bluuebunny/crossref_metadata_2025 huggingface dataset:
Exquisite control of electronic and spintronic properties on highly porous Covalent Organic Frameworks (COFs): transition metal intercalation in bilayers
Authors: Maldonado-Lopez Daniel , Mendoza Cortes Jose L
Published: August 2023

Two-dimensional covalent organic frameworks (2D COFs) are crystalline organic porous materials stacked in a layered fashion. In general, these materials have excellent structural tunability, which can be achieved through the various tools of organic synthesis. Their layered and porous nature makes them attractive candidates for electronics, optoelectronics, and catalysis. However, their application is still limited due to relatively poor π-delocalization and practical applications require controlling and tuning their electronic structure. In this paper, using hybrid density functional theory, we computationally explore a novel 2D COF architecture, consisting of only two crystalline atomic layers made of benzene, boroxine, and triazine rings. We study the intercalation of first-row transition metals in the bilayer to enhance and fine-tune their electronic and magnetic behavior. This resulted in the development of one pristine bilayer, 63 intercalated bilayers, and one trilayer 2D COF. We found that the concentration and position of transition metals in the structure can drastically change the 2D COFs’ electronic, magnetic, and spintronic features. Based on their spin-polarized electronic properties, these transition metal-intercalated 2D COFs have potential applications as water splitting catalysts, direct semiconductors in the visible range, half metals, half semiconductors, and bipolar magnetic semiconductors.
An optimization framework for targeted spinal cord stimulation
Authors: Mirzakhalili Ehsan , Rogers Evan R , Lempka Scott F
Published: August 2023

Objective. Spinal cord stimulation (SCS) is a common neurostimulation therapy to manage chronic pain. Technological advances have produced new neurostimulation systems with expanded capabilities in an attempt to improve the clinical outcomes associated with SCS. However, these expanded capabilities have dramatically increased the number of possible stimulation parameters and made it intractable to efficiently explore this large parameter space within the context of standard clinical programming procedures. Therefore, in this study, we developed an optimization approach to define the optimal current amplitudes or fractions across individual contacts in an SCS electrode array(s). Approach. We developed an analytic method using the Lagrange multiplier method along with smoothing approximations. To test our optimization framework, we used a hybrid computational modeling approach that consisted of a finite element method model and multi-compartment models of axons and cells within the spinal cord. Moreover, we extended our approach to multi-objective optimization to explore the trade-off between activating regions of interest (ROIs) and regions of avoidance (ROAs). Main results. For simple ROIs, our framework suggested optimized configurations that resembled simple bipolar configurations. However, when we considered multi-objective optimization, our framework suggested nontrivial stimulation configurations that could be selected from Pareto fronts to target multiple ROIs or avoid ROAs. Significance. We developed an optimization framework for targeted SCS. Our method is analytic, which allows for the fast calculation of optimal solutions. For the first time, we provided a multi-objective approach for selective SCS. Through this approach, we were able to show that novel configurations can provide neural recruitment profiles that are not possible with conventional stimulation configurations (e.g. bipolar stimulation). Most importantly, once integrated with computational models that account for sources of interpatient variability (e.g. anatomy, electrode placement), our optimization framework can be utilized to provide stimulation settings tailored to the needs of individual patients.
The mechanism of the global vertical force reduction in disruptions mitigated by massive material injection
Authors: Schwarz N. , Artola F.J. , Vannini F. , Hoelzl M. , Bernert M. , Bock A. , Driessen T. , Dunne M. , Giannone L. , Heinrich P. , de Marné P. , Papp G. , Pautasso G. , Gerasimov S. , Upgrade Team the ASDEX , Contributors JET ,   Team the JOREK
Published: August 2023

Disruptions lead to a rapid loss of thermal and magnetic energy and can cause large heat loads, mechanical forces, and the excitation of a beam of relativistic runaway electrons. The operation of tokamaks at high energy and plasma current requires the use of a mitigation system to limit such detrimental effects. Mitigation techniques rely mainly on the injection of a large amount of impurities to radiate the majority of the thermal and magnetic energies. Heat loads and electro-magnetic (EM) forces as well as their toroidal asymmetries can be greatly reduced by such measures. In this paper, a theory is lined out to explain the reduction of the global vertical force based on large toroidal halo currents that keep the current centroid stationary in the midplane. As a consequence, the vertical current moment, which is linked to the EM-force, is reduced. The theory is backed up by experimental observations in shattered pellet injection mitigated vertical displacement event experiments in ASDEX Upgrade (AUG) and JET as well as by 2D simulations with the extended MHD code JOREK. Scans in the boundary heat flux are carried out to estimate the correct scrape-off layer temperature and the influence of the fraction of conducted energy. Finally, predictive simulations for ITER confirm the reduction of the vertical force by the injection of impurities.
A weakly supervised framework for high-resolution crop yield forecasts
Authors: Paudel Dilli , Marcos Diego , de Wit Allard , Boogaard Hendrik , Athanasiadis Ioannis N
Published: August 2023

Predictor inputs and labels (e.g. yield data) for crop yield forecasting are not always available at the same spatial resolution. Common statistical and machine learning methods require inputs and labels at the same resolution. Therefore, they cannot produce high resolution (HR) yield forecasts in the absence of HR yield data. We propose a weakly supervised (WS) deep learning framework that uses HR inputs and low resolution (LR) labels (crop areas and yields) to produce HR forecasts. The forecasting model was calibrated by aggregating HR forecasts and comparing with LR crop area and yield statistics. The framework was evaluated by disaggregating yields from parent statistical regions to sub-regions for five countries and two crops in Europe. Similarly, corn yields were disaggregated from counties to 10 km grids in the US. The performance of WS models was compared with naive disaggregation (ND) models, which assigned LR forecasts for a region or county to all HR sub-units, and strongly supervised models trained with HR yield labels. In Europe, all models (ND, WS and strongly supervised) were statistically similar, mainly due to the effect of yield trend. In the US, the WS models performed even better than the strongly supervised models. Based on Kendall’s rank correlation coefficient, the WS model forecasts captured significant amounts of HR yield variability. Combining information from WS with Trend model (using LR yield trend) and WS No Trend model (not using yield trend) provided good estimates of yields as well as spatial variability among sub-regions or grids. High resolution crop yield forecasts are useful to policymakers and other stakeholders for local analysis and monitoring. Our weakly supervised framework produces such forecasts even in the absence of high resolution yield data.
Conditioning Boltzmann generators for rare event sampling
Authors: Falkner Sebastian , Coretti Alessandro , Romano Salvatore , Geissler Phillip L , Dellago Christoph
Published: August 2023

Understanding the dynamics of complex molecular processes is often linked to the study of infrequent transitions between long-lived stable states. The standard approach to the sampling of such rare events is to generate an ensemble of transition paths using a random walk in trajectory space. This, however, comes with the drawback of strong correlations between subsequently sampled paths and with an intrinsic difficulty in parallelizing the sampling process. We propose a transition path sampling scheme based on neural-network generated configurations. These are obtained employing normalizing flows, a neural network class able to generate statistically independent samples from a given distribution. With this approach, not only are correlations between visited paths removed, but the sampling process becomes easily parallelizable. Moreover, by conditioning the normalizing flow, the sampling of configurations can be steered towards regions of interest. We show that this approach enables the resolution of both the thermodynamics and kinetics of the transition region for systems that can be sampled using exact-likelihood generative models.
On the finite time collapsing rate of Kähler-Ricci flow on projective bundles
Authors: Zhang Lei , Zhang Zhenlei
Published: August 2023

This paper is concerned with a class of finite time collapsing rate along Kähler-Ricci flow on projective bundles. It is shown that the diameter of the fibers tend to zero at the rate

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Coordinated expression of replication-dependent histone genes from multiple loci promotes histone homeostasis in Drosophila
Authors: Chaubal Ashlesha , Waldern Justin M. , Taylor Colin , Laederach Alain , Marzluff William F. , Duronio Robert J.
Published: August 2023

Production of large amounts of histone proteins during S phase is critical for proper chromatin formation and genome integrity. This process is achieved in part by the presence of multiple copies of replication dependent (RD) histone genes that occur in one or more clusters in metazoan genomes. In addition, RD histone gene clusters are associated with a specialized nuclear body, the histone locus body (HLB), which facilitates efficient transcription and 3′ end-processing of RD histone mRNA. How all five RD histone genes within these clusters are coordinately regulated such that neither too few nor too many histones are produced, a process referred to as histone homeostasis, is not fully understood. Here, we explored the mechanisms of coordinate regulation between multiple RD histone loci in Drosophila melanogaster and Drosophila virilis. We provide evidence for functional competition between endogenous and ectopic transgenic histone arrays located at different chromosomal locations in D. melanogaster that helps maintain proper histone mRNA levels. Consistent with this model, in both species we found that individual histone gene arrays can independently assemble an HLB that results in active histone transcription. Our findings suggest a role for HLB assembly in coordinating RD histone gene expression to maintain histone homeostasis.
Loss of EGF receptor polarity enables homeostatic imbalance in epithelial-cell models
Authors: Carlin Cathleen R. , Ngalula Syntyche
Published: August 2023

The polarized distribution of membrane proteins into apical and basolateral domains provides the basis for specialized functions of epithelial tissues. The EGF receptor (EGFR) plays important roles in embryonic development, adult-epithelial tissue homeostasis, and growth and survival of many carcinomas. Typically targeted to basolateral domains, there is also considerable evidence of EGFR sorting plasticity but very limited knowledge regarding domain-specific EGFR substrates. Here we have investigated effects of selective EGFR mistargeting because of inactive-basolateral sorting signals on epithelial-cell homeostatic responses to growth-induced stress in MDCK cell models. Aberrant EGFR localization was associated with multilayer formation, anchorage-independent growth, and upregulated expression of the intermediate filament-protein vimentin characteristically seen in cells undergoing epithelial-to-mesenchymal transition. EGFRs were selectively retained following their internalization from apical membranes, and a signaling pathway involving the signaling adaptor Gab1 protein and extracellular signal-regulated kinase ERK5 had an essential role integrating multiple responses to growth-induced stress. Our studies highlight the potential importance of cellular machinery specifying EGFR polarity in epithelial pathologies associated with homeostatic imbalance.
Childhood Studies and the Politics of Horror
Authors: Soderberg Laura
Published: August 2023

Three [new] scholarly works … examine narratives in which childhood frightens both the children themselves and, more often, the adults observing childhood. … The childhoods they show can be both other and othering.
Pain in the Context of Virtual Neuropsychological Assessment of Older Adults
Authors: Patrick Karlee S , Gunstad John , Spitznagel Mary B
Published: August 2023

Objective

Pain and cognitive impairment are prevalent and often co-occur in older adults. Because pain may negatively affect cognitive test performance, identification of pain in the context of neuropsychological evaluation is important. However, pain detection based on self-report presents challenges, and pain is often under-detected in this population. Alternative methods (e.g., video-based automatic coding of facial biomarkers of pain) may facilitate pain identification and thus enhance interpretation of neuropsychological evaluation results.

Method

The current study examined pain in the context of virtual neuropsychological assessment in 111 community-dwelling older adults, first seeking to validate the use of software developed to automatically code biomarkers of pain. Measures of pain, including self-report of acute and chronic pain and automatic coding of pain, were compared while participants completed neuropsychological testing.

Results

Self-reported pain was negatively associated with poorer performance on a measure of executive function (both acute and chronic pain) and a global cognitive screening measure (acute pain only). However, self-reported acute and chronic pain did not correlate significantly with most neuropsychological tests. Automatic coding of pain did not predict self-report of pain or performance on neuropsychological tests beyond the influence of demographic factors and psychological symptoms.

Conclusions

Though results were largely not significant, correlations warrant further exploration of the influence of pain on neuropsychological test performance in this context to ensure that pain does not influence test performance in individuals with higher levels of pain and in other samples.
Tension Reduction With Force Modulating Tissue Bridges Reduces Wounds in Breast Surgery
Authors: Wall Holly C , Halani Sameer H , Mosieri Chizoba , Daniel Charles , Gallo Lucas , Eaves Felmont F , Coroneos Christopher J
Published: August 2023

Background

Tension on healing wounds increases the risk of dehiscence and poor or pathologic scar formation. Force modulating tissue bridges (FMTBs) represent a new class of wound closure and support devices designed to offload tension on healing wounds to improve wound healing and scar outcomes.

Objectives

The study was undertaken to assess the efficacy of FMTBs to reduce the risk of wound healing complications in elective breast surgery.

Methods

One hundred twenty-two consecutive patients undergoing bilateral aesthetic breast surgery underwent intraoperative placement of FMTBs on the vertical limb closure site. A matched case–control cohort of 121 consecutive patients was established for comparison. Wounds were considered significant if larger than 3 mm in diameter. The primary outcome of breast wounds >3 mm was reported with a relative risk, and all outcomes were framed with number needed to treat.

Results

The control and intervention cohorts had similar demographics, comorbidities, type of operation, and incision pattern utilized. Within the FMTB group, 96.7% (n = 118) patients completed treatment per protocol. Significant wounds occurred in 1.7% (n = 2) of patients in the tissue bridge vs 15.2% (n = 19) in controls on a per patient/per protocol basis (89% reduction, P < .001). Statistically significant improvements were maintained on sensitivity analyses with intention to treat, even when minor wounds were included. There were no complications noted related to FMTBs.

Conclusions

FMTBs are safe and highly effective at reducing the risk of wound formation in elective breast surgery. Results are consistent with sensitivity analyses based on clinical and methodological factors. Further research will assess long-term scar outcomes.

Level of Evidence: 4
GraphCpG: imputation of single-cell methylomes based on locus-aware neighboring subgraphs
Authors: Deng Yuzhong , Tang Jianxiong , Zhang Jiyang , Zou Jianxiao , Zhu Que , Fan Shicai
Published: August 2023

Motivation

Single-cell DNA methylation sequencing can assay DNA methylation at single-cell resolution. However, incomplete coverage compromises related downstream analyses, outlining the importance of imputation techniques. With a rising number of cell samples in recent large datasets, scalable and efficient imputation models are critical to addressing the sparsity for genome-wide analyses.

Results

We proposed a novel graph-based deep learning approach to impute methylation matrices based on locus-aware neighboring subgraphs with locus-aware encoding orienting on one cell type. Merely using the CpGs methylation matrix, the obtained GraphCpG outperforms previous methods on datasets containing more than hundreds of cells and achieves competitive performance on smaller datasets, with subgraphs of predicted sites visualized by retrievable bipartite graphs. Besides better imputation performance with increasing cell number, it significantly reduces computation time and demonstrates improvement in downstream analysis.

Availability and implementation

The source code is freely available at https://github.com/yuzhong-deng/graphcpg.git.
HAPNEST: efficient, large-scale generation and evaluation of synthetic datasets for genotypes and phenotypes
Authors: Wharrie Sophie , Yang Zhiyu , Raj Vishnu , Monti Remo , Gupta Rahul , Wang Ying , Martin Alicia , O’Connor Luke J , Kaski Samuel , Marttinen Pekka , Palamara Pier Francesco , Lippert Christoph , Ganna Andrea
Published: August 2023

Motivation

Existing methods for simulating synthetic genotype and phenotype datasets have limited scalability, constraining their usability for large-scale analyses. Moreover, a systematic approach for evaluating synthetic data quality and a benchmark synthetic dataset for developing and evaluating methods for polygenic risk scores are lacking.

Results

We present HAPNEST, a novel approach for efficiently generating diverse individual-level genotypic and phenotypic data. In comparison to alternative methods, HAPNEST shows faster computational speed and a lower degree of relatedness with reference panels, while generating datasets that preserve key statistical properties of real data. These desirable synthetic data properties enabled us to generate 6.8 million common variants and nine phenotypes with varying degrees of heritability and polygenicity across 1 million individuals. We demonstrate how HAPNEST can facilitate biobank-scale analyses through the comparison of seven methods to generate polygenic risk scoring across multiple ancestry groups and different genetic architectures.

Availability and implementation

A synthetic dataset of 1 008 000 individuals and nine traits for 6.8 million common variants is available at https://www.ebi.ac.uk/biostudies/studies/S-BSST936. The HAPNEST software for generating synthetic datasets is available as Docker/Singularity containers and open source Julia and C code at https://github.com/intervene-EU-H2020/synthetic_data.
Biological interactions involving the myrmecophyte Hirtella physophora and its associates
Authors: Dejean Alain , Leroy Céline , Corbara Bruno , Azemar Frederic , Orivel Jérôme
Published: August 2023

In ecological communities, several species interact with one another to regulate their abundance. For example, mutualisms benefit all species involved, commensalism benefits one species but not the other, competition (for a resource) lowers the fitness of all species involved, whereas for predation, herbivory and parasitism one species is negatively affected by the other. We present the biological interactions between the myrmecophyte Hirtella physophora (i.e. a plant sheltering ants in hollow structures) and other organisms. Two Allomerus ants build gallery-shaped traps on this plant using hairs from its stems and the mycelium of an Ascomycota fungus to capture prey. They also use their refuse to provide their host plant and the fungi with nutrients (myrmecotrophy). Social wasps build their nests under the Hirtella leaves to benefit from the protection provided by Allomerus against army ants. Several insects can rob parts of Allomerus prey (cleptobiosis), but can be captured in turn. Finally, the reduviid Zelus annulosus, which foils attacks by Allomerus due to the production of a sticky substance that covers its egg masses and coats its legs, mostly attacks prey in groups and then shares them. Their populations are regulated by parasitoid wasps. Consequently, almost all possible biological interactions were noted in this study.
Trophic interactions between plants, pollinators, florivores and predators: a global systematic review
Authors: Camurça Letícia Menezes , Santos André Mauricio Melo , Castro Cibele Cardoso , Leite Ana Virgínia
Published: August 2023

The multitrophic relationships between plants, pollinators, florivores and spiders that predate floral visitors influence plant reproductive success, and some plant characteristics influence the choices of these animals. The aim of this study was to integrate the global data on these multitrophic relationships and answer the following questions. How are the studies distributed by biomes? What are the groups of plants, pollinators, florivores, spiders and prey recorded? What plant features explain the presence of florivores and spiders? What is the effect of spiders on fruit set? A systematic literature review was carried out to extract the necessary information. The most frequently observed families of plants, pollinators, florivores, spiders and prey were, respectively, herbaceous Asteraceae, Apidae (bees), Chrysomelidae (beetles), Thomisidae (spiders) and Bombyliidae (flies). The choice of flowers by florivores was explained by floral longevity. The choice of flowers by spiders was explained by life-form, symmetry, shape, pollination unit (more frequent in isolated flowers than in inflorescences) and resource (nectar). Spiders had a neutral general effect on fruit set, indicating that the study scale influenced the result. An important knowledge gap concerns the influence of florivores on fruit set. Studies that follow standardized methodologies are necessary.
Preconditioning program reduces the incidence of prolonged hospital stay after lung cancer surgery: Results from the Move For Surgery randomized clinical trial
Authors: Patel Yogita S , Sullivan Kerrie A , Churchill Isabella F , Beauchamp Marla K , Wald Joshua , Mbuagbaw Lawrence , Fahim Christine , Hanna Waël C
Published: August 2023

Background

Lung cancer resection is associated with high rates of prolonged hospital stay. It is presumed that preconditioning with aerobic exercise can shorten the postoperative duration of hospital stay, but this has not yet been demonstrated in trials after lung cancer surgery. The aim of this study was to perform a RCT to determine whether Move For Surgery (MFS), a home-based and wearable technology-enhanced preconditioning program before lung cancer surgery, is associated with a lower incidence of prolonged hospital stay when compared to usual preoperative care.

Methods

Patients undergoing lung resection for early-stage non-small cell lung cancer were enrolled before surgery into this blinded, single-site RCT, and randomized to either the MFS or control group in a 1 : 1 ratio. Patients in the MFS group were given a wearable activity tracker, and education about deep breathing exercises, nutrition, sleep hygiene, and smoking cessation. Participants were motivated/encouraged to reach incrementally increasing fitness goals remotely. Patients in the control group received usual preoperative care. The primary outcome was the difference in proportion of patients with hospital stay lasting more than 5 days between the MFS and control groups.

Results

Of 117 patients screened, 102 (87.2 per cent) were eligible, enrolled, and randomized (51 per trial arm). The majority (95 of 102, 93.1 per cent) completed the trial. Mean(s.d.) age was 67.2(8.8) years and there were 55 women (58 per cent). Type of surgery and rates of thoracotomy were not different between arms. The proportion of patients with duration of hospital stay over 5 days was 3 of 45 (7 per cent) in the MFS arm compared to 12 of 50 (24 per cent) in the control arm (P = 0.021).

Conclusion

MFS, a home-based and wearable technology-enhanced preconditioning program before lung cancer surgery, decreased the proportion of patients with a prolonged hospital stay. Registration number: NCT03689634 (http://www.clinicaltrials.gov).
318 Advancing Surgery in Africa Through Education, Mentorship and Research; the Surgery Interest Group of Africa (SIGAf)
Authors: Jesuyajolu D , Chineme-Anyaeze C , Abdullateef R , Opashola K , Moti T , Ekennia-Ebeh J , Adegbite O
Published: August 2023

Aim

Peer-to-peer surgical education has improved remarkably over the last decade with the aid of interest groups and charity organisations such as ASiT, IncisioN, NANSIG, and StarSURG. Despite these advances, there remains a lack of collaborative interest groups tailored to improving surgical education in Africa. The Surgery Interest Group of Africa (SIGAf) was established in response, and this study assesses its benefits in research, education, and mentorship.

Method

Feedback data from over 20 virtual sessions grouped into six categories over seven months in 2022 were analysed in this study. The categories included the surgical conference (Exposure to African Surgery), Career talks, Surgical lecture series, Exam preparation lectures, Research and audit lectures and Journal club activities. Data on participant confidence levels, helpfulness, engagement, and interest in the lecture content were examined using a 5-point Likert scale.

Results

705 responses were recorded across the six categories. The participants’ confidence level increased from an indeterminate pre-session to a statistically significant fairly confident level post-session. The attendees perceived the conference, career talks, lecture series, and journal club activities as helpful and had the highest level of interest. The surgical conference, career talk and surgical lecture series all had a reasonably good engagement.

Conclusions

This study has shown that the virtual sessions held by the Surgery Interest Group of Africa aimed at advancing surgery across the continent through education, mentorship, and research have achieved reasonable success.
829 Bariatric Surgery Versus Medical Therapy for the Management of Obesity in Patients With Type 2 Diabetes
Authors: Shirke M , Sreejith G , Ravikumar N , Roy S , Nizam Z , Tuli K
Published: August 2023

Aim

The risks associated with Type 2 Diabetes (T2DM) and obesity are increasingly becoming relevant across the world. This review aims to compare the clinical outcomes of the Bariatric surgery versus medical therapy in management of obese patients with diabetes.

Method

A systematic, electronic search was performed according to PRISMA guidelines to identify relevant articles that compared outcomes of medical therapy versus the Bariatric surgery procedures for obesity in diabetic patients.

Results

Twelve studies were included, enrolling 4097 patients. A greater reduction in HbA1c (SMD -12.27, 95% CI[-16.99, -7.56]) and BMI (SMD -10.77, 95% CI[-12.59, -8.95]), was observed in the surgical group. Secondary outcomes, weight (SMD -2.14, 95% CI [-6.30, -1.21]), total cholesterol (SMD -5.78, 95% CI[-9.92, -1.65]), waist circumference (SMD = -5.24 [-9.20, -1.28]) and fasting glucose (SMD -3.75, 95% CI [-6.79, -1.19]) were statistically significant in favour of the Bariatric surgery approach. No significant differences were observed in the triglycerides (SMD -1.55 [-4.53, 1.42], p = 0.31) and diastolic blood pressure (SMD -0.12 [-1.14, 0.90], p = 0.82). Systolic blood pressure (SMD 1.26, 95% CI[0.42, 2.11]) was significantly in favour of medical therapy.

Conclusions

The Bariatric surgery approach is associated with a reduced HbA1c and BMI. However, the long-term benefits of the procedure need to be evaluated. This review calls for robust trials comparing the two techniques to further strengthen the evidence.
682 Accidental Toothpick Ingestion Causing Liver Abscess – a Case Report and Review of Literature
Authors: Anwar S , Aldajani N , Alozaibi L
Published: August 2023

Introduction

Perforation due to foreign body ingestion leading to pyogenic liver abscess is an unusual but fatal event. We present a rare case of accidentally ingested toothpick that perforated the duodenum and migrated to the liver causing abscess.

Case Presentation

A 40-year-old gentleman presented with symptoms and signs of sepsis. He reported having eaten dry fish and chicken with bones 4 days prior to presentation. Abdominal computed tomography (CT) scan revealed hepatic collection containing a linear object in the middle. Non-operative management improved patient’s general condition but an increase in the size of collection lead to operative management.

Discussion

Usual course of formation of a pyogenic liver abscess is due to ascending cholangitis or infections causing hematogenous spread. Such an event due to a foreign body perforating the gastro-intestinal tract and migrating to liver is rarely seen. Presentation ranges from mild abdominal pain to full blown septicemia. Diagnosis is challenging as patients may present with vague symptoms, or sometimes don’t even remember having ingested an indigestible object. A trial of conservative management can be given to stable patients who improve, but deterioration necessitates surgical intervention.

Conclusions

Pyogenic liver abscess due to foreign body ingestion leading to intestinal perforation and displacing to liver is seldom encountered, and a toothpick leading to such an event is a very rare event. Patients may improve clinically with non-operative management; definitive management lies in the surgical removal of foreign body.
It is worth a shot: vaccine uptake among an immunosuppressed dermatology cohort
Authors: McFeely Orla , Blasco Marta Costa , Wolinska Anna , Andrawis Madonna , Murphy Lisa , Tobin Anne-Marie
Published: August 2023

Adult patients diagnosed with chronic inflammatory skin disease are at a higher risk of vaccine-preventable diseases. Vaccination-seeking behaviours were lower than anticipated in this study, with a little over two-thirds of patients describing themselves as very likely to seek each of the flu, pneumococcal and COVID-19 vaccinations. Vaccine hesitancy among a high-risk group of immunosuppressed dermatology patients is an issue that should be highlighted and concerns raised by this group regarding vaccines should be addressed sensitively.
Individualized Antibiotic Plans as a Quality Improvement Initiative to Reduce Carbapenem Use for Hematopoietic Cell Transplant Patients at a Freestanding Pediatric Hospital
Authors: Brothers Adam W , Pak Daniel J , Poole Nicole M , Kronman Matthew P , Bettinger Brendan , Wilkes Jennifer J , Carpenter Paul A , Englund Janet A , Weissman Scott J
Published: August 2023

Background

Providers must balance effective empiric therapy against toxicity risks and collateral damage when selecting antibiotic therapy for patients receiving hematopoietic cell transplant (HCT). Antimicrobial stewardship interventions during HCT are often challenging due to concern for undertreating potential infections.

Methods

In an effort to decrease unnecessary carbapenem exposure for patients undergoing HCT at our pediatric center, we implemented individualized antibiotic plans (IAPs) to provide recommendations for preengraftment neutropenia prophylaxis, empiric treatment of febrile neutropenia, and empiric treatment for hemodynamic instability. We compared monthly antibiotic days of therapy (DOT) adjusted per 1000 patient-days for carbapenems, antipseudomonal cephalosporins, and all antibiotics during two 3-year periods immediately before and after the implementation of IAPs to measure the impact of IAP on prescribing behavior. Bloodstream infection (BSIs) and Clostridioides difficile (CD) positivity test rates were also compared between cohorts. Last, providers were surveyed to assess their experience of using IAPs in antibiotic decision making.

Results

Overall antibiotic use decreased after the implementation of IAPs (monthly reduction of 19.6 DOT/1000 patient-days; P = .004), with carbapenems showing a continuing decline after IAP implementation. BSI and CD positivity rates were unchanged. More than 90% of providers found IAPs to be either extremely or very valuable for their practice.

Conclusions

Implementation of IAPs in this high-risk HCT population led to reduction in overall antibiotic use without increase in rate of BSI or CD test positivity. The program was well received by providers.
Comparison of Bivalent and Monovalent mRNA Vaccine Boosters
Authors: Wong Carlos K H , Lau Kristy T K , Au Ivan C H , Lau Eric H Y , Cowling Benjamin J
Published: August 2023

In this cohort study conducted in Hong Kong where both bivalent and monovalent formulations of BNT162b2 were available, there were no significant differences in the mortality or hospitalization between those who received bivalent and monovalent mRNA as second boosters. Bivalent and monovalent mRNA boosters appear equally protective against clinical outcomes.
Predicting target lesion failure following percutaneous coronary intervention through machine learning risk assessment models
Authors: Mamas Mamas A , Roffi Marco , Fröbert Ole , Chieffo Alaide , Beneduce Alessandro , Matetic Andrija , Tonino Pim A L , Paunovic Dragica , Jacobs Lotte , Debrus Roxane , El Aissaoui Jérémy , van Leeuwen Frank , Kontopantelis Evangelos
Published: August 2023

Aims

Central to the practice of precision medicine in percutaneous coronary intervention (PCI) is a risk-stratification tool to predict outcomes following the procedure. This study is intended to assess machine learning (ML)-based risk models to predict clinically relevant outcomes in PCI and to support individualized clinical decision-making in this setting.

Methods and results

Five different ML models [gradient boosting classifier (GBC), linear discrimination analysis, Naïve Bayes, logistic regression, and K-nearest neighbours algorithm) for the prediction of 1-year target lesion failure (TLF) were trained on an extensive data set of 35 389 patients undergoing PCI and enrolled in the global, all-comers e-ULTIMASTER registry. The data set was split into a training (80%) and a test set (20%). Twenty-three patient and procedural characteristics were used as predictive variables. The models were compared for discrimination according to the area under the receiver operating characteristic curve (AUC) and for calibration. The GBC model showed the best discriminative ability with an AUC of 0.72 (95% confidence interval 0.69–0.75) for 1-year TLF on the test set. The discriminative ability of the GBC model for the components of TLF was highest for cardiac death with an AUC of 0.82, followed by target vessel myocardial infarction with an AUC of 0.75 and clinically driven target lesion revascularization with an AUC of 0.68. The calibration was fair until the highest risk deciles showed an underestimation of the risk.

Conclusion

Machine learning–derived predictive models provide a reasonably accurate prediction of 1-year TLF in patients undergoing PCI. A prospective evaluation of the predictive score is warranted.

Registration

Clinicaltrial.gov identifier is NCT02188355.
Building twenty-first century agricultural research and extension capacity in Africa
Authors: Jayne T S , Zingore Shamie , Niang Amadou Ibra , Palm Cheryl , Shah Saloni , Sanchez Pedro
Published: August 2023

This study explores the effectiveness of international efforts to build the capacities of national agricultural research and extension systems (NARES) in Africa and proposes actions to improve the performance of these systems. Analysis draws on agricultural research expenditure data in Africa, Asia and Latin America and key informant interviews of 26 senior representatives of international and African research organisations. We conclude that donors and international partners have increased the supply of professional African scientists while contributing relatively little to the institutional capacities of African NARES. We propose a transition to what we call a twenty-first century African-led agricultural research system and identify actions to manifest it.
Stroke risk in women with atrial fibrillation
Authors: Buhari Hifza , Fang Jiming , Han Lu , Austin Peter C , Dorian Paul , Jackevicius Cynthia A , Yu Amy Y X , Kapral Moira K , Singh Sheldon M , Tu Karen , Ko Dennis T , Atzema Clare L , Benjamin Emelia J , Lee Douglas S , Abdel-Qadir Husam
Published: August 2023

Background and aims

Female sex is associated with higher rates of stroke in atrial fibrillation (AF) after adjustment for other CHA2DS2-VASc factors. This study aimed to describe sex differences in age and cardiovascular care to examine their relationship with stroke hazard in AF.

Methods

Population-based cohort study using administrative datasets of people aged ≥66 years diagnosed with AF in Ontario between 2007 and 2019. Cause-specific hazard regression was used to estimate the adjusted hazard ratio (HR) for stroke associated with female sex over a 2-year follow-up. Model 1 included CHA2DS2-VASc factors, with age modelled as 66–74 vs. ≥ 75 years. Model 2 treated age as a continuous variable and included an age–sex interaction term. Model 3 further accounted for multimorbidity and markers of cardiovascular care.

Results

The cohort consisted of 354 254 individuals with AF (median age 78 years, 49.2% female). Females were more likely to be diagnosed in emergency departments and less likely to receive cardiologist assessments, statins, or LDL-C testing, with higher LDL-C levels among females than males. In Model 1, the adjusted HR for stroke associated with female sex was 1.27 (95% confidence interval 1.21–1.32). Model 2 revealed a significant age–sex interaction, such that female sex was only associated with increased stroke hazard at age >70 years. Adjusting for markers of cardiovascular care and multimorbidity further decreased the HR, so that female sex was not associated with increased stroke hazard at age ≤80 years.

Conclusion

Older age and inequities in cardiovascular care may partly explain higher stroke rates in females with AF.
Erosional exhumation of carbonate rock facilitates dispersal-mediated allopatric speciation in freshwater fishes
Authors: Kim Daemin , Stokes Maya F , Ebersole Sandy , Near Thomas J
Published: August 2023

A fundamental goal of evolutionary biology is to understand the mechanisms that generate and maintain biodiversity. Discovery and delimitation of species represent essential prerequisites for such investigations. We investigate a freshwater fish species complex comprising Etheostoma bellator and the endangered E. chermocki, which is endemic to the Black Warrior River system in Alabama, USA, a global hotspot of temperate freshwater biodiversity. Phylogenomic analyses delimit five geographically disjunct species masquerading as E. bellator. Three of these new species exhibit microendemic distributions comparable to that of E. chermocki raising the possibility that they also require protection. The species of the complex are found in streams flowing over carbonate rock and they are separated by waterways flowing over siliciclastic rock, a geographic pattern dictated by the underlying stratigraphy and structural geology. Over time, rivers have eroded downward through layers of siliciclastic rocks in the basin, gradually exposing underlying carbonate rock, the substrate of suitable habitat today. Our results suggest that episodic dispersal to patches of suitable habitat set the stage for allopatric speciation in the species complex. Our study suggests that the presence of heterogeneous rock can facilitate dispersal-mediated allopatric speciation in freshwater organisms in the absence of external tectonic or climatic perturbations.
Identifying barriers to the production and use of routine health information in Western Province, Zambia
Authors: Lee Na-Mee , Singini Douglas , Janes Craig R , Grépin Karen A , Liu Jennifer A
Published: August 2023

Recent decades of improvements to routine health information systems in low- and middle-income countries (LMICs) have increased the volume of health data collected. However, countries continue to face several challenges with quality production and use of information for decision-making at sub-national levels, limiting the value of health information for policy, planning and research. Improving the quality of data production and information use is thus a priority in many LMICs to improve decision-making and health outcomes. This qualitative study identified the challenges of producing and using routine health information in Western Province, Zambia. We analysed the interview responses from 37 health and social sector professionals at the national, provincial, district and facility levels to understand the barriers to using data from the Zambian health management information system (HMIS). Respondents raised several challenges that we categorized into four themes: governance and health system organization, geographic barriers, technical and procedural barriers, and challenges with human resource capacity and staff training. Staff at the facility and district levels were arguably the most impacted by these barriers as they are responsible for much of the labour to collect and report routine data. However, facility and district staff had the least authority and ability to mitigate the barriers to data production and information use. Expectations for information use should therefore be clearly outlined for each level of the health system. Further research is needed to understand to what extent the available HMIS data address the needs and purposes of the staff at facilities and districts.
Playful educational interventions in children and adolescents’ health literacy: a systematic review
Authors: Ribeiro Synthia Martins , Basso Maurício Bartelle , Massignan Carla , Leal Soraya Coelho
Published: August 2023

There is a need to investigate methods to increase children’s health knowledge. Therefore, the aim of this study was to systematically evaluate the literature on playful educational interventions in health literacy aimed at children aged 6–12 years. For this purpose, the Cochrane Library, EMBASE, LILACS, PubMed, Scopus, Web of Science and grey literature were searched for relevant studies. Randomized, quasi-randomized or non-randomized clinical trials, in which the primary outcome was health literacy in children, were included. Due to the heterogeneity of the studies, the data were qualitatively evaluated. Eleven studies were included in this analysis. Most of the studies were randomized (n = 10). Among the health issues addressed in these studies, obesity prevention was the most studied (n = 5). All participants had low methodological quality, and the most commonly used interventions were games, dramas and theatre plays. Although most studies have pointed to an increase in health knowledge after interventions, it was not possible to determine whether such knowledge was retained over time, whether it effectively changed health behaviours, or if it led to the effective adoption of a healthier lifestyle. Health literacy through playful methods is potentially effective in increasing health knowledge and changing health behaviours. However, literature on its impact on the adoption of healthy lifestyles is inconclusive. Future research with fewer limitations and better methodological designs may help selecting the best intervention strategy to promote health literacy.
Health action process approach: promoting physical activity, and fruit and vegetable intake among Australian adults
Authors: Parkinson Joy , Hannan Thomas , McDonald Nicole , Moriarty Stephanie , Nguyen Tuyet-Mai , Hamilton Kyra
Published: August 2023

Based on the health action process approach (HAPA) this study examined whether changes in social cognition constructs could predict change in physical activity and fruit and vegetable intake for adult participants in My health for life, an Australian health promotion behaviour change program. Variance-based structural equation modelling was used to analyse data obtained from Australian adult program participants (n = 167) at baseline (T1), week 14 (T2), week 26 (T2), and 6-month post-program (T4). Change scores were calculated for the social cognition constructs and behaviour. Changes in action self-efficacy and outcome expectancies positively predicted changes in intentions. Action self-efficacy changes also predicted changes in maintenance self-efficacy which, in turn, mediated the effect of action self-efficacy on recovery self-efficacy and planning. Planning was predicted by changes in intentions and maintenance self-efficacy. Findings support the use of the HAPA model in designing complex health behaviour change interventions to achieve sustained behaviour change.
Uncovering genetic and metabolite markers associated with resistance against anthracnose fruit rot in northern highbush blueberry
Authors: Jacobs MacKenzie , Thompson Samantha , Platts Adrian E , Body Melanie J A , Kelsey Alexys , Saad Amanda , Abeli Patrick , Teresi Scott J , Schilmiller Anthony , Beaudry Randolph , Feldmann Mitchell J , Knapp Steven J , Song Guo-qing , Miles Timothy , Edger Patrick P
Published: August 2023

Anthracnose fruit rot (AFR), caused by the fungal pathogen Colletotrichum fioriniae, is among the most destructive and widespread fruit disease of blueberry, impacting both yield and overall fruit quality. Blueberry cultivars have highly variable resistance against AFR. To date, this pathogen is largely controlled by applying various fungicides; thus, a more cost-effective and environmentally conscious solution for AFR is needed. Here we report three quantitative trait loci associated with AFR resistance in northern highbush blueberry (Vaccinium corymbosum). Candidate genes within these genomic regions are associated with the biosynthesis of flavonoids (e.g. anthocyanins) and resistance against pathogens. Furthermore, we examined gene expression changes in fruits following inoculation with Colletotrichum in a resistant cultivar, which revealed an enrichment of significantly differentially expressed genes associated with certain specialized metabolic pathways (e.g. flavonol biosynthesis) and pathogen resistance. Using non-targeted metabolite profiling, we identified a flavonol glycoside with properties consistent with a quercetin rhamnoside as a compound exhibiting significant abundance differences among the most resistant and susceptible individuals from the genetic mapping population. Further analysis revealed that this compound exhibits significant abundance differences among the most resistant and susceptible individuals when analyzed as two groups. However, individuals within each group displayed considerable overlapping variation in this compound, suggesting that its abundance may only be partially associated with resistance against C. fioriniae. These findings should serve as a powerful resource that will enable breeding programs to more easily develop new cultivars with superior resistance to AFR and as the basis of future research studies.