bluuebunny/crossref_metadata_2025 huggingface dataset:
An online qualitative study exploring wants and needs for a cooking programme during pregnancy in the UK and Ireland
Authors: Lavelle Fiona , McKernan Claire , Shrewsbury Vanessa , Wolfson Julia A. , Taylor Rachael M. , Duncanson Kerith , Martins Carla A. , Elliott Christopher , Collins Clare E.
Published: April 2024

Background

Optimal maternal nutrition is associated with better pregnancy and infant outcomes. Culinary nutrition programmes have potential to improve diet quality during pregnancy. Therefore, this research aimed to understand the experiences of cooking and the wants and needs of pregnant women regarding a cooking and food skills programme in the United Kingdom (UK) and Republic of Ireland (ROI).

Methods

Online focus group discussions with pregnant women and those who had experienced a pregnancy in the UK or ROI were conducted between February and April 2022. Two researchers conducted a thematic analysis. Seven focus groups with ROI participants (n = 24) and six with UK participants (n = 28) were completed.

Results

Five themes were generated. These were (1) cooking during pregnancy: barriers, motivators and solutions; (2) food safety, stress and guilt; (3) need for cooking and food skills programmes and desired content; (4) programme structure; (5) barriers and facilitators to programme participation. Overall, there was support for a programme focusing on broad food skills, including planning, food storage, using leftovers and to manage pregnancy‐specific physiological symptoms such as food aversions. Participants emphasised the importance of inclusivity for a diverse range of people and lifestyles for programme design and content.

Conclusions

Current findings support the use of digital technologies for culinary nutrition interventions, potentially combined with in‐person sessions using a hybrid structure to enable the development of a support network.
Dispositions, Virtues, and Indian Ethics
Authors: Raimondi Andrea , Jain Ruchika
Published: April 2024

According to Arti Dhand, it can be argued that all Indian ethics have been primarily virtue ethics. Many have indeed jumped on the virtue bandwagon, providing prima facie interpretations of Hindu, Jain, and Buddhist canons in virtue terms. Others have expressed firm skepticism, claiming that virtues are not proven to be grounded in the nature of things and that, ultimately, the appeal to virtue might just well be a mere façon de parler. In this paper, we aim to advance the discussion of Indian virtue ethics. Our intent is not to provide a catch‐all interpretation of the different Indian schools. Our goal is, more modestly, to offer a theory of virtues in Indian philosophies, as a framework for theorists and interpreters who see these diverse traditions as amenable to systematic virtue analysis. Our theory grounds virtues in the reality of genuine moral dispositions and in a system of beliefs where morality is understood as transformative in nature.
Trying to understand the illness: A qualitative investigation of health literacy of patients undergoing maintenance hemodialysis
Authors: Rahmawati Berlian Ayu , Rochmawati Erna
Published: April 2024

Limited health literacy is high among patients with chronic kidney disease, which can pose challenges in health care. Evidence of health literacy in Indonesia, particularly regarding patients undergoing hemodialysis, is lacking. In this study, we aimed to explore health literacy in adult patients undergoing maintenance hemodialysis. An inductive qualitative study was conducted. Individual semi‐structured interviews were conducted with 10 adult patients undergoing hemodialysis, four family caregivers, and four healthcare professionals. Interviews were transcribed verbatim and analyzed thematically. Three themes emerged from the data: “Trying to understand the illness,” “searching and obtaining health information,” and “applying health information.” Understanding and accepting the illness included raising awareness of the changes in their lives and accepting these changes. Participants actively sought information from healthcare professionals and other sources and used it carefully. Behavioral changes included patients' adherence to therapy, although participants often felt bored during the illness trajectory. Understanding the illness and being willing to seek and critically evaluate health information before implementing it are important. These aspects may affect patient outcomes and require further intervention and research.
Mycorrhizal fungi modify decomposition: a meta‐analysis
Authors: Choreño‐Parra Eduardo M. , Treseder Kathleen K.
Published: April 2024

It has been proposed that ectomycorrhizal fungi can reduce decomposition while arbuscular mycorrhizal fungi may enhance it. These phenomena are known as the ‘Gadgil effect’ and ‘priming effect’, respectively. However, it is unclear which one predominates globally.

We evaluated whether mycorrhizal fungi decrease or increase decomposition, and identified conditions that mediate this effect. We obtained decomposition data from 43 studies (97 trials) conducted in field or laboratory settings that controlled the access of mycorrhizal fungi to substrates colonized by saprotrophs.

Across studies, mycorrhizal fungi promoted decomposition of different substrates by 6.7% overall by favoring the priming effect over the Gadgil effect. However, we observed significant variation among studies. The substrate C : N ratio and absolute latitude influenced the effect of mycorrhizal fungi on decomposition and contributed to the variation. Specifically, mycorrhizal fungi increased decomposition at low substrate C : N and absolute latitude, but there was no discernable effect at high values. Unexpectedly, the effect of mycorrhizal fungi was not influenced by the mycorrhizal type.

Our findings challenge previous assumptions about the universality of the Gadgil effect but highlight the potential of mycorrhizal fungi to negatively influence soil carbon storage by promoting the priming effect.
Female delayed mating has a limited impact on the reproductive output of Cerambyx welensii, a synovigenic longhorn beetle
Authors: Torres‐Vila Luis M.
Published: April 2024

Increased female age at mating is considered a detrimental factor on reproductive output and fitness in insects, even if the impact is rather species specific. The effect of delayed mating on reproductive output has been widely studied in pest species controlled with mating disruption, as if the method is not fully effective in suppressing matings, it could still delay them, limiting female fitness and pest damage. Female mating delay, however, may also occur in natural habitats without invoking mating disruption. We studied the effect of female delayed mating in Cerambyx welensii (Küster) (Coleoptera: Cerambycidae), an oak‐living sapro‐xylophagous longhorn beetle considered a critical factor in oak decline. Several life history and ecological traits may potentially delay mating, including low abundance, (re)colonisation processes, sexual communication channel, host‐produced kairomones, operational sex ratio, reproductive interference and adverse weather conditions. We conducted laboratory tests to assess the impact of mating delays (0‐, 10‐, 20‐ and 30‐day post‐emergence) on reproductive output. Data showed that mating delay until at least 20 days of age had a limited effect on mating success, lifetime fecundity, longevity and fertility. The daily fecundity pattern depended on mating delay, and virgin females showed ovarian retention. We conclude that C. welensii females have evolved physiological adaptations to overcome mating delays and optimise fitness. We discuss our results from an evolutionary perspective, considering specifically the risk of early predation and egg‐laying time limitation. We hypothesise that unpredictable recurrent stochastic variation in male availability could act as an additional driver selecting for synovigeny in this longhorn species.
Molecular phylogeny and biogeography of the aquatic dance fly subfamily Clinocerinae (Diptera: Empididae)
Authors: Vojvoda Zeljko Tanja , Pavlek Martina , Wahlberg Emma , Sinclair Bradley J. , Ivković Marija
Published: April 2024

This study presents the first molecular phylogenetic analysis of the Clinocerinae, challenging the traditionally accepted monophyly of this subfamily. DNA was extracted from fresh and museum specimens representing all biogeographical regions. Maximum likelihood (ML) and Bayesian inference (BI) phylogenetic analyses were performed based on sequences from two mitochondrial genes, cytochrome c oxidase subunit I (COI) and cytochrome β, and three nuclear genes, carbomoylphosphate synthase domain of rudimentary, elongation factor‐1α and isocitrate dehydrogenase. Through molecular data and morphological examination, our results reveal a division within Clinocerinae, distinguishing ‘typical’ or Clinocerinae (s.s.) from several genera, specifically Afroclinocera Sinclair, Asymphyloptera Collin and Proagomyia Collin, possibly lending support for a reclassification of these genera outside Clinocerinae. Bergenstammia Mik is proposed as a junior synonym of Phaeobalia Mik, syn. n., and the following new combinations are recognized: Phaeobalia albanica (Wagner) comb. n., Phaeobalia aurinae (Pusch & Wagner) comb. n., Phaeobalia carniolica (Horvat) comb. n., Phaeobalia frigida (Vaillant) comb. n., Phaeobalia glacialis (Palaczyk & Słowińska) comb. n., Phaeobalia multiseta (Strobl) comb. n., Phaeobalia nudimana (Vaillant) comb. n., Phaeobalia nudipes (Loew) comb. n., Phaeobalia pulla (Vaillant & Wagner) comb. n., Phaeobalia pyrenaica (Vaillant & Vinçon) comb. n., Phaeobalia slovaca (Wagner) comb. n. and Phaeobalia thomasi (Vaillant & Vinçon) comb. n. Re‐evaluation of the genus Roederiodes resulted in the following new combinations: Clinocerella macedonicus (Wagner & Horvat) comb. n. and Clinocerella montenegrinus (Wagner & Horvat) comb. n. The origins of Clinocerinae (s.s.) are traced back to the Holarctic region, Laurasian origin, with a likely complex history of dispersal events into the Southern Hemisphere. Based on current knowledge, the greatest generic and species richness is confined to the Palaearctic Region. These findings provide valuable insights into the evolutionary relationships and distribution patterns of Clinocerinae (s.s.), challenging existing taxonomic classifications and shedding light on their historical biogeography.
Interactive visual query of density maps on latent space via flow‐based models
Authors: Li Ning , Liang Tianyi , Jiang Shiqi , Wang Changbo , Li Chenhui
Published: April 2024

Visual querying of spatiotemporal data has become a dominant mode in the field of visual analytics. Previous studies have utilized well‐designed data structures to speed up the querying of spatiotemporal data. However, reducing storage overhead while improving the querying efficiency of data distribution remains a significant challenge. We propose a flow‐based neural representation method for efficient visual querying. First, we transform spatiotemporal data into density maps through kernel density estimation. Then, we leverage the data‐driven modeling capabilities of a flow‐based neural network to achieve a highly latent representation of the data. Various computations and queries can be performed on the latent representation to improve querying efficiency. Our experiments demonstrate that our approach achieves competitive results in visually querying spatiotemporal data in terms of storage overhead and real‐time interaction efficiency.
The outstanding capacity of Prasiola antarctica to thrive in contrasting harsh environments relies on the constitutive protection of thylakoids and on morphological plasticity
Authors: Arzac Miren I. , Miranda‐Apodaca Jon , de los Ríos Asunción , Castanyer‐Mallol Francesc , García‐Plazaola José I. , Fernández‐Marín Beatriz
Published: April 2024

The determination of physiological tolerance ranges of photosynthetic species and of the biochemical mechanisms underneath are fundamental to identify target processes and metabolites that will inspire enhanced plant management and production for the future. In this context, the terrestrial green algae within the genus Prasiola represent ideal models due to their success in harsh environments (polar tundras) and their extraordinary ecological plasticity. Here we focus on the outstanding Prasiola antarctica and compare two natural populations living in very contrasting microenvironments in Antarctica: the dry sandy substrate of a beach and the rocky bed of an ephemeral freshwater stream. Specifically, we assessed their photosynthetic performance at different temperatures, reporting for the first time gnsd values in algae and changes in thylakoid metabolites in response to extreme desiccation. Stream population showed lower α‐tocopherol content and thicker cell walls and thus, lower gnsd and photosynthesis. Both populations had high temperatures for optimal photosynthesis (around +20°C) and strong constitutive tolerance to freezing and desiccation. This tolerance seems to be related to the high constitutive levels of xanthophylls and of the cylindrical lipids di‐ and tri‐galactosyldiacylglycerol in thylakoids, very likely related to the effective protection and stability of membranes. Overall, P. antarctica shows a complex battery of constitutive and plastic protective mechanisms that enable it to thrive under harsh conditions and to acclimate to very contrasting microenvironments, respectively. Some of these anatomical and biochemical adaptations may partially limit photosynthesis, but this has a great potential to rise in a context of increasing temperature.
Neuropsychopedagogical Motor Intervention Program Strengthening Inhibitory Control, Working Memory, and Language Abilities in Post-COVID-19 School Returnees
Authors: Cardoso Fabrício , Braga Lucianara , Loureiro Vitor , Bonone Filipe , Souza Samuel , Sholl-Franco Alfred
Published: April 2024

This study aimed to evaluate the effects of a neuropsychopedagogical motor intervention program (NMIP) on the cognitive functioning and academic achievement of students. 201 students aged 7 to 10 participated, randomly assigned to either the control group (103 students underwent two assessments during the NMIP period) or the experimental group (98 students underwent NMIP interspersed with two assessments). The NMIP utilized the Coordinating Methodology, focusing on motor development, executive functions, and mindfulness. It consisted of 36 sessions, each lasting 15 minutes, involving the coding and decoding of figures and colors with parts of the glass human body, implemented by the class teacher in the school setting. Cognitive functioning and academic achievement were assessed using the Children's Scale for Inhibitory Control Screening (CSICS), Neuropsychopedagogical Scale for Working Memory Screening (NSWMS), Scale for Screening Phonological Abilities (SSPA), and Children's Scale for Reading and Writing Screening (CSRWS) before and after the NMIP. The results showed significant improvements in the experimental group: ±19% (p<0.01) in CSICS, ±29% (p<0.01) in NSWMS, ±23% (p<0.01) in SSPA, and a reduction of ±52% (p<0.01) in reading and writing difficulties measured by CSRWS. Additionally, ANOVA analysis indicated superior performance (p<0.01) in cognitive functions and academic skills among children in the experimental group post-NMIP compared to those in the control group. In conclusion, the NMIP demonstrated substantial positive effects on both cognitive functioning and academic achievement in elementary school students.
Relying on LEADER? A place-based policy approach to the rural development of Finnish municipalities
Authors: Mustakangas Ella
Published: April 2024

In Finnish rural development, the role of municipalities has proven to be modest, even though the place-based policy approach in principle gives them an important position. The main part of municipal rural development involves cooperation with LEADER groups, to which municipalities give priority. In this study I ask: What explains the current status of municipalities in place-based rural development, that is, the dominance of LEADER and the small scale of the municipalities' own rural development? The methodology is based on critical realism, and the analysis draws from semi-structured interviews conducted in three municipalities. The aforementioned state of local rural development is called demi-regularity, which is the starting point of the research. Using a thematic analysis developed by Tom Fryer for critical realist research, the study proposes three causal explanations for this observation, namely the idea of responsible local communities, the development policy of the shrinking municipality, and the challenges of projectification. According to the findings, the increased role of villages in rural development does not necessarily support the involvement of municipalities, but rather the opposite. The study also shows that when municipalities are primarily looking for (economic) growth, they have difficulties in trusting the potential of rural areas, let alone exploiting it. On the other hand, the challenges of projectification do not characterise LEADER projects in the same way as other municipal project work, making it tempting to rely on LEADER in municipal rural development. Overall, the study shows how strongly and differently LEADER is rooted in place-based rural development in Finland. In order to bring municipalities back into the scene, a broader discussion on the actual preconditions of municipalities in place-based rural development is needed.
Lo móvil en la investigación etnográfica de los márgenes sociales: Acciones colectivas de trabajadoras sexuales
Authors: Espinoza Ibacache Jacqueline , Iñiguez-Rueda Lupicinio
Published: April 2024

El objetivo de este artículo es contribuir sobre lo móvil como concepto metodológico a través de una etnografía etnometodológica feminista sobre acciones colectivas de trabajadoras sexuales en el Norte de Chile, a partir de tres herramientas metodológicas: tránsito, liminalidad y conexiones íntimas. Definimos tránsito como los movimientos entre espacios virtuales, presenciales, híbridos, móviles de acuerdo con la cotidianeidad de las participantes. Liminalidad, como el análisis de las fronteras, como espacios de encuentro y desencuentro para observar la heterogeneidad y el confrontamiento de las diferencias. Conexiones íntimas, como el seguimiento de materialidades de presencia significativa en el campo, que se ensamblan con los métodos de las participantes y que cobran diversos significados. Así, proponemos una práctica etnográfica que mueva y movilice de acuerdo con sus participantes, que rompa dualismos, que sea fluida y, en este entramado, se enrede política y éticamente. No únicamente con un fin epistemológico, sino que también para contribuir activamente en la producción de otros sentidos, de otros mundos distintos.
Smaug regulates germ plasm assembly and primordial germ cell number in Drosophila embryos
Authors: Siddiqui Najeeb U. , Karaiskakis Angelo , Goldman Aaron L. , Eagle Whitby V. I. , Low Timothy C. H. , Luo Hua , Smibert Craig A. , Gavis Elizabeth R. , Lipshitz Howard D.
Published: April 2024

During Drosophila oogenesis, the Oskar (OSK) RNA binding protein (RBP) determines the amount of germ plasm that assembles at the posterior pole of the oocyte. Here, we identify mechanisms that subsequently regulate germ plasm assembly in the early embryo. We show that the Smaug (SMG) RBP is transported into the germ plasm of the early embryo where it accumulates in the germ granules. SMG binds to and represses translation of the
osk
messenger RNA (mRNA) as well as the
bruno 1
(
bru1
) mRNA, which encodes an RBP that we show promotes germ plasm production. Loss of SMG or mutation of SMG’s binding sites in the
osk
or
bru1
mRNA results in excess translation of these transcripts in the germ plasm, accumulation of excess germ plasm, and budding of excess primordial germ cells (PGCs). Therefore, SMG triggers a posttranscriptional regulatory pathway that attenuates the amount of germ plasm in embryos to modulate the number of PGCs.
Lessons in persistence
Authors: Couzin-Frankel Jennifer
Published: April 2024

New Long Covid trials aim to clear lingering virus—and help patients in dire need
Childhood
Mycoplasma pneumoniae
: epidemiology and manifestation in Northeast and Inner Mongolia, China
Authors: Wang Fei , Cheng Qi , Duo Hongying , Wang Jichun , Yang Jingjing , Jing Shujun , Li Jing , Zhou Xiandong , Shang Yunxiao , Chen Ning , Tian Zhiliang , Zhang Han , Cai Xuxu
Published: April 2024

Mycoplasma pneumoniae
(MP) is commonly detected in children. However, the epidemiological trends of MP in Northeast (NE) China are unclear. This retrospective study aimed to investigate the prevalence of MP infections in this understudied region. The clinical manifestations and bronchoscopic findings observed in hospitalized patients with severe
Mycoplasma pneumoniae
pneumonia (SMPP) were collected from comprehensive data obtained from six tertiary hospitals in NE and Inner Mongolian (IM) China, from 1 January 2017 to 31 December 2023. A total of 5,593,530 children who visited the outpatient and emergency departments, and 412,480 inpatient hospitalized children were included in the study. The positivity rate of MP immunoglobulin M (IgM) in the children who visited the outpatient and emergency departments varied from 7.80% to 10.12%, whereas that of MP infection in hospitalized children ranged from 27.18% to 30.10%. Children hospitalized for MP infection were mainly concentrated in the 1- to 4-year (41.39%) and 4- to 7-year (24.25%) age groups. Before 2020, the season with the highest incidence of MP was winter. After the implementation of non-pharmaceutical interventions (NPIs), the MP epidemic season changed, and the number of children with MP infections decreased; however, the proportion of MP infections in hospitalized children did not change significantly. Starting from August 2023, the MP infection rate in outpatient, emergency, and hospitalized children increased sharply, with SMPP and its complications (e.g., plastic bronchitis and pleural effusion) increasing significantly. MP is prevalent in NE and IM, China. When the NPIs ended, MP infection showed a delayed outbreak trend, and the number of children with severe infection increased significantly.

IMPORTANCE

In Northeastern (NE) and Inner Mongolia (IM), the incidence of
Mycoplasma pneumoniae
(MP) infections, including severe
Mycoplasma pneumoniae
pneumonia (SMPP), is high, posing health risks and imposing substantial economic burdens on the local population. Therefore, it is imperative to prioritize the study of MP prevalence and address the research gaps in MP epidemiology in these areas of China. We obtained a comprehensive collection of pediatric outpatient, emergency, and inpatient data from six public Grade III hospitals. We believe that our study makes a significant contribution to the literature because understanding regional variations in MP infections can help healthcare professionals tailor prevention and treatment strategies, and studying bronchoscopic manifestations can provide insights into the impact of the disease on the respiratory system, potentially leading to a more effective clinical management.
Linking the terrestrial environmental record at Mason Spur volcanic complex with the middle Miocene–Pleistocene Ross Sea marine record, Antarctica: A history of subaerial (ice-free) eruptions and glaciovolcanism under variable ice thicknesses
Authors: Smellie John L. , Martin Adam P. , Townsend Dougal B. , Di Vincenzo Gianfranco
Published: April 2024

Research into volcanism in southern Victoria Land, Antarctica, within the West Antarctic rift system, has focussed historically on the geochemistry and chronology of its volcanic centers. However, volcanoes in the West Antarctic rift system have also been dramatically influenced by the prevailing eruptive environment. Mason Spur is a middle Miocene to Pleistocene volcanic complex in the Erebus Volcanic Province. The deep interior of the complex is revealed and is used to assess its development under different environmental conditions. Many of the volcanic sequences erupted within ice and are thus ultraproximal compared with marine sediments, which are the usual source of environmental information. The volcanic rocks provide a unique, well-dated record of the terrestrial environmental conditions independent of the marine record, to which they are an important counterbalance. Evidence is provided for conditions varying between ice-free, alpine ice, and regional ice sheets, and direct comparisons are made with the marine record. The first contemporary ice thicknesses are also deduced for the Erebus Volcanic Province. The results significantly advance our understanding of the middle Miocene–Pleistocene Antarctic environment in the coastal Victoria Land region.
Supplemental Material: Excessive subsidence of oceanic basins caused by recycled oceanic crust in the mantle source: A new perspective on the oceanic topography within Southeast Asia
Authors: Yang Fan , Huang Xiao-Long , Xu Yi-Gang , al. et
Published: April 2024

These files include analytical methods, photographs of samples, descriptions of melt inclusion corrections, estimation of the amount of recycled oceanic crust in the South China Sea MORB source, details of numerical modeling, and data for samples and standards used in this study. 
Do patients with type 2 diabetes mellitus included in randomised clinical trials differ from general-practice patients? A cross-sectional comparative study
Authors: Dugard Amandine , Giraudeau Bruno , Dibao-Dina Clarisse
Published: April 2024

Objectives

To compare the characteristics of patients with type 2 diabetes mellitus in general practice and those included in randomised controlled trials on which clinical practice guidelines are based.

Design

Cross-sectional comparative study.

Setting

We asked 45 general practitioners from three French Departments to identify the 15 patients with type 2 diabetes mellitus they most recently saw in consultation. In parallel, we selected randomised controlled trials included in the Cochrane systematic review on which the clinical practice guidelines for type 2 diabetes mellitus were based.

Participants

We included 675 patients with type 2 diabetes mellitus, and data were collected from 23 randomised controlled trials, corresponding to 36 059 patients.

Outcome measures

Characteristics of general-practice patients were extracted from medical records by a unique observer. The same baseline characteristics of patients included in randomised controlled trials from the Cochrane systematic review were extracted and meta-analysed. We assessed standardised differences between these two series of baseline characteristics. A difference greater than 0.10 in absolute value was considered meaningful.

Results

General-practice patients were older than randomised controlled trial patients (mean (SD) 68.8 (1.1) vs 59.9 years (standardised difference 0.8)) and had a higher body mass index (mean (SD) 31.5 (6.9) vs 28.2 kg/m2(standardised difference 0.5)) but smoked less (11.0% vs 29.3% (standardised difference −0.6)). They more frequently used antihypertensive drugs (82.1% vs 37.5% (standardised difference 1.2)) but less frequently had a myocardial infarction (7.6% vs 23.1% (standardised difference −1.1)).

Conclusions

Patients with type 2 diabetes mellitus cared for in general practice differ in a number of important aspects from patients included in randomised controlled trials on which clinical practice guidelines are based. This situation hampers the applicability of these guidelines. Future randomised trials should include patients who better fit the ‘average’ general-practice patient with type 2 diabetes mellitus to help improve the translation of study findings in daily practice.
Cohort profile: the PERSIAN Dena Cohort Study (PDCS) of non-communicable diseases in Southwest Iran
Authors: Harooni Javad , Joukar Farahnaz , Goujani Reza , Sikaroudi Masoumeh Khalighi , Hatami Alireza , Zolghadrpour Mohammad-Amin , Hejazi Mahdi , Karimi Zahra , Rahmanpour Fatemeh , Askari Shahid Sakineh , Jowshan Mohammad-Reza
Published: April 2024

Purpose

This study conducted in Dena County is a population-based cohort study as part of the Prospective Epidemiological Research Studies in Iran (PERSIAN). The specific objectives of this study were to estimate the prevalence of region-specific modifiable risk factors and their associations with the incidence of major non-communicable diseases (NCDs).

Participants

This PERSIAN Dena Cohort Study (PDCS) was conducted on 1561 men and 2069 women aged 35–70 years from October 2016 in Dena County, Kohgiluyeh and Boyer-Ahmad Province, Southwest Iran. The overall participation rate was 82.7%.

Findings to date

Out of 3630 participants, the mean age was 50.16 years, 2069 (56.9%) were women and 2092 (57.6%) were rural residents. Females exhibited higher prevalence rates of diabetes, hypertension, fatty liver, psychiatric disorders, thyroiditis, kidney stones, gallstones, rheumatic disease, chronic lung disease, depression and osteoporosis compared with males (p<0.05). Furthermore, the urban population showed elevated rates of diabetes, thyroiditis, kidney stones and epilepsy, whereas psychiatric disorders and lupus were more prevalent in rural areas (p<0.05). According to laboratory findings, 418 (13.0%), 1536 (48.1%) and 626 (19.3%) of the participants had fasting blood sugar >126 mg/dL, low-density lipoprotein >100 mg/dL and haematuria, respectively; most of them were female and urban people (p<0.05).

Future plans

PDCS will be planned to re-evaluate NCD-related incidence, all-cause and cause-specific mortality every 5 years, along with annual follow-up for 15 years. Some examples of additional planned studies are evaluation of genetic, environmental risk, spirometry and ECG tests.
Evidence related to a vegetarian diet and metabolic dysfunction-associated steatotic liver disease: protocol for a scoping review
Authors: Moss Kasey , Gitman Victor , Pinto Sanchez M Ines , Oczkowski Simon , Armstrong David , Jayakumar Saumya , Karvellas Constantine Jason , Selzner Nazia , Dionne Joanna
Published: April 2024

Introduction

Metabolic dysfunction-associated fatty liver disease (MASLD) is the hepatic manifestation of metabolic syndrome and the leading cause of chronic liver disease worldwide. Given that there is no pharmacological treatment for MASLD, it is imperative to understand whether lifestyle modifications may improve biochemical and pathological outcomes. One commonly proposed dietary modification is the Mediterranean diet; however, vegetarianism may also be a promising intervention. Vegetarianism has been shown to be associated with reduced morbidity and mortality in metabolic syndrome outcomes in coronary artery disease and diabetes; however, the relationship between vegetarian diet and MASLD is less clear. In this scoping review, we will provide a comprehensive overview of the current body of evidence related to a vegetarian diet and MASLD.

Methods and analysis

The aim of this scoping review is to describe and summarise the current body of evidence related to MASLD and a vegetarian diet. This review will be conducted using Arksey and O’Malley’s framework. The literature review will be conducted using the following databases: SCOPUS, Web of Science, CINAHL-Plus, Cochrane Library and Medline. No restriction will be made on publication date. Included studies will encompass clinical trials and observational designs that examine effects or association of vegetarian diet in adults (≥16 years) and report on the incidence, prevalence or progression of MASLD. Grey literature, non-human studies and articles focusing on changes in a specific food or nutraceutical will be excluded. Articles must have an English-language abstract available to be considered for inclusion. Screening and data extraction will be conducted by two independent reviewers. The findings will be summarised with descriptive statistics.

Ethics and dissemination

Approval from a medical ethics committee is not required for this review. Once the review is complete, the findings will be submitted to a peer-reviewed journal.
Impact of omitting annual reviews for COPD on patient reported care quality– outcomes from the Asthma+Lung COPD patient passport
Authors: Williams Parris Jade , Bachir Leena , Philip Keir Elmslie James , Cumella Andrew , Polkey Mike , Laverty Anthony A , Hopkinson Nicholas S
Published: April 2024

Background

Regular clinical reviews of people with COPD provide an opportunity to optimise management and are recommended in national and international guidelines. However, there are limited data about the relationship between having an annual review and other aspects of care quality, which might influence decision-making by healthcare professionals and commissioners.

Method

Using data from 74 827 people with COPD completing the Asthma+Lung UK COPD Patient Passport, between 2014 and 2022, we conducted adjusted logistic regression (adjusting for year) and compared receipt of key items of care between those reporting that they had had an annual review (65.3%) and those who did not (34.7%). To further capture patient experience, we also analysed 4228 free-text responses to the 2021 Asthma+Lung UK annual COPD survey to the question ‘What is the one thing that could improve your COPD care?’

Results

We found that the absence of an annual review was associated with significantly worse COPD care across all domains studied; in particular, inhaler training (yes: 80.8% vs no: 38.4%, adjusted OR (AOR): 8.18, 95% CI (7.89 to 8.47), having a written care plan (89.6% vs 56.9%, AOR 6.68 (95% CI 6.35 to 7.05) and medication knowledge (72.6% vs 33.6%, AOR 5.73 (95% CI 5.51 to 5.96). Thematic analysis of the 2021 COPD survey responses identified three areas to improve care: (1) access and support from healthcare services, (2) improved treatment effectiveness and (3) interaction between COPD and the social environment.

Discussion

Failure to deliver annual COPD reviews is associated with worse patient-reported experience of care quality. In parallel, people with COPD express a desire for greater support and access to healthcare services.
Understanding responsibility for health inequalities in children’s hospitals in England: a qualitative study with hospital staff
Authors: Brewster Liz , Brennan Louise , Hindocha Avni , Lunn Judith , Isba Rachel
Published: April 2024

Objectives

This study aimed to understand how staff in children’s hospitals view their responsibility to reduce health inequalities for the children and young people who access their services.

Design

We conducted an exploratory qualitative study.

Setting

The study took place at nine children’s hospitals in England.

Participants

217 members of staff contributed via interviews and focus groups conducted January–June 2023. Staff were represented at all levels of the organisations, and all staff who volunteered to contribute were included in the study.

Analysis

Data were analysed using Rapid Research Evaluation and Appraisal (RREAL) methodology for rapid assessment procedures (RAP).

Results

All of the children’s hospitals were taking some action to reduce health inequalities. Two key themes were identified. First, it was clear that reducing health inequalities was seen as something that was of vital import and should be part of staff’s day-to-day activity, framed as ‘everyone’s business.’ Many staff felt that there was an obligation to intervene to ensure that children and young people receiving hospital treatment were not further disadvantaged by, for example, food poverty. Second, however, the deeply entrenched and intersectional nature of health inequalities sometimes meant that these inequalities were complex to tackle, with no clear impetus to specific actions, and could be framed as ‘no-one’s responsibility’. Within a complex health and social care system, there were many potential actors who could take responsibility for reducing health inequalities, and staff often questioned whether it was the role of a children’s hospital toleadthese initiatives.

Conclusions

Broadly speaking, senior leaders were clear about their organisational role in reducing health inequalities where they impacted on access and quality of care, but there was some uncertainty about the perceived boundaries of responsibility. This led to fragility in the sustainability of activity, and a lack of joined-up intervention. Most hospitals were forging ahead with activity, considering that it was more important to work to overcome health inequalities rather than debate whose job it was.
A cross-sectional study on the proper administration of eye medications and its determinants among outpatients attending Brhan Aini Ophthalmic National Referral Hospital in Asmara, Eritrea
Authors: Abdu Nuru , Weldemariam Dawit G , Goitom Tesfagaber Alemseghed , Tewelde Tomas , Tesfamariam Eyasu H
Published: April 2024

Objective

This study aimed to assess the administration technique of eye medications, its determinants and disposal practices among ophthalmic outpatients.

Design

An analytical cross-sectional study was conducted.

Setting

Brhan Aini Ophthalmic National Referral Hospital in Asmara, Eritrea.

Participants

Samples of ophthalmic outpatients aged>18 years who visited Brhan Aini Ophthalmic National Referral Hospital in Asmara, Eritrea. Systematic random sampling was used to select the study participants.

Data collection and analysis

Data were collected from August 2021 to September 2021, using an interview-based questionnaire. The collected data were entered and analysed using CSPro (V.7.3) and SPSS (V.26), respectively. Descriptive statistics and independent samples t-test were performed.P-values less than 0.05 were considered as significant.

Results

A total of 333 respondents with a mean age of 56.4 (SD: 18.76) years were recruited in the study. More than half of the respondents (57.4%) did not have any information on the time interval between two successive eye medications. However, only 16.5% of the respondents managed to close their tear ducts after the administration of eye medication. The mean (SD) score for proper administration of eye medication was 4.16 (1.07) out of 7.0. Female sex (p=0.002), the absence of glaucoma (p=0.035) and the presence of cataract (p=0.014) were significant determinants of the proper administration technique of eye medication. The most favoured disposal practice for unused and/or expired eye medications was disposing of regular garbage (79.9%).

Conclusion

This research revealed that there was an inappropriate administration technique and disposal practices of eye medications among ophthalmic outpatients. This requires immediate attention from policy-makers, programme managers and healthcare professionals to ensure the appropriate use of eye medications by the patients.
Care Under Pressure 2: a realist synthesis of causes and interventions to mitigate psychological ill health in nurses, midwives and paramedics
Authors: Taylor Cath , Maben Jill , Jagosh Justin , Carrieri Daniele , Briscoe Simon , Klepacz Naomi , Mattick Karen
Published: April 2024

Background

Nurses, midwives and paramedics comprise over half of the clinical workforce in the UK National Health Service and have some of the highest prevalence of psychological ill health. This study explored why psychological ill health is a growing problem and how we might change this.

Methods

A realist synthesis involved iterative searches within MEDLINE, CINAHL and HMIC, and supplementary handsearching and expert solicitation. We used reverse chronological quota screening and appraisal journalling to analyse each source and refine our initial programme theory. A stakeholder group comprising nurses, midwives, paramedics, patient and public representatives, educators, managers and policy makers contributed throughout.

Results

Following initial theory development from 8 key reports, 159 sources were included. We identified 26 context–mechanism–outcome configurations, with 16 explaining the causes of psychological ill health and 10 explaining why interventions have not worked to mitigate psychological ill health. These were synthesised to five key findings: (1) it is difficult to promote staff psychological wellness where there is a blame culture; (2) the needs of the system often over-ride staff psychological well-being at work; (3) there are unintended personal costs of upholding and implementing values at work; (4) interventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressors; and (5) it is challenging to design, identify and implement interventions.

Conclusions

Our final programme theory argues the need for healthcare organisations to rebalance the working environment to enable healthcare professionals to recover and thrive. This requires high standards for patient care to be balanced with high standards for staff psychological well-being; professional accountability to be balanced with having a listening, learning culture; reactive responsive interventions to be balanced by having proactive preventative interventions; and the individual focus balanced by an organisational focus.

PROSPERO registration number

CRD42020172420.
Storylines of family medicine III: core principles—primary care, systems and family
Authors: Ventres William B , Stone Leslie A , Joslin Timothy A , Saultz John W , Aldulaimi Sommer , Gordon Paul R , Lane John C , Lee Eric R , Prunuske Jacob , Gildenblatt Limor , Friedman Michael H , Fogarty Colleen T , McDaniel Susan H , Rohrberg Tessa , Odom Amy
Published: April 2024

Storylines of Family Medicineis a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In ‘III: core principles—primary care, systems, and family’, authors address the following themes: ‘Continuity of care—building therapeutic relationships over time’, ‘Comprehensiveness—combining breadth and depth of scope’, ‘Coordination of care—managing multiple realities’, ‘Access to care—intersectional, systemic, and personal’, ‘Systems theory—a core value in patient-centered care’, ‘Family-oriented practice—supporting patients’ health and well-being’, ‘Family physician as family member’ and ‘Family in the exam room’. May readers develop new understandings from these essays.
Respiratory complex I regulates dendritic cell maturation in explant model of human tumor immune microenvironment
Authors: Turpin Rita , Liu Ruixian , Munne Pauliina M , Peura Aino , Rannikko Jenna H , Philips Gino , Boeckx Bram , Salmelin Natasha , Hurskainen Elina , Suleymanova Ilida , Aung July , Vuorinen Elisa M , Lehtinen Laura , Mutka Minna , Kovanen Panu E , Niinikoski Laura , Meretoja Tuomo J , Mattson Johanna , Mustjoki Satu , Saavalainen Päivi , Goga Andrei , Lambrechts Diether , Pouwels Jeroen , Hollmén Maija , Klefström Juha
Published: April 2024

Background

Combining cytotoxic chemotherapy or novel anticancer drugs with T-cell modulators holds great promise in treating advanced cancers. However, the response varies depending on the tumor immune microenvironment (TIME). Therefore, there is a clear need for pharmacologically tractable models of the TIME to dissect its influence on mono- and combination treatment response at the individual level.

Methods

Here we establish a patient-derived explant culture (PDEC) model of breast cancer, which retains the immune contexture of the primary tumor, recapitulating cytokine profiles and CD8+T cell cytotoxic activity.

Results

We explored the immunomodulatory action of a synthetic lethal BCL2 inhibitor venetoclax+metformin drug combination ex vivo, discovering metformin cannot overcome the lymphocyte-depleting action of venetoclax. Instead, metformin promotes dendritic cell maturation through inhibition of mitochondrial complex I, increasing their capacity to co-stimulate CD4+T cells and thus facilitating antitumor immunity.

Conclusions

Our results establish PDECs as a feasible model to identify immunomodulatory functions of anticancer drugs in the context of patient-specific TIME.
Autologous human preclinical modeling of melanoma interpatient clinical responses to immunotherapeutics
Authors: Phoon Yee Peng , Lopes Jared E , Pfannenstiel Lukas W , Marcela Diaz-Montero Claudia , Tian Ye F , Ernstoff Marc S , Funchain Pauline , Ko Jennifer S , Winquist Raymond , Losey Heather C , Melenhorst Jan Joseph , Gastman Brian R
Published: April 2024

Background

Despite recent advances in immunotherapy, a substantial population of late-stage melanoma patients still fail to achieve sustained clinical benefit. Lack of translational preclinical models continues to be a major challenge in the field of immunotherapy; thus, more optimized translational models could strongly influence clinical trial development. To address this unmet need, we designed a preclinical model reflecting the heterogeneity in melanoma patients’ clinical responses that can be used to evaluate novel immunotherapies and synergistic combinatorial treatment strategies. Using our all-autologous humanized melanoma mouse model, we examined the efficacy of a novel engineered interleukin 2 (IL-2)-based cytokine variant immunotherapy.

Methods

To study immune responses and antitumor efficacy for human melanoma tumors, we developed an all-autologous humanized melanoma mouse model using clinically annotated, matched patient tumor cells and peripheral blood mononuclear cells (PBMCs). After inoculating immunodeficient NSG mice with patient tumors and an adoptive cell transfer of autologous PBMCs, mice were treated with anti-PD-1, a novel investigational engineered IL-2-based cytokine (nemvaleukin), or recombinant human IL-2 (rhIL-2). The pharmacodynamic effects and antitumor efficacy of these treatments were then evaluated. We used tumor cells and autologous PBMCs from patients with varying immunotherapy responses to both model the diversity of immunotherapy efficacy observed in the clinical setting and to recapitulate the heterogeneous nature of melanoma.

Results

Our model exhibited long-term survival of engrafted human PBMCs without developing graft-versus-host disease. Administration of an anti-PD-1 or nemvaleukin elicited antitumor responses in our model that were patient-specific and were found to parallel clinical responsiveness to checkpoint inhibitors. An evaluation of nemvaleukin-treated mice demonstrated increased tumor-infiltrating CD4+and CD8+T cells, preferential expansion of non-regulatory T cell subsets in the spleen, and significant delays in tumor growth compared with vehicle-treated controls or mice treated with rhIL-2.

Conclusions

Our model reproduces differential effects of immunotherapy in melanoma patients, capturing the inherent heterogeneity in clinical responses. Taken together, these data demonstrate our model’s translatability for novel immunotherapies in melanoma patients. The data are also supportive for the continued clinical investigation of nemvaleukin as a novel immunotherapeutic for the treatment of melanoma.