bluuebunny/crossref_metadata_2025 huggingface dataset:
Genomic Signatures of Adaptation Across a Precipitation Gradient From Niche Centre to Niche Edge
Authors: Van Deurs Samantha , Reutimann Oliver , Luqman Hirzi , Lifshitz Dikla , Mayzlish‐Gati Einav , Alexander Jake , Fior Simone
Published: February 2025

Evaluating the potential for species to adapt to changing climates relies on understanding current patterns of adaptive variation and selection, which might vary in intensity across a species' niche, hence affecting our inference of where adaptation might be most important in the future. Here, we investigate the genetic basis of adaptation in Lactuca serriola along a steep precipitation gradient in Israel approaching the species' arid niche limit and use candidate loci to inform predictions of its past and future adaptive evolution. Environmental association analyses combined with generalised dissimilarity models revealed 108 candidate genes showing nonlinear shifts in allele frequencies across the gradient, with 66% of these genes under strong selection near the dry niche edge. We detected selection acting on genes with separate suites of biological functions, specifically related to phenology and responses to environmental stressors, including osmotic stress, at the dry niche edge, and related to biotic interactions and defence closer to the niche centre. The adaptive genetic composition of populations, as inferred through polygenic risk scores, point to intensified selection operating towards the dry niche edge. However, inference of past and future evolutionary change predicts larger adaptive shifts occurring in the mesic part of the range, which is most affected by climate change. Our study reveals that adaptive shifts in response to climate change can be heterogeneous across a species' range and not necessarily strongest near its niche edge.
An optimized and precise road crack segmentation network in complex scenarios
Authors: Wang Gang , He MingFang , Liu Genhua , Li Liujun , Liu Exian , Zhou Guoxiong
Published: February 2025

Road cracks pose a serious threat to the stability of road structures and traffic safety. Therefore, this paper proposes an optimized accurate road crack segmentation network called MBGBNet, which can solve the problems of complex background, tiny cracks, and irregular edges in road segmentation. First, multi‐scale domain feature aggregation is proposed to address the interference of complex background. Second, bidirectional embedding fusion adaptive attention is proposed to capture the features of tiny cracks, and finally, Gaussian weighted edge segmentation algorithm is proposed to ensure the accuracy of crack edge segmentation. In addition, this paper uses the preheated bat optimization algorithm, which can quickly determine the optimal learning rate to converge the equilibrium. In the validation experiments on the self‐built dataset, mean intersection over union reaches 80.54% and precision of 86.38%. MBGBNet outperforms the other seven state‐of‐the‐art crack segmentation networks on the three classical crack datasets, highlighting its advanced segmentation capabilities. Therefore, MBGBNet is an effective auxiliary method for solving road safety problems.
Investigating Asthma After Coccidioidomycosis Among Patients With Commercial Health Insurance, United States, 2017–2022
Authors: Benedict Kaitlin , Smith Dallas J. , Haczku Angela , Zeki Amir A. , Hsu Joy , Toda Mitsuru , Kenyon Nicholas J. , Thompson George R.
Published: February 2025

Background

The relationship between asthma and coccidioidomycosis has not been fully described. We have hypothesised that Coccidioides could trigger inflammatory airway responses, similar to other fungi. Objectives: To estimate the frequency of new‐onset asthma‐related symptoms after coccidioidomycosis and identify potentially associated factors.

Patients/Methods

We used a large health insurance claims database to identify patients with coccidiomycosis with and without an asthma diagnosis code or a short‐acting β2 agonist prescription in the year after diagnosis.

Results

Thirteen per cent of 1657 patients with an asthma diagnosis code or a short‐acting β2 agonist prescription (median 2.5 months later).

Conclusions

Increased healthcare provider awareness of asthma as a potential coccidioidomycosis complication could benefit patients, especially female patients and patients with severe pulmonary infection.
Investigating the Impact of Açai (Euterpe oleracea) on Lipid Profile: A Comprehensive Systematic Review and Meta‐Analysis
Authors: Candeloro Bruno Moreira , Bitencourt Túlio H. B. , Elias Sergio F. R. , Rauli Maria Clara , Brandão Isabela B. , Barbalho Sandra Maria , Garner David M. , Raimundo Rodrigo D. , Porto Andrey A. , Valenti Vitor E.
Published: February 2025

Conditions such as obesity and cardiovascular diseases represent significant global public health challenges, driven by their increasing prevalence and profound effects on morbidity and mortality. Dyslipidemia, defined by abnormal lipid concentrations, performs a pivotal role in the onset of cardiovascular diseases, especially atherosclerosis. Dietary strategies and other nonpharmacological interventions are crucial for the management of dyslipidemia. Açaí (Euterpe oleracea), a fruit native to the Amazon, is recognised for its antioxidant properties and potential impact on lipid metabolism. This systematic review and meta‐analysis aimed to assess the impact of açaí consumption on lipid profile markers. A systematic search was performed across several databases, including MEDLINE/PubMed, EMBASE, Web of Science and Scopus. We included non‐randomised, randomised, no blind, blind and control trials involving adult participants who received açaí in any form. The outcome measures included triglycerides, total cholesterol, LDL‐c and HDL‐c. The screening of studies and data extraction were independently conducted by four reviewers. The risk of bias was evaluated using the Cochrane Risk of Bias tool, and meta‐analyses were completed where applicable. Out of 188 identified studies, 8 met the inclusion criteria. Meta‐analysis of 411 participants displayed no significant effect of açaí on LDL‐c (MD = 6.06 mg/dL 95% CI: −0.03, 12.48, p = 0.06), HDL‐c (MD = 0.30 mg/dL 95% CI: −1.54, 2.13, p = 0.75), total cholesterol (MD = 2.94 mg/dL 95% CI: −6.44, 12.31, p = 0.54) and triglycerides (MD = 2.05 mg/dL 95% CI: 1.79, 2.28, p = 0.59). Additionally, açaí consumption was related to a significant reduction in total lipids (MD = −9.80 g, 95% CI: −13.94 to −5.66, p < 0.001). GRADE evaluation pointed to low/very low certainty of evidence. Açaí consumption may lessen total lipid levels, but no significant effect was noted for cholesterol parameters and triglycerides. Further trials with more demanding research methodologies are required to clarify the effects of açaí on lipid profiles.

Trial Registration: CRD42024549531
Optimized Predator‐Prey and MPA Based Fishing Strategies for the Baltic Sea
Authors: Taylor Simon , Braack Malte
Published: February 2025

Marine protected areas (MPAs) have become the de‐facto mechanism for marine species conservation and management and the ecological benefits of no take zones (NTZs) are supported by an expanding scientific interest in their effectiveness. However, in the south‐western Baltic region there is a paucity of studies on the validity of MPAs, possibly due to the lack of enforcement. In this work we investigate the effects of nonconstant harvesting of a resource simultaneously under predation pressure. We use a functional response of the predator dependent Crowley‐Martin type in age‐structured state equations of a fixed time‐horizon optimal control problem, wherein a pre‐existing MPA may be encountered. Where available, only peer‐reviewed data and biomass stock levels are used for biological parameters in the state equations. Our results for the prey component of the model show that a moderate penalty exists that yields the same benefits as a fully closed reserve. However, taking into account the whole system we observe that an NTZ benefits the predator species too.
Functional traits and phylogenetic structure based on root neighborhoods shape the mechanisms of species coexistence in underground communities
Authors: Liu Minxia , Miao Lele , Yang Chunliang , Zhang Xin
Published: February 2025

Roots exhibit a wide range of morphological diversity and symbiotic relationships, which makes it challenging to find general patterns among different taxa under different ecological conditions. Competitive exclusion and environmental filtering can drive species coexistence and diversity maintenance mechanisms. However, it remains to be seen how these two mechanisms shape the functional characteristics and phylogenetic structure of root neighborhoods, and this lack of information hinders our understanding of the processes that build subterranean communities and maintain diversity. We randomly selected 675 root clusters from 207 soil samples along a latitudinal gradient in the northeastern Qinghai‐Tibet Plateau, China. We focused on eight root functional traits of 110 herbaceous species and analyzed root neighbors' functional traits and phylogenetic structure concerning environmental factors. The root system's phylogenetic structure and functional characteristics varied dramatically along the latitudinal gradient. First, the phylogenetic structure changed at a latitude of 35°12′00″N, diverging at a low latitude of 33°03′36″N and aggregating at a high latitude of 37°36′36″N. Second, root neighborhood functional trait aggregation was prevalent in individual root traits (72% of traits). Functional divergence (28% of traits) appeared to be associated with changes in environmental factors, showing a multidimensional adaptive synthesis. While environmental filtering can drive ecological niche differentiation of species to reduce competition, alternative rooting strategies may be equally important to promote resource use and species coexistence in the rooted neighborhood.
Fitness costs and benefits of a non‐native floral resource for subalpine solitary bees
Authors: Cahill Charlotte M. , CaraDonna Paul J. , Forrest Jessica R. K.
Published: February 2025

Organisms inhabiting seasonal environments must fit their life cycle into a limited time window while also synchronizing periods of resource consumption with timing of resource availability. Introduced non‐native species, which often differ in phenology from natives, can alter and expand the seasonal window of resource availability for native consumers, providing potential fitness benefits. However, if these non‐native resources are nutritionally unsuitable for native consumers, their presence could elicit foraging behaviour that proves maladaptive – i.e. they could act as an ecological trap. Here, we used multi‐year field observations and a laboratory experiment to investigate the impacts of a common non‐native plant species on two components of fitness in three solitary bee species (all specialist consumers of pollen from the plant family Asteraceae) native to the Colorado Rocky Mountains. First, we tested whether individual bees that collect pollen from the non‐native common dandelion Taraxacum officinale produce more offspring than those that do not, thanks to the unusually early flowering phenology of the non‐native. Second, we compared survival of bee larvae experimentally reared on Taraxacum pollen to that of larvae reared on native Asteraceae pollen. Bees that used at least some non‐native Taraxacum pollen produced more potentially viable offspring, but larval survival was significantly reduced for bee larvae experimentally fed provisions dominated by Taraxacum pollen. Therefore, survival costs may negate the potential fitness benefits of early nesting, indicating that non‐native floral resource use may act as an ecological trap for native bees. Using a series of simple simulations informed by our results, we explore the fitness effects of non‐native floral resource use, demonstrating that the net cost or benefit depends on how bees respond to resource shortages. Our results highlight the importance of considering organisms' full life cycles when evaluating the fitness consequences of resource availability and species introductions.
Predictors of Pain Concordance Among Caregiver–Child Dyads Undergoing Elective Surgery
Authors: Lim Paulina S. , Fortier Michelle A. , Kaplan Sherrie H. , Masague Sergio Gago , Kain Zeev N.
Published: February 2025

Background

A total of 80% of children experience postoperative pain following discharge. Effective postoperative pain management involves reliable caregiver pain assessment and/or child self‐report of pain. Unfortunately, caregiver and child ratings of postoperative pain are not always consistent (i.e., concordant). This study aimed to identify postoperative pain concordance among caregiver–child dyads and predictors for postoperative pain discordance.

Methods

Children and their caregivers completed preoperative baseline demographic, anxiety, and distress measures. Postoperatively, children and caregivers completed pain severity ratings using the Child Health Rating Inventories (CHRIS 2.0). On the basis of postoperative pain scores, caregiver–child dyads were classified as overestimators (i.e., caregivers rated pain as higher than children), in agreement, or underestimators (i.e., caregivers rated pain as lower than children).

Results

A large proportion of dyads disagreed on pain ratings (n = 104; 44%), with 64 (27%) caregivers classified as overestimators and 40 (17%) caregivers classified as underestimators. Caregivers were more likely to underestimate male children's pain, β = 1.238, OR = 3.35 (95% CI: 1.26, 9.43), p = 0.16, and Spanish–speaking Latinx caregivers were more likely to underestimate children's pain, β = 2.27, OR = 9.63 (95% CI: 2.35, 39.37), p = 0.002.

Conclusion

Although most caregiver–child dyads agreed with pain ratings, 44% of the dyads disagreed. Among those who disagreed, males from Spanish–speaking Latinx households were at greatest risk of having their pain underestimated by their caregiver, which could be explained by the influence of intersecting social identities on pain beliefs, expression, and behaviors. Future studies should explore how pain discrepancies influence postoperative recovery outcomes for Latinx children.
China's State‐Capitalist Development Model: Is It Viable in Ghana?
Authors: Abankwa Daniel
Published: February 2025

The relative success of China's state‐capitalist model has reignited debates about state centrality in economic growth and the feasibility of replicating the model in developing countries. Shedding new light on the ongoing dialogue, this study examines the viability of China's model in Ghana and applies the property rights, public choice, and principal‐agent theories to analyze State‐Owned Enterprise (SOE) reforms in Ghana and China. It argues that although Ghana's SOE sector under erstwhile President Nana Addo Dankwa Akufo‐Addo saw promising reforms mirroring China's early SOE reforms, the long‐term viability of a state‐capitalist approach is bleak. This is attributable to the non‐facilitatory political practices like regular political transitions and winner‐takes‐all politics, as well as the persistent operational inefficiencies in Ghana's SOE sector. The article contributes to the scholarly narrative suggesting that a wave of China's state capitalist model is gaining prominence in developing countries and potentially overshadowing the neoliberal economic systems prevalent in those countries.

Related Articles

Duggan, N. 2020. “China—The Champion of the Developing World: A Study of China's New Development Model and Its Role in Changing Global Economic Governance.” Politics & Policy 48, no. 5. https://doi.org/10.1111/polp.12377.

Ganda, W. D. 2020. “The China Model in Zimbabwe: The Belt and Road Initiative and Beyond.” Politics & Policy 48, no. 5. https://doi.org/10.1111/polp.12373.

Kinyondo, A. A. 2020. “Does Tanzania's Development Trajectory Borrow from the China Model?” Politics & Policy 48, no. 5:960–987. https://doi.org/10.1111/polp.12372.
Interplay of Polygenic Risk Score, Smoking Statuses, and Air Pollution on Lung Adenocarcinoma Risk in a Taiwanese Population
Authors: Chen I‐Chieh , Chen Yi‐Ming , Yang Hui‐Wen , Tseng Jeng‐Sen , Yang Tsung‐Ying
Published: February 2025

Background and Objective

We determined the impact of genetic susceptibility and its interaction with smoking and air pollution on the risk of developing lung adenocarcinoma.

Methods

This retrospective case–control study utilised data from Taiwan Precision Medicine Initiative (TPMI) project conducted between June 2019 and November 2022. The study population consisted of lung adenocarcinoma patients and 1:4 age‐, gender‐, and index year‐matched non‐lung cancer controls. We analysed polygenic risk scores (PRS), smoking status, as well as PM2.5 and PM10 exposures.

Results

A total of 681 lung adenocarcinoma patients and 2724 non‐lung cancer participants were included. PRS was significantly higher among lung adenocarcinoma patients than controls (p < 0.001). Overall, a higher PRS was associated with a higher risk of lung adenocarcinoma. A high PM2.5 exposure was associated with a higher risk of lung adenocarcinoma (OR 1.88 [95% CI 1.12–3.14], p = 0.0163) among never‐smokers with low genetic risk. Never‐smokers with a higher genetic risk were associated with a higher OR for lung adenocarcinoma with the highest OR among Q4 participants with high PM2.5 exposure (4.97 [95% CI 3.10–7.97], p < 0.001). There was no significant impact of PM2.5 exposure among individuals with higher genetic risks. Similar phenomena were observed in the PM10 analyses. There were no significant correlations of PRS with risk of lung adenocarcinoma among smokers.

Conclusion

PRS significantly predicted lung adenocarcinoma incident cases in a dose‐dependent manner among never‐smokers. The PRS effect was not noted in smokers. The results were consistent among participants exposed to different air pollution levels.

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Universal Multiplex Panel Testing of Donor Lungs as a Strategy to Optimize Antibiotic Prophylaxis Against Multidrug‐Resistant Bacteria
Authors: Abdulqawi Rayid , Saleh Rana A. , Alameer Reem M. , Alabiri Roaa , Alabiri Ruba , Alkattan Khaled , Almaghrabi Reem S. , Duhailib Zainab Al , Althawadi Sahar , Rahman Najib M. , Saleh Waleed , Yamani Amani H. , Al‐Mutairy Eid A.
Published: February 2025

Background

Twenty percent of lung donors in our transplant program carry respiratory carbapenem‐resistant (CR) gram‐negative bacteria (GNB), most commonly CR Acinetobacter baumannii. Universal multiplex panel testing of lung transplant donors was introduced in June 2022 as a strategy to expedite CR‐GNB detection and optimize perioperative antibiotic prophylaxis. We herein describe our experiences with this approach.

Methods

Retrospective single‐center cohort study including 53 adult patients who underwent lung‐only transplantation between June 2022 and December 2023.

Results

The most common bacteria identified by the multiplex panel were Staphylococcus aureus (n = 20), A. baumannii (n = 13), Klebsiella pneumoniae (n = 13), and Pseudomonas aeruginosa (n = 10). The panel detected 6/9 A. baumannii, 2/2 CR K. pneumoniae, 1/1 CR P. aeruginosa, and 7/8 methicillin‐resistant S. aureus that were grown on conventional cultures, corresponding to negative predictive values of 94%, 100%, 100%, and 98%. Based on panel or culture results, IV tigecycline was administered as prophylaxis in 19% of patients, colistin in 17%, and novel beta‐lactams in 15%.

Conclusion

The multiplex panel rapidly detected donor CR‐GNB with a high negative predictive value and resulted in clinical effects of reducing broad‐spectrum antibiotic prescriptions and maintaining adequate posttransplant outcomes. Prospective studies with predefined outcomes are needed to compare panel‐directed therapy against current standards of care.

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Aging and the Division of Labor of Theory of Mind Skills in Metaphor Comprehension
Authors: Ceccato Irene , Lecce Serena , Bischetti Luca , Mangiaterra Veronica , di San Pietro Chiara Barattieri , Cavallini Elena , Bambini Valentina
Published: February 2025

While some aspects of pragmatic competence are known to decline with age, for metaphor skills the evidence is inconclusive, possibly due to heterogeneity in the assessment tools. Furthermore, the previous literature on age‐related changes in pragmatic skills has rarely considered the role of Theory of Mind (ToM), which is described as one of the main factors affecting metaphor across theoretical and experimental studies in children and clinical populations. This study aimed at elucidating age‐related differences in metaphor understanding and the interplay between metaphor skills and ToM in middle‐aged and older adults with a fine‐grained approach. Participants (n = 201, age range 54–93) completed tasks assessing ToM and metaphor understanding. On the one side, we used the Physical and Mental Metaphors task, to distinguish between different types of metaphor (physical, such as “Lifeguards are lizards,” meaning that they lie in the sun, vs. mental, such as “Adolescents are pendulums,” meaning that they are emotionally unstable) and different aspects of metaphor understanding, namely, accuracy in finding a link between topic and vehicle versus type of interpretation (from physical to psychological). On the other side, we analyzed two aspects of ToM skills: the accuracy in mental state understanding and the intentionality, defined as the degree of mental state attribution, assessed with the Strange Stories and the Animated Social Triangles task, respectively. Structural equation models indicated a decline in metaphor skills with advancing age. Furthermore, we found that ToM is involved in metaphor understanding in a specific fashion. While higher ToM accuracy explained better metaphor accuracy, higher ToM intentionality explained better performance in the interpretation of mental, but not physical, metaphors. These findings suggest that age‐related differences in pragmatics extend to metaphor skills and that ToM plays a role in metaphor comprehension in older age, with a division of labor where the ability to understand what others think is key to spotting a metaphorical link, but the greater tendency to attribute mental states is what specifically helps when it comes to grasping the psychological nuances of a metaphor.
China Syndrome and Local Labor Markets: Sectoral Reallocation and Job Quality
Authors: Choi Jaehong , Chun Hyunbae , Hur Jung , Son Nyeong Seon
Published: February 2025

This paper examines the impact of Chinese import exposure on labour reallocation between the manufacturing and service sectors and its implications for job quality. To conduct this study, we focus on South Korea, an OECD country with the lowest labour productivity in the service sector compared to manufacturing. Our findings reveal that Chinese imports have led to employment shifts from manufacturing to the service sector within local labour markets. Additionally, exposure to Chinese imported products has decreased employment in non‐routine tasks and increased employment in routine tasks, resulting in a decline in job quality. These results suggest that in countries where the service sector is less productive than manufacturing, labour reallocation driven by Chinese imports can further exacerbate job quality issues.
E-professionalism assessment instruments in healthcare professionals: a systematic review protocol
Authors: de Castro Araújo-Neto Fernando , Gois dos Santos Lívia , Araújo Tavares Thaís Maria , de Menezes Santos Douglas , Pereira de Lyra-Jr Divaldo
Published: February 2025

Introduction

Social media has an impact on the reach and speed with which information is disseminated, benefiting patients and healthcare professionals by sharing knowledge, even from a distance. However, these channels can pose risks when used irresponsibly by these actors. Thus, e-professionalism emerges as a modulator of professionals’ behaviours and attitudes, and its evaluation is fundamental given the demand for quality in services, including in these settings. Thus, this study aims to identify instruments used to assess the e-professionalism of healthcare professionals.

Methods and analysis

A systematic review will be developed to answer the question: ‘How is e-professionalism in healthcare professionals evaluated in the literature?’. The searches will take place in the following databases: PUBMED/Medline, EMBASE, Web of Science, ERIC and Scopus using descriptors such as ‘professionalism’, ‘e-professionalism’, ‘social media’ and synonyms. Studies will be selected after evaluating titles and abstracts, followed by an analysis of full texts using the Rayyan tool. Studies that present the development and validation of e-professionalism assessment instruments for nursing, pharmacy, medicine and dentistry will be included. The quality of the instruments will be assessed based on evidence of content and construct validity reported by the developers.

Ethics and dissemination

This review is exempt from ethical approval because it does not include patient data. The results of the systematic review will be disseminated through a peer-reviewed journal and presented at a relevant conference.

PROSPERO registration number

CRD42023454825.
National yearly cost of breast cancer screening in the USA and projected cost of advocated guidelines: a simulation study with life table modelling
Authors: Badal Kimberly , Staib James , Tice Jeffrey A. , Kim Mi-Ok , Eklund Martin , Wilson Leslie , Dacosta Byfield Stacey , Catlett Kierstin , Maffey Liz , Soonavala Rashna , Shieh Yiwey , Esserman Laura J.
Published: February 2025

Objective

The aim of this study was to estimate the total national direct cost of breast cancer screening from 2019 to 2022 and project the total national cost and average lifetime cost of screening per woman for three current guidelines.

Design

We estimated the national cost of screening from 2019 to 2022, and per cancer detected in 2022, using real-world data on the number of mammograms performed per year. We also projected the national cost of screening using life table modelling for three guidelines: 2021/2023 American College of Radiology (ACR), 2023 American Cancer Society (ACS) and 2024 United States Preventative Services Task Force (USPSTF). The average lifetime cost to screen one woman until age 74 years with each guideline was also estimated. The Optum Labs Data Warehouse was used to estimate commercial and Medicare costs and recall rates. Sensitivity analyses were used to estimate uncertainty and determine which inputs had the largest impact on total national costs.

Setting

This study was conducted for the USA.

Participants

Women eligible for breast cancer screening.

Interventions

Digital mammograms (2D) or digital breast tomosynthesis (3D) and/or MRI.

Primary outcome measure

Total national cost of screening calculated as the sum of screening and recall costs. Average lifetime cost of screening per woman until 74 years.

Results

Nationally, screening cost approximately US$11 billion (B) per year from 2019 to 2022 with approximately 37% of eligible women screened each year. In 2022, screening cost US$55 471 per 3D-detected and US$44 000 per 2D-detected invasive or ductal carcinoma in situ case. Using target yearly participation rates of 54%–78% by age of women, the projected cost of screening was US$30B for ACR, US$18B for ACS and US$8B for USPSTF guidelines. The average lifetime cost to screen an average-risk woman was: US$13 416 for ACR, US$7946 for ACS and US$6931 for USPSTF. Participation rates, the proportion of women with a lifetime risk>20% and commercial MRI and 3D costs had the largest impact on total costs.

Conclusion

The cost of screening varies significantly by guideline (US$8B–US$30B) and was most influenced by participation rates, high-risk population proportions and technology costs. Future work can investigate whether risk-based screening strategies being tested in ongoing clinical trials can reduce national screening costs while improving outcomes.Cite Now
Association between Geriatric Nutritional Risk Index and survival outcomes in patients with urological cancers: an updated meta-analysis
Authors: Chen I-Wen , Hsu Jui-Hung , Huang Jing-Cyuan , Liu Wei-Cheng , Wu Jheng-Yan , Wang Kuei-Fen , Hung Kuo-Chuan
Published: February 2025

Objectives

This meta-analysis aimed to evaluate the association between the Geriatric Nutritional Risk Index (GNRI) and survival outcomes in patients with urological cancer.

Design

Systematic review and meta-analysis of observational studies.

Data sources

A comprehensive literature search was conducted in Medline, EMBASE, Google Scholar and the Cochrane Library from inception to 7 July 2024.

Eligibility criteria

Studies were included if they examined the correlation between the GNRI and long-term survival outcomes in adult patients (≥18 years old) with urological cancers.

Data extraction and synthesis

Two researchers independently extracted data and assessed study quality using the Newcastle-Ottawa Scale and certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology. Publication bias was evaluated using funnel plots and Egger’s test for outcomes with more than 10 studies. Pooled HRs and 95% CIs were calculated using a random-effects model. Subgroup analyses, meta-regression and sensitivity analyses were performed.

Results

17 studies involving 8816 patients were included. Study quality assessment showed that 15 studies had a low risk of bias (scores 7–9) and two had a high risk (scores 5–6). Low GNRI was significantly associated with poor overall survival (OS) (HR: 2.6, 95% CI: 2.0 to 3.38, p<0.00001, I² = 64%, 13 studies), cancer-specific survival (CSS) (HR: 2.65, 95% CI: 1.76 to 3.98, p<0.00001, I² = 75%, 7 studies), recurrence-free survival (RFS) (HR: 1.47, 95% CI: 1.02 to 2.1, p=0.04, I² = 58%, four studies) and progression-free survival (PFS) (HR: 1.86, 95% CI: 1.54 to 2.23, p<0.00001, I² = 0%, five studies). Funnel plot and Egger’s test (p=0.948) indicated a low risk of publication bias for OS. GRADE assessment showed low certainty of evidence for OS and PFS, and very low certainty for CSS and RFS. Meta-regression identified follow-up time and sample size as significant sources of heterogeneity.

Conclusions

A low GNRI is significantly associated with poor survival outcomes in patients with urological cancer. The GNRI may serve as a valuable prognostic tool in clinical practice. Further research is needed to validate these findings in diverse populations and to explore the underlying biological mechanisms.

Prospero registration number

CRD42023476678.
Impact of educational videos and user guide on indwelling pleural catheter caregiver training and unplanned healthcare encounters
Authors: Young Si Ling , Chua Brian Lee Wei , Tan Qiao Li , Leong Carrie Kah-Lai , Phua Ivana Gilcrist Chiew Sian , Wong Jane Jing Yi , Lim Wen Ting , Tang Kendra Jing Ying , Tan Aaron Jun Jie , Lee Fena Ming Qin , Goh Ken Junyang
Published: February 2025

Background

Indwelling pleural catheters (IPCs) are an effective first line option for the management of symptomatic malignant pleural effusions. However, patients with IPCs often require unplanned healthcare encounters (UHEs) due to complications or concerns with IPC care and drainage.

Local problem

There is a lack of readily accessible IPC-specific educational material to support caregiver training (CGT). As IPC care and drainage are performed primarily by patients and caregivers in our country due to the lack of community nursing support, ineffective CGT may lead to increased UHEs due to caregiver knowledge gaps or poor confidence in managing and caring for IPCs.

Aims

We aim to reduce the number of IPC-related UHEs.

Methods and interventions

We used a 5-why diagram and identified a lack of appropriate educational material as a key factor contributing to repeated UHEs. We therefore produced and employed IPC-specific educational videos and user guides, using a ‘Plan-Do-Study-Act’ approach, into our CGT programme. Patient demographics and clinical outcomes were collected prospectively for 166 consecutive patients with IPC insertions, with 72 patients in the preintervention group and 94 in the postintervention group. Survey questionnaires addressing caregiver competency and confidence were also administered after CGT using these tools.

Results

There was a significant decrease in the proportion of patients who had ≥2 (8.5% vs 40.9%, p<0.001) or ≥3 UHEs (3.2% vs 31.8%, p<0.001) in the intervention group. There was also a higher caregiver competency score achieved in the intervention group (7 (IQR: 7–7) vs 5 (IQR: 5–7), p<0.001). There was no difference in overall complication and IPC-related infection rates between groups.

Conclusion

IPC-specific educational videos and resources, which are readily accessible and easily implemented into CGT programmes, reduce UHEs due to IPC-related issues and may improve caregiver knowledge and competency in IPC care and drainage.
Relationship between multiple unemployment spells and cardiovascular disease mortality in South Korean workers
Authors: Jung Jaehyuk , Lee Kyeong Eun , Hong Seri , Park Jae Bum , Jeong Inchul
Published: February 2025

Background

It is necessary to explore the health problems of vulnerable workers who experience repeated unemployment spells. The number of unemployment spells should be considered in the relationship between unemployment and cardiovascular disease (CVD) mortality. Using nationwide data, we aimed to investigate the relationship between unemployment and CVD mortality and examine whether this effect varies depending on the number of unemployment spells.

Methods

Using data from Statistics Korea and employment insurance databases from 2018 to 2019, we identified an average of 1387 CVD deaths per year among 7.76 million workers who had at least one employment record prior to their death. The number of unemployment spells was calculated based on the employment history over the past 5 years. Crude mortality rates per 100 000 individuals and age-standardised mortality rates (SMRs) and sex-SMRs were calculated.

Results

The crude mortality rate due to CVD was 17.9 per 100 000 individuals among workers. Workers with one unemployment spell in the past 5 years had a significantly higher SMR than those without (2.01; 95% CI 1.87 to 2.16). Additionally, as unemployment spells increased, the SMR increased. The impact was more substantial among older workers than among younger workers. These findings remained consistent when CVD was divided into ischaemic heart disease and cerebrovascular disease.

Conclusion

Repeated unemployment spells may be a risk factor for increased CVD mortality. These findings underscore the vulnerability of individuals facing repeated unemployment spells, highlighting the necessity for economic as well as health and psychological support.
Hypertrophic cardiomyopathy and atrial fibrillation: the Cardiomyopathy/Myocarditis Registry of the EURObservational Research Programme of the European Society of Cardiology
Authors: Mizia-Stec Katarzyna , Gimeno Juan R , Charron Philippe , Elliott Perry M , Kaski Juan Pablo , Maggioni Aldo Pietro , Tendera Michal , Tavazzi Luigi , Wybraniec Maciej T , Laroche Cécile , Caforio Alida
Published: February 2025

Background

Hypertrophic cardiomyopathy (HCM) is commonly associated with atrial fibrillation (AF), but its impact on outcomes in real-world practice is uncertain. The aim of the study was to evaluate the clinical profile and prognosis of patients with HCM and AF.

Methods

Overall, 1739 adult patients with HCM (40.9% women; median age: 55.5 years) were enrolled in the EURObservational Research Programme (EORP) Cardiomyopathy/Myocarditis Registry. Clinical characteristics at baseline and cardiovascular endpoints at 1 year were prospectively assessed.

Results

At baseline, AF was present in 478 (27.5%) patients; an additional 48 patients (2.8%) developed AF at 1-year follow-up.Oral anticoagulants (OAC) were administered at baseline in 69.5% of the patients. Patients with AF were older and more symptomatic, had higher body mass index, more prevalent cardiovascular risk factors, a history of sustained ventricular tachycardia and implantable cardioverter-defibrillator, lower left ventricular ejection fraction (LVEF), larger left atria (LA) and more advanced LV diastolic dysfunction (pp<0.001 for all). Age at enrolment (OR=1.068, p<0.001), symptom: palpitations (OR=2.191, p<0.001), LVEF (OR=0.978, p<0.001) and LA diameter (OR=1.094, p<0.001) were independent predictors of AF in HCM population. Patients with AF had a higher annual incidence of stroke/transient ischaemic attack (2.6 vs 0.9%, p=0.009) and a trend towards increased all-cause mortality in comparison to the non-AF cohort (3.4 vs 1.7%, p=0.053).

Conclusions

AF affects nearly one-third of patients with HCM and is associated with higher symptom burden, increased prevalence of comorbidities, myocardial remodelling and increased annual risk of cerebral ischaemic events. In spite of this, the utilisation of OAC was suboptimal.
Preparation Strategies for Physiology Competition: Lessons Learned from Participants of Indonesian Medical Physiology Olympiad
Authors: Maulana Mohammad Nizar , Kurniawan Agde Muzaky , Argarini Raden , Rimbun Rimbun , Putri Eka Arum Cahyaning
Published: February 2025

Competitions outside the medical curriculum provide a platform for medical students to acquire advanced knowledge in specific medical subjects. Indonesian Medical Physiology (IMPhO) is the first and the largest competition in the field of physiology at the national level in Indonesia. It was held for the first time in 2017 and has been an annual physiology competition since then. This competition offers several challenges in different forms, including writing tests and oral rounds, to assess both individual and team capabilities in analyzing and comprehensively understanding human physiology. Consequently, the participants in this competition must have an in-depth understanding of human physiology concepts and develop a winning strategy to become a successful team. This article outlines the preparation strategies employed by the participants of IMPhO in 2022 and how it can be adopted to promote effective study skills for medical students. We conducted a semi-structured interview with participants and their accompanying lecturers to explore their strategies for the competition. We highlighted several important strategies, including utilizing resource materials effectively, fostering teamwork, providing mentorship, and emphasizing the role of lecturers as team supervisors. These competition-based learning strategies also can be adopted to promote effective study skills in formal curricula for medical students.
Developmental pyrethroid exposure disrupts molecular pathways for MAP kinase and circadian rhythms in mouse brain
Authors: Nguyen Jennifer H. , Curtis Melissa A. , Imami Ali S. , Ryan William G. , Alganem Khaled , Neifer Kari L. , Saferin Nilanjana , Nawor Charlotte N. , Kistler Brian P. , Miller Gary W. , Shukla Rammohan , McCullumsmith Robert E. , Burkett James P.
Published: February 2025

Neurodevelopmental disorders (NDDs) are a category of pervasive disorders of the developing nervous system with few or no recognized biomarkers. A significant portion of the risk for NDDs, including attention deficit hyperactivity disorder (ADHD), is contributed by the environment, and exposure to pyrethroid pesticides during pregnancy has been identified as a potential risk factor for NDD in the unborn child. We recently showed that low-dose developmental exposure to the pyrethroid pesticide deltamethrin in mice causes male-biased changes to ADHD- and NDD-relevant behaviors as well as the striatal dopamine system. Here, we used an integrated multiomics approach to determine the broadest possible set of biological changes in the mouse brain caused by developmental pyrethroid exposure (DPE). Using a litter-based, split-sample design, we exposed mouse dams during pregnancy and lactation to deltamethrin (3 mg/kg or vehicle every 3 days) at a concentration well below the EPA-determined benchmark dose used for regulatory guidance. We raised male offspring to adulthood, euthanized them, and pulverized and divided whole brain samples for split-sample transcriptomics, kinomics and multiomics integration. Transcriptome analysis revealed alterations to multiple canonical clock genes, and kinome analysis revealed changes in the activity of multiple kinases involved in synaptic plasticity, including the mitogen-activated protein (MAP) kinase ERK. Multiomics integration revealed a dysregulated protein-protein interaction network containing primary clusters for MAP kinase cascades, regulation of apoptosis, and synaptic function. These results demonstrate that DPE causes a multi-modal biophenotype in the brain relevant to ADHD and identifies new potential mechanisms of action.
Concomitant Atrial Fibrillation Radiofrequency Ablation During Total Thoracoscopic Valve Replacement: Safety, Early‐Term Efficacy, and Predictors of Early Atrial Arrhythmia Recurrence
Authors: Lin Zhiqin , Xu Zheng , Chen Liangwan , Dai Xiaofu
Published: February 2025

Background: Atrial fibrillation (AF) complicates cardiac surgery, including valve replacements, increasing perioperative risk and impacting long‐term outcomes. Concomitant radiofrequency ablation (RFA) during cardiac surgeries shows promise for managing AF. This study investigates the safety, early efficacy, and predictors of atrial arrhythmia recurrence (AAR) following AF RFA during total thoracoscopic valve replacement (TTVR).

Methods: This retrospective observational study included 625 patients who underwent TTVR with concomitant AF RFA from January 2017 to May 2023. Demographic data, preoperative characteristics, operative details, and postoperative outcomes were collected. The primary outcome was AAR within 3 months postoperatively.

Results: Of the 625 patients, AAR was observed in 21.6% (135 patients), with a median time to recurrence of 45 days. Independent predictors of early AAR included age, AF duration, body mass index (BMI), AF type, left atrial diameter, and ablation extent. Notably, persistent and long‐standing persistent AF, a larger left atrial diameter, and ablation of the left atrium alone were associated with higher recurrence risks. The in‐hospital mortality rate was 1.6%, with no significant differences in early complications between the recurrence and nonrecurrence groups.

Conclusions: Concomitant AF RFA during TTVR is a safe and effective strategy for managing AF in minimally invasive valve surgery. Early predictors of AAR include age, AF duration, BMI, AF type, left atrial diameter, and ablation extent. Future multicenter studies with longer follow‐ups are needed to validate these findings and provide robust evidence on long‐term outcomes.
The Home Use of Probiotics and Paraprobiotics for the Maintenance of Tongue Eubiosis: A Case Report
Authors: Cannizzaro Salvatore , Maiorani Carolina , Scribante Andrea , Butera Andrea
Published: February 2025

Aim: Halitosis is the unpleasant odor emitted from the oral cavity during exhalation and phonation. Using oral care products containing specific probiotics and paraprobiotics, combined with lifestyle changes, this study is aimed at resolving the patient’s altered breath odor.

Case Report: A 49‐year‐old male patient suffered from retronasal discharge, bacterial plaque on the back of his tongue, and bad breath. He underwent a professional oral hygiene session, received instructions in proper home oral hygiene techniques, and was advised on appropriate lifestyle changes. The use of oral care products based on probiotics and paraprobiotics was recommended. Sixty days later, the patient was reevaluated and was satisfied with the results, as his tongue had improved significantly, and he no longer experienced any bad sensations in his mouth.

Conclusion: Systematic removal of bacterial biofilm and the use of probiotics and paraprobiotics can be useful in the prevention and treatment of halitosis.
Neuron Segmentation via a Frequency and Spatial Domain–Integrated Encoder–Decoder Network
Authors: Song Haixing , Zeng Xuqing , Li Guanglian , Wu Rongqing , Liu Simin , He Fuyun
Published: February 2025

Three‐dimensional (3D) segmentation of neurons is a crucial step in the digital reconstruction of neurons and serves as an important foundation for brain science research. In neuron segmentation, the U‐Net and its variants have showed promising results. However, due to their primary focus on learning spatial domain features, these methods overlook the abundant global information in the frequency domain. Furthermore, issues such as insufficient processing of contextual features by skip connections and redundant features resulting from simple channel concatenation in the decoder lead to limitations in accurately segmenting neuronal fiber structures. To address these problems, we propose an encoder–decoder segmentation network integrating frequency domain and spatial domain to enhance neuron reconstruction. To simplify the segmentation task, we first divide the neuron images into neuronal cubes. Then, we design 3D FregSNet, which leverages both frequency and spatial domain features to segment the target neurons within these cubes. Then, we introduce a multiscale attention fusion module (MAFM) that utilizes spatial and channel position information to enhance contextual feature representation. In addition, a feature selection module (FSM) is incorporated to adaptively select discriminative features from both the encoder and decoder, increasing the weight on critical neuron locations and significantly improving segmentation performance. Finally, the segmented nerve fiber cubes were assembled into complete neurons and digitally reconstructed using available neuron tracking algorithms. In experiments, we evaluated 3D FregSNet on two challenging 3D neuron image datasets (the BigNeuron dataset and the CWMBS dataset). Compared to other advanced segmentation methods, 3D FregSNet demonstrates more accurate extraction of target neurons in noisy and weakly visible neuronal fiber images, effectively improving the performance of 3D neuron segmentation and reconstruction.
Some New Integral Inequalities via Strong Convexity
Authors: Yimer Markos Fisseha
Published: February 2025

We prove some new refined inequalities by using strong convexity. Some refinements of the Chebyšhev’s inequality are considered.
Coincidence Best Proximity Points of Proximal Berinde G‐Contractions
Authors: Gabeleh Moosa , Markin Jack
Published: February 2025

Recently, a concept of proximal Berinde contractions was introduced and applied to prove the existence of coincidence best proximity points in metric spaces. In this article, we established a new approach to show that these results can be obtained from a fixed point theorem for multivalued (β, L)‐weak contractions.