bluuebunny/crossref_metadata_2025 huggingface dataset:
Antibiotic Prophylaxis in Reduction Mammaplasty: A Network Meta-Analysis
Authors: Seretis Konstantinos , Bounas Nikolaos , Papaspyrou Foteini
Published: March 2023

Background

Mounting evidence suggests that breast reduction surgery displays higher rates of surgical site infections (SSI) than initially presumed. Objective of this network meta-analysis is to evaluate the effectiveness of different antibiotic regimens in the prophylaxis from surgical site infections and delayed wound healing (DWH) following breast reduction.

Methods

A network meta-analysis was conducted using a predetermined protocol after searching the electronic databases MEDLINE, Scopus, the Cochrane Library and US National Institutes of Health Ongoing Trials Register from inception to July 2022. The included studies had to examine breast reduction in females with at least 1-month follow-up, receiving antibiotics in an intervention arm compared to a control arm. The quality of studies was assessed using the Cochrane risk of bias tool. A frequentist Mantel-Haenszel approach was adopted for the reported SSI rates while an inverse variance random effects model was used for the DWH rates.

Results

A total of 10 studies was included in the analysis involving 1331 patients. All but one study controlled for major risk factors, and no differences were observed in patients’ baseline characteristics. Antibiotic administration significantly reduced the SSI rate after breast reduction, with the prolonged antibiotic regimen being the most efficacious (odds ratio [OR]: 0.36 [95%CI: 0.15–0.85]). No statistically significant reduction in delayed wound healing rate was revealed among the regimens.

Conclusions

Antibiotics mitigate the SSI rate after breast reduction. This meta-analysis provides an evidence-based strategy to optimize antibiotic administration. Further research is needed though to examine antibiotic prophylaxis on delayed wound healing.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Population characteristics, management, and survival outcomes in muscle-invasive urothelial carcinoma undergoing radical resection: the MINOTAUR study
Authors: Roupret Morgan , Brouquet Alice , Colrat Florian , Diez-Andreu Pauline , Prudent Alexis , Chartier Mélanie , Gaudin Anne-Françoise , Bugnard Françoise , Chillotti Louis , Bénard Stève , Branchoux Sébastien , Bellera Carine , Negrier Sylvie
Published: March 2023

Purpose

To describe the incidence, management, and survival outcomes of patients with muscle-invasive urothelial carcinoma (MIUC) undergoing radical surgery (RS) in France.

Methods

We relied on a non-interventional real-world retrospective study based on French National Hospitalization Database. Adults with MIUC with a first RS between 2015 and 2020 were selected. Subpopulations of patients with RS performed in 2015 and 2019 (pre-COVID-19) were extracted, according to cancer site: muscle-invasive bladder cancer (MIBC) or upper tract urothelial carcinoma (UTUC). Disease-free and overall survival (DFS, OS – Kaplan–Meier) were assessed on the 2015 subpopulation.

Results

Between 2015 and 2020, 21,295 MIUC patients underwent a first RS. Of them, 68.9% had MIBC, 28.9% UTUC, and 2.2% both cancers. Apart from fewer men among UTUC (70.2%) than MIBC patients (90.1%), patients’ demographic (mean age ~ 73 years) and clinical characteristics were similar whatever the cancer site or year of first RS. In 2019, RS alone was the most frequent treatment, occurring in 72.3% and 92.6% in MIBC and UTUC, respectively. Between 2015 and 2019, neoadjuvant use rate increased from 13.8% to 22.2% in MIBC, and adjuvant use rate increased from 3.7% to 6.3% in UTUC. Finally, median [95% confidence interval] DFS times were 16.0 [14.0–18.0] and 27.0 [23.0–32.0] months among MIBC and UTUC, respectively.

Conclusion

Among patients with resected MIUC annually, RS alone remained the main treatment. Neoadjuvant and adjuvant use increased between 2015 and 2019. Nonetheless, MIUC remains of poor prognosis, highlighting an unmet medical need, notably among patients at high risk of recurrence.
Genetic testing for Parkinson’s disease in clinical practice
Authors: Gasser Thomas
Published: March 2023

The identification of disease-causing mutations or strong risk factors for Parkinson’s disease in genes encoding proteins such as α-synuclein (SNCA), leucine-rich repeat kinase-2 (LRRK2), or glucocerebrosidase (GBA1) has led to a better understanding of the different components of disease pathogenesis. Many gene and mutation-specific targeted disease-modifying treatments are under development and several studies are under way. It is, therefore, important to raise awareness among patients and their families and to offer genetic testing, at least to those patients who are considering to participate in innovative trials.
Climatic characteristics of mesoscale convective systems in the warm season in North China
Authors: Long Linxue , He Lihua , Li Jiangbo , Zhang Wenlong , Zhang Yingxin
Published: March 2023

In this study, a total of 339 mesoscale convective systems (MCSs) are obtained in North China using the temperature of brightness blackbody (TBB) data from the FY-2E in the warm season from 2010 to 2018. The number of meso-α-scale convective systems (MαCSs) is much more than that of meso-β-scale convective systems (MβCSs). The number of mesoscale elongated convective systems (MECSs) is more than that of mesoscale circular convective systems (MCCSs). Most MCSs occur in July and August, which have the widest influence range, the longest duration, and the strongest convection. The MαCS develops slowly and weakens rapidly. The diurnal variation of MαCSs presents a bimodal distribution, most of MαCSs form in the afternoon, while some of MαCSs form in the evening. The MCSs activities in the warm season of North China are concentrated in two belts, namely, the east–west-oriented belt along Henan Province, Shandong Province and the Yellow Sea, and the south–north-oriented belt along central-western Shandong, Tianjin City, the west of Bohai Sea and the northeast of Hebei Province. MCSs mainly move eastward, and only some MECSs move southwestward and northwestward. The easterly and northerly moving MCSs are mainly affected by the steering flow, while the southerly moving MCSs are mainly affected by storm propagation. The MCSs of North China mainly form in the high temperature, high humidity and high energy area, with favorable dynamic conditions, such as middle-level trough or vortex, low-level shear line, surface inverted trough or surface convergence line, and the terrain. Meanwhile, the MCS pregnant environment is often accompanied by low-level jet and relatively strong vertical wind shear.
Potential of microalgae Bio-Coke as a sustainable solid fuel alternative to coal coke
Authors: Koesoemadinata Vidya Cundasari , Nakamura Shunsuke , Kamal Baharin Nur Syahirah , Yahya Wira Jazair , Muhamad Yuzir Muhamad Ali , Iwamoto Koji , Suzuki Kengo , Ida Tamio , Md Akhir Fazrena Nadia , Othman Nor’azizi , Hara Hirofumi
Published: March 2023

Energy and environmental issues have triggered the search for new sources of green energy alternatives in recent years. Biofuel production from renewable sources is widely considered one of the most sustainable alternatives for environmental and economic sustainability. Microalgae are currently being promoted as one of the most promising liquid biofuel feedstocks due to their rapid growth, high lipid production capacity, and carbon–neutral cycle. In this study, whole microalgae cells were utilized as raw material to produce solid biofuel, i.e., Bio-Coke, and this study aimed to investigate the possibility of microalgae Bio-Coke as an alternative to coal coke. The results show that Bio-Coke can be produced from microalgae in the temperature range of 80–100 °C. The apparent density is between 1.253 and 1.261 g/cm3, comparable to the apparent density of lignocellulosic Bio-Coke. Additionally, the calorific value is higher than the calorific value of lignocellulosic Bio-Coke and within the range of the calorific value of subbituminous coal. Therefore, microalgae Bio-Coke can be utilized to replace coal coke usage in the future.
Risk Factors Associated with HIV Acquisition in Males Participating in HIV Vaccine Efficacy Trials in South Africa
Authors: Malahleha Mookho , Laher Fatima , Dilraj Athmanundh , Smith Philip , Gray Glenda E. , Grove Doug , Odhiambo Jackline A. , Andrasik Michele P. , Grunenberg Nicole A. , Moodie Zoe , Huang Yunda , Borate Bhavesh R. , Gillespie Kevin M. , Allen Mary , Atujuna Millicent , Singh Nishanta , Kalonji Dishiki , Meintjes Graeme , Kotze Phillip , Bekker Linda-Gail , Janes Holly
Published: March 2023

In South Africa, HIV acquisition risk has been studied less in people assigned male at birth. We studied the associations between risk behaviors, clinical features and HIV incidence amongst males in two South African HIV preventive vaccine efficacy trials. We used Cox proportional hazards models to test for associations between demographics, sexual behaviors, clinical variables and HIV acquisition among males followed in the HVTN 503 (n = 219) and HVTN 702 (n = 1611) trials. Most males reported no male sexual partners (99.09% in HVTN 503) or identified as heterosexual (88.08% in HVTN 702). Annual HIV incidence was 1.39% in HVTN 503 (95% CI 0.76–2.32%) and 1.33% in HVTN 702 (95% CI 0.80–2.07%). Increased HIV acquisition was significantly associated with anal sex (HR 6.32, 95% CI 3.44–11.62), transactional sex (HR 3.42, 95% CI 1.80–6.50), and non-heterosexual identity (HR 16.23, 95%CI 8.13–32.41) in univariate analyses and non-heterosexual identity (HR 14.99, 95% CI 4.99–45.04; p < 0.01) in multivariate analysis. It is appropriate that prevention efforts in South Africa, although focused on the severe epidemic in young women, also encompass key male populations, including men who have sex with men, but also men who engage in anal or transactional sex.
A natural Hessian approximation for ensemble based optimization
Authors: Zhang Yiteng , Stordal Andreas S. , Lorentzen Rolf J.
Published: March 2023

A key challenge in reservoir management and other fields of engineering involves optimizing a nonlinear function iteratively. Due to the lack of available gradients in commercial reservoir simulators the attention over the last decades has been on gradient free methods or gradient approximations. In particular, the ensemble-based optimization has gained popularity over the last decade due to its simplicity and efficient implementation when considering an ensemble of reservoir models. Typically, a regression type gradient approximation is used in a backtracking or line search setting. This paper introduces an approximation of the Hessian utilizing a Monte Carlo approximation of the natural gradient with respect to the covariance matrix. This Hessian approximation can further be implemented in a trust region approach in order to improve the efficiency of the algorithm. The advantages of using such approximations are demonstrated by testing the proposed algorithm on the Rosenbrock function and on a synthetic reservoir field.
Environmental Harms at the Border: The Case of Lampedusa
Authors: Soliman Francesca
Published: March 2023

In this paper I examine authorities’ management of migrant boats on the island of Lampedusa, Italy, as an example of environmental border harm. A danger to trawlers, sunken wrecks are also hazardous to the environment, with pollutants such as oil and fuel seeping into the sea. Migrant boats that reach the island, whether independently or towed by rescuers, are left to accumulate in the harbour and eventually break up, scattering debris in bad weather. When boats are uplifted onto land, they are amassed in large dumps, leaking pollutants into the soil. Periodically, the resulting environmental crises trigger emergency tendering processes for the disposal of the boats, which allow for the environmental protections normally required in public bidding to be suspended for the sake of expediency. The disposal of migrant boats thus relies on a pattern of manufactured environmental emergencies, consistent with the intrinsically crisis-based management of the border itself.
Teacher profiles in higher education: the move to online education during the COVID-19 crisis
Authors: Stevens T. M. , den Brok P. J. , Noroozi O. , Biemans H. J. A.
Published: March 2023

During the COVID-19 pandemic, teachers were forced to move their teaching completely online. While some seized the opportunity to learn and innovate, others experienced difficulties. This study provides insights into the differences between university teachers during the COVID-19 crisis. A survey among university teachers (N = 283) was conducted to investigate their attitudes towards online teaching, beliefs about students’ learning, level of stress experienced, self-efficacy and beliefs about their own professional development. Employing a hierarchical cluster analysis, four distinct teacher profiles were found. Profile 1 was critical but eager; Profile 2 was positive but stressed; Profile 3 was critical and reluctant; Profile 4 was optimistic and easy-going. The profiles differed significantly in their use and perception of support. We suggest that teacher education research should carefully consider sampling procedures or take a person-centred research approach and that universities should develop targeted forms of teacher communication, support and policy.
National customer orientation: an empirical test across 112 countries
Authors: Mintz Ofer , Currim Imran S. , Deshpandé Rohit
Published: March 2023

Customer orientation is a central tenet of marketing. However, less is known about how customer orientation varies across countries and time. Mintz, Currim, and Deshpandé (Eur. J. Mark., 56: 1014–1041, 2022) propose a country-level construct, national customer orientation, and develop theoretical propositions on how a country’s wealth and average customer price sensitivity affect national customer orientation during and after global economic shocks without providing an empirical test. This paper tests drivers of national customer orientation by employing World Economic Forum and World Bank annual panel data from 112 countries between 2007 and 2017. The results show that customer orientation is a greater luxury of richer nations and price sensitivity is a partial mediator of that relationship; however, both relationships only transpire in non-recessionary times. The empirical test furthers scholarly research on national customer orientation and provides managers with country-level customer orientation benchmarks across countries and time.
Interstitial photodynamic therapy for newly diagnosed glioblastoma
Authors: Quach Stefanie , Schwartz Christoph , Aumiller Maximilian , Foglar Marco , Schmutzer Michael , Katzendobler Sophie , El Fahim Mohamed , Forbrig Robert , Bochmann Katja , Egensperger Rupert , Sroka Ronald , Stepp Herbert , Rühm Adrian , Thon Niklas
Published: March 2023

Purpose

Innovative, efficient treatments are desperately needed for people with glioblastoma (GBM).

Methods

Sixteen patients (median age 65.8 years) with newly diagnosed, small-sized, not safely resectable supratentorial GBM underwent interstitial photodynamic therapy (iPDT) as upfront eradicating local therapy followed by standard chemoradiation. 5-aminolevulinic acid (5-ALA) induced protoporphyrin IX was used as the photosensitizer. The tumors were irradiated with light at 635 nm wavelength via stereotactically implanted cylindrical diffuser fibers. Outcome after iPDT was retrospectively compared with a positively-selected in-house patient cohort (n = 110) who underwent complete tumor resection followed by chemoradiation.

Results

Median progression-free survival (PFS) was 16.4 months, and median overall survival (OS) was 28.0 months. Seven patients (43.8%) experienced long-term PFS > 24 months. Median follow-up was 113.9 months for the survivors. Univariate regression revealed MGMT-promoter methylation but not age as a prognostic factor for both OS (p = 0.04 and p = 0.07) and PFS (p = 0.04 and p = 0.67). Permanent iPDT-associated morbidity was seen in one iPDT patient (6.3%). Patients treated with iPDT experienced superior PFS and OS compared to patients who underwent complete tumor removal (p < 0.01 and p = 0.01, respectively). The rate of long-term PFS was higher in iPDT-treated patients (43.8% vs. 8.9%, p < 0.01).

Conclusion

iPDT is a feasible treatment concept and might be associated with long-term PFS in a subgroup of GBM patients, potentially via induction of so far unknown immunological tumor-controlling processes.
Multiple timing and spatial scaling for bifurcations
Authors: Verhulst Ferdinand
Published: March 2023

Scaling time and spatial domains often seem natural in ODEs, but unfortunately, its useful explicit form does not always agree with intuition. After reviewing the well-known methods, multiple timing and averaging, we will show that algebraic timelike variables may play a part in bifurcations. Part of this discussion is tied in with the problem of structural stability in the analysis of matrices, and another part is determined by bifurcation theory of nonlinear systems. Secondly, the theory of resonance manifolds for higher dimensional problems involving at least 2 angles will show the presence of unexpected small spatial domains that may emerge involving long timescales and containing interesting phenomena. A number of examples from mechanics are presented to demonstrate the theory.
Teacher exhaustion: The effects of disruptive student behaviors, victimization by workplace bullying, and social support from colleagues
Authors: Kollerová Lenka , Květon Petr , Zábrodská Kateřina , Janošová Pavlína
Published: March 2023

Exhaustion, as a key facet of burnout, is one of the most common risks that compromises teacher well-being and contributes to a shortage of teachers. While the school social environment has been identified as an influential context for teacher exhaustion, the relative importance of its different facets remains unclear. This study focused on the most proximal social environment in school and examined the role of teachers’ social experiences with students, fellow teachers, and leadership. The sample comprised teachers (N = 740; 77% women and 23% men) of adolescent students. In an online survey, participants reported their exhaustion and perceptions of student disruptive behaviors, victimization by workplace bullying, and social support from colleagues. A sequential linear regression controlling for gender, school type, and length of teaching experience indicated that exhaustion was positively associated with disruptive student behaviors and victimization by workplace bullying and negatively associated with social support from leadership. Regarding the individual control variables, exhaustion was higher in female teachers and in less experienced teachers. The type of school (elementary vs. secondary) did not play a role in exhaustion. The main findings suggest that to help prevent teacher exhaustion, teacher education should aim to better prepare teachers to handle disruptive student behaviors, and schools should maximize their efforts to reduce workplace bullying and foster leadership support for teachers.
Wide-Band Antenna on Flexible and Thin Substrate for Wireless Systems
Authors: Ibrahim Ahmed A. , Hassan Walaa M. , Dhasarathan Vigneswaran
Published: March 2023

This paper presents the design of a flexible monopole antenna for wideband applications. The proposed antenna is printed on flexible substrate material having a dielectric constant of 3 for the design and fabrication of the proposed antenna. The antenna dimensions are 3.8 cm × 4.1 cm × 0.025 cm. The antenna characteristics are investigated not only in flat conditions but also under bending configuration. Both flat and bending configurations are operated at frequency bands from 2.4 GHz up to 10 GHz with S- parameters lower than − 10 dB. The antenna parameters such as gain, efficiency, and radiation patterns are studied for both configurations. A deep study for time-domain response is discussed to validate the performance of the proposed antenna to operate at a wide band with a highly correlated response.
Symptom networks in glioma patients: understanding the multidimensionality of symptoms and quality of life
Authors: Röttgering J. G. , Varkevisser T. M. C. K. , Gorter M. , Belgers V. , De Witt Hamer P. C. , Reijneveld J. C. , Klein M. , Blanken T. F. , Douw L.
Published: March 2023

Purpose

To comprehend the complex relationship between symptoms and health-related quality of life (HRQoL) in patients with diffuse glioma, we applied symptom network analysis to identify patterns of associations between depression, cognition, brain tumor-related symptoms, and HRQoL. Additionally, we aimed to compare global strength between symptom networks to understand if symptoms are more tightly connected in different subgroups of patients.

Methods

We included 256 patients and stratified the sample based on disease status (preoperative vs. postoperative), tumor grade (grade II vs. III/IV), and fatigue status (non-fatigued vs. fatigued). For each subgroup of patients, we constructed a symptom network. In these six networks, each node represented a validated subscale of a questionnaire and an edge represented a partial correlation between two nodes. We statistically compared global strength between networks.

Results

Across the six networks, nodes were highly correlated: fatigue severity, depression, and social functioning in particular. We found no differences in GS between the networks based on disease characteristics. However, global strength was lower in the non-fatigued network compared to the fatigued network (5.51 vs. 7.49, p < 0.001).

Conclusions

Symptoms and HRQoL are highly interrelated in patients with glioma. Interestingly, nodes in the network of fatigued patients were more tightly connected compared to non-fatigued patients.

Implications for Cancer Survivors

We introduce symptom networks as a method to understand the multidimensionality of symptoms in glioma. We find a clear association between multiple symptoms and HRQoL, which underlines the need for integrative symptom management targeting fatigue in particular.
A systemic framework of energy efficiency in schools: experiences from six European countries
Authors: Brychkov Dmitry , Goggins Gary , Doherty Edelle , Romero Natalia , Roudil Nadine , Di Trani Antonella , Singh Abhigyan , Smit Sander , McLoughlin Eilish , de Castro Rodrigues Lima Raquel , Günbay Suzan Marie , Delmonte Branca Arthur , Hill Achim , Domegan Christine , Clifford Eoghan
Published: March 2023

Schools are complex physical and social institutions within national education systems. They account for significant energy consumption and like other buildings can demonstrate inefficient patterns of energy use. Poor energy performance of educational facilities is an intricate issue driven by complex causality of interconnected and dynamic factors. Addressing this issue requires a systemic approach, which is heretofore lacking. The aim of this research is to present and describe a systemic framework to facilitate energy reduction in schools across different European contexts. This transdisciplinary approach to sustainable energy use has been piloted in 13 post-primary schools located in six countries in northwest Europe. The research implements a series of planned activities and interventions, which help to unveil a systemic approach to improving energy efficiency in schools. The findings demonstrate how this approach, together with its ensuing methodologies and strategies, can contribute to reducing carbon emissions and improve knowledge and awareness around sustainable energy.
Isotope data in Migration Period archaeology: critical review and future directions
Authors: Depaermentier Margaux L. C.
Published: March 2023

Early Mediaeval Archaeology was long influenced by traditional narratives related to so-calledVölkerwanderungen. Based on the interpretation of ancient written sources, the “Migration Period” was traditionally perceived as a time of catastrophic changes triggered by the collapse of the Western Roman Empire and massive migration waves of “barbarian” groups across Europe. In the last decades, isotope analyses have been increasingly used to test these traditional narratives by exploring past mobility patterns, shifts in dietary habits, and changes in subsistence strategies or in socio-economic structures among early medieval societies. To evaluate the achievements of isotope studies in understanding the complexity of the so-called Migration Period, this paper presents a review of 50 recent publications. Instead of re-analysing the data per se, this review first explores the potentials and limitations of the various approaches introduced in the last decades. In a second step, an analysis of the interpretations presented in the reviewed studies questions to what extend traditional expectations are supported by isotope data from the Migration Period. Beside revising the concept of massive migrations, isotope data reveal so-far underestimated mobility patterns and open new perspectives in the investigation of early medieval world.
Acute Myocarditis Caused by Francisella tularensis: a Case Report
Authors: Bäck Anne Tuiskunen , Flygare Carolina , Eriksson Anders , Johansson Anders
Published: March 2023

Myocarditis is an inflammatory disease of the myocardium with either focal or diffuse involvement and usually gives rise to chest pain, dyspnea, palpitations, and fatigue. In severe cases, arrythmias, syncope, and cardiogenic shock may occur. Acute myocarditis is most commonly caused by a variety of viruses with cardiotropic properties. Rare causes of myocarditis include bacterial infections. We, herein, describe a case of acute myocarditis caused by the intracellular bacterium Francisella tularensis. A young and previously healthy male in Northern Sweden was referred to the emergency department due to intense upper-chest pain and dyspnea. ECG exhibited minimal ST-segment elevations and laboratory parameters revealed pathological levels of high-sensitivity cardiac troponin and C-reactive protein. Radiological imaging showed increased metabolism in enlarged lymph nodes in the chest and signs that could be compatible with increased metabolism in the left ventricular of the heart. The combination of acute myocarditis and enlarged lymph nodes was believed to be caused by the intracellular bacterium Francisella tularensis, endemic in the Northern Sweden, and was verified with positive serology. The patient showed full recovery after antimicrobial treatment. As this is the fifth published case of myocarditis associated with Francisella tularensis, we suggest considering tularemia in acute myocarditis in tularemia-endemic area.
The Politics of Budgets
Authors: Lipsmeyer Christine S. , Philips Andrew Q. , Whitten Guy D.
Published: March 2023

While governments prefer to alter budgets to fit their ideological stances, the domestic and international contexts can facilitate or constrain behavior. The Politics of Budgets demonstrates when governments do and do not make preferred budgetary changes. It argues for an interconnected view of budgets and explores both the reallocation of expenditures across policy areas and the interplay among budgetary components. While previous scholars have investigated how politics and economics shape a single budgetary category, or collective categories, this methodologically rich study analyzes data for thirty-three countries across thirty-five years to provide a more comprehensive theoretical approach: a 'holistic' framework about the competition and contexts around the budgetary process and an of examination of how and when these factors affect the budgetary decision-making processes.
SG-APSIC1059: Impact of a single intervention as part of a antimicrobial stewardship in a surgical unit of a tertiary-care referral center for neurosurgery
Authors: Raja Kavita , Ponnambath Dinoop Korol , Biju Shiny , Kaviyil Jyothi Embekkat
Published: March 2023

Background: Antimicrobial resistance is a worldwide problem leading to increasing deaths due to intractable infections, especially in postoperative patients who have extended stays in ICUs due to other surgical complications. Carbapenem and colistin resistance has been increasing here; hence, it was decided to monitor and control antibiotic use. In the neurosurgery unit of a quaternary-care hospital in South India, surgical prophylaxis was chosen as less problematic area in which to implement antibiotic stewardship. Objective: To study the difference in the antibiogram pattern of isolates from neurosurgery postoperative patients, before and after the introduction of a surgical antimicrobial prophylaxis policy from the UK National Health Service (NHS). Methods: After the implementation of a new surgical prophylaxis protocol taken from the UK NHS guidelines, we studied its impact by analyzing the antibiogram before implementation (period 1 from January 1, 2020, to December 31, 2020) and after implementation (period 2 from April 1, 2021, to September 30, 2021). This period corresponded to the same number of isolates as the earlier period. Antibiogram criteria: All clinically relevant infections due to the ESKAPE pathogens were included in the antibiogram. The antibiotics analyzed included β-lactams, cephalosporins, β-lactam- lactamase combinations, carbapenems, aminoglycosides, colistin and tigecycline for gram-negative bacilli and penicillin, oxacillin, aminoglycosides, vancomycin, and linezolid for gram-positive cocci. For analysis, the difference was deemed significant according to the criteria stated in CLSI document M39-A4 (4th edition, January 2014). Results: In period 1, 170 isolates were tested, and in period 2, 162 isolates were tested. Among the isolates, Enterococcus spp and Enterobacter spp were too few in number for a comparison. For the gram-negative bacilli, E. coli, Klebsiella pneumoniae, and Acinetobacter baumannii, the differences were significant for the β-lactam–lactamase combinations, carbapenems, and amikacin, with higher susceptibility in period 2. For Staphylococcus aureus, oxacillin, erythromycin, and clindamycin showed a significant increase in susceptibility in period 2. Relevant tables and a graph will be included in the presentation with detailed discussion. Conclusions: Controlled surgical prophylaxis strictly implemented can lead to a significant change in the antibiotic susceptibility pattern among isolates causing healthcare-associated infections among postoperative patients in intensive care units.
SG-APSIC1159: Control of hospital-acquired carbapenemase-producing carbapenem-resistant Enterobacteriaceae colonization: A descriptive study
Authors: Wu Tuodi , Jie Li , Cabahug Maria Theresa Mapalo Muyot , Liew Philomena , Hairu Chai , Nasir Suhailah Binte , Kaur Harminder , Rongyan An , Yun Foo Shi , Yen Tan Seow , Yen Tan Thean , Huei Tan Si
Published: March 2023

Objectives: Carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) are nosocomial pathogens, and control of CP-CRE transmission is one of the most important infection control issues healthcare organizations face today. Increasing colonization acquisition and clinical infections of CP-CRE occurred in our institution in 2019. In this observational study, we monitored CP-CRE acquisition following implementation of multimodal control measures, and we describe the impact of this intervention on clinical infections. Methods: Increased hospital-acquired CP-CRE colonization and clinical infections were observed in early 2019. Increased CP-CRE surveillance was implemented to include CP-CRE contacts, patients with lengths of stay >7 days, patients with a recent history of hospitalization in other hospitals, and renal dialysis patients. The following interventions were also implemented: (1) isolation or placing CP-CRE patients in cohorts in a designated multidrug-resistant organism (MDRO) ward; (2) emphasis on hand hygiene and contact precautions; (3) mandatory use of gown and gloves for predefined ‘high-risk’ nursing activities, including diaper changing, toilet assistance, wound dressing, and handling urine or stool; (4) enhanced environmental and equipment cleaning; (5) regular audit and feedback regarding compliance; and (6) weekly feedback on ward-level CP-CRE acquisition. CP-CRE
colonization cases and clinical infections were tracked by infection prevention and control nurses. Results: The hospital-acquired CP-CRE colonization rate was 4.39 per 10,000 patient days in 2019; it decreased slightly to 3.61 in 2020 and remained steady at 3.77 in 2021. The predominant CP-CRE genes were NDM, OXA-48–like, and KPC. There were 12 hospital-acquired CP-CRE infections in 2019, a rate of 0.37 per 10,000 patient days. This incidence decreased to 6 infections in 2020 and 3 infections in 2021, with corresponding infection rates of 0.19 and 0.09 per 10,000 patient days, respectively. Conclusions: Control of CP-CRE remains extremely challenging in hospitals with multibed open wards. A bundle approach to infection control showed a gradual reduction in CP-CRE cases, with a significant impact on the prevention of clinical infections.
Experimental monitoring of nonlinear wave interactions in crab orchard sandstone under uniaxial load
Authors: Malcolm Alison E. , Coates Lauren , Moravej Kamal , Melnikov Andrey , Butt Steve , Poduska Kristin M.
Published: March 2023

When two waves interact within a rock sample, the interaction strength depends strongly on the sample’s microstructural properties, including the orientation of the sample layering. The study that established this dependence on layering speculated that the differences were caused by cracks aligned with the layers in the sample. To test this, we applied a uniaxial load to similar samples of Crab Orchard Sandstone and measured the nonlinear interaction as a function of the applied load and layer orientation. We show that the dependence of the nonlinear signal changes on applied load is exponential, with a characteristic load of 11.4–12.5 MPa that is independent of sample orientation and probe wavetype (P or S); this value agrees with results from the literature, but does not support the cracks hypothesis.
Placed: Respect for Existing Value in Decolonizing Philosophy
Authors: Switzer M. Véronique
Published: March 2023

In “Rescuing Conservatism: A Defense of Existing Value,” G. A. Cohen offers an anticapitalist philosophy of valuing that takes as given the existence itself of particular valuable and valued things, and commitment through time to cherishing relationships to them. In this article, I argue that “being placed,” in precolonial senses, and decolonial “being in” and “seeking place,” are the givens of being valuing, living creatures among valuing, living creatures. Valuing as placed and valuing being placed are intrinsic to decolonial feminist resistance to the gendered, racialized, and denatured ideological warfare on the terms of life. Place is not one among other values; place and placed temporality must be accepted as given. In place, the past is living in the present. Placed decolonial valuing is the only resistance to solipsistic destruction of all that has value, to a coloniality that would fragment the past to destroy the life force of the capacity to value present existing and living. Thus I bring Cohen's rescuing valuable things, and the capacity to value them, to intergenerational, interspecies, temporally located placedness shared across diverse peoples prior to fifteenth- and sixteenth-century conquests and nineteenth-century imperialism, and in perpetual resistance to contemporary settler societies and coloniality.
Effects of a nozzle on the propeller wake in an oblique flow using modal analysis
Authors: Wang Tianyuan , Shi Hongda , Zhao Ming , Zhang Qin
Published: March 2023

The effect of a nozzle on the wake dynamics of a four-bladed propeller operating in an oblique flow is investigated via modal decomposition and flow visualization of the results obtained from numerical simulations using delayed detached eddy simulations. The wake characteristics and destabilization mechanisms of a non-ducted propeller (NP) and ducted propeller (DP) in axisymmetric and oblique flow conditions are systematically analysed. The wake characteristics on the windward side are very different from those on the leeward side in an oblique flow, and the nozzle has a crucial role in mitigating the asymmetry and weakening the wake deflection. More destabilization mechanisms are present in an oblique flow than in an axisymmetric flow, including the asymmetric evolution and destabilization of the helixes on the windward and leeward sides of the NP wake, the interaction between the vortex shedding and the helixes in the DP leeward region, and the generation of a tube-shaped wake envelope around the nozzle and its rolling-up. Moreover, the effect of the nozzle on wake meandering is discussed based on modal analysis.
All-cause mortality risk with different metabolic abdominal obesity phenotypes: the Rural Chinese Cohort Study
Authors: Wu Xiaoyan , Zhao Yang , Zhou Qionggui , Han Minghui , Qie Ranran , Qin Pei , Zhang Yanyan , Huang Zelin , Liu Jiong , Hu Fulan , Luo Xinping , Zhang Ming , Liu Yu , Sun Xizhuo , Hu Dongsheng
Published: March 2023

We aimed to investigate the association of metabolic obesity phenotypes with all-cause mortality risk in a rural Chinese population. This prospective cohort study enrolled 15 704 Chinese adults (38·86 % men) with a median age of 51·00 (interquartile range: 41·00–60·00) at baseline (2007–2008) and followed up during 2013–2014. Obesity was defined by waist circumference (WC: ≥ 90 cm for men and ≥ 80 cm for women) or waist-to-height ratio (WHtR: ≥ 0·5). The hazard ratio (HR) and 95 % CI for the risk of all-cause mortality related to metabolic obesity phenotypes were calculated using the Cox hazards regression model. During a median follow-up of 6·01 years, 864 deaths were identified. When obesity was defined by WC, the prevalence of participants with metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO) and metabolically unhealthy obesity (MUO) at baseline was 12·12 %, 2·80 %, 41·93 % and 43·15 %, respectively. After adjusting for age, sex, alcohol drinking, smoking, physical activity and education, the risk of all-cause mortality was higher with both MUNO (HR = 1·20, 95 % CI 1·14, 1·26) and MUO (HR = 1·20, 95 % CI 1·13, 1·27) v. MHNO, but the risk was not statistically significant with MHO (HR = 0·99, 95 % CI 0·89, 1·10). This result remained consistent when stratified by sex. Defining obesity by WHtR gave similar results. MHO does not suggest a greater risk of all-cause mortality compared to MHNO, but participants with metabolic abnormality, with or without obesity, have a higher risk of all-cause mortality. These results should be cautiously interpreted as the representation of MHO is small.
FUNCTIONAL SEQUENTIAL TREATMENT ALLOCATION WITH COVARIATES
Authors: Kock Anders Bredahl , Preinerstorfer David , Veliyev Bezirgen
Published: March 2023

We consider a sequential treatment problem with covariates. Given a realization of the covariate vector, instead of targeting the treatment with highest conditional expectation, the decision-maker targets the treatment which maximizes a general functional of the conditional potential outcome distribution, e.g., a conditional quantile, trimmed mean, or a socioeconomic functional such as an inequality, welfare, or poverty measure. We develop expected regret lower bounds for this problem and construct a near minimax optimal sequential assignment policy.
Uncovering the development of linguistic knowledge in lesser studied languages
Authors: DEMUTH Katherine , MOLOI Francina , MATLOSA Litsepiso , JOHNSON Mark
Published: March 2023

There has recently been an increased interest in studying the language development of non-western languages. This is not new - it began in 1960’s and continued into the 1980’s and 1990’s. The current renewed interest is much welcomed, and will benefit from many of the experimental methods and theoretical insights developed over the past decades.
The wrath of God or national hero? Nader Shah in European and Iranian historiography
Authors: Matthee Rudi
Published: March 2023

This article examines the way in which Iran's eighteenth-century ruler Nader Shah was portrayed in contemporary Europe as well as in Iran, and how the resulting image—half national hero, half ruthless warlord—has resonated until today. In an age short on ‘great’ leaders, Nader spoke to the imagination like no other contemporary ruler, Western or Asian. Nader's subsequent record can be read as a palimpsest, a layered series of images of multiple world conquerors, from Alexander to Napoleon. The latter, who shared Nader's humble background and evoked a similar ambivalence, represented the closest analogue, turning him into the European Nader Shah. In the modern West, Nader no longer speaks to the imagination. Modern Iranians, by contrast, have come to see him as the Iranian Napoleon. While still ambivalent about him, they admire him as the ruler who regenerated the nation and ended foreign occupation, yet his undeniable cruelty and imperialism make him an awkward national hero.
Income taxation and job creation
Authors: Röhrs Johanna
Published: March 2023

This paper augments the DMP model with large firms and intrafirm wage bargaining by an endogenous decision to become an entrepreneur that is based on heterogeneous entrepreneurial abilities. If workers’ wage bargaining power is not too large and the match efficiency is not too low, the decentralized market equilibrium features an inefficiently high number of entrepreneurs, because they appropriate large parts of the surplus from matches. A realistic calibration with empirically plausible parameters shows this case to be the relevant one. Consequently, introducing a tax on the profits of entrepreneurs restores the constrained first-best allocation by affecting occupational choices. It drives rather unproductive entrepreneurs out of the market since the marginal entrepreneur is affected and not the average one. Thus, the negative effects on job creation are small.
Secondary Cratering From Rheasilvia as the Possible Origin of Vesta's Equatorial Troughs
Authors: Hirata Naoyuki
Published: March 2023

Asteroid 4 Vesta has a set of parallel troughs aligned with its equator. Although previous evaluations suggest that it is of shock fracturing tectonic origin, we propose that the equatorial troughs can be created by secondary cratering from the largest impact basin, Rheasilvia. We calculated the trajectories of ejecta particles from Rheasilvia by considering Vesta's rapid rotation. As a result, we found that secondary craters should be parallel to the latitude. In particular, if we assume that ejecta particles are launched at an initial launch velocity of approximately 350–380 m/s and a launch angle of 25°, the parallel equatorial troughs, the Divalia Fossae, can be suitably explained by secondary cratering. This model works well on objects, such as Haumea, Salacia, and Chariklo, but not on Mercury, the Moon, and regular satellites.
Genome-wide meta-analysis identifies novel loci conferring risk of acne vulgaris
Authors: Teder-Laving Maris , Kals Mart , Reigo Anu , Ehin Riin , Objärtel Telver , Vaht Mariliis , Nikopensius Tiit , Metspalu Andres , Kingo Külli
Published: March 2023

Acne vulgaris is a common chronic skin disorder presenting with comedones, cystic structures forming within the distal hair follicle, and in most cases additionally with inflammatory skin lesions on the face and upper torso. We performed a genome-wide association study and meta-analysis of data from 34,422 individuals with acne and 364,991 controls from three independent European-ancestry cohorts. We replicated 19 previously implicated genome-wide significant risk loci and identified four novel loci [11q12.2 (FADS2), 12q21.1 (LGR5), 17q25.3 (FASN), and 22q12.1 (ZNRF3-KREMEN1)], bringing the total number of reported acne risk loci to 50. Our meta-analysis results explain 9.4% of the phenotypic variance of acne. A polygenic model of acne risk variants showed that individuals in the top 5% of the risk percentiles had a 1.62-fold (95% CI 1.47–1.78) increased acne risk relative to individuals with average risk (20–80% on the polygenic risk score distribution). Our findings highlight the Wnt and MAPK pathways as key factors in the genetic predisposition to acne vulgaris, together with the effects of genetic variation on the structure and maintenance of the hair follicle and pilosebaceous unit. Two novel loci, 11q12.2 and 17q25.3, contain genes encoding key enzymes involved in lipid biosynthesis pathways.
Visual electrophysiology and “the potential of the potentials”
Authors: Mahroo Omar A.
Published: March 2023

Visual electrophysiology affords direct, quantitative, objective assessment of visual pathway function at different levels, and thus yields information complementary to, and not necessarily obtainable from, imaging or psychophysical testing. The tests available, and their indications, have evolved, with many advances, both in technology and in our understanding of the neural basis of the waveforms, now facilitating more precise evaluation of physiology and pathophysiology. After summarising the visual pathway and current standard clinical testing methods, this review discusses, non-exhaustively, several developments, focusing particularly on human electroretinogram recordings. These include new devices (portable, non-mydiatric, multimodal), novel testing protocols (including those aiming to separate rod-driven and cone-driven responses, and to monitor retinal adaptation), and developments in methods of analysis, including use of modelling and machine learning. It is likely that several tests will become more accessible and useful in both clinical and research settings. In future, these methods will further aid our understanding of common and rare eye disease, will help in assessing novel therapies, and will potentially yield information relevant to neurological and neuro-psychiatric conditions.
Potent acyl-CoA synthetase 10 inhibitors kill Plasmodium falciparum by disrupting triglyceride formation
Authors: Bopp Selina , Pasaje Charisse Flerida A. , Summers Robert L. , Magistrado-Coxen Pamela , Schindler Kyra A. , Corpas-Lopez Victoriano , Yeo Tomas , Mok Sachel , Dey Sumanta , Smick Sebastian , Nasamu Armiyaw S. , Demas Allison R. , Milne Rachel , Wiedemar Natalie , Corey Victoria , Gomez-Lorenzo Maria De Gracia , Franco Virginia , Early Angela M. , Lukens Amanda K. , Milner Danny , Furtado Jeremy , Gamo Francisco-Javier , Winzeler Elizabeth A. , Volkman Sarah K. , Duffey Maëlle , Laleu Benoît , Fidock David A. , Wyllie Susan , Niles Jacquin C. , Wirth Dyann F.
Published: March 2023

Identifying how small molecules act to kill malaria parasites can lead to new “chemically validated” targets. By pressuring Plasmodium falciparum asexual blood stage parasites with three novel structurally-unrelated antimalarial compounds (MMV665924, MMV019719 and MMV897615), and performing whole-genome sequence analysis on resistant parasite lines, we identify multiple mutations in the P. falciparum acyl-CoA synthetase (ACS) genes PfACS10 (PF3D7_0525100, M300I, A268D/V, F427L) and PfACS11 (PF3D7_1238800, F387V, D648Y, and E668K). Allelic replacement and thermal proteome profiling validates PfACS10 as a target of these compounds. We demonstrate that this protein is essential for parasite growth by conditional knockdown and observe increased compound susceptibility upon reduced expression. Inhibition of PfACS10 leads to a reduction in triacylglycerols and a buildup of its lipid precursors, providing key insights into its function. Analysis of the PfACS11 gene and its mutations point to a role in mediating resistance via decreased protein stability.