bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapid Environmental Contamination With Candida auris and Multidrug-Resistant Bacterial Pathogens Near Colonized Patients
Authors: Sansom Sarah E , Gussin Gabrielle M , Schoeny Michael , Singh Raveena D , Adil Hira , Bell Pamela , Benson Ellen C , Bittencourt Cassiana E , Black Stephanie , Del Mar Villanueva Guzman Maria , Froilan Mary Carl , Fukuda Christine , Barsegyan Karina , Gough Ellen , Lyman Meghan , Makhija Jinal , Marron Stefania , Mikhail Lydia , Noble-Wang Judith , Pacilli Massimo , Pedroza Robert , Saavedra Raheeb , Sexton D Joseph , Shimabukuro Julie , Thotapalli Lahari , Zahn Matthew , Huang Susan S , Hayden Mary K
Published: December 2023

Background

Environmental contamination is suspected to play an important role in Candida auris transmission. Understanding speed and risks of contamination after room disinfection could inform environmental cleaning recommendations.

Methods

We conducted a prospective multicenter study of environmental contamination associated with C. auris colonization at 6 ventilator-capable skilled nursing facilities and 1 acute care hospital in Illinois and California. Known C. auris carriers were sampled at 5 body sites followed by sampling of nearby room surfaces before disinfection and at 0, 4, 8, and 12 hours after disinfection. Samples were cultured for C. auris and bacterial multidrug-resistant organisms (MDROs). Odds of surface contamination after disinfection were analyzed using multilevel generalized estimating equations.

Results

Among 41 known C. auris carriers, colonization was detected most frequently on palms/fingertips (76%) and nares (71%). C. auris contamination was detected on 32.2% (66/205) of room surfaces before disinfection and 20.5% (39/190) of room surfaces by 4 hours after disinfection. A higher number of C. auris–colonized body sites was associated with higher odds of environmental contamination at every time point following disinfection, adjusting for facility of residence. In the rooms of 38 (93%) C. auris carriers co-colonized with a bacterial MDRO, 2%–24% of surfaces were additionally contaminated with the same MDRO by 4 hours after disinfection.

Conclusions

C. auris can contaminate the healthcare environment rapidly after disinfection, highlighting the challenges associated with environmental disinfection. Future research should investigate long-acting disinfectants, antimicrobial surfaces, and more effective patient skin antisepsis to reduce the environmental reservoir of C. auris and bacterial MDROs in healthcare settings.
Seasonal temperatures in South Eleuthera, The Bahamas, have considerable impacts on the cardiorespiratory function and swimming performance of Nassau grouper (Epinephelus striatus)
Authors: Porter E S , Gamperl A K
Published: December 2023

Surprisingly, the impacts of environmental changes on the physiology of tropical/subtropical marine fishes have received limited attention. Given that (i) temperature is considered to be a key factor controlling the biology of fishes; (ii) no published data are available on the swimming performance, metabolic capacity or cardiac function of any of the ~165 grouper species worldwide; and (iii) the Nassau grouper is an endangered species of great ecological and socioeconomic significance in The Bahamas, we investigated how current summer/early fall (30°C) and winter (22°C) temperatures in South Eleuthera affected the aerobic metabolism and heart function of wild Nassau grouper when swum to exhaustion (i.e. to their critical swimming speed, Ucrit). The Nassau grouper had a very low Ucrit at 30°C (i.e. <1 body lengths s−1), and a 30% lower swimming performance during the winter (at 22°C), and this was that was indicative of a reduced absolute aerobic scope (~185 vs. 290 mg O2 kg−1 h−1) and values of maximum heart rate ($f$HMax) and scope for $f$H that were only one-half of that achieved at 30°C (~60 vs. 120 and 29 vs. 61 beats min−1, respectively). Overall, these data reveal that the Nassau grouper’s aerobic and swimming capacity are well below values reported for other tropical/subtropical fishes and suggest that, despite a compensatory (~30–40%) increase in stroke volume, constraints on $f$H near this species’ lower thermal limit negatively affect its cardiac output and swimming performance. These findings have considerable ecological implications as Bahamian grouper populations migrate over long distances to spawn during the winter months, and given the predicted increase in temperature variability with climate change.
Regurgitant volume to LA volume ratio in patients with secondary MR: the COAPT trial
Authors: Coisne Augustin , Scotti Andrea , Granada Juan F , Grayburn Paul A , Mack Michael J , Cohen David J , Kar Saibal , Lim D Scott , Lindenfeld JoAnn , Bax Jeroen , Kotinkaduwa Lak N , Redfors Björn , Weissman Neil J , Asch Federico M , Stone Gregg W
Published: December 2023

Aims

The conceptual framework of proportionate vs. disproportionate mitral regurgitation (MR) translates poorly to individual patients with heart failure (HF) and secondary MR. A novel index, the ratio of MR severity to left atrial volume (LAV), may identify patients with ‘disproportionate’ MR and a higher risk of events. The objectives, therefore, were to investigate the prognostic impact of MR severity to LAV ratio on outcomes among HF patients with severe secondary MR randomized to transcatheter edge-to-edge repair (TEER) with the MitraClip™ device plus guideline-directed medical therapy (GDMT) vs. GDMT alone in the COAPT trial.

Methods and results

The ratio of pre-procedural regurgitant volume (RVol) to LAV was calculated from baseline transthoracic echocardiograms. The primary endpoint was 2-year covariate-adjusted rate of HF hospitalization (HFH). Among 567 patients, the median RVol/LAV was 0.67 (interquartile range 0.48–0.91). In patients randomized to GDMT alone, lower RVol/LAV was independently associated with an increased 2-year risk of HFH (adjHR: 1.77; 95% CI: 1.20–2.63). RVol/LAV was a stronger predictor of adverse outcomes than RVol or LAV alone. Treatment with TEER plus GDMT compared with GDMT alone was associated with lower 2-year rates of HFH both in patients with low and high RVol/LAV (Pinteraction = 0.28). Baseline RVol/LAV ratio was unrelated to 2-year mortality, health status, or functional capacity in either treatment group.

Conclusion

Low RVol/LAV ratio was an independent predictor of 2-year HFH in HF patients with severe MR treated with GDMT alone in the COAPT trial. TEER improved outcomes regardless of baseline RVol/LAV ratio.

Clinical Trial Registration

Trial Name: Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation (The COAPT Trial) (COAPT)

ClinicalTrial.gov Identifier NCT01626079

URL https://clinicaltrials.gov/ct2/show/NCT01626079
Arrhythmic mitral valve prolapse: a practical approach for asymptomatic patients
Authors: Malagoli Alessandro , Albini Alessandro , Benfari Giovanni , Ilardi Federica , Lisi Matteo , Mandoli Giulia Elena , Pastore Maria Concetta , Sperlongano Simona , Cameli Matteo , D’Andrea Antonello
Published: December 2023

Mitral valve prolapse (MVP) is usually regarded as a benign condition though the proportion of patients with a life-threatening arrhythmic MVP form remains undefined. Recently, an experts’ consensus statement on arrhythmic MVP has proposed approaches for risk stratification across the spectrum of clinical manifestation. However, sudden cardiac death may be the first presentation, making clinicians focused to early unmasking this subset of asymptomatic patients. Growing evidence on the role of cardiac imaging in the in-deep stratification pathway has emerged in the last decade. Pathology findings have suggested the fibrosis of papillary muscles and inferobasal left ventricular wall as the malignant hallmark. Cardiac magnetic resonance, while of limited availability, allows the identification of this arrhythmogenic substrate. Therefore, speckle-tracking echocardiography may be a gateway to prompt referring patients to further advanced imaging investigation. Our review aims to summarize the phenotypic features linked to the arrhythmic risk and to propose an image-based algorithm intended to help stratifying asymptomatic MVP patients.
The gut microbiome across the cardiovascular risk spectrum
Authors: Prins Femke M , Collij Valerie , Groot Hilde E , Björk Johannes R , Swarte J Casper , Andreu-Sánchez Sergio , Jansen Bernadien H , Fu Jingyuan , Harmsen Hermie J M , Zhernakova Alexandra , Lipsic Erik , van der Harst Pim , Weersma Rinse K , Gacesa Ranko
Published: December 2023

Aims

Despite treatment advancements, cardiovascular disease remains a leading cause of death worldwide. Identifying new targets is crucial for enhancing preventive and therapeutic strategies. The gut microbiome has been associated with coronary artery disease (CAD), however our understanding of specific changes during CAD development remains limited. We aimed to investigate microbiome changes in participants without clinically manifest CAD with different cardiovascular risk levels and in patients with ST-elevation myocardial infarction (STEMI).

Methods and results

In this cross-sectional study, we characterized the gut microbiome using metagenomics of 411 faecal samples from individuals with low (n = 130), intermediate (n = 130), and high (n = 125) cardiovascular risk based on the Framingham score, and STEMI patients (n = 26). We analysed diversity, and differential abundance of species and functional pathways while accounting for confounders including medication and technical covariates. Collinsella stercoris, Flavonifractor plautii, and Ruthenibacterium lactatiformans showed increased abundances with cardiovascular risk, while Streptococcus thermophilus was negatively associated. Differential abundance analysis revealed eight species and 49 predicted metabolic pathways that were differently abundant among the groups. In the gut microbiome of STEMI patients, there was a depletion of pathways linked to vitamin, lipid, and amino acid biosynthesis.

Conclusion

We identified four microbial species showing a gradual trend in abundance from low-risk individuals to those with STEMI, and observed differential abundant species and pathways in STEMI patients compared to those without clinically manifest CAD. Further investigation is warranted to gain deeper understanding of their precise role in CAD progression and potential implications, with the ultimate goal of identifying novel therapeutic targets.
Tracking fungal species-level responses in soil environments exposed to long-term warming and associated drying
Authors: Romero-Olivares Adriana L , Frey Serita D , Treseder Kathleen K
Published: December 2023

Climate change is affecting fungal communities and their function in terrestrial ecosystems. Despite making progress in the understanding of how the fungal community responds to global change drivers in natural ecosystems, little is known on how fungi respond at the species level. Understanding how fungal species respond to global change drivers, such as warming, is critical, as it could reveal adaptation pathways to help us to better understand ecosystem functioning in response to global change. Here, we present a model study to track species-level responses of fungi to warming—and associated drying—in a decade-long global change field experiment; we focused on two free-living saprotrophic fungi which were found in high abundance in our site, Mortierella and Penicillium. Using microbiological isolation techniques, combined with whole genome sequencing of fungal isolates, and community level metatranscriptomics, we investigated transcription-level differences of functional categories and specific genes involved in catabolic processes, cell homeostasis, cell morphogenesis, DNA regulation and organization, and protein biosynthesis. We found that transcription-level responses were mostly species-specific but that under warming, both fungi consistently invested in the transcription of critical genes involved in catabolic processes, cell morphogenesis, and protein biosynthesis, likely allowing them to withstand a decade of chronic stress. Overall, our work supports the idea that fungi that invest in maintaining their catabolic rates and processes while growing and protecting their cells may survive under global climate change.
Peace at Home, Conflict Abroad: Government Ideology, Mission Type, and Parliamentary Support for Military Interventions
Authors: Vignoli Valerio , Baraldi Francesco
Published: December 2023

International relations scholarship has long overlooked the role of parliament in shaping states’ decision to go to war. In contrast, recent studies explored variations in parliamentary war powers across time and countries and their impact on troop deployments abroad. However, a systematic analysis of the determinants of support for military interventions in parliament is still missing. This article fills this literature gap by examining votes on 119 missions in twenty-one democracies between 1990 and 2019. Our findings suggest that parliamentary contestation is fundamentally driven by government ideology and the type of mission. Parliamentary support for military intervention is significantly higher when a left-wing government is in power. Moreover, “inclusive” missions with a robust humanitarian dimension draw a considerably lower level of contestation than “strategic” missions aimed at contrasting a security threat. Through such findings, the article contributes to the debates on the relevance of domestic political institutions in foreign policy and the party politics of military interventions.
Simplified homology-assisted CRISPR for gene editing in Drosophila
Authors: Rankin Anne E , Fox Elizabeth , Chisholm Townley , Lantz Nicole , Rajan Arjun , Phillips William , Griffin Elizabeth , Harper Jaekeb , Suhr Christopher , Tan Max , Wang Jason , Yang Alana , Kim Ella S , Ankrah Naa Kwama A , Chakraborty Praachi , Lam Alistair C K , Laws Madeleine E , Lee Jackson , Park Kyle K , Wesel Emily , Covert Peter H , Kockel Lutz , Park Sangbin , Kim Seung K
Published: December 2023

In vivo genome editing with clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 generates powerful tools to study gene regulation and function. We revised the homology-assisted CRISPR knock-in method to convert Drosophila GAL4 lines to LexA lines using a new universal knock-in donor strain. A balancer chromosome–linked donor strain with both body color (yellow) and eye red fluorescent protein (RFP) expression markers simplified the identification of LexA knock-in using light or fluorescence microscopy. A second balancer chromosome–linked donor strain readily converted the second chromosome–linked GAL4 lines regardless of target location in the cis-chromosome but showed limited success for the third chromosome–linked GAL4 lines. We observed a consistent and robust expression of the yellow transgene in progeny harboring a LexA knock-in at diverse genomic locations. Unexpectedly, the expression of the 3xP3-RFP transgene in the “dual transgene” cassette was significantly increased compared with that of the original single 3xP3-RFP transgene cassette in all tested genomic locations. Using this improved screening approach, we generated 16 novel LexA lines; tissue expression by the derived LexA and originating GAL4 lines was similar or indistinguishable. In collaboration with 2 secondary school classes, we also established a systematic workflow to generate a collection of LexA lines from frequently used GAL4 lines.
Identification of Candidate Genes Associated With Development of Vascular Cognitive Impairment by Integrated Bioinformatics Analysis Combined With Biological Experiments
Authors: Cheng Yajing , Liu Ying , Wu Rong , Xu Yiyuan , Sun Meiyue , Wang Feng , Geng Xin , Wang Fei
Published: December 2023

The morbidity and mortality associated with vascular cognitive impairment (VCI) generally increase steeply, and health systems will face increasing demand for services. The present study aims to screen key genes to give new insight into the mechanisms and treatment of VCI based on bioinformatic approaches combined with biological experiments in rats. The gene expression data of VCI patients contained in the GSE122063 data set were downloaded from the Gene Expression Omnibus. We performed a weighted gene co-expression network analysis to identify a hub module and 44 hub genes. Two hundred and seventy-seven differentially expressed genes (DEGs) were analyzed using R software by the “limma” package. STRING database was used to construct protein–protein interaction (PPI) network, after which 36 hub genes were identified through Cytoscape. Functional enrichment analysis revealed that these genes from the yellow module and 277 DEGs were mainly associated with these pathways, such as Staphylococcus aureus infection, complement, and coagulation cascades. These biological functions are related to inflammatory cell activation and inflammatory response. The key genes of VCI were the overlapping hub genes from the yellow module and the PPI network. The expressions of hub genes in rats were determined by quantitative reverse transcription-polymerase chain reaction, Western blot, immunohistochemistry, and immunofluorescence. In conclusion, C1QA, C1QB, C1QC, CD163, and FCGR2A were highly expressed in the hippocampus of VCI rats, and they can serve as candidate biomarkers for the diagnosis and prognosis of VCI. Finally, molecular docking results suggested that 5 genes interact with Bisphenol A. These findings open a new avenue to investigate molecular mechanisms for preventing or treating VCI.
The Phenomenon and Determinants of Healthcare Service Utilization for Older Adults With Multimorbidity in China: An Explanatory, Mixed-Method Study
Authors: Wu Jingjie , Xue Erxu , Fu Yujia , Zhao Binyu , Lai Chuyang , Shao Jing , Chen Dandan , Cui Nianqi , Zhang Hui , Tang Leiwen , Ye Zhihong
Published: December 2023

Objectives

The objective of this study was to explore the phenomenon and determinants of healthcare service utilization in Chinese older adults with multimorbidity.

Methods

We adopted a mixed-methods explanatory design from July 2022 to May 2023. The quantitative research was a social network analysis to explore the phenomenon of healthcare service utilization in target participants. The quantitative results were further interpreted as the participant’s propensity for healthcare services and the potential for information sharing between healthcare providers through shared patients. Logistic regression was conducted to identify individual determinants for healthcare service utilization. The quantitative research was followed by qualitative interviews with stakeholders to deeply understand the phenomenon of interest from the individual, healthcare system, and societal perspectives.

Results

We recruited 321 participants for the quantitative study. They preferred using medication services from primary healthcare providers, pharmacists at private pharmacies, and hospital specialists, and preferred using other services from hospital specialists. Dense relationships arose from shared patients among healthcare providers across various professions and settings, making it possible to share patient information. Primary healthcare providers were particularly important in the process, as they were closely related to others through patient sharing. Health status was identified through logistic regression and qualitative interviews as an individual determinant for healthcare service utilization. More determinants were explored in qualitative interviews with 30 stakeholders, including trust, resource allocation, healthcare accessibility, medical treatment process, and healthcare awareness.

Discussion

Strategies should be proposed to intervene with patients’ nonoptimal propensity toward healthcare services and promote information sharing among healthcare providers.
Characterizing hospitalization trajectories in the high-need, high-cost population using electronic health record data
Authors: Lee Scott S , French Benjamin , Balucan Francis , McCann Michael D , Vasilevskis Eduard E
Published: December 2023

High utilization by a minority of patients accounts for a large share of health care costs, but the dynamics of this utilization remain poorly understood. We sought to characterize longitudinal trajectories of hospitalization among adult patients at an academic medical center from 2017 to 2023. Among 3404 patients meeting eligibility criteria, following an initial “rising-risk” period of 3 hospitalizations in 6 months, growth mixture modeling discerned 4 clusters of subsequent hospitalization trajectories: no further utilization, low chronic utilization, persistently high utilization with a slow rate of increase, and persistently high utilization with a fast rate of increase. Baseline factors associated with higher-order hospitalization trajectories included admission to a nonsurgical service, full code status, intensive care unit-level care, opioid administration, discharge home, and comorbid cardiovascular disease, end-stage kidney or liver disease, or cancer. Characterizing hospitalization trajectories and their correlates in this manner lays groundwork for early identification of those most likely to become high-need, high-cost patients.
In safe hands: child health data storage, linkage and consent for use
Authors: Wild Cervantée E K , Rawiri Ngauru T , Taiapa Ken , Anderson Yvonne C
Published: December 2023

While there is potential for societal benefit from linkage and integration of large datasets, there are gaps in our understanding of the implications for children and young people, and limited inclusion of their views within this discourse. We aimed to understand the views and expectations of children, young people and their parents/caregivers in Aotearoa New Zealand regarding child health data storage, linkage and consent for use. This qualitative study included 24 Māori and non-Māori children, young people and their families across five focus groups, recruited from a community-based health service. A mixed Māori and non-Māori research team facilitated participant recruitment and data collection. Child, adolescent and parent/caregiver groups were held separately. Sessions were audio-recorded and the verbatim transcripts were analysed thematically. We identified three themes: (i) I am more than a number: seeing patients as people; (ii) In safe hands: data as power; and (iii) What are your intentions with my data? Consent as an active relationship. A key challenge was the reductive and stigmatizing potential of data integration for minoritised groups. Hypothetical discussions of data sharing and linkage were contingent on trust between the participant and the health professional, with negotiated data ownership. Consent was conceived as an active relationship needing renewal and renegotiation as children reached adulthood. Current consent processes for ongoing use of child data require further deliberation. Without a strong ethical and child rights-based approach to issues of child health data management, consent and linkage, we risk exacerbating health inequities and experiences of breach of trust.
A brief history of artificial intelligence embryo selection: from black-box to glass-box
Authors: Lee Tammy , Natalwala Jay , Chapple Vincent , Liu Yanhe
Published: December 2023

With the exponential growth of computing power and accumulation of embryo image data in recent years, artificial intelligence (AI) is starting to be utilized in embryo selection in IVF. Amongst different AI technologies, machine learning (ML) has the potential to reduce operator-related subjectivity in embryo selection while saving labor time on this task. However, as modern deep learning (DL) techniques, a subcategory of ML, are increasingly used, its integrated black-box attracts growing concern owing to the well-recognized issues regarding lack of interpretability. Currently, there is a lack of randomized controlled trials to confirm the effectiveness of such black-box models. Recently, emerging evidence has shown underperformance of black-box models compared to the more interpretable traditional ML models in embryo selection. Meanwhile, glass-box AI, such as interpretable ML, is being increasingly promoted across a wide range of fields and is supported by its ethical advantages and technical feasibility. In this review, we propose a novel classification system for traditional and AI-driven systems from an embryology standpoint, defining different morphology-based selection approaches with an emphasis on subjectivity, explainability, and interpretability.
Testing the waters: founding team composition and search heuristics in academic entrepreneurial ventures
Authors: Savage Jeffrey , Ziedonis Arvids A
Published: December 2023

Entrepreneurial action often stems from individual judgment about the value potential of market opportunities. Where entrepreneurs direct their search for and evaluate profitable opportunities has long received scholarly consideration. Attention has been increasingly directed toward how search is conducted, with a distinction between “cognitive” search, where actors are driven by a prior belief about the linkage between actions and outcomes (i.e., “learning-before-doing”) and “experiential search,” in which the solution must be realized through experimentation, trial-by-error, or “learning-by-doing.” We examine founders’ experiential search for market applications in uncertain technological environments. In doing so, we seek to uncover how founder background, experience, and depth of knowledge affect the firm’s degree of experiential search. We examine a sample of technology-oriented start-ups founded by researchers from six major US research universities to investigate the role of experiential search in university technology commercialization. In our context of academic entrepreneurship, we find that founding teams that draw from multiple disciplinary perspectives in selecting a market application to pursue exhibit a broader cognitive map of the technological landscape and thus expend more effort in the experiential search process than do teams with less varied backgrounds. Conversely, teams that include individuals with prior commercial experience conduct less experiential search, although this evidence is less strong. The inclusion of students appears to lead to greater experiential search by the founding team. Our findings add new understanding to the application of search heuristics by entrepreneurial firms in technology commercialization.
On Restricted Averages of Dedekind Sums
Authors: Minelli Paolo , Sourmelidis Athanasios , Technau Marc
Published: December 2023

We investigate the averages of Dedekind sums over rational numbers in the set $\mathscr {F}_{\alpha }(Q) = \{\,{v}/{w}\in \mathbb {Q}: 0<w\leq Q\,\}\cap \lbrack 0, \alpha )$ for fixed $\alpha \leq 1/2$. In previous work, we obtained asymptotics for $\alpha =1/2$, confirming a conjecture of Ito in a quantitative form. In the present article we extend our former results, first to all fixed rational $\alpha $ and then to almost all irrational $\alpha $. As an intermediate step we obtain a result quantifying the bias occurring in the second term of the asymptotic for the average running time of the by-excess Euclidean algorithm, which is of independent interest.
The Mapping Class Group of Manifolds Which Are Like Projective Planes
Authors: Su Yang , Wang Wei
Published: December 2023

In this paper, we compute the mapping class group of simply-connected closed smooth manifolds $M$ with integral homology $H_{*}(M) \cong {\mathbb {Z}} \oplus {\mathbb {Z}} \oplus {\mathbb {Z}}$ provided that $\dim M \ne 4$.
Poissonian Pair Correlation for $\alpha n^{\theta }$ mod 1
Authors: Radziwiłł Maksym , Shubin Andrei
Published: December 2023

We show that sequences of the form $\alpha n^{\theta } \pmod {1}$ with $\alpha> 0$ and $0 < \theta < \tfrac {43}{117} = \tfrac {1}{3} + 0.0341 \ldots $ have Poissonian pair correlation. This improves upon the previous result by Lutsko, Sourmelidis, and Technau, where this was established for $\alpha> 0$ and $0 < \theta < \tfrac {14}{41} = \tfrac {1}{3} + 0.0081 \ldots $. We reduce the problem of establishing Poissonian pair correlation to a counting problem using a form of amplification and the Bombieri–Iwaniec double large sieve. The counting problem is then resolved non-optimally by appealing to the bounds of Robert–Sargos and (Fouvry–Iwaniec–)Cao–Zhai. The exponent $\theta = \tfrac {2}{5}$ is the limit of our approach.
The Annual Economic Burden of Respiratory Syncytial Virus in Adults in the United States
Authors: Carrico Justin , Hicks Katherine A , Wilson Eleanor , Panozzo Catherine A , Ghaswalla Parinaz
Published: December 2023

Background

Current estimates of the economic burden of respiratory syncytial virus (RSV) are needed for policymakers to evaluate adult RSV vaccination strategies.

Methods

A cost-of-illness model was developed to estimate the annual societal burden of RSV in US adults aged ≥60 years. Additional analyses were conducted to estimate the burden of hospitalized RSV in all adults aged 50–59 years and in adults aged 18–49 years with potential RSV risk factors.

Results

Among US adults aged ≥60 years, the model estimated 4.0 million annual RSV cases (95% uncertainty interval [UI], 2.7–5.6 million) and an annual economic burden of $6.6 billion (95% UI, $3.1–$12.9 billion; direct medical costs, $2.9 billion; indirect costs, $3.7 billion). The 4% of RSV cases that were hospitalized contributed to 94% of direct medical costs. Additional analyses estimated $422 million in annual hospitalization costs among all adults aged 50–59 years. Among adults aged 18–49 years with RSV risk factors, annual per capita burden was highest among people with congestive heart failure at $51 100 per 1000 people.

Discussion

The economic burden of RSV is substantial among adults aged ≥50 years and among adults aged 18–49 years with RSV risk factors, underscoring the need for preventive interventions for these populations.
Antiviral Activity of Lenacapavir Against Human Immunodeficiency Virus Type 2 (HIV-2) Isolates and Drug-Resistant HIV-2 Mutants
Authors: Smith Robert A , Raugi Dana N , Nixon Robert S , Seydi Moussa , Margot Nicolas A , Callebaut Christian , Gottlieb Geoffrey S ,   for the University of Washington–Senegal HIV-2 Study Group, Sall Fatima , Diallo Khardiata , Diallo Mouhamadou Baïla , Faye Khadim , Cisse Samba , Simal Fatou , Sy Marie Pierre , Diaw Binetou , Ndiaye Ousseynou , Faye Babacar , Diop Ndeye Astou , Diop Amadou Bale , Fadiome Marianne , Sall ElHadji Ibrahima , Kande Boubacar , Malomar Jean Jacques , Cisse Ousseynou , Tamba Ibrahima Tito , Faye Dominique , Diallo Papa Amadou , Diop Mamadou Habib , Diatta Jean Phillippe , Diene Adji Fatoumata , Badiane François , Diatta Baboucar , Bakhoum Raphael , Barry Aissatou , Sané Aissatou Mamy , Sambou Jacques Francois , Diedhiou Bokeni , Diatta Sidy , Gomis Juliette , Dieye Terese , Hawes Stephen , Benzekri Noelle , Lin John , Chang Ming , Coombs Robert , Mullins James , Sow Papa Salif , Kiviat Nancy
Published: December 2023

The activity of lenacapavir against human immunodeficiency virus type 1 (HIV-1) has been extensively evaluated in vitro, but comparable data for human immunodeficiency virus type 2 (HIV-2) are scarce. We determined the anti–HIV-2 activity of lenacapavir using single-cycle infections of MAGIC-5A cells and multicycle infections of a T-cell line. Lenacapavir exhibited low-nanomolar activity against HIV-2, but was 11- to 14-fold less potent against HIV-2 in comparison to HIV-1. Mutations in HIV-2 that confer resistance to other antiretrovirals did not confer cross-resistance to lenacapavir. Although lenacapavir-containing regimens might be considered for appropriate patients with HIV-2, more frequent viral load and/or CD4 testing may be needed to assess clinical response.
Digital literacy in undergraduate pharmacy education: a scoping review
Authors: Alowais Mashael , Rudd Georgina , Besa Victoria , Nazar Hamde , Shah Tejal , Tolley Clare
Published: December 2023

Objectives

Conduct a scoping review to identify the approaches used to integrate digital literacy into undergraduate pharmacy programs across different countries, focusing on methods for education, training, and assessment.

Materials and methods

Following the Joanna Briggs Institute methodology, we searched 5 electronic databases in June 2022: MEDLINE (Ovid), PubMed, Embase, Scopus, and CINAHL. Three independent reviewers screened all articles; data extraction was conducted by 2 reviewers. Any discrepancies were arbitrated by 2 additional reviewers.

Results

Out of 624 articles, 57 were included in this review. Educational and training approaches for digital literacy in undergraduate pharmacy programs encompassed a theoretical understanding of health informatics, familiarization with diverse digital technologies, and applied informatics in 2 domains: patient-centric care through digital technologies, and the utilization of digital technologies in interprofessional collaboration. Blended pedagogical strategies were commonly employed. Assessment approaches included patient plan development requiring digital information retrieval, critical appraisal of digital tools, live evaluations of telehealth skills, and quizzes and exams on health informatics concepts. External engagement with system developers, suppliers, and other institutes supported successful digital literacy education.

Discussion and conclusion

This scoping review identifies various learning objectives, teaching, and assessment strategies to incorporate digital literacy in undergraduate pharmacy curricula. Recommendations include acknowledging the evolving digital health landscape, ensuring constructive alignment between learning objectives, teaching approach and assessments, co-development of digital literacy courses with stakeholders, and using standardized guidelines for reporting educational interventions. This study provides practical suggestions for enhancing digital literacy education in undergraduate pharmacy programs.
The mitochondrial fission protein DRP1 influences memory CD8+ T cell formation and function
Authors: Stevens Marissa G , Mason Frank M , Bullock Timothy N J
Published: December 2023

Pharmacological methods for promoting mitochondrial elongation suggest that effector T cells can be altered to support a memory T cell–like metabolic state. Such mitochondrial elongation approaches may enhance the development of immunological memory. Therefore, we hypothesized that deletion of the mitochondrial fission protein dynamin-related protein 1 (DRP1) would lead to mitochondrial elongation and generate a large memory T cell population, an approach that could be exploited to enhance vaccination protocols. We find that, as expected, while deletion of DRP1 from T cells in dLckCre × Drp1flfl does compromise the magnitude and functionality of primary effector CD8+ T cells, a disproportionately large pool of memory CD8+ T cells does form. In contrast to primary effector CD8+ T cells, DRP1-deficient memory dLckCre × Drp1flfl CD8+ T cells mount a secondary response comparable to control memory T cells with respect to kinetics, magnitude, and effector capabilities. Interestingly, the relative propensity to form memory cells in the absence of DRP1 was associated with neither differentiation toward more memory precursor CD8+ T cells nor decreased cellular death of effector T cells. Instead, the tendency to form memory CD8+ T cells in the absence of DRP1 is associated with decreased T cell receptor expression. Remarkably, in a competitive environment with DRP1-replete CD8+ T cells, the absence of DRP1 from CD8+ T cells compromised the generation of primary, memory, and secondary responses, indicating that approaches targeting DRP1 need to be carefully tailored.
Negative pressure wound therapy for complex oral wounds
Authors: Sternick Mykaihla , Gates James C , Champion Allen , Yampolsky Andrew
Published: December 2023

Negative pressure wound therapy provides a nonsurgical treatment option for many types of complex wounds. This therapy utilizes the vacuum-assisted closure device, which decreases air pressure, removes fluid that accumulates within the wound, and aids to facilitate changes that promote healing. Despite the increased use of negative pressure wound therapy in the head and neck region, there is substantially less data available on the management of transoral vacuum-assisted wound closure. Herein, we present a case of a novel approach for the creation and use of a transoral wound vac for a patient with a refractory orocutaneous wound in the setting of multiple previous free flaps and surgeries. A watertight seal was able to be maintained and the patient was compliant with treatment, resulting in successful management of the wound. We promote the consideration of this novel technique’s use for similar difficult-to-treat oral wounds.
Immune-mediated resolution of a herniated lumbar disc prolapse aided by motor control exercises—a case report
Authors: Garcia Abigail J , Ampat George
Published: December 2023

Low back pain is the global leading cause of disability. Herniated intervertebral discs are a common cause of lower back pain. The natural history of the herniated intervertebral disc is that it can resorb spontaneously through an immune-mediated mechanism. Despite this favourable natural history, there is an increasing reliance on surgical intervention. A 64-year-old presented with a left L3/4 disc prolapse. With reassurance, simple analgesics, and motor control exercises, the MRI scan confirmed the complete resolution of the disc prolapse within 3 months. Patients with disc prolapses should be reassured that disc prolapses will naturally resolve and advised to remain active. Surgical intervention should only be considered with the presence of red flags, progressive neurology, or when clear evidence exists that all non-interventional techniques have been exhausted. With such a favourable natural history, caution should be exercised before surgical intervention is recommended.
Splenic abscess with spontaneous gastrosplenic fistula: case report and review of the literature
Authors: Campisi Andrea , Rocca Lorenzo , Altieri Gaia , Fico Valeria , Pepe Gilda , Lodoli Claudio
Published: December 2023

Gastrosplenic fistula (GSF) is an unusual event that might occur in patients with various gastric or splenic diseases. While GSF related to gastric and splenic malignancies is well-documented in the literature, cases of GSF due to a splenic abscess are extremely rare. We experienced the case of a 49-year-old man with a medical history of tricuspid cardiac valve replacement for infective endocarditis who presented with a sudden onset of anemia and melena. With the assistance of imaging and endoscopy, a primary splenic abscess complicated by spontaneous GSF was diagnosed. A prompt splenectomy with partial gastrectomy was performed. GSF is a serious occurrence associated with a high risk of morbidity and mortality. The early recognition of GSF related to a splenic abscess is crucial to prevent major complications. Surgical resection with splenectomy and partial gastrectomy is frequently preferred for the treatment of large abscesses with GSF.
Two-stage repair for DeBakey type II acute aortic dissection and distal aortic arch aneurysm in a nonagenarian patient
Authors: Shirakura Kentaro , Kunioka Shingo , Miyatani Kazuki , Mochizuki Nobuhiro , Isa Hideki , Setogawa Yuki , Suzuki Fumitaka , Okubo Ryo , Ushioda Ryohei , Hirofuji Aina , Tsutsui Masahiro , Ishikawa Natsuya , Kamiya Hiroyuki
Published: December 2023

Although total arch replacement would be performed in a patient with acute type A aortic dissection and concomitant aortic aneurysm in the distal aortic arch, total arch replacement may be too invasive in elderly patients with significant morbidities. A 92-year-old female with acute type II DeBakey aortic dissection and concomitant distal aortic arch aneurysm was successfully treated with hemi-arch replacement followed by thoracic endovascular aortic repair. Hybrid two-stage repair of DeBakey type II aortic dissection complicated by distal arch aneurysm using thoracic endovascular aortic repair after hemi-arch replacement may be effective.
Anesthesia and perioperative management of bariatric surgery in a patient with BMI over 70 kg/m2: a case report
Authors: Dong Ling , Huang Chunxia , Jia Benli , Zhang Ye , Xue Qi
Published: December 2023

The anesthesia protocol of bariatric surgery has not been standardized in detail. This report introduced an optimized anesthesia strategy for a severely obese male patient for laparoscopic sleeve gastrectomy and a continuous follow-up for 12 months. A 34-year-old male patient was admitted for super-super-obesity with obstructive sleep apnea-hypopnea syndrome. Based on the results of the examination before laparoscopic sleeve gastrectomy, he received an efficient preoperative exercise guidance for pulmonary function promotion and diet restriction. Multiple analgesia scheme consisted of regional nerve block and analgesics cocktail. He lost 103 kg without any complications till postoperative 12 months. His mental characteristics were also improved gradually. This case presented a superior composition in perioperative anesthesia management for laparoscopic sleeve gastrectomy. To provide a reference for promoting the implementation of enhanced recovery after surgery protocols in bariatric surgery.
Metachronous colon cancer metastasis to abdominal wall 7 years after rectosigmoid resection: a case report and literature review
Authors: Nikolovski Andrej , Nevchev Ivan , Ristovski Gligor , Misimi Shqipe , Burovska Mare , Tahir Shenol
Published: December 2023

Distant metastases from colorectal cancer to the abdominal wall are rare presentations of the end-stage of the disease. In this case, we present a female patient treated for Stage I rectosigmoid cancer with the late occurrence of abdominal wall metastasis, 7 years after the primary cancer surgery. The patient was treated with surgical excision and abdominal wall reconstruction with the use of synthetic mesh. Literature research on the abdominal wall recurrence/metastases from colorectal cancer was performed.
Chronic sigmoid diverticulitis causing tubo-ovarian abscess and colo-uterine fistula
Authors: Anthony Phelopatir , Edwards Tracey , Andrawis Nagy
Published: December 2023

Colo-uterine fistulas are rarely reported in the literature, and its presentation in the presence of a tubo-ovarian abscess secondary to chronic sigmoid diverticulitis is currently not reported. As such, its presentation may pose a diagnostic dilemma. Here, we present a 68-year-old woman who was admitted under the colorectal service with a 1 month history of mild left iliac fossa pain, with computed tomography (CT) demonstrating complicated sigmoid diverticulitis. Progress CTs, however, demonstrated a progressively enlarging left iliac fossa mass, with air fluid levels, densely adherent to the sigmoid colon. The decision was eventually made to perform a laparoscopy, which demonstrated a left tubo-ovarian abscess communicating with the uterus and sigmoid colon, illustrating a colo-uterine fistula. Open resection of the sigmoid colon and uterus was performed and the patient recovered uneventfully. This case describes an uncommon complication of chronic sigmoid diverticulitis and the importance of its judicious surgical management.
Role of cytoreduction and hyperthermic intraperitoneal chemotherapy for metastatic gastroesophageal junction adenocarcinoma?
Authors: Zaidi Syed M H , Ho Kimberly , Sohail Amir H , Whittington Jennifer
Published: December 2023

Gastric cancer is the fifth most prevalent cancer worldwide and the third leading cause of cancer- related mortality. Peritoneal carcinomatosis can develop in patients with a primary gastric tumor in a substantial proportion of patients, with estimates ranging from 14% to 43%. For patients with peritoneal carcinomatosis from gastric cancer, therapeutic options are limited. Intraperitoneal chemotherapy, combined with hyperthermia (HIPEC), provides regional dose intensification within the peritoneal cavity, effectively targeting peritoneal carcinomatosis with minimal systemic exposure. We report a case of gastroesophageal junction adenocarcinoma with peritoneal metastasis successfully treated with of cytoreductive surgery and HIPEC, and followed by surgery and systemic chemotherapy, highlighting HIPEC as one of the viable options and the importance of a multimodal approach for the treatment of this case.
The ESC Textbook of Heart Failure
Authors: Coats Andrew , Filippatos Gerasimos , Bauersachs Johann , Rosano Giuseppe
Published: December 2023

It is estimated that the worldwide population of patients suffering from heart failure is approximately 26 million. The ESC Textbook of Heart Failure is the latest addition to the European Society of Cardiology (ESC) publications portfolio and brings together internationally renowned experts in the field of heart failure to present an up-to-date understanding of all aspects of this chronic condition that worsens with time. This clinically oriented work reflects contemporary European guidelines from the ESC and the European Heart Failure Association and summarizes the latest evidence from clinical trials. Comprising 18 different sections, the textbook covers the epidemiology, aetiology, prevention, pathophysiology, and clinical phenotypes of heart failure. The assessment and management of chronic, acute, and advanced heart failure are all discussed in detail. As well as chapters dedicated to self-care and patient education, the multidisciplinary approach to heart failure management, and clinical trial design and interpretation, the future direction of the field is discussed throughout with separate chapters on digital health, big data, and telemedicine/remote monitoring in heart failure.
Epidemiology of heart failure
Authors: Groenewegen Amy , Milinković Ivan , Hoes Arno W , Mosterd Arend , Rutten Frans H
Published: December 2023

Heart failure (HF) affects an estimated 64 million people worldwide. Ischaemic heart disease, chronic obstructive pulmonary disease, hypertensive heart disease, and rheumatic heart disease are responsible for over two-thirds of HF cases worldwide. While HF incidence rates appear stable, its prevalence is still increasing. The global incidence ranges from 1 to 9 cases per 1000 person-years, and the prevalence is estimated to be 1–2% of the general adult population. Prevalence estimates of all types of HF range from 0.7% to 1.3% in those aged <55 years, and from 4.7% to 13.3% in those aged ≥65 years. Suboptimal control of five modifiable risk factors (smoking, diabetes, hypertension, hyperlipidaemia, and obesity) accounts for an estimated 88.8% of incident cases of HF. Hospitalization due to HF represents 1–2% of all hospital admissions (with more than half of those patients aged >75 years), with a median number of HF discharges per million people assessed of 2671. Around 20% of patients are readmitted after 30 days, with over half during the first year and over 80% within 5 years after initial hospitalization. One- and 5-year mortality rates are 10.7% and 40.3%, respectively. Determinants of prognosis are age, renal function, blood pressure, sodium level, ejection fraction, male sex, natriuretic peptide levels, New York Heart Association class, diabetes, body mass index, and exercise capacity. The distribution of different phenotypes of HF is changing, with an increasing proportion of patients with heart failure with preserved ejection fraction. Heart failure with reduced ejection fraction is the most well studied, and clear prognostic benefits of therapy have been demonstrated in clinical trials.