bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of antimicrobial resistance in <5 h in Neisseria gonorrhoeae isolates using flow cytometry—proof of concept for seven clinically relevant antimicrobials
Authors: Somajo Sofia , Nilsson Frida , Ekelund Oskar , Unemo Magnus
Published: February 2024

Introduction

Antimicrobial resistance in Neisseria gonorrhoeae compromises gonorrhoea treatment and rapid antimicrobial susceptibility testing (AST) would be valuable. We have developed a rapid and accurate flow cytometry method (FCM) for AST of gonococci.

Methods

The 2016 WHO gonococcal reference strains, and WHO Q, R and S (n = 17) were tested against seven clinically relevant antibiotics (ceftriaxone, cefixime, azithromycin, spectinomycin, ciprofloxacin, tetracycline and gentamicin). After 4.5 h incubation of inoculated broth, the fluorescent dye Syto™ 9 was added, followed by FCM analysis. After gating, the relative remaining population of gonococci, compared with unexposed growth control samples, was plotted against antimicrobial concentration, followed by non-linear curve regression analysis. Furthermore, the response at one single concentration/tested antibiotic was evaluated with the intention to use as a screening test for detection of resistant gonococci.

Results

A dose-dependent response was seen in susceptible isolates for all tested antimicrobials. There was a clear separation between susceptible/WT and resistant/non-WT isolates for ceftriaxone, cefixime, spectinomycin, ciprofloxacin and tetracycline. In contrast, for azithromycin, only high-level-resistant isolates were distinguished, while resistant isolates with MICs of 4 mg/L were indistinguishable from WT (MIC ≤ 1 mg/L) isolates. For gentamicin, all tested 17 isolates were WT and FCM analysis resulted in uniform dose–response curves. Using a single antibiotic concentration and a 50% remaining cell population cut-off, the overall sensitivity and specificity for resistance detection were 93% and 99%, respectively.

Conclusions

By providing results in <5 h for gonococcal isolates, FCM-based AST can become a rapid screening method for antimicrobial resistance or antimicrobial susceptibility in gonococci.
Experiences of an inpatient penicillin allergy de-labelling pathway: capturing the patient voice
Authors: Powell Neil , Upton Mathew , Kent Bridie , Sandoe Jonathan , Tonkin-Crine Sarah
Published: February 2024

Background

Non-allergist-delivered penicillin allergy de-labelling (PADL) is supported by UK and other national guidelines but is not yet routine practice in UK hospitals. Those who have undergone PADL report high rates of acceptance, but it is unknown why some continue to avoid penicillin, and why some decline testing.

Objectives

To explore the experiences of patients recently approached for penicillin allergy (penA) assessment and de-label by non-allergists in a UK hospital to determine the barriers and enablers to patient acceptance of PADL.

Methods

Qualitative study using semi-structured interviews with patients who were penA assessed and de-labelled during an inpatient stay between November 2022 and January 2023. Thematic analysis was used to analyse the data.

Results

Nineteen patients were interviewed. Patients were largely unaware of the negative impact of penA on their healthcare. Patients had differing views on challenging their penA status while they were acutely unwell, some agreeing that it is the right time to test and others not. Patients declined testing because they felt they were at higher potential risk because they were older or had multiple comorbidities. Some patients who declined testing felt they would have been persuaded if they had received a better explanation of the risks and benefits of PADL.

Conclusions

Patients who were successfully de-labelled were positive about the experience. Those who declined testing did so for a variety of reasons including frailty/comorbidities or a fear of testing whilst unwell. Patients highlighted the importance of good communication about the personalized risks and benefits of testing.
Laboratory domestication of Lactiplantibacillus plantarum alters some phenotypic traits but causes non-novel genomic impact
Authors: Surve Sarvesh V , Shinde Dasharath B , Fernandes Joyleen M , Sharma Sharoni , Vijayvargiya Monty , Kadam Komal , Kulkarni Ram
Published: February 2024

Aims

Laboratory domestication has been negligibly examined in lactic acid bacteria (LAB). Lactiplantibacillus plantarum is a highly studied and industrially relevant LAB. Here, we passaged L. plantarum JGR2 in a complex medium to study the effects of domestication on the phenotypic properties and the acquisition of mutations.

Methods and results

Lactiplantibacillus plantarum JGR2 was passaged in mMRS medium (deMan Rogossa Sharpe supplemented with 0.05% w/v L-cysteine) in three parallel populations for 70 days. One pure culture from each population was studied for various phenotypic properties and genomic alterations. Auto-aggregation of the evolved strains was significantly reduced, and lactic acid production and ethanol tolerance were increased. Other probiotic properties and antibiotic sensitivity were not altered. Conserved synonymous and non-synonymous mutations were observed in mobile element proteins (transposases), β-galactosidase, and phosphoketolases in all three isolates. The evolved strains lost all the repeat regions and some of the functions associated with them. Most of the conserved mutations were found in the genomes of other wild-type strains available in a public database, indicating the non-novel genomic impact of laboratory passaging.

Conclusions

Laboratory domestication can affect the phenotypic and genotypic traits of L. plantarum and similar studies are necessary for other important species of LAB.
Bridging information gaps in menopause status classification through natural language processing
Authors: Eyre Hannah , Alba Patrick R , Gibson Carolyn J , Gatsby Elise , Lynch Kristine E , Patterson Olga V , DuVall Scott L
Published: February 2024

Objective

To use natural language processing (NLP) of clinical notes to augment existing structured electronic health record (EHR) data for classification of a patient’s menopausal status.

Materials and methods

A rule-based NLP system was designed to capture evidence of a patient’s menopause status including dates of a patient’s last menstrual period, reproductive surgeries, and postmenopause diagnosis as well as their use of birth control and menstrual interruptions. NLP-derived output was used in combination with structured EHR data to classify a patient’s menopausal status. NLP processing and patient classification were performed on a cohort of 307 512 female Veterans receiving healthcare at the US Department of Veterans Affairs (VA).

Results

NLP was validated at 99.6% precision. Including the NLP-derived data into a menopause phenotype increased the number of patients with data relevant to their menopausal status by 118%. Using structured codes alone, 81 173 (27.0%) are able to be classified as postmenopausal or premenopausal. However, with the inclusion of NLP, this number increased 167 804 (54.6%) patients. The premenopausal category grew by 532.7% with the inclusion of NLP data.

Discussion

By employing NLP, it became possible to identify documented data elements that predate VA care, originate outside VA networks, or have no corresponding structured field in the VA EHR that would be otherwise inaccessible for further analysis.

Conclusion

NLP can be used to identify concepts relevant to a patient’s menopausal status in clinical notes. Adding NLP-derived data to an algorithm classifying a patient’s menopausal status significantly increases the number of patients classified using EHR data, ultimately enabling more detailed assessments of the impact of menopause on health outcomes.
Physiological impacts of climate change on juvenile American lobster Homarus americanus (Decapoda: Astacidea: Nephropidae), a commercially important species
Authors: San Antonio Christine , Tlusty Michael , Hannigan Robyn
Published: February 2024

The American lobster, Homarus americanus, H. Milne Edwards, 1837 is an ecologically, economically, and culturally valuable marine resource for the coastal communities in the Gulf of Maine. Lobsters in the Gulf of Maine are experiencing the effects of rapid warming and acidification due to climate change. Lobster shells are comprised of chitin with precisely precipitated minerals (calcite, amorphous calcium carbonate, and carbonate apatite) that provide structural integrity to the shell and protection against predators and microbial intrusion. We examined the combined effects of ocean warming and acidification on shell mineralogy, epibiont abundance, and growth in early benthic juveniles. Lobsters were grown under six different temperature/pCO2 treatment conditions over 52 days (three replicates per treatment) aligned with environmentally relevant as well as predicted future extremes. Elevated pCO2 and temperature led to a decrease in shell calcium and magnesium content, suggesting that these environmental stressors inhibit shell biomineralization. There was an interactive effect of the stressors on epibiont abundance with the probability of epibiont coverage increasing with increasing pCO2 and temperature. Elevated pCO2 alone was significantly correlated (P = 0.002) to decreased growth, but only for female lobsters. Ocean acidification and warming significantly affect shell integrity in juvenile lobster, increasing risk to injury and disease with potential downstream consequences for the lobster fishery.
Social network analysis and counterterrorism: a double-edged sword for international humanitarian law
Authors: Moncrieff Michael , Kilibarda Pavle , Gaggioli Gloria
Published: February 2024

The use of social network analysis (SNA) during the War on Terror has been a topic of significant political and academic discourse. SNA is an empirical method that graphically and mathematically represents interactions or relationships between nodes (eg, individuals, organizations) and the ties that connect them. The nature and degree of interdependence among nodes are believed to provide insights into the relationships and behaviour of members within a social network. The scarcity of precise and comprehensive data on the structure, functioning, and activities of terrorist groups has prompted some states to incorporate SNA into their intelligence efforts and rely on its data for counterterrorism activities, including lethal operations. However, the compatibility of SNA with international law remains underexplored. In this article, we adopt a legal-empirical approach to elucidate SNA in accessible terms and examine the challenges it presents for international law. We contend that SNA is fundamentally incompatible with international humanitarian law (IHL) targeting rules, as the data it provides do not pertain to legally relevant criteria. Nevertheless, SNA offers valuable insights for IHL by illuminating intra-group dynamics to facilitate conflict classification, identifying legally relevant characteristics in armed groups’ internal networks, and determining the strength of relations between armed factions. Our findings underscore the importance of a nuanced understanding of SNA’s applications and limitations in the context of international law.
Round-up of non-traditional EU trade mark decisions 2023
Authors: Humphreys Gordon , Malovic Nedim , Martin Stefan
Published: February 2024

In 2023, a total of 148 586 trade marks were registered by the European Union Intellectual Property Office (EUIPO). Only 443 of these were ‘non-traditional trade marks’, by this inter alia meaning sounds, colours, patterns, shapes and holograms. Data suggest that the present trend towards obtaining EU trade mark (EUTM) registration for non-traditional trade marks remains low, with merely 0.29 per cent of all applications received by the EUIPO in 2023 concerning such signs. The limited number of cases decided during this period relates to the distinctiveness of such trade marks. This article provides an analysis of six decisions of the General Court and the EUIPO Boards of Appeal, within the field of non-traditional EUTM’s issued in the course of 2023.
The text and data mining opt-out in Article 4(3) CDSMD: Adequate veto right for rightholders or a suffocating blanket for European artificial intelligence innovations?
Authors: Ziaja Gina Maria
Published: February 2024

By introducing Article 4 in Directive 2019/790 (CDSMD), the European Union legislator intended to both encourage innovation and to provide more legal certainty for text and data mining (TDM) activities. That said, it appears that this provision does not strike a fair balance between the interests of rightholders and Artificial Intelligence (AI) developers. This article argues that Article 4(3) CDSMD does not necessarily strengthen the rightholders’ position whilst potentially hindering the advancement of AI developments in the European Union. It is unclear how the reservation of rights shall be realized in practice. By imposing transparency obligations on AI system providers, the upcoming Artificial Intelligence Act may however allow rightholders to make more effective use of the opt-out mechanism.
Species richness in Myotis (Chiroptera: Vespertilionidae): species delimitation and expanded geographic sampling reveal high Neotropical diversity
Authors: Carrión Bonilla Carlos Alberto , Ron Santiago , Cook Joseph A
Published: February 2024

With up to 137 species worldwide, Myotis,— a genus of small, insectivorous bats are an example for understanding biogeographic and evolutionary processes such as intercontinental colonization, diversification, speciation, and convergent adaptive evolution. Species limits and associated distributions, however, remain poorly delineated across significant portions of this diverse group and encompassing a vast geographic range. Here, we explore how diversity is partitioned across this radiation with a focus on Neotropical species of Myotis, using a barcoding approach (706 bp of the mitochondrial DNA gene cytochrome-b) that includes 544 individual sequences (116 newly generated sequences and 428 sequences from GenBank, including outgroups). Single-locus molecular barcoding is useful for identifying cryptic diversity and establishing hypotheses that can guide investigations of species boundaries and phylogenetic relationships, an especially important initial step in assessing poorly characterized, diverse clades. The global phylogeny produced from these data is consistent with the hypothesized monophyly of the New World clade and places the evolutionary relationships of Neotropical species of Myotis within the context of the Palearctic and Nearctic clades. We then explore species boundaries for 25 of the 36 nominal species of Neotropical Myotis, using 3 alternative species delimitation approaches (1 distance-based ABGD [Automatic Barcode Gap Discovery]; and 2 coalescent-based mPTP [multi-rate Poisson Tree Processes], GMYC [Generalized Mixed Yule Coalescent] model). The mPTP (n = 29 species) and ABGD (n = 26) approaches inferred different numbers of species than that recognized by current Neotropical Myotis taxonomy, whereas GMYC (n = 25) inferred the same number of species. In addition to the original 36 Neotropical nominal species currently recognized, we suggest that taxonomic revisions are needed to assess whether M. oxyotus gardneri and M. nigricans osculatii should be elevated to the species level and whether M. dinellii is distinct from M. levis. With the 7 potentially cryptic species identified herein that require further study, the number of Neotropical Myotis may approach 45 species. Taken together, our results suggest that rather than a classic example of a temperate radiation, there may be more species of Myotis in the Neotropics than Nearctic, Afrotropic, Indomalayan, and Oceanian Realms, with only the Palearctic region showing higher species richness.
Association of differential censoring with survival and suboptimal control arms among oncology clinical trials
Authors: Hsu Eric J , Lin Timothy A , Dabush Dor R , McCaw Zachary , Koong Alex , Lin Christine , Abi Jaoude Joseph , Patel Roshal , Kouzy Ramez , El Alam Molly B , Noticewala Sonal , Yang Yumeng , Sherry Alexander D , Fuller Clifton D , Thomas Charles R , Tang Chad , Msaouel Pavlos , Das Prajnan , Huang Bo , Tian Lu , Sun Ryan , Lee J Jack , Meirson Tomer , Ludmir Ethan B
Published: February 2024

Differential censoring, which refers to censoring imbalance between treatment arms, may bias the interpretation of survival outcomes in clinical trials. In 146 phase III oncology trials with statistically significant time-to-event surrogate primary endpoints, we evaluated the association between differential censoring in the surrogate primary endpoints, control arm adequacy, and the subsequent statistical significance of overall survival results. Twenty-four (16%) trials exhibited differential censoring that favored the control arm, whereas 15 (10%) exhibited differential censoring that favored the experimental arm. Positive overall survival was more common in control arm differential censoring trials (63%) than in trials without differential censoring (37%) or with experimental arm differential censoring (47%; odds ratio = 2.64, 95% confidence interval = 1.10 to 7.20; P = .04). Control arm differential censoring trials more frequently used suboptimal control arms at 46% compared with 20% without differential censoring and 13% with experimental arm differential censoring (odds ratio = 3.60, 95% confidence interval = 1.29 to 10.0; P = .007). The presence of control arm differential censoring in trials with surrogate primary endpoints, especially in those with overall survival conversion, may indicate an inadequate control arm and should be examined and explained.
Catastrophic health expenditures, insurance churn, and non-employment among women with breast cancer
Authors: Berlin Nicholas L , Albright Benjamin B , Moss Haley A , Offodile Anaeze C
Published: February 2024

Background

Breast cancer treatment and survivorship entails a complex and expensive continuum of subspecialty care. Our objectives were to assess catastrophic health expenditures, insurance churn, and non-employment among women younger than 65 years who reported a diagnosis of breast cancer. We also evaluated changes in these outcomes related to implementation of the Affordable Care Act.

Methods

The data source for this study was the Medical Expenditure Panel Survey (2005-2019), which is a national annual cross-sectional survey of families, providers, and insurers in the United States. To assess the impact of breast cancer, comparisons were made with a matched cohort of women without cancer. We estimated predicted marginal probabilities to quantify the effects of covariates in models for catastrophic health expenditures, insurance churn, and non-employment.

Results

We identified 1490 respondents younger than 65 years who received care related to breast cancer during the study period, representing a weight-adjusted annual mean of 1 062 129 patients. Approximately 31.8% of women with breast cancer reported health expenditures in excess of 10% of their annual income. In models, the proportion of women with breast cancer who experienced catastrophic health expenditures and non-employment was inversely related to increasing income. During Affordable Care Act implementation, mean number of months of uninsurance decreased and expenditures increased among breast cancer patients.

Conclusions

Our study underscores the impact of breast cancer on financial security and opportunities for patients and their families. A multilevel understanding of these issues is needed to design effective and equitable strategies to improve quality of life and survivorship.
Human-in-the-Loop: The Future of Machine Learning in Automated Electron Microscopy
Authors: Kalinin Sergei V , Liu Yongtao , Biswas Arpan , Duscher Gerd , Pratiush Utkarsh , Roccapriore Kevin , Ziatdinov Maxim , Vasudevan Rama
Published: February 2024

Machine learning (ML) methods are progressively gaining acceptance in the electron microscopy community for de-noising, semantic segmentation, and dimensionality reduction of data post-acquisition. The introduction of the application programming interfaces (APIs) by major instrument manufacturers now allows the deployment of ML workflows in microscopes, not only for data analytics but also for real-time decision-making and feedback for microscope operation. However, the number of use cases for real-time ML remains remarkably small. Here, we discuss some considerations in designing ML-based active experiments and pose that the likely strategy for the next several years will be human-in-the-loop automated experiments (hAE). In this paradigm, the ML learning agent directly controls beam position and image and spectroscopy acquisition functions, and a human operator monitors experiment progression in real and feature space of the system and tunes the policies of the ML agent to steer the experiment toward specific objectives.
Easy Access to Super-Resolution Applications with DeepSIM
Authors: Brighi Carlo , Clario Luca , Romanzi Sara
Published: February 2024

Super-resolution microscopy is becoming more and more relevant and widespread for solving complex biological questions. However, many super-resolution techniques require high-level expertise and specific sample preparation protocols limiting the kind of fluorophore that can be used and consequently the applications. CrestOptics DeepSIM supports researchers deploying standard sample preparation protocols used for confocal microscopy while offering staggering resolution, the possibility of doing live cell imaging, and the ability to image deep into tissues. DeepSIM also allows staining with commonly used fluorescent markers, making it compatible with a large variety of samples and applications.
A radio flare associated with the nuclear transient eRASSt J234403−352640: an outflow launched by a potential tidal disruption event
Authors: Goodwin A J , Anderson G E , Miller-Jones J C A , Malyali A , Grotova I , Homan D , Kawka A , Krumpe M , Liu Z , Rau A
Published: February 2024

We present an extensive radio monitoring campaign of the nuclear transient eRASSt J234402.9−352640 with the Australia Telescope Compact Array, one of the most X-ray luminous TDE candidates discovered by the SRG/eROSITA all-sky survey. The observations reveal a radio flare lasting >1000 d, coincident with the X-ray, UV, optical, and infrared flare of this transient event. Through modelling of the 10 epochs of radio spectral observations obtained, we find that the radio emission is well-described by an expanding synchrotron emitting region, consisting of a single ejection of material launched coincident with the optical flare. We conclude that the radio flare properties of eRASSt J234402.9−352640 are consistent with the population of radio-emitting outflows launched by non-relativistic tidal disruption events, and that the flare is likely due to an outflow launched by a tidal disruption event (but could also be a due to a new AGN accretion event) in a previously turned-off AGN.
Global epidemiology of kidney cancer
Authors: Cirillo Luigi , Innocenti Samantha , Becherucci Francesca
Published: February 2024

Kidney cancer (KC) is a disease with a rising worldwide incidence estimated at 400 000 new cases annually, and a worldwide mortality rate approaching 175 000 deaths per year. Current projections suggest incidence continuing to increase over the next decade, emphasizing the urgency of addressing this significant global health trend. Despite the overall increases in incidence and mortality, striking social disparities are evident. Low- and middle-income countries bear a disproportionate burden of the disease, with higher mortality rates and later-stage diagnoses, underscoring the critical role of socioeconomic factors in disease prevalence and outcomes. The major risk factors for KC, including smoking, obesity, hypertension and occupational exposure to harmful substances, must be taken into account. Importantly, these risk factors also often contribute to kidney injury, a condition that the review identifies as a significant, yet under-recognized, precursor to KC. Finally, the indispensable role of nephrologists is underscored in managing this complex disease landscape. Nephrologists are at the forefront of detecting and managing kidney injuries, and their role in mitigating the risk of KC is becoming increasingly apparent. Through this comprehensive analysis, we aim to facilitate a more nuanced understanding of KC's epidemiology and determinants providing valuable insights for researchers, clinicians and policymakers alike.
An umbrella review and meta-analysis of meta-analyses of the impact of Ramadan fasting on the metabolic syndrome components
Authors: Jahrami Haitham , Ammar Achraf , Glenn Jordan M , Saif Zahra , Chtourou Hamdi , Trabelsi Khaled
Published: February 2024

Context

Ramadan is a holy month of fasting, spiritual reflection, and worship for Muslims worldwide. However, the Ramadan fast – which involves abstaining from all food and drink, sunrise to sunset for 29 days–30 days annually – may also influence physical health outcomes, especially relating to the risk of metabolic syndrome.

Objective

The literature from the top of the pyramid of evidence was gathered and synthesized for this comprehensive umbrella review and meta-analysis of meta-analyses in order to provide an overall conclusion on the impact of Ramadan fasting with regard to metabolic syndrome components.

Data Extraction

Eleven systematic reviews and meta-analyses were included in the current umbrella review. Nine components, including waist circumference, body weight), high-density lipoprotein, low-density lipoprotein, total cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure), and fasting blood plasma glucose were analyzed.

Data Analysis

The random-effects meta-analysis results revealed standard mean differences as follows: waist circumference –0.30 (95% confidence interval [CI] –0.33 to –0.27), body weight –0.34 (95% CI –0.39 to –0.29), high-density lipoprotein 0.20 (95% CI 0.10 to 0.30), low-density lipoprotein –0.10 (95% CI –0.13 to –0.07), total cholesterol –0.15 (95% CI –0.21 to –0.09), triglycerides –0.16 (95% CI –0.24 to –0.08), systolic blood pressure –0.20 (95% CI –0.23 to –0.17), diastolic blood pressure –0.20 (95% CI –0.22 to –0.18), fasting blood plasma glucose –0.10 (95% CI –0.12 to –0.08).

Conclusion

Ramadan fasting appears to benefit body weight, lipid profile, blood pressure, and fasting blood glucose levels. Therefore, engaging in fasting during Ramadan may contribute to weight reduction, decreased cardiovascular disease risk, improved blood pressure, and enhanced glycemic control. Nevertheless, the methodological quality of the included reviews ranged from low to critically low, necessitating cautious interpretation of conclusions drawn from these data.

Systematic Review Registration

Open Science Framework Identifier: DOI 10.17605/OSF.IO/9WVJZ.
Coalition for Health and Gender Equity (CHANGE)—a protocol for a global cross-sectional survey of health and gender equity in rheumatology
Authors: Khursheed Tayyeba , Ovseiko Pavel , Dyball Sarah , Nakashima Ran , Gonzalez Ana Maria Arredondo , Babini Alejandra , Kalla Asgar Ali , Hill Catherine , Danda Debashish , Dey Dzifa , Traboco Lisa , Nikiphorou Elena , Harifi Ghita , Badshah Humeira , Hmamouchi Ihsane , Marie Von Feldt Joan , Farani Júlia Boechat , Andreoli Laura , Guimarães Mariana Peixoto , Toro Gutiérrez Carlos Enrique , Sieiro Santos Cristiana , Duftner Christina , Alpizar Rodriguez Deshire , Ziadé Nelly , Palominos Penélope Esther , Haq Syed Atiqul , Bautista-Molano Wilson , Tanaka Yoshiya , Gossec Laure , Agarwal Vikas , Wright Grace C , Coates Laura , Gupta Latika ,   the CHANGE Study Group, So Ho , Colunga-Pedraza Iris J , Chen Yi-Ming , Salim Babur , Vaidya Binit , Arredondo Gonzalez Ana Maria , Victoria Sadovici , Wang Qian , Akawatcharangura Phonpen , Siripaitoon Boonjing , Doskaliuk Bohdana , Sazliyana Shaharir Syahrul , Juge Pierre-Antoine , Klitz Uta , Mucke Johanna , Ravindran Vinod , Panagiotopoulos Alexandros , Colic Jelena , Bilgin Emre , Parodis Ioannis , de Hooge Manouk , Tα´lli Sandra , Magro Rosalie , Dourado Eduardo
Published: February 2024

Objectives

The primary aim of the CHANGE survey is to determine the current state of gender equity within rheumatology, and secondarily, to review the physician perspective on bullying, harassment and equipoise of opportunities within rheumatology.

Methods

The CHANGE e-survey is a cross-sectional self-reported questionnaire adapted from EULAR’s gender equity in academic rheumatology task force. The survey was launched in January 2023; it is available in six languages and distributed widely via rheumatology organizations and social media. Eligible participants include rheumatologist physicians and rheumatology health-care professionals. Survey responses will undergo descriptive analysis and inter-group comparison aiming to explore gender-based discrimination using logistic regression, with subgroup analyses for country/continent variations.

Conclusion

This e-survey represents a comprehensive global initiative led by an international consortium, aimed at exploring and investigating the gender-related disparities and obstacles encountered by rheumatologists and rheumatology health-care professionals across diverse communities and health-care environments. By pursuing this initiative, we aim to take the broader rheumatology community a step closer to understanding the underlying origins of inequities and their determinants. Such insights are pivotal in identifying viable interventions and strategies to foster gender equity within the field. Ultimately, our collective objective is to ensure equitable access to opportunities for every individual, irrespective of gender, thereby promoting inclusivity and fairness across the entire spectrum of professional practice and career development.
The one-year infection risk among patients diagnosed with giant cell arteritis: use of antibiotics and hospitalisations
Authors: Therkildsen Philip , de Thurah Annette , Nielsen Berit Dalsgaard , Faurschou Mikkel , Baslund Bo , Hansen Ib Tønder , Nørgaard Mette , Hauge Ellen-Margrethe
Published: February 2024

Objectives

Patients with giant cell arteritis (GCA) primarily have their infections managed by primary care providers and hospitalisation is rarely necessary. Existing studies in GCA focus on infection-related hospitalisations only, whereas the use of antibiotic prescriptions is largely unknown. This study aims to examine the one-year overall infection risk among patients with GCA.

Methods

This nationwide observational cohort study included patients aged ≥50 years with a first-time GCA diagnosis in the Danish National Patient Registry (1996–2022). Patients with GCA were matched 1:10 by sex and date of birth with general population individuals and followed from date of diagnosis. Overall infections were defined as redeemed antibiotic prescriptions or infection-related hospitalisations. Utilising a pseudo-observation approach, we assessed 1-year cumulative incidence proportions (CIP), risk differences (RD) and relative risks (RR) of infections.

Results

The study included 17 773 incident patients with GCA and 177 730 reference individuals. Patients with GCA had a 1-year CIP of 52.4% (95% CI: 51.7–53.2) for overall infections and 17.6% (95% CI: 17.1–18.2) for infection-related hospitalisations. Compared with the reference cohort, patients with GCA had a RR of 1.40 (95% CI: 1.38–1.42) for overall infections and 2.71 (95% CI: 2.61–2.82) for infection-related hospitalisations. Additionally, higher cumulative glucocorticoid doses, advanced age (≥70 years) and higher comorbidity were associated with an increased risk of infections among patients with GCA.

Conclusions

The use of antibiotic prescriptions and infection-related hospitalisations in the first year after a GCA diagnosis is high compared with the background population. The cumulative glucocorticoid dose is associated with the infection risk.
Combined effects of neuroticism and negative emotional context on spontaneous EEG dynamics
Authors: Deodato Michele , Seeber Martin , Mammeri Kevin , Michel Christoph M , Vuilleumier Patrik
Published: February 2024

Neuroticism is a personality trait with great clinical relevance, defined as a tendency to experience negative affect, sustained self-generated negative thoughts and impaired emotion regulation. Here, we investigated spontaneous brain dynamics in the aftermath of negative emotional events and their links with neuroticism in order to shed light on the prolonged activity of large-scale brain networks associated with the control of affect. We recorded electroencephalography (EEG) from 36 participants who were asked to rest after watching neutral or fearful video clips. Four topographic maps (i.e. microstates classes A, B, C and D) explained the majority of the variance in spontaneous EEG. Participants showed greater presence of microstate D and lesser presence of microstate C following exposure to fearful stimuli, pointing to changes in attention- and introspection-related networks previously associated with these microstates. These emotional effects were more pronounced for participants with low neuroticism. Moreover, neuroticism scores were positively correlated with microstate C and negatively correlated with microstate D, regardless of previous emotional stimulation. Our results reveal distinctive effects of emotional context on resting-state EEG, consistent with a prolonged impact of negative affect on the brain, and suggest a possible link with neuroticism.
Effect of extrusion on energy and nutrient digestibility of lentil-based diets containing either supplemental plant or animal protein fed to growing pigs
Authors: Sanchez-Zannatta Joaquin , Wang Li Fang , Beltranena Eduardo , Zijlstra Ruurd T
Published: February 2024

Non-food grade and excess lentil grain production may be included in swine feeds to provide starch and protein and reduce feed cost. Extrusion processing may increase energy and nutrient digestibility of lentil-based diets containing either supplemental plant or animal protein sources. Therefore, the apparent ileal digestibility (AID) of crude protein (CP) and amino acids (AA), apparent total tract digestibility (ATTD) of gross energy (GE), and digestible energy (DE) value of lentil-based diets were assessed in growing pigs. Two diets were formulated to provide 2.4 Mcal net energy (NE)/kg and 4.35 g standardized ileal digestible lysine/Mcal NE: (1) soybean meal (SBM) diet, containing 50% lentil, 31% wheat, and 12.8% SBM; and (2) fish meal (FM) diet, containing 40% lentil, 45% wheat, and 10% FM. Following mixing, each diet batch was divided into two parts: one part remained as mash, whereas the other part was extruded using a single-screw extruder (400 rpm, 250 kg/h). Eight ileal-cannulated barrows (32.3 ± 1.5 kg) were fed the four diets at 2.8 times maintenance DE requirement (110 kcal per kg of body weight0.75) for four 9-d periods in a double 4 × 4 Latin square to achieve 8 observations per diet. Data were analyzed as a 2 × 2 factorial arrangement including protein source, post-mixing processing, and their interaction as fixed effects. The lentil sample contained 32.3% starch, 24.4% CP, 9.3% total dietary fiber, and 1.7 mg/g of trypsin inhibitor activity on as is-basis. Interactions between dietary protein source and post-mixing processing were not observed. Feeding FM diets resulted in greater (P < 0.05) AID of dry matter (DM), GE, and most AA, and ATTD of CP, but lower apparent hindgut fermentation of DM and GE than SBM diets. Extrusion increased (P < 0.05) the ATTD of GE and DE value of diets. The AID of CP and AA was 3.2 and 4.7%-units greater (P < 0.05), respectively, for the extruded than mash diets. In conclusion, feeding FM diets resulted in greater ileal digestibility of DM, GE, and AA than SBM diets. Extrusion increased the AID of CP and most AA, and DE value of lentil-based diets containing either supplemental plant protein or animal-protein, indicating that extrusion can increase the energy and protein value of plant-based diets fed to pigs.
One-shot technology for three-dimensional imaging of large animals: perspectives for ruminant management
Authors: Le Cozler Yannick , Dumesny Maxime , Delouard Jean-Michel , Delattre Laurent , Luginbühl Thibault , Faverdin Philippe
Published: February 2024

In numerous systems of animal production, there is increasing interest in the use of three-dimensional (3D)-imaging technology on farms for its ability to easily and safely measure traits of interest in living animals. With this information, it is possible to evaluate multiple morphological indicators of interest, either directly or indirectly, and follow them through time. Several tools for this purpose were developed, but one of their main weaknesses was their sensitivity to light and animal movement, which limited their potential for large-scale application on farms. To address this, a new device, called Deffilait3D and based on depth camera technology, was developed. In tests on 31 Holstein dairy cows and 13 Holstein heifers, the values generated for most measured indicators were highly repeatable and reproducible, with coefficients of variation lower than 4%. A comparison of measurements obtained from both Deffilait3D and the previous validated system, called Morpho3D, revealed a high degree of similarity for most selected traits, e.g., less than 0.2% variation for animal volume and 1.2% for chest depth, with the highest degree of difference (8%) noted for animal surface area. Previously published equations used to estimate body weight with the Morpho3D device were equally valid using Deffilait3D. This new device was able to record 3D images regardless of the movement of animals and it is affected only by direct daylight. The ongoing step is now to develop methods for automated analysis and extraction from images, which should enable the rapid development of new tools and potentially lead to the large-scale adoption of this type of device on commercial farms.
Development of Health Professions Education Competencies for a National Fellowship Program: A Group Consensus Process
Authors: Caloudas Alexandra B. , Arredondo Kelley , Godwin Kyler M. , Watts Bradley V. , Croom Travis , O’Brien Bridget , Topor David R. , Battistone Michael J. , Edens Ellen L. , Singh Mamta K. , Horstman Molly J.
Published: February 2024

Health professions educators need knowledge, skills, and attitudes to provide high-quality education within dynamic clinical learning environments. Although postgraduate training opportunities in health professions education (HPE) have increased significantly, no shared competencies exist across the field. This article describes the systematic development of postgraduate HPE competencies for the Health Professions Education, Evaluation, and Research (HPEER) Advanced Fellowship, a 2-year, interprofessional, post–master’s degree and postdoctoral HPE training program funded through the Department of Veterans Affairs’ Office of Academic Affiliations. Using a modified RAND/University of California at Los Angeles Appropriateness Method, the authors developed competencies from March 2021 to August 2021 that were informed by current practices and standards in HPE. Literature reviews were conducted of published literature from November 2020 to February 2021 and gray literature from February to March 2021, identifying 78 and 274 HPE training competencies, respectively. These competencies were combined with 71 competencies submitted by program faculty from 6 HPEER fellowship sites, resulting in 423 initial competencies. Competencies were organized into 6 primary domains and condensed by deleting redundant items and combining overlapping concepts. Eight subject matter experts completed 3 Delphi surveys and met during 2 nominal group technique meetings. The final 25 competencies spanned 6 domains: teaching methods and learning theories; educational assessment and program evaluation; educational research methods; diversity, equity, and inclusion; interprofessional practice and team science; and leadership and management. In addition to informing the national HPEER curriculum, program evaluation, and learner assessment, these advanced competencies describe the knowledge, skills, and attitudes health professions educators need to provide high-quality education with an emphasis on the global and societal impact of HPE. These competencies represent a step toward leveraging HPE expertise to establish competencies to drive HPE program changes. Other programs should report their competencies and competency development processes to spur further dialog and progress.
Coronavirus Disease 2019 (COVID-19) in Heart Transplant Recipients and Anti-SARS-CoV-2 Monoclonal Antibodies: Experience, Lessons Learnt, and Future Challenges
Authors: Kapur Rohan , Okumura Kenji , Ohira Suguru , Isath Ameesh , Gandhi Aditya , Keller Marina , Nog Rajat , Gass Alan , Spielvogel David , Lansman Steven , Dhand Abhay
Published: February 2024

Solid organ transplant recipients (SOTRs), including heart transplant (HT) recipients, infected with Coronavirus disease 2019 (COVID-19) are at higher risk of hospitalization, mechanical ventilation, or death when compared with general population. Advances in diagnosis and treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have reduced COVID-19-related mortality rates from ~30% in the early pandemic to <3% in 2022 among HT recipients. We performed a retrospective chart review including adult HT recipients at Westchester Medical Center from January 1, 2020 to December 10, 2022, who received anti-SARS-CoV-2 monoclonal antibodies (mAbs) for treatment of mild-to-moderate COVID-19, and those who received tixagevimab/cilgavimab for preexposure prophylaxis. Additionally, a comprehensive review of the literature involving SOTRs who received mAbs for COVID-19 was conducted. In this largest single-center study in this population, 42 adult HT recipients received casirivimab/imdevimab (36%), sotrovimab (31%), or bebtelovimab (29%) for treatment of mild-to-moderate COVID-19. Among these recipients, no infusion-associated adverse effects, progression of disease, COVID-19-associated hospitalizations, or death were noted. Preexposure prophylaxis with tixagevimab/cilgavimab was given to 63 HT recipients in a dedicated infusion center (40%), inpatient setting (33%), or at time of annual heart biopsy (27%). No immediate adverse events were noted. There were 11 breakthrough infections, all mild. Overall, the data suggests that HT recipients receiving mAbs have reduced rates of hospitalization, need for intensive care unit care, or death. Use of anti-SARS-CoV-2 mAbs in SOTRs is resource intensive and requires a programmatic team approach for optimal administration and to minimize any risk of disparities in their use.
Innovations in Aortic Valve Replacement: A Comprehensive Overview of the Intuity Rapid Deployment Valve
Authors: Alaklabi Abdulaziz M. , Abdul Rab Saleha , Sabbah Belal N. , Maklad Ahmed Essam , Dokollari Aleksander , Van den Eynde Jef , Pompeu Sa Michel , Arjomandi Rad Arian , Ahsan Muhammad Rauf , Fatehi Hassanabad Ali
Published: February 2024

Rapid deployment/sutureless (RDS) valves have recently emerged as an innovative surgical solution, providing an alternative to traditional methods of surgical aortic valve replacement (SAVR) by eliminating the need for suture placement and tying. This innovation leads to a reduction in aortic crossclamp and cardiopulmonary bypass times, enhancing the efficiency of the procedure. Among the 2 available RDS valves, the Edwards Intuity valve in particular has been demonstrated to be a particularly promising substitute in the field of SAVR. The Intuity valve distinguishes itself from other RDS and conventional valves by yielding superior outcomes, such as a significant reduction in mortality, increase in the longevity of the valve, and a marked decrease in both mean and peak transvalvular pressure gradients. These benefits collectively contribute to its appeal as a favorable new solution. However, further investigation is needed to conclusively determine the long-term outcomes and safety of RDS valves. Nevertheless, the utilization of the Intuity valve presents an exciting solution to the existing limitations of conventional and minimally invasive SAVR, especially for patients afflicted with severe aortic stenosis.
Antithrombotic Stewardship: Evaluation of Platelet Reactivity-Guided Cangrelor Dosing Using the VerifyNow Assay
Authors: Connery Alexander , Ahuja Tania , Katz Alyson , Arnouk Serena , Zhu Eric , Papadopoulos John , Rao Sunil , Merchan Cristian
Published: February 2024

Cangrelor may be used as a bridge when temporary interruption of dual antiplatelet therapy is necessary. However, the optimal dose and monitoring of cangrelor in patients remains unknown, especially in the setting of mechanical circulatory support (MCS). We conducted an observational, single-center, retrospective cohort study of patients who had percutaneous coronary intervention within 3 months and received cangrelor while admitted to any intensive care unit. The primary outcome was the incidence of any major adverse cardiovascular event. Secondary outcomes included VerifyNow platelet reactivity units (PRUs) measured while on cangrelor and any bleeding events while on cangrelor. A total of 92 patients were included. The most common reason for cangrelor use was in the periprocedural setting, with or without MCS (42%–45%), followed by NPO status (26%–28%) and MCS alone (22%–24%). The primary outcome of major adverse cardiovascular event occurred in 1 patient (1.1%). Of 92 patients, 77% had a P2Y12 level collected within 24 hours, and 89% of the cohort was able to achieve the goal P2Y12 PRU of <194. The median P2Y12 value within 24 hours of cangrelor initation was 115 PRU (40–168 PRU). We observed a bleed event rate of 23% (21/92). We found a standardized protocol of cangrelor dosing in critically ill patients who received a drug-eluting stent in the past 3 months to be successful in achieving a goal P2Y12 PRU. Although the optimal PRU remains unknown, cardiovascular clinicians may monitor these levels to help guide decisions regarding cangrelor management. Future randomized controlled trials should evaluate the optimal PRU threshold to balance risks of ischemia and bleeding.
Sex differences in facial expressions of pain: results from a combined sample
Authors: Schneider Pia , Lautenbacher Stefan , Kunz Miriam
Published: February 2024

Facial expressions of pain play an important role in pain diagnostics and social interactions. Given the prominent impact of sex on various aspects of pain, it is not surprising that sex differences have also been explored regarding facial expressions of pain; however, with inconclusive findings. We aim to further investigate sex differences in facial expressions of pain by using a large, combined sample to maximize statistical power. Data from 7 previous studies of our group were merged, combining in total the data of 392 participants (male: 192, female: 200). All participants received phasic heat pain, with intensities being tailored to the individual pain threshold. Pain intensity ratings were assessed, and facial responses were manually analyzed using the Facial Action Coding. To compare facial and subjective responses between sexes, linear mixed-effects models were used, with study ID as a random effect. We found significant sex differences in facial responses, with females showing elevated facial responses to pain, although they received lower physical heat intensities (women had lower pain thresholds). In contrast, pain intensity ratings did not differ between sexes. Additionally, facial and subjective responses to pain were significantly associated across sexes, with females showing slightly stronger associations. Although variations in facial expressions of pain are very large even within each sex, our findings demonstrate that women facially communicate pain more intensively and with a better match to their subjective experience compared with men. This indicates that women might be better in using facial communication of pain in an intensity-discriminative manner.