bluuebunny/crossref_metadata_2025 huggingface dataset:
Uncertainty quantification of TMS simulations considering MRI segmentation errors
Authors: Zhang Hao , Gomez Luis J , Guilleminot Johann
Published: February 2022

Objective. Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation method that is used to study brain function and conduct neuropsychiatric therapy. Computational methods that are commonly used for electric field (E-field) dosimetry of TMS are limited in accuracy and precision because of possible geometric errors introduced in the generation of head models by segmenting medical images into tissue types. This paper studies E-field prediction fidelity as a function of segmentation accuracy. Approach.The errors in the segmentation of medical images into tissue types are modeled as geometric uncertainty in the shape of the boundary between tissue types. For each tissue boundary realization, we then use an in-house boundary element method to perform a forward propagation analysis and quantify the impact of tissue boundary uncertainties on the induced cortical E-field. Main results. Our results indicate that predictions of E-field induced in the brain are negligibly sensitive to segmentation errors in scalp, skull and white matter (WM), compartments. In contrast, E-field predictions are highly sensitive to possible cerebrospinal fluid (CSF) segmentation errors. Specifically, the segmentation errors on the CSF and gray matter interface lead to higher E-field uncertainties in the gyral crowns, and the segmentation errors on CSF and WM interface lead to higher uncertainties in the sulci. Furthermore, the uncertainty of the average cortical E-fields over a region exhibits lower uncertainty relative to point-wise estimates. Significance. The accuracy of current cortical E-field simulations is limited by the accuracy of CSF segmentation accuracy. Other quantities of interest like the average of the E-field over a cortical region could provide a dose quantity that is robust to possible segmentation errors.
Non-axisymmetric MHD simulations of the current quench phase of ITER mitigated disruptions
Authors: Artola F.J. , Loarte A. , Hoelzl M. , Lehnen M. , Schwarz N. , the JOREK Team
Published: February 2022

Non-axisymmetric simulations of the current quench phase of ITER disruptions are key to predict asymmetric forces acting into the ITER wall. We present for the first time such simulations for ITER mitigated disruptions at realistic Lundquist numbers. For these strongly mitigated disruptions, we find that the safety factor remains above 2 and the maximal integral horizontal forces remain below 1 MN. The maximal integral vertical force is found to be 13 MN and arises in a time scale given by the resistive wall time as expected from theoretical considerations. In this respect, the vertical force arises after the plasma current has completely decayed, showing the importance of continuing the simulations also in the absence of plasma current. We conclude that the horizontal wall force rotation is not a concern for these strongly mitigated disruptions in ITER, since when the wall forces form, there are no remaining sources of rotation.
Wall effects on a falling solid particle in an infinite channel
Authors: Usman K , Walayat K , Mahmood R , Jabeen S
Published: February 2022

We have examined the effects caused on the motion and sedimentation of a free falling solid particle by the hydrodynamic forces acting on the particle’s surface arising when particle is close to wall. Drag and lift coefficients for a settling particle inside a narrow domain are calculated. An Eulerian mesh is adopted for computing the motion of free moving solid particles through the domain. The combined particle and fluid mixture is treated with a fictitious boundary method approach. To avoid particle-wall collisions, an approach proposed by Singh, Glowinsk and coauthors is used to handle such interactions. The particulate flow is computed using multigrid finite element solver FEATFLOW (Finite element analysis tool for flow problems). Numerical experiments are performed by decreasing domain widths for a single falling particle. The size and density of the particle is varied to inspect the particle paths. The behavior of the particle and its interaction with wall while it is moving inside constricted domains is analyzed. Results for the drag and lift forces on the surface of particle are presented and compared with the reference values.
Effect of B2O3 addition on thermal and optical properties of TeO2–ZnO–Bi2O3–TiO2 glasses
Authors: Marzuki Ahmad , Ega Fausta Devara , Saraswati Azmi
Published: February 2022

New tellurite glasses with composition (in mol%): 60TeO2–(30-x)ZnO–5Bi2O3–5TiO2-xB2O3 (where x = 0, 2.5, 5.0, 7.5 and 10.0) were fabricated using conventional melt quenching method. Compositional dependence of the glasses on their density, thermal, refractive index and optical properties were investigated. X-Ray Diffraction analysis was carried out to confirm the nature of the thus formed glasses. Density, refractive index, and absorption spectra were measured at room temperature from which other glass characteristics such as polaron radius, oxygen packing density, field strength, B3+ interatomic distance, band gap energy, and Urbach tail were determined. Thermal characterisation to determine the change in glass transition temperature, glass crystallisation, melting point, and glass stability was carried out using Differential Scanning Calorimetry. A discussion was made in order to understand the results in terms of the ratio of bridging oxygen to non-bridging oxygen ions (BO/NBO). It was found that the addition of B2O3 results in increasing oxygen packing density, glass transition temperature, BO/NBO ratio and band gap energy, while decreasing density, refractive index, field strength, glass stability and Urbach tail energy. With increasing B2O3 concentration density changed from 5.879 to 5.646 g cm−3, refractive index 1.875 to 1.741, working temperature range (ΔT = 66 °C) and phonon energy within the range of 736–740 cm−1.
Sub-realtime simulation of a neuronal network of natural density
Authors: Kurth Anno C , Senk Johanna , Terhorst Dennis , Finnerty Justin , Diesmann Markus
Published: February 2022

Full scale simulations of neuronal network models of the brain are challenging due to the high density of connections between neurons. This contribution reports run times shorter than the simulated span of biological time for a full scale model of the local cortical microcircuit with explicit representation of synapses on a recent conventional compute node. Realtime performance is relevant for robotics and closed-loop applications while sub-realtime is desirable for the study of learning and development in the brain, processes extending over hours and days of biological time.
Global Prym-Torelli for double coverings ramified in at least six points
Authors: Naranjo Juan , Ortega Angela
Published: February 2022

We prove that the ramified Prym map

P

g
,
r

\mathcal P_{g, r}

which sends a covering

π
:
D
⟶
C

\pi :D\longrightarrow C

ramified in

r
r

points to the Prym variety

P
(
π
)
≔
K
e
r
(
N

m

π

)

P(\pi )≔Ker(Nm_{\pi })

is an embedding for all

r
≥
6

r\ge 6

and for all

g
(
C
)
>
0

g(C)>0

. Moreover, by studying the restriction to the locus of coverings of hyperelliptic curves, we show that

P

g
,
2

\mathcal P_{g, 2}

and

P

g
,
4

\mathcal P_{g, 4}

have positive dimensional fibers.
A characterization of productive cellularity
Authors: Aurichi Leandro , Junqueira Lúcia , Mezabarba Renan
Published: February 2022

We investigate the notion of productive cellularity of arbitrary posets and topological spaces. Particularly, by working with families of antichains ordered with reverse inclusion, we give necessary and sufficient conditions to determine whether a poset or a topological space is productively ccc.
An 𝐿^{𝑝} shock admissibility condition for conservation laws
Authors: Ohwa Hiroki
Published: February 2022

We estimate theLpL^p(p>0p>0) local distance between piecewise constant solutions to the Cauchy problem of conservation laws and propose a shock admissibility condition for having anLpL^plocal contraction of such solutions. Moreover, as an application, we prove that there existLpL^plocally contractive solutions on some set of initial functions, to the Cauchy problem of conservation laws with convex or concave flux functions. As a result, for conservation laws with convex or concave flux functions, we see that rarefaction waves have anLqL^q(q≥1q\geq 1) local contraction and shock waves have anLrL^r(0>r≤10>r\leq 1) local contraction.
“Do You Call Yourself a White Man?”
Authors: Klausen Susanne M
Published: February 2022

This essay is about the policing of white male heterosexuality in order to protect whites’ mythical racial purity in South Africa during the apartheid era (1948–94). Contrary to colonial authorities’ practice of turning a blind eye to settler men’s extramarital sexual exploits with colonized women, the apartheid regime attacked white heterosexual men’s patriarchal sexual liberties. In 1950, the National Party government passed the Immorality Amendment Act criminalizing extramarital sex between whites and people of color. Though technically gender neutral, the law was crafted by leaders of the authoritarian and puritanical Afrikaner nationalist movement to stop white heterosexual men from crossing the color line for illicit sex. Tens of thousands of people were arrested for contravening the law, and while its enforcement inflicted tremendous harm and hardship on women of color, it was white men, often Afrikaner themselves, who made up the single largest category of individuals prosecuted and convicted. This essay examines the origins of the law, state methods of enforcement, and some of the harmful gendered social consequences of its brutal application.
Development of a Crosswalk to Translate Italian Occupation Codes to ISCO-68 Codes
Authors: Spinazzè Andrea , Consonni Dario , Borghi Francesca , Mazzucchelli Libero Andrea , Rovelli Sabrina , Cattaneo Andrea , Zellino Carolina , Dallari Barbara , Pesatori Angela Cecilia , Kromhout Hans , Peters Susan , Riboldi Luciano , Mensi Carolina , Cavallo Domenico Maria
Published: February 2022

In occupational epidemiology, job coding is an important—but time-consuming—step in assigning exposure. We implemented a tool (i.e. a crosswalk) to translate occupation codes from the Italian (ISTAT-CIP-91, n = 6319 five-digit job codes) to the International Standard Classification of Occupations (ISCO-68, n = 1881 five-digit job codes). The former is currently used in Italy for various purposes (e.g. in the National Mesothelioma Registry). The latter has been used in several studies on occupational cancers because it facilitates communication of results to the scientific community and, most importantly, because some job exposure matrices (JEMs) are based on international codes. Three authors created a table containing the crosswalk structure, providing an interpretation for each of the ISTAT-CIP-91 codes job descriptions and then manually recoding them according to ISCO-68. Two other authors independently revised it. The performance of the final version was assessed by comparison with results obtained by manual ISCO-68 coding performed in two previous case-control studies on asbestos and mesothelioma. More specifically, the automatically obtained ISCO-68 codes were merged with a JEM (DOM-JEM). The resulting individual asbestos exposure estimates (ever versus never exposed) were compared to those originally obtained (using the same DOM-JEM) from manual translation of ISTAT-CIP-91 to ISCO-68 (considered as the ‘gold standard’). In the first study, among 159 peritoneal mesothelioma cases (400 job codes), Cohen’s kappa was 0.91, sensitivity 0.95, and specificity 0.96. In the second study, among 716 pleural mesothelioma cases and controls (4400 job codes) kappa was 0.86, sensitivity 0.94, and specificity 0.91. Performance was better among in women. For men, performance was lower among cases than among controls (kappa 0.70, sensitivity 0.95, specificity 0.72 versus kappa 0.87, sensitivity 0.97, and specificity 0.92). In conclusion, the proposed tool allowed a rapid translation of thousands of job codes with good to excellent accuracy. The table containing ISTAT-CIP-91 codes and job descriptions and the corresponding ISCO-68 codes and job descriptions is made publicly available and can be freely used for epidemiological analyses in Italy and international collaborations.
Rhizome trait scaling relationships are modulated by growth conditions and are linked to plant fitness
Authors: Thakur Dinesh , Münzbergová Zuzana
Published: February 2022

Background and Aims

Rhizomes are important organs allowing many clonal plants to persist and reproduce under stressful climates with longer rhizomes, indicating enhanced ability of the plants to spread vegetatively. We do not, however, know either how rhizome construction costs change with increasing length or how they vary with environmental conditions.

Methods

We analysed the rhizome length vs. mass scaling relationship, the plasticity in the scaling relationships, their genetic basis and how scaling relationships are linked to plant fitness. We used data from 275 genotypes of a clonal grass Festuca rubra originating from 11 localities and cultivated under four contrasting climates. Data were analysed using standard major axis regression, mixed-effect regression models and a structural equation model.

Key Results

Rhizome construction costs increased (i.e. lower specific rhizome length) with increasing length. The trait scaling relationships were modulated by cultivation climate, and its effects also interacted with the climate of origin of the experimental plants. With increasing length, increasing moisture led to a greater increase in rhizome construction costs. Plants with lower rhizome construction costs showed significantly higher fitness.

Conclusions

This study suggests that rhizome scaling relationships are plastic, but also show genetic differentiation and are linked to plant fitness. Therefore, to persist under variable environments, modulation in scaling relationships could be an important plant strategy.
YeastMate: neural network-assisted segmentation of mating and budding events inSaccharomyces cerevisiae
Authors: Bunk David , Moriasy Julian , Thoma Felix , Jakubke Christopher , Osman Christof , Hörl David
Published: February 2022

Here, we introduce YeastMate, a user-friendly deep learning-based application for automated detection and segmentation of Saccharomyces cerevisiae cells and their mating and budding events in microscopy images. We build upon Mask R-CNN with a custom segmentation head for the subclassification of mother and daughter cells during lifecycle transitions. YeastMate can be used directly as a Python library or through a standalone application with a graphical user interface (GUI) and a Fiji plugin as easy-to-use frontends.

Availability and implementation

The source code for YeastMate is freely available at https://github.com/hoerlteam/YeastMate under the MIT license. We offer installers for our software stack for Windows, macOS and Linux. A detailed user guide is available at https://yeastmate.readthedocs.io.

Supplementary information

Supplementary data are available at Bioinformatics online.
A chromosome-scale genome and transcriptomic analysis of the endangered tropical treeVatica mangachapoi(Dipterocarpaceae)
Authors: Tang Liang , Liao Xuezhu , Tembrock Luke R , Ge Song , Wu Zhiqiang
Published: February 2022

Vatica mangachapoi is a tropical tree species native to Southeast Asia. It has long been valued as a timber species because the wood resists decay, but it is now considered vulnerable to extinction due to habitat loss and overexploitation. Here, we present the first chromosome-level genome assembly of V. mangachapoi that we created by combining data from PacBio long read sequencing with Hi-C proximity ligation and Illumina short-read sequencing. The assembled genome was 456.21 Mb, containing 11 chromosome and a BUSCO score of 93.4%. From the newly assembled genome, 46,811 protein-coding genes were predicted. Repetitive DNA accounted for 53% of the genome. Phylogenomic and gene family analyses showed that V. mangachapoi diverged from a common ancestor of Gossypium raimondii 70 million years ago. Transcriptome analyses found 227 genes that were differentially expressed in the leaves of plants grown in normal soil relative to plants grown in dry, coastal, sandy soil. For these genes, we identified three significantly enriched with GO terms: responses to organonitrogen compounds, chitin-triggered immunity, and wound response. This genome provides an important comparative benchmark not only for future conservation work on V. mangachapoi but also for phylogenomics work on Dipterocarpaceae.
Role of epigenetic transgenerational inheritance in generational toxicology
Authors: Nilsson Eric E , Ben Maamar Millissia , Skinner Michael K
Published: February 2022

Many environmental toxicants have been shown to be associated with the transgenerational inheritance of increased disease susceptibility. This review describes the generational toxicity of some of these chemicals and their role in the induction of epigenetic transgenerational inheritance of disease. Epigenetic factors include DNA methylation, histone modifications, retention of histones in sperm, changes to chromatin structure, and expression of non-coding RNAs. For toxicant-induced epigenetic transgenerational inheritance to occur, exposure to a toxicant must result in epigenetic changes to germ cells (sperm or eggs) since it is the germ cells that carry molecular information to subsequent generations. In addition, the epigenetic changes induced in transgenerational generation animals must cause alterations in gene expression in these animals’ somatic cells. In some cases of generational toxicology, negligible changes are seen in the directly exposed generations, but increased disease rates are seen in transgenerational descendants. Governmental policies regulating toxicant exposure should take generational effects into account. A new approach that takes into consideration generational toxicity will be needed to protect our future populations.
Necessity of life-long follow-up after surgery for coarctation of the aorta: a case series of very late false aneurysm formation
Authors: Somers Tim , Nies Hedwig M J M , van Kimmenade Roland R J , Bosboom Dennis G H , Geuzebroek Guillaume S C , Morshuis Wim J
Published: February 2022

Background

Coarctation of the aorta accounts for 5–7% of congenital defects of the heart and great vessels. It requires treatment in the form of open surgical or percutaneous repair. Common long-term complications include re-stenosis and aneurysm formation. The formation of a false aneurysm is a complication with a significant morbidity and mortality.

Case summary

We reviewed six cases of late false aneurysm after repair of a coarctation of the aorta. Our six cases developed a false aneurysm after an open surgical repair of a coarctation more than 30 years after initial surgical repair. All aneurysms were located at the aortic repair site.

Discussion

The symptoms or risk factors in the described cases are not uniform and are difficult to include in a general follow-up protocol. Guidelines recommend frequent evaluation, but do not specify duration or intervals of imaging follow-up. Our cases support the necessity of life-long follow-up in patients with open aortic repairs irrespective of symptomatology.
Isolated cardiac sarcoidosis associated with coronary vasomotion abnormalities: a case report
Authors: Godo Shigeo , Hasebe Yuhi , Takahashi Jun , Shimokawa Hiroaki , Yasuda Satoshi
Published: February 2022

Background 

Cardiac sarcoidosis is a chronic, inflammatory disease that can affect the heart and often results in heart failure and lethal arrhythmias. A multimodality imaging approach without endomyocardial biopsy allows for the diagnosis of isolated cardiac sarcoidosis. Coronary vasomotion abnormalities are highly prevalent in various cardiovascular and inflammatory diseases. It remains unknown whether active myocardial inflammation due to cardiac sarcoidosis is associated with coronary vasomotion abnormalities.

Case summary 

A 68-year-old man without a past medical history experienced an out-of-hospital cardiac arrest due to ventricular fibrillation and was successfully resuscitated without neurologic sequelae. Coronary angiography showed normal coronary arteries; however, intracoronary acetylcholine provocation testing demonstrated both epicardial coronary and coronary microvascular spasm. He was diagnosed with isolated cardiac sarcoidosis by fulfilling the diagnostic criteria proposed by the Japanese Circulation Society 2016 diagnostic guidelines, including fatal ventricular arrhythmia, focal left ventricular wall asynergy, increased myocardial fluorodeoxyglucose uptake by positron emission tomography, and late gadolinium enhancement by cardiac magnetic resonance in the heart. He was treated with calcium-channel blocker for coronary artery spasm and prednisolone for cardiac sarcoidosis and underwent implantation of an implantable cardioverter-defibrillator for secondary prevention. Following the treatment, the severity of coronary artery spasm was reduced along with regression of the myocardial inflammation.

Discussion 

Epicardial coronary artery and coronary microvascular spasm can be accompanied by active myocardial inflammation of isolated cardiac sarcoidosis, and the treatment with corticosteroid and calcium-channel blocker may be effective for relieving the severity of coronary artery spasm in association with regression of myocardial inflammation of the disease.
Targeting the CCL2–CCR2 axis for atheroprotection
Authors: Georgakis Marios K , Bernhagen Jürgen , Heitman Laura H , Weber Christian , Dichgans Martin
Published: February 2022

Decades of research have established atherosclerosis as an inflammatory disease. Only recently though, clinical trials provided proof-of-concept evidence for the efficacy of anti-inflammatory strategies with respect to cardiovascular events, thus offering a new paradigm for lowering residual vascular risk. Efforts to target the inflammasome–interleukin-1β–interleukin-6 pathway have been highly successful, but inter-individual variations in drug response, a lack of reduction in all-cause mortality, and a higher rate of infections also highlight the need for a second generation of anti-inflammatory agents targeting atherosclerosis-specific immune mechanisms while minimizing systemic side effects. CC-motif chemokine ligand 2/monocyte-chemoattractant protein-1 (CCL2/MCP-1) orchestrates inflammatory monocyte trafficking between the bone marrow, circulation, and atherosclerotic plaques by binding to its cognate receptor CCR2. Adding to a strong body of data from experimental atherosclerosis models, a coherent series of recent large-scale genetic and observational epidemiological studies along with data from human atherosclerotic plaques highlight the relevance and therapeutic potential of the CCL2–CCR2 axis in human atherosclerosis. Here, we summarize experimental and human data pinpointing the CCL2–CCR2 pathway as an emerging drug target in cardiovascular disease. Furthermore, we contextualize previous efforts to interfere with this pathway, scrutinize approaches of ligand targeting vs. receptor targeting, and discuss possible pathway-intrinsic opportunities and challenges related to pharmacological targeting of the CCL2–CCR2 axis in human atherosclerotic disease.
Ormyrus labotus (Hymenoptera: Ormyridae): Another Generalist That Should not be a Generalist is not a Generalist
Authors: Sheikh Sofia I , Ward Anna K G , Zhang Y Miles , Davis Charles K , Zhang Linyi , Egan Scott P , Forbes Andrew A
Published: February 2022

Several recent reappraisals of supposed generalist parasite species have revealed hidden complexes of species, each with considerably narrower host ranges. Parasitic wasps that attack gall-forming insects on plants have life history strategies that are thought to promote specialization, and though many species are indeed highly specialized, others have been described as generalist parasites. Ormyrus labotus Walker (Hymenoptera: Ormyridae) is one such apparent generalist, with rearing records spanning more than 65 host galls associated with a diverse set of oak tree species and plant tissues. We pair a molecular approach with morphology, host ecology, and phenological data from across a wide geographic sample to test the hypothesis that this supposed generalist is actually a complex of several more specialized species. We find 16–18 putative species within the morphological species O. labotus, each reared from only 1–6 host gall types, though we identify no single unifying axis of specialization. We also find cryptic habitat specialists within two other named Ormyrus species. Our study suggests that caution should be applied when considering host ranges of parasitic insects described solely by morphological traits, particularly given their importance as biocontrol organisms and their role in biodiversity and evolutionary studies.
P04 An evaluation of antimicrobial stewardship education in the School of Pharmacy of an Irish university—a mixed methods study
Authors: Barbosa T. M. , Fleming A. , Crowley E. , O’Connor A. , Costello L. , McCarthy S.
Published: February 2022

Background

Antimicrobial stewardship (AMS) is essential to control the emergence of antimicrobial resistance (AMR) which has become an international health priority. Education of undergraduate students on AMS and AMR is a strategic objective in the WHO Global Action Plan on AMR and Ireland's National Action Plan.1,2 Research on AMS/AMR education has focused primarily on medical students with less emphasis on those from other healthcare profession including pharmacy students.

Objectives

To investigate AMS and AMR education in the Pharmacy undergraduate programme in the School of Pharmacy of an Irish University.

Methods

A mixed methods study was conducted. Ten semi-structured interviews were conducted in October 2019 with academic staff to capture their views on AMS education. Participants included staff members from different disciplines, those identified as involved in teaching elements of infectious disease, antibiotics, AMS and related topics, and those involved in curriculum design and approval within the School of Pharmacy. Interview transcripts were analysed by thematic analysis. An electronic survey of 17 questions was emailed to all second to fifth year UCC Pharmacy students in October 2019 to gather students’ views and experiences of AMS education. The survey contained four sections which addressed demographics, AMS, resources and education using open-ended, closed-ended or Likert-scale questions. Ethical approval was obtained.

Results

Six key themes were identified from the ten interviews: (i) curriculum priorities and capacity; (ii) housing of the subject, fragmentation and cohesion; (iii) integration; (iv) communication; (v) teaching methods; and (vi) assessment methods. 113 students participated in the survey (32.3% response rate). 96% agree that a strong knowledge of antimicrobials for their future careers is important, and over 89% of students desire more education on AMR and AMS. Only 43% of students found their AMS education provided sufficient preparation for practice. Students felt most prepared to recognize clinical signs of infection and least prepared for IV to oral switching, interpreting biological marker and de-escalation of antimicrobials. Over 50% of students never used or were not familiar with the national primary care antimicrobial guidelines: www.antibioticprescribing.ie.

Conclusions

Pharmacy students and staff agree that AMS and AMR are important and need enhanced educational focus. Students feel there are gaps in their AMS education and expressed a desire for more education in this area. Improved communication and identification of curriculum priorities by staff could help to establish a more cohesive and comprehensive educational approach to this area.
P08 The quality of life and cost benefits of domiciliary 24-hour piperacillin/tazobactam 13.5 g infusion in patients with necrotizing otitis externa
Authors: Sacranie Y. , Fleming N. , Smith W.
Published: February 2022

Background

The incidence of necrotizing otitis externa (NOE) is increasing with the rise in the population who are elderly or immunocompromised. Currently there is no consensus on an antibiotic regimen for NOE but in a recent survey of otolaryngologists, 90% recommended using IV antibiotics.1,2 An initial 6 week period of IV antibiotics such as piperacillin/tazobactam has been recommended, this necessitated a prolonged hospital stay in patients who could be managed at home. To enable domiciliary treatment, a patient pathway was set-up, a ‘mid-line’ inserted and once clinically well (after 0–10 days in hospital) home antibiotic treatment was commenced.

Objectives

To evaluate the patient satisfaction, safety and cost benefit of using 6 weeks of domiciliary piperacillin/tazobactam 13.5 g administered with infusion pump in patients with NOE.

Methods

Since September 2017 to present, 11 patients (9 males, 2 females aged 52–91 years) received domiciliary IV antibiotics for NOE, patients completed a patient satisfaction questionnaire [Glasgow Benefit Inventory (GBI), a validated questionnaire that is used to assess the impact of any clinical intervention]. The cost of this service was compared with the traditional 6 week stay in hospital for IV antibiotic therapy. Patients were only asked to complete the GBI to evaluate a recognized treatment.

Results

The GBI scale ranges from −100 (maximal negative benefit) to 0 (no benefit), to +100 (maximal benefit). Table 1 demonstrates that domiciliary IV antibiotics have a positive impact on total and general health but the low scores for social and physical health reflect worsening of quality of life in patients with NOE. All patients expressed they preferred being at home rather than being in hospital. 6 weeks inpatient care (at £250 per night) equates to £10 500 per patient. Piperacillin/tazobactam 4.5 g injection, costing £7.85 per ampoule, given thrice daily for 6 weeks costs £989. Domiciliary treatment using piperacillin/tazobactam 13.5 g infusion device is £98.16 daily, 6 weeks antibiotic costs £4122 per patient. A domiciliary nurse visit is £120 equates to nursing costs of £5040 for antibiotic given by infusion. Domiciliary potentially saves £2327 per patient.

Conclusions

Although studies have assessed community IV antibiotic service;3 this study albeit with limited patient numbers is the first evaluating patient satisfaction and cost benefit of domiciliary antibiotics in patients with NOE. All patients preferred to be treated at home with no safety issues raised. There is a potential saving of £2347 per patient with domiciliary rather than in-patient treatment as well as ‘freeing-up’ beds for other patients requiring admission.
P12 Important early prognostic laboratory indicators for COVID-19 mortality
Authors: Ramosaço Ergys , Kolovani Entela , Gjermeni Nevila , Çomo Najada
Published: February 2022

Background

COVID-19 has been marked as a highly pathogenic coronavirus of COVID-19 disease which has caused a pandemic into the human population, with a different course in different people, which contributed to the death of approximately over 5.02 million confirmed cases worldwide up till now. For this reason, it is quite important to have the earliest possible evaluation of laboratory-assisted indicators, especially for mortality risk prediction in developing countries, in addition to other clinical and imaging evaluations in order every physician to make the right medical decision.

Methods

In total, 277 patients of Infectious Diseases Hospital, UHC “Mother Teresa” were enrolled. All of them tested positive for COVID-19. We evaluated indicators such as d-dimer (N = 0–500 μg/L), lactate dehydrogenase LDH (N = 95–200 U/L) and the neutrophil/lymphocyte ratio (control group = 1.7 ± 0.392) in two groups of patients, the first one of 144 patients who were discharged from the hospital and the second one of 133 patients who died.

Results

What we observed was that the results were different for every test we performed in each group. Neutrophil/lymphocyte ratio was 8.69 ± 4.9 for the first group versus 14.7 ± 12.3 for the second one, P<0.05 (P = 0.013), LDH = 427 ± 241 versus 715 ± 347, P<0.05 (P = 0.0002), d-dimer = 1387 ± 763 versus 2650 ± 1322, P>0.05 (P = 0.28).

Conclusions

In addition to LDH as a prognostic factor, the neutrophil/lymphocyte ratio was considered as a low cost examination for severe prognosis and mortality risk (P<0.05), which can also serve as an alert for primary services for patient hospitalization, especially in developing countries after his clinical and image evaluation.
P23 Assessment of knowledge, attitude and practice towards antimicrobial use and resistance among students in three secondary schools in Dodoma City
Authors: Venant Erick , Stanley Baritazar K. , Mosha Michael J. , Msovela Kelvin E. , Mushi DorineGrace J. , Masanja Pendo , Wiedenmayer Karin , Ombaka Eva
Published: February 2022

Introduction

Antimicrobial resistance is still not given enough attention and the public is insufficiently aware of its existence, leading to behaviour, which propagates the rise of antimicrobial resistance (AMR). One of the objectives of Tanzania's national action plan on antimicrobial resistance is to improve awareness and understanding of antimicrobial use and resistance through effective communication, education and training. This task will need involvement of many stakeholders and sectors.

Objectives

To assess the knowledge, attitudes and practices toward antimicrobial use and resistance among students in three secondary schools in Dodoma city.

Methods

For this interventional pre-post comparative study, data were collected before and after training on antimicrobial use and resistance. Secondary school students from Mkonze, Merriwa and Kiwanja cha Ndege secondary school who are members of AMR school clubs participated. Training included classroom teaching and arts and crafts. We used quantitative and qualitative data collection methods by using self-administered paper-based structured coded questionnaires delivered to the students with the supervision of school guardians. Analysis was done through Excel and SPSS.

Results

Three aspects were investigated: awareness of ways to reduce AMR; knowledge that antibiotics cannot be used to treat flu and factors that contribute to AMR. Before the training knowledge of these was below 37%. Three months after the training knowledge had increased to above 90%.

Conclusions

Training of secondary school students significantly improved awareness, knowledge and attitude regarding antimicrobial use and antimicrobial resistance. AMR school clubs are an effective vehicle to raise awareness and mitigate the AMR crisis. Focus on students will lead to wider awareness in the community.
P30 Bacterial coinfection and prescribing trends in SARS-CoV-2 infection in two UK hospitals
Authors: Teoh P. J. , Maan I. , Uwagwu J. , Odedra A.
Published: February 2022

Objectives

To describe antibiotic prescribing and early bacterial and fungal coinfection in patients admitted to two London hospitals with COVID-19.

Methods

A retrospective review of adults with PCR-confirmed SARS-CoV-2 infection admitted between 9 February and 10 May 2020. Demographics, critical care unit (CCU) admission, antibiotic prescribing and microbiology results within 10 days of COVID-19 diagnosis were analysed.

Results

In total, 1155 patients were identified; 32.9% (380) died during admission and 12.4% (143) had positive microbiology. After excluding likely contaminants, 6.9% (80) had evidence of coinfection. The most common organisms isolated from blood cultures were Escherichia coli 9.5% (7), Klebsiella pneumoniae 4.0% (3), and MSSA 2.7% (2). Organisms isolated from lower respiratory tract samples included Candida albicans 44.4% (12), Staphylococcus aureus 22.2% (6), Klebsiella species 11.0% (3), Pseudomonas aeruginosa 11.0% (3) and Citrobacter species 11% (3). Legionella and pneumococcal urinary antigen tests were positive in 0/117 and 2/71 episodes, respectively. Patients admitted to CCU during their inpatient stay were more likely to have positive microbiology compared with patients managed outside CCU (26.2% versus 11.0%, P<0.001). Ninety-one percent (1051) of all patients received antibiotics. Clarithromycin (24.2% total antibiotic use) and amoxicillin (21%) were most frequently used, followed by piperacillin/tazobactam (12.6%), gentamicin (10.6%), co-amoxiclav (9.3%) and meropenem (3.2%). Patients given piperacillin/tazobactam or meropenem had a higher length of stay and mortality.

Conclusions

Bacterial coinfection in COVID-19 is uncommon, but more frequent in patients requiring CCU admission. Antibiotic use was widespread, despite lack of microbiological evidence of coinfection. When present, infection was more likely due to Gram-negative bacteria. Future local clinical and antimicrobial guidelines should reflect these findings.
P37 Variable adherence to and effectiveness of a vancomycin continuous infusion protocol within ICUs at a London tertiary-care hospital: a single-centre retrospective service evaluation
Authors: Oakley Robert , Bakrania Prijay , Yau Ting , Standing Joseph , Lonsdale Dagan
Published: February 2022

Background

Appropriate vancomycin dosing and therapeutic monitoring is important to optimize treatment for serious Gram-positive infections. In St George's Hospital ICUs, the treatment protocol is a loading dose (<65 kg, 1000 mg; ≥65 kg, 1500 mg), followed by a continuous infusion based on creatinine clearance (CLCR). Vancomycin serum concentrations are taken daily at 0600 hours (target therapeutic range 20–25 mg/L). Non-therapeutic concentrations may negatively affect clinical outcomes and prolong length of stay.1

Methods

Electronic prescribing and medicine administration data (vancomycin dose, dose timings, indication, patient biochemistry and demographics) within a 66-bed ICU service were reviewed retrospectively (July 2020–July 2021). Cockcroft-Gault CLCR was calculated using total body weight (TBW), or adjusted body weight in obese1 patients.

Standards

(i) Proportion of patients with a therapeutic concentration within two serum samples; and (ii) time taken to achieve therapeutic concentration.

Results

Ninety-four percent (51/54) of patients received a correct protocol instructed loading dose, 31% (17/54) received a correct loading and maintenance dose, and 70% (38/54) had a vancomycin serum concentration taken. Forty-one percent (7/17) of correctly protocol dosed and monitored patients were therapeutic at their first day serum concentration, which decreased to 20% (3/15) by their second day serum concentration. Consistently therapeutically dosed patient groups included obese and normal weight patients with CLCR 10–20  mL/min and 21–50  mL/min. Whereas underweight and obese patients with CLCR >50  mL/min and 21–50  mL/min became supratherapeutic by their second day serum concentration. Obese and normal weight patients with CLCR >50  mL/min were consistently subtherapeutic. The mean time taken for non-therapeutic patients who continued treatment (n = 7) to become therapeutic after dose adjustments was 4 days. Patients (n = 17) were 82% male and of a mean age of 62 ± 17 years. Mean TBW was 79 ± 23 kg and mean CLCR 65 ± 48  mL/min. Sepsis was the most common vancomycin indication (65%).

Conclusions

Multiple drug recording formats, plus adherence to and dosing of different aspects of the vancomycin protocol, requires review. This is to ensure accurate vancomycin administration documentation and that therapeutic concentrations are achieved more rapidly and consistently, whilst minimizing toxicity. A quality improvement project has been instigated to focus on protocol education, accessibility and improving IT infrastructure. Increased patient volume of distribution and renal function variability within the ICU population adds complexity to vancomycin pharmacokinetics. Research into pharmacokinetic models better representing the local ICU population and AUC24 drug monitoring is being explored based on recent international guidance.1
Radiation hydrodynamics modelling of kilonovae withSNEC
Authors: Wu Zhenyu , Ricigliano Giacomo , Kashyap Rahul , Perego Albino , Radice David
Published: February 2022

We develop a method to compute synthetic kilonova light curves that combine numerical relativity simulations of neutron star mergers and the SNEC radiation–hydrodynamics code. We describe our implementation of initial and boundary conditions, r-process heating, and opacities for kilonova simulations. We validate our approach by carefully checking that energy conservation is satisfied and by comparing the SNEC results with those of two semi-analytic light-curve models. We apply our code to the calculation of colour light curves for three binaries having different mass ratios (equal and unequal mass) and different merger outcome (short-lived and long-lived remnants). We study the sensitivity of our results to hydrodynamic effects, nuclear physics uncertainties in the heating rates, and duration of the merger simulations. We find that hydrodynamics effects are typically negligible and that homologous expansion is a good approximation in most cases. However, pressure forces can amplify the impact of uncertainties in the radioactive heating rates. We also study the impact of shocks possibly launched into the outflows by a relativistic jet. None of our models match AT2017gfo, the kilonova in GW170817. This points to possible deficiencies in our merger simulations and kilonova models that neglect non-LTE effects and possible additional energy injection from the merger remnant and to the need to go beyond the assumption of spherical symmetry adopted in this work.
Waves in weakly ionized solar plasmas
Authors: Alharbi A , Ballai I , Fedun V , Verth G
Published: February 2022

Here, we study the nature and characteristics of waves propagating in partially ionized plasmas in the weakly ionized limit, typical for the lower part of the solar atmosphere. The framework in which the properties of waves are discussed depends on the relative magnitude of collisions between particles, but also on the relative magnitude of the collisional frequencies compared to the gyro-frequency of charged particles. Our investigation shows that the weakly ionized solar atmospheric plasma can be divided into two regions, and this division occurs, roughly, at the base of the chromosphere. In the solar photosphere, the plasma is non-magnetized and the dynamics can described within the three-fluid framework, where acoustic waves associated to each species can propagate. Due to the very high concentration of neutrals, the neutral sound waves propagates with no damping, while for the other two modes the damping rate is determined by collisions with neutrals. The ion- and electron-related acoustic modes propagate with a cut-off determined by the collisional frequency of these species with neutrals. In the weakly ionized chromosphere, only electrons are magnetized, however, the strong coupling of charged particles reduces the working framework to a two-fluid model. The disassociation of charged particles creates electric currents that can influence the characteristic of waves. The propagation properties of waves with respect to the angle of propagation are studied with the help of polar diagrams.
The role of human umbilical cord mesenchymal stem cells-derived exosomal microRNA-431-5p in survival and prognosis of colorectal cancer patients
Authors: Qu Muwen , Li Junyi , Hong Zifu , Jia Fei , He Yinghua , Yuan Lingling
Published: February 2022

We aim to discuss the role of miR-431-5p in colorectal cancer (CRC) progression via regulating peroxiredoxin 1 (PRDX1). miR-431-5p and PRDX1 expression were detected in CRC tissues and cells, and the relationship between miR-431-5p expression and prognosis of CRC patients was analyzed. Exosomes were extracted from human umbilical cord mesenchymal stem cells (hUCMSCs) and co-cultured with LoVo cells. MTT assay, flow cytometry and Transwell assay were implemented to test cell viability, apoptosis and invasion and migration ability, respectively. The tumor growth was determined as well, and the binding relation between miR-431-5p and PRDX1 was confirmed. miR-431-5p was downregulated and PRDX1 was upregulated in CRC, and miR-431-5p downregulation was associated with poor prognosis. hUCMSC-Exos suppressed the malignant behaviors of LoVo cells, and overexpression of miR-431-5p further aggravated the inhibitory effect of hUCMSC-Exos on LoVo cells. hUCMSC-Exos inhibited PRDX1 expression via miR-431-5p. PRDX1 was targeted by miR-431-5p. miR-431-5p serves as a prognostic biomarker in CRC, and hUCMSC-Exos transfer of miR-431-5p decelerates CRC cell growth by inhibiting PRDX1.
Longing for Hezbollah
Authors: Ben-Ami Shlomo
Published: February 2022

Hezbollah’s perceived success in driving Israel out of Lebanon trapped the Palestinian leadership between the drive to resurrect the dormant ethos of armed struggle and the imperatives of the peace process. They dealt with their predicament by oscillating from rigid positions to surprisingly forthcoming ideas that carried the potential of a sensible endgame. But, neither the US Secretary of State Madeleine Albright’s visit nor the sober assessment of Military Intelligence of the scope of Arafat’s maneuvering capabilities changed Barak’s mind. Unsurprisingly, Arafat’s outburst at Albright for conniving with Israel’s unfulfilled obligations with regard to the Interim Agreement reflected his despair at the chances of reaching a final deal. Barak had to move or the process would die. He and the military hierarchy now came closer to assuming the inevitability of conceding sovereignty over the Jordan Valley.
“Take It or Leave It”: The Clinton Peace Parameters
Authors: Ben-Ami Shlomo
Published: February 2022

On December 20, the president invited the parties to the White House to hear a first version of his peace plan. He still wanted us to conduct one more round of talks to help him fine-tune his initially flexible peace parameters. The natural tendency of the teams, however, was to impact the president’s final peace outline by sticking to their maximalist positions. I thought otherwise, and advanced ideas on borders and the Temple Mount that went far beyond our traditional comfort zone. My proposals had “a dramatic influence on Clinton’s calculations.” On December 23, we returned to the White House to hear the president’s last, definitive, and nonnegotiable peace parameters, the most equitable and balanced peace plan ever offered by an American president that was, moreover, the natural outcome of the most laborious peace negotiations ever conducted by Israelis and Palestinians.
“A Crime against the Palestinian People”
Authors: Ben-Ami Shlomo
Published: February 2022

Back home, first a dramatic inner Cabinet meeting and then the full government overruled the army’s opposition and endorsed the Clinton peace parameters. The Palestinians, however, declared a total war on each and every aspect of the plan. Nor was the American performance particularly edifying. They gave in to Arafat’s irritating pressure for “clarifications,” and let him meet the president ten days after the deadline for an answer. Calls from world leaders pleading with him to give Clinton a yes and Arab envoys from Saudi Arabia and Egypt offering him their respective leaders’ encouragement were all ignored. Arafat’s reservations amounted to a resounding no. The Americans’ peace hopes faded away, and they shifted their attention to a “reduction of violence” or to some kind of presidential declaration that would enshrine the achievements of the process.