bluuebunny/crossref_metadata_2025 huggingface dataset:
Provider & nursing perspectives on the “panculture”: opportunities for innovative diagnostic stewardship interventions
Authors: Gibas Kevin M. , Mermel Leonard A.
Published: November 2024

Objective:

To examine practices of providers and nursing staff in evaluating febrile patients and identify drivers of excessive diagnostic testing.

Design:

Prospective multiple-choice surveys.

Setting:

Inpatient areas and the Emergency Department at Rhode Island Hospital (RIH) in Providence, RI.

Participants & Methods:

We conducted two surveys focused on the evaluation of febrile inpatients at RIH. One survey was of providers trained in internal medicine, surgery, pediatrics, emergency medicine, and neurology; the other survey was of nursing staff (registered nurses and certified nursing assistants), in inpatient areas and the emergency department.

Results:

70 providers (9%) and 178 nursing staff (12%) completed the surveys. 64% of providers (n = 43) reported “always” or “often” ordering full fever workups and 67% of providers (n = 47) reported “always” or “often” physically evaluating febrile patients. Nurses were less likely than providers to report that providers “always” or “often” physically evaluate febrile patients (n = 80, 45%; P < 0.01) and more likely to report providers “always” or “often” order full fever workups (n = 135, 76%; P = 0.04). 71% of providers (n = 50) reported “always” or “often” receiving written handoffs. 86% of providers (n = 60) reported handoffs are “always” or “often” accurate; however, only 17% of providers responded these were “always” accurate. 77% of providers (n = 54) reported “always” or “often” following handoff instructions to obtain a full fever workup for febrile patients, regardless of clinical status. Responses differed significantly by unit type and provider specialty and position.

Conclusions:

This study elucidates drivers of inefficient and excessive utilization of diagnostic studies and identifies targets for diagnostic stewardship interventions.
Can risk factors and risk scores help predict colonization and infection in multidrug-resistant gram-negative bacteria?
Authors: Restrepo-Arbeláez Natalia , García-Betancur Juan Carlos , Pallares Christian José , El Ayoubi L’Emir Wassim , Kiratisin Pattarachai , Kanj Souha S. , Villegas María Virginia
Published: November 2024

Antimicrobial resistance (AMR) is positioning as one of the most relevant threats to global public health and threatens the effective treatment of an ever-growing number of bacterial infections in various healthcare settings, particularly in acute care and surgical units, as well as in the community. Among multidrug-resistant (MDR) gram-negative bacteria (MDRGNB), Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii require special attention, since they account for most of the mortality associated with bacterial infections and are often MDR. It is clear that there is an important global variation in antibiotic resistance profiles among MDRGNB species. Extended-spectrum β-lactamase-producing Enterobacterales, carbapenem-resistant Enterobacterales, DTR-P. aeruginosa, and MDR-A. baumannii are the focus of this review. Here, we summarize a series of relevant studies on risk factors associated with colonization and infection with these MDRGNB. Likewise, we offer a comparative overview of those studies providing scoring systems to predict the risk of infection with these MDR pathogens, and their pros and cons. Despite the variable accuracy of published risk factors for predicting colonization or infection with MDRGNB, these scores are valuable tools that may help anticipate colonization and infection among those colonized. More importantly, they may help reduce unnecessary use of broad-spectrum antimicrobials and guiding the selection of an optimal treatment.
Environmental tobacco smoke exposure in a multi-city cohort of children with asthma: Analyzing true exposure and the validity of caregiver survey
Authors: McKeon Katherine , Werthmann Derek , Straubing Rebecca , Rodriguez Anna , Sosnoff Connie , Blount Benjamin C. , Chew Ginger L. , Reponen Tiina , Adamkiewicz Gary , Hsu Joy , Rabito Felicia A.
Published: November 2024

Introduction:

The avoidance of asthma triggers, like tobacco smoke, facilitates asthma management. Reliance upon caregiver report of their child’s environmental tobacco smoke (ETS) exposure may result in information bias and impaired asthma management. This analysis aimed to characterize the chronicity of ETS exposure, assess the validity of caregiver report of ETS exposure, and investigate the relationship between ETS exposure and asthma attack.

Methods:

A secondary data analysis was performed on data from a longitudinal study of 162 children aged 7–12 years with asthma living in federally subsidized housing in three US cities (Boston, Cincinnati, and New Orleans). Data were collected at three time points over 1 year.

Results:

Over 90% of children were exposed to ETS (≥0.25 ng/ml of urine cotinine (UC)). Exposure was consistent over 1 year. Questionnaire data had a sensitivity of 28–34% using UC ≥0.25 ng/ml as the gold standard. High ETS exposure (UC ≥ 30 ng/ml) was significantly associated with asthma attack (aOR 2.97, 0.93–9.52, p = 0.07). Lower levels (UC 0.25–30 ng/ml) were not statistically significant (aOR 1.76, 0.71– 4.38, p = 0.22). No association was found using caregiver-reported ETS exposure.

Conclusion:

Relying on questionnaire data to assess children’s exposure to tobacco smoke may lead to substantial information bias. For children with asthma, incorrect characterization may substantially impact asthma morbidity.
Health impacts of a remotely delivered prolonged nightly fasting intervention in stressed adults with memory decline and obesity: A nationwide randomized controlled pilot trial
Authors: James Dara L. , Mun Chung Jung , Larkey Linda K. , Ofori Edward , Hawley Nanako A. , Alperin Kate , Vance David E. , Sears Dorothy D.
Published: November 2024

Objective/Goals:

Cognitive decline is intricately linked to various factors such as obesity, stress, poor sleep, and circadian rhythm misalignment, which are interrelated in their impact on cognitive health. Irregular food-intake timing further compounds these issues. The practice of prolonged nightly fasting (PNF) may help synchronize food intake with circadian rhythms, potentially mitigating adverse effects of cognitive decline and associated factors.

Methods:

A pilot nationwide, remotely delivered, 2-arm randomized controlled trial was conducted to assess the 8-week outcomes of cognition, stress, and sleep, after a PNF intervention (14-hr nightly fast, 6 nights/week, no calories after 8 pm) compared to a health education (HED) control condition. Participants were living with memory decline, stress, and obesity and had weekly check-in calls to report fasting times (PNF) or content feedback (HED).

Results:

Participants were enrolled from 37 states in the US; N = 58, 86% women, 71% white, 93% non-Latinx, mean (SD) age 50.1 (5.1) years and BMI 35.6 (3.6) kg/m2. No group differences existed at baseline. Linear mixed-effects models were used to compare outcome change differences between groups. Compared to the HED control, the PNF intervention was associated with improved sleep quality (B = −2.52; SE = 0.90; 95% CI −4.30–−0.74; p = 0.006). Perceived stress and everyday cognition significantly changed over time (p < 0.02), without significant difference by group.

Discussion:

Changing food intake timing to exclude nighttime eating and promote a fasting period may help individuals living with obesity, memory decline, and stress to improve their sleep. Improved sleep quality may lead to additional health benefits.
A survey of individuals’ willingness to share real-world data postmortem with researchers
Authors: Hendricks-Sturrup Rachele M. , Lu Christine Y.
Published: November 2024

Objective:

As posthumous data use policy within the broader scope of navigating postmortem data privacy is a procedurally complex landscape, our study addresses this by exploring patterns in individuals’ willingness to donate data with health researchers after death and developing practical recommendations.

Methods:

An electronic survey was conducted in April 2021 among adults (≥18 years of age) registered in ResearchMatch (www.researchmatch.org), a national health research registry. Descriptive statistics were used to observe trends in, and multinomial logistic regression analyses were conducted at a 95% confidence interval to determine the association between, willingness to donate some, all, or no data after death with researchers based on the participants’ demographics (education level, age range, duration of using online medical websites, and annual frequency of getting ill).

Results:

Of 399 responses, most participants were willing to donate health data (electronic medical record data [67%], prescription history data [63%], genetic data [54%], and fitness tracker data [53%]) after death. Among 397 respondents, we identified that individuals were more likely to donate some data after death (vs. no data) if they had longer duration of using online medical websites (adjusted relative risk ratio = 1.22, p= 0.04, 95% CI: 1.01 to 1.48). No additional significant findings were observed between willingness to donate all, some, or none of their data after death and other demographic factors.

Conclusions:

Engaging patients in online medical websites may be one potential mechanism to encourage or inspire individuals to participate in posthumous data donation for health research purposes.
Medical Access and Care Continuity: Qualitative Assessments of Patients with Breast Cancer and Family Members’ Experiences Following the 2011 Triple Disaster in Fukushima, Japan
Authors: Singh Priya , Montesino Stephanie , Ozaki Akihiko , Murakami Michio , Kaneda Yudai , Abe Toshiki , Zhao Tianchen , Yamamoto Chika , Ito Naomi , Amir Isamu , Yamashita Erika , Saito Hiroaki , Sawano Toyoaki , Gonda Kenji , Ohira Hiromichi , Yanagisawa Robert , Katz Craig , Tsubokura Masaharu
Published: November 2024

Objectives

While studies have examined the effects of large-scale disasters on disaster-vulnerable individuals, these analyses may not capture the full impact. This study qualitatively explored the impacts of the March 2011 Fukushima triple disaster on patients with breast cancer and their families, aiming to highlight the importance of incorporating family narratives to grasp the full effect of large-scale disasters.

Methods

Utilizing the medical records from two hospitals, deceased patients with breast cancer from the disaster period were identified. Relatives were interviewed using a semi-structured approach. Thematic analysis was conducted via the Braun and Clarke method and Taguette transcription software.

Results

Interviews with seven family members of six patients revealed three main themes: the family’s caregiving burden and their deepened bonds with the patient, the patients’ extensive medical challenges and their physical and mental decline, and the shared confusion during the disaster due to resource shortages and evacuation dilemmas.

Conclusions

This study uncovered significant infrastructural issues such as reduced medical support and the heavy caregiving load on families, amidst some strengthened relationships during a time of crisis. Future research should investigate these issues across various disaster contexts, and proactive measures should be implemented to prevent exacerbation of these challenges.
Transmission of MRSA, ESBL E. coli, and C. difficile within a tertiary care hospital and across surrounding facilities in Japan: a molecular epidemiological study with the PCR-based Open-reading frame typing
Authors: Saito Hiroki , Miike Satoshi , Ohno Tatsuya , Anzai Momoko , Kasai Fumimasa , Hosoyama Akiko , Takakura Tomomi , Tanaka Yosuke , Fujitani Shigeki
Published: November 2024

Objective:

To determine the regional impact of transmission of multidrug-resistant organisms (MRDOs) and Clostridioides difficile (C. difficile) among a tertiary care hospital and surrounding facilities including long-term care facilities (LTCFs).

Design:

Retrospective cohort study.

Methods:

Patients admitted to a tertiary care hospital from July 2019 to July 2021 were recruited if their clinically collected cultures grew the following pathogens: Methicillin-resistant Staphylococcus aureus (MRSA), Extended-Spectrum Beta-Lactamase (ESBL) producing Enterobacterales, Pseudomonas aeruginosa with difficult-to-treat resistance, Carbapenem-resistant Enterobaterales, Vancomycin-resistant Enterococci, and C. difficile. Patient characteristics including admission and discharge pathway were collected. For the isolates of MRSA, ESBL-producing Escherichia coli (E. coli), and C. difficile, a molecular epidemiological analysis was conducted, utilizing the PCR-based Open-Reading Frame Typing (POT) method.

Results:

Three hundred-five patients were identified with a total of 332 culture specimens of the target pathogens. The top three were 132 MRSA isolates (43.3%, out of 305), 97 ESBL E. coli (31.8%), and 32 ESBL Enterobacterales (non-E. coli) (10.5%). The target pathogens were more detectable within 3 days among patients admitted from LTCFs or other hospitals than those admitted from home (Odds Ratio 4.6, 95% confidence interval 2.8-7.6, p-value < 0.001). The molecular epidemiological analysis suggested the transmissions of MRSA, ESBL E. coli and C. difficile occurred 52 out of 111 patients within the in-hospital environment, and 7 out of 128 within the prehospital environment, respectively.

Conclusions:

MDROs/C. difficile transmission is prevalent within a tertiary care hospital and further complicated by its inter-facility transmission across surrounding LTCFs and hospitals in Japan.
“A Place of Refuge to Republicans and Royalists”: The French Revolution in British Dominica
Authors: Freund Heather
Published: November 2024

During the French Revolution, thousands of revolutionaries and royalists fled the turmoil in French islands. Many went to nearby islands, from which they could observe events. Situated between Martinique and Guadeloupe, Dominica had a majority French population and a long history of connection with its French neighbors. This article uses the case of Dominica to explore the effects of the French Revolution on a non-French island in the Eastern Caribbean. From the start, its proximity to the French islands led to its entanglement in revolutionary politics. It was the first British island to receive refugees, and the influx of people of all racial, social, and political backgrounds into Dominica posed challenges for island officials. Officials had to determine on what terms to admit emigrants, whether they posed a threat to the colony, and how to feed and house them. They also worried about the influences of foreigners and revolutionary ideas on their own disaffected free and enslaved populations. This article argues that Dominica's location, heterogeneous population, and internal instability allowed it to become a node for regional migration and information networks that embroiled it in the turmoil that engulfed its neighbors and ultimately threatened British control of the island.
The use of experimental designs to examine causality in authentic leadership: A scoping review
Authors: Dadich Ann , Abbott Ling , Lux Andrei A. , Lowe Kevin B.
Published: November 2024

Authentic leadership studies are often criticised for the limited use of causally defined research designs. To advance scholarship is this area, this article presents a scoping review on the use of experimental designs to examine causality in authentic leadership. Eleven publications were identified, which presented 16 experiments that met the inclusion criteria. Generally, these experiments tested authentic leadership as an antecedent; were conducted online; used a one-factor design; involved large samples, typically of working adults or residents; involved a manipulation check; involved the use of written vignettes to manipulate levels of authentic leadership; included counterfactual conditions; culminated with outcomes pertaining to followers; and established the causal effects of authentic leadership on the outcome(s) of interest. These findings suggest the value of: written vignettes; multi-method approaches; and online experiments. They also highlight opportunities to advance authentic leadership research through the use of sequential experiments and immersive technologies.
Business Courts as Loci of Privilege: The Business Judgment Rule Abroad
Authors: Hofri-Winogradow Adam , Maimon-Blau Inbal
Published: November 2024

Business courts can function as loci of privilege, both institutional and substantive, expressing a clear privileging of business as a sphere of social action. Using an original case study, we show how the establishment of a new business court privileged businesspersons in two ways: by providing them with expert judicial services and by receiving into law a rule that gives them unique protection from liability—the Delaware Business Judgment Rule. We did not find that this reception reflected court capture by businesspersons. It did reflect a conviction that Delaware law is best, inculcated by US-educated academics, and inter-jurisdictional competitive aspirations. Our case study demonstrates how business courts express the structured power of business and businesspersons.
New radio continuum study of the large magellanic cloud supernova remnant N49
Authors: Ghavam Maddie , Filipović Miroslav D. , Alsaberi Rami , Barnes Luke , Crawford Evan J. , Haberl Frank , Kavanagh Patrick , Maggi Pierre , Payne Jeffrey , Rowell Gavin , Hidetoshi Sano , Sasaki Manami , Rajabpour Neda , Tothill Nicholas , Urošević Dejan
Published: November 2024

We present new Australia Telescope Compact Array (ATCA) radio observations towards N 49, one of the brightest extragalactic supernova remnants (SNRs) located in the Large Magellanic Cloud (LMC). Our new and archival ATCA radio observations were analysed along with Chandra X-ray data. These observations show a prominent ‘bullet’ shaped feature beyond the southwestern boundary of the SNR. Both X-ray morphology and radio polarisation analysis support a physical connection of this feature to the SNR. The ‘bullet’ feature’s apparent velocity is estimated at

$\sim$

1 300 km s

$^{-1}$

, based on its distance (

$\sim$

10 pc) from the remnant’s geometric centre and estimated age (

$\sim$

7 600 yr). we estimated the radio spectral index,

$\alpha= -0.55 \pm 0.03$

which is typical of middle-age SNRs. Polarisation maps created for N 49 show low to moderate levels of mean fractional polarisation estimated at 7

$\pm$

1% and 10

$\pm$

1% for 5.5 and 9 GHz, respectively. These values are noticeably larger than found in previous studies. Moreover, the mean value for the Faraday rotation of SNR N 49 from combining CABB data is 212

$\pm$

65 rad m

$^{-2}$

and the maximum value of RM is 591

$\pm$

103 rad m

$^{-2}$

.
Troubled water: Tracing the plastic tide on Sierra Leone’s beaches
Authors: Lavelle Stephanie , Preston-Whyte Fiona , Lamin Paul A. , Sankoh Salieu Kabba , Timbo Isha , Maes Thomas
Published: November 2024

This study provides the first investigation into quantities, types, and potential sources of anthropogenic beach litter in Sierra Leone. Beach litter surveys were conducted monthly at four sites over 11 months. A total of 72,901 litter items (1,246 kg dry weight) were categorised. Across all sites, an average of 1,657 items per 100 m (SD = 1,639) and 28.32 kg per 100 m (SD = 37.48) were recorded. Plastics accounted for 70% of the litter by count and 49% by weight. The three most abundant items by count were plastic bottles (25%), plastic caps and lids (13%), and plastic water sachets (12%). By weight, the three most abundant items were plastic bottles (36%), flip-flops (20%), and shoes (9%). Litter amounts decreased from wet to dry season. We provide the following policy recommendations: improving drinking water access and sanitation, waste management, infrastructure and behaviour change.
June Jordan’s Political Theory of Redesign
Authors: BEARD LISA
Published: November 2024

This essay examines June Jordan’s design writings to elaborate a political theory of redesign in her work. I show that Jordan’s redesign offers political principles for reimagining space at multiple scales and speaks to the question of how more livable, beautiful worlds may be wrought from the material contexts in which we presently live. Against the grain of the dismantling of public goods in the late twentieth century, Jordan re-envisioned public city spaces and housing with dignity and room for human flourishing. Her primary barometer for design was the fullest expression of human aliveness—she insisted that the built environment should “[cherish] as it amplifies the experience of being alive.” Jordan’s visionary pragmatism anticipates what Deva Woodly calls the “radical Black feminist pragmatism” of the twenty-first century’s Movement for Black Lives and speaks to contemporary abolitionist thought and struggles over the future of public goods.
Durkheim’s Empire: The Concept of Solidarity and Its Colonial Dimension
Authors: SYMANK ROUVEN
Published: November 2024

This article challenges prevailing national interpretations of solidarity by examining its colonial dimensions. Employing the Durkheimian school as a historical lens, I demonstrate how the colonial context during the Third Republic shaped the emergence and application of solidarity as a scientific concept. Informed by colonial ethnographies, solidarity was not merely a sociological self-description within European nations; it also formed part of political agendas beyond Europe. I illustrate how Durkheim’s concept was utilized to enhance scientific understanding of colonized societies, aiding French colonial administrators in promoting developmentalist reforms. As national models extended internationally, solidarity evolved from social cohesion to economic integration within the international legal order. This progression toward modern solidarity—and the injustices it entailed—appeared inevitable, masking political struggles for self-determination. By critically recontextualizing solidarity, this analysis contributes to contemporary political theory debates, demonstrating its application in supporting an inclusive legal-economic agenda while failing to systematically confront colonial injustices.
Effects of the rs174575 single nucleotide polymorphism in FADS2 on levels of long-chain PUFA: a meta-analysis
Authors: Liu Motong , Wu Yanyan , Ni Song , Gong Jiayu , Chen Yifei , He Yuan , Chen Shutong , Yu Haitao , Xie Lin
Published: November 2024

The influence of the SNP rs174575 (C/G) within the fatty acid desaturase 2 gene on the levels of long-chain PUFA was determined through statistical meta-analysis. Six databases were searched to retrieve the relevant literature. Original data were analysed using Stata 17·0, encompassing summary statistics, tests for heterogeneity, assessment of publication bias, subgroup analysis and sensitivity analysis. A total of ten studies were identified and grouped into twelve trials. Our results showed that individuals who carried the minor G allele of rs174575 had significantly higher dihomo-γ-linolenic acid levels (P = 0·005) and lower arachidonic acid levels (P = 0·033) than individuals who were homozygous for the major allele. The subgroup analysis revealed that the G-allele carriers of rs174575 were significantly positively correlated with linoleic acid (P = 0·002) and dihomo-γ-linolenic acid (P < 0·001) and negatively correlated with arachidonic acid (P = 0·004) in the European populations group. This particular SNP showed a potential association with higher concentrations of dihomo-γ-linolenic acid (P = 0·050) and lower concentrations of arachidonic acid (P = 0·030) within the breast milk group. This meta-analysis has been registered in the PROSPERO database (ID: CRD42023470562).
Exploring the impact of caloric restriction on molecular mechanisms of liver damage induced by sucrose intake in the drinking water
Authors: Wiszniewski Morena , Caldareri Lilian , Mori Diego , Martinez Calejman Camila , Cymeryng Cora B. , Repetto Esteban M.
Published: November 2024

A positive association has been demonstrated between consumption of sucrose-sweetened beverages and the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD). Since the administration of 30 % sucrose in the drinking water (sucrose-rich diet (SRD)) to rats has proven to be a good model of systemic insulin resistance, the aim of our study was to analyse the effect of caloric restriction applied on SRD-treated rats by switching back to a standard diet, on liver morphology, function and metabolism. Consumption of an SRD causes a metabolic shift towards gluconeogenesis and fatty acid synthesis leading to an increase in TAG levels in plasma and in the liver that were associated with a decrease in insulin sensitivity. Moreover, our results show that animals fed an SRD develop steatohepatitis characterised by the generation of oxidative stress, endoplasmic reticulum (ER) stress, inflammation and apoptosis. Although no histological changes were observed after a 2-week caloric restriction, key pathways associated with the progression of MASLD as inflammation, ER stress and apoptosis were slowed down. Notably, this 2-week intervention also increased liver insulin sensitivity (evaluated by AKT activity in this tissue) and drove the lipid metabolic profile towards oxidation, thus lowering circulating TAG levels. In summary, the present study uncovers underlying mechanisms affected, and their metabolic consequences, during the first stages of the phenotypic reversal of steatohepatitis by switching back to a standard diet after receiving sucrose-sweetened water for several weeks.
Temporal patterns of energy intake and physical activity and cross-sectional associations with body weight status in children and adolescents: results from the Portuguese National Food, Nutrition and Physical Activity Survey 2015–2016
Authors: Cardoso Sofia , Sanches Inês , Correia Daniela , Vilela Sofia
Published: November 2024

Temporal energy intake (EI) and physical activity (PA) patterns may be associated with obesity. We aimed to derive and characterise temporal EI and PA patterns, and assess their cross-sectional association with weight status, in 6-to-14-year-old Portuguese participants of the National Food, Nutrition and Physical Activity Survey 2015–2016. We extracted times and EI of all eating occasions from two 1-d food diaries/24-h recalls, while types and times of PA from 4-d PA diaries. We derived EI patterns (n 714) and PA patterns (n 595), using, respectively, a hierarchical and K-means cluster analysis, considering the average proportion of total daily EI (%TEI) and PA intensity (%TPA), within each 2-h interval across the 24-h day. Patterns were labelled based on the 2-h intervals of %TEI/TPA peaks. We assessed the association between patterns and overweight or obesity (BMI z-score ≥ +1 sd) using adjusted logistic regressions (OR (95 % CI)). Three EI patterns emerged: 1 – ‘Early afternoon and early evening’; 2 – ‘Early afternoon and late evening’; and 3 – ‘Late morning, early and mid-afternoon and late evening’. EI Pattern 3 v. Pattern 1 was negatively associated with overweight or obesity (0·49 (0·26, 0·92)). PA Pattern 1 – ‘Late morning, mid-afternoon and early evening’ v. Pattern 2 – ‘Late afternoon’, was not associated with weight status (0·95 (0·65, 1·38)). A daily EI pattern with more and even %TEI peaks at earlier daytime periods, rather than fewer and higher, may be negatively associated with overweight or obesity amongst this population whereas the identified PA patterns might have no relationship.
Prevalence of cardiometabolic diseases in underweight: a nationwide cross-sectional study
Authors: Chen Meng , Shi Shuxiao , Wang Sujing , Huang Yue , Zhou Feng , Zhong Victor W.
Published: November 2024

This study aimed to estimate the nationwide prevalence of cardiometabolic diseases (CMD) among adults with underweight in the US general population. Using data from the National Health and Nutrition Examination Survey (1999–2020), we estimated the age-standardised prevalence of dyslipidemia, hypertension, diabetes, chronic kidney disease, CVD and the presence of zero or at least two CMD. Multivariable Poisson regressions were used to compare CMD prevalence between subgroups, adjusting for age, sex and race/ethnicity. Among the 855 adults with underweight included, the weighted mean age was 40·8 years, with 68·1 % being women and 70·4 % non-Hispanic White. The estimated prevalence rates were 23·4 % for dyslipidemia (95 % CI 19·4 %, 27·5 %), 15·6 % for hypertension (95 % CI 13·3 %, 17·8 %), 2·5 % for diabetes (95 % CI 1·5 %, 3·5 %), 7·9 % for chronic kidney disease (95 % CI 6·9 %, 8·8 %) and 6·1 % for CVD (95 % CI 4·3 %, 7·9 %). The prevalence of having zero and at least two CMD was 50·6 % (95 % CI 44·1 %, 57·0 %) and 12·3 % (95 % CI 8·1 %, 16·4 %), respectively. Non-Hispanic Black adults had significantly higher prevalence of diabetes (adjusted prevalence ratio, 3·35; 95 % CI 1·35, 8·30) compared with non-Hispanic White adults. In conclusion, approximately half of the underweight adults had at least one CMD, and 12·3 % had at least two CMD. Prevention and management of CMD in underweight adults are critical yet neglected public health challenges.
Debating Biblical Translation in Late Elizabethan England
Authors: Spillane Harry
Published: November 2024

This article explores how Protestants defended the co-existence of multiple translations of the Bible into English in Elizabethan England. The matter of biblical plurality is considered through the prism of the debates surrounding bible translation which occurred throughout the 1580s between the Catholic translator of the Bible into English, Gregory Martin (c. 1542–1582), and the English Protestant polemicist William Fulke (1537/8–1589). It is contended that this debate, which has tended to be cast as a storm in a teacup, reveals how Protestants responded, innovatively, to the publication of the Catholic English New Testament. Attention is paid to how Martin attacked the existence of the many different Protestant English bible translations in circulation and, reciprocally, how Fulke defended them. This study of the Martin and Fulke debate thereby unsettles some long-standing assumptions about the combative relationship between different versions of the English Bible and it points, instead, to ways in which contemporaries might have seen the plurality of translations as spiritually and polemically advantageous. Fulke's arguments help us to comprehend how, prior to early seventeenth-century attempts to restrict the existence of multiple English bibles, some Elizabethans responded to, and even defended, the plurality of English bible translations which had come to exist.
Cactodera xinanensis n. sp. (Nematoda: Heteroderinae), a new species of cyst-forming nematode from Southwest China, with a key to the Genus Cactodera
Authors: Ni C.-H. , Li Q.-Y. , Yang Z.-F. , Xu C.-L. , Xie H.
Published: November 2024

The cyst nematodes, subfamily Heteroderinae, are plant pathogens of worldwide economic significance. A new cyst nematode of the genus Cactodera within the Heteroderinae, Cactodera xinanensis n. sp., was isolated from rhizospheres of crops in the Guizhou and Sichuan provinces of southwest China. The new species was characterized by having the cyst with a length/width = 1.3 ± 0.1 (1.1–1.6), a fenestral diameter of 28.1 ± 4.3 (21.3–38.7) μm, vulval denticles present; second-stage juvenile with stylet 21.5 ± 0.5 (20.3–22.6) μm long, tail 59.4 ± 2.0 (55.9–63.8) μm long and hyaline region 28.7 ± 2.7 (25.0–36.3) μm long, lateral field with four incisures; the eggshell with punctations. The new species can be differentiated from other species of Cactodera by a longer tail and hyaline region of second-stage juveniles. Phylogenetic relationships within populations and species of Cactodera are given based on the analysis of the internal transcribed spacer (ITS-rRNA), the large subunit of the nuclear ribosomal RNA (28S-rRNA) D2-D3 region and the partial cytochrome oxidase subunit I (COI) gene sequences here. The ITS-rRNA, 28S-rRNA and COI gene sequences clearly differentiated Cactodera xinanensis n. sp. from other species of Cactodera. A key and a morphological identification characteristic table for the species of Cactodera are included in the study.
Analyses of the essential C82 subunit uncovered some differences in RNA polymerase III transcription between Trypanosoma brucei and Leishmania major
Authors: Cano-Santiago Andrés , Florencio-Martínez Luis E. , Vélez-Ramírez Daniel E. , Romero-Chaveste Adrián J. , Manning-Cela Rebeca G. , Nepomuceno-Mejía Tomás , Martínez-Calvillo Santiago
Published: November 2024

The 17-subunit RNA polymerase III (RNAP III) synthesizes essential untranslated RNAs such as tRNAs and 5S rRNA. In yeast and vertebrates, subunit C82 forms a stable subcomplex with C34 and C31 that is necessary for promoter-specific transcription initiation. Little is known about RNAP III transcription in trypanosomatid parasites. To narrow this knowledge gap, we characterized the C82 subunit in Trypanosoma brucei and Leishmania major. Bioinformatic analyses showed that the 4 distinctive extended winged-helix (eWH) domains and the coiled-coil motif are present in C82 in these microorganisms. Nevertheless, C82 in trypanosomatids presents certain unique traits, including an exclusive loop within the eWH1 domain. We found that C82 localizes to the nucleus and binds to RNAP III-dependent genes in the insect stages of both parasites. Knock-down of C82 by RNA interference significantly reduced the levels of tRNAs and 5S rRNA and led to the death of procyclic forms of T. brucei. Tandem affinity purifications with both parasites allowed the identification of several C82-interacting partners, including C34 and some genus-specific putative regulators of transcription. However, the orthologue of C31 was not found in trypanosomatids. Interestingly, our data suggest a strong association of C82 with TFIIIC subunits in T. brucei, but not in L. major.
Understanding American tegumentary leishmaniasis in urban Montes Claros, Brazil: insights from clinical, immunological and therapeutic investigations
Authors: Lopes Dayse M. S. , Lima Jackeline M. S. , Ribeiro Karine S. M. , Gomes Clarissa F. , Rocha Rebeca M. , Gonçalves Thainara S. , Vieira Thallyta M. , de Carvalho Sílvio F. , Finn M. G. , Venuto Ana Paula , Marques Alexandre F.
Published: November 2024

The challenge of American tegumentary leishmaniasis (ATL) continues in Brazil, presenting a persistent public health issue despite initiatives aimed at public outreach, vector control and health education. To gain a deeper understanding of this disease, a study was conducted in an endemic region located in the northern region of the state of Minas Gerais, Brazil. The study monitored 30 resident patients diagnosed with ATL, using serum samples from 6 healthy individuals as controls. The localized cutaneous form of the disease was found to be predominant, with lesions appearing on various parts of the body and the majority of the affected individuals being male. The study found significantly higher levels of IgG anti-α-Gal antibodies in ATL-infected patients compared to healthy individuals. Treatment of 19 patients with meglumine antimoniate resulted in limited improvement in symptoms for most. Nonetheless, the study found that 12 patients who completed treatment with epithelialization of the lesions showed a significant decrease in IgG anti-α-Gal antibodies, indicating potential applications of this antibody in the diagnosis and monitoring of the disease. The study also identified Leishmania species in 7 analysed patients, revealing 6 cases infected by Leishmania braziliensis and 1 by L. infantum, with a significant difference in the anti-α-Gal responses. The findings of the study emphasize the urgent need for the development of human vaccines and innovative treatment strategies adapted to the diversity of Leishmania species causing cutaneous leishmaniasis and individual patient responses to improve the clinical management of ATL in Brazil and similar endemic regions.
The other mother: ancient and early Byzantine approaches to wet-nursing and mothering
Authors: Constantinou Stavroula , Skouroumouni-Stavrinou Aspasia
Published: November 2024

In premodernity, a time when human milk was the only safe means of infant nutrition, and in societies, such as those of classical antiquity and early Byzantium, where breastfeeding was considered servile work, wet-nursing was both a necessary and widespread occupation. Despite the social demand for the profession, public discourses around wet nurses were mostly negative, while their work was treated with both admiration and scorn. In an attempt to understand ancient and early Byzantine approaches to the wet nurse, this article takes a matricentric perspective. It investigates various discourses (rhetorical, moralist, philosophical, theological, hagiographical, medical and contractual) which establish the wet nurse as an essential part of the institution of motherhood, as a social and moral category whose work, way of life and behaviour are constantly defined, controlled and regulated. These discourses nevertheless tell us much more about the anxieties and preoccupations of the societies that produced them and much less about actual contemporary wet nurses. The choice of an investigation encompassing antiquity up to early Byzantium, an extension rarely seen in existing studies, further illuminates the mechanics and dynamics of the ideologies around the wet nurse, as these are preserved or evolve in time.
The dementia–nature–inclusivity nexus and the needs of people living with dementia
Authors: Stapley Sally , Page Stephen , Wheat Hannah , Owen Steve , Ledingham Katie , Price Stephan , Connell Joanne , Quinn Catherine , Opdebeeck Carol , Victor Christina , Clare Linda
Published: November 2024

Understanding how to improve the physical and cognitive accessibility of visitor economy businesses and organisations wanting to offer nature-based outdoor pursuits for people with dementia is key to supporting their inclusion and agency. The aim of this qualitative study was to understand the experiences, needs and preferences of people with dementia participating in nature-based outdoor pursuits in their leisure time. Semi-structured interviews were conducted with 15 people with dementia and 15 family members and subjected to thematic analysis. Four themes related to inclusion for people with dementia and their family members reflected diversity in individual needs and preferences for engaging with nature-based outdoor pursuits, their own adaptations to maintain access including accommodating risk, how cognitive and physical accessibility can be supported by businesses, and which practical and psychosocial barriers prevent inclusion. Learning from people with dementia and their family members has helped bridge the gap to their inclusion in nature-based outdoor pursuits. Their insights will inform the development of such pursuits by businesses and organisations as well as future work into risk decision-making.
Almost exact recovery in noisy semi-supervised learning
Authors: Avrachenkov Konstantin , Dreveton Maximilien
Published: November 2024

Graph-based semi-supervised learning methods combine the graph structure and labeled data to classify unlabeled data. In this work, we study the effect of a noisy oracle on classification. In particular, we derive the maximum a posteriori (MAP) estimator for clustering a degree corrected stochastic block model when a noisy oracle reveals a fraction of the labels. We then propose an algorithm derived from a continuous relaxation of the MAP, and we establish its consistency. Numerical experiments show that our approach achieves promising performance on synthetic and real data sets, even in the case of very noisy labeled data.
Objects, affordances, and material histories in Roman Palestine: a case study on Northern Collar-Neck Lamps and their uses in early Jewish Sources
Authors: Gardner Gregg E.
Published: November 2024

This article seeks to contribute to the growing scholarship on object-focused Roman histories by expanding the conversation to previously overlooked archaeological finds from Roman Palestine. This case study focuses on “Northern Collar-Neck Lamps,” which have been found throughout Roman Galilee and date to the first two centuries CE. I argue that their distinctive high collar, perhaps designed to reduce spillage, also served as an affordance that invited additional modes of interaction, namely placing a supplemental reservoir for oil – such as a pierced eggshell – over the filling hole. Once set up, this would allow for a slow drip of oil to prolong illumination time without human intervention. This usage is suggested from chronologically and geographically proximate sources, namely early rabbinic literature: Hebrew and Aramaic writings from the first centuries that reference physical details and uses of hundreds of objects and could prove helpful for future material histories of the Roman era.
A miniature marvel: left main coronary stenting in a tiny newborn after left coronary artery from the pulmonary artery surgery
Authors: Yükcü Bekir , Paksoy Samet , Ugan Atik Sezen , Gökalp Selman , Haydin Sertaç , Güzeltaş Alper
Published: November 2024

Anomalous left coronary artery from the pulmonary artery is a congenital coronary artery anomaly comprising 0.5% of all CHDs. Stenosis in the left coronary artery implanted in the sinus valsalva is one of the complications of surgical repair.

Management of coronary stenosis after surgery is very critical and difficult, especially in newborns and infants. Transcatheter procedures can be lifesaving. Herein, the coronary stenting procedure applied to a 3-month-old patient with post-surgical coronary stenosis is presented.
Longitudinal email-based electrocardiogram interpretation curriculum for paediatric residents
Authors: Van Der Bosch Margaret , Soohoo Megan
Published: November 2024

Background:

Electrocardiograms are frequently obtained in infants and children. Training specific to paediatric electrocardiogram interpretation is necessary given that cardiac physiology and electrocardiogram findings in children are different than adults and change throughout infancy and childhood. Distributed practice may be an effective method to improve paediatric residency electrocardiogram education efforts.

Methods:

A pre-survey was administered to paediatric and internal medicine/paediatrics residents to ascertain baseline comfort with electrocardiogram interpretation. Subsequently, residents were emailed a clinical vignette with an associated electrocardiogram and multiple-choice question 1–2 times monthly. After submitting their answer, residents were taken to a webpage explaining key concepts explored in the clinical vignette. After 6 and 12 months, a survey was administered asking residents to again rate their confidence in the same electrocardiogram interpretation skills.

Results:

The longitudinal email-based curriculum increased exposure to electrocardiogram training. Six months of participation in the curriculum correlated with significant increases in confidence in electrocardiogram interpretation skills. While there was no further increase in confidence seen at 12 months, the improvement seen at 6 months was durable. Participation in the curriculum most significantly correlated with changes in confidence in ability to utilise a stepwise approach for electrocardiogram interpretation.

Conclusions:

The curriculum resulted in durable improvement in confidence in electrocardiogram interpretation skills for paediatric residents at our centre, suggesting that email-based distributive practice can be an effective method for skill and knowledge improvement for complex educational topics.
Precision of artificial intelligence in paediatric cardiology multimodal image interpretation
Authors: Gritti Michael N. , Prajapati Rahil , Yissar Dolev , Morgan Conall T.
Published: November 2024

Multimodal imaging is crucial for diagnosis and treatment in paediatric cardiology. However, the proficiency of artificial intelligence chatbots, like ChatGPT-4, in interpreting these images has not been assessed. This cross-sectional study evaluates the precision of ChatGPT-4 in interpreting multimodal images for paediatric cardiology knowledge assessment, including echocardiograms, angiograms, X-rays, and electrocardiograms. One hundred multiple-choice questions with accompanying images from the textbook Pediatric Cardiology Board Review were randomly selected. The chatbot was prompted to answer these questions with and without the accompanying images. Statistical analysis was done using X2, Fisher’s exact, and McNemar tests. Results showed that ChatGPT-4 answered 41% of questions with images correctly, performing best on those with electrocardiograms (54%) and worst on those with angiograms (29%). Without the images, ChatGPT-4’s performance was similar at 37% (difference = 4%, 95% confidence interval (CI) –9.4% to 17.2%, p = 0.56). The chatbot performed significantly better when provided the image of an electrocardiogram than without (difference = 18, 95% CI 4.0% to 31.9%, p < 0.04). In cases of incorrect answers, ChatGPT-4 was more inconsistent with an image than without (difference = 21%, 95% CI 3.5% to 36.9%, p < 0.02). In conclusion, ChatGPT-4 performed poorly in answering image-based multiple-choice questions in paediatric cardiology. Its accuracy in answering questions with images was similar to without, indicating limited multimodal image interpretation capabilities. Substantial training is required before clinical integration can be considered. Further research is needed to assess the clinical reasoning skills and progression of ChatGPT in paediatric cardiology for clinical and academic utility.
Post-COVID condition: a focus on psychiatric symptoms and diagnoses in patients with cognitive complaints
Authors: Cerioli Matteo , Giacovelli Luca , Nostro Chiara , Larini Luca , Castiglioni Michele , Scarpa Carolina , Cassina Niccolò , Nicotra Alessia , Maestri Giorgia , Cucumo Valentina , Masserini Federico , Pomati Simone , Cirnigliaro Giovanna , Pantoni Leonardo , Dell’Osso Bernardo
Published: November 2024

Objective

Cognitive and psychiatric symptoms are frequently reported after SARS-CoV-2 infection, but their interplay has been only partially explored. We investigated frequency and severity of psychiatric symptoms in patients with persistent cognitive complaints after COVID-19.

Methods

We conducted a cross-sectional study. Neurologists assessed 101 patients reporting cognitive symptoms after COVID-19. Patients were invited to fill a screening battery with self-reported psychometric scales (Depression Anxiety Stress Scales-21, Impact of Event Scale-Revised, Insomnia Severity Index). Patients scoring above validated cut-offs in ≥1 scale were referred to psychiatrists who administered the Mini-International Neuropsychiatric Interview (M.I.N.I.), Hamilton Anxiety (HAM-A), and Hamilton Depression (HAM-D) rating scales and asked to complete the Personality Inventory for DSM-5-Brief Form (PID-5-BF).

Results

Out of the 57 referred patients, 38 (64.4%) accepted to undergo the psychiatric examination. Among these, 18 (47.4%) were diagnosed with adjustment disorder (23.7%), anxiety disorder (10.5%), major depressive disorder (7.9%), and post-traumatic stress disorder (2.6%). Pharmacologic treatment before post-COVID condition (present in 12 patients, 31.6%) was associated with a score above cut-off on the HAM-A and HAM-D scales. A longer duration of untreated psychiatric illness after COVID-19 was associated with worse scores on the same scales. Patients with a higher PID-5-BF total score had a higher probability of receiving a psychiatric diagnosis.

Conclusion

Almost half of patients with post-COVID-19 conditions reporting cognitive symptoms were found to suffer from a psychiatric condition after psychiatric evaluation. The application of a psychiatric screening in a population suffering from long-term effects of COVID-19 can lead to early diagnosis and timely treatment.