bluuebunny/crossref_metadata_2025 huggingface dataset:
The Burden of Hepatitis B and C in Asia, 1990–2019: An Update Analysis From the Global Burden of Disease Study 2019
Authors: Chen Qi , Huang Shu , Peng Jieyu , Wang Ping , Shi Xiaomin , Luo Rui , Xu Huan , Zhang Wei , Shi Lei , Peng Yan , Yuan Fangfang , Tang Xiaowei
Published: January 2025

Aim

This research was aimed to uncover the hepatitis B virus (HBV) and hepatitis C virus (HCV) related diseases burden in Asia over the past 3 decades, estimating from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.

Methods

Age‐standardised rates, case numbers of prevalence, disability‐adjusted life‐years (DALYs), incidence and deaths with 95% uncertainty intervals (UI) for HBV/HCV‐related diseases from 1990 to 2019 were derived from GBD 2019 database, with the estimated annual percentage changes (EAPCs) calculated. Our analysis also encompassed the association between the Sociodemographic Index (SDI) and the burden of HBV/HCV‐related diseases, future disease burden predictions in six selected countries and various risk factors.

Result

A general downward trend in the age‐standardised rates of death, disability‐adjusted life years (DALYs), prevalence and incidence for both HBV and HCV‐related diseases was observed in Asia during the past 30 years. Despite overall declining trends, some analysed diseases experienced an increase. Compared with females, the disease burden was greater in the male population and peaked in the age of 50–54 for both sexes. It is significant for the HBV‐related and HCV‐related diseases burden in Afghanistan, Cambodia, Mongolia and Pakistan. Drug use and smoking were prominent contributors to HCV and HBV‐related diseases. There was a negative relationship between the burden of HCV and HBV‐related diseases and SDI.

Conclusion

Although decreases were observed in Asia, the HBV‐ and HCV‐associated diseases burden remained high, highlighting that imperative measures for prevention and treatment should be taken by governments in Asia.
Imperial uses of non‐territorial autonomy: The projects of André Mandelstam and Boris Nolde
Authors: Khripachenko Tatiana
Published: January 2025

The article explores imperial uses of non‐territorial autonomy in the works of international lawyers André Mandelstam and Boris Nolde, which they wrote before the collapse of the Russian Empire. Although written in different contexts, their projects for non‐territorial autonomy departed from other similar plans proposed in the Russian Empire. Rather than an attempt to secure the status and the interests of ethno‐national groups within the framework of a multinational state, they pursued the goal of imperial domination and regarded the rights of minorities as a pretext for imposing limitations on other states (or states in the making). The project of André Mandelstam was a part of Russia's Plan of Reforms for the Ottoman Empire produced in 1913/1914, which aimed to protect its Armenian population, yet severely restricted the sovereignty of the Sultan. Written in July 1917, Boris Nolde's project developed the programme of the Constitutional Democratic Party on the national question. He was particularly concerned with the recognition of Ukrainian national‐territorial autonomy by the Provisional Government. For him, non‐territorial autonomy was an instrument of undermining the claims of the Ukrainian national movement and retaining control over Ukraine.
Editorial comment on “Immunomodulatory metabolites in IgE‐mediated food allergy and oral immunotherapy outcomes based on metabolomic profiling”
Authors: Jimenez Martha , Martí‐Castellote Celia , Leung Agnes Sze Yin , Eigenmann Philippe
Published: January 2025

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A Rapid and Reversible Molecular “Switch” Regulating Protein Expression in Chlamydomonas reinhardtii
Authors: Li Xinyi , Wang Song , Li Qianyi , Li Xiangyu , Lin Sirao , Zhao Wenyu , Liu Yingqi , Wu Bowen , Huang Ying , Jia Bin , Hu Zhangli
Published: January 2025

Chlamydomonas reinhardtii, a prominent chassis in synthetic biology, faces limitations in regulating the expression of exogenous genes. A destabilization domain (DD)/Shield‐1 system, originally derived from mammals, offers a ligand‐dependent control of stability, making it a valuable tool. This system utilises the destabilization domain to induce rapid degradation of target protein unless stabilised by Shield‐1, a synthetic ligand. Upon the addition of Shield‐1,the degradation is halted, leading to the accumulation and stabilisation of the target protein. This system has demonstrated successful regulation of foreign protein expression in mammals, parasites, and plants. In this study, the DD/Shield‐1 system was harnessed to regulate the expression of the paromomycin resistance gene and luciferase encoding gene in Chlamydomonas, revealing its capability for rapid, stable, and reversible protein expression regulation in microalgae, serving as a molecular switch. Furthermore, this regulation exhibits reagent dependency, enhancing its applicability in practical production. A strain with induced expression of the gene‐editing protein, LbCas12a, was successfully constructed and then tested for gene editing. The findings not only enrich the toolkit for Chlamydomonas molecular studies but offer a promising technique for regulating the expression and validating the functionality of exogenous proteins in microalgae.
Effects of transcranial photobiomodulation on fine motor skills in boccia para‐athletes
Authors: de Morais Garcez Edna , Baptista Alessandra , Hamblin Michael R. , Suzuki Selly S. , Garcez Aguinaldo , Nunez Silvia Cristina , Navarro Ricardo S. , Bassoto Thamiris , Garcez Aguinaldo Silva
Published: January 2025

This study investigated the effects of transcranial photobiomodulation (t‐PBM) on para‐athletes' manual dexterity and intralimbal coordination. Six para‐athletes from a Boccia Team participated. t‐PBM was administered using a LED helmet with 204 LEDs (660 and 850 nm) emitting 10 mW each, delivering 9 J/cm2 per LED during 15‐min sessions three times a week. The trial lasted 2 weeks, with baseline, placebo treatment, and post‐treatment assessments. Manual dexterity was measured by Box and Ball Test (BBLT), and intralimbal coordination by discrete and continuous horizontal and vertical touch tests. Results showed significant improvements in manual dexterity for the t‐PBM group compared to the placebo. Discrete vertical touch tests showed reduced time to perform movements, and continuous vertical touch tests showed increased movement frequency in the t‐PBM group. No significant improvements were observed in the placebo group. t‐PBM was shown to be a potentially effective treatment, with significant benefits in fine motor skills.
Cartesian know‐how
Authors: Morales Carbonell Felipe , González Rodrigo
Published: January 2025

In this article, we examine the prospect of extracting an account of know‐how from Descartes's philosophy. Against the traditional take, we argue that Descartes's views on know‐how cannot be simply reduced to his account of theoretical knowledge. The key to understanding Descartes on know‐how is to examine his accounts of moral certainty and the relation between the mind and the body in action.
From human to superhuman: the impact of the microbiome on physiology
Authors: Keely Stephen J. , Cotter Paul D. , Wahlstrom Annika , Schellekens Harriët , Weinkove David , Barrett Kim E.
Published: January 2025

The complex microbial community residing in the human gut has long been understood to regulate gastrointestinal physiology and to participate in digestive diseases, but its extraintestinal actions and influences are increasingly recognized. This article discusses bidirectional interactions between the gut microbiome and athletic performance, metabolism, longevity and the ability of the gut–brain axis to influence cognitive function and mental health.

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Enhancement of Synchronization in Nonlinear MEMS Oscillator Based on Electrothermal Adjustment
Authors: Xiao Zunhao , Shi Zhan , Wang Xuefeng , Chuang Kuo-Chih , Lv Qiangfeng , Wei Xueyong , Huan Ronghua
Published: January 2025

Synchronization in microelectromechanical systems (MEMS) typically encounters the impact of electrothermal phenomena, often in conjunction with piezoresistive detection or frequency tuning. However, the electrothermal effects on synchronization have not been previously explored. This paper investigates the electrothermal effects on synchronization bandwidth and frequency stability in a nonlinear MEMS arch oscillator. Experimental results demonstrate a non-monotonic pattern in synchronization bandwidth as electrothermal current increases, corroborated by theoretical models based on quality factors and equivalent nonlinearity. Drawing from theoretical analysis, which suggests that synchronization can be enhanced by adjusting feedback and perturbation strength, we achieved a 5.72-fold enhancement in synchronization bandwidth in our experiments. Furthermore, we observed that increased electrothermal significantly improves frequency stability. We developed a model based on the Allan deviation that incorporates electrothermal temperature to evaluate frequency stability, and this model successfully verified our experimental results. These experimental and theoretical findings highlight the potential of electrothermal effects to enhance synchronization and frequency stability in MEMS devices, paving the way for more robust sensor technology applications.
Localized surface plasmon resonance of Ag nanoparticle thin films deposited by direct-current magnetron sputtering
Authors: Kusano Eiji
Published: January 2025

This study investigates the localized surface plasmon resonance (LSPR) of Ag nanoparticle (NP) thin films deposited by magnetron sputtering on an alkaline-free aluminosilicate-glass substrate at a substrate temperature of 600 °C. The equivalent film thickness was controlled to be 5, 10, 20, and 50 nm by adjusting the deposition time. The deposited Ag thin films formed NPs with uniform diameter and spacing for all Ag thicknesses. The NP diameters ranged approximately from 16 to 88 nm, corresponding to the equivalent film thickness. Due to the formation of isolated NPs, all Ag thin films exhibited a singlet LSPR peak in their extinction spectra. The LSPR peak position in the extinction spectra shifted with the refractive index of the environmental solvent media when the Ag NP thin films were immersed in these media. In addition, the insertion of a MgO, Nb2O3, or TiO2 underlayer shifted the LSPR peak position in the extinction spectra according to the refractive index of each underlayer material. A peak shift corresponding to the refractive index of the environmental solvent media was also observed for Ag NP thin films deposited on underlayers. The relatively low sensitivity of the LSPR peak shift to the refractive index of the environmental solvent media suggests that the solvent media only covered the top surface of the Ag NPs distributed on the substrate but did not infiltrate the spaces between them. The results of this study demonstrate the applicability of sputter-deposited Ag NP thin films to solid LSPR devices.
Rescue-like behavior in a bystander mouse toward anesthetized conspecifics promotes arousal via a tongue-brain connection
Authors: Cao Peng , Liu Ying , Ni Ziyun , Zhang Mingjun , Wei Hong-Rui , Liu An , Guo Jin-Rong , Yang Yumeng , Xu Zheng , Guo Yuyu , Zhang Zhi , Tao Wenjuan , Wang Likui
Published: January 2025

Prosocial behaviors are advantageous to social species, but the neural mechanism(s) through which others receive benefit remain unknown. Here, we found that bystander mice display rescue-like behavior (tongue dragging) toward anesthetized cagemates and found that this tongue dragging promotes arousal from anesthesia through a direct tongue-brain circuit. We found that a direct circuit from the tongue → glutamatergic neurons in the mesencephalic trigeminal nucleus (MTN
Glu
) → noradrenergic neurons in the locus coeruleus (LC
NE
) drives rapid arousal in the anesthetized mice that receive the rescue-like behavior from bystanders. Artificial inhibition of this circuit abolishes the rapid arousal effect induced by the rescue-like behavior. Further, we revealed that glutamatergic neurons in the paraventricular nucleus of the thalamus (PVT
Glu
) that project to the nucleus accumbens shell (NAcSh) mediate the rescue-like behavior. These findings reveal a tongue-brain connection underlying the rapid arousal effects induced by rescue-like behavior and the circuit basis governing this specific form of prosocial behavior.
Evidence for transpression in the Picuris orogen: The deformation record of the Marqueñas Formation metaconglomerate, Picuris Mountains, New Mexico, USA
Authors: Bonamici Chloë , Sulthaus Danielle
Published: January 2025

The most recent models for the Mesoproterozoic (ca. 1.5−1.35 Ga) Picuris-Baraboo-Pinware orogeny call on transpression resulting from oblique, diachronous convergence at the southern margin of Laurentia to explain the patterns of deformation and magmatism along this transcontinental belt. The Marqueñas Formation metaconglomerate provides a rare opportunity to directly study the strain and kinematics of deformation within the intraplate Picuris segment of the orogen. Statistical analysis of deformed quartzite pebble and boulder dimensions shows ﬂattening strain at the outcrop to map scale (kilometers to meters). Quartz crystallographic preferred orientation (CPO) records a combination of flattening and non-coaxial shear at the intraclast scale (millimeters to micrometers). Kinematic vorticity axes, determined by crystallographic vorticity analysis on quartzite clasts, are well preserved despite widespread static recrystallization and align with principal strain axes determined from quartz CPO. The compatibility of strain and kinematic vorticity data indicates that flattening was produced in progressive, 3-D general shear. Outcrop-scale and map-scale structural relations link Marqueñas Formation ﬂattening strain to oblique slip, with components of north-directed thrusting and dextral shear, on the Plomo-Pecos shear zone. Quartz ﬂattening CPO yields predominantly crossed-girdle c-axis ﬁgures with opening angles of 69°−92° and a mean of 80°. Quartz c-axis opening angle thermometry yields deformation temperatures of 601 ± 50 °C, suggesting that ﬂattening was synchronous with prograde to peak metamorphism during the second phase of deformation (D2) in the Picuris Mountains. We conclude that flattening of the Marqueñas Formation records inclined transpression within the Picuris orogen, consistent with oblique convergence along the Mesoproterozoic Laurentian plate margin.
Supplemental Material: Substantiating the Paleozoic sedimentary record of the tectonic transition from a passive to an active continental margin along the eastern margin of Eurasia
Authors: Sun Ningchen , al. et
Published: January 2025

Figures S1–S3 and Tables S1 and S2.
Congenital cytomegalovirus pneumonia presents as pleural effusion in infancy
Authors: Rajvanshi Nikhil , Yadav Taruna , Kumar Prawin , Goyal Jagdish Prasad
Published: January 2025

Cytomegalovirus (CMV) infection is one of the most common congenital infections. We present a case of an infant who presented with respiratory distress since birth with a normal antenatal history. The infant had bilateral pleural effusion. He was malnourished with a small head. Chest auscultation revealed bilateral diffuse crepitation. The chest radiograph showed diffuse haziness with the interstitial pattern. Contrast-enhanced CT of the thorax showed diffuse areas of ground glass opacities with peribronchial thickening and patchy atelectasis in bilateral lower lobes. Detailed evaluation showed positive IgM CMV antibodies with >1000 copies/mL of CMV on urinary PCR. Hearing evaluation revealed bilateral moderate hearing loss.

This case emphasises that CMV may present as pneumonitis at birth. Early diagnosis and treatment are of paramount importance in such cases, as it can prevent permanent end-organ damage.
Gemcitabine-induced myositis in a patient with pancreatic cancer
Authors: Rubnitz Zach , Nevala-Plagemann Chris , Florou Vaia , Garrido-Laguna Ignacio
Published: January 2025

Gemcitabine, a cytosine analogue, is a cytotoxic agent commonly used in the treatment of patients with a variety of solid tumours, including non-small cell lung cancer, cholangiocarcinoma and breast, pancreatic, testicular and ovarian cancers. Although generally well-tolerated, several reports suggest that it can rarely cause myositis. We present a case of gemcitabine-induced myositis in a patient with pancreatic adenocarcinoma and review the literature on this topic.
Atypical presentation of gouty tophi in a resource-limited setting
Authors: Mwakyula Issakwisa Habakkuk , Mbwile Gloria Reginald , Torres Liset M , Chaula Baraka Michael
Published: January 2025

A man in his early 50s from Tanzania presented with chronic nodular skin lesions and joint pain, likely due to gout complicated by obesity, after over 15 years of misdiagnosis and ineffective treatment. Despite various therapies for leprosy, tuberculosis and steroid use, his condition worsened, leading to hyperglycaemia and significant financial strain. Missed opportunities to use simple, low-cost diagnostic tests such as ultrasound and examining nodule fluid for urate crystals led to delays in diagnosis. Instead, unnecessary tests were performed, increasing costs without aiding diagnosis. This case highlights the need to use simple, available diagnostic tests in resource-limited settings before relying on costly investigations that can impose a heavy financial burden on patients. Likewise, it emphasises recognising atypical presentations of gouty tophi, such as isolated soft tissue involvement without joint involvement.
Current and projected incidence rates of pancreatic cancer in 43 countries: an analysis of the Cancer Incidence in Five Continents database
Authors: Shou Songting , Liu Rui , He Jie , Jiang Xiaochen , Liu Fudong , Li Yi , Zhang Xiyuan , En Geer , Pu Zhiqing , Hua Baojin , Pang Bo , Zhang Xing
Published: January 2025

Objective

The aetiology of pancreatic cancer is complex, and there is limited research on its incidence. We aimed to investigate the incidence trends of pancreatic cancer in 43 countries and predict trends up to 2030.

Methods

The annual incidence of pancreatic cancer was obtained from the Cancer Incidence in Five Continents database, which comprises 108 cancer registries from 43 countries. Based on available data, we calculated age-standardized incidence rates (ASRs) per 100 000 people for 1988–2012. A Bayesian age-period-cohort model was used to predict the number of new cases and incidence rates up to 2030.

Results

From 1988 to 2012, the global incidence rate of pancreatic cancer showed a continuously increasing trend, with the ASR increasing from 5.89 in 1988 to 6.78 in 2012, representing an overall average annual percentage change of 8.45%. This increasing trend is expected to persist in most selected countries, whereas a few countries are projected to exhibit a declining trend by 2030.

Conclusion

It appears that the future global incidence of pancreatic cancer is on the rise, but the rate of increase varies among different countries, with some showing a declining trend.
Acceptance of multiple micronutrient supplementations (MMS) and iron and folic acid supplement utilisation among pregnant and lactating women in the rural part of Ethiopia, 2022: a cross-sectional study
Authors: Abebe Finina , Kidanemariam Yordanos Tadesse , Tsegaw Menen , Birhanu Zewdie , Abdi Ahmednasir , Chitekwe Stanley , Sharma Rachana , Getachew Hiwot , Noor Ramadhani , Aden Asli Hassan , Chuko Tesfaye , Dejene Tariku , Dawd Ahmed Mohammed
Published: January 2025

Objective

To assess the acceptance of multiple micronutrient supplements and current iron and folic acid supplement utilisation among pregnant and lactating women in rural Ethiopia.

Design

Community-based cross-sectional study using a mixed method.

Setting

This study was carried out in five regions (Oromia, Gambela, Sidama, SNNPR (Southern Nations, Nationalities and Peoples Region) and Somali) of Ethiopia, 2022. A multistage random sampling technique was employed. A structured questionnaire was used to collect data from 410 pregnant and lactating women. A purposive sampling technique was used to select participants for the five Focused Group Discussions and fifteen Key Informant Interviews. Both bivariable and multivariable logistic regression analysis was conducted with a p value<0.05, and a 95% CI was considered statistically significant. Qualitative data were coded and analysed thematically.

Participants

A total of 410 pregnant and lactating women.

Results

The overall level of iron-folic acid utilisation was 59.3%. The odds of using iron-folic acid among pregnant and lactating women in the Sidama region are significantly lower compared with Oromia (adjusted OR (AOR)=0.12, 95% CI: 0.04, 0.38). Lactating women have significantly lower odds of using iron-folic acid compared with pregnant women (AOR=0.09, 95% CI: 0.05, 0.17). Taking medication or supplements significantly increases the odds of iron-folic acid use (AOR=2.41, 95% CI: 1.16, 4.95). Recommending a new nutrition supplement significantly increases the odds of iron-folic acid use (AOR=2.38, 95% CI: 1.21, 4.68).

Conclusions

The consumption of iron-folic acid supplements among pregnant and lactating women in Ethiopia is lower than in other studies. Factors associated with iron-folic acid utilisation include region, taking medication/supplements, recommending nutrition and being a lactating mother. To ensure accessibility, the product should be sold in all town shops, pharmacies and through home delivery. Additionally, a strategy should be developed to provide access to the product in each adjacent community centre. Awareness creation should be a priority for community members to avoid misconceptions about pregnancy-related supplements.
IoC2 monitoring versus standard practice in reducing opioid consumption in elderly patients undergoing laparoscopic colorectal surgery: a study protocol for a randomised controlled trial
Authors: Li Zhe , Cai Huamei , Yan Yun , Liu Xiaowen , Zhao Jing
Published: January 2025

Introduction

Nociception monitoring has recently gained recognition as a valuable tool for guiding intraoperative opioid administration. Several nociception monitors, including the Surgical Pleth Index, the Index of Consciousness (IoC) and the Nociception Level, have been introduced for managing intraoperative analgesia. While these technologies show promise in initial applications, the effectiveness of IoC2 in guiding pain management during anaesthesia, particularly in elderly patients who require precise opioid use, remains unclear. This study aims to evaluate the effectiveness of IoC2 in guiding intraoperative opioid use in elderly patients.

Methods and analysis

We will conduct a prospective, randomised, controlled, single-blind, single-centre study with recruitment carried out from 1 February to 30 November 2025. Patients will be randomly assigned to either the IoC2 group or the control group. In the IoC2 group, sufentanil dosing will be guided by intraoperative IoC2 measurements, while in the control group, it will be guided by haemodynamic parameters. The primary outcome will be to compare intraoperative sufentanil consumption between the two groups to assess the potential role of IoC2 in optimising perioperative analgesia in elderly patients.

Ethics and dissemination

This study has been approved by the ethics committee of China-Japan Friendship Hospital (2024-KY-148-3) and registered in the Chinese Clinical Trial Registry (ChiCTR2400089115). The findings will be disseminated through academic presentations and peer-reviewed journal publications, providing valuable data and insights into the role of IoC2 in guiding intraoperative pain management.

Trial registration number

ChiCTR2400089115.
Using an app for COVID-19 contact tracing costs less per person traced than manual tracing: microcosting analysis of a randomised trial in Cameroon
Authors: Songane Mario , Tchakounte Youngui Boris , Mambo Albert , Bonabe Georges , Djikeussi Tatiana , Epee Emilienne , Tsigaing Philippe Narcisse , Ndongo Marie Louise Aimée , Mayap Njoukam Christelle , Kana Rogacien , Tenkeu Sylvain Zemsi , Simo Leonie , Kouatchouang Adrienne Vanessa , Machekano Rhoderick , Zoung-Kanyi Bissek Anne-Cecile , Tchendjou Patrice , Tiam Appolinaire , Guay Laura , Suleiman Khairunisa , Akinwusi Olukunle , Kadam Rigveda , Akugizibwe Paula , Mukherjee Sushant , Woelk Godfrey , Tchounga Boris
Published: January 2025

Introduction

SARS-CoV-2 contact tracing in Cameroon has been done manually using paper forms and phone calls. However, there were reports of inaccurate contact details, resulting in delays in identifying and testing contacts. A recently introduced digital contact-tracing module using the Mamal Pro app automatically sends SMS messages to notify all reported contacts and the district unit. We assessed the total costs, cost per contact reached, tested and found SARS-CoV-2-positive for both manual (standard of care, SOC) and app-based (intervention, ITV) contact-tracing approaches.

Methods

A cluster randomised trial comparing the SOC and ITV was implemented across eight health districts in Cameroon between October 2022 and March 2023. The cost per contact reached, tested and found SARS-CoV-2-positive was calculated by dividing the total cost of each approach by the number of contacts reached, tested and found SARS-CoV-2-positive, respectively. We also estimated the minimum number of SARS-CoV-2-positive contacts that need to be found and the maximum total cost of ITV in order to equal the SOC’s cost per SARS-CoV-2-positive contact.

Results

In the SOC, of 849 contacts identified, 463, 123 and 5 were reached, tested and found SARS-CoV-2-positive, respectively. In the ITV, of the 854 contacts identified, 801, 182 and 4 were reached, tested and found SARS-CoV-2-positive, respectively. In the SOC, the cost per contact reached was US$70, per contact tested was US$262 and per SARS-CoV-2-positive contact was US$6437. In the ITV, the cost per contact reached was US$48, per contact tested was US$210 and per SARS-CoV-2-positive contact was US$9573. The minimum number of SARS-CoV-2-positive contacts the ITV needs to find and the maximum total cost of the ITV to equal the SOC’s cost per SARS-CoV-2-positive were 6 and US$25 748, respectively.

Conclusion

Using the Mamal Pro digital contact tracing app module increased the number of clients’ contacts reached and tested for SARS-CoV-2 and reduced the cost per contact reached and tested.

Trial registration number

NCT05684887.
Exceeding the limits of paediatric heat stress tolerance: the risk of losing a generation to climate inaction
Authors: Azan Alexander , Nyimbili Sulani , Babayode Oyinkansola O , Bershteyn Anna
Published: January 2025

Greenhouse gas (GHG) emissions are creating unprecedented climate-driven extreme weather, with levels of heat and humidity surpassing human physiological tolerance for heat stress. These conditions create a risk of mass casualties, with some populations particularly vulnerable due to physiological, behavioural and socioeconomic conditions (eg, lack of adequate shelter, limited healthcare infrastructure, sparse air conditioning access and electrical grid vulnerabilities). Children, especially young children, are uniquely vulnerable to extreme heat-related morbidity and mortality due to factors including low body mass, high metabolism, suboptimal thermoregulatory mechanisms and behavioural vulnerabilities. Children are also uniquely vulnerable to non-fatal heat-related morbidities, including malnutrition due to agricultural disruptions and cardiometabolic, respiratory and mental illnesses from heat exposure and/or confinement during heat avoidance. Climate mitigation through GHG reductions is central to reducing harms to children and preventing the loss of a generation to climate change. In regions most predisposed to extreme heat-driven mass casualties under various GHG emission scenarios—particularly South Asian and Southwest Asian and North African regions—adaptation tools specific to children’s needs are the most urgently needed. Existing public health interventions (eg, cooling infrastructure and preventative educational campaigns) to reduce acute heat mortality, and medical infrastructure capacity to treat heat-related illnesses are currently inadequate to meet children’s growing heat resiliency needs. Paediatricians and other clinical and community child healthcare providers in these regions lack education about children’s heat risks and adaptation tools. Paediatricians and other child healthcare providers have a crucial role in research, education, clinical practice and advocacy to protect children during extreme heat events. Paediatricians, other child healthcare providers and stakeholders of children’s well-being are urged to act on young children’s behalf and to elevate youth leadership in GHG mitigation and extreme heat adaptation policy-making.
Retrospective cross-sectional study on bronchiectasis in adult Aboriginal Australians: disease characteristics and comparison with ethnically diverse global bronchiectasis registry cohorts
Authors: Heraganahally Subash , Gibbs Claire , J Ravichandran Shiidheshwar , Erdenebayar Davaadorj , Chen Winnie , Abeyaratne Asanga , Jersmann Hubertus , Jayaram Lata , Howarth Timothy
Published: January 2025

Background

Globally, adult Indigenous people, including Aboriginal Australians, have a high burden of chronic respiratory disorders, and bronchiectasis is no exception. However, literature detailing bronchiectasis disease characteristics among adult Indigenous people is sparse. This study assessed the clinical profile of bronchiectasis among adult Aboriginal Australians and compared against previously published international bronchiectasis registry reports.

Methods

Aboriginal Australians aged >18 years with chest CT confirmed bronchiectasis between 2011 and 2020 in the Top End Northern Territory of Australia were included. Demographics, chest CT findings, pulmonary function results, sputum microbiology, coexistent medical comorbidities, and pharmacotherapy use were assessed and compared against five published international bronchiectasis registry reports (Australian (ABR), European (European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC)-Europe), Indian (EMBARC-India), Korean (KMBARC) and the USA (USBRR)).

Results

A total of 459 patients were assessed. In comparison with international and non-Aboriginal Australian national cohorts, Aboriginal Australians were younger (median 56 years (IQR (48, 65)); however, sex distribution (55% female) and body mass index (23 kg/m2(IQR 19.4–27)) were comparable . Smoking rates were higher at 85% compared with other registry cohorts (22–46%) as was the prevalence of comorbidities (97%): cardiovascular diseases (73%), diabetes mellitus (50%) and chronic obstructive pulmonary disease (83%) compared with other registry cohorts (4–32%; 6–14%; and 14–37%, respectively). Spirometry demonstrated forced expiratory volume in 1 s of 38% predicted in comparison with 61–77% in other cohorts. Sputum microbiology showedHaemophilus influenzae(57%) isolated at 3.4 to 6 times the rate of other registry cohorts andPseudomonas aeruginosain 31%. Chest CT demonstrated multilobar and lower lobes involvement in 73% and inhaled pharmacotherapy use was recorded in up to 62% and long-term antibiotics in 5%.

Conclusion

The overall bronchiectasis disease burden is higher in Aboriginal Australian adults in comparison with global ethnically diverse non-Indigenous populations. Further efforts are required to address this disparity secondary to bronchiectasis among Indigenous people.
Effect of home environment on neuropsychiatric development in preterm infants discharged from NICU at 18 months corrected age
Authors: Tian Yuan , Zhang Chuncao , Liu Feng , Hong Xia , Shen Li , Chen Jinjin , Jiang Haifeng
Published: January 2025

Background

There have been numerous intervention studies focusing on the development of preterm infants, but there has been limited investigation into the home environment as a determinant of developmental outcomes in preterm infants. The aspects and extent to which the home environment affects the early (18 months corrected age) neuropsychological development of preterm infants are still unclear.

Aims

This study aimed to analyse the effect of the home environment on the neuropsychiatric development of preterm infants at 18 months corrected age after discharge from the neonatal intensive care unit (NICU). It also sought to provide a basis for promoting neuropsychiatric development among preterm infants by improving the home environment.

Methods

In this retrospective cross-sectional study, 275 preterm infants born between January 2019 and January 2022 were followed up for systematic management after discharge from the NICU at Shanghai Children’s Hospital. The Home Nurture Environment Questionnaire was used to assess the home environment of the infants and analyse its impact on the developmental quotient (evaluated by the Gesell Developmental Scale) and the rate of developmental delays at 18 months corrected age.

Results

A total of 41.454% of the infants were extremely preterm. The developmental quotient scores at 18 months corrected age were in the middle of the scale. The language domain had the highest rate of developmental delay (46.182%), followed by the adaptive domain (37.091%). Multiple logistic regression analyses showed that compared with infants in supportive home environments, infants with moderate/unsupportive home environments had significantly elevated risks of development delay: 2.162-fold for global (odds ratio (OR) 2.162, 95% confidence interval (CI) 1.274 to 3.665, p=0.004), 2.193-fold for fine motor (OR 2.193, 95% CI 1.161 to 4.140, p=0.016), 2.249-fold for language (OR 2.249, 95% CI 1.336 to 3.786, p=0.002) and 2.042-fold for personal-social (OR 2.042, 95% CI 1.149 to 3.628, p=0.015).

Conclusions

A supportive home environment is a crucial protective factor for the neuropsychological development of preterm infants. It is associated with higher developmental quotient scores and protects against neuropsychiatric delays. Incorporating evaluation and continuous improvement of the home environment into the management framework for preterm infants to promote optimal neurodevelopment is essential.
Prognostic role of con-/discordant coronary flow reserve and microvascular resistance in coronary microvascular disease: a systematic review and network meta-analysis
Authors: Al-Gully Jin , Oliveri Federico , Forouzanfar Jessica Parisa , Montero-Cabezas Jose Manuel , Jukema Johan Wouter , den Haan Melina Cynthia , Al Amri Ibtihal , Bingen Brian Oscar
Published: January 2025

Background

Coronary microvascular disease (CMD) is defined as impaired coronary flow reserve (CFR) and/or increased microvascular resistance (MR) without significant epicardial coronary stenosis. This definition allows for discordant CFR and MR values within patients with CMD. The aim of this meta-analysis is to characterise the prognostic value and pathophysiological backgrounds of CFR and MR con-/discordance.

Methods

A systematic search (PROSPERO CRD42024573004) identified studies determining CFR and MR in patients without significant epicardial coronary artery disease. Patients were divided into four groups: (1) normal CFR and MR, (2) abnormal CFR and MR, (3) abnormal CFR with normal MR and (4) normal CFR with abnormal MR and analysed for all-cause mortality and major adverse cardiovascular events (MACE).

Results

We identified four studies representing 2310 total participants. Group B had the highest MACE (OR: 3.23; 95% CI 1.95 to 5.36) and mortality rate (OR: 2.27; 95% CI 1.12 to 4.58) compared with group A. Group C, associated with female sex, showed significantly higher MACE (OR: 2.07; 95% CI 1.25 to 3.45) but not mortality (OR: 1.89; 95% CI 0.92 to 3.88) compared with group A. In group D, associated with high body mass index, MACE and mortality rates did not differ significantly from group A (OR: 1.19; 95% CI 0.67 to 2.11 and OR: 0.55; 95% CI 0.16 to 1.90, respectively).

Conclusions

Abnormal CFR and MR are associated with a high risk of MACE and death. Abnormal CFR and normal MR are associated with an increased MACE—but not death. MACE and mortality risk in discordantly normal CFR and abnormal MR are low. Our findings show the need for tailoring CFR and MR diagnostic thresholds to patient characteristics and raise questions about the presence of CMD in patients with abnormal MR with normal CFR.
Systolic blood pressure response during exercise testing in symptomatic severe aortic stenosis
Authors: Nilsson Henric , Bellander Carl , Carlén Anna , Nylander Eva , Hedman Kristofer , Tamás Éva
Published: January 2025

Aims

Exercise testing remains underused in patients with aortic stenosis (AS), partly due to concerns about an exercise-induced drop in systolic blood pressure (SBP). We aimed to study the SBP response to exercise in patients with severe symptomatic AS prior to surgery and 1 year postoperatively.

Methods

Patients scheduled for aortic valve replacement due to severe symptomatic AS were enrolled at a single centre in a prospective observational cohort study. Maximal cardiopulmonary exercise testing (CPET) was performed on a cycle ergometer at baseline and 1 year postoperatively, using standard termination criteria. The SBP response was categorised according to the last measurements of SBP during exercise, in relation to workload (the SBP/watt-slope) as ‘normal’ (>0.25 mm Hg/watt), ‘flat’ (0–0.25 mm Hg/watt) or ‘drop’ (<0 mm Hg/watt).

Results

45 patients (28 male, 66±9 years, left ventricular ejection fraction 59%±5%, aortic jet velocity 4.6±0.5 m/s) were included, with pairwise comparison available in 31 cases. There were no adverse events. Preoperatively, 4/45 patients were categorised as ‘drop’, 23 as ‘flat’ and 18 as ‘normal’. There was a change in the distribution of categories from preoperative to postoperative measurements (43% ‘normal’ vs 74% ‘normal’, p=0.0046). Maximal SBP and workload-indexed SBP were higher postoperatively than preoperatively (203±26 vs 182±28 mm Hg, p<0.001 and 0.43±0.14 vs 0.29±0.15 mm Hg/watt, p<0.001).

Conclusion

As a drop in SBP was infrequent (<10%) in patients with severe symptomatic AS and no adverse events occurred, our results indicate that CPET may be performed under careful monitoring in AS patients. Postoperatively, the SBP reaction improved, with no patient having a drop in SBP.

Trial registration number

NCT02790008.
Temporal order of atrial fibrillation and acute myocardial infarction and associated prognosis in the Danish Diet, Cancer and Health cohort
Authors: Frederiksen Tanja Charlotte , Christiansen Morten Krogh , Benjamin Emelia J , Olsen Anja , Jensen Henrik Kjærulf , Dahm Christina C
Published: January 2025

Background

Atrial fibrillation (AF) and acute myocardial infarction (AMI) share risk factors and are bidirectionally associated. Several studies found higher risks of outcomes in individuals with both conditions. Whether the risks of outcomes differ according to temporal order of AF and AMI is unclear.

Methods

The study was based on the Danish Diet, Cancer and Health cohort. We assessed the risk of heart failure (HF), ischaemic stroke (IS) and all-cause mortality during 10 years of follow-up in participants with both AF and AMI compared with only one and according to the temporal order of AF and AMI in participants with both conditions.

Results

We identified 5816 participants with newly diagnosed AF only, 3448 with first AMI only, 348 with AF before AMI and 721 participants with AMI before AF. The multivariable-adjusted risks of HF, IS and all-cause mortality were higher among participants with both AF and AMI compared with participants with only AF or AMI. In participants with both, there was no difference in risk of HF (HR 0.92, 95% CI 0.72 to 1.17) or IS (HR 1.12, 95% CI 0.76 to 1.66) between participants with AF before AMI compared with AMI before AF. AMI before AF was associated with lower all-cause mortality compared with AF before AMI (HR 0.70, 95% CI 0.54 to 0.90).

Conclusions

Risks of adverse outcomes were higher among participants with both AF and AMI compared with only AF or AMI. All-cause mortality, but not risk of HF or IS, differed according to temporal order with a lower mortality among participants with AMI before AF.
Efficacy of lactoferrin supplementation in pediatric infections: A systematic review and meta-analysis
Authors: Mayorga Valerie S. , Navarro Rafaella , Torres Roldan Victor D. , Urtecho Meritxell , Tipe Silvia , Calvert Bea , Wright Laura A. , Ochoa Theresa J.
Published: January 2025

Pediatric infections account for approximately one-third of all deaths in children under 5 globally. Lactoferrin (LF) supplementation has the potential to reduce infection-related morbidity due to its antimicrobial, anti-inflammatory and immunoregulatory properties. We conducted a systematic review and meta-analysis of oral LF supplementation randomized controlled trials (RCT) in population under 18 years old. The primary outcomes were infection-associated outcomes: late onset sepsis (LOS), diarrhea, and upper respiratory infections (URI). We also analyzed mortality among LOS studies. Of 1,594 citations identified, 25 studies met eligibility criteria, including 10 studies of LOS, 14 of diarrhea and 8 of URI. LF supplementation was associated with fewer patients with culture-proven or probable neonatal LOS compared to placebo (OR: 0.60; 95% CI: 0.42 to 0.86), with fewer patients with diarrhea compared to placebo in children (OR: 0.56; 95% CI: 0.41 to 0.75), and no significant fewer patients with URI (OR: 0.61; 95% CI: 0.27 to 1.40). Before LF can be used as a public health intervention, it is necessary to refine some aspects of the design of future trials. Ideally these trials should be conducted in countries with the highest burden of infections, where the potential benefit is expected to have the largest impact.
Improving smuon searches with neural networks
Authors: Cornell Alan S. , Fuks Benjamin , Goodsell Mark D. , Ncube Anele M.
Published: January 2025

We demonstrate that neural networks can be used to improve search strategies, over existing strategies, in LHC searches for light electroweak-charged scalars that decay to a muon and a heavy invisible fermion. We propose a new search involving a neural network discriminator as a final cut and show that different signal regions can be defined using networks trained on different subsets of signal samples (distinguishing low-mass and high-mass regions). We also present a workflow using publicly-available analysis tools, that can lead, from background and signal simulation, to network training, through to finding projections for limits using an analysis and libraries to interface network and recasting tools. We provide an estimate of the sensitivity of our search from Run 2 LHC data, and projections for higher luminosities, showing a clear advantage over previous methods.
The Science of Nanostructure Acoustic Vibrations
Authors: Wright Cameron , Hartland Gregory V.
Published: January 2025

Ultrafast excitation of nanoparticles can excite the acoustic vibrational modes of the structure that correlate with the expansion coordinates. These modes are frequently seen in transient absorption experiments on metal nanoparticle samples and occasionally for semiconductors. The aim of this review is to give an overview of the physical chemistry of nanostructure acoustic vibrations. The issues discussed include the excitation mechanism, how to calculate the mode frequencies using continuum mechanics, and the factors that control vibrational damping. Recent results that demonstrate that the high frequencies inherent to the acoustic modes of nanomaterials trigger a viscoelastic response in surrounding liquids are also discussed, as well as vibrational coupling between nanostructures and mode hybridization within the nanostructures. Mode hybridization provides a way of manipulating the lifetimes of the acoustic modes, which is potentially useful for applications such as mass sensing.
Comprehensive Assessment of Rapeseed Meal as a Fish Meal Substitute in Hybrid Sturgeon (Acipenser schrenckii ♀ × Acipenser baerii ♂) Diets: Impacts on Growth Performance, Body Composition, Immunological Responses, Intestinal Histology, and Inflammatory Response
Authors: Zhang Wenpeng , Liu Siyuan , Wang Shidi , Wang Huamin , Ge Kaibo , Yang Yuhong , Lu Shaoxia , Han Shicheng , Jiang Haibo , Wang Chang’an , Liu Hongbai
Published: January 2025

This study aimed to assess the impact of incorporating rapeseed meal (RM) as a partial substitute for fish meal (FM) in the diet of cultured hybrid sturgeon (Acipenser schrenckii ♀ × Acipenser baerii ♂). A total of 450 juvenile hybrid sturgeon with similar weights were randomly assigned to five dietary groups, each with triplicates of 30 fish per tank. For 12 weeks, FM was replaced with varying percentages of RM (0%, 25%, 50%, 75%, and 100%). Results indicated a decreasing trend in final body weight (FBW), weight gain, and survival rates (SRs) as the ratio of RM increased. Growth performance was less affected when the substitution ratio of FM was below 50%. The replacement of FM with RM showed a decreasing trend in crude protein and ash content of sturgeon body composition and no significant effect on moisture and crude lipid content (p > 0.05). Essential amino acids (EAAs) in whole fish, such as methionine (Met), threonine (Thr), and lysine (Lys), increased with higher substitution rates (p > 0.05). The lysozyme (LZM) activities in the pyloric cecum, duodenum, and valve intestine of the sturgeon showed a decreasing trend (p > 0.05). Nevertheless, at a 50% substitution level, sturgeon liver superoxide dismutase (SOD) and malondialdehyde (MDA) activities reached their peak. At 100% substitution, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities were significantly higher than in other groups (p < 0.05). At 50% substitution, sturgeon valve intestinal protease activity reached its maximum, and the duodenal villus height (VH) was not significantly different from that of the control group (morphological and structural indices were lower in the treatment groups). Gene expression of pro‐inflammatory factors IL‐1β, IL‐6, IL‐8, and TNF‐α increased with the substitution ratio, while anti‐inflammatory factor IL‐10 showed the opposite trend. NF‐κB and myeloid differentiation factor 88 (MyD88) expression increased with substitution ratio, and Toll‐like receptor 1 (TLR1) and Toll‐like receptor 2 (TLR2) showed the opposite trend in the intestine. The results of this study suggest that replacing less than 50% of fishmeal with RM in hybrid sturgeon diets can reduce the amount of fishmeal used without compromising fish health.
Vitreous Hemorrhage in Posterior Uveal Melanocytoma: Two Case Reports
Authors: Yeager Lauren B. , Li Chloe Y. , Bogolmony Dmitry , Debelenko Larisa , Marr Brian P.
Published: January 2025

Purpose: We describe the diagnostic challenge by melanocytomas originating from locations other than the optic nerve.

Methods: This is a retrospective case report of two patients who presented with vitreous hemorrhage with underlying melanocytomas.

Results: Both patients had hemorrhage obscuring indeterminant uveal masses; fine‐needle aspiration biopsies confirmed melanocytoma with necrosis and atypia and, in one case, concern for malignant transformation.

Conclusion: Melanocytomas are rare, benign melanocytic lesions that resemble nevi. In contrast to optic nerve melanocytoma, those involving the choroid and ciliary body lack specific clinical characteristics. Vitreous hemorrhage is an underrecognized complication, and uveal melanocytoma must be included in the differential diagnosis of vitreous hemorrhage with associated ciliary body or choroidal mass. Biopsy is required for definitive diagnosis and to identify malignant transformation of the lesion, a rare but possible occurrence.