bluuebunny/crossref_metadata_2025 huggingface dataset:
Biotic and Abiotic Stress Factors Induce Microbiome Shifts and Enrichment of Distinct Beneficial Bacteria in Tomato Roots
Authors: Flemer Burkhardt , Gulati Sneha , Bergna Alessandro , Rändler Manuela , Cernava Tomislav , Witzel Katja , Berg Gabriele , Grosch Rita
Published: September 2022

Crops are often simultaneously threatened by abiotic and biotic stress factors but the stress response of the plant holobiont is not well understood, despite the high importance of this response to ensure future plant production. Therefore, the aim of this study was to assess the impact of individual and combined abiotic (ionic and osmotic) and biotic ( Verticillium dahliae and Fusarium oxysporum) stress factors on plant performance and on the bacterial composition of the root endosphere in tomato. Structure and function of the microbiota was analyzed by 16S ribosomal RNA gene amplicon sequencing and a complementary cultivation approach, including in vitro and in vivo assays. Under all stress conditions, tomato growth and photosynthetic activity was reduced. Combined abiotic stressors with F. oxysporum but not with V. dahliae infection led to an additive negative effect on plant performance. All stress conditions induced a microbiome shift, and changed the relative abundance of phyla such as Firmicutes and classes of Proteobacteria. Endophytes identified as Bacillus, Paenibacillus, and Microbacterium spp. showed tolerance to abiotic stress conditions and plant beneficial effects. Stressor-specific enrichments of beneficial bacteria in the root were discovered (e.g., Paenibacillus in roots infected with F. oxysporum and Microbacterium in roots infected with V. dahliae). Interestingly, endophytes that were able to promote plant growth were obtained only from roots exposed to individual biotic and combined abiotic and biotic stress conditions but not individual abiotic stressors. Our study revealed stressor-specific enrichment of beneficial bacteria in tomato roots, which has implications for novel plant protection strategies.
Lack of Experience is a Main Cause of Maternal Death in Placenta Accreta Spectrum Patients
Authors: Nieto-Calvache A.J. , Palacios-Jaraquemada J.M. , Osanan G. , Cortes-Charry R. , Aryananda R.A. , Bangal V.B. , Slaoui A. , Abbas A.M. , Akaba G.O. , Joshua Z.N. , Vergara Galliadi L.M. , Nieto-Calvache A.S. , Sanín-Blair J.E. , Burgos-Luna J.M. ,   Latin American Group for the Study of Placenta Accreta Spectrum
Published: September 2022

(Acta Obstet Gynecol Scand. 2021;100:1445–1453)

Placenta accreta spectrum (PAS) often causes massive bleeding and has a mortality as high as 7%. While specific factors related to risk for maternal deaths due to PAS have not been sufficiently identified, few reports describe the contribution of inexperienced surgeons, underestimation of blood loss, and delays in transfusions. Although publications recommend that women affected by PAS receive attention in hospitals with teams trained in treatment of PAS, it is difficult to identify this type of hospital in low- and middle-income countries (LMICs). Even hospitals with personnel from multiple specialties may not ensure favorable outcomes as few are trained in the specific diagnosis and surgical treatment of PAS and inexperience is identified as a frequent contributing factor to maternal deaths associated with PAS. This report investigated PAS-associated causes of maternal death and challenges related to diagnosis and treatment.
Hydrocortisone to Prevent Bronchopulmonary Dysplasia: Not a Silver Bullet
Authors: Greenough A.
Published: September 2022

(N Engl J Med. 2022;386:1181–1183)

Bronchopulmonary dysplasia (BPD) is the most widely prevalent condition (75% worldwide) experienced by infants born <28 weeks gestation. In patients with a history of BPD, supplemental oxygen is often required at home and respiratory function may be impaired into adulthood. Reducing the incidence of BPD with associated oxygen requirements is a primary outcome targeted in trials for interventions, but other more significant related outcomes that may have higher impact. Nevertheless, survival without BPD continues to be a targeted outcome in large randomized controlled trials.
Mini-open Anterior Pelvic Osteotomy and Spica Casting for Primary Closure of the Pelvis in Infants With Classic Bladder Exstrophy
Authors: Abol Oyoun Nariman , Hassanein Mohamed Y. , Abdelhady Mohamed M. , Hammouda Hisham M. , Khaled Mohamed
Published: September 2022

Background:

The objective of this study was to investigate the efficacy and safety of mini-open Salter-like anterior pelvic osteotomy followed by spica casting as an adjunct to urological reconstruction in infants with classic bladder exstrophy (CBE).

Methods:

Twenty-eight infants with CBE were operated upon according to the following protocol: initial bilateral mini-open Salter-like osteotomies followed by urological reconstruction and subsequent spica casting for 3 to 4 weeks. Postoperative clinical and radiologic assessments of wound complications and union were done, respectively. During subsequent follow-ups, the foot progression angle (FPA), the interpubic (IP) distance, interischial (IS) distance, and the IS/IP ratio were measured. The Pearson correlation was used to correlate between age at the time of last follow-up, the FPA, the IP and IS distances, and the IS/IP ratio.

Results:

The mean age at the time of operation was 5.89±0.89 months. The operative procedure took 10 to 15 minutes (mean of 12.5±1.5 min) for each side and the blood loss was negligible. Tension-free complete approximation of the symphysis was achieved in all cases. No wound complications were reported in any case. The total duration of the cast was 3.07±0.14 weeks. The mean duration of follow-up was 4.78±3.09 years. Strong positive correlation was found between the IP and IS distances (r=0.833, P<0.0001) as well as the IS distance and age (r=0.455, P=0.015).

Conclusion:

Mini-open anterior pelvic osteotomy and spica casting may provide a minimally invasive and effective option for closure of the pelvis in infants with CBE.

Level of Evidence:

Level IV—case series.
Faith Community Nurses Key to Promoting Health in At-Risk Communities
Authors: Shannon Crystal , Dwyre Christina , Grafton Kelley
Published: September 2022

An integrative literature review was conducted to identify recommendations to implement culturally congruent and spiritually connected approaches to health promotion in at-risk faith communities. Five themes emerged from an analysis of 48 articles meeting criteria for the review. Review results repeatedly highlighted the impact nurses—more specifically faith community nurses (FCNs)—can have on at-risk population outcomes and bridging the gap between minority communities and the healthcare establishment. Five recommended action steps provide program guidance to FCNs for promoting faith-based health in at-risk minority communities.
Treatment of diabetic foot during the COVID-19 pandemic: A systematic review
Authors: Yan Jingui , Xiao Yiqing , Cao Rui , Su Yipeng , Wu Dan , Wang Yanjin
Published: September 2022

Background:

In the context of the novel coronavirus disease 2019 (COVID-19) pandemic, people have had to stay at home more and make fewer trips to the hospital. Furthermore, hospitals give priority to the treatment of COVID-19 patients. These factors are not conducive to the treatment of diabetic foot, and even increase the risk of amputation. Therefore, how to better treat patients with diabetic foot during the COVID-19 epidemic, prevent further aggravation of the disease and reduce the risk of amputation in patients with diabetic foot has become an urgent problem for doctors around the world.

Methods:

The researchers searched PubMed, the Cochrane Library, and the Embase database. The retrieval time was set from the database establishment to October 2021. All studies on treatment of diabetic foot in the COVID-19 pandemic were included in our study.

Results:

A total of 6 studies were included in this study. In the 6 protocols for treating patients with diabetic foot, the researchers classified patients according to the condition of their diabetic foot. Diabetic foot patients with general conditions received treatment at home, and doctors can guide the wound dressing change and medication treatment of patients through telemedicine. Patients with severe conditions of diabetic foot were admitted to hospital for treatment. Patients were screened for COVID-19 before hospitalization, those infected or suspected of COVID-19 were treated in isolation, and those not infected with COVID-19 were treated in a general ward.

Conclusion:

Through this systematic review, we proposed a new protocol for the treatment of patients with diabetic foot in the context of the COVID-19 pandemic. It provided reference for the treatment of diabetic foot in the context of COVID-19 epidemic. However, the global applicability of the treatment protocol for diabetic foot in the context of COVID-19 epidemic proposed in this study needs further clinical testing.
The role of task shifting in reforming the working styles of pediatricians in Japan: A questionnaire survey
Authors: Ishikawa Masatoshi
Published: September 2022

We aimed to shorten the working hours of pediatricians who are regularly experiencing overwork in Japan, recommended tasks for task shifting must be identified, and the impact of promoting task shifting on both the quality of medical care and working hours must be examined. Characteristics of the pediatric department must also be considered. A questionnaire survey was conducted with pediatricians working in hospitals across Japan. A multiple logistic regression analysis was performed with pediatricians who did not recommend task shifting in the workplace as the explained variable and the attributes of the responding pediatricians (gender, age, primary workplace, number of pediatricians, pediatric medical management fee) as the explanatory variables. Details about the tasks recommended for task shifting and the impact of recommending task shifting on the quality of medical care and working hours were described. Questionnaires were sent nationwide to 848 hospitals that calculated pediatric inpatient medical management fees and received responses from 1539 pediatricians in 416 hospitals (response rate: 49%). As a characteristic of 231 (15%) doctors who thought that the task shift had not progressed at all at their place of employment, significant positive associations were found in men, working at national and public university hospitals, private university hospitals, and private hospitals and pediatric inpatient medical care management fee 1 hospitals. Task shifting was not recommended overall, as the task items that a majority of pediatricians marked as “transferred” were limited to “medication instructions” and “intravenous injection of antibiotics, etc” More than half of the respondents (60%, a total of 921 doctors) reported that the quality of medical care improved slightly or significantly when task shifting was promoted. The most frequent response to survey items querying the number of work hours that could be shortened through task shifting was “1 to 2 hours.” The tasks suitable for task shifting were identified based on the characteristics of participants’ pediatric departments. Results suggest that task shifting was not recommended in university hospitals and that promotion of task shifting could improve the quality of medical care and reduce the working hours of pediatricians.
Dual intracranial infection with Nocardia farcinica and Cryptococcus neoformans diagnosed by next-generation sequencing in a patient with nephrotic syndrome: A case report
Authors: Ma Hongmei , Wang Xiangbo , Yan Heli , Liu Qing , Yang Dan , Bian Tingting
Published: September 2022

Rationale:

Intracranial infections are associated with high morbidity and mortality in immunocompromised patients, due to delayed diagnosis and treatment. Establishing a rapid, accurate diagnosis and a precise therapeutic regimen is crucial for management of the patients. Our report described a rare intracranial infection of patient with nephrotic syndrome.

Patient concerns:

A 66-year-old woman with a history of nephrotic syndrome presented symptoms in central nervous system for 1 month, followed by headache and fever over several days.

Diagnosis:

Neurological examination, brain imaging, and cerebrospinal fluid (CSF) tests exhibited resemblance to intracranial infection. Subsequently, CSF cultures confirmed the presence of Cryptococcus. Fortunately, next-generation sequencing revealed the concomitant infection with Nocardia farcinica in addition to Cryptococcus neoformans.

Interventions:

The treatment with intravenous fluconazole combined with amphotericin could not immediately ameliorate her symptoms. The patient’s condition improved significantly with minimal deficits after timely administration of antibiotics against N farcinica.

Outcomes:

One month later, cranial MRI indicated that basal ganglia lesions ameliorated. The patient has recovered well.

Lessons subsections:

To our best knowledge, this is the first case report of intracranial infection caused by both N farcinica and C neoformans in a patient with nephrotic syndrome. Remarkably, extensive application of next-generation sequencing can facilitate investigation on the potential role of various pathogenic organisms in infectious diseases.
Wolf-Hirschhorn syndrome with intrauterine growth restriction in a fetus: A case report
Authors: Wang Xuezhen , Sha Jing , Zhai Jingfang , Zhang Bei , Liu Min
Published: September 2022

Introduction:

Wolf-Hirschhorn syndrome (WHS), a genetic syndrome caused by deletion of the short arm of chromosome 4 (4p), is clinically characterized by “Greek warrior helmet” facial appearance, growth retardation, intellectual disability, seizures, skeletal anomalies, congenital cardiovascular defects, and other systemic defects. The severity of the WHS phenotype is related to the size of the missing 4p terminal fragment. In this article, we report and analyze a case of atypical WHS manifestations that revealed a 21-Mb deletion of the 4p terminal fragment in prenatal amniotic fluid examination by copy number variation sequencing (CNV-seq).

Patient concerns:

In our case, the fetal ultrasound results presented with intrauterine growth restriction and ocular hypertelorism and were characterized by atypical manifestations such as persistent left superior vena cava, nuchal fold thickness, and extrahepatic portosystemic shunt at 21 + 6 weeks of gestational age.

Diagnosis:

A fetus with WHS was detected by noninvasive prenatal screening and further diagnosed by chromosome karyotype analysis and CNV-seq.

Interventions:

After genetic counseling, the couple opted to terminate her pregnancy.

Outcomes:

Cytogenetic examination of the fetus revealed karyotype 46,XX,del(4)(p15.3). The CNV results showed a 21-MB deletion at the 4p16.3-p15.31 locus.

Lessons:

The WHS phenotype is atypical in fetuses. Prenatal molecular genetic testing combined with ultrasound screening is an effective method for diagnosing fetal WHS and can help clinicians offer subsequent clinical genetic counseling, manage fetal WHS, and guide the next pregnancy.
Pharmacological Management of Inflammatory Bowel Disease: a Century of Expert Opinions in Cecil Textbook of Medicine
Authors: Manu Peter , Rogozea Liliana M. , Dumitraşcu Dan L.
Published: September 2022

Background:

Advances in drug therapy for inflammatory bowel disease (IBD) [Crohn disease and ulcerative colitis (UC)] have contributed to a decrease in the severity of these chronic and disabling conditions.

Study Question:

What are the milestones of the changes in the expert approach to the pharmacological management of IBD in the past century?

Study Design:

To determine the changes in the experts' approach to the management of regional ileitis and UC, as presented in a widely used textbook in the United States.

Data Sources:

The chapters presenting the management of IBD in the 26 editions of Cecil Textbook of Medicine published from 1927 through 2020.

Results:

No specific interventions existed from 1927 through 1942. The pharmacological management of IBD has had 3 slightly overlapping eras starting in 1943. During the first period (1943–1951), the medical management relied on antibiotics, primarily sulfonamides and chloramphenicol. In the second (1955–75), experts recommended the use of adrenocorticotropic hormone or corticosteroids and 5-aminosalicylate. In the third era, which commenced in 1979 and is continuing to date, the pharmacological interventions have been expanded and refined to include 5 main drug classes, 5-aminosalicylates (sulfasalazine, mesalamine, and olsalazine), corticosteroids (prednisone and budesonide), immunomodulators (azathioprine, 6-mercaptopurine, cyclosporine, and tofacitinib), biologics (infliximab adalimumab certolizumab pegol, and natalizumab), and antibiotics (metronidazole and ciprofloxacin). A consensus exists that the monoclonal antibodies again tumor necrosis factor alpha are cost-effective for induction and maintenance of clinical remission in both UC (golimumab) and Crohn disease (certolizumab pegol). The newer agents ustekinumab (a monoclonal antibody to the interleukin p40 subunit) and vedolizumab (a monoclonal antibody to the homing receptor integrin complex) have also performed well.

Conclusions:

The pharmacological management of IBD has been the focus of intense research and development in the past 60 years. The pillars of drug treatment have been 5-aminosalicylates and corticosteroids. Recent pharmacological innovations (immunomodulators and biologicals) constitute an encouraging paradigm shift in the treatment of UC and Crohn disease.
Cardiovascular Assessment
Authors: Wodwaski Nadine , Webber Elaine
Published: September 2022

Cardiovascular (CV) disease affects 6.2 million people in the United States, placing many of these individuals at risk for heart failure. The number of patients with heart failure who utilize home healthcare services after hospital discharge is high. There is also a high rate of readmission following hospitalization for heart failure, contributing to morbidity and mortality, as well as creating a financial burden for healthcare systems. Home care clinicians can make a significant contribution to reducing CV morbidity and readmissions by becoming proficient at CV assessment and using this information to develop an action plan to prevent exacerbations and rehospitalizations. This article reviews the anatomy and physiology of the CV system and describes subjective and objective CV assessment.
Impact of Family Caregiver Training on Care of Burn Patients
Authors: Sadeghi Amir , Barkhordar Arash , Tapak Leili , Amini Roya
Published: September 2022

The purpose of this study was to investigate the impact of a family caregiver training program on care provision to burn patients. A quasi-experimental study was conducted with 96 family caregivers of burn patients admitted to a burn hospital in Iran. The caregivers' knowledge and training needs were measured at baseline. Four training sessions were provided for the experimental group and caregivers' practices were measured 6 weeks after discharge. Comparing the scores of knowledge and total care with its subdomains (i.e., diet and medication, wound care, itch decrease, wound scar healing, pain management, use of mobility assistive devices, and follow-up considerations) revealed a significant difference between the two groups of caregivers after the intervention (p < 0.01). The caregivers' practices regarding provision of care to burn patients were improved after attending the training program. Receiving sufficient and continuous information from admission to discharge can empower family members.
The 4Ms of an Age-Friendly Health System An evidence-based framework to ensure older adults receive the highest quality care.
Authors: Emery-Tiburcio Erin E. , Mack Laurin , Zonsius Mary C. , Carbonell Ellen , Newman Michelle
Published: September 2022

This article is the first in a new series, Supporting Family Caregivers in the 4Ms of an Age-Friendly Health System, published in collaboration with the AARP Public Policy Institute and originally appearing in the American Journal of Nursing, Volume 121, Issue 11, as part of the ongoing Supporting Family Caregivers: No Longer Home Alone series. The 4Ms of an Age-Friendly Health System (What Matters, Medication, Mentation, and Mobility) is an evidence-based framework for assessing and acting on critical issues in the care of older adults across settings and transitions of care. Engaging the health care team, including older adults and their family caregivers, with the 4Ms framework can help to ensure that every older adult gets the best care possible, is not harmed by health care, and is satisfied with the care they receive.

The articles in this new series present considerations for implementing the 4Ms framework in the inpatient hospital setting and incorporating family caregivers in doing so. Resources for both nurses and family caregivers, including a series of accompanying videos developed by AARP and the Rush Center for Excellence in Aging and funded by the John A. Hartford Foundation, are also provided. Nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet—Guide to the 4Ms of an Age-Friendly Health System for Family Caregivers—and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses. Cite this article as: Emery-Tiburcio, E.E., et al. The 4Ms of an Age-Friendly Health System. Am J Nurs 2021; 121(11): 44-49.
“Lounge & Learns”
Authors: Boespflug Danielle
Published: September 2022

What if you could increase learner engagement while providing data-driven education in a virtual format? Nursing professional development practitioners transitioned poorly attended, in-person continuing education opportunities to a virtual platform. Using technology, nursing professional development practitioners created a template to perform a needs assessment and designed targeted virtual education to address deficiencies using the ADDIE model. Increased attendance, continuing education credit claims, and postactivity confidence were realized. Lessons learned were examined.
Increased Risk of Sexually Transmitted Infections in Men Who Have Sex With Men Taking Preexposure Prophylaxis: A Meta-analysis
Authors: Zhou Qian , Liu Jingwei , Li Hao , Han Yan , Yin Yueping
Published: September 2022

Background

Men who have sex with men (MSM) are a priority population for preexposure prophylaxis (PrEP) for HIV prevention. We summarized the surveillance data from the studies of MSM taking PrEP versus before taking PrEP to investigate the possible increased risk of sexually transmitted infections (STIs).

Methods

Two researchers independently searched 5 databases from January 2012 to April 2022 to identify relevant studies reporting the incidence density of syphilis, gonorrhea, and chlamydia infection. Subgroup analyses based on the type and location of research were conducted. The publication bias was detected by Egger's publication bias plot.

Results

Twenty studies met the inclusion criteria for the meta-analysis. The pooled estimate of incidence density of syphilis was 9.53 per 100 person-years (PY), whereas 36.48 per 100 PY for chlamydial infection and 34.79 per 100 PY for gonorrhea, higher than the MSM before taking PrEP. The results of the subgroup analysis showed that the incidence density tended to be lower in prospective studies than in retrospective studies and lower in North American studies than in other regions' studies.

Conclusions

The high incidence of STIs in the MSM taking PrEP needs to be increasingly appreciated, and more effective prevention method for STIs is valuable among MSM alongside HIV prevention uptake.
The Temporal Association of the COVID-19 Pandemic and Pediatric Cardiopulmonary Resuscitation Quality and Outcomes*
Authors: Morgan Ryan W. , Wolfe Heather A. , Reeder Ron W. , Alvey Jessica S. , Frazier Aisha H. , Friess Stuart H. , Maa Tensing , McQuillen Patrick S. , Meert Kathleen L. , Nadkarni Vinay M. , Sharron Matthew P. , Siems Ashley , Yates Andrew R. , Ahmed Tageldin , Bell Michael J. , Bishop Robert , Bochkoris Matthew , Burns Candice , Carcillo Joseph A. , Carpenter Todd C. , Dean J. Michael , Diddle J. Wesley , Federman Myke , Fernandez Richard , Fink Ericka L. , Franzon Deborah , Hall Mark , Hehir David , Horvat Christopher M. , Huard Leanna L. , Manga Arushi , Mourani Peter M. , Naim Maryam Y. , Notterman Daniel , Pollack Murray M. , Sapru Anil , Schneiter Carleen , Srivastava Nerraj , Tabbutt Sarah , Tilford Bradley , Viteri Shirley , Wessel David , Zuppa Athena F. , Berg Robert A. , Sutton Robert M.
Published: September 2022

Objectives:

The COVID-19 pandemic resulted in adaptations to pediatric resuscitation systems of care. The objective of this study was to determine the temporal association between the pandemic and pediatric in-hospital cardiac arrest (IHCA) process of care metrics, cardiopulmonary resuscitation (cardiopulmonary resuscitation) quality, and patient outcomes.

Design:

Multicenter retrospective analysis of a dataset comprising observations of IHCA outcomes pre pandemic (March 1, 2019 to February 29, 2020) versus pandemic (March 1, 2020 to February 28, 2021).

Setting:

Data source was the ICU-RESUScitation Project (“ICU-RESUS;” NCT028374497), a prospective, multicenter, cluster randomized interventional trial.

Patients:

Children (≤ 18 yr) who received cardiopulmonary resuscitation while admitted to the ICU and were enrolled in ICU-RESUS.

Interventions:

None.

Measurements and Main Results:

Among 429 IHCAs meeting inclusion criteria, occurrence during the pandemic period was associated with higher frequency of hypotension as the immediate cause of arrest. Cardiac arrest physiology, cardiopulmonary resuscitation quality metrics, and postarrest physiologic and quality of care metrics were similar between the two periods. Survival with favorable neurologic outcome (Pediatric Cerebral Performance Category score 1–3 or unchanged from baseline) occurred in 102 of 195 subjects (52%) during the pandemic compared with 140 of 234 (60%) pre pandemic (p = 0.12). Among survivors, occurrence of IHCA during the pandemic period was associated with a greater increase in Functional Status Scale (FSS) (i.e., worsening) from baseline (1 [0–3] vs 0 [0–2]; p = 0.01). After adjustment for confounders, IHCA survival during the pandemic period was associated with a greater increase in FSS from baseline (+1.19 [95% CI, 0.35–2.04] FSS points; p = 0.006) and higher odds of a new FSS-defined morbidity (adjusted odds ratio, 1.88 [95% CI, 1.03–3.46]; p = 0.04).

Conclusions:

Using the ICU-RESUS dataset, we found that relative to the year prior, pediatric IHCA during the first year of the COVID-19 pandemic was associated with greater worsening of functional status and higher odds of new functional morbidity among survivors.
Statins Utilization in Adults With HIV: The Treatment Gap and Predictors of Statin Initiation
Authors: Coburn Sally B. , Lang Raynell , Zhang Jinbing , Palella Frank Joseph , Horberg Michael A. , Castillo-Mancilla Jose , Gebo Kelly , Galaviz Karla I. , Gill M. John , Silverberg Michael J. , Hulgan Todd , Elion Richard A. , Justice Amy C. , Moore Richard D. , Althoff Keri N. ,   for the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of IeDEA
Published: September 2022

Background:

We characterized trends in statin eligibility and subsequent statin initiation among people with HIV (PWH) from 2001 to 2017 and identified predictors of statin initiation between 2014 and 2017.

Setting:

PWH participating in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) enrolled in 12 US cohorts collecting data on statin eligibility criteria/prescriptions from 2001 to 2017.

Methods:

We determined the annual proportion eligible for statins, initiating statins, and median waiting time (from statin eligibility to initiation). Eligibility was defined using ATP III guidelines (2001–2013) and ACC/AHA guidelines (2014–2017). We assessed initiation predictors in 2014–2017 among statin-eligible PWH using Poisson regression, estimating adjusted prevalence ratios (aPRs) with 95% confidence intervals (95% CIs).

Results:

Among 16,409 PWH, 7386 (45%) met statin eligibility criteria per guidelines (2001–2017). From 2001 to 2013, statin eligibility ranged from 22% to 25%. Initiation increased from 13% to 45%. In 2014, 51% were statin-eligible, among whom 25% initiated statins, which increased to 32% by 2017. Median waiting time to initiation among those we observed declined over time. Per 10-year increase in age, initiation increased 46% (aPR 1.46, 95% CI: 1.29 to 1.67). Per 1-year increase in calendar year from 2014 to 2017, there was a 41% increase in the likelihood of statin initiation (aPR 1.41, 95% CI: 1.25 to 1.58).

Conclusions:

There is a substantial statin treatment gap, amplified by the 2013 ACC/AHA guidelines. Measures are warranted to clarify reasons we observe this gap, and if necessary, increase statin use consistent with guidelines including efforts to help providers identify appropriate candidates.
Volumetric Pancreas Segmentation on Computed Tomography: Accuracy and Efficiency of a Convolutional Neural Network Versus Manual Segmentation in 3D Slicer in the Context of Interreader Variability of Expert Radiologists
Authors: Khasawneh Hala , Patra Anurima , Rajamohan Naveen , Suman Garima , Klug Jason , Majumder Shounak , Chari Suresh T. , Korfiatis Panagiotis , Goenka Ajit Harishkumar
Published: September 2022

Purpose

This study aimed to compare accuracy and efficiency of a convolutional neural network (CNN)–enhanced workflow for pancreas segmentation versus radiologists in the context of interreader reliability.

Methods

Volumetric pancreas segmentations on a data set of 294 portal venous computed tomographies were performed by 3 radiologists (R1, R2, and R3) and by a CNN. Convolutional neural network segmentations were reviewed and, if needed, corrected (“corrected CNN [c-CNN]” segmentations) by radiologists. Ground truth was obtained from radiologists' manual segmentations using simultaneous truth and performance level estimation algorithm. Interreader reliability and model's accuracy were evaluated with Dice-Sorenson coefficient (DSC) and Jaccard coefficient (JC). Equivalence was determined using a two 1-sided test. Convolutional neural network segmentations below the 25th percentile DSC were reviewed to evaluate segmentation errors. Time for manual segmentation and c-CNN was compared.

Results

Pancreas volumes from 3 sets of segmentations (manual, CNN, and c-CNN) were noninferior to simultaneous truth and performance level estimation–derived volumes [76.6 cm3 (20.2 cm3), P < 0.05]. Interreader reliability was high (mean [SD] DSC between R2-R1, 0.87 [0.04]; R3-R1, 0.90 [0.05]; R2-R3, 0.87 [0.04]). Convolutional neural network segmentations were highly accurate (DSC, 0.88 [0.05]; JC, 0.79 [0.07]) and required minimal-to-no corrections (c-CNN: DSC, 0.89 [0.04]; JC, 0.81 [0.06]; equivalence, P < 0.05). Undersegmentation (n = 47 [64%]) was common in the 73 CNN segmentations below 25th percentile DSC, but there were no major errors. Total inference time (minutes) for CNN was 1.2 (0.3). Average time (minutes) taken by radiologists for c-CNN (0.6 [0.97]) was substantially lower compared with manual segmentation (3.37 [1.47]; savings of 77.9%–87% [P < 0.0001]).

Conclusions

Convolutional neural network–enhanced workflow provides high accuracy and efficiency for volumetric pancreas segmentation on computed tomography.
Collaborative Use of Lung Mechanics Simulation for Testing and Iterative Design for Three Emergency Use Ventilation Device Projects
Authors: Fanning Ruth M. , Gaba David M.
Published: September 2022

Summary Statement

We describe our collaboration with engineering, clinical, and simulation colleagues to use a lung simulator (IngMar Medical ASL 5000) to aid in the development of 3 open-source ventilation devices for patients with COVID-19.

Twenty-nine test conditions were created by programming software lung models of varying disease severity in the ASL 5000 to test basic functionality, safety features, and compliance with regulatory requirements for emergency use authorization for the 3 projects' prototypes. More than 200 simulations were performed, with the design team present to enable rapid troubleshooting and design iteration in real time.

Working with 3 separate simultaneous ventilation device projects allowed us to rapidly learn from each, improving our ability to successfully collaborate with the different design/build teams.

This project illustrates the role of simulation in facilitating collaborative innovation in health care, both in emergency and everyday settings that extend beyond the COVID-19 pandemic.
Streptomyces durocortorensis sp. nov., isolated from oak rhizosphere
Authors: Cassarini Mathieu , Rémond Caroline , Mühle Estelle , Clermont Dominique , Besaury Ludovic
Published: September 2022

Strain RHZ10T was isolated from an oak rhizosphere sampled in Reims, France, and characterized to assess its taxonomy. Based on 16S rRNA gene sequence similarity, strain RHZ10T was affiliated to the genus

Streptomyces

and the closest species were

Streptomyces anulatus

NRRL B-2000T and

Streptomyces pratensis

ch24T. Average nucleotide identity and digital DNA–DNA hybridization values were 77.3–92.4 % and 23.0–50.9 %, respectively, when compared to the type strains of fully sequenced related species having a 16S rRNA gene sequence similarity over 98 %. These data suggested that strain RHZ10T represented a novel species within the genus

Streptomyces

. The genome of RHZ10T was 8.0 Mbp long, had 7  894 predicted coding genes, and a G+C content of 71.7 mol%. Cultures of RHZ10T on ISP 2 medium mostly led to the production a green pigmentation of the core of its colonies in the vegetative mycelium, surrounded by white pigmentation of the aerial mycelium. The main fatty acids of RHZ10T were anteiso-C15 : 0, iso-C16 : 0, anteiso-C17 : 0 and C16 : 0. Polar lipids were phosphatidylethanolamine, diphosphatidylglycerol, unidentified lipids, unidentified phospholipids, unidentified aminolipids and unidentified glycolipids. Its main quinones were MK-9(H6) (69.3 %), MK-9(H4) (17.3 %) and MK-9(H8) (17.0%). Phylogenetic, physiological and chemotaxonomic studies clearly supported that strain RHZ10T represents a novel species within the genus

Streptomyces

, for which the name Streptomyces durocortorensis sp. nov. is proposed and the type strain is RHZ10T (=DSM 112634T=LMG 32187T=CIP 111907T).
Coverage and correlates of COVID-19 vaccination among children aged 5-11 years in Alberta, Canada
Authors: MacDonald Shannon E. , Reifferscheid Laura , Paudel Yuba Raj , Robinson Joan
Published: September 2022

Background and Objectives

In Alberta, Canada, the COVID-19 vaccination program for children aged 5-11 years opened on November 26, 2021. Our objectives were to determine the cumulative vaccine coverage, stratified by age, during the first seven months of vaccine availability, and investigate factors associated with vaccine uptake.

Methods

This retrospective cohort study used population-based administrative health data to assess COVID-19 vaccination coverage among children aged 5-11 years in Alberta, Canada. We determined cumulative vaccine coverage since the time of vaccine availability and used a modified Poisson regression to evaluate factors associated with vaccine uptake.

Results

Of 377,753 eligible children, 43.8 % (n=165,429) received one or more doses of COVID-19 vaccine during the study period (11.2% received only one dose, while 32.5 % received 2 doses). Almost 90% of initial doses were received within the first two months of vaccine availability. Of those eligible for a second dose, only 75.1% (n=122,973) received it during the study time period. We found a step-wise relationship between increasing child age and higher vaccine coverage. Other factors associated with higher vaccine coverage included living in a neighborhood with higher income, in a more densely populated area, and in certain geographic health zones. Registration in a private school was associated with lower vaccine coverage.

Conclusions

Messaging around COVID-19 vaccine safety and need should be tailored to child age, rather than uniform across the 5-11 year age range. Opportunities for targeted vaccination interventions should be considered.
Risk of lung cancer among welders and flame cutters: A Systematic Review and Meta-Analysis
Authors: Gupta Saptorshi
Published: September 2022

Background and Aim

The process of flame-cutting and welding is believed to highly hazardous for workers involved in related industries. The study aims to provide a comprehensive quantitative effect of the risk of lung cancer due to exposure to welding fumes.

Methods

A systematic review was conducted to extract published estimates of odd’s ratio of the association of lung cancer and exposure to welding fumes, till 2022. Studies were extracted from the PubMed database with clearly defined inclusion and exclusion criteria. Studies from all parts of the world were considered. A meta-analysis with random effects model was conducted resulting in formation of forest plot, influence analysis, sensitivity analysis and checking for publication bias using a funnel plot.

Results

The meta-analysis yielded an OR of 1.256 (95% CI 1.055-1.496), with a moderately high heterogeneity between the studies (I2 = 68.78% ; τ2 = 0.039; Q = 36.115(p < 0.001)). The sensitivity and influence analysis confirmed the absence of highly influential studies that may have led to potentially distorted outcomes. The funnel plot showed no evidence of publication bias among the studies included in this analysis.

Conclusion

As the association of lung cancer and occupational hazards from exposure to welding fumes is certain, there is a need to control and regulate industrial activities that involve welding and flame cutting. Already, restrictions on safe levels of fume in workplace is in operation.
Nucleotide and structural polymorphisms of the eastern oyster genome paint a mosaic of divergence, selection, and human impacts
Authors: Puritz Jonathan B. , Zhao Honggang , Guo Ximing , Hare Matthew P. , He Yan , LaPeyre Jerome , Lotterhos Katie E. , Lundgren Kathryn Markey , Modak Tejashree , Proestou Dina , Rawson Paul , Fernandez Robledo Jose Antonio , Weedop K. Bodie , Witkop Erin , Gomez-Chiarri Marta
Published: September 2022

The eastern oyster,Crassostrea virginica, is a valuable fishery and aquaculture species that provides critical services as an ecosystem engineer. Oysters have a life-history that promotes high genetic diversity and gene flow while also occupying a wide range of habitats in variable coastal environments from the southern Gulf of Mexico to the southern waters of Atlantic Canada. To understand the interplay of genetic diversity, gene flow, and intense environmental selection, we used whole genome re-sequencing data from 90 individuals across the eastern United States and Gulf of Mexico, plus 5 selectively bred lines. Our data confirmed a large phylogeographic break between oyster populations in the Gulf of Mexico and the Atlantic coast of the USA. We also demonstrated that domestication has artificially admixed genetic material between the two ocean basins, and selected lines with admixed ancestry continue to maintain heterozygosity at these sites through several generations post admixture, possibly indicating relevance to desirable aquaculture traits. We found that genetic and structural variation are high in both wild and selected populations, but we also demonstrated that, when controlling for domestication admixture across ocean basins, wild populations do have significantly higher levels of nucleotide diversity and copy number variation than selected lines. Within the Atlantic coast, we detected subtle but distinct population structure, introgression of selected lines within wild individuals, an interaction between structural variation and putatively adaptive population structure, and evidence of candidate genes responding to selection from salinity. Our study highlights the potential for applying whole genome sequencing to highly polymorphic species and provides a road map for future work examining the genome variation of eastern oyster populations.
Cardiac pericytes are necessary for coronary vasculature integrity and cardiomyocyte differentiation
Authors: Cornuault Lauriane , Hérion François-Xavier , Rouault Paul , Foussard Ninon , Alzieu Philippe , Chapouly Candice , Gadeau Alain-Pierre , Couffinhal Thierry , Renault Marie-Ange
Published: September 2022

Introduction: While the critical role of pericytes in maintaining vascular integrity has been extensively demonstrated in the brain and in the retina, very little is known about their role in the heart. Objective: We aim to investigate structural and functional consequences of partial pericyte depletion (about 60%) in the heart of adult mice. Methods: To deplete pericyte in adult mice, we used Pdgfrb-Cre/ERT2; Rosa-DTA mice and compared their phenotype to the one of control mice (Rosa-DTA) chosen among their littermates. Cardiac function was assessed via echocardiography and left ventricle (LV) catheterization one month after the first tamoxifen injection. Results: Mice depleted with pericytes displayed increased coronary endothelium leakage and activation which was associated with increased CD45 + cell infiltration in the heart. Pericyte depletion also modified the phenotype of cardiomyocytes with an increased expression of Myosin Heavy Chain 7, a decreased expression of ATPase Sarcoplasmic/Endoplasmic Reticulum Ca2+ Transporting 2, Connexin 43 and a decreased phosphorylation of Phospholamban suggesting cardiomyocyte dedifferentiation and impaired contractility. As a consequence, mice depleted with pericytes had a reduced LV ejection fraction and an increased end-diastolic pressure demonstrating both systolic and diastolic dysfunction. Accordingly, mice depleted with pericytes presented a decreased LV contractility and an increased LV relaxation time (dP/dtmin). Besides this study reveals that cardiac pericytes may undergo strong remodeling upon injury. Conclusion: Cardiac pericyte depletion induces both systolic and diastolic dysfunction suggesting that pericyte dysfunction may contribute to the occurrence of cardiac diseases.
X chromosome dosage drives statin-induced dysglycemia and mitochondrial dysfunction
Authors: Zhang Peixiang , Munier Joseph J. , Vergnes Laurent , Wiese Carrie B. , Link Jenny C. , Abbasi Fahim , Ronquillo Emilio , Muñoz Antonio , Kuang Yu-Lin , Liu Meng , Sanchez Gabriela , Oni-Orisan Akinyemi , Iribarren Carlos , McPhaul Michael J. , Nomura Daniel K. , Knowles Joshua W. , Krauss Ronald M. , Medina Marisa W. , Reue Karen
Published: September 2022

Statin drugs lower blood cholesterol levels for cardiovascular disease prevention. Women are more likely than men to experience adverse statin effects, particularly new-onset diabetes (NOD) and muscle weakness. We determined that female mice are more susceptible than males to glucose intolerance, fasting hyperglycemia, and muscle weakness after short-term statin treatment. Lipidomic, transcriptomic, and biochemical analyses identified reduced docosahexaenoic acid (DHA) levels, and impaired redox tone and mitochondrial respiration specifically in statin-treated female mice. Statin adverse effects could be prevented in females by complementation with a source of DHA. Statin adverse effects segregated with XX chromosome complement, and specifically dosage of the Kdm5c gene, which regulates fatty acid gene expression and has differential expression levels in females and males. In humans, we found that women experience more severe reductions than men in DHA levels after short-term statin administration, and that DHA reduction was correlated with increases in fasting glucose levels. Furthermore, induced pluripotent stem cells derived from women, but not men, who developed NOD exhibited impaired mitochondrial function when treated with statin. Overall, our studies identify biochemical mechanisms, biomarkers, and a genetic risk factor for susceptibility to statin adverse effects, and point to DHA supplementation as a preventive co-therapy.
Generalizable electroencephalographic classification of Parkinson’s Disease using deep learning
Authors: Sugden Richard James , Diamandis Phedias
Published: September 2022

There is growing interest in using electroencephalography (EEG) and deep learning (DL) to aid in the diagnosis of neurological conditions like Parkinson’s Disease (PD). Many existing DL approaches to classify PD from EEG data cite performance metrics in the high 90% accuracies, but may be grossly overestimating their real-word capabilities due to information-leakage between training and testing data. Our aim was to characterize the potential of deep learning for classifying PD using a conservative training approach with unseen external testing data. We used publicly available resting-state EEG data from patients with PD from two seperate centers (University of New Mexico (n = 54) and University of Iowa (n = 28)) for our training and testing sets, respectively. We implemented a channelwise convolutional neural network and tuned it using a subjectwise cross validation approach. We found that an approach commonly cited in the literature overestimated performance in excess of 20%, while our pipeline more conservatively estimated performance by epoch (accuracy: 69.2%; sensitivity: 66.5%; specificity: 72.2%) and by subject (accuracy: 77.4%, sensitivity: 76.9%, specificity: 77.8%). Moreover, we show that our model generalized well to an unseen and external testing dataset without degradation in performance by epoch (accuracy: 77.2; sensitivity: 83.5%; specificity: 71.0%) and by subject (accuracy: 83.8%, sensitivity: 88.6%, specificity: 79.0%). These results highlight the effect of information leakage and serve as a new benchmark for future generalization of DL approaches to classify PD using EEG data.
Clostridioides difficile PCR Positivity on Successive Days after Treatment Initiation
Authors: Shrestha Nabin K. , Shu Jeffrey , Shrestha Nishan K. , Gordon Steven M.
Published: September 2022

Among 1282 patients with a positive Clostridioides difficile PCR test who were retested within 14 days, the proportion of positive tests rapidly decreased on successive days within the first week since initiation of treatment. Between days 7 and 14 after treatment initiation, approximately 25% of tests remained positive.
Colorimetric and fluorometric reverse-transcription loop-mediated isothermal amplification (RT-LAMP) assay for diagnosis of SARS-COV-2
Authors: Alhamid Galyah , Tombuloglu Huseyin , Motabagani Dalal , Motabagani Dana , Rabaan Ali A. , Unver Kubra , Dorado Gabriel , Al-Suhaimi Ebtesam , Unver Turgay
Published: September 2022

The coronavirus disease 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has caused millions of infections and deaths worldwide, since it infected humans almost three years ago. Improvements of current assays and development of new rapid tests or to diagnose SARS-CoV-2 are urgent. Reverse-transcription loop-mediated isothermal amplification (RT-LAMP) is a rapid and propitious assay, allowing to detect both colorimetric and/or fluorometric nucleic-acid amplifications. This study describes the analytical and clinical evaluation of RT-LAMP assay for detection of SARS-CoV-2, by designing LAMP primers targeting N (nucleocapsid phosphoprotein), RdRp (polyprotein), S (surface glycoprotein) and E (envelope protein) genes. The assay’s performance was compared with the gold-standard RT-PCR, yielding 94.6% sensitivity and 92.9% specificity. Among the tested primer sets, the ones for S and N genes had the highest analytical sensitivity, showing results in about 20 minutes. The colorimetric and fluorometric comparisons revealed that the latter is faster than the former. The limit of detection (LoD) of RT-LAMP reaction in both assays is 50 copies/µl of reaction mixture. However, the simple eye-observation advantage of the colorimetric assay (with a color change from yellow to red) serves a promising on-site point-of-care testing method anywhere, including, for instance, laboratory and in-house applications.