bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurses' experience of end‐of‐life care for patients with COVID‐19: A descriptive phenomenology study
Authors: Kim Yujin , Kim Dong‐Hee
Published: May 2024

The mortality rates among critically ill patients with COVID‐19 have been high. The national and institutional infection control policies and resource shortages caused by the pandemic led patients to undergo deaths without dignity and inevitably changed intensive care unit (ICU) end‐of‐life care (EOLC) practices. This study explores ICU nurses' experiences of providing EOLC for patients with COVID‐19 who died. Eight nurses participated in a qualitative phenomenological study. Semi‐structured interviews were conducted from July to September 2022. Colaizzi's data analysis method was used, and the following four main themes emerged: (i) only companion in the death journey; (ii) helping families prepare for death; (iii) EOLC trapped within a framework; and (iv) EOLC in retrospect. To secure high‐quality EOLC in ICU, it is important to promote practical support for nurses and EOLC‐related discussions/education. Technical support, such as digital communication technologies, should be reinforced to help patients and their families participate in EOLC.
Combination of four features of SLC29A3 spectrum disorder in a child: A case report
Authors: Aslani Nahid , Abtahi‐Naeini Bahareh , Rastegarnasab Fereshte , Derakhshan Maryam , Tavousi Elham , Mehraein Kimia
Published: May 2024

SLC29A3 spectrum disorder, also known as histiocytosis‐lymphadenopathy plus syndrome (HLPS), presents a wide variety of multi‐systemic manifestations that can be mistaken for other conditions. Herein, we report a 9‐year‐old girl who presented with a complex clinical presentation since birth, including chronic generalized lymphadenopathy in association with hepatosplenomegaly, short stature, flexion contractures, hearing loss, hyperpigmentation, and heart anomalies. She was ultimately diagnosed with the SLC29A3 spectrum disorder.
Multi‐tiling neural radiance field (NeRF)—geometric assessment on large‐scale aerial datasets
Authors: Xu Ningli , Qin Rongjun , Huang Debao , Remondino Fabio
Published: May 2024

Neural radiance fields (NeRF) offer the potential to benefit 3D reconstruction tasks, including aerial photogrammetry. However, the scalability and accuracy of the inferred geometry are not well‐documented for large‐scale aerial assets. We aim to provide a thorough assessment of NeRF in 3D reconstruction from aerial images and compare it with three traditional multi‐view stereo (MVS) pipelines. However, typical NeRF approaches are not designed for large‐format aerial images, which result in very high memory consumption (often cost‐prohibitive) and slow convergence when directly applied to aerial assets. Despite a few NeRF variants adopting a representation tiling scheme to increase scalability, the random ray‐sampling strategy during training still hinders its general applicability for aerial assets. To perform an effective evaluation, we propose a new scheme to scale NeRF. In addition to representation tiling, we introduce a location‐specific sampling technique as well as a multi‐camera tiling (MCT) strategy to reduce memory consumption during image loading for RAM, representation training for GPU memory and increase the convergence rate within tiles. The MCT method decomposes a large‐frame image into multiple tiled images with different camera models, allowing these small‐frame images to be fed into the training process as needed for specific locations without a loss of accuracy. This enables NeRF approaches to be applied to aerial datasets on affordable computing devices, such as regular workstations. The proposed adaptation can be implemented to adapt for scaling any existing NeRF methods. Therefore, in this paper, instead of comparing accuracy performance against different NeRF variants, we implement our method based on a representative approach, Mip‐NeRF, and compare it against three traditional photogrammetric MVS pipelines on a typical aerial dataset against lidar reference data to assess NeRF's performance. Both qualitative and quantitative results suggest that the proposed NeRF approach produces better completeness and object details than traditional approaches, although as of now, it still falls short in terms of accuracy. The codes and datasets are made publicly available at https://github.com/GDAOSU/MCT_NERF.
Connection of social anxiety to impaired pattern of cognitive control and underlying motivational deficiencies: Evidence from event‐related potentials
Authors: Zhao Ruonan , Xu Cai , Shi Guangyuan , Li Chieh , Shao Siyang , Shangguan Fangfang , Cui Lixia
Published: May 2024

Numerous studies have established a correlation between social anxiety and poor cognitive control. However, little is known about the cognitive control pattern of individuals with high social anxiety (HSAs) and the underlying mechanisms. Based on the Dual Mechanisms of Control framework and the Expected Value of Control theory, this study explored whether HSAs have an impaired cognitive control pattern (Experiment 1) and whether motivational deficiencies underlie the impaired control pattern (Experiment 2). In Experiment 1, 21 individuals with low social anxiety (LSAs) and 21 HSAs completed an AX‐Continuous Performance Task. Results showed that HSAs had a smaller P3b amplitude than LSAs, indicating their weakened proactive control in the cue processing stage, but a larger contingent negative variation (CNV) on cue B as compensation for the negative effects of anxiety in the response preparation stage. No group difference was found in N2 and P3a amplitude on probes, suggesting that reactive control in HSAs was not affected compared to LSAs. In Experiment 2, 21 LSAs and 21 HSAs completed a cued‐flanker task, where the likelihood of proactive control engagement was manipulated. The results revealed that HSAs exhibited motivation deficiencies in engaging in proactive control, as evidenced by P3b, CNV amplitude, and response times. These findings shed light on the impaired cognitive control pattern of HSAs and suggest that motivational deficiencies may be the crucial underlying factor.
Stressing out! Effects of acute stress on prepulse inhibition and working memory
Authors: Santos‐Carrasco Daniel , De la Casa Luis Gonzalo
Published: May 2024

Prepulse inhibition (PPI) of the startle reflex serves as a pre‐cognitive marker of sensorimotor gating, and its deficit may predict cognitive impairments. Startle reflex is modulated by many factors. Among them, stress has been a topic of interest, but its effects on both pre‐cognitive and cognitive variables continue to yield divergent results. This study aims to analyze the effect of acute stress on PPI of the startle reflex and cognitive function (working memory, attention, inhibition, and verbal fluency). Participants were exposed to the MAST stress induction protocol or a stress‐neutral task: stress group (n = 54) or control group (n = 54). Following stress induction, participants' startle responses were recorded, and cognition was assessed. The results revealed that participants in the stress group exhibited greater startle magnitude, lower PPI, and lower scores in working memory tests compared with the control group. Additionally, a correlation was found between working memory and PPI across all the participants, independent of stress group. These findings support the notion that after stress, both greater startle magnitude and diminished PPI could play an adaptive role by allowing for increased processing of stimuli potentially dangerous and stress‐related. Similarly, our results lend support to the hypothesis that lower PPI may be predictive of cognitive impairment. Considering the impact of stress on both pre‐cognitive (PPI) and cognitive (working memory) variables, we discuss the possibility that the effect of stress on PPI occurs through motivational priming and emphasize the relevance of considering stress in both basic and translational science.
Are women politicians outperformed by men? The impact of gender on legislative activity in Japan
Authors: Yin Yue
Published: May 2024

Objectives

Given the distinct political landscape of Japan, this study aims to explore the impact of gender on the parliamentary behavior of Japanese legislators.

Methods

Utilizing a self‐constructed data set covering the 44th–48th Diets (2005–2021), this study examines the individual‐level parliamentary activities of male and female legislators in Japan. Key metrics analyzed include the frequency of speeches delivered in both plenary and committee sessions, alongside the submission of memorandums to the Diet.

Results

The findings indicate that on the whole, gender exerts only a minimal effect on parliamentary activities. However, upon closer examination of members belonging to opposition parties during specific time periods, female legislators emerge as more active in terms of questioning and memorandum submission compared to their male counterparts.

Conclusion

This study unveils a noteworthy trend wherein women legislators in Japan demonstrate equal or greater engagement in parliamentary activities than their male counterparts. These findings underscore the importance of exploring gender dynamics within political systems beyond the Western sphere. Moreover, they emphasize the necessity for ongoing research into gender representation and participation within Japan's political arena.
Molecular detection of intestinal parasites in a rural community of Colombia: A one health approach to explore potential environmental–zoonotic transmission
Authors: Castañeda Sergio , Acosta Claudia Patricia , Vasquez‐A Luis Reinel , Patiño Luz H. , Mejía Rojelio , Ramírez Juan David
Published: May 2024

Aims

Protozoan and helminth parasitic infections pose significant public health challenges, especially in developing countries with rural populations marked by suboptimal hygiene practices and socio‐economic constraints. The parasites are the etiological agents of these infections and have a notably elevated global prevalence. Therefore, this study focuses on estimating the frequency and transmission dynamics of several parasitic species, including Blastocystis, Giardia, Cryptosporidium spp., Entamoeba histolytica, Ascaris lumbricoides, Trichuris trichiura, Taenia spp. and hookworms, within a rural community in southwest Colombia with a particular emphasis on the One Health framework, considering environmental and zoonotic transmission potentials.

Methods and Results

This study involved the analysis of 125 samples, encompassing human participants (n = 99), their domestic pets (dogs) (n = 24) and water sources (n = 2). Parasite detection was carried out utilizing a combination of microscopy and molecular techniques. Furthermore, the characterization of Blastocystis subtypes (STs) was achieved through Oxford Nanopore sequencing of the rRNA‐18S gene. The investigation also entailed the examination of potential associations between intestinal parasitism and various sociodemographic factors. Results revealed a high frequency of parasitic infections when employing molecular methods, with Blastocystis (n = 109/87%), Giardia (n = 20/16%), Ancylostoma duodenale (n = 28/22%), Ancylostoma ceylanicum (n = 7/5.6%), E. histolytica (n = 6/4.8%), Cryptosporidium spp. (n = 12/9.6%) and even Taenia (n = 1/0.8%) detected. Cryptosporidium spp. was also identified in water samples. Coinfections were prevalent, with 57% (n = 70) of samples exhibiting single‐parasite infections and 43% (n = 53) showing various degrees of polyparasitism, emphasizing the complexity of transmission dynamics. Blastocystis subtyping, conducted via Oxford Nanopore sequencing, revealed a diversity of subtypes and coexistence patterns, with ST2 being the most prevalent.

Conclusions

This research underscores the importance of using molecular techniques for frequency estimation, particularly emphasizing the relevance of zoonotic transmission in parasitic infections. It highlights the significance of the One Health approach in comprehending the circulation of parasites among animals, humans and environmental sources, thereby directly impacting public health and epidemiological surveillance.
Heat‐related changes in the velocity and kinetic energy of flowing blood influence the human heart's output during hyperthermia
Authors: Watanabe Kazuhito , Koch Esteves Nuno , Gibson Oliver R. , Akiyama Koichi , Watanabe Sumie , González‐Alonso José
Published: May 2024

Passive whole‐body hyperthermia increases limb blood flow and cardiac output (), but the interplay between peripheral and central thermo‐haemodynamic mechanisms remains unclear. Here we tested the hypothesis that local hyperthermia‐induced alterations in peripheral blood flow and blood kinetic energy modulate flow to the heart and . Body temperatures, regional (leg, arm, head) and systemic haemodynamics, and left ventricular (LV) volumes and functions were assessed in eight healthy males during: (1) 3 h control (normothermic condition); (2) 3 h of single‐leg heating; (3) 3 h of two‐leg heating; and (4) 2.5 h of whole‐body heating. Leg, forearm, and extracranial blood flow increased in close association with local rises in temperature while brain perfusion remained unchanged. Increases in blood velocity with small to no changes in the conduit artery diameter underpinned the augmented limb and extracranial perfusion. In all heating conditions, increased in association with proportional elevations in systemic vascular conductance, related to enhanced blood flow, blood velocity, vascular conductance and kinetic energy in the limbs and head (all R2 ≥ 0.803; P < 0.001), but not in the brain. LV systolic (end‐systolic elastance and twist) and diastolic functional profiles (untwisting rate), pulmonary ventilation and systemic aerobic metabolism were only altered in whole‐body heating. These findings substantiate the idea that local hyperthermia‐induced selective alterations in peripheral blood flow modulate the magnitude of flow to the heart and through changes in blood velocity and kinetic energy. Localised heat‐activated events in the peripheral circulation therefore affect the human heart's output.

image

Key points

Local and whole‐body hyperthermia increases limb and systemic perfusion, but the underlying peripheral and central heat‐sensitive mechanisms are not fully established.

Here we investigated the regional (leg, arm and head) and systemic haemodynamics (cardiac output: ) during passive single‐leg, two‐leg and whole‐body hyperthermia to determine the contribution of peripheral and central thermosensitive factors in the control of human circulation.

Single‐leg, two‐leg, and whole‐body hyperthermia induced graded increases in leg blood flow and . Brain blood flow, however, remained unchanged in all conditions. Ventilation, extracranial blood flow and cardiac systolic and diastolic functions only increased during whole‐body hyperthermia.

The augmented with hyperthermia was tightly related to increased limb and head blood velocity, flow and kinetic energy.

The findings indicate that local thermosensitive mechanisms modulate regional blood velocity, flow and kinetic energy, thereby controlling the magnitude of flow to the heart and thus the coupling of peripheral and central circulation during hyperthermia.
A reconfigurable integrated smart device for real-time monitoring and synergistic treatment of rheumatoid arthritis
Authors: Liu Yu , Xie Weichang , Tang Zhibo , Tan Zhenfa , He Yizhe , Luo Jun , Wang Xiaolei
Published: May 2024

Rheumatoid arthritis (RA) is a global autoimmune disease that requires long-term management. Ambulatory monitoring and treatment of RA favors remission and rehabilitation. Here, we developed a wearable reconfigurable integrated smart device (ISD) for real-time inflammatory monitoring and synergistic therapy of RA. The device establishes an electrical-coupling and substance delivery interfaces with the skin through template-free conductive polymer microneedles that exhibit high capacitance, low impedance, and appropriate mechanical properties. The reconfigurable electronics drive the microneedle-skin interfaces to monitor tissue impedance and on-demand drug delivery. Studies in vitro demonstrated the anti-inflammatory effect of electrical stimulation on macrophages and revealed the molecular mechanism. In a rodent model, impedance sensing was validated to hint inflammation condition and facilitate diagnosis through machine learning model. The outcome of subsequent synergistic therapy showed notable relief of symptoms, elimination of synovial inflammation, and avoidance of bone destruction.
D-peptide-magnetic nanoparticles fragment tau fibrils and rescue behavioral deficits in a mouse model of Alzheimer’s disease
Authors: Hou Ke , Pan Hope , Shahpasand-Kroner Hedieh , Hu Carolyn , Abskharon Romany , Seidler Paul , Mekkittikul Marisa , Balbirnie Melinda , Lantz Carter , Sawaya Michael R. , Dolinsky Joshua L. , Jones Mychica , Zuo Xiaohong , Loo Joseph A. , Frautschy Sally , Cole Greg , Eisenberg David S.
Published: May 2024

Amyloid fibrils of tau are increasingly accepted as a cause of neuronal death and brain atrophy in Alzheimer’s disease (AD). Diminishing tau aggregation is a promising strategy in the search for efficacious AD therapeutics. Previously, our laboratory designed a six-residue, nonnatural amino acid inhibitor D-TLKIVW peptide (6-DP), which can prevent tau aggregation in vitro. However, it cannot block cell-to-cell transmission of tau aggregation. Here, we find D-TLKIVWC (7-DP), a
d
-cysteine extension of 6-DP, not only prevents tau aggregation but also fragments tau fibrils extracted from AD brains to neutralize their seeding ability and protect neuronal cells from tau-induced toxicity. To facilitate the transport of 7-DP across the blood-brain barrier, we conjugated it to magnetic nanoparticles (MNPs). The MNPs-DP complex retains the inhibition and fragmentation properties of 7-DP alone. Ten weeks of MNPs-DP treatment appear to reverse neurological deficits in the PS19 mouse model of AD. This work offers a direction for development of therapies to target tau fibrils.
Stepwise structural evolution toward robust carboranealkynyl-protected copper nanocluster catalysts for nitrate electroreduction
Authors: Wang Jie , Cai Jinmeng , Ren Kai-Xin , Liu Lin , Zheng Su-Jun , Wang Zhao-Yang , Zang Shuang-Quan
Published: May 2024

Atomically precise metal nanoclusters (NCs) are emerging as idealized model catalysts for imprecise metal nanoparticles to unveil their structure-activity relationship. However, the directional synthesis of robust metal NCs with accessible catalytic active sites remains a great challenge. In this work, we achieved bulky carboranealkynyl-protected copper NCs, the monomer
Cu

13

·3PF
6
and
nido
-carboranealkynyl bridged dimer
Cu

26

·4PF
6
, with fair stability as well as accessible open metal sites step by step through external ligand shell modification and metal-core evolution. Both
Cu

13

·3PF
6
and
Cu

26

·4PF
6
demonstrate remarkable catalytic activity and selectivity in electrocatalytic nitrate (NO
3
−) reduction to NH
3
reaction, with the dimer
Cu

26

·4PF
6
displaying superior performance. The mechanism of this catalytic reaction was elucidated through theoretical computations in conjunction with in situ FTIR spectra. This study not only provides strategies for accessing desired copper NC catalysts but also establishes a platform to uncover the structure-activity relationship of copper NCs.
Partnerships and collaboration drive innovative graduate training in materials informatics
Authors: Slates Angela M. , L. McAlexander Shana , Nolan Jennifer , de Pablo Juan , Chen Junhong , Johnson Harley T. , Brinson L. Catherine
Published: May 2024

Holistic and intentional training prepares next-generation materials informatics leaders and workforce for expedited materials discovery and design.
Calcium modulation of bacterial wilt disease on potato
Authors: Ferreira María Virginia , Naranjo Eber , Denis Nicol , Cobine Paul , De La Fuente Leonardo , Siri María Inés
Published: May 2024

Ralstonia solanacearum
species complex (RSSC) is a phytopathogenic bacterial group that causes bacterial wilt in several crops, being potato (
Solanum tuberosum
) one of the most important hosts. The relationship between the potato plant ionome (mineral and trace elements composition) and the resistance levels to this pathogen has not been addressed until now. Mineral content of xylem sap, roots, stems and leaves of potato genotypes with different levels of resistance to bacterial wilt was assessed in this work, revealing a positive correlation between divalent calcium (Ca) cation concentrations and genotype resistance. The aim of this study was to investigate the effect of Ca on bacterial wilt resistance, and on the growth and virulence of RSSC. Ca supplementation significantly decreased the growth rate of
Ralstonia pseudosolanacearum
GMI1000 in minimal medium and affected several virulence traits such as biofilm formation and twitching motility. We also incorporate for the first time the use of microfluidic chambers to follow the pathogen growth and biofilm formation in conditions mimicking the plant vascular system. By using this approach, a reduction in biofilm formation was observed when both, rich and minimal media, were supplemented with Ca. Assessment of the effect of Ca amendments on bacterial wilt progress in potato genotypes revealed a significant delay in disease progress, or a complete absence of wilting symptoms in the case of partially resistant genotypes. This work contributes to the understanding of Ca effect on virulence of this important pathogen and provides new strategies for an integrated control of bacterial wilt on potato.

IMPORTANCE

Ralstonia solanacearum
species complex (RSSC) includes a diverse group of bacterial strains that cause bacterial wilt. This disease is difficult to control due to pathogen aggressiveness, persistence, wide range of hosts, and wide geographic distribution in tropical, subtropical, and temperate regions. RSSC causes considerable losses depending on the pathogen strain, host, soil type, environmental conditions, and cultural practices. In potato, losses of $19 billion per year have been estimated for this pathogen worldwide. In this study, we report for the first time the mineral composition found in xylem sap and plant tissues of potato germplasm with different levels of resistance to bacterial wilt. This study underscores the crucial role of calcium (Ca) concentration in the xylem sap and stem in relation to the resistance of different genotypes. Our in vitro experiments provide evidence of Ca’s inhibitory effect on the growth, biofilm formation, and twitching movement of the model RSSC strain
R
.
pseudosolanacearum
GMI1000. This study introduces a novel element, the Ca concentration, which should be included into the integrated disease control management strategies for bacterial wilt in potatoes.
An updated list of eumycetoma causative agents and their differences in grain formation and treatment response
Authors: van de Sande Wendy W. J. , Fahal Ahmed H.
Published: May 2024

In 2023, the World Health Organization designated eumycetoma causative agents as high-priority pathogens on its list of fungal priority pathogens. Despite this recognition, a comprehensive understanding of these causative agents is lacking, and potential variations in clinical manifestations or therapeutic responses remain unclear. In this review, 12,379 eumycetoma cases were reviewed. In total, 69 different fungal species were identified as causative agents. However, some were only identified once, and there was no supporting evidence that they were indeed present in the grain.
Madurella mycetomatis
was by far the most commonly reported fungal causative agent. In most studies, identification of the fungus at the species level was based on culture or histology, which was prone to misidentifications. The newly used molecular identification tools identified new causative agents. Clinically, no differences were reported in the appearance of the lesion, but variations in mycetoma grain formation and antifungal susceptibility were observed. Although attempts were made to explore the differences in clinical outcomes based on antifungal susceptibility, the lack of large clinical trials and the inclusion of surgery as standard treatment posed challenges in drawing definitive conclusions. Limited case series suggested that eumycetoma cases caused by
Fusarium
species were less responsive to treatment than those caused by
Madurella mycetomatis
. However, further research is imperative for a comprehensive understanding.
Mycobacterium immunogenum
acquisition from hospital tap water: a genomic and epidemiologic analysis
Authors: Baker Arthur W. , Nick Sophie E. , Jia Fan , Graves Amanda M. , Warren Bobby G. , Zavala Sofia , Stout Jason E. , Lee Mark J. , Alexander Barbara D. , Davidson Rebecca M. , Anderson Deverick J.
Published: May 2024

We identified 23 cases of
Mycobacterium immunogenum
respiratory acquisition linked to a colonized plumbing system at a new hospital addition. We conducted a genomic and epidemiologic investigation to assess for clonal acquisition of
M. immunogenum
from hospital water sources and improve understanding of genetic distances between
M. immunogenum
isolates. We performed whole-genome sequencing on 28
M
.
immunogenum
isolates obtained from August 2013 to July 2021 from patients and water sources on four intensive care and intermediate units at an academic hospital. Study hospital isolates were recovered from 23 patients who experienced
de novo
respiratory isolation of
M. immunogenum
and from biofilms obtained from five tap water outlets. We also analyzed 10
M
.
immunogenum
genomes from previously sequenced clinical (
n
= 7) and environmental (
n
= 3) external control isolates. The 38-isolate cohort clustered into three clades with pairwise single-nucleotide polymorphism (SNP) distances ranging from 0 to 106,697 SNPs. We identified two clusters of study hospital isolates in Clade 1 and one cluster in Clade 2 for which clinical and environmental isolates differed by fewer than 10 SNPs and had less than 0.5% accessory genome variation. A less restrictive combined threshold of 40 SNPs and 5% accessory genes reliably captured additional isolates that met clinical criteria for hospital acquisition, but 12 (4%) of 310 epidemiologically unrelated isolate pairs also met this threshold. Core and accessory genome analyses confirmed respiratory acquisition of multiple clones of
M. immunogenum
from hospital water sources to patients. When combined with epidemiologic investigation, genomic thresholds accurately distinguished hospital acquisition.
Validation of a qualitative real-time PCR assay for the detection of
Candida auris
in hospital inpatient screening
Authors: Franco Lauren C. , Ahmed Mahmoud , Kendra Christopher G. , Sperling R. Matthew , Van Benten Kayla , Lavik John-Paul , Emery Christopher L. , Relich Ryan F. , Gavina Kenneth
Published: May 2024

Candida auris
is a multidrug-resistant opportunistic fungal pathogen capable of causing serious infections and healthcare-associated outbreaks. Screening for colonization with
C. auris
has become routine and is recommended in many hospitals and healthcare facilities as an infection control and prevention strategy. Subsequently, and since there are currently no FDA-approved tests for this purpose, clinical microbiology laboratories have become responsible for developing protocols to detect
C. auris
using axial and inguinal screening swabs. In a College of American Pathologists-accredited large academic healthcare center setting, we implemented a laboratory-developed nucleic-acid amplification test for the detection of
C. auris
DNA. Our test validation evaluated the performance of the DiaSorin
C. auris
primer set used in a real-time qualitative PCR assay on the LIAISON MDX thermocycler with the Simplexa Universal Disc. The assay was highly sensitive and specific, with a limit of detection of 1–2 CFU/reaction, with no observed cross-reactivity with other
Candida
spp., bacterial skin commensal organisms or commonly encountered viruses. When run in parallel with a culture-based detection method, the PCR assay was 100% sensitive and specific. The assay was precise, with low variability between replicates within and between runs. Lastly, pre-analytical factors, including swab storage time, temperature, and transport media, were assessed and found to have no significant effect on the detection of
C. auris
at variable concentrations. Taken together, this study expands the available options for nucleic acid detection of
C. auris
and characterizes pre-analytical factors for implementation in both high- and low-volume laboratory settings.

IMPORTANCE

This study overviews the validation and implementation of a molecular screening tool for the detection of
Candida auris
in a College of American Pathologist-accredited clinical laboratory. This molecular laboratory-developed test is both highly sensitive and specific and has significant health-system cost-savings associated with significantly reduced turn-around-time compared to traditional standard-of-care culture-based work up. This method and workflow is of interest to support clinical microbiology diagnostics and to help aid in hospital inpatient, and infection prevention control screening.
Draft genome sequences from 127
Legionella
spp. strains isolated in water systems linked to legionellosis outbreaks
Authors: Colautti Andrea , Civilini Marcello , Franchi Marinella , Felice Antonella , De Martin Stefano , De Paoli Emanuele , Vidotto Michele , Iacumin Lucilla
Published: May 2024

Legionnaires' disease is a severe form of pneumonia caused by
Legionella
spp. bacteria. According to the European Centre for Disease Prevention and Control, problems related to this pathogen showed a significant surge in recent years, making its monitoring critical.
Perilipin1 inhibits
Nosema bombycis
proliferation by promoting
Domeless-
and
Hop-
mediated JAK-STAT pathway activation in
Bombyx mori
Authors: Su Yaping , Qu Qingsheng , Li Junling , Han Zhenghao , Fang Yujia , Flavorta Billong Laura , Jia Zhenwei , Yu Qiong , Zhang Yiling , Qian Ping , Tang Xudong
Published: May 2024

Lipid droplets (LDs) are dynamic organelles that participate in the regulation of lipid metabolism and cellular homeostasis inside of cells. LD-associated proteins, also known as perilipins (PLINs), are a family of proteins found on the surface of LDs that regulate lipid metabolism, immunity, and other functions. In silkworms, pébrine disease caused by infection by the microsporidian
Nosema bombycis
(
Nb
) is a severe threat to the sericultural industry. Although we found that
Nb
relies on lipids from silkworms to facilitate its proliferation, the relationship between PLINs and
Nb
proliferation remains unknown. Here, we found
Nb
infection caused the accumulation of LDs in the fat bodies of silkworm larvae. The characterized perilipin1 gene (
plin1
) promotes the accumulation of intracellular LDs and is involved in
Nb
proliferation.
plin1
is similar to
perilipin1
in humans and is conserved in all insects. The expression of
plin1
was mostly enriched in the fat body rather than in other tissues. Knockdown of
plin1
enhanced
Nb
proliferation, whereas overexpression of
plin1
inhibited its proliferation. Furthermore, we confirmed that
plin1
increased the expression of the
Domeless
and
Hop
in the JAK-STAT immune pathway and inhibited
Nb
proliferation. Taken together, our current findings demonstrate that
plin1
inhibits
Nb
proliferation by promoting the JAK-STAT pathway through increased expression of
Domeless
and
Hop
. This study provides new insights into the complicated connections among microsporidia pathogens, LD surface proteins, and insect immunity.

IMPORTANCE

Lipid droplets (LDs) are lipid storage sites in cells and are present in almost all animals. Many studies have found that LDs may play a role in host resistance to pathogens and are closely related to innate immunity. The present study found that a surface protein of insect lipid droplets could not only regulate the morphological changes of lipid droplets but also inhibit the proliferation of a microsporidian pathogen
Nosema bombycis
(
Nb
) by activating the JAK-STAT signaling pathway. This is the first discovery of the relationship between microsporidian pathogen and insect lipid surface protein perilipin and insect immunity.
Shapeshifters: Global South scholars and their tensions in border-crossing to Global North journals
Authors: Naidu Thirusha , Cartmill Carrie , Swanepoel Sunitha , Whitehead Cynthia Ruth
Published: May 2024

Introduction

Global South researchers struggle to publish in Global North journals, including journals dedicated to research on health professions education (HPE). As a consequence, Western perspectives and values dominate the international academic landscape of HPE. This study sought to understand Global South researchers’ motivations and experiences of publishing in Global North journals.

Methods

This study used a hermeneutic phenomenological perspective. Unstructured interviews were conducted with 11 authors from 6 Global South countries. Interview transcripts were analysed through a process of familiarisation, identifying significant statements, formulating meanings, clustering themes, developing exhaustive descriptions, producing a fundamental structure and seeking verification.

Results

Participants described being motivated by local institutional expectations, to improve reputation, to meet Global North perceptions of quality and to draw attention to their Global South context. Participants described experiences where their work was deemed irrelevant to Global North audiences, they were unable to interpret rejections and had learnt to play the publishing game by attending to both local and global imperatives. These motivations and experiences revealed several practical, academic and transformational tensions that Global South authors faced.

Conclusion

The tensions and negotiations encountered by Global South authors who publish in HPE journals reflect a ‘border consciousness’ whereby authors must shift consciousness, or become ‘shapeshifters’, inhabiting two or more worlds as they cross borders between the Global South and Global North conventions. There is an added burden and risk in performing this shapeshifting, as Global South authors stand astride the borders of two worlds without belonging fully to either.
Cost-effectiveness of pessary therapy versus surgery for symptomatic pelvic organ prolapse: an economic evaluation alongside a randomised non-inferiority controlled trial
Authors: Ben Ângela J , van der Vaart Lisa R , E. Bosmans Judith , Roovers Jan-Paul W R , Lagro-Janssen Antoinette L M , van der Vaart Carl H , Vollebregt Astrid
Published: May 2024

Objective

To evaluate the cost-effectiveness of pessary therapy as an initial treatment option compared with surgery for moderate to severe pelvic organ prolapse (POP) symptoms in secondary care from a healthcare and a societal perspective.

Design

Economic evaluation alongside a multicentre randomised controlled non-inferiority trial with a 24-month follow-up.

Setting

21 hospitals in the Netherlands, recruitment conducted between 2015 and 2022.

Participants

1605 women referred to secondary care with symptomatic prolapse stage ≥2 were requested to participate. Of them, 440 women gave informed consent and were randomised to pessary therapy (n=218) or to surgery (n=222) in a 1:1 ratio stratified by hospital.

Interventions

Pessary therapy and surgery.

Primary and secondary outcome measures

The Patient Global Impression of Improvement (PGI-I), a 7-point scale dichotomised into successful versus unsuccessful, with a non-inferiority margin of −10%; quality-adjusted life-years (QALYs) measured by the EQ-5D-3L; healthcare and societal costs were based on medical records and the institute for Medical Technology Assessment questionnaires.

Results

For the PGI-I, the mean difference between pessary therapy and surgery was −0.05 (95% CI −0.14; 0.03) and −0.03 (95% CI −0.07; 0.002) for QALYs. In total, 54.1% women randomised to pessary therapy crossed over to surgery, and 3.6% underwent recurrent surgery. Healthcare and societal costs were significantly lower in the pessary therapy (mean difference=−€1807, 95% CI −€2172; −€1446 and mean difference=−€1850, 95% CI −€2349; −€1341, respectively). The probability that pessary therapy is cost-effective compared with surgery was 1 at willingness-to-pay thresholds between €0 and €20 000/QALY gained from both perspectives.

Conclusions

Non-inferiority of pessary therapy regarding the PGI-I could not be shown and no statistically significant differences in QALYs between interventions were found. Due to significantly lower costs, pessary therapy is likely to be cost-effective compared with surgery as an initial treatment option for women with symptomatic POP treated in secondary care.

Trial registration number

NTR4883.
Chiropractic spinal manipulation and likelihood of tramadol prescription in adults with radicular low back pain: a retrospective cohort study using US data
Authors: Trager Robert James , Cupler Zachary A , Srinivasan Roshini , Casselberry Regina M , Perez Jaime A , Dusek Jeffery A
Published: May 2024

Objectives

Patients receiving chiropractic spinal manipulation (CSM) for low back pain (LBP) are less likely to receive any opioid prescription for subsequent pain management. However, the likelihood of specifically being prescribed tramadol, a less potent opioid, has not been explored. We hypothesised that adults receiving CSM for newly diagnosed radicular LBP would be less likely to receive a tramadol prescription over 1-year follow-up, compared with those receiving usual medical care.

Design

Retrospective cohort study.

Setting

US medical records-based dataset including >115 million patients attending academic health centres (TriNetX, Inc), queried 9 November 2023.

Participants

Opioid-naive adults aged 18–50 with a new diagnosis of radicular LBP were included. Patients with serious pathology and tramadol use contraindications were excluded. Variables associated with tramadol prescription were controlled via propensity matching.

Interventions

Patients were divided into two cohorts dependent on treatment received on the index date of radicular LBP diagnosis (CSM or usual medical care).

Primary and secondary outcome measures

Risk ratio (RR) for tramadol prescription (primary); markers of usual medical care utilisation (secondary).

Results

After propensity matching, there were 1171 patients per cohort (mean age 35 years). Tramadol prescription was significantly lower in the CSM cohort compared with the usual medical care cohort, with an RR (95% CI) of 0.32 (0.18 to 0.57; p<0.0001). A cumulative incidence graph demonstrated that the reduced incidence of tramadol prescription in the CSM cohort relative to the usual medical care cohort was maintained throughout 1-year follow-up. Utilisation of NSAIDs, physical therapy evaluation and lumbar imaging was similar between cohorts.

Conclusions

This study found that US adults initially receiving CSM for radicular LBP had a reduced likelihood of receiving a tramadol prescription over 1-year follow-up. These findings should be corroborated by a prospective study to minimise residual confounding.
Coordination of oral anticoagulant care at hospital discharge (COACHeD): pilot randomised controlled trial
Authors: Holbrook Anne , Troyan Sue , Telford Victoria , Koubaesh Yousery , Vidug Kristina , Yoo Lindsay , Deng Jiawen , Lohit Simran , Giilck Stephen , Ahmed Amna , Talman Marianne , Leonard Blair , Refaei Mohammad , Tarride Jean-Eric , Schulman Sam , Douketis James , Thabane Lehana , Hyland Sylvia , Ho Joanne Man-Wai , Siegal Deborah
Published: May 2024

Objectives

To evaluate whether a focused, expert medication management intervention is feasible and potentially effective in preventing anticoagulation-related adverse events for patients transitioning from hospital to home.

Design

Randomised, parallel design.

Setting

Medical wards at six hospital sites in southern Ontario, Canada.

Participants

Adults 18 years of age or older being discharged to home on an oral anticoagulant (OAC) to be taken for at least 4 weeks.

Interventions

Clinical pharmacologist-led intervention, including a detailed discharge medication management plan, a circle of care handover and early postdischarge virtual check-up visits to 1 month with 3-month follow-up. The control group received the usual care.

Outcomes measures

Primary outcomes were study feasibility outcomes (recruitment, retention and cost per patient). Secondary outcomes included adverse anticoagulant safety events composite, quality of transitional care, quality of life, anticoagulant knowledge, satisfaction with care, problems with medications and health resource utilisation.

Results

Extensive periods of restriction of recruitment plus difficulties accessing patients at the time of discharge negatively impacted feasibility, especially cost per patient recruited. Of 845 patients screened, 167 were eligible and 56 were randomised. The mean age (±SD) was 71.2±12.5 years, 42.9% females, with two lost to follow-up. Intervention patients were more likely to rate their ability to manage their OAC as improved (17/27 (63.0%) vs 7/22 (31.8%), OR 3.6 (95% CI 1.1 to 12.0)) and their continuity of care as improved (21/27 (77.8%) vs 2/22 (9.1%), OR 35.0 (95% CI 6.3 to 194.2)). Fewer intervention patients were taking one or more inappropriate medications (7 (22.5%) vs 15 (60%), OR 0.19 (95% CI 0.06 to 0.62)).

Conclusion

This pilot randomised controlled trial suggests that a transitional care intervention at hospital discharge for older adults taking OACs was well received and potentially effective for some surrogate outcomes, but overly costly to proceed to a definitive large trial.

Trial registration number

NCT02777047.
Is the QCI framework suited for monitoring outcomes and costs in a teaching hospital using value-based healthcare principles? A retrospective cohort study
Authors: van Veghel Willem , van Dijk Suzanne C , Klem Taco MAL , Weel Angelique E , Bügel Jean-Bart , Birnie Erwin
Published: May 2024

Objectives

The objective is to develop a pragmatic framework, based on value-based healthcare principles, to monitor health outcomes per unit costs on an institutional level. Subsequently, we investigated the association between health outcomes and healthcare utilisation costs.

Design

This is a retrospective cohort study.

Setting

A teaching hospital in Rotterdam, The Netherlands.

Participants

The study was performed in two use cases. The bariatric population contained 856 patients of which 639 were diagnosed with morbid obesity body mass index (BMI) <45 and 217 were diagnosed with morbid obesity BMI ≥45. The breast cancer population contained 663 patients of which 455 received a lumpectomy and 208 a mastectomy.

Primary and secondary outcome measures

The quality cost indicator (QCI) was the primary measures and was defined as

QCI = (resulting outcome * 100)/average total costs (per thousand Euros)

where average total costs entail all healthcare utilisation costs with regard to the treatment of the primary diagnosis and follow-up care. Resulting outcome is the number of patients achieving textbook outcome (passing all health outcome indicators) divided by the total number of patients included in the care path.

Results

The breast cancer and bariatric population had the highest resulting outcome values in 2020 Q4, 0.93 and 0.73, respectively. The average total costs of the bariatric population remained stable (avg, €8833.55, min €8494.32, max €9164.26). The breast cancer population showed higher variance in costs (avg, €12 735.31 min €12 188.83, max €13 695.58). QCI values of both populations showed similar variance (0.3 and 0.8). Failing health outcome indicators was significantly related to higher hospital-based costs of care in both populations (p <0.01).

Conclusions

The QCI framework is effective for monitoring changes in average total costs and relevant health outcomes on an institutional level. Health outcomes are associated with hospital-based costs of care.
Assessing early feasibility of a novel innovation to increase consumer partnership capability within an Australian health innovation organisation using a mixed-method approach
Authors: Newton Liz , Dimopoulos-Bick Tara Louise
Published: May 2024

Objective

Engagement-capable health organisations recognise that consumer engagement (also known as patient engagement, consumer engagement, patient and public involvement) must occur at every level of the organisation if it is to be meaningful and genuine. Despite this aspiration, health organisations struggle to adopt, implement, and embody consumer engagement capability in a way that has yielded impact. The Partner Ring (PR) is an embedded model for building staff capability for consumer partnerships. It is hosted by an employed Patient Partner. PR was implemented at the Agency for Clinical Innovation in New South Wales, Australia. The aim of this study was to assess the feasibility (acceptability, demand and practicality) of this innovation to increase consumer engagement capability.

Design

One-group post-intervention mixed methods approach to assess feasibility.

Participants

ACI staff engaged in the PR (n=40 of 89 members).

Data collection and analysis

Qualitative data was collected through an artificial intelligence (AI)-driven interactive interview, with 40 responses received between 29 June and 12 July 2023. A framework analysis and Generative AI causal mapping were conducted to identify and visualise causal claims within the texts. Cost and session attendance collected from the same point in time supplemented the analysis.

Findings

Findings were categorised by the following feasibility constructs: acceptability, demand and practicality. Almost all the respondents indicated their intent to continue using the PR and outlined personal benefits and professional benefits. For example, (n=23, 57%) reacted positively to the psychological safety of the PR, and professionally people identified attendance increased their knowledge and skills (n=23, 57%).

Conclusion

The PR is feasible and likely to be an acceptable innovation for building staff capability and consumer engagement skills across a large health system or organisation. It could be adopted or adapted by other jurisdictions.