bluuebunny/crossref_metadata_2025 huggingface dataset:
Salpingectomy With Delayed Oophorectomy Versus Salpingo‐Oophorectomy in BRCA1/2 Carriers: Three‐Year Outcomes of a Prospective Preference Trial
Authors: Van Bommel Majke H. D. , Steenbeek Miranda P. , Inthout Joanna , Van Garderen Tessa , Harmsen Marline G. , Arts‐De Jong Marieke , Maas Angela H. E. M. , Prins Judith B. , Bulten Johan , Van Doorn Helena C. , Mourits Marian J. E. , Tros Rachel , Zweemer Ronald P. , Gaarenstroom Katja N. , Slangen Brigitte F. M. , Brood‐Van Zanten Monique M. A. , Vos M. Caroline , Piek Jurgen M. J. , van Lonkhuijzen Luc R. C. W. , Apperloo Mirjam J. A. , Coppus Sjors F. P. J. , Hoogerbrugge Nicoline , Hermens Rosella P. M. G. , De Hullu Joanne A.
Published: January 2025

Objective

To compare menopause‐related quality of life (QoL) after risk‐reducing salpingectomy (RRS) versus risk‐reducing salpingo‐oophorectomy (RRSO) until 3 years of post‐surgery.

Design

A prospective study (TUBA study) with treatment allocation based on patients' preference. Data were collected pre‐surgery and at 3 months, 1 and 3 years of post‐surgery.

Setting

Multicentre prospective preference trial in thirteen hospitals in the Netherlands.

Population

BRCA1/2 pathogenic variant (PV) carriers aged 25–40 (BRCA1) or 25–45 (BRCA2), who were premenopausal, without a future child wish and without current (treatment for) malignancy.

Methods

Treatment allocation was based on patients' preference: either RRS from the age of 25 years with delayed oophorectomy at the maximum age of 45 (BRCA1) or 50 (BRCA2), or RRSO between the ages of 35–40 (BRCA1) or 40–45 (BRCA2). After RRSO, hormone replacement therapy (HRT) was recommended, if not contraindicated. Primarily, menopause‐related QoL as measured with the Greene Climacteric Scale (GCS) was compared between the RRS and RRSO without HRT group. Secondarily, GSC‐scores of the RRS group were compared with the scores of the RRSO with HRT after surgery group. A higher GSC‐score reflects more climacteric symptoms.

Results

Until April 2023, 410 participants had undergone RRS and 160 RRSO. The BRCA1/BRCA2 proportions were 51.4%/48.6%. The mean age at surgery (SD) was 37.9 (3.5) years. Participants 3 years after RRSO without HRT had a 4.3 (95% CI 2.1–6.5; p < 0.001) point higher increase in GCS‐score from baseline compared to those after RRS, while the difference was 7.9 (95% CI 5.9–9.8) and 8.5 (95% CI 6.5–10.5) points at 3 and 12 months, respectively. Among participants with HRT after surgery, the RRSO group had a 2.4 (95% CI 0.8–3.9; p = 0.002) point higher increase in GCS‐score from baseline compared to the RRS group.

Conclusions

In this multicentre preference trial, menopause‐related QoL was better after RRS than after RRSO, even with HRT after RRSO. Differences between arms were most pronounced until one‐year post‐surgery.
The venture corporation
Authors: Weiss Gad
Published: January 2025

Corporate law does not support the corporate operating systems of Silicon Valley startups. Startups are exit‐driven, short‐term ventures. Their shareholders care from day 1 about the exit strategy that the startup will finally pursue (i.e., how and when it will be acquired or go public). Startup shareholders often have differing views in this respect, and to allow them to collaborate efficiently nonetheless, startups have developed unique governance structures. These structures rely substantially on giving prominent shareholders the power to force their desired exit strategy on other shareholders and startups' managements. At the same time, however, startups are practically required to organize their businesses as corporations, which strictly undermines these governance structures. Corporate law compels shareholders to entrust almost all exit‐related powers and discretion to the board of directors. The board, in turn, is obliged to serve the interests of the shareholders as a whole, disregarding particular shareholders' needs. This tension burdens startups by making their carefully crafted governance structures unreliable and difficult to enforce. Currently proposed solutions, whether based on sophisticated contracting or using non‐corporate business entities, prove inadequate for resolving this fundamental clash. Instead, this paper calls for policymakers to introduce the “venture corporation,” a new business entity designed to answer startups' unique governance needs.
Kickboxing Kloof Frogs: Territoriality, Female Parental Care and Other Reproductive Behaviours of Natalobatrachus bonebergi
Authors: van Niekerk Arno , Tarrant Jeanne , Armstrong Adrian J. , du Preez Louis H.
Published: January 2025

The Kloof Frog (Natalobatrachus bonebergi) is an Endangered South African endemic, demonstrating complex reproductive behaviours. This study, conducted in Vernon Crookes Nature Reserve, South Africa between April 2023 and April 2024, recorded acoustic and visual communication, male–male aggression, parental care and predation. In situ observations underscore the species' strategies of multimodal communication in male territoriality, mate attraction and female parental care of eggs in a structured habitat. This study provides perspective on the reproductive ecology of N. bonebergi. This species could serve as an important ecological model through which conservation management and actions could be improved upon.
Mapping entangled mobilities: Using participatory historical geography to explore the migration of objects and people across (neo)colonial spatialities
Authors: Linn Sarah , Lee Jina , Zorba Mariam , Nunn Caitlin , Cromwell Jennifer
Published: January 2025

This paper examines how creative counter‐maps can be a valuable participatory historical geography tool in their capacity to render visible multiple pasts, presents, and futures, and offer new possibilities for representation and belonging through visual and creative aesthetics. Emerging from the Ancient History, Contemporary Belonging project, the paper explores the co‐creation of a participatory counter‐map, Unprovenanced Map, displayed in Manchester Museum (2023–2025), which represents the entangled mobilities of ancient objects and contemporary migrants. Co‐designed by a creative map‐making artist in dialogue with Ancient History, Contemporary Belonging project researchers and youth researchers from Iranian, Iraqi, Syrian, Palestinian, and Kurdish backgrounds, the map integrates young people's personal ‘journey maps’ with archival research on ancient objects from their region of origin, drawn from collections in Manchester Museum. Reflecting the complexities and ambiguities of migration, the map represents places, borders, and movements as fractured, partial, and mutable, and embedded with the messiness of embodied and material migratory realities. In doing so, it confronts the (neo)colonial forces that shape maps and mobilities, engaging museum audiences with contextualised complexities of global movement through a migratory aesthetic. Simultaneously, this creative representation serves the practical‐political purpose of safeguarding youth researchers from the risks of challenging fixed imaginaries of spatial–temporal borders within a heritage institution – and city – grappling with their own colonial legacies, while also imagining new futures and possibilities of representation.
Gut decontamination in the poisoned patient
Authors: Gosselin Sophie , Hoegberg Lotte C. G. , Hoffman Robert S.
Published: January 2025

Poisoning management includes gastrointestinal decontamination strategies to decrease the burden of poison entering the body and change the expected severe toxicity expected to a less toxic, more favourable outcome. Common modalities are orogastric lavage, oral‐activated charcoal and whole‐bowel irrigation. Endoscopic retrieval and laparotomy are rare options reserved for severe ingestions and body packers. Although supporting data are generally of low quality, gastrointestinal decontamination is likely to improve patient outcome in many situations. Unfortunately, technical limitations and contraindications can explain their infrequent use. Orogastric lavage can be useful for early lethal ingestions, albeit with significant complications such as aspiration and perforation. Activated charcoal cannot adsorb every substance. Usual dosing is 1 g/kg per dose. Whole‐bowel irrigation is reserved for charged molecules or substances not adsorbed to activated charcoal but requires intact gut motility. Indications depend on several factors inherent to the ingestion (dose, time, poison) and patient's characteristics. During recent decades, studies of newer pharmaceuticals or modified‐release formulations showed that significant amounts of poison, especially pharmacobezoars, persist in the gut hours postingestion, thus are amenable to gastrointestinal decontamination. Improved understanding of gut motility in volunteer studies and overdose showed clinically significant reduction in drug exposure with activated charcoal. The 1‐h dogma for gastrointestinal decontamination, especially activated charcoal, is now obsolete. Clinicians must perform a risk assessment for each ingestion to determine the expected benefit at the time of decision‐making, choosing the modality to achieve reduction in the toxicity burden while planning for complications or contraindications.
Determination of Time Required for 5 Log Reduction of Foodborne Pathogens by High Hydrostatic Pressure Processing in Foods
Authors: Buzrul Sencer , Cam Mehmet Furkan
Published: January 2025

High hydrostatic pressure (HHP) is a nonthermal preservation technology for inactivating foodborne pathogens and spoilage organisms. The commercial use of HHP is generally performed at pressures of 400–600 MPa, at ambient initial temperature for less than 6 min. Moreover, at least 5 log10 reduction of target pathogen is required for safe HHP‐treated foods. Literature data of foodborne pathogens (Escherichia coli, Listeria monocytogenes, Salmonella spp., etc.) were collected based on these ranges and information (P: 400–600 MPa, T: 4°C–25°C, t ≤ 6 min) and were described by the reparameterized Weibull model to find times required for 5 log10 of target pathogens together with their confidence limits. Results indicated that pressure values of even 400–450 MPa were sufficient to obtain 5 log10 reduction for times ≤ 6 min for high acid foods. Furthermore, 600 MPa treatment, which is generally used by the industry, is a robust and efficient application as holding times less than 5 min were generally enough to obtain 5 log10 reduction for most of the pathogens. Nevertheless, for some pathogens in milk, such as E. coli and Stapylococcus aureus, higher holding times of > 10 min were necessary which was not practical for a commercial HHP application. Conditions for microbial HHP studies generally do not match with industrial HHP applications. However, data selection criteria in this study were based on commercial applications. Information provided in this study would be beneficial for researchers as well as for HHP food processors for designing future studies and HHP treatments.
A Framework for Behavioral Health Integration in the Program of All‐Inclusive Care for the Elderly (PACE)
Authors: Fleet Alexa , Simoun Alya , Shalev Daniel , Spaeth‐Rublee Brigitta , Patterson Taryn , Wardlow Liane , Roth Tessa , Pincus Harold Alan
Published: January 2025

Background

The Program of All‐inclusive Care for the Elderly (PACE) is a comprehensive care model that aims to promote aging in the home and community for older adults who are nursing‐home eligible needs‐wise. Older adults experience age‐related barriers to accessing behavioral health (BH) services. PACE programs play an important role in providing all‐inclusive health care for individuals over 55 who are dually eligible for Medicaid and Medicare. This article investigates behavioral health integration (BHI) within PACE Organizations (POs), produces a conceptual framework for BHI within PACE, and reports on current BH practices and programmatic needs to support the growing BH needs of participants.

Methods

The team adapted the BH–Serious Illness Care (BH‐SIC) Model, to produce a conceptual framework for BHI within PACE (BHI‐PACE Model). The model informed a mixed‐methods sequential approach to assess BHI at POs that include (i) a survey, (ii) use‐case interviews of POs, and (iii) qualitative analyses of interviews.

Results

We present the domains and subdomains for the BHI‐PACE Model. With respect to the national BH in PACE assessment, 38 POs representing 119 sites and 25,806 participants participated in the survey and 15 POs representing 58 sites and 10,029 participants participated in interviews. Survey results revealed a high rate of BH comorbidities among PACE participants (60% median rate, IQR: 70–44). The most common reasons for referral to BH specialists were depression and mood disorders 92.1%, behavioral and psychological symptoms of dementia (BPSD) 57.9%, and anxiety disorders 55.3%.

Conclusion

POs' current BH practices and challenges can guide other POs to better integrate BH. Integrating BH into the PACE model requires policy‐level action, though quality measurement and value‐based care efforts can support this endeavor.
Beyond motherhood: Childless Black women and compulsory mothering
Authors: Lee Austin Colby Guy
Published: January 2025

Objective

The current study asks how race, class, and the social pressure to care for children who are not one's own impact how childless Black women experience and make meaning of their parental status.

Background

While much of the existing qualitative research on childlessness has asked how white, middle‐class women experience social pressure to have children, this study shifts this focus to ask how Black women experience social pressure to care for children who are not their own.

Method

The study relied on virtual interviews with 40 class‐diverse childless Black women between 40 and 55. The recruitment strategy utilized a mixed‐method approach, including snowball sampling, online and physical advertising, and targeted outreach within online communities for Black women. Interviews were transcribed and iteratively analyzed to identify thematic codes and categories.

Results

The study identifies and terms “compulsory mothering” as a significant social pressure that leads childless Black women to assume caregiving roles within their kin networks, regardless of their parental status. This pressure is more pronounced among working‐class women, who engage more extensively in these roles compared to their middle‐class counterparts, highlighting how race and class intersect to shape their experiences of childlessness.

Conclusion

The study concludes that race and class influence women's experiences of childlessness. It also finds that childless Black women's relationships with their kin networks shape their experiences of childlessness and their reproductive preferences.
Biosafety and Withdrawal Period of In‐Feed Administered Antiparasitic Drug Emamectin Benzoate in Cirrhinus mrigala (Hamilton, 1822)
Authors: Solanki H. G. , Verma A. , Solanki H. K. , Raja R. A. , Avunje S. , Trangadia B. J. , Panda S. K. , Patil P. K.
Published: January 2025

Parasitic infestations are one of the most economically important disease conditions in the Indian major carps including mrigal, Cirrhinus mrigala. This study reported the biosafety and tissue withdrawal of in‐feed administered antiparasitic drug, emamectin benzoate (EMB). To evaluate the biosafety of the drug, behaviour, growth and tissue changes in Cirrhinus mrigala was recorded the following in‐feed administration of EMB up to 10 times (T1–50 μg kg−1 fish day−1 (1×), T2–125 μg kg−1 fish day−1 (2.5×), T3–250 μg kg−1 fish day−1 (5×), T4–375 μg kg−1 fish day−1 (7.5×) and T5–500 μg kg−1 fish day−1 (10×)) for the period of three times the recommended duration (7 days). The withdrawal period was calculated by feeding EMB at 50 μg kg−1 fish day−1 for consecutive 10 days followed by EMB‐free feed. The results revealed that the drug is safe to mrigal up to ten times the recommended dose, while the fish fed with the highest dose (500 μg kg−1 fish day−1) showed transient histological alterations. The feeding behaviour is affected with poor acceptability beyond 5× dosages. The drug residue at the concentration below the MRL (1.0 μg g−1) in the muscle tissue on the day of cessation of medicated feed administration indicates no requirement of the withdrawal period. The study suggests that EMB can be safely used at 50 μg kg−1 fish day−1 for 7 consecutive days, and no withdrawal period is required without affecting the feeding behaviour and tissue histological alterations.
Biochemical, photosynthetic and metabolomics insights of single and combined effects of salinity, heat, cold and drought in Arabidopsis
Authors: Secomandi Elena , De Gregorio Marco Armando , Castro‐Cegrí Alejandro , Lucini Luigi
Published: January 2025

Ensuring food security is one of the main challenges related to a growing global population under climate change conditions. The increasing soil salinity levels, drought, heatwaves, and late chilling severely threaten crops and often co‐occur in field conditions. This work aims to provide deeper insight into the impact of single vs. combined abiotic stresses at the growth, biochemical and photosynthetic levels in Arabidopsis thaliana (L.). Reduced QY max was recorded in salinity‐stressed plants, NPQ increased in heat and salinity single and combined stresses, and qP decreased in combined stresses. MDA and H2O2 content were consistently altered under all stress conditions, but higher values were recorded under salinity alone and in combination. Salinity alone and in stress combinations (especially with cold) provided a stronger hierarchical effect. Despite glycine and GABA osmolytes not significantly changing, proline highlighted the hierarchically stronger impact of salinity, while glycine‐betaine was decreased under drought combinations. Untargeted metabolomics pointed out distinct metabolic reprogramming triggered by the different stress conditions, alone or in combination. Pathway analysis revealed that abiotic stresses significantly affected hormones, amino acids and derivates, and secondary metabolites. Flavonoids accumulated under drought (alone and combined with heat and cold stresses), while N‐containing compounds decreased under all combined stresses. Looking at the interactions across the parameters investigated, antagonistic, additive, or synergistic effects could be observed depending on the biochemical process considered. Notwithstanding, these results contribute to delving into the impact of various stress combinations, hierarchically highlighting the stress‐specific effects and pointing out different combinations.
Nigerian English research: Developments and directions
Authors: Jowitt David , Ugwuanyi Kingsley O.
Published: January 2025

This article describes the progress made by scholars over a period of more than five decades in the field of Nigerian English studies. It will thus serve as a useful tool for those researching in this field; and apparently there has been no such attempt to date to review the research landscape of Nigerian English in order to show its key concerns. The article makes the case that, despite the claim that Nigerian English is under‐researched, Nigerian English has been the subject of a substantial body of research, even if much of it is unknown outside Nigeria. Following the qualitative‐oriented synthetic approach to literature review involving a synthesis of common themes across studies, research preoccupations, developments and directions in all the various language areas are examined, with opportunities for further research highlighted. Finally, prognostications are offered concerning the future directions of Nigerian English research.
Mouse models for metabolic health research: molecular mechanism of exercise effects on health improvement through adipose tissue remodelling
Authors: Kim Hye Jin , Kim Youn Ju , Seong Je Kyung
Published: January 2025

Exercise provides health benefits to multiple metabolic tissues through complex biological pathways and interactions between organs. However, investigating these complex mechanisms in humans is still limited, making mouse models extremely useful for exploring exercise‐induced changes in whole‐body metabolism and health. In this review, we focus on gaining a broader understanding of the metabolic phenotypes and molecular mechanisms induced by exercise in mouse models. We first discuss the differences in adaptations induced by aerobic and resistance exercise, and compare voluntary wheel running and forced treadmill exercise, the two main methods of aerobic exercise research in mice, to show the similarities and differences between the same aerobic exercise but different methods, and their impact on experimental outcomes. The effects of exercise on metabolic phenotypes, including alleviation of obesity and metabolic disorders, and the mechanisms involved in adipose tissue remodelling and browning are explored, as well as the role of the gut microbiota in mediating the physiological responses and metabolic effects of exercise. Understanding these molecular mechanisms and methodological aspects of exercise experiments in mouse models can serve as a valuable template for the design of future basic research in exercise physiology and will provide a strong scientific evidence base for optimizing the design of exercise intervention programmes for metabolic health.

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Application of Shear-Thickening Nanofluids in Enhanced Geothermal Systems: A Comprehensive Review
Authors: Konate Nabe , Reza Foudazi , Salehi Saeed , Hamid Karami
Published: January 2025

Shear-thickening fluids (STFs), especially nanofluids, are one of the key research areas in the world at the present time because of their ability to increase viscosity in response to specific shear conditions. This transition in viscosity is of great interest in various fields, including mechanical platforms and smart structures to advanced protective fabrics and armor. This increase in viscosity under applied shear conditions can be of great interest in the development of enhanced geothermal systems (EGSs). However, there is currently less research on the potential application of these shear-thickening nanofluids in EGS reservoirs. In this comprehensive review, the basic mechanisms of shear-thickening behavior in nanofluids are explained, while the effects of nanoparticle concentration, size, and temperature on this mechanism have been discussed in detail. This comprehensive review highlights how such factors can be optimized to adjust the rheological properties of nanofluids in order to improve their performance in fluid flow in highly fractured EGS reservoirs. An in-depth review of existing literature indicated that the combination of hydrolusters formation and the thermal properties of the shear-thickening nanofluids can be optimized to provide a potential solution to some of the EGS challenges such as thermal short-circuiting and low thermal energy extraction efficiency. Despite the huge potential of STF nanofluids in EGS development, extensive experimental and numerical investigations are needed to realize the effectiveness of these fluids further.
A metagenomic perspective on the microbial prokaryotic genome census
Authors: Wu Dongying , Seshadri Rekha , Kyrpides Nikos C. , Ivanova Natalia N.
Published: January 2025

Following 30 years of sequencing, we assessed the phylogenetic diversity (PD) of >1.5 million microbial genomes in public databases, including metagenome-assembled genomes (MAGs) of uncultivated microbes. As compared to the vast diversity uncovered by metagenomic sequences, cultivated taxa account for a modest portion of the overall diversity, 9.73% in bacteria and 6.55% in archaea, while MAGs contribute 48.54% and 57.05%, respectively. Therefore, a substantial fraction of bacterial (41.73%) and archaeal PD (36.39%) still lacks any genomic representation. This unrepresented diversity manifests primarily at lower taxonomic ranks, exemplified by 134,966 species identified in 18,087 metagenomic samples. Our study exposes diversity hotspots in freshwater, marine subsurface, sediment, soil, and other environments, whereas human samples yielded minimal novelty within the context of existing datasets. These results offer a roadmap for future genome recovery efforts, delineating uncaptured taxa in underexplored environments and underscoring the necessity for renewed isolation and sequencing.
Human P2X4 receptor gating is modulated by a stable cytoplasmic cap and a unique allosteric pocket
Authors: Shi Haoyuan , Ditter Ismayn A. , Oken Adam C. , Mansoor Steven E.
Published: January 2025

P2X receptors (P2XRs) are adenosine 5′-triphosphate (ATP)–gated ion channels comprising homomeric and heteromeric trimers of seven subtypes (P2X1–P2X7) that confer different rates of desensitization. The helical recoil model of P2XR desensitization proposes stability of the cytoplasmic cap sets the rate of desensitization, but timing of its formation is unclear for slow-desensitizing P2XRs. We report cryo–electron microscopy structures of full-length wild-type human P2X4 receptor in apo closed, antagonist-bound inhibited, and ATP-bound desensitized states. Because the apo closed and antagonist-bound inhibited state structures of this slow-desensitizing P2XR include an intact cytoplasmic cap while the ATP-bound desensitized state structure does not, the cytoplasmic cap is formed before agonist binding. Furthermore, structural and functional data suggest the cytoplasmic cap is stabilized by lipids to modulate desensitization, and P2X4 is modified by glycosylation and palmitoylation. Last, our antagonist-bound inhibited state structure reveals features specific to the allosteric ligand-binding pocket in human receptors that facilitates development of small-molecule modulators.
16S rRNA amplicon sequencing of organic and conventional chickens
Authors: Punchihewage-Don Anuradha J. , Hasan Nur A. , Parveen Salina
Published: January 2025

We report 16S rRNA sequencing of microbiomes associated with organic and conventional retail chickens (
n
=31), processed via whole-carcass enrichment and rinse methodologies. Amplicon sequencing was performed targeting the V3-V4 region of the 16S rRNA gene, which resulted with Good’s coverage exceeding 99.7% of the libraries.
Timing of and pressure-temperature constraints on deformation in the Toxaway dome, eastern Blue Ridge: Evidence for continuous deformation from the Neoacadian orogeny to the Alleghanian orogeny
Authors: Levine Jamie S.F. , Powell Nicholas E. , Casale Gabriele , Martin Claire P.
Published: January 2025

Many mountain belts are built through repeated collision, and in the case of orogenies closely spaced in time, determining when one orogeny ends and another begins can be challenging. The southern Appalachian mountains were formed by three mountain-building events closely spaced in time, including the Taconic (ca. 480−440 Ma), Neoacadian (ca. 375−340 Ma), and Alleghanian (ca. 330−265 Ma) orogenies. Notably, the end of the Neoacadian and the beginning of the Alleghanian are only separated by ∼10 m.y., and some published dates record deformation and metamorphism in the eastern Blue Ridge during this interval, blurring the boundary between these two discrete events.

The Toxaway dome, located along the North Carolina−South Carolina, USA, border at the eastern edge of the eastern Blue Ridge, is a structural dome cored by Mesoproterozoic Toxaway Gneiss and surrounded by the younger Tallulah Falls Formation. Previous ages constraints from the Toxaway dome (343 and 338 Ma U-Pb zircon ages) make it an ideal location to explore whether there was continuous deformation during this period of supposed quiescence between the Neoacadian and Alleghanian orogenies. We used optical microscopy and electron backscatter diffraction in quartz to determine deformation temperatures, thermobarometry to determine metamorphic pressure-temperature conditions, and monazite petrochronology to determine the timing of deformation. Quartz and feldspar recrystallization fabrics parallel to dome-defining fabrics indicate deformation occurred at amphibolite-facies conditions, which is corroborated by our pressure-temperature estimates of 0.67−0.8 ± 0.12 GPa and 661−689 ± 25 °C. Monazite grains that record the timing of reactions of garnet growth and breakdown range from 342 ± 4.8 Ma to 296 ± 10.8 Ma, bridging the interval between the Neoacadian and Alleghanian orogenies. Three samples from the nearby Tallulah Falls dome, which occupies a similar structural position along the edge of the eastern Blue Ridge in Georgia, record monazite dates of 334 ± 4.2 Ma to 304 ± 4.8 Ma, indicating there was tectonic activity in this region before the commonly defined beginning of the Alleghanian orogeny. We propose (1) there was no period of quiescence between the Neoacadian and Alleghanian orogenies in the eastern Blue Ridge, and (2) deformation during this time was at higher temperatures and pressures than previously reported.
Supplemental Material: Tourmaline geochemical and boron isotopic constraints on the magmatic-hydrothermal transition and Li mineralization in LCT-type pegmatites
Authors: Li Wenjing , Chen Bin , al. et
Published: January 2025

Table S1: Major (wt%) elements of tourmaline from the Li-rich and Li-poor pegmatites of the Dangba deposit. Table S2: Trace (ppm) elements of tourmalines from the Li-rich and Li-poor pegmatites. Table S3: Boron isotopic compositions of tourmalines from the Li-rich and Li-poor pegmatites. Figure S1: (A–E) Chondrite-normalized rare earth element patterns for tourmalines from the Li-rich and Li-poor pegmatites. Figure S2: Plots of (A) Ti (ppm), (B) V (ppm), and (C) Li (ppm) against Mg/(Mg + Fe) ratios for the tourmalines from the Li-rich and Li-poor pegmatites.
Synesis as a framework to enable safety interventions in complex healthcare environments
Authors: Bavare Aarti , Wrenn Tiffany , Lam Anne , Cargill Jamie , Salinas Lauren , Idowu Itode , Razavi Asma , Pinto Venessa Lynn , Williams Eric
Published: January 2025

Background

Despite wide adoption in the healthcare of safety event report (SER) systems, there is a paucity of unified structures for prompt analysis and action while retaining reporter confidentiality. We used a synesis framework to change siloed reviews of safety reports to a comprehensive appraisal of quality, safety, productivity and reliability to facilitate interventions.

Methods

After a needs assessment survey, we launched serial plan-do-study-act cycles to (1) enhance teams’ ability to access SERs, (2) facilitate regular multidisciplinary review of SERs to identify actionable opportunities, (3) allocate action priority using failure mode and effects analysis, and (4) launch actions and summarise data. Team of Teams model allowed for empowered execution. Measures included process—completion of review, team engagement, proportion of ‘open’ (those without action plan) reports within 1 month of filing; outcome—number of actions launched and completed, dissemination of actions and postintervention survey results; and balancing—resources invested.

Results

26 multidisciplinary leaders reviewed 3175 of the 3406 total reported SERs across four clinical units over 18 months. The proportion of reviewed to total SERs increased significantly from the first 6 months (75%) to the second 12 months (99%) (p<0.001), and the proportion of ‘open’ to reviewed SERs decreased significantly from 43% to 5.3% (p<0.001). Many local- and organisational-level actions were launched efficiently by the engaged and aligned team. Action impact was assessed by reviewing trends in SER themes and findings, and actions and impact were disseminated at unit, divisional and organisational levels. Postintervention survey showed improvement in leaders’ perceptions about SER reviews.

We successfully implemented a sustainable process to comprehensively review, prioritise and act on SERs in our large institution and facilitated safety interventions using a synesis framework.
Universal health coverage for women of reproductive ages: a survey-based comprehensive assessment of service utilisation and health expenditure in Tanzania
Authors: Kagoye Sophia Adam , Urassa Mark , Mangya Charles , Kishamawe Coleman , Todd Jim , Marston Milly , Binyaruka Peter , Boerma Ties
Published: January 2025

Introduction

Universal health coverage (UHC) for women of reproductive ages is a critical component of country and global health strategies but most evidence in high-fertility settings is limited to maternity care. Our study aimed to comprehensively assess women’s health service utilisation and expenditure, including an equity dimension.

Methods

We conducted a household survey among 15–49 years as a nested study within the Magu health and demographic surveillance study, northwest Tanzania, during 2020–2021. Data were collected on self-reported health, fertility, utilisation of health services, health expenditure and health insurance. We analysed key indicators by household wealth quintiles, place of residence and health insurance, using logistic regression models controlling for age and other confounders.

Results

Among 8665 women aged 15–49 years (response rate 81%), 3.0% reported poor or very poor health, 13% gave birth in the preceding year, and health insurance coverage was 5.1%. Coverage of antenatal (99.5%) and institutional delivery care (88%) were high; 7.3% of women reported at least one outpatient visit in the last 4 weeks, of which 81% were for their own non-maternal healthcare; 9.3% had been admitted to a hospital during the last year, and 74% of these admissions were for deliveries. The total average annual health expenditure per woman was about TZS 16 860 (US$7.50), of which 82% was for her own healthcare and 18% for maternity care. Additionally, women spent about TZS 23 172 (US$10.00) per year on self-treatment. The poorest women had poorer self-reported health, lower coverage of maternity care, lower utilisation of services for their own healthcare and lower health insurance coverage, and limited their expenditure by making greater use of nearby public services than richer women.

Conclusion

Women spent more financial resources on their own non-maternal healthcare than maternity care with poorer women still facing disadvantages for their own healthcare. Health insurance programmes were hardly but were associated with an increase in service use. Comprehensive assessments of women’s health needs, service use and expenditures with an equity focus are crucial for shaping UHC strategies tailored to women of reproductive ages.
Applying a diffusion of innovations framework to characterise diffusion groups and more effectively reach late adopters: a cross-sectional study on COVID-19 vaccinations in Canada in late 2021
Authors: Memedovich Ally , Steele Brian , Orr Taylor , Hollis Aidan , Salmon Charleen , Hu Jia , Zinszer Kate , Williamson Tyler , Beall Reed
Published: January 2025

Background

Rogers’ diffusion of innovation theory suggests innovations are adopted in stages by different groups (innovators/early adopters, early majority, late majority and late adopters). In healthcare, this could mean that there is the potential to worsen health disparities as later groups tend to also face more social and structural barriers. Determining the unique sociodemographic characteristics, beliefs and attitudes of those in each diffusion category could be useful for theorising how to reach later groups more effectively.

Methods

Using a cross-sectional survey among Canadian adults in late 2021, we assigned respondents to diffusion groups based on when they received their first dose, relative to others within their age group in accordance with Rogers’ model (ie, cut points: 16%, 50%, 84% with 100% being all those vaccinated within the age group). Participants answered questions about their COVID-19 vaccinations and questions related to their motivations, beliefs, values and attitudes towards COVID-19. A multinomial logistic regression model assessed the likelihood of participants being associated with each diffusion category (with the significance level set at p<0.05).

Results

The final sample included 2131 respondents. Late adopters were significantly more likely to identify as non-white, live in rural locations and receive vaccinations at pharmacies. Innovators and early adopters were significantly more likely to get vaccinated in settings other than pharmacies or community centres.

Conclusion

A diffusion group-based analysis brought insight into how vaccination strategies could be tailored to reach each diffusion group sooner, particularly late adopters who encounter more barriers.
‘It was just the given thing to do’: exploring enablers for high childhood vaccination uptake in East London’s Bangladeshi community—a qualitative study
Authors: Ali Ifra , Bell Sadie , Mounier-Jack Sandra
Published: January 2025

Background

Despite being an underserved ethnic minority group, characteristics which have been associated with low vaccine uptake, the Bangladeshi community in the UK exhibits high childhood vaccination uptake for several vaccines, including measles, mumps and rubella compared with several ethnic groups. This study explored key enablers for early childhood vaccination uptake among the Bangladeshi community in East London, UK.

Methods

A qualitative study using semi-structured interviews was conducted with 23 Bangladeshi parents 11 primary healthcare professionals (HCPs) and 5 community service providers (CSPs) involved in delivering childhood vaccination services, predominantly in the East London borough of Tower Hamlets. Parents were recruited purposively from the community while HCPs and CSPs were recruited from relevant organisations. The Social Ecological Model (SEM) was used as a theoretical framework for data collection and analysis. Data were analysed thematically.

Results

Multilevel vaccination enablers identified by parents, HCPs and CSPs across the different levels of the SEM included: parental trust in the immunisation programme and HCPs; a rigorous call and recall service; the normalisation of receiving childhood vaccinations within the Bangladeshi community and the availability of culturally tailored and accessible vaccination services.

Conclusions

This study highlights how multi-level trust in a vaccination programme can propel positive vaccine uptake in an underserved, ethnic minority population. Our findings suggest culturally sensitive, person-centred delivery of vaccination services, alongside leveraging community dynamics and trusted social networks, are imperative to meeting the informational, linguistic and cultural needs that facilitate vaccine uptake within the Bangaldeshi community. We recommend using existing trusted community networks to disseminate tailored vaccine information and actively reminding parents about due vaccinations to promote uptake amongst other underserved, ethnic minority communities with low uptake in high-income settings. Further research involving non-immunising parents is recommended to gain more comprehensive insight into vaccine decision-making within this community.
Unveiling the pathways: identifying the multifaceted determinants of low birth weight among neonates in low-income countries: a case-control study
Authors: Ayele Angefa , Boneya Dukele , Jara Dube , Beka Jitu , Gelchu Miesa , Edin Alo
Published: January 2025

Background

Low birth weight, as defined by the WHO, refers to the weight of a neonate below 2500 g at birth and is a significant public health concern globally, with both short- and long-term consequences. Despite the significance of low birth weight as a public health indicator, information gaps persist. Identifying at-risk mothers requires an understanding of the risk factors associated with low birth weight. Therefore, this study aimed to determine the common determinants of low birth weight among neonates born at public hospitals in Southern Ethiopia.

Methods

An unmatched case–control study was conducted among 258 neonates (86 cases and 172 controls) born at public hospitals between 15 April and 25 May 2022. The study participants were selected using a consecutive and systematic sampling technique. Data were analysed using Stata V.14, and a multivariable logistic regression model was performed. Statistical significance was declared at a p value<0.05.

Results

A total of 86 birth records of neonates with low birth weight and 172 birth records of neonates with normal birth weight were reviewed. The results revealed that lack of iron and folic acid supplementation (adjusted odds ratio (AOR) 2.47; 95% CI 1.16 to 5.25), lack of additional meal intake (AOR 2.66; 95% CI 1.16 to 6.00), anaemia (AOR 3.45; 95% CI 1.63 to 7.28), pregnancy-induced hypertension (AOR 2.49; 95% CI 1.04 to 5.97), mid-upper arm circumference (MUAC) (AOR 6.74; 95% CI 2.87 to 7.00), gestational age at first antenatal care (ANC) of ≥24 (AOR 7.31; 95% CI 3.43 to 15.58) and minimum food diversity (AOR 4.2; 95% CI 1.94 to 9.20) were common determinants of low birth weight.

Conclusion

Lack of iron and folic acid supplementation, additional meal intake, being anaemic, pregnancy-induced hypertension, gestational age at first ANC visit, MUAC ≤23 and minimum food diversity were common determinants of low birth weight. Initiating ANC services for all mothers and evaluating different risk factors may help to reduce low birth weight.
Nutritional status and risk factors for malnutrition among children aged 1–6 years in tribal communities of Malappuram district, Kerala: a cross-sectional study
Authors: Perayil Anjaly , K Sreelakshmi Mohandas
Published: January 2025

Introduction

Malnutrition has critical consequences for physical and cognitive growth, as well as for development. In Kerala, Malappuram district has the highest burden of malnutrition and is home to nearly half of the Paniya tribal population of the state.

Objective

To estimate the prevalence of undernutrition and the factors associated with the nutritional status of tribal children 1–6 years of age in Malappuram district of Kerala, India.

Methods

A community-based cross-sectional study was carried out between April to September 2022 among the tribal settlements in Nilamboor, Perinthalmanna and Edavanna, divisions of Malappuram district. A multistage cluster sampling was done and the minimum calculated sample size was 142. Parents of each child were interviewed using a semi-structured questionnaire along with anthropometric measurements for estimating height and weight. Data were analysed using ENA software and SPSS V.20.

Results

The prevalence of underweight, stunting and wasting were found to be 43%, 41.4% and 34.7%, respectively. Among them, 14%, 21.3% and 8.5% were severely underweight, severely stunted and severely wasted in this study population. Socio-demographic characteristics like maternal and paternal unemployment, maternal illiteracy, maternal habits like alcohol consumption, chewing tobacco and acute morbidities among children like diarrhoea and cough were found to be independent predictors for underweight among the tribal children of Malappuram district. Maternal unemployment and alcohol consumption were found to be independent predictors for stunting. For wasting, paternal unemployment, weaning practices and episodes of diarrhoea were found to be independent predictors.

Conclusion

Socio-demographic factors like parental unemployment, illiteracy and habits like alcohol consumption and tobacco use strongly influence the nutritional status of tribal children. An appropriately planned educational campaign and targeted interventions for improving nutritional status have to be deployed in these tribal communities.
Evaluating strategies for global respiratory pandemic control at ports: a modelling study
Authors: Guan Tong , Duoduwa Sharon Esi , Balakumar S , A Janhavi , Gan Gregory , Lim Jue Tao , Dickens Borame L
Published: January 2025

Background

Heavy reliance on container shipping during the COVID-19 pandemic with lockdown implementation and air travel bans placed substantial pressure on shipping crews and ports. Long waiting times at ports, substantial economic losses and massive supply chain disruption of essential and medical goods were observed. To minimise this for future pandemic preparedness, we explore the use of quarantining and testing of crews preboarding instead of quarantining at port calls or during voyages.

Methods

Using a microsimulation model of 10 000 vessels and 300 000 crew, we examine the effectiveness of nine predeparture control strategies in reducing COVID-19 outbreak sizes, from no control to the use of 7-day and 14-day quarantining, and addition of polymerase chain reaction (PCR) or antigen rapid test (ART) testing. To assess different infection parameters, we explored three variants (Alpha, Delta and Omicron), four prevalences (0.1%, 0.5%, 1% and 2%) and three quarantine compliances (50%, 90% and 100%).

Results

Across the prevalences with no intervention, our modelled simulations estimate that approximately 3%, 15%, 28% and 47% of crews are infected, totalling around 9400, 44 900, 82 600 and 141 300 infections. At 2% prevalence, averaged across variants and compliances, when 7-day predeparture quarantining (7DQ) is introduced, 23 900 (range: 21 500–25 200) estimated cases are averted, rising up to 40 900 (40 200–41 600) for 14DQ. With additional predeparture PCR testing, this increases further to 102 100 (100 100–104 500) and 106 800 (106 100–108 100) respectively. Should ART testing be used instead, 92 600 (92 200–93 200) and 100 000 (98 900–101 100) estimated cases are averted. The use of predeparture PCR testing and PCR testing 1 week before departure has the greatest reduction at 108 200 (106 400–110 600) and 111 600 (110 500–113 000).

Conclusion

In our simulation model, we show that preboarding control measures can be effective in limiting outbreaks, reducing the number of active cases on marine vessels without access to adequate medical care while simultaneously reducing port congestion and facilitating for the greater global transport of essential goods.
Advances in the understanding and therapeutic manipulation of cancer immune responsiveness: a Society for Immunotherapy of Cancer (SITC) review
Authors: Cesano Alessandra , Augustin Ryan , Barrea Luigi , Bedognetti Davide , Bruno Tullia C , Carturan Alberto , Hammer Christian , Ho Winson S , Kather Jakob Nikolas , Kirchhoff Tomas , Lu Rongze O , McQuade Jennifer , Najjar Yana G , Pietrobon Violena , Ruella Marco , Shen Rhine , Soldati Laura , Spencer Christine , Betof Warner Allison , Warren Sarah , Ziv Elad , Marincola Francesco M
Published: January 2025

Cancer immunotherapy—including immune checkpoint inhibition (ICI) and adoptive cell therapy (ACT)—has become a standard, potentially curative treatment for a subset of advanced solid and liquid tumors. However, most patients with cancer do not benefit from the rapidly evolving improvements in the understanding of principal mechanisms determining cancer immune responsiveness (CIR); including patient-specific genetically determined and acquired factors, as well as intrinsic cancer cell biology. Though CIR is multifactorial, fundamental concepts are emerging that should be considered for the design of novel therapeutic strategies and related clinical studies. Recent advancements as well as novel approaches to address the limitations of current treatments are discussed here, with a specific focus on ICI and ACT.