bluuebunny/crossref_metadata_2025 huggingface dataset:
2747 The impact of specialised geriatric 5 M education on mobilisation of older adult patients in acute care in five Canadian hospitals
Authors: Peterson J , Faig K , Yetman L , Robertson C , Flanagan K , Prosser J , Feltmate P
Published: January 2025

Background and Objectives

Research suggests that specialised education for nurses decreases frailty and improves functionality in hospitalised older adults. This study explored the impact of a specialised geriatric education program on mobilisation rates for older adult patients in acute care in 5 hospitals.

Methods

A mixed methods approach with pre- and post- intervention questionnaires (Geriatric In-hospital Nursing Care Questionnaire (Ger-INCQ) and study specific knowledge assessment) was used to explore facilitators and challenges of caring for older adults, the knowledge base and experiences of staff, and the impact of providing specialised education. Acute care nursing staff participated in a 4-hour education intervention focusing on the Geriatric 5Ms(Mind, Mobility, Medications, Multi-complexity and Matters Most) and frailty prevention. Patient level data was collected through mobility audits (I-MOVE) and observation of shift handover communication. Semi-structured interviews with staff were completed to explore the results of the questionnaires.

Results

Registered nurses, licensed practical nurses and personal care attendants (N = 64, Mean age = 36.9, 87% female) who participated in the specialised training did not show significant change in their assessment scores. Patient (N = 99, mean age = 76.2, 54.5% female) mobilisation did not differ between phases of intervention (p = 0.08), nor was there any significant change in reporting mobility at shift handover. Ger-INCQ indicated neutral responsibility for falls incidents and retention of patient mobility, with interviews (n = 26) revealing that patients are kept immobilised for safety and workload management.

Conclusion

Staff had positive attitudes towards caring for older adults; however, their understanding and application of geriatric principles were limited and remained unchanged. Interview participants stated their work environment limits their capacity to deliver the best practice care presented in the education sessions. These findings suggest that education alone is unlikely to influence prioritisation of mobility for frail older adults in a strained acute care setting.
Research on the provincial-level centralized function of integrating neural networks with electricity billing data analysis
Authors: Zhao Fangchu , Su Xin , Lu Xiaoxiao , Si Feiya , Lang Lingling , Sun Wenlei
Published: January 2025

This paper proposes a provincial-scale system integrating neural networks with electricity rate data analysis to enhance prediction accuracy and anomaly detection efficiency while ensuring user privacy. At its core is the electric rate analysis neural network (EANN), which combines LSTM and GCN to effectively capture the temporal dynamics of billing data and the relational structure among users. The system also introduces a privacy protection scheme based on personalized federated learning for secure cross-regional analysis. Experiments show that EANN improves prediction accuracy by 2.3% and reduces computational latency by 6.3% compared to traditional CNN–LSTM methods.
Plasmids encode and can mobilize onion pathogenicity in Pantoea agglomerans
Authors: Shin Gi Yoon , Asselin Jo Ann , Smith Amy , Aegerter Brenna , Coutinho Teresa , Zhao Mei , Dutta Bhabesh , Mazzone Jennie , Neupane Ram , Gugino Beth , Hoepting Christy , Khanal Manzeal , Malla Subas , Nischwitz Claudia , Sidhu Jaspreet , Burke Antoinette Machado , Davey Jane , Uchanski Mark , Derie Michael L , du Toit Lindsey J , Stresow-Cortez Stephen , Bonasera Jean M , Stodghill Paul , Kvitko Brian
Published: January 2025

Pantoea agglomerans is one of four Pantoea species reported in the USA to cause bacterial rot of onion bulbs. However, not all P. agglomerans strains are pathogenic to onion. We characterized onion-associated strains of P. agglomerans to elucidate the genetic and genomic signatures of onion-pathogenic P. agglomerans. We collected >300 P. agglomerans strains associated with symptomatic onion plants and bulbs from public culture collections, research laboratories, and a multi-year survey in 11 states in the USA. Combining the 87 genome assemblies with 100 high-quality, public P. agglomerans genome assemblies we identified two well-supported P. agglomerans phylogroups. Strains causing severe symptoms on onion were only identified in Phylogroup II and encoded the HiVir pantaphos biosynthetic cluster, supporting the role of HiVir as a pathogenicity factor. The P. agglomerans HiVir cluster was encoded in two distinct plasmid contexts: 1) as an accessory gene cluster on a conserved P. agglomerans plasmid (pAggl), or 2) on a mosaic cluster of plasmids common among onion strains (pOnion). Analysis of closed genomes revealed that the pOnion plasmids harbored alt genes conferring tolerance to Allium thiosulfinate defensive chemistry and many harbored cop genes conferring resistance to copper. We demonstrated that the pOnion plasmid pCB1C can act as a natively mobilizable pathogenicity plasmid that transforms P. agglomerans Phylogroup I strains, including environmental strains, into virulent pathogens of onion. This work indicates a central role for plasmids and plasmid ecology in mediating P. agglomerans interactions with onion plants, with potential implications for onion bacterial disease management.
Cross-border child abduction from the UK: comparative analysis of Polish and Lithuanian court cases
Authors: Limante Agne , Wysocka-Bar Anna
Published: January 2025

This article provides a comprehensive analysis of court cases related to parental child abduction addressed by Polish and Lithuanian courts, with a particular focus on those involving the UK. It aims to shed light on the legal complexities and challenges inherent in resolving such cases, particularly in relation to the interpretation and application of the 1980 Hague Convention on International Child Abduction in national legal systems. For this purpose, the article analyses court judgements rendered by Polish and Lithuanian courts over a 5-year period, from 2019 to 2023. By doing so, it seeks to uncover recurring patterns and trends in judicial decision-making processes and highlight any noticeable discrepancies and inconsistencies in legal proceedings. The article not only contributes to the academic discourse in this field but also offers practical insights for legal professionals dealing with cross-border child abduction cases.
Session 3: Beginning to Tackle Avoidance of Trauma Cues, Mindfulness (Part II)
Authors: Beck J. Gayle
Published: January 2025

This chapter explains how clients can utilize mindfulness to tackle their avoidance of trauma cues. Developing mindfulness skills can also help clients get more out of the Group CBT program, as they will be better able to absorb the material and use the new knowledge to their benefit. The chapter explains how exposure represents a powerful tool to reduce distress from trauma-related cues and outlines the best ways for clients to learn about their cues. Clients will be working with exposure at their own pace. The chapter outlines the rules for exposure, which include factors for gauging distress and the importance of repetition of exposure.
Mental Health Nursing Skills
Authors: Callaghan Patrick , Dickinson Tommy , Felton Anne
Published: January 2025

The second edition of Mental Health Nursing Skills is an evidence-based, user-friendly, practical textbook designed so students and newly qualified nurses can develop and apply the skills required for compassion-focused, inclusive, effective, evidence-based, contemporary mental health nursing practice. The book balances theory and practice with clear sections on evidence, step-by-step guidance, and practical examples of essential skills, clearly showing the student and newly qualified nurse what to do and why. Written by world-leading mental health nursing academics, clinicians, researchers, and people with lived experience of mental health care, the book reflects the art, science, and craft of mental health nursing. The authors have expanded the content to add new topics and updated existing chapters to reflect current practice, policy, and essential professional competencies. Thus, students and newly qualified nurses can be assured that their practice is rigorous. Like the first edition, the new edition of Mental Health Nursing Skills is accompanied by free online resources that provide students and lecturers with interactive resources to develop and practice the skills discussed in the text.
Building your psychotherapy skills
Authors: Rinaldi Matthew
Published: January 2025

Dreams are an opportunity to build an increasingly complex understanding of training patients. They can be understood as interpretations in themselves, encoded messages, a picture of the inner world, and a transference communication. In this chapter, these ways of understanding dreams are explained and a hierarchical, step-wise process for working with dreams is suggested, particularly focusing on affect. Some suggestions are made for promoting dream activity and how patients might work with their dreams between sessions.
Addressing discretization-induced bias in demographic prediction
Authors: Dong Evan , Schein Aaron , Wang Yixin , Garg Nikhil
Published: January 2025

Racial and other demographic imputation is necessary for many applications, especially in auditing disparities and outreach targeting in political campaigns. The canonical approach is to construct continuous predictions—e.g. based on name and geography—and then to often discretize the predictions by selecting the most likely class (argmax), potentially with a minimum threshold (thresholding). We study how this practice produces discretization bias. For example, we show that argmax labeling, as used by a prominent commercial voter file vendor to impute race/ethnicity, results in a substantial under-count of Black voters, e.g. by 28.2% points in North Carolina. This bias can have substantial implications in downstream tasks that use such labels. We then introduce a joint optimization approach—and a tractable data-driven threshold heuristic—that can eliminate this bias, with negligible individual-level accuracy loss. Finally, we theoretically analyze discretization bias, show that calibrated continuous models are insufficient to eliminate it, and that an approach such as ours is necessary. Broadly, we warn researchers and practitioners against discretizing continuous demographic predictions without considering downstream consequences.
Transcription factors HmeWRKY33 and HmeWRKY51 regulate the susceptibility of pitaya to canker disease
Authors: Luo Rongzheng , Zhang Rong , Chen Jiaxuan , Peng Shujun , Sabir Irfan Ali , Li Zhaoqing , Wu Liangfang , Hu Guibing , Shah Kamran , Qin Yonghua
Published: January 2025

Pitaya canker disease, caused by Neoscytalidium dimidiatum, is the primary threat to pitaya cultivation, significantly compromising fruit quality and reducing yield. WRKY transcription factors are essential regulators in plant pathogen recognition and defense mechanisms, yet their specific roles in the development of pitaya canker disease remain largely unexplored. In this study, five genes (HmeWRKY33, HmeWRKY51, HmePR1, HmeHsp70, and HmeSERK) associated with pitaya canker disease were identified through RNA-Seq analysis. The expression levels of HmeWRKY33 and HmeWRKY51 were upregulated following N. dimidiatum infection. Transient transformation revealed that these five genes negatively influenced the resistance of Nicotiana benthamiana leaves to canker disease, while promoting the accumulation of reactive oxygen species (ROS) and inducing cell death. Yeast one-hybrid and dual-luciferase reporter assays revealed that HmeWRKY33 directly activated the expression of HmeSERK, while HmeWRKY51 directly inhibited the expression of HmePR1 and HmeHsp70, co-participating in regulating the susceptibility of ‘Youcihuanglong’ pitaya to canker. These findings provide a theoretical basis for breeding new canker-resistant pitaya varieties through genetic transformation.
High-impact Chronic Pain in a Cohort of Urologic Chronic Pelvic Pain Syndrome Patients
Authors: Wang Tianyi , Bergmans Rachel , Minc Alexa , Krieger John , Harris Richard E. , Lai Henry H. , Clemens J. Quentin , Harte Steven E. , Kaplan Chelsea , Williams David A. , Naliboff Bruce , Gallop Robert , Till Sara , Schrepf Andrew
Published: January 2025

Objectives:

An emerging concept in the chronic pain literature, high-impact chronic pain (HICP), refers to pain that occurs very frequently and results in major disruption of daily life. Previous epidemiologic investigations have noted that lower educational attainment, age, and race appear to be associated with the frequency of HICP, but condition-specific investigations of HICP have been less common.

Methods:

Here we investigate HICP status and its clinical/demographic correlates in the Multidisciplinary Approach to the study of chronic Pelvic Pain research network Symptom Pattern Study.

Results:

Participants were 476 urologic pelvic pain syndrome (UCPPS) patients, 64% of whom were female. Of these, 22% were classified as having HICP, based on responses to the several questions about pain interference in daily life. We confirmed that African-American individuals and those with lower educational attainment were more likely to experience HICP (both P<0.05). Additionally, those with HICP demonstrated much greater levels of disability, genitourinary pain, urinary symptoms, widespread pain, pelvic floor tenderness, and were more likely experience pain in response to consuming standardized amounts of water (all P<0.05). Binary logistics regression showed that genitourinary pain, widespread pain, and race were the strongest prediction of pain in multivariate models. Furthermore, HICP status was associated with more self-reported healthcare utilization over the subsequent 18 months (P<0.05).

Discussion:

These findings suggest that HICP affects more than 1 out of 5 UCPPS patients, with significant associated morbidity. Demographic and clinical characteristics associated with HICP may be useful for identifying at-risk UCPPS patients.
The Correlation Between Gender, Age, Curvature, and Symptom-related Changes in C6 and C7 Slope in 10,000 Subjects
Authors: Sha Zongshuo , Yang Xue , Ran Yu , Liu Yixing , Qin Zerui , Xu Lin , Mu Xiaohong , Li Jinyu , Quan Lei , Chen Jiang , Han Dongran
Published: January 2025

Study Design.

A cross-sectional analysis of 10,000 cervical spine X-rays.

Objective.

This study investigates the variations in C6S and C7S across demographic factors (gender, age, cervical curvature, symptoms) and explores their correlation. Additionally, machine learning models are applied to improve the accuracy of C7S prediction.

Summary of Background Data.

The C7S is crucial for assessing cervical balance but is often limited by visibility issues. This study uses a large sample to validate the feasibility of the C6S as a substitute for C7S across diverse populations with varying ages, genders, symptoms, and cervical curvatures.

Methods.

A retrospective study was conducted on 10,000 subjects who underwent cervical sagittal X-ray imaging. Four orthopedic specialists labeled key points, which were cross-validated, and an algorithm was then used to measure C6S and C7S. Pearson correlation coefficients were calculated to assess the relationship between C6S and C7S, and linear regression derived a predictive equation for C7S. Various machine learning models were compared to improve C7S prediction accuracy.

Results.

The average angles for C6S and C7S were 15.4° (16.8° in males, 14.7° in females) and 19.1° (21.1° in males, 18.2° in females), respectively, with C7S generally larger than C6S, except in Sigmoid 1 curvature. Males exhibited higher values for both C6S and C7S, and both slopes increased after age 20. Both angles increased significantly with age from 20 to 90 years. A strong positive correlation was found between C6S and C7S (r>0.75, P<0.001), confirmed by linear regression (R²=0.688). Among the machine learning models, both Ridge Regression and Linear Regression performed better than the others, with R²=0.855 in predicting C7S.

Conclusion.

The strong correlation between C6S and C7S suggests that C6S can substitute for C7S when visibility is limited. Machine learning models further enhance prediction accuracy, demonstrating promising clinical potential.
Staged versus Simultaneous Surgery for Adult Spinal Deformity – A Systematic Review and Meta-analysis
Authors: Verma Aman , Bondarde Parshwanath , Kumar Anil , Sethy Siddharth Sekhar , Jain Aakash , Abrol Vibhor , Ahuja Kaustubh , Kandwal Pankaj
Published: January 2025

Study Design.

Systematic review and meta analysis.

Objective.

To assess the safety and efficacy of staged versus same-day spinal fusion surgeries in Adult spinal deformity (ASD).

Background.

ASD surgeries are associated with high complication rates, ranging from 10% to 40%. Among the strategies to enhance safety, staging the procedure into two smaller procedures has been evaluated as an effective alternative.

Methods.

A systematic literature review following PRISMA guidelines was conducted using PubMed, Cochrane, Scopus, and Embase. Studies comparing staged and same-day spinal fusion for ASD were included. Perioperative data, patient-reported outcomes (ODI, SRS), radiological outcomes, and complication rates were analysed. The extracted data was analyzed and forest plots were generated to draw comparisons between the staged and the same day groups.

Results.

Eleven studies, including 1323 patients (541 staged, 782 same-day) were analyzed. Staged surgeries were associated with longer operative time and length of hospital stay. There was no significant difference in estimated blood loss, clinical and radiological outcomes, or overall complication rates between groups. However, venous thrombo-embolism (VTE) rates were significantly higher in staged surgeries (odds ratio=4.33). In the staged group, surgical site infections was the most common complication with a rate of 10.5%, whereas neurological complications were the most frequent group of complications in same-day group.

Conclusion.

Staged surgeries for ASD result in longer operative time, length of hospital stay and increased VTE risk but show similar efficacy in clinical and radiological outcomes compared to same-day surgeries. Careful patient selection is crucial to balance risks and optimize outcomes in ASD surgical planning.
Mobile Phone Application to Support Self-care for Portuguese Patients With Type 2 Diabetes
Authors: LeSeure Peeranuch , Chin Elizabeth , Vieira MaryBeth , Zhang Shelley
Published: January 2025

Diabetes disproportionately affects certain racial and ethnic groups, including the Portuguese American population, one of the largest ethnic groups in the United States. Despite their substantial presence, the unique challenges and needs of this population in managing diabetes have been overlooked. Lacking cultural sensitivity poses challenges in providing adequate healthcare. No studies have investigated developing diabetes mobile applications specifically for Portuguese American users. This study aimed to use the design thinking methodology to develop a culturally appropriate diabetes mobile application for Portuguese Americans with type 2 diabetes. Phase 1 of the three phases of this study, presented in this article, aimed to understand users’ needs and preferences in adopting mobile apps to improve diabetes self-care. The results demonstrate that most participants expressed a positive attitude toward using mobile apps. They suggested five crucial instruments to be included in the mobile application to promote diabetes self-care: blood glucose monitoring, weight tracking, carbohydrate counting, an exercise log, and medication reminders. They emphasized the importance of cultural sensitivity, including incorporating traditional Portuguese dietary choices into the mobile application. These findings inform the subsequent phases of this study, ensuring that the prototype application is culturally sensitive and tailored to the specific needs of the Portuguese American population.
HPV vaccine hesitancy in the United States
Authors: Joshi Riya , Kilinsky Alexandra
Published: January 2025

Purpose of review

Human papillomavirus (HPV) is the most common STI and accounts for roughly 37 000 HPV-associated cancers annually in the United States. Despite documented safety and effectiveness of the HPV vaccine, vaccination rates should be higher. We summarize literature surrounding vaccine hesitancy, a main reason for suboptimal vaccine coverage. We aim to describe the complex factors that lead to hesitancy in order to support improvement of vaccination rates in our communities.

Recent findings

Studies document sustained immunogenicity and effectiveness 10 years post HPV vaccination. Vaccine coverage was rising until 2022, when initiation declined. Primary reasons for hesitancy are: perceived lack of provider recommendation, a lack of parental knowledge and necessity especially if an adolescent is not sexually active, and safety concerns. The COVID-19 pandemic challenged access to care and exacerbated vaccine-related discourse. Studies of hesitant adopters reveal that social processes, including conversations with community members, have a substantial impact on decisions to vaccinate.

We highlight recent literature behind parental hesitancy toward the HPV vaccine, focusing on concerns about its necessity and safety, exacerbated by medical mistrust and misinformation. We summarize findings of successful educational outreach and community-based interventions to improve vaccination rates in the postpandemic social media era.
Trends in mortality and disparities in dilated cardiomyopathy across gender, race, and region in the United States (1999-2020)
Authors: Ashraf Taimoor , Abunada Omar , Kumar Aashish , Ahmed Saboor , Ali Siddiqui Muhammad Basit , Memon Umer , Dev Shah , Meghjiani Aashish , Turesh Muskan , Khatri Govinda , Rai Aneesh , Manan Abdul , Deepak Fnu , Kumar Mukesh , Yusuf Salih Abdella , Siddiq Mohammad Arham , Haseeb Abdul , Shafique Muhammad Ashir
Published: January 2025

Background:

Dilated cardiomyopathy (DCM) is a significant contributor to heart failure and sudden cardiac death in the United States. Understanding mortality trends associated with DCM is crucial to inform healthcare strategies and policy interventions to mitigate its burden.

Objectives:

This study aimed to assess temporal trends in DCM-related mortality in the United States from 1999 to 2020, including an analysis of age-adjusted mortality rates (AAMRs), annual percent changes (APCs), and disparities across gender, racial/ethnic, geographic, and urbanization categories.

Methods:

A retrospective observational study was conducted using data from the CDC WONDER database. DCM-related mortality was identified using the ICD-10 code I42.0. The study population included individuals in the United States with DCM listed as a contributing or primary cause of death from 1999 to 2020. AAMRs were calculated and standardized to the U.S. 2000 standard population. Joinpoint regression analysis was used to evaluate trends and calculate APCs and subgroup analyses were conducted to assess disparities.

Results:

From 1999 to 2020, 168 702 deaths were attributed to DCM. The overall AAMR declined significantly from 9.33 per 100 000 individuals in 1999 to 6.61 in 2020 (APC: −3.43%, 95% CI: −4.09 to −2.70; P < 0.001). Males exhibited higher mortality rates (AAMR: 3.4) compared to females (AAMR: 1.5), with gender disparities persisting throughout the study. Blacks/African Americans and residents of the Western region experienced slower mortality declines compared to other groups. Geographic disparities were evident, with the Northeast showing the most significant drop (APC: −4.32%). In recent years, heart transplantation and advancements in Left Ventricular Assist Devices (LVADs) have significantly improved outcomes for end-stage DCM patients.

Conclusions:

While DCM-related mortality declined significantly, persistent gender, racial, and regional disparities highlight the need for targeted interventions. The evolving role of heart transplantation and LVADs underscores the importance of equitable access to advanced therapies to reduce DCM-related mortality further.
Knowledge, attitude, and practice of medical students toward Mpox in Saudi Arabia: a cross-sectional study
Authors: Peer-Zada Feham , Mahmoud Hadil , Rahman Heba , Abdulmowla Ola Muwafak , Mohamed Shaimaa , Raziq Tehreemah , Sajjad Maryam , Arai Momo , Dahman Huda , Naimi Hamna Waseem , Shibl Atef , Dirar Qais
Published: January 2025

Background:

Public health awareness is critical for preventing transmission of the Mpox virus, which is considered as a Public Health Emergency of International Concern by the WHO.

Objectives and methods:

We used a cross-sectional study across different academic phases to assess the knowledge, attitude, and practice of medical students at a Saudi university regarding Mpox.

Results:

Our data revealed that 84% of participants across all academic phases demonstrated poor knowledge of Mpox (score <13), with an average knowledge score of 8.58 out of 20. The widest knowledge gap was observed in 64% of respondents who were unaware of the Mpox misnomer, 73% not knowledgeable about the course of Mpox symptoms, and 68% unaware of the Mpox vaccine. About 72% of the respondents reported poor public awareness, but 57% expressed willingness to comply with preventative measures. Only 10% of our population did not adopt any proactive precautionary measures, and 65% were willing to get vaccinated against Mpox if made available in Saudi Arabia.

Conclusion:

Our findings revealed a general lack of adequate knowledge of Mpox symptoms, transmission, and vaccine options. We emphasize the need for greater public engagement through awareness campaigns and educational programs to mitigate the spread of this infectious disease.
A rare case of Takayasu arteritis with aortic dissection in a young male patient presented with hypertensive urgency
Authors: Pudasaini Kshitiz Raj , Ghimire Moniska , Basnet Prava , Shrestha Bikesh , Thapa Shovit , Shrestha Sheetal
Published: January 2025

Introduction and importance:

Takayasu arteritis (TA) is a granulomatous, large vessel inflammation characterized by occlusion, stenosis or aneurysm of the aorta and its branches. Aortic dissection (AD) is one of the rare manifestations of TA, which can present as uncontrolled hypertension. This case illustrates the severe rare cardiovascular complication that arises in a 21-year male patient with TA, including hypertensive urgency, AD and significant renal artery involvement.

Case presentation:

A 21-year-old male presented with complaints of fever, malaise and dizziness. On clinical examinations, a discrepancy in blood pressure was noted in bilateral arms. All the laboratory parameters were within normal limits. Echocardiography confirmed moderate concentric hypertrophy with Grade II diastolic dysfunction and a preserved ejection fraction. To rule out secondary causes of hypertension, an arterial Doppler was done, which showed features of renal artery stenosis and stenosis in the descending aorta. CTA revealed an intimal tear/dissection in the thoracoabdominal aorta consistent with Stanford Type B AD.

Clinical discussion:

Based on clinical presentation and imaging findings, large vessel vasculitis such as TA or giant cell arteritis (GCA) was suspected. Later, TA was diagnosed using the 2022 American College of Rheumatology/EULAR classification criteria for TA. The patient had rapid symptomatic improvement using antihypertensive drugs, corticosteroids and immunosuppressants.

Conclusion:

This explains rare manifestation of TA in a young male patient with normal inflammatory markers and underlying AD with hypertensive urgency. In those suspected with TA, screening for life threatening conditions such as AD should be done.
Experiences of Birthing Individuals Receiving Perinatal Behavioral Health Care in the Military Health System and Civilian Care With TRICARE Insurance
Authors: Wyatt Brelahn , Vereen Rasheda J. , Ryals Teri R. , Blevins Erin M. , Haischer-Rollo Gayle , Drumm Caitlin M. , Spalding Carmen N. , Plowden Torie C. , Fuller Shara M. , Musilli Megan G. , Konopasky Abigail , Lutgendorf Monica A.
Published: January 2025

OBJECTIVE:

To explore birthing individuals' experiences of mental health care in the Military Health System or through TRICARE insurance.

METHODS:

We conducted a qualitative study. This was an IRB-approved protocol for individuals who delivered within the previous 5 years at military treatment facilities or with TRICARE insurance at civilian hospitals and were recruited for semi-structured qualitative interviews from February 2023 to June 2023. Interviews focused on participants' experiences of care during pregnancy, delivery, and the postpartum period. Purposive and snowball sampling was used to ensure diverse participation. Interviews were recorded and transcribed with deductive coding, and themes were identified until saturation was reached.

RESULTS:

Thirty-one individuals completed interviews, with 12 main themes identified: importance of support from their obstetric clinician and colleagues, importance of mental health check-ins during pregnancy, challenges accessing care, feelings of dismissiveness regarding mental health needs, inadequate assessment of symptoms, curtailing of symptoms and situational stress, lack of postpartum care, waiting extended periods for postpartum visits, privacy concerns leading to the concealment of symptoms to avoid documentation, concern for the adverse effect on careers, and support from doulas and support groups postpartum. A common theme included the need to improve screening for depression and anxiety.

CONCLUSION:

These results indicate varied perinatal mental health care experiences. Some individuals had supportive care, whereas others experienced delays and challenges accessing care despite having universal insurance. Opportunities to improve perinatal behavioral health care include timely access and expanding support programs.
Energy-based modelling of single actin filament polymerization using bond graphs
Authors: Gawthrop Peter J. , Pan Michael , Rajagopal Vijay
Published: January 2025

Bond graphs provide an energy-based methodology for modelling complex systems hierarchically; at the moment, the method allows biological systems with both chemical and electrical subsystems to be modelled. Herein, the bond graph approach is extended to include chemomechanical transduction thus extending the range of biological systems to be modelled. Actin filament polymerization and force generation is used as an example of chemomechanical transduction, and it is shown that the
TF
(transformer) bond graph component provides a practical, and conceptually simple, alternative to the Brownian ratchet approach of Peskin, Odell, Oster and Mogilner. Furthermore, it is shown that the bond graph approach leads to the same equation as the Brownian ratchet approach in the simplest case. The approach is illustrated by showing that flexibility and non-normal incidence can be modelled by simply adding additional bond graph components and that compliance leads to non-convexity of the force–velocity curve. Energy flows are fundamental to life; for this reason, the energy-based approach is utilized to investigate the power transmission by the actin filament and its corresponding efficiency. The bond graph model is fitted to experimental data by adjusting the model physical parameters.
The plausibility of origins scenarios requiring two impactors
Authors: Anslow R. J. , Bonsor A. , Rimmer P. B. , Rae A. S. P. , McDonald C. H. , Walton C. R.
Published: January 2025

Hydrogen cyanide delivered by cometary impactors can be concentrated as ferrocyanide salts, which may support the initial stages of prebiotic chemistry on the early Earth. One way to achieve the conditions required for a variety of prebiotic scenarios, requiring, for example, the formation of cyanamide and cyanoacetylene, is through the arrival of a secondary impactor. In this work, we consider the bombardment of the early Earth, and quantitatively evaluate the likelihood of origins scenarios that invoke double impacts. Such scenarios are found to be possible only at very early times (>4 Gya), and are extremely unlikely settings for the initial stages of prebiotic chemistry, unless (i) ferrocyanide salts are stable on 1000 yr timescales in crater environments, (ii) there was a particularly high impact rate on the Hadean Earth, and (iii) environmental conditions on the Hadean Earth were conducive to successful cometary delivery (i.e. limited oceanic coverage and low (≲1 bar) atmospheric surface pressure). Whilst environmental conditions on the early Earth remain subject to debate, this work highlights the need to measure the typical lifetime of ferrocyanide salts in geochemically realistic environments, which will determine the plausibility of double impact scenarios.
First case report of disseminated gonococcal arthritis in Newfoundland and Labrador
Authors: Karsenti Nessika , Nelder Matthew , LeMeissurier Jennifer , Bourassa-Blanchette Samuel , Taylor Robert M.
Published: January 2025

Introduction. Disseminated gonococcal infections (DGIs) are a rare but often debilitating complication of Neisseria gonorrhoeae infections. Often presenting as arthritis–dermatitis syndrome, true suppurative joint infections are an even more rare form of DGI. Here, we present the first known case of DGI in Newfoundland and Labrador in over 10 years.

Case report. A 50-year-old man who is known to inject drugs with multiple housing and social challenges presented to the emergency department with a 2-day history of an isolated, painful, erythematous knee. After being assessed by orthopaedics and undergoing an operative debridement, intraoperative cultures grew N. gonorrhoeae. He was treated with intravenous ceftriaxone, and his course in hospital was complicated by inadequate pain control and a lack of stable housing.

Conclusion. Although rare, DGIs need to remain on every clinician’s differential for septic arthritis, given the increasing prevalence of gonorrhoeal infections in Canada, particularly in Newfoundland and Labrador. In addition, patients who are at risk of delaying accessing care, such as people who inject drugs and unhoused individuals, are at higher risk of complicated hospital stays.
Autocrine signaling in hormonally active cancer induces antigen expression for immunotherapy
Authors: Schauer Marc P. , Weber Justus , Altieri Barbara , Spieler Peter , Gehrke Leon , Sbiera Silviu , Kircher Stefan , Kurlbaum Max , Kroiss Matthias , Kiseljak-Vassiliades Katja , Wierman Margaret E. , Nerreter Thomas , Einsele Hermann , Fassnacht Martin , Landwehr Laura-Sophie , Hudecek Michael
Published: January 2025

Endocrine, but also many non-endocrine cancers produce hormones that modulate immune-recognition and -therapy. We used adrenocortical carcinoma (ACC) as model that produces high amounts of glucocorticoids (GCs) and studied cancer antigen expression and recognition. Our study revealed that the oncofetal antigen ROR1 is induced by autocrine GC-signaling and that its transcription is regulated by GC-activated human glucocorticoid receptor (hGR) in complex with STAT3. To exploit the exalted ROR1 expression on ACC, we engineered ROR1-specific chimeric antigen receptor (CAR)-T cells that were shieled from the immune-suppressive effect of GCs, and conferred complete remission of GC-producing ACC xenograftsin vivo. Our study identifies autocrine signaling as a mechanism that induces antigen expression in hormonally active cancer, which can be leveraged for effective immunotherapy with genetically-engineered CAR-T cells.

One-Sentence Summary

Autocrine glucocorticoid (GC) signaling induces the oncogenic driver ROR1 in hormonally active adrenocortical carcinoma (ACC), and exposes ACC to elimination by GC-resistant ROR1-specific CAR-T cells.
Mono and Multidomain Anti-phage Defense Toxins of the RelE/ParE Superfamily
Authors: Gerdes Kenn
Published: January 2025

Toxin-antitoxin (TA) modules are widely distributed across prokaryotes, often existing in large numbers despite their associated fitness costs. Most type II TA modules are bicistronic operons encoding a monodomain toxin and its cognate protein antitoxin. The RelE/ParE superfamily encompasses toxins with a conserved Barnase-EndoU-ColicinE5/D-RelE (BECR) fold, yet their cellular targets differ remarkably: RelE toxins function as ribosome-dependent RNases, while ParE toxins act as DNA gyrase inhibitors. Using a comprehensive bioinformatics approach, this study analyzed 13 BECR-fold toxin families as classified in the Pfam database. Intriguingly, the ParE family was found to include a subcluster of mRNA-cleaving toxins, challenging its conventional role as solely DNA-targeting. This study identified a novel tripartite operon encoding a PtuA-like defense ATPase, a homolog of type IV restriction endonucleases, and a RelE homolog, suggesting a coordinated role in defense mechanisms. Multidomain BECR-fold toxins, including transmembrane variants, were also discovered, extending the functional repertoire of type II TA modules to membrane-associated systems. These findings clarify the evolutionary relationships and functional diversity within the RelE/ParE superfamily, and discovers novel, putative defence systems that can now be investigated experimentally.
Using cryogenic electron microscopy methods to gain insight into structure and initial host attachment of the flagellotropic bacteriophage 7-7-1
Authors: Noteborn W.E.M. , Ouyang R. , Hoeksma T. , Sidi Mabrouk A. , Esteves N.C. , Pelt D.M. , Scharf B.E. , Briegel A.
Published: January 2025

Understanding the structural and functional mechanisms of bacteriophage 7-7-1, the flagellotropic phage infectingAgrobacteriumsp. H13-3, offers promising insights into phage-host interactions. Using single particle analysis (SPA) cryo-electron microscopy (cryo-EM), we determined the capsid and tail structure, and built atomic models of capsid hexamers, pentamers and tail. Combined with cryo-electron tomography (cryo-ET) and machine learning methodologies, our findings indicate that phage 7-7-1 uses capsid fibers to establish initial contact with the host flagellum, followed by subsequent attachment to cell surface receptors. Proteinase K treatment confirmed the time-dependent degradation of capsid fibers. The study also demonstrated that capsid fibers are flexible and can interact with other phages and host flagella, suggesting a cooperative infection strategy. These results provide crucial structural insights and may open avenues for developing phage-based therapeutics against resistant bacterial pathogens.
Estrogen-Related Receptor is Required in Adult Drosophila Females for Germline Stem Cell Maintenance
Authors: Zike Anna B. , Abel Madison G. , Fleck Sophie A. , DeWitt Emily D. , Weaver Lesley N.
Published: January 2025

Stem cell self-renewal and proper tissue function rely on conserved metabolic regulators to balance energy production with inter-organ metabolic trafficking. The estrogen-related receptor (ERR) subfamily of orphan nuclear receptors are major transcriptional regulators of metabolism. In mammals, ERRs have roles in regulating mitochondrial biosynthesis, lipid metabolism, as well as stem cell maintenance. The sole Drosophila ERR ortholog promotes larval growth by establishing a metabolic state during the latter half of embryogenesis. In addition, ERR is required in adult Drosophila males to coordinate glycolytic metabolism with lipid synthesis and within the testis to regulate spermatogenesis gene expression and fertility. Despite extensive work characterizing of the role of ERR in Drosophila metabolism, whether ERR has a conserved requirement in regulating stem cell behavior has been understudied. To determine whether ERR regulates stem cell activity in Drosophila, we used the established adult female germline stem cell (GSC) lineage as a model. We found that whole-body ERR knockout in adult females using conditional heat shock-driven FLP-FRT recombination significantly reduces egg production and decreases GSC number. In addition, we found that ERR activity is required cell-autonomously in the adult female germline for maintenance of GSCs; whereas ERR regulation of GSCs is independent of its activity in adult female adipocytes. Our results highlight an ancient and conserved role for ERRs in the regulation of stem cell self-renewal.
Deep-learning based Embedding of Functional Connectivity Profiles for Precision Functional Mapping
Authors: Tu Jiaxin Cindy , Kim Jung-Hoon , Luckett Patrick , Adeyemo Babatunde , Shimony Joshua S. , Elison Jed T. , Eggebrecht Adam T. , Wheelock Muriah D.
Published: January 2025

Spatial correlation of functional connectivity profiles across matching anatomical locations in individuals is often calculated to delineate individual differences in functional networks. Likewise, spatial correlation is assessed across average functional connectivity profiles of groups to evaluate the maturity of functional networks during development. Despite its widespread use, spatial correlation is limited to comparing two samples at a time. In this study, we employed a variational autoencoder to embed functional connectivity profiles from various anatomical locations, individuals, and group averages for simultaneous comparison. We demonstrate that our variational autoencoder, with pre-trained weights, can project new functional connectivity profiles from the vertex space to a latent space with as few as two dimensions, yet still retain meaningful global and local structures in the data. Functional connectivity profiles from various functional networks occupy distinct compartments of the latent space. Moreover, the variability of functional connectivity profiles from the same anatomical location is readily captured in the latent space. We believe that this approach could be useful for visualization and exploratory analyses in precision functional mapping.
Formation of singly ionized oxygen atoms from
O2
driven by XUV pulses: A toolkit for the breakup of free-electron-laser-driven diatomics
Authors: Mountney M. , Wang Z. , Meister S. , Trost F. , Lindenblatt H. , Magunia A. , Moshammer R. , Pfeifer T. , Emmanouilidou A.
Published: January 2025

We formulate a general hybrid quantum-classical technique to describe the interaction of diatomic molecules with XUV pulses. We demonstrate the accuracy of our model in the context of the interaction of the O2 molecule with an XUV pulse with photon energy ranging from 20–42 eV. We account for the electronic structure and electron ionization quantum mechanically employing accurate molecular continuum wave functions. We account for the motion of the nuclei using classical equations of motion. However, the force of the nuclei is computed by obtaining accurate potential-energy curves of O2 up to O22+, relevant to the 20–42 eV photon-energy range, using advanced quantum-chemistry techniques. We find the dissociation limits of these states and the resulting atomic fragments and employ the velocity-Verlet algorithm to compute the velocities of these fragments. We incorporate both electron ionization and nuclear motion in a stochastic Monte Carlo simulation and identify the ionization and dissociation pathways when O2 interacts with an XUV pulse. Focusing on the O++O+ dissociation pathway, we obtain the kinetic-energy release (KER) distributions of the atomic fragments and find very good agreement with experimental results. Also, we explain the main features of the KER in terms of ionization sequences consisting of two sequential single-photon absorptions resulting in different O+ and O2+ electronic state configurations involved in the two transitions.

Published by the American Physical Society
2025
Utility of a hybrid approach to the hadronic vacuum polarization contribution to the muon anomalous magnetic moment
Authors: Davies C. T. H. , Kronfeld A. S. , Lepage G. P. , McNeile C. , Van de Water R. S.
Published: January 2025

An accurate calculation of the leading-order hadronic vacuum polarization (LOHVP) contribution to the anomalous magnetic moment of the muon (aμ) is key to determining whether a discrepancy, suggesting new physics, exists between the Standard Model and experimental results. This calculation can be expressed as an integral over Euclidean time of a current-current correlator G(t), where G(t) can be calculated using lattice QCD or, with dispersion relations, from experimental data for e+e−→hadrons. The BMW/DMZ collaboration recently presented a hybrid approach in which G(t) is calculated using lattice QCD for most of the contributing t range, but using experimental data for the largest t (lowest energy) region. Here we study the advantages of varying the position t=t1 separating lattice QCD from data-driven contributions. The total LOHVP contribution should be independent of t1, providing both a test of the experimental input and the robustness of the hybrid approach. We use this criterion and a correlated fit to show that Fermilab/HPQCD/MILC lattice QCD results from 2019 strongly favor the CMD-3 cross section data for e+e−→π+π− over a combination of earlier experimental results for this channel. Further, the resulting total LOHVP contribution obtained is consistent with the result obtained by BMW/DMZ, and supports the scenario in which there is no significant discrepancy between the experimental value for aμ and that expected in the Standard Model. We then discuss how improved lattice results in this hybrid approach could provide a more accurate total LOHVP across a wider range of t1 values with an uncertainty that is smaller than that from either lattice QCD or data-driven approaches on their own.

Published by the American Physical Society
2025
QCD axion, color-mediated neutrino masses, and
B+→K++Emiss
anomaly
Authors: Hati Chandan , Leite Julio , Nath Newton , Valle José W. F.
Published: January 2025

Motivated by the recent Belle II result indicating a 2.7σ excess of B+→K++Emiss events compared to the Standard Model (SM) prediction for B+→K+νν¯, we explore an explanation to this anomaly based on a Kim-Shifman-Vainshtein-Zakharov-type QCD axion model featuring a Peccei-Quinn (PQ) symmetry breaking at high scale, which can provide a solution to the strong CP problem with dark matter relic abundance. The model contains a PQ-charged scalar leptoquark which can interact with the SM quarks only via mass mixing of the latter with vectorlike quarks. The mixing between SM and vectorlike quarks is determined by the PQ mass scales and can explain the excess B+→K++Emiss events while respecting other flavor constraints. The same PQ-charged scalar leptoquarks and vectorlike quarks also mediate the two-loop radiative neutrino masses.

Published by the American Physical Society
2025