bluuebunny/crossref_metadata_2025 huggingface dataset:
Professions and inequality: Challenges, controversies, and opportunities
Authors: Ashley Louise , Boussebaa Mehdi , Friedman Sam , Harrington Brooke , Heusinkveld Stefan , Gustafsson Stefanie , Muzio Daniel
Published: December 2022

On the basis of the EGOS 2021 sub-plenary on ‘Professions and Inequality: Challenges, Controversies, and Opportunities’, the presenters and panellists wrote four short essays on the relationship between inequality as a grand challenge and professional occupations and organizations, their structures, practices, and strategies. Individually, these essays take an inquisitorial stance on extant understandings of (1) how professions may exacerbate existing inequalities and (2) how professions can be part of the solution and help tackle inequality as a grand challenge. Taken together, the discussion forum aims at advancing scholarly debates on inequality by showing how professions’ scholarship may critically interrogate extant understandings of inequality as a broad, multifaceted concept, whilst providing fruitful directions for research on inequality, their potential solutions, and the role and responsibilities of organization and management scholars.
First report of a possible abdominalAngiostrongylus costaricensisin a French expatriate in the French Amazon
Authors: Desmoulin Anissa , Melzani Alessia , Dard Céline , Nacher Mathieu , Djossou Félix , Alsibai Mohamed Kinan Drak , Epelboin Loïc
Published: December 2022

Abdominal angiostrongyliasis is a parasitic disease caused by Angiostrongylus costaricensis. Cases have been reported from Texas to southern Argentina but not in the eastern part of the Amazon. We present the case of a 34-year-old French man living in French Guiana who had travelled to the Caribbean.
Energy in the European Green Deal: impacts and recommendations for MENA countries
Authors: Rybski Robert
Published: December 2022

The European Union (EU) presented its new and ambitious programme at the end of 2019—the European Green Deal (EGD), which should align its economy to reach the goal of climate neutrality in 2050. A vital part of the deal aims for the energy sector within the leitmotif of supplying clean, affordable and secure energy. Because energy-related Greenhouse Gas (GHG) emissions accounted in 2020 for three-quarters of all GHG emissions of the EU, the most important pillar for the EGD to succeed is the energy sector. The deal does not function within a vacuum as it will impact other countries, including those with vast conventional energy resources and close ties to the EU, like nations from the region of the Middle East and North Africa (MENA). This article assesses the deal’s impacts on MENA countries and includes recommendations concerning various aspects of low-carbon transition that could be applied. The EGD programme will be used as a reference scenario for those recommendations because of its universal character.
EMBL’s European Bioinformatics Institute (EMBL-EBI) in 2022
Authors: Thakur Matthew , Bateman Alex , Brooksbank Cath , Freeberg Mallory , Harrison Melissa , Hartley Matthew , Keane Thomas , Kleywegt Gerard , Leach Andrew , Levchenko Mariia , Morgan Sarah , McDonagh Ellen M , Orchard Sandra , Papatheodorou Irene , Velankar Sameer , Vizcaino Juan Antonio , Witham Rick , Zdrazil Barbara , McEntyre Johanna
Published: December 2022

The European Molecular Biology Laboratory's European Bioinformatics Institute (EMBL-EBI) is one of the world's leading sources of public biomolecular data. Based at the Wellcome Genome Campus in Hinxton, UK, EMBL-EBI is one of six sites of the European Molecular Biology Laboratory (EMBL), Europe's only intergovernmental life sciences organisation. This overview summarises the status of services that EMBL-EBI data resources provide to scientific communities globally. The scale, openness, rich metadata and extensive curation of EMBL-EBI added-value databases makes them particularly well-suited as training sets for deep learning, machine learning and artificial intelligence applications, a selection of which are described here. The data resources at EMBL-EBI can catalyse such developments because they offer sustainable, high-quality data, collected in some cases over decades and made openly availability to any researcher, globally. Our aim is for EMBL-EBI data resources to keep providing the foundations for tools and research insights that transform fields across the life sciences.
ONE-seq: epitranscriptome and gene-specific profiling of NAD-capped RNA
Authors: Niu Kongyan , Zhang Jinyang , Ge Shuwen , Li Dean , Sun Kunfeng , You Yingnan , Qiu Jiaqian , Wang Kun , Wang Xueting , Liu Rui , Liu Yandong , Li Bing , Zhu Zheng-Jiang , Qu Lefeng , Jiang Hong , Liu Nan
Published: December 2022

The hub metabolite, nicotinamide adenine dinucleotide (NAD), can be used as an initiating nucleotide in RNA synthesis to result in NAD-capped RNAs (NAD-RNA). Since NAD has been heightened as one of the most essential modulators in aging and various age-related diseases, its attachment to RNA might indicate a yet-to-be discovered mechanism that impacts adult life-course. However, the unknown identity of NAD-linked RNAs in adult and aging tissues has hindered functional studies. Here, we introduce ONE-seq method to identify the RNA transcripts that contain NAD cap. ONE-seq has been optimized to use only one-step chemo-enzymatic biotinylation, followed by streptavidin capture and the nudix phosphohydrolase NudC-catalyzed elution, to specifically recover NAD-capped RNAs for epitranscriptome and gene-specific analyses. Using ONE-seq, we discover more than a thousand of previously unknown NAD-RNAs in the mouse liver and reveal epitranscriptome-wide dynamics of NAD-RNAs with age. ONE-seq empowers the identification of NAD-capped RNAs that are responsive to distinct physiological states, facilitating functional investigation into this modification.
The climate impact of high seas shipping
Authors: Li Yuze , Jia Peng , Jiang Shangrong , Li Haijiang , Kuang Haibo , Hong Yongmiao , Wang Shouyang , Zhao Xueting , Guan Dabo
Published: December 2022

Strict carbon emission regulations are set with respect to countries’ territorial seas or shipping activities in exclusive economic zones to meet their climate change commitment under the Paris Agreement. However, no shipping policies on carbon mitigation are proposed for the world’s high seas regions, which results in carbon intensive shipping activities. In this paper, we propose a Geographic-based Emission Estimation Model (GEEM) to estimate shipping GHG emission patterns on high seas regions. The results indicate that annual emissions of carbon dioxide equivalent (CO2-e) in shipping on the high seas reached 211.60 million metric tonnes in 2019, accounting for about one-third of all shipping emissions globally and exceeding annual GHG emissions of countries such as Spain. The average emission from shipping activities on the high seas is growing at approximately 7.26% per year, which far surpasses the growth rate of global shipping emission at 2.23%. We propose implementation of policies on each high seas region with respect to the main emission driver identified from our results. Our policy evaluation results show that carbon mitigation policies could reduce emissons by 25.46 and 54.36 million tonnes CO2-e in the primary intervention stage and overall intervention stage, respectively, with 12.09% and 25.81% reduction rates in comparison to the 2019 annual GHG emissions in high seas shipping.
Toward revising dietary zinc recommendations for children aged 0 to 3 years: a systematic review and meta-analysis of zinc absorption, excretion, and requirements for growth
Authors: Ceballos-Rasgado Marena , Lowe Nicola M , Moran Victoria H , Clegg Andrew , Mallard Simonette , Harris Catherine , Montez Jason , Xipsiti Maria
Published: December 2022

Context

The Food and Agriculture Organization of the United Nations and the World Health Organization are updating their dietary zinc recommendations for children aged 0 to 3 years.

Objective

The aim of this review was to retrieve and synthesize evidence regarding zinc needs for growth as well as zinc losses, absorption, and bioavailability from the diet.

Data Sources

MEDLINE, Embase, and Cochrane Library databases were searched electronically from inception to August 2020. Studies assessing the above factors in healthy children aged 0 to 9 years were included, with no limits on study design or language.

Data Extraction

Ninety-four studies reporting on zinc content in tissue (n = 27); zinc absorption (n = 47); factors affecting zinc bioavailability (n = 30); and endogenous zinc losses via urine, feces, or integument (n = 40) met the inclusion criteria. Four reviewers extracted data and two reviewers checked for accuracy.

Data Analyses

Studies were synthesized narratively, and meta-analyses of zinc losses and gains as well the subgroups of age, type of feeding, country’s income, and molar ratio of phytate to zinc were conducted. Meta-analysis revealed an overall mean (95%CI) urinary and endogenous fecal zinc excretion of 17.48 µg/kg/d (11.80–23.15; I2 = 94%) and 0.07 mg/kg/d (0.06–0.08; I2 = 82%), respectively, with a mean fractional zinc absorption of 26.75% (23.69–29.81; I2 = 99%). Subgrouping by age revealed differences in mean values associated with the transition from milk-based diets to solid food during the first 3 years of life.

Conclusion

This review synthesizes data that may be used to formulate zinc requirements in young children. Results should be interpreted with caution because of considerable heterogeneity in the evidence.

Systematic Review Registration

PROSPERO registration number CRD42020215236.
Immune-Based Therapy for Hospitalized Patients With COVID-19 and Risk of Secondary Infections: A Systematic Review and Meta-analysis
Authors: Kabbani Dima , Sonpar Ashlesha , Weyant Benson , Lau Keith C K , Robbins Mark , Campbell Sandra , Doucette Karen , Abraldes Juan G , Lotfi Tamara , Chaktoura Marlene , Akl Elie A , Cervera Carlos
Published: December 2022

Background

Immune-based therapies are standard-of-care treatment for coronavirus disease 2019 (COVID-19) patients requiring hospitalization. However, safety concerns related to the potential risk of secondary infections may limit their use.

Methods

We searched OVID Medline, Ovid EMBASE, SCOPUS, Cochrane Library, clinicaltrials.gov, and PROSPERO in October 2020 and updated the search in November 2021. We included randomized controlled trials (RCTs). Pairs of reviewers screened abstracts and full studies and extracted data in an independent manner. We used RevMan to conduct a meta-analysis using random-effects models to calculate the pooled risk ratio (RR) and 95% CI for the incidence of infection. Statistical heterogeneity was determined using the I2 statistic. We assessed risk of bias for all studies and rated the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation methodology. We conducted a meta-regression using the R package to meta-explore whether age, sex, and invasive mechanical ventilation modified risk of infection with immune-based therapies. The protocol is registered with PROSPERO (CRD42021229406).

Results

This was a meta-analysis of 37 RCTs including 32 621 participants (mean age, 60 years; 64% male). The use of immune-based therapy for COVID-19 conferred mild protection for the occurrence of secondary infections (711/15 721, 4.5%, vs 616/16 900, 3.6%; RR, 0.82; 95% CI, 0.71–0.95; P = .008; I2 = 28%). A subgroup analysis did not identify any subgroup effect by type of immune-based therapies (P = .85). A meta-regression revealed no impact of age, sex, or mechanical ventilation on the effect of immune-based therapies on risk of infection.

Conclusions

We identified moderate-certainty evidence that the use of immune-based therapies in COVID-19 requiring hospitalization does not increase the risk of secondary infections.
Descriptive Data on Trends Among Patients Hospitalized With Lyme Disease in Southwest Michigan, 2017–2021
Authors: Avner Benjamin S
Published: December 2022

This retrospective chart review identifies hospitalizations for Lyme disease at two southwest Michigan hospital systems, 2017-2021. Lyme admissions increased sharply, while admissions for Lyme carditis and neuroborreliosis increased in parallel. Southwest Michigan is becoming an endemic area for Lyme disease.
Counting integral points on indefinite ternary quadratic equations over number fields
Authors: Xu Fei , Zhang Runlin
Published: December 2022

We study an asymptotic formula for counting integral points over an equation defined by a non-degenerate indefinite integral ternary quadratic form f representing a non-zero integer a such that $-a\cdot det(\,f)$ is square over a number field. In particular, we prove that the leading coefficient of this asymptotic formula is given by the product of local densities normalized by $1-p^{-1}$ over all finite primes p.
The association of trauma with self-reported flares and disease activity in systemic lupus erythematosus (SLE)
Authors: Katz Patricia , Patterson Sarah L , DeQuattro Kimberly , Lanata Cristina M , Barbour Kamil E , Greenlund Kurt J , Gordon Caroline , Criswell Lindsey A , Dall’Era Maria , Yazdany Jinoos
Published: December 2022

Objectives

Trauma has been linked to incident SLE, but its relationship with SLE disease activity is unknown. This analysis examines associations between trauma exposures and patient-reported SLE disease activity and flares.

Methods

Data were from the California Lupus Epidemiology Study (CLUES). Flares were self-reported as any flare and, of those, flares accompanied by medical care (hospitalization or physician contact). The Systemic Lupus Activity Questionnaire (SLAQ) assessed disease activity. The Brief Trauma Questionnaire (BTQ) assessed all historical trauma exposures. The Adverse Childhood Experiences (ACEs) questionnaire was available for a subset. Multivariable regression analyses (n = 252) examined whether trauma exposure was associated with flares or SLAQ controlling for age, sex, poverty, race/ethnicity, comorbidities, perceived stress, disease duration and self-reported disease damage.

Results

Excluding exposure to serious illness, 63.4% reported ≥1 trauma exposure. Any traumatic event, excluding illness, doubled the odds of a flare [OR 2.27 (95% CI 1.24, 4.17)] and was associated with significantly higher SLAQ scores [β 2.31 (0.86, 3.76)]. Adjusted odds of any flare and flare with medical care were significantly elevated for those with both BTQ and ACE exposures [5.91 (2.21, 15.82) and 4.69 (1.56, 14.07), respectively]. SLAQ scores were also higher for those with both exposures [β 5.22 (3.00, 7.44)].

Conclusion

In this cohort, those with a history of trauma reported more flares and greater disease activity. Identifying mechanisms of associations between trauma and disease activity and flares, as well as interventions to mitigate the effects of trauma exposures is critical, given the high rates of trauma exposures.
Serological evidence of hantavirus infection in neotropical bats in an urban area of São Paulo State, Brazil
Authors: Bueno Larissa M , Melo Danilo M , Azevedo Roberta D , de Souza William M , Figueiredo Luiz T M
Published: December 2022

Background

Although hantaviruses have long been associated with rodents, they are also described in other mammalian hosts, such as shrews, moles and bats. Hantaviruses associated with bats have been described in Asian, European and Brazilian species of bats. As these mammals represent the second major mammalian order, and they are the major mammals that inhabit urban areas, it is extremely important to maintain a viral surveillance in these animals. Our aim was to conduct serosurveillance in bats in an urban area in the city of Ribeirão Preto, São Paulo State, Brazil, to contribute to the information about hantaviruses circulation in bats.

Methods

We analyzed samples from 778 neotropical bat specimens classified into 21 bat species and four different families collected in the urban area of Ribeirão Preto city, from 2014 to 2019 by an ELISA for the detection of IgG antibodies against orthohantavirus.

Results

We detected IgG-specific antibodies against the nucleoprotein of orthohantavirus in 0.9% (7/778) bats tested, including four Molossus molossus (Pallas' Free-tailed Bat), two Glossophaga soricina (Pallas's Long-tongued Bat) and one Eumops glaucinus (Wagner's mastiff bat).

Conclusions

Overall, our results show the first serological evidence of hantavirus infection in three common bat species in urban areas.
Spatiotemporal analysis of malaria incidence in Côte d'Ivoire from 2015 to 2019
Authors: Azongnibo Konan R M , Guindo-Coulibaly Negnorogo , Bonnet Emmanuel , Kokro-Djahouri Maimouna N W , Assouho Konan F , Niamke Mathieu G , Fournet Florence , Anoh Paul K , Assi Serge-Brice , Adja Akré M
Published: December 2022

Background

The collection of malaria cases over time allows the identification of areas with the highest incidence. Our objective was to characterize the spatial distribution of malaria in Côte d’Ivoire from 2015 to 2019 at the health district level.

Methods

Data on the number of reported malaria cases confirmed by rapid diagnostic test (RDT) in the general population, the number of patients attending medical consultations and the total population by health district and year were collected from the National Malaria Control Program in Côte d’Ivoire. Crude and adjusted incidence rates were estimated for each health district and year. Adjusted incidence rates were used to perform global (Moran's index) and local indicators of spatial autocorrelation (LISA) analyses.

Results

Between 2015 and 2019, mean crude incidence rates increased from 155.5‰ to 229.8‰. We observed significant heterogeneity in malaria incidence rates across the study period and within a given year. The overall Moran index showed spatial autocorrelation for every year analysed except 2017. The LISA analysis showed that the health districts with high incidence rates were concentrated in the western zone of Côte d'Ivoire.

Conclusions

The use of spatial analyses to identify the areas with the highest malaria incidence rates is a relevant approach to optimize control measures in targeted areas.
Resistance toFusarium oxysporumf. sp.luffaeinLuffaGermplasm Despite Hypocotyl Colonization
Authors: Namisy Ahmed , Huang Jin-Hsing , Rakha Mohamed , Hong Cheng-Fang , Chung Wen-Hsin
Published: December 2022

Fusarium wilt of Luffa, caused by Fusarium oxysporum f. sp. luffae, causes great losses in Luffa plants worldwide. In this study, 45 accessions of Luffa germplasm were used to determine their resistance to F. oxysporum f. sp. luffae isolates (FOLUST, FOLUSC, Fomh16, and Fol114) in two independent trials. In the first trial, only FOLUST was used to preliminarily identify resistant accessions. Nine accessions of Luffa acutangula and five of L. aegyptiaca were resistant to the FOLUST isolate. In the second trial, the other three isolates were then used to reevaluate the 14 resistant accessions. The results indicated that the 14 accessions were resistant to FOLUSC but exhibited variable resistance to the Fomh16 and Fol114 isolates. Eight accessions of L. acutangula and one accession of L. aegyptiaca were resistant to Fol114. Seven accessions of L. acutangula and one accession of L. aegyptiaca were resistant to Fomh16. Despite the lack of any symptoms, the F. oxysporum f. sp. luffae isolates were recovered from the hypocotyls of all resistant accessions at 28 days postinoculation, except for isolates FOLUSC and FOLUST on one accession (LA140). A high percentage (87.5%) of accessions collected from Bangladesh were identified as resistant, highlighting the effect of local adaptation on resistance. These results provide potentially valuable genetic resources for breeding programs to develop new varieties or rootstocks that could be beneficial for controlling soilborne diseases in different cucurbit crops and further investigating the mechanisms of resistance to F. oxysporum f. sp. luffae in Luffa plants.
An Analysis and Evaluation of the Information-Motivation-Behavioral Skills (IMB) Model for Antiretroviral Therapy
Authors: Prakot Sirinan , Fink Anne M. , Culbert Gabriel , Visudtibhan Poolsuk Janepanish
Published: December 2022

We use Fawcett and DeSanto-Madeya's framework to critique Fisher and Fisher's information-motivation-behavioral skills model and determine its usefulness and applicability for nursing. Our analysis and evaluation show that the model is a parsimonious and useful situation-specific theory for guiding nursing research and practice because it shows good fit with the nursing context, has social and theoretical significance, and exhibits empirical and pragmatic adequacy. More consistency in using terms referring to each concept would help to improve the model's internal consistency. The model's testability could also be improved by measuring health outcomes (eg, viral load or CD4 count) in future research.
Opportunities and challenges of neoadjuvant targeted therapy in nonsmall cell lung cancer
Authors: Zou Ji’an , Zeng Yue , Wu Fang
Published: December 2022

Purpose of review

The aim of this study is to summarize the completed and ongoing clinical trials of neoadjuvant targeted therapy, discuss tolerability and efficacy, and explain the role of neoadjuvant targeted therapy in patients with resectable nonsmall cell lung cancer (NSCLC). At the same time, the existing challenges are presented, including assessment methods, biomarkers, surrogate endpoints and so on. We also put forward our views on possible ways to make improvements and establish neoadjuvant therapy a standard treatment in resectable NSCLC.

Recent findings

The mortality of lung cancer has decreased in the last 10 years, which can partly be attributed to advancement of targeted therapy. Targeted therapy has become the first-line treatment for patients with advanced mutation gene positive NSCLC, achieving the effect of prolonging overall survival (OS). Compared with chemotherapy, targeted therapy is associated with good tolerability and high response rate. Neoadjuvant targeted therapy has emerged in recent years and attracted attention of researchers. Early findings proved that neoadjuvant targeted therapy alone can improve patients’ disease-free survival (DFS) and the efficacy of combining with other forms of neoadjuvant therapy is also being explored by researchers.

Neoadjuvant targeted therapy is playing an important role in NSCLC and worth more in-depth research.
Agreement of Diagnostic Classification Between Structural Parameters in Pre-Perimetric and Early Perimetric Glaucoma
Authors: Mathews Basil , Le Patrick H. , Budenz Donald L. , Mwanza Jean-Claude
Published: December 2022

Précis:

In both pre-perimetric and early perimetric glaucoma, the diagnostic agreements between optic disk, retinal nerve fiber layer, and ganglion cell-inner plexiform layer parameters based on Cirrus HD-OCT normative database classification were mostly fair, suggesting that abnormal classification in 1 anatomic area may suffice for the diagnosis of glaucoma in early stages.

Purpose:

To evaluate the agreement of normative database diagnostic classification between optic disk, retinal nerve fiber layer (RNFL), and ganglion cell-inner plexiform layer (GCIPL) in patients with early glaucoma.

Methods:

Retrospective cross-sectional study involving 66 eyes (66 patients) with pre-perimetric and 97 eyes (97 patients) with early perimetric glaucoma. Normative database diagnostic classifications were retrieved from Cirrus HD-OCT scans of 1 eye per participant. An eye was considered abnormal if any of the optic disk, RNFL, or GCIPL was abnormal (yellow or red color-coded classification). For combined parameters, the eye had to be flagged as abnormal by both classifications, regardless of the parameters that were abnormal (global or sectorial). The agreement was assessed with Cohen’s Kappa statistics.

Results:

The agreement between RNFL and GCIPL was fair in both pre-perimetric (κ=0.25) and perimetric glaucoma (κ=0.21). Agreements between RNFL or GCIPL and optic nerve head parameters (rim area and vertical cup-to-disk ratio; VCDR) were inconclusive due to insufficient data (P>0.05). Combining GCIPL and rim area agreed fairly with RNFL both in pre-perimetric (κ=0.21) and perimetric glaucoma (κ=0.33). The best classification agreement (moderate) was achieved with the comparison of RNFL-rim area versus VCDR (κ=0.48 in pre-perimetric, 0.45 in perimetric glaucoma). There were no significant differences between pre-perimetric and perimetric glaucoma coefficients of classification agreement.

Conclusions:

The normative database diagnostic agreements between optic disk, RNFL, and GCIPL were mostly fair in both pre-perimetric and early perimetric glaucoma. Clinicians should not wait for multiple structures to show abnormality on OCT to diagnose early glaucoma.
Incidence of Group B Streptococcus Disease in Infants in China: An Updated Systematic Review and Meta-analysis
Authors: Ding Yijun , Hsia Yingfen , O’Sullivan Colleen , Wang Yajuan , Heath Paul T.
Published: December 2022

New studies of Group B Streptococcus (GBS) in infants <3 months of age in China have been published since our previous systematic review and meta-analysis. Using the same methodology, we updated these estimates and determined a total incidence of 0.41 (95% CI, 0.32–0.51) cases/1000 live births, lower than previously (0.55/1000). New intrapartum antibiotic prophylaxis policies may have played an important role in this reduction.
A Randomized Trial Assessing the Immunogenicity and Reactogenicity of Two Hexavalent Infant Vaccines Concomitantly Administered With Group B Meningococcal Vaccine
Authors: Rajan Matthew , Marchevsky Natalie , Sinclair Gemma , O’Brien Katie , Jefferies Kimberley , Owino Nelly , Hallis Bassam , Goldblatt David , Matheson Mary , Cuthbertson Hannah , Aley Parvinder , Liu Xinxue , Snape Matthew D.
Published: December 2022

Background:

Three hexavalent (DTaP-IPV-Hib-HepB) vaccines are licensed in Europe, only one of which (Vaxelis, Hex-V), uses a meningococcal outer membrane protein complex as a carrier protein for Hemophilus influenza type b (Hib), creating potential interactions with the meningococcal vaccine 4CMenB.

Methods:

In this single-center open-label randomized trial, infants were randomized in a 1:1 ratio to receive Hex-V or an alternative hexavalent vaccine (Infanrix-Hexa, Hex-IH) at 2, 3, and 4 months with 4CMenB (2, 4, and 12 months) in the UK routine immunization schedule. The primary outcome was noninferiority of geometric mean concentrations (GMCs) of anti-PRP (Hib) IgG at 5 months of age. Secondary outcomes included safety, reactogenicity, and immunogenicity of other administered vaccines measured at 5 and 13 months of age.

Results:

Of the 194 participants enrolled, 96 received Hex-V and 98 Hex-IH. Noninferiority of anti-PRP IgG GMCs at 5 months of age in participants receiving Hex-V was established; GMCs were 23-times higher following three doses of Hex-V than three doses of Hex-IH (geometric mean ratio (GMR) 23.25; one-sided 95% CI 16.21, -). 78/85 (92%) of Hex-V recipients and 43/87 (49%) of Hex-IH recipients had anti-PRP antibodies ≥1.0 µg/mL. At 5 months of age serum, bactericidal activity titers against MenB strain 5/99 were higher following Hex-V than Hex-IH (GMR 1.56; 95% CI, 1.13–2.14). The reactogenicity profile was similar in both groups.

Conclusions:

These data support flexibility in the use of either Hex-IH or Hex-V in infant immunization schedules containing 4CMenB, with the possibility that Hex-V may enhance protection against Hib.
Using unfolding case scenarios to promote clinical reasoning for nurse practitioner students
Authors: Ellis Misty , Hampton Debra , Makowski Andrew , Falls Candice , Tovar Elizabeth , Scott Leslie , Melander Sheila
Published: December 2022

This article describes how an unfolding case study can be used to promote the development of clinical reasoning through students' self-reported perceptions, although at the same time facilitating collaboration among providers from various specialties. An unfolding case (evolving case) provides sequential information about a patient's illness trajectory as they experience the illness and related symptomology. An unfolding case study was implemented during a college skills laboratory immersion experience for 33 nurse practitioner (NP) students who were in their final year of the NP program. Students were invited per email to complete a confidential REDCap survey after the case presentation and discussion. Twenty-three students completed the survey. More than half of the students (52%) stated the review of the unfolding case offered “significant learning value” and 78% rated the unfolding case as being “very to extremely” helpful in creating opportunities for critical thinking and engagement in clinical reasoning. Implementing unfolding case studies in NP student program curricula promotes critical thinking, clinical reasoning, and allows opportunities to engage in interprofessional collaboration.
The Demographics of Menière's Disease: Selection Bias or Differential Susceptibility?
Authors: Thompson-Harvey Adam , Friedland David R. , Adams Jazzmyne A. , Tong Ling , Osinski Kristen , Luo Jake
Published: December 2022

Objective

To clarify whether the reported lack of racial and ethnic diversity among Menière's disease (MD) patients is representative of selection bias or disease susceptibility.

Study Design

Retrospective medical record review and population-level analyses.

Setting

Tertiary referral center.

Patients

Cohort of 1091 patients diagnosed with MD by the tertiary otology service.

Main Outcome Measure

Demographic and population-level characteristics (age, sex, race, insurance status, ZIP code, median income, education level) compared with local, regional, health system, and otolaryngology clinic demographics.

Results

Patients seen for MD were significantly older than those seen throughout the otolaryngology clinic (median, 65.0 versus 58.8 yr) or health system (65.0 versus 50.8 yr). A majority of patients with MD were of White race (92%), compared with 2.7% Black race and 0.5% Asian. Using population-level data, median income and having medical insurance were significantly correlated with care for MD. A disproportionate rate of care for MD was seen in ZIP codes outside urban areas as compared with other otologic and otolaryngologic conditions seen in the same clinic.

Conclusion

Patients with MD are of older age, more likely to be of White race, and disproportionately from rural locales. The demographic profile of patients diagnosed with MD by tertiary otology is better explained by differential susceptibility to MD than by selection bias.
Sustained Low Efficiency Dialysis in Critically Ill Children With Acute Kidney Injury: Single-Center Observational Cohort in a Resource-Limited Setting
Authors: Shiri Swathi , Naik Naveen Maruti , AV Lalitha , Vasudevan Anil
Published: December 2022

OBJECTIVES:

To evaluate use of sustained low efficiency dialysis (SLED) in critically ill children with acute kidney injury in a resource-limited setting.

DESIGN:

Observational database cohort study (December 2016 to January 2020).

SETTING:

PICU of a tertiary hospital in India.

PATIENTS:

Critically ill children undergoing SLED were included in the study.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Demographic and clinical data, prescription variables, hemodynamic status, complications, kidney, and patient outcomes of all children undergoing SLED in the PICU were analyzed. A total of 33 children received 103 sessions of SLED. The median (interquartile range, IQR) age and weight of children who received SLED were 9 years (4.5–12.8 yr) and 26 kg (15.2–34 kg), respectively. The most common diagnosis was sepsis with septic shock in 17 patients, and the mean (±sd) Pediatric Risk of Mortality III score at admission was 11.8 (±6.4). The median (IQR) number and mean (±sd) duration of inotropes per session were 3 hours (2–4 hr) and 96 (±82) hours, respectively. Of 103 sessions, the most common indication for SLED was oligoanuria with fluid overload and the need for creating space for fluid and nutritional support in 45 sessions (44%). The mean (±sd) duration of SLED was 6.4 (±1.3) hours with 72 of 103 sessions requiring priming. The mean (±sd) ultrafiltration rate per session achieved was 4.6 (±3) mL/kg/hr. There was significant decrease in urea and creatinine by end of SLED compared with the start, with mean change in urea and serum creatinine being 32.36 mg/dL (95% CI, 18.53–46.18 mg/dL) (p < 0.001) and 0.70 mg/dL (95% CI, 0.35–1.06 mg/dL) (p < 0.001), respectively. Complications were observed in 44 of 103 sessions, most common being intradialytic hypotension (21/103) and bleeding at the catheter site (21/103). Despite complications in one third of the sessions, only nine sessions were prematurely stopped, and 23 of 33 patients receiving SLED survived.

Conclusion:

In critically ill children, our experience with SLED is that it is feasible and provides a viable form of kidney replacement therapy in a resource-limited setting.
Association between ten-eleven methylcytosine dioxygenase 2 genetic variation and viral load in people with HIV
Authors: Murray Daniel D. , Grund Birgit , MacPherson Cameron R. , Ekenberg Christina , Zucco Adrian G. , Reekie Joanne , Dominguez-Dominguez Lourdes , Leung Preston , Fusco Dahlene , Gras Julien , Gerstoft Jan , Helleberg Marie , Borges Álvaro H. , Polizzotto Mark N. , Lundgren Jens D.
Published: December 2022

Introduction:

Identifying genetic factors that influence HIV-pathogenesis is critical for understanding disease pathways. Previous studies have suggested a role for the human gene ten-eleven methylcytosine dioxygenase 2 (TET2) in modulating HIV-pathogenesis.

Methods:

We assessed whether genetic variation in TET2 was associated with markers of HIV-pathogenesis using both gene level and single nucleotide polymorphism (SNP) level association in 8512 HIV-positive persons across five clinical trial cohorts.

Results:

Variation at both the gene and SNP-level of TET2 was found to be associated with levels of HIV viral load (HIV-VL) consistently in the two cohorts that recruited antiretroviral-naïve participants. The SNPs occurred in two clusters of high linkage disequilibrium (LD), one associated with high HIV-VL and the other low HIV-VL, and were predominantly found in Black participants.

Conclusion:

Genetic variation in TET2 was associated with HIV-VL in two large antiretroviral therapy (ART)-naive clinical trial cohorts. The role of TET2 in HIV-pathogenesis warrants further investigation.
Characteristics of Potential and Actual Living Kidney Donors: A Single-center Experience
Authors: Cholin Liza K. , Schold Jesse D. , Arrigain Susana , Poggio Emilio D. , Sedor John R. , O’Toole John F. , Augustine Joshua J. , Wee Alvin C. , Huml Anne M.
Published: December 2022

Background.

There are limited data and no national capture of barriers associated with initiating and completing the donation process for potential living kidney donors (LKDs).

Methods.

We performed a retrospective analysis of 3001 intake forms completed by prospective LKDs from 2016 to 2019 at a single transplant center. We analyzed data from all potential donors who completed the intake until they became ineligible or withdrew or donation was complete. We used univariate and multivariate models to evaluate independent factors associated with donation at various stages in the donation process.

Results.

The donation process was deconstructed into 5 steps: intake form, immunologic compatibility testing, clinic evaluation, selection committee review, and donation. The highest percentage of potential donors dropped out after completing the intake form, primarily because of not responding to the follow-up phone call (22.6%). Of 455 potential LKDs that completed immunologic compatibility testing, 36% were ABO or crossmatch incompatible. One-hundred eighty-eight (7.5%) of all LKD applicants reached donation, the majority of whom were White (91.0%) and female (63.8%).

Conclusions.

A minority of LKD applicants make it to donation. Our ability to track all potential LKDs from the initial touch point to the transplant center will help us develop interventions to address barriers to a successful donation.
Early Detection of Epstein-Barr Virus as a Risk Factor for Chronic High Epstein-Barr Viral Load Carriage at a Living-donor–dominant Pediatric Liver Transplantation Center
Authors: Yamada Masaki , Fukuda Akinari , Ogura Miyuki , Shimizu Seiichi , Uchida Hajime , Yanagi Yusuke , Ishikawa Yuriko , Sakamoto Seisuke , Kasahara Mureo , Imadome Ken-Ichi
Published: December 2022

Background.

Epstein-Barr virus (EBV) infection and posttransplant lymphoproliferative disorders (PTLDs) after pediatric liver transplantation (LT) account for significant morbidity and mortality. Knowledge of EBV kinetics, epidemiology, and outcomes among pediatric living-donor LT cases is largely lacking. This study aims to provide clinical information related to EBV infection, chronic high EBV load (CHL) carriage, and PTLD at a living-donor–dominant pediatric LT center.

Methods.

A total of 5827 EBV load measurements from 394 LT recipients fulfilling inclusion criteria and their clinical data were analyzed. EBV loads >1000 copies/μg DNA (742 IU/μg DNA) were considered “high,” and CHL was defined by persistence >6 mo.

Results.

The highlighted results were as follows: (1) 94% of recipients underwent living-donor LT; (2) 80% of EBV seronegative recipients developed first EBV infection <2 y post-LT, and their EBV loads were consistently higher than those of seropositive recipients within <3 y post-LT but did not differ thereafter; (3) 61 (15%) recipients met CHL criteria, but none developed PTLD; (4) age <5 y, cytomegalovirus seronegative donors, and early development of EBV DNAemia <6 mo post-LT were independent risk factors for CHL; (5) the incidence of rejections after 1-y post-LT was comparably low among CHL carriers whose immunosuppression was minimized.

Conclusions.

Early detection of EBV following LT and CMV seronegative donors would facilitate risk stratification to prevent PTLD while titrating immunosuppression among pediatric LT recipients.
Humoral Responses in the Omicron Era Following 3-Dose SARS-CoV-2 Vaccine Series in Kidney Transplant Recipients
Authors: McEvoy Caitríona M. , Hu Queenie , Abe Kento T. , Yau Kevin , Oliver Matthew J. , Levin Adeera , Gingras Anne-Claude , Hladunewich Michelle A. , Yuen Darren A.
Published: December 2022

Background

Kidney transplant recipients (KTRs) have a diminished response to SARS-CoV-2 vaccination compared with immunocompetent individuals. Deeper understanding of antibody responses in KTRs following third-dose vaccination would enable identification of those who remain unprotected against Omicron.

Methods

We profiled antibody responses in KTRs pre- and at 1 and 3 mo post-third-dose SARS-CoV-2 mRNA-based vaccine. Binding antibody levels were determined by ELISA. Neutralization against wild type, Beta, Delta, and Omicron (BA.1) variants was determined using a SARS-CoV-2 spike-pseudotyped lentivirus assay.

Results

Forty-four KTRs were analyzed at 1 and 3 mo (n = 26) post-third dose. At 1 mo, the proportion of participants with a robust antibody response had increased significantly from baseline, but Omicron-specific neutralizing antibodies were detected in just 45% of KTRs. Median binding antibody levels declined at 3 mo, but the proportion of KTRs with a robust antibody response was unchanged; 38.5% KTRs maintained Omicron-specific neutralization at 3 mo. No clinical variables were significantly associated with Omicron-neutralizing antibodies, but antireceptor binding domain titers appeared to identify those with Omicron-specific neutralizing capacity.

Conclusions.

Over 50% of KTRs lack Omicron-specific neutralization capacity 1 mo post-third mRNA-vaccine dose. Antibody levels of responders were well preserved at 3 mo. Anti receptor binding domain antibody titers may identify patients with a detectable Omicron-neutralizing antibody response.
Blurred Lines: Memory, Perceptions, and Consciousness: Commentary on “Consciousness as a Memory System” by Budson et al (2022)
Authors: Hogendoorn Hinze
Published: December 2022

In the previous issue, Budson, Richman, and Kensinger (2022) put forth the intriguing proposal that consciousness may have evolved from the episodic memory system. In addition to providing a possible evolutionary trajectory for consciousness, I believe that viewing consciousness as an extension of memory in this way is particularly useful for understanding some of the puzzling temporal complexities that are inherent to consciousness. For example, due to neural transmission delays, our conscious experience must necessarily lag the outside world, which creates a paradox for both conscious perception (Do we see the past, rather than the present?) and action (How can we make rapid decisions if it takes so long to become conscious of something?). These paradoxes can be elegantly solved by treating consciousness as a memory system. Finally, the proposal put forth by Budson and colleagues (2022) aligns with the emerging perspective that consciousness, like memory, represents a narrative time line of events rather than any single instant. However, I believe that this conceptualization can be further extended to include not only the past, but also the future. In this way, consciousness can be provocatively viewed as the remembered past, present, and future.
Localized growth and remodelling drives spongy mesophyll morphogenesis
Authors: Treado John D. , Roddy Adam B. , Théroux-Rancourt Guillaume , Zhang Liyong , Ambrose Chris , Brodersen Craig R. , Shattuck Mark D. , O’Hern Corey S.
Published: December 2022

The spongy mesophyll is a complex, porous tissue found in plant leaves that enables carbon capture and provides mechanical stability. Unlike many other biological tissues, which remain confluent throughout development, the spongy mesophyll must develop from an initially confluent tissue into a tortuous network of cells with a large proportion of intercellular airspace. How the airspace in the spongy mesophyll develops while the tissue remains mechanically stable is unknown. Here, we use computer simulations of deformable polygons to develop a purely mechanical model for the development of the spongy mesophyll tissue. By stipulating that cell wall growth and remodelling occurs only near void space, our computational model is able to recapitulate spongy mesophyll development observed in
Arabidopsis thaliana
leaves. We find that robust generation of pore space in the spongy mesophyll requires a balance of cell growth, adhesion, stiffness and tissue pressure to ensure cell networks become porous yet maintain mechanical stability. The success of this mechanical model of morphogenesis suggests that simple physical principles can coordinate and drive the development of complex plant tissues like the spongy mesophyll.
A master equation for power laws
Authors: Roman Sabin , Bertolotti Francesco
Published: December 2022

We propose a new mechanism for generating power laws. Starting from a random walk, we first outline a simple derivation of the Fokker–Planck equation. By analogy, starting from a certain Markov chain, we derive a master equation for power laws that describes how the number of cascades changes over time (cascades are consecutive transitions that end when the initial state is reached). The partial differential equation has a closed form solution which gives an explicit dependence of the number of cascades on their size and on time. Furthermore, the power law solution has a natural cut-off, a feature often seen in empirical data. This is due to the finite size a cascade can have in a finite time horizon. The derivation of the equation provides a justification for an exponent equal to 2, which agrees well with several empirical distributions, including Richardson’s Law on the size and frequency of deadly conflicts. Nevertheless, the equation can be solved for any exponent value. In addition, we propose an urn model where the number of consecutive ball extractions follows a power law. In all cases, the power law is manifest over the entire range of cascade sizes, as shown through log–log plots in the frequency and rank distributions.
The problematic Cambrian arthropod
Tuzoia
and the origin of mandibulates revisited
Authors: Izquierdo-López Alejandro , Caron Jean-Bernard
Published: December 2022

The origin of mandibulates, the hyperdiverse arthropod group that includes pancrustaceans and myriapods, dates back to the Cambrian. Bivalved arthropod groups such as hymenocarines have been argued to be early mandibulates, but many species are still poorly known, and their affinities remain uncertain. One of the most common and globally distributed Cambrian bivalved arthropods is
Tuzoia
. Originally described in 1912 from the Burgess Shale based on isolated carapaces, its full anatomy has remained largely unknown. Here, we describe new specimens of
Tuzoia
from the Canadian Burgess Shale (Wuliuan, Cambrian) showcasing exceptionally preserved soft tissues, allowing for the first comprehensive reconstruction of its anatomy, ecology and evolutionary affinities. The head bears antennae and differentiated cephalic appendages. The body is divided into a cephalothorax, a homonomous trunk bearing
ca
10 pairs of legs with heptopodomerous endopods and enlarged basipods, and a tail fan with two pairs of caudal rami. These traits suggest that
Tuzoia
swam along the seafloor and used its spinose legs for predation or scavenging.
Tuzoia
is retrieved by a Bayesian phylogenetic analysis as an early mandibulate hymenocarine lineage, exemplifying the rapid diversification of this group in open marine environments during the Cambrian Explosion.
Preserving the woody plant tree of life in China under future climate and land-cover changes
Authors: Peng Shijia , Hu Ruocheng , Velazco Santiago José Elías , Luo Yuan , Lyu Tong , Zhang Xiaoling , Zhang Jian , Wang Zhiheng
Published: December 2022

The tree of life (TOL) is severely threatened by climate and land-cover changes. Preserving the TOL is urgent, but has not been included in the post-2020 global biodiversity framework. Protected areas (PAs) are fundamental for biological conservation. However, we know little about the effectiveness of existing PAs in preserving the TOL of plants and how to prioritize PA expansion for better TOL preservation under future climate and land-cover changes. Here, using high-resolution distribution maps of 8732 woody species in China and phylogeny-based Zonation, we find that current PAs perform poorly in preserving the TOL both at present and in 2070s. The geographical coverage of TOL branches by current PAs is approx. 9%, and less than 3% of the identified priority areas for preserving the TOL are currently protected. Interestingly, the geographical coverage of TOL branches by PAs will be improved from 9% to 52–79% by the identified priority areas for PA expansion. Human pressures in the identified priority areas are high, leading to high cost for future PA expansion. We thus suggest that besides nature reserves and national parks, other effective area-based conservation measures should be considered. Our study argues for the inclusion of preserving the TOL in the post-2020 conservation framework, and provides references for decision-makers to preserve the Earth's evolutionary history.