bluuebunny/crossref_metadata_2025 huggingface dataset:
Persistent oral health inequality in children—repeated cross-sectional studies in 2010 and 2019
Authors: Blomma Caroline , Davidson Thomas , Gerdin Elisabeth Wärnberg , Bågesund Mats , Lyth Johan
Published: December 2024

Background and aim

Children growing up in vulnerable circumstances have a higher risk of caries experience. Tracking the development of caries in relation to socioeconomic variables over time is essential for fair resource distribution to groups with higher caries risk and to even out inequalities in oral health. The aim was therefore to analyse the association between 6-year-olds´ caries prevalence and socioeconomic variables at family and residential area levels in 2010 and 2019 as well as potential differences in the association between 2010 and 2019.

Methods

The study design is an epidemiological registry-based, repeated cross-sectional study based on caries data (grouped as 0, 1–3 and > 3 dmft) for the population of 6-year-olds in 2010 (n = 4,408, 95% coverage) and 2019 (n = 5,199, 94% coverage) in a Swedish region. Multiple socioeconomic variables for the children’s families and residential areas were retrieved from official registries. Multinomial logistic regression was performed at both levels to produce models for each level and studied year.

Results

The variables that explained most of the association between caries and socioeconomic variables were mainly the same over the years at both levels. At the family level, these were: maternal age when having their first child (explained most of the association in both years, at 30 and 35%, respectively); maternal age when having the child in the study group; parental employment; parental and child’s migration background; maternal educational level; form of housing; and financial assistance (only 2010). At the residential area level, these were: migration background (explained most of the association both years; 82 and 52%, respectively), educational level and number of persons per household. The association between socioeconomic variables and caries was consistently stronger for severe caries (dmft > 3) than moderate (dmft 1–3). Multiple socioeconomic risk variables meant an even greater likelihood of caries.

Conclusion

Over the studied years, variables related to socioeconomic vulnerability continued to be associated with caries in young children growing up under socially disadvantaged circumstances. Effective efforts for families living in socially vulnerable contexts are needed to achieve good and equal oral health, as is continued follow-up to evaluate whether the goal is reached.
Associations between violence in childhood, depression and suicide attempts in adolescence: evidence from a cohort study in Luwero district, Uganda
Authors: Akunzirwe Rebecca , Carter Daniel J. , Hanna Lauren , Zinke-Allmang Anja , Akim Aggrey , Datzberger Simone , Parkes Jenny , Knight Louise , Atuhaire Lydia , Nakuti Janet , Mirembe Angel , Allen Elizabeth , Naker Dipak , Devries Karen , Bhatia Amiya
Published: December 2024

Background

Many studies have documented an association between violence victimisation and poor mental health. However, few studies use longitudinal data from low- and middle-income countries with attention to how associations differ by experiencing specific types of violence or alongside different contexts of peer and family support. In this study, we quantify the association between experiences of violence in early adolescence and depression and suicide attempts in late adolescence and explore whether this association is modified by family and peer connectedness.

Methods

Data came from the Contexts of Violence Against Children (CoVAC) cohort study in Luwero District, Uganda, involving 2773 participants aged 11–14 years at Wave 1 (2014) and 15–18 years at Wave 2 (2018). Physical, sexual, and emotional violence were measured at Wave 1. Mental health outcomes, depression symptoms in the past two weeks, and lifetime suicide attempts were measured at Wave (2) We used logistic regression models, stratified by sex, to estimate adjusted odds ratios with an interaction term to test for effect modification by peer and family connectedness at Wave 1.

Findings

At Wave 1, the prevalence of any violence from any perpetrator was 90% (physical violence: 87%, physical violence excluding caning: 68%, sexual violence: 6.3%, emotional violence: 56.8%). At Wave 2, 13.3% of participants had scores indicative of depression and 4.3% reported ever attempting suicide. Physical violence excluding caning, emotional violence, and sexual violence during early adolescence increased the odds of depression and attempting suicide in late adolescence for both boys and girls. Experiencing any violence (including caning) in early adolescence was not associated with depression in late adolescence, including in sex-stratified models. Childhood experience of any violence was associated with a suicide attempt violence in early adolescence (aOR: 2.60; 95%CI: 1.08, 6.27). High peer support mitigated the effect of any violence and physical violence on depression.

Conclusions

Findings highlight the importance of efforts to prevent violence and improve access to response and support services for violence and mental health for young people. Findings also underscore the important role friends and peer networks can play in mitigating the effects of violence as young people grow up.
Parents’ and informal caregivers’ experiences of accessing childhood vaccination services within the United Kingdom: a systematic scoping review of empirical evidence
Authors: Chisnall Georgia , Hersh-Toubia Samar , Mounier-Jack Sandra , Letley Louise , Chantler Tracey
Published: December 2024

Background

Despite repeated calls to action and considerable attention, childhood vaccination uptake has declined for a thirteenth consecutive year in the United Kingdom (UK). Increasingly, stakeholders are advocating for research which goes beyond vaccine hesitancy and explores service accessibility in greater depth. This scoping review aims to identify and critically assess how accessibility is being conceptualised and investigated with a view to informing future research. Research, that in turn, will dictate the interventions pursued to improve vaccination coverage.

Methods

A detailed search strategy was implemented across seven databases to identify research exploring parents’ experiences of accessing childhood vaccination services within the UK. The analysis explored the studies in relation to their conceptualisation of access, methodology, reported results, and recommendations for research or practice using a combination of descriptive qualitative content analysis, typologies, and frequency counts. Methods and reporting adhered to the ‘JBI Manual for Evidence Synthesis’ and the ‘Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews’.

Results

Forty-five studies were included in the analysis. Studies claimed to consider only attitudinal constructs (4%) or did not discuss access at all (33%) despite findings, in part, including access related issues. Remaining studies used the term access in passing or ambiguously (24%), distinguished between attitudes and access in-text (27%), and a minority of studies utilised a theoretical framework which acknowledged accessibility (13%). The focus on access to information (92% of studies) was disproportionately large compared to other domains of accessibility such as availability (11%), affordability (13%), and proximity (16%). Of the seven identified intervention studies, five were centred on information provision.

Conclusion

Accessibility is poorly conceptualised within most of the research conducted on childhood immunisation uptake within the UK. This, in part, is because exploring accessibility was not an explicit objective of many of the studies included in the review. It is vital that the accessibility of childhood vaccination services is given greater priority and appropriately defined in empirical research. Otherwise, researchers run the risk of limiting the scope of their findings based on their own conceptual ideas regarding the drivers of poor uptake rather than the lived reality of parents.
Community perceptions of health accountability meetings with local politicians to improve healthcare quality: a qualitative study in Western Uganda
Authors: Lee HaEun , Fiseha Neyat , Bateisibwa Jordan , Moyer Cheryl A. , Greenberg Joshua , Maffioli Elisa
Published: December 2024

Background

Lack of accountability within healthcare systems contributes to suboptimal healthcare quality and ultimately poor health outcomes, especially in low-income countries. In Uganda, our research team implemented a pilot project of quarterly health accountability meetings between community members and their local political leaders to discuss healthcare needs and strategies for quality improvement. In this study, we examine the community members’ understanding and perceptions of the health accountability meetings, as well as the perceived impact of the meetings on local healthcare services and community life.

Methods

We conducted a total of 12 focus group discussions (FGDs), half with men and half with women, in November 2022 across six randomly chosen communities out of the ten communities where health accountability meetings were held. We audio taped, transcribed, and translated all FGDs into English. We collected data on demographics, understanding of the meetings, and perceived changes within healthcare services and the community from 111 participants. Two researchers analyzed the data using an inductive thematic approach, generating five themes.

Results

We found the following themes: (1) increased inclusivity and promotion of bidirectional communication; (2) increased understanding of patient rights and practicing of collective empowerment by the community; (3) improved provider behavior; (4) enhanced relationships among politicians, community members, and healthcare providers; and (5) identified needs for future improvements.

Conclusion

Through this qualitative study, we found that the community members perceived the accountability meetings as beneficial in improving the local healthcare services and community life. The study demonstrates the need to prioritize the voices of local communities in efforts to address the accountability gaps, as well as the potential for utilizing the relationship between community members and politicians to address accountability shortfalls in other governmental functions beyond healthcare.

Trial registration

N/A.
Adaptation in adversity: innovative approaches to food security amidst COVID-19 in a remote First Nations community in Canada
Authors: Ahmed Fatima , Moriarity Robert J. , Spence Nicholas D. , Kataquapit Gisele , Sutherland Celine , Charania Nadia A. , Tsuji Leonard J. S. , Liberda Eric N.
Published: December 2024

The COVID-19 pandemic exacerbated food insecurity issues in geographically isolated communities, including Fort Albany First Nation (FAFN). This research examines FAFN’s adaptive strategies to improve food security, highlighting community resilience and leadership. Data were gathered through semi-structured interviews with 20 community members who were involved in the pandemic response, either as members of the pandemic committee or as managers of community programs. Thematic analysis revealed significant adaptation of existing programs and the establishment of new initiatives to address food security during the pandemic. Initiatives, such as the community garden and the Fort Albany Farmers Market were food security programs that existed prior to the pandemic, and despite labor shortages during the pandemic, logistical hurdles were addressed to maintain operations and enhance food distribution efficiency. New emergency food initiatives, backed by government support and community efforts, successfully delivered food to vulnerable households. Traditional subsistence activities, such as hunting and fishing, were essential for providing sustenance and strengthening community resilience. These adaptive strategies highlight the critical role of local leadership, community participation and ingenuity, and the utilization of Indigenous knowledge in overcoming food security challenges during crises. This paper underscores the need to support Indigenous food sovereignty and build resilient local food systems tailored to the unique needs of First Nations communities. The experiences of FAFN during the COVID-19 pandemic provide invaluable insights into the resilience and innovation required to improve food security in remote and vulnerable populations, emphasizing the need for sustained investment and policy support in these communities.
Predicting responsiveness to GLP-1 pathway drugs using real-world data
Authors: Zhu Xiaodong , Fowler Michael J. , Wells Quinn S. , Stafford John M. , Gannon Maureen
Published: December 2024

Background

Medications targeting the glucagon-like peptide-1 (GLP-1) pathway are an important therapeutic class currently used for the treatment of Type 2 diabetes (T2D). However, there is not enough known about which subgroups of patients would receive the most benefit from these medications.

Objective

The goal of this study was to develop a predictive model for patient responsiveness to medications, here collectively called GLP-1 M, that include GLP-1 receptor agonists and dipeptidyl peptidase-4 (DPP4) inhibitors (that normally degrade endogenously-produced GLP-1). Such a model could guide clinicians to consider certain patient characteristics when prescribing second line medications for T2D.

Methods

We analyzed de-identified electronic health records of 7856 subjects with T2D treated with GLP-1 M drugs at Vanderbilt University Medical Center from 2003–2019. Using common clinical features (including commonly ordered lab tests, demographic information, other T2D medications, and diabetes-associated complications), we compared four different models: logistic regression, LightGBM, artificial neural network (ANN), and support vector classifier (SVC).

Results

Our analysis revealed that the traditional logistic regression model outperforms the other machine learning models, with an area under the Receiver Operating Characteristic curve (auROC) of 0.77.Our model showed that higher pre-treatment HbA1C is a dominant feature for predicting better response to GLP-1 M, while features such as use of thiazolidinediones or sulfonylureas is correlated with poorer response to GLP-1 M, as assessed by lowering of hemoglobin A1C (HbA1C), a standard marker of glycated hemoglobin used for assessing glycemic control in individuals with diabetes. Among female subjects under 40 taking GLP-1 M, the simultaneous use of non-steroidal anti-inflammatory drugs (NSAIDs) was associated with a greater reduction in HbA1C (0.82 ± 1.72% vs 0.28 ± 1.70%, p = 0.008).

Conclusion

These findings indicate a thorough analysis of real-world electronic health records could reveal new information to improve treatment decisions for the treatment of T2D. The predictive model developed in this study highlights the importance of considering individual patient characteristics and medication interactions when prescribing GLP-1 M drugs.
Medical education videos – comparative analysis of sonography vs. clinical examination videos: user perception and educational value
Authors: Kuru Timur H. , Salem Johannes , Hircin Emrah , Siech Carolin , Moharam Nadim , Schoch Justine , Mattigk Angelika , Struck Julian , Borgmann Hendrik , Nestler Tim
Published: December 2024

Background

Video content has become an increasingly valuable tool in medical education, particularly for teaching hands-on skills like sonography and clinical examination. This study evaluates the satisfaction and content of sonography and clinical examination videos on the AMBOSS platform, a prominent medical education resource in Germany.

Objective

The goal of this study was to compare how effective and well-received sonography and clinical examination videos are on the AMBOSS platform. The study looked at aspects such as the medical and technical quality of the videos, their usefulness for learning, and overall user satisfaction.

Methods

Eighteen instructional videos were chosen and made accessible on the AMBOSS platform, grouped into sonography (n = 9) and clinical examination (n = 9) categories. Users were asked to voluntarily and anonymously fill out a questionnaire evaluating the videos. Over 49.5 months, data from 1,643,274 video views and 936 completed questionnaires were gathered.

Results

Clinical examination videos were watched significantly more often than sonography videos (86 vs. 14%). Both video types were highly rated in terms of medical and technical quality. However, sonography videos were judged superior in technical quality and clarity, whereas clinical examination videos were preferred for their medical quality and practical application. Feedback from users indicated a desire for more detailed annotations and clearer explanations.

Conclusion

The findings underline the crucial role of video resources in medical education, particularly in teaching practical skills. To improve educational outcomes, it is important to tailor content to the specific needs of medical students and professionals, incorporate user feedback, and take advantage of technological advancements.
Improving event prediction using general practitioner clinical judgement in a digital risk stratification model: a pilot study
Authors: Parry Emma , Ahmed Kamran , Guest Elizabeth , Klaire Vijay , Koodaruth Abdool , Labutale Prasadika , Matthews Dawn , Lampitt Jonathan , Nevill Alan , Pickavance Gillian , Sidhu Mona , Warren Kate , Singh Baldev M.
Published: December 2024

Background

Numerous tools based on electronic health record (EHR) data that predict risk of unscheduled care and mortality exist. These are often criticised due to lack of external validation, potential for low predictive ability and the use of thresholds that can lead to large numbers being escalated for assessment that would not have an adverse outcome leading to unsuccessful active case management. Evidence supports the importance of clinical judgement in risk prediction particularly when ruling out disease. The aim of this pilot study was to explore performance analysis of a digitally driven risk stratification model combined with GP clinical judgement to identify patients with escalating urgent care and mortality events.

Methods

Clinically risk stratified cohort study of 6 GP practices in a deprived, multi-ethnic UK city. Initial digital driven risk stratification into Escalated and Non-escalated groups used 7 risk factors. The Escalated group underwent stratification using GP global clinical judgement (GCJ) into Concern and No concern groupings.

Results

3968 out of 31,392 patients were data stratified into the Escalated group and further categorised into No concern (n = 3450 (10.9%)) or Concern (n = 518 (1.7%)) by GPs. The 30-day combined event rate (unscheduled care or death) per 1,000 was 19.0 in the whole population, 67.8 in the Escalated group and 168.0 in the Concern group (p < 0.001). The de-escalation effect of GP assessment into No Concern versus Concern was strongly negatively predictive (OR 0.25 (95%CI 0.19–0.33; p < 0.001)).

The whole population ROC for the global approach (Non-escalated, GP No Concern, GP Concern) was 0.614 (0.592—0.637), p < 0.001, and the increase in the ROC area under the curve for 30-day events was all focused here (+ 0.4% (0.3–0.6%, p < 0.001), translating into a specific ROC c-statistic for GP GCJ of 0.603 ((0.565—0.642), p < 0.001).

Conclusions

The digital only component of the model performed well but adding GP clinical judgement significantly improved risk prediction, particularly by adding negative predictive value.
Changes in provision of extended community pharmacy services in Aotearoa New Zealand, 2018 to 2022
Authors: Officer Tara , McDonald Janet , Jeffreys Mona , Cumming Jacqueline , Russell Lynne , McKinlay Eileen , Kennedy Jonathan , Tanuvasa Ausaga Fa’asalele , Morris Caroline
Published: December 2024

Background

Recognition is growing of the contributions community pharmacists make to the primary health care team, as their role shifts from a traditional dispensing focus to greater emphasis on fully applying their clinical skills. Some extended pharmacist services (e.g., vaccinations) are becoming increasingly common in New Zealand (Aotearoa). Community pharmacies provided key services during the COVID-19 response.

Methods

An online survey was sent to community and intern pharmacists in 2022, regarding delivery of extended services and enablers and barriers to service provision, to look at changes since a 2018 survey. New questions were included regarding pharmacy services during the COVID-19 pandemic.

Descriptive analyses were conducted, and comparisons made between reported proportions in the 2018 and 2022 surveys. For questions related to attributes of pharmacies rather than pharmacists, we weighted the data by the inverse of the number of pharmacists in the pharmacy.

Results

A total of 64 pharmacists and 25 interns responded to the survey. The most common services for which pharmacists were accredited were the provision of the emergency contraceptive pill (95%), sildenafil (94%), trimethoprim (88%) and immunisations (80%). There was an increase from 2018 to 2022 in the proportion of pharmacists who were accredited to provide selected oral contraceptives and immunisations. As in 2018, interns showed strong interest in gaining accreditation for all extended services. Enablers and barriers to offering extended services did not change materially between 2018 and 2022, other than a greater proportion of pharmacists reporting that they were too busy dispensing to offer more services (an increase from 46 to 63%, P = 0.033). Almost all (98%) reported that “COVID increased the levels of stress at work”, 94% that “workload has increased”, and 90% that “home delivery services increased.” Sixty-nine percent of pharmacists and 73% of interns reported work stress negatively affecting their wellbeing.

Conclusions

Most pharmacists want to work at the top of their scope of practice and are accredited to offer a range of extended services. However, their ability to focus on more patient-facing roles continues to be constrained by the time they spend dispensing. Adequate remuneration for services provided remains a concern.
Health benefits package selection in oncology: a clinical audit of palliative chemotherapy for breast cancer in an Indian health insurance scheme
Authors: Bauhoff Sebastian , Sengar Manju , Pramesh C. S. , Dhiman Anamika , Mehndiratta Abha
Published: December 2024

Background

The effective operation of health insurance requires functioning administrative processes, including appropriate filing for reimbursements. The unlisted palliative care package is one of the most utilized oncology packages within Indian state health insurance schemes. We conducted a clinical audit to evaluate the appropriateness of claims for this package for patients with breast cancer.

Methods

We obtained documentation submitted to support a random sample of insurance claims for the unlisted palliative care package for 50 patients (total) from one public and one private hospital, cataloged the available records, and assessed the appropriateness of package selection using clinical guidelines from India’s National Cancer Grid. Where sufficient documentation was available, we also assessed the clinical appropriateness of care. We also examined whether these patients received relevant care at other hospitals that participate in the scheme and, for five purposefully selected patients, whether additional documentation had been submitted alongside other claims.

Results

Claims for 45 of the 50 patients had sufficient documentation to assess whether the selected package was appropriate. Among these 45 claims only 33% were selected in accordance with guidelines; the public hospital had a relatively higher share of appropriate selections. In many cases (21 claims), the palliative care package was selected for adjuvant therapy and targeted therapy. While more than half of the sampled patients had multiple related encounters and sometimes received care from multiple hospitals, reviewing additional claims did not affect our conclusions.

Conclusion

Claims for the palliative chemotherapy unlisted package often had deficient documentation and were inappropriately selected.
Implementation of an advanced practice role for oxygen prescription by physiotherapists in pulmonary rehabilitation: an explanatory sequential mixed-method quality evaluation
Authors: Riegler Thomas F. , Marcin Thimo , Brun Patrick
Published: December 2024

Background

Physiotherapists play a key role in the administration of supplemental oxygen during physical activity in pulmonary rehabilitation. However, supplemental oxygen requires a medical prescription making processes cumbersome for physiotherapists. This study aimed to implement and evaluate an advanced practice role for physiotherapists (APO2) allowing them to prescribe oxygen during physical activity.

Methods

Training and certification process for respiratory physiotherapists employed in an inpatient rehabilitation clinic was implemented. A mixed-method approach for retrospective evaluation was used. Quantitative analysis included routine clinical data from oxygen prescriptions, titrations, and exercise capacity. Additionally, healthcare professionals’ experiences and perceptions of the new APO2 role was explored using a survey. Qualitative data included interprofessional interviews, survey comments, and data from the critical incidence reporting system.

Results

In 15% of patients during the evaluation period, certified APO2 were involved in oxygen prescription. These patients had more frequent titrations (median 8 [interquartile 6, 10] vs. 5 [4, 8]), prescription adjustments (3 [2, 4] vs. 1 [1, 2]), and narrower oxygen dosage ranges prescribed (2 [1, 3] vs. 4 [3, 4]). No significant difference in exercise capacity was observed and no adverse events reported. Survey data from 19 healthcare professionals and interviews indicated that the specialised expertise of APO2 positively impacts interprofessional collaboration and workflow efficiency.

Conclusions

Physiotherapy-led oxygen prescription during physical activity in pulmonary rehabilitation is feasible, safe, and perceived as beneficial for the workflow and interprofessional collaboration across healthcare professions.

Trial registration

According to Swiss law (Human Research Act, Art. 2), ethics approval for the study and informed consent were not required and were waived off. All methods were in accordance with the regulations and guidelines of the Swiss Human Research Act and Swiss ethics law.
Inequalities in the geographic access to delivery services in Brazil
Authors: Pinho Neto Valdemar , Machado Cecilia , Lima Felipe , Roman Soraya , Dutra Gilson
Published: December 2024

Background

Despite Brazil’s recent social progress, access to health services is still unequal. This article analyzes the inter-municipal distances traveled by pregnant women to access delivery services, documenting their magnitude and relationship to socioeconomic and risk factors for over a decade in Brazil.

Methods

Using data between 2007 and 2017 from the Brazilian Information System of Live Births and a matrix of inter-municipal distances, we describe the evolution of (i) the share of pregnant women that traveled across municipalities and (ii) the average distance they traveled. Next, we assess which of the previous variables explains the changes in travel distance over time. Finally, we estimate the difference in the average travel distance by individual risk factors and use regression analysis to measure the association between this distance and municipal socioeconomic determinants from the Brazilian census.

Results

We observe that, on average, (i) the share of women traveling for childbirth increased, reaching 31% in 2017, and (ii) distances got longer, approaching the 60-kilometer mark by 2017. The increase in distance is mainly due to more women traveling. Nevertheless, regional disparities persist, especially between the north/inland and coastal regions. Women with high-risk pregnancies or newborns with risks such as low birth weight tend to travel longer distances. However, those residing in higher-development municipalities tend to travel shorter distances.

Conclusion

Long distances remain an obstacle to accessing delivery facilities. This matter affects the most vulnerable disproportionately. Policymakers must consider the geographic accessibility of mothers when expanding birth-related services. Additionally, more research is required to understand the decision to travel and the distance effectively traveled as different accessibility facets.
Narratives of health-promoting experiences by older husbands and wives providing care to their home-dwelling spouses receiving home-care services in Norway
Authors: Melilla Hege Stokmo , Sverre Beate Lie , Eilertsen Grethe , Tønnessen Siri
Published: December 2024

Background

In today’s healthcare systems, older family caregivers who care for their spouses at home are indispensable providers of healthcare. However, many of these caregivers are at risk of becoming ill themselves. To prevent this and to guide the development of targeted healthcare services, home-care personnel need knowledge on how to promote the health of older family caregivers. The purpose of this study was to understand the health-promoting experiences of older family caregivers who care for their home-dwelling spouses receiving home-care services.

Methods

The experiences of older family caregivers were explored using a narrative design that involved narrative interviews and a narrative thematic and structural analytical approach. The sample consisted of four husbands and six wives aged 79–91 years. In the analysis, two storylines of narratives were constructed: one by husbands and one by wives.

Findings

In the husbands’ narrative, continuation of everyday life and social support in everyday life were highlighted as being health-promoting. In the wives’ narrative, the importance of having time for oneself and being seen, heard and included by the home-care personnel were emphasized as promoting their health. The husbands’ narrative contained stories of the past and the present, while the wives’ narrative mainly comprised stories of the present.

Conclusion

This study has provided insights into the narratives of older husbands and wives acting as family caregivers regarding what promotes their health caring for their spouses at home. Their stories show variations in care style, coping style and experiences of the caregiver burden. These findings suggest that home-care services should consider providing customized health-promoting services to older family caregivers who are providing care to their home-dwelling spouses receiving home-care services. Given the sample size of only ten participants, further qualitative and quantitative research is needed.
Pheromone relay networks in the honeybee: messenger workers distribute the queen’s fertility signal throughout the hive
Authors: Richardson Thomas O. , Kay Tomas , Keller Laurent , Stroeymeyt Nathalie
Published: December 2024

Background

The harmonious operation of many insect societies depends upon colony-wide dissemination of a non-volatile pheromone produced by a single queen, which informs workers of her presence. This represents a major challenge in large colonies. Honeybee colonies, which can exceed 60,000 bees, are believed to solve this challenge using ‘messenger’ workers that actively relay the queen pheromone throughout the hive. However, little is known about the structure and effectiveness of the underlying relay network or the biology of messaging.

Results

Here, we combine automated tracking with modelling to address these outstanding questions. We find that both queen movement and worker messaging play fundamental roles in queen pheromone dissemination. Fine-grained analyses of worker behaviour confirmed the existence of active messaging, as physical contacts with the queen caused workers to move faster and straighter, thereby accelerating pheromone transmission. Finally, we show that messaging follows a stereotypical developmental trajectory, resulting in an age-dependent hierarchical relay network, with the most intense messaging observed between three and five days of age, when workers undergo a suite of physiological changes associated with queen rearing.

Conclusions

These results suggest that the individuals that contribute most to advertising the presence of the queen are also the ones that control queen production.
Telomere length in relation to fecundability and use of assisted reproductive technologies: the Norwegian Mother, Father, and Child Cohort Study
Authors: Skåra Karoline H. , Lee Yunsung , Jugessur Astanand , Gjessing Håkon K. , Aviv Abraham , Brumpton Ben , Næss Øyvind , Hernáez Álvaro , Hanevik Hans Ivar , Magnus Per , Magnus Maria C.
Published: December 2024

Background

Telomere length (TL) has been reported to be associated with conditions such as endometriosis and polycystic ovary syndrome, with some studies finding associations with shorter TL and others with longer TL. In men, studies mostly report associations between shorter TL and sperm quality. To our knowledge, no studies have thus far investigated associations between TL and fecundability or the use of assisted reproductive technologies (ART).

Methods

This study is based on the Norwegian Mother, Father, and Child Cohort (MoBa) Study and uses data from the Medical Birth Registry of Norway (MBRN). We included women (24,645 with genotype data and 1054 with TL measurements) and men (18,339 with genotype data and 965 with TL measurements) participating between 1998 and 2008. We investigated associations between leukocyte TL (LTL) and fecundability (defined as the probability to conceive within a given menstrual cycle), infertility (defined has having spent 12 months or more trying to conceive without success), and ART use. We also repeated the analyses using instrumental variables for LTL consisting of genetic risk scores for LTL and genetically predicted LTL.

Results

Approximately 11% of couples had experienced infertility and 4% had used ART. LTL was not associated with fecundability in women (fecundability ratio [FR], 0.98; 95% confidence interval [CI], 0.92–1.04) or men (FR, 0.99; CI, 0.93–1.06), nor with infertility in women (odds ratio [OR], 1.03; CI, 0.85–1.24) or men (OR, 1.05; CI, 0.87–1.28). We observed an increased likelihood of using ART with increasing LTL in men (OR, 1.22; CI, 1.03–1.46), but not in women (OR, 1.10; CI, 0.92–1.31). No significant associations were observed using the instrumental variables for LTL.

Conclusions

We found no indication that LTL is a suitable biomarker for assessing fecundability, infertility, or ART use. Additional studies are required to replicate the association observed between LTL and ART use in men.
Identifying populations at high risk of malaria: a mixed-methods case–control study to inform targeted interventions in Senegal
Authors: Thiam Tidiane , Kande Demba , Ntuku Henry , Guinovart Caterina , Galles Natalie , Merriman Laura , Cissé Moustapha , Sall Abiboulaye , Diop Ndack , Diouf Aichatou Barry , Diaw Mama Moussa , Diop Mamadou , Camara Baba , Seck Niene , Ndour Aliou , Dieye Yakou , Smith Jennifer , Bennett Adam
Published: December 2024

Background

Senegal has made significant progress in reducing the burden of malaria, but transmission remains highly heterogeneous, with specific population subgroups likely at higher risk. Consultations with the National Malaria Control Programme (NMCP) and a review of available data identified nomadic pastoralists, gold miners, and Koranic school students as potential high-risk populations (HRPs). This study aimed to evaluate whether these populations are at higher risk of malaria and better characterize their exposure patterns to inform the design of targeted intervention strategies.

Methods

A mixed-methods study was conducted in the districts of Ranérou, Kaolack, and Saraya between November 2020 and December 2021. A formative assessment including key informant interviews (KII) and focus group discussions (FGD) was conducted with non-HRP and HRP members (nomadic pastoralists, gold miners, Koranic school students). A health facility-based case–control study was then conducted in nine health facilities across the three districts. 501 confirmed malaria cases and 1002 non-malaria controls were frequency matched by age and sex with a ratio of 1:2. A standardized questionnaire was administered to collect sociodemographic information, including occupation, use of malaria prevention measures, mosquito exposure, and travel history. Multivariable logistic regression was used to identify malaria risk factors.

Results

KIIs and FGDs indicated that nomadic pastoralists, gold miners and Koranic school students have high exposure to mosquito bites through outdoor sleeping, spending time outside at night and sleeping in informal structures, with important gaps in the coverage of indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) and limited access to health services. Compared to controls, cases had higher odds of being a nomadic pastoralist (odds ratio (OR) 4.67 95% CI 1.96–11.11) or gold miner (OR 1.92 95% CI 1.20–3.07). No evidence was found of an association with being a Koranic school student (OR 1.39 95% CI 0.80–2.39).

Conclusions

Nomadic pastoralists and gold miners in the study areas are at higher risk of malaria. Targeted interventions are needed to cover gaps in malaria prevention coverage and access to health services.
Dyslipidemia and metabolic syndrome in childhood-onset systemic lupus erythematosus: is it time to screen?
Authors: Nuntasri Sirin , Charuvanij Sirirat , Lomjansook Kraisoon , Saengpanit Puthita , Chotipanang Kwanjai , Sukharomana Maynart
Published: December 2024

Background

Childhood-onset systemic lupus erythematosus (cSLE) is associated with significant morbidity and mortality. Dyslipidemia and metabolic syndrome are recognized risk factors for premature atherosclerosis. This study aimed to determine the prevalence of dyslipidemia and metabolic syndrome, and to explore the relationships between lipid profiles, anthropometry, and disease status in cSLE.

Methods

This cross-sectional study was conducted at a university-based tertiary referral center from April 2023-March 2024. Patients aged 10–19 years with cSLE diagnosed before 18 years and at least 1 year follow-up were enrolled, excluding those with other autoimmune disorders, chronic kidney disease, infections, receiving lipid lowering drugs prior, and pregnancy. Demographic data, metabolic laboratory tests, disease status, dietary intake, anthropometry, and body composition via bioelectric impedance analysis were evaluated. The prevalence of dyslipidemia and metabolic syndrome were documented. Variables were compared between patients with and without dyslipidemia. Correlations between lipid profiles, metabolic laboratory variables, and SLE disease-related variables were explored.

Results

A total of 132 cSLE patients (94.7% female, mean age 11.6 ± 2.6 years) were included. Dyslipidemia was present in 48.5%, hypertriglyceridemia being the most common (28.8%); metabolic syndrome and hyperuricemia were present in 3.8% and 20.5%, respectively. Patients with dyslipidemia were significantly younger at cSLE diagnosis, had higher percentage of hypertension and active features of organ involvement, lower percentage of Lupus Low Disease Activity State, more use of mycophenolate mofetil and antihypertensive medications, higher uric acid level, higher waist circumference, body mass index, body mass index z-score, and fat mass (P < 0.05). Triglycerides, low-density lipoprotein cholesterol, and total cholesterol correlated positively with urine protein-to-creatinine ratio (r = 0.472, 0.469, and 0.591, respectively; P < 0.001) and negatively with serum albumin (r = -0.372, -0.506, and − 0.528, respectively; P < 0.001). Total cholesterol and low-density lipoprotein cholesterol correlated positively with cumulative prednisolone equivalent dose (rho = 0.350 and rho = 0.351, respectively, P < 0.001).

Conclusions

Nearly half of cSLE patients had dyslipidemia, especially those with younger age at diagnosis, higher body mass index, proteinuria, and suboptimal-controlled disease. Metabolic syndrome and hyperuricemia were present. Lipid profile assessment in early adolescents is recommended to identify metabolic comorbidities in cSLE.
Enhancing multi-sectoral collaborations for the prevention and control of NCDs in Thailand with a new approach
Authors: Sornpaisarn Bundit , Chunharas Somsak , Sornpaisarn Sarnti , Saonuam Pairoj , Nipun Rifat Farzan , Butryee Chaniphun , Samutachak Bhubate , Chandarasorn Maneekwan , Supadulya Nattapon , Chunsuttiwat Suttikarn , Singha Sumonmarn , Rojanapithayakorn Wiwat , Ungchusak Kumnuan , Rehm Jürgen
Published: December 2024

Background

To achieve the Sustainable Development Goals (SDGs) by 2030, Thailand must engage in effective multi-sectoral collaboration (MSC). However, implementing MSC in Thailand presents significant challenges. Although Thailand had a 2011–2020 MSC strategic plan for the control of non-communicable diseases (NCDs) with the prime minister taking the lead, joined by many non-health ministers, not a single meeting was called over those 10 years. This paper describes the development of a new tool created to enhance MSC between health and non-health sectors in controlling NCDs in Thailand. Stakeholder-engaged research will be used to implement and evaluate this tool. This paper also describes the research planned to test the new approach.

Methods

The authors used two main methods: (1) a narrative review on MSC enhancement and (2) a series of four consultation meetings with key stakeholders – in the health, non-health and academic sectors – to develop a research study to implement and evaluate the new approach.

Results

To address previous MSC implementation problems, the proposed novel MSC enhancement approach emphasizes three principles: (1) pursuit of committed-stakeholder involvement at the middle-management level, instead of relying on the top-management level, an approach which has never been successful; (2) production of knowledge to support specific, achievable target policies; and (3) use of a comprehensive set of knowledge-translation activities and knowledge brokers to solve the problem of ineffective routine official communications between members of the MSC. Using participatory consultations during the research proposal development, middle-level officials from three non-health ministries (the Ministries of Agriculture, Finance and Education) agreed to join the MSC to work together to solve specific problems regarding the control of NCDs. A target-advocated policy for each ministry was formulated and agreed upon by both non-health-sector and health-sector stakeholders.

Conclusions

This new approach (middle-management oriented), if implemented, may encourage more commitment from the Ministries’ representatives, policy-relevant knowledge generation and effective communications between ministries involved in an MSC. Ideally, it would complement the conventional approach (top-management oriented) in enhancing the MSC for controlling NCDs, and thereby bring hope for achieving the NCD-related SDGs for Thailand and possibly other countries as well.
In-vivo Raman microspectroscopy reveals differential nitrate concentration in different developmental zones in Arabidopsis roots
Authors: Fernández González Alma , Fang Ze Tian , Sen Dipankar , Henrich Brian , Nagashima Yukihiro , Sokolov Alexei V. , Okumoto Sakiko , Verhoef Aart J.
Published: December 2024

Background

Nitrate (NO3−) is one of the two major forms of inorganic nitrogen absorbed by plant roots, and the tissue nitrate concentration in roots is considered important for optimizing developmental programs. Technologies to quantify the expression levels of nitrate transporters and assimilating enzymes at the cellular level have improved drastically in the past decade. However, a technological gap remains for detecting nitrate at a high spatial resolution. Using extraction-based methods, it is challenging to reliably estimate nitrate concentration from a small volume of cells (i.e., with high spatial resolution), since targeting a small or specific group of cells is physically difficult. Alternatively, nitrate detection with microelectrodes offers subcellular resolution with high cell specificity, but this method has some limitations on cell accessibility and detection speed. Finally, optical nitrate biosensors have very good (in-vivo) sensitivity (below 1 mM) and cellular-level spatial resolution, but require plant transformation, limiting their applicability. In this work, we apply Raman microspectroscopy for high-dynamic range in-vivo mapping of nitrate in different developmental zones of Arabidopsis thaliana roots in-situ.

Results

As a proof of concept, we have used Raman microspectroscopy for in-vivo mapping of nitrate content in roots of Arabidopsis seedlings grown on agar media with different nitrate concentrations. Our results revealed that the root nitrate concentration increases gradually from the meristematic zone (~ 250 µm from the root cap) to the maturation zone (~ 3 mm from the root cap) in roots grown under typical growth conditions used for Arabidopsis, a trend that has not been previously reported. This trend was observed for plants grown in agar media with different nitrate concentrations (0.5–10 mM). These results were validated through destructive measurement of nitrate concentration.

Conclusions

We present a methodology based on Raman microspectroscopy for in-vivo label-free mapping of nitrate within small root tissue volumes in Arabidopsis. Measurements are done in-situ without additional sample preparation. Our measurements revealed nitrate concentration changes from lower to higher concentration from tip to mature root tissue. Accumulation of nitrate in the maturation zone tissue shows a saturation behavior. The presented Raman-based approach allows for in-situ non-destructive measurements of Raman-active compounds.