bluuebunny/crossref_metadata_2025 huggingface dataset:
Creating a Process for the Implementation of Tiered Huddles in a Veterans Affairs Medical Center
Authors: Merchant Naseema B , O’Neal Jessica , Montoya Alfred , Cox Gerard R , Murray John S
Published: March 2022

Introduction

In 2019, the Veteran’s Health Administration began its journey in pursuit of becoming an enterprise-wide High Reliability Organization (HRO). Improving the delivery of safe, high quality patient care is a central focus of HROs. Requisite to meeting this goal is the timely identification and resolution of problems. This is best achieved by empowering and engaging both clinical and non-clinical staff across the healthcare organization through the promotion of robust collaboration and communication between various disciplines. Improved care coordination and increased accountability are two important subsequent outcomes. One method for accomplishing this is through the implementation of tiered huddles.

Materials and Methods

An extensive review of the current literature from 2013 until June 2021 was conducted for evidence highlighting the experiences of other healthcare organizations during implementation of huddles. Following the review, a tiered huddle proposal was developed and presented to the executive leadership team of a healthcare system for approval. Pilot testing of the tiered huddle implementation plan began in October 2021 over a 12-week period with three services. On average, the pilot services had between three to four tiers from frontline staff to the executive level of leadership.

Results

Over the 12-week period, out of the possible 120 tiered huddles that could have been conducted, 68% (n = 81) were completed. Of the tiered huddles conducted, 99% (n = 80) started and ended on time. During the pilot test, seven issues were identified by frontline staff: coordination of pre-procedural coronavirus testing, equipment/computer issues, rooms out of service, staffing levels, and lack of responsiveness from other departments. Issues related to staffing, unresponsiveness from other departments, and equipment concerns required elevation to a higher-level tier with no issues remaining open. Delays in patient care, or prolongation of shift hours for staff because of tiered huddles, was low at 2.5% (n = 2). For the duration of the pilot test, a total of 75 minutes accounted for shifts being extended among five staff members.

Conclusions

The success of this initiative demonstrates the importance of thoughtfully creating a robust process when planning for the implementation of tiered huddles. The findings from this initiative will be of immense value with the implementation of tiered huddles across our healthcare system. We believe that this approach can be used by other healthcare institutions along their journey to improving patient safety and quality.
Downwards Propriety in Epistemic Utility Theory
Authors: Pérez Carballo Alejandro
Published: March 2022

Epistemic utility theory is often identified with the project of axiology-first epistemology—the project of vindicating norms of epistemic rationality purely in terms of epistemic value. One of the central goals of axiology-first epistemology is to provide a justification of the central norm of Bayesian epistemology, Probabilism. The first part of this paper presents a new challenge to axiology-first epistemology: I argue that in order to justify Probabilism in purely axiological terms, proponents of axiology-first epistemology need to justify a much stronger claim about epistemic value—what I label ‘Downwards Propriety’—than any they have offered a justification for. The second part of this paper offers an argument that this challenge cannot be met given a purely accuracy-based account of epistemic value: that there is no hope for providing a purely axiological justification of Downwards Propriety if accuracy is the fundamental source of epistemic value.
The VMC survey – XLVI. Stellar proper motions in the centre of the Large Magellanic Cloud
Authors: Niederhofer Florian , Cioni Maria-Rosa L , Schmidt Thomas , Bekki Kenji , de Grijs Richard , Ivanov Valentin D , Oliveira Joana M , Ripepi Vincenzo , Subramanian Smitha , van Loon Jacco Th
Published: March 2022

We present proper motion (PM) measurements within the central region of the Large Magellanic Cloud (LMC), using near-infrared data from the VISTA survey of the Magellanic Cloud system (VMC). This work encompasses 18 VMC tiles covering a total sky area of ∼28 deg2. We computed absolute stellar PMs from multiepoch observations in the Ks filter over time baselines between ∼12 and 47 months. Our final catalogue contains ∼6322 000 likely LMC member stars with derived PMs. We employed a simple flat-rotating disc model to analyse and interpret the PM data. We found a stellar centre of rotation ($\alpha _{0} = 79.95^{\circ }\,^{+0.22}_{-0.23}$, $\delta _0 = -69.31^{\circ }\,^{+0.12}_{-0.11}$) that is in agreement with that resulting from Hubble Space Telescope data. The inferred viewing angles of the LMC disc ($i=33.5^{\circ }\,^{+1.2}_{-1.3}$, $\Theta =129.8^{\circ }\,^{+1.9}_{-1.9}$) are in good agreement with values from the literature but suggest a higher inclination of the central parts of the LMC. Our data confirm a higher rotation amplitude for the young (≲0.5 Gyr) stars compared to the intermediate-age/old (≳1 Gyr) population, which can be explained by asymmetric drift. We constructed spatially resolved velocity maps of the intermediate-age/old and young populations. Intermediate-age/old stars follow elongated orbits parallel to the bar’s major axis, providing first observational evidence for x1 orbits within the LMC bar. In the innermost regions, the motions show more chaotic structures. Young stars show motions along a central filamentary bar structure.
Mechanical feedback from stellar winds with an application to galaxy formation at high redshift
Authors: Fichtner Yvonne A , Grassitelli Luca , Romano-Díaz Emilio , Porciani Cristiano
Published: March 2022

We compute different sets of stellar evolutionary tracks in order to quantify the energy, mass, and metals yielded by massive main-sequence and post-main-sequence winds. Our aim is to investigate the impact of binary systems and of a metallicity-dependent distribution of initial rotational velocities on the feedback by stellar winds. We find significant changes compared to the commonly used non-rotating, single-star scenario. The largest differences are noticeable at low metallicity, where the mechanical-energy budget is substantially increased. So as to establish the maximal (i.e. obtained by neglecting dissipation in the near circumstellar environment) influence of winds on the early stages of galaxy formation, we use our new feedback estimates to simulate the formation and evolution of a sub-L* galaxy at redshift 3 (hosted by a dark-matter halo with a mass of 1.8 × 1011 M⊙) and compare the outcome with simulations in which only supernova (SN) feedback is considered. Accounting for the continuous energy injection by winds reduces the total stellar mass, the metal content, and the burstiness of the star-formation rate as well as of the outflowing gas mass. However, our numerical experiment suggests that the enhanced mechanical feedback from the winds of rotating and binary stars has a limited impact on the most relevant galactic properties compared to the non-rotating single-star scenario. Eventually, we look at the relative abundance between the metals entrained in winds and those ejected by SNe and find that it stays nearly constant within the simulated galaxy and its surrounding halo.
Implementing FCTC Article 17 Through Participatory Research With Bidi Workers in Tamil Nadu, India
Authors: Russell Andrew , Chandra P , Robson Mary , Narayanan Pradeep , Joseph Stanley , Mukherjee Pavan , Aghi Mira , Otañez Marty , Dutta Madhumita , Bhojani Upendra , Pathak Prishanti , John Sushil
Published: March 2022

Introduction

The exploitation, poor conditions, and precarity in the bidi (hand-rolled leaf cigarette) industry in India make it ripe for the application of the FCTC’s Article 17, “Provision of support for economically viable alternative activities”. “Bottom-up”, participatory approaches give scope to explore bidi rollers’ own circumstances, experiences, and aspirations.

Methods

A team of six community health volunteers using a participatory research orientation developed a questionnaire-based semi-structured interview tool. Forty-six bidi rolling women were interviewed by pairs of volunteers in two northern Tamil Nadu cities. Two follow-up focus groups were also held. A panel of 11 bidi rollers attended a workshop at which the findings from the interviews and focus groups were presented, further significant points were made and possible alternatives to bidi rolling were discussed.

Results

Bidi workers are aware of the adverse impact of their occupation on them and their families, as well as the major risks posed by the product itself for the health of consumers. However, they need alternative livelihoods that offer equivalent remuneration, convenience, and (in some cases) dignity. Alternative livelihoods, and campaigns for better rights for bidi workers while they remain in the industry, serve to undercut industry arguments against tobacco control. Responses need to be diverse and specific to local situations, i.e. “bottom-up” as much as “top-down”, which can make the issue of scaling up problematic.

Conclusion

Participatory approaches involving bidi workers themselves in discussions about their circumstances and aspirations have opened up new possibilities for alternative livelihoods to tobacco.

Implications

Progress with the FCTC’s Article 17 has generally been slow and has focussed on tobacco cultivation rather than later stages in the production process. The bidi industry in India is ripe for the application of an alternative livelihoods approach. This study is one of the first to use participatory methods to investigate the circumstances, experiences, and aspirations of bidi workers themselves.
Overcoming Stenotrophomonas maltophilia Resistance for a More Rational Therapeutic Approach
Authors: Kullar Ravina , Wenzler Eric , Alexander Jose , Goldstein Ellie J C
Published: March 2022

Stenotrophomonas maltophilia is an underappreciated source of morbidity and mortality among gram-negative pathogens. Effective treatment options with acceptable toxicity profiles are limited. Phenotypic susceptibility testing via commercial automated test systems is problematic and no Food and Drug Administration breakpoints are approved for any of the first-line treatment options for S maltophilia. The lack of modern pharmacokinetic/pharmacodynamic data for many agents impedes dose optimization, and the lack of robust efficacy and safety data limits their clinical utility. Levofloxacin has demonstrated similar efficacy to trimethoprim-sulfamethoxazole, although rapid development of resistance is a concern. Minocycline demonstrates the highest rate of in vitro susceptibility, however, evidence to support its clinical use are scant. Novel agents such as cefiderocol have exhibited promising activity in preclinical investigations, though additional outcomes data are needed to determine its place in therapy for S maltophilia. Combination therapy is often employed despite the dearth of adequate supporting data.
What is the Role of Lateral Flow Immunoassay for the Diagnosis of Melioidosis?
Authors: Currie Bart J , Woerle Celeste , Mayo Mark , Meumann Ella M , Baird Robert W
Published: March 2022

Background

Culture of Burkholderia pseudomallei remains the gold standard for diagnosis of melioidosis but is not possible in many resource-limited settings where melioidosis is endemic. Direct identification of B. pseudomallei antigen in clinical samples has been developed using a lateral flow immunoassay (LFA) targeting B. pseudomallei capsular polysaccharide.

Methods

We summarized the findings from the 8 studies to date of the Active Melioidosis Detect (AMD) LFA and compared these with our results from 232 patients with culture-confirmed melioidosis. We have also optimized the methodology for testing different clinical samples.

Results

Sensitivity and specificity for different samples were broadly similar in our study to those published from Thailand, India, Laos, and Malaysia. One hundred thirty of 232 (56%) of our melioidosis patients were positive on 1 or more AMD tests: 27% for serum (rising to 39% in those with bacteremic melioidosis and 68% in those with septic shock), 63% for urine (72% in bacteremic melioidosis and 90% in septic shock), 85% in sputum that was culture positive, and 83% in pus that was culture positive. Heating sputum and pus samples increased sensitivity. Faint false-positive urine bands seen on earlier AMD versions were not seen when retested using the most recent version, AMD-Plus.

Conclusions

While the sensitivity of melioidosis LFA is low overall for blood samples, there is potential for use as a rapid diagnostic: testing serum and urine from those with severe sepsis who may have melioidosis and testing sputum and pus samples from clinically relevant scenarios. Prospective studies of patients with sepsis and other clinical presentations resembling melioidosis are required to ascertain if the specificity of AMD-PLUS is adequate to enable diagnosis of melioidosis with a high positive predictive value.
Syphilis in pregnancy and infant outcomes in Manitoba
Authors: Lopez Alison , Lee Santina J , Bullard Jared
Published: March 2022

Background

Infectious syphilis has been increasing in incidence in Manitoba since 2012, especially in heterosexual women of childbearing age resulting in an increasing number of infants with in utero exposure and who are at risk for congenital syphilis (CS). We aimed to evaluate the impact of syphilis in pregnancy on infants and to describe our experience with CS.

Methodology

This retrospective 2012 to 2018 cohort study reviewed women with syphilis in pregnancy and short-term infant outcomes. We grouped mother–infant pairs into high risk and low risk for CS and compared their management and outcomes. We also describe our cases of confirmed and possible CS.

Results

Seventy-nine mothers and 80 infants met inclusion criteria. Thirty mother–infant pairs were classified as high risk for CS. Nine of their infants were diagnosed with confirmed CS and four with possible CS. All confirmed CS cases were asymptomatic at birth but two were not recognized to have CS until they later presented with symptoms. One of these infants had negative serologies (treponemal and non-treponemal) at birth, but at 3 months old had reactive serologies. Two months of age was the earliest clearance of maternal treponemal antibodies amongst low-risk infants compared to 6 months in high-risk infants. Most infants who did not have confirmed CS had non-reactive non-treponemal tests by 6 months old.

Interpretation

Our study shows that symptoms and paired maternal-infant non-treponemal titres at birth are not sensitive for diagnosing CS. Serologies can be falsely negative with recent infection. Regardless of investigations or clinical findings, 10 days of intravenous penicillin G should be considered for all high-risk infants.
Thiol-based Oxidative Posttranslational Modifications (OxiPTMs) of Plant Proteins
Authors: Corpas Francisco J , González-Gordo Salvador , Rodríguez-Ruiz Marta , Muñoz-Vargas María A , Palma José M
Published: March 2022

The thiol group of cysteine (Cys) residues, often present in the active center of the protein, is of particular importance to protein function, which is significantly determined by the redox state of a protein’s environment. Our knowledge of different thiol-based oxidative posttranslational modifications (oxiPTMs), which compete for specific protein thiol groups, has increased over the last 10 years. The principal oxiPTMs include S-sulfenylation, S-glutathionylation, S-nitrosation, persulfidation, S-cyanylation and S-acylation. The role of each oxiPTM depends on the redox cellular state, which in turn depends on cellular homeostasis under either optimal or stressful conditions. Under such conditions, the metabolism of molecules such as glutathione, NADPH (reduced nicotinamide adenine dinucleotide phosphate), nitric oxide, hydrogen sulfide and hydrogen peroxide can be altered, exacerbated and, consequently, outside the cell’s control. This review provides a broad overview of these oxiPTMs under physiological and unfavorable conditions, which can regulate the function of target proteins.
THE INFLUENCE OF LOW-DOSE OCCUPATIONAL RADIATION EXPOSURE ON PERIPHERAL BLOOD CELLS IN A COHORT OF CHINESE MEDICAL RADIATION WORKERS
Authors: Wang Gui , Xu Chang , Li Shixia , Zhang Daguang , Chen Yue , Liu Juntian , Liu Ningbo
Published: March 2022

Objectives

The study aims to assess the change of peripheral blood cell numbers following protracted low-dose radiation exposure among medical radiation workers.

Methods

A cohort of 375 Chinese medical workers were followed for 5 years (2015–19) and recorded the changes in blood cells and cumulative doses. T-test, least significant difference-T test, variance analysis and correlation analysis were utilized in this study.

Results

Compared with the control group, the white blood cells, hemoglobin counts and the ratio of eosinophils in the study group showed a downward trend. The differences in blood cells between groups were mainly found in the number of red blood cells. In a short cumulative time, such as 1 or 3 years, a correlation between the cumulative dose and the quantity of blood cells was detected, but not at 5 years.

Conclusions

There is no significant difference in the blood cell counts between different types of work, and the long-term cumulative dose has not been statistically correlated with the number of blood cells. So that the number of peripheral blood cells can no longer be used as a good indicator of radiation damage.
Meaningful Refugee Participation: An Emerging Norm in the Global Refugee Regime
Authors: Milner James , Alio Mustafa , Gardi Rez
Published: March 2022

Is meaningful refugee participation a norm within the global refugee regime? Despite growing attention since 2016, we argue that meaningful refugee participation in the governance of the global refugee regime is not yet an established norm. By drawing on the norm lifecycle framework developed by Finnemore and Sikkink and an analysis of recent initiatives, we argue instead that meaningful refugee participation is an emerging norm that has the potential to become the standard of appropriate behaviour in global decision-making fora. Despite this progress, we argue that the pursuit of differentiated approaches to refugee participation by norm entrepreneurs may constrain efforts to advance the norm. By examining efforts by States, United Nations High Commissioner for Refugees and refugee-led initiatives in recent years, we seek to highlight the similarities and differences between these initiatives and the extent to which they meet the threshold for norm emergence. Through this analysis, we consider the current state of the norm of meaningful refugee participation and present some possible scenarios for the future of the norm. While meaningful refugee participation is not yet a norm in the global refugee regime, we argue that a deeper understanding of its steady emergence holds important lessons for future research, policy, and practice.
Dissemination of the Spear & Shield Project using a Training of Trainers Model: A reflection on challenges and successes
Authors: Bowa Kasonde , Rodriguez Violeta J , Malik Fayeza S , Knight Jennifer , Cristofari Nicholas , Parrish Manasi S , Jones Deborah L , Zulu Robert , Weiss Stephen M
Published: March 2022

Several large-scale clinical trials have conclusively demonstrated that voluntary medical male circumcision (VMMC) could provide a 50%–70% reduction in HIV acquisition, but willingness to undergo VMMC has been lowest in Zambia compared to other countries in eastern and southern Africa. This manuscript describes training for “task-shifting” among local healthcare workers at Community Health Centers (CHCs) applying state of the art strategies (e.g., Training of Trainers, i.e., ToT, and Training of Facilitators, ToF) to provide novel clinical services. Staff at 96 CHCs from four Provinces in Zambia were sequentially trained to provide the Spear & Shield intervention. A total of 45,630 men (n = 23,236) and women (n = 22,394) volunteered to participate in the S&S intervention service program when offered in the CHCs. Group session (total = 5313 sessions; 2,736 men’s and 2,582 women’s sessions) were conducted over 4.5 years. Remarkably, both men and women’s groups achieved 97% retention. Of these, 256 sessions recorded from 128 group leaders were assessed and scored for intervention fidelity; fidelity was 80%–90% among the majority of clinics. S&S program sustainment exceeded expectations among 85% of clinics (82/96) in all provinces across the duration of the study. Of note, attendance in the S&S program was encouraged by CHC staff, but no financial incentives were provided to those attending S&S. This study examined the effectiveness of the ToT/ToF model in dissemination of the S&S program, which proved to be feasible even in resource-limited settings. Benefits and challenges are discussed.
Bionomics of the unexplored sand flies fauna of District Mohmand, Khyber Pakhtunkhwa, Pakistan: assessing risk factors associated with cutaneous leishmaniasis
Authors: Khan Khurshaid , Sajjad Muhammad , Wahid Sobia , Gul Muhammad , Khan Luqman , Ullah Haseen , Rahman Yasin , Khan Dawood , Khan Kashif , Khan Muhammad Younas , Khan Saqib , Shah Safeer Ullah
Published: March 2022

Background

Sand flies are of considerable public health importance in Pakistan because these insects are vectors of leishmaniasis. The current study explores the bionomics of sand flies, their spatial distribution pattern and cutaneous leishmaniasis-associated risk factors in District Mohmand, Khyber Pakhtunkhwa, Pakistan.

Methods

Sand flies were collected from indoor and outdoor habitats in 69 villages of five tehsils in Mohmand during July–October 2019. Risk factor data were recorded for 829 households in 94 villages.

Results

In total, 2065 sand flies were captured. Phlebotomus (Paraphlebotbmus) sergenti was the most abundant species. Relative density for P. sergenti and Phlebotomus papatasi was highest in Prang Ghar and lowest in Safi. Sand flies abundance peaked in August and September, corresponding to maximum relative humidity, temperature and rainfall. Relative density for P. sergenti and P. papatasi was highest in combined dwellings (indoor) and cattle corrals (outdoor). Phlebotomus sergenti and P. papatasi were abundant at an elevation of 283–1140 m on agricultural land and rangelands. Both species were recorded abundantly on Carbontites, Mesozoic and Indus suture Melange rock formations. Presence of domestic animals, ownership of pet dogs, presence of muddy dunes in the village, knowledge of sandflies and use of mosquitoes spray remained significant risk factors.

Conclusions

The study reports sand fly bionomics in District Mohmand. Risk identified for cutaneous leishmaniasis are significant in strategising control methods for Health authorities can allocate localized control means to high-risk areas using these findings.
Long COVID-19 syndrome: a 14-months longitudinal study during the two first epidemic peaks in Southeast Brazil
Authors: de Miranda Daniel A P , Gomes Sarah V C , Filgueiras Priscilla S , Corsini Camila A , Almeida Nathalie B F , Silva Raphael A , Medeiros Maria Izabella V A R C , Vilela Raquel V R , Fernandes Gabriel R , Grenfell Rafaella F Q
Published: March 2022

Background

A growing number of long COVID cases after infection have been reported. By definition, long COVID is the condition whereby affected individuals do not recover for several weeks or months following the onset of symptoms suggestive of COVID-19, the profile and timeline of which remains uncertain.

Methods

In this work, in-home, outpatient and hospitalized COVID-19 positive patients were monitored for up to 14 mo to establish the prevalence of long COVID symptoms and their correlation with age, pre-existing comorbidities and course of acute infection. The longitudinal study included 646 positive patients who were monitored once a month.

Results

From the whole population, 50.2% presented with long COVID syndrome. Twenty-three different symptoms were reported. Most frequent were fatigue (35.6%), persistent cough (34.0%), dyspnea (26.5%), loss of smell/taste (20.1%) and frequent headaches (17.3%). Mental disorders (20.7%), change in blood pressure (7.4%) and thrombosis (6.2%) were also reported. Most patients presented with 2–3 symptoms at the same time. Long COVID started after mild, moderate and severe infection in 60, 13 and 27% of cases, respectively, and it was not restricted to specific age groups.

Conclusions

Older patients tended to have more severe symptoms, leading to a longer post-COVID-19 period. The presence of seven comorbidities was correlated with the severity of infection, and severity itself was the main factor that determined the duration of symptoms in long COVID cases.
Comparison of Current Peanut Fungicides Against Athelia rolfsii Through a Laboratory Bioassay of Detached Plant Tissues
Authors: Wei Xing , Langston David B. , Mehl Hillary L.
Published: March 2022

Southern stem rot of peanut, caused by Athelia rolfsii, is an important fungal disease that impacts peanut production worldwide. Foliar-applied fungicides are used to manage the disease, and several fungicides have been recently registered for southern stem rot control in peanuts. This study compared fungicidal, residual, and potential systemic activity of current fungicides against A. rolfsii using a laboratory bioassay. Peanut plants grown in the field were treated with eight fungicides approximately 90 days after planting, and plants were collected for the laboratory bioassay weekly for 5 weeks following application. Peanut plants were separated into the newest fully mature leaf present at sample collection, the second newest fully mature leaf present at the time of fungicide application, the upper stem, and the crown tissues. Each plant tissue was inoculated with A. rolfsii then incubated at 30°C for 2 days. Lesion length was measured, and percent inhibition of fungal growth by each fungicide relative to the control was calculated. All fungicides provided the greatest inhibition of A. rolfsii on leaf tissues that were present at the time of fungicide application, followed by the newly grown leaf and upper stem. Little inhibition occurred on the crown. Fungal inhibition decreased at similar rates over time for all fungicides tested. Succinate dehydrogenase inhibitors provided less basipetal protection of upper stems than quinone outside inhibitor or demethylation inhibitor fungicides. Properties of the fungicides characterized in this study, including several newly registered products, are useful for developing fungicide application recommendations to maximize their efficacy in controlling both foliar and soilborne peanut diseases.
Discovery ofFusarium proliferatumf. sp.malus domesticaCausing Apple Replant Disease in China
Authors: Duan Y. N. , Jiang W. T. , Zhang R. , Chen R. , Chen X. S. , Yin C. M. , Mao Z. Q.
Published: March 2022

Apple replant disease (ARD) is the most serious threat facing the apple industry globally. ARD is mainly manifested as decreased plant growth, serious root rot disease, and considerable yield loss. Microbial factors are the dominant factors leading to the occurrence of ARD. Research on soil-borne pathogenic fungi leading to the occurrence of ARD in China is limited. In the present study, we selected 16 replanting orchards from the Northwest Loess region and around the Bohai Gulf. Diseased roots and rhizosphere soil from healthy apple trees and trees showing ARD symptoms were sampled at random. High-throughput sequencing was used to study the fungal communities in the rhizosphere soil, which showed that the composition of the rhizosphere soil fungal community of ARD-symptomatic and healthy apple trees was different. Nectriaceae at the family level and Fusarium at the genus level dominated the rhizosphere soil fungal community in the two regions, while for healthy apple trees, the relative abundance of Mortierella, Minimedusa, Tetracladium, and Chaetomium was higher. Tissue separation and serial dilution were used to separate fungi, and a total of 89 genera and 219 species were obtained, most of which were Fusarium. Fusarium was further confirmed to be the most abundant pathogen species leading to the occurrence of ARD in China through pathogenicity assays. A pathogenicity assay was carried out by the dip-and-cut technique using different host plants. It was found that Fusarium MR5 showed strong aggressiveness to apple rootstocks. Diseased seedlings specifically exhibited chlorosis of the leaves, browning from the edge of the leaf, followed by rolling and yellowing of the leaves, resulting in wilting and eventually death. Strain MR5 was preliminarily identified as F. proliferatum according to the morphological and cultural characteristics. A maximum likelihood analysis of identities based on six gene sequence (ITS, TUB2, IGS, mtSSU, RPB2, and the TEF gene) alignments between the MR5 strain and other strains showed 99 to 100% homology with F. proliferatum. Based on our test results, strain MR5 was identified as F. proliferatum f. sp. malus domestica, which is of great significance for finding new measures to control ARD in China.
Exploring the Corn Microbiome: A Detailed Review on Current Knowledge, Techniques, and Future Directions
Authors: Singh Raksha , Goodwin Stephen B.
Published: March 2022

In their natural environment, plants are colonized by a plethora of microorganisms. These diverse microorganisms interact with each other and the host to form a complex microbiome community. A growing body of research suggests that the microbiome has a significant impact on plant yield or health by promoting growth, stress tolerance, and resistance to pathogens. Although plant microbiomes have great potential for improving plant health and productivity, studies on crop microbiomes, especially in corn, have only recently started to be conducted. During the last few years, progress in next-generation sequencing technologies has enabled an increasing number of studies of corn-associated microbiomes and their dynamics with the plant. The composition and differentiation of microbial communities are affected not only by environmental factors and agricultural management but also by host phenotype and genotype. Although challenges remain in understanding the microbiome, the combination of beneficial plant microbes, microbial community interactions, and the optimization of the taxonomic composition of microbiomes determine the overall health and fitness of the plant and thus lead to more sustainable agriculture. In this review, we present an overview of the current knowledge and research on corn microbiomes using traditional culture-based approaches and next-generation amplicon or metagenomic profiling, discuss results from these approaches with an emphasis on the influence of environmental and host genetic factors on corn-microbe interactions, and outline future directions and challenges in corn microbiome research. A better understanding of the corn microbiome diversity, function, and microbiology will contribute to the improvement of crop health and productivity.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
High-Resolution Melting Analysis Enables Efficient Detection and Differentiation of Two Boxwood Blight Pathogens by qPCR Assays
Authors: Gouker Fred E. , Guo Yonghong , Pooler Margaret R.
Published: March 2022

Boxwood blight is a devastating disease caused by the fungal pathogens Calonectria henricotiae ( Che) and C. pseudonaviculata ( Cps). Identification and detection of these pathogens from infected plant material could play a significant role in breeding and selection of resistant cultivars and development of disease management strategies in the ornamental nursery industry. We designed a simple, single-tube method for extraction of PCR-amplifiable DNA from boxwood leaves and cultures of the Calonectria pathogens. Previously developed fungal-specific primers based on histone and calmodulin regions were used to detect and distinguish between Che and Cps using real-time PCR and high-resolution melting (HRM) analysis, with discernable melting temperature differences of 0.5°C between amplified products. Here, we describe a single-tube acetone-based DNA extraction method and qPCR-HRM assay targeting single nucleotide polymorphisms within the calmodulin and histone H3 DNA regions as a fast and highly sensitive molecular method to detect and differentiate between Che and Cps species directly from plant tissue.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Paraspinal Necrotizing Fasciitis Associated with Pressure Injury: An Unusual Case Report
Authors: Kim Min Ji , Yang Kyung Min , Lim Hyoseob
Published: March 2022

Necrotizing fasciitis is a type of soft tissue infection that destroys subcutaneous tissue. It is particularly dangerous for patients with chronic diseases and those who are bedridden while recuperating. Although necrotizing fasciitis is often caused by trauma or postoperative infection, in rare cases, it can be attributed to pressure injury (PI). The disease progression is very aggressive and can be lethal for patients who are bedridden or immunocompromised.

This case report describes a 47-year-old man with a history of diabetes and hypertension who became bedridden after a sudden status decline caused by nephrotic syndrome. He gradually developed an infection and rare deterioration of a PI on his upper back. After radiologic evaluation with magnetic resonance imaging and computed tomography, surgical intervention was performed and necrotizing fasciitis was confirmed. In this case of necrotizing fasciitis derived from a PI on the upper back, the infected area spread to the periphery at a rapid rate. The infection spread over his back and across the T1-T9 levels.

In this report, the authors describe the integrated system of the thoracolumbar fascia and the very aggressive spread of necrotizing fasciitis. Because of the anatomic structure of the back and the characteristics of this infection, only aggressive surgical debridement could prevent the spread of infection and reduce the systemic effects of the infection. Physicians should be aware of the possibility of PIs in bedridden patients and, in cases of exacerbation of the wound, consider rapid surgical intervention after prompt examination and diagnosis to reduce mortality.
Diagnostic Accuracy of Ankle-Brachial Pressure Index Compared with Doppler Arterial Waveforms for Detecting Peripheral Arterial Disease: A Systematic Review
Authors: Kashetsky Nadia , Sachdeva Muskaan , Lu Justin D. , Mufti Asfandyar , Kim Patrick , Bagit Ahmed , Sibbald R. Gary
Published: March 2022

Although the ankle-brachial pressure index (ABPI) is a useful tool for the noninvasive assessment of peripheral arterial disease (PAD), it has several limitations necessitating alternative noninvasive diagnostic tools. This study assesses the diagnostic accuracy of ABPI compared with Doppler arterial waveforms (DAWs) to detect PAD. The authors searched Embase and MEDLINE for original studies that reported sensitivities and specificities for both the ABPI and DAW. Four studies were included representing 657 patients (58.8% men) with a mean age of 63.4 years. The authors detected overall higher sensitivities using DAW compared with ABPI but higher specificities with ABPI compared with DAW. In conclusion, because of the higher sensitivity and lower specificity of DAW compared with ABPI, the authors recommend DAW as a potential screening tool for PAD. To confirm these results, larger sample sizes and comparative trials with homogeneous reference standards and patient populations are required. In addition, DAW is not easily documented for everyday bedside practice in the community. With COVID-19 restrictions, an audible handheld Doppler signal may act as a reproducible equivalent to DAW and thus facilitate timely, safe application of compression therapy at point-of-care.

GENERAL PURPOSE

To present the results of a research study evaluating the diagnostic accuracy of the ankle-brachial pressure index (ABPI) compared with that of Doppler arterial waveforms (DAWs) to detect peripheral arterial disease (PAD).

TARGET AUDIENCE

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES

After completing this continuing education activity, the participant will:

1. Summarize the evidence the authors considered when comparing the diagnostic accuracy of the ABPI with that of Doppler arterial waveforms to detect PAD.

2. Select the characteristics of the participants in the studies the authors analyzed.

3. Identify the results of the authors’ study comparing the diagnostic accuracy of the ABPI with that of Doppler arterial waveforms to detect PAD.

4. Distinguish the authors’ conclusions about the advantages of using Doppler arterial waveforms to detect PAD.
Type 2 diabetes mellitus and cancer of unknown primary risk: results from the Netherlands Cohort Study
Authors: Hermans Karlijn E.P.E. , Haque Sharmi , van den Brandt Piet A. , Loef Caroline , Jansen Rob L.H. , Schouten Leo J.
Published: March 2022

Objective

Cancer of unknown primary (CUP) is a metastatic malignancy with an unidentifiable primary tumour origin. Previous studies suggest that type 2 diabetes mellitus (T2DM) and CUP risk are associated. This study examines the association in greater depth by investigating T2DM status, T2DM duration, T2DM age at diagnosis, and medication that was being used in relation to CUP.

Methods

Data were utilized from the Netherlands Cohort Study, a prospective cohort that includes 120 852 participants aged 55–69 years at baseline in 1986. All participants completed a self-administered questionnaire on cancer risk factors. CUP cases were identified through record linkage with the Netherlands Cancer Registry and Dutch Pathology Registry. After 20.3 years of follow-up, 963 incident CUP cases and 4288 subcohort members were available for case-cohort analyses. Proportional hazards models were employed to estimate multivariable-adjusted hazard ratios (HRs).

Results

Overall, we observed a nonsignificant positive association between T2DM status and CUP risk [HR, 1.35; 95% confidence interval (CI), 0.92–1.99], which increased in women after stratification for sex (HR, 1.55; 95% CI, 0.90–2.64). For participants who were aged less than 50 years at diagnosis of T2DM, a statistically significant positive association was found in relation to CUP (HR, 2.42; 95% CI, 1.26–4.65), compared with participants without T2DM.

Conclusion

Our findings indicate that there is a nonsignificant positive association between T2DM and CUP risk and that the association became stronger in women in stratified analyses.
In-the-bag injection and overfold technique for custom flexible prosthetic iris prostheses
Authors: Amaral Henryque L. , Snyder Michael E.
Published: March 2022

In-the-bag placement is the ideal location for an anterior segment implant, including the custom flexible artificial iris prosthesis (CUSTOMFLEX ARTIFICIALIRIS). Yet, an injection of a bag-filling iris device through a reasonably sized capsulorhexis creates a geometric challenge. First, the device must be placed into an injection cartridge. Folding into a conoid, trifold orientation improves the facility with which the device is loaded into the injector barrel. To facilitate placement into the capsular bag, the device that is approximately 10+ mm is injected into the nasal bag, and the temporal portion is overfolded on itself to reduce its outer diameter.
Correlation of Treponemal Chemiluminescent Microparticle Immunoassay Screening Test Signal Strength Values With Reactivity of Confirmatory Testing
Authors: Demir Çuha Mervenur , Özdemir Adem , Evren Kübra , Can Bariş , Doyuk Zahide , Yiş Reyhan , Başbulut Eşe , Us Ebru , Kalem Fatma , Appak Özgür , Berkem Rukiye , Sönmez Cemile , Zarakolu Pinar , Saribaş Zeynep , Şener Burçin
Published: March 2022

Background

Automated chemiluminescent microparticle immunoassays (CMIAs) are the most common first step at high-volume laboratories for syphilis screening. If the initial screening test is reactive, 1 more treponemal test is required, resulting in increased cost. In this multicenter study, we aimed to determine the correlation between the CMIA signal-to-cutoff ratio (S/Co) and the confirmatory tests to reduce unnecessary confirmatory testing.

Methods

Eight hospitals from 5 provinces participated in this study. All laboratories used Architect Syphilis TP CMIA (Abbott Diagnostics, Abbott Park, IL) for initial screening. Treponema pallidum hemagglutination (TPHA), rapid plasma reagin (RPR), and fluorescent treponemal antibody absorption (FTA-ABS) were used as confirmatory tests according to the reverse or European Centre for Disease Prevention and Control algorithms. A receiver operating characteristic analysis was used to determine the optimal S/Co ratio to predict the confirmation results.

Results

We evaluated 129,346 serum samples screened by CMIA between January 2018 and December 2020. A total of 2468 samples were reactive; 2247 (91%) of them were confirmed to be positive and 221 (9%) were negative. Of the 2468 reactive specimens, 1747 (70.8%) had an S/Co ratio ≥10.4. When the S/Co ratios were ≥7.2 and ≥10.4, the specificity values were determined to be 95% and 100%, respectively. In a subgroup of 75 CMIA-positive patients, FTA-ABS was performed and 62 were positive. Among these FTA-ABS–positive patients, 24 had an S/Co ratio <10.4, and negative TPHA and RPR.

Conclusions

We propose a potentially cost-effective reverse screening algorithm with a treponemal CMIA S/Co ratio ≥10.4, obviating the need for secondary treponemal testing in about 71% of the screening-reactive samples. This would substantially reduce the confirmatory testing volume and laboratory expenses. However, in high-risk group patients with CMIA positive results, S/Co ratio <10.4, and negative TPHA and RPR, FTA-ABS may be used for confirmation.
Beyond the Impact Factor: An Alternative Approach to Measure the Influence of the Journal Sexually Transmitted Diseases on Sexually Transmitted Infection Prevention and Practice
Authors: Rietmeijer Cornelis A. , Miller William C.
Published: March 2022

Background

A journal's quality is often assessed by its impact factor, a measure of the number of times a journal's published articles are cited in the scientific literature. However, the impact factor may not adequately measure a journal's influence on practice. As an alternative approach, we analyzed referenced articles of the 2015 and 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections (STI) Treatment Guidelines, arguably the most influential document on STI prevention and care in the Unites States.

Methods

Referenced articles in the 2015 and 2021 guidelines were abstracted and analyzed by source and year of publication, and sources were ranked by frequency of citation.

Results

Of 892 citations in 2015 and 1454 citations in 2021, the most frequently cited reference sources included the journals Sexually Transmitted Diseases (14.0% and 12.8% in 2015 and 2021, respectively), Clinical Infectious Diseases (7.5% and 8.2%), and Sexually Transmitted Infections (5.6% and 6.4%).

Conclusions

Sexually transmitted infection specialty journals influence STI prevention and practice beyond what would be expected from the journals' impact factor alone.
Cost-Effectiveness of Hepatitis B Testing and Vaccination of Adults Seeking Care for Sexually Transmitted Infections
Authors: Hutton David W. , Toy Mehlika , Salomon Joshua A. , Conners Erin E. , Nelson Noele P. , Harris Aaron M. , So Samuel
Published: March 2022

Background

The estimated number of people living with hepatitis B virus (HBV) infection acquired through sexual transmission was 103,000 in 2018, with an estimated incidence of 8300 new cases per year. Although hepatitis B (HepB) vaccination is recommended by the Advisory Committee for Immunization Practices for persons seeking evaluation and treatment for sexually transmitted infections (STIs), prevaccination testing is not yet recommended. Screening may link persons with chronic hepatitis B to care and reduce unnecessary vaccination.

Methods

We used a Markov model to calculate the health impact and cost-effectiveness of 1-time HBV testing combined with the first dose of the HepB vaccine for adults seeking care for STI. We ran a lifetime, societal perspective analysis for a hypothetical population of 100,000 aged 18 to 69 years. The disease progression estimates were taken from recent cohort studies and meta-analyses. In the United States, an intervention that costs less than $100,000 per quality-adjusted life-year (QALY) is generally considered cost-effective. The strategies that were compared were as follows: (1) vaccination without HBV screening, (2) vaccination and hepatitis B surface antigen (HBsAg) screening, (3) vaccination and screening with HBsAg and anti-HBs, and (4) vaccination and screening with HBsAg, anti-HBs, and anti-HBc. Data were obtained from Centers for Medicare & Medicaid services reimbursement, the Centers for Disease Control and Prevention vaccine price list, and additional cost-effectiveness literature.

Results

Compared with current recommendations, the addition of 1-time HBV testing is cost-saving and would prevent an additional 138 cases of cirrhosis, 47 cases of decompensated cirrhosis, 90 cases of hepatocellular carcinoma, 33 liver transplants, and 163 HBV-related deaths, and gain 2185 QALYs, per 100,000 adults screened. Screening with the 3-test panel would save $41.6 to $42.7 million per 100,000 adults tested compared with $41.5 to $42.5 million for the 2-test panel and $40.2 to $40.3 million for HBsAg alone.

Conclusions

One-time HBV prevaccination testing in addition to HepB vaccination for unvaccinated adults seeking care for STI would save lives and prevent new infections and unnecessary vaccination, and is cost-saving.