bluuebunny/crossref_metadata_2025 huggingface dataset:
Positive impacts of oral health services provision by a student‐led primary care clinic to an Australian rural indigenous community
Authors: March S , Mangoyana C , Oakley P , Lalloo R , Walsh LJ
Published: May 2023

Background

This study aimed to determine whether oral health services provision by a dental student clinical outplacement embedded within a Community Controlled Health Service positively impacted a rural Indigenous community and to explore the nature of these benefits.

Methods

Aggregated and de‐identified 2017, 2018 and 2019 student‐led clinic services provision data were retrospectively analysed. The change in services mix over time was measured. Rural outplacement clinic operational costs to the university were estimated. Government‐funded local public dental clinic waiting list and services provision data were used to identify any student clinic establishment effect.

Results

The student‐led clinic services mix shifted over time from mainly acute care for toothache towards prevention of disease and tooth restoration, indicating an improvement in patient oral health and correspondingly reduced system costs. Imputed value of 2017–2019 student‐led clinic services provision totalled almost AUD$1 million. Government public clinic waiting list times decreased after full establishment of the student‐led clinic, indicating decreased pressure on the public system.

Conclusion

The Community Controlled Health Service and university partnership improved community oral health care access, its timely delivery and simultaneously provided valuable human capital development from the student training experience. The student‐led clinic's targeted Indigenous community showed oral health improvement over time. © 2023 Australian Dental Association.
Who cares about Aboriginal Aged Care? Evidence of home care support needs and use in rural South Australia
Authors: Thomas Kym , Dettwiller Pascale , Gonzalez‐Chica David
Published: May 2023

Objective

To assess awareness, needs and use of Australian Government‐funded home aged care services among Aboriginal and Torres Strait Islander Peoples from rural and remote South Australia.

Design

Mixed‐method study.

Setting

Four rural and remote communities with a higher proportion of Aboriginal populations (Ceduna, Port Augusta, Port Lincoln and Whyalla).

Participants

Fifty Aboriginal peoples aged 50–89 years (68% females) interviewed between August 2020 and October 2021.

Main Outcome Measures

Participant awareness, needs and unmet needs.

Results

88% of the participants indicated they needed home care support with daily activities (median number of needs = 3; interquartile range 2–6 needs), especially housework (86%) and transportation (59%). However, only 41% of those reporting current needs were receiving home care services. The most prevalent unmet needs were allied health (87%), housework (79%), help with meals/meals preparation (76%), shopping (73%) and personal care (73%). Overall, 62% of the participants were unaware of the Commonwealth Home Support Programme, and 54% were unaware of the Home Care Packages program. Qualitative data showed participants felt there is insufficient information and public consultation about these services for older Aboriginal adults. Regular communication in group activities was the preferable approach to becoming aware of these services rather than websites, posted materials or phone calls.

Conclusion

Further work is needed to increase home aged care service access for Aboriginal and Torres Strait Islander Peoples living in rural and remote settings. Promotion of these programmes through local group activities could facilitate access to these services and facilitate community engagement in decision‐making.
Searching for evidence in neonatology
Authors: Saugstad Ola Didrik , Kirpalani Haresh
Published: May 2023

Evidence‐based medicine has changed clinical practice by incorporating data from randomised controlled trials (RCTs). While some biases in RCTs are well recognised, we discuss some less acknowledged. Selection bias may arise in the consent stage. Industry‐funded studies more often report a positive outcome. Post‐hoc changes of outcome measures and other mis‐reporting lowers the reliability of outcome data. Finally, even the GRADE system retains subjectivity.

Conclusion

Moving from “intuition” into “evidence‐based” medicine involves grappling with several pitfalls. These pose challenges for authors, editors, reviewers, and readers. All require vigilance before drawing conclusions from presented data.
Peripheral nerve involvement in hereditary spastic paraplegia characterized by quantitative magnetic resonance neurography
Authors: Jacobi Heike , Weiler Markus , Sam Georges , Heiland Sabine , Hayes John M. , Bendszus Martin , Schüle Rebecca , Hayes Jennifer C.
Published: May 2023

Background and objectives

Hereditary spastic paraplegias (HSPs) are heterogenous genetic disorders. While peripheral nerve involvement is frequent in spastic paraplegia 7 (SPG7), the evidence of peripheral nerve involvement in SPG4 is more controversial. We aimed to characterize lower extremity peripheral nerve involvement in SPG4 and SPG7 by quantitative magnetic resonance neurography (MRN).

Methods

Twenty‐six HSP patients carrying either the SPG4 or SPG7 mutation and 26 age‐/sex‐matched healthy controls prospectively underwent high‐resolution MRN with large coverage of the sciatic and tibial nerve. Dual‐echo turbo‐spin‐echo sequences with spectral fat‐saturation were utilized for T2‐relaxometry and morphometric quantification, while two gradient‐echo sequences with and without an off‐resonance saturation rapid frequency pulse were applied for magnetization transfer contrast (MTC) imaging. HSP patients additionally underwent detailed neurologic and electroneurographic assessments.

Results

All microstructural (proton spin density [ρ], T2‐relaxation time, magnetization transfer ratio) and morphometric (cross‐sectional area) quantitative MRN markers were decreased in SPG4 and SPG7 indicating chronic axonopathy. ρ was superior in differentiating subgroups and identifying subclinical nerve damage in SPG4 and SPG7 without neurophysiologic signs of polyneuropathy. MRN markers correlated well with clinical scores and electroneurographic results.

Conclusions

MRN characterizes peripheral nerve involvement in SPG4 and SPG7 as a neuropathy with predominant axonal loss. Evidence of peripheral nerve involvement in SPG4 and SPG7, even without electroneurographically manifest polyneuropathy, and the good correlation of MRN markers with clinical measures of disease progression, challenge the traditional view of the existence of HSPs with isolated pyramidal signs and suggest MRN markers as potential progression biomarkers in HSP.
Organisational impact on the use of restrictive measures: The perspective of Swedish front‐line managers
Authors: Björne Petra , McGill Peter , Deveau Roy , Hofvander Björn
Published: May 2023

Background

Restrictive measures (RM) are prevalent in services for people with intellectual disabilities. This study investigates managerial awareness of RM and the nature of organisational supports required to reduce their use.

Method

A survey asked front‐line managers and staff what (RM) were used, their purpose, impact and importance (10‐item Likert scales) and what organisational changes were required (free text). Responses were analysed using descriptive methods and content analysis.

Results

Managers reported a lower use of RM, compared with staff. According to managers, RM were mainly used to keep service users from harm, their use having a significant impact. Opportunities to change practices were limited by a lack of resources and organisational support.

Conclusion

Front‐line managers seem to lack the capacity to address the use of RM due to organisational drift; limited manager time and opportunity to allocate resources; inadequate environments; and lack of skilled staff, knowledge and relevant professional input.
Climate change and food safety: Temperature impact on the attachment of Escherichia coli pathogroups on cress leaf
Authors: Samut Hilal , Namli Şahin , Ozdemir Fatma Neslihan , Çömlekçioğlu Nuray , Soyer Yeşim
Published: May 2023

Climate change and its worldwide effects are undeniable. Temperature increase due to climate change may affect foodborne pathogen survival on fresh produce. This study aimed to present an evaluation of climate change impact regarding temperature rise situations, on attachment of different pathogenic Escherichia coli strains on cress grown under controlled conditions. EHEC O157:H7, EAEC O104:H4 and EPEC O26 were inoculated with initial inoculum concentration of 8 log MPN/mL at different stages during growth to observe how inoculation time (7, 14, 21 and 28 days post sowing; dps) and route (seed and leaves) affect pathogen load on fresh produce. This study revealed that temperature increase designed according to mitigation scenarios for climate change (+2, +4 and +6 °C) did not cause any considerable change in pathogen persistence on leaf at 30 dps (~4.5 to 7 log MPN/g). In plants contaminated at later stage (21 and 28 dps), higher bacterial populations were obtained for all temperatures studied. Our results show that E. coli translocated towards leaf portions from seed and established significant amount of pathogen load on leaf (~4 to 5.3 log MPN/g). Also, inoculated bacteria have tightly bound to leaf (~3.5 to 7 log MPN/g) and cannot be eliminated by washing. Although persistence of E. coli O157:H7, O104:H4 and O26 did not differ significantly according to temperature, the bacterial load on the leaves was above infectious dose for humans.
Color match of ultra‐translucency multilayer zirconia restorations with different designs and backgrounds
Authors: Ghoveizi Rahab , Baghaei Maryam , Tavakolizadeh Sara , Tabatabaian Farhad
Published: May 2023

Purpose

The purpose of this in vitro study was to assess the color match of ultra‐translucency multilayer zirconia restorations with different designs and backgrounds.

Materials and methods

Thirty ultra‐translucency multilayer zirconia crown specimens were made in VITA classical shade B2 for a prepared maxillary central incisor. The specimens were divided into three groups based on the restoration design: veneered zirconia with a trestle design (VZT), veneered zirconia with a dentin core design (VZD), and full‐contour zirconia (FCZ). In the groups VZT and VZD, the zirconia specimens were layered with a feldspathic veneering ceramic. The specimens were seated on five different backgrounds: shade B2 composite resin, shade B2 zirconia, copper‐colored metal alloy, silver‐colored metal alloy, and the prepared central incisor. CIELab values of the labial middle sections of the crown specimens were measured with a spectrophotometer. Color differences between the specimens and a shade B2 VITA classical tab (as a control) were calculated from the ΔE*ab formula and compared with an acceptability threshold (ΔE*ab = 3.7) to be clinically explicated.

Results

Mean ΔE*ab values ranged between 1.17 and 8.48. The restoration design, the background type, and their interaction affected the ΔE*ab (p < 0.001). The mean ΔE*ab values for VZT with all backgrounds and for VZD with the silver‐colored metal background were greater than the threshold (p < 0.001), whereas the mean ΔE*ab values for VZD with the other backgrounds and FCZ with all backgrounds were less than the threshold (p = 1).

Conclusions

Restoration design and background type affected the color match of ultra‐translucency multilayer zirconia restorations. VZT restorations on all backgrounds and VZD restorations on a silver‐colored metal background showed color mismatches. However, VZD restorations on the other backgrounds and FCZ restorations on all backgrounds demonstrated color matches.
How do people communicate about sensory descriptors in social media? An investigation comprising floral descriptors, four beverages, and thirteen English‐speaking countries
Authors: Mellish Elizabeth , Gomez‐Corona Carlos , Mariutti Lilian R. B. , Rodrigues Heber
Published: May 2023

The internet has become a mainstay of modern‐day life, with people worldwide using social media platforms to discuss ideas and exchange opinions. In recent years, social media platforms have become a data source for research focusing on consumers' natural and spontaneous lexicons. The increased use of social media and virtual meetings means people can exchange ideas, and cultural boundaries have blurred. Thus, this study aims to investigate how culture influences the use of the beverage descriptor “floral” on social media for four different beverages when people share the same language. A social media study was performed, collecting data over 1 year in 13 English‐speaking countries: Australia, Canada, South Africa, the United Kingdom, Singapore, New Zealand, and seven Caribbean Islands. Words associated with four beverages (beer, cocktails, tea, and wine) and floral were filtered on social media mentions. A total of 258,221 mentions were obtained from different types of social media such as Twitter, Instagram, Facebook, and so forth. The mentions were filtered to obtain the frequency of words by country. Each beverage was analyzed separately, and contingency tables were arranged by country and descriptor. A correspondence analysis was performed on each contingency table to identify relative similarities and dissimilarities between the countries in the study. Overall, rose was the most cited floral descriptor, and there was a link between beer and wine descriptions. However, for cocktails and tea, the floral descriptors varied per country. Thus, it suggests that the impact of culture on the use of floral descriptors depends on the beverage being discussed.

Practical Applications

The results obtained in this study have relevance for people interested in sensory and specifically in beverage descriptions, as well as those involved in the alcohol industry, particularly those involved in beer and wine, and the non‐alcohol industry (tea). These results can drive the construction of applied and effective marketing strategic plans for the beverage and flavor industry in the areas covered by the study.
Prevalence and Antifungal Susceptibility of Sporothrix species in Guangzhou, Southern China
Authors: Lin Li , Huang Junhao , Fang Junyue , Li Jiahao , Cai Wenying , Zhang Jing , Lu Sha
Published: May 2023

Introduction

Sporotrichosis is a subcutaneous and chronic infection caused by traumatic inoculation of pathogenic sporothrix species, usually infecting the skins and subcutaneous tissues of humans and animals. However, the lack of epidemiological data required further molecular identification to describe the distribution of this fungus in our region. In this study, forty‐eight clinical sporothrix isolated from Sun Yat‐Sen Memorial Hospital were classified, and the susceptibility of each strain to seven antifungal agents was determined.

Methods

Forty strains of S. globosa and eight strains of S. shenkshii were identified via colony morphology and PCR sequencing of calmodulin gene.

Results

Antifungal susceptibility tests of the mycelial phase in vitro showed terbinafine (TRB) and luliconazole (LULI) were the most effective, followed by itraconazole (ITZ) and amphotericin B (AMB). By contrast, voriconazole (VCZ), 5‐flucytosine (5FC) and fluconazole (FCZ) have low efficacy with high MIC.

Conclusion

Our results showed a predominantly S. globosa infection trend in southern China. Simultaneously, sporothrix is sensitive to TRB, LULI, ITZ and AMB whereas resistant to FCZ. This study firstly reports antifungal sensitivity test in vitro and epidemiological correlation analysis of sporothrix in southern China, and also the first time to find that sporothrix is sensitive to LULI.
Integrated testis transcriptome and whole genome analysis of sexual maturity in Large White and Tongcheng pigs
Authors: Li Xiu‐Ling , Wu Qingqing , Wang Tengfei , Zhang Lingyan , Wu Xianmeng , Zhang Yu , Liang Wan , Du Xiaoyong , Liu Xiao‐Lei , Zhou Xiang , Liu Bang
Published: May 2023

Testicular development and spermatogenesis play critical roles in male fertility and sexual maturation. To explore the genetic basis and key genes related to sexual maturity, we measured serum testosterone content and analysed testis tissue sections of Large White (LW) and Tongcheng (TC) boars at an immature age. We then screened differentially expressed genes (DEGs) in testis development in both breeds using RNA‐seq. Finally, we analysed the selection signatures of both breeds to investigate which DEGs were subjected to positive selection. Our findings showed that serum testosterone contents in TC pigs (~4 ng/mL) were much higher than those in LW pigs (<0.95 ng/mL). Haematoxylin and eosin staining of testicular sections showed that the cross‐sectional areas and perimeters of the seminiferous tubules in TC testes were larger and longer than those in LW pigs. A total of 5068 DEGs were selected by filtering criteria of q value <0.05 and |log2(fold change)| ≥ 1. Gene Ontology analysis revealed that 250 genes were enriched in 11 biological process categories involved in sexual maturity. Most candidate genes, including TRIP13, NR6A1, STRA8, PCSK4, ACRBP, TSSK1B and TSSK6, were under positive selection. These results provide a better understanding of the genetic basis for testicular maturation and are useful for enhancing boar reproductive traits through molecular breeding.
Evaluation of oral health education programs for oral health of individuals with visual impairment: An umbrella review
Authors: Sardana Divesh , Ritto Fernanda P. , Ciesla David , Fagan Timothy R.
Published: May 2023

Aim

To exemplify, summarize and critically appraise the systematic reviews (SRs) that evaluated different oral health education (OHE) interventions in individuals with visual impairment (VI).

Methodology

Six electronic databases were searched for SRs evaluating OHE programs in individuals with VI. The internal validity of the included SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews‐2 (AMSTAR‐2) tool. The degree of overlap of the primary studies in the included SRs was calculated using the “corrected covered area (CCA)” approach.

Results

Seven SRs were included in this umbrella review that included 30 primary studies with a CCA of 26% (very high overlap). Six of the included SRs were assessed to have critically low confidence in the results, whereas only one had moderate confidence.

Conclusions

A combination of various OHE methods for individuals with VI might be better than using one method alone to improve oral hygiene. There is no conclusive evidence that one OHE method is superior to others. However, the evidence of OHE in improving the outcomes related to dental trauma or caries is inconclusive. Furthermore, it appears that most of the evaluations of oral health programs come from limited parts of the world, and data from many other regions is lacking.
Mass spectrometric‐based assessment of the serum kappa to lambda immunoglobulin light chain ratio (κ:λ) in dogs with immunoglobulin secretory diseases
Authors: Moore A Russell , Brown Kitty , Chapman Cecelia , Broeckling Corey
Published: May 2023

The ratio of κ light chains to λ light chains (κ:λ) in serum is used as a biomarker of immunoglobulin secreting neoplasia in humans but has not been evaluated in dogs. A mass‐spectrometry based method for determining the canine serum κ:λ was developed and used to evaluate samples from control dogs, dogs with an infectious aetiology, dogs with secretory plasma cell tumours (sPCT) and dogs with non‐secretory B cell neoplasia. A human‐targeted immunoturbidometric κ:λ assay and immunofixation using antisera targeting human κ light chain or λ light chain was also performed on all samples. Using whole serum samples, the MS‐based κ:λ method identified 5 sPCT as κ‐predominant (mean κ:λ = 3.307) and 5 sPCT as λ‐predominant (mean κ:λ = 0.023) and documented differences between these groups and all other groups (p < 0.05 for all). The infectious aetiology group had a lower mean κ:λ ratio (mean κ:λ = 0.069) than control samples (mean κ:λ = 0.103, p = 0.035). Similar results were obtained when samples were enriched for proteins between 10 and 50 kDa using size exclusion chromatography, except for the statistical difference between the control and infectious aetiology group. All λ‐predominant cases had only anti‐human λ light chain labelling by immunofixation. Three κ‐predominant cases had only anti‐human κ‐light chain labelling and the remaining two cases did not label with either antisera by immunofixation. The immunoturbidometric method had high analytical CV% (λ light chain CV = 13%, κ light chain CV = 50%), was unable to measure light chains in 20.5% of samples and did not distinguish groups. The data suggests that the human‐targeted immunoturbidometric method would not be diagnostically useful and that the MS‐derived serum κ:λ may be a useful biomarker of canine immunoglobulin secretory neoplasia which may have the ability to distinguish neoplasia from infectious causes of immunoglobulin secretion.
The Role of International Organizations and Partnerships for Emergency Education in Ethiopian Higher Education Institutions: Online Learning During COVID-19 Pandemic
Authors: Tsega Tigist Wuhib
Published: May 2023

The purpose of the study was to explore the role of international organizations and partnerships that provided support to the higher education institutions of Ethiopia during the active COVID-19 emergency period. In addition, the study aimed to explore the experiences and challenges of students in working with the online learning platforms that were made available during the pandemic. Qualitative case study was employed. Official email communications and documents were reviewed from two USA based partner organizations that responded to the higher education teaching need during the pandemic. In addition, 30 graduate students from counseling psychology program of the School of Psychology, Addis Ababa University (AAU) were involved in responding to a qualitative questionnaire in Google forms. The qualitative data were analyzed using thematic analysis. All partnership and collaboration efforts were important in supporting the teaching need of the local institutions during the pandemic. The major themes that emerged as positive experiences were (a) ensuring continuity, (b) new opportunity, (c) safety and economic management, and (d) working with different platforms. The major themes that emerged as challenges were (a) difficulty to adjust oneself, (b) lack of personal touch, and (c) internet and power disruption. The study provided critical message of social infrastructures are highly important as that of physical infrastructure need during emergency education. Additional implications are highlighted in making education systems more resilient.
In-demand, interactive and an appetite for more: Analysis of learner enrolments and feedback in an open-access introductory telehealth course during COVID-19
Authors: Seaman Claire Ellen , Green Elyce , Cox Jennifer , Freire Kate , Mansfield Jacki
Published: May 2023

Introduction: The use of telehealth has accelerated with health service delivery restrictions experienced during the COVID-19 pandemic. This research assessed learner enrolments and feedback in an introductory, online, open-access, rural-focused telehealth training course to inform future telehealth education design.
Methods: Differences in enrolled learner demographics “before” (n = 331) and “after” (n = 3,776) COVID-19-related changes in Australia were assessed. Content analysis of learner feedback was conducted to understand the beneficial aspects of the course and to inform future telehealth education and training development.
Results: Concurrent with telehealth changes announced in Australia in March 2020, enrolments in the course sharply increased. While students comprised most enrolments, initial growth was strongest amongst health educators and health professionals. More learners enrolled from major city areas and other countries. User feedback indicated the flexible delivery mode, policy, links to resources and multimedia content were the most beneficial aspects of the course. Learners would like more client perspectives as well as discipline- and context-specific information. There is also an appetite for more practice-based telehealth education.
Conclusions: Growth in demand for the course and positive learner feedback showed it was filling an important introductory training gap. Learner feedback also highlighted several perceived barriers among learners in being able to implement best-practice telehealth in their current or future practice. This feedback could be used to inform the design of further telehealth training for health professionals and students to, ultimately, enhance the use of telehealth technologies.
Longitudinal Association of Changes in Parental Correlates With Screen Time in Chinese Preschoolers
Authors: Wu Yan , Ye Sunyue
Published: May 2023

Background: This study aimed to explore the relationship between the changes in parent-related factors and preschoolers exceeding screen time (ST) recommendations. Methods: A longitudinal analysis using 2-year follow-up data from 4 kindergartens (n = 409) was conducted in Zhejiang, China, from 2019 to 2021. Multivariate logistic regression models were used to determine the potential parental modifiable predictors. Results: The significant associations of baseline ST, change in screen accessibility, and the interaction of preschooler ST with maternal ST change with preschooler follow-up ST were observed. For preschool-aged children with baseline ST ≤ 1 hour per day, the follow-up of preschoolers with ST > 1 hour per day increased significantly when parental clarity of their ST rules decreased or remained low. For preschool children with baseline ST > 1 hour per day, follow-up ST increased significantly when their father kept ST >2 hours per day, when the screen accessibility became or remained easy, or when parental awareness of the ST decreased. Conclusions: Changes in parental correlates played an important role in preschooler ST based on 2-year longitudinal data. Early interventions should focus on improving the clarity of parental rules and perceptions, as well as on reducing parental ST and accessibility of home screens.
Current Technologies and Practices to Assess External Training Load in Paralympic Sport: A Systematic Review
Authors: Stieler Eduardo , de Mello Marco T. , Lôbo Ingrid L.B. , Gonçalves Dawit A. , Resende Renan , Andrade André G. , Lourenço Thiago F. , Silva Anselmo A.C. , Andrade Henrique A. , Guerreiro Renato , Silva Andressa
Published: May 2023

Context: Knowing the methods to assess the external load in Paralympic sports can help multidisciplinary teams rely on scientific evidence to better prescribe and monitor the athlete’s development, improving sports performance and reducing the risk of injury/illness of Paralympic athletes. Objectives: This review aimed to systematically explore the current practices of quantifying the external load in Paralympic sports and provide an overview of the methods and techniques used. Evidence Acquisition: A search in PubMed, Web of Science, Scopus, and EBSCO was carried out until November 2022. The measures of interest were objective methods for quantifying the external load of training or competition. The inclusion criteria for the studies were as follows: (1) peer-reviewed article; (2) the population were Paralympic athletes; (3) evaluated during training or competition; (4) reported at least one external load measure; and (5) published in English, Portuguese, or Spanish. Evidence Synthesis: Of the 1961 articles found, 22 were included because they met the criteria, and 8 methods were identified to quantify the external load in training or competition in 8 Paralympic sports. The methods varied according to the characteristics of the Paralympic sports. To date, the devices used included an internal radiofrequency-based tracking system (wheelchair rugby) a miniaturized data logger (wheelchair tennis, basketball, and rugby); a linear position transducer (powerlifting and wheelchair basketball); a camera (swimming, goalball, and wheelchair rugby); a global positioning system (wheelchair tennis); heart rate monitors that assess external load variables in set (paracycling and swimming) and an electronic timer (swimming). Conclusions: Different objective methods were identified to assess the external load in Paralympic sports. However, few studies showed the validity and reliability of these methods. Further studies are needed to compare different methods of external load quantification in other Paralympic sports.
Developing Vaccine Literacy for Urban Health Science Students, the Future Health Workforce
Authors: Carmona Naydu , Trujillo Monica
Published: May 2023

The 2019 coronavirus disease pandemic underlined a shift in attitudes against vaccines and a rise in hesitancy among some members of the population, despite the overwhelming evidence that vaccinations are one of the most successful and safe health interventions. Research has shown that vaccine hesitancy is complex and can result from an intersectionality of multiple factors.
Host Association and Spatial Proximity Shape but Do Not Constrain Population Structure in the Mutualistic Symbiont Xenorhabdus bovienii
Authors: Papudeshi Bhavya , Rusch Douglas B. , VanInsberghe David , Lively Curtis M. , Edwards Robert A. , Bashey Farrah
Published: May 2023

Microbial populations and species are notoriously hard to delineate. We used a population genomics approach to examine the population structure and the spatial scale of gene flow in
Xenorhabdus bovienii
, an intriguing species that is both a specialized mutualistic symbiont of nematodes and a broadly virulent insect pathogen.
Apobec3A Deamination Functions Are Involved in Antagonizing Efficient Human Adenovirus Replication and Gene Expression
Authors: Göttig Lilian , Weiß Christina , Stubbe Miona , Hanrieder Lisa , Hofmann Samuel , Grodziecki Alessandro , Stadler Daniela , Carpentier Arnaud , Protzer Ulrike , Schreiner Sabrina
Published: May 2023

Our data provide a novel conceptual insight into the virus/host-cell interplay, changing the current view of how a host-cell can defeat a virus infection. Thus, our study reveals a novel and general impact of cellular Apobec3A on the intervention of human adenovirus (HAdV) gene expression and replication by improving the host antiviral defense mechanisms, thereby providing a novel basis for innovative antiviral strategies in future therapeutic settings.
Transmembrane Transcription Regulators Are Widespread in Bacteria and Archaea
Authors: Demey Lucas M. , Gumerov Vadim M. , Xing Jiawei , Zhulin Igor B. , DiRita Victor J.
Published: May 2023

One-component signal transduction systems are the major class of signal transduction systems among bacteria and are commonly cytoplasmic. TTRs are a group of unique one-component signal transduction systems that influence transcription from the cytoplasmic membrane.
Comparison of Performances of GeneXpert MTB/RIF, Bactec MGIT 960, and Bactec Myco/F Systems in Detecting Mycobacterium tuberculosis in Biopsy Tissues: a Retrospective Study
Authors: Zhao Jiankang , Pu Danni , Zhang Yulin , Qu Jiuxin , Lu Binghuai , Cao Bin
Published: May 2023

Mycobacterium tuberculosis
(MTB) poses a severe threat to public health worldwide. The diagnosis of tuberculosis is challenging due to the low load of the microorganism in samples.
Efficient SARS-CoV-2 Surveillance during the Pandemic-Endemic Transition Using PCR-Based Genotyping Assays
Authors: Koets Lianne , van Leeuwen Karin , Derlagen Maaike , van Wijk Jalenka , Keijzer Nadia , Feenstra Jelena D. M. , Gandhi Manoj , Sorel Oceane , van de Laar Thijs J. W. , Koppelman Marco H. G. M.
Published: May 2023

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) genome changes constantly. It is estimated that there are thousands of variants of SARS-CoV-2 by now.
Garnet growth and diffusion zoning during the late Paleoproterozoic metamorphism, North Altyn area, SE Tarim Craton, NW China: Implications for a long-lived hot orogen
Authors: Wu Hailin , Zhu Wenbin , Ge Rongfeng
Published: May 2023

Metamorphic rocks encode invaluable information on the burial and exhumation history of rocks that is critical to our understanding of orogens. In this work, zircon U−Pb dating, pseudosection, and garnet zoning modeling were performed on samples from the North Altyn area, SE Tarim Craton, NW China. Zircon U−Pb geochronological data indicate that the peak metamorphism occurred at ca. 2.0 Ga. Pseudosection isopleth thermobarometry using garnet growth zoning of the sample from the northern part of the North Altyn area (Kalatashtagh) reveals a decompression and heating path to a peak temperature of 735 °C and 0.74 GPa under the equilibrium crystallization model. The preservation of growth zoning under high temperature requires relatively rapid cooling. In contrast, garnet from the southern part of the North Altyn area (Aktashtagh) preserves diffusion zoning. Metamorphic peak occurs at 670−735 °C and 0.67−0.73 GPa, which suggests a high dT/dP-type metamorphism. Diffusion zoning modeling suggests an extremely slow cooling rate of 1−5 °C/m.y., which indicates prolonged (∼100 m.y.) crustal residence time at high temperature. This requires a long-term heat supply, most likely from radiogenic heat from buried sediments or heat conducted from the asthenosphere. The high dT/dP and slow cooling rate, combined with extensive crustal anatexis from previous studies, indicate that the late Paleoproterozoic North Altyn Orogen is a long-lived hot orogen rather than a subduction−accretionary complex. We propose a tectonic model that involves a ca. 2.1−2.0 Ga arc−back-arc system in the SE Tarim Craton. The back-arc basin was subsequently closed by northward underthrusting due to arc−arc/continental collision at ca. 2.0−1.95 Ga during the integration of the Tarim Craton into the Columbia/Nuna supercontinent.
Profile and triage validity of trauma patients triaged green: a prospective cohort study from a secondary care hospital in India
Authors: Anthony Aroke Anna , Dutta Rohini , Sarang Bhakti , David Siddarth , O'Reilly Gerard , Raykar Nakul P , Khajanchi Monty , Attergrim Jonatan , Soni Kapil Dev , Sharma Naveen , Mohan Monali , Gadgil Anita , Roy Nobhojit , Gerdin Wärnberg Martin
Published: May 2023

Objectives

To evaluate the profile of non-urgent patients triaged ‘green’, as part of a triage trial in the emergency department (ED) of a secondary care hospital in India. The secondary aim was to validate the triage trial with the South African Triage Score (SATS).

Design

Prospective cohort study.

Setting

A secondary care hospital in Mumbai, India.

Participants

Patients aged 18 years and above with a history of trauma defined as having any of the external causes of morbidity and mortality listed in block V01–Y36, chapter XX of the International Classification of Disease version 10 codebook, triaged green between July 2016 and November 2019.

Primary and secondary outcome measures

Outcome measures were mortality within 24 hours, 30 days and mistriage.

Results

We included 4135 trauma patients triaged green. The mean age of patients was 32.8 (±13.1) years, and 77% were males. The median (IQR) length of stay of admitted patients was 3 (13) days. Half the patients had a mild Injury Severity Score (3–8), with the majority of injuries being blunt (98%). Of the patients triaged green by clinicians, three-quarters (74%) were undertriaged on validating with SATS. On telephonic follow-up, two patients were reported dead whereas one died while admitted in hospital.

Conclusions

Our study highlights the need for implementation and evaluation of training in trauma triage systems that use physiological parameters, including pulse, systolic blood pressure and Glasgow Coma Scale, for the in-hospital first responders in the EDs.
Using routine healthcare data to determine the factors associated with hospital length of stay for hypertensive inpatients in Ghana, 2012–2017
Authors: Afetor Maxwell , Harris Emmanuel , Der Joyce B , Narh Clement T
Published: May 2023

Objective

Hospitalisation for hypertension continues to rise in Ghana. It has been revealed that in Ghana, patients hospitalised for hypertension spend between 1 and 91 days on admission. This study therefore sought to estimate the hospital length of stay (LoS) of hypertensive patients and individual or health-related factors that may influence the hospitalisation duration in Ghana.

Methods

We employed a retrospective study design that used routinely collected health data on hospitalised hypertensive patients in Ghana from the District Health Information Management System database between 2012 and 2017 to model LoS using survival analysis. The cumulative incidence function for discharge stratified by sex was computed. To investigate the factors that influence hospitalisation duration, multivariable Cox regression was used.

Results

Out of a total of 106 372 hypertension admissions, about 72 581 (68.2%) were women. The mean age of the patients was 55.3 (SD=17.5) years. Overall, the median LoS was 3 days with almost 90% of all patients being discharged by the 10th day of admission. Patients admitted in Volta region (HR: 0.89, p<0.001) and Eastern region (HR: 0.96, p=0.002) experienced late discharge as compared with patients admitted in Greater Accra. It was revealed that women (HR: 1.09, p<0.001) were discharged earlier than men. However, having a surgical procedure (HR: 1.07, p<0.001) and having comorbidities such as diabetes (HR: 0.76, p<0.001) and cardiovascular diseases other than hypertension (HR: 0.77, p<0.001) increased the LoS of patients.

Conclusion

This study provides the first comprehensive assessment of factors influencing hospitalisation duration of admissions due to hypertension in Ghana. Female sex, all regions except Volta region and Eastern region, experienced early discharge. However, patients with a surgical intervention and comorbidity experienced late discharge.
Observational study of organisational responses of 17 US hospitals over the first year of the COVID-19 pandemic
Authors: Choo Esther K , Strehlow Matthew , Del Rios Marina , Oral Evrim , Pobee Ruth , Nugent Andrew , Lim Stephen , Hext Christian , Newhall Sarah , Ko Diana , Chari Srihari V , Wilson Amy , Baugh Joshua J , Callaway David , Delgado Mucio Kit , Glick Zoe , Graulty Christian J , Hall Nicholas , Jemal Abdusebur , KC Madhav , Mahadevan Aditya , Mehta Milap , Meltzer Andrew C , Pozhidayeva Dar'ya , Resnick-Ault Daniel , Schulz Christian , Shen Sam , Southerland Lauren , Du Pont Daniel , McCarthy Danielle M
Published: May 2023

Objectives

The COVID-19 pandemic has required significant modifications of hospital care. The objective of this study was to examine the operational approaches taken by US hospitals over time in response to the COVID-19 pandemic.

Design, setting and participants

This was a prospective observational study of 17 geographically diverse US hospitals from February 2020 to February 2021.

Outcomes and analysis

We identified 42 potential pandemic-related strategies and obtained week-to-week data about their use. We calculated descriptive statistics for use of each strategy and plotted percent uptake and weeks used. We assessed the relationship between strategy use and hospital type, geographic region and phase of the pandemic using generalised estimating equations (GEEs), adjusting for weekly county case counts.

Results

We found heterogeneity in strategy uptake over time, some of which was associated with geographic region and phase of pandemic. We identified a body of strategies that were both commonly used and sustained over time, for example, limiting staff in COVID-19 rooms and increasing telehealth capacity, as well as those that were rarely used and/or not sustained, for example, increasing hospital bed capacity.

Conclusions

Hospital strategies during the COVID-19 pandemic varied in resource intensity, uptake and duration of use. Such information may be valuable to health systems during the ongoing pandemic and future ones.
Short course antibiotic treatment of Gram-negative bacteraemia (GNB5): a study protocol for a randomised controlled trial
Authors: Tingsgård Sandra , Israelsen Simone Bastrup , Thorlacius-Ussing Louise , Frahm Kirk Karina , Lindegaard Birgitte , Johansen Isik S , Knudsen Andreas , Lunding Suzanne , Ravn Pernille , Østergaard Andersen Christian , Benfield Thomas
Published: May 2023

Introduction

Prolonged use of antibiotics is closely related to antibiotic-associated infections, antimicrobial resistance and adverse drug events. The optimal duration of antibiotic treatment for Gram-negative bacteremia (GNB) with a urinary tract source of infection is poorly defined.

Methods and analysis

Investigator-initiated multicentre, non-blinded, non-inferiority randomised controlled trial with two parallel treatment arms. One arm will receive shortened antibiotic treatment of 5 days and the other arm will receive antibiotic treatment of 7 days or longer. Randomisation will occur in equal proportion (1:1) no later than day 5 of effective antibiotic treatment as determined by antibiogram. Immunosuppressed patients and those with GNB due to non-fermenting bacilli (Acinetobacterspp,Pseudomonasspp),Brucellaspp,Fusobacteriumspp or polymicrobial growth are ineligible.

The primary endpoint is 90-day survival without clinical or microbiological failure to treatment. Secondary endpoints include all-cause mortality, total duration of antibiotic treatment, hospital readmission andClostridioides difficileinfection. Interim safety analysis will be performed after the recruitment of every 100 patients. Given an event rate of 12%, a non-inferiority margin of 10%, and 90% power, the required sample size to determine non-inferiority is 380 patients. Analyses will be performed on both intention-to-treat and per-protocol populations.

Ethics and dissemination

The study is approved by the Danish Regional Committee on Health Research (H-19085920) and the Danish Medicines Agency (2019-003282-17). The results of the main trial and each of the secondary endpoints will be submitted for publication in a peer-reviewed journal.

Trial registration number

ClinicalTrials.Gov:NCT04291768.
Home-based guided hypnotherapy for children with functional abdominal pain and irritable bowel syndrome in primary care: study protocol for a randomised controlled trial
Authors: Ganzevoort Ilse Nadine , Fokkema Tryntsje , Mol-Alma Harma J , Heida Anke , Van der Veen Adriëlla L , Vermeulen Karin , Benninga Marc A , Vlieger Arine M , Berger Marjolein Y , Holtman G A
Published: May 2023

Introduction

Children often present to primary care with functional abdominal pain (FAP) or irritable bowel syndrome (IBS), and around half still have abdominal complaints 1 year later. Hypnotherapy is an evidence-based treatment that is used in specialist care, but it lacks evidence in primary care. This study will investigate the (cost) effectiveness of home-based guided hypnotherapy for children with FAP or IBS in primary care.

Methods and analysis

We report the design of a pragmatic randomised controlled trial among children aged 7–17 years, diagnosed with FAP or IBS by their general practitioner (GP), with assessments over 12 months. The control group will receive care as usual (CAU) by their GP (eg, communication, education and reassurance), while the intervention group will receive CAU plus 3 months of home-based guided hypnotherapy via a website. The primary outcome will be the proportion of children with adequate relief from abdominal pain/discomfort at 12 months, analysed on an intention-to-treat basis. Secondary outcomes will include the adequacy of pain relief at 3 and 6 months, pain/discomfort severity, pain frequency and intensity, daily functioning and impact on function, anxiety and depression, pain beliefs, sleep disturbances, school absence, somatisation, and healthcare use and costs. We must include 200 children to determine a 20% difference in those with adequate relief (55% control vs 75% intervention).

Ethics and dissemination

The Medical Ethics Review Committee of the University Medical Center Groningen, the Netherlands, approved this study (METc2020/237). The results will be disseminated to patients, GPs and other stakeholders via email, a dedicated website, peer-reviewed publications and presentations at national and international conferences. We plan to collaborate with the Dutch Society of GPs to implement the results in clinical practice.

Trial registration number

NCT05636358.
Attitudes, confidence, barriers and current practice of managing depression in patients with COPD in Saudi Arabia: a national cross-sectional survey
Authors: Siraj Rayan A , Alrajeh Ahmed , Aldabayan Yousef S , Aldhahir Abdulelah Mastour , Alqahtani Jaber S , Alghamdi Saeed M , Alqarni Abdullah A , Banakher Bashaer O , Algarni Saleh S , Alhotye Munyra , Khormi Shahad K , Alghamdi Hussam S , Alotaibi Faisal F , Alahmari Mushabbab A
Published: May 2023

Objective

To investigate physicians’ perceptions and current practices of identifying and managing depression in patients with chronic obstructive pulmonary disease (COPD).

Design

A cross-sectional online survey was employed between March and September 2022.

Settings

Saudi Arabia.

Participants

1015 physicians, including general practitioners and family, internal and pulmonary medicine specialists.

Primary outcome measures

Physicians’ perceptions, confidence, practices and barriers to recognising and managing depression in patients with COPD.

Results

A total of 1015 physicians completed to the online survey. Only 31% of study participants received adequate training for managing depression. While 60% of physicians reported that depression interferes with self-management and worsens COPD symptoms, less than 50% viewed the importance of regular screening for depression. Only 414 (41%) physicians aim to identify depression. Of whom, 29% use depression screening tools, and 38% feel confident in discussing patients’ feelings. Having adequate training to manage depression (OR: 2.89; 95% CI: 2.02 to 3.81; p<0.001) and more years of experience (OR: 1.25; 95% CI: 1.08 to 1.45; p=0.002) were associated with the intention to detect depression in COPD patients. The most common barriers linked to recognising depression are poor training (54%), absence of standard procedures (54%) and limited knowledge about depression (53%).

Conclusion

The prevalence of identifying and confidently managing depression in patients with COPD is suboptimal, owing to poor training, the absence of a standardised protocol and inadequate knowledge. Psychiatric training should be supported in addition to adopting a systematic approach to detect depression in clinical practice.