bluuebunny/crossref_metadata_2025 huggingface dataset:
A new problem for rules
Authors: Kaplan Jeffrey
Published: December 2022

This paper presents a series of arguments aimed at showing that, for an important subclass of social rules—non‐summary rules—no adequate metaphysical account has been given, and it tentatively suggests that no such account can be given. The category of non‐summary rules is an important one, as it includes the rules of etiquette, fashion, chess, basketball, California state law, descriptive English grammar, and so on. This paper begins with behavioristic accounts of the conditions for the existence of such rules, and proceeds through progressively more complex accounts, all the way to what are labeled ‘normative attitude accounts,’ which are prima facie plausible and particularly popular. In each case it is argued that the type of account under consideration cannot explain the existence of the relevant type of social rule.
Between nature and nurture: The genetic overlap between psychological attributes and selection into public service employment
Authors: Tao Lei , Liang Hailun , Wen Bo , Huang Tao
Published: December 2022

Public administration scholars have had a long‐lasting interest in examining individual differences relevant to the attractiveness of public service employment. However, very few studies have explored the genetic underpinnings of these variations. This article builds upon recent behavioral genetics literature and explores whether there are genetic overlaps between psychological attributes and selection into public service employment. We construct the polygenic risk scores (PRSs) on two psychological attributes—neuroticism and positive affect—to model the genetic influence on public service employment in a nationwide UK dataset with 262,795 participants. The results suggest that the PRS of positive affect is a significant predictor of individuals' selection into public service employment, implying that individuals with high innate happiness are more likely to self‐select into service work. Taking the existing socialization literature and this result into consideration, our findings support that both nature and nurture factors shape individuals' selection into public service employment.
Establishing forbs for pollinators in agricultural landscapes of the Great Plains, U.S.A.
Authors: Rinella Matthew J. , Porensky Lauren M. , Bellows Susan E. , Knox Jeanne M. , Metier Emily P.
Published: December 2022

Pollinator insects are declining, partly because grasslands containing forbs they feed on have been converted to cropland. This conversion is prevalent in the Great Plains, home to several imperiled pollinators and 40% of U.S. honeybees. Over 1.0 million hectares of former cropland have been seeded with forbs that could benefit Great Plains pollinators, but success of these seeding efforts is unclear. We quantified forb abundances and factors regulating these abundances in 120 crop fields seeded to forbs and grasses by managers in the Great Plains (Colorado and Montana). Our data indicated a need to improve forb establishment. Two to five growing seasons after seeding, seeded forb cover was <10% in most fields, and no seeded forbs were observed in 23% of fields. Our data also indicated ways to benefit forbs. High grass seed rates and high weed densities shortly after seeding reduced forb cover at the end of the study. Past studies indicate certain post‐emergence herbicides sometimes benefit seeded forbs, and we recommend further research in this domain. Instead of beneficial herbicides applied after seeding, managers sometimes applied risky herbicides before seeding that appeared to persist in soil and reduce forb establishment. Seed rates were too low to maximize forb abundances, and much money was wasted buying seeds of species that did not establish. We identified several species with relatively high establishment probabilities that will support most pollinators. For now, these species should be seeded at high rates. Lower rates could become sufficient if effective weed control is implemented.
Mid‐ and long‐term ecological changes after enrichment planting with native tree species in Mexican tropical mountain forests
Authors: Martínez‐Ramos Marisol , González‐Espinosa Mario , Ramírez‐Marcial Neptalí , Negrete‐Yankelevich Simoneta , Mena Ramsés H.
Published: December 2022

Ecological restoration is a viable strategy to recover floristic, structural, and functional attributes of the very vulnerable and widely degraded tropical mountain forests. Most restoration efforts in these highly diverse and narrowly distributed systems involve unassisted forest regeneration or enrichment planting with a small number of species, usually those with commercial value and success evaluated after a few years. We assessed changes in soil attributes, forest composition and structure in four sites with plots under unassisted forest regeneration or enrichment planting. The sites are in the limestone massif of the central highlands of Chiapas (Mexico) and share geological, edaphic and climatic conditions, but differ in level of previous disturbance and the time elapsed since the enrichment planting (16–30 years). No changes in soil variables (contents of C, N, P, and K, cation exchange capacity, and pH) were detected. Total density of juveniles was not consistently related to unassisted forest regeneration or enrichment planting but was highest in the two sites that had severe disturbance level. Influence of enrichment planting on forest regeneration depended on the composition and structure of the surrounding stands, and more so when opportunistic trees like pines and other shade‐intolerant species are available. Yet long‐lived shade‐tolerant species, including oaks, which may have synergistic effects during forest recovery, were well represented in sites with original severe disturbance level.
Politics of problem definition: Comparing public support of climate change mitigation policies using machine learning
Authors: Choi Junghwa , Wehde Wesley , Maulik Romit
Published: December 2022

Public support is a key contributor to successful policy adoption and implementation. Given the urgency of climate change mitigation, scholars have explored various determinants that affect public support for climate change mitigation policy. However, the relative decisiveness of these factors in shaping public support is insufficiently examined. Therefore, we deploy interpretable machine learning to understand which factors, among many previously investigated, are most decisive for structuring public support for various climate change mitigation policies. In this paper, we particularly look at the decisiveness of problem definition for shaping public support among various factors. Using U.S national survey data, we find that how individuals define the issue of climate change is more decisive for structuring public support for promoting renewable energy and regulating pollutants to mitigate the risks associated with climate change. However, the results also indicate that the most decisive factors associated with public support vary depending on the types of mitigation policy. We conclude that different strategies should be utilized to increase public support for various climate change mitigation policy options. Our findings contribute to a scholarly understanding of the specific politics of problem definition in the context of environmental and climate change policy.
Advanced practice nurse capabilities: A mixed methods systematic review
Authors: Hako Laura , Turunen Hannele , Jokiniemi Krista
Published: December 2022

Background

Global health challenges demand the optimal use of nurses' professional competence and capability. Competencies related to the roles of advanced practice nurses have been developed, but research on these nurses' capabilities remains limited.

Aim

To summarise and compare the literature on the capabilities of advanced practice nurses and the dimensions of these capabilities.

Methods

We carried out a mixed methods systematic review, using CINAHL, PubMed, and Scopus to search literature published between 1998 and 2021. The quality of the selected articles was evaluated with the JBI Critical Appraisal Tools. We employed abductive content analysis, including deductive and inductive analysis. The reporting was guided by the standards of the Preferred Reporting Items for Systematic Review and Meta‐Analysis Statement.

Results

Eleven articles out of 357 met the inclusion criteria. We identified all five dimensions of Hase and Davis's (1999) capability framework: can apply competencies in familiar as well as unfamiliar situations, is creative, has a high degree of self‐efficacy, knows how to learn, and works well in teams. Additionally, we found a new dimension of capability: identifies factors affecting the scope of practice.

Limitations

This mixed methods systematic review was conducted about a little‐studied topic. Because country‐specific differences exist and consensus on advanced practice nursing roles is lacking, the concept of advanced practice nurse capabilities cannot be directly generalised.

Conclusions

Capability is a requirement and a necessity in the performance of advanced practice nurses. Identifying and defining the dimensions of advanced practice nurses' capabilities will lead the way in developing the roles, education, and capability assessments of advanced practice nurses. Identification of advanced practice nurses' capability will facilitate role understanding, visibility, and implementation in health care services. This can improve the quality and accessibility of care and improve the cost‐effectiveness of the use of health care professionals.
Examining 7 years of implementing quality management systems in medical laboratories in sub‐Saharan Africa
Authors: Odhiambo Collins O. , van der Puije Beatrice , Maina Michael , Mekonen Teferi , Diallo Samba , Datema Tjeerd , Loembe Marguerite M. , Kebede Yenew , Ndlovu Nqobile , Ondoa Pascale
Published: December 2022

Background

Achievement of ISO15189 accreditation demonstrates competency of a laboratory to conduct testing. Three programmes were developed to facilitate achievement of accreditation in low‐ and middle‐income countries: Strengthening Laboratory Management Towards Accreditation (SLMTA), Stepwise Laboratory Improvement Process Towards Accreditation (SLIPTA) and Laboratory Quality Stepwise Implementation (LQSI).

Objective

To determine the level of accreditation and associated barriers and facilitators among medical laboratories in the WHO‐AFRO region by 2020.

Methods

A desk review of SLIPTA and SLMTA databases was conducted to identify ISO15189‐accredited medical laboratories between January 2013 and December 2020. Data on access to the LQSI tool were extracted from the WHO database. Facility and country characteristics were collected for analysis as possible enablers of accreditation. The chi‐square test was used to analyse differences with level of significance set at <0.05.

Results

A total of 668 laboratories achieved accreditation by 2020 representing a 75% increase from the number in 2013. Accredited laboratories were mainly in South Africa (n = 396; 55%) and Kenya (n = 106; 16%), two countries with national accreditation bodies. About 16.9% (n = 113) of the accredited laboratories were registered for the SLIPTA programme and 26.6% (n = 178) for SLMTA. Approximately 58,217 LQSI users were registered by December 2020. Countries with a higher UHC index for access to HIV care and treatment, higher WHO JEE scores for laboratory networks, a larger number of registered LQSI users, with national laboratory policy/strategic plans and PEPFAR‐priority countries were more likely to have an accredited laboratory. Of the 475 laboratories engaged in the SLIPTA programme, 154 attained ≥4 SLIPTA stars (ready to apply for accreditation) and 113 achieved ISO 15189 accreditation, with 96 enrolled into the SLMTA programme. Lower‐tier laboratories were less likely to achieve accreditation than higher‐tier laboratories (7.7% vs. 30%) (p < 0.001). The probability of achieving ISO 15189 accreditation (19%) was highest during the first 24 months after enrolment into the SLIPTA programme.

Conclusion

To sustainably anchor quality improvement initiatives at facility level, national approaches including access to a national accreditation authority, adoption of national quality standards and regulatory frameworks are required.
The utility of the ‘Arable Weeds and Management in Europe’ database: Challenges and opportunities of combining weed survey data at a European scale
Authors: Metcalfe Helen , Bürger Jana , Redwitz Christoph von , Cirujeda Alicia , Fogliatto Silvia , Dostatny Denise F. , Gerowitt Bärbel , Glemnitz Michael , González‐Andújar José L. , Hernández Plaza Eva , Izquierdo Jordi , Kolářová Michaela , Ņečajeva Jevgenija , Petit Sandrine , Pinke Gyula , Schumacher Matthias , Ulber Lena , Vidotto Francesco , Fried Guillaume
Published: December 2022

Over the last 30 years, many studies have surveyed weed vegetation on arable land. The ‘Arable Weeds and Management in Europe’ (AWME) database is a collection of 36 of these surveys and the associated management data. Here, we review the challenges associated with combining disparate datasets and explore some of the opportunities for future research that present themselves thanks to the AWME database. We present three case studies repeating previously published national scale analyses with data from a larger spatial extent. The case studies, originally done in France, Germany and the UK, explore various aspects of weed ecology (community composition, management and environmental effects and within‐field distributions) and use a range of statistical techniques (canonical correspondence analysis, redundancy analysis and generalised linear mixed models) to demonstrate the utility and versatility of the AWME database. We demonstrate that (i) the standardisation of abundance data to a common measure, before the analysis of the combined dataset, has little impact on the outcome of the analyses, (ii) the increased extent of environmental or management gradients allows for greater confidence in conclusions and (iii) the main conclusions of analyses done at different spatial scales remain consistent. These case studies demonstrate the utility of a Europe‐wide weed survey database, for clarifying or extending results obtained from studies at smaller scales. This Europe‐wide data collection offers many more opportunities for analysis that could not be addressed in smaller datasets; including questions about the effects of climate change, macro‐ecological and biogeographical issues related to weed diversity as well as the dominance or rarity of specific weeds in Europe.
The effectiveness of lifestyle interventions for diabetes remission on patients with type 2 diabetes mellitus: A systematic review and meta‐analysis
Authors: Zhang Yating , Yang Yajie , Huang Qifang , Zhang Qi , Li Mingzi , Wu Yi
Published: December 2022

Background

Conventional wisdom affirmed that diabetes was irreversible, but current research shows that lifestyle interventions may achieve diabetes remission among patients with type 2 diabetes mellitus. Recently, many original studies have examined the effectiveness of lifestyle interventions. However, great heterogeneity in intervention approaches resulted in inconsistent intervention effects.

Aims

The aim of this study was to determine the effectiveness of lifestyle interventions for diabetes remission among patients with type 2 diabetes mellitus.

Methods

PubMed, CINAHL, Embase, Web of Science Core Collection, and Cochrane Library were searched for relevant articles from their inceptions to March 26, 2021. Reference lists and a relevant journal were searched manually as well. Both randomized controlled trials and quasi‐experimental studies were included. The quantitative data extracted from the selected studies included diabetes remission rate, weight, and quality of life score. The risk of bias was assessed by the Cochrane and Joanna Briggs Institute's tool. RevMan version 5.3. was used to carry out the meta‐analysis.

Results

This systematic review included 12 studies involving 3997 patients with type 2 diabetes mellitus. Lifestyle interventions included in the studies were mainly divided into diet‐only interventions and diet combined with physical activity interventions. Among them, there were three types of diet: (1) low‐energy diet, (2) low carbohydrate diet, and (3) Mediterranean diet. Moderate‐intensity aerobic and resistance physical activity, walking, and maintaining habitual physical activity were the three types of physical activity interventions employed in the included studies. The results indicated that lifestyle interventions were effective for achieving diabetes remission, reducing weight, and improving quality of life in patients with type 2 diabetes mellitus.

Linking Evidence to Action

Lifestyle interventions were associated with significant effects on diabetes remission, reducing weight, and improving quality of life. As an important part of lifestyle interventions, diet and physical activity have a significant effect on blood glucose and weight control in patients with type 2 diabetes mellitus. It is therefore suggested that the contents of lifestyle interventions should focus on diet and physical activity.
Physiological Axial Tibial Rotation of the Knee During a Weightbearing Flexion
Authors: Li Guoan , Zhou Chaochao , Yu Jia , Li Sophia , Foster Timothy , Bedair Hany
Published: December 2022

Axial tibial rotation is a characteristic motion of the knee, but how it occurs with knee flexion is controversial. We investigated the mechanisms of tibial rotations by analyzing in vivo tibiofemoral articulations. Twenty knees of 20 living human subjects were investigated during a weightbearing flexion from full extension to maximal flexion using a dual fluoroscopic imaging system. Tibiofemoral articular contact motions on medial and lateral femoral condyles and tibial surfaces were measured at flexion intervals of 15 deg from 0 deg to 120 deg. Axial tibial rotations due to the femoral and tibial articular motions were compared. Articular contact distances were longer on femoral condyles than on tibial surfaces at all flexion intervals (p < 0.05). The articular distance on medial femoral condyle is longer than on lateral side during flexion up to 60 deg. The internal tibial rotation was 6.8 ± 4.5 deg (Mean ± SD) at the flexion interval of 0–15 deg, where 6.1 ± 2.6 deg was due to articulations on femoral condyles and 0.7 ± 5.1 deg due to articulations on tibial surfaces (p < 0.05). The axial tibial rotations due to articulations on femoral condyles are significantly larger than those on tibial surfaces until 60 deg of flexion (p < 0.05). Minimal additional axial tibial rotations were observed beyond 60 deg of flexion. The axial tibial rotations were mainly attributed to uneven articulations on medial and lateral femoral condyles. These data can provide new insights into the understanding of mechanisms of axial tibial rotations and serve as baseline knowledge for improvement of knee surgeries.
Stable Inverse Dynamics for Feedforward Control of Nonminimum-Phase Underactuated Systems
Authors: Bettega Jason , Richiedei Dario , Tamellin Iacopo , Trevisani Alberto
Published: December 2022

An enhanced inverse dynamics approach is here presented for feedforward control of underactuated multibody systems, such as mechanisms or robots where the number of independent actuators is smaller than the number of degrees of freedom. The method exploits the concept of partitioning the independent coordinates into actuated and unactuated ones (through a QR-decomposition) and of linearly combined output, to obtain the internal dynamics of the nonminimum-phase system and then to stabilize it through proper output redefinition. Then, the exact algebraic model of the actuated sub-system is inverted, leading to the desired control forces with just minor approximations and no need for pre-actuation. The effectiveness of the proposed approach is assessed by three numerical test cases, by comparing it with some meaningful benchmarks taken from the literature. Finally, experimental verification through an underactuated robotic arm with two degrees of freedom is performed.
Wind noise suppression in filtered-x least mean squares-based active noise control systems
Authors: Chu Yijing , Zhao Sipei , He Longbiao , Niu Feng
Published: December 2022

Wind noise is notorious for its detrimental impacts on audio devices. This letter evaluates the influence of wind noise on the active noise control performance of headphones in a wind tunnel, and the noise reduction is found to decrease with wind speeds. To improve the performance of noise control systems in windy environments, the filtered-x least mean squares algorithm is modified based on the total least squares technique, taking the characteristics of wind noise into account. Computer simulations with real-recorded data demonstrate that the proposed algorithm could improve the noise reduction by approximately 3 dB in windy conditions.
Evolution of the candidacy requirements and patient perioperative assessment protocols for cochlear implantation
Authors: Biever Allison , Kelsall David C , Lupo J Eric , Haase Gerald M
Published: December 2022

Cochlear implantation as an approved clinical therapy ushered in an exciting era of innovation for the treatment of hearing loss. The U.S. Food and Drug Administration approved the use of cochlear implants as a treatment option for adults with profound sensorineural hearing loss in 1985. The landscape for treating adults and children with significant hearing loss has changed dramatically over the last three decades. The purpose of this paper is to examine the evolving regulatory process and changes to clinical care. A significant emerging trend in cochlear implantation is the consideration of steroids to preserve hearing during and following surgery. This parallels the quest for hearing preservation in noise-induced hearing disorders, especially considering the current interest in biological drug therapies in this population. The future will likely usher in an era of combination therapeutics utilizing drugs and cochlear implantation. For over 30+ years and following regulatory compliance, the Rocky Mountain Ear Center has developed an extensive candidacy and outcome assessment protocol. This systematic approach evaluates both unaided and aided auditory performance during candidacy stages and post-implantation. Adjunctive measures of cognition and quality-of-life augment the auditory assessment in specific populations. Practical insights into lessons learned have directed further clinical research and have resulted in beneficial changes to clinical care.
Decoding CAR T cell phenotype using combinatorial signaling motif libraries and machine learning
Authors: Daniels Kyle G. , Wang Shangying , Simic Milos S. , Bhargava Hersh K. , Capponi Sara , Tonai Yurie , Yu Wei , Bianco Simone , Lim Wendell A.
Published: December 2022

Chimeric antigen receptor (CAR) costimulatory domains derived from native immune receptors steer the phenotypic output of therapeutic T cells. We constructed a library of CARs containing ~2300 synthetic costimulatory domains, built from combinations of 13 signaling motifs. These CARs promoted diverse human T cell fates, which were sensitive to motif combinations and configurations. Neural networks trained to decode the combinatorial grammar of CAR signaling motifs allowed extraction of key design rules. For example, non-native combinations of motifs that bind tumor necrosis factor receptor–associated factors (TRAFs) and phospholipase C gamma 1 (PLCγ1) enhanced cytotoxicity and stemness associated with effective tumor killing. Thus, libraries built from minimal building blocks of signaling, combined with machine learning, can efficiently guide engineering of receptors with desired phenotypes.
Coordinated control of neuronal differentiation and wiring by sustained transcription factors
Authors: Özel Mehmet Neset , Gibbs Claudia Skok , Holguera Isabel , Soliman Mennah , Bonneau Richard , Desplan Claude
Published: December 2022

The large diversity of cell types in nervous systems presents a challenge in identifying the genetic mechanisms that encode it. Here, we report that nearly 200 distinct neurons in the
Drosophila
visual system can each be defined by unique combinations of on average 10 continuously expressed transcription factors. We show that targeted modifications of this terminal selector code induce predictable conversions of neuronal fates that appear morphologically and transcriptionally complete. Cis-regulatory analysis of open chromatin links one of these genes to an upstream patterning factor that specifies neuronal fates in stem cells. Experimentally validated network models describe the synergistic regulation of downstream effectors by terminal selectors and ecdysone signaling during brain wiring. Our results provide a generalizable framework of how specific fates are implemented in postmitotic neurons.
Getting bifunctional molecules into cells
Authors: Lokey R. Scott , Pye Cameron
Published: December 2022

A class of transmembrane proteins helps shuttle large drugs across the cell membrane
In Science Journals
Authors: Smith Keith T. , Norton Melissa , Wong Wei , Grocholski Brent , Suleymanov Yury , Yeston Jake , Ash Caroline , Alderton Gemma , Lavine Marc S. , Ray L. Bryan , Lopez Bianca , Vinson Valda , Williams Ifor
Published: December 2022

Highlights from the
Science
family of journals
NASA radar altimetry mission to study hidden ocean swirls
Authors: Voosen Paul
Published: December 2022

Enhanced resolution of SWOT satellite will highlight how small eddies soak up heat and carbon
New U.S. law aims to light up medical research on cannabis
Authors: Wadman Meredith
Published: December 2022

Biden signs bill streamlining pot studies and production
Complete Genomic Sequences of Two Aeromonas hydrophila Isolates Derived from Diseased Fish in South Korea
Authors: Ho Diem Tho , Lee Yoonhang , Kim Nameun , Roh HeyongJin , Kim Ahran , Kim Do-Hyung
Published: December 2022

Aeromonas hydrophila
is a Gram-negative pathogen that is associated with motile aeromonad septicemia in various fish species. Here, we report the complete genomic sequences of two
A. hydrophila
isolates derived from diseased fish in South Korea.
Characteristics and Correlations of the Oral and Gut Fungal Microbiome with Hypertension
Authors: Chen Bo-Yan , Lin Wen-Zhen , Li Yu-Lin , Bi Chao , Du Lin-Juan , Liu Yuan , Zhou Lu-Jun , Liu Ting , Xu Shuo , Shi Chao-Ji , Zhu Hong , Wang Yong-Li , Sun Jian-Yong , Liu Yan , Zhang Wu-Chang , Zhang Zhiyuan , Zhang Hui-li , Zhu Ya-Qin , Duan Sheng-Zhong
Published: December 2022

Our study fills the gap in human studies investigating the oral and gut fungal microbiota in association with blood pressure. It characterizes the diversity and composition of the oral and gut fungal microbiome in human subjects, elucidates the dysbiosis of fungal ecology in a hypertensive population, and establishes oral-gut fungal correlations and fungus-clinical parameter correlations.
Experiences from 4 Years of Organization of an External Quality Assessment for Mycobacterium tuberculosis Whole-Genome Sequencing in the European Union/European Economic Area
Authors: Anthony R. M. , Tagliani E. , Nikolayevskyy V. , de Zwaan R. , Mulder A. , Kamst M. , Ködmön C. , van der Werf M. J. , Cirillo D. , van Soolingen D. ,   ERLTB-Net members, Taylor Lucy , Rathod Priti , Lippert Kathrin , Mathys Vanessa , Soetaert Karine , Rasmussen Erik Michael , Haanperä Marjo , Morel Florence , Merker Matthias , Roycroft Emma , Fitzgibbon Margaret , Cabibbe Andrea Maurizio , Perrin Monique , Vegard Eldholm , Brønstad Ola , Macedo Rita , Herrera-Leon Laura , Samper Sofia , Mansjö Mikael , Groenheit Ramona
Published: December 2022

The wider availability of whole-genome sequencing (WGS) coupled to new developments in bioinformatic tools and databases to interpret
Mycobacterium tuberculosis
complex WGS data has accelerated the adoption of this method for the routine prediction of antimycobacterial drug resistance and genotyping, thus necessitating the establishment of a comprehensive external quality control system. Here, we report 4 years of development and results from such a panel.
Spore-Forming
Clostridium
(
Clostridioides
)
difficile
in Wastewater Treatment Plants in Western Australia
Authors: Chisholm Jessica M. , Putsathit Papanin , Riley Thomas V. , Lim Su-Chen
Published: December 2022

Clostridium difficile
infection (CDI) is a leading cause of antimicrobial-associated diarrhea in health care facilities. Extended hospital stays and recurrences increase the cost of treatment and morbidity and mortality.
Genetic Adaptation and Acquisition of Macrolide Resistance in Haemophilus spp. during Persistent Respiratory Tract Colonization in Chronic Obstructive Pulmonary Disease (COPD) Patients Receiving Long-Term Azithromycin Treatment
Authors: Carrera-Salinas Anna , González-Díaz Aida , Ehrlich Rachel L. , Berbel Dàmaris , Tubau Fe , Pomares Xavier , Garmendia Junkal , Domínguez M. Ángeles , Ardanuy Carmen , Huertas Daniel , Marín Alicia , Montón Conchita , Mell Joshua Chang , Santos Salud , Marti Sara
Published: December 2022

The immunomodulatory properties of azithromycin reduce the frequency of exacerbations and improve the quality of life of COPD patients. However, long-term administration may alter the respiratory microbiota, such as
Haemophilus influenzae
, an opportunistic respiratory colonizing bacteria that play an important role in exacerbations.
Stable Carbon Isotopic Composition (δ13C) as a Proxy of Organic Matter Dynamics in Soils on the Western Shore of Lake Baikal
Authors: Golubtsov V. A. , Vanteeva Yu. V. , Voropai N. N. , Vasilenko O. V. , Cherkashina A. A. , Zazovskaya E. P.
Published: December 2022

Assessing the main factors that control carbon dynamics in soils is an urgent problem in the context of modern climate change. The analysis of stable carbon isotope (δ13С) composition is one of the approaches to understanding this dynamics. The study was carried out in the landscapes of the southeastern slope and foothills of the Primorskii Range, characterized by contrasting physico-geographical conditions. Climatic parameters, spatial variations in the composition of stable carbon isotopes and their distribution in soil profiles, and soil physicochemical properties controlling carbon dynamics have been analyzed. The soil humus horizons formed in mountainous tundra and steppe landscapes manifest the highest δ13С values (–24.72 and –23.97…–24.75‰); whereas the lowest (–25.61…–27.18‰) values are registered in the mountainous taiga soils. Based on the calculation of linear dependence between δ13С values and the total carbon content in soil, which varies with the depth, the carbon turnover intensity was determined using the slope of linear regression. It was revealed that under the contrasting conditions of mountainous tundra and steppe landscapes, the climate (deficiency of heat and moisture) has a significant impact on the intensity of organic matter transformation, blocking the effect of edaphic (soil profile) factors. Under more favorable climatic conditions of mountainous taiga landscapes, the dynamics of organic matter in soils is controlled mainly by edaphic factors.
Somatic gene mutations in malignant steroid cell tumours and response to multiple treatments
Authors: Nakanishi Kazuho , Fukagawa Tomoaki , Yamada Takashi , Suzuki Shunji
Published: December 2022

Malignant ovarian steroid cell tumours are a rare subgroup of sex cord-stromal tumours. There are no systematic reviews on the associated treatments, and little is known about their genomic profile. We describe a case of a pelvic malignant ovarian steroid cell tumour in a premenopausal woman in her 40s. She received cytoreductive surgery and six cycles of paclitaxel+carboplatin+bevacizumab. After recurrence, the tumour was surgically removed again, followed by radiation and hormone blockade therapy. Complete remission was achieved after treatment with bleomycin, etoposide and cisplatin. She remained in a platinum-sensitive relapse state and subsequently received maintenance therapy with olaparib. Since the tumour was initially refractory to treatment, tissue specimens were screened for gene mutations using a next-generation sequencing oncology panel and a somatic variant detection system, which revealed somatic gene mutations in ARID1A, PIK3CA, TERT and ATM, some of which are involved in DNA repair.
Two siblings with non-classic P450scc deficiency resulted from a novel mutation inCYP11A1gene misdiagnosed as familial glucocorticoid deficiency
Authors: Le Binh Thanh , Duong Cuong Minh , Nguyen Tien Quoc , Nguyen Chau Minh
Published: December 2022

P450scc deficiency due toCYP11A1gene mutations is a rare cause of primary adrenal insufficiency (PAI) in children. We reported two young siblings with PAI presented with hyperpigmentation. They were referred to our clinic with a diagnosis of familial glucocorticoid deficiency (FGD), another rare cause of PAI. However, further hormonal evaluation revealed increased plasma renin activity, which was not congruent with the diagnosis of FGD. Genetic analysis showed the compound heterozygous mutations in exon 8 of theCYP11A1gene, including a missense mutation, R466W (c1396C>T), and a nonsense mutation, R439X (c1315C>T). A case responded well to hydrocortisone, while another case received prednisolone due to her unresponsiveness to hydrocortisone. To correctly diagnose P450scc deficiency, physicians should be alerted with the similarity between this disease and FGD because of their predominant glucocorticoid deficiency. Long-acting glucocorticoids may be used with caution to reach treatment goals.
Renal abscess withCapnocytophaga canimorsusinfection from a dog bite
Authors: Trainor-Moss Santiago , Acquah Rebecca Ruth , Peirse Mary , Beadles Wendy
Published: December 2022

We present a case of renal abscess caused byCapnocytophaga canimorsusinfection in a previously healthy middle-aged man. He presented with sepsis and an acute kidney injury, and although not identified on his initial assessment, he had sustained a dog bite 5 days prior to hospital admission. The patient developed left loin pain and imaging investigation revealed a renal abscess. Gram stain showed a gram-negative bacillus andC. canimorsuswas identified by 16S PCR from these samples along with aspirate from the abscess. The patient responded to treatment with carbapenems but required a prolonged course. His clinical condition was further complicated by a pleural effusion and the development of fatigue symptoms consistent with a post-infection chronic fatigue syndrome. We present this case which we believe to be the first documented case ofC. canimorsuscausing renal abscess. We discuss the challenges relating to investigation, management and the importance of detailed diagnostic exposure histories in sepsis of unknown origin.
Secondary hemophagocytic lymphohistiocytosis due to Heartland virus
Authors: Ahlers Carolyn G , Matthews Harrison , Perez Reinaldo , Naggie Susanna
Published: December 2022

An older man from the mid-Southeastern USA presented with acute onset of fever, fatigue, and non-bloody diarrhoea. There was high suspicion for tick-borne illness given exposure history, clinical presentation and laboratory abnormalities. Despite prompt treatment with doxycycline, the patient clinically worsened. He was diagnosed with secondary hemophagocytic lymphohistiocytosis (HLH) due to Heartland virus (HRTV). This is the second documented case of secondary HLH due to HRTV, and the first in a relatively immunocompetent patient. Furthermore, though HRTV has been primarily concentrated in the Central USA, our case provides evidence of further geographic expansion of HRTV, mirroring the increased range of the Lone Star tick. Clinicians should consider HRTV when a patient with a clinical presentation consistent with tick-borne illness fails to respond to doxycycline. Furthermore, healthcare providers should be aware of the geographic expansion of HRTV and the potential of HRTV to lead to secondary HLH.
Global burden of type 2 diabetes in adolescents and young adults, 1990-2019: systematic analysis of the Global Burden of Disease Study 2019
Authors: Xie Jinchi , Wang Maoqing , Long Zhiping , Ning Hua , Li Jingkuo , Cao Yukun , Liao Yunfei , Liu Gang , Wang Fan , Pan An
Published: December 2022

Objective

To estimate the global burden of type 2 diabetes in adolescents and young adults (aged 15-39 years) from 1990 to 2019.

Design

Systematic analysis.

Data source

Global Burden of Disease Study 2019. Participants aged 15-39 years from 204 countries and territories, 1990-2019.

Main outcomes measures

Age standardised incidence rate, age standardised disability adjusted life years (DALY) rate, and age standardised mortality rate for type 2 diabetes in people aged 15-39 years from 1990 to 2019, and proportional DALY attributable to different risk factors.

Results

From 1990 to 2019, significant increases in age standardised incidence rate and age standardised DALY rate were found for type 2 diabetes in adolescents and young adults globally (P<0.001). Age standardised incidence rate (per 100 000 population) increased from 117.22 (95% confidence interval 117.07 to 117.36) in 1990 to 183.36 (183.21 to 183.51) in 2019, and age standardised DALY rate (per 100 000 population) increased from 106.34 (106.20 to 106.48) in 1990 to 149.61 (149.47 to 149.75) in 2019. The age standardised mortality rate (per 100 000 population) was modestly increased from 0.74 (0.72 to 0.75) in 1990 to 0.77 (0.76 to 0.78) in 2019. When grouped by countries with different sociodemographic indexes, countries with a low-middle and middle sociodemographic index had the highest age standardised incidence rate and age standardised DALY rate in 2019, whereas countries with a low sociodemographic index had the lowest age standardised incidence rate but the highest age standardised mortality rate. Women generally had higher mortality and DALY rates than men at ages <30 years, but differences between the sexes were reversed in those aged >30 years except in countries with a low sociodemographic index. The main attributable risk factor for DALY for early onset type 2 diabetes was high body mass index in all regions by sociodemographic index. The proportional contribution of other risk factors varied across regions, however, with higher proportions of ambient particulate air pollution and smoking in countries with a high sociodemographic index and higher proportions of household air pollution from solid fuels and diet low in fruit in countries with a low sociodemographic index.

Conclusions

Early onset type 2 diabetes is a growing global health problem in adolescents and young adults, especially in countries with a low-middle and middle sociodemographic index. A greater disease burden in women aged <30 years was found. Specific measures are needed in countries with different levels of socioeconomic development because of the variable attributable risk factors for type 2 diabetes in adolescents and young adults.
Study protocol for controlled human infection for penicillin G againstStreptococcus pyogenes: a double-blinded, placebo-controlled, randomised trial to determine the minimum concentration required to prevent experimental pharyngitis (the CHIPS trial)
Authors: Hla Thel Khin , Osowicki Joshua , Salman Sam , Batty Kevin T , Marsh Julie A , Kado Joseph , Barr Renae , Enkel Stephanie L , Snelling Thomas L , McCarthy James , Steer Andrew C , Carapetis Jonathan , Manning Laurens
Published: December 2022

Introduction

Regular intramuscular benzathine penicillin G injections have been the cornerstone of rheumatic heart disease (RHD) secondary prophylaxis since the 1950s. As the pharmacological correlate of protection remains unknown, it is difficult to recommend changes to this established regimen. Determining the minimum effective penicillin exposure required to preventStreptococcus pyogenesinfection will accelerate development of new long-acting penicillins for RHD prevention as well as inform opportunities to improve existing regimens. The CHIPS trial will address this knowledge gap by directly testing protection afforded by different steady state plasma concentrations of penicillin in an established model of experimental humanS. pyogenespharyngitis.

Methods and analysis

This is a double-blinded, placebo-controlled, randomised experimental human infection study. Sixty healthy adult volunteers aged 18–40 years will be recruited and randomised 1:1:1:1:1 to continuous intravenous penicillin infusions targeting five different steady state plasma concentrations of 0 (placebo), 3, 6, 12 and 20 ng/mL via a midline catheter. Each participant’s penicillin pharmacokinetic parameters will be established prior to the challenge, to ensure accurate dosing for the continuous infusion. Following the challenge with a well-characterised strain ofS. pyogenes, participants will be observed for up to 6 days for the development of pharyngitis and treated with antibiotics prior to discharge. The primary objective is to determine the minimum effective steady-state plasma penicillin concentration required to prevent experimental pharyngitis. Secondary objectives will explore systemic and mucosal immunoinflammatory responses during pharyngitis, bacterial colonisation dynamics, environmental contamination and qualitative evaluation of the participant experience.

Ethics and dissemination

Ethical approval has been obtained (Bellberry Human Research Ethics Committee). Findings will be reported in peer-reviewed publications and presented at national/international stakeholder forums.

Trial registration number

ACTRN12621000751875.
General anesthesia vs procedural sedation for failed NeuroThrombectomy undergoing rescue stenting: intention to treat analysis
Authors: Mohammaden Mahmoud H , Haussen Diogo C , Al-Bayati Alhamza R , Hassan Ameer E , Tekle Wondwossen , Fifi Johanna T , Matsoukas Stavros , Kuybu Okkes , Gross Bradley A , Lang Michael , Narayanan Sandra , Cortez Gustavo M , Hanel Ricardo A , Aghaebrahim Amin , Sauvageau Eric , Farooqui Mudassir , Ortega-Gutierrez Santiago , Zevallos Cynthia B , Galecio-Castillo Milagros , Sheth Sunil A , Nahhas Michael , Salazar-Marioni Sergio , Nguyen Thanh N , Abdalkader Mohamad , Klein Piers , Hafeez Muhammad , Kan Peter , Tanweer Omar , Khaldi Ahmad , Li Hanzhou , Jumaa Mouhammad , Zaidi Syed F , Oliver Marion , Salem Mohamed M , Burkhardt Jan-Karl , Pukenas Bryan , Kumar Rahul , Lai Michael , Siegler James E , Peng Sophia , Alaraj Ali , Nogueira Raul G
Published: December 2022

Background

There is little data available to guide optimal anesthesia management during rescue intracranial angioplasty and stenting (ICAS) for failed mechanical thrombectomy (MT). We sought to compare the procedural safety and functional outcomes of patients undergoing rescue ICAS for failed MT under general anesthesia (GA) vs non-general anesthesia (non-GA).

Methods

We searched the data from the Stenting and Angioplasty In Neuro Thrombectomy (SAINT) study. In our review we included patients if they had anterior circulation large vessel occlusion strokes due to intracranial internal carotid artery (ICA) or middle cerebral artery (MCA-M1/M2) segments, failed MT, and underwent rescue ICAS. The cohort was divided into two groups: GA and non-GA. We used propensity score matching to balance the two groups. The primary outcome was the shift in the degree of disability as measured by the modified Rankin Scale (mRS) at 90 days. Secondary outcomes included functional independence (90-day mRS0-2) and successful reperfusion defined as mTICI2B-3. Safety measures included symptomatic intracranial hemorrhage (sICH) and 90-day mortality.

Results

Among 253 patients who underwent rescue ICAS, 156 qualified for the matching analysis at a 1:1 ratio. Baseline demographic and clinical characteristics were balanced between both groups. Non-GA patients had comparable outcomes to GA patients both in terms of the overall degree of disability (mRS ordinal shift; adjusted common odds ratio 1.29, 95% CI [0.69 to 2.43], P=0.43) and rates of functional independence (33.3% vs 28.6%, adjusted odds ratio 1.32, 95% CI [0.51 to 3.41], P=0.56) at 90 days. Likewise, there were no significant differences in rates of successful reperfusion, sICH, procedural complications or 90-day mortality among both groups.

Conclusions

Non-GA seems to be a safe and effective anesthesia strategy for patients undergoing rescue ICAS after failed MT. Larger prospective studies are warranted for more concrete evidence.
Endovascular thrombectomy after acute ischemic stroke of the basilar artery: a meta-analysis of four randomized controlled trials
Authors: Adusumilli Gautam , Kobeissi Hassan , Ghozy Sherief , Hardy Nicole , Kallmes Kevin M , Hutchison Kristen , Kallmes David F , Brinjikji Waleed , Albers Gregory W , Heit Jeremy J
Published: December 2022

Background

Previous randomized controlled trials (RCTs) and meta-analyses were underpowered to demonstrate the superiority of endovascular thrombectomy (EVT) over medical therapy (MEDT) in the treatment of acute ischemic stroke due to large vessel occlusion of the posterior circulation (PC-LVO). We performed an updated systematic review and meta-analysis after the publication of the BAOCHE and ATTENTION trials to determine whether EVT can benefit patients presenting with PC-LVO.

Methods

Using Nested Knowledge, we screened literature for RCTs on EVT in PC-LVO. The primary outcome was 90-day modified Rankin Scale (mRS) score 0–3, and secondary outcomes included 90-day mRS score 0–2, 90-day mortality, and rate of symptomatic intracranial hemorrhage (sICH). A random-effects model was used to compute rate ratios (RRs) and their corresponding 95% confidence intervals (CIs).

Results

Four RCTs with 988 patients, 556 patients in the EVT arm and 432 patients in the MEDT arm, were included in the meta-analysis. EVT resulted in significantly higher rates of mRS score 0–3 (RR=1.54; 95% CI 1.16 to 2.04; P=0.002) and functional independence (RR=1.83; 95% CI 1.08 to 3.08; P=0.024), and lower rates of mortality (RR=0.76; 95% CI 0.65 to 0.90; P=0.002) at 90-day follow-up compared with MEDT alone. However, EVT patients had higher rates of sICH (RR=7.48; 95% CI 2.27 to 24.61; P<0.001).

Conclusions

EVT conferred significant patient benefit over MEDT alone in the treatment of PC-LVO. Future studies should better define patients for whom EVT is futile and determine factors that contribute to higher rates of sICH.