bluuebunny/crossref_metadata_2025 huggingface dataset:
898 Is Primary Total Hip Arthroplasty Safe in Recipients of Solid Organ Transplants, and What Are the Considerations? a Systematic Review and Meta-analysis
Authors: Ahmed S , Lakha A , Remtulla M , Malik S , O’Callaghan J
Published: July 2024

Aim

Solid organ transplantation (SOT) is rising, with improvements in surgical technique and immunosuppressive therapy increasing patient survival. Age-related degeneration and long-term steroid therapy in SOT recipients lead to higher incidence of osteoarthritis and osteonecrosis. Total hip arthroplasty (THA) is offered electively for these indications. This meta-analysis assessed THA-related complications in SOT versus non-SOT recipients, reporting revision, infection rates, and all-cause mortality.

Method

This review was carried out using the PRISMA framework. A literature search of Medline, Embase, Transplant library, and Cochrane Library was carried out. Full text articles were screened. Summary statistics for outcomes of interest underwent meta-analyses to a confidence interval (CI) of 95% and are presented as Forest plots for Odds Ratio (OR).

Results

Literature search returned 1164 unique titles/s. 36 met inclusion criteria; 6 were retrospective cohort-studies. Meta-analysis of 5 studies showed no evidence of significant increase in revision rates with prior SOT, OR=0.67 (95%CI: 0.36-1.23, p=0.19). Meta-analysis of 6 studies showed no significant increase in infection (joint/surgical site) infection with prior SOT, OR=1.18 (95%CI: 0.40-3.50, p=0.77). Meta-analysis of 3 studies showed significant increase in all-cause mortality over 12 months post-arthroplasty, OR=1.99 (95%CI: 0.99-3.99, p=0.05). We report these summary statistics for the remaining case series.

Conclusions

We conclude that there is no significant increase in revision and infection rates for THA in SOT recipients. Consideration of a significant increase in all-cause mortality must be noted prior to offering this procedure to SOT recipients. Prospective studies are needed to assess risks/benefits of THA in SOT recipients.
1087 Factors That Impact Cold Ischaemia Time for Deceased Donor Kidney Transplants: Results of a National Transplant Access to Theatre Audit (NTACT)
Authors: Mujeeb M , Borbas B , Tanase A , Aroori S
Published: July 2024

Aim

Deceased donor kidney utilisation confronts challenges leading to prolonged cold ischemia time (CIT), affecting graft survival. Despite these challenges, an understanding of the obstacles remains unclear. This audit aims to identify the factors that prolong CIT.

Method

A multicentre, prospective audit of adult deceased donor kidney-only transplants spanned 14 UK transplant centres from February to September 2022. Data, encompassing time intervals between important checkpoints pre-transplantation and perceived reasons for delays, were collected through RedCap. Descriptive statistics was used for analysis.

Results

Data from 476 kidney-only transplants were gathered (29 excluded for incomplete/incorrect data). Of these, 230 were donations after brainstem death (DBD) organs, and 202 were donations after circulatory death (DCD) organs. Median CIT was 10:55 (IQR:08:11-15:13) for DBD organs and 11:19 (IQR:08:31-15:10) for DCD organs, with 42% of DCD and 15% of DBD organs surpassing national CIT recommendations. Median time from organ arrival to knife to skin was 04:02 (IQR:02:35-07:35). Full and virtual crossmatches constituted 35% and 65%, respectively, with 16% of results arriving after the organ arrives at centre. Anaesthetic time had a median duration of 00:55 (IQR:00:39-01:10) and Knife to skin to organ perfusion was 01:25 (01:10-01:51). Delays reported in 34% of transplant cases, most common causes were the availability of surgical and anaesthetic teams, porters, and the operating theatre.

Conclusions

This audit allowed us to uncover the factors that prolong CIT at each stage of the transplantation post-arrival. These findings will guide the establishment of realistic targets for optimizing processes in the future.
9 Early vs Late Definitive Fixation of Pelvic Ring Fractures in Polytraumatized Patients. a Systematic Review and Meta-Analysis
Authors: Oochit K , Imran A , Marsh A
Published: July 2024

Aim

The aim of this systematic review is to compare the short-term clinical outcomes between early (EDF) and late definitive fixation (LDF) in polytraumatized patients with pelvic ring fractures (PRF).

Method

The following databases: Embase, Medline and Cochrane Library were searched until June 2022. Studies comparing EDF and LDF for PRF in polytrauma patients defined as ISS >15 were included. The methodological quality of studies was assessed using the Newcastle Ottawa Scale.

Results

Out of 869 studies screened, 10 were included in the meta-analysis with a total of 2918 patients. The most common time point used to define EDF was within 24 hours of hospital admission and LDF (>24hr). The most common reasons for LDF were surgeon’s choice, availability of pelvic surgeon and transfer from other hospitals. Our meta-analysis revealed that EDF was associated with a reduced length of hospital stay (WMD=-3.52 days; 95% CI: [-5.43 to -1.62], p<0.0003) and lower incidence of ARDS (RR=0.48; 95% CI: [0.20 to 1.18], p=0.04). No significant association was found in mortality, length of ICU stays, multi-organ failure, sepsis and surgical site infection between EDF and LDF.

Conclusions

These findings suggest that early definitive fixation may be a safe and viable option with no increased risk of complications and mortality. However, the adequacy of resuscitation and the estimate of physiologic reserve should be balanced with the risks of operative fixation in all patients. Further prospective validation studies are warranted to test the predictive ability of the various proposed trauma care models and stratify patients for EDF.
803 Outcomes of Radical Nephroureterectomy: An Australian Multicentre Experience Using a Dedicated Upper Tract Data Registry
Authors: Harrington C I , Chui W , Kealey J , Picardo A , Hayne D , McCombie S , Sengupta S
Published: July 2024

Introduction

Radical nephroureterectomy (RNU) is used for the treatment of upper tract urothelial carcinoma (UTUC). It is a procedure with considerable morbidity. Australian data on UTUC is limited, and we have recently developed the ACCEPT-U database to try and address this. This study aims to examine the surgical and oncological outcomes in patients who have undergone RNU.

Method

We collected data using the ACCEPT-U database on patients who underwent (RNU) across two tertiary centres in Victoria and Western Australia between 2013 and 2022. Our primary outcomes were overall survival at one, two, and five years. Our secondary outcomes included postoperative complications and recurrence data.

Results

One hundred and one patients underwent RNU during the study period. The median age was 73 (IQR 64.0 to 80.5) years. The median hospital length of stay was 7 days (IQR 5-11) overall. Neither operative technique, CCI nor age affected hospital length of stay (p >0.05). The 30-day post-operative complication rate was 35% (n=35), with a median Clavien Dindo of II. Overall survival rates at one, two, and five years were 89%. (95% CI 81.4 - 94.0%); 79% (95% CI 70.2 - 86.1%) and 73% (95% CI 63.9 – 81.0%). Advanced pathological stage was associated with reduced overall 5-year survival (Pearson Chi-Squared = 10.40, p=0.006).

Conclusions

Radical nephroureterectomy in patients with UTUC has considerable morbidity and mortality in Australian centres but this appears comparable to published rates. The ACCEPT-U database will facilitate larger and prospective data collection, hopefully across multiple institutions, to further assess peri-operative outcomes and their determinants in the future.
1103 Gait Analysis Using Wearables and AI in Predicting Peripheral Arterial Disease: A Systematic Review
Authors: Abuchi-Ogbonda S , Ahmad M , Davies A H
Published: July 2024

Introduction

Peripheral arterial disease (PAD) affects over 230 million people globally. The trajectory of this disease process can culminate in major amputation. These patients demonstrate statistically significant changes in gait including changes in stride length, plantarflexion and other spatiotemporal parameters.

Aim

To determine if alterations in gait parameters can be detected and measured accurately by wearables and AI in PAD patients and if these measurements are predictive of PAD progression.

Method

A systematic review was performed in line with PRISMA guidelines. MEDLINE, Embase, Web of Science and Scopus were used for database searches. A combination of medical subject headings (MeSH) regarding ‘PAD’, ‘gait’, ‘kinetics’, ‘biomechanics’, ‘ambulation’, ‘artificial intelligence’, ‘sensors’ and ‘smartphone data’ were employed in the primary search string. Screening, full text reviews and data extraction was conducted by 2 reviewers using Covidence. Bias was assessed using the Newcastle-Ottawa scale.

Results

4719 studies were identified. 3873 were screened after de-duplication. 5 studies were included in the final review. The main methods of gait measurements included smartphones (iPhone and Samsung Galaxy), wearable sensors and motion sensor technology. Gait initiation parameters were sensitive in detecting gait impairment. iPhone pedometer demonstrated accuracy measuring steps comparable to reference Actigraph but was inaccurate measuring distance. Machine learning models including Random Forest algorithms and extreme gradient boosting, detected PAD patients with 89% and 92% accuracy respectively.

Conclusions

Wearables and AI algorithms can detect gait changes and differentiate PAD from non-PAD gait. All studies showed detective capability, however none demonstrated predictability of PAD. Limitations include accuracy and validation of measurement methods.
What politics does to the economic analysis of the employment relationship: a critical perspective on personnel economics
Authors: Bailly Franck , Dubrion Benjamin
Published: July 2024

Personnel economics has undoubtedly been one of the major developments in mainstream labour economics in recent decades. Its aim is not simply to report on firms’ actual labour management practices but also to prescribe the optimal practices for managers to adopt. The pursuit of this goal has led it to close itself off from other approaches to the analysis of the employment relationship. Drawing on concepts from political science, we show that personnel economics is imbued with a particular conception of politics, even though it goes unacknowledged. Making this point visible enables us to show that other conceptions of politics than that to which personnel economics refers are possible and leads to the acknowledgement of the legitimacy of other points of view in matters of labour management.
Reduction in kidney function decline and risk of severe clinical events in agalsidase beta–treated Fabry disease patients: a matched analysis from the Fabry Registry
Authors: Batista Julie L , Hariri Ali , Maski Manish , Richards Susan , Gudivada Badari , Raynor Lewis A , Ponce Elvira , Wanner Christoph , Desnick Robert J
Published: July 2024

Background

Patients with Fabry disease (FD, α-galactosidase A deficiency or absence) accumulate glycosphingolipids, leading to progressive dysfunction of kidneys, heart and nervous system. Generalizable real-world outcomes following agalsidase beta treatment initiation outside trials are limited. We investigated the associations of long-term agalsidase beta treatment with estimated glomerular filtration rate (eGFR) changes over time and the risk of developing a composite clinical event in a matched analysis of treated and untreated patients with FD.

Methods

Agalsidase beta–treated adult patients (aged ≥16 years) from the Fabry Registry and adult untreated patients from a natural history cohort were matched 1:1 and X:X (with one occurrence and multiple occurrences of each untreated patient, respectively) by sex, phenotype, age and (for eGFR slope analysis) baseline eGFR. Outcomes included eGFR slope over 5 years and composite clinical event risk (cardiovascular, cerebrovascular or renal event, or death) over 10+ years. As a surrogate indicator of therapeutic response in paediatric patients, the percentage experiencing normalization in plasma globotriaosylceramide (GL-3) from treatment initiation was assessed in patients aged 2 to <16 years.

Results

Overall, eGFR slopes for 1:1-matched untreated and treated adult patients [122 pairs (72.1% male)] were −3.19 and −1.47 mL/min/1.73 m2/year, respectively (reduction in rate of decline = 53.9%, P = .007), and for X:X-matched [122 untreated/950 treated (59.4% male)] were −3.29 and −1.56 mL/min/1.73 m2/year, respectively (reduction in rate of decline = 52.6%, P < .001). Agalsidase beta treatment was associated with lower risk of clinical events, with hazard ratios of 0.41 (P = .003) and 0.67 (P = .008) for 1:1-matched and X:X-matched analyses, respectively. Plasma GL-3 declined markedly in paediatric patients and normalized in most within 6 months of treatment initiation.

Conclusion

Agalsidase beta treatment preserves kidney function and delays progression to severe clinical events among adult patients with FD. Plasma GL-3 levels analysed in paediatric patients showed normalization of elevated pre-treatment levels in most patients.
High premature atrial complex burden and risk of renal function decline
Authors: Chen Chao-Yu , Yu Chih-Hen , Lee Po-Tseng , Huang Mu-Shiang , Chiu Pin-Hsuan , Su Pei-Fang , Liu Ping-Yen , Huang Ting-Chun
Published: July 2024

Background

Atrial arrhythmia, particularly atrial fibrillation (AF), is known to be associated with renal function decline and increased risk of end-stage kidney disease. In recent years, premature atrial complexes (PACs) as subclinical arrhythmia have been proposed to be a marker of atrial cardiomyopathy and associated with poor clinical outcomes. However, the relationship between excessive daily PAC burden and renal outcomes remains unexplored.

Methods

This retrospective, all-comers cohort study analyzed 30 488 consecutive Holter monitoring records obtained from a validated Holter databank at a referral medical center in Taiwan between 2011 and 2018. After exclusion, 10 981 patients were categorized into three groups: high daily PAC burden (≥100 beats per day), low PAC burden (<100 beats per day) and the AF group. We used parallel propensity score matching to balance confounding factors between groups. The primary study interest was major adverse kidney events, including an estimated glomerular filtration rate (eGFR) decline of 40%, eGFR <15 mL/min/1.73 m2 or the initiation of hemodialysis.

Results

After a mean follow-up of 4.07 ± 3.03 years, patients with high PAC burden had a 1.24-fold higher incidence of major adverse kidney events compared with the low PAC burden group [95% confidence interval (CI) 1.03–1.50]. The risk of major adverse kidney events was similar between patients with AF and those with high PAC burden [adjusted hazard ratio (HR) 1.05, 95% CI 0.87–1.25], but significantly higher in the AF group than in the low PAC burden group (adjusted HR 1.29, 95% CI 1.07–1.56).

Conclusion

Excessive daily PAC burden is associated with a higher risk of major adverse kidney events and has a comparable impact as AF.
Spatial, social, and environmental factors influencing natal dispersal in the colonial griffon vulture
Authors: Martínez Félix , Carrete Martina , Blanco Guillermo
Published: July 2024

Natal dispersal is a critical trait for individual fitness and the viability, structure, and genetic identity of populations. However, there is a pronounced information gap for large and long-lived species due to the difficulty of monitoring individuals at appropriate spatio-temporal scales. Here we study how individual traits and social and environmental characteristics influence natal dispersal decisions of griffon vultures (Gyps fulvus) using long-term (30 years) monitoring of a large number of individuals marked as nestlings in Spain. Our results show a strong philopatry in both sexes, with some individuals recruiting as breeders on the same cliffs, and even the same nests, where they were born. This philopatric tendency was modulated by the effect of conspecific density on individual parameters and emphasized the importance of conspecific attraction and changes in food availability that may have influenced the increment in colony size and the colonization of new areas. Although further research is needed considering smaller colonies and more isolated population nuclei, our results highlight the importance of long-term studies on long-lived species to understand the factors that determine their population dynamics and their relationship with anthropogenic activities, whose effects should be predicted and managed using conservation criteria.
Probabilistic programming for embedding theory and quantifying uncertainty in econometric analysis
Authors: Storm Hugo , Heckelei Thomas , Baylis Kathy
Published: July 2024

The replication crisis in empirical research calls for a more mindful approach to how we apply and report statistical models. For empirical research to have a lasting (policy) impact, these concerns are crucial. In this paper, we present Probabilistic Programming (PP) as a way forward. The PP workflow with an explicit data-generating process enhances the communication of model assumptions, code testing and consistency between theory and estimation. By simplifying Bayesian analysis, it also offers advantages for the interpretation, communication and modelling of uncertainty. We outline the advantages of PP to encourage its adoption in our community.
The Efficacy of a Home-Based Functional Skills Training Program for Older Adults With and Without a Cognitive Impairment
Authors: Czaja Sara J , Kallestrup Peter , Harvey Philip D
Published: July 2024

Background and Objectives

The performance of everyday technology-based tasks, such as online banking or shopping, can be challenging for older adults, especially those with a cognitive impairment. Technology-based tasks are cognitively demanding and require learning new skills. This study explored the efficacy of a technology-based functional skills assessment and training program (FUNSAT) among aging adults with and without mild cognitive impairment (MCI) in home settings.

Research Design and Methods

One hundred and eighty-four racially/ethnically diverse male and female adults aged 65+ participated in the study. The sample included 75 noncognitively impaired (NC) older adults and 109 older adults with MCI. The FUNSAT program includes medication and money management, transportation, and shopping tasks. The MCI participants were randomized to the FUNSAT training or FUNSAT training combined with computer-based cognitive training (FUNSAT/CCT). The nonimpaired adults received the FUNSAT training only. Using alternative forms of the assessment component of the FUNSAT program, assessments occurred at baseline, post-training, and 1- and 3-month post-training. This paper reports the post-training results.

Results

The findings indicated that the performance of both the nonimpaired and MCI participants improved significantly for all 6 tasks post-training. Specifically, training resulted in improvements in task completion time and task errors. Participants also reported greater confidence when performing the tasks in the real world.

Discussion and Implications

Nonimpaired aging adults and those with MCI can learn to perform technology-based everyday tasks. Further, home-based technology training protocols are feasible for aging adults with and without a cognitive impairment.

Clinical Trial Registration

NCT0467944 1
Identification of heparin-binding amino acid residues in antibody HS4C3 with the potential to design antibodies against heparan sulfate domains
Authors: Damen Lars A A , Bui Thao P , van Wessel Thierry , Li Yong , Straten Bart F , Pampiermole Robin , Daamen Willeke F , Fernig David G , van Kuppevelt Toin H
Published: July 2024

Heparan sulfate (HS) is a linear polysaccharide with high structural and functional diversity. Detection and localization of HS in tissues can be performed using single chain variable fragment (scFv) antibodies. Although several anti-HS antibodies recognizing different sulfation motifs have been identified, little is known about their interaction with HS. In this study the interaction between the scFv antibody HS4C3 and heparin was investigated. Heparin-binding lysine and arginine residues were identified using a protect and label methodology. Site-directed mutagenesis was applied to further identify critical heparin-binding lysine/arginine residues using immunohistochemical and biochemical assays. In addition, computational docking of a heparin tetrasaccharide towards a 3-D homology model of HS4C3 was applied to identify potential heparin-binding sites. Of the 12 lysine and 15 arginine residues within the HS4C3 antibody, 6 and 9, respectively, were identified as heparin-binding. Most of these residues are located within one of the complementarity determining regions (CDR) or in their proximity. All basic amino acid residues in the CDR3 region of the heavy chain were involved in binding. Computational docking showed a heparin tetrasaccharide close to these regions. Mutagenesis of heparin-binding residues reduced or altered reactivity towards HS and heparin. Identification of heparin-binding arginine and lysine residues in HS4C3 allows for better understanding of the interaction with HS and creates a framework to rationally design antibodies targeting specific HS motifs.
Export performance, innovation, and sectoral efficiency: a multilevel model for Argentinian manufacturing firms
Authors: Cassini Lorenzo
Published: July 2024

This paper assess how innovation is associated with the export performance of manufacturing firms across sectors categorized by their Ricardian, Keynesian, and Schumpeterian efficiencies (Dosi, G. (1988), ‘Institutions and markets in a dynamic world,’ The Manchester School, 56(2), 119–146). Utilizing data from 3691 Argentinian manufacturing firms over the period of 2010–2012, we employ multilevel models for estimation. Our findings indicate that innovation is positively associated with export performance across the entire economy, but this association varies depending on the sector. These results support the adoption of a vertical innovation policy, directing efforts toward the most promising sectors, given the limitations of market information regarding opportunities for technical change. Furthermore, we observe significant variations in the association of innovation and export performance even within sectors sharing the same efficiency. This specific finding highlights the need for improved methodologies to identify sectoral efficiencies or a more appropriate sectoral classification.
Phase retrieval for radar waveform design
Authors: Pinilla Samuel , Mishra Kumar Vijay , Sadler Brian M , Arguello Henry
Published: July 2024

The ability of a radar to discriminate in both range and Doppler velocity is completely characterized by the ambiguity function (AF) of its transmit waveform. Mathematically, it is obtained by correlating the waveform with its Doppler-shifted and delayed replicas. We consider the inverse problem of designing a radar transmit waveform that satisfies the specified AF magnitude. This process may be viewed as a signal reconstruction with some variation of phase retrieval methods. We provide a trust-region algorithm that minimizes a smoothed non-convex least-squares objective function to iteratively recover the underlying signal-of-interest for either time- or band-limited support. The method first approximates the signal using an iterative spectral algorithm and then refines the attained initialization based on a sequence of gradient iterations. Our theoretical analysis shows that unique signal reconstruction is possible using signal samples no more than thrice the number of signal frequencies or time samples. Numerical experiments demonstrate that our method recovers both time- and band-limited signals from sparsely and randomly sampled, noisy and noiseless AFs.
Epidemiology and clinical relevance of persistent bacteraemia in patients with Gram-negative bloodstream infection: a retrospective cohort study
Authors: Ong Sean W X , Luo Jin , Fridman Daniel J , Lee Samantha M , Johnstone Jennie , Schwartz Kevin L , Diong Christina , Patel Samir N , Macfadden Derek R , Langford Bradley J , Tong Steven Y C , Brown Kevin A , Daneman Nick
Published: July 2024

Objectives

The risk factors and outcomes associated with persistent bacteraemia in Gram-negative bloodstream infection (GN-BSI) are not well described. We conducted a follow-on analysis of a retrospective population-wide cohort to characterize persistent bacteraemia in patients with GN-BSI.

Methods

We included all hospitalized patients >18 years old with GN-BSI between April 2017 and December 2021 in Ontario who received follow-up blood culture (FUBC) 2–5 days after the index positive blood culture. Persistent bacteraemia was defined as having a positive FUBC with the same Gram-negative organism as the index blood culture. We identified variables independently associated with persistent bacteraemia in a multivariable logistic regression model. We evaluated whether persistent bacteraemia was associated with increased odds of 30- and 90-day all-cause mortality using multivariable logistic regression models adjusted for potential confounders.

Results

In this study, 8807 patients were included; 600 (6.8%) had persistent bacteraemia. Having a permanent catheter, antimicrobial resistance, nosocomial infection, ICU admission, respiratory or skin and soft tissue source of infection, and infection by a non-fermenter or non-Enterobacterales/anaerobic organism were associated with increased odds of having persistent bacteraemia. The 30-day mortality was 17.2% versus 9.6% in those with and without persistent bacteraemia (aOR 1.65, 95% CI 1.29–2.11), while 90-day mortality was 25.5% versus 16.9%, respectively (aOR 1.53, 95% CI 1.24–1.89). Prevalence and odds of developing persistent bacteraemia varied widely depending on causative organism.

Conclusions

Persistent bacteraemia is uncommon in GN-BSI but is associated with poorer outcomes. A validated risk stratification tool may be useful to identify patients with persistent bacteraemia.
Off-label use of dalbavancin in children: a case series
Authors: Gamell Anna , Velasco-Arnaiz Eneritz , López-Ramos Maria Goretti , Ríos-Barnés María , Simó-Nebot Sílvia , Fumadó Victoria , Noguera-Julián Antoni , Fortuny Clàudia
Published: July 2024

Introduction

Dalbavancin is an antibiotic active against most Gram-positive bacteria approved for acute bacterial skin and skin structure infections (ABSSSI). Owing to its long half-life, it is being increasingly used for other indications.

Patients and methods

We present a case series of children and adolescents treated with dalbavancin for osteoarticular, catheter-related and other non-ABSSSI infections.

Results

Dalbavancin was prescribed to 15 patients. Six (40%) were female and median age at prescription was 11.9 (IQR 1.3–18.0) years. Most of them (12/15) had significant comorbidities. Patients presented mainly with deep surgical site infections, osteoarticular infections and central-line-associated bloodstream infections. The most common isolate was Staphylococcus aureus followed by Staphylococcus epidermidis. Major reasons to prescribe dalbavancin were to ensure compliance and patients’ convenience. Two patients discontinued the drug due to adverse events possibly related to it. The rest of the patients completed the treatment with dalbavancin, with a median duration of 56 days (IQR 17.5, 115.5). All achieved complete resolution and present no relapse after a median follow-up of 9.9 months (IQR 4.8, 16.6).

Conclusions

Dalbavancin was a safe, effective and convenient alternative in selected paediatric patients with complicated non-ABSSSI infections caused by Gram-positive bacteria.
Detection of volatile organic compounds as new paradigm to accelerate antimicrobial susceptibility testing: performance evaluation of VITEK® REVEAL™
Authors: Bianco Gabriele , Boattini Matteo , Comini Sara , Bondi Alessandro , Curtoni Antonio , Piccinini Giorgia , Musso Tiziana , Broccolo Francesco , Cavallo Rossana , Nordmann Patrice , Costa Cristina
Published: July 2024

Objectives

The measurement of VOCs release in the headspace of a bacterial culture represents a new approach to rapidly assess antimicrobial susceptibility. Herein, we evaluated the diagnostic performance of the VITEK® REVEAL™ system directly from a collection of Gram-negative positive blood cultures.

Materials and methods

One hundred and twenty-eight positive blood cultures were included in the analysis (Enterobacterales, n = 95; Pseudomonas aeruginosa, n = 21; Acinetobacter baumannii complex, n = 12). Samples were processed using VITEK® REVEAL™ according to the manufacturer’s recommendations, and MICs of 22 antimicrobials were compared with those obtained using reference methods. Categorical agreement (CA), essential agreement (EA) and categorical errors were calculated.

Results

Overall, 2220 strain/antibiotic pair combinations were analysed. Of these, most were classified as resistant by reference antimicrobial susceptibility testing (1091/2220; 48.7%). The overall CA and EA were 97.6% and 97.7%, respectively. CA ranged from 97.5% in Enterobacterales to 97.9% in both P. aeruginosa and A. baumannii complex. The overall number of categorical discrepancies were: 18 very major errors (1.6%), 13 major errors (1.2%) and 22 minor errors (2.4%). EA ranged from 95.2% in P. aeruginosa to 98.1% in Enterobacterales. Screening test for ESBL phenotype was positive, indeterminate and negative in 13.7%, 32.6% and 27.4% of Enterobacterales isolates tested by both VITEK® REVEAL™ and the reference method, showing 100% CA.

Conclusions

VITEK® REVEAL™ represents a reliable tool to obtain antimicrobial susceptibility results of the main Gram-negative species directly from positive blood cultures with time to results of less than 8 h.
A proof-of-principle study for the point-of-care detection of ESBL (CTX-M) by NG-Test® CTX-M MULTI lateral flow assay in urine samples using a simplified method for use in a resource-limited setting
Authors: Nurjadi Dennis , Chalin Arnaud , Hauswaldt Susanne , Olson Linus , Larsson Mattias , Östholm Åse , Velavan Thirumalaisamy P , Boutin Sébastien , Rupp Jan , Nilsson Lennart E , Hanberger Håkan
Published: July 2024

Background

The rise of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) in low- and middle-income countries limits treatment options, leading to the frequent use of broad-spectrum antibiotics. Reducing time-to-result for a urinary infection can facilitate correct antibiotic treatment and support antimicrobial and diagnostic stewardship measures. This study compared two simplified enrichment methods for detecting CTX-M directly from urine specimens.

Methods

Two enrichment methods, namely centrifugation of 2 mL urine and filtration of 1 mL urine using the DirecTool adaptor, were compared using 20 culture-positive urine samples (20 suspected ESBL-E and 20 non-ESBL-E). CTX-M production was detected using a lateral flow assay (LFA), NG-Test® CTX-MMULTI. The presence of blaCTX-M genes was confirmed by whole-genome sequencing (WGS).

Results

The results of both enrichment methods were identical, with a sensitivity of 87.5% and a specificity of 100%. In 19/20 (95%) of the urine samples, the results of the CTX-M LFA were identical with the phenotypic confirmation and WGS. Both methods could detect ESBL-E bacteriuria with ≥104 cfu/mL. All ESBL-E-negative samples were identified accurately. Both enrichment methods yielded negative results in one ESBL-E-positive (CTX-M-15) sample despite phenotypic and genotypic confirmation of ESBL production. High leukocyte count (>500 cells/µL), the presence of boric acid or polymicrobial samples did not appear to impact the performance of both enrichment methods.

Conclusions

Our study underscores the feasibility of directly detecting CTX-M in urine. Simplified enrichment methods, particularly with a filtration kit, enhance the assay’s practicality, rendering it suitable for use in primary care, emergency departments or remote laboratories without sophisticated equipment.
Uncovering the function of insulin receptor substrate in termites’ immunity through active immunization
Authors: Zhou Wei , Zhao Xingying , Hassan Ali , Jia Bao , Liu Long , Huang Qiuying
Published: July 2024

Insulin receptor substrate (IRS) proteins are key mediators in insulin signaling pathway. In social insect lives, IRS proteins played important roles in caste differentiation and foraging, but there function in disease defenses such as active immunization has not been reported yet. To investigate the issue, we successfully suppressed the IRS gene 3 days after dsRNA injection. Suppressing IRS gene increased the contents of glucose, trehalose, glycogen, and triglyceride and decreased the content of pyruvate in termites, and led to the metabolic disorder of glucose and lipids. IRS suppressing significantly enhanced grooming behaviors of nestmates of fungus-contaminated termites and hence increased the conidial load in the guts of the nestmates. Additionally, IRS suppressing led to significant downregulation of the immune genes Gram-negative bacteria-binding protein2 (GNBP2) and termicin and upregulation of the apoptotic gene caspase8, and hence diminished antifungal activity of nestmates of fungus-contaminated termites. The above abnormal behavioral and physiological responses significantly decreased the survival rate of dsIRS-injected nestmates of the fungus-contaminated termites. These findings suggest that IRS is involved in regulation of active immunization in termites, providing a better understanding of the link between insulin signaling and the social immunity of termites.
Laboratory studies of movement and microenvironment choices of engorged adult female Amblyomma maculatum (Acari: Ixodidae)
Authors: Goddard Jerome , Caprio Michael , Bittner Jennifer , Willeford Kendall , Ward Samuel
Published: July 2024

Microenvironmental factors affect ovipositional choices and behavior in ticks. In this study, engorged female Amblyomma maculatum Koch were released in an observation arena covered with garden soil. The arena was evenly split into wet and dry sides, each containing 5 different types of structures (totaling 10). Upon release, observations at particular time points were made over 2 days as to speed, distance, actual paths traveled, and ultimate site selection, presumably for oviposition. In addition, time-lapse videography was utilized to record the track of each individual tick. This scenario was replicated 3 times with different cohorts of ticks (n = 5 per replicate). Of the total 15 ticks released in the arena, all attained a final site selection by 24 h. These final sites were 7/15 (47%) edge of arena; 2/15 (13%) under bark; 2/15 (13%) open soil; 2/15 (13%) at or near release point; 1/15 (7%) tunnel with animal fur; and 1/15 (7%) tunnel with chicken feathers. At final site selection, 11/15 (73%) subsequently burrowed into the soil, 3 of which were completely buried. Time-lapse videography revealed that most ticks (80%) explored the arena in a “looping back” fashion. Overall, engorged Gulf Coast ticks moved at an average speed of 0.09 mm/s, and the total distance traversed by the ticks averaged 2.37 m.
Ovarian cancer risk factors in relation to family history
Authors: Zheng Guoqiao , Baandrup Louise , Wang Jiangrong , Hertzum-Larsen Rasmus , Hannibal Charlotte Gerd , Faber Mette Tuxen , Sundström Karin , Kjær Susanne K
Published: July 2024

Background

Women with a family history of breast and/or ovarian cancer have an increased ovarian cancer risk. Yet it remains uncertain if common ovarian cancer risk factors—especially those that are modifiable—affect this high-risk population similarly to the general population.

Methods

Using the Danish and Swedish nationwide registers, we established 2 nested case-control study populations in women with a family history of breast and/or ovarian cancer (2138 ovarian cancers, 85 240 controls) and women without (10 730 ovarian cancers, 429 200 controls). The overall and histology-specific associations were assessed with conditional logistic regression. The country-specific estimates were combined based on a fixed-effect assumption.

Results

Multiparity, hysterectomy, tubal ligation, salpingectomy, and oral contraceptive (OC) use were associated with a reduced risk of ovarian cancer in women with and without a family history, while endometriosis and menopausal hormone therapy were associated with increased risk. Multiparity and OC use presented protective effects across all histologic subtypes except mucinous ovarian cancer, which was not associated with OC use. Menopausal hormone treatment increased the risk of serous ovarian cancer but decreased the risk of the mucinous and clear cell cancers. Endometriosis was especially related to an increased risk of endometrioid and clear cell ovarian cancer.

Conclusion

Factors associated with a decreased ovarian cancer risk were similar between women with and without a family history of breast and/or ovarian cancer. Given the higher baseline risk for women with a family history, special attention should be paid to risk factors like endometriosis and nulliparity in this high-risk population.
Effects of two fillers and process conditions on the water treatment efficiency of a continuous packed bed biofilm reactor
Authors: Fang Yijing , Li Zhifei , Wang Guangjun , Xia Yun , Zhang Kai , Gong Wangbao , Yu Ermeng , Xie Wenping , Li Hongyan , Tian Jingjing , Xie Jun , Xu Qiyou
Published: July 2024

This study evaluated the treatment efficiency of two selected fillers and their combination for improving the water quality of aquaculture wastewater using a packed bed biofilm reactor (PBBR) under various process conditions. The fillers used were nanosheet (NS), activated carbon (AC), and a combination of both. The results indicated that the use of combined fillers and the hydraulic retention time (HRT) of 4 h significantly enhanced water quality in the PBBR. The removal rates of chemical oxygen demand, NO2−─N, total suspended solids（TSS）, and chlorophyll a were 63.55%, 74.25%, 62.75%, and 92.85%, respectively. The microbiota analysis revealed that the presence of NS increased the abundance of microbial phyla associated with nitrogen removal, such as Nitrospirae and Proteobacteria. The difference between the M1 and M2 communities was minimal. Additionally, the microbiota in different PBBR samples displayed similar preferences for carbon sources, and carbohydrates and amino acids were the most commonly utilized carbon sources by microbiota. These results indicated that the combination of NS and AC fillers in a PBBR effectively enhanced the treatment efficiency of aquaculture wastewater when operated at an HRT of 4 h. The findings provide valuable insights into optimizing the design of aquaculture wastewater treatment systems.
Asteroseismology of the fast-rotating high-amplitude δ Scuti star V2367 Cygni
Authors: Daszyńska-Daszkiewicz J , Szewczuk W , Walczak P
Published: July 2024

We present the comprehensive analysis of the high-amplitude $\delta$ Sct star V2367 Cygni. First, we perform the frequency analysis for the whole available set of the Kepler and TESS photometry. Most of the frequency peaks are harmonics or combinations of the three known independent frequencies with the highest amplitudes, i.e.$\nu _1=5.661\,06$ d$^{-1}$, $\nu _2=7.14898$ d$^{-1}$, and $\nu _3=7.77557$ d$^{-1}$. The total number of independent frequencies is 26 and 25 from the Kepler and TESS light curve, respectively. Then, using the ${\it UBVRI}$ time-series photometry, we unambiguously identify the dominant frequency $\nu _1$ as the radial mode, whereas in the case of frequencies $\nu _2$ and $\nu _3$ the most probable mode degrees are $\ell =0$ or $\ell =2$. However, only the frequency $\nu _2$ can be associated with a radial mode, and only if higher order effects of rotation are taken into account. Including the rotational mode coupling, we constructed complex seismic models of V2367 Cyg, which fit $\nu _1$ and $\nu _2$ as radial modes, and reproduce the amplitude of bolometric flux variations (the parameter f) for the dominant mode. The empirical values of f are derived from the ${\it UBVRI}$ amplitudes and phases. We rely on the Bayesian analysis based on Monte Carlo simulations to derive constraints on evolutionary stage, mass, rotation, overshooting from the convective core, and efficiency of convective transport in the envelope. Our seismic analysis clearly indicates that V2367 Cyg is in a post-main sequence phase of evolution. This is the first extensive seismic modelling that takes into account the effect of rotational coupling between pulsation modes.
Greening Infection Prevention and Control: Multifaceted Approaches to a Sustainable Future
Authors: Lee Pamela S , Frantzis Irene , Abeles Shira R
Published: July 2024

Infection prevention and control, or IP&C, is a critical stakeholder in advancing environmental sustainability in health care. IP&C activities seek to ensure safety of processes in health care from an infection perspective, but how these are performed can drive substantial waste and pollution. There are certain IP&C measures that can, without compromising safety or efficiency, be adapted to more environmentally friendly practices and have a high impact benefit to sustainability without affecting patient outcomes. Moreover, IP&C practice stands to be significantly altered by climate change and pollution. Here, we describe the complex interdependence between sustainability, climate change, and IP&C, and opportunities for IP&C to be at the leading edge of optimizing healthcare's environmental footprint.
The Value of BLUE Protocol in the Diagnosis of Acute Onset of Respiratory Distress in Critically Ill Patient
Authors: Amin Koraa Alaa Eldin Abdelwahab , Elansary Adel Mohammed , Mohamed Hussen Mahmoud Hassan , Hussen Rania Maher , Elgamal Lobna Ahmed
Published: July 2024

To detect the value of BLUE protocol in the diagnosis of acute onset of respiratory distress in critically ill patients

This cross-sectional study conducted on 60 patients by performing ultrasonography on consecutive patients admitted to the ICU with acute onset of respiratory distress (dyspnea), comparing lung ultrasonography results on initial presentation with the final diagnosis with conventional method of diagnosis by the ICU team.

The BLUE protocol proved its importance, availability, easiness of application, accuracy and its ability to reach a final correct diagnosis in 90%of the patients. The lung U/S showed much better results than the CXR, but still the CT chest was more superior to the lung U/S as the sensitivity of the BLUE protocol in the diagnosis of pneumonia, pulmonary edema, pneumothorax, pleural effusion and COPD was 91.4%, 92.8%, 90%, 88.8% and 78.6 respectively.

The lung U/S (BLUE protocol) is a bedside, reliable, dynamic, rapid, and noninvasive technique, these results suggest it could have a significant role in the diagnostic workup of acute onset of respiratory distress in the ICU.
A Comparative Study of Erector Spinae Block versus Serratus Anterior Plane Block for Pain Management Following Video Assisted Thorocoscopic Surgery
Authors: Abd ELaziz Mai Mohsen , Saleh Mohamed Abd ELMawla , Elsaeidy Mohamed Ismail , Ibrahim Ghazy Dalia Mostafa
Published: July 2024

Background

Pain is an everyday challenge during all surgeries and it is a chief postoperative complication, so pain management is a corner stone in anesthetic practice. Minimally invasive thoracic surgery (MITS) has become more common over the past decade, with the proportion of lung resections performed using this technique increasing from 16% in 2005 to 47% in 2015. MITS includes both video-assisted and robotic-assisted techniques, with smaller skin incisions and chest wall trauma compared with open thoracotomy, Benefits include reduced postoperative pain, morbidity, and shorter hospital stay.

Objective

To compare efficacy between Serratus anterior block and Erector supinae block in Video assisted thoracoscopic surgery for minimally invasive thoracic surgery as regard post operative opioid consumption.

Patients and Methods

The study was conducted in Ain Shams University Hospitals after approval of the ethics committee and written patients‟ consent. It included a total of 40 adult patients aged 18-70 years, Scheduled for video assisted thoracoscopic surgeries. Patients were randomly divided into two equal groups, 20each, according to the inclusion and exclusion criteria.

Results

Intraoperative fentanyl consumption, postoperative opioid consumption and 1st rescue analgesic use were significantly lower in the ESPB group (P < 0.05). NRS scores were significantly lower in the ESPB group (P < 0.05) than SAPB from 2 to 8 hour only, mean arterial pressure and Heart rate was significantly lower from 2hour to 8hour in ESPB than SAPB but there were no significant difference in hemodynamics intraoperative.

Conclusion

Clinicians could develop a preference for either ESPB or SAPB for pain control after VATS based on their clinical experiences and personal choices. However, our study showed that US-guided ESPB may provide better pain control than SAPB.
Comparison of Volume-Controlled Ventilation (VCV) Mode and Pressure-Controlled Ventilation (PCV) Mode in Patients Undergoing Lumbar Spine Surgery in the Prone Position
Authors: Abd El Aziz Mohamed Saeed , Hassan Kachef Nevine Ahmed , Nasr Thabet Aziz , Ibrahim Ali Ismael Ibrahim
Published: July 2024

Background

The prone position is commonly required to enable surgical access during lumbar spine surgery. When a patient moves into the prone position, inferior vena cava obstruction causes reduced venous return and increase thoracic pressure results in reduced left ventricular compliance, leading to a decreased cardiac index (CI).

Aim of the Work

The aim of this study, we will compare the effects of the VCV and PCV on peak airway pressure (P peak), ETCO2 as a primary outcome ABG, SPO2, and hemodynamics as MAP, HR and as a secondary outcome in the prone position.

Patients and Methods

This prospective, single blinded study included 60 patients who assigned randomly into two equal groups: group A: patients on volume-controlled ventilation mode VCV and group B: patients on pressure-controlled ventilation mode PCV.

Results

Baseline characteristics (age, sex, BMI, ASA physical status, duration of anesthesia and surgery) were insignificantly different between both groups. Heart rate and MAP at supine and prone positions at all time measurements were insignificantly different between both groups. P peak and SpO2 at supine and prone positions at all time measurements were insignificantly different between both groups. Respiratory rate and ETCO2 at supine and prone positions at all time measurements were insignificantly different between both groups.

Conclusion

No significant difference between two modes of ventilation VCV and PCV in patients undergoing lumbar spine surgery in the prone position as regard P peak, ETCO2, SPO2, and hemodynamics.