bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification of ClpB, a molecular chaperone involved in the stress tolerance and virulence of Streptococcus agalactiae
Authors: Yang Lan , Wu Zhihao , Ma Tian-Yu , Zeng Hui , Chen Ming , Zhang Yong-An , Zhou Yang 
Published: May 2024

AbstractBacterial ClpB is an ATP-dependent disaggregate that belongs to the Hsp100/Clp family and facilitates bacterial survival under hostile environmental conditions. Streptococcus agalactiae, which is regarded as the major bacterial pathogen of farmed Nile tilapia (Oreochromis niloticus), is known to cause high mortality and large economic losses. Here, we report a ClpB homologue of S. agalactiae and explore its functionality. S. agalactiae with a clpB deletion mutant (∆clpB) exhibited defective tolerance against heat and acidic stress, without affecting growth or morphology under optimal conditions. Moreover, the ΔclpB mutant exhibited reduced intracellular survival in RAW264.7 cells, diminished adherence to the brain cells of tilapia, increased sensitivity to leukocytes from the head kidney of tilapia and whole blood killing, and reduced mortality and bacterial loads in a tilapia infection assay. Furthermore, the reduced virulence of the ∆clpB mutant was investigated by transcriptome analysis, which revealed that deletion of clpB altered the expression levels of multiple genes that contribute to the stress response as well as certain metabolic pathways. Collectively, our findings demonstrated that ClpB, a molecular chaperone, plays critical roles in heat and acid stress resistance and virulence in S. agalactiae. This finding provides an enhanced understanding of the functionality of this ClpB homologue in gram-positive bacteria and the survival strategy of S. agalactiae against immune clearance during infection.
The posteriori analysis of the spectral element discretization of the wave equation
Authors: Chorfi Nejmeddine 
Published: May 2024

AbstractThis work focuses on discretizing a second-order linear wave equation using the implicit Euler scheme for time discretization and the spectral element method for spatial discretization. We prove that optimal adaptivity can be achieved by combining adaptive time steps with adaptive spectral mesh. We introduce two sets of error indicators for time and space, respectively, and derive optimal estimates.
Healthcare workers perceptions of patient safety culture in selected Ghanaian regional hospitals: a qualitative study
Authors: Isaac Demuyakor , Li Yuanheng , Wang Yushu , Jiang Deyou , Liu Chenggang , Fan Chao , Boah Michael , Xie Yuzhuo , Ma Mingxue , Shan Linghan , Gao Lei , Jiao Mingli 
Published: May 2024

Abstract
Background
Patient safety culture is an integral part of healthcare delivery both in Ghana and globally. Therefore, understanding how frontline health workers perceive patient safety culture and the factors that influence it is very important. This qualitative study examined the health workers’ perceptions of patient safety culture in selected regional hospitals in Ghana.

Objective
This study aimed to provide a voice concerning how frontline health workers perceive patient safety culture and explain the major barriers in ensuring it.

Method
In-depth semi-structured interviews were conducted with 42 health professionals in two regional government hospitals in Ghana from March to June 2022. Participants were purposively selected and included medical doctors, nurses, pharmacists, administrators, and clinical service staff members. The inclusion criteria were one or more years of clinical experience. Interviews were recorded and transcribed. Thematic analysis was used to identify themes.

Result
The health professionals interviewed were 38% male and 62% female, of whom 54% were nurses, 4% were midwives, 28% were medical doctors; lab technicians, pharmacists, and human resources workers represented 2% each; and 4% were critical health nurses. Among them, 64% held a diploma and 36% held a degree or above. This study identified four main areas: general knowledge of patient safety culture, guidelines and procedures, attitudes of frontline health workers, and upgrading patient safety culture.

Conclusions
This qualitative study presents a few areas for improvement in patient safety culture. Despite their positive attitudes and knowledge of patient safety, healthcare workers expressed concerns about the implementation of patient safety policies outlined by hospitals. Healthcare professionals perceived that curriculum training on patient safety during school education and the availability of dedicated officers for patient safety at their facilities may help improve patient safety.
Dorsal root ganglion-derived exosomes deteriorate neuropathic pain by activating microglia via the microRNA-16-5p/HECTD1/HSP90 axis
Authors: Xing Yinghao , Li Pei , Jia Yuanyuan , Zhang Kexin , Liu Ming , Jiang Jingjing 
Published: May 2024

Abstract
Background
The activated microglia have been reported as pillar factors in neuropathic pain (NP) pathology, but the molecules driving pain-inducible microglial activation require further exploration. In this study, we investigated the effect of dorsal root ganglion (DRG)-derived exosomes (Exo) on microglial activation and the related mechanism.

Methods
A mouse model of NP was generated by spinal nerve ligation (SNL), and DRG-derived Exo were extracted. The effects of DRG-Exo on NP and microglial activation in SNL mice were evaluated using behavioral tests, HE staining, immunofluorescence, and western blot. Next, the differentially enriched microRNAs (miRNAs) in DRG-Exo-treated microglia were analyzed using microarrays. RT-qPCR, RNA pull-down, dual-luciferase reporter assay, and immunofluorescence were conducted to verify the binding relation between miR-16-5p and HECTD1. Finally, the effects of ubiquitination modification of HSP90 by HECTD1 on NP progression and microglial activation were investigated by Co-IP, western blot, immunofluorescence assays, and rescue experiments.

Results
DRG-Exo aggravated NP resulting from SNL in mice, promoted the activation of microglia in DRG, and increased neuroinflammation. miR-16-5p knockdown in DRG-Exo alleviated the stimulating effects of DRG-Exo on NP and microglial activation. DRG-Exo regulated the ubiquitination of HSP90 through the interaction between miR-16-5p and HECTD1. Ubiquitination alteration of HSP90 was involved in microglial activation during NP.

Conclusions
miR-16-5p shuttled by DRG-Exo regulated the ubiquitination of HSP90 by interacting with HECTD1, thereby contributing to the microglial activation in NP.
Emotional and motivational intelligence in Ethiopian high school learners' writing performance in relation to gender differences
Authors: Hiluf Belete , Alemu Marew 
Published: May 2024

AbstractIn recent years, there has been increasing interest in the role of emotional and motivational intelligence in educational settings. Studies have shown that these factors can significantly impact students' academic performance. However, little attention has been given to the influence of emotional and motivational intelligence on writing performance, especially in relation to gender differences. This study aims to examine the relationship between emotional and motivational intelligence and writing performance among Ethiopian high school learners, while considering potential variations based on gender. To achieve this, a sample of 176 Ethiopian high school learners (69 male and 107 female, aged between 17 and 24) was selected using a stratified random sampling technique. The participants completed self-reported questionnaires to assess their emotional and motivational intelligence, and their writing performance was evaluated based on a set of predetermined writing rubrics. The collected data was analyzed using Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), Pearson's correlation coefficient, and path coefficients to determine any significant relationships or gender differences. The results showed a statistically significant relationship between emotional intelligence dimensions and writing performance. However, there was no statistically significant difference in writing performance and writing motivation based on gender. These findings provide valuable insights into the influence of emotional and motivational intelligence on writing performance among Ethiopian high school learners. Emotional intelligence, including the ability to understand and manage one's own and others' emotions, positively affected writing performance. This study contributes to the existing literature on the role of emotional and motivational intelligence in educational settings, specifically focusing on writing performance among Ethiopian high school learners. Overall, this research sheds light on the importance of considering emotional and motivational factors in educational practices to foster improved academic outcomes.
Investigating seawater intrusion and salinization using the integration of hydrochemical and geoelectrical techniques
Authors: Hanafy Sherif , Benaafi Mohammed 
Published: May 2024

Seawater intrusion poses a significant environmental threat to water resources, agriculture, and ecosystems. We investigate the extent of seawater intrusion and salinization in the eastern coastal aquifers of Saudi Arabia. Hydrochemical measurements and electrical resistivity tomography (ERT) techniques are used to assess groundwater quality and the subsurface extension of seawater intrusion. Two resistivity profiles, 475 m long each, are analyzed to gain insights into the subsurface geology and seawater intrusion. The inversion of the recorded resistivity data reveal four distinct subsurface layers. The uppermost layer consists of surficial deposits, followed by a sandy seawater intrusion layer, beneath which lies a marl layer, and at the bottom, a dolomitic limestone layer representing the brackish-water aquifer. The ERT results are integrated with hydrochemical and hydrogeologic results from 12 wells to overcome the limitations of the ERT. The findings of this study would facilitate the development of efficient mitigation strategies and sustainable management of the groundwater resources in the study area or similar coastal regions affected by seawater intrusion. Understanding and delineating the boundary between saline and fresh water is crucial for safeguarding water resources for agricultural purposes, preserving ecosystem health, and ensuring the long-term sustainability of water supplies in coastal areas.
Prospective Study of Homologous Recombination Repair Gene Mutation Prevalence in Patients With Advanced Prostate Cancer From Latin America: Challenges and Future Approaches
Authors: Manneh Ray , Verson Carmen Alaez , Martin Angel , Delgado Arturo , Isaacsson Velho Pedro H. , Manduley Alejandro , Tejado Luis , Rodríguez Yolanda , Vargas Carmen , Barata Pedro C. 
Published: May 2024

PURPOSE The prevalence of homologous recombination repair gene mutations (HRRm) in patients with metastatic castration-resistant prostate cancer (mCRPC) in Latin America and the Caribbean (LAC) is unknown. Prevalence of homologous Recombination repair (HRR) gene mutatiOns in patientS with metastatic castration resistant ProstatE Cancer in LaTin America (PROSPECT) aimed to determine this prevalence and to describe the demographic and clinical characteristics of the participants. MATERIALS AND METHODS This was a prospective, cross-sectional, multicenter study across 11 cancer centers in seven LAC countries. After informed consent, all eligible participants underwent genomic testing by provided blood samples for germline HRR testing; they also provided PC tissue blocks if available for somatic HRR testing. RESULTS Between April 2021 and April 2022, 387 patients (median age, 70 years [49-89], 94.3% Eastern Cooperative Oncology Group 0-1) with mCRPC were enrolled in the study. Almost 40% of them had a family history of cancer, and the overall time from their initial PC and mCRPC diagnosis was 3 years and 1 year, respectively. The overall prevalence of germline HRRm was 4.2%. The mutations detected included the genes CHEK2 (n = 4, 1%), ATM (n = 3, 0.8%), BRCA2 (n = 3, 0.8%), BRIP1 (n = 2, 0.5%), RAD51B (n = 2, 0.5%), BRCA1 (n = 1, 0.3%), and MRE11 (n = 1, 0.3%). The prevalence of somatic HRRm could not be assessed because of high HRR testing failure rates (79%, 199/251) associated with insufficient DNA, absence of tumor cells, and poor-quality DNA. CONCLUSION Despite the study's limitations, to our knowledge, PROSPECT was the first attempt to describe the prevalence of HRRm in patients with PC from LAC. Notably, the germline HRRm prevalence in this study was inferior to that observed in North American and European populations. The somatic HRR testing barriers identified are being addressed by several projects to improve access to HRR testing and biomarker-based therapies in LAC.
Defining Overweight and Obesity by Percent Body Fat Instead of Body Mass Index
Authors: Potter Adam W , Chin Geoffrey C , Looney David P , Friedl Karl E 
Published: May 2024

Abstract

Objective
Thresholds for overweight and obesity are currently defined by body mass index (BMI), a poor surrogate marker of actual adiposity (percent body fat [%BF]). Practical modern technologies provide estimates of %BF but medical providers need outcome-based %BF thresholds to guide patients. This analysis determines %BF thresholds based on key obesity-related comorbidities, exhibited as metabolic syndrome (MetSyn). These limits were compared to existing BMI thresholds of overweight and obesity.

Design
Correlational analysis of data from cross sectional sampling of 16 918 adults (8734 men and 8184 women) from the US population, accessed by the National Health and Nutrition Examination Survey public use datasets.

Results
Individuals measured by BMI as overweight (BMI &gt; 25 kg/m2) and with obesity (BMI &gt; 30 kg/m2) included 5% and 35% of individuals with MetSyn, respectively. For men, there were no cases of MetSyn below 18%BF, %BF equivalence to “overweight” (ie, 5% of MetSyn individuals) occurred at 25%BF, and “obesity” (ie, 35% of MetSyn individuals) corresponded to 30%BF. For women, there were no cases of MetSyn below 30%BF, “overweight” occurred at 36%BF, and “obesity” corresponded to 42%BF. Comparison of BMI to %BF illustrates the wide range of variability in BMI prediction of %BF, highlighting the potential importance of using more direct measures of adiposity to manage obesity-related disease.

Conclusion
Practical methods of body composition estimation can now replace the indirect BMI assessment for obesity management, using threshold values provided from this study. Clinically relevant “overweight” can be defined as 25% and 36% BF for men and women, respectively, and “obesity” is defined as 30% and 42% BF for men and women.
Epidemiology of Intimate Partner and Domestic Violence–Related Traumatic Brain Injury in the United States, 2018 to 2021: A National Trauma Data Bank Cohort Analysis of 3891 Patients
Authors: Ramesh Rithvik , Yue John K. , Manley Geoffrey T. , Tarapore Phiroz E. , DiGiorgio Anthony M. 
Published: May 2024

BACKGROUND AND OBJECTIVES:
Despite profound medico-socio-legal consequences of traumatic brain injury (TBI) from intimate partner violence and domestic violence (IPV/DV), the incidence and acute outcomes of concurrent IPV/DV-TBI are not well understood. We examined US IPV/DV patients with/without TBI (IPV/DV-TBI; non-TBI) using the National Trauma Data Bank. We hypothesized IPV/DV-TBI would be associated with elevated morbidity.

METHODS:
National Trauma Data Bank Trauma Quality Programs Participant Use Files years 2018 to 2021 were queried for patients aged ≥18 years with IPV/DV using International Classification of Diseases, Tenth Revision external cause codes. TBI/non-TBI was defined using International Classification of Diseases, Tenth Revision diagnosis codes. TBI severity was defined by the Glasgow Coma Scale (severe = 3-8, moderate = 9-12, and mild = 13-15). Outcomes were intensive care unit (ICU) admission, in-hospital mortality, length of stay (LOS), and discharge home. Multivariable regressions examined associations between TBI and outcomes, controlling for sociodemographic and injury severity variables.

RESULTS:
Of 3891 IPV/DV-related cases, 31.1% were IPV/DV-TBI. Cranial injuries included skull fracture (30.2%), subdural (19.8%), subarachnoid (13.4%), and epidural (1.1%) hemorrhage, contusion (8.1%), and cerebral edema (3.3%). In IPV/DV-TBI, mild/moderate/severe TBI proportions were 87.4%/4.3%/8.3%, with mean LOS 11.5 ± 10.9/14.4 ± 27.3/5.0 ± 7.7-days and mortality 0.9%/22.5%/28.6%, respectively. Compared with non-TBI, IPV/DV-TBI had more female (77.2%/64.6%, P < .001) and fewer Black patients (28.9%/36.6%, P < .001), more ICU admissions (20.9%/7.5%, P < .001) and mortality (4.1%/1.8%, P < .001), longer LOS (5.3 ± 9.5/4.5 ± 6.4-days, P = .008), and decreased discharge home (79.8%/83.8%, P = .005). Multivariable regressions confirmed the associations between TBI and ICU admission (adjusted odds ratio [aOR] = 4.29, 95% CI [3.46-5.33]), mortality (aOR = 3.20 [1.99-5.15]), LOS (adjusted mean difference = +1.22 [0.68-1.76]), and inability to discharge home (aOR = 0.57 [0.46-0.71]).

CONCLUSION:
One-third of US IPV/DV-related trauma cases have TBI, comprising predominantly female patients. Black patients with IPV/DV-related trauma were overrepresented compared with US census estimates. IPV/DV-TBI had increased ICU admissions, LOS, in-hospital mortality, and inability to discharge home compared with non-TBI. Investigating morbidity risk factors and providing sociomedical resources during acute care are critically needed in this vulnerable population.
A zebrafish model of diabetic nephropathy shows hyperglycemia, proteinuria and activation of the PI3K/Akt pathway
Authors: Zang Liqing , Saitoh Sei , Katayama Kan , Zhou Weibin , Nishimura Norihiro , Shimada Yasuhito 
Published: May 2024

ABSTRACT
Diabetic nephropathy (DN), as a complication of diabetes, is a substantial healthcare challenge owing to the high risk of morbidity and mortality involved. Although significant progress has been made in understanding the pathogenesis of DN, more efficient models are required to develop new therapeutics. Here, we created a DN model in zebrafish by crossing diabetic Tg(acta1:dnIGF1R-EGFP) and proteinuria-tracing Tg(l-fabp::VDBP-GFP) lines, named zMIR/VDBP. Overfed adult zMIR/VDBP fish developed severe hyperglycemia and proteinuria, which were not observed in wild-type zebrafish. Renal histopathology revealed human DN-like characteristics, such as glomerular basement membrane thickening, foot process effacement and glomerular sclerosis. Glomerular dysfunction was restored upon calorie restriction. RNA sequencing analysis demonstrated that DN zebrafish kidneys exhibited transcriptional patterns similar to those seen in human DN pathogenesis. Notably, the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway was activated, a phenomenon observed in the early phase of human DN. In addition, metformin improved hyperglycemia and proteinuria in DN zebrafish by modulating Akt phosphorylation. Our results indicate that zMIR/VDBP fish are suitable for elucidating the mechanisms underlying human DN and could be a powerful tool for therapeutic discovery.
Adherence to General Medical Council guidance regarding disclosure of alternative treatments during the consent process
Authors: Bethell GS , Wheeler RA , Hall NJ 
Published: May 2024

Introduction General Medical Council (GMC) guidelines dictate that reasonable alternatives to treatment should be disclosed during the consent process. We aimed to determine whether GMC guidelines on disclosure of alternatives during consent are being followed in a real-world example which is disclosure of non-operative management as an alternative to appendicectomy in uncomplicated paediatric appendicitis. Methods We undertook a retrospective single-centre observational study and national consultant specialist paediatric surgeon survey. Two groups of 50 consecutively treated children (<16 years) with acute uncomplicated appendicitis were included in the observational study during two periods. UK-based consultant surgeons who treat appendicitis were included in the national survey. The main outcomes were disclosure and use of non-operative management (NOM) as an alternative to appendicectomy. Results Overall, in the observational study, NOM was disclosed in 30 (30%) children and 77% (23/30) opted for this treatment method when it was disclosed. There were 83 survey respondents representing all 25 eligible specialist paediatric surgery centres. Ten (12%) consultants reported routinely offering NOM, 39 (47%) offer it in select circumstances, and 34 (41%) never offer NOM. Only 25 (30%) respondents always disclose NOM as an alternative to appendicectomy, whereas 22 (27%) never do. Consultants who never disclose NOM are more likely to prefer appendicectomy over NOM compared with those who always disclose it (p<0.001). Conclusion In this illustrative clinical scenario, observed and reported practice regarding disclosure of alternative treatments during the consent process do not meet GMC guidance. This risks depriving children and caregivers of a choice that they are entitled to.
Accuracy of rapid lateral flow immunoassays for human leptospirosis diagnosis: A systematic review and meta-analysis
Authors: Nualnoi Teerapat , Lomlim Luelak , Naorungroj Supawadee 
Published: May 2024

Background
In the last two decades, several rapid lateral flow immunoassays (LFIs) for the diagnosis of human leptospirosis were developed and commercialized. However, the accuracy and reliability of these LFIs are not well understood. In this study, we aimed to evaluate the accuracy of leptospirosis LFIs as well as the factors affecting the test efficiency using systematic review and meta-analysis.

Methods and results
Original articles reporting the accuracy of human leptospirosis LFIs against microagglutination tests (MAT) or immunofluorescent assays (IFA) were searched from PubMed, Embase, and Scopus, and selected as per pre-set inclusion and exclusion criteria. A total of 49 data entries extracted from 24 eligible records published between 2003 and 2023 were included for meta-analysis. A meta-analysis was performed using STATA. The quality of the included studies was assessed according to the revised QUADAS-2. Only nine studies (32.1%) were considered to have a low risk of bias and no concern for applicability. Pooled sensitivity and specificity were calculated to be 68% (95% confidence interval, CI: 57–78) and 93% (95% CI: 90–95), respectively. However, the ranges of sensitivity (3.6 – 100%) and specificity (53.5 – 100%) of individual entries are dramatically broad, possibly due to the heterogeneity found in both study designs and LFIs themselves. Subgroup analysis demonstrated that IgM detection has better sensitivity than detection of IgG alone. Moreover, the test performance seems to be unaffected by samples from different phases of infection.

Conclusions
The pooled specificity of LFIs observed is somewhat acceptable, but the pooled sensitivity is low. These results, however, must be interpreted with caution because of substantial heterogeneity. Further evaluations of the LFIs with well-standardized design and reference test will be needed for a greater understanding of the test performance. Additionally, IgM detection type should be employed when leptospirosis LFIs are developed in the future.