bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequency of respiratory pathogens and SARS‐CoV‐2 in canine and feline samples submitted for respiratory testing in early 2020
Authors: Michael H. T. , Waterhouse T. , Estrada M. , Seguin M. A.
Published: February 2021

Objectives

The emergence of the 2019 novel coronavirus (SARS‐CoV‐2) has necessitated evaluation of the potential for SARS‐CoV‐2 infection in dogs and cats. Using a large data set, we evaluated the frequency of SARS‐CoV‐2 and other respiratory pathogens in samples submitted for respiratory testing from mid‐February to mid‐April 2020.

Materials and Methods

A SARS‐CoV‐2 real‐time PCR was developed and validated. A subset of canine and feline samples submitted for respiratory pathogen panel testing to reference laboratories in Asia, Europe, and North America were also tested for SARS‐CoV‐2. The frequency of respiratory pathogens was compared for the February–April period of 2020 and 2019.

Results

Samples from 4616 patients were included in the study and 44% of canine and 69% of feline samples were PCR positive with Mycoplasma cynos and Bordetella bronchiseptica and Mycoplasma felis and feline calicivirus, respectively. No SARS‐CoV‐2 infections were identified. Positive results for respiratory samples were similar between years.

Clinical Significance

The data in this study suggest that during the emergence of the SARS‐CoV‐2 pandemic in early 2020, respiratory diseases in tested pet cats and dogs were caused by common veterinary pathogens and that SARS‐CoV‐2 infections in dogs and cats are rare.
Assessment of postprandial hyperglycemia and circadian fluctuation of glucose concentrations in diabetic dogs using a flash glucose monitoring system
Authors: Shea Emily K. , Hess Rebecka S.
Published: February 2021

Background

Postprandial hyperglycemia (PPH) and circadian glucose concentration fluctuations recorded in the home environment of dogs with naturally occurring diabetes mellitus (DM) have not been reported.

Objectives

To determine if a flash glucose monitoring system (FGMS; FreeStyle Libre) can detect PPH and circadian fluctuations in glucose concentrations in dogs with variably controlled DM.

Animals

Fourteen client‐owned dogs with DM.

Methods

Prospective observational study. Interstitial glucose (IG) concentrations measured by the FGMS during a 13‐day study period were analyzed.

Results

A total of 17, 446 FGMS IG concentrations were analyzed. For all dogs analyzed together, median IG concentration measured within 30 (288 mg/dL), 60 (286 mg/dL), 90 (285 mg/dL), and 120 (285 mg/dL) minutes of meals was each significantly higher than the median IG concentration at all other times (260 mg/dL, 259 mg/dL, 258 mg/dL, and 257 mg/dL, respectively; range, 40‐500 mg/dL;P < .001 for each). Median night‐time IG concentration measured from all dogs on 3,547 samples recorded between 1:00 am and 6:00 am (268 mg/dL; range, 40‐500 mg/dL) was significantly higher than median IG measured on 13, 899 samples at all other time points (259 mg/dL; range, 40‐500 mg/dL;P < .001).

Conclusions and Clinical Importance

The FGMS can be used for future studies of PPH and circadian fluctuations of glucose concentrations in dogs with DM in their home environment.
Nonparallel transcriptional divergence during parallel adaptation
Authors: Fischer Eva K. , Song Youngseok , Hughes Kimberly A. , Zhou Wen , Hoke Kim L.
Published: February 2021

How underlying mechanisms bias evolution toward predictable outcomes remains an area of active debate. In this study, we leveraged phenotypic plasticity and parallel adaptation across independent lineages of Trinidadian guppies (Poecilia reticulata) to assess the predictability of gene expression evolution during parallel adaptation. Trinidadian guppies have repeatedly and independently adapted to high‐ and low‐predation environments in the wild. We combined this natural experiment with a laboratory breeding design to attribute transcriptional variation to the genetic influences of population of origin and developmental plasticity in response to rearing with or without predators. We observed substantial gene expression plasticity, as well as the evolution of expression plasticity itself, across populations. Genes exhibiting expression plasticity within populations were more likely to also differ in expression between populations, with the direction of population differences more likely to be opposite those of plasticity. While we found more overlap than expected by chance in genes differentially expressed between high‐ and low‐predation populations from distinct evolutionary lineages, the majority of differentially expressed genes were not shared between lineages. Our data suggest alternative transcriptional configurations associated with shared phenotypes, highlighting a role for transcriptional flexibility in the parallel phenotypic evolution of a species known for rapid adaptation.
Implementation of ABCDEF care bundle in intensive care units: A cross‐sectional survey
Authors: Liang Surui , Chau Janita Pak Chun , Lo Suzanne Hoi Shan , Li Shunling , Gao Mingrong
Published: February 2021

Background

Delirium affects up to 80% of patients in intensive care units (ICUs) and is associated with higher mortality, physical dependence, and health care costs. The 2018 pain, agitation, delirium, immobility, and sleep guideline recommended ABCDEF care bundle for delirium prevention and management. However, limited information is available regarding the adoption of the care bundle in ICUs in Mainland China.

Aims and objectives

To assess the current implementation of the ABCDEF care bundle for delirium prevention as reported by ICU nurses in Mainland China.

Design

A cross‐sectional study was conducted.

Methods

A cross‐sectional online survey using a validated questionnaire about the practices of the ABCDEF care bundle was conducted among 334 registered nurses in 167 ICUs of 65 cities in Mainland China.

Results

Almost 50% of the sampled ICU nurses were unaware of the ABCDEF care bundle, though 86.83% of the surveyed ICUs implemented pain assessments and 95.51% implemented sedation assessments. Nearly half (46.41%) of the surveyed ICUs performed routine spontaneous awaking trials, with 21.26% performing them daily. Spontaneous breathing trials were performed in 38.32% of the surveyed ICUs. Only 47% of the surveyed ICUs routinely monitored patients for delirium. About one‐third (38.35%) of the surveyed ICUs were supported by specialist teams that implemented the mobilization programmes. Most ICUs restricted the duration of family visits per day (<0.5 hour: 61.67%; 0.5‐2 hours: 23.65%; >2 hours: 3.29%) and only 28.14% of the surveyed ICUs employed dedicated staff to support the families.

Conclusions

Although most of the surveyed ICUs implemented pain and sedation assessments, many of them did not implement structured delirium assessments. Early mobilization programmes and family participation should be encouraged.

Relevance to clinical practice

Promoting the uses of a reliable delirium assessment tool such as Confusion Assessment Method for Intensive Care Unit patients, building an early mobilization team, and engaging family caregivers in the care plan may contribute to improved patients' clinical outcomes.
Anterior Controllable Antedisplacement and Fusion (ACAF) vs Posterior Laminoplasty for Multilevel Severe Cervical Ossification of the Posterior Longitudinal Ligament: Retrospective Study Based on a Two‐Year Follow‐up
Authors: Kong Qing‐jie , Luo Xi , Tan Ying , Sun Jing‐chuan , Wang Yuan , Tan Lei , Shi Jian‐gang
Published: February 2021

Objectives

To compare the clinical outcomes of anterior controllable antedisplacement fusion (ACAF), a new surgical technique, with laminoplasty for the treatment of multilevel severe cervical ossification of the posterior longitudinal ligament (OPLL) based on a 2‐year follow‐up.

Methods

Clinical data of 53 patients (21 by ACAF and 32 by laminoplasty) who have accepted surgery for treatment of cervical myelopathy caused by multilevel severe OPLL (occupying rate ≥ 50%) from March 2015 to March 2017 were retrospectively reviewed and compared between ACAF group and laminoplasty group. Operative time, blood loss, and complications of the two groups were recorded. Radiographic parameters were evaluated pre‐ and postoperatively: cervical lordosis on X‐ray, space available for the cord (SAC) and the occupying ratio (OR) on computed tomography (CT), and the anteroposterior (AP) diameter of the spinal cord at the narrowest level and the spinal cord curvature on magnetic resonance imaging (MRI). Japanese Orthopaedic Association (JOA) scoring was used to evaluate neurologic recovery. Statistical analysis was conducted to analyze the differences between two groups. The Mann–Whitney U test and chi square test were used to compare categorical variables. unpaired t test was used to compare continuous data.

Results

All patients were followed up for at least 24 months. The operative time was longer in ACAF group (286.5 vs 178.2 min, P < 0.05). The blood loss showed no significant difference (291.6 vs 318.3 mL, P > 0.05). Less complications were observed in ACAF group than in laminoplasty group (one case [4.7%] of C5 palsy and one case [4.7%] of cerebrospinal fluid [CSF] leakage in ACAF group; four cases [12.5%] of C5 palsy, two cases [6.3%] of CSF leakage, and four cases [12.5%] of axial symptoms in laminoplasty group). The mean JOA score at last follow‐up (14.6 vs 12.8, P < 0.05) and the improvement rate (IR) (63.8% vs 47.8%, P < 0.05) in ACAF group were superior to those in laminoplasty group significantly. The postoperative OR (16.7% vs 40.9%, P < 0.05), SAC (150.8 vs 110.5 mm2, P < 0.05), AP spinal cord diameter (5.5 vs 4.2 mm, P < 0.05), and cervical lordosis (12.7° vs 4.7°, P < 0.05) were improved more considerably in ACAF group, with significant differences between two groups. Notably, the spinal cord on MRI showed a better curvature in ACAF group.

Conclusions

This study showed that ACAF is considered superior to laminoplasty for the treatment of multilevel severe OPLL as anterior direct decompression and better curvature of the spinal cord led to satisfactory neurologic outcomes and low complication rate.
Pulsed Radiofrequency of Pudendal Nerve for Treatment in Patients with Pudendal Neuralgia. A Case Series with Long‐Term Follow‐Up
Authors: Krijnen Eva A. , Schweitzer Karlijn J. , van Wijck Albert J. M. , Withagen Mariella I. J.
Published: February 2021

Pudendal neuralgia (PN) is an impairing neuropathic disorder, affecting both men and women, involving a severe burning and sharp pain along the course of the pudendal nerve. Treatment is often insufficient, and options are limited. Pulsed radiofrequency (PRF) is a technique which might be useful in therapy. This case series aims to determine the effectiveness of PRF in patients with PN in the context of evaluation of care. Between 2010 and 2016, all female patients of University Medical Center Utrecht diagnosed with PN who experience insufficient pain relief after common treatment were offered PRF. Patient Global Impression of Improvement (PGI‐I) scores were assessed at 3‐month follow‐up and at long‐term follow‐up (median 4 years). PGI‐I scores were recorded to evaluate our quality of care. Twenty patients with PN consented to undergo PRF. We lost one patient in follow‐up. Seventy‐nine percent of the patients described their condition as “(very) much better” at 3‐month follow‐up. At long‐term follow‐up, 89% of the patients described their condition as “(very) much better.” No serious side effects were observed. In conclusion, PRF is a successful treatment option in patients not responding to standard treatment options, including pudendal nerve blocks. PRF of the pudendal nerve can be used for PN to provide relief in patients’ chronic pelvic pain.
Self‐transcendence among adults 65 years and older: A meta‐analysis
Authors: Haugan Gørill , Deliktaş Demirci Ayşe , Kabukcuoglu Kamile , Aune Ingvild
Published: February 2021

Introduction

Self‐transcendence is a human capacity for wellbeing by expanding one's personal boundaries and may act as a health‐promoting resource among adults ≥65 years. Therefore, the objectives of this meta‐analysis were to determine the mean score of self‐transcendence based on place of residence and gender, and to evaluate the correlations of self‐transcendence with meaning, sense of coherence, resilience and depression.

Methods

Based on inclusion criteria, 13 studies were included. Orwin Safe N and Egger's test assessed publication bias. The mean score of self‐transcendence and the correlation coefficients of the selected variables were estimated by random effects models.

Results

The self‐transcendence mean score (n = 1634) was low (M = 43.6) and a bit lower among those staying in care facilities (M = 42.8), but did not vary significantly across gender. The correlation coefficients were self‐transcendence_depression (r = −0.40), self‐transcendence_meaning‐in‐life (r = 0.53), self‐transcendence_resilience (r = 0.50) and self‐transcendence_sense of coherence (r = 0.28). The correlation coefficients, except for meaning‐in‐life, were homogeneous.

Conclusion

In a health‐promoting perspective, the concept of self‐transcendence can help to better understand wellbeing among older individuals and provide guidance for health professionals in facilitating wellbeing and health. The concept and theory of self‐transcendence can inspire health professionals in realising new health‐promoting approaches to support older individuals in maintaining health, wellbeing and independency.
Newly graduated nurses’ evaluation of the received orientation and their perceptions of the clinical environment: An intervention study
Authors: Lindfors Kirsi , Kaunonen Marja , Huhtala Heini , Paavilainen Eija
Published: February 2021

Background

New graduate nurses (NGN) are the future of healthcare organizations where a shortage of nurses will soon be reality. The transition from a student to a registered nurse can be a demanding and challenging time, and in order to retain new graduate nurses, the transition should be as smooth as possible.

Aim

The aim of this study was to examine preceptors’ education intervention’s impact on NGNs’ orientation period and their clinical learning environment from NGNs’ point of view.

Material and Methods

This survey was a part of a longitudinal quasi‐experimental intervention study. Participating units were randomized into intervention group and control group. The intervention group’s preceptors (n=174)were provided a face‐to‐face education about orientation.

Results

NGNs (n=72) were relatively satisfied with the received orientation. However, intervention group was more discontented with their orientation experiences than the control group. The control group’s NGNs had longer orientation periods and more feedback discussions. They were also more satisfied with their preceptor’s orientation skills and their working environment was more responsive.

Discussion

Even though the impact of the intervention was inconclusive, this study provided us important information about NGNs’ first steps towards the nursing profession by giving us clear improvement targets. We need a culture of feedback, individualized orientation and understanding that orientation should be our common interest. Investing in orientation is investing for the future.

Conclusion

This study indicated that the increase in knowledge did not translate into everyday practice. This finding will hopefully give rise to discussion within organizations on how to utilize employees’ gained knowledge more effectively.
A cross‐sectional study of hard ticks (acari: ixodidae) on horse farms to assess the risk factors associated with tick‐borne diseases
Authors: Kamran Kashif , Ali Abid , Villagra Cristian , Siddiqui Saima , Alouffi Abdulaziz S. , Iqbal Asim
Published: February 2021

Zoonotic diseases are significant public health issues. There is an urgent need to focus our efforts on the development of strategies that prevent and control potential arthropod vector‐borne pathogens. Hard ticks transmit a variety of viral, bacterial and protozoan pathogens to their vertebrate hosts. This is becoming of more concern, as anthropogenic alterations of the environment may unleash the spread of tick‐borne diseases throughout the world. Developing countries that are highly dependent on the livestock economy are a hot spot for tick‐borne infectious diseases. In this work, through a cross‐sectional approach that included a bibliographic survey, field collection and epidemiological questionnaire, we identified five tick species that were found to parasitize equines and transmit tick‐borne pathogens. Our data revealed a gap in fundamental knowledge of ticks and tick‐borne infectious diseases among equine breeders and owners. This article highlights the relevant risk factors that were found and the urgent actions that are needed to prevent the wide spread of hard ticks and their associated zoonotic diseases.
THE BIBLICAL ROOTS OF LOCKE'S THEORY OF PERSONAL IDENTITY
Authors: Lucci Diego
Published: February 2021

Locke's consciousness‐based theory of personal identity resulted not only from his agnosticism on substance, but also from his biblical theology. This theory was intended to complement and sustain Locke's moral and theological commitments to a system of otherworldly rewards and sanctions as revealed in Scripture. Moreover, he inferred mortalist ideas from the Bible, rejecting the resurrection of the same body and maintaining that the soul dies at physical death and will be resurrected by divine miracle. Accordingly, personal identity is neither in the soul, nor in the body, nor in a union of soul and body. To Locke, personal identity is in consciousness, which, extending “backwards to any past Action or Thought,” enables the self, both in this life and upon resurrection for the Last Judgment, to recognize that “it is the sameselfnow it was then; and ‘tis by the sameselfwith this present one that now reflects on it, that that Action was done” (EssayII.xxvii.9).
SCIENTIFIC UNIFORMITY OR “NATURAL” DIVINE ACTION: SHIFTING THE BOUNDARIES OF LAW IN THE NINETEENTH CENTURY
Authors: Bossoh Nathan K. C.
Published: February 2021

In October 1862, the Duke of Argyll published an article in the Edinburgh Review entitled “The Supernatural.” In it, Argyll argued that contrary to the prevailing assumption, miracles were “natural” rather than “supernatural” acts of God. This reconceptualization was a response to the controversial publication Essays and Reviews (1860), which challenged orthodox Biblical doctrine. Argyll's characterization of a miracle was not novel; a number of early modern Newtonian thinkers had advanced the same argument for similar reasons. New in this nineteenth‐century reconceptualization, however, were (1) the recent geological, physical, and evolutionary developments and (2) the introduction of German higher criticism. Argyll and the neo‐Newtonians thus attempted to construct a philosophico‐theological alternative, which would constitute a middle‐position between the traditional acceptance and liberal rejection of miracles. I argue finally that 21st‐century debates on divine action in fact exist as part of a longer historical tradition that dates back to Augustine.
A new species of Proprioseiulus Muma (Acari: Phytoseiidae) from Sri Lanka with a key to world species

Authors: Khaustov Vladimir A. , Döker Ismail , Joharchi Omid , Ermilov Sergey G.
Published: February 2021

A new predatory mite species, Proprioseiulus ceylonensis sp. nov. (Acari: Phytoseiidae) is described and illustrated based on female and male specimens collected from soil-litter in Sri Lanka. The new species can be easily distinguished from all other known species in the genus by the combination of the following characters: absence of ventral setae ZV3, presence of ten macrosetae on legs and saccular calyx of spermatheca. Moreover, an identification key to the world species of the genus is presented.
Development and life history parameters of Typhlodromus recki (Acari: Phytoseiidae) feeding on Tetranychus urticae (Acari: Tetranychidae) at different temperatures

Authors: Ersin Firdevs , Turanli Ferit , Cakmak Ibrahim
Published: February 2021

Typhlodromus recki (Acari: Phytoseiidae) was collected from aubergines, pepper, black nightshade and jimsonweed plants infested with spider mites from a pesticide-free vegetable garden in Denizli, Turkey. The biology and life table parameters for T. recki feeding on Tetranychus urticae (Acari: Tetranychidae) at different temperatures (15, 20, 25, 30 and 35 °C) were determined. The results showed that total preadult periods of T. recki at 15, 20, 25, 30 and 35 °C were 19.6±0.51, 9.4±0.16, 7.6±0.14, 5.7±0.14 and 4.5±0.08 days, respectively. The longest oviposition period was 23.5 days at 20 °C. Total fecundity of T. recki significantly differed between the constant temperatures and the highest was observed at 20 °C (28.6 eggs/female) and 25°C (23.5 eggs/female). Although females survived for 26 days at 35 °C, only four females laid eggs for 1 day. Thus, 35 °C is not suitable for the reproduction of T. recki. Total longevity of female was the longest at 15°C (59.5 days) and 20 °C (51.3 days) whereas male total longevity was the longest at 15°C (53.2 days). The intrinsic rate of increase (r) and finite rate of increase (λ) were numerically the highest at 30 °C (0.17 and 1.18 d-1), but there was no statistical difference observed between 25 and 30 °C for both r and λ values. The net productive rate was significantly highest at 20, 25 and 30 °C. The longest mean generation time occurred at 15 °C (42.6 days) and the shortest was at 35 °C (8.0 days). After some field trials, Typhlodromus recki could potentially be considered in the biological control agent of T. urticae.
On some species of the genus Ledermuelleriopsis Willmann (Acariformes: Stigmaeidae) in Turkey

Authors: Doğa Salih , Doğan Sibel , Khanjani Mohammad
Published: February 2021

A stigmaeid species, Ledermuelleriopsis punicae Khanjani, Mohammadi, Ghiasi, Izadi and Mirmoayedi (Acariformes: Stigmaeidae), originally found in Iran, is newly recorded from Turkey and re-described. The specimens of L. aminiae Nazari and Khanjani and L. aydinensis Akyol and Gül are re-examined, and L. aydinensis Akyol & Gül syn. nov. is proposed as a junior synonym of L. aminiae Nazari & Khanjani. L. aminiae is recorded from new localities, and in its deutonymph a malformation has been observed.
Influence of Contextual Factors, Technical Performance, and Movement Demands on the Subjective Task Load Associated With Professional Rugby League Match-Play
Authors: Mullen Thomas , Twist Craig , Daniels Matthew , Dobbin Nicholas , Highton Jamie
Published: February 2021

Purpose: To identify the association between several contextual match factors, technical performance, and external movement demands on the subjective task load of elite rugby league players. Methods: Individual subjective task load, quantified using the National Aeronautics and Space Administration Task Load Index (NASA-TLX), was collected from 29 professional rugby league players from one club competing in the European Super League throughout the 2017 season. The sample consisted of 26 matches (441 individual data points). Linear mixed modeling revealed that various combinations of contextual factors, technical performance, and movement demands were associated with subjective task load. Results: Greater number of tackles (effect size correlation ± 90% confidence intervals; η2 = .18 ± .11), errors (η2 = .15 ± .08), decelerations (η2 = .12 ± .08), increased sprint distance (η2 = .13 ± .08), losing matches (η2 = .36 ± .08), and increased perception of effort (η2 = .27 ± .08) led to most likely–very likely increases in subjective total task load. The independent variables included in the final model for subjective mental demand (match outcome, time played, and number of accelerations) were unclear, excluding a likely small correlation with technical errors (η2 = .10 ± .08). Conclusions: These data provide a greater understanding of the subjective task load and their association with several contextual factors, technical performance, and external movement demands during rugby league competition. Practitioners could use this detailed quantification of internal loads to inform recovery sessions and current training practices.
Population Pharmacokinetic and Pharmacodynamic Target Attainment Analysis of Cefazolin in the Serum and Hip Joint Capsule of Patients Undergoing Total Hip Arthroplasty
Authors: Komatsu Toshiaki , Natsume Yui , Uchiyama Katsufumi , Ikeda Shinsuke , Tomoda Yoshinori , Takayama Yoko , Takaso Masashi , Hanaki Hideaki , Atsuda Koichiro
Published: February 2021

The objectives of this study were to evaluate the population pharmacokinetics of prophylactic cefazolin (CFZ) from its serum and hip joint capsule concentrations in patients undergoing total hip arthroplasty and to establish the pharmacodynamic target concentration exceeding the MIC for designing an effective dosing regimen for serum and the hip joint capsule. We analyzed 249 serum samples and 125 hip joint capsule samples from 125 individuals using a nonlinear mixed-effects model.
Zn
2+
Intoxication of Mycobacterium marinum during Dictyostelium discoideum Infection Is Counteracted by Induction of the Pathogen Zn
2+
Exporter CtpC
Authors: Hanna Nabil , Koliwer-Brandl Hendrik , Lefrançois Louise H. , Kalinina Vera , Cardenal-Muñoz Elena , Appiah Joddy , Leuba Florence , Gueho Aurélie , Hilbi Hubert , Soldati Thierry , Barisch Caroline
Published: February 2021

Microelements are essential for the function of the innate immune system. A deficiency in zinc or copper results in an increased susceptibility to bacterial infections.
Antibody Landscape Analysis following Influenza Vaccination and Natural Infection in Humans with a High-Throughput Multiplex Influenza Antibody Detection Assay
Authors: Li Zhu-Nan , Liu Feng , Gross F. Liaini , Kim Lindsay , Ferdinands Jill , Carney Paul , Chang Jessie , Stevens James , Tumpey Terrence , Levine Min Z.
Published: February 2021

Repeated influenza vaccination and natural infections generate complex immune profiles in humans that require antibody landscape analysis to assess immunity and evaluate vaccines. However, antibody landscape analyses are difficult to perform using traditional assays.
Persistence of Human Bocavirus 1 in Tonsillar Germinal Centers and Antibody-Dependent Enhancement of Infection
Authors: Xu Man , Perdomo Maria Fernanda , Mattola Salla , Pyöriä Lari , Toppinen Mari , Qiu Jianming , Vihinen-Ranta Maija , Hedman Klaus , Nokso-Koivisto Johanna , Aaltonen Leena-Maija , Söderlund-Venermo Maria
Published: February 2021

Human bocavirus 1 (HBoV1), a common pediatric respiratory pathogen, can persist in airway secretions for months hampering diagnosis. It also persists in tonsils, providing potential reservoirs for airway shedding, with the exact location, host cell types, and virus activity unknown.
(p)ppGpp/GTP and Malonyl-CoA Modulate Staphylococcus aureus Adaptation to FASII Antibiotics and Provide a Basis for Synergistic Bi-Therapy
Authors: Pathania Amit , Anba-Mondoloni Jamila , Gominet Myriam , Halpern David , Dairou Julien , Dupont Laëtitia , Lamberet Gilles , Trieu-Cuot Patrick , Gloux Karine , Gruss Alexandra
Published: February 2021

Staphylococcus aureus
is a major human bacterial pathogen for which new inhibitors are urgently needed. Antibiotic development has centered on the fatty acid synthesis (FASII) pathway, which provides the building blocks for bacterial membrane phospholipids.
An Antibiotic-Impacted Microbiota Compromises the Development of Colonic Regulatory T Cells and Predisposes to Dysregulated Immune Responses
Authors: Zhang Xiaozhou , Borbet Timothy C. , Fallegger Angela , Wipperman Matthew F. , Blaser Martin J. , Müller Anne
Published: February 2021

The assembly of microbial communities that populate all mucosal surfaces of the human body begins right after birth. This process is prone to disruption as newborns and young infants are increasingly exposed to antibiotics, both deliberately for therapeutic purposes, and as a consequence of transmaternal exposure.
A Phosphonate Natural Product Made by Pantoea ananatis is Necessary and Sufficient for the Hallmark Lesions of Onion Center Rot
Authors: Polidore Alexander L. A. , Furiassi Lucia , Hergenrother Paul J. , Metcalf William W.
Published: February 2021

Pantoea ananatis
is a significant plant pathogen that targets a number of important crops, a problem that is compounded by the absence of effective treatments to prevent its spread. Our identification of pantaphos as the key virulence factor in onion center rot suggests a variety of approaches that could be employed to address this significant plant disease.
Systematic Analysis of the Lysine Crotonylome and Multiple Posttranslational Modification Analysis (Acetylation, Succinylation, and Crotonylation) in Candida albicans
Authors: Zhou Xiaowei , Song Nana , Li Dongmei , Li Xiaofang , Liu Weida
Published: February 2021

C. albicans
is a kind of pathogen of fungal infections that is found worldwide. Lysine crotonylation of proteins as a recently discovered PTM (posttranslational modification) may have a critical role in regulating cells.
Endovascular management of a patient with massive renal arteriovenous fistula: challenges and tricks
Authors: Balasubramanian Karthikumar , Keshava Shyamkumar N , Lenin Audrin , Mukha Rajiv
Published: February 2021

We describe the endovascular management of a patient with a massive renal arteriovenous fistula and a huge venous aneurysmal sac, who presented with features of cardiac failure and fever. The challenges faced and the outcomes are discussed with relevant literature review.
Spontaneous pneumomediastinum: an uncommon clinical problem with a potential for missed or delayed diagnosis
Authors: Treharne Clare , Coleman Holli , Iyer Arunachalam
Published: February 2021

A 15-year-old man presented with an acute history of facial swelling following a bout of forceful eructation after eating. Subcutaneous emphysema was noted on examination of his left face and neck. He was initially managed with intravenous antibiotics for suspected facial infection. A chest radiograph performed on day 3 of admission identified subcutaneous emphysema of the upper thorax and neck. CT with oral contrast confirmed extensive subcutaneous emphysema of neck, thorax and upper abdomen, with associated pneumomediastinum. The site of air leak was not identified. He subsequently underwent upper gastrointestinal endoscopy and this was normal. Despite the delay in diagnosis, he remained haemodynamically stable, and repeated radiography showed improvement reflecting the benign course of this condition as described in existing literature. There are no previous published reports of spontaneous pneumomediastinum following eructation; therefore, high clinical suspicion should be maintained in this presentation.
Critical appraisal and issues regarding generalisability of comparative effectiveness studies of NOACs in atrial fibrillation and their relation to clinical trial data: a systematic review
Authors: Bunge Eveline M , van Hout Ben , Haas Sylvia , Spentzouris Georgios , Cohen Alexander
Published: February 2021

Objective

To critically appraise the published comparative effectiveness studies on non-vitamin K antagonist oral anticoagulants (NOACs) in non-valvular atrial fibrillation (NVAF). Results were compared with expectations formulated on the basis of trial results with specific attention to the patient years in each study.

Methods

All studies that compared the effectiveness or safety between at least two NOACs in patients with NVAF were eligible. We performed a systematic literature review in Medline and EMbase to investigate the way comparisons between NOACs were made, search date 23 April 2019. Critical appraisal of the studies was done using among others ISPOR Good Research Practices for comparative effectiveness research.

Results

We included 39 studies in which direct comparison between at least two NOACs were made. Almost all studies concerned patient registries, pharmacy or prescription databases and/or health insurance database studies using a cohort design. Corrections for differences in patient characteristics was applied in all but two studies. Eighteen studies matched using propensity scores (PS), 8 studies weighted patients based on the inverse probability of treatment, 1 study used PS stratification and 10 studies applied a proportional hazards model. These studies have some important limitations regarding unmeasured confounders and channelling bias, even though the larger part of the studies were well conducted technically. On the basis of trial results, expected differences are small and a naïve analysis suggests trials with between 7200 and 56 500 patients are needed to confirm the observed differences in bleedings and between 51 800 and 7 994 300 to confirm differences in efficacy.

Discussion

Comparisons regarding effectiveness and safety between NOACs on the basis of observational data, even after correction for baseline characteristics, may not be reliable due to unmeasured confounders, channelling bias and insufficient sample size. These limitations should be kept in mind when results of these studies are used to decide on ranking NOAC treatment options.
Virtual reality intervention to improve apathy in residential aged care: protocol for a multisite non-randomised controlled trial
Authors: Saredakis Dimitrios , Keage Hannah A D , Corlis Megan , Loetscher Tobias
Published: February 2021

Introduction

Apathy is a prevalent neuropsychiatric symptom for older adults residing in aged care. Left untreated, apathy has been associated with accelerated cognitive decline and increased risk of mortality. Reminiscence therapy is commonly used in aged care and has demonstrated to reduce apathy. Traditional methods of reminiscence use physical objects and more recently technology including tablets and laptop computers have demonstrated potential. Virtual reality (VR) has successfully been used to treat psychological disorders; however, there is little evidence on using VR for behavioural symptoms such as apathy in older adults. Using VR to deliver reminiscence therapy provides an immersive experience, and readily available applications provide access to a large range of content allowing easier delivery of therapy over traditional forms of therapy. This study aims to identify changes in apathy after a reminiscence therapy intervention using head-mounted displays (HMDs).

Methods and analysis

Participants will be allocated to one of three groups; reminiscence therapy using VR; an active control using a laptop computer or physical items and a passive control. A total of 45 participants will be recruited from residential aged care (15 in each group). The three groups will be compared at baseline and follow-up. The primary outcome is apathy, and secondary outcomes include cognition and depression. Side effects from using HMDs will also be examined in the VR group. Primary and secondary outcomes at baseline and follow-up will be analysed using linear mixed modelling.

Ethics and dissemination

Ethics approval was obtained from the University of South Australia Human Research Ethics Committee. The results from this study will be disseminated through manuscript publications and national/international conferences.

Trial registration number

ACTRN12619001510134.
Publishing at any cost: a cross-sectional study of the amount that medical researchers spend on open access publishing each year
Authors: Ellingson Mallory K. , Shi Xiaoting , Skydel Joshua J. , Nyhan Kate , Lehman Richard , Ross Joseph S. , Wallach Joshua D.
Published: February 2021

Objective

To estimate the financial costs paid by individual medical researchers from meeting the article processing charges (APCs) levied by open access journals in 2019.

Design

Cross-sectional analysis.

Data sources

Scopus was used to generate two random samples of researchers, the first with a senior author article indexed in the ‘Medicine’ subject area (general researchers) and the second with an article published in the ten highest-impact factor general clinical medicine journals (high-impact researchers) in 2019. For each researcher, Scopus was used to identify all first and senior author original research or review articles published in 2019. Data were obtained from Scopus, institutional profiles, Journal Citation Reports, publisher databases, the Directory of Open Access Journals, and individual journal websites.

Main outcome measures

Median APCs paid by general and high-impact researchers for all first and senior author research and review articles published in 2019.

Results

There were 241 general and 246 high-impact researchers identified as eligible for our study. In 2019, the general and high-impact researchers published a total of 914 (median 2, IQR 1–5) and 1471 (4, 2–8) first or senior author research or review articles, respectively. 42% (384/914) of the articles from the general researchers and 29% (428/1471) of the articles from the high-impact medical researchers were published in fully open access journals. The median total APCs paid by general researchers in 2019 was US$191 (US$0–US$2500) and the median total paid by high-impact researchers was US$2900 (US$0–US$5465); the maximum paid by a single researcher in total APCs was US$30115 and US$34676, respectively.

Conclusions

Medical researchers in 2019 were found to have paid between US$0 and US$34676 in total APCs. As journals with APCs become more common, it is important to continue to evaluate the potential cost to researchers, especially on individuals who may not have the funding or institutional resources to cover these costs.
Status and disparities of diabetes among urban and rural residents aged 40 years and older: insight from a population-based study in northeast China, 2017–2019
Authors: Xing Liying , Tian Yuanmeng , Jing Li , Lin Min , Du Zhi , Sun Qun , Dai Dong , Shi Lei , Yang Zuosen , Liu Shuang
Published: February 2021

Objectives

To evaluate the up-to-date epidemiology of diabetes in northeast China.

Methods

The cross-sectional study was conducted between September 2017 and March 2019 using a multistage, stratified and cluster random sampling method. 18 796 participants (28.9% urban and 71.1% rural) aged ≥40 years were enrolled. Diabetes and pre-diabetes were diagnosed according to the history, fasting plasma glucose (FPG) and glycosylated haemoglobin A1c (HbA1c) levels.

Results

The prevalence of diabetes was 17.1%, higher in urban than in rural residents (20.2% vs 15.8%, p<0.001). Meanwhile, the prevalence of pre-diabetes was 44.3%, higher in rural than in urban areas (49.4% vs 31.8%, p<0.001). The overall FPG and HbA1c were 6.10±1.94 mmol/L and 5.59%±1.08%. The FPG level was higher in rural area than in urban areas (6.15±1.83 mmol/L vs 5.97±2.18 mmol/L, p<0.001). Among participants with diabetes, 47.5% were aware of their diabetes condition; 39.5% were taking antidiabetic medications and 36.8% of people had their diabetes controlled. The awareness and treatment rates in rural areas were lower than those in urban areas (47.3% vs 57.5%, 34.4% vs 49.5%, p<0.001). Patients with diabetic, especially those in rural areas, tended to have multiple risk factors including hypertension (71.7%), overweight or obesity (69.6%) and dyslipidaemia (52.8%).

Conclusion

A considerable burden of diabetes was observed in northeast China, with high percentage of untreated diabetes, high prevalence of pre-diabetes, high overall FPG level and multiple uncontrolled risk factors in patients with diabetics. Therefore, region-specific strategies on prevention and management of diabetes should be emphasised.
Audit of prescription of anti-malarial prophylaxis to patients admitted to Royal Centre for Defence Medicine (RCDM following evacuation from Afghanistan
Authors: Penn-Barwell J , Pengelly S
Published: February 2021

Introduction

For most of the year Military personnel deployed to Afghanistan are required to take anti-malarial chemoprophylaxis (AMC). This audit aims to quantify how many personnel taking AMC in theatre have it continued at RCDM.

Method

A database kept at RCDM was searched for details of all evacuated patients. Records of these patients were then searched to find out which had been admitted, how many had been taking AMC prior to admission and how many were prescribed it in hospital.

Results

During the study period 40 patients were evacuated to RCDM. 26 of these were admitted and had notes available and were therefore included in the study. 9 of these had been taking AMC prior to admission; of them, only 4 had been continued on AMC by the time they were admitted to RCDM.

Conclusion

Insufficient numbers of patients taking AMC prior to admission have it continued as an inpatient. Awareness of this issue needs to be raised at all points of the medical evacuation chain.
Fowl Surgery at Sea. Proving a microvascular capability in PCRF
Authors: Smith J J , Scerri G V , Rickard R F
Published: February 2021

RFA Argus Exercise Medical Endeavour 2006
Naval Service Cohort Study of Occupational Stress: Background to the research and a review of the latest findings
Authors: Bridger R S
Published: February 2021

The Naval Service has been actively involved in research on occupational stress for almost 10 years. Three cross-sectional studies have been completed during this time period. It has been shown that the prevalence rate of psychological strain amongst personnel is relatively constant at 31-34%. Several smaller studies, of personnel at sea and of the availability of support services have also been completed. In general, the research has shown that the prevalence rate of strain is higher in the NS than in the general population and is comparable to that found in similar uniformed service organisations, such as the Police.

Recognising the limitations of crosssectional research methods, the decision was made, in 2006, to follow a cohort of personnel over a 6-year period in order to gain better understanding of the processes by which work demands impact on psychological health and to determine whether psychological ill-health has an adverse impact on factors such as premature voluntary retirement and medical downgrading.

The paper presents the history of the research and some of the work in progress.

‘Disease is a pathological process that, at least in theory, is amenable to objective, external verification. Illness, on the other hand, is by definition, a subjective state’. D. Coggan 2006(1).
Asbestos – a legacy and a persistent problem
Authors: Brims F J H
Published: February 2021

Asbestos has been utilised by industrialised nations for over a century and its deleterious health effects have been reported for an almost equal length of time. Whilst developed countries have now reduced their asbestos use, developing nations are increasing their asbestos imports and consumption. Because of this, there is now a perceived risk to Non Government Organisation and military personnel involved in aid operations or conflict areas, where asbestos containing materials and buildings may have been disrupted.

With significant asbestos exposures to UK military and dockyard personnel in the past, the health consequences are continuing to increase, with the incidence of malignant mesothelioma expected to continue to rise until between 2012-2020. There is no effective cure or treatment for any of the lung or pleural asbestos related diseases; malignant mesothelioma has a median survival of just 6-12 months. Misconceptions about asbestos are widespread, contributed in part by a long latency between exposure and disease. Following diagnosis of an asbestos related disease, financial recompense for exservice personnel is limited, and the civilian legal implications continue to change. This review will encompass the historical usage of asbestos, its biological effects, the legal and financial implications of exposure, and establish that there may be a continuing threat of exposure to deployed military personnel
Lost Days – Diaries for Military Intensive Care Patients
Authors: Thomas J , Bell E
Published: February 2021

There is a real possibility of critically injured service personnel suffering from psychological disturbance as a result of not being able to recall traumatic events. Many patients report symptoms of depression, anxiety and other psychological disturbances such as hallucinations, delusional memories and nightmares after discharge from an Intensive Care Unit (ICU). Patients who have memories of ICU, sometimes unpleasant ones, as opposed to those who have no memories of their stay in ICU, suffer less anxiety, panic attacks and other PTSD-related symptoms. The impact for clinical practice is that, whilst health care professionals cannot remove all of the stressors of treatment in ICU for service personnel, we must try to minimise their impact by providing continued patient information and reassurance. The introduction of patient diaries has helped this vulnerable group of patients and the feedback from patients and their relatives validates this. Patient diaries have been developed and introduced for use by military patients and further exploration of their impact expected.
Case report – Carcinoid Syndrome: Two case reports from Reserve Unit
Authors: Smith D Fitzroy
Published: February 2021

Carcinoid tumours are uncommon and carcinoid syndrome is likely to be encountered only occasionally during a clinical career outside the Neuro-endocrine and related specialties. Two cases of carcinoid syndrome are described in Royal Naval Reserve (RNR) personnel presenting simultaneously in the same unit. Both had long histories and, despite early contact with medical staff, had for some time been dismissed as having trivial complaints. Both have responded well to treatment, though neither has been able to have curative surgery. The current methods of diagnosis which allow much earlier identification and localisation of these tumours are discussed. We also review the management options now available which will control disease and allow the patient to pursue their chosen career, be it military or civil.
Investigating hormonal adaptations to high altitude: five years of Defence Medical Services expeditions
Authors: Rowland C
Published: February 2021

The military has a tradition of supporting and promoting scientific expeditions. The past five years have witnessed a series of Defence Medical Service (DMS) expeditions to mountainous areas of the world, which set out with the dual purpose of researching high altitude human physiology and promoting the uptake of adventurous pursuits within the military. Beginning with exercise Medical Sentinel to Aconcagua, Argentina, in 2007, members of the DMS have since conducted two expeditions to the Himalayas (expedition Imja Tse, 2009 and expedition Khumbu Ramble, 2011) before returning to South America, to the Cordillera Real mountain range in Bolivia, on expedition Bolivian Venture, in late May 2012. This article aims to provide a brief background to the rationale behind these expeditions, a brief description of our understanding of altitude sickness and a history of the adventures that members of the Defence Medical Services have been having contributing to that understanding.
Anaesthesia and critical care aspects of Role 2 Afloat
Authors: Mercer S J , Heames R M
Published: February 2021

The equipment and procedures for providing anaesthesia and critical care within the Role 2 Afloat team are described. In particular the lessons learned from a recent exercise onboard RFA CARDIGAN BAY are outlined with emphasis on the constraints of the unique maritime environment and the essential differences between the level of care at Role 2 and Role 3.