bluuebunny/crossref_metadata_2025 huggingface dataset:
Sydowia polyspora associated with current season needle necrosis (CSNN) on Pinus brutia Ten. in Türkiye
Authors: Beram Refika Ceyda , Demiröz Fatma
Published: January 2024

Sydowia polyspora is a common fungal species living on conifers, often occurring as an epiphyte or endophyte on asymptomatic plants and in seeds. The fungus may become pathogenic under abiotic or biotic stress conditions. It is often associated with current season needle necrosis and shoot dieback on conifer species, especially Abies spp. and Pinus spp. throughout Europe and North America. The conifer Pinus brutia is common and widely distributed in Türkiye and is frequently used in reforestation. The work described here aimed to investigate the S. polyspora associated with needle necrosis and shoot dieback in five different Pinus brutia stands located in Denizli‐Türkiye, to determine the severity of the disease and to reveal the pathogenicity of this agent in P. brutia seedlings. For this purpose, fungal isolations from symptomatic P. brutia needles were carried out in five different stands. In total, 68 S. polyspora isolates were obtained, each from a different tree from which macroscopic‐microscopic morphological characterization was made and molecular characterization was done using the internal transcribed spacer (ITS) region. BLAST analysis of the ITS sequences confirmed the identification of the isolates, with 99–100% similarity to previously reported sequences of S. polyspora. Disease incidence and severity were assessed in five P. brutia stands. The disease incidence ranged between 38% and 62% (mean = 47%) while disease severity varied among sites. Pathogenicity studies were carried out on 2‐year‐old P. brutia seedlings using obtained isolates. Infection frequency in inoculated shoots was 90%. The pathogenicity tests, followed by re‐isolation of the fungus from symptomatic shoots clearly demonstrated that S. polyspora played a role in the development of needle necrosis and shoot dieback in P. brutia stands. To the best of our knowledge, this is the first report of current season needle necrosis and shoot dieback on P. brutia caused by S. polyspora in Türkiye.
Putting women back into the early modern economy: Work, occupations, and economic development
Authors: Whittle Jane
Published: January 2024

A dataset of just under 10,000 work tasks gleaned from court depositions that records women's as well as men's work, and unpaid as well as paid activities, prompts a reassessment of the transformation of the early modern economy and women's role within it. Rather than sectoral change in production activities with a growth of manufacturing at the expense of agriculture, the evidence suggests that work tasks changed little over time despite occupational specialization increasing. Women's labour force participation is shown to contribute 44 per cent of work in the economy, rather than 30 per cent as in previous estimates. This is partly because of the importance of commercialized housework and care work, which has been largely overlooked in existing models of the early modern economy. Turning to waged work, findings confirm that men's and women's participation in paid agricultural work were linked, with women being employed in greater numbers when men were not available. However, these trends had a strong relationship with access to land, a factor that has been neglected in comparison with demographic trends and the cost of consumables. The organization of work was transformed in the seventeenth century as the number of completely landless households increased rapidly.
Mitigating the adverse impact of coworker incivility on organizational deviance: The self‐regulatory roles of trait conscientiousness and gender
Authors: Potipiroon Wisanupong
Published: January 2024

Despite the current knowledge about the influence of peers in the workplace, we still know relatively little about the boundary conditions that may strengthen or weaken the adverse impact of coworker‐initiated incivility on targets' behavioral outcomes. Drawing upon self‐regulation impairment theory, this study aims to shed light on the impact of coworker incivility on targets' organizational deviance (e.g., working slower and taking longer breaks) and proposes that trait conscientiousness and gender can serve as self‐regulatory resources that jointly buffer its adverse impact. Survey data were collected from 401 employees nested in 83 teams in a large public organization in Thailand. The hypotheses were tested using multilevel structural equation modeling. Two‐way interaction analyses revealed that the effect of coworker incivility on supervisor‐rated organizational deviance was less pronounced among those with high levels of conscientiousness and among female targets. Three‐way interaction effects on both self‐rated and supervisor‐rated organizational deviance were also observed. Specifically, the results showed that targets with high levels of conscientiousness, regardless of gender, showed lower tendencies to engage in organizational deviance. Conversely, among targets with low conscientiousness levels, men were most likely to engage in organizational deviance, while women were also prone to do so, albeit to a lesser extent. The present findings emphasize the importance of considering individual differences in self‐regulation when addressing the detrimental effects of incivility.
Improved cooperative Ant Colony Optimization for the solution of binary combinatorial optimization applications
Authors: Prado‐Rodríguez Roberto , González Patricia , Banga Julio R. , Doallo Ramón
Published: January 2024

Binary combinatorial optimization plays a crucial role in various scientific and engineering fields. While deterministic approaches have traditionally been used to solve these problems, stochastic methods, particularly metaheuristics, have gained popularity in recent years for efficiently handling large problem instances. Ant Colony Optimization (ACO) is among the most successful metaheuristics and is frequently employed in non‐binary combinatorial problems due to its adaptability. Although for binary combinatorial problems ACO can suffer from issues such as rapid convergence to local minima, its eminently parallel structure means that it can be exploited to solve large and complex problems also in this field. In order to provide a versatile ACO implementation that achieves competitive results across a wide range of binary combinatorial optimization problems, we introduce a parallel multicolony strategy with an improved cooperation scheme to maintain search diversity. We evaluate our proposal (Binary Parallel Cooperative ACO, BiPCACO) using a comprehensive benchmark framework, showcasing its performance and, most importantly, its flexibility as a successful all‐purpose solver for binary combinatorial problems.
Dermoscopic features of pigmented basal cell carcinoma according to size
Authors: Wang Wei‐En , Chen Yen‐Ting , Wang Chien‐Hsing , Wang Jen‐Hung , Chang Chung‐Hsing
Published: January 2024

Background

Basal cell carcinoma (BCC), the most common skin cancer in humans, requires early detection. Dermoscopy enhances diagnostic accuracy through a noninvasive approach. Pigmented BCC (pBCC) is characterized by distinctive dermoscopic features, including the presence of pigmented globules or nests. While dermoscopic features of large pBCC (size >6 mm) have been extensively studied, limited data are available on small pBCC (size ≤6 mm) and its relationship with tumor progression.

Methods

Dermoscopic images of histologically proven pBCCs were collected between 2014 and 2022 at Hualien Tzu Chi Hospital. Each image was analyzed for patterns of pigmentation, vasculature, and epidermal and dermal structures. Statistical analysis was performed to compare the differences according to the size and the trend during tumor progression.

Results

In total, 135 pBCCs (48 small and 87 large) were included. Pigment structures were present in all cases. Short fine telangiectasia and small erosions constituted over 85% of the cases, showing no significant distinction between small and large pBCCs, nor any specific pattern correlating with tumor enlargement. The number of arborizing vessels, ulcerations, and shiny white structures showed an increasing trend associated with size progression. Arborizing vessels appeared when tumor size exceeded 6 mm.

Conclusions

This study provides a dynamic interpretation of the dermoscopic features of pBCC according to size enlargement. Short fine telangiectasia and small erosions are highly important features for the early diagnosis of small pBCCs. Arborizing vessels, ulceration, and shiny white structures are more frequent in large pBCCs, and they increase in association with tumor progression.
Encapsulation of tuna oil by liquid and solid self‐emulsifying delivery system: in vitro digestion and oxidative stability assessment
Authors: Klintham Pitirat , Pinket Wichchunee , Kasemwong Kittiwut , Aphibanthammakit Chutima
Published: January 2024

Tuna oil, one of the main sources of omega‐3 polyunsaturated fatty acids (omega‐3 or n‐3 PUFAs), is known to have limited bioavailability due to its hydrophobicity. Moreover, the main n‐3 PUFAs found in tuna oil, that is docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are prone to oxidation. To overcome these drawbacks, tuna oil encapsulation via liquid (LSEDS) and solid self‐emulsifying delivery system (SSEDS) was developed. Different LSEDS formulations were prepared and evaluated in terms of tuna oil droplet size and dispersibility. Accordingly, the formulation with small droplets size and narrow size distribution was selected and further developed into SSEDS by spray drying process. SSEDS was thereafter characterised concerning production yield, moisture content, size, size distribution and morphology. Furthermore, the in vitro simulated gastrointestinal model of LSEDS and SSEDS was carried out. The results showed that after intestinal digestion stage, 87% and 72% of DHA were released from LSEDS and SSEDS, respectively. Therefore, these formulations of LSEDS and SSEDS were proven their ability to enhance the bioaccessibility of DHA. Moreover, the oxidative stability of LSEDS and SSEDS formulation was investigated and compared to pure tuna oil using non‐isothermal differential scanning calorimetry (DSC) analysis under oxygen. The results showed that both LSEDS and SSEDS formulations exhibited a high oxidative resistance with a higher energy needed to induce tuna oil oxidation than pure tuna oil. The chemical and thermal stability given by LSEDS and SSEDS may be efficiently applied in food area to enhance the techno‐functional properties of hydrophobic compounds.
Exploring Visiting Artists' Dual Roles and Constraints in Art Educational Programmes
Authors: Xu Chang
Published: January 2024

This article investigated the multifaceted role of artists in educational programmes, focusing on the challenges they face while balancing their identity as artist‐teacher, artist teacher, artist‐educator, and artist educator. This research was conducted in two phases. Phase one interrogated the effectiveness of artists taking on dual roles as both artists and educators/teachers within international and New Zealand's educational programmes. This phase advocated for artists to embrace their original role as artists without the additional burdens of other roles. Moving to phase two, this research employed the method of document analysis to investigate the historical and current engagement of artists in students' museum education within the context of New Zealand. Historically, artists were considered as art technicians with no direct involvement in art teaching or creation. Although the current LEOTC and ELC programmes in New Zealand value artists' contributions to art education, they do not indicate artists' involvement in these two programmes. Drawing from the findings of phase one and two, the study proposed a novel model that emphasises the integration of three elements: learning environment (art museum), people (artists), and objects (artworks). This model suggested that the combined action of these three elements could lead to a transformation from teacher‐led teaching to student‐centred learning in art education. Such a transition held the potential to enrich students' educational experience through collaborative efforts between artists, museum educators, and schoolteachers, and also enhance students' interdisciplinary learning experiences.
Effects of extracellular vesicles from adipose‐derived stem cells on human keloid fibroblasts via the SOCS1/JAK2/STAT3 pathway
Authors: Ruan Hongru , Wang Jie , Shi Hui , Luan Wenkang
Published: January 2024

Background

Keloid represents a benign skin tumor with many cancer‐like features. Extracellular vesicles (EVs) derived from human adipose‐derived stem cells (hADSCs) play a role in cell migration of multiple diseases.

Aims

This study aimed to investigate the impact of hADSC‐EVs on human keloid fibroblasts (HKFs).

Methods

hADSCs were cultured to the 3rd generation, and subsequently assessed for their osteogenic, adipogenic, and chondrogenic differentiative abilities using flow cytometry, alizarin red, oil red O, and alcian blue staining techniques. hADSC‐EVs were isolated through ultracentrifugation and subsequently identified. HKFs at the 3rd generation were subjected to treatment with hADSC‐EVs to observe their endocytosis of EVs by immunofluorescence. CCK‐8, wound healing, and Transwell assays were performed to test HKF proliferation and migration. The levels of autophagy proteins, collagens, and Janus kinase 2 (JAK2) and Signal Transducer and Activator of Transcription 3 (STAT3) were determined through Western blot analysis. Suppressor of cytokine signaling 1 (SOCS1) expression was determined by RT‐qPCR and Western blot.

Results

hADSC‐EVs were successfully isolated from hADSCs. PKH67‐labeled hADSC‐EVs were observed to be endocytosed by HKFs, resulting the inhibition of HKF proliferation, migration, as well as a reduction in collagen deposition. hADSC‐EVs carried SOCS1 into HKFs to suppress HKF autophagy. SOCS1 downregulation in hADSC‐EVs partially nullified the inhibitory effect of hADSC‐EVs on HKFs. hADSC‐EV‐carried SOCS1 inhibited the activation of the JAK2/STAT3 pathway. JAK2/STAT3 pathway activation partially abrogated the suppression of hADSC‐EVs on the proliferation, migration, and collagen deposition of HKF.

Conclusion

hADSC‐EVs carried SOCS1 into HKFs and suppressed HKF autophagy, proliferation, migration, and collagen deposition by inactivating the JAK2/STAT3 pathway.
The effect of speed sintering on the optical properties and microstructure of multi‐layered cubic zirconia
Authors: Hassan Shohdy Engy Ibrahim , Sabet Ahmed , Sherif Ashraf Hussien , Salah Tarek
Published: January 2024

Purpose

Speed sintering was introduced to fabricate time‐efficient chairside restorations, however, its influence on the microstructure and optical properties of zirconia is still unclear. This study investigated the influence of speed sintering on the microstructure and optical properties of ultra‐translucent multi‐layered cubic zirconia.

Materials and methods

Ultra‐translucent cubic zirconia (Katana™ UTML; Kuraray Noritake Dental Inc., Aichi, Japan) was cut into a total of 80 specimens, twenty within each layer of the blank. The specimens were divided into 2 groups: speed and conventional sintering. The translucency parameter, opalescence, chromaticity, and color difference were recorded using a spectrophotometer. Scanning electron microscope images were used for crystallographic analysis. One‐way ANOVA and Tukey's post‐hoc test (p < 0.05) were used for data analysis.

Results

Speed sintering significantly reduced the translucency and opalescence compared to conventional sintering excluding the opalescence of the dentin layer. Chromaticity significantly decreased with speed sintering in less chromatic layers and significantly increased in more chromatic layers. Mean color change ranged between 0.65 and 1.25 across different layers. Mean crystal size decreased with speed sintering.

Conclusions

With speed sintering, translucency, and opalescence decrease while chromaticity increases in the more chromatic layers. Additionally, no clinically perceptible color change was found compared to conventional sintering.
A visual paired associate learning (vPAL) paradigm to study memory consolidation during sleep
Authors: Schmidig Flavio Jean , Geva‐Sagiv Maya , Falach Rotem , Yakim Sharon , Gat Yael , Sharon Omer , Fried Itzhak , Nir Yuval
Published: January 2024

Sleep improves the consolidation and long‐term stability of newly formed memories and associations. Most research on human declarative memory and its consolidation during sleep uses word‐pair associations requiring exhaustive learning. In the present study, we present the visual paired association learning (vPAL) paradigm, in which participants learn new associations between images of celebrities and animals. The vPAL is based on a one‐shot exposure that resembles learning in natural conditions. We tested if vPAL can reveal a role for sleep in memory consolidation by assessing the specificity of memory recognition, and the cued recall performance, before and after sleep. We found that a daytime nap improved the stability of recognition memory and discrimination abilities compared to identical intervals of wakefulness. By contrast, cued recall of associations did not exhibit significant sleep‐dependent effects. High‐density electroencephalography during naps further revealed an association between sleep spindle density and stability of recognition memory. Thus, the vPAL paradigm opens new avenues for future research on sleep and memory consolidation across ages and heterogeneous populations in health and disease.
Identification of uromodulin deposition in the stroma of perinephric fibromyxoid nephrogenic adenoma by mass spectrometry
Authors: Yoshimura Kaori , Ito Yukinobu , Suzuki Mina , Horie Masafumi , Nishiuchi Takumi , Shintani‐Domoto Yukako , Shigehara Kazuyoshi , Oshima Hiroko , Oshima Masanobu , Goto Akiteru , Nojima Takayuki , Tsuzuki Toyonori , Mizokami Atsushi , Ikeda Hiroko , Maeda Daichi
Published: January 2024

Nephrogenic adenoma (NA) is an epithelial lesion that usually occurs in the mucosa of the urinary tract. Rare cases of deep infiltrative or perinephric lesions have also been reported. Recently, NA with characteristic fibromyxoid stroma (fibromyxoid NA) has been proposed as a distinct variant. Although shedding of distal renal tubular cells due to urinary tract rupture has been postulated as the cause of NA in general, the mechanism underlying extraurinary presentation of NA and fibromyxoid stromal change in fibromyxoid NA remains unknown. In this study, we performed mass spectrometry (MS) analysis in a case of perinephric fibromyxoid NA of an 82‐year‐old man who underwent right nephroureterectomy for distal ureteral cancer. The patient had no prior history of urinary tract injury or radiation. Periodic acid‐Schiff staining‐positive eosinophilic structureless deposits in the stroma of fibromyxoid NA were microdissected and subjected to liquid chromatography/MS. The analysis revealed the presence of a substantial amount of uromodulin (Tamm−Horsfall protein). The presence of urinary content in the stroma of perinephric fibromyxoid NA suggests that urinary tract rupture and engraftment of renal tubular epithelial cells directly cause the lesion.
Species diversity of fusarioid genera associated with sweet potato in Brazil, including the description of a new species
Authors: de Mello Juliana Ferreira , da Silva Santos Ana Carla , de Queiroz Brito Amanda Cupertino , da Silva Neto José Vitorino , de Almeida Souza Ana Elisa , da Costa Antônio Félix , Gomes André Angelo Medeiros , de Souza‐Motta Cristina Maria , Lopes Ueder Pedro , Machado Alexandre Reis
Published: January 2024

The sweet potato is of great socioeconomic importance in Brazil and throughout the world. Among the fungal pathogens associated with root diseases of this crop, Fusarium is of particular importance due to the diversity of species, the pathogenic potential in their various hosts and their ability to survive inside plants as endophytes without apparently causing damage. The objective of this work was to identify fusarioid genera from stems and roots of symptomatic and asymptomatic plants. The identification of fungal species was based on multilocus phylogenetic analysis and morphology. A total of 51 isolates, distributed in the Fusarium incarnatum‐equiseti species complex (FIESC), Fusarium fujikuroi species complex (FFSC), Fusarium oxysporum species complex (FOSC)—with a taxonomic novelty—and Neocosmospora were identified. The pathogenicity test on roots showed that 13 of the 14 tested isolates obtained from symptomatic roots and stems and from asymptomatic stems were capable of reproducing the rot symptoms observed in the field. The confirmation of the pathogenicity of isolates from asymptomatic stems corroborates the hypothesis that these fungi can live endophytically in asymptomatic tissue and are capable of causing damage to their hosts in stress situations. This is the first report of Fusarium agrestense, Fusarium annulatum, Fusarium caatingaense, Fusarium elaeidis, Fusarium pernambucanum, Fusarium pseudocircinatum, Neocosmospora falciformis and Neocosmospora suttoniana associated with root and stem rot of sweet potato.
Identification of Bearing Clearance in Sugar Centrifuge Using Dimension Theory and Support Vector Machine on Vibration Measurement
Authors: Salunkhe Vishal G. , Desavale R. G. , Khot S. M. , Yelve Nitesh P.
Published: January 2024

Bearing fatigue life is significantly influenced by bearing clearance. Vibration monitoring of bearing clearance deviations can efficiently reveal bearing wear and give sufficient lead time for maintenance. This study investigates the dynamics of roller bearings utilizing the dimension theory with the support vector machine (SVM) technique for diagnosing the bearing clearance faults of revolving machines. The generation of local defects in rotating machines is closely related to the clearance behavior of the rotor-bearing system. A dynamic model of bearing with dimension theory by matrix method with SVM is developed for characteristics of bearing clearance considering the influence of local defects on the inner and outer bearings races. The characteristics of bearing internal radial clearance considering the impact of the defect on the bearing are analyzed. An experimental study has been performed to capture the vibration signature of radial clearance for different speeds and radial loads of the rotor. The rotor-bearing system equations are numerically integrated, and the results are validated with experimental findings. The collective effects among the four parameters (radial load, speed, defect size, radial clearance) are investigated in detail for the rotor-bearing system. The noisy signal is subsequently eliminated using the modulation signal bispectrum (MSB), and the peaks of the MSB results are represented by the bearing clearance indicator. The efficiency and reliability of the stated approach are evaluated using a specialized bearing test and a run-to-failure sugar centrifuge test. The results suggest that the proposed approach can detect a change in bearing clearance up to 40 µm.
A plasma membrane–associated form of the androgen receptor enhances nuclear androgen signaling in osteoblasts and prostate cancer cells
Authors: Kalyanaraman Hema , Casteel Darren E. , China Shyamsundar Pal , Zhuang Shunhui , Boss Gerry R. , Pilz Renate B.
Published: January 2024

Androgen binding to the androgen receptor (AR) in the cytoplasm induces the AR to translocate to the nucleus, where it regulates the expression of target genes. Here, we found that androgens rapidly activated a plasma membrane–associated signaling node that enhanced nuclear AR functions. In murine primary osteoblasts, dihydrotestosterone (DHT) binding to a membrane-associated form of AR stimulated plasma membrane–associated protein kinase G type 2 (PKG2), leading to the activation of multiple kinases, including ERK. Phosphorylation of AR at Ser
515
by ERK increased the nuclear accumulation and binding of AR to the promoter of
Ctnnb1
, which encodes the transcription factor β-catenin. In male mouse osteoblasts and human prostate cancer cells, DHT induced the expression of
Ctnnb1
and
CTNN1B
, respectively, as well as β-catenin target genes, stimulating the proliferation, survival, and differentiation of osteoblasts and the proliferation of prostate cancer cells in a PKG2-dependent fashion. Because β-catenin is a master regulator of skeletal homeostasis, these results explain the reported male-specific osteoporotic phenotype of mice lacking PKG2 in osteoblasts and imply that PKG2-dependent AR signaling is essential for maintaining bone mass in vivo. Our results suggest that widely used pharmacological PKG activators, such as sildenafil, could be beneficial for male and estrogen-deficient female patients with osteoporosis but detrimental in patients with prostate cancer.
Infectious bursal disease virus VP5 triggers host shutoff in a transcription-dependent manner
Authors: Niu Xinxin , Han Jinze , Huang Mengmeng , Wang Guodong , Zhang Yulong , Zhang Wenying , Yu Hangbo , Xu Mengmeng , Li Kai , Gao Li , Wang Suyan , Chen Yuntong , Cui Hongyu , Zhang Yanping , Liu Changjun , Wang Xiaomei , Gao Yulong , Qi Xiaole
Published: January 2024

Viruses have evolved intricate mechanisms to evade host antiviral responses and exploit cellular resources by manipulating the expression profile of host genes. During infection, viruses encode proteins with shutoff activity to globally inhibit host protein synthesis, which is an effective strategy for immune evasion. In this study, compelling evidence shows that infectious bursal disease virus (IBDV) infection triggers the suppression of host protein synthesis. Furthermore, using both
in vitro
and
in vivo
viral infection models, we have identified that IBDV specifically impedes the transcription of host genes via the shutoff activity of viral VP5, simultaneously conferring advantages to IBDV infection in these circumstances. The proposed mechanism suggests that VP5 competitively binds to RanBP1, disrupting the RanGDP/GTP gradient. This disruption interferes with cellular nucleocytoplasmic transport, impairing the nuclear import of proteins bearing nuclear localization signals. The nuclear transport of pivotal transcriptional regulatory factors, such as p65 and IFN regulatory factor 7, is also compromised, leading to the inhibition of pro-inflammatory cytokines and interferon expression. This newly discovered strategy employed by IBDV enables them to manipulate host gene expression, providing novel insights into how viruses evade host immune responses and establish infections.

IMPORTANCE

Viruses manipulate host processes at various levels to regulate or evade both innate and adaptive immune responses, promoting self-survival and efficient transmission. The “host shutoff,” a global suppression of host gene expression mediated by various viruses, is considered a critical mechanism for evading immunity. In this study, we have validated the presence of host shutoff during infectious bursal disease virus (IBDV) infection and additionally uncovered that the viral protein VP5 plays a pivotal role in inhibiting the overall synthesis of host proteins, including cytokines, through a transcription-dependent pathway. VP5 competitively binds with RanBP1, leading to disruption of the Ran protein cycle and consequently interfering with nucleocytoplasmic transport, which ultimately results in the suppression of host gene transcription. These findings unveil a novel strategy employed by IBDV to evade host innate immunity and rapidly establish infection. This study also suggests a novel supplement to understanding the pathway through which viruses inhibit host protein synthesis.
One-year surveillance for hypervirulent
Klebsiella pneumoniae
detected carbapenem-resistant superbugs
Authors: Merla C. , Kuka A. , Mileto I. , Petazzoni G. , Gaiarsa S. , De Vitis D. , Ardizzone M. , Corbella M. , Baldanti F. , Cambieri P.
Published: January 2024

Hypervirulent
Klebsiella pneumoniae
(hvKp) can cause infections in clinically healthy people, such as young and immunocompetent patients. Genes involved in the capsule synthesis or those encoding the siderophores have been adopted as predictors of hvKp. Certain sequence types, such as ST23 and ST86, have been associated with hvKp strains, too. The aim of this study was to investigate the presence of hvKp among 354
K. pneumoniae
strains isolated from clinical samples of patients admitted to an Italian 900-bed hospital between 21 May 2021 and April 2022. All the isolates were screened by PCR for the amplification of virulence loci. Whole genome sequencing was performed in strains tested positive for at least one target gene. Thirteen out of 354 (3.7%) were hvKp. Five were wild type and belonged to the hypervirulent clones ST23, ST86, ST5, and ST375 and to the new clone ST6310. Six strains carried the
blaKPC
gene: three belonged to ST101, two to ST512, and one to ST395. Two isolates were ST147 and carried the
blaNDM
gene. Although hvKp isolation is not frequent, their presence should be systematically investigated to avoid the spreading of both virulent strains and strains with combined increase in virulence and resistance to antibiotics. PCR-based protocols are essential for surveillance of these strains, which do not always show a recognizable phenotype. Moreover, hvKp strains were isolated also from patients without history of recent foreign travels, indicating an increased spreading of these strains as well as an underestimated of their circulation so far.

IMPORTANCE

Klebsiella pneumoniae
is a healthcare-associated pathogen frequently resistant to antibiotics. Hypervirulent strains of pneumoniae (hvKp) can spread from the primary site of infection to multiple sites causing life-threatening infections also in young otherwise healthy individuals. This study described the isolation of 13 isolates of
K. pneumoniae
with increased virulence in a large tertiary hospital over a 1-year period. Among them, eight strains were multidrug resistant and hypervirulent. Although these hypervirulent strains are still rare in Italy, their presence is particularly concerning since they can cause difficult-to-treat life-threatening infections. Moreover, not all the hypervirulent isolates were positive by the string test, so hvKp isolates were not always phenotypically detectable. Molecular biology techniques such as PCR amplification and next generation sequencing are therefore necessary for the detection of hvKp isolates, and surveillance programs exploiting molecular techniques are highly desirable.
Protocol for fever control using external cooling in mechanically ventilated patients with septic shock: SEPSISCOOL II randomised controlled trial
Authors: Guénégou-Arnoux Armelle , Murris Juliette , Bechet Stéphane , Jung Camille , Auchabie Johann , Dupeyrat Julien , Anguel Nadia , Asfar Pierre , Badie Julio , Carpentier Dorothée , Chousterman Benjamin , Bourenne Jeremy , Delbove Agathe , Devaquet Jérôme , Deye Nicolas , Dumas Guillaume , Dureau Anne-Florence , Lascarrou Jean-Baptiste , Legriel Stephane , Guitton Christophe , Jannière-Nartey Caroline , Quenot Jean-Pierre , Lacherade Jean-Claude , Maizel Julien , Mekontso Dessap Armand , Mourvillier Bruno , Petua Philippe , Plantefeve Gaetan , Richard Jean-Christophe , Robert Alexandre , Saccheri Clément , Vong Ly Van Phach , Katsahian Sandrine , Schortgen Frédérique
Published: January 2024

Introduction

Fever treatment is commonly applied in patients with sepsis but its impact on survival remains undetermined. Patients with respiratory and haemodynamic failure are at the highest risk for not tolerating the metabolic cost of fever. However, fever can help to control infection. Treating fever with paracetamol has been shown to be less effective than cooling. In the SEPSISCOOL pilot study, active fever control by external cooling improved organ failure recovery and early survival. The main objective of this confirmatory trial is to assess whether fever control at normothermia can improve the evolution of organ failure and mortality at day 60 of febrile patients with septic shock. This study will compare two strategies within the first 48 hours of septic shock: treatment of fever with cooling or no treatment of fever.

Methods and analysis

SEPSISCOOL II is a pragmatic, investigator-initiated, adaptive, multicentre, open-label, randomised controlled, superiority trial in patients admitted to the intensive care unit with febrile septic shock. After stratification based on the acute respiratory distress syndrome status, patients will be randomised between two arms: (1) cooling and (2) no cooling. The primary endpoint is mortality at day 60 after randomisation. The secondary endpoints include the evolution of organ failure, early mortality and tolerance. The target sample size is 820 patients.

Ethics and dissemination

The study is funded by the French health ministry and was approved by the ethics committee CPP Nord Ouest II (Amiens, France). The results will be submitted for publication in peer-reviewed journals.

Trial registration number

NCT04494074.
Is Internalised Homonegativity associated with HIV testing and HIV risk behaviours of men who have sex with men: a multilevel cross-sectional study of sub-Saharan African countries
Authors: Kalu Ngozi , Ross Michael W , Taegtmeyer Miriam , Spicer Neil , Adebajo Sylvia , Owolabi Rotimi , Lamontagne Erik , Howell Sean , Neuman Melissa
Published: January 2024

Objectives

This study assessed the associations of Internalised Homonegativity (IH) with HIV testing and risk behaviours of adult men who have sex with men (MSM) in sub-Saharan Africa (SSA) and effect modification by the legal climate.

Design

We used data from the cross-sectional 2019 Global Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI+) Internet survey study.

Setting and participants

Overall, the 2019 Global LGBTI Internet Survey collected data from 46 SSA countries. In this secondary analysis, we included data from 3191 MSM in 44 SSA countries as there were no eligible MSM responses in the 2 countries excluded.

Outcome measures

Our response variables were self-reported binary indicators of ever tested for HIV, recently tested in the past 6 months (from those who reported ever testing), transactional sex (paying for and being paid for sex in the past 12 months), and unprotected anal sex (that is without a condom or pre-exposure prohylaxis (PrEP)) with a non-steady partner (in the past 3 months).

Results

Our findings showed high levels of IH (range 1–7) in MSM across SSA (mean (SD)=5.3 (1.36)). We found that MSM with higher IH levels were more likely to have ever (adjusted OR (aOR) 1.18, 95% CI 1.03 to 1.35) and recently tested (aOR 1.19, 95% CI 1.07 to 1.32) but no evidence of an association with paying for sex (aOR 1.00, 95% CI 0.89 to 1.12), selling sex (aOR 1.06, 95% CI 0.95 to 1.20) and unprotected sex (aOR 0.99, 95% CI 0.89 to 1.09). However, we observed that a favourable legal climate modifies the associations of IH and paying for sex (aOR 0.75, 95% CI 0.60 to 0.94). Increasing levels of IH had a negative association with paying for sex in countries where same-sex relationships are legal. We found no associations of IH with unprotected anal sex in the population surveyed.

Conclusions

We confirm that IH is widespread across SSA but in countries that legalise same-sex relationships, MSM were less likely to engage in transactional sex compared with those in countries where homosexuality is criminalised.
Mortality in patients with adrenal insufficiency: a protocol for a systematic review and meta-analysis
Authors: Allosso Francesca , Dalakas Konstantinos , Bergthorsdottir Ragnhildur , Chantzichristos Dimitrios , Hessman Eva , Nwaru Bright I , Bobbio Emanuele , Pasquali Daniela , Johannsson Gudmundur , Esposito Daniela
Published: January 2024

Introduction

Adrenal insufficiency (AI) is a rare disorder characterised by an impaired secretion of glucocorticoids from the adrenal glands. Treatment strategies for AI have developed over time with reduced glucocorticoid replacement doses and improved circadian exposure regimens, but whether this has resulted in better survival is unknown. The main purpose of this systematic review is to gather and synthesise available evidence on long-term mortality in patients with AI. The secondary aim is to study causes of death, with focus on cardiovascular and infectious diseases, in AI patients.

Methods and analysis

Studies published from the inception of respective databases (Medline, Embase, Cochrane and Web of Science) until the end of May 2023 will be systematically synthetised. Observational studies with a reference population will be included, and their quality will be assessed using the Newcastle-Ottawa scale. Data collected will be narratively integrated and a meta-analysis will be performed to pool data from studies considered homogeneous. The systematic review will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This will be the first systematic review assessing mortality and causes of death in AI patients. The findings of this systematic review will be of value for both patients and healthcare providers.

Ethics and dissemination

This systematic review does not require ethical approval or informed consent because it will be based on previously published data only and does not implicate any direct contact with individual patients. The research results will be presented at scientific conferences and submitted for publication in an internationally recognised peer-reviewed scientific journal.

PROSPERO registration number

CRD42023416253.
Protocol for a comparative cross-sectional study on characterisation of auditory impairment in sickle cell disease and sickle cell trait and its impact on health-related quality of life in Nigeria
Authors: Ibekwe Titus S , Rogers Christine , Nnodu Obiageli , Ramma Lebogang
Published: January 2024

Introduction

Sickle cell disease (SCD) and sickle cell traits (SCT) are genetically inherited red blood cell disorders common among people of African descent. Nigeria has a high prevalence of SCD, with a prevalence of 2.28%–3% and SCT, 25%–30%. Poorly managed SCD and SCT can lead to sensorineural hearing loss and health-related quality of life (HRQoL) issues. This research aims to assess these possible complications of SCD and SCT in Nigeria.

Methods and analysis

The study will use a comparative cross-sectional design at study power 80% to investigate the association between SCD/SCT, hearing impairment and HRQoL. Participants will be divided into two groups: a cohort and a control group. Hearing levels will be assessed through audiometric assessments and categorised by type and severity of hearing impairments using WHO classifications. HRQoL will also be assessed using WHO Disability Assessment Schedule 2.0. Statistical analyses will be performed using the SAS V.9.4, with parametric or non-parametric analysis depending on the distribution. Relationship between key variables will be determined via correlational tests, χ2, Fisher’s exact test and multivariable logistic regression analyses.

Ethics and dissemination

The proposal has been fully reviewed and registered by the University of Cape Town’s Faculty of Health Sciences Human Research Ethics Committee (HREC REF 228/2022) and the University of Abuja Teaching Hospital Human Research Ethics Committee (HREC/PR/2020/08/007). Information dissemination will be through conferences, peer-review publication and personal communications. The Strengthening the Reporting of Observational Studies in Epidemiology statement will be followed in writing the manuscript.
Mixed-methods randomised study exploring the feasibility and acceptability of eye-movement desensitisation and reprocessing for improving the mental health of traumatised survivors of intensive care following hospital discharge: protocol
Authors: Bates Andrew , Golding Hannah , Rushbrook Sophie , Highfield Julie , Pattison Natalie , Baldwin David , Grocott Michael P W , Cusack Rebecca
Published: January 2024

Introduction

Post-traumatic symptoms are common among patients discharged from intensive care units (ICUs), adversely affecting well-being, increasing healthcare utilisation and delaying return to work. Non-pharmacological approaches (eg, music, therapeutic touch and patient diaries) have been suggested as candidate interventions and trauma-focused psychological interventions have been endorsed by international bodies. Neither category of intervention is supported by definitive evidence of long-term clinical effectiveness in patients who have been critically ill. This study assesses the feasibility and acceptability of using eye-movement desensitisation and reprocessing (EMDR) to improve the mental health of ICU survivors.

Methods and analysis

EMERALD is a multicentre, two-part consent, pilot feasibility study, recruiting discharged ICU survivors from three hospitals in the UK. We are gathering demographics and measuring post-traumatic symptoms, anxiety, depression and quality of life at baseline. Two months after discharge, participants are screened for symptoms of post-traumatic stress disorder (PTSD) using the Impact of Events Scale-Revised (IES-R). Patients with IES-R scores<22 continue in an observation arm for 12 month follow-up. IES-R scores≥22 indicate above-threshold PTSD symptoms and trigger invitation to consent for part B: a randomised controlled trial (RCT) of EMDR versus usual care, with 1:1 randomisation. The study assesses feasibility (recruitment, retention and intervention fidelity) and acceptability (through semistructured interviews), using a theoretical acceptability framework. Clinical outcomes (PTSD, anxiety, depression and quality of life) are collected at baseline, 2 and 12 months, informing power calculations for a definitive RCT, with quantitative and qualitative data convergence guiding RCT refinements.

Ethics and dissemination

This study has undergone external expert peer review and is funded by the National Institute for Health and Care Research (grant number: NIHR302160). Ethical approval has been granted by South Central-Hampshire A Research Ethics Committee (IRAS number: 317291). Results will be disseminated through the lay media, social media, peer-reviewed publication and conference presentation.

Trial registration number

NCT05591625.
Challenges of using body bags for COVID-19 deaths from the healthcare provider perspective – a qualitative study
Authors: Toyama Mayumi , Mori Hiroko , Kuriyama Akira , Sano Makiko , Imura Haruki , Nishimura Mayumi , Nakayama Takeo
Published: January 2024

Background

During the COVID-19 pandemic, numerous issues regarding end-of-life care for COVID-19 patients have been discussed. Among these issues, challenges related to the use of body bags following the death of COVID-19 patients have been suggested. This study aimed to identify the challenges faced by healthcare professionals (HCPs) when using body bags after the death of patients infected with COVID-19 in medical settings.

Methods

We conducted a qualitative descriptive study with semistructured in-depth interviews using inductive thematic analysis. From August to December 2021, we interviewed nurses and doctors who provided end-of-life care to COVID-19 patients focusing on their experiences with the use of body bags for the deceased.

Results

Of the 25 interviewees who mentioned body bag use, 14 were nurses (56%) and 13 were women (52%). The mean interview length was 52.0 min (SD 9.6 min). Challenges associated with body bag use were classified into four themes with eight categories: preserving the dignity of the deceased, consideration for the bereaved saying a final goodbye to a loved one in a body bag, the physical and emotional impact on HCPs, and diverse opinions on body bag use.

Conclusion

Our findings include ethical concerns about the dignity of the deceased, empathy for the grief of bereaved families, and the emotional and physical distress experienced by HCPs struggling with the recommendation to use body bags based on limited evidence. The diverse perspectives of HCPs in this study highlight potential issues that developers should consider when formulating more appropriate and acceptable guidelines/guidance and policies.
Personal goals of young survivors of violent injury: implications for practice
Authors: Miller Zoe Maya , Chapman-Kramer Kateri , Cooper Benjamin P. , Coffey Melik , Page Keyria , Meyers Jessica E. , Vogel Matt , Mancini Michael , Mueller Kristen
Published: January 2024

Introduction

Firearm injuries are the leading cause of death among young people in the USA and disproportionately impact communities of colour and those experiencing socioeconomic distress. Understanding the personal goals of violently injured patients is essential to identifying protective factors and developing interventions that promote them. However, limited research characterising these personal goals exists.

Objective

The objective of this study was to use qualitative thematic analysis to analyse and describe the personal goals of young people who enrolled in a region-wide hospital-based violence intervention programme after surviving a violent injury.

Methods

A qualitative coding framework was developed, evaluated, and implemented using data from Life Outside of Violence, the St. Louis Area Hospital-Based Violence Intervention Programme. Chart abstraction procedures were used to compile qualitative data on Life Outside of Violence participants’ personal goals documented by clinical case managers during individual treatment planning sessions with participants (n=168). Descriptive analyses are reported and implications for practice are discussed.

Results

Key findings reveal that (1) violent injury survivors have unmet therapeutic and resource needs, indicating the importance of having service providers with both clinical and case management skills, (2) anger management is a common clinical goal, and (3) employment opportunities are a common resource need.

Conclusions

Findings from this study inform the implementation of the Life Outside of Violence programme and offer a roadmap to other hospital-based violence intervention programmes operating nation-wide. Our results provide insight into participants’ needs, desires, and motivations, allowing unique opportunities for improved participant engagement and service delivery.
Antibiomania: clarithromycin-induced neurotoxicity mimicking autoimmune limbic encephalitis
Authors: Whittam Daniel , Matthews Rachael , Nimeri Randa , Shaik Saifuddin
Published: January 2024

We describe a 64-year-old woman with relapsing encephalopathy. She initially presented with 5 days of psychomotor agitation, progressing to mania, psychosis and seizures that mimicked autoimmune limbic encephalitis. During her first hospital admission, extensive investigation failed to establish the underlying cause, and she improved with antiseizure medication alone. After a month at home, she relapsed with identical symptoms, and only then did we recognise that both episodes had been provoked by clarithromycin, prescribed forHelicobacter pylorieradication. Clarithromycin-induced neurotoxicity is rarely reported but likely to be under-recognised. It usually manifests within days of starting treatment, with delirium, mania, psychosis or visual hallucinations, sometimes termed ‘antibiomania’. Seizures and status epilepticus appear to be less frequent. A full recovery is expected on stopping the medication.