bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequency of Salmonella serotypes among children in Iran: antimicrobial susceptibility, biofilm formation, and virulence genes
Authors: Rezaei Akram , Hashemi Farhad B. , Heshteli Roya Rasooly , Rahmani Maryam , Halimi Shahnaz
Published: September 2022

Background/significance

Salmonella gastroenteritis causes significant morbidity among pediatric patients, mainly in developing world, such as the Middle East and North Africa (MENA) region. Concurrently, data from MENA countries like Iran, regarding prevalence of Salmonella serotypes, antimicrobial susceptibility, and biofilm production is scarce.

Material & methods

Slide agglutination was used to determine the serogroup of 140 Salmonella isolates recovered from 4477 stool specimens collected from children with gastroenteritis, and isolates were serotyped by PCR assay. The antimicrobial susceptibility of isolates to five first line drugs was assessed by disk diffusion assay using CLSI guidelines. Semi-quantitative evaluation of biofilm production was done by microtiter plate assay followed by PCR detection of biofilm-associated virulence genes csgD, pefA, and bcsA for each isolate.

Results

Nearly 94% of Salmonella isolates were recovered from ≤ 5-year-old patients, and 99% of isolates were non-typhoidal. While we found extensive diversity among Salmonella isolates, serogroup D (46%) predominated, and Salmonella Enteritidis (41%) was the most common serotype that showed the highest antimicrobial susceptibility rate (> 96%). For the first time in Iran, S. Newport serotype from human specimens was isolated. Most isolates were sensitive to all test antimicrobials, but 35% of isolates were not-typed (NT) that showed the highest resistance with 48% being resistant to ≥ 1 test antimicrobial. Majority of isolates made weak (or no) biofilm, and we found a weak association between antimicrobial susceptibility, biofilm production, or virulence genes csgD, pefA, and bcsA.

Conclusions

The most effective measure that may control pediatric salmonellosis outbreaks is raising awareness of parents of preschoolers about food safety. Isolation of highly diverse Salmonella serotypes, including many commonly isolated from animals, indicates widespread contamination of the food chain. Majority of serotypes were sensitive to first-line antimicrobials, thus presently, pediatric Salmonella infections in this region may be controlled by conventional antimicrobials. However, despite the current trend, an imminent emergence of resistant Salmonella strains is foreseen, since various serotypes resistant to > 1 antimicrobial agent are typically associated with animals. Our results warrant further investigation that includes correlation analysis of clinical data regarding treatment outcomes, and serotype attributes like virulence genes.
Associations between sleep deficit and academic achievement - triangulation across time and subject domains among students and teachers in TIMSS in Norway
Authors: Vik Frøydis N. , Nilsen Trude , Øverby Nina C.
Published: September 2022

Background

Sufficient sleep is important to an individual’s health and well-being, but also for school achievement among adolescents. This study investigates the associations between sleepiness, sleep deficits, and school achievements among adolescents.

Methods

This trend study involved a representative sample of Norwegian adolescents based on the “Trends in International Mathematics and Science Study” (TIMSS), N = 4499 (2015) and N = 4685 (2019) and their teachers. The students were 9th graders from a Norwegian compulsory secondary school. The survey included questions on students’ sleepiness as students reported in 2019 and sleep deficits among students that limited teaching in class as their teachers reported in 2015 and 2019. Regression, triangulation, and mediation analyses were used. Mplus was used to perform the statistical analyses.

Results

The results revealed significant negative associations between sleep deficits and school achievements, adjusted for gender, socioeconomic status (SES), and minority status among Norwegian 9th graders. These results were found for both mathematics and science achievements in 2015 and 2019. Sleepiness that the students reported was negatively associated with school achievements in 2019. Trend and mediation analyses showed that sleep deficits explained 18 and 11% of the decrease in mathematics and science achievements, respectively, from 2015 to 2019.

Conclusions

Sleep deficits were associated with school achievements in mathematics and science among Norwegian 9th graders. Mediation analyses revealed that sleep deficits explained a significant part of the decline in academic achievements. Insufficient sleep may have negative public health implications and influence adolescents’ academic achievements and competences, and should therefore be discussed in both the educational and health systems.
Views of general practitioners on end-of-life care learning preferences: a systematic review
Authors: Atreya Shrikant , Datta Soumitra S. , Salins Naveen
Published: September 2022

Background

General practitioners (GPs) play a pivotal role in providing end-of-life care in the community. Although they value end-of-life care, they have apprehensions about providing care in view of the limitations in knowledge and skills in end-of-life care. This review aimed to explore, synthesise, and analyse the views of general practitioners on end-of-life care learning preferences.

Methods

MEDLINE, CINAHL, PsycINFO, EMBASE, Scopus, Web of Science, and Cochrane were searched for literature on the views of general practitioners on end-of-life care learning preferences from 01/01/1990 to 31/05/2021. Methodological quality was reported.

Results

Of the 10,037 articles identified, 23 were included for the review. Five themes developed from the review. The desire to provide palliative care, as well as self-actualisation needs, relevance to practice, a sense of responsibility, and a therapeutic bond, motivates general practitioners to learn end-of-life care. Some of the learning needs expressed were pain and symptom management, communication skills, and addressing caregiver needs. Experiential learning and pragmatist learning styles were preferred learning styles. They perceived the need for an amicable learning environment in which they could freely express their deficiencies. The review also identified barriers to learning, challenges at personal and professional level, feelings of disempowerment, and conflicts in care.

Conclusion

GPs’ preference for learning about end-of-life care was influenced by the value attributed to learning, context and content, as well as preference for learning styles and the availability of resources. Thus, future trainings must be in alignment with the GPs’ learning preferences.
Has vaccination alleviated the strain on hospitals due to COVID-19? A combined difference-in-difference and simulation approach
Authors: Grøsland Mari , Larsen Vilde Bergstad , Telle Kjetil , Gjefsen Hege Marie
Published: September 2022

Background

Serious measures, including mass vaccination, have been taken to ensure sufficient hospital capacity during the COVID-19 pandemic. Due to high hospitalization risk in the oldest age groups, most countries prioritized elderly for vaccines. The aim of this study is to broaden the understanding of how vaccination in younger age groups relieved the strain on hospitals during the pandemic.

Methods

To determine the impact of vaccination on hospitalization, we relied on individual level data on health care use and vaccination from the Norwegian Emergency Preparedness Register Beredt C19. Using a pre-post design, we estimated the increase in hospitalization days from before to after confirmed COVID-19 for individuals aged 18-64 who were fully vaccinated (N=2 419) or unvaccinated (N=55 168) with comparison groups of vaccinated (N=4 818) and unvaccinated (N= 97 126) individuals without COVID-19. To evaluate whether vaccination itself contributed to a strain in hospitals, we use a similar design to study hospitalization rates before and after vaccination by comparing individuals vaccinated with the first dose (N=67 687) to unvaccinated individuals (N=130 769). These estimates were incorporated into a simulation of hospitalization days with different vaccine scenarios to show how the estimated results might have mattered for the hospitals and their capacity.

Results

Hospitalization days increased by 0.96 percentage point each day during the first week and 1.57 percentage points during the second week after testing positive for COVID-19 for unvaccinated individuals. The corresponding increase was 0.46 and 0.32 for vaccinated individuals, i.e., a substantial difference. The increase was significantly higher for those aged 45-64 than for those aged 18-25. We find no increase in hospitalization days due to vaccination. Simulation results show that vaccination reduced hospitalization days by 25 percent, mainly driven by age 45-64.

Conclusion

Our findings indicate that vaccination of individuals aged 18-64 did alleviate pressure on hospitals. Whereas there was a substantial relieve from vaccinating the 45-64 age group, there was no such contribution from vaccinating the 18-25 age group. Our study highlights how simulation models can be useful when evaluating alternative vaccine strategies.
Activation of oxytocin receptors in mouse GABAergic amacrine cells modulates retinal dopaminergic signaling
Authors: Hu Songhui , Wang Yurong , Han Xu , Dai Min , Zhang Yongxing , Ma Yuanyuan , Weng Shijun , Xiao Lei
Published: September 2022

Background

Oxytocin, secreted by oxytocin neurons in the hypothalamus, is an endogenous neuropeptide involved in modulating multiple sensory information processing pathways, and its roles in the brain have been associated with prosocial, maternal, and feeding-related behaviors. Visual information is necessary for initiating these behaviors, with the retina consisting of the first stage in the visual system mediating external stimulus perception. Oxytocin has been detected in the mammalian retina; however, the expression and possible function of oxytocin receptors (OxtR) in the retina remain unknown. Here, we explore the role of oxytocin in regulating visual information processing in the retina.

Results

We observed that OxtR mRNA and protein are expressed in the mouse retina. With Oxtr-Cre transgenic mice, immunostaining, and fluorescence in situ hybridization, we found that OxtRs are mainly expressed in GABAergic amacrine cells (ACs) in both the inner nuclear layer (INL) and ganglion cell layer (GCL). Further immunoreactivity studies showed that GABAergic OxtR+ neurons are mainly cholinergic and dopaminergic neurons in the INL and are cholinergic and corticotrophin-releasing hormone neurons in the GCL. Surprisingly, a high level of Oxtr mRNAs was detected in retinal dopaminergic neurons, and exogenous oxytocin application activated dopaminergic neurons to elevate the retinal dopamine level. Relying on in vivo electroretinographic recording, we found that activating retinal OxtRs reduced the activity of bipolar cells via OxtRs and dopamine receptors.

Conclusions

These data indicate the functional expression of OxtRs in retinal GABAergic ACs, especially dopaminergic ACs, and expand the interactions between oxytocinergic and dopaminergic systems. This study suggests that visual perception, from the first stage of information processing in the retina, is modulated by hypothalamic oxytocin signaling.
The UK Coronavirus Job Retention Scheme and smoking, alcohol consumption and vaping during the COVID-19 pandemic: evidence from eight longitudinal population surveys
Authors: Green Michael J. , Maddock Jane , Di Gessa Giorgio , Wielgoszewska Bożena , Parsons Sam , Griffith Gareth J. , Croft Jazz , Stevenson Anna J. , Huggins Charlotte F. , Booth Charlotte , Wels Jacques , Silverwood Richard J. , Patalay Praveetha , Hughes Alun D. , Chaturvedi Nishi , Howe Laura D. , Fitzsimons Emla , Katikireddi Srinivasa Vittal , Ploubidis George B.
Published: September 2022

Background

Employment disruptions can impact smoking and alcohol consumption. During the COVID-19 pandemic, many countries implemented furlough schemes to prevent job loss. We examine how furlough was associated with smoking, vaping and alcohol consumption in the UK.

Methods

Data from 27,841 participants in eight UK adult longitudinal surveys were analysed. Participants self-reported employment status and current smoking, current vaping and alcohol consumption (>4 days/week or 5+ drinks per typical occasion) both before and during the early stages of the pandemic (April–July 2020). Risk ratios were estimated within each study using modified Poisson regression, adjusting for a range of potential confounders, including pre-pandemic behaviour. Findings were synthesised using random effects meta-analysis.

Results

Compared to stable employment and after adjustment for pre-pandemic characteristics, furlough was not associated with smoking (ARR = 1.05; 95% CI: 0.95–1.16;I2: 10%), vaping (ARR = 0.89; 95% CI: 0.74–1.08;I2: 0%) or drinking (ARR = 1.03; 95% CI: 0.94–1.13;I2: 48%). There were similar findings for no longer being employed, and stable unemployment, though this varied by sex: stable unemployment was associated with smoking for women (ARR = 1.35; 95% CI: 1.00–1.82;I2: 47%) but not men (0.84; 95% CI: 0.67–1.05;I2: 0%). No longer being employed was associated with vaping among women (ARR = 2.74; 95% CI: 1.59–4.72;I2: 0%) but not men (ARR = 1.25; 95% CI: 0.83–1.87;I2: 0%).

Conclusions

We found no clear evidence of furlough or unemployment having adverse impacts on smoking, vaping or drinking behaviours during the early stages of the COVID-19 pandemic in the UK. Differences in risk compared to those who remained employed were largely explained by pre-pandemic characteristics.
Prenatal diagnosis identifies compound heterozygous variants in RYR1 that causes ultrasound abnormalities in a fetus
Authors: Zhao Qiuling , Li Xiaoduo , Liu Li , Zhang Xu , Pan Xin , Yao Hong , Ma Yongyi , Tan Bo
Published: September 2022

Objective

We presented a non-consanguineous healthy Chinese couple with five pregnancies, three early miscarriages, the fetus II-2 and II-5 with similar abnormal phenotypes of fetal hydrops, scoliosis, fetal akinesia and polyhydramnios. This study aimed to uncover the molecular etiology of this family with a history of multiple adverse pregnancies.

Materials and methods

DNA extracted from the fifth fetal umbilical cord and parents’ peripheral blood were subjected to SNP-array and whole exome sequencing. The result was verified by Sanger sequencing. Functional characterization of the c.2682G > C (p.Ile860_Pro894del) variant was completed by minigene splicing assay.

Results

Trio whole-exome sequencing has identified compound heterozygous variants in RYR1 (c.2682G > C; p.Ile860_Pro894del and c.12572G > A; p.Arg4191His) in fetus II-5. The variant c.2682G > C (p.Ile860_Pro894del) comes from the father and the c.12572G > A (p.Arg4191His) comes from the mother. The c.2682G > C (p.Ile860_Pro894del) affects the splice site resulting in exon 21 skipping, therefore is classified as likely pathogenic. The c.12572G > A (p.Arg4191His) locates in the C-terminal hot spots region of the RYR1, classified as of uncertain significance.

Conclusions

We report the first prenatal case of RYR1-related disorders in Chinese population, expanding the variant spectrum of RYR1 in fetuses.
Clinical manifestations and outcomes of severe malaria in adult patients admitted to a tertiary hospital in the Gambia
Authors: Bittaye Sheikh Omar , Jagne Abubacarr , Jaiteh Lamin ES , Nadjm Behzad , Amambua-Ngwa Alfred , Sesay Abdul Karim , Singhateh Yankuba , Effa Emmanuel , Nyan Ousman , Njie Ramou
Published: September 2022

Background

Malaria is a major public health concern in The Gambia. There is limited data on the clinical manifestation and outcome of severe malaria in adult patients in The Gambia. The study therefore assessed the clinical manifestations and outcome of severe malaria in adult patients admitted at the Edward Francis Small Teaching Hospital.

Methods

The study retrospectively reviewed the records of all malaria patients admitted from 18th October 2020 to 2nd February 2022. Demographic data, clinical features, investigations, treatment, and outcomes were recorded.

Results

A total of 131 confirmed malaria patients were recruited into the study. The median age was 21 yrs, range (15–90) and most of them were within the youth age group (15–24yrs) 85 (64.9%). The majority of the patients were also male 88 (67.2%) with a male to female ratio of 2:1. The most common symptom at presentation was fever 119 (90.8%) and the most common sign was pallor 48 (36.6%). Seventy-six patients (58.1%) and 55 (41.9%) patients met the criteria for severe malaria and uncomplicated malaria diagnosis, respectively. The most common clinical feature amongst patients with severe malaria were impaired consciousness 34 (44.7%), severe anaemia 26 (34.2%) and acute kidney injury 20 (26.3%). Patients with severe malaria were younger with mean age of 22.9 vs. 29 yrs (p = 0.004), more likely to be referred from a lower-level health facility 62 (81.6%) vs. 34 (61.8%) (p = 0.012), to have a longer duration of admission (p = 0.024) and to die 13 (17.1%) vs. 0 (0%) (p = 0.001) as compared to patients with uncomplicated malaria. The total mortality was 13 (9.9%) and all the patients who died had severe malaria. Mortality was higher in patients with impaired consciousness 9 (26.5%) and there was a significant relationship between death and impaired consciousness 9 (69.3%) vs. 25 (21.4%) p = 0.001.

Conclusion

Severe malaria still affects young adults in an endemic area with significant mortality. This suggests the need for targeted malaria prevention, surveillance, case management and control strategies in this population group in The Gambia to help reduce morbidity and mortality of malaria.
Optic nerve head optical coherence tomography angiography findings in patients with thyroid eye disease: a case–control study
Authors: Sabermoghaddam Aliakbar , Shoeibi Nasser , Jafarzadeh Hamid , Bakhtiari Elham , Salahi Zeinab , Saeidi Rezvani Talieh , Heidarzadeh Hamid Reza , Abrishami Mojtaba
Published: September 2022

Background

To evaluate changes in the vessel density (VD) of the optic nerve head (ONH) microvasculature in thyroid eye disease (TED) using optical coherence tomography angiography (OCTA). This study aimed to applicate the OCTA as a noninvasive modality in screening TED patients to assess sub-clinical changes.

Methods

In a cross-sectional study, the control group patients were healthy individuals with no ocular abnormalities and were euthyroid. All patients with TED had clinical features of the disease. We divided them into two groups using the clinical activity score (CAS). Patients with CAS scores 0–2 were categorized as group A, and scores three or more as group B. All vessels (AV) and small vessels (SV) VD inside disc and radial peripapillary capillary network were measured using the ONH-OCTA.

Results

We evaluated 29 patients with TED and 28 healthy controls. The mean whole image AV VD (mean ± SD: 56.33 ± 2.56,p-value = 0.17) and the mean whole image SV VD (mean ± SD: 49.94 ± 2.56,p-value = 0.16) in the TED group had no statically significant difference compared with the control group (AV mean ± SD: 57.20 ± 20.22, SV mean ± SD: 50.84 ± 2.23). We found a non-significant decrease in AV and SV radial peripapillary capillary VD in the TED group. There was a significant decrease in the mean whole image AV VD (mean ± SD: 54.83 ± 3.07,p-value = 0.005) and the mean whole image SV VD (mean ± SD: 48.60 ± 3.18,p-value = 0.013) in CAS group B compared to group A (AV mean ± SD: 57.45 ± 1.33, SV mean ± SD: 50.95 ± 1.37).

Conclusion

Our study showed non-significant ONH vascular alterations in patients with TED, including reduced VD of ONH in the radial peripapillary capillary. Patients with higher CAS scores had a more noticeable decrease in ONH microvasculature.
The efficacy and safety of minocycline as adjuvant therapy in refractory mycoplasma pneumonia in Chinese children: a meta-analysis
Authors: Shen Hong-Xia , Liu Chang , Lin Hui-Jun , Xu Lu-Jie , Wang Guang-Yan , Yan Mei-Xing
Published: September 2022

Background

To explore the efficacy and safety of minocycline as adjuvant therapy for refractory mycoplasma pneumonia in Chinese children.

Methods

PubMed, EMBASE, Cochrane Library, CNKI, Wanfang database and VIP database were systematically searched. Studies where minocycline was used as adjuvant therapy for refractory mycoplasma pneumonia in Chinese children were included. The effect of numeration data and the measurement data were represented by odds ratios (OR) and weighted mean differences (MD), respectively. Review Manager version 5.3 was used to compare the treatment efficacy, time for the cough to subside, defervescence time, hospitalisation time, adverse events and other indicators.

Results

Ten studies involving 857 patients were included in the final analysis. Compared with the conventional treatment of refractory mycoplasma pneumonia in children, the addition of minocycline as adjuvant therapy was found to improve the treatment efficacy (OR: 5.45; 95% CI: 3.46, 8.57, p < 0.001); shorten the duration of cough (MD: -3.61; 95%CI: -4.25, -2.97, p < 0.001), fever time (MD: -4.77; 95% CI: -6.30, -3.23, p < 0.001) and hospitalisation time (MD: -5.53 (95% CI: -7.19, -3.88, p < 0.001); and decrease the concentration of C-reactive protein (MD: -13.95; 95%CI: -18.61, -9.29; p < 0.001) and the erythrocyte sedimentation rate (MD: -10.88; 95% CI: -14.05, -7.72, p < 0.001). The use of minocycline did not lead to significant adverse events (OR = 0.63; 95% CI: 0.39, 1.01, p = 0.05).

Conclusion

The use of minocycline as adjuvant treatment of refractory mycoplasma pneumonia in Chinese children has good efficacy and safety and may be promoted in clinical practice.
Follow-up study of infants recruited to the randomised, placebo-controlled trial of azithromycin for the prevention of chronic lung disease of prematurity in preterm infants—study protocol for the AZTEC-FU study
Authors: Kotecha Sarah J. , Course Christopher W. , Jones Kathryn E. , Watkins W. John , Berrington Janet , Gillespie David , Kotecha Sailesh
Published: September 2022

Background

Preterm birth, especially at less than 30 weeks’ gestation, is significantly associated with respiratory, neurodevelopmental and growth abnormalities. The AZTEC study has recruited 799 infants born at < 30 weeks’ gestation to determine if a ten-day intravenous treatment with azithromycin improves survival without development of chronic lung disease of prematurity (CLD) at 36 weeks’ post menstrual age (PMA) when compared to placebo. The follow-up studies will compare respiratory, neurodevelopmental and growth outcomes up to 2 years of corrected age between infants who received azithromycin and those who received placebo in the early neonatal period.

Methods

Survivors at 36 weeks’ PMA from the main Azithromycin Therapy for Chronic Lung Disease of Prematurity (AZTEC) study with parental consent will continue to be followed up to discharge from the neonatal unit and to 2 years of corrected age. Length of stay, rates of home oxygen, length of supplemental oxygen requirement, hospital admissions, drug usage, respiratory illness, neurodevelopmental disability and death rates will be reported. Data is being collected via parentally completed respiratory and neurodevelopmental questionnaires at 1 and 2 years of corrected age respectively. Additional information is being obtained from various sources including hospital discharge and clinical letters from general practitioners and hospitals as well as from national databases including the National Neonatal Research Database and NHS Digital.

Discussion

The AZTEC-FU study will assess mortality and important neonatal morbidities including respiratory, neurodevelopmental and growth outcomes. Important safety data will also be collected, including the incidence of potential consequences of early macrolide use, primarily pyloric stenosis. This study may have implications on future neonatal care.

Trial registration

The study was retrospectively registered on ISRCTN (ISRCTN47442783).
Lung cancer surgery after COVID-19 infection in a patient with severe interstitial pneumonia and restrictive ventilatory impairment
Authors: Komatsu Hiroaki , Izumi Nobuhiro , Tsukioka Takuma , Inoue Hidetoshi , Ito Ryuichi , Suzuki Satoshi , Nishiyama Noritoshi
Published: September 2022

Background

The spread of COVID-19 infection increased the number of patients who underwent pulmonary resection for lung cancer after COVID-19 infection. It is unclear how previous infection with COVID-19 affects perioperative complications and acute exacerbation of interstitial pneumonia after surgery in patients with interstitial pneumonia.

Case presentation

An 80-year-old man was referred to our hospital because of a tumor in his left lung. Chest computed tomography showed a 28-mm nodule in the lower lobe of the left lung and usual interstitial pneumonia in bilateral lungs. Bronchoscopic examination was performed, which diagnosed squamous cell carcinoma. Pulmonary function testing revealed restrictive ventilatory impairment, and we planned to perform basal segmentectomy of the left lung. However, before the planned surgery, the patient contracted symptomatic COVID-19. Chest computed tomography revealed ground-glass opacities owing to COVID-19. The patient was admitted for surgery 7 weeks after COVID-19 infection. Preoperatively, pulmonary function testing was repeated, which revealed decreased % vital capacity (%VC) and % diffusing capacity for carbon monoxide (%DLco). The 6-min walk test indicated a distance of 500 m, and the percutaneous oxygen saturation at the end of the test was 94%. Basal segmentectomy of the left lung was performed by video-assisted thoracoscopic surgery. The patient’s postoperative course was favorable, and he was discharged without the need for oxygen inhalational therapy 12 days after the surgery. Pathological examination of the resected specimen revealed usual interstitial pneumonia in the non-cancerous areas of the lung. Additionally, the infiltration of immature fibroblasts in the alveoli and perivascular infiltration of inflammatory cells were observed, which were consistent with fibrotic change after inflammation owing to COVID-19. Three months after the surgery, the patient was alive without recurrence or acute exacerbation of the interstitial pneumonia. Pulmonary function testing 6 weeks after surgery revealed decreased %VC and %DLco. Testing 12 weeks after surgery revealed persistently decreased %VC and improved %DLco (Table 1).Table 1

Pulmonary function test results before and after COVID-19 infection and 6 and 12 weeks after surgery

VC (ml)
%VC (%)
%DLco (%)

Before COVID-19 infection
2070
71.9
74.9

7 weeks after COVID-19 infection
1700
59.6
51.9

6 weeks after surgery
1500
52.6
53.1

12 weeks after surgery
1510
53.0
61.7

%VC % vital capacity, %DLco % diffusing capacity for carbon monoxide

Conclusion

We successfully performed basal segmentectomy of the left lung for lung cancer 7 weeks after COVID-19 infection in a patient with severe interstitial pneumonia and restrictive ventilatory impairment.
Phenotypic detection of methicillin resistance, biofilm production, and inducible clindamycin resistance in Staphylococcus aureus clinical isolates in Kathmandu, Nepal
Authors: Maharjan Sujina , Ansari Mehraj , Maharjan Pawan , Rai Kul Raj , Sabina K. C. , Kattel Hari Prasad , Rai Ganesh , Rai Shiba Kumar
Published: September 2022

Introduction

Methicillin resistance, inducible clindamycin resistance (ICR), biofilm production, and increased minimum inhibitory concentration (MIC) of vancomycin in Staphylococcus aureus are major causes of antibiotic treatment failure and increased morbidity and mortality. The surveillance of such isolates and the study of their antimicrobial pattern are essential in managing the infections caused by these isolates. This study aimed to determine methicillin resistance, biofilm production, and ICR in S. aureus isolates from a tertiary care hospital in Kathmandu, Nepal.

Materials and methods

A total of 217 S. aureus isolated from different samples were processed following standard laboratory procedures. Antibiotic susceptibility testing was performed by the Kirby–Bauer disk diffusion technique. Methicillin-resistant S. aureus (MRSA) were identified by the cefoxitin disk diffusion test, and biofilm producers were examined using the microtiter plate technique. D-test and E-test were performed to determine inducible clindamycin resistance and minimum inhibitory concentration of vancomycin, respectively.

Results

Among the 217 S. aureus isolates, 78.3% were multidrug-resistant (MDR), 47.0% were MRSA, 62.2% were biofilm producers, and 50.7% showed ICR. All MRSA isolates exhibited MIC levels of vancomycin within the susceptible range. Biofilm producers and MRSA isolates showed elevated antimicrobial resistance. MRSA was significantly associated with MDR. Biofilm-producing and multidrug-resistant MRSA isolates showed significantly higher MIC levels of vancomycin (p = 0.0013 and < 0.0001, respectively), while ICR was significantly higher in MDR (p = 0.0001) isolates.

Conclusion

High multidrug resistance, MRSA, and ICR in this study call for routine evaluation of antibiotic susceptibility patterns of S. aureus. Vancomycin can be used to treat serious staphylococcal infections. Clindamycin should be prescribed only after performing the D-test. Drugs like teicoplanin, chloramphenicol, doxycycline, amikacin, and levofloxacin can treat MRSA infections.
Predictors of ambulatory recovery and walking proficiency in community-dwelling stroke survivors: a cross-sectional study
Authors: Usman Jibrin Sammani , Gbiri Caleb Ademola Omuwa , Olawale Olajide Ayinla
Published: September 2022

Background

Although the major goal of rehabilitation is to return a stroke survivor (SSv) to as close to their pre-stroke functioning, limitation in ambulatory recovery and walking proficiency is the major impediment. Despite the importance of walking to the outcomes in stroke, factors predicting its recovery remain unclear. This study therefore was aimed at exploring the predictors of ambulatory recovery and walking proficiency in community-dwelling SSv.

Methods

This study involved 164 (83females) SSv from four tertiary health institutions in Nigeria. Ambulatory level and status was assessed using Functional Ambulatory Classification, motor function using the Fugl-Myer Assessment scale (lower limb), and ambulatory/waking endurance using the 6-min walk test. Ambulatory capability was assessed using the Lower Extremity Functional Scale, ambulatory self-confidence using the Ambulatory Self-Confidence Questionnaire, and functional ambulatory profile using the Modified Emory Functional Ambulation Profile. Mobility was assessed using the Modified Rivermead Mobility Index, functional mobility using Time Up and Go, balance using the Berg Balance Scale, and cognitive function using the modified Mini-Mental State Examination. Spatial indexes were assessed using the Footprint method and temporal variables using a stopwatch and gait speed on a 10-m walkway. Data was analyzed using multiple regression analysis atp≤ 0.05.

Results

Participants (mean age = 54.3±11.36 years) have had stroke for 12.9 ± 17.39 months and spent 9.82 ± 13.19 months in hospital admissions. More (65.2%) had ischemic stroke with 54.3% of them having left hemispheric stroke. The predictors of ambulatory onset in SSv were stroke duration and length of stay in hospital admission contributing 40.3% (β= 0.403) and 17.6% (β= 0.176) respectively to the variance. Mobility (β= 0.249,p< 0.001), gait speed (β= 0.185,p= 0.012), paretic double-limb support time (β= 0.155,p= 0.03), balance (β= 0.334,p< 0.001), and cognition (β= 0.155,p= 0.01) were predictors of ambulatory self-confidence contributing 59.5% to the variance. Balance (β= 0.363,p< 0.001) and mobility (β= 0.155,p= 0.015) were predictors of ambulatory capability contributing 52.9% to the variance. Balance (β= −0.489,p< 0.001), paretic double-limb support time (β= 0.223,p= 0.003), gait speed (β= −0.181,p= 0.022), and paretic swing phase duration (β= 0.177,p= 0.01) were predictors of functional ambulatory profile (p< 0.05) contributing 52.9% to the variance. Gait speed (β= −0.648,p< 0.001) and step length (β= −0.157,p= 0.003) were predictors of walking endurance contributing 76.5% to the variance.

Conclusion

Ambulatory recovery and walking proficiency depend on the interplay among duration of stroke and length of hospitalization on the one hand and balance performance, cognitive function, and the spatiotemporal integrity of the affected limb on the other hand.
Postoperative Delirium Severity and Recovery Correlate With Electroencephalogram Spectral Features
Authors: Guay Christian S. , Kafashan MohammadMehdi , Huels Emma R. , Jiang Ying , Beyoglu Bora , Spencer James W. , Geczi Kristin , Apakama Ginika , Ju Yo-El S. , Wildes Troy S. , Avidan Michael S. , Palanca Ben Julian A.
Published: September 2022

BACKGROUND:

Delirium is an acute syndrome characterized by inattention, disorganized thinking, and an altered level of consciousness. A reliable biomarker for tracking delirium does not exist, but oscillations in the electroencephalogram (EEG) could address this need. We evaluated whether the frequencies of EEG oscillations are associated with delirium onset, severity, and recovery in the postoperative period.

METHODS:

Twenty-six adults enrolled in the Electroencephalography Guidance of Anesthesia to Alleviate Geriatric Syndromes (ENGAGES; ClinicalTrials.gov NCT02241655) study underwent major surgery requiring general anesthesia, and provided longitudinal postoperative EEG recordings for this prespecified substudy. The presence and severity of delirium were evaluated with the confusion assessment method (CAM) or the CAM-intensive care unit. EEG data obtained during awake eyes-open and eyes-closed states yielded relative power in the delta (1–4 Hz), theta (4–8 Hz), and alpha (8–13 Hz) bands. Discriminability for delirium presence was evaluated with c-statistics. To account for correlation among repeated measures within patients, mixed-effects models were generated to assess relationships between: (1) delirium severity and EEG relative power (ordinal), and (2) EEG relative power and time (linear). Slopes of ordinal and linear mixed-effects models are reported as the change in delirium severity score/change in EEG relative power, and the change in EEG relative power/time (days), respectively. Bonferroni correction was applied to confidence intervals (CIs) to account for multiple comparisons.

RESULTS:

Occipital alpha relative power during eyes-closed states offered moderate discriminability (c-statistic, 0.75; 98% CI, 0.58–0.87), varying inversely with delirium severity (slope, –0.67; 98% CI, –1.36 to –0.01; P = .01) and with severity of inattention (slope, –1.44; 98% CI, –2.30 to –0.58; P = .002). Occipital theta relative power during eyes-open states correlated directly with severity of delirium (slope, 1.28; 98% CI, 0.12–2.44; P = .007), inattention (slope, 2.00; 98% CI, 0.48–3.54; P = .01), and disorganized thinking (slope, 3.15; 98% CI, 0.66–5.65; P = .01). Corresponding frontal EEG measures recapitulated these relationships to varying degrees. Severity of altered level of consciousness correlated with frontal theta relative power during eyes-open states (slope, 11.52; 98% CI, 6.33–16.71; P < .001). Frontal theta relative power during eyes-open states correlated inversely with time (slope, –0.05; 98% CI, –0.12 to –0.04; P = .002).

CONCLUSIONS:

Presence, severity, and core features of postoperative delirium covary with spectral features of the EEG. The cost and accessibility of EEG facilitate the translation of these findings to future mechanistic and interventional trials.
The Anzaldúan Theory Handbook
Authors: Keating AnaLouise
Published: September 2022

In The Anzaldúan Theory Handbook AnaLouise Keating provides a comprehensive investigation of the foundational theories, methods, and philosophies of Gloria E. Anzaldúa. Through archival research and close readings of Anzaldúa’s unpublished and published writings, Keating offers a biographical-intellectual sketch of Anzaldúa, investigates her writing process and theory-making methods, and excavates her archival manuscripts. Keating focuses on the breadth of Anzaldúa’s theoretical oeuvre, including Anzaldúa’s lesser-known concepts of autohistoria y autohistoria-teoría, nos/otras, geographies of selves, and El Mundo Zurdo. By investigating those dimensions of Anzaldúa’s theories, writings, and methods that have received less critical attention and by exploring the interconnections between these overlooked concepts and her better-known theories, Keating opens additional areas of investigation into Anzaldúa’s work and models new ways to “do” Anzaldúan theory. This book also includes extensive definitions, genealogies, and explorations of eighteen key Anzaldúan theories as well as an annotated bibliography of hundreds of Anzaldúa’s unpublished manuscripts.
Patient-specific modelling, simulation and real time processing for respiratory diseases
Authors: Νούσιας Σταύρος
Published: September 2022

Το άσθμα είναι μια χρόνια νόσος του αναπνευστικού συστήματος που προκαλεί σημαντική δυσχέρια και οικονομική επιβάρυνση. Επηρεάζει περισσότερους από 300 εκατομμύρια ανθρώπους παγκοσμίως, ενώ περισσότεροι από 100 εκατομμύρια άνθρωποι επιπλέον πιθανότατα θα έχουν άσθμα μέχρι το 2025. Η τιμή του άσθματος ποικίλλει πολύ από χώρα σε χώρα. Το μέσο ετήσιο κόστος μπορεί να εκτιμηθεί σε 1900 EUR στην Ευρώπη και 3100 $ στις Ηνωμένες Πολιτείες. Η διαχείριση του άσθματος περιλαμβάνει τον έλεγχο των συμπτωμάτων, την πρόληψη των παροξύνσεων και τη διατήρηση της πνευμονικής λειτουργίας. Ο βελτιωμένος έλεγχος του άσθματος μειώνει τον κίνδυνο παροξύνσεων και εξασθένησης της πνευμονικής λειτουργίας, ενώ μειώνει το άμεσο κόστος της φροντίδας του άσθματος και το έμμεσο κόστος που σχετίζεται με μειωμένη παραγωγικότητα. Η κατανόηση της πολύπλοκης δυναμικής του αναπνευστικού συστήματος και της ανταπόκρισης του πνεύμονα στην ασθένεια είναι θεμελιώδης για την πρόοδο της θεραπείας του άσθματος. Τα υπολογιστικά μοντέλα του αναπνευστικού συστήματος επιδιώκουν να παρέχουν ένα θεωρητικό πλαίσιο για την κατανόηση της αλληλεπίδρασης μεταξύ δομής και λειτουργίας. Η εφαρμογή τους μπορεί να βελτιώσει την ιατρική του αναπνευστικού συστήματος, μέσω μιας ειδικής για τον ασθενή προσέγγισης σε ιατρικές μεθοδολογίες που βελτιστοποιούν την παροχή δεδομένων της εξατομικευμένης γεωμετρίας και των εξατομικευμένων μοτίβων κυκλοφορίας του αέρα. Στην παρούσα διατριβή εξετάζεται ένας τριπλός στόχος. Το πρώτο μέρος αναφέρεται στην κατανόηση της πνευμονικής παθοφυσιολογίας και της μηχανικής του άσθματος και στη συνέχεια των συσταλτικών πνευμονικών καταστάσεων γενικότερα. Το δεύτερο μέρος αναφέρεται στον σχεδιασμό και την εφαρμογή εργαλείων που διευκολύνουν την εξατομικευμένη ιατρική για τη βελτίωση της παροχής και της αποτελεσματικότητας. Τέλος, το τρίτο μέρος αναφέρεται στην αυτοδιαχείριση της πάθησης, που σημαίνει ότι το ιατρικό προσωπικό και οι ασθενείς έχουν πρόσβαση σε εργαλεία και μεθόδους που επιτρέπουν στο πρώτο μέρος να παρακολουθεί εύκολα την πορεία της πάθησης και στο δεύτερο μέρος, δηλαδή στον ασθενή, να αυτοδιαχειριζεται τα συμπτώματα ελαφρύνοντας σημαντικά την επιβάρυνση στο σύστημα υγείας.
Design, development, and local production of lipid-based nutritional supplements to enhance the complementary feeding diet: A model for collaboration for a feeding trial in Bangladesh
Authors: Merrill Rebecca , de Pee Saskia , Ahmed Tahmeed , Kramer Klaus , Hossain Nahid , Choudhury Nuzhat , Schumacher Britta , Steiger Georg , Minhas Shahid , Shamim Abu Ahmed , Shaikh Saijuddin , Fuli Rachel , Christian Parul
Published: September 2022

Background: Lipid-based nutrient supplements (LNS) are effective for treating childhood wasting and for preventing stunting, wasting, and anemia, but large-scale production and programmatic use are a barrier. Locally-developed and produced LNS may be more affordable and reduce logistical procurement and importation hurdles, while promoting private sector engagement and partnership.

Methods: In northwestern Bangladesh, we conducted a community-based trial of complementary food supplementation to test its efficacy to reduce childhood stunting. Two locally-developed, small-quantity LNS (20g/day, rice-lentil and chick-pea based) were designed, developed first at small scale in the ‘kitchen’ laboratory under controlled conditions, followed by taking them to a local food manufacturer for larger production for the study. We describe here the partnership, required expertise and capacity, experiences, and lessons learned that made this uniquely complex undertaking possible

Results: Key steps in the journey included addressing the dynamics of clear communication between partners, executing on carefully assigned tasks and roles, correcting course when needed, and maintaining timeliness and roadmaps. Knowledge of food science and technology was key in solving many food-production challenges that were encountered in taking the laboratory recipe to the factory. Factory production was established and had to meet quality and hygiene criteria set for young children.

Conclusions: We provide documentation of this experience as a model to describe the various steps and considerations and what is entailed in local LNS production. We highlight the importance of a well-conceived collaboration with clear roles that created a ‘win-win’ situation for all partners for achieving common goals, establishing improved technology at the factory, and building new capacity to produce such products for children in a low resource setting.

Key words: micronutrient, lipid-based nutrient supplements, maternal and child, malnutrition, multiagency collaboration
STATE OF TRANSPORT INDUSTRY OF RUSSIA AND MAIN TRENDS OF ITS DEVELOPMENT
Authors: Mirkina Olga N.
Published: September 2022

The transport industry is the most important branch of the Russian economy. A significant part of the population is employed in the industry, it creates a significant amount of national income. An analysis of the most important indicators of the industry for 2018–2020 was carried out. To identify trends in the development of the transport industry, a detailed analysis was carried out in the following areas: freight transportation, passenger transportation, the length of transport routes, the presence of freight and passenger vehicles. An increase in transportation indicators, an increase in the length of public roads, a decrease in the availability of almost all types of vehicles were revealed. All indicators were adversely affected by pandemic-related constraints. At the same time, the economy of the country needs the development of the industry under consideration. Supporting the state and removing obstacles will allow the industry to develop.

The goal is to review the state of the transport industry of Russia and identify the main trends in its development.

Method or methodology of work: the study used general scientific methods – statistical, comparative analysis, logical generalizations.

Results: The current state of Transportation and Storage industry is assessed and some trends of its development are shown.

Field of application of the results: the obtained results can be used by economic entities in the field of transport organization.
DIAGNOSIS OF BRAKE SYSTEMS OF MOTOR VEHICLES IN OPERATING CONDITIONS
Authors: Huseynov Rasul V. , Alieva Karina A. , Nazhmudinova Madina N.
Published: September 2022

The article analyzes the effectiveness of methods for monitoring motor vehicles during operation. The relevance of the study lies in the fact that the braking system is an important element responsible for the safe operation of the car.

Purpose. To increase the efficiency of the technical operation of motor vehicles on the basis of the road method for diagnosing brake systems.

Methodology or methodology for conducting work. The article considers the road method using accelerometers.

Results. The main disadvantages of the road method and stands of various designs are considered, which give low reliability of the determined parameters of efficiency and stability during vehicle braking. The effectiveness of the implementation of on-line road diagnostics of automotive braking systems of multi-channel accelerometers is shown, which, when assessing course stability during braking, provide visually convincing information with a fairly high level of reliability.

Practical implications: the results of the study can be used by car service organizations.
MESOSCALE AND CONTINUUM MODELING OF BALLISTIC IMPACT ON KEVLAR/PHENOLIC COMPOSITE PLATES
Authors: CARPENTER ALEXANDER J. , CHOCRON SIDNEY , SCOTT NIKKI L. , ANDERSON, JR CHARLES E.
Published: September 2022

A woven aramid (Kevlar®)/polyvinyl butyral phenolic composite used in ballistic applications was subjected to ballistic impact tests involving various projectile masses and target panel thicknesses. Two different models were generated to simulate the impact tests. The first model is a mesoscale model in which fibers, the surrounding matrix, and interfaces are represented with separate finite elements and material models. The second model utilizes a continuum-level user material subroutine that utilizes rules of mixtures to relate stresses and strains within the fiber and matrix constituents. Simulations of the ballistic tests were conducted using both the mesoscale and continuum models, and the results were compared to velocity and backface deflection data from the tests. The simulation results suggested that the relatively large void content of the material (~11%) has a significant effect on the resulting impact response.
INITIATION CHARACTERISTICS OF COMP-B EXPLOSIVE SUBJECT TO SHAPED CHARGE JET
Authors: YAPING TAN , HENGXIANG HUANG , YOUER CAI
Published: September 2022

Under the development of insensitive munitions, the relationship of the diameter - velocity (dj-vj) plane of the jet and the initiation characteristics of explosives under jet impact is studied with conducting numerical simulations. It is found that under the action of jet impact, the initiation point of Comp-B explosive is concentrated at the lower right of the dj-vj plane, and the unexploded point is concentrated at the upper left of the dj-vj plane. There is an obvious boundary between the two domains. The desensitization characteristic of the precursor wave is verified, and it is proved that the vj 2dj criterion is not sufficient. It is also found that there are three different initiation modes of shelled Comp-B with jet impact. One is the impact initiation when the jet begins to penetrate the explosive, the other is the penetration initiation during jet penetration, and the third is the reflection wave initiation caused by the reflection enhancement of bow wave on the exit wall before shooting out of the target. With the increase of the barrier thickness, the three initiation modes change sequentially. Only impact initiation occurred in bare Comp-B and the gap shelled Comp-B.
A METHOD FOR DIGITALLY RECONSTRUCTING PROJECTILE FRAGMENTATION PATTERNS IN GELATIN BLOCKS THAT REQUIRES MINIMAL DATA COLLECTION
Authors: HOHNECKER KENNETH H.
Published: September 2022

The purpose of this paper is to propose a method for constructing a three-dimensional (3D) digital representation of projectile fragmentation patterns in gelatin blocks that requires minimal data collection. The data points required are the start and end points of each fragment’s wound track, as well as the track level designations (a means of organizing how the wound tracks are connected). The maximum likelihood estimates for the parameters of the wound track models are then used to determine the “best fit” fragmentation pattern. Though this paper focuses on the application to gelatin fragmentation patterns, the methodology can be readily used for any visco-elastic material.