bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Why doesn't anyone ask me’? Patients' experiences of receiving, performing and practices of oral care in an acute Orthopaedic Department
Authors: Rasmussen Isabella Lund , Halberg Nina , Jensen Pia Søe
Published: May 2023

Aims and objectives

Oral care is an integrated part of everyday life. Within nursing, barriers related to providing oral care often lead to unmet caring needs. Poor oral care is associated with a risk of respiratory and cardiovascular complications during hospitalisation. Knowledge on patients' perspectives of maintaining or receiving oral care during admissions are limited. Following the Fundamentals of Care (FOC) framework, this study uses a person‐centred approach to explore patients' perceptions and experiences of receiving or performing oral care, including the nursing staff's clinical practices.

Methodological design and justification

A focussed ethnographic approach was used to explore patients' perspectives and clinical practices during acute admissions in an Orthopaedic Department.

Ethics issues and approval

The local Data Protection Agency and the Ethics Committee approved the study.

Research methods, results and conclusions

Data were collected in an Orthopaedic ward at a Copenhagen University hospital, Hvidovre, and consisted of 14 days of field observations of clinical practices and 15 patient interviews. Data were analysed inductively using qualitative content analysis. Two themes were identified. The first, ‘The purpose of oral care is defined by the eye of the beholder’, describes the social implications for the patients and how patients reject the assumption of oral care being a transgressive act. The second, ‘The unspoken need’, focus on the lack of dialogue, including the limited provision of oral care and how the nursing staff assesses patients' ability to perform oral care (in)dependently without including the patients.

Conclusion

Oral care is related to the patient's psychological and physical well‐being and affects social appearance. When oral care is provided respectfully, patients do not experience oral care as a transgressive act. Nursing staff's self‐assessments of the patients' (in)dependency to perform oral care risk leading to incorrect care. Developing and implementing interventions applicable to the clinical practice is needed.
Long‐term static stretching can decrease muscle stiffness: A systematic review and meta‐analysis
Authors: Takeuchi Kosuke , Nakamura Masatoshi , Konrad Andreas , Mizuno Takamasa
Published: May 2023

Stretch training increases the range of motion of a joint. However, to date, the mechanisms behind such a stretching effect are not well understood. An earlier meta‐analysis on several studies reported no changes in the passive properties of a muscle (i.e., muscle stiffness) following long‐term stretch training with various types of stretching (static, dynamic, and proprioceptive neuromuscular stretching). However, in recent years, an increasing number of papers have reported the effects of long‐term static stretching on muscle stiffness. The purpose of the present study was to examine the long‐term (≥2 weeks) effect of static stretching training on muscle stiffness. PubMed, Web of Science, and EBSCO published before December 28, 2022, were searched and 10 papers met the inclusion criteria for meta‐analysis. By applying a mixed‐effect model, subgroup analyses, which included comparisons of sex (male vs. mixed sex) and type of muscle stiffness assessment (calculated from the muscle‐tendon junction vs. shear modulus), were performed. Furthermore, a meta‐regression was conducted to examine the effect of total stretching duration on muscle stiffness. The result of the meta‐analysis showed a moderate decrease in muscle stiffness after 3–12 weeks of static stretch training compared to a control condition (effect size = −0.749, p < 0.001, I2 = 56.245). Subgroup analyses revealed no significant differences between sex (p = 0.131) and type of muscle stiffness assessment (p = 0.813). Moreover, there was no significant relationship between total stretching duration and muscle stiffness (p = 0.881).
Single‐cell RNA sequencing analysis of the embryogenic callus clarifies the spatiotemporal developmental trajectories of the early somatic embryo in Dimocarpus longan
Authors: Zhang Shuting , Zhu Chen , Zhang Xueying , Liu Mengyu , Xue Xiaodong , Lai Chunwang , Xuhan Xu , Chen Yukun , Zhang Zihao , Lai Zhongxiong , Lin Yuling
Published: May 2023

Plant embryogenic calli (ECs) can undergo somatic embryogenesis to regenerate plants. This process is mediated by regulatory factors, such as transcription factors and specifically expressed genes, but the precise molecular mechanisms underlying somatic embryogenesis at the single‐cell level remain unclear. In this study, we performed high‐resolution single‐cell RNA sequencing analysis to determine the cellular changes in the EC of the woody plant species Dimocarpus longan (longan) and clarify the continuous cell differentiation trajectories at the transcriptome level. The highly heterogeneous cells in the EC were divided into 12 putative clusters (e.g., proliferating, meristematic, vascular, and epidermal cell clusters). We determined cluster‐enriched expression marker genes and found that overexpression of the epidermal cell marker gene GDSL ESTERASE/LIPASE‐1 inhibited the hydrolysis of triacylglycerol. In addition, the stability of autophagy was critical for the somatic embryogenesis of longan. The pseudo‐timeline analysis elucidated the continuous cell differentiation trajectories from early embryonic cell division to vascular and epidermal cell differentiation during the somatic embryogenesis of longan. Moreover, key transcriptional regulators associated with cell fates were revealed. We found that ETHYLENE RESPONSIVE FACTOR 6 was characterized as a heat‐sensitive factor that negatively regulates longan somatic embryogenesis under high‐temperature stress conditions. The results of this study provide new spatiotemporal insights into cell division and differentiation during longan somatic embryogenesis at single‐cell resolution.
Design and Performance Analysis of Simple WDM Optical Fiber Communication System
Authors: Fakhruldeen Hassan Falah , Khekan Ahlam R. , Al-Kharsan Ibrahim H.
Published: May 2023

WDM (wavelength division multiplexing) is used in this project to simultaneously send data over several channels at high speed. Single mode fiber is favored over Multimode fiber for long-distance communication. As data rate and optical fiber length grow, the quality factor falls. Dispersion effects on an 8-channel dense WDM system at a high data rate will be examined using the Optisystem 10 simulator. A dispersion compensation fiber (DCF) and an Erbium doped fiber amplifier (EDFA) are used to compensate for the dispersion and attenuation in the transmitted optical signal, respectively. Bit error rate (BER) and eye diagram analyzers were used to evaluate the optical communication system's performance.
Isometric actions on Lp-spaces: dependence on the value of p
Authors: Marrakchi Amine , de la Salle Mikael
Published: May 2023

Answering a question by Chatterji–Druţu–Haglund, we prove that, for every locally compact group $G$, there exists a critical constant $p_G \in [0,\infty ]$ such that $G$ admits a continuous affine isometric action on an $L_p$ space ($0< p<\infty$) with unbounded orbits if and only if $p \geq p_G$. A similar result holds for the existence of proper continuous affine isometric actions on $L_p$ spaces. Using a representation of cohomology by harmonic cocycles, we also show that such unbounded orbits cannot occur when the linear part comes from a measure-preserving action, or more generally a state-preserving action on a von Neumann algebra and $p>2$. We also prove the stability of this critical constant $p_G$ under $L_p$ measure equivalence, answering a question of Fisher.
Procedural pain assessment in neonates at risk of neonatal opioid withdrawal syndrome: a scoping review protocol
Authors: Lavergne Julianna , Langman Erin , Mansell Deborah , Dol Justine , West Claire , Benoit Britney
Published: May 2023

Objective:

The objective of this review is to identify evidence on pain assessment during acute procedures in hospitalized neonates at risk of neonatal opioid withdrawal syndrome (NOWS).

Introduction:

While all neonates are routinely exposed to various painful procedures, neonates at risk of NOWS have longer hospital stays and are exposed to multiple painful procedures. NOWS occurs when a neonate is born to a birth parent who identifies as having sustained opioid use (such as morphine or methadone) during pregnancy. Accurate pain assessment and management during painful procedures is critical for minimizing the well-documented adverse effects of unmanaged pain in neonates. While pain indicators and composite pain scores are valid and reliable for healthy neonates, there is no review of evidence regarding procedural pain assessment in neonates at risk of NOWS.

Inclusion criteria:

Eligible studies will include those reporting on hospitalized pre-term and full-term neonates at risk of NOWS having pain assessments (ie, behavioral indicators, physiological indicators, validated composite pain scores) during and/or after exposure to an acute painful procedure.

Methods:

This review will follow the JBI scoping review methodology. Databases to be searched will include MEDLINE (Ovid), CINAHL (EBSCO), Embase, PsyclNFO (EBSCO), and Scopus. The relevant data will be extracted by 2 reviewers using a modified JBI extraction tool. The results will be summarized in narrative and tabular format, including the components of participants, concept, and context (PCC).

Review registration:

Open Science Framework https://osf.io/fka8s.
Effectiveness of interventions to reduce sexually transmitted infections and blood-borne viruses in incarcerated adult populations: a systematic review protocol
Authors: Balmer Amanda , Brömdal Annette , Mullens Amy , Kynoch Kathryn , Osborne Sonya
Published: May 2023

Objective:

This review will identify, synthesize, and make recommendations regarding the effectiveness of interventions to reduce sexually transmitted infections (STIs) and blood-borne viruses (BBVs) in incarcerated adult settings.

Introduction:

High-risk sexual behaviors, intravenous drug use, piercing, and tattooing are well documented within incarceration environments. Despite the World Health Organization’s Global Health Sector Strategy on Sexually Transmitted Infections 2016–2021 and the Global Health Sector strategies on, respectively, HIV, viral hepatitis, and sexually transmitted infections for the period 2022–2030, STI rates within adult incarceration environments continue to rise. Identifying and implementing best-practice interventions to prevent and manage STIs and BBVs will aid infection reduction in correctional settings. The review results will inform the development of educational programs, health promotion, and policies and procedures to improve health outcomes for incarcerated populations.

Inclusion criteria:

This review will consider studies in any language from any adult incarceration facility. Studies set in juvenile facilities or detention centers will be excluded. Any intervention for preventing or reducing STI and/or BBV transmission will be included.

Methods:

This review will follow the JBI methodology for systematic reviews of effectiveness. Databases to be searched will include PubMed, CINAHL (EBSCO), Ovid Library, PsycINFO (EBSCO), Cochrane CENTRAL, and Scopus. Two independent reviewers will screen titles and abstracts and assess full-text citations against the inclusion criteria. Methodological quality will be appraised using JBI’s standardized critical appraisal instruments. Where possible, studies will be pooled using meta-analysis. Where statistical pooling is not possible, findings will be presented in narrative format. Certainty of evidence will be ascertained using the GRADE approach.

Review registration:

PROSPERO CRD42022325077
Resolving buried interfaces with low energy ion scattering
Authors: Valpreda Adele , Sturm Jacobus M. , Yakshin Andrey E. , Ackermann Marcelo
Published: May 2023

We investigate the use of low energy ion scattering (LEIS) to characterize buried interfaces of ultrathin films. LEIS spectra contain depth-resolved information in the so-called subsurface signal. However, the exact correlation between the subsurface signal and the sample’s depth composition is still unknown. For this reason, LEIS spectra so far only provided qualitative information about buried interfaces. In this study, we investigate nm-thin films of Si-on-W and Si-on-Mo, where we compare simulated data to LEIS spectra. We present a method to extract depth-sensitive compositional changes—resolving buried interfaces—from LEIS spectra for the first few nanometers of a thin-film sample. In the case of Si-on-Mo, the simulation of the LEIS subsurface signal allows obtaining a quantitative measurement of the interface profile that matches the value determined using the LEIS layer growth profile method with an accuracy of 0.1 nm. These results pave the way to further extend the use of LEIS for the characterization of features buried inside the first few nanometers of a sample.
Large diurnal compensatory effects mitigate the response of Amazonian forests to atmospheric warming and drying
Authors: Zhang Zhaoying , Cescatti Alessandro , Wang Ying-Ping , Gentine Pierre , Xiao Jingfeng , Guanter Luis , Huete Alfredo R. , Wu Jin , Chen Jing M. , Ju Weimin , Peñuelas Josep , Zhang Yongguang
Published: May 2023

Photosynthesis and evapotranspiration in Amazonian forests are major contributors to the global carbon and water cycles. However, their diurnal patterns and responses to atmospheric warming and drying at regional scale remain unclear, hindering the understanding of global carbon and water cycles. Here, we used proxies of photosynthesis and evapotranspiration from the International Space Station to reveal a strong depression of dry season afternoon photosynthesis (by 6.7 ± 2.4%) and evapotranspiration (by 6.1 ± 3.1%). Photosynthesis positively responds to vapor pressure deficit (VPD) in the morning, but negatively in the afternoon. Furthermore, we projected that the regionally depressed afternoon photosynthesis will be compensated by their increases in the morning in future dry seasons. These results shed new light on the complex interplay of climate with carbon and water fluxes in Amazonian forests and provide evidence on the emerging environmental constraints of primary productivity that may improve the robustness of future projections.
Microglia mediate neurocognitive deficits by eliminating C1q-tagged synapses in sepsis-associated encephalopathy
Authors: Chung Ha-Yeun , Wickel Jonathan , Hahn Nina , Mein Nils , Schwarzbrunn Meike , Koch Philipp , Ceanga Mihai , Haselmann Holger , Baade-Büttner Carolin , von Stackelberg Nikolai , Hempel Nina , Schmidl Lars , Groth Marco , Andreas Nico , Götze Juliane , Coldewey Sina M. , Bauer Michael , Mawrin Christian , Dargvainiene Justina , Leypoldt Frank , Steinke Stephan , Wang Zhao-Qi , Hust Michael , Geis Christian
Published: May 2023

Sepsis-associated encephalopathy (SAE) is a severe and frequent complication of sepsis causing delirium, coma, and long-term cognitive dysfunction. We identified microglia and C1q complement activation in hippocampal autopsy tissue of patients with sepsis and increased C1q-mediated synaptic pruning in a murine polymicrobial sepsis model. Unbiased transcriptomics of hippocampal tissue and isolated microglia derived from septic mice revealed an involvement of the innate immune system, complement activation, and up-regulation of lysosomal pathways during SAE in parallel to neuronal and synaptic damage. Microglial engulfment of C1q-tagged synapses could be prevented by stereotactic intrahippocampal injection of a specific C1q-blocking antibody. Pharmacologically targeting microglia by PLX5622, a CSF1-R inhibitor, reduced C1q levels and the number of C1q-tagged synapses, protected from neuronal damage and synapse loss, and improved neurocognitive outcome. Thus, we identified complement-dependent synaptic pruning by microglia as a crucial pathomechanism for the development of neuronal defects during SAE.
Secreted endogenous macrosomes reduce Aβ burden and ameliorate Alzheimer’s disease
Authors: Wang Cunli , Yang Yiming , Zhang Xiaoyu , Shi Zhenqiang , Gao Huiling , Zhong Manli , Fan Yonggang , Zhang Hongyan , Liu Bo , Qing Guangyan
Published: May 2023

Innovative therapeutic strategies are urgently needed for Alzheimer’s disease (AD) due to the increasing size of the aging population and the lack of effective drug treatment. Here, we report the therapeutic effects of extracellular vesicles (EVs) secreted by microglia, including macrosomes and small EVs, on AD-associated pathology. Macrosomes strongly inhibited β-amyloid (Aβ) aggregation and rescued cells from Aβ misfolding–induced cytotoxicity. Furthermore, macrosome administration reduced Aβ plaques and ameliorated cognitive impairment in mice with AD. In contrast, small EVs slightly promoted Aβ aggregation and did not improve AD pathology. Proteomic analysis of small EVs and macrosomes revealed that macrosomes harbor several important neuroprotective proteins that inhibit Aβ misfolding. In particular, the small integral membrane protein 10–like protein 2B in macrosomes has been shown to inhibit Aβ aggregation. Our observations provide an alternative therapeutic strategy for the treatment of AD over conventional ineffective drug treatments.
LOXL4, but not LOXL2, is the critical determinant of pathological collagen cross-linking and fibrosis in the lung
Authors: Ma Hsiao-Yen , Li Qingling , Wong Weng Ruh , N’Diaye Elsa-Noah , Caplazi Patrick , Bender Hannah , Huang Zhiyu , Arlantico Alexander , Jeet Surinder , Wong Aaron , Emson Claire , Brightbill Hans , Tam Lucinda , Newman Robert , Roose-Girma Merone , Sandoval Wendy , Ding Ning
Published: May 2023

Idiopathic pulmonary fibrosis is a progressive fibrotic disease characterized by excessive deposition of (myo)fibroblast produced collagen fibrils in alveolar areas of the lung. Lysyl oxidases (LOXs) have been proposed to be the central enzymes that catalyze the cross-linking of collagen fibers. Here, we report that, while its expression is increased in fibrotic lungs, genetic ablation of LOXL2 only leads to a modest reduction of pathological collagen cross-linking but not fibrosis in the lung. On the other hand, loss of another LOX family member, LOXL4, markedly disrupts pathological collagen cross-linking and fibrosis in the lung. Furthermore, knockout of both
Loxl2
and
Loxl4
does not offer any additive antifibrotic effects when compared to
Loxl4
deletion only, as LOXL4 deficiency decreases the expression of other LOX family members including
Loxl2
. On the basis of these results, we propose that LOXL4 is the main LOX activity underlying pathological collagen cross-linking and lung fibrosis.
Transformation of arginine into zero-dimensional nanomaterial endows the material with antibacterial and osteoinductive activity
Authors: Li Jiaying , Ma Jinjin , Sun Heng , Yu Meizhe , Wang Huan , Meng Qingchen , Li Zexi , Liu Dachuan , Bai Jianzhong , Liu Guoping , Xing Xiaodong , Han Fengxuan , Li Bin
Published: May 2023

Implant-associated infection is a major threat affecting the success of orthopedic surgeries. Although various materials scavenge bacteria by generating reactive oxygen species (ROS), the intrinsic inability of ROS to distinguish bacteria from cells notably limits the therapeutic effects. Here, we found that the arginine carbon dots (Arg-CDs) that were transformed from arginine exhibited supreme antibacterial and osteoinductive activity. We further designed the Schiff base bond between Arg-CDs and aldehyde hyaluronic acid/gelatin methacryloyl (HG) hydrogel to release Arg-CDs in response to the acidic bone injury microenvironment. The free Arg-CDs could selectively kill bacteria by generating excessive ROS. Furthermore, the Arg-CD–loaded HG composite hydrogel showed excellent osteoinductive activity through inducing the M2 polarization of macrophages by up-regulating interleukin-10 (
Il10
) expression. Together, our findings revealed that transformation of the arginine into zero-dimensional Arg-CDs could endow the material with exceptional antibacterial and osteoinductive activity, favoring the regeneration of infectious bone.
Global analysis of the yeast knockout phenome
Authors: Turco Gina , Chang Christie , Wang Rebecca Y. , Kim Griffin , Stoops Emily H. , Richardson Brianna , Sochat Vanessa , Rust Jennifer , Oughtred Rose , Thayer Nathaniel , Kang Fan , Livstone Michael S. , Heinicke Sven , Schroeder Mark , Dolinski Kara J. , Botstein David , Baryshnikova Anastasia
Published: May 2023

Genome-wide phenotypic screens in the budding yeast
Saccharomyces cerevisiae
, enabled by its knockout collection, have produced the largest, richest, and most systematic phenotypic description of any organism. However, integrative analyses of this rich data source have been virtually impossible because of the lack of a central data repository and consistent metadata annotations. Here, we describe the aggregation, harmonization, and analysis of ~14,500 yeast knockout screens, which we call Yeast Phenome. Using this unique dataset, we characterized two unknown genes (
YHR045W
and
YGL117W
) and showed that tryptophan starvation is a by-product of many chemical treatments. Furthermore, we uncovered an exponential relationship between phenotypic similarity and intergenic distance, which suggests that gene positions in both yeast and human genomes are optimized for function.
Tissue-resident memory T cells mediate mucosal immunity to recurrent urinary tract infection
Authors: Rousseau Matthieu , Lacerda Mariano Livia , Canton Tracy , Ingersoll Molly A.
Published: May 2023

Urinary tract infection (UTI) is one of the most prevalent human bacterial infections. New therapeutic approaches, including vaccination and immunotherapy, are urgently needed to combat the rapid global dissemination of multidrug-resistant uropathogens. Development of therapies is impeded by an incomplete understanding of memory development during UTI. Here, we found that reducing bacterial load early in infection, by reducing the inoculum or with antibiotics after infection, completely abrogated the protective memory response. We observed a mixed T helper (T
H
) cell polarization, composed of T
H
1, T
H
2, and T
H
17 T cells, among T cells infiltrating the bladder during primary infection. Thus, we hypothesized that reducing antigen load altered T
H
cell polarization, leading to poor memory. Unexpectedly, however, T
H
cell polarization was unchanged in these scenarios. Instead, we uncovered a population of tissue-resident memory (T
RM
) T cells that was significantly reduced in the absence of sufficient antigen. Demonstrating that T
RM
cells are necessary for immune memory, transfer of lymph node– or spleen-derived infection-experienced T cells to naïve animals did not confer protection against infection. Supporting that T
RM
cells are sufficient to protect against recurrent UTI, animals depleted of systemic T cells, or treated with FTY720 to block memory lymphocyte migration from lymph nodes to infected tissue, were equally protected compared with unmanipulated mice against a second UTI. Thus, we uncovered an unappreciated key role for T
RM
cells in the memory response to bacterial infection in the bladder mucosa, providing a target for non–antibiotic-based immunotherapy and/or new vaccine strategies to prevent recurrent UTI.
Waterfall height sets the mechanism and rate of upstream retreat
Authors: Inoue T. , Izumi N. , Scheingross J.S. , Hiramatsu Y. , Tanigawa S. , Sumner T.
Published: May 2023

Waterfalls are among the fastest-eroding parts of river networks, but predicting natural waterfall retreat rates is difficult due to multiple processes that can drive waterfall erosion. We lack data on how waterfall height influences the mechanism and rate of upstream waterfall retreat. We addressed this knowledge gap with experiments testing the influence of drop height on waterfall retreat. Our experiments showed that shorter waterfalls retreat up to five times faster than taller waterfalls, when bedrock strength, sediment supply, and water discharge are constant. This retreat rate difference is due to a change in the erosion mechanism. Short waterfalls retreat by the formation of several small, rapidly eroding bedrock steps (i.e., cyclic steps), whereas tall waterfalls tend to form large bedrock plunge pools where lateral plunge pool erosion allows headwall undercutting and subsequent waterfall retreat. Because waterfall height can be partially set by the waterfall formation mechanism, our results highlight that the rate of waterfall retreat and subsequent landscape evolution can be modulated by the processes that form waterfalls.
Mesenteric lipoblastomatosis: an uncommon fat-containing childhood tumour diagnosed on imaging
Authors: Yadav Richa , Kandasamy Devasenathipathy , Agarwal Sandeep , Gamanagatti, Shivanand
Published: May 2023

Lipoblastomatosis of mesentery is an extremely rare benign fat-containing mesenchymal tumour in infants and young children. On imaging, it appears as a solid infiltrating mass interspersed with macroscopic fat. We describe the distinctive imaging features of a large mesenteric Lipoblastomatosis, corroborated with intraoperative and histopathological features. We hope the case report and short review about this rare entity will increase the diagnostic confidence of reading radiologists while formulating differentials for lesions of similar appearance in the paediatric age group.
Pure primary renal yolk sac tumour in an adult: extremely rare clinical finding
Authors: Maclean Ellen , Barns Mitchell , McDermott Kara
Published: May 2023

We present a rare case of an extragonadal retroperitoneal yolk sac tumour in an adult male, who presented with severe abdominal pain to his local hospital. Imaging revealed a large retroperitoneal soft tissue mass with no evidence of metastases. Initial biopsy demonstrated poorly differentiated carcinoma, favoured to be renal cell carcinoma. The patient underwent surgical resection following re-presentation with severe abdominal pain and significant interval enlargement of the mass. Laparotomy revealed a renal tumour that had ruptured through the left mesocolon into the peritoneal cavity. Postoperative histopathological examination revealed a yolk sac tumour involving the kidney, perinephric fat, renal sinus fat, renal hilar lymph node and colonic mesentery. Immunohistochemical staining for alpha-fetoprotein and glypican 3 was positive in the tumour cells without evidence of other germ cell elements, confirming the diagnosis of a pure yolk sac tumour. To our knowledge, this is an extremely rare case of a primary pure yolk sac tumour arising from the kidney in an adult.
Geographic prioritisation in Kenya and Uganda: a power analysis of donor transition
Authors: Paina Ligia , Rodriguez Daniela Cristina , Zakumumpa Henry , Mackenzie Caroline , Ssengooba Freddie , Bennett Sara
Published: May 2023

IntroductionDonor transition for HIV/AIDS programmes remains sensitive, marking a significant shift away from the traditional investment model of large-scale, vertical investments to control the epidemic and achieve rapid scaling-up of services. In late 2015, the United States President’s Emergency Plan for AIDS Relief (PEPFAR) headquarters instructed their country missions to implement ‘geographic prioritisation’ (GP), whereby PEPFAR investments would target geographic areas with high HIV burden and reduce or cease support in areas with low burden.

MethodsUsing Gaventa’s power cube framework, we compare how power is distributed and manifested using qualitative data collected in an evaluation of the GP’s impact in Kenya and Uganda.

ResultsWe found that the GP was designed with little space for national and local actors to shape either the policy or its implementation. While decision-making processes limited the scope for national-level government actors to shape the GP, the national government in Kenya claimed such a space, proactively pressuring PEPFAR to change particular aspects of its GP plan. Subnational level actors were typically recipients of top-down decision-making with apparently limited scope to resist or change GP. While civil society had the potential to hold both PEPFAR and government actors accountable, the closed-door nature of policy-making and the lack of transparency about decisions made this difficult.

ConclusionDonor agencies should exercise power responsibly, especially to ensure that transition processes meaningfully engage governments and others with a mandate for service delivery. Furthermore, subnational actors and civil society are often better positioned to understand the implications and changes arising from transition. Greater transparency and accountability would increase the success of global health programme transitions, especially in the context of greater decentralisation, requiring donors and country counterparts to be more aware and flexible of working within political systems that have implications for programmatic success.
Integrating eye care in low-income and middle-income settings: a scoping review
Authors: Lee Ling , Moo Elise , Angelopoulos Tiffany , Dodson Sarity , Yashadhana Aryati
Published: May 2023

Objectives

Integrated people-centred eye care has been recommended as a strategic framework for reducing global vision impairment and blindness. The extent to which eye care has integrated with other services has not been widely reported. We aimed to investigate approaches to integrating eye care service delivery with other systems in low resource settings, and identify factors associated with integration.

Design

Rapid scoping review based on Cochrane Rapid Review and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources

MEDLINE, Embase, Web of Science, Scopus and Cochrane Library databases were searched in September 2021.

Eligibility criteria

Papers with interventions involving eye care or preventative eye care integrated into other health systems, peer-reviewed in English, conducted in low-income or middle-income countries, and published between January 2011 and September 2021 were included.

Data extraction and synthesis

Two independent reviewers screened, quality appraised and coded included papers. A deductive–inductive iterative analysis approach was used with a focus on integrating service delivery.

Results

The search identified 3889 potential papers, of which 24 were included. Twenty papers incorporated more than one intervention type (promotion, prevention and/or treatment), but none included rehabilitation. Most articles involved human resources development yet rarely appeared to be people-centred. The level of integration was associated with building relationships and enhancing service coordination. Integrating human resources was challenged by the need for ongoing support and worker retention. In primary care settings, workers were often already at full capacity, had competing priorities, varying capabilities and limited motivation. Additional barriers included inadequate referral and information systems, poor supply chain management and procurement practices and finite financing.

Conclusion

Integrating eye care into low resource health systems is a challenging task, compounded by resource limitations, competing priorities and ongoing support needs. This review highlighted a need for people-centred approaches to future interventions, and further investigation into integrating vision rehabilitation services.
Effect of Prophylactic Fibrinogen Concentrate In Scoliosis Surgery (EFISS): a study protocol of two-arm, randomised trial
Authors: Vrbica Kamil , Hudec Jan , Hrdy Ondrej , Galko Michal , Horalkova Hana , Demlova Regina , Kubelova Michaela , Repko Martin , Gal Roman
Published: May 2023

Introduction

Fibrinogen is one of the essential coagulation factors. Preoperative lower plasma fibrinogen level has been associated with higher blood loss. Scoliosis surgery presents a challenge for the anaesthetic team, one of the reasons being blood loss and transfusion management. Recently, the prophylactic fibrinogen administration has been a debated topic in various indications. It has been described for example, in urological or cardiovascular surgery, as well as in paediatrics. This pilot study is focused on verifying the feasibility of potential large randomised trial and verifying the safety of prophylactic fibrinogen administration in paediatric scoliosis surgery.

Methods and analysis

A total of 32 paediatric patients indicated for scoliosis surgery will be recruited. Participants will be randomised into study groups in a 1:1 allocation ratio. Patients in the intervention group will receive prophylactic single dose of fibrinogen, in addition to standard of care. Patients in the control group will receive standard of care without study medication prior to skin incision. The primary aim is to assess the safety of prophylactic fibrinogen administration during scoliosis surgery in children, the incidence of any adverse events (AEs) and reactions will be monitored during participation in the study. The secondary objective is to investigate the additional safety information, feasibility and efficacy of a prophylactic fibrinogen administration. The incidence of AEs and reactions according to selected adverse events of special interest will be monitored. All collected data will be subjected to statistical analysis according to a separate statistical analysis plan.

Ethics and dissemination

This trial follows the applicable legislation and requirements for good clinical practice according to the International Conference on Harmonisation E6(R2). All essential trial documents were approved by the relevant ethics committee and national regulatory authority (State Institute for Drug Control) and their potential amendments will be submitted for approval.

Trial registration number

NCT05391412.
Mental health help-seeking preferences and behaviour in elite male rugby players
Authors: Oguro Saki , Ojio Yasutaka , Matsunaga Asami , Shiozawa Takuma , Kawamura Shin , Yoshitani Goro , Horiguchi Masanori , Fujii Chiyo
Published: May 2023

Objectives

Mental health symptoms and mental illnesses are common in elite athletes. There is an urgent need to develop care systems to support the mental health of elite athletes. Understanding elite athletes’ preferences in mental health help seeking can help explore strategies to develop such systems. Therefore, this study aims to investigate with whom/where elite athletes feel comfortable discussing mental health concerns and seeking help.

Methods

We analyse data from 219 Japanese male rugby players out of 612 players (565 Japanese, 47 foreigners) aged 18 and over who belong to the Japan Rugby Players Association using a cross-sectional design and an anonymous, web-based, self-administered questionnaire. In the questionnaire, the players are asked to rate on a 5-point Likert scale how comfortable they feel talking about their mental health concerns with affiliation/team staff, family/relatives, friends, mental health professionals, rugby-related seniors and teammates. Analysis of variance and Dunnett’s test are performed to detect differences in their preferences for sources of help.

Results

Dunnett’s test shows that the mean scores for preferring to consult affiliation/team staff are significantly lower than for all the other groups (p<0.001), indicating that players are reluctant to seek help for mental health concerns from affiliation/team staff. Fewer players sought help from affiliation/team staff or mental health professionals than from other groups.

Conclusion

Regarding mental health concerns, for elite male rugby players as elite athletes, it can be difficult to ask for help or talk to team staff.
Clinical features, treatment strategies and outcomes of craniocervical junction arteriovenous fistulas: a cohort study of 193 patients
Authors: Ma Yongjie , Song Zihao , Wang Yinqing , Wang Jiachen , He Chuan , Li Guilin , Zhang Peng , Hong Tao , Sun Liyong , Hu Peng , Ye Ming , Zhang Hongqi
Published: May 2023

Background

Craniocervical junction (CCJ) arteriovenous fistulas (AVFs) are rare. The current treatment strategies for AVFs with different angioarchitecture need to be clarified. The present study aimed to analyse the correlation between angioarchitecture and clinical characteristics, share our experience in treating this disease and identify risk factors associated with subarachnoid haemorrhage (SAH) and poor outcomes.

Methods

A total of 198 consecutive patients with CCJ AVFs from our neurosurgical centre were retrospectively reviewed. The patients were grouped according to their clinical manifestations, and their baseline clinical characteristics, angioarchitecture, treatment strategies and outcomes were summarised.

Results

The patients’ median age was 56 years (IQR 47–62 years). The majority of patients were men with 166 (83.8%) patients. The most common clinical manifestation was SAH (52.0%), followed by venous hypertensive myelopathy (VHM) (45.5%). The most common CCJ AVFs type was dural AVF, with 132 (63.5%) fistulas. The most frequent fistula location was C-1 (68.7%) and dural branch of vertebral artery (70.2%) was the most involved arterial feeders for fistulas. The most common direction of venous drainage was descending intradural drainage (40.9%), followed by ascending intradural drainage (36.5%). Microsurgery was the most common treatment strategy applied for 151 (76.3%) patients, 15 (7.6%) patients were treated with interventional embolisation only, and 27 (13.6%) received both interventional embolisation and microsurgical treatment. The learning curve for microsurgery only was analysed by cumulative summation method, and the turning point was the 70th case, and blood loss in post-group was lower than that in pre-group (p=0.034). At the last follow-up, there were 155 (78.3%) patients with favourable outcomes (modified Rankin Scale(mRS)<3). Age≥56 (OR 2.038, 95% CI 1.039 to 3.998, p=0.038), VHM as the clinical manifestation (OR 4.102, 95% CI 2.108 to 7.982, p<0.001) and pretreatment mRS≥3 (OR 3.127, 95% CI 1.617 to 6.047, p<0.001) were significantly associated with poor outcomes.

Conclusion

The arterial feeders and direction of the venous drainage were important factors in the clinical presentations. The location of fistula and drainage vein was essential for choosing different treatment strategies. Older age, VHM onset and poor pretreatment functional status predicted poor outcomes.
When public health crises collide: 5 years of pediatric firearm injury prevention opportunities
Authors: Tatebe Leah C , Cone Jennifer T , Slidell Mark B , Chang Grace , Jonikas Meghan , Stewart Amy , Doherty James , Arunkumar Ponni , Schlanser Victoria , Dennis Andrew J
Published: May 2023

Objectives

Prior publications on pediatric firearm-related injuries have emphasized significant social disparities. The pandemic has heightened a variety of these societal stresses. We sought to evaluate how we must now adapt our injury prevention strategies.

Patients and methods

Firearm-related injuries in children 15 years old and under at five urban level 1 trauma centers between January 2016 and December 2020 were retrospectively reviewed. Age, gender, race/ethnicity, Injury Severity Score, situation, timing of injury around school/curfew, and mortality were evaluated. Medical examiner data identified additional deaths.

Results

There were 615 injuries identified including 67 from the medical examiner. Overall, 80.2% were male with median age of 14 years (range 0–15; IQR 12–15). Black children comprised 77.2% of injured children while only representing 36% of local schools. Community violence (intentional interpersonal or bystander) injuries were 67.2% of the cohort; 7.8% were negligent discharges; and 2.6% suicide. Median age for intentional interpersonal injuries was 14 years (IQR 14–15) compared with 12 years (IQR 6–14, p<0.001) for negligent discharges. Far more injuries were seen in the summer after the stay-at-home order (p<0.001). Community violence and negligent discharges increased in 2020 (p=0.004 and p=0.04, respectively). Annual suicides also increased linearly (p=0.006). 5.5% of injuries were during school; 56.7% after school or during non-school days; and 34.3% were after legal curfew. Mortality rate was 21.3%.

Conclusions

Pediatric firearm-related injuries have increased during the past 5 years. Prevention strategies have not been effective during this time interval. Prevention opportunities were identified specifically in the preteenage years to address interpersonal de-escalation training, safe handling/storage, and suicide mitigation. Efforts directed at those most vulnerable need to be reconsidered and examined for their utility and effectiveness.

Level of evidence

Level III; epidemiological study type.
Paralava and clinker from the Canadian Arctic: a record of combustion metamorphism dating back to the late Miocene
Authors: Reinhardt Lutz , Estrada Solveig , Dohrmann Reiner , Koglin Nikola , Piepjohn Karsten , Galloway Jennifer M.
Published: May 2023

Outcrops with conspicuous reddish to yellow-colored clinker, blackish paralava, and blends of both with a breccia-like appearance occur across the Canadian Arctic. We examined such rocks on Ellesmere Island, Banks Island, and the Mackenzie Delta area. These rocks are a product from natural combustion of bituminous shale and low-rank coal seams in Cretaceous and Paleogene host sedimentary rocks, respectively. The main mineral phases of clinker and silicate paralava samples are comprised of quartz + hematite ± feldspars ± cristobalite (or tridymite) ± cordierite–sekaninaite ± clinopyroxene ± sillimanite ± glass. Slag-like iron oxide paralava (74–95 wt.% total Fe2O3) consisting of hematite ± magnetite ± clinopyroxene occur in Paleogene host sedimentary rocks, rich in siderite concretions. The whole-rock geochemical composition of clinker and silicate paralava shows similarities for samples from the same outcrop. Regional and local specific elemental enrichments are mainly inherited from the sedimentary protoliths, which are characterized by volcanogenic input (Paleocene sedimentary rocks) or oxygen-depleted depositional conditions (Upper Cretaceous bituminous sedimentary rocks). Spontaneous combustion could take place when the organic-rich sedimentary rocks become exposed to atmospheric oxygen. This process has occurred at least since the Messinian stage (Miocene) on Ellesmere Island (6.1 ± 0.2 Ma; 40Ar/39Ar incremental heating dating on whole-rock paralava) and continues until now. An active combustion process on scree from a coal seam and clastic Eureka Sound Group sedimentary rocks was observed on Ellesmere Island.
Biodegradation of 2-methylpentane in fluid fine tailings amended with a mixture of iso-alkanes under sulfate-reducing conditions
Authors: Mohamad Shahimin Mohd Faidz , Siddique Tariq
Published: May 2023

Anaerobic microorganisms in Canada Natural Upgrading Limited (CNUL) fluid fine tailings (FFT) are sustained by residual solvent hydrocarbons. Although FFT are methanogenic in nature, sulfate-reducing microorganisms represent a significant portion of FFT bacterial community. In this study, we examined biodegradation of three iso-alkanes (2-methylbutane, 2-methylpentane, and 3-methylpentane), representing major iso-alkanes in paraffinic solvent, in CNUL FFT under sulfate-reducing conditions. During ∼1100 days of incubation, only 2-methylpentane was degraded partially, whereas 2-methylbutane and 3-methylpentane were not degraded. During active degradation of 2-methylpentane, the bacterial community was dominated by Anaerolineaceae followed by Syntrophaceae, Peptococcaceae, Desulfobacteraceae, and Desulfobulbaceae. The archaeal community was co-dominated by acetoclastic (Methanosaetaceae) and hydrogenotrophic (Methanobacteriaceae) methanogens. This study underlines the limited capability of the microbial community indigenous to CNUL FFT in degrading recalcitrant iso-alkanes under sulfate-reducing conditions.
Vitamins E and A increase the passing of the P-gp substrate ivermectin into the brain in mice
Authors: Tras Bunyamin , Uney Kamil , Parlak Tugba Melike , Tufan Oznur
Published: May 2023

This study aimed to determine the effect of administration of oral vitamins A and E at different doses on plasma and brain concentrations of ivermectin in mice. The study was carried out on 174 Swiss Albino male mice aged 8–10 weeks. After leaving six mice for method validation, the remaining mice were randomly divided into seven groups with equal numbers of animals. Mice received ivermectin (0.2 mg/kg, subcutaneous) alone and in combination with low (vitamin A: 4000 IU/kg; vitamin E: 35 mg/kg) and high (vitamin A: 30 000 IU/kg; vitamin E: 500 mg/kg) oral doses of vitamins A and E. The plasma and brain concentrations of ivermectin were measured using high-performance liquid chromatography-fluorescence detector. We determined that high doses of vitamins A and E and their combinations increased the passing ratio of ivermectin into the brain significantly. The high-dose vitamin E and the combination of high-concentration vitamins E and A significantly increased the plasma concentration of ivermectin ( P < 0.05). The high-dose vitamins E and A and their high-dose combination increased the brain concentration of ivermectin by 3, 2, and 2.7 times, respectively. This research is the first in vivo study to determine the interaction between P-gp substrates and vitamins E and A.
Preliminary assessment of thermal imaging equipped aerial drones for secretive marsh bird detection
Authors: Olsen Tabitha W. , Barron Trey , Butler Christopher J.
Published: May 2023

Rails are a highly secretive group of marshland obligate species that are difficult to consistently survey and detect. Current survey efforts utilize either call–playback or autonomous recording devices, but the low detection probabilities for rails create challenges for long-term systematic monitoring. Between 8 April and 16 May 2022, we flew a small aerial drone equipped with a thermal camera to survey for six species of rail (Black Rail ( Laterallus jamaicensis), Yellow Rail ( Coturnicops noveboracensis), Sora ( Porzana carolina), Virginia Rail ( Rallus limicola), Clapper Rail ( Rallus crepitans), and King Rail ( Rallus elegans)) along the Gulf Coast of Texas to assess the feasibility of long-term drone monitoring. We successfully conducted 33 flights at 15 m above ground level and detected rails on the first visit at 42% of known occupied points. We achieved 27 total rail detections, including 12 Black Rail/Yellow Rail detections. Of the birds detected, 81% exhibited no response to the drone’s first approach. We intend for this preliminary data to shape future survey protocol for secretive species occupying difficult to navigate terrain.
DOIN: a novel electronic personal dosemeter for neutrons
Authors: Calamida A. , Bedogni R. , Fontanilla A. , Campoy A. I. Castro , Cantone C. , Napolitano T. , Pietropaolo A.
Published: May 2023

Electronic personal dosemeters (EPD) are powerful tools for achieving ALARA (As Low As Reasonably Achievable) objectives in operational radiation protection. EPD for photons are well developed and their performances usually comply with relevant Standards. By contrast, a very few commercial models exist for neutrons and their energy dependence is too large for using them without pre-information on the workplace neutron spectrum. Within the INFN-based DOIN (DOsimetro Indossabile per Neutroni) project, a new EPD for neutrons was prototyped. Owing to a new patented design, a good dose response was achieved in the energy interval from thermal neutrons up to the quality of $$^{241}$$

241

Am-Be. The response is nearly isotropic and, if compared to commercial models, exhibits higher sensitivity.