bluuebunny/crossref_metadata_2025 huggingface dataset:
Patients' motivation to undergo transcatheter aortic valve replacement. A phenomenological hermeneutic study
Authors: Lachonius Maria , Wallström Sara , Odell Annika , Pétursson Pétur , Jeppsson Anders , Skoglund Kristofer , Nielsen Susanne J.
Published: December 2022

Background

Aortic stenosis is the most common valvular disease, and its prevalence is increasing due to the ageing population. Transcatheter aortic valve replacement (TAVR) is the recommended method when treating frail, older patients. Knowledge of what motivates older patients to undergo TAVR is important, in order to meet patients' expectations.

Objective

The study aimed to explore the meaning of older patients' motivation to undergo TAVR.

Design and Methods

The design was a qualitative study, analysed using a phenomenological hermeneutic approach. In‐depth, semi‐structured interviews with open‐ended questions were conducted. Participants were selected from a specialist cardiology clinic in Sweden. Eighteen patients, six women and twelve men, aged 66–92, were recruited.

Results

The analysis showed that patients who had agreed to undergo TAVR were deeply affected by their body's failure. Before the TAVR procedure, the participants were limited in their daily activities and experienced that their life was on hold. They experienced that they were barely existing. They were aware of their life‐threatening condition and were forced to confront death. Yet despite an advanced age, they still had considerable zest for life. It was very important to them to remain independent in everyday life, and fear of becoming dependent had a strong impact on their motivations for undergoing TAVR.

Conclusion

Older patients' motivations to undergo TAVR are strongly influenced by their fear of being dependent on others and their zest for life. Health care professionals need to support these patients in setting realistic and personalised goals.

Implication for practice

Person‐centered care actions could facilitate patients' involvement in the decision about TAVR and strenghten patients' beliefs in their own capabilities, before and after TAVR.
Examining daily disposable soft contact lens wearers' attitudes and beliefs using the Health Belief Model
Authors: Lutmer Kelly M. , Wagner Heidi , Richdale Kathryn , Zimmerman Aaron B. , Datta Ananya , Dougherty Bradley E.
Published: December 2022

Purpose

To use the Health Belief Model (HBM) to understand daily disposable (DD) soft contact lens (SCL) wearers' attitudes and beliefs.

Methods

A convenience sample of DD SCL wearers (18–33 years) was enrolled at two sites. Participants were queried about demographics, SCL wear and HBM constructs. Rasch analysis was used to assess the psychometric properties of the survey instrument and generate scores for each HBM subscale. ANOVA was used to determine relationships among HBM constructs, subject demographics and DD SCL‐related health behaviours.

Results

One hundred people participated (mean ± SD), age = 24.2 ± 3.9 years, 76% female. Thirty‐seven percent reported sleeping in DD SCLs and 25% reported reusing DD SCLs. Self‐report of reusing DD SCLs was associated with scores on the benefits: reuse (p = 0.02) and barriers (p = 0.007) subscales, and sleeping in lenses was associated with scores on the susceptibility (p = 0.05), benefits: wear behaviours (p = 0.006) and barriers (p = 0.01) subscales. Rasch analysis showed some subscales demonstrated multidimensionality.

Conclusions

Selected health belief constructs were associated with DD SCL‐related behaviours including reusing and overnight wear. Increased understanding of SCL attitudes and beliefs could inform patient education and interventions to decrease risks associated with improper SCL wear.
Identification of proline, 1‐pyrroline‐5‐carboxylate and glutamic acid as biomarkers of depression reflecting brain metabolism using carboxylomics, a new metabolomics method
Authors: Bian Xiqing , Zhou Na , Zhao Yiran , Fang Yichao , Li Na , Zhang Xin , Wang Xuan , Li Yunxia , Wu Jian‐Lin , Zhou Tingting
Published: December 2022

Aim

Depression is a psychiatric disease which is accompanied by metabolic disorder. Though depression has been widely studied, its metabolism is yet to be illustrated. We aimed to manifest the underlying mechanisms to diagnose depression.

Methods

One hundred thirty serum samples, including 65 patients and 65 healthy controls from different hospitals (training and validation cohorts), were recruited into the research. Sensitive Profiling for ChemoSelective Derivatization Carboxylomics (SPCSDCarboxyl) was applied to deeply hunt for the differential metabolites. Then, the serum, CSF, and hippocampus from depression rat models (CUMS group) were used to further confirm the results. Additionally, the co‐occurrence between enzymes and biomarkers, as well as the combinatorial marker panel and the correlation of biomarkers among serum, CSF, or hippocampus were elucidated.

Results

Two hundred eight metabolites were identified from the sera of patients. Proline, 1‐pyrroline‐5‐carboxylate (P5C), and glutamic acid could discriminate patients from healthy humans and were confirmed to be the potential biomarkers. After further validation through CUMS rats, proline, and P5C were enriched, while glutamic acid was depleted in the CUMS group. The co‐occurrence analysis of enzymes and biomarkers indicated that they could be used for the diagnosis of depression. Moreover, the combinatorial marker panel and the correlation analysis of biomarkers between serum and CSF or between serum and hippocampus revealed that serum could be an alternative approach to directly reflect the potential physiological mechanisms and diagnose depression instead of brain samples.

Conclusion

These integrated methods may facilitate the identification of biomarkers and help manifest the underlying mechanisms of depression.
Deceased donor organ allocation in pediatric transplantation: A historical narrative
Authors: Ettenger Robert , Venick Robert S. , Gritsch Hans A. , Alejos Juan C. , Weng Patricia L. , Srivastava Rachana , Pearl Meghan
Published: December 2022

Background

Since the earliest clinical successes in solid organ transplantation, the proper method of organ allocation for children has been a contentious subject. Over the past 30–35 years, the medical and social establishments of various countries have favored some degree of preference for children on the respective waiting lists. However, the specific policies to accomplish this have varied widely and changed frequently between organ type and country.

Methods

Organ allocation policies over time were examined. This review traces the reasons behind and the measures/principles put in place to promote early deceased donor transplantation in children.

Results

Preferred allocation in children has been approached in a variety of ways and with varying degrees of commitment in different solid organ transplant disciplines and national medical systems.

Conclusion

The success of policies to advantage children has varied significantly by both organ and medical system. Further work is needed to optimize allocation strategies for pediatric candidates.
State of pediatric liver transplantation in the United States and achieving zero wait list mortality with ideal outcomes: A statement from the Starzl Network for Excellence in Pediatric Transplant Surgeon's Working Group
Authors: Rasmussen Sara K. , Lemoine Caroline P. , Superina Riccardo , Sayed Blayne , Goldaracena Nico , Soltys Kyle A. , Griesemer Adam , Dick Andre , Angelis Michael , Chin L. Thomas , Florman Sander , Ganoza Armando , Lyer Kishore , Kang Sang‐Mo , Magliocca Joseph , Squires James , Eisenberg Elizabeth , Bray David , Tunno John , Reyes Jorge D. , Mazariegos George V.
Published: December 2022

Background

Liver transplant is a life‐saving therapy that can restore quality life for several pediatric liver diseases. However, it is not available to all children who need one. Expertise in medical and surgical management is heterogeneous, and allocation policies are not optimally serving children. Technical variant grafts from both living and deceased donors are underutilized.

Methods

Several national efforts in pediatric liver transplant to improve access to and outcomes from liver transplant for children have been instituted and include adjustments to allocation policies, UNOS‐sponsored collaborative improvement projects, and the emergence of national learning networks to study ongoing challenges in the field the Surgical Working group of the Starzl Network for Excellence in Pediatric Transplantation (SNEPT) discusses key issues and proposes potential solutions to eliminate the persistent wait list mortality that pediatric patients face.

Results

A discussion of the factors impacting pediatric patients’ access to liver transplant is undertaken, along with a proposal of several measures to ensure equitable access to life‐saving liver transplant.

Conclusions

Pediatric liver transplant wait list mortality can and should be eliminated. Several measures, including collaborative efforts among centers, could be leveraged to acheive this goal.
Validity as (material!) truth‐preservation in virtue of form
Authors: Haze Tristan Grøtvedt
Published: December 2022

According to a standard story, part of what we have in mind when we say that an argument is valid is that it is necessarily truth‐preserving: if the premises are true, the conclusion must also be true. But—the story continues—that's not enough, since ‘Roses are red, therefore roses are coloured’, for example, while it may be necessarily truth‐preserving, is not so in virtue of form. Thus we arrive at a standard contemporary characterisation of validity: an argument is valid when it is NTP in virtue of form. Here I argue that we can and should drop the N; the resulting account is simpler, less problematic, and performs just as well with examples.
Remember the time
Authors: van Es Sam W.
Published: December 2022

Like the ability of a fox to avoid the same snare twice, the plant Arabidopsis thaliana seems to be able to respond differently to an event it has previously encountered. Shrewdness is no surprising characteristic of a fox, but the comparison does invite the question: do plants possess memory? In this edition of Physiologia Plantarum, the article by Vyse et al. (2022) describes how Arabidopsis responds differently to cold‐stress, when encountering it for the first time (priming) and to a second similar stress after a memory phase (triggering). Arabidopsis seems to perceive the stress after triggering as a milder one and the authors postulate that the memory of the first occurrence of the stress reduces the amount of resources needed to cope with the cold‐stress a second time.
Contextual responsiveness in U.S. local government climate policy
Authors: Switzer David , Jung Jiwoong
Published: December 2022

Local governments have led the way on climate action in the United States. While the federal government has largely stood to the side, local governments have made great efforts to adopt policies aimed at reducing greenhouse gas emissions. A large and robust literature in urban politics has explored the variables that influence local government action on climate change in the United States. Issue severity and resident ideological preferences have been identified as two of the most important factors in local climate action. Governments that are more likely to face major impacts from climate, such as coastal communities, and governments serving more liberal residents have both been found to pursue climate policy at higher rates. In this paper we suggest that these relationships are better understood as conditional. We argue that the effect of issue severity will be moderated by ideology. When residents are liberal, issue severity will matter. When residents are conservative, the impact will be muted. We find strong evidence for this hypothesis. Coastal governments and governments that have experienced drought adopt more climate policies, but this is conditional on the ideology of residents.
Novel ultraviolet‐dermoscopy: Early diagnosis and activity evaluation of vitiligo
Authors: Yuan Mengyi , Xie Yasi , Zheng Yue , Zhang Ziwei , Yang Chuyan , Li Junjie
Published: December 2022

Background/Objective

Polarized dermoscopy, Wood's lamp, and reflectance confocal microscopy were currently commonly used auxiliary technology in vitiligo clinic diagnosis. To improve the efficiency and accuracy of different periods of lesions of vitiligo, we used a novel ultraviolet (UV)‐dermoscopy (Model CH‐UVDS30, Ultraviolet wavelength range of 360<390nm, Chuanghong Science and Technology Company, China) in clinical observation.

Materials and Methods

Three cases of different periods of vitiligo patients were included in this study. Polarised dermoscopy and novel UV‐dermoscopy (UV wavelength range of 360 nm < λ < 390 nm) were performed at 20 × magnification in polarized and UV modes. Characteristic manifestations of different periods of vitiligo lesions were captured and compared.

Results

The depigmented and pigmented junctional zone and perifollicular pigmentation areas could be easier and simultaneously identified via UV‐dermoscopy. In a progressive vitiligo patient (woman, 42 years old, face) enhanced perifollicular pigmentation and blurred border were clearly observed. In a stable vitiligo patient (man, 27 years old, right foot) sharply demarcated border and perifollicular depigmentation could be found. In a re‐pigmenting vitiligo patient (woman, 41 years old, neck) telangiectasias and pigmentation reservoirs were observed.

Conclusion

Novel UV‐dermoscopy, as a miniature and portable device, might help early diagnosis, active/progress judgment, and treatment effect evaluation of vitiligo in the clinic.
Promoting social and emotional learning competencies in science, technology, engineering, and mathematics project‐based mathematics classrooms
Authors: Lee Yi‐Jung
Published: December 2022

In this Information Age, mathematics learning has shifted from independent to collaborative, and the ability to utilize both intrapersonal and interpersonal skills in learning has become essential. To cultivate multiple intelligences in mathematics classrooms, integrating project‐based learning into mathematics instruction can be a promising approach. In this study, we analyzed 15 elementary interns' project‐based mathematics (PBM) lessons and observed their implementation at two public elementary schools in the southern United States. The findings revealed that the science, technology, engineering, and mathematics (STEM) PBM lessons conducted by the interns shared five common features: (a) enhancing empathy and social awareness, (b) solving real‐life mathematics‐related problems, (c) utilizing personal strengths to enhance the utility of mathematics, (d) supporting wide‐ranging and collective mathematics learning, and (e) cultivating personal responsibility in mathematical problem solving. We further discussed how these STEM PBM lessons guaranteed an opportunity to foster students' social and emotional learning competencies in mathematics classrooms. We conclude that PBM provides a practical way to effectively engage students and enhance learning purpose in elementary classrooms and recommend this innovative pedagogy to both novice and veteran elementary teachers.
Minute moss beetles in the Southern Hemisphere: Molecular phylogeny, historical biogeography and habitat shifts (Coleoptera: Hydraenidae)
Authors: Bilton David T. , Jäch Manfred A. , Ribera Ignacio , Toussaint Emmanuel F. A.
Published: December 2022

Minute moss beetles (Hydraenidae) are one of the most speciose and widespread families of aquatic Coleoptera, with an estimated 4000 extant species, found in the majority of aquatic habitats from coastal rock pools to mountain streams and from the Arctic Circle to the Antarctic islands. Molecular phylogenetic works have improved our understanding of the evolutionary history of the megadiverse Hydraena, Limnebius and Ochthebius in recent years, but most genera in the family have not yet been included in any phylogenetic analyses, particularly most of those which are restricted to the Southern Hemisphere. Using a multimarker molecular matrix, sampling over 40% of described species richness and 75% of currently recognized genera, we infer a comprehensive molecular phylogeny of these predominantly Gondwanan Hydraenidae. Whilst the genera we focus on are morphologically diverse, and currently classified across all four hydraenid subfamilies, our phylogenetic analyses suggest that these Gondwanan genera may instead constitute a single clade. As a result of our findings, the African genus Oomtelecopon Perkins syn.n. is shown to nest within Coelometopon Janssens, the New Zealand Homalaena Ordish syn.n. and Podaena Ordish syn.n. are synonymised with Orchymontia Broun, and the South African Pterosthetops Perkins syn.n. is synonymised with Prosthetops Waterhouse, resulting in Pterosthetopini Perkins syn.n. being synonymised with Prosthetopini Perkins. Mesoceratops Bilton & Jäch gen.n. is erected to accommodate six former members of Mesoceration Janssens, which is shown to be polyphyletic. We propose the replacement name Orchymontia ordishi Jäch & Bilton nom.n. for Homalaena dilatata Ordish, 1984 (now a junior homonym); altogether 39 new combinations are proposed. Our Bayesian divergence times infer an origin for this ‘Gondwana group’ of genera in Africa plus Madagascar in the mid‐Cretaceous and suggest that both vicariant and dispersal processes, together with extinctions, have shaped the biogeographic history of these beetles in the Southern Hemisphere during the Cretaceous, resulting in geographically conserved extant lineages. Finally, we reconstruct ancestral habitat shifts across our phylogeny, revealing numerous changes in habitat occupancy in these genera, including multiple origins of fully terrestrial, humicolous taxa in different regions.
The MITOCHONDRIAL TRANSCRIPT STABILITY FACTOR 4 (MTSF4) is essential for the accumulation of dicistronic rpl5‐cobmRNAs in Arabidopsis thaliana
Authors: Jung Lisa , Schleicher Sarah , Alsaied Taha Fatema , Takenaka Mizuki , Binder Stefan
Published: December 2022

The Arabidopsis thaliana genome harbors more than 450 nuclear genes encoding pentatricopeptide repeat (PPR) proteins that operate in the RNA metabolism of mitochondria and/or plastids. To date, the molecular function of many PPR proteins is still unknown. Here we analyzed the nucleus‐encoded gene At4g19440 coding for a P‐type PPR protein. Knockout of this gene interferes with normal embryo development and seed maturation. Two experimental approaches were applied to overcome lethality and to investigate the outcome of At4g19440 knockout in adult plants. These studies revealed changes in the abundance of several mitochondria‐encoded transcripts. In particular, steady‐state levels of dicistronic rpl5‐cob RNAs were markedly reduced, whereas levels of mature ccmC and rpl2‐mttB transcripts were clearly increased. Predictions according to the one repeat to one nucleotide code for PPR proteins indicate binding of the At4g19440 protein to a previously detected small RNA at the 3′ termini of the dicistronic rpl5‐cob transcripts. This potential interaction indicates a function of this protein in 3′ end formation and stabilization of these RNA species, whereas the increase in the levels of the ccmC mRNA along with other mitochondria‐encoded RNAs seems to be a secondary effect of At4g19440 knockout. Since the inactivation of At4g19440 influences the stability of several mitochondrial RNAs we call this gene MITOCHONDRIAL TRANSCRIPT STABILITY FACTOR 4 (MTSF4). This factor will be an interesting subject to study opposing effects of a single nucleus‐encoded protein on mitochondrial transcript levels.
Establishment of preliminary reference intervals and cytochemical staining of blood cells in big‐bellied seahorses (Hippocampus abdominalis)
Authors: Vergneau‐Grosset Claire , Frigon Jean‐Philippe , Benoit‐Biancamano Marie‐Odile , Raulic Juliette , Lessard Marie‐Pierre , Gara‐Boivin Carolyn
Published: December 2022

Background

Despite their popularity, hematology reference intervals (RIs) have not been established in big‐bellied seahorses (Hippocampus abdominalis).

Objective

The objectives of this study were to establish hematologic RIs to compare values between sex in regard to cytochemical staining of blood cells. We also sought to compare white blood cell concentrations using the Natt and Herrick technique vs blood smear estimates.

Methods

Forty‐three healthy individuals from the Aquarium du Québec (22 females and 21 males) were included. Normal health status was confirmed by an unremarkable physical examination in five individuals and by necropsy of five other individuals, of which all were excluded from further analyses. Venipuncture was performed from the ventral coccygeal vein in the remaining 33 individuals without anesthesia using heparinized insulin syringes. A blood volume of 0.05 to 0.1 ml was collected to prepare Wright Giemsa‐stained blood smears and hematocrits immediately after venipuncture. Whole blood was stored in heparinized Eppendorf tubes to determine red and white blood cell concentrations using the Natt and Herrick technique with a hemocytometer in 10 individuals; these results were compared with blood smear estimates. Additional blood smears were stained with alkaline phosphatase substrate, periodic acid Schiff, and toluidine blue stains.

Results

The reference intervals included the packed cell volume (27.4–67.5%), thrombocyte count (19.5–197.7 × 109/L), and white blood cell (WBC) count (2–54.8 × 109/L), including neutrophils (1.1–21.3 × 109/L), lymphocytes (2.7–45.5 × 109/L), and monocytes (0–2.2 × 109/L). The WBC hemocytometer counts showed no correlation with blood smear estimates (Spearman's rho = 0.2). There was also no significant difference between the sexes.

Conclusions

These preliminary reference intervals will help assess the health of seahorses.
A multicenter retrospective case–cohort study on the prevalence of incisional morbidities in late pregnant mares following exploratory celiotomy (2014–2019): 579 cases
Authors: Klein Chelsea E. , Stefanovski Darko , Gardner Alison K. , Woodie J. Brett , Embertson Rolf M. , Mudge Margaret C. , Hurcombe Samuel D.
Published: December 2022

Objective

To report the prevalence and risk factors for incisional morbidities in late pregnant and nonpregnant/early pregnant control mares following colic surgery.

Design

Multicenter, retrospective, cohort study from January 2014 to December 2019.

Setting

Two university teaching hospitals and 1 private referral center.

Animals

Five hundred and seventy‐nine fillies and mares ≥2 years old that underwent celiotomy. Pregnant mares (n = 54) were >240 days in gestation from the last known breeding date and were compared to control females (n = 525) undergoing colic surgery.

Interventions

None.

Measurements and Main Results

Morbidity rates were not different between mare groups with 56% of pregnant mares and 51% of control mares reporting at least 1 morbidity. Incisional swelling was the most common reported complication in both groups. Incisional swelling was associated with shorter hospital stays (odds ratio [OR], 0.18;P < 0.01), and drainage was associated with a longer hospital stay (OR, 1.27;P ≤ 0.01) and with use of an abdominal bandage (OR, 4.4;P < 0.01). Herniation was associated with hypercapnia under anesthesia (OR, 1.1;P = 0.048), previous abdominal surgery (OR, 8.3;P = 0.003), and with use of an abdominal bandage (OR, 56;P = 0.006). Body wall dehiscence was associated with longer hospital stay (OR, 1.2;P < 0.01). Nonsurvival was higher in pregnant mares (13%) compared to control mares (5%;P = 0.02).

Conclusions

The prevalence of incisional morbidities did not differ between pregnant and control mares undergoing colic surgery. Several factors were associated with incisional morbidities, including the duration of surgery and anesthesia, anesthetic variables, abdominal bandage use, previous ventral abdominal incision, and longer duration of hospitalization.
Preliminary study evaluating the assessment of changes in pulmonary function associated with body positioning in dogs with suspected aspiration pneumonia
Authors: Ten Cate Soscha C. , Urion Rebecca , Hostnik Eric T. , Yaxley Page E. , Cooper Edward S.
Published: December 2022

Objective

To evaluate the variability in arterial blood gas (ABG) assessment of pulmonary function with different body positioning in dogs with suspected aspiration pneumonia.

Key Findings

The median differences in alveolar–arterial gradient, Pao2, and Paco2 values in different recumbencies were not statistically significantly different, both within patients and across the study population. No difference was noted in ABG values in the subgroups with unilateral or bilateral disease or that were more affected on the right side versus the left side.

Significance

This preliminary study provides data that can be used to calculate appropriate sample sizes for subsequent studies investigating the impact of recumbency on pulmonary function in patients with aspiration pneumonia.
Artificial intelligence in veterinary diagnostic imaging: A literature review
Authors: Hennessey Erin , DiFazio Matthew , Hennessey Ryan , Cassel Nicky
Published: December 2022

Artificial intelligence in veterinary medicine is an emerging field. Machine learning, a subfield of artificial intelligence, allows computer programs to analyze large imaging datasets and learn to perform tasks relevant to veterinary diagnostic imaging. This review summarizes the small, yet growing body of artificial intelligence literature in veterinary imaging, provides necessary background to understand these papers, and provides author commentary on the state of the field. To date, less than 40 peer‐reviewed publications have utilized machine learning to perform imaging‐associated tasks across multiple anatomic regions in veterinary clinical and biomedical research. Major challenges in this field include collection and cleaning of sufficient image data, selection of high‐quality ground truth labels, formation of relationships between veterinary and machine learning professionals, and closure of the gap between academic uses of artificial intelligence and currently available commercial products. Further development of artificial intelligence has the potential to help meet the growing need for radiological services through applications in workflow, quality control, and image interpretation for both general practitioners and radiologists.
Adapted Physical Activity Policies for Children and Adolescents in Brazil: Extension of the Para Report Card Brazil
Authors: Silva Diego Augusto Santos , Silva Carolina Fernandes da
Published: December 2022

Brazil is a country member of the Para Report Card, and Brazilian researchers have frequently published information on physical activity of children and adolescents. The current study aimed to analyze the policies for the promotion of adapted physical activity to Brazilian children and adolescents with disabilities. Official government information on adapted physical activity was analyzed from the official websites. Policies were analyzed based on the Para Report Card benchmarks, and after that we used the principles of SWOT (strengths, weaknesses, opportunities, and threats) to analyze the information. Adapted physical activity is not the main focus of any of the many policies to promote physical activity for children and adolescents. Based on the Para Report Card initiative, the score for this indicator in Brazil is D. Brazil needs to develop specific policies to promote physical activity adapted to the pediatric population with disabilities.
Influence of Torque and Cadence on Power Output Production in Cyclists
Authors: Leo Peter , Mateo-March Manuel , Valenzuela Pedro L. , Muriel Xabier , Gandía-Soriano Alexis , Giorgi Andrea , Zabala Mikel , Barranco-Gil David , Mujika Iñigo , Pallarés Jesús G. , Lucia Alejandro
Published: December 2022

Purpose: No information is available on the torque/cadence relationship in road cyclists. We aimed to establish whether this relationship differs between cyclists of different performance levels or team roles. Methods: Mean maximal power (MMP) output data from 177 riders were obtained from 2012 to 2021 from training and competitions. Cyclists were categorized according to their performance level (world-tour [WT, n = 68], procontinental [PC, n = 63], or under 23 [U23, n = 46]) and team role (time trialists [n = 12], all-rounders [n = 94], climbers [n = 64], or team leaders [n = 7]). Results: A significant interaction effect was found for absolute and relative MMP (P < .001), with higher values in PC than WT for short (5–60 s) efforts and the opposite trend for longer durations. MMP was also greater in PC than in U23 for short efforts (30–60 s), with WT and PC attaining higher MMP than U23 for longer bouts (5–60 min). A significant interaction effect was found for cadence (P = .007, but with no post hoc differences) and absolute (P = .010) and relative torque (P = .002), with PC and WT showing significantly higher torque (all P < .05) than U23 for 5- to 60-minute efforts, yet with no differences between the former 2 performance levels. No interaction effect between team roles was found for cadence (P = .185) or relative torque (P = .559), but a significant interaction effect was found for absolute torque (P < .001), with all-rounders attaining significantly higher values than climbers for 5-second to 5-minute efforts. Conclusions: Differences in MMP between cycling performance levels and rider types are dependent on torque rather than cadence, which might support the role of torque development in performance.
Tramadol and Cycling: Is It the End of a “Painful” Relationship? An Insight From 60,802 Doping-Control Samples From 2012 to 2020
Authors: Zandonai Thomas , Peiró Ana M. , Covelli Caterina , de la Torre Xavier , Botré Francesco
Published: December 2022

Purpose: To assess the prevalence of tramadol use among athletes from 2012 to 2020. Methods: All urine samples were collected from national and international in-competition doping-control tests that took place in Italy between 2012 and 2020. The analysis of the samples was performed by gas chromatography coupled with mass spectrometry with electronic ionization and acquisition in selected ion monitoring. The cutoff tramadol concentration was >50 ng/mL. Results: Of the 60,802 in-competition urine samples we analyzed, 1.2% (n = 759) showed tramadol intake, with 84.2% (n = 637) of these coming from cyclists and 15.8% (n = 122) from other sports. In cycling, a strong and significant negative correlation was found (r = −.738; P = .003), showing a decrease of tramadol use compared with the other sports. Conclusions: The decrease in tramadol prevalence in cycling in the last years may be due to (1) the deterrent action of antidoping regulations and (2) the fact that tramadol may not have any actual ergogenic effect on performance.
Antimicrobial Susceptibility Testing Performed in RPMI 1640 Reveals Azithromycin Efficacy against Carbapenem-Resistant Acinetobacter baumannii and Predicts
In Vivo
Outcomes in Galleria mellonella
Authors: Miller Sarah , Goy Kristine , She Rosemary , Spellberg Brad , Luna Brian
Published: December 2022

Antimicrobial susceptibility testing (AST) in RPMI 1640, a more physiologically relevant culture medium, revealed that a substantial proportion of carbapenem-resistant
Acinetobacter baumannii
isolates were susceptible to azithromycin, a macrolide antibiotic not currently considered effective against
A. baumannii
. Experiments using
Galleria mellonella
validated these
in vitro
data.
Succession, Replacement, and Modification of Chicken Litter Microbiota
Authors: Kubasova Tereza , Faldynova Marcela , Crhanova Magdalena , Karasova Daniela , Zeman Michal , Babak Vladimir , Rychlik Ivan
Published: December 2022

Despite intimate contact, the composition of bedding, litter, and cecal microbiota differs considerably. Species characteristic for litter microbiota at different time points of chicken production were identified thus opening the possibility for active manipulation of litter microbiota.
Landscape of Post-Transcriptional tRNA Modifications in Streptomyces albidoflavus J1074 as Portrayed by Mass Spectrometry and Genomic Data Mining
Authors: Koshla Oksana , Vogt Lea-Marie , Rydkin Oleksandr , Sehin Yuliia , Ostash Iryna , Helm Mark , Ostash Bohdan
Published: December 2022

Post-transcriptional tRNA modifications (PTTMs) play an important role in maturation and functionality of tRNAs. Little is known about tRNA modifications in the antibiotic-producing actinobacterial genus
Streptomyces
, even though peculiar tRNA-based regulatory mechanisms operate in this taxon.
Structures of Fission Yeast Inositol Pyrophosphate Kinase Asp1 in Ligand-Free, Substrate-Bound, and Product-Bound States
Authors: Benjamin Bradley , Goldgur Yehuda , Jork Nikolaus , Jessen Henning J. , Schwer Beate , Shuman Stewart
Published: December 2022

The inositol pyrophosphate signaling molecule 1,5-IP
8
modulates fission yeast phosphate homeostasis via its action as an agonist of RNA 3′-processing and transcription termination. Cellular IP
8
levels are determined by Asp1, a bifunctional enzyme composed of an N-terminal kinase and a C-terminal pyrophosphatase domain.
Natural Variation in Diauxic Shift between Patagonian
Saccharomyces eubayanus
Strains
Authors: Molinet Jennifer , Eizaguirre Juan I. , Quintrel Pablo , Bellora Nicolás , Villarroel Carlos A. , Villarreal Pablo , Benavides-Parra José , Nespolo Roberto F. , Libkind Diego , Cubillos Francisco A.
Published: December 2022

The diauxic shift has been studied in budding yeast under laboratory conditions; however, few studies have addressed the diauxic shift between carbon sources under fermentative conditions. Here, we study the transcriptional and chromatin structure differences that explain the natural variation in fermentative capacity and efficiency during diauxic shift of natural isolates of
S. eubayanus
.
Finding a VOICE in the Southern Hemisphere: A new record of global organic carbon?
Authors: Weger Ralf J. , Eberli Gregor P. , Rodriguez Blanco Leticia , Tenaglia Maximillian , Swart Peter K.
Published: December 2022

Variations in the carbon isotopic composition of carbonate and organic carbon (δ13Ccarb and δ13Corg) are generally used to record perturbations in the global carbon cycle, which are in turn closely linked to changes in climate. However, because of climate gradients on Earth, assignment of the “global” signal in ancient records is not straightforward. Here, we report the δ13C values of organic material in the Upper Jurassic to Lower Cretaceous sedimentary record of the Vaca Muerta Formation, situated in the Neuquén Basin, Argentina, which show similar patterns to those observed in several northern latitude basins. This record of δ13C values in the organic material differs from those measured in the early Atlantic Ocean, a record previously considered to be representative of the global values of organic carbon. As a result of the global synchronicity observed in the δ13C values of organic material from both northern and southern latitudes, we suggest that these patterns may represent the global record of δ13C values in organic material rather than those measured in the proto−Atlantic Ocean. The δ13C values of the organic components show a slight initial decrease of ∼2‰ in the early Tithonian (149−145 Ma) and then another decrease of ∼2‰ before reaching a minimum of −30.29‰ in the late Tithonian (145−143 Ma), followed by a gradual increasing trend throughout the Berriasian (143.1−137.7 Ma). The early Valanginian (137.7−135.5 Ma) was marked by a more substantial increase in δ13C values up to −23.46‰. These changes mirror those seen in Northern Hemisphere locations during the Late Jurassic and Early Cretaceous, where this perturbation has been termed the Volgian isotopic carbon excursion (VOICE). This difference in the Late Jurassic and Early Cretaceous δ13C values between the early Atlantic Ocean and the Neuquén Basin is interpreted to be the result of the climate gradient at the time, which was characterized by more humid conditions in high latitudes compared to dry conditions in the Atlantic Ocean basin.
Newly diagnosed autoimmune Addison’s disease in a patient with COVID-19 with autoimmune disseminated encephalomyelitis
Authors: Beshay Lauren , Wei Kevin , Yang Qin
Published: December 2022

A man in his 20s with a history of acute disseminated encephalomyelitis (ADEM) was brought into the emergency department (ED) after his family found him at home collapsed on the floor unresponsive with a blood glucose of 28 mg/dL at the field. In the ED, the patient was tachycardic, tachypnoeic and hypotensive, requiring pressors and intubation at 9 hours and 12 hours after arrival, respectively. Laboratory results revealed a positive COVID-19 test, serum sodium of 125 mmol/L and persistent hypoglycaemia. The patient was given a high dose of dexamethasone for COVID-19 treatment 1 hour before pressors were started. He was then continued on a stress dose of intravenous hydrocortisone with rapid clinical improvement leading to his extubation, and discontinuation of vasopressors and glucose on day 2 of admission. The patient received his last dose of intravenous hydrocortisone on day 4 in the early afternoon with the plan to order adrenal testing the following morning prior to discharge. On day 5, the aldosterone <3.0 ng/dL, adrenocorticotropic hormone (ACTH) level >1250 pg/mL, and ACTH stimulation test showed cortisol levels of 3 and 3 µg/dL at 30 and 60 min, respectively. The anti-21-hydroxylase antibody was positive. The patient was discharged on hydrocortisone and fludrocortisone. The patient’s symptoms, elevated ACTH, low cortisol and presence of 21-hydroxylase antibodies are consistent with autoimmune Addison’s disease. This is the first case reporting autoimmune Addison’s disease in a patient with COVID-19 with a history of ADEM. The case highlights the importance of considering adrenal insufficiency as a diagnostic differential in haemodynamically unstable patients with COVID-19.
Unilateral panuveitis secondary toJAK2mutation-associated lymphoproliferative disease
Authors: Li Yafeng , Grommes Christian , Deobhakta Avnish , Diaz Maria
Published: December 2022

A woman in her 70s experienced painless vision loss in the right eye for 1 month. Acute retinal necrosis-induced panuveitis was the referral diagnosis. With dense vitreous haze, a vitrectomy was performed for vitreous biopsy followed by multimodal imaging. Vitreous biopsy yielded negative PCR results for herpes viruses and only inflammatory cells. Post-vitrectomy imaging showed involuted but pervasive pigmentary foci in the outer retina and the retinal pigment epithelium. Concurrently, peripheral blood showed pancytosis with giant platelets and a Janus kinase 2 (JAK2) mutation, which prompted a haematological evaluation. CT and MRI revealed a right frontal lobe intra-axial mass, diagnosed as diffuse large B cell lymphoma (DLBCL). Subsequently, bone marrow aspirate confirmed the pathogenic V617FJAK2mutation. Following chemotherapy, the patient achieved lymphoma regression and uveitic quiescence. This is the first case report of acute unilateral panuveitis in a patient withJAK2mutation and DLBCL but without evidence of intraocular involvement.
Between rules and resistance: moving public health emergency responses beyond fear, racism and greed
Authors: Jackson Carly , Habibi Roojin , Forman Lisa , Silva Diego S. , Smith Maxwell J.
Published: December 2022

In times of a public health emergency, lawyers and ethicists play a key role in ensuring that government responses, such as travel restrictions, are both legally and ethically justified. However, when travel bans were imposed in a broadly discriminatory manner against southern African countries in response to the Omicron SARS-CoV-2 variant in late 2021, considerations of law, ethics or science did not appear to guide politicians’ decisions. Rather, these bans appeared to be driven by fear of contagion and electoral blowback, economic motivations and inherently racist assumptions about low-income and middle-income countries (LMICs). With a new pandemic treaty and amendments to the WHO’s International Health Regulations (IHR) on the near-term horizon, ethics and international law are at a key inflection point in global health governance. Drawing on examples of bordering practices to contain contagion in the current pandemic and in the distant past, we argue that the current IHR is not adequately constructed for a just and equitable international response to pandemics. Countries impose travel restrictions irrespective of their need or of the health and economic impact of such measures on LMICs. While the strengthening and reform of international laws and norms are worthy pursuits, we remain apprehensive about the transformative potential of such initiatives in the absence of collective political will, and suggest that in the interim, LMICs are justified in seeking strategic opportunities to play the same stark self-interested hardball as powerful states.
Improving detection of undiagnosed HIV through routine screening in a central London emergency department
Authors: Fox Matilda , Pettit Rosie , Mutengesa Ernest , Harper Alice , Nakhoul Maria , Mitra Anu
Published: December 2022

HIV is a global public health issue. Routine testing for HIV should be performed on all 16–59 years old attending emergency departments (EDs) in high-prevalence areas in the UK.

In August 2020, Charing Cross Hospital ED, situated in an ‘extremely high-prevalence’ area, had no formal guidelines on HIV testing. We aimed to increase HIV testing in 16–59 years old attending our ED to 25% by August 2021 through a quality improvement project, based on the Methodology for Improvement Model, performing six Plan–Do–Study–Act cycles over a 12-month period.

An initial ED staff survey revealed 55% (n=22/40) of respondents were unsure of national HIV testing guidelines. Barriers to good testing practice included: lack of clarity on protocols for consent and indication, cost and perceived stigmatisation of patient groups. Interventions were employed at regular intervals, including employment of an HIV nurse advocate, inclusion of HIV tests in a blood test careset during ED triage, and updated trust guidelines that reflect national guidelines.

Overall, we did achieve our original 12 month aim, with an average testing rate of 28% of our target group between September 2020 and August 2021. Extending the project to January 2022 has resulted in continued improvements in monthly testing rates, reaching 44% in December 2021. Further analysis revealed interventions led to a statistically significant and sustained increase in monthly testing rates on seven occasions.

Valuable lessons were learnt in sustaining improvements in a busy department, changing long-held beliefs regarding consent for testing, and education around HIV care in the UK. Project write-up was formatted using the Revised Standards for Quality Improvement Reporting Excellence (SQUIRE) template.
Educational needs assessment identifying opportunities to improve sepsis care
Authors: Davino Tammy , Van Hoof Thomas J , Elwell Joy , DeLayo Michelle
Published: December 2022

Introduction

In 2015, the Centers for Medicare and Medicaid Services developed a national quality bundle for the management of patients with severe sepsis and septic shock (SEP-1). Despite performance improvement measures, compliance remains low. This needs assessment is the first stage of a quality improvement initiative to improve SEP-1 compliance. Using a conceptual outcomes framework, this needs assessment analyses SEP-1 compliance data, knowledge, and competence to identify gaps in care and educational opportunities.

Methods

The needs assessment began with a review of national and statewide SEP-1 compliance data to identify a need for improvement. The needs assessment proceeded with a retrospective chart review to evaluate process measures and identify which providers would most likely benefit from educational interventions. A focus group provided perspective on the chart review findings.

Results

During the period of 1 April 2017–31 March 2018, national SEP-1 compliance was 51% and compliance at the studied institution was 19%. The chart review included 51 patients (66.7% severe sepsis, 33.3% septic shock). Frequently missed SEP-1 measures included administration of intravenous fluids (0% severe sepsis, 58.8% septic shock), repeat lactate levels (52.6% severe sepsis, 60% septic shock), documentation of volume and tissue perfusion assessment (58.8%), vasopressor administration (73.3%) and administration of broad-spectrum antibiotics (76.5%, severe sepsis). Focus group perceptions identified themes related to gaps in declarative and dispositional knowledge.

Conclusions

This educational needs assessment highlights gaps in SEP-1 clinician performance, competence and knowledge. A multifaceted education programme is the next step for this performance improvement project. Education should include a series of meetings, activities, and workshops that include declarative knowledge, procedural knowledge and dispositional knowledge. Simulation activities can provide an opportunity for providers to demonstrate competence. Point-of-care prompts and performance measurement and feedback of patient care data can support clinician performance. This needs assessment underscores the need for a multifaceted approach to clinician education and performance to improve SEP-1 compliance.
Prospective application of the interdisciplinary bedside rounding checklist ‘TEMP’ is associated with reduced infections and length of hospital stay
Authors: Radhakrishnan Nila S , Lukose Kiran , Cartwright Richard , Sleiman Andressa , Matey Nicholas , Lim Duke , LeGault Tiffany , Pollard Sapheria , Gravina Nicole , Southwick Frederick S
Published: December 2022

Protocols that enhance communication between nurses, physicians and patients have had a variable impact on the quality and safety of patient care. We combined standardised nursing and physician interdisciplinary bedside rounds with a mnemonic checklist to assure all key nursing care components were modified daily. The mnemonic TEMP allowed the rapid review of 11 elements. T stands for tubes assuring proper management of intravenous lines and foleys; E stands for eating, exercise, excretion and sleep encouraging a review of orders for diet, exercise, laxatives to assure regular bowel movements, and inquiry about sleep; M stands for monitoring reminding the team to review the need for telemetry and the frequency of vital sign monitoring as well as the need for daily blood tests; and P stands for pain and plans reminding the team to discuss pain medications and to review the management plan for the day with the patient and family. Faithful implementation eliminated central line-associated bloodstream infections and catheter-associated urinary tract infections and resulted in a statistically significant reduction in average hospital length of stay of 13.3 hours, one unit achieving a 23-hour reduction. Trends towards reduced 30-day readmissions (20% down to 10%–11%) were observed. One unit improved the percentage of patients who reported nurses and doctors always worked together as a team from a 56% baseline to 75%. However, the combining of both units failed to demonstrate statistically significant improvement. Psychologists well versed in implementing behavioural change were recruiting to improve adherence to our protocols. Following training physicians and nurses achieved adherence levels of over 70%. A high correlation (r2=0.69) between adherence and reductions in length of stay was observed emphasising the importance of rigorous training and monitoring of performance to bring about meaningful and reliable improvements in the efficiency and quality of patient care.