bluuebunny/crossref_metadata_2025 huggingface dataset:
Distribution of Serotypes Causing Invasive Pneumococcal Disease in Children From High-Income Countries and the Impact of Pediatric Pneumococcal Vaccination
Authors: Grant Lindsay R , Slack Mary P E , Theilacker Christian , Vojicic Jelena , Dion Stephane , Reinert Ralf-Rene , Jodar Luis , Gessner Bradford D
Published: July 2022

Background

The introduction and adoption of pneumococcal conjugate vaccines (PCVs) into pediatric national immunization programs (NIPs) has led to large decreases in invasive pneumococcal disease (IPD) incidence caused by vaccine serotypes. Despite these reductions, the global IPD burden in children remains significant.

Methods

We collected serotype-specific IPD data from surveillance systems or hospital networks of all 30 high-income countries that met inclusion criteria. Data sources included online databases, surveillance system reports, and peer-reviewed literature. Percentage of serotyped cases covered were calculated for all countries combined and by PCV type in the pediatric NIP.

Results

We identified 8012 serotyped IPD cases in children <5 or ≤5 years old. PCV13 serotype IPD caused 37.4% of total IPD cases, including 57.1% and 25.2% for countries with PCV10 or PCV13 in the pediatric NIP, respectively, most commonly due to serotypes 3 and 19A (11.4% and 13.3%, respectively, across all countries). In PCV10 countries, PCV15 and PCV20 would cover an additional 45.1% and 55.6% of IPD beyond serotypes contained in PCV10, largely due to coverage of serotype 19A. In PCV13 countries, PCV15 and PCV20 would cover an additional 10.6% and 38.2% of IPD beyond serotypes contained in PCV13. The most common IPD serotypes covered by higher valency PCVs were 10A (5.2%), 12F (5.1%), and 22F and 33F (3.5% each).

Conclusions

Much of the remaining IPD burden is due to serotypes included in PCV15 and PCV20. The inclusion of these next generation PCVs into existing pediatric NIPs may further reduce the incidence of childhood IPD.
Impact of Hepatitis C Virus Cure on Depressive Symptoms in the Human Immunodeficiency Virus-Hepatitis C Virus Coinfected Population in Canada
Authors: Marathe Gayatri , Moodie Erica E M , Brouillette Marie-Josée , Lanièce Delaunay Charlotte , Cox Joseph , Martel-Laferrière Valérie , Gill John , Cooper Curtis , Pick Neora , Vachon Marie-Louise , Walmsley Sharon , Klein Marina B ,   the Canadian Co-Infection Cohort, Barrett Lisa , Cohen Jeff , Conway Brian , Cooper Curtis , Côté Pierre , Cox Joseph , Gill M John , Haider Shariq , Haase David , Hull Mark , Martel-Laferrière Valérie , Montaner Julio , Moodie Erica E M , Pick Neora , Rouleau Danielle , Sadr Aida , Sanche Steve , Sandre Roger , Tyndall Mark , Vachon Marie-Louise , Walmsley Sharon , Wong Alexander
Published: July 2022

Background

Depression is common in people with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), with biological and psychosocial mechanisms at play. Direct acting antivirals (DAA) result in high rates of sustained virologic response (SVR), with minimal side-effects. We assessed the impact of SVR on presence of depressive symptoms in the HIV-HCV coinfected population in Canada during the second-generation DAA era (2013–2020).

Methods

We used data from the Canadian CoInfection Cohort (CCC), a multicenter prospective cohort of people with a HIV and HCV coinfection, and its associated sub-study on food security. Because depression screening was performed only in the sub-study, we predicted Center for Epidemiologic Studies Depression Scale-10 classes in the CCC using a random forest classifier and corrected for misclassification. We included participants who achieved SVR and fit a segmented modified Poisson model using an interrupted time series design, adjusting for time-varying confounders.

Results

We included 470 participants; 58% had predicted depressive symptoms at baseline. The median follow-up was 2.4 years (interquartile range [IQR]: 1.0–4.5.) pre-SVR and 1.4 years (IQR: 0.6–2.5) post-SVR. The pre-SVR trend suggested depressive symptoms changed little over time, with no immediate level change at SVR. However, post-SVR trends showed a reduction of 5% per year (risk ratio: 0.95 (95% confidence interval [CI]: .94–.96)) in the prevalence of depressive symptoms.

Conclusions

In the DAA era, predicted depressive symptoms declined over time following SVR. These improvements reflect possible changes in biological pathways and/or better general health. If such improvements in depression symptoms are durable, this provides an additional reason for treatment and early cure of HCV.
Validation of a Health-Related Quality of Life Questionnaire in Patients With Recurrent Clostridioides difficile Infection in ECOSPOR III, a Phase 3 Randomized Trial
Authors: Lapin Brittany , Garey Kevin W , Wu Henry , Pham Sissi V , Huang Shirley P , Reese Pat Ray , Wang Elaine , Deshpande Abhishek
Published: July 2022

Background

Debilitating symptoms of recurrent Clostridioides difficile infection (rCDI) often lead to long-term effects on health-related quality-of-life (HRQOL). In ECOSPOR III, SER-109, an investigational oral microbiome therapeutic, was superior to placebo in reducing rCDI. We investigated the validity, reliability, and responsiveness of a 32-item, CDI-specific questionnaire—the Clostridium difficile Quality of Life Survey (Cdiff32)—across mental, physical, and social domains in patients with rCDI.

Methods

In this post hoc analysis of a phase 3 clinical trial, 182 outpatients with rCDI completed Cdiff32 and EQ-5D at baseline and at 1 and 8 weeks. Cdiff32 was evaluated for item performance, internal reliability, and convergent validity. To assess known-groups validity, Cdiff32 scores were compared by disease recurrence status at week 1; internal responsiveness was evaluated in the nonrecurrent disease group by 8 weeks by means of paired t test.

Results

All 182 patients (mean age [standard deviation], 65.5 [16.5] years; 59.9% female) completed baseline Cdiff32. Confirmatory factor analysis identified 3 domains (physical, mental, and social relationships) with good item fit. High internal reliability was demonstrated (Cronbach α = 0.94 with all subscales >0.80). Convergent validity was evidenced by significant correlations between Cdiff32 subscales and EQ-5D (r = 0.29–0.37; P < .001). Cdiff32 differentiated patients by disease recurrence status at week 1 (effect sizes, 0.38–0.42; P < .05 overall), with significant improvement from baseline through week 8 in patients with nonrecurrent disease at week 1 (effect sizes, 0.75–1.02; P < .001 overall).

Conclusions

Cdiff32 is a valid, reliable, and responsive disease-specific HRQOL questionnaire that is fit for purpose for interventional treatment trials. The significant improvement in patients with nonrecurrent disease by 8 weeks demonstrates the negative impact of rCDI on HRQOL.
Platypnea orthodeoxia syndrome after recent stroke: a case report of a sandwiched right atrium
Authors: Wiertsema Marijn H , Dickinson Michael G , Hoendermis Elke S , Geluk Christiane A
Published: July 2022

Background

Platypnea orthodeoxia syndrome (POS) is a condition characterized by onset or worsening of dyspnoea and desaturation in upright position that is relieved by returning to a supine position. This case report illustrates a sudden onset of severe platypnea caused by compression of the right atrium (RA) due to aortic dilatation and unilateral diaphragmatic paralysis after a recent stroke.

Case summary

A 71-year-male patient with a medical history of recent stroke of the left hemisphere was referred to emergency department with acute dyspnoea. During observation in the emergency department, desaturation was noted in upright position. A contrast computed tomography excluded pulmonary embolism but revealed a dilated aortic root and an elevated right hemidiaphragm. The RA was compressed between these two structures (sandwiched). Given the clinical suspicion of a POS, a transoesophageal echocardiography was performed which confirmed the presence of a persistent foramen ovale (PFO) in supine position. In upright position, there was a torrential increase in right-to-left shunting. The PFO was closed using an Occlutech™ device. Directly after the procedure, the patient was symptom free.

Discussion

A rise in RA pressure or difference in flow pattern in the RA can make a PFO become symptomatic. Elevated RA pressure was ruled out. Most anatomical pathologies influencing the flow pattern develop slowly over time. This case shows a presentation of POS after a recent stroke possible due to change in anatomy because of right hemidiaphragm paralysis in combination with the aortic dilatation.
Surgical aortic valve replacement with a stented pericardial bioprosthesis: 5-year outcomes
Authors: Klautz Robert J M , Dagenais François , Reardon Michael J , Lange Rüdiger , Moront Michael G , Labrousse Louis , Weissman Neil J , Rao Vivek , Patel Himanshu J , Liu Fang , Sabik Joseph F
Published: July 2022

OBJECTIVES

This analysis evaluated the safety, durability and haemodynamic performance of a stented bovine pericardial valve through 5 years of follow-up in patients with an indication for surgical aortic valve replacement.

METHODS

Kaplan–Meier analysis was used to estimate the incidence of survival and valve-related thromboembolism, major paravalvular leak, endocarditis, structural valve deterioration (SVD) and reintervention. The mean aortic gradient and New York Heart Association (NYHA) functional class were also evaluated.

RESULTS

A total of 1118 patients have received the Avalus valve; 564 have completed the 5-year follow-up. The median follow-up was 4.85 years (4810 patient-years total follow-up). At baseline, the mean age was 70.2 ± 9.0 years; 75.1% of patients were male. The Society of Thoracic Surgeons predicted risk of mortality was 2.0 ± 1.4%. Most patients were in NYHA functional class II (46.8%) or III (40.3%). At the 5-year follow-up, the overall Kaplan–Meier survival rate was 88.1% (85.9–90.0%). The Kaplan–Meier event rates were 5.6% (4.3–7.2%) for thromboembolism, 4.4% (3.2–6.0%) for endocarditis, 0.2% (0.0–0.7%) for a major paravalvular leak and 3.2% (2.3–4.6%) for reintervention. There were no cases of SVD. The mean gradient decreased from 42.1 ± 17.1 mmHg at baseline, to 13.1 ± 4.7 mmHg at discharge and remained stable at 12.5 ± 4.6 mmHg at 5 years. More than 95% of patients were in NYHA functional class I/II 5 years after surgery.

CONCLUSIONS

The findings of a high survival rate, excellent safety, no SVD and stable haemodynamic performance and functional status through 5 years of follow-up are encouraging. Additional follow-up is needed to assess the long-term durability of this contemporary surgical bioprosthesis.
Inhibition of SARS-CoV-2 wild-type (Wuhan-Hu-1) and Delta (B.1.617.2) strains by marine sulfated glycans
Authors: Dwivedi Rohini , Sharma Poonam , Farrag Marwa , Kim Seon Beom , Fassero Lauren A , Tandon Ritesh , Pomin Vitor H
Published: July 2022

The Coronavirus disease pandemic has steered the global therapeutic research efforts toward the discovery of potential anti-severe acute respiratory syndrome coronavirus (SARS-CoV-2) molecules. The role of the viral spike glycoprotein (S-protein) has been clearly established in SARS-CoV-2 infection through its capacity to bind to the host cell surface heparan sulfate proteoglycan (HSPG) and angiotensin-converting enzyme-2. The antiviral strategies targeting these 2 virus receptors are currently under intense investigation. However, the rapid evolution of the SARS-CoV-2 genome has resulted in numerous mutations in the S-protein posing a significant challenge for the design of S-protein-targeted inhibitors. As an example, the 2 key mutations in the S-protein receptor-binding domain (RBD), L452R, and T478K in the SARS-CoV-2 Delta variant (B.1.617.2) confer tighter binding to the host epithelial cells. Marine sulfated glycans (MSGs) demonstrate excellent inhibitory activity against SARS-CoV-2 via competitive disruption of the S-protein RBD-HSPG interactions and thus have the potential to be developed into effective prophylactic and therapeutic molecules. In this study, 7 different MSGs were evaluated for their anti-SARS-CoV-2 activity in a virus entry assay utilizing a SARS-CoV-2 pseudovirus coated with S-protein of the wild-type (Wuhan-Hu-1) or the Delta (B.1.617.2) strain. Although all tested MSGs showed strong inhibitory activity against both strains, no correlations between MSG structural features and virus inhibition could be drawn. Nevertheless, the current study provides evidence for the maintenance of inhibitory activity of MSGs against evolving SARS-CoV-2 strains.
Achieving holistic, quality-of-life focused care: description of a Compassion Care Community initiative in Canada
Authors: Howard Michelle , Pfaff Kathryn , Sattler Deborah , Dolovich Lisa , Marshall Denise , Zwarenstein Merrick , Upshur Ross
Published: July 2022

The compassionate community movement as both a public health approach and a social model of care for various life stages is gaining traction in Canada and elsewhere. One example is the Windsor-Essex Compassion Care Community (WECCC), an evidence-based model and set of tools to improve the quality of life, health and wellness of vulnerable and aging populations by identifying and addressing upstream and downstream social and other risks to physical and mental health. This paper presents findings from the WECCC pilot evaluation. The WECCC initiative provided one-on-one volunteer-supported quality of life assessment, resource navigation and goals support program (Catalyzing Community Connections). This was augmented with public education sessions on social connection and loneliness (Importance of Being Connected) for the broader population. The RE-AIM framework was used to frame evaluation of WECCC through the first 4 years. Questionnaires were used to evaluate participant outcomes related to implementation and effectiveness. Interviews and focus groups were completed to understand impacts. From 2017 to 2020, WECCC has engaged over 2,500 individuals, 65 organizations and 400 volunteers combined in both programs. Nearly all (82% to 95%) participants reported positive changes to health, quality of life and/or social connections. This developmental phase of a compassionate community initiative has allowed piloting of an evaluation framework focusing on reach, adoption, implementation and early signals of effectiveness and maintenance. This demonstration provides information on feasibility, acceptability and potential impacts of this type of over-arching community initiative.
Indigenous women's resistances at the start and end of the nuclear fuel chain
Authors: Runyan Anne Sisson
Published: July 2022

By focusing attention on the beginning and end of the nuclear fuel chain, which mostly takes place on Indigenous lands, this article examines the gendered effects of uranium mining and nuclear waste dumping on North American Indigenous women and their resistances to these processes. In so doing, the article reveals how mining and dumping are made possible by the denial or deflection not only of Indigenous peoples' sovereignty over their lands, but also of Indigenous women's political and cultural authority and bodily autonomy. The article further shows how Indigenous women's reassertions of their nations' and their own self-determination through resurgent practices, like water-walking in the case of the Anishnaabe women, contribute significantly to the resolve of Indigenous nations to refuse to consent to further nuclear colonialism; an example of this is the case of the Saugeen Ojibway Nation's referendum that stopped the siting of the deep geological repository for nuclear waste on their territory. This case suggests it is incumbent on non-Indigenous feminist IR critics of nuclear politics to engage with Indigenous feminist thought and centre Indigenous women's resistances to the nuclear fuel chain, in order to address the consequences of nuclear waste dumping in anti-colonial, and socially and environmentally just, ways.
MiniBioReactor Array (MBRA) in vitro gut model: a reliable system to study microbiota-dependent response to antibiotic treatment
Authors: Hobson C A , Vigue L , Naimi S , Chassaing B , Magnan M , Bonacorsi S , Gachet B , El Meouche I , Birgy A , Tenaillon O
Published: July 2022

Background

Antimicrobial drugs are mostly studied for their impact on emergence of bacterial antibiotic resistance, but their impact on the gut microbiota is also of tremendous interest. In vitro gut models are important tools to study such complex drug–microbiota interactions in humans.

Methods

The MiniBioReactor Array (MBRA) in vitro microbiota system; a single-stage continuous flow culture model, hosted in an anaerobic chamber; was used to evaluate the impact of three concentrations of a third-generation cephalosporin (ceftriaxone) on faecal microbiota from two healthy donors (treatment versus control: three replicates per condition). We conducted 16S microbiome profiling and analysed microbial richness, diversity and taxonomic changes. β-Lactamase activities were evaluated and correlated with the effects observed in the MBRA in vitro system.

Results

The MBRA preserved each donor’s specificities, and differences between the donors were maintained through time. Before treatment, all faecal cultures belonging to the same donor were comparable in composition, richness, and diversity. Treatment with ceftriaxone was associated with a decrease in α-diversity, and an increase in β-diversity index, in a concentration-dependent manner. The maximum effect on diversity was observed after 72 h of treatment. Importantly, one donor had a stronger microbiota β-lactamase activity that was associated with a reduced impact of ceftriaxone on microbiota composition.

Conclusions

MBRA can reliably mimic the intestinal microbiota and its modifications under antibiotic selective pressure. The impact of the treatment was donor- and concentration-dependent. We hypothesize these results could be explained, at least in part, by the differences in β-lactamase activity of the microbiota itself. Our results support the relevance and promise of the MBRA system to study drug–microbiota interactions.
Evaluation of antibiotic prescribing for ambulatory patients seeking primary dental care services in a public hospital in Ghana: a clinical audit study
Authors: Sefah Israel Abebrese , Sneddon Jacqueline , Essah Darius Obeng , Kurdi Amanj , Fadare Joseph , Jairoun Ammar Abdulrahman , Godman Brian
Published: July 2022

Background

One in 10 of all antibiotic prescriptions globally are for dental conditions with 80% of them being inappropriate, making it a potential driver of antimicrobial resistance.

Objectives

To evaluate the appropriateness of antibiotic use among ambulatory patients seeking dental care services in a public hospital in Ghana.

Methods

A retrospective clinical audit was conducted by extracting the medical records of all patients seeking dental care at the ambulatory care clinic of Keta Municipal Hospital (KMH) from January 2020 to December 2020 using the hospital’s electronic database. Descriptive statistics, bivariate and multivariate analysis were performed on the data collected.

Results

Overall, 1433 patient medical records were extracted from the database within the study period. The mean age of the patients identified was 39.9 years with almost two-thirds being female. The majority (91.1%, n = 1306) of them were attended to by a dental nurse. In total, 88.6% (n = 1269) of the patients received antibiotics and 87.5% (n = 1254) of antibiotics prescribed were non-compliant with Ghana Standard Treatment Guidelines. Three-quarters of the dental conditions were managed with dual antibiotics comprising amoxicillin and metronidazole. Antibiotic prescription was associated with age, gender, type of prescriber and type of dental condition diagnosed.

Conclusions

There is a high usage of antibiotics for dental conditions managed at the outpatient section of the hospital and most are inappropriate. Development of local guidelines supported by education of dental clinicians on empirical use of antibiotics is a suitable target for the antimicrobial stewardship team to address in KMH.
Decreasing the Lower Limit of Quantitation for Urine Albumin Improves Clinical Utility
Authors: Greene Dina N , Marzinke Mark A , Carter Claire , Chen Joyce , Hoenig Melanie P , Rummel Michael
Published: July 2022

Background

Urine albumin-to-creatinine ratio (uACR) is a screening assay for chronic kidney disease (CKD). A value of >30 mg/g is flagged abnormal, but lower ratios have prognostic implications. Thus, to maximize diagnostic utility, urine albumin (uAlb) should be measurable to 3 mg/L to match the lowest creatinine concentration generally utilized (10 mg/dL). Most uAlb assays have lower limits of quantitation (LLOQs) 2- to 4-fold higher. We sought to determine the performance characteristics of a commonly used uAlb assay at 3 mg/L and to evaluate the clinical screening impact of reducing the LLOQ.

Methods

Urine was serially diluted to assess uAlb linearity and precision for concentrations near the claimed LLOQ (12 mg/L). Samples (n = 30) with uAlb <12 mg/L were compared between laboratories. Sequential samples (n = 1239) were evaluated for clinical impact of reducing the measuring range to 3 mg/L.

Results

The assay was linear to 1.6 mg/L. Interday precision at 3.7 mg/L and 4.3 mg/L was 7.7% and 8.6%, respectively. Minimal bias was observed between labs (y = 1.091x − 0.75; average bias = −0.13 mg/L). Clinical validation demonstrated 501 of 1239 samples (40.4%) had uAlb <12 mg/L. Using 11.9 mg/L as the numerator for samples with uAlb <12 mg/dL and urine creatinine >10 mg/L, 107 of 499 (21.4%) would have a ratio flagged abnormal at >30 mg/g. Using the numeric value for these samples to 3 mg/L reduced alarm to <1%.

Conclusions

A uAlb LLOQ of 3 mg/L improves screening utility of uACR by simplifying reporting and clinical interpretation when uAlb is low and provides clinical information for prognostic tools developed for people at risk of CKD.
Introducing the Revised and Updated Financial Reform Database
Authors: Omori Sawa
Published: July 2022

This article introduces a revised and updated version of the Financial Reform Database, which is widely used by economists and political economists. In this revision, country coverage is extended from 91 to 100 economies. Also, the time period covered is extended from 1973–2005 to 1973–2013. Furthermore, the coding rule relating to the enhancement of banking supervision is revised to enhance the clarity of the coding criteria used to measure the independence of a banking supervisory agency, taking into account the concepts of institutional independence and supervisory independence. In addition, in order to systematically compare policy changes across time and countries, seven dimensions of financial policies are further divided into 20 financial policy subdimensions, and each of these subdimensional policy scores is separately coded in this revision. This allows researchers to utilize each subdimension depending on their interests. The detailed policy description of each subdimensional policy reform for all countries and all years is made publicly available. In this article, an overview of the updated Financial Reform Database is provided.
A Chromosome-Scale Genome Assembly of the Okapi (Okapia Johnstoni)
Authors: Winter Sven , Coimbra Raphael T F , Helsen Philippe , Janke Axel
Published: July 2022

The okapi (Okapia johnstoni), or forest giraffe, is the only species in its genus and the only extant sister group of the giraffe within the family Giraffidae. The species is one of the remaining large vertebrates surrounded by mystery because of its elusive behavior as well as the armed conflicts in the region where it occurs, making it difficult to study. Deforestation puts the okapi under constant anthropogenic pressure, and it is currently listed as “Endangered” on the IUCN Red List. Here, we present the first annotated de novo okapi genome assembly based on PacBio continuous long reads, polished with short reads, and anchored into chromosome-scale scaffolds using Hi-C proximity ligation sequencing. The final assembly (TBG_Okapi_asm_v1) has a length of 2.39 Gbp, of which 98% are represented by 28 scaffolds > 3.9 Mbp. The contig N50 of 61 Mbp and scaffold N50 of 102 Mbp, together with a BUSCO score of 94.7%, and 23 412 annotated genes, underline the high quality of the assembly. This chromosome-scale genome assembly is a valuable resource for future conservation of the species and comparative genomic studies among the giraffids and other ruminants.
Racializing Trade in Corn: México Fights Maíz Imports and GMOs
Authors: Hernández-López Ernesto
Published: July 2022

International economic law (IEL) is racialized in México. This is evident with the North American Free Trade Agreement, US Mexico Canada Agreement (USMCA), and ongoing litigation changing how Mexicans grow, buy, and consume corn. Racialization develops from law privileging foreign access, at the cost of domestic abilities to counter economic entry. This has domestic and international consequences. Mestizo, campesino, and Indigenous sectors disproportionately bear the domestic effects of corn imports and GMO (genetically modified organism) corn. Imports and GMOs displace rural labor. Meanwhile, GMOs irreparably harm biodiversity. The USMCA protects ‘trade in’ GMOs while simultaneously discounting sovereign determinations by Mexican regulators. This echoes international law’s history of racist reasoning to exclude Global South states. This article proposes racial capitalism methods to pinpoint how and where IEL racializes cross-border trade. They show how neoliberal laws resulted in price spikes, labor migration, and unhealthy diets. Current GMO controversies open the door to two IEL paths: resistance or market access. As resistance, Mexican court rulings based on Precautionary Principle norms prohibit GMO corn seeds. With market access, the USMCA harmonizes biotechnology regulations, effectively trumping determinations by Mexican authorities. In sum, as neoliberal and current developments show, IEL racializes trade with disproportionate consequences felt domestically and by displacing Mexican sovereignty internationally.
Moss C, N, P and K stoichiometry and their relationships are related to soil nutrients and environment in a temperate desert of central Asia
Authors: Li Yong-Gang , Zhou Xiao-Bing , Lu Yongxing , Zhang Yuan-Ming
Published: July 2022

Previous studies showed that moss stoichiometric characteristics were influenced by moss patch size, shrubs and the environment in the desert. The study of moss stoichiometry in different spatial distribution areas is crucial for an understanding of growth and adaptation strategy of the mosses. In this study, the dominant moss (Syntrichia caninervis) of biological soil crusts and soil under the moss patches in the Gurbantunggut Desert were selected to determine their stoichiometry in different dunes and sites. Moss stoichiometry and soil available nutrients were significantly influenced by different distribution areas except for moss C. The Nabovegroundvs. Nbelowground, Pabovegroundvs. Pbelowground and Kabovegroundvs. Kbelowground scaling exponents of moss were 0.251, 0.389 and 0.442, respectively. The N vs. P scaling exponents were 0.71, 0.84 in above- and below-ground parts of moss. Moss stoichiometry was disproportionately distributed in the above-ground and below-ground parts. Moreover, moss N, P and K elements were influenced by mean annual precipitation (MAP), longitude and soil nutrients. The nutrients of moss were affected by spatial distribution, mean annual temperature (MAT), MAP and soil nutrients. The growth of moss was limited by N element in the temperate desert. This study provides the stoichiometric characteristics of C, N, P and K of moss at different spatial scales and explores their relationships with environmental variables, which can help understand nutrient patterns and utilization strategy of N, P and K, and their potential responses to global climate changes in desert.
‘Low-hanging fruit’? Direct supply in China’s natural gas market reform
Authors: Fang Mandy Meng
Published: July 2022

This article is one of the first systematic discussions of the legal and regulatory aspects of direct supply in China’s gas market reform. By allowing large users to bypass urban gas companies and negotiate directly with upstream producers, direct supply can propel China’s gas sector towards a higher degree of marketization. Among the range of measures undertaken to reform the gas market, direct supply has received far less attention. Nevertheless, China’s regulators and policymakers at the central and sub-national levels have increasingly acknowledged the key role of direct supply in reducing the cost of gas and fostering more market competition. However, the remaining challenges to the implementation of direct supply are multiple and mainly originate from the extant restraints posed by the Chinese regulatory system governing the gas sector. Against this background, this article argues that the localized implementation of direct supply represents a ‘low-hanging fruit’ in China’s gas market reform.
The SAMI Galaxy Survey: the relationship between galaxy rotation and the motion of neighbours
Authors: Mai Yifan , Vaughan Sam P , Croom Scott M , van de Sande Jesse , Barsanti Stefania , Bland-Hawthorn Joss , Brough Sarah , Bryant Julia J , Colless Matthew , Goodwin Michael , Groves Brent , Konstantopoulos Iraklis S , Lawrence Jon S , Lorente Nuria P F , Richards Samuel N
Published: July 2022

Using data from the SAMI Galaxy Survey, we investigate the correlation between the projected stellar kinematic spin vector of 1397 SAMI galaxies and the line-of-sight motion of their neighbouring galaxies. We calculate the luminosity-weighted mean velocity difference between SAMI galaxies and their neighbours in the direction perpendicular to the SAMI galaxies’ angular momentum axes. The luminosity-weighted mean velocity offset between SAMI galaxies and neighbours, which indicates the signal of coherence between the rotation of the SAMI galaxies and the motion of neighbours, is 9.0 ± 5.4 km s−1 (1.7σ) for neighbours within 1 Mpc. In a large-scale analysis, we find that the average velocity offsets increase for neighbours out to 2 Mpc. However, the velocities are consistent with zero or negative for neighbours outside 3 Mpc. The negative signals for neighbours at a distance around 10 Mpc are also significant at the ∼2σ level, which indicate that the positive signals within 2 Mpc might come from the variance of large-scale structure. We also calculate average velocities of different subsamples, including galaxies in different regions of the sky, galaxies with different stellar masses, galaxy type, λRe, and inclination. Although subsamples of low-mass, high-mass, early-type, and low-spin galaxies show the 2–3σ signal of coherence for the neighbours within 2 Mpc, the results for different inclination subsamples and large-scale results suggest that the ∼2σ signals might result from coincidental scatter or variance of large-scale structure. Overall, the modest evidence of coherence signals for neighbouring galaxies within 2 Mpc needs to be confirmed by larger samples of observations and simulation studies.
Confronting double-detonation sub-Chandrasekhar models with the low-luminosity suppression of Type Ia supernovae
Authors: Ghosh Arka , Kushnir Doron
Published: July 2022

Type Ia supernovae (SNe Ia) are likely the thermonuclear explosions of carbon–oxygen (CO) white-dwarf (WD) stars, but their progenitor systems remain elusive. Recently, Sharon & Kushnir used The Zwicky Transient Facility Bright Transient Survey to construct a synthesized 56Ni mass, MNi56, distribution of SNe Ia. They found that the rate of low-luminosity ($M_\text{Ni56}\approx 0.15\, \mathrm{M}_{\odot }$) SNe Ia is lower by a factor of ∼10 than the more common $M_\text{Ni56}\approx 0.7\, \mathrm{M}_{\odot }$ events. We here show that in order for the double-detonation model (DDM, in which a propagating thermonuclear detonation wave, TNDW, within a thin helium shell surrounding a sub-Chandrasekhar mass CO core triggers a TNDW within the core) to explain this low-luminosity suppression, the probability of a low-mass ($\approx 0.85\, \mathrm{M}_{\odot }$) WD explosion should be ∼100-fold lower than that of a high-mass ($\approx 1.05\, \mathrm{M}_{\odot }$) WD. One possible explanation is that the ignition of low-mass CO cores is somehow suppressed. We use accurate one-dimensional numerical simulations to show that if a TNDW is able to propagate within the helium shell, then the ignition within the CO core is guaranteed (resolved here for the first time in a full-star simulation), even for $0.7\, \mathrm{M}_{\odot }$ WDs, providing no natural explanation for the low-luminosity suppression. DDM could explain the low-luminosity suppression if the mass distribution of primary WDs in close binaries is dramatically different from the field distribution; if the Helium shell ignition probability is suppressed for low-mass WDs; or if multidimensional perturbations significantly change our results.
New, late-type spectroscopic binaries with X-ray emission
Authors: Frasca A , Catanzaro G , Busà I , Guillout P , Alonso-Santiago J , Ferrara C , Giarrusso M , Munari M , Leone F
Published: July 2022

In this paper, we present a spectroscopic study of six double-lined binaries, five of which were recently discovered in a high-resolution spectroscopic survey of optical counterparts of stellar X-ray sources. Thanks to high-resolution spectra acquired with CAOS spectropolarimeter during 7 yr, we were able to measure the radial velocities of their components and determine their orbital elements. We have applied our code compo2 to determine the spectral types and atmospheric parameters of the components of these spectroscopic binaries and found that two of these systems are composed of main-sequence stars, while the other four contain at least one evolved (giant or subgiant) component, similar to other well-known RS CVn systems. The subtraction of a photospheric template built up with spectra of non-active stars of the same spectral type as those of the components of each system has allowed us to investigate the chromospheric emission that fills in the H α cores. We found that the colder component is normally the one with the largest H α emission. None of the systems show a detectable Li iλ6708 line, with the exception of TYC 4279-1821-1, which exhibits high photospheric abundances in both components. Photometric time-series from the literature allowed us to assess that the five systems with a nearly circular orbit have also photometric periods close or equal to the orbital ones, indicating spin–orbit synchronization. For the system with a highly eccentric orbit, a possible pseudo-synchronization with the periastron velocity is suggested.
Galaxy cluster photons alter the ionization state of the nearby warm–hot intergalactic medium
Authors: Štofanová Lýdia , Simionescu Aurora , Wijers Nastasha A , Schaye Joop , Kaastra Jelle S
Published: July 2022

The physical properties of the faint and extremely tenuous plasma in the far outskirts of galaxy clusters, the circumgalactic media of normal galaxies, and filaments of the cosmic web remain one of the biggest unknowns in our story of large-scale structure evolution. Modelling the spectral features due to emission and absorption from this very diffuse plasma poses a challenge, as both collisional and photoionization processes must be accounted for. In this paper, we study the ionization by photons emitted by the intracluster medium in addition to the photoionization by the cosmic ultraviolet/X-ray background on gas in the vicinity of galaxy clusters. For near-massive clusters such as A2029, the ionization parameter can no longer describe the ionization balance uniquely. The ionization fractions (in particular of C iv, C v, C vi, N vii, O vi, O vii, O viii, Ne viii, Ne ix, and Fe xvii) obtained by taking into account the photoionization by the cosmic background are either an upper or lower limit to the ionization fraction calculated as a function of distance from the emission from the cluster. Using a toy model of a cosmic web filament, we predict how the cluster illumination changes the column densities for two different orientations of the line of sight. For lines of sight passing close to the cluster outskirts, O vi can be suppressed by a factor of up to 4.5, O vii by a factor of 2.2, C v by a factor of 3, and Ne viii can be boosted by a factor of 2, for low-density gas.
Determination of fluorine distribution in shark teeth by laser-induced breakdown spectroscopy
Authors: Manard Benjamin T , Hintz Christopher J , Quarles C Derrick , Burns William , Zirakparvar N Alex , Dunlap Daniel R , Beiswenger Toya , Cruz-Uribe Alicia M , Petrus Joseph A , Hexel Cole R
Published: July 2022

Quantifying the chemical composition of fast-growing hard tissues in the environment can shed valuable information in terms of understanding ecosystems both prehistoric and current. Changes in chemical composition can be correlated with environmental conditions and can provide information about the organism's life. Sharks can lose 0.1 to 1.1 teeth/day, depending on species, which offers a unique opportunity to record environmental changes over a short duration of time. Shark teeth contain a biomineral phase that is made up of fluorapatite [Ca5(PO4)3F], and the F distribution within the tooth can be correlated to tooth hardness. Typically, this is determined by bulk acid digestion, energy-dispersive X-ray spectroscopy (EDS), or wavelength-dispersive spectroscopy. Here we present laser-induced breakdown spectroscopy (LIBS) as an alternative and faster approach for determining F distribution within shark teeth. Using a two-volume laser ablation chamber (TwoVol3) with innovative embedded collection optics for LIBS, shark teeth were investigated from sand tiger (Carcharias Taurus), tiger (Galeocerdo Cuvier), and hammerhead sharks (Sphyrnidae). Fluorine distribution was mapped using the CaF 603 nm band (CaF, Β 2Σ+ → X 2Σ+) and quantified using apatite reference materials. In addition, F measurements were cross referenced with EDS analyses to validate the findings. Distributions of F (603 nm), Na (589 nm), and H (656 nm) within the tooth correlate well with the expected biomineral composition and expected tooth hardness. This rapid methodology could transform the current means of determining F distribution, particularly when large sample specimens (350 mm2, presented here) and large quantities of specimens are of interest.
MEK inhibitors for neurofibromatosis type 1 manifestations: Clinical evidence and consensus
Authors: de Blank Peter M K , Gross Andrea M , Akshintala Srivandana , Blakeley Jaishri O , Bollag Gideon , Cannon Ashley , Dombi Eva , Fangusaro Jason , Gelb Bruce D , Hargrave Darren , Kim AeRang , Klesse Laura J , Loh Mignon , Martin Staci , Moertel Christopher , Packer Roger , Payne Jonathan M , Rauen Katherine A , Rios Jonathan J , Robison Nathan , Schorry Elizabeth K , Shannon Kevin , Stevenson David A , Stieglitz Elliot , Ullrich Nicole J , Walsh Karin S , Weiss Brian D , Wolters Pamela L , Yohay Kaleb , Yohe Marielle E , Widemann Brigitte C , Fisher Michael J
Published: July 2022

The wide variety of clinical manifestations of the genetic syndrome neurofibromatosis type 1 (NF1) are driven by overactivation of the RAS pathway. Mitogen-activated protein kinase kinase inhibitors (MEKi) block downstream targets of RAS. The recent regulatory approvals of the MEKi selumetinib for inoperable symptomatic plexiform neurofibromas in children with NF1 have made it the first medical therapy approved for this indication in the United States, the European Union, and elsewhere. Several recently published and ongoing clinical trials have demonstrated that MEKi may have potential benefits for a variety of other NF1 manifestations, and there is broad interest in the field regarding the appropriate clinical use of these agents. In this review, we present the current evidence regarding the use of existing MEKi for a variety of NF1-related manifestations, including tumor (neurofibromas, malignant peripheral nerve sheath tumors, low-grade glioma, and juvenile myelomonocytic leukemia) and non-tumor (bone, pain, and neurocognitive) manifestations. We discuss the potential utility of MEKi in related genetic conditions characterized by overactivation of the RAS pathway (RASopathies). In addition, we review practical treatment considerations for the use of MEKi as well as provide consensus recommendations regarding their clinical use from a panel of experts.
Risk factors for unplanned paediatric intensive care unit admission after anaesthesia—an international multicentre study
Authors: Taylor Katherine L , Frndova Helena , Szadkowski Leah , Joffe Ari R , Parshuram Christopher S
Published: July 2022

Objectives

Unplanned intensive care unit (ICU) admissions are associated with near-miss events, morbidity, and mortality. We describe the rate, resource utilization, and outcomes of paediatric patients urgently admitted directly to ICU post-anaesthesia compared to other sources of unplanned ICU admissions.

Methods

We performed a secondary analysis of data from specialist paediatric hospitals in 7 countries. Patients urgently admitted to the ICU post-anaesthesia were combined and matched with 1 to 3 unique controls from unplanned ICU admissions from other locations by age and hospital. Demographic, clinical, and outcome variables were compared using the Wilcoxon rank-sum test for continuous variables and chi-square or Fisher’s exact test for categorical variables. The effect of admission sources on binary outcomes was estimated using univariable conditional logistic regression models with stratification by matched set of anaesthesia and non-anaesthesia admission sources.

Results

Most admissions were <1 year of age and for respiratory reasons. Admissions post-anaesthesia were shorter, occurred later in the day, and were more likely to be mechanically ventilated. Admissions post-anaesthesia were less likely to have had a previous ICU admission (4.8% compared to 11%, P=0.032) or PIM ‘high-risk diagnosis’ (9.5% versus 17.2%, P=0.035) but there was no difference in the number of subsequent ICU admissions. There was no difference in the PIM severity of illness score and no mortality difference between the groups.

Conclusions

Young children and respiratory indications dominated unplanned ICU admissions post-anaesthesia, which was more likely later in the day and with mechanical ventilation.
Innovative Team Approach for Achieving DNP Program Competencies for Distance Learners During the COVID-19 Pandemic
Authors: Hardin Lee M. , Gurley Lisa E. , Cortes Cyndi
Published: July 2022

Doctor of nursing practice (DNP)-prepared nurses must be competent in organizational and systems leadership, advanced clinical skills, and initiation of policy and programmatic changes. Students develop competencies in the DNP advanced practice and nurse administrator specialty tracks through online didactic and in-person practicum experiences within various settings. The COVID-19 pandemic created a barrier to in-person practicum experiences and an urgent need for flexible practicum opportunities. In response, faculty developed, implemented, and evaluated an innovative pedagogical strategy utilizing a team-based case study assignment to facilitate achievement of DNP program competencies for distance learners in these specialty tracks.
Using checklists to improve care in the nonoperating room environment
Authors: Latzman Jessica Anne , Castellanos Jim G. , Anca Diana
Published: July 2022

Purpose of review

As the number and complexity of cases performed in the nonoperating room environment continue to increase to a higher share of all anesthetic procedures, checklists are needed to ensure staff and patient safety.

Recent findings

Providing anesthesia care in the nonoperating room environment poses specific challenges. Closed claims data base analysis shows a higher morbidity and mortality in this setting. This is driven by the location-related challenges, and critical patients undergoing minimally invasive procedures, as well as a higher percentage of emergency and after-hours procedures. Although adequate case preparation and maintaining the same standard of care as in the main operating room, establishing protocols and checklists for procedures in nonoperating room locations has emerged as a sound strategy in improving care and safety.

Anesthesia in the nonoperating room environment is becoming an increasing share of total anesthesia cases. Establishing protocols and implementing site-specific checklists is emerging as a strategy in improving care in the environment of nonoperating room.

Video Abstract

http://links.lww.com/COAN/A89.
Perioperative and Periprocedural anesthetic management of opioid tolerant patients and patients with active and medically treated opioid use disorder
Authors: Burns Stacey L. , Majdak Petra , Urman Richard D.
Published: July 2022

Purpose of review

The increasing prevalence of opioid tolerant individuals, in combination with the expanding scope and utilization of nonoperating room anesthesia (NORA) necessitates ongoing investigation into best clinical practice for managing surgical/procedural pain in this population. The purpose of this article is to review recent guidelines, identify specific challenges, and offer considerations for managing pain in patients who are opioid tolerant secondary to opioid use disorder (OUD), with or without medications for the treatment of OUD.

Recent findings

A comprehensive preoperative evaluation in conjunction with a multidisciplinary, multimodal pain approach is optimal. NORA adds unique situational and environmental challenges for optimizing acute on chronic pain control in tolerant individuals while maintaining safety. Direct and partial/mixed mu-agonists should typically be continued throughout the perioperative period, while mu-antagonists (naltrexone) should be held 72 h. Postprocedural discharge instructions and follow-up must be carefully arranged and ensured.

Clinical recommendations continue to evolve as new consensus guidelines are published, although institution-specific guidelines are most often followed. This review focuses on most recent best practices, within NORA and operating room settings, for managing opioid tolerant patients, patients with OUD and those on medications for the treatment of OUD.
The role of voltage-gated calcium channels in the mechanisms of anesthesia and perioperative analgesia
Authors: Joksimovic Sonja L. , Jevtovic-Todorovic Vesna , Todorovic Slobodan M.
Published: July 2022

Purpose of review

A family of neuronal voltage-gated calcium channels (VGCCs) have received only recently a significant consideration regarding the mechanisms of anesthesia because VGCC inhibition may be important in anesthetic action by decreasing neuronal excitability and presynaptic excitatory transmission. The T-type VGCCs channels (T-channels), although rarely involved in synaptic neurotransmitter release, play an important role in controlling neuronal excitability and in generating spontaneous oscillatory bursting of groups of neurons in the thalamus thought to be involved in regulating the state of arousal and sleep. Furthermore, these channels are important regulators of neuronal excitability in pain pathway. This review will provide an overview of historic perspective and the recent literature on the role of VGCCs and T-channel inhibition in particular in the mechanisms of action of anesthetics and analgesics.

Recent findings

Recent research in the field of novel mechanisms of hypnotic action of anesthetics revealed significant contribution of the CaV3.1 isoform of T-channels expressed in the thalamus. Furthermore, perioperative analgesia can be achieved by targeting CaV3.2 isoform of these channels that is abundantly expressed in pain pathways.

The review summarizes current knowledge regarding the contribution of T-channels in hypnosis and analgesia. Further preclinical and clinical studies are needed to validate their potential for developing novel anesthetics and new perioperative pain therapies.