bluuebunny/crossref_metadata_2025 huggingface dataset:
SG-APSIC1108: Implementation of infection prevention and control in Indonesian hospitals: Identification of strengths, gaps, and challenges in current practices
Authors: Supriadi Indri Rooslamiati , Saptawati Leli , Widodo Nani H. , Satari Hindra Irawan , Sitohang Gortap , Usman Yuslely , Anom Ida Bagus , Saraswati Ratih Dian , Severin Juliëtte A.
Published: March 2023

Objectives: Infection prevention and control (IPC) in hospitals is key to safe patient care. Currently, no data are available regarding the implementation of IPC in hospitals in Indonesia. We assessed the existing IPC practices in a nationwide survey using the World Health Organization (WHO) IPC assessment framework tool (IPCAF) to identify strengths, weaknesses, and challenges. Methods: A cross-sectional study was conducted from July to November 2021. Of all general hospitals in Indonesia, 475 (20%) were selected using stratified random sampling based on class (ie, A, B, C, and D; A being the larger hospitals with ≥250 beds) and region. IPCAF was translated into Indonesian and was tested in 4 hospitals. Questions were added regarding challenges in the implementation of IPC. Introduction meetings were held online with all selected hospitals, after which the IPCAF was sent as an online questionnaire. Results: In total, 355 hospitals (74.7%) participated in this study. The overall median score of IPCAF was 632.5. The level of
implementation of IPC was mostly advanced (56.9%), followed by intermediate (35.8%), basic (7.0%), and inadequate (0.3%). The core component with the highest scores was IPC guidelines; almost all hospitals had guidelines on the most important topics, including hand hygiene. Core components with the lowest scores were surveillance of healthcare-associated infections (HAIs), education and training, and multimodal strategies. Although >90% of hospitals indicated that surveillance of HAIs was performed, 57.2% reported no availability of adequate microbiology laboratory capacity to support HAI surveillance. The most reported challenges in the implementation of IPC were behavior change and lack of availability of antibiograms. Conclusions: The implementation of the IPC core components in most Indonesian hospitals was “advanced.” For surveillance of HAIs, the need for the availability and capability of the microbiology laboratory was revealed.
SG-APSIC1086: Case series: Examining healthcare-associated infection cases caused by Candida auris at Cho Ray Hospital, Vietnam
Authors: Hong Thoa Vo Thi , Thang Phung Manh , Ha Tran Thi Thu , Nhu Nguyen To , Chi Bui , Vasquez Amber
Published: March 2023

Objectives:Candida auris was first detected in Japan in 2009 and has been reported in >47 countries, typically causing outbreaks in healthcare settings. According to the US Centers for Disease Control and Prevention, this pathogen causes death in more than one-third of infected patients. This study describes characteristics of healthcare-associated infections (HAIs) related to C. auris and infection prevention and control (IPC) measures applied to control transmission in Cho Ray Hospital, a tertiary-care, referral, general hospital in southern Vietnam. Methods: We reviewed medical records of all patients with HAIs caused by C. auris at Cho Ray Hospital between April 2020 and March 2021, as well as the IPC measures applied for these patients. Results: Overall, 5 HAI cases caused by C. auris were identified in 5 patients, including 2 catheter-associated urinary tract infections, 2 ventilator-associated pneumonia cases, and 1 surgical site infection. These cases were sporadically detected in 4 different clinical departments; 2 cases occurred in the respiratory department in April and August 2020. The average age of the patients was 63, and 4 of 5 patients were male. The average hospital stay was 27.2 days; 4 patients died and 1 was discharged. IPC interventions were implemented to immediately respond to C. auris infection cases, including isolating the patients, applying standard and transmission-based precautions, supplying adequate personal protective equipment, cleaning environment surfaces and medical equipment in the patient’s room, and marking isolation areas with signage. No additional cases of C. auris infection were detected in the affected units. Conclusions:C. auris can spread in healthcare settings via contact with contaminated equipment and surfaces or from person to person, causing outbreaks in hospitals and leading to severe illness and high mortality for patients. Prompt application of appropriate IPC measures effectively helped prevent additional cases of C. auris in our hospital.
SG-APSIC1036: Effect of quality improvement in medical devices preparation on increasing customers’ satisfaction in services of the Central Sterile Supply Department of Srinagarind Hospital
Authors: Ruangprasertkul Sasithorn , Quobuwan Ponsawan
Published: March 2023

Objectives: Preparation of medical devices from central sterile supply department (CSSD) for use in hospital services requires quality and readiness for use. A guideline for good practice is necessary for safety, assurance, and maximum customer satisfaction, and to accommodate effective healthcare services. We sought to develop and improve medical-device preparation guidelines to satisfy clients. Methods: This action research was based on the concepts of Kaizen and eliminate–combine–rearrange–simplify (ECRS). The research was conducted in 3 phases. In the first phase, we designed the study, conducted problem analysis, and developed a plan for improving the preparation of medical devices. In the second phase, we improved the plan for implementation of medical-device preparation guidelines that the research team adapted and developed. We added inspection categories, trained staff members, conducted a focus group. We improved cleaning processes and the inventory system. In the third phase, we conducted an improvement evaluation for (1) quality improvement of medical device preparation and (2) client satisfaction. The research took place from January to December 2019. Results: The monthly percentages of medical equipment that passed quality criteria before and after the implementation plan were 91.82±1.19% and 95.33±1.25% (P ≤ .005). The average client satisfaction score increased from 76.80% to 83.40% (P = .006). Conclusions: The implementation of Kaizen and ECRS principles for quality improvement successfully increased the quality of equipment preparation and introduced standardized, quality guidelines. The plan–do–check–act (PDCA) process improved client satisfaction, staff performance, and operational efficiency while preventing damage to medical devices and improving readiness of use.
SG-APSIC1101: Virulence factors and antimicrobial resistance in coagulase-negative staphylococci isolated from blood of neonates
Authors: Kolesnichenko Svetlana , Kadyrova Irina , Lavrinenko Alyona , Akhmaltdinova Lyudmila , Panibratec Lyudmila
Published: March 2023

Objectives: To determine virulence genes and sensitivity to antibacterial drugs of Staphylococcus epidermidis isolated from blood cultures of newborns. Methods: A study of сoagulase-negative Staphylococcus (CoNS) from newborns with sepsis was conducted in the regional perinatal center in Karaganda, Kazakhstan. Blood-culture identification was performed using MALDI-TOF MS. Virulence factors were determined on primers (sdrG, sdrG, atl, lip, nuc, ebh, hlb, sspA, sspB, and gehD) with PCR (Bio-Rad CFX 96). Susceptibility to antibiotics determination was carried out using the disc-diffusion method. Testing with cefoxitin was used to detect methicillin resistance in staphylococci. Results: Overall, 18 Staphylococcus epidermidis isolates from blood cultures of newborns with sepsis were investigated from January to December 2021. The frequency of detection of virulence genes was distributed as follows: atl (94.5%), sspB (94.5%), sspA (89%), gehD (89%), ebh (89%), hlb (72%), sdrG (39%), sdrF (28%), nuc (28%), and lip (13%). Also, 10 isolates (55%) were resistant to cefoxitin (MRSE). Furthermore, 72% of S. epidermidis isolates showed resistance to azithromycin and 33% were resistant to clindamycin and gentamicin. Also, 39% of strains were resistant to fluorchinolones. All isolates were susceptible to vancomycin, linezolid, and fusidic acid. Conclusions:S. epidermidis strains isolated from blood cultures had high rates of exoenzymes sspB, sspA, gehD, autolysin (atl), β-hemolysin (hlb), and cell-wall–associated fibronectin-binding protein (ebh). Among 18 neonatal sepsis pathogens, 10 (55%) were MRSE, so it is necessary to pay attention to antibiotic therapy adjustment.
SG-APSIC1154: Evaluation of disposable antimicrobial curtains in an ambulatory cancer center
Authors: Wong Sin Hui , Yap Swee Peng , Han Ming Zhen Priscilla
Published: March 2023

Objectives: The prevention of nosocomial infection is a challenge for all healthcare institutions. Privacy curtains are often changed infrequently, and they are difficult to clean. Contaminated curtains can be touched by healthcare providers and patients, which may result in indirect transmission of infectious disease. Hence, we evaluated the impact of the antimicrobial properties of disposable curtains and their cost-effectiveness. Methods: This descriptive exploratory study was conducted in an ambulatory cancer center in 2017. Privacy curtains were assigned to 2 cohorts, labelled E1 and E2. They were placed in the clinical areas for 6–12 months. Moist swab samples for MRSA, VRE, and CP-CRE cultures were obtained from the leading edges of the curtains during the evaluation period. Also, 10-cm × 10-cm swatches were cut from the high-touch areas of curtains and were tested for total aerobic count on the first of the month and quarterly thereafter. Results: All bacterial culture swabs obtained from the E1 and E2 cohorts of curtains were negative. The total bacterial plate count results from E1 curtains were negative for up to 1 year. However, the total bacterial plate count results for E2 curtains were positive in the sixth month. Using disposable curtains yielded an annual cost saving of ~50%. Conclusions: The use of appropriate impregnated antimicrobial disposable curtains can improve patient safety in the clinical areas. These curtains may eliminate potential sources of infection and thereby decrease the rate of nosocomial infection. They also save significant institutional costs by reducing frequent laundry and manpower requirements needed for the installation of curtains.
SG-APSIC1121: Family caregivers in the patient room: Exploring the family involvement in care provision across hospital settings from an infection prevention and control (IPC) perspective
Authors: Park Ji yeon , Seale Holly , Pardosi Jerico Franciscus
Published: March 2023

Objectives: Across many Asian countries, family caregivers provide a wide range of patient care activities while staying in the patient’s room. This unique care arrangement has been reported as a factor contributing to the spread of outbreaks including Middle East respiratory syndrome and coronavirus disease 2019 (COVID-19) in many Asian countries. We sought to understand the context in which direct patient care activities are provided by family caregivers and/or private caregivers in hospitals across Bangladesh, Indonesia, and South Korea from the infection prevention and control (IPC) perspective. Methods: We used a multimethod design with both quantitative and qualitative approaches. In total, 432 patients were surveyed from 5 tertiary-care hospitals across 3 selected countries, and 64 participants from 2 groups were interviewed: group A comprised patients, family caregivers and private caregivers and group B comprised healthcare workers. Survey data were analyzed descriptively, and the interview data were analyzed using thematic analysis. Results: The study findings highlight the different landscapes of care provision in the selected countries. Both the interviews and surveys highlighted 2 aspects of family caregiving. (1) Family caregivers inhabit in the patient zone for long periods, resulting in overcrowding, and (2) they provide a wide ranges of physically associated care activities, including those associated with the risk of healthcare-associated infections (HAIs). Despite the high number of family caregivers and their in-depth involvement in direct patient care, education and support provided to family caregivers around IPC/HAI were insufficient and varied. Also, challenges related to maintaining adequate hygiene in the environment for minimum IPC were reported. Conclusions: This study has elucidated the current landscape of family involvement in inpatient care provision and acknowledges their contribution to high risks of HAI, as well as their current lack of IPC knowledge and practice. These findings reveal that future updates in IPC strategy should acknowledge this arrangement with family caregivers and should address this role with IPC measures.
SG-APSIC1031: Reappraisal of the effectiveness of a care bundle for patients with candidemia
Authors: Chen Changhua , Chen Yu-Min
Published: March 2023

Objectives: Candidemia has become one of the leading causes of healthcare-associated bloodstream infection, particularly in the intensive care unit. The management of candidemia remains challenging. We reassessed the protective effectiveness of a comprehensive care bundle on the management of candidemia and the effects of compliance with each element on the outcomes of patients. Methods: This network meta-analysis was conducted using the frequentist method. The participants included adult patients both infected with candidemia and who received bundle care. The primary outcome was the all-cause mortality among the patients included. Results: Studies in which a care bundle was created for patients with candidemia were identified, and 5 eligible studies with 5,808 participants were enrolled for further analysis. The random-effects model of the overall odds ratio (OR) revealed a significant reduction in the risk of all-cause mortality compared with that of the controls (OR, 0.599; 95% CI, 0.378–0.949; P = .025), as well as a reduction in the risk of developing persistent candidemia compared with the controls (OR, 0.483; 95% CI, 0.245–0.952; P = .008). In addition, no single element reached a protective effectiveness to improve the clinical outcome. Conclusions: This meta-analysis demonstrated that the combination of core elements in the care bundle resulted in protective effects, in that the all-cause mortality rates and incidence rates were effectively reduced among patients with persistent candidemia.
SG-APSIC1203: Detection of carbapenemase genes in donor lungs at the point of care before transplantation reduces the risk of carbapenem-resistant Enterobacteriaceae–associated donor-derived infection in lung-transplant recipients
Authors: Zhou Wenyong , Tang Yi-Wei
Published: March 2023

Objectives: The number of lung transplants is increasing year by year in China and globally. With the widespread use of donation after brainstem death (DBD) donor lungs and donation after circulatory death (DCD) donor lungs, donor-derived infection (DDI) poses a major challenge in lung transplantation. Using donor lungs infected or colonized with carbapenem-resistant Enterobacteriaceae (CRE) may have serious implications in lung-transplant recipients. Currently, traditional microbial culture along with antimicrobial susceptibility testing cannot fully meet the need for rapid and accurate diagnosis of CRE infection in a donor before organ harvest. Methods: The Xpert Carba-R device (Cepheid, Sunnyvale, CA) was used to detect and differentiate Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), Verona integron-encoded metallo-β-lactamase (VIM), active-on-imipenem (IMP), and OXA-48 carbapenemase genotypes in bronchial lavage fluid from donor lungs before organ harvest. Positive detection of 1 or more of these genotypes indicated a potentially CRE-infected donor lung, and these organs were removed from the lung transplantation cohort. Donor lungs negative for all KPC, NDM, VIM, IMP, and OXA-48 genotypes determined by the Xpert Carba-R device were used for lung transplantation. The incidence of CRE-associated DDI and infection-related complications were compared in the Xpert Carba-R screening group and an historic control group. Results: In this study, 21 donor lungs were tested with the Xpert Carba-R device to detect and differentiate carbapenemase genotypes. Among them, 4 were positive for 1 or more carbapenemase genotypes and were discarded, and the remaining 17 donor lungs showing no carbapenemase gene presence were used for lung transplantation. No CRE-associated DDI occurred in these 17 lung-transplant recipients. Conclusions: Rapid and accurate detection of the carbapenemase gene in donor lungs at the point of care before transplantation using the Xpert Carba-R device reduced the risk of CRE-associated DDI in lung-transplant recipients.
SG-APSIC1136: Multidrug-resistant organisms: Elevating issues identified by antimicrobial stewardship to improve infection control responses
Authors: Sheehan Frances , Sheel Meru , Kennedy Karina , Daveson Kathryn
Published: March 2023

Objectives: Resistance to third-generation cephalosporins in Escherichia coli bacteremia is on the rise in Australia. Currently, laboratory definitions of multidrug-resistant organisms determine infection control responses. The incidence of particular extended-spectrum β-lactamase (ESBL) E. coli phenotype, with nonsusceptibility to both ciprofloxacin and trimethoprim-sulfamethoxazole, is increasing in the Australian Capital Territory, Australia. The increase was noted primarily through antimicrobial stewardship clinical care rather than standard infection control or microbiology processes. Clinically, patients are left with limited or no oral therapeutic options for treatment. Despite not necessarily meeting the laboratory definition of a multidrug-resistant organism, this phenotype is likely to be just as transmissible as other healthcare-associated pathogens. We sought to determine whether laboratory definitions of multidrug-resistant organisms adequately inform infection control responses. Methods: Using laboratory data from Australian Capital Territory (ACT) Pathology, we identified all ESBL E. coli bloodstream isolate episodes from 2016 to 2020. We then reviewed the antibiotic sensitivities of each isolate to identify isolates with nonsusceptibility to both ciprofloxacin and trimethoprim-sulfamethoxazole. We then compared these isolates with the multidrug-resistant organism definition used by ACT Pathology. Results: In total, 152 isolates were reviewed. ACT Pathology classified 35 (23.0%) of these isolates as a multidrug-resistant organisms. We identified 80 (52.6%) isolates with nonsusceptibility to both ciprofloxacin and trimethoprim-sulfamethoxazole. Of these 80 isolates, only 24 (30.0%) met the ACT Pathology definition of a multidrug-resistant organism. Conclusions: Multidrug-resistant organism definitions should encompass a broad range of healthcare considerations. When the laboratory defines what is important, it may not include the complete spectrum of clinical care concerns. To help combat the rise of multidrug-resistant organisms, definitions for organisms of resistance and transmissibility significance should be developed in conjunction with microbiology, infection control, and antimicrobial stewardship.
SG-APSIC1166: Strategies to reduce hospital-onset Clostridioides difficile infections in an acute-care hospital in Singapore
Authors: Foo Shi Yun , JIe Li , Yun Foo Shi , Hairu Chai , Cabahug Theresa , Yan An Rong , Tuodi Wu , Nasir Suhailah Binte , Kaur Harminder
Published: March 2023

Objectives: Control of Clostridioides difficile infections (CDIs) in healthcare facilities presents significant challenges to infectious disease physicians, infection prevention and control practitioners, and environmental services staff. CDI is a common cause of infectious diarrhea and is associated with significant morbidity, mortality, and healthcare cost. A high infection rate was documented in our institution in 2017, higher than the national infection rate. Strategies to reduce hospital-onset CDI were implemented after review of international guidelines and relevant literature. The impact on hospital-onset CDI was assessed. Methods: The following strategies were implemented beginning early in 2018: (1) contact precautions for patients with diarrhea; (2) early recognition and diagnosis of C. difficile infection; (3) prompt isolation of C. difficile patients; (4) emphasis on hand hygiene and contact precautions; (5) enhanced environmental cleaning with chlorine-based disinfectant and use of UV-C and ionized hydrogen peroxide for equipment disinfection; (6) enhanced cleaning and disinfection using sporicidal wipes for shared high-risk equipment; (7) audit and feedback regarding compliance with practices and environmental cleaning; and (8) collaboration with antibiotics stewardship program (ASP) to reduce inappropriate antibiotic use. Hospital-onset CDI cases were tracked by infection prevention and control nurses using definitions from the Singapore Ministry of Health. Results: In total, 135 hospital-onset C. difficile infection cases occurred in 2017, a rate of 4.2 per 10,000 patient days. This rate gradually decreased to 3.0 in 2018 and to 2.3 in 2020, with an average of 87 infections per year. This rate further decreased to 1.8 infections per 10,000 patient days in 2021, with 61 clinical infections. Conclusions: Using multimodal strategies, CGH achieved a gradual and steady reduction in hospital-onset CDI over several years. These strategies require close collaboration among various departments to achieve the desired outcome.
SG-APSIC1109: Redesign of outpatient clinic clean care to decrease postoperative SSIs after orthopedic implants
Authors: Dahesihdewi Andaru , Hartatik Tri , Wijayanti Susi , Ryantinah  , Dahesihdewi Andaru
Published: March 2023

Objectives: Based on Sardjito Hospital surveillance data in 2020, the incidence of SSI in orthopedic implant surgery was 46 cases (4.7%), mostly in the outpatient clinic. We evaluated some of the potential risks and proposed redesign of infection prevention and control measures in April 2021 to improve the overall clean care at the orthopedic outpatient clinic. Methods: We conducted an operational study to redesign various components of clean care using a before-and-after evaluation of infection risk. The study was led by an IPC nurse and was supported by all levels of stakeholders at Sardjito Hospital, a referral and academic hospital in Yogyakarta, Indonesia, during May–September 2021. Results: The redesigned components covered continuing professional development (CPD) through a workshop on clean care and wound care for doctors and nurses. The workshop also encouraged high-level management to make several important changes: (1) to redistribute medical staff schedules, (2) to start online patient registration to better distribute and decrease patient loads, (3) to set up the waiting room as well as the dressing room with strictly separate between dirty and clean areas, (4) to schedule daily general disinfection at noon during service hours, and (5) to perform routine air disinfection after daily clinic services as well as placing an additional portable HEPA filter for continuous air disinfection. After the these changes, during 2021, 7 SSIs occurred among postoperative orthopedic implant patients, a decrease of 85%. We observed more clean and neat rooms without patient overcrowding as well as easy and comfortable flow of patients and staff. Environmental pathogen germ counts decreased significantly. Conclusions: A redesign project at the orthopedic outpatient clinic reduced the incidence of postoperative SSIs and reduced the number of environmental pathogens. Overall clean care is a basic strategy in IPC for improving patient safety.
SG-APSIC1084: Reduce cost and resterilization rate of reusable medical device sets by reorganizing and rearranging packaging and process
Authors: Sutthiwichienchot Rungtawan
Published: March 2023

Objectives: We evaluated the resterilization rate, user satisfaction, and cost of resterilization after rearranging and packing of reusable instrument sets. Methods: For 1 month in July 2018, we conducted an observational prospective study in 39 service departments for which sterilization and instrument packing was done by the central sterile supply department (CSSD). Common sterile instrument sets (eg, intercostal drainage (ICD) sets, bone-marrow aspiration sets, or suture sets) were analyzed to set up basic surgical instruments for common procedures and specific instruments for each procedure. Sets for common procedures were then packed and rearranged for use universally in various procedures separately from specific instruments. A questionnaire survey was delivered to all 39 service departments to evaluate user satisfaction. The resterilization rates and cost analyses before and after the rearranging and packing were compared for their effectiveness. The data were analyzed using descriptive statistics for percentage, mean, standard deviation, and inferential statistics. Categorical data were analyzed using the χ2 test and continuous data were analyzed using a t test with significance level of 0.05. Results: The resterilization rate decreased significantly from 7.1% to 0.1%. The cost of resterilization decreased from 76,500 Thai baht (US $2,287) to 4,800 Thai baht (US $143) within 1 month. Overall, user satisfaction regarding this intervention was 85.2%. Conclusions: This study highlights the need for the evaluation of process and customer demand to improve user satisfaction and reduce hospital cost by customizing the sterilization packaging and rearranging process.
SG-APSIC1045: A quantitative assessment of ATP bioluminescence on dental instruments reprocessed by automated washer-disinfector and ultrasonic machine
Authors: Man Vivian , Neo Tian Cheng
Published: March 2023

Objectives: Dental instruments are contaminated by blood and saliva during dental procedures. To prevent cross infection, all contaminants should be removed from the surfaces of instruments. Inadequate cleaning can hinder disinfection and sterilization process. To compare the cleaning efficacy of an automated washer–disinfector versus an ultrasonic machine on dental instruments, adenosine triphosphate (ATP) measurements were compared. Methods: From National University Polyclinic Bukit Panjang Dental Services, we collected 2 loads of 40 dental instruments previously used in dental treatments: extraction forceps, high-volume suction tips, Coupland elevators, matrix band holders, and ultrasonic scaler tips. At the point of use, gross soil was wiped from instrument surfaces with water. Each instrument was swabbed after cleaning either using a washer–disinfector or an ultrasonic machine. The relative light units (RLU) on the luminometer indicated the amount of ATP contaminants and residue bioburden present on the instruments. Results: The mean RLU values across all instruments in the washer–disinfector group was 2.5 times lower than the mean value of the instruments in the ultrasonic group (35.4 vs 89.9 RLU). This difference was statistically significant for all instrument groups except for the high-volume suction tips. The Mann-Whitney U test indicated that the RLU in the ultrasonic group was higher than the RLU for the washer–disinfector group for extraction forceps (P < .001), ultrasonic scaler tips (P < .023), and matrix bands (P < .006). A t test indicated the same relationship for Coupland elevators (P < .005). Conclusions: The mean RLU values for both cleaning methods were lower than the manufacturer’s benchmark (RLU ≤ 150), suggesting that both methods can achieve effective cleaning. However, cleaning using an automated washer–disinfector is significantly more effective than an ultrasonic machine for nonlumen instruments. The effectiveness of cleaning using ultrasonic machine varied greatly among different types of instruments with different design complexities.
Shape optimisation for a stochastic two-dimensional cylinder wake using ensemble variation
Authors: Lorente-Macias Javier , Bengana Yacine , Hwang Yongyun
Published: March 2023

In the present study, the shape of a two-dimensional cylinder is optimised to minimise the mean drag in laminar unsteady flow under a noisy environment. A small inline stochastic oscillation in the free-stream velocity, which follows the Ornstein–Uhlenbeck process, is considered for the noise. The small noise is found to yield a large random fluctuation in instantaneous drag of the cylinder due to the effect of added mass. Subject to the strong random fluctuation of drag, the shape optimisation is performed using an ensemble-variation-based method (EnVar), as the conventional adjoint-based optimisation is not applicable to such a flow environment with unknown free-stream noise. The optimised cylinder geometry is found to be a nearly-symmetric slender oval at a low Reynolds number. As the Reynolds number is increased, two optimal shapes emerge: one is identical to the oval obtained at the low Reynolds number, and the other is an asymmetric oval, the rear side of which is more slender than the front side, reminiscent of an aerofoil. Despite the large random fluctuation in the instantaneous drag, the optimal cylinder shapes obtained for different levels of the upstream noise are found to be almost identical. It is shown that the robust nature of the optimal cylinder shape originates from the limited influence of the small upstream noise on the mean flow properties of the cylinder wake. Finally, the optimised cylinder primarily reduces the pressure component of the drag, associated mainly with vortex shedding in the wake, and this is achieved by marginally increasing the viscous drag through the shape change.
Chelsea Manning, national security, and the cishetero/homonormative logics of protection
Authors: Châteauvert-Gagnon Béatrice
Published: March 2023

‘I feel like a monster’, typed Chelsea Manning, referring partly to her gender identity but mostly to her job in the US military. Morally conflicted by what she saw and read while serving in Iraq, extremely isolated from her unit and experiencing emotional distress in relation to her gender identity, Manning would act on these stressors by leaking hundreds of documents to Wikileaks, and coming out as a (trans) woman. While she was quick to be classified as either a hero or a traitor, her case evades such dichotomisation and calls for more sophisticated readings. While a lot has been written on Manning in queer and transgender studies, surprisingly little has been published on this case in International Relations, not even in the quickly growing field of Queer IR. Yet Manning’s case helps highlight many of its core concerns in relation to issues of power, security, and sovereignty. In fact, what is often lost when reading the Manning case are the queer and trans logics of protection that were disrupted by Manning’s disclosures and that made such disruption possible. These dominant logics rely upon a culture of secrecy that must be preserved for performances of national security to hold true.
Collecting language acquisition data from understudied urban communities: A reply to Cristia et al.
Authors: GARCIA Rowena , ALBERT Hannah Maria D. , BONDOC Ivan Paul , MARZAN Jocelyn Christina B.
Published: March 2023

In the target article, Cristia, Foushee, Aravena-Bravo, Cychosz, Scaff, and Casillas (2023) convincingly show the need to broaden the current language acquisition research base, not only in linguistic diversity, but also in terms of regions and cultural groups studied. In conducting acquisition research in understudied populations, such as in rural settings, the authors highlight the importance of using a multi-method approach. They present the challenges in adapting these methods to new settings and offer possible ways to promote this type of research. In this commentary, we extend the discussion to understudied urban communities, as we encounter several of the concerns raised in Cristia et al. when collecting observational and experimental language acquisition data from Metro Manila, Philippines. We first describe the community we study, the challenges and modifications needed for conducting research in this setting, and end with a discussion of possible strategies to promote research in communities with understudied populations.
Modelling India. Unfired clay figurines and the East India Company's collections: from devotional icons to didactic displays
Authors: MacGregor Arthur
Published: March 2023

A well-known series of miniature figures produced in India from unfired clay, appropriately clothed and in many instances represented carrying out their respective secular or ritual duties, enjoyed a period of particular popularity on the world stage in the nineteenth century when they were appropriated as illustrative devices in museum displays and international exhibitions. Over the previous half-century or more they had emerged as products of a dynamic industry that responded to changes in taste as well as religious and artistic practice within Indian society, before being taken up by the West to serve new colonial imperatives. There they received perhaps their most enthusiastic reception at the India Museum, established in the headquarters of the East India Company in London in the early 1800s, and surviving beyond the suppression of the Company itself until they were dispersed to a number of other institutions in 1879. From an early appearance at the Great Exhibition in 1851, the figures also became a regular feature of the international exhibitions of the latter part of the century. Initially they celebrated the traditional crafts and practices of India but gradually were recruited to communicate other messages of Western industrial dominance and perceived artistic and industrial superiority. Although comparatively few of these figures survive intact in Western collections, the history of their considerable impact on the European stage can be enlarged upon with the aid of the documentary record.
Development of EST-SSR markers for an endangered plant species, Camellia fascicularis (Theaceae)
Authors: Ma Luyao , Liu Cheng , Xin Jing , Li Bin , Tang Junrong , Xin Yaxuan , Ye Peng , Xin Peiyao , Bai Bin
Published: March 2023

The plant Camellia fascicularis, belonging to family Theaceae, has high ornamental and medicinal value, and rare gene resources for genetic improvement of Camellia crops, but is currently threatened with extinction because of the unique and extremely small wild populations. Molecular markers have clarified the wild plant species’ genetic diversity structure, new gene resources and relationship with crops. This will be beneficial for conservation of these valuable crop-related wild species and crop improvement. In this study, we identified 95,979 microsatellite loci from 155,011 transcriptome unigenes, and developed 14 polymorphic expressed sequence tag-derived simple sequence repeat (EST-SSR) microsatellite markers for C. fascicularis. The number of alleles (Na) per locus was 2–8 with a mean of 4.86. The genetic diversity of 40 individuals from four natural populations of C. fascicularis was analysed using these polymorphic markers. The number of alleles (Na) for EST-SSR ranged from 2 to 5, with the expected heterozygosities (He) and observed heterozygosities (Ho) in all loci ranging from 0.183 to 0.683, and from 0.201 to 0.700, respectively, implying a rich genetic variation present in wild C. fascicularis populations. Moreover, the phylogenetic analysis among four populations, using the 14 EST-SSR markers developed in this study, grouped 40 individuals into three groups, which coincide with their geographic distribution. These results showed that 14 EST-SSR markers are available for the analysis of genetic variation in C. fascicularis populations and genetic improvement of new Camellias cultivars by interspecific hybridization, and are beneficial for conservation of the endangered species.
From the Library of the Late Irving I. Gottesman: Memories and Treasures/Twin Research Reviews: Twin Study of Callous-Unemotional Traits; Depressive Symptoms in Prospective Chinese Twin Mothers; Twins With Sagittal Suture Craniosynostosis; Creative Expressiveness and Educational Achievement/Media Reports: Male-Female Twin Holocaust Survivors; Nontuplets Born in Mali; Indian Twins Marry Same Man; Twins Born From Longest-Frozen Embryos; Infant Twin Abduction; Twins Born in Different Years
Authors: Segal Nancy L.
Published: March 2023

The experience of going through the personal library of our late esteemed twin research colleague, Dr Irving I. Gottesman, is described. I came away with fond memories and unexpected treasures. This essay is followed by brief reviews of timely research on factors affecting callous-unemotional traits, depressive symptoms in prospective Chinese twin mothers, twins with sagittal suture craniosynostosis, and creative expressiveness and educational achievement. Media reports on informative topics of interest to researchers and the general public include male-female twin Holocaust survivors, nontuplets born in Mali, Indian twins who married the same man, twins born from the longest frozen embryos, an infant twin abduction and twins born in different years.
VLF and Ionospheric D‐Region Perturbations Associated With WWLLN‐Detected Lightning in the South Pacific Region
Authors: Chand Atishnal Elvin , Kumar Abhikesh , Kumar Sushil
Published: March 2023

The subionospheric early very low frequency (VLF) perturbations observed on NWC (19.8 kHz) navigational transmitter signal monitored at a low‐latitude station, Suva (18.1°S, 178.5°E), Fiji, during campaign periods of November 2011, 2012, and 2014 and December 2014, are presented. Early VLF events are associated with D‐region conductivity changes mainly produced by lightning‐generated transient luminous events (TLEs). Early VLF events occurred both during daytime and nighttime, with a considerably higher occurrence at nighttime. VLF perturbations caused by lightning strokes located up to 100 km off the transmitter‐receiver great circle path (TRGCP) are attributed to narrow‐angle scattering, while lightning strokes 100–500 km off the TRGCP are considered to cause early VLF events by wide‐angle scattering. Using the World Wide Lightning Location Network data, for the first time, we have studied the relationship between the energy of lightning strokes and the level of VLF perturbations. Greater is the energy of lightning, greater would be the strength of the VLF perturbation. However, the low‐energy lightning stroke can also produce a comparable level of perturbation to that of strong lightning. The modeling results of scattered amplitude (M) and echo phase (ϕE) of the unusually long recovery early/fast VLF event showed a better exponential fit (r ∼ 0.9) than the logarithmic fit. Long‐wavelength propagation capability (LWPC) code modeling of nighttime early VLF events considering causative TLE width of 50 km column indicated a decrease in the D‐region reference height (Hʹ) by up to 30 km and an increase in the sharpness factor (β) by 0.25 km−1.
In Situ Geologic Context Mapping Transect on the Floor of Jezero Crater From Mars 2020 Perseverance Rover Observations
Authors: Crumpler L. S. , Horgan B. H. N. , Simon J. I. , Stack K. M. , Alwmark S. , Dromart G. , Wiens R. C. , Udry A. , Brown A. J. , Russell P. , Amundson H. E. F. , Hamran S.‐E. , Bell J. , Shuster D. , Calef F. J. , Núñez J. , Cohen B. A. , Flannery D. , Herd C. D. K. , Hand K. P. , Maki J. N. , Schmidt M. , Golombek M. P. , Williams N. R.
Published: March 2023

In situ geologic context mapping based on rover and helicopter observations provides documentation of a nearly continuous record of geology and exposed surface structure over a 120 m‐wide corridor along the traverse of the Mars 2020/Perseverance rover. The results record the geologic context of Mars 2020 campaign sites and sample sites, including the local extent of bedrock outcrops, stratigraphy, attitude, and structure from imaging and rover‐based remote sensing, and outcrop lithology based on in situ proximity science. Mapping identifies a sequence of igneous lithologies including (a) early mafic, possibly intrusive, rocks; (b) pervasively fractured and deeply altered massive bedrock of undetermined protolith; (c) buried and exhumed lava flows with pahoehoe and aa textures; (d) several varieties of regolith; and (e) small impact craters.
IgSF11-mediated phosphorylation of pyruvate kinase M2 regulates osteoclast differentiation and prevents pathological bone loss
Authors: Kim Hyunsoo , Takegahara Noriko , Choi Yongwon
Published: March 2023

Osteoclasts are primary bone-resorbing cells, and receptor-activated NF-kB ligand (RANKL) stimulation is the key driver of osteoclast differentiation. During late-stage differentiation, osteoclasts become multinucleated and enlarged (so-called “maturation”), suggesting their need to adapt to changing metabolic demands and a substantial increase in size. Here, we demonstrate that immunoglobulin superfamily 11 (IgSF11), which is required for osteoclast differentiation through an association with the postsynaptic scaffolding protein PSD-95, regulates osteoclast differentiation by controlling the activity of pyruvate kinase M isoform 2 (PKM2). By using a system that directly induces the activation of IgSF11 in a controlled manner, we identified PKM2 as a major IgSF11-induced tyrosine-phosphorylated protein. IgSF11 activates multiple Src family tyrosine kinases (SFKs), including c-Src, Fyn, and HcK, which phosphorylate PKM2 and thereby inhibit PKM2 activity. Consistently, IgSF11-deficient cells show higher PKM2 activity and defective osteoclast differentiation. Furthermore, inhibiting PKM2 activities with the specific inhibitor Shikonin rescues the impaired osteoclast differentiation in IgSF11-deficient cells, and activating PKM2 with the specific activator TEPP46 suppresses osteoclast differentiation in wild-type cells. Moreover, PKM2 activation further suppresses osteoclastic bone loss without affecting bone formation in vivo. Taken together, these results show that IgSF11 controls osteoclast differentiation through PKM2 activity, which is a metabolic switch necessary for optimal osteoclast maturation.
Understanding repertoire sequencing data through a multiscale computational model of the germinal center
Authors: García-Valiente Rodrigo , Merino Tejero Elena , Stratigopoulou Maria , Balashova Daria , Jongejan Aldo , Lashgari Danial , Pélissier Aurélien , Caniels Tom G. , Claireaux Mathieu A. F. , Musters Anne , van Gils Marit J. , Rodríguez Martínez María , de Vries Niek , Meyer-Hermann Michael , Guikema Jeroen E. J. , Hoefsloot Huub , van Kampen Antoine H. C.
Published: March 2023

Sequencing of B-cell and T-cell immune receptor repertoires helps us to understand the adaptive immune response, although it only provides information about the clonotypes (lineages) and their frequencies and not about, for example, their affinity or antigen (Ag) specificity. To further characterize the identified clones, usually with special attention to the particularly abundant ones (dominant), additional time-consuming or expensive experiments are generally required. Here, we present an extension of a multiscale model of the germinal center (GC) that we previously developed to gain more insight in B-cell repertoires. We compare the extent that these simulated repertoires deviate from experimental repertoires established from single GCs, blood, or tissue. Our simulations show that there is a limited correlation between clonal abundance and affinity and that there is large affinity variability among same-ancestor (same-clone) subclones. Our simulations suggest that low-abundance clones and subclones, might also be of interest since they may have high affinity for the Ag. We show that the fraction of plasma cells (PCs) with high B-cell receptor (BcR) mRNA content in the GC does not significantly affect the number of dominant clones derived from single GCs by sequencing BcR mRNAs. Results from these simulations guide data interpretation and the design of follow-up experiments.
Surface warming and wetting due to methane’s long-wave radiative effects muted by short-wave absorption
Authors: Allen Robert J. , Zhao Xueying , Randles Cynthia A. , Kramer Ryan J. , Samset Bjørn H. , Smith Christopher J.
Published: March 2023

Although greenhouse gases absorb primarily long-wave radiation, they also absorb short-wave radiation. Recent studies have highlighted the importance of methane short-wave absorption, which enhances its stratospherically adjusted radiative forcing by up to ~ 15%. The corresponding climate impacts, however, have been only indirectly evaluated and thus remain largely unquantified. Here we present a systematic, unambiguous analysis using one model and separate simulations with and without methane short-wave absorption. We find that methane short-wave absorption counteracts ~30% of the surface warming associated with its long-wave radiative effects. An even larger impact occurs for precipitation as methane short-wave absorption offsets ~60% of the precipitation increase relative to its long-wave radiative effects. The methane short-wave-induced cooling is due largely to cloud rapid adjustments, including increased low-level clouds, which enhance the reflection of incoming short-wave radiation, and decreased high-level clouds, which enhance outgoing long-wave radiation. The cloud responses, in turn, are related to the profile of atmospheric solar heating and corresponding changes in temperature and relative humidity. Despite our findings, methane remains a potent contributor to global warming, and efforts to reduce methane emissions are vital for keeping global warming well below 2 °C above preindustrial values.
Hyperactive nanobacteria with host-dependent traits pervade Omnitrophota
Authors: Seymour Cale O. , Palmer Marike , Becraft Eric D. , Stepanauskas Ramunas , Friel Ariel D. , Schulz Frederik , Woyke Tanja , Eloe-Fadrosh Emiley , Lai Dengxun , Jiao Jian-Yu , Hua Zheng-Shuang , Liu Lan , Lian Zheng-Han , Li Wen-Jun , Chuvochina Maria , Finley Brianna K. , Koch Benjamin J. , Schwartz Egbert , Dijkstra Paul , Moser Duane P. , Hungate Bruce A. , Hedlund Brian P.
Published: March 2023

Candidate bacterial phylum Omnitrophota has not been isolated and is poorly understood. We analysed 72 newly sequenced and 349 existing Omnitrophota genomes representing 6 classes and 276 species, along with Earth Microbiome Project data to evaluate habitat, metabolic traits and lifestyles. We applied fluorescence-activated cell sorting and differential size filtration, and showed that most Omnitrophota are ultra-small (~0.2 μm) cells that are found in water, sediments and soils. Omnitrophota genomes in 6 classes are reduced, but maintain major biosynthetic and energy conservation pathways, including acetogenesis (with or without the Wood-Ljungdahl pathway) and diverse respirations. At least 64% of Omnitrophota genomes encode gene clusters typical of bacterial symbionts, suggesting host-associated lifestyles. We repurposed quantitative stable-isotope probing data from soils dominated by andesite, basalt or granite weathering and identified 3 families with high isotope uptake consistent with obligate bacterial predators. We propose that most Omnitrophota inhabit various ecosystems as predators or parasites.