bluuebunny/crossref_metadata_2025 huggingface dataset:
Diversified Bund Vegetation Coupled With Flowering Plants Enhances Predator Population and Early-Season Pest Control
Authors: Qian Ping , Bai Yueliang , Zhou Wenwu , Yu Hang , Zhu Zijie , Wang Guiyao , Quais Md Khairul , Li Feiqiang , Chen Yue , Tan Ye , Shi Xiaoxiao , Wang Xueqin , Zhong Xueming , Zhu Zeng-Rong
Published: March 2021

Insecticide overuse in crop production systems often results in detrimental effects on predators and parasitoids, which regulate important insect pests. The natural enemies are also unable to survive in monocrop landscapes with the absence of shelter or food sources. Diversified vegetation, especially with flowering plants, can enhance natural enemy abundance and diversity, thus strengthening biological control, enabling farmers to reduce insecticides. In this study, we conserved bund vegetation and manipulated the existing rice landscapes with flowering plants to provide food and shelter for the biological control agents. Our study revealed significant positive relationships between predator densities and bund plant diversity. The abundance of predators significantly increased in the eco-engineered plots, especially at the flowering peaks compared to the insecticide-treated and control plots, while parasitoids were more diverse in both the eco-engineered and control plots. There were no significant differences in planthopper and leafhopper densities among the treatments during the rice early and maximum tillering stages, suggesting effective natural control of these herbivore pests in the eco-engineered plots at the early rice-growing season. However, at the heading stage relatively higher planthopper and leafhopper populations in the control and eco-engineered plots than in the insecticide-sprayed plots were recorded, suggesting perhaps the need for insecticide interventions if exceeding the threshold at this time. Our study indicates that manipulating the habitats surrounding the rice fields to enhance natural enemies is a sustainable practice in rice production as it can enhance the natural suppression of pests and thus reducing the need for insecticide.
Severe chronic aortic regurgitation after percutaneous coronary intervention: a case report and literature review
Authors: Wedin Johan O , Vikholm Per , Alström Ulrica , Schiller Petter
Published: March 2021

Background

Severe aortic regurgitation (AR) is an extremely rare complication after coronary catheterization and percutaneous coronary intervention (PCI), where most reported cases have required relatively urgent surgical intervention due to acute-onset AR and cardiac decompensation.

Case summary

We report a case of a 60-year-old woman that previously presented with a non-ST-elevation myocardial infarction (NSTEMI) due to an ostial right coronary artery stenosis. During the course of 2 years, she developed five recurrent NSTEMI due to in-stent thrombosis, necessitating either a new coronary stent or balloon. She developed a chronic severe AR due to a drug-eluting coronary stent protruding from the right coronary artery and underwent successful aortic valve replacement and coronary artery by-pass grafting.

Discussion

We performed a literature review and identified 16 reported cases of iatrogenic severe aortic regurgitation related to coronary catheterization or percutaneous coronary intervention. All patients developed an acute aortic regurgitation and, thus, we report the first case of a delayed complication caused by a protruding coronary stent. The surgical strategy is related to the extent of the damage, where smaller perforations or lacerations seems to be feasible for aortic valve repair and larger defects more often lead to aortic valve replacement. Our patient developed a fibrotic right coronary cusp which could not be used to perform a successful aortic valve repair.
Capecitabine-mediated heart failure in colorectal cancer: a case series
Authors: McAndrew Erin N , Jassal Davinder S , Goldenberg Benjamin A , Kim Christina A
Published: March 2021

Background

Capecitabine is a pyrimidine antimetabolite that inhibits thymidylate synthase and is commonly used in the treatment of colorectal cancer. Adverse cardiac side effects are reported in 1–18% of patients receiving Capecitabine. The most commonly proposed mechanism of cardiotoxicity in the setting of Capecitabine use is vasospasm of the coronary arteries. However, cardiotoxicity can also present as an acute coronary syndrome, arrhythmia, hypertension, and/or sudden cardiac death. Profound non-vasospastic cardiotoxicity is rare.

Case summary

We describe two cases of acute heart failure leading to cardiogenic shock in patients shortly after exposure to Capecitabine. Both patients did not demonstrate the characteristic transient ST elevation seen in patients with coronary artery vasospasms secondary to Capecitabine. Both patients required admission to the Acute Cardiac Care Unit requiring vasopressor and inotropic support. Thorough diagnostic investigations including echocardiography, cardiac magnetic resonance imaging, and cardiac computed tomography did not identify infarction, myocarditis, or any infiltrative process to explain their symptoms. Both patients had complete resolution of cardiac function, with no long-term sequalae.

Discussion

In patients receiving Capecitabine, reversible heart failure leading to cardiogenic shock should be considered as a potential cardiotoxic side effect.
T cell responses toChlamydia
Authors: D. Helble Jennifer , N. Starnbach Michael
Published: March 2021

Chlamydia trachomatis is the most commonly reported sexually transmitted infection in the United States. The high prevalence of infection and lack of a vaccine indicate a critical knowledge gap surrounding the host's response to infection and how to effectively generate protective immunity. The immune response to C. trachomatis is complex, with cells of the adaptive immune system playing a crucial role in bacterial clearance. Here, we discuss the CD4+ and CD8+ T cell response to Chlamydia, the importance of antigen specificity and the role of memory T cells during the recall response. Ultimately, a deeper understanding of protective immune responses is necessary to develop a vaccine that prevents the inflammatory diseases associated with Chlamydia infection.
The Mitragyna speciosa (Kratom) Genome: a resource for data-mining potent pharmaceuticals that impact human health
Authors: Brose Julia , Lau Kin H , Dang Thu Thuy Thi , Hamilton John P , Martins Lívia do Vale , Hamberger Britta , Hamberger Bjoern , Jiang Jiming , O’Connor Sarah E , Buell C Robin
Published: March 2021

Mitragyna speciosa (kratom) produces numerous compounds with pharmaceutical properties including the production of bioactive monoterpene indole and oxindole alkaloids. Using a linked-read approach, a 1,122,519,462 bp draft assembly of M. speciosa “Rifat” was generated with an N50 scaffold size of 1,020,971 bp and an N50 contig size of 70,448 bp that encodes 55,746 genes. Chromosome counting revealed that “Rifat” is a tetraploid with a base chromosome number of 11, which was further corroborated by orthology and syntenic analysis of the genome. Analysis of genes and clusters involved in specialized metabolism revealed genes putatively involved in alkaloid biosynthesis. Access to the genome of M. speciosa will facilitate an improved understanding of alkaloid biosynthesis and accelerate the production of bioactive alkaloids in heterologous hosts.
High-resolution genome-wide association study pinpoints metal transporter and chelator genes involved in the genetic control of element levels in maize grain
Authors: Wu Di , Tanaka Ryokei , Li Xiaowei , Ramstein Guillaume P , Cu Suong , Hamilton John P , Buell C Robin , Stangoulis James , Rocheford Torbert , Gore Michael A
Published: March 2021

Despite its importance to plant function and human health, the genetics underpinning element levels in maize grain remain largely unknown. Through a genome-wide association study in the maize Ames panel of nearly 2,000 inbred lines that was imputed with ∼7.7 million SNP markers, we investigated the genetic basis of natural variation for the concentration of 11 elements in grain. Novel associations were detected for the metal transporter genes rte2 (rotten ear2) and irt1 (iron-regulated transporter1) with boron and nickel, respectively. We also further resolved loci that were previously found to be associated with one or more of five elements (copper, iron, manganese, molybdenum, and/or zinc), with two metal chelator and five metal transporter candidate causal genes identified. The nas5 (nicotianamine synthase5) gene involved in the synthesis of nicotianamine, a metal chelator, was found associated with both zinc and iron and suggests a common genetic basis controlling the accumulation of these two metals in the grain. Furthermore, moderate predictive abilities were obtained for the 11 elemental grain phenotypes with two whole-genome prediction models: Bayesian Ridge Regression (0.33–0.51) and BayesB (0.33–0.53). Of the two models, BayesB, with its greater emphasis on large-effect loci, showed ∼4–10% higher predictive abilities for nickel, molybdenum, and copper. Altogether, our findings contribute to an improved genotype-phenotype map for grain element accumulation in maize.
X-ray microtomography–based atlas of mouse cranial development
Authors: Matula Jan , Tesarova Marketa , Zikmund Tomas , Kaucka Marketa , Adameyko Igor , Kaiser Jozef
Published: March 2021

Background

X-ray microtomography (μCT) has become an invaluable tool for non-destructive analysis of biological samples in the field of developmental biology. Mouse embryos are a typical model for investigation of human developmental diseases. By obtaining 3D high-resolution scans of the mouse embryo heads, we gain valuable morphological information about the structures prominent in the development of future face, brain, and sensory organs. The development of facial skeleton tracked in these μCT data provides a valuable background for further studies of congenital craniofacial diseases and normal development.

Findings

In this work, reusable tomographic data from 7 full 3D scans of mouse embryo heads are presented and made publicly available. The ages of these embryos range from E12.5 to E18.5. The samples were stained by phosphotungstic acid prior to scanning, which greatly enhanced the contrast of various tissues in the reconstructed images and enabled precise segmentation. The images were obtained on a laboratory-based μCT system. Furthermore, we provide manually segmented masks of mesenchymal condensations (for E12.5 and E13.5) and cartilage present in the nasal capsule of the scanned embryos.

Conclusion

We present a comprehensive dataset of X-ray 3D computed tomography images of the developing mouse head with high-quality manual segmentation masks of cartilaginous nasal capsules. The provided μCT images can be used for studying any other major structure within the developing mouse heads. The high quality of the manually segmented models of nasal capsules may be instrumental to understanding the complex process of the development of the face in a mouse model.
Oxygenation as a driving factor in epithelial differentiation at the air–liquid interface
Authors: Kouthouridis Sonya , Goepp Julie , Martini Carolina , Matthes Elizabeth , Hanrahan John W , Moraes Christopher
Published: March 2021

Culture at the air–liquid interface is broadly accepted as necessary for differentiation of cultured epithelial cells towards an in vivo-like phenotype. However, air–liquid interface cultures are expensive, laborious and challenging to scale for increased throughput applications. Deconstructing the microenvironmental parameters that drive these differentiation processes could circumvent these limitations, and here we hypothesize that reduced oxygenation due to diffusion limitations in liquid media limits differentiation in submerged cultures; and that this phenotype can be rescued by recreating normoxic conditions at the epithelial monolayer, even under submerged conditions. Guided by computational models, hyperoxygenation of atmospheric conditions was applied to manipulate oxygenation at the monolayer surface. The impact of this rescue condition was confirmed by assessing protein expression of hypoxia-sensitive markers. Differentiation of primary human bronchial epithelial cells isolated from healthy patients was then assessed in air–liquid interface, submerged and hyperoxygenated submerged culture conditions. Markers of differentiation, including epithelial layer thickness, tight junction formation, ciliated surface area and functional capacity for mucociliary clearance, were assessed and found to improve significantly in hyperoxygenated submerged cultures, beyond standard air–liquid interface or submerged culture conditions. These results demonstrate that an air–liquid interface is not necessary to produce highly differentiated epithelial structures, and that increased availability of oxygen and nutrient media can be leveraged as important strategies to improve epithelial differentiation for applications in respiratory toxicology and therapeutic development.
ImmuneDEX: a strategy for the genetic improvement of immune competence in Australian Angus cattle
Authors: Reverter Antonio , Hine Brad C , Porto-Neto Laercio , Li Yutao , Duff Christian J , Dominik Sonja , Ingham Aaron B
Published: March 2021

In animal breeding and genetics, the ability to cope with disease, here defined as immune competence (IC), with minimal detriment to growth and fertility is a desired objective which addresses both animal production and welfare considerations. However, defining and objectively measuring IC phenotypes using testing methods which are practical to apply on-farm has been challenging. Based on previously described protocols, we measured both cell-mediated immune response (Cell-IR) and antibody-mediated immune response (Ab-IR) and combined these measures to determine an animal’s IC. Using a population of 2,853 Australian Angus steers and heifers, we compared 2 alternative methods to combine both metrics into a single phenotype to be used as a tool for the genetic improvement of IC. The first method, named ZMEAN, is obtained by taking the average of the individual metrics after subjecting each to a Z-score standardization. The second, ImmuneDEX (IDEX), is a weighted average that considers the correlation between Cell-IR and Ab-IR, as well as the difference in ranking of individuals by each metric, and uses these as weights in the averaging. Both simulation and real data were used to understand the behavior of ZMEAN and IDEX. To further ascertain the relationship between IDEX and other traits of economic importance, we evaluated a range of traits related to growth, feedlot performance, and carcass characteristics. We report estimates of heritability of 0.31 ± 0.06 for Cell-IR, 0.42 ± 0.06 for Ab-IR, 0.42 ± 0.06 for ZMEAN and 0.370 ± 0.06 for IDEX, as well as a unity genetic correlation (rg) between ZMEAN and IDEX. While a moderately positive rg was estimated between Cell-IR and Ab-IR (rg = 0.33 ± 0.12), strongly positive estimates were obtained between IDEX and Cell-IR (rg = 0.80 ± 0.05) and between IDEX and Ab-IR (rg = 0.85 ± 0.04). We obtained a moderately negative rg between IC traits and growth including an rg = −0.38 ± 0.14 between IDEX and weaning weight, and negligible with carcass fat measurements, including an rg = −0.03 ± 0.12 between IDEX and marbling. Given that breeding with a sole focus on production might inadvertently increase susceptibility to disease and associated antibiotic use, our analyses suggest that ImmuneDEX will provide a basis to breed animals that are both highly productive and with an enhanced ability to resist disease.
Psychological Aspects in Early Adjustment After Severe Burn Injury
Authors: Sirancova Katarina , Raudenska Jaroslava , Zajicek Robert , Dolezal Daniel , Javurkova Alena
Published: March 2021

Burn injury is one of the most serious traumatic events with possible psychological and psychosocial consequences. Health status perception is one of the main health outcomes. The severity of psychological symptoms does not always correlate with that of the burn injury, suggesting that early screening for psychological vulnerabilities may be beneficial. The aim of our study was to identify the personality, clinical, and sociodemographic characteristics related to patient’s subjective perception of health, depression, and anxiety in a sample of 52 adult patients with severe burn injury shortly before discharge from specialty burn clinic. Subjective health perception was predicted by depression (β = −.143, t(47) = −3.94, P < .001) and neuroticism (β = -.106, t(43) = −4.83, P < .001), and it correlated positively with extraversion (r = .2858, P = .0465) and conscientiousness (r = .3663, P = .0096). Depression was predicted by neuroticism (F(1,49) = 18.4; P < .001) and correlated with attachment avoidance (r = .29, P = .0383) and negatively with extraversion (r = −.32, P = .0220). Anxiety was related to attachment anxiety (F(1,49) = 4.25; P = .045), neuroticism (F(1,49) = 15.75; P < .001), and agreeableness (r = −.36, P = .0101). Unemployed patients experienced higher levels of depression and anxiety. This research suggests that personality traits and adult attachment may play an important role in the acute phase of the recovery from a severe burn injury. These findings can be relevant for early intervention and holistic rehabilitation.
The Impact of Peer Support Group Programs on Psychosocial Outcomes for Burn Survivors and Caregivers: A Review of the Literature
Authors: Won Paul , Bello Mariel S , Stoycos Sarah A , Carrera Brenda T , Kurakazu Dawn M , Briere John , Garner Warren L , Gillenwater Justin , Yenikomshian Haig A
Published: March 2021

Peer support group programs are often recommended for burn survivors as a way to facilitate their psychosocial recovery and reintegration into the community. Such programs provide opportunities for burn patients and their caretakers to access emotional and informational support from healthcare providers and other survivors in inpatient or outpatient settings. Despite their popularity, however, there is little information currently available on the efficacy of these groups. In response, we reviewed the existing literature on peer support group programs and their impacts on psychosocial outcomes for burn survivors and their caregivers. A systematic review of the literature utilizing PubMed, PsycINFO, and Medline databases was conducted for articles published between 1990 and 2018. Twenty-five articles including inpatient, outpatient, integrative peer support groups, and burn camps met our inclusion criteria. All inpatient peer support group program articles (n = 4) reported associations with psychosocial improvements. Integrative peer support group program articles (n = 2) reported associations with social integration and reduction in post-traumatic stress and anxiety. All outpatient peer support group program articles (n = 8) demonstrated associations with psychosocial outcomes involving life satisfaction, acceptance of self, and reduced levels of isolation. Findings were less consistent for burn camps: eight articles suggested improvements in psychological outcomes while three articles reported no significant psychosocial effects. Although these results are encouraging, further study is indicated both to replicate these findings, and to determine the optimal implementation of inpatient and outpatient peer support programs.
Reevaluating Conscience Clauses
Authors: Kane Tiernan B
Published: March 2021

Ronit Stahl and Ezekiel Emanuel have recently issued a stark challenge to conscience protections in medical law and ethics. Their argument is flawed, however. They misrepresent the nature and relevance of conscientious protection in the military, misinterpret the scope of consent tendered by modern medical professionals, and offer no reason to think either that conscientious objection harms patient well-being or that such harm should solely determine the permissibility of conscientious objection. Moreover, and most fundamentally, Stahl and Emanuel do not recognize that conscience protections promote moral integrity, a basic aspect of human well-being that justifies protective action.
“Whatever it Takes”: Sexual Harassment in the Context of Resource Dependence
Authors: Beaton Erynn E , LePere-Schloop Megan , Smith Rebecca
Published: March 2021

Research suggests powerful resource dependencies are present in the public and nonprofit sectors. The individuals operating at the nexus between organizations and resource providers, and who mitigate dependencies, are referred to as boundary spanners. Research suggests that there may be both positive and negative personal repercussions for boundary spanners, but research has not sufficiently examined these unintended consequences through a gender lens. Bringing together research on resource dependence and sexual harassment, this study explores sexual harassment as an unintended consequence for boundary spanners of resource dependence mitigation strategies. Drawing on a feminist methodology and purposive sampling, we engaged in interviews with 36 professional fundraisers, a quintessential boundary spanning role, to examine the problem of sexual harassment by donors. These experiences leave fundraisers feeling harassed by donors and exploited by employers that pressure them to do “whatever it takes” to obtain donations. We contribute to research on resource dependence by surfacing sexual harassment and exploitation as unintended consequences for boundary spanners of strategies to mitigate organizational resource dependence. Our findings assist in reconsidering the assumptions that underly resource dependence theory and related research.
Two-step sampling can produce triphasic species–area relationship
Authors: Pan Xubin
Published: March 2021

Aims

It is important to explore the underlying mechanisms that cause triphasic species–area relationship (triphasic SAR) across different scales in order to understand the spatial patterns of biodiversity.

Methods

Instead of theory establishment or field data derivation, I adopted a data simulation method that used the power function of SAR to fit log-normal distribution of species abundance.

Important Findings

The results showed that one-step sampling caused biphasic SAR and n-step sampling could cause 2n-phasic SAR. Practical two-step sampling produced triphasic SAR due to the Preston and Pan effects in large areas. Furthermore, before exploring biological or ecological mechanisms for the nature phenomenon, we should identify or exclude potential mathematical, statistical or sampling reasons.
Functional analysis of XRCC4 mutations in reported microcephaly and growth defect patients in terms of radiosensitivity
Authors: Asa Anie Day D C , Wanotayan Rujira , Sharma Mukesh Kumar , Tsukada Kaima , Shimada Mikio , Matsumoto Yoshihisa
Published: March 2021

Non-homologous end joining is one of the main pathways for DNA double-strand break (DSB) repair and is also implicated in V(D)J recombination in immune system. Therefore, mutations in non-homologous end-joining (NHEJ) proteins were found to be associated with immunodeficiency in human as well as in model animals. Several human patients with mutations in XRCC4 were reported to exhibit microcephaly and growth defects, but unexpectedly showed normal immune function. Here, to evaluate the functionality of these disease-associated mutations of XRCC4 in terms of radiosensitivity, we generated stable transfectants expressing these mutants in XRCC4-deficient murine M10 cells and measured their radiosensitivity by colony formation assay. V83_S105del, R225X and D254Mfs*68 were expressed at a similar level to wild-type XRCC4, while W43R, R161Q and R275X were expressed at even higher level than wild-type XRCC4. The expression levels of DNA ligase IV in the transfectants with these mutants were comparable to that in the wild-type XRCC4 transfectant. The V83S_S105del transfectant and, to a lesser extent, D254Mfs*68 transfectant, showed substantially increased radiosensitivity compared to the wild-type XRCC4 transfectant. The W43R, R161Q, R225X and R275X transfectants showed a slight but statistically significant increase in radiosensitivity compared to the wild-type XRCC4 transfectant. When expressed as fusion proteins with Green fluorescent protein (GFP), R225X, R275X and D254Mfs*68 localized to the cytoplasm, whereas other mutants localized to the nucleus. These results collectively indicated that the defects of XRCC4 in patients might be mainly due to insufficiency in protein quantity and impaired functionality, underscoring the importance of XRCC4’s DSB repair function in normal development.
The Trope of the Papers: Rethinking the (Un)Documented in African American Literature
Authors: Arrizón-Palomera Esmeralda
Published: March 2021

I argue for a reconceptualization of undocumentedness, the experience of being undocumented, from an experience that is simply a result of the modern immigration regime to an experience that is a result of interlocking systems of oppression and resistance to them that has shaped Blackness and the vision for black liberation. I make this argument by defining and tracing the trope of the papers—the use of legal and extralegal documents to examine and document African Americans’ and other people of African descent’s relationship to the nation-state—in the slave narrative and the neo-slave narrative. I offer a close readings of slave narratives, including Sojourner Truth’s The Narrative of Sojourner Truth (1850) and Harriet Jacobs’ Incidents in the Life of a Slave Girl, Written by Herself, and neo-slave narratives, including Toni Morrison’s A Mercy (2008) and Gayl Jones’s Mosquito (1999), to illustrate the significance of the undocumented immigrant in African American literature and demonstrate that writers of African American literature have been thinking intensely about undocumentedness, although not in the way undocumentedness is typically understood.
Molecular correlates of immune cytolytic subgroups in colorectal cancer by integrated genomics analysis
Authors: Roufas Constantinos , Georgakopoulos-Soares Ilias , Zaravinos Apostolos
Published: March 2021

Although immune checkpoint inhibition (ICI) has shown promising results in metastatic dMMR/MSI-H colorectal cancer (CRC), the majority of pMMR/MSS patients do not respond to such therapies. To systematically evaluate the determinants of immune response in CRC, we explored whether patients with diverse levels of immune cytolytic activity (CYT) have different patterns of chromothripsis and kataegis. Analysis of CRC genomic data from the TCGA, indicated an excess of chromothriptic clusters among CYT-low colon adenocarcinomas, affecting known cancer drivers (APC, KRAS, BRAF, TP53 and FBXW7), immune checkpoints (CD274, PDCD1LG2, IDO1/2 and LAG3) and immune-related genes (ENTPD1, PRF1, NKG7, FAS, GZMA/B/H/K and CD73). CYT-high tumors were characterized by hypermutation, enrichment in APOBEC-associated mutations and kataegis events, as well as APOBEC activation. We also assessed differences in the most prevalent mutational signatures (SBS15, SBS20, SBS54 and DBS2) across cytolytic subgroups. Regarding the composition of immune cells in the tumor milieu, we found enrichment of M1 macrophages, CD8+ T cells and Tregs, as well as higher CD8+ T-cells/Tregs ratio among CYT-high tumors. CYT-high patients had higher immunophenoscores, which is predictive of their responsiveness if they were to be treated with anti-PD-1 alone or in combination with anti-CTLA-4 drugs. These results could have implications for patient responsiveness to immune checkpoint inhibitors.
Near-infrared brightening around the periastron passages of the gamma-ray binary PSR B1259−63 / LS 2883
Authors: Kawachi Akiko , Moritani Yuki , Okazaki Atsuo T , Yoshida Hiromi , Suzuki Kenta
Published: March 2021

The binary of the pulsar PSR B1259−63 and the Be star LS 2883 has been observed at the 2010 and 2014 periastron passages in the near-infrared (NIR) bands using the IRSF/SIRIUS and SIRPOL. The light curves in the J-, H-, and Ks-bands are almost identical in these periastron passages. A flare starts no later than 10 days before periastron and the maximum brightening of about 0.1 mag is observed 12–17 days after periastron. The rising part of the light curve is steeper and reaches a peak slightly earlier in the Ks-band than in the other bands, thus a characteristic track appears on the NIR color–magnitude diagram. The time lag between the NIR light curves indicates that the variation in the Be circumstellar disk first occurs in an outer region. We propose that the initial rapid contraction followed by the gradual expansion of the disk is evoked by the rapidly changing tidal torque around periastron and the resultant change of the optically thick area causes the observed NIR light curves.
A mixed method study exploring patient satisfaction and feasibility of two exercise programmes in systemic sclerosis-associated microstomia
Authors: Sydow Ellinor , Van der Elst Kristien , Verschueren Patrick , Lenaerts Jan , Westhovens René , De Langhe Ellen
Published: March 2021

Objective

SSc often leads to fibrotic cutaneous involvement of the face and reduced oral aperture, with impaired food intake and oral hygiene. Oral exercises can increase oral aperture but are often hampered by low adherence rates. The aim of this mixed method study was to explore the feasibility, patient satisfaction and effectiveness of two exercise programmes in SSc-associated microstomia.

Methods

Adult patients suffering from SSc and microstomia (maximal oral aperture <40 mm) were randomized to two groups. Group A exercised with a jaw motion device (Therabite), whereas group B performed mouth-stretching exercises. Patients were expected to exercise for 10 min, three times per day for 3 months. Patients were evaluated at baseline, 3 months (period without intervention), 6 months (after 3 months of intervention) and 9 months (post-intervention). At month 6, semi-structured one-to-one interviews were conducted.

Results

We included six women and three men, median age 60 years and median disease duration 8 years. At 6 months, all patients in group A (n = 4) and four in group B (n = 5) improved, with a median of 9 and 7 mm, respectively. The adherence ranged between 63.7 and 98.9% in group A and between 48.5 and 97.4% in group B. The interview revealed three themes: drivers, challenges and perceived improvement.

Conclusion

Both interventions improved maximal oral aperture. The adherence to therapy was high, but none of the patients considered it feasible to continue practising three times per day. Future studies are needed in order to define feasible long-term exercise programmes.
Exploring the active ingredients of workplace physical and psychological wellbeing programs: a systematic review
Authors: Ryan J C , Williams G , Wiggins B W , Flitton A J , McIntosh J T , Carmen M J , Cox D N
Published: March 2021

Previous reviews have established that workplace wellbeing initiatives are effective at promoting wellbeing, but less is known about which intervention characteristics or “active ingredients” underpin this effectiveness (i.e., behavior change techniques [BCTs]). This review aims to illuminate the connections between the types of BCTs and the level of intervention intensity with intervention effectiveness. A systematic search for peer-reviewed studies evaluating a workplace wellbeing initiative was undertaken across five databases: Medline, Scopus, PsycInfo, and CINAHL (Ovid Emcare). Eligible studies included those that evaluated the effect of a workplace wellbeing initiative on participants’ physical wellbeing (e.g., physical activity and quality of life) and psychological wellbeing (e.g., mental health and stress), were published between 2009 and September 2019, and utilized a comparator (e.g., control group or prepost change). Studies were screened in independent duplicate to minimize bias. Effect sizes were calculated. Following removal of duplicates, 1,541 studies were identified and screened for eligibility. Of these, 23 studies reporting 28 comparisons were deemed to meet eligibility criteria. Just over 50% of these studies reported evidence of either a strong or moderate effect across a physical and a psychological outcome, providing a positive indication that workplace wellbeing programs can promote physical and psychological wellbeing in workers. Interventions tended to employ multiple BCTs (mean range 8.1–9.4), however, no discernible patterns between the types or numbers of BCTs employed and intervention effectiveness was found. Further experimental work is required that compares and contrasts workplace wellbeing initiatives to enable a better understanding of how to develop and implement highly effective programs.
Feasibility of patient-focused behavioral interventions to support adults experiencing chronic noncancer pain during opioid tapering: a systematic literature review
Authors: White Ruth , Bruggink Laura , Hayes Chris , Boyes Allison , Paul Chris
Published: March 2021

Guidelines for chronic noncancer pain prioritize behavioral treatments. In clinical practice transition from opioids to behavioral treatments is often not endorsed by patients or providers. Feasible interventions to support opioid tapering are needed, particularly in primary care.

The objectives of this paper is to review the feasibility of behavioral interventions to support opioid tapering.

Electronic databases (MEDLINE, Embase, PsycINFO, and CINAHL) were searched from inception to June 2019 to identify original studies reporting feasibility (consent rates; completion rates; patient-reported acceptability; integration into clinical practice; and adverse events) of opioid tapering and transition to behavioral treatments for adults experiencing chronic noncancer pain. Google scholar and contents tables of key journals were also searched. Two authors independently extracted data and assessed methodological quality using The Quality Assessment Tool for Quantitative Studies. Eleven publications met inclusion criteria, of which three were conducted in primary care. Consent rates ranged from 27% to 98% and completion rates from 6.6% to 100%. Four studies rated at least one component of patient acceptability: helpfulness from 50%–81%; satisfaction 71%–94%, and “recommend to others” 74%–91%. Three studies reported provider perspectives and two studies reported adverse events. Quality assessment indicated all 11 studies were moderate or weak, primarily due to selection bias and lack of assessor blinding. There was also considerable heterogeneity in study design. The limited available data suggest that attempts to translate opioid tapering interventions into practice are likely to encounter substantial feasibility challenges. One possible way to ameliorate this challenge may be a clear policy context, which facilitates and support opioid reduction.
Using a population health management approach to enroll participants in a diabetes prevention trial: reach outcomes from the PREDICTS randomized clinical trial
Authors: Wilson Kathryn E , Michaud Tzeyu L , Almeida Fabio A , Schwab Robert J , Porter Gwenndolyn C , Aquilina Kathryn H , Brito Fabiana A , Golden Caitlin A , Dressler Emily V , Kittel Carol A , Harvin Lea N , Boggs Ashley E , Katula Jeffrey A , Estabrooks Paul A
Published: March 2021

Population health management (PHM) strategies to address diabetes prevention have the potential to engage large numbers of at-risk individuals in a short duration. We examined a PHM approach to recruit participants to a diabetes prevention clinical trial in a metropolitan health system. We examined reach and representativeness and assessed differences from active and passive respondents to recruitment outreach, and participants enrolled through two clinical screening protocols. The PHM approach included an electronic health record (EHR) query, physician review of identified patients, letter invitation, and telephone follow-up. Data describe the reach and representativeness of potential participants at multiple stages during the recruitment process. Subgroup analyses examined proportional reach, participant differences based on passive versus active recruitment response, and clinical screening method used to determine diabetes risk status. The PHM approach identified 10,177 potential participants to receive a physician letter invitation, 60% were contacted by telephone, 2,796 (46%) completed telephone screening, 1,961 were eligible from telephone screen, and 599 were enrolled in 15 months. Accrual was unaffected by shifting clinical screening protocols despite the increase in participant burden. Relative to census data, study participants were more likely to be obese, female, older, and Caucasian. Relative to the patient population, enrolled participants were less likely to be Black and were older. Active respondents were more likely to have a higher income than passive responders. PHM strategies have the potential to reach a large number of participants in a relatively short period, though concerted efforts are needed to increase participant diversity.
Comparison of ABTS/DPPH assays for the detection of antioxidant capacity in foods
Authors: Floegel Anna , Kim Dae‐Ok , Chung Sang‐Jin , Chun Ock K.
Published: March 2021

The present study aimed to evaluate two different spectrophotometric assays for detection of vitamin C equivalent antioxidant capacity (VCEAC) of foods. Fifty popular, antioxidant‐rich fruits, vegetables and beverages in the U.S. diet were analyzed for their 2,2′‐azino‐bis‐3‐ethylbenzthiazoline‐6‐sulphonic acid (ABTS) anion radical scavenging activity (ABTS assay) and their ability to reduce 1,1‐diphenyl‐2picrylhydrazyl (DPPH) radical (DPPH assay). The highest VCEAC was detected for strawberry with 520.7 ± 39.3 mg vitamin C equivalent (VCE)/100 g by DPPH assay and for blueberry with 476.6 ± 28.9 mg VCE/100 g by ABTS assay. Although the order differed slightly, both assays identified the same top ten VCEAC food items in the U.S. diet based on fresh weight as blueberry, plum, strawberry, red cabbage, red wine, grape, cherry, green tea, broccoli and apple. VCEAC of 50 food items detected by ABTS assay showed a strong positive relationship with VCEAC measured by DPPH assay (r = 0.886, p<0.001). VCEAC detected by ABTS assay demonstrated a stronger positive association with the USDA database for the oxygen radical absorbance capacity (ORAC) (r = 0.473, p < 0.01). ABTS assay was superior to DPPH assay in reflecting the antioxidant levels of foods containing hydrophilic, lipophilic, high‐moisture, or high‐pigmented nutrients. Hence, ABTS assay may be more useful than DPPH assay in detecting VCEAC in foods.

Grant Funding Source: Supported by Beginning Grant in Aid (BGIA) No. 0865092E from the American Heart Association and University of Connecticut Faculty Large Grant
Evolution of VIM-1 producing Klebsiella pneumoniae isolates from a hospital outbreak reveals the genetic bases of the loss of the urease-positive identification character
Authors: Cabanel Nicolas , Rosinski-Chupin Isabelle , Chiarelli Adriana , Botin Tatana , Tato Marta , Canton Rafael , Glaser Philippe
Published: March 2021

Outbreaks of carbapenemase producing Klebsiella pneumoniae (CPKp) represent a major threat for hospitals. We molecularly characterized the first outbreak of VIM-1 producing K. pneumoniae in Spain, that raised fears about the spread of this strain or of the plasmid carrying blaVIM-1. Through in-depth genomic analysis of 18 isolates recovered between October 2005 and September 2007, we show that 17 ST39 isolates were clonal, whereas the last isolate had acquired the VIM-1 plasmid from the epidemic clone. The index isolate carried 31 antibiotic resistance genes (ARGs) and was resistant to almost all antibiotics tested. Later isolates further gained mutations in efflux pumps regulators ramR and opxR, deletion of mgrB (colistin resistance) and frameshift mutations in ompK36 (ß-lactam resistance) likely selected by antibiotic usage. Comparison with publicly available genome sequences and literature review revealed no sign of dissemination of this CPKp strain. However, the VIM-1 plasmid was found in diverse Enterobacterales species, although restricted to Spain. One isolate became urease negative following IS5075 transposition into ureC. Analysis of 9755 K. pneumoniae genomes showed the same ureC::IS5075 insertion in 14.1% of the isolates and explained why urease activity is a variable identification trait for K pneumoniae. Transposition into ureC results from the similarity of its 3’-end and the terminal inverted repeats of Tn21 like transposons, the targets of IS5075 and related ISs. As these transposons frequently carry ARGs, this might explain the frequent chromosomal invasion by these ISs and ureC inactivation in multidrug resistant isolates.

IMPORTANCE

Evolution of multidrug resistant bacterial pathogens occurs at multiple scales, in the patient, locally in the hospital or more globally. Some mutations or gene acquisitions, for instance in response to antibiotic treatment, may be restricted to a single patient due to their high fitness cost. However, some events are more general. By analyzing the evolution of a hospital acquired multidrug resistant K. pneumoniae strain producing the carbapenemase VIM-1, we showed a likely environmental source in the hospital and identified mutations contributing to a further decrease in antibiotic susceptibility. By combining the genomic analysis of this outbreak with literature data and genome sequences available in databases, we showed that the VIM-1 plasmid has been acquired by different Enterobacterales but is only endemic in Spain. We also discovered that urease loss in K. pneumoniae results from the specific transposition of an IS element into the ureC gene and was more frequent in fluoroquinolone resistant isolates and carrying a carbapenemase gene.
Long-term effects of mass screening for latent and active tuberculosis in the Marshall Islands
Authors: Ragonnet Romain , Williams Bridget M , Largen Angela , Nasa Joaquin , Jack Tom , Langinlur Mailynn K , Ko Eunyoung , Rahevar Kalpeshsinh , Islam Tauhid , Denholm Justin , Marais Ben J , Marks Guy B , McBryde Emma S , Trauer James M
Published: March 2021

Rationale

The Marshall Islands implemented ambitious population-based screening programs for latent and active tuberculosis in 2017 and 2018. These interventions’ long-term effects remain to be estimated.

Objectives

To predict the long-term impact of the previous interventions and identify strategies to drive tuberculosis towards elimination.

Methods

We built a transmission model of tuberculosis informed by local data to capture the epidemic’s historical dynamics. We used the model to project the future epidemic trajectory following the screening interventions, as well as considering a counterfactual scenario with no intervention. We also simulated future scenarios including periodic interventions similar to those previously implemented, to assess the feasibility of reaching the End TB Strategy targets and tuberculosis pre-elimination.

Measurements and Main Results

The 2017-2018 screening activities were estimated to have reduced tuberculosis incidence and mortality by more than one third in 2020, and are predicted to achieve the End TB Strategy milestone of 50% incidence reduction by 2025 compared to 2015. Interventions had a considerably greater impact when individuals were also screened for latent infection than active case finding alone. Such combined programs implemented at the national level could achieve tuberculosis pre-elimination by 2035 if repeated every two years, and around 2045 if repeated every five years.

Conclusions

We predict that it is possible to achieve tuberculosis pre-elimination by 2035 in the Marshall Islands through periodic repetition of the same ambitious interventions as those previously implemented. Including latent infection testing in active screening activities will be a critical pillar for achieving these ambitious goals.
Learning to Treat Hypotensive Episodes in Sepsis Patients Using a Counterfactual Reasoning Framework
Authors: Jeter Russell , Lehman Li-Wei , Josef Christopher , Shashikumar Supreeth , Nemati Shamim
Published: March 2021

The optimal treatment strategy for volume resuscitation and vasopressor dosing to combat hypotensive episodes in septic patients remains a subject of ongoing controversy and can vary from clinician to clinician. We develop a machine learning approach to guide a fluid and vasopressor dosing strategy that adapts to patient-specific clinical states to improve the survival of septic patients. We adopt a model-free reinforcement learning (RL) framework in a continuous action space with a clinically significant reward function, and use a Switching Generalized Linear Model (SGLM) to characterize patient-specific clinical states. We use retrospective data from the MIMIC III database to train this model to learn volume resuscitation and vasopressor dosing strategies among the 5,366 patients (totalling 352,328 unique hourly measurements) with ICU-onset sepsis or septic shock, as diagnosed by the Sepsis-3 definition. The RL agent receives short- and long-term rewards associated with optimizing in-hospital survival and avoiding end-organ damage to learn volume resuscitation and vasopressor dosing strategies. On average, the RL agent learns to resuscitate patients earlier than clinicians with a fluid bolus (one hour vs. four hours after the diagnosis of sepsis), and improves the expected survival by ≈ 3%. Our preliminary results indicate that adherence to RL-based individualized fluid and vasopressor dosing recommendations is associated with a significant mortality reduction in septic patients, even after adjusting for severity of illness.
Rapid increase of SARS-CoV-2 variant B.1.1.7 detected in sewage samples from England between October 2020 and January 2021
Authors: Wilton Thomas , Bujaki Erika , Klapsa Dimitra , Fritzsche Martin , Mate Ryan , Martin Javier
Published: March 2021

SARS-CoV-2 variants with multiple amino acid mutations in the spike protein are emerging in different parts of the world raising concerns on their possible impact on human immune response to the virus and vaccine efficacy against them. Recently, a variant named lineage B.1.1.7 was detected and shown to be rapidly spreading across the UK since November 2020. As surveillance for these SARS-CoV-2 variants of concern (VOCs) becomes critical, we have investigated the use of environmental surveillance (ES) for the rapid detection and quantification of B.1.1.7 viruses in sewage as a way of monitoring its expansion that is independent on the investigation of identified clinical cases. B.1.1.7 mutations in viral sequences from sewage were first identified in a sample collected in London on 10thNovember 2020 and shown to rapidly increase in frequency to >95% in January 2021, in agreement with clinical data over the same period. We show that ES can provide an early warning of VOCs becoming prevalent in the population and that, as well as B.1.1.7, our method can potentially detect VOCs B.1.351 and P.1, first identified in South Africa and Brazil, respectively, and other viruses also carrying critical spike mutation E484K, known to have an effect on virus antigenicity.