bluuebunny/crossref_metadata_2025_split huggingface dataset:
Digital tools for youth health promotion: principles, policies and practices in sub-Saharan Africa
Authors: Ferretti Agata , Adjei Kwame K , Ali Joseph , Atuire Caesar , Ayuk Betrand Tambe , Banougnin Boladé Hamed , Cengiz Nezerith , Gichoya Judy , Jjingo Daudi , Juma Damian Omari , Kotze Wiaan , Krubiner Carleigh , Littler Katherine , McCradden Melissa D , Moodley Keymanthri , Naidoo Meshandren , Nair Gonasagrie , Obeng-Kyereh Kingsley , Oliver Kedebone , Ralefala Dimpho , Toska Elona , Wekesah Frederick M , Wright Jonty , Vayena Effy 
Published: April 2024

Abstract
Although digital health promotion (DHP) technologies for young people are increasingly available in low- and middle-income countries (LMICs), there has been insufficient research investigating whether existing ethical and policy frameworks are adequate to address the challenges and promote the technological opportunities in these settings. In an effort to fill this gap and as part of a larger research project, in November 2022, we conducted a workshop in Cape Town, South Africa, entitled ‘Unlocking the Potential of Digital Health Promotion for Young People in Low- and Middle-Income Countries’. The workshop brought together 25 experts from the areas of digital health ethics, youth health and engagement, health policy and promotion and technology development, predominantly from sub-Saharan Africa (SSA), to explore their views on the ethics and governance and potential policy pathways of DHP for young people in LMICs. Using the World Café method, participants contributed their views on (i) the advantages and barriers associated with DHP for youth in LMICs, (ii) the availability and relevance of ethical and regulatory frameworks for DHP and (iii) the translation of ethical principles into policies and implementation practices required by these policies, within the context of SSA. Our thematic analysis of the ensuing discussion revealed a willingness to foster such technologies if they prove safe, do not exacerbate inequalities, put youth at the center and are subject to appropriate oversight. In addition, our work has led to the potential translation of fundamental ethical principles into the form of a policy roadmap for ethically aligned DHP for youth in SSA.
Functional characterization of archaic-specific variants in mitonuclear genes: insights from comparative analysis in S. cerevisiae
Authors: Aneli Serena , Ceccatelli Berti Camilla , Gilea Alexandru Ionut , Birolo Giovanni , Mutti Giacomo , Pavesi Angelo , Baruffini Enrico , Goffrini Paola , Capelli Cristian 
Published: April 2024

Abstract
Neanderthal and Denisovan hybridisation with modern humans has generated a non-random genomic distribution of introgressed regions, the result of drift and selection dynamics. Cross-species genomic incompatibility and more efficient removal of slightly deleterious archaic variants have been proposed as selection-based processes involved in the post-hybridisation purge of archaic introgressed regions. Both scenarios require the presence of functionally different alleles across Homo species onto which selection operated differently according to which populations hosted them, but only a few of these variants have been pinpointed so far. In order to identify functionally divergent archaic variants removed in humans, we focused on mitonuclear genes, which are underrepresented in the genomic landscape of archaic humans. We searched for non-synonymous, fixed, archaic-derived variants present in mitonuclear genes, rare or absent in human populations. We then compared the functional impact of archaic and human variants in the model organism Saccharomyces cerevisiae. Notably, a variant within the mitochondrial tyrosyl-tRNA synthetase 2 (YARS2) gene exhibited a significant decrease in respiratory activity and a substantial reduction of Cox2 levels, a proxy for mitochondrial protein biosynthesis, coupled with the accumulation of the YARS2 protein precursor and a lower amount of mature enzyme. Our work suggests that this variant is associated with mitochondrial functionality impairment, thus contributing to the purging of archaic introgression in YARS2. While different molecular mechanisms may have impacted other mitonuclear genes, our approach can be extended to the functional screening of mitonuclear genetic variants present across species and populations.
Safety and Immunogenicity of the H56:IC31 Tuberculosis Vaccine Candidate in Adults Successfully Treated for Drug-Susceptible Pulmonary Tuberculosis: A Phase 1 Randomized Trial
Authors: Tait Dereck , Diacon Andreas , Borges Álvaro H , van Brakel Elana , Hokey David , Rutkowski Kathryn T , Hunt Devin J , Russell Marisa , Andersen Peter L , Kromann Ingrid , Ruhwald Morten , Churchyard Gavin , Dawson Rodney 
Published: April 2024

Abstract

Background
H56:IC31 is a candidate vaccine against tuberculosis (TB) with the potential to reduce TB recurrence rate. It is thus important for future clinical trials to demonstrate safety and immunogenicity of H56:IC31 in individuals treated for TB.

Methods
Twenty-two adults confirmed to be Mycobacterium tuberculosis negative (by 2 GeneXpert tests or 2 sputum cultures) after 4–5 months of TB treatment, and not more than 28 days after completion of TB treatment, were randomized to receive 2 doses of H56:IC31 (5 mg H56:500 nmol IC31; n = 16) or placebo (n = 6) 56 days apart. Participants were followed for 420 days for safety and immunogenicity.

Results
H56:IC31 vaccination was associated with an acceptable safety profile, consisting mostly of mild self-limited injection site reactions. No serious adverse events or vaccine-related severe adverse events were reported. H56:IC31 induced a CD4+ T-cell response for Ag85B and ESAT-6, with ESAT-6 being immunodominant, which persisted through 6 months after the last vaccination. There was some evidence of CD8+ T-cell responses for both Ag85B and ESAT-6, but to a lesser extent than CD4+ responses.

Conclusions
H56:IC31 was associated with an acceptable safety profile, and induced a predominant CD4+ T-cell response, in adults recently treated for drug-susceptible, uncomplicated pulmonary TB.

Clinical Trials Registration
NCT02375698.
Identification of potential C1-binding sites in the immunoglobulin CL domains
Authors: Yanaka Saeko , Kodama Atsuji , Nishiguchi Shigetaka , Fujita Rina , Shen Jiana , Boonsri Pornthip , Sung Duckyong , Isono Yukiko , Yagi Hirokazu , Miyanoiri Yohei , Uchihashi Takayuki , Kato Koichi 
Published: April 2024

Abstract
Immunoglobulin G (IgG) molecules that bind antigens on the membrane of target cells spontaneously form hexameric rings, thus recruiting C1 to initiate the complement pathway. However, our previous report indicated that a mouse IgG mutant lacking the Cγ1 domain activates the pathway independently of antigen presence through its monomeric interaction with C1q via the CL domain, as well as Fc. In this study, we investigated the potential interaction between C1q and human CL isoforms. Quantitative single-molecule observations using high-speed atomic force microscopy revealed that human Cκ exhibited comparable C1q binding capabilities with its mouse counterpart, surpassing the Cλ types, which have a higher isoelectric point than the Cκ domains. Nuclear magnetic resonance and mutation experiments indicated that the human and mouse Cκ domains share a common primary binding site for C1q, centred on Glu194, a residue conserved in the Cκ domains but absent in the Cλ domains. Additionally, the Cγ1 domain, with its high isoelectric point, can cause electrostatic repulsion to the C1q head and impede the C1q-interaction adjustability of the Cκ domain in Fab. The removal of the Cγ1 domain is considered to eliminate these factors and thus promote Cκ interaction with C1q with the potential risk of uncontrolled activation of the complement pathway in vivo in the absence of antigen. However, this research underscores the presence of potential subsites in Fab for C1q binding, offering promising targets for antibody engineering to refine therapeutic antibody design.
Interprofessional education in antimicrobial stewardship, a collaborative effort
Authors: Chetty Sarentha , Swe-Han Khine Swe , Mahabeer Yesholata , Pillay Ashendri , Essack Sabiha Y 
Published: April 2024

Abstract

Introduction
Antimicrobial stewardship (AMS) education and interprofessional collaboration are integral to the success of a stewardship programme. An interactive interprofessional AMS workshop, designed to encourage workplace interprofessional collaboration was piloted in a tertiary hospital.

Objectives
To obtain feedback to determine the suitability and sustainability of the AMS workshop.

Methods
Feedback was elicited through a predesigned questionnaire containing both open-ended and closed questions on the content and structure of the workshop.

Results
The survey had a 70% (n = 16) overall response rate. All participants agreed that the goals of the workshop were met and that the knowledge and skills gained from the workshop would help them in their AMS roles. All participants indicated that the workshop content, and the level at which it was pitched, met their expectations and that it had improved their knowledge and skills. All agreed that they found it advantageous and enjoyed learning as an interprofessional group. Open feedback showed that the workshop was found to be useful and would potentially result in improved patient care, dissemination of knowledge, improved teamwork and organizational culture.

Conclusions
The positive feedback and changes made following the workshop demonstrated that a targeted AMS educational workshop adds value to an antimicrobial stewardship programme.
Genetically guided precision medicine clinical decision support tools: a systematic review
Authors: Johnson Darren , Del Fiol Guilherme , Kawamoto Kensaku , Romagnoli Katrina M , Sanders Nathan , Isaacson Grace , Jenkins Elden , Williams Marc S 
Published: April 2024

Abstract

Objectives
Patient care using genetics presents complex challenges. Clinical decision support (CDS) tools are a potential solution because they provide patient-specific risk assessments and/or recommendations at the point of care. This systematic review evaluated the literature on CDS systems which have been implemented to support genetically guided precision medicine (GPM).

Materials and Methods
A comprehensive search was conducted in MEDLINE and Embase, encompassing January 1, 2011–March 14, 2023. The review included primary English peer-reviewed research articles studying humans, focused on the use of computers to guide clinical decision-making and delivering genetically guided, patient-specific assessments, and/or recommendations to healthcare providers and/or patients.

Results
The search yielded 3832 unique articles. After screening, 41 articles were identified that met the inclusion criteria. Alerts and reminders were the most common form of CDS used. About 27 systems were integrated with the electronic health record; 2 of those used standards-based approaches for genomic data transfer. Three studies used a framework to analyze the implementation strategy.

Discussion
Findings include limited use of standards-based approaches for genomic data transfer, system evaluations that do not employ formal frameworks, and inconsistencies in the methodologies used to assess genetic CDS systems and their impact on patient outcomes.

Conclusion
We recommend that future research on CDS system implementation for genetically GPM should focus on implementing more CDS systems, utilization of standards-based approaches, user-centered design, exploration of alternative forms of CDS interventions, and use of formal frameworks to systematically evaluate genetic CDS systems and their effects on patient care.
Breast Hemangiomas: Imaging Features With Histopathology Correlation
Authors: Dhami Alysha , Hao Meng , Waheed Uzma , Dashevsky Brittany Z , Bean Gregory R 
Published: April 2024

Abstract
Breast hemangiomas are rare benign vascular lesions. In a previously performed review of approximately 10,000 breast surgical pathology results, roughly 0.15% (15/~10 000) were hemangiomas. Hemangiomas are more frequent in women and have a documented age distribution of 1.5 to 82 years. They are most often subcutaneous or subdermal and anterior to the anterior mammary fascia but may rarely be seen in the pectoralis muscles or chest wall. On imaging, breast hemangiomas typically present as oval or round masses, often measuring less than 2.5 cm, with circumscribed or mostly circumscribed, focally microlobulated margins, equal or high density on mammography, and variable echogenicity on US. Calcifications, including phleboliths, can be seen. Color Doppler US often shows hypovascularity or avascularity. MRI appearance can vary, although hemangiomas are generally T2 hyperintense and T1 hypointense with variable enhancement. Pathologic findings vary by subtype, which include perilobular, capillary, cavernous, and venous hemangiomas. If core biopsy pathology results are benign, without atypia, and concordant with imaging and clinical findings, surgical excision is not routinely indicated. Because of histopathologic overlap with well-differentiated or low-grade angiosarcomas, surgical excision may be necessary for definitive diagnosis. Findings that are more common with angiosarcomas include size greater than 2 cm, hypervascularity on Doppler US, irregular shape, and invasive growth pattern.
Impaired kidney function, cerebral small vessel disease and cognitive disorders: the Framingham Heart Study
Authors: Kelly Dearbhla M , Pinheiro Adlin A , Koini Marisa , Anderson Christopher D , Aparicio Hugo , Hofer Edith , Kern Daniela , Blacker Deborah , DeCarli Charles , Hwang Shih-Jen , Viswanathan Anand , Gonzales Mitzi M , Beiser Alexa S , Seshadri Sudha , Schmidt Reinhold , Demissie Serkalem , Romero Jose R 
Published: April 2024

ABSTRACT

Background and hypothesis
It remains unclear whether the relation of chronic kidney disease (CKD) with cognitive dysfunction is independent of blood pressure (BP). We evaluated kidney function in relation to premorbid BP measurements, cerebral small vessel disease (CSVD), and incident mild cognitive impairment (MCI) and dementia in Framingham Offspring Cohort participants.

Methods
We included Framingham Offspring participants free of dementia, attending an examination during midlife (exam cycle 6, baseline) for ascertainment of kidney function status, with brain magnetic resonance imaging late in life (exam cycles 7–9), cognitive outcome data, and available interim hypertension and BP assessments. We related CKD (estimated glomerular filtration rate &lt;60 ml/min/1.73 m2) and albuminuria (urine albumin-to-creatinine ratio ≥30 mg/g) to CSVD markers and cognitive outcomes using multivariable regression analyses.

Results
Among 2604 participants (mean age 67.4 ± 9.2, 64% women, 7% had CKD, and 9% albuminuria), albuminuria was independently associated with covert infarcts [adjusted OR, 1.55 (1.00–2.38); P = 0.049] and incident MCI and dementia [adjusted hazard ratio (HR), 1.68 (1.18–2.41); P = 0.005 and 1.71, (1.11–2.64); P = 0.015, respectively]. CKD was not associated with CSVD markers but was associated with a higher risk of incident dementia [HR, 1.53 (1.02–2.29); P = 0.041]. While albuminuria was predictive of the Alzheimer's disease subtype [adjusted HR = 1.68, (1.03–2.74); P = 0.04), CKD was predictive of vascular dementia [adjusted HR, 2.78 (1.16–6.68); P = 0.023].

Conclusions
Kidney disease was associated with CSVD and cognitive disorders in asymptomatic community dwelling participants. The relation was independent of premorbid BP, suggesting that the link between kidney and brain disease may involve additional mechanisms beyond BP-related injury.
Glyphosate Residues in Soil and Phosphate Fertilizer Affect Foliar Endophytic Microbial Community Composition and Phytohormone Levels in Potato
Authors: Mathew Suni Anie , Jeevannavar Aditya , Helander Marjo , Tamminen Manu , Puigbò Pere , Rainio Miia , Saikkonen Kari , Fuchs Benjamin 
Published: April 2024

Glyphosate, the active ingredient of glyphosate-based herbicides (GBHs), controls the growth of weeds by inhibiting the shikimate pathway, thereby interrupting amino acid biosynthesis in plants. However, several microbes have the shikimate pathway, and the effect of glyphosate on these non-target organisms is ignored. The action of GBHs is further complicated when used with other agrochemicals, such as phosphate fertilizers, often varying their mode of action depending on soil type or plant species. To address the impact of GBHs and phosphate fertilizers, we simulated agricultural application of GBHs and phosphate fertilizers in a field study, investigating the composition of endophytic microbial communities and correlation of phytohormone concentrations with the microbial diversity of potato ( Solanum tuberosum). In leaves, glyphosate residues in soil from GBH treatment alone and in combination with phosphate significantly shifted the bacterial community, whereas phosphate alone and in combination with glyphosate significantly altered the composition of the fungal community. There were no significant changes in microbial communities in roots and tubers. Plants treated with GBHs showed higher ratios of potentially glyphosate-resistant bacteria, with Xanthomonadaceae and Moraxellaceae being more abundant. Additionally, phytohormone concentrations showed various correlations with bacterial and fungal diversity in different treatments. The study highlights the impact of GBH residues in soil, particularly in combination with phosphate fertilizers, on the composition of plant-associated microbial communities. Together with changes in phytohormone concentrations, plant health may be affected. Future studies could provide insights into whether these agrochemicals influence the plant microbiome, leading to changes in phytohormones or vice versa. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Ensuring Continuity of Health Professions Training Amid a Global Pandemic: Lessons From the Uganda Safe Schools Initiative
Authors: Balizzakiwa Thomas , Achanga Pius , Ahaisibwe Bonaventure , Kerry Vanessa , Duhaga Irene Atuhairwe , Semakula Daniel , Sewankambo Nelson , Masood Kiran Mitha 
Published: April 2024

AbstractUganda experienced 2 COVID-19 waves that challenged health professional education. All health professions training institutions (HPTIs) in Uganda closed in March 2020. Cognizant of the threat to quality education and the frontline workforce, the National Council for Higher Education (NCHE) and Seed Global Health partnered to examine the risks and benefits of HPTI reopening through the Safe Schools Initiative (SSI). This article described the processes to unify stakeholders in health professions education and the outcomes from these discussions during the COVID-19 pandemic in Uganda.During the first COVID-19 wave, the SSI conducted consultative meetings with key stakeholders. The SSI developed guidelines around student welfare and issued standard operating procedures (SOPs) for HPTI reopening. The NCHE recommended in-person learning for final-year students and online learning for junior years, resulting in HPTIs being the first academic institutions to reopen in the country. During the second COVID-19 wave, schools closed again. The SSI utilized recently published literature and quantitative data to inform decision making in addition to expert consensus. The NCHE recommended immediate phased reopening for students in clinical years, blended learning for nonclinical years, and prioritizing health professions education in future lockdowns. Consequently, HPTIs reopened within a month of closure. The SSI demonstrated that national advocacy for health professions education can be effective when engaging stakeholders to build consensus around difficult decisions.Key lessons learned from the SSI include the following: (1) collaborating across sectors in health professions education can amplify change, (2) occupational health guidelines must include health professions students, (3) investing in online education and simulation has value in outbreak-prone areas, and (4) systemic inequities in health professions education will require persistence and advocacy to correct. Future pandemic preparedness must prioritize HPTIs to ensure quality education and continuity of a frontline workforce.
How a Team Effectiveness Approach to Health Systems Science Can Illuminate Undergraduate Medical Education Outcomes
Authors: Kim Jung G. , Gonzalo Jed D. , Chen Isabel , Vo Anne , Lupi Carla , Hyderi Abbas , Haidet Paul , DeWaters Ami , Blatt Barbara , Holmboe Eric , Thompson Lindsey R. , Jimenez Jazmin , Madigosky Wendy , Chung Paul J. 
Published: April 2024

Abstract
Health care delivery requires physicians to operate in teams to successfully navigate complexity in caring for patients and communities. The importance of training physicians early in core concepts of working in teams (i.e., “teaming”) has long been established. Over the past decade, however, little evidence of team effectiveness training for medical students has been available. The recent introduction of health systems science as a third pillar of medical education provides an opportunity to teach and prepare students to work in teams and achieve related core competencies across the medical education continuum and health care delivery settings. Although educators and health care system leaders have emphasized the teaching and learning of team-based care, conceptual models and evidence that inform effective teaming within all aspects of undergraduate medical education (including classroom, clinical, and community settings) are needed to advance the science regarding learning and working in teams. Anchoring teaming through the core foundational theory of team effectiveness and its operational components could catalyze the empirical study of medical student teams, uncover modifiable factors that lead to the evidence for improved student learning, and improve the link among competency-based assessments between undergraduate medical education and graduate medical education. In this article, authors articulate several implications for medical schools through 5 conceptual areas: admissions, the design and teaching of team effectiveness in health systems science curricula, the related competency-based assessments, and course and program evaluations. The authors then discuss the relevance of the measurable components and intended outcomes to team effectiveness in undergraduate medical education as critical to successfully prepare students for teaming in clerkships and eventually residency and clinical practice.