bluuebunny/crossref_metadata_2025 huggingface dataset:
Regulatory and structural mechanisms of PvrA-mediated regulation of the PQS quorum-sensing system and PHA biosynthesis inPseudomonas aeruginosa
Authors: Pan Xiaolei , Liang Han , Zhao Xinrui , Zhang Qionglin , Chen Lei , Yue Zhuo , Yin Liwen , Jin Yongxin , Bai Fang , Cheng Zhihui , Bartlam Mark , Wu Weihui
Published: February 2023

Pseudomonas aeruginosa is capable of causing acute and chronic infections in various host tissues, which depends on its abilities to effectively utilize host-derived nutrients and produce protein virulence factors and toxic compounds. However, the regulatory mechanisms that direct metabolic intermediates towards production of toxic compounds are poorly understood. We previously identified a regulatory protein PvrA that controls genes involved in fatty acid catabolism by binding to palmitoyl-coenzyme A (CoA). In this study, transcriptomic analyses revealed that PvrA activates the Pseudomonas quinolone signal (PQS) synthesis genes, while suppressing genes for production of polyhydroxyalkanoates (PHAs). When palmitic acid was the sole carbon source, mutation of pvrA reduced production of pyocyanin and rhamnolipids due to defective PQS synthesis, but increased PHA production. We further solved the co-crystal structure of PvrA with palmitoyl-CoA and identified palmitoyl-CoA-binding residues. By using pvrA mutants, we verified the roles of the key palmitoyl-CoA-binding residues in gene regulation in response to palmitic acid. Since the PQS signal molecules, rhamnolipids and PHA synthesis pathways are interconnected by common metabolic intermediates, our results revealed a regulatory mechanism that directs carbon flux from carbon/energy storage to virulence factor production, which might be crucial for the pathogenesis.
A Network Analysis of Cigarette Craving
Authors: Aslan Mihaela , Sala Margaret , Gueorguieva Ralitza , Garrison Kathleen A
Published: February 2023

Introduction

Craving is considered a central process to addictive behavior including cigarette smoking, although the clinical utility of craving relies on how it is defined and measured. Network analysis enables examining the network structure of craving symptoms, identifying the most central symptoms of cigarette craving, and improving our understanding of craving and its measurement.

Aims and Methods

This study used network analysis to identify the central symptoms of self-reported cigarette craving as measured by the Craving Experience Questionnaire, which assesses both craving strength and craving frequency. Data were obtained from baseline of a randomized controlled trial of mindfulness training for smoking cessation.

Results

The most central symptoms in an overall cigarette craving network were the frequency of imagining its smell, imagining its taste, and intrusive thoughts. The most central symptoms of both craving frequency and craving strength sub-networks were imagining its taste, the urge to have it, and intrusive thoughts.

Conclusions

The most central craving symptoms reported by individuals in treatment for cigarette smoking were from the frequency domain, demonstrating the value of assessing craving frequency along with craving strength. Central craving symptoms included multisensory imagery (taste, smell), intrusive thoughts, and urge, providing additional evidence that these symptoms may be important to consider in craving measurement and intervention. Findings provide insight into the symptoms that are central to craving, contributing to a better understanding of cigarette cravings, and suggesting potential targets for clinical interventions.

Implications

This study used network analysis to identify central symptoms of cigarette craving. Both craving frequency and strength were assessed. The most central symptoms of cigarette craving were related to craving frequency. Central symptoms included multisensory imagery, intrusive thoughts, and urge. Central symptoms might be targeted by smoking cessation treatment.
Decision-Making and Health-Related Quality of Life in Patients with Melanoma Considering Adjuvant Immunotherapy
Authors: Atkinson Thomas M , Hay Jennifer L , Young Kim Soo , Schofield Elizabeth , Postow Michael A , Momtaz Parisa , Warner Allison Betof , Shoushtari Alexander N , Callahan Margaret K , Wolchok Jedd D , Li Yuelin , Chapman Paul B
Published: February 2023

Background

Adjuvant anti-PD1 treatment improves relapse-free survival (RFS) but has not been shown to improve overall survival (OS) in melanoma and is associated with risks of immune-related adverse events (irAEs), some permanent. We identified factors patients consider in deciding whether to undergo adjuvant anti-PD1 treatment and assessed prospective health-related quality of life (HRQoL), treatment satisfaction, and decisional regret.

Patients and Methods

Patients with stage IIIB-IV cutaneous melanoma and free of disease, were candidates for adjuvant anti-PD1 immunotherapy, and had not yet discussed adjuvant treatment options with their oncologist were eligible. Participants viewed a 4-minute informational video tailored to their disease stage which communicated comprehensive, quantitative information about the risk of relapse both with and without adjuvant treatment, and risks of each irAE before deciding whether or not to opt for adjuvant therapy. We collected data on demographics, HRQoL, and attitudes toward adjuvant treatment over 1 year.

Results

14/34 patients (41%) opted for adjuvant anti-PD1 immunotherapy, 20/34 (59%) opted for observation. Patients choosing adjuvant immunotherapy scored higher on HRQoL social well-being at pre-treatment, were more likely to endorse positive statements about adjuvant immunotherapy, and to perceive that their physician preferred adjuvant therapy. They had lower decisional regret and higher satisfaction, even if they experienced toxicity or recurrence.

Conclusions

When provided with comprehensive quantitative information about risks and benefits of adjuvant anti-PD1 immunotherapy, 20/34 (59%) of patients opted for observation. Patients choosing adjuvant immunotherapy had lower decisional regret and higher satisfaction over time even if they had poorer outcomes in treatment.
Longitudinal proteomic investigation of COVID-19 vaccination
Authors: Wang Yingrui , Zhu Qianru , Sun Rui , Yi Xiao , Huang Lingling , Hu Yifan , Ge Weigang , Gao Huanhuan , Ye Xinfu , Song Yu , Shao Li , Li Yantao , Li Jie , Guo Tiannan , Shi Junping
Published: February 2023

Although the development of COVID-19 vaccines has been a remarkable success, the heterogeneous individual antibody generation and decline over time are unknown and still hard to predict. In this study, blood samples were collected from 163 participants who next received two doses of an inactivated COVID-19 vaccine (CoronaVac®) at a 28-day interval. Using TMT-based proteomics, we identified 1,715 serum and 7,342 peripheral blood mononuclear cells (PBMCs) proteins. We proposed two sets of potential biomarkers (seven from serum, five from PBMCs) at baseline using machine learning, and predicted the individual seropositivity 57 days after vaccination (AUC = 0.87). Based on the four PBMC’s potential biomarkers, we predicted the antibody persistence until 180 days after vaccination (AUC = 0.79). Our data highlighted characteristic hematological host responses, including altered lymphocyte migration regulation, neutrophil degranulation, and humoral immune response. This study proposed potential blood-derived protein biomarkers before vaccination for predicting heterogeneous antibody generation and decline after COVID-19 vaccination, shedding light on immunization mechanisms and individual booster shot planning.
Down the River: Glyphosate Use in Agriculture and Birth Outcomes of Surrounding Populations
Authors: Dias Mateus , Rocha Rudi , Soares Rodrigo R
Published: February 2023

This paper documents an externality from the agricultural use of the most widely applied herbicide in the world—glyphosate—on birth outcomes of surrounding populations. We focus on the subclinical effects of water contamination in areas distant from the original locations of application. Our identification relies on: (i) the regulation allowing the introduction of genetically modified seeds in Brazil; (ii) the potential gain in municipality-level productivity from adoption of genetically modified soybean seeds and the strong complementary between these seeds and glyphosate; and (iii) the direction of water flow within water basins. We document a significant deterioration in birth outcomes for populations downstream from locations that are likely to have increased relatively more the use of glyphosate. According to our preferred specification, the average increase in glyphosate use in the sample during 2000–10 period led to an increase of 5% of the average in infant mortality rate.
Reducing poverty and social exclusion in Europe: estimating the marginal effect of income on material deprivation
Authors: Notten Geranda , Guio Anne-Catherine
Published: February 2023

Advances in measuring poverty in non-monetary terms enable governments to track social progress on ends, the things that societies value doing and being. Using a national-level regression-based empirical strategy, this research demonstrates the magnitude of previously unmeasured policy effects on material deprivation, a non-monetary indicator of poverty. We apply this methodology to a comparative microdata set covering 32 European countries and estimate the average marginal effect of a small universal income increase on material deprivation. We illustrate the impact of the income transfer from various policy angles commonly used when analyzing the poverty reduction effects of social transfers. We show how impacts vary with characteristics such as country and household deprivation levels and the type of social transfers received. The methodology enables an analysis of the redistributive impact of social transfers on non-monetary social outcomes and is also suitable for other non-monetary social outcomes such as housing deprivation and food insecurity.
Feasibility of ultrasound in the diagnosis of neonatal respiratory distress syndrome in preterm infants
Authors: Zheng Lei , Jing Hongyan , Liu Lihong , Wang Lianyi
Published: February 2023

Background

The aim of this study was to investigate the feasibility of lung ultrasound in the diagnosis of neonatal respiratory distress syndrome (NRDS) in preterm infants.

Methods

One hundred and nine preterm infants were prospectively recruited. Three ultrasound diagnostic criteria were developed to diagnose preterm infants with NRDS: (A) thickened or not smooth pleural line, part of the lung field shows diffuse ‘B-line’ sign or alveolar-interstitial syndrome (AIS); (B) thickened or not smooth pleural line, all lung fields show AIS, signifying the ‘white lung’ sign; (C) thickened or rough pleural line, ‘white lung’ sign and ‘lung consolidation’ sign can be observed in any lung field.

Results

The sensitivity and negative predictive value of NRDS in preterm infants with diagnostic criteria A were 100%, but the specificity and positive predictive value were 67.95 and 55.36%, respectively. The specificity and positive predictive value of diagnostic criteria B and C were 100%, while the 95% CI of diagnostic criteria B was narrower than diagnostic criteria C. The sensitivity and negative predictive value of diagnostic criteria B were higher than that of diagnostic criteria C. Of the 31 NRDS cases, 15 cases had severe NRDS and the other 16 did not have severe NRDS.

Conclusion

Thickened or rough pleural line with white lung sign is an important characteristic for the diagnosis of NRDS by lung ultrasound. White lung sign combined with the lung consolidation sign had high diagnostic efficacy when distinguishing severe NRDS from not severe NRDS.
Mobile Broadband, Poverty, and Labor Outcomes in Tanzania
Authors: Bahia Kalvin , Castells Pau , Cruz Genaro , Masaki Takaaki , Rodríguez-Castelán Carlos , Sanfelice Viviane
Published: February 2023

What are the impacts of expanding mobile broadband coverage on poverty, household consumption, and labor-market outcomes in developing countries? Who benefits from improved coverage of mobile internet? To respond to these questions, this paper applies a difference-in-differences estimation using panel household survey data combined with geospatial information on the rollout of mobile broadband coverage in Tanzania. The results reveal that being covered by 3G networks has a large positive effect on total household consumption and poverty reduction, driven by positive impacts on labor-market outcomes. Working-age individuals living in areas covered by mobile internet witnessed an increase in labor-force participation, wage employment, and non-farm self-employment, and a decline in farm employment. These effects vary by age, gender, and skill level. Younger and more skilled men benefit the most through higher labor-force participation and wage employment, while high-skilled women benefit from transitions from self-employed farm work into non-farm employment.
Using Graduating Surgical Resident Milestone Ratings to Predict Patient Outcomes: A Blunt Instrument for a Complex Problem
Authors: Montgomery Kelsey B. , Lindeman Brenessa
Published: February 2023

In 2013, U.S. general surgery residency programs implemented a milestones assessment framework in an effort to incorporate more competency-focused evaluation methods. Developed by a group of surgical education leaders and other stakeholders working with the Accreditation Council for Graduate Medical Education and recently updated in a version 2.0, the surgery milestones framework is centered around 6 “core competencies”: patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. While prior work has focused on the validity of milestones as a measure of resident performance, associations between general surgery resident milestone ratings and their post-training patient outcomes have only recently been explored in an analysis in this issue of Academic Medicine by Kendrick et al. Despite their well-designed efforts to tackle this complex problem, no relationships were identified. This accompanying commentary discusses the broader implications for the use of milestone ratings beyond their intended application, alternative assessment methods, and the challenges of developing predictive assessments in the complex setting of surgical care. Although milestone ratings have not been shown to provide the specificity needed to predict clinical outcomes in the complex settings studied by Kendrick et al, hope remains that utilization of other outcomes, assessment frameworks, and data analytic tools could augment these models and further our progress toward a predictive assessment in surgical education. Evaluation of residents in general surgery residency programs has grown both more sophisticated and complicated in the setting of increasing patient and case complexity, constraints on time, and regulation of resident supervision in the operating room. Over the last decade, surgical education research efforts related to resident assessment have focused on measuring performance through accurate and reproducible methods with evidence for their validity, as well as on attempting to refine decision making about resident preparedness for unsupervised practice.
Full-Endoscopic Lumbar Discectomy Approach Selection
Authors: Kotheeranurak Vit , Liawrungrueang Wongthawat , Quillo-Olvera Javier , Siepe Christoph J. , Li Zhen Zhou , Lokhande Pramod V. , Choi Gun , Ahn Yong , Chen Chien-Min , Choi Kyung-Chul , Van Isseldyk Facundo , Hagel Vincent , Koichi Sairyo , Hofstetter Christoph P. , Del Curto David , Zhou Yue , Bolai Chen , Bae Jun seok , Assous Muhammed , Lin Guang-Xun , Jitpakdee Khanathip , Liu Yanting , Kim Jin-Sung
Published: February 2023

Study Design.

A systematic review of the literature to develop an algorithm formulated by key opinion leaders.

Objective.

This study aimed to analyze currently available data and propose a decision-making algorithm for full-endoscopic lumbar discectomy for treating lumbar disc herniation (LDH) to help surgeons choose the most appropriate approach [transforaminal endoscopic lumbar discectomy (TELD) or interlaminar endoscopic lumbar discectomy (IELD)] for patients.

Summary of Background Data.

Full-endoscopic discectomy has gained popularity in recent decades. To our knowledge, an algorithm for choosing the proper surgical approach has never been proposed.

Materials and Methods.

A systematic review of the literature using PubMed and MeSH terms was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Patient samples included patients with LDH treated with full-endoscopic discectomy. The inclusion criteria were interventional research (randomized and nonrandomized trials) and observation research (cohort, case-control, case series). Exclusion criteria were case series and technical reports. The criteria used for selecting patients were grouped and analyzed. Then, an algorithm was generated based on these findings with support and reconfirmation from key expert opinions. Data on overall complications were collected. Outcome measures included zone of herniation, level of herniation, and approach (TELD or IELD).

Results.

In total, 474 articles met the initial screening criteria. The detailed analysis identified the 80 best-matching articles; after applying the inclusion and exclusion criteria, 53 articles remained for this review.

Conclusions.

The proposed algorithm suggests a TELD for LDH located in the foraminal or extraforaminal zones at upper and lower levels and for central and subarticular discs at the upper levels considering the anatomic foraminal features and the craniocaudal pathology location. An IELD is preferred for LDH in the central or subarticular zones at L4/L5 and L5/S1, especially if a high iliac crest or high-grade migration is found.
The Effect of Adolescent Idiopathic Scoliosis on Natural Delivery and Epidural Use in Pregnant Females
Authors: Chapek Michael , Kessler Adam , Poon Selina , Cho Robert , Nguyen Cynthia , Kessler Jeffrey
Published: February 2023

Study Design.

Retrospective matched cohort study.

Objective.

The aim of this study was to determine whether females with idiopathic scoliosis (IS), both with and without spine fusion, experience different rates of cesarean section (CS) and epidural anesthesia (EA) than females without scoliosis.

Summary of Background Data.

IS is a common spine condition with a higher prevalence in females. It is unclear whether females with scoliosis, treated nonoperatively or operatively, have different rates of cesarean delivery or EA.

Materials and Methods.

Patients with IS who delivered in our integrated health care system during a 6-year period were identified (N = 1810). They were matched with a group without scoliosis who delivered during the same period (N = 1810). Rates and relative risk (RR) of CS and EA between cohorts and subgroups were calculated.

Results.

The scoliosis cohort had significantly higher rates and RR of EA (P = 0.002 and P = 0.004, respectively). Scoliosis patients treated nonoperatively had an 8% greater RR of EA (P = 0.004) and had a significantly lower rate of CS (23.2% vs. 26%, P = 0.048) compared with the control group. Among only scoliosis patients, those treated with spine fusion had a 38% decreased RR of EA (P < 0.001). Distal fusion level did not seem to influence the RR of EA or CS.

Conclusions.

Females with scoliosis were significantly more likely to receive EA at delivery compared with females without scoliosis. Rates and RR of cesarean delivery were not significantly lower among women with scoliosis, but females treated nonoperatively for scoliosis had a significantly lower CS rate than those without scoliosis. Females treated with spine fusion for scoliosis were far less likely to receive EA than both females without scoliosis and females with scoliosis treated nonoperatively.
Effect of High-Altitude Exposure on the Heart
Authors: Huang Lan
Published: February 2023

High altitude brings a great physiological change in human beings, both during short-term exposure and in lifelong residents, especially in the cardiovascular system. Hypoxia notably induces pulmonary vasoconstriction, thus resulting in a moderate increase in pulmonary arterial pressure. Acclimatized inhabitants exhibit lower pulmonary pressure and better exercise capacity than lowlanders during short-term high-altitude exposure. Rapid ascent to high altitude without adequate acclimatization can cause high-altitude pulmonary edema in susceptible individuals, with a rapid increase in pulmonary pressure. Cardiac output increases initially following acute high-altitude exposure and returns to normal as at sea level after a few days of acclimatization. Ventricular volumes at high altitude change consistently with decreases in plasma volume. Left ventricular systolic function is enhanced after acute high-altitude exposure and during chronic acclimatization. However, there are controversies on whether right ventricular systolic function is preserved or decreases after high-altitude exposure, probably due to variable hypoxic pulmonary vasoconstriction. High altitude induces altered ventricular diastolic patterns. Recently, a new perspective has emerged, whereby ventricular intrinsic relaxation is not impaired, as assessed by untwisting through speckle-tracking imaging. Persistent hypoxic pulmonary hypertension probably induced right ventricular dilation and hypertrophy, and even right heart failure, described as high-altitude heart diseases. Descent to lower altitude should be the best treatment for them, and potential pharmacological agents majorly focus on the inhabitation of pulmonary vasoconstriction, such as phosphodiesterase-5 inhibitors and endothelin receptor antagonists. Evidence on the risks of high-altitude exposure for patients with previous cardiovascular diseases is limited, and thus they should be prudent when ascending to high altitude. Further randomized large-scale studies are needed to explore cardiac performance at high altitudes and provide more evidence for the prevention and clinical management of medical complications at high altitude.
Trends in Outcomes and Variation by Race and Ethnicity in Pediatric Plastic Surgery in the United States
Authors: Netson Rebecca A. , Miller Stephanie , Nuzzi Laura C. , Parry Gareth J. , Bridges Samantha K. , Taghinia Amir H.
Published: February 2023

Background:

The American College of Surgeons' National Surgical Quality Improvement Project-Pediatric Data manages a multicenter dataset for monitoring outcomes in pediatric surgical care. We explored trends in outcomes in the most frequently sampled current procedural terminology codes related to craniofacial and cleft lip and palate (CLP) surgical procedures over a 7-year period.

Methods:

We used National Surgical Quality Improvement Project-Pediatric Data on 28,147 pediatric patients who underwent plastic surgical procedures between January 1, 2012, and December 31, 2018. Eighteen relevant current procedural terminology codes were selected and sorted into two procedure groups: CLP and craniofacial. For each group, we explored trends in readmission, reoperation, extended length of stay, morbidity, and racial and ethnic variation.

Results:

The proportion of readmissions following CLP repair saw a significant reduction per year (from 3.6% to 1.7%). African American or Black CLP patients had significantly higher rates of readmission and extended length of stay when compared to the overall cohort. Asian and White CLP patients had significantly lower rates of experiencing an extended length of stay. For craniofacial cases, extended length of stay decreased significantly per year (from 7.7% to 2.8%). One possible driver of this change was a decrease in transfusion rates during the study period from 59% to 47%.

Conclusions:

Pediatric CLP and craniofacial cases saw significant improvements in safety, as indicated by reductions in readmission and extended length of stay. Given the racial differences observed, especially among CLP patients, continued research to identify and address systems of racism in health care remains a priority.
Myth and misconception about long-acting reversible contraception use among reproductive age group women in Debre Berhan governmental health centers, Ethiopia: qualitative study
Authors: Haileyes Kidane G. , Asfaw Hussen M. , Ayele Siraye G. , Kitawu Leul D.
Published: February 2023

Background:

Despite the effectiveness, convenience, and reversibility of fertility, long-acting reversible contraceptive (LARC) method use is still low in the world and Sub-Saharan Africa, including Ethiopia. Myths and misconceptions are believed to be one of the major reported barriers and impediments to LARC use.

Objective:

The purpose of this study was to investigate myths and misconceptions about LARC use among women of reproductive age in Debre Brehan town, Ethiopia, at governmental health centers.

Methods:

A qualitative study using a qualitative descriptive design was conducted from January 24 to April 15, 2022. Twenty-nine reproductive-age women who came for family planning services and 6 key informants were selected using a purposive sampling technique, and an in-depth interview technique with semistructured questionnaires was used to collect the data. The analysis was conducted using the thematic analysis method and ATLAS. ti9 qualitative software was used to support the analysis.

Result:

The findings of this study revealed that women had a variety of myths and misconceptions about the use of long-acting reversible contraception, including that it had an adverse impact on reproductive health problems and a predisposition to maternal and fetal illness; that the method was unsafe and ineffective in its characteristics; and that, socio-culturally, it was an unacceptable and undesirable method for women to use.

Conclusion:

This study indicates that there are widespread myths and misconceptions regarding long-acting reversible contraception use in reproductive-age women, which emanate from different concerns in the community. Measures should be taken by the concerned body to dispel or at least reduce these myths and misconceptions.
Addressing barriers to colorectal cancer screening in a federally qualified health center
Authors: Centra Tania , Fogg Catherine
Published: February 2023

Background:

Colorectal cancer (CRC) is a leading cause of death from cancer in the United States, despite the availability of high-quality screening options. Multiple barriers to CRC screening have been identified, including cost (noninsured), younger age, racial or ethnic minority, recent immigration to the United States (non-English speaking), fear or distrust of the health care system, and rural residence.

Local Problem:

The mean CRC screening rate for the designated Federally Qualified Health Center (FQHC) was 33.7% for the 5 months preceding this quality improvement (QI) project. The benchmark target for CRC screening was 60.1%.

Methods:

The Model for Improvement and Plan-Do-Study-Act cycle created the framework for the CRC screening targeted interventions used in this FQHC patient population.

Interventions:

Multiple targeted interventions were implemented over a 4-month period that emphasized a strong provider recommendation, a team-based approach to identify and offer CRC screening options to the overdue patient. A chart audit was followed by a mailed fecal immunochemical test (FIT) and colonoscopy reminder letter initiative.

Results:

The performance metric for CRC screening reached 40% within 4 months. A second chart audit confirmed the CRC screening rate improved to 41.5% among patients aged 50–75 years. An overall 55% return rate was achieved with the mailed FIT initiative within 2 months.

Conclusions:

Continued quality improvement initiatives are needed to achieve the benchmark target for this FQHC. These team-based interventions can be used by the primary care nurse practitioner to improve health equity for CRC screening in other underserved populations.
Screening for Partner Postpartum Depression
Authors: Le Joria , Alhusen Jeanne , Dreisbach Caitlin
Published: February 2023

Background:

Postpartum depression is a significant mental health condition affecting an estimated 7% to 20% of women, with higher rates among individuals with increased risk factors. Most research on postpartum depression has focused on mothers, with less recognition of the mental health changes experienced by their partners. Research suggests almost 20% of partners may experience postpartum depression, yet our understanding is limited. An enhanced understanding of postpartum depression in a birthing person's partner is critical, given the mental and physical health sequelae associated with depression.

Purpose:

The purpose of this review was to systematically examine the current tools available to assess partner postpartum depression.

Methods:

We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were identified using selected key terms in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Ovid MEDLINE. Studies were included if they assessed partner depressive symptoms and identified the specified use of a tool or screening measure.

Results:

Seventeen studies met inclusion criteria. Seven different measures were used to assess postpartum depression. The Edinburgh Postnatal Depression Scale (EPDS) was used in 16 out of the 17 studies for depression assessment.

Clinical Implications:

Routine screening of partners for postpartum depression should be recommended as part of standard care. Nurses are critical liaisons for assessing risk and connecting relevant and timely resources to birthing people and their partners. Identifying the available screening tools may help to avoid adverse clinical outcomes associated with increased symptom severity and burden.
Identification of Active Pulmonary Tuberculosis Among Patients With Positive Interferon-Gamma Release Assay Results
Authors: Park Jongsoo , Hwang Eui Jin , Lee Jong Hyuk , Hong Wonju , Nam Ju Gang , Lim Woo Hyeon , Kim Jae Hyun , Goo Jin Mo , Park Chang Min
Published: February 2023

Purpose:

To evaluate the accuracy of a deep learning-based computer-aided detection (CAD) system in identifying active pulmonary tuberculosis on chest radiographs (CRs) of patients with positive interferon-gamma release assay (IGRA) results in different scenarios of clinical implementation.

Materials and Methods:

We collected the CRs of consecutive patients with positive IGRA results. Findings of active pulmonary tuberculosis on CRs were independently evaluated by the CAD and a thoracic radiologist, followed by interpretation using the CAD. Sensitivity and specificity were evaluated in different scenarios: (a) radiologists’ interpretation, (b) radiologists’ CAD-assisted interpretation, and (c) CAD-based prescreening (radiologists’ interpretation for positive CAD results only). We conducted a reader test to compare the accuracy of the CAD with those of 5 radiologists.

Results:

Among 1780 patients (men, 53.8%; median age, 56 y), 44 (2.5%) were diagnosed with active pulmonary tuberculosis. The CAD-assisted interpretation exhibited a higher sensitivity (81.8% vs. 72.7%; P=0.046) but lower specificity than the radiologists’ interpretation (84.1% vs. 85.7%; P<0.001). The CAD-based prescreening exhibited a higher specificity than the radiologists’ interpretation (88.8% vs. 85.7%; P<0.001) at the same sensitivity, with a workload reduction of 85.2% (1780 to 263). In the reader test, the CAD exhibited a higher sensitivity than radiologists (72.7% vs. 59.5%; P=0.005) at the same specificity (88.0%), and CAD-assisted interpretation significantly improved the sensitivity of radiologists’ interpretation (72.3%; P<0.001).

Conclusions:

For identifying active pulmonary tuberculosis among patients with positive IGRA results, deep learning-based CAD can enhance the sensitivity of interpretation. CAD-based prescreening may reduce the radiologists’ workload at an improved specificity.
Facial Allograft Donation: An Interpretative Phenomenological Analysis of the Experiences of Family Members
Authors: Verfaillie Anthony , De Corte Kim , Van Parys Hanna , Roche Nathalie A. , Stillaert Filip B. , Vermeersch Hubert F. , Peeters Patrick C. , Colenbie Luc , De Cubber Jan , De Roeck Frans , Blondeel Phillip N. , Lemmens Gilbert M.D.
Published: February 2023

Facial allograft transplantation can be regarded as a particular and complex type of donation because of its perceptibility and the importance of the face as an identity characteristic. As research on this topic is currently lacking, the objective of this study is to explore the experiences of the family members of the donor in facial allograft donation. In-depth, semi-structured interviews were conducted separately with the donor’s family members and analyzed using interpretative phenomenological analysis. Six themes were identified: (1) Contrasting facial donation to that of more commonly donated organs; (2) Consenting to facial donation; (3) Expectations towards the recipient of the facial graft; (4) Expectations and consequences of restoration of the donor’s face; (5) Relationship with the medical team during the process; and (6) Media attention. The findings of our study help to better support donor families through the facial donation process and to improve facial transplantation procedures.
The Feasibility of Electromagnetic Navigation Technique to Achieve Preoperative Plan in Mandibular Angle Osteotomy
Authors: Sun Mengzhe , Rao Lan , Chai Yuanhao , Lin Li , Zhang Cunliang , Gao Yuan , Chai Gang , Xu Haisong
Published: February 2023

Background:

In contrast to the most commonly used optical navigation system, electromagnetic navigation has huge potential in operations with a narrow field. The purpose of this experiment was to test and confirm whether the electromagnetic navigation method the authors developed for mandibular angle osteotomy (MAO) met clinical requirements.

Methods:

Using a dental splint that could be repeatedly mounted on teeth, registration between surgical plan and actual field was performed automatically.

Results:

Navigation of MAO was first performed on 10 mandibular models. The position precision measured using a coordinate measuring machine was 1.30±0.61 mm. Then, a navigation experiment was performed on 4 patients. Accuracy in actual operation measured by the NDI pointing sensor was 1.89±0.76 mm. Our noninvasive automatic registration process reduced the surgical exposure time and eliminated the bias of the manual selection of registration points.

Conclusions:

This preliminary study confirmed the feasibility of the electromagnetic navigation technique in terms of both applicability and accuracy in MAO surgery.
Autologous Costal Cartilage With Expanded Polytetrafluorethylene (ePTFE) Implants for the Treatment of Nasal Deformity After Unilateral Cleft Lip Repair
Authors: Li Haidong , Wang Jingyi , Song Tao
Published: February 2023

Objective:

To repair and reconstruct the secondary nasal deformity after unilateral cleft lip repair, we used autologous costal cartilage and expanded polytetrafluorethylene (ePTFE) to get a better nasal shape.

Method:

Nineteen patients with nasal deformity after unilateral cleft lip repair were treated from July 2018 to July 2021. During the operation, autologous costal cartilage was carved and formed and then implanted into the nasal tip and nasal columella, while the back of the nose was raised with ePTFE.

Result:

Nineteen cases were followed up for 6 to 30 months. No transplanted cartilage and swelling were exposed or discharged. The appearance was good, and the patients were satisfied.

Conclusion:

Autologous costal cartilage combined with ePTFE is an ideal treatment for nasal deformity after cleft lip repair.
How do fluctuating ecological dynamics impact the evolution of hosts and parasites?
Authors: Best A. , Ashby B.
Published: February 2023

Theoretical models of the evolution of parasites and their hosts have shaped our understanding of infectious disease dynamics for over 40 years. Many theoretical models assume that the underlying ecological dynamics are at equilibrium or constant, yet we know that in a great many systems there are fluctuations in the ecological dynamics owing to a variety of intrinsic or extrinsic factors. Here, we discuss the challenges presented when modelling evolution in systems with fluctuating ecological dynamics and summarize the main approaches that have been developed to study host–parasite evolution in such systems. We provide an in-depth guide to one of the methods by applying it to two worked examples of host evolution that have not previously been studied in the literature: when cycles occur owing to seasonal forcing in competition, and when the presence of a free-living parasite causes cycles, with accompanying interactive Python code provided. We review the findings of studies that have explored host–parasite evolution when ecological dynamics fluctuate, and point to areas of future research. Throughout we stress the importance of feedbacks between the ecological and evolutionary dynamics in driving the outcomes of infectious disease systems.

This article is part of the theme issue ‘Infectious disease ecology and evolution in a changing world’.
The socio-economic challenges of managing pathogen evolution in agriculture
Authors: Geffersa A. G. , Burdon J. J. , Macfadyen S. , Thrall P. H. , Sprague S. J. , Barrett L. G.
Published: February 2023

Genetic resistance forms the foundation of infectious disease management in crops. However, rapid pathogen evolution is causing the breakdown of resistance and threatening disease control. Recent research efforts have identified strategies for resistance gene deployment that aim to disrupt pathogen adaptation and prevent breakdown. To date, there has been limited practical uptake of such strategies. In this paper, we focus on the socio-economic challenges associated with translating applied evolutionary research into scientifically informed management strategies to control pathogen adaptation. We develop a conceptual framework for the economic valuation of resistance and demonstrate that in addition to various direct benefits, resistance delivers considerable indirect and non-market value to farmers and society. Incentives for stakeholders to engage in stewardship strategies are complicated by the uncertain timeframes associated with evolutionary processes, difficulties in assigning ownership rights to genetic resources and lack of governance. These interacting biological, socio-economic and institutional complexities suggest that resistance breakdown should be viewed as a wicked problem, with often conflicting imperatives among stakeholders and no simple cause or solution. Promoting the uptake of scientific research outcomes that address complex issues in sustainable crop disease management will require a mix of education, incentives, legislation and social change.

This article is part of the theme issue ‘Infectious disease ecology and evolution in a changing world’.
Intraspecific trait variation and changing life-history strategies explain host community disease risk along a temperature gradient
Authors: Halliday Fletcher W. , Czyżewski Szymon , Laine Anna-Liisa
Published: February 2023

Predicting how climate change will affect disease risk is complicated by the fact that changing environmental conditions can affect disease through direct and indirect effects. Species with fast-paced life-history strategies often amplify disease, and changing climate can modify life-history composition of communities thereby altering disease risk. However, individuals within a species can also respond to changing conditions with intraspecific trait variation. To test the effect of temperature, as well as inter- and intraspecifc trait variation on community disease risk, we measured foliar disease and specific leaf area (SLA; a proxy for life-history strategy) on more than 2500 host (plant) individuals in 199 communities across a 1101 m elevational gradient in southeastern Switzerland. There was no direct effect of increasing temperature on disease. Instead, increasing temperature favoured species with higher SLA, fast-paced life-history strategies. This effect was balanced by intraspecific variation in SLA: on average, host individuals expressed lower SLA with increasing temperature, and this effect was stronger among species adapted to warmer temperatures and lower latitudes. These results demonstrate how impacts of changing temperature on disease may depend on how temperature combines and interacts with host community structure while indicating that evolutionary constraints can determine how these effects are manifested under global change.

This article is part of the theme issue ‘Infectious disease ecology and evolution in a changing world’.
How public health authorities can use pathogen genomics in health protection practice: a consensus-building Delphi study conducted in the United Kingdom
Authors: Killough Nicholas , Patterson Lynsey ,   The COVID-19 Genomics UK (COG-UK) consortium†, Peacock Sharon J. , Bradley Declan T.
Published: February 2023

Pathogen sequencing guided understanding of SARS-CoV-2 evolution during the COVID-19 pandemic. Many health systems developed pathogen genomics services to monitor SARS-CoV-2. There are no agreed guidelines about how pathogen genomic information should be used in public health practice. We undertook a modified Delphi study in three rounds to develop expert consensus statements about how genomic information should be used. Our aim was to inform health protection policy, planning and practice. Participants were from organisations that produced or used pathogen genomics information in the United Kingdom. The first round posed questions derived from a rapid literature review. Responses informed statements for the subsequent rounds. Consensus was accepted when 70 % or more of the responses were strongly agree/agree, or 70 % were disagree/strongly disagree on the five-point Likert scale. Consensus was achieved in 26 (96 %) of 27 statements. We grouped the statements into six categories: monitoring the emergence of new variants; understanding the epidemiological context of genomic data; using genomic data in outbreak risk assessment and risk management; prioritising the use of limited sequencing capacity; sequencing service performance; and sequencing service capability. The expert consensus statements will help guide public health authorities and policymakers to integrate pathogen genomics in health protection practice.
Laboratory strains of Escherichia coli K-12: things are seldom what they seem
Authors: Browning Douglas F. , Hobman Jon L. , Busby Stephen J. W.
Published: February 2023

Escherichia coli

K-12 was originally isolated 100 years ago and since then it has become an invaluable model organism and a cornerstone of molecular biology research. However, despite its pedigree, since its initial isolation

E. coli

K-12 has been repeatedly cultured, passaged and mutagenized, resulting in an organism that carries many genetic changes. To understand more about this important model organism, we have sequenced the genomes of two ancestral K-12 strains, WG1 and EMG2, considered to be the progenitors of many key laboratory strains. Our analysis confirms that these strains still carry genetic elements such as bacteriophage lambda (λ) and the F plasmid, but also indicates that they have undergone extensive laboratory-based evolution. Thus, scrutinizing the genomes of ancestral

E. coli

K-12 strains leads us to examine whether

E. coli

K-12 is a sufficiently robust model organism for 21st century microbiology.
Strainy: phasing and assembly of strain haplotypes from long-read metagenome sequencing
Authors: Kazantseva Ekaterina , Donmez Ataberk , Frolova Maria , Pop Mihai , Kolmogorov Mikhail
Published: February 2023

Bacterial species in microbial communities are often represented by mixtures of strains, distinguished by small variations in their genomes. Despite the functional importance of intra-strain heterogeneity, its characterization from metagenomic sequencing data remains challenging. Short-read approaches can be used to detect small-scale variation between strains, but fail to phase these variants into contiguous haplotypes. Long-read metagenome assemblers can generate contiguous bacterial chromosomes, but often suppress strain-level variation in favor of species-level consensus. Here we present Strainy - an algorithm for strain-level metagenome assembly and phasing from Nanopore and HiFi reads. Strainy takes a de novo metagenomic assembly as input, identifies strain variants which are then phased and assembled into contiguous haplotypes. Using simulated and mock Nanopore and HiFi metagenome data, we show that Strainy assembles accurate and complete strain haplotypes, outperforming current Nanopore-based methods and comparable with HiFi-based algorithms in completeness and accuracy. We then use Strainy to assemble strain haplotypes of a complex environmental metagenome, revealing distinct mutational patterns in bacterial species.
Multi-response Mendelian randomization: Identification of shared and distinct exposures for multimorbidity and multiple related disease outcomes
Authors: Zuber Verena , Lewin Alex , Levin Michael G. , Haglund Alexander , Gonzalez Soumaya Ben-Aicha , Emanueli Costanza , Damrauer Scott , Burgess Stephen , Gill Dipender , Bottolo Leonardo
Published: February 2023

The existing framework of Mendelian randomization (MR) infers the causal effect of one or multiple exposures on one single outcome. It is not designed to jointly model multiple outcomes, as would be necessary to detect causes of more than one outcome and would be relevant to model multimorbidity or other related disease outcomes. Here, we introduce Multi-response Mendelian randomization (MR2), a novel MR method specifically designed for multiple outcomes to identify exposures that cause more than one outcome or, conversely, exposures that exert their effect on distinct responses. MR2uses a sparse Bayesian Gaussian copula regression framework to detect causal effects while estimating the residual correlation between summary-level outcomes, i.e., the correlation that cannot be explained by the exposures, andviceversa. We show both theoretically and in a comprehensive simulation study how unmeasured shared pleiotropy induces residual correlation. We also reveal how non-genetic factors that affect more than one outcome contribute to their correlation. We demonstrate that by accounting for residual correlation, MR2has higher power to detect shared exposures causing more than one outcome. It also provides more accurate causal effect estimates than existing methods that ignore the dependence between related responses. Finally, we illustrate how MR2detects shared and distinct causal exposures for five cardiovascular diseases in two applications considering cardiometabolic and lipidomic exposures and uncovers residual correlation between summary-level outcomes reflecting known relationships between cardiovascular diseases.