bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between postoperative complications and long-term survival after esophagectomy: a multicenter cohort study
Authors: Fransen Laura F C , Verhoeven Rob H A , Janssen Thijs H J B , van Det Marc J , Gisbertz Suzanne S , van Hillegersberg Richard , Klarenbeek Bastiaan , Kouwenhoven Ewout A , Nieuwenhuijzen Grard A P , Rosman Camiel , Ruurda Jelle P , van Berge Henegouwen Mark I , Luyer Misha D P
Published: December 2022

Conflicting results are reported on the association between post-esophagectomy complications and long-term survival. This multicenter study assesses the association between complications after an esophagectomy and long-term overall survival. Five Dutch high-volume centers collected data from consecutive patients undergoing esophagectomy between 2010 and 2016 and merged these with long-term survival data from the Netherlands Cancer Registry. Exclusion criteria were non-curative resections and 90-day mortality, among others. Primary outcome was overall survival related to the presence of a postoperative complication in general. Secondary outcomes analyzed the presence of anastomotic leakage and cardiopulmonary complications. Propensity score matching was performed and the outcomes were analyzed via Log-Rank test and Kaplan Meier analysis. Among the 1225 patients included, a complicated course occurred in 719 patients (59.0%). After matching for baseline characteristics, 455 pairs were successfully balanced. Patients with an uncomplicated postoperative course had a 5-year overall survival of 51.7% versus 44.4% in patients with complications (P = 0.011). Anastomotic leakage occurred in 18.4% (n = 226), and in 208 matched pairs, it was shown that the 5-year overall survival was 57.2% in patients without anastomotic leakage versus 44.0% in patients with anastomotic leakage (P = 0.005). Overall cardiopulmonary complication rate was 37.1% (n = 454), and in 363 matched pairs, the 5-year overall survival was 52.1% in patients without cardiopulmonary complications versus 45.3% in patients with cardiopulmonary complications (P = 0.019). Overall postoperative complication rate, anastomotic leakage, and cardiopulmonary complications were associated with a decreased long-term survival after an esophagectomy. Efforts to reduce complications might further improve the overall survival for patients treated for esophageal carcinoma.
Thrombolytic therapy for mechanical aortic valve thrombosis in pregnancy: case report
Authors: Nguyen Khoa , Prasad Pooja , Pare Emmanuelle , Chadderdon Scott , Khan Abigail
Published: December 2022

Background

Mechanical heart valves require long-term anticoagulation strategies to prevent valve thrombosis. Pregnant women with mechanical heart valves are especially susceptible to valve thrombosis, given their procoagulant state and the complexity of anticoagulation strategies during pregnancy. We describe a case of prosthetic valve thrombosis in a pregnant woman treated successfully with low-dose slow infusion of thrombolytic therapy.

Case Summary

A 23-year-old pregnant woman with a mechanical aortic valve on subcutaneous enoxaparin presented to the maternal cardiac clinic for a follow-up visit. Her physical exam was notable for a loud grade three crescendo decrescendo murmur and follow-up transthoracic echocardiography revealed peak and mean gradients of 87 and 58 mmHg, respectively. The Doppler velocity index (DVI) was 0.24 with an acceleration time of 130 ms. Fluoroscopy confirmed a stuck leaflet disk. Thrombolysis was performed using a low-dose ultra-slow infusion of thrombolytic therapy (1 mg/h of tissue-type plasminogen activator) with the restoration of normal valve function after 8 days. A repeat transthoracic echocardiography showed a decrease in the peak and mean gradients to 37 and 21 mmHg, respectively, with an improvement in the DVI to 0.53. Repeat fluoroscopy confirmed the opening of both leaflet disks.

Discussion

Treatment options for mechanical aortic valve thrombosis are either slow-infusion, low-dose thrombolytic therapy or emergency surgery. The hypercoagulable state of pregnancy makes adequate anticoagulation, proper monitoring, and medication adherence even more critical to prevent valve thrombosis. Physicians should educate pregnant patients on anticoagulation strategies and participate in shared decision-making.
Obesity-induced vena cava compression syndrome: a case report of a rare precipitant of a type 2 myocardial infarction in a patient with critical aortic stenosis
Authors: Sellers Alexander M , Alam Ferdous , Bennetts Jayme S , Lehman Sam J , Sinhal Ajay R
Published: December 2022

Background

Obesity is a global health problem of increasing prevalence with a broad range of multisystem complications. An under-recognized complication of severe obesity is the potential haemodynamic compromise that may arise due to pathological external compression of the inferior vena cava whilst lying in the supine position, a phenomenon known as obesity-induced vena cava compression syndrome.

Case summary

A 56-year-old independent woman presented to a rural Australian hospital for routine dressing care for bilateral lymphoedema on a background of class III morbid obesity (weight 197 kg, body mass index 68.55 kg/m3) and aortic stenosis. Whilst laid in the supine position with both legs elevated to aid lower limb venous return, the patient developed angina with associated troponin rise (15 to 75 to 332 ng/L) and inferolateral territory ischaemic changes on electrocardiogram. The pain then resolved shortly after restoring the patient to the upright position. A transthoracic echocardiogram showed critical bicuspid aortic stenosis. Computerized tomography coronary angiogram showed no significant coronary artery disease. Following multidisciplinary discussions, a transcatheter aortic valve insertion was performed via a transfemoral approach. Post-procedure, she went into atrial fibrillation, she was cardioverted into a sinus rhythm with new left bundle branch block. There were no complications otherwise, and the patient was discharged home following a brief period of convalescence.

Discussion

We describe a case of suspected obesity-induced vena cava compression syndrome precipitating a type 2 myocardial infarction in a pre-load dependent patient with critical bicuspid valve aortic stenosis. This case highlights a potential haemodynamic consequence of morbid obesity in the supine position.
Translational opportunities of single-cell biology in atherosclerosis
Authors: de Winther Menno P J , Bäck Magnus , Evans Paul , Gomez Delphine , Goncalves Isabel , Jørgensen Helle F , Koenen Rory R , Lutgens Esther , Norata Giuseppe Danilo , Osto Elena , Dib Lea , Simons Michael , Stellos Konstantinos , Ylä-Herttuala Seppo , Winkels Holger , Bochaton-Piallat Marie-Luce , Monaco Claudia
Published: December 2022

The advent of single-cell biology opens a new chapter for understanding human biological processes and for diagnosing, monitoring, and treating disease. This revolution now reaches the field of cardiovascular disease (CVD). New technologies to interrogate CVD samples at single-cell resolution are allowing the identification of novel cell communities that are important in shaping disease development and direct towards new therapeutic strategies. These approaches have begun to revolutionize atherosclerosis pathology and redraw our understanding of disease development. This review discusses the state-of-the-art of single-cell analysis of atherosclerotic plaques, with a particular focus on human lesions, and presents the current resolution of cellular subpopulations and their heterogeneity and plasticity in relation to clinically relevant features. Opportunities and pitfalls of current technologies as well as the clinical impact of single-cell technologies in CVD patient care are highlighted, advocating for multidisciplinary and international collaborative efforts to join the cellular dots of CVD.
Empagliflozin, irrespective of blood pressure, improves outcomes in heart failure with preserved ejection fraction: the EMPEROR-Preserved trial
Authors: Böhm Michael , Anker Stefan , Mahfoud Felix , Lauder Lucas , Filippatos Gerasimos , Ferreira João Pedro , Pocock Stuart J , Brueckmann Martina , Saloustros Ilias , Schüler Elke , Wanner Christoph , Zannad Faiez , Packer Milton , Butler Javed
Published: December 2022

Aims

Empagliflozin reduces the risk of cardiovascular death or heart failure (HF) hospitalization in patients with HF and preserved ejection fraction. This study aims to evaluate if systolic blood pressure (SBP) moderates these effects.

Methods and results

The association of SBP and the treatment effects of empagliflozin in EMPEROR-Preserved (empagliflozin outcome trial in patients with chronic heart failure with preserved ejection fraction) was evaluated. Randomized patients (n = 5988) were grouped according to SBP at baseline (<110 mmHg, n = 455; 110–130 mmHg, n = 2415; > 130 mmHg, n = 3118). The effect of empagliflozin on blood pressure, cardiovascular death or HF hospitalization (primary outcome), total HF hospitalizations, and rate of decline in estimated glomerular filtration rate was studied. Over a median of 26.2 months, the placebo-corrected decline was small and not significantly different across baseline SBP. On placebo, the risk of cardiovascular death or hospitalization for HF was 8.58 at >130 mmHg, 8.26 at 110–130 mmHg, and 11.59 events per 100 patient-years at <110 mmHg (P = 0.12 vs. > 130 mmHg, P = 0.08 vs. 110–130 mmHg). There was no evidence for baseline SBP moderating the effect of empagliflozin on risk of HF events (primary endpoint interaction P = 0.69, recurrent HF hospitalizations interaction P = 0.55). When comparing empagliflozin with placebo, SBP did not meaningfully associate with adverse events such as hypotension, volume depletion, and acute renal failure.

Conclusion

In EMPEROR-Preserved, empagliflozin was effective and safe without SBP meaningfully moderating empagliflozin’s treatment effects. This analysis of EMPEROR-Preserved shows that empagliflozin can be used safely and effectively without blood pressure being a meaningful moderator of the drug benefit.

Clinical Trial Registration

URL: https://www.clinicaltrials.gov Unique identifier: NCT03057951
Lifetime risk of comorbidity in patients with simple congenital heart disease: a Danish nationwide study
Authors: El-Chouli Mohamad , Meddis Alessandra , Christensen Daniel M , Gerds Thomas A , Sehested Thomas , Malmborg Morten , Phelps Matthew , Bang Casper N , Ahlehoff Ole , Torp-Pedersen Christian , Sindet-Pedersen Caroline , Raunsø Jakob , Idorn Lars , Gislason Gunnar
Published: December 2022

Aims

In a continuously ageing population of patients with congenital heart disease (CHD), understanding the long-term risk of morbidity is crucial. The aim of this study was to compare the lifetime risks of developing comorbidities in patients with simple CHD and matched controls.

Methods and results

Using the Danish nationwide registers spanning from 1977 to 2018, simple CHD cases were defined as isolated atrial septal defect (ASD), ventricular septal defect (VSD), pulmonary stenosis, or patent ductus arteriosus in patients surviving until at least 5 years of age. There were 10 controls identified per case. Reported were absolute lifetime risks and lifetime risk differences (between patients with simple CHD and controls) of incident comorbidities stratified by groups and specific cardiovascular comorbidities. Of the included 17 157 individuals with simple CHD, the largest subgroups were ASD (37.7%) and VSD (33.9%), and 52% were females. The median follow-up time for patients with CHD was 21.2 years (interquartile range: 9.4–39.0) and for controls, 19.8 years (9.0–37.0). The lifetime risks for the investigated comorbidities were higher and appeared overall at younger ages for simple CHD compared with controls, except for neoplasms and chronic kidney disease. The lifetime risk difference among the comorbidity groups was highest for neurological disease (male: 15.2%, female: 11.3%), pulmonary disease (male: 9.1%, female: 11.7%), and among the specific comorbidities for stroke (male: 18.9%, female: 11.4%). The overall risk of stroke in patients with simple CHD was mainly driven by ASD (male: 28.9%, female: 17.5%), while the risks of myocardial infarction and heart failure were driven by VSD. The associated lifetime risks of stroke, myocardial infarction, and heart failure in both sexes were smaller in invasively treated patients compared with untreated patients with simple CHD.

Conclusion

Patients with simple CHD had increased lifetime risks of all comorbidities compared with matched controls, except for neoplasms and chronic kidney disease. These findings highlight the need for increased attention towards early management of comorbidity risk factors.
Association between social jetlag and sugar-sweetened beverages (SSBs) in adolescents in Western Canada
Authors: Zhang Kexin , Guhn Martin , Conklin Annalijn I
Published: December 2022

Background

Sleep debt is linked to poor health behaviours, and adolescents may be especially vulnerable to deficit from the mismatch of their late chronotype with socially determined sleep timing. We aimed to investigate the potential association between social jetlag and sugar-sweetened beverages (SSBs) consumption among adolescents.

Methods

Cross-sectional data from 1031 adolescents (13–18 years) who participated in the population-based British Columbia Adolescent Substance Use Survey in 2012. Regression analysis using interaction terms estimated the associations between social jetlag (using self-reported weekday/weekends sleep times) and odds of SSB intake in girls and boys.

Results

On average, adolescents reported 1.59 (SD 0.73) hours of social jetlag, but girls had significantly more social jetlag (1.64) than boys (1.52). Most adolescents (84%) reported consuming SSBs, and significantly more boys (87%) than girls (81%); median SSB intake in boys was 1–2 times per week and in girls less than once per week. Significant differences in girls consuming any SSB were seen across levels of social jetlag. The odds of any SSB intake were significantly higher in adolescents with social jetlag between 1 and 2 h [odds ratio (OR): 1.6 (1.14–2.38)] and over 2 h [OR 1.87 (1.11–3.14)], compared with 1 h or less; associations were stronger and only significant in girls.

Conclusions

This study is the first to show social jetlag is a common sleep deficit that is associated with SSB intake in adolescents, particularly among teen girls.
Job satisfaction criteria to improve general practitioner recruitment: a Delphi consensus
Authors: Le Floch Bernard , Bastiaens Hilde , Le Reste Jean-Yves , Nabbe Patrice , Le Floch Perrine , Cam Mael , Montier Tristan , Peremans Lieve
Published: December 2022

Background

The clinical general practitioner (GP) workforce is decreasing. Many studies have analysed the negative aspects of the profession but, few examine the positive aspects and job satisfaction. A European collaborative group including 8 participating countries recently conducted a qualitative study to analyse the positive factors and found 31 job satisfaction factors.

Objectives

To determine which of these 31 factors are important and applicable to future policies to improve family medicine attractiveness, recruitment, and retention in France.

Method

The Delphi consensus method was chosen. Two Delphi rounds were conducted in March–April 2017 and retained satisfaction factors with at least 70% of scores ≥7. The Nominal Group Technique (NGT) was used to rank these retained factors. Participants assigned 5 points to the factor they considered most important, 3 points to the second, and 1 point to the third. Factors receiving at least 5% (10 points) of the total points (198 points) were included in the final list. The expert panel included GPs and non-GPs.

Results

Twenty-nine experts began the procedure and 22 completed it. Thirty factors were retained after the 2 Delphi rounds. The NGT resulted in 8 factors: (i) Engage in family medicine to take care of the patients; (ii) Care coordination, patient advocacy; (iii) Flexibility in work; (iv) Trying to be a person-centred doctor; (v) Involvement in healthcare organization; (vi) Benefiting from a well-managed practice; (vii) Being a teacher, a trainer; (viii) Efficient professional collaboration.

Conclusion

These 8 job satisfaction factors are important to consider and apply to future policy development.
Bacterial diversity across four drinking water distribution systems in Croatia: impacts of water management practices and disinfection by-products
Authors: Štiglić Jurica , Ujević Bošnjak Magdalena , Héry Marina , Kurajica Livia , Kinsela Andrew S , Casiot Corinne , Capak Krunoslav
Published: December 2022

Several factors may impact bacterial diversity in drinking water distribution systems (DWDSs) including the origin of the raw water, the water treatment technologies, and the disinfection practices applied. 16S rRNA metabarcoding was used for the in-depth characterization of bacterial communities in the four studied Croatian DWDSs (A, B, C, D) two of which had residual disinfectant (A, B) and two were without (C, D), while only B utilized the conventional water treatment technology. Significantly higher diversity and species richness were evidenced in non-disinfected DWDSs (P<0.05) compared to disinfected DWDSs. The phylum Proteobacteria was the most abundant in all the DWDSs, being proportionately higher in non-disinfected systems (P<0.05). The most abundant genera in DWDS-A Mycobacterium and Sphingomonas both positively correlated, whereas Lactobacillus negatively correlated with the concentration of disinfection by-products (DBPs) as a sum of haloacetic acids (HAAs). Conversely, the genus Ralstonia positively correlated with the individual DBP dichloroacetic acid. These results indicate that genera Sphingomonas, Mycobacterium, Lactobacillus, and Ralstonia could have an effect on promoting the formation of DBPs, in a similar manner to how negatively correlated taxa may influence their degradation.
Janthinobacterium kumbetense sp. nov., a violacein-producing bacterium isolated from spring water in Turkey, and investigation of antimicrobial activity of violacein
Authors: INAN BEKTAS Kadriye , Nalcaoglu Aleyna , Kati Hatice , Ceylan Esma , Nalcacioglu Remziye , Belduz Ali Osman , Canakci Sabriye
Published: December 2022

Strain GKT was isolated from the Kumbet plateu of Giresun in Turkey. Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain GKT belonged to genus Janthinobacterium and 16S rRNA gene sequence similarities with all type strains of the genus Janthinobacterium were 98.89%–99.78%. The calculated pairwise average nucleotide identity (ANI) values between strain GKT and all type strains of Janthinobacterium species were in the range of 79.8%–93.2%. In addition, digital DNA–DNA hybridization (dDDH) values were in the range of 23.0%–51.7%. Major fatty acids are C10:03OH, C12:0, C16:1ω7c, C16:0, and C18:1ω7c, and polar lipids included phosphatidylethanolamine, phosphatidylglycerol, also one unidentified phospholipid and one unidentified aminophospholipid. The respiratory quinone of strain GKT was determinated to be Q-8. The genome sizes of strain GKT was 6 197 538 bp with 63.16% G + C ratio. Strain GKT is Gram-stain-negative, aerobic, rod-shaped, and motile. A violet pigment was produced by strain GKT. The crude violacein pigments were separated into two diferent bands on a TLC sheet. Then violacein and deoxyviolacein were purifed by vacuum liquid column chromatography and identifed by NMR spectroscopy. The antimicrobial activities of purifed violacein and deoxyviolacein were screened for seven microorganisms. Based on the results of the morphological, biochemical, physiological, phylogenetic, and genomic characteristics, we propose classifying the strain GKT as representative of a novel species of the genus Janthinobacterium, for which the name Janthinobacterium kumbetense sp. nov. is proposed (GKT = LMG 32662T = DSM 114233T).
Writing and Selfhood in the Pedagogy of Célestin Freinet
Authors: Mason Richard
Published: December 2022

This article explores the relationship between writing and selfhood in the thought and practice of the French pedagogue Célestin Freinet. After setting out the centrality of writing practices to Freinetian pedagogy, the article analyses writing’s conceptual parameters within this context, stressing in particular Freinet’s desire to make the classroom permeable to the outside world, and the vitalist orientation of his approach. Freinet’s educational politics and his iconoclastic attitude towards the orthodoxies of the
école républicaine
led him to refuse the educational and cultural privilege traditionally accorded to writing. In keeping with broader tendencies within the international New Education movement, Freinet prioritized instead a more inclusive notion of expression. This article explores in particular Freinet’s conception of the passage from lived experience to written expression, as well as his promotion of collective expressive practices over individualized models of creativity and authorship. More broadly, the article invites consideration of what examples drawn from the domain of education might have to offer transdisciplinary reflections on the relationship between writing and selfhood.
Daytime Napping and Cognitive Health in Older Adults: A Systematic Review
Authors: Li Junxin , McPhillips Miranda V , Deng Zhongyue , Fan Fangfang , Spira Adam
Published: December 2022

Background

Daytime napping may improve cognitive function in older adults. However, the association can be complicated by specific features of napping and the older adult’s health. This systematic review aims to synthesize the current literature on napping and cognition in older adults and provide recommendations for future research and daytime sleep practice in older adults.

Methods

Systematic searches for relative research published between January 1995 and October 2022 were conducted at PubMed, MEDLINE, PsycINFO, and Google Scholar using keywords individually and in multiple combinations. Manual searches were performed to identify additional studies. All included studies were critically appraised by 2 authors.

Results

Thirty-five studies, including 23 observational and 12 intervention studies, were reviewed. Findings from observational studies suggest a possible inverted U-shaped association between napping duration and cognitive function: short and moderate duration of naps benefited cognitive health in older adults compared with both non-napping and long or extended napping. Findings from intervention studies suggest one session of afternoon napping might improve psychomotor function and working memory, although with some inconsistency. The effect of multiple nap sessions on cognition was inconclusive due to a limited number of studies.

Conclusion

More rigorous research studies are needed to investigate what causes different patterns of daytime napping, the associations between these distinct patterns and cognitive function, and to determine whether interventions targeting napping patterns can improve cognition in older adults. In addition, future research needs to comprehensively assess daytime napping using a combination of measures such as sleep diary and actigraphy.
The Intersectional Impact of Race/Ethnicity and Sex on Access to Technology Among Older Adults
Authors: Suntai Zainab , Beltran Susanny J
Published: December 2022

Background and Objectives

Research on technological access and usage has revealed a digital divide based on several sociodemographic factors, including race/ethnicity, sex, income, and education. While several studies have examined these factors separately, few studies have considered how multiple vulnerable identities may combine to influence access to technology. Using the theory of intersectionality, this study assesses the combined impact of race/ethnicity and sex on access to a working cellphone and a working laptop/computer among U.S. older adults.

Research Design and Methods

Data were derived from the 2018 National Health and Aging Trends Study. Chi-square tests were used to test group differences, and four multivariable logistic regression models were used to examine the association between the intersection of race/ethnicity and sex, and access to a working cellphone and a working laptop/computer.

Results

After accounting for other explanatory variables, White female participants, Black male participants, Black female participants, Hispanic male participants, and Hispanic female participants were all less likely to have a working cellphone or a working laptop/computer compared to White male participants.

Discussion and Implications

The results of this study point to a significant disparity in access to technology based on intersectional identities, with Black and Hispanic female participants having the least access to technology. Interventions aiming to improve access to technology should target these two groups, with a focus on reducing the cost of purchasing technological equipment and the provision of training programs that improve technological skills.
A Randomized Control Trial for ReDeSign: A Dementia-Friendly Mobile Microlearning Training for Store Workers in Japan
Authors: Matsumoto Hiroshige , Hagiwara Yasuhiro , Yamamoto-Mitani Noriko , Igarashi Ayumi
Published: December 2022

Background and Objectives

Dementia-friendly training should be incorporated in neighborhood stores for people living with dementia to maintain engagement in social activities. However, there is a lack of evidence of dementia-friendly training in these workplaces, and existing trainings have time constraints. We developed a mobile microlearning program based on stigma theory and the bystander intervention model. This study aimed to evaluate the microlearning program’s effectiveness.

Research Design and Methods

Convenience store workers in Tokyo were recruited for a randomized, waiting-list, and controlled trial. The intervention group completed a 50-min online course. The primary outcome was an attitude toward people living with dementia. The secondary outcomes were knowledge of dementia and helping behavior toward customers suspected of having dementia. Data were collected at baseline, after 1 month, and 4 months following the randomization.

Results

Process evaluations confirmed satisfaction and high completion rates of the program. In total, 150 participants were included in the analysis. The intervention group showed significantly greater improvements in attitude (Hedge’s g = 0.70) and knowledge (g = 0.59) after 1 month, compared to the control group. Helping behavior increased in the intervention group, although it did not differ significantly between the groups. All outcomes remained significantly improved after 4 months.

Discussion and Implications

The findings provide evidence that dementia-friendly training reduces the general public’s stigma and increases helping behavior in stores. Mitigation of time constraints through mobile microlearning is expected to contribute to the dissemination and help people living with dementia maintain their social participation in the communities.

Clinical Trials Registration Number: UMIN000043623
3-D complex resistivity imaging using controlled source electromagnetic data: a multistage procedure using a second order polynomial parametrization
Authors: Porté J , Bretaudeau F , Girard J F
Published: December 2022

In some Earth materials, significant induced polarization (IP) phenomena are occurring when an electric perturbation is applied. These mechanisms are described by a frequency-dependent complex resistivity (CR). The study of the CR spectral signature allows to access indirectly to several properties of interest of the subsurface linked to the interaction between the pore space and fluids. CR is usually studied using the electrical method with a direct current approximation, neglecting by the way electromagnetic (EM) induction that can occur in the data. However, EM induction increases with frequency and offset, resulting in limitations at high frequencies or for the investigation of deep target. We implemented a frequency-dependent CR in a 3-D finite-differences (FD) modelling and inversion code for frequency domain controlled-source electromagnetic (CSEM) data to take into consideration IP information contained in EM data or reciprocally. The CSEM methods are resistivity imaging techniques using multifrequency EM fields that fully take into account EM induction with large investigation depth. Following a preliminary sensitivity study, a multistage inversion framework was designed to constrain the multiparameter inverse problem. Furthermore, to manage the increasing number of parameters, a second-order polynomial parametrization is used to describe independently frequency variation of CR norm and phase. We demonstrate the method through 1-D and 3-D synthetic data inversions for a deep-target model. We show that we were able to recover the CR and its frequency variation from CSEM data in the IP/EM coupling domain for 1-D targets. The problem of deep polarizable 3-D targets is more challenging and the resolution of the recovered CR spectrum was impacted. Nevertheless, we retrieved from a model containing several polarizable anomalies some crucial information allowing the discrimination of the targets from the non-polarizable background and from different spectral CR signatures. Our inversion strategy allows thus accessing to IP parameters of the medium in an extended frequency domain by fully taking EM induction information into account.
MaDREB1F confers cold and drought stress resistance through common regulation of hormone synthesis and protectant metabolite contents in banana
Authors: Xu Yi , Hu Wei , Song Shun , Ye Xiaoxue , Ding Zehong , Liu Juhua , Wang Zhuo , Li Jingyang , Hou Xiaowan , Xu Biyu , Jin Zhiqiang
Published: December 2022

Adverse environmental factors severely affect crop productivity. Improving crop resistance to multiple stressors is an important breeding goal. Although CBFs/DREB1s extensively participate in plant resistance to abiotic stress, the common mechanism underlying CBFs/DREB1s that mediate resistance to multiple stressors remains unclear. Here, we show the common mechanism for MaDREB1F conferring cold and drought stress resistance in banana. MaDREB1F encodes a dehydration-responsive element binding protein (DREB) transcription factor with nuclear localization and transcriptional activity. MaDREB1F expression is significantly induced after cold, osmotic, and salt treatments. MaDREB1F overexpression increases banana resistance to cold and drought stress by common modulation of the protectant metabolite levels of soluble sugar and proline, activating the antioxidant system, and promoting jasmonate and ethylene syntheses. Transcriptomic analysis shows that MaDREB1F activates or alleviates the repression of jasmonate and ethylene biosynthetic genes under cold and drought conditions. Moreover, MaDREB1F directly activates the promoter activities of MaAOC4 and MaACO20 for jasmonate and ethylene syntheses, respectively, under cold and drought conditions. MaDREB1F also targets the MaERF11 promoter to activate MaACO20 expression for ethylene synthesis under drought stress. Together, our findings offer new insight into the common mechanism underlying CBF/DREB1-mediated cold and drought stress resistance, which has substantial implications for engineering cold- and drought-tolerant crops.
Assessing the digital literacy levels of the community pharmacy workforce using a survey tool
Authors: Crilly Philip , Fletcher John , Chandegra Nishma , Khalefa Asem , Rouf S K M , Zein Mohamed , Kayyali Reem
Published: December 2022

Objectives

To investigate the digital literacy of staff in London, UK, community pharmacies and to explore their perceptions about the use of eHealth tools.

Methods

The study population was community pharmacy staff (N = 21,346) in Greater London. A survey tool was divided into six sections: Use of the internet; Use of social media; Use of mobile health applications (MHAs); Perception of and practical use of digital health tools; Scenario-based questions and demographics. Responses were analysed in SPSS. Following data collection, Health Education England’s (HEE’s) Digital Capabilities Framework (DCF) was published. The authors mapped the survey tool retrospectively to the framework.

Key findings

Almost all respondents (98.0%, n = 551/562) used eHealth tools at work, mainly to access medicine information (89.8%, n = 495/551). Almost one-third (31.7%, N = 178/562) used social media regularly, while many (79.4%, N = 446/562) were aware of MHAs. Self-perceived digital literacy indicated that 63.3% (n = 356/562) deemed themselves to be above average. Under 35s rated their digital literacy more highly than over 35s (P < 0.001). HEE’s DCF indicated that actual digital literacy was lower than that of self-perceived. Despite the high use of eHealth tools, respondents were reluctant to recommend these to the public for health advice.

Conclusions

Community pharmacy staff self-report their digital literacy to be high yet do not use these skills for public health purposes. Furthermore, these self-reported skills appear to be over-estimated. Despite high levels of use of digital tools at work, staff do not use them for public health, therefore, further training to build confidence to better utilise them is recommended.
A systematic review on methods for developing and validating deprescribing tools for older adults with limited life expectancy
Authors: Shrestha Shakti , Poudel Arjun , Forough Ayda S , Steadman Kathryn J , Nissen Lisa M
Published: December 2022

Objectives

A number of deprescribing tools are available to assist clinicians to make decisions on medication management. We aimed to review deprescribing tools that may be used with older adults that have limited life expectancy (LLE), including those at the palliative and end-of-life stage, and consider the rigour with which the tools were developed and validated.

Key findings

Literature was searched in PubMed, Embase, CINHAL and Google Scholar until February 2021 for studies involving the development and/or consensus validation of deprescribing tools targeting those aged ≥65 years with LLE. We were interested in the tool development process, tool validation process and clinical components addressed by the tool.

Six studies were included. The approaches followed for tool development were systematic review (n = 3), expert-literature review (n = 2) and concept data (n = 1). The content included a list of disease-non-specific medications divided with or without recommendations (n = 4) and disease-specific medications with recommendations (n = 2). The tool validation was performed using the Delphi method (n = 4) or GRADE framework (n = 2) with panel size ranging from 8 to 17 and 60–80% consensus agreement with or without a rating scale. LLE targeted were ≤1 year (n = 2) or ≤3 months (n = 1).

There is a limited number of deprescribing tools with consensus validation available for use in older adults with LLE. These tools are either targeted for disease-specific medication/medication class guided by the GRADE framework or targeted for a list of medications or medication classes irrespective of disease that are developed using a combination of approaches and validated using a Delphi method.
Discharge to post–acute care and other predictors of prolonged length of stay during the initial COVID-19 surge: a single site analysis
Authors: O’neil Jessica C , Geisler Benjamin P , Rusinak Donna , Bassett Ingrid V , Triant Virginia A , Mckenzie Rachael , Mattison Melissa L , Baughman Amy W
Published: December 2022

Background

During the initial surge of coronavirus disease 2019 (COVID-19), health-care utilization fluctuated dramatically, straining acute hospital capacity across the USA and potentially contributing to excess mortality.

Methods

This was an observational retrospective study of patients with COVID-19 admitted to a large US urban academic medical center during a 12-week COVID-19 surge in the Spring of 2020. We describe patterns in length of stay (LOS) over time. Our outcome of interest was prolonged LOS (PLOS), which we defined as 7 or more days. We performed univariate analyses of patient characteristics, clinical outcomes and discharge disposition to evaluate the association of each variable with PLOS and developed a final multivariate model via backward elimination, wherein all variables with a P-value above 0.05 were eliminated in a stepwise fashion.

Results

The cohort included 1366 patients, of whom 13% died and 29% were readmitted within 30 days. The LOS (mean: 12.6) fell over time (P < 0.0001). Predictors of PLOS included discharge to a post–acute care (PAC) facility (odds ratio [OR]: 11.9, 95% confidence interval [CI] 2.6–54.0), uninsured status (OR 3.2, CI 1.1–9.1) and requiring intensive care and intubation (OR 18.4, CI 11.5–29.6). Patients had a higher readmission rate if discharged to PAC facilities (40%) or home with home health agency (HHA) services (38%) as compared to patients discharged home without HHA services (26%) (P < 0.0001).

Conclusion

Patients hospitalized with COVID-19 during a US COVID-19 surge had a PLOS and high readmission rate. Lack of insurance, an intensive care unit stay and a decision to discharge to a PAC facility were associated with a PLOS. Efforts to decrease LOS and optimize hospital capacity during COVID-19 surges may benefit from focusing on increasing PAC and HHA capacity and resources.
From guo to tianxia: linking two Daoist theories of International Relations
Authors: Joshi Devin
Published: December 2022

This study examines the international relations theory (IRT) of Daoism, one of Asia’s long-standing traditions to have theorized international politics. Drawing upon Laozi’s Dao De Jing, this study elucidates two Daoist IR theories. First, Laozi provides a state-focused guo-based IRT for conducting foreign policy and managing inter-state relations with emphasis on yielding and softness to overcome violence and domination. Second, Laozi offers a Utopian and globalist tianxia-centered IRT based on following the Dao whereby inter-state rivalry is dissolved in favor of peaceful planetary governance in harmony with the natural rhythms of the cosmos. Whereas previous scholarship often concentrates on only one of these two scenarios, I argue the two visions are tightly connected with the more pragmatic first theory envisioned as a stepping stone to obtaining the second. This link demonstrates how Daoism offers a sophisticated non-Western IRT with relevance to addressing planetary challenges today.
Oral ciprofloxacin activity against ceftriaxone-resistantEscherichia coliin anin vitrobladder infection model
Authors: Abbott Iain J , van Gorp Elke , Cottingham Hugh , Macesic Nenad , Wallis Steven C , Roberts Jason A , Meletiadis Joseph , Peleg Anton Y
Published: December 2022

Objectives

Pharmacodynamic profiling of oral ciprofloxacin dosing for urinary tract infections caused by ceftriaxone-resistant Escherichia coli isolates with ciprofloxacin MIC ≥ 0.25 mg/L.

Background

Urine-specific breakpoints for ciprofloxacin do not exist. However, high urinary concentrations may promote efficacy in isolates with low-level resistance.

Methods

Ceftriaxone-resistant E. coli urinary isolates were screened for ciprofloxacin susceptibility. Fifteen representative strains were selected and tested using a dynamic bladder infection model. Oral ciprofloxacin dosing was simulated over 3 days (250 mg daily, 500 mg daily, 250 mg 12 hourly, 500 mg 12 hourly and 750 mg 12 hourly). The model was run for 96 h. Primary endpoint was change in bacterial density at 72 h. Secondary endpoints were follow-up change in bacterial density at 96 h and area-under-bacterial-kill-curve. Bacterial response was related to exposure (AUC0–24/MIC; Cmax/MIC). PTA was determined using Monte-Carlo simulation.

Results

Ninety-three clinical isolates demonstrated a trimodal ciprofloxacin MIC distribution (modal MICs at 0.016, 0.25 and 32 mg/L). Fifteen selected clinical isolates (ciprofloxacin MIC 0.25–512 mg/L) had a broad range of quinolone-resistance genes. Following ciprofloxacin exposure, E. coli ATCC 25922 (MIC 0.008 mg/L) was killed in all dosing experiments. Six isolates (MIC ≥ 16 mg/L) regrew in all experiments. Remaining isolates (MIC 0.25–8 mg/L) regrew variably after an initial period of killing, depending on simulated ciprofloxacin dose. A >95% PTA, using AUC0–24/MIC targets, supported 250 mg 12 hourly for susceptible isolates (MIC ≤ 0.25 mg/L). For isolates with MIC ≤ 1 mg/L, 750 mg 12 hourly promoted 3 log10 kill at the end of treatment (72 h), 1 log10 kill at follow-up (96 h) and 90% maximal activity (AUBKC0–96).

Conclusions

Bladder infection modelling supports oral ciprofloxacin activity against E. coli with low-level resistance (ciprofloxacin MIC ≤ 1 mg/L) when using high dose therapy (750 mg 12 hourly).
In vitro activity of gepotidacin against urine isolates of Escherichia coli from outpatient departments in Germany
Authors: Kresken Michael , Wohlfarth Esther , Weikel Chase , Butler Deborah , Pfeifer Yvonne , Werner Guido ,   ‘Antimicrobial Resistance’ Study Group of the Paul Ehrlich Society for Infection Therapy, Anlauf G , Berwian E , Korkmaz M , Wernicke S , Artz L , Baadte B , Betz U , Cremer J , Eigner U , Esser J , Fenner I , Ferner R , Friederichs C , Geisel R , Grundmann Y , Haas C , Haftendorn I , Hamann I , Hermann T , Hoffmann I , Holfelder M , Hönerlage W , Hugo F , Kolbert M , Krämer S , Krajewski R , Kühnen E , Mack D , Mair A , Meerbach A , Pranada A , Prian M , Purr I , Reinecke A , Reinhardt B , Sahly H , Schmitt S , Schuhmacher U , Siedlaczek A , Sitaru G , Sperber S , Stelter J , Wisplinghoff H , Wolff D , Wydra S , Zimmer C
Published: December 2022

Background

Escherichia coli is the leading pathogen of community-acquired urinary tract infections. Gepotidacin is a novel, bactericidal, first-in-class triazaacenaphthylene oral antibiotic that inhibits bacterial DNA replication by a distinct mechanism of action that confers activity against most strains of target pathogens, such as E. coli, Staphylococcus saprophyticus and Neisseria gonorrhoeae, including those resistant to other antibiotics.

Objectives

This study assessed the in vitro activity of gepotidacin in comparison with ciprofloxacin and other oral standard-of-care antibiotics using a large collection of urine isolates of E. coli obtained from outpatients in Germany.

Methods

Four hundred and sixty E. coli collected from 23 laboratories during a surveillance study in 2019/2020 were tested. Forty-six isolates (10.0%) produced an ESBL of the CTX-M family, half of which belonged to MDR clonal subgroups of E. coli ST131. Antibiotic susceptibilities were tested at a reference laboratory by broth microdilution according to the standard ISO 20776-1.

Results

Fifty-three (11.5%) isolates were ciprofloxacin resistant, 25 (47.2%) of which also produced an ESBL. Overall, MIC50/90 values for gepotidacin were 2/4 mg/L (MIC range 0.125–16 mg/L), with no differences in activity between ciprofloxacin-susceptible and ciprofloxacin-resistant isolates, ESBL-producing and non-ESBL isolates, O25b-ST131 isolates, and isolates susceptible or resistant to fosfomycin, mecillinam or nitrofurantoin.

Conclusions

Gepotidacin showed promising in vitro activity against urine isolates of E. coli, including ciprofloxacin-resistant isolates, ESBL-producing isolates and isolates resistant to oral standard-of-care antibiotics.
A novel peptide isolated from Catla skin collagen acts as a self-assembling scaffold promoting nucleation of calcium-deficient hydroxyapatite nanocrystals
Authors: Asokan Vishwadeep , Yelleti Geethika , Bhat Chetna , Bajaj Mayur , Banerjee Pradipta
Published: December 2022

Catla collagen hydrolysate (CH) was fractionated by chromatography and each fraction was subjected to HA nucleation, with the resultant HA-fraction composites being scored based on the structural and functional group of the HA formed. The process was repeated till a single peptide with augmented HA nucleation capacity was obtained. The peptide (4.6 kDa), exhibited high solubility, existed in polyproline-II conformation and displayed a dynamic yet stable hierarchical self-assembling property. The 3D modelling of the peptide revealed multiple calcium and phosphate binding sites and a high propensity to self-assemble. Structural analysis of the peptide-HA crystals revealed characteristic diffraction planes of HA with mineralization following the (002) plane, retention of the self-assembled hierarchy of the peptide and intense ionic interactions between carboxyl groups and calcium. The peptide-HA composite crystals were mostly of 25–40 nm dimensions and displayed 79% mineralization, 92% crystallinity, 39.25% porosity, 12GPa Young’s modulus and enhanced stability in physiological pH. Cells grown on peptide-HA depicted faster proliferation rates and higher levels of osteogenic markers. It was concluded that the prerequisite for HA nucleation by a peptide included: a conserved sequence with a unique charge topology allowing calcium chelation and its ability to form a dynamic self-assembled hierarchy for crystal propagation.
Molecular ecology of the sleeper shark subgenusSomniosus (Somniosus)reveals genetic homogeneity within species and lack of support forS. antarcticus
Authors: Timm Laura E , Tribuzio Cindy , Walter Ryan P , Larson Wesley A , Murray Brent W , Hussey Nigel E , Wildes Sharon
Published: December 2022

Inferences made from molecular data support regional stock assessment goals by providing insights into the genetic population dynamics of enigmatic species. Population genomics metrics, such as genetic diversity and population connectivity, serve as useful proxies for species health and stability. Sleeper sharks (genus Somniosus) are ecologically important deep-sea predators, estimated to reach ages of 250 to 300 yr and taking decades to reach sexual maturity. The subgenus Somniosus (Somniosus) is comprised of 3 species: S. pacificus, S. microcephalus, and S. antarcticus. Given the life history strategy of somniosids, they are vulnerable to overfishing and population declines. Further, data to assess the stocks of these species are limited. To address this deficiency, we used the reduced representation library method Restriction-site Associated DNA sequencing (RADseq) to conduct phylogenomic and population genomics analyses, providing novel information for use in stock assessments. Our results strongly support the species status of S. microcephalus (N = 79), but recover S. antarcticus (N = 2) intermixed within the S. pacificus (N = 170) clade. Population genomics analyses reveal genetic homogeneity within S. pacificus and S. microcephalus, and estimates of effective population size were in the hundreds for both species. Kinship analysis identified 2 first-degree relative pairs within our dataset (1 within each species). Our results contribute new information for stock assessments of these uniquely long-lived species by providing the strongest molecular evidence to date for the synonymization of S. antarcticus and S. pacificus, as well as estimating population genomic metrics for each supported species within the Somniosus (Somniosus) subgenus.