bluuebunny/crossref_metadata_2025 huggingface dataset:
Comprehensive investigation of ergonomic challenges and predictors of work-related musculoskeletal disorders among intensive care unit nurses of Western India through convergent mixed methods study
Authors: Detroja Sonali , Mahajan Rajkumar , Sheth Ankit
Published: February 2025

Background

Work-related musculoskeletal disorders (WRMSDs) are significant concern in intensive care units (ICUs) due to distinct work environment. This study aims to comprehensively investigate determinants of WRMSDs and ergonomic challenges, specific to ICU nurses, providing valuable insights for targeted interventions.

Methods

In this six-month convergent mixed methods study, 200 consenting nurses with over one year of experience from seven ICUs across three public tertiary hospitals of Ahmedabad participated. Structured questionnaires were used to collect data on socio-demographics, occupation, physical and workplace factors, risk perception, and musculoskeletal pain (through modified Nordic Musculoskeletal Questionnaire) and ergonomic issues using REBA (Rapid Entire Body Assessment) scale. Qualitative insights were obtained through in-depth interviews until saturation of responses. Statistical analysis involved chi-square, t-test and logistic regression, with a significance level set at p < 0.05. Thematic analysis was used to interpret the findings of qualitative study.

Results

The study included predominantly female ICU nurses (78%) with a mean age of 34 years. A high prevalence of WRMSDs (84%) was observed, with the lower back and neck being the most affected regions. Nurses with WRMSDs reported significantly higher mean scores for physical factors (15.1 vs. 11.1, p = 0.00), physical workload (12.8 vs. 10.7, p = 0.001), work environment (13.1 vs. 10.1, p = 0.00), and risk perception (11.8 vs. 8.9, p = 0.00) compared to those without WRMSDs. Logistic regression identified key risk factors for WRMSDs, including longer ICU tenure [OR = 1.4 (1.13–1.66)], high shift frequency [OR = 2.7 (1.27–5.95)], higher physical factor score [OR = 1.2 (1.05–1.42)], higher physical workload score [OR = 1.2 (1.09–1.49)], higher risk perception [OR = 1.3 (1.10–1.78)], and lack of exercise [OR = 0.5 (0.27–0.93)]. The qualitative findings highlighted key ergonomic challenges, including inadequate equipment, heavy patient loads, poor posture during tasks, and insufficient breaks, contributing to WRMSDs among ICU nurses.

Conclusion

The findings underscore urgent need for targeted interventions to address risk factors associated with WRMSDs, including ergonomic training, workplace modifications, and education programs to enhance risk awareness and preventive behaviours. Future research should focus on developing and evaluating comprehensive interventions that integrate both physical and work environment factors to effectively mitigate WRMSDs among ICU nurses.
Design and assessment of lipase-CuO nanoparticle conjugates for enhanced antimicrobial efficacy against clinical pathogens
Authors: Handak Eman M. , Amin Dina H. , Elhateir Mai M.
Published: February 2025

In the battle against clinical infections particularly the resistant pathogens, the creation of new antimicrobial drugs is essential. This study focuses on synthesis and characterization of Lipase-CuO nanoparticle conjugates in order to investigate their antibacterial efficiency. Lipase enzyme and CuO nanoparticles were synthesized biologically by specific selected fungal strains. Statistical optimization of lipase enzyme was done using a Plackett-Burman design giving two enhancement models for lipase production with increasing in productivity up to 143.43% (2800 U/ml). Copper oxide (CuO) nanoparticles were characterized using visual indication of greenish color formation, UV-vis spectrum analysis which revealed a strong peak at 300 nm. Also, CuO nanoparticles appeared as distinct, well-dispersed spherical particles with average size of 71.035 nm using TEM, while conjugate appears as large protein molecules linked to the nanoparticles. Also, using techniques like energy dispersive X-ray (EDAX) the resultant conjugates formation was confirmed as the elemental analysis approved its formation. The antimicrobial activity of Lipase-CuO nanoparticles conjugates was tested against a range of clinical pathogens. The results demonstrated a significant increase in antimicrobial potency compared to both CuO nanoparticles and lipase alone particularly against E. coli strain NRC B-3703 with remarkable increase of 373.6% and 75% followed by S. aureus with increase of 50 and 42.8%compared to that of individual CuO nanoparticles and lipase enzyme, respectively. These findings suggest that Lipase-CuO nanoparticle conjugates hold great promise as a novel antimicrobial strategy, offering a potential solution to combat bacterial infections, especially those caused by multidrug-resistant strains. The study highlights the importance of nanotechnology in enhancing the efficacy of traditional antimicrobial agents and opens new avenues for targeted antimicrobial therapies.
Defining competence profiles in obstetrics and gynecology using the modified requirement tracking questionnaire
Authors: Tarasi Baptiste , Oubaid Viktor , Baud David
Published: February 2025

Background

Data about the competencies needed for physicians in obstetrics and gynecology (O&G) is currently insufficient. The aim of this study is to define the competence profile needed in this sector for daily professional activity, in order to account for these criteria in future recruitment.

Methods

The modified requirement-tracking questionnaire (R-track) was sent to 307 physicians working in the field of O&G with different training levels and practice locations. The R-track is designed to assess professional competence profiles and contains 66 items covering the following eight competence areas: “Mental abilities”, “Social sensibility”, “Psychomotor and multitasking abilities”, “Solutions orientation”, “Social interactive competences”, “Personality traits”, “Verbal competences” and “Resistance capacity”. The mean scores of single items and competence areas were calculated. Results were compared between gender, training level, and place of practice.

Results

The participation rate was 65.5%, with 201 physicians returning the questionnaire. In this sample, 50.2% of them were in training and 49.8% were practicing O&G specialists. The proportion of physicians working in a hospital setting was 64.7% while 30.3% worked in private practice. The competence areas “Social sensibility” and “Psychomotor & multitasking abilities” appear to be the most important for daily professional activity. At the item level, “Stress resistance”, followed by “Workload management” and “Tactfulness” were considered as the most valuable characteristics. Differences between gender, level of training, and place of practice were not significant.

Conclusion

The identified competence profile could serve as a basis for developing a new method of O&G residency selection. In addition, such a profile could help medical students to decide on a professional specialization at a very early stage by comparing their personal competence profile with the one in the field or with their mentors.
The association between TyG index and cardiovascular mortality is modified by antidiabetic or lipid-lowering agent: a prospective cohort study
Authors: Fang Changchang , Peng Nanqin , Cheng Jiang , Zhang Xiyu , Gu Wenli , Zhu Zicheng , Yin Xiaoping , Yan Zhiwei , Zhang Jing , Yu Peng , Liu Xiao
Published: February 2025

Background

The triglyceride-glucose (TyG) index is recognized as an alternative measure of insulin resistance (IR) and has been linked to the risks of cardiovascular disease (CVD) and mortality. This study aimed to evaluate whether the association between the TyG index and CVD mortality is influenced by the use of antidiabetic and hypolipidemic agents, given their potential modifying effects on the TyG index.

Methods

Participants from the National Health and Nutrition Examination Survey (1999–2018) were included in the study. Mortality outcomes were tracked through linkage with National Death Index records until December 31, 2019. Data on the use of antidiabetic and hypolipidemic medications (including prescribed insulin, diabetic pills, and cholesterol-lowering agents) were self-reported by participants.

Results

A total of 5,046 adults (representing 42,753,806 individuals, weighted mean age 61.08 years [SE: 0.24]; 49.35% female) were analyzed. The TyG index was significantly associated with all-cause and CVD mortality, and these associations were modified by the use of antidiabetic and hypolipidemic agents (p < 0.01). Significant interactions were observed between the TyG index and the use of these agents for mortality outcomes after full adjustments (p-value for interaction < 0.05). Exposure-effect analysis revealed a U-shaped relationship between TyG index levels and the risks of all-cause and CVD mortality in participants using these agents, while a linear positive relationship was observed in participants not using these agents.

Conclusions

The use of antidiabetic and hypolipidemic agents modify the association between the TyG index and all-cause and CVD mortality. These findings suggest that future studies on the TyG index and its relationship with CVD and mortality should account for the modifying effects of these agents.

Graphical abstract
Barriers to health equity in the United States of America: can they be overcome?
Authors: Chen Allen M.
Published: February 2025

Health equity—defined by the Centers for Disease Control and Prevention as " the state in which everyone has a fair and just opportunity to attain their highest level of health—” represents one of the most critical issues facing modern societies. While seemingly an increasing focus of policymakers in recent years, this concept is hardly a novel one. In 1948, the inaugural Constitution of the newly founded World Health Organization clearly stated that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” Yet nearly a century later, it is arguable how much progress society has made in achieving health equity, particularly in the United States of America where numerous factors at both the level of the individual and population contribute to significant complexity with respect to healthcare access and delivery. The purpose of this review is to thus outline the barriers to health equity so that thoughtful discourse can be promoted to create a more even playing field for the lives of the disadvantaged and underserved in the future.
Clinically meaningful improvements after gene therapy for aromatic L-amino acid decarboxylase deficiency (AADCd) in the Peabody Developmental Motor Scale, Second Edition (PDMS-2) and correlation with Bayley-III scores and motor milestones
Authors: Hwu Wuh-Liang , Lee Hui-Min , Peipert John Devin , Zhang Rongrong , Werner Christian , Sierra J. Rafael , O’Connell Thomas , Woolley Jonathan J. , Crowell Marjorie , Wang Antonia , Tomazos Ioannis
Published: February 2025

Background

Aromatic L-amino acid decarboxylase deficiency (AADCd) is a rare genetic disorder characterized by movement disorders, motor and autonomic dysfunction, and developmental delays. The gene therapy eladocagene exuparvovec has become available in some regions; pooled clinical trial results demonstrate continuous long-term improvement in motor development and cognitive function. We sought to characterize clinically meaningful change in motor function, as measured by Total Peabody Developmental Motor Scales-Second Edition (PDMS-2) score, and assess correlations with cognition and language domains of the Bayley-III and motor milestone (MM) achievement.

Methods

Data from N = 30 patients from three single-arm clinical studies of eladocagene exuparvovec were analyzed. Anchor-based estimation of the meaningful score difference (MSD) of Total PDMS-2 score was conducted using mean-difference and receiver operating characteristic curve (ROC) approaches. MM achievement served as the anchor defining meaningful change.

Results

An MSD of 40 points for Total PDMS-2 score was selected for analysis as it yielded specificity > 0.95 using the ROC approach, and generally aligned with the mean-difference approach. Cumulative incidence analysis reflected that 50% of patients treated with eladocagene exuparvovec may achieve the MSD of 40-point change in Total PDMS-2 score at 6 months, and 86% at 18 months. Correlations between measures were of large magnitude and improved over time (Month 6: r = 0.599 [p = 0.0032]; Month 18: r = 0.796 [p = 0.0002]; Month 60: r = 0.861 [p = 0.0007]).

Conclusions

The MSD of 40 points for Total PDMS-2 score enables the interpretation of changes observed in patients with AADCd, and suggests that treatment with eladocagene exuparvovec leads to significant improvements in motor and cognitive function.
Disparate and shared transcriptomic signatures associated with cortical atrophy in genetic behavioral variant frontotemporal degeneration
Authors: Shen Ting , Vogel Jacob W. , Van Deerlin Vivianna M. , Suh EunRan , Dratch Laynie , Phillips Jeffrey S. , Massimo Lauren , Lee Edward B. , Irwin David J. , McMillan Corey T.
Published: February 2025

Background

Cortical atrophy is a common manifestation in behavioral variant frontotemporal degeneration (bvFTD), exhibiting spatial heterogeneity across various genetic subgroups, which may be driven by distinct biological mechanisms.

Methods

We employed an integrative imaging transcriptomics approach to identify both disparate and shared transcriptomic signatures associated with cortical thickness in bvFTD with C9orf72 repeat expansions or pathogenic variants in GRN or MAPT. Functional enrichment analyses were conducted on each gene list significantly associated with cortical thickness. Additionally, we mapped neurotransmitter receptor/transporter density maps to the cortical thickness maps, to uncover different correlation patterns for each genetic form. Furthermore, we examined whether the identified genes were enriched for pathology-related genes by using previously identified genes linked to TDP-43 positive neurons and genes associated with tau pathology.

Results

For each genetic form of bvFTD, we identified cortical thickness signatures and gene sets associated with them. The cortical thickness associated genes for GRN-bvFTD were significantly involved in neurotransmitter system and circadian entrainment. The different patterns of spatial correlations between synaptic density and cortical thinning, further confirmed the critical role of neurotransmission and synaptic signaling in shaping brain structure, especially in the GRN-bvFTD group. Furthermore, we observed significant overlap between genes linked to TDP-43 pathology and the gene sets associated with cortical thickness in C9orf72-bvFTD and GRN-bvFTD but not the MAPT-bvFTD group providing specificity for our associations. C9orf72-bvFTD and GRN-bvFTD also shared genes displaying consistent directionality, with those exhibiting either positive or negative correlations with cortical thickness in C9orf72-bvFTD showing the same direction (positive or negative) in GRN-bvFTD. MAPT-bvFTD displayed more pronounced differences in transcriptomic signatures compared to the other two genetic forms. The genes that exhibited significantly positive or negative correlations with cortical thickness in MAPT-bvFTD showed opposing directionality in C9orf72-bvFTD and GRN-bvFTD.

Conclusions

Overall, this integrative transcriptomic approach identified several new shared and disparate genes associated with regional vulnerability with increased biological interpretation including overlap with synaptic density maps and pathologically-specific gene expression. These findings illuminated the intricate molecular underpinnings contributing to the heterogeneous nature of disease distribution in bvFTD with distinct genetic backgrounds.
Pharmacological activity of OST-01, a natural product from baccharis coridifolia, on breast cancer cells
Authors: Kang HyunJun , Hoang Dinh Hoa , Valerio Melissa , Pathak Khyatiben , Graff William , LeVee Alexis , Wu Jun , LaBarge Mark A. , Frankhouser David , Rockne Russell C. , Pirrotte Patrick , Zhang Bin , Mortimer Joanne , Nguyen Le Xuan Truong , Marcucci Guido
Published: February 2025

Natural products have long been a viable source of therapeutic agents, providing unique structures and mechanisms that may be beneficial for cancer treatment. Herein we first report on the anticancer activity OST-01, a natural product from Baccharis Coridifolia, on breast cancer cells, including triple-negative breast cancer (TNBC). OST-01 significantly inhibited cell proliferation and oncogenic activities of TNBC cells in vitro. OST-01 also markedly inhibited TNBC tumor growth in vivo, with > 50% reduction in tumor size compared to vehicle control treatment in different in vivo models, i.e., cell line-derived (CDX), patient-derived (PDX), and mammary fat pad xenografts. Mechanistically, OST-01 induces ferroptosis by downregulating LRP8-regulated selenoproteins, i.e., GPX4. A shift from a basal-mesenchymal to a luminal-epithelial state of breast cancer stem cells (BCSCs) as supported by the downregulation of stemness (e.g., CD44) and mesenchymal (e.g., FN1 and vimentin) markers, along with the upregulation of differentiation markers (e.g., CD24) and luminal-epithelial markers (e.g., CK19), was also observed.
Metabolic consequences and nailfold capillary changes in children with familial Mediterranean fever
Authors: Abo Hola Ahmed S. , El Zayat Rania S. , Shehata Wafaa Ahmed , Elashmawy Mai I. , Khalaf Noha E. , El Zefzaf Heba M. S.
Published: February 2025

Background

There’s an increasing role of nailfold capillaroscopy in the evaluation of peripheral vascular disease in chronic inflammatory disorders. Familial Mediterranean fever (FMF) is one such disorder, which raises concerns about increased cardiovascular risk, with scarce data available in children. Therefore, we aimed to evaluate insulin resistance, lipid profile, atherogenic indices, and nailfold capillary (NC) changes in children with FMF.

Methods

Fifty-four children diagnosed with FMF were evaluated by measuring complete blood count, ESR, CRP, serum amyloid A (SAA), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), lipid profile, and atherogenic indices, along with a nailfold capillaroscopic examination, both during acute attacks and attack-free periods.

Results

During attack-free periods, patients exhibited higher total leucocytic counts, ESR, CRP, SAA, HOMA-IR, total cholesterol (TC), non-high-density lipoprotein cholesterol (non-HDL-C), Castelli’s risk index I (CRI I), and atherogenic coefficient (AC), and a lower hemoglobin level than controls. Additionally, the NC examination identified avascular areas in 14.8% of patients, tortuosities in 18.5%, enlargements in 14.8%, and microhemorrhages in 7.4%. These parameters showed significant increases during acute attacks. HOMA-IR showed positive correlations with TC, non-HDL-C, CRI I, and AC; however, NC changes were strongly connected with disease duration and SAA.

Conclusions

Insulin resistance, alterations in serum lipids and atherogenic indices, and NC changes significantly endure in children with FMF during attack-free periods compared to controls, with more prominence during acute attacks. These parameters are linked to subclinical vascular injury and elevated cardiovascular risk, so their monitoring is crucial in these patients for early detection and intervention.
How long does it take to start minimal enteral feeding in preterm Neonates admitted to NICUs in Southern Oromia, Ethiopia?
Authors: Fikrie Anteneh , Yambo Terefu , Edin Alo , Gelchu Miesa , Hailu Dejene , Spigt Mark
Published: February 2025

Background

The timely initiation of trophic feeding (TF) is crucial for premature newborns, but challenging due to immaturity, respiratory instability, abdominal distension, resource scarcity, and healthcare worker expertise. Moreover, there is a dearth of information on predictors of full trophic feeding time. Therefore, this retrospective cohort study aimed to investigate the time it takes and its predictors to initiate minimal enteral feeding in preterm neonates in Southern Oromia, Ethiopia.

Method

A facility-based retrospective follow up study was conducted among 434 randomly selected preterm neonates admitted to NICU of Bule Hora University Teaching Hospital and Yabello General Hospital from January 1, 2021 to December 30, 2022. Data were extracted by a pretested structured checklist, entered into Epidata 3.1 and then transferred to Stata version 17 for analysis. Kaplan Meier survival curve and log rank test were used to estimate survival time and a statistical comparison respectively. Bivariable and multivariable cox proportional hazard model was fitted to identify predictors of time to initiate TF and their outputs are presented using Adjusted Hazard Ratio (AHR) with 95% Confidence Intervals (CIs).

Result

The overall incidence density of TF initiation was reported as 43.6 per 100 neonate-days. Moreover, the median (IQR) time to initiate TF was found to be 2 (1–4) days. Neonates delivered vaginally had a higher likelihood of early TF initiation (AHR: 1.64, CI: 1.26, 2.13), while those born between 32 and 34 weeks (AHR: 0.61, CI: 0.46, 0.81), VLBW neonates (AHR: 0.45, CI: 0.34, 0.60), neonates without KMC (AHR: 0.59, CI: 0.46, 0.79), and those in level II hospitals were less likely to start TF promptly (AHR: 0.78, CI: 0.62, 0.99). Furthermore, neonates with sepsis (AHR: 1.76, CI: 1.36, 2.28) and hypothermia (AHR: 1.51, CI: 1.19, 1.93) had delayed TF initiation.

Conclusion

We observed a significant low rate of early TF initiation and higher death rate of preterm newborn in our study as compared to the global. Preterm neonates with lower GA, no KMC, and a VLBW are more likely to have a delayed initiation. Our results highlight that staff training on identifying neonates suitable for TF, and ensuring adequate resources for KMC in all NICU levels should be considered.
Impact of Paracoccus sp. EGY7 carotenoids on triple-negative breast cancer cells: invitro study
Authors: Abdelazim Karim , Hussein Ahmed , Khattab Sherine N. , El Feky Shaymaa Essam , Noby Nehad
Published: February 2025

This study investigates the effect of Paracoccus sp. EGY7 carotenoids on the triple-negative breast cancer cell line (MDA-MB-231). The bacterial strain was isolated, and its carotenoids profile was analyzed via HPLC-DAD-MS. Cytotoxicity, migration tests and the expression of BAX and BCL-2 at the gene and protein levels were carried out to evaluate the therapeutic efficiency of the produced carotenoids. Molecular docking analysis estimated the binding affinity between zeaxanthin and BCL-2 protein. Chromatographic analysis revealed zeaxanthin as the major carotenoid (48.3%). The extract exhibited significant cytotoxicity against MDA-MB-231 cells with an IC50 of 1200 µg. It notably reduced cell migration, with wound closure percentages of 37.50% and 79.17% for the 600 µg group, while the percentages were 12.50% and 53.50% for the 1200 µg group, compared to 71.67% and 95.67% for the control at 24 and 48 h post-treatment, respectively. The extract induced apoptosis, as evidenced by significantly increased BAX/BCL-2 gene expression ratios at 600 and 1200 µg (p < 0.05). Western blotting showed increased BAX protein expression at 600 and 1200 µg compared to the control group (p < 0.001), and significantly lower BCL-2 protein expression (p = 0.000005 for 1200 µg and p = 0.0001 for 600 µg). Docking analysis indicated a strong affinity of zeaxanthin to BCL-2 (ΔG = -9.773241 kcal/mol) compared to obatoclax (ΔG = -7.419345 kcal/mol). Paracoccus sp. EGY7 carotenoids are a promising anticancer agent against MDA-MB-231 cells. They effectively promote apoptosis and prevent metastasis, crucial for disease advancement in cancer cells.
Investigating the implementation of infection prevention and control practices in neonatal care across country income levels: a systematic review
Authors: Nyantakyi Emanuela , Baenziger Julia , Caci Laura , Blum Kathrin , Wolfensberger Aline , Dramowski Angela , Albers Bianca , Castro Marta , Schultes Marie-Therese , Clack Lauren
Published: February 2025

Background

Despite the proven effectiveness of infection prevention and control (IPC) practices in reducing healthcare-associated infections and related costs, their implementation poses a challenge in neonatal care settings across high-income (HICs) and low- and middle-income countries (LMICs). While existing research has predominantly focused on assessing the clinical effectiveness of these practices in neonatal care, aspects concerning their implementation remain underexplored. This systematic review therefore aimed to analyze implementation determinants and employed strategies for implementing IPC practices in inpatient neonatal care across country income levels.

Methods

Following a targeted search in seven databases, titles and abstracts as well as full texts were screened in a dual review process to identify studies focusing on the implementation of IPC practices in inpatient neonatal care and reporting on implementation determinants and/or implementation strategies. Implementation determinants were synthesized using the updated Consolidated Framework for Implementation Research. Implementation strategies were coded according to the Expert Recommendations for Implementing Change taxonomy. A convergent integrated approach was used to narratively summarize results across qualitative and quantitative studies. χ

2
Tests and Fisher’s Exact Tests were performed to analyze differences in implementation determinants and strategies across IPC practices and country income levels. The quality of included studies was assessed using the Mixed Methods Appraisal Tool.

Results

Out of 6,426 records, a total of 156 studies were included in the systematic review. Neonatal units in LMICs and HICs showed general commonalities in reported implementation determinants, which were mainly reported at the organizational level. While educational as well as evaluative and iterative strategies were most frequently employed to support the implementation of IPC practices in both LMICs and HICs, other strategies employed showed variance across country income levels. Notably, the statistical analyses identified a significant association between country income levels and implementation determinants and strategies respectively (
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<0.05).

Conclusion

The results of this systematic review underscore the importance of the organizational level for the implementation of IPC practices in neonatal care irrespective of country income level. However, further research is needed to understand the underlying relationships of factors and dynamics contributing to the observed practice variances in LMICs and HICs.

Registration

PROSPERO (CRD42022380379).
The mechanical test as a supplemental decision support tool for the safe removal of an Ilizarov circular external fixator
Authors: Xu Yulin , Liu Jialin , Yang Jinghong , Zhang Tao , Li Zhong , Liu Yanshi
Published: February 2025

Background

Timing the fixator removal is vital for a successful external fixation treatment. The purpose of this study was to determine the effectiveness of axial load–share ratio in vivo as a supplemental decision support tool for the safe removal of an Ilizarov circular external fixator.

Methods

This prospective observational study consists of 83 patients undergoing tibial or femoral lengthening with Ilizarov circular external fixation in our institution, from January 2011 to October 2019. In group I (38 patients), the external fixator was removed based on the surgeon’s clinical experience and radiographs from January 2011 to June 2015. In group II (45 patients), from July 2015 to October 2019, the supplemental axial load–share (LS) ratio test was accomplished without the knowledge of the clinical results by another medical team. The test was performed by electronically measuring forces in the fixator rods and in a ground force plate. When the LS ratio < 10% was consistent with the conclusion (dense bone formation was achieved in the distraction zone) drawn from the corresponding routine radiographs by the treating surgeon, the external fixator was removed.

Results

There was no statistical significance in demographic data between the two groups (P > 0.05). In group I, 4 of the 38 patients suffered refracture (the refracture rate was 10.5%) after fixator removal, and bone union was finally achieved with further intervention by intramedullary nail. In group II, 36 patients terminated the external fixation after the first mechanical test, and another 9 patients terminated the external fixation at the subsequent test. None of the 45 patients in group II suffered refracture (the refracture rate was 0%). There was statistical significance in the refracture rate between the two groups (P < 0.05).

Conclusions

Adequate assessment of bone regenerate is crucial before removing an external fixator to prevent deformation or refracture. The axial load–share ratio in vivo is a practically quantitative method to supplement radiography and clinical experience for the assessment of regenerate healing, and the axial load–share ratio dropped below 10% is a safe limit for the Ilizarov circular external fixator removal.
Antibiotic-associated changes in Akkermansia muciniphila alter its effects on host metabolic health
Authors: Han Yumin , Teng Teh Min , Han Juwon , Kim Heenam Stanley
Published: February 2025

Background

Altered gut microbiota has emerged as a major contributing factor to the etiology of chronic conditions in humans. Antibiotic exposure, historically dating back to the mass production of penicillin in the early 1940s, has been proposed as a primary contributor to the cumulative alteration of microbiota over generations. However, the mechanistic link between the antibiotics-altered microbiota and chronic conditions remains unclear.

Results

In this study, we discovered that variants of the key beneficial gut microbe, Akkermansia muciniphila, were selected upon exposure to penicillin. These variants had mutations in the promoter of a TEM-type β-lactamase gene or pur genes encoding the de novo purine biosynthesis pathway, and they exhibited compromised abilities to mitigate host obesity in a murine model. Notably, variants of A. muciniphila are prevalent in the human microbiome worldwide.

Conclusions

These findings highlight a previously unknown mechanism through which antibiotics influence host health by affecting the beneficial capacities of the key gut microbes. Furthermore, the global prevalence of A. muciniphila variants raises the possibility that these variants contribute to global epidemics of chronic conditions, warranting further investigations in human populations.
Bacterial community assembly of specific pathogen-free neonatal mice
Authors: Kennedy Elizabeth A. , Weagley James S. , Kim Andrew H. , Antia Avan , DeVeaux Anna L. , Baldridge Megan T.
Published: February 2025

Background

Neonatal mice are frequently used to model diseases that affect human infants. Microbial community composition has been shown to impact disease progression in these models. Despite this, the maturation of the early-life murine microbiome has not been well-characterized. We address this gap by characterizing the assembly of the bacterial microbiota of C57BL/6 and BALB/c litters from birth to adulthood across multiple independent litters.

Results

The fecal microbiome of young pups is dominated by only a few pioneering bacterial taxa. These taxa are present at low levels in the microbiota of multiple maternal body sites, precluding a clear identification of maternal source. The pup microbiota begins diversifying after 14 days, coinciding with the beginning of coprophagy and the consumption of solid foods. Pup stool bacterial community composition and diversity are not significantly different from dams from day 21 onwards. Short-read shotgun sequencing-based metagenomic profiling of young pups enabled the assembly of metagenome-assembled genomes for strain-level analysis of these pioneer Ligilactobacillus, Streptococcus, and Proteus species.

Conclusions

Assembly of the murine microbiome occurs over the first weeks of postnatal life and is largely complete by day 21. This detailed view of bacterial community development across multiple commonly employed mouse strains informs experimental design, allowing researchers to better target interventions before, during, or after the maturation of the bacterial microbiota. The source of pioneer bacterial strains appears heterogeneous, as the most abundant taxa identified in young pup stool were found at low levels across multiple maternal body sites, suggesting diverse routes for seeding of the murine microbiome.
Fabrication of Au-doped mesoporous TiO2 supported on g-C3N4 as an efficient light-assisted catalyst for oxidative desulfurization of model fuels with different sulfur content
Authors: Moeinifard Behzad , Najafi Chermahini Alireza
Published: February 2025

In the present study, the mesoporous TiO2 that was supported on graphitic carbon nitride (g-C3N4) was decorated with Au. The nanocomposite (Au-m-TiO2/g-C3N4) has been successfully synthesized by combining sono-chemical and EISA methods and was subsequently used in photocatalytic oxidative desulfurization of dibenzothiophene (DBT) in n-octane as a model fuel and under visible illumination. The Au-m-TiO2/g-C3N4 photocatalyst was characterized by X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), UV–Vis diffusive reflectance spectra (UV–Vis DRS), high-resolution transmission electron microscopy (HR-TEM), Fourier transform infrared spectra (FT-IR), and nitrogen adsorption measurements. The removal efficiency of DBT was 98.7% under the optimized reaction conditions and under visible-light irradiation (λ > 400 nm).
Nutritional knowledge and practices of low-income women during pregnancy: a qualitative study in two Oaxacan cities
Authors: Marian Marian , Pérez Ramona L. , McClain Amanda C. , Hurst Samantha , Reed Elizabeth , Barker Kathryn M. , Lundgren Rebecka
Published: February 2025

Background

Adequate dietary intake is critical for healthy pregnancies. Recent changes in social services in Mexico, coupled with high levels of food insecurity, call into question whether expecting women of the lowest socioeconomic status are able to meet their dietary and nutritional needs in this changing context. The aim of this study was to explore the nutritional practices, education and received and employed among women during their pregnancy.

Methods

Guided by Ecological Systems Theory and an Intersectionality Framework, this qualitative study was carried out in Oaxaca City and Puerto Escondido, in Oaxaca, a Mexican state with high levels of food insecurity. Women who had at least one child in the past five years and had lived in Oaxaca for the past five years were eligible to participate. Twenty-five women participated in semi-structured in-depth interviews conducted between June and December of 2023. A grounded theory approach was used for coding. NVivo was used for coding and analyses.

Results

Five key themes emerged linked to individual-level characteristics and the multiple social identities related to the social support for nutritional knowledge and practices among low-income Oaxacan women during pregnancy: (1) Life experiences, sociodemographic, and health characteristics that influence nutritional practices and knowledge during pregnancy; (2) Female family members as a primary source of nutritional knowledge and food support; (3) Support from other members of women’s social networks; (4) Medical guidance for nutrition during pregnancy; and (5) Quality and gaps in the broader health care system and social services. These themes highlight how women’s own experiences and social identities and the different interpersonal and community-level environments, particularly those of mothers and grandmothers and health care providers, interact and shape women’s nutritional knowledge and practices, such as foods and nutritional supplements consumed, during pregnancy.

Conclusion

Nutritional knowledge and practices during pregnancy are impacted by multiple social identities women have and different factors at the individual, group, and structural level. Future multi-level approaches in research and programming that take into consideration the individual, family members, and other social influences are needed to address the gaps in nutrition that women in Oaxaca go through during the prenatal period.
Proximity induced superconductivity and Andreev reflection on the surface of nodal Weyl semimetals
Authors: Hu Xiang
Published: February 2025

In nodel Dirac semimetals the bulk conduction and valence bands touch along a line, typically a ring. One of the key properties of nodal Dirac semimetals is to have drumhead surface states, i.e. surface states with a very large effective mass. In the presence of certain types of spin-rotation symmetry breaking perturbations the Dirac ring split into two Weyl rings. In this work, we study the superconducting pairing induced via the proximity effect to the surface of nodal Weyl semimetals. We find how the the tunneling to the surface affects the symmetry of the proximity-induced superconducting pairing. We then calculate the Andreev reflection and show that it can be used to probe the drumhead states.
Prevalence and Determinants of Diabetes Mellitus in 2338 Long-Term Dutch Childhood Cancer Survivors (DCCS-LATER2 Study)
Authors: Bolier Melissa , de Winter Demi T C , Fiocco Marta , van den Berg Sjoerd A A , Bresters Dorine , van Dulmen-den Broeder Eline , van der Heiden-van der Loo Margriet , Hoefer Imo , Janssens Geert O , Kremer Leontien C M , Loonen Jacqueline J , Louwerens Marloes , van der Pal Heleen J , Pluijm Saskia M F , Tissing Wim J E , van Santen Hanneke M , de Vries Andrica C H , van der Lely Aart-Jan , van den Heuvel-Eibrink Marry M , Neggers Sebastian J C M M
Published: February 2025

Context

Diabetes mellitus (DM), a possible adverse effect of childhood cancer treatment, is strongly associated with cardiovascular disease and early mortality in adult childhood cancer survivors (CCS).

Objective

Here, we assess the prevalence and determinants of DM in our nationwide CCS cohort.

Methods

In this cross-sectional study, the prevalence of DM was assessed in 2338 CCS, using the Lifelines cohort (n = 132 226 adults with no history of cancer) as a reference. DM was defined through serum glucose measurement (fasting glucose ≥7.0 mmol/L or nonfasting ≥11.1 mmol/L) and/or self-report (previous diagnosis and/or medication use). Multivariable logistic regression models, adjusted for age, sex, and body mass index (BMI), were used to assess the cohort effect on the presence of DM. Multivariable logistic regression analysis was used to identify determinants of DM in CCS.

Results

Survivors (median age 34.7 years, median follow-up time 27.1 years) showed increased odds for hyperglycemia (aOR = 2.72; 95% CI, 2.06-3.59), previous DM diagnosis (aOR = 3.03; 95% CI, 2.33-3.95), and antidiabetic medication use (aOR = 2.94; 95% CI, 2.17-3.99), compared to the reference cohort. Age (OR = 4.32; 95% CI, 1.84-10.15, >35 vs 18-35 years), BMI (OR = 1.12; 95% CI, 1.08-1.16, per point), family history of DM (OR = 2.38; 95% CI, 1.51-3.76), prior abdominal/pelvic radiotherapy (OR = 4.19; 95% CI, 2.32-7.55), total body irradiation (OR = 14.31; 95% CI, 6.98-29.34), hypogonadism (OR = 2.40; 95% CI, 1.15-4.99), hypertension (OR = 1.71; 95% CI, 1.06-2.76), and dyslipidemia (OR = 3.81; 95% CI, 2.15-6.75) were associated with DM in CCS. A statistically significant interaction between age and sex on the development of DM in survivors was identified.

Conclusion

The identified 3-fold increased risk of DM in CCS, along with the clinically relevant and some modifiable determinants, underscores the importance of early risk-based screening and the exploration of lifestyle interventions in this population.
Vitamin D and Selenium: Review of Clinical Trials of Synergistic Effects on Thyroid Antibody Levels and Disease Progression in Hashimoto’s Thyroiditis
Authors: Starzyk Agnieszka , Charzewski Piotr
Published: February 2025

Introduction:Hashimoto's Thyroiditis (HT) is a common autoimmune thyroid disorder caused by genetic predispositions and environmental factors, such as iodine imbalance, selenium deficiency, and stress. It is characterized by chronic lymphocytic infiltration of the thyroid gland, leading to hypothyroidism and the production of thyroid-specific autoantibodies, particularly anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies.
Materials and Methods:This study combined a literature review with clinical trial analysis to evaluate the role of selenium and vitamin D in HT. A systematic approach was used to identify and assess high-quality, relevant evidence.
Results:Selenium supplementation reduced TSH levels in patients without thyroid hormone replacement therapy (THRT) and significantly decreased TPOAb and MDA levels, with no impact on fT4, T3, or TGAb. Adverse events were rare and comparable to placebo. Vitamin D deficiency correlated with elevated TSH, anti-TPO, and anti-TG levels, with HT patients showing significantly lower vitamin D levels than healthy controls or hypothyroid patients. Both selenium and vitamin D demonstrated potential immunomodulatory benefits.
Conclusions:Selenium and vitamin D supplementation may aid in managing HT by reducing TSH and thyroid antibody levels, emphasizing the importance of addressing micronutrient deficiencies in autoimmune thyroid disorders.
Comparative outcomes of the thenar flap, partial toe pulp free flap, and radial artery superficial palmar flap for fingertip and pulp defect reconstruction: a retrospective chart review
Authors: Kim Sangwoo , Ryu Deokhyeon , Whang Jongick , Seo Hyeunggyo , Heo Jaewoo
Published: February 2025

Purpose: This study compared the outcomes of three commonly used reconstructive techniques—the thenar flap, partial toe pulp free flap, and radial artery superficial palmar (RASP) flap—for the reconstruction of fingertip and pulp defects, in order to provide guidance for surgeons in selecting the appropriate method based on defect size and patient characteristics.Methods: A retrospective chart review was conducted on 50 patients who underwent fingertip or pulp reconstruction. Nine patients received thenar flaps, 26 received partial toe pulp free flaps, and 15 received RASP flaps. Patient demographics, defect size, flap survival, donor site morbidity, and patient satisfaction were analyzed. Results: All flaps survived. In the RASP flap group, three cases of partial necrosis were successfully managed without additional surgical interventions. The thenar flap group had donor site pain and joint stiffness, while the partial toe pulp free flap group exhibited no donor site complications. The RASP flap group experienced hypertrophic scarring in five cases. Patient satisfaction was high across all groups, with the partial toe pulp free flap yielding the most positive outcomes.Conclusion: The thenar flap is a reliable option for small defects, especially those with exposed bone, but is associated with donor site morbidity and joint stiffness. The partial toe pulp free flap provides superior functional and aesthetic results for moderate defects, though it requires more surgical expertise and has a longer recovery time. The RASP flap is optimal for larger defects, offering good cosmetic results but requiring careful donor site management to avoid hypertrophic scarring.
Caught in the crossfire: a case of splenic infarction amid G-CSF therapy in chronic myelomonocytic leukaemia
Authors: Peshin Supriya , Rahimuddin Bilal , Dharia Adit , Singh Shagun , Kapadia Chirag , Krishnadasan Ravitharan
Published: February 2025

This report highlights a rare but significant complication associated with the use of granulocyte-colony stimulating factor (G-CSF) therapy, specifically splenic infarction, in a 67-year-old male with chronic myelomonocytic leukaemia (CMML) undergoing chemotherapy. G-CSFs, such as pegfilgrastim, are frequently used to prevent febrile neutropenia in cancer patients undergoing myelotoxic chemotherapy. While G-CSF is effective in reducing the risk of neutropenia, its administration has been linked to uncommon but severe complications such as splenic infarction and rupture. Our patient, receiving dose-dense chemotherapy with G-CSF support, developed severe abdominal pain midway through treatment. A computed tomography (CT) scan revealed multiple splenic hypodensities consistent with splenic infarction, but no active bleeding. Conservative management was successfully employed, avoiding surgical intervention. This case underscores the need for vigilance when administering G-CSF, particularly in patients at high risk for complications, and contributes to the limited body of literature on G-CSF-induced splenic infarction.
Streptococcus pneumoniae meningitis complicated by hygroma and vasculitis
Authors: Dib Abdelkader , Salem Johny , Dawood Mohamad , Osman Omar , Fares Mirna
Published: February 2025

Hygroma and vasculitis are rare complications of meningitis, that are serious and potentially fatal. In this case report, we present a 71-year-old male diagnosed with Streptococcus pneumoniae meningitis who developed bilateral subdural hygroma and vasculitis despite appropriate treatment in the intensive care unit. The patient experienced seizures and persistent febrile episodes, leading to the diagnosis of these complications. Despite surgical and medical management, the patient’s neurological status did not improve, and he remained comatose and was eventually transitioned to palliative care.
The enduring neglect of vital signs assessment: a concept map of contributing factors
Authors: Elliott Malcolm , Kaur Rajkiranjeet
Published: February 2025

Vital signs assessment is a critical component of clinical monitoring and a crucial nursing responsibility. Contemporary and past research has found, however, that this assessment is often neglected and remains an enduring problem. Research has identified various contributing or causal factors but, to date, there has been no attempt to show how these factors interrelate. A concept map highlighting these relationships is presented in this article. The map can be used as a tool for developing educational resources to address the enduring neglect of vital signs assessment.