bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcriptional profiles of
Microcystis
reveal gene expression shifts that promote bloom persistence in
in situ
mesocosms
Authors: Krausfeldt Lauren E. , Samuel Paisley S. , Smith Robert P. , Urakawa Hidetoshi , Rosen Barry H. , Colwell Rita R. , Lopez Jose V. 
Published: November 2024

ABSTRACT

Harmful algal blooms caused by cyanobacteria threaten aquatic ecosystems, the economy, and human health. Previous work has tried to identify the mechanisms that allow blooms to form, focusing on the role of nutrients. However, little is known about how introduced nutrients influence gene expression
in situ
. To address this knowledge gap, we used
in situ
mesocosms initiated with water experiencing a
Microcystis
bloom. We added pulses of nutrients that are commonly associated with anthropogenic sources to the mesocosms for 72 hours and collected samples for metatranscriptomics to examine how the physiological function of
Microcystis
and bloom status changed. The addition of nitrogen (N) as urea, but not the addition of PO
4
, resulted in conspicuous bloom persistence for at least 9 days after the final introduction of nutrients. The addition of urea initially resulted in the upregulation of photosynthesis machinery, as well as phosphate, carbon, and N transport and metabolism. Once
Microcystis
presumably became N-replete, upregulation of amino acid metabolism, microcystin biosynthesis, and other processes associated with biomass generation occurred. These capacities coincided with the upregulation of toxin-antitoxin systems, CRISPR-
cas
genes, and transposases suggesting that phage defense and genome rearrangement are critical in bloom persistence. Overall, our results show the stepwise transcriptional response of a
Microcystis
bloom to the introduction of nutrients, specifically urea, as it is sustained in a natural setting. The transcriptomic shifts observed herein may serve as markers of the longevity of blooms while providing insight into why
Microcystis
blooms over other cyanobacteria.

IMPORTANCE

Harmful algal blooms represent a threat to human health and ecosystems. Understanding why blooms persist may help us develop warning indicators of bloom persistence and create novel mitigation strategies. Using mesocosm experiments initiated with water with an active bloom, we measured the stepwise transcription changes of the toxin-producing cyanobacterium
Microcystis
in response to the addition of nutrients that are important in causing blooms. We found that nitrogen (N), but not phosphorus, promoted bloom longevity. The initial introduction of N resulted in the upregulation of genes involved in photosynthesis and N import. At later times in the bloom, upregulation of genes involved in biomass generation, phage protection, genomic rearrangement, and toxin production was observed. Our results suggest that
Microcystis
first fulfills nutritional requirements before investing energy in pathways associated with growth and protection against competitors, which allowed bloom persistence more than a week after the final addition of nutrients.
High level non-carbapenemase carbapenem resistance by overlaying mutations of
mexR
,
oprD,
and
ftsI
in
Pseudomonas aeruginosa
Authors: Yang Yan , Li Xue , Sun Lang , Wang Xiu-Kun , Zhang You-Wen , Pang Jing , Li Guo-Qing , Hu Xin-Xin , Nie Tong-Ying , Yang Xin-Yi , Liu Jian-Hua , Brandis Gerrit , You Xue-Fu , Li Cong-Ran 
Published: November 2024

ABSTRACT

Carbapenem-resistant
Pseudomonas aeruginosa
(CRPA) is a global threat, but the mechanism of non-carbapenemase carbapenem resistance is still unclear. In the current study, we investigated the contributions of point mutations in
mexR
,
oprD
, and
ftsI
to carbapenem resistance in
P. aeruginosa
during
in vivo
evolution studies with consecutive clinical isolates. Real-time qPCR and Electrophoretic Mobility Shift Assay demonstrated that MexR (Gln55Pro) mutation increased MexAB efflux pump genes expression by altering MexR’s binding capacity, leading to a four- to eight-fold increase in meropenem MIC in the Pae d1 Green ∆
mexR
and PAO1∆
mexR
mutants. The OprD (Trp415*) truncation affected porin structure, and the constructed mutant Pae d1 Green
oprD
Trp415* increased meropenem MIC by 16-fold (from 0.25 to 4 µg/mL). The contribution of
ftsI
mutation to meropenem resistance was confirmed by clinical linkage analysis and was estimated to cause a two-fold increase in meropenem MIC by comparing the resistant clinical isolate with the Pae d1 Green
oprD
Trp415*∆
mexR
double mutant. The study found that the oprD Trp415* allele alone accounts for the imipenem MIC in clinical isolates, while the ∆
mexR
and
ftsI
Arg504Cys alleles do not contribute to imipenem resistance. In conclusion, we identified and explored the contributions of
mexR
,
oprD,
and
ftsI
mutations to high level non-carbapenemase carbapenem resistance in
P. aeruginosa
. These findings highlight the interplay of different mutations in causing non-carbapenemase carbapenem-resistance in
P. aeruginosa
.

IMPORTANCE

The emergence of carbapenem-resistant
Pseudomonas aeruginosa
(CRPA) poses a significant global health threat, complicating treatment options for infections caused by this pathogen. Understanding the mechanisms behind non-carbapenemase carbapenem resistance is critical for developing effective therapeutic strategies. This study provides crucial insights into how specific point mutations in key genes-
mexR
,
oprD
, and
ftsI
-contribute to carbapenem resistance, particularly the MexR (Gln55Pro) mutation’s effect on efflux pump expression and the OprD (Trp415*) truncation’s impact on porin structure. The findings elucidate the complex interplay of these mutations, highlighting their roles in conferring high-level resistance, and underscore the imperative for continued research to inform therapeutic strategies against CRPA infections.
Incidence of sudden unexplained death in childhood for children aged 1–14 years in England and Wales during 2001–2020: an observational study
Authors: Garstang Joanna Jane , Tosyali Merve , Menka Marivjena , Blair Peter S 
Published: November 2024

ObjectiveThe objective is to determine the incidence of sudden unexplained death in childhood (SUDC) for children aged 1–14 years in England and Wales during 2001–2020.DesignObservational study using official national statistics on death registrations and child population.SettingEngland and Wales.PatientsChildren dying of SUDC, aged 1–14 years, registered as International Classification of Disease version 10 codes R95–99.Main outcome measuresIncidence of SUDC, proportion of child mortality due to SUDC.ResultsA total of 582 children aged 1–14 years died of SUDC, 450 (77.3%) deaths were in children aged 1–4 years, 55 (9.5%) in those aged 5–9 years and 77 (13.2%) in those aged 10–14 years. The number of SUDC was relatively stable with a mean of 29 cases per year (range 21–38, SD 4.2). Overall child mortality fell from 1482 deaths in 2001 to 826 in 2020. The incidence of SUDC for children aged 1–14 years ranged between 0.002 and 0.004 per 1000. The relative proportion of child mortality due to SUDC increased from 1.96% of all child deaths in 2001 to 3.03% in 2020 (p=0.103), SUDC accounted for 5.8% of deaths of children aged 1–4 years by 2020. At all ages, SUDC was more common in male children than female children.ConclusionThe incidence of SUDC has remained static despite overall child mortality almost halving in the last two decades. SUDC is now more widely recognised due to improved investigation, but there has been limited research into SUDC; potential causes and associated risk factors remain unknown. As the relative proportion of child deaths due to SUDC increases, child health professionals must be aware of SUDC to support bereaved families.
Refractive changes in children in the Chicago area during the COVID-19 pandemic: a retrospective observational study
Authors: Kim Eugene , Stec Magdalena , Shaikh Noreen , Huang Jonathan , Ralay Ranaivo Hantamalala , Mets-Halgrimson Rebecca 
Published: November 2024

BackgroundRemote learning during the COVID-19 pandemic caused behavioural changes such as increased screen time and decreased outdoor time. This study aimed to investigate myopia progression in children during the COVID-19 pandemic.MethodsThis was a retrospective observational study performed among 2064 patients ages 2–17 with cycloplegic refractions in the months of January 2019–March 2021 at a tertiary children’s hospital. Exclusion criteria were a medical history of relevant connective tissue diseases, myopia control treatment, pseudophakia and aphakia.ResultsThe overall cohort (n=2064) had a mean spherical equivalent (SE) of 0.12±3.70 D in 2019, −0.07±3.95 D in 2020 and −0.49±3.85 D in 2021. The change in mean SE (0.42 D) from 2020 to 2021 was 2.2 times greater than the change (0.19 D) from 2019 to 2020 at baseline. In the cohort of return patients, there was a significant difference in myopic shift between years (F-ratio=14.4, p<0.00001), and a significant change from 2020 to 2021 (p=0.00008) but not from 2019 to 2020. When observing the prevalence of myopia grouped by age, 8-year-old and 17-year-old patients had the greatest increase compared with baseline. When grouped by refractive error, low myopia children (−0.5 D to −3.00 D) displayed the greatest change in mean SE 2020–2021.ConclusionsThere was a substantial increase in myopia progression for children in the Chicagoland area after the period of COVID-19 changes. The behavioural changes of home confinement and online learning during the pandemic may explain these findings.
Seven core competencies and conditions for equitable partnerships and power sharing in community-based participatory research
Authors: Ozano Kim , Alam Wafa , Aktar Bachera , Okoth Linet , Chumo Ivy , Quach Jessica Amegee , Muturi Nelly , Saidu Samuel , Gandi Ibrahim , Wiltgen Georgi Neele , Otiso Lilian , Conteh Abu , Theobald Sally , Dean Laura , Tolhurst Rachel , Karuga Robinson , Karki Jiban , Garimella Surekha , Rao Vinodkumar , Mwanki Anthony , Islam Nazia , Tengbe Sia Morenike , Dash Sweta , Saligram Prasanna Subramanya , Rashid Sabina , Steege Rosie 
Published: November 2024

Equitable health research requires actively engaging communities in producing new knowledge to advocate for their health needs. Community-based participatory research (CBPR) relies on the coproduction of contextual and grounded knowledge between researchers, programme implementers and community partners with the aim of catalysing action for change. Improving coproduction competencies can support research quality and validity. Yet, frameworks and guidance highlighting the ideal competencies and conditions needed for all research partners to contribute meaningfully and equitably are lacking. This paper aims to advance CBPR by laying out seven core competencies and conditions that can promote power sharing in knowledge production, application and dissemination at the individual, community, organisational and systems levels.Competencies were developed through an iterative process, that synthesised pre-existing literature and frameworks with a wide range of tacit knowledge from researchers, activists, implementation partners and community researchers from Bangladesh, India, Kenya, Sierra Leone and the UK.The seven core competencies and conditions are: (1) capacity to interpret and respond to individual and relational identity, connection, uniqueness and inequities; (2) ability of communities and partners to work in the most suitable, inclusive and synergistic way; (3) aptitude for generating safe and inclusive spaces for multidirectional knowledge and skills exchange that goes beyond the research focus; (4) expertise in democratic leadership and/or facilitation to balance competing priorities and ensure shared decision-making; (5) capacity to analyse readiness for action, successes and areas for improvements throughout the research process; (6) ability to instigate sustainable change processes within the political dimensions of systems, policies and practices using advocacy, lobbying or activism approaches and (7) skills to interpret and disseminate findings and outputs that are understandable, respectful and promote community ownership. We present core competency and condition areas, individual and collective expertise associated with competencies, likely outcomes, examples of activities and sources of evidence.
Comparative effectiveness of monovalent XBB.1.5 containing covid-19 mRNA vaccines in Denmark, Finland, and Sweden: target trial emulation based on registry data
Authors: Andersson Niklas Worm , Thiesson Emilia Myrup , Pihlström Nicklas , Perälä Jori , Faksová Kristýna , Gram Mie Agermose , Poukka Eero , Leino Tuija , Ljung Rickard , Hviid Anders 
Published: November 2024

ObjectiveTo estimate the effectiveness of vaccination with a monovalent covid-19 mRNA vaccine containing the omicron XBB.1.5 subvariant against severe covid-19 disease in Denmark, Finland, and Sweden.DesignTarget trial emulation based on registry data.SettingDenmark, Finland, and Sweden, 1 October 2023 to 21 April 2024.ParticipantsSource population of 3 898 264 individuals eligible for vaccination with the XBB.1.5 containing covid-19 mRNA vaccine at the start of the study on 1 October 2023. Study cohort comprised 1 876 282 recipients of an XBB.1.5 containing vaccine during the study period matched with 1 876 282 non-recipients. Individuals were aged ≥65 years (mean age 75.4 years, standard deviation 7.4 years) and had received at least four doses of a previous covid-19 vaccine.Main outcome measuresCumulative incidences of hospital admissions and deaths related to covid-19 in a follow-up period of 24 weeks after immunisation (defined as one week after vaccination) in recipients of an XBB.1.5 containing covid-19 mRNA vaccine and matched non-recipients. Cumulative incidences were used to calculate comparative vaccine effectiveness (1−risk ratio) and risk differences.ResultsThe associated comparative vaccine effectiveness was 57.9% (95% confidence interval (CI) 49.9% to 65.8%) against hospital admission for covid-19 (1085 v2635 events) and 75.2% (70.6% to 79.9%) against deaths related to covid-19 disease (348 v1458 events) after 24 weeks of follow-up. This result corresponded to 154.7 (95% CI 78.3 to 231.0) hospital admissions for covid-19 and 120.3 (110.5 to 130.2) deaths prevented per 100 000 individuals who were vaccinated with an XBB.1.5 containing vaccine. The associated comparative vaccine effectiveness was similar irrespective of sex, age group (65-74v≥75 years), number of doses of previous covid-19 vaccines, subgroup of co-administered seasonal influenza vaccines, and period of when either the omicron XBB or BA.2.86 sublineage was predominant. Although the observed reduction in risk was highest during the first weeks after vaccination, comparative vaccine effectiveness was well maintained after 24 weeks of follow-up.ConclusionsIn this study, in adults aged ≥65 years, vaccination with a monovalent XBB.1.5 containing covid-19 mRNA vaccine was associated with reduced rates of hospital admissions for covid-19 and deaths related to covid-19, during the autumn and winter of 2023-24 in Denmark, Finland, and Sweden.
Which glaucoma patients should be monitored at home and exploration of clinician perceptions on home monitoring? a survey of glaucoma specialists in the UK
Authors: Alagappan Uma , Stewart Carrie , Azuara-Blanco Augusto , King Anthony J , Tatham Andrew , Hernández Rodolfo , MacLennan Graeme , Shotton Darian , Forrest Mark , Gillies Katie 
Published: November 2024

ObjectivesTo identify suitable patients for glaucoma home monitoring and explore clinicians’ perceptions of the possible benefits and risks of home monitoring within the National Health Service.DesignAn online survey composed of open-ended and closed-ended questions.SettingSecondary care.ParticipantsGlaucoma specialists registered with the UK and Eire Glaucoma Society.Outcome measuresAgreement with clinical scenarios.ResultsThe estimated response rate was 68% (n=49). Of 49 participants, 92% (n=45) were consultant ophthalmologists and 71% (n=35) had over 10-year experience. There was a poor agreement regarding an ideal glaucoma patient for home monitoring, with only one scenario achieving over 60% agreement. Most participants believed that home monitoring would be most suitable for low-risk scenarios, rather than high-risk, due to fear of missing progression. In relation to acceptability, key facilitators included the potential to increase healthcare capacity and promote patient safety. However, low clinician trust in equipment reliability and fear of patient harm were reported as concerns.ConclusionsThere was no clear consensus on which patients would benefit most from glaucoma home monitoring. While many clinicians believe home monitoring may enhance healthcare, there were also many concerns about the technologies themselves. Further work to address clinician concerns is warranted.Research Registry registration number6213.
Turnover intention and influential factors among primary healthcare workers in Guangdong province, China: a cross-sectional study
Authors: Li Xia , Wang Jianli , He Lian , Hu Yang , Li Caiwen , Xie Yinmei , Wang Ningning , Luo Anfei , Lu Zhiwei 
Published: November 2024

ObjectivesPrimary health workers are crucial to the healthcare system, yet China experiences a notable shortage driven by high turnover rates. This study aimed to investigate the prevalence and determinants of turnover intention among primary health workers.DesignCross-sectional study.SettingPrimary healthcare facilities across 21 cities in Guangdong province, China.ParticipantsOnline questionnaires (SurveyStar, Changsha Ranxing Science and Technology) were administered to 16 573 primary health workers in September and October 2022.Primary and secondary outcome measuresVariables measured included demographics, work-related factors, job satisfaction, emotional exhaustion and turnover intention. Comparisons of turnover intention were made across different categorical groups, and hierarchical regression analysis was used to pinpoint influencing factors.ResultsThe average turnover intention score among participants was 10.49±2.93. Notable positive correlations included those with male gender, single marital status, leadership positions and roles as public health physicians. Emotional exhaustion correlated positively (β=0.108), while job satisfaction showed a significant negative correlation (β=−0.154). Other negative influential factors were observed with tenure lengths of 6–10 years, 11–15 years and ≥16 years, as well as with senior professional titles, lower salary levels and perceptions of fair compensation.ConclusionsTurnover intention is notably prevalent among primary healthcare workers, with emotional exhaustion and job satisfaction identified as primary determinants. Salary, payment justice in compensation and tenure also significantly influence turnover intention. Based on the above analysis, a series of intervention measures can be expectedly unveiled to reduce the turnover intention of primary health workers and maintained the steady development of basic medical resources.
Exploring paruresis (‘shy bladder syndrome’) and factors that may contribute to it: a cross-sectional UK survey study
Authors: Hutchings Hayley Anne , Kehinde Abi 
Published: November 2024

ObjectivesTo assess the prevalence and severity of paruresis (‘shy bladder syndrome’) in a population of university staff and students and to determine if there was any relationship between demographics, self-esteem, presence of social anxiety disorders and negative toilet experiences and paruresis.DesignWe undertook an anonymised cross-sectional online survey using Microsoft Forms. We invited participants aged 18 and over to complete the survey which included demographic information; any pre-existing medically or self-diagnosed anxiety-related conditions; Shy Bladder Scale (SBS); Rosenberg Self-Esteem Scale (RSES) and questions about using school toilets in their younger life. We defined ‘mild’ and ‘severe’ paruresis based on total SBS cut-off scores of greater than or equal to 31 and greater than or equal to 40. We calculated prevalence of paruresis, and explored differences in self-esteem, school toilet experience and social anxiety disorders between individuals with and without paruresis. Multivariable logistic regression was used to determine which variables had any influence on having a ‘mild’ and ‘severe’ paruresis diagnosis.SettingWe distributed the survey to all staff and students via their university email address as well as promoting the survey on university social media sites.ResultsWe received responses from 356 individuals. Most participants (237, 66.6%) were within the 18–30 year age category and most (277, 77.8%) were white. There were 221 (62.1%) females, 119 (33.4%) males and 16 (4.5%) other genders. The prevalence of ‘mild’ paruresis was 25.8% and of ‘severe’ paruresis 14.9% in this sample. 73.0% indicated that they had at least one medically or self-diagnosed anxiety disorder. There was a statistically significant difference in the total SBS score between individuals with and without an existing anxiety disorder (8 vs 19, <0.001). The adjusted odds of ‘mild’ paruresis were higher for men than women (OR 3.39; 95% CI 1.90 to 6.06), lower for those with a lower RSES score (OR 0.90; 95% CI 0.85 to 0.96), lower for those for a lower school toilet experience score (OR 0.88; 95% CI 0.78 to 0.99) and higher for those with at least one anxiety disorder (OR 3.164; 95% CI 1.52 to 6.59). The adjusted odds of ‘severe’ paruresis were higher for men than women (OR 2.60; 95% CI 1.32 to 5.12), lower for those with a lower RSES score (OR 0.90; CI 0.84 to 0.97) and higher for those with at least one anxiety disorder (OR 2.99 (1.18–7.56)).ConclusionLarge organisations should consider measures to help manage anxiety and improve toilet experiences. These could include resources and signposting to manage anxiety disorders and single-occupancy toilets and toilets in quiet areas to limit anxiety associated with shy bladder syndrome.