bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacist‐driven interventions to de‐escalate urinary antimuscarinics in the Programs of All‐Inclusive Care for the Elderly
Authors: Ha Meghan , Furman Anna , Al Rihani Sweilem B. , Michaud Veronique , Turgeon Jacques , Bankes David L.
Published: July 2022

Background

Given associations with serious cognitive and physical adverse effects (e.g., dementia, falls), strong anticholinergics, like urinary antimuscarinics (UAMs), should be avoided in older adults. This feasibility study aimed to (1) evaluate the implementation rate of pharmacists' recommendations intended to de‐escalate UAMs, (2) quantify the change in overall anticholinergic dosing exposure from these recommendations, and (3) investigate factors that predict recommendation implementation.

Methods

This was a retrospective, observational, before‐and‐after study. Pharmacists (n = 18) devised strategies to de‐escalate UAMs in 187 participants (mean age 72.4 ± 9.4; 77.0% female; mean number of medications 12.9 ± 4.6) of 35 Programs of All‐Inclusive Care for the Elderly (PACE). PACE prescribers (non‐physicians and physicians) determined whether to implement recommendations. Implementation was defined as a change in the prescription records consistent with the pharmacist's recommendation at 2‐, 4‐, 6‐, and 9‐months post‐recommendation. Anticholinergic dosing exposure was measured at each time point using standardized daily doses (SDD). Multivariable logistic regression was used to identify factors that predicted recommendation implementation.

Results

Across 9 months, recommendations were implemented in 118 out of 187 participants, yielding a 63.1% implementation rate. Of these, 77.1% (n = 91/118) implemented by month 2. Implementers' mean overall anticholinergic SDD decreased 65.4% from baseline (baseline: 2.6 [95% CI: 2.2, 3.0] to month 9: 0.9 [95% CI: 0.6,1.2], p < 0.001) whereas non‐implementers demonstrated no significant change (p = 0.52). Taking <10 baseline medications (OR 2.75; 95% CI: 1.09, 7.61); baseline UAM SDD ≥2 (OR 2.20; 95% CI: 1.11, 4.44); uncomplicated recommendations (OR 3.38; 95% CI: 1.67–7.03); and baseline calcium channel blocker use (OR 2.19; 95% CI: 1.09, 4.52) predicted implementation.

Conclusion

Our high implementation rate indicates that pharmacists' recommendations to de‐escalate UAMs as a way to reduce overall anticholinergic exposure is feasible in medically complex, community‐dwelling older adults. Future research should investigate whether these recommendations benefit cognitive (e.g., delirium, dementia) and/or physical functioning (e.g., falls).
The future of artificial intelligence in the context of industrial ecology
Authors: Donati Franco , Dente Sébastien M. R. , Li Chen , Vilaysouk Xaysackda , Froemelt Andreas , Nishant Rohit , Liu Gang , Tukker Arnold , Hashimoto Seiji
Published: July 2022

Artificial intelligence (AI) applications and digital technologies (DTs) are increasingly present in the daily lives of citizens, in cities and in industries. These developments generate large amounts of data and enhance analytical capabilities that could benefit the industrial ecology (IE) community and sustainability research in general. With this communication, we would like to address some of the opportunities, challenges, and next steps that could be undertaken by the industrial ecology community in this realm. This article is an adapted summary of the discussion held by experts in industrial ecology, AI, and sustainability during the 2021 Industrial Ecology Day conference session titled “The Future of Artificial Intelligence in the Context of Industrial Ecology.” In brief, building on previous studies and communications, we advise the industrial ecology community to: (1) create internal committees and working groups to monitor and coordinate AI applications within and outside the community; (2) promote and ensure transdisciplinary efforts; (3) determine optimal infrastructure and governance of AI for IE to minimize undesired effects; and (4) act on effective representation and on reduction of digital divides.
Ultrasonographic measurement of vaginal thickness: Relation to menopausal status and genitourinary syndrome of menopause
Authors: Türk Sema , Ertürk Coşkun Ayşe D. , Vural Fisun
Published: July 2022

Objective

To compare the total vaginal wall thickness (TVT) and total mucosal thickness (TMT) measurements of premenopausal and postmenopausal women measured by ultrasonography and to determine the association of these measurements to findings and symptoms of genitourinary syndrome of menopause

Methods

Healthy volunteers, 80 postmenopausal and 80 premenopausal, were included. Ultrasonographic TVT and TMT measurements, vaginal health index (VHI) scores and pH values were recorded. The daily impact of vaginal aging (DIVA) scale was administered to women in the postmenopausal group.

Results

TVT measurements of the postmenopausal group (6.55 ± 2.00 mm) were lower than the premenopausal group (10.37 ± 2.11 mm) (p: 0.000). TMT measurements of the postmenopausal group (1.46 ± 0.50 mm) were lower than the premenopausal group (2.19 ± 0.60 mm) (p: 0.000). The VHI scores of the postmenopausal group were significantly lower than the premenopausal group, the pH value was higher (p < 0.05). Considering all women TVT and TMT measurements were inversely correlated with pH values and positively correlated with total VHI scores. There was no significant correlation between any component scores of the DIVA scale and TVT, TMT, pH, and VHI total (p > 0.05).

Conclusions

TVT and TMT measurements in postmenopausal women are significantly lower than premenopausal women. Examination findings and thickness measurements are correlated. Transabdominal ultrasonography is a method that can be used in the evaluation of vaginal thickness which is not painful for the patient, is easy to apply and gives results consistent with the examination findings. However, measurements and examination findings do not correlate with the DIVA scores in postmenopausal women.
Pharmacokinetics and anti‐nausea effects of intravenous ondansetron in hospitalized dogs exhibiting clinical signs of nausea
Authors: Sotelo Cindy K. , Shropshire Sarah B. , Quimby Jessica , Simpson Sydney , Gustafson Daniel L. , Zersen Kristin M.
Published: July 2022

The purpose of this study was to evaluate the pharmacokinetics of intravenous (IV) ondansetron in a population of hospitalized dogs exhibiting clinical signs of nausea. The causes of nausea included pancreatitis, gastroenteritis, endocarditis, chemotherapy‐induced nausea, diabetes mellitus and ketoacidosis, acute kidney injury with aspiration pneumonia, pyometra, uroabdomen, neoplasia, and hepatopathy. Twenty‐four dogs were randomly assigned to one of the following IV ondansetron protocols: 1 mg/kg q12h, 0.5 mg/kg q12h, 1 mg/kg q8h, 0.5 mg/kg q8h. Serum was collected at 0, 0.25, 0.5, 1, 2, 4, 8, 16, and 24 h after the first dose, and nausea scores were recorded at multiple time points. Ondansetron and arginine vasopressin (AVP) concentrations were measured via high‐performance liquid chromatography coupled to tandem mass spectrometry and ELISA, respectively. Noncompartmental pharmacokinetic modeling and dose interval modeling were performed. Ondansetron displayed linear pharmacokinetics. In the 0.5 mg/kg group, mean Cmax = 214 ng/ml, AUC0–8h = 463 ng/ml*h, and calculated half‐life was 1.9 h. In the 1 mg/kg group, mean Cmax = 541 ng/ml, AUC0–8h = 1057 ng/ml*h and calculated half‐life was 1.6 h. Serum ondansetron concentrations were not significantly different between dogs that required rescue anti‐nausea medication (non‐responders) and dogs that did not require rescue therapy (responders). In total, 83.3% of patients in the 0.5 mg/kg q8h, 0.5 mg/kg q12h, and 1 mg/kg q8h groups had improvement in nausea scores. In total, 66.7% of patients in the 1 mg/kg q12h group had improvement in nausea scores. In total, 33% of patients had resolution of nausea in the 0.5 mg/kg q8h, 1 mg/kg q8h, and 1 mg/kg q12h groups, and 16% of patients had resolution of nausea in the 0.5 mg/kg q12h group. AVP concentrations were highly variable and did not correlate with nausea scores. Nausea scores significantly decreased regardless of dosage protocol. AVP was not a reliable biomarker of nausea in this group of dogs.
The role of macrophage TAM receptor family in the acute‐to‐chronic progression of liver disease: From friend to foe?
Authors: Huang Haitao , Jiang Jingyu , Chen Ruihan , Lin Yimou , Chen Hui , Ling Qi
Published: July 2022

Hepatic macrophages, the key cellular components of the liver, emerge as essential players in liver inflammation, tissue repair and subsequent fibrosis, as well as tumorigenesis. Recently, the TAM receptor tyrosine kinase family, consisting of Tyro3, Axl and MerTK, was found to be a pivotal modulator of macrophages. Activation of macrophage TAM receptor signalling promotes the efferocytosis of apoptotic cells and skews the polarization of macrophages. After briefly reviewing the mechanisms of TAM receptor signalling in macrophage polarization, we focus on their role in liver diseases from acute injury to chronic inflammation, fibrosis and then to tumorigenesis. Notably, macrophage TAM receptor signalling seems to be a two‐edged sword for liver diseases. On one hand, the activation of TAM receptor signalling inhibits inflammation and facilitates tissue repair during acute liver injury. On the other hand, continuous activation of the signalling contributes to the process of chronic inflammation into fibrosis and tumorigenesis by evoking hepatic stellate cells and inhibiting anti‐tumour immunity. Therefore, targeting macrophage TAM receptors and clarifying its downstream pathways will be exciting prospects for the precaution and treatment of liver diseases, particularly at different stages or statuses.
No Experience Required: Early Donations and Amateur Candidate Success in Primary Elections
Authors: Porter Rachel , Steelman Tyler S.
Published: July 2022

The electoral dominance of “quality” candidates—political insiders with a history of holding office—is well‐established. However, research on the recent rise in successful political neophytes is less studied. Despite longstanding trends in the predominance of experienced candidates in primary elections, nearly half of all quality candidates who ran in non‐incumbent races lost to a candidate without prior electoral experience in 2018. In this article, we investigate the success of political newcomers in elections for the U.S. House of Representatives by examining a topic often overlooked in the growing literature on primaries: campaign finance. We show that, from 2016 to 2020, political newcomers saw (1) greater success in future fundraising, and (2) an increased likelihood of primary election victory when they garnered more early contributions from outside their district. This contrasts with prior elections, where early money from inside a candidate's own congressional district served as the strongest predictor of future fundraising and electoral success.
Efficacy of anti‐fungal agents for invasive fungal infection prophylaxis in liver transplant recipients: A network meta‐analysis
Authors: Liu Yusi , Lan Chunhai , Qin Sibei , Qin Zhuo , Zhang Zhiqiang , Zhang Peng , Cao Weiling
Published: July 2022

At present, there is still a lack of effective invasive fungal prophylaxis therapy in liver transplant recipients (LTRs). This study aimed to analysis the latest evidence on efficacy of current prophylactic anti‐fungal therapy, and systematically compare between anti‐fungal agents and placebo by a fixed‐effects meta‐analysis in all randomised controlled trials. A network meta‐analysis was performed for invasive fungal infection (IFI) among different agents in 14 randomised controlled trials, in which 10 anti‐fungal approaches were identified. Overall, anti‐fungal prophylaxis reduced the rate of IFI (RR 0.30, 95% CI 0.18–0.52) and proven IFI (RR 0.27, 95% CI 0.14–0.53) when compared to placebo. In the network meta‐analysis, an equivalent reduction in the rate of IFI was observed in fluconazole (OR 4.70, 95% CI 1.22–18.10), itraconazole (OR 5.82, 95% CI 1.10–30.71) and Liposomal amphotericin B (LAmB, OR 5.74, 95% CI 1.29–25.58) groups when compared with placebo. Anidulafungin might be the most effective agents in IFI prevention; however, this superiority did not meet statistically significance. Our study indicated that fluconazole, echinocandins and LAmB are equivalent in efficacy. Of which, fluconazole is recommended for the prevention of IFI in LTRs due to its efficacy, economics and compliance.
A novel SREBF1::NACC1 gene fusion in an unclassifiable intracranial tumour
Authors: Takeuchi Yasuhide , Mineharu Yohei , Arakawa Yoshiki , Hara Masayuki , Oichi Yuki , Kamata Takahiko , Fukuyama Keita , Yamamoto Yoshihiro , Yamanaka Toshiyuki , Kakiuchi Nobuyuki , Hiratomo Emi , Hirata Masahiro , Yokoo Hideaki , Hirose Takanori , Minamiguchi Sachiko , Ogawa Seishi , Muto Manabu , Miyamoto Susumu , Haga Hironori
Published: July 2022

A 39‐year‐old man had an intracranial tumour without infiltration into the surrounding cerebral tissue. The tumour recurred seven times in 11 years but maintained a well‐demarcated character. Histopathological examination of the 4th surgical specimens showed nests of tumour cells surrounding small blood vessels. The tumour cells harboured amphophilic cytoplasm and small round nuclei with fine chromatin, and perinuclear haloes and clear borders were frequently observed, which was unclassifiable histology. By the Deutsches Krebsforschungszentrum methylation classifier, the tumour was not classified into any of the methylation classes. mRNA sequencing identified a novel SREBF1::NACC1 gene fusion. This intracranial tumour could be a novel tumour entity with NACC1 rearrangement showing characteristic histological and diagnostic imaging findings.
Atrial myxoma surgery and P‐wave remodeling
Authors: Herrera Cristian , Bruña Vanesa , Barrio Jose María , Cuerpo Gregorio , Fernández‐Avilés Francisco , Bayés de Luna Antonio , Martínez‐Sellés Manuel
Published: July 2022

Introduction

Data regarding atrial electrocardiographic parameters in patients with atrial myxomas are scarce.

Methods

We aimed to study atrial electrocardiographic features in patients with atrial myxomas, before and after surgery. We also analyze the incidence of atrial fibrillation during follow‐up and its correlation with different P‐wave indexes. In total 32 patients in sinus rhythm that underwent atrial myxoma surgery were included.

Results

Mean age was 55.0 ± 12.6 years and 18 (56.3%) were women. Ten patients had left atrial enlargement (31.3%). Only one myxoma was located in the right atrium. At baseline seven cases of partial interatrial block (IAB) were detected (21.9%), two in the absence of left atrial enlargement. There were significant differences in atrial electrocardiographic indexes before and after surgery, including P‐wave duration (108.9 ± 17.9 ms vs. 93.0 ± 12.4 ms; p < .001), partial IAB (21.9% vs. 3.1%; p = .012) and duration of P‐wave terminal force in lead V1 negativity (−0.6 ± 0.3 vs. −0.5 ± 0.3 mm; p = .034). At a mean follow‐up of 10.0 ± 5.5 years, 10 patients (31.3%) had experienced at least one episode of atrial fibrillation. Post‐operative P‐wave duration was associated with atrial fibrillation occurrence during follow‐up (Hazard ratio: 0.90, 95% confidence interval: 0.83–0.98; p = .020).

Conclusions

Abnormalities in atrial electrocardiographic indexes are common in atrial myxomas and frequently improve after surgery. Post‐operative P‐wave duration is associated with atrial fibrillation occurrence during follow‐up.
How does religion affect health in the gold mining industry? Evidence from Nigeria
Authors: Wang Dongqin
Published: July 2022

This study investigates the interaction effects of the environmental factors of mining and religion on health. Using data from the Demographic and Health Survey and gold mine geolocation data in Nigeria, the difference‐in‐differences estimation reveals that artisanal and small‐scale gold mining in Nigeria has an adverse health effect on Muslim women's fertility. In particular, living near gold mines increases Muslim women's (i.e., the treated group) probability of infecundity or premature menopause by about 12 percentage points compared to Christian women (i.e., the untreated group), and the effects are stronger in northern Nigeria than in southern Nigeria. By eliminating other possible channels, the results show that the main mechanism appears to be Muslim women being more likely to work in gold mines in their family compounds. The results are robust to the alternative distance cutoffs, other measures of health outcomes, and triple‐difference approach. Understanding the impact of religion on the health of women in the mining industry may help effectively reduce infertility in developing countries.
Robust Correspondence Analysis
Authors: Riani Marco , Atkinson Anthony C. , Torti Francesca , Corbellini Aldo
Published: July 2022

Correspondence analysis is a method for the visual display of information from two-way contingency tables. We introduce a robust form of correspondence analysis based on minimum covariance determinant estimation. This leads to the systematic deletion of outlying rows of the table and to plots of greatly increased informativeness. Our examples are trade flows of clothes and consumer evaluations of the perceived properties of cars. The robust method requires that a specified proportion of the data be used in fitting. To accommodate this requirement we provide an algorithm that uses a subset of complete rows and one row partially, both sets of rows being chosen robustly. We prove the convergence of this algorithm.
Examining associations between suicidal desire, implicit fearlessness about death, and lifetime frequency of suicide attempts
Authors: Tull Matthew T. , DeMoss Zachary T. , Anestis Michael D. , Lavender Jason M. , McDermott Michael J. , Gratz Kim L.
Published: July 2022

Introduction

Suicide models propose that the capability for suicide, such as fearlessness about death (FAD), is necessary for the transition from suicidal desire to a suicide attempt. Most studies have relied on self‐report methods to assess FAD. However, this research has produced equivocal results. As individuals may have limited awareness of learned or pre‐existing associations between fearlessness and death, implicit measures of FAD hold promise. This study used a novel implicit association test (IAT), the IAT‐FAD, to examine associations between suicidal desire, implicit FAD, and lifetime suicide attempt frequency.

Methods

Patients in residential substance use treatment (N = 75), a population with increased suicide risk and exposure to painful and provocative events, completed the IAT‐FAD and assessments of suicidal desire and past suicide attempts.

Results

Implicit FAD moderated the association between suicidal desire and lifetime frequency of suicide attempts associated with an intent to die and requiring medical attention (although not ambivalent suicide attempts). Suicidal desire related to medically attended suicide attempts only at high implicit FAD levels, and to suicide attempts with a clear intent to die only at high or mean implicit FAD levels.

Conclusion

Results provide initial support for the relevance of implicit measures of FAD for understanding suicide risk.
Distribution of active tectonics in the Himalayan piedmont (Darjeeling, eastern India) inferred from Horizontal‐to‐Vertical spectral ratio analysis of passive seismic records
Authors: Large E. , Huyghe Pascale , Mugnier J‐L. , Guillier B. , Taral S. , Gyawali B.R. , Chabraborty T.
Published: July 2022

The pattern of active deformation of frontal structures in Darjeeling Himalaya is complex with out‐of‐sequence reactivations in the chain and development of scarps associated with earthquake ruptures reaching the surface in the piedmont. To clarify the distribution of active deformation in this area, we analyse passive seismic records by the Horizontal‐to‐Vertical Spectral Ratio method along three NS trending profiles. We image the Siwalik sedimentary rocks / recent deposits interface under the piedmont and show folded and faulted geometries. Two of these faults are located under scarps of about 10 m affecting the 3.7 ± 0.7 ka old surface of the Tista megafan. Such features imply that about half of the convergence is expressed south of the Himalayan front while the other part occurs out‐of‐sequence in the chain, suggesting a very limited activity of the Main Frontal Thrust itself.
A Speech Act Analysis of the United Nations Secretary-General's Opening Remarks to the General Assembly Emergency Special Session on Ukraine
Authors: AlAfnan Mohammad Awad , Oshchepkova Tamara
Published: July 2022

This study examines language use as social action. Using Austin’s (1962), Bach’s (2003), and Searle’s (1969) speech act theory and categorizations of constative utterances, performative utterances, illocutionary acts, and perlocutionary acts, this study examines the speech acts used by the UN’s Secretary-General in his opening remarks in the Emergency Special Session on Ukraine. The study likewise examines the intended social actions and the social effects they have on the audience. This study reveals that the UN’s Secretary-General made use of a balance between the usage of utterances that express a belief, intention, and desire (constative utterances) and utterances that carry social actions (performative utterances). This study furthermore reveals that reporting, informing, and announcing are the most popular constative utterances in the speech to provide Security Council members a comprehensive idea about the situation in Ukraine and the possible consequences. The study also affirms that directive and assertive illocutionary acts are the most popular performative utterances used in the speech to achieve the perlocutionary effects of asserting, stating, claiming, concluding, requesting, urging, advising, requiring, and ordering. Speech analysis reveals that the UN’s Security General did not use any declarative illocutionary act as he intended to avoid jumping to conclusions, on the one hand and avoid taking sides, on the other hand.
A Mathematical Model of Maladaptive Inward Eutrophic Remodeling of Muscular Arteries in Hypertension
Authors: Rachev Alexander , Shazly Tarek
Published: July 2022

We propose a relatively simple two-dimensional mathematical model for maladaptive inward remodeling of resistive arteries in hypertension in terms of vascular solid mechanics. The main premises are: (i) maladaptive inward remodeling manifests as a reduced increase in the arterial mass compared to the case of adaptive remodeling under equivalent hypertensive pressures and (ii) the pressure-induced circumferential stress in the arterial wall is restored to its basal target value as happens in the case of adaptive remodeling. The rationale for these assumptions is the experimental findings that elevated tone in association with sustained hypertensive pressure down-regulate the normal differentiation of vascular smooth muscle cells from contractile to synthetic phenotype and the data for the calculated hoop stress before and after completion of remodeling. Results from illustrative simulations show that as the hypertensive pressure increases, remodeling causes a nonmonotonic variation of arterial mass, a decrease in inner arterial diameter, and an increase in wall thickness. These findings and the model prediction that inward eutrophic remodeling is preceded by inward hypertrophic remodeling are supported by published observations. Limitations and perspectives for refining the mathematical model are discussed.
Femoral neck phantom imaging using time-domain topological energy method
Authors: Rosa Paulo Tadeu C. R. , Fontes-Pereira Aldo José , Grimal Quentin , Pereira Wagner Coelho de Albuquerque
Published: July 2022

Ultrasonic bone imaging is a complex task, primarily because of the low energy contained in the signals reflected from the internal bone structures. In this study, the reconstruction of a bone-mimicking phantom echographic image using time-domain topological energy (TDTE) is proposed. A TDTE image results from a combination of forward and adjoint fields. The first is a solution of a numerical model that reproduces the setup of the experimental data acquisition to the best extent possible. The second has similar characteristics, but the source term is the time-reversed residue between the forward field and signals obtained from the experiment. The acquisition-reconstruction system used a linear phased-array transducer with a 5 MHz center frequency to acquire the signals and was coupled with a k-wave toolbox to implement the numerical models and perform the image reconstruction. The results showed good agreement between the geometry of the real phantom and the ultrasonic images. However, thickness evaluation errors were observed, which may be due to incorrect assumptions about the velocity models throughout the medium, a priori assumed to be known. Thus, this method has shown promising results and should be applied to the real femoral neck as a long-term objective.
Celebrating the one millionth cochlear implant
Authors: Zeng Fan-Gang
Published: July 2022

Cochlear implants have been the most successful neural prosthesis, with one million users globally. Researchers used the source-filter model and speech vocoder to design the modern multi-channel implants, allowing implantees to achieve 70%–80% correct sentence recognition in quiet, on average. Researchers also used the cochlear implant to help understand basic mechanisms underlying loudness, pitch, and cortical plasticity. While front-end processing advances improved speech recognition in noise, the unilateral implant speech recognition in quiet has plateaued since the early 1990s. This lack of progress calls for action on re-designing the cochlear stimulating interface and collaboration with the general neurotechnology community.
Mechanism-based design of agents that selectively target drug-resistant glioma
Authors: Lin Kingson , Gueble Susan E. , Sundaram Ranjini K. , Huseman Eric D. , Bindra Ranjit S. , Herzon Seth B.
Published: July 2022

Approximately half of glioblastoma and more than two-thirds of grade II and III glioma tumors lack the DNA repair protein O
6
-methylguanine methyl transferase (MGMT). MGMT-deficient tumors respond initially to the DNA methylation agent temozolomide (TMZ) but frequently acquire resistance through loss of the mismatch repair (MMR) pathway. We report the development of agents that overcome this resistance mechanism by inducing MMR-independent cell killing selectively in MGMT-silenced tumors. These agents deposit a dynamic DNA lesion that can be reversed by MGMT but slowly evolves into an interstrand cross-link in MGMT-deficient settings, resulting in MMR-independent cell death with low toxicity in vitro and in vivo. This discovery may lead to new treatments for gliomas and may represent a new paradigm for designing chemotherapeutics that exploit specific DNA repair defects.
The ascent of Moderna
The Messenger: Moderna, the Vaccine, and the Business Gamble That Changed the World
Peter Loftus
Harvard Business Review Press, 2022. 320 pp.
Authors: Dolgin Elie
Published: July 2022

From scrappy startup to household name, a journalist traces the trajectory of the company and its mRNA vaccine
How will EPA regulate the power sector?
Authors: Revesz Richard L.
Published: July 2022

As threats from climate change become more urgent, the US Supreme Court has responded by erecting a new roadblock to effective climate policy. Last month, it struck down the Clean Power Plan, the Obama administration’s never-implemented regulation of greenhouse gas emissions from existing power plants. The ruling [
West Virginia v. Environmental Protection Agency
(EPA)] is a blow to climate action and could signal the court’s hostility to a wide range of future regulations within and beyond the climate and environmental sphere, including those related to consumer protection and worker safety. Although the immediate effects on US climate policy aren’t pervasive, EPA now needs to evaluate the emissions-reduction potential and legal risks of alternative regulatory approaches for the power sector.
In Other Journals
Authors: Yiu Yuen , Szuromi Phil , Hines Pamela J. , Ash Caroline , McCartney Melissa , Kelly Priscilla N. , Uzogara Ekeoma
Published: July 2022

Editors’ selections from the current scientific literature
Bacillus coagulans in Combination with Chitooligosaccharides Regulates Gut Microbiota and Ameliorates the DSS-Induced Colitis in Mice
Authors: Liu Zhenzhen , Jiang Ziyang , Zhang Zhenting , Liu Tong , Fan Yurong , Liu Tao , Peng Nan
Published: July 2022

Probiotic and prebiotic are believed to be useful in alleviating the inflammatory, thereby resolving or preventing the severity of UC. Spore-forming bacteria
Bacillus coagulans
show advantages of stability and probiotic effects, being suggested as the important probiotics for UC treatment.
Increased Expression and Amplification of
bla
KPC-2
Contributes to Resistance to Ceftazidime/Avibactam in a Sequence Type 11 Carbapenem-Resistant Klebsiella pneumoniae Strain
Authors: Li Xinhui , Zhang Jisheng , Yang Chengru , Li Jie , Wang Jianmin , Huang Wan , Zeng Lingyi , Liang Xushan , Long Wenzhang , Zhang Xiaoli
Published: July 2022

Klebsiella pneumoniae
carbapenemase (KPC) production is the most common mechanism of
K. pneumoniae
resistance to carbapenems in China. Currently, CAZ/AVI is considered a potential alternative therapeutic option for infections caused by these isolates.
Interaction between Cervical Microbiota and Host Gene Regulation in Caesarean Section Scar Diverticulum
Authors: Yang Xing , Pan Xinyi , Li Manchao , Zeng Zhi , Guo Yanxian , Chen Panyu , Liang Xiaoyan , Chen Peigen , Liu Guihua
Published: July 2022

Cesarean section scar diverticulum (CSD) has become a formidable obstacle preventing women receiving CS from reproducing. In this study, we revealed that potentially harmful microbes do have adverse effects on the host endometrium.
Early-onset neonatal sepsis in the Paris area: a population-based surveillance study from 2019 to 2021
Authors: Sikias Paola , Biran Valérie , Foix-L'Hélias Laurence , Plainvert Céline , Boileau Pascal , Bonacorsi Stéphane
Published: July 2022

Background

Early-onset neonatal sepsis (EOS) is a rare condition but an important cause of severe morbidity and mortality in neonates.

Methods

This is a prospective observational study in neonates born at ≥34 weeks of gestation (WG). The primary endpoint was EOS, defined by isolation of pathogenic species from blood culture and/or cerebrospinal fluid culture within 72 hours after birth. Data on EOS were collected exhaustively from all maternity wards in Paris area (April 2019–March 2021).

Results

108 EOS were recorded (annual incidence, 0.32 per 1000 live births; 95% CI 0.26 to 0.38). In term infants, the most frequent pathogens were group BStreptococcus(GBS) (n=47) andEscherichia coli(n=20); in late preterm infants, the most frequent pathogens wereE. coli(n=15) and GBS (n=7). Fifteen meningitis cases were diagnosed. FiveE. colistrains (14%) were resistant to both amoxicillin and gentamicin, which is an empiric treatment for EOS. Of the 54 infants with GBS infections, 35 were born from mothers with negative GBS prepartum screening test and 8 from mothers with no screening. Two deaths were reported, both in term infants (Proteus mirabilisandE. coli).

Conclusion

In neonates ≥34 WG born in the Paris area, GBS was twice as frequent asE. coliin term infants. EOS was six times more frequent in late preterm than in term infants and was due toE. coliin 60% of cases. Prevention of GBS EOS and empiric antibiotic treatment of EOS could be improved.
Rate of invasive bacterial infection in recently vaccinated young infants with fever without source
Authors: Barreiro-Parrado Ana , Lopez Eider , Gomez Borja , Lejarzegi Ainara , Fernandez-Uria Amaia , Benito Javier , Mintegi Santiago
Published: July 2022

Objective

To compare the rates of invasive bacterial infection (IBI) (bacterial pathogen in blood or cerebrospinal fluid) and urinary tract infection (UTI) in febrile infants between 42 and 90 days of age who had and had not been vaccinated in the previous 48 hours.

Design

Observational study; secondary analysis of a prospective registry-based cohort study.

Setting

Paediatric emergency department.

Patients

Infants 42–90 days of age with fever without source seen between 2010 and 2021.

Main outcome measures

Rates of IBI (bacterial pathogen in blood or cerebrospinal fluid) and UTI (urine culture obtained by an aseptic method yielding growth of ≥10 000 cfu/mL with associated leucocyturia).

Results

We included 1522 infants, including 185 (12.2%) vaccinated in the previous 48 hours. Overall, 19 (1.25%) were diagnosed with an IBI and 282 (18.5%) with a UTI. No recently immunised infants were diagnosed with an IBI (vs 19, 1.4% of those not recently immunised, p=0.2). The UTI rate was higher in infants not recently immunised (20.1% vs 7.0%, p<0.01; OR: 3.3 (1.9–5.9)).

Conclusions

Although the rate of UTI in recently immunised infants 42–90 days old with fever without a source is lower than in those not recently immunised, recommending screening for UTI seems appropriate. If the lower rate of IBI among recently immunised well-appearing infants is confirmed, the recommendation to systematically perform blood tests in these infants should be reconsidered.
Relapse of immune thrombotic thrombocytopenic purpura (iTTP) possibly triggered by COVID-19 vaccination and/or concurrent COVID-19 infection
Authors: Fang Fei , Tse Brandon , Pavenski Katerina
Published: July 2022

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease that may be triggered by inflammation, including infection or vaccination. Since the start of the COVID-19 pandemic, several case reports were published on de novo or relapsed immune TTP (iTTP) in COVID-19-infected patients. Case reports of iTTP episodes following vaccination against COVID-19 are also emerging. We report a case of relapsed iTTP in a patient who received Moderna mRNA-1273 SARS-CoV-2 vaccine and developed concurrent severe COVID-19 infection. The patient’s iTTP was successfully managed with caplacizumab, therapeutic plasma exchange and high-dose steroids. We summarise published cases of iTTP associated with COVID-19 infection or vaccination.
Cost-effectiveness of primary surgical versus primary medical management in the treatment of patients presenting with advanced glaucoma
Authors: Kernohan Ashleigh , Homer Tara , Shabaninejad Hosein , King Anthony J , Hudson Jemma , Fernie Gordon , Azuara-Blanco Augusto , Burr Jennifer , Sparrow John M , Garway-Heath David , Barton Keith , Norrie John , Maclennan Graeme , Vale Luke
Published: July 2022

Synopsis

Advanced glaucoma is associated with sight loss. This within-trial economic evaluation compares medical and surgical management strategies. At 2 years, medication appears more cost-effective though longitudinal outcomes are an important subject in future research.

Background/aims

Open angle glaucoma (OAG) is a progressive optic neuropathy. Approximately 25% of newly diagnosed patients with OAG present with advanced disease in at least one eye. The vision loss associated with OAG can lead to significant impacts on vision, quality of life and health care resources. The Treatment of Advanced Glaucoma Study is a randomised controlled trial comparing the effectiveness of primary surgical and medical management for newly diagnosed advanced patients with OAG. An economic evaluation was carried out to understand the costs and benefits of each strategy.

Methods

A cost utility analysis was carried out from a National Health Service perspective over a 2-year time horizon inclusive of patient costs. The primary outcome was patient health-related quality of life measured by the EQ-5D-5L, Health Utilities Index 3 (HUI3) and Glaucoma Utility Index (GUI). Results were expressed as incremental cost per QALY gained.

Results

Trabeculectomy was associated with higher costs and greater effect, the EQ-5D-5L results have an incremental cost per QALY of £45,456. The likelihood of surgery being cost-effective at a £20, 000, £30,000 and £50,000 QALY threshold is 0%, 12% and 56%, respectively. The results for the HUI3, GUI and inclusion of patient costs do not change the conclusions of the study.

Conclusion

This is the first study to evaluate management strategies for those presenting with advanced glaucoma. At a 2-year time horizon, medication is the more cost-effective approach for managing glaucoma. Future research can focus on the costs and benefits of the treatments over a longer time horizon.
Iron deficiency and symptoms in women aged 20–49 years and relation to upper gastrointestinal and colon cancers
Authors: Szpakowski Jean-Luc , Tucker Lue-Yen
Published: July 2022

Objective

Iron deficiency anaemia (IDA) in women aged 20–49 years may be caused by menses or gastrointestinal cancer. Data are sparse on the yield of endoscopy/colonoscopy in this population. Our aim was to determine the association of IDA and symptoms with cancers.

Design

Retrospective cohort study within Kaiser Permanente Northern California. Participants were women aged 20–49 years tested for iron stores and anaemia during 1998, 2004 and 2010 and followed for 5 years for outcomes of oesophageal, gastric and colon cancers. Symptoms from the three prior years were grouped into dysphagia, upper gastrointestinal (UGI), lower gastrointestinal (LGI), rectal bleeding and weight loss.

Results

Among 9783 anaemic women aged 20–49 years, there were no oesophageal, 6 gastric and 26 colon cancers. Incidences per 1000 for gastric cancer with and without iron deficiency (ID) were 0.60 (95% CI 0.23 to 1.55) and 0.63 (95% CI 0.17 to 2.31), and for colon cancer, 2.72 (95% CI 1.72 to 4.29) and 2.53 (95% CI 1.29 to 4.99). Endoscopies for UGI or dysphagia symptoms rather than bidirectional endoscopy for ID yielded more gastric cancers (n=5 and n=4, respectively) with fewer procedures (3793 instead of 6627). Colonoscopies for LGI or rectal bleed instead of for ID would detect more colon cancers (n=19 and n=18) with about 40% of the procedures (=2793/6627).

Conclusions

UGI and colon cancers were rare in women of menstruating age and when controlled for anaemia were as common without as with ID. Using symptoms rather than IDA as an indication for endoscopy found equal numbers of cancers with fewer procedures.
Korean OBEsity Surgical Treatment Study (KOBESS): protocol of a prospective multicentre cohort study on obese patients undergoing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass
Authors: Park Young Suk , Park Do Joong , Lee Joo Ho , Lee Hyuk-Joon , Ha Tae Kyung , Kim Yong-Jin , Ryu Seung-Wan , Han Sang-Moon , Yoo Moon-Won , Park Sungsoo , Han Sang-Uk , Heo Yoonseok
Published: July 2022

Introduction

Bariatric surgery effectively induces long-term weight loss in Western populations. However, its effectiveness in Asians remains to be confirmed objectively. The Korean Society for Metabolic and Bariatric Surgery proposes the first prospective cohort study on Koreans undergoing bariatric surgery.

Methods and analysis

The Korean OBEsity Surgical treatment Study (KOBESS) is a prospective, multicentre, single-arm, observational, cohort study on morbidly obese patients who undergo primary sleeve gastrectomy or Roux-en-Y gastric bypass in Korea. In total, 100 consecutive obese Asian patients who will undergo bariatric surgery will be recruited in 2016–2017; follow-up will be for 1 year. Primary outcomes are change in body weight and waist circumference at 1 year. All patients will undergo anthropometry, laboratory tests, bioelectrical impedance analysis, gastrofibroscopy, polysomnography and fat-measuring CT before and after surgery. Patients with diabetes will also undergo perioperative oral glucose tolerance and endocrinological hormone tests. Hypertensive patients will also undergo perioperative echocardiography and carotid Doppler ultrasonography. Female patients suspected of having polycystic ovarian syndrome will also undergo perioperative hormone tests and abdominal ultrasonography. Visceral and subcutaneous fat will be harvested during surgery. Blood, stool and urine samples will be taken at various perioperative time points. Although the cohort is small and the follow-up duration is relatively short, this study will determine whether bariatric surgery induces satisfactory weight loss in obese Koreans. Significantly, the tissue samples will also facilitate many studies examining the effects of bariatric surgery and their mechanisms.

Ethics and dissemination

Ethics approval was obtained from the institutional review board of each participating hospital. All findings arising from this cohort study will be published in open-access peer-reviewed journals and will be presented at national and international meetings. All KOBESS investigators will be able to propose research studies and potential publications based on KOBESS data and tissue samples.

Trial registration number

NCT03100292; Pre-results.
Why India is struggling to feed their young children? A qualitative analysis for tribal communities
Authors: Lakhanpaul Monica , Roy Susrita , Benton Lorna , Lall Marie , Khanna Rajesh , Vijay Virendra Kumar , Sharma Sanjay , Manikam Logan , Santwani Neha , Reddy Hanimi , Chaturvedi Hemant , Allaham Shereen , Pattanaik Satya Prakash , Singh Tol , Pandya Pramod , Dang Priyanka , Parikh Priti
Published: July 2022

Objective

This interdisciplinary qualitative study aims to explore the health, education, engineering and environment factors impacting on feeding practices in rural India. The ultimate goal of the Participatory Approach for Nutrition in Children: Strengthening Health Education Engineering and Environment Linkages project is to identify challenges and opportunities for improvement to subsequently develop socioculturally appropriate, tailored, innovative interventions for the successful implementation of appropriate infant and young child feeding (IYCF) practices locally.

Design

Qualitative research method, involving five phases: (1) identification of local feeding practices; (2) identification of the local needs and opportunities for children aged 6–24 months; and (3–5) analysis of the gathered qualitative data, intervention design, review and distribution.

Setting

Nine villages in two community development blocks, that is, Ghatol and Kushalgarh, located in the Banswara district in Rajasthan, India.

Participants

68 participants completed semistructured interviews or focus group discussions including: mothers, grandmothers, auxiliary nurse midwife, Anganwadi worker, ASHA Sahyogini, school teachers and local elected representative.

Phenomenon of interest

IYCF practices and the factors associated with it.

Analysis

Thematic analysis.

Results

Our results could be broadly categorised into two domains: (1) the current practices of IYCF and (2) the key drivers and challenges of IYCF. We explicate the complex phenomena and emergent model focusing on: mother’s role and autonomy, knowledge and attitude towards feeding of young children, availability of services and resources that shape these practices set against the context of agriculture and livelihood patterns and its contribution to availability of food as well as on migration cycles thereby affecting the lives of ‘left behind’, and access to basic health, education and infrastructure services.

Conclusions

This interdisciplinary and participatory study explored determinants impacting feeding practices across political, village and household environments. These results shaped the process for cocreation of our context-specific intervention package.
Effectiveness of interventions on healthcare professionals’ understanding and use of conscience: a systematic review protocol
Authors: Lamb Christina , Kennedy Megan , Clark Alex , Pituskin Edith , Kirkwood Ken , Babenko-Mould Yolanda
Published: July 2022

Introduction

Conscience is central to moral decision making. In the context of morally pluralistic workplaces today, healthcare professionals’ conscience may prompt them to make moral decisions to refrain from providing services they morally disagree with. However, such decisions are largely viewed as contentious, giving rise to polarising arguments for and against healthcare professionals’ freedom of conscience. Yet, little work has been done to understand and support healthcare professionals’ conscience. Instead, the rising polarity related to healthcare professionals’ freedom of conscience stems from a central lack of understanding of what conscience is and the relevance it holds for healthcare professionals’ clinical practice. Therefore, the degree and extent to which healthcare professionals are supported to understand and use their conscience is unknown. The objective of this review is to critically analyse the scholarly evidence available to ascertain the effectiveness of interventions that support healthcare professionals to understand and use their conscience in care practice.

Methods and analyses

At least two reviewers will systematically review 10 interdisciplinary, scholarly databases to examine qualitative, quantitative and mixed-methods studies including clinical trials pertaining to interventions related to conscience for healthcare professionals. Databases to be searched include: the Cochrane Controlled Register of Trials, Medline, EMBASE, PsycINFO, Cumulative Index for Nursing and Allied Health Literature (CINAHL), Academic Search Complete, ATLA Religion Database, Religion and Philosophy Collection, PhilPapers and Scopus. Databases were searched in May 2021. Study screening, selection, extraction and risk of bias assessments on each study using the Mixed Methods Appraisal Tool will be independently conducted by independent reviewers. Descriptive data synthesis will be carried out. Statistical analysis and meta-analysis will be conducted as relevant, based on homogeneity of findings. The quality of the aggregate evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations criteria.

Ethics and dissemination

Ethical approval is not required for this review. This protocol will not involve individual patient information endangering participant rights. The results will be reported in a peer-reviewed journal and disseminated at conferences.

PROSPERO registration number

CRD42021256943.