bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a new system for the rapid identification of clinically important yeasts
Authors: Segal E , Ajello L
Published: June 2021

The rapid system developed by Huppert et al. (1975) for the identification of yeasts based on assimilation and fermentation patterns and on germ tube and pseudohyphal production was evaluated in a comparative study with conventional procedures. The 95 test cultures were members of the genera Candida, Cryptococcus, Rhodotorula, Saccharomyces, Torulopsis, and Trichosporon. The study revealed that approximately 94% of the isolates were correctly identified by the rapid method in comparison with the standard method. With the rapid method identification was accomplished in 72h, and with the conventional procedures identification was completed in 2 weeks. Although it was difficult with some isolates to obtain definitive speciation by the rapid method, this method promises to be especially useful in clinical laboratories for the identification of yeasts of medical importance. Modifications were made in the procedure of Huppert et al. (1975) to improve the reading of reactions. Commercial media and a disk dispenser to make the method more useful were also investigated.
Latex agglutination in the diagnosis of pneumococcal infection
Authors: Coonrod J D , Rylko-Bauer
Published: June 2021

A latex agglutination (LA) method for detection of pneumococcal antigens was evaluated and compared with counterimmunoelectrophoresis (CIE). LA was 2 to 10 times more sensitive than CIE for the detection of purified capsular polysaccharides in defined media, but only when a 1+ or 2+ agglutination reaction was interpreted as positive. LA was much less sensitive than CIE with clinical samples. In 50 cases of pneumococcal pneumonia, antigen was detected in the serum almost twice as often with CIE (40%) as with LA (22%). LA was positive in six cases of pneumonia where CIE was negative; however, in three of these cases, antigen was detected only in undiluted sera, which raised some question about the specificity of the result. With 18 samples of cerebrospinal fluid (CSF) from 11 patients with pneumococcal meningitis, the CIE test was positive more frequenlty (14 samples) than was LA (11 samples). Moreover, antigen was detected in CSF by LA in only one additional patient than was positive by CIE alone. There was one false-positive LA reaction among 45 samples of CSF from patients without pneumococcal infection. Although LA is a less complicated method than CIE, it is not a sensitive test for pneumococcal antigens and would be of little value as a routine diagnostic method.
Isolation of Vibrio parahaemolyticus from fecal specimens on mannitol salt agar
Authors: Carruthers M M , Kabat W J
Published: June 2021

Unless laboratories use an inhibitory medium, Vibrio parahaemolyticus will be unrecognizable in fecal specimens. The use of a medium exclusively for vibrio isolation, such as thiosulfate-citrate-bile salts-sucrose agar (TCBS), however, may not be considered economically justified in the United States. The isolation and recognition of V. parahaemolyticus is reported on mannitol salt agar (MS), a medium which is used for fecal specimens here. Eight Kanagawa-positive and two of three Kanagawa-negative strains of V. parahaemolyticus grew as well on MS as on TCBS and better than on a representative enteric medium, Hektoen enteric agar (HE). Twenty-two fecal specimens from 16 noninfected individuals were inoculated with known quantities of V. parahaemolyticus, and recovery of these vibrios was assessed on TCBS, MS, and HE. Recovery of vibrios from MS and TCBS was similar when inoculum size was 10(3) colony-forming units/ml or greater. Recovery of vibrios from mixed culture was distinctly lower on HE. The colonial morphology of V. parahaemolyticus and several other bacteria on MS is illustrated.
Comparison of Spontaneous and Antibiotic-Induced L-Form Production in
Neisseria gonorrhoeae
Authors: Mickelsen Patricia A. , Dalton Harry P.
Published: June 2021

The ability of
Neisseria gonorrhoeae
to grow as L-forms was found to be independent of the presence of an antibiotic inducing agent and colony type.
Isolation of
Haemophilus aphrophilus
from an Adult with Acute Leukemia
Authors: Enck Robert E. , Bennett John M.
Published: June 2021

During the course of treatment for acute myelocytic leukemia,
Haemophilus aphrophilus
was isolated from eight blood cultures associated with the clinical picture of bacterial endocarditis.
Comparison of API and Minitek to Center for Disease Control methods for the biochemical characterization of anaerobes
Authors: Hansen S L , Stewart B J
Published: June 2021

Two commercially available micromethod multitest systems (API, Analytab Products, Inc., Minitek-Bioquest) were compared with conventional tests suggested by the Center for Disease Control for the identification of anaerobes. Anaerobiosis for the microsystems was achieved using GasPak system (BBL), A total of 175 anaerobes, including 158 clinical isolates and 17 reference strains, were used. Gram morphology, gas-liquid chromatography data, and biochemical reactions from the Center for Disease Control and Virginia Polytechnic Institute anaerobic manuals were used to identify the organisms. The Minitek system included a new anaerobe inoculum broth and two new disks, dextrose without nitrate and nitrate reductase disks. The percentage of correlation of 12 biochemicals using Minitek and 11 biochemicals using the API were compared with the Center for Disease Control reactions. The percentage of correlation of both positive and negative reactions with the API anaerobic strip ranged from 70.8 to 99.4% and with the Minitek from 97.1 to 100%. The microsystems were also evaluated as to the ease of use, adaptabilty to a clinical laboratory, time, and cost.
Bacteriocin (klebocin) sensitivity typing of klebsiella
Authors: Buffenmyer C L , Rycheck R R , Yee R B
Published: June 2021

High-titer preparations of Klebsiella bacteriocins (klebocins) were obtained by using mitomycin to induce standard strains of Klebsiella. Of 296 clinical isolates of Klebsiella, 67% could be typed on the basis of their sensitivity to klebocins. The method proposed in this paper affords a standard basis for the further development of klebocin typing as a suitable procedure for hospital laboratories concerned with epidemiological investigations of hospital-associated infections. Evidence is also provided to show that high-titered klebocin typing can be used in conjunction with biochemical typing to provide a sensitive epidemiological marker for Klebsiella.
Caprylate-thallous agar medium for selectively isolating Serratia and its utility in the clinical laboratory
Authors: Starr M P , Grimont P A , Grimont F , Starr P B
Published: June 2021

A defined agar medium (hereinafter designated caprylate-thallous [CT5 agar) containing 0.01% yeast extract, 0.1% caprylic (n-octanoic) acid, and 0.025% thallous sulfate is highly selective for all Serratia species and effectively discriminates against most non-Serratia strains likely to be in the same habitats. The selectivity of CT agar is demonstrated by the very high efficiency of colony formation (mean, 80.7% of that on a nonselective complex medium) on CT agar by known Serratia strains and the very low efficiency of colony formation (close to zero) on CT agar by bacterial strains known not to be Serratia. The utility of this medium in actual clinical laboratory practice is demonstrated by the more rapid and higher recovery of Serratia on this selective medium as compared to conventional procedures of in-tandem runs of 513 consecutive urine, feces, and sputum specimens. Pigmented and nonpigmented Serratia strains deliberately added to fecal specimens can be selectively and quantitatively recovered on CT agar. CT agar compares favorably with, or in some cases is an improvement over, other selective media which have been recommended for isolating Serratia. This selective CT agar medium could be quite useful in ecological surveys, especially those related to hospital-acquired infections.
Evaluation of the sodium polyanethol sulfonate disk test for the identification of Peptostreptococcus anaerobius
Authors: Wideman P A , Vargo V L , Citronbaum D , Finegold S M
Published: June 2021

The previously reported sodium polyanethol sulfonate disk test for the identification of Peptostreptococcus anaerobius (Graves et al., 1974) was evaluated, with modifications. Three bands of brucella agar, three inoculum sizes, and two inoculum sources were compared. Nine stock cultures of P. anaerobius (eight normal flora isolates and ATCC 27337) and 16 fresh clinical isolates were used. All cultures of P. anaerobius showed inhibition zones of 12 to 30 mm in diameter, regardless of test conditions. Out of 103 clinical isolates of other species of anaerobic gram-positive cocci tested, only two had an inhibition zone size in this range (one P. micros of 11 studied had a zone of 12 mm and one P. prevotii of 14 studied had a zone of 16). The test had an overall accuracy of 98% in the identification of P. anaerobius from clinical specimens. Since P. anaerobius accounts for one-fifth to one-third of all anaerobic gram-positive cocci encountered in clinical specimens, this simple and rapid technique can be very useful for presumptive identification.
Comparison of heat shocking and acridine orange treatment in phage typing of nontypable strains of Staphylococcus aureus
Authors: Perkins R E , Kundsin R B
Published: June 2021

Forty-five percent of 108 nontypable strains of Staphylococcus aureus from clinical and environmental sources were phage typable after heat shock and acridine orange treatment. Although phage patterns were produced by different types of treatment, the same phage groups were present, showing specificity. The newly typable strains appear to be similar in phage group distribution to the primary typable strains typed at the Peter Bent Brigham Hospital during the same time period. Ten of the originally nontypable S. aureus strains that showed lytic patterns after heat shock or acridine orange treatment were subcultured four times from the treated culture and then tested again with bacteriophages. Phage patterns were still present in 8 of the 10 strains without any further treatment. These findings are compatible with the findings of other workers, who have shown that the insensitivity of primary nontypable S. aureus strains to phage is linked to phage-resistant genes in extrachromosomal genetic elements that can be "cured" by both heat shock and acridine treatment.
Simplified scheme for identification of prompt lactose-fermenting members of the Enterobacteriaceae
Authors: Hicks M J , Ryan K J
Published: June 2021

A brief, simplified scheme involving the spot indole test and colonial morphology was evaluated for genus level identification of prompt lactose-fermenting (PLF) members of the Enterobacteriaceae. One hundred and ninety-four consecutive, clinically important PLF gram-negative rods isolated in a clinical microbiology laboratory were identified by this simplified scheme, as well as by standard biochemical tests, and the API 20E (Analytab Products, Inc., Plainview, N.Y.) system. In the simplified scheme a flat, spot indole-positive colony was identified as Escherichia coli. Spot indole-negative organisms forming nucoid colonies were identified as Klebsiella sp. or Enterobacter sp. on the basis of semisolid motility and ornithine decarboxylase tests. Approximately 94% of the study isolates followed reactions typical for E. coli, Klebsiella sp., and Enterobacter sp. as defined by this simplified scheme. When compared with the standard and Analytab Products Inc. identifications, the overall accuracy was 97.4%. The accuracy of identification of E. coli, Klebsiella sp., and Enterobacter sp. was 98.1%, 95.6%, and 87.5%, respectively. This simplified scheme is recommended for identification of selected PLF isolates in the clinical microbiology laboratory.
Microbial production of surfactants and their commercial potential
Authors: Desai J D , Banat I M
Published: June 2021

Many microorganisms, especially bacteria, produce biosurfactants when grown on water-immiscible substrates. Biosurfactants are more effective, selective, environmentally friendly, and stable than many synthetic surfactants. Most common biosurfactants are glycolipids in which carbohydrates are attached to a long-chain aliphatic acid, while others, like lipopeptides, lipoproteins, and heteropolysaccharides, are more complex. Rapid and reliable methods for screening and selection of biosurfactant-producing microorganisms and evaluation of their activity have been developed. Genes involved in rhamnolipid synthesis (rhlAB) and regulation (rhlI and rhlR) in Pseudomonas aeruginosa are characterized, and expression of rhlAB in heterologous hosts is discussed. Genes for surfactin production (sfp, srfA, and comA) in Bacillus spp. are also characterized. Fermentative production of biosurfactants depends primarily on the microbial strain, source of carbon and nitrogen, pH, temperature, and concentration of oxygen and metal ions. Addition of water-immiscible substrates to media and nitrogen and iron limitations in the media result in an overproduction of some biosurfactants. Other important advances are the use of water-soluble substrates and agroindustrial wastes for production, development of continuous recovery processes, and production through biotransformation. Commercialization of biosurfactants in the cosmetic, food, health care, pulp- and paper-processing, coal, ceramic, and metal industries has been proposed. However, the most promising applications are cleaning of oil-contaminated tankers, oil spill management, transportation of heavy crude oil, enhanced oil recovery, recovery of crude oil from sludge, and bioremediation of sites contaminated with hydrocarbons, heavy metals, and other pollutants. Perspectives for future research and applications are also discussed.
Potential virulence factors of Proteus bacilli
Authors: Rózalski A , Sidorczyk Z , Kotełko K
Published: June 2021

The object of this review is the genus Proteus, which contains bacteria considered now to belong to the opportunistic pathogens. Widely distributed in nature (in soil, water, and sewage), Proteus species play a significant ecological role. When present in the niches of higher macroorganisms, these species are able to evoke pathological events in different regions of the human body. The invaders (Proteus mirabilis, P. vulgaris, and P. penneri) have numerous factors including fimbriae, flagella, outer membrane proteins, lipopolysaccharide, capsule antigen, urease, immunoglobulin A proteases, hemolysins, amino acid deaminases, and, finally, the most characteristic attribute of Proteus, swarming growth, enabling them to colonize and survive in higher organisms. All these features and factors are described and commented on in detail. The questions important for future investigation of these facultatively pathogenic microorganisms are also discussed.
Fate and activity of microorganisms introduced into soil
Authors: van Veen J A , van Overbeek L S , van Elsas J D
Published: June 2021

Introduced microorganisms are potentially powerful agents for manipulation of processes and/or components in soil. Fields of application include enhancement of crop growth, protection of crops against plant-pathogenic organisms, stimulation of biodegradation of xenobiotic compounds (bioaugmentation), and improvement of soil structure. Inoculation of soils has already been applied for decades, but it has often yielded inconsistent or disappointing results. This is caused mainly by a commonly observed rapid decline in inoculant population activity following introduction into soil, i.e., a decline of the numbers of inoculant cells and/or a decline of the (average) activity per cell. In this review, we discuss the available information on the effects of key factors that determine the fate and activity of microorganisms introduced into soil, with emphasis on bacteria. The factors addressed include the physiological status of the inoculant cells, the biotic and abiotic interactions in soil, soil properties, and substrate availability. Finally, we address the possibilities available to effectively manipulate the fate and activity of introduced microorganisms in relation to the main areas of their application.
Common themes in microbial pathogenicity revisited
Authors: Finlay B B , Falkow S
Published: June 2021

Bacterial pathogens employ a number of genetic strategies to cause infection and, occasionally, disease in their hosts. Many of these virulence factors and their regulatory elements can be divided into a smaller number of groups based on the conservation of similar mechanisms. These common themes are found throughout bacterial virulence factors. For example, there are only a few general types of toxins, despite a large number of host targets. Similarly, there are only a few conserved ways to build the bacterial pilus and nonpilus adhesins used by pathogens to adhere to host substrates. Bacterial entry into host cells (invasion) is a complex mechanism. However, several common invasion themes exist in diverse microorganisms. Similarly, once inside a host cell, pathogens have a limited number of ways to ensure their survival, whether remaining within a host vacuole or by escaping into the cytoplasm. Avoidance of the host immune defenses is key to the success of a pathogen. Several common themes again are employed, including antigenic variation, camouflage by binding host molecules, and enzymatic degradation of host immune components. Most virulence factors are found on the bacterial surface or secreted into their immediate environment, yet virulence factors operate through a relatively small number of microbial secretion systems. The expression of bacterial pathogenicity is dependent upon complex regulatory circuits. However, pathogens use only a small number of biochemical families to express distinct functional factors at the appropriate time that causes infection. Finally, virulence factors maintained on mobile genetic elements and pathogenicity islands ensure that new strains of pathogens evolve constantly. Comprehension of these common themes in microbial pathogenicity is critical to the understanding and study of bacterial virulence mechanisms and to the development of new "anti-virulence" agents, which are so desperately needed to replace antibiotics.
Molecular Simulations of CO2/CH4, CO2/N2 and N2/CH4 Binary Mixed Hydrates
Authors: Sizova A. A. , Grintsevich S. A. , Kochurin M. A. , Sizov V. V. , Brodskaya E. N.
Published: June 2021

Grand canonical Monte Carlo simulations were performed to study the occupancy of structure I multicomponent gas hydrates by CO2/CH4, CO2/N2, and N2/CH4 binary gas mixtures with various compositions at a temperature of 270 K and pressures up to 70 atm. The presence of nitrogen in the gas mixture allows for an increase of both the hydrate framework selectivity to CO2 and the amount of carbon dioxide encapsulated in hydrate cages, as compared to the CO2/CH4 hydrate. Despite the selectivity to CH4 molecules demonstrated by N2/CH4 hydrate, nitrogen can compete with methane if the gas mixture contains at least 70% of N2.
Respiratory support after delayed cord clamping: a prospective cohort study of at-risk births at ≥35+0 weeks gestation
Authors: Badurdeen Shiraz , Santomartino Georgia A , Thio Marta , Heng Alissa , Woodward Anthony , Polglase Graeme R , Hooper Stuart B , Blank Douglas A , Davis Peter G
Published: June 2021

Objective

To identify risk factors associated with delivery room respiratory support in at-risk infants who are initially vigorous and received delayed cord clamping (DCC).

Design

Prospective cohort study.

Setting

Two perinatal centres in Melbourne, Australia.

Patients

At-risk infants born at ≥35+0 weeks gestation with a paediatric doctor in attendance who were initially vigorous and received DCC for >60 s.

Main outcome measures

Delivery room respiratory support defined as facemask positive pressure ventilation, continuous positive airway pressure and/or supplemental oxygen within 10 min of birth.

Results

Two hundred and ninety-eight infants born at a median (IQR) gestational age of 39+3 (38+2–40+2) weeks were included. Cord clamping occurred at a median (IQR) of 128 (123–145) s. Forty-four (15%) infants received respiratory support at a median of 214 (IQR 156–326) s after birth. Neonatal unit admission for respiratory distress occurred in 32% of infants receiving delivery room respiratory support vs 1% of infants who did not receive delivery room respiratory support (p<0.001). Risk factors independently associated with delivery room respiratory support were average heart rate (HR) at 90–120 s after birth (determined using three-lead ECG), mode of birth and time to establish regular cries. Decision tree analysis identified that infants at highest risk had an average HR of <165 beats per minute at 90–120 s after birth following caesarean section (risk of 39%). Infants with an average HR of ≥165 beats per minute at 90–120 s after birth were at low risk (5%).

Conclusions

We present a clinical decision pathway for at-risk infants who may benefit from close observation following DCC. Our findings provide a novel perspective of HR beyond the traditional threshold of 100 beats per minute.
Readiness and early response to COVID-19: achievements, challenges and lessons learnt in Ethiopia
Authors: Lanyero Betty , Edea Zewdu Assefa , Musa Emmanuel Onuche , Watare Shambel Habebe , Mandalia Mayur Lalji , Livinus Martin Chibueze , Ebrahim Faiqa Kassim , Girmay Abiy , Bategereza Aggrey Kaijuka , Abayneh Aschalew , Sambo Boureima Hama , Abate Ebba
Published: June 2021

Declaration of the novel coronavirus disease as a Public Health Emergency of International Concern necessitated countries to get ready to respond. Here, we describe key achievements, challenges and lessons learnt during the readiness and early response to COVID-19 in Ethiopia. Readiness activities commenced as early as January 2020 with the activation of a national Public Health Emergency Operations Centre and COVID-19 Incident Management System (IMS) by the Ethiopian Public Health Institute. The COVID-19 IMS conducted rapid risk assessments, developed scenario-based contingency plans, national COVID-19 guidelines and facilitated the enhancement of early warning and monitoring mechanisms. Early activation of a coordination mechanism and strengthening of detection and response capacities contributed to getting the country ready on time and mounting an effective early response. High-level political leadership and commitment led to focused efforts in coordination of response interventions. Health screening, mandatory 14-day quarantine and testing established for all international travellers arriving into the country slowed down the influx of travellers. The International Health Regulations (IHR) capacities in the country served as a good foundation for timely readiness and response. Leveraging on existing IHR capacities in the country built prior to COVID-19 helped slow down the importation and mitigated uncontrolled spread of the disease in the country. Challenges experienced included late operationalisation of a multisectoral coordination platform, shortage of personal protective equipment resulting from global disruption of importation and the huge influx of over 10 000 returnees from different COVID-19-affected countries over a short period of time with resultant constrain on response resources.
How well do doctors understand a scientific article in English when it is not their first language? A randomised controlled trial
Authors: Rostadmo Martine , Strømme Siri Lunde , Nylenna Magne , Gulbrandsen Pal , Hem Erlend , Skovlund Eva , Brean Are , Orstavik Ragnhild
Published: June 2021

Introduction

English is thelingua francaof science. How well doctors understand English is therefore crucial for their understanding of scientific articles. However, only 5% of the world’s population have English as their first language.

Methods

Objectives: To compare doctors’ comprehension of a scientific article when read in their first language (Norwegian) versus their second language (English). Our hypothesis was that doctors reading the article in Norwegian would comprehend the content better than those reading it in English.

Design: Parallel group randomised controlled trial. We randomised doctors to read the same clinical review article in either Norwegian or English, before completing a questionnaire about the content of the article.

Setting: Conference in primary care medicine in Norway, 2018.

Participants: 130 native Norwegian-speaking doctors, 71 women and 59 men. One participant withdrew before responding to the questionnaire and was excluded from the analyses.

Interventions: Participants were randomly assigned to read a review article in either Norwegian (n=64) or English (n=66). Reading time was limited to 7 min followed by 7 min to answer a questionnaire.

Main outcome measures: Total score on questions related to the article content (potential range −9 to 20).

Results

Doctors who read the article in Norwegian had a mean total score of 10.40 (SD 3.96) compared with 9.08 (SD 3.47) among doctors who read the article in English, giving a mean difference of 1.32 (95% CI 0.03 to 2.62; p=0.046). Age was independently associated with total score, with decreased comprehension with increasing age.

Conclusion

The difference in comprehension between the group who read in Norwegian and the group who read in English was statistically significant but modest, suggesting that the language gap in academia is possible to overcome.
Stroke care and case fatality in people with and without schizophrenia: a retrospective cohort study
Authors: Kapral Moira K , Kurdyak Paul , Casaubon Leanne K , Fang Jiming , Porter Joan , Sheehan Kathleen A
Published: June 2021

Background

Schizophrenia is associated with an increased risk of death following stroke; however, the magnitude and underlying reasons for this are not well understood.

Objective

To determine the association between schizophrenia and stroke case fatality, adjusting for baseline characteristics, stroke severity and processes of care.

Design

Retrospective cohort study used linked clinical and administrative databases.

Setting

All acute care institutions (N=152) in the province of Ontario, Canada.

Participants

All patients (N=52 473) hospitalised with stroke between 1 April 2002 and 31 March 2013 and included in the Ontario Stroke Registry. Those with schizophrenia (n=612) were identified using validated algorithms.

Main outcomes and measures

We compared acute stroke care in those with and without schizophrenia and used Cox proportional hazards models to examine the association between schizophrenia and mortality, adjusting for demographics, comorbidity, stroke severity and processes of care.

Results

Compared with those without schizophrenia, people with schizophrenia were less likely to undergo thrombolysis (10.1% vs 13.4%), carotid imaging (66.3% vs 74.0%), rehabilitation (36.6% vs 46.6% among those with disability at discharge) or be treated with antihypertensive, lipid-lowering or anticoagulant therapies. After adjustment for age and other factors, schizophrenia was associated with death from any cause at 1 year (adjusted HR (aHR) 1.33, 95% CI 1.14 to 1.54). This was mainly attributable to early deaths from stroke (aHR 1.47, 95% CI 1.20 to 1.80, with survival curves separating in the first 30 days), and the survival disadvantage was particularly marked in those aged over 70 years (1-year mortality 46.9% vs 35.0%).

Conclusions

Schizophrenia is associated with increased stroke case fatality, which is not fully explained by stroke severity, measurable comorbid conditions or processes of care. Future work should focus on understanding this mortality gap and on improving acute stroke and secondary preventive care in people with schizophrenia.
Protocol for a realist synthesis of health systems responsiveness in low-income and middle-income countries
Authors: Mirzoev Tolib , Cronin de Chavez Anna , Manzano Ana , Agyepong Irene Akua , Ashinyo Mary Eyram , Danso-Appiah Anthony , Gyimah Leveana , Yevoo Lucy , Awini Elizabeth , Ha Bui Thi Thu , Do Thi Hanh Trang , Nguyen Quynh-Chi Thai , Le Thi Minh , Le Vui Thi , Hicks Joseph Paul , Wright Judy M , Kane Sumit
Published: June 2021

Introduction

Health systems responsiveness is a key objective of any health system, yet it is the least studied of all objectives particularly in low-income and middle-income countries. Research on health systems responsiveness highlights its multiple elements, for example, dignity and confidentiality. Little is known, however, about underlying theories of health systems responsiveness, and the mechanisms through which responsiveness works. This realist synthesis contributes to bridging these two knowledge gaps.

Methods and analysis

In this realist synthesis, we will use a four-step process, comprising: mapping of theoretical bases, formulation of programme theories, theory refinement and testing of programme theories using literature and empirical data from Ghana and Vietnam. We will include theoretical and conceptual pieces, reviews, empirical studies and grey literature, alongside the primary data. We will explore responsiveness as entailing external and internal interactions within health systems. The search strategy will be purposive and iterative, with continuous screening and refinement of theories. Data extraction will be combined with quality appraisal, using appropriate tools. Each fragment of evidence will be appraised as it is being extracted, for its relevance to the emerging programme theories and methodological rigour. The extracted data pertaining to contexts, mechanisms and outcomes will be synthesised to identify patterns and contradictions. Results will be reported using narrative explanations, following established guidance on realist syntheses.

Ethics and dissemination

Ethics approvals for the wider RESPONSE (Improving health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam) study, of which this review is one part, were obtained from the ethics committees of the following institutions: London School of Hygiene and Tropical Medicine (ref: 22981), University of Leeds, School of Medicine (ref: MREC19-051), Ghana Health Service (ref: GHS-ERC 012/03/20) and Hanoi University of Public Health (ref: 020-149/DD-YTCC).

We will disseminate results through academic papers, conference presentations and stakeholder workshops in Ghana and Vietnam.

PROSPERO registration number

CRD42020200353. Full record:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020200353.
SARS-CoV-2 seroprevalence in students and teachers: a longitudinal study from May to October 2020 in German secondary schools
Authors: Kirsten Carolin , Unrath Manja , Lück Christian , Dalpke Alexander H , Berner Reinhard , Armann Jakob
Published: June 2021

Objective

To quantify the number of SARS-CoV-2 infections in secondary schools after their reopening in May 2020.

Design

Repeated SARS-CoV-2 seroprevalence study after the reopening of schools and 4 months later.

Setting

Secondary school in Dresden, Germany.

Participants

1538 students grades 8–12 and 507 teachers from 13 schools.

Interventions

Serial blood sampling and SARS-CoV-2 IgG antibody assessment.

Primary and secondary outcome measure

Seroprevalence of SARS-CoV-2 antibodies in study population. Number of undetected cases.

Results

1538 students and 507 teachers were initially enrolled, and 1334 students and 445 teachers completed both study visits. The seroprevalence for SARS-CoV-2 antibodies was 0.6% in May/June and the same in September/October. Even in schools with reported COVID-19 cases before the lockdown of 13 March, no clusters could be identified. Of 12 persons with positive serology five had a known history of confirmed COVID-19; 23 out of 24 participants with a household history of COVID-91 were seronegative.

Conclusions

Schools do not play a crucial role in driving the SARS-CoV-2 pandemic in a low-prevalence setting. Transmission in families occurs very infrequently, and the number of unreported cases is low in this age group. These observations do not support school closures as a strategy fighting the pandemic in a low-prevalence setting.

Trial registration number

DRKS00022455.
Cryopyrin-associated periodic syndrome: a treatable genetic inflammatory condition
Authors: Christensen Maja , Wallis Mathew , Jessup Peter , Lemelle Irène , Jones Dean L
Published: June 2021

A 20-year-old man presented with recurrent subdural haemorrhages on a background of progressive sensorineural hearing loss, juvenile idiopathic arthritis and intracranial hypertension of unknown cause. His mother had a similar previous history. They both had a persistently mildly elevated serum C reactive protein. Repeat lumbar punctures identified persistently elevated intracranial pressure and mild pleocytosis. A dural biopsy showed necrotising pachymeningitis with granulomatous vasculitis. The underlying cause in both patients was a cryopyrin-associated periodic syndrome. We discuss its varied phenotype and how clinicians need to be aware of this treatable genetic condition to facilitate early treatment and to prevent accumulation of disability.
Tocilizumab decreases T cells but not macrophages in the synovium of patients with rheumatoid arthritis while it increases the levels of serum interleukin-6 and RANKL
Authors: Chatzidionysiou Katerina , Circiumaru Alexandra , Rethi Bence , Joshua Vijay , Engstrom Marianne , Hensvold Aase , af Klint Erik , Catrina Anca
Published: June 2021

Objectives

Our knowledge about the effect of tocilizumab (TCZ) on the synovium in rheumatoid arthritis (RA) is limited. The aim of this study was to investigate the effect of TCZ on citrullination and on inflammation in the synovial tissue and in the peripheral blood.

Methods

15 patients with RA underwent synovial biopsy before and 8 weeks after TCZ initiation. Clinical evaluation was performed at baseline and at 8 weeks. Using immunohistochemistry, we evaluated the expression of CD68, CD3, CD20, osteoprotegerin (OPG) and receptor activator for nuclear factor-κB ligand (RANKL) before and after treatment with TCZ. We also analysed the expression of protein arginine deiminase (PAD)-2 and PAD-4 enzymes in the synovial tissue and protein citrullination patterns with the help of anticitrullinated protein antibody (ACPA) clones 1325:04C03 and 1325:01B09. Serum levels of interleukin-6 (IL-6), IL-8, RANKL, OPG and C-terminal crosslinked telopeptide type II collagen were measured by ELISA. Paired-wise Wilcoxon signed-rank test was used to compare median values before and after treatment.

Results

Disease activity in patients was reduced from baseline to 8 weeks. Although PAD-2 and PAD-4 expressions remained unchanged after TCZ treatment, the binding of one ACPA clone decreased in the synovial tissue. TCZ did not affect the number of CD68+ macrophages or CD20+ B cells but induced significant decrease in the number of CD3+ T cells. RANKL and OPG expression remained unchanged in the synovial tissue. A significant increase in the levels of IL-6 and RANKL was observed in the serum. This increase was statistically significant in patients who responded to TCZ (achieving Clinical Disease Activity Index low disease activity or remission) but not in non-responders.

Conclusions

TCZ reduced synovial T-cell counts but not macrophages. A significant increase of serum IL-6 was observed in responders.
IMAGE ENCRYPTION BASED ON TWO-DIMENSIONAL FRACTIONAL QUADRIC POLYNOMIAL MAP
Authors: LIU ZE-YU , XIA TIE-CHENG , FENG HUA-RONG , MA CHANG-YOU
Published: June 2021

A new fractional two-dimensional quadric polynomial discrete chaotic map (2D-QPDM) with the discrete fractional difference is proposed. Afterwards, the new dynamical behaviors are observed, so that the bifurcation diagrams, the largest Lyapunov exponent plot and the phase portraits of the proposed map are given, respectively. The new discrete fractional map is exploited into color image encryption algorithm and it is illustrated with several examples. The proposed image encryption algorithm is analyzed in six aspects which indicates that the proposed algorithm is superior to other known algorithms as a conclusion.
Drilling into mines for heat: geological synthesis of the UK Geoenergy Observatory in Glasgow and implications for mine water heat resources
Authors: Monaghan Alison A. , Starcher V. , Barron H. F. , Shorter K. , Walker-Verkuil K. , Elsome J. , Kearsey T. , Arkley S. , Hannis S. , Callaghan E.
Published: June 2021

Thermal energy from groundwater in abandoned, flooded, coal mines has the potential to make a significant contribution to decarbonization of heat and net-zero carbon emissions. In Glasgow, UK, a subsurface observatory has been constructed for mine water heat and heat storage research. We synthesize geological and mine water resource findings from a 4 year period of borehole planning, drilling, logging and testing. The heterogeneous bedrock is typical of the Scottish Coal Measures Group, whereas superficial deposits are more sand- and gravel-dominated than predicted. Mine water boreholes encountered workings in the Glasgow Upper, Glasgow Ell and Glasgow Main coal seams, proving water-filled voids, mine waste, fractured rock mass and intact coal pillars, with high yields on initial hydrogeological testing. Although the depth and extent of mine workings delineated on mine abandonment plans proved accurate, metre-scale variability was expected and proved in the boreholes. A mine water reservoir classification established from the observatory boreholes highlights the resource potential in areas of total extraction, stowage, and stoop and room workings. Because their spatial extent is more extensive across the UK than shafts or roadways, increasing the mine water energy evidence base and reducing exploration risk in these types of legacy workings is important.

Supplementary material:
Borehole reports and other datasets are available at
https://ukgeos.ac.uk/data-downloads
(mixture of over 20 DOI datasets and reports or data packs published openly on
https://nora.nerc.ac.uk
; all material is deposited in the National Geoscience Data Centre).
Diaphragm neurostimulation during mechanical ventilation reduces atelectasis and transpulmonary plateau pressure, preserving lung homogeneity and PaO2/FIO2
Authors: Rohrs Elizabeth C. , Bassi Thiago G. , Fernandez Karl C. , Ornowska Marlena , Nicholas Michelle , Wittmann Jessica C. , Reynolds Steven C.
Published: June 2021

Temporary transvenous diaphragm neurostimulation has been shown to mitigate diaphragm atrophy in a preclinical model. This study contributes to this work by demonstrating that diaphragm neurostimulation can also offer lung protection from ventilator injury, providing a potential solution to the dilemma of lung- versus diaphragm-protective ventilation. Our findings show that neurostimulation on every breath preserved [Formula: see text]/[Formula: see text], end-expiratory lung volume, alveolar homogeneity, and required lower pressures than lung-protective ventilation over 50 h in healthy pigs.
Acute exercise-induced changes in cardiac function relates to right ventricular remodeling following 12-wk hypoxic exercise training
Authors: Kleinnibbelink Geert , van Dijk Arie P. J. , Fornasiero Alessandro , Speretta Guilherme F. , Johnson Christopher , Sculthorpe Nicholas , George Keith P. , Somauroo John D. , Thijssen Dick H. J. , Oxborough David L.
Published: June 2021

During exercise, the right ventricle is exposed to a disproportionally higher wall stress than the left ventricle, which is further exaggerated under hypoxia. In this study, we showed that 12-wk high-intensity running hypoxic exercise training induced right-sided structural remodeling, which was, in part, related to baseline cardiac increase in RV fractional area change to acute exercise. These data suggest that acute RV responses to exercise are related to subsequent right ventricular remodeling in healthy individuals upon hypoxic training.
Design of Ideological and Political Multimedia Network Teaching Resources Integration System Based on Wireless Network
Authors: Rong Liu
Published: June 2021

The main purpose of the integration of network media and middle school ideological and political course is to better realize the moral education function of middle school ideological and political development. The use of resource integration technology to manage distributed teaching resources is conducive to improving the level of information construction in colleges and universities, and so on. This paper puts forward the integration system of ideological and political multimedia network teaching resources based on wireless network. Firstly, it presents an overview of the Radio Resource Management (RRM) problem and projected strategies within wireless network framework, where several Radio Access Technologies (RATs) are collectively controlled and identify the different activities relating to the CRRM issues. Secondly, this paper targets providing a summary of the RRM problem and projected solutions within wireless network. Thirdly, the theoretical elements of the design and the teaching resource management assessment process are clarified by using XML as the data exchange carrier to realize the automatic integration of teaching resources. Fourthly, we have used dSPACE platform, by calling its API function, which then call the subscribe function of dSPACE framework and store the subscription information in the database. Whenever new teaching resources enter the subscribed field, the dSPACE framework will automatically send e-mail to the subscribers. Finally, during the operation of the system, all functions operate normally and have strong security, so as to avoid the illegal theft or leakage of the data about the education system.
Simulation Analysis of Cylindrical Shell Cavity Noise with Melamine Foam Lining
Authors: Qi Menghui , Li Bin , Yan Shilin , Yan Qinghua , He Qiyu
Published: June 2021

To solve the problem of the harsh midlow frequency noise of rocket fairing, the cylindrical section of the protective precision instrument fairing is simplified as cylindrical shells, and different lining strategies of melamine foam (MF) are studied experimentally and numerically. Based on Virtual.Lab Acoustic software, a finite element model of the cylindrical cavity is established, and the correctness is verified by comparison with the measured data. On that basis, the influences of the lining position of different thickness MF on the noise reduction of cylindrical shells are investigated. It is shown that the thickness and location of the laying material have a significant effect on the noise reduction at the same specific gravity.
Government Supervision on Explosive Enterprises’ Immoral Behaviors in E‐Commerce Enterprises: An Evolutionary Game Analysis
Authors: Shen Liang , Chen Yuanyuan , Fan Runjie , Wang Yuyan
Published: June 2021

Explosive enterprises’ immoral behaviors in the online shopping market are widespread and have not been effectively solved. Especially in developing countries, there is a direct relationship between massive immoral behaviors and the inefficiency of government supervision. Using an evolutionary game, this paper finds that immoral behavior is more likely to spread in online markets than in traditional markets. Only when government supervision and punishment are large enough and government’s punishment for the illegal enterprise exceeds extra supervision costs that government pays, explosive immoral behaviors can be curbed. Additionally, consumer support is an essential factor in improving the efficiency of government supervision. This study sorts out the interactions between e‐commerce market participants and the government, obtains a path to achieve efficient government regulation, and offers management insights. The findings can serve as a reference for ensuring order in the emerging online shopping market and can also provide theoretical references for future related research.
[Retracted] Stability Evaluation of Rock Slope in Hydraulic Engineering Based on Improved Support Vector Machine Algorithm
Authors: Li Fei , Zhang Hongyun
Published: June 2021

The safety problem of the slope has always been an important subject in engineering geology, which has a wide range of application background and practical significance in reality. How to correctly evaluate the stability of the slope and obtain the parameters of the slope has always been the focus of research and production personnel at home and abroad. In recent years, various artificial intelligence calculation methods have been applied to the field of rock engineering and engineering geology, providing some new ideas for the solution of slope stability analysis and parameter back analysis. Support vector machine (SVM) algorithm has unique advantages and generalization in dealing with finite samples and highly complex and nonlinear problems. At present, it has become a research hotspot of intelligent methods and has been widely paid attention to in various application fields of slope engineering. In this paper, a cuckoo search algorithm‐improved support vector machine (CS‐SVM) method is applied to slope stability analysis and parameter inversion. Aiming at the problem of selecting kernel function parameters and penalty number of SVM, a method of using cuckoo search algorithm to improve support vector machine was proposed, and the global optimization ability of cuckoo search algorithm was used to improve the algorithm. Aiming at the slope samples collected, the classification algorithm of support vector machine (SVM) was used to identify the stable state of the test samples, and the improved SVM algorithm was used to analyze the safety factor of the test samples. The results show that the proposed method is reasonable and reliable. Based on the inversion of the permeability coefficient of the test samples by the improved support vector machine, the comparison between the inversion value and the theoretical value shows that it is basically feasible to invert the permeability coefficient of the dam slope by the improved support vector machine.
PFKFB4 Overexpression Facilitates Proliferation by Promoting the G1/S Transition and Is Associated with a Poor Prognosis in Triple-Negative Breast Cancer
Authors: Cai Yu-Chen , Yang Hang , Shan Hong-Bo , Su Hui-Fang , Jiang Wen-Qi , Shi Yan-Xia
Published: June 2021

Background. 6-Phosphofructo-2-kinase/fructose-2,6-biphosphate-4 (PFKFB4) is a key factor that plays an important role in tumorigenesis. However, its role in triple-negative breast cancer (TNBC) progression needs to be further validated. We investigated whether PFKFB4 is directly involved in the oncogenic signaling networks of TNBC. Methods. First, we assessed the expression level of PFKFB4 in tumor tissue specimens by immunohistochemistry and evaluated its prognostic value. Next, the effect of PFKFB4 on TNBC cell growth and associated mechanisms were investigated. Finally, the results were further verified in vivo. Results. We found that PFKFB4 overexpression was associated with an unfavorable prognosis in TNBC patients. PFKFB4 was overexpressed in TNBC cell lines in hypoxic environments, and its overexpression promoted tumor progression in vitro and in vivo. Further analyses demonstrated that the possible mechanism might be that PFKFB4 overexpression facilitates TNBC progression by enhancing the G1/S phase transition by increasing the protein level of CDK6 and phosphorylation of Rb. Conclusions. These data suggest that PFKFB4 plays significant roles in the tumorigenesis and development of TNBC.