bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient-shared knowledge and information in clinical decision-making: an international survey of the perspectives and experiences of naturopathic practitioners
Authors: Steel Amie , Brand Sarah , Leach Matthew , Lloyd Iva , Ward Vicky
Published: July 2023

Introduction

Most knowledge translation models pay relatively little attention to patient-held knowledge and are largely based on the premise that researchers and clinicians hold all valuable knowledge, and patients are passive recipients of such knowledge. Counter to this clinician- and researcher-centred lens is a growing interest and awareness of patients as experts in their health. While naturopathic medicine is described and experienced as a patient-centred system of traditional medicine, the position of patient-held knowledge is unclear particularly when considered alongside their use of other more objective forms of knowledge such as research evidence.

Methods

This international online cross-sectional survey aimed to explore naturopathic practitioners’ perceptions of the value and contribution of patient-shared knowledge and information within the context of naturopathic clinical consultations.

Results

The survey was completed by 453 naturopathic practitioners (response rate: 74.3%). Approximately two-thirds (68.2%) of respondents reported using information shared by the patient. Most rated ‘information provided by the patient’ as either ‘extremely important’ (60.7%) or ‘very important’ (31.4%) to patients. Highest levels of trust were reported for information provided by the patient (‘completely’: 9.9%; ‘a lot’: 53.6%). Most practitioners indicated they trusted knowledge and information derived from the patient’s personal health history ‘completely’ (n = 79; 21.8%) or ‘a lot’ (n = 226; 62.4%) from the patient’s perspective of living with a health condition (‘completely’ [n = 63, 17.4%]; ‘a lot’ [n = 224, 61.9%]). Patients were the highest ranked stakeholder group (mean: 1.5) perceived to influence NP use of patient experience of living with a health condition to inform clinical decision-making.

Conclusion

Researchers and policy makers are increasingly focused on the value of the ‘expert patient’ in clinical decision-making, yet health professionals’ report challenges and, in some cases, resistance to meaningfully engaging with patient-shared knowledge in practice. However, our study has found patient-shared knowledge – inclusive of patient experience of their health condition – is among the knowledge used and trusted by naturopathic practitioners to inform their clinical decision-making. This study both offers insights into the knowledge translation behaviours of an under-researched health profession and provides a novel contribution to the wider aim of adopting patient-shared knowledge into clinical care more generally.
An evaluation of truncated birth histories for the rapid measurement of fertility and child survival
Authors: Masquelier Bruno , Menashe-Oren Ashira , Reniers Georges
Published: July 2023

Background

Full birth histories (FBHs) are a key tool for estimating fertility and child mortality in low- and middle-income countries, but they are lengthy to collect. This is not desirable, especially for rapid turnaround surveys that ought to be short (e.g., mobile phone surveys). To reduce the length of the interview, some surveys resort to truncated birth histories (TBHs), where questions are asked only on recent births.

Methods

We used 32 Malaria Indicator Surveys that included TBHs from 18 countries in sub-Saharan Africa. Each set of TBHs was paired and compared to an overlapping set of FBHs (typically from a standard Demographic and Health Survey). We conducted a variety of data checks, including a comparison of the proportion of children reported in the reference period and a comparison of the fertility and mortality estimates.

Results

Fertility and mortality estimates from TBHs are lower than those based on FBHs. These differences are driven by the omission of events and the displacement of births backward and out of the reference period.

Conclusions

TBHs are prone to misreporting errors that will bias both fertility and mortality estimates. While we find a few significant associations between outcomes measured and interviewer’s characteristics, data quality markers correlate more consistently with respondent attributes, suggesting that truncation creates confusion among mothers being interviewed. Rigorous data quality checks should be put in place when collecting data through this instrument in future surveys.
‘The tabloid test’: a qualitative interview study on the function and purpose of termination of pregnancy review committees in Victoria, Australia
Authors: Bowman-Smart Hilary , Keogh Louise , Haining Casey M. , O’Rourke Anne , de Crespigny Lachlan , Savulescu Julian
Published: July 2023

Background

Termination of pregnancy (TOP) is not an uncommon procedure. Availability varies greatly between jurisdictions; however, additional institutional processes beyond legislation can also impact care and service delivery. This study serves to examine the role institutional processes can play in the delivery of TOP services, in a jurisdiction where TOP is lawful at all gestations (Victoria, Australia). As per theAbortion Law Reform Act 2008, TOPs post-24 weeks require the approval of two medical practitioners. However, in Victoria, hospitals that offer post-24 week TOPs generally require these cases to additionally go before a termination review committee for assessment prior to the service being provided. These committees are not stipulated in legislation. Information about these committees and how they operate is scarce and there is minimal information available to the public.

Methods

To trace the history, function, and decision-making processes of these committees, we conducted a qualitative interview study. We interviewed 27 healthcare professionals involved with these committees. We used purposive sampling to gain perspectives from a range of professions across 10 hospitals. Interviews were transcribed verbatim, identifying details removed and inductive thematic analysis was performed.

Results

Here, we report the three main functions of the committees as described by participants. The functions were to protect: (1) outward appearances; (2) inward functionality; and/or, (3) service users. Function (1) could mean protecting the hospital’s reputation, with the “Herald Sun test”—whether the TOP would be acceptable to readers of the Herald Sun, a tabloid newspaper—used as a heuristic. Function (2) related to logistics within the hospital and protecting the psychological wellbeing and personal reputation of healthcare professionals. The final function (3) related to ensuring patients received a high standard of care.

Conclusions

The primary functions of these committees appear to be about protecting hospitals and clinicians within a context where these procedures are controversial and stigmatized. The results of this study provide further clarity on the processes involved in the provision of TOPs at later gestations from the perspectives of the healthcare professionals involved. Institutional processes beyond those required by legislation are put in place by hospitals. These findings highlight the additional challenges faced by patients and their providers when seeking TOP at later gestations.
Variations in small-scale movements of, Rousettus aegyptiacus, a Marburg virus reservoir across a seasonal gradient
Authors: Wood Matthew R. , de Vries J. Low , Epstein Jonathan H. , Markotter Wanda
Published: July 2023

Background

Bats are increasingly being recognized as important hosts for viruses, some of which are zoonotic and carry the potential for spillover within human and livestock populations. Biosurveillance studies focused on assessing the risk of pathogen transmission, however, have largely focused on the virological component and have not always considered the ecological implications of different species as viral hosts. The movements of known viral hosts are an important component for disease risk assessments as they can potentially identify regions of higher risk of contact and spillover. As such, this study aimed to synthesize data from both virological and ecological fields to provide a more holistic assessment of the risk of pathogen transmission from bats to people.

Results

Using radiotelemetry, we tracked the small-scale movements of Rousettus aegyptiacus, a species of bat known to host Marburg virus and other viruses with zoonotic potential, in a rural settlement in Limpopo Province, South Africa. The tracked bats exhibited seasonal variations in their movement patterns including variable usage of residential areas which could translate to contact between bats and humans and may facilitate spillover. We identified a trend for increased usage of residential areas during the winter months with July specifically experiencing the highest levels of bat activity within residential areas. July has previously been identified as a key period for increased spillover risk for viruses associated with R. aegyptiacus from this colony and paired with the increased activity levels, illustrates the risk for spillover to human populations.

Conclusion

This study emphasizes the importance of incorporating ecological data such as movement patterns with virological data to provide a better understanding of the risk of pathogen spillover and transmission.
Surgical residents as “second victims” following exposure to medical errors in a tertiary health training facility in Nigeria: a phenomenology study
Authors: Balogun James Ayokunle , Adekanmbi Adefisayo Ayoade , Balogun Folusho Mubowale
Published: July 2023

Introduction

The “second victim” phenomenon refers to the distress and other negative consequences that physicians experience when they commit medical error. There has been increasing awareness about this phenomenon and efforts are being made to address it. However, there is dearth of information about it in developing countries. This study explored the experiences of surgical resident doctors of the University College Hospital in Ibadan, Nigeria about the “second victim” phenomenon and the support they had following medical errors.

Methods

This is a phenomenology study in which qualitative data were obtained from interviews with 31 resident doctors across 10 surgical units/departments. Interviews were transcribed verbatim, and data were coded inductively. Data were analyzed using content analysis method. Themes and subthemes were generated using axial coding. The themes were then integrated using selective coding.

Results

There were 31 participants and 10(32.3%) were females. All had witnessed other physicians encountering medical errors while 28(90.3%) had been directly involved in medical errors. Most of the errors were at the inter-operative stage. Prolonged work hours with inadequate sleep were identified as major causes of most medical errors. The feelings following medical errors were all negative and was described as ‘stressful’. Most of the residents got support from their colleagues, mostly contemporaries following medical errors, and many viewed medical errors as a learning point to improve their practice. However, there was a general belief that the systemic support following medical errors was inadequate.

Conclusion

The “second victim” phenomenon was common among the study group with consequent negative effects. Normalizing discussions about medical errors, reduction of work hours and meticulous intraoperative guidance may reduce medical errors and its consequences on the surgical residents. Steps should be taken within the system to address this issue effectively.
Evaluating the efficacy and safety of acotiamide in patients with esophagogastric junction outflow obstruction: study protocol for an investigator-initiated, multi-center, randomized, double-blind, placebo-controlled phase II trial
Authors: Esaki Mitsuru , Ihara Eikichi , Manabe Noriaki , Kawami Noriyuki , Iwakiri Katsuhiko , Akiyama Junichi , Kuribayashi Shiko , Uraoka Toshio , Ogino Haruei , Chinen Takatoshi , Misumi Akiko , Watanabe Hiroko , Suzuki Maya , Kishimoto Junji , Ogawa Yoshihiro
Published: July 2023

Background

We have determined that the impaired accommodation of the lower esophageal sphincter (LES) underlies the pathogenesis of esophagogastric junction outflow obstruction (EGJOO). We have also found that acotiamide may treat EGJOO by improving impaired LES accommodation. The effects of acotiamide in patients with EGJOO need to be further confirmed in a prospective study.

Methods

This trial is a multicenter, randomized, double-blind, placebo-controlled study to compare the efficacy and safety of acotiamide (300 mg/day or 600 mg/day) with those of a placebo in the treatment of patients with EGJOO. The primary endpoint will be the proportion of patients who report an improvement in symptom of food sticking in the chest after 4 weeks of treatment period 1. The secondary endpoints will be the proportion of patients with normalized integrated relaxation pressure (IRP), the value of change from baseline in the distal contractile integral, basal LES pressure, EGJOO–quality of life score, Gastrointestinal Symptom Rating Scale, and the correlation between IRP and each symptom score. During the 2-year trial period, 42 patients from five institutions will be enrolled.

Discussion

This trial will provide evidence to clarify the efficacy and safety of acotiamide as a treatment for patients with EGJOO. Acotiamide might help improve the quality of life of patients with EGJOO and is expected to prevent the progression of EGJOO to achalasia.

Trial registration

This study was approved by the Institutional Review Board (IRB) of Kyushu University Hospital as well as the local IRBs of the participating sites for clinical trials and registered in the Japan Registry of Clinical Trials (jRCT: 2071210072). The registration date is on October 11, 2021.
A prospective double-blinded randomized study on drug-eluting stent implantation into nitrate-induced maximally dilated vessels in patients with coronary artery disease
Authors: Yoon Gwang-Seok , Choi Seong-Huan , Kwon Sung Woo , Park Sang-Don , Woo Seong-Ill
Published: July 2023

Background

Percutaneous coronary intervention (PCI) has been developed using drug-eluting stents (DES); however, stent implantation is associated with concerns of stent thrombosis and target vessel revascularization (TVR). The stent diameter is a critical factor in TVR and clinical events. The nitrate administration in coronary angiography can dilate the reference vessel diameter, enabling accurate vessel size measurement and optimal stent implantation support. This study was designed to evaluate the effect of stent implantation in the maximally dilated coronary artery in patients with coronary artery disease (CAD).

Methods

This prospective double-blinded randomized (1:1) study is designed to compare the efficacy and safety between DES implantation into the nitrate-induced maximally dilated vessels and conventional DES implantation in patients with CAD. A total of 400 patients who underwent PCI with a sirolimus-eluting stent will be enrolled. The primary endpoint is the mean diameter of the deployed stents. Secondary endpoints include cardiac death, myocardial infarction, stent thrombosis, or ischemia-driven TVR 1 year after the procedure.

Discussion

This study will be the first randomized controlled trial to evaluate the effect of DES implantation on nitrate-induced maximally dilated vessels in patients with CAD.

Trial registration

The trial was registered on 18 June 2021 as Effect of Ultimaster Stents Treated to the Most Dilated Coronary Vessels (ClinicalTrials.gov Identifier: NCT04931784).
Regulation of acetate tolerance by small ORF-encoded polypeptides modulating efflux pump specificity in Methylomonas sp. DH-1
Authors: Cha Seungwoo , Cho Yong-Joon , Lee Jong Kwan , Hahn Ji-Sook
Published: July 2023

Background

Methanotrophs have emerged as promising hosts for the biological conversion of methane into value-added chemicals, including various organic acids. Understanding the mechanisms of acid tolerance is essential for improving organic acid production. WatR, a LysR-type transcriptional regulator, was initially identified as involved in lactate tolerance in a methanotrophic bacteriumMethylomonassp. DH-1. In this study, we investigated the role of WatR as a regulator of cellular defense against weak organic acids and identified novel target genes of WatR.

Results

By conducting an investigation into the genome-wide binding targets of WatR and its role in transcriptional regulation, we identified genes encoding an RND-type efflux pump (WatABO pump) and previously unannotated small open reading frames (smORFs),watS1towatS5, as WatR target genes activated in response to acetate. ThewatS1towatS5 genes encode polypeptides of approximately 50 amino acids, and WatS1 to WatS4 are highly homologous with one predicted transmembrane domain. Deletion of the WatABO pump genes resulted in decreased tolerance against formate, acetate, lactate, and propionate, suggesting its role as an efflux pump for a wide range of weak organic acids. WatR repressed the basal expression ofwatSgenes but activatedwatSand WatABO pump genes in response to acetate stress. Overexpression ofwatS1increased tolerance to acetate but not to other acids, only in the presence of the WatABO pump. Therefore, WatS1 may increase WatABO pump specificity toward acetate, switching the general weak acid efflux pump to an acetate-specific efflux pump for efficient cellular defense against acetate stress.

Conclusions

Our study has elucidated the role of WatR as a key transcription factor in the cellular defense against weak organic acids, particularly acetate, inMethylomonassp. DH-1. We identified the genes encoding WatABO efflux pump and small polypeptides (WatS1 to WatS5), as the target genes regulated by WatR for this specific function. These findings offer valuable insights into the mechanisms underlying weak acid tolerance in methanotrophic bacteria, thereby contributing to the development of bioprocesses aimed at converting methane into value-added chemicals.
Consequences of migratory distance, habitat distribution and season on the migratory process in a short distance migratory shorebird population
Authors: Hedh Linus , Hedenström Anders
Published: July 2023

Background

The migratory process in birds consists of alternating periods of flight and fueling. Individuals of some populations make few flights and long stopovers, while others make multiple flights between short stopovers. Shorebirds are known for executing marathon flights (jumps), but most populations studied are long distance migrants, often crossing major barriers and thus forced to make long-haul flights. The sub-division of migration in short/medium distance migratory populations, where the total migration distance is shorter than documented non-stop flight capacity and where routes offer more homogenous stopover landscape, is little explored.

Methods

Here we combine data based on conventional light level geolocators and miniaturized multi sensor loggers, comprising acceleration and light sensors, to characterize the migratory routes and migration process for a short/medium distance (~ 1300 to 3000 km) migratory population of common ringed plover (Charadrius hiaticula) breeding in southern Sweden. We were specifically interested in the variation in number and duration (total and individual) of flights/stopovers between seasons and in relation to migration distance.

Results

Most stopovers were located along the European Atlantic coast. On average 4.5 flights were made during autumn migration irrespective of migration distance, but in spring the number of flights increased with distance. The equal number of flights in autumn was explained by that most individuals migrating farther performed one longer flight (all but one lasting > 20 h), likely including crossing of the Bay of Biscay. Median duration of single flights was 8.7 h in autumn and 5.5 h in spring, and median stopover duration was ~ 1 day in both seasons. There was a positive relationship between total flight duration and migration distance, but total flight duration was 36% lower in spring compared to autumn.

Conclusions

Our results suggest that when suitable stopovers are abundant common ringed plovers prefer making shorter flights even if longer flights are within the capacity of the species. This behaviour is predicted under both time and energy minimizing strategies, although the variable flight distances suggest a policy of time selected migration. Even if populations using several stopovers seem to be more resilient for environmental change along the route, these results are informative for conservation efforts and for predicting responses to future environmental change.
Alterations in iron content, iron-regulatory proteins and behaviour without tau pathology at one year following repetitive mild traumatic brain injury
Authors: Juan Sydney M. A. , Daglas Maria , Truong Phan H. , Mawal Celeste , Adlard Paul A.
Published: July 2023

Repetitive mild traumatic brain injury (r-mTBI) has increasingly become recognised as a risk factor for the development of neurodegenerative diseases, many of which are characterised by tau pathology, metal dyshomeostasis and behavioural impairments. We aimed to characterise the status of tau and the involvement of iron dyshomeostasis in repetitive controlled cortical impact injury (5 impacts, 48 h apart) in 3-month-old C57Bl6 mice at the chronic (12-month) time point. We performed a battery of behavioural tests, characterised the status of neurodegeneration-associated proteins (tau and tau-regulatory proteins, amyloid precursor protein and iron-regulatory proteins) via western blot; and metal levels using bulk inductively coupled plasma-mass spectrometry (ICP-MS). We report significant changes in various ipsilateral iron-regulatory proteins following five but not a single injury, and significant increases in contralateral iron, zinc and copper levels following five impacts. There was no evidence of tau pathology or changes in tau-regulatory proteins following five impacts, although some changes were observed following a single injury. Five impacts resulted in significant gait deficits, mild anhedonia and mild cognitive deficits at 9–12 months post-injury, effects not seen following a single injury. To the best of our knowledge, we are the first to describe chronic changes in metals and iron-regulatory proteins in a mouse model of r-mTBI, providing a strong indication towards an overall increase in brain iron levels (and other metals) in the chronic phase following r-mTBI. These results bring to question the relevance of tau and highlight the involvement of iron dysregulation in the development and/or progression of neurodegeneration following injury, which may lead to new therapeutic approaches in the future.
Companion crops alter olfactory responses of the fall armyworm (Spodoptera frugiperda) and its larval endoparasitoid (Cotesia icipe)
Authors: Peter Emmanuel , Tamiru Amanuel , Sevgan Subramanian , Dubois Thomas , Kelemu Segenet , Kruger Kerstin , Torto Baldwyn , Yusuf Abdullahi
Published: July 2023

Background

The fall armyworm (FAW),Spodoptera frugiperda, is a devastating invasive pest and a threat to food security in Africa, with yield losses of 20–50%. Recent studies highlighted the importance of cereal crops such as maize and sorghum as the most preferred host plants for FAW oviposition. In the current work, we investigated the olfactory responses of FAW and its key larval endoparasitoidCotesia icipeto odours from the preferred host (maize) in the presence of six potential companion crops including beans, groundnut, sweet potato, greenleaf- and silverleaf desmodium, and cassava. We hypothesized that odours released by companion crops in maize-based intercropping systems would alter host preferences of FAW for oviposition and its parasitoid responses.

Results

In dual choice oviposition bioassays, FAW laid significantly more eggs on maize than on the other plants. However, in the multiple-choice bioassays, significantly fewer eggs were laid on maize when companion plants were present except cassava. While wind tunnel bioassays confirmed the differential behavioural responses of FAW, we found that its larval endoparasitoidC. icipewas attracted to volatiles from the companion plants tested individually and/or when they were combined with maize. Coupled gas chromatography–mass spectrometry (GC–MS) analysis detected several potential behaviour-modifying compounds including (Z)-3-hexenyl acetate, (E)-β-ocimene, (E)-4,8-dimethyl-1,3,7-nonatriene, (E)-β-caryophyllene, camphor, methyl salicylate and (E, E)-4,8,12-trimethyl-1,3,7,11-tridecatetraene.

Conclusions

Our findings provide evidence supporting diversified maize cropping system could reduce FAW damage by repelling the pest while simultaneously recruiting its natural enemies. Hence, diversifying cereal cropping system with companion crops could serve as an ecologically sustainable FAW management strategy.

Graphical Abstract
Elucidating the effects of organic vs. conventional cropping practice and rhizobia inoculation on rhizosphere microbial diversity and yield of peanut
Authors: Paudel Dev , Wang Liping , Poudel Ravin , Acharya Janam P , Victores Samantha , de Souza Cleber Henrique Lopes , Rios Esteban , Wang Jianping
Published: July 2023

Legumes such as peanut (Arachis hypogea) can fulfill most of their nitrogen requirement by symbiotic association with nitrogen-fixing bacteria, rhizobia. Nutrient availability is largely determined by microbial diversity and activity in the rhizosphere that influences plant health, nutrition, and crop yield, as well as soil quality and soil fertility. However, our understanding of the complex effects of microbial diversity and rhizobia inoculation on crop yields of different peanut cultivars under organic versus conventional farming systems is extremely limited. In this research, we studied the impacts of conventional vs. organic cultivation practices and inoculation with commercial vs. single strain inoculum on peanut yield and soil microbial diversity of five peanut cultivars. The experiment was set up in the field following a split-split-plot design. Our results from the 16 S microbiome sequencing showed considerable variations of microbial composition between the cultivation types and inoculum, indicating a preferential association of microbes to peanut roots with various inoculum and cropping system. Alpha diversity indices (chao1, Shannon diversity, and Simpson index) of soil microbiome were generally higher in plots with organic than conventional inorganic practices. The cultivation type and inoculum explained significant differences among bacterial communities. Taxonomic classification revealed two phyla, TM6 and Firmicutes were significantly represented in inorganic as compared to organic soil, where significant phyla were Armatimonadetes, Gemmatimonadetes, Nitrospirae, Proteobacteria, Verrucomicrobia, and WS3. Yields in the organic cultivation system decreased by 10–93% of the yields in the inorganic cultivation system. Cultivar G06 and T511 consistently showed relative high yields in both organic and inorganic trials. Our results show significant two-way interactions between cultivation type and genotype for most of the trait data collected. Therefore, it is critical for farmers to choose varieties based on their cultivation practices. Our results showed that bacterial structure was more uniform in organic fields and microbial diversity in legumes was reduced in inorganic fields. This research provided guides for farmers and scientists to improve peanut yield while promoting microbial diversity and increasing sustainability.
Heart Rate Variability-Derived Thresholds for Exercise Intensity Prescription in Endurance Sports: A Systematic Review of Interrelations and Agreement with Different Ventilatory and Blood Lactate Thresholds
Authors: Kaufmann Sebastian , Gronwald Thomas , Herold Fabian , Hoos Olaf
Published: July 2023

Background

Exercise intensities are prescribed using specific intensity zones (moderate, heavy, and severe) determined by a ‘lower’ and a ‘higher’ threshold. Typically, ventilatory (VT) or blood lactate thresholds (LT), and critical power/speed concepts (CP/CS) are used. Various heart rate variability-derived thresholds (HRVTs) using different HRV indices may constitute applicable alternatives, but a systematic review of the proximity of HRVTs to established threshold concepts is lacking.

Objective

This systematic review aims to provide an overview of studies that determined HRVTs during endurance exercise in healthy adults in comparison with a reference VT and/or LT concept.

Methods

A systematic literature search for studies determining HRVTs in healthy individuals during endurance exercise and comparing them with VTs or LTs was conducted in Scopus, PubMed and Web of Science (until January 2022). Studies claiming to describe similar physiological boundaries to delineate moderate from heavy (HRVTlow vs. VTlow and/or LTlow), and heavy from severe intensity zone (HRVThigh vs. VThigh and/or LThigh) were grouped and their results synthesized.

Results

Twenty-seven included studies (461 participants) showed a mean difference in relative HR between HRVTlow and VTlow of − 0.6%bpm in weighted means and 0.02%bpm between HRVTlow and LTlow. Bias between HR at HRVTlow and VTlow was 1 bpm (limits of agreement (LoA): − 10.9 to 12.8 bpm) and 2.7 bpm (LoA: − 20.4 to 25.8 bpm) between HRVTlow and LTlow. Mean difference in HR between HRVThigh and VThigh was 0.3%bpm in weighted means and 2.9%bpm between HRVThigh and LThigh while bias between HR at HRVThigh and VThigh was − 4 bpm (LoA: − 17.9 to 9.9 bpm) and 2.5 bpm (LoA: − 12.1 to 17.1 bpm) between HRVThigh and LThigh.

Conclusion

HRVTlow seems to be a promising approach for the determination of a ‘lower’ threshold comparable to VTlow and potentially for HRVThigh compared to VThigh, although the latter needs further empirical evaluation. LoA for both intensity zone boundaries indicates bias of HRVTs on an individual level. Taken together, HRVTs can be a promising alternative for prescribing exercise intensity in healthy, male athletes undertaking endurance activities but due to the heterogeneity of study design, threshold concepts, standardization, and lack of female participants, further research is necessary to draw more robust and nuanced conclusions.
The paradox of externally driven localisation: a case study on how local actors manage the contradictory legitimacy requirements of top-down bottom-up aid
Authors: Mulder Femke
Published: July 2023

There are ongoing calls in the humanitarian and development sectors to localise aid, make it more participatory and involve communities. A common response to these calls by INGOs and national governments is to work with local actors to jointly deliver local, community-based, participatory aid. However, this setup tends to be hierarchical, with external actors taking the lead on project design and local actors on implementation. As a result, key outcomes envisioned for localisation and participation in aid often do not materialise. This paper explores the role legitimacy work plays in maintaining this unhelpful status quo. To this end, it provides a qualitative case study analysis of an aid project in Ethiopia (2016–2020) that was initiated by two INGOs and built on government structures designed to facilitate mass volunteering at community level: the Women’s Development Army. The paper argues that externally driven localisation is often organised around project models that are shaped by two contradictory paradigms: one centring resilience and one centring surveillance. As a result, local aid workers and civil servants are faced with incompatible legitimacy requirements in their work. This paper uses a paradox perspective as a theoretical lens to explore how these local actors navigate these conflicting needs. It finds that they use impression management, especially visuals and performances, to sidestep the contradictions. This imagery conceals the disconnects between project strategy, implementation and the reality on the ground. As a side effect, it renders the problems with the externally driven approach invisible and legitimises the hierarchical status quo.
Stimulation parameters for directional vagus nerve stimulation
Authors: Villalobos Joel , Payne Sophie C. , Ward Glenn M. , Andrikopoulos Sofianos , Hyakumura Tomoko , MacIsaac Richard J. , Fallon James B.
Published: July 2023

Background

Autonomic nerve stimulation is used as a treatment for a growing number of diseases. We have previously demonstrated that application of efferent vagus nerve stimulation (eVNS) has promising glucose lowering effects in a rat model of type 2 diabetes. This paradigm combines high frequency pulsatile stimulation to block nerve activation in the afferent direction with low frequency stimulation to activate the efferent nerve section. In this study we explored the effects of the parameters for nerve blocking on the ability to inhibit nerve activation in the afferent direction. The overarching aim is to establish a blocking stimulation strategy that could be applied using commercially available implantable pulse generators used in the clinic.

Methods

Male rats (n = 20) had the anterior abdominal vagus nerve implanted with a multi-electrode cuff. Evoked compound action potentials (ECAP) were recorded at the proximal end of the electrode cuff. The efficacy of high frequency stimulation to block the afferent ECAP was assessed by changes in the threshold and saturation level of the response. Blocking frequency and duty cycle of the blocking pulses were varied while maintaining a constant 4 mA current amplitude.

Results

During application of blocking at lower frequencies (≤ 4 kHz), the ECAP threshold increased (ANOVA, p < 0.001) and saturation level decreased (p < 0.001). Application of higher duty cycles (> 70%) led to an increase in evoked neural response threshold (p < 0.001) and a decrease in saturation level (p < 0.001). During the application of a constant pulse width and frequency (1 or 1.6 kHz, > 70% duty cycle), the charge delivered per pulse had a significant influence on the magnitude of the block (ANOVA, p = 0.003), and was focal (< 2 mm range).

Conclusions

This study has determined the range of frequencies, duty cycles and currents of high frequency stimulation that generate an efficacious, focal axonal block of a predominantly C-fiber tract. These findings could have potential application for the treatment of type 2 diabetes.
Fine structural characteristics of the chorionic microspheres on the egg surface of the orb web spider Trichonephila clavata
Authors: Lee Seung-Min , Moon Myung-Jin
Published: July 2023

The eggs laid by the orb web spider Trichonephila clavata must overwinter in bitterly freezing and dry conditions before hatching, but there does not seem to be any protection like a compact silk case covering the entire eggmass. Instead, the surface of the eggmass is completely coated with a milky coating called chorionic microspheres (CM). Therefore, we investigated the fine structural characteristics of CM to demonstrate their ecological importance. Although the diameter of CM in outer eggmass exhibits a significant variation, the chorionic surface is coated with a single layer of CM, characterized by a consistent diameter of approximately 2.3 µm. The surface structure of aggregated CM shows short papillary projections demonstrating segmental adhesion of mucous components. CM is insoluble in water but partially soluble in anhydrous ethanol, and its spherical structure is completely decomposed by hexafluoroisopropanol (HFIP), a strong organic solvent. Since our fine structural observations clearly show that CM is not derived from vitellogenic or choriogenetic processes, the CM adhesive coatings during ovipositional process appears to be equivalent to cocoon silk for various protective functions in silken eggcase.
ISO-FLUCS: symmetrization of optofluidic manipulations in quasi-isothermal micro-environments
Authors: Minopoli Antonio , Wagner Susan , Erben Elena , Liao Weida , Stoev Iliya D. , Lauga Eric , Kreysing Moritz
Published: July 2023

Recently, it has been demonstrated that thermoviscous flows can be used for a range of fine micromanipulations, such as moving the cytoplasm of cells and developing embryos, intracellular rheology, and femtonewton-range force measurements. These flows, also known as focused-light-induced cytoplasmic streaming (FLUCS), are induced by mid-infrared laser scanning of a temperature spot through the sample. However, localized laser scanning can inflict temperature perturbations of several Kelvins on the sample, potentially eliciting unspecific biological responses. In this study, we demonstrate how exploiting symmetry relations during laser scanning effectively disentangles laser heating and flow induction. We introduce flow-neutral scan sequences that use dynamic photothermal stimuli and spatiotemporal symmetry relations of scanning bridging up to three distinct time scales. We leverage further insights from a recently published analytical model of flow fields to present quasi-homogenous temperature distributions that leave flow lines and their local and directed character largely invariant. We present practical, intuitive solutions through predesigned sets of scan lines with near isothermal distributions and demonstrate that they are sufficient to generate and control flows in Caenorhabditis elegans embryos on a magnitude well in excess of endogenous flow velocities. Our results enable the separation of two previously tightly linked classes of physical stimuli, introduce a new, even less invasive standard for performing FLUCS perturbations, and pave the way for new unexplored avenues in the fields of soft matter and biomedicine.

Graphical Abstract
Spatial distribution of heavy metals in groundwater around automobile workshops in a popular Niger-Delta University town, Nigeria
Authors: Owamah Hilary Ijeoma , Akpoedafe Thomas Obaro , Ikpeseni Sunday Chukwuyem , Atikpo Eguakhide , Orugba Henry Oghenero , Oyebisi Solomon
Published: July 2023

The research was carried out to assess the concentration and distribution of heavy metals in groundwater from selected automobile workshops in Ozoro metropolis, a busy university town, in the Niger Delta region of Nigeria. The major activities carried out in the sampled automobile workshops include vehicle maintenance, painting, panel beating and fabrication. Nine (9) groundwater samples from the automobile workshops and one control sample 2 km away from the influence area were analyzed. Heavy metal concentration, contamination factor, and pollution loading indices were investigated using geostatistical modeling and statistical analysis tools. Heavy metal concentrations in the various samples were determined in accordance with the Association of Official Agricultural Chemists (AOAC) International guidelines. Findings obtained from the study revealed that the groundwater was affected by leachates from the automobile workshops, as the heavy metal levels in the groundwater from the sampling sites were considerably higher than the reference point. The concentration ranges (mg/L) of the heavy metals were Cd (0.0217–0.0412), Cr (0.0643–0.0901), Cu (0.0599–0.0803), Fe (0.3118–0.4171), and Pb (0.1423–0.1781). The spatial distribution maps showed that the metals spread unevenly across the study area. The pollution indices revealed that groundwater from the sampling sites is moderately polluted with heavy metals and the trend of the pollution load index (PLI) is Cd > Ni > Cu > Mn > Pb > Zn > Fe. Comparing the results with those of international regulatory bodies, the groundwater from the study area was found to still be within the approved range for potable water. However, there is evidence of slight contamination due to the activities of the automobile workshops. This may call for minor treatment before usage, regular monitoring and ensuring that the artisans comply with relevant regulations in their operations.
Nonalcoholic Fatty Liver Disease Incidence and Remission and Their Predictors During 7 Years of Follow-up Among Finns
Authors: Korpimäki Satu , Rovio Suvi P , Juonala Markus , Hutri-Kähönen Nina , Lehtimäki Terho , Laitinen Tomi P , Tossavainen Päivi , Jokinen Eero , Loo Britt-Marie , Männistö Satu , Tammelin Tuija , Haarala Atte , Aatola Heikki , Komar Gaber , Viikari Jorma , Raitakari Olli , Kähönen Mika , Pahkala Katja
Published: July 2023

Context

The incidence and remission of nonalcoholic fatty liver disease (NAFLD) are sparsely studied outside Asia.

Objective

This prospective study aimed to investigate NAFLD incidence and remission, and their predictors among a general Finnish population.

Methods

The applied cohort included 1260 repeatedly studied middle-aged participants with data on liver ultrasound and no excessive alcohol intake. Hepatic steatosis was assessed by liver ultrasound with a 7.2-year study interval. Comprehensive data on health parameters and lifestyle factors were available.

Results

At baseline, 1079 participants did not have NAFLD, and during the study period 198 of them developed NAFLD. Of the 181 participants with NAFLD at baseline, 40 achieved NAFLD remission. Taking multicollinearity into account, key predictors for incident NAFLD were baseline age (odds ratio 1.07; 95% CI, 1.02-1.13; P = .009), waist circumference (WC) (2.77, 1.91-4.01 per 1 SD; P < .001), and triglycerides (2.31, 1.53-3.51 per 1 SD; P < .001) and alanine aminotransferase (ALAT) (1.90, 1.20-3.00 per 1 SD; P = .006) concentrations as well as body mass index (BMI) change (4.12, 3.02-5.63 per 1 SD; P < .001). Predictors of NAFLD remission were baseline aspartate aminotransferase (ASAT) concentration (0.23, 0.08-0.67 per 1 SD; P = .007) and WC change (0.38, 0.25-0.59 per 1 SD; P < .001).

Conclusion

During follow-up, NAFLD developed for every fifth participant without NAFLD at baseline, and one-fifth of those with NAFLD at baseline had achieved NAFLD remission. NAFLD became more prevalent during the follow-up period. From a clinical perspective, key factors predicting NAFLD incidence and remission were BMI and WC change independent of their baseline level.
ARF6 plays a general role in targeting palmitoylated proteins from the Golgi to the plasma membrane
Authors: Wang Juan , Zheng Lang-Fan , Ren Su , Li Dong-Lin , Chen Chen , Sun Hui-Hui , Liu Li-Ying , Guo Huiling , Zhao Tong-Jin
Published: July 2023

Protein palmitoylation is a post-translational lipid modification of proteins. Accumulating evidence reveals that palmitoylation functions as a sorting signal to direct proteins to destinations; however, the sorting mechanism remains largely unknown. Here, we show that ARF6 plays a general role in targeting palmitoylated proteins from the Golgi to the plasma membrane (PM). Through shRNA screening, we identified ARF6 as the key small GTPase in targeting CD36, a palmitoylated protein, from the Golgi to the PM. We found that the N-terminal myristoylation of ARF6 is required for its binding with palmitoylated CD36, and the GTP-bound form of ARF6 facilitates the delivery of CD36 to the PM. Analysis of stable isotope labeling by amino acids in cell culture revealed that ARF6 might facilitate the sorting of 359 of the 531 palmitoylated PM proteins, indicating a general role of ARF6. Our study has thus identified a sorting mechanism for targeting palmitoylated proteins from the Golgi to the PM.
Implementing a quality improvement initiative for reducing intravenous antihypertensive utilization in the hospital setting: Improving patient outcomes without prolonging hospital stay
Authors: Alnazeer Moez , Jones Jessica , Ficklen David
Published: July 2023

Background: This project aimed to implement a quality improvement initiative to reduce the utilization of non-indicated intravenous (IV) antihypertensive medications in the hospital setting and evaluate its impact on hospital length of stay.

Methods: A quality improvement initiative was conducted at a 500-bed regional hospital to improve management of inpatients with asymptomatic severe hypertension. An algorithm was developed to guide management to minimize the inappropriate use of IV antihypertensives. Educational sessions were conducted with medical providers and nursing staff to promote adherence to the algorithm. Pharmacy records were reviewed to assess the utilization of IV antihypertensive medications. Aggregated length of hospital stay before and after the intervention were compared. Statistical analysis was performed using paired t-tests.

Results: The utilization of IV antihypertensive medications was reduced by 47.6% after the intervention, as measured by days of therapy per 1000 patient days (p <0.001). However, the average length of hospital stay did not show a significant difference before and after the intervention (p = 0.094).

Conclusions: The implementation of a quality improvement initiative, including an algorithm and education for healthcare staff, successfully reduced the utilization of non-indicated IV antihypertensive medications in the hospital setting. This approach has the potential to improve patient safety and reduce healthcare costs. Further research is needed to explore the long-term effectiveness of this intervention and its impact on patient outcomes.
The effectiveness of different aerobic exercises to improve pain intensity and disability in chronic low back pain patients: a systematic review
Authors: Sany Shabbir Ahmed , Mitsi Maria , Tanjim Taukir , Rahman Minhazur
Published: July 2023

Background: Physical activity, including aerobic exercise, is highly recommended for chronic low back pain (CLBP) patients to improve pain intensity and functional disability.

Objectives: To assess the effectiveness of different aerobic exercises to reduce pain intensity and functional disability in patients with CLBP.

Methods: A computer-aided search was performed to find Randomised controlled Trials (RCTs) that evaluated the effectiveness of different aerobic exercises in CLBP. Articles published between January 2007 to December 2020 were included in the review. Quality assessment using the PEDro scale, extraction of relevant information, and evaluation of outcomes were done by two reviewers independently.

Results: A total of 17 studies were included that involved 1146 participants. Outcomes suggested that aerobic exercise combined with other interventions was more effective than aerobic exercise alone. Aerobic exercise with higher frequency (≥ 5 days/week) and longer duration (≥ 12 weeks) were effective to gain clinically significant (≥ 30%) improvements. Environment and using pedometer did not seem to influence the outcomes.

Conclusions: Pain intensity and functional disability in CLBP patients can be minimized by prescribing aerobic exercise. However, to get better improvements, aerobic exercise should be done in combination with other interventions and at optimum frequency and duration. Further studies should emphasize examining the optimal doses and period of different aerobic exercises.