bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatio-temporal spread of artemisinin resistance in Southeast Asia
Authors: Flegg Jennifer A. , Kandanaarachchi Sevvandi , Guerin Philippe J. , Dondorp Arjen M. , Nosten Francois H. , Otienoburu Sabina Dahlström , Golding Nick
Published: April 2024

Current malaria elimination targets must withstand a colossal challenge–resistance to the current gold standard antimalarial drug, namely artemisinin derivatives. If artemisinin resistance significantly expands to Africa or India, cases and malaria-related deaths are set to increase substantially. Spatial information on the changing levels of artemisinin resistance in Southeast Asia is therefore critical for health organisations to prioritise malaria control measures, but available data on artemisinin resistance are sparse. We use a comprehensive database from the WorldWide Antimalarial Resistance Network on the prevalence of non-synonymous mutations in the Kelch 13 (K13) gene, which are known to be associated with artemisinin resistance, and a Bayesian geostatistical model to produce spatio-temporal predictions of artemisinin resistance. Our maps of estimated prevalence show an expansion of the K13 mutation across the Greater Mekong Subregion from 2000 to 2022. Moreover, the period between 2010 and 2015 demonstrated the most spatial change across the region. Our model and maps provide important insights into the spatial and temporal trends of artemisinin resistance in a way that is not possible using data alone, thereby enabling improved spatial decision support systems on an unprecedented fine-scale spatial resolution. By predicting for the first time spatio-temporal patterns and extents of artemisinin resistance at the subcontinent level, this study provides critical information for supporting malaria elimination goals in Southeast Asia.
Association of liver function and prognosis in patients with severe fever with thrombocytopenia syndrome
Authors: Zhang Shaoqiu , Wang Jian , Zhang Qun , Pan Yifan , Zhang Zhiyi , Geng Yu , Jia Bei , Li Yuanyuan , Xiong Yali , Yan Xiaomin , Li Jie , Wang Huali , Wu Chao , Huang Rui
Published: April 2024

Objectives

Severe fever with thrombocytopenia syndrome (SFTS) is an epidemic emerging infectious disease with high mortality rate. We investigated the association between liver injury and clinical outcomes in patients with SFTS.

Methods

A total of 291 hospitalized SFTS patients were retrospectively included. Cox proportional hazards model was adopted to identify risk factors of fatal outcome and Kaplan-Meier curves were used to estimate cumulative risks.

Results

60.1% of patients had liver injury at admission, and the median alanine transaminase, aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBil) levels were 76.4 U/L, 152.3 U/L, 69.8 U/L and 9.9 μmol/L, respectively. Compared to survivors, non-survivors had higher levels of AST (253.0 U/L vs. 131.1 U/L, P < 0.001) and ALP (86.2 U/L vs. 67.9 U/L, P = 0.006), higher proportion of elevated ALP (20.0% vs. 4.4%, P < 0.001) and liver injury (78.5% vs. 54.9%, P = 0.001) at admission. The presence of liver injury (HR 2.049, P = 0.033) at admission was an independent risk factor of fatal outcome.

Conclusions

Liver injury was a common complication and was strongly associated with poor prognosis in SFTS patients. Liver function indicators should be closely monitored for SFTS patients.
Local amphotericin B therapy for Cutaneous Leishmaniasis: A systematic review
Authors: Alves Líndicy Leidicy , Freire Mariana Lourenço , Troian Isadora Lana , Morais-Teixeira Eliane de , Cota Gláucia
Published: April 2024

Background

Cutaneous leishmaniasis (CL) is characterized by potentially disfiguring skin ulcers carrying significant social stigma. To mitigate systemic drug exposure and reduce the toxicity from available treatments, studies addressing new local therapeutic strategies using available medications are coming up. This review systematically compiles preclinical and clinical data on the efficacy of amphotericin B (AmB) administered locally for cutaneous leishmaniasis.

Methodology

Structured searches were conducted in major databases. Clinical studies reporting cure rates and preclinical studies presenting any efficacy outcome were included. Exclusion criteria comprised nonoriginal studies, in vitro investigations, studies with fewer than 10 treated patients, and those evaluating AmB in combination with other antileishmanial drug components.

Principal findings

A total of 21 studies were identified, encompassing 16 preclinical and five clinical studies. Preclinical assessments generally involved the topical use of commercial AmB formulations, often in conjunction with carriers or controlled release systems. However, the variation in the treatment schedules hindered direct comparisons. In clinical studies, topical AmB achieved a pooled cure rate of 45.6% [CI: 27.5–64.8%; I2 = 79.7; p = 0.002), while intralesional (IL) administration resulted in a 69.8% cure rate [CI: 52.3–82.9%; I2 = 63.9; p = 0.06). In the direct comparison available, no significant difference was noted between AmB-IL and meglumine antimoniate-IL administration (OR:1.7; CI:0.34–9.15, I2 = 79.1; p = 0.00), however a very low certainty of evidence was verified.

Conclusions

Different AmB formulations and administration routes have been explored in preclinical and clinical studies. Developing therapeutic technologies is evident. Current findings might be interpreted as a favorable proof of concept for the local AmB administration which makes this intervention eligible to be explored in future well-designed studies towards less toxic treatments for leishmaniasis.
Effects of psychogenic stress on oxidative stress and antioxidant capacity at different growth stages of rats: Experimental study
Authors: Lee Sangun , Itagaki Atsunori , Satoh Atsuko , Sugimoto Issei , Saito Takumi , Shibukawa Yoshihiko , Tatehana Haruka
Published: April 2024

This study examined the psychogenic stress (PS) effects on changes in oxidative stress and the antioxidant capacity of an organism at different growth stages. The experimental animals were male Wistar rats of five different ages from growth periods (GPs) to old age. The growth stages were randomly classified into control (C) and experimental (PS) groups. The PS was performed using restraint and water immersion once daily for 3 h for 4 weeks. Reactive oxygen metabolites (d-ROMs) and the biological antioxidant potential (BAP) were measured before and after the experiment. In addition, the liver and adrenal glands were removed, and the wet weight was measured. The d-ROM and BAP of all growth stages given PS increased significantly. The d-ROM in the C group without PS increased significantly in GPs while decreased significantly in old-aged rats. In addition, the BAP of the C group in GP and early adulthood were all significantly elevated. There were significant differences in organ weights between the C and PS groups at all growth stages. Oxidative stress and antioxidant capacity differed depending on the organism’s developmental status and growth stage, and PS also showed different effects. In particular, the variability in oxidative stress was remarkable, suggesting that the effect of PS was more significant in the organism’s immature organs.
Investigating the potential of Juglans regia phytoconstituents for the treatment of cervical cancer utilizing network biology and molecular docking approach
Authors: Dua Riya , Bhardwaj Tulika , Ahmad Irshad , Somvanshi Pallavi
Published: April 2024

The fourth most frequent type of cancer in women and the leading cause of mortality for females worldwide is cervical cancer. Traditionally, medicinal plants have been utilized to treat various illnesses and ailments. The molecular docking method is used in the current study to look into the phytoconstituents of Juglans regia’s possible anticancer effects on cervical cancer target proteins. This work uses the microarray dataset analysis of GSE63678 from the NCBI Gene Expression Omnibus database to find differentially expressed genes. Furthermore, protein-protein interactions of differentially expressed genes were constructed using network biology techniques. The top five hub genes (IGF1, FGF2, ESR1, MYL9, and MYH11) are then determined by computing topological parameters with Cytohubba. In addition, molecular docking research was performed on Juglans regia phytocompounds that were extracted from the IMPPAT database versus hub genes that had been identified. Utilizing molecular dynamics, simulation confirmed that prioritized docked complexes with low binding energies were stable.
Predictors for liver fibrosis in non-alcoholic patients with psoriatic diseases: A multicenter cross sectional-study
Authors: Chavez-Tapia Norberto Carlos , Sanchez-Jimenez Beatriz A. , Vidaña-Perez Desiree , Corrales-Rosas Beatriz , Balderas-Garces Brenda , Vera-Izaguirre Diana , Santa Cruz Fermin Jurado , Maldonado-Garcia Cesar , Juarez-Hernandez Eva , Uribe Misael
Published: April 2024

Psoriasis has been related to metabolic dysfunction-associated fatty liver disease and, liver fibrosis. This study aimed to evaluate the prevalence of liver fibrosis in psoriasis and identify predictors for fibrosis. This is a cross-sectional study conducted from December 2012 to June 2016 assessing psoriasis and psoriatic arthritis patients attended at four centers in Mexico City. Data regarding history of the skin disease, previous and current medication, and previously diagnosed liver disease was collected. Liver fibrosis was assessed with four different non-invasive methods (FIB4, APRI, NAFLD score and elastography). We compared data based on the presence of fibrosis. Adjusted-logistic regression models were performed to estimate OR and 95% CI. A total of 160 patients were included. The prevalence of significant fibrosis using elastography was 25% (n = 40), and 7.5% (n = 12) for advanced fibrosis. Patients with fibrosis had higher prevalence of obesity (60% vs 30.8%, P = 0.04), type 2 diabetes (40% vs 27.5%, P = 0.003), gamma-glutamyl transpeptidase levels (70.8±84.4 vs. 40.1±39.2, P = 0.002), and lower platelets (210.7±58.9 vs. 242.8±49.7, P = 0.0009). Multivariate analysis showed that body mass index (OR1.11, 95%CI 1.02–1.21), type 2 diabetes (OR 3.44, 95%CI 1.2–9.88), and gamma-glutamyl transpeptidase (OR 1.01, 95%CI1-1.02) were associated with the presence of fibrosis. The use of methotrexate was not associated. Patients with psoriasis are at higher risk of fibrosis. Metabolic dysfunction, rather than solely the use of hepatotoxic drugs, likely plays a major role; it may be beneficial to consider elastography regardless of the treatment used. Metabolic factors should be assessed, and lifestyle modification should be encouraged.
Research ethics review during the COVID-19 pandemic: An international study
Authors: Salamanca-Buentello Fabio , Katz Rachel , Silva Diego S. , Upshur Ross E. G. , Smith Maxwell J.
Published: April 2024

Research ethics review committees (ERCs) worldwide faced daunting challenges during the COVID-19 pandemic. There was a need to balance rapid turnaround with rigorous evaluation of high-risk research protocols in the context of considerable uncertainty. This study explored the experiences and performance of ERCs during the pandemic. We conducted an anonymous, cross-sectional, global online survey of chairs (or their delegates) of ERCs who were involved in the review of COVID-19-related research protocols after March 2020. The survey ran from October 2022 to February 2023 and consisted of 50 items, with opportunities for descriptive responses to open-ended questions. Two hundred and three participants [130 from high-income countries (HICs) and 73 from low- and middle-income countries (LMICs)] completed our survey. Respondents came from diverse entities and organizations from 48 countries (19 HICs and 29 LMICs) in all World Health Organization regions. Responses show little of the increased global funding for COVID-19 research was allotted to the operation of ERCs. Few ERCs had pre-existing internal policies to address operation during public health emergencies, but almost half used existing guidelines. Most ERCs modified existing procedures or designed and implemented new ones but had not evaluated the success of these changes. Participants overwhelmingly endorsed permanently implementing several of them. Few ERCs added new members but non-member experts were consulted; quorum was generally achieved. Collaboration among ERCs was infrequent, but reviews conducted by external ERCs were recognized and validated. Review volume increased during the pandemic, with COVID-19-related studies being prioritized. Most protocol reviews were reported as taking less than three weeks. One-third of respondents reported external pressure on their ERCs from different stakeholders to approve or reject specific COVID-19-related protocols. ERC members faced significant challenges to keep their committees functioning during the pandemic. Our findings can inform ERC approaches towards future public health emergencies. To our knowledge, this is the first international, COVID-19-related study of its kind.
Members of the paralogous gene family 12 from the Lyme disease agent Borrelia burgdorferi are non-specific DNA-binding proteins
Authors: Brangulis Kalvis , Akopjana Inara , Drunka Laura , Matisone Sofija , Zelencova-Gopejenko Diana , Bhattacharya Shapla , Bogans Janis , Tars Kaspars
Published: April 2024

Lyme disease is the most prevalent vector-borne infectious disease in Europe and the USA. Borrelia burgdorferi, as the causative agent of Lyme disease, is transmitted to the mammalian host during the tick blood meal. To adapt to the different encountered environments, Borrelia has adjusted the expression pattern of various, mostly outer surface proteins. The function of most B. burgdorferi outer surface proteins remains unknown. We determined the crystal structure of a previously uncharacterized B. burgdorferi outer surface protein BBK01, known to belong to the paralogous gene family 12 (PFam12) as one of its five members. PFam12 members are shown to be upregulated as the tick starts its blood meal. Structural analysis of BBK01 revealed similarity to the coiled coil domain of structural maintenance of chromosomes (SMC) protein family members, while functional studies indicated that all PFam12 members are non-specific DNA-binding proteins. The residues involved in DNA binding were identified and probed by site-directed mutagenesis. The combination of SMC-like proteins being attached to the outer membrane and exposed to the environment or located in the periplasm, as observed in the case of PFam12 members, and displaying the ability to bind DNA, represents a unique feature previously not observed in bacteria.
Multi-assay approach shows species-associated personality patterns in two socially distinct gerbil species
Authors: Tchabovsky Andrey V. , Surkova Elena N. , Savinetskaya Ludmila E.
Published: April 2024

We aimed to investigate whether two closely related but socially distinct species of gerbils differ in personality patterns. Using a suit of multivariate repeated assays (docility test, dark-light emergence test, startle test, novel object test, elevated platform test, and stranger test), we assessed contextual and temporal consistency of docility, boldness, exploration, anxiety, and sociability in the solitary midday gerbil, Meriones meridianus, and social Mongolian gerbil, M. unguiculatus. We revealed contextually consistent and highly repeatable sex-independent but species-specific personality traits. Species differed in temporal repeatability of different behaviours, and contextual consistency was more pronounced in solitary M. meridianus than in social M. unguiculatus. This finding contradicts the social niche specialization hypothesis, which suggests that personality traits should be more consistent in more social species. Instead, we hypothesize that social complexity should favour more flexible and less consistent behavioural traits. The habituation effect indicative of learning abilities was weak in both species yet stronger in social M. unguiculatus, supporting the relationship between the sociality level and cognitive skills. In both species, only a few different behavioural traits covaried, and the sets of correlated behaviours were species-specific such that the two species did not share any pair of correlated traits. Between-species differences in personality traits, habituation, and behavioural syndromes may be linked to differences in sociality. The lack of prominent behavioural syndromes is consistent with the idea that context-specific individual behavioural traits might be favoured to allow more flexible and adequate responses to changing environments than syndromes of correlated functionally different behaviours.
Characterization of β-lactamase and virulence genes in Pseudomonas aeruginosa isolated from clinical, environmental and poultry sources in Bangladesh
Authors: Islam Raihana , Ferdous Farhana Binte , Hoque M. Nazmul , Asif Nowshad Atique , Rana Md. Liton , Siddique Mahbubul Pratik , Rahman Md. Tanvir
Published: April 2024

The emergence and spread of multidrug-resistant pathogens like Pseudomonas aeruginosa are major concerns for public health worldwide. This study aimed to assess the prevalence of P. aeruginosa in clinical, environmental, and poultry sources in Bangladesh, along with their antibiotic susceptibility and the profiling of β-lactamase and virulence genes using standard molecular and microbiology techniques. We collected 110 samples from five different locations, viz., BAU residential area (BAURA; n = 15), BAU Healthcare Center (BAUHCC; n = 20), BAU Veterinary Teaching Hospital (BAUVTH; n = 22), Poultry Market (PM; n = 30) and Mymensingh Medical College Hospital (MCCH; n = 23). After overnight enrichment in nutrient broth, 89 probable Pseudomonas isolates (80.90%) were screened through selective culture, gram-staining and biochemical tests. Using genus- and species-specific PCR, we confirmed 22 isolates (20.0%) as P. aeruginosa from these samples. Antibiogram profiling revealed that 100.0% P. aeruginosa isolates (n = 22) were multidrug-resistant isolates, showing resistance against Doripenem, Penicillin, Ceftazidime, Cefepime, and Imipenem. Furthermore, resistance to aztreonam was observed in 95.45% isolates. However, P. aeruginosa isolates showed a varying degree of sensitivity against Amikacin, Gentamicin, and Ciprofloxacin. The blaTEM gene was detected in 86.0% isolates, while blaCMY, blaSHV and blaOXA, were detected in 27.0%, 18.0% and 5.0% of the P. aeruginosa isolates, respectively. The algD gene was detected in 32.0% isolates, whereas lasB and exoA genes were identified in 9.0% and 5.0% P. aeruginosa isolates. However, none of the P. aeruginosa isolates harbored exoS gene. Hence, this study provides valuable and novel insights on the resistance and virulence of circulating P. aeruginosa within the clinical, environmental, and poultry environments of Bangladesh. These findings are crucial for understanding the emergence of β-lactamase resistance in P. aeruginosa, highlighting its usefulness in the treatment and control of P. aeruginosa infections in both human and animal populations.
Psychosocial working conditions as determinants of slips and lapses, and poor social interactions with patients among medical assistants in Germany: A cohort study
Authors: Mambrey Viola , Loerbroks Adrian
Published: April 2024

Objective

We sought to examine the relationship of unfavorable psychosocial working conditions with slips and lapses and poor patient interaction as well as potential intermediate factors among medical assistants (MAs) in Germany based on prospective data.

Methods

We used data from 408 MAs from a 4-year cohort study (follow-up: 2021). At baseline, psychosocial working conditions were assessed by the established effort-reward-imbalance questionnaire and a MA-specific questionnaire with 7 subscales. Frequency of slips and lapses (e.g., pertaining to measurements and documentation) and the quality of patient interactions (e.g., unfriendliness or impatience) due to work stress were assessed at follow-up with three items each (potential score ranges = 3–15). Potential intermediate factors at baseline included work engagement (i.e., vitality and dedication (UWES)), work satisfaction (COPSOQ), anxiety (GAD-2), depressiveness (PHQ-2), and self-reported health. We ran multivariable linear regression using z-standardized exposures to estimate unstandardized coefficients (B) and 95% confidence intervals (CI). Potential intermediate factors were added separately to the regression models. Attenuation of the association between exposure and outcome toward the null value (B = 0) was interpreted as mediation.

Results

High reward and lack of resources were weakly associated with the frequency of slips and lapses (the Bs were -0.18 and 0.23, respectively; p<0.05), with little evidence of mediation. With the exception of low recognition, all unfavorable psychosocial working conditions predicted a higher frequency of poor interactions with patients (p-values<0.01). These associations were attenuated by work engagement, work satisfaction, and health outcomes.

Conclusion

We found mostly non-significant associations between adverse psychosocial working conditions and the frequency of slips and lapses. However, unfavorable psychosocial working conditions among MAs predicted a higher frequency of poor interaction with patients due to stress.
An exploration of the (3+1)-dimensional negative order KdV-CBS model: Wave solutions, Bäcklund transformation, and complexiton dynamics
Authors: Vivas-Cortez Miguel , Rani Beenish , Raza Nauman , Basendwah Ghada Ali , Imran Mudassar
Published: April 2024

This research paper focuses on the study of the (3+1)-dimensional negative order KdV-Calogero-Bogoyavlenskii-Schiff (KdV-CBS) equation, an important nonlinear partial differential equation in oceanography. The primary objective is to explore various solution techniques and analyze their graphical representations. Initially, two wave, three wave, and multi-wave solutions of the negative order KdV CBS equation are derived using its bilinear form. This analysis shed light on the behavior and characteristics of the equation’s wave solutions. Furthermore, a bilinear Bäcklund transform is employed by utilizing the Hirota bilinear form. This transformation yields exponential and rational function solutions, contributing to a more comprehensive understanding of the equation. The resulting solutions are accompanied by graphical representations, providing visual insights into their structures. Moreover, the extended transformed rational function method is applied to obtain complexiton solutions. This approach, executed through the bilinear form, facilitated the discovery of additional solutions with intriguing properties. The graphical representations, spanning 2D, 3D, and contour plots, serve as valuable visual aids for understanding the complex dynamics and behaviors exhibited by the equation’s solutions.
AM-18002, a derivative of natural anmindenol A, enhances radiosensitivity in mouse breast cancer cells
Authors: Eum Da-Young , Jeong Myeonggyo , Park Soon-Yong , Kim Jisu , Jin Yunho , Jo Jeyun , Shim Jae-Woong , Lee Seoung Rak , Park Seong-Joon , Heo Kyu , Yun Hwayoung , Choi Yoo-Jin
Published: April 2024

Natural anmindenol A isolated from the marine-derived bacteria Streptomyces sp. caused potent inhibition of inducible nitric oxide synthase without any significant cytotoxicity. This compound consists of a structurally unique 3,10-dialkylbenzofulvene skeleton. We previously synthesized and screened the novel derivatives of anmindenol A and identified AM-18002, an anmindenol A derivative, as a promising anticancer agent. The combination of AM-18002 and ionizing radiation (IR) improved anticancer effects, which were exerted by promoting apoptosis and inhibiting the proliferation of FM3A mouse breast cancer cells. AM-18002 increased the production of reactive oxygen species (ROS) and was more effective in inducing DNA damage. AM-18002 treatment was found to inhibit the expansion of myeloid-derived suppressor cells (MDSC), cancer cell migration and invasion, and STAT3 phosphorylation. The AM-18002 and IR combination synergistically induced cancer cell death, and AM-18002 acted as a potent anticancer agent by increasing ROS generation and blocking MDSC-mediated STAT3 activation in breast cancer cells.
Guidelines for tuberculosis screening and preventive treatment among pregnant and breastfeeding women living with HIV in PEPFAR-supported countries
Authors: Hirsch-Moverman Yael , Hsu Allison , Abrams Elaine J. , Killam William P. , Moore Brittany , Howard Andrea A.
Published: April 2024

Background

Tuberculosis (TB) preventive treatment (TPT) is recommended by the World Health Organization (WHO) for persons living with HIV, including pregnant and breastfeeding women. Given the President’s Emergency Plan for AIDS Relief (PEPFAR)’s investment in TPT services for persons living with HIV as a strategy to prevent TB as well as uncertainty in guidelines and policy regarding use of TPT during pregnancy and the postpartum period, we conducted a review of current relevant national guidelines among PEPFAR-supported countries.

Methods

Our review included 44/49 PEPFAR-supported countries to determine if TB screening and TPT are recommended specifically for pregnant and breastfeeding women living with HIV (WLHIV). National guidelines reviewed and abstracted included TB, HIV, prevention of vertical HIV transmission, TPT, and any other relevant guidelines. We abstracted information regarding TB screening, including screening tools and frequency; and TPT, including timing, regimen, frequency, and laboratory monitoring.

Results

Of 44 PEPFAR-supported countries for which guidelines were reviewed, 66% were high TB incidence countries; 41% were classified by WHO as high TB burden countries, and 43% as high HIV-associated TB burden countries. We found that 64% (n = 28) of countries included TB screening recommendations for pregnant WLHIV in their national guidelines, and most (n = 35, 80%) countries recommend TPT for pregnant WLHIV. Fewer countries included recommendations for breastfeeding as compared to pregnant WLHIV, with only 32% (n = 14) mentioning TB screening and 45% (n = 20) specifically recommending TPT for this population; most of these recommend isoniazid-based TPT regimens for pregnant and breastfeeding WLHIV. However, several countries also recommend isoniazid combined with rifampicin (3RH) or rifapentine (3HP).

Conclusions

Despite progress in the number of PEPFAR-supported countries that specifically include TB screening and TPT recommendations for pregnant and breastfeeding WLHIV in their national guidelines, many PEPFAR-supported countries still do not include specific screening and TPT recommendations for pregnant and breastfeeding WLHIV.
Post-operative bracing following adult spine deformity surgery: Results from the AO Spine surveillance of post-operative management of patients with adult spine deformity
Authors: Kato So , Smith Justin S. , Driesman Devin , Shaffrey Christopher I. , Lenke Lawrence G. , Lewis Stephen J. ,   AO Spine Knowledge Forum Deformity
Published: April 2024

Study design

Cross-sectional international survey with a literature review.

Objectives

While some surgeons favor spine bracing after surgery for adult spine deformity (ASD) to help prevent mechanical failures, there is a lack of evidence. The objective of the present study was to better understand the current trend in the use of bracing following ASD surgery based on an international survey.

Methods

An e-mail-based online survey was conducted among over 6000 international AO Spine members regarding the post-operative management of patients with ASD. The details of brace prescription, indications and influencing factors were solicited. Descriptive data were summarized based on different demographic groups and fusion levels for the responding surgeons who annually perform at least 10 long-segment fusions of >5 levels extending to the pelvis.

Results

A total of 116 responses were received, including 71 surgeons (61%) who used post-operative bracing for >5 levels of long fusion. The most common reason for bracing was pain management (55%) and bone quality was the strongest influencing factor (69%). Asia-Pacific surgeons had the highest rate of bracing (88%), while North American surgeons had the lowest (45%). The most common type of brace used were TLSO for cases with an uppermost instrumented vertebra (UIV) in the low- or mid-thoracic spine and a cervical brace for UIV at T1-3. The majority (56%) used bracing for 6–12 weeks after surgery.

Conclusions

The present survey demonstrated significant interest in bracing following ASD surgery, however, there is substantial variability in post-operative bracing practice. A formal study on the role of bracing in ASD surgery is needed.
The effect of explicit convection on simulated malaria transmission across Africa
Authors: Talib Joshua , Abatan Abayomi A. , HoekSpaans Remy , Yamba Edmund I. , Egbebiyi Temitope S. , Caminade Cyril , Jones Anne , Birch Cathryn E. , Olagbegi Oladapo M. , Morse Andrew P.
Published: April 2024

Malaria transmission across sub-Saharan Africa is sensitive to rainfall and temperature. Whilst different malaria modelling techniques and climate simulations have been used to predict malaria transmission risk, most of these studies use coarse-resolution climate models. In these models convection, atmospheric vertical motion driven by instability gradients and responsible for heavy rainfall, is parameterised. Over the past decade enhanced computational capabilities have enabled the simulation of high-resolution continental-scale climates with an explicit representation of convection. In this study we use two malaria models, the Liverpool Malaria Model (LMM) and Vector-Borne Disease Community Model of the International Centre for Theoretical Physics (VECTRI), to investigate the effect of explicitly representing convection on simulated malaria transmission. The concluded impact of explicitly representing convection on simulated malaria transmission depends on the chosen malaria model and local climatic conditions. For instance, in the East African highlands, cooler temperatures when explicitly representing convection decreases LMM-predicted malaria transmission risk by approximately 55%, but has a negligible effect in VECTRI simulations. Even though explicitly representing convection improves rainfall characteristics, concluding that explicit convection improves simulated malaria transmission depends on the chosen metric and malaria model. For example, whilst we conclude improvements of 45% and 23% in root mean squared differences of the annual-mean reproduction number and entomological inoculation rate for VECTRI and the LMM respectively, bias-correcting mean climate conditions minimises these improvements. The projected impact of anthropogenic climate change on malaria incidence is also sensitive to the chosen malaria model and representation of convection. The LMM is relatively insensitive to future changes in precipitation intensity, whilst VECTRI predicts increased risk across the Sahel due to enhanced rainfall. We postulate that VECTRI’s enhanced sensitivity to precipitation changes compared to the LMM is due to the inclusion of surface hydrology. Future research should continue assessing the effect of high-resolution climate modelling in impact-based forecasting.
Study protocol for the Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) global cross-specialty surveys and consensus
Authors: Cacciamani Giovanni E. , Sholklapper Tamir , Eppler Michael B. , Sayegh Aref , Storino Ramacciotti Lorenzo , Abreu Andre L. , Sotelo Rene , Desai Mihir M. , Gill Inderbir S.
Published: April 2024

Annually, about 300 million surgeries lead to significant intraoperative adverse events (iAEs), impacting patients and surgeons. Their full extent is underestimated due to flawed assessment and reporting methods. Inconsistent adoption of new grading systems and a lack of standardization, along with litigation concerns, contribute to underreporting. Only half of relevant journals provide guidelines on reporting these events, with a lack of standards in surgical literature. To address these issues, the Intraoperative Complications Assessment and Reporting with Universal Standard (ICARUS) Global Surgical Collaboration was established in 2022. The initiative involves conducting global surveys and a Delphi consensus to understand the barriers for poor reporting of iAEs, validate shared criteria for reporting, define iAEs according to surgical procedures, evaluate the existing grading systems’ reliability, and identify strategies for enhancing the collection, reporting, and management of iAEs. Invitation to participate are extended to all the surgical specialties, interventional cardiology, interventional radiology, OR Staffs and anesthesiology. This effort represents an essential step towards improved patient safety and the well-being of healthcare professionals in the surgical field.
“It doesn’t matter if you are in charge of the trees, you always miss the trees for the forest”: Power and the illusion of explanatory depth
Authors: Körner Robert , Schütz Astrid , Petersen Lars-Eric
Published: April 2024

Power can increase overconfidence and illusory thinking. We investigated whether power is also related to the illusion of explanatory depth (IOED), people’s tendency to think they understand the world in more detail, coherence, and depth than they actually do. Abstract thinking was reported as a reason for the IOED, and according to the social distance theory of power, power increases abstract thinking. We linked these literatures and tested construal style as a mediator. Further, predispositions can moderate effects of power and we considered narcissism as a candidate because narcissism leads to overconfidence and may thus increase the IOED especially in combination with high power. In three preregistered studies (total N = 607), we manipulated power or measured feelings of power. We found evidence for the IOED (regarding explanatory knowledge about devices). Power led to general overconfidence but had only a small impact on the IOED. Power and narcissism had a small interactive effect on the IOED. Meta-analytical techniques suggest that previous findings on the construal-style-IOED link show only weak evidential value. Implications refer to research on management, power, and overconfidence.
Aspirin or enoxaparin for VTE prophylaxis after primary partial, total or revision hip or knee arthroplasty: A secondary analysis from the CRISTAL cluster randomized trial
Authors:   The CRISTAL Study Group
Published: April 2024

Background

This study compares aspirin to enoxaparin for symptomatic VTE prophylaxis within 90 days of any type of hip or knee arthroplasty performed for any diagnosis, in patients enrolled in the CRISTAL trial.

Materials and methods

CRISTAL was a cluster-randomised crossover, registry-nested non-inferiority trial across 31 hospitals in Australia. The primary publication was restricted to patients undergoing primary total hip or knee arthroplasty for a diagnosis of osteoarthritis. This report includes all enrolled patients undergoing hip or knee arthroplasty procedures (partial or total, primary or revision) performed for any indication. Hospitals were randomized to administer patients aspirin (100mg daily) or enoxaparin (40mg daily), for 35 days after hip arthroplasty and 14 days after knee arthroplasty. Crossover occurred after the patient enrolment target had been met for the first group. The primary outcome was symptomatic VTE within 90 days. Analyses were performed by randomization group.

Results

Between April 20, 2019 and December 18, 2020, 12384 patients were enrolled (7238 aspirin group and 5146 enoxaparin). Of these, 6901 (95.3%) given aspirin and 4827 (93.8%) given enoxaparin (total 11728, 94.7%) were included in the final analyses. Within 90 days, symptomatic VTE occurred in 226 (3.27%) aspirin patients and 85 (1.76%) enoxaparin patients, significant for the superiority of enoxaparin (estimated treatment difference 1.85%, 95% CI 0.59% to 3.10%, p = 0.004). Joint-related reoperation within 90 days was lower in the enoxaparin group (109/4827 (2.26%) vs 171/6896 (2.47%) with aspirin, estimated difference 0.77%; 95% CI 0.06% to 1.47%, p = 0.03). There were no significant differences in the other secondary outcomes.

Conclusion

In patients undergoing hip or knee arthroplasty (of any type, performed for any indication) enrolled in the CRISTAL trial, aspirin compared to enoxaparin resulted in a significantly higher rate of symptomatic VTE and joint-related reoperation within 90 days. These findings extend the applicability of the CRISTAL trial results.

Trial registration

Anzctr.org.au, identifier: ACTRN12618001879257.
Research on the factors and path of sports industry development in China: A fsQCA study of 31 provinces
Authors: Shi Yi , Song Qingyao , Li Lin
Published: April 2024

The advancement of the sports industry’s development constitutes a critical concern shared by regional authorities and the scholarly community, reflecting its significant role in economic and social development. This study employs a Fuzzy-set Qualitative Comparative Analysis (fsQCA) methodology to examine the 31 provincial-level administrative units in China. The objective is to elucidate the influence of technological, organizational, and environmental factors on the industry’s development level, considering both a holistic national framework and dissected regional approaches (Eastern, Central, and Western China). This paper’s contribution to the literature is structured around the following core findings: (1) The study establishes that a singular condition does not suffice as an essential prerequisite for achieving a heightened development state within the sports industry. (2) At the national level, there are three pathways to enhance the development level of the sports industry, specifically identified as "network-human resources dominant pathway," "technological innovation-human resources dominant pathway," and "comprehensive synergistic pathway."(3) From a regional perspective, the Eastern region has two pathways for sports industry enhancement: "network-economic pathway" and "comprehensive synergistic pathway." The Central region follows a "technology pathway," while the Western region has three pathways: "organization-environment pathway," "network-organization-environment pathway," and "organization pathway."(4) The synthesis of these findings underscores the multifactorial nature of sports industry development, suggesting a paradigm where diverse routes can lead to equivalent outcomes. This heterogeneity indicates that provinces or regions can tailor their development strategies to their unique situational contexts.
Widely targeted metabolomics reveals differences in metabolites of Paeonia lactiflora cultivars
Authors: Li Yonghui , Tian Yingying , Zhou Xiaojun , Guo Xiangmeng , Ya Huiyuan , Li Shipeng , Yu Xiangli , Yuan Congying , Gao Kai
Published: April 2024

Introduction

Paeonia lactiflora contains diverse active constituents and exhibits various pharmacological activities. However, only partial identification of biologically active substances from P. lactiflora has been achieved using low-throughput techniques. Here, the roots of P. lactiflora, namely, Fenyunu (CK), Dafugui (DFG), and Red Charm (HSML), were studied. The primary and secondary metabolites were investigated using ultrahigh-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (UPLC-ESIMS/MS).

Methods

The chemical compounds and categories were detected using broadly targeted UPLC–MS/MS. Principal component analysis (PCA), orthogonal partial least-squares discriminant analysis (OPLS-DA), and hierarchical clustering analysis (HCA) were carried out for metabolites of different varieties of P. lactiflora.

Results

A total of 1237 compounds were detected and classified into 11 categories. HCA, PCA, and OPLS-DA of these metabolites indicated that each variety of P. lactiflora was clearly separated from the other groups. Differential accumulated metabolite analysis revealed that the three P. lactiflora varieties contained 116 differentially activated metabolites (DAMs) involved in flavonoid, flavone, and flavonol metabolism. KEGG pathway analysis revealed that, in 65 pathways, 336 differentially abundant metabolites (DMs) were enriched in the CK and DFG groups; moreover, the type and content of terpenoids were greater in the CK group than in the DFG group. The CK and HSML groups contained 457 DMs enriched in 61 pathways; the type and amount of flavonoids, terpenoids, and tannins were greater in the CK group than in the HSML group. The DFG and HSML groups contained 497 DMs enriched in 65 pathways; terpenoids and alkaloids were more abundant in the HSML variety than in the DFG variety.

Conclusions

A total of 1237 compounds were detected, and the results revealed significant differences among the three P. lactiflora varieties. Among the three P. lactiflora varieties, phenolic acids and flavonoids composed the largest and most diverse category of metabolites, and their contents varied greatly. Therefore, CK is suitable for medicinal plant varieties, and DFG and HSML are suitable for ornamental plant varieties. Twelve proanthocyanidin metabolites likely determined the differences in color among the three varieties.
Biophysical characterization of the CXC chemokine receptor 2 ligands
Authors: Martin Patrick , Kurth Emily A. , Budean David , Momplaisir Nathalie , Qu Elaine , Simien Jennifer M. , Orellana Grace E. , Brautigam Chad A. , Smrcka Alan V. , Haglund Ellinor
Published: April 2024

The chemokines of the immune system act as first responders by operating as chemoattractants, directing immune cells to specific locations of inflamed tissues. This promiscuous network is comprised of 50 ligands and 18 receptors where the ligands may interact with the receptors in various oligomeric states i.e., monomers, homodimers, and heterodimers. Chemokine receptors are G-protein coupled receptors (GPCRs) present in the membrane of immune cells. The migration of immune cells occurs in response to a concentration gradient of the ligands. Chemotaxis of neutrophils is directed by CXC-ligand (CXCL) activation of the membrane bound CXC chemokine receptor 2 (CXCR2). CXCR2 plays an important role in human health and is linked to disorders such as autoimmune disorders, inflammation, and cancer. Yet, despite their important role, little is known about the biophysical characteristics controlling ligand:ligand and ligand:receptor interaction essential for biological activity. In this work, we study the homodimers of three of the CXCR2 cognate ligands, CXCL1, CXCL5, and CXCL8. The ligands share high structural integrity but a low sequence identity. We show that the sequence diversity has evolved different binding affinities and stabilities for the CXC-ligands resulting in diverse agonist/antagonist behavior. Furthermore, CXC-ligands fold through a three-state mechanism, populating a folded monomeric state before associating into an active dimer.
Health outcomes in Deaf signing populations: A systematic review
Authors: Rogers Katherine D. , Rowlandson Aleix , Harkness James , Shields Gemma , Young Alys
Published: April 2024

Objectives

(i) To identify peer reviewed publications reporting the mental and/or physical health outcomes of Deaf adults who are sign language users and to synthesise evidence; (ii) If data available, to analyse how the health of the adult Deaf population compares to that of the general population; (iii) to evaluate the quality of evidence in the identified publications; (iv) to identify limitations of the current evidence base and suggest directions for future research.

Design

Systematic review.

Data sources

Medline, Embase, PsychINFO, and Web of Science.

Eligibility criteria for selecting studies

The inclusion criteria were Deaf adult populations who used a signed language, all study types, including methods-focused papers which also contain results in relation to health outcomes of Deaf signing populations. Full-text articles, published in peer-review journals were searched up to 13th June 2023, published in English or a signed language such as ASL (American Sign Language).

Data extraction

Supported by the Rayyan systematic review software, two authors independently reviewed identified publications at each screening stage (primary and secondary). A third reviewer was consulted to settle any disagreements. Comprehensive data extraction included research design, study sample, methodology, findings, and a quality assessment.

Results

Of the 35 included studies, the majority (25 out of 35) concerned mental health outcomes. The findings from this review highlighted the inequalities in health and mental health outcomes for Deaf signing populations in comparison with the general population, gaps in the range of conditions studied in relation to Deaf people, and the poor quality of available data.

Conclusions

Population sample definition and consistency of standards of reporting of health outcomes for Deaf people who use sign language should be improved. Further research on health outcomes not previously reported is needed to gain better understanding of Deaf people’s state of health.
Double-duty caregivers enduring COVID-19 pandemic to endemic: “It’s just wearing me down”
Authors: Parmar Jasneet , L’Heureux Tanya , Lobchuk Michelle , Penner Jamie , Charles Lesley , St. Amant Oona , Ward-Griffin Catherine , Anderson Sharon
Published: April 2024

The COVID-19 pandemic has considerably strained health care providers and family caregivers. Double-duty caregivers give unpaid care at home and are employed as care providers. This sequential mixed-method study, a survey followed by qualitative interviews, aimed to comprehensively understand the experiences of these Canadian double-duty caregivers amidst the pandemic and the transition to the endemic phase. The multi-section survey included standardized assessments such as the Double-duty Caregiver Scale and the State Anxiety Scale, along with demographic, employment-related, and care work questions. Data analysis employed descriptive and linear regression modeling statistics, and content analysis of the qualitative data. Out of the 415 respondents, the majority were female (92.5%) and married (77.3%), with 54.9% aged 35 to 54 years and 29.2% 55 to 64 years. 68.9% reported mental health decline over the past year, while 60.7% noted physical health deteriorated. 75.9% of participants self-rated their anxiety as moderate to high. The final regression model explained 36.8% of the variance in participants’ anxiety levels. Factors contributing to lower anxiety included more personal supports, awareness of limits, younger age, and fewer weekly employment hours. Increased anxiety was linked to poorer self-rated health, and both perceptions and consequences of blurred boundaries. The eighteen interviewees highlighted the stress of managing additional work and home care during the pandemic. They highlighted the difficulty navigating systems and coordinating care. Double-duty caregivers form a significant portion of the healthcare workforce. Despite the spotlight on care and caregiving during the COVID-19 pandemic, the vital contributions and well-being of double-duty caregivers and family caregivers have remained unnoticed. Prioritizing their welfare is crucial for health systems as they make up the largest care workforce, particularly evident during the ongoing healthcare workforce shortage.