bluuebunny/crossref_metadata_2025 huggingface dataset:
Possible sleep bruxism and hair cortisol in children: A birth cohort study
Authors: Pauli Laís Anschau , Murray Joseph , Tovo‐Rodrigues Luciana , Correa Marcos Britto , Barros Fernando , de Oliveira Isabel Oliveira , Domingues Marlos Rodrigues , Demarco Flavio Fernando , Goettems Marília Leão
Published: November 2024

This study aimed to test for an association between hair cortisol, as an indicator of chronic stress, and possible sleep bruxism among children participating in the 2015 Pelotas Birth Cohort Study. Data from 3229 children were analysed. Possible sleep bruxism was identified based on caregivers' reports when the child was 4 years old. Trained fieldworkers collected hair samples from children, and a standardized protocol was used for hormone extraction and cortisol quantification from the hair. Information on socioeconomic, demographic, psychological and behavioural characteristics was gathered through questionnaires. Poisson regression with robust variance was used to evaluate the impact of hair cortisol concentration on the occurrence of possible sleep bruxism, guided by a directed acyclic graph. The prevalence of possible sleep bruxism was 21.46% (n = 693); median hair cortisol concentration was 7.8 pg mg−1. Hair cortisol concentration was not found to be associated with the occurrence of sleep bruxism. However, the presence of sleep bruxism was linked to higher maternal education (p = 0.027), maternal stress level (p = 0.032), excessive use of electronic devices (p = 0.007), and child emotional and behavioural problems (p = 0.003). Furthermore, female sex was associated with a lower frequency of possible sleep bruxism (p = 0.003). There was no association between chronic stress, as measured by hair cortisol concentration, and the occurrence of possible sleep bruxism. This study underscores the role of sociodemographic factors and children's mental health in the occurrence of sleep bruxism among children in this population.
Can EEG spectral analysis distinguish children with narcolepsy from those with idiopathic hypersomnia and subjective sleepiness?
Authors: Plunkett Georgina , Shetty Marisha , Davey Margot J. , Nixon Gillian M. , Walter Lisa M. , Horne Rosemary S. C.
Published: November 2024

EEG spectral analysis provides a more sensitive measure of sleep disruption than conventional sleep macro‐architecture. We aimed to examine the use of this technique applied to overnight polysomnography in distinguishing children with narcolepsy and idiopathic hypersomnia (IH) from subjectively sleepy children with a non‐diagnostic multiple sleep latency test. The relative power was calculated for delta (0.5–3.9 Hz), theta (4–7.9 Hz), alpha (8–11.9 Hz), sigma (12–13.9 Hz), and beta power (14–30 Hz). A mean value for each frequency was calculated for each 30 s epoch then averaged for each sleep stage within each child. Data are presented as median and interquartile range. Twenty‐eight children with narcolepsy, 11 with IH, and 26 with subjective sleepiness were included and individually matched for age and sex with a control child. In N2, the F4 beta power was lower in the narcolepsy compared with the IH group (p < 0.05). The F4 theta power was higher in the narcolepsy compared with the subjectively sleepy group during wake (p < 0.001), N2 (p < 0.01), N3 (p < 0.05), and total sleep (p < 0.01). During total sleep the F4 delta power was lower in both the narcolepsy and IH groups compared with the subjectively sleepy group (p < 0.05 for both). Our study identified specific EEG frequencies which differed between groups of children referred for assessment of EDS. In particular, differences in theta and delta power in children with narcolepsy and IH compared with others with subjective sleepiness may provide insights into the pathophysiology associated these conditions.
The Liquidity Uncertainty Premium Puzzle
Authors: Flora Maria , Gianstefani Ilaria , Renò Roberto
Published: December 2024

The puzzling negative relation between liquidity uncertainty and asset returns, originally put forward by Chordia, Subrahmanyam, and Anshuman (2001) and confirmed by the subsequent empirical literature up to date, is neither robust to the aggregation period, nor to the observation frequency used to compute the volatility of trading volume. We demonstrate that their procedure involves an estimation bias due to the persistence and skewness of volumes. When using an alternative approach based on high‐frequency data to measure liquidity uncertainty, the relationship turns out to be positive. However, portfolio strategies based on liquidity uncertainty do not appear to be profitable.
Biosynthesis of sakuranetin regulated by OsMPK6‐OsWRKY67‐OsNOMT cascade enhances resistance to false smut disease
Authors: Ma Jinbiao , Wei Lirong , Huang Keyi , Wang Dacheng , Gao Jiameng , Chen Xi , Guo Huimin , Gao Shangyu , Zhang Min , Li Shujing , Yu Chenjie , Zhao Jing , Wu Jingni , Gu Qin , Kim Sun Tae , Gupta Ravi , Xiong Guosheng , Lo Clive , Liu Yongfeng , Wang Yiming
Published: November 2024

Rice false smut disease, caused by the fungal pathogen Ustilaginoidea virens, significantly restricts both the production and quality of rice grains. However, the molecular mechanism underlying rice resistance against U. virens remain largely elusive.

Transcriptome analysis of rice panicles infected with U. virens revealing the crucial role of genes involved in sakuranetin biosynthesis in conferring resistance to the pathogen. In vitro assays demonstrated that sakuranetin was most effective at inhibiting mycelial growth, spore germination, and host infection by U. virens.

The expression of OsNOMT, the key enzyme in sakuranetin biosynthesis, is directly regulated by the transcription factor OsWRKY67. Furthermore, OsMPK6, a mitogen‐activated protein kinase, interacts with and phosphorylates OsWRKY67, thereby modulating sakuranetin biosynthesis and resistance to U. virens. Moreover, the exogenous application of synthetic sakuranetin significantly reduces U. virens infection.

Our findings reveal that the OsMPK6‐OsWRKY67‐OsNOMT signaling cascade plays a pivotal role in rice resistance to U. virens by regulating sakuranetin biosynthesis.
The dynamics of adaptive evolution in microalgae in a high‐CO2 ocean
Authors: Wu Fenghuang , Zhou Yunyue , Beardall John , Raven John A. , Peng Baoyi , Xu Leyao , Zhang Hao , Li Jingyao , Xia Jianrong , Jin Peng
Published: November 2024

Marine microalgae demonstrate a notable capacity to adapt to high CO2 and warming in the context of global change. However, the dynamics of their evolutionary processes under simultaneous high CO₂ and warming conditions remain poorly understood.

Here, we analyze the dynamics of evolution in experimental populations of a model marine diatom Phaeodactylum tricornutum. We conducted whole‐genome resequencing of populations under ambient, high‐CO2, warming and high CO2 + warming at 2‐yr intervals over a 4‐yr adaptation period.

The common genes selected between 2‐ and 4‐yr adaptation were found to be involved in protein ubiquitination and degradation and the tricarboxylic acid (TCA) cycle, and were consistently selected regardless of the experimental conditions or adaptation duration. The unique genes selected only by 4‐yr adaptation function in respiration, fatty acid, and amino acid metabolism, facilitating adaptation to prolonged high CO2 with warming conditions. Corresponding changes at the metabolomic level, with significant alterations in metabolites abundances involved in these pathways, support the genomic findings.

Our study, integrating genomic and metabolomic data, demonstrates that long‐term adaptation of microalgae to high CO2 and/or warming can be characterized by a complex and dynamic genetic process and may advance our understanding of microalgae adaptation to global change.
Unveiling a Hidden Synergy: Empowering Biofertilizers for Enhanced Plant Growth With Silicon in Stressed Agriculture
Authors: Etesami Hassan
Published: December 2024

Food security is increasingly threatened by climate change and environmental pressures that hinder plant growth and development. Harnessing soil microorganisms, such as mycorrhizal fungi and plant growth‐promoting bacteria, offers a promising approach to boost crop production. However, existing screening methods for these microorganisms often prove ineffective in real‐world, stress‐prone environments, limiting the efficacy of microbial biofertilizers. To address this challenge, this review proposes the integration of silicon—renowned for its stress‐mitigating properties in plants—with biofertilizers. Silicon has been shown to work synergistically with plant growth‐promoting microorganisms, enhancing plant resilience to environmental stress while improving colonization efficiency and plant‐microbe interactions in stressful conditions. By combining silicon with biofertilizers to create silicon‐enriched biofertilizers, this strategy has the potential to optimize microbial performance and fortify food security against global challenges. The review advocates for the co‐application of silicon and microbial biofertilizers as a sustainable solution to boost plant resilience against environmental stressors, thereby contributing to agricultural sustainability.
Anatomical and Trait Analyses Reveal a Silicon‐Carbon Trade‐Off in the Epidermis of Sedges
Authors: de Tombeur Félix , Plouzeau Lucas , Shaw Jeremy , Hodson Martin J. , Ranathunge Kosala , Kotula Joanna , Hayes Patrick E. , Tremblay Maëva , Coq Sylvain , Stein Mathias , Nakamura Ryosuke , Wright Ian J. , Lambers Hans , Violle Cyrille , Clode Peta L.
Published: November 2024

In recent years, the detection of numerous negative correlations between silicon (Si) and carbon (C)‐based compounds in plants has suggested trade‐offs between different stress resistance and/or mechanical support strategies. However, nearly all studies have involved whole‐leaf analysis, and it is unclear how the trade‐off operates mechanistically, at the cellular level. Here we combined leaf trait measurements and microscopic analyses (electron microscopy with elemental X‐ray mapping and X‐ray microtomography) of 17 species from a high‐Si family: Cyperaceae. Accumulation of Si was strongly negatively correlated with C‐based compounds, particularly tannins. Our microscopical investigations showed that the accumulation of phenolics and deposition of silica were mutually exclusive in the outer epidermal cell walls. This trade‐off was independent of that between the construction of tough, sclerenchyma‐rich leaves and growth potential (the leaf economics spectrum). We also identified a strong negative correlation between Si and accumulation of epicuticular waxes. Previous whole leaf analyses were, in effect, hiding the locations of the trade‐off between Si and C‐based compounds in plants. The epidermal location of this trade‐off and the specific involvement of tannins and waxes suggest the existence of different strategies to resist environmental stresses. Our study provides key insights into plant Si utilization and highlights the multidimensionality of plant stress resistance strategies.
Depressive symptoms spillover between romantic partners partially explained by anxious attachment
Authors: Morgan Preston C. , Durtschi Jared A. , King Salena
Published: December 2024

Depressive symptoms can spillover between romantic partners. From an attachment lens, depressive symptoms passing from one partner to another may be more frequent in the context of anxious attachment. Using 1179 German couples who remained together across 4 years (five waves) from the Panel Analysis on Intimate Relationships and Family Dynamics, analyses tested the extent anxious attachment moderated the initial level of depressive symptom spillover between partners' depressive symptom trajectories. Results revealed that men's and women's higher initial depressive symptoms were not significantly associated with changes in their partners' depressive symptom trajectories. However, the current study found that women's anxious attachment was associated with the link between men's initial depressive symptoms and the trajectory of women's depressive symptoms. Specifically, women who were more anxiously attached had a small, but greater risk of experiencing increased depressive symptom spillover across a four‐year period when their male partners had higher initial depressive symptoms. Together, this suggests depressive symptom spillover did occur among a general population of German couples, but primarily in the context of more anxiously attached women. Future research should examine the role attachment plays in the depressive symptom spillover among couples.
“Where you stand depends on where you sit”: The politics of petroleum pricing in Ghana's election cycle
Authors: Yeboah‐Assiamah Emmanuel , Kundi Shadrach Baa‐Naa , Asamoah Kwame
Published: November 2024

This study examines how fuel pricing in Ghana has been used as a political tool to win votes and the government's role in this process. Applying Mile's Law, it explores post‐truth theory through content analysis of secondary data and interviews with energy experts. The findings indicate that political parties gain significant political leverage by promising lower fuel prices during campaigns but fail to deliver once in office. The government's influence on fuel pricing is minimal, largely due to factors beyond its control. To stabilize fuel prices, the study recommends improving fiscal and economic performance to combat currency instability and educating the public on the factors influencing fuel pricing to prevent misinformation.

Related Articles

Asiegbu, Martin F., Okey Marcellus Ikeanyibe, Pius Otu Abang, Okwudili Chukwuma Nwosu, and Chuka Eugene Ugwu. 2024. “Natural Resource Fund Governance and the Institutionalization of Rent Seeking in Nigeria's Oil Sector.” Politics & Policy 52(1): 169–95. https://doi.org/10.1111/polp.12579.

Ayanoore, Ishmael, and Sam Hickey. 2022. “Reframing the Politics of Natural Resource Governance in Africa: Insights from the Local Content Legislation Process in Ghana.” Politics & Policy 50(1): 119–36. https://doi.org/10.1111/polp.12449.

Kuyini Mohammed, Abdulai. 2013. “Civic Engagement in Public Policy Making: Fad or Reality in Ghana?” Politics & Policy 41(1): 117–52. https://doi.org/10.1111/polp.12003.
Privacy‐preserving federated data access and federated learning: Improved data sharing and AI model development in transfusion medicine
Authors: Li Na , Lewin Antoine , Ning Shuoyan , Waito Marianne , Zeller Michelle P. , Tinmouth Alan , Shih Andrew W. ,   The Canadian Transfusion Trials Group
Published: November 2024

Background

Health data comprise data from different aspects of healthcare including administrative, digital health, and research‐oriented data. Together, health data contribute to and inform healthcare operations, patient care, and research. Integrating artificial intelligence (AI) into healthcare requires understanding these data infrastructures and addressing challenges such as data availability, privacy, and governance. Federated learning (FL), a decentralized AI training approach, addresses these challenges by allowing models to learn from diverse datasets without data leaving its source, thus ensuring privacy and security are maintained. This report introduces FL and discusses its potential in transfusion medicine and blood supply chain management.

Methods and Discussion

FL can offer significant benefits in transfusion medicine by enhancing predictive analytics, personalized medicine, and operational efficiency. Predictive models trained on diverse datasets by FL can improve accuracy in forecasting blood transfusion demands. Personalized treatment plans can be refined by aggregating patient data from multiple institutions using FL, reducing adverse reactions and improving outcomes. Operational efficiency can also be achieved through precise demand forecasting and optimized logistics. Despite its advantages, FL faces challenges such as data standardization, governance, and bias. Harmonizing diverse data sources and ensuring fair, unbiased models require advanced analytical solutions. Robust IT infrastructure and specialized expertise are needed for successful FL implementation.

Conclusion

FL represents a transformative approach to AI development in healthcare, particularly in transfusion medicine. By leveraging diverse datasets while maintaining data privacy, FL has the potential to enhance predictions, support personalized treatments, and optimize resource management, ultimately improving patient care and healthcare efficiency.
Long‐term orientation and outward foreign direct investment: Evidence from Chinese listed firms
Authors: Cheng Bowen , Dong Baomin
Published: November 2024

There is growing interest in comprehending how cultural traits affect firms' behaviour. In this paper, we examine the effect of managerial long‐term orientation (LTO), an intrinsic cultural trait, on the firms' foreign direct investment (FDI) decisions. Our empirical analysis indicates that the LTO plays a positive role in firms' FDI decisions and the results remain robust when subjected to a variety of robustness tests. To address potential endogeneity concerns, we employ the CEOs' early‐life disaster experience as an instrumental variable. Further examination reveals that financing costs act as a mechanism through which the LTO influences firms' FDI. Finally, heterogeneity analysis indicates that the positive effect of LTO on OFDI is more pronounced for greenfield relative to brownfield FDI, for small‐size firms relative to large‐size firms and for private firms relative to state‐owned firms.
Respiratory delivery of single low-dose nebulized PFCE-C25 NEs for lymphatic transport and durable stimulation of antitumor immunity in lung cancer
Authors: Rong A  , Han Zhaoguo , Zhou Meifang , Nie Chaoqun , Zhu Mengyuan , Cheng Sijie , Wang Tianyi , Wang Jing , Quan Zhen , Wang Kaiqi , Liu Shanshan , Hu Xinxin , Wang Haoyu , Wang Jiannan , Wu Yongyi , Sun Xilin
Published: November 2024

The currently available immune checkpoint inhibitors (ICIs) often fail to achieve the desired clinical outcomes due to inadequate immune activation, particularly in patients with lung cancer. To reverse this situation, we synthesized inhalable PFCE-C25 nanoemulsions (NEs), which target lymphocyte activation genes (LAG-3) on immune cells within tumor microenvironment and tumor-draining lymph nodes (TDLNs). By combining in vivo
19
F-MR molecular imaging, we investigate the immunological effects of a single low-dose PFCE-C25 NEs in multiple murine lung cancer models, including human immune system (HIS) mouse models, and validated its immunological effects in human TDLNs. The nebulization therapy with PFCE-C25 NEs demonstrated a notable and enduring maturation of dendritic cells (DCs) in TDLNs, leading to systemic immune responses, prolonged survival, the establishment of immune memory, and resistance to tumor rechallenge. Thus, PFCE-C25 NEs successfully demonstrate a promising and efficient approach for enhancing lymphatic transport and sustained activation of antitumor immune responses in lung cancer.
FERONIA adjusts CC1 phosphorylation to control microtubule array behavior in response to salt stress
Authors: Liu Xin , Wang Liu , Liu Linlin , Li Yuan , Ogden Michael , Somssich Marc , Liu Yutong , Zhang Yuwen , Ran Minyuan , Persson Staffan , Zhao Chunzhao
Published: November 2024

Cell wall remodeling is important for plants to adapt to environmental stress. Under salt stress, cortical microtubules undergo a depolymerization-reassembly process to promote the biosynthesis of stress-adaptive cellulose, but the regulatory mechanisms underlying this process are still largely unknown. In this study, we reveal that FERONIA (FER), a potential cell wall sensor, interacts with COMPANION OF CELLULOSE SYNTHASE1 (CC1) and its closest homolog, CC2, two proteins that are required for cortical microtubule reassembly under salt stress. Biochemical data indicate that FER phosphorylates CC1 on multiple residues in its second and third hydrophobic microtubule-binding regions and that these phosphorylations modulate CC1 trafficking and affect the ability of CC1 to engage with microtubules. Furthermore, CC1 phosphorylation level is altered upon exposure to salt stress, which coincides with the changes of microtubule organization. Together, our study outlines an important intracellular mechanism that maintains microtubule arrays during salt exposure in plant cells.
Molecular principles of the assembly and construction of a carboxysome shell
Authors: Wang Peng , Li Jianxun , Li Tianpei , Li Kang , Ng Pei Cing , Wang Saimeng , Chriscoli Vincent , Basle Arnaud , Marles-Wright Jon , Zhang Yu-Zhong , Liu Lu-Ning
Published: November 2024

Intracellular compartmentalization enhances biological reactions, crucial for cellular function and survival. An example is the carboxysome, a bacterial microcompartment for CO
2
fixation. The carboxysome uses a polyhedral protein shell made of hexamers, pentamers, and trimers to encapsulate Rubisco, increasing CO
2
levels near Rubisco to enhance carboxylation. Despite their role in the global carbon cycle, the molecular mechanisms behind carboxysome shell assembly remain unclear. Here, we present a structural characterization of α-carboxysome shells generated from recombinant systems, which contain all shell proteins and the scaffolding protein CsoS2. Atomic-resolution cryo–electron microscopy of the shell assemblies, with a maximal size of 54 nm, unveil diverse assembly interfaces between shell proteins, detailed interactions of CsoS2 with shell proteins to drive shell assembly, and the formation of heterohexamers and heteropentamers by different shell protein paralogs, facilitating the assembly of larger empty shells. Our findings provide mechanistic insights into the construction principles of α-carboxysome shells and the role of CsoS2 in governing α-carboxysome assembly and functionality.
Rapid spread of the SARS-CoV-2 Omicron XDR lineage derived from recombination between XBB and BA.2.86 subvariants circulating in Brazil in late 2023
Authors: Arantes Ighor , Ito Kimihito , Gomes Marcelo , Carvalho Felipe Cotrim de , Ferreira de Almeida Walquiria Aparecida , Khouri Ricardo , Miyajima Fabio , Wallau Gabriel Luz , Naveca Felipe Gomes , Pereira Elisa Cavalcante ,   COVID-19 Fiocruz Genomic Surveillance Network, Mendonça Siqueira Marilda , Resende Paola Cristina , Bello Gonzalo
Published: November 2024

Recombination plays a crucial role in the evolution of SARS-CoV-2. The Omicron XBB* recombinant lineages are a noteworthy example, as they have been the dominant SARS-CoV-2 variant worldwide in the first half of 2023. Since November 2023, a new recombinant lineage between Omicron subvariants XBB and BA.2.86, designated XDR, has been detected mainly in Brazil. In this study, we reconstructed the spatiotemporal dynamics and estimated the absolute and relative transmissibility of the XDR lineage. The XDR lineage displayed a recombination breakpoint in the ORF1a-coding region, and the most closely related sequences to the 5′ and 3′ ends of the recombinant correspond to JD.1.1 and JN.1.1 lineages, respectively. The first XDR sequences were detected in November 2023 in the Northeastern Brazilian region, and their prevalence rapidly surged from <1% to 25% by February 2024. The Bayesian phylogeographic analysis supports that the XDR lineage likely emerged in the Northeastern Brazilian region around late October 2023 and rapidly disseminated within and outside Brazilian borders from mid-November onward. The median effective reproductive number of the XDR lineage in Brazil during the initial expansion phase was estimated to be around 1.5, and the average relative instantaneous reproduction numbers of XDR and JN* lineages were estimated to be 1.37 and 1.29 higher than that of co-circulating XBB* lineages. In summary, these findings support that the recombinant lineage XDR arose in the Northeastern Brazilian region in October 2023, shortly after the first detection of JN.1 sequences in the country. In Brazil, the XDR lineage exhibited a higher transmissibility level than its parental XBB.* lineages and is spreading at a rate similar to or slightly faster than the JN.1* lineages.

IMPORTANCE

This study highlights the emergence and rapid dissemination of the recombinant SARS-CoV-2 XDR lineage, derived from the Omicron lineages JD.1.1 and JN.1.1. The XDR lineage exhibited equivalent transmissibility to its JN.1* parental lineages and quickly spread across Brazil in late 2023. The findings underscore the critical role of real-time genomic surveillance in detecting novel variants with higher transmission potential. By utilizing phylogenetic and epidemiological methods, this research provides important insights into the molecular dynamics of XDR, which could inform public health responses and vaccine composition updates. The study’s significance lies in its ability to document the impact of recombination on viral evolution, offering valuable information to the field of virology and pandemic preparedness.
Management of Legg-Calve-Perthes disease: a scoping review with advice on initial management
Authors: Beni Rebecca , Hussain Sabba A , Monsell Fergal , Gelfer Yael
Published: November 2024

Background

Legg-Calve-Perthes disease (LCPD) is a developmental disorder causing avascular necrosis of the femoral head in children, with long-term consequences that can extend into adulthood. Early diagnosis and management in primary care are crucial but challenging.

Aim

This review aims to provide a concise overview of the presentation, differential diagnosis and management of LCPD, offering practical guidance for primary healthcare professionals.

Method

Recent literature and expert opinions were reviewed to summarise the epidemiology, diagnosis and current management of LCPD.

Results

LCPD commonly presents as a painless limp in children aged between 2 and 14 years, with the diagnosis based on the clinical features and radiographic abnormalities. Management is individualised and includes non-operative care to surgery, which attempts to correct anatomical abnormalities and therefore delay the onset of osteoarthritis. The review highlights the importance of primary care in early detection, appropriate referral and interim management.

Conclusion

LCPD is a rare condition that can lead to long-term disability, affecting a child's physical, mental and social development, often presenting as a painless limp. Diagnosis typically involves plain radiographs, with MRI or hip joint arthrography providing additional details for management, which may include both non-surgical (eg, physiotherapy) and surgical options. Early recognition by primary care providers is crucial for timely referral to orthopaedic services, along with interim support through physiotherapy, pain management and access to mental health and educational resources.
Traumatic bilateral internuclear ophthalmoplegia with plus syndrome
Authors: Oinam Somapika Devi , Hingorani-Bang Puja
Published: November 2024

A young man in his 20s sustained head and body injuries after a fall from a height, 1 year ago for which he received emergency medical and surgical intervention. A month after the trauma, he noticed outward deviation of the right eye intermittently but did not experience diplopia. On examination, he had a bilateral adduction deficit, bilateral abduction nystagmus and a bilateral vertical nystagmus. The MRI (plain) showed an old haematoma with haemosiderin staining of the posterior midbrain and pons (extending to the bilateral medial longitudinal fasciculi). The patient was managed conservatively and was followed up closely. The present case describes bilateral internuclear ophthalmoplegia presenting subtly (without manifest exotropia or accompanying diplopia); hence, the condition remained undiagnosed. Though internuclear ophthalmoplegia (INO) due to demyelinating disease, ischaemia and infection may have a good prognosis; INO due to traumatic haemorrhage with chronic haematoma formation may take time to recover or become irreversible.
Machine learning approaches to injury risk prediction in sport: a scoping review with evidence synthesis
Authors: Leckey Christopher , van Dyk Nicol , Doherty Cailbhe , Lawlor Aonghus , Delahunt Eamonn
Published: November 2024

Objective

This study reviewed the current state of machine learning (ML) research for the prediction of sports-related injuries. It aimed to chart the various approaches used and assess their efficacy, considering factors such as data heterogeneity, model specificity and contextual factors when developing predictive models.

Design

Scoping review.

Data sources

PubMed, EMBASE, SportDiscus and IEEEXplore.

Results

In total, 1241 studies were identified, 58 full texts were screened, and 38 relevant studies were reviewed and charted. Football (soccer) was the most commonly investigated sport. Area under the curve (AUC) was the most common means of model evaluation; it was reported in 71% of studies. In 60% of studies, tree-based solutions provided the highest statistical predictive performance. Random Forest and Extreme Gradient Boosting (XGBoost) were found to provide the highest performance for injury risk prediction. Logistic regression outperformed ML methods in 4 out of 12 studies. Three studies reported model performance of AUC>0.9, yet the clinical relevance is questionable.

Conclusions

A variety of different ML models have been applied to the prediction of sports-related injuries. While several studies report strong predictive performance, their clinical utility can be limited, with wide prediction windows or broad definitions of injury. The efficacy of ML is hampered by small datasets and numerous methodological heterogeneities (cohort sizes, definition of injury and dependent variables), which were common across the reviewed studies.
Indigenous-led struggles for health justice in the context of the climate emergency: insights from Guatemala
Authors: Samuel Jeannie , Batzin Benilda , Medina Rosaura , Caal Evaristo , Slowing Karin , Sabbatasso Esteban , Flores Walter
Published: November 2024

This practice paper reflects on an ongoing Participatory Action Research project that combines community-engaged methods, national data analysis and advocacy to support community-based emergency response to extreme weather events in 16 Indigenous communities in Alta Verapaz province, Guatemala. Our work points to a worrying predicament experienced in climate-affected areas, where some populations face a dangerous confluence of climate vulnerability, social exclusion and state abandonment that imperils human health. Indigenous communities in Alta Verapaz are often particularly vulnerable to health impacts from climate-driven extreme weather events, a reality compounded by the historical and contemporary ways the state marginalises them. We share work from our project activities to shed light on these interconnected problems and how Indigenous communities in Alta Verapaz, especially Maya Q’eqchi’ communities, are using creative strategies to confront them. Technical solutions are important but insufficient responses. Community-led activism to push for state support to address extreme weather events, as has been practised in struggles for health rights, can provide vital tools for addressing the increasing challenges these populations face in the context of the climate crisis.
Exploring the use of ChatGPT-4o in enhancing career development counseling for medical students: a study protocol
Authors: Tang Haitao , Wang Jinsong , Liu Qiang , Bao Ji , Zeng Wen
Published: November 2024

Background

The advent of pre-trained generative transformers, exemplified by ChatGPT, has significantly impacted medical education, catalysing a wealth of research focused on enhancing educational methodologies. Despite this, the application of ChatGPT in the specific area of career planning for medical students remains relatively unexplored. This study seeks to rigorously evaluate the potential of ChatGPT-4o in facilitating the career planning of medical students, comparing its effectiveness with that of traditional human educators. It also aims to identify optimal strategies for integrating ChatGPT-4o with human educators to maximise support in career planning for medical students.

Methods

Adopting a mixed-methods approach, this research combines qualitative insights from interviews with quantitative data from questionnaires. The research is bifurcated into two primary segments: first, evaluating the proficiency of ChatGPT-4o in aiding medical students’ career planning, and second, identifying effective collaborative practices between ChatGPT-4o and human educators.

Discussion

The study focuses on assessing ChatGPT-4o’s utility in career planning for medical students and determining how it can be best used within medical education by both educators and students. The aim is to augment the career planning consultation process, thereby enhancing the efficiency and quality of human educators’ contributions. This includes exploring how ChatGPT-4o can supplement traditional teaching methods, providing a more robust and comprehensive support system for career planning in medical education.
Methods of detection of adverse events in critical care: a protocol for a systematic review
Authors: Gorman Jay , Kung Janice Y , Rewa Oleksa , Widder Sandy , Slemko Jocelyn
Published: November 2024

Introduction

Adverse events, defined as unintended patient harm contributed to by healthcare, continue to increase morbidity, mortality and cost. Critically ill patients are at high risk of adverse events; however, the optimal approach to detection in this setting is unknown. Numerous approaches have been used, including voluntary reporting, chart reviews and trigger tools. The objective of this systematic review is to gain insight into the capacity of individual methods to detect adverse events in the intensive care unit (ICU), to inform implementation, and to facilitate quality improvement.

Methods and analysis

Ovid MEDLINE, Ovid EMBASE, CINAHL, the Cochrane Library and Google Scholar were searched on 2 October 2023 for randomised controlled trials and observational studies evaluating the implementation or ongoing use of one or more systems of detection of adverse events in ICUs (neonatal to adult). Outcomes will include the total number of adverse events identified by detection method per 100 patient days (primary outcome), categories of adverse events, associated harm and whether detection informed quality improvement. A risk of bias assessment will be performed. The results will provide insight into each method’s capacity to detect adverse events in addition to their associated severity.

Ethics and dissemination

Ethics approval was not required as patient data will not be collected. A manuscript will be submitted to a peer-reviewed scientific journal.

PROSPERO registration number

CRD42024466584.
Value-based healthcare from a military health system perspective: a systematic review
Authors: van der Wal Henk , Duijnkerke Damon , Engel Maarten F M , Hoencamp Rigo , Hazelzet Jan Antonius
Published: November 2024

Objectives

The aim of this systematic review was to provide an overview of value-based healthcare (VBHC) strategies and/or components within military medicine. For this purpose, the extent to which VBHC has been applied within a military health system (MHS), with emphasis on military trauma care was assessed.

Design

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources

Medline, Embase, Web of Science CC and the Cochrane CRCT databases were searched from 1946 to present for VBHC strategies and/or components and military settings, including associated keywords.

Eligibility criteria for selecting studies

We included observational and trial studies focused on the presence of VBHC components and/or system, and the presence of acute/trauma operational care or definitive postoperational care regarding combat injured service members. The included articles were classified into injury-related and system-level studies.

Data extraction and synthesis

Two independent reviewers used standardised methods to search, screen and code included studies. For quality assessment, the Mixed Methods Appraisal Tool version 2018 was used.

Results

A total of 3241 publications were screened, and 18 were included for data extraction. 15 studies focused on (military) medical trauma-related conditions (injury groups), and 3 studies focused on an MHS approach. Four articles contained the two VBHC components (‘creating an integrated practice unit’ and ‘measuring outcomes and costs for every patient’) considered the basis for successful implementation. The ‘outcomes and costs’ and ‘patient-centred care’ components were most prevalent as respectively mentioned in 17 and 8 included studies.

Conclusion

The systematic review showed the application of VBHC components in military medicine, although use of standard VBHC terminology is not consistently applied. This study suggests that implementing VBHC as a concept in military healthcare, could enhance benchmarking to provide insight in health outcomes (both clinically and patient-reported), and overall quality of care.
Health economics of virtual versus face-to-face glaucoma clinics: a time-driven activity-based costing study
Authors: Shah Vishal , Jackson Timothy L , Edwards Rhiannon Tudor , Attlee Joel , Kailani Obeda
Published: November 2024

Background/Aims

Staffing represents the most significant cost to the National Health Service, and ophthalmology is its largest outpatient specialty. Value-based healthcare (VBH) focuses on care processes. Innovative models include a shift towards ‘virtual’ glaucoma services. We used VBH costing methodology to quantify personnel costs of virtual and face-to-face (F2F) glaucoma clinics.

Methods

Virtual and F2F clinics were process-mapped to produce step-by-step pathways of patients in each setting. Real-world timings were then audited, and time-driven activity-based costing was used to calculate the personnel cost-per-patient for both settings.

Results

Data were captured from 24 consecutive virtual glaucoma patients and 42 consecutive patients across two F2F clinics. The capacity cost rates in £/min were £0.24 for technicians and £1.16 for consultants. The average time taken to acquire clinical data in the virtual pathway was 39 min per patient (95% CI 36 to 43, range 27–61) with 14 min (95% CI 13 to 14, range 12–20) for their remote consultant review. The estimated personnel costs associated with a single virtual glaucoma clinic visit totalled £25.60 (95% CI £23.72 to £33.52). The average time taken to be seen in the F2F clinic was 50 min (95% CI 42 to 59 min, range 12–123 min) with a personnel cost of £31.08 (95% CI £19.70-£42.43).

Conclusion

Staff costs associated with visits to the consultant-delivered virtual and F2F glaucoma clinics were similar (p value=0.14), supporting virtual clinics to provide service capacity. The main limitations were that our study involved a single site, small sample size and did not consider the severity of glaucoma.
Embryoid body-based differentiation of human-induced pluripotent stem cells into cells with a corneal stromal keratocyte phenotype
Authors: Chen Jie , Ou Qingjian , Liu Yifan , Cui Tingting , Yang Huimin , Tang Jiancen , Lu Lixia , Xu Guotong , Cui Hongping , Jin Caixia , Li Qian
Published: November 2024

Objective

The transparency of the cornea is determined by the extracellular matrix, which is secreted by corneal stromal keratocytes (CSKs). Human-induced pluripotent stem cell (hiPSC)-derived keratocytes (hiPSC-CSKs) can be used in cell-based therapy for treating corneal blindness. Our goal was to develop an effective small molecule-based technique for differentiating hiPSCs into keratocytes.

Methods and analysis

hiPSCs were cultured in chemically defined medium, and embryoid bodies (EBs) were generated; these EBs were induced into CSKs using keratocyte-differentiated medium. The expression of keratocyte-specific markers was assessed using quantitative RT-PCR, immunostaining and Western blotting.

Results

We found that the expression of genes encoding keratocyte markers, including aldehyde dehydrogenase 1 family member A1 (ALDH1A1), lumican and keratocan, was upregulated. Immunostaining showed positive staining for ALDH1A1 and keratocan in the hiPSC-CSK samples. Similarly, western blot analysis indicated that ALDH1A1 and keratocan expression levels were significantly greater in the hiPSC-CSKs than in the control cells. In addition, hiPSC-CSKs were not transformed into fibroblasts or myofibroblasts.

Conclusion

We established an innovative and effective method to generate CSKs via the EB-based differentiation of hiPSCs, which might be employed for cell-based therapy of corneal stromal opacities.
Clot-in-transit and pulmonary embolism: an urgent call for awareness and action
Authors: Di Marino Mario , Cicchitti Vincenzo , Ianni Umberto , Ricci Fabrizio , Mantini Cesare , Niccoli Giampaolo , Pelliccia Francesco , Gallina Sabina , De Caterina Raffaele , Kaski Juan-Carlos , Mamas Mamas A , Zimarino Marco
Published: November 2024

Patients with acute pulmonary embolism (PE) have a wide spectrum of clinical presentations, from incidental findings to sudden cardiac death. Management and treatment recommendations in currently available guidelines vary according to patient risk and haemodynamic profile. A clot-in-transit (CiT) in the right heart chambers may be occasionally identified and is, therefore, an under-recognised but challenging condition, often preceding an abrupt clinical deterioration, and associated with increased mortality. Data on the detection of a CiT are sparse but consistent in attributing negative prognostic relevance, and therefore the presence of CiT should be systematically investigated and recorded in the setting of PE.

In this review, the challenges related to the identification of a CiT are highlighted. Here, we propose an algorithm where the role of the Pulmonary Embolism Response Team (PERT) is reinforced. The PERT should convene once the CiT is suspected, to define the timeline for the diagnostic steps and subsequent management on a case-by-case basis. A patient with PE and CiT requires close bedside monitoring and rapid escalation therapy in case of clinical deterioration. Beyond anticoagulation alone, more aggressive strategies can be considered, including systemic thrombolysis, surgical pulmonary embolectomy and the currently emerging catheter-directed therapies. PROSPERO registration number: CRD42024493303.
Psychosocial risks faced by olive workers in Spain: evaluated using the ‘Mini Psychosocial Factors’ questionnaire
Authors: Olivencia-Manzano María , Gómez-Galán Marta , Díaz-Pérez Manuel , Callejon-Ferre Angel Jesus
Published: November 2024

Background

Spain has the largest olive-growing area in Europe. The goal of the present research is to evaluate the psychosocial risks faced by workers in the olive groves of Jaén (the largest olive grove region of Spain).

Method

This method consists of 15 questions that analyse a total of 12 variables (mental load, demands, health, etc). A total of 502 questionnaires were completed. The method was performed using a non-stratified (with respect to the location of the growing areas) random selection with ‘Universal Transverse Mercator’ coordinates on a map of Jaen extracted from Andalusia region mapping. Multiple correspondence analysis, the Burt table and descriptive statistics (with a χ2test) have been used to analyse the results.

Results

The responses of all the workers are identified in detail in the Burt table. Olive grove workers, regardless of their characteristics or the type of farm, are at a medium risk level for the different psychosocial factors (around 57% on average). The low-risk level is the next most common (around 36% on average). On average, only 7% of individuals are found at the high-risk level (only intensive olive groves exceed 10% of individuals at this risk level). Using multiple correspondence analysis, a video has been created to demonstrate the relationship between all the categories of all the variables studied from various perspectives in three dimensions. The first dimension captures mainly aspects of the social working environment (relation, recognition, support, compensation, control, mental load), whereas the second dimension captures mainly work demands (rhythm, demands). The third dimension is more about physical status (weight, body mass index).

Conclusion

The risks found will improve injury prevention and are possibly caused by mismanagement of prevention. The extreme drought conditions of the 2022/2023 agricultural season could have affected the demands faced by workers.
Epidemiology of burn injuries in a Canadian population during the COVID-19 pandemic
Authors: Michelberger Alexander , Macpherson Alison K , Rotondi Michael
Published: November 2024

Objective

The COVID-19 pandemic affected burn injury patterns in many countries, but literature on this topic in Canada is limited. The objective of this study is to investigate the changes in the epidemiology of burn injuries in a Canadian population during the COVID-19 pandemic.

Methods

Data from the Canadian Institute for Health Information were used to evaluate differences in emergency department visits before and during the COVID-19 pandemic. Logistic regression models estimated the odds of a severe burn occurrence.

Results

During the pandemic, there were significant decreases in emergency department visits for burns. Distributions of factors associated with burns showed little to no change. The pandemic period, age, sex, income, month and time of day were significantly associated with severe burns during the study time period.

Conclusions

The study found large reductions in the number of emergency department visits during the pandemic, but no evidence of changes in the epidemiology of burns or patterns in the patient populations. Demographic factors associated with severe burns were identified. These factors should be studied to deepen the understanding of the relationship between burn injuries and patient populations.
Analysing programme implementation across districts: a qualitative study of a national falls prevention initiative for older people in New Zealand
Authors: Pirouzi Maryam , Selak Vanessa , Tenbensel Tim
Published: November 2024

Background

Falls among older people are a major cause of the global burden of disease. This study investigated the implementation of the Falls and Fracture Prevention Programme, a multicomponent population-based intervention, across diverse districts in New Zealand.

Methods

We conducted a comparative case study through 28 semi-structured interviews with programme coordinators and managers across four districts. Transcripts were analysed using the programme framework, focusing on the implementation and outcomes of three primary components: Community Strength and Balance, In-Home Strength and Balance and Fracture Liaison Service.

Results

We found both similarities and differences in the implementation of the programme’s components. All districts successfully engaged community providers to deliver accredited group exercises for Community Strength and Balance, though there were variations in human resources and community awareness of sessions. In-Home Strength and Balance implementation differed, affecting attendance, with successful implementation linked to empowering private physiotherapy organisations; however, funding withdrawal raised sustainability concerns. Variations in the Fracture Liaison Service implementation underscored inconsistencies in patient identification, highlighting the importance of primary care engagement and standardised protocols. Primary care involvement across all components was essential for successful implementation, and districts with higher primary care engagement and well-planned awareness sessions reported increased patient attendance.

Conclusions

Overall, effective screening, primary care engagement and collaboration with private organisations and community providers were vital for the successful implementation of this population-based falls prevention programme.