bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethylene increases the NaHCO3 stress tolerance of grapevines partially via the VvERF1B‐VvMYC2‐VvPMA10 pathway
Authors: Xiang Guangqing , Fan Zongbao , Lan Shuxia , Wei Dezheng , Gao Yazhe , Kang Hui , Yao Yuxin
Published: January 2025

Here, we evaluated the role of ethylene in regulating the NaHCO3 stress tolerance of grapevines and clarified the mechanism by which VvERF1B regulates the response to NaHCO3 stress. The exogenous application of ACC and VvACS3 overexpression in grapevines and grape calli revealed that ethylene increased NaHCO3 stress tolerance, and this was accompanied by increased plasma membrane H+‐ATPase (PMA) activity. The expression of VvERF1B was strongly induced by ACC, and overexpression of this gene in grapevines conferred increased NaHCO3 stress tolerance and enhanced PMA activity and H+ and oxalate secretion. Additionally, the function of VvERF1B was also verified using mutant transgenic grape calli and overexpression in Arabidopsis plants. The expression of VvPMA10 was strongly induced following the overexpression of VvERF1B in grapevine roots, and VvPMA10 was shown to regulate PMA activity, oxalate and H+ secretion, and NaHCO3 stress tolerance via its overexpression and mutation in grapevine roots, calli, and/or Arabidopsis. However, VvPMA10 was not a direct target gene of VvERF1B but was directly transactivated by VvMYC2. The function of VvMYC2 was shown to be similar to that of VvPMA10 via its overexpression and mutation in grape calli. Additional experiments revealed that the interaction of VvERF1B with VvMYC2 increased its ability to activate VvPMA10 expression and that VvMYC2 played a role in the VvERF1B‐mediated pathway. Overall, the VvERF1B‐VvMYC2‐VvPMA pathway played a role in regulating ethylene‐induced NaHCO3 stress tolerance in grapevines, and this process contributed to increases in PMA activity and H+ and oxalate secretion.
A Second Look: Retrospective Identification of Thrombotic Microangiopathy in Pediatric Stem Cell Transplant Patients With Veno‐Occlusive Disease
Authors: Rahim Mahvish Q. , Nichols Cydney , Althouse Sandra , Rahrig April L.
Published: January 2025

Background

Veno‐occlusive disease (VOD) and transplant‐associated thrombotic microangiopathy (TA‐TMA) remain a diagnostic and therapeutic challenge for patients undergoing hematopoietic stem cell transplant (HSCT). Both VOD and TA‐TMA share an underlying etiology of microvascular endothelial damage. Potential under‐recognition of TA‐TMA in the context of VOD leaves HSCT recipients vulnerable to additional endothelial damage, and risk of end‐organ failure.

Methods

A cohort of 44 pediatric HSCT recipients diagnosed with VOD between 2010and 2019 were retrospectively evaluated for the development of TA‐TMA within 1 week before and 2 months after VOD diagnosis. Patients were classified into three categories: sole diagnosis of VOD (VOD), concurrent clinical diagnosis of TA‐TMA during the VOD course (VOD+TA‐TMA), and patients with VOD who on retrospective review satisfied criteria for diagnosis of TA‐TMA (VOD+rTA‐TMA).

Results

A total of 42 patients were evaluated and 50% of the patients were diagnosed clinically with TA‐TMA (5) or where retrospectively identified to have TA‐TMA (16). There was no difference in the severity of the course of VOD between the three groups based on need for intubation, dialysis, and pediatric intensive care unit (PICU) care. Patients in the VOD only group had the highest survival at 1 year (66.7%, n = 14) compared with patients in the VOD+TA‐TMA group (60%, n = 3) and VOD+rTA‐TMA group (62.5%, n = 10), p = 0.9582.

Conclusion

Better understanding of the association between these two endotheliopathies is essential to improve diagnosis, treatment, and prevention of potentially fatal adverse outcomes in transplant recipients.
A Qualitative Phenomenological Study of the Lived Experiences of Female Sex Workers in a Bangladesh Brothel
Authors: Parkman Suzanne , Stratton Erin C.
Published: January 2025

Aim

The purpose of this study was to explore the lived experiences of female sex workers in the Kandapara Brothel in Tangail to build a better understanding of their lived perspective.

Design

This qualitative study was based on the philosophical underpinnings of Giorgi's descriptive phenomenological philosophy.

Methods

A purposive, convenience sample of 24 participants (N = 24) was recruited in the brothel, sufficient for data saturation. The inclusion criteria included (a) must work in the brothel and (b) must be ≥ 18 years old. In‐depth interviews were conducted, and transcript data were reduced, managed and coded.

Ethics

The university institutional review board and ethics committee approved the study, and participants provided written informed consent.

Findings

A qualitative analysis of transcribed in‐depth interviews revealed four major themes: (1) Early Trauma and Dysregulation, which reflects the trauma experienced by the women working in the brothel and being trafficked at a very early age; (2) Internal life describes the emotional experience and gratitude; the feelings of the sex workers in the brothel, (3) External life reflects the view of the greater Bangladeshi society of the sex workers and (4) The Brothel Life examines the relationships, competition, isolation, health concerns and workers' desire/uncertainty to leave the brothel. The four themes, while appearing separate, overlap with the other themes.

Conclusions

This phenomenological study illustrates the complexity of brothel workers' lived experiences. Understanding sex workers' lived experiences through a caring lens promotes care that allows for self‐determination, reflection, growth, acceptance and, most of all, healing.
Fouling analysis of polyvinyl chloride/polyethylene glycol‐b‐poly(1,2‐dichloroethylene) blend membranes for oily wastewater treatment
Authors: Khosroshahi Maryam Monsefi , Jafarzadeh Yoones , Nasiri Morteza , Dizajyekan Elham Sabzi
Published: January 2025

Polyethylene glycol‐b‐poly(1,2‐dichloroethylene)/polyvinyl chloride membranes were prepared and evaluated in oily wastewater treatment. The fouling mechanisms were investigated using Resistance‐in‐series and Hermia's models. The effects of membrane composition on the fouling were also studied. The surface hydrophilicity, roughness, density of finger‐like voids and porosity of the membranes were enhanced by blending the PEG‐b‐PDCE. The pore size of membranes shifted toward smaller pores as the PEG‐b‐PDCE concentration increased to 0.075 wt.%. The M‐3 membrane was found to be the best one showing 749.11 L.m−2.h−1 flux and 99.76% oil rejection, 82.90% porosity, 55.17
contact angle and 50 nm mean pore size. In addition, irreversible resistance was the main cause of the fouling and the results showed that complete blockage and intermediate pore blocking models yielded the best fit to data for the neat and PVC/PEG‐b‐PDCE membranes. The PEG‐b‐PDCE proved to be a good candidate for PVC membrane engineering and can be tested for other constituent polymers.
Pharmacological reduction of lipid hydroperoxides as a potential modulator of sarcopenia
Authors: Brown Jacob L. , Xu Hongyang , Duggan Elizabeth , Rosenfeld Craig S. , Van Remmen Holly
Published: January 2025

We previously reported that elevated expression of phospholipid hydroperoxide glutathione peroxidase 4, an enzyme that regulates membrane lipid hydroperoxides, can mitigate sarcopenia in mice. However, it is still unknown whether a pharmacological intervention designed to modulate lipid hydroperoxides might be an effective strategy to reduce sarcopenia in aged mice. Here we asked whether a newly developed compound, CMD‐35647 (CMD), can reduce muscle atrophy induced by sciatic nerve transection. We treated mice daily with vehicle or CMD (15 mg/kg, i.p. injection) starting 1 day prior to denervation. CMD treatment reduced hydroperoxide generation and blunted muscle atrophy by over 17% in denervated muscle. To test whether CMD can reduce ageing‐induced muscle atrophy and weakness, we treated mice with either vehicle or CMD (15 mg/kg, i.p. injection) 3 days per week for 8 months, starting at 18 months of age until 26 months of age. We measured muscle mass, functional status of neuromuscular junctions, muscle contractile function and mitochondrial function in control and CMD‐treated 26‐month‐old female mice. Treatment with CMD conferred protection against muscle atrophy in both tibialis anterior and extensor digitorum longus that was associated with maintenance of fibre size of MHC 2b and 2x fibres. Mitochondrial respiration was also protected in CMD‐treated mice. We also found that muscle force generation was protected with CMD treatment despite denervation in ∼25% of the muscle fibres. Overall, this study shows that pharmacological interventions designed to reduce lipid hydroperoxides might be effective for preventing sarcopenia.

image

Key points

Sarcopenia in aged mice is associated with muscle loss, contractile dysfunction, denervation, and reduced mitochondrial respiration.

CMD‐35647 is a pharmocological compound that can neutralize lipid hydroperoxides.

8 month treatment of CMD‐35647 mitigated muscle atrophy in tibialis anterior and extensor digitorum longus.

8 month treatment of CMD‐35647 improved muscle function in aged mice independent of the neuromuscular junction.

Aged mice treated with CMD‐35647 had greater respiration in red gastrocnemius muscle when compared to vehicle treated mice.
Prediction of Laminate Stiffness Reduction by Regression Equations for Damage Variables Obtained From the Stress-Based Variational Model
Authors: Nagumo Yoshiko , Onodera Sota , Hajikazemi Mohammad , Okabe Tomonaga
Published: January 2025

Continuous fiber-reinforced materials have low strength under loads perpendicular to the fibers, and transverse cracks easily occur parallel to the fibers. Since transverse cracks cause a reduction in stiffness and strength of continuous fiber-reinforced laminates, understanding the mechanical behavior of cracked laminates is of great importance, and many studies have been conducted. Among these studies, there is the continuum damage mechanics (CDM) model, which directly reflects the effect of damage modes in the constitutive law with the idea of damage variables, and the stress-based variational model, which uses the principle of minimum complementary energy to obtain a three-dimensional stress field in a cracked laminate to predict stiffness. Although the variational model can accurately predict the stiffness degradation of a cracked laminate, it is much more complicated than the continuum damage mechanics model in terms of the expression of the theoretical solution and the computational process. In this study, we derived explicit closed-form expressions for damage variables within the CDM framework, based on the variational model's calculations, estimating both the in-plane and out-of-plane laminate thermoelastic properties. This combines the simplicity of CDM with the accuracy of the variational approach. The damage variables are expressed explicitly using normalized values, incorporating cracked ply material and geometrical properties, crack geometry, and adjacent ply properties, making them applicable to a wide range of laminate materials and crack configurations. The validity of the regression equations was verified by comparing them with the previous CDM model's results, finite element analysis results, and experimental data.
Tunable in-plane conductance anisotropy in 2D semiconductive AgCrP
2
S
6
by ion-electron co-modulations
Authors: Sun Yujie , Zhang Rongjie , Tan Junyang , Zeng Shengfeng , Li Shengnan , Wei Qiang , Zhang Zhi-Yuan , Zhao Shilong , Zou Xiaolong , Liu Bilu , Cheng Hui-Ming
Published: January 2025

In-plane anisotropic two-dimensional (2D) semiconductors have gained much interest due to their anisotropic properties, which opens avenues in designing functional electronics. Currently reported in-plane anisotropic semiconductors mainly rely on crystal lattice anisotropy. Herein, AgCrP
2
S
6
(ACPS) is introduced as a promising member to the anisotropic 2D semiconductors, in which, both crystal structure and ion-electron co-modulations are used to achieve tunable in-plane conductance anisotropy. Scanning tunneling electron microscopy and polarized Raman spectroscopy show the structural anisotropy of ACPS. Electrical transport measurements show that its tunable in-plane conductance anisotropy is related to the ion-electron co-modulations, where Ag ion migration is anisotropic along
a
axis and
b
axis. Electrical transport measurements show the semiconducting properties of ACPS, as also supported by photoluminescence results. Moreover, the transfer curves of ACPS showcase large
V
g
-related hysteresis, which is directionally controlled by anisotropic Ag ion migration. This work offers a possibility of using anisotropic charge transport in functional electronics by ion-electron co-modulations.
Metal-organic frameworks as thermocatalysts for hydrogen peroxide generation and environmental antibacterial applications
Authors: Pal Arnab , Suresh Sreerag , Khan Arshad , Kuo Li Huai , Chi Li Tang , Ganguly Anindita , Kao Chih-Yao , Sharma Manish Kumar , Wang Tsung-Shing Andrew , Kang Dun-Yen , Lin Zong-Hong
Published: January 2025

Reactive oxygen species (ROS) are highly reactive, making them useful for environmental and health applications. Traditionally, photocatalysts and piezocatalysts have been used to generate ROS, but their utilization is limited by various environmental and physical constraints. This study introduces metal-organic frameworks (MOFs) as modern thermocatalysts efficiently producing hydrogen peroxide (H
2
O
2
) from small temperature differences. Temperature fluctuations, abundant in daily life, offer tremendous potential for practical thermocatalytic applications. As proof of concept, MOF materials coated onto carbon fiber fabric (MOF@CFF) created a thermocatalytic antibacterial filter. The study compared three different MOFs (CuBDC, MOF-303, and ZIF-8) with bismuth telluride (Bi
2
Te
3
), a known thermocatalytic material. ZIF-8 demonstrated superior H
2
O
2
generation under low-temperature differences, achieving 96% antibacterial activity through temperature variation cycles. This work advances potential in thermoelectric applications of MOFs, enabling real-time purification and disinfection through H
2
O
2
generation. The findings open interdisciplinary avenues for leveraging thermoelectric effects in catalysis and various technologies.
Complete genome sequence of a
Mycobacterium bovis
strain associated with a bovine tuberculosis outbreak on a cattle farm in Saskatchewan, Canada
Authors: Andrievskaia Olga , Garceac Amalia , Lloyd Dara , Savic Mirjana , Duceppe Marc-Olivier
Published: January 2025

Bovine tuberculosis is an important zoonotic infectious disease that presents a risk to human health, livestock, and wildlife. We report the complete genome sequence of a new
Mycobacterium bovis
strain that caused a bovine tuberculosis outbreak on a cattle farm in Saskatchewan, Canada, in 2023.
Complete genome sequence of
Roseburia faecis
M72/1
T
Authors: Murotomi Kazutoshi , Tourlousse Dieter M. , Hamajima Mayu , Sekiguchi Yuji
Published: January 2025

We describe a complete genome sequence of
Roseburia faecis
strain M72/1
T
(= JCM 17581
T
= DSM 16840
T
= NCIMB 14031
T
). The genome assembly consists of a single circular chromosome with a length of 3,385,415 base pairs and was predicted to contain 3,338 genes and encode for 3,180 proteins.
Small RNA CjNC110 regulates the activated methyl cycle to enable optimal chicken colonization by
Campylobacter jejuni
Authors: Ruddell Brandon , Hassall Alan , Sahin Orhan , Plummer Paul J. , Zhang Qijing , Kreuder Amanda J.
Published: January 2025

Post-transcriptional gene regulation by non-coding small RNAs (sRNAs) is critical for colonization and survival of enteric pathogens, including the zoonotic pathogen
Campylobacter jejuni
. In this study, we utilized
C. jejuni
IA3902 (a representative isolate of the sheep abortion clone) and
C. jejuni
W7 (a highly motile variant of NCTC 11168, a human gastroenteritis strain) to further investigate regulation by sRNA CjNC110. Both motility and autoagglutination ability were confirmed to be phenotypes of conserved regulation by CjNC110. However, we demonstrated that W7∆CjNC110 does not change chicken colonization levels compared to W7 wild type, directly contrasting IA3902∆CjNC110, which had decreased colonization ability. Subsequently, we determined strain-specific phenotype variation between W7∆CjNC110 and IA3902∆CjNC110 when examining intracellular L-methionine (L-met) levels controlled by the activated methyl cycle (AMC). We hypothesized that the presence of a secondary system for L-met production conferred by MetAB in W7 but not IA3902 might explain the difference in both chicken colonization and L-met availability. Insertion of
metAB
within IA3902∆CjNC110 (naturally absent) restored intracellular L-met levels in IA3902∆CjNC110::metAB and overcame the colonization defect that resulted from mutagenesis of CjNC110 in IA3902. Deletion of metAB in W7∆CjNC110 (naturally present) led to a decrease in L-met in W7∆CjNC110∆metAB and a colonization defect which was otherwise masked in W7∆CjNC110. Our results indicate that regulation of the AMC leading to altered L-met availability is a conserved regulatory function of CjNC110 in
C. jejuni
and confirm that L-met generation via the AMC as activated by CjNC110 is critical for optimal host colonization.

IMPORTANCE

During this study, the regulatory action and conservation of function of CjNC110 between two different zoonotically important
Campylobacter jejuni
strains were examined. Critically, this work for the first time reveals regulation of L-methionine (L-met) production within the activated methyl cycle (AMC) by small RNA (sRNA) CjNC110 as a key factor driving
C. jejuni
optimal chicken colonization. As a growing body of evidence suggests that maintenance of L-met homeostasis appears to be critical for
C. jejuni
colonization, interventions targeting the AMC could provide a critical control point for therapeutic drug options to combat this zoonotic pathogen. Our results also indicate that even for conserved sRNAs such as CjNC110, strain-specific differences in phenotypes regulated by sRNAs may exist, independent of conserved regulatory action. Depending on the strain examined and accessory genomic content present, conserved regulatory actions might be masked, thus investigation in multiple strains may be warranted.
Preparation and application of porcine broadly neutralizing monoclonal antibodies in an immunoassay for efficiently detecting neutralizing antibodies against foot-and-mouth disease virus serotype O
Authors: Cao Yimei , Li Fengjuan , Xing Xiangchuan , Zhang Huiyan , Zhao QiongQiong , Sun Pu , Fu Yuanfang , Li Pinghua , Ma Xueqing , Zhang Jing , Zhao Zhixun , yuan Hong , Wang Jian , Wang Tao , Bao Huifang , Bai Xingwen , Li Dong , Zhang Qiang , Li Kun , Lu Zengjun
Published: January 2025

Neutralizing antibodies provide vital protection against foot-and-mouth disease virus (FMDV). The virus neutralization test (VNT) is a gold standard method for the detection of neutralizing antibodies. However, its application is limited due to the requirement for live virus and unsuitability for large-scale serological surveillance. In this study, a porcine broadly neutralizing monoclonal antibody (PO18-10) against FMDV was obtained from the heterologous sequentially vaccinated pig using single-B-cell antibody technology. A competitive enzyme-linked immunosorbent assay (C-ELISA) for detecting neutralizing antibodies against FMDV serotype O was developed using biotinylated PO18-10 as a detector antibody. The sensitivity and specificity of the assay were 100% and 99.55%, respectively, and the positive/negative coincidence rate with VNT was 94%, suggesting that C-ELISA based on natural host-derived monoclonal antibody (mAb) could be a promising tool to detect neutralizing antibodies against FMDV serotype O and evaluate the vaccine efficacy.

IMPORTANCE

Foot-and-mouth disease virus (FMDV) serotype O is one of the most prevalent serotypes in the world. The neutralizing antibody titers in primo-vaccinated animals are directly related to their level of protection against a virus challenge. The development of a safe, rapid, and accurate method for the detection of the neutralizing antibody is essential for the control and eradication of FMD. In this study, an inter-serotype broadly neutralizing monoclonal antibody PO18-10 was successfully produced using single-B-cell antibody technology from sequentially vaccinated pigs. A competitive ELISA based on this natural host-derived mAb for the detection of neutralizing antibodies against FMDV serotype O was developed and validated. The assay demonstrates high sensitivity, specificity, and coincidence rate with VNT, making it an alternative tool for confirming FMDV infection and evaluating the vaccine efficacy.
Supplemental Material: A probabilistic model for coseismic vertical displacement hazard in coastal settings
Authors: Delano Jaime , al. et
Published: January 2025

The supplementary files include Figures S1–S7 and Table S1 that provide additional modeling data and results.
Supplemental Material: Amphibole fractionation controls the redox state of magmas in porphyry Cu ore systems: Constraints from amphibole-rich rocks in eastern China
Authors: Du Jingguo , al. et
Published: January 2025

Tables S1–S8, Figures S1–S4, and methods.
Neonatal encephalopathy: when the diagnosis is not hypoxic ischaemic encephalopathy
Authors: Reading Jacob Christopher Sutton , Smith Martin , Joseph Robin , Ramdas Sithara
Published: January 2025

Neonatal encephalopathy (NE) presents as reduced consciousness, often with seizures, abnormal tone, feeding and respiratory difficulties. The most common cause is secondary to a hypoxic-ischaemic event. However, there are many important diagnoses that can also present as NE, so-called ‘hypoxic ischaemic encephalopathy (HIE) mimics’. This paper, aimed at paediatric trainees, aims to describe clinical situations in which a diagnosis other than HIE should be suspected, the differential diagnoses to consider and appropriate investigations.
Aseptic meningitis from herpes simplex virus proctitis
Authors: Adibmoradi Bardia , Penaranda, Luis , Wacher Nathalie , Sikha Anita
Published: January 2025

Sexually transmitted proctitis, a prevalent concern among men who have sex with men (MSM) is frequently caused by a range of pathogens, including herpes simplex virus (HSV),Neisseria gonorrhoeaeandChlamydia trachomatis. While HSV-associated proctitis typically presents with visible lesions, cases without external manifestations remain evasive. We report the case of an MSM in his early 30s presenting with dyschezia and perineal discomfort after unprotected anoreceptive intercourse. Despite initial inconspicuous findings, rectal swabs revealed HSV-2 infection. Subsequent escalation to purulent discharge prompted further investigation, revealing mucosal thickening on imaging consistent with proctitis. Remarkably, the patient later exhibited symptoms suggestive of aseptic meningitis, with cerebrospinal fluid (CSF) analysis confirming HSV-2 DNA. This atypical progression underscores the covert threat posed by HSV-2 proctitis, potentially culminating in neurological complications. Our case highlights the imperative for heightened vigilance and comprehensive testing in MSM engaging in receptive anal intercourse, advocating for early detection and intervention to prevent grave sequelae.
Severe hypophosphataemia following denosumab administration successfully managed using a calcimimetic agent
Authors: Omori Makiko , Matsukawa Yukihiro , Ikeda Yuhachi , Sakai Tomoyuki
Published: January 2025

Denosumab, an anti-RANKL antibody, induces bone metabolism to a low-turnover bone status by arresting osteoclast activity. Frequent adverse events include infusion reactions, fever and hypocalcaemia but not hypophosphataemia. We report a case of severe hypophosphataemia associated with secondary hyperparathyroidism following denosumab administration in a young boy with recurrent osteosarcoma who was successfully treated with evocalcet. He developed hypocalcaemia and severe refractory hypophosphataemia after receiving denosumab for bone metastases despite calcium, cholecalciferol and phosphorus supplementation. Laboratory data revealed secondary hyperparathyroidism due to denosumab-induced hypocalcaemia as the cause of hypophosphataemia. Evocalcet contributed to the normalised parathyroid hormone and phosphorus levels, allowing the discontinuation of phosphorus supplementation. This case highlights the complexity of managing electrolyte imbalances induced by bone-modifying agents, such as denosumab, underscoring the importance of monitoring bone metabolism markers and the potential effectiveness of evocalcet in managing drug-induced secondary hyperparathyroidism and hypophosphataemia.
Prevalence and risk factors of myopic macular degeneration: the Aier-SERI high myopia adult cohort
Authors: Foo Li Lian , Jiang Yanfeng , Hoang Quan V , Htoon Hla Myint , Hu Ziqi , Pan Wei , Cheong Kai Xiong , Lamoureux Ecosse Luc , Yang Zhikuan , Lan Weizhong , Saw Seang-Mei
Published: January 2025

Purpose

To assess the prevalence and risk factors of myopic macular degeneration (MMD) in young and middle-aged individuals with high myopia in Changsha, central China.

Methods

A total of 445 adults with high myopia (worse than or equal to −5.0 D) were examined between 2021 and 2023. Autorefraction and biometry using IOLMaster were conducted, and fundus photos were graded for MMD using Meta-PM criteria. MMD was diagnosed if category 2, 3, 4 or any plus lesion was present. Risk factors such as age, gender, spherical equivalent (SE)/axial length (AL), body mass index, education and residence were analysed via logistic regression.

Results

Participants had an average age of 42.3±7.3 years. MMD prevalence was 21.8% (71 adults) with a mean SE of −9.5±4.7 D and AL of 27.3±1.9 mm. Significant risk factors included greater myopic SE (OR=1.7 per 1 D decrease) and longer AL (OR=3.6 per 1 mm increase). MMD prevalence rose sharply with myopia worse than −10.00 D and AL >27.00 mm, reaching up to 100% for myopia worse than −14.00 D or AL ≥29.00 mm.

Conclusion

MMD affects about one in five young to middle-aged adults with high myopia. Those exceeding critical myopia and AL thresholds are at higher risk and should be closely monitored. Further research on interventions to prevent axial elongation is needed, particularly for those with high genetic risk.
Management of alcohol withdrawal syndromes in general hospital settings
Authors: Kast Kristopher A , Sidelnik S Alex , Nejad Shamim H , Suzuki Joji
Published: January 2025

The covid-19 pandemic was associated with an unprecedented increase in alcohol consumption and associated morbidity, including hospitalizations for alcohol withdrawal. Clinicians based in hospitals must be ready to identify, assess, risk-stratify, and treat alcohol withdrawal with evidence based interventions. In this clinically focused review, we outline the epidemiology, pathophysiology, clinical manifestations, screening, assessment, and treatment of alcohol withdrawal in the general hospital population. We review and summarize studies addressing the drug treatment of alcohol withdrawal syndromes in inpatient populations, with a focus on the use of benzodiazepine drugs, phenobarbital, antiseizure drugs, and α-2 adrenergic drugs. Emerging areas of interest include the use of novel alcohol biomarkers, risk stratification instruments, alternative symptom severity scales, severe withdrawal syndromes resistant to benzodiazepine drugs, and treatment protocol variations–including non-symptom-triggered and benzodiazepine-sparing protocols. We identify key areas for research including identification of populations who will benefit from non-benzodiazepine strategies, more individualized risk stratification approaches to guide treatment, and greater inclusion of gender and racial and ethnic minorities in future studies.
Helping people with psychosis with a low-cost intervention DIALOG+: protocol for the economic evaluation in a randomised control trial in India and Pakistan
Authors: Malik Ashar Muhammad , Peppl Renata , Sajun Sana Zehra Zehra , Qureshi Onaiza , Priya Krishna , Sarwar Hufsa , Ramachandran Padmavati , Venkatraman Lakshmi , Evans-Lacko Sara , Bird Victoria Jane
Published: January 2025

Background

Approximately 69%–89% of people with severe mental illnesses, particularly psychosis, experience a treatment gap in low- and middle-income countries (LMICs) due to factors such as low public spending on health and weak healthcare systems. The PIECEs project aims to assess the effectiveness and cost-effectiveness of a solution-focused resource-oriented approach (DIALOG+) for improving the quality of life and mental well-being of people with psychosis in India and Pakistan.

Methods

The research design of this analysis is an economic evaluation piggybacked on the PIECEs randomised control trial to test the feasibility of DIALOG+ in India and Pakistan. It implies a cost-utility analysis with a health system perspective. The costs include the cost of the intervention, the cost of healthcare providers and the cost to the household. The primary outcome will be quality-adjusted life years. Incremental cost, incremental effectiveness and incremental cost-effectiveness ratios will be calculated using linear regression models with a hierarchical data structure. A probabilistic sensitivity analysis will be carried out to test for the uncertainty surrounding the estimates of cost-effectiveness.

Discussion

This study will provide evidence of a patient-centred approach to improve the quality of community-based care for people with psychosis in India and Pakistan. The economic evaluation will support efforts to scale up low-cost healthcare interventions such as DIALOG+ to rural and unserved areas, which is otherwise challenging in the resource-constrained health systems in many LMICs.

Conclusion

The evidence on the cost-effectiveness of DIALOG+ will contribute to efforts to improve community-based care and the quality of life for millions of people suffering from mental health problems in India and Pakistan who experience psychosis.

Ethics and dissemination

This study is approved by the Queen Mary Ethics of Research Committee (UK), Institutional Ethics Committee of SCARF (India), IRD’s Independent Institutional Review Board (IRD_IRB_2021_01_005) (Pakistan), Karawan-e-Hayat Management Committee (Institutional Approval) (Pakistan), Jinnah Postgraduate Medical Centre Research Committee (NO.F.2-81/2021-GENL/60224/JPMC) (Pakistan), Aga Khan’s Ethics Research Committee (2021-5933-17533) (Pakistan) and National Bio-Ethics Committee, Pakistan (Ref: No.4–87/NBC-774/22/2037 Date: 17 May 2022).

The findings of this research will be widely disseminated through research publications and engagement with the communities and the healthcare providers in the public and not-for-profit sectors.

Trial registration number

ISRCTN13022816.
Five-year trajectories of symptom severity, physical and mental functioning in patients with persistent somatic symptoms: the PROSPECTS cohort study
Authors: Barends Hieke , van der Horst Henriëtte E , van der Wouden Johannes C , Claassen Nikki , Dekker Joost , Hoekstra Trynke
Published: January 2025

Objectives

Knowledge about the long-term course and prognosis of persistent somatic symptoms (PSS) is important to improve clinical decision-making and guidance for patients with PSS. Therefore, we aimed to: (1) identify distinct 5-year trajectories of symptom severity, physical and mental functioning in adult patients with PSS and (2) explore patient characteristics associated with these trajectories.

Design

We used longitudinal data (seven measurements over a 5-year period) of the PROSPECTS study: a prospective cohort of adult patients with PSS. We applied Latent Class Growth Mixture Modelling to identify distinct trajectories for the three outcomes.

Setting and participants

Patients were recruited in general practices and specialised treatment facilities for PSS throughout the Netherlands. The study population consisted of participants with three or more measurements available (n=297).

Primary outcome measures

Symptom severity (Patient Health Questionnaire 15), physical and mental functioning (RAND-36 Physical Component Summary and Mental Component Summary).

Results

For symptom severity, we identified two ‘stable’ trajectories: ‘severe symptoms, stable’ (15.8%) and ‘moderate symptoms, stable’ (84.2%). For physical functioning, we identified three trajectories: ‘poor physical functioning, marked improvement’ (8.5%); ‘poor physical functioning, stable’ (34.7%) and ‘moderate physical functioning, slight improvement’ (56.8%). For mental functioning, we identified three trajectories: ‘poor mental functioning, marked improvement’ (13.9%); ‘moderate mental functioning, deterioration’ (12.2%) and ‘moderate mental functioning, slight improvement’ (73.8%). Patients’ characteristics such as personal, social and environmental background, illness stressors, comorbid diseases, cognitive, emotional and behavioural responses varied for the distinct trajectories.

Conclusions

We identified distinct 5-year trajectories for the three outcomes. Our findings suggest a high prevalence of persistence of symptoms and limited improvement in physical and mental functioning in the majority of patients with PSS. In a small proportion of patients, we identified trajectories that showed considerable physical or mental improvement or deterioration. Patient characteristics differed for the identified trajectories and may guide early recognition, although predictive studies are warranted.
Exploring the relationship between professional roles and behavioural intentions in chronic kidney disease management: a cross-sectional study among primary and specialist health professionals in Shanghai, China
Authors: Wu Liutao , Wang Wenyi , Liang Yan
Published: January 2025

Objectives

General practitioners, nephrologists and renal nurses play key roles in professional integration in chronic kidney disease (CKD) management. Professional roles may influence professionals’ behavioural intentions, namely, the degree to which individuals formulate behavioural plans to attain a behavioural goal. However, little is known about the relationship between professional roles and their behavioural intentions in CKD management. Therefore, in this study, we aimed to explore the relationship between professional roles and their behavioural intentions in CKD management and the mediating role of normative and functional factors.

Design

Cross-sectional.

Setting

A cross-sectional survey study was conducted in Shanghai, China.

Participants

A total of 244 responses were obtained, including 145 from general practitioners, 37 from nephrologists and 62 from renal nurses. We used a self-administered questionnaire to collect data through hospital unit/Community Health Service Centre visits. We performed exploratory factor analysis for behavioural intentions in CKD management. The Karlson-Holm-Breen method was used to decompose the total effect of roles on behavioural intentions in CKD management into direct and indirect (ie, mediational) effects and to calculate the mediated percentage.

Results

The indirect effect of personal norm (should CKD management be included in daily work or not) accounted for 51.91% of the total effect of nephrologists on one-to-multiple CKD management intentions and 43.79% of the total effect of renal nurses on one-to-multiple CKD management intentions.

Conclusion

Our results support the mediating pathways of personal norms on the relationship between roles and behavioural intentions, but the mediating role of functional factors was not supported. These findings suggest that enhancing the personal norms of general practitioners may benefit their behavioural intentions in CKD management.
Exploring intersectional determinants of, and interventions for, low uptake of human papillomavirus vaccine in sub-Saharan Africa: a scoping review protocol
Authors: Kailemia Peter Ntoiti , Mukami Victoria
Published: January 2025

Introduction

Cervical cancer is the most diagnosed cancer and the leading cause of cancer-related death in 36 low- and middle-income countries, with the majority located in sub-Saharan Africa (SSA), South America and Southeastern Asia. The highest regional incidence and mortality occur in SSA. Despite the high efficacy and cost-effectiveness of the human papillomavirus (HPV) vaccine in preventing cervical cancer, its uptake remains unacceptably low in SSA. This scoping review aims to integrate evidence from SSA on social determinants of HPV vaccine uptake with complementary evidence on interventions to promote its uptake.

Methods and analysis

The proposed review will be conducted following the guidelines of the Joanna Briggs Institute Scoping Review Methodology Group. Additionally, a sequential explanatory design will guide the integration of determinant evidence with intervention evidence. This scoping review will be reported per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews checklist. Six databases, PubMed/MEDLINE, LIVIVO, Google Scholar, BASE (Grey Literature), preprint databases (eg, OSF and medRxiv) and African Journals Online will be searched, with results limited to English language publications and those published from 2006 to 2024. Two forms will be used for data extraction from determinant and intervention studies by two independent reviewers. A narrative summary of evidence from both determinant and intervention studies will be conducted. Furthermore, a multilevel analysis will be conducted to explore the intersections of determinants across socioecological levels of health behaviour. A further integrative cross-study analysis of results from determinant and intervention studies will be conducted, where the determinant evidence will be used to interrogate the intervention evidence. Data will be presented in tables and matrices.

Ethics and dissemination

No ethical approval will be required for this study because it will be based on data collected from publicly available records. The review results will be disseminated widely through a peer-reviewed publication and other forums such as workshops, conferences and meetings with local health administrators, policymakers and other wider stakeholder engagements.
Do continuous glucose monitoring (CGM) metrics predict macrovascular and microvascular complications in diabetes? The FACULTY protocol of a retrospective real-world cohort study
Authors: Ajjan Ramzi A , Battelino Tadej , Seufert J , Blin Patrick , de Pouvourville Gérard , Vicaut Eric , Carcaillon-Bentata Laure , Levrat-Guillen Fleur , Cosson Emmanuel , Joubert Michael
Published: January 2025

Introduction

Glycated haemoglobin (HbA1c) is currently the gold standard for assessing glycaemic control in diabetes, given the established relationship with microvascular and macrovascular complications in this condition. However, HbA1c is affected by non-glycaemic factors, while also failing to provide data on hypoglycaemic exposure and glucose variability, which are associated with adverse vascular outcomes. Continuous glucose monitoring (CGM)-derived glucose metrics provide a more comprehensive assessment of glycaemia, but their role in predicting future vascular complications remains unclear. Here, we present the protocol for a real-world cohort study, aiming to establish the relationship between CGM-derived glycaemic metrics and the incidence of macrovascular and/or microvascular complications in people with diabetes.

Methods and analysis

This cohort study will use data from all CGM new users (FreeStyle Libre system) in France who uploaded their glycaemic values onto the LibreView cloud-based system, linked with data from the French nationwideSystème National des Données de Santéclaims database. The study is expected to include a minimum of 70 000 individuals with diabetes with a first date of glucose data upload to the LibreView platform after 1 January 2018 and with a 6-year follow-up period. The primary outcomes are the first occurrence of new macrovascular or microvascular complications, analysed as a composite outcome and separately. Secondary outcomes will include all-cause mortality and hospital admissions for any cause. This longitudinal study will provide key data on the relationship between CGM-derived glycaemic metrics and micro/macrovascular complications in diabetes. This will have an impact on routine clinical practice by setting targets for the different glycaemic markers, based on robust outcome data, thus helping to optimise glucose management in diabetes.

Ethics and dissemination

The study data-collection protocol is approved by the French National Commission for Informatics and Liberties, including approval from theComité Ethique et Scientifique pour les Recherches, les Etudes et les Evaluations dans le domaine de la Santé. This study complies with French and European regulations, including those relating to the General Data Protection Regulation. This study uses pseudonymous information, not requiring informed consent. Dissemination plans include full publication of the study outcomes in peer-reviewed journal(s) with open access and presentations at national and international diabetes and cardiovascular conferences.
Utilisation of outpatient care immediately before emergency admission for ambulatory care-sensitive conditions in Japan: a retrospective observational study
Authors: Nagashima Ryotaro , Kato Hirotaka , Matsuzaki Tatsuya , Nagahama Takayoshi , Goto Rei
Published: January 2025

Objective

This study assessed whether patients with potentially preventable emergency admissions had limited access to outpatient care immediately before admission and whether they received appropriate outpatient care during their outpatient visits.

Design

Retrospective observational study.

Setting

Linked outpatient and inpatient care records obtained from a nationwide claims database in Japan.

Participants

Patients who experienced emergency admissions for ambulatory care-sensitive conditions between April 2005 and March 2020. Patient and regional characteristics were examined to assess the types of patients who faced difficulties with outpatient visits and receiving outpatient care related to the disease that resulted in admissions (hereafter referred to as admission-related outpatient care).

Main outcome measures

(1) Whether patients had an outpatient visit during the 2 weeks preceding admission and (2) whether patients received admission-related outpatient care during the 2 weeks before admission.

Results

This study included 18 449 emergency admissions for ambulatory care-sensitive conditions, representing 16.3% (18 449/113 669) of all emergency admissions in our data. Among patients with emergency admissions for ambulatory care-sensitive conditions, 37.4% did not have an outpatient visit within the 2 weeks preceding admission and 29.9% did not receive admission-related outpatient care despite having an outpatient visit. In total, 67.4% did not receive admission-related outpatient care during the 2 weeks preceding admission. Patients in their 40s and 50s were less likely to have outpatient visits and receive admission-related outpatient care before admission. No evidence associates regional characteristics with outpatient visits and receiving admission-related outpatient care before admission.

Conclusion

Most patients who underwent emergency admissions for ambulatory care-sensitive conditions did not have an outpatient visit or receive admission-related outpatient care, despite having an outpatient visit immediately before admission. Our findings suggest that emergency admissions may be prevented by improving access to timely and effective outpatient care.
Review protocol for a systematic review and meta-analysis on HIV inequities in transgender and non-binary populations
Authors: Lucas Ruby , Moodley Ruwenne , Garcia Gutiérrez Jessie M. , Bambilla Audren J K , Singh Dil , Rogers Hannah , Sherwood Jennifer , Dusic Emerson , Giovenco Danielle , Sun Shufang , Operario Don , Restar Arjee
Published: January 2025

Introduction

Global disparities in HIV prevalence among transgender women are well documented. However, current epidemiological literature on HIV disparities demonstrates gaps in research that include the diversity within transgender populations—for example, transgender men and non-binary trans people across global regions. This systematic review and meta-analysis protocol aims to summarise global HIV inequities among all transgender and non-binary (trans) populations. The objectives of this review are to estimate pooled HIV prevalence and prevention outcomes (pre-exposure prophylaxis and antiretroviral therapy) and differences by gender identity, global regions and self-report versus lab-confirmed findings among trans adults worldwide.

Methods and analysis

We will conduct a systematic review of all studies on HIV outcomes among trans youth and adults (aged 15+ years) published between 2000 and 2024, following the Preferred Reporting Items for Systematic Review and Meta-Analysis Prereporting guidelines. We will use Covidence software for the title and abstract screening, full-text review and data abstraction processes. We will summarise the study’s descriptive statistics and conduct meta-analyses of extracted data points to calculate and synthesise pooled findings and effect size. Specifically, we will use the Mantel–Haenszel method with random effects to model our meta-analyses and the DerSimonian and Laird Q test for heterogeneity testing. We will conduct a narrative synthesis on the areas of research that have been conducted to improve HIV prevention and treatment among trans populations and summarise their findings. Subgroup analyses by gender identity, global regions and self-report versus lab-confirmed findings will be conducted.

Ethics and dissemination

Ethics approval is not applicable for this review since we will not be collecting primary data. The results will be disseminated through peer-reviewed publications and conference presentations.

PROSPERO registration number

The protocol is registered in the International Prospective Register of Systematic Reviews database (PROSPERO ID: CRD42022357285).