bluuebunny/crossref_metadata_2025 huggingface dataset:
Carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa causing infection in Africa and the Middle East: a surveillance study from the ATLAS programme (2018–20)
Authors: Karlowsky James A , Bouchillon Samuel K , El Mahdy Kotb Ramy , Mohamed Naglaa , Stone Gregory G , Sahm Daniel F
Published: June 2022

Objectives

To determine the in vitro susceptibility of Enterobacterales (n = 5457) and Pseudomonas aeruginosa (n = 1949) isolated from hospitalized patients in Africa (three countries) and the Middle East (five countries) in 2018–20 to a panel of 11 antimicrobials and to identify β-lactamase/carbapenemase genes in isolates with meropenem-non-susceptible and/or ceftazidime/avibactam-resistant phenotypes.

Methods

CLSI broth microdilution testing generated MICs that were interpreted using CLSI (2021) breakpoints. β-Lactamase/carbapenemase genes were identified using multiplex PCR assays.

Results

Enterobacterales isolates were highly susceptible to amikacin (96.7%), ceftazidime/avibactam (96.6%) and tigecycline (96.0%), and slightly less susceptible to meropenem (94.3%). In total, 337 Enterobacterales isolates (6.2% of all Enterobacterales isolates) carried one or more carbapenemase genes: 188 isolates carried a serine carbapenemase (178 OXA, 10 KPC) and 167 isolates carried an MBL (18 isolates carried both an MBL and an OXA). NDM-1 was the most common MBL identified (64.1% of NDM enzymes; 59.9% of all MBLs). OXA-48 (47.8%) and OXA-181 (38.8%) were the most common OXAs detected. P. aeruginosa isolates were most susceptible to ceftazidime/avibactam (89.1%) and amikacin (88.9%). Only 73.1% of P. aeruginosa isolates were meropenem susceptible. The majority (68.1%) of P. aeruginosa isolates tested for carbapenemase/β-lactamase genes were negative. In total, 88 isolates (4.5% of all P. aeruginosa isolates) carried one or more carbapenemase genes: 81 isolates carried an MBL and 8 carried a GES carbapenemase (1 isolate carried genes for both).

Conclusions

Carbapenemase detection was closely associated with meropenem-non-susceptible phenotypes for Enterobacterales (89.1%) but not for P. aeruginosa (24.2%). Wide geographic variation in carbapenemase type and frequency of detection was observed.
Design and implementation of an integrated data model to support clinical and translational research administration
Authors: Wood Elizabeth A , Campion Thomas R
Published: June 2022

Objective

Both academic medical centers and biomedical research sponsors need to understand impact of scientific funding to determine value. For the National Institutes of Health (NIH) Clinical and Translational Science Award (CTSA) hubs, tracking research activities can be complex, often involving multiple institutions and continually changing federal reporting requirements. Existing research administrative systems are institution-specific and tend to focus only on parts of a greater whole. The goal of this case report is to describe a comprehensive data model that addresses this gap.

Materials and Methods

Web-based Center Administrative Management Program (WebCAMP) has been developed over a period of over 15 years in the context of CTSA hubs, with the recent addition of T32 programs. Its data model centers around the key concepts of people, projects, resources (inputs), and outcomes (outputs).

Results

The WebCAMP data model and associated toolset for biomedical research administration integrates multiple components of the research enterprise, has been used by our CTSA hub for over 15 years and has been adopted by more than 20 other CTSA hubs.

Discussion

To the best of our knowledge, this study is among the first to describe a comprehensive data model for biomedical research administration. Opportunities for future work include improved grant tracking through the development of a universal identifier that spans public and private funders, and a more generic outcomes tracking model able to rapidly incorporate new outcome types.

Conclusion

We propose that the WebCAMP data model, or a derivative of it, could serve as a future standard for research administrative data warehousing.
Latrine ecology of nilgai antelope
Authors: Zoromski Lisa D , DeYoung Randy W , Goolsby John A , Foley Aaron M , Ortega-S. J Alfonso , Hewitt David G , Campbell Tyler A
Published: June 2022

The use of scent for communication is widespread in mammals, yet the role of scent-marking in the social system of many species is poorly understood. Nilgai antelope (Boselaphus tragocamelus) are native to India, Nepal, and Pakistan. They were introduced to Texas rangelands in the United States during the 1920s to 1940s, and have since expanded into much of coastal South Texas and northern Mexico. The nilgai social system includes the use of latrines or repeated defecation at a localized site. We quantified and described physical and behavioral characteristics of nilgai latrine ecology to investigate drivers of latrine use at three sites in South Texas, during April 2018 to March 2019. Latrines were abundant (2.6–8.7 latrines/ha on unpaved roads, 0.4–0.9 latrines/ha off-roads), with no evidence for selection as to vegetation communities; latrines were dynamic in persistence and visitation rates. We found higher densities of latrines in Spring surveys, just after the peak of nilgai breeding activity, compared to Autumn surveys. Density of nilgai latrines was 3–10 times greater than estimated population densities, indicating individual nilgai must use multiple latrines. Camera traps and fecal DNA analysis revealed latrines were mainly (70%) visited by bulls and defecated on by bulls (92% in photos, 89% for DNA samples). The greatest frequency of visits occurred during the peak in the nilgai breeding season, from December–February; latrines were visited every 2–3 days on average. Body characteristics of photographed individuals and genetic analysis of feces indicated repeated visits from the same individuals. Nilgai cows occasionally used latrines; their use was sometimes followed by bulls showing flehmen responses after a female defecated or urinated on the latrine. We propose that dominant bulls use latrines for territory demarcation to display social dominance to both cows in estrus and subordinate bulls. Cows likely use latrines to communicate reproductive status. This study is the first intensive assessment focused on latrine ecology in nilgai. Our results directly contradict anecdotal descriptions of latrine use and behavior in nilgai but are consistent with predictions of antelope social systems based on body size, feeding type, and group dynamics.
The Competitive Effects of China’s Legal Data Regime
Authors: Giladi Shtub Tamar , Gal Michal S
Published: June 2022

The global race for data-based technological superiority is on. In a world where “data are the new oil,” data-based comparative advantages may affect not only competition between firms but also the balance of power among jurisdictions. In the past two decades, China has made important strides in gaining such advantages. Some of China’s comparative advantages are natural. For example, its population size creates unparalleled potential for harvesting data. Some are cultural, such as the traditionally low significance of Western-style privacy concerns. This research focuses on a third, often overlooked, source: comparative advantages created by China’s data regime—the system of policies, laws, regulations, and practices that govern or influence the data value chain. The article provides a detailed outline of China’s data regime and offers analysis of its possible competitive effects on China and on other jurisdictions. This analysis also provides a wider context for understanding China’s recent competition law actions against Chinese technology giants, after years of extremely lax policy. Indeed, as this article shows, to fully understand China’s actions, it is necessary to consider not only its competition law enforcement but also other ways in which the government is involved in the data value chain.
Triplex vascular prostheses elongation in post-operative course
Authors: Narita Masahiko , Shirasaka Tomonori , Ushioda Ryohei , Kamiya Hiroyuki
Published: June 2022

Triplex (Terumo Corp, Tokyo, Japan) is a relatively new vascular protheses with a non-biodegradable coating material. We experienced two cases of graft elongation in Triplex grafts post-operatively. In one of the cases, the graft elongation led to occlusion of the left subclavian artery. In the other case, the graft elongation resulted in a pseudoaneurysm of the ascending aorta. A unique feature of Triplex grafts is that they may reduce post-operative inflammation reaction; however, they could also invite a limited adhesion formation with the surrounding tissue, which contribute to prostheses elongation, due to a lack of prostheses stability and fixation. A careful observation based on the feature of implanted protheses is required.
Genetic mapping of sexually dimorphic volatile and non-volatile floral secondary chemistry of a dioecious willow
Authors: Keefover-Ring Ken , Carlson Craig H , Hyden Brennan , Azeem Muhammad , Smart Lawrence B
Published: June 2022

Secondary chemistry often differs between sexes in dioecious plant species, a pattern attributed to its possible role in the evolution and/or maintenance of dioecy. We used GC-MS to measure floral volatiles emitted from, and LC-MS to quantitate non-volatile secondary compounds contained in, female and male Salix purpurea willow catkins from an F2 family. Using the abundance of these chemicals, we then performed quantitative trait locus (QTL) mapping to locate them on the genome, identified biosynthetic candidate genes in the QTL intervals, and examined expression patterns of candidate genes using RNA-seq. Male flowers emitted more total terpenoids than females, but females produced more benzenoids. Male tissue contained greater amounts of phenolic glycosides, but females had more chalcones and flavonoids. A flavonoid pigment and a spermidine derivative were found only in males. Male catkins were almost twice the mass of females. Forty-two QTL were mapped for 25 chemical traits and catkin mass across 16 of the 19 S. purpurea chromosomes. Several candidate genes were identified, including a chalcone isomerase associated with seven compounds. A better understanding of the genetic basis of the sexually dimorphic chemistry of a dioecious species may shed light on how chemically mediated ecological interactions may have helped in the evolution and maintenance of dioecy.
Germany, year 2020. The tension between asylum right, border control, and economy, through the imperative of deservingness
Authors: Fontanari Elena
Published: June 2022

This article discusses the new asylum laws implemented in Germany from 2015 to 2020 and places them in the wider context of the bordering process developed in Europe to control migrants’ mobility since the year 2011. ‘Asylum packages’ and the Integration Act combine a restriction of asylum rights with measures to quickly channel refugees into the German labor market. Focusing on a specific regulation that aims at integrated rejected asylum-seekers through vocational training programs—the Ausbildungsduldung—this article highlights the contradictions from the attempts to meet the German economic needs and the efforts to enforce migration control. Moreover, this work highlights how the moral economy of deservingness, which underpins the practices of confinement and selection of the migrant population, influences the new laws. Ultimately, the asylum realm is deprived of being the source of the right to stay, whose conditionality became anchored to the needs of the German economy.
Serial migrant mothers and permanent temporariness in Dubai
Authors: Al-Dabbagh May
Published: June 2022

Based on a five-year urban ethnography, this article explores the subjectivities of permanent temporariness that characterize the experience of serial migrant mothers in Dubai. By going beyond approaches that select middle class participants based on fixed category classifications such as ethnicity or citizenship, this article uses a processual lens and sheds light on a sociologically unmarked category of migrants in the city whose experiences of mothering and work have been shaped by shifting intersectionality in the context of multinational migration. Through detailed biographies of four serial migrants, this article offers an illustration of the subjectivities of permanent temporariness and shows how they are reproduced through three mothering practices: propagating roots, reflexive selving, and normalizing movement. Examining serial migrant motherhood practices challenges methodological nationalism and illustrates how the flow and friction of multinational migration gets reconstituted into family and work lives.
Prevalence and Predictors of Pseudomonas aeruginosa Among Hospitalized Patients With Diabetic Foot Infections
Authors: Veve Michael P , Mercuro Nicholas J , Sangiovanni Ryan J , Santarossa Maressa , Patel Nimish
Published: June 2022

Background

Diabetic foot infections (DFIs) are commonly associated with antibiotic overuse. Empiric DFI treatment often includes coverage for Pseudomonas aeruginosa (PsA), but the frequency of PsA DFIs is poorly understood. The study objectives were to quantify the prevalence of and determine predictors for PsA DFIs.

Methods

This multicenter, retrospective cohort included hospitalized patients with DFI from 2013 through 2020 who were age ≥18 years; diabetes mellitus diagnosis; and DFI based on International Classification of Diseases, Tenth Revision coding, antibiotic treatment, and DFI culture with organism growth. Osteomyelitis was excluded. Patient characteristics were described and compared; the primary outcome was presence of PsA on DFI culture. Predictors of PsA DFI were identified using multivariable logistic regression.

Results

Two hundred ninety-two patients were included. The median age was 61 (interquartile range [IQR], 53–69) years; the majority were men (201 [69%]) and White (163 [56%]). The most commonly isolated organisms were methicillin-susceptible Staphylococcus aureus (35%) and streptococci (32%); 147 (54%) cultures were polymicrobial. Two hundred fifty-seven (88%) patients received empiric antibiotics active against PsA, but only 27 (9%) patients had PsA DFI. Immunocompromised status (adjusted odds ratio [aOR], 4.6 [95% confidence interval {CI}, 1.3–16.7]) and previous outpatient DFI antibiotic treatment failure (aOR, 4.8 [95% CI, 1.9–11.9]) were associated with PsA DFI.

Conclusions

PsA DFI is uncommon, but most patients receive empiric antipseudomonal antibiotics. Empiric broad-spectrum antibiotics are warranted given the frequency of mixed infections, but patient-specific risk factors should be considered before adding antipseudomonal coverage.
Antibiotic Prescribing Practices for Upper Respiratory Tract Infections Among Primary Care Providers: A Descriptive Study
Authors: Chandra Deb Liton , McGrath Brenda M , Schlosser Levi , Hewitt Austin , Schweitzer Connor , Rotar Jeff , Leedahl Nathan D , Crosby Ross , Carson Paul
Published: June 2022

Background

Most antibiotics are prescribed in the ambulatory setting with estimates that up to 50% of use is inappropriate. Understanding factors associated with antibiotic misuse is essential to advancing better stewardship in this setting. We sought to assess the frequency of unnecessary antibiotic use for upper respiratory infections (URIs) among primary care providers and identify patient and provider characteristics associated with misuse.

Methods

Unnecessary antibiotic prescribing was assessed in a descriptive study by using adults ≥18 years seen for common URIs in a large, Upper Midwest, integrated health system, electronic medical records from June 2017 through May 2018. Individual provider rates of unnecessary prescribing were compared for primary care providers practicing in the departments of internal medicine, family medicine, or urgent care. Patient and provider characteristics associated with unnecessary prescribing were identified with a logistic regression model.

Results

A total of 49 463 patient encounters were included. Overall, antibiotics were prescribed unnecessarily for 42.2% (95% confidence interval [CI], 41.7–42.6) of the encounters. Patients with acute bronchitis received unnecessary antibiotics most frequently (74.2%; 95% CI, 73.4–75.0). Males and older patients were more likely to have an unnecessary antibiotic prescription. Provider characteristics associated with higher rates of unnecessary prescribing included being in a rural practice, having more years in practice, and being in higher volume practices such as an urgent care setting. Fifteen percent of providers accounted for half of all unnecessary antibiotic prescriptions.

Conclusions

Although higher-volume practices, a rural setting, or longer time in practice were predictors, unnecessary prescribing was common among all providers.
Different Clinical Presentations of Human Rhinovirus Species Infection in Children and Adults in Mexico
Authors: Galindo-Fraga Arturo , Guerra-de-Blas Paola del Carmen , Ortega-Villa Ana M , Mateja Allyson , Ruiz Quiñones Jesus Arturo , Ramos Cervantes Pilar , Ledesma Barrientos Fernando , Ortiz-Hernández Ana A , Llamosas-Gallardo Beatriz , Ramírez-Venegas Alejandra , Valdéz Vázquez Rafael , Noyola Chepitel Daniel , Moreno-Espinosa Sarbelio , Powers John H , Guerrero M Lourdes , Ruiz-Palacios Guillermo M , Beigel John H ,   for the Mexican Emerging Infectious Diseases Network
Published: June 2022

Background

Human rhinoviruses (HRVs) are a common cause of influenza-like illness, with the ability to infect the upper and lower respiratory tracts. In this study we aim to describe the clinical and molecular features of HRV infection in Mexican children and adults.

Methods

We performed a hospital-based, 4-year multicenter prospective observational cohort study of patients with influenza-like illness. Participants who tested positive for HRV were included. We described demographic, clinical, and laboratory characteristics and the association between HRV types, illness severity, and clinical outcomes.

Results

Of the 5662 subjects recruited, 1473 (26%) had HRV; of those, 988 (67.1%) were adults (≥18 years) and 485 (32.9%) were children. One hundred sixty-seven (11.33%) samples were sequenced; 101 (60.5%) were rhinovirus species A (HRV-A), 22 (13.2%) were rhinovirus species B (HRV-B), and 44 (26.3%) were rhinovirus species C (HRV-C). Among children and adults, 30.5% and 23.5%, respectively, were hospitalized (non–intensive care unit [ICU]). The odds of HRV-C are higher than HRV-A for participants in the ICU (compared to outpatient) and when platelets, lymphocytes, white blood cells, and lactate dehydrogenase are increased. The odds of HRV-C are higher than HRV-A and HRV-B with shortness of breath. The odds of HRV-A are higher than HRV-B, and the odds of HRV-B are higher than HRV-C, when mild symptoms like muscle ache and headache occur.

Conclusions

Rhinoviruses are a common cause of influenza-like illness. It is necessary to improve the surveillance, testing, and species identification for these viruses to understand different clinical presentations and risk factors associated with worse outcomes.

Clinical Trials Registration. NCT01418287.
Comparative Lessons in Sectional Title Laws: Mitigating Urban Inequality in South Africa
Authors: Ti Edward S W
Published: June 2022

Urban inequality in South Africa is a formidable problem that is linked to the injustices of its historical apartheid past. This paper identifies sectional titles, a form of property ownership where proprietors wholly own their apartment unit while co-owning the land and common property, as critical to providing more affordable housing. Sectional title schemes mitigate urban inequality by giving a greater proportion of the country the opportunity to own legally secure, well-located dwellings while serving as a platform where communal living could take place. Two suggestions how sectional title legislation can further alleviate aspects of urban inequality are made (1) Permitting a supermajority of sectional owners to terminate a sectional scheme prevents holdout and allows urban land to be redeveloped, providing an increase in housing. (2) Municipalities could consider mandating ethnic integration in sectional schemes to counter the organic formation of mono-racial residential enclaves which remain in present-day South Africa.
The State of American Federalism 2021–2022: Federal Courts, State Legislatures, and the Conservative Turn in the Law
Authors: Konisky David M , Nolette Paul
Published: June 2022

Contemporary American politics features intense political polarization and closely contested battles over the direction of public policy. Conservatives and liberals alike have used the many venues in the American federal system to try to gain an advantage. In this article, we suggest that a key feature of contemporary American federalism is the institutional advantage that conservatives have achieved due to recent shifts in the ideological conservatism of the federal judiciary and growing Republican dominance in state legislatures. We assess the consequences of these developments, focusing on efforts to weaken federal administrative agencies’ authority and discretion, challenge individual voting rights and institutional control over elections, expand conservative approaches to personal liberties in areas such as abortion, religious practice, and gun rights, and to preempt local policy authority. These developments have the effect of consolidating authority in the hands of Republican-controlled state governments and in some cases bringing about national-level policy changes via state initiatives, and with important implications for American society, politics, and federalism.
TOX promotes follicular helper T cell differentiation in patients with primary Sjögren’s syndrome
Authors: Liu Suying , Yang Yanlei , Zeng Liuting , Wang Li , He Chengmei , Chen Zhilei , Sun Jinlei , Lyu Taibiao , Wang Mu , Chen Hua , Zhang Fengchun
Published: June 2022

Objectives

Whether naive CD4+ T cells are dysregulated and associated with the overactivation of CD4+ T cells in primary SS (pSS) remains unclear. We aimed to explore the role and underlying mechanism of naive CD4+ T cells in pSS.

Methods

We examined the activation, proliferation and differentiation of naive CD4+ T cells from pSS patients and healthy controls. Differentially expressed genes were identified using RNA sequencing, and were overexpressed or silenced to determine the gene regulating follicular helper T (Tfh) cells. Assay for transposase-accessible chromatin with high-throughput sequencing (ATAC-seq) with chromatin immunoprecipitation with high-throughput sequencing (ChIP-seq) was performed to explore the epigenetic mechanism. Naive CD4+ T cells were treated with pSS-related cytokines to explore the upstream signalling pathway.

Results

pSS naive CD4+ T cells had higher potentials of activation, proliferation and differentiation towards Tfh cells. Thymocyte selection-associated high mobility group box protein (TOX) was upregulated in pSS naive CD4+ T cells and promoted T cell activation and Tfh cell polarization. TOX silencing in pSS naive CD4+ T cells downregulated B cell lymphoma 6 (BCL6) expression and altered levels of multiple Tfh-associated genes. ChIP-seq analysis implied that TOX bound to the BCL6 locus, where there were accessible regions found by ATAC-seq. IFN-α induced TOX overexpression, which was attenuated by Janus kinase (JAK) and signal transducer and activator of transcription 1 (STAT1) inhibitors.

Conclusion

Our data suggest that TOX in pSS naive CD4+ T cells is upregulated, which facilitates Tfh cell differentiation. Mechanistically, IFN-α induces TOX overexpression in naive CD4+ T cells through JAK–STAT1 signalling and TOX regulates BCL6 expression. Therefore, IFN-α-JAK–STAT1 signalling and TOX might be potential therapeutic targets in pSS.
STUDY OF EFFECTIVENESS OF SHELTERING FROM RADIATION EXPOSURE DUE TO ACCIDENTAL RELEASE OF RADIOACTIVITY
Authors: Singh Ashish Kumar , Dey Riya , Deokar U V , Ganesh G , Kulkarni M S , Anand S
Published: June 2022

Sheltering is one of the important protective actions as a part of emergency response during the early phases of an accident—mostly precautionary in nature. Sheltering via structural shielding reduces the direct exposure from plume/cloud shine and ground shine doses as well as the airborne radioactivity concentration and hence inhalation dose. The present study was aimed at estimating the shielding factor in the case of Indian houses for external exposure pathways using the FLUKA Monte Carlo based radiation transport code. Furthermore, the dose reduction factor due to exposure from the inhalation pathway was estimated using an indoor aerosol model. These factors were assessed for the three major types of dwellings, and they provided important inputs for decision-making for sheltering or evacuation in case of any sudden release of radionuclides into the environment.
Placebo Response in Trials of Negative Symptoms in Schizophrenia: A Critical Reassessment of the Evidence
Authors: Czobor Pál , Kakuszi Brigitta , Bitter István
Published: June 2022

Background

Summarizing evidence from clinical trials of patients with schizophrenia with predominant or prominent negative symptoms (NS), a prior meta-analysis reported a large placebo effect in negative symptoms (Cohen’s d = 2.909). Assuming that such an effect was clinically not plausible, we performed a critical re-assessment and an update of the previous results with newly available data from add-on and monotherapy studies.

Study Design

Random-effect meta/regression analysis of trials that focused on predominant or prominent NS; and adopted a double-blind, randomized, placebo-controlled design. The final pooled meta-analytic database, based on the available add-on and monotherapy studies combined, included 24 publications containing data on a total of 25 studies (21 add-on, 4 monotherapy).

Study Results

The pooled overall estimate for the placebo effect from the primary analysis for all included studies had a medium effect size, with a Cohen’s d value of 0.6444 (SE = 0.091). The estimates were similar in the add-on and monotherapy studies. Meta-regression indicated that the high placebo response was significantly associated with clinical trial characteristics, including the high ratio of patients assigned to active vs. placebo treatment and short trial duration.

Conclusions

These results represent a major downward correction for a current effect size estimate of the placebo response in the negative symptoms of schizophrenia. Our findings also pinpoint certain clinical trial characteristics, which may serve as important predictors of the placebo response. The knowledge of these factors can have important implications for drug development and trial design for new drugs for negative symptoms of schizophrenia.
Identification of diverse viruses associated with grasshoppers unveils the parallel relationship between host phylogeny and virome composition
Authors: Xu Yao , Jiang Jingyi , Lin Xiaoju , Shi Wangpeng , Cao Chuan
Published: June 2022

Grasshoppers (Orthoptera: Acridoidea) are one of the most dangerous agricultural pests. Environmentally benign microbial pesticides are increasingly desirable for controlling grasshopper outbreaks in fragile ecosystems. However, little is known about natural pathogens infecting this pest. Here we profile the rich viral communities in forty-five grasshopper species and report 302 viruses, including 231 novel species. Most of the identified viruses are related to other insect viruses, and small RNA sequencing indicates that some are targeted by host antiviral RNA interference (RNAi) pathway. Our analysis of relationships between host phylogeny and virus diversity suggests that the composition of viromes is closely allied with host evolution. Overall, this study is a first extensive exploration of viruses in grasshoppers and provides a valuable comparative dataset of both academic and applied interest.
The autophagy‐related degradation of MDA5 by Tembusu virus nonstructural 2B disrupts IFNβ production
Authors: Wu Zhen , Hu Tao , Chen Weiqiong , Cheng Yao , Wang Mingshu , Jia Renyong , Zhu Dekang , Liu Mafeng , Zhao Xinxin , Yang Qiao , Wu Ying , Zhang Shaqiu , Huang Juan , Mao Sai , Ou Xumin , Gao Qun , Sun Di , Cheng Anchun , Chen Shun
Published: June 2022

Duck Tembusu virus (TMUV) is a serious avian pathogen causing a decline in egg production, but the mechanism of the virus that breaks through the innate immune system is poorly understood. Here, we show that TMUV inhibits poly(I:C)‐induced interferon (IFN) production. Because poly(I:C) transfection can specifically activate the MDA5 pathway in duck primary cells, we found that infection with TMUV can specifically target MDA5 and lead to its degradation. MDA5 downregulation could be blocked by the autophagy inhibitor 3‐methyladenine (3‐MA) but not a proteasome inhibitor, strongly implicating MDA5 degradation as an autophagy‐related degradation pathway. Pretreatment with 3‐MA enhanced the expression of MDA5 and inhibited TMUV replication. To screen TMUV proteins that degraded MDA5, the TMUV replicon and MDA5‐Flag were cotransfected into cells, and the western blot analysis showed that nonstructural 2B (NS2B) can degrade MDA5 in a dose‐dependent manner. Dual‐luciferase assays indicate that NS2B alone inhibits MDA5‐ or poly(I:C)‐mediated IFN production. NS2B binds MDA5 in the presence of 3‐MA. The deletion of the amino acids of NS2B from residues 51 to 92 (hydrophilic area) restored the expression of MDA5 and relieved the MDA5‐mediated IFNβ production inhibition by NS2B, indicating that the hydrophilic area of NS2B is important for its interaction with host innate immunity.
Clinical and Dermoscopic Evaluation of Trichloroacetic Acid 20% Versus Long-Pulsed 1064-nm Nd-YAG Laser in the Treatment of Keratosis Pilaris
Authors: Hassan Akmal S. , Abdel Aziz Mai , Saadi Dina G.
Published: June 2022

BACKGROUND

Keratosis pilaris (KP) is a common disorder of keratinization with different therapeutic modalities; however, none of them is completely satisfactory.

OBJECTIVE

Assess and compare the efficacy of trichloroacetic acid (TCA) 20% and long-pulsed 1,064-nm Nd:YAG laser in the treatment of KP.

MATERIALS AND METHODS

Twenty patients with symmetrically distributed areas of KP were enrolled in this study. In each patient, 2 symmetrical KP areas were randomly assigned to receive 4 sessions of either long-pulsed Nd:YAG laser or TCA 20%. Clinical evaluation by Investigator Global Assessment (IGA) was done by 2 blinded physicians after treatment. Dermoscopic assessment was done at baseline and at the end point of the study.

RESULTS

Investigator Global Assessment of laser-treated area showed that 2 patients (10%) had moderate improvement, 10 patients (50%) had marked improvement, and 8 patients (40%) had excellent improvement. Investigator Global Assessment of TCA-treated area showed that 9 patients (45%) had marked improvement and 11 patients (55%) had excellent improvement. Dermoscopic score of KP showed a significant reduction with both modalities. The IGA and reduction in dermoscopic scores were comparable between the 2 modalities.

CONCLUSION

Both long-pulsed 1,064-nm Nd:YAG laser and 20% TCA are effective in the treatment of KP.

CLINICAL TRIAL REGISTRATION:

Name of the trial register: clinicaltrial.gov. Registration number: NCT04797663.
Employee silence in health care: Charting new avenues for leadership and management
Authors: Montgomery Anthony , Lainidi Olga , Johnson Judith , Creese Jennifer , Baathe Fredrik , Baban Adriana , Bhattacharjee Anindo , Carter Madeline , Dellve Lotta , Doherty Eva , Jendeby Mimmi Kheddache , Morgan Karen , Srivastava Manjari , Thompson Neill , Tyssen Reidar , Vohra Veena
Published: June 2022

Issue

Health care management is faced with a basic conundrum about organizational behavior; why do professionals who are highly dedicated to their work choose to remain silent on critical issues that they recognize as being professionally and organizationally significant? Speaking-up interventions in health care achieve disappointing outcomes because of a professional and organizational culture that is not supportive.

Critical Theoretical Analysis

Our understanding of the different types of employee silence is in its infancy, and more ethnographic and qualitative work is needed to reveal the complex nature of silence in health care. We use the sensemaking theory to elucidate how the difficulties to overcoming silence in health care are interwoven in health care culture.

Insight/Advance

The relationship between withholding information and patient safety is complex, highlighting the need for differentiated conceptualizations of silence in health care. We present three Critical Challenge points to advance our understanding of silence and its roots by (1) challenging the predominance of psychological safety, (2) explaining how we operationalize sensemaking, and (3) transforming the role of clinical leaders as sensemakers who can recognize and reshape employee silence. These challenges also point to how employee silence can also result in a form of dysfunctional professionalism that supports maladaptive health care structures in practice.

Practice Implications

Delineating the contextual factors that prompt employee silence and encourage speaking up among health care workers is crucial to addressing this issue in health care organizations. For clinical leaders, the challenge is to valorize behaviors that enhance adaptive and deep psychological safety among teams and within professions while modeling the sharing of information that leads to improvements in patient safety and quality of care.
Traditional Chinese medicine injections with activating blood circulation, equivalent effect of anticoagulation or antiplatelet, for acute myocardial infarction
Authors: Li Xiang , Lou Yan , Shang Ju-Ju , Liu Hong-Xu , Chen Jia-Ping , Zhou Hui-Wen
Published: June 2022

Background

In spite of a growing number in the use of percutaneous coronary intervention (PCI) in China, the mortality of acute myocardial infarction (AMI) has not decreased. Traditional Chinese medicine injections for Activating Blood Circulation (TCMi-ABC), equivalent effect of anticoagulation or antiplatelet, are widely used in China; however, the improvement of fatality towards AMI is unclear. Therefore, we intend to conduct a systematic review and meta-analysis to evaluate the efficacy and safety of TCMi-ABC in treatment with AMI.

Methods

Based on the “National Medical Products Administration of China,” TCMi-ABC with AMI treatment indication will be selected, including Danhong injection, Sodium Tanshinone IIA Sulfonate injection, Danshen Chuanxiongqin injection, and Puerarin injection. Randomized controlled studies will be searched from as follows: PubMed, Embase, the CENTRAL in Cochrane Library, Chinese Biomedical Literature Database (SinoMed), China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang Data Knowledge Service Platform. Two researchers will work independently on literature selection, data extraction, and quality assessment. The outcomes focus on the effects of TCMi-ABC on fatality of patients with AMI in hospitalization and in the long term, the incidence of malignant arrhythmia, left ventricular ejection fraction, and adverse events. RevMan 5.4.1 software was used for mate analysis.

Results

This study will conduct a comprehensive literature search and provide a systematic synthesis of current published data to explore the efficacy and safety of TCMi-ABC for AMI.

Conclusion

This study will provide high-quality evidence for treatment of AMI with TCMi-ABC in terms of efficacy and safety, which may help clinicians make a better complementary treatment schedule of patients with AMI.
The role of statins in patients with early diabetic nephropathy
Authors: Zhao Xi , Zhou Shu Chun , Wang Xiu Fang , Liao Hong Wu
Published: June 2022

Background:

Little is known about the renoprotective effects of statins on the regulation of urinary oxidative stress markers and proteinuria in patients with diabetic nephropathy. Therefore, we conducted this protocol of systematic review and meta-analysis to evaluate the role of statins in patients with early diabetic nephropathy.

Methods:

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols reporting guidelines to conduct this study. The electronic databases EMBASE, PUBMED, CINAHL, and Web of Science will be searched from the earliest available time to July 2022. The population is defined as participants with early diabetic nephropathy. The Intervention groups are given any one of the statins, such as simvastatin or rosuvastatin. The control groups are treated with angiotensin-converting enzyme inhibitor or placebo alone. The primary outcome is estimated glomerular filtration rate; secondary outcome is serological indicators including triglyceride, cholesterol, C-reactive protein, and complications. The Jadad scale will be used to assess the methodological quality of each study included in this meta-analysis.

Result & Conclusion:

We hypothesized that statins would have a positive renoprotective effect in such patients.

OSF registration number:

10.17605/OSF.IO/ESMWR.
A rare cause of persistent leukocytosis with massive splenomegaly
Authors: Gao Lu , Xu Yan , Weng Lan-chun , Tian Zu-guo
Published: June 2022

Rationale:

Persistent leukocytosis with megalosplenia is a common manifestation among patients with myeloproliferative neoplasm (MPN), especially for chronic myeloid leukemia (CML) patients. Here, we report a rare case of myeloid neoplasm with BCR-PDGFRA rearrangement characterized by obvious elevation of leukocyte count and megalosplenia.

Patient concerns:

A 32-year-old man presented with persistent leukocytosis and megalosplenia.

Diagnosis:

This patient was characterized by increased leukocyte count and megalosplenia, and was clinically diagnosed as CML. However, the BCR/ABL fusion gene of the patient was negative, which did not support CML. Moreover, the results of the karyotype showed 46, XY, t(4;22)(q12;q11) and RT-PCR + Sanger detection showed positive PDGFA/BCR. Accordingly, the diagnosis of myeloid neoplasm with BCR-PDGFA rearrangement was confirmed.

Interventions:

This patient was initially received imatinib (400 mg) orally once a day, and the dosage was adjusted to 100 mg owing to suffering from grade IV bone marrow suppression.

Outcomes:

Hematological remission was achieved after 2 weeks, the best treatment response was achieved after 3 months, and the main molecular biological response was achieved after 12 months.

Lesson:

This case suggests that rare PDGFA fusion genes screening for patients comorbid with leukocytosis and megalosplenia is necessary to avoid misdiagnosis. Unlike other rearrangements of PDGFRA, the clinical manifestations of BCR-PDGFRA rearrangement are resembling CML without eosinophilia increase.
Recent advances in targeting calcitonin gene-related peptide for the treatment of menstrual migraine
Authors: Jiang Yan , Huang Zhen-Lun
Published: June 2022

Menstrual migraine (MM) has a longer duration and higher drug resistance than non-perimenstrual migraine. Calcitonin gene-related peptide (CGRP) and CGRP receptors are expressed in the peripheral and central nervous systems throughout the trigeminovascular system. The CGRP/CGRP receptor axis plays an important role in sensory physiology and pharmacology. CGRP receptor antagonists and anti-CGRP monoclonal antibodies (mAbs) have shown consistent efficacy and tolerability in the prevention of chronic or episodic migraine and are now approved for clinical use. However, few studies have reported the use of these drugs in MM, and no specific treatment for MM has been approved. This review aimed to shed light on the recent advances in targeting calcitonin gene-related peptides for the treatment of menstrual migraines in PubMed. In this review, we first discuss the axis of the CGRP/CGRP receptor. We then discuss the role of CGRP receptor antagonists and anti-CGRP mAbs in MM treatment. Finally, we discuss the role of the combination of anti-CGRP mAbs and CGRP receptor antagonists in migraine treatment and the drugs that inhibit CGRP release. Altogether, the anti-CGRP mAbs or CGRP receptor antagonists showed good efficacy and safety in the treatment of MM.
The effect of binaural beat audio on anxiety in patients undergoing fiberoptic bronchoscopy
Authors: Opartpunyasarn Pornchai , Vichitvejpaisal Pornpattana , Oer-areemitr Nittha
Published: June 2022

Background:

Fiberoptic bronchoscopy is an invasive procedure known to induce anxiety in patients. Binaural beat therapy, in which sounds of different frequencies are delivered to the 2 ears to entrain the brainwaves, has been used to reduce anxiety in some operations. This study aimed to determine the anxiolytic effects of binaural beat audio in patients undergoing fiberoptic bronchoscopy.

Methods:

Eligible subjects were randomly assigned to receive binaural beat music, plain music, or no music. They were asked to wear earphones starting approximately 15 minutes before the bronchoscopy. The level of anxiety was measured using the State-Trait Anxiety Inventory questionnaire. Blood pressure, heart rate, and sedative drug administration were also recorded.

Results:

One hundred and twelve subjects were randomized into binaural beat music (n = 38), plain music (n = 38), and no music (n = 36) groups. The mean change in post-bronchoscopy State-Trait Anxiety Inventory state score in the binaural beat music, plain music, and no music group was −7.26 (P < .001), −3.92 (P = .005), and −1.12 (P = .454), respectively. The mean systolic blood pressure and diastolic blood pressure significantly decreased from baseline by −9.89 (P = .002) and −5.76 (P = .005), respectively, in the binaural group. The mean heart rate increased from baseline by 3.32 (P = .035), 5.21 (P = .038), and 3.64 (P = .149) in the binaural beat music, plain music, and no music groups, respectively.

Conclusion:

Binaural beat music appeared to reduce anxiety among patients undergoing fiberoptic bronchoscopy.

Trial registration: TCTR, TCTR20200915002. Registered 14 September 2020 - Retrospectively registered.
Dynamic distribution and correlation analysis of the angle kappa in myopia patients undergoing femtosecond-assisted laser in situ keratomileusis
Authors: Deng Wen-Qing , Fang Yu-Hui , Lin Shu-Hua , Li Ying-Jun
Published: June 2022

Purpose:

To explore the offset distribution of pupillary centres, the offset between the pupil centre and the coaxially sighted corneal light reflex (P-Dist) and their correlation in femtosecond laser combined with excimer laser in situ keratomileusis.

Methods:

Randomly selected 194 patients (398 eyes) who underwent femtosecond-assisted laser in situ keratomileusis with preoperative use of WaveLight Allegro Topolyzer Corneal Topography (WaveLight Laser Technologies AG, Erlangen, Germany) to measure the pupil size and centre position. The P-Dist of the patients was recorded by the X and Y axis eyeball tracking adjustment program of the WaveLight Eagle Vision EX500 excimer laser system.

Results:

The P-Dist was 0.214 ± 0.092 mm in the right eyes and 0.228 ± 0.105 mm in the left eyes (P = .041). Under scotopic conditions, the pupil centre of left eye X-axis was −0.046 ± 0.091 mm, the right eye was −0.152 ± 0.084 mm, with significant differences (P = .015), and the Y-axis direction showed no significant changes (P = .062). The white to white was positively correlated with changes of pupil diameter (scotopic pupil diameter-photopic pupil diameter) (r = 0.270, P < .001). The equivalent spherical mirror and measured centroid shift were negatively correlated (r = −0.214, P = .002).

Conclusion:

The angle kappa of the right eye is smaller than that of the left eye and from scotopic to photopic condition, the pupil centroid shift of both eyes to the nasal inferior side. If the cornea is too large, the low illumination environment should be maintained during the operation to improve the efficiency of pupil matching.
Practical parameters that can be used for nutritional assessment in patients hospitalized in the intensive care unit with the diagnosis of chronic obstructive pulmonary disease
Authors: Baldemir Ramazan , Cirik Mustafa Özgür
Published: June 2022

Malnutrition is an important condition in patients diagnosed with chronic obstructive pulmonary disease (COPD). There is a need for practical and objective nutritional assessment methods in patients hospitalized in the intensive care unit with the diagnosis of COPD. In this study, it was aimed to determine the parameters that can practically evaluate the nutritional status of these patients. It was aimed to determine the relationship between prognostic nutritional index (PNI), and nutritional risk screening (NRS)-2002, nutrition risk in the critical ill (Nutric) Score and to determine a cut-off value for PNI, neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and other complete blood count parameters.

Hemogram values, albumin values, NLR, PLR, LMR, NRS-2002, PNI and modified Nutric Score calculations of the patients hospitalized in the intensive care unit due to COPD were recorded. The relationship between PNI and NRS-2002 and modified Nutric Score, as well as the relationship between NLR, PLR, LMR, hemogram parameters and PNI were analyzed using statistical methods.

The PNI cut-off value for nutritional assessment in patients hospitalized in the intensive care unit due to COPD was determined as 38.5 (area under curve = 0.891, sensitivity 80.8%, specificity 88.1%, positive predictive value 92.9%, negative predictive value 88%). High-risk group according to PNI compared to low-risk group, lymphocyte count (P < .001), basophil count (P = .004), red blood cell (P < .001), hemoglobin (P < .001), hematocrit (P < .001), and LMR (P = .001) were statistically significantly lower, while NLR (P < .001) and PLR (P = .001) were statistically significantly higher. Cut-off values for lymphocyte count, basophil count, NLR, PLR, and LMR were found to be 1.18, 0.035, 7.97, 291.10, and 2.606, respectively.

Nutritional risk assessment can be made in a practical way by using PNI in patients hospitalized in intensive care unit due to COPD. For this, the PNI cut-off value was determined as 38.5 in our study. In addition, NLR, PLR, LMR, basophil and lymphocyte values, which can be calculated using complete blood count parameters, may also be useful in the evaluation of nutritional status in these patients. In our study, the cut-off values determined for NLR, PLR, LMR, basophil and lymphocyte were 7.97, 291.10 and 2.606, 0.035 and 1.18, respectively. We think that the results we have obtained can provide preliminary information for future research.