bluuebunny/crossref_metadata_2025 huggingface dataset:
Serrated Polyposis Syndrome: A Literature Review
Authors: Stephanini Guilherme Campos , Pinto Nathan Assis Jordão , Faraco Jarbas , Correa Paulo Alberto Falco Pires
Published: November 2023

Serrated polyposis syndrome is considered the most prevalent colonic polyposis syndrome in the world. Its importance has been increasingly discussed due to the significant increase in the risk of developing colorectal cancer in its affected individuals, similarly to other well-known polyposis syndromes, such as familial adenomatous polyposis.

Serrated lesions of the colon play a major role in this syndrome represented by hyperplastic polyps, serrated sessile lesions and traditional serrated adenomas. Among these lesions, the sessile serrated lesion stands out, considered the main precursor lesion of the serrated pathway of colon carcinogenesis.

Diagnosis of serrated polyposis syndrome is given through colonoscopy examination. Diagnostic criteria are: 1) 5 or more serrated lesions proximal to the rectum, all >4mm in size, with at least two >9mm in size; or 2) 20 serrated lesions of any size located anywhere in the large intestine, with >4 lesions proximal to the rectum.

The ideal treatment is removal of all relevant serrated lesions by colonoscopy. In case of failure of endoscopic therapy, surgery is indicated. This manuscript is based on two case reports and a literature review and aims to broaden the discussion about the subject.
How do line extensions impact brand sales? The role of feature similarity and brand architecture
Authors: Sezen Burcu , Pauwels Koen , Ataman Berk
Published: November 2023

Brand architecture decisions have important performance implications but have seen little quantitative research. In particular, there is little empirical evidence on how the strength of the link established among clusters of products within the company’s portfolio impact the sales effects of typical marketing actions such as line extensions. This paper quantifies the effect of different brand architecture choices and product feature similarity in moderating the impact of line extensions on brand sales. Based on categorization theory, the authors hypothesize that brand name similarity and feature similarity, both independently, and in interaction, increase brand cannibalization. The empirical analysis in three consumer packaged-goods categories shows that it is more critical to minimize the feature similarity than brand name similarity to limit cannibalization and generate higher incremental sales from line extensions. Controlling for feature similarity, line extensions introduced under sub-brands cause greater cannibalization.
Organic agriculture and agri-food system democracy: an institutional perspective from Kenya
Authors: Canwat Vincent , Onakuse Stephen
Published: November 2023

The discontent with the undemocratic agricultural food system inspired the emergence of many alternative agri-food systems, including organic agriculture. This study analysed how organic agriculture promotes agri-food system democracy concerning traditional knowledge integration, community and women participation, market, and policy integration. The study found that organic agriculture conversion increases traditional knowledge integration, community and women participation, and market integration. Although, it promotes policy integration by contributing to organic standards and policy development, the policy has remained in draft form for too long. The study implies supporting organic agriculture can promote agri-food system democracy, but its potential is compromised by the lack of an approved policy. Thus, stakeholders should increase their advocacy efforts for speedy organic policy approval and broader policy scope, including compensating organic producers for supplying public goods.
On the origin and elimination of cross coupling between tunneling current and excitation in scanning probe experiments that utilize the qPlus sensor
Authors: Schelchshorn Michael , Stilp Fabian , Weiss Marco , Giessibl Franz J.
Published: November 2023

The qPlus sensor allows for the simultaneous operation of scanning tunneling microscopy (STM) and atomic force microscopy (AFM). When operating a combined qPlus sensor STM/AFM at large tunneling currents, a hitherto unexplained tunneling current-induced cross coupling can occur, which has already been observed decades ago. Here, we study this phenomenon both theoretically and experimentally; its origin is voltage drops on the order of μV that lead to an excitation or a damping of the oscillation, depending on the sign of the current. Ideally, the voltage drops would be phase-shifted by π/2 with respect to a proper phase angle for driving and would, thus, not be a problem. However, intrinsic RC components in the current wiring lead to a phase shift that does enable drive or damping. Our theoretical model fully describes the experimental findings, and we also propose a way to prevent current-induced excitation or damping.
Influence of optical property contrast on the critical distribution of electrostatic torques in double-beam torsional Casimir actuators: Non-linear actuation toward chaotic motion
Authors: Dadi Z. , Masoudi A. A. , Tajik F. , Palasantzas G.
Published: November 2023

Here, we discuss how to achieve the stable actuation of a double beam torsional micro-actuator over the largest possible displacement of the moving component under the influence of Casimir and electrostatic torques, when the rotating component is constructed from different materials. The main part of this study is devoted to finding the optimal distribution of the electrostatic torque between the left and right sides of the micro-actuator to reach the maximum stable operation of the device. The latter is manifested by switching from homoclinic to heteroclinic orbits in the phase portraits. Indeed, the bifurcation curves and the phase portraits have been employed to show the sensitivity of the critical distribution of the electrostatic torque, beyond which the device does show stable performance, on the contrast of the optical properties of the moving component and the applied voltage in a conservative autonomous system. Moreover, for driven systems, the Melnikov function approach and the Poincaré portraits are used to study the presence of chaotic motion, which eventually leads to stiction. It is shown that the application of the optimal distribution of the electrostatic torque can significantly decrease the possibility of chaotic motion, and at this optimal level, the threshold curves reveal less difference between systems with different optical contrast.
Transparent conductive oxides and low-loss nitride-rich silicon waveguides as building blocks for neuromorphic photonics
Authors: Gosciniak Jacek , Khurgin Jacob B.
Published: November 2023

Fully CMOS-compatible photonic memory holding devices hold a potential in the development of ultrafast artificial neural networks. Leveraging the benefits of photonics such as high-bandwidth, low latencies, low-energy interconnect, and high speed, they can overcome the existing limits of electronic processing. To satisfy all these requirements, a photonic platform is proposed that combines low-loss nitride-rich silicon as a guide and low-loss transparent conductive oxides as an active material that can provide high nonlinearity and bistability under both electrical and optical signals.
Study on the influence of building aerodynamic shadows on the heat transfer performance of natural draft dry cooling towers
Authors: Zhao Jincheng , Ma Mingrui , Wang Zhichao , Tan Dunhu , Chen Lin , Zhang Feng , Han Xu , Wang Zhi
Published: November 2023

Previous studies have shown that the heat transfer of air cooling towers is mainly affected by crosswind. To improve the cooling performance of air-cooled towers under crosswind and the efficiency of power plants, this paper studies the influence mechanism of buildings on the heat dissipation performance of natural draft dry cooling towers (NDDCTs). The numerical simulation of a 2 × 1000 MW NDDCT is carried out to analyze the distribution of the aerodynamic shadow area and its influence on the heat transfer performance of the NDDCT. The study found that at a wind speed of 12 m/s, the heat dissipation efficiency of the NDDCT under the influence of the original building decreased by 4.74%, and the total ventilation volume decreased by 2595.76 kg/s. When the NDDCT was located in the aerodynamic shadow wake area of the building, the heat dissipation efficiency increased by 8.36%. This shows that the aerodynamic shadow area of the building will lead to deflection deceleration and a steady flow effect of the flow field near the tower base, which has a double-sided effect on the heat transfer of the NDDCT. By adjusting the interference of the aerodynamic shadow wake area of the building on the NDDCT, the high wind speed sensitivity and the heat dissipation deviation of the two towers can be reduced.
Intrinsic magnetic properties of the layered antiferromagnet CrSBr
Authors: Long Fangchao , Mosina Kseniia , Hübner René , Sofer Zdenek , Klein Julian , Prucnal Slawomir , Helm Manfred , Dirnberger Florian , Zhou Shengqiang
Published: November 2023

van der Waals magnetic materials are an ideal platform to study low-dimensional magnetism. Opposed to other members of this family, the magnetic semiconductor CrSBr is highly resistant to degradation in air, which, in addition to its exceptional optical, electronic, and magnetic properties, is the reason the compound is receiving considerable attention at the moment. For many years, its magnetic phase diagram seemed to be well-understood. Recently, however, several groups observed a magnetic transition in magnetometry measurements at temperatures of around 40 K that is not expected from theoretical considerations, causing a debate about the intrinsic magnetic properties of the material. In this Letter, we report the absence of this particular transition in magnetization measurements conducted on high-quality CrSBr crystals, attesting to the extrinsic nature of the low-temperature magnetic phase observed in other works. Our magnetometry results obtained from large bulk crystals are in very good agreement with the magnetic phase diagram of CrSBr previously predicted by the mean-field theory; A-type antiferromagnetic order is the only phase observed below the Néel temperature at TN = 131 K. Moreover, numerical fits based on the Curie–Weiss law confirm that strong ferromagnetic correlations are present within individual layers even at temperatures much larger than TN.
Theoretical study of the properties of multiphoton MINFLUX and RASTMIN super-resolution imaging
Authors: Lin Baichang , Han Hongyi , Xiang Ruijie , Gao Xinwei , Zhang Renlong , Wu Guang , Yan Wei , Qu Junle
Published: November 2023

Fluorescence microscopy is an important tool for studying cellular physiological functions, and the precise localization of the individual fluorescent molecules is crucial for resolution. In recent years, researchers have proposed various single-molecule localization methods with molecular-level precision. Here, we conducted simulation calculations and feasibility studies on two imaging techniques of minimal emission fluxes (MINFLUX) and RASTer scanning a minimum of light (RASTMIN) for single-photon and multiphoton imaging. Our results indicated that the single-photon excitation wavelength had little influence on the localization precision of MINFLUX and RASTMIN, but multiphoton MINFLUX and RASTMIN significantly improved the center localization precision. However, in multiphoton MINFLUX, the average localization precision was slightly compromised. In contrast, benefiting from the advantages of raster scanning, the average localization precision of multiphoton RASTMIN was superior to that of single-photon RASTMIN. Furthermore, to address the issues of reduced average localization accuracy with multiphoton MINFLUX, we propose an increase in the number of scanning points to enhance the performance of multiphoton MINFLUX imaging.
A density functional theory and simulation study of stripe phases in symmetric colloidal mixtures
Authors: Prestipino Santi , Pini Davide , Costa Dino , Malescio Gianpietro , Munaò Gianmarco
Published: November 2023

In a binary mixture, stripes refer to a one-dimensional periodicity of the composition, namely, a regular alternation of layers filled with particles of mostly one species. We have recently introduced [Munaò et al., Phys. Chem. Chem. Phys. 25, 16227 (2023)] a model that possibly provides the simplest binary mixture endowed with stripe order. The model consists of two species of identical hard spheres with equal concentration, which mutually interact through a square-well potential. In that paper, we have numerically shown that stripes are present in both liquid and solid phases when the attraction range is rather long. Here, we study the phase behavior of the model in terms of a density functional theory capable to account for the existence of stripes in the dense mixture. Our theory is accurate in reproducing the phases of the model, at least insofar as the composition inhomogeneities occur on length scales quite larger than the particle size. Then, using Monte Carlo simulations, we prove the existence of solid stripes even when the square well is much thinner than the particle diameter, making our model more similar to a real colloidal mixture. Finally, when the width of the attractive well is equal to the particle diameter, we observe a different and more complex form of compositional order in the solid, where each species of particle forms a regular porous matrix holding in its holes the other species, witnessing a surprising variety of emergent behaviors for a very basic model of interaction.
A new univariate continuous distribution with applications in reliability
Authors: Marzouk Waleed , Shafiq Shakaiba , Naz Sidra , Jamal Farrukh , Sapkota Laxmi Prasad , Nagy M. , Mansi A. H. , Hussam Eslam , Gemeay Ahmed M.
Published: November 2023

In this article, the odd Lomax Gompertz distribution has been introduced, which is derived by modifying the Gompertz distribution to serve as a baseline model in the odd generalized Lomax distribution. The newly proposed model offers enhanced flexibility and provides a promising alternative for modeling lifetime data. This study seeks to establish a solid theoretical foundation for its application through the exploration of several properties, such as non-central moments, stochastic orderings quantile function, and entropy measure, for the new model. Additionally, by conducting simulation analysis, the performance of the various estimation methods is being assessed, which enables the identification of the most reliable approach for estimating the unknown parameters of the newly developed model. The simulation analysis of the two-risk metrics, namely, value at risk and expected shortfall, revealed the ability of the distribution to capture diverse failure rate patterns, which makes it particularly relevant for assessing financial risks. Finally, the suggested model is practiced to two real-life datasets to provide the compelling evidence of superior flexibility and practical versatility compared to existing models in the literature.
Speaking out, talking back? African feminist politics and decolonial poetics of knowing, organising and loving
Authors: Dieng Rama Salla
Published: November 2023

This piece reviews the ‘Talking back: African feminism in dialogue’ interview series I conducted with 15 African feminist activists, policymakers, researchers and artists of diverse ages, genders, sexualities, ability and nationality in which they shared their visions, personal and institutional biographies and aspirations. It explores the intersections of feminist activism, knowledge production, solidarity and power dynamics in Africa and the African diaspora. The essay delves into how African feminists challenge existing power structures, including patriarchy, colonialism, racism, fundamentalisms, capitalism and heteronormativity. It emphasises the importance of feminist scholarship and activism in reshaping political economies and political ecologies and challenging the status quo. The piece discusses the lived experiences of African feminist social movements and their efforts to redefine social contracts.
Research progress of biomass-derived carbon for the supercapacitors
Authors: Zhang Miao , Peng Lihua
Published: November 2023

In order to fulfil the requirements of various equipment in different fields for energy storage components, there is an increasing number of studies being conducted on the development of electrode materials for supercapacitors. At present, carbon materials used in electrode components in supercapacitors are mostly graphene, porous carbon, activated carbon, and carbon nanotubes. Due to the fast advancements in modern technology and science, which have stimulated the demand for sustainable and eco-friendly energy storage materials, biomass-derived carbon materials have gradually emerged in the public eye. The carbon source of biomass-derived carbon is usually a natural substance, which has advantages such as low cost, easy availability, and environmental friendliness. Due to the diversity of material structures, the required electrode materials can be designed and prepared according to performance requirements. At the same time, biomass-derived carbon is also capable of being combined alongside various electrode materials to create asymmetric capacitors, combining the advantages of the two to enhance capacitor electrochemical performance. This article first introduces different sources of biomass-derived carbon-based electrode materials and compares their electrochemical performance. Then, based on various research results, the factors that affect their electrochemical performance are discussed in detail. Then, the preparation methods of biomass-derived carbon electrode materials are introduced, and the specific requirements, advantages and disadvantages of different preparation methods are briefly analyzed. The application of biomass-derived carbon electrode materials in supercapacitors in combination with other materials is listed. Finally, a summary and outlook of the current research status are provided to provide a reference for the rational design of biomass carbon supercapacitors in the future.
Predictors of U.S. public support for climate aid to developing countries
Authors: Ansah Patrick O , Campbell Eryn , Kotcher John , Rosenthal Seth A , Leiserowitz Anthony , Maibach Edward
Published: November 2023

Effectively responding to global warming requires mitigation and adaptation efforts worldwide. Although developed countries have pledged substantial financial support to help developing countries respond to climate change, these pledges have yet to be fulfilled. A majority of American voters support providing aid to developing nations, however, levels of support differ sharply between Democrats and Republicans. To investigate the predictors of support for climate aid among registered voters in the United States and to assess the effect of political party identification, we conducted hierarchical regression and relative weight analysis on a nationally representative sample of U.S. registered voters (n = 898) surveyed in 2021. Among all voters, the predictors of support for climate aid were: party identification (with more support among Democrats), perceived risk to developing countries, worry about global warming, injunctive beliefs that the U.S. should do more, and global warming belief certainty. Among Democrats, the predictors were: perceived risk to the U.S., worry, injunctive beliefs the U.S. should do more, education, and income. Among Republicans, the predictors were: perceived risk to developing countries, and injunctive beliefs the U.S. should do more. These findings have both theoretical and practical relevance for efforts to build public support for development assistance aimed at reducing climate change.
Plant-based carbon dots are a sustainable alternative to conventional nanomaterials for biomedical and sensing applications
Authors: Priya S Shanmuga , S R Suseem
Published: November 2023

Carbon dots are small carbon-based particles with unique properties that make them useful in various applications. Some advantages include low toxicity, bio-compatibility, excellent photo luminescence, high stability, and ease of synthesis. These features make them promising for biomedical imaging, drug delivery, and optoelectronic devices. Carbon dots derived from plants have several advantages, including their low toxicity, biocompatibility, and renewable sources. They also have excellent water solubility and high stability and can be easily synthesized using simple and low-cost methods. These properties make them promising candidates for various biomedicine, sensing, and imaging applications. Plant-based carbon dots have shown great potential in metal sensing and bio-imaging applications. They can act as efficient sensors for detecting heavy metals due to their strong chelation and fluorescence properties. This article showcases plant-based carbon dots, emphasizing their low toxicity, biocompatibility, renewability, and potential in metal sensing and bio-imaging. It aims to illustrate their versatile applications and ongoing research for broader use. The current investigation explores their full potential and develops new synthesis and application methods.
An abstract approach to Marcinkiewicz-Zygmund inequalities for approximation and quadrature in modulation spaces
Authors: Ehler Martin , Gröchenig Karlheinz
Published: November 2023

We study the approximation and quadrature error of points that satisfy Marcinkiewicz-Zygmund inequalities. First, we investigate the use of Marcinkiewicz-Zygmund inequalities in an abstract Hilbert space for an abstract approximation and quadrature rule. The setting is then specified to Sobolev spaces induced by Freud weights

e

−
2
σ

|

x

|

α

e^{-2\sigma |x|^\alpha }

with

α
>
1

\alpha >1

and

σ
>
0

\sigma >0

, and we derive specific bounds for the approximation and quadrature error. For the Gaussian weight

e

−
2
π

x
2

e^{-2\pi x^2}

, we verify that the Sobolev spaces essentially coincide with a specific class of modulation spaces that are well known in (time-frequency) analysis.
LncPCD: a manually curated database of experimentally supported associations between lncRNA-mediated programmed cell death and diseases
Authors: He Ni , Li Danyang , Xu Fanfan , Jin Jingnan , Li Lifang , Tian Liting , Chen Biying , Li Xiaoju , Ning Shangwei , Wang Lihua , Wang Jianjian
Published: November 2023

Programmed cell death (PCD) refers to controlled cell death that is conducted to keep the internal environment stable. Long noncoding RNAs (lncRNAs) participate in the progression of PCD in a variety of diseases. However, no specialized online repository is available to collect and store the associations between lncRNA-mediated PCD and diseases. Here, we developed LncPCD, a comprehensive database that provides information on experimentally supported associations of lncRNA-mediated PCD with diseases. The current version of LncPCD documents 6666 associations between five common types of PCD (apoptosis, autophagy, ferroptosis, necroptosis and pyroptosis) and 1222 lncRNAs in 331 diseases. We also manually curated a wealth of information: (1) 7 important lncRNA regulatory mechanisms, (2) 310 PCD-associated cell types in three species, (3) detailed information on lncRNA subcellular locations and (4) clinical applications for lncRNA-mediated PCD in diseases. Additionally, 10 single-cell sequencing datasets were integrated into LncPCD to characterize the dynamics of lncRNAs in diseases. Overall, LncPCD is an extremely useful resource for understanding the functions and mechanisms of lncRNA-mediated PCD in diseases.

Database URL:  http://spare4.hospital.studio:9000/lncPCD/Home.jsp
Cardiac output drop reflects circulatory attrition after Fontan completion: serial cardiac magnetic resonance study
Authors: Arrigoni Sara C , Berger Rolf M F , Ebels Tjark , Postmus Douwe , Hoendermis Elke S , Schoof Paul H , Willems Tineke P , van Melle Joost P
Published: November 2023

Aims

Cardiac magnetic resonance (CMR) imaging is a main diagnostic tool in the follow-up of Fontan patients. However, the value of serial CMR for the evaluation of Fontan attrition is unknown. The aim of this prospective study of serial CMR is to describe the analysis of time-dependent evolution of blood flow distribution, ventricular volumes, and function in patients after Fontan completion.

Methods and results

In this prospective single-centre study, between 2012 and 2022, 281 CMR examinations were performed in 88 Fontan patients with distribution of blood flows, measurements of ventricular volumes, and ejection fraction. Linear mixed model regression for repeated measurements was used to analyse changes of measurements across serial CMR examinations. During a time interval of 10 years, the median number of CMR per patient was 3 (range 1–5). Indexed flow of ascending aorta, caval veins, and pulmonary arteries decreased significantly across serial CMR examinations. Although a decrease of mean indexed aortic flow (3.03 ± 0.10 L/min/m2 at first CMR vs. 2.36 ± 0.14 L/min/m2 at fourth CMR, P < 0.001) was observed, ejection fraction did not decline (50 ± 1% at first CMR vs. 54 ± 2% at fourth CMR, P = 0.070). Indexed ventricular volumes did not differ significantly across serial CMR examinations.

Conclusion

The decrease of indexed aortic and cavopulmonary flows reflects the attrition of univentricular circulation and can be detected by means of serial CMR. Ventricular systolic dysfunction does not contribute significantly to this attrition. In order to detect significant change of indexed aortic flow, we recommend performing serial CMR as routine practice in the Fontan population.
Senescence evolution under the catastrophic accumulation of deleterious mutations
Authors: Aubier Thomas G , Galipaud Matthias
Published: November 2023

For aging to evolve, selection against mortality must decrease with age. This prevailing view in the evolutionary theory of senescence posits that mutations with deleterious effects happening late in life—when purging selection is weak—may become fixed via genetic drift in the germline, and produce a senescent phenotype. Theory, however, has focused primarily on growing populations and the fate of single deleterious mutations. In a mathematical model, we demonstrate that relaxing both of these simplifying assumptions leads to unrealistic outcomes. In density-regulated populations, previously fixed deleterious mutations should promote the fixation of other deleterious mutations that lead to senescence at ever younger ages, until death necessarily occurs at sexual maturity. This sequential fixation of deleterious mutations is not promoted by a decrease in population size, but is due to a change in the strength of selection. In an individual-based model, we also show that such evolutionary dynamics should lead to the extinction of most populations. Our models therefore make rather unrealistic predictions, underlining the need for a reappraisal of current theories. In this respect, we have further assumed in our models that the deleterious effects of mutations can only occur at certain ages, marked, for instance, by somatic or physiological changes. Under this condition, we show that the catastrophic accumulation of deleterious mutations in the germline can stop. This new finding emphasizes the importance of investigating somatic factors, as well as other mechanisms underlying the deleterious effects of mutations, to understand senescence evolution. More generally, our model therefore establishes that patterns of senescence in nature depend not only on the decrease in selection strength with age but also on any mechanism that stops the catastrophic accumulation of mutations.
Cytogenetics of the Hybridogenetic Frog Pelophylax grafi and Its Parental Species Pelophylax perezi
Authors: Dudzik Anna , Dedukh Dmitrij , Crochet Pierre-André , Rozenblut-Kościsty Beata , Rybka Hanna , Doniol-Valcroze Paul , Choleva Lukáš , Ogielska Maria , Chmielewska Magdalena
Published: November 2023

Hybrid taxa from the genus Pelophylax can propagate themselves in a modified way of sexual reproduction called hybridogenesis ensuring the formation of clonal gametes containing the genome of only one parental (host) species. Pelophylax grafi from South-Western Europe is a hybrid composed of P. ridibundus and P. perezi genomes and it lives with a host species P. perezi (P-G system). Yet it is unknown, whether non-Mendelian inheritance is fully maintained in such populations. In this study, we characterize P. perezi and P. grafi somatic karyotypes by using comparative genomic hybridization, genomic in situ hybridization, fluorescent in situ hybridization, and actinomycin D-DAPI. Here, we show the homeology of P. perezi and P. grafi somatic karyotypes to other Pelophylax taxa with 2n = 26 and equal contribution of ridibundus and perezi chromosomes in P. grafi which supports F1 hybrid genome constitution as well as a hemiclonal genome inheritance. We show that ridibundus chromosomes have larger regions of interstitial (TTAGGG)n repeats flanking the nucleolus organizing region on chromosome no. 10 and a high quantity of AT pairs in the centromeric regions. In P. perezi, we found species-specific sequences in metaphase chromosomes and marker structures in lampbrush chromosomes. Pericentromeric RrS1 repeat sequence was present in perezi and ridibundus chromosomes, but the blocks were stronger in ridibundus. Various cytogenetic techniques applied to the P-G system provide genome discrimination between ridibundus and perezi chromosomal sets. They could be used in studies of germ-line cells to explain patterns of clonal gametogenesis in P. grafi and broaden the knowledge about reproductive strategies in hybrid animals.
Measuring Overweight and Obesity in Persons with Spinal Cord Injury: What Do Health Providers Use and What are the Challenges?
Authors: Pellegrini Christine A , Burkhart Lisa , Ramey Kaitlyn , LaVela Sherri L
Published: November 2023

Introduction

Obesity is a significant health concern for veterans and individuals with spinal cord injury, yet screening for overweight/obesity can be challenging. This study examines how healthcare providers screen for overweight/obesity and the challenges encountered in identifying overweight/obesity in veterans and persons with spinal cord injury.

Materials and Methods

Healthcare providers who provide care for persons with spinal cord injury completed a semi-structured interview. The interview explored their perspectives on measuring overweight/obesity in persons with spinal cord injury and the challenges they faced. Thematic analysis was used to identify themes that emerged from the interviews.

Results

Twenty-five providers (88% female with an average experience of 9.6 ± 7.3 years in providing care for spinal cord injury patients) participated in the interviews. The themes described the health indicators and equipment used to assess overweight/obesity, provider concerns regarding measurement, and criteria for classifying overweight/obesity. Body weight and body mass index were the most commonly used indicators. However, concerns were raised regarding accuracy of these measures for spinal cord injury patients, as well as issues related to the accessibility, calibration, and usability of the equipment. Many providers reported using standard body mass index ranges and categories instead of those specific to spinal cord injury.

Conclusion

This study identified the most commonly used indicators of weight or body composition in veterans and persons with spinal cord injury and highlighted providers’ concerns with these measures. Future research is needed to identify the most feasible, accurate, and appropriate health indicators that could be used in a clinical setting to identify overweight and obesity in this population.
1451. Elizabethkingia spp. Outbreak in a Ventilator-capable Skilled Nursing Facility, Chicago 2023
Authors: Thigpen Sidney , Walblay Kelly , Adil Hira , Zelencik Shane , Zelinski Christy , Nelson Kathryn , Cox Brian , McQuiston John R , Turner Janice , Toews Karrie-Ann , Kim Do Young , Black Stephanie R
Published: November 2023

Background

In July 2022, the Chicago Department of Public Health (CDPH) was notified of four residents with Elizabethkingia (Ek) infections at a ventilator-capable skilled nursing facility (vSNF A). The facility reviewed microbiology records, identified six additional cases and CDPH initiated an investigation.

Methods

A case-patient was defined as a resident at vSNF A with Ek spp. identified from a clinical specimen. Information was collected via case report form regarding risk factors for Ek infection. Site visits were conducted to observe dialysis, wound care practices, and water disruption. Environmental and clinical isolates were sequenced by the CDC to assess genetic relatedness.

Results

January 2021-2023, 14 case-patients were identified with Ek infection: 11 bacteremias, two pneumonias, and one had both. Two case-patients died. Nine case-patients were hemodialyzed, six required ventilator support, and all case-patients had decubitus ulcers. Seven had exposures to tap-water during care. Site visits revealed potential exposure through bathing or healthcare worker hands contaminated by tap-water, personal items on sink-tops, and sterile supplies stored by sinks. Water quality parameters verified chlorine levels above minimum standards by the Illinois Pollution Control Board. Among environmental samples collected, E. anophelis was isolated from first-catch water in the room of a ventilated case-patient. Whole genome sequencing indicated this isolate was closely related to the clinical isolate of the case-patient in the room and a case-patient on a different floor. Both patients were hemodialyzed and exposed to tap-water for bathing.

Conclusion

Infection control recommendations included avoiding tap-water for bathing, not disposing body-fluid in sinks, routine flushing, disinfecting or removing aerators, and disinfecting sink drains with scheduled foaming disinfectant application. This investigation demonstrates a persistent outbreak of Ek in a vSNF population, likely related to contaminated tap-water. We postulate that Elizabethkingia persisted in water system biofilms, despite measurable chlorine levels, leading to patient exposure by contaminated healthcare worker hands or through tap water bathing in the presence of decubitus ulcers.

Disclosures

All Authors: No reported disclosures
161. Impact of Committee-Based Diagnostic Stewardship on Performance of metagenomic Next-Generation Sequence Testing for Suspected Infections in Children
Authors: Allen Brian S , Sue Paul K , Filkins Laura , Teherani Mehgan
Published: November 2023

Background

Metagenomic next generation sequencing (mNGS) is a novel, unbiased approach to identify clinically relevant microorganisms. While an increasing body of lliterature suggests the potential positive impact of mNGS testing, best–use cases remain unclear, with rates of clinically significant outcomes as low as 10%. We implemented a restrictive testing model requiring pre-approval for mNGS testing via an ad-hoc committee of infectious disease specialists and pathologists, to optimize utilization of mNGS testing and aid in interpretation of results. We hypothesized that implementation of this diagnostic stewardship model would lead to higher rates of clinically actionable results.

Methods

We performed a retrospective review of mNGS requests at our institution from August 1, 2018 – April 30, 2021. Cases were evaluated by the mNGS committee within 24 hours, and following committee-provider discussion, either approved, denied as inappropriate, or denied in favor of additional conventional evaluation. Charts were subsequently reviewed and mNGS testing adjudicated as having either positive, negative, or no impact .

Results

12 mNGS requests were adjudicated, with 9 subjects approved for testing. Median age of participants was 8 years, with a large proportion (67%) of immunocompromised individuals. The most common indication for mNGS testing was persistent fever (58%). All samples were collected within 24 hours of request, with a median result time of 4 days. Among the 9 approved tests, seven (67%) were deemed to be clinically significant and directly impacted care, while three (33%) resulted in no impact. In total, mNGS testing led to 7 changes in management, 3 clinically relevant organisms identified, and 2 invasive procedures avoided. No adverse outcomes were observed among the denied requests. .

Conclusion

Plasma cell-free DNA mNGS is a promising albeit limited diagnostic tool for clinically relevant infectious diseases, and in the absence of diagnostic stewardship, may lead to unnecessary treatment and excess costs. Implementation of committee-based pre-approval and testing restriction led to high rates of clinically actionable results, and may improve the utility of mNGS testing, while neither delaying care nor negatively impacting outcomes.

Disclosures

Paul K. Sue, MDCM, Allovir, Inc: Participant in Industry Sponsored Trial|Gilead Sciences, Inc: Participant in Industry Sponsored Trial|Merck & Co.: Participant in Industry Sponsored Trial Laura Filkins, PhD, Avsana Labs: Board Member|Avsana Labs: Stocks/Bonds|Biofire Diagnostics: Grant/Research Support
532. Nirmatrelvir/Ritonavir Versus Placebo in Unvaccinated and Vaccinated High Risk Patients
Authors: Leister-Tebbe Heidi , Bao Weihang , Fountaine Robert , Baniecki Mary Lynn , Hendrick Victoria , Wisemandle Wayne , Hammond Jennifer , Rusnak James
Published: November 2023

Background

Nirmatrelvir with ritonavir (nirmatrelvir/r) is an oral antiviral treatment for COVID-19. EPIC-high risk (HR) was a Ph 2/3 double-blind, randomized, placebo (PBO)-controlled trial to evaluate nirmatrelvir/r in symptomatic, unvaccinated, nonhospitalized patients (pts) with ≥ 1 risk factor for progression to severe COVID-19. EPIC-standard risk (SR), a similarly designed trial enrolled pts with no risk factors, and fully vaccinated pts with ≥ 1 risk factor. An integrated analysis of treated pts with risk factors, including unvaccinated pts from EPIC-HR and vaccinated pts from EPIC-SR has been conducted.

Methods

Eligible adults from EPIC-HR and EPIC-SR with confirmed SARS-CoV-2 were randomized 1:1 within 5 days (d) of symptom onset to receive nirmatrelvir/r 300 mg/100 mg or PBO every 12 hrs for 5 d. Efficacy of nirmatrelvir/r was compared with PBO for COVID-19-related hospitalization or death from any cause through day 28. Other endpoints, including number of medical visits/hospital days and quantification of SARS-CoV-2 viral RNA load in nasopharyngeal swabs, and TEAEs through day 35 were evaluated.

Results

Nirmatrelvir/r reduced COVID-19-related hospitalization or death due to any cause by 83% (Relative Risk Reduction, RRR) compared to the PBO (0.94% vs 5.52%, p< 0.0001). The rate of hospitalization or death was lower among sero+ or vaccinated pts, however, nirmatrelvir/r treatment was associated with a substantial risk reduction among sero+ EPIC-HR pts (87.9% RRR), vaccinated EPIC-SR pts (57.6% RRR), or pts who were either vaccinated or sero+ (73.8% RRR) (Figure 1). These observations were regardless of age, gender, BMI, coexisting conditions, baseline serology status, viral RNA load and vaccination status (Figure 2). On average, pts treated with nirmatrelvir/r spent significantly fewer days in hospital and had significantly fewer medical visits compared with PBO. Nirmatrelvir/r treated pts had significantly greater reductions in viral RNA load from baseline to day 5 than PBO. Rates of all-causality TEAEs were similar between treatment groups and most were mild to moderate in severity.

Conclusion

The efficacy and safety of nirmatrelvir/r was demonstrated in vaccinated and unvaccinated pts at high risk as well as in pts with serologic evidence of prior exposure to COVID-19.

Disclosures

Heidi Leister-Tebbe, BSN, Pfizer Inc: Employee|Pfizer Inc: Stocks/Bonds Weihang Bao, PhD, Pfizer, Inc.: Employee of Pfizer|Pfizer, Inc.: Stocks/Bonds Robert Fountaine, PharmD, Pfizer Inc: Employee|Pfizer Inc: Stocks/Bonds Mary Lynn Baniecki, PhD, Pfizer Inc: Employee|Pfizer Inc: Stocks/Bonds Victoria Hendrick, BSc, Pfizer: Employee|Pfizer: Stocks/Bonds Wayne Wisemandle, MA, Pfizer Inc: Employee|Pfizer Inc: Stocks/Bonds Jennifer Hammond, PhD, Pfizer: Employee|Pfizer: Stocks/Bonds James Rusnak, MD, PhD, Pfizer Inc: Employee|Pfizer Inc: Stocks/Bonds
866. A new protocol for bacterial identification and carbapenemases by MALDI-TOF and lateral flow assay directly from positive blood culture: MALDI-FAST
Authors: Josa D I E G O , Silva Edwin , Osorio Juan Pablo , Hernandez Paula , Torres Isabel , Quiroga Blanca , martinez Deisy , Pescador Luz , Hurtado Lydy , Trujillo Paola , Cortes Fabian
Published: November 2023

Background

Infectious diseases are a global public health problem, accounting for more than 20% of the mortality burden. Klebsiella pneumoniae and Pseudomonas aeruginosa caused more than 1.3 million deaths globally in 2019. Antimicrobial resistance (AMR) is a major factor in this mortality. Rapid molecular test for the detection of the blaKPC gene improves treatment time and mortality in patients with bacteremia caused by carbapenem-resistant Enterobacterales, however, the use of molecular biology techniques may not be optimal in multiple resourced care settings limited. Our goal is to perform rapid identification of Gram-negative bacilli and detection of carbapenemases directly from blood cultures using the combination of mass spectrometry (MALDI-TOF) and the lateral flow immunochromatography test.4

Methods

We analyzed 97 bottles of positive blood cultures detected by the BACT/Alert 3D system (BioMérieux®). Our new method (MALDI-FAST) uses 0.5ml of blood obtained from the positive blood culture bottle for Gram-negative bacilli, from which a pellet is obtained by rapid centrifugation in 3 minutes. This material is processed both for bacterial identification by MALDI-TOF mass spectrophotometry (Bruker®), and rapid detection of carbapenemases by NG Test Carba 5 lateral flow immunochromatography (NG Biotech®). The results obtained were compared with the gold standard RT-PCR FilmArray Panel BCID 2.0 (BioMérieux®)

Results

Of the 97 blood culture bottles, 94/97 (96.9%) were correctly identified to the species level and 3/97 (3.1%) were polymicrobial blood cultures. Klebsiella pneumoniae was detected in 39 samples, E. coli in 24, and 34 other microorganisms including non-fermenting bacteria. Excellent concordance (kappa index 1,000) was achieved in 31/97 blood cultures (31.9%) that presented carbapenemases, 18/31 KPC (18.6%) and 13/31 with KPC and NDM coproduction (13.4%). 66/97(68.15%) bottles did not present carbapenemase.

Conclusion

Our protocol presents very good results for bacterial identification by mass spectrometry and carbapenemase detection by lateral flow immunoassay in a few minutes directly from the positive blood culture, becoming a fast and cost-effective tool to contribute to patient management.

Disclosures

All Authors: No reported disclosures
Health Care Costs and Corporate Investment
Authors: Tong Joy Tianjiao
Published: November 2023

Health care costs for U.S. employers have tripled over the past 20 years. Using firm-specific health expense data, I show that firms negatively adjust capital expenditures and R&D expenses in response to increases in health care costs. The effects are more pronounced for firms that are financially constrained, employ more high-skilled workers, and have less bargaining power relative to insurers. Furthermore, policy uncertainty surrounding health care costs is substantial and discourages capital investment. These findings suggest that an elevated level of health care costs and the associated uncertainty limit a firm’s ability to expand physically or through innovation.
Aripiprazole and Other Third-Generation Antipsychotics as a Risk Factor for Impulse Control Disorders
Authors: Williams Benjamin David , Lee Kenn , Ewah Silas Okey , Neelam Kishen
Published: November 2023

Background

Increasing evidence suggests an association between third-generation antipsychotics (TGAs) and impulse control disorders (ICDs). This is thought to be due to their partial agonism of dopamine receptors. However, neither the relative nor absolute risks of ICDs in those prescribed TGAs are well established. To inform clinical practice, this systematic review and meta-analysis summarizes and quantifies the current evidence for an association.

Methods

An electronic search of Medline, PsychINFO, EMBASE, and the Cochrane Clinical Trials Database was undertaken from database inception to November 2022. Three reviewers screened abstracts and reviewed full texts for inclusion. A random-effects meta-analysis was conducted with eligible studies.

Results

A total of 392 abstracts were retrieved, 214 remained after duplicates were removed. Fifteen full texts were reviewed, of which 8 were included. All 8 studies found that TGAs were associated with increased probability of ICDs. Risk of bias was high or critical in 7 of 8 studies. Three studies were included in the pooled analysis for the primary outcome, 2 with data on each of aripiprazole, cariprazine, and brexpiprazole. Exposure to TGAs versus other antipsychotics was associated with an increase in ICDs (pooled odds ratio, 5.54; 2.24–13.68). Cariprazine and brexpiprazole were significantly associated with ICDs when analyzed individually. Aripiprazole trended toward increased risk, but very wide confidence intervals included no effect.

Conclusions

Third-generation antipsychotics were associated with increased risk of ICDs in all studies included and pooled analysis. However, the risk of bias is high, confidence intervals are wide, and the quality of evidence is very low for all TGAs examined.
Workplace Harassment and Health
Authors: Abdulla Ahmad M. , Lin Tracy W. , Rospenda Kathleen M.
Published: November 2023

Objective

We examine relationships between workplace harassment (WH) and onset of health conditions over a 23-year period.

Methods

Participants were surveyed at seven points between 1997–2006 and again in 2020. Regression analyses (n= 921) assessed effects of chronic WH exposure on onset or recent health conditions by 2020.

Results

Growth mixture modeling revealed infrequent and chronic classes of generalized workplace harassment (GWH; 33.39% chronic) and sexual harassment (SH; 32.32% chronic). Prevalence of health conditions ranged from 3.71% for myocardial infarction to 43.06% for hypertension. Analysis via propensity score matching showed chronic WH class membership increased odds of coronary heart disease (GWH, odds ratio [OR] = 3.42,P< 0.05), arthritic/rheumatic conditions (SH, OR = 1.56,P< 0.05), and recent migraine (SH, OR = 1.68,P< 0.05).

Conclusions

Workplace harassment is associated with coronary heart disease, arthritic/rheumatic conditions, and migraine. Worker health can be protected through strengthening and enforcing organizational and social antiharassment policies and laws.