bluuebunny/crossref_metadata_2025 huggingface dataset:
B-272 Interference Assays: How Different Substances can Affect the Detection of Respiratory Viruses Using a Quick Molecular Solution
Authors: Martínez-Santolaria M , García-Manrique B , Machetti-Mareca E , Gil-Rodríguez C
Published: September 2023

Background

Some substances present in clinical samples could affect the performance of qPCR and significantly impact its results. If nucleic acids are obtained using quick lysis reagents, the inhibition effect could be even worse since no washing steps are included. Thence, the aim of this study was to evaluate some potentially interfering substances that may be present in respiratory samples and their effect on the diagnosis using a quick molecular solution.

Methods

Ten negative nasopharyngeal swab samples in Viral Transport Medium (VTM, Vircell) were pooled and enriched with a known concentration of viral cultures from ATCC (Influenza A: VR-95PQ™ A/Puerto Rico/8/34; Human Respiratory Syncytial virus (RSV): VR26PQ™; and SARS-CoV-2: VR-1986HK™ SARS-Related Coronavirus 2, Isolate USA-WA1/2020) to obtain positive samples around the limit of detection. The pool was divided into seven aliquots. Six of them were spiked (each) with a known concentration of potentially respiratory interfering substances, according to FDA recommendations (Table 1). Another aliquot did not contain any substance and was considered as the positive control. Each aliquot was processed in triplicate using VIASURE Resp. viruses Quick Lysis Reagent (Certest Biotec S. L), following the manufacturer’s instructions. Nucleic acids were analysed with VIASURE SARS-CoV-2, Flu & RSV Real Time PCR Detection Kit (Certest Biotec S.L) in triplicate on CFX96™ Real-Time PCR Detection System (Bio-Rad).

Results

Almost all substances did not interfere throughout the workflow at the concentrations tested. Only benzocaine had a negative effect on the three pathogens analysed (SARS-CoV-2, Influenza A and RSV), detecting less than 8/9 replicates. This problem was resolved when the substance was tested at 0.15 mg/ml.

Conclusion

Evaluation of potentially interfering substances in quick molecular solutions is important, especially if nucleic acids processing methods do not have many purification steps. Thus, the study confirmed that the diagnosis using this solution is not easily compromised.
B-281 Analytical Validation of the Mindray High Sensitivity Cardiac Troponin I Assay
Authors: Fabre-Estremera B , Schulz K M , Ladd A , Buño Soto A , Apple F S
Published: September 2023

Background

According to recent global guidelines for patients presenting with ischemia, high sensitivity cardiac troponin I and T (hs-cTn) are the preferred biomarkers for the diagnosis and risk assessment of acute myocardial infarction (MI) and myocardial injury. The purpose of our study was to perform an analytical validation study of the Mindray hs-cTnI assay.

Methods

Analytical studies were designed according to Clinical and Laboratory Standards Institute protocols (CLSI). We used one reagent lot and one CL1200i chemiluminescence Immunoassay Analyzer (Mindray Bio Medical Electronics Co., Shenzhen, China). Following the CLSI EP17 A2 document, the limit of blank (LoB) and limit of detection (LoD) were assessed following analysis of a) Mindray controls without cTnI concentrations added for the LoB and b) 4 lithium heparin (LiHep) fresh samples with low cTnI concentrations, for 3 days for LoB and LoD, with 5 replicates per day (60 replicates per study). For the precision study, according to the CLSI EP15-A3 protocol, we used 12 LiHep fresh samples, measured for 10 days, with 2 runs per day (separated by a minimal time of 2 h) and in replicates of 3 (n = 720). For the 12 samples for the precision study, 7 were chosen with hs-cTnI concentrations close to the manufacturer sex-specific 99th percentile upper reference limits (URL; 31 ng/L for males and 15 ng/L for females). The CLSI EP06 protocol was followed to study linearity, using 9 fresh LiHep samples analyzed the same day in replicates of 7 (n = 63). A blank sample between every sample was used to avoid carryover. Our analytical specification for linearity was an allowable deviation <10%. Analyses were performed with Analyze it for Excel (Method Validation edition, version 6.15).

Results

Using both parametrical and non-parametrical analyses, LoB was <0.1 ng/L, with a relative light unit (RLU) of 5394. LoD was 0.1 ng/L according to the parametrical analysis. Regarding imprecision, for samples ranging from cTnI concentrations of 1 to 106 ng/L, repeatability had a coefficient of variation (%CV) from 1.15% to 3.83%, and within-laboratory imprecision ranging from 1.69% to 5.03%. Using samples with hs-cTnI concentrations close to the manufacture’s sex-specific upper reference limits (9–36 ng/L), the repeatability and within-laboratory precision was 1.27%–1.61% and 1.92%–2.52%, respectively. The measuring interval for the linearity study ranged from 1.1 to 30 772 ng/L. All analytical parameters met CLSI limits of acceptable performance. No carry over was detected.

Conclusion

Our analytical observations of the Mindray hs-cTnI assay demonstrate excellent LoB, LoD, imprecision and linearity, that were in alignment of with the manufacturer’s claims and published guidelines for hs-cTnI.
B-329 Comparison Between Trough and AUC Monitoring of MPA in Patients With and Without Organ Transplantation. Influence of the Co-administered Immunosuppressant
Authors: Svinarov D
Published: September 2023

Background

Monitoring of mycophenolic acid (MPA) could be performed by measurement of trough concentrations with target therapeutic range of 1.3 to 3.5 mg/L, or by calculation of area under the drug concentration vs time curve (AUC) utilizing 3 or 4 samples within a dosing interval, with a target range of 30 to 60 mg*h/L. AUC is considered more reliable compared to trough levels, and MPA kinetics are dependent on the type of the co-administered calcineurine inhibitor. This study compares trough vs AUC MPA monitoring received alone or in co-administration with Cyclosporine (CsA) or with Tacrolimus (TAC).

Methods

77 transplanted patients receiving MPA, 25 of them on CsA, 49 on TAC, and 20 non-transplanted patients on MPA alone, were evaluated more than once, yielding 260 monitoring consults included for assessment: 45 for MPA alone, 108 for MPA combined with CsA, and 117 consults for the MPA combined with TAC. MPA, CsA, and TAC levels were measured by validated LC/MS/MS methods. Validated pharmacokinetic programs for the calculation of MPA AUC were used, adapted to the type of calcineurine inhibitor. Assessment was made by comparison of the distribution and coincidence between trough levels and AUC with respect to the above therapeutic ranges.

Results

Transplanted patents: when combined with CsA, MPA AUC was in the target range in 61% of cases, under it—in 31%, and in 8%—over it, while trough levels were 52% under, 42.5% within, and 5.5% over the therapeutic range; agreement between trough MPA and MPA AUC was poor—there was coincidence in 37.5% of sub-therapeutic, 63% of therapeutic and 0% of supra-therapeutic ranges, 3 cases were identified with sub-therapeutic trough and supra-therapeutic AUC; when combined with TAC, MPA AUC was in the target range in 63% of cases, under it—in 13%, and in 24%—over it; trough levels being 23% under, 60% within and 17% over the therapeutic range; agreement between trough MPA and MPA AUC was much better, compared to the combination with CsA: there was coincidence in 56% of sub-therapeutic, 84% of therapeutic and 80% of supra-therapeutic ranges. Nevertheless, 1 case was found with sub-therapeutic trough and supra-therapeutic AUC. In non-transplanted patients MPA AUC was in the target range in 47% of cases, under it—in 13%, and in 40%—over it; trough levels being 18% under, 53% within and 29% over the therapeutic range; agreement between trough MPA and MPA AUC showed coincidence in 75% of sub-therapeutic, 75% of therapeutic and 92% of supra-therapeutic ranges.

Conclusion

This study confirms that MPA AUC is more relevant than trough monitoring for dose individualization. It also shows that MPA trough levels are much more concordant with MPA AUC in non-transplanted patients and in transplanted patients on TAC, while in combination with CsA, discordance remains significant.
Estimating pregnancy rate from blubber progesterone levels of a blindly biopsied beluga population poses methodological, analytical and statistical challenges
Authors: Renaud L -A , Bordeleau X , Kellar N M , Pigeon G , Michaud R , Morin Y , Lair S , Therien A , Lesage V
Published: September 2023

Beluga (Delphinapterus leucas) from the St. Lawrence Estuary, Canada, have been declining since the early 2000s, suggesting recruitment issues as a result of low fecundity, abnormal abortion rates or poor calf or juvenile survival. Pregnancy is difficult to observe in cetaceans, making the ground truthing of pregnancy estimates in wild individuals challenging. Blubber progesterone concentrations were contrasted among 62 SLE beluga with a known reproductive state (i.e. pregnant, resting, parturient and lactating females), that were found dead in 1997 to 2019. The suitability of a threshold obtained from decaying carcasses to assess reproductive state and pregnancy rate of freshly-dead or free-ranging and blindly-sampled beluga was examined using three statistical approaches and two data sets (135 freshly harvested carcasses in Nunavik, and 65 biopsy-sampled SLE beluga). Progesterone concentrations in decaying carcasses were considerably higher in known-pregnant (mean ± sd: 365 ± 244 ng g−1 of tissue) than resting (3.1 ± 4.5 ng g−1 of tissue) or lactating (38.4 ± 100 ng g−1 of tissue) females. An approach based on statistical mixtures of distributions and a logistic regression were compared to the commonly-used, fixed threshold approach (here, 100 ng g−1) for discriminating pregnant from non-pregnant females. The error rate for classifying individuals of known reproductive status was the lowest for the fixed threshold and logistic regression approaches, but the mixture approach required limited a priori knowledge for clustering individuals of unknown pregnancy status. Mismatches in assignations occurred at lipid content < 10% of sample weight. Our results emphasize the importance of reporting lipid contents and progesterone concentrations in both units (ng g−1 of tissue and ng g−1 of lipid) when sample mass is low. By highlighting ways to circumvent potential biases in field sampling associated with capturability of different segments of a population, this study also enhances the usefulness of the technique for estimating pregnancy rate of free-ranging population.
Sublobar resection is not always superior for early-stage lung cancer in high-risk patients
Authors: Fukui Mariko , Matsunaga Takeshi , Hattori Aritoshi , Takamochi Kazuya , Nojiri Shuko , Suzuki Kenji
Published: September 2023

OBJECTIVES

The phase III trial, Japan Clinical Oncology Group 0802, illustrated the superiority of sublobar resection for early-stage lung cancer in terms of overall survival, with more non-lung cancer-related deaths after a lobectomy. The advantages of sublobar resection may be more pronounced in high-risk patients. The goal of this study was to elucidate the prognoses of high-risk patients.

METHODS

Patients with a risk of being ineligible for Japan Clinical Oncology Group 0802 for general conditions were classified as the high-risk group, and those who were not at risk of being ineligible were classified as the normal-risk group. Overall survival and prognostic factors were analysed in the high-risk group.

RESULTS

There were 254 (19.4%) and 1054 patients in the high- and normal-risk groups, respectively. Five-year survival rates were 94.5% and 79.1% in the normal-risk and high-risk groups, respectively (P < 0.001). More patients in the high-risk group died of lung cancer (P < 0.001) and non-lung cancer deaths (P < 0.001) than patients in the normal-risk group.

In the high-risk group, 151 lobectomies and 103 sublobar resections were performed. There was no significant difference in the numbers of lung cancer deaths and of non-lung cancer deaths between the procedures. Stratified survival analyses showed that the diffusing capacity of the lungs for carbon monoxide  < 40% tended to favour sublobar resection; being female and having a high carcinoembryonic antigen level tended to favour a lobectomy.

CONCLUSIONS

Sublobar resection is not always superior for early-stage lung cancer. Even in such cases, the surgical method should be determined by taking into consideration the patient's background and lung cancer surveillance.
Smoking and cardiovascular outcomes after percutaneous coronary intervention: a Korean study
Authors: Ki You-Jeong , Han Kyungdo , Kim Hyo-Soo , Han Jung-Kyu
Published: September 2023

Background and Aims

The authors investigated the impact of smoking and its cessation after percutaneous coronary intervention (PCI) on cardiovascular outcomes.

Methods

Using a nationwide database from the Korean National Health Insurance System, 74 471 patients undergoing PCI between 2009 and 2016 were classified as non-, ex-, or current smokers, depending on smoking status at the first health check-up within 1 year after PCI. The primary outcome was major adverse cardiovascular and cerebrovascular event (MACCE), a composite of all-cause death, myocardial infarction, coronary revascularization, and stroke.

Results

During 4.0 years of follow-up, current smokers had a 19.8% higher rate of MACCE than non-smokers [adjusted hazard ratio (aHR) 1.198; 95% confidence interval (CI) 1.137–1.263], and ex-smokers tended to have a comparable rate with that of non-smokers (aHR 1.036; 95% CI .992–1.081). For 31 887 patients with both pre- and post-PCI health check-up data, the effects of smoking cessation were analysed. Among quitters who stopped smoking after PCI, quitters with cumulative smoking exposure of <20 pack-years (PYs) tended to have a comparable rate of MACCE with that of persistent non-smokers. However, the rate in quitters with cumulative exposure of ≥20 PYs was comparable with that of persistent smokers [aHR (95% CI) for <10 PY, 1.182 (.971–1.438); 10–20 PYs 1.114 (.963–1.290); 20–30 PYs 1.206 (1.054–1.380); ≥ 30 PYs 1.227 (1.113–1.352); persistent smokers 1.223 (1.126–1.328), compared with persistent non-smokers, respectively, P for interaction <.001].

Conclusions

Smoking is associated with a higher risk of adverse outcomes in patients undergoing PCI. Quitters after PCI with <20 PYs were associated with a risk comparable with that of non-smokers.
Disparities in cannabis use outcomes, perceived risks and social norms across sexual orientation groups of US young adult women and men
Authors: Romm Katelyn F , Cohn Amy M , Beebe Laura A , Berg Carla J
Published: September 2023

Little research has examined mechanisms driving cannabis use disparities among sexual minority (SM; versus heterosexual) young adults (YAs). Participants were US YA women (N = 1345; 24.8% bisexual, 6.1% lesbian) and men (N = 998: 8.9% bisexual, 13.8% gay). Bivariate analyses examined associations between sexual orientation (heterosexual, gay/lesbian, bisexual) and cannabis use outcomes (past 30-day [current] use, use frequency, cannabis-tobacco dual use, use intentions), perceived risks (harm, addictiveness) and social norms (social acceptability, peer use). Regressions examined sexual orientation, perceived risks and social norms as correlates of cannabis outcomes. Bisexual and lesbian (versus heterosexual) women reported lower cannabis-related perceived risks, greater social norms and higher odds of current use. Bisexual (versus heterosexual) women reported more days of use, higher odds of cannabis-tobacco dual use and greater use intentions. Gay (versus heterosexual) men reported lower perceived addictiveness, greater social norms and higher odds of current use. Lower perceived risks and greater social norms predicted greater use outcomes for women and men. Bisexual women displayed higher odds of several cannabis use outcomes, whereas lesbian women and gay men displayed higher odds of current cannabis use only. Cannabis-related perceptions and social norms may be important targets for public health messaging for SMYAs.
Disrupted phase behavior of FUS underlies poly-PR-induced DNA damage in amyotrophic lateral sclerosis
Authors: Wang Yixin , Liu Liu , Chen Hui , Yang Yinxue , Mu Chenchen , Ren Haigang , Liu Yanli , Yu Liqiang , Fang Qi , Wang Guanghui , Hao Zongbing
Published: September 2023

GGGGCC (G4C2) hexanucleotide repeat expansion (HRE) in the first intron of the chromosome 9 open reading frame 72 (C9ORF72) gene is the most common genetic cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Among the five dipeptide repeat proteins translated from G4C2 HRE, arginine-rich poly-PR (proline:arginine) is extremely toxic. However, the molecular mechanism responsible for poly-PR-induced cell toxicity remains incompletely understood. Here, we found that poly-PR overexpression triggers severe DNA damage in cultured cells, primary cortical neurons, and the motor cortex of a poly-PR transgenic mouse model. Interestingly, we identified a linkage between poly-PR and RNA-binding protein fused in sarcoma (FUS), another ALS-related gene product associated with DNA repair. Poly-PR interacts with FUS both in vitro and in vivo, phase separates with FUS in a poly-PR concentration-dependent manner, and impairs the fluidity of FUS droplets in vitro and in cells. Moreover, poly-PR impedes the recruitment of FUS and its downstream protein XRCC1 to DNA damage foci after microirradiation. Importantly, overexpression of FUS significantly decreased the level of DNA damage and dramatically reduced poly-PR-induced cell death. Our data suggest the severe DNA damage caused by poly-PR and highlight the interconnection between poly-PR and FUS, enlightening the potential therapeutic role of FUS in alleviating poly-PR-induced cell toxicity.
The evolving story of catadromy in the European eel (Anguilla anguilla)
Authors: Durif C M F , Arts M , Bertolini F , Cresci A , Daverat F , Karlsbakk E , Koprivnikar J , Moland E , Olsen E M , Parzanini C , Power M , Rohtla M , Skiftesvik A B , Thorstad E , Vøllestad L A , Browman H I
Published: September 2023

Anguillid eels were once considered to be the classic example of catadromy. However, alternative life cycles have been reported, including skipping the freshwater phase and habitat shifting between fresh, brackish, and saltwater throughout the growth phase. There is a lack of knowledge regarding these alternate life strategies, for example, the proportion of individuals in the population that adopt them compared to classic catadromy. We provide a description of these alternate life cycle strategies in temperate anguillids, their possible drivers, and the methods available to investigate them. These methods (lethal and non-lethal), include otolith microchemistry, fatty acid and stable isotope analyses, parasite identification, blood transcriptomics, and electronic tags. We argue that since the current management framework for the European eel and other temperate eels is based mainly on the freshwater component of the population, it ignores eels growing in saline waters. Many of the factors that are thought to be responsible for the precipitous decline of the eel population are more prevalent in freshwater systems. Therefore, the contribution of saline eels may be more important than currently estimated. The habitat-shifting ability of eels may be all the more crucial for the persistence and recovery of those species that are endangered.
Using BCG Vaccine to Enhance Nonspecific Protection of Health Care Workers During the COVID-19 Pandemic: A Randomized Controlled Trial
Authors: Madsen Anne Marie Rosendahl , Schaltz-Buchholzer Frederik , Nielsen Sebastian , Benfield Thomas , Bjerregaard-Andersen Morten , Dalgaard Lars Skov , Dam Christine , Ditlev Sisse Bolm , Faizi Gulia , Azizi Mihnaz , Hameed Zainab Nadhim , Johansen Isik Somuncu , Kofoed Poul-Erik , Krause Tyra Grove , Kristensen Gitte Schultz , Loekkegaard Ellen Christine Leth , Mogensen Christian Backer , Mohamed Libin , Oedegaard Emilie Sundhaugen , Ostenfeld Anne , Soerensen Marcus Kjaer , Wejse Christian , Netea Mihai G , Aaby Peter , Benn Christine Stabell
Published: September 2023

Background

The BCG (Bacillus Calmette-Guérin) vaccine can induce nonspecific protection against unrelated infections. We aimed to test the effect of BCG on absenteeism and health of Danish health care workers (HCWs) during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

A single-blinded randomized controlled trial included 1221 HCWs from 9 Danish hospitals. Participants were randomized 1:1 to standard dose BCG or placebo. Primary outcome was days of unplanned absenteeism. Main secondary outcomes were incidence of COVID-19, all-cause hospitalization, and infectious disease episodes.

Results

There was no significant effect of BCG on unplanned absenteeism. Mean number of days absent per 1000 workdays was 20 in the BCG group and 17 in the placebo group (risk ratio, 1.23; 95% credibility interval, 0.98–1.53). BCG had no effect on incidence of COVID-19 or all-cause hospitalization overall. In secondary analyses BCG revaccination was associated with higher COVID-19 incidence (hazard ratio [HR], 2.47; 95% confidence interval [CI], 1.07–5.71), but also reduced risk of hospitalization (HR, 0.28; 95% CI, .09–.86). The incidence of infectious disease episodes was similar between randomization groups (HR, 1.09; 95% CI, .96–1.24).

Conclusions

In this relatively healthy cohort of HCWs, there was no overall effect of BCG on any of the study outcomes.

Clinical Trials Registration

NCT0437329 and EU Clinical Trials Register (EudraCT number 2020-001888-90).
IL-27 regulates NLRP3 inflammasome activation of MDSCs in experimental Sjögren’s syndrome
Authors: Xia Xiaoyu , Long Qiqiang , Zha Jie , Jiang Tingting , Guo Junqiao , Jiang Bo , Li Xiaojing , Yao Genhong
Published: September 2023

Excessive NOD-like receptor thermal protein domain associated protein 3 (NLRP3) inflammasome activation has an important function in the pathogenesis of Sjögren’s syndrome (SS). Increased and dysfunctional myeloid-derived suppressor cells (MDSCs) promoted SS. However, NLRP3 inflammasome activation of MDSCs in SS and its regulated components are unclear. Splenic MDSCs were purified by immunomagnetic beads and cultured. Western blot was used to assess NLRP3 inflammasomes. Interleukin-1β (IL-1β) and IL-18 were measured using enzyme-linked immunosorbent assay. Here we showed that the NLRP3 inflammasome was activated in non-obese diabetic (NOD) mice with SS-like manifestations. We found that NLRP3 inflammasome activation was augmented in MDSCs of SS mice and NLRP3 inflammasome activation was suppressed in IL-27-deficient NOD mice. Consistent with findings of SS mice in vivo, we observed that NLRP3 inflammasome activation by adenosine triphosphate and lipopolysaccharide was remarkably intensified in MDSCs with IL-27 treatment in vitro. Collectively, our data highlighted that IL-27 regulates NLRP3 inflammasome activation of MDSCs in experimental SS.
The use of natural language processing in detecting and predicting falls within the healthcare setting: a systematic review
Authors: Trinh Vincent Quoc-Nam , Zhang Steven , Kovoor Joshua , Gupta Aashray , Chan Weng Onn , Gilbert Toby , Bacchi Stephen
Published: September 2023

Falls are a common problem associated with significant morbidity, mortality, and economic costs. Current fall prevention policies in local healthcare settings are often guided by information provided by fall risk assessment tools, incident reporting, and coding data. This review was conducted with the aim of identifying studies which utilized natural language processing (NLP) for the automated detection and prediction of falls in the healthcare setting. The databases Ovid Medline, Ovid Embase, Ovid Emcare, PubMed, CINAHL, IEEE Xplore, and Ei Compendex were searched from 2012 until April 2023. Retrospective derivation, validation, and implementation studies wherein patients experienced falls within a healthcare setting were identified for inclusion. The initial search yielded 2611 publications for title and abstract screening. Full-text screening was conducted on 105 publications, resulting in 26 unique studies that underwent qualitative analyses. Studies applied NLP towards falls risk factor identification, known falls detection, future falls prediction, and falls severity stratification with reasonable success. The NLP pipeline was reviewed in detail between studies and models utilizing rule-based, machine learning (ML), deep learning (DL), and hybrid approaches were examined. With a growing literature surrounding falls prediction in both inpatient and outpatient environments, the absence of studies examining the impact of these models on patient and system outcomes highlights the need for further implementation studies. Through an exploration of the application of NLP techniques, it may be possible to develop models with higher performance in automated falls prediction and detection.
Innovative approaches to analysing aged care falls incident data: international classification for patient safety and correspondence analysis
Authors: Seaman Karla , Meulenbroeks Isabelle , Nguyen Amy , Silva Sandun , Wabe Nasir , Huang Guogui , Hibert Peter , Paudel Pramilia , Westbrook Johanna
Published: September 2023

Falls in residential aged care facilities (RACFs) are common and can have significant health consequences. Understanding how and why falls occur in RACFs is an essential step to design targeted fall prevention and intervention programmes; however, little is known about falls’ mechanisms in RACFs. This study aims to use international incident classification systems and novel analysis techniques to describe factors that contribute to falls requiring hospitalization in RACFs. Retrospective data of falls assessed by nurses as requiring hospitalization from 429 residents in 22 Australian RACFs in 2019 were used. Data were reviewed using a modified version of the International Classification for Patient Safety (ICPS), which categorizes patient safety into incident types and contributing factors using a three-tiered structure. The ICPS codes were summarized using the descriptive statistics. The association between assigned ICPS codes were analysed using correspondence analysis. Six hundred and three falls assessed as requiring hospitalization were classified into 659 incident types, with the most common incident type being ‘patient incidents’ (injury sustained/adverse effect in the health care system) (603, 91.5%) at Level 1, ‘falls’ (601, 91.2%) at Level 2, and ‘falls involving bedrooms’ (214, 32.5%) at Level 3. The 603 falls had 1082 contributing factors, with the most common contributing factor being ‘patient factors’ (events affected by factors associated with the patient) (982, 90.8%) at Level 1, ‘patient not elsewhere classified’ (characteristics of the patient contributed to the incident not classified elsewhere) (571, 52.8%) at Level 2, and ‘loss of balance’ (361, 33.4%) at Level 3. In a correspondence analysis, three dimensions were responsible for 81.2% of the variation in falls incidents and environmental and organizational factors were important factors contributing to falls. The application of the ICPS demonstrated that personal factors (e.g. pre-existing physical and psychological health or impairment) were the most common contributing factors to falls assessed as requiring hospitalization, while the correspondence analysis highlighted the role of environmental and organizational factors. The results signal the need for more research into multifactorial falls prevention interventions in RACFs.
Effects of remdesivir on SARS-CoV-2 viral dynamics and mortality in viraemic patients hospitalized for COVID-19
Authors: Hagman Karl , Hedenstierna Magnus , Widaeus Jacob , Arvidsson Emelie , Hammas Berit , Grillner Lena , Jakobsson Jan , Gille-Johnson Patrik , Ursing Johan
Published: September 2023

Background

Studies on the antiviral effects of remdesivir have shown conflicting results. SARS-CoV-2 viraemia could identify patients in whom antiviral treatment may be particularly beneficial.

Objectives

To investigate antiviral effects and clinical outcomes of remdesivir treatment in viraemic patients.

Methods

Viraemic patients hospitalized for COVID-19 with ratio of arterial oxygen partial pressure to fractional inspired oxygen of ≤300, symptom duration ≤10 days, and estimated glomerular filtration rate ≥30 mL/min were included in a cohort. The rate of serum viral clearance and serum viral load decline, 60 day mortality and in-hospital outcomes were estimated. A subgroup analysis including patients with symptom duration ≤7 days was performed.

Results

A total of 318 viraemic patients were included. Thirty-three percent (105/318) received remdesivir. The rate of serum viral clearance [subhazard risk ratio (SHR) 1.4 (95% CI 0.9–2.0), P = 0.11] and serum viral load decline (P = 0.11) were not significantly different between remdesivir-treated patients and controls. However, the rate of serum viral clearance was non-significantly higher [SHR 1.6 (95% CI 1.0–2.7), P = 0.051] and the viral load decline was faster (P = 0.03) in remdesivir-treated patients with symptom duration ≤7 days at admission. The 60 day mortality [HR 1.0 (95% CI 0.6–1.8), P = 0.97] and adverse in-hospital outcomes [OR 1.4 (95% CI 0.8–2.4), P = 0.31] were not significantly different between remdesivir-treated patients and controls.

Conclusions

Remdesivir treatment did not significantly change the duration of SARS-CoV-2 viraemia, decline of serum viral load, 60 day mortality or in-hospital adverse outcomes in patients with ≤10 days of symptoms at admission. Remdesivir appeared to reduce the duration of viraemia in a subgroup of patients with ≤7 days of symptoms at admission.
Effects of the F94L myostatin gene mutation in beef × dairy crossed cattle on muscle fiber type, live performance, carcass characteristics, and boxed beef and retail cut yields
Authors: Waller Bryanne E , Garcia Samuel R , Fuerniss Luke K , Johnson Bradley J , Woerner Dale R , Wulf Duane M
Published: September 2023

Producer live performance data and carcasses from steers (n = 116) resulting from the mating of four Limousin/Angus sires heterozygous for the F94L myostatin mutation to Jersey/Holstein dams were utilized to evaluate the effects of one copy of the F94L allele on live performance, carcass traits and USDA grades, and boxed beef and retail yields. Slaughter data were collected at time of harvest and carcass data were collected 48 hours postmortem. One side from each of the 58 carcasses was fabricated into boxed beef and retail cuts by experienced lab personnel 5–8 d postmortem. One copy of the F94L allele did not affect gestation length, birth weight, percentage of unassisted births, feedlot average daily gain, live weight at harvest, hot carcass weight, or dressing percentage (P > 0.05). Muscle fiber analysis indicated that the increase in muscularity by the F94L allele in the semitendinosus and longissimus was likely due to hyperplasia as there was a 19% increase in the quantity of myosin heavy chain type IIA and IIX fibers in the semitendinosus (P < 0.05) with no effect on muscle fiber size (P > 0.05). Carcasses from steers with one F94L allele had larger ribeye areas (99.2 vs. 92.3 sq.cm.), greater ribeye width:length ratios (0.498 vs. 0.479), lower USDA yield grades (2.21 vs. 2.66), and lower marbling scores (438 vs. 480) (P < 0.05). Additionally, for boxed beef yields, one F94L allele, vs. zero F94L alleles, increased (P < 0.05) 85/15 trimmings (+0.59%), top round (+0.28%), strip loin (+0.12%), eye round (+0.11%), tenderloin (+0.07%), boneless foreshank (+0.07%), cap/wedge (+0.06%), and tri-tip (+0.04%). Overall, carcasses from steers with one F94L allele had a greater boxed beef yield (+1.06%), boxed beef plus 85/15 trimmings yield (+1.65%), and total retail cuts plus ground beef 85/15 yield (+1.78%) than carcasses from steers with zero F94L alleles (P < 0.05). One copy of the F94L allele utilized in beef-on-dairy breeding system had no significant impact on live performance traits but resulted in lower marbling scores and increased muscularity as evidenced through larger, more beef-shaped ribeyes, lower USDA yield grades, and greater carcass cutout yields (both boxed beef and retail yields).
Early- and mid-lactation milk traits are associated with piglet growth during lactation
Authors: Rempel Lea A , Oliver William T , Miles Jeremy R
Published: September 2023

Preweaning piglet growth is tied to milk quality and consumption. To determine the relationship of milk traits from parity 1–4 dams and piglet growth, early- and mid-lactation (day 2 and day 16) milk samples were collected from 48 litters and analyzed for protein, fat, somatic cell count (SCC), lactose, other solids (solids excluding protein and fat), total solids, and milk urea nitrogen (MUN). There were no interactions of parity by day therefore only main effects were tested. Milk volume and percent MUN were greatest (P < 0.05) from fourth parity dams. Nulliparous dams had elevated (P < 0.05) SCC. Several milk traits were different by day. Percent milk protein, fat, and total solids were greater (P < 0.05) from day 2 milk, while percent milk lactose and other solids were greater (P < 0.05) from day 16 milk. Each milk trait was categorically identified as high, moderate, or low at ¼, ½, or ¼ distribution, respectively. Mixed models were used to determine the association of individual milk traits with piglet lactation growth (gain calculated from body weights at birth, day 10, and day 25 weaning; WN). Moderate levels of day 2 milk protein were associated with the greatest (P < 0.05) gain during lactation in comparison to low and high levels. High levels of day 2 milk lactose and day 2 other solids were both related (P < 0.05) to piglet gain over the lactation period. Evaluation of day 16 milk traits with piglet gain over lactation indicated high levels of fat, other solids, and total solids had the greatest (P < 0.05) gain in comparison to moderate and low levels of each trait. Within phase of lactation weight gain, association of day 2 or day 16 milk traits with early weight gain (birth to day 10) or late weight gain (day 10 to WN) were performed. The greatest (P < 0.05) early weight gains were associated with moderate levels of day 2 protein, high levels of day 2 lactose and day 2 other solids, and low levels of day 2 MUN. High levels of day 2 milk lactose and day 16 milk fat were associated (P < 0.05) with piglet gain during late lactation (day 10 to weaning). Genetic selection or improved management that allows for favorable milk traits at critical periods of lactation for improved weight gain will improve pig production.
Urinary bladder matrix for lower extremity split-thickness skin graft donor site
Authors: Bormann Sydney , Lawrence Zachary , Karu Heather
Published: September 2023

Split-thickness skin grafts (STSG) are commonly used to treat soft-tissue defects. Harvesting a STSG creates an additional partial thickness wound at the donor site which must be managed. Many dressings are commercially available for the management of STSG donor sites; however, there is no evidence-based consensus on optimal dressing for site management. Urinary bladder matrix (UBM) is an extracellular matrix that acts as a structural support for tissue remodeling and provides molecular components for repair. Common clinical applications of UBM include coverage of deep wounds, burns, and irradiated skin. Skin grafting from the lower extremities poses a challenge due to the increased dermal tension. UBM-based reconstruction is an alternative method of managing lower extremity skin graft donor sites. This case study demonstrates the use of UBM in the reconstruction of a STSG donor site of the anterolateral thigh, which resulted in satisfactory healing, no pain, and excellent cosmetic and functional outcomes.
Single pulse emission from PSR B0809+74 at 150 MHz using Polish LOFAR station
Authors: Basu Rahul , Lewandowski Wojciech , Kijak Jarosław , Bartosz Śmierciak , Soida Marian , Błaszkiewicz Leszek , Krankowski Andrzej
Published: September 2023

We report the observations of single pulse emission from the pulsar B0809+74 at 150 MHz using the Polish LOFAR station, PL-611. The three major phenomena of subpulse drifting, nulling, and mode changing associated with single pulse variations are prominently seen in these observations. The pulsar has a single-component conal profile and the single pulses are primarily in the ‘normal’ drift mode with periodicity (P3) 11.1 ± 0.5 P for 96  per cent of the observing duration, while the shorter duration ‘slow-drift’ mode has P3 = 15.7 ± 1.2 P. We were able to measure the phase behaviour associated with drifting from the fluctuation spectral analysis that showed identical linear phase variations across the pulse window for both modes despite their different periodic behaviour. Earlier studies reported that the transitions from the normal state to the slow-drift mode were preceded by the presence of nulling with typical durations of 5 to 10 periods. Our observations however seem to suggest that the transition to nulling follows shortly after the pulsar switches to the slow-drift mode and not at the boundary between the modes, with one instance of complete absence of nulling between mode switching. In addition, we also detected a second type of short-duration nulls not associated with the mode changing that showed quasi-periodic behaviour with periodicity PN ∼ 44 ± 7. The variety of features revealed in the single pulse sequence makes PSR B0809+74 an ideal candidate to understand the physical processes in the Partially Screened Gap dominated by non-dipolar magnetic fields.
Formation of the hydrogen line 21-cm in Dark Ages and Cosmic Dawn: dependences on cosmology and first light
Authors: Novosyadlyj Bohdan , Kulinich Yurii , Milinevsky Gennadi , Shulga Valerii
Published: September 2023

We analyse the formation of the redshifted hyperfine structure line 21-cm of hydrogen atom in the Dark Ages, Cosmic Dawn, and Reionization epochs. The evolution of the global differential brightness temperature in this line was computed to study its dependence on the values of cosmological parameters and physical conditions in the intergalactic medium. Variations of the depth of the Dark Ages absorption line at z ∼ 80 with variations of the cosmological parameters Ωb, Ωcdm, ΩΛ, ΩK, and H0 are studied. The standard model with post-Planck parameters predicts a value of the differential brightness temperature in the centre of the absorption line ∼30–50 mK. The profile of this line can be quite another in the non-standard cosmological models, which include the annihilating or decaying dark matter, a primordial stochastic magnetic field, etc. It can be shallower or be an emission bump instead of an absorption trough. It is also shown that the position and depth of the Cosmic Dawn absorption line formed at 10 < z < 30, due to the Wouthuysen–Field effect, is mainly defined by the spectral energy distribution of the first sources of light. If reionization occurs at zri = 7 ± 1, then the differential brightness temperature in the centre of this line is ∼80 mK. During the reionization, the emission with an amplitude of ∼20 mK is possible. It is also shown that the temperature, density, and degree of ionization of the baryonic component are decisive in calculating the intensity of the 21-cm absorption/emission line from these epochs.
The effect of intra-articular steroid injection on the cartilage and tendon thicknesses in juvenile idiopathic arthritis
Authors: Şahin Nihal , Özdemir Çiçek Sümeyra , Paç Kısaarslan Ayşenur , Dursun İsmail , Poyrazoğlu Muammer Hakan , Düşünsel Ruhan
Published: September 2023

Objectives

Intra-articular corticosteroid injection (IACI) is a safe first-line or adjunct therapy used in any subtype of juvenile idiopathic arthritis (JIA). Limited studies evaluated the effect of IACI on cartilage. Our study aimed to examine the femoral cartilage thickness of patients with JIA who received IACI to the knee joint using ultrasound.

Methods

We randomly selected JIA patients who performed IACI in the knee joint. Baseline bilateral joint cartilage and tendon thicknesses were measured. The articular fluid was aspirated, and applied IACI at the same period. Six months after injection, the exact measurements were repeated. Distal femoral cartilage, quadriceps tendon, and distal and proximal patellar tendon thicknesses were compared at the baseline (before IACI) and 6 months after IACI.

Results

Thirty patients with JIA were included, and 23 (76.7%) were female. The median age was 11 years (interquartile range, 6 to 14), and the median disease duration was 3.3 years (interquartile range, 5 months to 5 years). The subtypes of JIA were oligoarticular in 25 (83.3%), polyarticular in 2 (6.7%), enthesitis-related arthritis in 2 (6.7%), and juvenile psoriatic arthritis in 1 (3.3%). Distal femoral cartilage thickness was 2.96 ± 0.79 mm at baseline and 2.85 ± 0.70 mm at 6 months after IACI (P = .35). The tendon thicknesses were similar at 6 months after baseline measurements.

Conclusions

Our findings reveal that knee IACI in patients with JIA did not significantly change cartilage and tendon thicknesses. This observation could indicate that IACIs have no detrimental effects on the cartilage and the tendons.
Epidemiology and Risk Factors for Invasive Fungal Infections in Pancreas Transplant in the Absence of Postoperative Antifungal Prophylaxis
Authors: Zachary Jessica , Chen Jeanne M , Sharfuddin Asif , Yaqub Muhammad , Lutz Andrew , Powelson John , Fridell Jonathan A , Barros Nicolas
Published: September 2023

Background

Invasive fungal infections (IFIs) remain a rare yet dreaded complication following pancreas transplantation. Current guidelines recommend antifungal prophylaxis in patients with 1 or more risk factors. At our center, single-dose antifungal prophylaxis is administered in the operating room but none subsequently, regardless of risk factors. Here we evaluate the 1-year incidence, outcome, and risk factors associated with IFI following pancreas transplantation.

Methods

A retrospective, single-center cohort study was conducted in patients who underwent pancreas transplantation between 1 January 2009 and 31 December 2019. Records were manually reviewed, and cases were adjudicated using consensus definitions. The 1-year cumulative incidence, mortality, and risk factors were analyzed by Kaplan-Meier method and differences between populations were assessed with Fisher test and Mann-Whitney U test.

Results

Three hundred sixty-nine recipients were included. Twelve IFIs were identified: candidiasis (8), aspergillosis (2), histoplasmosis (1), and cryptococcosis (1). Intra-abdominal infections were the most common presentation (5), followed by bloodstream infections (3), disseminated disease (2), pulmonary disease (1), and invasive fungal sinusitis (1). Median time to IFI was 64 days (interquartile range, 30–234 days). One-year cumulative incidence was 3.25% (95% confidence interval, 1.86%–5.65%). There were no significant differences between patients with or without IFI regarding type of transplant (P = .17), posttransplant dialysis (P = .3), rejection (P = .5), cytomegalovirus serostatus (P = .45), or reoperation (P = .19). For patients with IFI, the 1-year graft and patient survival rates were 58% versus 95% (P < .0001) and 75% versus 98.6% (P < .001), respectively.

Conclusions

Our study suggests that the use of a single-dose antifungal prophylaxis administered in the operating room but none subsequently does not result in an increased incidence of IFI following pancreas transplantation.
The silent invader: a case of intrapericardial hydatid cyst with exceptional pulmonary artery involvement
Authors: Soufiani Aida , El-Mhadi Samah , Chraibi Hamza , Agoumy Zineb , Fehri Zineb Fassi , Es-sebbani Sanae , Leghlimi Hasnaa , El Kettani Omar Ech-cherif , Lachhab Fadoua , Tribak Mohammed , Fellat Rokya , Bendagha Nesma , Moughil Said
Published: September 2023

A 70-year-old woman was referred to our cardiology department for the management of dyspnoea. Cardiovascular examination revealed a loud P2, with no sign of right-sided heart failure. Chest X-ray showed a convex left medium cardiac border and a double contour along the right cardiac border. Transthoracic echocardiogram revealed a cystic mass attached to the right ventricle apex. Computed tomography scan showed cyst with fluid density on the apex of the right ventricle; and a honeycomb-like aspect cyst with partial occlusion in the left pulmonary artery. Cardiac magnetic resonance imaging revealed the presence of hydatic intrapericardial cyst that compresses the right ventricular apex; associated with intraluminal left pulmonary artery cyst. Hydatic serology was positive. The patient refused surgery and was discharged on a regimen of Albendazole. She has been followed up closely with a good outcome.
Improved Symptom Change Enhances Quality of Dying in Patients With Advanced Cancer: An East Asian Cross-Cultural Study
Authors: Huang Hsien-Liang , Chen Ping-Jen , Mori Masanori , Suh Sang-Yeon , Wu Chien-Yi , Peng Jen-Kuei , Shih Chih-Yuan , Yao Chien-An , Tsai Jaw-Shiun , Chiu Tai-Yuan , Hiratsuka Yusuke , Kim Sun-Hyun , Morita Tatsuya , Yamaguchi Takashi , Tsuneto Satoru , Hui David , Cheng Shao-Yi
Published: September 2023

Background

Symptom burdens tend to increase for patients with cancer and their families over the disease trajectory. There is still a lack of evidence on the associations between symptom changes and the quality of dying and death. In this context, this research investigated how symptom changes influence the quality of dying and death.

Methods

This international prospective cohort study (the East Asian Collaborative Cross-Cultural Study to Elucidate the Dying Process (EASED), 2017-2019) included 22, 11, and 4 palliative care units across Japan, South Korea, and Taiwan. Eligible participants were adults (Japan and Korea, ≥18 years; Taiwan, ≥20 years) with locally advanced or metastatic cancer. Physical and psychological symptoms were assessed by physicians upon admission and within 3 days before death. Death quality was assessed using the Good Death Scale (GDS), developed in Taiwan. Univariate and multivariate regression analyses were used to identify correlations between symptom severity changes and GDS scores.

Results

Among 998 patients (542 [54.3%] men and 456 [45.7%] women; mean [SD] age = 70.1 [± 12.5] years), persistent dyspnea was associated with lower GDS scores when compared to stable dyspnea (β = −0.427, 95% CI = −0.783 to −0.071). Worsened (−1.381, −1.932 to −0.831) and persistent (−1.680, −2.701 to −0.659) delirium were also significantly associated with lower GDS scores.

Conclusions

Better quality of dying and death was associated with improved symptom control, especially for dyspnea and delirium. Integrating an outcome measurement for the quality of dying and death is important in the management of symptoms across the disease trajectory in a goal-concordant manner.