bluuebunny/crossref_metadata_2025 huggingface dataset:
Climate change impacts on blanket peatland in Great Britain
Authors: Ritson Jonathan P. , Lees Kirsten J. , Hill James , Gallego‐Sala Angela , Bebber Daniel P.
Published: January 2025

Peatland restoration has been suggested as a key method for the UK to meet national, legally binding climate targets. This can involve blocking up drainage ditches or erosion features, as well as encouraging regeneration of peatland vegetation through Sphagnum reintroduction or removal of scrub or trees. It is unclear, however, how suitable future conditions will be for both peat accumulation and Sphagnum survival.

We applied three bioclimatic envelope models for blanket bogs in Britain to assess how future climate is likely to deviate from current conditions, focussing on four national parks with significant peatland area (Dartmoor, the Flow Country, the Peak District and Snowdonia). We also assessed the likelihood of thresholds being passed at which irreversible desiccation of Sphagnum moss may occur.

Our bioclimatic envelope models use updated climate projections (bias‐corrected UKCP18 projections under Representative Concentration Pathways (RCP) 2.6, 4.5 and 8.5) that are more accurate in the upland regions in which blanket bogs can occur, and use thresholds of blanket bog occurrence which are tailored to Britain. This gives us higher confidence in the results as compared to previous models.

Our results show substantial losses in areas suitable for peatland by 2061–2080 under all RCPs. Under RCP8.5 there is virtually no peatland within its current bioclimatic envelope in our case study areas and only limited areas in Snowdonia under RCP4.5, suggesting these regions will be outside the ideal conditions that lead to peat accumulation. Only western Scotland retains substantial areas suitable for peat.

The frequency of Sphagnum desiccation events is projected to increase by between 44% and 82% which will likely result in decreased success of hummock forming species, particularly at easterly sites where rainfall is lower, though wetter microsites will likely allow more drought‐tolerant species to persist.

Policy implications. Action should be taken to raise water tables at degraded sites to limit the impact of future drought conditions. However, climatic conditions being outside the current bioclimatic envelope may make full restoration challenging. Sphagnum reintroduction programmes may have greater success utilising drought‐tolerant species as hummock forming species are at greater risk of die off during desiccation events.
Notes for PhDs in Economics and Finance on Getting a Job
Authors: Clements Kenneth W.
Published: January 2025

The notes start with a description of the market for PhDs in economics and finance. Then follows some suggestions and comments on an important part of the academic market, the job‐market paper – its nature and the pros and cons of co‐authorship. Finally, I discuss the role of the oral presentation, also important for a job in academe, as well as in other areas.
Variations in pelvic tilt between relaxed‐seated and flexed‐seated positions affect stability assessment in 3D modelling in total hip replacement
Authors: Gilbertson Bryn , Babazadeh Sina , van Bavel Dirk
Published: January 2025

Background

The spinopelvic axis is becoming recognized as an essential contributor to impingement and instability leading to dislocation. Computer‐assisted hip surgery uses standing and relaxed‐seated radiographs as a surrogate marker of pelvic tilt in all seated positions. However, the flexed‐seated position is a high‐risk position for dislocation, and the standing and relaxed‐seated radiographs may not reflect this risk. This study aims to determine whether adding a flexed‐seated radiograph affects stability assessment in 3D modelling of THR.

Methods

Ninety patients with osteoarthritis underwent computer‐assisted THR and received standing, relaxed‐seated, and flexed‐seated radiographs. Sacral slope (SS) was measured and analysed using Pearson correlation. Key measures were degree of tilt between positions, as well as correlations between dynamic hip movements.

Results

Of the examined patients, 96.7% anteriorly tilted their pelvis moving from relaxed‐seated to flexed‐seated, and 50% of patients anteriorly tilted by >10° SS. There was a moderate correlation between standing SS and flexed‐seated SS (r = 0.33, P ≤ 0.1). There was a strong correlation between relaxed‐seated SS and flexed‐seated SS (r = 0.77, P ≤ 0.001); however, there was a wide variance of flexed‐seated SS for any given relaxed‐seated or standing SS.

Conclusion

The flexed‐seated position poses a higher risk of anterior impingement in 96.7% of patients compared to the relaxed seated‐position. The flexed‐seated position cannot be predicted by existing radiographs, making it a valuable marker in surgical planning to mitigate the risk of hip instability.
Normothermic Machine Perfusion vs. Static Cold Storage in Liver Transplantation: A Systematic Review and Meta‐Analysis
Authors: Viana Patricia , Castillo‐Flores Samy , Mora Maria M. R. , Cabral Thamiris D. D. , Martins Paulo N. , Kueht Michael , Faria Isabella
Published: January 2025

Background

Normothermic machine perfusion (NMP) represents an alternative to prolong liver preservation and reduce organ discard rates. We performed an updated systematic review and meta‐analysis to compare NMP with static cold storage (SCS) in liver transplantation.

Methods

MEDLINE, Embase, and Cochrane were searched for randomized controlled trials (RCTs) or observational studies. Risk ratios (RR) and mean differences were calculated. p < 0.05 was considered significant. A random‐effects model was applied for all outcomes. PROSPERO ID: CRD42023486184.

Results

We included 1295 patients from 5 RCTs and 6 observational studies from 2016 to 2023. 592 (45.7%) underwent NMP. A subgroup RCT analysis favored NMP for non‐anastomotic strictures (RR 0.4; 95% CI 0.2, 0.9), postreperfusion syndrome (RR 0.4; 95% CI 0.27, 0.56), and early allograft dysfunction (RR 0.6; 95% CI 0.4, 0.9). NMP favored higher organ utilization rates (RR 1.1; 95% CI 1.02, 1.18). No significant differences between NMP and SCS were observed in graft survival or patient survival at 12 months, primary non‐function, serious adverse events, overall biliary complications, AST, or bilirubin levels peak within the first 7 days, ICU or hospital length of stay.

Conclusion

Our findings suggest that NMP is associated with lower non‐anastomotic biliary stricture rates, postreperfusion syndrome, early allograft dysfunction, and higher organ utilization in the RCT subgroup analysis, without increasing adverse events.
Xenotransplantation as a business solution to the organ shortage
Authors: Bobier Christopher , Gibson Richard B. , Merlocco Anthony , Rodger Daniel , Hurst Daniel J.
Published: January 2025

Xenotransplantation has the potential to alter the U.S. transplant system in profound ways. However, this emerging “spare parts” solution spearheaded by biotechnology companies raises concerns about its impact on the organ shortage, healthcare systems, population health, and health inequalities. We contend that xenotransplantation may have limited benefits in improving health, could prove prohibitively expensive for many, and may divert resources away from proven public health measures. Additionally, it carries the risk of perpetuating stigma. Xenotransplantation may thereby exacerbate existing healthcare inequities across racial, ethnic, socio‐economic, and geographic lines. To mitigate these risks, we contend that public health expert input is integral for xenotransplant policy development and outreach and that this underscores the importance of federal government investment in transplant infrastructure.
Effects of Nighttime Procurement and Transplantation on Outcomes Following Heart Transplantation
Authors: Hong Yeahwa , Hess Nicholas R. , Dorken‐Gallastegi Ander , Abdullah Mohamed , Iyanna Nidhi , Nasim Umar , Sultan Ibrahim , Hickey Gavin W. , Keebler Mary E. , Kaczorowski David J.
Published: January 2025

Background

This study evaluates the effects of nighttime procurement and transplantation on outcomes following heart transplantation.

Methods

The UNOS registry was queried to analyze adult recipients who underwent isolated orthotopic heart transplantation between January 1, 2010, and September 30, 2022. The cohort was stratified into daytime (4 am–8 pm) and nighttime (8 pm–4 am) transplant groups. The primary outcome was 1‐year survival. Propensity score‐matching was performed. Risk adjustment was performed using multivariable Cox regression. Restricted cubic spline was used to model the association between the time of transplantation and the likelihood of 1‐year mortality. Sub‐analysis was performed to evaluate the impact of nighttime procurement.

Results

Altogether 30 426 recipients were analyzed, where 10 807 recipients (35.5%) underwent nighttime transplantation. The nighttime recipients had reduced 1‐year post‐transplant survival compared to the daytime recipients (90.6% vs. 91.5%, p = 0.019), and this lower survival persisted in the propensity score‐matched comparison. After adjusting for established predictors for post‐transplant mortality, nighttime transplantation continued to have a significantly increased risk of 1‐year mortality (hazard ratio [HR] 1.12, 95% confidence interval [CI] 1.03–1.21, p = 0.005). The spline model demonstrated increased odds of 1‐year mortality between 5 pm and 4 am, with the highest odds at 11 pm (odds ratio [OR] 1.25, 95% CI 1.07–1.47), compared to the reference transplantation time of 7 am. When assessing the impact of procurement timing, nighttime procurement negatively impacted 1‐year post‐transplant survival among the daytime recipients.

Conclusion

This study demonstrates the adverse impact of nighttime heart procurement and transplantation on early post‐transplant survival. With emerging organ perfusion and thermal protection systems, additional studies are warranted to assess the safety of extending the heart preservation period to optimize the timing of transplantation.
Assessing the Quality of Life in Adult Lung Transplant Recipients Quality of Life Post‐Lung Transplant
Authors: Al‐Shweeman Bashayer M. , Mohamed Gamal , Alawwad Atheer
Published: January 2025

Background

Significant limitations in daily life characterize end‐stage lung diseases (ESLD) due to symptoms such as dyspnea, recurrent infections, side effects of immunosuppressive medication, and frequent need for hospitalizations. In addition to physical symptoms, ESLD is associated with emotional and social sources of distress such as depression, anxiety, fear of dying, financial concerns, and regular need for relocation. A transplant can significantly affect the recipients’ life domains, from physical and emotional well‐being to social relationships and roles.

Objective

This study aims to assess the quality of life of adult lung transplant recipients in Saudi Arabia.

Method

A cross‐sectional quantitative design was employed using the self‐administered World Health Organization Quality of Life (WHOQOL‐BREF) questionnaire, a sociodemographic and clinical questionnaire, and a medical chart review. The study was conducted in a tertiary care center in Saudi Arabia. Data were collected from November 2023 to April 2024.

Results

One hundred fifty‐seven individuals with a mean age of 45 years had completed the questionnaire, and there was no participant refusal (Response rate = 100%). Males accounted for 61.1%, and most participants were married (63.7%). About half (44.6%) had at least one comorbidity outside ESLD. Only 26.7% were working post‐transplant. Overall, the data strongly suggests that as individuals adjust and recover post‐transplant, they tend to feel increasingly positive with time. Most rated their quality of life and health satisfaction as high. The lowest score was for the physical domain.

Conclusion

The study's findings showed that the quality was good overall across various domains, with moderate scores, with the lowest score on the physical domain. Improving rehabilitation strategies would help transplanted patients live more fulfilling lives.
Ordo renascendi est crescere posse malis (Rutilius Namatianus I.140): the sack of Rome and the resilience of western Roman aristocracies
Authors: Kultzen Sophie
Published: January 2025

Rutilius Namatianus’ poem De reditu suo was written a few years after the devastation of Rome in 410. It has been read as nostalgia for Rome’s past greatness written in a climate of senatorial escapism. This article revises this reading, instead analysing the poem as the literary expression of resilience on the part of the traditional western aristocracies. The collective strategy of conservative western Roman elites was to face the crisis by rebuilding the beatitudo temporum of urban structures and consolidating the ideology of the Urbs aeterna. By contrast, the increasing importance of ascetic movements can be seen as an alternative coping strategy adopted by the Christian aristocracy, overcoming the trauma of 410 through religious renewal.
Association between fungal detection, airways inflammation and diagnosis of moderate to severe asthma in horses
Authors: Barbazanges Pauline , Couroucé Anne , Le Digarcher Gabin , Cardwell Jacqueline M. , Schmitt Eliott , Toquet Marie‐Pierre , Lemonnier Louise C. , Richard Eric A.
Published: January 2025

Background

Fungi are ubiquitous in horses' environment. Their contribution to the pathophysiology of severe asthma (SA) is acknowledged, while controversies remain for mild–moderate asthma (MA).

Objectives

We hypothesised that fungi are a risk factor for asthma. Our objective was to compare different combinations of analytical methods (cytology, culture) and sampling sites (tracheal wash (TW), bronchoalveolar lavage fluid (BALF)) in relation to clinical status (control, MA, SA).

Study design

Prospective cross‐sectional study.

Methods

The study population included asymptomatic racing horses in the field and horses referred to the hospital for respiratory investigations. Fungi were detected by cytology and identified by mycology on TW and pooled BALF. Chi‐square tests and multivariable logistic regressions were used for prevalence comparison between groups and association with clinical investigations.

Results

In total 155 horses (85 MA, 35 SA and 35 controls) were included in the study. The overall proportions of fungal detection in TW ranged from 45.7% to 89.4% among groups. The prevalence of fungal detection in BALF was significantly lower by cytology for SA (5.7%) than MA horses (23.6%) and significantly higher by culture for MA horses (31.8%) than controls (8.6%). Fungal detection by culture in BALF was significantly associated with high tracheal mucus score, high neutrophil proportions in BALF and diagnosis of MA.

Main limitations

Mycology was only performed in pooled BALF, and environment was not sampled.

Conclusions

Fungi were significantly more prevalent in the airways of MA horses than SA and/or controls. Fungal detection on TW, either by cytology or culture, was uninformative in a clinical context. Fungal detection by culture, but not cytology in BALF was associated with MA.
Circulating concentrations of vitamins C, D and E vary with age but not with pneumonia status in foals during the first 5 months of life
Authors: Helbig Hannah , Berghaus Londa J. , Venner Monica , Berghaus Roy , Hart Kelsey A.
Published: January 2025

Background

Adequate vitamin availability is vital for cellular and immune function and for normal growth. Available data on age‐related changes in serum concentrations of vitamins in foals are limited. In addition, associations between circulating vitamin concentrations and the development of bronchopneumonia in foals are not described.

Objectives

(1) To quantify circulating concentrations of vitamins C, D and E from birth to weaning in foals; (2) to determine associations between vitamin concentrations and the development of bronchopneumonia during this period.

Study design

Prospective cohort study.

Methods

Blood samples were serially collected from 100 initially healthy Warmblood foals from birth to 5 months of age. Health status was evaluated weekly, and the development of subclinical and clinical bronchopneumonia was recorded. After weaning, foals were allocated to healthy, subclinical and clinical pneumonia groups, and samples from 15 foals/group were randomly selected for vitamin C, D and E quantification via ELISA and HPLC. Data were analysed with linear mixed models (p < 0.05).

Results

Circulating concentrations of vitamins C, D and E did not differ between healthy foals and foals with subclinical or clinical pneumonia. Foal age significantly impacted vitamin concentrations (p < 0.001) in a vitamin‐specific manner. Vitamins C and E concentrations increased during the first week of life and then decreased until weaning. Vitamin C concentrations were higher at pneumonia diagnosis in foals with pneumonia diagnosed at or before 8 weeks of age than in healthy foals. Vitamin D concentrations were lowest on Day 7 and then increased steadily until weaning.

Main limitations

A small number of foals was included, and results may be specific to this study population due to environmental and farm management factors.

Conclusions

Circulating concentrations of vitamins C, D and E vary with age in foals, but do not appear to be related to the development of bronchopneumonia.
Intrinsic Value, Transaction Price Movement, and Cointegration
Authors: Hardin William G. , Jiang Xiaoquan , Wu Zhongua , Zhang Qianying
Published: January 2025

The commercial real estate market provides a unique environment to evaluate the movement of transaction price to intrinsic value. Given the latent nature of intrinsic value, empirical assessment has been difficult. Long‐term use of both judgment (appraisal)‐ and transaction‐based values in real estate to provide tradable price and return benchmark allows testing of the intrinsic value to price relation. Based on NCREIF property return data from 1984 to 2019, we show that the transaction‐based index (TBI) and the appraisal‐based index (NPI) are cointegrated, and the error correction term forecasts TBI returns but not NPI returns. These results indicate that when short‐run deviation occurs, it is the TBI not the NPI that eventually converges back to the equilibrium state of the TBI–NPI system. Further tests reveal that the common trend of the TBI–NPI cointegrated system is associated with the income stream from commercial properties (a fundamental variable).
Stakeholder orientation and insider trading
Authors: Akbulut Mehmet E. , Staer Arsenio , Ucar Erdem
Published: January 2025

Using the staggered adoption of constituency statutes across US states as an exogenous shock to stakeholder orientation, we examine its impact on opportunistic insider trading. We show a strong mitigating effect of stakeholder orientation on insider trading. We find that firms incorporated in states that passed stakeholder constituency statutes have a lower likelihood of opportunistic insider purchases, particularly in environments characterized by high information asymmetry and weak monitoring. Additionally, we find that stakeholder orientation mitigates other measures of financial misconduct, like securities class action lawsuits and financial misstatements. Our results are supported by a variety of robustness and causality tests.
Determinants of limitations in activities of daily living among community‐dwelling persons aged 80 years and older: Longitudinal national evidence from the Health, Aging and Retirement in Thailand study, 2015–2022
Authors: Pengpid Supa , Peltzer Karl , Hajek André , Gyasi Razak M
Published: January 2025

Aim

Few studies have longitudinally assessed the determinants of limitations in activities of daily living (LADL) among persons aged ≥80 years. The aim of this study was to estimate the determinants of LADL among persons aged ≥80 years based on 4‐wave national longitudinal data from Thailand.

Methods

Data from the Health, Aging and Retirement in Thailand study from 2015, 2017, 2020 and 2022 were utilized. The sample was restricted to community‐dwelling persons aged ≥80 years (analytic sample: n = 3113 observations). For the pooled sample, the average age was 85.4 years (range 80–117 years). Established measurements were used to assess LADL. Linear fixed effects regression was applied to assess the time‐varying determinants and outcomes.

Results

Linear fixed effects regressions showed that increasing age, an increase in the number of chronic conditions, an increase in depressive symptoms, higher religious involvement and being underweight increased LADL, whereas increases in exercise frequency and increases in subjective life expectancy decreased LADL. In addition, in subgroup analysis among 60–79‐year‐olds, transitioning to widowhood and work status decreased LADL. Further differences between ≥80‐year‐olds and 60–79‐year‐olds include that an increase in depressive symptoms and increase in chronic conditions only increased LADL among ≥80‐year‐olds and not among 60–79‐year‐olds.

Conclusions

This longitudinal study enhances our understanding of the determinants of LADL among persons aged ≥80 years. Strategies to delay or decrease depressive symptoms and chronic conditions, proper weight management and increasing physical activity might help in reducing LADL. Geriatr Gerontol Int 2025; ••: ••–••.
Toward a Comprehensive Understanding of Nurses' Compassion Fatigue: A Meta‐Integrative Qualitative Synthesis
Authors: Zhang Huiling , Dator Wireen Leila
Published: January 2025

Aims

The study aims to conduct a thematic synthesis approach of existing qualitative research to synthesise the real experiences of nurses dealing with compassion fatigue. This integration seeks to provide a comprehensive overview, identify common themes, and offer theoretical support for developing effective intervention strategies to mitigate compassion fatigue in healthcare settings.

Design

A thematic synthesis approach was utilised, synthesising qualitative studies on nurses' experiences of compassion fatigue.

Data Sources

Data were collected from major academic databases, including PubMed, CINAHL, Scopus, and Web of Science. A total of 15 studies met the inclusion criteria.

Review Methods

This study systematically reviewed 11 qualitative research articles from China, the United States, Japan, Spain, Iran and Finland, involving 1076 nurses, to analyse and integrate the phenomenon of compassion fatigue among nurses and extract common themes.

Results

The analysis revealed that the leading causes of compassion fatigue include insufficient time and resources, psychosocial stressors, compassion overload and organisational and environmental factors. The manifestations of compassion fatigue primarily consist of work‐related difficulties and impacts on family life, emotional and physical exhaustion and a mix of positive and negative emotions. Coping strategies focus on self‐care and emotional regulation, symptom recognition and response strategies and organisational interventions and training.

Conclusion

This study's findings provide theoretical support for healthcare institutions to develop effective intervention strategies to alleviate compassion fatigue among nurses and improve the quality of care.

Impact

The study contributes to the body of knowledge by systematically synthesising qualitative evidence on compassion fatigue among nurses. The results have practical implications for nursing management and policy, emphasising the need for supportive measures to protect nurses from compassion fatigue and ensure sustainable care practices.

Patient or Public Contribution

This research does not directly involve patients or public participants but focuses on synthesising the experiences of nurses as reported in existing studies, thereby indirectly contributing to improving patient care by addressing the well‐being of healthcare providers.
First Reports of Dual‐Chamber Leadless Pacemaker Implantation via Intrajugular Access
Authors: Suresh Sruthi Prabha , Buchanan Emily Boone , Yoo Dale
Published: January 2025

Introduction

The Aveir Dual‐Chamber (DR) is the first entirely intracardiac dual‐chamber leadless pacing system. Implantation of this device is typically achieved via femoral access, which may be a significant obstacle in patients with complex femoral vasculature or contraindications to femoral access.

Methods and Results

This report describes the world's first three cases of dual‐chamber leadless pacemaker implantation via the right internal jugular vein.

Conclusions

The intrajugular approach is a feasible, safe, and efficient alternative to femoral access for any patient receiving or upgrading to an Aveir DR.
Issues Related to Patient Participation in Psychiatric Hospital Care—An Integrative Literature Review of Patient Safety Research
Authors: Antikainen Reija , Turunen Hannele , Kuosmanen Anssi , Haatainen Kaisa
Published: January 2025

Aim

Explore how previous patient safety research has described issues related to patient participation in psychiatric hospital care.

Design

Integrated literature review.

Methods

The literature review was conducted according to Cooper's framework with the following five‐step protocol: problem identification, a literature search, data evaluation, data analysis, and the presentation of results.

Data Sources

CINAHL, PubMed, PsycINFO, Scopus databases, years 2005–2023. After quality appraisal, a total of 62 articles were reviewed.

Results

Three main categories related to patient participation in psychiatric hospital care were identified: communication (having information, being heard, therapeutic relationships and interaction quality), decision‐making (treatment planning, treatment decisions, activities and working on behalf of patients) and restrictive measures (setting limits, exercising power, balancing patient autonomy and safety).

Conclusion

Psychiatric hospital care nursing staff continuously balance patients' autonomy, self‐determination, and safety, taking into account their well‐being and issues of responsibility. Wider use of positive risk‐taking is needed to increase patient participation and safety in psychiatric hospital care.

Implications for the Profession and Patient Care

Nursing staff should create favourable facilities for patient participation, foster an atmosphere of trust, respect, and encouragement, provide patients individual time to improve patient safety and recognise that they can exert power over patients due to constantly balancing patient autonomy and safety.

Reporting Method

PRISMA guidelines.

Patient or Public Contribution

No patient or public contribution.
(Re)assessment of the COSMED Quark CPET and VO2Master Pro Systems for Measuring Pulmonary Gas Exchange and Ventilation
Authors: Thiessen Johan S. , Guluzade Nasimi A. , Faricier Robin , Keir Daniel A.
Published: January 2025

We assessed the validity, reliability, and transferability of gas exchange and ventilatory variables from two commonly used metabolic measurement systems (COSMED Quark and VO2Master Pro). Two identical devices from each system were independently connected to a metabolic simulator (VacuMed), and 2 min of steady‐state data was recorded at simulated oxygen uptake (V̇O2) of 1, 2, 3, and 4 L∙min−1 achieved through minute ventilation (V̇E) of 30, 60, 105, and 150 L∙min−1. Each metabolic analyzer recorded data three times for each “intensity” in a randomized order, and assessments were completed on two separate days. Douglas bag‐based measurements were also made once at each simulated “intensity”. Measured steady‐state data (average of final 1.5 min) for both V̇O2 (STPD) and V̇E (ATPS) were compared with simulated values to assess validity, repeated values between and within days assessed reliability, and between‐device comparisons provided transferability. Including both COSMED devices at all intensities, the mean percent error for V̇O2 was 3.5% (range: −2.5%–8.1%) and, for V̇E, was 2.0% (−0.5%–7.6%). For the VO2Master, these values averaged 0.6% (−9.3%–4.8%) and 1.1% (−6.3%–4.0%) for V̇O2 and V̇E, respectively. Mean percent error for Douglas Bag was 1.5%, −3.7%, −3.1%, and −2.0% for 1, 2, 3, and 4 L∙min−1, respectively. Between‐day differences (reliability) for V̇O2 of both COSMED devices ranged from −4.1% to 2.2% (mean 0.1%) and, for both VO2Masters, between −1.6% and 11.1% (mean 1.2%). Between‐device differences (transferability) ranged from −3.5% to 0.5% (mean 1.3%) for COSMED and from −11.0% to 3.6% (mean 0.0%) for VO2Master. Mean values and ranges for V̇E were similar. When used appropriately in laboratory settings, the COSMED Quark and VO2Master Pro systems provide gas exchange and ventilatory data within an acceptable range for metabolic testing equipment that are both reliable and transferable between optimally performing devices.
Application of Syndromic Panels for respiratory Tract Infections in Lung Transplantation: A Critical Review on Current Evidence and Future Perspectives
Authors: Lombardi Andrea , Renisi Giulia , Liparoti Arianna , Bobbio Chiara , Bandera Alessandra
Published: January 2025

Background

Infections are a common complication among lung transplant recipients (LuTR), particularly in the first year post‐transplant, with respiratory tract infections (RTI) being predominant. Syndromic molecular panels have been suggested to reduce morbidity and mortality by providing a diagnosis quickly. However, integrating these panels into clinical practice remains debated.

Methods

An electronic search was conducted in PubMed, Scopus, and Embase to identify studies on applying syndromic panels for RTI diagnosis in LuTR. Three reviewers independently screened‐extracted data from relevant studies, focusing on concordance between syndromic panels and standard microbiologic tests and reporting isolates not detected by syndromic panels.

Results

Four studies met the inclusion criteria, including 308 patients. The BioFire FilmArray Pneumonia Panel was the syndromic panel most frequently employed. In three studies, the syndromic panel was employed in LuTR with suspected RTI or during routine surveillance bronchoalveolar lavage; only in one case was the syndromic panel employed during the transplant procedure on samples from the donor. Agreement between syndromic panels and standard tests ranged from 0.56 to 0.98, with result turnaround times between 2.3 and 21.2 h. Sensitivity ranged from 58% to 94%, and specificity from 78% to 100%. Pathogens outside syndromic panels targets but identified by standard tests included Candida spp., unspecified gram‐negative rods, and Aspergillus spp.

Conclusion

Syndromic panels offer a faster alternative to standard microbiologic tests. However, they miss numerous possible pathogens, highlighting the necessity for concurrent standard testing. Further research is needed to establish the most efficient integration of syndromic panels in LuTx infection diagnostic.

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Tiger recovery amid people and poverty
Authors: Jhala Yadvendradev V. , Mungi Ninad Avinash , Gopal Rajesh , Qureshi Qamar
Published: January 2025

Recovery of large yet ecologically important carnivores poses a formidable global challenge. Tiger (
Panthera tigris
) recovery in India, the world’s most populated region, offers a distinct opportunity to evaluate the socio-ecological drivers of megafauna recovery. Tiger occupancy increased by 30% (at 2929 square kilometers per year) over the past two decades, leading to the largest global population occupying ~138,200 square kilometers. Tigers persistently occupied human-free, prey-rich protected areas (35,255 square kilometers) but also colonized proximal connected habitats that were shared with ~60 million people. Tiger absence and extinction were characterized by armed conflict, poverty, and extensive land-use changes. Sparing land for tigers enabled land sharing, provided that socioeconomic prosperity and political stability prevailed. India’s tiger recovery offers cautious optimism for megafauna recovery, particularly in the Global South.
Randomizing the human genome by engineering recombination between repeat elements
Authors: Koeppel Jonas , Ferreira Raphael , Vanderstichele Thomas , Riedmayr Lisa Maria , Peets Elin Madli , Girling Gareth , Weller Juliane , Murat Pierre , Liberante Fabio Giuseppe , Ellis Tom , Church George McDonald , Parts Leopold
Published: January 2025

We lack tools to edit DNA sequences at scales necessary to study 99% of the human genome that is noncoding. To address this gap, we applied CRISPR prime editing to insert recombination handles into repetitive sequences, up to 1697 per cell line, which enables generating large-scale deletions, inversions, translocations, and circular DNA. Recombinase induction produced more than 100 stochastic megabase-sized rearrangements in each cell. We tracked these rearrangements over time to measure selection pressures, finding a preference for shorter variants that avoided essential genes. We characterized 29 clones with multiple rearrangements, finding an impact of deletions on expression of genes in the variant but not on nearby genes. This genome-scrambling strategy enables large deletions, sequence relocations, and the insertion of regulatory elements to explore genome dispensability and organization.
Energetic constraints drive the decline of a sentinel polar bear population
Authors: Archer Louise C. , Atkinson Stephen N. , Lunn Nicholas J. , Penk Stephanie R. , Molnár Péter K.
Published: January 2025

Human-driven Arctic warming and resulting sea ice loss have been associated with declines in several polar bear populations. However, quantifying how individual responses to environmental change integrate and scale to influence population dynamics in polar bears has yet to be achieved. We developed an individual-based bioenergetic model and hindcast population dynamics across 42 years of observed sea ice conditions in Western Hudson Bay, a region undergoing rapid environmental change. The model successfully captured trends in individual morphometrics, reproduction, and population abundance observed over four decades of empirical monitoring data. Our study provides evidence for the interplay between individual energetics and environmental constraints in shaping population dynamics and for the fundamental role of a single limiting mechanism—energy—underpinning the decline of an apex Arctic predator.
The Sikkim flood of October 2023: Drivers, causes and impacts of a multihazard cascade
Authors: Sattar Ashim , Cook Kristen L. , Rai Shashi Kant , Berthier Etienne , Allen Simon , Rinzin Sonam , Van Wyk de Vries Maximillian , Haeberli Wilfried , Kushwaha Pradeep , Shugar Dan H. , Emmer Adam , Haritashya Umesh K. , Frey Holger , Rao Praful , Gurudin Kori Sanjay Kumar , Rai Prabhakar , Rajak Rajeev , Hossain Faruk , Huggel Christian , Mergili Martin , Azam Mohd. Farooq , Gascoin Simon , Carrivick Jonathan L. , Bell Louie Elliot , Ranjan Rakesh Kumar , Rashid Irfan , Kulkarni Anil. V. , Petley Dave , Schwanghart Wolfgang , Watson C. Scott , Islam Nazimul , Gupta Moushumi Das , Lane Stuart N. , Bhat Shahid Younis
Published: January 2025

On 3 October 2023, a multihazard cascade in the Sikkim Himalaya, India, was triggered by 14.7 million m
3
of frozen lateral moraine collapsing into South Lhonak Lake, generating an ~20 m tsunami-like impact wave, breaching the moraine, and draining ~50 million m
3
of water. The ensuing Glacial Lake Outburst Flood (GLOF) eroded ~270 million m
3
of sediment, which overwhelmed infrastructure, including hydropower installations along the Teesta River. The physical scale and human and economic impact of this event prompts urgent reflection on the role of climate change and human activities in exacerbating such disasters. Insights into multihazard evolution are pivotal for informing policy development, enhancing Early Warning Systems (EWS), and spurring paradigm shifts in GLOF risk management strategies in the Himalaya and other mountain environments.
Laser-powered accelerators, compact and cheap, get real
Authors: Cho Adrian
Published: January 2025

Encouraging lab results bolster plans to harness a new kind of particle accelerator in x-ray sources
In India, a debate over the benefits of gas stoves
Authors: Chandrashekhar Vaishnavi
Published: January 2025

Surprise finding of few health payoffs complicates push to replace biomass fuel
The complete genome of
Mycoplasmoides cavipharyngis
strain 117C, a close relative of hemotrophic mycoplasma
Authors: Kramer Janina , Zübert Christina , Huettel Bruno , Kube Michael , Hoelzle Ludwig E.
Published: January 2025

Mycoplasmoides cavipharyngis
is one of the closest relatives of the highly host-adapted and uncultivable hemotrophic mycoplasma. The complete genome of strain 117C was constructed from long-reads derived from Pacific Biosciences single-molecule, real-time sequencing technology. The genome is organized into one circular, gapless chromosome with a length of 1,034 kb.
Abortion and unintended pregnancy in Pakistan: new evidence for 2023 and trends over the past decade
Authors: Sathar Zeba , Singh Susheela , Shah Iqbal H , Niazi Muhammad Rehan , Parveen Tahira , Mulhern Octavia , Mir Ali Mohammad
Published: January 2025

Background

Despite induced abortion being highly legally restricted in Pakistan, studies in 2002 and 2012 showed that many women rely on abortion when faced with an unintended pregnancy. Following the 2012 study, concerted efforts were made to improve contraceptive services and to strengthen postabortion care. The availability and use of misoprostol also expanded in the past decade. Our primary objective was to provide new evidence on the rates of unintended pregnancy, induced abortion and postabortion care in 2023 and to assess trends in these outcomes since 2012.

Methods

This is a cross-sectional study based on a Health Professional Survey, and a nationally representative Health Facilities Survey, conducted in 2023. A widely applied methodology is used to estimate rates of abortion and unintended pregnancy. Data sources and methods are comparable across the 2012 and 2023 studies.

Results

In 2023, an estimated six million unintended pregnancies occurred and 64% of them or 3.8 (95% CI 2.2 to 6.4) million resulted in induced abortions. This corresponds to an annual unintended pregnancy rate of 104 and an induced abortion rate of 66 (95% CI 38 to 111) per 1000 women aged 15–49. There was no significant change in the unintended pregnancy rate, but the abortion rate increased by 25% between 2012 and 2023. In 2023, 697 913 women were treated for postabortion complications, corresponding to an annual rate of 12.1 (95% CI 6.4 to 16.5) per 1000 women ages 15–49. This treatment rate declined by 16% between 2012 and 2023.

Conclusions

The unintended pregnancy rate has remained stable in the past decade. However, Pakistani women are increasingly relying on abortion to resolve unintended pregnancy. The treatment rate of postabortion complications has declined, owing largely to widespread access to misoprostol. This transformation of the abortion landscape calls for concerted efforts to increase contraceptive use and strengthen postabortion care.
Continuous individual feedback to nurses at emergency medical dispatch centres: a stepped-wedge, interrupted time series analysis
Authors: Spangler Douglas Nils , Blomberg Hans
Published: January 2025

Background

Clinical feedback is often lacking in prehospital care, and while performance data is increasingly available to clinical and operational leadership, it is seldom made available to care providers themselves. In this study, we investigate the impact of a simple intervention consisting of the provision of monthly feedback reports via email to emergency medical dispatch nurses in three Swedish regions.

Method

Individualised reports consisting of 14 measures divided into descriptive (eg, priority-setting and call times), process (eg, dispatch times and documentation completeness) and outcome (eg, over/under triage rate) categories were developed with staff and management input. Report delivery was implemented using a stepped-wedge design, and effects were evaluated using a hierarchical regression-based interrupted time series analysis.

Results

40 dispatchers were included in the study between March 2020 and October 2023, who handled a total of 246 353 incidents. Some impacts on documentation-related process measures were identified, with the odds of complete documentation increasing by 7.5% (95% CI 5.1 to 9.9) and the odds of having a documented contact reason increasing by 3.8% (1.5–5.9). These effects remained robust over the post-intervention period. Weaker impacts on outcome measures were identified which could be explained by a higher priority given to emergency medical dispatches overall.

Conclusion

Providing performance data can influence care providers to adjust their behaviour to improve process-related quality metrics under their direct control. The intervention may also have induced nurses to more often upgrade the priority of their patients. Improving outcome metrics may however require more intensive, multifaceted interventions.
Risk of long covid in patients with pre-existing chronic respiratory diseases: a systematic review and meta-analysis
Authors: Terry Paul , Heidel R Eric , Wilson Alexandria Q , Dhand Rajiv
Published: January 2025

Background

An estimated 10–30% of people with COVID-19 experience debilitating long-term symptoms or long covid. Underlying health conditions associated with chronic inflammation may increase the risk of long covid.

Methods

We conducted a systematic review and meta-analysis to examine whether long covid risk was altered by pre-existing asthma or chronic obstructive pulmonary disease (COPD) in adults. We identified studies by searching the PubMed and Embase databases from inception to 13 September 2024. We excluded studies that focused on children or defined long covid only in terms of respiratory symptoms. We used random-effects, restricted maximum likelihood models to analyse data pooled from 51 studies, which included 43 analyses of asthma and 30 analyses of COPD. The risk of bias was assessed using a ROBINS-E table.

Results

We found 41% increased odds of long covid with pre-existing asthma (95% CI 1.29 to 1.54); pre-existing COPD was associated with 32% increased odds (95% CI 1.16 to 1.51). Pre-existing asthma, but not COPD, was associated with increased odds of long covid-associated fatigue. We observed heterogeneity in the results of studies of asthma related to hospitalisation status. Potential confounding and inconsistent measurement of exposure and outcome variables were among the identified limitations.

Conclusions

Our findings support the hypothesis that pre-existing asthma and COPD increase the risk of long covid, including chronic fatigue outcomes in patients with asthma. Because COVID-19 targets the respiratory tract, these inflammatory conditions of the lower respiratory tract could provide mechanistic clues to a common pathway for the development of long-term sequelae in patients with long covid.
Low-coverage whole genome sequencing of low-grade dysplasia strongly predicts advanced neoplasia risk in ulcerative colitis
Authors: Al Bakir Ibrahim , Curtius Kit , Cresswell George D , Grant Heather E , Nasreddin Nadia , Smith Kane , Nowinski Salpie , Guo Qingli , Belnoue-Davis Hayley L , Fisher Jennifer , Clarke Theo , Kimberley Christopher , Mossner Maximilian , Dunne Philip D , Loughrey Maurice B , Speight Ally , East James E , Wright Nicholas A , Rodriguez-Justo Manuel , Jansen Marnix , Moorghen Morgan , Baker Ann-Marie , Leedham Simon J , Hart Ailsa L , Graham Trevor A
Published: January 2025

Background

The risk of developing advanced neoplasia (AN; colorectal cancer and/or high-grade dysplasia) in ulcerative colitis (UC) patients with a low-grade dysplasia (LGD) lesion is variable and difficult to predict. This is a major challenge for effective clinical management.

Objective

We aimed to provide accurate AN risk stratification in UC patients with LGD. We hypothesised that the pattern and burden of somatic genomic copy number alterations (CNAs) in LGD lesions could predict future AN risk.

Design

We performed a retrospective multicentre validated case–control study using n=270 LGD samples from n=122 patients with UC. Patients were designated progressors (n=40) if they had a diagnosis of AN in the ~5 years following LGD diagnosis or non-progressors (n=82) if they remained AN-free during follow-up. DNA was extracted from the baseline LGD lesion, low-coverage whole genome sequencing performed and data processed to detect CNAs. Survival analysis was used to evaluate CNAs as predictors of future AN risk.

Results

CNA burden was significantly higher in progressors than non-progressors (p=2×10−6in discovery cohort) and was a very significant predictor of AN risk in univariate analysis (OR=36; p=9×10−7), outperforming existing clinical risk factors such as lesion size, shape and focality. Optimal risk prediction was achieved with a multivariate model combining CNA burden with the known clinical risk factor of incomplete LGD resection. Within-LGD lesion genetic heterogeneity did not confound risk prediction.

Conclusion

Measurement of CNAs in LGD is an accurate predictor of AN risk in inflammatory bowel disease and is likely to support clinical management.
Complex high-risk indicated PCI (CHIP-PCI): is it safe to let fellows-in-training perform it as primary operators?
Authors: Protty Majd B , Hasan Saad , Premawardhana Diluka , Addin Mohammed Shugaa , Morgan Holly , Bundhoo Shantu , Hussain Hussain , Ul-Haq Zia , Chase Alexander , Hildick-Smith David , Choudhury Anirban , Kinnaird Tim , Hailan Ahmed
Published: January 2025

Background

Training in complex high-risk indicated percutaneous coronary intervention (CHIP-PCI) has frequently been reserved for established operators (consultants/attending) with trainees (fellows-in-training or FIT) being often discouraged from carrying out such procedures as a primary operator due to their high-risk nature. Whether the outcomes of these cases differ if the primary operator is a supervised FIT compared with a consultant is unknown.

Methods

Using multicentre PCI data from three cardiac centres in South Wales, UK (2018–2022), we identified 2295 CHIP-PCI cases with a UK-BCIS CHIP Score of 3 or more. These were then divided by primary operator status (supervised FIT vs consultant); the primary outcome was in-hospital major adverse cardiac events (IH-MACCE). Multivariate logistic models were developed to adjust for differences in baseline and procedural characteristics.

Results

The primary operator in 838 (36%) of the PCIs was a supervised FIT. Baseline and procedural characteristics had lower complexity in CHIP-PCI cases carried out by supervised FIT vs consultant. In a multivariate-adjusted model, supervised FIT procedures were associated with lower odds of concurrent valve disease (OR 0.45, 95% CI: 0.29 to 0.69), dual access (OR 0.58, 95% CI: 0.41 to 0.83), cutting/scoring balloons (OR 0.59, 95% CI: 0.44 to 0.79) and rotational atherectomy (OR 0.60, 95% CI: 0.42 to 0.87). After adjusting for all variables, however, there was no difference in the primary outcome (OR 0.72, 95% 0.34 to 1.51) or any secondary outcomes. Sensitivity analyses restricted to patients with higher CHIP Scores (4+ and 5+) showed comparable IH-MACCE.

Conclusions

Training FIT as primary operators in CHIP-PCI appears to be feasible and safe and can be delivered within the standard training programme. The comparable outcomes are likely driven by the two-operator ‘buddy’ effect that a FIT supervised by a consultant benefits from.