bluuebunny/crossref_metadata_2025 huggingface dataset:
Occupational characteristics and disability-free survival after retirement age: an exploratory analysis from the ASPREE study
Authors: Alif Sheikh M. , Benke Geza P. , Ronaldson Kathlyn J. , Walker-Bone Karen , Woods Robyn L. , Tran Cammie , Beilin Lawrence J. , Tonkin Andrew M. , Owen Alice J. , McNeil John J.
Published: December 2023

Background

Certain occupational characteristics have been linked with poor health and reduced longevity. However, the association between occupational characteristics and survival free of disability in a post-retirement age group has not been investigated.

Methods

We investigated outcomes in 12,215 healthy older Australian adults in the Aspirin in Reducing Events in the Elderly (ASPREE) and ASPREE Longitudinal Study of Older Persons (ALSOP) sub-study. The ISCO-88 major occupational groups, settings, and activity levels were assigned based on free-text job descriptions. The Finnish Job Exposure Matrix was used to assign occupational characteristics to the three longest-held jobs. The primary endpoint, disability-free survival, was defined as a composite measure of death, dementia, or persistent physical disability. The endpoint of all-cause mortality was analyzed separately. Because of multiple exploratory analyses, only those associations with a two-sided value of p less than 0.005 were considered statistically significant. Cox proportional hazard models were used to calculate adjusted hazard ratios.

Results

Having worked in an ‘elementary’ occupation was associated with a reduction in disability-free survival. A specific impact on disability-free survival was observed among those whose work had involved high accident risk and adverse social climate. No significant relationship was identified with those previously exposed to sedentary work, vigorous physical activity, work primarily outdoors, or a range of other occupational characteristics. All-cause mortality was not increased among any of the occupational groups.

Conclusion

This exploratory study found a reduction in disability-free survival among people who worked in ‘elementary’ occupations, with specific risks associated with occupations involving high accident risks and adverse social climate.
Depressive and anxiety symptoms during the COVID-19 pandemic in the oldest-old population and the role of psychosocial factors: a multivariate and multi-wave analysis
Authors: Gerhards Sina K. , Pabst Alexander , Luppa Melanie , Riedel-Heller Steffi G.
Published: December 2023

Background

Since the oldest-old population was identified as a high-risk group for a severe course of the coronavirus disease and higher mortality, it was assumed that they might be particularly psychologically burdened. The aim of the study is to analyze the development of anxiety and depressive symptoms over the course of the pandemic from 2020 to 2022, as well as psychosocial factors associated with these outcomes.

Method

We analyzed data of n = 135 participants aged 78 to 97 years old (2020: M = 86.77, SD = 4.54) with three points of measurement from May to June 2020 (t1), March to May 2021 (t2) and November to January 2022 (t3). Besides sociodemographic variables, worries about the Sars-Cov-2 virus, living situation, perceived social support (ESSI), resilience (BRS), anxiety and depressive symptoms (BSI-18) were assessed. We calculated multilevel mixed-effects generalized linear models with a negative binominal distribution to model anxiety and depressive symptoms over time.

Results

While there is an increase in depressive and anxiety symptoms in the investigated oldest-old individuals in Germany from 2020 to 2021, there is no further increase in symptomatology from 2021 to 2022. Participants of older age reported higher levels of anxiety symptoms. Higher perceived social support was associated with both less depressive and less anxiety symptoms, while resilience was associated with less depressive symptoms only. More worries about the Sars-Cov-2 virus were associated with higher anxiety levels.

Conclusion

Overall, the oldest-old population appeared to show rather stable mental health after a slight increase in symptomatology within the first year of the pandemic. Social support is an important factor to target in mental health prevention programs for oldest-old individuals in times of future crises such as a pandemic.
Education for public health 2030: transformation to meet health needs in a changing world
Authors: Sullivan Lisa M. , Weist Elizabeth M. , Barrington Wendy E. , Fairchild Amy L. , Hwang Wenke , Kiviniemi Marc T. , Mohammed Shan D. , Wyant Victoria A. , Alexander Linda A. , Magaña Laura
Published: December 2023

Education for public health is at a critical inflection point, and either transforms for success or fails to remain relevant. In 2020, the Association for Schools and Programs of Public Health launched an initiative, Framing the Future 2030: Education for Public Health (FTF 2030) to develop a resilient educational system for public health that promotes scientific inquiry, connects research, education, and practice, eliminates inequities, incorporates anti-racism principles, creates and sustains diverse and inclusive teaching and learning communities, and optimizes systems and resources to prepare graduates who are clearly recognizable for their population health perspectives, knowledge, skills, attitudes, and practices. Three expert panels: (1) Inclusive excellence through an anti-racism lens; (2) Transformative approaches to teaching and learning; and (3) Expanding the reach, visibility, and impact of the field of academic public health are engaged in ongoing deliberations to generate recommendations to implement the necessary change. The article describes the panels’ work completed thus far, a “Creating an Inclusive Workspace” guide, and work planned, including questions for self-evaluation, deliberation, and reflection toward actions that support academe in developing a resilient education system for public health, whether beginning or advancing through a process of change. The FTF 2030 steering committee asserts its strong commitment to structural and substantial change that strengthens academic public health as an essential component of a complex socio-political system. Lastly, all are called to join the effort as collaboration is essential to co-develop an educational system for public health that ensures health equity for all people, everywhere.
The assessment of musculoskeletal disorders, quality of life, and comorbidities in older people in Bangladesh
Authors: Jahan Sharmila , Islam Rabiul , Rahman Tania , Kabir Md. Feroz , Islam Md. Waliul , Hossain Kabir , Hossain K. M. Amran , Hossain Md. Zahid , Rahman Ehsanur , Chakrovorty Sonjit Kumar , Sarker Altaf Hossain , Moula Golam , Antara Atqiya , Afridi Shahid
Published: December 2023

Musculoskeletal disorders are debilitating conditions that significantly impact the state of health, especially in older people. The study, which employed a cross-sectional design and practical sampling, included 206 participants among them 124 (62.2%) were men and 82 (39.8%) were women, from all over Bangladesh with musculoskeletal issues of varying severity and impact. The mean age of the participants was 64.9 (SD 4.3). The study was carried out between January and June of 2022. The majority of participants experienced musculoskeletal pain. Back pain was the most commonly complained of symptom among the participants (74.9%). It was also common to have limited mobility as a result of arthritic change, which eventually affected daily activities like taking care of oneself. To improve the health of the older adult population, more studies must be conducted to identify the many factors that contribute to musculoskeletal issues. The development of effective prevention and rehabilitation programs must then be based on this knowledge.
Short- and long-term effects of radiation exposure at low dose and low dose rate in normal human VH10 fibroblasts
Authors: Akuwudike Pamela , López-Riego Milagrosa , Marczyk Michal , Kocibalova Zuzana , Brückner Fabian , Polańska Joanna , Wojcik Andrzej , Lundholm Lovisa
Published: December 2023

Introduction

Experimental studies complement epidemiological data on the biological effects of low doses and dose rates of ionizing radiation and help in determining the dose and dose rate effectiveness factor.

Methods

Human VH10 skin fibroblasts exposed to 25, 50, and 100 mGy of 137Cs gamma radiation at 1.6, 8, 12 mGy/h, and at a high dose rate of 23.4 Gy/h, were analyzed for radiation-induced short- and long-term effects. Two sample cohorts, i.e., discovery (n = 30) and validation (n = 12), were subjected to RNA sequencing. The pool of the results from those six experiments with shared conditions (1.6 mGy/h; 24 h), together with an earlier time point (0 h), constituted a third cohort (n = 12).

Results

The 100 mGy-exposed cells at all abovementioned dose rates, harvested at 0/24 h and 21 days after exposure, showed no strong gene expression changes. DMXL2, involved in the regulation of the NOTCH signaling pathway, presented a consistent upregulation among both the discovery and validation cohorts, and was validated by qPCR. Gene set enrichment analysis revealed that the NOTCH pathway was upregulated in the pooled cohort (p = 0.76, normalized enrichment score (NES) = 0.86). Apart from upregulated apical junction and downregulated DNA repair, few pathways were consistently changed across exposed cohorts. Concurringly, cell viability assays, performed 1, 3, and 6 days post irradiation, and colony forming assay, seeded just after exposure, did not reveal any statistically significant early effects on cell growth or survival patterns. Tendencies of increased viability (day 6) and reduced colony size (day 21) were observed at 12 mGy/h and 23.4 Gy/min. Furthermore, no long-term changes were observed in cell growth curves generated up to 70 days after exposure.

Discussion

In conclusion, low doses of gamma radiation given at low dose rates had no strong cytotoxic effects on radioresistant VH10 cells.
Application progress of ensemble forecast technology in influenza forecast based on infectious disease model
Authors: Chen Lianglyu
Published: December 2023

To comprehensively understand the application progress of ensemble forecast technology in influenza forecast based on infectious disease model, so as to provide scientific references for further research. In this study, two keywords of “influenza” and “ensemble forecast” are selected to search and select the relevant literatures, which are then outlined and summarized. It is found that: In recent years, some studies about ensemble forecast technology for influenza have been reported in the literature, and some well-performed influenza ensemble forecast systems have already been operationally implemented and provide references for scientific prevention and control. In general, ensemble forecast can well represent various uncertainties in forecasting influenza cases based on infectious disease models, and can achieve more accurate forecasts and more valuable information than single deterministic forecast. However, there are still some shortcomings in the current studies, it is suggested that scientists engaged in influenza forecast based on infectious disease models strengthen cooperation with scholars in the field of numerical weather forecast, which is expected to further improve the skills and application level of ensemble forecast for influenza.
The steps that young people and suicide prevention professionals think the social media industry and policymakers should take to improve online safety. A nested cross-sectional study within a Delphi consensus approach
Authors: Robinson Jo , Thorn Pinar , McKay Samuel , Richards Hannah , Battersby-Coulter Rikki , Lamblin Michelle , Hemming Laura , La Sala Louise
Published: December 2023

Introduction

Concerns exist about the relationship between social media and youth self-harm and suicide. Study aims were to examine the extent to which young people and suicide prevention professionals agreed on: (1) the utility of actions that social media companies currently take in response to self-harm and suicide-related content; and (2) further steps that the social media industry and policymakers could take to improve online safety.

Methods

This was a cross-sectional survey study nested within a larger Delphi expert consensus study. A systematic search of peer-reviewed and grey literature and roundtables with social media companies, policymakers, and young people informed the questionnaire development. Two expert panels were developed to participate in the overarching Delphi study, one of young people and one of suicide prevention experts; of them 43 young people and 23 professionals participated in the current study. The proportion of participants “strongly agreeing”, “somewhat agreeing”, “neither agreeing nor disagreeing”, and “somewhat disagreeing” or “strongly disagreeing” for each item were calculated; items that achieved =>80% of agreement from both panels were strongly endorsed.

Results

There was limited consensus across the two groups regarding the utility of the safety strategies currently employed by companies. However, both groups largely agreed that self-harm and suicide-related content should be restricted. Both groups also agreed that companies should have clear policies covering content promoting self-harm or suicide, graphic depictions of self-harm or suicide, and games, pacts and hoaxes. There was moderate agreement that companies should use artificial intelligence to send resources to users at risk. Just over half of professionals and just under half of young people agreed that social media companies should be regulated by government. There was strong support for governments to require schools to educate students on safe online communication. There was also strong support for international collaboration to better coordinate efforts.

Discussion

Study findings reflect the complexity associated with trying to minimise the risks of communicating online about self-harm or suicide whilst capitalising on the benefits. However, a clear message was the need for better collaboration between policymakers and the social media industry and between government and its international counterparts
Broad spectrum micronutrients: a potential key player to address emotional dysregulation
Authors: Villagomez Amelia , Cross Michelle , Ranjbar Noshene
Published: December 2023

Psychiatric conditions are inherently multifactorial and must be understood and addressed within a multidimensional framework. Adequate nutritional intake is necessary for optimal mental health and is thus an essential component of any psychiatric treatment plan; this is especially true as many patients have a diet high in ultra-processed foods. However, due to a variety of factors such as individual biological and behavioral contributors, modern farming practices, and climate change, implementing a healthy diet alone may not be sufficient to satisfy nutritional requirements. Research studies on three formulations of broad-spectrum micronutrients (BSMs) have demonstrated significant efficacy in treating a range of mental health disorders. In particular, outcomes associated with emotional regulation via BSMs across a variety of psychiatric illnesses (ADHD, autism, trauma, mood disorders, nicotine dependence, and psychosis) to date have been positive.
Jitter error evaluation in large-aperture optical telescopes based on normalized point source sensitivity
Authors: Yuan-Guo Liu , Fei Yang , Jia-Kang Zhu , Yin-Long Huo
Published: December 2023

To comprehensively analyze the jitter error in large-aperture optical telescopes, this paper introduces normalized point source sensitivity (PSSn) to evaluate the telescope system. First, the concept and basic properties of PSSn were introduced, and then the jitter error under expected random loads and the contribution percentage of each mode to the total jitter were analyzed through a model. The PSSn of the system under the influence of different error sources was studied, and its variation trend was estimated. A comparison of evaluation methods, such as the Strehl ratio, and the proposed method reflects the characteristics of more accurate data and a more concise calculation. The jitter error evaluation method proposed in this article, combined with PSSn, provides practical and beneficial guidance for the design and detection of large-aperture optical telescope systems.
Realizing in-house algorithm-driven free fibula flap set up within 24 hours: a pilot study evaluating accuracy with open-source tools
Authors: Vollmer Andreas , Saravi Babak , Breitenbuecher Niko , Mueller-Richter Urs , Straub Anton , Šimić Luka , Kübler Alexander , Vollmer Michael , Gubik Sebastian , Volland Julian , Hartmann Stefan , Brands Roman C.
Published: December 2023

Objective

This study aims to critically evaluate the effectiveness and accuracy of a time safing and cost-efficient open-source algorithm for in-house planning of mandibular reconstructions using the free osteocutaneous fibula graft. The evaluation focuses on quantifying anatomical accuracy and assessing the impact on ischemia time.

Methods

A pilot study was conducted, including patients who underwent in-house planned computer-aided design and manufacturing (CAD/CAM) of free fibula flaps between 2021 and 2023. Out of all patient cases, we included all with postoperative 3D imaging in the study. The study utilized open-source software tools for the planning step, and three-dimensional (3D) printing techniques. The Hausdorff distance and Dice coefficient metrics were used to evaluate the accuracy of the planning procedure.

Results

The study assessed eight patients (five males and three females, mean age 61.75 ± 3.69 years) with different diagnoses such as osteoradionecrosis and oral squamous cell carcinoma. The average ischemia time was 68.38 ± 27.95 min. For the evaluation of preoperative planning vs. the postoperative outcome, the mean Hausdorff Distance was 1.22 ± 0.40. The Dice Coefficients yielded a mean of 0.77 ± 0.07, suggesting a satisfactory concordance between the planned and postoperative states. Dice Coefficient and Hausdorff Distance revealed significant correlations with ischemia time (Spearman's rho = −0.810, p = 0.015 and Spearman's rho = 0.762, p = 0.028, respectively). Linear regression models adjusting for disease type further substantiated these findings.

Conclusions

The in-house planning algorithm not only achieved high anatomical accuracy, as reflected by the Dice Coefficients and Hausdorff Distance metrics, but this accuracy also exhibited a significant correlation with reduced ischemia time. This underlines the critical role of meticulous planning in surgical outcomes. Additionally, the algorithm's open-source nature renders it cost-efficient, easy to learn, and broadly applicable, offering promising avenues for enhancing both healthcare affordability and accessibility.
Effect of Plasma Actuator Layout on the Passage Vortex Reduction in a Linear Turbine Cascade for a Wide Range of Reynolds Numbers
Authors: Matsunuma Takayuki , Segawa Takehiko
Published: December 2023

This study examined how various plasma actuator (PA) configurations affect the passage vortex (PV) reduction in a linear turbine cascade (LTC) utilizing dielectric barrier discharge PAs. The experiments were carried out under three specific layout conditions: axial placement of the PA, slanted placement at the blade inlet, and slanted placement inside the blade. Particle image velocimetry was employed to measure the velocity distribution of the secondary flow at the LTC exit, followed by an analysis of the streamline patterns, turbulence intensity distribution, and vorticity distribution. At a Reynolds number of 3.7 × 104, the PA with an oblique orientation at the blade inlet provided the most effective PV suppression. The average value of the secondary flow velocity and the peak vorticity value at the LTC exit decreased by 59.0% and 68.8%, respectively, compared to the no-control case. Furthermore, the wind tunnel blower’s rotation speed was modified, adjustments were made to the LTC’s mainstream velocity, and the Reynolds number transitioned from 1.0 × 104 to 9.9 × 104, approximately 10 times. When the slanted PA was used at the blade inlet, the PV suppression effect was the highest. The peak vorticity value owing to the PV at the LTC exit decreased by 62.9% at the lowest Reynolds number of 1.0 × 104. The Reynolds number increased with a higher mainstream velocity and decreased flow induced by the PA, consequently reducing the PV suppression effect. However, the drive of the PA was effective even under the most severe conditions (9.9 × 104), and the peak vorticity value was reduced by 20.2%.
Numerical Investigation of Transverse-Jet-Assisted Initiation of Oblique Detonation Waves in a Combustor
Authors: Zhang Zijian , Jiang Ziqi
Published: December 2023

Detonation initiation is a prerequisite to normal operations of an oblique detonation engine (ODE), and initiation-assistant measures are imperative in cases of initiation failure that occur in a length-limited combustor under wide-range flight conditions. This study numerically investigates the initiation characteristics of oblique detonation waves (ODWs) in H2-fueled ODE combustors at wide-range flight Mach numbers Maf or flight altitudes Hf. Failures of ODW initiation are observed at both low Maf and high Hf if no measure is taken to assist initiation. Through analyses of the flow fields and theoretical predictions of the ignition induction length Lind, the data reveal that the detonation failure at low Maf is raised by the significant decrease in the post-shock temperature due to insufficient shock compression, leading to a significant increase in Lind. The detonation failure at high Hf is caused by the rapid decrease in the combustor inflow pressure as Hf increases, which also results in an increase in Lind. With further identifications of the key flow structures crucial to detonation initiation, an initiation-assistant concept employing a transverse H2 jet is proposed. The simulation results show that through an interaction between the incident oblique shock wave and the jet shock wave, the transverse jet helps to initiate an ODW in the combustor at a low Maf, and the initiation location is relatively fixed and determined by the jet location. At high Hf, a Mach reflection pattern is formed in the combustor under the effects of the transverse jet, and detonative combustion is achieved by the generated Mach stem and its reflected shock waves. The proposed concept of using transverse jets to assist detonation initiation provides a practical reference for future development of ODEs that are expected to operate under wide-range flight conditions.
Strategic Analysis for Advancing Smart Agriculture with the Analytic SWOT/PESTLE Framework: A Case for Turkey
Authors: Uztürk Deniz , Büyüközkan Gülçin
Published: December 2023

In the contemporary discourse, smart agriculture (SA) stands out as a potent driver for sustainable economic growth. The challenges of navigating SA transition are notably intricate in developing nations. To effectively embark on this transformative journey, strategic approaches are imperative, necessitating a thorough examination of the prevailing agricultural ecosystem. This study seeks to formulate strategies that advance Turkey’s agricultural sector. The primary research questions focus on optimizing the benefits of SA by aligning strengths and opportunities with diverse socio-economic and environmental factors, while also exploring effective strategies to mitigate the impact of weaknesses and threats within the agricultural landscape. To achieve this objective, the utilization of the 2-Tuple linguistic (2TL) model integrated DEMATEL (Decision-Making Trial and Evaluation Laboratory) methodology in conjunction with SWOT (Strengths, Weaknesses, Opportunities, and Threats) and PESTLE (Political, Economic, Social, Technological, Legal, Environmental) analyses is proposed. The integration of linguistic variables enhances the capacity to delve deeper into system analysis, aligning more closely with human cognitive processes. The research commences with SWOT and PESTLE analyses applied to Turkey’s agricultural sector. Subsequently, the 2TL-DEMATEL approach is employed to investigate interrelationships among analysis components. This inquiry aims to establish causal relations, facilitating the derivation of relevant strategies. The case study centers on Turkey, a developing country, with outcomes indicating that the highest-priority strategies revolve around addressing ‘environmental threats’ and ‘economic weaknesses’. The subsequent evaluation encompasses eight dimensions, resulting in the generation of fifteen distinct strategies, a process facilitated by collaboration with field experts. Importantly, both the results and strategies undergo rigorous validation, drawing upon insights from the recent literature and field experts. Significantly, these findings align seamlessly with the Sustainable Development Goals (SDGs), substantiating the study’s broader significance in fostering a sustainable future for Turkey.
A Simulation and Experiment on the Optimization Design of an Air Outlet Structure for an Air-Assisted Sprayer
Authors: Jing Shuaijie , Ren Longlong , Zhang Yue , Han Xiang , Gao Ang , Liu Baoyou , Song Yuepeng
Published: December 2023

In response to the issues of low-velocity zones and non-uniform jet velocity distribution in the airflow field of traditional air-assisted orchard sprayers, an arc-shaped air outlet suitable for axial-flow air-assisted systems is designed. This article employs the method of CFD numerical simulation and experimental verification to compare and analyze the internal flow field of the air-assisted system and validates the reliability of the numerical simulation results through calculation error and chi-square test. The wind speed of the cross-section is measured at different distances from the outlet, and the distribution characteristics of the outflow field wind speed before and after the structural optimization of the air-assisted system are compared. The horizontal distribution of fog droplets is collected using a fog collection chamber. The experimental results show that the design of the arc-shaped outlet increases the average wind speed of the annular outlet from 14.95 m/s to 18.20 m/s and reduces the proportion of low-speed area from 20.83% to 0.71%. When the rounded corner radius of the air outlet is 50 mm, optimal parameters are attained. The maximum error between the simulated and experimental values is 9.52%. At a significance level of 0.05, the χ2 value is 0.252, indicating that the simulated values follow the distribution of the actual measurement values. On the cross-sections located at distances of 0.5, 0.75, 1, 1.25, and 1.5 m from the air outlet, the wind speed distribution with no arc-shaped air outlets exhibits a “low left and high right” type, tending to shift towards the right as a whole. Fog droplets also display a drift tendency towards the right side. The wind speed distribution with arc-shaped air outlets shows a symmetric “high in the middle and low on the sides” type. Fog droplets concentrate in the central position. The optimized air-assisted system can reduce the air field’s low-flow area, increase the airflow distribution uniformity, improve the average wind speed at the outlet, and decrease fog droplet drift. This provides a reference for the structural design of air-assisted systems in current orchard sprayers of the same type.
Changes in Polar Metabolites during Seed Germination and Early Seedling Development of Pea, Cucumber, and Wheat
Authors: Szablińska-Piernik Joanna , Lahuta Lesław Bernard
Published: December 2023

Seed-to-seedling transition plays a crucial role in plant vegetation. However, changes in the metabolome of crop seedlings during seed germination and early seedling development are mostly unknown and require a deeper explanation. The present study attempted to compare qualitative and quantitative changes in polar metabolites during the seed germination and early development of seedlings of three different and important crop types: pea, cucumber, and wheat. The application of gas chromatography coupled with a flame ionization detector, as well as gas chromatography coupled with mass spectrometry, identified 51 polar metabolites. During seed imbibition/germination, the rapid degradation of raffinose family oligosaccharides (RFOs) preceded a dramatic increase in the concentrations of intermediates of glycolysis and the TCA cycle in embryonic axes (of pea and cucumber) or embryos (of wheat), confirming the important role of RFOs in the resumption of respiration and seed-to-seedling transition. After germination, the metabolic profiles of the growing roots, epicotyl/hypocotyl/coleoptile, and cotyledons/endosperm changed according to fluctuations in the concentrations of soluble carbohydrates, amino acids, and organic acids along the timeline of seedling growth. Moreover, the early increase in species-specific metabolites justified their role in seedling development owing to their participation in nitrogen metabolism (homoserine in pea), carbon translocation (galactinol, raffinose, and stachyose), and transitory carbon accumulation (1-kestose in wheat). The obtained metabolic profiles may constitute an important basis for further research on seedling reactions to stress conditions, including identification of metabolic markers of stress resistance.
Gut-Antimicrobial Peptides: Synergistic Co-Evolution with Antibiotics to Combat Multi-Antibiotic Resistance
Authors: Baindara Piyush , Mandal Santi M.
Published: December 2023

Due to huge diversity and dynamic competition, the human gut microbiome produces a diverse array of antimicrobial peptides (AMPs) that play an important role in human health. The gut microbiome has an important role in maintaining gut homeostasis by the AMPs and by interacting with other human organs via established connections such as the gut–lung, and gut–brain axis. Additionally, gut AMPs play a synergistic role with other gut microbiota and antimicrobials to maintain gut homeostasis by fighting against multi-antibiotic resistance (MAR) bacteria. Further, conventional antibiotics intake creates a synergistic evolutionary pressure for gut AMPs, where antibiotics and gut AMPs fight synergistically against MAR. Overall, gut AMPs are evolving under a complex and highly synergistic co-evolutionary pressure created by the various interactions between gut microbiota, gut AMPs, and antibiotics; however, the complete mechanism is not well understood. The current review explores the synergistic action of gut AMPs and antibiotics along with possibilities to fight against MAR bacteria.
How We Treat Drug-Susceptible Pulmonary Tuberculosis: A Practical Guide for Clinicians
Authors: Riccardi Niccolò , Occhineri Sara , Vanino Elisa , Antonello Roberta Maria , Pontarelli Agostina , Saluzzo Francesca , Masini Tiziana , Besozzi Giorgio , Tadolini Marina , Codecasa Luigi ,   on behalf of StopTB Italia
Published: December 2023

Tuberculosis (TB) remains one of the leading causes of morbidity and mortality worldwide and pulmonary TB (PTB) is the main variant responsible for fueling transmission of the infection. Effective treatment of drug-susceptible (DS) TB is crucial to avoid the emergence of Mycobacterium tuberculosis-resistant strains. In this narrative review, through a fictional suggestive case of DS PTB, we guide the reader in a step-by-step commentary to provide an updated review of current evidence in the management of TB, from diagnosis to post-treatment follow-up. World Health Organization and Centre for Diseases Control (CDC) guidelines for TB, as well as the updated literature, were used to support this manuscript.
Adaptive Phage Therapy for the Prevention of Recurrent Nosocomial Pneumonia: Novel Protocol Description and Case Series
Authors: Zurabov Fedor , Petrova Marina , Zurabov Alexander , Gurkova Marina , Polyakov Petr , Cheboksarov Dmitriy , Chernevskaya Ekaterina , Yuryev Mikhail , Popova Valentina , Kuzovlev Artem , Yakovlev Alexey , Grechko Andrey
Published: December 2023

Nowadays there is a growing interest worldwide in using bacteriophages for therapeutic purposes to combat antibiotic-resistant bacterial strains, driven by the increasing ineffectiveness of drugs against bacterial infections. Despite this fact, no novel commercially available therapeutic phage products have been developed in the last two decades, as it is extremely difficult to register them under the current legal regulations. This paper presents a description of the interaction between a bacteriophage manufacturer and a clinical institution, the specificity of which is the selection of bacteriophages not for an individual patient, but for the entire spectrum of bacteria circulating in the intensive care unit with continuous clinical and microbiological monitoring of efficacy. The study presents the description of three clinical cases of patients who received bacteriophage complex via inhalation for 28 days according to the protocol without antibiotic use throughout the period. No adverse effects were observed and the elimination of multidrug-resistant microorganisms from the bronchoalveolar lavage contents was detected in all patients. A decrease in such inflammatory markers as C-reactive protein (CRP) and procalcitonin was also noted. The obtained results demonstrate the potential of an adaptive phage therapy protocol in intensive care units for reducing the amount of antibiotics used and preserving their efficacy.
Effective Antimicrobial Prophylaxis in Surgery: The Relevance and Role of Pharmacokinetics-Pharmacodynamics
Authors: Zelenitsky Sheryl A.
Published: December 2023

Appropriate surgical antimicrobial prophylaxis (SAP) is an important measure in preventing surgical site infections (SSIs). Although antimicrobial pharmacokinetics–pharmacodynamics (PKPD) is integral to optimizing antibiotic dosing for the treatment of infections, there is less research on preventing infections postsurgery. Whereas clinical studies of SAP dose, preincision timing, and redosing are informative, it is difficult to isolate their effect on SSI outcomes. Antimicrobial PKPD aims to explain the complex relationship between antibiotic exposure during surgery and the subsequent development of SSI. It accounts for the many factors that influence the PKs and antibiotic concentrations in patients and considers the susceptibilities of bacteria most likely to contaminate the surgical site. This narrative review examines the relevance and role of PKPD in providing effective SAP. The dose–response relationship i.e., association between lower dose and SSI in cefazolin prophylaxis is discussed. A comprehensive review of the evidence for an antibiotic concentration–response (SSI) relationship in SAP is also presented. Finally, PKPD considerations for improving SAP are explored with a focus on cefazolin prophylaxis in adults and outstanding questions regarding its dose, preincision timing, and redosing during surgery.
3-Substituted Coumarins Inhibit NorA and MepA Efflux Pumps of Staphylococcus aureus
Authors: Araújo-Neto José B. de , Oliveira-Tintino Cícera D. de M. , de Araújo Gildênia A. , Alves Daniel S. , Ribeiro Fernanda R. , Brancaglion Guilherme A. , Carvalho Diogo T. , Lima Clara Mariana Gonçalves , Mohammed Ali Hani S. H. , Rather Irfan A. , Wani Mohmmad Y. , Emran Talha B. , Coutinho Henrique D. M. , Balbino Valdir de Q. , Tintino Saulo R.
Published: December 2023

Coumarins are compounds with scientifically proven antibacterial properties, and modifications to the chemical structure are known to improve their effects. This information is even more relevant with the unbridled advances of antibiotic resistance, where Staphylococcus aureus and its efflux pumps play a prominent role. The study’s objective was to evaluate the potential of synthetic coumarins with different substitutions in the C-3 position as possible inhibitors of the NorA and MepA efflux pumps of S. aureus. For this evaluation, the following steps took place: (i) the determination of the minimum inhibitory concentration (MIC); (ii) the association of coumarins with fluoroquinolones and ethidium bromide (EtBr); (iii) the assessment of the effect on EtBr fluorescence emission; (iv) molecular docking; and (v) an analysis of the effect on membrane permeability. Coumarins reduced the MICs of fluoroquinolones and EtBr between 50% and 87.5%. Coumarin C1 increased EtBr fluorescence emission between 20 and 40% by reinforcing the evidence of efflux inhibition. The molecular docking results demonstrated that coumarins have an affinity with efflux pumps and establish mainly hydrogen bonds and hydrophobic interactions. Furthermore, C1 did not change the permeability of the membrane. Therefore, we conclude that these 3-substituted coumarins act as inhibitors of the NorA and MepA efflux pumps of S. aureus.
Evaluating the In Vivo Virulence of Environmental Pseudomonas aeruginosa Using Microinjection Model of Zebrafish (Danio rerio)
Authors: Kaszab Edit , Jiang Dongze , Szabó István , Kriszt Balázs , Urbányi Béla , Szoboszlay Sándor , Sebők Rózsa , Bock Illés , Csenki-Bakos Zsolt
Published: December 2023

(1) Background: Microinjection of zebrafish (Danio rerio) embryos offers a promising model for studying the virulence and potential environmental risks associated with Pseudomonas aeruginosa. (2) Methods: This work aimed to develop a P. aeruginosa infection model using two parallel exposition pathways on zebrafish larvae with microinjection into the yolk and the perivitelline space to simultaneously detect the invasive and cytotoxic features of the examined strains. The microinjection infection model was validated with 15 environmental and clinical strains of P. aeruginosa of various origins, antibiotic resistance profiles, genotypes and phenotypes: both exposition pathways were optimized with a series of bacterial dilutions, different drop sizes (injection volumes) and incubation periods. Besides mortality, sublethal symptoms of the treated embryos were detected and analyzed. (3) Results: According to the statistical evaluation of our results, the optimal parameters (dilution, drop size and incubation period) were determined. (4) Conclusions: The tested zebrafish embryo microinjection infection model is now ready for use to determine the in vivo virulence and ecological risk of environmental P. aeruginosa.
Exploring Facilitators and Barriers to Delayed Antibiotic Prescribing in Rural Northwest China: A Qualitative Study Using the Theoretical Domains Framework and Behavior Change Wheel
Authors: Wushouer Haishaerjiang , Ko Weihsin , Du Kexin , Zhang Wanmeng , Hu Lin , Yu Junxuan , Zhang Kairui , Shi Luwen , Guan Xiaodong
Published: December 2023

Background: Antimicrobial resistance, exacerbated by antibiotic misuse, poses a global threat. Though delayed antibiotic prescribing (DAP) can mitigate antibiotic overuse, its adoption in developing nations, such as China, is limited. This study probed barriers and facilitators to DAP in Xinjiang, characterized by extensive rural landscapes and primary care institutions (PCIs). Methods: Adopting a qualitative methodology, we conducted key informant interviews with thirty participants across six county hospitals in Xinjiang using VooV Meeting. Employing a two-stage sampling method targeting economically diverse areas, our interviews spanned physicians, pharmacists, patients, and caregivers. We organized the data according to the Theoretical Domains Framework (TDF) and the Behavior Change Wheel (BCW), spotlighting behavioral and policy elements impacting DAP. Results: Our research included thirty interviewees. Twelve physicians contemplated delayed prescriptions, while five adult patients and six caregivers encountered recommendations for delayed antibiotic prescriptions. Six patients sought pharmacists’ advice on antibiotic necessity. Prominent TDF domains were memory, attention, and beliefs about consequences. Critical intervention functions included education and environmental restructuring, while vital policy categories encompassed communication/marketing and guidelines. Conclusions: Countering antibiotic misuse and resistance in China necessitates overcoming barriers through strategic resource distribution, comprehensive education, rigorous training, and consistent monitoring, thereby promoting DAP adoption. The adoption of DAP in rural healthcare settings in China has the potential to significantly reduce antibiotic misuse, thereby mitigating the global threat of antimicrobial resistance.
Traffic Density Exposure, Oxidative Stress Biomarkers and Plasma Metabolomics in a Population-Based Sample: The Hortega Study
Authors: Sanchez-Rodriguez Laura , Galvez-Fernandez Marta , Rojas-Benedicto Ayelén , Domingo-Relloso Arce , Amigo Nuria , Redon Josep , Monleon Daniel , Saez Guillermo , Tellez-Plaza Maria , Martin-Escudero Juan Carlos , Ramis Rebeca
Published: December 2023

Exposure to traffic-related air pollution (TRAP) generates oxidative stress, with downstream effects at the metabolic level. Human studies of traffic density and metabolomic markers, however, are rare. The main objective of this study was to evaluate the cross-sectional association between traffic density in the street of residence with oxidative stress and metabolomic profiles measured in a population-based sample from Spain. We also explored in silico the potential biological implications of the findings. Secondarily, we assessed the contribution of oxidative stress to the association between exposure to traffic density and variation in plasma metabolite levels. Traffic density was defined as the average daily traffic volume over an entire year within a buffer of 50 m around the participants’ residence. Plasma metabolomic profiles and urine oxidative stress biomarkers were measured in samples from 1181 Hortega Study participants by nuclear magnetic resonance spectroscopy and high-performance liquid chromatography, respectively. Traffic density was associated with 7 (out of 49) plasma metabolites, including amino acids, fatty acids, products of bacterial and energy metabolism and fluid balance metabolites. Regarding urine oxidative stress biomarkers, traffic associations were positive for GSSG/GSH% and negative for MDA. A total of 12 KEGG pathways were linked to traffic-related metabolites. In a protein network from genes included in over-represented pathways and 63 redox-related candidate genes, we observed relevant proteins from the glutathione cycle. GSSG/GSH% and MDA accounted for 14.6% and 12.2% of changes in isobutyrate and the CH2CH2CO fatty acid moiety, respectively, which is attributable to traffic exposure. At the population level, exposure to traffic density was associated with specific urine oxidative stress and plasma metabolites. Although our results support a role of oxidative stress as a biological intermediary of traffic-related metabolic alterations, with potential implications for the co-bacterial and lipid metabolism, additional mechanistic and prospective studies are needed to confirm our findings.
Study of a Small Robot for Mine Hole Detection
Authors: Ge Liang , Fang Ziyang , Li Hao , Zhang Le , Zeng Wen , Xiao Xiaoting
Published: December 2023

China is rich in coal resources, but complex hydrogeological conditions lead to difficulties in coal mining, including coal mine collapses, roof and water damage, and other accidents that occur frequently, resulting in many casualties and property losses. The use of coal mine hole detection technology to detect and analyze the internal environment of the coal mines in advance helps to reduce safety hazards and prevent coal mine accidents; however, the operation of existing coal mine hole detection technology is cumbersome, difficult to control, and encounters problems due to an insufficient depth of jacking. This paper designs a new type of small robot for mine hole detection. Firstly, we analyzed the function and structural design of the mine hole detection robot, designed a variable diameter function according to the characteristics of narrow and uneven mine holes in coal mines, and analyzed the mechanics of the critical parts using theoretical calculations. Secondly, using three-dimensional modeling software (Solidworks 2019), we established a structural model of the small robot for mine hole detection. After that, we designed a hardware circuit and control program for the robot and emphasized the safety design of the circuit, considering the presence of water and gas inside the coal mine. Finally, to verify the feasibility of the design program, the basic parameters and function tests of the mine hole-detection small robot were carried out. The experimental results show that the developed mine hole-detection small robot can adapt to working hole diameters from 65 mm to 100 mm and has a maximum working power of only 12 W and a maximum crawling speed of 3.96 m/min. The maximum crawling slope reaches 90°, which can meet existing mine hole inspection needs. This research provides theoretical and design guidance for developing mine hole-detection robots with substantial engineering practical reference values.
Longitudinal Dynamic Response of a Large-Diameter-Bored Pile Considering the Bottom Sediment and Radial Unloading of the Surrounding Soil
Authors: Zhang Cun , Zhuoma Pingcuo , Zhang Yongjuan , Li Zhenya
Published: December 2023

The longitudinal dynamic response of a large-diameter-bored pile is investigated considering the bottom sediment and the radial unloading of the surrounding soil. First, the sediment between the pile tip and the bedrock is treated as a fictitious soil pile with a cross-sectional area similarto that of the pile tip. The large-diameter-bored pile (including the fictitious soil pile) is considered as a Rayleigh–Love rod and is divided into finite segments. Under theseconditions, the three-dimensional (3D) effect of the wave propagation along the pile is indirectly simulated by considering the transverse inertia of the pile to avoid complicated calculations. Meanwhile, the surrounding soil is divided into finite annular zones in the radial direction, with the soil properties varying radially as well to simulate the radial unloading of the surrounding soil during construction. The governing equation for each soil zone is built and solved, from zone to zone, to obtain the shear stress acting on the pile. Then, the governing equation for the fictitious soil pile (i.e., the sediment) is solved to derive the dynamic action at the pile tip. In a similar manner to that ofthe fictitious soil pile and together with the recursion method, the governing equation for the pile is solved to obtain the pile’s complex impedance and velocity response. The proposed solution is verified and then introduced to portray the coupling effect of the sediment, pile parameters and radial unloading of the surrounding soil on the longitudinal dynamic response of the large-diameter-bored pile.