bluuebunny/crossref_metadata_2025 huggingface dataset:
The art of sleep: examining sleep strategies in the general population with a focus on the use of music for sleep
Authors: Buus Rasmus Møller , Genovese Silvia , Jespersen Kira Vibe
Published: February 2025

Insomnia is highly prevalent and associated with serious health issues. Despite the negative impact of poor sleep on mind and body, most people do not seek treatment. This study aimed to examine the strategies used to improve sleep in the general population with a particular focus on music. A survey was distributed via Facebook advertisements to Danish adults aged ≥18 years. Among 3667 responders, a representative subsample of 1195 participants was randomly selected based on age and sex. Data analysis involved chi‐square tests and logistic regression with adjustments for age, sex, education, and insomnia status. The results showed that nearly all participants utilised strategies to aid their sleep, with the most common strategies being ‘following a routine’ (73%), ‘reducing caffeine in the afternoon/evening’ (65%) and ‘lowering the temperature in the bedroom’ (62%). Individuals with insomnia utilised significantly more strategies (average 8.4 strategies) compared to those without insomnia (average 6.6 strategies). Among all participants, 20% reported using music for sleep at least 1–2 times/month, whereas 11% used music for sleep weekly, and 4.5% used music almost daily. Music users tended to be younger, and they were also more likely to have insomnia. By evaluating 24 different sleep strategies, this study shows that people do several things to promote sleep in their daily lives. These findings enhance our understanding of sleep behaviour, providing an important fundament for targeting future public health interventions to reduce the use of sleep disruptive strategies and promote strategies known to improve sleep health.
Elagolix to Treat Menstrual Related Symptom Exacerbations in Early Onset Parkinson Disease: A Case Report
Authors: Rima Hajjar , Akhila Sangadi , Brian Villafuerte‐Trisolini , Fein Lydia A.
Published: February 2025

Parkinson's Disease (PD) is a neurodegenerative condition characterized by motor and cognitive impairment and autonomic dysfunction. Limited data exist on the management of menstrual exacerbation of PD. We present a case of a 48‐year‐old woman with early‐onset PD and worsening symptoms prior to the onset of menses. Her complex medical history of prior thrombosis and progesterone dermatitis contraindicated hormonal menstrual suppression with estrogen and progesterone therapy. The patient was successfully treated with Elagolix, a GnRH antagonist. Elagolix appears to have a role in menstrual suppression in patients with menstrual‐related fluctuations of PD who have contraindications to or fail hormonal therapy.
Exploring Uncharted Territory: CEOs as Gatekeepers in Utilizing Industrial Platforms Through Data Sharing
Authors: Friedrich Lars , Leutheuser Viktoria , Mertel Michael , Voigt Kai‐Ingo
Published: February 2025

According to the silo mentality theory, companies are reluctant to share data between organizations. This study explores the reasons for this corporate behavior. To gain empirical insights, we conducted 42 semi‐structured interviews with the chief executive officers (CEOs) of German small‐ and medium‐sized enterprises (SMEs). Not only can the CEOs of SMEs control their private data, but they are also gatekeepers for business decisions, such as corporate data sharing. Following grounded theory, we identified four factors that influence data sharing. (1) Data characteristics—CEOs perceive social and financial data as sensitive in both private and corporate contexts. Furthermore, CEOs perceive additional types of corporate data as critical and are generally more skeptical of data sharing because of the complexity of data security. (2) Relationships via platforms—companies are often forced to participate in platforms, despite preferring long‐term personal relationships. (3) Competition—platforms enable easy and rapid product comparison. SMEs want to avoid transparency and fear that platform providers may compete for specific products. (4) Individual motivation—increased visibility among potential customers is an important incentive for participating in platforms, although CEOs perceive such participation to be time‐consuming. The findings extend the theory of silo mentality by indicating that the theory is not only relevant in the intra‐organizational context but also in the inter‐organizational context. Finally, we provide three propositions for future research.
Advancing social‐ecological restoration through elicitation of cultural ecosystem services and landscape feature perceptions in restored quarries: a Flickr data analysis
Authors: Svobodova Kamila , Chang Ping , Olafsson Anton Stahl , Plieninger Tobias
Published: February 2025

With increasing urbanization and demand for construction materials, quarries have become central to the recovery of degraded landscapes into spaces that offer ecological, but also social benefits. While ecological restoration has long been investigated, integrated social‐ecological restoration of post‐quarrying landscapes remains underexplored. The overall aim of this study is to advance social‐ecological restoration by assessing how cultural ecosystem services (CES) and landscape features (LF) are represented in social media posts about quarries in Germany, Denmark, and the Czech Republic. We focus on concepts of CES and LF to investigate the interactions between humans and restored ecosystems. Using a mixed‐methods approach, we analyzed 1,660 geotagged photographs from 50 quarries across three regions: Berlin, Roskilde, and the Czech Karst. Flickr social media data were analyzed to elicit the richness of CES and LF and to identify popular quarries. Our results indicate that rehabilitated quarries exhibit higher CES richness than abandoned or operational ones, and that accessibility significantly influences public engagement. Our study demonstrates that once primarily industrial sites, quarries can evolve into vibrant social‐ecological systems that provide diverse LF and CES. It also points to the potential of social media data for designing restoration efforts from a social‐ecological perspective. Such an approach provides insights into public perceptions of restored urban landscapes and may inform future restoration strategies.
Comparison of the in vitro antibiofilm activities of otic cleansers against canine otitis externa pathogens
Authors: Savaliya Bhumika F. , Kim Sorae , Veltman Tania , Trott Darren J.
Published: February 2025

Background

Biofilm production by canine otitis externa (COE) pathogens and resistance development to multiple antimicrobials are commonly reported problems in veterinary practice. The use of adjuvants to disrupt biofilms may be a viable adjunctive therapy.

Hypothesis/Objectives

To compare the in vitro antibiofilm activity against COE pathogens of three otic cleansers: PHMB‐EDTA (poly [hexamethylene] biguanide hydrochloride and disodium edetate), N‐acetylcysteine (NAC) and Triz‐EDTA.

Animals/Isolates

Thirty isolates of each species, including Staphylococcus pseudintermedius, Pseudomonas aeruginosa, Streptococcus canis, Proteus mirabilis, Escherichia coli, and Malassezia pachydermatis, were collected from COE cases and stored at −80°C until tested.

Methods and Materials

Biofilm production was determined by Congo‐red agar and microtitre plate‐assay methods. Ten of the best biofilm‐producing isolates per species were selected to determine minimum biofilm eradication concentration (MBEC) values. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values were determined to compare MBEC/MIC and MBEC/MBC.

Results

PHMB‐EDTA possessed antibiofilm activity at low concentrations (MBEC range 3.9/2.3–500/300 μg/mL) against all tested COE pathogens. NAC demonstrated antibiofilm activity for all tested bacterial COE pathogens (MBEC range 4,925–19,700 μg/mL); however, most M. pachydermatis isolates exhibited MBEC values >20,000 μg/mL. Triz/EDTA at the highest concentration tested (3,025/19,520 μg/mL) did not demonstrate antibiofilm activity against most COE pathogens except for S. canis (94.5/610 μg/mL).

Conclusions and Clinical Relevance

PHMB‐EDTA had intrinsic antibiofilm activity at low concentrations against all COE pathogens. Therefore, it is likely to be a very effective adjuvant when used in conjunction with other antimicrobials for the treatment of COE caused by biofilm‐producing pathogens.
Kindergarten Students’ Receptiveness to Messages Conveyed by Counter-Stereotyping Picturebooks
Authors: Kalaitzi Christina
Published: February 2025

The study explores kindergarten students’ receptiveness to messages conveyed by counter-stereotyping picturebooks and the effect of a curriculum integrating counter-stereotyping picturebooks to children’s approach of gender-associated stereotypes. A curriculum programme using specific themed picturebooks as a medium is implemented, focusing on gender-associated colours, toys, clothes, sports, occupations, and physical characteristics. To test the extent to which picturebooks’ messages influence kindergarten students’ gender associations, both the Experimental and the Control Group completed a semi-structured questionnaire before (baseline) and after the programme (Time 2). Results demonstrate significant changes in children’s gender associations after the programme. Data indicate notable shifts in perceptions regarding gender-associated toys, appearance features and occupational roles. Discussion of findings asserts that picturebooks’ counter-stereotypic messages influence kindergarten students in order to expand their gender associations and adopt counter-stereotypical gender perceptions. Hence, the need for integrating counter-stereotyping picturebooks into the preschool curriculum for approaching gender associations is highlighted.
Media Consumption of Youth in the Border Regions of Kazakhstan and Its Impact on National Identity
Authors: Petrov Bogdan , Yesdauletov Aitmukhanbet , Abiltayeva Ainur , Ibrayeva Daiana
Published: February 2025

National identity of youth is an important part of social identity in general and is formed at the intersection of personal and public factors. The nature and structure of youth media consumption in the border regions differs from the situation in the central and remote regions of the countries. In such regions, the content of local media can be directly or indirectly linked to neighboring states, which contributes to the emergence of cultural and information transformations. This is especially acute in the context of geopolitical and cultural changes, such as armed conflicts, migration flows and other global processes.Based on the analysis of scientific literature, this article examines the goals, strategies and methods of foreign propaganda using the example of Russian case. Through a survey of 565 young individuals from the North Kazakhstan, Kostanay, and Pavlodar regions, this research examines how does media consumption in border regions affect youth perception of their national identity and political views. The survey results indicate that a significant portion of respondents engage with Russian media and social networks, with 27% trusting foreign news sources. The study also highlights a potential crisis of identity, as reflected in the respondents' ambiguous political views on sensitive issues.
Cohomological boundedness for flat bundles on surfaces and applications
Authors: Hu Haoyu , Teyssier Jean-Baptiste
Published: February 2025

This paper explores the cohomological consequences of the existence of moduli spaces for flat bundles with bounded rank and irregularity at infinity and gives unconditional proofs. Namely, we prove the existence of a universal bound for the dimension of de Rham cohomology of flat bundles with bounded rank and irregularity on surfaces. In any dimension, we prove a Lefschetz recognition principle stating the existence of hyperplane sections distinguishing flat bundles with bounded rank and irregularity after restriction. We obtain in any dimension a universal bound for the degrees of the turning loci of flat bundles with bounded rank and irregularity. Along the way, we introduce a new operation on the group of

$b$

-divisors on a smooth surface (the partial discrepancy) and prove a closed formula for the characteristic cycles of flat bundles on surfaces in terms of the partial discrepancy of the irregularity

$b$

-divisor attached to any flat bundle by Kedlaya.
Strategies to support the mental health and well-being of migrant LGBTQIA+ college and university students: a scoping review protocol
Authors: Haghiri-Vijeh Roya , Huel Christine , Maimets Ilo-Katryn , Montague Janet , Clark Nancy , Lou Nigel Mantou , Lee Edward Ou Jin
Published: February 2025

Objective:

This review will identify and explore strategies employed by health care professionals, higher education institutions, and organizations to support the mental health and well-being of migrant lesbian, gay, bisexual, transgender, queer, intersex, asexual, and more (LGBTQIA +) college and university students.

Introduction:

Migrant LGBTQIA + students face substantial challenges to their identity formation and social development while studying in their newly settled countries. Little is known about how colleges and universities support LGBTQIA + students’ mental health and well-being from the perspectives of migration status, stigma, and discrimination. Understanding what is known about strategies to support migrant LGBTQIA + students can inform future policy directions for promoting LGBTQIA + mental health and well-being in the context of higher education.

Inclusion criteria:

This review will incorporate literature from all geographical contexts that focuses on strategies to support the mental health and well-being of migrant LGBTQIA + college and university students. Literature not related to LGBTQIA + migrant students will be excluded.

Methods:

The JBI methodological framework for scoping reviews will be used in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guidelines. Several databases and sources of gray literature will be searched from 2004 to 2024. The review will include literature published in any language and will be independently screened by 2 reviewers. A modified JBI data extraction tool will be used and data will be presented as diagrams along with narrative summaries to answer the review questions.

Review registration:

Open Science Framework osf.io/bj2hu
Effectiveness, acceptability, and cost-effectiveness of digital health interventions for diabetes self-management in adults with or without hypertension: an umbrella review protocol
Authors: Zhang Min , Ge Jiahui , Yu Xinrong , Wang Tian , Wang Fenglan , Kuchawo Madalo Gloria Kalero , Ge Li
Published: February 2025

Objective:

This review will synthesize evidence on the effectiveness, acceptability, and cost-effectiveness of digital health interventions in implementing and maintaining effective self-management among adults (≥ 18 years) with diabetes, with or without comorbid hypertension.

Introduction:

Diabetes and hypertension are becoming the most challenging global health burdens. Growing evidence underscores the effectiveness of digital health interventions for diabetes and hypertension. However, it is unclear whether these strategies can be recommended to improve diabetes self-management among adults with or without hypertension in primary health care.

Inclusion criteria:

We will include systematic reviews (with or without meta-analysis) examining the effectiveness, acceptability, and cost-effectiveness of digital health interventions in improving self-management behaviors among adults living with diabetes, with or without hypertension, in primary health care. There will be no gender, ethnicity, language, or geographic limitations.

Methods:

The review will follow the JBI methodology for umbrella reviews. MEDLINE (EBSCOhost), CINAHL (EBSCOhost), Embase, Epistemonikos, PsycINFO (EBSCOhost), Web of Science, Scopus, Cochrane Library, Campbell Systematic Reviews, and JBI EBP Database (Ovid) will be searched from the inception to the present to identify systematic reviews. Gray literature sources, including OpenGrey, ProQuest Dissertations and Theses, and Google Scholar, will be searched, followed by a manual search of reference lists of included articles. Two independent reviewers will perform screening, critical appraisal, and data extraction. The review results will be presented through various approaches, including a narrative synthesis, graphical representation, and tabular summary. The JBI critical appraisal checklist for systematic reviews and research syntheses will be applied. Certainty of evidence will be assessed following the GRADE approach.

Systematic review registration number:

PROSPERO CRD42023471615
Dwelling with limits: the work of love in participatory research
Authors: Aiava Raine , Pyyry Noora
Published: February 2025

In this article, we examine some of the theoretical and methodological challenges facing Participatory Action Research (PAR), including the continued challenge of the silence of the subaltern, the re-subjugating power relations in many traditional epistemologies of research production, and the problems of representation. We attempt to address these considerations by looking beyond the relational, outlining the originary call to ethics at the heart of PAR in terms of a commitment to a sustained engagement with that which outstrips relationality, namely the radical alterity of the other. Proposing a rigorous articulation of the concept of translation as a means of meaningfully and ethically thinking with the subaltern, disenfranchised, and at-risk — including young people — in PAR, we unpack Spivak’s articulation of a hesitant love in translation that is marked by a surrendering to the call of the other, and to the work of putting oneself into a position not to ‘speak for’ but to ‘hear from’ the unknowable, and un-preemptable other. Understanding love as a doing that affects, we outline the need to consider ‘action’ in PAR in terms of practice beyond happenings, representations, and method, to acknowledge the movements and shifts in the research encounter that refuse representational knowing. We add to this by outlining the researcher’s ontological indebtedness to this alterity by re-considering our notion of translation in terms of Heidegger’s trans-position, highlighting the ‘rhizovocality’ of the research encounter as fundamentally beyond any notion of authentic voice or settled subjectivities. In highlighting the ontological dependency inherent in the research encounter, we revisit the commitment of PAR as a work of being vulnerable — of putting ourselves into play by dwelling with the foreignness of the other, and in doing so, trans-posing ourselves unto new understanding.
Designing Multimedia Learning Materials in Rural Settings Located in the Colombian Coffee Region
Authors: Quintero Corzo Josefina , Posada Silva Wadis Yovany , Munévar Quintero Fabio Ignacio
Published: February 2025

This article addresses results from a research work following the principles and methods of the qualitative-evaluative approach that intended to design, develop, and validate a series of multimedia learning materials applied to different curriculum disciplines. The study was carried out in rural schools located in an underdeveloped Colombian Coffee Region from 2018 to 2020. Guidelines, class observations, surveys, interviews, and expert assessment were the most useful instruments and sources of data. The results indicate that given the novelty, attractiveness, and curiosity towards the use of multimedia components, rural schoolchildren acquired different levels of active learning competencies. Bearing in mind that digital divide may intensify the existing rural-urban gap, it is crucial to embrace innovative solutions to persistent problems in declining equity and quality taking into account the rural students’ contexts. It is a curricular innovation providing teachers the possibility to conduct interactive, dynamic, playful, and creative classes according to the rural reality.
Friction consumption and leakage performance of step piston in a novel synchronous lubrication radial piston pump
Authors: Yongkang Li , Shang Xiao
Published: February 2025

To alleviate the wear caused by insufficient lubrication of the slipper and piston pair due to the expansion of the piston pump speed range, a novel synchronous lubrication structure with step piston was proposed, which can generate high-pressure oil to lubricate the friction pair while discharging the working medium synchronously. However, the step structure inevitably influences the film's characteristics and has unclear effects on friction and leakage performance. Therefore, the lubrication and deformation model of the step piston, verified by comparison with classical literature, is established by combining the finite difference method and finite element method. The influence of load pressure, shaft speed, and step parameters on its tribological characteristics was further analyzed. The results show that the local step bearing effect is produced near the piston step, but at the expense of the decreased upstream fluid pressure. The matching length reduction caused by the step piston does not aggravate the piston eccentricity, but alleviates the eccentricity and leakage; The friction consumption and leakage are positively correlated with the load pressure and shaft speed, the step bearing effect and the piston anti-capsizing ability can be significantly improved with a smaller step height, which is also conducive to reducing leakage but increasing the friction consumption. There is an optimal step height to increase the pump efficiency.
Impact of indoor soundscape workshop on sound awareness of interior architecture students
Authors: Al-Bayyar Zinah , Dökmeci Yörükoğlu Papatya Nur , Kitapci Kivanc , Türker Bayrak Özlem
Published: February 2025

This study aims to investigate the effects of attending a soundscape workshop on the awareness of sound as a design element for interior architects. The workshop is structured in three phases: theoretical lectures, practical applications, and discussions. In the first phase, fundamentals of architectural acoustics, the sense of place, and soundscape theory were delivered through theoretical lectures. In the second phase, participants were asked to design a sound environment for a restaurant and an office. In the third and final phase, participants discussed their sound designs from the perspectives of the lectures and sound-related topics. Additionally, participants completed an open-ended questionnaire to evaluate their workshop experience and provided suggestions for improvement. The effectiveness of the workshop in raising awareness was tested using a pre-test/post-test analysis method, with data collected through structured questionnaires completed by participants before and after the workshop. The results of the statistical analysis show that attending the workshop changed participants' evaluations of sound expectations and preferences, as well as their sensitivity to sound. The findings indicate that participating in an indoor soundscape workshop can positively influence interior architects' understanding of sound as a design element to be considered in their future work.
An experimental study on subharmonic-aided pressure estimation with commercial scanners
Authors: Dong Yi-fan , Zhang Li , Chen Yao , Jiang Wei , Tian Ji-feng , Chen Dan , Wang Ya-hong , Wang Ying , Wang Xin , Ge Zhi-tong , Yang Xiao , Han Xiao-dong , Li Jian-chu
Published: February 2025

This study evaluates the performance of subharmonic-aided pressure estimation (SHAPE) with ultrasound contrast agents using data obtained from calibration procedures. A commercial scanner of ultrasonography (GE Healthcare Logiq E20, Wuxi, China) was used to perform SHAPE on a flowing contrast agent (Sonazoid) in a phantom setup under controlled microbubble stability and flow velocity conditions. Subharmonic time-intensity curves were collected during the SHAPE calibration procedure for analysis. Subharmonic amplitude of diluted contrast agents exhibited a time-dependent decline but was not affected by velocity. SHAPE sensitivity was measured through reciprocal pressurizing and depressurizing sequences to mitigate the effect of subharmonic decline over time. A wide range of mechanical index (MI) levels within the steady growth phase of the calibration curve showed higher SHAPE sensitivity compared to the traditionally recommended “optimal” MI at the maximum slope. The approximate maximum SHAPE sensitivity was −0.04 dB/mm Hg. Subharmonic amplitude was linearly correlated with pressure at a range of MI levels (R2 > 0.9, p < 0.05) but showed significant variations (approximately 2 dB standard deviation) in the time series. The lowered sensitivity compared to previous reports, combined with the substantial variation in subharmonic amplitude, raises concerns about the accuracy and consistency of SHAPE in clinical applications.
Bubble curtains for noise mitigation: One vs two
Authors: Beelen Simon , Nijhof Marten , de Jong Christ , van Wijngaarden Leen , Krug Dominik
Published: February 2025

Bubble curtains are widely used to protect marine life from exposure to harmful noise during offshore pile driving. However, operating a bubble curtain is costly and compliance with government noise regulations remains a challenge. It is therefore important to optimise the acoustic effect of the available compressed air. An interesting approach to achieving this is to split the air flow rate into two separate bubble curtains, rather than one single bubble curtain. This concept is tested both experimentally and numerically in this paper. The experiments and the model show the expected increase in performance of the supplied compressed air when it is split between two manifolds. An increased insertion loss of up to 11 dB is measured. This increase in performance is possibly due to the fact that the reflective properties of the bubble curtains are maintained even when the air flow rate is halved. In effect, by splitting the air flow between two manifolds, a second acoustic barrier is added. Additionally, the variations in the bubble curtain performance between individual measurements are shown to be largely caused by temporal variations in the air distribution within the curtain. The applicability of equivalent fluid models for bubble curtains is discussed, and it is shown that accounting for a gap in the bubble curtain, close to the manifold where the bubble curtain is not yet fully developed, results in better agreement between the modelled and the measured values of the insertion loss.
Linear nonreciprocal dynamics of coupled modulated systems
Authors: Wu Jiuda , Yousefzadeh Behrooz
Published: February 2025

Waveguides subject to spatiotemporal modulations are known to exhibit nonreciprocal vibration transmission, whereby interchanging the locations of the source and receiver changes the end-to-end transmission characteristics. The scenario of typical interest is unidirectional transmission in long, weakly modulated systems: when transmission is possible in one direction only. Here, with a view toward expanding their potential application as devices, we explore the vibration characteristics of spatiotemporally modulated systems that are short and strongly modulated. Focusing on two coupled systems, we develop a methodology to investigate the nonreciprocal vibration characteristics of both weakly and strongly modulated systems. In particular, we highlight the contribution of phase to nonreciprocity, a feature that is often overlooked. We show that the difference between the transmitted phases is the main contributor to breaking reciprocity in short systems. We clarify the roles of primary and sideband resonances, and their overlaps, in breaking reciprocity. We discuss the influence of modulation amplitude and wavenumber on the resonances of the modulated system. We hope this work brings more attention to the dynamics of strongly modulated systems.
Cell wall glycosyltransferase of
Streptococcus mutans
impacts its dissemination to murine organs
Authors: Hashizume-Takizawa Tomomi , Ando Taiki , Urakawa Ayaka , Aoki Kazuhiro , Senpuku Hedenobu
Published: February 2025

Streptococcus mutans
, a cariogenic bacterium in humans, is associated with systemic disorders. Its cariogenic factors include glucosyltransferases (GTFs) and the glycosyltransferase rhamnose–glucose polysaccharide I (RgpI), which is involved in cell wall synthesis. However, the potential roles of these enzymes in systemic disorders remain unclear. We constructed a luciferase-tagged
S. mutans
UA159 mutant strain that lacked
rgpI
to explore the involvement of this enzyme in the systemic pathogenicity of
S. mutans
. We also employed the luciferase-tagged
S. mutans
UA159 variant, which exhibited reduced GTF production and therefore had a low glucan synthesis ability. We intravenously inoculated these luciferase-tagged mutants and parent strains into 12-week-old male BALB/c mice to evaluate their distribution to organs. Strong luminescence was noted in the spleen and kidneys, indicating that
S. mutans
was disseminated to these organs. Several organs collected from mice inoculated with the luciferase-tagged parent strain emitted a signal, and inflammatory cytokine production was detected in the blood. The luminescence intensity was lower in the kidneys of mice challenged with the mutant strain, which has a low glucan synthesis ability. Conversely, challenge with the
rgpI
deletion mutant strain resulted in the lowest number of luminescent organs, with a lower intensity and attenuated inflammation. Furthermore, all the mice inoculated with the
rgpI
deletion mutant strain survived, whereas not all the mice inoculated with the parent strain survived. Collectively, these results suggest that RgpI is involved in the systemic pathogenicity of
S. mutans
UA159.
Genome sequence of bacteriophage PensacolaC28 isolated using
Microbacterium sp
. Casco Bay
Authors: Girard Lucas R. , Cousins Samuel R. , Heald Alexis C. , Tanzey Doxel A. , Omo Elizabeth M. , Flannigan Connor R. , Chung Hui-Min , Tarbox Brian P. , Savage Emily F.
Published: February 2025

Bacteriophage PensacolaC28 is a lytic phage isolated on
Microbacterium sp
. Casco Bay (NCMA B81), a marine bacterium originally cultured in South Portland, Maine, USA. PensacolaC28 was isolated from an environmental sample collected in Pensacola, Florida, USA. It is a singleton siphovirus with a 16,749 bp genome and contains 24 protein coding genes.
Toxidromes and a general approach to poisoning
Authors: Hoffman Robert J , Nillas Andrea
Published: February 2025

A toxicologic syndrome, or toxidrome, is a distinct pattern of effects of poisoning. Well-defined toxidromes are the opioid, anticholinergic, cholinergic and sympathomimetic, and an additional described toxidrome is GABAergic. These toxidromes are named for the receptor effects causing their specific clinical findings, and knowledge of toxidromes allows rapid pattern recognition of specific poisonings. In this review, toxidromes and the initial assessment and general approach to management of acute poisoning are discussed. This article details the receptor-level effects of the poisoning, key clinical signs and symptoms and the role antidotes play in treatment. Clinical resources such as Toxbase and others exist to provide detailed guidance on clinical management of poisoning.
Acute hypophysitis with pachymeningitis
Authors: Sahu Mayank , Chakraborty Debabrata , Chatterjee Suddhasatwya , Das Abhijit
Published: February 2025

Often the workup to find the causes of common symptoms can lead to unexpected findings, thereby emphasising the need to keep a broad suspicion and continued search for emerging evidence. In this report, we describe the case of an elderly woman in her late 60s without any comorbidities, who presented with new-onset neck stiffness, progressive headache and continuous fever with no other clue that could lead us to a telltale diagnosis, and in whom the diagnostic staircase ultimately led to the diagnosis of IgG4 hypophysitis and pachymeningitis. Only a prompt clinical suspicion and appropriately timed workup can help in revealing such intricate and uncommon diagnosis among the maze of more common differentials having similar manifestations. Especially in such uncommon scenarios, common aetiologies such as tuberculosis should always be kept in the horizon.
Neutrophilic leucocytosis as a presenting sign of primary gastric Hodgkin’s lymphoma
Authors: Shreim Mohammad , Salhab Ahmad , Abu Sabha Mosa , Karama Akram
Published: February 2025

A male patient in his 60s was admitted due to unexplained neutrophilic leucocytosis. Further diagnostic workup revealed a large gastric polyp with partial pyloric obstruction. Biopsy revealed numerous neutrophils surrounding atypical cells resembling Reed-Sternberg cells. The diagnosis of gastric Hodgkin’s lymphoma was confirmed through immunohistochemistry. According to his disease stage and high cardiac risk, he was started on the GVP (gemcitabine, vinorelbine and prednisone) protocol. Following a partial response, he experienced disease progression and relapse with hepatic involvement, indicating relapsed and refractory disease. Therefore, he was started on nivolumab, which was the most suitable option, given his specific tumour microenvironment. In the light of this, we recommend a deeper understanding of the tumour microenvironment for each patient to guide effective treatment strategies. This is especially important in the era of advanced immunotherapies, such as programmed death-1 and programmed death-ligand 1 inhibitors and chimeric antigen receptor T-cell therapy.
Glycogen storage disease type V: delayed diagnosis of a cause of exercise intolerance in a patient with hereditary haemorrhagic telangiectasia
Authors: Krekora Urszula , Mathavan Akash , Mathavan Akshay , Ataya Ali
Published: February 2025

Hereditary haemorrhagic telangiectasia (HHT) is a genetic disorder characterised by epistaxis, mucocutaneous telangiectasias and arteriovenous malformations. Iron deficiency due to chronic bleeding events is a common manifestation that produces a range of nonspecific symptoms. We report on a patient with HHT with longstanding fatigue and exercise intolerance, which was persistently attributed to iron deficiency, who was revealed to have glycogen storage disease type V, an autosomal recessive metabolic myopathy caused by deficiency of myophosphorylase due toPYGMvariants. Genetic testing revealed a pathogenic common exon mutation of one allele and a pathogenic intronic mutation of the other, possibly suggestive of a milder phenotype. We not only detail the first case of concurrent HHT and glycogen storage disease in the literature but more importantly emphasise the need for clinician awareness of the disorders to avoid perpetuating a biased clinical impression and delay in diagnosis as well as prevent potentially harmful interventions.
Use of cyclosporine A 0.05% ophthalmic emulsion for a distinctive intrapalpebral phenotype of anterior scleritis
Authors: Grullon Jason Rafael , Mueller Christian , Iacob Codrin E , Swan Robert
Published: February 2025

Chronic scleritis poses a diagnostic and therapeutic challenge with multiple mimickers, underlying autoimmune conditions, diverse presentations and variable course. Treatment for mild forms includes topical corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs). For long-term control in patients with inadequate responses to steroids and NSAIDs, immunomodulators are employed. While oral cyclosporine has been used for inflammatory ocular conditions, research on topical cyclosporine for scleritis is limited. We present two cases: a man in his early 60s and a women in her late 20s, both with chronic, bilateral, intrapalpebral nodular scleritis with the clinical appearance of an inflamed pinguecula. After an initial poor response to conventional treatments, both patients responded positively to cyclosporine 0.05% ophthalmic emulsion as long-term monotherapy, likely due to cyclosporine’s inhibitory effects. These outcomes suggest topical cyclosporine as an effective additive therapy to steroids to maintain quiescence for this particular subset of nodular scleritis, especially when traditional therapies are inadequate.
Quantifying the relative intensity of free-living physical activity: differences across age, association with mortality and clinical interpretation—an observational study
Authors: Rowlands Alex V , Orme Mark W , Maylor Benjamin D , Kingsnorth Andrew P , Henson Joe , Goldney Jonathan , Davies Melanie , Razieh Cameron , Khunti Kamlesh , Zaccardi Francesco , Yates Thomas
Published: February 2025

Objectives

To describe age-related differences in the absolute and relative intensity of physical activity (PA) and associations with mortality.

Methods

UK Biobank participants with accelerometer-assessed PA (mg) and fitness data (N=11 463; age: 43–76 years) were included. The intensity distribution of PA was expressed in absolute and relative terms. The outcome was mortality.

Results

PA volume (average acceleration) and absolute intensity were lower with increasing age (~−0.03 to −0.04 SD of mean value across all ages per year; p<0.001) but differences in relative intensity by age were markedly smaller in women (−0.003 SD; p<0.184) and men (−0.012 SD; p<0.001). Absolute intensity was higher in men, but relative intensity higher in women (p<0.001). Over a median (IQR) follow-up of 8.1 (7.5–8.6) years, 121 (2.4 per 1000-person-years) deaths occurred in women and 203 (5.0 per 1000-person-years) in men. Lower risk of mortality was observed for increasing absolute or relative intensity in women, but for absolute intensity only in men. In men, the lowest risk (HR 0.62, 95% CI 0.43, 0.91) was observed in those with high absolute intensity (80th centile), but low relative intensity (20th centile). Conversely, in women, the lowest risk was associated with high levels (80th centile) of both absolute and relative intensity (HR 0.59, 95% CI 0.41, 0.86).

Conclusion

Absolute PA intensity dropped with age, while relative intensity was fairly stable. Associations between PA intensity and mortality suggest that prescribing intensity in absolute terms appears appropriate for men, while either absolute or relative terms may be appropriate for women.
Differentiated community-based point-of-care early infant diagnosis to improve HIV diagnosis and ART initiation among infants and young children in Zambia: a quasi-experimental cohort study
Authors: Manasyan Albert , Tembo Tannia , Dale Helen , Pry Jake M , Itoh Megumi , Williamson Dhelia , Kapesa Herbert , Derado Josip , Beard Rachel Suzanne , Iyer Shilpa , Gass Salome , Mwila Annie , Herce Michael E
Published: February 2025

Introduction

An estimated 800 000 children (<15 years) globally living with HIV remain undiagnosed. To reach these children with timely HIV testing services during infancy, we implemented a community-based differentiated care model using mobile point-of-care (POC) technology for early infant diagnosis (EID) of HIV, and assessed its effects on EID positivity, antiretroviral therapy (ART) initiation and 3-month retention in care.

Methods

Between 1 June 2019 and 31 May 2020 at six health facilities in Lusaka, Zambia, we enrolled mother-infant pairs (MIPs) at high risk for vertical transmission of HIV based on missing or late infant EID testing or other maternal risk factors. We offered these MIPs community POC EID testing (post-intervention), and compared their outcomes to historical high-risk controls at the same sites (1 June 2017–31 May 2018; pre-intervention). We used propensity score matched weighting and mixed effects regression modelling to estimate outcome differences pre-intervention and post-intervention, and to identify MIP characteristics predictive of vertical transmission of HIV.

Results

2577 MIPs were included in the analysis: 1763 and 814 high-risk MIPs from the pre-intervention and post-intervention periods, respectively. Infant HIV positivity was significantly higher in the post-intervention (2.2%) vs pre-intervention (1.1%) period (p=0.038), however this difference was attenuated (0.83%, 95% CI: −0.50%, 2.15%) after adjusting for differences in maternal age, maternal antenatal care visits, infant birth month and facility. During the post-intervention period, MIPs where the mother disengaged from care were 12.97 (95% CI: 2.41, 69.98) times as likely to have an infant diagnosed with HIV vs those in which the infant received late EID testing without maternal care disengagement. Among 18 infants diagnosed with HIV by the intervention, 16 (88.9%) initiated same-day ART and all continued ART at 3-month follow-up.

Conclusion

Community-based differentiated care employing POC EID technology increased testing positivity in unadjusted analyses, and resulted in high ART initiation and early care retention, suggesting it may be a promising approach for reaching infants and young children living with HIV being missed by current facility-based approaches.

Trial registration number

This trial is registered under the following Clinicaltrials.gov Identifier:NCT03133728
Development and evaluation of a national administrative code-based system for estimation of hospital-acquired venous thromboembolism in Ireland
Authors: Kirke Ciara , Daly Richard , Dalchan Therese , Curley Jacqui , Buckley Ruth , Lynch Deirdre , Crowley Maeve P , Kevane Barry , Gallagher Emer , O’Neill Ann Marie , Ní Áinle Fionnuala
Published: February 2025

Background

Hospital-acquired venous thromboembolism (HA-VTE) is a significant patient safety concern contributing to preventable deaths. Internationally, estimating HA-VTE relies on administrative codes, in particular the International Classification of Disease (ICD) codes, but their accuracy has been debated. The Irish Health Service Executive (HSE) launched a National Key Performance Indicator (KPI) in 2019 for monitoring HA-VTE rates using the Australian Modification of ICD-10 (ICD-10-AM) codes.

Objectives

This study aims to (1) describe the development of the national HSE KPI and determine the national HA-VTE occurrence rate per 1000 discharges in 2022; (2) assess the contribution of each VTE ICD-10-AM code to the national HA-VTE figure; (3) estimate the positive predictive value (PPV) of the HSE KPI against true HA-VTE, in a single large tertiary (Irish Model 4) hospital.

Methods

A retrospective observational study used national data from Irish publicly funded acute hospitals, focusing on discharges from 2022. The HSE KPI was based on an assessment of HA-VTE as a rate per 1000 hospital discharges (as per the national metadata). Inclusion criteria were inpatient only, length of stay ≥2 days, age ≥16 years and non-maternity admission type (elective or emergency only). Maternity and paediatric hospitals were excluded.

The PPV was determined through a detailed review of HA-VTE cases identified through the HSE KPI from April 2020 to October 2022 in a single large tertiary referral centre and determining the proportion indicating a true HA-VTE. Data analysis employed GraphPad Prism (Horsham, PA, USA).

Results

The national mean monthly HA-VTE rate was 11.38 per 1000 discharges in 2022. Pulmonary embolism (PE) without acute cor pulmonale (I26.9) was the most frequent contributor (59%). The mean PPV in the tertiary hospital was 0.37, with false positives attributed to acute illnesses, historical VTE coding errors and dual VTE diagnoses at admission.

Discussion

HA-VTE is a preventable cause of morbidity and mortality, necessitating accurate measurement. Administrative codes, while cost-effective and timely, reveal limitations in precision. This study identifies opportunities to improve code accuracy, address coding challenges and enhance the PPV.

Conclusion

This study provides valuable insights into estimated HA-VTE rates, the contribution of each individual ICD-10-AM code to the overall HA-VTE rate and the PPV of the measure. Ongoing refinement and quality enhancement are needed.
Effectiveness of pain neuroscience education, motivational interviewing and cognition targeted exercise therapy in patients with chronic neck pain: protocol for a multicentre randomised controlled trial (the COGMO-AP study)
Authors: Morales Tejera David , Nijs Jo , Malfliet Anneleen , Prieto Aldana María Adoración , Gallardo Vidal María Isabel , Polentinos Castro Elena , Linares Fernández María Teresa , Fernández-Carnero J
Published: February 2025

Introduction

In primary care, the prevalence of neck pain has increased substantially. Evidence regarding treatment of chronic neck pain (CNP) is scarce, and its effectiveness is not entirely proven in different stages of chronicity, nor for different types of cervical disorders. The goal of this study is to evaluate the effectiveness of a complex intervention (COGMO intervention) compared with usual practice in primary care physiotherapy to improve neck pain intensity, severity and disability in patients with CNP.

Methods and analysis

Design: a pragmatic cluster-randomised clinical trial design with a 12-month follow-up. Setting: primary care. Participants: physiotherapists as randomisation unit, and patients as analysis unit. Inclusion criteria: individuals aged 18 to 65 years suffering from moderate to severe CNP. Sample size expected: 142 patients. Recruitment: patients referred from primary care physicians to physiotherapy. Intervention: pain neuroscience education (PNE), motivational interviewing (MI) and cognition targeted exercise therapy (CTE) compared with the standard treatment in primary care. Outcomes: the main variable is reduction in pain intensity; secondary variables include pain severity, conditioned pain modulation, temporal summation, neck disability, fear/avoidance behaviour, kinesiophobia, catastrophising, therapeutic alliance and quality of life. Sociodemographic information and adherence to the intervention will be recorded. Data collection: baseline, and follow-up at 3, 6 and 12 months. Analysis: it will follow intention-to-treat principles, and difference in percentage of subjects achieving success on the primary endpoint at 12 months. A model with multilevel analysis will be adjusted through logistic regression (being the dependent variable pain intensity, and the independent, the intervention).

Ethics and dissemination

Ethical approval has been awarded by the Regional Ethics Committee of Madrid (code: COGMO-AP) and the primary health care central commission of research (code: 20210011). The results of the study will be disseminated through international peer-reviewed journals, international conferences, press and social media.

Trial registration number

NCT05785455.