Research Institute Research Articles

228 Evaluation of sire vs. dam influences on age at first parturition in Brahman heifers

Abstract The objective of this study was to determine if sire or dam had a stronger impact on age at first parturition of Brahman heifers (n = 833) born between 2000-2021. Typically, in Bos taurus heifers, puberty occurs between 10 to 12 mo of age leading to parturition of the first calf occurring around 24 mo of age. However, in Bos indicus cattle, puberty is achieved between 15 to 17 mo of age leading to a first calf around 36 mo of age. The ability of heifers to achieve pubertal status earlier plays a vital role in reproductive success. For selection purposes, knowing if early pubertal attainment is influenced more by the sire or dam is important for herd management. For this study, to minimize any epigenetic and environmental changes, all heifers originated and were developed at the Texas A&M AgriLife Research Center at Overton. Sire groups (SG) and dam groups (DG) were established based on the number of offspring used in the study. Sire groups were comprised of SG-1 (1+ calves sired; n = 58 sires), SG-2 (5+ calves sired; n = 44 sires), SG-3 (10+ calves sired; n = 31 sires), SG-4 (15+ calves sired; n = 23 sires), SG-5 (20+ calves sired; n = 17 sires), and SG-6 (25+ calves sired; n = 12 sires). Dam groups consisted of DG-1 (1+ calves; n = 489 dams), DG-2 (2+ calves; n = 215 dams), DG-3 (3+ calves; n = 81 dams), DG-4 (4+ calves; n = 38 dams), and DG-5 (5+ calves; n = 9 dams). Statistical analysis (PROC GLM; SAS 9.4) included the fixed effect of sire group (dam group) and all dams (sires) utilized in that grouping. Significance for age at first calving was considered at P < 0.05. Mean separation for age was performed using LSmeans. Sire significantly impacted age at first calving in SG-1 (P = 0.0173) vs dam effect (P = 0.3993; n = 489 dams), SG-2 (P = 0.0159) vs dam effect (P = 0.5476; n = 481 dams), SG-3 (P = 0.0023) vs dam effect (P = 0.2532; n = 439 dams), SG-4 (P = 0.0022) vs dam effect (P = 0.3997; n = 400 dams), SG-5 (P = 0.0002) vs dam effect (P = 0.0602; n = 361 dams), and SG-6 (P = 0.0005) vs dam effect (P = 0.1058; n = 305 dams). The dam impact on age at first calving was never significant in the dam groupings but sires did impact age at first calving in two groups: DG-1 (P = 0.3993) vs sire effect (P = 0.0173; n = 58 sires), DG-2 (P = 0.4823) vs sire effect (P = 0.0173; n = 56 sires), DG-3 (P = 0.3011) vs sire effect (P = 0.3420; n = 49 sires), DG-4 (P = 0.3911) vs sire effect (P = 0.6278; n = 40 sires), and DG-5 (P = 0.3042) vs sire effect (P = 0.9159; n = 23 sires). In summary, evaluation of sire and dam influences on age at first parturition for female offspring demonstrates that the ability to calve at an earlier age is influenced by the sire but not the dam. Further studies into the mechanisms for the transmission of this trait are warranted.

184 Effects of cattle hide color and changing environmental conditions at northern latitudes on feeder cattle performance and behavior

Abstract While suitable research has been done on the influence of climatic conditions on feeder cattle welfare, we have seen limited work done that assesses the relationship of hide color and cattle thermoregulation in response to extreme environmental changes, particularly of those seen at northern latitudes. Specifically, there is limited research on the effects of environmental stressors and cattle hide color on performance and intake. Therefore, the objective of this study is to evaluate feeder cattle performance in response to environmental conditions and hide color. Angus-based yearling steers [n = 40; average body weight (BW) = 409.28 kg were stratified by BW and hide color (red, white, and black) and were randomized into 10 pens at the Northern Agricultural Research Center in Havre, MT. Steers were on trial from 20 February 2023 to 11 July 2023 (141 d) and fitted with an electronic ear tag and adapted to the Vytelle system (Vytelle, Lenexa, KS) for 14 d prior to the start of the study. All 10 pens consisted of two electronic feed bunks equipped with an antenna to detect animal presence, load cells to measure feed disappearance and wireless transfer to a data-acquisition computer. Finishing diet (8.6% CP, 75% TDN) consisted of 69% corn, 21% corn silage, 10% wheat straw, and 0.45 kgּ animal-1ּ d-1 of beef grower pellet with a fortified mineral and vitamin package. Initial and final unshrunk BW were obtained on two consecutive days and averaged. Every 28 d during the experiment, steers were weighed prior to feeding and a measurement of coat depth was taken. Animal surface temperature was recorded via a FLIR E5xt thermal imaging camera on the same day of every week at 0730 h (prior to feeding) and 1330 h (6 h post feeding), for 20 wk. There was no difference in hair depth between the white hided steers and other treatments (P ≥ 0.26). However, there was a treatment effect (P = 0.01) of hide color on cattle surface temperature, with black and red hided steers averaging 2.85°C greater than white hided steers. There was no effect of treatment on average daily gain (P = 0.55) averaging 1.34 kg/d. Additionally, there was no treatment effect on average daily intake (P = 0.36), averaging 10.76 kg per day. There was a treatment effect on gain to feed efficiency (P = 0.05); however, post hoc means separation analysis showed no difference between treatments. In summary, although there were treatment effects on animal surface temperature, they were not reflected in animal performance.

194 Evaluation of a method to optimize diets of individual dairy cows to maximize income over feed cost

Abstract Recent optimization methods have demonstrated the potential to maximize marginal profits in beef (Marques et al., 2020) and dairy (Campos et al., 2023) by optimizing diet formulation. These methods present an opportunity to explore how diets could be optimized for individual dairy cows, such as in a closed-loop precision feeding system. Therefore, our objectives were to 1) compare individual income over feed costs (IOFC), calculated with observed dry matter intake (DMI), milk yield (MY), milk protein and milk fat, with a predicted IOFC for the same diet and cows using the NASEM (2021) model, and 2) optimize the inclusion rate of ingredients in the diet to maximize predicted IOFC. Previously, 20 multiparous (lactation 2 through 4) and 9 primiparous cows, ranging from 22 to 472 d in milk (DIM), were housed in a free-stall pen at the Ontario Dairy Research Centre (Canada) equipped with sensors to record DMI, body weight (BW; walk-over-weight) and body condition score (BCS; DeLavel 3D camera), in addition to daily MY, weekly milk component tests, and 4 X/d respiratory gas exchange measurements (GreenFeed, C-Lock Inc, USA) for estimation of daily energy flows (Kedzierski, 2020). Weekly means for each cow were used to evaluate IOFC in this study (n = 116). Each IOFC was calculated as milk revenue minus total feed cost. Milk revenue was calculated from milk fat, protein and other solids, consistent with pricing on Canadian dairy farms. The observed IOFC was calculated using the observed MY, milk components and DMI, and the same diet formulation and costs for all cows, whereas the predicted IOFC estimated these values using the NASEM (2021) model with all available observed animal inputs (e.g., BW, BCS, DIM). However, the observed DMI and MY had to be provided initially for the model, as the DMI prediction equation requires a target MY, but the prediction of MY requires DMI. Final predicted DMI and MY values were used in the calculation of predicted IOFC. The differential evolution algorithm from the ‘SciPy’ package (v 1.11.4) in python (v 3.12.0) was used to maximize IOFC by adjusting the inclusion of wheat straw, alfalfa silage, corn silage and high moisture corn grain, while fixing minerals to their original proportions. Overall, the concordance correlation coefficient (CCC) indicated moderate agreement (0.62) between the predicted IOFC and observed IOFC and good agreement (0.99) between the predicted IOFC and the optimized IOFC, suggesting the optimization method was able to select diets to meet a similar objective. Results indicate that a strategy is needed to minimize the residual error between predicted and observed values for individual cows, such as algebraic reparameterization of the NASEM model, before using an optimization method to automatically formulate diets.

The Most Influential Publications Regarding Hair Transplantation: A Bibliometric Review.

This bibliometric review aims to assess the impact of significant publications within the field of hair transplantation. Citation counts will serve as a primary influence indicator. An exhaustive search was conducted using Clarivate's Web of Science database, yielding 260 publications related to hair transplantation. These were evaluated and sorted based on citations, narrowing down to the 50 most highly cited works for analysis. Parameters including citation density, authorship, institutional affiliations, country of origin, year of publication, article topic, and the level of evidence for each publication were obtained. Analyzed publications were cited a total of 1341 times. Authorship analysis revealed that the most significant contributors regarding hair transplantation were Bernstein and Rassman. We also identified the leading institutions affiliated with these works, highlighting the primary academic and research centers driving the field. Geographical analysis exhibited the US' dominance in producing impactful publications. Most publications were also classified within Level IV and Level V according to the Oxford Levels of Evidence system. This review provides a comprehensive snapshot of the pivotal publications shaping hair transplantation. Our findings underscore significant contributions within this field and may assist researchers and clinicians in understanding the evolution and the current state of the hair transplantation literature. This bibliometric analysis can serve as a roadmap for those seeking to delve into this rapidly evolving field, facilitating the identification of research gaps and formulating future research directions. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Assessment of male creatinine levels and fecundity in couples planning pregnancy: a national cohort study in China.

Is there an association between male creatinine levels and time to pregnancy (TTP) in couples planning pregnancy? Low and high male creatinine concentrations were associated with reduced couple fecundity. Abundant evidence suggests male creatinine dysfunction is associated with infertility in males with kidney diseases. However, the association of preconception creatinine levels with reduced fecundity among general reproductive-aged couples lacks evidence from an in-depth population study. Based on the population-based cohort study from the National Free Preconception Check-up Projects, 4023204 couples were recruited and met the inclusion criteria from 1 January 2015 to 31 December 2017. They were planning pregnancy and were followed up every 3 months until achieving pregnancy as detected by gynaecological ultrasonography or were followed up for 1 year for the analysis of TTP. Cox regression models were used to estimate hazard ratios (HRs) and 95% CI for creatinine deciles. Restricted cubic spline regression was adopted for the dose-response relationship of creatinine with HRs. R statistical software was used for data analysis. Of the included participants, 2756538 (68.52%) couples successfully conceived. The median male serum creatinine was 81.50 μmol/l. Compared with the reference group (78.00-81.49 μmol/l) including the median creatinine, fecundity in the first (≤64.89 μmol/l), second (64.90-69.99 μmol/l), third (70.00-73.99 μmol/l), and tenth (≥101.00 μmol/l) deciles decreased by 8%, 5%, 2%, and 1%, respectively (Decile 1 Adjusted HR 0.92, 95% CI 0.91-0.92; Decile 2 Adjusted HR 0.95, 95% CI 0.95-0.96; Decile 3 Adjusted HR 0.98, 95% CI 0.97-0.99; Decile 10 Adjusted HR 0.99, 95% CI 0.98-0.99). An inverse-U-shaped association was consistently presented among males such that non-inferiority for fecundity was shown when creatinine was in the 81.66-104.90 μmol/l range (P for non-linearity < 0.001). For males over 40 years old, the risk of fecundity impairment was more obvious and the recommended range of creatinine levels for TTP was reduced and more narrow, compared with that for younger males. Not including the time couples spend preparing for pregnancy before enrolment would lead to an overestimation of fecundity; additionally some couples place pregnancy plans on hold due to special emergencies, which would not have been recognized. Due to the lack of information regarding semen quality, psychological factors, sexual intercourse frequencies, and hazardous environmental factors, we could not adjust for these factors. Some variates were self-reported and dichotomized, which were prone to bias. Direct variables reflecting muscle mass and impaired kidney function were lacking. Thus, extrapolation should be done with caution. Male creatinine is associated with couples' fecundity and the relationship varied by age. This study provides a better understanding of the potential implications and significance of different creatinine levels and their association with the clinical significance regarding couples' fecundity. This research has received funding from the National Natural Science Foundation of China (Grant No. 81872634), the Basic Research Funds of Central Public Welfare Research Institutes of China (Grant No. 2023GJZ03), the National Key Research and Development Program of China (Grant No. 2016YFC1000307), and the Project of National Research Institute for Family Planning (Grant No. 2018NRIFPJ03), People's Republic of China. The authors have no conflicts of interest to declare. N/A.

Diagnostic accuracy of Cardiochek® PA point-of-care testing (POCT) analyser with a 3-in-1 lipid panel for epidemiological surveys

BackgroundPoint-of-care testing (POCT) is commonly used in epidemiological surveys due to its various advantages, such as portability and immediate test results. The CardioChek® PA analyser 3-in-1 lipid panel measures total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol. This study tested the reliability and diagnostic accuracy of the CardioChek® PA analyser using a 3-in-1 lipid panel.MethodsA cross-sectional study design with quota sampling was used. A total of 203 respondents aged 18 years and above from a research centre in the Ministry of Health, Malaysia, were recruited. Venous blood was sent to the laboratory and tested with Siemens Atellica CH, while a POCT analyser was used for capillary blood measurements. Intraclass coefficient correlation (ICC) analysis was employed to determine the agreement between capillary and venous blood parameters. The diagnostic performance of the evaluated tests was evaluated using STATA version 12.ResultsThe agreement between capillary and laboratory venous blood was moderate (0.64–0.67) for TC and HDL, good (0.75) for LDL and excellent (0.91) for TG). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were as follows: TC, 57.1%, 94.3%, 92.3% and 64.8%; TG, 76.0%, 100%, 100%, and 96.6%; HDL, 96.2%, 83.2%, 47.2% and 99.3%; and LDL, 81.0%, 100%, 100% and 68.3%, respectively.ConclusionsThe CardioChek® PA analyser showed acceptable diagnostic accuracy for screening high-risk individuals more often in places where laboratories are inaccessible. It could also be used in clinical settings where patients would benefit from swift treatment decisions.

Entrepreneurship and Corporate ESG Performance—A Case Study of China’s A-Share Listed Companies

This paper examines the contemporary implications of entrepreneurship and utilizes panel data from Chinese A-share listed companies spanning 2011 to 2022. Based on the five aspects of Chinese entrepreneurship, namely “patriotism, courage to innovate, integrity and law-abiding, social responsibility, and international vision”, the findings suggest that fostering entrepreneurship enhances the environmental, social, and governance (ESG) performance of firms. Mechanism analysis indicates that green technology innovation, social performance enhancement, and governance capability optimization mediate this relationship. Furthermore, factors such as corporate market power, regional marketization processes, and advancements in artificial intelligence technology influence the link between entrepreneurship and ESG performance. Robust entrepreneurship equips firms to navigate environmental uncertainties, but entrepreneurship cannot improve corporate governance performance. This article elucidates the distinctive significance of entrepreneurship, expanding the institutional economics research perspective, offering practical insights for cultivating entrepreneurship and elucidating potential determinants of corporate ESG performance. This article also provides spiritual guidance for sustainable development.

Exploring research trends and hotspots on oxidative stress and bronchopulmonary dysplasia: Insights from bibliometric and visualized study.

Bronchopulmonary dysplasia (BPD) is a severe chronic lung disease primarily affecting premature infants, often resulting from prolonged mechanical ventilation and oxygen therapy. Oxidative stress plays a critical role in the pathogenesis of BPD, contributing to lung injury, inflammation, and impaired lung development. Despite extensive research, there is a need to systematically map out the research trends and hotspots in this field to inform future studies and therapeutic strategies. This study utilized bibliometric and visualized analysis to explore global research trends and hotspots on oxidative stress and BPD from 2004 to 2024. A comprehensive literature search was conducted in the Web of Science Core Collection, focusing on publications related to oxidative stress and BPD. Tools such as VOSviewer, Citespace, and the R package Bibliometrix were employed to analyze Coauthorship, co-citation, and keyword co-occurrence networks, as well as to identify emerging research fronts and influential studies. The analysis identified 597 relevant publications, showing a steady increase in research output over the 20-year period, with a significant surge in the last decade. The United States led in research contributions, followed by China and Germany, with notable collaborations among these countries. Coauthorship analysis highlighted key research institutions, such as Harvard University and the University of California, as central nodes in the research network. Thematic clustering revealed five major research areas: antioxidant mechanisms, inflammation, molecular pathways, lung development, and therapeutic interventions. The keyword co-occurrence analysis showed a shift in research focus over time. Early studies concentrated on basic pathophysiological mechanisms, while recent research has increasingly focused on advanced molecular techniques, such as gene expression and targeted therapies. Notably, the study identified emerging research hotspots, including the role of extracellular vesicles and cellular senescence in BPD, as well as the potential therapeutic applications of antioxidants like superoxide dismutase mimetics. This bibliometric study provides a comprehensive overview of the research landscape on oxidative stress and BPD, identifying key trends, influential authors, and emerging research topics. The findings underscore the importance of continued research in this field, particularly in translating basic scientific insights into clinical applications to improve outcomes for infants affected by BPD. The study also highlights potential areas for future investigation, including the development of novel therapeutic strategies targeting oxidative stress in BPD.

Knowledge and control of cocoa black pod disease and factors influencing the sourcing of planting material by smallholder farmers in Cross River State, Nigeria

ABSTRACT This study assessed the level of awareness and management of cocoa black pod disease and factors influencing the sourcing of planting materials by smallholder farmers in Cross River State, Nigeria. A questionnaire, designed to assess farmers’ knowledge and control measures, was administered to 200 cocoa farmers. The data collected were analyzed using descriptive statistics and a linear regression model to determine factors influencing planting material sourcing. The study revealed that the majority of farmers were small- or medium-scale, with a small household size, limiting the adoption of improved technology. A majority of smallholder farmers planted Amazon cocoa varieties while 21.4% of respondents did not know the variety of cocoa they planted. The majority of farmers used fungicides to control black pod disease, and respondents obtained cocoa planting materials from other farmers (71%) or from Cocoa Research Institute of Nigeria Stations and Agricultural Development Stations (29%). The study found that only three variables significantly predicted the source of cocoa planting materials: variety of cocoa planted, quantity of fungicide used per annum, and fungicide/harvest ratio. There is a need to extend agricultural development stations as well as increase extension services to help farmers getting improved cocoa varieties from authorized centers.

The role of corpora in the work of the Language Consulting Service of the HUN-REN Hungarian Research Centre for Linguistics

The role of corpora in the work of the Language Consulting Service of the HUN-REN Hungarian Research Centre for Linguistics

Postprandial metabolomics analysis reveals disordered serotonin metabolism in post-bariatric hypoglycemia.

Bariatric surgery is a potent therapeutic approach for obesity and type 2 diabetes but can be complicated by post-bariatric hypoglycemia (PBH). PBH typically occurs 1 to 3 hours after meals, in association with exaggerated postprandial levels of incretins and insulin. To identify mediators of disordered metabolism in PBH, we analyzed plasma metabolome in fasting state and 30 and 120 minutes after mixed meal in 3 groups: PBH (n = 13), asymptomatic post-RYGB (n = 10), and non-surgical controls (n = 8). In the fasting state, multiple tricarboxylic acid cycle intermediates and the ketone beta-hydroxybutyrate were increased by 30% to 80% in PBH vs. asymptomatic. Conversely, multiple amino acids (BCAA, tryptophan) and polyunsaturated lipids were reduced by 20% to 50% in PBH versus asymptomatic. Tryptophan-related metabolites, including kynurenate, xanthurenate, and serotonin, were reduced by 2- to 10-fold in PBH in fasting state. Postprandially, plasma serotonin was uniquely increased by 1.9-fold in PBH versus asymptomatic post-RYGB. In mice, serotonin administration lowered glucose and increased plasma insulin and GLP-1. Moreover, serotonin-induced hypoglycemia in mice was blocked by the nonspecific serotonin receptor antagonist cyproheptadine and the specific serotonin receptor 2 antagonist ketanserin. Together these data suggest that increased postprandial serotonin may contribute to the pathophysiology of PBH and provide a potential therapeutic target. NIH grant R01 DK121995, NIH grant P30 DK036836 (Diabetes Research Center grant, Joslin Diabetes Center), and Fundação de Amparo à Pesquisa do Estado de São Paulo-FAPESP grant 2018/22111-2.

The Effect of Relative Humidity in Conductive Atomic Force Microscopy.

Conductive atomic force microscopy (CAFM) analyzes electronic phenomena in materials and devices with nanoscale lateral resolution, and it is widely used by companies, research institutions, and universities. Most data published in the field of CAFM is collected in air at a relative humidity (RH) of 30-60%. However, the effect of RH in CAFM remains unclear becauseprevious studies often made contradictory claims, plus the number of samples and locations tested is scarce. Moreover, previous studies on this topic didnot apply current limitations, which can degrade the CAFM tips and generate false data. This article systematically analyzes the effect of RH in CAFM by applying ramped voltage stresses at over 17,000 locations on ten different samples (insulating, semiconducting, and conducting) under seven different RH. An ultra-reliable setup with a 110-pA current limitation during electrical stresses is employed, andexcellent CAFM tip integrity after thousands of tests is demonstrated. It is found that higher RH results in increased currents due to the presence of a conductivewater meniscus at the tip/sample junction, which increases the effective area forelectron flow. This trend is observed in insulators and ultra-thin semiconductors; however, in thicker semiconductors the electron mean free path is high enough to mask this effect. Metallic samples show no dependence on RH. This study clarifies the effect of relative humidity in CAFM, enhances understanding of the technique, and teaches researchers how to improve the reliability of their studies in this field.

Involving lead users in firm’s standardization strategy within action groups: evidence from smart robotics

PurposeThis research explores how firms manage the complex technologies standardization in action groups. It considers the strategic issues that technology producers face when involving lead users in architecture design. Drawing on the multi-mode standardization literature, this study addresses two dilemmas regarding value creation and appropriation by technology producers within coalitions. The first dilemma is how to create value by developing solutions in compliance with industry standards. The second one is how to appropriate value while ensuring the technology sharing with action groups. The answers to these two dilemmas contribute to filling the research gap on value creation and appropriation in multi-mode standardization.Design/methodology/approachThe research focuses on technology producers participating in action groups where lead users play a crucial role. We conducted a qualitative analysis based on the standardization experience of a Japanese company specializing in smart robotics. Data are collected through semi-structured interviews with key actors. Action groups are defined operationally as a set of stakeholders including competitors of the technology producers, component suppliers, end users, services providers, research centers and academia. The case study is suitable for highlighting specific aspects of the standardization process during its manifestation. It reveals how firms create and appropriate value, providing details about its standardization strategy.FindingsOur findings show that smart robotics standardization is drivn by collaborative models, where the two dilemmas of value creation and appropriation are evident. Firstly, the case revealed that standardization is lead users oriented. Secondly, lead users’ involvement is crucial to customize technologies. Thirdly, the firm’s position is to share a part of the value with the members. The IPR policy is a matter of interest within action groups, since the collaboration is based on open innovation models to share patents and licenses related knowledge.Research limitations/implicationsThis research has some limitations attributable to the limited generalizability of the results due to the qualitative analysis. In addition, this study considers the perspective of technology producers, but should also take into account the perspective of both collective actions itself and the lead users. Findings have some implications in the strategy negotiation. Participating in action groups is not enough to ensure a competitive advantage. Involving lead users is of strategic importance to acquire a competitive advantage. Lead users contribute to the producers’ technology design, helping firms to differentiate solutions from the industry standard and create value from customized technologies.Practical implicationsThis study helps practitioners understand the competitive side of collective actions, clarifying the value capture and appropriability in standardization. The research provides insights to policymakers and standard development organizations committees when they are called to harmonize standards considering the fallouts on the sector’s competitiveness. Findings suggest appropriate property rights policies to manage the issues related to the value appropriability and technology sharing, recognizing action groups members for their contribution in value creation.Originality/valueThis study shows how firms deal within action groups with the two dilemmas of variety versus technology conformity and property rights versus technology sharing. It fills the research gap in collective actions, emphasizing the perspective of the individual firm in the group rather than the coalition strategy itself. This topic highlights the crucial role of lead users within action groups in managing the two dilemmas, offering a new perspective for understanding critical issues of multi-mode standardization. Reflecting on mechanisms and tools to manage the two dilemmas allows firms to protect their competitive advantage in coalitions.

Sex and gender reporting in UK emergency medicine trials from 2010 to 2023: a systematic review

BackgroundFemale participants are underrepresented in randomised control trials conducted in urgent care settings. Although sex and gender are frequently reported within demographic data, it is less common for primary outcomes...

The consequences of micro-discretions and boundaries in the social prescribing link worker role in England: a realist evaluation.

Social prescribing addresses non-medical factors affecting health and well-being. Link workers are key to its delivery by connecting people to relevant support, often in the voluntary, community and social enterprise sector. Funding from the National Health Service means that link workers are becoming a common part of primary care in England. To explore and understand the implementation of link workers in primary care in England. A realist evaluation addressed the question - When implementing link workers in primary care to sustain outcomes - what works, for whom, why and in what circumstances? Link workers and staff associated with seven primary care sites across England. Researchers spent 3 weeks with each link worker, going to meetings with them, watching them interact with patients, with healthcare staff and with voluntary, community and social enterprise organisations. In addition, interviews were conducted with 61 patients and 93 professionals (voluntary, community and social enterprise representatives and healthcare staff, including link workers). Follow-up interviews were conducted with 41 patients and with link workers 9-12 months later. Data were coded and developed into statements to identify how context around the link worker triggers mechanisms that lead to intended and unintended outcomes. We found that link workers exercise micro-discretions in their role - actions and advice-giving based on personal judgement of a situation, which may not always reflect explicit guidance or protocols. Our analysis highlighted that micro-discretions engender positive connections (with patients, healthcare staff, the voluntary, community and social enterprise sector) and promote buy-in to the link worker role in primary care. Micro-discretions supported delivery of person-centred care and enhanced job satisfaction. Data also highlighted that lack of boundaries could place link workers at risk of overstepping their remit. Our research focused on link workers attached to primary care; findings may not be applicable to those working in other settings. Data were collected around seven link worker cases, who were selected purposively for variation in terms of geographical spread and how/by whom link workers were employed. However, these link workers were predominately white females. Enabling link workers to exercise micro-discretions allows for responsiveness to individual patient needs but can result in uncertainty and to link workers feeling overstretched. Poor link worker retention may, in part, be associated with a lack of clarity around their role. Research to explore how this shapes intention to leave their job is being conducted by authors of this paper. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR130247.

Epidemiology of Wilson disease in Germany – real-world insights from a claims data study

BackgroundWilson disease (WD) is a rare disorder of copper metabolism, causing copper accumulation mainly in the liver and the brain. The prevalence of WD was previously estimated around 20 to 33.3 patients per million for the United States, Europe, and Asia, but data on the prevalence of WD in Germany are limited.ObjectivesTo describe patient characteristics and to assess prevalence of WD in Germany using a representative claims database.MethodsWD patients were identified in the WIG2 (Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung; Scientific Institute for Health Economics and Health Systems Research) benchmark database of 4.5 million insured Germans by combining ICD-10-coding with WD-specific lab tests and treatments. The study period ranged from 2013 to 2016 for assessing patient characteristics, and to 2018 for prevalence, respectively.ResultsSeventy unique patients were identified. Most patients (86%) were between 18 and 64 years of age and more often male (60%) than female. Two patients (3%) younger than 18 years were included, as well as 8 patients (11%) older than 64 years. Most common WD subtypes were hepatic (57%), psychiatric (49%), and neurologic (44%). Average prevalence was 20.3 patients per million (range: 17.8–24.4), with similar results for two-year prevalence. Generally, prevalence increased steadily over the study period. Observed mortality was low, with only one death during the study period.ConclusionsThis study adds valuable real-world data on the prevalence and patient characteristics of WD in Germany. Generally, our findings align with other reports and contribute to the global understanding of WD epidemiology. Still, regional and temporal trends remain to be investigated more thoroughly to further the understanding of the natural history and epidemiology of this rare disease.

Real-time estimation of immunological responses against emerging SARS-CoV-2 variants in the UK: a mathematical modelling study.

The emergence of SARS-CoV-2 variants and COVID-19 vaccination have resulted in complex exposure histories. Rapid assessment of the effects of these exposures on neutralising antibodies against SARS-CoV-2 infection is crucial for informing vaccine strategy and epidemic management. We aimed to investigate heterogeneity in individual-level and population-level antibody kinetics to emerging variants by previous SARS-CoV-2 exposure history, to examine implications for real-time estimation, and to examine the effects of vaccine-campaign timing. Our Bayesian hierarchical model of antibody kinetics estimated neutralising-antibody trajectories against a panel of SARS-CoV-2 variants quantified with a live virus microneutralisation assay and informed by individual-level COVID-19 vaccination and SARS-CoV-2 infection histories. Antibody titre trajectories were modelled with a piecewise linear function that depended on the key biological quantities of an initial titre value, time the peak titre is reached, set-point time, and corresponding rates of increase and decrease for gradients between two timing parameters. All process parameters were estimated at both the individual level and the population level. We analysed data from participants in the University College London Hospitals-Francis Crick Institute Legacy study cohort (NCT04750356) who underwent surveillance for SARS-CoV-2 either through asymptomatic mandatory occupational health screening once per week between April 1, 2020, and May 31, 2022, or symptom-based testing between April 1, 2020, and Feb 1, 2023. People included in the Legacy study were either Crick employees or health-care workers at three London hospitals, older than 18 years, and gave written informed consent. Legacy excluded people who were unable or unwilling to give informed consent and those not employed by a qualifying institution. We segmented data to include vaccination events occurring up to 150 days before the emergence of three variants of concern: delta, BA.2, and XBB 1.5. We split the data for each wave into two categories: real-time and retrospective. The real-time dataset contained neutralising-antibody titres collected up to the date of emergence in each wave; the retrospective dataset contained all samples until the next SARS-CoV-2 exposure of each individual, whether vaccination or infection. We included data from 335 participants in the delta wave analysis, 223 (67%) of whom were female and 112 (33%) of whom were male (median age 40 years, IQR 22-58); data from 385 participants in the BA.2 wave analysis, 271 (70%) of whom were female and 114 (30%) of whom were male (41 years, 22-60); and data from 248 participants in the XBB 1.5 wave analysis, 191 (77%) of whom were female, 56 (23%) of whom were male, and one (<1%) of whom preferred not to say (40 years, 21-59). Overall, we included 968 exposures (vaccinations) across 1895 serum samples in the model. For the delta wave, we estimated peak titre values as 490·0 IC50 (95% credible interval 224·3-1515·9) for people with no previous infection and as 702·4 IC50 (300·8-2322·7) for people with a previous infection before omicron; the delta wave did not include people with a previous omicron infection. For the BA.2 wave, we estimated peak titre values as 858·1 IC50 (689·8-1363·2) for people with no previous infection, 1020·7 IC50 (725·9-1722·6) for people with a previous infection before omicron, and 1422·0 IC50 (679·2-3027·3) for people with a previous omicron infection. For the XBB 1.5 wave, we estimated peak titre values as 703·2 IC50 (415·0-3197·8) for people with no previous infection, 1215·9 IC50 (511·6-7338·7) for people with a previous infection before omicron, and 1556·3 IC50 (757·2-7907·9) for people with a previous omicron infection. Our study shows the feasibility of real-time estimation of antibody kinetics before SARS-CoV-2 variant emergence. This estimation is valuable for understanding how specific combinations of SARS-CoV-2 exposures influence antibody kinetics and for examining how COVID-19 vaccination-campaign timing could affect population-level immunity to emerging variants. Wellcome Trust, National Institute for Health Research University College London Hospitals Biomedical Research Centre, UK Research and Innovation, UK Medical Research Council, Francis Crick Institute, and Genotype-to-Phenotype National Virology Consortium.

A regional One Health approach to the risk of invasion by Anopheles stephensi in Mauritius.

Anopheles stephensi is an invasive malaria vector in Africa that threatens to put an additional 126 million people at risk of malaria if it continues to spread. The island nation of Mauritius is highly connected to Asia and Africa and is at risk of introduction due to this connectivity. For early detection of An. stephensi, the Vector Biology and Control Division under the Ministry of Health in Mauritius, leveraged a well-established Aedes program, as An. stephensi is known to share Aedes habitats. These efforts triggered multisectoral coordination and cascading benefits of integrated vector and One Health approaches. Beginning June 2021, entomological surveys were conducted at points of entry (seaport, airport) and on ships transporting livestock in collaboration with the Civil Aviation Department, the Mauritian Port Authority and National Veterinary Services. A total of 18, 39, 723 mosquito larval surveys were respectively conducted in the airport, seaport, and other localities in Mauritius while two, 20, and 26 adult mosquito surveys were respectively conducted in the airport, seaport, and twenty-six animal assembly points. Alongside adult mosquito surveys, surveillance of vectors of veterinary importance (e.g.- Culicoides spp.) was also carried out in collaboration with National Parks and Conservation Service and land owners. A total of 8,428 adult mosquitoes were collected and 1,844 larval habitats were positive for mosquitoes. All collected mosquitoes were morphologically identified and 151 Anopheles and 339 Aedes mosquitoes were also molecularly characterized. Mosquito species detected were Aedes albopictus, Anopheles arabiensis, An. coustani, An. merus, Culex quinquefasciatus, Cx. thalassius and Lutzia tigripes. Anopheles stephensi was not detected. The One Health approach was shared with the French Agricultural Research Centre for International Development (CIRAD), strengthening collaboration between Mauritius and Réunion Island on vector surveillance at entry points and insecticide resistance monitoring. The Indian Ocean Commission (IOC) was also alerted to the risk of An. stephensi, leading to regional efforts supporting trainings and development of a response strategy to An. stephensi bringing together stakeholders from Comoros, Madagascar, Mauritius, Réunion Island and Seychelles. Mauritius is a model system showing how existing public health entomology capabilities can be used to enhance vector surveillance and control and create multisectoral networks to respond to any emerging public and veterinary health vector-borne disease threat.

Iinaaka Siinakupii Tsiniikii (Little video storyteller): co-designing digital literacy with Piikani First Nation

Tensions persist in co-designing appropriate forms of digital literacy with Indigenous peoples, particularly in contexts of settler colonialism. Given the historically extractive nature of many institutional research relations with Indigenous peoples, emphasis should be placed on community-led approaches to learn how people are adapting and adopting digital technologies. Through concepts like Niitooii (the same that is real; paralleling), Indigenous peoples offer guidance to ensure projects generate reciprocal benefits for both researchers and communities. In this context, our article documents a multi-year project to co-design a land-based camp blending Piikani (Scabby Robe People; an Indigenous People, prairie regions of Alberta, Canada and northern Montana, USA) First Nation culture with digital literacy pedagogies. Guided by Aapátohsipikáni (Northern Piikani, an Indigenous People, prairie region of Alberta, Canada) scholarship and research on Indigenous-settler relations and methodologies, we illustrate how our long-term, iterative project design generated good relations and moments of tension and transformation.

Safety of pelvic and abdominal radiation therapy for patients with inflammatory bowel disease: a dosimetric analysis of acute bowel toxicity

ObjectivesInflammatory bowel disease (IBD) has been considered a relative contraindication to radiation therapy (RT) due to the potential greater risk of RT-induced toxicities. This study aims to assess acute toxicity outcomes in patients with IBD treated with abdominal/pelvic RT. MethodsAfter institutional review board approval, patients with IBD who received RT to the abdomen/pelvis were identified from an institutional research repository and their electronic medical records were reviewed. The IBD cohort was matched 1:1 with controls according to all of the following: radiotherapy, gender, disease site, age, and year of RT. Acute toxicity was defined as toxicity occurring within 3 months of RT. Primary outcomes were assessed via univariable logistic regression models and predicted probability of acute toxicity and acute gastrointestinal (GI) toxicity were plotted for the most significant covariates. IBD and control control cohorts were compared on demographic and toxicity variables using chi-square/Fisher's exact tests and Kruskal-Wallis tests where appropriate. ResultsWe identified 62 patients with median age of 64 years (interquartile range [IQR] 54-70) who received RT from 2006-2022. Patients were treated with intensity-modulated RT (38; 61.3%), 3-dimensional conformal RT (12; 19.4%), and stereotactic body RT/brachytherapy (12; 19.4%). After RT, 28 (45.2%) and 23 (37.1%) patients experienced grade ≥2 acute (any) and acute GI toxicity, respectively. Higher overall RT dose and RT dose to small bowel were found to be signicantly associated with increased risk of grade ≥2 acute toxicities (OR=1.041 per unit Gy, 95% CI 1.005-1.084, p=0.034 and OR=1.046, 95% CI 1.018-1.082, p=0.003, respectively). Between IBD and control cohorts, there were no significant differences in grade ≥2 acute (any) and acute GI toxicities (p=0.710 and p=0.704, respectively). ConclusionIn patients with IBD treated with abdominal/pelvic RT for malignancy, RT was effective and well-tolerated. RT treatment planning should carefully consider the location(s) of IBD inflammation and dose to bowel structures, in particular, dose to small bowel.