bluuebunny/crossref_metadata_2025 huggingface dataset:
Influenza in Adults Seeking Care at Seven European Emergency Departments: A Prospective Active Surveillance During the 2019–2020 Influenza Season
Authors: Amour Sélilah , Rubio Alberto Perez , Orsi Andrea , Oppert Michael , Loebermann Micha , del Pozo Vegas Carlos , Tazarourte Karim , Douplat Marion , Jacquin Laurent , Icardi Giancarlo , Walker Jonas , Glass Andrea , Nealon Joshua , Chaves Sandra S. ,   FERS Study Group, Bricout Hélène , Vanhems Philippe
Published: November 2024

Background

Influenza can be associated with nonrespiratory disease presentation, but these are less well documented due to the lack of routine testing for influenza in the healthcare system, especially if patients do not present with influenza‐like illness (ILI). We aimed to measure the proportion of influenza cases seeking care at emergency department (ED) for a nontraumatic cause, to describe their clinical presentation and their ED‐discharge diagnosis.

Methods

The study was conducted at seven hospitals in France, Spain, Italy and Germany during the 2019–20 influenza season, for a period of 10 weeks. Patients (≥ 18 years) consulting for nontraumatic causes at the ED were invited to participate. Consenting patients provided upper respiratory swab samples for influenza testing by reverse transcription polymerase chain reaction. Clinical and demographic data were collected.

Results

There were 8678 patients included, 50.7% were female and the median age was 57 years. Among them, 494 (5.7%) were laboratory‐confirmed influenza (LCI) cases. Nonetheless, only 24.3% of LCI cases had an ED‐discharge of influenza. Of all cases confirmed as influenza, 47.6% had a nonrespiratory discharge diagnosis, which frequency increased with age. ILI case definition from the European Centre for Disease Prevention and Control was the most frequently met among influenza cases (68.6%). Older patients (≥ 65 years) were less frequently identified based on any ILI signs/symptoms.

Conclusion

Our findings indicate that the impact of influenza among patients seeking care at the ED cannot be easily assessed based on clinical presentation and medical records alone. Preventing influenza among adult population may reduce healthcare utilization.
Clinical nurses' attitudes towards medical device‐related pressure injuries and an analysis of relevant influencing factors: A cross‐sectional study in China
Authors: Lv Tan , Tang Anlin , Yang Yaping , Wang Jing
Published: November 2024

This study aimed to explore Chinese clinical nurses' attitudes towards medical device‐related pressure injuries (PIs) and analyse the relevant influencing factors. Between December 2023 and January 2024, a cross‐sectional survey of 1740 clinical nurses from three tertiary hospitals, three secondary hospitals and five community hospitals in Shanghai, China, was conducted via the Chinese version of the Attitude towards medical device‐related pressure ulcers/injuries questionnaire. A total of 1693 nurses participated in this study. Nurses' total score regarding their attitudes towards medical device‐related PIs was 36.60 ± 8.97, and multiple linear regression analysis revealed that clinical nurses' highest level of education (p < 0.001), professional title (p < 0.001), position (p = 0.001), years of work experience (p < 0.001) and participation in medical device‐related pressure injury (PI) training (p < 0.001) influenced their attitudes towards medical device‐related PIs. Nurses' attitudes towards medical device‐related PIs ranged between negative and positive. Therefore, it is essential to focus on the highest level of education, professional title, position and years of work experience. Increasing the frequency of medical device‐related pressure injury (PI) prevention training will improve nurses' attitudes towards medical device‐related PIs.
Non‐invasive techniques for wound assessment: A comprehensive review
Authors: Zhao Chunlin , Guo Yuchen , Li Lingli , Yang Mei
Published: November 2024

Efficient wound assessment is essential for healthcare teams to facilitate prompt diagnosis, optimize treatment plans, reduce workload, and enhance patients' quality of life. In recent years, non‐invasive techniques for aiding wound assessment, such as digital photography, 3D modelling, optical imaging, fluorescence and thermography, as well as artificial intelligence, have been gradually developed. This paper aims to review the various methods of measurement and diagnosis based on non‐invasive wound imaging, and to summarize their application in wound monitoring and assessment. The goal is to provide a foundation and reference for future research on wound assessment.
The needs of family members of people with severe or profound intellectual disabilities when collaborating with healthcare professionals: a systematic review
Authors: van Beurden K. , Vereijken F. R. , Frielink N. , Embregts P. J. C. M.
Published: November 2024

Background

Collaboration with healthcare professionals is crucial in arranging necessary lifelong support for people with intellectual disabilities. However, family members often face challenges when collaborating with healthcare professionals. Family members of people with severe and profound intellectual disabilities often encounter many professionals due to medical needs and the severity of their disability. Therefore, providing a comprehensive overview of existing literature on the needs and experiences of family members of relatives with severe or profound intellectual disabilities when collaborating with healthcare professionals is needed to provide insight into how to stimulate and support collaboration.

Method

The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement. Seven databases were systematically searched and a thematic analysis was conducted on 23 studies.

Results

Five overarching themes were identified: (1) need for a balanced view of their relative; (2) need for recognition and compassion; (3) healthcare professionals facilitating close and active involvement; (4) desired qualities of healthcare professionals and (5) conditions for successful interaction between family members and healthcare professionals.

Conclusions

The results indicated distinct needs that family members had for themselves and their relatives, as well as desired qualities (e.g. trustworthiness) and supporting factors (e.g. information). Furthermore, the review highlighted persisting needs, such as the need for information and empathy, as well as emerging needs, such as the desire to be recognised as experts and to develop personal bonds with healthcare professionals. These insights can inform future research by identifying areas that require deeper exploration.
Effects of Nurse‐Led e‐Health Interventions on the Health‐Related Outcomes of Pregnant Women: A Systematic Review
Authors: Han Yujie , Tian Qi , Xu Mengmeng , Zhao Wei , Wang Ziqi , Zhang Wei
Published: November 2024

Background

Pregnancy is a special time for women that involves substantial emotional, physical, social, and family changes, which can lead to physical and psychological harm. The rapid development of e‐health has provided a favourable platform for managing health‐related outcomes in pregnant women, and nurses are the professional group that is most likely to provide e‐health services. Nurse‐led e‐health interventions have attracted increasing attention, but their effects are uncertain.

Objective

To identify the effectiveness of nurse‐led e‐health interventions in improving health‐related outcomes in pregnant women.

Design

A systematic review.

Data Sources

The PubMed, PsycINFO, EMBASE, CINAHL, ProQuest, MEDLINE, Scopus, Web of Science and Cochrane Library databases were searched from inception to March 2023.

Methods

Two reviewers independently assessed study eligibility and extracted data. The Cochrane risk of bias tool was used for quality assessment. The findings of this review are presented using a narrative synthesis.

Results

This review included 14 studies involving 2016 participants. Three out of five studies reported that nurse‐led e‐health interventions significantly reduced depressive symptoms. Four studies reported significant improvements in stress and self‐efficacy after the intervention. Two studies reported significant improvements in anxiety symptoms, self‐management ability, and quality of life after the intervention. One study showed that weight gain and physical activity significantly improved after the intervention. Due to the heterogeneity in the included studies, no meta‐analysis was conducted.

Conclusions

Nurse‐led e‐health interventions may be beneficial for improving anxiety symptoms, depressive symptoms, stress, self‐efficacy, weight gain, self‐management ability, physical activity, and quality of life in pregnant women.

Relevance to Clinical Practice

Nurse‐led e‐health interventions could provide individualised, economic, interactive, and convenient nursing modes for pregnant women. Rigorous and high‐quality evidence confirming the long‐term effects of these interventions on pregnant women is necessary.

No Patient or Public Contribution

The patients had no direct involvement in the present study.

Registration Number

PROSPERO registration ID: CRD42023401973
Japan Society of Obstetrics and Gynecology revised diagnostic criteria for polycystic ovary syndrome: JSOG2024 criteria
Authors: Noguchi Hiroki , Iwase Akira , Iwasa Takeshi , Kanasaki Haruhiko , Kimura Fuminori , Kugu Koji , Saito Kazuki , Baba Tsuyoshi , Hara Tetsuaki , Minato Saki , Yanagihara Rie , Matsuzaki Toshiya ,   from the subcommittee “Validation of diagnostic criteria for polycystic ovary syndrome in Japan” in Reproductive Endocrine Committee, Japan Society of Obstetrics and Gynecology
Published: November 2024

Japanese patients with polycystic ovary syndrome (PCOS) exhibit distinct body type characteristics, such that the rate of overweight/obese women is remarkably low. In addition, hyperandrogenism is relatively rare among Japanese PCOS patients. Therefore, these factors are considered in PCOS diagnostic criteria used in Japan. Diagnostic criteria for PCOS were recently revised by the Japan Society of Obstetrics and Gynecology based on a nationwide survey of PCOS and released on December 5, 2023 (JSOG2024). JSOG2024 criteria diagnosed PCOS according to the following three items: (1) irregular menstrual cycle/chronic anovulation, (2) polycystic ovarian morphology or elevated serum anti‐Müllerian hormone (AMH) level, and (3) hyperandrogenism or high luteinizing hormone. The presence of all three items is required to diagnose PCOS, after excluding other diseases with symptoms similar to PCOS. We also established AMH cut‐off values by age and a system for evaluating ovarian findings useful for both the JSOG2024 and Rotterdam criteria. We anticipate that the JSOG2024 criteria with cut‐off values will enhance the treatment of Japanese patients with PCOS and those of other ethnicities with low obesity and hirsutism.
Stigma Management within and between Levels
Authors: Mitchell Rebecca , Maley Jane , Boyle Brendan , Gu Jun
Published: November 2024

We respond to recent calls to connect our understanding of stigma across and between levels of analysis by investigating how stigma management strategies to the same stigma vary and relate in nested industry, organizational, and individual actors. Drawing on data collected from 61 interviews with various workers in the coal industry in Australia, we find evidence of commonalities across individual, organizational, and industry stigma management strategies as well as substantial distinctions. Furthermore, we find evidence of cross‐level influence efforts that aim to increase the probability that specific tactics will be more likely adopted or effective. While individual, organizational, and industry actors can all be ‘labelled’ by the same stigmatization, the present study is, to our knowledge, the first that explores whether and how actors at different levels manage the same stigma.
A phylogenetic analysis of scale insects (Hemiptera, Coccoidea) based on genomic and transcriptomic data
Authors: Song Nan , Wang Miaomiao , Tang Huiji , Dang Zhihao
Published: November 2024

Coccoidea (Hemiptera, Sternorrhyncha) are widely distributed and agriculturally significant insects known for their distinctive morphology and biological traits. The Coccoidea are often called scales or mealybugs because many species have a shell‐like covering resembling a scale or are covered with mealy wax. Knowledge of scale insects beyond the female adult stage is limited, partly because other life stages are less conspicuous, shorter‐lived, and less impactful on host plants. This complicates accurate classification, further compounded by limited molecular phylogenetic studies. This study presents the first phylogenetic analyses combining genome and transcriptome sequence data. We sequenced five whole genomes and one transcriptome from Pseudococcidae and integrated these new genome‐scale data with existing genome and transcriptome sequences to perform phylogenomic analysis of scale insects. The analysis yielded robustly supported relationships within Coccoidea, resolving several high‐level relationships. The current genome‐scale data support the monophyly of Monophlebidae, Pseudococcidae, Kerriidae, and Diaspididae, while not supporting the monophyly of Coccidae and Eriococcidae. Bayesian inferences using site‐heterogeneous models corroborated Pseudococcidae as the sister group of all other neococcoid families. Within Pseudococcidae, two subfamilies, Phenacoccinae and Pseudococcinae, were supported. At the tribe level, Phenacoccini was found to be monophyletic, whereas Planococcini, Trabutinini, and Pseudococcini were not.
Poor sleep quality is a risk factor for adverse clinical outcomes in patients with acute aortic dissection: A prospective cohort study
Authors: Cai Meiling , Jiang Fei , Lin Lingyu , Peng Yanchun , Li Sailan , Chen Liangwan , Lin Yanjuan
Published: November 2024

The decrease in sleep quality leads to an increased risk of cardiovascular disease and is closely related to the prognosis of various diseases. However, the relationship between preoperative sleep quality and postoperative clinical outcomes in patients with acute aortic dissection is still unclear. We aimed to assess the relationship between sleep quality and the clinical outcomes of acute aortic dissection. We assessed participants' sleep quality and the clinical outcomes of acute aortic dissection, which included prolonged mechanical ventilation, postoperative delirium, in‐hospital death, continuous renal replacement therapy, intensive care unit stay time, and length of stay. Patients were divided into good sleep quality group (n = 103) and poor sleep quality group (n = 113). Postoperative delirium, in‐hospital death, prolonged mechanical ventilation and intensive care unit stay time were significantly increased in the poor sleep quality group when compared with the good sleep quality group (p < 0.05). Multivariate regression analysis showed that the poorer sleep quality, the greater the risk of in‐hospital death (odds ratio = 3.451, 95% confidence interval 1.19–10.004) and prolonged mechanical ventilation (odds ratio = 6.302, 95% confidence interval 3.105–12.791), and the longer intensive care unit stay time (β = 62.37, 95% confidence interval 22.411–102.329). In addition, the higher the incidence of smoking history (odds ratio = 7.417, 95% confidence interval 2.425–22.684), poor sleep quality (odds ratio = 11.59, 95% confidence interval 3.844–34.942) and postoperative delirium (odds ratio = 5.1, 95% confidence interval 1.793–14.504), the greater the risk of prolonged mechanical ventilation. Our findings revealed that poor sleep quality may be a risk factor for adverse clinical outcomes of acute aortic dissection. Rapid assessment of self‐reported sleep quality may be a simple and effective way to identify patients with acute aortic dissection who are at high risk for prolonged mechanical ventilation.
How reliably do keratinous tissues predict total mercury concentration in internal tissues of a highly mobile carnivore with a terrestrial diet?
Authors: Warret Rodrigues C. , Wang F. , Halden N. M. , Yang P. , Roth J. D.
Published: November 2024

Hair offers a non‐invasive way to assess mercury exposure in diverse species, but variable and poorly understood molt patterns in wildlife may hamper the interpretation of tracer levels in hair. The reliability of using hair to precisely assess internal mercury burden, thus, varies across species, but few studies have assessed the reliability of using claw. Claws grow continuously, and growth rate may be easier to monitor than molt patterns. We quantified total mercury concentration (THg) in internal and keratinous tissues of 55 red foxes (Vulpes vulpes) legally harvested near Arctic tree line in Canada in winter (i.e., when mobility and opportunistic foraging are maximal) to compare the performance of hair and claw in predicting internal mercury burden, and examine the overall capacity of THg in keratinous tissues to predict internal THg at low exposure. Red foxes are widespread, occur at high densities and occupy a high trophic position, and thus could be a good sentinel species for monitoring mercury in the less‐studied terrestrial food webs. We found generally low levels of THg in all fox tissues (range: 0.06 mg kg−1 in brain to 1.13 mg kg−1 in hair) indicating overall low contamination of this low‐Arctic terrestrial food web. Relationships between THg of diverse internal organs were strong, but THg in both claws and hair were poor predictors of THg in internal organs. We thus advise caution when interpreting mercury levels in keratinous tissues of highly mobile species, as they may over‐ or underestimate the overall levels of exposure of a population because of non‐continuous or seasonal growth. Adding a time component using segmental analysis of continuously growing keratinous tissues, or associating multiple tissues reflecting diverse timeframes and physiological processes, may offer a more accurate and complete understanding of toxicological risks.
Immigrant detention be banned? Constituent, subconstituent, and elite influence over House Democrat's decision to cosponsor the Dignity for Detained Immigrants Act
Authors: Morín Jason L. , Collingwood Loren
Published: November 2024

How responsive are House members to the immigration policy interest of constituents, sub‐constituencies, and businesses? We test members' responsiveness to each of these groups by focusing on House Democrats' decision to cosponsor the Dignity for Detained Immigrants Act (DDIA), a bill that phases out the use of private immigrant detention facilities. We expect House Democrats to be more likely to cosponsor DDIA when their constituents possess more liberal immigration attitudes and represent larger Latino, Asian American, and foreign‐born populations. Conversely, we expect House Democrats with private immigrant detention facilities in their districts or accept PAC contributions from private prison companies to be less likely to cosponsor the legislation. Our findings show general support for all three expectations. Thus, even though some House Democrats are unlikely to take positions on liberal immigration reform policies, such as the DDIA, House Democrats are responsive to their constituents on the issue of immigration.
Elevational Range Impacts Connectivity and Predicted Deme Sizes From Models of Habitat Suitability
Authors: French Connor M. , Damasceno Roberta P. , Vasconcellos Mariana M. , Rodrigues Miguel T. , Carnaval Ana C. , Hickerson Michael J.
Published: November 2024

In integrative distributional, demographic and coalescent (iDDC) modelling, a critical component is the statistical relationship between habitat suitability and local population sizes. This study explores this relationship in two Enyalius lizard species from the Brazilian Atlantic Forest: the high‐elevation E. iheringii and low‐elevation E. catenatus and how this transformation affects spatiotemporal demographic inference. Most previous iDDC studies assumed a linear relationship, but this study hypothesises that the relationship may be nonlinear, especially for high‐elevation species with broader environmental tolerances. We test two key hypotheses: (1) The habitat suitability to population size relationship is nonlinear for E. iheringii (high‐elevation) and linear for E. catenatus (low‐elevation); and (2) E. iheringii exhibits higher effective migration across populations than E. catenatus. Our findings provide clear support for hypothesis (2), but mixed support for hypothesis (1), with strong model support for a nonlinear transformation in the high‐elevation E. iheringii and some (albeit weak) support for a nonlinear transformation also in E. catenatus. The iDDC models allow us to generate landscape‐wide maps of predicted genetic diversity for both species, revealing that genetic diversity predictions for the high‐elevation E. iheringii align with estimated patterns of historical range stability, whereas predictions for low‐elevation E. catenatus are distinct from range‐wide stability predictions. This research highlights the importance of accurately modelling the habitat suitability to population size relationship in iDDC studies, contributing to our understanding of species' demographic responses to environmental changes.
Detecting Echinocandin Resistance in C. glabrata Using Commercial Methods: Are CLSI or EUCAST Breakpoints Suitable for Categorical Classification?
Authors: Escribano Pilar , Cuéllar Laura Alguacil , Álvarez‐Gutiérrez Almudena , Muñoz Patricia , Guinea Jesús
Published: November 2024

Background

Previous studies correlated Sensititre YeastOne and gradient diffusion plastic strips with standard procedures for the detection of echinocandin‐resistant C. glabrata isolates. However, these studies were limited by the low number of resistant isolates studied; the inclusion of sufficient numbers of mutant isolates is essential to test the procedures' capacity to detect resistance.

Objective

We assessed the performance of Sensititre YeastOne and Etest strips to detect echinocandin resistance in susceptible or resistant C. glabrata isolates (n = 80) in which the FKS genes were sequenced, and MICs interpreted using EUCAST and CLSI breakpoints.

Patients/Methods

Isolates were echinocandin‐susceptible (n = 50) or echinocandin‐resistant according to EUCAST 7.4 methodology. Echinocandin susceptibility using Sensititre YeastOne and Etest strips and categorical agreement were assessed.

Results

All except one anidulafungin‐resistant isolate had an anidulafungin Sensititre YeastOne MIC ≥ 0.25 mg/L, while most micafungin‐resistant isolates had a MIC ≥ 0.25 mg/L. Likewise, all anidulafungin‐resistant isolates had an anidulafungin Etest strip‐obtained MIC ≥ 0.03 mg/L, whereas micafungin‐resistant isolates were ≥ 0.125 mg/L. Overall, these commercial methods correctly classified > 90% of isolates by using any breakpoint. Despite the low number of errors detected, these were mostly false resistance (major errors) with EUCAST breakpoints and false susceptibility (very major errors) with CLSI breakpoints.

Conclusions

Sensititre YeastOne and Etest strips were suitable procedures to detect echinocandin resistance in C. glabrata. The high number of FKS mutants included reinforces our study and opens the door for multicentre validations.
Neuromorphic engineering: Artificial brains for artificial intelligence
Authors: Leugering Johannes
Published: November 2024

Neuromorphic engineering is a research discipline that tries to bridge the gaps between neuroscience and engineering, cognition and algorithms, and natural and artificial intelligence. Neuromorphic engineering promises revolutionary breakthroughs that could rapidly advance our understanding of the brain and pave the way toward more human‐like and sustainable artificial intelligence. But first, it will have to find its way out of the laboratory.
The root hairless mutant buzz in Brachypodium distachyon shows increased nitrate uptake and signaling but does not affect overall nitrogen use efficiency
Authors: Rosas Miguel A. , Alvarez José M. , Sanguinet Karen A.
Published: November 2024

Root systems are uniquely adapted to fluctuations in external nutrient availability. In response to suboptimal nitrogen conditions, plants adopt a root foraging strategy that favors a deeper and more branched root architecture, enabling them to explore and acquire soil resources. This response is gradually suppressed as nitrogen conditions improve. However, the root hairless mutant buzz in Brachypodium distachyon shows a constitutive nitrogen‐foraging phenotype with increased root growth and root branching under nitrate‐rich conditions. To investigate how this unique root structure and root hair morphology in the buzz mutant affects nitrate metabolism, we measured the expression of nitrate‐responsive genes, nitrate uptake and accumulation, nitrate reductase activity, and nitrogen use efficiency. We found that nitrate responses were upregulated by low nitrate conditions in buzz relative to wild type and correlated with increased expression of nitrate transport genes. In addition, buzz mutants showed increased nitrate uptake and a higher accumulation of nitrate in shoots. The buzz mutant also showed increased nitrate reductase activity in the shoots under low nitrate conditions. However, developmentally mature wild‐type and buzz plants grown under low nitrate had similar nitrogen use efficiencies. These findings suggest that BUZZ influences nitrate signaling and that enhanced responsiveness to nitrate is required in buzz seedlings to compensate for the lack of root hairs. These data question the importance of root hairs in enhancing nitrate uptake and expand our understanding of how root hairs in grasses affect physiological responses to low nitrate availability.
How Do Pre-Service Teachers Perceive Their Teacher Education Courses? The Impact on Inclusive Classroom Management Self-Efficacy
Authors: Yogaranee S.
Published: November 2024

In the successful implementation of inclusive education, classroom management (CM) is considered one of the significant tasks of teachers to ensure that the classroom is supportive and conducive to students’ academic and social-emotional development. However, CM has become a challenge for pre-service teachers (PSTs) due to accommodating more learners with unique and diverse needs in regular classrooms. It is a mandate of the teacher education institutions to prepare PSTs with adequate knowledge and competence to manage inclusive classrooms effectively; however, how adequately they are prepared to perform this task is a persisting question. Using a descriptive survey design, this study mainly focused on how pre-service teachers’ perceptions of the courses offered by the teacher education programs that included coursework related to CM impact confidence in their ability to manage inclusive classrooms. Online data were collected from 243 PSTs from the teacher education institutions of Sri Lanka by administering the Tamil Inclusive Classroom Management Self-Efficacy scale and the Teacher Perceptions of Teacher Training Courses scale. Data were analyzed using structural equation modelling, and results show that teachers’ increased perceptions affected their reactive CM actions more than other CM strategies. The study suggests more focused attention on the multifaceted aspects of CMSE by emphasizing the developmental nature of students’ appropriate behaviour rather than relying on correcting disruptive behaviours to enable inclusive, student-friendly classrooms, thereby ensuring equality of educational opportunities for all.
Chloronitramide anion is a decomposition product of inorganic chloramines
Authors: Fairey Julian L. , Laszakovits Juliana R. , Pham Huong T. , Do Thien D. , Hodges Samuel D. , McNeill Kristopher , Wahman David G.
Published: November 2024

Inorganic chloramines are commonly used drinking water disinfectants intended to safeguard public health and curb regulated disinfection by-product formation. However, inorganic chloramines themselves produce by-products that are poorly characterized. We report chloronitramide anion (Cl–N–NO
2
−
) as a previously unidentified end product of inorganic chloramine decomposition. Analysis of chloraminated US drinking waters found Cl–N–NO
2
−
in all samples tested (
n
= 40), with a median concentration of 23 micrograms per liter and first and third quartiles of 1.3 and 92 micrograms per liter, respectively. Cl–N–NO
2
−
warrants occurrence and toxicity studies in chloraminated water systems that serve more than 113 million people in the US alone.
Portraits of the Universe
Hidden in the Heavens
Jason Steffen
Princeton University Press, 2024. 272 pp.
Pillars of Creation
Richard Panek
Little, Brown, 2024. 256 pp.
Authors: Carson Jennifer
Published: November 2024

A pair of books celebrate the discoveries made by two major space telescope programs
The chloramine dilemma
Authors: McCurry Daniel L.
Published: November 2024

A decades-long drinking-water disinfection mystery ends with a potentially toxic surprise
A novel virus potentially evolved from the N4-like viruses represents a unique viral family:
Poorviridae
Authors: Wang Wei , Wang Hongmin , Zou Xiao , Liu Yundan , Zheng Kaiyang , Chen Xin , Wang Xinyi , Sun Shujuan , Yang Yang , Wang Min , Shao Hongbing , Liang Yantao
Published: November 2024

Pseudoalteromonas
are widely distributed in marine extreme habitats and exhibit diverse extracellular protease activity, which is essential for marine biogeochemical cycles. However, our understanding of viruses that infect
Pseudoalteromonas
remains limited. This study isolated a virus infecting
Pseudoalteromonas nigrifaciens
from Xiaogang in Qingdao, China. vB_PunP_Y3 comprises a linear, double-strand DNA genome with a length of 48,854 bp, encoding 52 putative open reading frames. Transmission electron microscopy demonstrates the short-tailed morphology of vB_PunP_Y3. Phylogenetic and genome-content-based analysis indicate that vB_PunP_Y3 represents a novel virus family named as
Poorviridae
, along with three high-quality uncultivated viral genomes. Biogeographical analyses show that
Poorviridae
is distributed across five viral ecological zones, and is predominantly detected in the Antarctic, Arctic, and bathypelagic zones. Comparative genomics analyses identified three of the seven hallmark proteins of N4-like viruses (DNA polymerase, major capsid protein, and virion-encapsulated RNA polymerase) from vB_PunP_Y3, combing with the protein tertiary structures of the major capsid protein, suggesting that vB_PunP_Y3 might evolve from the N4-like viruses.

IMPORTANCE

vB_PunP_Y3 is a unique strain containing three of the seven hallmark proteins of N4-like viruses, but is grouped into a novel family-level viral cluster with three uncultured viruses from metagenomics, named
Poorviridae
. This study enhanced the understanding about the genetic diversity, evolution, and distribution of
Pseudoalteromonas
viruses and provided insights into the novel evolution mechanism of marine viruses.
The
Bordetella
effector protein BteA induces host cell death by disruption of calcium homeostasis
Authors: Zmuda Martin , Sedlackova Eliska , Pravdova Barbora , Cizkova Monika , Dalecka Marketa , Cerny Ondrej , Allsop Tania Romero , Grousl Tomas , Malcova Ivana , Kamanova Jana
Published: November 2024

Bordetella pertussis
is the causative agent of whooping cough in humans, a disease that has recently experienced a resurgence. In contrast,
Bordetella bronchiseptica
infects the respiratory tract of various mammalian species, causing a range of symptoms from asymptomatic chronic carriage to acute illness. Both pathogens utilize type III secretion system (T3SS) to deliver the effector protein BteA into host cells. Once injected, BteA triggers a cascade of events leading to caspase 1-independent necrosis through a mechanism that remains incompletely understood. We demonstrate that BteA-induced cell death is characterized by the fragmentation of the cellular endoplasmic reticulum and mitochondria, the formation of necrotic balloon-like protrusions, and plasma membrane permeabilization. Importantly, genome-wide CRISPR-Cas9 screen targeting 19,050 genes failed to identify any host factors required for BteA cytotoxicity, suggesting that BteA does not require a single nonessential host factor for its cytotoxicity. We further reveal that BteA triggers a rapid and sustained influx of calcium ions, which is associated with organelle fragmentation and plasma membrane permeabilization. The sustained elevation of cytosolic Ca
2+
levels results in mitochondrial calcium overload, mitochondrial swelling, cristolysis, and loss of mitochondrial membrane potential. Inhibition of calcium channels with 2-APB delays both the Ca
2+
influx and BteA-induced cell death. Our findings indicate that BteA exploits essential host processes and/or redundant pathways to disrupt calcium homeostasis and mitochondrial function, ultimately leading to host cell death.

IMPORTANCE

The respiratory pathogens
Bordetella pertussis
and
Bordetella bronchiseptica
exhibit cytotoxicity toward a variety of mammalian cells, which depends on the type III secretion effector BteA. Moreover, the increased virulence of
B. bronchiseptica
is associated with enhanced expression of T3SS and BteA. However, the molecular mechanism underlying BteA cytotoxicity is elusive. In this study, we performed a CRISPR-Cas9 screen, revealing that BteA-induced cell death depends on essential or redundant host processes. Additionally, we demonstrate that BteA disrupts calcium homeostasis, which leads to mitochondrial dysfunction and cell death. These findings contribute to closing the gap in our understanding of the signaling cascades targeted by BteA.
Effect of rol Genes of the A4, 15834, and K599 Strains of Agrobacterium rhizogenes on Root Growth and States of the Antioxidant Systems of Transgenic Tobacco Plants Subjected to Abiotic Stress
Authors: Shvets D. Yu. , Berezhneva Z. A. , Musin Kh. G. , Kuluev B. R.
Published: November 2024

An attempt is made to create transgenic plants using rol genes from A4, 15834, and K599 strains of A. rhizogenes. Strains A4 and 15834 transformed tobacco plants are found to display better root growth than their wild types under normal conditions and at elevated concentrations of sodium chloride or cadmium acetate. At the same time, the rol genes acquired from the K599 strain negatively affect root growth under both normal and stressful conditions (e.g., salinization, hypothermia, or excess cadmium acetate). The levels of total protein, proline, total glutathione, and superoxide dismutase activity are higher in the roots of the transgenic plants with rol genes from the A4 and 15834 strains than in nontransgenic control plants under both optimum conditions and salinization. When using rol transgenes from the K599 strain, the activities of superoxide dismutase, guaiacol peroxidase, and glutathione-S-transferase are enhanced in the roots subjected to salinization. The positive effect rol genes have on the root growth of transgenic plants could therefore be explained by their influence on components of the antioxidant system. Results suggest that using rol genes from the A4 and 15834 strains of A. rhizogenes are promising for breeding plant cultivars and liness with improved parameters of root growth and stress tolerance. At the same time, rol genes from the K599 strain appear to be inadequate for this task.
Hysterotomy for retained placenta in suspected angular pregnancy
Authors: Newman Rachel , Nazir Alia , Leung Michael , Patni Deepali
Published: November 2024

Background

Angular pregnancy is a rare event and is a commonly missed diagnosis in the antepartum period. Data regarding the optimal mode of delivery and management of the placenta are limited.

Case description

A patient in her 30s, gravida 3, para 1 presented at 37 weeks with severe range blood pressure and was admitted for induction of labour due to preeclampsia. Her labour course and delivery of the neonate were uncomplicated. Despite attempts at manual extraction and suction dilation and curettage, the placenta was unable to be removed. Ultrasound revealed the placenta in the right cornua, suspicious for angular pregnancy. She was taken to the operating room for exploratory laparotomy and hysterotomy for extraction of the placenta. She had an uncomplicated postpartum course and was discharged home on postpartum day 4.

Conclusion

In patients with suspected angular pregnancy, exploratory laparotomy and hysterotomy may be required for placental removal.
Myriad of congenital excavated optic disc anomalies in achondroplasia
Authors: Khullar Srishti , Ambiya Vikas , Kapoor Gaurav , Sharma Vijay K
Published: November 2024

Achondroplasia is a genetic condition resulting from specific disruptions in the formation of endochondral bone. Telecanthus, exotropia, angle anomalies and cone–rod dystrophy have been observed as associated ophthalmic features in patients with achondroplasia. Here, we present a case of achondroplasia associated with unique ocular features including telecanthus, esotropia and bilateral microphthalmos. Fundus evaluation revealed a distinctive combination of optic disc anomalies, namely, optic disc coloboma, morning glory disc and optic disc pit maculopathy, along with retroorbital cysts. This represents the first reported case of such a combination of ocular anomalies in achondroplasia.
Advances in the management of psoriatic arthritis in adults
Authors: Kharouf Fadi , Gladman Dafna D
Published: November 2024

Psoriatic arthritis is an inflammatory arthritis that affects around 30% of patients with psoriasis. The disease spectrum includes peripheral arthritis, enthesitis, tenosynovitis, dactylitis, axial involvement, and skin and nail psoriasis in most patients. In addition to the cutaneous and musculoskeletal manifestations, several comorbidities can complicate the disease course, including cardiovascular disease, diabetes mellitus, metabolic syndrome, gout, anxiety, and depression. The management of patients with psoriatic arthritis begins with a careful assessment of the skin and joints and screening for comorbidities. This review describes the assessment tools and outcome measures used in the evaluation of patients with psoriatic arthritis. It summarizes the approach to therapy, including non-medicinal interventions such as education, lifestyle changes, physiotherapy, and occupational therapy. It discusses the evidence on pharmacologic treatments, including drugs used for symptomatic relief such as non-steroidal anti-inflammatory drugs, and those used to control the disease process; this last group comprises conventional synthetic disease modifying anti-rheumatic drugs (DMARDs), including methotrexate, leflunomide, and sulfasalazine, and biologic and targeted DMARDs, including anti-tumor necrosis factor (TNFα), anti-interleukin-17 (IL-17), anti-IL-12/23, and anti-IL-23 agents, as well as Janus kinase (JAK) inhibitors and phosphodiesterase 4 (PDE4) antagonists. Although these drugs are usually tailored to the clinical profile of the patient, biomarkers predictive of response to therapy are needed so that a more personalized approach can be followed.
Becoming Active in Beating osteoarthritiS: study protocol of a randomised controlled trial on the effectiveness of an information campaign in improving the management of osteoarthritis and quality of care in general practices in the Netherlands
Authors: Oomen Jeanne , Schers Henk , Das Enny , Koeter Sander , van den Ende Cornelia HM , Assendelft Willem JJ
Published: November 2024

Introduction

Despite recommendations, non-surgical treatment modalities in knee and/or hip osteoarthritis (KHOA) are underused. An information campaign was developed targeting patients with early stage KHOA and healthcare professionals (HCPs) to optimise timing of referral to secondary care. This protocol describes the development and design of this information campaign and a randomised controlled trial (RCT) on its effectiveness in impacting healthcare utilisation.

Methods and analysis

The behaviour change wheel was used as a theoretical framework for the campaign design. After an inventory of the literature, a selection was made of factors influencing healthcare use. Effectiveness will be evaluated with a cluster RCT. The study aims to recruit 300 patients in 24 general practices, randomly allocated to intervention or usual care (ratio 1:1). General practitioners and affiliated HCPs are invited to participate in the trial and recruit patients. Patients are eligible to participate if they are Dutch speaking, aged 50–75 years, registered with KHOA at the general practice, without joint replacement nor having considerable walking impairment. The main end point is the difference in rate of referral to hospital care as reported by patients over a period of 18 months. Secondary parameters include quality of care, beliefs about KHOA treatment modalities, physical activity, self-management behaviour and referral rates to secondary care. Patients receive online questionnaires at baseline, 6, 12 and 18 months. Online questionnaires are sent to HCPs at baseline and after 12 months to assess (changes in) beliefs about KHOA treatment modalities.

Ethics and dissemination

All methods are carried out in accordance with relevant guidelines and regulations and ethical approval was waived by the Dutch medical research ethical committee of Arnhem-Nijmegen (file number 2020-7246). Trial results will be communicated to participants and patient representatives via news letters, the public via the Sint Maartenskliniek website and journals of patient organisations and HCPs via congresses and international scientific journals.

Trial registration number

NL9140.
Outcomes and costs of home hospitalisation compared to traditional hospitalisation for infectious diseases in Israel: a cohort study
Authors: Yehoshua Ilan , Baruch Gez Sharon , Cohen Bar , Hemo Beatriz , Irony Angela , Abou Houssien Khaled , Shental Omri , Shapiro Ben David Shirley , Adler Limor
Published: November 2024

Objectives

This study aims to evaluate and compare health outcomes and costs between home hospitalisation and traditional hospitalisation for three common diagnoses—cellulitis, urinary tract infection (UTI) and pneumonia.

Design

A retrospective cohort study.

Setting

Primary care, nationwide.

Participants

1311 patients in home hospitalisation and 992 in traditional hospitalisation.

Interventions

The primary intervention is home hospitalisation, compared with traditional hospitalisation. The intervention was performed according to medical considerations by a specialised team, and this study was done retrospectively to evaluate it.

Primary and secondary outcome measures

Primary measures included healthcare costs, length of hospitalisation, referrals for further medical services and mortality.

Results

Costs of home hospitalisation were lower compared with traditional hospitalisation (6056 vs 9619 NIS for pneumonia, 6011 vs 9767 NIS for cellulitis, 6466 vs 8552 NIS for UTI and p value<0.05). The length of home hospitalisations was shorter for pneumonia and cellulitis (5.01 vs 6.05 days, p value 0.001 and 5.3 vs 6.1 days, p value<0.001, respectively). Likewise, for pneumonia and cellulitis, home-hospitalised patients had fewer ED referrals 30 days after discharge (13.7% vs 24%, p value<0.001 and 13.5% vs 19.8%, p value 0.002, respectively). No differences were found in recurrent hospitalisation and mortality 7 and 30 days after discharge.

Conclusions

Primary care physicians should consider home hospitalisation for these diagnoses as an alternative to traditional hospitalisation. Policymakers should encourage Primary care physicians to use home hospitalisation, as it has financial advantages and better health outcomes.
Association between sedentary time, physical activity, biochemical markers in the blood (heart and muscles) and heart failure in adults with congenital heart disease: a study protocol of a cross-sectional cohort study in Sweden (the ACHD trial protocol)
Authors: Vahlberg Birgit Maria , Jansson Christer , Åkerfeldt Torbjörn , Christersson Christina
Published: November 2024

Introduction

Adults with congenital heart disease (ACHD) are a heterogeneous group with a large variation in the severity of lesions and symptoms. This population has rapidly grown in recent years due to improved surgical and medical treatments. Sedentary time and physical activity (PA) and health among individuals classified with single lesions, for example, shunt defects such as atrial and ventricular septal defects, and patent foramen ovale (PFO) with stroke are less studied. The present study describes the study protocol and examines associations between sedentary time, PA, circulating biomarkers in the blood (heart and muscles) and heart failure. Results have the potential to supply the healthcare system with information if further action to promote cardiovascular health in ACHD is needed.

Methods and analysis

A cross-sectional design will be used with data from the local heart register, Swedish Registry for Congenital Heart Disease in Uppsala, Sweden. Individuals ≥18 years of age with simple congenital heart disease, according to the definition atrial septal defect, ventricle septal defect or PFO as the cause of stroke, will be included.

Outcome measures: Self-reported questionnaire: demographic characteristics, education, the prevalence of diabetes, smoking, ethnicity, self-reported level of sitting time and leisure-time PA/exercise, everyday activities, commuting and degree of symptoms associated with exertion. Blood analyses: blood lipids (total cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol, apolipoprotein A1 and B), creatinine, cystatin-C (eGFR), creatine kinase, myoglobin, high-sensitivity troponin, brain natriuretic peptide, C-reactive protein and glycated haemoglobin. Quantitative methods will be used for statistical analyses.

Ethics and dissemination

The Swedish Ethical Review Authority has approved the study (registration numbers 2022-06525-01 and 2023-02082-02). Results will be disseminated in peer-reviewed journals, research meetings, conferences and possibly patient organisations.
Estimating the herd effects of anti-microbial-based decontamination (ABD) interventions on intensive care unit (ICU) acquired bloodstream infections: a deductive meta-analysis
Authors: Hurley James
Published: November 2024

Objective

To estimate the herd effects of anti-microbial-based decontamination (ABD) interventions on bloodstream infections (BSIs) among groups of intensive care unit (ICU) patients in relation to group mean length of stay (LOS). To deduce which of three competing hypotheses of ABD effect mediation best accounts for the observed effects.

Design

Arms-based meta-regression of ICU-acquired BSI incidence against group mean LOS for control and interventions arms of ABD and non-ABD controlled trials each versus that in arms of observational studies.

Exposures

Within controlled trials of ABD, intervention, concurrent control (CC) and non-concurrent (NCC) groups are directly, indirectly and non-exposed, respectively.

Main outcomes and measures

BSI incidence, both overall and for BSI subtypes.

Results

In the arms-based meta-regression, the predicted BSI incidence per 100 patients in the ABD intervention arms increased from 4.6 (95% CI 3.8 to 5.5) at mean LOS 7 days to 13.0 (10.4–16.0) at mean LOS 20 days (n=60 arms) and CC arms 8.5 (6.7–11.0) increasing to 19.3 (14.8–24.8; n=52). These increases were double those in the observational (7.2; 6.1–8.5 increasing to 12.9; 10.4–16.7; n=99) and NCC arms and non-ABD arms. These results triangulate with the notional effect size observed in contrast-based meta-analyses.

Conclusions

The increased tempo of BSI acquisition, both overall and for various BSI subtypes, within intervention and CC groups of ABD randomised concurrent controlled trials versus other groups implicate rebound and spillover, respectively. Mechanisms other than colonisation resistance mediate ABD effects.