bluuebunny/crossref_metadata_2025 huggingface dataset:
Alternaria mycotoxin degradation and quality evaluation of orange juice by ozone treatment
Authors: Wang Xiaoyuan , Liu Qing , Han Yike , Zong Wei , Ge Zhenzhen , Wei Xiaopeng
Published: August 2024

The effect of ozone treatment on the degradation of two Alternaria mycotoxins, alternariol (AOH) and alternariol monomethyl ether (AME), in both aqueous solution and orange juice was investigated. In addition, the quality of orange juice after ozone treatment was evaluated. The results demonstrated that ozone treatment effectively eliminated AOH and AME. In an aqueous solution, AOH exhibited a reduction of 57.95%, while AME decreased by 40.24% after 5 s treatment. And the two toxins could be almost completely degraded within 40 s. Moreover, an alkaline condition with a pH value of 10 facilitated complete degradation within just 15 s of treatment. Furthermore, higher temperatures may enhance the degradation percentage. Regarding orange juice, the degradation percentages of AOH and AME after ozone treatment for 600 s were recorded as 51.86% and 49.04%, respectively, which were comparatively lower than those observed in aqueous solution. The toxin degradation increased with longer treatment times and higher flow rates, but decreased with the initial concentration of mycotoxins. Meanwhile, the results of the quality evaluation showed that the color and browning index (BI) of orange juice did not change significantly, while the pH value was reduced. Additionally, the clarification, antioxidant properties, and stability of orange juice were significantly improved after ozone treatment. In conclusion, ozone treatment is an effective approach for degrading Alternaria mycotoxins while also improving certain quality parameters within a given treatment time frame. Therefore, it can be considered a promising non‐thermal alternative technology for removing Alternaria mycotoxins from food systems.

Practical applications

The Alternaria fungus has the capacity to infect a wide range of crops, with infections occurring during various stages such as planting, transportation, and processing. Ozone technology has been extensively utilized in drinking water treatment, wheat flour treatment, wastewater treatment, aquaculture, and medical industries. However, current methods for controlling mycotoxins fail to meet industry demands for high removal rates, environmental friendliness, efficiency, and convenience as well as low‐cost maintenance required to preserve the sensory quality and nutritional value of food products. Therefore, there is an urgent need to explore novel approaches that can effectively address these challenges in practical production settings. Furthermore, the parameter optimization of specific technologies within the food sector remains underdeveloped and requires further research. In this context, ozone technology holds promise for controlling Alternaria mycotoxins degradation in orange juice while offering valuable insights into toxin degradation within the beverage industry.
Innovations in Preconception Care: Optimizing Health for All Individuals
Authors: Nypaver Cynthia , Yeager Amanda
Published: August 2024

Optimizing the overall health of individuals prior to pregnancy can improve both pregnancy and lifelong health outcomes. Despite extremely high financial expenditure on birth in the United States, maternal and infant mortality rates continue to rise. Moreover, significant racial and ethnic disparities persist in perinatal health outcomes. Preconception care, or health care provided before or between pregnancies, has the capacity to meet these challenges. Preconception care can be integrated into every health care visit, including visits with primary care, reproductive health, and mental health care clinicians. Increasing awareness among clinicians of the benefits of preconception care and equipping them with innovative strategies to implement this care into practice, the number of people receiving optimal care could be increased. Recent innovations in preconception care include group care, health applications (apps), reminders in electronic health records, social marketing campaigns, social media movements, community‐based partnerships, health care policy and access, and improving public and clinician education on preconception health topics. Ultimately, improving preconception health is best done in partnership between the consumer and clinician. Midwives, whose care is person‐centered and partnership‐focused, are well positioned to champion the innovation and implementation of equitable preconception care. The purpose of this State of the Science review, therefore, is to synthesize the literature on recent evidence‐based innovations that may be used to improve preconception health and counseling.
Cranial bone microarchitecture in a mouse model for syndromic craniosynostosis
Authors: Ajami Sara , Van den Dam Zoe , Hut Julia , Savery Dawn , Chin Milton , Koudstaal Maarten , Steacy Miranda , Carriero Alessandra , Pitsillides Andrew , Chang Y.‐M. , Rau Christoph , Marathe Shashidhara , Dunaway David , Jeelani Noor Ul Owase , Schievano Silvia , Pauws Erwin , Borghi Alessandro
Published: August 2024

Crouzon syndrome is a congenital craniofacial disorder caused by mutations in the Fibroblast Growth Factor Receptor 2 (FGFR2). It is characterized by the premature fusion of cranial sutures, leading to a brachycephalic head shape, and midfacial hypoplasia. The aim of this study was to investigate the effect of the FGFR2 mutation on the microarchitecture of cranial bones at different stages of postnatal skull development, using the FGFR2C342Y mouse model. Apart from craniosynostosis, this model shows cranial bone abnormalities. High‐resolution synchrotron microtomography images of the frontal and parietal bone were acquired for both FGFR2C342Y/+ (Crouzon, heterozygous mutant) and FGFR2+/+ (control, wild‐type) mice at five ages (postnatal days 1, 3, 7, 14 and 21, n = 6 each). Morphometric measurements were determined for cortical bone porosity: osteocyte lacunae and canals. General linear model to assess the effect of age, anatomical location and genotype was carried out for each morphometric measurement. Histological analysis was performed to validate the findings. In both groups (Crouzon and wild‐type), statistical difference in bone volume fraction, average canal volume, lacunar number density, lacunar volume density and canal volume density was found at most age points, with the frontal bone generally showing higher porosity and fewer lacunae. Frontal bone showed differences between the Crouzon and wild‐type groups in terms of lacunar morphometry (average lacunar volume, lacunar number density and lacunar volume density) with larger, less dense lacunae around the postnatal age of P7–P14. Histological analysis of bone showed marked differences in frontal bone only. These findings provide a better understanding of the pathogenesis of Crouzon syndrome and will contribute to computational models that predict postoperative changes with the aim to improve surgical outcome.
Diabetes self‐care activities and its correlates in patients with diabetic neuropathy
Authors: Kang Younhee , Park Inkyung
Published: August 2024

Background

Diabetic neuropathy is the most common chronic complication observed in patients with diabetes and has significant clinical implications, such as decreased quality of life and increased morbidity and mortality rates. Studies on the factors affecting diabetes self‐care activities pertaining to patients with diabetic neuropathy are limited. Therefore, a more in‐depth study targeting individuals with diabetic neuropathy is required to develop patient‐centred nursing interventions.

Aim

This study aimed to identify diabetes self‐care activities among patients with diabetic neuropathy and determine their correlates.

Methods

This study employed a descriptive correlational design and the study subjects consisted of 99 patients with diabetic neuropathy. Descriptive statistics and hierarchical regression analyses were used to analyse the factors affecting diabetes self‐care activities. This study follows the STROBE guidelines to ensure rigorous reporting of cross‐sectional studies.

Results

Our findings revealed positive correlations between diabetes self‐care activities and factors including knowledge of diabetes foot care, diabetes foot care practices, interpretation of diabetic neuropathy and foot care confidence. Foot care confidence positively correlated with diabetes foot care knowledge, practices and interpretation of neuropathy, but negatively related to diabetic stress. In determining the impact of these factors on diabetes self‐care activities, hierarchical regression analysis revealed that patients with higher diabetes foot care practices and foot care confidence demonstrated higher levels of diabetes self‐care activities.

Conclusion

The study findings confirmed that diabetic foot care practices and foot care confidence significantly influenced self‐care activities in patients with diabetic neuropathy. Considering these results, customizing the intervention content to match diabetic foot care practices and diabetic foot care confidence can enhance self‐care activities in patients with diabetic neuropathy.

Patient or Public Contribution

Survey questionnaires were completed by patients with diabetic neuropathy in this study.
Diseases with oral malignant potential: Need for change to inform research, policy, and practice
Authors: Celentano Antonio , Cirillo Nicola
Published: August 2024

This manuscript critically examines the current classification of oral potentially malignant disorders, questioning the practicality and implications of labeling such a large population as precancerous, given that the actual progression to oral cancer is significantly low for most disorders. The paper advocates for a revised classification system that accurately reflects the varying malignancy risks associated with different disorders. It suggests a reassessment of the diagnostic and management approaches to mitigate overdiagnosis and alleviate patient burdens. We propose categorizing diseases with oral malignant potential as follows: Oral Precancerous Diseases, encompassing high‐risk lesions and conditions like erythroplakia, non‐homogeneous leukoplakia, proliferative leukoplakia, and actinic keratosis; Oral Potentially Premalignant Diseases, covering lesions, conditions, and systemic diseases with distinct oral manifestations harboring a limited or undefined risk of transformation, such as homogeneous leukoplakia, oral submucous fibrosis, oral lichenoid diseases, chronic hyperplastic candidosis, keratosis of known aetiology (smokeless tobacco, khat), palatal lesions in reverse smokers, and dyskeratosis congenita; and Systemic Conditions with Oral Malignant Potential including Fanconi's anemia, xeroderma pigmentosum, and chronic immunosuppression (including patients post‐bone marrow transplantation), which are associated with an increased risk of oral cancer without preceding precursor lesions. We provide illustrative examples to demonstrate how this framework offers practical guidance for research, policy‐making, and clinical practice.
Neonatal acuity tool‐defined staffing ratios in a tertiary Australian neonatal intensive care unit
Authors: Barnett Adam , Crawford Tara M , Stark Michael J
Published: August 2024

Aims

There is well‐established data linking the adequacy of nurse staffing to patient outcomes. Evidence‐based standards for staffing are therefore critical to drive improvements in clinical care. One such evidence‐based approach is the use of patient acuity‐based tools. The objective of this study is to determine the performance of a neonatal acuity tool in an Australian tertiary neonatal health‐care setting, focusing on the classification of patient acuity and nursing:patient staffing ratios compared to current practice.

Methods

Acuity data were collected in a neonatal intensive care unit (NICU) and special care baby unit (SCBU) over a 10‐week period in 2023. Patient data were scored in the 16 domains at two time points (prior to morning and evening nursing shift changeover) for all admitted newborns.

Results

For ventilated newborns nursed with a nurse:patient staffing ratio of 1:1, 78% of scores were within the L4‐high acuity (score ≥ 26) band, with the remaining scores within the L3‐high acuity (18–25) band. For newborns on non‐invasive respiratory support in NICU staffed 1:1, the proportion scoring within the L4 acuity band was higher in the nasal high‐flow group compared to the nasal continuous positive airway pressure group (P = 0.032), an effect not seen for those nursed 1:2 in NICU or for those on nasal high‐flow nursed in SCBU either 1:2 or 1:3.

Conclusion

This study of how a neonatal acuity classification system compares with current nurse:patient staffing allocations in an Australian tertiary NICU, suggests refinements in staffing ratios for specific patient groups on respiratory support are possible.
Using theoretical engagement to understand workplace learning across contexts—Bringing worlds apart together
Authors: Olmos‐Vega Francisco M. , Stalmeijer Renée E.
Published: August 2024

The pivotal importance of workplace learning (WPL) within health professions education has elevated its understanding and improvement to a major research priority. From a sociocultural learning theory perspective, WPL is inherently situated and context‐specific. This means that the health care settings in which (future) health care professionals are trained will impact how and what is learned. However, to what extent is the research performed thus far transferable across professional contexts, cultures and borders? To what extent has WPL research sufficiently addressed the contextual characteristics of WPL to enable the evaluation of its transferability? To what extent have methodological and theoretical approaches enabled the building of understanding across contexts?

We propose that heightening the transferability of WPL research as well as opening up the conversation to more diverse WPL contexts, settings and cultures will require mapping context and theoretical engagement. To explore what theoretical engagement may afford to our understanding of the influence of context on WPL, we use two theories: Landscapes of Practice and Figured Worlds. These theories with sociocultural groundings provide concrete lenses to understand the interplay between the individual and the context. We conclude with implications for research and practice and advocate for more attention to research practices that may deepen our understanding and heighten the transferability of workplace learning research.
The role of solar photolysis in the atmospheric removal of methacrolein oxide and the methacrolein oxide—water van‐der Waals complex in pristine environments
Authors: Guidry Lily M. , Bardash Londyn A. , Yigiter Aylin , Ravi Satyam , Marchetti Barbara , Karsili Tolga N. V.
Published: August 2024

Biogenic hydrocarbons are emitted into the Earth's atmosphere by terrestrial vegetation as by‐products of photosynthesis. Isoprene is one such hydrocarbon and is the second most abundant volatile organic compound emitted into the atmosphere (after methane). Reaction with ozone represents an important atmospheric sink for isoprene removal, forming carbonyl oxides (Criegee intermediates) with extended conjugation. In this manuscript, we argue that the extended conjugation of these Criegee intermediates enables electronic excitation of these compounds, on timescales that are competitive with their slow unimolecular decay and bimolecular chemistry. We show that the complexation of methacrolein oxide with water enhances the absorption cross section of the otherwise dark S1 state, potentially revealing a new avenue for forming lower volatility compounds via tropospherically relevant photochemistry.
Rapid response and uncertain agendas: Senators' response to Dobbs
Authors: Connor Corinne , Russell Annelise
Published: August 2024

We examine policymakers' nuanced strategies of digital agenda setting during times of lawmaker uncertainty versus anticipated policy communication. Whereas existing agenda‐setting studies tend to focus on how policymakers allocate attention to preferred policies, we explain how policymakers react to an issue in a digital media climate where the expectation is engagement. We explore the dynamics of digital agenda setting with U.S. senators' Twitter activity in response to the unexpected document leak overturning Roe v. Wade and the anticipated, subsequent Supreme Court decision. Policymakers across the political spectrum quickly reacted to both events, capturing shared policy attention, yet did so with variable response times and differing frames for the issue. We argue that when the agenda rapidly contracts and issues become salient on Twitter, the uncertainty, time, and tenor of lawmakers' response tell us about their policy‐making priorities. Punctuated attention cycles churn fast in a digital climate, but even amid these quick, attention‐grabbing news cycles, the nuance of those moments and policy uncertainty suggest that rhetorical agendas differ when galvanizing events are anticipated. How policymakers convey their agenda when the media environment incentivizes lawmakers to respond regardless of issue prioritization is fundamental to understanding policy attention by lawmakers operating a digital media environment.
Line‐field confocal optical coherence tomography: Characteristic hints for the diagnosis of scarring alopecia due to lupus erythematodes: A preliminary study
Authors: Nutz Marie‐Christine , Deußing Maximilian , Hartmann Daniela , Daxenberger Fabia , Eijkenboom Quirine Louise , Gust Charlotte , French Lars E. , Schuh Sandra , Welzel Julia , Sattler Elke C.
Published: August 2024

Introduction

Lupus erythematosus (LE) is an inflammatory autoimmune disease, that can affect the skin to varying degree. In particular, discoid LE (DLE) and the rare form of lupus panniculitis/profundus are associated with scarring alopecia. The heterogeneity of the clinical, dermatoscopic, and histologic presentation poses a major challenge to the clinician in the diagnosis and differential diagnosis of other forms of scarring alopecia.

Objective

While noninvasive imaging techniques using optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) have proven to be helpful in the diagnosis of scarring alopecia in the context of LE, this study aimed to investigate line‐field confocal OCT (LC‐OCT) to identify characteristic features of cicatricial alopecia in LE.

Methods

Fifteen patients with cicatricial alopecia in LE were included and the most affected/inflamed areas of the scalp were prospectively examined. In analogy to histopathology and previously reported criteria in RCM, all images were evaluated according to seven established criteria and underwent descriptive analyses.

Results

LC‐OCT revealed characteristic features of cicatricial alopecia, such as lymphocytic interface dermatitis (14/15; 93.3%) and basal cell vacuolization (13/15; 86.7%). The most impressive feature was the occurrence of prominent hyperreflective fibers in 14/15 patients (93.3%).

Conclusion

LC‐OCT imaging can noninvasively detect morphologic criteria such as lymphocytic and vacuolar interface dermatitis of cicatricial alopecia due to LE. In particular, the presence of hyperreflective collagen fibers appears to be a characteristic easily recognizable feature that may facilitate differential diagnosis with other forms of cicatricial alopecia. Further studies are mandatory to differentiate other forms of scarring alopecia.
Skin mechanical properties measured with skin elasticity measurement device in patients with lymphedema: Scoping review
Authors: Fujimoto Yudai , Yuri Yoshimi , Tamiya Hironari
Published: August 2024

Background

Skin conditions in patients with lymphedema have been identified according to changes in skin mechanical properties. The skin elasticity meter is a non‐invasive tool for measuring the mechanical properties of the skin; however, its potential use in patients with lymphedema has received little attention. This review aimed to provide an overview of studies measuring the skin mechanical properties of patients with lymphedema using a skin elasticity meter.

Materials and methods

Search terms and synonyms related to lymphedema and skin mechanical property measurement using a skin elasticity meter were identified, and electronic databases containing articles in English were searched.

Results

A total of 621 articles were retrieved, and four articles were analyzed after screening. Despite this research subject receiving increasing attention, no consensus has been reached regarding the best methods.

Conclusion

Measurement methods are expected to be standardized in the future to elucidate the skin mechanical properties of patients with lymphedema.
Towards strain gauge 2.0: Substituting the electric resistance routinely deposited on polyimide film by the optimal pattern for full‐field strain measurement
Authors: Vinel A. , Grédiac M. , Balandraud X. , Blaysat B. , Jailin T. , Sur F.
Published: August 2024

The checkerboard constitutes the best pattern for full‐field strain measurement because it maximizes image gradient. In the experimental mechanics community, employing this pattern is currently strongly limited because depositing it on the surface of specimens raises practical difficulties. A recent study shows, however, that it is technically possible by using a laser engraver. The present paper aims to push this solution forward by printing a checkerboard pattern on a thin polymeric film and then gluing the resulting laser‐engraved film on the specimen surface. The underlying idea is to separate the manufacturing process of this optical strain gauge on the one hand and its use on the other hand to help spread this strain measuring tool in the experimental mechanics community. The polymeric film employed here is the same as that used in the manufacturing process of classic electrical gauges, so one can rely on the know‐how of classic strain gauge bonding to glue this optical strain gauge on the specimen surface. The main difference between the proposed tool and classic electrical gauges is that the strain field beneath the polymeric support is measured instead of localized strain values. The paper is a proof of concept for this strain field measuring tool. The manufacturing and bonding processes are described in the paper. The localized spectrum analysis, a spectral technique developed for processing images of periodic patterns, is used to retrieve the strain fields from checkerboard images. Through two complementary examples, we show the ability of this new type of strain gauge to detect and quantify local details in the strain field beneath. A simplified 1D model is also proposed to assess the minimum width of the strain peak that can reliably be measured with this technique.
Prevalence of red blood cell alloantibodies in pregnant women with sickle cell disease in Bamako
Authors: Fomba Minkoro , Toure Boubacari , N'dour Cécile Toly , Bagayoko Aliou , Baby Mounirou
Published: August 2024

Background and Objectives

Pregnancy in women with sickle cell disease (SCD) is associated with severe complications. Red blood cell (RBC) alloimmunisation is a worrying situation in pregnant women with SCD. This could increase the difficulty in finding a pheno‐compatible red blood product. Our study aimed to determine the prevalence of RBC alloantibodies in pregnant women with SCD and to determine the risk factors for alloantibodies formation.

Methods/Materials

We conducted a prospective study at the “Centre National de Transfusion Sanguine de Bamako” from August 2022 to January 2023. For each participant, we collected important information, including obstetrical and transfusion histories. We performed ABO group, Rh and Kell phenotyping, and antibody screening in all study participants. We performed statistical analysis.

Results

We recruited 95 pregnant women with SCD. In our study, 62% of our participant had a history of blood transfusion. Only 23% of our pregnant women with SCD had a history of miscarriage. The prevalence of RBC alloantibodies was 14%. The main antibodies detected were anti‐E (38%) and pan‐agglutinins (23%). Miscarriage history, blood transfusion history, and pregnancy number were the main risk factors for RBC alloimmunisation.

Conclusion

The care of pregnant women with SCD is complex and requires collaboration between haematologists, clinicians and gynaecologists. National guidelines should be implemented to make ABO and D typing, Rh and Kell phenotyping and antibody screening routine for all pregnant women. This would facilitate early detection of high‐risk situations. Particular attention should be paid to SCD pregnant women with miscarriage and blood transfusion histories.
Circadian rhythm of brain‐derived neurotrophic factor in serum and plasma
Authors: Ehrhardt Maren , Schreiber Stefanie , Duderstadt Yves , Braun‐Dullaeus Rüdiger , Borucki Katrin , Brigadski Tanja , Müller Notger G. , Leßmann Volkmar , Müller Patrick
Published: August 2024

The neurotrophic growth factor brain‐derived neurotrophic factor (BDNF) plays a crucial role in various neurodegenerative and psychiatric diseases, such as Alzheimer's disease, schizophrenia and depression. BDNF has been proposed as a potential biomarker for diagnosis, prognosis and monitoring therapy. Understanding the factors influencing BDNF levels and whether they follow a circadian rhythm is essential for interpreting fluctuations in BDNF measurements. We aimed to investigate the circadian rhythm of BDNF by collecting multiple peripheral venous blood samples from young, healthy male participants at 12 different time points over 24 h. In addition, vital parameters, cortisol and insulin like growth factor 1 (IGF1) were measured to explore potential regulatory mechanisms, interfering variables and their correlations with BDNF concentration. The findings revealed that plasma BDNF did not exhibit any significant fluctuations over 24 h, suggesting the absence of a circadian rhythm. However, serum BDNF levels decreased during sleep. Furthermore, serum BDNF showed a positive correlation with heart rate but a negative correlation with IGF1. No significant correlation was observed between cortisol and BDNF or IGF1. Although plasma BDNF suggests steady‐state conditions, the decline of serum BDNF during the nocturnal period could be attributed to physical inactivity and associated with reduced haemodynamic blood flow (heart rate reduction during sleep). The type of sample collection (peripheral venous cannula vs. blood sampling using a butterfly system) does not significantly affect the measured BDNF levels. The sample collection during the day did not significantly affect BDNF analysis, emphasizing the importance of considering activity levels rather than timing when designing standardized protocols for BDNF assessments.
On the Challenges of Integrating a Rotating Detonation Combustor With an Industrial Gas Turbine and Important Design Considerations for Row-1 Blades
Authors: Rathod Dharmik S , Meadows Joseph
Published: August 2024

In an effort to increase the efficiency and performance of gas turbine power cycles, pressure gain combustion (PGC) has gained significant interest. Since rotating detonation combustors (RDC) can provide a quasi-steady mode of operation, research has been triggered to integrate RDC with power-generating gas turbines. However, the presence of subsonic and supersonic flow fields which are generated due to the shock waves that stem from the detonation wave front and the highly nonuniform temperature and velocity profiles may cause a depreciation in the turbine performance. The current study seeks to investigate the challenges of integrating the RDC with nozzle guide vanes (NGV) of an industrial, can-annular gas turbine and attempts to understand the major contributors that impact efficiency and identify the key areas of optimization that need to be considered for maximizing performance. The RDC was integrated with the NGVs through a nonoptimized straight duct-type geometry with a diffuser cone. 3-Dimensional Numerical analyses were performed to investigate sources of total pressure loss and to understand the unsteady effects of RDC which contribute toward the deterioration of performance. The entropy generation at different regions of interest was calculated to identify the major irreversibility's in the system. Also, total pressure and temperature distribution along the radial direction at the exit of the transitional duct is presented.
Increasing Anaerobic Power in Cycling By Implementing Embodied Self-Talk
Authors: Mateos Rafael , Ruiz Inés C. , Horcajo Javier
Published: August 2024

The current study employed a within-participant design to analyze the effects of head movements in three conditions (i.e., head nodding, head shaking, and no head movements) during positive (motivational) self-talk among 22 male cyclists. After the self-talk and head-movements task, physical performance (i.e., anaerobic power) was assessed using a Wingate Test for each experimental condition. Each cyclist participated individually on three separate days, completing one of the three experimental conditions each day. We hypothesized and found that the head-nodding condition resulted in greater physical performance (i.e., mean and peak power) than the no-head-movements condition. This is the first time that head nodding has been shown to improve physical performance compared with no head movements during encouraging and self-assuring self-talk. Relevantly, these findings emphasize the importance of focusing on athletes’ nonverbal behavior (e.g., head movements) when engaging in positive (motivational) self-talk to perform better.
One-step genome engineering in bee gut bacterial symbionts
Authors: Lariviere Patrick J. , Ashraf A. H. M. Zuberi , Navarro-Escalante Lucio , Leonard Sean P. , Miller Laurel G. , Moran Nancy A. , Barrick Jeffrey E.
Published: August 2024

Mechanistic understanding of interactions in many host-microbe systems, including the honey bee microbiome, is limited by a lack of easy-to-use genome engineering approaches. To this end, we demonstrate a one-step genome engineering approach for making gene deletions and insertions in the chromosomes of honey bee gut bacterial symbionts. Electroporation of linear or non-replicating plasmid DNA containing an antibiotic resistance cassette flanked by regions with homology to a symbiont genome reliably results in chromosomal integration. This lightweight approach does not require expressing any exogenous recombination machinery. The high concentrations of large DNAs with long homology regions needed to make the process efficient can be readily produced using modern DNA synthesis and assembly methods. We use this approach to knock out genes, including genes involved in biofilm formation, and insert fluorescent protein genes into the chromosome of the betaproteobacterial bee gut symbiont
Snodgrassella alvi
. We are also able to engineer the genomes of multiple strains of
S. alvi
and another species,
Snodgrassella communis
, which is found in the bumble bee gut microbiome. Finally, we use the same method to engineer the chromosome of another bee symbiont,
Bartonella apis
, which is an alphaproteobacterium. As expected, gene knockout in
S. alvi
using this approach is
recA
-dependent, suggesting that this straightforward procedure can be applied to other microbes that lack convenient genome engineering methods.

IMPORTANCE

Honey bees are ecologically and economically important crop pollinators with bacterial gut symbionts that influence their health. Microbiome-based strategies for studying or improving bee health have utilized wild-type or plasmid-engineered bacteria. We demonstrate that a straightforward, single-step method can be used to insert cassettes and replace genes in the chromosomes of multiple bee gut bacteria. This method can be used for investigating the mechanisms of host-microbe interactions in the bee gut community and stably engineering symbionts that benefit pollinator health.
Whole-genome sequencing for antimicrobial surveillance: species-specific quality thresholds and data evaluation from the network of the European Union Reference Laboratory for Antimicrobial Resistance genomic proficiency tests of 2021 and 2022
Authors: Sørensen Lauge Holm , Pedersen Susanne Karlsmose , Jensen Jacob Dyring , Lacy-Roberts Niamh , Andrea Athina , S. M. Brouwer Michael , Veldman Kees T. , Lou Yan , Hoffmann Maria , S. Hendriksen Rene
Published: August 2024

As antimicrobial resistance (AMR) surveillance shifts to genomics, ensuring the quality of whole-genome sequencing (WGS) data produced across laboratories is critical. Participation in genomic proficiency tests (GPTs) not only increases individual laboratories' WGS capacity but also provides a unique opportunity to improve species-specific thresholds for WGS quality control (QC) by repeated resequencing of distinct isolates. Here, we present the results of the EU Reference Laboratory for Antimicrobial Resistance (EURL-AR) network GPTs of 2021 and 2022, which included 25 EU national reference laboratories (NLRs). A total of 392 genomes from 12 AMR-bacteria were evaluated based on WGS QC metrics. Two percent (
n
= 9) of the data were excluded, due to contamination, and 11% (
n
= 41) of the remaining genomes were identified as outliers in at least one QC metric and excluded from computation of the adjusted QC thresholds (AQT). Two QC metric correlation groups were identified through linear regression. Eight percent (
n
= 28) of the submitted genomes, from 11 laboratories, failed one or more of the AQTs. However, only three laboratories (12%) were identified as underperformers, failing across AQTs for uncorrelated QC metrics in at least two genomes. Finally, new species-specific thresholds for “N50” and “number of contigs > 200 bp” are presented for guidance in routine laboratory QC. The continued participation of NRLs in GPTs will reveal WGS workflow flaws and improve AMR surveillance data. GPT data will continue to contribute to the development of reliable species-specific thresholds for routine WGS QC, standardizing sequencing data QC and ensure inter- and intranational laboratory comparability.

IMPORTANCE

Illumina next-generation sequencing is an integral part of antimicrobial resistance (AMR) surveillance and the most widely used whole-genome sequencing (WGS) platform. The high-throughput, relative low-cost, high discriminatory power, and rapid turnaround time of WGS compared to classical biochemical methods means the technology will likely remain a fundamental tool in AMR surveillance and public health. In this study, we present the current level of WGS capacity among national reference laboratories in the EU Reference Laboratory for AMR network, summarizing applied methodology and statistically evaluating the quality of the obtained sequence data. These findings provide the basis for setting new and revised thresholds for quality metrics used in routine WGS, which have previously been arbitrarily defined. In addition, underperforming participants are identified and encouraged to evaluate their workflows to produce reliable results.
Navigating the complexities of a forgotten double J stent
Authors: Bahadur Anupama , Mundhra Rajlaxmi , Heda Ayush , Panwar Vikas Kumar
Published: August 2024

Double-J (DJ) stents are most commonly used urological tools these days. Serious complications may occur when stents are left in place for longer duration. We present a case of a woman in her 40s with a forgotten DJ stent for 4 years, leading to complications such as encrustations, bladder and renal stone formation. The patient underwent a comprehensive endourological approach, including endoscopic cystolithotomy and left-sided percutaneous nephrolithotomy. The case highlights the importance of timely stent removal to prevent complications such as encrustations and stone formation. Patient education and counselling are crucial to avoid poor compliance and the associated risks of forgotten stents. This case underscores the significance of a multidisciplinary approach and emphasises the need for proactive measures to prevent such complications, including the implementation of a stent placement registry.
Resolution of a chronic occipital wound with exposed skull bone with a fish skin graft: a successful treatment approach
Authors: Veitinger Alexander B , Lippert Burkard M , Fiedler Lukas S
Published: August 2024

Chronic skin defects in the head, face and neck pose challenges for closure, especially after multiple surgeries or radiation therapy. We report the case of a woman in her 70s with a chronic occipital wound following squamous cell carcinoma resections, resulting in exposed skull bone. Despite various options, we successfully treated the 4 cm x 5 cm wound with a Kerecis fish skin graft (FSG), observing significant improvement within a week. The FSG promoted granulation tissue formation, enabling subsequent full-thickness skin grafting from the patient’s groin. Complete wound closure was achieved within 2 weeks, indicating FSG’s efficacy in complex wound management. Our experience highlights FSG’s potential as a valuable tool in wound healing and reconstruction, particularly in challenging cases involving the head and neck.
Impact of mitigating obesity, smoking, and physical inactivity on type 2 diabetes mellitus burden in Oman: insights from mathematical modeling
Authors: Alareeki Asalah , Awad Susanne F , Al-Mawali Adhra , Morsi Magdi , Critchley Julia A , Al-Lawati Jawad A , Abu-Raddad Laith J
Published: August 2024

Introduction

To estimate the impact of reducing obesity, smoking, and physical inactivity (PIA) prevalence, and of introducing physical activity (PA) as an explicit intervention, on the prevalence, incidence, and mortality of type 2 diabetes mellitus (T2DM) in Oman.

Research design and methods

A deterministic population-level mathematical model was employed to investigate the impact of different scenarios for reducing T2DM risk factors on T2DM epidemiology. The model was stratified by sex, age group, risk factor status, T2DM status, and intervention status and parameterized with nationally representative data. Intervention scenarios were calculated and compared with a baseline (no-intervention) scenario for changes in T2DM prevalence, incidence, and mortality among adult Omanis between 2020 and 2050.

Results

In the no-intervention scenario, T2DM prevalence increased from 15.2% in 2020 to 23.8% in 2050. Achieving the goals of halting the rise of obesity, reducing smoking by 30%, and reducing PIA by 10% as outlined in the WHO’s Global Action Plan for Non-communicable Diseases (implemented between 2020 and 2030 and then maintained between 2031 and 2050) would reduce T2DM prevalence by 32.2%, cumulative incidence by 31.3%, and related deaths by 19.3% by 2050. Halting the rise of or reducing obesity prevalence by 10%–50% would reduce T2DM prevalence by 33.0%–51.3%, cumulative incidence by 31.9%–53.0%, and related deaths by 19.5%–35.6%. Reducing smoking or PIA prevalence by 10%–50% would lead to smaller reductions of less than 5% in T2DM prevalence, cumulative incidence, and related deaths. Introducing PA with varying intensities at a 25% coverage would reduce T2DM prevalence by 4.9%–14.1%, cumulative incidence by 4.8%–13.8%, and related deaths by 3.4%–9.6% by 2050.

Conclusions

Intervention-for-prevention efforts targeting obesity reduction and introducing PA could result in major reductions in the T2DM burden. Prioritizing such interventions could alleviate the burden of T2DM in Oman and other countries with similarly high T2DM and obesity burdens.
Changes in use and hospital outcomes of bariatric surgery in Spain (2016–2022): analysis of the role of type 2 diabetes using propensity score matching
Authors: Lopez-de-Andres Ana , Jimenez-Garcia Rodrigo , Cuadrado-Corrales Natividad , Carabantes-Alarcon David , Hernandez-Barrera Valentin , de Miguel-Diez Javier , Jimenez-Sierra Ana , Zamorano-Leon José Javier
Published: August 2024

Introduction

The objectives of this study were to examine temporal trends in the incidence of bariatric surgery (Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG)) in patients with and without type 2 diabetes mellitus (T2DM). Outcomes of hospitalization and the impact of T2DM on these outcomes were also analyzed.

Research design and methods

We performed an observational study with the Spanish national hospital discharge database. Obese patients with and without T2DM who underwent RYGB and SG between 2016 and 2022 were identified. Propensity score matching (PSM) and logistic regression were used to compare patients with and without T2DM and to evaluate the effect of T2DM and other variables on outcomes of surgery. A variable “severity” was created to cover patients who died in hospital or were admitted to the intensive care unit (ICU).

Results

A total of 32,176 bariatric surgery interventions were performed (28.86% with T2DM). 31.57% of RYGBs and 25.53% of SG patients had T2DM. The incidence of RYGB and SG increased significantly between 2016 and 2022 (p<0.001), with a higher incidence in those with T2DM than in those without (incidence rate ratio 4.07 (95% CI 3.95 to 4.20) for RYGB and 3.02 (95% CI 2.92 to 3.14) for SG). In patients who underwent SG, admission to the ICU and severity were significantly more frequent in patients with T2DM than in those without (both p<0.001). In the multivariate analysis, having T2DM was associated with more frequent severity in those who received SG (OR 1.23; 95% CI 1.07 to 1.42).

Conclusions

Between 2016 and 2022, bariatric surgery procedures performed in Spain increased in patients with and without T2DM. More interventions were performed on patients with T2DM than on patients without T2DM. RYGB was the most common procedure in patients with T2DM. The presence of T2DM was associated with more severity after SG.
Trends in colorectal cancer surgical resection rates during the screening era: a retrospective study in Italy
Authors: Zorzi Manuel , Calciano Lucia , Gennaro Nicola , Memo Laura , Rizzato Silvia , Stocco Carmen , Urso Emanuele D L , Negro Silvia , Spolverato Gaya , Pucciarelli Salvatore , Sbaraglia Marta , Guzzinati Stefano
Published: August 2024

Background

Faecal immunochemical test (FIT)-based screening is effective in reducing colorectal cancer (CRC) incidence, but its sensitivity for proximal lesions remains low.

Objectives

We compared age-adjusted CRC surgical resection rates across anatomic sites (proximal colon, distal colon, rectum), age groups and sex over 20 years in a large Italian population. We particularly focused on changes in trends following FIT-screening implementation in the target population (50–69 years).

Design

This retrospective study analysed data from the Veneto Region’s administrative Hospital Discharge Dataset, involving over 54 000 patients aged 40–89 (43.4% female) who underwent CRC surgery between 2002 and 2021.

Results

Overall, surgery rates increased until 2007 (annual percentage changes: 2.5% in males, 2.9% in females) and then declined (−4.2% in males, −3.4% in females). This decline was steeper for distal and rectal cancers compared with proximal cancer, suggesting a shift towards more right-sided CRC surgery.

In males, the prescreening increase in proximal surgery was reversed after screening implementation (slope change: −6%) while the prescreening decline accelerated for distal (−4%) and rectal (−3%) surgeries. In females, stable prescreening trends shifted downward for all sites (−5% for proximal, −8% for distal and −7% for rectal surgery). However, the change in trends between prescreening and postscreening periods was not different across anatomic sites for either sex (all slope change differences in pairwise comparisons were not statistically significant).

Conclusion

The shift towards proximal surgery may not be entirely due to the FIT’s low sensitivity but may reflect an underlying upward trend in proximal cancers independent of screening.
Functional seizures and their mimics: a retrospective service review of cases from a tertiary video telemetry database
Authors: Dudley Peter , Marquez Jan Paul , Farrell Fiona , Benson Jennifer , Rugg-Gunn Fergus , Sidhu Meneka K , O'Sullivan Suzanne , Walker Matthew , Yogarajah Mahinda
Published: August 2024

Objective

Identify the proportion of patients referred with putative functional seizures (FS) that were subsequently re-diagnosed as epileptic seizures (ES), or an alternative diagnosis, following video telemetry EEG (VTEEG). In addition, describe the characteristics of those seizures.

Methods

The VTEEG reports from patients admitted to the Chalfont Centre for Epilepsy between 2019 and 2022 were reviewed. Pre-VTEEG and post-VTEEG diagnoses were compared to identify whether a diagnostic revision was made from suspected FS to ES or another diagnosis. Diagnostic revision cases were then grouped into cohorts with associated features and reviewed to characterise and describe FS mimics.

Results

444 VTEEG reports where patients had habitual events were identified. 4.7% of patients were referred with FS and were subsequently diagnosed with ES or another diagnosis. In this group, several cohorts could be identified including frontal lobe epileptic seizures, ES with functional overlay, insular or temporal lobe epileptic seizures associated with autonomic or marked experiential peri-ictal symptoms, and individuals who had both ES and FS but whose ES were revealed on medication withdrawal.

Conclusion

In patients referred to a tertiary epilepsy unit, a small minority of cases had seizures diagnosed as functional and reclassified as epileptic or an alternative diagnosis. It is clinically important to be aware of these FS mimics.
Primary care providers’ perspectives on referrals to the Diabetes Prevention Programme: a qualitative comparative study across varied referral patterns
Authors: Stephenson-Hunter Cara , Gonzalez Christopher J , Franco Stacey , Hashmi Maryam , Tisor Ochuwa , Gonzalez Cristina M
Published: August 2024

Introduction

Despite the effectiveness of Diabetes Prevention Programmes (DPP) in reducing diabetes risk, primary care provider (PCP) referrals remain low, especially among men and racial/ethnic minorities, exacerbating their under-representation in DPPs. Understanding PCPs’ perspectives on referrals is crucial for enhancing the intervention’s reach and effectiveness.

Research design and methods

We conducted a qualitative study to explore PCPs’ experiences, perspectives and engagement with DPP referrals, focusing on factors influencing variations in referral rates. Based on electronic record data, high and low-referring PCPs from a large integrated health system in the Bronx, NY, participated in interviews conducted between February and September 2023. Interviews were conducted and recorded on Zoom, anonymised, transcribed and analysed using the constant comparative method.

Results

From 22 PCP interviews, 4 themes emerged representing factors that influenced referrals: (1) perceived barriers to the patient engagement with the DPP, including infrastructure gaps, programme accessibility issues and unmet social needs, particularly affecting low-referring PCPs; (2) perceived effectiveness of the DPP, with concerns raised about its efficacy, especially for male and socioeconomically disadvantaged patients; (3) perceived self-efficacy in referring patients, driven by knowledge gaps and limited opportunities, especially among low-referrers and (4) recommendations to facilitate and strengthen referrals, highlighting areas for PCP and patient support. The perspectives of high-referring/low-referring PCPs often differed across these themes and associated subthemes.

Conclusions

Our research illuminates the challenges PCPs face in treating prediabetic patients and factors influencing DPP referrals in underserved populations. This understanding can guide interventions to enhance equitable DPP referrals and engagement, thereby reducing diabetes risk in vulnerable populations.