bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic Associations of Oral Clefts in Arabs
Authors: Alkharafi Lateefa , Alhasawi Saud , Burezq Hisham , Alduraie Alhanouf , Alhuwais Muneera , Aldoub Fatema , Alduwaisan Maryam , Aldoseri Sara , Hamdan Hala , Abdelhafez Nada , Mokhtar Ashraf , Alqatami Fawzi , Al-Serri Ahmad , Hartsfield James , Al-Bustan Suzanne
Published: February 2024

Objective

This study aims to investigate genetic association between Non-syndromic Cleft lip with or without palate (NCLP) and 14 specific Single Nucleotide Polymorphism (SNPs) reported to be associated with NCLP from previous Genome Wide Association Studies (GWAS).

Design

A prospective case-control study.

Setting

Ministry of Health (MOH) Cleft and Craniofacial Clinic and Kuwait University.

Patients/Participants

One hundred sixty-four NCLP patients were recruited from MOH Cleft and Craniofacial clinic, and 491 controls from the Kuwait DNA bank established at Kuwait University.

Interventions

Total gDNA was extracted from whole blood withdrawn from patients and genotyped by real time PCR. Hardy-Weinberg Equilibrium was tested, and the set p value for significance (p < 0.05) was adjusted using the Benjamini - Hoochberg procedure to achieve 5% false discovery rate.

Main Outcome Measures

Logistic regression multivariate analysis was used to test statistically significant differences between cases and controls. Genotyping both groups for the variants was determined through the allele discrimination software program.

Results

There was statistically significant difference between cases and controls in relation to two SNPs; LOC102724968 (rs13041247) (MAF cases/control = C (0.28/0.39) OR Homozygous = 1.30; 95% CI = 1.09–1.56, p = 0.0041) and PVT1 (rs987525) (MAF cases/control = A (0.41/0.27) OR heterozygous = 1.48; 95% CI =1.12–1.95, p = 0.0073), increasing the susceptibility to NCLP.

Conclusions

Genetic variations are associated with the occurrence of oral clefts. Customized Next Generation Sequencing (NGS) panel to the Arab ethnicity is encouraged. In Addition, national preconception genetic carrier screening tests should expand to include common craniofacial anomalies.
Evaluation Capacity Building Through Community-University Partnership
Authors: Suiter Sarah , Morgan Kathryn Y. , Eccleston Sara
Published: February 2024

Evaluation is essential to achieving program outcomes, especially when stakeholders engage with evaluation and make use of the findings. Both of these activities require evaluation capacity that might not be present in community-based organizations. In this paper, we describe how community-university partnership models can support evaluation capacity building (ECB). The basic framework for our ECB initiative was a semester-long, master's-level university course in which 5–6 community partners worked with small groups of 3–4 students to design an evaluation plan. We used mixed-methods to assess (1) if organizations implemented the evaluation plans developed in the course; (2) how organizations used the findings; and (3) what evaluation skills participants continued to use after the course ended. We found that organizations that implemented their evaluation plans gained intended outcomes of ECB, such as improving practice and communicating with stakeholders. These results suggest that community-university partnerships for developing ECB can be effective.
“I can feel the rhythm, and it is somehow nice”: Deafness challenging the hierarchy of senses in music education
Authors: Sutela Katja , Ahonen Outi
Published: February 2024

In this article, we explore how deafness challenges the hierarchy of senses in music education. As part of a larger three-year research project focusing on memories of Finnish state schools for the d/Deaf, “Voices of a Silent People—Renovated Bodies,” this article concentrates on experiences of music education. The methodological starting point of the research project is sign history, with a focus on d/Deaf people’s signed memories. The interview data for the whole research project (N = 116) were collected by interviewing d/Deaf people in group discussions and individual interviews. There were 61 participants who produced the transcribed interview data related to the third substudy on music education (n = 61). Our critique of the hierarchy of senses in music education is based on Merleau-Ponty’s phenomenological thought and, more specifically, the criticism of the mind–body, self–other, and subject–object dichotomies in the listening process. The results suggest that d/Deaf people can feel sound with their bodies. Sound is experienced holistically through different channels: body, touch, vision, and for some, through hearing or feeling bass frequencies. Sound is not categorized into perceptions of one sense. To conclude, four dimensions that make it possible to formulate more inclusive and multisensory music education are presented.
Evaluation of short-term mortality in patients with Medicare undergoing endovascular interventions for chronic limb-threatening ischemia
Authors: Cleman Jacob , Romain Gaëlle , Callegari Santiago , Scierka Lindsey , Jacque Francky , Smolderen Kim G , Mena-Hurtado Carlos
Published: February 2024

Introduction:

Patients with chronic limb-threatening ischemia (CLTI) have high mortality rates after revascularization. Risk stratification for short-term outcomes is challenging. We aimed to develop machine-learning models to rank predictive variables for 30-day and 90-day all-cause mortality after peripheral vascular intervention (PVI).

Methods:

Patients undergoing PVI for CLTI in the Medicare-linked Vascular Quality Initiative were included. Sixty-six preprocedural variables were included. Random survival forest (RSF) models were constructed for 30-day and 90-day all-cause mortality in the training sample and evaluated in the testing sample. Predictive variables were ranked based on the frequency that they caused branch splitting nearest the root node by importance-weighted relative importance plots. Model performance was assessed by the Brier score, continuous ranked probability score, out-of-bag error rate, and Harrell’s C-index.

Results:

A total of 10,114 patients were included. The crude mortality rate was 4.4% at 30 days and 10.6% at 90 days. RSF models commonly identified stage 5 chronic kidney disease (CKD), dementia, congestive heart failure (CHF), age, urgent procedures, and need for assisted care as the most predictive variables. For both models, eight of the top 10 variables were either medical comorbidities or functional status variables. Models showed good discrimination (C-statistic 0.72 and 0.73) and calibration (Brier score 0.03 and 0.10).

Conclusion:

RSF models for 30-day and 90-day all-cause mortality commonly identified CKD, dementia, CHF, need for assisted care at home, urgent procedures, and age as the most predictive variables as critical factors in CLTI. Results may help guide individualized risk-benefit treatment conversations regarding PVI.
Relationship between smoking and mental health in educational settings with high smoking rates: a cohort study among Danish youth
Authors: Kjeld Simone G. , Homberg Teresa , Andersen Susan
Published: February 2024

Background:

Smoking and poor mental health in youth represent important public health priorities. This study aimed to (i) compare tobacco-related behaviors and mental health in two educational settings with high smoking rates: vocational education and training (VET) schools and preparatory basic education (PBE) schools, and (ii) examine associations between smoking at school start and mental health 5 months later.

Methods:

Data were obtained from baseline ( N = 1843) and follow-up ( N = 1039) assessments conducted as part of a school-based trial in two rounds (baseline in August 2018 and August 2019). Students’ characteristics were presented by adjusted prevalences. Logistic regression analyses assessed associations between smoking and measures of mental health: school-related well-being, overall loneliness, and stress.

Results:

More PBE students than VET students reported daily smoking (40% vs. 27%), nicotine dependence, perceived benefits of smoking (e.g., stress reduction: 41% vs. 33%), low smoking-related self-efficacy (e.g., ability to resist smoking if offered by a friend: 20% vs. 32%), school-related loneliness, and low school connectedness (25% vs. 11%). Daily smokers at VET and PBE schools had lower odds of school-related loneliness (AOR = 0.51, 95% CI: 0.35–0.74) and higher odds of stress (AOR = 2.75, 95% CI: 2.00–3.80). Smoking was associated with better classmate relations in VET schools but not in PBE schools.

Conclusions:

Our study suggested that students in PBE schools constitute a more vulnerable group in terms of smoking and mental health compared with students in VET schools. Smoking seemed to prevent loneliness in school but was associated with heightened stress levels.
Tarot as affective cartography in the uneven Anthropocene
Authors: Murney Anastasia
Published: February 2024

In the context of anthropogenic climate change, this article critiques the prevalence of ocularcentric strategies, such as spectacular large-scale artworks and data visualizations, questioning the epistemological assumptions underpinning them. The author proposes Tarot, a dialogical practice unfolding through a deck of cards, often used for divination or occult purposes, as a valuable method for addressing the cognitive and affective messiness of climate crisis. This article examines three socially engaged art practices centring Tarot – James Leonard’s The Tent of Casually Observed Phenologies (2017–), Adelita Husni-Bey’s The Reading/La Seduta (2017) and Denise Ferreira da Silva and Valentina Desideri’s poethical readings (2015–). These case studies advance an understanding of Tarot as affective cartography, foregrounding the embodied and interpretive labour of negotiating connections across different crises and contradictions. Tarot provides a social context to experiment with new possibilities, unsettling ‘rational’ habits of thought and rethinking the practice of ‘making sense’ in the uneven Anthropocene.
Financial distressed companies and directors’ obligation to consider creditors’ interests: An Anglo-Australian comparison of the obligation's trigger and application
Authors: Keay Andrew , Lombard Sulette
Published: February 2024

Many common law jurisdictions recognise that directors have an obligation to consider the interests of company creditors when the company is experiencing financial distress. Despite numerous cases attempting to crystalise legal principles related to this obligation and significant academic commentary on the topic, the parameters of the obligation remain uncertain. This paper provides an analytical comparison of the latest case law in Australia and the UK concerning the two most important issues that exist in relation to this obligation, namely when is the obligation triggered and what do directors have to do to ensure that they comply with the obligation. We found that the UK courts appear to be adopting a much more restrictive approach regarding the trigger for the obligation, whereas the obligation may arise much earlier in Australia, due to the liberal framing of the trigger. An analysis of case law also revealed that the weight attached to the interests of creditors once the obligation is triggered seems to be much more significant in the UK, compared to Australia. This analysis is important as there is no doubt that courts in other common law jurisdictions, and particularly in the Commonwealth, will examine the Australian and UK jurisprudence in making their decisions in relation to any claim that directors have failed to comply with the obligation to consider the interests of creditors.
Efficient structural damage detection via the lω regularization and randomized extended Kaczmarz algorithm
Authors: Huang Sining , Zheng Ran , Sun Xiao , Qiao Tiantian , Zhang Feiyu
Published: February 2024

Structural damage detection (SDD) is an important aspect of structural health monitoring. This study aimed to explore a new method IT ω-REK θ(ω = 1, 1/2; θ = 1,2,3) for SDD based on the lω sparse regularization model and the randomized extended Kaczmarz (REK) type algorithms. When ω = 1/2, the l1/2 sparse regularization model was applied to enhance the ill-posedness of the damage identification problem and ensure the sparsity of the solution. The REK, θ = 1, partially randomized extended Kaczmarz (θ = 2), and fast maximum-distance extended Kaczmarz (θ = 3) algorithms with different threshold operators were used to solve the lω regularization model. These algorithms could obtain optimal identification results and significantly improve computational efficiency by randomly and partially selecting the data of the sensitivity equations. Numerical and experimental studies on different structures showed that the proposed method could fast locate structural damage and accurately identify the damage extents, which was robust to the SDD problem with noise.
Deep learning integrated Bayesian health indicator for cross-machine health monitoring
Authors: Kim Taewan , Lee Seungchul
Published: February 2024

Constructing a good health indicator (HI) plays a key role in machinery health monitoring. However, due to the training dataset dependency, most conventional deep-learning-based HIs exhibit inconsistent HI scales and limited cross-domain applicability. This study proposes a deep learning integrated Bayesian health indicator (DBHI) to quantify and evaluate system health states in cross-domain applications accurately. The construction of the DBHI comprises two steps: probability space mapping and probabilistic inference. In the first step, the degradation features are extracted from the data and mapped into a probability space by the proposed adversarial autoencoder model. In the second step, the DBHI is calculated by evaluating the relative risk of the current state based on Bayes’ theorem. The effectiveness of the proposed DBHI was validated on two run-to-failure degradation test datasets. In a cross-domain application, the proposed DBHI achieved good performance without retraining compared to other deep learning-based methods that showed invalid results. The proposed DBHI addresses the limitations of conventional deep-learning-based HIs and provides a more reliable and consistent measure of system health, even in a cross-domain application.
A quantitative methodology for justification of platform edge protection systems on passenger rail networks
Authors: Harding Jonathan F , Reed Jonathan , Elsmore Matthew T , Harding Kimberley C , Lee Alan R , McDonald Reuben
Published: February 2024

The implementation of appropriate platform edge protection systems (PEPSs) is a vital consideration in modern rail platform design to reduce injuries caused at the platform-train interface. This work presents a commercially tried and tested methodology for assessing the practicability of implementing PEPSs based on statistical analyses in combination with an As-Low-As-Reasonably-Practicable (ALARP) assessment, to assist in the justification of asset application viability. By extrapolating fatality-weighted injury data relating to the inclusion or non-inclusion of PEPSs, a safety risk model predicts changes in injury statistics to establish a quantified safety impact. The economic cost analysis identifies the operational expenditure for PEPSs throughout their lifecycle along with the capital expenditure and any impacts on the operational railway. The outcomes from these analyses are combined to produce a ratio of safety and operational benefits to capital and operational cost which is scrutinised against a designated disproportionality factor to establish suitability for use.
Vasospastic angina: a review on diagnostic approach and management
Authors: Jenkins Kenny , Pompei Graziella , Ganzorig Nandine , Brown Sarah , Beltrame John , Kunadian Vijay
Published: February 2024

Vasospastic angina (VSA) refers to chest pain experienced as a consequence of myocardial ischaemia caused by epicardial coronary spasm, a sudden narrowing of the vessels responsible for an inadequate supply of blood and oxygen. Coronary artery spasm is a heterogeneous phenomenon that can occur in patients with non-obstructive coronary arteries and obstructive coronary artery disease, with transient spasm causing chest pain and persistent spasm potentially leading to acute myocardial infarction (MI). VSA was originally described as Prinzmetal angina or variant angina, classically presenting at rest, unlike most cases of angina (though in some patients, vasospasm may be triggered by exertion, emotional, mental or physical stress), and associated with transient electrocardiographic changes (transient ST-segment elevation, depression and/or T-wave changes). Ischaemia with non-obstructive coronary arteries (INOCA) is not a benign condition, as patients are at elevated risk of cardiovascular events including acute coronary syndrome, hospitalization due to heart failure, stroke and repeat cardiovascular procedures. INOCA patients also experience impaired quality of life and associated increased healthcare costs. VSA, an endotype of INOCA, is associated with major adverse events, including sudden cardiac death, acute MI and syncope, necessitating the study of the most effective treatment options currently available. The present literature review aims to summarize current data relating to the diagnosis and management of VSA and provide details on the sequence that treatment should follow.
Assessment of Risk Factors and Rate of Conversion to Total Hip Arthroplasty Within 2 Years After Hip Arthroscopy Utilizing a Large Database of Commercially Insured Patients in the United States
Authors: Tiao Justin , Ranson William , Ren Renee , Wang Kevin C. , Rosenberg Ashley M. , Herrera Michael , Zubizarreta Nicole , Anthony Shawn G.
Published: February 2024

Background:

The conversion rate of hip arthroscopy (HA) to total hip arthroplasty (THA) has been reported to be as high as 10%. Despite identifying factors that increase the risk of conversion, current studies do not stratify patients by type of arthroscopic procedure.

Purpose/Hypothesis:

To analyze the rate and predictors of conversion to THA within 2 years after HA. It was hypothesized that osteoarthritis (OA) and increased patient age would negatively affect the survivorship of HA.

Study Design:

Cohort study; Evidence level, 3.

Methods:

The IBM MarketScan database was utilized to identify patients who underwent HA and converted to THA within 2 years at inpatient and outpatient facilities between 2013 and 2017. Patients were split into 3 procedure cohorts as follows: (1) femoroacetabular osteoplasty (FAO), which included treatment for femoroacetabular impingement; (2) isolated debridement; and (3) isolated labral repair. Cohort characteristics were compared using standardized differences. Conversion rates between the 3 cohorts were compared using chi-square tests. The relationship between age and conversion was assessed using linear regression. Predictors of conversion were analyzed using multivariable logistic regression. The median time to conversion was estimated using Kaplan-Meier tests.

Results:

A total of 5048 patients were identified, and the rates of conversion to THA were 12.86% for isolated debridement, 8.67% for isolated labral repair, and 6.76% for FAO (standardized difference, 0.138). The isolated labral repair cohort had the shortest median time to conversion (isolated labral repair, 10.88 months; isolated debridement, 10.98 months; and FAO, 11.9 months [ P = .034). For patients >50 years, isolated debridement had the highest rate of conversion at 18.8%. The conversion rate increased linearly with age. Factors that increased the odds of conversion to THA were OA, having an isolated debridement procedure, and older patient age ( P < .05).

Conclusion:

Older patients and those with preexisting OA of the hip were at a significantly increased risk of failing HA and requiring a total hip replacement within 2 years of the index procedure. Younger patients were at low risk of requiring a conversion procedure no matter which arthroscopic procedure was performed.
Reliability of Manual Measurements Versus Semiautomated Software for Glenoid Bone Loss Quantification in Patients With Anterior Shoulder Instability
Authors: Karpinski Katrin , Akguen Doruk , Gebauer Henry , Paksoy Alp , Lupetti Mattia , Markova Viktoria , Zettinig Oliver , Moroder Philipp
Published: February 2024

Background:

The presence of glenoid bone defects is indicative in the choice of treatment for patients with anterior shoulder instability. In contrast to traditional linear- and area-based measurements, techniques such as the consideration of glenoid concavity have been proposed and validated.

Purpose:

To compare the reliability of linear (1-dimensional [1D]), area (2-dimensional [2D]), and concavity (3-dimensional [3D]) measurements to quantify glenoid bone loss performed manually and to analyze how automated measurements affect reliability.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

Computed tomography images of 100 patients treated for anterior shoulder instability with differently sized glenoid defects were evaluated independently by 2 orthopaedic surgeons manually using conventional software (OsiriX; Pixmeo) as well as automatically with a dedicated prototype software program (ImFusion Suite; ImFusion). Parameters obtained included 1D (defect diameter, best-fit circle diameter), 2D (defect area, best-fit circle area), and 3D (bony shoulder stability ratio) measurements. Mean values and reliability as expressed by the intraclass correlation coefficient [ICC]) were compared between the manual and automated measurements.

Results:

When manually obtained, the measurements showed almost perfect agreement for 1D parameters (ICC = 0.83), substantial agreement for 2D parameters (ICC = 0.79), and moderate agreement for the 3D parameter (ICC = 0.48). When measurements were aided by automated software, the agreement between raters was almost perfect for all parameters (ICC = 0.90 for 1D, 2D, and 3D). There was a significant difference in mean values between manually versus automatically obtained measurements for 1D, 2D, and 3D parameters ( P < .001 for all).

Conclusion:

While more advanced measurement techniques that take glenoid concavity into account are more accurate in determining the biomechanical relevance of glenoid bone loss, our study showed that the reliability of manually performed, more complex measurements was moderate.
More Than One Way: Fifth-Graders’ Varied Digital Reading Behaviors and Comprehension Outcomes
Authors: Shimizu Amanda Yoshiko , Havazelet Michael , Goodwin Amanda P.
Published: February 2024

Digital reading is ubiquitous, yet understanding digital reading processes and links to comprehension remains underdeveloped. Guided by new literacies and active reading theories, this study explored the reading behaviors and comprehension of thirteen fifth graders who read static digital texts. We coded for the quantity and quality of digital reading behaviors and employed action path diagrams to connect behaviors to comprehension. We used timescape analyses to visualize how behaviors were orchestrated differently across readers. Findings showed no single behavior was related directly to comprehension, indicating varying pathways to digital reading success. Occasional rereading seemed to support active reading and improved comprehension. Instances of students subverting expected digital tools were observed. Minor distractions like mind-wandering did not link to poor performance. This research deepens our understanding of self-monitoring and active reading in static digital contexts, offering insights for future study of more complex digital reading contexts like reading on the internet.
Descriptive Analysis of Vitreoretinal Surgery Fellowship Program Directors
Authors: Jiao Cheng , Patel Parth A. , Ibnamasud Shadman , Patel Prem N. , Ahmed Harris , Law Janice C.
Published: February 2024

Purpose: To evaluate the demographic, educational, and scholarly characteristics of Association of University Professors of Ophthalmology–accredited vitreoretinal surgery fellowship program directors in the United States and Canada. Methods: Demographic, educational, and scholarly profiles of identified program directors were collated from online public resources. Characteristics were compared by sex, program size, ranking, and affiliation. Results: Eighty-one program directors (mean age [±SD] 54.7 ± 11.0 years) from 78 fellowship programs were identified. The minority were women (14.8%), who were on average 6 years younger than their male counterparts ( P = .07). The majority of program directors had an academic affiliation (90.1%), most commonly professor (54.8%). The mean h-index, 5-year h-index, and m-quotient were 20.9 ± 14.9, 5.9 ± 4.4, and 0.82 ± 0.42, respectively. Compared with their counterparts, program directors of both “top 10” and large programs published more manuscripts ( P < .05), accrued more citations ( P < .05), and had a higher h-index ( P < .05). Fellowship programs with female program directors had a significantly larger proportion of female retina faculty ( P = .002). Conclusions: The backgrounds of vitreoretinal surgery program directors are diverse. However, women remain underrepresented in this position, highlighting an area with the potential for greater equity in ophthalmology.
Environmental (in)security, peacebuilding and green economic recovery in the context of Russia’s war against Ukraine
Authors: Flamm Patrick , Kroll Stefan
Published: February 2024

In addition to the loss of many lives and livelihoods, Russia’s war of aggression against Ukraine has also led to direct and indirect harm to the environment in Ukraine and other parts of the world: local ecosystems have been destroyed and polluted, affecting human security and health as well as biodiversity for many years to come. Any attempt to build a sustainable peace after the war will have to consider these environmental insecurities and their origins in historically asymmetric relationships between Ukraine and external actors centred around resource extractivism. In this paper, we pursue a complementary approach between the political ecology and environmental peacebuilding scholarships: while the former offers an interrogation of larger power structures and practices at this environment–conflict nexus, ranging from Russian imperialism to a sought-after European integration, the latter enables a discussion of the conditions under which the necessary environmental recovery and remediation initiatives may contribute to local peacebuilding instead of further conflict. Taking both approaches together, we argue that the key to a politically and environmentally sustainable peace lies in the centring of Ukrainian civil society and local communities.
Heterogeneity in maternal mRNAs within clutches of eggs in response to thermal stress during the embryonic stage
Authors: Sato Atsuko , Mihirogi Yukie , Wood Christine , Suzuki Yutaka , Truebano Manuela , Bishop John
Published: February 2024

Background

The origin of variation is of central interest in evolutionary biology. Maternal mRNAs govern early embryogenesis in many animal species, and we investigated the possibility that heterogeneity in maternal mRNA provisioning of eggs can be modulated by environmental stimuli.

Results

We employed two sibling species of the ascidian Ciona, called here types A and B, that are adapted to different temperature regimes and can be hybridized. Previous study showed that hybrids using type B eggs had higher susceptibility to thermal stress than hybrids using type A eggs. We conducted transcriptome analyses of multiple single eggs from crosses using eggs of the different species to compare the effects of maternal thermal stress on heterogeneity in egg provisioning, and followed the effects across generations. We found overall decreases of heterogeneity of egg maternal mRNAs associated with maternal thermal stress. When the eggs produced by the F1 AB generation were crossed with type B sperm and the progeny (‘ABB’ generation) reared unstressed until maturation, the overall heterogeneity of the eggs produced was greater in a clutch from an individual with a heat-stressed mother compared to one from a non-heat-stressed mother. By examining individual genes, we found no consistent overall effect of thermal stress on heterogeneity of expression in genes involved in developmental buffering. In contrast, heterogeneity of expression in signaling molecules was directly affected by thermal stress.

Conclusions

Due to the absence of batch replicates and variation in the number of reads obtained, our conclusions are very limited. However, contrary to the predictions of bet-hedging, the results suggest that maternal thermal stress at the embryo stage is associated with reduced heterogeneity of maternal mRNA provision in the eggs subsequently produced by the stressed individual, but there is then a large increase in heterogeneity in eggs of the next generation, although itself unstressed. Despite its limitations, our study presents a proof of concept, identifying a model system, experimental approach and analytical techniques capable of providing a significant advance in understanding the impact of maternal environment on developmental heterogeneity.
ST218 Klebsiella pneumoniae became a high-risk clone for multidrug resistance and hypervirulence
Authors: Yang Ping , Liu Chao , Du Pengcheng , Yi Juan , Wu Zhenchao , Zheng Jiajia , Shen Ning , Cui Liyan , Lu Ming
Published: February 2024

Background

The occurrence of multidrug-resistant and hypervirulent Klebsiella pneumoniae (MDR-hvKp) worldwide poses a great challenge for public health. Few studies have focused on ST218 MDR-hvKp.

Methods

Retrospective genomic surveillance was conducted at the Peking University Third Hospital from 2017 and clinical information was obtained. To understand genomic and microbiological characteristics, antimicrobial susceptibility testing, plasmid conjugation and stability, biofilm formation, serum killing, growth curves and whole-genome sequencing were performed. We also assessed the clinical and microbiological characteristics of ST218 compared with ST23.

Results

A total of eleven ST218 Kp isolates were included. The most common infection type was lower respiratory tract infection (72.7%, 8/11) in our hospital, whereas ST23 hvKp (72.7%, 8/11) was closely associated with bloodstream infection. Notably, nosocomial infections caused by ST218 (54.5%, 6/11) was slightly higher than ST23 (36.4%, 4/11). All of the ST218 and ST23 strains presented with the virulence genes combination of iucA + iroB + peg344 + rmpA + rmpA2. Interestingly, the virulence score of ST218 was lower than ST23, whereas one ST218 strain (pPEKP3107) exhibited resistance to carbapenems, cephalosporins, β-lactamase/inhibitors and quinolones and harbored an ~ 59-kb IncN type MDR plasmid carrying resistance genes including blaNDM-1, dfrA14 and qnrS1. Importantly, blaNDM-1 and qnrS1 were flanked with IS26 located within the plasmid that could successfully transfer into E. coli J53. Additionally, PEKP2044 harbored an ~ 41-kb resistance plasmid located within tetA indicating resistance to doxycycline.

Conclusion

The emergence of blaNDM-1 revealed that there is great potential for ST218 Kp to become a high-risk clone for MDR-hvKp, indicating the urgent need for enhanced genomic surveillance.
Identification of candidate genes and residues for improving nitrogen use efficiency in the N-sensitive medicinal plant Panax notoginseng
Authors: Cun Zhu , Li Xia , Zhang Jin-Yan , Hong Jie , Gao Li-Lin , Yang Jing , Ma Su-Yun , Chen Jun-Wen
Published: February 2024

Background

Nitrogen (N) metabolism-related key genes and conserved amino acid sites in key enzymes play a crucial role in improving N use efficiency (NUE) under N stress. However, it is not clearly known about the molecular mechanism of N deficiency-induced improvement of NUE in the N-sensitive rhizomatous medicinal plant Panax notoginseng (Burk.) F. H. Chen. To explore the potential regulatory mechanism, the transcriptome and proteome were analyzed and the three-dimensional (3D) information and molecular docking models of key genes were compared in the roots of P. notoginseng grown under N regimes.

Results

Total N uptake and the proportion of N distribution to roots were significantly reduced, but the NUE, N use efficiency in biomass production (NUEb), the recovery of N fertilizer (RNF) and the proportion of N distribution to shoot were increased in the N0-treated (without N addition) plants. The expression of N uptake- and transport-related genes NPF1.2, NRT2.4, NPF8.1, NPF4.6, AVP, proteins AMT and NRT2 were obviously up-regulated in the N0-grown plants. Meanwhile, the expression of CIPK23, PLC2, NLP6, TCP20, and BT1 related to the nitrate signal-sensing and transduction were up-regulated under the N0 condition. Glutamine synthetase (GS) activity was decreased in the N-deficient plants, while the activity of glutamate dehydrogenase (GDH) increased. The expression of genes GS1-1 and GDH1, and proteins GDH1 and GDH2 were up-regulated in the N0-grown plants, there was a significantly positive correlation between the expression of protein GDH1 and of gene GDH1. Glu192, Glu199 and Glu400 in PnGS1 and PnGDH1were the key amino acid residues that affect the NUE and lead to the differences in GDH enzyme activity. The 3D structure, docking model, and residues of Solanum tuberosum and P. notoginseng was similar.

Conclusions

N deficiency might promote the expression of key genes for N uptake (genes NPF8.1, NPF4.6, AMT, AVP and NRT2), transport (NPF1.2 and NRT2.4), assimilation (proteins GS1 and GDH1), signaling and transduction (genes CIPK23, PLC2, NLP6, TCP20, and BT1) to enhance NUE in the rhizomatous species. N deficiency might induce Glu192, Glu199 and Glu400 to improve the biological activity of GS1 and GDH, this has been hypothesized to be the main reason for the enhanced ability of N assimilation in N-deficient rhizomatous species. The key genes and residues involved in improving NUE provide excellent candidates for the breeding of medicinal plants.
The complete plastomes of thirteen Libanotis (Apiaceae, Apioideae) plants: comparative and phylogenetic analyses provide insights into the plastome evolution and taxonomy of Libanotis
Authors: Liu Li-Jia , Liu Chang-Kun , Cai Jing , Deng Jiao-Jiao , He Xing‑Jin , Zhou Song‑Dong
Published: February 2024

Background

The genus Libanotis Haller ex Zinn, nom. cons., a contentious member of Apiaceae, encompasses numerous economically and medicinally significant plants, comprising approximately 30 species distributed across Eurasia. Despite many previous taxonomic insights into it, phylogenetic studies of the genus are still lacking. And the establishment of a robust phylogenetic framework remains elusive, impeding advancements and revisions in the taxonomic system for this genus. Plastomes with greater variability in their genetic characteristics hold promise for building a more robust Libanotis phylogeny.

Results

During our research, we sequenced, assembled, and annotated complete plastomes for twelve Libanotis species belong to three sections and two closely related taxa. We conducted a comprehensive comparative analysis through totally thirteen Libanotis plastomes for the genus, including an additional plastome that had been published. Our results suggested that Libanotis plastome was highly conserved between different subclades, while the coding regions were more conserved than the non-coding regions, and the IR regions were more conserved than the single copy regions. Nevertheless, eight mutation hotspot regions were identified among plastomes, which can be considered as candidate DNA barcodes for accurate species identification in Libanotis. The phylogenetic analyses generated a robustly framework for Libanotis and revealed that Libanotis was not a monophyletic group and their all three sections were polygenetic. Libanotis schrenkiana was sister to L. sibirica, type species of this genus, but the remainders scattered within Selineae.

Conclusion

The plastomes of Libanotis exhibited a high degree of conservation and was effective in enhancing the support and resolution of phylogenetic analyses within this genus. Based on evidence from both phylogeny and morphology, we propose the recognition of "Libanotis sensu stricto" and provide taxonomic recommendations for other taxa that previously belonged to Libanotis. In conclusion, our study not only revealed the phylogenetic position and plastid evolution of Libanotis, but also provided new insights into the phylogeny of the family Apiaceae and phylogenetic relationships within the tribe Selineae.
Association between Internet use and depressive symptoms among older adults in two regions of Myanmar: a cross-sectional study
Authors: Sasaki Yuri , Shobugawa Yugo , Nozaki Ikuma , Takagi Daisuke , Nagamine Yuiko , Shirakura Yuki , Lwin Kay Thi , Zin Poe Ei , Bo Thae Zarchi , Sone Tomofumi , Win Hla Hla
Published: February 2024

Background

Internet use has both positive and negative effects on mental health. However, few studies have examined the association between internet use and mental health among older adults in developing countries. This study aimed to investigate the association between Internet use and depressive symptoms among older adults in two regions of Myanmar.

Methods

Data based on a visit to 1,200 older adults in urban and rural Myanmar were obtained through stratified random sampling using the cross-sectional baseline survey of the longitudinal study titled “Healthy and Active Aging in Myanmar.”

Our analysis included 1,186 participants. The dependent variable was depressive symptoms, and the 15-item version of the Geriatric Depression Scale (GDS) was used as a continuous variable; the higher the score, the more likely a person was to be depressed. Internet use (one of the questions about household property ownership) was used as an independent variable. After confirming the absence of multicollinearity, we adjusted for age, gender, educational background, activities of daily living, residential area, and frequency of meeting friends, and stratified by subjective economic status (above or below average). We also examined the interaction between internet use and subjective economic status. A linear regression analysis was performed.

Results

Among the 1,186 participants included in the analysis (women: 59.5%; median age: 68 years old), 202 (17.0%) were Internet users (95% Confidential Interval [CI]: 0.15, 0.19), and they had significantly lower GDS scores than the participants who did not use the Internet (B: -1.59, 95% CI: -2.04, -1.13).GDS showed a negative association with Internet use even in the multivariate analysis (B: -0.95, 95% CI: -1.41, -0.50). However, the interaction term for GDS between Internet use and subjective economic status was not significantly associated (B: 0.43, 95% CI: -1.11, 1.98).

Conclusions

Internet use and depressive symptoms were associated especially among the older adults. However, there were no significant interaction between Internet use and subjective economic status for GDS.
Six dilemmas for stakeholders inherently affecting data sharing during a zoonotic (re-)emerging infectious disease outbreak response
Authors: van Roode Martine Y. , dos S. Ribeiro Carolina , Farag Elmoubasher , Nour Mohamed , Moustafa Aya , Ahmed Minahil , Haringhuizen George , Koopmans Marion P.G. , van de Burgwal Linda H.M.
Published: February 2024

Background

Timely access to outbreak related data, particularly in the early events of a spillover, is important to support evidence based control measures in response to outbreaks of zoonotic Emerging Infectious Diseases (EID). Yet, this is impeded by several barriers that need to be understood to promote timely sharing of data. Using the MERS epidemic as a model for a zoonotic EID outbreak, this study sought to provide an in-depth understanding of data sharing practices.

Methods

Semi-structured interviews with 25 experts were conducted, along with Focus Group Discussions with 15 additional experts. A root-cause analysis was performed to examine the causal relationships between barriers. Enablers were mapped to the root-cause analysis to understand their influence on the barriers. Finally, root causes were placed in context of core dilemmas identified from the qualitative analysis.

Findings

Eight barriers to data sharing were identified, related to collaboration, technical preparedness, regulations, and (conflict of) interests, and placed in the context of six dilemmas inherent to the multi-stakeholder collaboration required for a zoonotic outbreak response. Fourteen identified enablers showed the willingness of stakeholders to overcome or circumvent these barriers, but also indicated the inherent trial and error nature of implementing such enablers.

Interpretation

Addressing the barriers requires solutions that must consider the complexity and interconnectedness of the root causes underlying them, and should consider the distinct scopes and interests of the different stakeholders. Insights provided by this study can be used to encourage data sharing practices for future outbreaks

Funding

Wellcome Trust and UK Aid; EU-H2020 Societal Challenges (grant agreement no. 643476), Nederlandse Organisatie voor Wetenschappelijk Onderzoek (VI.Veni.201S.044)
Patterns of antibiotic administration in Chinese neonates: results from a multi-center, point prevalence survey
Authors: Zhang Jiaosheng , Lin Li , Lu Gen , Wu Keye , Tian Daiyin , Tang Lanfang , Ma Xiang , Wang Yajuan , Liu Gang , Li Yanqi , Qian Jing , Wang Ping , Cao Qing , Zhang Wenshuang , Wu Lijuan , Si Ligang , Wu Yue , Zheng Yuejie , Shen Kunling , Deng Jikui , Li Defa , Yang Yonghong
Published: February 2024

Objectives

In this study, we describe the patterns of antibiotic prescription for neonates based on World Health Organization’s (WHO) Essential Medicines List Access, Watch, and Reserve (AWaRe), and the Management of Antibiotic Classification (MAC) Guidelines in China.

Methods

One-day point-prevalence surveys (PPS) on antimicrobial prescriptions were conducted on behalf of hospitalized neonates in China from September 1 and November 30, annually from 2017 to 2019.

Results

Data was collected for a total of 2674 neonatal patients from 15 hospitals in 9 provinces across China of which 1520 were newborns who received at least one antibiotic agent. A total of 1943 antibiotic prescriptions were included in the analysis. The most commonly prescribed antibiotic was meropenem (11.8%). The most common reason for prescribing antibiotic to neonates was pneumonia (44.2%). There were 419 (21.6%), 1343 (69.1%) and 6 (0.3%) antibiotic prescriptions in the Access, Watch and Reserve groups, respectively. According to MAC Guidelines in China, there were 1090 (56.1%) antibiotic agents in the Restricted and 414 (21.3%) in the Special group.

Conclusion

Broad-spectrum antibiotics included in the Watch and Special groups were likely to be overused in Chinese neonates.
Prevalence and outcomes of chronic comorbid conditions in patients with sepsis in Korea: a nationwide cohort study from 2011 to 2016
Authors: Kang Christine , Choi Seongmi , Jang Eun Jin , Joo Somin , Jeong Jae Hoon , Oh Seung-Young , Ryu Ho Geol , Lee Hannah
Published: February 2024

Background

Chronic comorbid conditions are common in patients with sepsis and may affect the outcomes. This study aimed to evaluate the prevalence and outcomes of common comorbidities in patients with sepsis.

Methods

We conducted a nationwide retrospective cohort study. Using data from the National Health Insurance Service of Korea. Adult patients (age ≥ 18 years) who were hospitalized in tertiary or general hospitals with a diagnosis of sepsis between 2011 and 2016 were analyzed. After screening of all International Classification of Diseases 10th revision codes for comorbidities, we identified hypertension, diabetes mellitus (DM), liver cirrhosis (LC), chronic kidney disease (CKD), and malignancy as prevalent comorbidities.

Results

Overall, 373,539 patients diagnosed with sepsis were hospitalized in Korea between 2011 and 2016. Among them, 46.7% had hypertension, 23.6% had DM, 7.4% had LC, 13.7% had CKD, and 30.7% had malignancy. In-hospital mortality rates for patients with hypertension, DM, LC, CKD, and malignancy were 25.5%, 25.2%, 34.5%, 28.0%, and 33.3%, respectively, showing a decreasing trend over time (P < 0.001). After adjusting for baseline characteristics, male sex, older age, use of mechanical ventilation, and continuous renal replacement therapy, LC, CKD, and malignancy were significantly associated with in-hospital mortality.

Conclusions

Hypertension is the most prevalent comorbidity in patients with sepsis, and it is associated with an increased survival rate. Additionally, liver cirrhosis, chronic kidney disease, and malignancy result in higher mortality rates than hypertension and DM, and are significant risk factors for in-hospital mortality in patients with sepsis.
Risk factors of adverse birth outcomes among a cohort of pregnant women in Coastal Kenya, 2017–2019
Authors: Mirieri Harriet , Nduati Ruth , Dawa Jeanette , Okutoyi Lydia , Osoro Eric , Mugo Cyrus , Wamalwa Dalton , Jin Hafsa , Mwaengo Dufton , Otieno Nancy , Marwanga Doris , Shabibi Mufida , Munyua Peninah , Kinuthia John , Clancey Erin , Widdowson Marc-Alain , Njenga M. Kariuki , Verani Jennifer R. , Inwani Irene
Published: February 2024

Introduction

Adverse birth outcomes particularly preterm births and congenital anomalies, are the leading causes of infant mortality globally, and the burden is highest in developing countries. We set out to determine the frequency of adverse birth outcomes and the risk factors associated with such outcomes in a cohort of pregnant women in Kenya.

Methods

From October 2017 to July 2019, pregnant women < 28 weeks gestation were enrolled and followed up until delivery in three hospitals in coastal Kenya. Newborns were examined at delivery. Among women with birth outcome data, we assessed the frequency of congenital anomalies defined as gastroschisis, umbilical hernia, limb abnormalities and Trisomy 21, and adverse birth outcomes, defined as either stillbirth, miscarriage, preterm birth, small for gestational age, or microcephaly. We used log-binomial regression to identify maternal characteristics associated with the presence of at least one adverse outcome.

Results

Among the 2312 women enrolled, 1916 (82.9%) had birth outcome data. Overall, 402/1916 (20.9%; 95% confidence interval (CI): 19.1–22.8) pregnancies had adverse birth outcomes. Specifically, 66/1916 (3.4%; 95% CI: 2.7–4.4) were stillbirths, 34/1916 (1.8%; 95% CI: 1.2–2.4) were miscarriages and 23/1816 (1.2%; 95% CI: 0.8–1.9) had congenital anomalies. Among the participants with anthropometric measurements data, 142/1200 (11.8%; 95% CI: 10.1 − 13.8) were small for gestational age and among the participants with ultrasound records, 143/1711 (8.4%; 95% CI: 7.1–9.8) were preterm. Febrile illnesses in current pregnancy (adjusted risk ratio (aRR): 1.7; 95% CI: 1.1–2.8), a history of poor birth outcomes in prior pregnancy (aRR: 1.8; 95% CI: 1.3–2.4) and high blood pressure in pregnancy (aRR: 3.9, 95% CI: (1.7–9.2) were independently associated with adverse birth outcomes in a model that included age, education, human immunodeficiency virus status and high blood pressure at enrolment.

Conclusion

We found similar rates of overall adverse birth outcomes, congenital anomalies, and small for gestational age but higher rates of stillbirths and lower rates of prematurity compared to the rates that have been reported in the sub-Saharan Africa region. However, the rates of adverse birth outcomes in this study were comparable to other studies conducted in Kenya. Febrile illnesses during the current pregnancy, previous history of poor birth outcomes and high blood pressure in pregnancy are predictive of an increased risk of adverse birth outcomes.