney Jon
Published: January 2025

The hemlock woolly adelgid (HWA Adelges tsugae) is an invasive insect on the east coast of North America where it has resulted in the widespread death and decline of hemlock trees. In Canada the most commonly used control strategy is the application of imidacloprid-based insecticides by basal bark spray, which could pose risk to non-target species. We monitored soil concentrations 50-400 cm away from trees for 24 months post application of Xytect 2f at a rate of 0.278 g imidacloprid/cm DBH and conducted a preliminary risk characterization by calculating Risk Quotients (RQ) for soil invertebrates derived from species sensitivity distributions build from No Observed Effect Concentrations (NOEC) and EC50 values. Imidacloprid was detected in 58.3–96.8% of samples at 50 and 100 cm and 8.3–45.8% at 200 and 400 cm from treated trees. The RQ values exceeded 1 at all times 50 cm from the tree for the median exposure, and at all distances and times for the upper 95% CI exposure. The frequency that RQ’s exceeded 1 declined with distance from tree at all time periods and declined over time at 50 and 100 cm from treated trees, but not at 200 and 400 cm. Overall, the highest risk to non-target soil invertebrates from basal bark application of imidacloprid occurs within 200 cm of treated trees.
Tracing metal sources and groundwater flow paths in the Upper Animas River watershed using rare earth elements and stable isotopes
Authors: Newman Connor P. , Cowie Rory , Wilkin Richard T. , Navarre-Sitchler Alexis
Published: January 2025

Groundwater flow paths and processes that govern metal mobility and transport are difficult to characterize in mountainous bedrock watersheds. Despite the difficulty in holistic characterization, conceptual understanding of subsurface hydrologic and geochemical processes is key to developing remediation plans for locations affected by acid mine drainage, such as the Upper Animas River watershed in southwestern Colorado, USA. Stable isotopes of water and rare earth elements were utilized to evaluate groundwater flow and metal sources within this complex catchment. Stable isotope samples collected from draining mine adits and springs display systematic spatial variation wherein sample sites at higher elevations have greater seasonal variability than sites at lower elevations. The Upper Cement Creek watershed, where multiple draining mines are present, displays the lowest seasonal variation in stable isotopic signatures, potentially indicating the presence of a large, well-mixed volume of groundwater storage or interbasin groundwater flow. Rare earth elements display statistically significant variation between different alteration styles in the catchment. Overprinting of regional propylitic alteration is evident based on enrichment of middle rare earth elements in acidic springs and mines that are not spatially associated with surficial exposures of acid generating alteration styles. Europium anomaly and middle rare earth enrichment signatures from two flooded mine tunnels on opposite sides of a watershed divide indicate connections to the same subsurface flooded mine workings.