bluuebunny/crossref_metadata_2025 huggingface dataset:
How Passive Neck Immobilisation Influences Tongue Mobility and Strength: An Observational Study
Authors: Pérez‐González Alberto , Paris‐Alemany Alba , Chamorro‐Sánchez Jorge , La Touche Roy
Published: January 2025

Background

There is a physiological association of the neck movements and jaw and tongue movements. However, there are no previous data regarding the performance of the tongue when the neck is under a lack of movement condition.

Objective

To quantify the tongue's maximal strength and mobility under an experimental restriction of cervical mobility.

Methods

This cross‐sectional study recruited 33 healthy volunteers. We measured the tongue's mobility and maximal strength reached at the posterior, middle and anterior parts of the tongue; all were performed with and without neck immobilisation. A neck collar was used for the experimental restriction of cervical mobility.

Results

ANOVA revealed no differences in tongue strength between cervical condition (p = 0.84), but differences were found among the three tongue areas' strength (p < 0.001), according to the post hoc results the posterior area of the tongue resulted significantly weaker compared to the anterior (with collar p = 0.006; without collar p = 0.01) and midparts (with collar p = 0.03; without collar p = 0.006). Significant differences were also found in the tongue's range of motion (ROM) between groups for the protraction (p = 0.02). A subclassification of the participants was made according to the greatest strength obtained with (CCI group) or without (WCI group) neck collar, or no difference (NC group). The analysis of variance showed significant changes in tongue strength between groups at the tongue's anterior area (F = 5.28; p = 0.01), middle area (F = 9.83; p < 0.001) and posterior area (F = 4.05; p = 0.02). The post hoc analyses showed strength in the middle area of the tongue changed between neck conditions, obtaining significantly greater results without the neck collar compared with those with the neck collar (p = 0.01; d = 1.10).

Conclusion

The results of this study indicate a trend suggesting that posture induced by experimental cervical fixation may influence tongue strength, with a possible greater effect in the middle area of the tongue compared to the anterior and posterior areas; however, it affects tongue range of motion. These findings suggest that cervical posture could be an important factor to consider in clinical assessments and interventions involving tongue function. Nonetheless, a larger sample size and further studies are needed to draw more definitive conclusions and understand these potential associations.
Cause‐Specific Secular Trends and Prevention Measures of Post‐Neonatally Acquired Cerebral Palsy in Victoria and Western Australia 1975–2014: A Population‐Based Observational Study
Authors: Waight E. , McIntyre S. , Woolfenden S. , Goldsmith S. , Reid S. , Watson L. , Britton P. N. , Webb A. , Hansen M. , Badawi N. , Smithers‐Sheedy H.
Published: January 2025

Aim

To describe the timing and causes of post‐neonatally acquired cerebral palsy (PNN‐CP) and map the implementation of relevant preventive strategies against cause‐specific temporal trends in prevalence.

Methods

Data for a 1975–2014 birth cohort of children with PNN‐CP (brain injury between 28 days and 2 years of age) were drawn from the Victorian and Western Australian CP Registers. Descriptive statistics were used to report causal events and timing. Poisson regression models were used to investigate the strength of evidence for cause‐specific temporal trends in prevalence. Preventive strategies were mapped alongside cause‐specific trends.

Results

Amongst 512 children, causes of PNN‐CP included infections (31%, n = 157), head injuries (24%, n = 121) and cerebrovascular accidents (CVAs) (23%, n = 119). Infections were the only main causal group of PNN‐CP that declined significantly (p = 0.014). Fifty two percent (n = 267) of the PNN‐CP cohort acquired their brain injury before 6 months of age, the majority having an infectious cause (57%, n = 90). Improved clinical care and a range of preventive strategies, including childhood vaccination programs, occurred during this period.

Conclusion

Infants under 6 months are a priority group for preventive strategies for PNN‐CP. Declining temporal trends were observed for PNN‐CP caused by infection, and the causal subgroup of CVAs associated with surgery. Interventions aimed at further reducing the risk of head injury, CVAs and infections, are needed to reduce the prevalence of PNN‐CP.
High‐Energy Nutrition in Hospitalised Paediatric Patients With Congenital Heart Disease: A Systematic Review and Meta‐Analysis
Authors: Galvao Lorhayne Kerley Capuchinho Scalioni , de Farias Santos Ana Clara Felix , Zamora Fernanda Valeriano , Pimenta Nicole dos Santos , Salles João Pedro Costa Esteves Almuinha , Guzzardi Hable Isabella
Published: January 2025

Aims

Congenital heart disease (CHD) is a significant cause of growth failure and neonatal mortality worldwide, and requirement‐focused nutritional management can deeply impact the prognosis. Despite multiple trials, there is no published meta‐analysis on the impact of high‐energy nutrition in this population.

Methods

We searched PubMed, Embase and Cochrane Central for RCTs comparing high‐energy to standard formulas in hospitalised patients. We computed mean differences (MDs) for continuous outcomes and odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs).

Results

Five studies comprising 276 patients were included, of whom 139 (50.4%) received the high‐energy formula. Compared with the standard, they had higher weight gain (MD 276.37; 95% CI 56.29, 496.46). Despite no statistical significance, the length of hospital stay (MD −3.51; 95% CI −7.33, 0.3) tends to be shorter. There were no significant differences regarding the length of ICU stay (MD −10.32; 95% CI −58.04, 37.40) and mechanical ventilation (MD −19.54; 95% CI −47.81, 8.73). The presence of side effects (OR 1.82; 95% CI 0.58, 5.7; p = 0.3) was one of the outcomes most reported as better in the control group, but overall, there's no significant difference.

Conclusion

Our findings suggest the high‐energy formula may be superior to control considering weight gain. In addition, the presence of side effects was not significantly different between groups.
Not a quiet place: Validating C‐ and F‐PODs to predict harbor porpoise presence in the Ems estuary
Authors: Gauger Marco F. W. , Taupp Thomas
Published: January 2025

Shifting from cetacean porpoise detectors (C‐POD) to full waveform capture porpoise detectors (F‐POD) poses the question as to which device detects more harbor porpoises' echolocations and offers a higher level of precision and accuracy and a lower validation effort. C‐ and F‐PODs were deployed together in the Ems estuary at the German–Dutch border during their spring peak presence (February–June 2023). Detections were validated visually, and ecological models were parametrized for “NBHF” (narrow band high frequency, unvalidated) and “verified” data (validated) to showcase the risk of ignoring bias. Time‐aggregated porpoise detections were significantly lower in C‐ than in F‐PODs (1,644 vs. 2601 min; 1,094 vs. 1,301 10‐min intervals). Overall, C‐PODs achieved a higher level of precision and accuracy (Hi and Mod setting: 0.81 and 0.96) than F‐PODs (0.39 and 0.51). In F‐PODs, applying filters during train processing increased the relative number of harbor porpoise click‐trains and reduced validation effort. As random forest models have shown from “NBHF” and “verified” data, overestimation and underestimation led to false association of ecological variables with harbor porpoise presence and biased predictions. Hence, visual validation is required for data of both porpoise detectors to ensure unbiased ecological interpretations.
Single‐use versus multiple‐use endotracheal suction catheters flushed with chlorhexidine in mechanically ventilated ICU patients: A study protocol of a feasibility randomized controlled trial with an embedded qualitative study
Authors: Eid Mohamed H. , Hambridge Kevin , Schofield Pat , Latour Jos M.
Published: January 2025

Background

Endotracheal suction catheters are often used multiple times during endotracheal suctioning procedures in resource‐limited intensive care units (ICU). The impact of this practice on mechanically ventilated patients' outcomes remains unclear.

Aim

The aim of this feasibility randomized controlled trial (fRCT) is to assess the feasibility and acceptability of single‐use versus multiple‐use endotracheal suction catheters flushed with chlorhexidine in mechanically ventilated ICU patients.

Design

This study is a three‐armed fRCT with an embedded qualitative study.

Methods

The trial involves three groups. One group includes endotracheal suctioning using a single‐use catheter; the second group includes a multiple‐use endotracheal suction catheter flushed with chlorhexidine and the control group includes a multiple‐use endotracheal suction catheter flushed with normal saline. Sixty adult ICU patients (20 in each group) will be recruited, along with 12–16 ICU nurses delivering the interventions, and 12–16 patients' next‐of‐kin for semi‐structured interviews. The study protocol has been approved by two ethics committees. Study recruitment will be conducted over an 8‐month period with an expected start date of 12 April 2024.

Outcome Measures

The feasibility outcome measures will be recruitment, retention, and follow‐up measures as well as the identification of clinical outcomes such as Ventilator‐Associated Pneumonia (VAP) using the modified clinical pulmonary infection score, and ICU length‐of‐stay.

Relevance to Clinical Practice

This study will help ICU nurses to understand how different methods of endotracheal suctioning affects patients in ICUs with limited resources. The findings could influence clinical practice and improve patient outcomes.
Can a plant biologist fix a thermostat?
Authors: Michael Todd P.
Published: January 2025

The shift to reductionist biology at the dawn of the genome era yielded a ‘parts list’ of plant genes and a nascent understanding of complex biological processes. Today, with the genomics era in full swing, advances in high‐definition genomics enabled precise temporal and spatial analyses of biological systems down to the single‐cell level. These insights, coupled with artificial intelligence‐driven in silico design, are propelling the development of the first synthetic plants. By integrating reductionist and systems approaches, researchers are not only reimagining plants as sources of food, fiber, and fuel but also as ‘environmental thermostats’ capable of mitigating the impacts of a changing climate.
LepR‐Expressing Cells in Bone and Periodontium
Authors: Li Yue , Li Peitong , Xue Kun , Shi Peilei , Xie Xudong , Wang Jun , Xu Chunmei
Published: January 2025

Objective

LepR‐expressing cells (LepR+ cells), a critical subpopulation of mesenchymal stem cells, have gained increasing attention in the last decade. LepR+ cells have been found to play a crucial role in maintaining bone and periodontal homeostasis. This review summarizes current research advances focusing on the role of LepR+ cells and their underlying regulatory molecular mechanisms in bones and periodontium, aiming to provide a better understanding of the therapeutic potential of this cell lineage.

Methods

A literature review was conducted based on publications in PubMed over the past 20 years, summarizing the research progress on LepR+ cells in bone and periodontal tissues.

Results

Current evidence revealed that LepR+ cells possess the ability of self‐renewal and multilineage differentiation and are essential for bone turnover and periodontal tissue remodeling. In addition, LepR+ cells participate in the processes of bone fracture healing and alveolar socket healing. Moreover, under pathological conditions such as osteoporosis, bone marrow fibrosis, and periodontitis, LepR+ cells exhibit enhanced adipogenic or fibrogenic differentiation abilities.

Conclusion

Therapeutic approaches targeting the cell fate of LepR+ cells hold the potential to provide novel insights into bone/periodontal repair and regeneration therapy.
Downregulation of PAX1 in OSCC Enhances Stemness and Immunosuppression via IFIT1 and PD‐L1 Pathways
Authors: Ko Hui‐Hsin , Peng Hsin‐Hui , Chou Han‐Yi E. , Hou Hsin‐Han , Liu Wei‐Wen , Kuo Mark Yen‐Ping , Lee Alan Yueh‐Luen , Kao Hsiang‐Fong , Lin Hung‐Ying , Chang Ying‐Chieh , Kuo Wei‐Ting , Cheng Shih‐Jung
Published: January 2025

Objective

Our study investigated how arecoline‐induced extracellular vesicle (EV) secretion suppresses PAX1 protein production through DNA hypermethylation and examined whether PAX1 downregulation enhances cancer stemness and immunosuppression in the tumor microenvironment.

Materials and Methods

EVs were isolated from SAS/TW2.6 cancer cell lines using ultracentrifugation and identified using transmission electron microscopy. PAX1 DNA methylation was tested in an ISO17025‐certified lab, with and without EV pretreatment. Stemness and epithelial–mesenchymal transition markers were assessed by western blotting and 3D culture. PAX1, IFIT1, and PD‐L1 co‐expression were examined through immunofluorescence. Flow cytometry detected various T cells.

Results

Arecoline‐induced EVs enhanced PAX1 methylation, suppressing its tumor‐suppressive function. Reduced PAX1 mRNA in OSCCs was linked to larger tumors, nodal metastasis, late‐stage disease, areca quid chewing, and poor survival. Downregulated PAX1 protein negatively correlated with IFIT1 and PD‐L1 expression. Reduced PAX1 promoted stemness via the IFIT1 pathway, increasing PD‐L1 secretion and aiding immune evasion. PD‐L1 expression correlated with Treg and CD8+ T cell levels in OSCC tissues, and the CD4+/CD8+ T cell ratio was lower in OSCC patients than in controls.

Conclusion

Arecoline‐induced EV production, which influences PAX1/IFIT1/PD‐L1 function, may serve as a reliable biomarker for targeted therapy in OSCC patients.
Nursing Partnerships Are Crucial for Bridging Education and Public Health
Authors: McCabe Ellen M. , Jameson Beth E. , Maughan Erin D.
Published: January 2025

Public health nurses (PHNs) and school nurses are integral in addressing health disparities, managing chronic illnesses, preventing and controlling communicable diseases, and promoting wellness within communities. Schools serve as pivotal platforms for implementing health initiatives and providing opportunities for disease prevention and health promotion. School nurses identify and address health risks, including chronic conditions, communicable diseases, substance abuse, and mental health concerns, and often act as knowledgeable authorities to access community resources. PHNs perform a vital role in communicating the health experiences of diverse and sometimes vulnerable individuals and families to health planners and policymakers. They also empower community members to articulate concerns and goals, promoting a collaborative approach to public health development. Collaboration between PHNs and school nurses enhances community health through joint efforts in screenings, health education, and community‐wide interventions. However, barriers, such as isolated strategic planning, siloed funding, and inadequate information systems, hinder effective collaboration. The authors advocate for joint strategic planning, integrated funding, and interoperable health information systems that may now be fragmented to strengthen these partnerships in order to improve population health. Enhancing these collaborations is vital for creating supportive environments where students can thrive academically and health‐wise, ensuring a sustainable impact on community health.
An analysis of the influence of education level on Rowland Universal Dementia Assessment Scale (RUDAS) scores among stroke patients
Authors: Wang Ya , Zhang Yu , Zhang Yi
Published: January 2025

Objective

To explore the influence of education level on scores in the Mandarin Chinese version of the Rowland Universal Dementia Assessment Scale (RUDAS) among stroke patients and to provide guidance regarding the application and optimisation of the RUDAS.

Methods

A total of 235 stroke patients were census sampled for an evaluation of cognitive function using the Mandarin Chinese version of the RUDAS. A test was carried out to analyze the differences in RUDAS scores between sexes, and one‐way analysis of variance and the Scheffe multiple comparison test were used to analyze the differences in RUDAS scores between age groups and between education levels. SPSS 22.0 software was used for statistical analysis. Differential item functioning (DIF) analysis was performed using logistic regression. If P < 0.05, then an item was considered to exhibit DIF.

Results

The overall education levels of the stroke patients were moderate. There was no significant difference in RUDAS scores based on education level or sex, but there was a difference between age groups. There were three items that exhibited DIF: square, internal line and external line.

Conclusion

RUDAS scores were not strongly influenced by education level, and most items were suitable for screening among stroke patients with different education levels. However, when drawing a cube, differences in education level should be taken into consideration.
Citizens' perceptions of the legitimacy of independent agencies: The effects of expertise‐based and reputation‐sourced authority
Authors: Rimkutė Dovilė , Mazepus Honorata
Published: January 2025

Legitimacy is a central concern for independent agencies tasked with shaping policies. While expertise‐based and reputation‐sourced authority bases are assumed to be relevant for agency legitimacy, their individual and joint effects on citizens' perceptions lack comprehensive examination. To address this gap, the study integrates insights from bureaucratic politics, bureaucratic reputation, and cognitive psychology. Our survey experiment with Dutch citizens, focusing on the European Food Safety Authority, suggests that expertise‐based authority positively affects perceived agency legitimacy, while a negative reputation has detrimental effects. Furthermore, expertise‐based authority moderates the impact of reputation, amplifying positive effects and mitigating negative ones. This implies that agencies are more susceptible to reputational threats when they lack expertise‐based authority. The study advances the theoretical tenets of bureaucratic reputation theory and offers effective strategies for agencies to strengthen their legitimacy among the most critical audience in democratic political systems—citizens.
Moss‐covered biodegradable weed barriers promote biocrust establishment but fail to suppress exotic plants
Authors: Bowker Matthew A. , Anenberg Jasmine , Antoninka Anita , Ramsey Philip W. , Durham Rebecca A.
Published: January 2025

Ecological restoration often requires exotic invasive plant control. In many ecosystems, reestablishment of biological soil crusts (biocrusts) is a desired restoration outcome because biocrusts enhance ecosystem function and may favor native plants over exotics. We sought to pair exotic plant suppression with biocrust restoration using a novel restoration material: biocrust‐covered weed barriers. We tested five different barriers, including three biodegradable weed barriers, one synthetic weed barrier commonly used in the study area, and burlap cloth, because it has previously been shown to be useful in biocrust establishment. We grew biocrust moss over the surface of each barrier type in a fog chamber. Each barrier type was attached to the ground in the field with moss on the underside of the barrier (moss‐down), the top, or not present. We monitored the establishment of moss biocrusts and exotic plants and the durability of the barriers. The most successful barrier type for biocrust establishment was burlap, but one biodegradable weed barrier made of maize‐derived polylactic acid (corn) promoted biocrusts, especially in the moss‐down position. Only the synthetic weed barrier suppressed exotic plants for two growing seasons. The corn barrier only partially suppressed exotic plants for one growing season. Less durable weed barriers were less able to suppress exotic plants. Though we failed to identify a biodegradable barrier that both stimulates biocrust recovery and suppresses exotic plants beyond one growing season, our results suggest that our goal may be attainable if more durable biodegradable weed barriers were used or created.
Can Adjust the Fiscal Expenditure Structure Promote Inclusive Green Growth? Empirical Evidence From China
Authors: Wu Yanghong , Song Li , Zhou Xiaoliang
Published: January 2025

In the context of the intensification of the contradiction between fiscal revenue and expenditure in China, the adjustment of fiscal policy with Inclusive Green Growth as the development goal is conducive to improving the efficiency of the use of fiscal funds. Therefore, it is necessary to empirically test how the fiscal expenditure structure affects Inclusive Green Growth. Through the theoretical combing of the influence mechanism of Inclusive Green Growth and fiscal expenditure structure, the corresponding research hypotheses are put forward; Based on this, China's Regional Panel Data from 2007 to 2019 is selected as the data of the investigation period, and a two‐way fixed effect model is set; Finally, the proposed hypothesis is empirically tested and analyzed. The results show that fiscal economic constructive expenditure has a “U” shaped nonlinear impact on Inclusive Green Growth. Fiscal social security expenditure and fiscal ecological protection expenditure have a significant positive impact on Inclusive Green Growth; Grouping sample regression analysis is consistent in the overall direction of fiscal expenditure structure; Marketization index, human capital, and environmental regulation all have a positive moderating effect on the impact relationship.
Disease ecology in health and medical geography: History, progress, and innovations†
Authors: Emch Michael , Goel Varun
Published: January 2025

This paper describes the development of the disease ecology tradition of health and medical geography including some key themes and innovations. It first grounds disease ecology in the history of ecology from the natural sciences and the human ecology traditions within the social sciences. These ecological studies of disease developed in response to limitations in the biomedical approach to studying health and disease that developed after germ theory. While the biomedical approach, which mostly focused on human biology, led to groundbreaking advances in medicine for many decades, it had its limits. Disease ecology applications have modern roots in the decades before and after World War II through colonial and tropical medicine as well as work conducted in an array of other sites, including Nazi Germany, the Soviet Union, and the United States when there were large efforts to create infectious diseases maps and conduct ecological analyses of diseases. Hundreds of disease ecology studies have been implemented on diverse disease systems since World War II. The field progressively broadened in scope, especially during the 1990s and beyond, with several innovations including the application of political ecology approaches to the study of health and disease. Two other recent innovations are summarized through case studies: disease ecology approaches in health intervention research and applications of theory and methods from landscape genetics. The first case study highlights the ecological and geographic heterogeneity associated with the health impacts of drinking‐water tubewell interventions in rural Bangladesh. The paper also considers ‘landscape genetics’ approaches via a case study about influenza that uses modern genetic and spatial tools along with an ecological approach; it describes how the evolution of the virus is related to human‐environment‐animal interactions. The paper concludes by outlining promising future directions for disease ecology, emphasizing the field's ongoing incorporation of new theories and methods.
Deep potential molecular dynamics simulations of low-temperature plasma-surface interactions
Authors: Kounis-Melas Andreas , Vella Joseph R. , Panagiotopoulos Athanassios Z. , Graves David B.
Published: January 2025

Machine learning approaches to potential generation for molecular dynamics (MD) simulations of low-temperature plasma-surface interactions could greatly extend the range of chemical systems that can be modeled. Empirical potentials are difficult to generalize to complex combinations of multiple elements with interactions that might include covalent, ionic, and metallic bonds. This work demonstrates that a specific machine learning approach, Deep Potential Molecular Dynamics (DeepMD), can generate potentials that provide a good model of plasma etching in the Si-Cl-Ar system. Comparisons are made between MD results using DeepMD models and empirical potentials, as well as experimental measurements. Pure Si properties predicted by the DeepMD model are in reasonable agreement with experimental results. Simulations of Si bombardment by Ar+ ions demonstrate the ability of the DeepMD method to predict sputtering yields as well as the depth of the amorphous-crystalline interface. Etch yields as a function of flux ratio and ion energy for simultaneous Cl2 and Ar+ impacts are in good agreement with previous simulation results and experiment. Predictions of etch yields and etch products during plasma-assisted atomic layer etching of Si-Cl2-Ar are shown to be in good agreement with MD predictions using empirical potentials and with experiment. Finally, good agreement was also seen with measurements for the spontaneous etching of Si by Cl atoms at 300 K. The demonstration that DeepMD can reproduce results from MD simulations using empirical potentials is a necessary condition to future efforts to extend the method to a much wider range of systems for which empirical potentials may be difficult or impossible to obtain.
Information sharing within a social network is key to behavioral flexibility—Lessons from mice tested under seminaturalistic conditions
Authors: Winiarski Maciej , Madecka Anna , Yadav Anjaly , Borowska Joanna , Wołyniak Maria R. , Jędrzejewska-Szmek Joanna , Kondrakiewicz Ludwika , Mankiewicz Lech , Chaturvedi Mayank , Wójcik Daniel K. , Turzyński Krzysztof , Puścian Alicja , Knapska Ewelina
Published: January 2025

Being part of a social structure offers chances for social learning vital for survival and reproduction. Nevertheless, studying the neural mechanisms of social learning under laboratory conditions remains challenging. To investigate the impact of socially transmitted information about rewards on individual behavior, we used Eco-HAB, an automated system monitoring the voluntary behavior of group-housed mice under seminaturalistic conditions. In these settings, male mice spontaneously form social networks, with individuals occupying diverse positions. We show that a rewarded group member’s scent affects the ability of conspecifics to search for rewards in familiar and novel environments. The scent’s impact depends on the animal’s social position. Furthermore, disruption of neuronal plasticity in the prelimbic cortex (PL) disrupts the social networks and animals’ interest in social information related to rewards; only the latter is blocked by the acute PL inhibition. This experimental design represents a cutting-edge approach to studying the brain mechanisms of social learning.
Transcriptional coupling of telomeric retrotransposons with the cell cycle
Authors: Liu Mengmeng , Xie Xiao-Jun , Li Xiao , Ren Xingjie , Sun Jasmine L. , Lin Zhen , Hemba-Waduge Rajitha-Udakara-Sampath , Ji Jun-Yuan
Published: January 2025

Unlike most species that use telomerase for telomere maintenance, many dipterans, including
Drosophila
, rely on three telomere-specific retrotransposons (TRs)—
HeT-A
,
TART
, and
TAHRE
—to form tandem repeats at chromosome ends. Although TR transcription is crucial in their life cycle, its regulation remains poorly understood. This study identifies the Mediator complex, E2F1-Dp, and Scalloped/dTEAD as key regulators of TR transcription. Reducing the activity of the Mediator or Sd/dTEAD increases TR expression and telomere length, while overexpressing E2F1-Dp or depleting Rbf1 stimulates TR transcription. The Mediator and Sd/dTEAD regulate this process through E2F1-Dp. CUT&RUN (Cleavage under targets and release using nuclease) analysis shows direct binding of CDK8, Dp, and Sd/dTEAD to telomeric repeats, with motif enrichment revealing E2F- and TEAD-binding sites. These findings uncover the Mediator complex’s role in controlling TR transcription and telomere length through E2F1-Dp and Sd, coupling the transcriptional regulation of the TR life cycle with host cell-cycle machinery to protect chromosome ends in
Drosophila
.
Suppression of thrombospondin-1–mediated inflammaging prolongs hematopoietic health span
Authors: Ramalingam Pradeep , Gutkin Michael C. , Poulos Michael G. , Winiarski Agatha , Smith Arianna , Carter Cody , Doughty Chelsea , Tillery Taylor , Redmond David , Freire Ana G. , Butler Jason M.
Published: January 2025

Chronic low-grade inflammation observed in older adults, termed inflammaging, is a common feature underlying a multitude of aging-associated maladies including a decline in hematopoietic activity. However, whether suppression of inflammaging can preserve hematopoietic health span remains unclear, in part because of a lack of tools to measure inflammaging within hematopoietic stem cells (HSCs). Here, we identify thrombospondin-1 (Thbs1) as an essential regulator of inflammaging within HSCs. We describe a transcriptomics-based approach for measuring inflammaging within stem cells and demonstrate that deletion of
Thbs1
is sufficient to prevent HSC inflammaging. Our results demonstrate that suppression of HSC inflammaging prevents aging-associated defects in hematopoietic activity including loss of HSC self-renewal, myeloid-biased HSC differentiation, and anemia. Our findings indicate that suppression of HSC inflammaging may also prolong overall systemic health span.
Cerebral aspergillosis in a patient with chronic lymphocytic leukaemia complicated by Evans syndrome
Authors: Elyas Mortada , amer Aly
Published: January 2025

This case report presents a complex medical scenario involving early 60s female patient with a history of chronic lymphocytic leukaemia (CLL) complicated by Evans syndrome, characterised by autoimmune haemolytic anaemia and immune thrombocytopenia. The patient had received various treatments, including steroids, rituximab, cyclosporine and acalabrutinib. The patient’s neurological symptoms began around 3 years prior to presentation, with shaking of her right leg, followed by shaking of both hands, particularly the left hand. She experienced shaking during activities and at rest. Additional symptoms included voice changes, numbness in the feet, dizziness, faintness, fatigue, nausea, vomiting, headaches, walking difficulty, speech changes and back pain. Neurological examination revealed resting tremors, bradykinesia, rigidity and infrequent blinking. An MRI of the brain revealed a 28 mm enhancing intra-axial lesion in the right frontal parietal lobe, accompanied by a 7 mm nodule in the left parietal lobe, both suggestive of neoplastic aetiology. A surgical resection was performed, identifying septate branching fungal hyphae consistent with Aspergillus species, leading to the diagnosis of cerebral aspergillosis. Voriconazole was initiated and subsequently adjusted based on therapeutic drug levels. The patient’s treatment course was complicated by declining platelets, diagnosed as thrombocytopenia, and a positive COVID-19 test result. She received rituximab, immunoglobulin therapy and antifungal treatment adjustments. The patient’s clinical condition improved, including a reduction in tremors and regained mobility. This case underscores the challenges of managing a patient with CLL-associated immune complications, cerebral aspergillosis and a dynamic treatment plan. Clinicians must consider individualised therapeutic strategies and monitor for treatment-related complications in complex cases like this one
Bona fide diminished ovarian reserve or profound ovarian suppression by long-term oral contraceptive use?
Authors: Tsai Shelun , Pereira Nigel
Published: January 2025

Combined oral contraceptives (COCs) are widely used by reproductive-aged women. Current data suggest that long-term use of COCs can suppress ovarian reserve markers, including anti-mullerian hormone and antral follicle count, which may negatively impact ovarian response and oocyte yield in patients undergoing planned oocyte cryopreservation to preserve future reproductive potential. Discontinuation of COCs can improve ovarian stimulation outcomes, though the ideal duration of cessation is unknown. In this case report, we describe a patient with profound ovarian suppression from long-term COC use and her delayed reversal in ovarian suppression as demonstrated by longitudinal assessment of ovarian reserve markers and ovarian stimulation outcomes.
Liquorice-induced pseudohyperaldosteronism: a rare cause for severe hypertension
Authors: Karthik Vijayakumar , Alam Ahmad , Nair Sasikumar , Asok Arsha Chandrasobha
Published: January 2025

This case report describes an adult man in his 50s with a history of type 2 diabetes and previously well-controlled hypertension, who presented with uncontrolled hypertension, muscle weakness and fatigue. Biochemical testing revealed hypokalaemia. There was no evidence of renal/renovascular disease. Evaluation for primary hyperaldosteronism revealed suppressed renin concentration with low aldosterone levels. Detailed history taking revealed the daily consumption of three to four cups of liquorice root tea for 3 months. Glycyrrhetinic acid, a metabolite of glycyrrhizic acid found in liquorice, inhibits the 11 beta-hydroxysteroid dehydrogenase-2 (11β-HSD2 enzyme present at the renal tubule, leading to cortisol-mediated mineralocorticoid receptor activation. The diagnosis of liquorice-induced pseudohyperaldosteronism was made, and the discontinuation of liquorice with short-term use of mineralocorticoid receptor blockers led to normalisation of blood pressure and serum potassium. This case highlights the importance of considering the possibility of excess use of liquorice in the differential diagnosis of unexplained hypertension, especially in the context of low-renin hypertension.
Nutritional Support in the ICU
Authors: Reignier Jean , Rice Todd W , Arabi Yaseen M , Casaer Michael
Published: January 2025

Critical illness is a complex condition that can have a devastating impact on health and quality of life. Nutritional support is a crucial component of critical care that aims to maintain or restore nutritional status and muscle function. A one-size-fits-all approach to the components of nutritional support has not proven beneficial. Recent randomized controlled trials challenge the conventional strategy and support the safety and potential benefits of below-usual calorie and protein intakes at the early, acute phase of critical illness. Further research is needed to define optimal nutritional support throughout the intensive care unit stay. Individualized nutritional strategies relying on risk assessment tools or biomarkers deserve further investigation in rigorously designed, large, multicenter, randomized, controlled trials. Importantly, although nutritional support is crucial, it might not be sufficient to enhance the recovery of critically ill patients. Thus, achieving the greatest efficacy may require individualized nutritional support combined with early, prolonged physical rehabilitation within a multimodal, holistic care program throughout the patient's recovery journey.
Factors affecting mental health service delivery from primary healthcare facilities of western hilly district of Nepal: a qualitative study
Authors: Devkota Gaurav , Basnet Puspa , Thapa Bijay , Subedi Madhusudan
Published: January 2025

Aim

To explore factors at different socioecological levels that affect mental health service delivery from primary healthcare (PHC) facilities of Arghakhanchi district, a western hilly district of Nepal.

Background

Mental health service delivery has seen four transformational shifts from Alma Ata to Astana Declaration. Mental Health Gap Action Programme has facilitated the delivery of evidence-based interventions on mental, neurological and substance use disorders by non-specialised health workers in PHC settings as well as advocated scaling up of mental healthcare through integration of mental health in PHC.

Methods

A cross-sectional qualitative study was conducted in Arghakhanchi district of Nepal from July to August 2019 that collected information through face-to-face key informant interviews of 16 purposively selected participants using validated interview guidelines. Thematic analysis was performed using RQDA package for EZR software. Validation of translated transcripts, member checking and inter-coder percent agreement were performed to maintain rigour in the study.

Results

Lack of mental health training and no authority to prescribe psychotropic medications coupled with lack of mental health commodities acted as barriers for mental health service delivery. Awareness regarding mental health and modalities of treatment to the community and provision of training and authority to prescribe psychotropic medicines were recommended by the participants for proper mental health service delivery.

Conclusions

Awareness regarding mental illness treatment modalities to the community and mental health training for healthcare service providers would help increase mental health service delivery from PHC facilities. Moreover, strengthened referral system and availability of psychotropic medicines at the PHC level would assist in mental health service delivery from PHC facilities. However, regular monitoring and supervision of the services being delivered is essential.
Preferred labels and language to improve communication about lesions at low risk of progressing to cancer: qualitative interviews with patients and physicians
Authors: Lyons Mavis S , Baker Clara , Chaput Genevieve , Finelli Antonio , Kupets Rachel , Look Hong Nicole J , Wright Frances C , Gagliardi Anna R
Published: January 2025

Objectives

We explored how to improve communication about low-risk lesions including labels, language and other strategies.

Design

Qualitative description and thematic analysis to examine the transcripts of telephone interviews with patients who had low-risk lesions and physicians; and mapping to Communication Accommodation Theory to interpret themes.

Setting

Canada

Participants

15 patients: 6 (40%) bladder, 5 (33%) prostate and 4 (27%) cervix lesions; and 13 physicians: 7 (54%) cervix, 3 (23%) bladder and 3 (23%) prostate lesions.

Main outcome measures

Patient and physician views of labels, language and other strategies to improve communication about low-risk lesions.

Results

Patients and clinicians held discordant views about low-risk lesion label impact, preferences and rationale. All labels prompted confusion and anxiety among patients. In contrast, physicians perceived that patients understood that labels they used across all label categories (abnormal, precursor-to-cancer and cancer) implied low risk for cancer progression. Patients preferred abnormal cells, particularly when first learning of their diagnosis, and desired additional information to distinguish their diagnosis from cancer and justify treatment. In contrast, physicians favoured precursor-to-cancer and cancer labels out of habit, to match labels that patients saw elsewhere (online, charts) and to convince patients to attend follow-up and treatment visits. However, patients and physicians largely agreed on the need for 16 strategies that could improve communication about low-risk lesions including language (eg, plain language, situate low-risk lesions on cancer spectrum) and complementary communication strategies (eg, longer appointments, visual aids, connect patients with support services or groups).

Conclusions

The findings build on prior research by revealing that modifying labels is not the only or best strategy needed to improve communication about low-risk lesions. Ongoing research should examine how best to implement the strategies recommended by patients and physicians.
Perspectives of older patients on the preventability of their unplanned emergency department return visit within 30 days in the Netherlands: a multicentre mixed methods study
Authors: van den Broek Steef , Roordink Marije , Willems Odette , Sir Özcan , Westert Gert P , Hesselink Gijs , Schoon Yvonne
Published: January 2025

Objective

Older adults are prone to unplanned emergency department (ED) return visits (URVs). Knowledge about patient perspectives on the preventability and reasons for these URVs is limited and lacks a representable ED study population. This study aims to determine the proportion of URVs and to explore the preventability and underlying causes as perceived by a wide range of older adults and their caregivers.

Design

A multicentre mixed-methods study.

Setting

The ED of one academic and one regional hospital in the Netherlands.

Participants

Patients aged ≥70 years with a URV within 30 days after the index ED visit, consecutively sampled during a 6-week period.

Outcome measurements

Quantitative data regarding patient and clinical characteristics and perceived preventability of a URV were prospectively collected and analysed using descriptive statistics. Underlying causes of a URV were collected by semistructured interviews with patients and caregivers. Thematic content analysis was used to analyse the interview transcripts.

Results

Out of 1291 patients of 70 years and older, 151 patients had a URV (11.7%). In total, 64 patients were included after informed consent (42.4%). A total of 33 patients (51.5%) found their URV preventable. Perceived causes for a URV were categorised in six themes: (1) suboptimal treatment of health complaints, (2) premature hospital discharge, (3) poor assessment and arrangement of postdischarge needs, (4) patient and caregiver behaviour, (5) lack of advance care planning and insight in treatment options and (6) deficits in general practitioner care.

Conclusions

Our high rate of preventable URVs (51.5%) perceived by patients and caregivers underscores the importance to reduce URVs among older adults. Perceived causes in this study add other unexplored themes to the existing knowledge and create support for further research and interventional opportunities.
Patient-sharing networks among Finnish primary healthcare professionals taking care of patients with mental health or substance use problems: a register study
Authors: Hietapakka Laura , Sinervo Timo , Väisänen Visa , Niemi Ripsa , Gutvilig Mai , Linnaranta Outi , Suvisaari Jaana , Hakulinen Christian , Elovainio Marko
Published: January 2025

Objectives

Patient-sharing networks based on administrative data are used to understand the organisation of healthcare. We examined the patient-sharing networks between different professionals taking care of patients with mental health or substance use problems.

Design

Register study based on the Register of Primary Health Care visits (Avohilmo) that covers all outpatient primary health care visits in Finland.

Setting

We used the register data covering the visits for the service providers of seven municipalities, adult patients with at least one visit to a health and social service centre within one of the municipalities and visits during the year 2021.

Participants

We first selected patients with mental health or substance use problems based on psychiatric diagnoses and information on service type and then identified the professionals (N=1566) visited. A patient-sharing relationship was defined between two professionals if a same patient had visited both of them at least once.

Primary outcome measures

We analysed the potential associations of the network structure and the nodal attributes (municipality, belonging to a certain occupational group and the service type) with nodal formation using Exponential Random Graph Models.

Results

The main findings showed that two professionals were more likely to share patient(s) when they belonged to the same occupational group, provided similar types of services or worked in the same municipality. Being a physician was associated with having more connections to other professionals than belonging to other occupational groups (OR for nurses 0.70, 95% CI 0.69 to 0.7 and for other occupations 0.83, 95% CI 0.81 to 0.84). Shared patients among different professionals were also more probable when the patients were shared with the professionals working within mental health or substance use services compared with outpatient healthcare services (OR 1.64, 95% CI 1.61 to 1.67).

Conclusions

Patient-sharing contacts were mainly homogenous, supporting the tendency of people to have connections with similar people. The results also highlight the role of the physicians as important partners in the patient-sharing networks.
Identifying the burdens for informal caregivers of tracheostomy-dependent people: a scoping review protocol
Authors: Luo Haiyan , Miao Xiao , Chu Yuan , Liming Song
Published: January 2025

Introduction

It is complicated and time-consuming to care for tracheostomised patients, and many informal caregivers are said to feel a variety of burdens, although we are unsure of the specifics of this burden. This scoping review aims to identify and examine the caregiver burden encountered by informal caregivers of patients with tracheostomy.

Methods and analysis

This scoping review will be carried out in accordance with Arksey and O’Malley and its extended framework, along with adherence to the guidelines provided by the Joanna Briggs Institute. Reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review checklists. Searches will be conducted in PubMed, PsycINFO via EBSCO, Embase, Web of Science and CINAHL via EBSCO databases, as well as grey literature sources from the inception of the databases to July 2024. Additionally, reference lists of included studies will be manually reviewed for further sources. The quality of included studies will be assessed using the Crowe Critical Appraisal Tool, involving at least two reviewers in all steps of the review process. Data charting will be conducted in a narrative format, encompassing the study’s objectives and questions. This review will also aim to identify any existing research gaps.

Ethics and dissemination

This review protocol does not involve ethical disclosure. This scoping review will identify the burden for informal caregivers of tracheostomy-dependent people and share the results via professional organisations, conferences and scholarly publications.

Trial registration number

This protocol was preregistered with the Open Science Framework (CENTER FOR OPEN SCIENCE), with Registration DOI (https://doi.org/10.17605/OSF.IO/YCWXR).