bluuebunny/crossref_metadata_2025_split huggingface dataset:
Structural basis of transcriptional regulation by UrtR in response to uric acid
Authors: Song Wan Seok , Ki Dong Uk , Cho Hye Yeon , Kwon Oh Hyun , Cho Hongbaek , Yoon Sung-il 
Published: November 2024

Abstract
Uric acid (UA)-responsive transcriptional regulators (UrtRs), which belong to the multiple antibiotic resistance regulator (MarR) superfamily, transcriptionally coordinate virulence and metabolism in bacteria by modulating interactions with operator DNA in response to UA. To elucidate the transcriptional regulatory mechanism of UrtR, we structurally analyzed UrtR proteins, including PecS, MftR, and HucR, alone and in complex with UA or DNA. UrtR contains a dimerization domain (DD) and a winged helix-turn-helix domain (wHTHD) and forms a homodimer primarily via the DD, as observed for other MarR superfamily proteins. However, UrtRs are characterized by a unique N-terminal α-helix, which contributes to dimerization and UA recognition. In the absence of UA, the UrtR dimer symmetrically binds to the operator double-stranded DNA (dsDNA) by inserting its α4 recognition helix and β-stranded wing within the wHTHD into the major and minor grooves of dsDNA, respectively. Upon exposure to UA, UrtR accommodates UA in the intersubunit pocket between the DD and wHTHD. UA binding induces a conformational change in the major groove-binding core element of the UrtR wHTHD, generating a DNA binding-incompatible structure. This local allosteric mechanism of UrtR completely differs from that generally observed in other MarR superfamily members, in which the entire wHTHD undergoes effector-responsive global shifts.
Effects of E-cigarettes on Combustible Cigarette Smoking Among Adults With Opioid Use Disorder on Buprenorphine: Single Arm ERASER Pilot Trial
Authors: Pericot-Valverde Irene , Heo Moonseong , Nahvi Shadi , Barron Justin , Voss Sarah , Ortiz Erik G , Gaalema Diann , Thrasher James F , Batchelder Abigail W , Byrne Kaileigh A , Kunkel Deborah , Litwin Alain H 
Published: November 2024

Abstract

Introduction
People with opioid use disorder (OUD) on buprenorphine smoke at high rates and have low cessation rates, even with evidence-based medications. Electronic cigarettes (EC) are a promising harm reduction strategy for combusted cigarette (CC) smokers unable to quit. Unfortunately, people with OUD are underrepresented in EC research.

Aims and Methods
A pilot study assessed the feasibility, acceptability, and preliminary effectiveness of EC as a harm reduction tool among CC smokers with OUD on buprenorphine (N = 30). Participants were provided with an EC and freebase nicotine liquid (6 mg/mL) with a choice of flavor and a brief training session. Research visits were scheduled in person at baseline, week 4, and week 8 (follow-up). Daily diary assessments were completed during the 4-week EC period.

Results
Most visits (&gt;74%) and 61.4% of daily diary assessments were completed. During the 4-week study period, 90% of participants used the EC at least one day, 66.7% used the EC for at least 16 days, and 43.3% used the EC every day. Significant reductions were observed between baseline and both weeks 4 and 8 in cigarettes smoked per day (CPDbaseline = 16.2[8.3], CPDweek4 = 9.6[9.3], CPDweek8 = 8.4[8.3]) carbon monoxide (CO) levels (CObaseline = 21.5[15.0], COweek4 = 16.9[9.6], COweek8 = 15.7[10.0]), and nicotine dependence measured using the Fagerström Test for Nicotine Dependence (FTNDbaseline = 5.4[2.5], FTNDweek4 = 4.2[2.6], FTNDweek8 = 4.4[2.6]), with all p-values &lt; .05.

Conclusions
Implementing an EC protocol in outpatient maintenance treatment programs is feasible and acceptable. Preliminary results suggest that ECs may facilitate reductions in cigarettes per day, CO levels, and nicotine dependence. Future research should explore the effect of prolonged EC use on harm reduction and cessation milestones.

Implications
EC are a potentially promising harm reduction strategy for adult CC smokers with OUD on buprenorphine who are unable to quit using evidence-based medications. However, previous studies have largely overlooked people with OUD on buprenorphine with recent drug use. This study addresses this gap through a pilot trial investigating the feasibility, acceptability, and preliminary effects of EC on CC behavior. The brief and standardized nature of the protocol and its implementation in outpatient settings highlights its potential for widespread implementation in facilities providing care to people with OUD on buprenorphine.
Evolution of stressors for healthcare workers over the COVID-19 pandemic
Authors: Labrèche F , Durand-Moreau Q , Adisesh A , Galarneau J- M , Ruzycki S M , Zadunayski T , Cherry N 
Published: November 2024

Abstract

Background
Many studies have documented exposure to psychosocial factors in healthcare workers (HCWs) during the coronavirus disease 2019 (COVID-19) pandemic. Few have done it prospectively with open-ended questions.

Aims
To describe the evolution of stress factors reported by HCWs during the pandemic.

Methods
A prospective cohort of 4964 HCWs (physicians, nurses, healthcare aides and personal support workers), from four Canadian provinces, received four online questionnaires between the spring 2020 and 2022. Responses to an open-ended question on stressful events were coded into 25 stressors. Multilevel logistic regressions assessed trends in stressors, and the effect of gender, occupation and age.

Results
In 2020, 91% of participants reported at least one stressor compared to 51% in spring 2022. Overall, eight stressors were reported 1000 times or more among 16 786 questionnaires. Five stressors decreased over time: fear of COVID-19, problems with personal protective equipment, changing guidelines, management of difficult cases and changes to work routine. Conversely, an increasing trend was noted for volume of work, and poor behaviour from the public or colleagues. Difficulties managing patients’ deaths remained steady. Changes in stressors over time were similar by gender, professional role and age group, although the reporting of some stressors varied within subgroups.

Conclusions
Reporting of most stressors decreased over the pandemic, except for stressors arising from the changing demands on staff and patients as the pandemic progressed. Such changes in workplace psychosocial factors need to be addressed by prevention programmes to ensure an appropriate support response to the needs of HCWs.
Working at home: Individual level drivers of MEPs’ focus on constituency work
Authors: Laloux Thomas , Laloux Clement 
Published: November 2024

Abstract
This article investigates how Members of the European Parliament (MEPs) allocate resources between their parliamentary and constituency work, focusing on their staffing decisions. Specifically, it examines the distribution of MEPs’ staff between accredited assistants, based in the European Parliament (EP), and local staff working in their constituency. The study seeks to explain why some MEPs allocate a larger share of their staff to constituency work compared to others by testing several hypotheses related to the individual characteristics of MEPs while controlling for variations across Member States. Using a newly developed database with data on MEP assistants at three points during the 9th EP, the analysis reveals that Member State differences do not solely explain the variation in staff distribution. While there is no evidence that staff allocation is driven by strategic considerations to secure re-election, it depends significantly on their ideology and past political experience.
Auditory processing up to cortex is maintained during sleep spindles
Authors: Jourde Hugo R , Coffey Emily B J 
Published: November 2024

Abstract
Sleep spindles are transient 11–16 Hz brain oscillations generated by thalamocortical circuits. Their role in memory consolidation is well established, but how they play a role in sleep continuity and protection of memory consolidation against interference is unclear. One theory posits that spindles or a neural refractory period following their offset act as a gating mechanism, blocking sensory information en route to the cortex at the level of the thalamus. An alternative model posits that spindles do not participate in the suppression of neural responses to sound, although they can be produced in response to sound. We present evidence from three experiments using electroencephalography and magnetoencephalography in humans that examine different evoked responses in the presence of and following sleep spindles. The results provide convergent empirical evidence suggesting that auditory processing up to cortex is maintained during sleep spindles, and their refractory periods.
Associations of mixed metals exposure with cognitive impairment risk: a cross-sectional study in Chinese adults
Authors: Wang Jierui , Wang Weixuan , Zheng Gang , Shi Fan , Wu Shouling , Zhang Yanshu 
Published: November 2024

Abstract

Background
Associations between exposure to single metals and cognitive impairment or related outcomes have been reported in many previous studies. However, co-exposure to more than one metal is common situation. In recent years, studies on the effects of exposure to multiple metals on cognitive impairment or related outcomes have increased, but remain very limited, with a focus on populations with occupational exposure to metals, children, and adolescents. The potential relationships between exposure to metal mixtures and risk of cognitive impairment in adults remain to be clarified.

Objective
To determine the associations between blood metal mixtures and cognitive impairment risk.

Methods
Inductively coupled plasma mass spectrometry (ICP-MS) was utilized to detect the blood levels of lead (Pb), iron (Fe), copper (Cu), calcium (Ca), magnesium (Mg), and zinc (Zn). Multivariable logistic regression and Bayesian kernel machine regression (BKMR) models were employed to assess the relationships of exposure to these blood metal mixtures with the risk of cognitive impairment.

Results
It was found that four metals (Pb, Fe, Cu, and Mg) were positively correlated with cognitive impairment in each single metal model. The association of Pb and Cu remained significant after adjusting for these six metals, with the odds ratios (95% confidence intervals) in the highest quartiles of 9.51 (4.41–20.54, p-trend &lt;0.01) and 4.87 (2.17–10.95, p-trend &lt;0.01), respectively. The BKMR models indicated that co-exposure levels of Ca, Cu, Fe, Mg, Pb, and Zn were related to increased risk of cognitive impairment at ≥25th percentile compared with median, and Pb and Cu mainly contributed to the joint effect. In addition, the interaction effects of Mg and Pb/Pb and Cu on the risk of cognitive impairment were observed.

Significance
Co-exposure of six metals (Pb, Fe, Cu, Ca, Mg, and Zn) increased the risk of cognitive impairment in Chinese adults, with Pb and Cu likely to have greater impact. Potential interaction effects of Mg and Pb, Pb and Cu on the risk of cognitive impairment may exist.
Temporal and regional variation in the use of biologic and targeted synthetic DMARDs for rheumatoid arthritis: a nationwide cohort study
Authors: Russell Mark D , Yang Zijing , Dooley Niamh , Gibson Mark , Zuckerman Benjamin , Adas Maryam A , Alveyn Edward , Patel Samir , Bechman Katie , Price Elizabeth , Gallagher Sarah , Coalwood Callum , Cope Andrew P , Norton Sam , Galloway James B 
Published: November 2024

Abstract

Objective
The objective of this study was to evaluate temporal and regional variation in biologic and targeted synthetic DMARD (b/tsDMARD) initiation for RA in England and Wales.

Methods
An observational cohort study was conducted for people with RA enrolled in the National Early Inflammatory Arthritis Audit (NEIAA) between May 2018 and April 2022 who had 12-month follow-up data available. Temporal trends in escalation to b/tsDMARDs within 12 months of initial rheumatology assessment were explored, including comparisons before and after publication (July 2021) of national guidelines that lowered the threshold for b/tsDMARD initiation to include moderate-severity RA. Case-mix–adjusted, mixed-effects regression was used to evaluate regional and hospital-level variation in b/tsDMARD initiation.

Results
Of 6098 RA patients with available follow-up, 508 (8.3%) initiated b/tsDMARDs within 12 months of initial assessment. b/tsDMARD escalation increased marginally towards the end of the study period (9.2% in May 2021/22); however, no significant differences were evident after guidelines were published permitting b/tsDMARD use for moderate-severity RA. The proportion of individuals escalated to b/tsDMARDs varied considerably between regions, ranging from 5.1% in Wales to 10.7% in North-West England. Following case-mix adjustment, the intraclass correlation (ICC) for hospitals within regions was 0.17, compared with a between-region ICC of 0.0, suggesting that the observable regional variation reflected hospital-level differences rather than systematic differences between regions themselves.

Conclusion
There is marked variation in escalation to b/tsDMARDs for people newly diagnosed with RA throughout England and Wales, despite a universal health-care system. These disparities must be addressed if we are to deliver equitable access to b/tsDMARDs, regardless of geography.
Rapid Evolution of Host Repertoire and Geographic Range in a Young and Diverse Genus of Montane Butterflies
Authors: Mo Shifang , Zhu Yaowei , Braga Mariana P , Lohman David J , Nylin Sören , Moumou Ashraf , Wheat Christopher W , Wahlberg Niklas , Wang Min , Ma Fangzhou , Zhang Peng , Wang Houshuai 
Published: November 2024

Abstract
Evolutionary changes in geographic distribution and larval host plants may promote the rapid diversification of montane insects, but this scenario has been rarely investigated. We studied the rapid radiation of the butterfly genus Colias, which has diversified in mountain ecosystems in Eurasia, Africa, and the Americas. Based on a data set of 150 nuclear protein-coding genetic loci and mitochondrial genomes, we constructed a time-calibrated phylogenetic tree of Colias species with broad taxon sampling. We then inferred their ancestral geographic ranges, historical diversification rates, and the evolution of host use. We found that the most recent common ancestor of Colias was likely geographically widespread and originated ~3.5 Ma. The group subsequently diversified in different regions across the world, often in tandem with geographic expansion events. No aspect of elevation was found to have a direct effect on diversification. The genus underwent a burst of diversification soon after the divergence of the Neotropical lineage, followed by an exponential decline in diversification rate toward the present. The ancestral host repertoire included the legume genera Astragalus and Trifolium but later expanded to include a wide range of Fabaceae genera and plants in more distantly related families, punctuated with periods of host range expansion and contraction. We suggest that the widespread distribution of the ancestor of all extant Colias lineages set the stage for diversification by isolation of populations that locally adapted to the various different environments they encountered, including different host plants. In this scenario, elevation is not the main driver but might have accelerated diversification by isolating populations.
La régulation des compétences juridictionnelles dans la CEMAC
Authors: Nkili Mbida Eugène Pascal Parfait 
Published: November 2024

Résumé
Le 23 décembre 2021, le Tribunal Administratif du Littoral a rendu le Jugement n°416/QD/2021 dans l’affaire AYINDA Germain contre Organe de Gestion de la Carte Rose CEMAC.
Par cette décision, le juge national procède à la reconnaissance nationale d’un principe général du Droit CEMAC, celui de la séparation des fonctions entre la Cour de justice communautaire et les juridictions nationales. Pour cela, elle mobilise sa fonctionnalité communautaire issue de la subsidiarité juridictionnelle ontologique à l’ordre juridique de la CEMAC.
Cependant, s’il s’agit d’une décision inédite par la symbolique juridique qu’elle contient, elle a aussi le mérite de révéler l’appropriation insuffisante du Droit CEMAC par les justiciables communautaires.
Species level hidden diversity within morphospecies: Anatolia-based evolution and cryptic species diversity in the Simulium (Wilhelmia) equinum species group (Diptera: Simuliidae)
Authors: Kaya Sarp , Fidan Ebru Ceren , Küçükyetim Merve , Şirin Davut Ümit 
Published: November 2024

Abstract
Cryptic species are black boxes of taxonomy and need to be addressed with an integrative taxonomic approach. Simulium (Diptera: Simuliidae) may contain a substantial amount of cryptic species diversity due to its large cross-continental distribution and habitat-based canalization in taxonomic characters. Except for Simulium sergenti, the following six species Simulium equinum, Simulium paraequinum, Simulium pseudequinum, Simulium turgaicum, Simulium balcanicum, and Simulium lineatum are the most widely distributed species of the subgenus Wilhelmia in the Palearctic region. However, the conspecific diversity and evolutionary history of these species are not yet well understood. In this study, therefore, we used mitochondrial COI and nuclear ITS1-2 sequences to perform species delimitation tests, and demographic and phylogeographic analyses to understand candidate species and evolutionary history of the seven species. While our results did not support the species status of S. balcanicum, S. turgaicum, and S. lineatum, it did suggest several candidate species within S. equinum and S. pseudequinum. Molecular clock analysis revealed that significant branching events occurred in the Pliocene, and demographic fluctuations in the populations occurred intensely during the Pleistocene. Overall, the results indicated that Anatolia has served as a significant refugium for ancestral haplotypes, and it is an important dispersal corridor between the eastern and western Palearctic for Wilhelmia species.
Outcome of Locking Plate Fixation Adjunctive to Intramedullary Rodding in Osteogenesis Imperfecta Patients
Authors: Shuhiamy Norsaidatul N.A. , Lee Wonik , Didi Faris I. , Song Mi Hyun , Shin Chang Ho , Cho Tae-Joon 
Published: November 2024

Background:
An intramedullary rodding is the preferred fixation method in limb stabilization of OI patients. However, the intramedullary rod may not provide adequate fixation and rotational stability, especially in adolescents and adults. The incorporation of adjunctive plate fixation alongside intramedullary rodding has been introduced to enhance this stability, although its complications remain insufficiently understood. The goal of this study was to explore the outcomes of adjunctive plating in conjunction with intramedullary rodding for limb stabilization in OI patients, emphasizing the complications related to the plates during the healing phase and following plate removal.

Methods:
This retrospective study examined 74 limb segments from 45 patients with OI who underwent intramedullary rodding and adjunctive plating from 2008 to 2022. Criteria for inclusion comprised surgical treatment followed by a minimum of 2 years of follow-up or complication before that time point. The need for adjunctive plating arose from inadequate fixation, rotational instability, and persistent cortical gaps with intramedullary rodding alone. Medical records and follow-up radiographs were reviewed to assess the healing of the target lesion and any complications.

Results:
The study encompassed 30 males and 15 females, ranging in age from 4 to 38 years, with 51 femoral and 23 tibial segments receiving treatment. Union was successfully achieved in 63 cases (85.3%), with an average union time of 14.4 months. Plates were subsequently removed in 62 cases after an average duration of 18.0 months. Before union, 11 revision surgeries were performed in 4 peri-implant fractures, 1 screw pull-out, and 6 failure of union. One sustained peri-implant fracture after the union. Following the removal of plates, complications included 10 refractures at screw sites, 3 progressive angulations at the previously targeted lesions, and 1 osteomyelitis. Kaplan-Meier analysis revealed that half of the refractures occurred within 1.8 years postplate removal. The overall complication showed borderline significance (P=0.056) among age groups. All the plate-related complications occurred at the diaphyseal, unicortical screws.

Conclusions:
Plate fixation, when used as an adjunct to intramedullary rodding, effectively stabilizes limbs in OI patients when intramedullary rods alone are inadequate. Nevertheless, given the significant risks associated with plate-related complications, adjunctive plating should be employed selectively only in instances where the union is unlikely to be achieved with intramedullary rodding alone.

Level of Evidence:
Level IV—case series.
Risk Factors for Postoperative Shoulder Imbalance in Patients With Lenke Type 1 and 2 Scoliosis Treated Using the Vertebral Coplanar Alignment Technique
Authors: Shimura Arihisa , Nojiri Hidetoshi , Ishijima Muneaki , Moridaira Hiroshi , Arai Hidekazu , Takada Satoshi , Yamada Katsutaka , Kondo Naoya , Morino Tadao , Nakamura Eiichiro , Tomori Masaki , Otani Kazuyuki , Akeda Koji , Nagai Takuya , Toyoda Hiromitsu , Ito Kenyu , Katayanagi Junya , Taneichi Hiroshi 
Published: November 2024

Study Design.
This was a multicenter retrospective cohort study.

Objective.
We investigated the incidence of postoperative shoulder imbalance (PSI) and its risk factors in patients with Lenke types 1 and 2 scoliosis corrected using vertebral coplanar alignment (VCA).

Summary of Background Data.
PSI in scoliosis affects patient quality of life. While other correction methods have reported a high correction rate for the main thoracic curve (MTC) in relation to PSI, this correlation has not been confirmed for the VCA technique.

Materials and Methods.
We studied 176 patients with Lenke types 1 and 2 scoliosis who underwent posterior corrective fusion surgery using the VCA technique at 11 institutions. At 2 years postoperatively, patients were divided into two groups based on radiographic shoulder height (RSH): PSI− (RSH<2 cm) and PSI+ (RSH ≥2 cm) groups. We analyzed the risk factors for PSI.

Results.
The overall incidence of PSI 2 years postoperatively was 11.4% (20/176), with 9.2% (11/119) and 15.8% (9/57) in patients with Lenke types 1 and 2, respectively. Contrary to a previous study, a high MTC correction rate did not emerge as a risk factor for PSI. Instead, preoperative left shoulder elevation, low postoperative thoracic kyphosis, greater T1 tilt, and high apical vertebral body-to-rib ratio were associated with PSI in patients with Lenke type 1. Preoperative left shoulder elevation and a low postoperative proximal thoracic curve (PTC) correction rate were identified as risk factors for PSI in patients with Lenke type 2.

Conclusion.
Our results suggest that proper PTC correction, rather than compromising MTC correction, may help prevent PSI in the VCA technique. This method is particularly advantageous for addressing Lenke type 1 scoliosis and yields favorable outcomes in shoulder balance. Patients with preoperative left shoulder elevation, especially Lenke type 2, are at high risk of developing PSI.

Level of Evidence.
Level 4.