bluuebunny/crossref_metadata_2025 huggingface dataset:
Addressing the Nursing Shortage: A Creative Solution for Operating Room Staffing
Authors: McSpadden Micaela , Seabold Daniel , Rice Evangela , Sparks Debra , Conine Katrina
Published: February 2025

The ongoing nursing shortage in the United States continues to challenge the financial stability and quality of care in healthcare institutions. Operating rooms are integral to hospital revenue and disruptions in staffing can significantly impact the institution’s financial health. Many operating rooms report difficulty recruiting qualified candidates due to a lack of exposure during nursing school. Nurse intern programs are a creative way for perioperative administrators to create sustainable staffing pipelines.
Design, Implementation, and Evaluation of Case-Based Learning Aimed at Improving Undergraduate Medical Students’ Satisfaction, Attitude, Knowledge, and Skills in the Anatomy Course: An Interventional Study
Authors: Salehi Amir Mohammad , Ramezani Mahdi , Khanlarzadeh Elham , Khatiban Mahnaz , Ahmadian Mohammad , Alizadeh Zohreh
Published: February 2025

OBJECTIVE

Anatomy, a foundational preclinical course in medical education, is crucial for students. However, a comprehensive comparison of case-based learning (CBL) and lecture-based learning (LBL) in anatomy instruction is lacking. This study investigates the effectiveness of CBL and LBL methods in a lower limb anatomy course, evaluating medical students' satisfaction, attitudes, knowledge, and skills.

METHOD

This prospective cohort comparison study was conducted over three academic years, using a hybrid instructional approach to accommodate COVID-19 protocols. Six groups of undergraduate medical students (n = 466) were randomly assigned to either CBL (n = 231) or LBL (n = 235). Both groups had the same curriculum, learning objectives, and instructor. The LBL group received lectures, while the CBL group engaged with clinical cases and radiographic images, followed by interaction and knowledge application. Questionnaires were used to collect data on student demographics, satisfaction, and attitudes, and learning progress was assessed through tests. Data were analyzed using SPSS 22 with t-tests, Wilcoxon tests, and Pearson's correlation coefficient (≤ .05).

RESULTS

Compared to the LBL group, the CBL group demonstrated significantly higher levels of knowledge (15.05 ± 3.12 vs. 13.32 ± 3.77; P < .001) and skills (15.54 ± 3.95 vs. 12.75 ± 5.09; P < .001). Students in the CBL group also reported significantly greater satisfaction ( P < .001) and a more positive attitude toward the learning method (42.78 ± 8.01 vs. 34.7 ± 35.64; P < .001).

CONCLUSION

CBL significantly enhances knowledge, skills, satisfaction, and attitudes of first-year medical students learning lower limb anatomy. This makes CBL an effective instructional method for anatomy courses.
We have never owned ‘Us’: A philosophical critique of nationalist b/ordering and othering ideologies
Authors: van Asseldonk Maxim , van Houtum Henk
Published: February 2025

The recent decades have witnessed a proliferation of theorising about borders. Having moved away from the positivist paradigm that views borders as static ‘lines in the sand’, a myriad of different conceptualisations of borders as continuous socio-political processes have emerged: bordering, borderscapes and borderlands are just some of the more common ones. In this paper we aim to contribute to this processual turn in border studies by offering a philosophical critique of the typical appropration logic - the claim to own our ‘Us’ again - in nationalist b/ordering and othering processes. Specifically, we theorise about the critical potential of the concepts of community and immunity in understanding these appropriative nationalist bordering processes. To that end, we notably draw on the works of philosophers Jean-Luc Nancy and Roberto Esposito. Both agree that community – human coexistence – is not an object and therefore cannot be appropriated. Esposito takes this further by elaborating on the logic immunity, through which the order deemed to be ‘Ours’ is meant to be protected from the disorder represented by an Other. He explains that immunisation is an attempt to appropriate an inappropriable identity. Ultimately, drawing on both thinkers, we argue that bordering efforts are self-defeating. B/ordering attempts to enclose a supposed identity to protect ‘us’, but in so doing the ‘us’ becomes owned by this supposed identity rather than vice versa. Immunity, Esposito specifies, eliminates community, and therefore ultimately so does b/ordering.
Chronic exposure to a synthetic cannabinoid improves cognition and increases locomotor activity in Tg4-42 Alzheimer's disease mice
Authors: Ott Frederik W , Sichler Marius E , Bouter Caroline , Enayati Marzieh , Wiltfang Jens , Bayer Thomas A , Beindorff Nicola , Löw Maximilian J , Bouter Yvonne
Published: February 2025

Background

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by cognitive decline and behavior impairments. Despite recent approvals of anti-amyloid antibodies, there remains a need for disease modifying and easily accessible therapies. Emerging evidence suggests that targeting the endocannabinoid system may hold promise for AD therapy as it plays a crucial role in different physiological processes, including learning, memory and anxiety, as well as inflammatory and immune responses.

Objective

In this study, we investigated the therapeutic potential of the synthetic cannabinoid WIN 55,212-2 on memory deficits in Tg4-42 transgenic mice.

Methods

Tg4-42 mice were assigned to two treatment groups to investigate the preventive effects of WIN 55,212-2 after a prolonged washout period, as well as the therapeutic effects of WIN 55,212-2 on behavior. Furthermore, the effects of WIN 55,212-2 treatment on AD pathology, including inflammation, amyloid-β load, neurogenesis, and brain glucose metabolism, were evaluated.

Results

Therapeutic WIN 55,212-2 treatment rescued recognition memory and spatial reference deficits in Tg4-42 mice. Furthermore, therapeutic WIN 55,212-2 administration improved motor performance. In addition, preventative WIN 55,212-2 treatment rescued spatial learning and reference memory deficits. Importantly, WIN 55,212-2 treatment did not affect anxiety-like behavior. However, therapeutic and preventative WIN 55,212-2 treatment resulted in an increase locomotor activity and swimming speed in Tg4-42 mice. WIN-treatment reduced microgliosis in the hippocampus of preventively treated mice and rescued brain glucose metabolism in therapeutically treated Tg4-42 mice.

Conclusions

Our findings emphasize the therapeutic promise of the synthetic cannabinoid WIN 55,212-2 in alleviating behavioral and cognitive deficits linked to AD.
Application of implementation science frameworks to inform the adaptation process of an evidence-based eating disorder prevention program for high-risk perinatal individuals
Authors: Vanderkruik Rachel , Woodworth Emily C. , Frisch Caroline M. , Nelson Stacey , Dunk Madison M. , Freeman Marlene P. , Cohen Lee S. , Stice Eric , Bartels Stephen J.
Published: February 2025

Background

The perinatal period is a high-risk time for body dissatisfaction and disordered eating. Evidence-based interventions for disordered eating have not been adapted to address the needs of this population. We describe the process of adapting the Body Project, an evidence-based eating disorder (ED) prevention program, for pregnant individuals with histories of disordered eating behaviors.

Method

Our approach is informed by ADAPT, a framework offering guidance for adapting interventions to new contexts, to modify the Body Project for pregnant individuals. Following initial adaptations informed by a needs assessment and stakeholder input, we conducted a pilot trial with individuals who have lived experience relative to our target population (i.e., previously pregnant individuals with ED history, n = 10). Participants provided feedback on the intervention through surveys and a focus group assessing perceptions of the intervention and barriers and facilitators to its implementation as guided by the Consolidated Framework for Implementation Research (CFIR).

Results

Eighty percent of enrolled participants attended five or more sessions (out of six). Across sessions, average satisfaction ratings were 9.28 (1 =  poor to 10 =  excellent). Most participants (89%) reported improvements in body satisfaction. Approximately 33% reported reductions in disordered eating with the remainder reporting no change due to healthy eating behaviors at baseline. Themes from the focus group are reported aligning with CFIR domains and all final modifications are summarized and reported aligning with the Framework for Reporting Adaptation and Modifications-Enhanced.

Conclusions

Applying implementation science frameworks to structure our process for making and summarizing planned adaptations, we adapted an empirically supported ED prevention program for pregnant individuals with histories of an ED. We made adaptation decisions based on participant feedback while weighing intervention fidelity and scalability. We will formally test the adapted intervention in a subsequent pilot randomized controlled trial versus a time- and dose-matched educational control.
A Scoping Review of Community Harm Reduction Strategies for Maternal and Fetal Opioid Impacts: Implications for Policy
Authors: Voss Maren Wright , Smid Marcela C. , Herrick Julie C. , Cleveland Aarica , Van Komen Amelia , Johanson Joli , Huntington Matthew
Published: February 2025

Background:

Community-based harm reduction for opioid use may be crucial for mitigating maternal and fetal harms by reducing information bias, fostering trust, and connecting individuals to essential treatment and services. This scoping review examines community-based harm reduction strategies and policies addressing maternal opioid use occurring in nonclinical settings, including stigma reduction, public health education, service access, and integration. The objectives of this scoping review are to 1) delineate community-based harm reduction approaches; 2) contextualize findings; 3) identify policy gaps; and 4) synthesize insights for policy.

Methods:

A systematic selection of articles was conducted using predefined inclusion and exclusion criteria. Three search domains (mother–child dyad, opioid misuse, and harm reduction) were used from PubMed, PsychINFO, and Scopus databases from 2013 onward. Articles were screened using title and abstract review, full-text analysis, and cross-referencing to ensure relevance. Articles focusing on policy related to community-based harm reduction strategies for pregnant individuals experiencing opioid misuse were included in the final review.

Results:

Initial search yielded 548 articles with 45 articles identified as domain relevant. After full-text review, 26 articles were included in final scoping review. Number of publications increased over time (2013-2017, n = 6; 2018-2021, n = 20). Twenty articles (77%) addressed multisystem level interventions, defined as coordinated strategies across multiple sectors (e.g., healthcare, education, and social services) and favored supportive (over punitive) harm reduction methods. Identified needs included addressing socioeconomic disparities and ensuring equitable access to care. Literature gaps highlight an oversimplification of outcomes such as narrow definitions of neonatal abstinence syndrome that do not account for overall harm reduction.

Conclusions:

Policy review favored systemic interventions over individual-level criminalization or remediation. Community-based, comprehensive, integrated, and supportive care received less attention than medication-based treatment. These results underscore urgent need for consideration of evidence-based community-level harm reduction strategies to effectively address maternal opioid use and its associated challenges.
Constitutive systemic inflammation in Shwachman-Diamond Syndrome
Authors: Sabbioni Giuseppe , D’Aversa Elisabetta , Breveglieri Giulia , Altieri Maria Teresa , Boni Christian , Pegoraro Anna , Finotti Alessia , Gambari Roberto , D’Amico Giovanna , Vella Antonio , Lippi Giuseppe , Cipolli Marco , Bezzerri Valentino , Borgatti Monica
Published: February 2025

Background and purpose

Shwachman-Diamond Syndrome (SDS) is an autosomal recessive disease belonging to the inherited bone marrow failure syndromes and characterized by hypocellular bone marrow, exocrine pancreatic insufficiency, and skeletal abnormalities. SDS is associated with increased risk of developing myelodysplastic syndrome (MDS) and/or acute myeloid leukemia (AML). Although SDS is not primarily considered an inflammatory disorder, some of the associated conditions (e.g., neutropenia, pancreatitis and bone marrow dysfunction) may involve inflammation or immune system dysfunctions. We have already demonstrated that signal transducer and activator of transcription (STAT)-3 and mammalian target of rapamycin (mTOR) were hyperactivated and associated with elevated IL-6 levels in SDS leukocytes. In this study, we analyzed the level of phosphoproteins involved in STAT3 and mTOR pathways in SDS lymphoblastoid cells (LCLs) and the secretomic profile of soluble pro-inflammatory mediators in SDS plasma and LCLs in order to investigate the systemic inflammation in these patients and relative pathways.

Methods

Twenty-six SDS patients and seven healthy donors of comparable age were recruited during the programmed follow-up visits for clinical evaluation at the Verona Cystic Fibrosis Center Human. The obtained samples (plasma and/or LCLs) were analyzed for: phosphoproteins, cytokines, chemokines and growth factors levels by Bio-plex technology; microRNAs profiling by next generation sequencing (NGS) and microRNAs expression validation by Real Time-PCR (RT-PCR) and droplet digital PCR (ddPCR) .

Results

We demonstrated dysregulation of ERK1/2 and AKT phosphoproteins in SDS, as their involvement in the hyperactivation of the STAT3 and mTOR pathways confirmed the interplay of these pathways in SDS pathophysiology. However, both these signaling pathways are strongly influenced by the inflammatory environment. Here, we reported that SDS is characterized by elevated plasma levels of several soluble proinflammatory mediators. In vitro experiments show that these pro-inflammatory genes are closely correlated with STAT3/mTOR pathway activation. In addition, we found that miR-181a-3p is down-regulated in SDS. Since this miRNA acts as a regulator of several pro-inflammatory pathways such as STAT3 and ERK1/2, its down-regulation may be a driver of the constitutive inflammation observed in SDS patients.

Conclusions

The results obtained in this study shed light on the complex pathogenetic mechanism underlying bone marrow failure and leukemogenesis in SDS, suggesting the need for anti-inflammatory therapies for SDS patients.
Preoperative conjunctival flora and antibiotic susceptibility in cataract surgery patients at Ibn Al-Haitham teaching eye hospital in Baghdad, Iraq
Authors: Fenjan Mohammed A. , Hamied Furkaan Majied , Al Sakini Ahmed Sermed , Khorsheed Hamzeh , Al-aish Sandra Thair
Published: February 2025

Background

Endophthalmitis is a rare but severe eye inflammatory disorder caused by bacterial infection that can occur after cataract surgery. Most bacteria are part of the patient’s natural flora, and even with antibiotic treatment, it causes considerable ocular morbidity and vision loss.

Purpose

To investigate the preoperative conjunctival flora and their antibiotic susceptibility in patients undergoing cataract surgery at Ibn Al-Haitham Teaching Eye Hospital, a tertiary ophthalmology center in Baghdad, Iraq.

Methods

This cross-sectional, single-center study based on conjunctival swabs of patients prior to cataract surgery and cultured using blood agar, chocolate agar, MacConkey agar, and Sabouraud agar. Bacterial isolates were identified using Gram staining and biochemical tests, and antibiotic sensitivity was determined using the disc diffusion method according to CLSI guidelines. Statistical analysis was done by SPSS Statistics Version 23.

Results

A total of 200 patients (200 conjunctival swabs of consecutive 200 eyes) scheduled for cataract surgery were included. Positive cultures were found in 45 (24%) patients. Coagulase-negative Staphylococcus epidermidis was the most frequently isolated microorganism (75% of isolates), followed by Staphylococcus aureus (14.58%), Aspergillus species (6.25%), and E. coli (4.17%). S. epidermidis showed the highest sensitivity to ofloxacin (97.2%) and chloramphenicol (94.4%) and the lowest sensitivity to fusidic acid (11.1%) and ceftazidime (5.6%). S. aureus exhibited the highest sensitivity to chloramphenicol (100%) and tobramycin (85.7%) but was completely resistant to ceftazidime and fusidic acid (100% resistance). E. coli isolates were 100% sensitive to ciprofloxacin, ofloxacin, and chloramphenicol.

Conclusion

The study revealed conjunctival microbial colonization in 24% of cataract surgery candidates, with S. epidermidis being the most prevalent isolate. Chloramphenicol, ofloxacin, Tobramycin, and Ciprofloxacin showed high sensitivity. Fusidic acid and Ceftazidime exhibited negligible sensitivity.
How do people with multimorbidity prioritise healthcare when faced with tighter financial constraints? A national survey with a choice experiment component
Authors: Larkin James , Foley Louise , Timmons Shane , Hickey Tony , Clyne Barbara , Harrington Patricia , Smith Susan M.
Published: February 2025

Background

People with multimorbidity (i.e., two or more chronic conditions) experience increased out-of-pocket healthcare costs and are vulnerable to cost-related non-adherence to recommended treatment. The aim of this study was to understand how people with multimorbidity prioritise different healthcare services when faced with tighter budget constraints and how they experience cost-related non-adherence.

Methods

A national cross-sectional online survey incorporating a choice experiment was conducted. Participants were adults aged 40 years or over with at least one chronic condition, recruited in Ireland (December 2021 to March 2022). The survey included questions about real-life experiences of cost-related non-adherence and financial burden. The choice experiment element involved participants identifying how they would prioritise their real-world healthcare utilisation if their monthly personal healthcare budget was reduced by 25%.

Results

Among the 962 participants, 64.9% (n = 624) had multimorbidity. Over one third (34.5%, n = 332) of participants reported cost-related non-adherence in the previous 12 months, which included not attending a healthcare appointment and/or not accessing medication. Similar findings on prioritisation were observed on the choice task. When presented with the hypothetical tighter budget constraint, participants reduced expenditure on ‘other healthcare (hospital visits, specialist doctors, etc.)’ by the greatest percentage (50.2%) and medicines by the lowest percentage (24.8%). Participants with multimorbidity tended to have a condition they prioritised over others. On average, they reduced expenditure for their top-priority condition by 71% less than would be expected if all conditions were valued equally, while they reduced expenditure for their least prioritised condition by 60% more than would be expected. Independence, symptom control and staying alive were rated as the most important influencing factors when making prioritisation decisions (median score = 5 out of 5).

Conclusion

When faced with tighter financial constraints, people with multimorbidity tended to have a condition they prioritised over others. Participants were also more likely to prioritise medicines over other aspects of healthcare. Researchers, policymakers and clinicians should take greater consideration of the different ways people respond to tighter financial constraints. This could involve reducing the payment barriers to accessing care or clinicians discussing healthcare costs and coverage with patients as part of cost-of-care conversations.
Antitumor activity of gamma-irradiated Rosa canina L. against lung carcinoma in rat model: a proposed mechanism
Authors: Abo-Zaid Omayma A. R. , Moawed Fatma S. M. , Eldin Eman S. , Farrag Mostafa A. , Ahmed Esraa S. A.
Published: February 2025

Background

Lung cancer is one of the most prevalent malignancies globally and is the leading cause of cancer-related mortality. Although cisplatin is a widely utilized chemotherapeutic agent, its clinical efficacy is often hampered by significant toxicity and undesirable side effects. Rosa canina, a medicinal plant, has demonstrated a range of beneficial biological activities, including anti-inflammatory, anticancer, immunomodulatory, antioxidant, and genoprotective effects.

Methods

This study aimed to investigate the potential of Rosa canina to enhance the anticancer efficacy of cisplatin in a dimethyl benz(a)anthracene-induced lung cancer model using female rats. The animals were administered Rosa canina, cisplatin, or a combination of both treatments. The expression levels of critical signaling molecules were evaluated, including phosphoinositide-3-kinase (PI3K), Akt, mammalian target of rapamycin (mTOR), cleaved poly (ADP-ribose) polymerase (PARP-1), myeloid differentiation factor 88 (MyD88), and tumor necrosis factor receptor-associated factor (TRAF), in addition to various autophagic markers. Furthermore, we assessed the levels of toll-like receptor 2 (TLR2), nuclear factor kappa B (NF-κB), and apoptotic markers in lung tissue, complemented by histopathological examinations.

Results

The combined treatment of Rosa canina extract and cisplatin significantly inhibited lung cancer cell proliferation by downregulating PARP-1 and the TLR2/MyD88/TRAF6/NF-κB signaling pathway, as well as the PI3K/Akt/mTOR pathway. Moreover, this combination therapy promoted autophagy and apoptosis, evidenced by elevated levels of autophagic and apoptotic markers.

Conclusion

Overall, the findings of this study suggest that Rosa canina enhances the anticancer effects of cisplatin by inhibiting cancer cell proliferation while simultaneously inducing autophagy and apoptosis. Thus, Rosa can be used as adjuvant to cisplatin chemotherapy to overcome its limitations which may be considered a new approach during lung cancer treatment strategy.

Graphical Abstract
Turkish validity and reliability of children’s environmental health knowledge and skills questionnaires for nursing students
Authors: Gürgen Şimşek Hatice , Dağhan Şafak
Published: February 2025

Background

A constantly changing and polluted environment can negatively affect children’s health. Nursing education should enable the training of future nurses who are fully equipped to protect and improve children’s health. In this respect, it is necessary to evaluate the knowledge and skills of nurse candidates. To examine the psychometric properties of the “Children’s Environmental Health Knowledge (ChEHK-Q) and Skills (ChEHS-Q) Questionnaire” among Turkish-speaking nursing students.

Methods

This study employed a methodological method. An online survey was administered to 300 students in a nursing department in western Türkiye in 2021. Expert opinions were obtained for content and language validity. The validity of the scales was analysed via “Rasch measurement theory”, and whether the necessary preconditions for the analysis (the item function difference, local independence, reliability, and unidimensionality) were met was checked. Then, the item difficulty, person ability, and response threshold value ranking data were obtained. SPSS 25.0 software, LISREL Vrs. 8.80 program and Winsteps 3.92.1 Version program were used.

Results

The content validity indices of both scales were above 0.80. Only item 12 of the ChEHS-Q was removed because it did not provide cultural appropriateness. Both scales met the Rasch measurement theory assumption and had model fit. The ChEHK-Q infit values ranged from 0.13 to 1.07, and the outfit values ranged from 0.88 to 1.17. The ChEHS-Q infit values ranged from 0.82 to 1.19, and the outfit values ranged from 0.86 to 1.19.

Conclusions

Both questionnaires were found to be valid and reliable instruments in the Turkish language. Scales can provide ideas for shaping the nursing education curriculum in Türkiye. In this way, by determining which subjects are deficient, education programs can be arranged to eliminate these deficiencies. Nurses’ awareness of environmental health is also important in improving public health. Graduating nurses can inform families by identifying environmental risks and contribute to the creation of healthy living conditions.In addition, it can be used in clinical practice (public health nursing, etc.) and national and international research (randomized controlled trials evaluating planned educational activities).

Clinical Trial Number

Not applicable.
Global and regional incidence of intrahepatic cholestasis of pregnancy: a systematic review and meta-analysis
Authors: Jamshidi Kerachi Ali , Shahlaee Mohammad Amin , Habibi Pardis , Dehdari Ebrahimi Niloofar , Ala Moein , Sadeghi Alireza
Published: February 2025

Background

Intrahepatic cholestasis of pregnancy (ICP) can be a source of significant distress for both pregnant women and the fetus, impairing the quality of life and well-being of pregnant women, leading to psychological disorders among pregnant women with severe or recurrent ICP, and causing life-threatening complications among fetuses. Regrettably, our current understanding of ICP globally is limited, lacking a comprehensive estimation of its incidence. Therefore, in this systematic review and meta-analysis, we aimed to investigate the global and regional incidence of ICP and identify factors that account for its variety across studies.

Methods

A comprehensive search strategy was implemented across PubMed, Scopus, and Web of Science databases. To stabilize the variance, the Freeman-Tukey double arcsine transformation was employed. Subgroup analyses were conducted based on continent, publication type, study design and timing, regional classifications, developmental status, and World Bank income grouping. A multivariate meta-regression analysis was performed to estimate the effects of the continuous moderators on the effect size.

Results

A total of 42,972,872 pregnant women were analyzed from 302 studies. The overall pooled incidence [95% confidence interval] of ICP was 2.9% [2.5, 3.3]. Studies with larger sample sizes tended to provide significantly lower estimates of ICP incidence: 1.6% [1.3, 2] vs 4.7% [3.9, 5.5]. Asia had the highest incidence of ICP among the continents, whereas Oceania had the lowest. Countries that were classified as developed and with higher income had a lower incidence of ICP than those classified as developing and low and middle income.

Conclusions

The findings of this study will provide valuable insights into the current knowledge regarding the association of the quality of public health and socioeconomic variations with the incidence of ICP on a global scale.

Graphical Abstract
Accelerometer-measured physical activity, frailty, and all-cause mortality and life expectancy among middle-aged and older adults: a UK Biobank longitudinal study
Authors: Yang Yang , Chen Liangkai , Filippidis Filippos T.
Published: February 2025

Background

Physical activity (PA) is associated with reduced frailty and lower mortality rates among middle-aged and older adults. However, the extent to which total PA volume and specific PA intensities are associated with mortality risk across frailty status remains unclear. We aimed to investigate the interactive effects of accelerometer-measured PA with frailty on all-cause mortality and life expectancy.

Methods

A total of 78,508 participants were sourced from the UK Biobank for analysis. Frailty index (FI) was used to assess frailty status. Physical activity and sedentary behavior were quantified through accelerometer measurements, capturing the total volume of physical activity (TVPA), moderate-to-vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA), and sedentary time (ST). Cox proportional hazard models were applied to calculate adjusted hazard ratios (HRs) and predict life expectancy.

Results

During a median follow-up of 6.9 years, 2618 deaths (2.9%) were identified. Compared with robust and physically active counterparts, individuals characterized by frailty, combined with the lowest levels of TVPA (HR 3.05, 95% CI: 2.50–3.71), MVPA (HR 2.65, 95% CI: 2.19–3.21), LPA (HR 2.26; 95% CI: 1.81–2.83), or the highest level of ST (HR 2.08, 95% CI: 1.66–2.61), were found to have the greatest risk of all-cause mortality after comprehensive adjustment. The dose–response relationship, assessed using restricted cubic splines, consistently demonstrated that regardless of frailty categories, higher levels of TVPA, MVPA, and LPA were associated with lower mortality risks, while higher ST level was associated with increased risk. Notably, across the frailty spectrum, individuals in the low tertile of TVPA, MVPA, and LPA, or the top tertile of ST, were associated with reduced life expectancy, with this pattern being more pronounced among frail men compared to frail women.

Conclusions

Our findings highlighted the importance of increasing total PA volume, emphasizing MVPA and LPA, and reducing ST across the frailty spectrum to improve life expectancy.
Cumulative risk assessment methodology applied to non-dietary exposures: developmental alterations in professional agricultural settings
Authors: Tosti Luca , Marazzini Martina , Kanadil Mohammed , Metruccio Francesca
Published: February 2025

The safety assessment of combined exposure to xenobiotics has been an emerging topic for several years. Methodologies and approaches for cumulative risk assessment (CRA) are being developed primarily for the dietary risk assessment of pesticides, thus focusing only on consumer exposure. However, as highlighted in recent years, non-dietary exposures, such as those encountered by professionals in agricultural settings, may pose a significant risk due to their higher levels compared to dietary exposure. Despite this, existing methodologies for cumulative risk assessment (CRA) have not adequately addressed this critical aspect. In the EU, even if several legislations highlight the need to address the non-dietary CRA, no legal requirements are in place yet, therefore, there are no harmonized methodologies and approaches currently available. In a first step to fill this gap, this study is aimed at exploring CRA methodology applied to non-dietary exposure to pesticide in agricultural settings, specifically targeting operators, re-entry workers, and bystanders. The primary objective of the study was to verify the feasibility of an electronic register of plant protection treatments as data source for identifying and characterizing in field mixtures and consequently estimating cumulative non-dietary systemic exposure in real life. The relevant active substances selected for this investigation were those listed in foetal craniofacial alterations cumulative assessment groups (CAGs), established by the European Food Safety Authority (EFSA) for dietary CRA. Exposures to pesticides were estimated using European Union agreed mathematical models. The preliminary findings of this investigation effectively revealed the value of the register of treatments in assessing real-life plant protection products (PPP) usage in professional agricultural settings. In conclusion, the study provides encouraging insights into using the pesticide dietary CRA approach for non-dietary risk assessment in agricultural settings, underlining the necessity for further research and investigation of its feasibility for the evaluation of other acute effects but also for long-term effects related CAGs.
Relationship between point-of-care ultrasound venous congestion assessment parameters, intravenous pressure, and venous return: a post-hoc analysis of a prospective cohort study
Authors: Ruste Martin , Delas Quentin , Reskot Rehane , Fellahi Jean-Luc , Jacquet-Lagrèze Matthias
Published: February 2025

Background

A recent study suggested that point-of-care ultrasound (POCUS) venous congestion assessment poorly describes the changes in venous return during a fluid challenge. The aim of the present study was to explore the relationship between POCUS venous congestion assessment parameters and the determinants of venous return in steady state and during a fluid challenge.

Methods

This study is a post-hoc analysis of a single-centre prospective cohort study of patients presenting acute circulatory failure and venous congestion. The protocol consisted in a fluid administration of 4mL/kg over five minutes, just preceded and followed by the acquisition of haemodynamic data and POCUS venous congestion assessment parameters (VExUS score and portal pulsatility index, PPi). Venous return (dVR) was defined as the difference between mean systemic filling pressure analogue estimated by the mathematical approach of Parkin and Leaning (Pmsa) and central venous pressure (CVP). Relationships between Pmsa, CVP, dVR, and VExUS score and PPi were analysed using linear regression and Jonckheere-Terpstra test for trend.

Results

Thirty-two patients were included in the analysis. Fluid challenge induced a significant increase in CVP, Pmsa, dVR, and VExUS score. In steady state, there was a significant association of VExUS score and PPi with CVP (P-value = 0.006 and 0.002, respectively) and Pmsa (P-value = 0.004 and 0.003, respectively) but not with dVR (P-value = 0.943 and 0.408, respectively). The variations induced by fluid challenge in CVP, Pmsa and dVR were not associated with variations in PPi (P-value = 0.844, 0.912 and 0.716, respectively). Patients without VExUS score increase during the fluid challenge presented a higher increase in Pmsa than patients with an increase in VExUS score.

Conclusion

In steady state, POCUS venous congestion assessment parameters are associated with CVP and Pmsa but not with dVR. After fluid administration, changes in POCUS venous congestion assessment parameters were not associated with changes in CVP, Pmsa, and dVR.
Social inequalities at the transition to higher education: the role of personality for graduates from vocational and general schools
Authors: Nika David
Published: February 2025

Previous research has shown that social inequalities in the transition to higher education are a persistent phenomenon in Germany. Additionally, studies indicate that graduates from vocational schools are less likely to enter higher education, compared to their peers who graduated from general schools. However, research is scarce about how social background effects may differ for graduates from vocational schools in comparison to general schools. This paper aims to examine this twofold inequality, by introducing personality traits as resources that support graduates from disadvantaged social backgrounds to enter higher education, especially if they graduated from vocational schools. Therefore, this study distinguishes between graduates from general schools, as well as from vocational schools with a general and a specific higher education entrance qualification. Drawing on data of the two most recent cohorts of the school leaver cohort of the German Student Life Cycle Panel, logistic regression models with interaction terms are employed and average marginal effects are reported. The findings reveal that, although vocational schools are less socially selective in their student decomposition as well as in the transition into higher education, inequalities based on social background persist. Two of the five personality traits showed significant positive effects for graduates from disadvantaged social background for entering higher education: while openness appears to be beneficial for students who graduated from general schools and vocational schools, agreeableness is especially advantageous for students who graduated from vocational schools with a specific higher education entrance qualification. This paper highlights how personality traits can mitigate social inequalities in higher education transitions and underscores the importance of distinguishing social background effects across different school types. The results have broader implications for addressing educational inequalities and understanding the role of individual resources in diverse institutional contexts.
Towards transient space-use dynamics: re-envisioning models of utilization distribution and their applications
Authors: Tao Yun , Giunta Valeria , Börger Luca , Wilber Mark Q.
Published: February 2025

Background

Models of utilization distribution in the form of partial differential equations have long contributed to our understanding of organismal space use patterns. In studies of infectious diseases, they are also being increasingly adopted in support of epidemic forecasting and scenario planning. However, as movement research shifts its focus towards large data collection and statistical modeling of movement trajectories, the development of such models has notably slowed.

Methods

Here, we demonstrate the continued importance of modeling utilization distribution to predict variation in space-use patterns over time. We highlight the considerable, yet largely untapped, potential of such models, which have historically been limited by the steady-state assumption due to longstanding technical constraints. Now, by adapting existing computational tools primarily developed for material science and engineering, we can probe beyond the steady states and unlock from them a broad spectrum of complex, transient space-use dynamics. Our approach requires little experience in numerical analysis and is readily accessible to model practitioners in ecology and epidemiology across diverse systems where movement is a critical feature.

Results

We illustrated our approach using a mix of canonical and novel case studies, covering topics from wildlife translocation to vaccine deployment. First, we revisited a classical model of canid territorial formation driven by scent-mediated conspecific avoidance. Transient space-use analysis uncovered previously hidden spatial dynamics that are ecologically informative. Next, we applied our approach to long-distance movement on realistic landscapes. Habitat and land-use heterogeneities markedly affected the transient space-use dynamics and short-term forecasts, even when the steady state remained unchanged, with direct implications for conservation management. Finally, we modeled transient space-use dynamics as both a response to and a driver of transient population dynamics. The importance of this interdependence was shown in the context of epidemiology, in a scenario where the movement of healthcare personnel is influenced by local outbreak conditions that are stochastically evolving.

Conclusions

By facilitating transient space-use analysis, our approach could lead to reevaluations of foundational ecological concepts such as home range and territory, replacing static with dynamic definitions that more accurately reflect biological realities. Furthermore, we contend that a growing interest in transient space-use dynamics, spurred by this work, could have transformative effects, stimulating new research avenues in ecology and epidemiology.
Understanding caregiver preferences for firearm locking devices in a pediatric emergency department
Authors: Lennon Tyler , Kemal Samaa , Shankar Sanjana , Tunick Robert , Lorenz Doug , Hoffmann Jennifer A.
Published: February 2025

Background

Around 40% of US households with children have a firearm kept in the home. This study sought to describe firearm storage practices and locking device preferences among caregivers of children presenting to a pediatric emergency department (ED).

Methods

We conducted a cross-sectional survey of caregivers of children presenting to a pediatric ED who endorsed having a firearm in the home from August 2023 to May 2024. A self-administered electronic survey inquired about current firearm storage practices and locking device preferences. Caregivers who endorsed any unsafe firearm storage practice (i.e., firearm stored unlocked, loaded, and/or with ammunition) were offered, based on their preference, a free cable gun lock, lock box, or gun safe along with safe firearm storage education materials. Caregivers given a device were surveyed 30 days later to reevaluate firearm storage behavior. McNemar’s test was used to evaluate differences in reported baseline locking device use. Wilcoxon signed rank test was used to evaluate changes in storage behaviors (locked, unloaded, and stored separate from ammunition) from baseline to 30-day follow-up.

Results

Of 139 caregivers with a firearm in the home, 91% (n = 126) reported having a handgun and 41% (n = 57) reported storing firearms with triple safe storage. Safes/vaults were more frequently used (40%, n = 56) than cable gun locks (20%, n = 28) (p = 0.003). Factors involved in caregiver preference for firearm locking devices were: speed of access to firearms (47%, n = 66), strength of the device (45%, n = 63), and cost of device (42%, n = 58). Seventeen caregivers were provided a free device based on preference: 15 gun safes, 2 lock boxes, and 0 cable gun locks. At 30-day follow up, 70.6% (n = 12) of eligible caregivers responded, and the proportion of respondents who reported storing all firearms locked increased significantly from baseline (from 67 to 100%, p = 0.036).

Conclusions

Caregivers in a pediatric ED reported using safes most frequently and, when offered a device, preferred safes over other locking devices. After being provided a free device of their preference, all caregivers who completed follow-up surveys reported all firearms were locked. Healthcare and community organizations should align resources with caregiver preferences.
High-resolution stacking image based on common-image gathers
Authors: Wu Chengliang , Wang Huazhong , Feng Bo , Ning Chao , Sheng Shen , Tang Xianggong
Published: February 2025

Seismic migration is an effective technique for reconstructing the subsurface geological structure. Focusing on common-image gathers (CIGs) produced by pre-stack depth migration, the imaging result is usually obtained by mean stacking CIGs from different shot-receiver pairs. For optimal results, the desired CIGs should exhibit consistent depth and waveform of the imaging wavelet across different angles or offsets. However, raw CIGs often suffer from misalignment due to inaccuracies in the migration velocity model and mad physical limitations. Additionally, factors such as complex topography, intricate subsurface structures, irregular acquisition geometries, and space-variant seismic wavelets contribute to uneven illumination and migration artifacts within CIGs. As a result, directly stacking CIGs does not yield high-resolution imaging. To address these challenges, we propose a novel imaging method based on CIGs. First, we analyze the high-resolution imaging process and identify residual depth, residual phase, and uneven illumination in CIGs as the primary factors affecting the stacking quality. To obtain high-resolution imaging, it is crucial to ensure that CIGs are flat and consistent in depth. Therefore, we have developed an improved dynamic programming method to flatten the CIGs. Next, to account for the uneven illumination across different angles and offsets, we propose an illumination-based weighted operator to optimize the CIGs, complemented by a similarity coefficient method for generating the stacking image. Finally, we present results from a synthetic model and field dataset to demonstrate the effectiveness of the proposed method. The results indicate that our approach significantly enhances imaging resolution and amplitude preservation, thereby improving imaging quality in complex exploration areas.
Somatic Landscape of Oncogenic Variants Across the Main Cancer Subtypes in Latin America: A Narrative Review
Authors: Wegman-Ostrosky Talia , Taja-Chayeb Lucia , Zatarain-Barrón Zyanya Lucia , Trejo-Becerril Catalina , Shveid Gerson Daniela , Espino-Gutiérrez Isabel , Gutiérrez-Lara Andrea , Bonilla Salcedo Andrés Yesid , Castellanos Mares Mistral , García-Ortiz José Elias , Robles-Espinoza Carla Daniela , Ruíz-Patiño Alejandro
Published: February 2025

Variations in somatic genetic alterations can be observed across different cancer types and diverse populations. Understanding the frequency of oncogenic variants in specific populations helps elucidate carcinogenesis and risk factors, with somatic variants often serving as treatment markers. Data regarding the somatic landscape across the main tumor subtypes in patients from Latin America and the Caribbean (LAC) have increased recently, highlighting important differences from contrasting populations in North America, Europe, and Asia. Many of these differences have pressing implications regarding screening, risk factor management, targeted therapies, and health care policy. This review aims to synthesize the existing information on somatic oncogenic variants in patients' tumors from LAC. We included the frequency of somatic oncogenic variants of the most frequent tumors in LAC: prostate cancer, female breast cancer, colon cancer, gastric cancer, and lung cancer. Furthermore, we add information from tumors that are relevant in LAC because of their high incidence, specific subtypes, or aggressive phenotypes, namely gallbladder cancer, acral melanoma, and hematologic neoplasms, respectively. The data highlight distinct differences in the reported prevalences of various somatic variants across a spectrum of neoplasms. Moreover, it demonstrates that an extensive number of genetic and molecular studies have been carried out in the region, improving the level of characterization for this complex, admixed population. Nonetheless, data from many individual countries are still scarce or altogether missing, underscoring the need to establish collaborative groups to further advance progress in LAC. The need for further comprehensive research in the area should not be substituted with data from other regions as we seek to empower the choices to improve our health care outlook.
Expanding Germline Hereditary Cancer Gene Panel Testing by Nongenetics Providers: 3-Year Experience in Large Integrated Health Care Delivery System
Authors: Hoffman Trevor L. , Brasfield Farah M. , Tewari Devansu , Greenberg Jeffery D. , Kershberg Hilary B. , Goff John , Haque Reina , Alvarado Monica
Published: February 2025

PURPOSE

Demand for germline hereditary cancer genetic testing has increased because of reduced cost, gene discovery, expanding indications, and precision cancer therapies. The traditional model for germline testing, where a genetics provider performs all steps of the testing process (pretest counseling, test ordering, results disclosure, and post-test counseling), is no longer able to meet testing needs especially for patients with cancer needing timely germline testing for treatment decisions. Mainstreaming has emerged as an alternative approach to increase testing capacity and efficiency, where nongenetics providers perform these steps and genetics providers focus on post-test counseling for positive results.

METHODS

This study reports a 3-year experience with mainstreaming hereditary cancer gene panel testing at Kaiser Permanente Southern California. The study compared demographic characteristics, cancer diagnoses, and test results between patients tested by genetics providers (traditional model) versus nongenetics providers (mainstreaming) over 3 years. Over 32,000 germline hereditary cancer gene panels were completed, including nearly 12,000 mainstreaming tests.

RESULTS

Mainstreaming substantially increased testing volume. Patients undergoing mainstream testing were more likely to have cancer, be male, and self-report being Asian or Black. The positive test rate was slightly lower in the mainstreaming group (11%) compared with the traditional testing model (15%), with similar rates of variants of uncertain significance. Post-test genetic counseling was high in both groups for positive results.

CONCLUSION

This study demonstrates that mainstreaming can be successfully implemented in a large health care system and significantly expand testing capacity.