bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding Segment-specific Key Drivers to Guide Strategy: The Impact of Value on Key Drivers of Relative Satisfaction
Authors: Perkins-Munn Tiffany , Evans Heather , Buoye Alexander , Rubin Dan , Keiningham Timothy , Aksoy Lerzan
Published: October 2022

The purpose of this research is to establish a procedure for identifying the distinct key drivers of relative satisfaction for customer segments defined in terms of value. A survey approach was used to elicit 3,793 brand ratings from 693 customers who were representative of a bank’s customer base. Segment-specific key drivers of relative satisfaction were determined for both user-defined segments and segments determined through latent class analysis (LCA) to compare the adequacy of both methods. Subjective approaches to value-based segmentation provide an adequate, but suboptimal basis for determining segment-specific key drivers of relative satisfaction. Segments derived from LCA provide an optimized basis for identifying a customer base’s heterogeneous key drivers of relative satisfaction. Firms would benefit from segmenting customers on the basis of customer value when trying to identify key drivers of relative satisfaction. Thus, resources can be strategically allocated to affect the drivers of relative satisfaction that are unique to a firm’s most valuable customers. While LCA provides an optimized basis for this segmentation, utilizing easier-to-apply user-defined value-based segments is preferable to performing key drivers analysis (KDA) without segmentation. This work makes several important substantive and theoretical contributions. We highlight the need to apply segmentation to KDA by showing that value-based segments have distinct key drivers of relative satisfaction. We establish that oft-used practices for identifying value-based segments are useful in KDA, but that LCA provides the optimized basis for segmentation. Finally, we add to a growing literature encouraging the application of KDA to relative metrics.
Pesticide Use in Indian Agriculture: Policy Alternatives for Environmental Health
Authors: Chaudhry Divya
Published: October 2022

This article makes a case for introducing actionable policy alternatives to address the human health hazards posed by agricultural use of pesticides in India. Pesticides, which include insecticides, rodenticides, herbicides, and fungicides, are widely used in global agricultural practices to protect crops from pest attacks. While pesticides are considered important for their role in boosting agricultural productivity and meeting global food security targets, the article argues that pesticides have a detrimental impact on human health both via occupational and non-occupational routes of exposure. It discusses the human health effects of prolonged pesticide exposure both in the international and national contexts. The article shows that despite a lower aggregate and per capita pesticide consumption vis-à-vis other countries at the national level, the use of agricultural pesticides in India has led to a disproportionate burden of premature deaths due to chronic diseases. By categorising the registered Indian pesticides as per the World Health Organization’s toxicity criterion, the paper argues that unregulated sale of both registered and unregistered pesticides must be addressed to counter the broader health hazards associated with pesticides in general, and the looming burden of chronic diseases that India is faced with in particular.
Imaginaries on ice: Sociotechnical futures of data centre development in Norway and Iceland
Authors: Upham Paul , K Sovacool Benjamin , G Monyei Chukwuka
Published: October 2022

In 2018, Norway promoted itself as a ‘Datacentre Nation’. In terms of low cost, renewably generated sources of electricity and low ambient temperatures, Nordic countries and the data centre sector are potentially mutual beneficiaries – yet, there are also negative impacts associated with the necessary electric power production. With this as a starting point, for Norway and Iceland, we explore how data centre proponents promulgate similar techno-environmental imaginaries, but achieve differing degrees of stabilisation. To this end, we use three sources of imaginaries relating to data centre development in Iceland and Norway: those implicit in promotional imagery originating within the countries concerned; those implicit in international newspapers, as indicative of external perceptions; and those implicit in focus groups with the Norwegian and Icelandic public. We show how data centre advocates deploy visual imagery to create a promotional techno-environmental imaginary that marries nature with the digital in a symbiotic form, and we observe that this is largely consistent with the more mundane international imaginary of Norwegian data centres. For Iceland, however, the external imaginary is dominated by associations of excess energy consumption by bitcoin mining. For the publics questioned, there are multiple imaginaries of data centres, with significant notes of moral and other forms of scepticism. Looking ahead, we suggest that for long-term stabilisation of positive data centre imaginaries, conducive to investment, the capacity of Iceland and Norway to equitably supply sufficient renewable power will need to be addressed as a matter of urgency.
Postcolonial churn and the impact of the criminal justice system on Aboriginal people in Western Australia, 1829–2020
Authors: Roscoe Katherine , Godfrey Barry
Published: October 2022

This article analyses how the criminalisation and imprisonment of Aboriginal people operated as tools of colonisation in Western Australia (WA) in the nineteenth century, and how this shaped the postcolonial criminal justice system. The racialised double standard embedded in the colonial foundations of state institutions, including the criminal justice system, rippled across generations of Aboriginal people: a reiterative and disruptive process that we dub the ‘postcolonial churn’. This term, adapted from the ‘carceral churn’, describes the destabilising mobilisations embedded in carceral and settler-colonial logics over the long term. It uses data from archival prison registers (Rottnest Island 1838–1931 and Roebourne Prison 1908–1961), as well as historic court, police and newspaper data to map the use of the criminal code in protecting and expanding colonial property rights in the original waves of settler-colonisation. WA is an outlier among the Australian colonies: it was the largest in terms of size (2,642,753 km2), the last colony to receive European convicts (1850–1868), and the last to be awarded self-government (1890). This created a situation where the British government dictated policy for legal forms of subjugation of Aboriginal people at the frontier (first for resisting pastoral industry, later as workers in it) which butted up against localised extra-legal violence by police and settlers. We can trace this dichotomy between policy and practice in the development of surveillance and policing of Aboriginal populations across time and settler-colonial space due to the protracted pace of frontier ‘development’. Revealing the mediated historical aspects of structural racism is crucial to analysing the persistence of racialised policing in postcolonial settings and understanding why, despite repeated inquiries into mistreatment of Aboriginal people, institutional inertia remains.
Interprofessional Collaboration Between a Clinical Pharmacist and Specialty Physicians to Treat Hepatitis C in an Interdisciplinary Medical Practice Setting
Authors: Fix Jennifer T. , Hauf Steven , Herrera Michael , Martin Randy , Sweeden Mason , Meyer Karl
Published: October 2022

Objective: Describes the activities of a clinical pharmacist in a gastroenterology (GI) clinic providing services to hepatitis C virus (HCV) patients, with a focus on practice management activities and tools. Practice Description: Located inside a GI specialty clinic in Fort Worth, Texas, the pharmacist provides comprehensive medication management under a collaborative practice agreement (CPA). Once referred by the GI physician, the pharmacist has face-to-face patient visits, develops the care plan, orders medications, and follows patients through sustained virologic response and the development of a hepatocellular carcinoma surveillance plan. Practice Innovation: The role of pharmacists in the management of HCV is important to understand. This article details a pharmacist-led clinic in an open GI medical practice. Evaluation: A retrospective chart review study was conducted to assess outcomes related to the integration of the clinical pharmacist. Methods: Completed by the study team, this study included manual chart reviews of patients with the ambulatory care pharmacist-driven HCV practice to pull data and information that were then tabulated using Qualtrics. Results: A total of 95 charts were surveyed, 78 records were created, and 49 patients were started on direct-acting antiviral (DAA) treatment by the pharmacist. Patients required multiple pharmacist communication actions. The minimum duration of the pharmacist service was 6 months and could extend more than 9 months depending on the time it took to get the patient started on medication. Pharmacist integration into the practice resulted in improved intake for the GI clinic, improved interprofessional interaction, and increased utilization of newer treatment modalities for HCV which feature cure rates up to 99% with limited side effects. Conclusion: Clinical pharmacists are well positioned to help navigate patients through the complexities of the medication use system, medication access, drug interactions and adverse effects, promote medication adherence, and allow patients to start and complete therapy.
The role of macrophage subtypes and exosomes in immunomodulation
Authors: Gharavi Abdulwahab Teflischi , Hanjani Niloofar Asadi , Movahed Elaheh , Doroudian Mohammad
Published: October 2022

Macrophages are influential members of the innate immune system that can be reversibly polarized by different microenvironment signals. Cell polarization leads to a wide range of features, involving the migration, development, and organization of the cells. There is mounting evidence that macrophage polarization plays a key role in the initiation and development of a wide range of diseases. This study aims to give an overview of macrophage polarization, their different subtypes, and the importance of alternatively activated M2 macrophage and classically activated M1 macrophage in immune responses and pathological conditions. This review provides insight on the role of exosomes in M1/M2-like macrophage polarization and their potential as a promising therapeutic candidate.
Atomistic Simulations of the Elastic Compression of Platinum Nanoparticles
Authors: Padilla Espinosa Ingrid M. , Jacobs Tevis D. B. , Martini Ashlie
Published: October 2022

The elastic behavior of nanoparticles depends strongly on particle shape, size, and crystallographic orientation. Many prior investigations have characterized the elastic modulus of nanoscale particles using experiments or simulations; however their reported values vary widely depending on the methods for measurement and calculation. To understand these discrepancies, we used classical molecular dynamics simulation to model the compression of platinum nanoparticles with two different polyhedral shapes and a range of sizes from 4 to 20 nm, loaded in two different crystal orientations. Multiple standard methods were used to calculate the elastic modulus from stress-vs-strain data for each nanoparticle. The magnitudes and particle-size dependence of the resulting moduli varied with calculation method and, even for larger nanoparticles where bulk-like behavior may be expected, the effective elastic modulus depended strongly on shape and orientation. Analysis of per-atom stress distributions indicated that the shape- and orientation-dependence arise due to stress triaxiality and inhomogeneity across the particle. When the effective elastic modulus was recalculated using a representative volume element in the center of a large nanoparticle, the elastic modulus had the expected value for each orientation and was shape independent. It is only for single-digit nanoparticles that meaningful differences emerged, where even the very center of the particle had a lower modulus due to the effect of the surface. These findings provide better understanding of the elastic properties of nanoparticles and disentangle geometric contributions (such as stress triaxiality and spatial inhomogeneity) from true changes in elastic properties of the nanoscale material.
The use of tamsulosin in the treatment of 10–15 mm lower ureteral stones in adults: a double-blinded randomized controlled trial
Authors: Shalaby Mahmoud M. , Eldardery Mahmoud A. , Elderwy Ahmad A. , Abdelaziz Mohamed A.
Published: October 2022

Background

The discovery of alpha-adrenergic receptors in the ureteral smooth muscle cells led to a thorough investigation of the therapeutic potential of alpha-blockers for ureteral calculi. Tamsulosin is a selective blocker of alpha-1A and alpha-1B adrenoceptors. It significantly improved the expulsion of distal ureteral stones measuring 3–10 mm in most randomized trials. To the best of our knowledge, tamsulosin was not tested before in the management of ureteral stones 10–15 mm. Hence, the present study aimed at estimation of the efficacy of tamsulosin in the expulsion of lower ureteral stones 10–15 mm in length compared to placebo in adult patients (primary goal) and the need for ureteral dilatation at scheduled ureteroscopy.

Methods

Between November 2017 and November 2019, 80 patients with distal ureteral stones 10–15 mm were divided into two equal groups. One group received tamsulosin 0.4 mg/day and the other received a placebo. Patients were followed-up for 8 weeks.

Results

Six patients of the tamsulosin group (15%) passed their stones spontaneously compared to none of the placebo group (p = 0.026). Two of the 6 patients who passed the ureteral stones developed urinary retention and required endoscopic treatment of urethral stones. So, the adjusted spontaneous ureteral stone passage ratios for the tamsulosin and the control groups were 10 and 0%, respectively (p = 0.12). Overall, 37.5% reported adverse effects in the tamsulosin group, and 30% in the placebo group (p = 0.7). The most common adverse effect reported in both groups was dizziness, which occurred more frequently with tamsulosin (25%) than placebo (22.5%) (p = 0.9). We noticed increased ejaculatory dysfunction among men in the tamsulosin group versus placebo group [17.9% vs. 3.5% (p = 0.1)]. Among patients who needed ureteroscopy, ureteral dilatation was always needed in the control group versus 85.3% of the tamsulosin group (p = 0.015). Although 23.5% of the treatment group didn’t need stents after ureteroscopy compared to only 12.5% of the control group, this difference was not statistically significant (p = 0.2).

Conclusions

Although tamsulosin significantly increased spontaneous passage of 10–15 mm lower ureteral stones in adults, it did not decrease the need for operative intervention. Preoperative tamsulosin significantly facilitated ureteral dilations during ureteroscopic management.
Glycine and GABAA receptors suppressively regulate the inspiratory-related calcium rise in the thoracic inspiratory cells of the neonatal rat
Authors: Mikami Yoshihiro , Iizuka Makito , Onimaru Hiroshi , Izumizaki Masahiko
Published: October 2022

We previously demonstrated that in an isolated brainstem–spinal cord preparation from neonatal rats, a local bath application of strychnine (a broad antagonist of glycine and GABAA receptors) to the spinal cord enhances thoracic inspiratory motor activity. Herein, to investigate the involvement of the inspiratory spinal interneurons that provide excitatory input to the motoneuron, we conducted calcium imaging using this preparation. Oregon Green 488 BAPTA-1 AM, a fluorescent calcium indicator, was injected into the ventromedial surface of the thoracic cord. In all cells that showed inspiratory-related fluorescence changes > 2% of the baseline fluorescence intensity, the inspiratory-related fluorescence change decreased when the focal depth was deepened. The application of strychnine to the spinal cord increased the inspiratory-related intracellular calcium rise in these cells. These results suggest that the enhancement of inspiratory interneuron activity could be involved in this enhancement of inspiratory motor activity.
Genomic insight into the nocturnal adaptation of the black-crowned night heron (Nycticorax nycticorax)
Authors: Luo Haoran , Luo Site , Fang Wenzhen , Lin Qingxian , Chen Xiaolin , Zhou Xiaoping
Published: October 2022

Background

The black-crowned night heron (Nycticorax nycticorax)is an ardeid bird successfully adapted to the nocturnal environment. Previous studies had indicated that the eyes of the night herons have evolved several specialized morphological traits favoring nocturnal vision. However, the molecular mechanisms of the nocturnal vision adaptation of night herons remained inattentions. In this study, the whole genome ofN.nycticoraxwas sequenced and comparative analyses were performed on the vision-related and olfactory receptor (OR) genes to understand the molecular mechanisms of the visual and olfactory adaptation of night herons.

Results

The results indicated that a number of vision genes were under positive or relaxed selection inN. nycticorax, whereas a number of other vision genes were under relaxed or intensified selection in the boat-billed heron (Cochlearius cochlearius), which suggested that the two species adapt to nocturnality with different genetic mechanisms. The different selections acting on vision genes are probably associated with the enlargement of eye size and the enhancement of visual sensitivity in night herons. The analyses on olfactory receptor (OR) genes indicated that the total number of OR genes in the genomes ofN. nycticoraxandC. cochleariuswere about half those in the little egret (Egretta garzetta), whereas the diversity of their OR genes was not remarkably different. Additionally, the number of expressed OR genes in the transcriptomes ofN. nycticoraxwas also fewer than that inE. garzetta. These results suggest a reduced olfactory capability in night herons compared withE. garzetta.

Conclusions

Our results provided evidence that several vision genes of the night herons were subjected to different natural selections, which can contribute to a better understanding of the genetic mechanisms of visual adaptions of the night heron. In addition, the finding of the reduced number of total and expressed OR genes in night herons may reflect a trade-off between olfaction and vision.
The added value of radiomics from dual-energy spectral CT derived iodine-based material decomposition images in predicting histological grade of gastric cancer
Authors: Shi Cen , Yu Yixing , Yan Jiulong , Hu Chunhong
Published: October 2022

Background

The histological differentiation grades of gastric cancer (GC) are closely related to treatment choices and prognostic evaluation. Radiomics from dual-energy spectral CT (DESCT) derived iodine-based material decomposition (IMD) images may have the potential to reflect histological grades.

Methods

A total of 103 patients with pathologically proven GC (low-grade in 40 patients and high-grade in 63 patients) who underwent preoperative DESCT were enrolled in our study. Radiomic features were extracted from conventional polychromatic (CP) images and IMD images, respectively. Three radiomic predictive models (model-CP, model-IMD, and model-CP–IMD) based on solely CP selected features, IMD selected features and CP coupled with IMD selected features were constructed. The clinicopathological data of the enrolled patients were analyzed. Then, we built a combined model (model-Combine) developed with CP–IMD and clinical features. The performance of these models was evaluated and compared.

Results

Model-CP–IMD achieved better AUC results than both model-CP and model-IMD in both cohorts. Model-Combine, which combined CP–IMD radiomic features, pT stage, and pN stage, yielded the highest AUC values of 0.910 and 0.912 in the training and testing cohorts, respectively. Model-CP–IMD and model-Combine outperformed model-CP according to decision curve analysis.

Conclusion

DESCT-based radiomics models showed reliable diagnostic performance in predicting GC histologic differentiation grade. The radiomic features extracted from IMD images showed great promise in terms of enhancing diagnostic performance.
A CT-based nomogram for differentiating invasive fungal disease of the lung from bacterial pneumonia
Authors: Gong Meilin , Xu Jingmei , Li Kang , Li Ke , Xia Yuwei , Jing Yang , Chen Jiafei , Li Jing , Yang Jing , Du Mingshan , Hou Wenjing , Ou Yuan , Li Lian , Chen Wei
Published: October 2022

Background

There is an annual increase in the incidence of invasive fungal disease (IFD) of the lung worldwide, but it is always a challenge for physicians to make an early diagnosis of IFD of the lung. Computed tomography (CT) may play a certain role in the diagnosis of IFD of the lung, however, there are no specific imaging signs for differentiating IFD of lung from bacterial pneumonia (BP).

Methods

A total of 214 patients with IFD of the lung or clinically confirmed BP were retrospectively enrolled from two institutions (171 patients from one institution in the training set and 43 patients from another institution in the test set). The features of thoracic CT images of the 214 patients were analyzed on the picture archiving and communication system by two radiologists, and these CT images were imported into RadCloud to perform radiomics analysis. A clinical model from radiologic analysis, a radiomics model from radiomics analysis and a combined model from integrating radiologic and radiomics analysis were constructed in the training set, and a nomogram based on the combined model was further developed. The area under the ROC curve (AUC) of the receiver operating characteristic (ROC) curve was calculated to assess the diagnostic performance of the three models. Decision curve analysis (DCA) was conducted to evaluate the clinical utility of the three models by estimating the net benefit at a range of threshold probabilities.

Results

The AUCs of the clinical model for differentiating IFD of lung from BP in the training set and test sets were 0.820 and 0.827. The AUCs of the radiomics model in the training set and test sets were 0.895 and 0.857. The AUCs of the combined model in the training set and test setswere 0.944 and 0.911. The combined model for differentiating IFD of lung from BP obtained the greatest net benefit among the three models by DCA.

Conclusion

Our proposed nomogram, based on a combined model integrating radiologic and radiomics analysis, has a powerful predictive capability for differentiating IFD from BP. A good clinical outcome could be obtained using our nomogram.
Real-world depression, anxiety and safety outcomes of intramuscular ketamine treatment: a retrospective descriptive cohort study
Authors: Ahuja Sachin , Brendle Madeline , Smart Leo , Moore Claire , Thielking Paul , Robison Reid
Published: October 2022

Background

Ketamine has emerged as a promising pharmacotherapy for depression and other mental illnesses, and the intramuscular (IM) administration of ketamine is now offered at many North American outpatient psychiatric clinics. However, a characterization of the outpatient population receiving IM ketamine treatment and an evaluation of the real-world depression, anxiety, and safety outcomes of long-term psychiatric IM ketamine treatment has not been reported. This study aimed to evaluate the clinical characteristics, treatment patterns, clinical outcomes, and adverse events of patients receiving IM ketamine treatment.

Methods

Patient data from the electronic health records of a private outpatient psychiatric clinic network in the United States were collected and analyzed retrospectively. Adults with any psychiatric diagnosis who received ketamine treatment only by IM administration from January 2018 to June 2021 were included. A total of 452 patients were included in the cohort.

Results

Patients receiving IM ketamine treatment had a mean of 2.8 (SD 1.4) psychiatric diagnoses. 420 (93%) patients had a diagnosis of major depressive disorder, 243 (54%) patients had a diagnosis of generalized anxiety disorder, and 126 (28%) patients had a diagnosis of post-traumatic stress disorder. Patients received a median of 4 (range 1–48) IM ketamine treatments. Median depression scores (PHQ-9) improved 38% from 16.0 (IQR 11.3–21.8) at baseline to 10.0 (IQR 6.0–15.0) at last treatment (p < .001). Median anxiety scores (GAD-7) improved 50% from 14.0 (IQR 8.0–17.0) at baseline to 7.0 (IQR 4.3–11.8) at last treatment (p < .001). With maintenance ketamine treatments, average improvements in depression (PHQ-9) and anxiety (GAD-7) scores of at least 4.7 and 4.9 points were maintained for over 7 months. An adverse event occurred during 59 of 2532 treatments (2.3%).

Conclusions

IM ketamine is being utilized to treat psychiatric outpatients with multiple mental illnesses not limited to depression. Average depression and anxiety levels significantly improve throughout IM ketamine treatment and do not regress to baseline during patients’ maintenance treatment phase. Prospective studies are recommended to confirm the long-term effectiveness and safety of IM ketamine.
How a generally well-accepted measles vaccine mandate may lead to inequities and decreased vaccine uptake: a preregistered survey study in Germany
Authors: Neufeind Julia , Schmid-Küpke Nora , Rehfuess Eva , Betsch Cornelia , Wichmann Ole
Published: October 2022

Background

In Germany, a measles vaccine mandate came into effect in March 2020, requiring proof of measles immunization for children attending kindergarten or school and for staff in a variety of facilities. Mandates can be successful if implemented with care and in a context-sensitive manner. They may, however, also lead to inequities and decreased uptake of other vaccines. The aim of this study was to investigate the acceptance and potential unintended consequences of the measles vaccine mandate in Germany.

Methods

As part of a larger evaluation project on the new mandate, we conducted an online survey among parents in August/September 2020. We assessed differences in knowledge about the mandate and the measles vaccine by socio-economic status. We used linear and logistic regression to estimate how reactance to the mandate was associated with vaccination status and vaccination intention against other diseases. We used mediation analysis to measure how trust in institutions had an impact on the attitude towards the mandate, mediated by level of reactance.

Results

In total, 4,863 parents participated in the study (64.2% female, mean age = 36.8 years). Of these, 74.1% endorsed a measles vaccine mandate for children. Parents with lower socio-economic status had less knowledge about the mandate and the measles vaccine. The higher parents’ levels of reactance, the lower the vaccination intentions and the likelihood for the child to be vaccinated against other diseases. Furthermore, higher institutional trust decreased the level of reactance and increased positive attitudes towards the mandate (partial mediation).

Conclusions

The new measles vaccine mandate in Germany, though well accepted by many, might have unintended consequences. Parents with lower socio-economic status, who know less about the mandate and vaccine, might be less likely to comply with it. The mandate may also lead to some parents omitting other childhood vaccines, as a way to restore their freedom. This could decrease vaccination coverage of other vaccines. Any potential loss of trust might provoke more reactance and lower acceptance of mandates. Policymakers should now expand communication activities on the mandate, monitor trends in vaccination coverage carefully and take measures to strengthen trust.
The triglyceride glucose index is associated with future cardiovascular disease nonlinearly in middle-aged and elderly Chinese adults
Authors: Ye Zixiang , Xie Enmin , Gao Yanxiang , Li Peizhao , Tu Yimin , Guo Ziyu , Li Qing , Wu Yaxin , Yu Xiaozhai , Li Yike , Yu Changan , Zheng Jingang
Published: October 2022

Objective

We aimed to investigate the association between triglyceride glucose index and cardiovascular disease (CVD) development in the Chinese middle-aged and elderly population using the China Health and Retirement Longitudinal Study dataset 2011–2018.

Methods

Basic characteristics of participants, including sociodemographic information, and health conditions, were acquired. Logistic regression analyses and restricted cubic spline regression analyses were conducted to investigate the association between the triglyceride glucose index and future CVD risks. Subgroup analyses were performed to evaluate potential interaction.

Results

Seven hundred fifty-three of 6114 (12.3%) participants have developed CVD in 2018 over an approximately 7-year follow-up. The logistic regression analysis exhibited that compared to the lowest triglyceride glucose index group, the multivariable OR for future CVD was 0.985 (95%CI 0.811–1.198) in the T2 triglyceride glucose index group and 1.288 (95%CI 1.068–1.555) in the T3 TyG index (P for trend 0.006). The restricted cubic spline regression analysis showed the nonlinear association between triglyceride glucose index and CVD incidence; the cut-off values were 8.07 and 8.57, respectively, after total adjustment. Gender, fast blood glucose, and triglycerides interacted with triglyceride glucose index and CVD except for BMI.

Conclusion

The triglyceride glucose index was nonlinearly related to the risk of future cardiovascular disease in the middle-aged and elderly Chinese population.
Comparative evaluation of propolis nanostructured lipid carriers and its crude extract for antioxidants, antimicrobial activity, and skin regeneration potential
Authors: Elkhateeb Ola M. , Badawy Mohamed E. I. , Noreldin Ahmed E. , Abou-Ahmed Howaida M. , El-Kammar Mahmoud H. , Elkhenany Hoda A.
Published: October 2022

Background

Propolis extracted from beehives has been conferred with natural antimicrobial and antioxidant properties. Hence, it has been recommended as a wound healing therapy. This study investigated the additive value of nanotechnology to the herbal extract, (propolis rebuts), after which we examined its efficacy in wound healing.

Methods

Propolis nanostructured lipid carriers (NLCs) were first prepared using the emulsion-evaporation-solidification method at three concentrations. Then, we compared their flavonoid and phenolic contents and phenolic contents. Their antioxidant, antibacterial, and antifungal effects were also investigated after which, the skin regenerative capacity of propolis-NLCs was assessed using full-thickness skin wounds in rabbits.

Results

This study showed that propolis-NLCs had increased the phenolic and flavonoid contents compared to the raw propolis extract (EXTR) (9-fold and 2-fold, respectively). This increase was reflected in their antioxidant activities, which dramatically increased by 25-fold higher than the propolis-EXTR. Also, propolis-NLCs exhibited a 2-fold higher potent inhibitory effect than propolis-EXTR on Gram-positive bacteria (Bacillus subtilisandStaphylococcus aureus), Gram-negative bacterium (Salmonella spp.), and fungus (Candida albicans) microbes (p < 0.0001). Investigations also revealed that treatment of full-thickness skin injuries with propolis-NLCs resulted in significantly higher wound closure compared to propolis-EXTR and the control after two weeks (p < 0.0001).

Conclusion

With a prominent broad-spectrum antibacterial effect propolis-NLCs exhibited higher skin regenerative potency than propolis-EXTR. We also highlighted the additive impact of nanotechnology on herbal extract, which accounted for the increased flavonoid content and hence a better antioxidant and antimicrobial effect and propose it as a potential therapy for wound healing.
Long-term antibody production and viremia in American mink (Neovison vison) challenged with Aleutian mink disease virus
Authors: Farid A. Hossain , Hussain Irshad , Rupasinghe Priyanka P. , Stephen Jancy , Arju Irin
Published: October 2022

Background

Selecting American mink (Neovison vison) for tolerance to Aleutian mink disease virus (AMDV) has gained popularity in recent years, but data on the outcomes of this activity are scant. The objectives of this study were to determine the long-term changes in viremia, seroconversion and survival in infected mink. Mink were inoculated intranasally with a local isolate of Aleutian mink disease virus (AMDV) over 4 years (n = 1742). The animals had been selected for tolerance to AMDV for more than 20 years (TG100) or were from herds free of AMDV (TG0). The progenies of TG100 and TG0, and their crosses with 25, 50 and 75% tolerance ancestry were also used. Blood samples were collected from each mink up to 14 times until 1211 days post-inoculation (dpi) and were tested for viremia by PCR and for anti-AMDV antibodies by counter-immunoelectrophoresis (CIEP). Viremia and CIEP status were not considered when selecting replacements. Low-performing animals were pelted and the presence of antibodies in their blood and antibody titer were measured by CIEP, and viremia and viral DNA in seven organs (n = 936) were tested by PCR.

Results

The peak incidences of viremia (66.7%) and seropositivity (93.5%) were at 35 dpi. The incidence of viremia decreased over time while the incidence of seroconversion increased. The least-squares means of the incidence of PCR positive of lymph node (0.743) and spleen (0.656) were significantly greater than those of bone marrow, liver, kidneys, lungs and small intestine (0.194 to 0.342). Differences in tolerant ancestry were significant for every trait measured. Incidences of viremia over time, terminal viremia, seropositivity over time, AMDV DNA in organs and antibody titer were highest in the susceptible groups (TG0 or TG25) and lowest in the tolerant groups (TG100 or TG75).

Conclusion

Previous history of selection for tolerance resulted in mink with reduced viral replication and antibody titer. Viremia had a negative effect and antibody production had a positive effect on survival and productivity.
Ceftolozane/tazobactam for the treatment of bacteremia: a systematic literature review (SLR)
Authors: Khankhel Z. S. , Dillon R. J. , Thosar M. , Bruno C. , Puzniak L.
Published: October 2022

Background

Bloodstream infections (BSIs), or bacteremia, are responsible for considerable disease burden. Increasing rates of antibiotic resistance and delays in selection of appropriate treatment lead to increased morbidity, mortality, and costs. Due to limitations of current standard treatments, especially for bacteremia caused by resistant pathogens, a systematic literature review (SLR) was conducted to understand the utilization of ceftolozane/tazobactam (C/T) in bacteremia.

Methods

Electronic database searches of EMBASE®, MEDLINE®, CCTR and Northern Lights, as well as hand searches of conference proceedings from the last two annual meetings (i.e., 2018, 2019) of the European Congress of Clinical Microbiological and Infectious Diseases (ECCMID) and the Infectious Diseases Society of America’s annual meeting (IDWeek) were conducted. A total of 23 studies reporting on patients with bacteremia receiving C/T were included in the review.

Results

Most studies were observational (k = 20 studies), though few interventional studies were also identified (k = 3). Heterogeneity was ubiquitous with respect to source of bacteremia (i.e., primary or secondary), source of infection (for secondary bacteremia), pathogen type, antibiotic resistance, C/T dose, and outcome definitions. This heterogeneity, along with limited data, and small sample sizes (n = 1 to 31) made it difficult to draw any substantial conclusions, though overall results were favorable to C/T with respect to the outcomes of interest. Nineteen studies reported clinical cure or success (primary bacteremia: k = 6, reported range: 33.3% to 100%; secondary bacteremia: k = 8, 60% to 100%; mixed/unspecified bacteremia: k = 10, 50% to 91.7%). Eight studies reported microbiological cure or eradication rates (primary: k = 3, all reporting 100%; secondary: k = 4, 68% to 80%; mixed/unspecified: k = 5, 60% to 80%). Thirteen studies reported mortality (primary: k = 4, 0% to 14%; secondary: k = 7, 0% to 100%; or mixed/unspecified bacteremia: k = 7, 0% to 51.6%). One study each also reported composite clinical response, relapse, hospital re-admission, and hospital length of stay.

Conclusions

Although the available evidence and observed trends for C/T in bacteremia should be interpreted with caution, the direction of effect would support the utilization of C/T for these difficult to treat infections. Future research should supplement the existing evidence by considering the impact of key treatment effect modifiers without contributing to the observed heterogeneity.
Roles of mitochondrial fusion and fission in breast cancer progression: a systematic review
Authors: Xing Jixiang , Qi Luyao , Liu Xiaofei , Shi Guangxi , Sun Xiaohui , Yang Yi
Published: October 2022

Background

Mitochondria play critical roles in cellular physiological activity as cellular organelles. Under extracellular stimulation, mitochondria undergo constant fusion and fission to meet different cellular demands. Mitochondrial dynamics, which are involved in mitochondrial fusion and fission, are regulated by specialized proteins and lipids, and their dysregulation causes human diseases, such as cancer. The advanced literature about the crucial role of mitochondrial dynamics in breast cancer is performed.

Methods

All related studies were systematically searched through online databases (PubMed, Web of Science, and EMBASE) using keywords (e.g., breast cancer, mitochondrial, fission, and fusion), and these studies were then screened through the preset inclusion and exclusion criteria.

Results

Eligible studies (n = 19) were evaluated and discussed in the systematic review. These advanced studies established the roles of mitochondrial fission and fusion of breast cancer in the metabolism, proliferation, survival, and metastasis. Importantly, the manipulating of mitochondrial dynamic is significant for the progresses of breast cancer.

Conclusion

Understanding the mechanisms underlying mitochondrial fission and fusion during tumorigenesis is important for improving breast cancer treatments.
Comparing two implementation strategies for implementing and sustaining a case management practice serving homeless-experienced veterans: a protocol for a type 3 hybrid cluster-randomized trial
Authors: Gabrielian Sonya , Finley Erin P. , Ganz David A. , Barnard Jenny M. , Jackson Nicholas J. , Montgomery Ann Elizabeth , Nelson Richard E. , Cordasco Kristina M.
Published: October 2022

Background

The Veterans Health Administration (VA) Grant and Per Diem case management “aftercare” program provides 6 months of case management for homeless-experienced veterans (HEVs) undergoing housing transitions. To standardize and improve aftercare services, we will implement critical time intervention (CTI), an evidence-based, structured, and time-limited case management practice. We will use two strategies to support the implementation and sustainment of CTI at 32 aftercare sites, conduct a mixed-methods evaluation of this implementation initiative, and generate a business case analysis and implementation playbook to support the continued spread and sustainment of CTI in aftercare.

Methods

We will use the Replicating Effective Programs (REP) implementation strategy to support CTI implementation at 32 sites selected by our partners. Half (n=16) of these sites will also receive 9 months of external facilitation (EF, enhanced REP). We will conduct a type 3 hybrid cluster-randomized trial to compare the impacts of REP versus enhanced REP. We will cluster potential sites into three implementation cohorts staggered in 9-month intervals. Within each cohort, we will use permuted block randomization to balance key site characteristics among sites receiving REP versus enhanced REP; sites will not be blinded to their assigned strategy. We will use mixed methods to assess the impacts of the implementation strategies. As fidelity to CTI influences its effectiveness, fidelity to CTI is our primary outcome, followed by sustainment, quality metrics, and costs. We hypothesize that enhanced REP will have higher costs than REP alone, but will result in stronger CTI fidelity, sustainment, and quality metrics, leading to a business case for enhanced REP. This work will lead to products that will support our partners in spreading and sustaining CTI in aftercare.

Discussion

Implementing CTI within aftercare holds the potential to enhance HEVs’ housing and health outcomes. Understanding effective strategies to support CTI implementation could assist with a larger CTI roll-out within aftercare and support the implementation of other case management practices within and outside VA.

Trial registration

This project was registered with ClinicalTrials.gov as “Implementing and sustaining Critical Time Intervention in case management programs for homeless-experienced Veterans.” Trial registration NCT05312229, registered April 4, 2022.
Evaluation of inhaled nitric oxide (iNO) treatment for moderate-to-severe ARDS in critically ill patients with COVID-19: a multicenter cohort study
Authors: Al Sulaiman Khalid , Korayem Ghazwa B. , Altebainawi Ali F. , Al Harbi Shmeylan , Alissa Abdulrahman , Alharthi Abdullah , Kensara Raed , Alfahed Amjaad , Vishwakarma Ramesh , Al Haji Hussain , Almohaimid Naif , Al Zumai Omar , Alrubayan Fahad , Asiri Abdulmajid , Alkahtani Nasser , Alolayan Abdulaziz , Alsohimi Samiah , Melibari Nawal , Almagthali Alaa , Aljahdali Seba , Alenazi Abeer A. , Alsaeedi Alawi S. , Al Ghamdi Ghassan , Al Faris Omar , Alqahtani Joud , Al Qahtani Jalal , Alshammari Khalid A. , Alshammari Khalil I. , Aljuhani Ohoud
Published: October 2022

Background

Inhaled nitric oxide (iNO) is used as rescue therapy in patients with refractory hypoxemia due to severe COVID-19 acute respiratory distress syndrome (ARDS) despite the recommendation against the use of this treatment. To date, the effect of iNO on the clinical outcomes of critically ill COVID-19 patients with moderate-to-severe ARDS remains arguable. Therefore, this study aimed to evaluate the use of iNO in critically ill COVID-19 patients with moderate-to-severe ARDS.

Methods

This multicenter, retrospective cohort study included critically ill adult patients with confirmed COVID-19 treated from March 01, 2020, until July 31, 2021. Eligible patients with moderate-to-severe ARDS were subsequently categorized into two groups based on inhaled nitric oxide (iNO) use throughout their ICU stay. The primary endpoint was the improvement in oxygenation parameters 24 h after iNO use. Other outcomes were considered secondary. Propensity score matching (1:2) was used based on the predefined criteria.

Results

A total of 1598 patients were screened, and 815 were included based on the eligibility criteria. Among them, 210 patients were matched based on predefined criteria. Oxygenation parameters (PaO2, FiO2 requirement, P/F ratio, oxygenation index) were significantly improved 24 h after iNO administration within a median of six days of ICU admission. However, the risk of 30-day and in-hospital mortality were found to be similar between the two groups (HR: 1.18; 95% CI: 0.77, 1.82; p = 0.45 and HR: 1.40; 95% CI: 0.94, 2.11; p= 0.10, respectively). On the other hand, ventilator-free days (VFDs) were significantly fewer, and  ICU and hospital LOS were significantly longer in the iNO group. In addition, patients who received iNO had higher odds of acute kidney injury (AKI) (OR (95% CI): 2.35 (1.30, 4.26), p value = 0.005) and hospital/ventilator-acquired pneumonia (OR (95% CI): 3.2 (1.76, 5.83), p value = 0.001).

Conclusion

In critically ill COVID-19 patients with moderate-to-severe ARDS, iNO rescue therapy is associated with improved oxygenation parameters but no mortality benefits. Moreover, iNO use is associated with higher odds of AKI, pneumonia, longer LOS, and fewer VFDs.
Trends in mortality in septic patients according to the different organ failure during 15 years
Authors: Lorencio Cárdenas Carolina , Yébenes Juan Carlos , Vela Emili , Clèries Montserrat , Sirvent Josep Mª , Fuster-Bertolín Cristina , Reina Clara , Rodríguez Alejandro , Ruiz-Rodríguez Juan Carlos , Trenado Josep , Esteban Torné Elisabeth
Published: October 2022

Background

The incidence of sepsis can be estimated between 250 and 500 cases/100.000 people per year and is responsible for up to 6% of total hospital admissions. Identified as one of the most relevant global health problems, sepsis is the condition that generates the highest costs in the healthcare system. Important changes in the management of septic patients have been included in recent years; however, there is no information about how changes in the management of sepsis-associated organ failure have contributed to reduce mortality.

Methods

A retrospective analysis was conducted from hospital discharge records from the Minimum Basic Data Set Acute-Care Hospitals (CMBD-HA in Catalan language) for the Catalan Health System (CatSalut). CMBD-HA is a mandatory population-based register of admissions to all public and private acute-care hospitals in Catalonia. Sepsis was defined by the presence of infection and at least one organ dysfunction. Patients hospitalized with sepsis were detected, according ICD-9-CM (since 2005 to 2017) and ICD-10-CM (2018 and 2019) codes used to identify acute organ dysfunction and infectious processes.

Results

Of 11.916.974 discharges from all acute-care hospitals during the study period (2005–2019), 296.554 had sepsis (2.49%). The mean annual sepsis incidence in the population was 264.1 per 100.000 inhabitants/year, and it increased every year, going from 144.5 in 2005 to 410.1 in 2019. Multiorgan failure was present in 21.9% and bacteremia in 26.3% of cases. Renal was the most frequent organ failure (56.8%), followed by cardiovascular (24.2%). Hospital mortality during the study period was 19.5%, but decreases continuously from 25.7% in 2005 to 17.9% in 2019 (p < 0.0001). The most important reduction in mortality was observed in cases with cardiovascular failure (from 47.3% in 2005 to 31.2% in 2019) (p < 0.0001). In the same way, mean mortality related to renal and respiratory failure in sepsis was decreased in last years (p < 0.0001).

Conclusions

The incidence of sepsis has been increasing in recent years in our country. However, hospital mortality has been significantly reduced. In septic patients, all organ failures except liver have shown a statistically significant reduction on associated mortality, with cardiovascular failure as the most relevant.
Population structure discovery in meta-analyzed microbial communities and inflammatory bowel disease using MMUPHin
Authors: Ma Siyuan , Shungin Dmitry , Mallick Himel , Schirmer Melanie , Nguyen Long H. , Kolde Raivo , Franzosa Eric , Vlamakis Hera , Xavier Ramnik , Huttenhower Curtis
Published: October 2022

Microbiome studies of inflammatory bowel diseases (IBD) have achieved a scale for meta-analysis of dysbioses among populations. To enable microbial community meta-analyses generally, we develop MMUPHin for normalization, statistical meta-analysis, and population structure discovery using microbial taxonomic and functional profiles. Applying it to ten IBD cohorts, we identify consistent associations, including novel taxa such as Acinetobacter and Turicibacter, and additional exposure and interaction effects. A single gradient of dysbiosis severity is favored over discrete types to summarize IBD microbiome population structure. These results provide a benchmark for characterization of IBD and a framework for meta-analysis of any microbial communities.