bluuebunny/crossref_metadata_2025_split huggingface dataset:
A temporary cholesterol-rich diet and bacterial extracellular matrix factors favor
Salmonella
spp. biofilm formation in the cecum
Authors: Cruz-Cruz Alonso , Schreeg Megan E. , Gunn John S. 
Published: December 2024

ABSTRACT

Asymptomatic chronic carriers occur in approximately 5% of humans infected with
Salmonella enterica
serovar Typhi (
S
. Typhi) and represent a critical reservoir for bacterial dissemination. While chronic carriage primarily occurs in the gallbladder (GB) through biofilms on gallstones, additional anatomic sites have been suggested that could also harbor
Salmonella. S
. Typhimurium, orally infected 129 × 1/SvJ mice were pre-treated with a cholesterol-rich diet as a gallstone model for chronic carriage. We observed
S
. Typhimurium in feces and the cecum during early and persistent infection. Furthermore, bacterial biofilm-like aggregates were associated with the cecum epithelium at 7 and 21 days post-infection (DPI) in mice on a lithogenic diet (Ld) and correlated with an increase in cecal cholesterol at 21 DPI.
Salmonella
’s extracellular matrix (ECM) was demonstrated as important in colonizing the cecum, as survival and aggregate formation significantly decreased when mice were infected with a quadruple ECM mutant strain. Gallbladder
Salmonella
counts were low at 36 DPI while cecal
Salmonella
were high, suggesting that gallbladder colonization was likely not responsible for the high cecal burden. All cecum phenotypes were significantly diminished in mice fed a normal diet (Nd). Finally, we examined the capability of
S
. Typhi to colonize the cecum and showed
S
. Typhi in feces and in aggregates in the cecum up to 7 DPI, with slightly higher counts in mice fed a Ld compared to Nd. Our findings suggest that the cecum, particularly under cholesterol-rich conditions, serves as an adaptative niche for
Salmonella
spp. aggregates/biofilms and is a putative site for long-term infection.

IMPORTANCE

Typhoid fever is a systemic infectious disease triggered by the gastrointestinal dissemination of
Salmonella
Typhi and Paratyphi in humans. Three to five percent of infected individuals become chronic carriers, a state in which gallstone biofilm formation facilitates spread of the bacteria in feces. Notably, surgical removal of the gallbladder (GB) in some chronic carriers (22%) does not guarantee the elimination of the bacteria, and the rationale for this remains poorly understood. This study is significant as it explores other tissues associated with the chronic carrier state. It highlights not only a cholesterol-rich diet as an important etiological factor for
Salmonella
colonization but also identifies the cecum as a crucial tissue promoting fecal shedding. Additionally, we determined that biofilm matrix components of
Salmonella
are key factors contributing to these effects. A greater understanding of these mechanisms will allow the formulation of new therapeutic strategies specifically targeted at preventing typhoid fever dissemination from chronic carriers.
Comparative risk of type 2 diabetes development between women with gestational diabetes and women with impaired glucose tolerance over two decades: a multiethnic prospective cohort in New Zealand
Authors: Yu Dahai , Fu Hang , Zhao Zhanzheng , Pickering Karen , Baker John , Cutfield Richard , Orr-Walker Brandon J , Sundborn Gerhard , Cai Yamei , Wang Zheng , Wang Chengzeng , Simmons David 
Published: December 2024

IntroductionTo evaluate the long-term risk of developing type 2 diabetes (T2D) among women with a history of gestational diabetes mellitus (GDM) compared with those with impaired glucose tolerance (IGT).Research design and methodsUsing data from a primary care dataset linked with multiple health registries, this longitudinal study analyzed demographics, clinical data, and lifestyle factors of women diagnosed with GDM or IGT, assessing T2D incidence over 25 years, using Cox regression models.ResultsWomen with GDM, especially those over 35 years of Māori ethnicity, or socioeconomic deprivation, exhibited an elevated risk of T2D compared with those with IGT. The first 5 years post partum emerged as a critical window for intervention.ConclusionsThis study underscores the importance of early, targeted post-GDM interventions to mitigate T2D risk. It highlights the necessity of personalized post-GDM interventions to reduce T2D incidence which consider age, ethnicity, and socioeconomic status to maximize effectiveness.
Chemotherapy combined with cadonilimab (AK104) as neoadjuvant treatment for locally advanced gastric/gastro-oesophageal junction adenocarcinoma: study protocol for a single-arm, phase II clinical trial
Authors: Zhang Peng-Fei , Zhang Wei-Han , Liu Xi-Jiao , He Du , Yang Kun , Gou Hong-Feng , Hu Jian-Kun 
Published: December 2024

IntroductionNeoadjuvant chemotherapy has been demonstrated to be effective and recommended as the standard treatment option in patients with locally advanced gastric or gastro-oesophageal junction (G/GOJ) cancer. In this study, we will explore the efficacy and safety of chemotherapy combined with cadonilimab, a programmed death-1/cytotoxic T lymphocyte-associated antigen-4 bispecific antibody, in neoadjuvant therapy for locally advanced G/GOJ adenocarcinoma.Methods and analysisThis is a single-centre, single-arm, open-label, phase II trial that will enrol 37 patients in total. Eligible patients will be registered and receive three cycles of oxaliplatin and S-1 (SOX) regimen in combination with cadonilimab. Radical D2 (D2 lymphadenectomy) gastrectomy will be performed within 4 weeks after the last administration of chemotherapy plus cadonilimab. The primary endpoint is the pathological complete response rate. Secondary endpoints are R0 resection rate, major pathological response, 2-year disease-free survival rate, 2-year overall survival rate and safety. The first participant was recruited on 1 September 2023 and the enrolment will be completed in July 2025.Ethics and disseminationWritten informed consent will be required from and provided by all the patients enrolled. The study protocol (V.3.0, 28 April 2023) has been approved by the independent ethics committee of West China Hospital, Sichuan University (approval number: 2023526) and conducted under the Declaration of Helsinki. The results of the study may provide more evidence for neoadjuvant immunotherapy combined with chemotherapy in locally advanced G/GOJ adenocarcinoma.Trial registration numberClinicalTrials.gov,NCT05948449.
Bridging theory and practice: a scoping review protocol on gamification’s impact in clinical reasoning education
Authors: Lee Ching-Yi , Lee Ching-Hsin , Lai Hung-Yi , Chen Po-Jui , Chen Mi-Mi , Yau Sze-Yuen 
Published: December 2024

IntroductionIn the rapidly evolving field of medical education, gamification has emerged as a promising strategy to enhance clinical reasoning skills among healthcare professionals. By incorporating game-like elements into the learning environment, gamification strives to enhance engagement, motivation and knowledge retention. Given the importance of clinical reasoning in medical decision-making and patient care, this scoping review protocol aims to systematically explore developments, implementations and outcomes of gamification in clinical reasoning education.Methods and analysisThe scoping review will follow the Arksey and O'Malley methodological framework, enhanced by guidelines from the Joanna Briggs Institute. We will search four major databases: OVID Medline, Scopus and Web of Science using key terms such as “gamification,” “clinical reasoning,” and “medical education”. Studies will be selected based on the participants, concepts and contexts (PCC) framework, focusing on literature published in English. Two independent reviewers will screen studies and extract data on gamification elements used in clinical reasoning education. Any disagreement between the reviewers will be resolved by consulting a third person. We will provide a narrative synthesis of the findings, highlighting the variety of gamified strategies and their effects on clinical reasoning skills. This review will also map out gaps in the current literature and provide direction for future research.Ethics and disseminationThe scoping review, which aggregates and synthesises publicly available studies, does not require ethics approval due to its nature as a compilation of existing research. The reporting of findings will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist, promoting both thoroughness and transparency in our analysis. Our dissemination plan encompasses publication in a peer-reviewed journal and presentations at academic conferences focused on medical education. This strategy is designed to engage educators, curriculum designers and policymakers within the sector, ensuring our insights reach those who can apply them most effectively.
Mifepristone as a non-emergency contraceptive among women of reproductive age: a protocol for systematic review and meta-analysis
Authors: Nkangu Miriam , Frisendahl Caroline , Polis Chelsea , Chen Tracy , Sterling Evan , Gomperts Rebecca , Plagianos Marlena , Haddad Lisa , Gemzell-Danielsson Kristina 
Published: December 2024

BackgroundMifepristone is a selective progesterone receptor modulator with decades of data demonstrating its potential as a highly effective emergency as well as non-emergency contraceptive. Despite considerable evidence pointing to the potential effectiveness of mifepristone as a non-emergency contraceptive, no systematic review has been conducted to synthesise the available evidence. This systematic review aims to synthesise the current evidence on the use of mifepristone as a non-emergency contraceptive to prevent pregnancy among cisgender girls and women of reproductive age.MethodsWe developed an electronic search strategy in collaboration with the research librarian. We will search five databases (Ovid Medline, CINAHL, EMBASE, Cochrane-Central Trials and Global Health) from inception and identify additional studies using several grey literature search strategies. All databases will be searched from inception, and we planned to complete the search by 30 June 2024. An Ovid Medline search strategy conducted on 24 May 2024 is provided as an example. We will include all studies that involve cisgender girls and/or women of reproductive age (defined as 54 years or younger), which assessed mifepristone as a non-emergency contraceptive to prevent pregnancy. The primary outcome is contraceptive effectiveness. Two independent reviewers will screen studies for eligibility through title, abstract, and full-text review. We will extract data with Covidence software using a Cochrane Effective Practice and Organisation of Care (EPOC)-adapted data-extraction tool and will assess risk of bias using the EPOC risk of bias tool and the Newcastle–Ottawa Scale. If sufficient data are available, we will conduct a meta-analysis using fixed and/or random effect models. However, if we are unable to conduct a meta-analysis, we will present the results narratively using the synthesis without meta-analysis guidelines and the EPOC table recommended for presenting findings without meta-analysis. Grades of Recommendation, Assessment, Development and Evaluation will be used to assess the quality of the evidence. We will report this review according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines.Ethics and disseminationThis review is focused on secondary data and does not require any ethical approval. We aim to publish the review in a peer-reviewed scientific journal to promote knowledge transfer and present results using other knowledge translation mediums.PROSPERO registration numberCRD42024554720.
Electroacupuncture for abdominal obesity: protocol for a systematic review and meta-analysis of randomised controlled trials
Authors: Lu Qiuling , Xu Mindong , Zhang Lida , Gao Li , Mao Wei , Han Wei , Xu Nenggui 
Published: December 2024

Introduction
The prevalence of obesity is rising, significantly impacting health and quality of life. Effective treatment is crucial, particularly for abdominal obesity (AO). Electroacupuncture (EA), which combines acupuncture and moxibustion with electric current, shows promise but lacks reliable clinical evidence for its efficacy and safety. Therefore, a meta-analysis is essential to assess the clinical effectiveness of EA in treating AO.

Methods and analysis
A systematic search of PubMed, Medline, Embase, the Cochrane Library, China National Knowledge Infrastructure, Wanfang and Allied and Alternative Medicine (AMED) databases will be conducted from database inception to 1 June 2024 to identify randomised controlled trials investigating the effectiveness and safety of EA in treating AO. Two authors will independently carry out data extraction and evaluate the risk of bias. RevMan software (V.5.4) will be used for data analysis, and publication bias will be assessed using funnel plots and Egger’s test. The quality of evidence will be evaluated according to Grades of Recommendation, Assessment, Development, and Evaluation, and trial sequence analysis will be used to calculate the final total sample size required for the meta-analysis. The primary outcome will be the measurement of waist circumference. Secondary outcomes will include the quality of life, hip circumference, waist-to-hip ratio, body mass index, body fat percentage, visceral fat thickness and serum markers such as triglycerides, total cholesterol, low-density lipoprotein and high-density lipoprotein cholesterol. The data will be pooled and analysed, with subgroup analyses conducted if needed.

Ethics and dissemination
This systematic review and meta-analysis does not require ethical approval because the data for this review will be extracted from already published journal articles. The protocol for this review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO). This review and its findings will be published in a peer-reviewed journal or presented at scientific conferences.

PROSPERO registration number
CRD42024562984.
Proxy medical decision-making: national survey
Authors: Phua Andrew Ian-Hong , Zakaria Camellia , Pakianathan Pavithren VS , Chan Noreen , Lim Mervyn Jun Rui , Liew Tau Ming , Koh Gerald Choon Huat , Foong Pin Sym 
Published: December 2024

ObjectivesPopulation ageing and increased care needs lead to adults making consequential medical decisions for others, potentially impacting treatment and end of life. We aim to describe the prevalence of medical decision-making by proxy among the national population and associated demographic and care factors.MethodsWe designed a cross-sectional online survey with a nationally representative adult cohort with an 80% participation rate. 311 Singapore residents completed the survey.Results73% of respondents reported having ever assisted others with medical decisions, while 58% have ever assisted with activities of daily living (ADLs), and 88% with instrumental ADLs (IADLs). Having a digital caregiver account, having a lasting power of attorney as a donee and assisting with ADLs and IADLs are significantly associated with proxy medical decision-making. Gender, ethnicity, income and age did not appear to have a significant impact.ConclusionsA majority of Singapore adults assist others with caregiving tasks and medical decision-making. These helping behaviours are often performed informally, which may increase decisional burden for caregivers and potential abuse of power.
Examining changes in the sodium content of Canadian prepackaged foods: 2013 to 2017
Authors: Christoforou Anthea , Bernstein Jodi , Dickinson Kacie , Yang Yahan , Arcand JoAnne , L'Abbe Mary 
Published: December 2024

In an effort to improve high sodium consumption in the population, in 2012 Health Canada released voluntary sodium reduction targets for prepackaged foods to be met before 2017. This study used the University of Toronto’s Food Label Information Program database (FLIP), 2013 and 2017 collections, to evaluate changes and differences in mean sodium content of Canadian prepackaged foods and manufacturers’ progress in meeting Health Canada’s average and maximum sodium reduction targets. Changes to sodium content (reformulation) in products present in both FLIP years and differences across years including both new and existing products were assessed via paired and independent t-tests, respectively. The average sodium content from FLIP 2017 was also compared to previously published sales-weighted average sodium content published by Health Canada to aid in the interpretation of our results. Our reformulation analyses of consistent products between years revealed that 50% of food subcategories did not have significant changes in mean sodium from 2013 to 2017. Examining both new and existing foods, 59% of subcategories had no significant difference in mean sodium content between 2013 and 2017. The proportion of foods meeting final sodium targets was 33.6% in 2013 and 37.3% in 2017. In 2013 and 2017, 20.8% and 19.6% of products exceeded the maximum sodium targets, respectively. For almost all major food categories, a greater proportion of new products in 2017 met final sodium targets compared to existing foods (present in both FLIP 2013 and 2017). Nearly, half the major food categories examined had more new products meeting the maximum sodium target than existing products. Less than half of food subcategories (48%, n = 45/94) from FLIP 2017 differed by ≥20% compared to sales-weighted averages published by Health Canada. Our findings reveal limited progress in the reduction of sodium in prepackaged foods. Calls for more robust policy initiatives and the continued independent monitoring of food industry efforts in Canada are warranted.
Injection, confinement, and diagnosis of electrons and positrons in a permanent magnet dipole trap
Authors: von der Linden J. , Nißl S. , Deller A. , Singer M. , Belmore N. , Hugenschmidt C. P. , Pedersen T. Sunn , Saitoh H. , Stenson E. V. 
Published: December 2024

Abstract
Prerequisites for the goal of studying long-lived, magnetically confined, electron–positron pair plasmas in the laboratory include the injection of both species into the trap, long trapping times, and suitable diagnostic methods. Here we report recent progress on these tasks achieved in a simple dipole trap based on a supported permanent magnet. For the injection of electrons, both an

$$\textbf{E}\times B$$

E
×
B

drift technique (of a

$$\sim $$

∼

2–

$$\upmu $$

μ

A, 6-eV beam) and “edge injection” (from a filament emitting a few mA and biased to some tens of volts) have been demonstrated; the former is suitable for low-density beams with smaller spatial and velocity spreads, while the latter employs fluctuations arising from collective behavior. To diagnose the edge-injected electrons, image potentials and currents induced on a wall probe, the magnet case, and wall electrodes were measured. Confinement of drift-injected positrons, measured experimentally, exhibited at least two well-separated timescales. Simulations reproduced this qualitatively, using a simple model of elastic collisions with residual background gas, and point to small adjustments for increasing trapping times. In a major upgrade to diagnostic capabilities, 25 bismuth germanate detectors, placed in three reentrant ports, are able to localize annihilation gammas, which will be used in future experiments to distinguish between different loss channels.

Graphical abstract
Soliton dynamics and nonlinear wave theory: Understanding the interplay of thermal effects in plasma waves
Authors: Owyed Saud , Khater Mostafa M. A. 
Published: December 2024

The regularized long-wave ([Formula: see text]) equation is a fundamental model in shallow water wave theory, with extended relevance to other physical systems, such as plasma physics. The [Formula: see text] equation governs key nonlinear wave phenomena, including the propagation and interaction of solitons, or localized solitary waves. In plasma physics, it describes ion-acoustic waves, which are low-frequency compressional waves arising from the interaction between ions and electrons. While the ion-acoustic wave exhibits Korteweg–de Vries soliton behavior in the cold plasma limit, the [Formula: see text] equation offers a more accurate representation of ion-acoustic solitons and peaked structures in warm plasmas by accounting for thermal effects. This research presents novel analytical approximations for solitary wave solutions within the [Formula: see text] equation, which is critical for modeling nonlinear shallow water and plasma waves. The equation’s ability to describe peaked solitary waves, known as “peakons”, represents wave-breaking phenomena. By employing the improved Riccati expansion and modified Fan expansion techniques, this study derives periodic peakon solutions, offering new insights into the equation’s behavior. A thorough analysis of the [Formula: see text] equation is provided, emphasizing its importance for nonlinear wave modeling in both fluid and plasma systems. This paper also includes numerical validation using He’s variational iteration method, which enhances the transparency of the findings by addressing the underlying assumptions and limitations. The principal findings contribute to the broader understanding of nonlinear solitary wave theory, with practical implications for nonlinear wave dynamics across multiple physical domains. Suggested extensions are outlined for further investigation within this established theoretical framework. This study maintains consistent notation and terminology to facilitate clear communication of ideas in adherence to academic standards.