bluuebunny/crossref_metadata_2025 huggingface dataset:
Revision of Recurrent Hallux Valgus Deformity Using a Percutaneous Distal Transverse Osteotomy: Surgical Considerations and Mean 3.6 Year Results
Authors: Lewis Thomas L. , Ray Robbie , Murphy Evelyn , Chua Min Jia , Watt Clare , Lam Peter
Published: December 2024

Category:

Bunion; Lesser Toes

Introduction/Purpose:

Hallux Valgus (HV) is a common forefoot deformity that can cause pain and difficulty with walking. There are a range of surgical techniques to treat HV deformity, but there is a risk of recurrence. This paper reviews the clinical assessment and management of recurrent HV as well as a detailed description of how percutaneous surgical techniques can be used to treat recurrent HV. This paper identifies technical challenges of percutaneous HV surgery for recurrent HV deformity as well as strategies to address and mitigate these.

Methods:

This was a multicenter retrospective review of adult patients who had recurrent hallux valgus deformity (defined as hallux valgus angle>15° and having previously undergone primary surgical intervention for HV deformity correction) who were treated with a percutaneous metatarsal extra-capsular transverse osteotomy (META) technique between 5/12/2013 and 8/1/2022, with at least one year of follow-up data. Demographic information, hallux valgus angle, 1-2 intermetatarsal angle, Manchester-Oxford Foot Questionnaire (MOXFQ;validated for hallux valgus surgery), visual analog scale (VAS), and EQ-5D-5L scores were collected. All p-values < 0.05 were considered significant.

Results:

We retrospectively evaluated 34 feet from 32 patients with a mean age of 63.1±9.2 (range 41-82) who underwent revision hallux valgus surgery using a percutaneous technique. The mean follow up was 3.6±2.3 (range 0.5-8.7 years. The breakdown of index HV surgeries was: 17 Chevron, 9 Scarf/Akin, 6 medial bunionectomy, 1 Lapidus, 1 proximal rotation osteotomy. There was a statistically significant improvement in both clinical foot function and radiographic deformity after surgery. The mean hallux valgus angle decreased from 32.9±8.6° to 13.4±7.3°, and the intermetatarsal angle decreased from 12.7±3.8° degrees to 3.8±3.1°(p< 0.05). The mean MOXFQ Index score significantly improved from 49.4±23.1 to 14.6±19.4 (p< 0.05).

Conclusion:

This paper suggests that percutaneous surgical techniques using a transverse osteotomy and screw fixation can successfully treat a wide range of recurrent HV deformity severities with significant improvement in clinical and radiographic outcomes.
A brief description of the woodblock prints of the “Naxi Pictographs and Geba Script Comparative Lexicon” in the Lijiang Museum collection
Authors: Mu Chen
Published: December 2024

The woodblock prints of the “Naxi Pictographs and Geba Script Comparative Lexicon” collected by the Lijiang Museum are the only existing woodblock prints of the Naxi script, and are classified as national third-class cultural relics. These prints bear witness to a Naxi script unification movement initiated by Dongba ritualists in the Lijiang Basin during the first half of the 20th century, holding significant historical importance in the development of Naxi script. This article describes the features and contents of these woodblocks; through an investigation of the historical events related to the script unification, it corrects the dating of the woodblocks and analyzes the cultural background and deeper reasons for the interruption of this Naxi script unification movement.
Channels, Transporters, and Receptors at Membrane Contact Sites
Authors: Casas Maria , Dickson Eamonn James
Published: December 2024

Membrane contact sites (MCSs) are specialized regions where two or more organelle membranes come into close apposition, typically separated by only 10–30 nm, while remaining distinct and unfused. These sites play crucial roles in cellular homeostasis, signaling, and metabolism. This review focuses on ion channels, transporters, and receptors localized to MCSs, with particular emphasis on those associated with the plasma membrane and endoplasmic reticulum (ER). We discuss the molecular composition and functional significance of these proteins in shaping both organelle and cellular functions, highlighting their importance in excitable cells and their influence on intracellular calcium signaling. Key MCSs examined include ER–plasma membrane, ER–mitochondria, and ER–lysosome contacts. This review addresses our current knowledge of the ion channels found within these contacts, the dynamic regulation of MCSs, their importance in various physiological processes, and their potential implications in pathological conditions.
Developing a systematic fall risk assessment tool for outpatient clinics
Authors: Drees Allison , Heinlein Lewis , Yang Yushi
Published: December 2024

Background

In healthcare settings, fall incidents represent a significant public health issue and often result in severe injuries, prolonged hospital admissions, and substantial healthcare costs. Despite current fall risk reduction strategies, falls continue to be among the leading causes of sentinel events.

Objective

This study aims to identify fall risk factors present in an outpatient clinic work system and develop tools to support proactive risk mitigation.

Research Design

We introduced a systematic fall risk assessment (SFRA) tool where front-line staff can evaluate their work systems for fall risks. The tool was developed using literature review, observations, and interviews with focus groups. The tool includes step-by-step instructions for an outpatient clinic fall risk assessment, factors to consider in various settings of patient care, and guiding principles to address fall risks in an outpatient work system.

Results

This tool underwent user testing, which validated its learnability, usability, and usefulness, and was rated positively by a diverse range of clinics and roles. Our preliminary results suggested that the tool was effective in identifying potential fall risk factors of outpatient clinics, even when used by non-experts.

Conclusion

We demonstrated the effective use of human factors methods to equip front-line staff with tools to proactively evaluate outpatient clinic work systems for fall risks and develop mitigation strategies.
Assessment of reproductive knowledge among young adults utilizing Amazon mechanical Turk survey
Authors: Varnum Alexandra Aponte , Velasquez David A. , Codrington Jason , Evans Aymara , Dubin Justin M. , Ramasamy Ranjith
Published: December 2024

Background:

Reproductive health technology has evolved significantly since the introduction of in vitro fertilization in 1978, enhancing the possibility of conceiving children at later stages in life. Despite these advancements, there remains a critical gap in fertility knowledge among young adults, as demonstrated by recent studies. This gap is compounded by the growing influence of social media on health information, where misinformation can distort public understanding of fertility-related issues. Addressing this knowledge deficit is essential for empowering individuals to make informed decisions about their reproductive futures.

Objectives:

With the increasing prevalence of older individuals becoming parents and the growing reliance on Assisted Reproductive Technologies for conception, our study aimed to assess fertility knowledge among young adults.

Design:

This study employed a survey-based approach using Amazon’s crowd-sourcing marketing platform, Mechanical Turk (MTurk). Participants were asked to complete a 17-question survey that included a section on demographic information. The questionnaire explored various aspects of knowledge and perceptions regarding male and female fertility.

Methods:

The survey was completed by 983 participants aged 18–30, recruited through MTurk. Individuals outside this age range were excluded from the study. Participants received a $0.50 incentive for their participation.

Results:

Notably, a high percentage of respondents correctly identified the age range at which female fertility (70.4% of participants) declines, while fewer (56.4% of participants) demonstrated awareness of the age range at which male fertility declines. Furthermore, an overwhelming majority exhibited appropriate knowledge regarding the impact of lifestyle factors, such as obesity and smoking, on fertility. The findings suggest an encouragingly high level of awareness among participants regarding fundamental fertility concepts. Approximately 63% of participants reported social media as a source of this information.

Conclusion:

This study yields promising insights into fertility knowledge among young adults. However, it underscores a notable deficiency in understanding male fertility, emphasizing the imperative for further educational initiatives in this domain. These results also highlight the crucial role of healthcare providers in maintaining an online presence to disseminate valuable, evidence-based knowledge. By doing so, healthcare professionals can empower individuals to make informed decisions regarding fertility.
Biogenic synthesized CuO nanoparticles and 5-fluorouracil loaded anticancer gel for HeLa cervical cancer cells
Authors: Dutta Gouranga , Chinnaiyan Santhosh Kumar , Palaniyandi Thirunavukkarasu , Sugumaran Abimanyu , Narayanasamy Damodharan
Published: December 2024

Cervical cancer remains a significant health challenge in developing countries are high due to low HPV vaccination rates, delayed diagnosis, and restricted healthcare access. Metal nanomaterials, such as copper oxide (CuO) nanoparticles (NPs), have shown significant promise in cancer therapy due to their ability to induce apoptosis. 5-Fluorouracil (5-Fu) enhances the cytotoxic effect against cervical cancer, working synergistically with CuO NPs to maximize the therapeutic impact while potentially reducing the 5-Fu's systemic side effects. This study explores the synergistic therapeutic potential of green-synthesized CuO NPs combined with 5-Fu in a gel formulation for targeted anticancer activity against HeLa cervical cancer cells. CuO NPs were synthesized using Trichosanthes dioica dried seeds extract and incorporated into a pectin-xanthan gum-based gel. The green-synthesized CuO NPs exhibited a zeta potential of −23.7 mV, a particle size of approximately 26 nm, and spherical morphology. Characterization studies, including FTIR, viscosity, spreadability, pH, and stability assessments, confirmed the gel's suitability for vaginal delivery. In-vitro drug release showed xanthan gum extended the release up to 8 h. The MTT assay revealed PXFCu6 gel's IC50 at 11.82 ± 0.22 μg/mL, significantly more cytotoxic to HeLa cells, being 3.62 times potent than CuO NPs (IC50: 42.8 ± 0.24 μg/mL) and 1.63 times potent than 5-Fu alone (IC50: 19.3 ± 0.49 μg/mL). The antibacterial assay showed no inhibition for the plain gel, but T. dioica-mediated CuO NPs exhibited inhibition of 22.35 ± 4.9 mm. PXFCu6 gel had the more potent inhibition at 52.05 ± 1.37 mm against Escherichia coli growth. The PXFCu6 gel showed better stability at 4 °C, maintaining viscosity, pH, and drug release, unlike 25 °C where a mild degradation occurred. This research highlights the potential of the CuO NPs-5-Fu gel as a novel, effective therapeutic strategy for cervical cancer treatment.

Graphical abstract
A rare case of Stenotrophomonas maltophilia endogenous endophthalmitis in pediatric age group
Authors: Jain Tanya , Muralidhar Alankrita , Gandhi Arpan
Published: December 2024

Background

We report a unique case of Stenotrophomonas maltophilia-related pediatric endogenous endophthalmitis.

Case presentation

A 10-year-old male presented with redness and loss of vision in his right eye for two weeks. Clinical examination and ultrasound features were suggestive of endophthalmitis, most likely endogenous due to the absence of a history of trauma or intraocular intervention. Following vitrectomy and appropriate intravitreal antibiotics, the vision improved to 20/80. Vitreous culture revealed a gram-negative bacillus Stenotrophomonas maltophilia.

Conclusion

Timely recognition of this pathogen and management as per antibiotic sensitivity can help salvage functional vision in this condition.
LCRAnnotationsDB: a database of low complexity regions functional and structural annotations
Authors: Ziemska-Legiecka Joanna , Jarnot Patryk , Szymańska Sylwia , Błaszczyk Dagmara , Staśczak Alicja , Langer-Macioł Hanna , Lucińska Kinga , Widzisz Karolina , Janas Aleksandra , Słowik Hanna , Śliwińska Wiktoria , Gruca Aleksandra , Grynberg Marcin
Published: December 2024

Low Complexity Regions (LCRs) are segments of proteins with a low diversity of amino acid composition. These regions play important roles in proteins. However, annotations describing these functions are dispersed across databases and scientific literature. LCRAnnotationsDB aims to consolidate knowledge about LCRs and store relevant annotations in a single place. To unify redundant annotations, we assigned them categories based on similarity in function, protein structure, and biological process. Categories are organized hierarchically by linking them to Gene Ontology terms. The LCRAnnotationsDB database can be accessed at https://lcrannotdb.lcr-lab.org/.
The necessity of validity diagnostics when drawing causal inferences from observational data: lessons from a multi-database evaluation of the risk of non-infectious uveitis among patients exposed to Remicade®
Authors: Weaver James , Voss Erica A. , Cafri Guy , Beyrau Kathleen , Nashleanas Michelle , Suruki Robert
Published: December 2024

Background

Autoimmune disorders have primary manifestations such as joint pain and bowel inflammation but can also have secondary manifestations such as non-infectious uveitis (NIU). A regulatory health authority raised concerns after receiving spontaneous reports for NIU following exposure to Remicade®, a biologic therapy with multiple indications for which alternative therapies are available. In assessment of this clinical question, we applied validity diagnostics to support observational data causal inferences.

Methods

We assessed the risk of NIU among patients exposed to Remicade® compared to alternative biologics. Five databases, four study populations, and four analysis methodologies were used to estimate 80 potential treatment effects, with 20 pre-specified as primary. The study populations included inflammatory bowel conditions Crohn’s disease or ulcerative colitis (IBD), ankylosing spondylitis (AS), psoriatic conditions plaque psoriasis or psoriatic arthritis (PsO/PsA), and rheumatoid arthritis (RA). We conducted four analysis strategies intended to address limitations of causal estimation using observational data and applied four diagnostics with pre-specified quantitative rules to evaluate threats to validity from observed and unobserved confounding. We also qualitatively assessed post-propensity score matching representativeness, and bias susceptibility from outcome misclassification. We fit Cox proportional-hazards models, conditioned on propensity score-matched sets, to estimate the on-treatment risk of NIU among Remicade® initiators versus alternatives. Estimates from analyses that passed four validity tests were assessed.

Results

Of the 80 total analyses and the 20 analyses pre-specified as primary, 24% and 20% passed diagnostics, respectively. Among patients with IBD, we observed no evidence of increased risk for NIU relative to other similarly indicated biologics (pooled hazard ratio [HR] 0.75, 95% confidence interval [CI] 0.38–1.40). For patients with RA, we observed no increased risk relative to similarly indicated biologics, although results were imprecise (HR: 1.23, 95% CI 0.14–10.47).

Conclusions

We applied validity diagnostics on a heterogenous, observational setting to answer a specific research question. The results indicated that safety effect estimates from many analyses would be inappropriate to interpret as causal, given the data available and methods employed. Validity diagnostics should always be used to determine if the design and analysis are of sufficient quality to support causal inferences. The clinical implications of our findings on IBD suggests that, if an increased risk exists, it is unlikely to be greater than 40% given the 1.40 upper bound of the pooled HR confidence interval.
Cognitive functioning in children and adolescents with cerebral palsy: protocol for the Danish CPCog-Youth study
Authors: Uhre Camilla Funch , Caspersen Ida Dyhr , Lose Carsten , Rackauskaite Gija , Robotham Ro , Hoei-Hansen Christina E.
Published: December 2024

Background

Many children and adolescents with cerebral palsy (CP) experience cognitive difficulties, impacting their academic, social, and emotional well-being. A Danish study from 2023 revealed that merely 40% of individuals with CP complete their elementary school education, and previous neuropsychological studies have found that most children and adolescents with CP experience cognitive difficulties. Yet, cognitive functioning is often assumed rather than assessed, and CP follow-up programs focus predominantly on physical functioning. Recognizing this gap, we aim to investigate cognitive functioning in children and adolescents with CP in mainstream schools in Denmark, using standardized neuropsychological tests. Our objective is to provide valuable insights to guide clinical practice on cognitive assessment and intervention, ultimately fostering a more effective support system for individuals with CP.

Methods

The study employs a cross-sectional design, involving 100 children and adolescents with CP aged 11–15 years attending mainstream schools in Denmark. Cognitive assessment includes the core battery from a proposed Nordic test protocol for children and adolescents with CP – the CPCog – encompassing general cognitive functioning (intelligence), executive functions, and visuo-motor skills. Supplementary tests cover verbal and nonverbal short-term memory, attention, fatigue, and mental health. The assessment protocol will also be evaluated by parents of participating children and adolescents with CP. The project is conducted collaboratively by the neuropsychological teams at three assessment sites, in conjunction with the Center for Cerebral Palsy, Rigshospitalet, Aarhus University Hospital, and Aalborg University Hospital. The study benefits from an external advisory board comprising leading international CP experts.

Discussion

Cognitive difficulties in children and adolescents with CP are often overlooked. Few cognitive studies exist, with some providing only estimated cognitive functioning. The CPCog-Youth study will help advance our understanding of the cognitive challenges experienced by children and adolescents attending mainstream schools. The findings will contribute to the development of targeted cognitive assessment and intervention programs for individuals with CP, addressing this commonly neglected aspect of care. By also seeking feedback from participating families and the involved neuropsychologists, we aim to investigate whether the proposed cognitive assessment is feasible and beneficial in real-world settings.

Trial registration

The study was registered on ClinicalTrials.gov on June 27, 2023 (ID: NCT05921422).
Onset and predictors of first-line antiretroviral therapy treatment failure among children in Ethiopia: a systematic review and meta-analysis
Authors: Birhanu Molla Yigzaw , Bekele Getamesay Molla , Endalew Bekalu , Alemu Simegn , Lashargie Cheru Tesema , Birhanu Dereje Ayalew , Mulualem Assefa , Jemberie Selamawit Shita
Published: December 2024

Introduction

The emergence of First-line Antiretroviral Therapy (ART) regimens fails; it necessitates the use of more costly and less tolerable second-line medications. Therefore, it is crucial to identify and address factors that increase the likelihood of first-line ART regimen failure in children. Although numerous primary studies have examined the incidence of first-line ART failure among HIV-infected children in Ethiopia, national-level data on the onset and predictors remain inconsistent. Hence, this study was conducted to fill the gaps in determining the onset of first-line ART failure and its predictors among HIV-infected children in Ethiopia.

Methods

Articles related to our topic of interest were searched using a systematic approach in national and international electronic databases. The retrospective follow-up cohort studies published in English up to 2022 were included. The data were extracted using a Microsoft Excel spread sheet and exported into Stata™ Version 17.0 for further management and analysis. The level of heterogeneity was quantified using I2 test together with a 95% confidence interval (CI). The incidence of the primary estimates was estimated using a random effects model in the Dersimonian-Lairedmethod. Subgroup analysis, Meta regression, and sensitivity analysis were computed to identify the source of heterogeneity but not explained. The predictors of first-line ART failure were explained using relative risk (RR) with 95% confidence interval (CI).

Results

Ten studies having a total of 5446 children were included. The pooled onset of first-line ART failure was 3.18 (95% CI: 1.91, 4.44) per 100 child-years of observations. Those study participants who began ART at an advanced WHO clinical stage at ART initiation had a 3.05 (95% CI: 1.47, 6.36), having poor ART adherence had a 2.19 (95% CI: 1.29, 3.70), and having TB-HIV coinfection at ART initiation had a 1.43 (95% CI: 1.06, 1.94) times higher chance of experiencing first-line ART failure than their corresponding counterparts.

Conclusion

The onset of first-line ART failure was high to achieve the 2030 UNAIDS target of ending the AIDS epidemic. Advanced WHO clinical stage, poor first-line ART adherence, and having TB-HIV coinfection were identified predictors. Hence, community HIV screening should continue to strengthen early ART initiation, and the attention of ART adherence should be kept to achieve ending the AIDS epidemic. The baseline tests and diagnosis, like TB diagnosis should be maintained for HIV-infected children while they begin ART.
Particular vulnerability of patients with borderline personality disorder during the COVID-19 pandemic – a retrospective chart review
Authors: Kippe Yann David , Gutwinski Stefan , Adam Maia , Finck Anna , Schouler-Ocak Meryam , Goldschmidt Thomas
Published: December 2024

Background

Mental health consequences of the COVID-19 pandemic have been a major research focus since its beginning. A specific vulnerability of patients with borderline personality disorder (BPD) following social distancing measures has been reported, however there is a lack of adequately sized studies that provide evidence of this vulnerability. Suicide attempts may reflect mental health effects of the COVID-19 pandemic in psychiatric settings.

Methods

Retrospective follow-up analysis of clinical documentation in a psychiatric emergency department (pED) of a major academic psychiatric hospital in Berlin, Germany. Observation periods include the first- (3/2/2020–5/24/2020) and second-wave (9/15/2020–3/1/2021) of the COVID-19 pandemic in Germany and respective periods one year earlier as control-periods. Poisson-regression was used for statistical modelling of individual counts of pED presentations after a suicide attempt.

Results

N = 4110 patients attended the pED during the four observation periods. BPD patients were associated with elevated risk of pED presentation after a suicide attempt during COVID-periods (RR = 3.4; p = .014). Schizophrenia and psychotic disorders showed lower risk of pED presentation after a suicide attempt during COVID-periods (RR = 0.4; p = .048). Other diagnostic groups did not show significant interaction effects with COVID-periods. The first-wave was a risk factor for pED presentation after a suicide attempt affecting the sample across all diagnostic groups (RR = 3.1; p = .006).

Conclusions

BPD patients seem to be particularly vulnerable during the COVID-19 pandemic showing increased rates of suicide attempts during both COVID-periods. This should be addressed in future health crises by ensuring availability of psychosocial help. There is a need for further research regarding BPD patients in public health crisis situations.
Reusing routine electronic health record data for nationwide COVID-19 surveillance in nursing homes: barriers, facilitators, and lessons learned
Authors: Wieland-Jorna Y , Verheij RA , Francke AL , Coppen R , de Greeff SC , Elffers A , Oosterveld-Vlug MG
Published: December 2024

Background

At the beginning of the COVID-19 pandemic in 2020, little was known about the spread of COVID-19 in Dutch nursing homes while older people were particularly at risk of severe symptoms. Therefore, attempts were made to develop a nationwide COVID-19 repository based on routinely recorded data in the electronic health records (EHRs) of nursing home residents. This study aims to describe the facilitators and barriers encountered during the development of the repository and the lessons learned regarding the reuse of EHR data for surveillance and research purposes.

Methods

Using inductive content analysis, we reviewed 325 documents written and saved during the development of the COVID-19 repository. This included meeting minutes, e-mails, notes made after phone calls with stakeholders, and documents developed to inform stakeholders. We also assessed the fitness for purpose of the data by evaluating the completeness, plausibility, conformity, and timeliness of the data.

Results

Key facilitators found in this study were: 1) inter-organizational collaboration to create support; 2) early and close involvement of EHR software vendors; and 3) coordination and communication between partners. Key barriers that hampered the fitness of EHR data for surveillance were: 1) changes over time in national SARS-CoV-2 testing policy; 2) differences between EHR systems; 3) increased workload in nursing homes and lack of perceived urgency; 4) uncertainty regarding the legal requirements for extracting EHR data; 5) the short notice at which complete and understandable information about the repository had to be developed; and 6) lack of clarity about the differences between various COVID-19 monitors.

Conclusions

Despite the urgent need for information on the spread of SARS‐CoV‐2 among nursing home residents, setting up a repository based on EHR data proved challenging. The facilitators and barriers found in this study affected the extent to which the data could be used. We formulated nine lessons learned for developing future repositories based on EHR data for surveillance and research purposes. These lessons were in three main areas: legal framework, contextual circumstances, and quality of the data. Currently, these lessons are being applied in setting up a new registry in the nursing home sector.
Diagnostic accuracy of metagenomic next-generation sequencing in pulmonary tuberculosis: a systematic review and meta-analysis
Authors: You Yajie , Ni Ying meng , Shi Guochao
Published: December 2024

Background

Metagenomic next-generation sequencing (mNGS) has emerged as a promising tool in clinical practice due to its unbiased approach to pathogen detection. Its diagnostic performance in pulmonary tuberculosis (PTB), however, remains to be fully evaluated.

Objective

This study aims to systematically review and Meta-analyze the diagnostic accuracy of mNGS in patients with PTB.

Methods

We conducted a literature search in PubMed (MEDLINE), Web of Science, Cochrane, and EMBASE databases, including studies published up to 2024. Studies comparing the diagnostic accuracy of mNGS with other methods such as Xpert-MTB/RIF and Mycobacteria tuberculosis (MTB) culture using bronchoalveolar lavage fluid (BALF), sputum, and lung biopsy tissue were included. Preclinical studies, review articles, editorials, conference abstracts, and book chapters were excluded. Statistical analysis was performed using Rev-man5, R package metabias, and Stata software.

Results

Thirteen studies met the inclusion criteria and were included in the meta-analysis. The pooled sensitivity and specificity of mNGS for PTB were 83% (95% CI: 69–91%) and 99% (95% CI: 92–100%), respectively. Subgroup analyses revealed that in BALF, mNGS demonstrated a pooled sensitivity of 73% (95% CI: 61–82%) and specificity of 98% (95% CI: 92–100%); in the sputum, the pooled sensitivity was 60% (95% CI: 38–87%) with a specificity of 99% (95% CI: 96–100%); and in the lung biopsy tissue, the pooled sensitivity was 71% (95% CI: 38–95%) and the specificity was 98% (95% CI: 93–100%).

For Xpert-MTB/RIF, the pooled sensitivity and specificity were 72% (95% CI: 53–85%) and 100% (95%CI: 100–100%), respectively. Subgroup analyses demonstrated that in BALF, Xpert-MTB/RIF exhibited a pooled sensitivity of 69% (95% CI: 53–81%) and a specificity of 100% (95% CI: 77–100%).

The pooled sensitivity and specificity of mycobacteria culture were 50% (95% CI: 36–64%) and 100% (95% CI: 83–100%), respectively. Subgroup analyses indicated that in BALF, the pooled sensitivity of mycobacteria culture was 44% (95% CI: 37–52%) with a specificity of 100% (95% CI: 8–100%); in the sputum, the pooled sensitivity was 42% (95% CI: 21–65%) and the specificity was 100% (95% CI: 100–100%).

When combining mNGS with Xpert-MTB/RIF, the pooled sensitivity and specificity were 79% (95% CI: 40–97%) and 98% (95% CI: 95–100%), respectively.

Conclusion

mNGS demonstrates similar diagnostic accuracy to Xpert-MTB/RIF in PTB and outperforms mycobacteria culture in terms of sensitivity. Furthermore, mNGS exhibits good detection capabilities across various PTB clinical samples.

Systematic review registration

PROSPERO CRD42023427586.
SARS-CoV-2 membrane protein induces neurodegeneration via affecting Golgi-mitochondria interaction
Authors: Wang Fang , Han Hailong , Wang Caifang , Wang Jingfei , Peng Yanni , Chen Ye , He Yaohui , Deng Zhouyang , Li Fang , Rong Yikang , Wang Danling , Liu Wen , Chen Hualan , Zhang Zhuohua
Published: December 2024

Background

Neurological complications are a significant concern of Coronavirus Disease 2019 (COVID-19). However, the pathogenic mechanism of neurological symptoms associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is poorly understood.

Methods

We used Drosophila as a model to systematically analyze SARS-CoV-2 genes encoding structural and accessory proteins and identified the membrane protein (M) that disrupted mitochondrial functions in vivo. The M protein was stereotaxically injected to further assess its effects in the brains of wild-type (WT) and 5 × FAD mice. Omics technologies, including RNA sequencing and interactome analysis, were performed to explore the mechanisms of the effects of M protein both in vitro and in vivo.

Results

Systematic analysis of SARS-CoV-2 structural and accessory proteins in Drosophila identified that the M protein induces mitochondrial fragmentation and dysfunction, leading to reduced ATP production, ROS overproduction, and eventually cell death in the indirect flight muscles. In WT mice, M caused hippocampal atrophy, neural apoptosis, glial activation, and mitochondrial damage. These changes were further aggravated in 5 × FAD mice. M was localized to the Golgi apparatus and genetically interacted with four wheel drive (FWD, a Drosophila homolog of mammalian PI4KIIIβ) to regulate Golgi functions in flies. Fwd RNAi, but not PI4KIIIα RNAi, reversed the M-induced Golgi abnormality, mitochondrial fragmentation, and ATP reduction. Inhibition of PI4KIIIβ activity suppressed the M-induced neuronal cell death. Therefore, M induced mitochondrial fragmentation and apoptosis likely through disruption of Golgi-derived PI(4)P-containing vesicles.

Conclusions

M disturbs the distribution and function of Golgi, leading to mitochondrial abnormality and eventually neurodegeneration via a PI4KIIIβ-mediated mechanism. This study reveals a potential mechanism for COVID-19 neurological symptoms and opens a new avenue for development of therapeutic strategies targeting SARS-CoV-2 M or mitochondria.
Assessing ambulance staff attitudes toward mental health conditions: translation and psychometric evaluation of the medical condition regard scale among ambulance staff
Authors: Häikiö Kristin , Christiansen Carl Robert , Kveen Rune , Flaathen Eva Marie Engebakken , Hagen Milada
Published: December 2024

Introduction

Ambulance staff play a crucial role in responding to mental health crises. However, negative regard toward patients with mental health conditions can hinder care. The Medical Condition Regard Scale (MCRS) assesses regards or attitudes but has not previously been validated for educated ambulance staff and has never been translated into Norwegian. This study aims to translate the instrument into Norwegian, test it on a population of ambulance staff, explore the psychometric properties of the Norwegian version, and measure regard for patients with psychosis.

Method

The MCRS is an 11-item instrument with a Likert scale of 1–6. Possible sum scores range from 11 to 66 (higher score = more positive regards). We chose “psychosis” as the condition to investigate. Translation followed eight steps: (1) preparation, (2) forward translation, (3) backward translation, (4) first expert panel review, (5) harmonisation, (6) cognitive debriefing, (7) second expert panel review, and (8) writing of the final version. The instrument was tested and re-tested regarding the condition “psychosis” on a representative sample of 114 Norwegian ambulance staff in 2023, with a temporal gap of one month. We explored item scores and distribution, as well as floor and ceiling effects. We tested the internal consistency of the items using Cronbach’s Alpha and consistency in answers over time (test and re-test) using the Paired Sample-T test. We used factor analyses to explore the inter-item relationships of the items.

Results

The 114 participants had a mean sum score of 47, which is mid-range. The scale has a ceiling effect on five items, which was not described in detail earlier. Two items regarding the monetary spending on patients with the given condition had the largest ceiling effects. However, the Norwegian translation showed adequate internal consistency (Cronbach’s Alpha = 0.82) and is reliable over time. Test and re-test showed no significant differences in the scale’s total score (Paired sample T-test, p > 0.05). Exploratory and confirmatory factor analyses indicate that the scale should be used as a one-dimensional instrument in a Norwegian setting in ambulance staff populations.

Conclusion

The Norwegian translation of the MCRS is a reliable instrument for ambulance staff measuring medical condition regards. However, the ceiling effect limits the ability to discern differences among high-scoring individuals. Ambulance staff’s regard for patients with psychosis is medium positive (mid-range level), but slightly more positive than what is reported in the international literature regarding patients with mental health issues.
Automated hypocenter determination of tectonic tremors in the Nankai subduction zone using convolutional neural networks combined with semblance analysis
Authors: Sugii Amane , Hiramatsu Yoshihiro , Uchide Takahiko , Imanishi Kazutoshi
Published: December 2024

Recent advances in deep learning have enhanced our ability to analyze seismic waveforms. Here, we developed and evaluated a convolutional neural network (CNN) model to classify tectonic tremors, earthquakes, and noise in seismic waveform data recorded by a seismic array in the Nankai subduction zone. The trained CNN model achieved high accuracy, with both precision and recall exceeding 97%, and correctly detected 96% of distant earthquakes. The probability of tectonic tremor as a function of the signal-to-noise ratio (SNR) increased steeply from 10 to 90% at an SNR of 4. We highlighted tectonic tremor waveforms using the integrated gradients (IG) method for interpreting CNN models. IG filter averaging over the stations of an array outperforms bandpass filters and other interpretation methods for CNN models in locating tectonic tremors by semblance analysis, providing the largest number of tectonic tremor sources. As reported previously, located sources of tectonic tremor during episodic tremor and slip events migrate along the strike of the subducting plate. The source location error increases significantly at epicentral distances greater than 30 km because of low SNRs. The technique developed in this study equips CNN models with a high ability to distinguish tectonic tremors and earthquakes from noise and to locate tectonic tremors with sources that are not far from seismic stations.

Graphical abstract
Condylar position changes and prognosis in patients with unilateral mandibular condylar fracture treated non-surgically
Authors: Lim Jihye , Jo Woomin , Jeon Hyelynn , Song Seung Il , Lee Jeong Keun
Published: December 2024

Background

Non-surgical method is a treatment option for mandibular condylar fracture; however, it is questionable whether bone fragments are adequately reduced and remodeled. The purpose of this study was to identify three-dimensional positional changes in the mandibular condyles in patients treated non-surgically, analyze factors influencing the extent of positional changes, and evaluate clinical prognosis.

Methods

This retrospective study included 31 patients with unilateral mandibular condylar fractures treated non-surgically at the Ajou University Dental Hospital between 2005 and 2023. Computed tomography was performed at the time of the fracture (T0) and > 6 months after non-surgical treatment (T1). The extent of recovery of the highest point of the condyle head was measured in three-dimensional x-, y-, and z-axes. At the last follow-up > 6 months after remodeling (T1), the prognosis was evaluated by clinical examination of mouth opening limitation, malocclusion, deviation on opening, temporomandibular joint disorder (TMD), and facial asymmetry.

Results

Position differences were statistically significant between T0 and T1 (paired Student’s t-test, P < 0.05), and between the x-, y-, and z-axes (Welch’s ANOVA, P < 0.05). The degree of positional recovery in the superior and lateral directions showed a statistically significant negative correlation with age (Pearson’s correlation analysis, P < 0.05). The average amount of recovery between two age groups of over and under 19 years old was statistically significant (independent t-test, P < 0.05). Complications included TMD (6.4%), malocclusion (3.2%) and facial asymmetry (3.2%).

Conclusion

After non-surgical treatment, the condyle head of the fractured mandible recovered significantly laterally and superiorly in under 19-year-olds. The functional prognosis was favorable in all age groups. Non-surgical treatment can be an applicable treatment option for patients with mandibular condylar fractures.
Prevalence of Schistosoma infection and associated factors among pregnant women attending antenatal care at Shewa Robit Health Center, North-Central Ethiopia: a cross-sectional study
Authors: Zewdie Woubshet , Alemu Getaneh , Hailu Tadesse
Published: December 2024

Background

Schistosoma spp. and other intestinal parasites are common in Ethiopia. During pregnancy, SCH increases the risk of adverse birth outcomes. However, its epidemiology among pregnant women and awareness level about the disease are not well addressed in Ethiopia. This study was conducted to address this gap.

Methods

A cross-sectional study was conducted from April to June 2023 among 422 pregnant women who attended Shewa Robit Health Center. Pregnant women who came to the health center for antenatal care services were enrolled in the study following systematic random sampling technique. Questionnaire data was collected on socio-demographic characteristics, KAP towards SCH, and associated factors. Stool samples were processed using the Kato–Katz technique, while urine samples were tested with urine test strips for hematuria, and filtration and centrifugation methods for detection of S. haematobium. Data were entered and analyzed using SPSS software version 25. Descriptive statistics and logistic regression were performed at a 95% confidence level.

Results

Among 422 pregnant women, 38 (9.0%) were positive for hematuria, but none were infected by S. haematobium. Schistosoma mansoni was detected in 40 (9.5%; 95% confidence interval (CI): 6.6–12.6) participants. Habit of swimming or bathing (adjusted odds ratio (AOR) = 4.896; 95% CI: 2.193–10.933, p < 0.001) and habit of crossing freshwater on barefoot (AOR = 5.113; 95% CI: 1.171–22.324, p = 0.030) were significantly associated with S. mansoni infection. Of the participants, only 74 (17.5%) had previously heard of SCH. Out of 74 aware participants, 49 (66.2%) and 14 (18.9%) were unaware of the causative agent and possibility of a cure for SCH, respectively. Sixty-one (82.4%) were aware that SCH is preventable. Fifty-three (71.6%) and 4 (5.4%) participants believed that SCH is preventable and serious disease, respectively. Eight (10.8%) and 9 (12.2%) participants avoided contact with freshwater and used clean water for drinking and washing, respectively.

Conclusions

There is nearly moderate prevalence of S. mansoni infection in the study area. Pregnant women who often had freshwater contact were more likely to contract S. mansoni. Most pregnant women in the study area had low KAP levels towards SCH. Therefore, women of reproductive age groups should be the focus of SCH control programs.
Nonlinear Raman-Nath diffraction in submicron-thick periodically poled lithium niobate thin film
Authors: Li Xiao-Ni , Peng Ling-Zhi , Liu Yuan-Yuan , Hong Li-Hong , Hu De-Ming , Zhao Yuan-Yuan , Duan Xuan-Ming , Chen Bao-Qin , Li Zhi-Yuan
Published: December 2024

Nonlinear Raman-Nath diffraction (NRND) is a unique diffraction pattern formed when a high-intensity laser interacts with a nonlinear microstructure bulky medium relying only on the transverse phase matching condition. Here, we report on the first experimental observation of NRND in a submicron-thick periodically poled lithium niobate thin film (PPLNTF) by geometric reflection pumped via a near-infrared femtosecond pulse laser. We further observe the evolution of the diffracted signals after broadening of the pump laser via a fused silica plate. We systematically analyze the spectral properties of multi-order second harmonic generation (SHG) diffracted signals exhibiting asymmetric distributions and explicitly clarify their phase matching conditions, simultaneously considering the impacts of the incident pump wavelength, the sample poling period, and the incident angle on the properties of the angular distribution diffracted beams. The realization of NRND phenomena with appreciable on-chip efficiency at a submicron interaction length is mainly attributed to the significant contribution of domain walls to enhance the nonlinear effects along with the modulation of second-order nonlinear susceptibilities $${\chi }^{(2)}$$

χ

(
2
)

. This NRND scheme provides a high-resolution, non-destructive on-chip microstructure diagnostic method, and even has the potential to develop novel on-chip integrated optoelectronic devices for applications such as precision metrology, biosensing, and spectral analysis.
Prevalence of anxiety symptoms and associated factors at 2 months postpartum, results from a 2021 French national prospective cohort study
Authors: Doncarli Alexandra , Demiguel Virginie , Le Ray Camille , Deneux-Tharaux Catherine , Lebreton Elodie , Apter Gisèle , Boudet-Berquier Julie , Crenn-Hebert Catherine , Vacheron Marie-Noëlle , Regnault Nolwenn , Tebeka Sarah ,   Members of the ENP2021 Study Group
Published: December 2024

Background

Postpartum anxiety (PPA) symptoms have harmful effects on child development and mother–infant interactions. Accordingly, in-depth knowledge of associated risk factors is crucial for prevention policies. This study aimed to estimate PPA symptom prevalence at 2 months and to identify associated risk factors in a representative sample of all women who gave birth in France in 2021, and in two subgroups: women with no postpartum depression (PPD) symptoms, and those with no history of mental health care.

Methods

Among the 12,723 women included in the representative French national perinatal survey 2021ENP, 7,133 completed the Edinburgh Postnatal Depression Scale (EPDS) self-administered questionnaire – including three anxiety-specific items (EPDS-3A) – at 2 months postpartum. We estimated the adjusted prevalence ratios (aPR) of PPA symptoms using Poisson regression models with robust variance.

Results

PPA symptom prevalence at 2 months was 27.6% (95% CI [26.5–28.8]). Associated risk factors were: age ≤ 34 years (maximum aPR = 1.38 [1.22–1.58] obtained for persons aged 25–29 years vs. 35–39 years), poorer health literacy (1.15 [1.07–1.23]), a history of medical termination of pregnancy (1.32 [1.05–1.68]), psychological (1.31 [1.17–1.47]) or psychiatric (1.42 [1.24–1.63]) care history since adolescence, nulliparity (1.23 [1.12–1.35]), no weight gain or loss (1.29 [1.03–1.61] vs. 9–15 kg gain) or gain ≥23 kg (1.20 [1.00–1.43]) during pregnancy, ≥3 pregnancy-related emergency consultations (1.16 [1.03–1.31] vs. none), poor/good support during pregnancy, (1.16 [1.00–1.34] and 1.15 [1.05–1.26], respectively, vs. very good), sadness (1.52 [1.36–1.69]), anhedonia (1.48 [1.27–1.72]), or both (1.99 [1.79–2.21]) during pregnancy, not at all/not very satisfied with pain management during childbirth (1.16 [1.01–1.32] vs. quite/very satisfied). Similar risk factors were found in the ‘no PPD symptoms’ and ‘no history of mental health care’ subgroups.

Conclusions

Estimated PPA symptom prevalence at 2 months in our study sample was 27.6%. The risk factors we identified may guide future prevention policies.
Brazilian port reform: An analysis of investments after law nº 12.815/2013
Authors: Ribeiro da Glória Igor , Barbosa Lúcio Otávio Seixas , Vianna Cássio Becacici Esteves
Published: December 2024

Since the enactment of Law nº 12.815/2013, private agents have been allowed to build ports to mainly exploit it commercially, offering port services to anyone interested in moving cargo. This amendment to the legislation aimed to attract private investment to the sector, reducing Brazil’s existing port infrastructure deficit. This work evaluated private investments carried out during the period from 2013 to 2021 in port facilities after the new regulatory framework. The methodology was based on descriptive data analysis, using information from the regulatory agency’s administrative processes authorizing investment in port terminals. The results indicated that investments were focused especially in places where barriers to entry were lower, such as on the banks of inland waterways or, in the case of maritime facilities, where there was already waterway infrastructure managed by some public Port Authorities.
Estudo sobre a capacidade de movimentação de contêineres no porto de Santos
Authors: Favarin Julio
Published: December 2024

O Porto de Santos é o principal porto da América do Sul e representa 38% de toda a movimentação do Brasil, atuando como hub port brasileiro ao concentrar cargas, especialmente contêineres, e redistribuí-las por cabotagem e feeder para outras regiões. Desde 2020, discute-se a capacidade do porto para atender à crescente demanda de contêineres, levando à proposta do terminal STS10, suspenso em meio ao debate sobre a desestatização do porto. Por mais que o planejamento portuário e os indicadores operacionais apontem para falta de capacidade imediata, em um processo de consulta pública recente, a Autoridade Portuária de Santos argumentou que não há necessidade de um novo terminal no curto prazo, enquanto um relatório do TCU sinaliza na direção oposta. Esse estudo teve como objetivo aplicar uma metodologia de cálculo de capacidade e analisar o Porto de Santos através do nível de utilização dos três grandes terminais que movimentam contêineres: DP World, Santos Brasil e BTP. Os resultados revelam que Santos opera com uma utilização acima da ideal, indicando a necessidade imediata de implantar o projeto do terminal STS10 com a finalidade de ampliar a capacidade para atendimento da demanda de contêineres até 2035, estimular a cabotagem e ampliar a participação ferroviária desta carga, contribuindo para descongestionar as rodovias e descarbonizar a matriz de transporte.