bluuebunny/crossref_metadata_2025 huggingface dataset:
Home-delivered meals as an adjuvant to improve volume overload and clinical outcomes in hemodialysis
Authors: Perez Luis M , Biruete Annabel , Wilund Kenneth R
Published: April 2022

Patients on chronic hemodialysis are counseled to reduce dietary sodium intake to limit their thirst and consequent interdialytic weight gain (IDWG), chronic volume overload and hypertension. Low-sodium dietary trials in hemodialysis are sparse and mostly indicate that dietary education and behavioral counseling are ineffective in reducing sodium intake and IDWG. Additional nutritional restrictions and numerous barriers further complicate dietary adherence. A low-sodium diet may also reduce tissue sodium, which is positively associated with hypertension and left ventricular hypertrophy. A potential alternative or complementary approach to dietary counseling is home delivery of low-sodium meals. Low-sodium meal delivery has demonstrated benefits in patients with hypertension and congestive heart failure but has not been explored or implemented in patients undergoing hemodialysis. The objective of this review is to summarize current strategies to improve volume overload and provide a rationale for low-sodium meal delivery as a novel method to reduce volume-dependent hypertension and tissue sodium accumulation while improving quality of life and other clinical outcomes in patients undergoing hemodialysis.
Advances in scaling community discovery methods for signed graph networks
Authors: Tomasso Maria , Rusnak Lucas J , Tešić Jelena
Published: April 2022

Community detection is a common task in social network analysis with applications in a variety of fields including medicine, criminology and business. Despite the popularity of community detection, there is no clear consensus on the most effective methodology for signed networks. In this article, we summarize the development of community detection in signed networks and evaluate current state-of-the-art techniques on several real-world datasets. First, we give a comprehensive background of community detection in signed graphs. Next, we compare various adaptations of the Laplacian matrix in recovering ground-truth community labels via spectral clustering in small signed graph datasets. Then, we evaluate the scalability of leading algorithms on small, large, dense and sparse real-world signed graph networks. We conclude with a discussion of our novel findings and recommendations for extensions and improvements in state-of-the-art techniques for signed graph community discovery in real-world signed graphs.
met v1: expanding on old estimations of biodiversity from eDNA with a new database framework
Authors: Molik David C
Published: April 2022

A long-standing problem in environmental DNA has been the inability to compute across large number of datasets. Here we introduce an open-source software framework that can store a large number of environmental DNA datasets, as well as provide a platform for analysis, in an easily customizable way. We show the utility of such an approach by analyzing over 1400 arthropod metabarcode datasets. This article introduces a new software framework, met, which utilizes large numbers of metabarcode datasets to draw conclusions about patterns of diversity at large spatial scales. Given more accurate estimations on the distribution of variance in metabarcode datasets, this software framework could facilitate novel analyses that are outside the scope of currently available similar platforms.

Database URL https://osf.io/spb8v/
Eligibility of extracorporeal cardiopulmonary resuscitation on in-hospital cardiac arrests in Sweden: a national registry study
Authors: Ölander Carl Henrik , Vikholm Per , Schiller Petter , Hellgren Laila
Published: April 2022

Aims

Extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest (CA) is used in selected cases. The incidence of ECPR-eligible patients is not known. The aim of this study was to identify the ECPR-eligible patients among in-hospital CAs (IHCA) in Sweden and to estimate the potential gain in survival and neurological outcome, if ECPR was to be used.

Methods and results

Data between 1 January 2015 and 30 August 2019 were extracted from the Swedish Cardiac Arrest Register (SCAR). Two arbitrary groups were defined, based on restrictive or liberal inclusion criteria. In both groups, logistic regression was used to determine survival and cerebral performance category (CPC) for conventional cardiopulmonary resuscitation (cCPR). When ECPR was assumed to be possible, it was considered equivalent to return of spontaneous circulation, and the previous logistic regression model was applied to define outcome for comparison of conventional CPR and ECPR. The assumption in the model was a minimum of 15 min of refractory CA and 5 min of cannulation. A total of 9209 witnessed IHCA was extracted from SCAR. Depending on strictness of inclusion, an average of 32–64 patients/year remains in refractory after 20 min of cCPR, theoretically eligible for ECPR. If optimal conditions for ECPR are assumed and potential negative side effects disregarded of, the estimated potential benefit of survival of ECPR in Sweden would be 10–19 (0.09–0.19/100 000) patients/year, when a 30% success rate is expected. The benefit of ECPR on survival and CPC scoring was found to be detrimental over time and minimal at 60 min of cCPR.

Conclusion

The number of ECPR-eligible patients among IHCA in Sweden is dependent on selection criteria and predicted to be low. There is an estimated potential benefit of ECPR, on survival and neurological outcome if initiated within 60 min of the IHCA.
Tricuspid leaflet flail after Micra™ leadless pacemaker implantation: a case report
Authors: Pingitore Annachiara , Calcagno Simone , Salvador Loris , Mennuni Silvia , Cavarretta Elena
Published: April 2022

Background

Currently, the leadless pacemaker indications are limited to few and highly selected cases.

Case summary

We describe the first reported case of an atrioventricular Micra™ leadless pacemaker implantation complicated by tricuspid posterior leaflet flail with severe regurgitation in a 29-year-old man affected by asymptomatic and progressive high degree atrio-ventricular block. The patient was then treated with endoscopic tricuspid valve repair, leadless pacemaker removal and implantation of an epicardial pacemaker.

Discussion

Leadless pacemaker complications are multiple, hence it is essential to ensure a safe procedure, especially in the younger patients. We thought that the application of a transesophageal echocardiography guidance might mitigate the risk of major complications.
Mechanical support of pulmonary blood flow as a strategy to support the Norwood circulation-lumped parameter model study
Authors: Peer Syed Murfad , Yildirim Canberk , Desai Manan , Ramakrishnan Karthik , Sinha Pranava , Jonas Richard , Yerebakan Can , Pekkan Kerem
Published: April 2022

OBJECTIVES

We hypothesize that mechanical assistance of the pulmonary blood flow in a Norwood circulation can increase systemic blood flow and oxygen delivery. The aim of the study was to compare haemodynamics of an unassisted Norwood Blalock–Taussig shunt circulation with a mechanically assisted pulmonary flow-based Norwood circulation, using a lumped parameter computational model.

METHODS

A neonatal circulatory lumped parameter model was developed to simulate a Norwood circulation with a 3.5-mm Blalock–Taussig shunt in a 3.5-kg neonate. A roller pump circulatory assist device with an inflow bladder was incorporated into the Norwood circulation to mechanically support the pulmonary circulation. Computer simulations were used to compare the haemodynamics of the assisted and unassisted circulations. Assisted and unassisted models with normal (56%) and reduced ejection fraction (30%) were compared.

RESULTS

Compared to the unassisted Norwood circulation, the systemic flow in the assisted Norwood increased by 25% (ejection fraction = 56%) and 41% (ejection fraction = 30%). The central venous pressure decreased by up to 3 mmHg (both ejection fraction = 56% and ejection fraction = 30%) at a maximum pulmonary assist flow of 800 ml/min. Initiation of assisted pulmonary flow increased the arterial oxygen saturation by up to 15% and mixed venous saturation by up to 20%.

CONCLUSIONS

This study demonstrates that an assisted pulmonary flow-based Norwood circulation has higher systemic flow and oxygen delivery compared to a standard Norwood Blalock–Taussig shunt circulation.
Modeling the evolution of SARS-CoV-2 under non-pharmaceutical interventions and testing
Authors: Gurevich Yael , Ram Yoav , Hadany Lilach
Published: April 2022

Background and objectives

Social and behavioral non-pharmaceutical interventions (NPIs), such as mask-wearing, social distancing and travel restrictions, as well as diagnostic tests, have been broadly implemented in response to the COVID-19 pandemic. Epidemiological models and data analysis affirm that wide adoption of NPIs helps to control the pandemic. However, SARS-CoV-2 has extensively demonstrated its ability to evolve. Therefore, it is crucial to examine how NPIs may affect the evolution of the virus. Such evolution could have important effects on the spread and impact of the pandemic.

Methodology

We used evo-epidemiological models to examine the effect of NPIs and testing on two evolutionary trajectories for SARS-CoV-2: attenuation and test evasion.

Results

Our results show that when stronger measures are taken, selection may act to reduce disease severity. Additionally, the timely application of NPIs could significantly affect the competition between viral strains, favoring the milder strain. Furthermore, a higher testing rate can select for a test-evasive viral strain, even if that strain is less infectious than the detectable competing strain. Importantly, if a less detectable strain evolves, epidemiological metrics such as confirmed daily cases may distort our assessment of the pandemic.

Conclusions and implications

Our results highlight the important implications NPIs can have on the evolution of SARS-CoV-2.

Lay Summary

We used evo-epidemiological models to examine the effect of non-pharmaceutical interventions and testing on two evolutionary trajectories for SARS-CoV-2: attenuation and test evasion. Our results show that when stronger measures are taken, selection may act to reduce disease severity.
Elucidating the correlation between the number of TTTTGAT heptamer repeats and cholera toxin promoter activity in Vibrio cholerae O1 pandemic strains
Authors: Naha Arindam , Withey Jeffrey H , Mukherjee Piyali , Saha Rudra Narayan , Samanta Prosenjit , Ghosh Amit , Miyoshi Shin-Ichi , Dutta Shanta , Mukhopadhyay Asish K
Published: April 2022

A complex virulence-regulatory cascade controls expression of the cholera toxin genes (ctxAB) in Vibrio cholerae, which eventually leads to the production and secretion of choleragen (CT), responsible for rice watery diarrhoea in infected individuals. The cholera toxin promoter (PctxAB) contains a series of heptad repeats (5′-TTTTGAT-3′), which has previously been shown to play a crucial role in transcriptional regulation of ctxAB by recruiting the transcriptional activators ToxT, ToxR and the nucleoid-associated protein H-NS along the ctx promoter. The number of these repeats differs not only between the two biotypes of V. cholerae O1 strains, but also among the strains belonging to the same biotype. In this study, we examined if regulation of PctxAB is influenced in any way by the number of these repeats. Based on our observations, we posit that ctx activation indeed depends on the number of TTTTGAT heptad repeats within PctxAB, and occupation of the distal repeats by H-NS could prevent transcriptional activation of the ctx genes in V. cholerae O1 pandemic isolates. Our results suggest that ToxT-dependent transcriptional activation may not require entire displacement of H-NS and supports a recently described revised model of ToxT and H-NS mediated PctxAB transcriptional regulation.
National Norms for the Elixhauser and Charlson Comorbidity Indexes Among Hospitalized Adults
Authors: Boogaerts Garner , Loyd Christine , Zhang Yue , Kennedy Richard E , Brown Cynthia J
Published: April 2022

Background

Comorbidity burden is commonly measured among hospitalized adults, yet the U.S. national norms for 2 commonly used comorbidity indexes have not yet been reported. Thus, this study reports U.S. national norms for both Charlson Comorbidity Index (CCI) and the Elixhauser Comorbidity Index (ECI) among hospitalized adults based on age, biological sex, and race.

Methods

A retrospective observational cohort study using data from the Agency of Healthcare Research and Quality U.S. National Inpatient Sample database for 2017. Patient data were extracted from 7 159 694 inpatient adults, and analyses were focused on individuals older than 45 years, yielding 4 370 225 patients. International Classification of Diseases, 10th Edition, diagnostic codes were used to calculate CCI and ECI scores. These scores were then weighted for the U.S. national population.

Results

The weighted mean CCI was 1.22 (95% confidence interval [CI]: 1.22, 1.22), and the weighted mean ECI was 2.76 (95% CI: 2.76, 2.76). Both indexes had increasing average scores with increasing age, independent of sex and race (all p values < .001).

Conclusion

For the first time, U.S. national norms for the CCI and ECI are reported for adult inpatients. The norms can serve as a reference tool for determining if clinical and research populations have greater or lesser comorbidity burden than typical hospitalized adults in the United States for their age, sex, and race.
Using Voice and Touchscreen Controlled Smart Speakers to Protect Vulnerable Clients in Long-Term Care Facilities
Authors: Davitt Joan K , Brown Jocelyn
Published: April 2022

Background and Objectives

The Centers for Medicare and Medicaid Services restricted long-term care facility visitation to only essential personnel during the coronavirus disease 2019 pandemic. The Maryland Department of Human Services distributed Amazon Echoshow 8 voice and touchscreen controlled smart speakers (VTCSS) to a sample of their institutionalized guardianship clients to enhance caseworker access during the pandemic.

Research Design and Methods

This pilot study focused on understanding VTCSS use challenges and the effects on clients’ safety and well-being. Two focus groups were conducted with caseworkers (N = 16) who piloted the devices. The interviews were recorded, transcribed, and analyzed using open and axial coding.

Results

Four themes were identified, including challenges to providing casework during the pandemic (e.g., facility technology gaps), challenges to device installation and use (e.g., privacy concerns), strategies for overcoming challenges (e.g., alert features), and benefits (e.g., stimulation, care monitoring) and uses (e.g., enhanced access, entertainment).

Discussion and Implications

VTCSS show great promise to engage the client, maintain visual access, and monitor quality of care. However, facilitating access to such technology requires planning and training before installation.
Reactions to Amyloid PET Scan Results and Levels of Anxious and Depressive Symptoms: CARE IDEAS Study
Authors: Bélanger Emmanuelle , D’Silva Jessica , Carroll Michaela S , Van Houtven Courtney H , Shepherd-Banigan Megan , Smith Valerie A , Wetle Terrie T
Published: April 2022

Background and Objectives

Few studies have examined care partners’ reactions to their loved ones receiving amyloid-β positron emission tomography (PET) scan results, which can be indicative of Alzheimer’s disease. We explored care partners’ reactions qualitatively, and checked the association of scan results and diagnostic category (dementia vs mild cognitive impairment [MCI]) with care partner anxious and depressive symptoms through quantitative analysis.

Research Design and Methods

Using data from 1,761 care partners in the Caregivers’ Reactions and Experience, a supplemental study of the Imaging Dementia Evidence for Amyloid Scanning study, we applied an exploratory sequential mixed-methods design and examined the reactions of 196 care partners to receiving amyloid PET scan results through open-ended interview questions. Based on the qualitative content analysis, we hypothesized there would be an association of care partners’ depressive (Patient Health Questionnaire-2) and anxious (6-item State–Trait Anxiety Inventory) symptoms with scan results and diagnostic category which we then tested with logistic regression models.

Results

Content analysis of open-ended responses suggests that when scan results follow the care partner’s expectations, for example, elevated amyloid in persons with dementia, care partners report relief and gratitude for the information, rather than distress. Adjusted logistic regression models of survey responses support this finding, with significantly higher odds of anxiety, but not depressive symptoms, among care partners of persons with MCI versus dementia and elevated amyloid.

Discussion and Implications

Care partners of persons with MCI reported distress and had higher odds of anxiety after receiving elevated amyloid PET scan results than care partners of persons with dementia. This has the potential to inform clinical practice through recommendations for mental health screening and referrals.
Digitization of GLAM Collections and Copyright: Policy Paper
Authors: Benhamou Yaniv , Ferland Justine
Published: April 2022

Copyright can be a major obstacle for cultural institutions regarding digitization and online accessibility, which ultimately leads to the under-exploitation of collections at the expense of society and to a need to support cultural heritage institutions with legislative and/or policy changes or at least clarifications. This contribution is a policy paper that aims to clarify the copyright law principles applicable to museum professionals dealing with digital cultural heritage worldwide, and to formulate policies to facilitate their digital activities. An initial version of this policy paper was published on a dedicated website and led to an international conference held in 2020 in Geneva. Although it is primarily addressed to museums, this policy paper may also serve as guidance to stakeholders in other areas dealing with digital cultural heritage, in particular Galleries, Libraries, Archives and Museums (GLAM). Part I proposes policies directed towards national and international policymakers. Parts II and III are directed towards cultural institutions, and set out a code of conduct that cultural institutions may follow when pursuing digitization and dissemination activities in order to comply with the actual state of the law and minimize the risks associated with these activities (Part II), and an alternative dispute resolution (ADR) procedure to help cultural institutions and rights holders identify issues and reach satisfactory solutions in disputes around digital activities (Part III).***
What will the future make of our discoveries?
Authors: Montgomery John C
Published: April 2022

Science is an ecosystem, and its evolution is driven by the legacy of what has gone before. I have been privileged to be part of this, finding a niche in which to work and live, in the biome of marine science. Entering science through curiosity and connection to the sea, I was lucky to encounter mentors who lit up potential career paths and facilitated connections to community. My career is an ongoing part of their legacy. Like evolution itself, the journey of science practice is not pre-ordained, with no itinerary. Various paths are tried, and some become established through the selection pressure of success. Opportunities arise, and collaborations are formed with a commonality of interest and purpose, and a diversity of ideas and expertise. Supervision of postgraduates also provides an expanding legacy out in to the wider world. What will our individual and collective legacy look like? My hope is that our understanding of complex systems, such as ocean ecosystems, is captured and challenged by computational models capable of predicting future states. Being able to see what different futures look like, with and without positive interventions, should help us make better choices and create a sustainable Anthropocene future by active design.
Amplicon Sequencing as a Potential Surveillance Tool for Complexity of Infection and Drug Resistance Markers in Plasmodium falciparum Asymptomatic Infections
Authors: Wamae Kevin , Kimenyi Kelvin M , Osoti Victor , de Laurent Zaydah R , Ndwiga Leonard , Kharabora Oksana , Hathaway Nicholas J , Bailey Jeffrey A , Juliano Jonathan J , Bejon Philip , Ochola-Oyier Lynette Isabella
Published: April 2022

Background

Genotyping Plasmodium falciparum subpopulations in malaria infections is an important aspect of malaria molecular epidemiology to understand within-host diversity and the frequency of drug resistance markers.

Methods

We characterized P. falciparum genetic diversity in asymptomatic infections and subsequent first febrile infections using amplicon sequencing (AmpSeq) of ama1 in Coastal Kenya. We also examined temporal changes in haplotype frequencies of mdr1, a drug-resistant marker.

Results

We found >60% of the infections were polyclonal (complexity of infection [COI] >1) and there was a reduction in COI over time. Asymptomatic infections had a significantly higher mean COI than febrile infections based on ama1 sequences (2.7 [95% confidence interval {CI}, 2.65–2.77] vs 2.22 [95% CI, 2.17–2.29], respectively). Moreover, an analysis of 30 paired asymptomatic and first febrile infections revealed that many first febrile infections (91%) were due to the presence of new ama1 haplotypes. The mdr1-YY haplotype, associated with chloroquine and amodiaquine resistance, decreased over time, while the NY (wild type) and the NF (modulates response to lumefantrine) haplotypes increased.

Conclusions

This study emphasizes the utility of AmpSeq in characterizing parasite diversity as it can determine relative proportions of clones and detect minority clones. The usefulness of AmpSeq in antimalarial drug resistance surveillance is also highlighted.
Short- and Medium-term Impacts of Employability Training: Evidence from a Randomised Field Experiment in Rwanda
Authors: Alcid Annie , Bulte Erwin , Lensink Robert , Sayinzoga Aussi , Treurniet Mark
Published: April 2022

We use a randomised field experiment to study short-term and medium-term impacts of a training intervention that aims to increase employability of Rwandan (underemployed) youths. The training includes networking and mentorship as well as modules on developing entrepreneurship, technical skills and soft social skills. We evaluate intended outcomes of the training on attitudes towards work, employability and labour market outcomes. We also consider unintended social impacts of the training. The outcomes of the intervention are modest. While on the short term the training positively impacted ‘work readiness’ and networking, we do not document significant effects on employment status or income. In the medium term, we do not find any significant effect. Non-compliance and attrition reduced statistical power of our analysis.
DoE Engineered Development and Validation of an RP-HPLC Method for Simultaneous Estimation of Temozolomide and Resveratrol in Nanostructured Lipid Carrier
Authors: Mittal Saurabh , Ali Javed , Baboota Sanjula
Published: April 2022

Background

Temozolomide is drug of choice for the treatment of glioblastoma, but dose-related side effects limit its use. Resveratrol suppresses tumor growth and promotes apoptosis. Many studies showed synergistic activity of resveratrol and temozolomide against glioblastoma. There are methods reported for the assessment of temozolomide and resveratrol individually, but no analytical method has been reported for assessment of temozolomide and resveratrol simultaneously.

Objective

Therefore, the present study aimed to develop and optimize an HPLC analytical method for the simultaneous assessment of temozolomide and resveratrol in a developed nanostructured lipid carrier.

Method

A Central composite rotable design was used to optimize the method. The method was developed using a C18 column. The composition of the mobile phase was 30% methanol and 70% glacial acetic acid (0.1% v/v in HPLC grade water); detecting wavelength was 310 nm. Forced degradation test was also performed to demonstrate the proposed HPLC method’s ability to indicate stability.

Results

The LOD for temozolomide and resveratrol was found to be 1.10 and 0.83 µg/mL, respectively, while LOQ was 3.33 and 2.52 µg/mL, respectively. The drug loading and entrapment efficacy of the formulation, as determined using the aforementioned method, was found to be 6.73 and 96.28% for temozolomide and 3.45 and 89.39% for resveratrol, respectively.

Conclusions

The developed HPLC method was simple, rapid, economical, precise, accurate, and reproducible, and it had high selectivity with good detection limits. Standard guidelines of ICH Q2 (R1) including linearity, specificity, system suitability, robustness, precision, accuracy, the LOQ, and LOD gave satisfactory results. Forced degradation studies showed a good stability-indicating capacity of the developed HPLC method.

Highlights

Analytical Quality by Design is a powerful tool that could be used for the development of the analytical method. Central composite rotable design was used for optimizing the method. The percent of methanol and concentration of glacial acetic acid were selected as two independent variables for optimization.
Maternal immune activation and dietary soy isoflavone supplementation influence pig immune function but not muscle fiber formation
Authors: Bryan Erin E , Chen Xuenan , Smith Brooke Nicole , Dilger Ryan Neil , Dilger Anna C
Published: April 2022

The goals of this study were to determine the impact of maternal PRRSV infection on offspring muscle and immune development and the potential of dietary soy isoflavones to mitigate those effects. Thirteen first-parity gilts (“gilts”) were randomly allotted into one of three treatments: not infected and fed a diet devoid of isoflavones (CON), infected with porcine reproductive and respiratory syndrome virus (PRRSV) and fed the control diet (POS) or that supplemented with 1,500 mg/kg soy-derived isoflavones (ISF). Gilts were inoculated with PRRSV intranasally on gestational day (GD) 70. After farrowing (GD 114 ± 2), 1–2 offspring (“pigs”) closest to the average litter weight were selected either at birth (3 ± 2 d of age) or weaning (21 ± 2 d of age) to determine body, muscle, and organ weights as well as muscle cell number and size. Four weaned pigs of average body weight within each litter were selected for postnatal immune challenge. At PND 52, pigs were injected with 5 µg/kg BW lipopolysaccharide (LPS) intraperitoneally. Serum was collected at 0, 4, and 8 h following LPS administration to analyze tumor necrosis factor alpha (TNF-α). At PND 59, pigs were administered a novel vaccine to elicit an adaptive immune response. At PND 59, 66, and 73, peripheral blood mononuclear cells were isolated and T-cell populations determined by flow cytometry. Both POS and ISF pigs exhibited persistent PRRSV infections throughout the study (PND 1-73). At PND 3, whole body, muscle, and organ weights were not different (P > 0.22) between groups, with the exception of relative liver weight, which was increased (P < 0.05) in POS compared with CON pigs. At PND 21, ISF pigs had reduced (P ≤ 0.05) whole body and muscle weights, but greater (P < 0.05) kidney weight compared with CON, and greater (P < 0.05) relative liver weight compared with CON and POS. Muscle fiber number and size were not different (P > 0.39) between groups at birth or weaning. After LPS administration, TNF-α was greatest in ISF pigs (P < 0.05) at both 0 and 8 h post-challenge. At the peak time-point of 4 h post-challenge, ISF pigs had the greatest concentration of TNF-α and CON pigs had the lowest, with POS pigs being intermediate (P = 0.01). After vaccination, ISF offspring had shifts in T-cell populations indicating an impaired immune response. These data indicate that maternal PRRSV infection may impact offspring organ growth and immune function, particularly when the dam is supplemented with isoflavones.
The effects of creep feed composition and form and nursery diet complexity on small intestinal morphology and jejunal mucosa-specific enzyme activities after weaning in pigs
Authors: Christensen Brenda , Huber Lee-Anne
Published: April 2022

Fifty-six litters from first-parity sows standardized to 12 piglets were used to determine the effects of creep feed composition and form and the provision of low- or high-complexity nursery diets on the evolution of small intestinal histomorphology and jejunal mucosa-specific enzyme activities postweaning. At 5 d of age, litters (initial bodyweight [BW] 2.31 ± 0.61 kg) were assigned to one of four creep feeding regimens (n = 14): 1) commercial creep feed (COM), 2) liquid milk replacer (LMR), 3) pelleted milk replacer (PMR), or 4) no creep feed (NO). At weaning (21 d of age), six pigs per litter were provided a HIGH- (contained highly digestible animal proteins) or LOW- (contained corn and soybean meal as main protein sources) complexity nursery diet (n = 7). At 21, 28, and 59 d of age, two pigs per pen (one castrated male and one female) were euthanized, and ileal and jejunal segments for histomorphological measurements and jejunal mucosal scrapings were collected to determine specific mucosa enzyme activities. At weaning, pigs provided COM had a greater ileal absorptive capacity (M) than LMR or NO, which were not different (14.1 vs. 10.4 and 10.5 ± 0.9 μm2; P < 0.05); PMR was intermediate. On days 28 and 59, M was not different among pigs regardless of creep feed treatments. Pigs fed LOW had reduced jejunal villus height (VH; P < 0.001) and M (P < 0.001) on day 28 vs. day 21. The VH and M were not different for pigs fed HIGH or LOW by the end of the nursery period. For all dietary treatments except COM-HIGH and COM-LOW, jejunal mucosal maltase-specific activity was not different between days 21 and 28 of age but greater on day 59 (P < 0.05). For pigs that received COM-HIGH, maltase-specific activity was not different between days 21 and 28 but greater on day 59 than day 28 (P < 0.05). For pigs that received COM-LOW, maltase-specific activity was not different between days 21, 28, and 59. Regardless of creep or nursery treatment, sucrase-specific activity was the greatest on day 59, followed by days 21 and 28 (P < 0.001), and lactase-specific activity was greater on day 21 than on days 28 and 59 (P < 0.001), which were not different. Therefore, pigs that provided LOW diet had greater villus atrophy and reduced M during the first week after weaning vs. pigs that provided HIGH, regardless of creep feeding regimen, but were able to recover by the end of the nursery period.
Classification and distribution of evergreen broad-leaved forests in Jiangxi, East China
Authors: Liu Yizhen , Shen Haihua , Ge Gang , Xing Aijun , Tang Zhiyao , Fang Jingyun
Published: April 2022

Evergreen broad-leaved forest (EBLF) is climax vegetation in East China, and Jiangxi Province is located at the center of EBLF. Although many phytosociological studies have provided detailed descriptions on this forest at local and regional scales, knowledge on the high-level classification of EBLF and factors controlling their tree species composition and distribution are still lacking. We aim at providing a high-level classification framework for EBLF in Jiangxi and exploring the roles of topographic and climatic factors in driving their distributions. We investigated 205 EBLF plots covering the main alliances across Jiangxi Province. Two-way indicator species analysis (TWINSPAN) and detrended correspondence analysis (DCA) were used to distinguish the EBLF types. Diagnostic and indicator species were detected. The nonparametric Kruskal–Wallis test was used to compare the differences between the groups of EBLFs. We also used redundancy analysis and variation partitioning to estimate the effects of climatic, geographical and topographical factors on the distribution of EBLFs in Jiangxi. The EBLFs in Jiangxi were classified into four types based on the diagnostic taxa and verified by TWINSPAN, i.e. lowland, ravine monsoon, montane typical and dwarf cloud EBLF types. These four EBLF types are associated with climatic and topographic conditions, and their distribution pattern reflects biogeographic differences. Our study provides an important basis for the syntaxonomic classification of EBLFs and further in-depth studies on humid EBLFs in East China. We also emphasize the importance of conservation practices to protect these forests as diversified Tertiary relict plants.
Cutaneous fistula on the cheek associated with oculo-auriculo-vertebral spectrum
Authors: Nishimoto Soh , Kawai Kenichiro , Fujiwara Toshihiro , Ishise Hisako , Kakibuchi Masao
Published: April 2022

A Japanese boy, presented with epibulbar dermoid and ipsilateral preauricular appendages, had a pit on his cheek of the same side. An atrial septal defect and vertebral fusions were also identified. He was diagnosed with a mild type of oculo-auriculo-vertebral spectrum (OAVS). At the age of 18 months, his cheek was swollen with a slight fever. An infected cyst and cutaneous fistula enveloped by the risorius muscle were extracted. It was assumed to be a remnant of the fissure between the maxillary and mandibular prominences. This was the first case of cutaneous fistula confirmed histologically with OAVS, although there seem to be more cases. The possibility of the mechanism of smiling cheek dimple is also discussed.
Recombination between SARS-CoV-2 Omicron BA.1 and BA.2 variants identified in a traveller from Nepal at the airport quarantine facility in Japan
Authors: Sekizuka Tsuyoshi , Saito Masumichi , Itokawa Kentaro , Sasaki Naobumi , Tanaka Rina , Eto Satsuki , Someno Risa , Ogamino Akina , Yokota Eiichi , Saito Tomoya , Kuroda Makoto
Published: April 2022

We have detected novel SARS-CoV-2 variants at the airport quarantine facility in Japan. This study revealed novel Omicron recombinant in a traveller visiting from Nepal, suggesting a possibility of its further dissemination in surrounding countries with limited sequencing capacity. Quarantine monitoring could aid timely response to avoid global dissemination.
Veteran Suicide: Missed Opportunities for Suicide Prevention Within Concealed Pistol License Curriculum
Authors: Consolino Tara A , Yarvis Jeffrey S
Published: April 2022

Introduction

Veteran suicide is a growing topic for public health concern. Despite enhancements from the Department of Veterans Health Administration, clinicians continue to struggle to identify and engage veterans at risk for suicide.

Materials and Methods

Examining suicide prevention efforts, epidemiology, risk factors, and barriers to care; Substance Abuse and Mental Health Services Administration and the U.S. Department of Veterans Affairs Governor’s Challenges identified lethal means as one of 3 priority areas to focus on in during this agenda.

Results

The writers identified gaps within the current literature as an area for future research on lethal means within the veteran population and opportunity for intervention with concealed pistol license curriculum.

Conclusion

This article ends with recommendations for further research on veteran suicides, acquisition of concealed pistol licenses, and advocacy for legislative change to require suicide prevention resources and education to be included in the training curriculum for concealed pistol license holders.
The extragalactic γ-ray background: imprints from the physical properties and evolution of star-forming galaxy populations
Authors: Owen Ellis R , Kong Albert K H , Lee Khee-Gan
Published: April 2022

Star-forming galaxies (SFGs) harbour an abundant reservoir of cosmic rays (CRs). At GeV energies, these CRs undergo interactions with their environment to produce γ-rays, and the unresolved γ-ray emission from populations of SFGs form a component of the isotropic extragalactic γ-ray background (EGB). In this work, we investigate the contribution to the 0.01–50 GeV EGB from SFG populations located up to redshift z = 3. We find this is dominated by starbursts, while the contribution from main-sequence SFGs is marginal at all energies. We also demonstrate that most of the γ-ray contribution from SFGs emanates from low-mass galaxies, with over 80 per cent of the emission originating from galaxies with stellar masses below $10^8 \, {\rm M}_{\odot }$. Many of these galaxies are located at relatively high redshift, with their peak EGB contribution arising ∼700 Myr before the noon of cosmic star formation. We find that the precise redshift distributions of EGB sources at different energies imprint intensity signatures at different angular scales, which may allow their contribution to be distinguished using analyses of small-scale EGB intensity anisotropies, particularly if the diffuse EGB is dominated by hadronic CR-driven γ-ray emission from SFGs. We show that the EGB is sensitive to the evolution of low-mass populations of galaxies, particularly around z ∼ 2.5, and that it provides a new means to probe the engagement of CRs in these galaxies before the high noon of cosmic star formation.
Anti-neutrophil cytoplasmic antibody-associated vasculitis complicated by thrombotic microangiopathy with posterior reversible encephalopathy syndrome successfully treated with eculizumab: A case report
Authors: Kitamura Fumiya , Yamaguchi Makoto , Nishimura Minori , Katsuno Takayuki , Ito Mayumi , Sugiyama Hirokazu , Iwagaitsu Shiho , Nobata Hironobu , Kinashi Hiroshi , Ishimoto Takuji , Banno Shogo , Ito Yasuhiko
Published: April 2022

Thrombotic microangiopathy is characterised by endothelial cell injury, intravascular platelet-fibrin thrombi, and vascular damage, leading to acute kidney injury, thrombocytopenia, and microangiopathic haemolytic anaemia. Among the autoimmune diseases related to thrombotic microangiopathy, anti-neutrophil cytoplasmic antibody-associated vasculitis-related thrombotic microangiopathy cases have been rarely reported; therefore, the optimal treatment for associated vasculitis-related thrombotic microangiopathy remains unknown. An 84-year-old woman without significant medical history presented with a 1-month history of general fatigue, fever, and deteriorating bilateral leg numbness and was admitted to our hospital. She had elevated myeloperoxidase anti-neutrophil cytoplasmic antibody levels, polyneuropathy, and rapid progressive glomerulonephritis because of pauci-immune crescentic glomerulonephritis, as revealed by a kidney biopsy. Accordingly, we diagnosed her with microscopic polyangiitis. After administering methylprednisolone pulse therapy, rituximab, and intravenous immunoglobulin, the patient’s mental state deteriorated, presenting signs of thrombotic microangiopathy with posterior reversible encephalopathy syndrome. Intermittent haemodialysis and plasma exchange were initiated; however, her condition did not improve, and eculizumab administration was initiated thereafter. The patient’s symptoms showed a remarkable response to eculizumab; thrombotic microangiopathy findings, kidney function, and neurological symptoms improved after only two doses of eculizumab, and she achieved sustained remission. The extremely effective course of eculizumab treatment indicated that overt complement activation affected the development of thrombotic microangiopathy. Anti-neutrophil cytoplasmic antibody-associated vasculitis-related thrombotic microangiopathy may be mediated by complement activation, and prompt induction of eculizumab therapy may be a superior strategy to prevent organ damage. Further studies should elucidate the role of complement activation in associated vasculitis-related thrombotic microangiopathy and the efficacy of eculizumab treatment.
Follow-up Blood Culture Practices for Gram-Negative Bloodstream Infections in Immunocompromised Hosts at a Large Academic Medical Center
Authors: Buzzalino Lauren Groft , Mease James , Bernhardi Ciera L , Bork Jacqueline T , Johnson J Kristie , Claeys Kimberly C
Published: April 2022

The role of follow-up blood cultures (FUBCs) in gram-negative bloodstream infections to improve clinical outcomes remains controversial, especially among immunocompromised patients. Among 139 patients, FUBCs were common (117, 84.2%); however, positive FUBCs were rare (3, 2.6%). Only presence of fever was associated with a positive FUBC.
SARS-CoV-2 mRNA Vaccine Effectiveness in Health Care Workers by Dosing Interval and Time Since Vaccination: Test-Negative Design, British Columbia, Canada
Authors: El Adam Shiraz , Zou Macy , Kim Shinhye , Henry Bonnie , Krajden Mel , Skowronski Danuta M
Published: April 2022

Background

One- and two-dose mRNA vaccine effectiveness (VE) estimates against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by dosing interval and time since vaccination were assessed among healthcare workers (HCWs) in publicly funded acute and community (nonresidential) healthcare facilities in British Columbia, Canada.

Methods

A test-negative design was used with controls matched to cases (6:1) on epidemiological week of SARS-CoV-2 test date. mRNA vaccination was defined by receipt of the first dose ≥21 days or second dose ≥14 days before the test date. HCWs ≥18 years old tested for SARS-CoV-2 between epi-weeks 3 and 39 (January 17–October 2, 2021) were included, when varying dosing intervals and a mix of circulating variants of concern contributed, including Delta dominance provincially from epi-week 31 (August 1).

Results

Single- and two-dose analyses included 1265 and 1246 cases, respectively. The median follow-up period (interquartile range) was 49 (34–69) days for single-dose and 89 (61–123) days for two-dose recipients, with 12%, 31%, and 58% of second doses given 3–5, 6, or ≥7 weeks after the first. Adjusted mRNA VE against SARS-CoV-2 was 71% (95% CI, 66%–76%) for one dose and 90% (95% CI, 88%–92%) for two doses, similar to two heterologous mRNA doses (92%; 95% CI, 86%–95%). Two-dose VE remained >80% at ≥28 weeks post–second dose. Two-dose VE was consistently 5%–7% higher with a ≥7-week vs 3–5-week interval between doses, but with overlapping confidence intervals.

Conclusions

Among HCWs, we report substantial single-dose and strong and sustained two-dose mRNA vaccine protection, with the latter maintained for at least 7 months. These findings support a longer interval between doses, with global health and equity implications.
The Value of a Longitudinal Human Immunodeficiency Virus Track for Medical Students: 10-Year Program Evaluation
Authors: Marcelin Jasmine R , Brosnihan Paul , Swindells Susan , Fadul Nada , Bares Sara H
Published: April 2022

We surveyed graduates of a longitudinal medical school human immunodeficiency virus curriculum to evaluate its impact. Respondents felt comfortable caring for people with human immunodeficiency virus (PWH) and found value from the curriculum regardless of ultimate career path. Programs like this contribute to the development of culturally sensitive clinicians comfortable caring for PWH.
Navigating Human Immunodeficiency Virus Screening Recommendations for People on Pre-Exposure Prophylaxis and the Need to Update Testing Algorithms
Authors: Meyerowitz Eric A , Bernardo Raffaele M , Collins-Ogle Michelle D , Czeresnia Jonathan M , Matos Cariane M , Mullis Caroline , Root Heather B , Torres-Isasiga Julián A , Tsai Helen , Zingman Barry S
Published: April 2022

Incident HIV infections occurring in people on PrEP may have delayed seroconversion. New CDC guidelines recommend the addition of HIV-1 viral load for screening for all on PrEP. We believe antigen/antibody screening should continue for tenofovir-based PrEP at this time.
W 49 N MCN-a: A disk-accreting massive protostar embedded in an early-phase hot molecular core
Authors: Miyawaki Ryosuke , Hayashi Masahiko , Hasegawa Tetsuo
Published: April 2022

We present ALMA archival data for 219–235 GHz continuum and line observations toward the hot molecular core (HMC) W 49 N MCN-a (UCHII region J1) at a resolution of ∼${0.^{\prime \prime }3}$. The dust continuum emission, showing an elongated structure of ${1.^{\prime \prime }40} \times {0.^{\prime \prime }95}$ (position angle = 43.°5) perpendicular to the outflow seen in SiO and SO, represents a rotating flattened envelope, or torus, with a radius of 7800 au inclined at 47.°5 or larger. The emissions from CH3CN, 13CS, HNCO, HC3N, SO2, DCN, H2CO, OCS, CH3OH, and C18O exhibit a consistent velocity gradient as a result of rotation. The magnitude of each velocity gradient is different, reflecting that each line samples a specific radial region. This allows us to derive a rotation curve as Vrot ∝ R0.44 ± 0.11 for 2400 au ≲  R  ≲ 14000 au, giving the dynamical mass as $M_{\rm dyn} = 57.0^{+24.5}_{-17.1}\, (R\, [{\rm au}]/3000)^{1.88}\, M_{\odot }$. The envelope mass independently estimated from the dust emission is 910 M⊙ (for Tdust = 180 K) for R ≤ 7800 au and 32 M⊙ (for Tdust = 300 K) for R ≤ 1700 au. The dynamical mass formula agrees well with these mass estimates within an uncertainty of a factor of three in the latter. The envelope is self-gravitating and is unstable to form spiral arms and fragments, allowing rapid accretion to the inner radii with a rate of the order of 10−2 M⊙ yr−1, although inward motion was not detected. The envelope may become a non-self-gravitating Keplerian disk at R  ≲  (300–1000) au. The formula is also consistent with the total mass ∼104 M⊙ of the entire HMC 0.15 pc (31000 au) in radius. Multiple transitions of CH3CN, HNCO, and CH3OH provide rotation temperatures of 278$^{+39}_{-30}$, 297$^{+52}_{-39}$, and 154$^{+73}_{-37}$ K, respectively, for R  ≲  1700 au, suggesting that the central source of MCN-a has an intrinsic bolometric luminosity of ∼106 L⊙. These results have revealed the structure and kinematics of MCN-a at its intermediate radii. With no broad-line H30α emission detected, MCN-a may be in the earliest phase of massive star formation.
Fungi hijack a ubiquitous plant apoplastic endoglucanase to release a ROS scavenging β-glucan decasaccharide to subvert immune responses
Authors: Chandrasekar Balakumaran , Wanke Alan , Wawra Stephan , Saake Pia , Mahdi Lisa , Charura Nyasha , Neidert Miriam , Poschmann Gereon , Malisic Milena , Thiele Meik , Stühler Kai , Dama Murali , Pauly Markus , Zuccaro Alga
Published: April 2022

Plant pathogenic and beneficial fungi have evolved several strategies to evade immunity and cope with host-derived hydrolytic enzymes and oxidative stress in the apoplast, the extracellular space of plant tissues. Fungal hyphae are surrounded by an inner insoluble cell wall layer and an outer soluble extracellular polysaccharide (EPS) matrix. Here, we show by proteomics and glycomics that these two layers have distinct protein and carbohydrate signatures, and hence likely have different biological functions. The barley (Hordeum vulgare) β-1,3-endoglucanase HvBGLUII, which belongs to the widely distributed apoplastic glycoside hydrolase 17 family (GH17), releases a conserved β-1,3;1,6-glucan decasaccharide (β-GD) from the EPS matrices of fungi with different lifestyles and taxonomic positions. This low molecular weight β-GD does not activate plant immunity, is resilient to further enzymatic hydrolysis by β-1,3-endoglucanases due to the presence of three β-1,6-linked glucose branches and can scavenge reactive oxygen species. Exogenous application of β-GD leads to enhanced fungal colonization in barley, confirming its role in the fungal counter-defensive strategy to subvert host immunity. Our data highlight the hitherto undescribed capacity of this often-overlooked EPS matrix from plant-associated fungi to act as an outer protective barrier important for fungal accommodation within the hostile environment at the apoplastic plant–microbe interface.