bluuebunny/crossref_metadata_2025 huggingface dataset:
Urine Neutrophil Gelatinase‐Associated Lipocalin in Non‐Associative Immune Mediated Hemolytic Anemia: A Prospective Controlled Study in 22 Dogs
Authors: Lantzaki Vasiliki , Fulton Emily A. , McLaughlin Mark , Bennet Euan D. , Conway Elizabeth A. , Ridyard Alison E.
Published: January 2025

Background

Urine neutrophil gelatinase‐associated lipocalin (uNGAL) is a biomarker for the early diagnosis of AKI.

Objectives

To evaluate uNGAL in dogs with non‐associative immune mediated hemolytic anemia (IMHA) and to evaluate whether uNGAL correlates with disease severity markers, negative prognostic indicators and outcome.

Animals

Twenty‐two dogs with non‐associative IMHA and 14 healthy dogs.

Methods

Prospective case–control study. uNGAL was measured by a commercially available ELISA‐kit and corrected to urine creatinine (uNGAL to creatinine ratio [UNCR]). uNGAL and UNCR of IMHA cases were compared to that of healthy dogs and the correlation with other clinicopathological markers was evaluated. uNGAL and UNCR were also compared between dogs with a CHAOS or ASA score < 3 and ≥ 3.

Results

uNGAL and UNCR were significantly higher in dogs with IMHA when compared to healthy controls (uNGAL median 114.58 and 0.43 ng/mL, respectively, p < 0.001; UNCR median 174.87 and 0.13 ng/mg, respectively, p < 0.001). uNGAL and UNCR were moderately positively correlated with urea (p = 0.005, r = 0.58, 0.20–0.81 95% CI and p = 0.001, r = 0.64, 0.29–0.84 95% CI, respectively) and total bilirubin (p = 0.003, r = 0.60, 0.22–0.82 95% CI and p = 0.002, r = 0.62, 0.25–0.83 95% CI, respectively). These were also significantly higher in dogs with hemoglobinuria compared to those without (uNGAL: median 269 and 30.99 ng/mL, respectively, p < 0.001; UNCR: median 585.3 and 352 37.47 ng/mg, respectively, p < 0.001). There was no statistically significant difference in uNGAL or UNCR when assessing survival to discharge (p = 0.24 and p = 0.16, respectively, 95% CI).

Conclusions

This study suggests that renal injury might be underappreciated in dogs with IMHA.
Pegcetacoplan for the Treatment of Paediatric C3 Glomerulonephritis: A Case Report
Authors: Guzman German Lozano , Perry Katherine W.
Published: January 2025

Complement 3 glomerulonephritis (C3GN) is a rare glomerular disease involving dysregulation of the complement system. We describe our experience using pegcetacoplan, an inhibitor of C3 and its activation fragment, C3b, for treatment‐resistant C3GN in a 9‐year‐old boy referred for evaluation of refractory membranoproliferative glomerulonephritis. Despite treatment with intense immunosuppression (high‐dose steroids, mycophenolate mofetil and calcineurin inhibitor), he continued to have high disease activity with low C3 levels (35 mg/dL), hypertension, symptomatic oedema, anaemia, and nephrotic‐range proteinuria (e.g., urine protein‐to‐creatinine ratio [uPCR], 10 g/g; serum creatinine, 0.4 mg/dL). Given the concern for refractory C3GN following a steroid taper and tacrolimus trial with modest response (reduced proteinuria), we initiated pegcetacoplan 540 mg twice weekly for 1 week, followed by 648 mg twice weekly. Laboratory values before pegcetacoplan initiation included uPCR, 1.1 g/g, serum creatinine, 0.87 mg/dL, serum albumin, 4.7 g/dL, and serum C3, 30 mg/dL. Clinically significant improvements in serum C3 (142 mg/dL) and uPCR (422 mg/g) were observed within 1 week of pegcetacoplan initiation; within 3 months (uPCR, 322 mg/g; serum creatinine, 0.69 mg/dL; serum C3, 297 mg/dL), all immunosuppressive and antihypertensive medications were discontinued. No adverse effects of pegcetacoplan were reported. A kidney biopsy after 6 months of pegcetacoplan treatment showed mesangial and focal endocapillary proliferative glomerulonephritis with isolated C3c deposition by immunofluorescence, consistent with previous C3GN diagnosis. In this paediatric patient, compassionate use of pegcetacoplan was associated with rapid clinical improvement without adverse effects, and clinical effectiveness was confirmed by laboratory and histologic results within 6 months of treatment initiation.
Asyneuma ozudogrui (Campanulaceae), a new species from southern Anatolia
Authors: Özgişi Kurtuluş
Published: January 2025

Asyneuma ozudogrui is described as a new species from Antalya, Turkey. Morphologically, it is similar to Asyneuma lobelioides and A. davisianum, but is easily distinguished by several morphological characters, including trichome types, the shape of the basal leaves and bracts, seed features and pollen grains. A detailed description, diagnostic characters and photographs of the new species are provided. Additionally, its IUCN Red List category, ecological observations of the populations, and a distribution map of the new species and its close relatives in Turkey are included.
Synergistic effects of GmLFYa and GmLFYb on Compound Leaf Development in Soybean
Authors: Wang Dongfa , Zhao Baolin , Zhou Xuan , Zhou Shaoli , Yang Liling , Mao Yawen , Bai Quanzi , Zhao Weiyue , Sun Mingzhu , Liu Mingli , Gu Zhijia , He Liangliang , Chen Jianghua
Published: January 2025

Legume leaves exhibit diverse compound forms, with various regulatory mechanisms underlying the development. The transcription factor‐encoding KNOXI genes are required to promote leaflet initiation in most compound‐leafed angiosperms. In non‐IRLC (inverted repeat‐lacking clade) legumes, KNOXI are expressed in compound leaf primordia but not in others (IRLC). Recent studies have highlighted LFY genes' role in regulating leaflet initiation across legumes. The LFY functions in leaf development are well understood in IRLC legumes but remain unclear in non‐IRLC legumes. Soybean, a major crop belonging to non‐IRLC legumes, has limited research on the trifoliate leaf morphogenesis. Here, we comprehensively analyzed soybean trifoliate leaf development and characterized two GmLFY gene copies, GmLFYa and GmLFYb, in compound leaf morphogenesis. Analyzing the loss‐of‐function mutants revealed that Gmlfya displayed a low frequency of simple‐like leaves, while the Gmlfyb showed no visible phenotype. However, the Gmlfya Gmlfyb double mutant predominantly displayed simple‐like leaves. Additionally, mutations in two genes also affect floral development: each single mutant exhibited slightly deformed floral organs, while double mutant produced inflorescence‐like structures. The transformation from floral meristems to inflorescence‐like structures is similar to lfy mutant in Arabidopsis but quite different from M. truncatula and L. japonicus. These findings suggest that the two GmLFY genes in soybean collaboratively regulate both compound leaf and flower morphogenesis. Our study not only creates foundational mutant materials for future research on leaf and flower development in soybean but also reinforces the role of LFY orthologs as master regulators in compound leaf morphogenesis across a broader range of legume taxa than previously recognized.
Network position and academic achievement in middle school
Authors: Horowitz Jonathan , Hamm Jill
Published: January 2025

Does network position promote academic achievement net of the characteristics of friends in the network? Using nearly complete friendship network data at two middle schools, we estimate fixed‐effects models to examine whether degree centrality and brokerage position affect grades, net of all time‐invariant student characteristics, and the observable content of the friend network. The results show that more central network positions advance academic achievement, but these effects are not the same across mathematics and language arts subjects. Degree centrality affects mathematics grades, while brokerage position impacts performance in language arts. These findings highlight the importance of network position on academic achievement and the relevance of different types of centrality for achievement in mathematics and language arts.
Privately Provided Public Service and Local Financial Condition: The Cost of Externalized Service Accountability
Authors: Park HyungGun
Published: January 2025

Objective

This study investigates how special districts affect the financial condition of general‐purpose governments, specifically focusing on the nontraditional budgetary indicators focusing on the financial and service liabilities of local governments.

Methods

Based on the extant literature, the concept of financial condition of local government is operationalized through solvency and efficiency type measures as well as a construct of local finance to capture the dependent variable's sophisticated characteristics. Using a balanced MSA year dataset between 1972 and 2017, the estimations run several empirical models with panel‐corrected standard error.

Results

The estimation results generally indicate that the proliferation of special districts undermines the financial condition of cities and counties. While special districts may contribute positively to the local economy, their privately provided public services indirectly create financial stress. This burden falls on general‐purpose governments, particularly when social issues arise from insufficient universal service provision for the less affluent populations additionally.

Conclusion

The findings indicate that general‐purpose governments are compelled to adopt less efficient methods to deliver comparable services to underserved constituent groups without access to specialized services, emphasizing that the creation of special districts often incurs greater costs than anticipated.
ZmDREB1A controls plant immunity via regulating salicylic acid metabolism in maize
Authors: Zhang Chunxia , Zhang Huanbo , Lin Wanping , Chai Jiahao , Shangguan Xiaoqing , Zhao Tianyong
Published: January 2025

DREB1A, a pivotal transcription factor, has long been known to regulate plant abiotic stress tolerance. However, its role in plant biotic stress tolerance and the underlying mechanisms have remained a mystery. Our research reveals that the maize ZmDREB1A gene is up‐regulated in maize seedlings when the plants are infected by Rhizoctonia solani (R. solani). The maize ZmDREB1A knock‐out mutant exhibits increased disease resistance against the pathogen R. solani. Further investigation showed that ZmDREB1A regulates salicylic acid (SA) metabolism by inhibiting ZmSARD1 gene and activating ZmSAGT gene expression. Additionally, the SA level was increased while the SAG level was decreased in zmdreb1a mutant seedlings when the plants were infected with the pathogen R. solani. Furthermore, overexpression of ZmSAGT in Arabidopsis reduced plant resistance to Pst DC3000 by decreasing SA levels and increasing SAG levels. These data demonstrate that ZmDREB1A regulates the metabolism of SA and controls plant immune response in maize.
On the Mechanism of Rotating Stall in a Boundary Layer Ingesting Fan
Authors: Deng Hefang , Zhang Songan , Xia Kailong , Qiang Xiaoqing , Zhu Mingmin , Teng Jinfang
Published: January 2025

Next-generation boundary layer ingesting (BLI) aircraft can achieve significant reductions in fuel burns compared to conventional aircraft. One of the challenges for BLI aircraft is the need for the fan to continuously operate with inlet distortions. However, until now the effect of real BLI distortions on rotating stall remains unclear. In this work, full-annulus unsteady simulations are conducted to analyze the mechanism of rotating stalls in a boundary layer ingesting fan. The complete stall hysteresis loop at BLI distortions is investigated. Similar to the uniform inflow, the fan at the BLI distortions also exhibits the spike-type rotating stalls, and its stall inception is also attributed to the radial vortex structure caused by the shear interaction between the incoming flow and backflow. However, at the BLI distortions, the evolution process of rotating stall is accompanied by the growth and decay of disturbances because of the significant variation of the inflow condition around the whole annulus. Only when the stall disturbance becomes large enough can it propagate circumferentially across the whole annulus to form the full stall cell. In addition, due to the significant decrease in total pressure ratio, the fan at the BLI distortions is easier to exit the rotating stall compared to the uniform inflow. These results enhance the understanding of the rotating stall mechanism not only for BLI fans but also for many turbine engines that suffer from inlet distortions.
Extending the Trans-Contextual Model for Predicting Physical Activity Participation: The Role of Metacognition in Contextual Transfer
Authors: Lee Doheung , Jang Dojin
Published: January 2025

Purpose: This study aimed to validate the utility of an extended Trans-Contextual Model, which incorporates the moderating role of metacognition facilitating contextual transfer from physical education (PE) to leisure time, in predicting the level of physical activity among university students. Method: A three-wave longitudinal design was employed, with 400 university students completing surveys at different time points. Data from the final 210 participants were utilized to validate the measurement model and assess the research model (moderated mediation model). Results: The findings supported a significant mediating pathway from instructor autonomy support to autonomous motivation of PE and leisure time, physical activity intention, and actual participation. Furthermore, the study confirmed that the level of metacognition significantly moderated the transfer process of autonomous motivation from PE to leisure time. Discussion/Conclusion: This research underscores the importance of instructors’ autonomy support within university PE classes and advocates for pedagogical approaches aimed at fostering metacognition.
Use of analytical strategies to understand spatial chemical variation in bacterial surface communities
Authors: Weaver Abigail A. , Shrout Joshua D.
Published: January 2025

Not only do surface-growing microbes such as biofilms display specific traits compared to planktonic cells, but also they display many heterogeneous behaviors over many spatial and temporal contexts. While the application of molecular genetics tools to extract or visualize gene expression or regulatory function data is now common in studying surface growth, the use of analytical chemistry tools to visualize the spatiotemporal distribution of chemical products synthesized by these surface microbes is less common. Here, we review chemical imaging tools that have been used to inform our understanding of surface-growing microbes. We highlight the use of confocal Raman Microscopy, surface-enhanced Raman spectroscopy, matrix-assisted laser desorption/ionization, secondary ion mass spectrometry, desorption electrospray ionization, and electrochemical imaging that have been applied to assess two-dimensional chemical profiles of bacteria. We specifically discuss the use of these tools to study rhamnolipids, alkylquinolones, and phenazines of the bacterium
Pseudomonas aeruginosa
.
Conformational flexibility is a critical factor in designing broad-spectrum human norovirus protease inhibitors
Authors: Pham Son , Zhao Boyang , Neetu Neetu , Sankaran Banumathi , Patil Ketki , Ramani Sasirekha , Song Yongcheng , Estes Mary K. , Palzkill Timothy , Prasad B. V. Venkataram
Published: January 2025

Human norovirus (HuNoV) is a leading cause of gastroenteritis worldwide and is associated with significant morbidity, mortality, and economic impact. There are currently no licensed antiviral drugs for the treatment of HuNoV-associated gastroenteritis. The HuNoV protease plays a critical role in the initiation of virus replication by cleaving the polyprotein. Thus, it is an ideal target for developing antiviral small-molecule inhibitors. While rupintrivir, a potent small-molecule inhibitor of several picornavirus proteases, effectively inhibits GI.1 protease, it is an order of magnitude less effective against GII protease. Other GI.1 protease inhibitors also tend to be less effective against GII proteases. To understand the structural basis for the potency difference, we determined the crystal structures of proteases of GI.1, pandemic GII.4 (Houston and Sydney), and GII.3 in complex with rupintrivir. These structures show that the open substrate pocket in GI protease binds rupintrivir without requiring significant conformational changes, whereas, in GII proteases, the closed pocket flexibly extends, reorienting arginine-112 in the BII-CII loop to accommodate rupintrivir. Structures of R112A protease mutants with rupintrivir, coupled with enzymatic and inhibition studies, suggest R112 is involved in displacing both substrate and ligands from the active site, implying a role in the release of cleaved products during polyprotein processing. Thus, the primary determinant for differential inhibitor potency between the GI and GII proteases is the increased flexibility in the BII-CII loop of the GII proteases caused by the H-G mutation in this loop. Therefore, the inherent flexibility of the BII-CII loop in GII proteases is a critical factor to consider when developing broad-spectrum inhibitors for HuNoV proteases.

IMPORTANCE

Human noroviruses are a significant cause of sporadic and epidemic gastroenteritis worldwide. There are no vaccines or antiviral drugs currently available to treat infections. Our work elucidates the structural differences between GI.1 and GII proteases in response to inhibitor binding and will inform the future development of broad-spectrum norovirus protease inhibitors.
Tracing crustal recycling mechanisms using Mo isotopes in high-Mg andesites
Authors: Zeng Yunchuan , Xu Jifeng , Chen Jianlin , Li Jie , Huang Feng
Published: January 2025

High-Mg andesites (HMAs) are key magmatic markers of crust-mantle interaction, yet the mechanisms driving this process remain elusive. This study presents Mo isotope data for Eocene (post-collision) HMAs from central Tibet, showing high δ98Mo values comparable to arc basalts, arc crustal xenoliths, and melts from undetached Tibetan crust, but distinct from deeply subducted oceanic or continental crust. Coupled with their adakitic signatures and seismic imaging, these HMAs are interpreted as products of interactions between lower crustal drip melts and peridotite. We propose that negligible Mo isotope fractionation occurs during the delamination and subsequent melting of lower continental crust, unlike the substantial fractionation observed in subducting slabs, where heavy Mo is lost during dehydration along distinct pressure-temperature paths. Thus, Mo isotopes in HMAs offer a promising avenue for resolving the longstanding conundrum on whether crustal materials are recycled back into the mantle through subduction or delamination.
Supplemental Material: Seismic anatomy of Miocene clinoform sequences on the New Jersey (USA) shelf, and implications for sediment transport during base-level rhythms
Authors: Aali Masoud , al. et
Published: January 2025

Supplemental File S1: Perspective view of seismically defined systems tracts on the New Jersey (USA) shelf. Supplemental File S2: Tables S1–S3. 
Listening to the voices of adolescents with inflammatory bowel disease after returning to school: a qualitative study
Authors: Peng Keyuan , Zhu Pingting , Gu Xinyue , Hu Chenglei , Teng Yi , Gu Zhie
Published: January 2025

Background

The prevalence of inflammatory bowel disease (IBD) among Chinese adolescents has continued to increase in recent years. Adolescents with IBD interrupted their schooling due to the diagnosis and treatment of the disease. And when the condition stabilises, they will return to school. However, as a lifelong and recurrent disease, the instability of the disease after returning to school affects normal school participation.

Objective

This study aims to explore the psychological and life challenges of adolescents with IBD in the complex and intertwined situations of disease management, adolescent development and school social interactions.

Methods

A qualitative descriptive study was conducted. Qualitative data were collected from adolescents aged 11–19 (n=21; 7 males and 14 females) through in-depth, semistructured interviews. Reflexive thematic analysis was employed to ensure rigour.

Results

The results highlight the challenges of returning to school for adolescents with IBD. There are three emerging themes and nine subthemes (in parentheses). (1) Problems of continued disease management (occasional uncontrollable flare-ups of symptoms, regular medical checkups disrupting daily school programming and shame from medication management). (2) Difficulties of impaired school functioning (difficulty keeping up with academic study and participating in high-intensity sports activities). (3) Challenges of maintaining friendship (burden of disease disclosure, difficulty in sharing food with friends, common topics of conversation decreasing and absence of group activities).

Conclusion

We call on medical institutions and schools to strengthen cooperation and further optimise support measures for this group through the intermediary role of school health clinics.
‘I wish I had been better prepared’: a mixed-methods study of psychological reactions, perceptions and opinions of cardiovascular preparticipation screening among young competitive athletes
Authors: Grubic Nicholas , Fraser Matthew , Ford Meghan K , Hill Braeden , Mantella Laura E , Mihajlovic Valentina , Bennett Ryan , Syan Rohaan , Law Anhadh , Thornton Jane S , Johri Amer M
Published: January 2025

Objective

To evaluate the psychological reactions, perceptions and opinions of cardiovascular preparticipation screening (PPS) among young competitive athletes.

Methods

This convergent parallel mixed-methods study recruited 222 athletes (mean age: 18.7 years) who underwent PPS at a Canadian university. All athletes completed a cardiovascular history questionnaire, and a subgroup (n=165) additionally obtained an ECG and physical exam. On registering for PPS, athletes completed a psychological impact survey. Survey items were measured on a 5-point scale, ranging from −2 (strongly disagree) to 2 (strongly agree) and reported as means. After completing PPS, 18 athletes participated in focus groups or interviews to explore screening experiences. Qualitative data were analysed using reflexive thematic analysis, following an inductive and critical realist approach.

Results

Athletes reported minimal symptoms of anxiety (−1.29), stress (−1.41) or worry (−1.12) concerning their participation in PPS and agreed that screening was beneficial for their safety (1.25). Psychological symptoms were higher in athletes who reported cardiovascular symptoms or a family history than those who did not. Athletes required to undergo an ECG and physical exam were less anxious, stressed and worried about PPS but more interested in learning about their results than those screened with only a history questionnaire. Three themes described athletes’ responses to PPS: (1) importance of communication and service navigation; (2) distress surrounding the uncertainty of results and (3) screening as a non-disruptive and essential part of ‘being an athlete’.

Conclusion

The PPS process does not lead to excessive distress among young competitive athletes before, during or after screening. Athletes identified solutions to enhance the PPS experience, including tailored educational resources and an integrated support system to manage psychological symptoms.
The association between Guardian Cap use during practices and sport-related concussion risk in high school American football players
Authors: Hammer Erin , Mosiman Sam , Joachim Mikel R , Taylor Ethan , Cordum Adam , Brooks M Alison , McGuine Timothy
Published: January 2025

Objective

Guardian Caps (GCs) have been widely implemented at all levels of American football participation based on laboratory evidence that they may reduce head impact forces. The purpose of this study was to determine if GC use during practice was associated with a lower risk of sport-related concussion (SRC) during practices and games among high school football players.

Methods

Data were collected on 2610 athletes from 41 Wisconsin schools that self-selected into GC or Non-GC cohorts. Athletic trainers recorded practice and game exposures and SRCs through the 2023 season. Generalised linear mixed models were built to determine the effect of GC utilisation on SRC rates, accounting for school and player exposures.

Results

In the total cohort (Non-GC n=1188 (45.5%); GC n=1422 (54.5%)), 180 athletes (6.9%) sustained SRCs. 64 SRCs occurred during practice (GC n=33 (51.6%); Non-GC n=31 (48.4%)). GC use was not associated with a decreased risk of SRC during practice in the univariable analysis (relative risk (RR)=1.04, 95% CI 0.58 to 1.86, p=0.90) or after accounting for previous SRC within the last year (RR 1.01, 95% CI 0.57 to 1.79, p=0.97). No players of either cohort wore GCs during games. There were 116 SRCs sustained during games (GC n=68 (58.6%); Non-GC n=48 (41.4%)). GC use during practice was not associated with the risk of SRC during games in the univariable analysis (RR 1.13, 95% CI 0.72 to 1.78, p=0.60) or after accounting for previous SRC within the last year (RR 1.13, 95% CI 0.71 to 1.78, p=0.61).

Conclusion

GC use during practice in high school American football players was not associated with a decreased risk of sustaining SRC in practice or games.
5  Post-infectious sequelae of cryptosporidiosis in a military cohort
Authors: Hale Isra , Toriro Romeo
Published: January 2025

Background

Infectious gastroenteritis is a common medical presentation in deployed military settings. Post-infectious sequelae in military populations are rarely reported. Following a British military cryptosporidiosis outbreak in Kenya in 2022, and subsequent molecular characterisation of faecal samples from consented study participants, we conducted a longitudinal cohort-study investigating health impacts following resolution of acuteCryptosporidium hominisinfection.

Method

The study has followed up 40 military personnel at 3-months, 6-months and 12-months post-acuteCryptosporidium hominisinfection. Telephone consultations were conducted by a Medical Officer using a bespoke questionnaire to identify gastrointestinal and systemic symptoms which may present post-infection. Clinical consultation was used to exclude other causes of these symptoms. Findings were recorded as consultations in patient medical notes then anonymised and, entered into Microsoft Excel. Follow-up is ongoing, and we plan to calculate confidence intervals for proportions, 95% confidence intervals for risk ratios, chi squared for trend and to examine association between symptoms and case status with logistic regressions.

Results

New symptoms reported at 3-months included; diarrhoea 9/40 (22.5%), abdominal pain 5/40 (12.5%), nausea 5/40 (12.5%), bloating 5/40 (12.5%), myalgia 4/40 (10%), fatigue 4/40 (10%), joint pain 3/40 (7.5%), and weight loss 2/40 (5%). At the 6-month point, diarrhoeal symptoms persisted in 7/40 (17.5%), abdominal pain persisted in 2/40 (5%) and weight loss was reported in 4/40 (10%). At 12-months one participant reported referral to gastroenterology, diarrhoea was reported in 2/40 (5%) and abdominal pain reported in 3/40 (7.5%).

Conclusions

On-site diagnostic capability in remote settings, and further molecular sequencing enabled identification of a novelC.hominissubtype. Findings demonstrate unexpectedly high rates of post-infectious sequelae, particularly diarrhoea, following acute cryptosporidiosis in healthy military personnel. This post-infectious sequalae, in military personnel, may negatively impact their wellbeing and potentially impact their medical deployability. Patient education on potential health impacts post cryptosporidiosis infection would encourage appropriate health-seeking behaviour.
Investigating the implementation of a Trial of Labour After Caesarean (TOLAC) delivery bundle with respect to decreasing caesarean delivery rates: a multisite quality improvement initiative
Authors: Miazga Elizabeth , Reed Cheyanne , Olsthoorn Alisha , Fan Isabella , Zhao Eliya , Shapiro Jodi , Cipolla Amanda , Tunde-Byass Modupe , Shore Eliane M
Published: January 2025

Objectives

To study the effect of implementing a Trial of Labour After Caesarean (TOLAC) delivery bundle with respect to decreasing caesarean delivery rates across five hospitals.

Design

Prospective quality improvement study.

Setting

Five Canadian hospital sites participated, two academic centres and three community hospitals, with annual delivery rates ranging from 2500 to 7500 per site.

Participants

All obstetrical patients with a singleton gestation in cephalic presentation and only one previous caesarean delivery were included.

Interventions

A TOLAC bundle was introduced at each hospital site, consisting of three main interventions: (1) education for healthcare providers, (2) a TOLAC discussion sheet and (3) patient educational tools.

Primary and secondary outcome measures

The primary outcome was the caesarean delivery rate in eligible patients. Secondary outcomes included rates of trial of labour after caesarean delivery, vaginal birth after caesarean delivery and induction of labour. Balance measures included rates of uterine rupture and neonatal intensive care unit admission. Process measures included attendance at educational rounds, elements of the interventions identified in chart review and view counts for educational videos.

Results

The baseline caesarean delivery rate was 77% (1730 out of 2244 eligible patients). Following the introduction of the bundle, the caesarean delivery rate decreased to 71% (1497 out of 2097 eligible patients; 6% decrease, p<0.001). A significant increase in induction rate was noted from 5% preintervention to 9% postintervention (p<0.001). There was no increase in the uterine rupture or neonatal intensive care admission rates.

Conclusion

This TOLAC bundle can decrease caesarean delivery rates without negatively impacting uterine rupture or neonatal intensive care admission rates. The interventions can be easily adapted for use in different hospitals and practice environments.
New Artisse intrasaccular device for intracranial aneurysm treatment: short term clinical and angiographic result from the prospective registry INSPIRE-A
Authors: Hohenstatt Sophia , Costalat Vincent , Dargazanli Cyril , Killer-Oberpfalzer Monika , Schreiber Barbara , Rautio Riitta , Sinisalo Matias , Lamin Saleh , Chew Han Seng , Spelle Laurent , Tomasello Alejandro , Patankar Tufail , Piano Mariangela , Fiehler Jens , Möhlenbruch Markus A
Published: January 2025

Background

Intrasaccular devices have broadened treatment options for wide necked aneurysms. This study presents the preliminary experience with the Artisse 2.0 device.

Methods

Innovative NeurovaScular Product SurveIllance REgistry (INSPIRE) is a non-randomized, multicenter, real world clinical study with treatment arms for aneurysms (INSPIRE-A) and acute ischemic stroke (INSPIRE-S). This interim analysis included 87 patients enrolled from November 2022 to April 2024 in the INSPIRE-A Artisse cohort across 16 Europoean centers. Procedures followed standard clinical care, with 6 months of follow-up. Safety and efficacy endpoints included major stroke, neurological death, serious adverse events (SAEs), aneurysm occlusion, and retreatment rates. An independent core laboratory assessed imaging, and all SAEs were reviewed by a clinical events committee. The Artisse steering committee provided independent oversight of the data.

Results

The Artisse device achieved an overall successful implantation rate of 96.6% (84/87), with satisfactory placement rates of 98.7% (74/75) for unruptured and 88.9% (8/9) for ruptured aneurysms. Following the procedure, 46.2% of unruptured aneurysm patients were receiving antiplatelet therapy (APT), predominantly aspirin monotherapy, while no ruptured aneurysm patients received APT. Device related SAE rate was 1.3% (1/87), and the overall stroke rate was 2.3% (2/87), including both ruptured and unruptured aneurysms. At 6 months, 80.0% (28/35) of patients with unruptured aneurysms showed complete obliteration, with no recurrences or retreatments.

Conclusions

Preliminary experience with the Artisse 2.0 device demonstrated high technical success, favorable safety, and efficacy in aneurysm obliteration at 6 months. Larger studies with longer follow-up periods are needed to confirm these findings.
‘What Matters to Staff Programme’: eight steps to improve staff well-being at work
Authors: Turner Karen , Longmate Rebecca , Coy-Terry Jane , Dai Meric
Published: January 2025

Background and aim

The What Matters to Staff programme was designed at the Royal Free Hospital to address a key priority of improving workforce well-being. The initial aim was to set up a programme that responded to what mattered to staff and could be spread to 70 teams across the hospital within 2 years.

Methods

The programme was developed by adding a set of simple, yet important steps around the ‘what matters to you’ conversation from the Joy in Work Framework. The programme enrolled its first teams in January 2022 and has since spread widely to over 90 areas and has involved approximately 3000 staff.

Results

There have been significant improvements in staff experience, staff engagement and workforce metrics since the programme began and it is now embedded as business as usual within each division. It was easily scalable on minimal resources due to its standardised and systematic approach and because the programme was seen to drive positive and impactful change.

Conclusion

Over the past 2 years, the programme has given staff the opportunity to have their voice heard and has supported leaders to ask, listen and do what matters most for their teams. This has led to improved workforce metrics and the programme being widely scaled and spread.
Functional impairment in COPD can be predicted using genomic-derived data
Authors: Marçalo Rui , Rodrigues Guilherme , Pinheiro Miguel , Neto Sonya , Marques Sofia L , Simão Paula , Martins Vitória , Andrade Lília , Mendes Maria Aurora , Santos Manuel , Afreixo Vera , Marques Alda , Moura Gabriela
Published: January 2025

Objective

Reduced functional capacity and muscle weakness are two major contributors to functional impairment in chronic obstructive pulmonary disease (COPD). The underlying causes of functional impairment are poorly understood and, therefore, we sought to investigate the contribution of genetic factors.

Methods

We conducted a cross-sectional analysis of sociodemographic, clinical and genetic information of people with COPD. Hierarchical clustering based on functional capacity (6-minute walk test and 1-minute sit-to-stand test) and muscle strength (quadriceps isometric muscle strength and handgrip muscle strength) was performed. A genome-wide association study (GWAS) was performed using cluster assignment as phenotype. Polygenic risk scores (PRSs) were calculated for each variable. Genomic-derived data was used to construct a model to predict functional impairment.

Results

Two clusters were identified among 245 individuals. Cluster 1 (n=104) was composed of younger, less symptomatic patients, with preserved functional capacity and muscle strength, whereas cluster 2 (n=141) included those older, more symptomatic, with reduced functional capacity and muscle weakness. GWAS identified two polymorphisms suggestively associated with functional impairment, mapped toxanthine dehydrogenase. Cluster 2 was enriched in individuals with risk alleles for rs1991541 and rs10524730, and lower PRSs for functional capacity and muscle strength. A prediction model using genomic-derived data was constructed (n=159) and tested (n=37), yielding an area under the curve of 0.87 (0.76–0.99).

Conclusion

Genetic factors are significantly associated with functional impairment in COPD. The incorporation of genetic information, particularly PRSs, into a predictive model offers a promising avenue for timely identifying individuals at greater risk of functional decline, potentially facilitating personalised and preventive interventions. Further studies on independent external cohorts are needed to validate our model.
Poromechanical analysis of regional frozen ground responses under heat exchanger operations
Authors: Khaksar Kian , Li Biao
Published: January 2025

The permafrost of the northern hemisphere is under threat of degradation due to increasing global temperatures resulting from climate change. Thawing permafrost exhibits lower strength and increased permeability, leading to soil instability and subsidence beneath structures. To mitigate the effects of permafrost thaw, heat extraction is utilized to cool the frozen soil bodies. Ground heat exchangers (GHE) are geo-structures that exchange heat with the ground and can be used for heat extraction. In this work, Thermo-Hydro-Mechanical modeling is employed to simulate the state of a saturated soil body during freezing and thawing in Umiujaq, Quebec, Canada. An initially frozen soil body is analyzed under seasonal temperature variations and GHE operations. The pore pressure development and ground deformation are well quantified. It is shown that GHE operations can effectively mitigate the risks associated with talik formation, with group-GHE formations being more effective in this regard. Additionally, it is demonstrated that group-GHE operations are effective in mitigating excessive thawing settlement. Furthermore, the shortcomings of single-GHE operations, such as limited radius of effect and differential settlement, can be improved by group-GHE formations through a confinement effect.
ACM Risks Forum Quarterly Summary
Authors: Neumann Peter G.
Published: January 2025

This is an annotated summary of the main items contributed to the ACM Risks Forum in the most recent quarter, orgnanized categorically. References (R i j) to the online Risks Forum denote RISKS vol i number j. Cited RISKS items generally identify contributors and sources, together with URLs. Official RISKS archives are available at www.risks.org, with nice html formatting and search engine courtesy of Lindsay Marshall at Newcastle: http://catless.ncl.ac.uk/Risks/i.j.html (also ftp://www.sri.com/risks). CACM Inside Risks: https://www.csl.sri.com/users/neumann/insiderisks.html
SRF: SpectrumRecombineFormer for Hyperspectral Image Classification
Authors: Jing Weipeng , Kang Peilun , Di Donglin , Gu Juntao , Li Linhui , Emam Mahmoud , Mohaisen Linda , Yang Xun , Li Chao
Published: January 2025

Hyperspectral (HS) imaging is a valuable technique for accurately classifying materials because of the abundance of spectral information and high resolution it provides. However, the characteristics of Hyperspectral images (HSI), such as high-dimensional features and information redundancy, pose significant challenges to data processing. Traditional dimensionality reduction methods often have information loss, high computational complexity, and easy to ignore the strong correlation between HSI spectral bands when dealing with HSI data. Although other methods can achieve satisfactory classification performance, they do not consider the dimensionality reduction of HSI, and they focus on the model performance, which limits further improvement in classification performance. This paper proposes a transformer-based framework called “SpectrumRecombineFormer” (SRF), which is composed of two key modules, namely “Spatial Spectral ReCombination” (SSRC) and “Cross-layer Fusion” (CF). The SSRC is capable of utilizing both adjacent and non-adjacent spectrums to generate the spatial-sequential perceptive representations, which alleviates the effect of the strong correlation between HSI spectral bands. The CF can avoid the loss of information during the feed-forward procedure among layers. Extensive experiments on five existing datasets (widely-adopted Indian Pines, Houston2013, Pavia University, Salinas and KSC) demonstrate the capability of our proposed method to address the above mentioned challenges. Both quantitative and qualitative experimental ablation studies, including visualization results, reveal that the proposed SRF method can successfully and efficiently classify hyperspectral images and surpass the other state-of-the-art methods. For access to the source code, please visit
https://github.com/kangpeilun/SRF-HSI-Classification-master
.
Designer Organs: Ethical Genetic Modifications in the Era of Machine Perfusion
Authors: Filz von Reiterdank Irina , Bento Raphaela , Hyun Insoo , Isasi Rosario , Wolf Susan M. , Coert J. Henk , Mink van der Molen Aebele B. , Parekkadan Biju , Uygun Korkut
Published: January 2025

Gene therapy is a rapidly developing field, finally yielding clinical benefits. Genetic engineering of organs for transplantation may soon be an option, thanks to convergence with another breakthrough technology, ex vivo machine perfusion (EVMP). EVMP allows access to the functioning organ for genetic manipulation prior to transplant. EVMP has the potential to enhance genetic engineering efficiency, improve graft survival, and reduce posttransplant complications. This will enable genetic modifications with a vast variety of applications, while raising questions on the ethics and regulation of this emerging technology. This review provides an in-depth discussion of current methodologies for delivering genetic vectors to transplantable organs, particularly focusing on the enabling role of EVMP. Organ-by-organ analysis and key characteristics of various vector and treatment options are assessed. We offer a road map for research and clinical translation, arguing that achieving scientific benchmarks while creating anticipatory governance is necessary to secure societal benefit from this technology.
A Comprehensive Understanding of Camellia sinensis Tea Metabolome: From Tea Plants to Processed Teas
Authors: Mozumder N.H.M. Rubel , Lee Jang-Eun , Hong Young-Shick
Published: January 2025

Tea (Camellia sinensis) is one of the most popular nonalcoholic beverages in the world, second only to water. Six main types of teas are produced globally: green, white, black, oolong, yellow, and Pu-erh. Each type has a distinctive taste, quality, and cultural significance. The health-promoting effects of tea are attributed to the complex metabolite compositions present in tea leaves. These metabolite compositions vary in response to different factors. In addition to manufacturing processes in processed tea, the primary factors influencing variations of fresh tea leaf metabolites include genetics, cultivation management, and environmental conditions. Metabolomics approaches, coupled with high-throughput statistical analysis, offer promising tools for the comprehensive identification and characterization of tea leaf metabolites according to growing conditions, cultivation practices, manufacturing processes, seasonality, climate, cultivars, and geography. This review highlights the distinctive variations in fresh tea leaf metabolites, which change in response to various factors, using a metabolomics approach, which are also extended to various processed teas.
Jigsaw technique: will it help Gen Z nursing students?
Authors: Chandel Rashmi , Bhagat Anumeha , Malhotra Anita S. , Rohilla Ravi , Kaur Gurjit , Prakash Kiran
Published: January 2025

In our study, we found that the jigsaw technique (JST) significantly improves understanding, comprehension, and retention of topics among nursing students. It also enhances teamwork, self-confidence, and communication skills, aligning with the preferences of Generation Z students. Student feedback analysis reveals that JST facilitates easier understanding of topics, increases self-confidence, improves interpersonal skills, and creates an interactive learning environment. The authors suggest practical implications for nursing education by integrating JST into the curriculum, despite time constraints.
Tumor metabolism as a factor affecting diversity in cancer cachexia
Authors: Bathe Oliver F.
Published: January 2025

Cancer cachexia is a multifaceted metabolic syndrome characterized by muscle wasting, fat redistribution, and metabolic dysregulation, commonly associated with advanced cancer but sometimes also evident in early-stage disease. More subtle body composition changes have also been reported in association with cancer, including sarcopenia, myosteatosis, and increased fat radiodensity. Emerging evidence reveals that body composition changes including sarcopenia, myosteatosis, and increased fat radiodensity, arise from distinct biological mechanisms and significantly impact survival outcomes. Importantly, these features often occur independently, with their combined presence exacerbating poor prognoses. Tumor plays a pivotal role in driving these host changes, either by acting as a metabolic parasite or by releasing mediators that disrupt normal tissue function. This review explores the diversity of tumor metabolism. It highlights the potential for tumor-specific metabolic phenotypes to influence systemic effects, including fat redistribution and sarcopenia. Addressing this tumor-host metabolic interplay requires personalized approaches that disrupt tumor metabolism while preserving host health. Promising strategies include targeted pharmacological interventions and anticachexia agents like growth differentiation factor 15 (GDF-15) inhibitors. Nutritional modifications such as ketogenic diets and omega-3 fatty acid supplementation also merit further investigation. In addition to preserving muscle, these therapies will need to be evaluated for their capability to improve survival and quality of life. This review underscores the need for further research into tumor-driven metabolic effects on the host and the development of integrative treatment strategies to address the interconnected challenges of cancer progression and cachexia.
Neurocognitive Impairment and HIV Treatment Engagement in Men Who Have Sex With Men Living With HIV Who Report Chronic Pain and Substance Use
Authors: Sullivan Matthew C. , Wirtz Megan R. , McKetchnie Samantha M. , Gulbicki Lauren R. , Taylor S. Wade , Jampel Jonathan D. , Banerjee Nikhil , O’Cleirigh Conall
Published: January 2025

This study explored relationships between neurocognitive impairment (NCI), engagement in HIV care, and functional disability among sexual minority men aged 50 years or older living with HIV, chronic pain, and recent substance use. Sixty‐three participants completed cross‐sectional assessments including a neurocognitive screening measure, self‐reported HIV medication adherence, past‐year attendance at HIV‐care appointments, and indices of pain and functional impairment. Mean participant age was 57.2 years; most identified as White (55%), followed by Black/African American (42%). On average, participants reported moderate pain; 66.7% met DSM‐5 criteria for a substance use disorder. Average Montreal Cognitive Assessment (MoCA) performance reflected mild NCI. Regression analyses indicated an association between poorer MoCA performance and past‐year missed HIV‐care appointments (B = −0.09, t (59) = −3.10, p = 0.004). Self‐reported cognitive impairment was associated with more missed HIV‐care visits (B = 0.20, t (59) = 4.82, p < 0.001) and greater functional disability, whereas poorer semantic fluency was associated with fewer missed HIV‐care visits (B = −0.49, t (59) = −3.99, p < 0.001). Increased brief neuropsychological assessment and linkage to tailored interventions for HIV‐care engagement and substance use mitigation are warranted to support PLWH with NCI in clinical care.