bluuebunny/crossref_metadata_2025 huggingface dataset:
China's Responses After the Russian War of Aggression Against Ukraine vis-à-vis the European Union and Its Own Population
Authors: Gündoğan Ilker
Published: November 2023

This study examines the Chinese party-state's reactions to the Russian war of aggression against Ukraine, focusing on its response to the European Union (EU) and its own population during the first six months of the war's outbreak. Drawing on actor-centred institutionalism, it analyses institutional changes and political steering actions by Chinese party-state actors, a perspective that has rarely been applied to China's foreign policy. The “explaining-outcome process tracing” method was applied to reconstruct political processes and interactions between actors based on extensive document and secondary data analysis. Findings reveal that the EU and its partners warned Chinese leaders not to help the Russian government evade sanctions. In this modified institutional setting, the Chinese party-state has responded with “soft” discursive steering towards the EU and, in addition to this “soft” element, with targeted “hard” steering actions towards its own population. While the political steering towards the EU has failed, the steering towards its own population seems to have been partially successful.
Management of dyslipidaemia in individuals with severe mental illness: a population-based study in the Greater Copenhagen Area
Authors: Mohr Grimur Høgnason , Barcella Carlo Alberto , Grand Mia Klinten , Kriegbaum Margit , Siersma Volkert , Hahn Margaret K. , Agarwal Sri Mahavir , Bakkedal Catrine , Baandrup Lone , Knop Filip Krag , Andersen Christen Lykkegaard , Ebdrup Bjørn Hylsebeck
Published: November 2023

Background:

Severe mental illness (SMI) is associated with increased cardiovascular risk. Dyslipidaemia is a potentially modifiable risk factor, which may be inadequately managed in patients with SMI.

Objectives:

To assess management of dyslipidaemia in patients with SMI versus healthy controls (HCs) in 2005 and 2015.

Design and methods:

Using Danish registers, we identified adult patients with SMI in the Greater Copenhagen Area (schizophrenia spectrum disorders or bipolar disorder) with ⩾1 general practitioner contact in the year before 2005 and 2015, respectively, and HCs without SMI matched on age and gender (1:5). Outcomes were lipid-profile measurements, presence of dyslipidaemia and redemption of lipid-lowering pharmacotherapy. Differences in outcomes between patients with SMI and controls were measured with multivariable logistic regression.

Results:

We identified 7217 patients with SMI in 2005 and 9939 in 2015. After 10 years, patients went from having lower odds of lipid measurements to having higher odds of lipid measurements compared with HCs [odds ratio (OR)2005 0.70 (99% confidence interval (CI) 0.63–0.78) versus OR2015 1.34 (99% CI 1.24–1.44); p2005 versus2015 < 0.01]. Patients had higher odds of dyslipidaemia during both years [OR2005 1.43 (99% CI 1.10–1.85) and OR2015 1.23 (99% CI 1.08–1.41)]. Patients went from having lower odds of receiving lipid-lowering pharmacotherapy to having higher odds of receiving lipid-lowering pharmacotherapy [OR2005 0.77 (99% CI 0.66–0.89) versus OR2015 1.37 (99% CI 1.24–1.51); p2005 versus2015 < 0.01]. However, among persons at high cardiovascular risk, patients had lower odds of receiving lipid-lowering pharmacotherapy during both years, including subsets with previous acute coronary syndrome [OR2005 0.30 (99% CI 0.15–0.59) and OR2015 0.44 (99% CI 0.24–0.83)] and ischaemic stroke or transient ischaemic attack (TIA) [OR2005 0.43 (99% CI 0.26–0.69) and OR 2015 0.61 (99% CI 0.41–0.89)].

Conclusion:

These results imply an increased general awareness of managing dyslipidaemia among patients with SMI in the primary prophylaxis of cardiovascular disease. However, secondary prevention with lipid-lowering drugs in patients with SMI at high cardiovascular risk may be lacking.
Global evaluation of the antibacterial activity of Ceftolozane/Tazobactam against ESBLs-producing Escherichia coli and Klebsiella pneumoniae: a systematic review and meta-analysis
Authors: Rahim Khorasani Marzieh , Rostami Soodabeh , Bakhshi Arash , Sheikhi Raheleh
Published: November 2023

Background:

Ceftolozane/Tazobactam is a β-lactam/β-lactamase inhibitor combination with a high range of efficacy and broad-spectrum action against multidrug-resistant bacterial strains.

Objectives:

The present study aimed to analyze the in vitro activity of Ceftolozane/Tazobactam against extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli (ESBLs-EC) and Klebsiella pneumonia (ESBLs-KP) in the published literature to provide international data on the antimicrobial stewardship programs.

Design:

Systematic review and meta-analysis.

Methods:

A systematic literature search was conducted on the Web of Science, Embase, PubMed, Scopus, and Google Scholar electronic databases from the beginning of databases to December 2022 to cover all published articles relevant to our scope.

Results:

At last, 31 publications that met our inclusion criteria were selected for data extraction and analysis by Comprehensive Meta-Analysis Software. The pooled prevalence of Ceftolozane/Tazobactam susceptibility for ESBLs-EC and ESBLs-KP was estimated at 91.3% [95% confidence interval (CI): 90.1–92.5%] and 65.6% (95% CI: 60.8–70.2%), respectively. There was significant heterogeneity among the 31 studies for ESBLs-EC (χ2 = 91.621; p < 0.001; I2 = 67.256%) and ESBLs-KP (χ2 = 348.72; p < 0.001; I2 = 91.4%). Most clinical isolates of ESBLs-EC had MIC50 and MIC90 at a concentration of 0.5 and 2 µg/mL [minimum inhibitory concentration (MIC) at which 50% and 90% of isolates were inhibited], respectively. In contrast, most clinical isolates of ESBLs-KP had MIC50 and MIC90 at a concentration of 1 and 32 µg/mL, respectively.

Conclusion:

Based on the meta-analysis results, Ceftolozane/Tazobactam has a more promising in vitro antibacterial activity against ESBLs-EC isolates from different clinical sources than ESBLs-KP isolates. Therefore, Ceftolozane/Tazobactam can be a useful therapeutic drug as an alternative to carbapenems. Randomized clinical trials are needed to provide clinical evidence to support these observations.
A case of radiotherapy-induced bullous pemphigoid with unusually delayed onset: A case report
Authors: El Barch Maha , Davar Sandra , Bélisle Annie
Published: November 2023

Bullous pemphigoid is an auto-immune blistering disease that generally affects older patients. Radiotherapy is one of the many triggering factors that have been described. Time to disease onset is variable; cases have been described during the course of radiotherapy while others have occurred up to 9 years later. We report a case of localized bullous pemphigoid on an irradiated site with unusual late presentation, 25 years after radiotherapy for left breast cancer. The pathophysiology of radiation-induced bullous pemphigoid is not clear, but the concept of an immunocompromised district seems to be a plausible explanation for the delayed onset of the disease.
Successful treatment of erosive lichen planus with Upadacitinib complicated by oral squamous cell carcinoma
Authors: Landells Fiona M , Goudie Shaina , McGrath Jerry , Tibbo Jamie , Landells Ian DR
Published: November 2023

Erosive lichen planus is a chronic auto-inflammatory disease which affects the stratified squamous epithelia resulting in painful ulcerations of both the skin and mucosal surfaces, and has a known malignant potential. Management of erosive lichen planus has proven to be difficult; however, recent reports of treatment with Janus kinase inhibitors such as Upadacitinib, are encouraging. This report outlines the third reported case of erosive lichen planus to be successfully treated with Upadacitinib in a 70-year-old woman with treatment-resistant disease. In addition, we report the complication of oral squamous cell carcinoma which became apparent once the extensive erosive lichen planus had healed. This case report highlights the importance of monitoring for mucosal squamous cell carcinoma in areas affected by erosive lichen planus, as squamous cell carcinoma can mimic the erosions of erosive lichen planus.
Mental health challenges and digital platform opportunities in patients and families affected by pediatric neuromuscular diseases - experiences from Switzerland
Authors: Gruebner Oliver , van Haasteren Afua , Hug Anna , Elayan Suzanne , Sykora Martin , Albanese Emiliano , Stettner Georg M. , Waldboth Veronika , Messmer-Khosla Sandra , Enzmann Cornelia , Baumann Dominique , von Wyl Viktor , Fadda Marta , Wolf Markus , von Rhein Michael
Published: November 2023

Receiving the diagnosis of a severe disease may present a traumatic event for patients and their families. To cope with the related challenges, digital interventions can be combined with traditional psychological support to help meet respective needs. We aimed to 1) discuss the most common consequences and challenges for resilience in Neuro Muscular Disease patients and family members and 2) elicit practical needs, concerns, and opportunities for digital platform use. We draw from findings of a transdisciplinary workshop and conference with participants ranging from the fields of clinical practice to patient representatives. Reported consequences of the severe diseases were related to psychosocial challenges, living in the nexus between physical development and disease progression, social exclusion, care-related challenges, structural and financial challenges, and non-inclusive urban design. Practical needs and concerns regarding digital platform use included social and professional support through these platforms, credibility and trust in online information, and concerns about privacy and informed consent. Furthermore, the need for safe, reliable, and expert-guided information on digital platforms and psychosocial and relationship-based digital interventions was expressed. There is a need to focus on a family-centered approach in digital health and social care and a further need in researching the suitability of digital platforms to promote resilience in the affected population. Our results can also inform city councils regarding investments in inclusive urban design allowing for disability affected groups to enjoy a better quality of life.
Magnetic resonance imaging based neurosurgical planning on hololens 2: A feasibility study in a paediatric hospital
Authors: Antonelli Martina , Lucignani Martina , Parrillo Chiara , Grassi Francesco , Figà Talamanca Lorenzo , Rossi Espagnet Maria C , Gandolfo Carlo , Secinaro Aurelio , Pasquini Luca , De Benedictis Alessandro , Placidi Elisa , De Palma Luca , Marras Carlo E , Marasi Alessandra , Napolitano Antonio
Published: November 2023

Objective

The goal of this work is to show how to implement a mixed reality application (app) for neurosurgery planning based on neuroimaging data, highlighting the strengths and weaknesses of its design.

Methods

Our workflow explains how to handle neuroimaging data, including how to load morphological, functional and diffusion tensor imaging data into a mixed reality environment, thus creating a first guide of this kind. Brain magnetic resonance imaging data from a paediatric patient were acquired using a 3 T Siemens Magnetom Skyra scanner. Initially, this raw data underwent specific software pre-processing and were subsequently transformed to ensure seamless integration with the mixed reality app. After that, we created three-dimensional models of brain structures and the mixed reality environment using Unity™ engine together with Microsoft® HoloLens 2™ device. To get an evaluation of the app we submitted a questionnaire to four neurosurgeons. To collect data concerning the performance of a user session we used Unity Performance Profiler.

Results

The use of the interactive features, such as rotating, scaling and moving models and browsing through menus, provided by the app had high scores in the questionnaire, and their use can still be improved as suggested by the performance data collected. The questionnaire's average scores were high, so the overall experiences of using our mixed reality app were positive.

Conclusion

We have successfully created a valuable and easy-to-use neuroimaging data mixed reality app, laying the foundation for more future clinical uses, as more models and data derived from various biomedical images can be imported.
A Rare Entity: Double Outlet of Both Ventricles
Authors: Zainuddin Zaynah , Raju Vijayakumar , Vijayaraghavan Aparna , Krishna Mani Ram
Published: November 2023

Double outlet of both ventricles is an anomaly wherein both ventricles equally share the arterial trunks. A majority of the literature describes a variant of this disease with a muscular outlet septum which is perpendicular to the plane of the ventricular septum although a variant with a fibrous muscular septum can also be present. The condition may be associated with obstruction of either outflow tract, which may complicate repair. We report a child with double outlet of both ventricles and a fibrous outlet septum with unobstructed outflows. The child underwent a successful surgical repair using a two-patch technique.
The Relationship Between Cooperative Learning, Cultural Intelligence, EFL Motivation and Students’ Performance: A Structural Equation Modeling Approach
Authors: Bećirović Senad
Published: November 2023

Cooperative learning, cultural intelligence and learning English as a foreign language (EFL) represent important concepts in contemporary education, particularly in a diverse environment where students need to collaborate with individuals from different cultural backgrounds. This study aimed to investigate the interrelationships among cooperative learning, cultural intelligence, EFL motivation, achievement, and grade point average (GPA). The previously developed and validated questionnaires were used for data collection, while convenience sampling was applied to select 211 participants studying at a high school level. A Confirmatory Factor Analysis was performed to determine the reliability and a Structural Equation Modeling approach was employed to test the measurement and the hypothesized model. The results showed that cooperative learning positively predicted students’ cultural intelligence and EFL motivation, which was a significant predictor of EFL achievement. Furthermore, cooperative learning negatively predicted EFL achievement, and insignificantly predicted GPA, while cultural intelligence insignificantly predicted both GPA and EFL achievement. These results may contribute to a broader understanding of the relationship between the investigated constructs, and may help instructors design effective classes that will imbed key components of cooperative learning and increase students’ motivation, cultural intelligence, and learning success.
Well-Being of Israeli Nurse Practitioners During Times of Crisis: A Cross-Sectional Study
Authors: Zalcman Beth G. , Pinchas-Mizrachi Ronit , Romem Ayal , Romem Anat
Published: November 2023

Introduction

For healthcare workers, good work-related well-being positively affects enthusiasm, efficiency, and job satisfaction. Conversely, poor well-being is associated with burnout and negative patient outcomes. During times of crises, it is difficult to balance professional responsibilities with well-being.

Objective

This study aimed to evaluate the degree of well-being among nurse practitioners in Israel who worked in COVID-19 units or allied units during the delta wave.

Methods

This was a web-based, cross-sectional study. Nurse practitioners who worked within the COVID-19 units in Israeli hospitals were asked to complete several questionnaires: a sociodemographic questionnaire, the Subjective Happiness Scale, the Mental Health Continuum-Short Form, and the Center for Epidemiologic Studies-Depression.

Results

Forty-nine nurse practitioners participated in the survey. Scores from the Subjective Happiness Scale and the Mental Health Continuum-Short Form indicate that most nurses have relatively positive mental health. Conversely, scores on the Center for Epidemiologic Studies indicated that participants are at risk for clinical depression. There was a positive moderate association between the number of years worked as a nurse practitioner and depression and a moderate negative association between the number of years worked as a nurse practitioner and happiness.

Conclusions

Understanding how nurses’ mental health is impacted during crises can provide healthcare systems with tools to prevent negative outcomes. This, in turn, may contribute to a lower burnout rate, higher satisfaction from work, and better patient outcomes.
The Impact of Grid Size and Statistical Uncertainty on the Accuracy of VMAT Plans Based on Dosimetric Parameters for Head and Neck Cancers
Authors: Javid Asma , Nagesh Jyothi , Singh Rajpal , Andavar S Senni , C Shambhavi , Sharan Krishna , Kour Preeti
Published: November 2023

Aim

Grid size and Statistical Uncertainty (SU) settings have an impact on the efficiency and accuracy of the treatment plans. Hence, it is very important, to find an optimum combination of the two-dose calculation parameters for efficient treatment planning. This study aims to study the impact of Grid Size and SU on Head and Neck cancer plans which were planned using the Volumetric-Modulated Arc Therapy (VMAT) technique.

Materials and Methods

15 patients were selected for this retrospective study who had undergone radiation therapy at KMC, Manipal for various Head and Neck cancers. VMAT plans were generated for each case in Monaco 5.11 Treatment Planning System (TPS) using the Monte Carlo algorithm. For each patient, nine plans were generated in which the Grid size values were taken as 2 mm, 3 mm, and 5 mm and for each Grid size, SU settings were varied as 1%, 2%, and 5%. The plans were analysed and evaluated using outcome measures such as the Homogeneity Index (HI) and the Conformity Index (CI).

Results

The plans were evaluated as per the ICRU guidelines. In all the plans, PTV coverage achieved was above 95% with the maximum coverage (97.009) achieved with the 3 mm/1% combination. Overall, the effect of varying Grid Size and SU was insignificant in the plans generated, but there were few variations in the dose calculation parameters. For 2 mm/1%, 2 mm/2%, 2 mm/5%, 3 mm/1%, 3 mm/2%, 3 mm/5%, 5 mm/1%, 5 mm/2%, 5 mm/5%, the mean values of HI were 1.073, 1.078,1.078, 1.075, 1.0805, 1.0805, 1.068, 1.079, 1.089, and the mean values of CI were 0.968, 0.967, 0.967, 0.968, 0.958, 0.96, 0.954, 0.946, 0.948, respectively. Among all the combinations, the results for 5 mm/1% yielded more homogeneity, whereas 2 mm/1% and 3 mm/1% combinations resulted in better conformity. The 3 mm/1% combination gave maximum target coverage and quite fewer Monitor Units (MU) as well.

Conclusion

3 mm Grid Size and 1% SU is suggested for the Head and Neck carcinomas planned using the VMAT technique.
Nutrition and Emotional Health Education: The Use of Emotional Intelligence and a Plant-Based Diet to Reduce Cardiometabolic Risk
Authors: Abu Dabrh Abd Moain , Haga Claire B. , Conrad Jarik , Perlman Adam I. , Allyse Megan A. , Albertie Monica L. , Martinez-Heath Maia , Ball Colleen T. , Willis Floyd B.
Published: November 2023

Background

For individuals living with chronic conditions like diabetes mellitus and obesity, there is a need for sustainable behavioral strategies and physiologic tools. These tools support identifying and addressing barriers to healthy eating, reducing body mass index (BMI), and building increased physical resilience in real time.

Objective

To evaluate whether a 12-week learning management system designed to combine nutritional intervention with education and coaching on improving emotional intelligence (EI) could alter cardiometabolic outcomes.

Methods

This pre-post prospective study enrolled 37 adult volunteers with BMI greater than 25 to participate in a 12-week learning management system. Primary (BMI, systolic blood pressure, diastolic blood pressure, low-density lipoprotein [LDL], high-density lipoprotein, and fasting glucose levels) and secondary self-reported outcomes were assessed at baseline, 12 weeks, and 6 months after enrollment using Short Form-36, Emotional Quotient Inventory (EQi), and Whole Health Index (WHI). Linear mixed-effects regression models with random effect were used to estimate changes in primary and secondary outcomes. We adjusted for multiple testing using Holm step-down method.

Results

BMI and LDL were the only primary endpoints lower at program completion and 6-month follow-up compared to baseline levels (−1.63 and −17.77 mg/dL, respectively; P < .001). Secondary outcomes showing statistically significant improvement from baseline to 6-month follow-up included energy/fatigue (Short Form-36), self-regard (EQi), decision-making (EQi), impulse control (EQi), stress management (EQi), Whole Brain – Form A (WHI), Whole Food – Form C (WHI), and Whole Body – Form D (WHI).

Conclusion

This study provides preliminary evidence that lifestyle programs combining nutritional interventions and EI can have a significant impact on BMI and LDL. Our study highlights the potential importance of both nutrition and EI in programs targeting diet and lifestyle modification.
A phylogeny of the evening primrose family (Onagraceae) using a target enrichment approach with 303 nuclear loci
Authors: Overson Rick P. , Johnson Matthew G. , Bechen Lindsey L. , Kinosian Sylvia P. , Douglas Norman A. , Fant Jeremie B. , Hoch Peter C. , Levin Rachel A. , Moore Michael J. , Raguso Robert A. , Wagner Warren L. , Skogen Krissa A. , Wickett Norman J.
Published: November 2023

Background

The evening primrose family (Onagraceae) includes 664 species (803 taxa) with a center of diversity in the Americas, especially western North America. Ongoing research in Onagraceae includes exploring striking variation in floral morphology, scent composition, and breeding system, as well as the role of these traits in driving diversity among plants and their interacting pollinators and herbivores. However, these efforts are limited by the lack of a comprehensive, well-resolved phylogeny. Previous phylogenetic studies based on a few loci strongly support the monophyly of the family and the sister relationship of the two largest tribes but fail to resolve several key relationships.

Results

We used a target enrichment approach to reconstruct the phylogeny of Onagraceae using 303 highly conserved, low-copy nuclear loci. We present a phylogeny for Onagraceae with 169 individuals representing 152 taxa sampled across the family, including extensive sampling within the largest tribe, Onagreae. Deep splits within the family are strongly supported, whereas relationships among closely related genera and species are characterized by extensive conflict among individual gene trees.

Conclusions

This phylogenetic resource will augment current research projects focused throughout the family in genomics, ecology, coevolutionary dynamics, biogeography, and the evolution of characters driving diversification in the family.
Mitogenome sequences of domestic cats demonstrate lineage expansions and dynamic mutation processes in a mitochondrial minisatellite
Authors: Patterson Emily C. , Lall Gurdeep Matharu , Neumann Rita , Ottolini Barbara , Batini Chiara , Sacchini Federico , Foster Aiden P. , Wetton Jon H. , Jobling Mark A.
Published: November 2023

Background

As a population genetic tool, mitochondrial DNA is commonly divided into the ~ 1-kb control region (CR), in which single nucleotide variant (SNV) diversity is relatively high, and the coding region, in which selective constraint is greater and diversity lower, but which provides an informative phylogeny. In some species, the CR contains variable tandemly repeated sequences that are understudied due to heteroplasmy. Domestic cats (Felis catus) have a recent origin and therefore traditional CR-based analysis of populations yields only a small number of haplotypes.

Results

To increase resolution we used Nanopore sequencing to analyse 119 cat mitogenomes via a long-amplicon approach. This greatly improves discrimination (from 15 to 87 distinct haplotypes in our dataset) and defines a phylogeny showing similar starlike topologies within all major clades (haplogroups), likely reflecting post-domestication expansion. We sequenced RS2, a CR tandem array of 80-bp repeat units, placing RS2 array structures within the phylogeny and increasing overall haplotype diversity. Repeat number varies between 3 and 12 (median: 4) with over 30 different repeat unit types differing largely by SNVs. Five SNVs show evidence of independent recurrence within the phylogeny, and seven are involved in at least 11 instances of rapid spread along repeat arrays within haplogroups.

Conclusions

In defining mitogenome variation our study provides key information for the forensic genetic analysis of cat hair evidence, and for the first time a phylogenetically informed picture of tandem repeat variation that reveals remarkably dynamic mutation processes at work in the mitochondrion.
Association of cigarette smoking with oral bacterial microbiota and cardiometabolic health in Chinese adults
Authors: Huang Qiumin , Wu Xuemei , Zhou Xiaofeng , Sun Zhonghan , Shen Jie , Kong Mengmeng , Chen Nannan , Qiu Jian-Ge , Jiang Bing-Hua , Yuan Changzheng , Zheng Yan
Published: November 2023

The interplay among cigarette smoking status, oral microbiota, and cardiometabolic health is poorly understood. We aimed to examine the association of cigarette smoking status with oral microbiota and to assess the association of the identified microbial features with cardiometabolic risk factors in a Chinese population. This study included 587 participants within the Central China Cohort, including 111 smokers and 476 non-smokers, and their oral microbiota was profiled by 16S rRNA sequencing. Both oral microbial alpha- and beta-diversity were distinct between smokers and non-smokers (p < 0.05). With adjustment for sociodemographics, alcohol and tea drinking, tooth brushing frequency, and body mass index, the relative abundance of nine genera and 26 pathways, including the genus Megasphaera and two pathways involved in inositol degradation which have potentially adverse effects on cardiometabolic health, was significantly different between two groups (FDR q < 0.20). Multiple microbial features related to cigarette smoking were found to partly mediate the associations of cigarette smoking with serum triglycerides and C-reactive protein levels (p-mediation < 0.05). In conclusion, cigarette smoking status may have impacts on the oral microbial features, which may partially mediate the associations of cigarette smoking and cardiometabolic health.
Wastewater from healthcare centers in Burkina Faso is a source of ESBL, AmpC-β-lactamase and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae
Authors: Garba Zakaria , Bonkoungou Isidore O. J. , Millogo Nadège O. , Natama H. Magloire , Vokouma Pingdwendé A. P. , Bonko Massa dit A. , Karama Ibrahima , Tiendrebeogo Lagmêyesgo A. W. , Haukka Kaisa , Tinto Halidou , Sangaré Lassana , Barro Nicolas
Published: November 2023

Background

Extended-spectrum β-lactamase (ESBL), plasmid-mediated AmpC-β-lactamase and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae have spread into the environment worldwide posing a potential public health threat. However, the prevalence data for low- and middle-income countries are still scarce. The aim of this study was to evaluate the presence of ESBL, AmpC-β-lactamase and carbapenemase-producing and multidrug-resistant E. coli and K. pneumoniae in wastewaters from healthcare centers in Burkina Faso.

Results

Eighty-four (84) wastewater samples were collected from five healthcare centers and plated on selective ESBL ChromAgar. E. coli and Klebsiella pneumoniae isolates were identified using API20E. ESBL-producing bacteria were detected in 97.6% of the samples and their average concentration per hospital ranged from 1.10 × 105 to 5.23 × 106 CFU/mL. Out of 170 putative ESBL-producing isolates (64% of them were E. coli) and 51 putative AmpC-β-lactamase-producing isolates, 95% and 45% were confirmed, respectively. Carbapenemase production was detected in 10 isolates, of which 6 were NDM producers, 3 were OXA-48 producers and 1 was NDM and OXA-48 producer. All isolates were multidrug resistant and, moreover, all of them were resistant to all tested β-lactams. Resistance to ESBL inhibitors was also common, up to 66% in E. coli and 62% in K. pneumoniae. Amikacin, fosfomycin and nitrofurantoin were the antibiotics to which the least resistance was detected.

Conclusions

This study showed that wastewater from healthcare centers constitutes a reservoir of multidrug-resistant bacteria in Burkina Faso, including carbapenemase producers. Untreated healthcare wastewater entering the environment exposes people and animals to infections caused by these multi-resistant bacteria, which are difficult to treat, especially in the resource-poor settings.
The effect of spermine on Tetranychus urticae-Cucumis sativus interaction
Authors: Shahtousi Shima , Talaee Ladan
Published: November 2023

Background

Two spotted spider mite, Tetranychus urticae (Acari: Tetranychidae) is one of the most important plant pests in the world. Due to increased resistance of mites to acaricides, it is necessary to use other methods such as inducing resistance in plants by natural compounds for pests' management. Polyamins such as spermine are effective in increasing plant resistance to biotic and abiotic stressors. In this research, the effect of spermine treatments in cucumber plants on life table parameters of T. urticae was investigated. Also, top-down effect of spermine and T. urticae on cucumber biochemical parameters was measured. In the experiments, 1, 2 and 3 mM spermine concentrations were used.

Results

Amongst the spermine treatments, those mites that fed on cucumbers which received 1 mM spermine showed the shortest protonymphal period and higher ovipositon period, fecundity, gross and net reproductive rates and life expectancy compare to control. Treatment with 2 mM spermine lead to the longest teleochrysalis period and shortest range of age-stage-specific fecundity period. In addition, 2 mM spermine lowered intrinsic and finite rate of population increase in T. urticae. The longest larval period of T. urticae was observed in 3 mM spermine. Feeding of T. urticae from cucumber plants increased hydrogen peroxide (H2O2), malondialdehyde (MDA) content, electrolyte leakage (EL) level and ascorbate peroxidase (APX) activity but inhibited catalase (CAT) activity in this plant. Infested cucumber plants treated with 2 mM spermine showed lower H2O2 and MDA content and highest activity of APX and CAT on day 1 and 3 compare to the others. The 3 mM spermine increased H2O2 content in infested plants during the whole experiment as well as non-infested plants in day 5 and 9 only. This treatment induced the highest MDA content and lowest catalase activity on day1, 3 and 5 of experiment in infested plants.

Conclusion

This study showed that 2 mM spermine was the only effective concentration that reduce cucumber sensitivity to T. urticae. The trend of changes in biochemical parameters, especially H2O2, in 3 mM spermine was abnormal, and this concentration could be considered toxic.
Role of colectomy in the management of appendiceal tumors: a retrospective cohort study
Authors: Marks Victoria A. , Kerekes Daniel , Butensky Samuel , Ahuja Nita , Johnson Caroline , Turaga Kiran , Khan Sajid A.
Published: November 2023

Background

Appendiceal tumors represent a range of histologies that vary in behavior. Recommendations for treatment with appendectomy versus right hemicolectomy (RHC) for different tumor types are evolving and sometimes conflicting. This study sought to characterize variation in the United States around surgical treatment of major appendiceal tumor types over time and describe differences in outcomes based on procedure.

Methods

Patients diagnosed with appendiceal goblet cell adenocarcinoma (GCA), mucinous adenocarcinoma, neuroendocrine neoplasm (NEN), or non-mucinous adenocarcinoma from 2004–2017 were identified in the National Cancer Database. Trends in RHC over time and predictors of RHC were identified. Surgical outcomes for each histologic type and stage were compared.

Results

Of 18,216 patients, 11% had GCAs, 34% mucinous adenocarcinoma, 31% NENs, and 24% non-mucinous adenocarcinoma. Rate of RHC for NEN decreased from 68% in 2004 to 40% in 2017 (p = 0.008) but remained constant around 60–75% for other tumor types. Higher stage was associated with increased odds of RHC for all tumor types. RHC was associated with higher rate of unplanned readmission (5% vs. 3%, p < 0.001) and longer postoperative hospital stay (median 5 days vs. 3 days, p < 0.001). On risk-adjusted analysis, RHC was significantly associated with increased survival versus appendectomy for stage 2 disease of all tumor types (HRs 0.43 to 0.63) and for stage 1 non-mucinous adenocarcinoma (HR = 0.56).

Conclusions

Most patients with appendiceal tumors undergo RHC, which is associated with increased readmission, longer length of stay, and improved survival for stage 2 disease of all types. RHC should be offered selectively for appendiceal tumors.
High neutrophil-lymphocyte ratio indicates a worse response to ursodeoxycholic acid in primary biliary cholangitis: a retrospective cohort study
Authors: Zhu Huiling , Zheng Mengyao , He Haiyu , Lei Hongtao , Tai Wenlin , Yang Jinhui
Published: November 2023

Background

Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease characterized by inflammation of the interlobular bile ducts. Ursodeoxycholic acid (UDCA) is the only FDA approved first-line therapy for PBC, but up to 40% of patients with PBC have an incomplete response to UDCA. Neutrophil-to-lymphocyte (NLR) has been used to predict prognosis in various liver diseases. There is limited evidence on the treatment response to UDCA in PBC patients. Our study aimed to evaluate the relationship between NRL and the response to UDCA treatment in PBC patients.

Methods

A total of 257 primary biliary cholangitis (PBC) patients treated with UDCA (13–15 mg/kg/d) were enrolled in this retrospective study. The response to treatment was evaluated based on alkaline phosphatase levels ≤1.67 times the upper limit of the normal value after 12 months of UDCA treatment. Multivariable logistic regression analysis was performed to investigate the association between NLR at baseline and the response to 12 months of UDCA treatment after adjusting for important confounding variables. The stability of the results was evaluated by unadjusted and adjusted models.

Results

The results of multiple regression analysis showed that NLR at baseline was positively associated with the nonresponse to UDCA treatment after adjustments for potential confounders (age, sex, BMI, hypertension, arterial plaque, thyroid disease, jaundice, albumin, globulin, total bile acid, ALP, GGT, LDLC, total cholesterol, hemoglobin, and APTT) (OR = 1.370, 95% CI 1.066–1.761). These results reveal that NLR is an independent risk factor for UDCA treatment nonresponse.

Conclusions

Our results suggest that PBC patients with a high NLR had a worse response to UDCA therapy.
Comparison of clinical outcomes between culture-negative and positive peritonitis in patients undergoing maintenance peritoneal dialysis: a prospective cohort study
Authors: Chienwichai Kittiphan , Sangaew Sorawat , Chuachanpipat Laksamee , Chang Arunchai
Published: November 2023

Background

Culture-negative peritonitis is a serious complication in patients undergoing maintenance peritoneal dialysis (PD) and occurs in up to 40% of all peritonitis episodes. Despite its high incidence, data regarding treatment response and prognosis remain poorly defined. This study compared the clinical outcomes of patients with culture-negative and positive peritonitis.

Method

This prospective cohort study was conducted between 2021 and 2022. Patients treated with maintenance PD who developed PD-associated peritonitis were included and received standard treatment. The primary endpoint was the primary response (resolution of peritonitis 10 days after the initiation of treatment).

Results

Of the 81 patients who developed PD-associated peritonitis during the study, 35 and 46 had culture-negative and culture-positive peritonitis, respectively. Overall, 52 (64.2%) patients achieved the primary response: 24 (68.6%) in the culture-negative group and 28 (60.9%) in the culture-positive group (p = 0.630). There were no significant differences between the two groups in the incidence of complete cure (complete resolution of peritonitis without the need for Tenckhoff catheter removal or salvage antibiotic therapy or peritonitis within 120 days after treatment) (culture-negative vs. culture-positive group, 57.1% vs. 45.7%), refractory peritonitis (28.6% vs. 41.3%), relapse peritonitis (8.6% vs. 2.2%), repeat peritonitis (11.4% vs. 10.9%), salvage antibiotics (40.0% vs. 50.0%), permanent hemodialysis transfer (11.4% vs. 10.9%), Tenckhoff catheter removal (25.7% vs. 41.3%), or mortality (2.9% vs. 2.2%) (all p > 0.05).

Conclusion

This study offers valuable insights into the clinical outcomes of culture-negative peritonitis versus culture-positive peritonitis. However, caution must be exercised in interpreting these findings due to the limitations of the small sample size.

Clinical trial registration

The study was retrospectively registered in the Thai Clinical Trials Registry (TCTR20221130006).
Incidence and risk factors of acute kidney injury in patients with malignant tumors: a systematic review and meta-analysis
Authors: Can Wang , Rong Li , Lixia Liu
Published: November 2023

Background

There are significant differences in the incidence and risk factors of tumor patients, and there is no relevant statistical data. Therefore, this study aims to clarify the incidence and risk factors of acute kidney injury (AKI) in malignant tumor patients and compare critically ill patients with non-critically ill patients.

Methods

Relevant literature on the occurrence of AKI in malignant tumors was retrieved from databases. Two authors independently screened and evaluated the eligibility and quality of the literature and extracted the data. The Stata 12.0 software was used for meta-analysis.

Results

A total of 3922 articles were initially retrieved, and 24 articles were finally included, 8 of which were about critically ill malignant tumor patients, and 16 were about malignant tumor patients. Among the 4107 patients included in the 8 studies on critically ill malignant tumors, 1932 developed AKI, with an incidence rate of 52% (95%CI 34–70%, I2 = 99%). The risk factors for AKI in critically ill malignant tumor patients were sepsis and hypovolemia, which were different from those in non-critically ill patients. Among the 292,874 patients included in the 16 studies on malignant tumors, 51,211 developed AKI, and the combined incidence rate was 24% (95%CI 17–30%, I2 = 100%). The risk factors for AKI in critical malignant tumor patients were sepsis and hypovolemia.

Conclusion

This meta-analysis shows that the incidence of AKI in critically ill malignant tumor patients is consistent with that in other critically ill patients, and independent risk factors are sepsis and hypovolemia. The incidence of AKI in malignant tumor patients is higher than that in other patients, and tumor is a risk factor for AKI. This study has been registered in INPLASY (INPLASY202320079),Registered February 18,2023.
Association of known SARS-CoV-2 serostatus and adherence to personal protection measures and the impact of personal protective measures on seropositivity in a population-based cross-sectional study (MuSPAD) in Germany
Authors: Kettlitz R. , Harries M. , Ortmann J. , Krause G. ,   MuSPAD Team, Strengert Monika , Castell Stefanie , Heise Jana-Kirstin , Hernandez Pilar , Gornyk Daniela , Schlüter Monike , Kerrines Tobias , Schneiderhan-Marra Nicole , Dulovic Alex , Bojara Gerhard , Frank Kerstin , Gubbe Knut , Tonn Torsten , Kappert Oliver , Kern Winfried V. , Illig Thomas , Klopp Norman , Roller Gottfried , Ziemons Michael , Rolle Gottfried , Aigner A. , Lange B.
Published: November 2023

Background

In 2020/2021 in Germany, several non-pharmacological interventions were introduced to lower the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We investigated to what extent knowledge of prior infection with SARS-CoV-2 or vaccination status influenced the use of personal protection measures (PPM). Further, we were interested in the effect of compliance with PPM on SARS-CoV-2 serostatus.

Methods

Data was based on a sequential, multilocal seroprevalence study (MuSPAD), carried out in eight locations from July 2020 to August 2021. We estimated the association between a known SARS-CoV-2 serostatus (reported positive PCR test or vaccination) and self-reported PPM behavior (hand hygiene, physical distancing, wearing face mask), just as the association of PPM compliance with seropositivity against nucleocapsid (NC), receptor-binding domain (RBD), and spike protein (S) antigens. We identified relevant variables and deduced adjustment sets with directed acyclic graphs (DAG), and applied mixed logistic regression.

Results

Out of the 22,297 participants (median age: 54 years, 43% male), 781 were classified as SARS-CoV-2-infected and 3,877 had a vaccinated immune response. Vaccinated individuals were less likely to keep 1.5 m distance [OR = 0.74 (95% CI: 0.57–0.97)] and only partly physically distanced [OR = 0.71 (95% CI: 0.58–0.87)]. Participants with self-reported positive PCR test had a lower chance of adhering partly to physical distancing [OR = 0.70 (95% CI: 0.50–0.99)] in comparison to the reference group. Higher odds of additionally wearing a face mask was observed in vaccinated [OR = 1.28 (95% CI: 1.08–1.51)] even if it was not obligatory. Overall, among unvaccinated participants, we found little evidence of lower odds of seropositivity given mask wearing [OR: 0.91 (95% CI: 0.71–1.16)], physical distancing [OR: 0.84 (95% CI: 0.59–1.20)] and no evidence for completely adhering to hand cleaning [OR: 0.97 (95% CI: 0.29–3.22)].

Conclusions

A known confirmed prior infection and vaccination may have the potential to influence adherence to PPM.
The relationship between family function and the incidence of overweight/obesity in children and adolescents in Chengdu city, Sichuan province of China: based on latent profile analysis
Authors: Jiang Xixi , Zhao Xiufang , Zhou Junxia , Zhang Xiujuan , Song Yan , Zhao Li
Published: November 2023

Background

Overweight/obesity in children and adolescents has become a global health problem, and family function may be associated with its occurrence. Studies exploring the association between family function and overweight/obesity in children and adolescents were performed in Western and Taiwan, China. To date, related studies haven’t been conducted in Mainland China.

Objectives

To investigate the current status of overweight, obesity, and family function among children and adolescents in Chengdu, China, and to explore their associations.

Methods

Children and adolescents in five primary and middle schools were chosen by cluster sampling. Body Mass Index was used to measure the status of overweight and obesity, and the Chinese family assessment instrument was adopted to assess family function. Latent profile analysis and stepwise logistic regression were applied to identify family classification and explore the relationships between family function and overweight/obesity.

Results

A total of 7616 (84.92%) children and adolescents out of 8968 completed the study with qualified-filled questionnaires. Nine hundred and sixty-six (12.68%)participants were overweight and 656 (8.61%) were obese. The family function was categorized into three profiles: mild (63.93%), moderate (12.32%), and severe (23.75%) dysfunction. The prevalence of overweight was 12.16%, 14.71%, and 13.05% for mild, moderate, and severe family dysfunction, respectively. And the prevalence of obesity was 8.19%, 10.77%, and 8.62% respectively. Participants in moderate and severe dysfunction families were more likely to be overweight (moderate: OR = 1.27, 95% CI:1.01 ~ 1.59, P = 0.04; severe: OR = 1.38, 95% CI:1.15 ~ 1.66, P = 0.001) and obese (moderate: OR = 1.35, 95% CI:1.02 ~ 1.79, P = 0.03; severe: OR = 1.55, 95% CI:1.23 ~ 1.96, P < 0.001). Sociodemographic data such as gender, residence, grade, pocket money per week, the number of siblings, and the education level of the mother were all associated with the risk of being overweight/obese in children and adolescents.

Conclusions

The problems of being overweight or obese exist among children and adolescents in Chengdu. And the risk of being overweight or obese increases along with the decrease in family function.
Twenty-four-month interim results from a prospective, single-arm clinical trial evaluating the performance and safety of cellular bone allograft in patients undergoing lumbar spinal fusion
Authors: Park Daniel K. , Wind Joshua J. , Lansford Todd , Nunley Pierce , Peppers Timothy A. , Russo Anthony , Hassanzadeh Hamid , Sembrano Jonathan , Yoo Jung , Sales Jonathan
Published: November 2023

Background

Autologous bone grafts are the gold standard for spinal fusion; however, harvesting autologous bone can result in donor site infection, hematomas, increased operative time, and prolonged pain. Cellular bone allografts (CBAs) are a viable alternative that avoids the need for bone harvesting and may increase fusion success alone or when used as an adjunct material. The present study examined the efficacy and safety of CBA when used as an adjunct graft material to lumbar arthrodesis.

Methods

A prospective, single-arm, multicenter clinical trial (NCT 02969616) was conducted in adult subjects (> 18 years of age) undergoing lumbar spinal fusion with CBA graft (CBA used as primary (≥ 50% by volume), with augmentation up to 50%). Radiographic fusion status was assessed by an independent review of dynamic radiographs and CT scans. Clinical outcomes were assessed with the Oswestry Disability Index (ODI), and Visual Analog Scales (VAS) score for back and leg pain. Adverse events were assessed through the 24-month follow-up period. The presented data represents an analysis of available subjects (n = 86) who completed 24 months of postoperative follow-up at the time the data was locked for analysis.

Results

Postoperative 24-month fusion success was achieved in 95.3% of subjects (n = 82/86) undergoing lumbar spinal surgery. Clinical outcomes showed statistically significant improvements in ODI (46.3% improvement), VAS-Back pain (75.5% improvement), and VAS-Leg pain (85.5% improvement) (p < 0.01) scores at Month 24. No subject characteristics or surgical factors were associated with pseudoarthrosis. A favorable safety profile with a limited number of adverse events was observed.

Conclusions

The use of CBA as an adjunct graft material showed high rates of successful lumbar arthrodesis and significant improvements in pain and disability scores. CBA provides an alternative to autograft with comparable fusion success rates and clinical benefits.

Trial registration

NCT 02969616.