bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distribution and insecticide resistance profile of the major malaria vectorAnopheles funestusgroup across theAfricancontinent
Authors: Wangrawa Dimitri W. , Odero Joel O. , Baldini Francesco , Okumu Fredros , Badolo Athanase 
Published: February 2024

AbstractThere has been significant progress in malaria control in the last 2 decades, with a decline in mortality and morbidity. However, these gains are jeopardised by insecticide resistance, which negatively impacts the core interventions, such as insecticide‐treated nets (ITN) and indoor residual spraying (IRS). While most malaria control and research efforts are still focused onAnopheles gambiaecomplex mosquitoes,Anopheles funestusremains an important vector in many countries and, in some cases, contributes to most of the local transmission. As countries move towards malaria elimination, it is important to ensure that all dominant vector species, includingAn. funestus, an important vector in some countries, are targeted. The objective of this review is to compile and discuss information related toA. funestuspopulations' resistance to insecticides and the mechanisms involved across Africa, emphasising the sibling species and their resistance profiles in relation to malaria elimination goals. Data on insecticide resistance inAn. funestusmalaria vectors in Africa were extracted from published studies. Online bibliographic databases, including Google Scholar and PubMed, were used to search for relevant studies. Articles published between 2000 and May 2023 reporting resistance ofAn. funestusto insecticides and associated mechanisms were included. Those reporting only bionomics were excluded. Spatial variation in species distribution and resistance to insecticides was recorded from 174 articles that met the selection criteria. It was found thatAn. funestuswas increasingly resistant to the four classes of insecticides recommended by the World Health Organisation for malaria vector control; however, this varied by country. Insecticide resistance appears to reduce the effectiveness of vector control methods, particularly IRS and ITN. Biochemical resistance due to detoxification enzymes (P450s and glutathione‐S‐transferases [GSTs]) inAn. funestuswas widely recorded. However,An. funestusin Africa remains susceptible to other insecticide classes, such as organophosphates and neonicotinoids. This review highlights the increasing insecticide resistance ofAn. funestusmosquitoes, which are important malaria vectors in Africa, posing a significant challenge to malaria control efforts. WhileAn. funestushas shown resistance to the recommended insecticide classes, notably pyrethroids and, in some cases, organochlorides and carbamates, it remains susceptible to other classes of insecticides such as organophosphates and neonicotinoids, providing potential alternative options for vector control strategies. The study underscores the need for targeted interventions that consider the population structure and geographical distribution ofAn. funestus, including its sibling species and their insecticide resistance profiles, to effectively achieve malaria elimination goals.
Stomatal conductance reduction tradeoffs in maize leaves: A theoretical study
Authors: Srivastava Antriksh , Srinivasan Venkatraman , Long Stephen P. 
Published: February 2024

AbstractAs the leading global grain crop, maize significantly impacts agricultural water usage. Presently, photosynthesis () in leaves of modern maize crops is saturated with , implying that reducing stomatal conductance () would not affect but reduce transpiration (), thereby increasing water use efficiency (WUE). While reduction benefits upper canopy leaves under optimal conditions, the tradeoffs in low light and nitrogen‐deficient leaves under nonoptimal microenvironments remain unexplored. Moreover, reduction increases leaf temperature () and water vapor pressure deficit, partially counteracting transpiratory water savings. Therefore, the overall impact of reduction on water savings remains unclear. Here, we use a process‐based leaf model to investigate the benefits of reduced in maize leaves under different microenvironments. Our findings show that increases in due to reduction can diminish WUE gains by up to 20%. However, reduction still results in beneficial WUE tradeoffs, where a 29% decrease in in upper canopy leaves results in a 28% WUE gain without loss in . Lower canopy leaves exhibit superior tradeoffs in reduction with 178% gains in WUE without loss in . Our simulations show that these WUE benefits are resilient to climate change.
Burden of impaired awareness of hypoglycemia in people with diabetes undergoing hemodialysis
Authors: Habte-Asres Hellena Hailu , Jiang Yutong , Rosenthal Miranda , Wheeler David Collins 
Published: February 2024

IntroductionImpaired awareness of hypoglycemia (IAH) refers to a diminished capacity to detect hypoglycemia. IAH can result in severe and even life-threatening outcomes for individuals with diabetes, especially those in advanced stages of the disease. This study aimed to assess the prevalence of IAH in people with diabetes on hemodialysis.Research design and methodsWe conducted a single-center audit to assess the prevalence of IAH using the Clarke questionnaire. Simultaneously, we measured fear of hypoglycemia with an adapted version of the Hypoglycemia Survey and recorded the incidence of severe hypoglycemia. Data were presented as mean±SD or counts/percentages. Logistic regression was then employed to analyze the association between IAH and various sociodemographic and clinical factors.ResultsWe included 56 participants with diabetes on hemodialysis, with a mean age of 67.2 years (±12.9), of whom 51.8% were male. The ethnic distribution was 23.2% white, 23.2% black, 19.6% Asian, and 33.9% unspecified. The mean HbA1c was 52 mmol/mol (±18.6). The majority (91.1%) had a diagnosis of type 2 diabetes, and 55.4% of those were treated with insulin. The use of diabetes technology was low, with 2.8% of the participants using a continuous glucose monitor. IAH prevalence was 23.2%, and among the 57 participants, 23.6% had a history of severe hypoglycemia, and 60.6% reported fear of hypoglycemia. There were no significant differences in sociodemographic and clinical characteristics between those with IAH and normal hypoglycemia awareness.ConclusionsWe observed that 23.2% of individuals with diabetes undergoing hemodialysis had IAH. IAH was more prevalent in people who reported a fear of hypoglycemia and had a history of severe hypoglycemia episode. The study highlights the unmet needs and disparities in access to diabetes technology within this population.
CD, or not CD, that is the question: a digital interobserver agreement study in coeliac disease
Authors: Denholm James , Schreiber Benjamin A , Jaeckle Florian , Wicks Mike N , Benbow Emyr W , Bracey Tim S , Chan James Y H , Farkas Lorant , Fryer Eve , Gopalakrishnan Kishore , Hughes Caroline A , Kirkwood Kathryn J , Langman Gerald , Mahler-Araujo Betania , McMahon Raymond F T , Myint Khun La Win , Natu Sonali , Robinson Andrew , Sanduka Ashraf , Sheppard Katharine A , Tsang Yee Wah , Arends Mark J , Soilleux Elizabeth J 
Published: February 2024

ObjectiveCoeliac disease (CD) diagnosis generally depends on histological examination of duodenal biopsies. We present the first study analysing the concordance in examination of duodenal biopsies using digitised whole-slide images (WSIs). We further investigate whether the inclusion of immunoglobulin A tissue transglutaminase (IgA tTG) and haemoglobin (Hb) data improves the interobserver agreement of diagnosis.DesignWe undertook a large study of the concordance in histological examination of duodenal biopsies using digitised WSIs in an entirely virtual reporting setting. Our study was organised in two phases: in phase 1, 13 pathologists independently classified 100 duodenal biopsies (40 normal; 40 CD; 20 indeterminate enteropathy) in the absence of any clinical or laboratory data. In phase 2, the same pathologists examined the (re-anonymised) WSIs with the inclusion of IgA tTG and Hb data.ResultsWe found the mean probability of two observers agreeing in the absence of additional data to be 0.73 (±0.08) with a corresponding Cohen’s kappa of 0.59 (±0.11). We further showed that the inclusion of additional data increased the concordance to 0.80 (±0.06) with a Cohen’s kappa coefficient of 0.67 (±0.09).ConclusionWe showed that the addition of serological data significantly improves the quality of CD diagnosis. However, the limited interobserver agreement in CD diagnosis using digitised WSIs, even after the inclusion of IgA tTG and Hb data, indicates the importance of interpreting duodenal biopsy in the appropriate clinical context. It further highlights the unmet need for an objective means of reproducible duodenal biopsy diagnosis, such as the automated analysis of WSIs using artificial intelligence.
Performance of large language models on advocating the management of meningitis: a comparative qualitative study
Authors: Fisch Urs , Kliem Paulina , Grzonka Pascale , Sutter Raoul 
Published: February 2024

ObjectivesWe aimed to examine the adherence of large language models (LLMs) to bacterial meningitis guidelines using a hypothetical medical case, highlighting their utility and limitations in healthcare.MethodsA simulated clinical scenario of a patient with bacterial meningitis secondary to mastoiditis was presented in three independent sessions to seven publicly accessible LLMs (Bard, Bing, Claude-2, GTP-3.5, GTP-4, Llama, PaLM). Responses were evaluated for adherence to good clinical practice and two international meningitis guidelines.ResultsA central nervous system infection was identified in 90% of LLM sessions. All recommended imaging, while 81% suggested lumbar puncture. Blood cultures and specific mastoiditis work-up were proposed in only 62% and 38% sessions, respectively. Only 38% of sessions provided the correct empirical antibiotic treatment, while antiviral treatment and dexamethasone were advised in 33% and 24%, respectively. Misleading statements were generated in 52%. No significant correlation was found between LLMs’ text length and performance (r=0.29, p=0.20). Among all LLMs, GTP-4 demonstrated the best performance.DiscussionLatest LLMs provide valuable advice on differential diagnosis and diagnostic procedures but significantly vary in treatment-specific information for bacterial meningitis when introduced to a realistic clinical scenario. Misleading statements were common, with performance differences attributed to each LLM’s unique algorithm rather than output length.ConclusionsUsers must be aware of such limitations and performance variability when considering LLMs as a support tool for medical decision-making. Further research is needed to refine these models' comprehension of complex medical scenarios and their ability to provide reliable information.
Waiting-list interventions for children and young people using child and adolescent mental health services: a systematic review
Authors: Valentine Althea Z , Hall Sophie S , Sayal Kapil , Hall Charlotte L 
Published: February 2024

QuestionChildren and young people experience delays in assessment and/or treatment within mental health services. The objective of this systematic review, funded by the Emerging Minds Network, was to explore the current evidence base for mental health waiting list interventions to support children and young people.Study selection and analysisA literature search was conducted in MEDLINE, PsycINFO, Web of Science and the Cochrane databases from 2000 to 2023 (last searched October 2023). Included studies described interventions to support children and young people and/or their family while on a waiting list for child and adolescent mental health services. Titles and abstracts were screened independently by two reviewers, data were extracted by one reviewer, confirmed by a second and a narrative synthesis was provided.FindingsEighteen studies including 1253 children and young people were identified. Studies described waiting list interventions for autism spectrum disorders, eating disorders, generic conditions, transgender health, anxiety/depression, self-harm and suicide and behavioural issues. Many interventions were multicomponent; 94% involved psychoeducation, other components included parental support, bibliotherapy and coaching. Duration of the interventions ranged from a single session to over a year; 66% involved face-to-face contact. All studies demonstrated benefits in terms of improved clinical outcomes and/or feasibility/acceptability. Evidence for service outcomes/efficiency was largely unexplored. Limitations of the underpinning research, such as sample size and low-quality papers, limit the findings.ConclusionsThere is limited research exploring waiting list interventions, however, the findings from small-scale studies are promising. Further research using robust study designs and real-world implementation studies are warranted.
Framework for understanding movement and physical activity in patients diagnosed with psychosis
Authors: Diamond Rowan , Waite Felicity , Boylan Anne-Marie , Hicks Alice , Kabir Thomas , Freeman Daniel 
Published: February 2024

BackgroundPatients diagnosed with psychosis often spend less time than others engaged in exercise and more time sitting down, which likely contributes to poorer physical and mental health.ObjectiveThe aim of this study was to develop a comprehensive framework from the perspective of patients, carers, and staff for understanding what promotes movement and physical activity.MethodsA critical realist approach was taken to design the study. Interviews (n=23) and focus groups (n=12) were conducted with (1) outpatients aged 16 years or older diagnosed with psychosis, and under the care of a mental health team, (2) carers and (3) mental health staff working in the community. Purposive sampling was used to maximise variation in participant characteristics. Data were analysed using reflexive thematic analysis.Findings19 patients (9 women and 10 men, mean age=45·0 (SD=12·2) years, 15 White British, 2 Black African, 1 Pakistani and 1 other ethnic group), 14 carers (11 women and 3 men, mean age=59·9 (SD=12·7) years, 13 White British and 1 Asian) and 18 staff (14 women and 4 men, mean age=38·7 (SD=12·3) years, 15 White British, 1 White other, 1 Asian Bangladeshi and 1 other Asian) participated in the study. Five factors were found to promote movement and physical activity. Patients must be able to find a purpose to moving which is meaningful to them (Factor 1: Purpose). Patients need to have an expectation of the positive consequences of movement and physical activity, which can be influenced by others’ expectations (Factor 2: Predictions). A patient’s current physical (eg, pain) and emotional state (eg, distress about voices) needs to be addressed to allow movement and physical activity (Factor 3: Present state). Movement and physical activity can also be encouraged by the availability of effective and tailored support, provided by engaged and supported people (Factor 4: Provision). Finally, through the identification and interruption of vicious cycles (eg, between inactivity and mood states) more positive cycles can be put in place (Factor 5: Process).Conclusions and clinical implicationsThe 5 P (Purpose, Predictions, Present state, Provision and Process Physical Activity Framework) for understanding movement and physical activity for people diagnosed with psychosis has the potential to inform future research and guide interventions. A checklist is provided for clinicians to help foster change in activity levels.
Exploring rural households’ knowledge and perception of acute kidney injury in the southern region of The Gambia: a mixed-method community-based cross-sectional study design
Authors: Kinteh Bakary , Jatta Solomon P S , Kinteh Sambou L S , Badjie Mansour , Touray Ebrima , Sillah Sheikh Omar , Barrow Amadou 
Published: February 2024

BackgroundThe Acute Kidney Injury (AKI) outbreak in The Gambia is a national tragedy attracting international concern, linked to nearly 100 deaths in children. This situation arose due to the use of contaminated medical products by children in the country.MethodWe used a mixed-method, cross-sectional study design to assess households’ knowledge and perceptions of AKI in the southern region of The Gambia. A total of 2174 respondents from 123 rural communities were recruited via multistage sampling and were interviewed face-to-face using a questionnaire. Qualitatively, focus group discussions and key informant interviews were conducted. The collected data were analysed as categorical and continuous variables, and thematic areas using SPSS V.26 and NVivo software.ResultsThe mean age was 36 years (SD±14.17) and 70% of the respondents were women. Most respondents had no formal education (45.6%), lived in extended family households (55%) and 91.6% earned a monthly income of less than GMD5000 (Gambian dalasi) (<US$100). Although 80% of the respondents were aware of the AKI outbreak in The Gambia, 90% showed poor knowledge about the disease. Half of the respondents correctly identified contaminated medical products as the cause of AKI. Interestingly, 97.1% of the participants held a moderate perception of AKI in The Gambia and firmly rejected the notion that the outbreak was politically motivated. The AKI outbreak was viewed as a stern lesson and a wake-up call for the Ministry of Health to take the necessary actions.ConclusionA significant deficiency in AKI knowledge exists among rural households, even though their perceptions of health services remain positive and unwavering. AKI is viewed as a widespread health concern rather than a political issue. To maintain this view and enhance trust, a national dialogue involving the Ministry of Health and the population is recommended.
Genomic discordances and heterogeneous mutational burden, PD-L1 expression and immune infiltrates of non-small cell lung cancer metastasis
Authors: Wu Jianghua , Mao Luning , Lei Wanjun , Sun Wei , Yang Xin , Zhang Yanhui , Huang Xiaozheng , Lin Dongmei 
Published: February 2024

AimsTo investigate the genomic discordances and heterogeneous mutational burden, PD-L1 expression and immune cell (IC) infiltrates of non-small cell lung cancer (NSCLC) metastasis.MethodsSurgical samples from 41 cases of NSCLC with metastatic tumours (MTs) and paired primary tumours (PTs) were collected. PD-L1 expression and ICs were quantified using image-based immunohistochemistry profiling. Whole exome sequencing was employed to explore discrepancies in genomic characteristics, tumour mutational burden (TMB) and tumour neoantigen burden (TNB) in 28 cases.ResultsNon-synonymous mutations in MTs were slightly more than in PTs, with only 42.34% of mutations shared between paired PTs and MTs. The heterogeneity of TMB showed no significant difference (p=0.785) between MTs and PTs, while TNB significantly increased in MTs (p=0.013). MTs generally exhibited a higher density of PD-L1+ cells and a higher tumour proportion score with a lower density of IC infiltrates. Subgroup analysis considering clinicopathological factors revealed that the heterogeneity of immune biomarkers was closely associated with the histology of lung adenocarcinoma, metastatic sites of extrapulmonary, time intervals and treatment history. Prognosis analysis indicated that a high density of CD8+ T cells was a low-risk factor, whereas a high density of PD-L1+ cells in MTs was a high-risk factor for cancer-related death in metastatic NSCLC.ConclusionsThe mutational burden, PD-L1 expression and IC infiltrates undergo changes during NSCLC metastasis, which may impact the immunotherapeutic benefits in patients with NSCLC with metastatic progression and should be monitored according to clinical scenarios.
Embolization of the middle meningeal artery for the prevention of chronic subdural hematoma recurrence in high-risk patients: a randomized controlled trial—the EMPROTECT study protocol
Authors: Shotar Eimad , Mathon Bertrand , Rouchaud Aymeric , Mounayer Charbel , Salle Henri , Bricout Nicolas , Lejeune Jean-Paul , Janot Kevin , Zemmoura Ilyess , Naggara Olivier , Roux Alexandre , Goutagny Stéphane , Guedon Alexis , Brunel Herve , Troude Lucas , Dufour Henry , Bernat Anne-Laure , Tuilier Titien , Bresson Damien , Apra Caroline , Fouet Mathilde , Escalard Simon , Chauvet Dorian , Baptiste Amandine , Lebbah Said , Dechartres Agnès , Clarençon Frédéric 
Published: February 2024

BackgroundMiddle meningeal artery (MMA) embolization has been proposed as a treatment of chronic subdural hematoma (CSDH). The benefit of the procedure has yet to be demonstrated in a randomized controlled trial. We aim to assess the efficacy of MMA embolization in reducing the risk of CSDH recurrence 6 months after burr-hole surgery compared with standard medical treatment in patients at high risk of postoperative recurrence.MethodsThe EMPROTECT trial is a multicenter open label randomized controlled trial (RCT) involving 12 French centers. Adult patients (≥18 years) operated for CSDH recurrence or for a first episode with a predefined recurrence risk factor are randomized 1:1 to receive either MMA embolization within 7 days of the burr-hole surgery (experimental group) or standard medical care (control group). The number of patients to be included is 342.ResultsThe primary outcome is the rate of CSDH recurrence at 6 months. Secondary outcomes include the rate of repeated surgery for a homolateral CSDH recurrence during the 6-month follow-up period, the rate of disability and dependency at 1 and 6 months, defined by a modified Rankin Scale (mRS) score ≥4, mortality at 1 and 6 months, total cumulative duration of hospital stay during the 6-month follow-up period, directly or indirectly related to the CSDH and embolization procedure-related complication rates.ConclusionsThe EMPROTECT trial is the first RCT evaluating the benefit of MMA embolization as a surgical adjunct for the prevention of CSDH recurrence. If positive, this trial will have a significant impact on patient care.Trial registration numberNCT04372147.
An assessment of microplastics in fecal samples from polar bears (Ursus maritimus) in Canada's North
Authors: Iyare P.U. , Vanderlip H.L. , Dias M. , Provencher J.F. , Zou S. , Lougheed S.C. , Van Coeverden de Groot P.J. , Whitelaw G. , Branigan M. , Dyck M. , Orihel D.M. 
Published: February 2024

We assessed the potential for plastic ingestion in polar bears ( Ursus maritimus (Phipps (1774))) using fecal analysis. Two method studies ensured our protocols could effectively recover and identify plastics in feces. First, microplastics (film, foam, or fragments) were intentionally introduced into a model organic matrix. Recovery rates (mean ± standard deviation) averaged 95.8 ± 14.7% ( n = 18) and were significantly affected by microplastic morphology but not digestion status. Second, microplastic fragments of polypropylene, polyethylene terephthalate, and polystyrene were intentionally introduced to polar bear feces. Recovery rates averaged 79.3 ± 21.6% ( n = 8) and Raman microscopy successfully identified all three polymers in 87.5% of samples. The main study then investigated the presence of microplastics in hunter-collected polar bear feces in the Canadian Arctic. Feces from the colons of hunted bears ( n = 15) and field scat ( n = 15) were collected through collaboration with Inuit communities. Polypropylene, polyethylene, and/or polyethylene terephthalate were detected in the feces of eight bears. Concentrations of microplastics in feces were, on average, less than 1 particle/g dry weight feces and at or near detection limits. Overall, this work suggests microplastic ingestion by Canadian polar bears may be low and demonstrates the utility of fecal sampling for community-based monitoring programs.