bluuebunny/crossref_metadata_2025 huggingface dataset:
SG-APSIC1207: Effectiveness of a surgical-site infection bundle in reducing postoperative infection in cesarean deliveries in a tertiary-care teaching hospital in Malaysia
Authors: Sri Ponnampalavanar Sasheela Sri La , Rajandra Arulvani , Suhaimi Nur Alwani , Ji Cindy Teh Shuan , Xuen Sia Jia , Fan Tan Shu , Razali Siti Zuhairah binti Mohd , Yin Kam Yit , Kong Zhi Xian , Lau Min Yi , Lee Yee Qing , Zainon Siti Norintan , Kukreja Anjanna , Saaibon Suzana , Shamsudin Siti Shuhaida
Published: March 2023

Objectives: Surgical-site infections (SSIs) cause significant increases in mortality, morbidity, and prolonged hospitalization after cesarean deliveries. We assessed the effectiveness of the implementation of an SSI bundle in reducing postoperative infections in cesarean deliveries in a tertiary-care teaching hospital in Malaysia. Method: We conducted a quality-improvement study on all women who underwent labor and scheduled cesarean sections at the University Malaya Medical Center (UMMC) between May and December 2020. The preintervention period was May–June 2020 and the postintervention period was September–December 2020. Patients were followed for 90 days after their operation. Before the intervention, SSI rates and compliance with prevention practices were documented. A multidisciplinary team was formed, and education regarding the elements of the SSI prevention bundle was conducted before they were implemented. The care bundle focused on monitoring compliance with preoperative bathing, contact time for skin preparation, hair management, and antibiotics prophylaxis given within 60 minutes prior to incision, as well as patient education. Result: With the implementation of the SSI bundle, we observed a significant reduction in the SSI rate by 50%, from 7 per 100 procedures to 2 per 100 procedures. Compared with the preintervention period, overall compliance with bundle elements improved greatly for preoperative bathing (0 vs 95.7%) and contact time for skin preparation (0 vs 98.8%). In the postintervention period, the method of hair removal was documented, compared to no documentation during the preintervention period. The administration of prophylactic antibiotics within 60 minutes prior incision decreased from 99% to 92.3%. Conclusion: Implementation of an SSI prevention bundle successfully reduced the rate of SSI after cesarean section. The SSI prevention bundle together with improvements by multidisciplinary teams and a good patient-safety culture helped reduce SSI rates. Patient education on pre- and postoperative infection prevention also played an important role in reducing this infection rate.
SG-APSIC1107: Surgical-site infection in Hung Vuong Hospital, a gynecology and obstetrics tertiary-care hospital in Ho Chi Minh City, Vietnam
Authors: Dinh Anh , Hang Phan Thi , Kien To Gia , Hang Tran Thi Thuy , Nhung Ngo My , Tham Ngo Thi Thanh
Published: March 2023

Objectives: Surgical site infection (SSI) is the most common healthcare-associated infection (HAI) in our gynecology and obstetrics hospital. SSI among patients following gynecological and obstetrical surgery not only results in increased morbidity but also has far-reaching implications. Thus, this study was conducted to determine the incidence, risk factors, and bacterial pathogens related to SSI. Methods: We conducted this retrospective study based on medical records from January 2019 to December 2020 at Hung Vuong Hospital. Results: Of 51,466 patients undergoing surgery, 581 patients (1.34%) developed an SSI after cesarean section and 145 patients (1.77%) developed an SSI after gynecological surgery. A multivariate logistic regression analysis identified the following risk factors among patients who underwent cesarean section: age (OR, 1.02; 95% CI, 1.01–1.04), emergency cesarean section (OR, 1.62; 95% CI, 1.36–1.93), operation time >60 minutes (OR, 2.04; 95% CI, 1.48–2.80), surgery during the night shift (OR, 1.29; 95% CI, 1.08–1.54), and prolonged hospital stay ≥2 days (OR, 1.51; 95% CI, 1.21–1.89). SSI risk factors for patients following gynecological surgery included age (OR, 1.03; 95% CI, 1.02–1.05), contaminated wound (OR, 3.44; 95% CI, 1.56–7.57), dirty wound (OR, 3.61; 95% CI, 1.44–9.05), vertical abdominal incision (OR, 2.49; 95% CI, 1.65–3.77), and duration of surgery >180 minutes (OR, 2.02; 95% CI, 1.24–3.29). Staphylococcus aureus was the most commonly identified SSI pathogen following cesarean section (49.56%), and Escherichia coli was isolated in 44.93% of SSIs among patients undergoing gynecological surgery. Conclusions: SSI interventions should target this high-risk group. Based on microbiology culture and susceptibility results isolated from SSI cases, novel antibiotic therapies are needed to treat SSIs.
SG-APSIC1149: Continuous quality improvement project: Changing from sterile to clean perineal care sets at Maharaj Nakorn Chiang Mai Hospital
Authors: Wongkreua Prapaipan , Lerskornsan Narumon
Published: March 2023

Objectives: The central sterile supply department (CSSD) provides sterile perineal care sets (SPC sets) for use with patients. However, the SPC sets exceed the standard, and the sterilization process incurs high cost. Therefore, a CSSD nursing team set out to find ways to save costs by providing clean perineal care sets (CPC sets) instead of sterile sets. We examined the rate of catheter-associated urinary tract infection (CAUTI) after using CPC sets, measured the satisfaction of the nursing staff who use the CPC sets, evaluated the decrease in the cost to the hospital. Methods: The CSSD nursing team presented some evidence of the benefits of using the CPC sets to the infection control subcommittee and asked for their approval to use CPC sets instead of SPC sets. After approval by the subcommittee, the CSSD nursing staff began to use CPC sets for patients. The incidence of CAUTI was monitored, and a satisfaction survey of the nurses who used the CPC sets was performed. We compared the costs between the SPC set and the CPC set to determine the cost savings. Results: The CAUTI rate did not change after using CPC sets. The nurses who used the CPC sets indicated no difference in satisfaction between the SPC and CPC sets, and the cost of the CPC set was cheaper than the SPC set (27 Baht per set). Conclusions: In a quality improvement effort, using the CPC set was safe for patients. The users were satisfied with the CPC set and trusted the safety of the instruments. Moreover, using the less expensive CPC sets saved the hospital >700,000 Baht per year.
Drive-Through Mass Vaccination Center Operations in a Rural, Medically Underserved Area Using Military Civilian Partnership During the COVID-19 Pandemic
Authors: Rowh Marta , Rowh Adam , Lambert Steven , Nickerson Holly , Webb Christopher
Published: March 2023

During the coronavirus disease (COVID-19) pandemic, mass vaccination centers became an essential element of the public health response. This drive-through mass vaccination operation was conducted in a rural, medically underserved area of the United States, employing a civilian–military partnership. Operations were conducted without traditional electronic medical record systems or Internet at the point of vaccination. Nevertheless, the mass vaccination center (MVC) achieved throughput of 500 vaccinations per hour (7200 vaccinations in 2 days), which is comparable with the performance of other models in more ideal conditions. Here, the study describes the minimum necessary resources and operational practicalities in detail required to implement a successful mass vaccination event. This has significant implications for the generalizability of our model to other rural, underserved, and international settings.
Nosocomial influenza in a pediatric general ward: Effects of isolation and cohort placement of children with influenza
Authors: Suh Woosuck , Han Seung Beom
Published: March 2023

Objective:

Many studies have described nosocomial outbreaks of influenza in specialized wards. We evaluated nosocomial transmission of influenza in a pediatric general ward.

Design:

Retrospective observational study.

Setting:

Single secondary hospital.

Patients:

The study included 814 hospitalized children with influenza between September 2015 and August 2020.

Methods:

The medical records of the included children were retrospectively reviewed, and clinical characteristics of children with community-acquired (CA) influenza and hospital-acquired (HA) influenza were determined. The room of each included child during hospitalization was traced to identify the children exposed to them.

Results:

CA influenza and HA influenza were diagnosed in 789 (96.9%) and 25 (3.1%) children, respectively. Among children with CA influenza, 691 (87.6%) were isolated or place in a cohort on admission. In total, 98 children (12.4%) admitted to multibed rooms exposed 307 children with noninfluenza diseases to influenza during 772 patient days; 3 exposed children (1.0%) were diagnosed with HA influenza. Including these 3 children, 25 children (19 without definite in-hospital exposure to influenza and 3 exposed to other children with HA influenza) were diagnosed with HA influenza, and 11 (44.0%) exposed 31 children with noninfluenza diseases to influenza for 85 patient days. Also, 3 exposed children (9.7%) were diagnosed with HA influenza, a significantly higher rate than that for CA influenza (P = .005). The clinical characteristics were comparable between children with HA influenza and those with CA influenza.

Conclusions:

Cohort placement of children with influenza in a pediatric general ward can be effective in controlling nosocomial transmission of influenza. However, control measures for children with HA influenza should be emphasized.
Heat-transfer scaling at moderate Prandtl numbers in the fully rough regime
Authors: Zhong Kevin , Hutchins Nicholas , Chung Daniel
Published: March 2023

In the fully rough regime, proposed models predict a scaling for a roughness heat-transfer coefficient, e.g. the roughness Stanton number

${St}_k \sim (k^+)^{-p} {Pr}^{-m}$

where the exponent values

$p$

and

$m$

are model dependent, giving diverse predictions. Here,

$k^+$

is the roughness Reynolds number and

${Pr}$

is the Prandtl number. To clarify this ambiguity, we conduct direct numerical simulations of forced convection over a three-dimensional sinusoidal surface spanning

$k^+ = 5.5$

–

$111$

for Prandtl numbers

${Pr} = 0.5$

, 1.0 and 2.0. These unprecedented parameter ranges are reached by employing minimal channels, which resolve the roughness sublayer at an affordable cost. We focus on the fully rough phenomenologies, which fall into two groups:

$p=1/2$

(Owen & Thomson, J. Fluid Mech., vol. 15, issue 3, 1963, pp. 321–334; Yaglom & Kader, J. Fluid Mech., vol. 62, issue 3, 1974, pp. 601–623) and

$p=1/4$

(Brutsaert, Water Resour. Res., vol. 11, issue 4, 1975b, pp. 543–550). Although we find the mean heat transfer favours the

$p=1/4$

scaling, the Prandtl–Blasius boundary-layer ideas associated with the Reynolds–Chilton–Colburn analogy that underpin the

$p=1/2$

can remain an apt description of the flow locally in regions exposed to high shear. Sheltered regions, meanwhile, violate this behaviour and are instead dominated by reversed flow, where no clear correlation between heat and momentum transfer is evident. The overall picture of fully rough heat transfer is then not encapsulated by one singular mechanism or phenomenology, but rather an ensemble of different behaviours locally. The implications of the approach to a Reynolds-analogy-like behaviour locally on bulk measures of the Nusselt and Stanton numbers are also examined, with evidence pointing to the onset of a regime transition at even-higher Reynolds numbers.
Reflection and transition of planar curved shock waves
Authors: Zhang Tao , Xu Kejing , Shi Chongguang , Zhu Chengxiang , You Yancheng
Published: March 2023

In this paper, the reflection of curved shock waves over a symmetry plane in planar supersonic flow is studied. This includes stable Mach reflection (MR) and the regular reflection (RR) to MR transition process. Curved shock theory (CST) is applied to derive the high-order parameters in front of and behind the shock wave. The method of curved shock characteristics is used to establish an analytical model to predict the wave configurations. The shock structures provided by the proposed model agree well with the numerical results. Flow structures, such as the height of the Mach stem and the shape of the shock wave and slip line, are studied by applying the analytical model. Isentropic waves generated from a curved wall are found to significantly influence the flow patterns. It appears that the compression waves obstruct the formation of the sonic throat and increase the Mach-stem height. The expansion waves have the opposite effect. The evolution mechanism of the Mach stem is found in conjunction with the RR-to-MR transition process. The CST is extended to a moving frame and used to model the transition. The time history of the moving triple point illustrates the effects of the incident shock angle and isentropic waves on the transition process.
Hemline breakup of gel drops subjected to a continuous air flow
Authors: Wang Zi-Yu , Yao Feng , Zhao Hui , Shi Zhe-Hang , Liu Hai-Feng
Published: March 2023

To explore the effect of yield stress on the secondary breakup of gel drops, experimental and theoretical investigations are carried out by employing a high-speed camera. A unique hemline-type breakup, as a modified behaviour of sheet-thinning breakup, occurs when the air velocity increases to a high region. The edges of the drops constantly deform into thin membranes when the high-velocity air skims over the gel drops. These membranes vibrate vertically, and breaking points occur at high amplitudes, causing the formation of reticular fragments. The results of linear stability analysis indicated that the yield stress of the gel drops has an influence on the formation and breakup of the gel membranes. The breakup regime map and breakup times are also studied.
What to expect when you're electing: citizen forecasts in the 2020 election
Authors: Huber Gregory A. , Tucker Patrick D.
Published: March 2023

Political divisions in the lead-up to the 2020 US presidential election were large, leading many to worry that heighted partisan conflict was so stark that partisans were living in different worlds, divided even in their understanding of basic facts. Moreover, the nationalization of American politics is thought to weaken attention to state political concerns. 2020 therefore provides an excellent, if difficult, test case for the claim that individuals understand their state political environment in a meaningful way. Were individuals able to look beyond national rhetoric and the national environment to understand state-level electoral dynamics? We present new data showing that, in the aggregate, despite partisan differences in electoral expectations, Americans are aware of their state's likely political outcome, including whether it will be close. At the same time, because forecasting the overall election outcome is more difficult, Electoral College forecasts are much noisier and display persistent partisan difference in expectations that do not differ much with state of residence.
Adolescent nutrition and health: characteristics, risk factors and opportunities of an overlooked life stage
Authors: Moore Heslin Aoibhín , McNulty Breige
Published: March 2023

Adolescence is a pivotal, yet frequently overlooked, period of life, with this age group often no longer receiving the focus, care and protection devoted to other life stages. Nutritional vulnerability increases in adolescence due to heightened nutritional requirements, yet the quality of the diets consumed by this age group often deteriorates significantly. Poor-quality dietary patterns and insufficient nutrient intakes are frequently observed amongst adolescents both in Ireland and globally. This deterioration in diet quality is greatly influenced by individual, social and environmental determinants of behaviour and health. The influences of each of these factors change and increase as adolescents begin to interact independently with the surrounding world. Poor nutrition during adolescence can result in several immediate and long-term health consequences, including micronutrient deficiencies, increased risk of overweight/obesity and increased presentation of cardiometabolic risk factors, all of which have been observed as persistent issues amongst adolescents in Ireland and internationally. Adolescence is a critical period of intervention to protect youth both now and into their future lives. This age group can be particularly receptive to the influence of society and the surrounding environment, posing several avenues in which to influence adolescents towards more health-promoting behaviour. This review aims to summarise the key nutritional and dietary characteristics of adolescents, to provide an overview of the causes and consequences of poor nutrition in adolescence, and to highlight potential opportunities for intervention to protect the health of this age group, with a particular focus on evidence from an Irish context.
Design and validation of a novel adaptive motion control for a pendulum spherical robot
Authors: Huo Jianwen , Lin Rui , Yang Maotao
Published: March 2023

Spherical robots (SRs) have the characteristics of nonholonomic constraints, underactuation, nonchain, and strong coupling, which increase the difficulty of modeling and motion control compared with traditional robots. In this study, we develop an adaptive motion control scheme for a nonholonomic SR, in which an omnidirectional dynamic model is carried out by using the Euler–Lagrange method to describe the omnidirectional motion of the SR more accurately. Furthermore, to facilitate the design of the motion controller, the dynamic model is simplified to obtain the state space expression of the SR. Aiming at the problem of poor control effect caused by the change of system model parameters which are influenced by dynamic model reduction, an adaptive motion control law of SR is designed based on MRAC. And the coefficient adjustment of the controller is obtained by the Lyapunov method, with the guaranteed stability of the closed-loop system. Finally, the controller designed in this thesis is compared with four controllers including linear quadratic regulator, Fuzzy PID, PSO-ADRC, and hierarchical SMC. The experimental comparison proves that the control scheme proposed in this study still has good control ability when the motion parameters are disturbed.
First-in-paediatric uses of a mechanical aspiration system for percutaneous removal of right atrial masses
Authors: Daniels Zachary , Armstrong Aimee K. , Salavitabar Arash
Published: March 2023

We present the first-in-paediatric uses of a mechanical aspiration system for percutaneous removal of right atrial masses in three patients, including central line-related thrombus and metastatic tumour. Percutaneous mechanical removal of right atrial masses can be performed safely and effectively.
Neurological soft signs and schizophrenia
Authors: Tsapakis Eva-Maria , Mitkani Calypso A. , Fountoulakis Konstantinos N.
Published: March 2023

Neurological soft signs (NSS) are likely to represent abnormal neurodevelopment and aberration in neural maturation and connectivity. They may not be unique to schizophrenia, but they appear to be a trait characteristic in psychosis and therefore could serve as an objective measure for the assessment of serious psychiatric disorder in the prodromal phase, at onset, and along the course of the disease. Evidence so far proposes that NSS are independent of antipsychotic treatment and therefore constitute a trait symptom, independent of the illness stage and medication. Somatomotor and somatosensory regions, spatial orientation, and visual processing areas, cerebellum, and basal ganglia are implicated as possible structural substrates of NSS. Several studies have examined the relationship between NSS and schizophrenia positive, negative symptoms and deficit syndrome; however, results have been so far ambiguous. Neurocognitive symptoms have been moderately related to NSS suggesting that neurocognitive deficits may contribute to the construct of NSS. Regardless of the fact that NSS are not unique to schizophrenia but extend across to the schizotypy continuum, they may help identify individuals at risk of developing schizophrenia later in life.
Gender Equality and Authoritarian Regimes: New Directions for Research
Authors: Bush Sarah Sunn , Zetterberg Pär
Published: March 2023

There are competing global trends in terms of gender equality. International concern with gender inequality is significant. The Beijing Declaration and Platform for Action (1995), United Nations Security Council Resolution 1325 on Women, Peace and Security (2000), and the United Nations’ Sustainable Development Goals (2015), among other instruments, pushed countries to increase women’s access to decision-making and basic rights such as education, paid labor, and health care. Yet more recently, there has been a “backlash” against progress in gender equality (Berry, Bouka, and Kamuru 2021; Chenoweth and Marks 2022; Piscopo and Walsh 2020; Roggeband and Krizsán 2018).
Tracking Land Use and Deforestation in the Amazon
Authors: Rodrigues Meghie
Published: March 2023

A new study mapped 2 decades of deforestation in the Amazon and concluded that some types of land management are more effective than others.
Highly transparent silanized cellulose aerogels for boosting energy efficiency of glazing in buildings
Authors: Abraham Eldho , Cherpak Vladyslav , Senyuk Bohdan , ten Hove Jan Bart , Lee Taewoo , Liu Qingkun , Smalyukh Ivan I.
Published: March 2023

To maintain comfortable indoor conditions, buildings consume ~40% of the energy generated globally. In terms of passively isolating building interiors from cold or hot outdoors, windows and skylights are the least-efficient parts of the building envelope because achieving simultaneously high transparency and thermal insulation of glazing remains a challenge. Here we describe highly transparent aerogels fabricated from cellulose, an Earth-abundant biopolymer, by utilizing approaches such as colloidal self assembly and procedures compatible with roll-to-roll processing. The aerogels have visible-range light transmission of 97–99% (better than glass), haze of ~1% and thermal conductivity lower than that of still air. These lightweight materials can be used as panes inside multi-pane insulating glass units and to retrofit existing windows. We demonstrate how aerogels boost energy efficiency and may enable advanced technical solutions for insulating glass units, skylights, daylighting and facade glazing, potentially increasing the role of glazing in building envelopes.
Designing spin and orbital sources of Berry curvature at oxide interfaces
Authors: Lesne Edouard , Saǧlam Yildiz G. , Battilomo Raffaele , Mercaldo Maria Teresa , van Thiel Thierry C. , Filippozzi Ulderico , Noce Canio , Cuoco Mario , Steele Gary A. , Ortix Carmine , Caviglia Andrea D.
Published: March 2023

Quantum materials can display physical phenomena rooted in the geometry of electronic wavefunctions. The corresponding geometric tensor is characterized by an emergent field known as the Berry curvature (BC). Large BCs typically arise when electronic states with different spin, orbital or sublattice quantum numbers hybridize at finite crystal momentum. In all the materials known to date, the BC is triggered by the hybridization of a single type of quantum number. Here we report the discovery of the first material system having both spin- and orbital-sourced BC: LaAlO3/SrTiO3 interfaces grown along the [111] direction. We independently detect these two sources and probe the BC associated to the spin quantum number through the measurements of an anomalous planar Hall effect. The observation of a nonlinear Hall effect with time-reversal symmetry signals large orbital-mediated BC dipoles. The coexistence of different forms of BC enables the combination of spintronic and optoelectronic functionalities in a single material.
Probing many-body dynamics in a two-dimensional dipolar spin ensemble
Authors: Davis E. J. , Ye B. , Machado F. , Meynell S. A. , Wu W. , Mittiga T. , Schenken W. , Joos M. , Kobrin B. , Lyu Y. , Wang Z. , Bluvstein D. , Choi S. , Zu C. , Jayich A. C. Bleszynski , Yao N. Y.
Published: March 2023

The most direct approach for characterizing the quantum dynamics of a strongly interacting system is to measure the time evolution of its full many-body state. Despite the conceptual simplicity of this approach, it quickly becomes intractable as the system size grows. An alternate approach is to think of the many-body dynamics as generating noise, which can be measured by the decoherence of a probe qubit. Here we investigate what the decoherence dynamics of such a probe tells us about the many-body system. In particular, we utilize optically addressable probe spins to experimentally characterize both static and dynamical properties of strongly interacting magnetic dipoles. Our experimental platform consists of two types of spin defects in nitrogen delta-doped diamond: nitrogen-vacancy colour centres, which we use as probe spins, and a many-body ensemble of substitutional nitrogen impurities. We demonstrate that the many-body system’s dimensionality, dynamics and disorder are naturally encoded in the probe spins’ decoherence profile. Furthermore, we obtain direct control over the spectral properties of the many-body system, with potential applications in quantum sensing and simulation.
Novel mouse models based on intersectional genetics to identify and characterize plasmacytoid dendritic cells
Authors: Valente Michael , Collinet Nils , Vu Manh Thien-Phong , Popoff Dimitri , Rahmani Khalissa , Naciri Karima , Bessou Gilles , Rua Rejane , Gil Laurine , Mionnet Cyrille , Milpied Pierre , Tomasello Elena , Dalod Marc
Published: March 2023

Plasmacytoid dendritic cells (pDCs) are the main source of type I interferon (IFN-I) during viral infections. Their other functions are debated, due to a lack of tools to identify and target them in vivo without affecting pDC-like cells and transitional DCs (tDCs), which harbor overlapping phenotypes and transcriptomes but a higher efficacy for T cell activation. In the present report, we present a reporter mouse, pDC-Tom, designed through intersectional genetics based on unique Siglech and Pacsin1 coexpression in pDCs. The pDC-Tom mice specifically tagged pDCs and, on breeding with Zbtb46GFP mice, enabled transcriptomic profiling of all splenic DC types, unraveling diverging activation of pDC-like cells versus tDCs during a viral infection. The pDC-Tom mice also revealed initially similar but later divergent microanatomical relocation of splenic IFN+ versus IFN− pDCs during infection. The mouse models and specific gene modules we report here will be useful to delineate the physiological functions of pDCs versus other DC types.
Neoadjuvant chemotherapy plus nivolumab with or without ipilimumab in operable non-small cell lung cancer: the phase 2 platform NEOSTAR trial
Authors: Cascone Tina , Leung Cheuk H. , Weissferdt Annikka , Pataer Apar , Carter Brett W. , Godoy Myrna C. B. , Feldman Hope , William William N. , Xi Yuanxin , Basu Sreyashi , Sun Jing Jing , Yadav Shalini S. , Rojas Alvarez Frank R. , Lee Younghee , Mishra Aditya K. , Chen Lili , Pradhan Monika , Guo Haiping , Sinjab Ansam , Zhou Nicolas , Negrao Marcelo V. , Le Xiuning , Gay Carl M. , Tsao Anne S. , Byers Lauren Averett , Altan Mehmet , Glisson Bonnie S. , Fossella Frank V. , Elamin Yasir Y. , Blumenschein George , Zhang Jianjun , Skoulidis Ferdinandos , Wu Jia , Mehran Reza J. , Rice David C. , Walsh Garrett L. , Hofstetter Wayne L. , Rajaram Ravi , Antonoff Mara B. , Fujimoto Junya , Solis Luisa M. , Parra Edwin R. , Haymaker Cara , Wistuba Ignacio I. , Swisher Stephen G. , Vaporciyan Ara A. , Lin Heather Y. , Wang Jing , Gibbons Don L. , Jack Lee J. , Ajami Nadim J. , Wargo Jennifer A. , Allison James P. , Sharma Padmanee , Kadara Humam , Heymach John V. , Sepesi Boris
Published: March 2023

Neoadjuvant ipilimumab + nivolumab (Ipi+Nivo) and nivolumab + chemotherapy (Nivo+CT) induce greater pathologic response rates than CT alone in patients with operable non-small cell lung cancer (NSCLC). The impact of adding ipilimumab to neoadjuvant Nivo+CT is unknown. Here we report the results and correlates of two arms of the phase 2 platform NEOSTAR trial testing neoadjuvant Nivo+CT and Ipi+Nivo+CT with major pathologic response (MPR) as the primary endpoint. MPR rates were 32.1% (7/22, 80% confidence interval (CI) 18.7–43.1%) in the Nivo+CT arm and 50% (11/22, 80% CI 34.6–61.1%) in the Ipi+Nivo+CT arm; the primary endpoint was met in both arms. In patients without known tumor EGFR/ALK alterations, MPR rates were 41.2% (7/17) and 62.5% (10/16) in the Nivo+CT and Ipi+Nivo+CT groups, respectively. No new safety signals were observed in either arm. Single-cell sequencing and multi-platform immune profiling (exploratory endpoints) underscored immune cell populations and phenotypes, including effector memory CD8+ T, B and myeloid cells and markers of tertiary lymphoid structures, that were preferentially increased in the Ipi+Nivo+CT cohort. Baseline fecal microbiota in patients with MPR were enriched with beneficial taxa, such as Akkermansia, and displayed reduced abundance of pro-inflammatory and pathogenic microbes. Neoadjuvant Ipi+Nivo+CT enhances pathologic responses and warrants further study in operable NSCLC. (ClinicalTrials.gov registration: NCT03158129.)
Genetic association analysis of 77,539 genomes reveals rare disease etiologies
Authors: Greene Daniel ,   Genomics England Research Consortium, Pirri Daniela , Frudd Karen , Sackey Ege , Al-Owain Mohammed , Giese Arnaud P. J. , Ramzan Khushnooda , Riaz Sehar , Yamanaka Itaru , Boeckx Nele , Thys Chantal , Gelb Bruce D. , Brennan Paul , Hartill Verity , Harvengt Julie , Kosho Tomoki , Mansour Sahar , Masuno Mitsuo , Ohata Takako , Stewart Helen , Taibah Khalid , Turner Claire L. S. , Imtiaz Faiqa , Riazuddin Saima , Morisaki Takayuki , Ostergaard Pia , Loeys Bart L. , Morisaki Hiroko , Ahmed Zubair M. , Birdsey Graeme M. , Freson Kathleen , Mumford Andrew , Turro Ernest
Published: March 2023

The genetic etiologies of more than half of rare diseases remain unknown. Standardized genome sequencing and phenotyping of large patient cohorts provide an opportunity for discovering the unknown etiologies, but this depends on efficient and powerful analytical methods. We built a compact database, the ‘Rareservoir’, containing the rare variant genotypes and phenotypes of 77,539 participants sequenced by the 100,000 Genomes Project. We then used the Bayesian genetic association method BeviMed to infer associations between genes and each of 269 rare disease classes assigned by clinicians to the participants. We identified 241 known and 19 previously unidentified associations. We validated associations with ERG, PMEPA1 and GPR156 by searching for pedigrees in other cohorts and using bioinformatic and experimental approaches. We provide evidence that (1) loss-of-function variants in the Erythroblast Transformation Specific (ETS)-family transcription factor encoding gene ERG lead to primary lymphoedema, (2) truncating variants in the last exon of transforming growth factor-β regulator PMEPA1 result in Loeys–Dietz syndrome and (3) loss-of-function variants in GPR156 give rise to recessive congenital hearing impairment. The Rareservoir provides a lightweight, flexible and portable system for synthesizing the genetic and phenotypic data required to study rare disease cohorts with tens of thousands of participants.
A longitudinal circulating tumor DNA-based model associated with survival in metastatic non-small-cell lung cancer
Authors: Assaf Zoe June F. , Zou Wei , Fine Alexander D. , Socinski Mark A. , Young Amanda , Lipson Doron , Freidin Jonathan F. , Kennedy Mark , Polisecki Eliana , Nishio Makoto , Fabrizio David , Oxnard Geoffrey R. , Cummings Craig , Rode Anja , Reck Martin , Patil Namrata S. , Lee Mark , Shames David S. , Schulze Katja
Published: March 2023

One of the great challenges in therapeutic oncology is determining who might achieve survival benefits from a particular therapy. Studies on longitudinal circulating tumor DNA (ctDNA) dynamics for the prediction of survival have generally been small or nonrandomized. We assessed ctDNA across 5 time points in 466 non-small-cell lung cancer (NSCLC) patients from the randomized phase 3 IMpower150 study comparing chemotherapy-immune checkpoint inhibitor (chemo-ICI) combinations and used machine learning to jointly model multiple ctDNA metrics to predict overall survival (OS). ctDNA assessments through cycle 3 day 1 of treatment enabled risk stratification of patients with stable disease (hazard ratio (HR) = 3.2 (2.0–5.3), P < 0.001; median 7.1 versus 22.3 months for high- versus low-intermediate risk) and with partial response (HR = 3.3 (1.7–6.4), P < 0.001; median 8.8 versus 28.6 months). The model also identified high-risk patients in an external validation cohort from the randomized phase 3 OAK study of ICI versus chemo in NSCLC (OS HR = 3.73 (1.83–7.60), P = 0.00012). Simulations of clinical trial scenarios employing our ctDNA model suggested that early ctDNA testing outperforms early radiographic imaging for predicting trial outcomes. Overall, measuring ctDNA dynamics during treatment can improve patient risk stratification and may allow early differentiation between competing therapies during clinical trials.
Impact of hypothermia alert device (BEMPU) on improvement of duration of Kangaroo Mother Care (KMC) provided at home: parallel-group randomized control trial
Authors: Nimbalkar Somashekhar Marutirao , Patel Viral Thakorbhai , Patel Dipen Vasudev , Phatak Ajay Gajanan
Published: March 2023

The objective of the study was to determine if using the hypothermia-detecting bracelet (named BEMPU) improves the duration of Kangaroo Mother Care (KMC) at home by one hour. This parallel-group randomized controlled trial was conducted at a step-down nursery of a teaching hospital. Neonates between 1000 and 2000 g were randomized to BEMPU and control groups at the time of discharge. BEMPU was applied at the wrist of each newborn in the BEMPU (intervention) group. Parents were advised to keep the BEMPU in place till 4 weeks post-discharge. The BEMPU generates a beep sound as an alarm when a newborn's temperature drops below 36.5 °C. Parents in both groups were trained to provide KMC at home. Parents in the BEMPU group received the "KMC chart" and "BEMPU beep chart," while the control group received the "KMC chart" only. In the "KMC chart," parents entered information about KMC hours on a real-time basis, and in the "BEMPU beep chart," they entered information about alarm beeps from BEMPU on a real-time basis till 4 weeks post-discharge. Independent samples t-test was used to compare mean KMC hours between the two groups. A total of 128 neonates participated in the study (64 in BEMPU and 64 in Control groups). The mean(SD) gestational age for the BEMPU group was 34.04(2.84) weeks vs 34.75(2.70) weeks for the control group. In BEMPU group, mean(SD) daily time spent doing KMC was significantly higher in 1st week [4.78(2.93) vs. 3.22(2.44) h, p = 0.003], in 2nd week [4.52(3.43) vs. 2.84(2.95) h, p = 0.008], in 3rd week [4.23(3.71) vs. 2.30(2.70) h, p = 0.003], in 4th week [3.72(3.30) vs. 1.95(2.65) h, p = 0.003] as compared to control group. BEMPU improved the daily duration of KMC hours at home compared to the control group over four weeks.

Clinical Trial Registration: This trial is registered at Clinical Trials Registry India with registration number: CTRI/2018/08/015154 and accessible at http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=27600&EncHid=&modid=&compid=%27,%2727600det%27 Registered on 01/08/2018.
On the forecastability of food insecurity
Authors: Foini Pietro , Tizzoni Michele , Martini Giulia , Paolotti Daniela , Omodei Elisa
Published: March 2023

Food insecurity, defined as the lack of physical or economic access to safe, nutritious and sufficient food, remains one of the main challenges included in the 2030 Agenda for Sustainable Development. Near real-time data on the food insecurity situation collected by international organizations such as the World Food Programme can be crucial to monitor and forecast time trends of insufficient food consumption levels in countries at risk. Here, using food consumption observations in combination with secondary data on conflict, extreme weather events and economic shocks, we build a forecasting model based on gradient boosted regression trees to create predictions on the evolution of insufficient food consumption trends up to 30 days in to the future in 6 countries (Burkina Faso, Cameroon, Mali, Nigeria, Syria and Yemen). Results show that the number of available historical observations is a key element for the forecasting model performance. Among the 6 countries studied in this work, for those with the longest food insecurity time series, that is Syria and Yemen, the proposed forecasting model allows to forecast the prevalence of people with insufficient food consumption up to 30 days into the future with higher accuracy than a naive approach based on the last measured prevalence only. The framework developed in this work could provide decision makers with a tool to assess how the food insecurity situation will evolve in the near future in countries at risk. Results clearly point to the added value of continuous near real-time data collection at sub-national level.
A pangenome approach-based loop-mediated isothermal amplification assay for the specific and early detection of Bordetella pertussis
Authors: Juscamayta-López Eduardo , Valdivia Faviola , Soto María Pía , Nureña Brenda , Horna Helen
Published: March 2023

Despite widespread vaccination, Bordetella pertussis continues to cause pertussis infections worldwide, leaving infants at the highest risk of severe illness and death, while people around them are likely the main sources of infection and rapidly spread the disease. Rapid and less complex molecular testing for the specific and timely diagnosis of pertussis remains a challenge that could help to prevent the disease from worsening and prevent its transmission. We aimed to develop and validate a colorimetric loop-mediated isothermal amplification (LAMP) assay using a new target uvrD_2 informed by the pangenome for the specific and early detection of B. pertussis. Compared to that of multitarget quantitative polymerase chain reaction (multitarget qPCR) using a large clinical DNA specimen (n = 600), the diagnostic sensitivity and specificity of the uvrD_2 LAMP assay were 100.0% and 98.6%, respectively, with a 99.7% degree of agreement between the two assays. The novel colorimetric uvrD_2 LAMP assay is highly sensitive and specific for detecting B. pertussis DNA in nasopharyngeal swabs and showed similar diagnostic accuracy to complex and high-cost multitarget qPCR, but it is faster, simpler, and inexpensive, which makes it very helpful for the reliable and timely diagnosis of pertussis in primary health care and resource-limited settings.
Identification of potential LncRNAs as papillary thyroid carcinoma biomarkers based on integrated bioinformatics analysis using TCGA and RNA sequencing data
Authors: Feng Jia-Lin , Zheng Wen-Jie , Xu Le , Zhou Qin-Yi , Chen Jun
Published: March 2023

The roles and mechanisms of long non-coding RNAs (lncRNAs) in papillary thyroid cancer (PTC) remain elusive. We obtained RNA sequencing (RNA-seq) data of surgical PTC specimens from patients with thyroid cancer (THCA; n = 20) and identified differentially expressed genes (DEGs) between cancer and cancer-adjacent tissue samples. We identified 2309 DEGs (1372 significantly upregulated and 937 significantly downregulated). We performed Gene Ontology, Kyoto Encyclopedia of Genes and Genomes, gene set enrichment, and protein–protein interaction network analyses and screened for hub lncRNAs. Using the same methods, we analyzed the RNA-seq data from THCA dataset in The Cancer Genome Atlas (TCGA) database to identify differentially expressed lncRNAs. We identified 15 key differentially expressed lncRNAs and pathways that were closely related to PTC. Subsequently, by intersecting the differentially expressed lncRNAs with hub lncRNAs, we identified LINC02407 as the key lncRNA. Assessment of the associated clinical characteristics and prognostic correlations revealed a close correlation between LINC02407 expression and N stage of patients. Furthermore, receiver operating characteristic curve analysis showed that LINC02407 could better distinguish between cancerous and cancer-adjacent tissues in THCA patients. In conclusion, our findings suggest that LINC02407 is a potential biomarker for PTC diagnosis and the prediction of lymph node metastasis.
Ecological niche overlap in the Arctic vegetation influenced by seabirds
Authors: Zwolicki Adrian , Zmudczyńska-Skarbek Katarzyna , Weydmann-Zwolicka Agata , Stempniewicz Lech
Published: March 2023

In the High Arctic, nutrients are the most limiting resources, so terrestrial vegetation is of low complexity and grows slowly. However, locally, large seabird colonies increase soil fertility by deposition of faeces, supporting the development of rich and fast-growing plant communities. Here, we assessed how seabird colonies affected ecological niche segregation of plants, across the fertilisation gradient. Study sites were located near five little auk colonies, distributed longitudinally across the Svalbard archipelago. We described vascular plant composition and identified 13 environmental variables, based on which, we calculated and tested the niche overlap (NO) between the 18 most frequent species. Based on the hierarchical classification of the NO matrix, we distinguished typical High Arctic Vegetation (HAV), and Bird-Cliff Vegetation (BCV). The BCV was characterised by higher average NO and soilδ15N compared to HAV. The highest NO values across the fertilisation gradient were found on the border between the distinguished communities and were positively correlated with species diversity. We suggest that in the High Arctic, seabirds-delivered nutrients lead to the development of separate plant communities through the mechanism of avoiding inter-species competition, while simultaneous high species diversity and NO are related to high facilitation between plants on the border between the communities.
Food taboo practices and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis
Authors: Debela Berhanu Gidisa , Sisay Daniel , Hareru Habtamu Endashaw , Ewune Helen Ali , Tesfa Anene , Shewaye Daniel Alayu , Ewunie Temesgen Muche
Published: March 2023

Food taboos have a negative impact on pregnant women and their fetuses by preventing them from consuming vital foods. Previous research found that pregnant women avoided certain foods during their pregnancy for a variety of reasons. This review aimed to determine the pooled prevalence of food taboo practices and associated factors in Ethiopia. In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, we searched the literature using PubMed/MEDLINE, AJOL (African Journal Online), HINARI, Science Direct, Google Scholar, and Google electronic databases. The random-effects model was used to estimate the pooled prevalence of food taboo and its determinants at a 95% confidence interval with their respective odds ratios. The pooled food taboo practice among Ethiopian pregnant women was 34.22% (95% CI 25.47–42.96), and after adjustment for publication bias with the trim-and-fill analysis, the pooled food taboo practice of pregnant women was changed to 21.31% (95% CI: 10.85–31.67%). Having less than a secondary education level (OR = 3.57; 95% CI 1.43–8.89), having no ANC follow-up (OR = 4.35; 95% CI 1.12–16.94), and being a rural resident (OR = 3.08; 95% CI 1.14–8.28) were the significant factors. Dairy products, some fruits, green leafy vegetables, meat, and honey are among the taboo foods. The most frequently stated reasons for this taboo practice were: fear of producing a big fetus, which is difficult during delivery; attachment to the fetus's body or head; and fear of fetal abnormality.
Long-term prognostic value of Murray law-based quantitative flow ratio in jailed left circumflex coronary artery after left main crossover stenting
Authors: Li Lieyou , Feng Zhihai , Zhang Lin , Chen Huang , Zheng Hong , Lin Huizhong , Jiang Qiong , Lin Yunlin , Chen Lianglong , Fan Lin
Published: March 2023

We aimed to evaluate the impact of new Murray law-based QFR of jailed left circumflex coronary artery (LCx) on long-term clinical outcomes after left main coronary artery (LM) simple crossover stenting. 164 patients who underwent LM-to-left anterior descending coronary artery simple crossover stenting and had appropriate angiographic view of LCx for QFR computation were enrolled. The primary clinical outcome was the 5-year target lesion failure (TLF), defined as a composite of cardiac death, a target vessel myocardial infarction or target lesion repeat revascularization. The mean QFR of the LCx after LM stent implantation was 0.88 ± 0.09, and 29 patients (17.7%) had a low QFR (< 0.80), which was significantly associated with a higher 5-year rate of TLF when compared with the high QFR group (27.6% vs. 6.7%; HR: 4.235; 95% CI 1.21–14.95; p = 0.0015). The 5-year LCx ostium-related TLR rate in the low QFR group was also higher (17.2% vs. 3.0% in the high QFR group; HR: 6.07, 95% CI 1.63–22.59, p = 0.002). In a multivariate Cox regression analysis, a low QFR in the LCx after LM stenting was an independent predictor of the 5-year TLF rate (HR: 3.21, 95% CI 1.21–8.53; p = 0.019). ROC analysis showed that QFR a negative predictive value (NPV) of 89.6% ([AUC] 0.73, 95% CI 0.58–0.88, p < 0.05), the cutoff point is 0.85. The patients with a low QFR (< 0.80) in jailed LCX after LM simple crossover stenting had worse 5-year outcomes than those with a high QFR. Conversely, a QFR ≥ 0.85 of jailed LCx could serve as a good predictor of low risk of adverse outcome in LCx ostium. The QFR computation of the jailed LCx may be helpful to determine whether an additional procedure is required for the jailed side branch.
Whole genome characterization and diagnostics of prunus necrotic ringspot virus (PNRSV) infecting apricot in India
Authors: Noorani Md Salik , Baig Mirza Sarwar , Khan Jawaid Ahmad , Pravej Alam
Published: March 2023

Prunus necrotic ringspot virus (PNRSV) is a pathogen that infects Prunus species worldwide, causing major economic losses. Using one and two-step RT-PCR and multiplex RT-PCR, the whole genome of the PNRSV-infecting apricot was obtained and described in this study. Computational approaches were used to investigate the participation of several regulatory motifs and domains of the Replicase1, Replicase2, MP, and CP. A single degenerated reverse and three forward oligo primers were used to amplify PNRSV’s tripartite genome. The size of RNA1 was 3.332 kb, RNA2 was 2.591 kb, and RNA3 was 1.952 kb, according to the sequencing analysis. The Sequence Demarcation Tool analysis determined a percentage pair-wise identity ranging between 91 and 99% for RNA1 and 2, and 87–98% for RNA3. Interestingly, the phylogenetic analysis revealed that closely related RNA1, RNA2, and RNA3 sequences of PNRSV strains from various geographical regions of the world are classified into distinct clades or groups. This is the first report on the characterization of the whole genome of PNRSV from India, which provides the cornerstone for further studies on the molecular evolution of this virus. This study will assist in molecular diagnostics and management of the diseases caused by PNRSV.