bluuebunny/crossref_metadata_2025 huggingface dataset:
Mandibular fracture in medication‐associated osteonecrosis following infliximab therapy: A case report
Authors: Kolodziejwski Waleska Tychanowicz , Rosa Camila Adriane Leffa , Guimarães Angela Maira , da Silva Priscila Queiroz Mattos , de Araujo Melissa Rodrigues
Published: July 2024

Introduction

Medication‐associated osteonecrosis of the jaws (MRONJ) is characterized by the presence of exposed bone or an intraoral or extraoral fistula in the maxillofacial region in patients with a history of treatment with anti‐resorptive and anti‐angiogenic drugs, such as monoclonal antibodies, and without a history of radiotherapy or metastatic diseases in the area.

Objective

The aim of this study is to report a case of a pathological mandibular fracture in an area of MRONJ in a patient diagnosed with Crohn's disease treated with infliximab.

Case report

A 53‐year‐old male patient, an active smoker for 35 years, diagnosed with Crohn's disease, undergoing intravenous administration of infliximab 300 mg for 1 year and 3 months, with no previous history of anti‐angiogenic or anti‐resorptive medication, presenting with an extraoral fistula in the submandibular region for 4 months, with painful symptoms, diagnosed as MRONJ. He was initially treated conservatively, using antimicrobial photodynamic therapy (aPDT), antibiotic therapy, and the PENTO protocol. However, the patient evolved with a pathological fracture in the mandibular parasymphysis, requiring surgical reconstruction.

Final considerations

Pathological fracture of the mandible is a complication of MRONJ that compromises the patient's quality of life. The management of patients with MRONJ is complex and challenging.
Paradigm shift: Exploring the impact of digital technologies on the welfare state through a systematic literature review
Authors: Alexopoulou Sofia
Published: July 2024

This systematic literature review (SLR) explores the impact of digital technologies on welfare states and bureaucracies, analyzing the evolving dynamics between the state and citizens. The integration of digital technologies reshapes traditional interactions, granting citizens new levels of autonomy and responsibility. Service delivery evolves from conventional bureaucracies to dynamic, data‐driven systems. Employing the PRISMA methodology, the review covers articles from 2017 to 2024, synthesizing insights from 37 selected articles. Key themes, challenges, and opportunities associated with digital transformation in the welfare state are identified. The study offers valuable insights for policymakers, scholars, and practitioners navigating the complex intersection of technology and welfare provision. It underscores the need for a balanced approach to welfare transformation, addressing both the benefits of digitalization and potential challenges such as exclusion, citizen profiling, and other ethical concerns.
Bridging theory and practice: A framework forSTEMteacher leadership
Authors: Pynes D'Anna , Kloser Matthew , Wagner Catherine , Szopiak Michael , Wilsey Matthew , Svarovsky Gina Navoa , Trinter Christine
Published: July 2024

Increasing demand for high‐quality STEM education calls for the formation and retention of effective educators with STEM expertise; yet endeavors to meet this demand require organizational structures and supports that can overcome the lack of collective understanding around STEM education, limited STEM knowledge by leadership, and mounting teacher attrition. STEM teacher leadership is one mechanism for addressing this challenge by empowering excellent classroom teachers with opportunities to institutionally shape STEM learning, without extracting them from their instructional role. This paper offers a STEM teacher leadership framework that targets teachers' identity development toward an equity‐focused, transformational STEM teacher leader. First, we examine the field of teacher leadership (both STEM‐specific and generally) to provide a foundation for the areas of potential impact by STEM teacher leaders, as well as dispositions and stances that support their emergent leadership. Complementing the literature, we explore and elevate aspiring STEM teacher leaders' perspectives, drawn from baseline surveys and interviews of a multi‐year professional development program for middle grade teachers in STEM disciplines. The framework, iteratively informed by these sources, includes our stance on equity in STEM education, eight dispositions, and four domains of knowledge and practices that shape STEM teacher leadership in K‐8 school settings.
Arabidopsis DNA glycosylase MBD4L improves recovery of aged seeds
Authors: Lescano López Ignacio , Torres José Roberto , Cecchini Nicolás Miguel , Alvarez María Elena
Published: July 2024

DNA glycosylases initiate the base excision repair (BER) pathway by catalyzing the removal of damaged or mismatched bases from DNA. The Arabidopsis DNA glycosylase methyl‐CpG‐binding domain protein 4 like (MBD4L) is a nuclear enzyme triggering BER in response to the genotoxic agents 5‐fluorouracil and 5‐bromouracil. To date, the involvement of MBD4L in plant physiological processes has not been analyzed. To address this, we studied the enzyme functions in seeds. We found that imbibition induced the MBD4L gene expression by generating two alternative transcripts, MBD4L.3 and MBD4L.4. Gene activation was stronger in aged than in non‐aged seeds. Seeds from mbd4l‐1 mutants displayed germination failures when maintained under control or ageing conditions, while 35S:MBD4L.3/mbd4l‐1 and 35S:MBD4L.4/mbd4l‐1 seeds reversed these phenotypes. Seed nuclear DNA repair, assessed by comet assays, was exacerbated in an MBD4L‐dependent manner at 24 h post‐imbibition. Under this condition, the BER genes ARP, APE1L, and LIG1 showed higher expression in 35S:MBD4L.3/mbd4l‐1 and 35S:MBD4L.4/mbd4l‐1 than in mbd4l‐1 seeds, suggesting that these components could coordinate with MBD4L to repair damaged DNA bases in seeds. Interestingly, the ATM, ATR, BRCA1, RAD51, and WEE1 genes associated with the DNA damage response (DDR) pathway were activated in mbd4l‐1, but not in 35S:MBD4L.3/mbd4l‐1 or 35S:MBD4L.4/mbd4l‐1 seeds. These results indicate that MBD4L is a key enzyme of a BER cascade that operates during seed imbibition, whose deficiency would cause genomic damage detected by DDR, generating a delay or reduction in germination.
Blood safety markers in Dutch donors after relaxation of deferral for men who have sex with men: re‐emergence of syphilis and HIV pre‐exposure prophylaxis use
Authors: Quee Franke A. , Slot Ed , van Leeuwen Ingeborg , Brands Ralph , Franssen Eric J. F. , Hogema Boris M. , Zaaijer Hans L. , van de Laar Thijs J. W.
Published: July 2024

Background

Less discriminatory donor selection policies for men who have sex with men (MSM) may impact transfusion safety in terms of higher residual risks for known transfusion‐transmitted infections (TTIs), increased vulnerability toward new TTIs that are also transmitted via sex, and HIV infections masked by pre‐exposure prophylaxis (PrEP).

Study Design and Methods

TTI trends in Dutch donors were studied over a 13‐year period (2011–2023), characterized by successive relaxations of MSM deferral criteria. Structured posttest counseling was performed to determine risk factors in TTI‐positive donors. PrEP drug levels were measured in 9977 donations from male donors living in urban areas and in 67 donors with active or resolved syphilis.

Results

HIV incidence (from 5.8 to 1.5 per 1,000,000 donor years (DY)) and HBV incidence (from 12.4 to 4.5 per 1,000,000 DY) in Dutch donors decreased with less stringent MSM deferral criteria, while syphilis prevalence (from 26.4 to 44.1 per 100,000 new donors) and syphilis incidence (from 18.3 to 46.3 per 1,000,000 DY) increased over time. The proportion of MSM‐related syphilis rose from 2% to 32% in new donors and from 12% to 27% in repeat donors. PrEP was detected in 2 of 9977 (0.02%) donations from male donors living in urban areas, and in 1 of 39 (2.6%) male donors with syphilis.

Discussion

To date, phasing out donor deferral for MSM had no significant impact on transfusion safety in the Netherlands. However, rising syphilis rates and (recent) PrEP use in the blood donor population, albeit rare, suggest an influx of donors with higher sexual risk profiles and requires intensified TTI surveillance in donors.
Treatment of textile wastewater in a single‐step moving bed‐membrane bioreactor: Comparison with conventional membrane bioreactor in terms of performance and membrane fouling
Authors: Tecirli Emine Sule , Akgun Kadir , Caglak Abdulkadir , Sari Erkan Hanife , Onkal Engin Guleda
Published: July 2024

Membrane bioreactor (MBR) is a promising technology for the treatment of municipal and industrial wastewater, including highly contaminated textile wastewater. However, membrane fouling remains a critical challenge due to reduced flux. This study investigates the efficacy of a moving bed MBR (MB‐MBR) technology for textile wastewater treatment, focusing on chemical oxygen demand (COD) removal, and its impact on mitigating membrane fouling. In a 50‐day study, a conventional MBR (R1) was compared with an MB‐MBR (R2) augmented with free‐floating biocarriers (accounting for 20% of the reactor volume). Both systems used flat sheet ceramic membrane modules. The results indicate that the MB‐MBR achieved superior performance, with COD and colour removal of 89% and 81%, respectively, compared with 87% and 73% in the conventional MBR. Importantly, the introduction of biocarriers eliminated the need for offline physical membrane cleaning in the MB‐MBR. The free‐floating biocarriers lowered transmembrane pressure, reduced capillary suction time and reduced fouling through their scouring action.
Changing soil properties influenced vegetation diversity along effluent‐dominated river courses in dry areas of north‐western India
Authors: Singh Genda , Nagora Prem Raj , Haksar Parul , Mishra Deepak
Published: July 2024

Improving the environmental quality of effluent‐dominated seasonal rivers is a fundamental challenge for sustaining life in drylands, where people utilize contaminated water to produce food, which ultimately accumulates in the food chain. Preventing further contaminations and phytoremediation are needed to avoid environmental degradation and health risks. This study aimed at analysing water quality and its impacts on soil and vegetation at effluent‐impacted, river‐edge and non‐polluted (control) micro‐habitats at five sites along Luni, Bandi and Jojari Rivers each in western Rajasthan. Soil and water samples were collected and analysed, and vegetation was recorded. River water exhibited high pH (7.60–8.60), electrical conductivity (EC; 2.45–38.20 dS m−1), total dissolved solid (TDS; 1.26–30.86 g L−1), alkalinity (24.0–250.0 mg L−1) and Na (1.50–30.00 g L−1), K (29.0–1100.0 mg L−1), Ca (136.0–3800.0 mg L−1) and Mn (0.05–83.92 mg L−1) concentrations and low NH4‐N, NO3‐N, PO4‐P and heavy metals. Species numbers ranged between 32 along Luni and 20 along Jojari. Soil pH, EC, PO4‐P and shrub richness (R), diversity (H′) and evenness (e') were highest for Bandi, whereas NH4‐N, NO3‐N, K and tree R and H′ were highest for Jojari River. Soil variables decreased and plant diversity increased downstream. Concentrations of Cd, Zn, Cr, Cu and Pb were above the acceptable limit in leaf of Salvadora persica and Prosopis juliflora. Principal component analysis (PCA) revealed significant relationships between different variables of river water, soil, and vegetation and 11 PCA axes. Conclusively, industry effluents negatively affected water, soil and river ecology. Effluent‐impacted soils had high salinity and less diversity adapted by salt‐tolerant species, complementary effects of which contribute to restoring the modified ecosystem and urban greening. Although people utilize effluent‐contaminated water in irrigation, precautions should be taken to avoid environmental and animal/human health risks.
Molecular phylogenetics of the superfamily Stromboidea (Caenogastropoda): New insights from increased taxon sampling
Authors: Irwin Alison R. , Bouchet Philippe , Crame J. Alistair , Harper Elizabeth M. , Kronenberg Gijs C. , Strong Ellen E. , Williams Suzanne T.
Published: July 2024

The superfamily Stromboidea is a clade of morphologically distinctive gastropods which include the iconic Strombidae, or ‘true conchs’. In this study, we present the most taxonomically extensive phylogeny of the superfamily to date, using fossil calibrations to produce a chronogram and extant geographical distributions to reconstruct ancestral ranges. From these results, we confirm the monophyly of all stromboidean families; however, six genera are not monophyletic using current generic assignments (Strombidae: Lentigo, Canarium, Dolomena, Doxander; Xenophoridae: Onustus, Xenophora). Within Strombidae, analyses resolve an Indo‐West Pacific (IWP) clade sister to an East Pacific/Atlantic clade, together sister to a second, larger IWP clade. Our results also indicate two pulses of strombid diversification within the Miocene, and a Tethyan/IWP origin for Strombidae—both supported by the fossil record. However, conflicts between divergence time estimates and the fossil record warrant further exploration. Species delimitation analyses using the COI barcoding gene support several taxonomic changes. We synonymise Euprotomus aurora with Euprotomus bulla, Strombus alatus with Strombus pugilis, Dolomena abbotti with Dolomena labiosa, and Dolomena operosa with Dolomena vittata. We identified cryptic species complexes within Terebellum terebellum, Lambis lambis, “Canarium” wilsonorum, Dolomena turturella and Maculastrombus mutabilis. We reinstate Rimellopsis laurenti as a species (previously synonymised with R. powisii) and recognise Harpago chiragra rugosus and Lambis truncata sowerbyi valid at the rank of species. Finally, we establish several new combinations to render Lentigo, Dolomena, and Canarium monophyletic: Lentigo thersites, Dolomena robusta, Dolomena epidromis, Dolomena turturella, Dolomena taeniata, Dolomena vanikorensis, D. vittata, “Canarium” wilsonorum, Hawaiistrombus scalariformis, Maculastrombus mutabilis, Maculastrombus microurceus.
Shock Response of Water-Protected Spherical Explosion Containment Vessels
Authors: Liu Zhenfeng , Li Xiaojie , Wang Yang , Yan Honghao , Zhou Dezheng
Published: July 2024

Explosion containment vessels (ECVs) are important equipment used for underwater explosion experiment research. In this paper, a method is proposed to improve the blast resistance of the ECV by placing it in the water medium. The shock response caused by the underwater explosion in a spherical ECV is studied. The single-layer thin-walled spherical vessel shell submerged in an infinite domain water medium is deduced and simplified as a single-degree-of-freedom elastic vibration system with viscous damping. The underwater explosion shock wave is simplified to an exponential shock loading, and the analytical solutions of the radial shock vibration of the spherical shell are obtained using Duhamel's integrals. Compared with the numerical simulation results, the accuracy of the theoretical model is verified. The study results show that the water medium radiates out vibration energy and plays an important role in eliminating vibration through damping. It is found that the vibration damping ratio can be controlled by adjusting the vessel radius and thickness, so that the vibration of the shell can be controlled within three periods and the impact fatigue can be reduced. In addition, the radiation damping of the water medium greatly reduces the maximum radial displacement of the spherical shell, which significantly improves the blast resistance of the spherical shell.
An atlas of transcribed enhancers across helper T cell diversity for decoding human diseases
Authors: Oguchi Akiko , Suzuki Akari , Komatsu Shuichiro , Yoshitomi Hiroyuki , Bhagat Shruti , Son Raku , Bonnal Raoul Jean Pierre , Kojima Shohei , Koido Masaru , Takeuchi Kazuhiro , Myouzen Keiko , Inoue Gyo , Hirai Tomoya , Sano Hiromi , Takegami Yujiro , Kanemaru Ai , Yamaguchi Itaru , Ishikawa Yuki , Tanaka Nao , Hirabayashi Shigeki , Konishi Riyo , Sekito Sho , Inoue Takahiro , Kere Juha , Takeda Shunichi , Takaori-Kondo Akifumi , Endo Itaru , Kawaoka Shinpei , Kawaji Hideya , Ishigaki Kazuyoshi , Ueno Hideki , Hayashizaki Yoshihide , Pagani Massimiliano , Carninci Piero , Yanagita Motoko , Parrish Nicholas , Terao Chikashi , Yamamoto Kazuhiko , Murakawa Yasuhiro , Guerrini Matteo , Hatano Hiroaki , Ishigaki Kazuyoshi , Ishikawa Yuki , Komatsu Shuichiro , Kono Michihiro , Murakawa Yasuhiro , Nakano Masahiro , Oguchi Akiko , Son Raku , Suzuki Akari , Takeuchi Kazuhiro , Tanaka Nao , Terao Chikashi , Tomizuka Kohei , Yamamoto Kazuhiko , Yoshino Soichiro ,   ITEC Consortium‡
Published: July 2024

Transcribed enhancer maps can reveal nuclear interactions underpinning each cell type and connect specific cell types to diseases. Using a 5′ single-cell RNA sequencing approach, we defined transcription start sites of enhancer RNAs and other classes of coding and noncoding RNAs in human CD4
+
T cells, revealing cellular heterogeneity and differentiation trajectories. Integration of these datasets with single-cell chromatin profiles showed that active enhancers with bidirectional RNA transcription are highly cell type–specific and that disease heritability is strongly enriched in these enhancers. The resulting cell type–resolved multimodal atlas of bidirectionally transcribed enhancers, which we linked with promoters using fine-scale chromatin contact maps, enabled us to systematically interpret genetic variants associated with a range of immune-mediated diseases.
Unsupervised evolution of protein and antibody complexes with a structure-informed language model
Authors: Shanker Varun R. , Bruun Theodora U. J. , Hie Brian L. , Kim Peter S.
Published: July 2024

Large language models trained on sequence information alone can learn high-level principles of protein design. However, beyond sequence, the three-dimensional structures of proteins determine their specific function, activity, and evolvability. Here, we show that a general protein language model augmented with protein structure backbone coordinates can guide evolution for diverse proteins without the need to model individual functional tasks. We also demonstrate that ESM-IF1, which was only trained on single-chain structures, can be extended to engineer protein complexes. Using this approach, we screened about 30 variants of two therapeutic clinical antibodies used to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We achieved up to 25-fold improvement in neutralization and 37-fold improvement in affinity against antibody-escaped viral variants of concern BQ.1.1 and XBB.1.5, respectively. These findings highlight the advantage of integrating structural information to identify efficient protein evolution trajectories without requiring any task-specific training data.
Ultrastrong MXene film induced by sequential bridging with liquid metal
Authors: Li Wei , Zhou Tianzhu , Zhang Zejun , Li Lei , Lian Wangwei , Wang Yanlei , Lu Junfeng , Yan Jia , Wang Huagao , Wei Lei , Cheng Qunfeng
Published: July 2024

Assembling titanium carbide (Ti
3
C
2
T

x

) MXene nanosheets into macroscopic films presents challenges, including voids, low orientation degree, and weak interfacial interactions, which reduce mechanical performance. We demonstrate an ultrastrong macroscopic MXene film using liquid metal (LM) and bacterial cellulose (BC) to sequentially bridge MXene nanosheets (an LBM film), achieving a tensile strength of 908.4 megapascals. A layer-by-layer approach using repeated cycles of blade coating improves the orientation degree to 0.935 in the LBM film, while a LM with good deformability reduces voids into porosity of 5.4%. The interfacial interactions are enhanced by the hydrogen bonding from BC and the coordination bonding with LM, which improves the stress-transfer efficiency. Sequential bridging provides an avenue for assembling other two-dimensional nanosheets into high-performance materials.
Lymphocytes as a living drug for cancer
Authors: Rosenberg Steven A.
Published: July 2024

Using a patient’s lymphocytes is approved to treat melanoma and has wider applications
Breaking boundaries: Bacteria act as architects of host T cell modulators using bile acids
Authors: Yao Lina
Published: July 2024

Bacteria act as architects of host T cell modulators using bile acids
A new path to migraine
Authors: Russo Andrew F. , Iliff Jeffrey J.
Published: July 2024

Cerebrospinal fluid influx directly activates trigeminal neurons in a migraine model
DNA and gelatin—a cool aerogel mix
Authors: Shen Changyu , Liu Xianhu
Published: July 2024

A degradable biopolymer is an effective radiative cooling material
American academic freedom is in peril
Authors: Calo Ryan , Starbird Kate
Published: July 2024

Academics researching online misinformation in the US are learning a hard lesson: Academic freedom cannot be taken for granted. They face a concerted effort—including by members of Congress—to undermine or silence their work documenting false and misleading internet content. The claim is that online misinformation researchers are trying to silence conservative voices. The evidence suggests just the opposite.
Methods for Functional Characterization of Genetic Polymorphisms of Non-Coding Regulatory Regions of the Human Genome
Authors: Uvarova Aksinya N. , Tkachenko Elena A. , Stasevich Ekaterina M. , Zheremyan Elina A. , Korneev Kirill V. , Kuprash Dmitry V.
Published: July 2024

Currently, numerous associations between genetic polymorphisms and various diseases have been characterized through the Genome-Wide Association Studies. Majority of the clinically significant polymorphisms are localized in non-coding regions of the genome. While modern bioinformatic resources make it possible to predict molecular mechanisms that explain influence of the non-coding polymorphisms on gene expression, such hypotheses require experimental verification. This review discusses the methods for elucidating molecular mechanisms underlying dependence of the disease pathogenesis on specific genetic variants within the non-coding sequences. A particular focus is on the methods for identification of transcription factors with binding efficiency dependent on polymorphic variations. Despite remarkable progress in bioinformatic resources enabling prediction of the impact of polymorphisms on the disease pathogenesis, there is still the need for experimental approaches to investigate this issue.
Treatment of toxic shock in children
Authors: Giang Vivian , McMullan Brendan
Published: July 2024

Toxic shock syndrome (TSS) is a life-threatening complication of infection typically caused by one of two bacterial species:Staphylococcus aureusandStreptococcus pyogenes. The outcomes in children with TSS can be devastating. Careful consideration of TSS is required as a potential differential diagnosis of children presenting with sepsis or severe illness associated with fever and rash.
Optimising paediatric bedside teaching for medical students
Authors: Oswal Abhishek , Collicott Nathan , Jennings Steve , Kelly Alison
Published: July 2024

Bedside teaching is a common teaching modality in undergraduate and postgraduate curricula and involves students being supervised in a clinical interaction at a patient’s bedside by a more senior clinician. Following the clinical encounter, the students and teacher discuss the case and students’ consultation skills. This is of particular value in teaching paediatrics to medical students, for whom paediatrics is an unfamiliar environment, and the approach to consultation is very different to usual adult practice. Junior doctors are often tasked with teaching medical students, either in structured bedside teaching sessions during formal teaching roles, or in ad hoc sessions with students shadowing on clinical placements. As paediatrics may be unfamiliar to the junior doctors themselves, offering teaching to medical students may cause some anxiety in their own ability and knowledge. This article provides doctors in paediatrics with an insight into the evidence base underlying paediatric bedside teaching, including model structures for bedside teaching and debriefing after the session, with the aims of improving their confidence in undertaking these sessions and improving their learners’ and their own yield of learning.
Robotic-assisted laparoscopic resection of a pelvic solitary fibrous tumour causing distal ureteric compression
Authors: Benn Matthew , Hii Wesley
Published: July 2024

This case report describes a male in his late 40s with a 4 cm pelvic mass compressing the left distal ureter, resulting in left hydroureteronephrosis. Biopsy of the mass was suggestive of a solitary fibrous tumour. The patient underwent a robotic-assisted laparoscopic excision of the left pelvic mass. Intraoperatively, the mass was found to be densely adhered to the ureter, necessitating a left distal ureterectomy and ureteric reimplantation. Subsequent histopathological analysis revealed the mass was a solitary fibrous tumour with no evidence of malignancy.
The effect of an annual temporary abstinence campaign on population-level alcohol consumption in Thailand: a time-series analysis of 23 years
Authors: Saengow Udomsak , Patanavanich Roengrudee , Suriyawongpaisal Paibul , Aekplakorn Wichai , Sornpaisarn Bundit , Jiang Huan , Rehm Jurgen
Published: July 2024

Rationale

A small number of earlier studies have suggested an effect of temporary abstinence campaigns on alcohol consumption. However, all were based on self-reported consumption estimates.

Objectives

Using a time series of 23-year monthly alcohol sales data, this study examined the effect of an annual temporary abstinence campaign, which has been organised annually since 2003 during the Buddhist Lent period (spanning 3 months), on population-level alcohol consumption.

Methods

Data used in the analysis included a time series of monthly alcohol sales data from January 1995 to September 2017 and the midyear population counts for those years. Generalised additive models (GAM) were applied to estimate trends as smooth functions of time, while identifying a relationship between the Buddhist Lent abstinence campaigns on alcohol consumption. The sensitivity analysis was performed using a seasonal autoregressive integrated moving average with exogenous variables (SARIMAX) model.

Intervention

The Buddhist Lent abstinence campaign is a national mass media campaign combined with community-based activities that encourages alcohol abstinence during the Buddhist Lent period, spanning 3 months and varying between July and October depending on the lunar calendar. The campaign has been organised annually since 2003.

Main outcome

Per capita alcohol consumption using monthly alcohol sales data divided by the midyear total population number used as a proxy.

Results

Median monthly per capita consumption was 0.43 (IQR: 0.37 to 0.51) litres of pure alcohol. Over the study period, two peaks of alcohol consumption were in March and December of each year. The significant difference between before-campaign and after-campaign coefficients in the GAM, −0.102 (95% CI: −0.163 to –0.042), indicated an effect of the campaign on alcohol consumption after adjusting for the time trend and monthly seasonality, corresponding to an average reduction of 9.97% (95% CI: 3.65% to 24.18%). The sensitivity analyses produced similar results, where the campaign was associated with a decrease in consumption of 8.1% (95% CI: 0.4% to 15.7%).

Conclusions

This study demonstrated that the temporary abstinence campaign was associated with a decrease in population-level alcohol consumption during campaign periods. The finding contributed to a growing body of evidence on the effectiveness of emerging temporary abstinence campaigns.
Evaluating associations between patient-to-nurse ratios and mortality, process of care events and vital sign documentation on paediatric wards: a secondary analysis of data from the EPOCH cluster-randomised trial
Authors: Gawronski Orsola , Parshuram Christopher S , Cecchetti Corrado , Tiozzo Emanuela , Szadkowski Leah , Ciofi Degli Atti Marta Luisa , Dryden-Palmer Karen , Dall'Oglio Immacolata , Raponi Massimiliano , Joffe Ari Robin , Tomlinson George
Published: July 2024

Objective

To describe the associations between patient-to-nurse staffing ratios and rates of mortality, process of care events and vital sign documentation.

Design

Secondary analysis of data from the evaluating processes of care and outcomes of children in hospital (EPOCH) cluster-randomised trial.

Setting

22 hospitals caring for children in Canada, Europe and New Zealand.

Participants

Eligible hospitalised patients were aged>37 weeks and <18 years.

Primary and secondary outcome measures

The primary outcome was all-cause hospital mortality. Secondary outcomes included five events reflecting the process of care, collected for all EPOCH patients; the frequency of documentation for each of eight vital signs on a random sample of patients; four measures describing nursing perceptions of care.

Results

A total of 217 714 patient admissions accounting for 849 798 patient days over the course of the study were analysed. The overall mortality rate was 1.65/1000 patient discharges. The median (IQR) number of patients cared for by an individual nurse was 3.0 (2.8–3.6). Univariate Bayesian models estimating the rate ratio (RR) for the patient-to-nurse ratio and the probability that the RR was less than one found that a higher patient-to-nurse ratio was associated with fewer clinical deterioration events (RR=0.88, 95% credible interval (CrI) 0.77–1.03; P (RR<1)=95%) and late intensive care unit admissions (RR=0.76, 95% CrI 0.53–1.06; P (RR<1)=95%). In adjusted models, a higher patient-to-nurse ratio was associated with lower hospital mortality (OR=0.77, 95% CrI=0.57–1.00; P (OR<1)=98%). Nurses from hospitals with a higher patient-to-nurse ratio had lower ratings for their ability to influence care and reduced documentation of most individual vital signs and of the complete set of vital signs.

Conclusions

The data from this study challenge the assumption that lower patient-to-nurse ratios will improve the safety of paediatric care in contexts where ratios are low. The mechanism of these effects warrants further evaluation including factors, such as nursing skill mix, experience, education, work environment and physician staffing ratios.

Trial registration number

EPOCH clinical trial registered on clinical trial.govNCT01260831; post-results.
Unique immune characteristics and differential anti-PD-1-mediated reinvigoration potential of CD8+TILs based onBRCA1/2mutation status in epithelial ovarian cancers
Authors: Park Junsik , Kim Jung Chul , Lee Yong Jae , Kim Sunghoon , Kim Sang Wun , Shin Eui-Cheol , Lee Jung Yun , Park Su-Hyung
Published: July 2024

Background

We aimed to investigate the distinct immunological characteristics of the tumor immune microenvironment in epithelial ovarian cancer (EOC) according toBRCA1/2mutations status and differential PD-1 expression levels.

Methods

Tumor-infiltrating lymphocytes (TILs) were collected from patients with newly diagnosed advanced-stage EOC (YUHS cohort, n=117). This YUHS cohort was compared with The Cancer Genome Atlas (TCGA) data for ovarian serous cystadenocarcinoma (n=482), in terms of survival outcomes and immune-related gene profiles according toBRCA1/2status. We used multicolor flow cytometry to characterize the immune phenotypes and heterogeneity of TILs with or withoutBRCA1/2mutations.In vitrofunctional assays were conducted to evaluate the reinvigorating ability of CD8+TILs on anti-PD-1 treatment.

Results

We found that EOC patients withBRCA1/2mutations (BRCA1/2mt) exhibited better survival outcomes and significantly higher tumor mutation burden (TMB), compared withBRCA1/2non-mutated (BRCA1/2wt) patients. Furthermore, CD8+TILs withinBRCA1/2mt tumors displayed characteristics indicating more severe T-cell exhaustion than theirBRCA1/2wt counterparts. Notably, the capacity for anti-PD-1-mediated reinvigoration of CD8+TILs was significantly greater inBRCA1/2wt tumors compared withBRCA1/2mt tumors. Additionally, within theBRCA1/2wt group, the frequency of PD-1highCD8+TILs was positively correlated with the reinvigoration capacity of CD8+TILs after anti-PD-1 treatment.

Conclusion

Our results highlight unique immune features of CD8+TILs in EOC and a differential response to anti-PD-1 treatment, contingent onBRCA1/2mutation status. These findings suggest that immune checkpoint blockade may be a promising frontline therapeutic option for selectedBRCA1/2wt EOC patients.
Responsibility is an adequate requirement for authorship: a reply to Levy
Authors: Helgesson Gert , Bülow William
Published: July 2024

Neil Levy argues in a recent JME ‘Current controversy’ paper that responsibility is not an adequate authorship requirement for human researchers, which makes it unjustified to require it from artificial intelligence contributing to research and scientific paper production, although he softens his stance towards the end and accepts that a limited responsibility requirement might after all be reasonable. The main argument provided by Levy against a more extensive responsibility requirement in science is that there are many cases where not all researchers listed as coauthors can assume responsibility for the entire paper or even the central research questions. In this reply, we argue that the more limited responsibility requirement is the ethically reasonable one to ask of all authors, considering the conditions for and value of collaboration, and that this should also have ramifications for the legal regulation of scientific misconduct.
Describing the effect of COVID-19 on sexual and healthcare-seeking behaviours of men who have sex with men in three counties in Kenya: a cross-sectional study
Authors: Shaw Souradet Y , Biegun Jeffery C S , Leung Stella , Isac Shajy , Musyoki Helgar K , Mugambi Mary , Kioko Japheth , Musimbi Janet , Olango Kennedy , Kuria Samuel , Ongaro Martin K , Walimbwa Jeffrey , Emmanuel Faran , Blanchard James , Pickles Michael , Mishra Sharmistha , Becker Marissa L , Lazarus Lisa , Lorway Robert , Bhattacharjee Parinita
Published: July 2024

Background

While the COVID-19 pandemic disrupted HIV preventative services in sub-Saharan Africa, little is known about the specific impacts the pandemic has had on men who have sex with men (MSM) in Kenya.

Methods

Data were from an HIV self-testing intervention implemented in Kisumu, Mombasa and Kiambu counties in Kenya. Baseline data collection took place from May to July 2019, and endline in August–October 2020, coinciding with the lifting of some COVID-19 mitigation measures. Using endline data, this study characterised the impact the pandemic had on participants’ risk behaviours, experience of violence and behaviours related to HIV. Logistic regression was used to understand factors related to changes in risk behaviours and experiences of violence; adjusted AORs (AORs) and 95% CIs are reported.

Results

Median age was 24 years (IQR: 21–27). Most respondents (93.9%) reported no change or a decrease in the number of sexual partners (median number of male sexual partners: 2, IQR: 2–4). Some participants reported an increase in alcohol (10%) and drug (16%) consumption, while 40% and 28% reported decreases in alcohol and drug consumption, respectively. Approximately 3% and 10% reported an increase in violence from intimate partners and police/authorities, respectively. Compared with those with primary education, those with post-secondary education were 60% less likely to report an increase in the number of male sexual partners per week (AOR: 0.4, 95% CI: 0.2 to 0.9), while those who were HIV positive were at twofold the odds of reporting an increase or sustained levels of violence from intimate partners (AOR: 2.0, 95% CI: 1.1 to 4.0).

Conclusion

The results of this study demonstrate heterogeneity in participants’ access to preventative HIV and clinical care services in Kenya after the onset of the COVID-19 epidemic. These results indicate the importance of responding to specific needs of MSM and adapting programmes during times of crisis.
Environmental exposures associated with early childhood recurrent wheezing in the mother and child in the environment birth cohort: a time-to-event study
Authors: Asharam Kareshma , Mitku Aweke A Abebaw , Ramsay Lisa , Jeena Prakash Mohan , Naidoo Rajen N
Published: July 2024

Background

Antenatal factors and environmental exposures contribute to recurrent wheezing in early childhood.

Aim

To identify antenatal and environmental factors associated with recurrent wheezing in children from birth to 48 months in the mother and child in the environment cohort, using time-to-event analysis.

Method

Maternal interviews were administered during pregnancy and postnatally and children were followed up from birth to 48 months (May 2013–October 2019). Hybrid land-use regression and dispersion modelling described residential antenatal exposure to nitrogen dioxide (NO2) and particulate matter of 2.5 µm diameter (PM2.5). Wheezing status was assessed by a clinician. The Kaplan-Meier hazard function and Cox-proportional hazard models provided estimates of risk, adjusting for exposure to environmental tobacco smoke (ETS), maternal smoking, biomass fuel use and indoor environmental factors.

Results

Among 520 mother–child pairs, 85 (16%) children, had a single wheeze episode and 57 (11%) had recurrent wheeze. Time to recurrent wheeze (42.9 months) and single wheeze (37.8 months) among children exposed to biomass cooking fuels was significantly shorter compared with children with mothers using electricity (45.9 and 38.9 months, respectively (p=0.03)). Children with mothers exposed to antenatal ETS were 3.8 times more likely to have had recurrent wheeze compared with those not exposed (adjusted HR 3.8, 95% CI 1.3 to 10.7). Mean birth month NO2was significantly higher among the recurrent wheeze category compared with those without wheeze. NO2and PM2.5were associated with a 2%–4% adjusted increased wheezing risk.

Conclusion

Control of exposure to ETS and biomass fuels in the antenatal period is likely to delay the onset of recurrent wheeze in children from birth to 48 months.
Epidemiology of childhood interstitial lung disease in France: the RespiRare cohort
Authors: Fletcher Camille , Hadchouel Alice , Thumerelle Caroline , Mazenq Julie , Fleury Manon , Corvol Harriet , Jedidi Nouha , Benhamida Myriam , Bessaci Katia , Bilhouee Tiphaine , Borie Raphael , Brouard Jacques , Cantais Aurélie , Clement Annick , Coutier Laurianne , Cisterne Camille , Cros Pierrick , Dalphin Marie-Laure , Delacourt Christophe , Deneuville Eric , Dubus Jean-Christophe , Egron Carole , Epaud Ralph , Fayon Michael , Forgeron Aude , Gachelin Elsa , Galode François , Gertini Isabelle , Giovannini-Chami Lisa , Gourdan Pierre , Guiddir Tamazoust , Herzog Audrey , Houdouin Véronique , Hullo Églantine , Jarreau Pierre-Henri , Labbé Guillame , Labouret Géraldine , Ladaurade Alice , Le Clainche Viala Laurence , Marguet Christophe , Masson-Rouchaud Alexandra , Perisson Caroline , Rames Cinthia , Reix Philippe , Renoux Marie-Catherine , Roditis Léa , Schweitzer Cyril , Tatopoulos Aurélie , Trioche-Eberschweiler Pascale , Troussier Françoise , Vigier Clémentine , Weiss Laurence , Legendre Marie , Louvrier Camille , de Becdelievre Alix , Coulomb Aurore , Sileo Chiara , Ducou le Pointe Hubert , Berteloot Laureline , Delestrain Céline , Nathan Nadia
Published: July 2024

Introduction

Interstitial lung disease in children (chILD) are rare and mostly severe lung diseases. Very few epidemiological data are available in limited series of patients. The aim of this study was to assess the prevalence and incidence of chILD in France.

Methods

We performed within the RespiRare network a multicentre retrospective observational study in patients with chILD from 2000 to 2022 and a prospective evaluation of chILD’s incidence between February 2022 and 2023.

Results

chILD was reported in 790 patients in 42 centres. The estimated 2022 prevalence in France was 44 /million children (95% CI 40.76 to 47.46) and the computed incidence was 4.4 /million children (95% CI 3.44 to 5.56). The median age at diagnosis was 3 months with 16.9% of familial forms. Lung biopsy and genetic analyses were performed in 23.4% and 76.9%, respectively. The most frequent chILD aetiologies in the <2 years group were surfactant metabolism disorders (16.3%) and neuroendocrine cell hyperplasia of infancy (11.8%), and in the 2–18 years group diffuse alveolar haemorrhage (12.2%), connective tissue diseases (11.4%), hypersensitivity pneumonitis (8.8%) and sarcoidosis (8.8%). The management included mainly oxygen therapy (52%), corticosteroid pulses (56%), oral corticosteroids (44%), azithromycin (27.2%), enteral nutrition (26.9%), immunosuppressants (20.3%) and hydroxychloroquine (15.9%). The 5-year survival rate was 57.3% for the patients diagnosed before 2 years and 86% between 2 and 18 years.

Conclusion

This large and systematic epidemiological study confirms a higher incidence and prevalence of chILD than previously described. In order to develop international studies, efforts are still needed to optimise the case collection and to harmonise diagnostic and management practices.
Trauma centers: an underfunded but essential asset to the community
Authors: Fracasso Joseph L , Ahmed Nasim
Published: July 2024

Research indicates that specialized trauma centers, especially those of level I and II designation, can generate revenue if financial support is provided, and most importantly provide better outcomes for an injured patient by reducing length of stay and mortality when compared with treatment at hospitals without trauma center designation.

Costs associated with trauma center operation have risen over the past few years in association with growing patient volumes and inflation. Documentation regarding costs for trauma center operations is sparse, and there exists a large variance between reported numbers based on their region. In most cases, the greatest proportion of funds are spent on clinical personnel while the smallest fraction is dedicated to educational and prevention programs. Studies confirm that as a product of these rising costs and a lack of state and federal funding that trauma centers remain uniquely financially vulnerable.

Multiple strategies have been implemented to mitigate these costs but have proven insufficient. Legislations providing patients with expanded access to healthcare such as the Affordable Healthcare Act have failed to deliver on their intended purposes, and managed care organizations have moved to protect their own interest at the expense of trauma patient mortality. In lieu of concerted federal support, states and municipalities have explored solutions to support trauma centers such as small fees added to fines or encouraging charitable donations, although these programs have not seen ubiquitous implementation. Most trauma centers have begun incorporating activation costs to recoup losses from their low reimbursement rate, but these have continued to inflate, and pose a growing burden on vulnerable patients.

Lack of funding from external sources such as state or federal appropriations poses a tangible threat to trauma centers for closure, and with multiple trauma centers acting as critical pillars of healthcare infrastructure for disadvantaged communities as well as the impact of this lack of funding being so broad and systemic, multiple ‘trauma deserts’ may emerge, leaving communities—especially disadvantaged communities which rely on the safety-net function of many high designation trauma centers—deprived of an essential treatment resource and increasing annual mortalities that could have otherwise been averted.
Genomic regions underlying variation in wattles, horns, and supernumerary teats phenotypes in Egyptian goats
Authors: Sallam Ahmed M.
Published: July 2024

Goats play a crucial role in providing humans with various types of valuable products including milk and meat. The underlying genetic mechanisms of important morphological aspects remain largely unknown in goats, highlighting the need for further investigation. A genome-wide association analysis (GWAS) was conducted for three morphological phenotypes in Egyptian goats. All animals were genotyped using the Illumina 65 K SNP BeadChips. Results of GWAS for wattles identified two significant ( P ≤ 1.4 × 10–6, false discovery rate (FDR) ≤ 0.05) single nucleotide polymorphisms (SNPs) on chromosome 10 within a region (72–74 Mb) containing FMN1 and GREM1 genes that are important for limb development and growth. For horns, three significant SNPs were identified on chromosome 1 (119–131 Mb) harbouring candidate genes for embryonic development and tissue differentiation, such as CEP70, DZIP1L, CLDN18, SOX14, and SLC35G2. For supernumerary teats, four significant SNPs located on chromosomes 25 (8.7 Mb), 9 (47.8 Mb), 17 (45.1 Mb), and 28 (6.7 Mb) were identified, harbouring candidate genes involved in morphogenesis and reproductive traits such as EMP2, MDN1, PCDH10, and GHITM. This study identified novel candidate genes alongside previously reported ones in other goat breeds, suggesting their potential as candidate genes for the studied traits in Egyptian goats.
A test for the redshift dependence of $$\sigma _8$$ using $$f\sigma _8$$ measurements
Authors: Manna Siddhant , Desai Shantanu
Published: July 2024

We search for a redshift dependence of $$\sigma _8^0$$

σ
8
0

using 23 growth rate measurements from redshift space distortions and peculiar velocity measurements as a consistency check of $$\Lambda $$
Λ
CDM. For this purpose we use the dataset from Sagredo et al. (Phys Rev D 98:083543, 2018) consisting of 22 measurements, which has been vetted for internal consistencies. Eighteen of these measurements have been obtained from the Gold-2017 sample, collated from multiple redshift space distortion surveys between 2009 and 2016, whereas the remaining four have been obtained from the eBOSS DR14 quasar survey. We also added one additional data point from the BOSS DR12 CMASS galaxy sample. We find that for this dataset the $$\sigma _8^0$$

σ
8
0

values are consistent between the low redshift and high redshift samples using three different redshift cuts. This implies that the growth rate measurements are consistent with a constant $$\sigma _8^0$$

σ
8
0

in accord with $$\Lambda $$
Λ
CDM, assuming there are no uncontrolled systematics in this dataset.