bluuebunny/crossref_metadata_2025 huggingface dataset:
Placement, management and complications associated with peripheral intravenous catheter use in UK small animal practice
Authors: Haskey E. , Maund V. , Allerton F. , Browse B. , Heard C. , O'Donnell C. , Davison K. , Hertel C. , Booth E. , Lawrence S. , Dever E. , Bowe L. , Taylor H. , Hall K. , Trimble K. , Junior M. , Fennell C. , Stevenson N. , Sterritt A. , Penn E. , Nowell L. , Collins A. , Jones E. , Scudder C.
Published: September 2024

Objectives

To describe the techniques for preparation and placement of peripheral intravenous catheters (PIVCs), to describe the complications associated with PIVCs, and to identify factors associated with PIVC complications in small animal practice in the United Kingdom.

Materials and Methods

A prospective multicentre observational study was undertaken between January 2022 and January 2023. Data collected included patient information, information regarding the placement and maintenance of PIVCs, and PIVC complications, from privately owned cats and dogs presenting to veterinary institutes in the United Kingdom. Patients required a PIVC to be placed as part of their care and the PIVC was anticipated to be in situ for >24 hours to be eligible for PIVC complication analysis.

Results

A total of 19 institutes recorded data regarding 382 PIVCs, with 325 (85.1%) placed in dogs and 57 (14.9%) in cats. The most common reasons for placement were to administer intravenous fluid therapy (74.3%) and intravenous medications (71.7%). There were 102 of 382 (26.7%) PIVCs associated with a complication, with limb swelling/suspected phlebitis in 44 of 382 (11.5%) and PIVC dislodgement/patient interference in 30 of 382 (7.9%) PIVCs. Factors associated with increased risk of complication were more than 1 attempt to place the PIVC, a second or subsequent PIVC being placed during hospitalisation, flush frequency different than every 1 to 24 hours, and flush solution with compound sodium lactate.

Clinical Significance

Veterinary professionals must be vigilant when monitoring a patient with a PIVC in situ, particularly if a PIVC is associated with one of the aforementioned factors of increased likelihood of complication.
Successful clinical management of canine intestinal lipogranulomatous lymphangitis through exclusive medical and nutritional treatment: four cases (2018‐2023)
Authors: Crisonà M. , Tardo A. M. , Pietra M. , Del Magno S. , Linta N. , Diana A. , Muscatello L. V. , Peccolo G. , Del Baldo F.
Published: September 2024

Objectives

To describe clinical, ultrasonographic, pathological features and response to medical therapy of four dogs with intestinal lipogranulomatous lymphangitis.

Methods

Retrospective review of medical records of dogs with an ultrasonographic evidence of focal or multifocal intestinal wall thickening and a histological diagnosis of lipogranulomatous lymphangitis. Only dogs that did not undergo surgical resection of the lesions were included. The clinical response to medical treatment, consisting of low‐fat or hydrolysed diet along with immunosuppressive agents was assessed; clinicopathological and ultrasonographic abnormalities were re‐evaluated over time, with a median follow‐up period of 16.5 months.

Results

Four dogs met the inclusion criteria. The main historical complaints were diarrhoea (three of four dogs), vomiting (three of four dogs) and abdominal pain (two of four dogs). Clinicopathological abnormalities comprised hypoproteinaemia, hypoalbuminaemia and mild/moderate increase in C‐reactive protein levels (three of four dogs). Abdominal ultrasound revealed focal (two of four dogs) or multifocal (two of four dogs) intestinal wall thickening involving distal jejunum, ileum and ileocolic junction. Histopathology of full thickness intestinal biopsies revealed granulomatous enteritis and lymphangitis with lymphangiectasia. Nutritional and medical treatment allowed complete clinical remission in all four dogs within a month of therapy. Improvement of ultrasound abnormalities was noted in three of the four dogs over a 3‐ to 12‐month period.

Clinical Significance

Intestinal lipogranulomatous lymphangitis is a rare form of canine chronic enteropathy characterised by focal or multifocal intestinal lesions due to the presence of transmural intestinal lipogranulomas. This is the first case series describing successful management of intestinal lipogranulomatous lymphangitis through medical treatment alone.
Multi‐omics Analysis to Identify Key Immune Genes for Osteoporosis based on Machine Learning and Single‐cell Analysis
Authors: Zhang Baoxin , Pei Zhiwei , Tian Aixian , He Wanxiong , Sun Chao , Hao Ting , Ariben Jirigala , Li Siqin , Wu Lina , Yang Xiaolong , Zhao Zhenqun , Wu Lina , Meng Chenyang , Xue Fei , Wang Xing , Ma Xinlong , Zheng Feng
Published: September 2024

Objective

Osteoporosis is a severe bone disease with a complex pathogenesis involving various immune processes. With the in‐depth understanding of bone immune mechanisms, discovering new therapeutic targets is crucial for the prevention and treatment of osteoporosis. This study aims to explore novel bone immune markers related to osteoporosis based on single‐cell and transcriptome data, utilizing bioinformatics and machine learning methods, in order to provide novel strategies for the diagnosis and treatment of the disease.

Methods

Single cell and transcriptome data sets were acquired from Gene Expression Omnibus (GEO). The data was then subjected to cell communication analysis, pseudotime analysis, and high dimensional WGCNA (hdWGCNA) analysis to identify key immune cell subpopulations and module genes. Subsequently, ConsensusClusterPlus analysis was performed on the key module genes to identify different diseased subgroups in the osteoporosis (OP) training set samples. The immune characteristics between subgroups were evaluated using Cibersort, EPIC, and MCP counter algorithms. OP's hub genes were screened using 10 machine learning algorithms and 113 algorithm combinations. The relationship between hub genes and immunity and pathways was established by evaluating the immune and pathway scores of the training set samples through the ESTIMATE, MCP‐counter, and ssGSEA algorithms. Real‐time fluorescence quantitative PCR (RT‐qPCR) testing was conducted on serum samples collected from osteoporosis patients and healthy adults.

Results

In OP samples, the proportions of bone marrow‐derived mesenchymal stem cells (BM‐MSCs) and neutrophils increased significantly by 6.73% (from 24.01% to 30.74%) and 6.36% (from 26.82% to 33.18%), respectively. We found 16 intersection genes and four hub genes (DND1, HIRA, SH3GLB2, and F7). RT‐qPCR results showed reduced expression levels of DND1, HIRA, and SH3GLB2 in clinical blood samples of OP patients. Moreover, the four hub genes showed positive correlations with neutrophils (0.65–0.90), immature B cells (0.76–0.92), and endothelial cells (0.79–0.87), while showing negative correlations with myeloid‐derived suppressor cells (negative 0.54–0.73), T follicular helper cells (negative 0.71–0.86), and natural killer T cells (negative 0.75–0.85).

Conclusion

Neutrophils play a crucial role in the occurrence and development of osteoporosis. The four hub genes potentially inhibit metabolic activities and trigger inflammation by interacting with other immune cells, thereby significantly contributing to the onset and diagnosis of OP.
Burden and associated characteristics in caregivers of Parkinson's disease patients
Authors: Inaltekin Ali , Kocatürk Idris
Published: September 2024

Background

Parkinson's disease (PD) increases patient load and requirements of care. Determining the burden on PD patients' caregivers and associated factors may help to identify methods to reduce caregiver burden. This study investigated the factors associated with caregiver burden among PD patients caregivers.

Methods

Eighty‐five PD patients and 85 caregivers were included in the study. Zarit Burden Interview (ZBI) was used to measure caregiver burden; the Ways of Coping Scale (WCS) was used for coping; Modified Hoehn‐Yahr Staging (MHYS) was used for staging patients. The International Parkinson and Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) parts 1 and 3 were used to evaluate non‐motor and motor problems. Caregivers' depression and anxiety levels were evaluated with the Beck Depression Inventory and Beck Anxiety Inventory (BAI). Spearmen correlation coefficient was used to evaluate the relationship of variables with the ZBI score, and multiple linear regression analysis was used to determine the predictors of the ZBI score.

Results

A positive significant relationship was found between the ZBI score and BAI score, MHYS score, WCS total score, and subscales: keeping to self, seeking refuge in fate, and seeking refuge in supernatural forces. MHYS score, WCS total score, BAI score, and MDS‐UPDRS‐1 were predictors of the ZBI score.

Conclusions

The anxiety levels of caregivers, their ways of coping, and the patient's stage of the disease are important in caregiver burden. Coping ways can be changed to reduce the care burden. Developing psychological interventions for caregivers to change their coping styles can be important.
Restoration seed and plant material supply chains are complex social networks
Authors: Allen Eve B. , Cross Adam T. , Berger Alan M. , Aronson James
Published: September 2024

Previous studies have advanced the conceptual framing of a “supply chain” to describe and examine key steps, inputs, and flows related to the production and use of seed and plant material in ecological restoration. However, these studies have paid less attention to investigating interrelationships among social actors throughout the “supply chain” stages for ecological restoration and allied activities. We applied social network analysis metrics to evaluate the number, kind, and strength of relationships among 157 social actors in the nine‐state region of the Northeastern United States, where rapid growth in restoration activities is driving a demand surge for native seed and plant materials. Restoration supply chains are more complex than previous conceptualization suggests, and we argue that the term “restoration supply networks” is more illustrative of this complexity. Results highlighted interdependency among different sectors, marked variation in input and output flows across spatial–temporal scales, and interplay among linear and nonlinear supply chain steps. The restoration supply network in the study area had a core–periphery structure, with a core comprising end‐users such as government agencies, design and build contractors, and non‐profit organizations surrounded by a periphery of seed and plant material suppliers. It is important to avoid oversimplifying seed and plant material supply chains as linear systems with strong linkages. Understanding relationship patterns among supply network actors can enhance communication, coordination, and collaboration among actors in all key restoration supply chain steps, a prerequisite to overcoming seed and plant material bottlenecks and meeting global restoration goals in the coming decades.
A Two‐Step Approach to Extracting Sandy Beaches Through Integrating Spatial Semantic Information From Open‐Source Geospatial Datasets
Authors: Wang Zhe , Fang Zhixiang , Chang Jiayi , Wang Zhongyuan , Shen Weiming
Published: September 2024

Sandy beaches, widespread in coastal areas, provide valuable economic and ecological benefits. However, a substantial proportion of sandy beaches are undergoing erosion caused by marine disasters and human interventions. Advanced sandy beach extraction (SBE) approaches are indispensable to sandy beach observation and protection. This study proposes a novel two‐step SBE approach using remote sensing images and digital elevation models. First, sea–land segmentation is performed as a preparatory work. We model sea–land segmentation as an optimization problem and develop an improved NSGA‐II, SCS‐NSGA‐II, to solve it, considering both topographical and spectral costs. Second, a region growing algorithm is applied to generate the final sandy beach extents. The assessment results verify that (1) our approach effectively reduces the false‐positive rate, thereby resulting in more accurate SBE results compared with existing approaches. (2) SCS‐NSGA‐II ensures the diversity of individuals in spatial patterns and exhibits superior performance compared with NSGA‐II in this task.
Intercellular Mitochondrial Transfer: The Novel Therapeutic Mechanism for Diseases
Authors: Liu Huimei , Mao Hui , Ouyang Xueqian , Lu Ruirui , Li Lanfang
Published: September 2024

Mitochondria, the dynamic organelles responsible for energy production and cellular metabolism, have the metabolic function of extracting energy from nutrients and synthesizing crucial metabolites. Nevertheless, recent research unveils that intercellular mitochondrial transfer by tunneling nanotubes, tumor microtubes, gap junction intercellular communication, extracellular vesicles, endocytosis and cell fusion may regulate mitochondrial function within recipient cells, potentially contributing to disease treatment, such as nonalcoholic steatohepatitis, glioblastoma, ischemic stroke, bladder cancer and neurodegenerative diseases. This review introduces the principal approaches to intercellular mitochondrial transfer and examines its role in various diseases. Furthermore, we provide a comprehensive overview of the inhibitors and activators of intercellular mitochondrial transfer, offering a unique perspective to illustrate the relationship between intercellular mitochondrial transfer and diseases.
Design and Manufacture of SiC/SiC Nozzle Guide Vanes With Environmental Barrier Coatings for High-Pressure Turbines
Authors: Süß Fabia , Schöffler Robin , Friedrich Lion , Petersen Anna , Vogel Felix , Frieß Martin , Ebach-Stahl Andrea
Published: September 2024

Increasing the efficiency of jet engines is essential to meet the demanded climate targets. Ceramic matrix composites (CMCs) are strong candidates for aircraft applications because they withstand high temperatures, while their density is two-thirds lower than that of conventional nickel-based alloys. This leads to cooling air savings and a lower overall engine weight, resulting in a potential reduction of emissions. To investigate the potential benefits and manufacturing techniques required for the introduction of CMC to the high-pressure turbine (HPT) of a modern jet engine, the geometry of a nozzle guide vane of an existing turbine was redesigned considering ceramic specific constraints. Then, the liquid silicon infiltration (LSI) process was used to manufacture silicon carbide fiber-reinforced silicon carbide (SiC/SiC) nozzle guide vanes (NGV). Hi-Nicalon S woven fabric was used together with a chemical vapor infiltration (CVI)-based fiber coating. The outer surface of the vane was ground to meet the requirements for surface roughness, and geometric and positional tolerances. Cylindrical, laser-drilled cooling holes were introduced for trailing edge cooling. In the final step, an environmental barrier coating (EBC) system consisting of yttrium disilicate (Y-DS) and yttrium monosilicate (Y-MS) layers was applied using physical vapor deposition (PVD) processing. Wind tunnel testing under technology readiness level (TRL) 4 will be performed and vane performance will be evaluated.
An Analytical Study on the Effects of Non-Uniform Vane Spacing on Forced Response Reduction in a Mistuned Blisk Rotor in a Multistage Axial Compressor
Authors: Leng Yujun , Dodda Jhansi R. , Key Nicole L.
Published: September 2024

Stators with non-uniform vane spacing (NUVS) have been sought as an effective way to reduce the rotor-forced response at certain resonance crossing of concern. A comprehensive experimental study has been conducted in Purdue three-stage axial research compressor to evaluate the effectiveness of the NUVS stator on reducing the forced response of the downstream rotor using strain gauge measurement. The experimental results showed that the classical estimation method failed to predict the reduction factor correctly, mainly due to the lack of consideration for the damping and mistuning effects. To better understand the experimental results, and to provide an efficient and more accurate analysis tool for the rotor forced response under NUVS stator excitation, a detailed analytical study was conducted in this paper. The blade-forced response was solved using an efficient, steady-state linearized approach. A single-blade analysis was done first to study the effect of damping. The case studies show that higher damping causes more overlap of the blade forced response from adjacent engine order excitations and, thus, increases the total normalized blade response under NUVS stator excitation. A mistuned blisk aeroelastic model was introduced next, with the mistuning effect modeled using the fundamental mistuning model. Both structural coupling and aerodynamic coupling effects can be included in the aeroelastic model. Similar to the experimental results, the mistuned blisk case study shows a large blade-to-blade variation in the blade-forced response under both symmetric and asymmetric NUVS stator excitation, even at a low, non-intentional mistuning level. A statistical study with 100 randomly generated mistuned blisks shows that the forced response reduction effect of a specific NUVS design could vary significantly with a small change of the mistuning pattern, which suggests that mistuning has to be carefully considered in the design, evaluation, and optimization of the NUVS stator.
Investigating muscle coordination patterns with Granger causality analysis in protrusive motion from tagged and diffusion MRI
Authors: Park Hyeonjeong , Xing Fangxu , Stone Maureen , Kang Hahn , Liu Xiaofeng , Zhuo Jiachen , Fels Sidney , Reese Timothy G. , Wedeen Van J. , Fakhri Georges El , Prince Jerry L. , Woo Jonghye
Published: September 2024

The human tongue exhibits an orchestrated arrangement of internal muscles, working in sequential order to execute tongue movements. Understanding the muscle coordination patterns involved in tongue protrusive motion is crucial for advancing knowledge of tongue structure and function. To achieve this, this work focuses on five muscles known to contribute to protrusive motion. Tagged and diffusion MRI data are collected for analysis of muscle fiber geometry and motion patterns. Lagrangian strain measurements are derived, and Granger causal analysis is carried out to assess predictive information among the muscles. Experimental results suggest sequential muscle coordination of protrusive motion among distinct muscle groups.
“What Is Lost so That Other Things Can Be Sustained?”: The Climate Crisis, Loss, and the Afterlife of Golf
Authors: Millington Brad , Wilson Brian
Published: September 2024

This article introduces sociological conceptions of loss to literature on sport to assess the “life” and “death” of golf courses—as well as the “afterlife” of golf terrain once golf courses close. As indicated by the quotation from Rebecca Elliott’s writing (2018) in our title, a loss framing differs from the concept of sustainability by considering practices that might be discarded to serve better environmental futures. We consider loss vis-à-vis three golf industry “outlooks”: (1) strategic and gradual loss, where loss serves an industry-friendly view of sustainability; (2) permanent loss, where courses “die,” potentially toward greener “afterlives”; and (3) transformational loss, where golf courses remain but are substantially changed. We conclude with reflections on loss and the study of sport beyond golf.
The ultralow viscosity of volatile-rich kimberlite magma: Implications for the water content of primitive kimberlite melts
Authors: Hao Ming , Zhou Wen-Yi , Hrubiak Rostislav , Kenney-Benson Curtis , Kavanagh Janine L. , Davis William , Zhang Jin S.
Published: September 2024

The eruption of deeply sourced kimberlite magma offers the fastest route to bring deep-seated volatiles back to the Earth’s surface. However, the viscosity of kimberlite magma, a factor governing its migration and eruption dynamics within Earth, remains poorly constrained. We conducted synchrotron in situ falling sphere viscometry experiments to examine kimberlite magma with different volatile contents (0 to 5 wt % H
2
O and 2 to 8 wt % CO
2
) under high pressure-temperature conditions. The results reveal that the viscosity of volatile-rich kimberlite magma is ~1 to 2 orders lower than that of mid-ocean ridge basalt (MORB) and comparable to the ultramobile pure carbonate melt. Using the measured viscosity values, we simulated the ascent and eruption process of kimberlite magma. We found that a minimum content of ~0.5 wt % water in the primitive magma is necessary to allow the ultrafast eruption process of kimberlite, thereby enabling the preservation of diamonds and high-pressure mineral inclusions transported by the magma.
Meter-scale van der Waals films manufactured via one-step roll printing
Authors: Lee Kyuho , Higashitarumizu Naoki , Wang Shu , Kim Chunghee , Ho Chun Yuen , Oh Jin Woo , Zan Guangtao , Madsen Morten , Lee Tae-Woo , Chrzan Daryl C. , Park Cheolmin , Javey Ali
Published: September 2024

A weak van der Waals (vdW) force in layered materials enables their isolation into thin flakes through mechanical exfoliation while sustaining their intrinsic electronic and optical properties. Here, we introduce a universal roll-printing method capable of producing vdW multilayer films on wafer-to-meter scale. This process uses sequential exfoliation and transfer of layered materials from the powder sources to target substrates through a repeated rolling of a cylindrical metal drum. We achieve uniformly coated films with a library of vdW powders on various mechanically rigid and flexible substrates. The printed films are configured into different devices including light-emitting diodes and photodetectors. The presented technique offers substantial benefits in terms of cost efficiency and a low thermal budget while offering high material quality.
Transgenic overexpression of bmo-miR-6498-5p increases resistance to
Nosema bombycis
in the silkworm,
Bombyx mori
Authors: Hu Congwu , Deng Boyuan , Fang Wenxuan , Guo Bingyu , Chen Peng , Lu Cheng , Dong Zhanqi , Pan Minhui
Published: September 2024

Microsporidia are unfriendly microorganisms, and their infections cause considerable damage to economically or environmentally important insects like silkworms and honeybees. Thus, the identification of measures to improve host resistance to microsporidia infections is critically needed. Here, an overexpressed miR-6498-5p transgenic silkworm line was constructed. Importantly, the survival rates and median lethal doses of the transgenic line were clearly higher after infection with
Nosema bombycis
. H&E staining and RT-qPCR analyses revealed an inhibitory effect on the proliferation of
N. bombycis
in the transgenic larvae. Metabolomics analysis further revealed the presence of 56 differential metabolites between the two lines. KEGG analysis of these 56 metabolites found that they were involved in various amino acid and vitamin metabolism pathways. Notably, VB6 metabolism was enriched among the metabolites, and the pathway was well known for its involvement in the synthesis, interconversion, and degradation of amino acids. These suggest that miR-6498-5p modifies parasitic environments to inhibit the proliferation of
N. bombycis
by affecting the host amino acid metabolism. These results demonstrate the potential of microRNAs as biomolecules that can promote resistance to microsporidia and provide new insights and a new approach to generate microsporidia-resistant biological materials.

IMPORTANCE

Microsporidia have an extremely wide host range and are capable of infecting a wide variety of insects and vertebrates, including humans, and their lethality to multiple species often poses significant environmental management challenge. Here, we successfully constructed a microsporidium-resistant line in the silkworm, based on the overexpression of miR-6498-5p. Our results strongly support the hypothesis that miR-6498-5p efficiently suppresses the proliferation of
Nosema bombycis
by regulating the host VB6 metabolism, a key pathway for enzymes involved in amino acid transport and protein metabolism. Our study provides new insights for understanding host anti-pathogen defenses toward microsporidia.
A monoclonal antibody targeting the Nipah virus fusion glycoprotein apex imparts protection from disease
Authors: Avanzato Victoria A. , Bushmaker Trenton , Oguntuyo Kasopefoluwa Y. , Yinda Claude Kwe , Duyvesteyn Helen M. E. , Stass Robert , Meade-White Kimberly , Rosenke Rebecca , Thomas Tina , van Doremalen Neeltje , Saturday Greg , Doores Katie J. , Lee Benhur , Bowden Thomas A. , Munster Vincent J.
Published: September 2024

Nipah virus (NiV) is a highly pathogenic paramyxovirus capable of causing severe respiratory and neurologic disease in humans. Currently, there are no licensed vaccines or therapeutics against NiV, underscoring the urgent need for the development of countermeasures. The NiV surface-displayed glycoproteins, NiV-G and NiV-F, mediate host cell attachment and fusion, respectively, and are heavily targeted by host antibodies. Here, we describe a vaccination-derived neutralizing monoclonal antibody, mAb92, that targets NiV-F. Structural characterization of the Fab region bound to NiV-F (NiV-F–Fab92) by cryo-electron microscopy analysis reveals an epitope in the DIII domain at the membrane distal apex of NiV-F, an established site of vulnerability on the NiV surface. Further, prophylactic treatment of hamsters with mAb92 offered complete protection from NiV disease, demonstrating beneficial activity of mAb92
in vivo
. This work provides support for targeting NiV-F in the development of vaccines and therapeutics against NiV.

IMPORTANCE

Nipah virus (NiV) is a highly lethal henipavirus (HNV) that causes severe respiratory and neurologic disease in humans. Currently, there are no licensed vaccines or therapeutics against NiV, highlighting a need to develop countermeasures. The NiV surface displays the receptor binding protein (NiV-G, or RBP) and the fusion protein (NiV-F), which allow the virus to attach and enter cells. These proteins can be targeted by vaccines and antibodies to prevent disease. This work describes a neutralizing antibody (mAb92) that targets NiV-F. Structural characterization by cryo-electron microscopy analysis reveals where the antibody binds to NiV-F to neutralize the virus. This study also shows that prophylactic treatment of hamsters with mAb92 completely protected against developing NiV disease. This work shows how targeting NiV-F can be useful to preventing NiV disease, supporting future studies in the development of vaccines and therapeutics.
Experimental viral spillover across 25 million year gap in Rodentia reveals limited viral transmission and purifying selection of a picornavirus
Authors: Shepherd Frances K. , Roach Shanley N. , Sanders Autumn E. , Liu Yanan , Putri Dira S. , Li Rong , Merrill Nathan , Pierson Mark J. , Kotenko Sergei V. , Wang Zhongde , Langlois Ryan A.
Published: September 2024

When a virus crosses from one host species to another, the consequences can be devastating. However, animal models to empirically evaluate cross-species transmission can fail to recapitulate natural transmission routes, physiologically relevant doses of pathogens, and population structures of naturally circulating viruses. Here, we present a new model of cross-species transmission where deer mice (
Peromyscus maniculatus
) are exposed to the natural virome of pet store mice (
Mus musculus
). Using RNA sequencing, we tracked viral transmission via fecal–oral routes and found the evidence of transmission of murine astroviruses, coronaviruses, and picornaviruses. Deep sequencing of murine kobuvirus revealed tight bottlenecks during transmission and purifying selection that leaves limited diversity present after transmission from
Mus
to
Peromyscus
. This work provides a structure for studying viral bottlenecks across species while keeping natural variation of viral populations intact and a high resolution look at within-host dynamics that occur during the initial stages of cross-species viral transmission.

IMPORTANCE

Viral spillover events can have devastating public health consequences. Tracking cross-species transmission in real-time and evaluating viral evolution during the initial spillover event are useful for understanding how viruses adapt to new hosts. Using our new animal model and next generation sequencing, we develop a framework for understanding intrahost viral evolution and bottleneck events, which are very difficult to study in natural transmission settings.
Effects of exercise, metformin and their combination on glucose metabolism in individuals with abnormal glycaemic control: a systematic review and network meta-analysis
Authors: Zhao Tong , Yang Qize , Feuerbacher Joshua F , Yu Bizhu , Brinkmann Christian , Cheng Sulin , Bloch Wilhelm , Schumann Moritz
Published: September 2024

Objective

To compare the efficacy of exercise, metformin and their combination on glucose metabolism in individuals with abnormal glycaemic control.

Design

Systematic review and network meta-analysis.

Data sources

Embase, Web of Science, PubMed/MEDLINE and SPORTDiscus.

Eligibility criteria

Randomised controlled trials involving exercise, metformin or their combined treatments in individuals with prediabetes or type 2 diabetes mellitus (T2DM) were included. Outcomes included haemoglobin A1c (HbA1c), 2-hour glucose during oral glucose tolerance test, fasting glucose, fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR).

Results

407 articles with 410 randomised controlled trials (n=33 802) were included. In prediabetes, the exercise showed greater efficacy than metformin on HbA1c levels (mean difference −0.16%, 95% CI (−0.23 to −0.09) vs −0.10%, 95% CI (−0.21 to 0.02)), 2-hour glucose (−0.68 mmol/L, 95% CI (−0.97 to −0.39) vs 0.01 mmol/L, 95% CI (−0.38 to 0.41)) and HOMA-IR (−0.54, 95% CI (−0.71 to −0.36) vs −0.23, 95% CI (−0.55 to 0.10)), while the efficacy on fasting glucose was comparable (−0.26 mmol/L, 95% CI (−0.32 to −0.19) vs −0.33 mmol/L, 95% CI (−0.45 to −0.21)). In T2DM, metformin was more efficacious than exercise on HbA1c (−0.88%, 95% CI (−1.07 to −0.69) vs −0.48%, 95% CI (−0.58 to −0.38)), 2-hour glucose (−2.55 mmol/L, 95% CI (−3.24 to −1.86) vs −0.97 mmol/L, 95% CI (−1.52 to −0.42)) and fasting glucose (−1.52 mmol/L, 95% CI (−1.73 to −1.31) vs −0.85 mmol/L, 95% CI (−0.96 to −0.74)); exercise+metformin also showed greater efficacy in improving HbA1c (−1.23%, 95% CI (−2.41 to –0.05)) and fasting glucose (−2.02 mmol/L, 95% CI (−3.31 to –0.74)) than each treatment alone. However, the efficacies were modified by exercise modality and metformin dosage.

Conclusion

Exercise, metformin and their combination are efficacious in improving glucose metabolism in both prediabetes and T2DM. The efficacy of exercise appears to be superior to metformin in prediabetes, but metformin appears to be superior to exercise in patients with T2DM.

PROSPERO registration number

CRD42023400622.
Patient journey and timeliness of care for patients with breast cancer in Africa: a scoping review protocol
Authors: Kibret Anteneh Ayelign , Jiang Heng , Yang Haifeng , Liu Chaojie
Published: September 2024

Introduction

Cancer is the leading cause of death worldwide, with breast cancer being one of the most commonly diagnosed types. Low-income and middle-income countries account for nearly half of all breast cancer cases and related fatalities. In Africa, mortality rates are higher and survival rates are lower compared with developed countries. Timeliness of care is a critical aspect of healthcare, but various studies and healthcare systems use different criteria and methods to measure it. Assessing the breast cancer care pathway and understanding the determinants of delayed care are essential for effective interventions. Therefore, this scoping review aims to evaluate the methods used to measure the timeliness of breast cancer care, identify specific points in the care pathway where delays are most frequently reported, and examine the factors affecting the timeliness of breast cancer care in Africa.

Methods and analysis

We will conduct this scoping review using the Arksey and O’Malley framework endorsed by the Joanna Briggs Institute. A scoping review of articles written in English concerning the timeliness of breast cancer care in the African context will be undertaken. Six electronic databases (MEDLINE, EMBASE, CINAHL, SCOPUS, WEB Of SCIENCE and PsycINFO) will be searched to identify published literature on timeliness of breast care in Africa. Two reviewers will independently screen the articles at both the abstract and full-text stages, guided by predetermined inclusion and exclusion criteria. The full texts of identified studies will be further examined and charted using a data extraction form guided by the Model of Pathways to Treatment framework. Publications describing the time to diagnosis and its associated factors in the contexts of breast cancer will be considered for inclusion, with no restrictions based on date of publication. Studies that are published in languages other than English and that do not focus on the timeliness of care or time-related aspects within the care pathway will be excluded. Evidence will be narratively synthesised and analysed.

Ethics and dissemination

Ethical approval is not needed as this scoping review does not involve collecting data from human participants. The results produced from this review will be submitted to a scientific peer-reviewed journal for publication and will be presented at scientific meetings.
Disability in childhood and the equity of health services: a cross-sectional comparison of mass drug administration strategies for soil-transmitted helminths in southern Malawi
Authors: Witek-McManus Stefan , Simwanza James , Msiska Rejoice , Mangawah Hastings , Oswald William , Timothy Joseph , Galagan Sean , Pearman Emily , Shaikh Mariyam , Legge Hugo , Walson Judd , Juziwelo Lazarus , Davey Calum , Pullan Rachel , Bailey Robin L , Kalua Khumbo , Kuper Hannah
Published: September 2024

Background

School-based approaches are an efficient mechanism for the delivery of basic health services, but may result in the exclusion of children with disabilities if they are less likely to participate in schooling. Community-based ‘door to door’ approaches may provide a more equitable strategy to ensure that children with disabilities are reached, but disability is rarely assessed rigorously in the evaluation of health interventions.

Objectives

To describe the prevalence and factors associated with disability among children aged 5–17 years and to assess the relative effectiveness of routine school-based deworming (SBD) compared with a novel intervention of community-based deworming (CBD) in treating children with disabilities for soil-transmitted helminths.

Setting

DeWorm3 Malawi Site (DMS), Mangochi district, Malawi.

Participants

All 44 574 children aged 5–17 years residing within the DMS.

Primary and secondary outcome measures

Disability was defined as a functional limitation in one or more domains of the Washington Group/UNICEF Child Functioning Module administered as part of a community-based census. Treatment of all children during SBD and CBD was independently observed and recorded. For both intervention types, we performed bivariate analyses (z-score) of the absolute proportion of children with and without disabilities treated (absolute differences (ADs) in receipt of treatment), and logistic regression to examine whether disability status was associated with the likelihood of treatment (relative differences in receipt of treatment).

Results

The overall prevalence of disability was 3.3% (n=1467), and the most common domains of disability were hearing, remembering and communication. Boys were consistently more likely to have a disability compared with girls at all age groups, and disability was strongly associated with lower school attendance and worse levels of education. There was no significant difference in the proportion of children with disabilities treated during SBD when assessed by direct observation (−1% AD, p=0.41) or likelihood of treatment (adjusted risk ratio (aRR)=1.07, 95% CI 0.89 to 1.28). Treatment of all children during CBD was substantially higher than SBD, but again showed no significant difference in the proportions treated (−0.5% AD, p=0.59) or likelihood of treatment (aRR=1.04, 95% CI 0.99 to 1.10).

Conclusion

SBD does not appear to exclude children with disabilities, but the effect of consistently lower levels of educational participation of children with disabilities should be actively considered in the design and monitoring of school health interventions.

Trial registration number

NCT03014167.
Cost-effectiveness analysis of app-delivered self-management support (selfBACK) in addition to usual care for people with low back pain in Denmark
Authors: Kongstad Line Planck , Øverås Cecilie Krage , Skovsgaard Christian Volmar , Sandal Louise Fleng , Hartvigsen Jan , Søgaard Karen , Mork Paul Jarle , Stochkendahl Mette Jensen
Published: September 2024

Objectives

This study aims to investigate the cost-effectiveness of individually tailored self-management support, delivered via the artificial intelligence-based selfBACK app, as an add-on to usual care for people with low back pain (LBP).

Design

Secondary health-economic analysis of the selfBACK randomised controlled trial (RCT) with a 9-month follow-up conducted from a Danish national healthcare perspective (primary scenario) and a societal perspective limited to long-term productivity in the form of long-term absenteeism (secondary scenario).

Setting

Primary care and an outpatient spine clinic in Denmark.

Participants

A subset of Danish participants in the selfBACK RCT, including 297 adults with LBP randomised to the intervention (n=148) or the control group (n=149).

Interventions

App-delivered evidence-based, individually tailored self-management support as an add-on to usual care compared with usual care alone among people with LBP.

Outcome measures

Costs of healthcare usage and productivity loss, quality-adjusted life-years (QALYs) based on the EuroQol-5L Dimension Questionnaire, meaningful changes in LBP-related disability measured by the Roland-Morris Disability Questionnaire (RMDQ) and the Pain Self-Efficacy Questionnaire (PSEQ), costs (healthcare and productivity loss measured in Euro) and incremental cost-effectiveness ratios (ICERs).

Results

The incremental costs were higher for the selfBACK intervention (mean difference €230 (95% CI −136 to 595)), where ICERs showed an increase in costs of €7336 per QALY gained in the intervention group, and €1302 and €1634 for an additional person with minimal important change on the PSEQ and RMDQ score, respectively. At a cost-effectiveness threshold value of €23250, the selfBACK intervention has a 98% probability of being cost-effective. Analysis of productivity loss was very sensitive, which creates uncertainty about the results from a societal perspective limited to long-term productivity.

Conclusions

From a healthcare perspective, the selfBACK intervention is likely to represent a cost-effective treatment for people with LBP. However, including productivity loss introduces uncertainty to the results.

Trial registration number

NCT03798288.
Workplace active breaks for university workers: the UNIFIT pilot study protocol
Authors: Scoppolini Massini Maria , Pinelli Erika , Masini Alice , Zinno Raffaele , Dallolio Laura , Bragonzoni Laura
Published: September 2024

Sedentary behaviour (SB) is associated with an increased risk of metabolic issues (negative effects on diabetes, fasting glucose, fasting insulin, triglycerides, high-density lipoprotein cholesterol and waist circumference), cardiovascular diseases, increased risk of all-cause mortality and accelerated ageing of skeletal muscle power. The research on SB is relatively new, with much evidence regarding its negative health effects gathered within the last decade. Office workers exhibit pronounced sedentary habits, with studies indicating they can spend up to 82% of their working day sitting. To address this issue, workplaces are responsible for promoting physical activity and minimising SB among employees. In this context, one potential strategy for reducing SB and its associated risks could be implementing active breaks (ABs). ABs are defined as brief, structured periods of physical activity or exercise. This quasi-experimental pilot study aims to implement workplace ABs programme aimed at interrupting SB among the University of Bologna (Italy) workers, and it will include both intervention and control groups. The intervention group will participate in an 8-week ABs programme. The findings from this study could establish a robust basis for future large-scale research on the effectiveness of ABs interventions in workplace settings.
Redlining in New York City: impacts on particulate matter exposure during pregnancy and birth outcomes
Authors: Herrera Teresa , Seok Eunsil , Cowell Whitney , Brown Eric , Magzamen Sheryl , Ako Ako Adams , Wright Rosalind J , Trasande Leonardo , Ortiz Robin , Stroustrup Annemarie , Ghassabian Akhgar
Published: September 2024

Background

Evidence suggests historical redlining shaped the built environment and health outcomes in urban areas. Only a handful of studies have examined redlining’s association with air pollution and adverse birth outcomes in New York City (NYC). Additionally, no NYC-specific studies have examined the impact of redlining on birth weight.

Methods

This longitudinal cohort study analysed data from the National Institute of Health Environmental Influences on Child Health Outcomes Programme to investigate the extent to which maternal residence in a historically redlined neighbourhood is associated with fine particulate matter (PM2.5) exposure during pregnancy using multivariable regression models. Additionally, we examined how maternal residence in a historically redlined neighbourhood during pregnancy influenced birth weight z-score, preterm birth and low birth weight.

Results

Our air pollution model showed that living in a historically redlined census tract or an ungraded census tract was associated with increased PM2.5exposure during pregnancy. We also found living in a historically redlined census tract or an ungraded census tract was associated with a lower birth weight z-score. This finding remained significant when controlling for individual and census tract-level race, ethnicity and income. When we controlled PM2.5in our models assessing the relationship between redlining grade and birth outcome, our results did not change.

Discussion

Our study supports the literature linking redlining to contemporary outcomes. However, our research in ungraded tracts suggests redlining alone is insufficient to fully explain inequality in birth outcomes and PM2.5levels today.
State-level association between income inequality and mortality in the USA, 1989–2019: ecological study
Authors: Dunn James R , Park Gum-Ryeong , Brydon Robbie , Veall Michael , Rolheiser Lyndsey A , Wolfson Michael , Siddiqi Arjumand , Ross Nancy A
Published: September 2024

Background

Prior studies have shown a positive relationship between income inequality and population-level mortality. This study investigates whether the relationship between US state-level income inequality and all-cause mortality persisted from 1989 to 2019 and whether changes in income inequality were correlated with changes in mortality rates.

Methods

We perform repeated cross-sectional regressions of mortality on state-level inequality measures (Gini coefficients) at 10-year intervals. We also estimate the correlation between within-state changes in income inequality and changes in mortality rates using two time-series models, one with state- and year-fixed effects and one with a lagged dependent variable. Our primary regressions control for median income and are weighted by population.

Main outcome measures

The two primary outcomes are male and female age-adjusted mortality rates for the working-age (25–64) population in each state. The secondary outcome is all-age mortality.

Results

There is a strong positive correlation between Gini and mortality in 1989. A 0.01 increase in Gini is associated with more deaths: 9.6/100 000 (95% CI 5.7, 13.5, p<0.01) for working-age females and 29.1 (21.2, 36.9, p<0.01) for working-age males. This correlation disappears or reverses by 2019 when a 0.01 increase in Gini is associated with fewer deaths: −6.7 (−12.2, –1.2, p<0.05) for working-age females and −6.2 (−15.5, 3.1, p>0.1) for working-age males. The correlation between the change in Gini and change in mortality is also negative for all outcomes using either time-series method. These results are generally robust for a range of income inequality measures.

Conclusion

The absence or reversal of correlation after 1989 and the presence of an inverse correlation between change in inequality and change in all-cause mortality represents a significant reversal from the findings of a number of other studies. It also raises questions about the conditions under which income inequality may be an important policy target for improving population health.
Women working as cleaners in Spain: working conditions and use of psychotropic drugs
Authors: Utzet Mireia , Llorens-Serrano Clara , Ayala-Garcia Amaya , Esteve-Matalí Laura , Navarro-Giné Albert , Bacigalupe Amaia
Published: September 2024

Goals

To describe the exposure to psychosocial risks at work and the consumption of psychotropic drugs and opioids among women working as cleaners; and to analyse the association between their exposure to psychosocial risks and drug use.

Methods

Observational cross-sectional study based on an online survey (collected during April and May 2021) from the wage-earning population in Spain. In this study, only women working in manual occupations were included (n=3430). Working conditions and drug consumption of cleaning workers were compared with those of other manual workers through bivariate analysis. The adjusted prevalence ratios and the corresponding 95% CIs were estimated using Poisson regression models with robust variance.

Results

Cleaning workers were older and had more problems making ends meet than other manual workers and were significantly more exposed to low possibilities for development (85.2 (95% CI 81.8 to 88.0)), high strain (51.9 (95% CI 47.3 to 55.9)) and low social support from colleagues (72.0 (95% CI 68.1 to 75.7)) and supervisors (61.7 (95% CI 57.3 to 65.6)). They also scored higher prevalence rates for the use of tranquillisers (37.7 (95% CI 32.0 to 43.3)) and opioids (33.3 (95% CI 27.9 to 38.6)) consumption indicators. This consumption was associated significantly with high strain exposure and high insecurity over working conditions.

Discussion

Under the umbrella of the 2012 labour reform, cleaning companies shift the pressure and burden they have on ordinary cleaning staff in the form of low wages and precarious working conditions. Our results imply that addressing adverse working conditions, mainly high strain and insecurity over working conditions, may significantly contribute to reducing the gender and social inequalities among cleaning workers.